2024-11-15T08:16:20-06:00 2023-12-31 454051133 FREED MAXICK CPAS PC 424 MAIN STREET SUITE 800 BUFFALO NY 142023508 990 2023-01-01 237259920 JENNIE B RICHMOND CHAFFEE NURSING HOME COMPANY INC JENN 7165922871 222 EAST MAIN STREET SPRINGVILLE NY 14141 CAROLE FRANCIS CFO 7165922871 2024-11-14 1 0 MARY MADONIA P00405803 7168472651 2024-11-13 2023 2024-10-15 13:58:12Z TERESA DONOHUE 222 EAST MAIN STREET SPRINGVILLE NY 14141 5954420 0 X BERTRANDCHAFFEE.COM X 1974 NY TO PROVIDE LONG-TERM CARE AND REHABILITATIVE SERVICES TO THE RESIDENTS OF SPRINGVILLE AND THE SURROUNDING REGION TO ENHANCE THE HEALTH STATUS OF RESIDENTS AND RESPOND TO COMMUNITY HEALTH NEEDS. 12 12 115 16 0 0 1675 13571 5265691 5939179 788 1670 0 0 5268154 5954420 0 0 0 0 4562416 4107285 0 0 0 2672708 2621417 7235124 6728702 -1966970 -774282 1281582 2121225 1105151 2719076 176431 -597851 TO PROVIDE LONG-TERM CARE AND REHABILITATIVE SERVICES TO THE RESIDENTS OF SPRINGVILLE AND THE SURROUNDING REGION TO ENHANCE THE HEALTH STATUS OF RESIDENTS AND RESPOND TO COMMUNITY HEALTH NEEDS. 0 0 5868029 5939179 PROFESSIONAL CARE OF PATIENTS - FACILITY PROVIDED 80 NURSING BEDS, NURSING SERVICES, AND OTHER RELATED SERVICES AND SUPPLIES. 5868029 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 22 0 1 115 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X THE ORGANIZATION 7165922871 JB RICHMOND CHAFFEE NURSING HOME SPRINGVILLE NY 14141 MICHAEL BOZA BOARD MEMBER/TREASURER 2.00 2.00 X X 0 0 0 GARY EPPOLITO BOARD MEMBER/PRESIDENT 3.00 3.00 X X 0 0 0 STAN HANDZLIK BOARD MEMBER 2.00 2.00 X 0 0 0 ROBBIN HANSEN BOARD MEMBER/VICE PRESIDENT 2.00 2.00 X X 0 0 0 CLAUDIA MILLER BOARD MEMBER 2.00 2.00 X 0 0 0 KAREN STANFORD BOARD MEMBER/SECRETARY (TO 5/18/23) 2.00 2.00 X 0 0 0 PETER SWALES BOARD MEMBER 2.00 2.00 X 0 0 0 ROBERT ROGGIE BOARD MEMBER 2.00 2.00 X 0 0 0 JOHANNA HEALY BOARD MEMBER/SECRETARY 3.00 3.00 X X 0 0 0 ASHLEY LOWRY BOARD MEMBER 2.00 2.00 X 0 0 0 LIZ MELOCK BOARD MEMBER (BEGAN 6/1/2023) 2.00 2.00 X 0 0 0 ALLISON DUWE BOARD MEMBER (BEGAN 6/1/2023) 2.00 2.00 X 0 0 0 GEORGETTE WAY-MILLER BOARD MEMBER/ADMINISTRATOR (MARCH-SEPT 2023) 40.00 X 42832 0 15444 SHARON ZEAMER BOARD MEMBER/ADMINISTRATOR (BEGAN NOV 2023) 40.00 X 20000 0 64 CAROLE M FRANCIS CFO 10.00 30.00 X 0 0 136060 62832 0 151568 0 0 0 0 FUSION WORKFORCE SOLUTIONS PO BOX 30133 OMAHA NE 30133 TEMPORARY AGENCY STAFFING 392304 1 13571 13571 PROGRAM SERVICES 623000 4884787 4884787 GRANT REVENUE 623000 1054392 1054392 5939179 1670 1670 5954420 5939179 0 1670 62832 62832 3359013 3134460 224553 88420 83999 4421 384836 365594 19242 212184 197968 14216 38576 38576 147852 55397 92455 4800 4800 360056 335899 24157 105052 105052 5541 5541 76686 72852 3834 65269 65269 SHARED SERVICES 1315416 1056096 259320 NYS ASSESSMENT FEE 318084 318084 CONTRACTED SERVICES 80754 80754 MISCELLANEOUS 48369 23062 25307 54962 28471 26491 6728702 5868029 860673 0 249734 1035932 571999 680585 8132 10435 4723555 4442638 357603 280917 94114 113356 1281582 2121225 719330 2432383 13894 14189 371927 272504 1105151 2719076 X 176431 -597851 176431 -597851 1281582 2121225 -774282 0 X X 0 1 X 1 1 1 X 200 3472 6426 1675 13571 25344 6832103 7639117 6210678 5265691 5939179 31886768 6832303 7642589 6217104 5267366 5952750 31912112 0 0 0 31912112 571 164 486 788 1670 3679 571 164 486 788 1670 3679 6832874 7642753 6217590 5268154 5954420 31915791 0.99990 0.99990 0.00010 0.00010 X 0 1 X 16000 16000 2729536 2571233 158303 1816952 1738251 78701 161067 133154 27913 280917 DUE FROM THIRD PARTIES 44710 PATIENT TRUST ACCOUNTS 14189 ESCROW ACCOUNTS 54457 113356 DUE TO 3RD PARTIES 272504 272504 X PART IV, LINE 2B: THE HOME ACTS AS CUSTODIAN FOR RESIDENT PERSONAL FUNDS. PART X, LINE 2: THE HOSPITAL AND HOME ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND, ACCORDINGLY, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL AND HOME ACCOUNT FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH U.S. GAAP, WHICH REQUIRES THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS THAT THE HOSPITAL AND HOME HAVE TAKEN OR EXPECTS TO TAKE ON THEIR TAX RETURNS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE, INDEPENDENT ACCOUNTING FIRM. THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE 990 PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST QUESTIONNAIRE FORMS ARE COMPLETED BY DIRECTORS AND MANAGERS ANNUALLY. THEY ARE REVIEWED BY THE COMPLIANCE OFFICER AND ADDRESSED AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION FORMED AN INDEPENDENT SEARCH COMMITTEE THAT WAS INVOLVED IN NEGOTIATING THE CONTRACT OF THE CURRENT CEO. OTHER OFFICER AND KEY EMPLOYEE SALARIES ARE REVIEWED BY THE BOARD OF DIRECTORS AND SALARIES ARE COMPARED TO PEERS IN THE SURROUNDING AREA TO DETERMINE AN APPROPRIATE PAY SCALE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: AUDIT OVERSIGHT THE AUDIT OVERSIGHT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART IV, LINE 34: RELATED PARTIES THE BERTRAND CHAFFEE HOSPITAL FOUNDATION, INC. (THE FOUNDATION) WAS ORGANIZED TO RECEIVE AND ADMINISTER FUNDS AND BEQUESTS TO BENEFIT THE COMMUNITY. WHILE THE FOUNDATION MAY, AT TIMES, MAKE DONATIONS TO JENNIE B. RICHMOND CHAFFEE NURSING HOME COMPANY ("JBR") OR BERTRAND CHAFFEE HOSPITAL ("BCH"), THERE IS NO OBLIGATION TO DO SO. THE FOUNDATION WAS NOT ORGANIZED SOLELY TO BENEFIT EITHER OF THESE ENTITIES. THE RELATIONSHIP BETWEEN THE FOUNDATION, JBR AND BCH DOES NOT MEET ANY "RELATED PARTY OR "CONTROL" DEFINITIONS STATED IN THE FORM 990 INSTRUCTIONS. BERTRAND CHAFFEE HOSPITAL 224 EAST MAIN STREET SPRINGVILLE NY 14141 160743921 HOSPITAL/HEALTH CARE NY 501(C)(3) LINE 3 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0