2023-08-01T11:30:38-05:00 2022-12-31 161092347 MENGEL METZGER BARR & CO LLP 333 EAST WATER ST STE 200 ELMIRA NY 14901 990 2022-01-01 510191763 BETHANY NURSING HOME AND HEALTH RELATED FACILITY INC BETH 6077344183 3005 WATKINS ROAD HORSEHEADS NY 14845 MICHAEL KISER EXECUTIVE DIRECTOR 6077344183 2023-06-07 1 MICHAEL KISER 999009999 1 KRISTA L NILES-UPDYKE P00958947 6077344183 2023-06-07 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z MICHAEL KISER 3005 WATKINS ROAD HORSEHEADS NY 14845 8525087 0 X WWW.BETHANY-VILLAGE.ORG X 1975 NY TO PROVIDE REGIONAL LEADERSHIP, SERVICES, ADVOCACY, AND EDUCATION FOR QUALITY SENIOR LIVING, WHILE OPERATING A VIBRANT, LIFE-AFFIRMING RESIDENTIAL COMMUNITY THAT CELEBRATES SPIRITUAL WELL-BEING, ENHANCES INDEPENDENCE AND PROMOTES WELLNESS AS ITS RESIDENTS EVOLVE TOWARD THEIR FULL POTENTIAL. 11 11 213 13 0 0 1602698 164240 8830357 8168051 9123 48002 134979 144794 10577157 8525087 0 0 0 0 5492073 5395348 0 0 0 4138376 3812345 9630449 9207693 946708 -682606 9235158 7727443 6244990 5419881 2990168 2307562 X THE MISSION OF BETHANY VILLAGE IS TO PROVIDE REGIONAL LEADERSHIP, SERVICES, ADVOCACY, AND EDUCATION FOR QUALITY SENIOR LIVING, WHILE OPERATING A VIBRANT, LIFE-AFFIRMING RESIDENTIAL COMMUNITY THAT CELEBRATES SPIRITUAL WELL-BEING, ENHANCES INDEPENDENCE AND PROMOTES WELLNESS AS ITS RESIDENTS EVOLVE TOWARD THEIR FULL POTENTIAL. 0 0 7920491 8360847 OPERATES A SKILLED NURSING FACILITY WHICH PROVIDES HEALTH CARE SERVICES TO THE ELDERLY. 7920491 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 11 0 1 213 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MICHAEL KISER CPA 6077398711 3005 WATKINS ROAD HORSEHEADS NY 14845 RICHARD CARR TREASURER / SECRETARY 2.00 X X 0 0 0 RANDI HEWIT BOARD MEMBER 1.00 X 0 0 0 ANITA LEWIS BOARD MEMBER 1.00 X 0 0 0 CAROL LINCOLN BOARD MEMBER 1.00 X 0 0 0 MARY THERESE OWEN BOARD MEMBER 1.00 X 0 0 0 JASON PARMENTER BOARD VICE CHAIR 2.00 X X 0 0 0 KIMBERLEE MIDDAUGH BOARD MEMBER 1.00 X 0 0 0 DAWN BURLEW BOARD CHAIR 2.00 X X 0 0 0 ALISON HUNT BOARD MEMBER 1.00 X 0 0 0 DAVID HELSING BOARD MEMBER 1.00 X 0 0 0 JACK BENJAMIN BOARD MEMBER 1.00 X 0 0 0 MICHAEL KISER EXECUTIVE DIRECTOR 40.00 X 184489 0 28079 LESLEY LATSHAW ASSOCIATE EXECUTIVE DIRECT 40.00 X 162329 0 66709 346818 0 94788 2 0 1 0 PREFERRED PHYSICAL THERAPY SOLUTIONS 850 SILAS DEAVE HIGHWAY 2ND FLOOR WAETHERSFIELD CT 06109 MANAGES AND STAFFS PT/OT/SLP THERAPY PRO 734747 SODEXO INC PO BOX 360170 PITTSBURGH PA 15251 DIETARY SERVICES 538308 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICES 318879 3 113571 50669 164240 MEDICARE AND MEDICAID 623000 6388757 6388757 PRIVATE PAY 623000 1753449 1753449 ANCILLARY SERVICES 623000 25845 25845 8168051 48002 48002 SHARED SERVICES/MGMT F 623000 113944 113944 SUNDRY 623000 30850 30850 144794 8525087 8360847 0 0 441606 441606 4075984 3671647 404337 84343 78739 5604 429926 387275 42651 363489 302967 60522 5223 5223 53007 10294 42713 826147 825540 607 32300 18797 13503 47190 31856 15334 164807 162246 2561 1755 1755 137202 136530 672 293227 254188 39039 144607 24356 120251 CONTRACTED SERVICES 1181079 1135545 45534 CASH RECEIPTS ASSESSMEN 398565 398565 MEDICAL SUPPLIES AND DR 236638 236638 GENERAL SUPPLIES AND MA 169768 145802 23966 120830 99506 21324 9207693 7920491 1287202 0 1300 1300 5018156 3990480 970337 936088 93835 102808 12248522 11233580 1268913 1014942 1882617 1681825 9235158 7727443 916841 763120 127763 84685 2878003 2668597 2322383 1903479 6244990 5419881 X 2990168 2307562 2990168 2307562 9235158 7727443 -682606 0 X X 0 1 X 1 0 X 61286 207891 1388350 1516483 669 3174679 10888582 11246463 10655560 8830357 8168051 49789013 10949868 11454354 12043910 10346840 8168720 52963692 0 0 0 52963692 655 790 5189 9123 48002 63759 655 790 5189 9123 48002 63759 588351 43007 415839 134979 144794 1326970 11538874 11498151 12464938 10490942 8361516 54354421 0.97440 0.97190 0.00120 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 24400 24400 7415929 7058308 357621 293064 227110 65954 4515129 3948162 566967 1014942 DUE FROM MEDICAID 33221 DUE FROM AFFILIATED ENTITY 50777 RESTRICTED CASH - RESIDENT DEPOSITS 83844 EMPLOYEE RETENTION CREDIT 1513983 1681825 DUE TO THIRD PARTIES 184857 CAP LEASE OBLIG WITH AFFILIATE 1667981 DUE TO AFFILIATED ENTITIES 50641 1903479 X 8525087 0 8525087 0 8525087 9207693 0 9207693 0 9207693 PART IV, LINE 2B: RESIDENT DEPOSITS REPRESENT CASH HELD ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT LIVING ALLOWANCES RECEIVED FROM THE STATE OF NEW YORK, AS WELL AS OTHER RESIDENT FUNDS DEPOSITED WITH THE FACILITY FOR SAFE KEEPING. PART X, LINE 2: THE FACILITY IS A NON-PROFIT ORGANIZATION EXEMPT FROM FEDERAL AND STATE INCOME TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE REGULATIONS. THE FACILITY HAS FILED FOR AND RECEIVED INCOME TAX EXEMPTIONS IN THE VARIOUS JURISDICTIONS WHERE THEY ARE REQUIRED TO DO SO. THE FACILITY FILES FORM 990 TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND IN NEW YORK STATE. WITH FEW EXCEPTIONS, AS OF DECEMBER 31, 2022, THE FACILITY IS NO LONGER SUBJECT TO U.S. FEDERAL OR STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE DECEMBER 31, 2019. THE TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2019 THROUGH DECEMBER 31, 2022 ARE STILL SUBJECT TO POTENTIAL AUDIT BY THE IRS AND THE TAXING AUTHORITIES IN NEW YORK STATE. MANAGEMENT OF THE FACILITY BELIEVES IT HAS NO MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, IT HAS NOT RECOGNIZED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. 0 0 0 0 0 0 0 0 0 LESLEY LATSHAW ASSOCIATE EXECUTIVE DIRECT 162329 0 0 0 0 0 0 0 66709 0 229038 0 0 0 MICHAEL KISER EXECUTIVE DIRECTOR 184489 0 0 0 0 0 0 0 28079 0 212568 0 0 0 PART I, LINE 1B THE GOVERNING BOARD REVIEWS AND APPROVES ALL WAGE AND SALARY INCREASES THROUGH THE BUDGET PROCESS FOR THE EXECUTIVE DIRECTOR AND ASSOCIATE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE MEETS WITH A DESIGNATED BOARD MEMBER WHO HAS BEEN ASSIGNED BY THE OTHER BOARD MEMBERS TO REVIEW THE FORM 990. THE FORM 990 IS PRESENTED TO THE DESIGNATED BOARD MEMBER AND THE FULL EXTENT OF THE FORM AND ITS PREPARATION IS EXPLAINED AT THAT TIME. THE DESIGNATED BOARD EMMBER THEN REVIEWS AND APPROVES THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS WRITTEN CONFLICT OF INTEREST POLICY AT QUARTERLY MEETINGS AND QUALITY ASSURANCE AUDITS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS AND APPROVES ALL WAGE AND SALARY INCREASES THROUGH THE BUDGET PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. BETHANY RETIREMENT HOME INC 3005 WATKINS ROAD HORSEHEADS NY 14845 160988865 HOUSING ELDERLY NY 501(C)(3) LINE 10 N/A 0 ORCHARD HOMES AT BETHANY VILLAGE INC 3005 WATKINS ROAD HORSEHEADS NY 14845 202019814 HOUSING ELDERLY NY 501(C)(3) LINE 10 N/A 0 BETHANY SENIOR CITIZENS' HOUSING INC 3005 WATKINS ROAD HORSEHEADS NY 14845 222238087 HOUSING ELDERLY NY 501(C)(3) LINE 10 N/A 0 BETHANY VILLAGE DEVELOPMENT CORPORATION 3005 WATKINS ROAD HORSEHEADS NY 14845 813458789 PROPERTY INVESTMENTS NY BETHANY NURSING HOME AND HEALTH RELATED FACILITY INC C 1.00000 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 BETHANY SENIOR CITIZEN'S HOUSING INC L 109384 MANAGEMENT AGREEMENT (CONTRACT) BETHANY RETIREMENT HOME INC Q 1098988 SHARED SERVICE ALLOCATION ORCHARD HOMES AT BETHANY VILLAGE INC L 113946 SHARED SERVICE ALLOCATION BETHANY RETIREMENT HOME INC K 81220 DIRECT FINANCE LEASE INTEREST BETHANY RETIREMENT HOME INC R 313980 DIRECT FINANCE LEASE PRINCIPAL ORCHARD HOMES AT BETHANY VILLAGE INC Q 22528 SHARED SERVICE ALLOCATION BETHANY SENIOR CITIZEN'S HOUSING INC Q 5820 MANAGEMENT AGREEMENT (CONTRACT)