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PROVIDENCE REST: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
PROVIDENCE REST (EIN 13-1740301)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-13
IRS object ID
202303179349312185
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-13T21:41:04-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN873231666PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PKF O'CONNOR DAVIES ADVISORY LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 MAMARONECK AVENUE SUITE 301AddressLine1Txt
CityHARRISONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP105281633ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN131740301EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE RESTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPROVBusinessNameControlTxt
Phone7189313000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13304 WATERBURY AVENUEAddressLine1Txt
CityBRONXCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10465ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANNMARIE COVONEPersonNm
Person TitleEXECUTIVE VP & CFOPersonTitleTxt
Phone7189313000PhoneNum
Signature2023-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstANNMARIEPersonFirstNm
Person LastCOVONEPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGARRETT M HIGGINSPreparerPersonNm
PTINP00543209PTIN
Phone9143818900PhoneNum
Preparation2023-11-11PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1ARCHCARE AT PROVIDENCE RESTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSCOTT P LA RUEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1205 LEXINGTON AVE - 2ND FLOORAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10016ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$36,967,394GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PROVIDENCEREST.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTO RENDER INPATIENT MEDICAL CARE TO THE AGED.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee240TotalEmployeeCnt
Total Volunteers21TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,082,071PYContributionsGrantsAmt
CY Contributions Grants$534,930CYContributionsGrantsAmt
PY Program Service Revenue$23,612,330PYProgramServiceRevenueAmt
CY Program Service Revenue$26,774,130CYProgramServiceRevenueAmt
PY Investment Income$742,285PYInvestmentIncomeAmt
CY Investment Income$381,606CYInvestmentIncomeAmt
PY Other Revenue-$50,268PYOtherRevenueAmt
CY Other Revenue-$19,115CYOtherRevenueAmt
PY Total Revenue$27,386,418PYTotalRevenueAmt
CY Total Revenue$27,671,551CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$15,609,047PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,934,246CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$14,773,486PYOtherExpensesAmt
CY Other Expenses$18,535,644CYOtherExpensesAmt
PY Total Expenses$30,382,533PYTotalExpensesAmt
CY Total Expenses$33,469,890CYTotalExpensesAmt
PY Revenues Less Expenses-$2,996,115PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$5,798,339CYRevenuesLessExpensesAmt
Total Assets BOY$37,979,898TotalAssetsBOYAmt
Total Assets EOY$31,027,186TotalAssetsEOYAmt
Total Liabilities BOY$25,723,108TotalLiabilitiesBOYAmt
Total Liabilities EOY$27,398,854TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,256,790NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,628,332NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIT IS OUR MISSION TO PROVIDE EXCEPTIONAL SKILLED NURSING AND REHABILITATIVE CARE IN A SAFE, PEACE-FILLED, SPIRITUALLY-CENTERED ENVIRONMENT TO THE OLDER ADULTS ENTRUSTED TO US. WE CONSIDER IT OUR PRIVILEGE TO CARE FOR EACH PERSON AS GOD'S PRECIOUS GIFT OF LIFE AND LOVE. WE FULLY COMMIT OURSELVES TO A CIRCLE OF COMMUNITY WITH OUR RESIDENTS AS THE CENTER, SURROUNDED BY STAFF, FAMILIES AND FRIENDS; THE RECOGNITION OF EACH RESIDENT AS AN AUTONOMOUS INDIVIDUAL WITH SPECIAL AND UNIQUE NEEDS, INTERESTS AND PREFERENCES; THE INVOLVEMENT OF ALL STAFF IN THE DAILY LIVES OF OUR RESIDENTS; CREATING A CARE ENVIRONMENT WHERE ALL THE MEMBERS OF OUR COMMUNITY WORK IN HARMONY TO PROVIDE A HAPPY HOME.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$28,947,019ExpenseAmt
Grant$0GrantAmt
Revenue$26,774,130RevenueAmt
DescOUR SNF OFFERS SHORT TERM REHABILITATION, SUBACUTE SERVICES, LONG TERM CARE AND RESPITE CARE. IN ADDITION, WE HAVE A COMPREHENSIVE PALLIATIVE CARE PROGRAM AND PROVIDE IN-PATIENT HOME HOSPICE CARE. OUR SERVICES FOCUS ON THE OLDER ADULTS IN OUR COMMUNITY. WE HAVE A PERSON-CENTERED PHILOSOPHY, FOCUSING ON ALL THE NEEDS OF EACH INDIVIDUAL ENTRUSTED TO US PHYSICAL, SPIRITUAL, PSYCHOLOGICAL AND SOCIAL. WE HAD 467 ADMISSIONS TO PROVIDENCE REST IN 2022, DISCHARGED 186 RESIDENTS BACK TO THEIR HOMES. WE RENDERED 64,350 DAYS OF RESIDENT CARE AND 16 DAYS OF RESPITE CARE. PROVIDENCE REST CONTINUED TO EXTEND THE BOUNDARIES OF THE HOME TO THE COMMUNITY AT LARGE, SHARING EXPERTISE, PROGRAMS AND RESOURCES, THROUGH INTERNSHIP PROGRAMS, COMMUNITY INFORMATION PROGRAMS, HEALTH FAIR PARTICIPATION AND OTHER OUTREACH EFFORTS INCLUDING PROVIDING THE BOARD OF ELECTIONS WITH PROVIDENCE AS A NEW, HANDICAPPED ACCESSIBLE POLLING SITE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$0ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescOUR OUTPATIENT PROGRAM PROVIDES PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES TO THE ADULTS OF OUR COMMUNITY, SPECIALIZING IN REHABILITATION FOR THE SENIOR POPULATION. THE PROGRAM ALSO PROVIDES CONTINUITY FOR OUR DISCHARGED SHORT-TERM REHAB CLIENTS WHO CHOOSE TO REMAIN WITH OUR THERAPISTS FOR THEIR REHABILITATION ONCE THEY RETURN HOMEDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$28,947,019TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document42IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee240EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANNMARIE COVONEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6466334700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1205 LEXINGTON AVENUE - 2ND FLRAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10016ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
SCOTT P LA RUE
PRESIDENT & CEO0.1038.70Yes (X)Yes (X)$0$1,570,889$397,993
ANNMARIE COVONE
EXECUTIVE VP/CFO0.1038.70Yes (X)Yes (X)$0$1,054,969$275,645
SISTER SELINE FLORES
BOARD MEMBER/CEO35.001.70Yes (X)Yes (X)$0$0$0
HUGO PIZZURO
BOARD MEMBER, THRU OCT 20220.1035.00Yes (X)$0$548,894$371,004
JOHN DECINA
CHAIRMAN0.100.00Yes (X)Yes (X)$0$0$0
JOHN F GLEASON
BOARD MEMBER0.101.70Yes (X)$0$0$0
JOSEPH SAPORITO
BOARD MEMBER0.101.70Yes (X)$0$0$0
JOSEPH SCIAME
BOARD MEMBER0.101.70Yes (X)$0$0$0
RICHARD P BISCOTTI
ADMINISTRATOR35.000.00$294,848$0$59,673Yes (X)
MAUREEN BOOTHBY
DIRECTOR OF NURSING35.000.00$204,273$0$23,887Yes (X)
CATHERINE T PEMBERTON-PARKER
ASSISTANT DIRECTOR OF NURSING35.000.00$119,052$0$34,775Yes (X)
YAKOV KATSNELSON
PLANT OPERATION & MAINTENANCE35.000.00$112,881$0$23,844Yes (X)
OKSANA A BADANINA
NURSE MANAGER35.000.00$105,801$0$0Yes (X)
ROSEMARIE HOFSTEIN
DIRECTOR OF SOCIAL WORK35.000.00$105,753$0$11,400Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$942,608TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,174,752TotReportableCompRltdOrgAmt
Total Other Compensation$1,198,221TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CATHOLIC HEALTH CARE SYSTEM
205 LEXINGTON AVE 2ND FLRNEW YORKNY10012ADMINISTRATIVE SERVICES$1,625,001
MORRISON MANAGEMENT SPECIALIST
100 SOUTHCREST DRIVESTOCKBRIDGEGA30281NUTRITION MGMT SERVICES$1,593,157
RCM TECHNOLOGIES
PO BOX 536342PITTSBURGHPA15253STAFFING SERVICES$1,266,310
THERADYNAMICS REHAB LLC
337 CROSSWAY PARK DRIVEWOODBURYNY11797REHAB SERVICES$663,535
AEQUOR HEALTHCARE SERVICES
377 HOES LANENEW YORKNY10010STAFFING SERVICES$619,198
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt
Fundraising$124,030FundraisingAmt
Government Grants$264,374GovernmentGrantsAmt
All Other Contributions$146,526AllOtherContributionsAmt
Total Contributions$534,930TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAID REVENUE623000$13,136,000$13,136,000
MEDICARE REVENUE623000$7,823,849$7,823,849
PRIVATE PAY AND OTHER623000$4,363,953$4,363,953
OTHER PATIENT REVENUE623000$1,450,328$1,450,328
FieldValueIRS element (for citing)
Total Program Service Revenue$26,774,130TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$228,183TotalRevenueColumnAmt
Exclusion$228,183ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$618RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$618RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$618TotalRevenueColumnAmt
Exclusion$618ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$9,355,255SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$9,201,832SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$153,423SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$153,423TotalRevenueColumnAmt
Exclusion$153,423ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$15,390FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$124,030ContriRptFundraisingEventAmt
Fundraising Direct Expenses$80,935FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$65,545TotalRevenueColumnAmt
Exclusion-$65,545ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$7,875GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,875TotalRevenueColumnAmt
Exclusion$7,875ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$36,842GrossSalesOfInventoryAmt
Cost Of Goods Sold$13,076CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,766TotalRevenueColumnAmt
Exclusion$23,766ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
INTEREST ON PAST DUE ACCTS900099$8,064$8,064
CABLE/PHONE CHARGES900099$4,606$4,606
OTHER REVENUE900099$1,212$1,212

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$289TotalRevenueColumnAmt
Exclusion$289ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$14,171OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,671,551TotalRevenueColumnAmt
Related Or Exempt Func Income$26,774,130RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$362,491ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$305,022TotalAmt
Management And General$305,022ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,370,622TotalAmt
Program Services$9,102,578ProgramServicesAmt
Management And General$268,044ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$915,865TotalAmt
Program Services$875,560ProgramServicesAmt
Management And General$40,305ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,670,891TotalAmt
Program Services$2,544,735ProgramServicesAmt
Management And General$126,156ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,671,846TotalAmt
Program Services$1,578,622ProgramServicesAmt
Management And General$93,224ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,000,000TotalAmt
Management And General$1,000,000ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$86,746TotalAmt
Management And General$86,746ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$69,500TotalAmt
Management And General$69,500ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$14,900TotalAmt
Management And General$14,900ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$47,324TotalAmt
Management And General$47,324ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,398,563TotalAmt
Program Services$7,776,462ProgramServicesAmt
Management And General$622,101ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$109TotalAmt
Management And General$109ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$687,084TotalAmt
Program Services$520,133ProgramServicesAmt
Management And General$166,951ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$247,592TotalAmt
Management And General$247,592ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,320,511TotalAmt
Program Services$1,219,588ProgramServicesAmt
Management And General$100,923ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$790TotalAmt
Program Services$410ProgramServicesAmt
Management And General$380ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,830,181TotalAmt
Program Services$2,830,181ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$495,188TotalAmt
Management And General$495,188ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
NY CASH RECEIPT ASSMNT$1,137,460$1,137,460
BAD DEBT EXPENSE$760,304$760,304
PURCHASED SERVICES$472,966$444,735$28,231
MEDICATIONS$471,471$471,471

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$494,955TotalAmt
Program Services$445,084ProgramServicesAmt
Management And General$49,871ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$33,469,890TotalAmt
Program Services$28,947,019ProgramServicesAmt
Management And General$4,522,871ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$827,365BOYAmt
EOY$807,962EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,489,162BOYAmt
EOY$4,434,012EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,103,003BOYAmt
EOY$4,394,036EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$147,516BOYAmt
EOY$94,869EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$203,365BOYAmt
EOY$282,925EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$66,127,398LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$53,967,054LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,369,141BOYAmt
EOY$12,160,344EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$14,214,907BOYAmt
EOY$7,151,849EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$625,439BOYAmt
EOY$1,701,189EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$37,979,898BOYAmt
EOY$31,027,186EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,945,900BOYAmt
EOY$6,115,235EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$193,644EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,617,801BOYAmt
EOY$16,580,435EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$339,054BOYAmt
EOY$253,662EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,820,353BOYAmt
EOY$4,255,878EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,723,108BOYAmt
EOY$27,398,854EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,256,790BOYAmt
EOY$3,628,332EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,256,790BOYAmt
EOY$3,628,332EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$37,979,898BOYAmt
EOY$31,027,186EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$5,798,339ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,477,184NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$352,935OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$353,407CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,274,456CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,204,677CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,082,071CurrentTaxYearMinus1YearAmt
Current Tax Year$534,930CurrentTaxYearAmt
Total$7,449,541TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$27,405,705CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$27,244,362CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,545,205CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$23,612,330CurrentTaxYearMinus1YearAmt
Current Tax Year$26,774,130CurrentTaxYearAmt
Total$127,581,732TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$27,759,112CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$28,518,818CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$24,749,882CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,694,401CurrentTaxYearMinus1YearAmt
Current Tax Year$27,309,060CurrentTaxYearAmt
Total$135,031,273TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,513CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,373CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,070CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,550CurrentTaxYearMinus1YearAmt
Current Tax Year$9,450CurrentTaxYearAmt
Total$63,956TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,513CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,373CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,070CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,550CurrentTaxYearMinus1YearAmt
Current Tax Year$9,450CurrentTaxYearAmt
Total$63,956TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$134,967,317PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$585,284CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$594,055CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$568,158CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$237,939CurrentTaxYearMinus1YearAmt
Current Tax Year$228,801CurrentTaxYearAmt
Total$2,214,237TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$585,284CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$594,055CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$568,158CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$237,939CurrentTaxYearMinus1YearAmt
Current Tax Year$228,801CurrentTaxYearAmt
Total$2,214,237TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$50,992CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$53,982CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$58,937CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,996CurrentTaxYearMinus1YearAmt
Current Tax Year$51,013CurrentTaxYearAmt
Total$247,920TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$28,395,388CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$29,166,855CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,376,977CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,965,336CurrentTaxYearMinus1YearAmt
Current Tax Year$27,588,874CurrentTaxYearAmt
Total$137,493,430TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98160PublicSupportCY509Pct
Public Support PY5090.98100PublicSupportPY509Pct
Investment Income CY0.01610InvestmentIncomeCYPct
Investment Income PY0.01670InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER REVENUE - 2018 AMOUNT: $ 1,386. 2019 AMOUNT: $ 4,060. 2021 AMOUNT: $ 881. 2022 AMOUNT: $ 1,212. CABLE / PHONE CHARGES - 2018 AMOUNT: $ 10,039. 2019 AMOUNT: $ 8,079. 2020 AMOUNT: $ 6,902. 2021 AMOUNT: $ 4,655. 2022 AMOUNT: $ 4,606. PURCHASE DISCOUNTS - 2018 AMOUNT: $ 29,959. 2019 AMOUNT: $ 26,929. 2020 AMOUNT: $ 6,734. INTEREST ON PAST DUE ACCOUNTS - 2018 AMOUNT: $ 7,174. 2019 AMOUNT: $ 11,102. 2020 AMOUNT: $ 12,484. 2021 AMOUNT: $ 3,526. 2022 AMOUNT: $ 8,064. MEDICAL RECORD ABSTRACTS - 2018 AMOUNT: $ 2,434. 2019 AMOUNT: $ 3,612. 2020 AMOUNT: $ 2,213. 2021 AMOUNT: $ 560. 2022 AMOUNT: $ 289. REBATES - 2019 AMOUNT: $ 200. 2020 AMOUNT: $ 3,246. BEAUTY PARLOR - 2020 AMOUNT: $ 7,037. 2021 AMOUNT: $ 8,072. 2022 AMOUNT: $ 14,164. COFFEE SHOP - 2020 AMOUNT: $ 20,321. 2021 AMOUNT: $ 15,302. 2022 AMOUNT: $ 22,678.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$14,900OtherActivitiesAmt
Total Lobbying Expenditures$14,900TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationAMOUNTS REPORTED ON LINE 1I REPRESENTS THE PORTION OF MEMBERSHIP DUES PAID BY THE ORGANIZATION TO PROFESSIONAL ASSOCIATIONS AND SIMILAR ORGANIZATIONS ATTRIBUTABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,525,290OtherCostOrOtherBasisAmt
Book Value$2,525,290BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$58,370,055OtherCostOrOtherBasisAmt
Depreciation$49,937,911DepreciationAmt
Book Value$8,432,144BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$52,275OtherCostOrOtherBasisAmt
Depreciation$52,275DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,179,778OtherCostOrOtherBasisAmt
Depreciation$3,976,868DepreciationAmt
Book Value$1,202,910BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,160,344TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DUE FROM THIRD PARTY$90,963
RESTRICTED CASH$253,662
INSURANCE RECOVERY RECEIVABLE$1,356,564
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,701,189TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DUE TO THIRD PARTY PAYORS$144,281
ACCRUED PENSION OBLIGATION$1,719,487
PROFESSIONAL LIABILITIES$1,356,564
DUE TO RELATED PARTY$1,035,546
FieldValueIRS element (for citing)
Total Liability$4,255,878TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$24,399,815TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$2,477,184NetUnrealizedGainsInvstAmt
Other Revenue$13,076OtherRevenueAmt
Revenue Not Reported-$2,464,108RevenueNotReportedAmt
Revenue Subtotal$26,863,923RevenueSubtotalAmt
Investment Expenses Not Incld$47,324InvestmentExpensesNotIncldAmt
Other Revenues Not Included$760,304OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$807,628RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$27,671,551TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$32,675,338TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$13,076OtherExpensesIncludedAmt
Expenses Not Reported$13,076ExpensesNotReportedAmt
Expenses Subtotal$32,662,262ExpensesSubtotalAmt
Investment Expenses Not Incld2$47,324InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$760,304OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$807,628ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$33,469,890TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:RESIDENTS' FUNDS ARE HELD BY THE HOME ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE HOME FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE HOME AT THE REQUEST OF, OR ON BEHALF OF, RESIDENTS FOR THEIR PERSONAL USE.
PART X, LINE 2:THE HOME RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE HOME HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE HOME IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2019.
PART XI, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD REPORTED ON PART VIII, LINE 10B 13,076.
PART XI, LINE 4B - OTHER ADJUSTMENTS:RECLASS OF BAD DEBT EXPENSE TO PART IX, LINE 24 760,304.
PART XII, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD REPORTED ON PART VIII, LINE 10B 13,076.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RECLASS OF BAD DEBT EXPENSE TO PART IX, LINE 24 760,304.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF EVENTEvent1Nm
Gross Receipts Event1$139,420GrossReceiptsEvent1Amt
Charitable Contri Event1$124,030CharitableContriEvent1Amt
Gross Revenue Event1$15,390GrossRevenueEvent1Amt
Rent Facility Costs Event1$47,351RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$33,584OtherDirectExpensesEvent1Amt
Gross Receipts Total$139,420GrossReceiptsTotalAmt
Charitable Contributions Tot$124,030CharitableContributionsTotAmt
Gross Revenue Total Events$15,390GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$47,351RentFcltyCostsTotalEventsAmt
Oth Direct Expnss Total Events$33,584OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$80,935DirectExpenseSummaryEventsAmt
Net Income Summary-$65,545NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SCOTT P LA RUE
PRESIDENT & CEO$0$1,267,660$0$139,407$0$163,822$0$372,318$0$25,675$0$1,968,882$0$300,458
ANNMARIE COVONE
EXECUTIVE VP/CFO$0$837,632$0$117,271$0$100,066$0$262,461$0$13,184$0$1,330,614$0$135,664
HUGO PIZZURO
BOARD MEMBER, THRU OCT 2022$0$358,490$0$78,149$0$112,255$0$343,436$0$27,568$0$919,898$0$78,149
RICHARD P BISCOTTI
ADMINISTRATOR$247,950$0$46,898$0$0$0$35,552$0$24,121$0$354,521$0$46,898$0
MAUREEN BOOTHBY
DIRECTOR OF NURSING$178,142$0$26,131$0$0$0$12,118$0$11,769$0$228,160$0$26,131$0
CATHERINE T PEMBERTON-PARKER
ASSISTANT DIRECTOR OF NURSING$119,052$0$0$0$0$0$0$0$34,775$0$153,827$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT ITS EXECUTIVE COMPENSATION IS REASONABLE. TOWARD THAT END, THE BOARD OF TRUSTEES HAS A COMPENSATION COMMITTEE OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN ANY PROPOSED COMPENSATION ARRANGEMENT. THE BOARD ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT WHO CONDUCTED INDEPENDENT RESEARCH AND UTILIZED A WIDE RANGE OF INDUSTRY DATA TO DEVELOP COMPARABILITY OR BENCHMARKING DATA FOR APPROPRIATE LEVELS OF COMPENSATION FOR TOP MANAGEMENT, OFFICERS, AND KEY EMPLOYEES. THE CONSULTANT PROJECTED THE DATA FOR THE FOLLOWING THREE YEARS FOR EACH SALARY LEVEL. THE COMPENSATION COMMITTEE, TAKING THE CONSULTANT'S RECOMMENDATIONS UNDER ADVISEMENT, HELD A MEETING AT WHICH CONTEMPORANEOUS MINUTES WERE KEPT AND AT THAT MEETING DETERMINED TO MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES THEN CONSIDERED AND APPROVED THE RECOMMENDATIONS OF THE COMPENSATION COMMITTEE, WHICH APPROVAL WAS RECORDED IN THE MINUTES OF THE MEETING OF THE BOARD OF TRUSTEES. IN 2022, THE CONSULTANT UPDATED ITS REVIEW OF THE COMPENSATION STRUCTURE OF TOP MANAGEMENT, OFFICERS, AND KEY EMPLOYEES FOLLOWING THE METHOD DESCRIBED ABOVE. IN ADDITION, THE ORGANIZATION UPDATED ITS REVIEW OF THE COMPENSATION STRUCTURE FOR ALL OTHER POSITIONS (NON-UNION).
PART I, LINES 4A-BSCOTT P. LA RUE AND ANNMARIE COVONE ALSO PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE DISTRIBUTED $160,192 TO SCOTT AND $86,225 TO ANNMARIE IN THEIR 2022 W-2S. HUGO PIZARRO RECEIVED SEVERANCE INCLUDED IN HIS 2022 FORM W-2 IN THE AMOUNT OF $102,165, PAID BY CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE.
PART I, LINE 7THE ORGANIZATION PAID DISCRETIONARY BONUSES TO CERTAIN INDIVIDUALS LISTED IN PART II AS REPORTED IN COLUMN B(II) FOR THE APPLICABLE INDIVIDUALS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1DORMITORY AUTHORITY OF THE STATE OF NEW YORK (DASNY)BusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN146000293BondIssuerEIN
CUSIP000000000CUSIPNum
Bond Issued2016-12-29BondIssuedDt
Issue Price$22,821,500IssuePriceAmt
PurposeREFINANCING ISSUEPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$5,835,829RetiredAmt
Total Proceeds$22,821,500TotalProceedsAmt
In Reserve Fund$3,932,841InReserveFundAmt
Issuance Costs From Proceeds$400,862IssuanceCostsFromProceedsAmt
Other Spent Proceeds$18,487,797OtherSpentProceedsAmt
Substantial Completion2016SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts0EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION HAS A MANAGEMENT AGREEMENT FOR CERTAIN ADMINISTRATIVE AND CONSULTING SERVICES WITH CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE. CATHOLIC HEALTH CARE SYSTEM SHALL PROVIDE HUMAN RESOURCES, IT SERVICES, FINANCE SERVICES, LEGAL SERVICES, COMPLIANCE, AND SUPPLY CHAIN MANAGEMENT TO THE ORGANIZATION. ANNMARIE COVONE AND SCOTT LA RUE (OFFICERS OF THE FILING ORGANIZATION) WERE PAID BY CATHOLIC HEALTH CARE SYSTEM. THEIR 2022 COMPENSATION IS REPORTED IN PART VII, SECTION A AND SCHEDULE J, PART II. CATHOLIC HEALTH CARE SYSTEM WAS PAID $1,000,000 FOR SERVICES PROVIDED IN 2022.
FORM 990, PART VI, SECTION A, LINE 6THE SOLE "MEMBER" IS CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER HAS THE RIGHT TO APPOINT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES, APPOINT THE CHAIRMAN OF THE BOARD, AMEND THE BY-LAWS AND CERTIFICATE OF INCORPORATION AND APPROVE SUBSTANTIAL TRANSACTIONS.
FORM 990, PART VI, SECTION A, LINE 7BTHE SOLE MEMBER HAS THE RIGHT TO AMEND THE BY-LAWS AND CERTIFICATE OF INCORPORATION AND APPROVE SUBSTANTIAL TRANSACTIONS.
FORM 990, PART VI, SECTION B, LINE 11BPROVIDENCE REST HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE BOARD MEMBERS OF THE ORGANIZATION FOR ANY COMMENTS. ANY COMMENTS ARE THEN GROUPED, SUMMARIZED AND PROVIDED TO THE OUTSIDE ACCOUNTANTS. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING.
FORM 990, PART VI, SECTION B, LINE 12CCOMPLIANCE OFFICER OBTAINS DISCLOSURE FROM EACH BOARD MEMBER PRIOR TO A DIRECTOR'S FIRST ATTENDANCE AT A BOARD MEETING AND FROM ALL BOARD MEMBERS AT LEAST EVERY TWO YEARS. BOARD MEMBERS ARE IN-SERVICED ANNUALLY ON THE POLICIES AND PROCEDURES OF THE CORPORATE COMPLIANCE PROGRAM. EMPLOYEES ARE IN-SERVICED ON THE POLICY AND CORPORATE COMPLIANCE PROGRAM DURING ORIENTATION AND ANNUALLY DURING THE MONTH OF JULY. THEY ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST TO THE ADMINISTRATOR AND TO AVOID PARTICIPATING IN ANY DECISIONS OR DELIBERATIONS RELATED TO AN INSTITUTIONAL OR BUSINESS TRANSACTION IN WHICH A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS. AN EMPLOYEE WHO FAILS TO DISCLOSE A CONFLICT MAY BE DISCIPLINED AND/OR DISCHARGED. IN ADDITION, UNDER THE CORPORATE COMPLIANCE PROGRAM ANYONE CAN REPORT A SUSPECTED VIOLATION OF THE CONFLICT OF INTEREST POLICY. THE COMPLIANCE OFFICER AND/OR COMPLIANCE COMMITTEE WILL INVESTIGATE THE ALLEGATION TO DETERMINE ITS VALIDITY. THE COMPLIANCE OFFICER CONDUCTS A COMPREHENSIVE INVESTIGATION INCLUDING INTERVIEWS WITH APPROPRIATE STAFF, VENDORS, REVIEW OF DOCUMENTS, CONSULTATION WITH LEGAL COUNSEL IF NECESSARY. THE COMPLIANCE OFFICER KEEPS THE ADMINISTRATOR AND CHAIRMAN OF THE BOARD APPRISED OF THE PROGRESS OF THE INVESTIGATION. AT THE CONCLUSION OF THE INVESTIGATION A REPORT IS PREPARED FOR THE ADMINISTRATOR. IF THE INVESTIGATION REVEALED A VIOLATION HAD OCCURRED THE OFFICER WILL RECOMMEND CORRECTIVE ACTION. APPROPRIATE ACTION MAY INCLUDE DISCIPLINARY ACTION, DISMISSAL (BOARD MEMBER), COMMUNICATIONS TO EMPLOYEES, STAFF, CONTRACTORS AND BOARD MEMBERS. AUDITS ARE CONDUCTED DURING THE YEAR TO ENSURE EMPLOYEES, CONSULTANTS AND CONTRACTORS ARE ADHERING TO THE POLICY. THIS INCLUDES A REVIEW OF EACH NEW CONTRACTOR AND/OR VENDOR PRIOR TO BUSINESS BEING CONDUCTED.
FORM 990, PART VI, SECTION B, LINE 15BTHE CORPORATION UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT ITS EXECUTIVE COMPENSATION IS REASONABLE AND COMPETITIVE. TOWARD THAT END, THE BOARD OF TRUSTEES HAS A COMPENSATION COMMITTEE OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN ANY PROPOSED COMPENSATION ARRANGEMENT. THE BOARD ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT WHO CONDUCTED INDEPENDENT RESEARCH AND UTILIZED A WIDE RANGE OF INDUSTRY DATA TO DEVELOP COMPARABILITY OR BENCHMARKING DATA FOR APPROPRIATE LEVELS OF COMPENSATION FOR TOP MANAGEMENT, OFFICERS, AND KEY EMPLOYEES. IN ADDITION, THE CONSULTANT CREATED A COMPENSATION STRUCTURE FOR ALL OTHER POSITIONS (NON-UNION). THIS STRUCTURE IS REVIEWED EVERY THREE YEARS. THE CONSULTANT REVIEWS EXECUTIVE COMPENSATION ANNUALLY AND REVIEWS THESE RESULTS WITH THE COMPENSATION COMMITTEE. THE CONSULTANT PROJECTED THE DATA FOR THE FOLLOWING THREE YEARS FOR EACH SALARY LEVEL. THE COMPENSATION COMMITTEE, TAKING THE CONSULTANT'S RECOMMENDATIONS UNDER ADVISEMENT, HELD A MEETING AT WHICH CONTEMPORANEOUS MINUTES WERE KEPT AND AT THAT MEETING DETERMINED TO MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES THEN CONSIDERED AND APPROVED THE RECOMMENDATIONS OF THE COMPENSATION COMMITTEE, WHICH APPROVAL WAS RECORDED IN THE MINUTES OF THE MEETING OF THE BOARD OF TRUSTEES. IN 2022, THE CONSULTANT UPDATED ITS REVIEW OF THE COMPENSATION STRUCTURE OF TOP MANAGEMENT, OFFICERS, AND KEY EMPLOYEES FOLLOWING THE METHOD DESCRIBED ABOVE. IN ADDITION, THE ORGANIZATION UPDATED ITS REVIEW OF THE COMPENSATION STRUCTURE FOR ALL OTHER POSITIONS (NON-UNION).
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE ON GUIDESTAR AND OTHER SIMILAR WEBSITES.
FORM 990, PART VI, SECTION C, LINE 19PROVIDENCE REST MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINACIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. THE ORGANIZATION ALSO FILES AN ANNUAL COST REPORT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH CONTAINS FINANCIAL STATEMENTS AND RELATED NOTE DISCLOSURES, WHICH IS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GBILLING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 159,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 159,000. CONSULTING: PROGRAM SERVICE EXPENSES 60,090. MANAGEMENT AND GENERAL EXPENSES 422,995. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 483,085. DASNY FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 10,487. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,487. EMPLOYMENT AGENCY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 29,619. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,619. ENGINEERING: PROGRAM SERVICE EXPENSES 270,561. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 270,561. FOOD SERVICES: PROGRAM SERVICE EXPENSES 1,675,731. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,675,731. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 234,808. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 234,808. PHYSICAL THERAPISTS: PROGRAM SERVICE EXPENSES 5,100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,100. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 104,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 104,000. LABORATORY/RADIOLOGY: PROGRAM SERVICE EXPENSES 72,556. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 72,556. RN, LPN, CAN: PROGRAM SERVICE EXPENSES 3,659,815. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,659,815. SECURITY: PROGRAM SERVICE EXPENSES 226,153. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 226,153. THERAPISTS & NON PHYS.: PROGRAM SERVICE EXPENSES 1,082,994. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,082,994. PASTORAL CARE: PROGRAM SERVICE EXPENSES 384,654. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 384,654.
FORM 990, PART XI, LINE 9:EFFECT OF PENSION LIABILITY ADJUSTMENT -490,209. EQUITY TRANSFER FROM CATHOLIC HEALTH CARE SYSTEM 137,274.
FORM 990, PART XII, LINE 2C:THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ARCHCARE COMMUNITY SERVICES INC
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016813563801PROVIDE COMMUNITY AND PASTORAL SERVICES AND SUPPORTIVE HOUSINGNY501(C)(3)LINE 12B, IICATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
BENEFICE ADVANTAGE INC
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016134201050DORMANT/PROVIDE ADMIN., BENEFITS COORDINATING AND OTHER SERVICES TO ARCHCARENY501(C)(3)LINE 1CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
BROOKLYN VISITING NURSE FOUNDATION
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016113312248DORMANT/RAISE FUNDS FOR AFFILIATED ORGANIZATIONSNY501(C)(3)LINE 12B, IIVISITING NURSE REGIONAL HEALTH CARE SYSTEM INC0
CALVARY FUND INC
1740 EASTCHESTER ROADBRONXNY10461133259649SUPPORT CALVARY HOSPITALNY501(C)(3)LINE 12A, ICALVARY HOLDING COMPANY INC0
CALVARY HOLDING COMPANY
1740 EASTCHESTER ROADBRONXNY10461061531426SUPPORT THE CALVARY HOSPITAL AND ITS AFFILIATED ORGANIZATIONSNY501(C)(3)LINE 12A, ICATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
CALVARY HOSPITAL
1740 EASTCHESTER ROADBRONXNY10461131740274OPERATE A TAX EXEMPT HOSPITALNY501(C)(3)LINE 3CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
CARMEL RICHMOND NURSING HOME INC
88 OLD TOWN ROADSTATEN ISLANDNY103044299132720248OPERATE SKILLED NURSING & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
CATHOLIC HEALTH CARE FOUNDATION OF THE ARCHDIOCESE OF NY
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016134054158PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIESNY501(C)(3)LINE 7CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016133896624MGT SVCS FOR HEALTH-RELATED FACILITIES IN THE ARCHDIOCESENY501(C)(3)LINE 10PROVIDENCE HEALTH SERVICES0
CATHOLIC MANAGED LONG TERM CARE INC
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016208180809OPERATE A MANAGED LONG TERM CARE PLANNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
CATHOLIC RESOURCES INC
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016261306110PROVIDE PARISH OUTREACH SERVICES & SOCIAL & HEALTH CARE SERVICE INFORMATIONNY501(C)(3)LINE 3CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
DOMINICAN SISTERS FAMILY HEALTH SERVICE INC
299 NORTH HIGHLAND AVENUEOSSININGNY10562131740242HOME HEALTH AGENCYNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
EMPIRE STATE HOME CARE SERVICES INC
15 METROTECH CENTER 11 FLBROOKLYNNY11201113618585HOME HEALTH CARE SERVICESNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
FAMILY HOME HEALTH CARE INC
65 SOUTH BROADWAYTARRYTOWNNY10591133831377HOME CARENY501(C)(3)LINE 10DOMINICAN SISTERS FAMILY HEALTH SERVICE INC0
FERNCLIFF NURSING HOME COMPANY INC
21 FERNCLIFF DRIVERHINEBECKNY12572141514053OPERATE SKILLED NURSING FACILITY & ADULT HEALTH CARE PROGRAMNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
KATERI RESIDENCE
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016133086309DORMANT/OPERATE SKILLED NURSING & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
MARY MANNING WALSH NURSING HOME CO INC
1339 YORK AVENUENEW YORKNY10021136220617OPERATE SKILLED NURSING & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
OUR LADY OF MERCY FUND OF NEW YORK NY
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016133452084DORMANT/PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIESNY501(C)(3)LINE 7OUR LADY OF MERCY HEALTHCARE SYSTEM INC0
OUR LADY OF MERCY HEALTHCARE SYSTEM INC
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016133395946DORMANT/PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIESNY501(C)(3)LINE 12A, ICATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
PROVIDENCE HEALTH SERVICES
1011 1ST AVENUENEW YORKNY10022133354940SPONSOR OF CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARENY501(C)(3)LINE 30N/A
ST TERESA'S NURSING HOME INC
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016237012219DORMANT/OPERATE SKILLED NURSING & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
ST TERESA'S RESIDENCE
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016133110063DORMANT/INTERMEDIATE CARE FACILITY FOR DEVELOPMENTALLY DISABLEDNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
ST VINCENT DE PAUL RESIDENCE
900 INTERVALE AVENUEBRONXNY10459133598842OPERATE SKILLED NURSING & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
TERENCE CARDINAL COOKE HEALTH CARE CENTER
1249 FIFTH AVENUENEW YORKNY10029133007801OPERATE SKILLED NURSING & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
ULSTER HOME CARE INC
PO BOX 1850KINGSTONNY12402141702962HOME CARENY501(C)(3)LINE 10UMC INC0
ULSTER HOME HEALTH SERVICES INC
PO BOX 1850KINGSTONNY12402141513989HOME CARENY501(C)(3)LINE 10UMC INC0
UMC INC
PO BOX 1850KINGSTONNY12402141701702MANGEMENT SERVICESNY501(C)(3)LINE 12B, IICATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
VISITING NURSE REGIONAL HEALTH CARE SYSTEM INC
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016113574017DORMANT/SUPPORT AND MANAGEMENT SERVICES FOR ITS AFFILIATESNY501(C)(3)PFCATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE0
VISITING NURSE ASSOCIATION OF BROOKLYN INC
205 LEXINGTON AVE - 2ND FLNEW YORKNY10016111977434DORMANT/HOME HEALTH CARENY501(C)(3)PFVISITING NURSE REGIONAL HEALTH CARE SYSTEM INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ST AGNES HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1305 NORTH STREETHAddressLine1Txt
CityWHITE PLAINSCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10605ZIPCd
FieldValueIRS element (for citing)
EIN131740121EIN
Primary ActivitiesST. AGNES HOSPITALPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTHCARE SYSTEM DBA ARCHCAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd