2022-10-24T08:11:43-05:00 2021-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2021-01-01 160962256 GOOD SHEPHERD-FAIRVIEW HOME INC GOOD 6077242477 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 JAMES KONISZEWSKI CFO 6077242477 2022-10-21 1 JAMES KONISZEWSKI 999009999 AMANDA L DELLA SALA P02064655 5853811000 2022-09-29 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MICHAEL J KEENAN 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 10646167 0 X WWW.GSFHOME.COM X 1969 NY THE GOOD SHEPHERD-FAIRVIEW HOME, INC. OPERATES A MULTI-LEVEL RETIREMENT COMMUNITY. ITS PURPOSE IS TO PROVIDE SUITABLE HOUSING AND HEALTH CARE FOR THE ELDERLY. 12 12 356 58 0 0 1666320 344665 10664882 9889928 3002 48242 228363 363332 12562567 10646167 0 0 0 0 7589683 7511792 0 0 0 4905702 4764000 12495385 12275792 67182 -1629625 9862430 8540087 2766535 3049216 7095895 5490871 THE GOOD SHEPHERD-FAIRVIEW HOME, INC. OPERATES A MULTI-LEVEL RETIREMENT COMMUNITY. ITS PURPOSE IS TO PROVIDE SUITABLE HOUSING AND HEALTH CARE FOR THE ELDERLY. 0 0 5468458 6168361 SKILLED NURSING FACILITY AND REHAB 2896937 3267714 ADULT CARE FACILITY 724462 817185 INDEPENDENT LIVING 9089857 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 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 0 0 0 1 27 0 1 356 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 0 1 1 1 1 1 1 1 0 NY X X JAMES KONISZEWSKI CFO 6077242477 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 JILL GILBERT DIRECTOR 0.25 0.75 X 0 0 0 KATHLEEN BUNNELL CHAIR 0.25 0.75 X X 0 0 0 ANGELO GALLO DIRECTOR 0.25 0.75 X 0 0 0 JOANN NAVARRO SECRETARY 0.25 0.75 X X 0 0 0 ROGER HALBERT DIRECTOR 0.25 0.75 X 0 0 0 JOAN LACEY DIRECTOR 0.25 0.75 X 0 0 0 TIMOTHY HYLE VICE CHAIR 0.25 0.75 X X 0 0 0 PAUL PARKER DIRECTOR 0.25 0.75 X 0 0 0 ERIC WEBSTER DIRECTOR 0.25 0.75 X 0 0 0 DAWN LANOUETTE DIRECTOR 0.25 0.75 X 0 0 0 ELSIE WAGER DIRECTOR 0.25 0.75 X 0 0 0 MARY RONEY DIRECTOR 0.25 0.75 X 0 0 0 MICHAEL KEENAN PRESIDENT & CEO 8.00 32.00 X 0 1090411 140431 PATRICIA MACKEY COO 8.00 32.00 X 0 248473 21420 JAMES KONISZEWSKI CFO 8.00 32.00 X 0 195088 18357 KATHY SWEZEY EXECUTIVE DIRECTOR 40.00 0.00 X 160965 0 24534 DAVID WATKINS HOUSE CHARGE 40.00 0.00 X 120974 0 18056 281939 1533972 222798 2 0 1 0 MEDICINE SHOPPE 4999 LOUISE DRIVE SUITE 204 MECHANICSBURG PA 17055 PHARMACY & CONSULTATION 261109 SODEXO 9801 WASHINGTON BLVD GAITHERSBURG MD 20878 DINING SERVICES 116252 2 149178 130978 64509 344665 HEALTHCARE REVENUE 623000 9032048 9032048 INDEPENDENT LIVING AND RELATED SE 623000 857880 857880 9889928 38458 38458 9784 0 9784 9784 9784 SOLD SERVICES 623000 133223 133223 GUEST MEALS 722210 71964 71964 REFUNDS 900099 69648 69648 88497 88497 363332 10646167 10253260 0 48242 160965 160965 6002079 5618622 383457 79852 79852 812103 546919 265184 456793 417035 39758 35126 35126 25240 25240 29358 28062 1296 91058 91058 339814 280929 58885 3774 2944 830 49500 49500 560713 560713 119848 5093 114755 MANAGEMENT SERVICES - R 965349 153684 811665 PURCHASED SERVICES 592185 530786 61399 FOOD 468803 450353 18450 SUPPLIES 416068 383171 32897 1067164 672259 394905 12275792 9089857 3185935 0 1483648 456086 702958 504024 276076 276076 131502 166881 23000460 18238264 5227673 4762196 309521 358554 1651151 1626000 79901 390270 9862430 8540087 718367 890368 69105 46099 1979063 2112749 2766535 3049216 X 5411002 3777130 1684893 1713741 7095895 5490871 9862430 8540087 X -1629625 49752 -25151 X X 0 1 X 1 0 X 16932 402884 2951161 1666320 344665 5381962 11078544 11201540 11179774 10664882 9889928 54014668 11095476 11604424 14130935 12331202 10234593 59396630 0 0 0 59396630 11869 50860 65782 27182 109867 265560 11869 50860 65782 27182 109867 265560 246784 332597 236577 204183 301707 1321848 11354129 11987881 14433294 12562567 10646167 60984038 0.97400 0.97710 0.00440 0.00270 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 475533 475533 10623440 7891954 2731486 7801280 6824364 976916 4100207 3521946 578261 4762196 BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 1626000 F 1626000 DEFERRED COMPENSATION LIABILITY 9801 DUE TO THIRD PARTY PAYORS 284468 RELATED PARTY DEBT 1759715 RESIDENT DEPOSITS 58765 2112749 10670768 49752 -25151 24601 10646167 0 10646167 12275792 0 12275792 0 12275792 PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION -25,151. 0 1 0 0 0 0 0 0 0 MICHAEL KEENAN PRESIDENT & CEO 0 363683 0 33768 0 692960 0 119500 0 20931 0 1230842 0 0 PATRICIA MACKEY COO 0 210791 0 37682 0 0 0 13849 0 7571 0 269893 0 0 JAMES KONISZEWSKI CFO 0 195088 0 0 0 0 0 10836 0 7521 0 213445 0 0 KATHY SWEZEY EXECUTIVE DIRECTOR 145540 0 15425 0 0 0 9315 0 15219 0 185499 0 0 0 PART I, LINE 4B CERTAIN OFFICERS AND DIRECTORS OF GOOD SHEPHERD-FAIRVIEW HOME, INC. PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIRMENT PLAN PROVIDED BY FGS, INC., A RELATED IRC SECTION 501(C)(3) ORGANIZATION. FGS, INC. DEPOSITED $100,000 INTO A 457(F) PLAN AND $19,500 INTO A 457(B) PLAN IN 2021 FOR MICHAEL KEENAN, PRESIDENT & CEO. FORM 990, PART VI, SECTION B, LINE 11B REVIEWED BY OPERATIONS COMMITTEE OF FGS, INC. D/B/A GOOD SHEPHERD COMMUNITIES FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST DISCLOSURES ARE UPDATED ANNUALLY WITH MEMBERS. ANY CONFLICT IS REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 CEO COMPENSATION IS DETERMINED BY THE BOD EXECUTIVE COMMITTEE WITH COO PROVIDING MARKET SURVEY DATA. AN OUTSIDE CONSULTANT WAS HIRED TO REVIEW COMPENSATION AND FOUND IT TO BE COMPETITIVE. CEO IS UNDER MULTIPLE YEAR WRITTEN CONTRACT. CEO DETERMINES COMPENSATION OF ALL SENIOR MANAGEMENT POSITIONS WITH MARKET SURVEY DATA PROVIDED BY AN OUTSIDE CONSULTANT. FORM 990, PART VI, SECTION C, LINE 18 FORM 990 IS AVAILABLE BY REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, ETC. ARE AVAILABLE BY REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION -25,151. FORM 990, PART XII, LINE 2(C): NO CHANGE FROM PRIOR YEAR. GOOD SHEPHERD-FAIRVIEW FOUNDATION INC 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 133386383 TO PROVIDE FINANCIAL SUPPORT FOR AFFILIATED COMPANIES NY 501(C)(3) LINE 7 FGS DBA GOOD SHEPHERD COMMUNITIES 0 GOOD SHEPHERD VILLAGE AT ENDWELL INC 32 VILLAGE DRIVE ENDWELL NY 13760 205580506 TO PROVIDE A CONTINUING CARE RETIREMENT COMMUNITY FOR THE ELDERY NY 501(C)(3) LINE 10 FGS DBA GOOD SHEPHERD COMMUNITIES 0 FGS DBA GOOD SHEPHERD COMMUNITIES 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 161256975 TO PROVIDE SUITABLE HOUSING TO THE ELDERLY NY 501(C)(3) LINE 12C, III-FI N/A 0 CHASE MEMORIAL NURSING HOME COMPANY INC ONE TERRACE HEIGHTS NEW BERLIN NY 13411 160977850 LONG TERM HEALTH CARE FOR ELDERLY NY 501(C)(3) LINE 10 FGS DBA GOOD SHEPHERD COMMUNITIES 0 CHASE HOUSING CORPORATION ONE TERRACE HEIGHTS NEW BERLIN NY 13411 161080510 HOUSING COMPLEX FOR THE ELDERLY AND HANDICAPPED NY 501(C)(3) LINE 10 FGS DBA GOOD SHEPHERD COMMUNITIES 0 CHASE MEMORIAL COMMUNITY CENTER INC ONE TERRACE HEIGHTS NEW BERLIN NY 13411 150539044 SUPPORT OF HEALTH CARE/ELDERLY SERVICES NY 501(C)(3) LINE 10 FGS DBA GOOD SHEPHERD COMMUNITIES 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0