JAMAICA HOSPITAL NURSING HOME INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- JAMAICA HOSPITAL NURSING HOME INC (EIN 23-7216197)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202213159349304011
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-11T12:02:08-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 221478099 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COHNREZNICK LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 AVENUE OF THE AMERICAS | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10019 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237216197 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMAICA HOSPITAL NURSING HOME | BusinessNameLine1Txt |
| Business Name Line2 | COMPANY INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JAMA | BusinessNameControlTxt |
| Phone | 7182065101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 89-40 135TH STREET | AddressLine1Txt |
| City | JAMAICA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 114182898 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MOUNIR F DOSS | PersonNm |
| Person Title | EXEC. VP & CFO | PersonTitleTxt |
| Phone | 7182065101 | PhoneNum |
| Signature | 2022-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MOUNIR | PersonFirstNm |
| Person Last | DOSS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LORI ROTHE YOKOBOSKY CPA | PreparerPersonNm |
| PTIN | P01273422 | PTIN |
| Phone | 2122970400 | PhoneNum |
| Preparation | 2022-11-06 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRUMP PAVILION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MOUNIR F DOSS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 89-40 135TH STREET | AddressLine1Txt |
| City | JAMAICA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 114182898 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $34,835,286 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TRUMPPAVILION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE JAMAICA HOSPITAL NURSING HOME CO INC (THE NURSING HOME) IS A 228 BED, NOT FOR PROFIT INSTITUTION PROVIDING SKILLED NURSING CARE TO THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 292 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,172,746 | PYContributionsGrantsAmt |
| CY Contributions Grants | $764,853 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $27,561,454 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $34,014,921 | CYProgramServiceRevenueAmt |
| PY Investment Income | $46,217 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,894 | CYInvestmentIncomeAmt |
| PY Other Revenue | $46,139 | PYOtherRevenueAmt |
| CY Other Revenue | $49,618 | CYOtherRevenueAmt |
| PY Total Revenue | $29,826,556 | PYTotalRevenueAmt |
| CY Total Revenue | $34,835,286 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $19,341,250 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,779,377 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,517,090 | PYOtherExpensesAmt |
| CY Other Expenses | $15,242,249 | CYOtherExpensesAmt |
| PY Total Expenses | $34,858,340 | PYTotalExpensesAmt |
| CY Total Expenses | $34,021,626 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$5,031,784 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $813,660 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $41,197,934 | TotalAssetsBOYAmt |
| Total Assets EOY | $42,982,074 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $102,630,867 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $72,868,318 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$61,432,933 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$29,886,244 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE JAMAICA HOSPITAL NURSING HOME CO INC (THE NURSING HOME) IS A 228 BED, NOT FOR PROFIT INSTITUTION PROVIDING SKILLED NURSING CARE TO THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $30,884,831 | ExpenseAmt |
| Revenue | $34,014,921 | RevenueAmt |
| Desc | THE NURSING HOME, WHICH HAS 228 BEDS, FOCUSES ON PROVIDING SKILLED NURSING CARE AND REHABILITATION TO THE COMMUNITY. | Desc |
| Total Program Service Expenses | $30,884,831 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 94 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 292 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LISA GARCIA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7182066291 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 89-40 135TH STREET | AddressLine1Txt |
| City | JAMAICA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11418 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ANTHONY MAZZO | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ANTOIETTA MORISCO MD | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BRUCE FLANZ | ||||||||
| PRESIDENT & CEO | 2.50 | 62.50 | Yes (X) | $0 | $2,081,833 | $54,769 | Yes (X) | |
| DOUGLAS W SINGER | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GEOFFREY DOUGHLIN MD | ||||||||
| THIRD VICE PRESIDENT | 2.00 | 40.00 | Yes (X) | $0 | $512,345 | $56,163 | ||
| HON TIMOTHY J DUFFICY | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH FERRARA | ||||||||
| ASSISTANT TREASURER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH LIANA | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| NEIL FOSTER PHILLIPS | ||||||||
| CHAIRMAN | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PHILIPPA KARTERON | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT W KOOP | ||||||||
| SECOND VICE CHAIRMAN & TRE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| WALTER J COOK | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANTHONY DIMARIA | ||||||||
| SECRETARY | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MOUNIR DOSS | ||||||||
| EXEC VP & CFO | 2.50 | 62.50 | $0 | $1,456,143 | $54,769 | Yes (X) | ||
| ANGELA CZARNECKI | ||||||||
| DIRECTOR | 40.00 | $138,913 | $0 | $32,762 | Yes (X) | |||
| LISA GARCIA | ||||||||
| CONTROLLER | 40.00 | $187,446 | $0 | $52,382 | Yes (X) | |||
| MODUPE-ADEDEJI-FAJOBI | ||||||||
| DIRECTOR OF NURSING | 40.00 | $182,668 | $0 | $33,828 | Yes (X) | |||
| THOMAS YOUNGHANS | ||||||||
| VICE PRESIDENT | 40.00 | $383,078 | $0 | $54,769 | Yes (X) | |||
| MARY ELLEN PECK | ||||||||
| DIRECTOR | 40.00 | $130,700 | $0 | $32,573 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,022,805 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,050,321 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $372,015 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SODEXO | |||||
| 500 ROSS STREET 154-0455 | PITTSBURGH | PA | 15262 | FOOD SERVICES | $786,845 |
| METROPOLITAN PT OT RT SLT | |||||
| 8900 VAN WYCK EXPWY | JAMAICA | NY | 11418 | REHAB AGENCY STAFF | $299,397 |
| ARAMARK MANAGEMENT SERVICES | |||||
| 2300 WARRENVILLE ROAD | DOWNERS GROVE | IL | 60515 | HOUSEKEEPING MANAGEMENT SERVICES | $285,343 |
| REHAB ALTERNATIVE PLLC | |||||
| 125 JERICHO TURNPIKE SUITE 404 | JERICHO | NY | 11753 | REHAB AGENCY STAFF | $257,836 |
| FDR SERVICES CORP OF NEW YORK | |||||
| 44 NEWMANS COURT | HEMPSTEAD | NY | 11550 | LAUNDRY SERVICES | $219,979 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $727,572 | GovernmentGrantsAmt |
| All Other Contributions | $37,281 | AllOtherContributionsAmt |
| Total Contributions | $764,853 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SKILLED NURSING FACILITY | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $34,014,921 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,014,921 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $34,014,921 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,894 | TotalRevenueColumnAmt |
| Exclusion | $5,894 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,000 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,000 | TotalRevenueColumnAmt |
| Exclusion | $22,000 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| PARKING FACILITIES REV. | 900099 | $27,230 | $27,230 | |
| MISC. REVENUE | 900099 | $388 | $388 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $27,618 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,835,286 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,015,309 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $55,124 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,526,381 | TotalAmt |
| Program Services | $12,279,249 | ProgramServicesAmt |
| Management And General | $1,247,132 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,111,768 | TotalAmt |
| Program Services | $1,009,263 | ProgramServicesAmt |
| Management And General | $102,505 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,767,351 | TotalAmt |
| Program Services | $2,512,201 | ProgramServicesAmt |
| Management And General | $255,150 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,373,877 | TotalAmt |
| Program Services | $1,247,206 | ProgramServicesAmt |
| Management And General | $126,671 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,535 | TotalAmt |
| Program Services | $9,564 | ProgramServicesAmt |
| Management And General | $971 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,996 | TotalAmt |
| Program Services | $90,776 | ProgramServicesAmt |
| Management And General | $9,220 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,540,554 | TotalAmt |
| Program Services | $5,029,715 | ProgramServicesAmt |
| Management And General | $510,839 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,993 | TotalAmt |
| Program Services | $120,731 | ProgramServicesAmt |
| Management And General | $12,262 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,289 | TotalAmt |
| Program Services | $140,971 | ProgramServicesAmt |
| Management And General | $14,318 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $446,551 | TotalAmt |
| Program Services | $405,379 | ProgramServicesAmt |
| Management And General | $41,172 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,900 | TotalAmt |
| Program Services | $4,448 | ProgramServicesAmt |
| Management And General | $452 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,820,965 | TotalAmt |
| Program Services | $1,653,072 | ProgramServicesAmt |
| Management And General | $167,893 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,077,633 | TotalAmt |
| Program Services | $1,886,075 | ProgramServicesAmt |
| Management And General | $191,558 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $966,268 | TotalAmt |
| Program Services | $877,178 | ProgramServicesAmt |
| Management And General | $89,090 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CASH ASSESMENT | $1,518,663 | $1,378,642 | $140,021 |
| FOOD SERVICES | $1,140,191 | $1,035,065 | $105,126 |
| MEDICAL SUPPLIES | $869,402 | $789,243 | $80,159 |
| BAD DEBT | $284,702 | $258,453 | $26,249 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,607 | TotalAmt |
| Program Services | $157,600 | ProgramServicesAmt |
| Management And General | $16,007 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,021,626 | TotalAmt |
| Program Services | $30,884,831 | ProgramServicesAmt |
| Management And General | $3,136,795 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,240,386 | BOYAmt |
| EOY | $1,538,766 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,228,950 | BOYAmt |
| EOY | $4,560,773 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $801,667 | BOYAmt |
| EOY | $880,103 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $50,259,695 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,589,932 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,595,519 | BOYAmt |
| EOY | $18,669,763 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $450,000 | BOYAmt |
| EOY | $450,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,881,412 | BOYAmt |
| EOY | $16,882,669 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,197,934 | BOYAmt |
| EOY | $42,982,074 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,937,188 | BOYAmt |
| EOY | $2,348,132 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,138 | BOYAmt |
| EOY | $110,458 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,828,685 | BOYAmt |
| EOY | $32,701,235 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,736,856 | BOYAmt |
| EOY | $37,708,493 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,630,867 | BOYAmt |
| EOY | $72,868,318 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$61,432,933 | BOYAmt |
| EOY | -$29,886,244 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$61,432,933 | BOYAmt |
| EOY | -$29,886,244 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,197,934 | BOYAmt |
| EOY | $42,982,074 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $813,660 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $30,733,029 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $3,460 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $3,460 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAID LEADING AGE NY $3,460 IN LOBBYING COSTS. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $583,417 | OtherCostOrOtherBasisAmt |
| Book Value | $583,417 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $45,612,813 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,989,717 | DepreciationAmt |
| Book Value | $17,623,096 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,063,465 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,600,215 | DepreciationAmt |
| Book Value | $463,250 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,669,763 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEFERRED FINANCING COSTS | $360,412 |
| FUNDS HELD IN TRUST BY RESIDENTS | $126,321 |
| INSURANCE RECEIVABLE | $2,004,208 |
| ASSETS LIMITED TO USE | $14,391,728 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $16,882,669 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO REALTED PARTIES | $34,607,258 |
| ESTIMATED WORKERS COMP LIABILITY | $2,004,208 |
| DUE TO THIRD-PARTY PAYORS | $1,097,027 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $37,708,493 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $34,835,286 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $34,835,286 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $34,835,286 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $34,021,626 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $34,021,626 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $34,021,626 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE NURSING HOME PROVIDES BANKING SERVICES FOR OUR RESIDENTS AND MANAGE THOSE ACCOUNTS ON THEIR BEHALF. THE LIABILITY CONNECTED WITH THESE BALANCES ARE REPORTED AS FUNDS HELD IN TRUST ON THE FINANCIAL STATEMENTS. |
| PART X, LINE 2: | THE NURSING HOME QUALIFIES AS A TAX-EXEMPT, NON-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL, STATE, AND LOCAL INCOME TAXES, PURSUANT TO SECTION 501(A) OF THE CODE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRUCE FLANZ | ||||||||||||||
| PRESIDENT & CEO | $0 | $1,927,217 | $0 | $0 | $0 | $154,616 | $0 | $7,250 | $0 | $47,519 | $0 | $2,136,602 | $0 | $0 |
| MOUNIR DOSS | ||||||||||||||
| EXEC VP & CFO | $0 | $1,423,725 | $0 | $0 | $0 | $32,418 | $0 | $7,250 | $0 | $47,519 | $0 | $1,510,912 | $0 | $0 |
| GEOFFREY DOUGHLIN MD | ||||||||||||||
| THIRD VICE PRESIDENT | $0 | $512,345 | $0 | $0 | $0 | $0 | $0 | $7,250 | $0 | $48,913 | $0 | $568,508 | $0 | $0 |
| THOMAS YOUNGHANS | ||||||||||||||
| VICE PRESIDENT | $371,156 | $0 | $0 | $0 | $11,922 | $0 | $7,250 | $0 | $47,519 | $0 | $437,847 | $0 | $0 | $0 |
| LISA GARCIA | ||||||||||||||
| CONTROLLER | $187,040 | $0 | $0 | $0 | $406 | $0 | $4,863 | $0 | $47,519 | $0 | $239,828 | $0 | $0 | $0 |
| MODUPE-ADEDEJI-FAJOBI | ||||||||||||||
| DIRECTOR OF NURSING | $182,165 | $0 | $0 | $0 | $503 | $0 | $4,688 | $0 | $29,140 | $0 | $216,496 | $0 | $0 | $0 |
| ANGELA CZARNECKI | ||||||||||||||
| DIRECTOR | $138,262 | $0 | $0 | $0 | $651 | $0 | $3,591 | $0 | $29,171 | $0 | $171,675 | $0 | $0 | $0 |
| MARY ELLEN PECK | ||||||||||||||
| DIRECTOR | $130,700 | $0 | $0 | $0 | $0 | $0 | $3,402 | $0 | $29,171 | $0 | $163,273 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEDISYS HEALTH NETWORK IS THE SOLE MEMBER IN THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEDISYS HEALTH NETWORK, AS THE SOLE MEMBER CAN APPOINT THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS PREPARED BY OUTSIDE ACCOUNTANT AND REVIEWED INTERNALLY BY MANAGEMENT, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS PRESENTED TO THE TRUSTEES VIA EMAIL AND OR A BOARD MEETING. ONCE THE REVIEW OF THE FORM 990 HAS BEEN COMPLETED TO THE BOARD'S SATISFACTION, IT IS FINALIZED AND SUBSEQUENTLY FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES THAT SATISFY THE CRITERIA TO BE CONSIDERED AN "INTERESTED PERSON" IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE COMPLIANCE OFFICERS REVIEW THE SUBMISSIONS FOR CONFLICTS AND REPORTS THEM TO THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII, SECTION A, LINE 1B: | FOR BRUCE FLANZ, PRESIDENT & CEO, MOUNIR DOSS, EXECUTIVE VICE PRESIDENT & CFO, THE HOURS REPORTED BELOW REFLECT THE TOTAL TIME WORKED AS OFFICERS FOR ALL OF THE RELATED ORGANIZATIONS SHOWN ON SCHEDULE R. TOTAL COMPENSATION IS REPORTED ON EACH ENTITY'S FORM 990. COST ALLOCATION AMONG THE ENTITIES IS PERFORMED CONSISTENTLY WITH ACCOUNTING RULES AND APPLICABLE COST ALLOCATION METHODOLOGIES. ESTIMATED NUMBER OF HOURS WORKED PER WEEK FOR RELATED ORGANIZATIONS IS AS FOLLOWS: MEDISYS HEALTH NETWORK - 10 HOURS PER WEEK FLUSHING HOSPITAL MEDICAL CENTER - 15 HOURS PER WEEK JAMAICA HOSPITAL MEDICAL CENTER - 30 HOURS PER WEEK OTHER RELATED ENTITIES LISTED ON SCHEDULE R - 10.0 HOURS PER WEEK |
| FORM 990, PART IX, LINE 11G | HOSPITAL SUPPORT: PROGRAM SERVICE EXPENSES 3,860,254. MANAGEMENT AND GENERAL EXPENSES 392,064. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,252,318. PHYSICIAN AND THERAPY: PROGRAM SERVICE EXPENSES 557,742. MANAGEMENT AND GENERAL EXPENSES 56,647. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 614,389. LINEN SERVICE: PROGRAM SERVICE EXPENSES 169,070. MANAGEMENT AND GENERAL EXPENSES 17,171. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 186,241. HOUSEKEEPING SERVICES: PROGRAM SERVICE EXPENSES 267,154. MANAGEMENT AND GENERAL EXPENSES 27,133. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 294,287. CONSULTING FEES: PROGRAM SERVICE EXPENSES 148,982. MANAGEMENT AND GENERAL EXPENSES 15,131. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,113. WASTE REMOVAL: PROGRAM SERVICE EXPENSES 26,513. MANAGEMENT AND GENERAL EXPENSES 2,693. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,206. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER FROM JAMAICA HOSPITAL 30,733,029. |
| FORM 990, PART XII, LINE 2C: | THE OVERSIGHT AND SELECTION PROCESSES DID NOT CHANGE FROM THE PRIOR YEAR. |
| FORM 990, PART IV, LINE 20: | THE ORGANIZATION IS LICENSED UNDER ARTICLE 28 OF NEW YORK STATE PUBLIC HEALTH LAW. HOWEVER, SUBSECTION 10 OF ARTICLE 28 EXCLUDES CERTAIN HEALTHCARE FACILITIES FROM THE DEFINITION OF GENERAL HOSPITAL. THEREFORE, THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990 AS THEY DO NOT MEET THIS DEFINITION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCED CENTER FOR PSYCHOTHERAPY | |||||||||||
| 89-06 135TH STREET | JAMAICA | NY | 11418 | 111864871 | HEALTHCARE | NY | 501(C)(3) | LINE 10 | MEDISYS HEALTH NETWORK | 0 | |
| ALLIED HEALTH FOUNDATION OF QUEENS INC | |||||||||||
| 4500 PARSONS BLVD | FLUSHING | NY | 11355 | 112813535 | INACTIVE | NY | 501(C)(3) | LINE 12A, I | MEDISYS HEALTH NETWORK | 0 | |
| FLUSHING HOSPITAL MEDICAL CENTER | |||||||||||
| 4500 PARSONS BLVD | FLUSHING | NY | 11355 | 111631781 | HOSPITAL | NY | 501(C)(3) | LINE 3 | MEDISYS HEALTH NETWORK | 0 | |
| INTERNATIONAL ASSOCIATION OF MEDICAL BIKE UNITS INC | |||||||||||
| 8900 VAN WYCK EXPY | JAMAICA | NY | 11418 | 113483140 | INACTIVE | NY | 501(C)(3) | LINE 10 | MEDISYS HEALTH NETWORK | 0 | |
| JAMAICA HOSPITAL MEDICAL CENTER | |||||||||||
| 8900 VAN WYCK EXPY | JAMAICA | NY | 11418 | 111631788 | HEALTHCARE | NY | 501(C)(3) | LINE 3 | MEDISYS HEALTH NETWORK | 0 | |
| MEDISYS AMBULANCE SERVICE | |||||||||||
| 8900 VAN WYCK EXPY | JAMAICA | NY | 11418 | 542124788 | HEALTHCARE | NY | 501(C)(3) | LINE 10 | MEDISYS HEALTH NETWORK | 0 | |
| MEDISYS HEALTH NETWORK | |||||||||||
| 8900 VAN WYCK EXPY | JAMAICA | NY | 11418 | 113316802 | ADMIN | NY | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| THE JAMAICA HOSPITAL DIAG AND TREAT CTR | |||||||||||
| 8900 VAN WYCK EXPY | JAMAICA | NY | 11418 | 113340969 | HEALTHCARE | NY | 501(C)(3) | LINE 3 | MEDISYS HEALTH NETWORK | 0 | |
| VWE PROPERTIES CORPORATION | |||||||||||
| 8900 VAN WYCK EXPY | JAMAICA | NY | 11418 | 113485165 | PARKING GARAGE | NY | 501(C)(3) | LINE 12A, I | MEDISYS HEALTH NETWORK | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NHP HOLDINGS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 521 FIFTH AVE 3RD FLOOR | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10175 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203418837 | EIN |
| Primary Activities | HOLDING COMPANY | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| FRR RECOVERY SERVICES | |||||||||
| 80 MARCUS DRIVE | MELVILLE | NY | 11747 | 113454555 | COLLECTION AGENCY | NY | N/A | C | 0 |
| HI TECH MEDICAL EQUIPMENT | |||||||||
| 103-51 101 ST | OZONE PARK | NY | 11416 | 113313334 | DURABLE MEDICAL EQUIPMENT COMPANY/INACTIVE | NY | N/A | C | 0 |
| JAMAICA RX | |||||||||
| 8900 VAN WYCK EXPRESSWAY | JAMAICA | NY | 11418 | 205292781 | RETAIL PHARMACY | NY | N/A | C | 0 |
| MEDISYS HOME CARE SERVICE INC | |||||||||
| 8900 VAN WYCK EXPRESSWAY | JAMAICA | NY | 11418 | 030474027 | HOME CARE STAFFING/INACTIVE | NY | N/A | C | 0 |
| MEDISYS IPA | |||||||||
| 8900 VAN WYCK EXPRESSWAY | JAMAICA | NY | 11418 | 113452476 | PHYSICIAN CONTRACTING/INACTIVE | NY | N/A | C | 0 |
| MEDISYS SERVICE CORPORATION | |||||||||
| 8900 VAN WYCK EXPRESSWAY | JAMAICA | NY | 11418 | 113479920 | HOLDING COMPANY | NY | N/A | C | 0 |
| MEDISYS VENTURES | |||||||||
| 111 STEWART AVE | HICKSVILLE | NY | 11801 | 113431792 | HOLDING COMPANY | NY | N/A | C | 0 |
| MHN REALTY | |||||||||
| 8900 VAN WYCK EXPRESSWAY | JAMAICA | NY | 11418 | 113458286 | REAL ESTATE/INACTIVE | NY | N/A | C | 0 |
| SECOND CENTURY SERVICE CORPORATION | |||||||||
| 4500 PARSONS BLVD | FLUSHING | NY | 11355 | 112843101 | RETAIL PHARMACY | NY | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |