2022-10-24T08:12:05-05:00 2021-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2021-01-01 205580506 GOOD SHEPHERD VILLAGE AT ENDWELL INC GOOD 6077573100 32 VILLAGE DRIVE ENDWELL NY 13760 JAMES KONISZEWSKI CFO 6077573100 2022-10-21 1 JAMES KONISZEWSKI 999009999 AMANDA L DELLA SALA P02064655 5853811000 2022-10-10 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MICHAEL J KEENAN 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 15180205 0 X WWW.GSVILLAGE.COM X 2006 NY A CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES INDEPENDENT LIVING, ASSISTED LIVING AND SKILLED NURSING FOR THE ELDERLY. 12 12 318 12 0 0 1383866 39454 14526804 14966721 58572 55875 33670 118155 16002912 15180205 0 0 0 0 5940175 6434029 0 0 0 7785008 8169186 13725183 14603215 2277729 576990 61231079 76298914 71365934 87169843 -10134855 -10870929 X A CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES INDEPENDENT LIVING, ASSISTED LIVING AND SKILLED NURSING FOR THE ELDERLY. 0 0 4525778 8502224 HEALTH CARE CENTER 4525777 6464497 INDEPENDENT LIVING 118155 OTHER PROGRAM SERVICES RELATED TO THE ORGANIZATION'S MISSION. 118155 9051555 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 35 0 1 318 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 ERIC WEBSTER DIRECTOR 0.25 0.75 X 0 0 0 TIMOTHY HYLE VICE CHAIR 0.25 0.75 X X 0 0 0 DAWN LANOUETTE DIRECTOR 0.25 0.75 X 0 0 0 MARY RONEY DIRECTOR 0.25 0.75 X 0 0 0 PAUL PARKER DIRECTOR 0.25 0.75 X 0 0 0 ELSIE WAGNER 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 0 1533972 180208 0 0 1 0 SODEXO 9801 WASHINGTON BLVD GAITHERSBURG MD 20878 DINING SERVICES 402429 MEDICINE SHOPPE 4999 LOUISE DRIVE STE 204 MECHANICSBURG PA 17055 DRUGS AND CONSULTANT 112409 2 33575 5879 39454 RESIDENT SERVICES 623000 8502224 8502224 INDEPENDENT LIVING REVENUE 623000 6044591 6044591 RESIDENCY FEES 623000 419906 419906 14966721 55875 55875 OTHER OPERATING REVENUE 900099 91580 91580 OTHER INCOME 900099 26575 26575 118155 15180205 15084876 0 55875 5337787 4856444 481343 42988 42988 654849 353936 300913 398405 363214 35191 11022 11022 103374 103374 88978 88978 573042 446883 126159 33351 32205 1146 1159782 1159782 1835861 1835861 137516 17795 119721 MANAGEMENT SERVICES- RE 1179121 187716 991405 SUPPLIES AND OTHER 989114 865633 123481 PURCHASED SERVICES 851322 797405 53917 FOOD 608024 608024 598679 418926 179753 14603215 9051555 5551660 0 10783022 10892670 380802 438941 1833828 1759715 135680 133275 202746 166263 59247521 22198731 38429156 37048790 8656085 24715034 704231 674579 105529 469647 61231079 76298914 662932 901507 2362798 2852641 38807202 55429611 29533002 27986084 71365934 87169843 X -10134855 -10870929 -10134855 -10870929 61231079 76298914 X 576990 -1313064 X X 0 1 X 1 0 X 6427 15400 25304 1383866 39454 1470451 14131424 14095023 14319503 14526804 14966721 72039475 14137851 14110423 14344807 15910670 15006175 73509926 0 0 0 73509926 21550 49510 33670 33670 26575 164975 21550 49510 33670 33670 26575 164975 91580 91580 14159401 14159933 14378477 15944340 15124330 73766481 0.99650 0.99780 0.00220 0.00220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 970283 970283 47414129 16638818 30775311 3721569 3033407 688162 7141540 2526506 4615034 37048790 ASSETS WHOSE USE IS LIMITED 24715034 F 24715034 DEPOSITS ON UNOCCUPIED UNITS 227643 REFUNDABLE RESIDENCY FEES 27757000 RESIDENT DEPOSITS 1441 27986084 15180205 0 15180205 0 15180205 15916279 1313064 1313064 14603215 0 14603215 PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DEBT REFINANCING 1,313,064. 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 PART I, LINE 4B CERTAIN OFFICERS AND DIRECTORS OF GOOD SHEPHERD VILLAGE AT ENDWELL, 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. A BROOME COUNTY LOCAL DEVELOPMENT CORPORATION 300769309 114731BE1 2021-12-08 56677714 TO ADVANCE REFUND SERIES 2015 BONDS AND PROVIDE FUNDS TO RENOVATE VILLAGE 0 0 0 A 56677714 3229000 37089931 1075270 15000000 283513 2021 1 0 1 1 A 0 0 0 0 1 0 0 0 0 A 0 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: LOSS ON DEBT REFINANCING -1,313,064. FORM 990, PART XII, LINE 2(C): NO CHANGES FROM PRIOR YEAR. GOOD SHEPHERD-FAIRVIEW HOME INC 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 160962256 TO PROVIDE SUITABLE HOUSING AND HEALTH CARE FOR THE ELDERLY NY 501(C)(3) LINE 10 FGS DBA GOOD SHEPHERD COMMUNITIES 0 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 FGS INC DBA GOOD SHEPHERD COMMUNITIES 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 161256975 TO PROVIDE SUITABLE HOUSING AND HEALTH CARE FOR 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