HOOSICK FALLS HEALTH CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HOOSICK FALLS HEALTH CENTER (EIN 14-1370000)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202243189349318499
- 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 | 2022-11-14T18:08:49-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271728945 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PKF O'CONNOR DAVIES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MAMARONECK AVENUE SUITE 301 | AddressLine1Txt |
| City | HARRISON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 105281633 | 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 | 141370000 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOOSICK FALLS HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOOS | BusinessNameControlTxt |
| Phone | 5186864371 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 21 DANFORTH STREET | AddressLine1Txt |
| City | HOOSICK FALLS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12090 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN MAJETICH | PersonNm |
| Person Title | TREASURER & CFO | PersonTitleTxt |
| Phone | 5186864371 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEPHEN | PersonFirstNm |
| Person Last | MAJETICH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GARRETT M HIGGINS | PreparerPersonNm |
| PTIN | P00543209 | PTIN |
| Phone | 9143818900 | PhoneNum |
| Preparation | 2022-11-14 | 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 | CENTER FOR NURSING AND REHABILITATION AT | BusinessNameLine1Txt |
| Business Name Line2 | HOOSICK FALLS | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GREGORY LAURIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 21 DANFORTH STREET | AddressLine1Txt |
| City | HOOSICK FALLS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12090 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,084,654 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NURSINGANDREHAB.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1914 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE CENTERS MISSION IS TO PROVIDE REHABILITATION AND LONG-TERM CARE SERVICES TO THOSE IN NEED. WE STRIVE TO PROVIDE RESIDENT CENTERED CARE IN OUR 82 BED SKILLED NURSING FACILITY SO THAT EACH RESIDENT HAS THE OPPORTUNITY TO REACH THEIR MAXIMUM POTENTIAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 188 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $837,264 | PYContributionsGrantsAmt |
| CY Contributions Grants | $167,834 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,209,239 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,906,621 | CYProgramServiceRevenueAmt |
| PY Investment Income | $778 | PYInvestmentIncomeAmt |
| CY Investment Income | $298 | CYInvestmentIncomeAmt |
| PY Other Revenue | $79,337 | PYOtherRevenueAmt |
| CY Other Revenue | $9,901 | CYOtherRevenueAmt |
| PY Total Revenue | $7,126,618 | PYTotalRevenueAmt |
| CY Total Revenue | $6,084,654 | 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 | $5,324,352 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,984,277 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,887,752 | PYOtherExpensesAmt |
| CY Other Expenses | $3,178,823 | CYOtherExpensesAmt |
| PY Total Expenses | $8,212,104 | PYTotalExpensesAmt |
| CY Total Expenses | $8,163,100 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,085,486 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,078,446 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,281,403 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,877,210 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,413,159 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,082,508 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,131,756 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$3,205,298 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE ARE AN 82 BED SKILLED NURSING HOME FACILITY PROVIDING 24 HR/7 DAYS A WEEK HEALTH CARE TO THOSE IN NEED IN A HOME LIKE ATMOSPHERE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,938,736 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $5,906,621 | RevenueAmt |
| Desc | HOOSICK FALLS HEALTH CENTER FOCUSES ON DEVELOPING, MANAGING, AND OPERATING NURSING HOME CARE IN THE HOOSICK FALLS, NEW YORK AREA AND PROVIDING SERVICES TO THE COMMUNITY. THE ORGANIZATION SPECIALIZES IN LONG-TERM CARE AND REHABILITATION SERVICES, AND PROVIDES GREAT NURSING CARE, GOOD FOOD AND FRIENDLY AND HELPFUL PEOPLE, AND A SUPPORTING AND CARING ENVIRONMENT. THE HOOSICK FALLS HEALTH CENTER HAS 82 SKILLED NURSING BEDS. DURING THE YEAR, THE TOTAL PATIENT/RESIDENT DAYS WERE 21,621. | Desc |
| Total Program Service Expenses | $6,938,736 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 10 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 188 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | Yes (1) | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHEN MAJETICH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8024474587 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 21 DANFORTH STREET | AddressLine1Txt |
| City | HOOSICK FALLS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12090 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| STEPHEN D MAJETICH | |||||||
| TREASURER & CFO | 1.00 | 46.15 | Yes (X) | Yes (X) | $0 | $529,249 | $89,533 |
| GREGORY LAURIN | |||||||
| PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| WILLIAM KOESTER | |||||||
| VICE PRESIDENT | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOYCE DAVIS | |||||||
| SECRETARY | 1.00 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PATTY RYAN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BILL COTTRELL | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KEN FACIN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SUZANNE ANAIR | |||||||
| ADMINISTRATOR | 40.00 | 40.00 | Yes (X) | $117,994 | $99,843 | $32,582 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $117,994 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $629,092 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $122,115 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL SOLUTIONS LLC | |||||
| PO BOX 310737 | DES MOINES | IA | 50331 | STAFFING AGENCY | $305,043 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 829864 | PITTSBURGH | PA | 19182 | COVID-19 TESTING SERVICES | $211,610 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $23,290 | RelatedOrganizationsAmt |
| Government Grants | $121,749 | GovernmentGrantsAmt |
| All Other Contributions | $22,795 | AllOtherContributionsAmt |
| Total Contributions | $167,834 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID REVENUE | 623000 | $3,754,795 | $3,754,795 |
| PRIVATE PATIENT REVENU | 623000 | $1,216,693 | $1,216,693 |
| MEDICARE REVENUE | 623000 | $935,133 | $935,133 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,906,621 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $298 | TotalRevenueColumnAmt |
| Exclusion | $298 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,600 | 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 | $6,600 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,600 | TotalRevenueColumnAmt |
| Exclusion | $6,600 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER INCOME | 900099 | $2,060 | $2,060 |
| RECOVERY OF BAD DEBT | 900099 | $1,241 | $1,241 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,301 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,084,654 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,906,621 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,199 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,940 | TotalAmt |
| Program Services | $124,506 | ProgramServicesAmt |
| Management And General | $11,434 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,971,274 | TotalAmt |
| Program Services | $3,634,845 | ProgramServicesAmt |
| Management And General | $336,429 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,135 | TotalAmt |
| Program Services | $84,276 | ProgramServicesAmt |
| Management And General | $7,859 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,488 | TotalAmt |
| Program Services | $324,270 | ProgramServicesAmt |
| Management And General | $30,218 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,440 | TotalAmt |
| Program Services | $393,748 | ProgramServicesAmt |
| Management And General | $36,692 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,675 | TotalAmt |
| Management And General | $9,675 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,282 | TotalAmt |
| Management And General | $131,282 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,959 | TotalAmt |
| Management And General | $2,959 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,225,994 | TotalAmt |
| Program Services | $849,206 | ProgramServicesAmt |
| Management And General | $376,788 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,066 | TotalAmt |
| Management And General | $2,066 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $502,711 | TotalAmt |
| Program Services | $396,240 | ProgramServicesAmt |
| Management And General | $106,471 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,908 | TotalAmt |
| Program Services | $180 | ProgramServicesAmt |
| Management And General | $78,728 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,332 | TotalAmt |
| Program Services | $186,683 | ProgramServicesAmt |
| Management And General | $10,649 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,994 | TotalAmt |
| Program Services | $2,101 | ProgramServicesAmt |
| Management And General | $9,893 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,309 | TotalAmt |
| Program Services | $457,309 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,207 | TotalAmt |
| Management And General | $73,207 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| NY CASH RECEIPT ASSMT. | $280,555 | $280,555 | |
| REPAIRS AND MAINTENANCE | $147,113 | $147,099 | $14 |
| PHARMACEUTICALS | $55,525 | $55,525 | |
| STAFF DEVELOPMENT | $2,193 | $2,193 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,163,100 | TotalAmt |
| Program Services | $6,938,736 | ProgramServicesAmt |
| Management And General | $1,224,364 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $357,515 | BOYAmt |
| EOY | $333,746 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,087 | BOYAmt |
| EOY | $83,795 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,885 | BOYAmt |
| EOY | $524,634 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,398 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,295 | BOYAmt |
| EOY | $26,557 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,577,997 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,814,662 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,123,084 | BOYAmt |
| EOY | $3,763,335 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,139 | BOYAmt |
| EOY | $145,143 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,281,403 | BOYAmt |
| EOY | $4,877,210 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,136,536 | BOYAmt |
| EOY | $1,637,980 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,087 | BOYAmt |
| EOY | $83,795 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $946 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,205,590 | BOYAmt |
| EOY | $6,360,733 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,413,159 | BOYAmt |
| EOY | $8,082,508 | 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 | -$1,205,158 | BOYAmt |
| EOY | -$3,283,604 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,402 | BOYAmt |
| EOY | $78,306 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,131,756 | BOYAmt |
| EOY | -$3,205,298 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,281,403 | BOYAmt |
| EOY | $4,877,210 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,078,446 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $4,904 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $25,520 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,811,091 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,314,630 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $837,264 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $167,834 | CurrentTaxYearAmt |
| Total | $5,156,339 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,326,025 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,894,979 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,589,604 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,209,239 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,906,621 | CurrentTaxYearAmt |
| Total | $30,926,468 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,351,545 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,706,070 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,904,234 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,046,503 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,074,455 | CurrentTaxYearAmt |
| Total | $36,082,807 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $36,082,807 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,434 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,248 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,916 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,378 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,898 | CurrentTaxYearAmt |
| Total | $40,874 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,434 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,248 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,916 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,378 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,898 | CurrentTaxYearAmt |
| Total | $40,874 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $141,900 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,762 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $52,759 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,737 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,301 | CurrentTaxYearAmt |
| Total | $326,459 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,504,879 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,770,080 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,963,909 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,126,618 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,084,654 | CurrentTaxYearAmt |
| Total | $36,450,140 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98990 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98980 | PublicSupportPY509Pct |
| Investment Income CY | 0.00110 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00130 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | RECOVERY OF BAD DEBT EXPENSE - 2020 AMOUNT: $ 70,268. 2021 AMOUNT: $ 1,241. OTHER INCOME - 2017 AMOUNT: $ 11,170. 2018 AMOUNT: $ 55,762. 2019 AMOUNT: $ 52,759. 2020 AMOUNT: $ 2,469. 2021 AMOUNT: $ 2,060. LOAN FORGIVENESS - 2017 AMOUNT: $ 130,730. | ExplanationTxt |
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 |
| Media Advertisements | $0 | MediaAdvertisementsAmt |
| Mailings Members | 0 | MailingsMembersInd |
| Mailings Members | $0 | MailingsMembersAmt |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Publications Or Broadcast | $0 | PublicationsOrBroadcastAmt |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $0 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Rallies Demonstrations | $0 | RalliesDemonstrationsAmt |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,959 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,959 | 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 | AMOUNTS REPORTED ON LINE 1I REPRESENTS THE PORTION OF MEMBERSHIP DUES, PAID BY THE ORGANIZATION TO TRADE OR PROFESSIONAL ASSOCIATIONS, ATTRIBUTABLE TO LOBBYING ACTIVITIES. | 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 | $60,499 | OtherCostOrOtherBasisAmt |
| Book Value | $60,499 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,433,077 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,131,124 | DepreciationAmt |
| Book Value | $1,301,953 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,493,011 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,146,820 | DepreciationAmt |
| Book Value | $2,346,191 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $591,410 | OtherCostOrOtherBasisAmt |
| Depreciation | $536,718 | DepreciationAmt |
| Book Value | $54,692 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,763,335 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTY PAYORS | $249,786 |
| DUE TO FOUNDATION | $29,273 |
| ESTIMATED INSURANCE LIABILITIES | $113,104 |
| DUE TO AFFILIATES | $5,968,570 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,360,733 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $6,094,309 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $9,655 | OtherRevenueAmt |
| Revenue Not Reported | $9,655 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,084,654 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,084,654 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,170,524 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $7,424 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $7,424 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,163,100 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,163,100 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | RESIDENTS' FUNDS ARE HELD BY THE HEALTH CENTER ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE HEALTH CENTER FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE HEALTH CENTER AT THE REQUEST OF, OR ON BEHALF OF, RESIDENTS FOR THEIR PERSONAL USE. |
| PART X, LINE 2: | THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2018. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | REVENUE ATTRIBUTED TO AFFILIATE 4,751. CHANGE IN VALUE OF BENEFICIAL INTEREST IN TRUST 4,904. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES ATTRIBUTED TO AFFILIATE 7,424. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEPHEN D MAJETICH | ||||||||||||||
| TREASURER & CFO | $0 | $329,910 | $0 | $115,525 | $0 | $83,814 | $0 | $50,817 | $0 | $38,716 | $0 | $618,782 | $0 | $34,127 |
| SUZANNE ANAIR | ||||||||||||||
| ADMINISTRATOR | $111,770 | $99,678 | $6,000 | $0 | $224 | $165 | $3,610 | $3,046 | $14,336 | $11,590 | $135,940 | $114,479 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | STEPHEN D. MAJETICH, PARTICIPATED IN NONQUALIFIED DEFERRED COMPENSATION PLAN DESCRIBED 457(F) SPONSORED BY A RELATED TAX-EXEMPT ENTITY, SOUTHWESTERN VERMONT MEDICAL CENTER. DURING THE YEAR, $45,000 WAS CONTRIBUTED TO THE PLAN. ADDITIONALLY, HE RECEIVED A DISTRIBUTION FROM THE PLAN IN THE AMOUNT OF $34,127. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CENTER IS SVHC - HOOSICK FALLS LLC, A SINGLE MEMBER LLC OF SOUTHWESTERN VERMONT HEALTH CARE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER HAS THE POWER TO APPOINT, FIX THE NUMBER OF, AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER HAS THE POWER TO: (1) APPROVE, INTERPRET AND CHANGE THE STATEMENT OF MISSION AND PHILOSOPHY ADOPTED BY THE CORPORATION AND TO REQUIRE THAT THE CORPORATION OPERATE IN CONFORMANCE WITH ITS MISSION AND PHILOSOPHY; (2) APPROVE AND AMEND THE BYLAWS AND CERTIFICATE OF INCORPORATION OF THE CORPORATION; (3) APPROVE ANY PLAN OF MERGER, CONSOLIDATION, DISSOLUTION OR REORGANIZATION OF THE CORPORATION OR ANY SALE, LEASE OR OTHER DISPOSITION OF ALL OF SUBSTANTIALLY ALL OF THEIR ASSETS; (4) ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND/OR THE ADMINISTRATOR OF THE NURSING HOME IF OTHER THAN THE CEO; (5) TO APPROVE THE DEBT OF THE CORPORATION, IN EXCESS OF AN AMOUNT TO BE FIXED FROM TIME TO TIME BY THE CORPORATION, EXCEPT FOR DEBT NECESSARY TO FINANCE THE COST OF COMPLIANCE WITH OPERATIONAL OR PHYSICAL PLAN STANDARDS REQUIRED BY LAW; (6) TO APPROVE THE SALE, ACQUISITION, LEASE, TRANSFER, MORTGAGE, PLEDGE OR OTHER ALIENATION OF REAL OR PERSONAL PROPERTY OF THE CORPORATION IN EXCESS OF AN AMOUNT TO BE FIXED FROM TIME TO TIME BY THE BOARD OF MANAGERS OF THE MEMBER; (7) TO APPROVE THE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION TO ENSURE THAT SUCH BUDGETS CONFORM TO THE MISSION AND PHILOSOPHY OF THE CORPORATION; (8) TO APPROVE SETTLEMENTS OF LITIGATION WHEN SUCH SETTLEMENTS EXCEED APPLICABLE INSURANCE COVERAGE OR THE AMOUNT OF ANY APPLICABLE SELF-INSURANCE FUND; (9) TO APPROVE ANY CORPORATE REORGANIZATION OF THE CORPORATION AND THE DEVELOPMENT OR DISSOLUTION OF ANY SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; (10) TO APPROVE THE STRATEGIC PLAN OF THE CORPORATION, PROVIDED THAT SUCH RIGHT OF APPROVAL SHALL NOT PERMIT THE CORPORATION TO EXERCISE ANY OF THE GOVERNANCE AUTHORITY UNDER APPLICABLE REGULATIONS UNLESS THE CORPORATION HAS RECEIVED ESTABLISHMENT APPROVAL FROM THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL; (11) TO APPROVE ANY APPLICATION TO THE NEW YORK STATE DEPARTMENT OF HEALTH BY THE CORPORATION FOR A CERTIFICATE OF NEED; (12) TO APPROVE ANY FINAL SETTLEMENT BY THE CORPORATION RELATED TO MEDICAID OR ANY OTHER PAYOR AUDITS; AND (13) TO APPROVE ANY RATE APPEALS TO BE INITIATED BY THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION 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 FOR APPROVAL. ONCE THE BOARD HAS APPROVED THE RETURN IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH EMPLOYEE AND BOARD MEMBER HAS A RESPONSIBILITY AT ALL TIMES TO PROMOTE THE BEST INTERESTS OF THE CENTER FOR NURSING AND REHABILITATION AT HOOSICK FALLS. A CONFLICT OF INTEREST OCCURS WHEN AN EMPLOYEE'S JUDGMENT IN ACTING FOR THE FACILITY IS ADVERSELY AFFECTED. EXAMPLES OF CONFLICTS OF INTEREST INCLUDE BUT ARE NOT LIMITED TO: - ACCEPTING GRATUITIES FROM OTHER COMPANIES OR INDIVIDUALS WHO DO BUSINESS WITH THIS FACILITY OR SEEK TO DO BUSINESS WITH IT. - RENDERING SERVICES TO COMPETITORS. - USING, FACILITATING, CONVEYING, OR PERMITTING OTHERS TO USE FACILITY DOCUMENTS, EQUIPMENT, CONFIDENTIAL INFORMATION OR TRADE SECRETS. - BENEFITING PERSONALLY FROM ANY PURCHASES OR SALES BY THIS FACILITY. - ENGAGING IN OTHER EMPLOYMENT TO THE DETRIMENT OF THE EMPLOYEE'S WORK FOR THE FACILITY. ANNUALLY, ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM REPORTING ANY POTENTIAL CONFLICT OF INTERESTS. IF ONE BELIEVES A CONFLICT OF INTEREST EXISTS THE INDIVIDUAL MUST CONSULT THEIR SUPERVISOR, DEPARTMENT MANAGER, OR ADMINISTRATOR IN WHICH THE DETERMINATION OF WHETHER A CONFLICT EXISTS WILL BE MADE AND REVIEWED. ENGAGEMENT IN ANY BUSINESS PRACTICES THAT COMPROMISE THE FACILITY IN ANY WAY MAY RESULT IN THE IMMEDIATE TERMINATION OF ANY AND ALL EMPLOYEES INVOLVED IN SUCH ACTIVITY, AND MAY BE GROUNDS FOR LEGAL ACTION AGAINST THOSE EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST AT 21 DANFORTH STREET, HOOSICK FALLS, NY 12090 OR BY CALLING THE ORGANIZATION DIRECTLY AT 518-686-4371. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN & NURSING PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 543,835. MANAGEMENT AND GENERAL EXPENSES 376,788. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 920,623. COVID TESTING: PROGRAM SERVICE EXPENSES 174,089. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 174,089. CONSULTANTS: PROGRAM SERVICE EXPENSES 36,203. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,203. CONTINUING EDUCATION SERVICES: PROGRAM SERVICE EXPENSES 1,362. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,362. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 93,717. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,717. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN TRUST 4,904. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HOOSICK FALLS HEALTH CENTER FOUNDATION INC | |||||||||||
| 21 DANFORTH STREET | HOOSICK FALLS | NY | 12090 | 223186959 | SUPPORT THE OPERATIONS OF THE HOOSICK FALLS HEALTH CENTER, INC. | NY | 501(C)(3) | LINE 7 | HOOSICK FALLS HEALTH CENTER INC | Yes (1) | |
| SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | |||||||||||
| 100 HOSPITAL DRIVE | BENNINGTON | VT | 05201 | 030179435 | HOSPITAL | VT | 501(C)(3) | LINE 3 | 0 | N/A | |
| SOUTHWESTERN VT HEALTH CARE FOUNDATION | |||||||||||
| 100 HOSPITAL DRIVE | BENNINGTON | VT | 05201 | 453362785 | FUNDRAISING | VT | 501(C)(3) | LINE 12A, I | SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | 0 | |
| SOUTHWESTERN VERMONT MEDICAL CENTER | |||||||||||
| 100 HOSPITAL DRIVE | BENNINGTON | VT | 05201 | 222563241 | HOSPITAL | VT | 501(C)(3) | LINE 3 | SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | 0 | |
| MOUNT ANTHONY HOUSING CORPORATION | |||||||||||
| 100 HOSPITAL DRIVE | BENNINGTON | VT | 05201 | 030279740 | NURSING HOME | VT | 501(C)(3) | LINE 10 | SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | 0 | |
| TWIN RIVERS MEDICAL PC | |||||||||||
| 2 SUNRISE DRIVE | HOOSICK FALLS | NY | 12090 | 473028931 | HEALTHCARE | NY | 501(C)(3) | LINE 10 | SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | 0 | |
| NORTHERN BERKSHIRE MEDICAL PC | |||||||||||
| 375 MAIN STREET | WILLIAMSTOWN | MA | 01267 | 814023607 | HEALTHCARE | MA | 501(C)(3) | LINE 10 | SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | 0 | |
| SOUTHWESTERN VERMONT HEALTH CARE AUXILIARY | |||||||||||
| 100 HOSPITAL DRIVE | BENNINGTON | VT | 05201 | 222563243 | TO SERVE AND ASSIST SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | VT | 501(C)(3) | LINE 10 | SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHWESTERN VT HEALTH CARE ENTERPRISES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 HOSPITCAL DRIVE | AddressLine1Txt |
| City | BENNINGTON | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030314501 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | 0 | 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 |