2021-11-12T13:54:05-06:00 2020-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2020-01-01 223240227 THE HIGHLANDS LIVING CENTER INC HIGH 5853890988 500 HAHNEMANN TRAIL PITTSFORD NY 14534 CARRIE FULLER-SPENCER ASSOCIATE VP & CFO 5853890988 2021-11-10 1 CARRIE FULLER-SPENCER 999009999 SAM PITTS P01521839 5853811000 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CARRIE FULLER-SPENCER 500 HAHNEMANN TRAIL PITTSFORD NY 14534 14994756 0 X WWW.HIGHLANDSATPITTSFORD.ORG/THE-LIVING-CENTER/ X 1997 NY TO PROVIDE A CARING, COMPASSIONATE AND QUALITY-FOCUSED LIVING ENVIRONMENT IN A 122 BED SKILLED-NURSING FACILITY. 10 7 313 7 0 0 5845 2684748 13138886 12217297 0 0 18878 92711 13163609 14994756 0 0 0 0 9939767 9130856 0 0 0 4694359 5375664 14634126 14506520 -1470517 488236 7649331 7198290 11457126 10272171 -3807795 -3073881 TO PROVIDE A CARING, COMPASSIONATE AND QUALITY-FOCUSED LIVING ENVIRONMENT IN A 122 BED SKILLED-NURSING FACILITY. 0 0 13598610 12137621 OPERATE A 122 BED SKILLED-NURSING FACILITY AT 94.63% OCCUPANCY WITH 41,031 NUMBER OF DAYS SERVED. 182025 79676 OPERATE A 20 SLOT ADULT DAY CARE MEDICAL PROGRAM FOR RESIDENTS OF THE SURROUNDING COMMUNITY WITH 806 NUMBER OF DAYS SERVED. 13780635 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 313 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JUDY SEIER 5853890988 500 HAHNEMANN TRAIL PITTSFORD NY 14534 MICHAEL P RIORDAN BOARD CHAIR 1.00 X X 0 0 0 ELIZABETH GARRETT BOARD MEMBER 1.00 X 0 0 0 WILLIAM J HALL MD BOARD MEMBER 1.00 X 0 3920 0 ROBERT LATELLA BOARD MEMBER 1.00 X 0 0 0 ROBBIE MAGEE BOARD MEMBER 1.00 X 0 0 0 GERALD VAN STRYDONK BOARD MEMBER 1.00 X 0 0 0 JAMES MOORE BOARD MEMBER 1.00 X 0 0 0 ROBERT MCCANN MD BOARD MEMBER 1.00 60.00 X 0 590034 47667 VALERIE C BENJAMIN BOARD MEMBER 1.00 X 0 0 0 KATHLEEN PARRINELLO BOARD MEMBER 1.00 68.00 X 0 738110 100121 STEVEN I GOLDSTEIN PRESIDENT 1.00 70.00 X 0 1352695 336816 CARRIE FULLER-SPENCER ASSOCIATE VP & CFO 1.00 63.00 X 0 413502 59772 ELISA CHAMBRY ADMINISTRATOR 45.00 X 140902 0 22413 ADAM ANOLIK FORMER EXECUTIVE VP & CFO 1.00 63.00 X 0 655895 108478 140902 3754156 675267 1 1 1 0 MEDLINE INDUSTRIES INC PO BOX 382075 PITTSBURGH PA 15251 SUPPLIES 418481 SYSCO FOOD SERVICES PO BOX 80 WARNERS NY 13164 FOOD 354124 RELIANT STAFFING SYSTEMS PO BOX 412058 BOSTON MA 02241 TEMP. SERVICES 294823 MEDICAL STAFFING NETWORK 95 CANAL LANDING BLVD ROCHESTER NY 14626 TEMP. SERVICES 144609 AID TO HOSPITALS INC 45 MCKEE RD ROCHESTER NY 14611 LINEN 125236 6 2680537 4211 2684748 RESIDENT SERVICE REVENUE 900099 12217297 12217297 12217297 OTHER REVENUE 900099 92711 92711 92711 14994756 12310008 0 0 7594025 7366205 227820 60107 58304 1803 895781 868907 26874 580943 563515 17428 40808 40808 22445 22445 11050 11050 192309 173078 19231 310727 279654 31073 1154 1039 115 62375 62375 400955 360860 40095 46761 42085 4676 NON-MEDICAL SUPPLIES 942462 848216 94246 MEDICAL CARE ITEMS 926513 926513 TEMP AGENCY 701883 701883 CONTRACT SERVICES 679041 553195 125846 1037181 1037181 14506520 13780635 725885 0 476767 331414 284016 2090757 1765308 45095 91033 16515089 12486667 4029154 4028422 1007558 698097 7649331 7198290 650998 1159493 237934 10806128 8874744 11457126 10272171 X -3807795 -3073881 -3807795 -3073881 7649331 7198290 X 488236 245678 X X 0 1 X 1 0 X 12620 17968 6546 5845 2684748 2727727 12742527 13062590 13280235 13138886 12217297 64441535 12755147 13080558 13286781 13144731 14902045 67169262 0 0 0 67169262 49377 38891 39765 128033 49377 38891 39765 128033 51 155 385 18878 92711 112180 12804575 13119604 13326931 13163609 14994756 67409475 0.99640 0.99720 0.00190 0.00250 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 922 0 0 0 922 0 PART II-B, LINE 1: THE $922 IN LOBBYING EXPENSES ARE THE LOBBYING EXPENSES ASSOCIATED WITH THE LEADING AGE NY DUES PAID IN 2020 250000 250000 11893788 9324590 2569198 2944503 2429509 514994 1426798 732568 694230 4028422 DUE FROM RELATED PARTIES 54039 RESIDENT ACCOUNTS HELD IN TRUST 38585 ASSETS WHOSE USE IS LIMITED 327594 OTHER NONCURRENT ASSETS 277879 698097 DUE TO RELATED PARTIES 5955280 ACCRUED WORKERS' COMPENSATION - LONG TERM 1013042 RESIDENT ACCOUNTS HELD IN TRUST 38585 ESTIMATED THIRD PARTY SETTLEMENTS, NET 890000 ACCRUED WORKERS' COMPENSATION - SHORT TERM 117837 NOTE PAYABLE - LONG TERM 295000 NOTE PAYABLE - SHORT TERM 565000 8874744 14994756 0 14994756 0 14994756 14506520 0 14506520 0 14506520 0 1 0 0 0 0 0 0 0 STEVEN I GOLDSTEIN PRESIDENT 0 1113771 0 0 0 238924 0 315600 0 21216 0 1689511 0 111000 KATHLEEN PARRINELLO BOARD MEMBER 0 631303 0 0 0 106807 0 79200 0 20921 0 838231 0 52000 ADAM ANOLIK FORMER EXECUTIVE VP & CFO 0 652602 0 0 0 3293 0 86200 0 22278 0 764373 0 0 ROBERT MCCANN MD BOARD MEMBER 0 575196 0 0 0 14838 0 18500 0 29167 0 637701 0 0 CARRIE FULLER-SPENCER ASSOCIATE VP & CFO 0 412976 0 0 0 526 0 31384 0 28388 0 473274 0 0 ELISA CHAMBRY ADMINISTRATOR 140902 0 0 0 0 0 4985 0 17428 0 163315 0 0 0 PART I, LINE 3 AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHODS DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFERE TO SCHEDULE O, DESCRIPTION OF COMPENSATION REVIEW AND APPROVAL. PART I, LINE 4B PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED PLAN - BOX 4B HAS BEEN CHECKED YES, SINCE CERTAIN OFFICERS OF HIGHLANDS LIVING CENTER PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PROVIDED BY THE UNVIERSITY OF ROCHESTER, A RELATED IRC SECTION 501(C)(3) ORGANIZATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND RECEIVED EMPLOYER-PAID AMOUNTS THAT ARE INCLUDED IN DEFERRED COMPENSATION: STEVEN I. GOLDSTEIN SERP PLAN $159,400 STEVEN I. GOLDSTEIN 457(F) PLAN $150,000 ROBERT MCCANN, MD SERP PLAN $12,300 ADAM ANOLIK SERP PLAN $80,000 CARRIE FULLER-SPENCER SERP PLAN $20,000 KATHLEEN PARRINELLO SERP PLAN $60,000 KATHLEEN PARRINELLO 457(F) PLAN $13,000 PURSUANT TO THE UNIVERSITY'S IRC SECTION 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, PARTICIPANTS ARE ENTITLED TO DISTRIBUTIONS FROM THE PLAN UPON THE OCCURENCE OF CERTAIN VESTING EVENTS. THE FOLLOWING INDIVIDUALS MET THE VESTING CONDITIONS UNDER THE PLAN AND RECEIVED DISTRIBUTIONS IN CALENDAR YEAR 2020, WHICH ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B) (III) AS OTHER REPORTABLE COMPENSATION: STEVEN GOLDSTEIN 457(F) PLAN $152,459 KATHLEEN PARRINELLO 457(F) PLAN $63,664 THESE AMOUNTS REPRESENT EMPLOYEE DEFERRALS OF COMPENSATION OVER SEVERAL YEARS THAT VESTED AND WERE PAID PURSUANT TO THE REQUIREMENTS OF THE PLAN. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C IN PRIOR YEARS AND ARE ALSO REFLECTED IN SCHEDULE J. PART II, COLUMN (F). FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE HIGHLANDS LIVING CENTER, INC. IS STRONG PARTNERS HEALTH SYSTEM, INC. ("SPHS"). SPHS, ACTING THROUGH ITS BOARD OF DIRECTORS, HAS THE AUTHORITY TO ELECT THE GOVERNING BODY OF HLC, AND CERTAIN DECISIONS OF THE HLC BOARD ARE SUBJECT TO THE APPROVAL OF THE SPHS BOARD. SUCH DECISIONS INCLUDE APPOINTMENT OF THE HLC PRESIDENT AND CEO, AMENDMENT OF THE CERTIFICATE OF INCORPORATION AND BYLAWS, APPROVAL OF EXTRAORDINARY CORPORATE ACTIONS SUCH AS MERGER OR DISSOLUTION, AND APPROVAL OF CAPITAL AND OPERATING BUDGETS, STRATEGIC PLANS, AND INCURRENCE OF CERTAIN DEBT. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE HIGHLANDS LIVING CENTER, INC. IS STRONG PARTNERS HEALTH SYSTEM, INC. ("SPHS"). SPHS, ACTING THROUGH ITS BOARD OF DIRECTORS, HAS THE AUTHORITY TO ELECT THE GOVERNING BODY OF HLC, AND CERTAIN DECISIONS OF THE HLC BOARD ARE SUBJECT TO THE APPROVAL OF THE SPHS BOARD. SUCH DECISIONS INCLUDE APPOINTMENT OF THE HLC PRESIDENT AND CEO, AMENDMENT OF THE CERTIFICATE OF INCORPORATION AND BYLAWS, APPROVAL OF EXTRAORDINARY CORPORATE ACTIONS SUCH AS MERGER OR DISSOLUTION, AND APPROVAL OF CAPITAL AND OPERATING BUDGETS, STRATEGIC PLANS, AND INCURRENCE OF CERTAIN DEBT. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE HIGHLANDS LIVING CENTER, INC. IS STRONG PARTNERS HEALTH SYSTEM, INC. ("SPHS"). SPHS, ACTING THROUGH ITS BOARD OF DIRECTORS, HAS THE AUTHORITY TO ELECT THE GOVERNING BODY OF HLC, AND CERTAIN DECISIONS OF THE HLC BOARD ARE SUBJECT TO THE APPROVAL OF THE SPHS BOARD. SUCH DECISIONS INCLUDE APPOINTMENT OF THE HLC PRESIDENT AND CEO, AMENDMENT OF THE CERTIFICATE OF INCORPORATION AND BYLAWS, APPROVAL OF EXTRAORDINARY CORPORATE ACTIONS SUCH AS MERGER OR DISSOLUTION, AND APPROVAL OF CAPITAL AND OPERATING BUDGETS, STRATEGIC PLANS, AND INCURRENCE OF CERTAIN DEBT. FORM 990, PART VI, SECTION B, LINE 11B HLC'S FORM 990 IS PREPARED BY INDEPENDENT ACCOUNTANTS AND PROVIDED TO SENIOR MANAGEMENT FOR REVIEW PRIOR TO FILING. THE FORM 990 WAS PROVIDED TO HLC'S BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, COMMITTEE MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE A CONFLICT OF INTEREST: (A) PRIOR TO VOTING ON OR OTHERWISE DISCHARGING THEIR DUTIES WITH RESPECT TO ANY MATTER INVOLVING THE CONFLICT WHICH COMES BEFORE THE BOARD OR ANY COMMITTEE; (B) PRIOR TO ENTERING INTO ANY CONTRACT OR TRANSACTION INVOLVING THE CONFLICT; (C) AS SOON AS POSSIBLE AFTER THE DIRECTOR, COMMITTEE MEMBER OR OFFICER LEARNS OF THE CONFLICT; AND (D) ON AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE FORM IS DISTRIBUTED ANNUALLY AND REQUIRES DISCLOSURE OF ALL CONFLICTS OF INTEREST, INCLUDING SPECIFIC INFORMATION CONCERNING THE TERMS OF ANY CONTRACT OR TRANSACTION WITH HLC THAT INVOLVES A POTENTIAL CONFLICT OF INTEREST FOR THE INDIVIDUAL. THE FORMS ARE REVIEWED BY THE BOARD CHAIR AND LEGAL COUNSEL, AND CONFLICTS DISCLOSED ON THE FORMS OR ON AN AD HOC BASIS ARE REVIEWED BY A BOARD COMMITTEE. THE COMMITTEE CONSIDERS THE MATERIAL FACTS CONCERNING ANY PROPOSED CONTRACT OR TRANSACTION, INCLUDING THE PROCESS BY WHICH THE DECISION WAS MADE TO APPROVE OR RECOMMEND ENTERING INTO THE ARRANGEMENT ON THE TERMS PROPOSED, AND APPROVES SUCH CONTRACTS OR TRANSACTIONS ONLY IF THE TERMS ARE FAIR AND REASONABLE TO HLC AND THE ARRANGEMENTS ARE CONSISTENT WITH THE BEST INTEREST OF HLC. FORM 990, PART VI, SECTION B, LINE 15 WRITTEN SELF-EVALUATIONS AND PERFORMANCE EVALUATIONS FOR HLC OFFICERS AND THE ADMINISTRATOR ANNUALLY ARE REVIEWED BY THE COMMITTEE ON COMPLIANCE AND COMPENSATION OF THE UNIVERSITY OF ROCHESTER MEDICAL CENTER BOARD. THE COMMITTEE HAS AVAILABLE EVALUATIONS FROM THE CEO OF URMC HEALTH SYSTEM FOR THE OFFICERS, AND FROM HLC'S CEO FOR THE ADMINISTRATOR. THE COMMITTEE REVIEWS AND APPROVES TOTAL COMPENSATION FOR OFFICERS AND THE ADMINISTRATOR AND CONSIDERS, IN ADDITION TO THE EVALUATIONS, THE SCOPE OF THE INDIVIDUAL'S JOB RESPONSIBILITIES, PREVIOUS COMPENSATION AND COMPARABLE COMPENSATION PAID TO PEOPLE WITH SIMILAR RESPONSIBILITIES AT COMPARABLE INSTITUTIONS. THE COMPARABLE INFORMATION IS PROVIDED BY AN INDEPENDENT CONSULTANT AND IS BASED ON LOCAL, REGIONAL AND NATIONAL COMPENSATION SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 PART VI-C LINE 19 HLC'S FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. HLC'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE NOT ROUTINELY MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: TRANSFERS FROM THE UNIVERSITY OF ROCHESTER 245,678. FORM 990, PART XII, LINE 2C: NO CHANGES FROM THE PRIOR YEAR. 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