2021-10-26T10:58:16-05:00 2020-12-31 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2020-01-01 221500539 THE HOUSE OF THE GOOD SHEPHERD HOUS 9086845900 798 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 SUSAN LANZA PRESIDENT/CEO 9086845900 2021-10-21 1 SUSAN LANZA 999009999 KERRI N BOGDA CPA P00760402 7177404863 X 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SUSAN LANZA 798 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 11025536 0 X WWW.HOTGS.ORG X 1884 NJ TO PROVIDE CARE, NURTURANCE AND HOUSING FOR THE ELDERLY THROUGH OPERATION OF VARIOUS FACILITIES. 13 13 229 13 0 0 107866 585615 10864122 10247969 90161 60320 21607 99581 11083756 10993485 0 0 0 0 6874514 6694986 0 0 0 4821020 5513317 11695534 12208303 -611778 -1214818 14625342 13366071 11637887 11512186 2987455 1853885 X TO MEET THE LIFE-STYLE, SPIRITUAL AND HEALTH-CARE NEEDS OF OLDER PERSONS, ON AND OFF OUR CAMPUS, IN A FAITH-BASED, CARING AND DIGNIFIED MANNER. 0 0 9683787 0 10328479 HOUSE OF THE GOOD SHEPHERD OPERATES A CONTINUING CARE RETIREMENT COMMUNITY PROVIDING HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO ELDERLY RESIDENTS THROUGH THE OPERATION OF A NURSING FACILITY, ASSISTED LIVING, COMPREHENSIVE PERSONAL CARE AND INDEPENDENT LIVING UNITS. DURING 2020, THERE WERE 13,837 NURSING FACILITY PATIENT DAYS, 7,605 PERSONAL CARE DAYS AND 11,064 ASSISTED LIVING DAYS.FIVE EPISCOPAL CONGREGATIONS IN THE ORANGES FOUNDED THE HOUSE OF THE GOOD SHEPHERD IN 1884. IN THOSE DAYS ITS FOCUS WAS TO PROVIDE CARE AND SERVICES TO THE POOR AND DISABLED. A 20-ROOM RENTAL HOME LAUNCHED OUR HUMBLE BEGINNINGS. BY 1890, A NEW HOME WAS BUILT ON HENRY STREET. IN THE EARLY 1960'S A WOODED, 15-ACRE SITE WAS PURCHASED IN HACKETTSTOWN. THE GOAL WAS TO DEVELOP A RETIREMENT COMMUNITY FOR THE EVER-GROWING POPULATION OF SENIORS IN NORTHERN NEW JERSEY. FOUR LEVELS OF SERVICES ARE PROVIDED:THERE ARE 48 UNITS OF INDEPENDENT LIVING LOCATED IN OUR MAIN BUILDING AND ON THE GROUNDS. COTTAGES, APARTMENTS AND DUPLEXES SERVE SENIORS WHO ARE INDEPENDENT YET VALUE THE SECURITY OF 24/7 EMERGENCY ASSISTANCE AND A WIDE VARIETY OF SERVICES AND PROGRAMS.IN 61 UNITS OF ASSISTED LIVING AND COMPREHENSIVE PERSONAL CARE, STAFF IS AVAILABLE TO ASSIST WITH MEDICATION ADMINISTRATION AND PROVIDE WATCHFUL OVERSIGHT TO SENIORS WHO ARE NO LONGER ABLE TO BE TOTALLY INDEPENDENT.A 62-BED SKILLED NURSING UNIT SERVES SENIORS WHO REQUIRE TOTAL CARE.POST-HOSPITAL, SUBACUTE CARE IS PROVIDED ON THE SKILLED NURSING UNIT TO SENIORS SEEKING A TEMPORARY STAY TO REHABILITATE AFTER A HOSPITAL STAY.SECURITY: IN ADDITION TO SEEKING A SECURE ENVIRONMENT IN WHICH TO LIVE, RESIDENTS COME TO THE HOUSE WITH THE KNOWLEDGE THAT, WHEN THEIR ASSETS ARE DEPLETED, THE HOUSE WILL, WITHIN ITS FINANCIAL CAPACITY, UTILIZE ITS AVAILABLE RESOURCES TO PROVIDE LIFELONG CARE AND SERVICES. IN ADDITION TO SUBSIDIZING RESIDENTS WITHOUT ASSETS IN INDEPENDENT LIVING, THE HOUSE SUBSIDIZES RESIDENTS OF COMPREHENSIVE PERSONAL CARE AND SKILLED CARE WHO ARE RECIPIENTS OF MEDICAID.LICENSES: THE HOUSE OF THE GOOD SHEPHERD IS LICENSED BY THE STATE OF NEW JERSEY AS A: (1) CONTINUING CARE RETIREMENT COMMUNITY, (2) SKILLED NURSING FACILITY, (3) ASSISTED NURSING FACILITY, AND (4) COMPREHENSIVE PERSONAL CARE FACILITY. 9683787 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 50 0 229 1 0 0 0 0 0 1 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X HOLLIE DRISCOLL 9086845734 798 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 DAVID SULLIVAN CHAIR/TRUSTEE 0.30 0.30 X X 0 0 0 REV PAUL OLSSON VICE CHAIR/TRUSTEE (DEPARTED 9/20) 0.30 0.30 X X 0 0 0 JUDY KILGORE TREASURER/TRUSTEE (DEPARTED 9/20) 0.30 0.30 X X 0 0 0 CHRISTINE BRODEUR SECRETARY/TRUSTEE (DEPARTED 11/20) 0.30 0.30 X X 0 0 0 DESPINA PAGHIDAS RESIDENT TRUSTEE (DEPARTED 11/20) 0.20 0.20 X 0 0 0 GINA DIMAIO TRUSTEE 0.20 0.20 X 0 0 0 PHILLIP GUIDONE ESQ TRUSTEE 0.20 0.20 X 0 0 0 REV DEBRA BREWIN-WILSON TRUSTEE 0.20 0.20 X 0 0 0 REV SHEILA SHUFORD TRUSTEE (DEPARTED 1/20) 0.20 0.20 X 0 0 0 REV DAVID RUDE TRUSTEE 0.20 0.20 X 0 0 0 REV NINABETH METCALF TRUSTEE (DEPARTED 11/20) 0.20 0.20 X 0 0 0 ROBERT BARTKUS ESQ TRUSTEE (DEPARTED 9/20) 0.20 0.20 X 0 0 0 ROBYN JENSEN TRUSTEE 0.20 0.20 X 0 0 0 SR SUZANNE ELIZABETH TRUSTEE (DEPARTED 11/20) 0.20 0.20 X 0 0 0 NORMAN WORTH TRUSTEE 0.20 0.20 X 0 0 0 GREGORY ACKERSON TREASURER/TRUSTEE 0.30 0.30 X X 0 0 0 GENE MILTON VICE CHAIR/TRUSTEE 0.30 0.30 X X 0 0 0 JUDITH WIEGAND TRUSTEE 0.20 0.20 X 0 0 0 REV ANNE KITCH TRUSTEE 0.20 0.20 X 0 0 0 HOLLIE DRISCOLL CHIEF FINANCIAL OFFICER 40.00 2.00 X 123515 0 10832 SUSAN LANZA PRESIDENT/CEO 40.00 2.00 X 223687 0 20082 JOANNE WARD DIRECTOR OF NURSING 40.00 X 121489 0 18197 468691 0 49111 3 0 1 0 SODEXO INC & AFFILIATES 6145 PARK SQUARE DRIVE UNIT 1-6 LORAIN OH 44053 FOOD SERVICE MGMT 851625 FELLOWSHIP VILLAGE 8000 FELLOWSHIP RD BASKING RIDGE NJ 07920 THERAPY PROVIDER 258754 BAKER TILLY 4807 INNOVATE LANE MADISON WI 53718 CONSULTING SERVICES 165375 OLMEC SYSTEMS 85 BLOOMFIELD AVE DENVILLE NJ 07834 IT CONSULTANT 132383 ANTHONY FINE WOODWORKING LLC 193 JONATHAN PLACE SOMERSET NJ 08873 WOODWORKING SERVICES 121078 4 11878 50010 520248 3479 585615 NET RESIDENT SVC REV 623000 10247969 10247969 10247969 60320 60320 34170 21563 12607 12607 12607 5447 11878 10488 -5041 -5041 CAPITATION INCOME 900099 80510 80510 DISCOUNTS EARNED 900099 11100 11100 ADMINISTRATIVE SERVICES 900099 405 405 92015 10993485 10247969 0 159901 378116 378116 4768499 4294161 474338 309250 269282 39968 824912 703826 121086 414209 347690 66519 16333 16333 24872 24872 717 717 9965 9965 1065015 873298 191717 122561 122561 910021 652665 257356 471218 471218 21297 21297 253650 253650 1023543 1023543 482451 482451 FOOD 491760 491760 BAD DEBTS 221008 221008 PHARMACY 192682 192682 LICENSES & FEES 86321 86321 119903 88715 31188 12208303 9683787 2524516 0 62334 17701 358322 4175 886637 1352908 314867 348119 31757182 22812229 9597400 8944953 3367272 2656831 38510 41384 14625342 13366071 1141692 1243881 144728 124393 10074083 9346771 16634 16391 520000 260750 260750 11637887 11512186 X 2534206 1399786 453249 454099 2987455 1853885 14625342 13366071 X -1214818 131258 -50010 X 0 1 X 1 0 X 176103 393770 281454 107866 585615 1544808 11673298 11715831 10839781 10864122 10247969 55341001 11849401 12109601 11121235 10971988 10833584 56885809 0 0 0 56885809 100896 106414 122263 122631 94490 546694 100896 106414 122263 122631 94490 546694 16849 11060 1495 3430 92015 124849 11967146 12227075 11244993 11098049 11020089 57557352 0.98830 0.98950 0.00950 0.00960 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2016 AMOUNT: $ 5,253. 2017 AMOUNT: $ 1,580. 2018 AMOUNT: $ 1,495. 2019 AMOUNT: $ 2,565. 2020 AMOUNT: $ 405. FUNDRAISING GAMING - 2016 AMOUNT: $ 11,596. 2017 AMOUNT: $ 9,480. DISCOUNTS EARNED - 2019 AMOUNT: $ 865. 2020 AMOUNT: $ 11,100. CAPITATION INCOME - 2020 AMOUNT: $ 80,510. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 717 717 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO THE STATE (LEADINGAGE NJ) AND NATIONAL (LEADINGAGE) ASSOCIATIONS OF HOMES AND SERVICES FOR THE AGING. A PORTION OF THESE DUES ARE USED FOR LOBBYING PURPOSES. THE $717 REPORTED AS LOBBYING EXPENDITURES IS THE PORTION OF DUES THAT WERE USED FOR LOBBYING PURPOSES BY LEADINGAGE, NJ AND LEADINGAGE. 0 1 X 594896 34513 2196 627213 554605 42374 2083 594896 568326 -11746 1975 554605 553256 17130 2060 568326 546428 8974 2146 553256 0.33000 0.67000 0.00000 0 0 328328 328328 27733333 19817622 7915711 3664014 2994607 669407 31507 31507 8944953 REFUNDABLE FEES AND DEPOSITS 260750 260750 10885776 131258 -221008 -89750 10975526 17959 17959 10993485 12019346 32051 32051 11987295 221008 221008 12208303 PART IV, LINE 2B: CURRENT ASSETS REPORTED ON THE ORGANIZATION'S BALANCE SHEET AS OF 12/31/20 INCLUDE THE AMOUNT OF THE PNA TRUST FUND (I.E. RESIDENT TRUST FUNDS) HELD WITH FULTON BANK AS WELL AS THE PETTY CASH FUND HELD ONSITE. THE LIABILITIES RELATED TO THESE ACCOUNTS ARE REPORTED ON LINE 21 OF PART X OF THE 990. THESE ACCOUNTS ARE FUNDS HELD FOR THE RESIDENTS. PART V, LINE 4: THE INCOME FROM THE ENDOWMENT FUNDS ARE DESIGNATED TO SUBSIDIZE RESIDENTS WHO HAVE OUTLIVED THEIR FUNDS. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -221,008. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -21,563. ADJUSTMENT TO CONTRIBUTIONS NOT RECOGNIZED IN FINANCIAL STATEMENTS 50,010. FUNDRAISING EXPENSES -10,488. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 21,563. FUNDRAISING EXPENSES 10,488. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 221,008. GOLF OUTING 17325 11878 5447 7763 2725 17325 11878 5447 7763 2725 10488 -5041 X X X X 0 0 0 0 0 0 0 0 0 SUSAN LANZA PRESIDENT/CEO 223687 0 0 0 0 0 8001 0 12081 0 243769 0 0 0 A NEW JERSEY HEALTH CARE FACILITIES FINANCING AUTHORITY SERIES 2012-1 221987084 2012-11-27 14645000 REFUNDING OF 2001 BOND ISSUE 0 0 0 A 5165000 14645000 227814 14417186 2012 1 0 1 1 A 0 0 1 0 1 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS THE AMOUNT REPORTED ON PART II, LINE 11, REPRESENTS PROCEEDS OF THE BOND ISSUE USED TO CURRENTLY REFUND THE 2001 BOND ISSUE. SCHEDULE K, PART III PRIVATE BUSINESS USE PART III ON PRIVATE BUSINESS USE HAS BEEN INTENTIONALLY LEFT BLANK BECAUSE THE BONDS ISSUED ON 11/27/2012 WERE ISSUED AS A REFUNDING ISSUE OF BONDS ORIGINALLY ISSUED ON 8/16/2001 PER THE FORM 8038. ACCORDINGLY, THE INSTRUCTIONS TO SCHEDULE K STATE THAT PART III DOES NOT NEED TO BE COMPLETED FOR LISTED BOND ISSUES THAT ARE POST-DECEMBER 31, 2002 REFUNDING ISSUES WHICH REFUND PRE-JANUARY 1, 2003 BOND ISSUES DIRECTLY OR THROUGH A SERIES OF REFUNDINGS. FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER PERFORM A DETAILED REVIEW OF THE FORM 990. AFTER THEIR REVIEW, THE TREASURER OF THE BOARD REVIEWS THE FORM 990 IN DETAIL. A COPY OF THE ORGANIZATION'S FINAL FORM 990 IS PROVIDED TO THE GOVERNING BODY MEMBERS AT THE NEXT MEETING OF THE BOARD OF TRUSTEES FOLLOWING COMPLETION OF THE FORM BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE POLICY IS GIVEN TO AND SIGNED BY EACH BOARD MEMBER AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. ANY CONFLICTS OF INTEREST MUST BE DISCLOSED AND BOARD MEMBERS MUST ABSTAIN FROM VOTING IF SUCH CONFLICTS ARISE AT MEETINGS. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE POLICY. THE EXECUTIVE DIRECTOR REVIEWS THE CONFLICT FORMS FOR THE BOARD OF DIRECTORS. IF A CONFLICT ARISES, THE ACTIONS TAKEN AND RESULTS ARE DOCUMENTED IN THE BOARD MINUTES. THE CONFLICT OF INTEREST STATEMENTS FOR SENIOR MANAGEMENT ARE SUBMITTED TO THE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 15 THE PERSONNEL COMMITTEE REFERS TO COMPENSATION STUDIES DONE BY TRADE ORGANIZATIONS EACH YEAR FOR COMPARATIVE INFORMATION ON SALARY/WAGE DATA. THEY ALSO LOOK AT SURROUNDING RETIREMENT COMMUNITIES TO ENSURE THEIR TOP MANAGEMENT OFFICIALS' PAY IS COMMENSURATE WITH SIMILAR POSITIONS AT THOSE ORGANIZATIONS. AFTER THE PERSONNEL COMMITTEE ESTABLISHES COMPENSATION AMOUNTS FOR THE EXECUTIVE DIRECTOR, THE PAYROLL BUDGET FOR OTHER PERSONNEL IS REVIEWED BY THE PERSONNEL COMMITTEE AND APPROVED BY THE BOARD OF TRUSTEES. THIS PROCESS AND FINAL DETERMINATIONS ARE DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: ADJUSTMENT TO CONTRIBUTIONS NOT RECOGNIZED IN FINANCIAL STATEMENTS -50,010. THE HOUSE OF THE GOOD SHEPHERD FOUNDATION INC 798 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 223692108 SUPPORTING ORGANIZATION FOR THE HOUSE OF THE GOOD SHEPHERD NJ 501(C)(3) LINE 12A, I THE HOUSE OF THE GOOD SHEPHERD 1 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 THE HOUSE OF THE GOOD SHEPHERD FOUNDATION INC C 50010 COST