2020-11-16T11:19:53-06:00 2019-12-31 271728945 PKF O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE HARRISON NY 105281633 990 2019-01-01 135562377 VISITING NURSE ASSOCIATION HEALTH CARE SERVICES INC VISI 7188163510 399 LAKE AVENUE STATEN ISLAND NY 10303 HOPE ILICETO PRESIDENT & CEO 7188163510 2020-11-16 1 GARRETT M HIGGINS P00543209 9143818900 2020-11-13 24.190.81.120 2020-11-16 11:19:48 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9616F4B14A694591D1E716C270910E6FA5556DA3 2019 2021-01-29 14:40:06Z X HOPE ILICETO 399 LAKE AVENUE STATEN ISLAND NY 10303 11141718 0 X N/A X 1928 NY TO PROVIDE THE HIGHEST QUALITY THERAPEUTIC, SUPPORT AND PREVENTIVE HEALTH CARE SERVICES OUTSIDE THE HOSPITAL SETTING AS AN INDEPENDENT HEALTH CARE AGENCY. 14 14 124 14 0 0 204000 203000 10191194 10223503 539 3199 583123 712016 10978856 11141718 0 0 0 0 7352685 7203231 0 0 0 5073878 5769971 12426563 12973202 -1447707 -1831484 4743711 4271860 7130758 5790391 -2387047 -1518531 TO PROVIDE THE HIGHEST QUALITY THERAPEUTIC, SUPPORT AND PREVENTIVE HEALTH CARE SERVICES OUTSIDE THE HOSPITAL SETTING AS AN INDEPENDENT HEALTH CARE AGENCY. 0 0 9660231 10223503 THE AGENCY PROVIDED 64,587 HOME CARE VISITS TO MORE THAN 2,300 PATIENTS OVER THE COURSE OF THE YEAR. SERVICES INCLUDED SKILLED NURSING, PHYSICAL, OCCUPATIONAL AND OTHER THERAPIES, HOME HEALTH AIDES AND PERSONAL CARE WORKERS. THE AGENCY IS REIMBURSED FOR THESE SERVICES PRINCIPALLY BY MEDICARE, MEDICAID AND INSURANCE COMPANIES AND/OR INDIVIDUALS. 9660231 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 85 0 124 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X X HOPE ILICETO 7188163510 399 LAKE AVENUE STATEN ISLAND NY 10303 X BARRINGTON BURKE-GREEN PRESIDENT & CEO (THRU 10/21/19) 35.50 2.00 X 313073 0 20004 KWONG-KEUNG S LEUNG DIRECTOR INFO SYSTEMS 37.50 X 104526 0 33959 MELISSA CRUZ HI TECH RN 37.50 X 116879 0 20136 MARLON CANCIO CONTRACT SERVICE OT 37.50 X 103095 0 32943 CHERYL O'CONNELL INTAKE HOME HEALTH COORDINATOR 37.50 X 110467 0 12572 JANINE DALESSANDRO CARE TRANSITION TEAM 37.50 X 104013 0 1768 JAMES F MITCHELL VP PUBLIC RELATIONS (THRU 2019) 18.70 18.80 X 7972 0 0 DAVID LEHR CHAIRMAN 0.50 0.10 X X 0 0 0 KATHLEEN HEAD 1ST VICE CHAIR 0.50 0.10 X X 0 0 0 DAN SWEENEY 2ND VICE CHAIR 0.50 0.10 X X 0 0 0 SUSAN LEWIS TREASURER / SECRETARY 0.50 0.10 X X 0 0 0 FRANK J BESIGNANO DIRECTOR 0.10 0.10 X 0 0 0 ROY DANISCHEWSKI DIRECTOR 1.00 0.50 X 0 0 0 WILLIAM FANI DIRECTOR 0.50 0.10 X 0 0 0 JANE FEMINELLA DIRECTOR 0.10 0.05 X 0 0 0 GARY LIGRECI DIRECTOR 0.50 0.10 X 0 0 0 THOMAS MCDONOUGH DIRECTOR 0.50 0.10 X 0 0 0 JACK OEHM DIRECTOR 0.50 0.10 X 0 0 0 ALAN PORITZ DIRECTOR 0.50 0.10 X 0 0 0 DOLLY SMITH DIRECTOR 0.50 0.10 X 0 0 0 WINSTON WOHR DIRECTOR 0.40 0.10 X 0 0 0 HOPE ILLICETO ACTING PRESIDENT & CEO (AS OF 11/19) 35.50 2.00 X 0 0 0 860025 0 121382 10 0 1 0 NETSMART TECHNOLOGIES INC PO BOX 823519 PHILADELPHIA PA 19182 EMR SYSTEM 686497 MARGARET ULTRA HOME CARE INC 34 BEACH STREET STATEN ISLAND NY 10304 HOME HEALTH & PERSONAL CARE AIDES 302717 SPECIAL TOUCH HOME CARE SERVICES 2091 CONEY ISLAND AVENUE BROOKLYN NY 11223 HOME HEALTH & PERSONAL CARE AIDES 201960 CITY INVESTIGATION & SECURITY 368 AVENUE U BROOKLYN NY 11223 INVESTIGATION & SECURITY SERVICE 162340 JAISON OMMEN 18 CHAPEL HILL CT SPARTA NJ 07871 CONTRACT THERAPIST 162183 9 203000 203000 NET PATIENT SERVICE REVENUE 623000 10223503 10223503 10223503 3199 3199 REIMBURSEMENTS 900099 525889 525889 MANAGEMENT FEES 900099 154000 154000 OTHER OPERATING INCOME 900099 22916 22916 9211 9211 712016 11141718 10223503 0 715215 X 341049 246332 94717 6924 4960 1964 5368568 3845631 1522937 92894 75971 16923 859886 703236 156650 533910 437919 95991 54954 54954 121466 121466 3249733 3186716 63017 15989 14490 1499 374857 339708 35149 124638 112951 11687 391174 354495 36679 73020 73020 4022 4022 54863 14984 39879 100098 90712 9386 BAD DEBT EXPENSE 1002997 1002997 MEDICAL SUPPLIES 129767 117599 12168 NYS ASSESSMENT 31029 31029 COMMUNITY AFFAIRS 23215 21038 2177 18149 16447 1702 12973202 9660231 3312971 0 2840 1878 365656 619416 2885441 1909546 358397 404422 2387532 2023958 356944 363574 774433 973024 4743711 4271860 2532234 1932121 551291 621037 4047233 3237233 7130758 5790391 X -2387047 -1518531 -2387047 -1518531 4743711 4271860 X -1831484 2700000 X X 0 1 X 1 0 X 213969 165090 354500 204000 203000 1140559 14498416 11392050 9070037 10191194 10223503 55375200 14712385 11557140 9424537 10395194 10426503 56515759 0 0 0 56515759 14292 107 192 539 3199 18329 14292 107 192 539 3199 18329 197893 220803 244199 583123 712016 1958034 14924570 11778050 9668928 10978856 11141718 58492122 0.96620 0.97710 0.00030 0.00040 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MANAGEMENT FEES - 2015 AMOUNT: $ 184,500. 2016 AMOUNT: $ 190,750. 2017 AMOUNT: $ 165,000. 2018 AMOUNT: $ 138,000. 2019 AMOUNT: $ 154,000. MISCELLANEOUS - 2015 AMOUNT: $ 2,720. 2016 AMOUNT: $ 24,259. 2017 AMOUNT: $ 780. 2018 AMOUNT: $ 579. 2019 AMOUNT: $ 22,916. MEDICAL RECORDS - 2015 AMOUNT: $ 10,673. 2016 AMOUNT: $ 5,794. 2017 AMOUNT: $ 11,242. 2018 AMOUNT: $ 5,999. 2019 AMOUNT: $ 9,211. REIMBURSEMENTS - 2017 AMOUNT: $ 67,177. 2018 AMOUNT: $ 438,545. 2019 AMOUNT: $ 525,889. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 270873 270873 598344 559742 38602 1518315 1464216 54099 363574 DUE FROM AFFILIATES 973024 973024 DUE TO THIRD PARTY PAYORS 312131 DUE TO AFFILIATE 2925102 3237233 X 10059721 0 10059721 1081997 1081997 11141718 11891205 0 11891205 1081997 1081997 12973202 PART X, LINE 2: THE ASSOCIATION RECOGNIZES THE EFFECT OF TAX POSITIONS ONLY WHEN THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE ASSOCIATION HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE ASSOCIATION IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO 2016. PART XI, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT FEE INCOME REPORTED ON PART VIII, LINE 11A 79,000. BAD DEBT EXPENSE REPORTED ON PART IX, LINE 24 1,002,997. PART XII, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT FEE INCOME REPORTED ON PART VIII, LINE 11A 79,000. BAD DEBT EXPENSE REPORTED ON PART IX, LINE 24 1,002,997. X X 1 0 0 0 0 0 0 1 0 BARRINGTON BURKE-GREEN PRESIDENT & CEO (THRU 10/21/19) 143628 0 50000 0 119445 0 3660 0 16344 0 333077 0 0 0 PART I, LINE 4A BARRINGTON BURKE-GREEN, PRESIDENT & CEO, RECIEVED A SEVERANCE PAYMENT OF $110,000 IN 2019. PART I, LINE 7 BARRINGTON BURKE-GREEN, PRESIDENT & CEO, RECIEVED A DISCRETIONARY BONUS OF $50,000 IN 2019. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION (PARENT) IS THE VISITING NURSE ASSOCIATION OF STATEN ISLAND, INC. (VNASI). FORM 990, PART VI, SECTION A, LINE 7A WHENEVER DIRECTORS ARE TO BE ELECTED BY THE MEMBERS, THEY SHALL BE ELECTED BY A PLURALITY OF THE VOTES CAST AT A MEETING OF SUCH MEMBERS BY THE MEMBERS ENTITLED TO VOTE IN THE ELECTION. FORM 990, PART VI, SECTION A, LINE 7B WHENEVER ANY CORPORATE ACTION, OTHER THAN THE ELECTION OF DIRECTORS IS TO BE TAKEN BY VOTE OF THE MEMBERS, IT SHALL, EXCEPT AS OTHERWISE REQUIRED BY LAW, BE AUTHORIZED BY A MAJORITY OF THE VOTES CAST AT A MEETING OF MEMBERS BY THE MEMBERS ENTITLED TO VOTE THEREON. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY OUR INDEPENDENT ACCOUNTANTS FROM INFORMATION GATHERED AS PART OF THEIR AUDIT AND FROM OTHER INFORMATION SUPPLIED BY THE AGENCY. A DRAFT OF THE 990 IS REVIEWED BY MANAGEMENT. AFTER THEIR REVIEW, THE FORM 990 IS ELECTRONICALLY SENT TO THE BOARD FOR THEIR REVIEW BEFORE BEING ELECTRONICALLY FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION CURRENTLY HAS IN PLACE A CONFLICT OF INTEREST POLICY WHICH IT ANNUALLY MONITORS AND ENFORCES. THE BOARD CURRENTLY MANDATES THAT ALL MEMBERS OF MANAGEMENT AND THE GOVERNING BODY ANNUALLY SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST. THE SIGNED CONFLICT OF INTEREST POLICY IS SUBMITTED TO THE CORPORATE COMPLIANCE OFFICER WHO REVIEWS THE SIGNED ATTESTATIONS FOR POTENTIAL OR ACTUAL CONFLICTS. IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS, THE CORPORATE COMPLIANCE OFFICER WILL NOTIFY A MEMBER OF MANAGEMENT OR THE GOVERNING BODY ABOUT SUCH CONFLICT AND INVESTIGATE THE CONFLICT. THE RESULTS OF THE INVESTIGATION WILL BE SUMMARIZED AND DOCUMENTED BY THE CORPORATE COMPLIANCE OFFICER AND BE REPORTED TO THE GOVERNING BODY. IF THE CORPORATE COMPLIANCE OFFICER ESTABLISHES THAT AN ACTUAL CONFLICT EXISTS, THE MEMBER OF MANAGEMENT OR THE GOVERNING BODY WILL BE NOTIFIED IMMEDIATELY AND WILL NOT BE ALLOWED TO VOTE OR BE A PART OF ANY DECISIONS ABOUT ANY SUCH TRANSACTIONS THAT HAVE TO DO WITH THE CONFLICT UNTIL SUCH TIME THERE IS NO LONGER A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE COMMITTEE, CONSISTING OF PERSONS WITHOUT CONFLICTS OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT, ESTABLISHES THE CEO'S COMPENSATION USING COMPARABLE DATA AND DETERMINES THAT THE SALARY IS REASONABLE. THE EXECUTIVE COMMITTEE'S DECISION ON THE AMOUNT OF COMPENSATION PAID IS REQUIRED TO BE DOCUMENTED IN A WRITTEN FORMAT INCLUDING THE DATE OF THE DECISION. THE COMPENSATION REVIEW PROCESS FOR THE CEO WAS LAST UNDER TAKEN IN 2017. FORM 990, PART VI, SECTION C, LINE 19 THE ASSOCIATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ASSOCIATION'S FORM 990 IS AVAILABLE ON WWW.GUIDESTAR.ORG AND OTHER SIMILAR TYPE WEBSITES. FORM 990, PART VII: CERTAIN OFFICERS AND HIGHLY COMPENSATED EMPLOYEES ARE PAID BY THE ORGANIZATION BUT SPEND A PERCENTAGE OF THEIR TIME WORKING FOR VISITING NURSE ASSOCIATION OF STATEN ISLAND(VNASI) AND VISITING NURSE PLUS(VNP). FORM 990, PART IX, LINE 11G BILING SERVICES: PROGRAM SERVICE EXPENSES 457,928. MANAGEMENT AND GENERAL EXPENSES 47,382. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 505,310. CONSULTANTS: PROGRAM SERVICE EXPENSES 30,115. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,115. CONTRACT HEALTH WORKERS: PROGRAM SERVICE EXPENSES 2,547,570. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,547,570. RNS, LPNS AND PHYSICIANS: PROGRAM SERVICE EXPENSES 151,103. MANAGEMENT AND GENERAL EXPENSES 15,635. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 166,738. FORM 990, PART XI, LINE 9: EQUITY TRANSFER FROM AFFILIATE 2,700,000. FORM 990, PART XII, LINE 2C: THE ASSOCIATION HAS A FINANCE COMMITTEE WHICH FUNCTIONS AS AN AUDIT COMMITTEE AND WHICH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. VISITING NURSE ASSOCIATION OF STATEN ISLAND INC 399 LAKE AVENUE STATEN ISLAND NY 10303 133272923 TO SUPPORT VNAHCS NY 501(C)(3) LINE 12A, I N/A 0 VISITING NURSE PLUS INC 399 LAKE AVENUE STATEN ISLAND NY 10303 133712494 HOME HEALTH CARE NY 501(C)(3) LINE 10 VISITING NURSE ASSOCIATION OF STATEN ISLAND 0 HEALTH WATCH-LIFELINE INC 399 LAKE AVENUE STATEN ISLAND NY 10303 133484488 PERS MONITORING NY VISITING NURSE ASSOCIATION OF STATEN ISLAND INC C 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 0 1