2020-11-11T11:40:02-06:00 2019-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2019-01-01 222902896 IDEAL SENIOR LIVING CENTER INC IDEA 6077867491 508 HIGH AVENUE ENDICOTT NY 13760 KAY BOLAND 2ND VICE CHAIRMAN 6077867308 2020-11-04 1 ANGELA M FRANCO P00589741 3154463600 2020-11-04 67.249.32.8 2020-11-04 14:37:28 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 864D215B06E9E3399D3A212A6FE2BC19AC3A6BDB 2019 2021-01-29 14:40:06Z KAY BOLAND 508 HIGH AVENUE ENDICOTT NY 13760 13137195 0 X WWW.NYUHS.0RG X 1988 NY HEALTHCARE FOR THE ELDERLY 12 8 346 11 0 0 62087 16232 11867905 12830403 17201 10334 329654 280226 12276847 13137195 0 0 0 0 9447008 9539544 0 0 0 6193406 6579710 15640414 16119254 -3363567 -2982059 6598281 6043857 15772046 18023625 -9173765 -11979768 X UHS SENIOR LIVING AT IDEAL PROVIDES SECURITY AND PEACE OF MIND TO SENIORS, OUR RESIDENTS, AND THEIR FAMILIES BY OFFERING COMPASSIONATE, PERSONALIZED CARE TO PROMOTE THE HIGHEST LEVEL OF HEALTHCARE FUNCTIONING. WE DO THIS IN A FULL CONTINUUM THAT INCLUDES HOME CARE, RESIDENTIAL, AND SKILLED NURSING SERVICES. WE ARE STEWARDS TO THE COMMUNITY AT LARGE, AND FULFILL THIS COMMUNITY NEED AS A MEMBER OF UHS. AS SUCH, WE ARE EVER MINDFUL OF OUR RESPONSIBILITY TO MANAGE OUR FINANCES TO SUSTAIN OUR ORGANIZATION. 0 0 14790180 12830403 IDEAL SENIOR LIVING CENTER, INC. (ISLC) IS PART OF A NOT-FOR-PROFIT FULL SERVICE SENIOR COMMUNITY WHICH PROVIDES NURSING CARE AND HOUSING SERVICES TO RESIDENTS OF BROOME COUNTY, NEW YORK AND SURROUNDING AREAS. THE PROGRAM AT ISLC CONSISTS OF A 150 BED NURSING HOME. ISLC IS A MEMBER OF UNITED HEALTH SERVICES, INC. AND IS LOCATED ON THE SAME CAMPUS AS ITS SISTER COMPANY, IDEAL SENIOR LIVING CENTER HOUSING CORPORATION (ISLCHC), WHICH RUNS A 35 BED ADULT CARE FACILITY, 35 BED ASSISTED LIVING PROGRAM, AND HAS 33 INDEPENDENT LIVING APARTMENTS.ISLC OPERATES TWO GENERAL CARE UNITS IN ITS NURSING CENTER, AND OPERATES FOUR UNITS FOR THE TREATMENT OF SPECIAL MEDICAL PROBLEMS. TWO OF THE UNITS ARE DEVOTED TO THE CARE OF RESIDENTS WITH EARLY AND ADVANCED DEMENTIA OR ALZHEIMER'S DISEASE. ONE UNIT IS FOR RESIDENTS WITH SPECIAL MEDICAL NEEDS SUCH AS CONTINUAL OXYGEN, AND ANOTHER IS DEVOTED TO RESIDENTS WHO NEED RESTORATIVE THERAPY.THE REHABILITATION UNIT FOCUSES ON THE RESTORATION OF THE MOVEMENT OF LIMBS AND HELPING PEOPLE COPE WITH THEIR DISABILITIES SO THAT THEY CAN LIVE MORE INDEPENDENTLY. THE UNIT SERVES RESIDENTS WHO NEED A LESS INTENSIVE OR LONGER PERIOD OF THERAPY THAN IS ECONOMICALLY APPROPRIATE IN A HOSPITAL. RESIDENTS OF THE REHABILITATION UNIT ARE OFTEN DISCHARGED TO THEIR HOMES AFTER TREATMENT IS COMPLETED. 0 14790180 1 1 0 1 0 0 0 0 1 1 1 0 0 0 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 18 0 1 346 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 8 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NY X MARILYN BARBIERI 6077867302 508 HIGH AVENUE ENDICOTT NY 13760 X SHARON YAPLE CHAIRMAN 2.00 X X 0 0 0 LILLIAN LEVY 1ST VICE CHAIR 2.00 X X 0 0 0 KAY BOLAND 2ND VICE CHAIR 2.00 55.00 X X 0 584156 32699 HAROLD BEAM TREASURER 2.00 X X 0 0 0 PETER NEWMAN TRUSTEE 2.00 X 0 0 0 EVELYN ROZUNIK TRUSTEE 2.00 X 0 0 0 ROBERT GOMULKA TRUSTEE 2.00 X 0 0 0 JEROME BIGNOLI TRUSTEE 2.00 X 0 0 0 MICHELLE KAREDES TRUSTEE 2.00 55.00 X 0 184677 35776 BARBARA TRAVIS TRUSTEE 2.00 X 0 0 0 CORY JACOBS EX-OFFICIO 2.00 55.00 X X 0 151297 7137 NANCY RONGO SECRETARY 2.00 55.00 X 0 287490 36722 MICHELE GORDON ADMINISTRATOR 44.00 11.00 X 132819 33205 23482 MARILYN BARBIERI DIRECTOR OF FINANCE 44.00 11.00 X 75301 18825 15917 RON CEROW FORMER ADMINISTRATOR 0.00 55.00 X 0 141871 22705 208120 1401521 174438 1 1 1 0 AMN HEALTHCARE INC PO BOX 56157 LOS ANGELES CA 900746157 TEMPORARY SVCS 1704849 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 303682289 FOOD SERVICES 1097196 CROTHALL HEALTHCARE 13028 COLLECTIONS CENTER DR CHICAGA IL 60693 FACILITIES MAINT SVC 128672 BATES TROY 151 LAUREL AVE BINGHAMTON NY 13905 LAUNDRY SERVICE 106838 4 16232 16232 NURSING FACILITY REVENUE 623000 12830403 12830403 12830403 10334 10334 SERVICES RENDERED 561000 240204 240204 BEAUTY SHOP REVENUE 812900 27530 27530 MISCELLANEOUS REVENUE 900099 10292 10292 2200 2200 280226 13137195 12830403 0 290560 X 239640 239640 7123354 6796720 326634 309746 295785 13961 1050550 1003916 46634 816254 770679 45575 109034 109034 62061 62061 47189 47189 614776 415690 199086 72881 28418 44463 136864 83000 53864 258736 258736 10564 6524 4040 203231 190553 12678 421417 421417 309755 223776 85979 TEMPORARY SERVICES 1553290 1553290 SUPPLIES 746011 742195 3816 NYS ASSESSMENT 730456 730456 SERVICE CONTRACTS 643542 643542 659903 625483 34420 16119254 14790180 1329074 0 415012 1077053 2284335 1933254 9851 16221 16305303 13571536 3058000 2733767 772962 238884 58121 44678 6598281 6043857 1321994 1195483 43196 44357 3851633 3489496 10555223 13294289 15772046 18023625 X -9188690 -11980089 14925 321 -9173765 -11979768 6598281 6043857 X -2982059 4516 171540 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1580 1580 0 PART II-B, LINE 1: EXPENDITURES FOR LOBBYING IS A PERCENTAGE OF THE DUES TO LEADINGAGE (13.50%), HANYS (17.97%), AND AHIMA (5.00%). 0 1 X 14925 -14604 321 65662 -50737 14925 49449 16213 65662 16698 32751 49449 18688 -1990 16698 1.00000 1 0 10171132 7904480 2266652 882431 812024 70407 5251740 4855032 396708 2733767 DUE TO AFFILIATES: UHS HOSPITALS 11228260 DUE TO AFFILIATES: UHS, INC. 166815 DUE TO AFFILIATES: PHC 1336 DUE TO AFFILIATES: UMA 2362 ACCRUED PENSION AND POST RETIREMENT LIABILITIES 817597 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS, NET 289652 CURRENT PORTION OF CAPITAL LEASE OBLIGATION - AFFILIATE 709819 WORKERS COMP HONY TRUST, NON CURRENT 78448 13294289 X 12568825 0 12568825 568370 568370 13137195 15560654 0 15560654 558600 558600 16119254 PART IV, LINE 2B: ISLC MAINTAINS A RESIDENT TRUST FUND ACCOUNT TO HOLD PERSONAL FUNDS IN A SECURE LOCATION. THE RESIDENT TRUST FUND ACCOUNT IS ORGANIZED AS A SINGLE BANK ACCOUNT THAT INCLUDES THE FUNDS OF ALL RESIDENTS WHO HAVE CHOSEN TO USE IT. HOWEVER, EACH RESIDENT'S FINANCES ARE TRACKED SEPARATELY, AND THE RESIDENT OR THE RESIDENT'S APPOINTED FINANCIAL REPRESENTATIVE MUST APPROVE EVERY TRANSACTION. IF THE RESIDENT LEAVES THE FACILITY FOR ANY REASON OR PASSES AWAY, THE FUNDS ARE THEN RETURNED TO THE RESIDENT, THE RESIDENT'S ESTATE, OR IF NECESSARY DSS. PART X, LINE 2: THE FACILITY IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2019 AND 2018, THE FACILITY DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS NOR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2016 THROUGH 2019. THE FACILITY DOES NOT ANTICIPATE ANY UNRECOGNIZED TAX BENEFITS TO CHANGE IN THE NEXT TWELVE MONTHS. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAPITAL GRANT DONATIONS 9,770. PROVISION FOR BAD DEBT 558,600. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION BAD DEBT 558,600. X X X X 0 0 0 0 0 1 1 0 0 KAY BOLAND 2ND VICE CHAIR 0 496311 0 87845 0 0 0 19000 0 13699 0 616855 0 0 MICHELLE KAREDES TRUSTEE 0 172777 0 11900 0 0 0 12532 0 23244 0 220453 0 0 CORY JACOBS EX-OFFICIO 0 151297 0 0 0 0 0 6065 0 1072 0 158434 0 0 NANCY RONGO SECRETARY 0 251536 0 35954 0 0 0 19000 0 17722 0 324212 0 0 MICHELE GORDON ADMINISTRATOR 124209 31052 8610 2153 0 0 9013 2253 9773 2443 151605 37901 0 0 RON CEROW FORMER ADMINISTRATOR 0 123471 0 18400 0 0 0 7081 0 15624 0 164576 0 0 PART I, LINE 6 THE EXECUTIVE COMPENSATION PLAN HAS VARIOUS PERFORMANCE MEASURES WHICH INCLUDE ONES FOR CLINICAL EXCELLENCE, MARKET GROWTH, AND FINANCIAL STRENGTH. ONE MEASURE UNDER THE FINANCIAL STRENGTH HEADING IS THE COMBINED NET INCOME OF THE UNITED HEALTH SERVICES SYSTEM. A PORTION OF THE 2019 INCENTIVE COMPENSATION PAYMENTS WERE ATTRIBUTABLE TO MEETING THE COMBINED NET INCOME, PATIENT SAFETY, AND QUALITY GOALS. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. FORM 990, PART VI, SECTION B, LINE 11B THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE IDEAL SENIOR LIVING CENTER, INC. (ISLC) BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF THE 990 TO MANAGEMENT. THE UHS FINANCE DEPARTMENT PREPARES THE 990 WHICH IS THEN REVIEWED BY THE CORPORATE CFO AND INDEPENDENT AUDITORS PRIOR TO FILING. A SUMMARY OF KEY ELEMENTS OF THE 990 IS SHARED WITH THE BOARD OF DIRECTORS FOR INFORMATION PURPOSES. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS AND KEY EMPLOYEES SUBMIT CONFLICT OF INTEREST STATEMENTS ANNUALLY WHICH ARE REVIEWED BY THE ADMINISTRATOR, 2ND VICE CHAIR AND BOARD CHAIRMAN. FORM 990, PART VI, SECTION B, LINE 15 IT IS THE PHILOSOPHY OF IDEAL SENIOR LIVING CENTER, INC.(ISLC) THAT ALL STAFF INCLUDING THE EXECUTIVE STAFF BE COMPENSATED FAIRLY FOR THEIR WORK. BASE SALARY LEVELS, INCENTIVE/BONUS PROGRAMS AND BENEFIT PLANS SHALL TAKE INTO ACCOUNT THE LOCAL, REGIONAL AND NATIONAL MARKETS TO ALLOW ISLC TO RECRUIT, MOTIVATE, REWARD, RECOGNIZE AND RETAIN HIGHLY TALENTED EXECUTIVES WITH THE SKILL SETS REQUIRED TO FULFILL ITS MISSION CRITICAL PERFORMANCE OBJECTIVES THAT WILL LEAD TO THE ORGANIZATION'S AND SYSTEM'S SUCCESS. TO CARRY OUT THIS COMPENSATION PHILOSOPHY, UHS, INC.--THE SOLE CORPORATE MEMBER OF ISLC--PERFORMS HUMAN RESOURCES SERVICES FOR ISLC. UHS, INC. PREPARES AND RECOMMENDS ISLC EXECUTIVE COMPENSATION PACKAGES USING BENCHMARKS PROVIDED BY IROQUOIS HEALTHCARE ALLIANCE TO DETERMINE REASONABLE COMPENSATION LEVELS. THE ISLC BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE THEN REVIEWS THE RECOMMENDATIONS TO ENSURE THE APPROPRIATENESS OF BASE SALARY, INCENTIVES, AND BENEFITS. THE COMPENSATION COMMITTEE WILL THEN MAKE ANY NECESSARY REVISIONS PRIOR TO APPROVING EXECUTIVE COMPENSATION PACKAGES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, COLUMN B THE FOLLOWING BOARD MEMBERS ARE ACTIVE ON THE IDEAL SENIOR LIVING CENTER, INC BOARD OF DIRECTORS AND WERE EMPLOYED FULL TIME BY ONE OR MORE RELATED ORGANIZATIONS: NANCY RONGO KAY BOLAND MICHELLE KAREDES FORM 990, PART VII, SECTION A, COLUMN B IDEAL SENIOR LIVING CENTER, INC. (ISLC) HAS AN ADMINISTRATION/MANAGEMENT SERVICES INTERCOMPANY CONTRACT WITH UHS HOSPITALS. THE ADMINISTRATOR--MICHELE GORDON--SPENDS 80% OF HER TIME PERFORMING ADMINISTRATION DUTIES FOR ISLC, AND 20% FOR IDEAL SENIOR LIVING CENTER HOUSING CORPORATION (ISLCHC). ISLC HAS A FINANCIAL SERVICES INTERCOMPANY CONTRACT WITH ISLCHC. THE DIRECTOR OF FINANCE--MARILYN BARBIERI--SPENDS 80% OF HER TIME PERFORMING FINANCIAL DUTIES FOR ISLC AND 20% OF HER TIME FOR ISLCHC. FORM 990, PART XI, LINE 9: CHANGE IN RETIREMENT PLAN OBLIGATION 186,144. CHANGE IN INTEREST OF TEMPORARILY RESTRICTED ASSETS OF UHS FOUNDATION -14,604. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED ITS ORGANIZATION OR SELECTION PROCESS DURING THE TAX YEAR. THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE IDEAL SENIOR LIVING CENTER, INC. (ISLC) BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF THE 990 TO MANAGEMENT. THE UHS FINANCE DEPARTMENT PREPARES THE 990 WHICH IS THEN REVIEWED BY THE CORPORATE CFO AND INDEPENDENT AUDITORS PRIOR TO FILING. A SUMMARY OF KEY ELEMENTS OF THE 990 IS SHARED WITH THE BOARD OF DIRECTORS FOR INFORMATION PURPOSES. UHS INC 10-42 MITCHELL AVE BINGHAMTON NY 13903 222682421 PARENT COMPANY NY 501(C)(3) 10 N/A 0 IDEAL SENIOR LIVING CTR HOUSING CORPORATION 508 HIGH AVE ENDICOTT NY 13760 222902899 SENIOR HOUSING NY 501(C)(3) 10 N/A 0 PROFESSIONAL HOME CARE 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 161261977 HOME HEALTH CARE NY 501(C)(3) 10 N/A 0 TWIN TIER HOME HEALTH CARE 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 222348211 HOME HEALTH CARE NY 501(C)(3) 7 N/A 0 UHS HOSPITALS INC 10-42 MITCHELL AVE BINGHAMTON NY 13903 161165049 ACUTE & OUTPATIENT SERVICES NY 501(C)(3) 3 N/A 0 CHENANGO MEMORIAL HOSPITAL INC 179 NORTH BROAD STREET NORWICH NY 13815 150532180 HOSPITAL NY 501(C)(3) 3 N/A 0 DELAWARE VALLEY HOSPITAL INC 1 TITUS PLACE WALTON NY 138561457 150524324 HOSPITAL NY 501(C)(3) 3 N/A 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 0 0