2020-11-13T15:38:05-06:00 2019-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2019-01-01 223240227 THE HIGHLANDS LIVING CENTER INC HIGH 5853890988 500 HAHNEMANN TRAIL PITTSFORD NY 14534 CARRIE FULLER-SPENCER CHIEF FINANCIAL OFFICER 5853890988 2020-11-13 1 KELLEY DEMONTE P01382609 5853811000 4.14.157.197 2020-11-13 15:20:46 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EEB0F1D07ECCEF90BDF2AB918C22792D9EBD0503 2019 2021-01-29 14:40:06Z CARRIE FULLER-SPENCER 500 HAHNEMANN TRAIL PITTSFORD NY 14534 13163609 0 X N/A X 1997 NY TO PROVIDE A CARING, COMPASSIONATE AND QUALITY-FOCUSED LIVING ENVIRONMENT IN A 122 BED SKILLED-NURSING FACILITY. 9 7 318 8 0 0 6546 5845 13280235 13138886 0 0 40150 18878 13326931 13163609 0 0 0 0 8742419 9939767 0 0 0 4651897 4694359 13394316 14634126 -67385 -1470517 7863009 7649331 10603237 11457126 -2740228 -3807795 TO PROVIDE A CARING, COMPASSIONATE AND QUALITY-FOCUSED LIVING ENVIRONMENT IN A 122 BED SKILLED-NURSING FACILITY. 0 0 13125300 12655424 OPERATE A 122 BED SKILLED-NURSING FACILITY AT 94.63% OCCUPANCY WITH 42,139 NUMBER OF DAYS SERVED. 280564 502340 OPERATE A 20 LOT ADULT DAY CARE MEDICAL PROGRAM FOR RESIDENTS OF THE SURROUNDING COMMUNITY WITH 4,628 NUMBER OF DAYS SERVED. 13405864 1 0 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 18 0 1 318 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 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 ROBERT LATELLA BOARD MEMBER 1.00 X 0 0 0 ROBBIE MAGEE BOARD MEMBER 1.00 X 0 0 0 JAMES MOORE BOARD MEMBER 1.00 X 0 0 0 GERALD VAN STRYDONK BOARD MEMBER 1.00 X 0 0 0 VALERIE C BENJAMIN BOARD MEMBER 1.00 X 0 0 0 ROBERT MCCANN MD BOARD MEMBER 1.00 60.00 X 0 610788 65990 KATHLEEN PARRINELLO EXECUTIVE VP AND COO 1.00 68.00 X 0 783014 144617 WILLIAM J HALL MD BOARD MEMBER 1.00 60.00 X 0 118312 6476 STEVEN I GOLDSTEIN PRESIDENT 1.00 70.00 X 0 1232162 505762 CARRIE FULLER-SPENCER CHIEF FINANCIAL OFFICER 1.00 63.00 X 0 445805 77031 ELISA CHAMBERY ADMINISTRATOR 45.00 X 139892 0 26410 ADAM ANOLIK FORMER EXECUTIVE VP & CFO 1.00 63.00 X 0 721744 151089 139892 3911825 977375 1 1 1 0 RELIANT STAFFING SYSTEMS PO BOX 412058 BOSTON MA 02241 TEMP. SERVICES 352300 MEDLINE INDUSTRIES INC PO BOX 382075 PITTSBURGH PA 15251 SUPPLIES 330869 UR MEDICINE GERIATRICS GROUP 1870 S WINTON RD ROCHESTER NY 14618 PHYSICIAN SERVICES 261456 SYSCO FOOD SERVICES PO BOX 80 WARNERS NY 13164 FOOD 208092 STRONG MEMORIAL LTC PHARMACY 5901 LAC DE VILLE BLVD ROCHESTER NY 14618 PHARM/DRUGS 196272 5 5845 5845 RESIDENT SERVICE REVENUE 900099 13138886 13138886 13138886 OTHER REVENUE 900099 18878 18878 18878 13163609 13157764 0 0 7414309 7191880 222429 56135 54451 1684 1902128 1845064 57064 567195 550179 17016 75763 75763 22400 22400 8192 8192 196116 176504 19612 311418 280276 31142 3920 3528 392 93850 93850 433628 433628 37842 34058 3784 NON-MEDICAL SUPPLIES 834614 751153 83461 TEMP AGENCY 828881 828881 CONTRACT SERVICES 635574 577729 57845 MEDICAL CARE ITEMS 507389 507389 704772 604772 100000 14634126 13405864 1228262 0 734931 476767 2217929 2090757 46064 45095 16114867 12085713 3926030 4029154 938055 1007558 7863009 7649331 825975 650998 9777262 10806128 10603237 11457126 X -2740228 -3807795 -2740228 -3807795 7863009 7649331 X -1470517 402950 X X 0 1 X 1 0 X 13368 12620 17968 6546 5845 56347 12496742 12742527 13062590 13280235 13138886 64720980 12510110 12755147 13080558 13286781 13144731 64777327 0 0 0 64777327 35960 49377 38891 39765 0 163993 35960 49377 38891 39765 163993 780 51 155 385 18878 20249 12546850 12804575 13119604 13326931 13163609 64961569 0.99720 0.99690 0.00250 0.00300 X 0 0 0 0 0 1 1029 0 0 0 1029 0 PART II-B, LINE 1: THE $1029 IN LOBBYING EXPENSES ARE THE LOBBYING EXPENSES ASSOCIATED WITH THE LEADING AGE NY DUES PAID IN 2019. 250000 250000 11785785 9040758 2745027 2903662 2323206 580456 1175420 721749 453671 4029154 DUE FROM RELATED PARTIES - SHORT TERM 60148 RESIDENT ACCOUNTS HELD IN TRUST 24487 ASSETS WHOSE USE IS LIMITED - SHORT TERM 322133 OTHER ASSETS - LONG TERM 573306 DUE FROM RELATED PARTIES - LONG TERM 27484 1007558 DUE TO RELATED PARTIES - SHORT TERM 6447335 DUE TO RELATED PARTIES - LONG TERM 1999189 RESIDENT ACCOUNTS HELD IN TRUST 24487 THIRD PARTY LIABILITY 741000 ACCRUED WORKERS COMPENSATION - SHORT TERM 199117 NOTE PAYABLE - LONG TERM 860000 NOTE PAYABLE - SHORT TERM 535000 10806128 13163609 0 13163609 0 13163609 14634126 0 14634126 0 14634126 0 1 0 0 0 0 0 0 0 ROBERT MCCANN MD BOARD MEMBER 0 596094 0 0 0 14694 0 39154 0 26836 0 676778 0 0 KATHLEEN PARRINELLO EXECUTIVE VP AND COO 0 650948 0 90000 0 42066 0 127854 0 16763 0 927631 0 0 STEVEN I GOLDSTEIN PRESIDENT 0 1143063 0 5000 0 84099 0 486254 0 19508 0 1737924 0 0 CARRIE FULLER-SPENCER CHIEF FINANCIAL OFFICER 0 445805 0 0 0 0 0 52795 0 24236 0 522836 0 0 ELISA CHAMBERY ADMINISTRATOR 139892 0 0 0 0 0 5699 0 20711 0 166302 0 0 0 ADAM ANOLIK FORMER EXECUTIVE VP & CFO 0 714726 0 0 0 7018 0 126854 0 24235 0 872833 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 $300,000 ROBERT MCCANN, MD SERP PLAN $12,300 ADAM ANOLIK SERP PLAN $100,000 CARRIE FULLER-SPENCER SERP PLAN $25,000 KATHLEEN PARRINELLO SERP PLAN $75,000 KATHLEEN PARRINELLO 457(F) PLAN $26,000 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE HIGHLANDS LIVING CENTER, INC. CORPORATION 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. CORPORATION 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. CORPORATION 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 402,950. FORM 990, PART XII, LINE 2C: THERE HAVE BEEN NO CHANGES TO THE PROCEDURES SINCE THE PRIOR YEAR. 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