2020-11-16T15:53:48-06:00 2019-12-31 454051133 FREED MAXICK CPAS PC 424 MAIN STREET SUITE 800 BUFFALO NY 142023508 990 2019-01-01 237155198 BROTHERS OF MERCY NURSING HOME CO INC BROT 7167596985 10570 BERGTOLD ROAD CLARENCE NY 14031 JOSEPH WIDMER CFO 7167596985 2020-11-16 1 MARY MADONIA P00405803 7168472651 2020-11-16 104.193.28.34 2020-11-16 16:00:00 ES P 4D1D5D60F95EDCD5C44013F29593736C3DE82965 4D1D5D60F95EDCD5C44013F29593736C3DE82965 2019 2021-01-29 14:40:06Z PETER EIMER 10570 BERGTOLD ROAD CLARENCE NY 14031 26131931 0 X BROTHERSOFMERCY.ORG X 1971 NY TO PROVIDE REHABILITATION SERVICES AND SKILLED NURSING CARE. 10 9 659 85 0 0 163935 216500 22851825 24690083 48657 68138 460607 477516 23525024 25452237 0 0 0 0 13391245 13749655 0 0 0 9994775 10859947 23386020 24609602 139004 842635 9856470 14898972 4362656 8490481 5493814 6408491 TO PROVIDE REHABILITATION SERVICES AND SKILLED NURSING CARE. 0 0 21652919 24991585 NURSING CARE AND REHABILITATION SERVICE FOR A 240 BED NYS LICENSED NURSING FACILITY. 21652919 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 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 41 0 1 659 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NY X X JOSEPH WIDMER 7167596985 4520 RANSOM ROAD CLARENCE NY 14031 BROTHER KENNETH THOMAS BOARD MEMBER 6.25 31.25 X 0 0 0 BROTHER MATHIAS MOLLER BOARD MEMBER/TREASURER 0.50 2.50 X X 0 0 0 PETER EIMER BOARD MEMBER/ CORPORATE CEO 24.50 13.00 X X 117904 63487 6235 DR JOSEPH DUNN BOARD MEMBER/CHAIRMAN 0.50 2.50 X X 0 0 0 MICHAEL NOE BOARD MEMBER/SECRETARY 0.50 2.50 X X 0 0 0 SISTER PATRICIA BURKARD BOARD MEMBER 0.50 2.50 X 0 0 0 MICHAEL MCRAE BOARD MEMBER 0.50 2.50 X 0 0 0 THOMAS FENTNER BOARD MEMBER 0.50 2.50 X 0 0 0 MSGR DAVID LIPUMA BOARD MEMBER 0.50 2.50 X 0 0 0 DAVID NASCA BOARD MEMBER 0.50 2.50 X 0 0 0 JOSEPH WIDMER CFO 22.50 15.00 X 74674 95040 21515 NICOLE ECKERT DE SANTIAGO DIRECTOR OF NURSING 37.50 X 104461 0 18750 NICOLE DEKAY FORMER DIRECTOR OF NURSING 37.50 X 115941 0 9956 VALERIE KANE CORPORATE COMPLIANCE OFFIC 15.00 22.50 X 56697 96539 11484 TERESA DILLSWORTH ADMINISTRATOR 37.50 X 164496 0 15418 634173 255066 83358 4 0 1 0 SELECT REHABILITATION INC PO BOX 809056 CHICAGO IL 600689056 THERAPY - PT, OT, SPEECH 2283784 SODEXO INC& AFFILIATES PO BOX 360170 PITTSBURGH PA 15251 DINING, ENIVO, FACILITIES 1056565 BRIMS LLC (DBA BEACON SOLUTIONS GROUP) 100 CORPORATE PARKWAY AMHERST NY 14226 CLINICAL/NURSING CONSULTING 239563 3 216500 216500 RESIDENT SERVICE REVENUE 623000 24690083 24690083 24690083 66332 66332 681500 678611 1083 2889 -1083 1806 1806 OTHER INCOME 623000 195828 195828 CAFETERIA INCOME 722210 152454 152454 GIFT SHOP INCOME 453220 77538 53978 23560 51696 51696 477516 25452237 24991585 0 244152 X 399337 220267 179070 11549047 11076873 472174 99650 93045 6605 782469 722068 60401 919152 865559 53593 1627387 1627387 18977 18977 172606 33573 139033 6643 6643 3436541 3436541 61393 61393 386434 340442 45992 4850 2649 2201 104902 104902 509100 483645 25455 646260 632689 13571 NEW YORK STATE FEES 1091564 1091564 MISCELLANEOUS 1071951 751887 320064 MEDICAL SUPPLIES/EQUIPM 913808 913808 FOOD 778315 778315 29216 24722 4494 24609602 21652919 2956683 0 276700 462246 519612 316437 3750230 5339967 1271226 1696760 98061 127798 81872 86765 21107505 16200606 3189558 4906899 412109 1758407 257102 203693 9856470 14898972 3658879 3896164 65708 53788 445840 4514219 192229 26310 4362656 8490481 X 5493814 6350841 57650 5493814 6408491 9856470 14898972 842635 72042 0 X X 0 1 X 1 0 X 35409 37800 152326 163935 216500 605970 20967283 22046576 22639247 23157558 24991585 113802249 89131 142656 164707 154874 176014 727382 21091823 22227032 22956280 23476367 25384099 115135601 0 0 0 115135601 26620 20407 47754 51589 66332 212702 26620 20407 47754 51589 66332 212702 21118443 22247439 23004034 23527956 25450431 115348303 0.99820 0.99710 0.00180 0.00120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 16000 16000 15312530 11993638 3318892 77709 74070 3639 5227600 4132898 1094702 473666 473666 4906899 CAPITAL LEASE OBLIGATIONS 26310 26310 X 25524279 72042 72042 25452237 0 25452237 24609602 0 24609602 0 24609602 PART IV, LINE 2B: RESIDENT FUNDS HELD IN TRUST, CONSISTING OF AMOUNTS DEPOSITED ON BEHALF OF RESIDENTS AND USED FOR THEIR PERSONAL CARE. PART X, LINE 2: THE HOME IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 509(A) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(C)(3) OF THE CODE. ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. THE COMPANY FILES ITS RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX IN THE U.S FEDERAL JURISDICTION AND ITS ANNUAL FILING OF CHARITABLE ORGANIZATIONS IN NEW YORK STATE. X X X 0 0 0 0 0 0 0 0 0 PETER EIMER BOARD MEMBER/ CORPORATE CEO 117904 63487 0 0 0 0 2355 1268 1698 914 121957 65669 0 0 JOSEPH WIDMER CFO 74674 95040 0 0 0 0 1518 1933 7948 10116 84140 107089 0 0 VALERIE KANE CORPORATE COMPLIANCE OFFIC 56697 96539 0 0 0 0 1128 1921 3121 5314 60946 103774 0 0 TERESA DILLSWORTH ADMINISTRATOR 164496 0 0 0 0 0 606 0 14812 0 179914 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CFO PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C QUESTIONNAIRE IS SENT OUT ANNUALLY AND INFORMATION REGARDING POTENTIAL CONFLICTS OF INTEREST IS MAINTAINED BY ADMINISTRATION. COMPLETED QUESTIONNAIRES ARE KEPT ON FILE IN THE FINANCE OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS REVIEWS SALARIES FOR TOP MANAGEMENT OFFICIALS AND USES COMPARABILITY DATA FROM LEADING AGE OF NY IN ORDER TO DETERMINE SALARIES. THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 1023 AND FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 DISCLOSURE OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS IS BASED ON THE PURPOSE OF THE REQUEST. FORM 990, PART IX, LINE 11G MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 2,685,519. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,685,519. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 214,859. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 214,859. X-RAY SERVICES: PROGRAM SERVICE EXPENSES 86,952. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 86,952. CONSULTING: PROGRAM SERVICE EXPENSES 449,211. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 449,211. FORM 990, PART XII, LINE 2C THERE HAS BEEN NO CHANGE IN THE AUDIT OVERSIGHT PROCESS OR THE AUDITOR SELECTION PROCESS. BROTHERS OF MERCY HOLDING COMPANY INC 4520 RANSON ROAD CLARENCE NY 14031 160746852 HOLDING COMPANY NY 501(C)(3) LINE 12D N/A 0 BROTHERS OF MERCY SACRED HEART HOME 4520 RANSON ROAD CLARENCE NY 14031 161082636 ADULT CARE FACILITY NY 501(C)(3) LINE 10 N/A 0 BROTHERS OF MERCY HOUSING CO INC 10500 BERGTOLD ROAD CLARENCE NY 14031 237117107 HOUSING FOR ELDERLY NY 501(C)(3) LINE 7 N/A 0 BROTHERS OF MERCY FACILITIES FOUNDATION 4520 RANSON ROAD CLARENCE NY 14031 161558645 SUPPORT CHARITABLE PURPOSES OF BROTHERS NY 501(C)(3) LINE 7 N/A 0 BROTHERS OF MERCY OF MONTABAUR APARTMENT COMPLEX INC 4530 RANSON ROAD CLARENCE NY 14031 464619699 HOUSING FOR ELDERLY NY 501(C)(3) LINE 10 N/A 0 BROTHERS OF MERCY MANAGEMENT COMPANY 4520 RANSON ROAD CLARENCE NY 14031 813966963 SUPPORT SERVICES FOR RELATED PARTIES NY 501(C)(3) LINE 10 N/A 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 BROTHERS OF MERCY HOLDING COMPANY INC (FORMERLY BROTHERS OF MERCY INC) K 94525 ACCOUNTING RECORDS BROTHERS OF MERCY OF MONTABAUR APARTMENTS COMPLEX INC D 406621 END OF YEAR BALANCE BROTHERS OF MERCY MANAGEMENT COMPANY D 793851 END OF YEAR BALANCE BROTHERS OF MERCY SACRED HEART HOME D 482412 END OF YEAR BALANCE BROTHERS OF MERCY FACILITIES FOUNDATION C 216500 ACCOUNTING RECORDS