2018-10-26T09:02:15-05:00 2017-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2017-01-01 113109867 ST JOHNLAND NURSING CENTER INC STJO 6312695800 395 SUNKEN MEADOW ROAD KINGS PARK NY 11754 MARY JEAN WEBER CEO 6312695800 2018-10-25 1 AARON SHAPIRO P01333816 2128674000 64.22.227.161 2018-10-26 07:19:35 ED P 4275C7E7C8129915C35F764424C97B97C01C68F2 82FF71277CCFCE0526AA11C39E3CDADE20CEB2CB 2017 2018-06-14 16:35:46Z MARY JEAN WEBER 395 SUNKEN MEADOW ROAD KINGS PARK NY 11754 35084209 0 X WWW.STJOHNLAND.ORG X 1991 NY TO CREATE A CARING AND SUPPORTIVE ENVIRONMENT COMMITTED TO THE HIGHEST STANDARDS OF QUALITY HEALTHCARE. 8 8 524 8 0 0 200000 350000 34523197 34323618 2565 2773 298680 407818 35024442 35084209 0 0 0 0 24506730 24893677 0 0 0 9621800 9624866 34128530 34518543 895912 565666 16887108 18097309 19804471 20469300 -2917363 -2371991 TO CREATE A CARING AND SUPPORTIVE ENVIRONMENT COMMITTED TO THE HIGHEST STANDARDS OF QUALITY HEALTHCARE. IT SEEKS TO UPHOLD THE PRINCIPLES OF HUMAN DIGNITY AND WORTH, AND AFFIRMS THE RIGHT OF EVERY INDIVIDUAL TO MAINTAIN THE OPTIMUM QUALITY OF LIFE. 0 0 1020705 32569210 INPATIENT PROGRAM WITH 230 RESIDENT CARE BEDS. 26965098 1754408 ADULT DAY CARE PROGRAM FOR 100 REGISTRANTS. 27985803 1 1 0 0 0 0 0 0 1 1 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 24 0 524 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X MICHAEL BARTOLOTTA 6312695800 395 SUNKEN MEADOW RD KINGS PARK NY 11754 TRUDY H CALABRESE PRESIDENT 0.50 1.00 X X 0 0 0 CARL H DOERGE JR VICE PRESIDENT 0.50 1.00 X X 0 0 0 SHARON FUENTES VICE PRESIDENT 0.50 1.00 X X 0 0 0 DAVID H DEMING VICE PRESIDENT 0.50 1.00 X X 0 0 0 PETER FETTEROLF SECRETARY 0.50 1.00 X X 0 0 0 JOAN M HEANEY ASSISTANT SECRETARY 0.50 1.00 X X 0 0 0 WILLIAM D KEEN TREASURER 0.50 1.00 X X 0 0 0 FREDRIC R LAMARCA ASSISTANT TREASURER 0.50 1.00 X X 0 0 0 MARY JEAN WEBER CEO 30.00 7.50 X 306567 26658 47150 MICHAEL BARTOLOTTA FISCAL DIRECTOR 30.50 7.00 X 177631 21210 43077 DR MAUREEN ORSEN MEDICAL DIRECTOR 37.50 X 270507 0 45062 DEANNA BAEZ ASSISTANT ADMINISTRATOR 35.00 2.50 X 133328 9524 18795 DR ALEX CZIRA PHYSICIAN 37.50 X 125709 0 40650 EILEEN GIORDANO CASE MANAGER 37.50 X 122631 0 18129 MARJORIE MOMBELEUR PHYSICIAN 37.50 X 125115 0 40632 KWANG JUNG PHYSICIAN 37.50 X 144056 0 41285 1405544 57392 294780 14 0 1 0 MORRISON MANAGEMENT PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 3236321 MEDLINE INDUSTRIES PO BOX 382075 PITTSBURGH PA 15251 MEDICAL SUPPLIES 592832 CARE & COMFORT 1580 OCEAN AVENUE BOHEMIA NY 11716 TRANSPORTATION 420335 PROCARE PHARMACY 111 EXECUTIVE BLVD FARMINGDALE NY 11735 PHARMACEUTICAL 410981 LOEB & TROPER LLP 655 THIRD AVE NEW YORK NY 10017 ACCOUNTING SERVICES 217195 11 200000 150000 350000 SKILLED NURSING FACILITY 623000 32569210 32569210 ADULT DAY CARE 623000 1754408 1754408 34323618 2773 2773 OTHER 900099 270447 270447 PENSION CREDIT 900099 137371 137371 407818 35084209 34323618 0 410591 881627 722934 158693 17553255 14393669 3159586 114730 94078 20652 5088909 4172905 916004 1255156 1029228 225928 181210 181210 207597 207597 1896765 1555347 341418 1680 1680 1196124 979939 216185 1026843 842012 184831 409901 336119 73782 15105 12386 2719 75223 61683 13540 866214 710295 155919 356176 292064 64112 NYS CASH RECEIPT ASSESS 1596330 1308991 287339 FOOD & KITCHEN 1036204 849687 186517 PRESCRIPTION DRUGS/SUPP 435058 356748 78310 MISCELLANEOUS 319860 262286 57574 4576 3752 824 34518543 27985803 6532740 0 690238 527357 870403 481955 4207851 5913697 1158565 619946 115414 99132 1160399 1233616 40803108 31744543 8664611 9058565 19627 163041 16887108 18097309 5885979 15148711 5865 169130 123902 3072804 2298496 960102 658712 9710591 2239479 19804471 20469300 X -2959863 -2414491 42500 42500 -2917363 -2371991 16887108 18097309 X 565666 -20294 X X 0 1 X 1 0 X 533147 566439 200000 200000 350000 1849586 34286331 33593781 35217294 34523197 34323618 171944221 34819478 34160220 35417294 34723197 34673618 173793807 0 0 0 173793807 63898 529 461 2565 2773 70226 63898 529 461 2565 2773 70226 344003 622068 383320 298680 407818 2055889 35227379 34782817 35801075 35024442 35084209 175919922 0.98790 0.98720 0.00040 0.00090 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUES AMNESTY PROGRAM INCOME PENSION REFUND OTHER INCOME 0 1 X 42500 42500 42500 42500 42500 42500 42500 42500 42500 42500 1.00000 0 0 452043 452043 22176539 17049523 5127016 17830631 14695020 3135611 343895 343895 9058565 LINE OF CREDIT 1000000 SECURITY DEPOSITS 17814 ESTIMATED AMOUNT DUE TO THIRD PARTY PAYORS 1221665 2239479 X 35084209 0 35084209 0 35084209 34518543 0 34518543 0 34518543 PART IV, LINE 1B: RESIDENT FUNDS AND SECURITY DEPOSITS - RESIDENT FUNDS AND SECURITY DEPOSITS ARE MAINTAINED IN BANK ACCOUNTS THAT ARE SEPARATE FROM THE CENTER'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS AND SECURITY DEPOSITS ARE CREDITED TO THEIR ACCOUNTS. PART IV, LINE 2B: AMOUNTS HELD IN TRUST FOR RESIDENTS. PART V, LINE 4: THE CENTER HAS ONE INDIVIDUAL DONOR-RESTRICTED ENDOWMENT FUND ESTABLISHED FOR SUPPORT FOR THE ELDERLY. PART X, LINE 2: THE CENTER HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2014 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPPLICABLE TAXING AUTHORITIES. X X X X X 0 0 0 0 0 0 0 0 0 MARY JEAN WEBER CEO 305110 26531 0 0 1457 127 9197 800 34181 2972 349945 30430 0 0 MICHAEL BARTOLOTTA FISCAL DIRECTOR 177138 21151 0 0 493 59 5329 636 33153 3959 216113 25805 0 0 DR MAUREEN ORSEN MEDICAL DIRECTOR 267459 0 0 0 3048 0 8115 0 36947 0 315569 0 0 0 DEANNA BAEZ ASSISTANT ADMINISTRATOR 133064 9505 0 0 264 19 4000 286 13542 967 150870 10777 0 0 DR ALEX CZIRA PHYSICIAN 125709 0 0 0 0 0 3771 0 36879 0 166359 0 0 0 MARJORIE MOMBELEUR PHYSICIAN 125115 0 0 0 0 0 3753 0 36879 0 165747 0 0 0 KWANG JUNG PHYSICIAN 144056 0 0 0 0 0 4322 0 36963 0 185341 0 0 0 PART I, LINE 3 THE ORGANIZATION RELIES ON THE BOARD OF DIRECTORS TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. THIS PROCESS WAS LAST DONE IN DECEMBER 2016. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD ELECT THE DIRECTORS OF EACH PROGRAM EACH SPRING AT THE ANNUAL MEETING OF EACH CORPORATION. IF A VACANCY OCCURS ON THE BOARD IN THE INTERIM, THE REMAINING DIRECTORS MAY ELECT A SUCCESSOR TO SERVE UNTIL THE NEXT ANNUAL MEETING OF MEMBERS. AT THE NEXT ANNUAL MEETING, THE MEMBERS ELECT DIRECTORS FOR SPECIFIC TERMS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS HAVE THE RIGHTS AND DUTIES PROVIDED BY STATUTE UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW WHICH ARE NOT UNLIKE THOSE OF STOCKHOLDERS IN A TRADITIONAL "FOR PROFIT" CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING WITH THE IRS, COPIES HAVE BEEN PROVIDED TO ALL BOARD MEMBERS FOR REVIEW. QUESTIONS AND COMMENTS HAVE BEEN FOWARDED TO THE CEO, WHO HAS DISCUSSED WITH THE PREPARER ANY CHANGES THAT MAY NEED TO BE ADDRESSED. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF ST. JOHNLAND NURSING CENTER, INC. THAT ALL DIRECTORS, OFFICERS, EMPLOYEES, AGENTS AND CONTRACTORS AVOID ANY ALL ACTIVITIES THAT CONFLICT WITH OR APPEAR TO CONFLICT WITH THEIR RESPONSIBILITIES AND OBLIGATIONS TO ST. JOHNLAND. CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE REQUIRED TO BE SIGNED BY EMPLOYEES. WHEN A CONFLICT ARISES, IT IS BROUGHT TO THE BOARD'S ATTENTION TO BE DISCUSSED. THE BOARD MEMBER WHO HAS THIS CONFLICT MUST RECUSE THEMSELVES FROM PARTICIPATING IN ANY DISCUSSION RELATED TO THE MATTER. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION RELIES ON THE BOARD OF DIRECTORS TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. THIS PROCESS WAS LAST DONE IN DECEMBER 2016. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: ADJUSTMENT TO REFLECT PENSION FUNDED STATUS -20,294. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SOCIETY OF ST JOHNLAND 395 SUNKEN MEADOW RD KINGS PARK NY 11758 111890580 FUND RAISING NY 501(C)(3) LINE 7 N/A 0 ST JOHNLAND RESIDENCES II INC 395 SUNKEN MEADOW RD KINGS PARK NY 11758 200316499 TO ESTABLISH, OPERATE AND MAINTAIN AN ADULT RESIDENTIAL FACILITY NY 501(C)(3) LINE 12B, II N/A 0 0 0 1 0 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0