MICHAEL MALOTZ SKILLED NURSING PAVILION: Form 990EZ, tax year 2016
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- Organization
- MICHAEL MALOTZ SKILLED NURSING PAVILION (EIN 31-1587828)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201733199349206183
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-15T15:30:36-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271728945 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PKF O'CONNOR DAVIES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MAMARONECK AVENUE | AddressLine1Txt |
| City | HARRISON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 105281633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311587828 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL MALOTZ SKILLED NURSING PAVILION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MICH | BusinessNameControlTxt |
| Phone | 9149644691 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 PARK AVENUE | AddressLine1Txt |
| City | YONKERS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10703 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENNIS M KEANE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9149644691 | PhoneNum |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GARRETT M HIGGINS | PreparerPersonNm |
| PTIN | P00543209 | PTIN |
| Phone | 9143818900 | PhoneNum |
| Preparation | 2017-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 65.51.112.58 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-15 | IPDt |
| IP Tm | 16:27:53 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 45D10729E84C80409783239EA0C370A8A08632B7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 45D10729E84C80409783239EA0C370A8A08632B7 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | WWW.RIVERSIDEHEALTH.ORG | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $181,368 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Program Service Revenue | $147,534 | ProgramServiceRevenueAmt |
| Investment Income | $3,521 | InvestmentIncomeAmt |
| Other Revenue Total | $30,313 | OtherRevenueTotalAmt |
| Total Revenue | $181,368 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $942,586 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $151,506 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $5,417 | OccupancyRentUtltsAndMaintAmt |
| Other Expenses Total | $450,658 | OtherExpensesTotalAmt |
| Total Expenses | $1,550,167 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$1,368,799 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $1,074,299 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | -$294,500 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,296,271 | BOYAmt |
| EOY | $40,525 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,475,053 | BOYAmt |
| EOY | $175,487 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,771,324 | BOYAmt |
| EOY | $216,012 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,697,025 | BOYAmt |
| EOY | $510,512 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,074,299 | BOYAmt |
| EOY | -$294,500 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | TO PROVIDE SKILLED NURSING AND REHABILITATION SERVICES TO GERIATRIC, SUBACUTE AND VENTILATOR DEPENDENT RESIDENTS. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | IN JULY 2014, THE MICHAEL MALOTZ SKILLED NURSING PAVILION ("MMSNP") ENTERED INTO AN ASSET PURCHASE AND SALE AGREEMENT WITH AN UNRELATED BUYER FOR THE PURCHASE OF THE FACILITY. THE SALE WAS COMPLETED ON AUGUST 31, 2015 (THE CLOSING DATE). THE MMSNP IS IN THE PROCESS OF DISSOLVING. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $0 | GrantsAndAllocationsAmt |
| Program Service Expenses | $0 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $0 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (2 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| DENNIS M KEANE | ||||
| CHIEF FINANCIAL OFFICER | 0.50 | $0 | $0 | $0 |
| MARK POHAR | ||||
| ADMINISTRATOR THRU MAY 2016 | 37.50 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUBERT MOSEJCZUK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 PARK AVENUE | AddressLine1Txt |
| City | YONKERS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10703 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9149644691 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,537 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,621 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $210 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $875 | CurrentTaxYearMinus1YearAmt |
| Total | $11,243 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,330,802 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,349,225 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,787,389 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,390,388 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $147,534 | CurrentTaxYearAmt |
| Total | $58,005,338 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,334,339 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,355,846 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,787,599 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,391,263 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $147,534 | CurrentTaxYearAmt |
| Total | $58,016,581 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $950 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,150 | CurrentTaxYearMinus3YearsAmt |
| Total | $4,100 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $950 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,150 | CurrentTaxYearMinus3YearsAmt |
| Total | $4,100 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $58,012,481 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $29,148 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,516 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,298 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,905 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,521 | CurrentTaxYearAmt |
| Total | $85,388 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $29,148 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,516 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,298 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,905 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,521 | CurrentTaxYearAmt |
| Total | $85,388 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $35,112 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $51,149 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $33,694 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,514 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $30,313 | CurrentTaxYearAmt |
| Total | $174,782 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,398,599 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,430,511 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,840,591 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,425,682 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $181,368 | CurrentTaxYearAmt |
| Total | $58,276,751 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99550 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99580 | PublicSupportPY509Pct |
| Investment Income CY | 0.00150 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00170 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | VENDING MACHINES INCOME - 2013 AMOUNT: $ 1,937. 2014 AMOUNT: $ 1,836. 2015 AMOUNT: $ 989. MEDICAL ABSTRACTION FEES - 2013 AMOUNT: $ 7. REFUNDS AND REBATES - 2012 AMOUNT: $ 3,863. 2013 AMOUNT: $ 9,179. 2014 AMOUNT: $ 13,180. 2015 AMOUNT: $ 8,900. 2016 AMOUNT: $ 4,771. EMPLOYEE PARKING FEES - 2012 AMOUNT: $ 19,700. 2013 AMOUNT: $ 19,097. 2014 AMOUNT: $ 17,796. 2015 AMOUNT: $ 11,799. OTHER - 2012 AMOUNT: $ 11,549. 2013 AMOUNT: $ 1,967. 2014 AMOUNT: $ 882. 2015 AMOUNT: $ 301. 2016 AMOUNT: $ 25,542. TELEPHONE/TELEVISION INCOME - 2013 AMOUNT: $ 18,962. 2015 AMOUNT: $ 2,525. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INTEREST INCOME. AMOUNT: 3,521. |
| FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE | DESCRIPTION: REBATES. AMOUNT: 4,771. DESCRIPTION: MISCELLANEOUS REVENUE. AMOUNT: 25,542. TOTAL TO FORM 990-EZ, LINE 8: 30,313. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: NYS CASH RECEIPT ASSESSMENT. AMOUNT: 34,370. DESCRIPTION: OFFICE. AMOUNT: 1,918. DESCRIPTION: MISCELLANEOUS. AMOUNT: 7,283. DESCRIPTION: MALPRACTICE INSURANCE. AMOUNT: 390,000. DESCRIPTION: CONSULTING. AMOUNT: 16,720. DESCRIPTION: SEMINARS. AMOUNT: 335. DESCRIPTION: TRAVEL. AMOUNT: 32. TOTAL TO FORM 990-EZ, LINE 16: 450,658. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: ACCOUNTS RECEIVABLE. BEG. OF YEAR AMOUNT: 300,017. END OF YEAR AMOUNT: 172,655. DESCRIPTION: PREPAID EXPENSES. BEG. OF YEAR AMOUNT: 41,754. END OF YEAR AMOUNT: 0. DESCRIPTION: RESTRICTED CASH - RESIDENT'S FUNDS. BEG. OF YEAR AMOUNT: 2,832. END OF YEAR AMOUNT: 2,832. DESCRIPTION: DUE FROM THIRD PARTY PAYORS. BEG. OF YEAR AMOUNT: 466,450. END OF YEAR AMOUNT: 0. DESCRIPTION: INSURANCE RECOVERY RECEIVABLE. BEG. OF YEAR AMOUNT: 664,000. END OF YEAR AMOUNT: 0. |
| FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES | DESCRIPTION: ACCOUNTS PAYABLE AND ACCRUED EXPENSES. BEG. OF YEAR AMOUNT: 424,847. END OF YEAR AMOUNT: 966. DESCRIPTION: ESCROW ACCOUNT LIABILITY. BEG. OF YEAR AMOUNT: 2,832. END OF YEAR AMOUNT: 2,832. DESCRIPTION: DUE TO THIRD PARTY PAYORS. BEG. OF YEAR AMOUNT: 387,909. END OF YEAR AMOUNT: 419,877. DESCRIPTION: DUE TO ST. JOHN'S RIVERSIDE HOSPITAL. BEG. OF YEAR AMOUNT: 217,437. END OF YEAR AMOUNT: 86,837. DESCRIPTION: PROFESSIONAL LIABILITIES. BEG. OF YEAR AMOUNT: 664,000. END OF YEAR AMOUNT: 0. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | DeclarationDesc |