2017-11-15T15:30:36-06:00 2016-12-31 271728945 PKF O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE HARRISON NY 105281633 990EZ 2016-01-01 311587828 MICHAEL MALOTZ SKILLED NURSING PAVILION MICH 9149644691 2 PARK AVENUE YONKERS NY 10703 DENNIS M KEANE CFO 9149644691 2017-11-15 1 GARRETT M HIGGINS P00543209 9143818900 2017-11-15 65.51.112.58 2017-11-15 16:27:53 ES P 45D10729E84C80409783239EA0C370A8A08632B7 45D10729E84C80409783239EA0C370A8A08632B7 2016 2021-01-29 14:40:06Z X X WWW.RIVERSIDEHEALTH.ORG X X 181368 X 147534 3521 30313 181368 942586 151506 5417 450658 1550167 -1368799 1074299 0 -294500 X 1296271 40525 1475053 175487 2771324 216012 1697025 510512 1074299 -294500 X TO PROVIDE SKILLED NURSING AND REHABILITATION SERVICES TO GERIATRIC, SUBACUTE AND VENTILATOR DEPENDENT RESIDENTS. 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. 0 0 0 DENNIS M KEANE CHIEF FINANCIAL OFFICER 0.50 0 0 0 MARK POHAR ADMINISTRATOR THRU MAY 2016 37.50 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NY HUBERT MOSEJCZUK 2 PARK AVENUE YONKERS NY 10703 9149644691 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X 3537 6621 210 875 11243 15330802 16349225 15787389 10390388 147534 58005338 15334339 16355846 15787599 10391263 147534 58016581 950 3150 4100 0 950 3150 4100 58012481 29148 23516 19298 9905 3521 85388 29148 23516 19298 9905 3521 85388 35112 51149 33694 24514 30313 174782 15398599 16430511 15840591 10425682 181368 58276751 0.99550 0.99580 0.00150 0.00170 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: 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. 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. 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.