2017-11-15T13:10:49-06:00 2016-12-31 061667465 PRAGER METIS CPAS LLC 222 MOUNT AIRY ROAD BASKING RIDGE NJ 07920 990 2016-01-01 222823794 ST ANN'S HOME FOR THE AGED CORP STAN 2014330950 198 OLD BERGEN ROAD JERSEY CITY NJ 07305 JANET MERLY-LIRANZO ADMINISTRATOR ADMINISTRATOR 2014330950 2017-11-15 1 STEPHEN COBELL P00288771 9087669800 2017-11-15 96.57.153.126 2017-11-15 11:50:44 ES P 84763887A726337ED125C036FB8ECA22DB28EAD1 A184E2B6ABE0CA2EB7539731BF9CCF90CF703620 2016 2021-01-29 14:40:06Z PEACE CARE ST ANN'S 198 OLD BERGEN ROAD JERSEY CITY NJ 07305 14846372 0 X WWW.PEACECARENJ.ORG X 1987 NJ THE HOME PROVIDES LONG TERM NURSING CARE AS WELL AS ADULT MEDICAL DAYCARE TO THE COMMUNITY. PEACE CARE ST. ANN'S ADULT MEDICAL DAY CARE WAS CREATED FOR INDIVIDUALS WHO LIVE AT HOME BUT REQUIRE SUPPORTIVE HEALTH CARE. THE PROGRAM OFFERS A SAFE ENVIRONMENT AND INCORPORATES ONGOING ACTIVITIES WITH MEDICAL CARE. OURS IS A FRIENDLY ATMOSPHERE THAT FACILITATES SOCIALIZATION WITH PEERS WHILE PROVIDING SERVICES FOR A VARIETY OF NEEDS. 6 5 230 0 0 0 38050 39120 13269131 14425995 395245 256821 58275 31102 13760701 14753038 0 0 0 0 8250935 8747386 0 0 0 5417545 5256370 13668480 14003756 92221 749282 28089914 29014411 13310795 12736409 14779119 16278002 X SAINT ANN'S, THROUGH ITS MINISTRY OF HEALTH CARE WITH COMPASSION AND DIGNITY, ASSURES QUALITY OF LIFE, WHEREIN, ALL ARE ENCOURAGED TO REACH THEIR POTENTIAL. THIS IS ACHIEVED THROUGH MUTUAL RESPECT, TEAMWORK AND COMMUNITY INVOLVEMENT. 0 0 13902057 14697048 THE HOME PROVIDES LONG TERM NURSING CARE AS WELL AS ADULT MEDICAL DAYCARE TO THE PUBLIC. THE HOME PROVIDES LONG TERM NURSING CARE AS WELL AS GERIATRIC DAYCARE TO THE COMMUNITY 13902057 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 27 0 230 1 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 1 0 1 1 1 1 1 0 0 1 0 0 1 1 0 0 X X JASMIN GOMEZ - ST ANNS HOME FOR THE AGED CORP 2014330950 198 OLD BERGEN RD JERSEY CITY NJ 07305 SR BREDA BOYLE SEC/TREASURER 1.00 X 0 0 0 MS MARYANN CONTE BOARD MEMBER 1.00 X 0 0 0 MR MICHAEL D'AGNES VICE PRESIDENT 1.00 X 0 0 0 MR BILL HASSAN BOARD MEMBER 1.00 X 0 0 0 MR EDWARD REILLY BOARD MEMBER 1.00 X 0 0 0 CHRIS BACKIEL ASST SEC/TREASURER 1.00 X 0 0 0 HAMMAD CHOUDHRY MD BOARD MEMBER 1.00 X 0 0 0 DOMINICK CONDO MD BOARD MEMBER 1.00 X 0 0 0 CHARLES DEDERDING BOARD MEMBER 1.00 X 0 0 0 RYAN KENNEDY BOARD MEMBER 1.00 X 0 0 0 JANET MERLY-LIRANZO ADMINISTRATOR 40.00 X 144866 0 5395 RATA ELIZABETH BAMBALAN DIRECTOR OF NURSING 40.00 X 110805 0 3717 255671 0 9112 2 0 1 0 UNIDINE CORPORATION 1000 WASHINGTON STREET BOSTON MA 02118 FOOD & DINING MANAGEMENT 1132912 CIGNA 900 COTTAGE GROVE ROAD BLOOMFIELD CT 06002 INSURANCE 1070362 PSEG 325 COUNTRY AVENUE SECAUSUS NJ 07094 ELECTRIC 292234 DISCOVER (PHARMACY) 201 LYONS AVE NEWARK NJ 07112 MEDICAL SUPPLIES 256623 NJ MANUFACTURERS 301 SULLIVAN WAY WEST TRENTON NJ 08628 INSURANCE 243553 5 39120 39120 PATIENT SERVCIE REVENUE 623000 14425995 14425995 14425995 243914 243914 76763 63856 12907 12907 12907 46348 29478 16870 16870 CANTEEN INCOME 623990 16959 16959 BEAUTY PARLOR INCOME 623990 2466 2466 GIFT SHOP INCOME 623990 909 909 -6102 -6102 14232 14753038 14697048 0 16870 X 6953725 6953725 132768 132768 1079990 1079990 580903 580903 18700 18700 60010 60010 22989 22989 1065 1065 595522 595522 967746 967746 115568 115568 DIETARY EXPENSES 535774 535774 DIETARY MANAGEMENT 401547 401547 ADMIN PROVIDER ASSESSME 395428 395428 UTILITIES 374378 374378 1767643 1767643 14003756 13902057 101699 0 180008 178820 1786724 1910866 406929 431457 29064407 14128520 15055320 14935887 9911908 10974367 749025 583014 28089914 29014411 911462 883033 10924635 10705737 1474698 1147639 13310795 12736409 X 14779119 16278002 14779119 16278002 28089914 29014411 X 749282 503594 246007 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2973595 2973595 23642210 11014411 12627799 2092305 2058479 33826 356297 1055630 -699333 14935887 RESIDENT DEPOSITS 611546 INTEREST RATE EXCHANGE AGREEMENT LIABILI 530416 ROOM & BOARD OVERPAYMENTS 5677 1147639 X 14753038 0 14753038 0 14753038 14003756 0 14003756 0 14003756 PART X, LINE 2: THE HOME'S ACCOUNTING POLICY IS TO EVALUATE UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, "ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES." UNDER THE GUIDANCE OF THIS STANDARD, THE HOME MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF THE HOME AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AS OF DECEMBER 31, 2016 AND 2015 MANAGEMENT HAS NOT IDENTIFIED ANY UNRECOGNIZED TAX BENEFITS OR RECORDED ANY LIABILITIES FOR UNCERTAIN TAX POSITIONS. X GALA 46348 46348 29478 46348 46348 29478 29478 16870 0 0 0 0 0 0 0 0 0 JANET MERLY-LIRANZO ADMINISTRATOR 144866 0 0 0 0 0 0 0 5395 0 150261 0 0 0 A NJ HEALTHCARE FACILITIES FINANCING 2001-05-20 11625000 EXPANSION OF THE FACILITY AND RETIREMENT OF EXISITING BANK DEBT 0 0 0 A 11625000 273173 232500 5083173 6036154 2011 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 1 TD SECURITIES 30.000000000000 1 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 4 BY-LAWS WERE CHANGES TO MAKE PEACE CARE, INC. THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS PEACE CARE, INC. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION HAS THE POWER TO APPOINT TRUSTEES AND OFFICERS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS RESERVED POWERS OF GOVERNANCE OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS SUBMITTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND COMMENT AFTER WHICH THE FORM 990 IS SUBMITTED TO THE FULL BOARD FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 15A THE PERFORMANCE AND COMPENSATION OF THE CEO (ADMINISTRATOR) OF THE FACILITY WAS REVIEWED BY A MEMBER OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 24E BAD DEBT: PROGRAM SERVICE EXPENSES 265,745. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 265,745. LEGEND AND NON LEGEND DRUGS: PROGRAM SERVICE EXPENSES 265,558. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 265,558. MAINTENANCE & REPAIRS: PROGRAM SERVICE EXPENSES 263,471. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 263,471. ANCILARIES: PROGRAM SERVICE EXPENSES 230,100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 230,100. DAYCARE EXPENSES: PROGRAM SERVICE EXPENSES 163,491. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 163,491. ADMIN EXPENSES: PROGRAM SERVICE EXPENSES 118,802. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 118,802. HOUSEKEEPING & MAINTENANCE: PROGRAM SERVICE EXPENSES 114,208. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 114,208. TELEPHONE: PROGRAM SERVICE EXPENSES 59,082. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 59,082. PAYROLL FEES: PROGRAM SERVICE EXPENSES 35,707. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,707. ADMIN CONSULTANT HEALTHCARE: PROGRAM SERVICE EXPENSES 30,865. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,865. ACTIVITIES EXPENSE: PROGRAM SERVICE EXPENSES 26,029. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,029. NURSING CONSULTANTS: PROGRAM SERVICE EXPENSES 22,349. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,349. HR EXPENSES: PROGRAM SERVICE EXPENSES 20,330. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,330. MARKETING: PROGRAM SERVICE EXPENSES 20,034. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,034. PHARMACY CONSULTANT: PROGRAM SERVICE EXPENSES 18,750. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,750. NURSING EXPENSES: PROGRAM SERVICE EXPENSES 18,099. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,099. ENVIRONMENTAL SERVICES SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 17,579. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,579. EQUIPMENT RENTAL: PROGRAM SERVICE EXPENSES 13,965. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,965. SOCIAL SERVICES : PROGRAM SERVICE EXPENSES 8,434. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,434. INSERVICE TRAINING: PROGRAM SERVICE EXPENSES 8,099. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,099. MASSES: PROGRAM SERVICE EXPENSES 7,800. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,800. REAL ESTATE TAXES: PROGRAM SERVICE EXPENSES 6,942. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,942. MEDICAL & NURSING SUPPLIES: PROGRAM SERVICE EXPENSES 6,826. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,826. PEACECARE HR CONSULTANT: PROGRAM SERVICE EXPENSES 6,075. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,075. FINANCE SUPPLIES: PROGRAM SERVICE EXPENSES 4,552. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,552. PASTORIAL SUPPLIES: PROGRAM SERVICE EXPENSES 4,111. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,111. PENSION COSTS: PROGRAM SERVICE EXPENSES 3,861. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,861. BANK FEES: PROGRAM SERVICE EXPENSES 2,204. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,204. DONATIONS: PROGRAM SERVICE EXPENSES 2,055. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,055. DAYCARE CONSULTANT: PROGRAM SERVICE EXPENSES 1,600. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,600. PARKING: PROGRAM SERVICE EXPENSES 620. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 620. DUES & SUBS: PROGRAM SERVICE EXPENSES 220. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 220. ENVIRONMENTAL SERVICES TRAVEL/EDUCATION: PROGRAM SERVICE EXPENSES 80. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP PAYABLE AGREEMENT 246,007. CHANGE IN PENSION LIABILITY PEACE CARE 399 HUSON TERRACE ENGLEWOOD NJ 07632 812589807 SPONSORSHIP OF HEALTH CARE RELATED INSTITUTIONS AND ORGANIZATIONS NJ 501(C)(3) LINE 3 0 MARGARET ANNA CUSACK CARE CENTER DBA PEACE CARE ST JOSEPH'S 537 PAVONIA AVENUE JERSEY CITY NJ 07306 760847915 TO PROVIDE HIGH QUALITY LONG TERM AND SHORT TERM NURSING & REHAB. CARE NJ 501(C)(3) LINE 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0