2016-11-14T09:17:28-06:00 2015-12-31 861065772 Deloitte Tax LLP 191 Peachtree Street Suite 2000 Atlanta GA 303031749 990 2015-01-01 452964584 Bon Secours New York Health System Affiliated Group BONS 7185481700 2975 Independence Ave Bronx NY 10463 Kity Khundkar Chief Financial Officer 7185481700 2016-11-14 0 John W Sadoff Jr P00540589 4042201500 2015 2017-02-10 21:41:12Z Carlos Beato 2975 Independence Ave Bronx NY 10463 52831336 1 1 5816 X www.scherviercares.org X Nursing care and multi-family housing project for the elderly and handicapped. 13 10 568 82 0 0 705389 2234515 50401000 49845883 -237784 7197 495842 729523 51364447 52817118 0 6934 0 0 31451864 30263492 0 0 0 25262361 22479829 56714225 52750255 -5349778 66863 42584044 43530950 65531750 61241235 -22947706 -17710285 X The mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help people and communities to health and wholeness. 0 0 47486347 6934 49693986 Frances Schervier Home and Hospital consists of 364 skilled nursing beds and 2 respite beds. Facility is located in the Riverdale section of the northwest Bronx. The organization provides long-term, 24-hour skilled nursing, rehabilitation services, palliative care, and care in a secure environment for those with Alzheimer's and other cognitive impairments. In addition, short-term rehabilitation and cardio-pulmonary rehabilitation programs provide services for those recovering from illness and injury and returning to their home and community. Service lines include:NursingPhysical, occupational, respiratory, and speech therapy available seven days a week, as neededPalliative & hospice careRespite careSocial servicesClinical Nutrition ServicesTherapeutic recreationThe Schervier Long Term Home Health Care Program provides in-home nursing care to residents of the Bronx and Westchester County. The home care program provides a comprehensive, coordinated and medically case managed package of services to meet the individual's needs. Services include:NursingPhysical Therapy and Occupational therapy Speech and Language TherapiesMedical Supply ManagementMedical Social WorkHome Health AidesPersonal Care Aides The Bon Secours New York Healthy Communities initiative is sponsored by the mission fund of Bon Secours Health System, a related organization. Bon Secours Health System is committed to creating communities of health, hope and well-being. Bon Secours is developing long term, collaborative relationships with the people who live and work in selected neighborhoods in the communities we serve and with other local organizations so that together we can identify and address priorities to improve the quality of life and health. BSNY Healthy Communities employs a multi-faceted approach to tackling diet-related illness in priority neighborhoods in Upper Manhattan and the Bronx. Program activities in collaboration with agencies and area partners include: Youthmarkets, Youth Farm, Healthy Hikes, Healthy Corner Stores, Healthy Mothers, Healthy Families, and Farm-to-Door- among many other green technology, nutrition, and social enterprise endeavors aimed at food justice. 428476 392052 Frances Schervier Housing Development Fund Corporation (the Corporation) is a not-for-profit organization for the elderly and handicapped. The corporation operates an independent living unit in the Bronx, New York. The 14-story, 154-unit building provides affordable housing to more than 170 low income seniors and mobility-impaired individuals through the Section 8 federally subsidized housing sponsored by the Department of Housing and Urban Development (HUD). 47914823 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 85 0 1 568 1 0 0 0 0 0 1 1 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X Laura Ellison 4433673835 8990 Old Annapolis Road Columbia MD 21045 X Maria Branca DPM Board Member 1.00 0.00 X 0 0 0 John Corcoran Board Member 1.00 1.00 X 0 0 0 Ralph Dimpel Board Member 1.00 1.00 X 0 0 0 Catherine Gasteyer Board Member 1.00 1.00 X 0 0 0 Monica Higgins Board Member 1.00 0.00 X 0 0 0 Frank Maselli MD Board Member 1.00 0.00 X 0 0 0 Howard Malatzky Sec/Treas (SNCC)/BM (Housing) 1.00 1.00 X X 0 0 0 Sr Patricia Mennor Chairman 2.00 2.00 X X 0 0 0 Sr Fran Gorsuch Board Member 1.00 49.00 X 0 0 0 Marlon Priest MD Board Member 1.00 49.00 X 0 1484428 37981 Carlos Beato CEO - BSNY 48.50 1.50 X X 0 545685 16037 Br Art Caliman President 20.00 30.00 X X 0 0 0 Kity Khundkar CFO - BSNY/Treasurer (Housing) 40.00 10.00 X X 345443 0 19943 Dominic D'Ambrosio Administrator - Support Services 50.00 0.00 X 263246 0 26738 Donald Mallo Director of HR 50.00 0.00 X 201564 0 19920 Stephen Kazanjian VP of Mission 50.00 0.00 X 168858 0 24000 Laura Amerman Director of Marketing 50.00 0.00 X 123779 0 19884 Andrea Weaver Director of Quality and Risk Mgmt 50.00 0.00 X 123254 0 24838 Divina Adlawan RN 50.00 0.00 X 116208 0 0 Theresa Geenty Director of Admissions 50.00 0.00 X 115316 0 18313 Joseph Scarpa Former Highest Paid Employee 0.00 0.00 X 244745 0 18189 1702413 2030113 225843 18 1 1 0 Morrison Mgt Specialists PO Box 102289 Atlanta GA 303682289 Food Service 2628623 Phys and Occup Rehab Therapy PO Box 505109 St Louis MO 631505109 PT, OT and Speech Therapy 2373310 Pillsbury Winthrop Shaw PO Box 601240 Charlotte NC 282601240 Legal Services 1003320 All Pro Home and Health Care 230 N Main St Spring Valley NY 10977 Agency Service 639498 Allied Barton Security PO Box 828854 Philadelphia PA 191828854 Security Service 354653 8 48749 194948 1990411 407 2234515 Patient Service Rev. 623000 49365803 49365803 Residential Services 900099 392052 392052 Management Services 561000 88028 88028 49845883 7197 7197 132557 0 132557 132557 132557 14218 48749 14218 0 CHHA Revenue 900099 240155 240155 Cafeteria/Vending/Gift 722212 204642 204642 Rebates 900099 71191 71191 80978 80978 596966 52817118 50086038 0 496565 6934 6934 770584 693525 77059 20689052 18620147 2068905 5406906 4866215 540691 607712 546941 60771 2789238 2510314 278924 1509082 1358174 150908 31426 28283 3143 3683 3315 368 1196571 1196571 29087 26178 2909 836226 752603 83623 571258 514132 57126 1654156 1488740 165416 100948 90853 10095 14667 13200 1467 409956 409956 1813916 1632524 181392 613442 552098 61344 Purchased Services 7404109 6663698 740411 NY State Medicare Asses 2447814 2203033 244781 Medical Supplies 2274562 2274562 Bad Debt 507935 507935 1060991 954892 106099 52750255 47914823 4835432 0 3200 2800 1902772 1221832 4820354 6281951 115131 107525 130081 262354 44458263 23103987 25209725 21354276 2855162 2698008 18427 7547619 11583777 42584044 43530950 6088872 6361270 46155 146487 23900000 185084 203425 5820785 20200000 29490854 34330053 65531750 61241235 X -23864038 -18630699 916332 920414 -22947706 -17710285 42584044 43530950 X 66863 33901 5136657 X 0 1 X 1 1 1 X 298111 377798 570741 705389 2234515 4186554 54855699 53554775 51958624 50401000 49845883 260615981 209262 175107 201977 197608 444797 1228751 55363072 54107680 52731342 51303997 52525195 266031286 0 0 0 266031286 189769 155625 170520 177874 139754 833542 189769 155625 170520 177874 139754 833542 158713 75661 68082 128156 166387 596999 55711554 54338966 52969944 51610027 52831336 267461827 0.99470 0.99400 0.00310 0.00380 X Schedule A, Part III, Line 12, Explanation of Other Income: Fundraising - 2011 Amount: $ 123,775. 2015 Amount: $ 14,218. Risk Management Salary - Rebates/Discounts - 2011 Amount: $ 30,787. 2012 Amount: $ 25,030. 2013 Amount: $ 46,311. 2014 Amount: $ 68,441. 2015 Amount: $ 71,191. All other revenue - 2011 Amount: $ 4,151. 2012 Amount: $ 50,631. 2013 Amount: $ 21,771. 2014 Amount: $ 59,715. 2015 Amount: $ 80,978. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3683 3683 0 Part II-B, Line 1: The filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i. 0 1 X 2722295 2722295 26030540 14594356 11436184 17080 12455 4625 13105555 8210668 4894887 2582793 286508 2296285 21354276 HPL/GL 5269481 Misc A/R 2331641 Medicaid Settlement 1676252 Due from Affiliates 840743 Assets Held in Trust 203605 LT Deposits 72000 Other Misc Assets 1190055 11583777 Due to BSHSI 21440449 LT HPL/GL 5364003 Other LT Pension/Retirement Liab 3823606 Medicare Liab 1512132 FIN47 Asbestos Liab 1236311 Patient Credit Balances 563990 Patient Deposits 196747 Other Miscellaneous 192815 34330053 Part IV, Line 2b: Frances Schervier Home and Hospital (dba Schervier Nursing Care Center) holds, safeguards, manages and accounts for the personal funds of residents who have authorized the facility in writing to manage any personal funds. Fund requests less than $50 are available for immediate distribution to residents. Written requests for $50 or more are honored within 3 business days. All excess custodial funds are held in interest bearing accounts separate from that of the organization. Cocktail Party 62967 48749 14218 100 7018 1950 5150 62967 48749 14218 100 7018 1950 5150 14218 0 1 1 0 0 0 0 0 0 0 Marlon Priest MD Board Member 0 772417 0 541976 0 170035 0 15900 0 22081 0 1522409 0 0 Carlos Beato CEO - BSNY 0 280093 0 216116 0 49476 0 15900 0 137 0 561722 0 0 Kity Khundkar CFO - BSNY/Treasurer (Housing) 245069 0 60455 0 39919 0 2496 0 17447 0 365386 0 0 0 Dominic D'Ambrosio Administrator - Support Services 174571 0 70159 0 18516 0 2845 0 23893 0 289984 0 0 0 Donald Mallo Director of HR 161579 0 38171 0 1814 0 1265 0 18655 0 221484 0 0 0 Stephen Kazanjian VP of Mission 130023 0 30796 0 8039 0 616 0 23384 0 192858 0 0 0 Joseph Scarpa Former Highest Paid Employee -5476 0 0 0 250221 0 0 0 18189 0 262934 0 0 0 Part I, Line 3 Bon Secours Health System, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee Part I, Lines 4a-b Bon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: Joseph Scarpa, $232,824. The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Carlos Beato, $6,421. Form 990, Part VI, Section A, line 6 Bon Secours Health System, Inc. is the sole member of Bon Secours New York Health System, Inc. (BSNYHS). BSNYHS is the sole corporate member and parent of Frances Schervier Home & Hospital (FSHH) and Frances Schervier Housing Development Fund Corporation (FSHDFC). Form 990, Part VI, Section A, line 7a As the sole corporate member, BSNYHS has the power to appoint the President and Executive Vice President of FSHH and FSHDFC. BSNYHS has the power to approve or withhold approval of amendments to their bylaws, approve strategic plans, approve capital budgets, approve operating budgets as well as change the philosophy objectives or purposes of both organizations. In addition, BSNYHS has the power to remove or replace any member of their boards of directors. Form 990, Part VI, Section A, line 7b Certain authorities of FSHH and FSHDFC are reserved to their members or to Bon Secours Health System, Inc. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). Form 990, Part VI, Section B, line 15b The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Form 990, Part VI, Section b, Line 15b: Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. Form 990, Part VI, Section C, line 19 The organizations provide any documents open to public inspection upon request. Form 990, Part VII Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. Sr. Fran Gorsuch and Brother Art Caliman do not receive payroll distributions as they have each taken a vow of poverty. Form 990, Part XI, line 9: Pension Related Changes 514,731. Changes in net assets related to sale of apartments to NFP org. 4,987,995. Differences between GAAP income and income reported for 990 purposes -366,069. Bon Secours Health System Inc (BSHSI) 1505 Marriottville Road Marriottsville MD 21104 521301088 Parent Org - Management Services MD 501(c)(3) Line 11c, III-FI Bon Secours Inc 0 Schervier Apartments LLC 2975 Independence Avenue Bronx NY 10463 471364217 Low Income Housing NY 501(c)(3) Line 9 Bon Secours New York Health Sysem Inc 0 Bon Secours New York Health System Inc 2975 Independence Avenue Bronx NY 10463 912135196 Parent Org - Management Services NY 501(c)(3) Line 11c, III-FI Bon Secours Health System Inc 0 Bon Secours New York Housing Development Fund Corporation 2975 Independence Avenue Bronx NY 10463 472224316 Low Income Housing NY N/A C 0 0 0 1 0 1 0 1 0 0 0 0 0 1 0 0 0 1 0 0