2016-11-10T09:56:04-06:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2015-01-01 112167809 OZANAM HALL OF QUEENS NURSING HOME INC OZAN 7184232000 42-41 201ST STREET BAYSIDE NY 11361 JAMES M KONIARSKI CFO 7184232000 2016-11-01 1 JUDY DALEY P01294075 6179848100 2016-11-01 2015 2017-02-10 21:41:12Z SR J CATHERINE RAYMOND 42-41 201ST STREET BAYSIDE NY 11361 70164278 0 0928 X WWW.OZANAMHALL.ORG X 1969 NY THE CARMELITE SYSTEM FOSTERS THE HEALING MINISTRY OF CHRIST INCATHOLIC HEALTH CARE BY PROCLAIMING THE VALUE AND DIGNITY OF THE AGED AND INFIRM AND PROVIDING COLLABORATIVE WAYS TO MEET THE NEEDS OF TODAY'S ELDERLY, A COMMITMENT TO COMPASSIONATE, LOVING CARE OF THE HIGHEST STANDARDS WITH WISE STEWARDSHIP OF RESOURCES IS THE HALLMARK OF PROGRAMS AND SERVICES RENDERED. 18 18 721 392 0 0 578539 93592 51854192 53448539 798205 323237 687104 412540 53918040 54277908 0 0 0 0 37404579 38336431 0 0 0 17738941 18037821 55143520 56374252 -1225480 -2096344 91482147 85209814 41252816 37414405 50229331 47795409 X THE CARMELITE SYSTEM FOSTERS THE HEALING MINISTRY OF CHRIST INCATHOLIC HEALTH CARE BY PROCLAIMING THE VALUE AND DIGNITY OF THE AGED AND INFIRM AND PROVIDING COLLABORATIVE WAYS TO MEET THE NEEDS OF TODAY'S ELDERLY, A COMMITMENT TO COMPASSIONATE, LOVING CARE OF THE HIGHEST STANDARDS WITH WISE STEWARDSHIP OF RESOURCES IS THE HALLMARK OF PROGRAMS AND SERVICES RENDERED. 0 0 48198618 53764364 OZANAM HALL IS A 432-BED SKILLED NURSING FACILITY THAT PROVIDED 140,416 NURSING DAYS TO VARIOUS RESIDENTS AS FOLLOWS: 15,965 MEDICARE DAYS, 101,165 MEDICAID DAYS, 17,422 PRIVATE DAYS, AND 5,864 OTHER PROVIDER DAYS. THE REHAB CENTER REHABILITATED AND RETURNED 404 RESIDENTS TO THE COMMUNITY. OUR "LOVE MADE VISIBLE" INITIATIVE IMPACTED 213 ALZHEIMER'S RESIDENTS. THE INITIATIVE EXTENDS TO WEEKENDS. OUR ANNUAL "MEMORY SCREENING" ALZHEIMER MEMORIAL CANDLE LIGHTING CEREMONY AND "BLOOD DRIVE" CONTINUES. WE CONTINUE TO PROVIDE DEMENTIA TRAINING TO THE PUBLIC. OZANAM HALL ALSO PARTICIPATES IN THE AMERICAN CANCER SOCIETY'S MAKING STRIDES AGAINST BREAST CANCER FUNDRAISER. 48198618 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 1 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 1 147 0 1 721 1 0 0 0 0 0 1 1 0 0 0 0 X 18 18 0 0 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NY X JAMES M KONIARSKI 7184232000 42-41 201ST STREET BAYSIDE NY 11361 X REV MSGR AUSTIN F BENNETT CHAIR 0.50 0.00 X X 0 0 0 SR MICHELLE ANNE REHO PRESIDENT 0.50 0.00 X X 0 0 0 REV ROBERT J WHELAN VICE PRESIDENT 0.50 0.00 X X 0 0 0 REV MSGR ALFRED P LOPINTO TREASURER 0.50 0.00 X X 0 0 0 SR M JOSEPH CATHERINE RAYMOND CEO & SECRETARY 37.50 0.00 X X 0 0 0 SR M KEVIN PATRICIA MEMBER 0.50 0.00 X 0 0 0 SR M SEAN WILLIAM MEMBER 0.50 0.00 X 0 0 0 PATRICK F DONNELLAN CPA MEMBER 0.50 0.00 X 0 0 0 MARY P GIORDANO ESQ MEMBER 0.50 0.00 X 0 0 0 LESLEE A DEVLIN MEMBER 0.50 0.00 X 0 0 0 KEITH M POWERS MEMBER 0.50 0.00 X 0 0 0 MOST REV NICHOLAS DIMARZIO MEMBER 0.50 0.00 X 0 0 0 MOTHER M MARK LOUIS RANDALL MEMBER 0.50 3.00 X 0 0 0 SR MAUREEN MURRAY MEMBER 0.50 0.00 X 0 0 0 SR M ANTHONY VEILLEUX MEMBER 0.50 0.00 X 0 0 0 SR ANN ELIZABETH BROWN MEMBER 0.50 0.00 X 0 0 0 SR BERNADETTE THERESE REILLY MEMBER 0.50 0.00 X 0 0 0 JOAN MARREN MEMBER 0.50 0.00 X 0 0 0 JAMES M KONIARSKI CPA CFO 37.50 0.00 X 170712 0 43546 MARGARET WHITE DIRECTOR OF REHABILITATION 37.50 0.00 X 160303 0 43546 HARRY ITOKA CONTROLLER 37.50 0.00 X 136943 0 31990 MADELENE SUPRENA RN 37.50 0.00 X 134900 0 35038 THERESA KEMPF DIRECTOR OF NURSING 37.50 0.00 X 124493 0 8715 727351 0 162835 5 0 1 0 ACSA GROUP INSURANCE PO BOX 416799 BOSTON MA 02241 MEDICAL 6561454 PHARMSCRIPT LLC 150 PIERCE STREET SOMERSET NJ 08873 PHARMACEUTICALS 670325 AFCO INSURANCE PREMIUM FINANCE PO BOX 371889 PITTSBURG PA 15250 INSURANCE 399195 UNITEX TEXTILE RENTAL SERVICES 161 SOUTH MACQUESTEN PARKWAY MOUNT VERNON NY 10550 TEXTILE RENTAL & LAUNDRY 306598 MCKESSON MEDICAL SURGICAL PO BOX 204786 DALLAS TX 75320 MEDICAL SUPPLIES 287237 5 70224 23368 93592 NET RESIDENT SERVICES REVENUE 623000 53448539 53448539 53448539 74608 74608 34589 0 34589 34589 34589 16029178 15780549 248629 248629 248629 167947 70224 105821 62126 62126 OTHER OPERATING INCOME 900099 315825 315825 315825 54277908 53764364 0 419952 214258 214258 25204634 18359663 6844971 1661303 1517677 143626 9288561 8525312 763249 1967675 1797562 170113 310606 310606 55358 55358 1177384 1177384 14860 14860 611577 611577 1533940 1533940 1354 1354 11920 11920 1773402 1773402 4211152 4211152 575315 575315 SUPPLIES 2748151 2748151 NYC ASSESSMENT 2468112 2468112 RESIDENT FOOD SERVICES 1306327 1306327 BAD DEBTS 578818 578818 659545 620128 39417 56374252 48198618 8175634 0 1147402 1062315 3518313 3547906 8645093 6313183 154378 1154317 278813 93722481 43589573 54235344 50132908 8688448 7532166 13938852 16342523 91482147 85209814 3206495 3143599 0 32044 1069486 1219716 33277985 31951174 3698850 1067872 41252816 37414405 X 49595475 47290495 633856 504914 50229331 47795409 91482147 85209814 -2096344 -337576 -2 0 X X 0 1 X 1 0 X 754475 294813 217538 578539 93592 1938957 53198432 51081690 49869262 51995434 53616486 259761304 53952907 51376503 50086800 52573973 53710078 261700261 0 0 0 261700261 54008 39790 72566 100588 109197 376149 31257 30614 29444 79497 170812 85265 70404 102010 180085 109197 546961 515504 653086 716186 693335 315827 2893938 54553676 52099993 50904996 53447393 54135102 265141160 0.98700 0.98640 0.00210 0.00200 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 850000 850000 90184705 42150331 48034374 2687776 1439242 1248534 50132908 OTHER ASSETS 354890 UNIVERSAL SETTLEMENT RECEIVABLE 3229914 INSURANCE PROCEEDS RECEIVABLE 395570 DEPOSITS 1625000 DEFERRED FINANCING COSTS, NET 1324112 DUE FROM THIRD PARTY PAYORS 9413037 16342523 OTHER CURRENT LIABILITIES 295102 DUE TO THIRD PARTY PAYORS 377200 INSURANCE LIABILITY 395570 1067872 X 54277908 0 54277908 0 54277908 56374252 0 56374252 0 56374252 PART IV, LINE 2B: RESIDENTS' FUNDS ARE HELD BY THE HOME ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT LIVING ALLOWANCES RECEIVED BY RESIDENTS AND OTHER RESIDENTS' FUNDS DEPOSITED WITH THE HOME FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE HOME AT THE REQUEST OF, OR ON BEHALF OF, RESIDENTS FOR THEIR PERSONAL USE. PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE 2012 THROUGH 2015 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. GOLF OUTING 63119 0 63119 19480 9083 GALA 173831 70224 103607 15861 11233 3 1221 1221 12950 37214 238171 70224 167947 12950 35341 57530 105821 62126 X X X X X 0 0 0 0 0 0 0 0 0 JAMES M KONIARSKI CPA CFO 170712 0 0 0 0 0 10500 0 33046 0 214258 0 0 0 MARGARET WHITE DIRECTOR OF REHABILITATION 160303 0 0 0 0 0 10500 0 33046 0 203849 0 0 0 HARRY ITOKA CONTROLLER 136943 0 0 0 0 0 9586 0 22404 0 168933 0 0 0 MADELENE SUPRENA RN 134900 0 0 0 0 0 9621 0 25417 0 169938 0 0 0 PART I, LINE 3 A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS THE COMMITTEE MEETS YEARLY AND RECOMMENDS TO THE BOARD THE COMPENSATION FOR COVERED INDIVIDUALS BASED ON RELEVANT DATA INCLUDING COMPARABILITY COMPENSATION FOR SIMILARLY SITUATED ENTITIES AND INDEPENDENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS AS DEEMED NECESSARY. A DORMITORY AUTHORITY OF THE STATE OF NEW YORK 166000293 64983Q7J2 2006-12-19 41443072 TO FUND THE HOME'S CAPITAL RENOVATION PROJECT 0 0 0 A 41443072 3980435 2053732 35408905 2010 0 0 0 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 4 OZANAM HALL OF QUEENS NURSING HOME, INC. IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE A GERIATRIC RESIDENTIAL HEALTH CARE FACILITY AND HOME FOR THE AGED AND INFIRMED. OZANAM IS LICENSED BY THE STATE OF NEW YORK AND SPONSORED BY THE CARMELITE SISTERS FOR THE AGED AND INFORM (CARMELITE SISTERS) AND THE ROMAN CATHOLIC DIOCESES OF BROOKLYN. DURING 2015, THE CARMELITE SYSTEM, INC., A RELATED NON-PROFIT, WAS ADMITTED AS A MEMBER, RESULTING IN CONTROL OF OZANAM VIA MAJORITY VOTING INTEREST. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION SHALL BE THE SPONSOR MEMBERS AND THE SYSTEM MEMBER. THE SPONSOR MEMBERS OF THE CORPORATION (THE "SPONSOR MEMBERS") SHALL CONSIST OF THE FOLLOWING INDIVIDUALS: THE SUPERIOR GENERAL OF THE COMMUNITY OF CARMELITE SISTERS FOR THE AGED AND INFIRM; THE ORDINARY OF THE ROMAN CATHOLIC DIOCESE OF BROOKLYN, NEW YORK; TWO (2) MEMBERS OF THE GENERAL COUNCIL OF CARMELITE SISTERS TO BE SELECTED BY THE SUPERIOR GENERAL OF THE COMMUNITY; AND TWO (2) MEMBER PRIESTS OF THE BROOKLYN DIOCESE TO BE SELECTED BY THE ORDINARY OF THE DIOCESE OF BROOKLYN. ANY ACTION BY THE SPONSOR MEMBERS SHALL BE AUTHORIZED BY THE AFFIRMATIVE VOTE OF AT LEAST FOUR (4) SPONSOR MEMBERS. THE SOLE SYSTEM MEMBER OF THE CORPORATION SHALL BE THE CARMELITE SYSTEM, INC., A NEW YORK NOT-FOR-PROFIT CORPORATION (THE "SYSTEM MEMBER"). ANY ACTION BY THE SYSTEM MEMBER SHALL BE TAKEN IN ACCORDANCE WITH THE BY-LAWS OF THE CARMELITE SYSTEM, INC. THE SUPERIOR GENERAL AND THE GENERAL COUNCIL OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM SHALL SERVE AS THE MEMBERS OF THE CARMELITE SYSTEM, INC. WITH SPECIFIED RESERVED POWERS. FORM 990, PART VI, SECTION A, LINE 7A THE COMMUNITY OF CARMELITE SISTERS AND THE ORDINARY OF THE ROMAN CATHOLIC DIOCESE OF BROOKLYN MAY EACH APPOINT TWO MEMBERS OF THE CORPORATION TO BE DIRECTORS OF THE CORPORATION (MEMBERS-DIRECTORS). EXCEPT AS OTHERWISE EXPRESSLY PROVIDED HEREIN, ALL STANDARDS APPLICABLE TO DIRECTORS IN THE BY LAWS SHALL ALSO APPLY TO MEMBERS-DIRECTORS FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBERS OF THE CORPORATION: ANY AMENDMENT OF THE BY-LAWS; AMENDMENTS OF THE CORPORATION'S CERTIFICATE OF INCORPORATION; APPROVAL OR APPOINTMENT OF THE ADMINISTRATOR; THE APPROVAL OF INDIVIDUALS ELIGIBLE TO BE OFFICERS OF THE CORPORATION; THE APPROVAL OF INDIVIDUAL ELIGIBLE TO BE MEMBERS OF THE EXECUTIVE COMMITTEE; THE FORMULATION OR CHANGE FROM TIME TO TIME OF THE PHILOSOPHY, OBJECTIVE AND PURPOSES OF THE CORPORATION; THE PURCHASE, SALE, MORTGAGE OR LEASE OF REAL PROPERTY OF THE CORPORATION, OR THE SALE OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; CONSOLIDATION OF THE CORPORATION WITH ANOTHER NOT FOR PROFIT CORPORATION ORGANIZED FOR SIMILAR PURPOSES AND THE APPROVAL OF ANY PLAN FOR THE DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE REPORTS TO THE BOARD OF DIRECTORS REGARDING THE REVIEW OF THE FORM 990. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST DISCLOSURE POLICY REQUIRES ALL OFFICERS AND BOARD MEMBERS TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. IN ADDITION, SHOULD AN OFFICER OR BOARD MEMBER ASSUME NEW EXTERNAL INTERESTS THAT POTENTIALLY CONFLICT WITH HIS/HER ROLE WITH THE ORGANIZATION SUCH INDIVIDUALS IS REQUIRED TO DISCLOSE IN WRITING THE NATURE OF SUCH EXTERNAL INTERESTS. THE DISCLOSURE STATEMENT IS PROVIDED TO THE CHAIR OF THE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 15 A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION FOR A COVERED INDIVIDUAL BASED ON RELEVANT DATA INCLUDING COMPARABILITY OF COMPENSATION FOR SIMILARLY SITUATE ENTITIES AND COMPENSATION SURVEYS COMPLIED BY INDEPENDENT FIRMS AS REQUIRED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS HAS DESIGNED A COMMITTEE TO MANAGE THE PROCESS OF SELECTION AND OVERSIGHT OF THE AUDIT AND INDEPENDENT ACCOUNTANT, THE COMMITTEE MEETS WITH MANAGEMENT AND THE INDEPENDENT AUDITORS TO REVIEW THE ENGAGEMENT PROPOSAL, RESULTS OF THE AUDIT, DRAFT AUDIT REPORT, MANAGEMENT LETTER. THE COMMITTEE MAY MEET WITH THE INDEPENDENT AUDITORS IN EXECUTIVE SESSION BEFORE CONCLUDING ITS REVIEW AND ACCEPTANCE OF THE ANNUAL AUDIT REPORT. THE COMMITTEE REPORTS ITS FINDING AND MAKES RECOMMENDATION TO THE BOARD OF DIRECTORS. CARMELITE SISTERS FOR THE AGED AND INFIRM INC 600 WOODS ROAD GERMANTOWN NY 12526 141369151 TO SPONSOR NURSING HOMES NY 501(C)(3) LINE 9 0 ST PATRICK'S RESIDENCE 1400 BROOKDALE ROAD NAPERVILLE IL 60563 362527011 SKILLED NURSING FACILITY IL 501(C)(3) LINE 9 0 ST PATRICK'S MANOR INC 863 CENTRAL STREET FRAMINGHAM MA 01701 042157057 SKILLED NURSING FACILITY MA 501(C)(3) LINE 9 0 ST PATRICK'S HOME FOR THE AGED AND INFIRM INC 66 VAN CORTLAND PARK SOUTH BRONX NY 10463 121740033 SKILLED NURSING FACILITY NY 501(C)(3) LINE 9 0 ST MARGARET HALL INC 1960 MADISON ROAD CINCINNATI OH 45206 310655031 SKILLED NURSING AND ASSISTED LIVING FACILITY OH 501(C)(3) LINE 9 0 MOTHER ANGELINE MCCRORY MANOR INC 5199 EAST BROAD STREET COLUMBUS OH 43213 912134683 SKILLED NURSING FACILITY OH 501(C)(3) LINE 9 0 MARIAN MANOR FOR THE AGED AND INFIRM INC 130 DORCHESTER STREET BOSTON MA 02127 042173054 SKILLED NURSING FACILITY MA 501(C)(3) LINE 9 0 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE INC 315 SOUTH FLAGLER DRIVE WEST PALM BEACH FL 33401 590879342 SKILLED, ASSISTED & INDEPENDENT LIVING FACILITY FL 501(C)(3) LINE 9 0 KAHL HOME FOR THE AGED AND INFIRM 6701 JERSEY RIDGE ROAD DAVENPORT IA 52807 420760833 SKILLED NURSING FACILITY IA 501(C)(3) LINE 9 0 CARMEL TERRACE INC 933 CENTRAL STREET FRAMINGHAM MA 01701 043210051 ASSISTED LIVING FACILITY MA 501(C)(3) LINE 9 0 CARMEL MANOR INC 100 CARMEL MANOR ROAD FT THOMAS KY 41075 610523290 SKILLED NURSING FACILITY KY 501(C)(3) LINE 9 0 VILLAS AT SAINT THERESE INC 5253 EAST BROAD STREET COLUMBUS OH 43213 472021696 INDEPENDENCE LIVING FACILITY OH 501(C)(3) LINE 9 0 THE CARMELITE SYSTEM INC 646 WOODS ROAD GERMANTOWN NY 12526 141810368 MANAGEMENT OF AFFILIATED FACILITIES NY 501(C)(3) LINE 9 0 MOUNT CARMEL CARE CENTER INC 320 PITTSFIELD ROAD LENOX MA 01240 383902709 SKILLED NURSING FACILITY MA 501(C)(3) LINE 9 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0