MICHAEL MALOTZ SKILLED NURSING PAVILION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MICHAEL MALOTZ SKILLED NURSING PAVILION (EIN 31-1587828)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-05-13
- IRS object ID
- 201601349349300330
- Schema version
- 2015v2.1
- 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 | 2016-05-13T08:50:32-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | 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 | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | 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 | 9149644340 | 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 | RON CORTI | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 9149644340 | PhoneNum |
| Signature | 2016-05-13 | 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 | 2016-05-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | RON CORTI | PrincipalOfficerNm |
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) |
|---|---|---|
| Gross Receipts | $32,500,682 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RIVERSIDEHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | RIVERSIDE HEALTH CARE SYSTEM, INC. WHICH INCLUDES ST. JOHN'S RIVERSIDE HOSPITAL (SJRH) AND MICHAEL MALOTZ SKILLED NURSING PAVILION ("PAVILION") IS DEDICATED TO PROVIDING COMPREHENSIVE MEDICAL CARE IN A COMPASSIONATE, PROFESSIONAL, RESPECTFUL AND ETHICAL MANNER TO EVERY PATIENT. BY OFFERING EXCELLENCE IN MEDICAL AND NURSING CARE, STATE-OF-THE-ART TECHNOLOGIES, CONTINUING EDUCATION AND PREVENTIVE SERVICES, WE ARE COMMITTED TO IMPROVING THE CARE WE PROVIDE AND THE QUALITY OF LIFE IN OUR COMMUNITY. WE ARE OPEN TO NEW IDEAS, DIRECTIONS AND INITIATIVES THAT MOST EFFECTIVELY RESPOND TO COMMUNITY HEALTH CARE NEEDS. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 214 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $210 | PYContributionsGrantsAmt |
| CY Contributions Grants | $875 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,787,389 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,390,388 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,298 | PYInvestmentIncomeAmt |
| CY Investment Income | $17,335,694 | CYInvestmentIncomeAmt |
| PY Other Revenue | $33,694 | PYOtherRevenueAmt |
| CY Other Revenue | $24,514 | CYOtherRevenueAmt |
| PY Total Revenue | $15,840,591 | PYTotalRevenueAmt |
| CY Total Revenue | $27,751,471 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,335,686 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,565,745 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,282,163 | PYOtherExpensesAmt |
| CY Other Expenses | $6,833,806 | CYOtherExpensesAmt |
| PY Total Expenses | $17,617,849 | PYTotalExpensesAmt |
| CY Total Expenses | $15,399,551 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,777,258 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,351,920 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,918,706 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,771,324 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,496,327 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,697,025 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$5,577,621 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,074,299 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE SKILLED NURSING AND REHABILITATION SERVICES TO GERIATRIC, SUBACUTE AND VENTILATOR DEPENDENT RESIDENTS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $13,178,324 | ExpenseAmt |
| Revenue | $10,390,388 | RevenueAmt |
| Desc | THE HOME DELIVERS SHORT AND LONG TERM, 24 HOUR SKILLED NURSING CARE AND A FULL RANGE OF REHABILITATION AND ANCILLARY SERVICES TO THE FRAIL AND CHRONICALLY ILL. THE HOME HAS PROVIDED CARE FOR 408 RESIDENTS, 398 GERIATRIC AND 10 VENTILATOR DEPENDENT RESIDENTS. PATIENT DAYS OF CARE FOR THE YEAR WAS 26,161: GERIATRIC DAYS OF 24,299 AND VENTILATOR DEPENDENT DAYS OF 1,862.IN AUGUST 2015, THE ORGANIZATION SOLD THE NURSING HOME FACILITY AND CEASED CONDUCTING PROGRAMS. IT IS IN THE PROCESS OF DISSOLVING. | Desc |
| Total Program Service Expenses | $13,178,324 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 214 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DENNIS KEANE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9149644340 | 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 |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| ALFRED M GOMEZ MD | |||||||||
| CHAIRMAN | 0.30 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ANIL M JOSHI MD | |||||||||
| VICE CHAIRMAN | 0.30 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| KEVIN T FAY | |||||||||
| TRUSTEE | 0.30 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD PETERSON | |||||||||
| TRUSTEE | 0.30 | Yes (X) | $0 | $0 | $0 | ||||
| DIANE SKALICKY | |||||||||
| TRUSTEE | 0.30 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD KOMOSINSKY | |||||||||
| TRUSTEE | 0.30 | Yes (X) | $0 | $0 | $0 | ||||
| MARK POHAR | |||||||||
| ADMINISTRATOR | 37.50 | Yes (X) | $162,855 | $89,642 | $181,153 | ||||
| SHERWIN CHUE | |||||||||
| CONTROLLER | 30.00 | $142,677 | $65,260 | $100,678 | 7.50 | Yes (X) | |||
| DELBERT CARTER | |||||||||
| RN | 37.50 | $103,776 | $0 | $41,670 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $409,308 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $154,902 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $323,501 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ST JOHN'S RIVERSIDE HOSPITAL | |||||
| 967 N BROADWAY | YONKERS | NY | 10701 | VARIOUS SERVICES: DIETARY, LAB, LAUNDRY, | $1,396,805 |
| EMB PHYSICAL THERAPY | |||||
| PO BOX 273 | HARTSDALE | NY | 10530 | REHAB AGENCY (PT, OT, ST) | $424,252 |
| RAYMOND JAMES | |||||
| 630 FIFTH AVENUE | NEW YORK | NY | 10111 | BROKERS FEE | $241,194 |
| GARFUNKEL & WILD | |||||
| 111 GREAT NECK ROAD | GREAT NECK | NY | 11021 | LEGAL FEES | $204,396 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $875 | AllOtherContributionsAmt |
| Total Contributions | $875 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 623000 | $5,639,442 | $5,639,442 |
| MEDICARE | 623000 | $2,560,289 | $2,560,289 |
| COMMERCIAL INSURANCE | 623000 | $1,201,436 | $1,201,436 |
| PRIVATE PAY | 623000 | $989,221 | $989,221 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,390,388 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,905 | TotalRevenueColumnAmt |
| Exclusion | $9,905 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $22,075,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,749,211 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $17,325,789 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,325,789 | TotalRevenueColumnAmt |
| Exclusion | $17,325,789 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| EMPLOYEE PARKING | 812930 | $11,799 | $11,799 |
| REBATES | 900099 | $8,900 | $8,900 |
| TELEPHONE/TELEVISION INCOME | 900099 | $2,525 | $2,525 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,290 | TotalRevenueColumnAmt |
| Exclusion | $1,290 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $24,514 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,751,471 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,390,388 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $17,360,208 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $692,079 | TotalAmt |
| Management And General | $692,079 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,223,127 | TotalAmt |
| Program Services | $5,092,176 | ProgramServicesAmt |
| Management And General | $130,951 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $954,258 | TotalAmt |
| Program Services | $820,725 | ProgramServicesAmt |
| Management And General | $133,533 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,056,245 | TotalAmt |
| Program Services | $1,023,162 | ProgramServicesAmt |
| Management And General | $33,083 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $640,036 | TotalAmt |
| Program Services | $542,162 | ProgramServicesAmt |
| Management And General | $97,874 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,378 | TotalAmt |
| Management And General | $107,378 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,000 | TotalAmt |
| Management And General | $48,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,419 | TotalAmt |
| Management And General | $2,419 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,120,666 | TotalAmt |
| Program Services | $1,194,992 | ProgramServicesAmt |
| Management And General | $925,674 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,037 | TotalAmt |
| Program Services | $75,942 | ProgramServicesAmt |
| Management And General | $9,095 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,351 | TotalAmt |
| Program Services | $35,351 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $603,117 | TotalAmt |
| Program Services | $589,871 | ProgramServicesAmt |
| Management And General | $13,246 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,507 | TotalAmt |
| Program Services | $233 | ProgramServicesAmt |
| Management And General | $1,274 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,605 | TotalAmt |
| Program Services | $49,009 | ProgramServicesAmt |
| Management And General | $1,596 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,279 | TotalAmt |
| Program Services | $485,471 | ProgramServicesAmt |
| Management And General | $15,808 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,939 | TotalAmt |
| Program Services | $201,722 | ProgramServicesAmt |
| Management And General | $9,217 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PROVISION FOR BAD DEBTS | $1,814,001 | $1,814,001 |
| MEDICAL SUPPLIES | $751,465 | $751,465 |
| NYS CASH ASSESSMENT | $470,201 | $470,201 |
| MISCELLANEOUS EXPENSES | $24,871 | $24,871 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,970 | TotalAmt |
| Program Services | $6,970 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,399,551 | TotalAmt |
| Program Services | $13,178,324 | ProgramServicesAmt |
| Management And General | $2,221,227 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $612,621 | BOYAmt |
| EOY | $553,671 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,985 | BOYAmt |
| EOY | $742,600 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,856,344 | BOYAmt |
| EOY | $300,017 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,339 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,443 | BOYAmt |
| EOY | $41,754 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,427,351 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,742,623 | BOYAmt |
| EOY | $1,133,282 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,918,706 | BOYAmt |
| EOY | $2,771,324 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,404,464 | BOYAmt |
| EOY | $424,847 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,501 | BOYAmt |
| EOY | $2,832 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,209,115 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,738,247 | BOYAmt |
| EOY | $1,269,346 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,496,327 | BOYAmt |
| EOY | $1,697,025 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,577,621 | BOYAmt |
| EOY | $1,074,299 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,577,621 | BOYAmt |
| EOY | $1,074,299 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,918,706 | BOYAmt |
| EOY | $2,771,324 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $12,351,920 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$5,700,000 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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 | $50,565 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,537 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,621 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $210 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $875 | CurrentTaxYearAmt |
| Total | $61,808 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,916,272 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,330,802 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,349,225 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,787,389 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,390,388 | CurrentTaxYearAmt |
| Total | $72,774,076 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,966,837 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,334,339 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,355,846 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,787,599 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,391,263 | CurrentTaxYearAmt |
| Total | $72,835,884 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,420 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $950 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,150 | CurrentTaxYearMinus2YearsAmt |
| Total | $8,520 | 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 | $4,420 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $950 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,150 | CurrentTaxYearMinus2YearsAmt |
| Total | $8,520 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $72,827,364 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $41,336 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,148 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,516 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,298 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,905 | CurrentTaxYearAmt |
| Total | $123,203 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $41,336 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,148 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,516 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,298 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,905 | CurrentTaxYearAmt |
| Total | $123,203 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,250 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $35,112 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $51,149 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $33,694 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,514 | CurrentTaxYearAmt |
| Total | $172,719 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,036,423 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,398,599 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,430,511 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,840,591 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,425,682 | CurrentTaxYearAmt |
| Total | $73,131,806 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99580 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99540 | PublicSupportPY509Pct |
| Investment Income CY | 0.00170 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00210 | 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. CASH DISCOUNT - MEDICAL ABSTRACTION FEES - 2013 AMOUNT: $ 7. REFUNDS AND REBATES - 2011 AMOUNT: $ 8,089. 2012 AMOUNT: $ 3,863. 2013 AMOUNT: $ 9,179. 2014 AMOUNT: $ 13,180. 2015 AMOUNT: $ 8,900. SOLD SERVICES - EMPLOYEE PARKING FEES - 2011 AMOUNT: $ 19,195. 2012 AMOUNT: $ 19,700. 2013 AMOUNT: $ 19,097. 2014 AMOUNT: $ 17,796. 2015 AMOUNT: $ 11,799. OTHER - 2011 AMOUNT: $ 966. 2012 AMOUNT: $ 11,549. 2013 AMOUNT: $ 1,967. 2014 AMOUNT: $ 882. 2015 AMOUNT: $ 301. TELEPHONE/TELEVISION INCOME - 2013 AMOUNT: $ 18,962. 2015 AMOUNT: $ 2,525. | ExplanationTxt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,419 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,419 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | COSTS ARE INCURRED AS PART OF DUES PAID TO NURSING HOME INDUSTRY ORGANIZATIONS AND UNIONS (1199). | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM THIRD PARTY PAYORS | $466,450 |
| RESIDENT FUNDS | $2,832 |
| INSURANCE RECOVERY RECEIVABLE | $664,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,133,282 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTY PAYORS | $387,909 |
| DUE TO ST. JOHN'S RIVERSIDE HOSPITAL | $217,437 |
| PROFESSIONAL LIABILITIES | $664,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,269,346 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $26,985,493 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $26,985,493 | RevenueSubtotalAmt |
| Other Revenues Not Included | $765,978 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $765,978 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $27,751,471 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,633,573 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,633,573 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $765,978 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $765,978 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $15,399,551 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | RESIDENTS' FUNDS ARE HELD BY THE PAVILION ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE PAVILION FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE PAVILION AT THE REQUEST OF, OR ON BEHALF OF RESIDENTS FOR THEIR PERSONAL USE. ON SEPTEMBER 8, 2015, RESIDENT FUNDS WERE TRANSFERRED TO THE NEW OWNERS OF THE FACILITY FOR THOSE RESIDENTS WHO WERE RESIDING AT THE FACILITY ON AUGUST 31, 2015. THE REMAINING RESIDENT FUNDS WILL BE RELEASED AND PAID OUT IN 2016. |
| PART X, LINE 2: | THE PAVILION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE PAVILION HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE PAVILION IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2012. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RECLASS SEVERANCE ACCURALS NETTED AGAINST GAIN ON SALE OF ASSETS 765,978. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RECLASS SEVERANCE ACCURALS NETTED AGAINST GAIN ON SALE OF ASSETS 765,978. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK POHAR | ||||||||||||||
| ADMINISTRATOR | $162,855 | $89,642 | $0 | $0 | $0 | $0 | $153,519 | $0 | $27,634 | $0 | $344,008 | $89,642 | $0 | $0 |
| SHERWIN CHUE | ||||||||||||||
| CONTROLLER | $142,677 | $65,260 | $0 | $0 | $0 | $0 | $57,631 | $14,408 | $22,911 | $5,728 | $223,219 | $85,396 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 | ANNUAL MEMBERSHIP DUES ARE PAID TO SEVERAL PROFESSIONAL ASSOCIATIONS AND ORGANIZATIONS ON BEHALF OF MARK POHAR AND SHERWIN CHUE. |
| PART III, COLUMN (C): | MARK POHAR, ADMINISTRATOR, AND SHERWIN CHUE, CONTROLLER, BECAME ENTITLED TO SEVERANCE PAY OF $133,696 AND $55,330 (30 AND 14 WEEKS) RESPECTIVELY BASED ON THE NUMBER OF YEARS EMPLOYED AND POSITION HELD WITH THE ORGANIZATION. THIS WAS PAID OUT IN 2016. |
| PART II, LINE 2 (I) AND (II): | SHERWIN CHUE, CONTROLLER IS ALSO THE CONTROLLER OF VALENTINE LANE FAMILY PRACTICE, INC., A NOT-FOR-PROFIT OUTPATIENT CLINIC OF ST. JOHNS RIVERSIDE HOSPITAL. |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | PROPERTY, BUILDING, AND EQUIPMENT AND OPERATIONS OF THE NURSING HOME | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2015-08-31 | DistributionDt |
| Fair Market Value Of Asset | $22,075,000 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | CONTRACT PRICE | MethodOfFMVDeterminationTxt |
| EIN | 472540994 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | L & A OPERATIONS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1772 58TH STREET | AddressLine1Txt |
| City | BROOKLYN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | LLC | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | 0 | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | 0 | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | Yes (1) | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 2E: | FormAndLineReferenceDesc |
| Explanation | EXPLANATION OF INVOLVEMENT: MARK POHAR, ADMINISTRATOR, AND SHERWIN CHUE, CONTROLLER, BECAME ENTITLED TO SEVERANCE PAY OF $133,696 AND $55,330 (30 AND 14 WEEKS) RESPECTIVELY BASED ON THE NUMBER OF YEARS EMPLOYED AND POSITION HELD WITH THE ORGANIZATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | IN AUGUST 2015, THE ORGANIZATION SOLD THE NURSING HOME FACILITY AND CEASED CONDUCTING PROGRAMS. IT IS IN THE PROCESS OF DISSOLVING. |
| FORM 990, PART VI, SECTION A, LINE 6 | RIVERSIDE HEALTH CARE SYSTEM, INC. IS THE SOLE MEMBER OF THE PAVILION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER OF THE PAVILION HAS THE POWER TO ELECT AND REMOVE THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | RESERVED POWERS OF MEMBER THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBER, AND NO ATTEMPTED EXERCISE OF ANY SUCH POWERS BY ANYONE OTHER THAN THE MEMBER SHALL BE VALID OR OF ANY FORCE OR EFFECT WHATSOEVER: (A) POWER TO ELECT AND REMOVE THE BOARD OF TRUSTEES (B) POWER TO AMEND THE CERTIFICATE OF INCORPORATION AND BYLAWS OF THE CORPORATION (C) POWER TO ACQUIRE, ALIENATE, CONVEY OR MORTGAGE THE REAL PROPERTY, ENDOWMENT FUNDS OR OTHER PERMANENT ASSETS OF THE CORPORATION (D) POWER TO DISPOSE OF ALL OR SUBSTANTIALLY ALL OF THE PHYSICAL ASSETS OF THE CORPORATION PROVIDED THAT THE BOARD OF TRUSTEES SHALL HAVE THE RIGHT TO APPROVE CERTIFICATE OF NEED APPLICATIONS FILED BY OR ON BEHALF OF THE CORPORATION AND THE RELATED USE OF ASSETS. (E) POWER TO AUTHORIZE THE ESTABLISHMENT OF SUBSIDIARY AND SPONSORED CORPORATIONS AND TO APPROVE THE INITIAL CERTIFICATE OF INCORPORATION AND BYLAWS OF SUCH ORGANIZATIONS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE IRS FORM 990 IS PREPARED BY THE CONTROLLER OF MICHAEL MALOTZ SKILLED NURSING PAVILION AND REVIEWED BY THE CHIEF FINANCIAL OFFICER OF RIVERSIDE HEALTH CARE SYSTEM, INC. THE OUTSIDE ACCOUNTING FIRM THEN REVIEWS THE DRAFT FORM 990 BEFORE A COPY IS PROVIDED TO THE BOARD. THE DRAFT WAS PROVIDED BY EMAIL TO ALL BOARD TRUSTEES BEFORE ITS BOARD MEETING. THE IRS FORM 990 WAS REVIEWED AND DISCUSSED IN DETAIL AT THE MEETING PRIOR TO FILING THE FORM WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST STATEMENTS ARE SENT BY ST. JOHN'S RIVERSIDE HOSPITAL'S DIRECTOR OF PERFORMANCE IMPROVEMENT (COMPLIANCE OFFICER) TO ALL DEPARTMENT HEADS, KEY EMPLOYEES AND BOARD TRUSTEES ANNUALLY AT THE END OF THE FISCAL YEAR, WITH THE EXPECTATION THAT THEY BE RETURNED TO THE COMPLIANCE OFFICER IN JANUARY OF THE FOLLOWING YEAR. WHEN RETURNED, THE STATEMENTS ARE REVIEWED BY THE COMPLIANCE OFFICER. ALL INFORMATION IS KEPT CONFIDENTIAL AND STATEMENTS ARE MAINTAINED IN THE COMPLIANCE OFFICE. THE COMPLIANCE OFFICER WILL CONSULT WITH OUTSIDE COUNSEL AS NECESSARY CONCERNING ANY POTENTIAL PROBLEMS OR POSSIBLE CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER WILL REPORT ANY CONFLICTS OF INTEREST OR POSSIBLE CONFLICTS OF INTEREST TO THE THE BOARD OF TRUSTEES FOR REVIEW. THE INDIVIDUAL WITH THE CONFLICT WILL BE EXCUSED FROM VOTING ON THE MATTER IN WHICH A DECISION IS MADE ON HOW TO PROCEED WITH THE POTENTIAL CONFLICT. ANY DECISION MADE BY THE BOARD IS DOCUMENTED IN THE MINUTES TO THAT MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15 | INDEPENDENT MEMBERS OF THE BOARD OF TRUSTEES MAKE THE DECISION ON APPROVING THE SALARY CHANGES FOR THE OFFICERS. AN EXECUTIVE COMPENSATION REVIEW TOOK PLACE IN SPRING 2013 IN WHICH AN EXECUTIVE COMPENSATION STUDY WAS CONDUCTED BY AN OUTSIDE CONSULTANT. THE STUDY REVIEWED COMPENSATION FOR LIKE POSITIONS IN THE WESTCHESTER COUNTY, NEW YORK AREA. THERE WERE COLA SALARY INCREASES OF 3% AWARDED IN 2015 TO NON UNION EMPLOYEES, INCLUDING THE OFFICERS, WHICH WAS DOCUMENTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE PAVILLION MAKES ITS FORM 1023 AND FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. THE PAVILION'S FORM 990 IS ALSO AVAILABLE ON GUIDESTAR'S WEBSITE, AND OTHER SIMILAR TYPES OF WEBSITES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE MICHAEL MALOTZ SKILLED NURSING PAVILION (PAVILION) MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. THE PAVILION ALSO FILES AN ANNUAL COST REPORT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH CONTAINS FINANCIAL STATEMENTS AND RELATED NOTE DISCLOSURES, WHICH IS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | LAUNDRY: PROGRAM SERVICE EXPENSES 84,479. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,479. DIETARY: PROGRAM SERVICE EXPENSES 302,094. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 302,094. NURSING AGENCY FEES: PROGRAM SERVICE EXPENSES 12,278. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,278. PHYSICAN FEES: PROGRAM SERVICE EXPENSES 2,250. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,250. ADMINISTRATIVE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 886,049. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 886,049. MEDICAL FEES: PROGRAM SERVICE EXPENSES 10,859. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,859. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 197,528. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 197,528. OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 345,304. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 345,304. SPEECH THERAPY: PROGRAM SERVICE EXPENSES 22,301. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,301. AUDIOLOGY CONSULTANTS: PROGRAM SERVICE EXPENSES 9,450. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,450. PHARMACY CONSULTANTS: PROGRAM SERVICE EXPENSES 19,008. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,008. SOCIAL SERVICES & RECREATION: PROGRAM SERVICE EXPENSES 9,826. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,826. LABORATORY: PROGRAM SERVICE EXPENSES 32,912. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,912. RADIOLOGY: PROGRAM SERVICE EXPENSES 29,460. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,460. DENTAL: PROGRAM SERVICE EXPENSES 25,864. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,864. HOUSEKEEPING: PROGRAM SERVICE EXPENSES 24,116. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,116. MAINTENANCE: PROGRAM SERVICE EXPENSES 65,669. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,669. BUSINESS OFFICE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 16,548. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,548. CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,594. MANAGEMENT AND GENERAL EXPENSES 23,077. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,671. |
| FORM 990, PART XI, LINE 9: | TRANSFER TO AFFILIATE - RIVERSIDE HEALTH CARE SYSTEM, INC. -5,700,000. |
| FORM 990, PART XII, LINE 2C | THE BOARD OF TRUSTEES ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOHN'S RIVERSIDE HOSPITAL | |||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 131740126 | HOSPITAL | NY | 501(C)(3) | LINE 3 | RIVERSIDE HEALTH CARE SYSTEM INC | 0 | |
| RIVERSIDE HEALTH CARE SYSTEM INC | |||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 133237215 | HOSPITAL | NY | 501(C)(3) | LINE 7 | 0 | N/A | |
| VALENTINE LANE FAMILY PRACTICE | |||||||||||
| 2 PARK AVENUE | YONKERS | NY | 10703 | 133520368 | CLINIC FOR ST. JOHN'S RIVERSIDE HOSPITAL | NY | 501(C)(3) | LINE 3 | RIVERSIDE HEALTH CARE SYSTEM INC | 0 | |
| RIVERSIDE HEALTH CARE FOUNDATION | |||||||||||
| 128 ASHFORD AVENUE | DOBBS FERRY | NY | 10522 | 133971735 | FUNDRAISING | NY | 501(C)(3) | LINE 11D, III-O | ST JOHN'S RIVERSIDE HOSPITAL | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|
| SJR MEDICAL PC | ||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 134185781 | MEDICAL SERVICES | NY | ST JOHNS RIVERSIDE HOSPITAL | C | 0 | |
| RIVER MANAGEMENT INC | ||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 133474004 | MANAGEMENT | NY | RIVERSIDE HEALTH CARE SYSTEM | C | 0 | |
| RIVERSIDE HEALTH CARE SYSTEM BERMUDA | ||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 133237215 | INSURANCE | RIVERSIDE HEALTH CARE SYSTEM | C | 0 | BD | |
| RIVERSIDE MANAGEMENT SERVICES ORGANIZATION | ||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 133846601 | MANAGEMENT | NY | RIVERSIDE HEALTH CARE SYSTEM | C | 0 | |
| SMITHERS FUND FOR ALCOHOLISM PREVENTATION | ||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 273308526 | ALCOHOL RECOVERY | NY | RIVERSIDE HEALTH CARE SYSTEM | C | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |