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MICHAEL MALOTZ SKILLED NURSING PAVILION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
MICHAEL MALOTZ SKILLED NURSING PAVILION (EIN 31-1587828)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-08-04
IRS object ID
201402169349300230
Schema version
2013v3.0
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

FieldValueIRS element (for citing)
Return2014-08-04T09:56:51-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN271728945PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1O'CONNOR DAVIES LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 MAMARONECK AVENUEAddressLine1
CityHARRISONCity
StateNYState
ZIP Code105281633ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311587828EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL MALOTZ SKILLED NURSING PAVILIONBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlMICHBusinessNameControlTxt
Phone9149643333PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 ODELL AVENUEAddressLine1
CityYONKERSCity
StateNYState
ZIP Code107011408ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK POHARPersonNm
Person TitleADMINISTRATORPersonTitleTxt
Phone9149643333PhoneNum
Signature2014-07-30SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGARRETT M HIGGINSPreparerPersonNm
PTINP00543209PTIN
Phone9143818900PhoneNum
Preparation2014-07-29PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK POHARPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 ODELL AVENUEAddressLine1
CityYONKERSCity
StateNYState
ZIP Code107011408ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$16,430,511GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RIVERSIDEHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1998FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionRIVERSIDE 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
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee254TotalEmployeeCnt
Total Volunteers7TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,537PYContributionsGrantsAmt
CY Contributions Grants$6,621CYContributionsGrantsAmt
PY Program Service Revenue$15,330,802PYProgramServiceRevenueAmt
CY Program Service Revenue$16,349,225CYProgramServiceRevenueAmt
PY Investment Income$29,148PYInvestmentIncomeAmt
CY Investment Income$23,516CYInvestmentIncomeAmt
PY Other Revenue$35,112PYOtherRevenueAmt
CY Other Revenue$51,149CYOtherRevenueAmt
PY Total Revenue$15,398,599PYTotalRevenueAmt
CY Total Revenue$16,430,511CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,001,657PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,683,483CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,365,801PYOtherExpensesAmt
CY Other Expenses$6,598,050CYOtherExpensesAmt
PY Total Expenses$15,367,458PYTotalExpensesAmt
CY Total Expenses$17,281,533CYTotalExpensesAmt
PY Revenues Less Expenses$31,141PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$851,022CYRevenuesLessExpensesAmt
Total Assets BOY$18,477,700TotalAssetsBOYAmt
Total Assets EOY$18,993,321TotalAssetsEOYAmt
Total Liabilities BOY$21,427,041TotalLiabilitiesBOYAmt
Total Liabilities EOY$22,793,684TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$2,949,341NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$3,800,363NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE SKILLED NURSING AND REHABILITATION SERVICES TO GERIATRIC, SUBACUTE AND VENTILATOR DEPENDENT RESIDENTS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$16,185,096ExpenseAmt
Revenue$16,349,225RevenueAmt
DescSKILLED NURSING, REHABILITATION AND ANCILLARY SERVICES PROVIDED TO GERIATRIC, SUB-ACUTE AND VENTILATOR DEPENDENT RESIDENTS. PATIENT DAYS OF CARE FOR THE YEAR WAS 41,071: GERIATRIC DAYS OF 38,158 AND VENTILATOR DEPENDENT DAYS OF 2,913. THE NUMBER OF RESIDENTS SERVED IN 2013 WAS 523: 495 GERIATRIC AND 28 VENTILATOR DEPENDENT RESIDENTS.Desc
Total Program Service Expenses$16,185,096TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee254EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHERWIN CHUEBusinessNameLine1
FieldValueIRS element (for citing)
Phone9149643333PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 ODELL AVENUEAddressLine1
CityYONKERSCity
StateNYState
ZIP Code107011408ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ALFRED M GOMEZ MD
CHAIRMAN0.30Yes (X)Yes (X)$0$0$0
ANIL M JOSHI MD
VICE CHAIRMAN0.30Yes (X)Yes (X)$0$0$0
KEVIN T FAY
TRUSTEE0.30Yes (X)$0$0$01.00
ROYDEN LETSEN
TRUSTEE0.30Yes (X)$0$0$01.00
RICHARD PETERSON
TRUSTEE0.30Yes (X)$0$0$0
DIANE SKALICKY
TRUSTEE0.30Yes (X)$0$0$0
RICHARD KOMOSINSKY
TRUSTEE0.30Yes (X)$0$0$01.00
MARK POHAR
ADMINISTRATOR37.50Yes (X)$195,314$0$33,703
SHERWIN CHUE
CONTROLLER30.00$196,103$0$34,5707.50Yes (X)
SHARON CARBERRY
NURSING SUPERVISOR37.50$104,231$0$28,613Yes (X)
IYAD ANNABI MD
MEDICAL DIRECTOR20.00$100,169$0$23,275Yes (X)
RUTH ARCIGAL
DIRECTOR OF NURSING37.50$100,931$0$15,440Yes (X)
BARBARA CRONIN-LAPERCHE
DIRECTOR OF REHABILITATION37.50$104,978$0$6,910Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$801,726TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$142,511TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
ST JOHN'S RIVERSIDE HOSPITAL
967 N BROADWAYYONKERSNY10701VARIOUS SERVICES: DIETARY, LAB, LAUNDRY,$743,920
MITCHELLMARTIN INC
307 W 38TH ST 1305NEW YORKNY10018PHYSICAL THERAPY$157,991
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$6,621AllOtherContributionsAmt
Total Contributions$6,621TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAID623000$9,251,922$9,251,922
MEDICARE623000$4,498,261$4,498,261
COMMERCIAL INSURANCE623000$1,777,931$1,777,931
PRIVATE PAY623000$821,111$821,111
FieldValueIRS element (for citing)
Total Program Service Revenue$16,349,225TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,516TotalRevenueColumnAmt
Exclusion$23,516ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
EMPLOYEE PARKING812930$19,097$19,097
TELEPHONE/TELEVISION INCOME900099$18,962$18,962
REBATE900099$9,179$9,179

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,911TotalRevenueColumnAmt
Exclusion$3,911ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$51,149OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,430,511TotalRevenueColumnAmt
Related Or Exempt Func Income$16,349,225RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$74,665ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$485,507TotalAmt
Management And General$485,507ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,052,345TotalAmt
Program Services$6,913,021ProgramServicesAmt
Management And General$139,324ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,093,057TotalAmt
Program Services$1,079,849ProgramServicesAmt
Management And General$13,208ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,208,855TotalAmt
Program Services$1,124,714ProgramServicesAmt
Management And General$84,141ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$843,719TotalAmt
Program Services$770,457ProgramServicesAmt
Management And General$73,262ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$83,701TotalAmt
Management And General$83,701ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$40,000TotalAmt
Management And General$40,000ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$1,505TotalAmt
Management And General$1,505ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$365,868TotalAmt
Program Services$355,021ProgramServicesAmt
Management And General$10,847ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$320,181TotalAmt
Program Services$297,105ProgramServicesAmt
Management And General$23,076ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$45,740TotalAmt
Program Services$45,740ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,026,303TotalAmt
Program Services$1,002,219ProgramServicesAmt
Management And General$24,084ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,396TotalAmt
Program Services$3,317ProgramServicesAmt
Management And General$2,079ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$109,863TotalAmt
Program Services$106,398ProgramServicesAmt
Management And General$3,465ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$769,706TotalAmt
Program Services$745,433ProgramServicesAmt
Management And General$24,273ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$203,844TotalAmt
Program Services$194,123ProgramServicesAmt
Management And General$9,721ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT EXPENSE$1,360,000$1,360,000
PURCH & CONTRACTED SERV$894,620$816,376$78,244
MEDICAL SUPPLIES$696,431$696,431
NYS CASH ASSESSMENT$581,412$581,412

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$93,480TotalAmt
Program Services$93,480ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,281,533TotalAmt
Program Services$16,185,096ProgramServicesAmt
Management And General$1,096,437ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$176,670BOYAmt
EOY$69,644EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$453,312BOYAmt
EOY$37,795EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,006,039BOYAmt
EOY$2,948,195EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$12,768BOYAmt
EOY$10,560EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$35,292BOYAmt
EOY$81,445EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$20,743,203LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$13,609,447LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,692,945BOYAmt
EOY$7,133,756EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$7,100,674BOYAmt
EOY$8,711,926EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,477,700BOYAmt
EOY$18,993,321EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,494,501BOYAmt
EOY$1,531,430EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$187,465BOYAmt
EOY$219,864EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$11,939,008BOYAmt
EOY$11,585,886EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,806,067BOYAmt
EOY$9,456,504EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,427,041BOYAmt
EOY$22,793,684EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$2,949,341BOYAmt
EOY-$3,800,363EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$2,949,341BOYAmt
EOY-$3,800,363EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,477,700BOYAmt
EOY$18,993,321EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$851,022ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,155CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,109CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$50,565CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,537CurrentTaxYearMinus1YearAmt
Current Tax Year$6,621CurrentTaxYearAmt
Total$70,987TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,275,709CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,592,296CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,916,272CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,330,802CurrentTaxYearMinus1YearAmt
Current Tax Year$16,349,225CurrentTaxYearAmt
Total$73,464,304TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,278,864CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,599,405CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,966,837CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,334,339CurrentTaxYearMinus1YearAmt
Current Tax Year$16,355,846CurrentTaxYearAmt
Total$73,535,291TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$500CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,325CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,420CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$950CurrentTaxYearMinus1YearAmt
Current Tax Year$3,150CurrentTaxYearAmt
Total$10,345TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$500CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,325CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,420CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$950CurrentTaxYearMinus1YearAmt
Current Tax Year$3,150CurrentTaxYearAmt
Total$10,345TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$73,524,946PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$64,582CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$45,935CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$41,336CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$29,148CurrentTaxYearMinus1YearAmt
Current Tax Year$23,516CurrentTaxYearAmt
Total$204,517TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$64,582CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$45,935CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$41,336CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$29,148CurrentTaxYearMinus1YearAmt
Current Tax Year$23,516CurrentTaxYearAmt
Total$204,517TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$30,187CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,473CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$28,250CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$35,112CurrentTaxYearMinus1YearAmt
Current Tax Year$51,149CurrentTaxYearAmt
Total$180,171TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,373,633CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,680,813CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,036,423CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,398,599CurrentTaxYearMinus1YearAmt
Current Tax Year$16,430,511CurrentTaxYearAmt
Total$73,919,979TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99470PublicSupportCY509Pct
Public Support PY5090.99360PublicSupportPY509Pct
Investment Income CY0.00280InvestmentIncomeCYPct
Investment Income PY0.00370InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part IV Form990ScheduleAPartIVGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationVENDING MACHINES INCOME - 2009 AMOUNT: $ 2,725. 2010 AMOUNT: $ 2,551. 2013 AMOUNT: $ 1,937. CASH DISCOUNT - 2009 AMOUNT: $ 418. 2010 AMOUNT: $ 242. MEDICAL ABSTRACTION FEES - 2009 AMOUNT: $ 1,566. 2010 AMOUNT: $ 4,716. 2013 AMOUNT: $ 7. REFUNDS AND REBATES - 2009 AMOUNT: $ 1,346. 2010 AMOUNT: $ 6,015. 2011 AMOUNT: $ 8,089. 2012 AMOUNT: $ 3,863. 2013 AMOUNT: $ 9,179. SOLD SERVICES - 2009 AMOUNT: $ 12,000. 2010 AMOUNT: $ 9,000. EMPLOYEE PARKING FEES - 2009 AMOUNT: $ 9,577. 2010 AMOUNT: $ 12,949. 2011 AMOUNT: $ 19,195. 2012 AMOUNT: $ 19,700. 2013 AMOUNT: $ 19,097. OTHER - 2009 AMOUNT: $ 2,555. 2011 AMOUNT: $ 966. 2012 AMOUNT: $ 11,549. 2013 AMOUNT: $ 1,967. TELEPHONE/TELEVISION INCOME - 2013 AMOUNT: $ 18,962.ExplanationTxt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$1,505OtherActivitiesAmt
Total Lobbying Expenditures$1,505TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationCOSTS ARE INCURRED AS PART OF DUES PAID TO NURSING HOME INDUSTRY ORGANIZATIONS AND UNION (1199).ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10OtherCostOrOtherBasisAmt
Book Value$10BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,021,786OtherCostOrOtherBasisAmt
Depreciation$11,622,588DepreciationAmt
Book Value$6,399,198BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,721,407OtherCostOrOtherBasisAmt
Depreciation$1,986,859DepreciationAmt
Book Value$734,548BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,133,756TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
DUE FROM THIRD PARTY PAYORS$1,794,254
ASSETS LIMITED AS TO USE - CASH AND CASH EQUIVALENTS$2,764,181
ASSETS LIMITED AS TO USE - CERTIFICATES OF DEPOSIT$3,035,627
SECURITY DEPOSITS$219,864
INSURANCE RECOVERY RECEIVABLE$898,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,711,926TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO THIRD PARTY PAYORS$324,441
DUE TO ST. JOHN'S RIVERSIDE HOSPITAL$8,234,063
PROFESSIONAL LIABILITIES$898,000
FieldValueIRS element (for citing)
Total Liability$9,456,504TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$16,430,511TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$16,430,511RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$16,430,511TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$17,281,533TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$17,281,533ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$17,281,533TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:RESIDENTS' FUNDS ARE HELD BY MMSNP ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH MMSNP FOR SAFEKEEPING. THE FUNDS ARE DISBURSED BY MMSNP AT THE REQUEST OF, OR ON BEHALF OF RESIDENTS FOR THEIR PERSONAL USE.
PART X, LINE 2:MMSNP RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT MMSNP HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. MMSNP IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2010.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MARK POHAR
ADMINISTRATOR$195,314$0$0$0$0$0$15,742$0$17,961$0$229,017$0$0$0
SHERWIN CHUE
CONTROLLER$196,103$0$0$0$0$0$15,757$0$18,813$0$230,673$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationANNUAL MEMBERSHIP DUES ARE PAID TO SEVERAL PROFESSIONAL ASSOCIATIONS AND ORGANIZATIONS ON BEHALF OF MARK POHAR AND SHERWIN CHUE.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6RIVERSIDE HEALTH CARE SYSTEM, INC. IS THE SOLE MEMBER OF THE PAVILION.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER OF THE PAVILION HAS THE POWER TO ELECT AND REMOVE THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7BRESERVED 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 11THE 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 12CTHE 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 15THE BOARD OF TRUSTEES REVIEWS AND APPROVES SALARY RECOMMENDATIONS OF TOP MANAGEMENT EMPLOYEES, KEY EMPLOYEES AND OFFICERS. SALARY RECOMMENDATIONS ARE PROVIDED BY RIVERSIDE HEALTH CARE SYSTEM'S HUMAN RESOURCES DEPARTMENT WHICH INCLUDES STUDIES FROM INDEPENDENT OUTSIDE FIRMS AND SAMPLING OF LOCAL AREAS SALARY STRUCTURES.
FORM 990, PART VI, SECTION C, LINE 18THE 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 19THE 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 XII, LINE 2CTHE 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 (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ST JOHN'S RIVERSIDE HOSPITAL
967 NORTH BROADWAYYONKERSNY10701131740126HOSPITALNY501(C)(3)3RIVERSIDE HEALTH CARE SYSTEM INC0
RIVERSIDE HEALTH CARE SYSTEM INC
967 NORTH BROADWAYYONKERSNY10701133237215HOSPITALNY501(C)(3)30N/A
VALENTINE LANE FAMILY PRACTICE
120 ODELL AVENUEYONKERSNY10701133520368CLINIC FOR ST. JOHN'S RIVERSIDE HOSPITALNY501(C)(3)3RIVERSIDE HEALTH CARE SYSTEM INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Entity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
SJR MEDICAL PC
967 NORTH BROADWAYYONKERSNY10701134185781MEDICAL SERVICESNYST JOHNS RIVERSIDE HOSPITALC0
FOUNDATION FOR COMMUNITY HOSPITAL AT DOBBS FERRY
128 ASHFORD AVENUEDOBBS FERRYNY10522133971735FUNDRAISINGNYST JOHNS RIVERSIDE HOSPITALC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd