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RUTLAND NURSING HOME INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
RUTLAND NURSING HOME INC (EIN 11-2164674)
Tax period
2011-01-01 to 2011-12-31
Filed
2013-01-28
IRS object ID
201300289349300120
Schema version
2011v1.5
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)
Timestamp2013-01-28T10:34:52-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1300 Madison AvenueAddressLine1
CityNew YorkCity
StateNYState
ZIP Code10017ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN112164674EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1RUTLAND NURSING HOME INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JOHN SCHMITTInCareOfName
Name ControlRUTLNameControl
Phone7186045532Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1585 SCHENECTADY AVENUEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11203ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN SCHMITTName
TitleCFOTitle
Date Signed2013-01-23DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone6464713000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLINDA BRADY MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1585 SCHENECTADY AVENUEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11203ZIPCode
FieldValueIRS element (for citing)
Gross Receipts74087169GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.KINGSBROOK.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1971YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionOUR MISSION IS TO PARTNER WITH OUR CULTURALLY DIVERSE COMMUNITIES TO PROVIDE A CONTINUUM OF OUTSTANDING HEALTH CARE SERVICES TO INDIVIDUALS AND FAMILIES THROUGH A CARING AND TRUSTWORTHY STAFF.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers129TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year557793ContributionsGrantsCurrentYear
Program Service Revenue Prior Year71238182ProgramServiceRevenuePriorYear
Program Service Revenue CY73386587ProgramServiceRevenueCY
Investment Income Prior Year145757InvestmentIncomePriorYear
Investment Income Current Year142789InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year71383939TotalRevenuePriorYear
Total Revenue Current Year74087169TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year48860495SalariesEtcPriorYear
Salaries Etc Current Year51605000SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year27521225OtherExpensePriorYear
Other Expenses Current Year28309516OtherExpensesCurrentYear
Total Expenses Prior Year76381720TotalExpensesPriorYear
Total Expenses Current Year79914516TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4997781RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-5827347RevenuesLessExpensesCY
Total Assets BOY23598761TotalAssetsBOY
Total Assets EOY22084455TotalAssetsEOY
Total Liabilities BOY53025589TotalLiabilitiesBOY
Total Liabilities EOY57338630TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-29426828NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-35254175NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOUR MISSION IS TO PARTNER WITH OUR CULTURALLY DIVERSE COMMUNITIES TO PROVIDE A CONTINUUM OF OUTSTANDING HEALTH CARE SERVICES TO INDIVIDUALS AND FAMILIES THROUGH A CARING AND TRUSTWORTHY STAFF.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Activity Code623000ActivityCode
Expense68014089Expense
Revenue73386587Revenue
DescriptionRUTLAND NURSING HOME, LOCATED ON THE CAMPUS OF KINGBROOK JEWISH MEDICAL CENTER IS A 538-BED, LONG AND SHORT-TERM CARE FACILITY OFFERING SKILLED NURSING, PHYSICAL REHABILITATION, COMPREHENSIVE WOUND CARE, A SPECIALTY UNIT FOR VENTILATOR DEPENDENT RESIDENTS AND AN ARRAY OF OTHER SUB-ACUTE SERVICES. ALL THE RESOURCES OF THE MEDICAL CENTER, INCLUDING GENERAL MEDICAL AND SUB-SPECIALTIES, SURGICAL, ORTHOPAEDIC, PSYCHIATRIC AND DENTAL SERVICES, AND THE EMERGENCY ROOM, ARE IMMEDIATELY AVAILABLE TO THE RESIDENTS. NURSING HOME RESIDENTS ARE EASILY TRANSFERRED TO THE ACUTE SERVICES OF THE HOSPITAL IF MEDICAL NECESSITY REQUIRES, AND SUBSEQUENTLY RETURNED TO THE NURSING HOME. RUTLAND NURSING HOME HAS A DEDICATED 32-BED PAEDIATRIC LONG-TERM CARE UNIT FOR CHILDREN WITH SEVERE DEVELOPMENTAL AND METABOLIC DISORDERS. THE UNIT IS STAFFED WITH NURSES AND PAEDIATRICIANS 24 HOURS A DAY, SEVEN DAYS A WEEK. MEDICAL CARE IN THE RUTLAND NURSING HOME IS COORDINATED BY PHYSICIANS EXPERIENCED AND DEDICATED TO PAEDIATRICS AND GERIATRICS. ENCOURAGING THE RESIDENTS TO MAXIMIZE THEIR ABILITY TO LEAD ACTIVE AND FULFILLING LIVES, LICENSED NURSES AND THERAPISTS DELIVER STATE-OF-THE-ART PHYSICAL, OCCUPATIONAL, RECREATIONAL AND SPEECH THERAPIES. TO ENSURE COMPREHENSIVE CARE, DIETICIANS AND SOCIAL WORKERS AUGMENT THE TREATMENT TEAM.Description
Total Program Service Expense68014089TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109622NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOHN SCHMITTNamePerson
Telephone Number7186045532TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1585 SCHENECTADY AVENUEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11203ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployee
EDWARD LIEBERSTEIN
CHAIRMAN2.0X000
SEEMA GOLDSTEIN
VICE CHAIRMAN1.5X000
LINDA BRADY MD
PRESIDENT & BOARD DIRECTOR12.0X0131081347816X
GWENDOLYN BRADHAM-LEWIS
SECRETARY & BOARD DIRECTOR1.0X000
HENNA WHITE
BOARD DIRECTOR3.0X000
GEOFFREY PATRICE MD
BOARD DIRECTOR1.0X048000
RAFIQUE CHAUDRHY MD
BOARD DIRECTOR1.0X011001100
ROBERT REISS
BOARD DIRECTOR1.5X000
VALERIE BYNOE-KASDEN ESQ
BOARD DIRECTOR1.0X000
VICTOR AYALA PHD
BOARD DIRECTOR2.0X000
WILLIAM LOIS MD
BOARD DIRECTOR1.0X037152347816
JOHN SCHMITT CPA
CFO12.0042167847816X
SUSAN ZINDER
GENERAL COUNSEL, UNTIL 2/4/1112.00439734177X
MICHAEL MCDERMOTT
GENERAL COUNSEL, START 2/22/1112.0020576937400X
ROBERT DUBICKI
COO12.0043298647816X
HAROLD MCDONALD
SVP12.0032143223275X
MARYANNE ROSE
ADMINISTRATOR, UNTIL 8/12/1140.0023242442971X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4445508TotalReportableCompFrmRltdOrgs
Total Other Compensation299087TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonEXCLUSIVE TRANSPORTATIONNamePerson

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 476AddressLine1
CityLAWRENCECity
StateNYState
ZIP Code11559ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPATIENT TRANSPORTDescriptionOfServices
Compensation133606Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Government Grants557793GovernmentGrants
Total Contributions557793TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6230007188465471884654
MEDICARE DRUG BILLING52411415019331501933
FieldValueIRS element (for citing)
Total Program Service Revenue73386587TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column142789TotalRevenueColumn
Exclusion$142,789ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column74087169TotalRevenueColumn
Related Or Exempt Function Income73386587RelatedOrExemptFunctionIncome
Exclusion$142,789ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total37626000Total
Program Services32759306ProgramServices
Management And General4866694ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13979000Total
Program Services12170902ProgramServices
Management And General1808098ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total104290Total
Program Services82599ProgramServices
Management And General21691ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total66366Total
Program Services52563ProgramServices
Management And General13803ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total145206Total
Program Services115005ProgramServices
Management And General30201ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1270Total
Program Services1006ProgramServices
Management And General264ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total18693425Total
Program Services14805418ProgramServices
Management And General3888007ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total933299Total
Program Services739184ProgramServices
Management And General194115ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total48227Total
Program Services38196ProgramServices
Management And General10031ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total249501Total
Program Services197608ProgramServices
Management And General51893ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total869372Total
Program Services688553ProgramServices
Management And General180819ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVISION FOR BAD DEBT31848123184812
NY STATE ASSESSMENT40137483178937834811

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total79914516Total
Program Services68014089ProgramServices
Management And General11900427ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4727487BOY
EOY2759798EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY239035BOY
EOY240497EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9112077BOY
EOY10022197EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis39616577LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec33240431LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6093576BOY
EOY6376146EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY291889BOY
EOY312644EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3134697BOY
EOY2373173EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY23598761BOY
EOY22084455EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY540866BOY
EOY850594EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY5099438BOY
EOY4114828EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY47385285BOY
EOY52373208EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY53025589BOY
EOY57338630EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-29426828BOY
EOY-35254175EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-29426828BOY
EOY-35254175EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY23598761BOY
EOY22084455EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-5827347ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years48999CurrentTaxYearMinus2Years
Current Tax Year557793CurrentTaxYear
Total606792Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years65592253CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years66027895CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years67382695CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year71238182CurrentTaxYearMinus1Year
Current Tax Year73386587CurrentTaxYear
Total343627612Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years65592253CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years66027895CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years67431694CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year71238182CurrentTaxYearMinus1Year
Current Tax Year73944380CurrentTaxYear
Total344234404Total
FieldValueIRS element (for citing)
Public Support Total509344234404PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years320362CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years238712CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years158667CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year145757CurrentTaxYearMinus1Year
Current Tax Year142789CurrentTaxYear
Total1006287Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years320362CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years238712CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years158667CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year145757CurrentTaxYearMinus1Year
Current Tax Year142789CurrentTaxYear
Total1006287Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years65912615CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years66266607CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years67590361CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year71383939CurrentTaxYearMinus1Year
Current Tax Year74087169CurrentTaxYear
Total345240691Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99709PublicSupportPercentage509
Prior Year Support Percentage0.99650PriorYearSupportPercentage
Investment Income Percentage0.00292InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00330PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$60,000DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$6,366OtherActivitiesAmount
Total Lobbying Expenditures IIB66366TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE C, PART II-B, LINE 1IIdentifier
Return ReferenceOTHER ACTIVITIESReturnReference
ExplanationRUTLAND NURSING HOME PAYS DUES TO CONTINUING CARE LEADERSHIP COALITION (CCLC). IN ACCORDANCE WITH SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY CCLC, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2011 CCLC DUES WAS $6,366. ADDITIONALLY, THE ORGANIZATION HAS A CONTRACT WITH A LOBBYIST WHO WAS ENGAGED TO LOBBY LEGISLATORS ON BEHALF OF THE ORGANIZATION REGARDING POLICIES WHICH IMPACT THE ORGANIZATION'S EXEMPT PURPOSE AND WHICH PERTAIN TO PUBLIC HEALTH CARE. DURING 2011 RUTLAND NURSING HOME PAID $60,000 IN CONNECTION WITH THESE SERVICES.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis825000OtherCostOrOtherBasis
Book Value825000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis31428340OtherCostOrOtherBasis
Depreciation27849362Depreciation
Book Value3578978BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6502834OtherCostOrOtherBasis
Depreciation5391069Depreciation
Book Value1111765BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis860403OtherCostOrOtherBasis
Book Value860403BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6376146TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
OTHER ASSETS1548094
OPERATING ESCROW ACCOUNT712800
INVESTM IN DEBT & EQUITY SECUR110620
MORTGAGE REPAYMENT ESCROW1659
FieldValueIRS element (for citing)
Total Book Value Other Assets2373173TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
DUE TO KINGSBROOK JEWISH MEDICAL CENTER$26,714,217
ESTIMATED THIRD PARTY SETTLEMENTS$24,957,221
OTHER CURRENT LIABILITIES - 3RD PARTY$368,872
CASH FUNDS HELD IN TRUST FOR RESIDENTS$240,498
FIN 47 LIABILITY$92,400
FieldValueIRS element (for citing)
Total Of Amounts52373208TotalOfAmounts
Total Revenue74087169TotalRevenue
Total Expenses79914516TotalExpenses
Excess Or Deficit For Year-5827347ExcessOrDeficitForYear
Excess Or Deficit Per FS-5827347ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt74087169TotRevenueEtcAuditedFinclStmt
Revenue Subtotal74087169RevenueSubtotal
Total Revenue Per Form99074087169TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt79915131TotExpensesEtcAuditedFinclStmt
Prior Year Adjustments615PriorYearAdjustments
Expenses Not Rptd F990615ExpensesNotRptdF990
Expenses Subtotal79914516ExpensesSubtotal
Total Expenses Per Form99079914516TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LINDA BRADY MD
0750845028000702799610232750245410135862900
JOHN SCHMITT CPA
0326386074769020523023275024541046949400
MICHAEL MCDERMOTT
02057690000014547022853024316900
RAFIQUE CHAUDRHY MD
00000110011000000110011000
WILLIAM LOIS MD
03715230000023275024541041933900
ROBERT DUBICKI
040589200027094023275024541048080200
HAROLD MCDONALD
03044190001701302327500034470700
MARYANNE ROSE
019400103842300018430024541027539500

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE J, PART III, ADDITIONAL INFORMATIONPART II, COLUMN (C) RETIREMENT AND OTHER DEFERRED COMPENSATIONTHE DEFERRED COMPENSATION REPORTED FOR KINGSBROOK JEWISH MEDICAL CENTER EMPLOYEE, JOHN SCHMITT, INCLUDES ACCRUALS FOR THE TRANSITION STABILIZATION PLAN WHICH WAS IMPLEMENTED IN 2009. THE VALUE OF THE PLAN IS SUBJECT TO RISK OF FORFEITURE (PURSUANT TO IRS REGULATIONS) UNTIL THE EMPLOYEES MEET SPECIFIC AND DOCUMENTED FUTURE SERVICE REQUIREMENTS. THE PLAN WAS REVIEWED DISCUSSED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE JOINT BOARD OF TRUSTEES/DIRECTORS TO ENHANCE THE RETENTION OF KEY EXECUTIVES AND TO MAINTAIN LEADERSHIP STABILITY AS KINGSBROOK JEWISH MEDICAL CENTER PURSUES OPPORTUNITIES FOR SUSTAINED VIABILITY. THE PLAN IS CONSISTENT WITH TYPICAL MARKET PRACTICES AND REASONABLE IN THE CONTEXT OF THE EMPLOYEES' TOTAL REMUNERATION, BASED ON ADVICE PROVIDED BY INDEPENDENT EXECUTIVE COMPENSATION CONSULTANTS. THE AGREEMENT EXPIRED 12/31/2011 AND WAS PAID OUT IN JANUARY 2012. THE PAYMENT WAS REPORTED AS COMPENSATION IN 2012 AND IS SUBJECT TO ALL APPLICABLE WITHHOLDING AND EMPLOYMENT TAXES.
SCHEDULE J, PART IIIGENERAL COMPENSATION NOTE:1) WILLIAM LOIS - THE COMPENSATION WAS PAID FOR SALARY AS CHIEF OF SURGERY BY KINGSBROOK JEWISH MEDICAL CENTER. NO COMPENSATION WAS PAID FOR BOARD DIRECTOR POSITION 2) GEOFFREY PATRICE MD - THE COMPENSATION WAS PAID FOR SALARY AS ON-CALL PHYSICIAN BY KINGSBROOK JEWISH MEDICAL CENTER. NO COMPENSATION WAS PAID FOR BOARD DIRECTOR POSITION. 3) RAFUQUE CHAUDHAM-LEWIS - THE COMPENSATION WAS PAID FOR SALARY AS CHIEF OF ANAESTHESIOLOGY BY KINGSBROOK JEWISH MEDICAL CENTER. NO COMPENSATION WAS PAID FOR BOARD DIRECTOR POSITION.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (24 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, LINE 6MEMBERS OF THE ORGANIZATIONKINGSBROOK HEALTHCARE SYSTEM ("KHS") IS THE SOLE MEMBER OF RUTLAND NURSING HOME, INC.
FORM 990, PART VI, LINE 7A & 7BELECTION & DECISIONS OF THE GOVERNING BODYKHS IS THE SOLE MEMBER OF RUTLAND NURSING HOME, INC. AND IT HAS RESERVED POWERS THAT ARE DELINEATED IN THE BYLAWS OF RUTLAND NURSING HOME, INC.
FORM 990, PART VI, LINE 11AREVIEW PROCESS FOR FORM 990THE CFO HAS CONDUCTED A DETAILED REVIEW OF THE 990 WITH THE HOSPITALS TAX ACCOUNTANT AND ALL APPROPRIATE CHANGES HAVE BEEN MADE. THE 990 IS THEN REVIEWED BY THE CEO FOR ANY ADDITIONAL COMMENTARY, OBSERVATIONS, OR RECOMMENDATIONS. THE 990 IS THEN REVIEWED BY THE CHAIRMAN OF THE AUDIT AND COMPLIANCE COMMITTEE AND THEN PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW FOR ANY ADDITIONAL COMMENTARY, OBSERVATIONS, OR RECOMMENDATIONS. ONCE COMPLETED AND FILED, FORM 990 IS MADE AVAILABLE TO THE FULL BOARD BY THE CHAIRMAN OF THE AUDIT AND COMPLIANCE COMMITTEE.
FORM 990, PART VI, LINE 12CCONFLICT OF INTEREST POLICYRUTLAND NURSING H0ME, INC FOLLOWS KINGSBROOK JEWISH MEDICAL CENTER'S CONFLICT OT INTEREST POLICY. AT KINGSBROOK JEWISH MEDICAL CENTER, ALL CONFLICTS OF INTEREST ARE REVIEWED BY THE COMPLIANCE OFFICER. ANY POTENTIAL CONFLICTS INVOLVING BOARD MEMBERS ARE REFERRED TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW AND/OR ACTION, AS NECESSARY.
FORM 990, PART VI, LINE 13WHISTLEBLOWER POLICYKINGSBROOK JEWISH MEDICAL CENTER HAS A WRITTEN WHISTLEBLOWER POLICY WHICH APPLIES TO THE ACTIVITIES OF RUTLAND NURSING HOME, INC.
FORM 990, PART VI, LINE 14DOCUMENT RETENTION POLICYKINGSBROOK JEWISH MEDICAL CENTER'S DOCUMENT RETENTION AND DESTRUCTION POLICY APPLIES TO ALL BOOKS AND RECORDS HELD BY RUTLAND NURSING HOME, INC.
FORM 990, PART VI, LINE 15A & 15BCOMPENSATION POLICY AND REVIEW PROCESSRUTLAND NURSING HOME, INC. DID NOT PAY COMPENSATION DIRECTLY FOR ITS EMPLOYEES. THE COMPENSATION AND BENEFITS ARE PAID THROUGH KINGSBROOK JEWISH MEDICAL CENTER'S PAYROLL SYSTEM AND ARE RECORDED ON THE FORM 941 FILED BY KINGSBROOK JEWISH MEDICAL CENTER UNDER THE EMPLOYER INDENTIFICATION NUMBER 11-1631759. THE COMPENSATION OF EXECUTIVE OFFICERS IS REVIEWED ANNUALLY BY KINGSBROOK JEWISH MEDICAL CENTER (KJMC), FOLLOWING BELOW PROCESS: CONSISTENT WITH BEST PRACTICES IN GOVERNANCE AND FIDUCIARY OVERSIGHT OF TAX-EXEMPT FUNDS, KINGSBROOK JEWISH MEDICAL CENTER (KJMC) HAS INSTITUTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER. THE COMPENSATION COMMITTEE IS AUTHORIZED BY THE BOARD TO DEVELOP AND RECOMMEND FOR BOARD APPROVAL THE COMPENSATION OF THE PRESIDENT AND CEO AND MEMBERS OF SENIOR MANAGEMENT (SENIOR VICE PRESIDENTS, VICE PRESIDENTS AND VICE PRESIDENTS). ONLY INDEPENDENT MEMBERS OF THE BOARD SHALL PARTICIPATE IN COMPENSATION DELIBERATIONS AND DECISIONS (I.E., EMPLOYEES, MEMBERS OF THE MEDICAL STAFF AND CONSULTANTS ARE NOT DEEMED INDEPENDENT FOR THESE PURPOSES). ALL EXECUTIVE COMPENSATION DECISIONS ARE BASED ON COMPETITIVE MARKET DATA, ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE RESULTS, AND ALIGNMENT WITH KJMC'S EXECUTIVE COMPENSATION PHILOSOPHY. THE BOARD'S COMPENSATION COMMITTEE REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION TO ENDURE LEGAL AND REGULATORY COMPLIANCE AND ADHERENCE TO GOVERNANCE BEST PRACTICES AND PROPER FIDUCIARY OVERSIGHT AS STEWARDS OF TAX EXEMPT ASSETS. THE EXECUTIVE COMPENSATION PHILOSOPHY STATES ITS INTENT IS TO MAINTAIN A COMPETITIVE EXECUTIVE COMPENSATION PROGRAM IN ORDER TO ATTRACT, RETAIN AND MOTIVATE QUALIFIED EMPLOYEES TO SUPPORT THE MISSION AND BUSINESS GOALS OF KJMC. THE COMPENSATION COMMITTEE RETAINS OUTSIDE LEGAL COUNSEL WHO REVIEWS COMPLIANCE WITH TAX AND REGULATORY REQUIREMENTS AS WELL AS THE SERVICES OF AN INDEPENDENT QUALIFIED COMPENSATION CONSULTANT WHO COMPILES AND ANALYZES PUBLISHED SURVEY-DATA FOR BASE SALARIES AND TOTAL COMPENSATION PROVIDED BY TAX EXEMPT HOSPITALS AND MEDICAL CENTERS SIMILAR TO KJMC IN SIZE, OPERATIONS AND LOCATION. THE COMMITTEE'S REVIEW OF COMPENSATION OCCURS ANNUALLY SUCH THAT EXECUTIVE COMPENSATION AND BENEFITS CONTINUE TO BE COMPETITIVE AND REASONABLE BY FOLLOWING THE PRECEDING GOVERNANCE AND FIDUCIARY PRACTICES, THE COMMITTEE QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS REGULATIONS OF THE INTERNAL REVENUE CODE SUCH THAT THE TOTAL COMPENSATION PROVIDED TO THE EXECUTIVES IS COMPARED TO WHAT IS "ORDINARILY PAID FOR LIKE SERVICES BY LIKE ENTERPRISES UNDER LIKE CIRCUMSTANCES," AS DEFINED IN THE INTERMEDIATE SANCTIONS REGULATIONS. BASE PAY FOR EACH EXECUTIVE IS BASED ON FACTORS INCLUDING MARKET DATA, TENURE, EXPERIENCE, AND INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. EXECUTIVE BASE PAY IS REVIEWED AND SET ANNUALLY BY THE INDEPENDENT MEMBERS OF THE COMPENSATION COMMITTEE OF THE INDEPENDENT DIRECTORS OF KINGSBROOK JEWISH MEDICAL CENTER (KJMC), BASED ON THE EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER. AS DESCRIBED IN KJMC'S EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER, KJMC SUPPORTS PERFORMANCE BASED COMPENSATION AND THEREFORE HAS IMPLEMENTED AN ANNUAL INCENTIVE PAY PROGRAM (EXECUTIVE MANAGEMENT ANNUAL INCENTIVE PLAN) FOR THE EXECUTIVES AND A LONG-TERM INCENTIVE PAY PROGRAM (ANNUALIZED STRATEGIC PERFORMANCE INCENTIVE) FOR THE PRESIDENT AND CEO. THE ANNUAL AND LONG-TERM INCENTIVE PAY PROGRAMS ARE DESIGNED TO SUPPORT THE ATTAINMENT OF ANNUAL AND STRATEGIC PERFORMANCE OBJECTIVES AND REFLECT A COMBINATION OF FORMULAIC WEIGHTINGS PROVIDING FOR THRESHOLD, TARGET AND MAXIMUM BONUS LEVELS AND DISCRETIONARY JUDGMENT AS DETERMINED BY THE COMPENSATION COMMITTEE. THE PERFORMANCE MEASURES ARE SET PRIOR TO THE BEGINNING OF EACH PLAN YEAR AND PLAN PAYMENTS ARE DETERMINED BASED ON AUDITED FINANCIAL RESULTS AND OTHER MEASURES. THE PROCESS USED FOR DETERMINING THE COMPENSATION OF THE CEO ALSO APPLIES TO MEMBERS OF THE EXECUTIVE STAFF, DEPARTMENT CHAIRS AND OTHER HIGHLY COMPENSATED STAFF EXCEPT THAT THE PRESIDENT AND CEO MAKES COMPENSATION RECOMMENDATIONS TO THE COMPENSATION SUBCOMMITTEE FOR THOSE EMPLOYEES.
FORM 990, PART VI, LINE 19DOCUMENTS AVAILABLE FOR PUBLIC INSPECTIONUPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS.
FORM 990, PART VII, LINE 2RUTLAND NURSING HOME, INC. DOES NOT DIRECTLY PAY ITS EMPLOYEES. THE COMPENSATION AND BENEFITS ARE ALLOCATED FROM KINGSBROOK JEWISH MEDICAL CENTER. THE COMPENSATION AND BENEFITS ARE RECORDED ON FORM 941 FILED BY KINGSBROOK JEWISH MEDICAL CENTER UNDER EMPLOYER IDENTIFICATION NUMBER 11-1631759.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:EDWARD LIEBERSTEIN TITLE:CHAIRMAN HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:SEEMA GOLDSTEIN TITLE:VICE CHAIRMAN HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:LINDA BRADY MD TITLE:PRESIDENT & BOARD DIRECTOR HOURS:37
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:GWENDOLYN BRADHAM-LEWIS TITLE:SECRETARY & BOARD DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:HENNA WHITE TITLE:BOARD DIRECTOR HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:GEOFFREY PATRICE MD TITLE:BOARD DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:RAFIQUE CHAUDRHY MD TITLE:BOARD DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ROBERT REISS TITLE:BOARD DIRECTOR HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:VALERIE BYNOE-KASDEN ESQ TITLE:BOARD DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:VICTOR AYALA PHD TITLE:BOARD DIRECTOR HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:WILLIAM LOIS, MD TITLE:BOARD DIRECTOR HOURS:32
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN SCHMITT CPA TITLE:CFO HOURS:37
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:SUSAN ZINDER TITLE:GENERAL COUNSEL, UNTIL 2/4/11 HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MICHAEL MCDERMOTT TITLE:GENERAL COUNSEL, START 2/22/11 HOURS:37
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ROBERT DUBICKI TITLE:COO HOURS:35

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
KINGSBROOK HEALTHCARE SYSTEM
585 SCHENECTADY AVENUEBROOKLYNNY11203030464734SUPPORT ORGNY501(C)(3)11AN/Afalse
KINGSBROOK JEWISH MEDICAL CENTER
585 SCHENECTADY AVENUEBROOKLYNNY11203111631759HOSPITALNY501(C)(3)3falseKHS
KINGSBROOK JEWISH MEDICAL CENTER AUXILIA
585 SCHENECTADY AVENUEBROOKLYNNY11203113016121SUPPORT ORGNY501(C)(3)11AfalseKJMC
KINGSBROOK JEWISH MEDICAL CTR FDN
585 SCHENECTADY AVENUEBROOKLYNNY11203112845058SUPPORT ORGNY501(C)(3)11AfalseKJMC

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssets
KSI INC
585 SCHENECTADY AVENUEBROOKLYNNY11203562327654INACTIVENYKHS INCC CORP00
SINGULAB INC
585 SCHENECTADY AVENUEBROOKLYNNY11203562327669INACTIVEDEKSI INCC CORP00
ATM NURSE REGISTRY
585 SCHENECTADY AVENUEBROOKLYNNY11203562327649INACTIVENYKSI INCLLC00
KINGSBROOK LTACH INC
585 SCHENECTADY AVENUEBROOKLYNNY11203800712226INACTIVENYKHS INCC CORP00
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg