MICHAEL MALOTZ SKILLED NURSING PAVILION: Form 990, tax year 2012
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- Organization
- MICHAEL MALOTZ SKILLED NURSING PAVILION (EIN 31-1587828)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-07-23
- IRS object ID
- 201332049349300218
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2013-07-23T11:30:39-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271728945 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'CONNOR DAVIES LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MAMARONECK AVENUE | AddressLine1 |
| City | HARRISON | City |
| State | NY | State |
| ZIP Code | 105281633 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311587828 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL MALOTZ SKILLED NURSING PAVILION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MICH | NameControl |
| Phone | 9149643333 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 ODELL AVENUE | AddressLine1 |
| City | YONKERS | City |
| State | NY | State |
| ZIP Code | 107011408 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARK POHAR | Name |
| Title | ADMINISTRATOR | Title |
| Phone | 9149643333 | Phone |
| Date Signed | 2013-07-22 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GARRETT M HIGGINS | Name |
| PTIN | P00543209 | PTIN |
| Phone | 9143818900 | Phone |
| Date Prepared | 2013-07-22 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARK POHAR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 ODELL AVENUE | AddressLine1 |
| City | YONKERS | City |
| State | NY | State |
| ZIP Code | 107011408 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 15398599 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.RIVERSIDEHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1998 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 233 | TotalNbrEmployees |
| Total Nbr Volunteers | 8 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 50565 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3537 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 14916272 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 15330802 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 38446 | InvestmentIncomePriorYear |
| Investment Income Current Year | 29148 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 31140 | OtherRevenuePriorYear |
| Other Revenue Current Year | 35112 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15036423 | TotalRevenuePriorYear |
| Total Revenue Current Year | 15398599 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9460087 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10001657 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5296568 | OtherExpensePriorYear |
| Other Expenses Current Year | 5365801 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14756655 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15367458 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 279768 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 31141 | RevenuesLessExpensesCY |
| Total Assets BOY | 19024050 | TotalAssetsBOY |
| Total Assets EOY | 18477700 | TotalAssetsEOY |
| Total Liabilities BOY | 22004533 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 21427041 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -2980483 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -2949341 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE SKILLED NURSING AND REHABILITATION SERVICES TO GERIATRIC, SUBACUTE AND VENTILATOR DEPENDENT RESIDENTS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 14413881 | Expense |
| Revenue | 15330802 | Revenue |
| Description | SKILLED NURSING, REHABILITATION AND ANCILLARY SERVICES PROVIDED TO GERIATRIC, SUB-ACUTE AND VENTILATOR DEPENDENT RESIDENTS. PATIENT DAYS OF CARE FOR THE YEAR WAS 42,097: GERIATRIC DAYS OF 39,531 AND VENTILATOR DEPENDENT DAYS OF 2,566. THE NUMBER OF RESIDENTS SERVED IN 2012 WAS 476: 430 GERIATRIC AND 46 VENTILATOR DEPENDENT RESIDENTS. | Description |
| Total Program Service Expense | 14413881 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 16 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 233 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHERWIN CHUE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9149643333 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 ODELL AVENUE | AddressLine1 |
| City | YONKERS | City |
| State | NY | State |
| ZIP Code | 107011408 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| ALFRED M GOMEZ MD | |||||||||
| CHAIRMAN | 0.30 | X | X | 0 | 0 | 0 | |||
| ANIL M JOSHI MD | |||||||||
| VICE CHAIRMAN | 0.30 | X | X | 0 | 0 | 0 | |||
| KEVIN T FAY | |||||||||
| TRUSTEE | 0.30 | X | 0 | 0 | 0 | ||||
| GEORGE S GORMAN | |||||||||
| SECRETARY | 0.30 | X | X | 0 | 0 | 0 | 3.60 | ||
| ROYDEN LETSEN | |||||||||
| TRUSTEE | 0.30 | X | 0 | 0 | 0 | 1.00 | |||
| RICHARD PETERSON | |||||||||
| TRUSTEE | 0.30 | X | 0 | 0 | 0 | ||||
| DIANE SKALICKY | |||||||||
| TRUSTEE | 0.30 | X | 0 | 0 | 0 | ||||
| RICHARD KOMOSINSKI | |||||||||
| TRUSTEE | 0.30 | X | 0 | 0 | 0 | 1.00 | |||
| MARK POHAR | |||||||||
| ADMINISTRATOR | 37.50 | X | 185201 | 0 | 33761 | ||||
| SHERWIN CHUE | |||||||||
| CONTROLLER | 30.00 | 193860 | 0 | 34300 | 7.50 | X | |||
| IYAD ANNABI MD | |||||||||
| MEDICAL DIRECTOR | 20.00 | 100915 | 0 | 24919 | X | ||||
| DEBRA DUNNE | |||||||||
| DIRECTOR OF NURSING | 37.50 | 108638 | 0 | 16939 | X | ||||
| BARBARA CRONIN-LAPERCHE | |||||||||
| DIRECTOR OF REHABILITATION SERVICES | 37.50 | 103404 | 0 | 7081 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 692018 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 117000 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOHN'S RIVERSIDE HOSPITAL | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 967 N BROADWAY | AddressLine1 |
| City | YONKERS | City |
| State | NY | State |
| ZIP Code | 10701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | VARIOUS SERVICES: DIETARY, LAB, LAUNDRY, | DescriptionOfServices |
| Compensation | 663427 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 3537 | AllOtherContributions |
| Total Contributions | 3537 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICAID | 623000 | 8218770 | 8218770 |
| MEDICARE | 623000 | 3651881 | 3651881 |
| COMMERCIAL INSURANCE | 623000 | 2335543 | 2335543 |
| PRIVATE PAY | 623000 | 1124608 | 1124608 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 15330802 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 29148 | TotalRevenueColumn |
| Exclusion | $29,148 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| EMPLOYEE PARKING | 812930 | 19700 | $19,700 |
| OTHER INCOME | 900099 | 9200 | $9,200 |
| REBATE | 900099 | 3863 | $3,863 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2349 | TotalRevenueColumn |
| Exclusion | $2,349 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 35112 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15398599 | TotalRevenueColumn |
| Related Or Exempt Function Income | 15330802 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $64,260 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 408314 | Total |
| Management And General | 408314 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6864326 | Total |
| Program Services | 6718183 | ProgramServices |
| Management And General | 146143 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 747192 | Total |
| Program Services | 735933 | ProgramServices |
| Management And General | 11259 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1266996 | Total |
| Program Services | 1192881 | ProgramServices |
| Management And General | 74115 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 714829 | Total |
| Program Services | 679990 | ProgramServices |
| Management And General | 34839 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45199 | Total |
| Management And General | 45199 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40000 | Total |
| Management And General | 40000 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6326 | Total |
| Management And General | 6326 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 268579 | Total |
| Program Services | 254962 | ProgramServices |
| Management And General | 13617 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 426651 | Total |
| Program Services | 393156 | ProgramServices |
| Management And General | 33495 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44293 | Total |
| Program Services | 44293 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1060402 | Total |
| Program Services | 1035615 | ProgramServices |
| Management And General | 24787 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2617 | Total |
| Program Services | 1717 | ProgramServices |
| Management And General | 900 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118101 | Total |
| Program Services | 114377 | ProgramServices |
| Management And General | 3724 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 775264 | Total |
| Program Services | 750816 | ProgramServices |
| Management And General | 24448 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200535 | Total |
| Program Services | 190661 | ProgramServices |
| Management And General | 9874 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCH & CONTRACTED SERV | 771368 | 694831 | 76537 |
| MEDICAL SUPPLIES | 660030 | 660030 | |
| NYS CASH ASSESSMENT | 627375 | 627375 | |
| BAD DEBT EXPENSE | 261832 | 261832 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57229 | Total |
| Program Services | 57229 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15367458 | Total |
| Program Services | 14413881 | ProgramServices |
| Management And General | 953577 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 249083 | BOY |
| EOY | 176670 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 378069 | BOY |
| EOY | 453312 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3018684 | BOY |
| EOY | 3006039 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13976 | BOY |
| EOY | 12768 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38145 | BOY |
| EOY | 35292 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 20532686 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12839741 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8355825 | BOY |
| EOY | 7692945 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6970268 | BOY |
| EOY | 7100674 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19024050 | BOY |
| EOY | 18477700 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1419393 | BOY |
| EOY | 1494501 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 177854 | BOY |
| EOY | 187465 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12269965 | BOY |
| EOY | 11939008 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8137321 | BOY |
| EOY | 7806067 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22004533 | BOY |
| EOY | 21427041 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -2980483 | BOY |
| EOY | -2949341 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -2980483 | BOY |
| EOY | -2949341 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19024050 | BOY |
| EOY | 18477700 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 31141 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 1 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3333 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3155 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7109 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 50565 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3537 | CurrentTaxYear |
| Total | 67699 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 14180053 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13275709 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13592296 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14916272 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15330802 | CurrentTaxYear |
| Total | 71295132 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 14183386 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13278864 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13599405 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14966837 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15334339 | CurrentTaxYear |
| Total | 71362831 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 640 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 500 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1325 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4420 | CurrentTaxYearMinus1Year |
| Current Tax Year | 950 | CurrentTaxYear |
| Total | 7835 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 640 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 500 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1325 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4420 | CurrentTaxYearMinus1Year |
| Current Tax Year | 950 | CurrentTaxYear |
| Total | 7835 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 71354996 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 87521 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 64582 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 45935 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 41336 | CurrentTaxYearMinus1Year |
| Current Tax Year | 29148 | CurrentTaxYear |
| Total | 268522 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 87521 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 64582 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 45935 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 41336 | CurrentTaxYearMinus1Year |
| Current Tax Year | 29148 | CurrentTaxYear |
| Total | 268522 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 51091 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 30187 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 35473 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 28250 | CurrentTaxYearMinus1Year |
| Current Tax Year | 35112 | CurrentTaxYear |
| Total | 180113 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 14321998 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13373633 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13680813 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 15036423 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15398599 | CurrentTaxYear |
| Total | 71811466 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99360 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99150 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00370 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00530 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $6,326 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 6326 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | COSTS ARE INCURRED AS PART OF DUES PAID TO NURSING HOME INDUSTRY ORGANIZATIONS. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
| Explanation In Part XIII | X | ExplanationInPartXIII |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10 | OtherCostOrOtherBasis |
| Book Value | 10 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18021786 | OtherCostOrOtherBasis |
| Depreciation | 11013730 | Depreciation |
| Book Value | 7008056 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2510890 | OtherCostOrOtherBasis |
| Depreciation | 1826011 | Depreciation |
| Book Value | 684879 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7692945 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM THIRD PARTY PAYORS | 943348 |
| ASSETS LIMITED AS TO USE - CASH AND CASH EQUIVALENTS | 2688485 |
| ASSETS LIMITED AS TO USE - CERTIFICATES OF DEPOSIT | 3017252 |
| SECURITY DEPOSITS | 187465 |
| INSURANCE RECOVERY RECEIVABLE | 264124 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 7100674 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THIRD PARTY PAYORS | $284,571 |
| DUE TO ST. JOHN'S RIVERSIDE HOSPITAL | $7,257,372 |
| PROFESSIONAL LIABILITIES | $264,124 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 7806067 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 15398599 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 15398599 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 15398599 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15367458 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15367458 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15367458 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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. THE FUNDS ARE DISBURSED BY THE PAVILION AT THE REQUEST OF, OR ON BEHALF OF RESIDENTS FOR THEIR PERSONAL USE. | |
| 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, 2009. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK POHAR | ||||||||||||||
| ADMINISTRATOR | 185201 | 0 | 0 | 0 | 0 | 0 | 14769 | 0 | 18992 | 0 | 218962 | 0 | 0 | 0 |
| SHERWIN CHUE | ||||||||||||||
| CONTROLLER | 193860 | 0 | 0 | 0 | 0 | 0 | 15397 | 0 | 18903 | 0 | 228160 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 7 | ReturnReference |
| Explanation | ANNUAL MEMBERSHIP DUES ARE PAID TO SEVERAL PROFESSIONAL ASSOCIATIONS AND ORGANIZATIONS ON BEHALF OF MARK POHAR AND SHERWIN CHUE. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 | THE 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. A COMPENSATION INCREASE WAS APPROVED IN JANUARY 2012 EFFECTIVE APRIL 2012. | |
| 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 XI, LINE 9: | ROUNDING 1. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| 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
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOHN'S RIVERSIDE HOSPITAL | |||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 131740126 | HOSPITAL | NY | 501(C)(3) | 3 | RIVERSIDE HEALTH CARE SYSTEM INC | 0 | |
| RIVERSIDE HEALTH CARE SYSTEM INC | |||||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 133237215 | HOSPITAL | NY | 501(C)(3) | 3 | 0 | N/A | |
| VALENTINE LANE FAMILY PRACTICE | |||||||||||
| 120 ODELL AVENUE | YONKERS | NY | 10701 | 133520368 | CLINIC FOR ST. JOHN'S RIVERSIDE HOSPITAL | NY | 501(C)(3) | 3 | RIVERSIDE HEALTH CARE SYSTEM INC | 0 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| SJR MEDICAL PC | |||||||||
| 967 NORTH BROADWAY | YONKERS | NY | 10701 | 134185781 | MEDICAL SERVICES | NY | ST JOHNS RIVERSIDE HOSPITAL | C | 0 |
| FOUNDATION FOR COMMUNITY HOSPITAL AT DOBBS FERRY | |||||||||
| 128 ASHFORD AVENUE | DOBBS FERRY | NY | 10522 | 133971735 | FUNDRAISING | NY | ST JOHNS RIVERSIDE HOSPITAL | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |