2013-11-11T07:11:38-06:00 2012-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2012-01-01 133591762 ST MARY'S CENTER INC STMA 2126655992 516 WEST 126TH STREET NEW YORK NY 10027 HOLLY ARGENT-TARIQ 2126655992 2013-11-08 1 FREDERICK H ROTHMAN P01275277 2128674000 2012 2016-03-07 17:11:31Z HOLLY ARGENT-TARIQ 516 WEST 126TH STREET NEW YORK NY 10027 9306910 0 X N/A X 1990 NY ST. MARY'S CENTER, INC. OPERATES SPECIAL CARE NURSING FACILITY FOR ADULTS WHO TEST POSITIVE FOR THE HUMAN IMMUNODEFICIENCY VIRUS (HIV) AND ARE SYMPTOMATIC OR ARE DIAGNOSED AS HAVING CONTRACTED AQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS). THE CENTER'S PRIMARY SOURCES OF REVENUES ARE PATIENT SERVICE FEES PAID BY MEDICAID. 8 8 63 8 0 0 6570 11111 9321653 9187157 43674 33627 40471 75015 9412368 9306910 0 0 0 0 4075569 3992730 0 0 0 5085422 4761723 9160991 8754453 251377 552457 11465780 10594842 5558007 4134612 5907773 6460230 X MISSION STATEMENT: THE MISSION OF ST. MARY'S EPISCOPAL CENTER, INC. A NOT FOR PROFIT SKILLED NURSING FACILITY LOCATED IN HARLEM, IS TO PROVIDE QUALITY HEALTHCARE, ADDICTION COUNSELING, ABSTINENCE SUPORT AND SOCIAL SERVICES TO PEOPLE LIVING WITH HIV/AIDS AND THEIR FAMILIES. OUR SERVICES ARE PROVIDED IN A CLEAN AND SAFE HOMELIKE ENVIRONMENT THAT IS FREE FROM ABUSE, NEGLECT AND MISTREATMENT. ALL SERVICES ARE GEARED TOWARD MAINTAINING THE RESIDENT'S DIGNITY AND RESPECT. WE EDUCATE, SUPPORT AND EMPOWER EACH RESIDENT AND THEIR SIGNIFICANT OTHERS WITH INFORMATION AND RESOURCES IMPROVING AND MAINTAINING THE HIGHEST POSSIBLE QUALITY OF LIFE WHILE LIVING WITH HIV/AIDS. WE STRIVE TO CONTINUOUSLY IMPROVE SERVICES THROUGH THE RECRUITMENT AND RETENTION OF COMPETENT, QUALIFIED AND CARING STAFF. WE MONITOR QUALITY OF CARE THROUGH OUR INTERDISCIPLINARY CONTINUOUS QUALITY IMPROVEMENT PROGRAM. 0 0 5220543 6700377 NURSING HOME SERVICES-ST. MARYS CENTER INC. OPENED ITS DOORS IN AUGUST 1992 AS A 40 BED NURSING HOME FOR AIDS PATIENTS WHEN IT WAS LICENSED BY THE STATE DEPARTMENT OF HEALTH. SINCE THAT TIME WE HAVE CONSISTENTLY MAINTAINED A PATIENT CENSUS OF AT OR NEAR CAPACITY. YEAR ENDING 12/31/12 WE WERE AT 96%. IN 2011 WE WERE AT 87%. WE PROVIDE A FULL COMPLIMENT OF NURSING HOME RELATED SERVICES INCLUDING ROOM AND BOARD, MEDICAL, CLINICAL AND SOCIAL SERVICES. 1834245 2427950 ADULT-DAY HEALTH CARE- IN MAY 1997 WITH DOH APPROVAL, WE BECAME LICENSED TO OPEN A 50 PATIENT ADULT DAY TREATMENT CENTER FOR PEOPLE LIVING WITH HIV/AIDS. THE PROGRAM HAS THRIVED SINCE ITS OPENING BY PROVIDING A FULL SPECTRUM OF SUPPORT SERVICES FROM RECREATION TO PRIMARY CARE. THE PROGRAM HAS CONSISTENTLY MAINTAINED AN ANNUAL AVERAGE OF CLINIC VISITS RANGING FROM 12,000-14,000. 0 59288 PRIMARY CARE/AMIDACARE-(FORMERLY VIDACARE) IN 2002 ST. MARY'S CENTER BECAME PART OF THIS SPECIAL NEEDS PLAN FOR PEOPLE WITH HIV/AIDS WHICH PROVIDES "ONE STOP SHOPPING" HIGH QUALITY HEALTH CARE. 7054788 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 63 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 1 0 0 0 NY X XIOMARA LANTIGUA 2126655992 ST MARYS CENTER 516 WEST 126TH NEW YORK NY 10027 DIANE B POLLARD 5.00 X X 0 0 0 GEORGE W GOODWILL 2.00 X X 0 0 0 MARTIN A WITT 2.00 X X 0 0 0 REV EARL KOOPERKAMP 2.00 X 0 0 0 PAULA WILSON 2.00 X 0 0 0 REV GEORGE W BRANDT JR 2.00 X 0 0 0 NELL GIBSON 2.00 X 0 0 0 PEARL HARRIS 2.00 X 0 0 0 HOLLY ARGENT-TARIQ 35.00 X 189351 0 18283 XIOMARA LANTIGUA 35.00 X 87328 0 12917 DR HARRISON MITCHELL 30.00 X 150899 0 15557 DR PATRICIA OLGIVIE 35.00 X 126103 0 13901 MS BIBI NIZAM 35.00 X 128357 0 6947 BETTY HALLUMS 35.00 X 105045 0 13843 787083 0 81448 5 0 1 0 UNIDINE CORPORATION ONE GATEWAY CENTER SUITE 751 NEWTON MA 02458 DIETARY SERVICES 654818 BURNS INTERNATIONAL SECURITY PO BOX 403412 ATLANTA GA 30368 SECURITY SERVICES 404268 NPORT THERAPY 3041 AVENUE U BROOKLYN NY 11229 STAFFING AGENCY 112534 LOEB & TROPER LLP 655 THIRD AVENUE NEW YORK NY 10017 AUDITORS & CONSULTANTS 108374 4 11111 11111 NURSING HOME SERVICES 623000 6697147 6697147 ADULT HEALTH CARE 623000 2430722 2430722 AMIDACARE 623000 59288 59288 9187157 33627 33627 INSURANCE RECOVERIES 900099 73877 73877 REFUNDS 900099 1027 1027 MEDICAL RECORDS 900099 60 60 51 51 75015 9306910 9187157 0 108642 X 474335 366993 107342 2713349 2099318 614031 146270 113169 33101 460514 356300 104214 198262 153395 44867 54378 1340 53038 66422 66422 1853006 1725755 127251 15699 15699 348604 187097 161507 77306 35084 42222 603246 511290 91956 121277 119743 1534 33989 14056 19933 60922 47135 13787 609698 474677 135021 127370 98546 28824 HEALTH FACILITY ASSESSM 599958 599958 MEDICAL SUPPLIES 99983 99983 STIPENDS 24529 6165 18364 AMORTIZATION-DEFERRED F 3818 3818 61518 44784 16734 8754453 7054788 1699665 0 275790 173957 1788201 1873914 960996 928662 113554 94919 13146160 7338729 6249562 5807431 927943 570043 1149734 1145916 11465780 10594842 1155329 993339 2622423 2622423 702577 127577 86237 35228 991441 356045 5558007 4134612 X 5907773 6460230 5907773 6460230 11465780 10594842 552457 0 X X 0 1 X 1 0 X 5000 3945 3099 6570 11111 29725 10401090 10034368 10221730 9321653 9187157 49165998 10406090 10038313 10224829 9328223 9198268 49195723 0 0 0 49195723 93924 47805 40151 43674 33627 259181 93924 47805 40151 43674 33627 259181 1550 250573 589 40471 75015 368198 10501564 10336691 10265569 9412368 9306910 49823102 0.98740 0.98670 0.00520 0.00730 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: INSURANCE RECOVERIES REFUNDS MEDICAL RECORDS MISCELLANEOUS INCOME 127000 127000 9348574 4884665 4463909 2555832 1925105 630727 1114754 528959 585795 5807431 DEBT SERVICE RESERVE 438845 INVESTMENT IN PROPERTY 707071 1145916 DUE TO THIRD PARTY PAYORS 345837 RESIDENT FUNDS 10208 356045 X 9306910 0 9306910 0 9306910 8754453 0 8754453 0 8754453 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CENTER ADOPTED THE PROVISIONS PERTAINING TO UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2009 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. X X 0 0 0 0 0 0 0 0 0 HOLLY ARGENT-TARIQ 189269 0 0 0 82 0 9468 0 8815 0 207634 0 0 0 DR HARRISON MITCHELL 150864 0 0 0 35 0 7574 0 8012 0 166485 0 0 0 A DORMITORY AUTHORITY STATE OF NEW YORK 146000293 64983QDG1 2005-04-13 2647023 REFUND PRIOR ISSUE 0 0 0 A 2647023 458223 2365991 51107 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE COMPLETED 990 IS REVIEWED BY THE SENIOR FINANCE STAFF. ANY COMMENTS ARISING FROM THE REVIEW ARE NOTED ON THE DRAFT. THAT DRAFT IS SUBMITTED TO THE AUDIT COMMITTEE FOR ITS REVIEW AND APPROVAL. ONCE THE AUDIT COMMITTEE HAS COMPLETED ITS REVIEW, COPIES OF THE APPROVED RETURN WILL BE PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION C, LINE 18 THESE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 COPIES ARE PROVIDED UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G PURCHASE & CONTRACT FOR THERAPEUTIC/DENTAL : PROGRAM SERVICE EXPENSES 1,315,915. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,315,915. SPECIAL PROJECT CONSULTING: PROGRAM SERVICE EXPENSES 201,881. MANAGEMENT AND GENERAL EXPENSES 104,305. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 306,186. OTHER SERVICE: PROGRAM SERVICE EXPENSES 207,959. MANAGEMENT AND GENERAL EXPENSES 22,946. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 230,905. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.