2012-11-14T15:38:38-06:00 2011-12-31 233022325 ZELENKOFSKE AXELROD LLC 2370 YORK ROAD SUITE A-5 JAMISON PA 18929 990 2011-01-01 251313958 SUSQUE-VIEW HOME INC SUSQ 5707481784 22 CREE DRIVE LOCK HAVEN PA 17745 DENNIS STAUFFER 5707481784 2012-11-14 1 ZELENKOFSKE AXELROD LLC P00671750 2159182277 2011 2016-02-24 21:20:13Z DENNIS STAUFFER 22 CREE DRIVE LOCK HAVEN PA 17745 10554787 0 X WWW.SUSQUEVIEWHOME.COM X 1976 PA SUSQUE-VIEW HOME IS DEDICATED TO MEETING THE NEEDS OF OUR COMMUNITY AS A LEADING REGIONAL RESOURCE FOR COMPREHENSIVE PROGRESSIVE HEALTHCARE. BY PROVIDING EXCELLENT QUALITY CARE IN A VIBRANT ENVIRONMENT, WE SEEK TO HELP OUR CITIZENS LIVE TO THEIR HIGHEST POTENTIAL. SUSQUE-VIEW HOME WILL USE RESOURCES IN A COST EFFECTIVE AND COMMUNITY-RESPONSIVE MANNER, WORKING WITH PHYSICIANS, STAFF, VOLUNTEERS AND OTHER HEALTH PROFESSIONALS. WE WILL CONTINUE TO EXPLORE NEW PROGRAMS AND OPPORTUNITIES IN RESPONSE TO THE NEEDS OF OUR COMMUNITY. 3 3 196 50 0 0 10579 0 10304016 10462486 17935 1856 24104 17746 10356634 10482088 0 0 0 0 6305183 6476654 0 0 0 3720274 3868777 10025457 10345431 331177 136657 8273078 8451414 2072760 2114439 6200318 6336975 X SUSQUE-VIEW HOME, INC. IS DEDICATED TO MEETING THE NEEDS OF OUR COMMUNITY AS A LEADING REGIONAL RESOURCE FOR COMPREHENSIVE PROGRESSIVE HEALTHCARE. BY PROVIDING EXCELLENT QUALITY CARE IN A VIBRANT HEALTHY ENVIRONMENT, WE SEEK TO HELP OUR CITIZENS LIVE TO THEIR HIGHEST POTENTIAL. SUSQUE-VIEW HOME WILL USE RESOURCES IN A COST-EFFECTIVE AND COMMUNITY-RESPONSIVE MANNER. WORKING WITH PHYSICIANS, STAFF, VOLUNTEERS AND OTHER HEALTH PROFESSIONALS, WE WILL CONTINUE TO EXPLORE NEW PROGRAMS AND OPPORTUNITIES IN RESPONSE TO THE NEEDS OF OUR COMMUNITY. 0 0 9381049 10453944 THE SUSQUE-VIEW HOME, INC. PROVIDES EXTENDED CARE SERVICES TO RESIDENTS OF CLINTON COUNTY AND SURROUNDING AREAS. THE HOME SERVES PRIVATE PAY AND INSURED PATIENTS AS WELL AS BENEFICIARIES OF THE MEDICARE AND MEDICAL ASSISTANCE PROGRAMS. 9381049 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27 0 1 196 1 0 0 0 0 0 0 0 0 X 3 3 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 PA X DENNIS STAUFFER CONTROLLER 5707481784 22 CREE DRIVE LOCK HAVEN PA 17745 JOEL LONG 2.00 X 0 0 0 PETE SMELTZ 2.00 X 0 0 0 JEFF SNYDER 2.00 X 0 0 0 VIRGINIA CREVELING 50.00 X 107597 0 0 DENNIS STAUFFER 45.00 X 63462 0 0 171059 0 0 1 0 0 0 SODEXO INC PO BOX 360170 PITTSBURGH PA 15251 DIETARY 1413372 ADVANTAGE CORE 5035 CLAIRTON BLVD PITTSBURGH PA 15236 THERAPY SERVICES 499894 PREMIERE HEALTHCARE RESOURCES 2009 RENAISSANCE BLVD STE 300 KING OF PRUSSIA PA 19406 MANAGEMENT CONSULTANT 237184 MILLENIUM PHARMACY SYSTEM PO BOX 823441 PHILADELPHIA PA 19182 PHARMACY 224928 LOCK HAVEN HOSPITAL 24 CREE DRIVE LOCK HAVEN PA 17745 ELECTRICAL, LAB, X-RAY 161024 5 PROGRAM SERVICE REVENU 623000 10462486 10462486 10462486 28144 28144 46411 72699 -26288 -26288 -26288 BEAUTY SHOP REVENUE 900099 11884 11884 BEAUTY SHOP RENT 900099 5862 5862 17746 10482088 10453944 0 28144 171059 171059 4356695 4197154 159541 91188 85580 5608 1534964 1440563 94401 322748 297404 25344 242688 242688 14075 14075 26413 26413 5653 5653 1804822 1798013 6809 19804 19804 481362 421839 59523 31515 7029 24486 359184 359184 6176 586 5590 6553 4248 2305 1569 1569 390202 390202 100683 100683 RESIDENT MEDICATIONS 189060 189060 BAD DEBT EXPENSE 90000 90000 OXYGEN 52699 52699 EQUIPMENT MAINTENANCE 46319 45919 400 10345431 9381049 964382 0 4789 0 2861191 1978212 1320226 1059780 15125 0 76841 87049 11117507 8252240 2849146 2865267 1145760 2461106 8273078 8451414 1178657 1225588 50036 44230 844067 844621 2072760 2114439 X 6200318 6336975 6200318 6336975 8273078 8451414 136657 0 X X 0 1 1 X 0 X 1842 2040 2273 10579 16734 9536774 9692435 9812564 10328120 10480232 49850125 9538616 9694475 9814837 10338699 10480232 49866859 0 0 0 49866859 50372 29755 17712 20341 28144 146324 50372 29755 17712 20341 28144 146324 9588988 9724230 9832549 10359040 10508376 50013183 0.99710 0.99650 0.00290 0.00350 X 0 1 4073466 2960894 1112572 6737252 5117142 1620110 306789 174204 132585 2865267 WC FUND BALANCE AND RESERVE FOR MEDICAL LIABILITY 844621 844621 10482088 10345431 136657 136657 10826566 26715 317763 344478 10482088 0 10482088 10663194 317763 317763 10345431 0 10345431 PART IV, LINE 2B: SUSQUE-VIEW HOME HAS CUSTODY OF SOME OF THE RESIDENTS' PERSONAL FUNDS PART X - LIABILITY UNDER FIN 48 FOOTNOTE INCOME TAXES - THE HOME IS NON-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES. FASB CLARIFIES THE ACCOUNTING OF UNCERTAINTY IN INCOMES TAXES BY PRESCRIBING THE RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. THIS WAS EFFECTIVE FOR FISCAL YEARS BEGINNING AFTER DECEMBER 15 ,2008 AND WAS ADOPTED BY THE HOME FOR THE YEAR ENDING DECEMBER 31, 2009. PART XII LINE 2D - RECONCILIATION OF CHANGES - OTHER COUNTY MEDICAL ASSISTANCE FUNDING REFUND PART XIII LINE 2D - RECONCILIATION OF CHANGES - OTHER COUNTY MEDICAL ASSISTANCE FUNDING REFUND FORM 990, PART VI, SECTION A, LINE 3 SUSQUE-VIEW HOME IS MANAGED BY PREMIER HEALTHCARE RESOURCES, INC., WHICH PROVIDES MANAGEMENT AND ADMINISTRATIVE SERVICES TO SUSQUE-VIEW HOME. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATIONS CFO REVIEWS THE FORM 990 WITH THE BOARD OF DIRECTORS AT THE MONTHLY BOARD MEETINGS PRIOR TO FILING FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS AND UPDATES THE POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 , PART XII, LINE 2C: THE ORGANIZATION HAS MAINTAINED THE SAME POLICY AS THE PRIOR YEAR.