2011-11-15T16:00:38-06:00 2010-12-31 O'CONNOR DAVIES MUNNS & DOBBINS LLP 500 MAMARONECK AVENUE HARRISON NY 105281618 990 2010-01-01 136220617 MARY MANNING WALSH NURSING HOME CO INC MARY 6466334700 1339 YORK AVENUE NEW YORK NY 100214707 ANNMARIE COVONE 6466334700 2011-11-15 1 GARRETT HIGGINS 9143818900 2011-11-14 2010 2016-03-07 17:11:31Z ARCHCARE AT MARY MANNING WALSH HOME KARL P ADLER 205 LEXINGTON AVENUE - 2ND FLOOR NEW YORK NY 10016 52622598 0 0928 X WWW.ARCHCARE.ORG X 1967 NY ARCHCARE AT MARY MANNING WALSH IS A 362-BED SKILLED NURSING AND REHABILITATION CENTER SERVING THE UPPER EAST SIDE NEIGHBORHOOD OF MANHATTAN.SKILLED NURSING IS AVAILABLE TO ALL RESIDENTS ACCORDING TO THEIR NEEDS. THERE IS A NURSING STATION NEAR THE MIDDLE OF EACH FLOOR AND A GERIATRIC ATTENDANT THAT IS ASSIGNED TO HELP RESIDENTS.THE BUILDING'S MANY PUBLIC SPACES, INCLUDING AN OUTDOOR TERRACE ON THE 7TH FLOOR, HOST ACTIVITIES TO MEET INDIVIDUAL NEEDS AND PROVIDE OPPORTUNITIES FOR SOCIALIZATION. WHILE THE CONCOURSE LEVEL COFFEE SHOP IS A FAVORITE MEETING PLACE FOR FAMILY AND FRIENDS, MANY RESIDENTS ARE MOST FOND OF THE WALSH HOME'S EMERALD LOUNGE WHERE MANY GATHER FOR COCKTAILS AND COMPANIONSHIP EACH EVENING. EVENTS CALENDARS ARE POSTED AT NURSES' STATIONS, IN ELEVATORS AND IN THE MAIN DINING ROOM. WITH THE HELP OF AN ACTIVE FAMILY CIRCLE AND A STRONG VOLUNTEER PROGRAM, THE WALSH HOME IS ABLE TO OFFER ITS RESIDENTS HIGHLY SATISFYING ACTIVITIES TO FILL THEIR DAYS. 23 23 602 773 0 0 820247 204016 47657370 47392988 -72298 44685 231695 101017 48637014 47742706 0 0 0 0 27024925 28839429 14000 15000 28310 18461594 19233248 45500519 48087677 3136495 -344971 41079867 38949440 14945383 13132890 26134484 25816550 X THE NURSING HOME IS DEVOTED TO CARING FOR THE SICK AND DISABLED WITH COMPASSION IN THE TRADITION OF CATHOLIC HEALTH CARE. IT SEEKS TO DELIVER HIGH QUALITY CARE, TO TREAT ALL PATIENTS WITH DIGNITY, AND TO PROVIDE A CARING ENVIRONMENT FOR PATIENTS AT THE NURSING HOME. AS A PARTICIPATING MEMBER OF THE CATHOLIC HEALTH CARE SYSTEM, THE NURSING HOME IS ALSO COMMITTED TO FURTHERING THE SYSTEM'S ABILITY TO PROMOTE HIGH QUALITY CARE, TO ENHANCE ITS SERVICES, AND TO OPERATE EFFECTIVELY AS A HEALTH CARE SYSTEM. 0 0 42602547 47392988 CARE SERVICES AT MARY MANNING WALSH INCLUDE: 24-HOUR SKILLED NURSING SERVICES; SHORT-TERM REHABILITATION SERVICES INCLUDING SPEECH, PHYSICAL AND OCCUPATIONAL THERAPY; CLINICAL AND PHYSICIAN SERVICES INCLUDING CONSULTING PHYSICIANS FOR DENTAL, OPHTHALMOLOGY, AND PODIATRY; LABORATORY SERVICES; RELIGIOUS SERVICES; RECREATION THERAPY; RADIOLOGY SERVICES; NUTRITION SERVICES; IV THERAPY; PAIN MANAGEMENT, AND FAMILY AND RESIDENT COUNCILS. DURING 2010, 130,451 DAYS OF CARE WERE PROVIDED BY THE NURSING HOME TO OVER 1,289 PATIENTS. 42602547 1 1 0 1 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 29 0 1 602 1 0 0 0 0 0 1 1 0 0 0 0 X 23 23 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X ANNMARIE COVONE 6466334702 205 LEXINGTON AVE - 2ND FLOOR NEW YORK NY 10016 X KARL P ADLER 1.00 X X 0 0 0 MANFRED ALTSTADT 1.00 X 0 0 0 MSGR WILIAM BELFORD 1.00 X 0 0 0 WALTER M CADETTE 1.00 X 0 0 0 JOHN T DUNLAP 1.00 X 0 0 0 MSGR CHARLES J FAHEY 1.00 X 0 0 0 THOMAS J FAHEY JR MD 1.00 X 0 0 0 BERNARD P GAWLEY 1.00 X 0 0 0 RORY KELLEHER 1.00 X 0 0 0 JOHN MARINELLI 1.00 X 0 0 0 THOMAS M O'BRIEN 1.00 X X 0 0 0 SISTER PATRICIA RAWDON 1.00 X 0 0 0 FRANCIS J SERBAROLI ESQ 1.00 X 0 0 0 JOAN M SQUIRES 1.00 X 0 0 0 DOMINICK M STANZIONE 1.00 X 0 0 0 BISHOP DENNIS SULLIVAN 1.00 X 0 0 0 GT SWEENEY 1.00 X 0 0 0 SISTER ANTHONY VEILLEUX 1.00 X 0 0 0 ROGER G WEAVING 1.00 X 0 0 0 JAMES E INTRONE 0.10 X X 0 795861 8935 JOSEPH P ANDERSON 1.00 X 0 0 0 ERIC P FELDMANN 1.00 X 0 0 0 MSGR GREGORY MUSTACIUOLO 1.00 X 0 0 0 KATHRYN ROONEY 1.00 X 0 0 0 ANNMARIE COVONE 0.10 X 0 408658 22051 DOUGLAS SANSTED 1.00 X 0 0 0 SCOTT P LA RUE 0.10 X 0 437709 22051 RICHARD P BISCOTTI 35.00 X 203107 0 31270 WILLIAM GRIFFO 35.00 X 159935 0 12836 LUCAS DEDRICK 35.00 X 136236 0 17134 HELEN YEE 35.00 X 122410 0 30523 ALFONSO S RAMSAY 35.00 X 106700 0 23371 FRANCES BRENNAN 35.00 X 100913 0 23654 829301 1642228 191825 6 0 1 0 CATHOLIC HEALTH CARE SYSTEM 205 LEXINGTON AVENUE 2ND FLR NEW YORK NY 10016 ADMINISTRATIVE AND CONSULTING SERVICES 2176702 MORRISON SENIOR DINING PO BOX 102289 ATLANTA GA 30368 NUTRITIONAL MANAGEMENT 1927535 CARMELITE SISTERS FOR THE AGED & INFIRM 1339 YORK AVENUE NEW YORK NY 10022 ADMINISTRATIVE & DIRECT CARE SERVICES 573063 RCM TECHNOLOGIES PO BOX 7777 W0570 PHILADELPHIA PA 19175 STAFFING AGENCY 541929 SECURITAS SECURITY SERVICES PO BOX 403412 ATLANTA GA 30384 SECURITY AGENCY 287130 15 143102 60914 204016 MEDICAID 623000 19403269 19403269 PRIVATE PATIENT REVENU 623000 14743916 14743916 MEDICARE 623000 12397177 12397177 OTHER PATIENT REVENUE 623000 848626 848626 47392988 41803 41803 170556 185300 -14744 -14744 -14744 4655137 4652255 2882 2882 2882 55240 143102 42337 12903 12903 COFFEE SHOP 900099 68678 68678 VENDING MACHINES 900099 12100 12100 GIFT SHOP 900099 7337 7337 14743 14743 102858 47742706 47392988 0 145702 225356 225356 19937696 19523318 414378 1368826 1336159 32667 5599499 5454249 145250 1708052 1655798 52254 2392142 2392142 212733 212733 57204 57204 1606 1606 15000 15000 2256261 1909577 346494 190 15014 1894 13120 3777892 3555662 222230 122229 122229 3010726 2905013 105713 4155 1803 2352 10154 10154 2098045 1953139 144906 796321 796321 NYS CASH RECEIPT ASSESS 1935384 1935384 PURCH. & CONTRACTED SER 1925829 1859242 66587 BAD DEBT 497114 497114 OTHER DIRECT EXPENSE 120439 16089 104350 48087677 42602547 5456820 28310 3886378 3572553 3597510 2257382 8458563 9082316 17710 28507 271486 222162 49172349 37846661 12441017 11325688 12407203 12460832 41079867 38949440 4376151 3951433 9360000 7835000 370419 417819 838813 928638 14945383 13132890 X 26134484 25816550 26134484 25816550 41079867 38949440 X -344971 27037 X X 0 1 1 X 0 X 341753 182469 528591 820247 204016 2077076 39672123 42269863 45504974 47691570 47448228 222586758 40013876 42452332 46033565 48511817 47652244 224663834 4425 4425 0 4425 4425 224659409 333469 274462 409011 257551 212359 1486852 333469 274462 409011 257551 212359 1486852 297953 331225 315820 65264 102858 1113120 40645298 43058019 46758396 48834632 47967461 227263806 0.98850 0.98650 0.00650 0.00760 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME COFFEE SHOP GIFT SHOP VENDING MACHINE REBATES CAFETERIA MEDICAL RECORDS PAST DUE ACCOUNTS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1606 1606 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: MARY MANNING WALSH NURSING HOME CO., INC. 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 2010 CCLC DUES WAS $1,606. 0 1 1500000 1500000 38532448 30390521 8141927 8674827 7456140 1218687 465074 465074 11325688 DUE FROM RELATED PARTIES 359817 INTEREST RECEIVABLE 100335 DEFERRED FINANCING COST, NET 18201 OTHER ASSETS 32872 OTHER RECEIVABLE 5403 DUE FROM THIRD PARTY PAYORS 1142112 ASSETS LIMITED AS TO USE - CASH 8443828 ASSETS LIMITED AS TO USE - MUTUAL FUNDS 677897 ASSETS LIMITED AS TO USE - U.S. GOVERNMENT OBLIGATIONS 1680367 12460832 ASSET RETIREMENT OBLIGATION 72400 ACCRUED PENSION LIABILITY 670324 DUE TO RELATED PARTIES 185914 928638 47742706 48087677 -344971 6312 20725 27037 -317934 47943024 6312 207316 213628 47729396 13310 13310 47742706 48281683 207316 207316 48074367 13310 13310 48087677 PART IV, LINE 2B: RESIDENTS' FUNDS ARE HELD BY THE HOME ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE HOME FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE HOME AT THE REQUEST OF, OR ON BEHALF OF, RESIDENTS FOR THEIR PERSONAL USE. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOME RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE HOME HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE HOME IS NO LONGER SUBJECT TO AUDITS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2007. PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION LIABILITY ADJUSTMENT 20,725. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT SPECIAL EVENT COST RECLASS 22,016. RENTAL EXPENSES ALLOCATED TO REVENUE 185,300. PART XII, LINE 4B - OTHER ADJUSTMENTS: INDIRECT SPECIAL EVENT COSTS 13,310. PART XIII, LINE 2D - OTHER ADJUSTMENTS: DIRECT SPECIAL EVENT COST RECLASS 22,016. RENTAL EXPENSES ALLOCATED TO REVENUE 185,300. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INDIRECT SPECIAL EVENT COSTS 13,310. COCKTAIL RECEPTION 198342 143102 55240 147 37601 2300 2289 198342 143102 55240 147 37601 2300 2289 42337 12903 X X X X X 1 0 0 0 0 0 0 1 0 JAMES E INTRONE 0 639647 0 30000 0 126214 0 0 0 8935 0 804796 0 0 ANNMARIE COVONE 0 388646 0 11682 0 8330 0 0 0 22051 0 430709 0 0 SCOTT P LA RUE 0 416960 0 12419 0 8330 0 0 0 22051 0 459760 0 0 RICHARD P BISCOTTI 185767 0 17340 0 0 0 9500 0 21770 0 234377 0 0 0 WILLIAM GRIFFO 159935 0 0 0 0 0 9500 0 3336 0 172771 0 0 0 LUCAS DEDRICK 136236 0 0 0 0 0 9500 0 7634 0 153370 0 0 0 HELEN YEE 122410 0 0 0 0 0 9500 0 21023 0 152933 0 0 0 PART I, LINE 4A JAMES INTRONE RECEIVED A SEVERANCE PAYMENT OF $13,893 PAID BY CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE. PART I, LINE 7 THE 2009 BONUSES WERE PAID IN 2010 AND WERE BASED ON A A BOARD APPROVED INCENTIVE PROGRAM. THE INCENTIVE PROGRAM WAS BASED ON MEETING COMPANY FINANCIAL GOALS RELATING TO THE 2009 BUDGET. THE DETERMINED AMOUNT WAS BASED ON THE INDIVIDUALS SALARY. RICHARD BISCOTTI RECEIVED A BONUS PAYMENT IN 2010. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS A MANAGEMENT AGREEMENT FOR CERTAIN ADMINISTRATIVE AND CONSULTING SERVICES WITH CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE "MEMBER" IS CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE "MEMBER" HAS THE RIGHT TO APPOINT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES, APPOINT THE CHAIRMAN OF THE BOARD, AMEND THE BY-LAWS AND CERTIFICATE OF INCORPORATION AND APPROVE SUBSTANTIAL TRANSACTIONS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE "MEMBER" HAS THE RIGHT TO AMEND THE BY-LAWS AND CERTIFICATE OF INCORPORATION AND APPROVE SUBSTANTIAL TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 11 MARY MANNING WALSH NURSING HOME COMPANY INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE BOARD MEMBERS OF THE ORGANIZATION FOR ANY COMMENTS. ANY COMMENTS ARE THEN GROUPED, SUMMARIZED AND PROVIDED TO THE OUTSIDE ACCOUNTANTS. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY ON CONFLICTS OF INTEREST IS DESIGNED TO PROVIDE GUIDANCE TO ALL MEMBERS OF THE BOARD, THE OFFICERS OF THE ORGANIZATION, AND TO ALL PERSONS EMPLOYED BY THE ORGANIZATION. A BOARD MEMBER OR OFFICER SHALL DISCLOSE ANY CONFLICT OF INTEREST OF WHICH HE OR SHE HAS KNOWLEDGE: (A) PRIOR TO VOTING ON OR OTHERWISE DISCHARGING HIS OR HER DUTIES WITH RESPECT TO ANY MATTER INVOLVING THE CONFLICT WHICH COMES BEFORE THE BOARD OR ANY COMMITTEE OF THE BOARD; (B) PRIOR TO ENTERING INTO ANY CONTRACT OR TRANSACTION INVOLVING THE ORGANIZATION; (C) AS SOON AS POSSIBLE AFTER THE BOARD MEMBER OR OFFICER SHALL LEARN OF A CONFLICT OF INTEREST IN ANY OTHER CONTEXT. DISCLOSURE OF THE MATERIAL FACTS SURROUNDING THE BOARD MEMBER OR OFFICER'S CONFLICT OF INTEREST SHALL BE MADE TO THE SECRETARY OF THE BOARD OF MANAGERS OR, IN THE CASE OF A COMMITTEE, TO THE CHAIRPERSON OF THAT COMMITTEE (WHO SHALL NOTIFY THE SECRETARY). THE SECRETARY OR COMMITTEE CHAIRPERSON SHALL INFORM THE OTHER MEMBERS OF THE BOARD OR COMMITTEES PRIOR TO ANY ACTION THEREON. FAILURE TO DISCLOSE ADEQUATELY A POTENTIAL OR ACTUAL CONFLICT OF INTEREST SHALL CONSTITUTE CAUSE FOR REMOVAL FROM THE BOARD. FOLLOWING RECEIPT OF INFORMATION CONCERNING A CONTRACT OR TRANSACTION INVOLVING A POTENTIAL CONFLICT OF INTEREST, THE BOARD SHALL CONSIDER THE MATERIAL FACTS CONCERNING THE PROPOSED CONTRACT OR TRANSACTION, INCLUDING THE PROCESS BY WHICH THE DECISION WAS MADE TO RECOMMEND ENTERING INTO THE ARRANGEMENT ON THE TERMS PROPOSED. (A) AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. AN INTERESTED BOARD MEMBER MAY NOT BE COUNTED IN DETERMINING THE PRESENCE OF A QUORUM AT A MEETING OF THE BOARD OR COMMITTEE AT WHICH DISCUSSION OR A VOTE ON THE TRANSACTION OR ARRANGEMENT TAKES PLACE. (B) AN INTERESTED BOARD MEMBER OR OFFICER SHALL NOT USE PERSONAL INFLUENCE WITH REGARD TO THE BOARDS DETERMINATION THAT A CONFLICT EXISTS OR THE BOARD'S VOTE ON THE MATTER. (C) IF APPROPRIATE, THE CHAIRPERSON SHALL APPOINT A DISINTERESTED PERSON OR A COMMITTEE OF THE BOARD TO CONDUCT AN ASSESSMENT OF FAIR MARKET VALUE FOR A PARTICULAR TRANSACTION, OR TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. (D) THE BOARD SHALL APPROVE ONLY THOSE CONTRACTS OR TRANSACTIONS IN WHICH THE TERMS ARE FAIR AND REASONABLE TO THE ORGANIZATION AND THE ARRANGEMENTS ARE CONSISTENT WITH THE BEST INTERESTS OF THE ORGANIZATION. THE MINUTES OF THE BOARD AND OF ALL COMMITTEES WITH BOARD DELEGATED POWERS SHALL CONTAIN THE FOLLOWING WITH REGARD TO CONSIDERATION OF ANY MATTER INVOLVING A CONFLICT OF INTEREST: (A) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL OR OTHER INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE CONFLICT OF INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; (B) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, A SUMMARY OF THE CONTENT OF THE DISCUSSION, INCLUDING CONSIDERATION OF ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT AND THE NATURE OF AND SOURCE OF ANY DATA RELIED UPON IN MAKING AN ASSESSMENT OF FAIR MARKET VALUE, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; AND (C) IN ANY CASE WHEN THE BOARD APPROVES AN ARRANGEMENT OR TRANSACTION INVOLVING A CONFLICT OF INTEREST, THE MINUTES OF THE MEETING SHALL SET FORTH THE BASIS FOR THE BOARD'S DECISION. AN EMPLOYEE OF THE ORGANIZATION WITH A POTENTIAL CONFLICT OF INTEREST IN A PARTICULAR MATTER SHALL PROMPTLY AND FULLY DISCLOSE THE POTENTIAL CONFLICT TO HIS OR HER SUPERVISOR. THE EMPLOYEE SHALL THEREAFTER REFRAIN FROM PARTICIPATING IN ANY DECISIONS RELATING TO THE MATTER AND FOLLOW THE DIRECTION OF THE SUPERVISOR AS TO HOW THE ORGANIZATION'S DECISIONS WHICH ARE THE SUBJECT OF THE CONFLICT WILL BE DETERMINED. THE EXECUTIVE DIRECTOR OF THE ORGANIZATION SHALL BE RESPONSIBLE FOR DETERMINING THE PROPER WAY FOR THE ORGANIZATION TO HANDLE THE ORGANIZATION'S DECISIONS WHICH INVOLVE UNRESOLVED EMPLOYEE CONFLICTS OF INTEREST. IN MAKING SUCH DETERMINATIONS, THE EXECUTIVE DIRECTOR OF THE ORGANIZATION MAY CONSULT WITH LEGAL COUNSEL, AS APPROPRIATE. THE EXECUTIVE DIRECTOR OF THE ORGANIZATION SHALL REPORT TO THE BOARD AT LEAST ANNUALLY CONCERNING EMPLOYEE CONFLICTS OF INTEREST WHICH HAVE BEEN DISCLOSED AND CONTRACTS AND TRANSACTIONS INVOLVING EMPLOYEE CONFLICTS WHICH THE SECRETARY OF THE ORGANIZATION'S BOARD OF MANAGERS HAS APPROVED. EACH BOARD MEMBER, OFFICER, MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, AND EMPLOYEE OF THE ORGANIZATION SHALL SIGN A STATEMENT WITHIN 30 DAYS OF ASSUMING SUCH RESPONSIBILITY, AND ANNUALLY THEREAFTER, AFFIRMING THAT SUCH PERSON: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY; AND (D) UNDERSTANDS THAT THE ORGANIZATION CANNOT ENGAGE IN A TRANSACTION OR ENTER INTO A COMPENSATION ARRANGEMENT WITH BOARD MEMBERS, OFFICERS, SENIOR STAFF MEMBERS, OR OTHERS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION THAT PROVIDES AN ECONOMIC BENEFIT TO SUCH PERSON IN EXCESS OF THE CONSIDERATION OR SERVICES THAT THE ORGANIZATION RECEIVES IN RETURN. FORM 990, PART VI, SECTION B, LINE 15 THE CORPORATION UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT ITS EXECUTIVE COMPENSATION IS REASONABLE. TOWARD THAT END, THE BOARD OF TRUSTEES HAS A COMPENSATION COMMITTEE OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN ANY PROPOSED COMPENSATION ARRANGEMENT. IN 2008, THE BOARD ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT WHO CONDUCTED INDEPENDENT RESEARCH AND UTILIZED A WIDE RANGE OF INDUSTRY DATA TO DEVELOP COMPARABILITY OR BENCHMARKING DATA FOR APPROPRIATE LEVELS OF COMPENSATION FOR TOP MANAGEMENT, OFFICERS, AND KEY EMPLOYEES. THE CONSULTANT PROJECTED THE DATA FOR THE FOLLOWING THREE YEARS FOR EACH SALARY LEVEL. THE COMPENSATION COMMITTEE, TAKING THE CONSULTANT'S RECOMMENDATIONS UNDER ADVISEMENT, HELD A MEETING AT WHICH CONTEMPORANEOUS MINUTES WERE KEPT AND AT THAT MEETING DETERMINED TO MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES THEN CONSIDERED AND APPROVED THE RECOMMENDATIONS OF THE COMPENSATION COMMITTEE, WHICH APPROVAL WAS RECORDED IN THE MINUTES OF THE MEETING OF THE BOARD OF TRUSTEES. COMPENSATION PAID TO THE ADMINISTRATOR: PLEASE NOTE THAT THE ADMINISTRATOR AS A RELIGIOUS MEMBER OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM, INC. (THE ORDER) HAS TAKEN A VOW OF POVERTY AND IS PROVIDED WITH ZERO (0) COMPENSATION FROM THE HOME. ALL COMPENSATION THAT WOULD HAVE BEEN PAID TO THE ADMINISTRATOR ON BEHALF OF SERVICES PROVIDED TO THE HOME IS INSTEAD PAID TO THE CARMELITE SISTERS OF THE AGED AND INFIRM, INC. RATHER THAN THE INDIVIDUAL. FOR 2010, THE HOME PAID THE ORDER AN AMOUNT OF $207,021 FOR THE SERVICES THE ADMINISTRATOR (SISTER SEAN WILLIAM O'BRIEN) PROVIDED TO THE HOME. TOTAL PAYMENTS IN 2010 TO THE ORDER FROM THE HOME FOR SERVICES PROVIDED BY ALL THE SISTERS WORKING WITHIN THE HOME AMOUNTED TO $650,531. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. THE ORGANIZATION 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 VII, SECTION A THE FOLLOWING ORGANIZATIONS, INCLUDING MARY MANNING WALSH NURSING HOME COMPANY, HAVE MIRROR BOARDS: CATHOLIC HEALTH CARE FOUNDATION OF THE ARCHDIOCESE OF NEW YORK, INC., ST. TERESA'S NURSING HOME, KATERI RESIDENCE, CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE, CARMEL RICHMOND NURSING HOME INC., ST. VINCENT DE PAUL RESIDENCE, FERNCLIFF NURSING HOME COMPANY, INC., AND TERENCE CARDINAL COOKE HEALTH CARE CENTER. AT THE BOARD MEETINGS, ALL OF THE ENTITIES ARE DISCUSSED. ON AVERAGE, THE BOARD MEMBERS SPEND ONE HOUR WORKING ON THESE ORGANIZATIONS. ANNMARIE COVONE, SENIOR VP/CFO, SCOTT P. LA RUE, COO AND JAMES E. INTRONE, THE PRESIDENT AND CEO, EACH SPEND ON AVERAGE .10 HOURS PER WEEK, WORKING ON THE FILING ORGANIZATION AS WELL AS THE RELATED ENTITIES. THEY SPENT 35 HOURS PER WEEK WORKING FOR CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE. THE FOLLOWING BOARD MEMBERS AND OFFICERS OF THE FILING ORGANIZATION ALSO SPENT ON AVERAGE .10 HOURS PER WEEK WORKING ON CATHOLIC MANAGED LONG TERM CARE, INC: KARL P. ADLER MD, FRANCIS J. SERBAROLI ESQ., G.T. SWEENEY, JAMES E. INTRONE, AND ANNMARIE COVONE. MANFRED ALTSTADT AND DR. THOMAS FAHEY JR. ARE BOARD MEMBERS OF CALVARY HOSPITAL, AND WORK ON AVERAGE, 2 HOURS A WEEK AT CALVARY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 6,312. PENSION LIABILITY ADJUSTMENT 20,725. TOTAL TO FORM 990, PART XI, LINE 5: 27,037. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE 205 LEXINGTON AVE - 2ND FL NEW YORK NY 10016 133896624 MGT SVCS FOR HEALTH-RELATED FACILITIES IN THE ARCHDIOCESE NY 501(C)(3) 9 N/A 0 CATHOLIC HEALTH CARE FOUNDATION OF THE ARCHDIOCESE OF NY 205 LEXINGTON AVE - 2ND FL NEW YORK NY 10016 134054158 PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIES NY 501(C)(3) 7 N/A 0 FERNCLIFF NURSING HOME COMPANY INC 21 FERNCLIFF DRIVE RHINEBECK NY 12572 141514053 OPERATE SKILLED NURSING FACILITY & ADULT HEALTH CARE PROGRAM NY 501(C)(3) 9 N/A 0 KATERI RESIDENCE 150 RIVERSIDE DRIVE NEW YORK NY 10024 133086309 OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) 9 N/A 0 ST TERESA'S NURSING HOME INC 120 HIGHLAND AVENUE MIDDLETOWN NY 10940 237012219 OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) 9 N/A 0 ST TERESA'S RESIDENCE 30 SOUTH 10TH AVENUE MT VERNON NY 10550 133110063 INTERMEDIATE CARE FACILITY FOR DEVELOPMENTALLY DISABLED NY 501(C)(3) 9 N/A 0 CARMEL RICHMOND NURSING HOME INC 88 OLD TOWN ROAD STATEN ISLAND NY 103044299 132720248 OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) 9 N/A 0 TERENCE CARDINAL COOKE HEALTH CARE CENTER 1249 FIFTH AVENUE NEW YORK NY 10029 133007801 OPERATE SKILLED NURSING FACILITY & OTHER OP & IP SERVICES NY 501(C)(3) 9 N/A 0 ST VINCENT DE PAUL RESIDENCE 900 INTERVALE AVENUE BRONX NY 10459 133598842 OPERATE SKILLED NURSING FACILITY & ADULT HEALTH CARE PROGRAM NY 501(C)(3) 9 N/A 0 CATHOLIC MANAGED LONG TERM CARE INC 205 LEXINGTON AVE - 2ND FL NEW YORK NY 10016 208180809 OPERATE A MANAGED LONG TERM CARE PLAN NY 501(C)(3) 9 N/A 0 CALVARY HOSPITAL 1740 EASTCHESTER ROAD BRONX NY 10461 131740274 OPERATE A TAX EXEMPT HOSPITAL NY 501(C)(3) 3 N/A 0 OUR LADY OF MERCY HEALTHCARE SYSTEM INC 205 LEXINGTON AVE - 2ND FL NEW YORK NY 10016 133395946 PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIES NY 501(C)(3) 11 N/A 0 OUR LADY OF MERCY FUND OF NEW YORK NY 205 LEXINGTON AVE - 2ND FL NEW YORK NY 10016 133452084 PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIES NY 501(C)(3) 7 N/A 0 OLM DEVELOPMENT CORPORATION 205 LEXINGTON AVENUE-2ND FLOOR NEW YORK NY 10016 133272992 DEVELOP HOUSING NY N/A C 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0