2011-11-15T16:00:38-06:00 2010-12-31 O'CONNOR DAVIES MUNNS & DOBBINS LLP 500 MAMARONECK AVENUE HARRISON NY 10528 990 2010-01-01 237012219 ST TERESA'S NURSING HOME INC STTE 6466334700 120 HIGHLAND AVENUE MIDDLETOWN NY 10940 ANNMARIE COVONE 6466334700 2011-11-15 1 GARRETT HIGGINS 9143818900 2011-11-14 2010 2016-02-24 21:20:13Z ARCHCARE AT ST TERESA'S NURSING AND KARL P ADLER 205 LEXINGTON AVENUE - 2ND FLOOR NEW YORK NY 10016 9215268 0 X WWW.ARCHCARE.ORG X 1968 NY AN INTIMATE 98-BED SKILLED NURSING AND REHABILITATION FACILITY, ST. TERESA'S NURSING HOME SERVES THE COMMUNITY OF MIDDLETOWN IN ORANGE COUNTY, NEW YORK AND OFFERS A HIGHLY PERSONALIZED AND COMPREHENSIVE LONG-TERM ELDERCARE AND SHORT-TERM REHABILITATION.ST. TERESA'S REPUTATION IN THE MIDDLETOWN AREA IS UNSURPASSED. WE HAVE 25% OF OUR RESIDENTS RETURN HOME TO THE COMMUNITY (AFTER BEING REHABILITATED) ON A REGULAR BASIS. OUR REHABILITATION PROGRAM, WHICH IS SIX DAYS A WEEK, IS RECOGNIZED BY THE COMMUNITY AND AREA HOSPITALS ROUTINELY. ADDITIONALLY, ST. TERESA'S DOES NOT USE AGENCY NURSING STAFF, WHICH HELPS TO ENHANCE ITS HOMELIKE ATMOSPHERE. 23 23 182 52 0 0 2490 12475 8923205 9197949 2273 1429 1026 3415 8928994 9215268 0 0 0 0 5360081 5652235 0 0 0 3325915 3210895 8685996 8863130 242998 352138 3553492 4742650 5408219 6235525 -1854727 -1492875 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 7561894 9197949 CARE SERVICES AT ST. TERESA'S 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; HOSPICE; AND FAMILY AND RESIDENT COUNCILS. DURING 2010 THE ORGANIZATION PROVIDED APPROXIMATELY 34,660 DAYS OF CARE TO OVER 328 PATIENTS. 7561894 1 0 0 1 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 13 0 1 182 1 0 0 0 0 0 0 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 0 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 WILLIAM 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 1.00 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 1.00 X 0 408658 22051 DOUGLAS SANSTED 1.00 X 0 0 0 SCOTT P LA RUE 0.10 X 0 437709 22051 MICHAEL CHAIKEN 40.00 X 185396 0 1817 DEBORAH ANN GRANATA 40.00 X 103507 0 13998 288903 1642228 68852 2 0 1 0 MORRISON MANAGEMENT SPECIALIST PO BOX 102289 ATLANTA GA 30368 NUTRITIONAL MANAGEMENT 327982 1 12475 12475 MEDICAID 623000 4938247 4938247 MEDICARE 623000 2584123 2584123 PRIVATE PATIENT 623000 1545254 1545254 OTHER PATIENT REVENUE 623000 130325 130325 9197949 1429 1429 MISCELLANEOUS 900099 3415 3415 3415 9215268 9197949 0 4844 189746 189746 3742319 3648808 93511 311489 289184 22305 1044836 975554 69282 363845 337791 26054 429948 429948 290 290 30900 30900 4148 4148 306133 236392 69741 513 513 920894 833222 87672 32044 32044 302063 289834 12229 3787 2143 1644 1643 1643 183432 175483 7949 186971 186971 PURCH & CONTRACTED SERV 419401 402336 17065 NYS CASH RECEIPT ASSESS 267819 267819 BAD DEBT 98626 98626 OTHER DIRECT EXPENSES 22283 4702 17581 8863130 7561894 1301236 0 177613 318057 54600 51380 1430766 1572062 54166 50973 5264988 4393227 1020271 871761 816076 1878417 3553492 4742650 2001655 2432449 76073 55900 386524 246524 2943967 3500652 5408219 6235525 X -1854727 -1492875 -1854727 -1492875 3553492 4742650 X 352138 9714 X X 0 1 1 X 0 X 30681 25255 170039 2490 12475 240940 7066108 7491413 7935317 8923205 9197949 40613992 7096789 7516668 8105356 8925695 9210424 40854932 0 0 0 40854932 21321 6072 9933 2273 1429 41028 21321 6072 9933 2273 1429 41028 5965 21362 14542 1026 3415 46310 7124075 7544102 8129831 8928994 9215268 40942270 0.99790 0.99830 0.00100 0.00050 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME 0 0 0 0 0 0 0 0 1 4148 4148 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: ST. TERESA'S NURSING HOME, INC. PAYS DUES TO LOCAL 1199 - HEALTH EDUCATION PROJECT (LOCAL 1199). IN ACCORDANCE WITH SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY LOCAL 1199, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2010 LOCAL 1199 DUES WAS $4,148. 0 1 75000 75000 3601119 3093562 507557 1487597 1227759 259838 101272 71906 29366 871761 OTHER NON-CURRENT ASSETS 13146 DUE FROM THIRD PARTY PAYORS 1410605 ASSETS LIMITED AS TO USE - CASH 415689 ASSETS LIMITED AS TO USE - U.S. GOVERNMENT OBLIGATIONS 38977 1878417 DUE TO RELATED PARTIES 2857597 DUE TO THIRD-PARTY PAYORS 72892 OTHER NON-CURRENT LIABILITIES 19600 ACCRUED PENSION LIABILITY 550563 3500652 9215268 8863130 352138 9714 9714 361852 9215268 0 9215268 0 9215268 8863130 0 8863130 0 8863130 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 9,714. 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 MICHAEL CHAIKEN 169568 0 15828 0 0 0 0 0 1817 0 187213 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. MICHAEL CHAIKEN 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 THE ORGANIZATION 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 15A THE ORGANIZATION 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. 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 ST. TERESA'S NURSING HOME, HAVE MIRROR BOARDS: MARY MANNING WALSH NURSING HOME COMPANY, CARMEL RICHMOND NURSING HOME INC., CATHOLIC HEALTH CARE FOUNDATION OF THE ARCHDIOCESE OF NEW YORK, INC., CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE, ST. VINCENT DE PAUL RESIDENCE, KATERI 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 1 HOUR 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: PENSION LIABILITY ADJUSTMENT 9,714. TOTAL TO FORM 990, PART XI, LINE 5: 9,714. 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 INC 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 FACILITY & REHABILITATION FACILITY NY 501(C)(3) 9 N/A 0 MARY MANNING WALSH NURSING HOME COMPANY INC 1339 YORK AVENUE NEW YORK NY 100214707 136220617 OPERATE SKILLED NURSING FACILITY & REHABILITATION FACILITY NY 501(C)(3) 9 N/A 0 ST THERESA'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 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 CARMEL RICHMOND NURSING HOME INC 88 OLD TOWN ROAD STATEN ISLAND NY 103044299 132720248 OPERATE SKILLED NURSING FACILITY & 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 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 INC 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