2023-11-15T12:15:58-06:00 2022-12-31 873231666 PKF O'CONNOR DAVIES ADVISORY LLC 500 MAMARONECK AVENUE SUITE 301 HARRISON NY 105281633 990 2022-01-01 264827558 QUEENS-LONG ISLAND RENAL INSTITUTE QUEE 7182892600 271-11 76TH AVENUE NEW HYDE PARK NY 11040 ROBERT WERNER CFO/EVP FOR OPERATIONS 7182892600 2023-11-15 1 ROBERT WERNER XXX-XX-XXXX 1 EVA MRUK P00543254 9143818900 2023-11-13 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z MICHAEL ROSENBLUT 271-11 76TH AVENUE NEW HYDE PARK NY 11040 4895470 0 X WWW.QLIRI.ORG X 2009 NY TO ASSURE DIALYSIS PATIENTS OF THE FINEST QUALITY OF CARE, STATE-OF-THE-ART TECHNOLOGY AND UNCOMPROMISED DIGNITY, IN A COMFORTABLE SETTING. 9 9 80 9 0 0 285902 0 4524786 4876577 2223 1906 167186 16987 4980097 4895470 0 0 0 0 2350569 2342466 0 0 0 2930415 2950218 5280984 5292684 -300887 -397214 4125753 3365776 1002824 648354 3122929 2717422 X TO ASSURE DIALYSIS PATIENTS OF THE FINEST QUALITY OF CARE, STATE-OF-THE-ART TECHNOLOGY AND UNCOMPROMISED DIGNITY, IN A COMFORTABLE SETTING. 1 0 4040987 0 4876577 QUEENS-LONG ISLAND RENAL INSTITUTE, INC. IS A CHARITABLE ORGANIZATION THAT RENDERS RENAL REPLACEMENT THERAPY SERVICES TO THOSE IN NEED. THE FACILITY IS LOCATED IN NEW HYDE PARK, NEW YORK AND PROVIDES IN-CENTER HEMODIALYSIS TO PATIENTS SUFFERING FROM END STAGE RENAL DISEASE (ESRD). TREATMENTS ARE PROVIDED TO PATIENTS IN FOUR DIFFERENT PATIENTS' SHIFTS, SIX DAYS PER WEEK. HEMODIALYSIS SERVICES ARE PROVIDED TO PATIENTS BY LICENSED AND TRAINED PROFESSIONALS IN ACCORDANCE WITH ALL STATE AND FEDERAL REGULATIONS. THE ORGANIZATION WILL BILL MEDICARE, MEDICAID AND OTHER THIRD PARTY PAYERS FOR SERVICES RENDERED TO PATIENTS. IN 2022 QUEENS-LONG ISLAND RENAL INSTITUTE SERVED 315 PATIENTS THROUGHOUT THE YEAR. IN 2022 QUEENS-LONG ISLAND RENAL INSTITUTE ALSO STARTED ITS HOME HEMODIALYSIS SERVICES. THE HOME HEMODIALYSIS PROGRAM SERVED 3 PATIENTS. 4040987 1 0 0 0 0 0 0 0 0 0 1 1 0 0 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 1 13 0 80 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X X ROBERT WERNER 7183432100 271-11 76TH AVENUE NEW HYDE PARK NY 11040 ROBERT STERLING CHAIRMAN 1.00 3.10 X X 0 0 0 MICHAEL L DENHOFF VICE CHAIR 1.00 3.10 X X 0 0 0 GARY GRANOFF VICE CHAIR 1.00 3.10 X X 0 0 0 JERRY LANDSBERG VICE CHAIR 1.00 3.10 X X 0 0 0 NINA KOPPELMAN TREASURER 1.00 3.10 X X 0 0 0 PHILIP KAPLAN ASSISTANT TREASURER 1.00 3.10 X X 0 0 0 SHERYL SILVERSTEIN DMD SECRETARY 1.00 3.10 X X 0 0 0 LEE CHARLES TRUSTEE 1.00 3.10 X 0 0 0 LEONARD TANZER TRUSTEE 1.00 3.10 X 0 0 0 MICHAEL ROSENBLUT PRESIDENT/CEO 5.50 49.50 X 0 1951820 118377 ROBERT WERNER CFO/EVP FOR OPERATIONS 2.50 46.50 X 0 850948 92097 GERALDINE RAMOS DIRECTOR OF PATIENT CARE SERVICES 37.50 0.00 X 122586 0 47579 ROBERTO ALINDOGAN HEMODIALYSIS RN 37.50 0.00 X 105130 0 14039 TAHIRA KHAN RN - HOME HEMO COORDINATOR 37.50 0.00 X 100786 0 9589 328502 2802768 281681 3 0 1 0 PARKER JEWISH INSTITUTE FOR HEALTH CARE 271-11 76TH AVENUE NEW HYDE PARK NY 11040 ADMINISTRATIVE SERVICES 375000 RENALLIANCE BILLING GROUP 2711 CONEY ISLAND AVE BROOKLYN NY 11235 BILLING AND CONSULTING SERVICES 133003 ASCEND CLINICAL LLC 435 OAKMEAD PKWY SUNNYVALE CA 94085 MEDICAL LAB TESTING SERVICES 104188 3 MEDICARE 623000 2758557 2758557 OTHER PATIENT SERVICE 623000 2019242 2019242 MEDICAID 623000 98778 98778 4876577 1894 1894 12 0 12 12 12 PURCHASE DISCOUNTS 900099 16546 16546 RECOVERY OF BAD DEBT 900099 347 347 MEDICAL RECORDS 900099 94 94 16987 4895470 4876577 0 18893 X 1994351 1732152 262199 14184 11126 3058 155273 121796 33477 178658 140139 38519 356 356 41500 41500 821407 309814 511593 195320 195320 33436 6041 27395 38224 38224 162711 162711 1785 630 1155 204105 204105 84897 84897 PHARMACEUTICALS 734532 734532 MEDICAL SUPPLIES 438077 438077 WATER TREATMENT 61747 61747 BAD DEBT EXPENSE 52228 52228 79893 79893 5292684 4040987 1251697 0 673204 189129 1268011 1043543 541494 571420 115279 148694 72795 56410 3712199 2888002 917574 824197 37368 32355 500028 500028 4125753 3365776 474620 514114 384999 0 143205 134240 1002824 648354 X 3122929 2717422 3122929 2717422 4125753 3365776 X -397214 -5890 -2403 X X 0 1 X 1 0 X 2418982 1934494 484488 1293217 953508 339709 824197 INVESTMENT IN PRINE HEALTH HOLDINGS LLC 500028 F 500028 DUE TO THIRD-PARTY PAYORS 134240 134240 X 4834949 -5890 -5890 4840839 54631 54631 4895470 5240456 0 5240456 52228 52228 5292684 PART X, LINE 2: QLIRI RECOGNIZES THE EFFECT OF TAX POSITIONS WHEN THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT QLIRI HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. QLIRI IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2019. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE REPORTED ON PART IX 52,228. LOSS ON DISPOSAL OF ASSETS REPORTED ON PART XI 2,403. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE REPORTED ON PART IX 52,228. 0 1 0 0 0 0 0 1 0 MICHAEL ROSENBLUT PRESIDENT/CEO 0 1887477 0 0 0 64343 0 54867 0 63510 0 2070197 0 48418 ROBERT WERNER CFO/EVP FOR OPERATIONS 0 820625 0 0 0 30323 0 28060 0 64037 0 943045 0 21461 GERALDINE RAMOS DIRECTOR OF PATIENT CARE SERVICES 121120 0 1000 0 466 0 6236 0 41343 0 170165 0 0 0 PART I, LINE 3 THE CEO'S COMPENSATION IS DETERMINED AND PAID BY A RELATED PARTY, PARKER JEWISH INSTITUTE FOR HEALTH CARE AND REHABILITATION, USING THE FOLLOWING PROCESS: A WRITTEN EMPLOYMENT CONTRACT IS CURRENTLY IN PLACE FOR THE PRESIDENT/CEO. THE CONTRACT WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. EXTERNAL INFORMATION AND SURVEYS WERE USED FOR COMPARATIVE PURPOSES IN DETERMINING THE COMPENSATION AMOUNTS IN THE CONTRACT. PERFORMANCE IS REVIEWED ANNUALLY BY THE CHAIRMAN OF THE BOARD OF TRUSTEES. RECOMMENDATIONS ARE MADE TO THE COMPENSATION COMMITTEE OF THE EXECUTIVE COMMITTEE OF THE BOARD WHO APPROVE THE SALARIES OF THE KEY EMPLOYEES AND OTHER OFFICERS. RECOMMENDATIONS ARE BASED ON A REVIEW OF FORM 990'S OF SIMILAR-SIZED ORGANIZATIONS. THE BOARD'S APPROVAL OF THE SALARIES ARE DOCUMENTED IN THE MINUTES TO THE MEETING. PART I, LINE 4B CONTRIBUTIONS MADE BY PARKER JEWISH INSTITUTE FOR HEALTH CARE AND REHABILITATION TO A SUPPLEMENTARY NON-QUALIFIED RETIREMENT PLAN DURING 2022 ARE AS FOLLOWS: MICHAEL N. ROSENBLUT $48,767 ROBERT M. WERNER $21,960 DISTRIBUTIONS WERE MADE FROM A SUPPLEMENTARY NON-QUALIFIED RETIREMENT PLAN DURING 2022 TO THE FOLLOWING: MICHAEL N. ROSENBLUT $61,888 ROBERT M. WERNER $25,595 PART I, LINE 7 INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A DISCRETIONARY BONUS DURING CALENDAR YEAR 2022, WHICH WAS INCLUDED IN COLUMN B(II) HEREIN AND IN THEIR 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. FORM 990, PART III, LINE 2 IN 2022 QUEENS-LONG ISLAND RENAL INSTITUTE ALSO STARTED ITS HOME HEMODIALYSIS SERVICES. QUEENS-LONG ISLAND RENAL INSTITUTE'S (QLIRI), HOME HEMODIALYSIS PROGRAM ALLOWS PATIENTS TO TRANSITION FROM AN IN-CENTER SETTING TO RECEIVING HEMODIALYSIS FROM THE COMFORT OF THEIR HOME, USING THE TABLO HEMODIALYSIS SYSTEM. PATIENTS WHO ENROLL IN THE PROGRAM ARE FIRST TRAINED AT QLIRI BY A REGISTERED NURSE, WHO PROVIDES STEP-BY-STEP OVER THE COURSE OF FOUR WEEKS. DURING THE TRAINING, PATIENTS LEARN HOW TO USE THE SYSTEM BEFORE THEY TRANSITION TO HOME HEMODIALYSIS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS GERIATRIC RESOURCES OF NEW YORK, INC. FORM 990, PART VI, SECTION A, LINE 7A AT EACH ANNUAL MEETING OF GERIATRIC RESOURCES OF NEW YORK, INC., THE SOLE CORPORATE MEMBER OF THE CORPORATION, TRUSTEES OF THE CORPORATION, OTHER THAN THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, SHALL BE ELECTED TO VACANT POSITIONS ON THE BOARD OF TRUSTEES, EACH FOR A TERM OF ONE (1) YEAR, TO HOLD OFFICE UNTIL THEIR SUCCESSORS HAVE BEEN ELECTED AND DULY QUALIFIED. THERE SHALL BE NO LIMITATION AS TO THE NUMBER OF TERMS TRUSTEES MAY SERVE AND TRUSTEES SHALL BE PERMITTED TO SERVE SUCCESSIVE TERMS. NEWLY CREATED TRUSTEESHIPS RESULTING FROM AN INCREASE IN THE NUMBER OF TRUSTEES, AND VACANCIES OCCURRING IN THE BOARD OF TRUSTEES FOR ANY REASON, SHALL BE FILLED BY VOTE OF THE BOARD OF TRUSTEES OF GERIATRIC RESOURCES OF NEW YORK, INC., THE SOLE MEMBER OF THE CORPORATION. TRUSTEES ELECTED TO FILL NEWLY CREATED TRUSTEESHIPS SHALL HOLD OFFICE IN ACCORDANCE WITH THEIR CLASSIFICATION (IF TRUSTEES ARE CLASSIFIED) AND UNTIL THEIR SUCCESSORS HAVE BEEN ELECTED AND HAVE QUALIFIED. TRUSTEES ELECTED TO FILL VACANCIES SHALL SERVE UNTIL THE END OF THE VACATED TERM AND UNTIL THEIR SUCCESSORS ARE ELECTED AND HAVE QUALIFIED. FORM 990, PART VI, SECTION A, LINE 7B THE REPEAL OR AMENDMENT OF ANY BYLAW OF THE CORPORATION SHALL BE EFFECTED BY EITHER OF THE FOLLOWING METHODS: (I) BY ACT OF THE BOARD OF TRUSTEES OF GERIATRIC RESOURCES OF NEW YORK, INC., THE SOLE CORPORATE MEMBER OF THE CORPORATION; OR (II) BY A VOTE OF A MAJORITY OF THE VOTING TRUSTEES OF THE BOARD OF TRUSTEES OF THE CORPORATION, PROVIDED THAT WRITTEN NOTICE OF EITHER THE TEXT OR THE SUBSTANCE OF ANY PROPOSED AMENDMENT OR REPEAL OF THE BYLAWS SHALL BE GIVEN TO ALL TRUSTEES AT LEAST FIVE (5) BUSINESS DAYS PRIOR TO THE DATE OF THE MEETING AT WHICH THE AMENDMENT OR REPEAL IS TO BE PROPOSED. IN ADDITION, ANY TRUSTEE MAY RESIGN AT ANY TIME BY GIVING WRITTEN NOTICE TO THE CHAIRMAN OR TO THE SECRETARY OF GERIATRIC RESOURCES OF NEW YORK, INC., THE SOLE CORPORATE MEMBER OF THE CORPORATION. SUCH RESIGNATION SHALL TAKE EFFECT AT THE TIME SPECIFIED THEREIN OR, IF NO TIME IS SPECIFIED, ON DELIVERY. ANY OR ALL OF THE TRUSTEES MAY BE REMOVED FOR CAUSE OR WITHOUT CAUSE BY AN ACTION OF THE BOARD OF TRUSTEES OF GERIATRIC RESOURCES OF NEW YORK, INC., THE SOLE CORPORATE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B QUEENS-LONG ISLAND RENAL INSTITUTE 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 ANNUALLY, THE BOARD OF TRUSTEES AND OFFICERS OF THE BOARD ARE ASKED TO REVIEW THE CONFLICT OF INTEREST POLICY. EACH PERSON MUST COMPLETE A STATEMENT AFFIRMING THAT THEY DO NOT HAVE ANY CONFLICTS OR POTENTIAL CONFLICTS. WHEN A POTENTIAL OR ACTUAL FINANCIAL INTEREST HAS BEEN DISCLOSED, THE BOARD (OR A COMMITTEE) SHALL EVALUATE WHETHER THE ORGANIZATION COULD, WITH REASONABLE EFFORT, OBTAIN A MORE ADVANTAGEOUS TRANSACTION WITH ANOTHER ENTITY. ANY BOARD COMMITTEE MAY CONDUCT THIS EVALUATION ON BEHALF OF THE BOARD AND MAKE RECOMMENDATIONS TO THE BOARD. TYPICALLY, THE EVALUATION WILL INVOLVE OBTAINING ONE OR MORE COMPETITIVE BIDS, EXCEPT WHERE (A) THE CONTEMPLATED TRANSACTION IS SO SMALL THAT THE DOLLAR AMOUNTS INVOLVED DO NOT JUSTIFY A COMPETITIVE BID; AND/OR (B) THE ORGANIZATION IS REASONABLY CERTAIN, AND CAN DOCUMENT, THAT THE CONTEMPLATED PRODUCT OR SERVICE IS BEING OFFERED AT OR BELOW FAIR MARKET RATES. IF, BASED ON THE ABOVE EVALUATION, THE ORGANIZATION DETERMINES THAT IT CANNOT OBTAIN, WITH REASONABLE EFFORT, A MORE ADVANTAGEOUS TRANSACTION WITH ANOTHER ENTITY, THE FACILITY MAY PROCEED WITH THE PROPOSED TRANSACTION OR ARRANGEMENT, SO LONG AS THE BOARD DETERMINES, BY A MAJORITY VOTE OF DISINTERESTED DIRECTORS, THAT THE PROPOSED TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST AND IS FAIR AND REASONABLE. THE TRUSTEE OR OFFICER WITH THE POTENTIAL OR ACTUAL FINANCIAL INTEREST SHALL NOT BE PRESENT DURING THE DISCUSSION OF THE ISSUE OR THE VOTE. THE MINUTES OF THE BOARD (AND OF THE BOARD'S EXECUTIVE COMMITTEE) SHALL INCLUDE: THE NAMES OF THE TRUSTEES, OFFICERS OR COMMITTEE MEMBERS, IF ANY, WHO DISCLOSED FINANCIAL INTERESTS; THE NATURE OF THE FINANCIAL INTEREST THAT POSES A POTENTIAL OR ACTUAL CONFLICT; A SUMMARY OF THE CONTENT OF THE BOARD'S (OR EXECUTION COMMITTEE'S) DISCUSSIONS (INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT); AND A RECORD THAT A VOTE WAS TAKEN REGARDING THE PROPOSED TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION, FORM 990, FORM 1023, AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART IX, LINE 11G CONSULTANTS: PROGRAM SERVICE EXPENSES 12,610. MANAGEMENT AND GENERAL EXPENSES 4,026. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,636. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 297,204. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 297,204. BILLING & A/R SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 132,567. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 132,567. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 375,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 375,000. FORM 990, PART XI, LINE 9: LOSS FROM DISPOSAL OF ASSETS -2,403. 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. PARKER JEWISH INSTITUTE FOR HEALTH CARE & REHAB FOUNDATION 271-11 76TH AVENUE NEW HYDE PARK NY 11040 113041480 TO SUPPORT PARKER JEWISH INSTITUTE FOR HEALTH CARE AND REHABILITATION NY 501(C)(3) LINE 7 GERIATRIC RESOURCES OF NEW YORK 0 GERIATRIC RESOURCES OF NEW YORK 271-11 76TH AVENUE NEW HYDE PARK NY 11040 113100541 SUPPORT PJI FOR HEALTH CARE AND REHABILITATION AND ITS AFFILIATES NY 501(C)(3) LINE 12B, II N/A 0 PARKER JEWISH INSTITUTE FOR HEALTH CARE AND REHABILITATION 271-11 76TH AVENUE NEW HYDE PARK NY 11040 132631069 OPERATE A SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 GERIATRIC RESOURCES OF NEW YORK 0 LEAGUE OF THE PARKER INSTITUTE FOR HEALTH CARE AND REHABILITATION 271-11 76TH AVENUE NEW HYDE PARK NY 11040 112516708 SUPPORT THE RESIDENTS OF THE INSTITUTE NY 501(C)(3) LINE 10 GERIATRIC RESOURCES OF NEW YORK 0 AGEWELL NEW YORK LLC 271-11 76TH AVENUE NEW HYDE PARK NY 11040 300743059 OPERATES A PARTIALLY CAPITATED MEDICAID & MEDICARE MANAGED LT CARE PROGRAM NY PARKER JEWISH INSTITUTE FOR HEALTH CARE AND REHABILITATION RELATED 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0