2023-09-22T07:50:11-05:00 2022-12-31 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2022-01-01 760847915 MARGARET ANNA CUSACK CARE CENTER INC % DONALD LYNCH LNHA MARG 2016538300 537 PAVONIA AVENUE JERSEY CITY NJ 07306 KYLE HREBEN COO 2016538300 2023-09-14 true KYLE HREBEN 000000000 HAYLEY L STOUT CPA P01293083 9738989494 3 2022 2023-04-26 12:10:37Z PEACE CARE ST JOSEPH'S DONALD LYNCH LNHA 537 PAVONIA AVENUE JERSEY CITY NJ 07306 20576459 false 0928 X WWW.PEACECARENJ.ORG X 2006 NJ PROVIDING SKILLED NURSING CARE ROOTED IN CATHOLIC TRADITION FOR THE ELDERLY. 5 3 206 3 0 0 409352 599120 13180141 13416240 2088860 -31804 9685 2027 15688038 13985583 0 11194 0 0 8396486 9561322 0 0 124873 6386049 5879800 14782535 15452316 905503 -1466733 25370856 20747629 9502448 6247256 15868408 14500373 X MARGARET ANNA CUSACK CARE CENTER, INC. (THE CENTER) IS A COMMUNITY OF SKILLED, COMPASSIONATE CAREGIVERS, ROOTED IN CATHOLIC TRADITION AND THE VALUES OF THE SISTERS OF ST. JOSEPH OF PEACE. THE CENTER PROVIDES CARE WITH DIGNITY FOR THE HEALING OF THE WHOLE PERSON. false false 13106450 11194 13416240 MARGARET ANNA CUSACK CARE CENTER INC. DBA PEACE CARE ST. JOSEPH'S (THE "CENTER") IS A NONPROFIT ORGANIZATION WHICH OPERATES A 139-BED NURSING HOME IN JERSEY CITY, NEW JERSEY. THE CENTER PROVIDES LONG-TERM, POST-ACUTE AND RESPITE CARE SERVICES. POST-ACUTE CARE IS A SHORT-TERM REHABILITATION SERVICE PROVIDED TO A PATIENT FOLLOWING SURGERY, HOSPITALIZATIONS, INJURY, OR A DISABILITY. THE SHORT-TERM REHABILITATION SERVICES INCLUDE SKILLED NURSING, SOCIAL SERVICES FOR THE OVERALL WELL-BEING OF THE PATIENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND/OR SPEECH THERAPY PROVIDED BY HIGHLY TRAINED STAFF. RESPITE CARE IS A SHORT-TERM STAY AVAILABLE FOR A VARIETY OF CARE LEVELS FOR PATIENTS WHO NEED EXTRA ASSISTANCE BEFORE RETURNING HOME AFTER A HOSPITAL STAY OR SIMPLY FOR CARETAKERS WHO NEED A BREAK FROM TAKING CARE OF THEIR FAMILY MEMBER. 13106450 true true false true false false false false true false true false true false true false true true false false false false false false false false false true false true false false false false false false false false false false false false false true false false false true 24 3 true 206 true false false false false false true true false false false false false false X 5 3 false true false false true true true true true false false true true true true true true true false false NJ X X DONALD LYNCH LNHA 2016538300 537 PAVONIA AVENUE JERSEY CITY NJ 07306 X JANE SUPUKO NURSING SUPERVISOR 37.5 0.0 X 197685 0 3818 THOMAS P SHEEHY LNHA TRUSTEE-PCSJ ADMIN(TERM 12/22) 40.0 0.0 X X 168717 0 27589 EVERYLYNE G OMBIRO NURSING SUPERVISOR 37.5 0.0 X 175530 0 2680 MONA DAUPHIN MSN RN-BC DIRECTOR OF NURSING 40.0 0.0 X 157556 0 16031 SUSSIE MENSAH-NARH ASSISTANT DIRECTOR OF NURSING 40.0 0.0 X 141599 0 17150 RACQUEL PALMER NURSING SUPERVISOR 37.5 0.0 X 128120 0 24168 KYLE HREBEN MBA LNHA TRUSTEE - COO (EFF 7/5/22) 19.5 20.5 X X 0 116042 5907 CHERYL DORN TRUSTEE - COO (TERMED 2/17/22) 19.5 20.5 X X 0 112999 174 TERESA M DONOHUE CSJP CHAIRPERSON - TRUSTEE 2.0 2.0 X X 0 0 0 CATHERINE YAXLEY MBACPARN SECRETARY - TRUSTEE 2.0 4.0 X X 0 0 0 SILVANA BUCCIANTI TREASURER - TRUSTEE 2.0 3.0 X X 0 0 0 KENNETH D ROBBINS TRUSTEE-INTERIM COO (2/14-6/3) 19.5 20.5 X X 0 0 0 969207 229041 97517 7 false true false SELECT REHABILITATION LLC PO BOX 809056 CHICAGO IL 60680 REHABILITATION 1451886 1 160000 250775 188345 599120 NET PATIENT SERVICE REVENUE 623110 13408704 13408704 OTHER HEALTHCARE RELATED REVENUE 623110 7536 7536 13416240 104099 104099 0 0 0 0 0 6446000 6581903 -135903 -135903 -135903 1000 3973 -2973 -2973 10000 5000 5000 5000 0 0 0 0 13985583 13416240 -29777 11194 11194 0 0 0 196306 117784 78522 0 7651129 6809498 754185 87446 77615 62574 14147 894 1627761 1310932 297994 18835 8511 6881 1533 97 86523 62854 23306 363 32000 23246 8620 134 72441 52624 19513 304 469 341 126 2 0 7310 7310 371734 270044 100128 1562 25787 18733 6946 108 242838 176408 65410 1020 94513 68658 25458 397 0 470185 341562 126648 1975 13321 9677 3588 56 0 1993 1448 537 8 92153 71757 20116 280 0 847807 660166 185067 2574 194113 141012 52286 815 MEDICAL SUPPLIES 1767114 1525168 236614 5332 PATIENT FOOD & NOURISHMENTS 536735 536735 NJ STATE ASSESSMENT 398628 398628 REPAIRS & MAINTENANCE 297750 216298 80201 1251 326386 212228 112738 1420 15452316 13106450 2220993 124873 X 163217 730080 163470 172090 0 0 1964283 1748713 0 0 0 0 0 0 50745 31898 123504 128421 33848104 19831200 14724906 14016904 0 0 0 0 7861373 3447033 0 0 319358 472490 25370856 20747629 1592858 1485309 0 0 71463 13889 0 0 135185 139611 0 0 2791483 0 0 0 4911459 4608447 9502448 6247256 X 15723763 14312564 144645 187809 15868408 14500373 25370856 20747629 X -1466733 -931172 1029870 X X false true X true false X 579657 785395 3250820 409352 599120 5624344 13928270 14760950 13164527 13180141 13416240 68450128 0 0 0 14507927 15546345 16415347 13589493 14015360 74074472 0 6917 6917 6917 6917 74067555 119968 137451 110725 76718 104099 548961 0 119968 137451 110725 76718 104099 548961 0 42834 137192 10358 27614 11000 228998 14670729 15820988 16536430 13693825 14130459 74852431 0.98951 0.98941 0.00733 0.00733 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X false false false false false false false false true 469 469 false SCHEDULE C, PART II-B; LINE 1I This organization is a member of LeadingAge New Jersey & Delaware and Leading Age National, both of which engage in lobbying efforts on behalf of member organizations. A portion of the dues paid to these organizations have been allocated to lobbying activities on behalf of Peace Care St. Joseph's. This allocation amounted to $469 during 2022. false true X 2281004 2281004 30561264 19230421 11330843 354849 92557 262292 650987 508222 142765 14016904 0 0 DUE TO AFFILIATES 1021065 ACCRUED PENSION PAYABLE 3363954 DUE TO THIRD PARTIES 89386 OTHER LIABILITIES 134042 4608447 13100522 -931172 44448 -886724 13987246 7310 -8973 -1663 13985583 15498427 44448 8973 53421 15445006 7310 7310 15452316 SCHEDULE D, PART IV; LINE 2B The organization maintains separate bank accounts for resident security deposits and personal funds received on behalf of numerous residents. The organization has fiduciary responsibility for the administration of the bank accounts and the distribution of the funds to residents. SCHEDULE D, PART XI; LINE 4B AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: - SPECIAL EVENT EXPENSES - ($3,973); AND - RAFFLE EXPENSES - ($5,000). SCHEDULE D, PART XII; LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: - SPECIAL EVENT EXPENSES - $3,973; AND - RAFFLE EXPENSES - $5,000. true ST ANN'S HOME FOR THE AGED CORP 198 OLD BERGEN ROAD JERSEY CITY NJ 07305 222823794 501(C)(3) 11194 PROGRAM SUPPORT 1 SCHEDULE I, PART I, LINE 2 The funds transferred to related Internal Revenue Code section 501(c)(3) tax-exempt affiliates are intended to support these related organizations. The use of funds is monitored through common management with related organizations. X X X false false false false false false false true false JANE SUPUKO NURSING SUPERVISOR 197685 0 0 0 0 0 925 0 2893 0 201503 0 0 0 THOMAS P SHEEHY LNHA TRUSTEE-PCSJ ADMIN(TERM 12/22) 167576 0 0 0 1141 0 925 0 26664 0 196306 0 0 0 EVERYLYNE G OMBIRO NURSING SUPERVISOR 175430 0 100 0 0 0 425 0 2255 0 178210 0 0 0 MONA DAUPHIN MSN RN-BC DIRECTOR OF NURSING 157322 0 0 0 234 0 925 0 15106 0 173587 0 0 0 SUSSIE MENSAH-NARH ASSISTANT DIRECTOR OF NURSING 138743 0 0 0 2856 0 425 0 16725 0 158749 0 0 0 RACQUEL PALMER NURSING SUPERVISOR 126620 0 1500 0 0 0 425 0 23743 0 152288 0 0 0 CORE FORM, PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2022 FORMS W-2. SCHEDULE J, PART I, QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2022 WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. CORE FORM, PART I AND CORE FORM, PART X The beginning balance sheet has been restated to conform with the current year presentation. This restatement has no effect on the organization's net assets. CORE FORM, PART VI, SECTION A; QUESTION 3 The organization is an affiliate within Peace Care, Inc. and affiliates. This organization has a financial management services agreement with Holy Name Medical Center, Inc.; an internal revenue code section 501(c)(3) tax-exempt hospital organization. Through this agreement, Holy Name provides this organization with certain back office financial support services and financial management services. Peace Care, Inc. is a related 501(C)(3) tax-exempt organization that serves as the parent entity of this organization. Peace Care, Inc. provides this organization with certain centralized administrative services, including management, finance, human resources, marketing, public relations and development. In addition, during the year ended December 31, 2022, Peace Care, Inc. delegated control over the management duties of its Chief Operating Officer position to an independent firm, Scott Senior Services, LLC. On behalf of Scott Senior Services, LLC, Kenneth D. Robbins assumed the role of interim Chief Operating Officer for the period February 14, 2022 through June 3, 2022. The amount paid for these services totaled $97,000. These payments were made by Peace Care St. Ann's; a related Internal Revenue Code Section 501(c)(3) tax-exempt organization, on behalf of and for the benefit of Peace Care, Inc. and its affiliates. The amounts paid were rendered at fair market value pursuant to arm's length negotiations. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 Peace Care, Inc. is the sole member of this organization. Peace Care, Inc. has the ultimate authority and right to elect the members of this organization's board of trustees and has certain reserved powers as defined in this organization's bylaws. CORE FORM, PART VI, SECTION B; QUESTION 11B The organization is an affiliate within Peace Care, Inc. and affiliates ("system"). The organization's federal form 990 was provided to each voting member of the organization's governing body prior to filing of the form 990 with the internal revenue service ("irs"). As part of the tax return preparation process the organization hired a professional certified public accounting ("CPA") firm with experience and expertise in both healthcare and not-for-profit tax return preparation to prepare the federal form 990. The CPA firm's tax professionals worked closely with the system's finance personnel and various other system individuals ("internal working group") to obtain the information needed in order to prepare a complete and accurate tax return. The CPA firm prepared a draft federal form 990 and furnished it to the system's internal working group for their review. The internal working group reviewed the draft federal form 990 and discussed questions and comments with the CPA firm. Revisions were made to the draft federal form 990 where necessary and a final draft was furnished by the CPA firm to the internal working group for final review. Following this review, the form 990 was then presented to Peace Care, Inc.'s audit and compliance committee and provided to the organization's governing body prior to filing with the irs. CORE FORM, PART VI, SECTION B, LINE 12C The organization is an affiliate within Peace Care, Inc. and affiliates ("system"). The organization and system regularly monitor and enforce compliance with its conflict of interest policy. The primary purpose of the policy is to ensure that the board and executive staff can make decisions in an objective manner without undue influence by interested persons and to ensure that the center fulfills its charitable purposes. Each board member and principal officer with board delegated power shall annually sign a statement which affirms that such persons have complied with the following: 1) received a copy of this policy, 2) read and understand this policy, 3) agreed to comply with this policy, 4) understand that the center is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes and, 5) disclosed activities and financial interests which may result in a conflict of interest. Potential conflicts are discussed at the appropriate audit committee meeting and a decision on how to handle is voted on in the absence of the individual who has a conflict. CORE FORM, PART VI, SECTION B, LINE 15A THE ORGANIZATION IS AN AFFILIATE WITHIN PEACE CARE, INC. AND AFFILIATES ("SYSTEM"). THE ORGANIZATION HAS A COMPENSATION COMMITTEE ("COMMITTEE") OF THE BOARD OF TRUSTEES. THE COMPENSATION AND BENEFITS OF THIS ORGANIZATION'S OFFICER(S) ARE REVIEWED BY THE COMMITTEE ON AN ANNUAL BASIS TO ENSURE FAIR MARKET VALUE COMPENSATION IS PAID. WHERE APPROPRIATE, THE COMMITTEE ALSO REVIEWS EXTERNAL COMPARABLE DATA AND SEEKS ADVICE FROM EXTERNAL INDUSTRY CONSULTANTS. CORE FORM, PART VI, SECTION C; QUESTION 18 Pursuant to State of New Jersey P.L. 2021, Chapter 457, (which was effective on November 1, 2022), this organization has posted on its internet website a copy of this Internal Revenue Service (IRS) Form 990 and all schedules and supporting documentation required to be submitted to the IRS in conjunction with the Form 990 with the exception of those schedules not open for public inspection. Said Form 990 was posted by the organization after filing its Form 990 with the IRS. CORE FORM, PART VI, SECTION C; QUESTION 19 The organization's filed certificate of incorporation and any amendments can be obtained and reviewed through the State of New Jersey Department of the Treasury. In addition, the organization's conflict of interest policy and audited financial statements are available upon request. CORE FORM, PART VII AND SCHEDULE J Core form, part vii and schedule j reflect certain board members and officers receiving compensation and benefits from this organization or a related organization. Please note that this remuneration was for services rendered as full-time employees of the organization or a related organization and not for services rendered as a voting member or officer of this organization's board of trustees. CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - CHANGE IN DEFINED BENEFIT PENSION PLAN - $1,029,870. CORE FORM, PART XII; QUESTION 2 The organization is an affiliate within Peace Care, Inc. and affiliates ("system"). An independent CPA firm audited the consolidated financial statements of Peace Care, Inc. and affiliates, for the years ended December 31, 2022 and December 31, 2021; respectively. The audited consolidated financial statements contain consolidating schedules on an entity by entity basis. The independent CPA firm issued an unmodified opinion with respect to the audited consolidated financial statements each year. In addition, an independent CPA firm audited the separate financial statements of Peace Care St. Joseph's, for the years ended December 31, 2022 and December 31, 2021; respectively. The independent CPA firm issued an unmodified opinion with respect to the audited separate financial statements each year. Peace Care, Inc.'s audit and compliance committee has assumed responsibility for the oversight of the audit of the consolidated financial statements, which includes this organization and the selection of an independent auditor. PEACE CARE INC 198 OLD BERGEN ROAD JERSEY CITY NJ 07305 812589807 HEALTH SVCS. NJ 501(C)(3) 509(A)(3) PEACE MINIST false ST ANN'S HOME FOR THE AGED CORP 198 OLD BERGEN ROAD JERSEY CITY NJ 07305 222823794 HEALTH SVCS. NJ 501(C)(3) 509(A)(2) PEACE CARE false PEACE MINISTRIES INC 399 HUDSON TERRACE ENGLEWOOD CLIFFS NJ 07632 465202238 RELIGIOUS NJ 501(C)(3) 509(A)(1) NA false false false true true false false false false false false false false false true true true true false false SCHEDULE R, PART V This organization is a member of Peace Care, Inc. and affiliates ("system"). Funds are routinely transferred between affiliates and business activities are common on behalf of the system's affiliates, including this organization. These transactions may be recorded on the revenue/expense and balance sheet statements of this organization and other affiliates. These entities work together to deliver high quality cost effective healthcare and wellness services to their communities and in furtherance of charitable tax-exempt purposes.