2024-11-11T13:54:03-06:00 2023-12-31 990 2023-01-01 200167745 OUR LADY OF VICTORY RENAISSANCE CORP OURL 7168282974 144 GENESEE STREET BUFFALO NY 14203 RUSSELL EDWARDS VP FINANCE / CORP. CONTROLLER 7169232968 2024-11-11 0 2023 2024-10-15 13:58:12Z JOYCE MARKIEWICZ 6TH FLOOR144 GENESEE ST BUFFALO NY 14203 3957201 0 X WWW.CHSBUFFALO.ORG X 2003 NY THE MISSION OF OUL LADY OF VICTORY, AS PART OF THE CATHOLIC HEALTH SYSTEM (CHS) IN WESTERN NEW YORK, IS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A LONG TERM CARE SETTING. COMMITTED TO A COMMON MISSION, THE PROVIDERS OF OUR LADY OF VICTORY CONTINUE THE HEALING MINISTRY OF JESUS, SEEKING TO IMPROVE THE HEALTH OF INDIVIDUALS AND COMMUNITIES. WE PROVIDE HIGH QUALITY SERVICE THAT HAS REVERENCE, COMPASSION, JUSTICE, AND EXCELLENCE. THE 2023 COMMUNITY SERVICE PLAN CAN BE FOUND AT HTTPS://WWW.CHSBUFFALO.ORG/ABOUT-US/COMMUNITY 4 1 0 2 1542397 270258 0 6590 4380880 3898718 0 0 66091 51893 4446971 3957201 0 0 0 0 280698 296594 0 0 0 4073479 4018376 4354177 4314970 92794 -357769 13248508 13260802 8298038 8222877 4950470 5037925 X THE MISSION OF OUL LADY OF VICTORY, AS PART OF THE CATHOLIC HEALTH SYSTEM (CHS) IN WESTERN NEW YORK, IS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A LONG TERM CARE SETTING. COMMITTED TO A COMMON MISSION, THE PROVIDERS OF OUR LADY OF VICTORY CONTINUE THE HEALING MINISTRY OF JESUS, SEEKING TO IMPROVE THE HEALTH OF INDIVIDUALS AND COMMUNITIES. WE PROVIDE HIGH QUALITY SERVICE THAT HAS REVERENCE, COMPASSION, JUSTICE, AND EXCELLENCE. THE 2023 COMMUNITY SERVICE PLAN CAN BE FOUND AT HTTPS://WWW.CHSBUFFALO.ORG/ABOUT-US/COMMUNITY 0 0 4248880 3905309 THE CAMPUS INCLUDES 74 UNITS OF LOW/MODERATE INCOME SENIOR APARTMENTS FINANCED BY LOW INCOME HOUSING TAX CREDITS; AN 84 BED SKILLED NURSING FACILITY ("SNF") AND A PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY ("PACE"). SEE COMMUNITY SERVICE PLAN AT WWW.CHSBUFFALO.ORG. 4248880 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 13 0 1 0 1 1 0 0 0 0 0 0 0 0 0 X 4 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X RUSSELL EDWARDS VP FINACECORP CONTROLLER 7169232968 144 GENESEE STREET BUFFALO NY 14203 MARK SULLIVAN PRESIDENT & CEO 0.00 55.00 X X 0 1635876 104188 THOMAS GLEASON PRESIDENT & CEO OF HCBC 0.00 55.00 X X 0 308852 53293 DAVID VITKA DIRECTOR 0.00 55.00 X 0 210486 60520 JAMES BIDDLE SR DIRECTOR 0.00 4.00 X 0 0 0 MONSIGNOR ROBERT E ZAPFEL DIRECTOR 0.00 8.00 X 0 0 0 JOYCE MARKIEWICZ CHIEF BUSINESS DEVELOPMENT OFFICER,PRESIDENT & CEO 0.00 55.00 X 0 1086472 81890 DAVID MACHOLZ CHIEF FINANCE OFFICER 0.00 55.00 X 0 672043 80342 DR MICHAEL GALANG SENIOR VP, CHIEF INFORMATION OFFICER 0.00 55.00 X 0 513743 72873 HANS CASSAGNOL EXECUTIVE VP, CHIEF PHYSICIAN OFFICER 0.00 55.00 X 0 655794 62247 WILLIAM PRYOR EXECUTIVE VP, CHIEF ADMIN. OFFICER 0.00 55.00 X 0 524095 68469 BARTHOLOMEW RODRIGUES CHIEF MISSION OFFICER 0.00 55.00 X 0 277358 62942 JAMES M GARVEY EXECUTIVE VP, CHIEF OPERATING OFFICER 0.00 55.00 X 0 773675 66683 REBECCA MCCORMICK BOYLE CHIEF INTEGRATION OFFICER 0.00 55.00 X 0 256911 27612 LEONARDO SETTE-CAMARA GENERAL COUNSEL - SECRETARY 0.00 55.00 X 0 340468 46568 LISA CILANO SENIOR VP, RMC & BUSINESS ADVISORY 0.00 55.00 X 0 352866 114286 MARTIN BORYSZAK SENIOR VP OF ACUTE CARE & PRESIDENT OF MHB 0.00 55.00 X 0 597531 56537 0 8206170 958450 0 0 1 0 IR MUELLER CORP 789 COLVIN BLVD BUFFALO NY 14217 SECURITY SERVICES 368419 MDC SOLUTIONS INC 4039 GENESEE STREET BUFFALO NY 14225 CONSULTING SERVICES 287005 RAYMOND E KELLEY INC 33 MAIN STREET BOWMANSVILLE NY 14026 PROFESSIONAL SERVICES 180965 TELCO CONSTRUCTION INC 500 BUFFALO RD EAST AURORA NY 14052 CONSTRUCTION SERVICES 150709 TRANE US INC 1 CENTENNIAL AVENUE SUITE 101 PISCATAWAY NJ 08854 TECHNOLOGY AND ENERGY SERVICES 112636 5 6590 6590 RENTAL REVENUE 532000 3898718 2356321 1542397 3898718 OTHER 531390 53516 53516 INEFFECTIVE PORTION OF SWAP 900001 -1623 -1623 51893 3957201 2408214 1542397 0 232317 232317 5833 5833 58444 58444 2866 2866 367586 367586 1328360 1328360 135757 135757 PURCHASED SERVICES 2047748 1981658 66090 SUPPLIES 83211 83211 PROPERTY TAXES 40120 40120 MISC 12728 12728 4314970 4248880 66090 0 2901600 3285795 42356 223389 14462 17119 29859714 21424439 9316538 8435275 973552 1299224 13248508 13260802 848837 1110366 309455 245611 6275000 5715000 864746 1151900 8298038 8222877 X 4694438 4781893 256032 256032 4950470 5037925 13248508 13260802 X -357769 445223 X 0 0 0 X 6590 6590 4071447 4107890 4127464 2714882 2356321 17378004 4071447 4107890 4127464 2714882 2362911 17384594 0 0 0 17384594 1295249 1541783 1653265 1665998 1542397 7698692 1295249 1541783 1653265 1665998 1542397 7698692 5366696 5649673 5780729 4380880 3905308 25083286 0.69310 0.72860 0.30690 0.27140 X 23149157 17158216 5990941 6061428 4266223 1795205 649129 649129 8435275 ASSETS LIMITED AS TO USE 446246 INTEREST IN NETS ASSETS OF CONTINUING CARE FOUNDATION 30158 NOTE RECEIVABLE - RELATED PARTY 300000 DUE FROM AFFILIATES 216524 INVESTMENTS 306296 1299224 NOTES PAYABLE 300000 INTEREST RATE SWAP LIABILITY 323818 ASSET RETIREMENT OBLIGATION 182478 OTHER LONG TERM LIABLITIES -52566 DUE TO AFFILIATES 398170 1151900 X X X X X X 1 0 0 0 0 0 0 0 0 MARK SULLIVAN PRESIDENT & CEO 0 926960 0 0 0 708916 0 86783 0 17405 0 1740064 0 0 JOYCE MARKIEWICZ CHIEF BUSINESS DEVELOPMENT OFFICER,P 0 970344 0 25 0 116103 0 64816 0 17074 0 1168362 0 0 JAMES M GARVEY EXECUTIVE VP, CHIEF OPERATING OFFICE 0 747189 0 0 0 26486 0 49548 0 17135 0 840358 0 0 DAVID MACHOLZ CHIEF FINANCE OFFICER 0 654116 0 0 0 17927 0 63292 0 17050 0 752385 0 0 HANS CASSAGNOL EXECUTIVE VP, CHIEF PHYSICIAN OFFICE 0 637924 0 0 0 17870 0 38637 0 23610 0 718041 0 0 MARTIN BORYSZAK SENIOR VP OF ACUTE CARE & PRESIDENT 0 580304 0 0 0 17227 0 32978 0 23559 0 654068 0 0 WILLIAM PRYOR EXECUTIVE VP, CHIEF ADMIN. OFFICER 0 488143 0 0 0 35952 0 50299 0 18170 0 592564 0 0 DR MICHAEL GALANG SENIOR VP, CHIEF INFORMATION OFFICER 0 494029 0 0 0 19714 0 64188 0 8685 0 586616 0 0 LISA CILANO SENIOR VP, RMC & BUSINESS ADVISORY 0 335091 0 0 0 17775 0 105738 0 8548 0 467152 0 0 LEONARDO SETTE-CAMARA GENERAL COUNSEL - SECRETARY 0 339934 0 0 0 534 0 23225 0 23343 0 387036 0 0 THOMAS GLEASON PRESIDENT & CEO OF HCBC 0 291937 0 0 0 16915 0 30015 0 23278 0 362145 0 0 BARTHOLOMEW RODRIGUES CHIEF MISSION OFFICER 0 259345 0 0 0 18013 0 39675 0 23267 0 340300 0 0 REBECCA MCCORMICK BOYLE CHIEF INTEGRATION OFFICER 0 246815 0 0 0 10096 0 27371 0 241 0 284523 0 0 DAVID VITKA DIRECTOR 0 201088 0 0 0 9398 0 37307 0 23213 0 271006 0 0 PART I, LINE 3: THE CHANGE IN PRESENT VALUE SHOWN FOR EACH PARTICIPANT REPRESENTS THE CHANGE IN THE ACTUARIAL VALUE OF THE ACCRUED BENEFIT, WHETHER OR NOT FUNDED, VESTED OR SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. NOTE THAT THE CHANGE IN PRESENT VALUE IS PARTLY DUE TO CHANGES IN THE DISCOUNT RATE AND, FOR THOSE ACCRUING UNDER THE CASH BALANCE FORMULA, THE ASSUMPTIONS FOR FUTURE CASH BALANCE INTEREST CREDITING RATES AND FACTORS APPLICABLE TO ANNUITY CONVERSIONS. A ERIE COUNTY INDUSTRIAL DEVELOPMENT AGENCY 161090858 295085BG8 2007-04-26 10220000 PART VI 0 0 0 A 5173750 10220000 314820 424430 97186 9383564 2008 0 0 1 1 A 0 0 0 0 0 0 1 A 1 0 1 HSBC BANK NA 24.900000000000 0 0 0 0 1 A 1 PART I A (F) DESCRIPTION OF PURPOSE: TO FINANCE THE COST OF RECONSTRUCTION AND RENOVATION OF AN APPROXIMATELY 97,000 SQUARE FOOT FACILITY FOR USE AS A SKILLED NURSING FACILITY. RACHEL MARKIEWICZ DAUGHTER IN LAW OF CHIEF BUSINESS DEVELOPMENT OFFICER, JOYCE MARKIEWICZ 68928 SOCIAL WORKER, MSW 0 CARRIE SETTE-CAMARA WIFE OF KEY EMPLOYEE, LEONARDO SETTE-CAMARA 94614 PUBLIC RELATIONS MANAGER, SISTERS 0 DIANA SEDITA SISTER OF KEY EMPLOYEE, LAURA CIANFLONE 144571 DIRECTOR MARKETING & COMMUNICATIONS 0 FORM 990, PART VI, SECTION A, LINE 6 CHS HAS TWO MEMBERS: THE FRANCISCAN SISTERS OF ST. JOSEPH OF HAMBURG, NY, AND THE DIOCESE OF BUFFALO, NY. EACH MEMBER IS ABLE TO PARTICIPATE EQUALLY IN ELECTING THE GOVERNING BODY, APPROVING SIGNIFICANT DECISIONS OF THE GOVERNING BODY, AND HAVE THE POWER TO APPROVE ANY PLAN OF DISSOLUTION OF THE CORPORATION AND THE DISTRIBUTION OF THE ASSETS UPON DISSOLUTION, ACCORDING TO THE CHS BYLAWS. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE CHS BYLAWS, EACH MEMBER IS EQUALLY ALLOWED TO APPOINT ONE REPRESENTATIVE AND ONE ALTERNATIVE REPRESENTATIVE TO SERVE ON THE CORPORATE MEMBER COUNCIL AND TO SERVE AS A VOTING DIRECTOR ON THE CHS BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B YES, THE CORPORATE MEMBERS DO HAVE RESERVE POWERS. FORM 990, PART VI, SECTION B, LINE 11B YES, AN ELECTRONIC COPY OF FORM 990 WAS PROVIDED TO THE CHS BOARDS OF DIRECTORS BEFORE IT WAS FILED. THE CHS BOARD OF DIRECTORS HAS DELEGATED THE RESPONSIBILITY TO REVIEW THE 990 TO THE AUDIT COMMITTEE. THE CHS AUDIT COMMITTEE REVIEWED IN DETAIL SELECTED INFORMATION FOR ALL CHS ENTITIES THAT FILE A 990. REVIEWED WITH THE AUDIT COMMITTEE: 1. CORE FORM PART IV: CHECKLIST OF REQUIRED SCHEDULES 2. CORE FORM PART VI: GOVERNANCE, MANAGEMENT AND DISCLOSURE 3. CORE FORM PART VII: COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND INDEPENDENT CONTRACTORS 4. SCHEDULE H: HOSPITALS 5. SCHEDULE K: SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS 6. SCHEDULE J: COMPENSATION INFORMATION 7. SCHEDULE L; TRANSACTIONS WITH INTERESTED PERSONS 8. SCHEDULE R: RELATED ORGANIZATIONS AND UNRELATED PARTNERSHIPS 9. PROCESS FOR WHICH REMAINING CORE FORM WAS COMPLETED, UTILIZING AUDITED FINANCIAL INFORMATION. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT (COIDS) IN ORDER TO FULFILL THE ANNUAL REQUIREMENTS. COIDS ARE DISTRIBUTED TO ALL PARTIES, AS PER APPLICABLE POLICY, AND ONCE COMPLETE ARE FOLLOWED UP WITH AS FOLLOWS: 1. ASSOCIATE AND PHYSICIAN COMPLETED COIDS ARE REVIEWED AND SIGNED OFF BY THE MANAGER. IF A DISCLOSURE IS NOTED, IT IS DISCUSSED BY THE MANAGER, THE DOCUMENT IS FORWARDED TO THE COMPLIANCE OFFICER WHO REVIEWS AND FOLLOWS UP AS APPROPRIATE. ONCE REVIEW/FOLLOW UP IS COMPLETED THE COMPLIANCE OFFICER WILL SIGN THE COIDS, MAINTAIN A COPY IN THE COMPLIANCE OFFICE AND RETURN THE ORIGINAL TO HR FOR FILING IN THE PERSONNEL FILE. 2. ALL BOARD MEMBER COIDS' ARE RETURNED TO THE COMPLIANCE OFFICER FOR REVIEW AND FOLLOW UP AS WARRANTED. THE COMPLIANCE OFFICER WILL SIGN EACH COIDS AND RETAIN ON FILE IN THE COMPLIANCE OFFICE IN A CONFIDENTIAL MANNER. FORM 990, PART VI, SECTION B, LINE 15 CHS, IN DETERMINING THE COMPENSATION FOR THE CEO, UTILIZES A PROCESS OF REVIEW AND APPROVAL, GOVERNED BY THE BOARD OF DIRECTORS THAT INCLUDES AN OUTSIDE NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NON-PROFIT HEALTHCARE ORGANIZATIONS, AND COMPARABILITY DATA. IN 2023, THE CATHOLIC HEALTH SYSTEM UTILIZED A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS TO MONITOR THE EXECUTIVE COMPENSATION AS PER THE EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY FOR THE CHS CEO AND TOP SENIOR EXECUTIVES FORM 990, PART VI, SECTION C, LINE 19 WE MAKE OUR FORM 990 OPEN FOR PUBLIC INSPECTION UPON REQUEST. OUR WEBSITE INCLUDES AN ANNUAL REPORT WHICH INCLUDES SELECTED FINANCIAL INFORMATION. OUR FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE PROVIDED UPON REQUEST ACCORDING TO APPLICABLE FEDERAL AND STATE LAWS. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER, NET OF INTEREST RATE SWAP EXPENSE -45,317. CONTRIBUTIONS FOR PP&E 490,540. CATHOLIC HEALTH SYSTEM INC 144 GENESEE STREET BUFFALO NY 14203 222565278 HEALTH CARE DELIVERY SYSTEM NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 MERCY HOSPITAL OF BUFFALO 565 ABBOTT ROAD BUFFALO NY 14220 160756336 ACUTE CARE HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM INC 0 SISTERS OF CHARITY HOSPITAL 2157 MAIN STREET BUFFALO NY 14214 160743187 ACUTE CARE HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM INC 0 KENMORE MERCY HOSPITAL 2950 ELMWOOD AVENUE KENMORE NY 14217 160762843 ACUTE CARE HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM INC 0 NAZARETH HOME OF THE FRANCISCAN SISTERS 291 NORTH STREET BUFFALO NY 14201 160813142 SKILLED NURSING FACILITY NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 ST ELIZABETH HOME FOR THE AGED 5539 BROADWAY LANCASTER NY 14086 160743154 ADULT HOME NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 ST FRANCIS HOME OF WILLIAMSVILLE 147 REIST STREET WILLIAMSVILLE NY 14221 160743153 SKILLED NURSING FACILITY NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 ST FRANCIS OF BUFFALO INC 34 BENWOOD AVENUE BUFFALO NY 14214 161523535 SKILLED NURSING FACILITY NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 ST VINCENT MANOR 319 WASHINGTON AVENUE DUNKIRK NY 14048 160743167 ADULT HOME NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 WNY CATHOLIC LONG TERM CARE 6400 POWERS ROAD ORCHARD PARK NY 14127 161434368 SKILLED NURSING FACILITY NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 NIAGARA HOMEMAKER SERVICES (MERCY HOME CARE) 2875 UNION ROAD CHEEKTOWAGA NY 14227 161317960 HOME CARE PROVIDER NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 MCAULEY SETON HOME CARE 144 GENESEE STREET BUFFALO NY 14203 161310062 HOME CARE PROVIDER NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 CATHOLIC HEALTH SYSTEM INFUSION PHARMACY INC 6350 TRANSIT ROAD DEPEW NY 14043 200198518 HOME CARE INFUSION SERVICES NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 CHS CONTINUING CARE FOUNDATION 144 GENESEE STREET BUFFALO NY 14203 200947831 FOUNDATION NY 501(C)(3) LINE 7 CATHOLIC HEALTH SYSTEM INC 0 CHS PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY INC 55 MELROY AVENUE LACKAWANA NY 14218 261252884 ALL-INCLUSIVE CARE FOR THE ELDERLY NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM INC 0 OLV COMMUNITY HOUSING DEVELOPMENT ORGANIZATION 144 GENESEE STREET BUFFALO NY 14203 200372194 LOW INCOME HOUSING NY 501(C)(3) LINE 11 CATHOLIC HEALTH SYSTEM INC 0 TRINITY MEDICAL WNYPC 2625 HARLEM ROAD CHEEKTOWAGA NY 14225 272576645 PRIMARY CARE PROVIDER NY 501(C)(3) LINE 12B, II CATHOLIC HEALTH SYSTEM INC 0 MOUNT ST MARY'S HOSPITAL OF NIAGARA FALLS 5300 MILITARY ROAD LEWISTON NY 14092 161523353 ACUTE CARE HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM INC 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1