Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Visiting Nurse Service of New York Home Care II
Employer identification number
13-1624211
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2,375,340
2,468,502
1,922,026
2,615,334
2,915,644
12,296,846
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
624,701,277
630,608,993
625,017,966
598,668,453
588,696,690
3,067,693,379
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
627,076,617
633,077,495
626,939,992
601,283,787
591,612,334
3,079,990,225
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
0
c
Add lines 7a and 7b..
0
8
Public Support (Subtract line 7c from line 6.)
3,079,990,225
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
627,076,617
633,077,495
626,939,992
601,283,787
591,612,334
3,079,990,225
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
91,801
23,807
33,352
148,960
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
91,801
23,807
33,352
148,960
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
1,057,712
1,847,798
1,294,475
1,063,425
1,038,187
6,301,597
13
Total support (Add lines 9, 10c, 11 and 12.).
628,134,329
635,017,094
628,258,274
602,347,212
592,683,873
3,086,440,782
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
99.790 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
99.830 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
0 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Visiting Nurse Service of New York Home Care II
Employer identification number
13-1624211
Identifier
Return Reference
Explanation
Form 990, Part VI, Section A, line 6
Visiting Nurse Service of New York is the sole corporate member.
Form 990, Part VI, Section A, line 7a
The member may elect the Directors.
Form 990, Part VI, Section A, line 7b
Visiting Nurse Service of New York is the sole corporate member. The member holds annual meetings to elect the Directors and the member may take action as required or permitted under the organization's bylaws or under any provision of law.
Form 990, Part VI, Section B, line 11
The Audit Committee of VNSNY and its affiliated organizations reviewed the Form 990. The Form 990 was made available to the Board of Directors and discussed at a Board meeting.
Form 990, Part VI, Section B, line 12c
The Compliance Officer reviews the Disclosure Statement completed annually by each officer, director, and key employee and consults with the Senior Vice President for Legal and Government Affairs as appropriate. Any potential conflicts are vetted with the CEO, Senior Vice President for Legal and Government Affairs and, as appropriate, the Chair of the Board. Specific follow-up action is taken on a case-by-case basis.
Form 990, Part VI, Section B, line 15
The following is the process for reviewing the executive compensation paid to top management officials. Review of executive compensation is done on a periodic basis, with the last review taking place in 2009. Members of Executive Committee of VNSNY Board of Directors, comprised of members of the Board that have no material interest in the setting of executive compensation levels and who receive no compensation from the reporting organization or any of its related organizations, review the compensation paid to top management officials. Members of the Committee review data of an outside third-party consultant to provide its members with information regarding executive compensation levels and practices at similarly situated healthcare, healthcare-related organizations, and appropriate general industry information, based on annual revenue, geography and mission.
Form 990, Part VI, Section C, line 19
Documents are available upon request.
Organization's governing body:
Form 990, Part VI, Lina 1a
There are 5 members of the VNSNY Home Care Executive Committee out of a governing body of 41. Each Executive Committee member is a director of VNSNY Home Care. The Executive Committee has all of the powers of the Board in the management of the affairs of the Corporation, including long term planning, when the Board is not in session, except that the Executive Committee shall have no authority as to the following: (a) The election of directors or the filling of vacancies in the Board or in the Executive Committee. (b) The amendment or repeal of the By-laws or the adoption of new By-laws. (c) The amendment or repeal of any resolution of the Board which by its terms shall not be so amendable or repealable. (d) Removing directors.
Average hours per week worked for related organizations:
Form 990, Part VII, Section A:
Samuel Heller: Visiting Nurse Service of New York 36.30 hrs New Partners Inc. 1.00 hrs VNS Group Health Home Care 0.10 hrs Total hours worked for related organizations 37.40 hrs Joan Marren: Visiting Nurse Service of New York 36.30 hrs VNS Continuing Care Development Corporation 0.10 hrs Family Care Services Inc. 1.00 hrs Total hours worked for related organizations 37.40 hrs Eunice An Visiting Nurse Service of New York 1.00 hrs Family Care Services Inc. 1.00 hrs Total hours worked for related organization 2.00 hrs Gayle Perkins Atkins Visiting Nurse Service of New York 1.00 hrs Visiting Nurse Service of New York Hospice Care 1.00 hrs Total hours worked for related organizations 2.00 hrs Margaret A. Bancroft Visiting Nurse Service of New York 1.00 hrs Douglas D. Broadwater Visiting Nurse Service of New York 2.50 hrs VNS Continuing Care Development Corporation 0.10 hrs Total hours worked for related organizations 2.60 hrs Mary E. Cummins Visiting Nurse Service of New York 1.00 hrs New Partners Inc. 1.00 hrs Family Care Services Inc. 1.00 hrs Total hours worked for related organizations 3.00 hrs Robert C. Daum Visiting Nurse Service of New York 1.00 hrs VNS CHOICE 1.00 hrs VNS CHOICE Community Care 1.00 hrs Total hours worked for related organizations 3.00 hrs E. Mary C. Davidson Visiting Nurse Service of New York 1.00 hrs Visiting Nurse Service of New York Hospice Care 1.00 hrs Total hours worked for related organizations 2.00 hrs Eugenie F. Doyle, MD Visiting Nurse Service of New York 1.00 hrs Anne Bick Ehrenkranz Visiting Nurse Service of New York 1.00 hrs New Partners Inc. 1.00 hrs Total hours worked for related organization 2.00 hrs Claire M. Fagin, RN, PHD, FAAN Visiting Nurse Service of New York 1.00 hrs Alice C. Frelinghuysen Visiting Nurse Service of New York 1.00 hrs VNS Group Health Home Care Corporation 0.10 hrs Total hours worked for related organizations 1.10 hrs Stephen V.R. Goodhue Visiting Nurse Service of New York 1.00 hrs New Partners Inc. 1.00 hrs Total hours worked for related organizations 2.00 hrs Betsy Gotbaum Visiting Nurse Service of New York 1.00 hrs Clare Gregorian Visiting Nurse Service of New York 1.00 hrs Mary R. (Nina) Henderson Visiting Nurse Service of New York 1.00 hrs Dorothy Hidalgo Visiting Nurse Service of New York 1.00 hrs Peter L. Hutchings Visiting Nurse Service of New York 1.00 hrs VNS CHOICE 1.00 hrs VNS CHOICE Community Care 1.00 hrs Total hours worked for related organizations 3.00 hrs Attallah Kappas, MD Visiting Nurse Service of New York 1.00 hrs Robert M. Kaufman Visiting Nurse Service of New York 1.00 hrs Visiting Nurse Service of New York Hospice Care 1.00 hrs Total hours worked for related organizations 2.00 hrs Michael B. Laskoff Visiting Nurse Service of New York 1.00 hrs New Partners Inc. 1.00 hrs Total hours worked for related organizations 2.00 hrs Arthur Lindenauer Visiting Nurse Service of New York 1.00 hrs New Partners Inc. 1.00 hrs Total hours worked for related organizations 2.00 hrs Arthur S. Lukach, Jr. Visiting Nurse Service of New York 1.00 hrs Family Care Services 1.00 hrs Total hours worked for related organizations 2.00 hrs Kwan-Lan (Tom) Mao Visiting Nurse Service of New York 1.00 hrs VNS Continuing Care Development Corporation 0.10 Hrs VNS CHOICE 1.00 HRS VNS CHOICE Community Care 1.00 HRS Total hours worked for related organizations 3.10 Hrs Joseph Mark Visiting Nurse Service of New York 1.00 hrs VNS CHOICE 1.00 hrs VNS CHOICE Community Care 1.00 hrs Total hours worked for related organizations 3.00 hrs Jon E. Mattson Visiting Nurse Service of New York 1.00 hrs Mathy Mezey, EdD, RN, FAAN Visiting Nurse Service of New York 1.00 hrs Visiting Nurse Service of New York Hospice Care 1.00 hrs VNS Continuing Care Development Corporation 0.10 hrs Total hours worked for related organizations 2.10 hrs Phyllis J. Mills, RN Visiting Nurse Service of New York 1.00 hrs VNS Continuing Care Development Corporation 0.10 Hrs VNS CHOICE 1.00 hrs VNS CHOICE Community Care 1.00 hrs Total hours worked for related organizations 3.10 hrs Gwendolyn Adams Norton Visiting Nurse Service of New York 1.00 hrs New Partners Inc. 1.00 hrs Total hours worked for related organizations 2.00 hrs Brian C. Offutt Visiting Nurse Service of New York 1.00 hrs Valerie S. Peltier Visiting Nurse Service of New York 1.00 hrs Carl H. Pforzheimer III Visiting Nurse Service of New York 1.00 hrs John P. Rafferty Visiting Nurse Service of New York 1.00 hrs Corinne H. Rieder, EdD Visiting Nurse Service of New York 1.00 hrs Visiting Nurse Service of New York Hospice Care 1.00 hrs Total hours worked for related organizations 2.00 hrs Ira S. Rimerman Visiting Nurse Service of New York 1.00 hrs
Average hours per week worked for related organizations;
Form 990, Part VII, Section A:
Paula L. Root Visiting Nurse Service of New York 1.00 hrs Visiting Nurse Service of New York Hospice Care 1.00 hrs Family Care Services 1.00 hrs Total hours worked for related organizations 3.00 hrs William J. Scanlon, PhD Visiting Nurse Service of New York 1.00 hrs VNS CHOICE 1.00 hrs VNS CHOICE Community Care 1.00 Hrs Total hours worked for related organizations 3.00 hrs Andrew N. Schiff, MD Visiting Nurse Service of New York 1.00 hrs VNS CHOICE 1.00 hrs VNS CHOICE Community Care 1.00 Hrs Total hours worked for related organizations 3.00 hrs Albert L. Siu, MD, MSPH Visiting Nurse Service of New York 1.00 hrs Kenneth G. Standard Visiting Nurse Service of New York 1.00 hrs Family Care Services 1.00 hrs Total hours worked for related organizations 2.00 hrs Frank S. Vigilante Visiting Nurse Service of New York 1.00 hrs Visiting Nurse Service of New York Hospice Care 1.00 hrs Total hours worked for related organizations 2.00 hrs David O. Wicks Visiting Nurse Service of New York 1.00 hrs VNS Continuing Care Development Corporation 0.10 Hrs VNS CHOICE 1.00 hrs VNS CHOICE Community Care 1.00 Hrs Family Care Services, Inc. 1.00 Hrs Total hours worked for related organizations 4.10 hrs
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.