Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 900 | 0 | 0 | 900 |
| 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 | 554,701,046 | 1,237,626 | 1,094,234 | 990,803 | 1,055,281 | 559,078,990 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | |||||
| 6 | Total. Add lines 1 through 5 | 554,701,046 | 1,237,626 | 1,095,134 | 990,803 | 1,055,281 | 559,079,890 |
| 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.) | 559,079,890 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 554,701,046 | 1,237,626 | 1,095,134 | 990,803 | 1,055,281 | 559,079,890 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | |||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 0 | |||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 2,602 | 1,015 | 3,617 | |||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 554,703,648 | 1,238,641 | 1,095,134 | 990,803 | 1,055,281 | 559,083,507 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2018 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part I, Line 1 | Description of Organization Mission VNSNY'S CHOICE COMMUNITY CARE MISSION, AS AN AFFILIATE OF VISITING NURSE SERVICE OF NEW YORK ("VNSNY"), IS TO HELP MEMBERS CONTINUE TO LIVE INDEPENDENTLY IN THEIR OWN HOME AND COMMUNITIES; PROMOTE CHOICE IN HEALTH AND LONG TERM CARE AND TO PROVIDE INNOVATIVE HEALTH AND LONG TERM CARE SOLUTIONS THAT ARE BENEFICIAL, COST EFFECTIVE, AND SERVE EACH MEMBER'S NEEDS. |
| Form 990, Part III, Line 1 | Description of Organization THE MISSION OF VNSNY CHOICE COMMUNITY CARE IS TO HELP MEMBERS CONTINUE TO LIVE INDEPENDENTLY IN THEIR OWN HOME AND COMMUNITIES FOR AS LONG AS POSSIBLE; PROMOTE CHOICE IN HEALTH AND LONG TERM CARE; AND PROVIDE INNOVATIVE HEALTH AND LONG TERM CARE SOLUTIONS THAT ARE BENEFICIAL, COST EFFECTIVE, AND SERVE EACH MEMBERS NEEDS. |
| Form 990, Part VI, Section A, Line 3 | MATTHEW BOX SERVED AS INTERIM CFO OF THE ORGANIZATION FROM JUNE 11, 2017 TO JANUARY 28, 2018. MATTHEW BOX IS A MANAGING DIRECTOR WITH ALVAREZ & MARSAL, AND HIS SERVICES AS INTERIM CFO WERE PROVIDED PURSUANT TO A CONTRACT WITH ALVAREZ & MARSAL. VNSNY HAD A PRIOR BUSINESS RELATIONSHIP WITH ALVAREZ & MARSAL THAT PRECEDED MATTHEW BOX'S APPOINTMENT AS INTERIM CFO. MATTHEW BOX RECUSED HIMSELF FROM ANY DISCUSSIONS THAT THE MANAGEMENT OF VNSNY HAD REGARDING CONTRACTS WITH ALVAREZ & MARSAL. FOR THE PERIOD OF 1/1/2018 - 1/28/2018, ALVAREZ & MARSAL WAS PAID $73,600 FOR THE SERVICES PROVIDED BY MATTHEW BOX AS INTERM CFO OF VNSNY. Form 990, Part VI, Section A, Line 6 VNS CHOICE 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 | VNS CHOICE IS THE SOLE CORPORATE MEMBER. PER THE ORGANIZATION'S BYLAWS, 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 11a | THE AUDIT COMMITTEE OF VNSNY AND ITS AFFILIATED ORGANIZATIONS REVIEWED THE FORM 990. A COMPLETE COPY OF THE ORGANIZATION'S FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH VOTING MEMBER OF THE VNS CHOICE COMMUNITY CARE'S BOARD BEFORE ITS FILING WITH THE IRS. |
| Form 990, Part VI, Section B, Line 12c | THE TAXPAYER DOES NOT HAVE A SEPARATE POLICY BUT HAS ADOPTED THE POLICIES AND PROCEDURES OF VNSNY. THE PROCEDURES UNDERTAKEN AT THE VNSNY LEVEL ARE DESCRIBED BELOW: THE CHIEF AND PRIVACY COMPLIANCE OFFICER REVIEWS THE DISCLOSURE STATEMENTS COMPLETED ANNUALLY BY EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE, AND CONSULTS WITH THE EXECUTIVE VICE PRESIDENT, GENERAL COUNSEL & CHIEF RISK OFFICER AS APPROPRIATE. ANY POTENTIAL CONFLICTS ARE VETTED WITH THE CEO, EXECUTIVE VICE PRESIDENT, GENERAL COUNSEL & CHIEF RISK OFFICER 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, Lines 13 & 14 | THE TAXPAYER DOES NOT HAVE A SEPARATE WHISTLEBLOWER OR DOCUMENT RETENTION AND DESTRUCTION POLICY, BUT HAS ADOPTED THE POLICIES AND PROCEDURES OF VNSNY. |
| Form 990, Part VI, Section B, Line 15A & 15B | THE TAXPAYER DOES NOT HAVE A SEPARATE POLICY BUT HAS ADOPTED THE POLICIES AND PROCEDURES OF VNSNY. THE PROCEDURES UNDERTAKEN AT THE VNSNY LEVEL ARE DESCRIBED BELOW: VNSNY REVIEWS ITS OVERALL EXECUTIVE COMPENSATION PROGRAM ON A PERIODIC BASIS. EXECUTIVE COMPENSATION REVIEWS WERE DONE IN PART IN 2017 AND IN 2018. THE PROCESS FOR DETERMINING THE INDIVIDUAL COMPENSATION LEVELS OF VNSNY'S TOP MANAGEMENT, INCLUDING THE CEO, AND ALL OFFICERS MEETS THE THREE REQUIREMENTS OF THE REBUTTABLE PRESUMPTION UNDER TREAS. REG. 53.4958-6. A COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS FOR THE PURPOSE OF ASSISTING THE BOARD TO FULFILL ITS RESPONSIBILITY TO VNSNY AND THE COMMUNITY TO ENSURE THE COMPENSATION IS IN ACCORDANCE WITH VNSNY'S POLICIES. THE COMMITTEE IS COMPRISED OF FOUR DIRECTORS WHO ARE INDEPENDENT OF MANAGEMENT AND VNSNY AND FREE OF ANY CONFLICTS OF INTEREST THAT WOULD INTERFERE WITH THEIR EXERCISE OF INDEPENDENT JUDGMENT. PRIOR TO MAKING COMPENSATION DECISIONS, THE COMMITTEE OBTAINS AND RELIES UPON APPROPRIATE DATA AS TO COMPARABILITY. THE COMMITTEE RETAINS AN INDEPENDENT COMPENSATION CONSULTANT AND UTILIZES LOCAL AND NATIONAL COMPENSATION SURVEYS TO ASSIST IN SETTING COMPENSATION LEVELS. THE COMPENSATION COMMITTEE ADEQUATELY AND ON A TIMELY BASIS DOCUMENTS THE BASIS FOR SETTING COMPENSATION WITH THE MAKING OF THE DETERMINATION. |
| Form 990, Part VI, Section C, Line 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED HHA/HHA PROVIDERS TOTAL FEES:184402 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED HEALTH .PROVIDERS TOTAL FEES:22434 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PROFESIONAL SERVICES TOTAL FEES:2180 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TEMPORARY HELP TOTAL FEES:990 |
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| Software Version: |