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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
HARTWYCK WEST NURSING HOME INC
 
Employer identification number

22-1802017
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS JFK HEALTH SYSTEM, INC. AS ITS SOLE MEMBER.
FORM 990, PART VI, SECTION A LINE 7B CERTAIN DECISIONS OF THE GOVERNING BODY OF THE ORGANIZATION ARE SUBJECT TO APPROVAL BY THE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11 An Ad-hoc Committee, which includes the Chairman of the Audit and Compliance Committee and a selected designee of the Audit and Compliance Committee as well as designees from the Finance, Legal, Audit and Compliance departments, review the IRS 990 Tax Returns with EisnerAmper LLP, the tax accountant for JFK Health System, Inc. During this review, all comments and recommendations that are made are addressed by the Finance, Legal, and Audit and Compliance departments along with EisnerAmper. The final revised drafts are reviewed by the Ad-hoc Committee to ensure all comments and recommendations were addressed in the final drafts. The Audit and Compliance committee has given the Ad-hoc Committee the authority to approve the IRS 990 Tax Returns. Once the IRS 990 Tax Returns are approved by the Ad-hoc Committee, all Board members are sent an e-mail with instructions on how to access the respective IRS 990 Tax Returns for their review and comments for 4 days on a secure website provided by EisnerAmper LLP. At the end of the 4 day review period, and after any comments have been addressed, the IRS 990 Tax Returns are finalized and filed. Also, after the IRS 990 Tax Returns are filed, the returns are posted on the JFK Health System Board Portal.
FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE DISTRIBUTED TO ALL BOARD MEMBERS AND EMPLOYEES THAT ARE DEPARTMENT HEADS AND HIGHER LEVELS. ALL DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICER AND THE CHAIR OF THE JFK HEALTH SYSTEM AUDIT AND COMPLIANCE COMMITTEE. ANY POTENTIAL CONFLICT OF INTEREST IS BROUGHT TO SAID COMMITTEE FOR REVIEW AND CONSIDERATION AND ANY APPROPRIATE ACTION DEEMED NECESSARY PURSUANT TO THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15 THE JFK HEALTH SYSTEM BOARD OF DIRECTORS HAS DULY APPOINTED AN EXECUTIVE COMPENSATION COMMITTEE (THE "COMMITTEE") THAT IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF ALL COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVE MANAGEMENT OF THE ORGANIZATION. THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT AND AN EXECUTIVE COMPENSATION COMMITTEE CHARTER. THE COMMITTEE FOLLOWS THE PROCEDURES DESCRIBED IN THE PHILOSOPHY STATEMENT AND THE CHARTER WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND EMPLOYEE BENEFITS PROVIDED TO THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER. THE COMMITTEE'S REVIEW ANALYZES EVERY ELEMENT OF COMPENSATION, INCLUDING CURRENT AND DEFERRED COMPENSATION, AND BENEFITS, INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS. THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY, AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE TOTAL COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION. THE COMMITTEE CONSISTS ENTIRELY OF INDEPENDENT MEMBERS OF THE JFK HEALTH SYSTEM BOARD, THE COMMITTEE REVIEWS IN ADVANCE INDEPENDENT DATA SHOWING THE COMPENSATION PROVIDED BY NON-PROFIT ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS, AND THE COMMITTEE PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS DELIBERATIONS AND CONCLUSIONS. ASSISTING THE COMMITTEE IS AN OUTSIDE COMPENSATION CONSULTANT ALONG WITH OUTSIDE LEGAL COUNSEL. AS A RESULT, THE COMMITTEE'S REVIEW PROCESS IS DESIGNED TO SATISFY THE PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES.
FORM 990, PART VI, SECTION C, LINE 19 JFK HEALTH SYSTEMS' CONSOLIDATED AND THE ORGANIZATION'S CONSOLIDATING FINANCIAL STATEMENTS ARE POSTED ON THE JFK HEALTH SYSTEM WEBSITE. ANY OTHER PUBLIC INFORMATION IS AVAILABLE UPON REQUEST.
FORM 990, PART XII, QUESTION 2C THE PROCESS HAS NOT CHANGED SINCE LAST YEAR. JFK HEALTH SYSTEM HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.
FORM 990, PART VII METHOD EMPLOYED IN THE DETERMINATION OF ESTIMATED HOURS PER WEEK. DURING THE ANNUAL BUDGET PROCESS, THE FINANCE DEPARTMENT PERFORMS AN ANALYSIS OF THE EXECUTIVE LEVEL EMPLOYEES' TIME ALLOCATION FROM TIME KEEPING RECORDS. THE APPROPRIATE ADJUSTMENTS ARE MADE TO THE TIME ALLOCATIONS AT THAT TIME. THE OFFICERS OF JFK HEALTH SYSTEM HOURS PER WEEK ARE ALLOCATED AMONG MANY OF THE RELATED ORGANIZATIONS.
HARTWYCK WEST NURSING HOME'S PURPOSE HARTWYCK WEST NURSING HOME ("CEDAR BROOK") IS A 106 BED FACILITY THAT HAS PROVIDED QUALITY LONG-TERM CARE SINCE 1968. LOCATED NEXT TO SCENIC CEDAR BROOK PARK IN PLAINFIELD, THE NURSING CENTER HOUSES THE STATE'S FIRST UNIT DEDICATED TO THE CARE OF HUNTINGTON'S DISEASE PATIENTS. IN ADDITION TO COMPLETE SERVICES FOR GERIATRIC RESIDENTS, IT ALSO OFFERS LONG-TERM CARE FOR INDIVIDUALS IN PERSISTENT COMA. CEDAR BROOK IS BRIGHT AND CHEERFUL, WITH TWO SOLARIUMS IN EACH WING. A LARGE, BEAUTIFUL ALL-PURPOSE ROOM SERVES AS AN EXQUISITE DINING AREA. THERE ARE PLENTY OF AREAS FOR SOCIALIZING WITH FAMILY OR OTHER RESIDENTS, INCLUDING A LOBBY AND SEVERAL LOUNGES.
CEDAR BROOK'S DEMOGRAPHICS CEDAR BROOK IS LOCATED IN PLAINFIELD - AN URBAN / SUBURBAN AREA OF UNION COUNTY.
EXTENSION DESCRIPTION ON WHY THE RETURN WAS NOT TIMELY FILED. AWAITING INFORMATION FROM THIRD PARTIES NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN.
SCHEDULE R, PART V, LINE 1O JFK HEALTH SYSTEM MAINTAINS A MASTER EMPLOYEE LEASING AGREEMENT THAT PROVIDES FOR THE LEASING OF PERSONNEL TO AND FROM VARIOUS JFK HEALTH SYSTEM ENTITIES.
FORM 990, PART VI, SECTION A, LINE 7A WHILE THE MEMBER CANNOT ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY, ALL BOARD APPOINTMENTS ARE SUBJECT TO APPROVAL BY THE MEMBER. THE DIRECTORS, OTHER THAN EX-OFFICIO DIRECTORS, ARE ELECTED BY A VOTE OF THE BOARD AT THE ANNUAL MEETING OF THE CORPORATION. THE DIRECTOR MEMBERSHIP COMMITTEE SHALL NOMINATE A SLATE OF DIRECTORS TO SERVE AS OFFICERS TO REPLACE OR REELECT THOSE OFFICERS WHOSE TERMS ARE ENDING.
FORM 990, PART VII DEFINITION OF EX-OFFICIO PEOPLE WHO HOLD A POSITION BY VIRTUE OF THEIR OFFICE
FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS: TRANSFER FROM JFKHS: $92,259. TOTAL $92,259.
FORM 990, PART VI, SECTION A, LINE 3 The organization uses outside management services for rehabilitation services and housekeeping/laundry services.
FORM 990, PART VII, SECTION A AS OF DECEMBER 2014, LEONARD SENDELSKY IS NO LONGER A BOARD MEMBER.
Form 990, Part I, Question 1 DESCRIBE THE ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES. WE ARE COMMITTED TO EXCELLENCE IN PROVIDING QUALITY AND COMPASSIONATE HEALTHCARE SERVICES TO OUR DIVERSE COMMUNITIES. THE JFK HARTWYCK NETWORK IS COMMITTED TO PROVIDING BOTH HIGH QUALITY CARE AND MANAGEMENT SERVICES FOR PEOPLE IN NEED OF LONG TERM CARE, SUBACUTE CARE, HUNTINGTONS DISEASE, HEAD INJURY PROGRAMMING, RESPIRATORY CARE, TRANSITIONAL LIVING AND ASSISTED LIVING, IN A MANNER THAT PROMOTES RESIDENT DIGNITY AND CHOICE WITHIN THE CONTINUUM OF CARE IN THE JFK HEALTH SYSTEM.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

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