OZANAM HALL OF QUEENS NURSING HOME, INC. FINANCIAL STATEMENTS YEAR ENDED DECEMBER 31, 2015

Transcription

1 OZANAM HALL OF QUEENS NURSING HOME, INC. FINANCIAL STATEMENTS YEAR ENDED

2 TABLE OF CONTENTS YEAR ENDED INDEPENDENT AUDITORS REPORT 1 FINANCIAL STATEMENTS STATEMENT OF FINANCIAL POSITION 3 STATEMENT OF ACTIVITIES AND CHANGES IN NET ASSETS 4 STATEMENT OF CASH FLOWS 5 6

3 CliftonLarsonAllen LLP CLAconnect.com INDEPENDENT AUDITORS REPORT Board of Directors Ozanam Hall of Queens Nursing Home, Inc. Queens, New York We have audited the accompanying financial statements of Ozanam Hall of Queens Nursing Home, Inc., which comprise the statement of financial position as of December 31, 2015, and the related statements of activities and changes in net assets, and cash flows for the year then ended, and the related notes to the financial statements. Management s Responsibility for the Financial Statements Management is responsible for the preparation and fair presentation of these financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation, and maintenance of internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error. Auditors Responsibility Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free from material misstatement. An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditors judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity s preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity s internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion. An independent member of Nexia International (1)

4 Board of Directors Ozanam Hall of Queens Nursing Home, Inc. Opinion In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Ozanam Hall of Queens Nursing Home, Inc. as of December 31, 2015, and the changes in its net assets and its cash flows for the year then ended in accordance with accounting principles generally accepted in the United States of America. CliftonLarsonAllen LLP Boston, Massachusetts June 10, 2016 (2)

5 STATEMENT OF FINANCIAL POSITION ASSETS CURRENT ASSETS Cash and Cash Equivalents $ 1,062,315 Accounts Receivable, Net 6,313,183 Prepaid Expenses 278,813 Assets Limited as to Use - Required for Current Liabilities 1,219,716 Universal Settlement Receivable - Current Portion 1,291,966 Other Current Assets 232,709 Total Current Assets 10,398,702 ASSETS LIMITED AS TO USE Board 1,275,341 Trustee 547,935 Temporarily Restricted 504,914 Total Assets Limited as to Use 2,328,190 PROPERTY AND EQUIPMENT, NET 50,132,908 OTHER ASSETS Investments 7,532,166 Deferred Financing Costs, Net 1,324,112 Due From Third Party Payors 9,413,037 Universal Settlement Receivable - Net of Current 1,937,948 Insurance Proceeds Receivable 395,570 Deposits 1,625,000 Other Assets 122,181 Total Other Assets 22,350,014 TOTAL ASSETS $ 85,209,814 LIABILITIES AND NET ASSETS CURRENT LIABILITIES Accounts Payable $ 1,819,536 Deferred Revenue 32,044 Accrued Expenses 1,324,063 Current Maturities on Long-Term Debt 1,310,000 Due to Third Party Payors 377,200 Other Current Liabilities 1,514,818 Total Current Liabilities 6,377,661 LONG-TERM DEBT AND OTHER LIABILITIES Long-Term Debt, Net of Current Maturities 30,641,174 Insurance Liability 395,570 Total Long-Term Debt and Other Liabilities 31,036,744 TOTAL LIABILITIES 37,414,405 NET ASSETS Unrestricted 47,290,495 Temporarily Restricted 504,914 Total Net Assets 47,795,409 TOTAL LIABILITIES AND NET ASSETS $ 85,209,814 See accompanying Notes to Financial Statements. (3)

6 STATEMENT OF ACTIVITIES AND CHANGES IN NET ASSETS YEAR ENDED UNRESTRICTED NET ASSETS: REVENUES, GAINS, AND OTHER SUPPORT Net Resident Services Revenue $ 53,448,539 Other Operating Income 315,825 Net Assets Released from Restriction 112,893 Total Unrestricted Revenues, Gains, and Other Support 53,877,257 OPERATING EXPENSES Nursing Service 20,855,489 General Service 5,226,147 Dietary 4,205,855 Administrative 3,479,460 Employee Benefits 12,961,085 Bed Tax/Assessment 2,468,112 Insurance 575,316 Interest 1,773,402 Bad Debt 578,818 Depreciation & Amortization 4,211,151 Total Expenses 56,334,835 LOSS from OPERATIONS (2,457,578) NONOPERATING GAINS Unrestricted Contributions - Net 132,350 Investment Income 74,608 Net Realized Gains on Investments 248,629 Other Nonoperating Gains 34,589 Total Nonoperating Gains 490,176 DEFICIENCY OF REVENUES OVER EXPENSES (1,967,402) OTHER CHANGES IN UNRESTRICTED NET ASSETS Change in Net Unrealized Losses on Investments (337,576) DECREASE IN UNRESTRICTED NET ASSETS (2,304,978) CHANGE IN TEMPORARILY RESTRICTED NET ASSETS Contributions 23,368 Write-off of Uncollectable Promises to Give (39,417) Temporarily Restricted Net Assets Released from Restriction (112,893) DECREASE IN TEMPORARILY RESTRICTED NET ASSETS (128,942) DECREASE IN NET ASSETS (2,433,920) NET ASSETS - BEGINNING OF YEAR 50,229,329 NET ASSETS - END OF YEAR $ 47,795,409 See accompanying Notes to Financial Statements. (4)

7 STATEMENT OF CASH FLOWS YEAR ENDED CASH FLOWS FROM OPERATING ACTIVITIES Change in Net Assets $ (2,433,920) Adjustments to Reconcile Change in Net Assets to Net Cash Provided for Operating Activities: Depreciation and Amortization Expense 4,211,151 Amortization of Bond Premium (76,811) Net Realized and Unrealized Investment Loss 88,947 Provision for Bad Debts 578,818 Restricted Contributions (23,368) (Increase) Decrease in Assets: Resident Accounts Receivable 1,753,090 Prepaid Expenses (24,496) Universal Settlement Receivable (3,229,914) Other Current Assets (160,836) Deposits (725,000) Due From Third Party Payors 151,078 Increase (Decrease) in Liabilities: Accounts Payable 227,711 Accrued Expenses 6,312 Deferred Revenue 32,044 Due To Third Party Payors 17,351 Other Current Liabilities 139,813 CASH PROVIDED BY OPERATING ACTIVITIES 531,970 CASH FLOWS FROM INVESTING ACTIVITIES Purchase of Investments (15,082,935) Proceeds from Sales and Maturities of Investments 16,029,178 Purchase of Property and Equipment (457,367) Change in Other Assets (11,829) CASH PROVIDED BY INVESTING ACTIVITIES 477,047 CASH FLOWS FROM FINANCING ACTIVITIES Principal Payments on Long Term Debt (1,250,000) Restricted Contributions 23,368 CASH USED FOR FINANCING ACTIVITIES (1,226,632) NET DECREASE IN CASH IN CASH AND CASH EQUIVALENTS (217,615) CASH AND CASH EQUIVALENTS AT BEGINNING OF YEAR 1,279,930 CASH AND CASH EQUIVALENTS AT END OF YEAR $ 1,062,315 SUPPLEMENTAL DISCLOSURES Cash Paid for Interest $ 1,585,500 NON-CASH INVESTING ACTIVITIES Increase in Property and Equipment $ (25,086) Add: Payment of Accrued Construction Costs (139,481) Add: Write-off of Accrued Construction Costs (292,800) Cash Paid for Property and Equipment $ (457,367) See accompanying Notes to Financial Statements. (5)

8 NOTE 1 ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Organization Ozanam Hall of Queens Nursing Home, Inc. (the Home ) is a New York not-forprofit corporation organized to provide a geriatric residential health care facility and home for the aged and infirm. The Home licensed by the State of New York and sponsored by the Carmelite Sisters for the Aged and Infirm (Carmelite Sisters) and the Roman Catholic Dioceses of Brooklyn. It is primarily a rehabilitative and long term health care facility for the aged and infirm. During 2015, the Carmelite System, Inc. (The System) was admitted as a member, resulting in control of the Home via majority voting interest. Ozanam Hall of Queens Nursing Home, Inc. consists of a 432 bed skilled nursing facility in Queens, New York. Resident Service Revenue Resident service revenue is reported at the estimated net realizable amounts. Third-party payor revenues are recorded as indicated in Note 2. All other revenue is recognized on the accrual basis of accounting. Net Assets Net assets of the Home are classified and reported as follows: Unrestricted Net Assets Net assets that are not subject to donor-imposed stipulations. Temporarily Restricted Net Assets Net assets subject to donor-imposed stipulations that may or will be met either by actions of the Home and/or the passage of time. Permanently Restricted Net Assets Include contributions which require by donor restriction that the corpus be invested in perpetuity, and only the income be made available for operations in accordance with donor restrictions. There were no permanently restricted assets at December 31, Investments Investments in money market funds and equity securities with readily determinable fair values and investments in debt securities are measured at their fair value in the statement of financial position. Investment income or loss (including realized gains and losses on investments, interest and dividends) is included in the excess (deficiency) of revenues over expenses unless the income or loss is restricted by donor or law. Unrealized gains and losses on investments are excluded from excess (deficiency) of revenues over expenses and losses. (6)

9 NOTE 1 ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) Cash and Cash Equivalents The Home considers all short-term debt securities purchased with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents designated for long-term purposes or received with donor-imposed restrictions are not considered cash and cash equivalents for purposes of the statement of cash flows. Accounts Receivable Accounts receivable are recorded net of an allowance for expected losses. The allowance is estimated from historical performance and projections of trends. Credit is extended to customers and collateral is not required. The Home determines delinquent accounts based on individual facts and circumstances. Historically, the Home has not charged interest on accounts that are deemed to be delinquent. The allowance was $1,593,900 at December 31, Assets Limited as to Use Assets limited as to use can include assets restricted through internal designators by the Board of Directors, temporarily restricted by donors, assets set aside by a donor for permanent endowment, assets restricted by a mortgagee, assets held by a trustee under bond indenture agreement and trust arrangements, assets restricted by issuers of letters of credit, and security deposits held in escrow, as applicable. Property and Equipment Property and equipment are recorded at cost. Assets are capitalized if they have an estimated useful life greater than one year and a value over $500. Donated property is recorded at its estimated fair value at the date of receipt. Gifts of long-lived assets are recorded at their fair market value at the date of donation and reported as unrestricted support unless explicit donor stipulations specify how the assets are to be used, and gifts of cash or other assets that must be used to acquire long-lived assets are reported as restricted support. Absent explicit donor stipulation about how long those assets must be maintained, expiration of donor restrictions are reported when the donated or acquired long-lived assets are placed into service. Depreciation is computed using the straight-line method over the estimated useful life of the assets. The Home uses estimated lives of between 5 and 40 years. Deferred Financing Charges Deferred financing charges are amortized over the period the obligation is outstanding using the straight line method. Amortization charged to operations was $83,628 for (7)

10 NOTE 1 ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) Bond Premium Bond premium, which is recorded as an increase of long-term debt, is being amortized over the life of the bonds using the straight line method, which approximates the effective interest method. Amortization credited to operations, which is included as a component of interest expense, amounted to $76,811 in Fair Value Measurement The Home categorizes its assets and liabilities measured at fair value into a threelevel hierarchy based on the priority of the inputs to the valuation technique used to determine fair value. The fair value hierarchy gives the highest priority to quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). If the inputs used in the determination of the fair value measurement fall within different levels of the hierarchy, the categorization is based on the lowest level input that is significant to the fair value measurement. Assets and liabilities valued at fair value are categorized based on the inputs to the valuation techniques as follows: Level 1 Inputs that utilize quoted prices (unadjusted) in active markets for identical assets or liabilities that the Home has the ability to access. Level 2 Inputs that include quoted prices for similar assets and liabilities in active markets and inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument. Fair values for these instruments are estimated using pricing models, quoted prices of securities with similar characteristics, or discounted cash flows. Level 3 Inputs that are unobservable inputs for the asset or liability, which are typically based on an entity s own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input that is significant to the fair value measurement in its entirety. (8)

11 NOTE 1 ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) Restricted and Unrestricted Revenue and Support Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions. Promotional Advertising Promotional advertising costs are expensed as incurred. Operating Income (Loss) The Home s statement of activities distinguishes between unrestricted operating and nonoperating gains (losses). Operating revenues result from transactions associated with providing health care services, the Home s principal activity. The nonoperating gains and losses are peripheral or incidental transactions of the Home not deemed by management to be major or central to the provision of health care services and investment income and net realized gains or losses on investments. Excess (Deficiency) of Revenues over Expenses The statement of activities includes excess (deficiency) of revenues over expenses. Changes in unrestricted net assets which are excluded from excess (deficiency) of revenues over expenses, consistent with industry practice, include the change in net unrealized gains (losses) on investments, transfers of assets to and from affiliates for other than goods and services, and contributions of long-lived assets (including assets acquired using contributions which, by donor restriction, were to be used for the purpose of acquiring such assets). Income Taxes Ozanam Hall of Queens Nursing Home, Inc. is a not-for-profit corporation as described in section 501(c)(3) of the Internal Revenue Code and is exempt from federal and state income taxes on related income pursuant to section 501(a) of the code. The 2012 through 2015 tax years are open for examination by federal and state taxing authorities. Functional Expenses The costs of providing the various programs and other activities of the Home have been summarized in Note 12. Certain costs have been allocated between program and supporting services. (9)

12 NOTE 1 ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) Estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates. Deposits Deposits consist of funds on account with the Organization s worker s compensation insurance provider. Insurance Claims and Receivables In accordance with accounting standards, the Home records expected insurance recoveries of claim settlements in the statement of financial position, not netted against accrued losses. Receivables are evaluated for collectability. At December 31, 2015, the Home has recorded a gross receivable in insurance proceeds receivable and a gross liability in insurance liability as further explained in Note 11. All pending claims were fully covered by insurance. The accruals had no impact on net income. Subsequent Events In preparing these financial statements, the Home has evaluated events and transactions for potential recognition or disclosure through June 10, 2016, the date the financial statements were available to be issued. NOTE 2 PATIENT SERVICE REVENUES FROM THIRD PARTY PAYORS Summary of the Payment Arrangements with Third Party Payors: Medicaid - Standard Payments to Nursing Facilities Inpatient services rendered to Medicaid program beneficiaries are at prospectively determined per-diem rates. These rates vary according to a patient classification system that is based on clinical, diagnostic and other factors. In addition, a portion of the reimbursement rate is based on the actual capital-related costs of the Home. Under the New York Medicaid reimbursement system, the non-capital Medicaid reimbursement from New York State is provided under a statewide pricing methodology that incorporates 2007 New York State allowable costs trended forward, facility-specific patient acuity levels and a wage adjustment that blends regional and facility-specific wage information. (10)

13 NOTE 2 PATIENT SERVICE REVENUES FROM THIRD PARTY PAYORS (CONTINUED) Medicare Prospective Payment System The Home receives reimbursement for the care of certain patients under the federally sponsored Medicare prospective payment system (PPS) through an insurance intermediary. The federal rates utilize facility case-mix resident assessment data, completed by the Home to assign patients into Resource Utilization Groups (RUGS). Organizations must complete the resident assessments according to a specific time schedule designed for Medicare payment. Organizations that do not comply with this requirement will be paid at a default payment (the lowest of the federal rates) for the days of a patient s care for which the Home is not in compliance. The PPS program mandates the implementation of fee schedules for therapy services to residents not in a covered Part A stay and to non-residents who receive outpatient rehabilitation services from the Home. The Centers for Medicare and Medicaid Services imposed a limit for both physical therapy (including speech therapy) and occupational therapy, except for certain medical conditions. Due From/To Third Party Payors At December 31, 2015, the Home recorded a receivable of $8,052,399 from the New York State Department of Health Medicaid program for the appeal of reimbursable depreciation related to the renovation of the Home s exterior. Management believes this amount to be fully collectible and has not established an allowance for doubtful accounts related to the above. In addition to the above, the Home recorded an additional estimated receivable of $1,125,933 and liability of $377,200 for various payment adjustments, appeals, and balances due to third party payors, as of December 31, The amounts are included under the captions of Due from Third Party Payors and Due to Third Party Payors respectively, on the accompanying Statement of Financial Position and Net Resident Service Revenue on the Statement of Activities and Changes in Net Assets to the extent not previously recorded. The Home has also recorded a provision for estimated settlements of any retroactive revenue adjustments of $234,705 under the caption Due from Third Party Payors as of December 31, Universal Settlement The Home entered into a Universal Settlement Agreement with the New York State Department of Health in an effort to cease pending rate appeals and litigation that dispute any prior reimbursement methodology. The Home has agreed in exchange for payments to release any known or unknown claims brought or could be brought on or before March 9, 2016, the effective date of the agreement, unless specifically excluded from the agreement. (11)

14 NOTE 2 PATIENT SERVICE REVENUES FROM THIRD PARTY PAYORS (CONTINUED) Universal Settlement (Continued) The appeal of reimbursable depreciation related to the renovation of the Home s exterior and other appeals, as described previously in Note 2, are specifically excluded from the Universal Settlement, and are still considered to be an active appeal. At December 31, 2015, the Home reported a receivable of $3,229,914 to be received over 5 years, with a current portion of $1,291,966. Management believes the amount to be fully collectable. The amounts have also been reflected under the caption of Net Resident Service Revenue on the Statement of Activities and Changes in Net Assets to the extent not previously recorded. NOTE 3 CONCENTRATION OF CREDIT RISK Financial instruments that potentially subject the Home to concentrations of credit risk consist principally of the following: Cash and Cash Equivalents For purposes of reporting cash flows, the Home considers all highly liquid debt instruments with an initial maturity of less than three months to be cash equivalents. The balances are insured by the Federal Deposit Insurance Corporation (FDIC) up to certain limits. At times, cash in bank may exceed FDIC insurable limits. Investments The Home has investments in the amount of $7,532,166 as of December 31, Accounts Receivable The Home extends unsecured credit to its private residents and residents covered under third-party payor arrangements. Accounts receivable from private residents and third-party payors totaled $18,956,134 at December 31, Approximately 5% and 75% of the Home s accounts receivable is due from Medicare and Medicaid, respectively. See Note 2 for details of third-party payor arrangements. Assets Limited as to Use The Home has assets limited as to use comprised of cash and cash equivalents in the amount of $3,547,906 as of December 31, Major Customers At December 31, 2015, approximately 19% and 61% of the Home s operating revenue is derived from Medicare and Medicaid, respectively. (12)

15 NOTE 4 ASSETS LIMITED AS TO USE Board Designated Board designated assets include certain funds received as donations which have been designated by the board to fund future building improvements, renovations and possible program expansion. Trust Indenture Under terms of a master trust indenture, the Organization is required to maintain and fund various escrow accounts. These escrows are held in trust and disbursements are made in accordance with the master trust indenture. Approved withdrawals from the escrow accounts not spent at December 31, 2015 amounted to $574,925. Temporarily Restricted Temporarily restricted net assets at December 31, 2015 consist of $504,914 in donations restricted for the Home s building renovation project. NOTE 5 INVESTMENTS The Home has investments that are unrestricted; investments are as follows as of December 31: 2015 Investments: Cost Market Money Market Funds $ 1,726,047 $ 1,726,024 Common Stocks 2,302,094 2,812,409 Government Obligations 3,541,744 3,539,396 Total Investments $ 7,569,885 $ 8,077,829 Investment Classifications: Market Investments Limited as to Use $ 545,663 Investments Unrestricted 7,532,166 Total Investments $ 8,077,829 (13)

16 NOTE 6 PROPERTY AND EQUIPMENT Property and equipment consist of the following at December 31: 2015 Land & Land Improvements $ 1,190,709 Building & Building Improvements 81,428,587 Equipment 6,608,992 Major Movable $ 4,494,192 93,722,480 Less Accumulated Depreciation $ (43,589,572) 50,132,908 Depreciation expense charged to operations was $4,127,523 for NOTE 7 LONG-TERM DEBT The Home is obligated under long-term debt as follows at December 31: 2015 Revenue Bonds, Series 2006 $ 30,735,000 Less current portion (1,310,000) Add unamortized bond premium 1,216,174 Total Long Term Debt $ 30,641,174 The mortgage payable is associated with the fixed rate tax exempt bonds issued as Dormitory Authority of the State of New York Ozanam Hall of Queens Nursing Home, Inc. Revenue Bonds, Series 2006, dated December 19, The bonds are a combination of serial bonds and term bonds, with a coupon rate ranging from 3.75% to 5.00%. Proceeds from the bonds were used to repay a bridge loan and to fund the Home s major modernization project. Interest expense related to the refinanced debt is expensed and the interest expense associated with the capital project was capitalized during the construction term. The total interest capitalized during construction was $5,707,366, and the capitalized interest has been recorded as a component of the cost of building improvements and is being depreciated accordingly. The Home s major modernization project was substantially completed as of March 31, 2010, with subsequent interest payments charged to expense as incurred. By the provisions of the documents associated with the Home s mortgage payable, the Home is required to meet certain covenants, including a debt service coverage ratio. Interest expense on the above debt was $1,498,272 for the year ended December 31, 2015, and is reported net of bond issuance premium amortization of $83,628. (14)

17 NOTE 7 LONG-TERM DEBT (CONTINUED) The bonds are secured by a 10 year letter of credit with the Bank renewable annually. The letter of credit is secured by substantially all assets of the Home. Letter of credit fees were $275,130 for the year ended December 31, 2015, and are reported as a component of interest expense. Maturities of debt related to the capital renovation project began with the first payment of principal paid on November 1, 2010, and will continue each November 1 thereafter as follows: Revenue Bonds, Series 2006 $ 30,735,000 Less current portion (1,310,000) Add unamortized bond premium 1,216,174 Total Long Term Debt $ 30,641,174 NOTE 8 RETIREMENT PLAN The Home participates in a multi-employer defined benefit pension plan administered by the Dioceses of Brooklyn (the Plan ). Pension expense for the year ended December 31, 2015 was $1,517,677. The Plan is currently underfunded by an undetermined amount. The Home has not evaluated the effect of such underfunding on future contributions as information is not available as to the vested and non-vested earned benefits and plan assets for only the employees of the Home, but believes that any increased contributions will not materially affect its financial condition in the near term. NOTE 9 FAIR VALUE OF FINANCIAL INSTRUMENTS & FAIR VALUE MEASUREMENTS Cash and cash equivalents carrying amount approximates fair value because of the short maturities of these financial instruments. The fair value of assets limited as to use and level 1 marketable securities are obtained from various quotation services. Level 2 marketable securities consist mainly of fixed government securities measured based on quoted market prices of similar assets. The fair value of bonds payable are based on quoted market prices. The estimated fair value of bonds payable is $31,213,300 at December 31, The Home uses fair value measurements to record fair value adjustments to certain assets to determine fair value disclosures. For additional information on how the Home measures fair value, refer to Note 1 Organization and Summary of Significant Accounting Policies. (15)

18 NOTE 9 FAIR VALUE OF FINANCIAL INSTRUMENTS & FAIR VALUE MEASUREMENTS (CONTINUED) The following table presents the Home s fair value hierarchy for those assets measures at fair value on a recurring basis as of December 31: Level 1 Level 2 Level 3 Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Balance December 31, 2015 Money Market Funds $ 1,726,024 $ - $ - $ 1,726,024 Common Stocks 2,812, ,812,409 Government Obligations 470,750 3,068,646-3,539,396 Total $ 5,009,183 $ 3,068,646 $ - $ 8,077,829 NOTE 10 RELATED PARTY TRANSACTIONS Certain members of the administrative and supervisory personnel of the Home are members of the Carmelite Sisters. Salaries charged to operations from the Carmelite Sisters amounted to $507,583 in Additionally, the Home received reimbursement from the Carmelite Sisters of $225,726 in 2015 for room and board. The Home paid dues to The System of $429,304 for the year ended December 31, Centralized Insurance In October 2003, The System acquired shares of stock in Preferred Professional Insurance Company ( PPIC ). PPIC is owned by Catholic Healthcare Systems and supports the Catholic health care ministry of its owners through an array of insurance products. In August 2014, PPIC was acquired by another company and the shares of stock were redeemed. PPIC continues to provide insurance coverage to the System affiliates. (16)

19 NOTE 10 RELATED PARTY TRANSACTIONS (CONTINUED) Centralized Insurance (Continued) The System established a centralized insurance program on behalf of The System Affiliates. Insurance coverage for various lines of insurance is available through the program under arrangements with PPIC and other carriers. Health Insurance Effective January 1, 2008, The System established a Health and Welfare Trust ( Trust ) for the purposes of funding a self-insured health benefit program on behalf of The System Affiliates ( Affiliates ). In connection with formation of the Trust, the Affiliates have delegated administration of the program to The System. These administrative duties include collection of health benefit premiums from the Affiliates, payment of medical and pharmaceutical claims to the third party administrator and the purchase of stop-loss reinsurance for the program. Annual funding levels are developed on an actuarial basis by the third party administrator using aggregate program claims history, national and regional medical trends and the balance in the Trust. Each participant in the program shares equally in the annual prospective funding determination. The Health and Welfare Trust had an accumulated deficit in 2011 and as a result, the participants in the program provided a deposit to the Trust to serve as a reserve to offset a portion of the deficit, the Home made a deposit of $90,000 in 2011 which is reflected in other assets on the statement of financial position. NOTE 11 COMMITMENTS AND CONTINGENCIES Third-Party Payors A significant portion of the Home s net revenues and accounts receivable are derived from services reimbursable under the Medicaid and the Medicare programs. There are numerous healthcare reform proposals being considered on the federal and state levels. The Home cannot predict at this time whether any of these proposals will be adopted or, if adopted and implemented, what effect such proposals would have on the Home. The Home s Medicare Claims are also subject to audit or medical review by the fiscal intermediary (FI). It is not possible at this time to determine whether the Home s claims will be subjected to post payment review by the FI. (17)

20 NOTE 11 COMMITMENTS AND CONTINGENCIES (CONTINUED) Medical Malpractice Claims The Home purchases professional and general liability insurance to cover medical malpractice claims. Through December 31, 2015, the Home was covered by a claims-made basis policy. There are no known claims and incidents that may result in the assertion of additional claims, as well as no claims from unknown incidents that may be asserted arising from services provided to patients. Based on historical evidence, the Home believes that a reserve for claims from unknown incidents is not necessary, and as such, no reserve has been accrued in the financial statements as of December 31, The Home has known claims pending against it which arose in the normal course of business. In the opinion of management, other than the known claims noted above, no claims have been asserted against the Home which, either individual or in the aggregate, are considered to be material or will be in excess of its insurance coverage. However, an estimated accrual has been recorded under the caption of Insurance Liability, with an offsetting receivable under the caption Insurance Proceeds Receivable in the amount of $395,570 for the expected recoveries of the above noted claims as of December 31, Collective Bargaining Agreements Approximately 80% of the Home s employees are covered by two separate collective bargaining agreements. Both collective bargaining agreements expired subsequent to year end on March 31, The Home is currently bargaining in good faith with the two Unions involved, but cannot estimate when new agreements will be reached. The Home cannot currently estimate the potential financial impact of the ongoing negotiations. NOTE 12 FUNCTIONAL EXPENSES The Home s expenses related to the provision of its mission based on services are classified as follows for the year ended December 31: 2015 Program $ 48,198,618 Administrative 8,136,217 Total Expenses $ 56,334,835 (18)