On June 28, 2023 a
Exhibit,Appendix
was filed
involving a dispute between
People Of The State Of New York, By Letitia James, Attorney General Of The State Of New York,
and
Abraham Operations Associates Llc Dba Beth Abraham Center For Rehabilitation And Nursing,
Aharon Lantzitsky,
Amir Abramchik,
Aron Gittleson,
Beth Rozenberg,
Bis Funding Capital Llc,
Centers For Care Llc Dba Centers Health Care,
Cfsc Downstate Llc,
Daryl Hagler,
David Greenberg,
Delaware Operations Associates Llc Dba Buffalo Center For Rehabilitation And Nursing,
Delaware Real Property Associates Llc,
Elliot Kahan,
Hollis Operating Co Llc Dba Holliswood Center For Rehabilitation And Healthcare,
Hollis Real Estate Co Llc,
Jeffrey Sicklick,
Jonathan Hagler,
Kenneth Rozenberg,
Leo Lerner,
Light Property Holdings Ii Associates Llc,
Mordechai Moti Hellman,
Reuven Kaufman,
Schnur Operations Associates Llc Dba Martine Center For Rehabilitation And Nursing,
Skilled Staffing Llc,
Sol Blumenfeld,
for Commercial - Other - Commercial Division
in the District Court of New York County.
Preview
FILED: NEW YORK COUNTY CLERK 06/28/2023 02:27 PM INDEX NO. 451549/2023
NYSCEF DOC. NO. 68 RECEIVED NYSCEF: 06/28/2023
BUDIMIR EXHIBIT 9C
FILED: HOLLISWOOD
7003409N NEW YORKCENTER
COUNTY CLERK 06/28/2023 02:27
FOR REHABILITATION PM INDEX NO. 451549/2023
DCN: 12301510
Report
NYSCEF Period: 01/01/20
DOC. NO. 68 - 12/31/20 RHCF-4 Cost Report 16-Jun-22,
RECEIVED 05:0006/28/2023
NYSCEF: PM
Notes to Financial Statements
1) Organization:
Hollis Operating Co., LLC (Facility), a limited liability company,
was formed t
2) Summary of Significant Accounting Policies:
The accounting policies that affect the significant elements of the
financial s
Basis of Accounting b
The Facility maintains its books and prepares its financial
statements on the a
Use of Estimates b
The preparation of financial statements in conformity with generally
accepted ac
Cash b
For purposes of the statement of cash flows, the Facility consider
time deposit
Fixed Assets b
Property and equipment including items acquired under capital leases are
recorde
Residentsb
Residentsbu
Inventory b
Inventories, which consist primarily of food and supplies,
are stated at the l
Goodwill and Other Intangible Assets b
Intangible assets subject to amortization are shown net of accumulated
amortizat
2) Summary of Significant Accounting Policies (Continued):
Accrued Payroll b
Most employees earn credits during the current year for vacations to be
taken in
Patient Care Revenue b
Major portions of the Facilitybi
Medicaid revenue under the current statewide pricing methodology is based
on a b
Patient acuity is based on submission of a minimum data set (MDS)
assessment for
NYS implemented a new managed care Medicaid formula in February 2015,
whereby Me
Advertising b
Advertising costs are expensed as incurred and included in general and
administr
Income Taxes b
Hollis Operating Co., LLC, is treated as a partnership for income tax
FILED: purposes,
NEW YORK COUNTY CLERK 06/28/2023 02:27 PM INDEX NO. 451549/2023
NYSCEF DOC. NO. 68 RECEIVED NYSCEF: 06/28/2023
2) Summary of Significant Accounting Policies (Continued):
Uncertainty in Income Taxes b
Management has determined that there are no material uncertain tax
positions th
3) Accounts Receivable:
The Facility grants credit, without collateral, to its patients,
the majority o
Concentration
of Risk
Medicaid Patients $ 2,406,530 52.72%
Medicare Patients 1,355,386 29.69
Private & HMO 803,700 17.59
64,565,116 100.00%
Less: Allowance for Doubtful Accounts (111,000)
$ 4,454,116
Management provides for probable uncollectible amounts through a charge to
earni
4) Intangible Assets:
The following is a schedule of the Facilityb
Gross Carrying
Amount Accumulated
Amortization Estimated
Useful Life
Goodwill $16,376,390 0 N/A
Organizational Cost 66,643 $66,643 5 - years
5) Loan Receivable:
In 2017, the Facility loaned $7,951,200 to CBO Lending, LLC. This note is
non in
6) Line of Credit and Notes Payable:
a) In 2013, the Facility obtained a revolving credit agreement with
Amalgamated
b) On December 1, 2013, the Facility entered into an unsecured loan
agreement wi
c) Effective May 7, 2013, the Facility obtained an unsecured loan form
Hollis Re
As of December 31, 2020, combined principal payments for the next five
years are
2021 $ 286,126
2022 300,080
2023 1,774,724
2024 293,926
2025 308,964
Thereafter 14,072,323
$ 17,036,143
FILED: NEW YORK COUNTY CLERK 06/28/2023 02:27 PM INDEX NO. 451549/2023
NYSCEF DOC. NO. 68 RECEIVED NYSCEF: 06/28/2023
7) Lease Commitments:
a) The Facility has a non-cancelable lease for its building with
Hollis Real Est
Future required minimum lease payments are as follows:
2021 $ 4,864,509
2022 4,864,509
2023 4,864,509
2024 4,864,509
2025 4,864,509
Thereafter 82,696,653
$ 107,019,198
b) The Facility also rents additional space on a month-to-month basis.
The total
8) Union:
The majority of the Facility's employees are members of Local 1199 S.E.I.U.
Al
9) Multiemployer Pension Plan:
The facilitybd
Pension
Trust Fund
EIN/PN
PPA Zone Status 2020
FIP/RP Status Pending/
Implemented
Contributions by the Facility
2020
Surcharge Imposed
Expiration Date of CBA
1199 SEIU
13-3604862001
Green
N/A
$1,046,165
No
9/30/2021
10) Revenue Assessment:
Effective April 1, 2005, all New York State facilities were
assessed a 6% reven
11) Nursing Home Quality Initiative:
The New York State Quality Initiative (NHQI) is an annual
quality and performa
FILED: NEW YORK COUNTY CLERK 06/28/2023 02:27 PM INDEX NO. 451549/2023
NYSCEF DOC. NO. 68 RECEIVED NYSCEF: 06/28/2023
12) 1% Supplemental Payment:
The 2019-2020 State budget includes a 1% supplemental payment to reimburse
facil
13) Health and Human Services Stimulus Packages:
The U.S. Department of Health and Human Services distributed relief funds
to ski
14) Coronavirus Pandemic:
In December 2019, an outbreak of a novel strain of Corona virus (COVID-19)
origi
15) Subsequent Events:
The Facility has evaluated subsequent events through dateoffinancial, the
date w
Preview
FILED: NEW YORK COUNTY CLERK 06/28/2023 02:27 PM INDEX NO. 451549/2023 NYSCEF DOC. NO. 68 RECEIVED NYSCEF: 06/28/2023 BUDIMIR EXHIBIT 9C FILED: HOLLISWOOD 7003409N NEW YORKCENTER COUNTY CLERK 06/28/2023 02:27 FOR REHABILITATION PM INDEX NO. 451549/2023 DCN: 12301510 Report NYSCEF Period: 01/01/20 DOC. NO. 68 - 12/31/20 RHCF-4 Cost Report 16-Jun-22, RECEIVED 05:0006/28/2023 NYSCEF: PM Notes to Financial Statements 1) Organization: Hollis Operating Co., LLC (Facility), a limited liability company, was formed t 2) Summary of Significant Accounting Policies: The accounting policies that affect the significant elements of the financial s Basis of Accounting b The Facility maintains its books and prepares its financial statements on the a Use of Estimates b The preparation of financial statements in conformity with generally accepted ac Cash b For purposes of the statement of cash flows, the Facility consider time deposit Fixed Assets b Property and equipment including items acquired under capital leases are recorde Residentsb Residentsbu Inventory b Inventories, which consist primarily of food and supplies, are stated at the l Goodwill and Other Intangible Assets b Intangible assets subject to amortization are shown net of accumulated amortizat 2) Summary of Significant Accounting Policies (Continued): Accrued Payroll b Most employees earn credits during the current year for vacations to be taken in Patient Care Revenue b Major portions of the Facilitybi Medicaid revenue under the current statewide pricing methodology is based on a b Patient acuity is based on submission of a minimum data set (MDS) assessment for NYS implemented a new managed care Medicaid formula in February 2015, whereby Me Advertising b Advertising costs are expensed as incurred and included in general and administr Income Taxes b Hollis Operating Co., LLC, is treated as a partnership for income tax FILED: purposes, NEW YORK COUNTY CLERK 06/28/2023 02:27 PM INDEX NO. 451549/2023 NYSCEF DOC. NO. 68 RECEIVED NYSCEF: 06/28/2023 2) Summary of Significant Accounting Policies (Continued): Uncertainty in Income Taxes b Management has determined that there are no material uncertain tax positions th 3) Accounts Receivable: The Facility grants credit, without collateral, to its patients, the majority o Concentration of Risk Medicaid Patients $ 2,406,530 52.72% Medicare Patients 1,355,386 29.69 Private & HMO 803,700 17.59 64,565,116 100.00% Less: Allowance for Doubtful Accounts (111,000) $ 4,454,116 Management provides for probable uncollectible amounts through a charge to earni 4) Intangible Assets: The following is a schedule of the Facilityb Gross Carrying Amount Accumulated Amortization Estimated Useful Life Goodwill $16,376,390 0 N/A Organizational Cost 66,643 $66,643 5 - years 5) Loan Receivable: In 2017, the Facility loaned $7,951,200 to CBO Lending, LLC. This note is non in 6) Line of Credit and Notes Payable: a) In 2013, the Facility obtained a revolving credit agreement with Amalgamated b) On December 1, 2013, the Facility entered into an unsecured loan agreement wi c) Effective May 7, 2013, the Facility obtained an unsecured loan form Hollis Re As of December 31, 2020, combined principal payments for the next five years are 2021 $ 286,126 2022 300,080 2023 1,774,724 2024 293,926 2025 308,964 Thereafter 14,072,323 $ 17,036,143 FILED: NEW YORK COUNTY CLERK 06/28/2023 02:27 PM INDEX NO. 451549/2023 NYSCEF DOC. NO. 68 RECEIVED NYSCEF: 06/28/2023 7) Lease Commitments: a) The Facility has a non-cancelable lease for its building with Hollis Real Est Future required minimum lease payments are as follows: 2021 $ 4,864,509 2022 4,864,509 2023 4,864,509 2024 4,864,509 2025 4,864,509 Thereafter 82,696,653 $ 107,019,198 b) The Facility also rents additional space on a month-to-month basis. The total 8) Union: The majority of the Facility's employees are members of Local 1199 S.E.I.U. Al 9) Multiemployer Pension Plan: The facilitybd Pension Trust Fund EIN/PN PPA Zone Status 2020 FIP/RP Status Pending/ Implemented Contributions by the Facility 2020 Surcharge Imposed Expiration Date of CBA 1199 SEIU 13-3604862001 Green N/A $1,046,165 No 9/30/2021 10) Revenue Assessment: Effective April 1, 2005, all New York State facilities were assessed a 6% reven 11) Nursing Home Quality Initiative: The New York State Quality Initiative (NHQI) is an annual quality and performa FILED: NEW YORK COUNTY CLERK 06/28/2023 02:27 PM INDEX NO. 451549/2023 NYSCEF DOC. NO. 68 RECEIVED NYSCEF: 06/28/2023 12) 1% Supplemental Payment: The 2019-2020 State budget includes a 1% supplemental payment to reimburse facil 13) Health and Human Services Stimulus Packages: The U.S. Department of Health and Human Services distributed relief funds to ski 14) Coronavirus Pandemic: In December 2019, an outbreak of a novel strain of Corona virus (COVID-19) origi 15) Subsequent Events: The Facility has evaluated subsequent events through dateoffinancial, the date w