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GROTON COMMUNITY HEALTH CARE CENTER, INC.

Company Details

Name: GROTON COMMUNITY HEALTH CARE CENTER, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 30 Apr 1973 (52 years ago)
Entity Number: 260026
ZIP code: 13073
County: Tompkins
Place of Formation: New York
Address: 100 SYKES STREET, GROTON, NY, United States, 13073

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GROTON COMMUNITY HEALTH CARE CENTER, INC. 403(B) PLAN 2023 237300255 2024-09-19 GROTON COMMUNITY HEALTH CARE CENTER , INC. 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073
GROTON COMMUNITY HEALTH CARE CENTER, INC. 403(B) PLAN 2022 237300255 2024-01-04 GROTON COMMUNITY HEALTH CARE CENTER , INC. 122
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s mailing address 120 SYKES STREET, GROTON, NY, 13073
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073

Number of participants as of the end of the plan year

Active participants 72
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 5
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 14
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0
GROTON COMMUNITY HEALTH CARE CENTER, INC 2022 237300255 2023-10-12 GROTON COMMUNITY HEALTH CARE CENTER 122
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s mailing address 120 SYKES STREET, GROTON, NY, 13073
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073

Number of participants as of the end of the plan year

Active participants 72
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 5
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 14
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0
GROTON COMMUNITY HEALTH CARE CENTER, INC 2021 237300255 2022-08-22 GROTON COMMUNITY HEALTH CARE CENTER 106
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073
GROTON COMMUNITY HEALTH CARE CENTER, INC 2020 237300255 2021-07-23 GROTON COMMUNITY HEALTH CARE CENTER 114
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073
GROTON COMMUNITY HEALTH CARE CENTER, INC 2019 237300255 2020-07-10 GROTON COMMUNITY HEALTH CARE CENTER 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073
GROTON COMMUNITY HEALTH CARE CENTER, INC 2018 237300255 2019-10-10 GROTON COMMUNITY HEALTH CARE CENTER 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073
GROTON COMMUNITY HEALTH CARE CENTER INC 403(B) PLAN 2017 237300255 2018-02-14 GROTON COMMUNITY HEALTH CARE CENTER INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073

Signature of

Role Plan administrator
Date 2018-02-14
Name of individual signing NASAR KHAN
GROTON COMMUNITY HEALTH CARE CENTER INC 403(B) PLAN 2016 237300255 2017-10-16 GROTON COMMUNITY HEALTH CARE CENTER INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073

Signature of

Role Plan administrator
Date 2017-10-16
Name of individual signing NASAR KHAN
GROTON COMMUNITY HEALTH CARE CENTER INC 403(B) PLAN 2015 237300255 2016-10-05 GROTON COMMUNITY HEALTH CARE CENTER INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 623000
Sponsor’s telephone number 6078985876
Plan sponsor’s address 120 SYKES STREET, GROTON, NY, 13073

Signature of

Role Plan administrator
Date 2016-10-05
Name of individual signing NASAR KHAN

Agent

Name Role Address
GROTON COMMUNITY HEALTH CARE CENTER, INC. Agent 206 WEST SOUTH ST., GROTON, NY, 13073

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 100 SYKES STREET, GROTON, NY, United States, 13073

Filings

Filing Number Date Filed Type Effective Date
C286238-1 2000-03-21 ASSUMED NAME CORP INITIAL FILING 2000-03-21
940908000281 1994-09-08 CERTIFICATE OF AMENDMENT 1994-09-08
A786329-6 1981-07-30 CERTIFICATE OF AMENDMENT 1981-07-30
A267399-12 1975-10-20 CERTIFICATE OF MERGER 1975-10-20
A67926-7 1973-04-30 CERTIFICATE OF INCORPORATION 1973-04-30

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
336447388 0215800 2012-09-18 120 SYKES STREET, GROTON, NY, 13073
Inspection Type Planned
Scope Complete
Safety/Health Health
Close Conference 2012-12-06
Emphasis N: NURSING, N: SSTARG11, P: NURSING
Case Closed 2014-10-30

Violation Items

Citation ID 01001A
Citaton Type Serious
Standard Cited 19100133 A01
Issuance Date 2012-12-12
Current Penalty 2700.0
Initial Penalty 3600.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.133(a)(1): Protective eye equipment was not required where there was a reasonable probability of injury that could be prevented by such equipment: a) Throughout the facility, on or about 9/18/12: Splash goggles were not provided for employees working with corrosive cleaning compounds including, but not limited to Simoniz Full Strength containing 20 % hydrochloric acid.
Citation ID 01001B
Citaton Type Serious
Standard Cited 19101200 H03 III
Issuance Date 2012-12-12
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 5
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1200(h)(3)(iii): Employee training did not include the measures employees can take to protect themselves from chemical hazards, including specific procedures the employer had implemented to protect employees from exposure to hazardous chemicals, such as appropriate work practices, emergency procedures and personal protective equipment to be used: a) Throughout the facility, on or about 9/18/12: Information on the location and use of eyewashes was not covered for employees working with corrosive cleaning compounds including, but not limited to Simoniz Full Strength containing 20 % hydrochloric acid.
Citation ID 01002
Citaton Type Serious
Standard Cited 19100212 A01
Issuance Date 2012-12-12
Current Penalty 2025.0
Initial Penalty 2700.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 5
Gravity 1
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.212(a)(1): One or more methods of machine guarding was not provided to protect the operator and other employees in the machine area from hazards such as those created by point of operation, ingoing nip points, rotating parts, flying chips and sparks: a) Dietary area, on or about 9/18/12: Protective guards were not placed on garbage disposal opening to protect against projectile hazards.
Citation ID 01003A
Citaton Type Serious
Standard Cited 19101030 C01 V
Issuance Date 2012-12-12
Abatement Due Date 2013-01-16
Current Penalty 3375.0
Initial Penalty 4500.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 20
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1030(c)(1)(v): The employer, who is required to establish an Exposure Control Plan, did not solicit input from non-managerial employees responsible for direct patient care who are potentially exposed to injuries from contaminated sharps in the identification, evaluation and selection of effective engineering and work practice controls and did not document the solicitation in the Exposure Control plan: a) Throughout the facility, on or about 9/18/12: The annual review of the Exposure Control Plan did not include documentation of employee input into current use of needles equipped with sharps injury protection. Abatement certification must be submitted for this item.
Citation ID 01003B
Citaton Type Serious
Standard Cited 19101030 D04 IV A 2
Issuance Date 2012-12-12
Abatement Due Date 2013-01-16
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 20
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1030(d)(4)(iv)(A)(2): Contaminated laundry was not placed and/or transported in bags or containers which were labeled or color-coded in accordance with 29 CFR 1910.1030(g)(1)(i): a) Misty Meadows, !st Floor, on or about 9/18/12: Clothing contaminated with Clostridium difficile was not red bagged when removed from room and transported to laundry area. Abatement certification must be submitted for this item.
Citation ID 01003C
Citaton Type Serious
Standard Cited 19101030 G02 VII F
Issuance Date 2012-12-12
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 20
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1030(g)(2)(vii)(F): The bloodborne pathogens training program did not contain an explanation of the use or limitations of methods that would prevent or reduce exposure including appropriate engineering controls, work practices or personal protective equipment: a) Throughout the facility, on or about 9/18/12: Training on bloodborne pathogens did not include the proper use of safety needles with engineered sharps injury protection and how to activate the safety mechanism.
Citation ID 01004A
Citaton Type Serious
Standard Cited 19101030 F03
Issuance Date 2012-12-12
Abatement Due Date 2013-01-16
Current Penalty 3375.0
Initial Penalty 4500.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 1
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1030(f)(3): Following a report of an exposure incident, the employer did not make immediately available to the exposed employee a confidential medical evaluation or follow-up: a) Dirty linen room, 1st floor of Groton Nursing Home, on or about 9/2/12: An employee stuck by a dirty needle found in a garbage bag was not sent immediately for a medical evaluation. The employee was sent 8 hours later at the end of the shift. Abatement certification must be submitted for this item.
Citation ID 01004B
Citaton Type Serious
Standard Cited 19101030 G02 VII K
Issuance Date 2012-12-12
Abatement Due Date 2013-01-16
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 104
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1030(g)(2)(vii)(K): The bloodborne pathogens training program did not contain an explanation of the procedure to follow if an exposure incident occurred, including the method of reporting the incident or the medical follow-up that would be made available: a) Throughout the facility, on or about 9/2/12: Training on procedures to follow if an exposure incident should occur was not provided to employees including, but not limited to a maintenance employee stuck by a dirty needle while removing a garbage bag. Abatement certification must be submitted for this item.
Citation ID 01004C
Citaton Type Serious
Standard Cited 19101030 H05 I
Issuance Date 2012-12-12
Abatement Due Date 2012-12-22
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 1
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1030(h)(5)(i): The sharps injury log did not contain the minimum required information listed in subitems (A)-(C): a) Throughout the facility, on or about 9/2/12: For a needlestick occurrring on 9/2/12, the sharps injury log did not include: 1) the type and brand of device involved, and 2) the name of the department or area where incident occurred. Abatement certification must be submitted for this item.
Citation ID 02001
Citaton Type Other
Standard Cited 19040008 A
Issuance Date 2012-12-12
Abatement Due Date 2012-12-22
Current Penalty 675.0
Initial Penalty 900.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 1
FTA Current Penalty 0.0
Citation text line 29 CFR 1904.8(a): Employee's privacy was not protected when the employee's name was entered on the OSHA 300 Log: a) Throughout the facility, on or about 9/2/12: An entry on the 2012 OSHA 300 log included the name of an employee incurring a needlestick on 9/2/12. Abatement certification must be submitted for this item.
Citation ID 02002
Citaton Type Other
Standard Cited 19101030 H01 II B
Issuance Date 2012-12-12
Abatement Due Date 2013-01-16
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-12-20
Nr Instances 1
Nr Exposed 6
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1030(h)(1)(ii)(B): The medical record for an employee with occupational exposure did not include a copy of the employee's hepatitis B vaccination status, including the dates of all the hepatitis B vaccinations or any medical records relative to the employee's ability to receive vacination as required by 29 CFR 1910.1030(f)(2): a) Throughout the facility, on or about 9/18/12: Record for the hepatitis B vaccine status of six employees was not available. Abatement certification must be submitted for this item.
304586571 0215800 2001-07-03 120 SYKES STREET, GROTON, NY, 13073
Inspection Type Planned
Scope Complete
Safety/Health Safety
Close Conference 2001-07-17
Emphasis S: NURSING HOMES, N: MMTARG
Case Closed 2001-08-20

Violation Items

Citation ID 01001A
Citaton Type Serious
Standard Cited 19100304 A02
Issuance Date 2001-08-06
Abatement Due Date 2001-08-09
Current Penalty 536.25
Initial Penalty 825.0
Nr Instances 1
Nr Exposed 3
Gravity 01
Citation ID 01001B
Citaton Type Serious
Standard Cited 19100305 B01
Issuance Date 2001-08-06
Abatement Due Date 2001-08-09
Nr Instances 2
Nr Exposed 3
Gravity 02
Citation ID 02001
Citaton Type Other
Standard Cited 19100147 C04 II
Issuance Date 2001-08-06
Abatement Due Date 2001-09-10
Nr Instances 1
Nr Exposed 3
Gravity 01
Citation ID 02002
Citaton Type Other
Standard Cited 19100212 A05
Issuance Date 2001-08-06
Abatement Due Date 2001-08-09
Nr Instances 1
Nr Exposed 1
Gravity 01
304586605 0215800 2001-07-03 120 SYKES STREET, GROTON, NY, 13073
Inspection Type Planned
Scope Complete
Safety/Health Health
Close Conference 2001-07-10
Emphasis S: NURSING HOMES, N: MMTARG
Case Closed 2001-08-20

Violation Items

Citation ID 01001
Citaton Type Serious
Standard Cited 19100133 A01
Issuance Date 2001-08-06
Abatement Due Date 2001-08-08
Current Penalty 372.5
Initial Penalty 573.0
Nr Instances 2
Nr Exposed 2
Gravity 01
Citation ID 01002
Citaton Type Serious
Standard Cited 19101030 D04 IIA
Issuance Date 2001-08-06
Abatement Due Date 2001-09-08
Current Penalty 438.75
Initial Penalty 675.0
Nr Instances 1
Nr Exposed 81
Gravity 01
Citation ID 02001
Citaton Type Other
Standard Cited 19101030 F02 I
Issuance Date 2001-08-06
Abatement Due Date 2001-08-19
Nr Instances 2
Nr Exposed 2
Gravity 01
Citation ID 02002
Citaton Type Other
Standard Cited 19101030 G02 IIA
Issuance Date 2001-08-06
Abatement Due Date 2001-08-09
Nr Instances 4
Nr Exposed 4
Gravity 01

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
23-7300255 Corporation Unconditional Exemption 120 SYKES ST, GROTON, NY, 13073-1231 1974-01
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-12
Asset 1,000,000 to 4,999,999
Income 5,000,000 to 9,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 2187079
Income Amount 9609060
Form 990 Revenue Amount 9534379
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name GROTON COMMUNITY HEALTH CARE CENTER INC
EIN 23-7300255
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name GROTON COMMUNITY HEALTH CARE CENTER INC
EIN 23-7300255
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name GROTON COMMUNITY HEALTH CARE CENTER INC
EIN 23-7300255
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name GROTON COMMUNITY HEALTH CARE CENTER INC
EIN 23-7300255
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name GROTON COMMUNITY HEALTH CARE CENTER INC
EIN 23-7300255
Tax Period 201612
Filing Type E
Return Type 990
File View File

Date of last update: 18 Mar 2025

Sources: New York Secretary of State