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  5. BROTHERS OF MERCY NURSING HOME COMPANY, INC.

BROTHERS OF MERCY NURSING HOME COMPANY, INC.

Company Details

Name: BROTHERS OF MERCY NURSING HOME COMPANY, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 08 Jun 1971 (54 years ago)
Entity Number: 309080
ZIP code: 14031
County: Erie
Place of Formation: New York
Address: 4520 RANSOM RD., CLARENCE, NY, United States, 14031

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
JTZLPHBL4LC1 2023-03-19 10570 BERGTOLD RD, CLARENCE, NY, 14031, 2105, USA 10570 BERGTOLD RD, CLARENCE, NY, 14031, 2105, USA

Business Information
Doing Business As BROTHERS OF MERCY NURSING & REHABILITATION CENTER
Congressional District 27
State/Country of Incorporation NY, USA
Activation Date 2022-02-21
Initial Registration Date 2020-06-10
Entity Start Date 1975-01-01
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JOSEPH WIDMER
Address 10570 BERGTOLD RD, CLARENCE, NY, 14031, USA
Government Business
Title PRIMARY POC
Name TERESA DILLSWORTH
Role ADMINISTRATOR
Address 10570 BERGTOLD RD, CLARENCE, NY, 14031, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BROTHERS OF MERCY HEALTH CARE PLAN 2023 237155198 2025-01-15 BROTHERS OF MERCY NURSING HOME COMPANY INC 440
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 7167597600
Plan sponsor’s DBA name BROTHERS OF MERCY NURSING AND REHABILITATION CENTER
Plan sponsor’s mailing address 10570 BERGTOLD RD, CLARENCE, NY, 140312105
Plan sponsor’s address 10570 BERGTOLD RD, CLARENCE, NY, 140312105

Number of participants as of the end of the plan year
Active participants 403
Retired or separated participants receiving benefits 8
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2025-01-15
Name of individual signing JOSEPH WIDMER
Valid signature Filed with authorized/valid electronic signature
BROTHERS OF MERCY HEALTH CARE PLAN 2022 237155198 2023-10-14 BROTHERS OF MERCY NURSING HOME COMPANY INC 189
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 7167597600
Plan sponsor’s DBA name BROTHERS OF MERCY NURSING AND REHABILITATION CENTER
Plan sponsor’s mailing address 10570 BERGTOLD RD, CLARENCE, NY, 140312105
Plan sponsor’s address 10570 BERGTOLD RD, CLARENCE, NY, 140312105

Number of participants as of the end of the plan year
Active participants 176
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2023-10-14
Name of individual signing JOSEPH WIDMER
Valid signature Filed with authorized/valid electronic signature
BROTHERS OF MERCY HEALTH CARE PLAN 2020 237155198 2021-07-30 BROTHERS OF MERCY NURSING HOME COMPANY ,INC. 279
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 7167597600
Plan sponsor’s mailing address 10570 BERGTOLD RD, CLARENCE, NY, 140312105
Plan sponsor’s address 10570 BERGTOLD RD, CLARENCE, NY, 140312105

Number of participants as of the end of the plan year
Active participants 221
Retired or separated participants receiving benefits 3
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2021-07-30
Name of individual signing JOSEPH WIDMER
Valid signature Filed with authorized/valid electronic signature
BROTHERS OF MERCY HEALTH CARE PLAN 2019 237155198 2020-10-15 BROTHERS OF MERCY NURSING HOME COMPANY, INC. 259
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 7167597600
Plan sponsor’s mailing address 10570 BERGTOLD RD, CLARENCE, NY, 140312105
Plan sponsor’s address 10570 BERGTOLD RD, CLARENCE, NY, 140312105

Number of participants as of the end of the plan year
Active participants 273
Retired or separated participants receiving benefits 6
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing JOSEPH WIDMER
Valid signature Filed with authorized/valid electronic signature
BROTHERS OF MERCY HEALTH CARE PLAN 2018 237155198 2019-10-15 BROTHERS OF MERCY NURSING HOME COMPANY, INC 302
Three-digit plan number (PN) 505
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 7167596985
Plan sponsor’s mailing address 10570 BERGTOLD RD, CLARENCE, NY, 140312105
Plan sponsor’s address 10570 BERGTOLD RD, CLARENCE, NY, 140312105

Number of participants as of the end of the plan year
Active participants 252
Retired or separated participants receiving benefits 7
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing JOSEPH WIDMER
Valid signature Filed with authorized/valid electronic signature
BROTHERS OF MERCY HEALTH CARE PLAN 2018 237155198 2019-10-15 BROTHERS OF MERCY NURSING HOME COMPANY, INC 302
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 7167596985
Plan sponsor’s mailing address 10570 BERGTOLD RD, CLARENCE, NY, 140312105
Plan sponsor’s address 10570 BERGTOLD RD, CLARENCE, NY, 140312105

Number of participants as of the end of the plan year
Active participants 252
Retired or separated participants receiving benefits 7
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing JOSEPH WIDMER
Valid signature Filed with authorized/valid electronic signature
BROTHERS OF MERCY HEALTH CARE PLAN 2017 237155198 2018-10-15 BROTHERS OF MERCY NURSING HOME COMPANY, INC. 342
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 7167596985
Plan sponsor’s mailing address 10570 BERGTOLD RD, CLARENCE, NY, 14031
Plan sponsor’s address 10570 BERGTOLD RD, CLARENCE, NY, 14031

Number of participants as of the end of the plan year
Active participants 291
Retired or separated participants receiving benefits 11

Signature of
Role Plan administrator
Date 2018-10-10
Name of individual signing JOSEPH WIDMER
Valid signature Filed with authorized/valid electronic signature
BROTHERS OF MERCY RETIREMENT SAVINGS PLAN 2016 237155198 2017-10-14 BROTHERS OF MERCY NURSING HOME COMPANY, INC. 240
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-01-01
Business code 623000
Sponsor’s telephone number 7167596985
Plan sponsor’s mailing address 10570 BERGTOLD ROAD, CLARENCE, NY, 140312105
Plan sponsor’s address 10570 BERGTOLD ROAD, CLARENCE, NY, 140312105

Number of participants as of the end of the plan year
Active participants 196
Retired or separated participants receiving benefits 3
Other retired or separated participants entitled to future benefits 27
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 243

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing JOSEPH F. WIDMER
Valid signature Filed with authorized/valid electronic signature
BROTHERS OF MERCY HEALTH CARE PLAN 2016 237155198 2017-10-14 BROTHERS OF MERCY NURSING HOME COMPANY, INC. 345
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 7167596985
Plan sponsor’s mailing address 10570 BERGTOLD RD, CLARENCE, NY, 14031
Plan sponsor’s address 10570 BERGTOLD RD, CLARENCE, NY, 14031

Number of participants as of the end of the plan year
Active participants 332
Retired or separated participants receiving benefits 10

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing JOSEPH WIDMER
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
%THE CORP. DOS Process Agent 4520 RANSOM RD., CLARENCE, NY, United States, 14031

Filings

Filing Number Date Filed Type Effective Date
20151222023 2015-12-22 ASSUMED NAME LLC INITIAL FILING 2015-12-22
A76574-9 1973-06-06 CERTIFICATE OF AMENDMENT 1973-06-06
912982-9 1971-06-08 CERTIFICATE OF INCORPORATION 1971-06-08

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
23-7155198 Corporation Unconditional Exemption 10570 BERGTOLD RD, CLARENCE, NY, 14031-2105 1973-06
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 Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 16188349
Income Amount 26768788
Form 990 Revenue Amount 26768788
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 BROTHERS OF MERCY NURSING HOME COMPANY INC
EIN 23-7155198
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name BROTHERS OF MERCY NURSING HOME COMPANY INC
EIN 23-7155198
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name BROTHERS OF MERCY NURSING HOME COMPANY INC
EIN 23-7155198
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name BROTHERS OF MERCY NURSING HOME CO INC
EIN 23-7155198
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name BROTHERS OF MERCY NURSING HOME CO INC
EIN 23-7155198
Tax Period 201812
Filing Type P
Return Type 990
File View File
Organization Name BROTHERS OF MERCY NURSING HOME CO INC
EIN 23-7155198
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name BROTHERS OF MERCY NURSING HOME CO INC
EIN 23-7155198
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name BROTHERS OF MERCY NURSING HOME CO INC
EIN 23-7155198
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9506697207 2020-04-28 0296 PPP 10570 Bergtold Rd, Clarence, NY, 14031-2105
Loan Status Date 2021-09-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2600988.75
Loan Approval Amount (current) 2600988.75
Undisbursed Amount 0
Franchise Name -
Lender Location ID 78723
Servicing Lender Name Northwest Bank
Servicing Lender Address Liberty & Second St, WARREN, PA, 16365
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Clarence, ERIE, NY, 14031-2105
Project Congressional District NY-23
Number of Employees 346
NAICS code 623110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 78723
Originating Lender Name Northwest Bank
Originating Lender Address WARREN, PA
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 2633839.59
Forgiveness Paid Date 2021-08-10

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Related by address

4520 RANSOM RD., CLARENCE, NY, United States, 14031

BROTHERS OF MERCY HOUSING COMPANY, INC.

Date of last update: 18 Mar 2025

Sources: New York Secretary of State

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