2023-07-25T09:44:15-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 8390 EAST CRESCENT PARKWAY SUITE 300 GREENWOOD VILLAGE CO 80111 990 2022-01-01 742376546 SHALOM PARK SHAL 3036805000 14800 EAST BELLEVIEW DRIVE AURORA CO 800152258 MARC PENNER PRESIDENT/CEO 3036805000 2023-07-21 1 MARC PENNER 999009999 1 SARAH HINTZ P00492291 3037795710 2023-07-11 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARC PENNER 14800 EAST BELLEVIEW DRIVE AURORA CO 800152258 17293870 0 X WWW.SHALOMPARK.ORG X 1984 CO CREATING A JOYFUL COMMUNITY WHERE HONOR AND BELONGING FLOURISH. 19 18 306 80 0 0 2845905 3437547 12508074 13807873 0 0 65915 48450 15419894 17293870 588 0 0 0 9076317 10512340 0 0 359421 6468038 6835392 15544943 17347732 -125049 -53862 9949868 10054926 1696997 1855917 8252871 8199009 X CREATING A JOYFUL COMMUNITY WHERE HONOR AND BELONGING FLOURISH. SHALOM PARK, AN EDEN ALTERNATIVE MILESTONE II ORGANIZATION, OPERATES A NURSING HOME FOR THE AGED. IT PROVIDES HEALTH CARE AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A MULTI-LEVEL SKILLED NURSING FACILITY. 0 0 14866098 0 13807873 SHALOM PARK OPERATES A NURSING HOME. DURING 2022, THE ORGANIZATION PROVIDED CARE FOR 279 ELDERS. 14866098 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 63 0 1 306 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 18 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 CO X MARC PENNER 3036805000 14800 E BELLEVIEW DRIVE AURORA CO 800152258 MARC PENNER PRESIDENT/CEO 26.00 14.00 X X 337324 0 30200 MINDY MOSCOWITZ NURSING HOME ADMINISTRATOR 40.00 0.00 X 160824 0 16707 THEOPHILUS FRIMPONG DIRECTOR OF NURSING 40.00 0.00 X 143532 0 11598 PREETY SHRESTHA CHIEF FINANCIAL OFFICER 36.00 4.00 X 119106 0 19257 DENISE BILYEU DIRECTOR OF HUMAN RESOURCE 40.00 0.00 X 122217 0 14788 HIRUT MEKONNEN ASSISTANT DIR OF NURSING 40.00 0.00 X 113642 0 11036 ELISA ROBYN CHAIR & DIRECTOR 10.00 1.00 X X 0 0 0 SAM ZAITZ VICE CHAIR & DIRECTOR 2.00 0.00 X X 0 0 0 FRAN SIMON SECRETARY & DIRECTOR 2.00 0.00 X X 0 0 0 LYNN GELLER TREASURER & DIRECTOR 2.00 0.00 X X 0 0 0 NEIL OBERFELD IMMEDIATE PAST CHAIR & DIRECTOR 2.00 1.00 X X 0 0 0 JASON ALDERSON DIRECTOR 1.00 0.00 X 0 0 0 MIKE CHAPMAN DIRECTOR 1.00 0.00 X 0 0 0 LISA COOK DIRECTOR 1.00 0.00 X 0 0 0 JAN FISHER DIRECTOR 1.00 0.00 X 0 0 0 SUSY GRAZI DIRECTOR (THRU 06/22) 1.00 0.00 X 0 0 0 JULIE GUTMAN DIRECTOR 1.00 0.00 X 0 0 0 ANDY HEINS DIRECTOR 1.00 1.00 X 0 0 0 MARC LEVINE DIRECTOR 2.00 0.00 X 0 0 0 JAY MOSKOWITZ DIRECTOR 1.00 0.00 X 0 0 0 STUART PACK DIRECTOR 2.00 0.00 X 0 0 0 MELINDA QUIAT DIRECTOR (THRU 01/22) 1.00 0.00 X 0 0 0 BEV ROULEAU DIRECTOR 1.00 0.00 X 0 0 0 JARED SEIDENBERG DIRECTOR 1.00 0.00 X 0 0 0 JJ SLATKIN DIRECTOR 1.00 0.00 X 0 0 0 CATHY SUNSHINE DIRECTOR 1.00 0.00 X 0 0 0 ERIN YOURTZ DIRECTOR (THRU 03/22) 1.00 0.00 X 0 0 0 996645 0 103586 9 0 1 0 MORRISON MANAGEMENT SPECIALIST PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICES 2029355 PREMERE REHAB LLC 25117 SW PARKWAY SUITE D WILSONVILLE OR 97070 THERAPY SERVICES 338947 HAYNES MECHANICAL SYSTEMS 5700 S QUEBEC ST 210 GREENWOOD VILLAGE CO 80111 MECHANICAL MAINTENANCE 283431 PLANTE & MORAN 8181 E TUFTS AVENUE SUITE 600 DENVER CO 80237 IT CONSULTING & SERVICES 274250 STERLING COMMUNICATION TECHNOLOGIES 8369 SOUTHPARK LANE SUITE B LITTLETON CO 80120 CALL LIGHT SYSTEM INSTALLATION 250468 10 1223213 496678 1717656 3437547 RESIDENT SERVICES 623000 13696684 13696684 ANCILLARY SERVICES 623000 111189 111189 13807873 OTHER REVENUE 623000 48450 48450 48450 17293870 13807873 0 48450 X 343255 223115 120140 8876868 7823508 983818 69542 128734 117202 11532 416315 359686 50562 6067 747168 635093 97132 14943 11412 11412 50499 50499 2620240 2227204 340631 52405 21982 18684 2858 440 127284 108191 16547 2546 223064 189605 28998 4461 468099 397884 60853 9362 63380 53873 8239 1268 25085 21322 3261 502 1029477 875055 133832 20590 310277 263735 40336 6206 PROGRAM SUPPLIES 1391981 1391981 REPAIRS AND MAINTENANCE 129583 110145 16846 2592 EMPLOYEE EXPENSES 98107 83391 12754 1962 EDUCATION 71298 60603 9269 1426 193624 128936 19719 44969 17347732 14866098 2122213 359421 502302 232837 33834 23360 40251 360976 1058663 1303581 188873 215316 26892788 19108214 7588062 7784574 537883 134282 9949868 10054926 1010543 1118623 60000 16865 33834 23360 523371 425923 69249 271146 1696997 1855917 X 8252871 7735333 463676 8252871 8199009 9949868 10054926 -53862 0 X X 0 1 X 1 1 1 X 9427314 780553 3357758 2845905 3437547 19849077 13433948 14245235 13450880 12508074 13807873 67446010 22861262 15025788 16808638 15353979 17245420 87295087 98510 712446 810956 0 98510 712446 810956 86484131 846 2 0 848 846 2 848 70452 202668 175252 65915 48450 562737 22932560 15228456 16983892 15419894 17293870 87858672 0.98440 0.99250 0.00000 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME FUNDRAISING MISC REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 4676369 102391 -578799 4199961 3699521 548649 428199 4676369 3318718 380803 3699521 2951498 90000 277220 3318718 2898466 249998 -196966 2951498 0.00000 0.78930 0.21070 1 1 1 2561563 2561563 17452720 15244386 2208334 1730614 1686565 44049 4482101 2177263 2304838 665790 665790 7784574 DUE TO RELATED ORGANIZATIONS 271146 271146 15519317 -509402 -509402 16028719 1265151 1265151 17293870 18176685 870891 870891 17305794 41938 41938 17347732 PART IV, LINE 2B: SHALOM PARK HOLDS RESIDENT FUNDS IN TRUST FOR THEIR SECURITY. RESIDENTS MAY ACCESS THEIR FUNDS DURING NORMAL BUSINESS HOURS BY MAKING A REQUEST AT THE BUSINESS OFFICE. THE FUNDS ARE HELD IN A SEPARATE INTEREST-BEARING ACCOUNT. THE INTEREST IS CREDITED TO THE RESIDENTS' RESPECTIVE ACCOUNTS. PART V, LINE 4: BETH ISRAEL FOUNDATION FOR THE AGED, A RELATED ORGANIZATION, HOLDS ASSETS IN ENDOWMENT FUNDS. THE ENDOWMENTS CONSIST OF VARIOUS INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ORGANIZATION TRANSFERRED CERTAIN ENDOWMENT CONTRIBUTIONS TO THE ROSE COMMUNITY FOUNDATION (RCF) AS PART OF ITS ENDOWMENT CHALLENGE, WHICH WAS COMPLETED IN 2002. RCF AMENDED ITS AGREEMENT WITH THE ORGANIZATION DURING THE YEAR ENDED DECEMBER 31, 2008. PRIOR TO THE AMENDMENT, DISTRIBUTIONS TO THE ORGANIZATION WERE THE LESSER OF (I) 5% OF THE MONTHLY AVERAGE BALANCE IN THE FUND DURING THE PRECEDING YEAR OR (II) NET INVESTMENT INCOME ACCRUING TO THE FUND DURING THE PRECEDING YEAR REDUCED BY ANY FEES AND EXPENSES. PURSUANT TO THE AMENDMENT, DISTRIBUTIONS WILL NOT BE LIMITED BY NET INVESTMENT INCOME. DISTRIBUTIONS WILL BE EQUAL TO 5% OF THE MONTHLY AVERAGE BALANCE IN THE FUND DURING THE PRECEDING YEAR. PART XI, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION AND WELLNESS CENTER REVENUE -509,402. PART XI, LINE 4B - OTHER ADJUSTMENTS: EVENT EXPENSE 41,938. INTERCOMPANY TRANSFERS NOT REPORTED IN FINANCIAL STATEMENTS 1,223,213. PART XII, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION AND WELLNESS CENTER EXPENSE 870,891. PART XII, LINE 4B - OTHER ADJUSTMENTS: EVENT EXPENSE 41,938. X X X 0 0 0 0 0 0 0 0 0 MARC PENNER PRESIDENT/CEO 327260 0 9964 0 100 0 9150 0 21050 0 367524 0 0 0 MINDY MOSCOWITZ NURSING HOME ADMINISTRATOR 150874 0 9750 0 200 0 4969 0 11738 0 177531 0 0 0 THEOPHILUS FRIMPONG DIRECTOR OF NURSING 133443 0 9975 0 114 0 3299 0 8299 0 155130 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS COMPOSED OF THE CURRENT OFFICERS, THE PAST CHAIR(S) AND SUCH OTHER MEMBERS AS ARE APPOINTED BY THE CHAIR. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF AND IN PLACE OF THE BOARD BETWEEN REGULAR MEETINGS OF THE BOARD WHEN REASONABLY NECESSARY TO FULFILL THE PURPOSES AND DUTIES OF THE BOARD, AS DETERMINED BY THE CHAIR, AND IS RESPONSIBLE FOR MAKING RECOMMENDATIONS TO THE BOARD OF TRUSTEES AND FOR SUCH OTHER POWERS AS THE BOARD FROM TIME TO TIME MAY PRESCRIBE. ACTIONS OF THE EXECUTIVE COMMITTEE MAY BE OVERRULED OR AMENDED BY LATER ACTION OF THE BOARD, BUT ANY ACTION PROPERLY TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE BINDING UPON THE ORGANIZATION UNTIL SUCH LATER ACTION OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 2 SAM ZAITZ AND LISA COOK HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 8B THE FINANCE COMMITTEE AND EXECUTIVE COMMITTEE DO NOT KEEP MINUTES OF THEIR MEETINGS. FORM 990, PART VI, SECTION B, LINE 11B THE CONTROLLER AND CEO REVIEWED THE FORM 990, AFTER WHICH THE FINANCE COMMITTEE REVIEWED AND APPROVED THE FORM 990. THE RETURN WAS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL AFFIRMATION SIGNED BY EACH TRUSTEE. THE ORGANIZATION MONITORS COMPLIANCE WITH THE POLICY DURING THE YEAR BY INQUIRING AT ITS BOARD MEETINGS WHETHER ANY CONFLICTS OF INTEREST HAVE ARISEN SINCE THE ANNUAL AFFIRMATION WAS SIGNED. AN INDIVIDUAL WITH A CONFLICT MAY NOT VOTE ON ANY MATTER THAT MAY INVOLVE THE CONFLICT OF INTEREST. DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT/ CEO'S COMPENSATION IS DETERMINED BY SHALOM PARK BOARD OF DIRECTORS. THE FOLLOWING ARE USED BY SHALOM PARK IN SETTING THE PRESIDENT/ CEO'S COMPENSATION: 1. COMPENSAION COMMITTEE 2. COMPENSATION SURVEY OR STUDY 3. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THIS PROCESS LAST TOOK PLACE IN 2020. COST OF LIVING ADJUSTMENTS ARE SENT FOR APPROVAL BY THE BOARD CHAIR EACH YEAR AND AFFECT EVERYONE IN THE ORGANIZATION, INCLUDING THE CEO. THE LAST ADJUSTMENT WAS MADE IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 2,227,204. MANAGEMENT AND GENERAL EXPENSES 340,631. FUNDRAISING EXPENSES 52,405. TOTAL EXPENSES 2,620,240. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. SHALOM CARES WELLNESS CENTER LLC 14800 E BELLEVIEW DRIVE AURORA CO 80015 452808418 FITNESS AND THERAPY CO 250868 4916455 BETH ISRAEL FOUNDATION FOR THE AGED BETH ISRAEL FOUNDATION FOR THE AGED 14800 E BELLEVIEW DRIVE AURORA CO 80015 742195249 FUNDRAISING TO SUPPORT SHALOM PARK CO 501(C)(3) LINE 7 SHALOM PARK 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 BETH ISRAEL FOUNDATION FOR THE AGED C 1223213 CASH BETH ISRAEL FOUNDATION FOR THE AGED E 271146 END OF YEAR BALANCE BETH ISRAEL FOUNDATION FOR THE AGED D 134282 END OF YEAR BALANCE