2023-07-17T17:46:18-05:00 2022-08-31 910189318 MOSS ADAMS LLP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2021-09-01 953510024 LOS ANGELES JEWISH HOME FOR THE AGING LOSA 8187743372 7150 TAMPA AVE RESEDA CA 913353700 CRYSTAL RUDITSKY CFO 8187743372 2023-07-17 1 CRYSTAL RUDITSKY 999009999 LAUREN A HAVERLOCK P00545829 8185771900 2023-07-17 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DALE SUROWITZ 7150 TAMPA AVE RESEDA CA 913353700 35351614 0 X WWW.LAJHEALTH.ORG X 1912 CA NURSING, RESIDENTIAL AND CLINICAL CARE FOR THE ELDERLY. 17 17 313 17 2546 1269 11343564 14216080 19828950 20420052 200798 229758 23044 -289940 31396356 34575950 0 0 0 0 21538849 20604565 0 0 2180058 35005286 30110934 56544135 50715499 -25147779 -16139549 249529041 240284875 314234802 319296207 -64705761 -79011332 EXCELLENCE IN SENIOR CARE REFLECTIVE OF JEWISH VALUES. 0 0 23111338 3943914 FUNDING ORGANIZATION AND MANAGEMENT SERVICES FOR RELATED ORGANIZATIONS: EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING, GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING, JHA GERIATRIC SERVICES, ANNENBERG SCHOOL OF NURSING AND BRANDMAN CENTERS FOR SENIOR CARE, INC. 21929074 16476138 DEVELOPMENT AND OPERATIONS OF AN INDEPENDENT LIVING FACILITY THAT PROVIDES MEMORY CARE SERVICES. 45040412 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 280 0 1 313 1 1 1 0 0 0 0 0 1 1 0 0 0 0 0 X 17 17 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X CRYSTAL RUDITSKY 8187743000 7150 TAMPA AVENUE RESEDA CA 91335 A BERMAN CHAIR 2.00 0.00 X X 0 0 0 R BENDER DIRECTOR 2.00 0.00 X 0 0 0 J BRANDMAN DIRECTOR 2.00 6.00 X 0 0 0 J FRIEDMAN-RUDZKI DIRECTOR 2.00 4.00 X 0 0 0 S GOOD VICE CHAIR 2.00 0.00 X X 0 0 0 L GRANOW DIRECTOR 2.00 0.00 X 0 0 0 I HALPERN DIRECTOR 2.00 4.00 X 0 0 0 J HELD VICE CHAIR 2.00 0.00 X X 0 0 0 R HIRSCH DIRECTOR, PAST CHAIR 2.00 2.00 X 0 0 0 S HIRSCH WOHL DIRECTOR 2.00 0.00 X 0 0 0 M LIEBERMAN DIRECTOR 2.00 0.00 X 0 0 0 A PRICE DIRECTOR 2.00 0.00 X 0 0 0 D ROSETT SECRETARY, VICE CHAIR 2.00 6.00 X X 0 0 0 M RUBIN DIRECTOR 2.00 4.00 X 0 0 0 DR E SCHNEIDER DIRECTOR 2.00 5.00 X 0 0 0 J SEIDEL DIRECTOR 2.00 0.00 X 0 0 0 D SWARTZ IMM PAST CHAIR 2.00 0.00 X 0 0 0 D SUROWITZ CEO-PRESIDENT 30.00 13.00 X 727616 0 22988 M FORREST VP (THRU 7/7/2022) 40.00 0.00 X 338155 0 11277 C RUDITSKY CFO 30.00 13.00 X 120911 0 4798 L STEPANIANS COO 40.00 4.00 X 407424 0 18160 N MARCO CMO 38.00 1.00 X 469658 0 27641 A POSSICK CSO (THRU 4/30/22) 40.00 4.00 X 378963 0 20442 A ALDERMAN VP, HUMAN RESOURCES 38.00 2.00 X 216399 0 12604 T CARLSON COMPLIANCE OFFICER 40.00 0.00 X 242595 0 7684 S KLAPPHOLZ FOUNDATION SR VP (THRU 1/31/22) 40.00 0.00 X 316135 0 18726 C SLAVIN VP FUND DEVELOPMENT 40.00 0.00 X 238776 0 17559 H SABET SENIOR MGR INFO SYSTEMS 40.00 0.00 X 225740 0 11750 L PLACHTA DIRECTOR FUND DEVELOPMENT 40.00 0.00 X 214834 0 16376 L NUSSBAUM DIRECTOR OF FOUNTAINVIEW MARKETING 40.00 0.00 X 203322 0 17378 A AUTOLINO DIRECTOR OF ACCOUNTS RECEIVABLE 40.00 0.00 X 185461 0 16410 G GOLDENBERG FORMER CFO 0.00 0.00 X 213579 0 4301 4499568 0 228094 42 1 1 0 UNIVERSAL PROTECTION SERVICE LP PO BOX 31001-2374 PASADENA CA 91110 SECURITY SERVICES 671082 PLANTE & MORAN PLLC 16060 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CONSULTING 354000 LITTLER MENDELSON PO BOX 207137 DALLAS TX 75320 LEGAL SERVICES 329274 KAN-DI-KI LLC (DIAGNOSTIC LABORATORIES L 6400 PINE PLANO TX 75024 LABORATORY SERVICES 235855 MOSS ADAMS LLP PO BOX 101822 PASADENA CA 91189 AUDIT, TAX 194809 10 406115 3004641 10805324 294000 14216080 CCRC REVENUE 900099 16476138 16476138 SERVICE TO BCSC 900099 3204139 3204139 RENT FROM BCSC 900099 523344 523344 SERVICE TO HOSPICE 900099 215181 215181 JHA WEST 16 APP FEE REVENUE 900099 1250 1250 20420052 225518 2546 222972 4240 4240 294000 294000 0 45124 406115 481664 -436540 -436540 OTHER REVENUE 900099 146600 146600 146600 34575950 20420052 2546 -62728 5088448 4110309 725349 252790 12294362 9590721 1692480 1011161 256717 191631 33817 31269 1761441 1407292 248346 105803 1203597 953499 168264 81834 259069 189334 63111 6624 215640 194076 21564 885158 595102 198366 91690 68345 68345 274414 217193 38328 18893 3670420 3670420 986137 907931 78206 15119 5492 969 8658 271489 6665 1176 263648 3478965 3478965 5799594 5799594 1802205 1531874 270331 FUNDING TO RELATED ORGS 3942638 3942638 DIETARY AND FOOD SUPPLI 1688776 1688776 HOUSEKEEPING & MAINTENA 1124460 1124460 RESIDENT RELATED ACTIVI 426847 426847 5201658 4939248 32928 229482 50715499 45040412 3495029 2180058 1622596 1719933 10057423 6294398 19701074 18387803 249991 100760 542546 832996 202784601 42354058 165416656 160430543 16653000 17390061 35285755 35128381 249529041 240284875 45249228 50987767 144628163 146986326 65681214 63150766 113756 87267 43371119 42094136 2964192 12227130 15989945 314234802 319296207 X -112524195 -125337580 47818434 46326248 -64705761 -79011332 249529041 240284875 X -16139549 1775046 58932 X 0 1 X 1 1 1 X 39223489 17710255 12749584 11342064 14216080 95241472 39223489 17710255 12749584 11342064 14216080 95241472 47956380 47285092 379531 731148 303247 183156 227212 1824294 132330 23044 155374 60841 2336453 437 146600 2544331 99765471 91752653 0.47400 0.51910 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SETTLEMENT OTHER INCOME - 2017 AMOUNT: $ 60,841. 2018 AMOUNT: $ 2,336,453. 2019 AMOUNT: $ 437. 2021 AMOUNT: $ 146,600. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 49842753 1085530 73015 3831153 47170145 59220268 -6347715 56080 3085880 49842753 60724340 2188772 33997 3726841 59220268 57651177 6240194 35939 3202970 60724340 37437877 24492812 33963 4313475 57651177 0.00000 0.31000 0.69000 0 0 21480859 21480859 153839266 24929045 128910221 26026660 16883839 9142821 1437816 541174 896642 160430543 FUNDS HELD BY TRUSTEE UNDER DEBT AGREEMENT 8544037 CHARITABLE REMAINDER TRUST RECEIVABLES 473180 ARTWORK 121042 GOODWILL 200000 DUE FROM RELATED PARTIES 25760945 DEPOSITS 29177 35128381 ANNUITY OBLIGATIONS 1759185 OTHER 985403 OBLIGATION TO PROVIDE FUTURE SNF 255572 OTHER PAYABLES 1364 REFUNDABLE ENTRANCE FEES 6036280 CCRC ESCROW DEPOSITS 351450 LT ACCRUED COMP 6600691 15989945 X PART IV, LINE 2B: THE RESIDENTS AT GONDA RAISE MONEY TO HELP PAY FOR A RABBI AND OTHER SPIRITUAL EXPENSES. SINCE THEY WERE RAISING MONEY USING GONDA'S NAME WE WANTED THEM TO HAVE SOME INTERNAL CONTROLS AND RULES TO FOLLOW TO SAFEGUARD THE CASH. HOWEVER, THE CASH BELONGS TO THE RESIDENTS AND THAT'S WHY WE RECORD THESE AS A LIABILITY. PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS. PART X, LINE 2: WITH THE EXCEPTION OF THE IPA, LAJH IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701D OF THE CALIFORNIA REVENUE AND TAXATION CODE AND IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, LAJH IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS TAKEN AS A WHOLE. LAJH RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE-LIKELY-THAN-NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF AUGUST 31, 2022 OR 2021. SCH D PART V LINE 1B COLUMN (B): IN FISCAL YEAR 2021, THERE WAS A NEGATIVE ADJUSTMENT FOR CONTRIBUTIONS DUE TO THE RESTRUCTURING OF A PLEDGE. GOLF TOURNAMENT 155470 139923 15547 3000 5484 CIRCLE OF LIFE 106792 96113 10679 26559 6 188977 170079 18898 354055 92566 451239 406115 45124 383614 98050 481664 -436540 X X X X X 0 0 0 0 0 0 0 1 0 D SUROWITZ CEO-PRESIDENT 727616 0 0 0 0 0 4618 0 18370 0 750604 0 0 0 N MARCO CMO 469658 0 0 0 0 0 13032 0 14609 0 497299 0 0 0 L STEPANIANS COO 407424 0 0 0 0 0 11393 0 6767 0 425584 0 0 0 A POSSICK CSO (THRU 4/30/22) 378963 0 0 0 0 0 9274 0 11168 0 399405 0 0 0 M FORREST VP (THRU 7/7/2022) 338155 0 0 0 0 0 9750 0 1527 0 349432 0 0 0 S KLAPPHOLZ FOUNDATION SR VP (THRU 1/31/22) 316135 0 0 0 0 0 7842 0 10884 0 334861 0 0 0 C SLAVIN VP FUND DEVELOPMENT 238776 0 0 0 0 0 7232 0 10327 0 256335 0 0 0 T CARLSON COMPLIANCE OFFICER 242595 0 0 0 0 0 0 0 7684 0 250279 0 0 0 H SABET SENIOR MGR INFO SYSTEMS 225740 0 0 0 0 0 6510 0 5240 0 237490 0 0 0 L PLACHTA DIRECTOR FUND DEVELOPMENT 214834 0 0 0 0 0 6470 0 9906 0 231210 0 0 0 A ALDERMAN VP, HUMAN RESOURCES 216399 0 0 0 0 0 6277 0 6327 0 229003 0 0 0 L NUSSBAUM DIRECTOR OF FOUNTAINVIEW MARKETING 200172 0 3150 0 0 0 5772 0 11606 0 220700 0 0 0 G GOLDENBERG FORMER CFO 213579 0 0 0 0 0 0 0 4301 0 217880 0 0 0 A AUTOLINO DIRECTOR OF ACCOUNTS RECEIVABLE 185461 0 0 0 0 0 5696 0 10714 0 201871 0 0 0 PART I, LINE 7 ALL BONUSES PAID BY THE ORGANIZATION ARE DISCRETIONARY. A CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13080SXU3 2019-09-26 59324635 REFUND OUTSTANDING DEBT ISSUED 12/1/2003 0 0 0 B CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 000000000 2019-08-08 16594304 SEE PART VI 0 0 0 A 5420000 59327825 2516077 916551 1511051 54396208 2008 1 0 1 1 B 1220000 16595354 653461 331886 450589 15158368 2003 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 0 0 1 0 0 0 0 0 A 0 B 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/26/2019 ISSUER NAME: CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 08/09/2019 SCHEDULE K, PART II LINE 3 BOND A THIS AMOUNT INCLUDES INVESTMENT INCOME EARNED FROM THE GROSS PROCEEDS IN RESERVE. SCHEDULE K, PART II LINE 3 BOND B THIS AMOUNT INCLUDES INVESTMENT INCOME EARNED FROM THE GROSS PROCEEDS IN RESERVE. X 1 294000 SALES PRICE 1 0 1 1 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. PART I, LINE 32B: APPLIES TO STOCK GIFTS ONLY, WHICH ARE IMMEDIATELY FORWARDED TO UBS PAINE WEBBER FOR SALE. IN FY2022, THE ORGANIZATION UTILIZED A REAL ESTATE BROKER TO SELL A DONATED CONDOMINIUM. FORM 990, PART VI, SECTION A, LINE 2 R HIRSCH AND S HIRSCH WOHL HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE REVIEWED BY THE VOTING MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY RECEIVES A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT FROM EACH ACTIVE BOARD MEMBER AND OFFICER. THE DISCLOSURES ARE REVIEWED BY THE BOARD, AND IF NECESSARY, ARE FURTHER DISCUSSED UNTIL A DETERMINATION IS MADE AS TO WHETHER A CONFLICT OF INTEREST EXISTS. THE ORGANIZATION WILL TAKE APPROPRIATE ACTION, DEPENDENT ON THE OUTCOME OF THE ABOVE REFERENCED DISCUSSION, AND IF NECESSARY, THE INTERESTED PERSON WILL RECUSE THEMSELVES FROM THE DELIBERATIONS AND DECISIONS. FORM 990, PART VI, SECTION B, LINE 15 POLICY FOR DETERMINATION OF EXECUTIVE COMPENSATION, OFFICERS AND TOP MANAGEMENT INCLUDES REVIEWING COMPARABILITY DATA FROM NUMEROUS SALARY AND COMPENSATION SURVEYS AND THE FORM 990 DATA OF SIMILAR ORGANIZATIONS. THE COMPENSATION FOR TOP MANAGEMENT IS DETERMINED BY THE EXECUTIVE REVIEW COMMITTEE AND APPROVED BY THE FULL EXECUTIVE COMMITTEE OF THE BOARD. COMPENSATION IS REVIEWED FOR OFFICERS AND TOP MANAGEMENT ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: OTHER 61,478. UNRELATED BUSINESS TAXABLE INCOME -2,546. JHA WEST 16 LLC 7150 TAMPA AVENUE RESEDA CA 91335 263639876 CONTINUING CARE RETIREMENT COMMUNITY CA 17863947 181361662 LOS ANGELES JEWISH HOME FOR THE AGING JHA GERIATRIC SERVICES INC 7150 TAMPA AVE RESEDA CA 91335 954407317 CLINICAL AND HOSPICE SERVICES FOR THE ELDERLY CA 501(C)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING 7150 TAMPA AVE RESEDA CA 91335 951691015 RESIDENTIAL CARE AND SKILLED NURSING FACILITY CA 501(C)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 ANNENBERG SCHOOL OF NURSING 7150 TAMPA AVE RESEDA CA 91335 208449705 VOCATIONAL NURSE EDUCATION CA 501(C)(3) 2 LOS ANGELES JEWISH HOME FOR THE AGING 1 GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING 7150 TAMPA AVE RESEDA CA 91335 951831045 RESIDENTIAL CARE AND SKILLED NURSING FACILITY CA 501(C)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 BRANDMAN CENTERS FOR SENIOR CARE INC 7150 TAMPA AVE RESEDA CA 91335 264023159 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY CA 501(C)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 JEWISH HOME FOUNDATION 7150 TAMPA AVE RESEDA CA 91335 800927200 FUNDRAISING CA 501(C)(3) LINE 12A, I LOS ANGELES JEWISH HOME FOR THE AGING 1 BRANDMAN HEALTH PLAN 7150 TAMPA AVE RESEDA CA 91335 844235030 HEALTH CARE SERVICE PLAN CA 501(C)(4) LOS ANGELES JEWISH HOME FOR THE AGING 1 BRANDMAN RESEARCH INSTITUTE 7150 TAMPA AVE RESEDA CA 91335 954414031 GERONTOLOGICAL RESEARCH CA 501(C)(3) LINE 12A, I LOS ANGELES JEWISH HOME FOR THE AGING 1 CHARITABLE REMAINDER TRUSTS (70) TRUST MANAGEMENT CA N/A 0 0 0 0 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 ANNENBERG SCHOOL OF NURSING P 230321 FMV JHA GERIATRIC SERVICES P 5732958 FMV BRANDMAN HEALTH PLAN P 514195 FMV BRANDMAN CENTERS FOR SENIOR CARE INC P 3337096 FMV EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING P 7060309 FMV GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING P 12723054 FMV BRANDMAN CENTERS FOR SENIOR CARE INC Q 3277548 FMV GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING Q 20504840 FMV EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING Q 1779939 FMV JHA GERIATRIC SERVICES Q 84859 FMV