2023-08-15T10:48:30-05:00 2022-09-30 111986323 MARCUM LLP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 990 2021-10-01 060646672 HEBREW HOME & HOSPITAL HEBR 8602182300 1 ABRAHMS BLVD WEST HARTFORD CT 06117 DENISE PETERSON PRESIDENT & CEO 8602182300 2023-08-14 1 DENISE PETERSON 999009999 MARY ANTONETTI P00431862 2037819600 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z HOSPITAL AT HEBREW SENIOR CARE DENISE PETERSON 1 ABRAHMS BLVD WEST HARTFORD CT 06117 11293117 0 X HEBREWSENIORCARE.ORG X 1901 CT TO PROVIDE QUALITY HEALTH CARE TO SENIOR ADULTS IN THE GREATER HARTFORD AREA. 10 10 168 11 0 0 384706 241952 10112845 11045874 -61648 229 3425969 5062 13861872 11293117 0 0 0 0 6678268 7591632 0 0 0 2213121 2677549 8891389 10269181 4970483 1023936 4153957 4922820 4800911 4545838 -646954 376982 X THE MISSION OF HEBREW HOME AND HOSPITAL ALIGNS WITH THE MISSION OF ITS PARENT ORGANIZATION, HEBREW HEALTH CARE, TO PROVIDE QUALITY SERVICES TO SENIOR ADULTS. (SEE SCHEDULE O)AS PART OF AN INTEGRATED SYSTEM TO ASSIST SENIORS IN THE HARTFORD, CONNECTICUT HEBREW HOME & HOSPITAL OPERATES A LICENSED HOSPITAL FACILITY. 0 0 8393262 11050936 BEHAVIORAL HEALTH UNIT (BHU). ON OUR 38-BED HOSPITAL BHU, WE TREAT CHRONIC MENTAL HEALTH ISSUES THAT ARE EXACERBATED BY AGE, NEW BEHAVIORAL SYMPTOMS AND/OR THE ONSET OF DEMENTIA. WE MANAGE CHALLENGING BEHAVIORS WITH THE GOAL OF BRINGING PATIENTS BACK TO A STABLE BASELINE SO THAT THEY CAN RETURN TO THEIR PRIOR LIVING SETTINGS, WHETHER THAT IS IN THE COMMUNITY, IN AN ASSISTED LIVING FACILITY, OR A LONG TERM CARE NURSING HOME. IN THE CASE OF THE LATTER TWO SETTINGS, WE WORK COLLABORATIVELY WITH STAFF TO HELP THEM UNDERSTAND HOW THEY CAN HELP AVOID ENVIRONMENTAL TRIGGERS TO FUTURE EXACERBATIONS AND BEHAVIORAL DISTURBANCES. OUR PSYCHIATRISTS SEE EVERY PATIENT EVERY DAY. A GERIATRICIAN IS ASSIGNED TO EVERY PATIENT TO EVALUATE AND TREAT MEDICAL ISSUES. INDIVIDUAL AND GROUP THERAPIES ARE PROVIDED DAILY; AND SUPPORT GROUPS FOR FAMILIES ARE ALSO AN INTEGRAL PART OF THE CARE PLAN. CONDITIONS WE TREAT INCLUDE CHRONIC PSYCHIATRIC ISSUES, BIPOLAR DISORDER, DELUSIONAL DISORDER, ALZHEIMER'S DISEASE WITH BEHAVIORAL DISTURBANCES, DEPRESSION, SCHIZOPHRENIA AND PARANOID DISORDER. OUR HOSPITAL SERVICES ARE MEDICARE AND MEDICAID CERTIFIED. 8393262 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 19 0 1 168 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 X X FRED DALICANDRO 8602128558 1 ABRAHMS BLVD WEST HARTFORD CT 06117 CARLOS SALMON BOARD MEMBER 1.00 3.00 X 0 0 0 DEBORAH M KLEINMAN BOARD MEMBER (UNTIL 11/2021) 1.00 4.00 X X 0 0 0 GARY S GREENBERG CHAIR 1.00 4.00 X X 0 0 0 ILENE KOHLUN BOARD MEMBER 1.00 3.00 X 0 0 0 JEFFREY S HOFFMAN BOARD MEMBER 1.00 4.00 X 0 0 0 JEFFREY BLAU BOARD MEMBER 1.00 3.00 X 0 0 0 MARK SELTZER SECRETARY 1.00 3.00 X X 0 0 0 MICHAEL BLOOM BOARD MEMBER 1.00 3.00 X 0 0 0 RICHARD ROBINSON TREASURER 1.00 4.00 X X 0 0 0 RICHARD RUBENSTEIN BOARD MEMBER (FROM 1/2022) 1.00 4.00 X 0 0 0 PAMELA ATWOOD BOARD MEMBER (FROM 10/2021) 1.00 3.00 X 0 0 0 DENISE PETERSON PRESIDENT & CEO 10.00 31.00 X 0 278250 23696 LIISA LIVINGSTON CFO (UNTIL 11/2021) 10.00 31.00 X 0 153032 0 ROBERT LEAKE CFO 10.00 31.00 X 0 0 0 MADELENE FRANCESE VP OF DEVELOPMENT 15.00 25.00 X 0 150601 0 LASHONIE L DOUGLAS NURSE 40.00 0.00 X 124907 0 0 JOY A HUGHES NURSE 40.00 0.00 X 115053 0 19470 HAROLD E SANDALS NURSE 40.00 0.00 X 109650 0 0 KATHLEEN A SMITH DIRECTOR OF CLINICAL SERVICES 40.00 0.00 X 106304 0 0 455914 581883 43166 4 0 1 0 CARDINAL HEALTH 7000 CARDINAL PLACE DUBLIN OH 43017 PHARMACY SERVICES 206964 WOODMARK PHARMACY 1142 WEHRLE DRIVE WILLIAMSVILLE NY 14221 PHARMACY SERVICES 159703 BEHAVIORAL HEALTH ADVISORY GROUP 259 NASSAU STREET SUITE 386 PRINCETON NJ 08542 CONSULTING 158901 GERIATRIC MENTAL HEALTH SPECIALIST 270 FARMINGTON AVE 309 FARMINGTON CT 06032 MEDICAL SERVICES 121225 4 157976 83976 241952 BEHAVIORAL HEALTH HOSPITAL 622210 10343531 10343531 PHARMACY 446110 702343 702343 11045874 229 229 OTHER INCOME 900099 5062 5062 5062 11293117 11050936 0 229 5396834 5396735 99 1838722 616187 1222535 356076 284861 71215 23155 23155 86736 20124 66612 201852 169030 32822 120 120 136309 93997 42312 48122 38498 9624 285426 238248 47178 12117 10100 2017 7236 7236 107379 21476 85903 395045 146466 248579 PROVISION FOR BAD DEBTS 520596 520596 MEDICAL SUPPLIES 404572 404572 DIETARY 315349 315349 STORAGE EXPENSE 67619 54095 13524 65916 55572 10344 10269181 8393262 1875919 0 154137 169860 1245536 1103091 1443 36278 32412 45917 2175319 389894 1356049 1785425 2108 2337 1362272 1779912 4153957 4922820 1011038 923882 79574 87555 1725585 1588841 1984714 1945560 4800911 4545838 X -646954 376982 0 0 -646954 376982 4153957 4922820 1023936 0 X X 0 1 X 1 0 X 10500 1000 384706 241952 638158 7300001 7246607 8223581 10112845 11045874 43928908 7310501 7247607 8223581 10497551 11287826 44567066 0 0 0 44567066 278 206 309 229 1022 278 206 309 229 1022 921051 381117 144998 1515196 5062 2967424 8231830 7628930 8368888 12012747 11293117 47535512 0.93760 0.94060 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1240766 168951 1071815 934553 220943 713610 1785425 DEPOSITS 7089 OTHER RECEIVABLES 168417 RIGHT OF USE ASSET - BUILDING 3000 DUE FROM AFFILIATES 1601406 1779912 FUNDS HELD IN TRUST 100135 PAYMENTS DUE UNDER PLAN OF REORGANIZATION 997976 DEFERRED RENT 511572 CAPITAL LEASE OBLIGATIONS 335877 1945560 X 11140521 -152596 -152596 11293117 0 11293117 10116585 0 10116585 152596 152596 10269181 PART X, LINE 2: THE FOLLOWING FOOTNOTE IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR HEBREW HEALTH CARE, INCORPORATED AND AFFILIATES. EACH ENTITY, WITH THE EXCEPTION OF CGSG, IS QUALIFIED UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. CGSG ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES. FASB ASC 740 IS AN ASSET AND LIABILITY METHOD, WHICH REQUIRES THE RECOGNITION OF DEFERRED TAX ASSETS AND LIABILITIES FOR THE EXPECTED FUTURE TAX CONSEQUENCES OF TEMPORARY DIFFERENCES BETWEEN THE TAX AND FINANCIAL REPORTING BASIS OF CERTAIN ASSETS AND LIABILITIES. AS OF SEPTEMBER 30, 2022 AND 2021, CGSG HAD A NET FEDERAL OPERATING LOSS CARRYFORWARD AVAILABLE TO REDUCE ITS FUTURE TAXABLE INCOME OF APPROXIMATELY $3.75 MILLION AND $3.5 MILLION, RESPECTIVELY, AND STATE OF CONNECTICUT NET OPERATING LOSS CARRYFORWARD OF $3.76 MILLION AND $3.3 MILLION, RESPECTIVELY. THE CARRYFORWARD PERIODS EXPIRE AT VARIOUS DATES THROUGH 2036. THE DEFERRED TAX ASSET OF APPROXIMATELY $1 MILLION AND $939,000, AS OF SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY, ASSOCIATED WITH CGSG'S LOSS CARRYFORWARD AND ACCRUED EXPENSES WAS OFFSET BY A CORRESPONDING VALUATION ALLOWANCE OF $1 MILLION AND $939,000 AS OF SEPTEMBER 30, 2022 AND 2021, AS REALIZATION OF SUCH LOSS CARRYFORWARDS IS NOT ASSURED. THE VALUATION ALLOWANCE FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021 INCREASED BY APPROXIMATELY $72,000 AND $250,000, RESPECTIVELY. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740 WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTY IN TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2022 AND 2021, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS WITHIN ADMINISTRATION EXPENSES. AS OF SEPTEMBER 30, 2022 AND 2021, THE ORGANIZATION DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE ORGANIZATION'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. DURING OCTOBER 2021, THE ORGANIZATION RECEIVED NOTICE FROM THE IRS REGARDING A COMPLIANCE CHECK RELATED TO ADHERENCE WITH IRS FINANCIAL ASSISTANCE POLICIES. ALL REQUIRED DOCUMENTATION HAS BEEN UPDATED AND AT THE DATE OF THIS REPORT, THE IRS COMPLIANCE CHECK IS STILL IN PROCESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -152,596. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 152,596. 1 1 1 X 1 X 1 1 1 0 1 1 568846 509816 59030 0.00610 568846 509816 59030 0.00610 3100 3100 0.00030 3100 3100 0.00030 571946 509816 62130 0.00640 5204 5204 0.00050 5204 5204 0.00050 1 525596 5000 6991810 5243858 1747952 X 1 1 1 1 THE HOSPITAL AT HEBREW HEALTH CARE 1 ABRAHMS BLVD WEST HARTFORD CT 06117 HEBREWSENIORCARE.ORG 16CD X BEHAVIORAL UNITS THE HOSPITAL AT HEBREW HEALTH CARE 1 0 0 1 X X X X X X X 22 1 0 0 1 X WWW.HEBREWSENIORCARE.ORG X 1 22 1 WWW.HEBREWSENIORCARE.ORG 0 1 X 100.000000000000 25.000000000000 1 1 X X X 1 X WWW.HEBREWSENIORCARE.ORG X WWW.HEBREWSENIORCARE.ORG X WWW.HEBREWSENIORCARE.ORG X X X X X 1 X X 0 X 0 X X 0 0 THE HOSPITAL AT HEBREW HEALTH CARE PART V, SECTION B, LINE 3J: EXPAND RESIDENT MEMBER FUND TO ASSIST IN FINANCIAL AID FOR RESIDENTS IN NEED. TRIAL A DRIVING SERVICE TO ASSIST SENIORS WITH HEALTHCARE RELATED APPOINTMENTS. THESE IMPLEMENTATION ITEMS WERE TEMPORARILY SUSPENDED DUE TO THE OUTBREAK OF COVID 19 WHICH CAUSED DISRUPTION TO ALL HOSPITAL ACTIVITIES. THE HOSPITAL AT HEBREW HEALTH CARE PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS DISTRIBUTED TO COMMUNITY MEMBERS, ADULT CARE COORDINATORS AND FAMILY SERVICES INCLUDING: SENIOR ADULT AND FAMILY SERVICES FOR THE TOWN OF MANCHESTER, NCAAA, CENTER FOR HEALTHY AGING, VARIOUS SENIOR CENTERS IN CENTRAL CONNECTICUT AND THE MANCHESTER COMMUNITY SERVICES COUNCIL. THE HOSPITAL AT HEBREW HEALTH CARE PART V, SECTION B, LINE 11: THE HOSPITAL HAS INDENTIFIED 4 SIGNIFICANT NEEDS IT PLANS TO ADDRESS:1. DEVELOP EDUCATIONAL OPPORTUNITIES ABOUT COGNITIVE IMPAIRMENT;2. OFFER SEMINARS ABOUT HOW TO DOWNSIZE IN ORDER TO MOVE INTO INDEPENDENT/ASSISTED LIVING FACILITIES;3. DEVELOP PROGRAMS TO EDUCATE PEOPLE ABOUT MEDICARE, PROBATE AND ESTATE PLANNING; AND, 4. HELP PEOPLE DEVELOP AND UNDERSTAND APPROPRIATE ACTIVITIES FOR PEOPLE WITH COGNITIVE IMPAIRMENT.THE HOSPITAL PLANS TO ADDRESS THESE NEEDS THROUGH THE CREATION OF PROGRAMS AND COLLABORATING WITH PARTNERS. PART I, LINE 7: THE ORGANIZATION USED THE RATIO OF PATIENT CARE COST TO CHARGES. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 520,596. PART II, COMMUNITY BUILDING ACTIVITIES: HEBREW SENIOR CARE PROVIDES COMMUNITY BENEFITS TO THE GREATER HARTFORD REGION. OUR ORGANIZATION PROVIDES INFORMATION TO THE COMMUNITY IN SEVERAL WAYS:- OUR VP OF MARKETING HAS A CABLE ACCESS SHOW THAT AIRS ON A MONTHLY BASIS. THE CABLE ACCESS SHOW FEATURES HEALTH PROFESSIONALS WHO CAN PROVIDE ADVICE REGARDING SENIOR HEALTH AND WELLNESS. - OUR ORGANIZATION RUNS DRIVES FOR A VARIETY OF NEEDS: FOOD, COATS AND SCHOOL SUPPLIES FOR LOCAL SCHOOLS IN HARTFORD. -WE OFFER SUPPORT GROUPS FOR FAMILIES STRUGGLING WITH AGING PARENTS OR SPOUSES WHO MAY HAVE DEMENTIA. PART III, LINE 2: THE ORGANIZATION ESTIMATES BAD DEBT BASED ON HISTORICAL EXPERIENCE AS WELL AS ACTUAL ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE. PART III, LINE 3: THE HOSPITAL SERVES THE ELDERLY POPULATION OF THE GREATER HARTFORD CONNECTICUT AREA WHICH IS A VULNERABLE POPULATION WHO OFTEN LIVE ON A FIXED INCOME. IN ORDER TO ENSURE QUALITY CARE TO THIS DEMOGRAPHIC, THE HOSPITAL INCURS BAD DEBT EXPENSE WHEN THE INDIVDIUALS CAN NOT PAY. SINCE THERE IS AN IDENTIFIED NEED TO PROVIDE SERVCIES TO THE ELDERLY, THE HOSPITAL BELIEVES THE AMOUNT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. THE HOSPITAL WAS NOT ABLE TO ESTIMATE THE PERCENTAGE OF THE BAD DEBT RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE; HOWEVER, SOME PORTION OF THE BAD DEBT RELATES TO THESE INDIVIDUALS. PART III, LINE 4: THERE IS NO BAD DEBT FOOTNOTE IN THE FINANCIAL STATEMENTS BUT THE METHOD FOR EVALUATING ACCOUNTS RECEIVABLE IS INCLUDED IN NOTE 2 ON PAGE 15 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE HOSPITAL SERVES THE ELDERLY POPULATION OF THE GREATER HARTFORD CONNECTICUT AREA WHICH IS A VULNERABLE POPULATION WHO OFTEN LIVE ON A FIXED INCOME. IN ORDER TO ENSURE QUALITY CARE TO THIS DEMOGRAPHIC. THE HOSPITAL WAS NOT ABLE TO ESTIMATE THE MEDICARE ALLOWABLE COSTS BUT BELIEVES THE SERVICES RESULTED IN A LOSS. SINCE MEDICARE DOES NOT FULLY COVER THE COST OF THE SERVICES PROVICED AND THERE IS AN IDENTIFIED NEED TO PROVIDE SERVCIES TO THE ELDERLY, THE HOSPITAL BELIEVES THE SHORTFALL AMOUNT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 9B: SPECIAL CONSIDERATION IS MADE ON CASE BY CASE BASIS IF PATIENT MEETS THE CHARITY CARE POLICY GUIDELINES AS WELL AS ALL TROUBLED ACCOUNTS. PART VI, LINE 2: THE COMMUNITY NEEDS ASSESSMENT SURVEY SENT TO ORGANIZATIONS THAT SERVICE GERIATRIC POPULATION OF WEST HARTFORD SURROUNDING COMMUNITIES. THE SURVEY IDENTIFIES THE RESPONDENTS, THE MOST SIGNIFICANT HEALTH NEEDS/ISSUES, GROUPS/INDIVIDUALS THAT COULD BE EFFECTIVE IN HELPING THOSE NEEDS AND ROLE HEBREW HEALTH CARE CAN PROVIDE. PART VI, LINE 3: FINANCIAL AID APPLICATIONS CAN BE CONSIDERED ANYTIME FROM THE POINT OF SERVICE TO THE BILL BEING RECEIVED. THE FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE TO PATIENTS WHOSE FAMILY INCOME IS 200 PERCENT OR LESS OF THE FEDERAL POVERTY GUIDELINES AND INDIVIDUAL FINANCIAL CIRCUMSTANCES WILL BE USED IN CONJUNCTION WITH FEDERAL POVERTY GUIDELINES FOR DETERMINATION OF INDIVIDUAL FINANCIAL ASSISTANCE PROGRAM WRITE-OFFS. WHEN AN APPLICATION FOR FINANCIAL ASSISTANCE AND CHARITY CARE IS DENIED, THE RESPONSIBILITY PARTY SHALL RECEIVE A WRITTEN NOTICE OF DENIAL WHICH INCLUDES THE REASON OR REASONS FOR THE DENIAL; THE DATE OF THE DECISION; AND THE INSTRUCTIONS FOR APPEAL OR RECONSIDERATION. THE LETTER ALSO INCLUDES A DESCRIPTION OF THE INFORMATION THAT WAS REQUESTED AND NOT PROVIDED IF THIS IS THE CASE. THE CFO AND/OR ADMINISTRATOR WILL REVIEW ALL APPEALS. IF THIS REVIEW REAFFIRMS THE PREVIOUS DENIAL OF FINANCIAL ASSISTANCE AND CHARITY CARE, WRITTEN NOTIFICATION WILL BE SENT TO THE RESPONSIBLE PARTY AND ALL OTHER STATE LAWS REGARDING NOTIFICATION WILL BE FOLLOWED. PART VI, LINE 4: OUR BEHAVIORAL HEALTH UNIT WAS OPENED IN 2005, WE HAVE SPECIALIZED IN THE CARE AND TREATMENT OF OLDER ADULTS AGE 50+ WHO ARE EXPERIENCING BEHAVIORAL HEALTH DISORDERS. THE COMMUNITY SERVED BY HEBREW SENIOR CARE'S GERIATRIC BEHAVIORAL HEALTH HOSPITAL IS THE SENIOR POPULATION (AGE 50 AND OLDER) IN THE GREATER HARTFORD CONNECTICUT AREA. THIS IS THE GEOGRAPHIC AREA MOST COMMONLY SERVED BY HEBREW SENIOR CARE'S BEHAVIORAL HEALTH HOSPITAL. HOWEVER, MANY INDIVIDUALS SERVED BY THE GERIATRIC BEHAVIORAL HEALTH HOSPITAL COME FROM THROUGHOUT THE STATE OF CONNECTICUT DUE TO THE LACK OF BEHAVIORAL HEALTH BEDS DEDICATED TO SENIORS. PART VI, LINE 5: HEBREW SENIOR CARE PROVIDES COMMUNITY BENEFITS TO THE GREATER HARTFORD REGION. DEEPLY DEVOTED LAY LEADERSHIP, A RESPONSIBILITY PROUDLY HANDED DOWN FROM GENERATION TO GENERATION, BEST DEFINES THE COMMITMENT OF HEBREW SENIOR CARE'S BOARD OF TRUSTEES. THE BOARD OF TRUSTEES PROVIDES FISCAL OVERSIGHT WHILE HONORING THE TENETS OF JUDAISM PROVIDING CARE TO THOSE WHO CAME BEFORE US REGARDLESS OF ONE'S ABILITY TO PAY AND ONE'S RELIGIOUS AFFILIATION. HEBREW SENIOR CARE'S LAY LEADERSHIP WORKS IN PARTNERSHIP WITH THE TALENTED STAFF TO ENSURE SERVICE LINES REMAIN RELEVANT IN THIS FAST-CHANGING HEALTH CARE ENVIRONMENT, AND THAT STANDARDS FOR CARE REMAIN AT THE HIGHEST LEVELS. THE BOARD OF DIRECTORS IS A VOLUNTEER BOARD COMPRISED OF PROMINENT MEMBERS OF THE COMMUNITY. THE HOSPITAL ALSO HAS AN OPEN MEDICAL STAFF ALLOWING COMMUNITY PHYSICIANS TO SERVE THEIR PATIENTS. PART VI, LINE 6: THE STORY OF HEBREW SENIOR CARE CONTINUES TO BE ONE OF COMMITMENT TO SENIOR HEALTH AND WELLNESS, FAITHFULNESS TO OUR JEWISH HERITAGE, AND RESPONSIVENESS TO THE COMMUNITY'S NEEDS. SINCE 1901, HEBREW SENIOR CARE HAS DEVOTED ITSELF TO THE CARE OF OLDER ADULTS AND HAS PROVIDED SENIOR SERVICES THROUGH THE JEWISH TRADITION OF CARING FOR THE ELDERLY WITH COMPASSION AND NOT FORSAKING THE ELDERLY WHEN THEIR STRENGTH FAILS. HEBREW SENIOR CARE SERVICES ARE OPEN TO BOTH THE JEWISH COMMUNITY AND THE COMMUNITY AT LARGE.HEBREW SENIOR CARE HAS SIX AFFILIATES: HEBREW HOME & HOSPITAL - THE ORGANIZATION OPERATES A 38-BED BEHAVIORAL HEALTH HOSPITAL TYPICALLY FOR INDIVIDUALS EXPERIENCING ACUTE PSYCHIATRIC SYMPTOMS OR BEHAVIORS THAT INTERFER WITH THEIR CARE. WHETHER AN OLDER ADULT IS EXPERIENCING DEPRESSION, DEMENTIA ACCOMPANIED BY BEHAVIORAL DISTURBANCES OR SCHIZOPHRENIA, ANXIETY, BIPOLAR DISORDER OR ALCOHOL WITHDRAWAL THE BEHAVIORAL HEALTH HOSPITAL AT HEBREW SENIOR CARE ARE EXPERTS IN SERVING THIS VULNERABLE POPULATION. THE BEHAVIORAL HEALTH HOSPITAL AT HEBREW SENIOR CARE SPECIALIZES IN SERVING OLDER ADULTS (50 YEARS AND OLDER)HEBREW COMMUNITY SERVICES, INC. - THIS ORGANIZATION PROVIDES A SENIOR DAY CARE CENTER AND AN ASSISTED LIVING SERVICES AGENCY. HEBREW LIFE CHOICES, INC. - THIS ORGANIZATION PROVIDES INDEPENDENT AND ASSISTED SENIOR LIVING.HEBREW HEALTH CARE FOUNDATION, INC. - THIS ORGANIZATION PROVIDES FUNDRAISING SERVICES FOR OTHER ORGANIZATIONS IN THE HEBREW SENIOR CARE SYSTEM.HEBREW HEALTH CARE, INC. - THIS ORGANIZATION PROVIDES ADMINISTRATIVE, OVERSIGHT AND FUNDRAISING SERVICES FOR OTHER ORGANIZATIONS IN THE HEBREW SENIOR CARE SYSTEM.CONNECTICUT GERIATRIC SPECIALTY GROUP, PC - THIS ORGANIZATION OPERATES A PHYSICIAN PRACTICE.PART VI, LINE 7 THE HOSPITAL OPERATES IN THE STATE OF CONNECTICUT WHICH DOES NOT REQUIRE REPORTING. 0 0 0 0 0 0 0 0 0 DENISE PETERSON PRESIDENT & CEO 0 265750 0 12500 0 0 0 0 0 23696 0 301946 0 0 LIISA LIVINGSTON CFO (UNTIL 11/2021) 0 153032 0 0 0 0 0 0 0 0 0 153032 0 0 MADELENE FRANCESE VP OF DEVELOPMENT 0 150601 0 0 0 0 0 0 0 0 0 150601 0 0 PART I, LINE 3 THE COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR IS PAID BY HEBREW HEALTH CARE, INC. WHICH USES THE FOLLOWING METHODS WHEN DETERMINING COMPENSATION: - COMPENSATION COMMITTEE - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE - COMPENSATION SURVEY OR STUDY FORM 990, PART VI, SECTION A, LINE 6 HEBREW HOME & HOSPITAL ("THE HOSPITAL") HAS ONLY ONE MEMBER. THE SOLE MEMBER OF THE ORGANIZATION IS HEBREW HEALTH CARE, INC., A CONNECTICUT NONSTOCK CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE BYLAWS, THE BOARD SHALL HAVE FOURTEEN (14) EX-OFFICIO TRUSTEES. THE PERSONS WHO HOLD THE FOLLOWING OFFICES OR POSITIONS SHALL BE THE EX-OFFICIO TRUSTEES OF THE HOME AT ALL TIMES WHILE SERVING IN SUCH OFFICES OR POSITIONS, AUTOMATICALLY AND WITHOUT THE NEED FOR ANY ACTION BY THE MEMBER OR THE OTHER TRUSTEES: (I) THE CHAIRPERSON OF THE BOARD OF TRUSTEES OF THE HEBREW HEALTH CARE FOUNDATION, INC., A CONNECTICUT NONSTOCK CORPORATION; (II) THE CHAIRPERSON OF THE BOARD OF TRUSTEES OF HEBREW COMMUNITY SERVICES, INC., A CONNECTICUT NONSTOCK CORPORATION; (III) THE CHAIRPERSON OF THE BOARD OF TRUSTEES OF HEBREW LIFE CHOICES, INC., A CONNECTICUT NONSTOCK CORPORATION, (IV) THE PRESIDENT OF THE AUXILIARY OF THE HEBREW HOME AND HOSPITAL, INCORPORATED (THE "AUXILIARY"); (V) THE IMMEDIATE PAST PRESIDENT OF THE AUXILIARY; (VI) THE PRESIDENT ELECT OF THE AUXILIARY; (VII) THE PRESIDENT OF THE HOME; (VIII) THE IMMEDIATE PAST CHAIRPERSON OF THE BOARD OF TRUSTEES OF THE HOME; (IX) THE CHAIRPERSON OF THE BOARD OF TRUSTEES OF HEBREW HEALTH CARE, INC.; (X) THE PRESIDENT OF HEBREW HEALTH CARE, INC.; (XI) THE SENIOR VICE PRESIDENT OF HEBREW HEALTH CARE, INC.; AND (XII) THE SECRETARY OF HEBREW HEALTH CARE, INC.; (XIII) THE VICE CHAIRPERSON OF FINANCE OF HEBREW HEALTH CARE, INC.; AND (XIV) THE ASSISTANT VICE CHAIRPERSON OF FINANCE OF HEBREW HEALTH CARE, INC. A PERSON SHALL CEASE TO BE AN EX-OFFICIO TRUSTEE IMMEDIATELY UPON CEASING TO HOLD THE OFFICE OR POSITION FROM WHICH HIS OR HER EX-OFFICIO TRUSTEE STATUS DERIVED, AND HIS OR HER SUCCESSOR IN SUCH OFFICE OR POSITION SHALL AUTOMATICALLY BE AN EX-OFFICIO TRUSTEE, WITHOUT THE NEED FOR ANY ACTION BY THE MEMBER OR THE OTHER TRUSTEES. THE EX-OFFICIO TRUSTEES SHALL BE COUNTED FOR PURPOSES OF DETERMINING THE PRESENCE OF A QUORUM AT MEETINGS OF THE BOARD OF TRUSTEES AND EACH EX-OFFICIO TRUSTEE SHALL HAVE A VOTE ON ALL MATTERS THAT COME BEFORE THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B PURSUANT TO THE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO VOTE ON ALL MATTERS UPON WHICH MEMBERS OF A CONNECTICUT NONSTOCK CORPORATION ARE AFFORDED THE RIGHT TO VOTE UNDER THE ACT. WITHOUT LIMITING THE FOREGOING, EACH OF THE FOLLOWING MATTERS SHALL REQUIRE THE APPROVAL OF THE MEMBER: (A) ADOPTION OF THE HOME'S ANNUAL BUDGET FOR ANTICIPATED REVENUES AND EXPENDITURES, BOTH OPERATING AND CAPITAL; (B) UNLESS ADOPTED AS PART OF THE HOME'S ANNUAL BUDGET: (1) THE SALE, LEASE, EXCHANGE OR OTHER TRANSFER OR DISPOSITION (OTHER THAN AS PROVIDED FOR IN SUBPARAGRAPH (B)(2) BELOW) OF ANY OF THE HOME'S PROPERTY OF ANY NATURE HAVING A VALUE OF MORE THAN $20,000 IN ONE YEAR; (2) THE MORTGAGE, PLEDGE OR OTHER ENCUMBRANCE OF ANY OF THE HOME'S PROPERTY OR ASSETS OF ANY NATURE THAT IS NOT IN CONNECTION WITH A PLANNED GIVING OR OTHER CHARITABLE ARRANGEMENT, INCLUDING BUT NOT LIMITED TO THE HOME'S ISSUANCE OF CHARITABLE GIFT ANNUITIES; (3) THE INCURRENCE BY THE HOME OF INDEBTEDNESS FOR BORROWED MONEY OR THE ISSUANCE BY THE HOME OF A GUARANTY OR OTHER UNDERTAKING TO BECOME OBLIGATED FOR ANY DEBT OR OBLIGATION OF ANY PARTY (IN EACH CASE, OTHER THAN IN CONNECTION WITH A PLANNED GIVING OR OTHER CHARITABLE ARRANGEMENT, INCLUDING BUT NOT LIMITED TO THE HOME'S ISSUANCE OF CHARITABLE GIFT ANNUITIES); (4) THE MAKING OF ANY LOAN BY THE HOME TO ANY PARTY IN EXCESS OF $500; (C) ANY AMENDMENT OR REPEAL OF ANY PROVISION OF THE BYLAWS OF THE HOME; (D) ANY CHANGE IN THE PURPOSES OR MISSION OF THE HOME; (E) ANY MERGER INVOLVING THE HOME; (F) THE DISSOLUTION OF THE HOME; (G) PARTICIPATION BY THE HOME IN ANY JOINT VENTURE, PARTNERSHIP OR SIMILAR ACTIVITY; (H) ENGAGING IN ANY TRANSACTION IN WHICH THE HOME BECOMES A SHAREHOLDER, MEMBER OR EQUITY OWNER OF A CORPORATION, LIMITED LIABILITY COMPANY OR OTHER ENTITY; (I) THE ANNUAL APPOINTMENT OF A FIRM OF PUBLIC ACCOUNTANTS TO CONDUCT AN INDEPENDENT AUDIT OF THE HOME'S FINANCIAL AFFAIRS; OR (J) ANY AMENDMENT OR REPEAL OF ANY PROVISION OF THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OF THE HOME. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH THE ASSISTANCE OF MANAGEMENT. A DRAFT FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR THE SOLE MEMBER HEBREW HEALTH CARE, INC. FOR REVIEW AND OVERSIGHT. FORM 990, PART VI, SECTION B, LINE 12C THIS ORGANIZATION HAS ADOPTED THE POLICY OF ITS SOLE MEMBER HEBREW HEALTH CARE, INC. REGARDING CONFLICT OF INTEREST. PER THE CONFLICT OF INTEREST POLICY WHICH APPLIES TO ALL ORGANIZATIONS IN THE HEBREW SENIOR CARE SYSTEM, OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES HAVE A DUTY TO DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST. FOLLOWING DISCLOSURE OF AN ACTUAL OR POSSIBLE CONFLICT, THE OTHER MEMBERS OF THE BOARD OR COMMITTEE WILL DETERMINE WHAT FURTHER STEPS MAY BE REQUIRED TO INVESTIGATE THE SITUATION. THE INDIVIDUAL WITH THE POTENTIAL CONFLICT WILL RECUSE THEMSELF FROM THE DISCUSSION OF THE MATTER. THE POLICY INCLUDESMPROVISIONS FOR VIOLATION AND FAILURE TO DISCLOSE WHICH COULD LEAD TO DISCIPLINARY AND CORRECTIVE ACTION, INCLUDING, BUT NOT LIMITED TO REMOVAL FROM THE BOARD OR COMMITTEE IN ACCORDANCE WITH THE BYLAWS OF THE ENTITY. THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE ADMINISTRATIVE SECRETARY OF HEBREW HOME & HOSPITAL, A MEMBER OF THE HEBREW SENIOR CARE SYSTEM. FORM 990, PART VI, SECTION B, LINE 15A ALL COMPENSATION FOR THE PRESIDENT AND OFFICERS ARE PAID BY THE SOLE MEMBER, HEBREW HEALTH CARE, INC. THIS ORGANIZATION HAS ADOPTED THE POLICY OF ITS SOLE MEMBER HEBREW HEALTH CARE, INC. REGARDING COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HEBREW HEALTH CARE INC 1 ABRAHMS BLVD WEST HARTFORD CT 06117 043750515 ADMIN OVERSIGHT & FUNDRAISING CT 501(C)(3) LINE 7 N/A 0 HEBREW COMMUNITY SERVICES INC 1 ABRAHMS BLVD WEST HARTFORD CT 06117 223182447 SENIOR DAY CTR & ALSA CT 501(C)(3) LINE 10 HEBREW HEALTH CARE INC 0 HEBREW LIFE CHOICES INC 1 ABRAHMS BLVD WEST HARTFORD CT 06117 061557313 SENIOR ASSISTED LIVING CT 501(C)(3) LINE 10 HEBREW HEALTH CARE INC 0 HEBREW HEALTH CARE FOUNDATION INC 1 ABRAHMS BLVD WEST HARTFORD CT 06117 061310204 REPOSITORY CT 501(C)(3) LINE 12B, II HEBREW HEALTH CARE INC 0 CONNECTICUT GERIATRIC SPECIALTY GROUP PC 1 ABRAHMS BLVD WEST HARTFORD CT 06117 593840584 PHYSICIAN GROUP CT N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 HEBREW HEALTH CARE FOUNDATION INC C 157976