2022-08-12T14:24:35-05:00 2021-09-30 111986323 MARCUM LLP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 990 2020-10-01 060658099 ELIM PARK BAPIST HOME INC ELIM 2032723547 140 COOK HILL ROAD CHESHIRE CT 06410 ZELL GASTON CFO 2032723547 2022-08-12 1 ZELL GASTON 999009999 MARY-EVELYN ANTONETTI P00431862 2037819600 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ZELL GASTON 140 COOK HILL ROAD CHESHIRE CT 06410 37923293 0 X WWW.ELIMPARK.ORG X 1906 CT ELIM PARK WAS FOUNDED IN 1906 BY THE SWEDISH BAPTIST CONFERENCE WITH THE MISSION TO CARE FOR AND PROVIDE A HOME OF REST FOR THE FRAIL AND ELDERLY MEMBERS OF THEIR CONFERENCE. SINCE OUR INCORPORATION, OUR MISSION HAS EXPANDED AND MATURED, AND WE ARE NO LONGER A "HOME OF REST," BUT RATHER A HOME WHERE RESIDENTS CAN FLOURISH AND LIVE ACTIVE, INSPIRED, FULFILLING LIVES. THE INTERDENOMINATIONAL NATURE OF OUR ORGANIZATION WELCOMES OLDER ADULTS OF ALL FAITHS, WITH A CARING STAFF AND CHRIST-CENTERED ENVIRONMENT THAT ALLOWS THEM TO GROW IN SPIRITUAL HEALTH AS WELL AS MEETING THEIR PHYSICAL NEEDS. OUR MISSION IS TO PROVIDE QUALITY CARE THROUGH EXCITING CULTURAL AND FITNESS PROGRAMS AND A BROAD SPECTRUM OF HEALTH SERVICES IN A CHRIST-CENTERED ENVIRONMENT. ELIM PARK LOOKS UPON ITS MISSION AS AN EXTENSION OF THE CHURCH MINISTRY WITHIN THE BAPTIST GENERAL CONFERENCE AND GIVES ADMISSION PRIORITY TO ITS MEMBERS. 6 6 581 0 0 0 245942 4454855 30491793 28845969 635227 607975 0 0 31372962 33908799 509334 607696 0 0 17097688 15360734 0 0 58975 11872863 12309662 29479885 28278092 1893077 5630707 79527072 82860943 75360386 71825174 4166686 11035769 X ELIM PARK WAS FOUNDED IN 1906 BY THE SWEDISH BAPTIST CONFERENCE WITH THE MISSION TO CARE FOR AND PROVIDE A HOME OF REST FOR THE FRAIL AND ELDERLY MEMBERS OF THEIR CONFERENCE. SINCE OUR INCORPORATION, OUR MISSION HAS EXPANDED AND MATURED, AND WE ARE NO LONGER A "HOME OF REST." BUT RATHER A HOME WHERE RESIDENTS CAN FLOURISH AND LIVE ACTIVE, INSPIRED, FULFILING LIVES. THE INTERDENOMINATIONAL NATURE OF OUR ORGANIZATION WELCOMES OLDER ADULTS OF ALL FAITHS, WITH A CARING STAFF AND CHRIST-CENTERED ENVIRONMENT THAT ALLOWS THEM TO GROW IN SPIRITUAL HEALTH AS WELL AS MEETING THEIR PHYSICAL NEEDS. OUR MISSION IS TO PROVIDE QUALITY CARE THROUGH EXCITING CULTURAL AND FITNESS PROGRAMS AND A BROAD SPECTRUM OF HEALTH SERVICES IN A CHRIST-CENTERED ENVIRONMENT. ELIM PARK LOOKS UPON ITS MISSION AS AN EXTENSION OF THE CHRUCH MINISTRY WITHIN THE BAPTIST GENERAL CONFERENCE AND GIVES ADMISSION PRIORITY TO ITS MEMBERS. 0 0 23838266 607696 28845969 THE CONSTELLATION OF SERVICES OFFERED AT ELIM PARK HAS ENHANCED LIFE FOR OUR RESIDENTS AND CONTINUES TO MAKE A POSITIVE IMPACT ON OUR COMMUNITY. THROUGH OUR MISSION OF PROVIDING QUALITY CARE THROUGH COMPREHENSIVE WELLNESS PROGRAMS AND MEDICAL FACILITIES IN A CHRIST-CENTERED ENVIRONMENT, WE ARE ABLE TO NURTURE THE WHOLE PERSON AND FOCUS ON TOTAL WELLNESS OF MIND, BODY AND SPIRIT. OUR SUB-ACUTE CARE, SHORT-TERM REHABILITATION AND WELLNESS PROGRAMS WORK TOGETHER TO ENSURE THAT RESIDENTS ARE LEADING THE MOST PRODUCTIVE LIFESTYLES APPROPRIATE TO THEIR VARIED LEVELS OF INDEPENDENCE. SHOULD A RESIDENT'S DEPENDENCY LEVEL INCREASE, OUR SKILLED NURSING FACILITY UNIT PROVIDES A SMOOTH TRANSITION TO ON-SITE NURSING CARE.ELIM PARK'S NON-PROFIT STATUS ALLOWS US TO CHANNEL REVENUE BACK INTO PROGRAMS AND SITE IMPROVEMENTS TO ENRICH THE LIVES OF OUR RESIDENTS. BENEFITS TO THE COMMUNITY INCLUDE A BROAD SPECTRUM OF OUT-PATIENT AND THERAPEUTIC SERVICES, AQUATIC THERAPY, HOSTING COMMUNITY EVENTS, OFFERING A PROFESSIONAL ENTERTAINMENT SERIES, AND OPENING OUR CAMPUS FOR USE BY LOCAL CIVIC GROUPS AND ORGANIZATIONS.WE CONTINUE TO UPGRADE OUR PHYSICAL PLANT TO MAINTAIN THE HIGHEST SAFETY STANDARDS AND A WELCOME ENVIRONMENT. WE MAKE TECHNOLOGICAL IMPROVEMENTS WHICH CONTRIBUTE TO THE WELL-BEING AND COMFORT OF OUR RESIDENTS. WE MAINTAIN THE CHRIST-CENTERED COMMUNITY THAT OUR FOUNDING CHURCHES ENVISIONED AS THE CORNERSTONE UPON WHICH ELIM PARK CONTINUES TO GROW. 23838266 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 80 0 1 581 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X ZELL GASTON CFO 2032723547 140 COOK HILL ROAD CHESHIRE CT 06410 CHRIS NELSON IMMEDIATE PAST CHAIR 2.00 2.00 X 0 0 0 GEOFFREY SWANSON SECRETARY 2.00 2.00 X X 0 0 0 GLENN MASON TREASURER 2.00 2.00 X X 0 0 0 ROBERTO ECKER CHAIR 2.00 2.00 X X 0 0 0 TERRENCE BRENNAN DIRECTOR 2.00 2.00 X 0 0 0 WAYNE DETZLER DIRECTOR 2.00 2.00 X 0 0 0 TIM PONZANI DIRECTOR 2.00 2.00 X 0 0 0 JEANNINE DELIVRON VICE CHAIR (LEFT 3/27/2021) 2.00 X X 0 0 0 BRIAN BEDARD PRESIDENT 36.50 1.00 X 282835 0 53374 ZELL GASTON CHIEF FINANCIAL OFFICER 36.50 1.00 X 183838 0 14790 JANICE LEXTON CHIEF NURSING OFFICER 37.50 X 155577 0 17008 JOHN SWEENEY ADMINSTRATOR OF HEALTH SER 37.50 X 160721 0 7542 ROSE RETUYA RN 37.50 X 124711 0 13055 DEBORAH SMITH STAFF DEVELOPMENT AN 37.50 X 123425 0 23089 ROBERT COTA DIRECTOR OF INDEPENDENT LIVING 37.50 X 116606 0 29729 1147713 0 158587 7 0 1 0 SODEXO 9801 WASHINGTONIAN BLVD GAITHERSBERG MD 20878 DIETARY MANAGEMENT 728474 S & S WIRED SYSTEM 24 TWILIGHT DRIVE GRANBY CT 06035 ELECTRICAL AND CONSTRUCTION 207710 STEADAST HVAC LLC 71 BENDER ROAD HAMDEN CT 06518 HEATING/AIR CONDITIONNING 163447 BROWN ROOFING COMPANY INC 12 PROGRESS AVE SEYMOUR CT 06483 ROOFING 139890 4 4262981 191874 4454855 MEDICARE/MEDICAID PMT 623110 13658119 13658119 IL RENTAL FEE 623300 9222860 9222860 AMORT. OF ENTRANCE FEE 623990 4981707 4981707 ANCILLARY REVENUE 623300 983283 983283 28845969 387309 387309 4235160 4014494 220666 220666 220666 33908799 28845969 0 607975 607696 607696 503168 503168 12163559 10538351 1592723 32485 363874 302733 60208 933 1419087 1175391 233765 9931 911046 757964 150746 2336 69484 69484 118168 118168 27653 27653 128502 128502 310122 23723 286399 451877 70954 380923 245220 245220 1856723 1856723 15635 15635 390249 390249 3694681 3694681 356827 356827 DIETARY 2178040 2178040 NURSING 694267 694267 ANCILLARY 547352 547352 PPP LOAN RESERVE 350000 350000 874862 277680 583892 13290 28278092 23838266 4380851 58975 1780 1622 17546109 19924873 4081140 3626296 320348 265200 112741243 64833012 48759103 47908231 6899231 8645854 1919361 2488867 79527072 82860943 4093693 4018589 31807698 32742491 12211770 11409934 27247225 23654160 75360386 71825174 X 2442098 8943811 1724588 2091958 4166686 11035769 79527072 82860943 X 5630707 1158198 80178 X 0 1 X 1 1 1 X 226988 194005 191753 245942 4454855 5313543 29123686 29935378 30860855 30491793 28845969 149257681 29350674 30129383 31052608 30737735 33300824 154571224 0 0 0 154571224 252147 324653 308565 380376 387309 1653050 252147 324653 308565 380376 387309 1653050 29602821 30454036 31361173 31118111 33688133 156224274 0.98940 0.99000 0.01060 0.01000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2305410 108803 309894 82750 2641357 2054002 162143 116482 27217 2305410 1903883 107954 83980 41815 2054002 2164893 136730 63598 461338 1903883 1930328 150060 136130 51625 2164893 0.02045 0.97955 0 1 1 958123 958123 91647118 52708865 38938253 17211359 10354197 6857162 2924643 1769950 1154693 47908231 DUE TO THIRD-PARTY REIMBURSEMENT AGENCIES 540917 CHARITABLE GIFT ANNUITIES 358744 OTHER LONG-TERM LIABILITIES 1707645 ENTRANCE FEE REFUNDS PAYABLE 20436905 OTHER CURRENT LIABILITIES 526233 PATIENT FUNDS PAYABLE 83716 23654160 X PART V, LINE 4: THE RESIDENT BENEVOLENT FUND IS RESTRICTED FOR USE TO ASSIST RESIDENTS IN NEED WITH MONTHLY SERVICE FUNDS. THE MARY MELBY FUND INTENDED USE IS FOR THE SUPPORT OF RESIDENT PASTORS. ADDITIONAL RESTRICTED AMOUNTS ARE USED PURSUANT TO THE REQUIREMENTS OF THE DONOR RESTRICTION. PART X, LINE 2: THE CORPORATION AND THE FOUNDATION HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTY IN INCOME 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, 2021 AND 2020, THERE ARE NO TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 CHESHIRE FIRE DEPARTMENT 250 MAPLE AVE CHESHIRE CT 06410 066001971 CHESHIRE 195000 2020 SERVICE/COMMUNITY DONATION CHESHIRE POLICE DEPARTMENT 500 HIGHLAND AVE CHESHIRE CT 06410 066001971 CHESHIRE 195000 2020 SERVICE/COMMUNITY DONATION CONVERGE NORTHEAST 150 COOK HILL ROAD CHESHIRE CT 06410 042464446 501(C)(3) 205000 ANNUAL TITHE CONNECTICUT COMMUNITY FOUNDATION 43 FIELD STREET WATERBURY CT 06702 066038074 501(C)(3) 10000 SCHOLARSHIP FUND 3 PART I, LINE 2: THE ORGANIZATION IS NOT A GRANT MAKING ORGANIZATION, ELIM PARK BAPTIST HOME, INC. DOES MAKE CHARITABLE CONTRIBUTIONS TO LOCAL TAX EXEMPT ORGANIZATIONS IN FURTHERANCE OF THEIR EXEMPT PURPOSE. X 1 1 X X X 0 0 0 0 0 0 0 0 0 BRIAN BEDARD PRESIDENT 282685 0 0 0 150 0 8569 0 44805 0 336209 0 0 0 ZELL GASTON CHIEF FINANCIAL OFFICER 183688 0 0 0 150 0 3152 0 11638 0 198628 0 0 0 JANICE LEXTON CHIEF NURSING OFFICER 155427 0 0 0 150 0 6566 0 10442 0 172585 0 0 0 JOHN SWEENEY ADMINSTRATOR OF HEALTH SER 160571 0 0 0 150 0 4946 0 2596 0 168263 0 0 0 PART I, LINE 3 THE PRESIDENT OF ELIM PARK IS REQUIRED TO LIVE ON THE FACILITY CAMPUS AS A CONDITION OF EMPLOYMENT. HOUSING IS CONSIDERED NONTAXABLE COMPENSATION AND THE VALUE IS INCLUDED IN PART II COLUMN D. A CONNECTICUT INNOVATIONS INCORPORATED 061423798 2012-12-21 17714000 REFINANCING OF CDA BONDS 0 0 0 A 6289815 17714000 321009 17392991 2012 1 0 1 1 A 0 0 1 0 0 0 0 1 A 0 0 1 0 0 1 KEYBANK 10.000000000000 0 0 0 0 1 A 0 PART II LINE 11 OTHER SPENT PROCEEDS $57,824 OF THE OTHER SPENT PROCEEDS WAS USED TO PAY ISSUER ADMINISTRATIVE FEE AND TITLE INSURANCE. $17,335,167 OF THE OTHER SPENT PROCEEDS WAS USED TO PAY BONDS DATED AUGUST 26, 1998 AND APRIL 15, 2003. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION UTILIZED SODEXO INC. TO MANAGE ITS DIETARY FUNCTION DURING THE TAX YEAR. THE MANAGEMENT OF THESE FUNCTIONS INCLUDED THE MANAGEMENT OF PERSONNEL (INCLUDING HIRING AND TERMINATION OF EMPLOYEES FOR THIS DEPARTMENT), AND THE RESPONSBILITY OF PREPARING A COST BUDGET AND CONTROLLING/MONITORING ACTUAL COSTS IN ACCORDANCE WITH THE BUDGET. FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEES HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE CONTROLLER AND CFO. THE FORM 990 IS PROVIDED TO THE FULL BOARD FOR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, DISCLOSURES ARE FILLED OUT BY EACH DIRECTOR. THESE ARE REVIEWED ANNUALLY TO ENSURE COMPLIANCE. IF AN ISSUE COMES UP, IT IS ADDRESSED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS INDEPENDENT STUDIES, THE COMMITTEE THEN DISCUSSES AND VOTES. THIS ACTION IS DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE TO RESIDENTS AND POTENTIAL RESIDENTS. THEY ARE ALSO AVAILABLE IN THE ANNUALLY FILED DISCLOSURE STATEMENT TO THE STATE OF CT. FORM 990, PART XI, LINE 9: CHANGE IN NET UNREALIZED LOSS ON SWAPS 145,182. CHANGE IN CHARITABLE GIFT ANNUITIES -10,004. CORRECTION FOR TRANSFERS -55,000. CONNECTICUT ALLIANCE FOR LONG TERM CARE 217 AVERY HEIGHTS HARTFORD CT 06106 061465316 ADMINISTER PROVIDER BASED NETWORK TO PROVIDE COST-EFFECTIVE HEALTH CARE CT 501(C)(3) LINE 12A, I N/A 0 ELIM PARK LEGACY FOUNDATION INC 140 COOK HILL ROAD CHESHIRE CT 06410 900436482 TO SUPPORT ELIM PARK CT 501(C)(3) LINE 12A, I ELIM PARK BAPTIST HOME INC 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 ELIM PARK LEGACY FOUNDATION INC D 2193750 LOAN BALANCE