2022-11-15T14:43:41-06:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2021-01-01 510141617 CHELSEA JEWISH LIFECARE INC CHEL 6178870001 165 CAPTAINS ROW CHELSEA MA 02150 JENNIFER SANTERRE CFO 9784715118 2022-11-15 1 JENNIFER SANTERRE 999009999 DANIELLE NIHILL P01350943 7819821001 2022-11-15 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z LEGACY LIFECARE MANAGEMENT ADAM BERMAN 165 CAPTAINS ROW CHELSEA MA 02150 8106917 0 X WWW.CHELSEAJEWISH.ORG X 1975 MA TO MANAGE A CONTINUUM OF SENIOR CARE BUSINESS LINES. 11 8 1239 10 0 0 531465 75000 7429720 8008444 21024 23473 0 0 7982209 8106917 0 0 0 0 6360329 6821003 0 0 951963 1238757 1713844 7599086 8534847 383123 -427930 34483348 26644582 28507677 2891790 5975671 23752792 X THE ORGANIZATION'S MISSION IS TO MANAGE A CONTINUUM OF SENIOR CARE BUSINESS LINES THAT CONSISTENTLY PROVIDE HIGH-QUALITY COMPASSIONATE CARE WHILE FOCUSING ON THE DEVELOPMENT OF INNOVATIVE PROGRAMS AND SERVICES THAT ENABLE INIDIVIDUALS TO LIVE AS INDEPENDENTLY AS POSSIBLE. 0 0 490677 0 8008444 MANAGEMENT & SUPPORT - TO MANAGE A CONTINUUM OF SENIOR CARE BUSINESS LINES THAT CONSISTENTLY PROVIDE HIGH-QUALITY COMPASSIONATE CARE WHILE FOCUSING ON THE DEVELOPMENT OF INNOVATIVE PROGRAMS AND SERVICES THAT ENABLE INIDIVIDUALS TO LIVE AS INDEPENDENTLY AS POSSIBLE. 490677 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 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1239 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 8 1 0 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X JENNIFER SANTERRE 9784715118 240 LYNNFIELD STREET PEABODY MA 01960 BARRY BERMAN TREASURER 26.00 14.00 X X 711685 0 20397 ADAM BERMAN PRESIDENT AND CEO 26.00 14.00 X X 455719 0 27541 JEFFREY LANDA CFO 26.00 14.00 X 276879 0 29524 ELIZABETH MULLEN COO AND CLERK 26.00 14.00 X 252926 0 11000 RONILO ANGLO CHIEF CLINICAL OFFICER 26.00 14.00 X 215993 0 27422 KAREN PETRUCCELLI VP CLINICAL QUALITY IMPROVEMENT 26.00 14.00 X 198950 0 12738 KATHERINE SANTOS VP OF STRATEGY & OPERATION 26.00 14.00 X 192277 0 2229 THERESA HALLIDAY-BURRI CHIEF DEVELOPMENT OFFICER 26.00 14.00 X 172926 0 11038 MEGIN HEMMERLING DIRECTOR OF ASSISTED LIVING SERVICES 26.00 14.00 X 131363 0 1686 GILDA RICHMAN CHAIR 1.00 39.00 X X 77866 0 58 JOEL MAZER DIRECTOR 1.00 7.00 X 0 0 0 JUDY WEISS DIRECTOR 1.00 7.00 X 0 0 0 ESTELLE BOOKMAN DIRECTOR 1.00 X 0 0 0 JEFFREY BRUDNICK DIRECTOR 1.00 X 0 0 0 STUART ANFANG DIRECTOR 1.00 7.00 X 0 0 0 SUSAN GOLDSMITH DIRECTOR 1.00 7.00 X 0 0 0 HOWARD GREENSPAN DIRECTOR 1.00 X 0 0 0 SHARON FORMAN DIRECTOR 1.00 X 0 0 0 MARK DINDAS DIRECTOR (THROUGH OCT 2021) 1.00 3.00 X 0 0 0 DORIS TOLTZ FRIEDMAN DIRECTOR (THROUGH FEB 2021) 1.00 X 0 0 0 2686584 0 143633 69 0 1 0 SPERLING INTERACTIVE 10 DERBY SQUARE SALEM MA 01970 MARKETING/WEB DESIGN 269262 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 ACCOUNTANTS 153532 2 75000 75000 MANAGEMENT FEE 561000 7915712 7915712 MISCELLANEOUS INCOME 561000 92732 92732 8008444 23473 23473 8106917 8008444 0 23473 X 1785671 163497 968186 653988 34137 34137 3892108 193846 3473004 225258 15169 1285 11312 2572 593432 14927 577336 1169 500486 34878 396632 68976 61281 3064 58217 66005 66005 425278 425278 271060 271060 437435 1421 436014 131016 9637 121379 61421 6142 55279 69291 2057 67234 49752 49752 8817 853 7964 23814 2381 21433 37548 1877 35671 LICENSES AND DUES EXPEN 31758 31758 PRIOR YEAR EXPENSE ADJU 20279 20279 STORE EXPENSE 9867 9867 9222 396 8826 8534847 490677 7092207 951963 267360 556895 100000 100000 1583981 1245059 17587644 17610238 324163 515901 386491 342785 59947 43706 14560253 6572783 34483348 26644582 1272587 1341910 40000 40000 309080 300229 971312 26886010 238339 28507677 2891790 X 3340244 21456288 2635427 2296504 5975671 23752792 34483348 26644582 X -427930 357249 17847802 X 0 1 X 1 1 1 X 1152243 132462 131928 531465 75000 2023098 1152243 132462 131928 531465 75000 2023098 561912 1461186 232952 18739 31792 21024 23473 327980 2351078 32455401 0.62150 0.70220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3098469 3098469 3440141 78328 420000 3098469 3874919 190222 625000 3440141 3133290 1096629 355000 3874919 60578 60578 0 325913 282207 43706 43706 OTHER RECEIVABLES 62930 DUE FROM RELATED PARTIES 6476841 CONSTRUCTION IN PROGRESS 2350 OTHER 618 SOFTWARE, NET 30044 6572783 DUE TO RELATED PARTIES 238339 238339 X PART V, LINE 4: DURING 2020, IT WAS DETERMINED THAT THE AMOUNTS REPORTED IN PRIOR YEARS CONSIST OF DONOR RESTRICTED FUNDS AND DO NOT REPRESENT EITHER TERM OR PERMANENT ENDOWMENTS. THEREFORE, THESE FUNDS ARE NOT REQUIRED TO BE REPORTED IN SCHEDULE D, PART V AND THE BALANCE AS OF DECEMBER 31, 2020 WAS REDUCED TO ZERO. PART X, LINE 2: THE MEMBERS OF THE ORGANIZATION HAVE BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) AND APPLICABLE STATE STATUTES; ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. X X X 0 0 0 0 0 0 0 0 0 BARRY BERMAN TREASURER 677007 0 0 0 34678 0 800 0 19597 0 732082 0 0 0 ADAM BERMAN PRESIDENT AND CEO 428158 0 0 0 27561 0 800 0 26741 0 483260 0 0 0 JEFFREY LANDA CFO 276879 0 0 0 0 0 800 0 28724 0 306403 0 0 0 ELIZABETH MULLEN COO AND CLERK 252926 0 0 0 0 0 800 0 10200 0 263926 0 0 0 RONILO ANGLO CHIEF CLINICAL OFFICER 215993 0 0 0 0 0 800 0 26622 0 243415 0 0 0 KAREN PETRUCCELLI VP CLINICAL QUALITY IMPROVEMENT 198950 0 0 0 0 0 800 0 11938 0 211688 0 0 0 KATHERINE SANTOS VP OF STRATEGY & OPERATION 192277 0 0 0 0 0 800 0 1429 0 194506 0 0 0 THERESA HALLIDAY-BURRI CHIEF DEVELOPMENT OFFICER 172926 0 0 0 0 0 800 0 10238 0 183964 0 0 0 ANDREW MULLEN ENVIRONMENTAL ENGINE RELATED TO ELIZABETH MULLEN, COO AND DIRECTOR OF THE BOARD OF THE ORGANIZAT 34138 SALARY AND BENEFITS 0 FORM 990, PART IV, SECTION A, LINE 28C: JEFFREY BRUDNICK, DIRECTOR, HAS A BUSINESS RELATIONSHIP WITH THE ORGANIZATION; HOWEVER TRANSACTION AMOUNTS ARE BELOW SCHEDULE L REPORTING THRESHOLDS. FORM 990, PART V, LINE 2A: THIS ORGANIZATION USES A COMMON PAYMASTER, AS SUCH, ALL EMPLOYEES ARE LISTED UNDER THE COMMON PAYMASTER, CHELSEA JEWISH LIFECARE, INC. OF THE 1239 EMPLOYEES PAID BY THE COMMON PAYMASTER, 55 EMPLOYEES HAD A PORTION OR ALL OF THEIR TIME ALLOCATED TO THIS ORGANIZATION DURING 2021. FORM 990, PART VI, SECTION A, LINE 2 ADAM BERMAN, PRESIDENT AND CEO, AND BARRY BERMAN, TREASURER, HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE JANUARY 1, 2021, THE SOLE MEMBER OF THE CORPORATION IS LEGACY LIFECARE, INC. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS A RELATED ORGANIZATION, LEGACY LIFECARE, INC. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S COMPLETE FORM 990 IS REVIEWED BY THE TOP MANAGEMENT PRIOR TO FILING WITH THE IRS. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, ALL BOARD MEMBERS ARE INSTRUCTED TO INFORM THE REST OF THE BOARD IF ANY CONFLICT OF INTEREST EXISTS PERTAINING TO THEIR MEMBERSHIP ON THE BOARD. ANY POTENTIAL CONFLICT OF INTEREST IS THEN DISCUSSED AND ASSESSED BY THE REMAINING BOARD MEMBERS. IF A CONFLICT EXISTS, IT MUST BE DISCLOSED AND HELD TO A HIGHER LEVEL OF SCRUTINY IN ORDER TO VERIFY THAT ALL TRANSACTIONS ARE AT ARMS-LENGTH. ANY BOARD MEMBER DEEMED TO HAVE A CONFLICT OF INTEREST WILL ABSTAIN FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. THE PRESIDENT AND CEO ARE RESPONSIBLE FOR OVERSEEING THAT THE CONFLICT OF INTEREST PROCESS TAKES PLACE. FORM 990, PART VI, SECTION B, LINE 15 PRIOR TO MAJOR SALARY ADJUSTMENTS FOR THE CEO, THE ORGANIZATION'S BOARD OF DIRECTORS COMPENSATION COMMITTEE ARRANGES FOR A SALARY STUDY TO BE PERFORMED. THE STUDY INCLUDES THE EXECUTIVE SALARIES OF COMPARABLY-SIZED COMPANIES IN THE INDUSTRY. THE BOARD OF DIRECTORS THEN CONSIDERS THE FINDINGS OF THE STUDY IN SETTING THE CEO'S COMPENSATION. 2021 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION FOR KEY EMPLOYEES IS DETERMINED THROUGH THE USE OF SALARY STUDIES OR OTHER DATA AND ADJUSTED BASED ON THE EMPLOYEE'S YEARS OF EXPERIENCE AND RESPONSIBILITIES BY BOARD OF DIRECTORS COMPENSATION COMMITTEE. 2021 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 5: GILDA RICHMAN'S COMPENSATION RELATES TO HER ROLE AS AN EMPLOYEE AND IS ALLOCATED TO A RELATED ORGANIZATION. AS SUCH, HER COMPENSATION IS REFLECTED ON THE RELATED ORGANIZATION'S STATEMENT OF FUNCTIONAL EXPENSES. FORM 990, PART XI, LINE 9: CHANGE IN PLEDGE DISCOUNT 163,826. TRANSFERS OF NET ASSETS WITHOUT DONOR RESTRICTIONS 17,683,976. ADMIRAL'S HILL ASSISTED LIVING CORP II 201 CAPTAINS ROW CHELSEA MA 02150 043538833 ASSISTED LIVING MA 501(C)(3) PF CHELSEA JEWISH LIFECARE INC 1 CHELSEA JEWISH CHARITABLE FOUNDATION INC 240 LYNNFIELD STREET PEABODY MA 01960 261244471 FUNDRAISING & SUPPORT MA 501(C)(3) LINE 12B, II CHELSEA JEWISH LIFECARE INC 1 CHELSEA JEWISH COMMUNITY INC 165 CAPTAINS ROW CHELSEA MA 02150 271756594 MANAGEMENT, HOMECARE, HOSPICE MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 1 CHELSEA JEWISH GREEN HOUSE INC 165 CAPTAINS ROW CHELSEA MA 02150 043326727 ASSISTED LIVING & NURSING HOME MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 1 CHELSEA JEWISH NORTH SHORE ASSISTED LIVING INC 240 LYNNFIELD STREET PEABODY MA 01960 043274643 ASSISTED LIVING MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 1 CHELSEA JEWISH NURSING HOME INC 17 LAFAYETTE AVENUE CHELSEA MA 02150 042200583 NURSING HOME MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 1 JEWISH NURSING HOME OF WESTERN MA INC 770 CONVERSE STREET LONGMEADOW MA 01106 043138403 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 1 JEWISH REHABILITATION CENTER FOR AGED OF THE NORTH SHORE INC 240 LYNNFIELD STREET PEABODY MA 01960 042106768 SKILLED NURSING & ADH MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 1 JGS ADMINISTRATIVE SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 01106 043295014 ADMIN SUPPORT TO JEWISH GERIATRIC SERVICES MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 1 JGS HOUSING SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 01106 043321157 ASSISTED LIVING MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 1 JGS LIFECARE CORPORATION 770 CONVERSE STREET LONGMEADOW MA 01106 042129128 GERIATRIC/NURSING PROVIDER MA 501(C)(3) LINE 7 CHELSEA JEWISH LIFECARE INC 1 LEGACY LIFECARE INC 240 LYNNFIELD STREET PEABODY MA 01960 223102199 SUPPORT SERVICES AND FUNDRAISING MA 501(C)(3) LINE 12A, I N/A 0 SPECTRUM HOME CARE INC 770 CONVERSE STREET LONGMEADOW MA 01106 043399549 NON-CERTIFIED HOME HEALTH AGENCY MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 1 SPECTRUM HOME HEALTH AND HOSPICE CARE INC 770 CONVERSE STREET LONGMEADOW MA 01106 043237982 HOME HEALTH & HOSPICE CARE MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 1 DEUTSCHES ALTENHEIM INC 2222 CENTRE STREET WEST ROXBURY MA 02132 042104144 SKILLED NURSING & ADH & AL MA 501(C)(3) LINE 10 LEGACY LIFECARE INC 0 WINTHROP APARTMENTS LLC 165 CAPTAINS ROW CHELSEA MA 02150 463739775 REAL ESTATE MA 0 0 0 0 1 1 0 0 0 0 0 0 1 0 1 1 1 1 0 0 CHELSEA JEWISH GREEN HOUSE INC D 15326491 COST CHELSEA JEWISH NURSING HOME INC D 2417835 COST JEWISH NURSING HOME OF WESTERN MA INC L 802310 COST JEWISH REHAB CENTER FOR AGED OF NS INC L 1191002 COST ADMIRAL'S HILL ASSISTED LIVING CORP II L 82084 COST CHELSEA JEWISH COMMUNITY INC L 283334 COST CHELSEA JEWISH GREEN HOUSE INC L 1166818 COST CHELSEA JEWISH NORTH SHORE ASSISTED LIVING INC L 442248 COST CHELSEA JEWISH NORTH SHORE ASSISTED LIVING INC L 956863 COST CHELSEA JEWISH NURSING HOME INC L 867308 COST JEWISH REHAB CENTER FOR AGED OF NS L 2295915 COST JGS HOUSING SERVICES INC L 138240 COST SPECTRUM HOME HEALTH AND HOSPICE L 113284 COST ADMIRAL'S HILL ASSISTED LIVING CORP II O 80912 COST CHELSEA JEWISH COMMUNITY INC O 217171 COST CHELSEA JEWISH GREEN HOUSE INC O 449874 COST CHELSEA JEWISH NORTH SHORE ASSISTED LIVING INC O 314874 COST CHELSEA JEWISH NURSING HOME INC O 534186 COST JEWISH REHAB CENTER FOR AGED OF NS O 373821 COST WINTHROP APARTMENTS LLC D 186325 COST DEUTSCHES ALTENHEIM INC L 760792 COST JGS LIFECARE CORPORATION D 225750 COST JGS LIFECARE CORPORATION E -172289 COST DEUTSCHES ALTENHEIM INC D 289617 COST