2022-11-14T12:31:21-06:00 2021-12-31 113360065 ROTH & COMPANY LLP 1428 36TH STREET SUITE 200 BROOKLYN NY 11218 990 2021-01-01 112940331 CHAI LIFELINE INC CHAI 2124651300 151 WEST 30TH STREET 7TH FL NEW YORK NY 10001 STEPHEN SCHOLAR CHIEF EXECUTIVE OFFICER 2124651300 2022-11-10 1 STEPHEN SCHOLAR 999009999 ZACHARIA WAXLER P00502633 7182361600 2022-11-08 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CAMP SIMCHA STEPHEN SCHOLAR 151 WEST 30TH STREET 7TH FLOOR NEW YORK NY 10001 37743706 0 X CHAILIFELINE.ORG X 1988 NY CHAI LIFELINE IS AN INTERNATIONAL HEALTH SUPPORT NETWORK, PROVIDING SOCIAL, EMOTIONAL, FINANCIAL AND PRACTICAL ASSISTANCE TO CHILDREN, FAMILIES AND COMMUNITIES FACING ILLNESS, CRISIS, OR LOSS. CHAI LIFELINE OFFERS MORE THAN TWO-DOZEN YEAR-ROUND PROGRAMS AND SERVICES, INCLUDING CASE MANAGEMENT AND COUNSELING; MEALS DELIVERED TO HOSPITALS AND HOMES; TRANSPORTATION TO MEDICAL APPOINTMENTS; HOSPITAL AND IN-HOME RESPITE; EMERGENCY FINANCIAL ASSISTANCE; INSURANCE ADVOCACY; TRIPS, RETREATS AND SPECIAL EVENTS; PROJECT CHAI CRISIS INTERVENTION, TRAUMA, AND BEREAVEMENT SUPPORT; CLINICAL INTERVENTIONS; EDUCATIONAL RESOURCES; I-SHINE AFTERSCHOOL PROGRAMMING; AND ITS FLAGSHIP SUMMER PROGRAMS CAMP SIMCHA, CAMP SIMCHA SPECIAL, AND CAMP SIMCHA WITHOUT BORDERS FOR CHILDREN AND TEENS WITH LIFE-THREATENING AND LIFELONG ILLNESS. 20 20 238 4137 0 0 26295874 37415005 0 251875 -856728 -3533 -2549174 -5213361 22889972 32449986 825069 971062 0 0 11907008 12006739 0 0 2577580 9274756 11767817 22006833 24745618 883139 7704368 18906274 26757379 5474371 6259108 13431903 20498271 X CHAI LIFELINE IS AN INTERNATIONAL HEALTH SUPPORT NETWORK, PROVIDING SOCIAL, EMOTIONAL, FINANCIAL AND PRACTICAL ASSISTANCE TO CHILDREN, FAMILIES AND COMMUNITIES FACING ILLNESS, CRISIS, OR LOSS. CHAI LIFELINE OFFERS MORE THAN TWO-DOZEN YEAR-ROUND PROGRAMS AND SERVICES, INCLUDING CASE MANAGEMENT AND COUNSELING; MEALS DELIVERED TO HOSPITALS AND HOMES; TRANSPORTATION TO MEDICAL APPOINTMENTS; HOSPITAL AND IN-HOME RESPITE; EMERGENCY FINANCIAL ASSISTANCE; INSURANCE ADVOCACY; TRIPS, RETREATS AND SPECIAL EVENTS; PROJECT CHAI CRISIS INTERVENTION, TRAUMA, AND BEREAVEMENT SUPPORT; CLINICAL INTERVENTIONS; EDUCATIONAL RESOURCES; I-SHINE AFTERSCHOOL PROGRAMMING; AND ITS FLAGSHIP SUMMER PROGRAMS CAMP SIMCHA, CAMP SIMCHA SPECIAL, AND CAMP SIMCHA WITHOUT BORDERS FOR CHILDREN AND TEENS WITH LIFE-THREATENING AND LIFELONG ILLNESS. 0 0 5106682 CHAI LIFELINE OPERATES TWO MEDICALLY SUPERVISED SUMMER CAMP PROGRAMS ON ONE CAMPUS FOR SERIOUSLY ILL CHILDREN. CAMP SIMCHA IS OPEN TO CHILDREN AND TEENS WITH CANCER AND OTHER BLOOD-BASED ILLNESSES. CAMP SIMCHA SPECIAL IS DESIGNED TO MEET THE MEDICAL AND SOCIAL NEEDS OF CHILDREN AND TEENS WITH MULTIPLE, DISPARATE CHRONIC ILLNESSES AND/OR DISABILITIES. EACH CAMP RUNS TWO, TWO-WEEK SESSIONS EVERY SUMMER AT THEIR 125-ACRE, FULLY HANDICAPPED ACCESSIBLE CAMPGROUND IN GLEN SPEY, NY. ACTIVITIES INCLUDE ADAPTED SPORTS, SWIMMING (INCLUDING RED CROSS INSTRUCTION), BOATING, CRAFTS, WORKSHOPS, AND SPECIAL EVENTS LIKE CONCERTS AND SHOWS. THE GOALS OF THE CAMPS ARE TO FACILITATE INDEPENDENCE; BUILD SOCIAL, EMOTIONAL AND DAILY LIVING SKILLS; ENHANCE KNOWLEDGE OF ONE'S ILLNESS AND CAPABILITIES; AND ENCOURAGE THE DEVELOPMENT OF FRIENDSHIPS AND SUPPORTIVE RELATIONSHIPS THAT CONTINUE THROUGHOUT THE YEAR. IN ADDITION, CHAI LIFELINE OPERATES CAMP SIMCHA WITHOUT BORDERS, WHICH HOSTS PROGRAMS AND EVENTS IN COMMUNITIES ACROSS THE U.S. IN TOTAL, MORE THAN 1,000 CHILDREN AND TEENS TOOK PART IN SIMCHA PROGRAMMING IN 2021. 5093934 197306 251875 CHAI LIFELINE PROVIDES EMOTIONAL AND SOCIAL SUPPORT FROM THE MOMENT OF DIAGNOSIS THROUGH TREATMENT AND RECOVERY. GOALS INCLUDE ENABLING THE FAMILY UNIT TO CONTINUE TO FUNCTION DURING MEDICAL CRISES; PROVIDING IN-HOSPITAL SUPPORT TO PATIENTS AND CAREGIVERS; AND BRINGING JOY AND HOPE TO YOUNG PATIENTS AND THEIR FAMILIES. INITIAL SUPPORT BEGINS WITH A CASE MANAGER'S EVALUATION THAT IDENTIFIES NEEDS AND SUGGESTS PROGRAMMATIC RESPONSES. IN 2021, CHAI LIFELINE PROVIDED EMOTIONAL, SOCIAL, AND FINANCIAL SUPPORT TO 5690 FAMILIES THROUGH REFERRALS, INFORMATION AND ADVOCACY CONTACTS; 4,413 VOLUNTEER VISITS RAISED SPIRITS AND OFFERED NEEDED RESPITE TO PARENTS STANDING VIGIL AT CHILDREN'S BEDSIDES; PROVIDED 12,979 RIDES BY VOLUNTEERS OR CHAI LIFELINE VANS TO MEDICAL APPOINTMENTS, THUS FACILITATING TREATMENT COMPLIANCE; 91,954 NOURISHING MEALS WERE DELIVERED TO HOSPITALS AND HOMES; 6,098 HOURS OF INSURANCE ADVOCACY HELPED 294 FAMILIES NAVIGATE THEIR COVERAGE, FIGHT DENIALS AND TURNDOWNS, AND COMPLETE PAPERWORK ACCURATELY; AND 587 OVERNIGHT VISITS AT THE CHAI HOUSE FOR FAMILIES WITH LOVED ONES AT THE CHILDREN'S HOSPITAL OF PHILADELPHIA. 9490343 383006 FAMILY AND COMMUNITY PROGRAMS: THESE PROGRAMS HELP YOUNG PATIENTS AND THEIR FAMILIES LIVE AS NORMALLY AS POSSIBLE WHILE FIGHTING ILLNESS BY ENHANCING EMOTIONAL AND SOCIAL BONDS. IN THE PAST YEAR, 705 BIG BROTHERS AND SISTERS WERE MENTORS TO ILL CHILDREN AND SIBLINGS. 287 RECREATIONAL ACTIVITIES DONE REMOTELY UTILIZING TECHNOLOGY FOR PATIENTS, SIBLINGS, PARENTS, AND FAMILIES OFFERED OPPORTUNITIES FOR FRIENDSHIP AND SUPPORT. 29 HOLIDAY PARTIES AND FAMILY DAYS GAVE CHILDREN AND FAMILIES A CHANCE TO CELEBRATE TOGETHER. 930 HOURS OF COUNSELING HELPED FAMILIES COPE WITH CRISIS. I-SHINE AFTERSCHOOL PROGRAMMING PROVIDED MENTORING AND CARE TO HUNDREDS OF CHILDREN LIVING WITH ILLNESS OR LOSS IN THEIR HOMES. 2,083 CRISIS INTERVENTION WORKSHOPS, PRESENTATIONS, AND MEETINGS WITH FAMILIES, SCHOOLS, AND COMMUNITY ORGANIZATIONS. 390749 390749 GRANTS TO VARIOUS CHARITABLE ORGANIZATIONS 390749 390749 20081708 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 93 0 238 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA MD NJ NY X X STEPHEN SCHOLAR 2124651300 151 WEST 30TH STREET 7TH FLOOR NEW YORK NY 10001 SOLOMON MAYER PRESIDENT 1.00 X X 0 0 0 MORDY ROTHBERG PRESIDENT 1.00 X X 0 0 0 JOSEPH HAMMER CHAIRMAN OF EXECUTIVE COMMITTEE 1.00 X X 0 0 0 LARRY SPIEWAK CHAIRMAN OF BOARD 1.00 X X 0 0 0 MECHEL BERGER SECRETARY 1.00 X X 0 0 0 SHIMMY BERTRAM TREASURER 1.00 X X 0 0 0 BRIAN HAIMM BOARD MEMBER 1.00 X 0 0 0 MAYER FISCHL BOARD MEMBER 1.00 X 0 0 0 DAVID KLEIN BOARD MEMBER 1.00 X 0 0 0 MOSHE KLEIN BOARD MEMBER 1.00 X 0 0 0 ABIE MALEH BOARD MEMBER 1.00 X 0 0 0 DAVID MANDELBAUM BOARD MEMBER 1.00 X 0 0 0 HILLEL MOERMAN BOARD MEMBER 1.00 X 0 0 0 ELLIOT MOSKOWITZ BOARD MEMBER 1.00 X 0 0 0 AVIGAIL ROSEMORE BOARD MEMBER 1.00 X 0 0 0 ELI SCHRON BOARD MEMBER 1.00 X 0 0 0 ALAN SHAMAH BOARD MEMBER 1.00 X 0 0 0 SHOLOM STEIN BOARD MEMBER 1.00 X 0 0 0 MOSHE TAUB BOARD MEMBER 1.00 X 0 0 0 DANIEL WEINGARTEN BOARD MEMBER 1.00 X 0 0 0 ABRAHAM M COHEN EXECUTIVE DIRECTOR 50.00 X 215724 0 75000 ESTHER BERGMAN CHIEF FINANCIAL OFFICER 50.00 X 247678 0 863 STEPHEN SCHOLAR CHIEF EXECUTIVE OFFICER 50.00 X 390845 0 66182 ISRAEL FRIED NJ REGIONAL DIRECTOR 50.00 X 307556 0 81262 MATTHEW YANIV CHIEF MARKETING OFFICER 50.00 X 191519 0 56642 MORDECHAI E GOBIOFF DIRECTOR OF CLIENT SERVICES 50.00 X 208127 0 75267 NACHMAN MAIMON CAMP DIRECTOR 50.00 X 171911 0 71412 ARYE ADEST DIRECTOR OF COMMUNITY DEVELOPMENT NJ 50.00 X 201390 0 65282 HERSHEY KATZ REGIONAL DIRECTOR 50.00 X 306247 0 30907 LEVI Y KATLOWITZ DIRECTOR OF COMMUNITY DEVELOPMENT 50.00 X 207804 0 62830 RANDI GROSSMAN REGIONAL DIRECTOR 50.00 X 183153 0 7082 YOEL D MARGOLESE BIKE4CHAI DIRECTOR 50.00 X 179691 0 60505 2811645 0 653234 30 0 1 0 BB CYCLING EVENTS LLC PO BOX 244 AMENIA FL 12501 EVENT ORGANIZER 215089 BIG FILMS 1202 CORNAGA AVE FAR ROCKAWAY NY 11691 FILMING 119350 REGAL LITH PRINTERS LLC 1725 OAK STREET LAKEWOOD NJ 08701 PRINTING 105798 3 14776848 1911925 20726232 343160 37415005 RESPITE SERVICES 624100 251875 251875 251875 290 290 536 4359 -3823 -3823 -3823 76000 14776848 5289361 -5213361 -5213361 32449986 251875 0 -5216894 390750 390750 580312 580312 2159985 1412262 465351 282372 8036292 6481104 725517 829671 662302 511649 79426 71227 216615 201732 14883 931545 713347 118892 99306 97374 91355 6019 97949 97949 1009257 890678 118579 632934 207413 5781 419740 2489544 1855574 112163 521807 401513 211419 72642 117452 1871413 1674979 156186 40248 1246019 1094093 117812 34114 130804 123936 2525 4343 830443 819799 10644 332740 320622 7603 4515 FOOD SERVICES 2012272 1979973 22484 9815 EVENTS AND ENTERTAINMEN 615555 612066 3489 24745618 20081708 2086330 2577580 1054535 6559896 3208675 5302608 18472 26483380 11977789 14573916 14505591 5927 1568 44749 387716 18906274 26757379 1610770 2281639 119530 161613 3744071 3177856 0 638000 5474371 6259108 X 12720386 19786754 711517 711517 13431903 20498271 18906274 26757379 X 7704368 -638000 X 0 1 X 1 0 X 25298562 27676304 28899879 26295874 37491006 145661625 25298562 27676304 28899879 26295874 37491006 145661625 145661625 24744 1453 1257 125 290 27869 42286 11760 53261 107307 145796801 251875 0.99910 0.99870 X SCHEDULE A, PART II, LINE 10 EXPLANATION FOR OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 711517 711517 711517 711517 711517 711517 733131 21614 711517 711517 39574 17960 733131 1.00000 0 0 160071 1874107 2034178 960429 19662338 8837846 11784921 342170 119434 222736 3484265 3020509 463756 14505591 LOSS CONTINGENCY 638000 638000 32527137 715151 -638000 77151 32449986 0 32449986 25460769 715151 715151 24745618 0 24745618 PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS CONTINGENCY PART V, LINE 4: CHAI LIFELINE'S PERMANENTLY RESTRICTED NET ASSETS CONSIST OF TWO ENDOWMENT FUNDS WHOSE ASSETS ARE TO BE HELD IN PERPETUITY. THE INCOME FROM THE ASSETS CAN BE USED TO SUPPORT CHAI LIFELINE GENERAL ACTIVITIES. BIKE 4 CHAI 9009316 9009316 495239 442851 137444 2045813 NEW YORK DINNER 2765874 2689874 76000 208906 116444 150350 195732 2 3077658 3077658 96178 76159 45733 1278512 14852848 14776848 76000 800323 635454 333527 3520057 5289361 -5213361 1 AMERICAN FRIENDS OF CHAIYANU INC 151 WEST 30TH STREET NEW YORK NY 10001 311718648 501(C)3 214923 0 GENERAL SUPPORT CONGREGATION CHAI LIFELINE 151 WEST 30TH STREET NEW YORK NY 10001 412100349 501(C)3 143389 0 GENERAL SUPPORT 2 FINANCIAL ASSISTANCE 758 580312 PART I, LINE 2: CASE MANAGERS SUBMIT RECOMMENDATIONS, WHICH ARE SUBSEQUENTLY APPROVED BY THEIR RESPECTIVE SUPERVISORS. ANY AMOUNT ABOVE $5,000 MUST BE APPROVED BY THE CHIEF EXECUTIVE OFFICER. ALL RECORDS ARE APPROPRIATELY MAINTAINED. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 STEPHEN SCHOLAR CHIEF EXECUTIVE OFFICER 246394 0 75000 0 69451 0 12710 0 53472 0 457027 0 0 0 ISRAEL FRIED NJ REGIONAL DIRECTOR 206493 0 100250 0 813 0 12482 0 68780 0 388818 0 0 0 HERSHEY KATZ REGIONAL DIRECTOR 118007 0 127427 0 60813 0 9715 0 21192 0 337154 0 0 0 ABRAHAM M COHEN EXECUTIVE DIRECTOR 211515 0 250 0 3959 0 8884 0 66116 0 290724 0 0 0 MORDECHAI E GOBIOFF DIRECTOR OF CLIENT SERVICES 177064 0 30250 0 813 0 8520 0 66747 0 283394 0 0 0 LEVI Y KATLOWITZ DIRECTOR OF COMMUNITY DEVELOPMENT 156741 0 50250 0 813 0 8162 0 54668 0 270634 0 0 0 ARYE ADEST DIRECTOR OF COMMUNITY DEVELOPMENT NJ 140327 0 60250 0 813 0 5079 0 60203 0 266672 0 0 0 ESTHER BERGMAN CHIEF FINANCIAL OFFICER 222428 0 25250 0 0 0 0 0 863 0 248541 0 0 0 MATTHEW YANIV CHIEF MARKETING OFFICER 186269 0 5250 0 0 0 8264 0 48378 0 248161 0 0 0 NACHMAN MAIMON CAMP DIRECTOR 140848 0 30250 0 813 0 7130 0 64282 0 243323 0 0 0 YOEL D MARGOLESE BIKE4CHAI DIRECTOR 133541 0 46150 0 0 0 7171 0 53334 0 240196 0 0 0 RANDI GROSSMAN REGIONAL DIRECTOR 172903 0 10250 0 0 0 7082 0 0 0 190235 0 0 0 PART I, LINE 7 BONUSES ARE GIVEN WITH THE APPROVAL OF THE COMPENSATION COMMITTEE BASED ON MERIT. X 35 224245 FAIR MARKET VALUE X SUPPLIES 2593 118915 COST 0 0 0 FORM 990, PART I, ITEM C DBA: THE SPECIAL FUND DBA: I-SHINE DBA: CAMP SIMCHA SPECIAL DBA: TEAM LIFELINE DBA: BIKE 4 CHAI DBA: LETOUR DE SIMCHA DBA: LACEY LEGACY DBA: EVAN LEVY ZL FUND DBA: ACHIM BYACHAD FORM 990, PART VI, SECTION B, LINE 11B A BOARD MEETING WAS HELD BY THE BOARD OF DIRECTORS TO PRESENT, REVIEW AND APPROVE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST. FAILURE TO DISCLOSE A POTENTIAL CONFLICT OF INTEREST OR ENGAGING IN A PRACTICE DETERMINED TO BE A CONFLICT OF INTEREST MAY RESULT IN DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT COMPENSATION CONSULTANT AND COMPENSATION SURVEY ARE USED TO DETERMINE COMPENSATION. THIS PROCESS WAS PERFORMED IN 2018. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST, THE PUBLIC MAY VIEW THE ORGANIZATIONS' GOVERNING AND RELATED DOCUMENTS AT THE ADDRESS LOCATED ON PAGE 1 OF FORM 990. FORM 990, PART XI, LINE 9: CONTINGENCY LOSS -638,000. AMERICAN FRIENDS OF CHAIYANU INC 151 WEST 30TH STREET 7TH FL NEW YORK NY 10001 311718648 PROVIDES MORAL AND FINANCIAL SUPPORT TO ILL CHILDREN AND THEIR FAMILIES NY 501(C)(3) LINE 7 CHAI LIFELINE INC 1 CONGREGATION CHAI LIFELINE 151 WEST 30TH STREET 7TH FL NEW YORK NY 10001 412100349 CONGREGATION NY 501(C)(3) LINE 1 CHAI LIFELINE INC 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AMERICAN FRIENDS OF CHAIYANU INC B 214923 CASH CONGREGATION CHAI LIFELINE B 143389 CASH