2021-11-12T10:08:14-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2020-01-01 043138403 JEWISH NURSING HOME OF WESTERN MASSACHUSETTS INC JEWI 4165676211 770 CONVERSE ST LONGMEADOW MA 011061786 JEFFREY LANDA CFO 6178870001 2021-11-11 1 JEFFREY LANDA 999009999 DOUGLAS FIEBELKORN P00173341 7819821001 2021-11-11 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z ADAM BERMAN 240 LYNNFIELD STREET PEABODY MA 01960 20040739 0 X WWW.JGSLIFECARE.ORG X 1991 MA TO CARE FOR THE FRAIL, ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 9 6 361 6 0 0 0 2856291 20268205 17111210 319 1238 267093 72000 20535617 20040739 0 0 0 0 12326769 12368826 0 0 0 9680961 8112386 22007730 20481212 -1472113 -440473 29184155 29154300 30262876 30673494 -1078721 -1519194 TO CARE FOR THE FRAIL, ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 0 0 17050414 17183210 THE HOME IS A NON-PROFIT ORGANIZATION WHICH OWNS AND OPERATES A 200 BED SKILLED NURSING FACILITY, WHICH INCLUDES A 24 BED SHORT STAY UNIT, AND AN ADULT DAY CARE CENTER. 17050414 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 18 0 1 361 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X JEFFREY LANDA 9784715100 240 LYNNFIELD STREET PEABODY MA 01960 BARRY BERMAN CEO 1.00 39.00 X X 0 708781 10885 ADAM BERMAN PRESIDENT 1.00 39.00 X X 0 405889 19653 ERIC BERG CHAIR 1.00 5.00 X X 0 0 0 JAMES GORDON CLERK 1.00 1.00 X X 0 0 0 STUART ANFANG TREASURER 1.00 6.00 X X 0 0 0 ANNE CHERNICK DIRECTOR 1.00 3.00 X 0 0 0 RICHARD CHASE DIRECTOR 1.00 5.00 X 0 0 0 ROBERT BAEVSKY DIRECTOR 1.00 5.00 X 0 0 0 SUSAN GOLDSMITH DIRECTOR 1.00 4.00 X 0 0 0 JEFFREY LANDA CFO 1.00 39.00 X 0 308473 18060 ELIZABETH MULLEN COO 1.00 39.00 X 0 252721 8658 RONILO ANGLO CHIEF CLINICAL OFFICER 1.00 39.00 X 0 240736 18449 KATHERINE SANTOS VP OF STRATEGY & OPERATIONAL EXCELLENCE 1.00 39.00 X 0 212816 1578 ESTHER KAIRU LPN 0.00 40.00 X 0 187788 13747 THERESA HALLIDAY-BURRI CHIEF DEVELOPMENT OFFICER 1.00 39.00 X 0 189904 7532 ARTHUR SCHUNCK SINDONI SR. VP OF FINANCE 1.00 39.00 X 0 183771 2327 0 2690879 100889 11 0 1 0 PRO EMS SOLUTIONS INC 31 SMITH PLACE CAMBRIDGE MA 02138 COVID TESTING 108960 1 2856291 2856291 PROGRAM SERVICE REVENUE 623000 17000363 17000363 MISC REVENUE 900099 67964 67964 CAFE, COFFEE, BEAUTY, GIFT SHOPS 453220 42883 42883 17111210 1238 1238 72000 0 72000 72000 72000 20040739 17183210 0 1238 10334152 9339544 994608 1276280 1225956 50324 758394 683418 74976 787922 787922 50109 50109 43163 38847 4316 387777 330945 56832 1832 1832 203517 168373 35144 164730 159678 5052 745337 610806 134531 40541 40541 3897 3897 434007 347224 86783 1086430 869144 217286 458421 413946 44475 USER FEE ASSESSMENT 878969 878969 NURSING SUPPLIES & EXPE 862818 862818 BAD DEBT EXPENSE 754292 754292 FOOD 531210 531153 57 677414 549052 128362 20481212 17050414 3430798 0 1070351 2118370 2633751 2505457 55452 72790 51098184 26744124 25167042 24354060 257559 103623 29184155 29154300 2053832 1499877 102000 76839 28107044 29096778 30262876 30673494 X -1078721 -1519194 -1078721 -1519194 29184155 29154300 -440473 0 X 0 1 X 1 0 X 121000 1851014 2856291 4828305 20044973 19799625 20810855 20462398 17111210 98229061 20165973 19799625 22661869 20462398 19967501 103057366 0 0 0 103057366 73200 73222 73243 73219 73238 366122 73200 73222 73243 73219 73238 366122 82207 130879 136063 349149 20321380 20003726 22871175 20535617 20040739 103772637 0.99310 0.99290 0.00350 0.00290 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 2372731 2372731 41853339 21546615 20306724 6872114 5197509 1674605 24354060 DUE TO RELATED PARTIES 27730463 DUE TO THIRD PARTY, CURRENT 890659 OTHER LONG TERM LIABILITIES 42574 FUNDS HELD FOR RESIDENTS 102282 DUE TO THIRD PARTY, LONG-TERM 330800 29096778 X PART X, LINE 2: JGS AND ITS AFFILIATES ARE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. JGS AND ITS AFFILIATES FILE AS TAX-EXEMPT ENTITIES. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE 2017 THROUGH 2020 TAX YEARS ARE OPEN FOR EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES. JGS AND ITS AFFILIATES FOLLOW THE POLICY FOR UNCERTAINTY IN INCOME TAXES TO BE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE POLICY PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. NO UNCERTAIN INCOME TAX POSITIONS WERE IDENTIFIED. X X 0 0 0 0 0 0 0 0 0 BARRY BERMAN CEO 0 681362 0 0 0 27419 0 1455 0 9430 0 719666 0 0 ADAM BERMAN PRESIDENT 0 390424 0 0 0 15465 0 1960 0 17693 0 425542 0 0 JEFFREY LANDA CFO 0 308473 0 0 0 0 0 1430 0 16630 0 326533 0 0 ELIZABETH MULLEN COO 0 252721 0 0 0 0 0 1573 0 7085 0 261379 0 0 RONILO ANGLO CHIEF CLINICAL OFFICER 0 240736 0 0 0 0 0 979 0 17470 0 259185 0 0 KATHERINE SANTOS VP OF STRATEGY & OPERATIONAL EXCELLE 0 212816 0 0 0 0 0 0 0 1578 0 214394 0 0 ESTHER KAIRU LPN 0 187788 0 0 0 0 0 731 0 13016 0 201535 0 0 THERESA HALLIDAY-BURRI CHIEF DEVELOPMENT OFFICER 0 189904 0 0 0 0 0 874 0 6658 0 197436 0 0 ARTHUR SCHUNCK SINDONI SR. VP OF FINANCE 0 183771 0 0 0 0 0 1060 0 1267 0 186098 0 0 JEFFREY BRUDNICK LOUIS J BRUDNICK JEFFREY BRUDNICK IS A DIRECTOR OF THE BOARD OF CHELSEA JEWISH LIFECARE 462389 INSURANCE BROKER/AGENT 0 SUSAN GOLDSMITH BUSINESS RELATIONSHIP - DIRECTOR ON BOARD 13139 PURCHASES FROM MARCUS PRINTING, OF WHICH SUSAN GOLDMITH IS AN OWNER. 0 FORM 990, PART VI, SECTION A, LINE 2 ADAM BERMAN, PRESIDENT, AND BARRY BERMAN, CEO, HAVE A FAMILY RELATIONSHIP. SUSAN GOLDSMITH, DIRECTOR, IS OWNER OF MARCUS PRINTING, A VENDOR OF THE FACILITY. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION ENTERED INTO A MANAGEMENT AGREEMENT WITH CHELSEA JEWISH LIFECARE, INC. EFFECTIVE SEPTEMBER 4, 2018. CHELSEA JEWISH LIFECARE, INC. PROVIDED MANAGEMENT SERVICES WHICH INCLUDED THE FOLLOWING RESPONSIBILITIES: 1) KEY PERSONNEL MANAGEMENT 2) PERSONNEL OVERSIGHT (EMPLOYEES & ADMINISTRATION) 3) FINANCIAL RESPONSIBILITIES 4) MANAGEMENT REPORTS 5) REGULATORY COMPLIANCE 6) QUALITY ASSURANCE 7) PURCHASING & CONTRACTING 8) BANK ACCOUNTS FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS A RELATED ORGANIZATION, JGS LIFECARE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE APPROVAL OF THE MEMBER, JGS LIFECARE CORPORATION, IS REQUIRED TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE APPROVAL OF THE MEMBER (JGS LIFECARE CORPORATION), SUBJECT TO ITS BY-LAWS AND ANY REQUIRED APPROVAL OF THE SOLE MEMBER (CHELSEA JEWISH LIFECARE. INC.) OF THE MEMBER, IS REQUIRED BEFORE THE BOARD OF DIRECTORS' ACTION ON ANY OF THE FOLLOWING BECOMES EFFECTIVE: (A) TO AMEND OR TO REPEAL THE ARTICLES OF ORGANIZATION OR THE BY-LAWS OF THE CORPORATION OR THOSE OF THE AFFILIATES; (B) TO APPROVE ALL PLANS OF MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION, OR THE SALE, LEASE, ASSIGNMENT OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR AN AFFILIATE, OR THE PURCHASE OR ACQUISITION BY THE CORPORATION OR BY AN AFFILIATE OF ANY INTEREST IN ANY CORPORATION, PARTNERSHIP, JOINT VENTURE OR OTHER ENTITY, WHETHER NEWLY CREATED OR PREVIOUSLY EXISTING; (C) TO APPROVE ANY BORROWING, GRANTING OF A SECURITY INTEREST BY THE CORPORATION OR BY AN AFFILIATE IN ANY ASSETS OF THE CORPORATION, THE GUARANTY OF ANY DEBT, AND THE GRANTING OF ANY MORTGAGE; (D) TO APPROVE ALL GIFTS, GRANTS, DONATIONS OR SIMILAR TRANSFERS OF FUNDS OF THE CORPORATION OR OF AN AFFILIATE TO ANY ENTITY OTHER THAN THE MEMBER; (E) TO APPROVE OR REMOVE DIRECTORS OR OFFICERS ELECTED BY THE CORPORATION OR BY ANY OF THE AFFILIATES; (F) TO APPROVE THE FORMATION OF ANY SUBSIDIARY OF THE CORPORATION OR THAT OF AN AFFILIATE OR ANY INVESTMENT IN ANOTHER ENTITY OF ANY TYPE; (G) TO APPROVE ANNUAL BUDGETS AND THE SELECTION OF KEY EXECUTIVES OF THE CORPORATION OR AN AFFILIATE; AND (H) TO APPOINT THE CORPORATION'S OR THE AFFILIATES' AUDITORS, ATTORNEYS OR OTHER BUSINESS ADVISORS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S MANAGEMENT TEAM WILL CONDUCT A REVIEW OF THE FORM 990 AFTER IT HAS BEEN FINALIZED, INCLUDING READING AND REVIEWING THE KEY INFORMATION. MANAGEMENT WILL REPORT TO THE BOARD IF THERE ARE ANY MAJOR DEVIATIONS FROM THE PROVIDED DATA. 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. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS PAID FROM A RELATED ORGANIZATION. PRIOR TO MAJOR SALARY ADJUSTMENTS FOR THE CEO, A RELATED ORGANIZATION'S BOARD OF DIRECTORS 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. 2019 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: OFFICERS AND KEY EMPLOYEES ARE PAID FROM A RELATED ORGANIZATION. 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 A RELATED ORGANIZATION'S BOARD OF DIRECTORS. 2019 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. JGS LIFECARE CORPORATION 770 CONVERSE STREET LONGMEADOW MA 01106 042129128 GERIATRIC/NURSING PROVIDER MA 501(C)(3) LINE 7 CHELSEA JEWISH LIFECARE INC 0 JGS ADMINISTRATIVE SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 01106 043295014 MANAGERIAL & ADMINISTRATIVE SUPPORT MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 0 JGS HOUSING SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 01106 043321157 ASSISTED LIVING MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 0 SPECTRUM HOME CARE INC 770 CONVERSE STREET LONGMEADOW MA 01106 043399549 NON-CERTIFIED HOME HEALTH MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 0 SPECTRUM HOME HEALTH AND HOSPICE CARE INC 770 CONVERSE STREET LONGMEADOW MA 01106 043237982 HOME HEALTH AND HOSPICE MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 0 GENESIS HOUSE INC 770 CONVERSE STREET LONGMEADOW MA 01106 042817295 ELDERLY HOUSING MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 0 GENESIS HOUSE III INC 770 CONVERSE STREET LONGMEADOW MA 01106 000739159 ELDERLY HOUSING MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 0 GENESIS LIFECARE CORPORATION 770 CONVERSE STREET LONGMEADOW MA 01106 812041419 LOW-INCOME ELDERLY HOUSING (HUD SUBSIDIZED) MA 501(C)(3) LINE 10 JGS LIFECARE CORPORATION 0 CHELSEA JEWISH LIFECARE INC 165 CAPTAINS ROW CHELSEA MA 02150 510141617 MANAGEMENT OF GERIATRIC/SENIOR CARE PROVIDER CONTINUUMS MA 501(C)(3) LINE 7 N/A 0 CHELSEA JEWISH COMMUNITY INC 165 CAPTAINS ROW CHELSEA MA 02150 271756594 HOMECARE AND HOSPICE MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 0 CHELSEA JEWISH CHARITABLE FOUNDATION INC 240 LYNNFIELD ST PEABODY MA 01960 261244471 FUNDRAISING AND SUPPORT MA 501(C)(3) LINE 12B, II CHELSEA JEWISH LIFECARE INC 0 CHELSEA JEWISH GREEN HOUSE INC 165 CAPTAINS ROW CHELSEA MA 02150 043326727 NURSING HOME AND ASSISTED LIVING MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 0 CHELSEA JEWISH NORTH SHORE ASSISTED LIVING INC 240 LYNNFIELD ST PEABODY MA 01960 043274643 ASSISTED LIVING MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 0 JEWISH REHABILITATION CENTER FOR AGED OF THE NORTH SHORE INC 240 LYNNFIELD ST PEABODY MA 01960 042106768 SKILLED NURSING & ADH MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 0 LEGACY LIFECARE INC 240 LYNNFIELD ST PEABODY MA 01960 223102199 SUPPORT SERVICES & FUNDRAISING MA 501(C)(3) LINE 7 N/A 0 CHELSEA JEWISH NURSING HOME INC 17 LAFAYETTE AVE CHELSEA MA 02150 042200583 NURSING HOME MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 0 ADMIRAL HILL ASSISTED LIVING CORP II 201 CAPTAINS ROW CHELSEA MA 02150 043538833 ASSISTED LIVING MA 501(C)(3) PF CHELSEA JEWISH LIFECARE INC 0 0 0 0 1 1 0 0 0 0 1 0 0 1 1 1 0 0 0 0