2020-07-15T15:01:59-05:00 2019-08-31 910189318 MOSS ADAMS LLP 10960 WILSHIRE BLVD SUITE 1100 LOS ANGELES CA 90024 990 2018-09-01 208449705 ANNENBERG SCHOOL OF NURSING ANNE 8187743372 7150 TAMPA AVENUE RESEDA CA 913353700 GILAD GOLDENBERG CFO 8187743372 2020-07-08 1 LAUREN A HAVERLOCK P00545829 3104770450 2020-07-08 68.5.96.36 2020-07-08 18:59:24 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A684B3357E27637731C2152B3B8EE3B07A471F14 2018 2021-01-29 14:40:06Z GILAD GOLDENBERG 7150 TAMPA AVENUE RESEDA CA 913353700 645251 0 X WWW.ASN.EDU X 2006 CA VOCATIONAL NURSE AND NURSE ASSISTANT EDUCATION PROGRAMS 7 4 6 4 0 0 73616 71334 624871 553736 10966 11060 3365 9121 712818 645251 33500 46000 0 0 521991 586582 0 0 0 142060 166475 697551 799057 15267 -153806 956341 1084830 137536 419831 818805 664999 X THE ANNENBERG SCHOOL OF NURSING EDUCATES AND TRAINS WOMEN AND MEN TO BECOME QUALIFIED VOCATIONAL NURSES, NURSE ASSISTANTS AND HOME HEALTH AIDES WHO WILL, IN THE COURSE OF THEIR CAREERS, MEET THE NEEDS OF A CULTURALLY DIVERSE SOCIETY IN ITS CONTINUUM OF ILLNESS AND WELLNESS, AND TO PREPARE FOR ENTRY INTO NURSING PRACTICE. 0 0 612808 46000 553736 PROVIDE EDUCATION AND TRAINING FOR VOCATIONAL NURSES, NURSE ASSISTANTS, AND HOME HEALTH AIDES IN SUPPORT OF THE ACTIVITIES AND PROGRAMS OF THE LOS ANGELES JEWISH HOME FOR THE AGING AND SURROUNDING COMMUNITIES. 612808 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 6 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X GILAD GOLDENBERG 8187743000 7150 TAMPA AVENUE RESEDA CA 91335 S STEIER CHAIR 2.00 0.00 X X 0 0 0 R HIRSCH VICE CHAIR 2.00 2.00 X X 0 0 0 G MILLMAN RN MEMBER 2.00 0.00 X 0 0 0 S GREENFELD RN MEMBER 2.00 0.00 X 0 0 0 M FORREST CEO 2.00 38.00 X X 0 739205 13481 A ALDERMAN VP HUMAN RESOURCES 2.00 38.00 X X 0 155180 10350 I SILBERMAN CFO/TREASURER (THROUGH 2/1/2019) 2.00 38.00 X X 0 330992 25389 G GOLDENBERG CFO/TREASURER (START 6/10/2019) 2.00 38.00 X X 0 0 0 S CUNNINGHAM CFO/TREASURER (2/3/19 THRU 7/9/19) 2.00 38.00 X X 0 39962 0 0 1265339 49220 0 0 1 0 0 71334 71334 ASN TUITION 611600 380380 380380 FUNDING FROM RELATED O 900099 173356 173356 553736 11060 11060 9121 9121 9121 645251 553736 0 20181 46000 46000 478441 340885 137556 12885 9239 3646 56747 45331 11416 38509 24424 14085 12706 12706 29129 29129 10966 4126 6840 1534 1534 2005 2005 4808 4808 15444 15444 STUDENTS MATERIAL 42867 42867 PURCHASED SERVICES 25976 25976 DUES 5765 5765 15275 15275 799057 612808 186249 0 100 569700 570000 344942 475737 49875 19713 24202 30162 17497 8831 956341 1084830 30008 31411 107528 388420 137536 419831 X 34518 -177682 284287 342681 500000 500000 818805 664999 956341 1084830 -153806 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 784288 71334 11060 46000 820682 733206 73616 10966 33500 784288 634685 117804 9717 29000 733206 611222 71636 5463 53636 634685 567234 73000 8988 38000 611222 0.00000 0.60920 0.39080 0 1 1 49875 19713 30162 30162 X 725705 0 725705 -80454 -80454 645251 730103 0 730103 68954 68954 799057 PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS PART X, LINE 2: WITH THE EXCEPTION OF THE IPA, THE HOME IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701D OF THE CALIFORNIA REVENUE AND TAXATION CODE AND IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE HOME IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS TAKEN AS A WHOLE. THE HOME RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF AUGUST 31, 2019 OR 2018. PART XI, LINE 4B - OTHER ADJUSTMENTS: SCHOLARSHIPS 46,000. BOOK TO TAX ADJUSTMENTS -126,454. PART XII, LINE 4B - OTHER ADJUSTMENTS: SCHOLARSHIPS 46,000. BOOK TO TAX ADJUSTMENTS 22,954. 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 SCHEDULE E, PART I, LINE 3 POLICY IS STATED ON THE WEBSITE, BUT NOT ON THE HOMEPAGE. SCHEDULE E, PART I, LINE 6 THE ORGANIZATION IS CERTIFIED TO PARTICIPATE IN FEDERAL STUDENT AID TITLE IV PROGRAMS OF DIRECT LOANS AND PELL GRANTS. DURING THE FISCAL YEAR ENDING AUGUST 2018, THE ORGANIZATION RECEIVED $120,265 AND $94,636 OF DIRECT LOAN AND PELL GRANT, RESPECTIVELY. 1 TUITION REDUCTIONS FOR STUDENTS ATTENDING ANNENBERG SCHOOL OF NURSING 35 46000 PART I, LINE 2: TUITION REDUCTIONS WERE GIVEN QUARTERLY TO ALL STUDENTS WHO ENROLLED IN THE LICENSE VOCATIONAL PROGRAM AT ANNENBERG SCHOOL OF NURSING AND HAD AN ACCEPTABLE GRADE IN THE IMMEDIATE PRIOR QUARTER. 0 0 0 0 0 0 0 0 0 M FORREST CEO 0 589205 0 150000 0 0 0 8850 0 4631 0 752686 0 0 A ALDERMAN VP HUMAN RESOURCES 0 145180 0 10000 0 0 0 4708 0 5642 0 165530 0 0 I SILBERMAN CFO/TREASURER (THROUGH 2/1/2019) 0 295992 0 35000 0 0 0 7605 0 17784 0 356381 0 0 PART I, LINE 3 COMPENSATION FOR THE CEO WAS DETERMINED BY THE LOS ANGELES JEWISH HOMES FOR THE AGING, A RELATED ORGANIZATION, BY COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART V, LINE 1 THE ORGANIZATION USES A COMMON PAYMASTER TO SUBMIT INFORMATION RETURNS (FORM 1099) ON THEIR BEHALF. FORM 990, PART VI, SECTION A, LINE 6 THE PARENT ORGANIZATION, LOS ANGELES JEWISH HOME FOR THE AGING, HAS THE RIGHT TO PARTICIPATE IN THE GOVERNANCE OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE PARENT ORGANIZATION, LOS ANGELES JEWISH HOME FOR THE AGING, HAS THE RIGHT TO APPOINT THE ANNENBERG SCHOOL OF NURSING DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE PARENT ORGANIZATION, LOS ANGELES JEWISH HOME FOR THE AGING, HAS THE RIGHT TO APPROVE CERTAIN ACTIONS TAKEN BY ANNENBERG SCHOOL OF NURSING. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE REVIEWED BY THE VOTING MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST FORM SPECIFIES ACTIONS THAT WOULD BE CONSIDERED CONFLICTS OF INTEREST AND EXPLAINS THE ORGANIZATION'S PROCEDURES TO REPORT ANY SUSPECTED CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 POLICY FOR DETERMINATION OF EXECUTIVE COMPENSATION, OFFICERS AND TOP MANAGEMENT INCLUDES REVIEWING COMPARABILITY DATA FROM NUMEROUS SALARY AND COMPENSATION SURVEYS AND THE FORM 990 DATA OF SIMILAR ORGANIZATIONS. THE COMPENSATION FOR TOP MANAGEMENT IS DETERMINED BY THE EXECUTIVE REVIEW COMMITTEE AND APPROVED BY THE FULL EXECUTIVE COMMITTEE OF THE BOARD. COMPENSATION IS REVIEWED FOR OFFICERS AND TOP MANAGEMENT ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. LOS ANGELES JEWISH HOME FOR THE AGING 7150 TAMPA AVE RESEDA CA 91335 953510024 NURSING, RESIDENTIAL AND CLINICAL CARE FOR THE ELDERLY CA 501(C)(3) LINE 7 N/A 0 JHA GERIATRIC SERVICES INC 7150 TAMPA AVE RESEDA CA 91335 954407317 CLINICAL AND HOSPICE SERVICES FOR THE ELDERLY CA 501(C)(3) LINE 10 LA JEWISH HOME FOR THE AGING 0 EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING 7150 TAMPA AVE RESEDA CA 91335 951691015 RESIDENTIAL CARE AND SKILLED NURSING FACILITY CA 501(C)(3) LINE 10 LA JEWISH HOME FOR THE AGING 0 GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING 7150 TAMPA AVE RESEDA CA 91335 951831045 RESIDENTIAL CARE AND SKILLED NURSING FACILITY CA 501(C)(3) LINE 10 LA JEWISH HOME FOR THE AGING 0 BRANDMAN CENTERS FOR SENIOR CARE INC 7150 TAMPA AVE RESEDA CA 91335 264023159 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY CA 501(C)(3) LINE 10 LA JEWISH HOME FOR THE AGING 0 JEWISH HOME FOUNDATION 7150 TAMPA AVE RESEDA CA 91335 800927200 FUNDRAISING CA 501(C)(3) LINE 12A, I LA JEWISH HOME FOR THE AGING 0 BRANDMAN RESEARCH INSTITUTE 7150 TAMPA AVE RESEDA CA 91335 954414031 GERONTOLOGICAL RESEACH CA 501(C)(3) LINE 12A, I LA JEWISH HOME FOR THE AGING 0 LOS ANGELES JEWISH HOME IPA 7150 TAMPA AVE RESEDA CA 91335 811160437 INDEPENDENT PRACTICE ASSOCIATION CA N/A C 0 0 0 0 1 1 0 0 0 0 0 1 1 1 1 1 0 1 1 1