2019-11-15T08:53:18-06:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2018-01-01 043274643 CHELSEA JEWISH NORTH SHORE ASSISTED LIVING INC CHEL 9784715100 240 LYNNFIELD STREET PEABODY MA 01960 JEFFREY LANDA CHEIF FINANCIAL OFFICER 9784715100 2019-11-12 1 DOUGLAS FIEBELKORN P01294075 6179848100 2019-11-12 67.137.57.251 2019-11-12 13:25:47 ES P FBF91E9F6601ABEAE195131D925EE83266DF73FD EAD1050B096A5AD20989DB7D26358B2771A7DE8D 2018 2020-03-31 21:24:44Z HARRIETT & RALPH KAPLAN ESTATES ADAM BERMAN 240 LYNNFIELD STREET PEABODY MA 01960 8013148 0 X WWW.CHELSEAJEWISH.ORG X 1995 MA THE ORGANIZATION'S MISSION IS TO ENRICH THE LIFE OF EACH OF OUR RESIDENTS AND PROGRAM PARTICIPANTS. 10 6 158 21 0 0 0 250 7875179 8011807 0 0 1546 1018 7876725 8013075 0 0 0 0 3805904 3975372 0 0 56649 3492984 3063958 7298888 7039330 577837 973745 14114104 14831613 13503821 13212001 610283 1619612 TO ENRICH THE LIFE OF EACH OF OUR RESIDENTS AND PROGRAM PARTICIPANTS SO THAT EACH MAY CONTINUE TO LIVE HIS OR HER LIFE WITH A SENSE OF MEANING AND PURPOSE. WE PROVIDE ASSISTED LIVING UNITS FOR OUR TENANTS. 0 0 5544465 0 8012825 ASSISTED LIVING - OPERATION OF A 130-UNIT ASSISTED LIVING FACILITY IN PEABODY, MA. 32 UNITS WERE SPECIALLY DESIGNED AND DESIGNATED FOR CARE SPECIALIZING IN MEMORY ISSUES. 5544465 1 0 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 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 158 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 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 ADAM BERMAN PRESIDENT 1.00 39.00 X X 0 344889 53739 BARRY BERMAN TREASURER 1.00 39.00 X X 0 667074 71732 JOEL MAZER CHAIR 1.00 8.00 X X 0 0 0 ELIZABETH MULLEN CLERK 1.00 39.00 X X 0 230583 23481 SUSAN BRUDNICK DIRECTOR 1.00 8.00 X 0 0 0 CHARLOTTE FLORENCE DIRECTOR 1.00 8.00 X 0 0 0 SHARON FORMAN DIRECTOR 1.00 8.00 X 0 0 0 HOWARD GREENSPAN DIRECTOR 1.00 8.00 X 0 0 0 ROBERT RICHMAN DIRECTOR 1.00 8.00 X 0 0 0 JUDY WEISS DIRECTOR 1.00 8.00 X 0 0 0 JEFFREY LANDA CFO 1.00 39.00 X 0 286005 34952 MEGIN HEMMERLING EXECUTIVE DIRECTOR 40.00 X 126643 0 11764 126643 1528551 195668 1 0 1 0 0 250 250 PROGRAM SERVICE INCOME 623000 7846193 7846193 OTHER INCOME 623000 165614 165614 8011807 1091 73 1018 1018 8013075 8012825 0 0 3449357 2760017 632691 56649 7897 7542 355 246811 195333 51478 271307 259098 12209 475843 475843 23745 22676 1069 329331 250687 78644 34185 34185 70770 56212 14558 362843 335683 27160 14279 13185 1094 15482 15482 378194 349281 28913 563223 522753 40470 102511 97971 4540 FOOD 417260 417260 SUPPLIES 239867 232863 7004 MISCELLANEOUS 35441 11699 23742 LICENSE, DUES, & SUBSCR 12984 12205 779 -12000 -12000 7039330 5544465 1438216 56649 720084 1117766 97622 72735 35179 28742 21188478 8727640 12968391 12460838 292828 1151532 14114104 14831613 465508 482793 111939 226392 11587925 10148031 1338449 2354785 13503821 13212001 X 610283 1619612 610283 1619612 14114104 14831613 X 973745 35584 X 0 1 X 1 0 X 250 250 8246911 8190785 8148438 7876822 8012898 40475854 8246911 8190785 8148438 7876822 8013148 40476104 0 0 0 40476104 55 55 55 55 8246966 8190785 8148438 7876822 8013148 40476159 1.00000 1.00000 0.00000 X 1771258 1771258 17165636 6856702 10308934 2251584 1870938 380646 12460838 DUE FROM RELATED PARTY 1061986 DEPOSITS 6845 FAIR VALUE INTEREST RATE SWAP 43068 SOFTWARE, NET 500 CONSTRUCTION IN PROGRESS 39133 1151532 SECURITY DEPOSITS 608827 DEFERRED MANAGEMENT FEES - RELATED PARTY 1745958 2354785 X PART X, LINE 2: THE FOUNDATION, THE SKILLED NURSING FACILITY, AND THE ASSISTED LIVING ARE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ITS 2015 THROUGH 2018 TAX YEARS ARE OPEN FOR EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES. THE OBLIGATED GROUP FOLLOWS 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 FOR THE YEAR ENDED DECEMBER 31, 2018. X X 0 0 0 0 0 0 0 0 0 ADAM BERMAN PRESIDENT 0 344889 0 0 0 0 0 0 0 53739 0 398628 0 0 BARRY BERMAN TREASURER 0 667074 0 0 0 0 0 0 0 71732 0 738806 0 0 ELIZABETH MULLEN CLERK 0 230583 0 0 0 0 0 0 0 23481 0 254064 0 0 JEFFREY LANDA CFO 0 286005 0 0 0 0 0 0 0 34952 0 320957 0 0 A MASS DEVELOPMENT FINANCE AGENCY 043431814 57583UBR8 2011-04-29 15446112 TO REFUND OLD BONDS AND REPLACE EXISTING FACILITY. 0 0 0 A 4952567 15446112 230600 189401 15026111 2012 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 M&T BANK & CITIZENS BANK 5.000000000000 0 0 0 0 0 A 0 SCHEDULE K SUPPLENTAL INFORMATION THIS ORGANIZATION IS REPORTING THEIR RESPECTIVE SHARE OF THE $50M BOND ISSUED ON 04/29/11. SEE JEWISH REHABILITATION CENTER FOR AGED OF THE NORTH SHORE, INC. (EIN 04-2106768) FOR THE REMAINING PORTION. JEFFREY BRUDNICK (LOUIS J BRUDNICK & SONS) SUSAN BRUDNICK, SPOUSE, IS A DIRECTOR OF THE BOARD 7903 INSURANCE BROKER/AGENT 0 FORM 990, PART VI, SECTION A, LINE 2 ADAM BERMAN, PRESIDENT, AND BARRY BERMAN, TREASURER, HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION ENTERED INTO A MANAGEMENT AGREEMENT WITH CHELSEA JEWISH LIFECARE EFFECTIVE JANUARY 1,2017. 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, CHELSEA JEWISH LIFECARE, INC. FORM 990, PART VI, SECTION A, LINE 7A THE APPROVAL OF THE MEMBER, CHELSEA JEWISH LIFECARE, INC., IS REQUIRED TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE APPROVAL OF THE MEMBER, CHELSEA JEWISH LIFECARE, INC., IS REQUIRED BEFORE THE BOARD OF DIRECTOR'S ACTION ON ANY OF THE FOLLOWING BECOMES EFFECTIVE: (A) TO AMEND OR TO REPEAL THE ARTICLES OF ORGANIZATION OR THE BYLAWS OF THE CORPORATION; (B) TO APPROVE ALL PLANS OF MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, OR THE SALE, LEASE, ASSIGNMENT OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PURCHASE OR ACQUISITION BY THE CORPORATION OF THE CORPORATION OF AN INTEREST IN ANY CORPORATION, PARTNERSHIP, JOINT VENTURE OR OTHER ENTITY, WHETHER NEWLY CREATED OR PREVIOUSLY EXISTING, WHICH INTEREST, IN THE CASE OF A FOR-PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT (25%) OR MORE OF THE VOTING POWER THEREOF OR EQUITY INTEREST THEREIN, OR, IN THE CASE OF A NON-PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT (25%) OR MORE OF THE VOTING POWER THEREOF OR MEMBERSHIP INTEREST THEREIN; (C) TO APPROVE ALL GIFTS, GRANTS, DONATIONS OR SIMILAR TRANSFERS OF FUNDS OF THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OR ITS SUBSIDIARIES; (D) TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION; (E) TO APPROVE THE FORMATION OF ANY SUBSIDIARY OF THE CORPORATION; AND (F) TO APPOINT THE CORPORATION'S AUDITORS. 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. 2014 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. THIS PROCESS WILL BE COMPLETED AGAIN IN 2019. 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. 2014 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION.THIS PROCESS WILL BE COMPLETED AGAIN IN 2019. 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 XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 35,584. CHELSEA JEWISH LIFECARE INC 165 CAPTAINS ROW CHELSEA MA 02150 510141617 MANAGEMENT MA 501(C)(3) LINE 7 N/A 0 CHELSEA JEWISH COMMUNITY INC 165 CAPTAINS ROW CHELSEA MA 02150 271756594 MANAGEMENT, HOMECARE, PERSONAL CARE, HOSPICE, THERAPY MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 0 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 0 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 0 CHELSEA JEWISH NORTH SHORE FOUNDATION INC 240 LYNNFIELD STREET PEABODY MA 01960 223102199 FUNDRAISING & SUPPORT MA 501(C)(3) LINE 7 CHELSEA JEWISH LIFECARE INC 0 CHELSEA JEWISH NURSING HOME INC 17 LAFAYETTE AVENUE CHELSEA MA 02150 042200583 NURSING HOME MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 0 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 0 ADMIRAL'S HILL ASSISTED LIVING CORP II 165 CAPTAINS ROW CHELSEA MA 02150 043538833 ASSISTED LIVING MA 501(C)(3) LINE 10 CHELSEA JEWISH LIFECARE INC 0 WINTHROP APARTMENTS LLC 165 CAPTAINS ROW CHELSEA MA 02150 463739775 REAL ESTATE MA N/A 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0