2018-11-15T13:23:42-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2017-01-01 042106768 JEWISH REHABILITATION CENTER FOR THE AGED OF THE NORTH SHORE INC JEWI 9784715100 240 LYNNFIELD STREET PEABODY MA 01960 BARRY BERMAN TREASURER 9784715100 2018-11-13 1 JUDY DALEY P01294075 6179848100 2018-11-13 67.137.57.251 2018-11-13 11:20:20 ES P 839A7130264BF8A4AA8E0E9B35915F0C6C2A2968 49D45E06031322FC5F433B8196F1C5D2180A31DD 2017 2019-02-21 02:37:17Z JEFFREY & SUSAN BRUDNICK CENTER FOR LIVING BARRY BERMAN 240 LYNNFIELD STREET PEABODY MA 01960 19368096 0 X WWW.CHELSEAJEWISH.ORG X 1944 MA THE ORGANIZATION'S MISSION IS TO ENRICH THE LIFE OF EACH OF OUR RESIDENTS AND PROGRAM PARTICIPANTS, SO THAT EACH CAN CONTINUE TO LIVE HIS OR HER LIFE WITH A SENSE OF MEANING AND PURPOSE THROUGH THE OPERATION OF A 180-BED NURSING HOME WITH AN ADULT DAY CARE CENTER. 10 7 646 41 0 0 0 0 18953045 19367936 0 0 332 160 18953377 19368096 0 0 0 0 11790936 12498976 0 0 0 9198792 7974715 20989728 20473691 -2036351 -1105595 34027445 32386029 28879175 28138383 5148270 4247646 THE ORGANIZATION'S MISSION IS TO ENRICH THE LIFE OF EACH OF OUR RESIDENTS AND PROGRAM PARTICIPANTS, SO THAT EACH CAN CONTINUE TO LIVE HIS OR HER LIFE WITH A SENSE OF MEANING AND PURPOSE THROUGH THE OPERATION OF A 144-BED NURSING HOME WITH AN ADULT DAY CARE CENTER. 0 0 18205848 19368096 NURSING HOME - PROVIDE QUALITY SKILLED NURSING CARE & REHABILITATIVE THERAPY FOR UP TO 144 ELDERLY RESIDENTS OF A NURSING HOME.ADULT DAY CARE - PROVIDE SUPPORTIVE CARE TO PATIENTS OF THE ADULT DAY CARE FACILITY. 18205848 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 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 20 0 646 1 0 0 0 0 0 0 0 0 0 0 X 10 7 1 1 0 0 1 1 1 1 1 0 0 0 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 314049 34154 BARRY BERMAN TREASURER 1.00 39.00 X X 0 633783 31259 JOEL MAZER CHAIR 1.00 7.00 X X 0 0 0 ELIZABETH MULLEN CLERK 1.00 39.00 X X 0 209621 20349 SUSAN BRUDNICK DIRECTOR 1.00 7.00 X 0 0 0 CHARLOTTE FLORENCE DIRECTOR 1.00 7.00 X 0 0 0 SHARON FORMAN DIRECTOR 1.00 7.00 X 0 0 0 HOWARD GREENSPAN DIRECTOR 1.00 7.00 X 0 0 0 ROBERT RICHMAN DIRECTOR 1.00 7.00 X 0 0 0 JUDY WEISS DIRECTOR 1.00 7.00 X 0 0 0 CAROLYN FENN EXECUTIVE DIRECTOR 40.00 0.00 X 118632 0 16806 TAMMY STARION DIRECTOR OF NURSING 40.00 0.00 X 135438 0 29275 CARLEEN MCLAUGHLIN RN 40.00 0.00 X 118468 0 17794 ESTHER KAIRU LPN 40.00 0.00 X 114613 0 21076 487151 1157453 170713 4 0 1 0 LANDMARK STRUCTURES 282 MONTVALE AVENUE WOBURN MA 01801 ARCHITECT/CONSTRUCTION 409379 1 PROGRAM SERVICE INCOME 623000 19272848 19272848 OTHER INCOME 623000 95088 95088 19367936 160 0 160 160 19368096 19368096 0 0 135438 135438 10678122 10024381 653741 56609 52559 4050 858043 812264 45779 770764 715625 55139 1141164 1141164 35530 35530 38645 38645 158357 158357 5073 5073 141688 141688 796782 796782 186698 186698 6524 6524 794694 794694 1462083 1462083 154381 154381 USER FEE 836832 836832 ANCILLARIES 787063 787063 SUPPLIES 454062 454062 FOOD 423871 423871 551268 551268 20473691 18205848 2267843 0 1101298 919354 2681097 2105920 149641 129525 37590201 8392774 30073754 29197427 21655 33803 34027445 32386029 1636590 1471805 18397 23432 23751983 23168430 56435 56798 3415770 3417918 28879175 28138383 X 5148270 4247646 5148270 4247646 34027445 32386029 X -1105595 204971 X 0 1 X 1 0 X 17113013 17528364 18621075 18953377 19368096 91583925 17113013 17528364 18621075 18953377 19368096 91583925 0 0 0 91583925 135 1185 494 1814 135 1185 494 1814 2086763 2086763 17113148 19616312 18621569 18953377 19368096 93672502 0.97770 0.98110 0.00000 X 10573 X RELIGIOUS CEREMONIES 31437891 4322709 27115182 516823 41271 475552 5569414 4020469 1548945 66073 8325 57748 29197427 DUE TO RELATED PARTIES 1571382 SECURITY DEPOSITS 16340 DEFERRED MANAGEMENT FEES - RELATED PARTY 1830196 3417918 PART III, LINE 4: TORAH - USED FOR JEWISH RELIGIOUS CEREMONIES FOR RESIDENTS. 0 0 0 0 0 0 0 0 0 ADAM BERMAN PRESIDENT 0 314049 0 0 0 0 0 0 0 34154 0 348203 0 0 BARRY BERMAN TREASURER 0 633783 0 0 0 0 0 0 0 31259 0 665042 0 0 ELIZABETH MULLEN CLERK 0 209621 0 0 0 0 0 0 0 20349 0 229970 0 0 TAMMY STARION DIRECTOR OF NURSING 135438 0 0 0 0 0 0 0 29275 0 164713 0 0 0 A MASS DEVELOPMENT FINANCE AGENCY 043431814 57583UBR8 2011-04-29 34553888 TO REFUND OLD BONDS AND REPLACE EXISTING FACILITY. 0 0 0 A 11385458 34553888 1314672 1601175 690823 529178 30418040 2012 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 M&T 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 CHELSEA JEWISH NORTH SHORE ASSISTED LIVING, INC. (FKA AVIV ASSISTED LIVING, INC.) (EIN 04-3274643) FOR THE REMAINING PORTION. JEFFREY BRUDNICK LOUIS J BRUDNICK SUSAN BRUDNICK, SPOUSE, IS A DIRECTOR OF THE BOARD 21562 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. 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. 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 204,971. 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 7 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 ASSISTED LIVING INC 240 LYNNFIELD STREET PEABODY MA 01960 043274643 ASSISTED LIVING 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 ADMIRAL'S HILL ASSISTED LIVING CORP II 201 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