2017-11-15T17:18:19-06:00 2016-12-31 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2016-01-01 043138403 JEWISH NURSING HOME OF WESTERN MASSACHUSETTS INC JEWI 4135676211 770 CONVERSE STREET LONGMEADOW MA 011061786 BETH CHAGUE CFO 4135676211 2017-11-15 1 ELIZABETH SOLECKI P00235171 8605614000 2017-11-15 50.200.120.74 2017-11-15 14:55:18 ES P 2964E4F0F81691D3DB56C451C8C2389B613F3BD9 66876C9D7A8912D94FE5179D9C72F3F6E6F290C8 2016 2021-01-29 14:40:06Z BETH CHAGUE 770 CONVERSE STREET LONGMEADOW MA 011061786 20321380 0 X WWW.JGSLIFECARE.ORG X 1992 MA TO CARE FOR THE FRAIL ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 4 3 397 83 0 0 0 121000 18270873 20044973 33 0 153556 155407 18424462 20321380 0 0 0 0 10215846 10563401 0 0 0 9800827 10217591 20016673 20780992 -1592211 -459612 8342514 22538744 11082973 25738815 -2740459 -3200071 X TO CARE FOR THE FRAIL ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 1 0 16147233 20200380 THE HOME IS A NON-PROFIT ORGANIZATION WHICH OWNS AND OPERATES A 200 BED SKILLED NURSING FACILITY, AN ADULT DAY CARE CENTER, AND A SHORT-TERM REHABILITATION CENTER. 16147233 1 1 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 1 0 0 0 1 12 0 1 397 1 0 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 MA X JGS LIFECARE CORPORATION BETH CHAGUE CFO 4135675211 770 CONVERSE STREET LONGMEADOW MA 011061786 MARTIN BAICKER PRESIDENT AND CEO 1.00 44.00 X X 0 267321 16068 ERIC BERG BOARD MEMBER 1.00 3.00 X 0 0 0 STUART ANFANG BOARD MEMBER 1.00 2.00 X 0 0 0 JAMES GORDON BOARD MEMBER 1.00 1.00 X 0 0 0 BETH CHAGUE CFO 1.00 44.00 X 0 167973 2634 LORI A YOUNG DIRECTOR OF NURSING 40.00 0.00 X 118500 0 6601 118500 435294 25303 1 0 1 0 HEALTHPRO REHABILITATION 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY 833789 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 HOUSEKEEPING 628318 MEDLINE INDUSTRIES PO BOX 382075 PITTSBURGH PA 15251 MEDICAL SUPPLIES 414094 HPC FOOD SERVICE DEPT 385 PO BOX 150473 HARTFORD CT 06115 FOOD 369457 OMNICARE DEPT 781668 PO BOX 78000 DETROIT MI 48278 PHARMACY 305130 6 121000 121000 NURSING HOME 623000 19367395 19367395 DAY CARE REVENUE 624100 625034 625034 MEALS PROGRAM 624100 52544 52544 20044973 73200 0 73200 73200 73200 COFFEE, BEAUTY, GIFT SHOPS 453220 47846 47846 MISC REVENUE 900099 34361 34361 82207 20321380 20200380 0 0 X 8739972 8341847 398125 1178381 1044236 134145 645048 603094 41954 2389053 79700 2309353 61817 61817 2474297 2399961 74336 460732 419459 41273 635530 633203 2327 300892 140818 160074 485399 485399 953786 953786 157997 157997 USER FEE 1152425 1152425 FOOD FUNCTIONS 694973 694973 PHARMACY 295831 295831 MISCELLANEOUS 154859 54926 99933 20780992 16147233 4633759 0 966481 1067041 1758138 2014370 54412 28754 40855217 21428138 5561983 19427079 1500 1500 8342514 22538744 2546853 3195745 89250 63614 69442 85739 57243 8386767 22327135 11082973 25738815 X -2740459 -3200071 -2740459 -3200071 8342514 22538744 -459612 0 X 0 1 X 1 0 X 121000 121000 18589592 18731232 17744387 18270873 20044973 93381057 18589592 18731232 17744387 18270873 20165973 93502057 0 0 0 93502057 32 129206 73207 73233 73200 348878 32 129206 73207 73233 73200 348878 41044 182818 80356 82207 386425 18589624 18901482 18000412 18424462 20321380 94237360 0.99220 0.99330 0.00370 0.00300 X SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: MISCELLANEOUS INCOME 2013 AMOUNT: $ 41,044 2014 AMOUNT: $ 182,818 2015 AMOUNT: $ 80,356 2016 AMOUNT: $ 82,207 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 83562 83562 23376829 12085754 11291075 10358376 4966771 5391605 6390282 4266294 2123988 646168 109319 536849 19427079 DUE TO AFFILIATES 22197298 DUE TO THIRD PARTIES 87263 ASSET RETIREMENT OBLIGATION 42574 22327135 X PART IV, LINE 2B: THE ORGANIZATION HOLDS FUNDS ON BEHALF OF ITS RESIDENTS TO BE USED AS DIRECTED BY THE RESIDENTS. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT BELIEVES THAT NO UNCERTAIN TAX POSITIONS EXIST AS OF DECEMBER 31, 2016. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X X X X 0 0 0 0 0 0 0 0 0 MARTIN BAICKER PRESIDENT AND CEO 0 267321 0 0 0 0 0 0 0 16068 0 283389 0 0 BETH CHAGUE CFO 0 167973 0 0 0 0 0 0 0 2634 0 170607 0 0 FORM 990, PART III, LINE 2 THE ORGANIZATION OPENED THE SOSIN CENTER FOR REHABILITATION DURING THE YEAR. THE CENTER PROVIDES SHORT-TERM PHYSICAL, OCCUPATIONAL, AND SPEECH SHORT-TERM REHABILITATION. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS REVIEWED BY MANAGEMENT, AND A COPY WAS REVIEWED BY THE BOARD MEMBERS AFTER FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICTS OF INTEREST POLICY- THE CORPORATE COMPLIANCE OFFICER CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH ANNUAL CORPORATE COMPLIANCE TRAINING AND CONFIRMATIONS SIGNED BY ALL EMPLOYEES AND BY OBTAINING ANNUAL WRITTEN CONFIRMATIONS FROM INDEPENDENT BOARD MEMBERS. THE POLICY STATES THAT EMPLOYEES OR DIRECTORS MUST SEEK GUIDANCE FROM APPROPRIATE MANAGEMENT PERSONNEL PRIOR TO PURSUING ANY BUSINESS OR PERSONAL ACTIVITY THAT MAY CONSTITUTE A CONFLICT OF INTEREST. ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO APPROPRIATE PERSONNEL. FORM 990, PART VI, SECTION B, LINE 15A THE HUMAN RESOURCES COMMITTEE REVIEWS AND APPROVES SALARIES OF TOP MANAGEMENT FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990, PART IX, LINE 11G PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 931,552. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 931,552. LAUNDRY AND HOUSEKEEPING: PROGRAM SERVICE EXPENSES 699,659. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 699,659. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 276,592. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 276,592. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 201,214. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 201,214. ENGINEERING: PROGRAM SERVICE EXPENSES 170,449. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 170,449. OTHER FEES: PROGRAM SERVICE EXPENSES 77,576. MANAGEMENT AND GENERAL EXPENSES 8,865. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 86,441. NURSING: PROGRAM SERVICE EXPENSES 42,919. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,919. ADMINISTRATIVE/BUSINESS OFFICE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 65,471. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,471. JGS LIFECARE CORPORATION 770 CONVERSE STREET LONGMEADOW MA 011061786 042129128 GERIATRIC/NURSING PROVIDER MA 501(C)(3) LINE 10 0 JGS ADMINISTRATIVE SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 011061786 043295014 MANAGERIAL & ADMINISTRATIVE SUPPORT MA 501(C)(3) LINE 10 0 JGS HOUSING SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 011061786 043321157 ASSISTED LIVING FACILITY MA 501(C)(3) LINE 10 0 SPECTRUM HOME HEALTH AND HOSPICE CARE INC 770 CONVERSE STREET LONGMEADOW MA 011061786 043237982 PATIENT TRANSITION ASSISTANCE MA 501(C)(3) LINE 10 0 SPECTRUM HOME CARE INC 770 CONVERSE STREET LONGMEADOW MA 011061786 043399549 NON-CERTIFIED HOME HEALTH AGENCY MA 501(C)(3) LINE 10 0 GENESIS HOUSE INC 770 CONVERSE STREET LONGMEADOW MA 011061786 042817295 ELDERLY HOUSING MA 501(C)(3) LINE 10 0 GENESIS HOUSE II INC 770 CONVERSE STREET LONGMEADOW MA 011061786 222611647 ELDERLY HOUSING MA 501(C)(3) LINE 10 0 GENESIS HOUSE III INC 770 CONVERSE STREET LONGMEADOW MA 011061786 000739159 ELDERLY HOUSING MA 501(C)(3) LINE 10 0 0 0 1 1 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0