2016-11-10T12:55:24-06:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2015-01-01 042106768 JEWISH REHABILITATION CENTER FOR THE AGED OF THE NORTH SHORE INC JEWI 9784715100 240 LYNNFIELD STREET PEABODY MA 01960 JEFFREY M LANDA CFO 9784715100 2016-11-08 1 JUDY DALEY P01294075 6179848100 2016-11-07 2015 2017-02-10 21:41:12Z JEFFREY & SUSAN BRUDNICK CENTER FOR LIVING JEFFREY M LANDA 240 LYNNFIELD STREET PEABODY MA 01960 18621569 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 NURSING HOME WITH AN ADULT DAY CARE CENTER. 7 6 373 25 0 0 0 0 17527831 18620499 2087948 494 533 576 19616312 18621569 0 0 0 0 11539972 11283865 0 0 0 8419977 8621212 19959949 19905077 -343637 -1283508 37067898 36014222 42710705 42694834 -5642807 -6680612 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 NURSING HOME WITH AN ADULT DAY CARE CENTER. 0 0 16577203 17832476 NURSING HOME - PROVIDE QUALITY SKILLED NURSING CARE & REHABILITATIVE THERAPY FOR UP TO 144 ELDERLY RESIDENTS OF A NURSING HOME. 853731 788599 ADULT DAY CARE - PROVIDE SUPPORTIVE CARE TO PATIENTS OF THE ADULT DAY CARE FACILITY. 17430934 1 0 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 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 17 0 1 373 1 0 0 0 0 0 0 0 0 0 0 X 7 6 1 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 1 0 MA X JEFFREY M LANDA CFO 9784715100 240 LYNNFIELD STREET PEABODY MA 01960 ADAM BERMAN PRESIDENT 1.00 3.00 X X 0 0 0 BARRY BERMAN TREASURER 1.00 3.00 X X 0 0 0 JOEL MAZER CHAIR 1.00 3.00 X X 0 0 0 ELIZABETH MULLEN SECRETARY 1.00 3.00 X X 0 0 0 SUSAN BRUDNICK DIRECTOR 1.00 3.00 X 0 0 0 SHARON FORMAN DIRECTOR 1.00 3.00 X 0 0 0 ROBERT RICHMAN DIRECTOR 1.00 3.00 X 0 0 0 KIM JOYCE CFO 1.00 39.00 X 0 185413 17390 JEFF GOPEN EXEC. VP OF OPERATIONS 40.00 0.00 X 206784 0 21930 MARY OGAH REGISTERED NURSE 40.00 0.00 X 109521 0 10774 CARLEEN MCLAUGHLIN REGISTERED NURSE 40.00 0.00 X 103926 0 15342 ESTHER KAIRU LPN 40.00 0.00 X 103201 0 20207 523432 185413 85643 4 0 1 0 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE QUINCY MA 02169 ACCOUNTING & TAX SERVICES 143083 1 PROGRAM SERVICE FEES 623000 18404242 18404242 OTHER INCOME 624100 216257 216257 18620499 494 494 576 0 576 576 18621569 18621569 0 0 9704415 9375959 328456 24824 23984 840 712634 688514 24120 841992 813494 28498 1827572 1827572 71534 71534 60359 60359 537724 404960 132764 8266 8266 142801 142801 548111 548111 146290 146290 21196 21196 849634 849634 1573160 1573160 42185 42185 ANCILLARIES 810742 810742 USER FEE 692419 692419 SUPPLIES 494774 494774 FOOD 428871 428871 365574 365574 19905077 17430934 2474143 0 931133 1304963 1943544 2151427 499 0 351577 183265 36977156 5509673 32898453 31467483 942692 907084 37067898 36014222 1514107 1386696 155442 100311 29136380 26556574 269034 57775 11635742 14593478 42710705 42694834 X -5642807 -6680612 -5642807 -6680612 37067898 36014222 X -1283508 245703 X 0 1 X 1 0 X 1607943 1607943 17078920 15224807 17113013 17528364 18621075 85566179 18686863 15224807 17113013 17528364 18621075 87174122 1607943 1607943 0 1607943 1607943 85566179 935711 138 135 1185 494 937663 935711 138 135 1185 494 937663 -406566 2086763 1680197 19622574 14818379 17113148 19616312 18621569 89791982 0.95290 0.95190 0.01040 0.01070 X 31514335 2762233 28752102 5405765 2700957 2704808 57056 46483 10573 31467483 DUE TO RELATED PARTIES 14266105 FAIR VALUE OF INTEREST RATE SWAPS 305963 SECURITY DEPOSITS 21410 14593478 X PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. THE 2012 THROUGH 2015 TAX YEARS ARE OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X 1 0 0 0 0 0 0 0 0 KIM JOYCE CFO 0 185413 0 0 0 0 0 0 0 17390 0 202803 0 0 JEFF GOPEN EXEC. VP OF OPERATIONS 206784 0 0 0 0 0 0 0 21930 0 228714 0 0 0 PART I, LINE 4A JEFF GOPEN, EXECUTIVE VP OF OPERATIONS, WILL RECEIVE A SEVERANCE PAYMENT OF $161,480 TO BE PAID IN 2016. A MASS DEVELOPMENT FINANCE AGENCY 043431814 57583UBR8 2011-04-29 34553888 TO REFUND OLD BONDS AND REPLACE EXISTING FACILITY. 0 0 0 A 5417508 34553888 1314672 690823 529178 26601707 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 BRUNICK LOUIS J BRUDNICK SPOUSE ON THE BOARD OF DIRECTORS. 32699 INSURANCE BROKER/AGENT OF THE ORGANIZATION'S INSURANCE COMPANY. 0 FORM 990, PART VI, SECTION A, LINE 1 DURING 2014, A STRATEGIC PLANNING COMMITTEE WAS PUT IN PLACE TO REVIEW AND EVALUATE THE ORGANIZATIONS. SIX MEMBERS OF FORMER BOARD WORKED TOGETHER WITH BANKS AND MANAGEMENT TO IDENTIFY OUTSIDE ORGANIZATION TO CONTINUE MISSION OF CHELSEA JEWISH (FKA AVIV) WITH THE CAPACITY TO TAKE ON DEBT AND PROJECT IMPROVEMENT IN OPERATIONS TO BE ABLE TO PAY DEBT. 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 COMMUNITY, INC., A SUBSIDIARY OF CHELSEA JEWISH FOUNDATION, EFFECTIVE DECEMBER 1, 2014. CHELSEA JEWISH COMMUNITY, 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 B, LINE 11 THE ORGANIZATION'S MANAGEMENT REVIEWS THE CPA-PREPARED FORM 990 PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD OF DIRECTORS AND EXECUTIVE MANAGERS ARE REQUIRED ANNUALLY TO COMPLETE A CONFLICT OF INTEREST STATEMENT. STATEMENTS ARE REVIEWED BY A SUBCOMMITTEE OF BOARD MEMBERS AND THE CEO. MONTHLY COMPLIANCE COMMITTEE MEETINGS INCLUDE REVIEW AND MONITORING OF ANY POTENTIAL OR ACTUAL CONFLICTS. DETERMINING THE LEVEL OF CONFLICT FOR REVIEW IS BASED ON POTENTIAL FINANCIAL OR LEGAL RISK TO THE ORGANIZATION. IF A CONFLICT (ACTUAL OR POTENTIAL) IS RAISED FOR A BOARD MEMBER, HE/SHE IS REFRAINED FROM VOTING ON RELATED TOPICS. MANAGERS WITH CONFLICT (ACTUAL OR POTENTIAL) ARE BANNED FROM OVERSIGHT AND DECISION MAKING FOR THAT SUBJECT. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE, A SUBCOMMITTEE OF THE BOARD, ANNUALLY REVIEWS CEO AND TOP MANAGEMENT COMPENSATION. INDUSTRY SALARY AND BENEFIT SURVEYS AS WELL AS MARKET DATA ARE REVIEWED AS DEEMED NECESSARY. THE COMPENSATION COMMITTEE AND REVIEW OF COMPENSATION IS DOCUMENTED IN THE FORM OF A REPORT AND MAINTAINED IN HUMAN RESOURCE FILES. 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 -90,104. EQUITY TRANSFER WITH RELATED PARTY 335,807. CHELSEA JEWISH FOUNDATION INC 240 LYNNFIELD STREET PEABODY MA 01960 223102199 FUNDRAISING MA 501(C)(3) LINE 7 CHELSEA JEWISH NORTH SHORE INC 0 CHELSEA JEWISH NORTH SHORE ASSISTED LIVING INC 240 LYNNFIELD STREET PEABODY MA 01960 043274643 ASSISTED LIVING MA 501(C)(3) LINE 9 CHELSEA JEWISH NORTH SHORE INC 0 CHELSEA JEWISH NORTH SHORE INC 240 LYNNFIELD STREET PEABODY MA 01960 261244471 MANAGEMENT MA 501(C)(3) LINE 11B, II 0 JRC REALTY CORPORATION INC 240 LYNNFIELD STREET PEABODY MA 01960 043321272 REAL ESTATE MA N/A C 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 FORM 990, SCHEDULE R, PART IV: JRC REALTY CORPORATION, INC., A RELATED FOR-PROFIT CORPORATION WHICH HELD REAL PROPERTY INVESTMENTS, WAS DISSOLVED DURING THE 2015 CALENDAR YEAR.