2016-11-14T12:32:55-06:00 2015-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2015-01-01 273960910 Jewish Home Lifecare University Avenue Assisted Living Inc JEWI 2128705000 120 West 106th Street New York NY 10025 Audrey S Weiner President and CEO 2128705000 2016-11-04 1 Aaron Shapiro P01333816 2128674000 2015 2017-02-10 21:41:12Z Audrey S Weiner 120 West 106th Street New York NY 10025 2583524 0 X www.jewishhome.org X 2010 DE Jewish Home Lifecare, University Avenue Assisted Living, Inc., was formed for the purpose of operation of a Medicaid assisted living facility on the Bronx Campus. Under the supervision of the New York State Department of Health the building was completed and residents began to move-in in 2014. 10 6 25 6 0 0 0 51796 879825 2531728 0 0 0 0 879825 2583524 0 0 0 0 784939 1413258 0 0 0 996640 1880612 1781579 3293870 -901754 -710346 26855203 25977828 1446139 1279110 25409064 24698718 X Jewish Home Lifecare (d.b.a. The New Jewish Home), University Avenue Assisted Living, Inc., was formed for the purpose of operating a Medicaid assisted living facility on the Bronx Campus. Under the supervision of the New York State Department of Health the building was completed in 2014. 0 0 3002397 2531728 See Schedule OUniversity Avenue Assisted Living is a high-quality living option for medically- and income-eligible Bronx seniors aged 65 and older who are independent yet require support services. The building is located on The New Jewish Home's, Harry and Jeanette Weinberg Campus, Bronx. Completed in fall of 2013, the 72-bed facility features handicapped accessible studio apartments each with a kitchenette and private bathroom. The building has dining and program spaces. Residents receive three daily meals, weekly housekeeping, personal care and medication assistance, on-site nursing services and physician visits, social work services and 24-hour security. Individuals continue to enjoy their independent lifestyle while receiving the care and support they need.For more information, visit www.jewishhome.org 3002397 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 1 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 6 0 25 1 0 0 0 0 0 0 0 0 0 0 X 10 6 0 1 0 0 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 0 NY X Elliot Hagler 2128705973 120 West 106th Street New York NY 10025 Elizabeth Grayer Chair 0.25 6.05 X X 0 0 0 Stanley H Pantowich Treasurer 0.25 5.75 X X 0 0 0 David Haas Secretary 0.25 5.85 X X 0 0 0 Audrey S Weiner President and CEO 0.50 48.50 X X 13217 1379768 64600 Thomas J Gilmartin Chief Financial Officer 0.50 52.50 X X 5439 535893 115358 Edward A Greenberg Director 0.10 2.60 X 0 0 0 Lynn Oberlander Director 0.10 5.30 X 0 0 0 Mel Barkan Director 0.10 4.00 X 0 0 0 Bridget Gallagher Director/Senior VP Community Svs 0.10 50.90 X 0 362397 127576 Rita Morgan Director/Administrator of Bronx 0.10 37.40 X 0 159259 21 Audrey Wathen Senior VP Human Resources 0.50 46.50 X 2644 234228 31322 Bruce Nathanson Senior VP Marketing 0.50 40.50 X 854 203104 42953 Nancy Stoddard Vice President IT 0.50 43.50 X 2895 256424 47972 Firouzeh Naima Director of Finance 0.50 41.50 X 2157 191051 26202 Dale Cooper Associate General Counsel 0.50 40.50 X 1971 174578 28726 Regina Melly VP Business Development 0.50 41.50 X 2883 255349 37082 Maryanne Morgan Director of Finance 0.50 42.50 X 1917 169793 35548 Elizabeth Weingast VP of Clinical Excellence 0.50 42.50 X 1851 163939 59869 Robert Lanfranchi Director of IT 0.50 45.50 X 2273 201386 11669 Svetlana DeBellis VP Managed Care 0.50 37.50 X 3124 200797 37486 Antonio Pilgrim Director of Internal Audit 0.50 39.50 X 1738 153923 26921 Thomas Mathew Director of Finance 0.50 40.50 X 1177 104335 25489 44140 4746224 718794 0 0 1 0 Jewish Home Lifecare Home Assistanc 2545 University Avenue Bronx NY 10468 Home Health Aides and Social Workers 400259 Morrison Dietary 4721 Morrison Drive Suite 300 Mobile AL 36609 Dietary services 192566 2 5000 46796 51796 Inpatient Revenue 623000 2531728 2531728 2531728 2583524 2531728 0 0 X 38238 38238 976130 976130 75059 75059 244359 244359 79472 76810 2662 37863 37863 474 474 605209 605209 22 22 196325 196325 98465 98465 4500 4500 668517 668517 Administration allocati 250099 250099 19138 19138 3293870 3002397 291473 0 103606 85951 562207 260618 26523649 1002776 26189390 25520873 0 110386 26855203 25977828 91065 575252 7348 34585 1347726 669273 1446139 1279110 X 25409064 24698718 25409064 24698718 26855203 25977828 -710346 0 X X 0 1 X 1 0 X 2589553 5775649 17950105 51796 26367103 879825 2531728 3411553 2589553 5775649 17950105 879825 2583524 29778656 0 0 0 29778656 108 108 108 108 2589553 5775649 17950213 879825 2583524 29778764 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 474 0 0 474 0 Part II-B, Line 1: Expenses related to lobbying activities for the time spent and travel by CEO. 0 1 X 26510799 993474 25517325 12850 9302 3548 25520873 Accrued salaries 64273 Estimated liabilities to third parties 605000 669273 X 2583524 0 2583524 0 2583524 3293870 0 3293870 0 3293870 Part IV, Line 2b: The organization maintains resident personal funds in a separate bank account. Part X, Line 2: Jewish Home Lifecare, University Avenue Assisted Living, Inc. has determined that there are no material uncertain tax positions that require recognition or disclosure in the financial statements. Periods ending December 31, 2012 and subsequent remain subject to examination by applicable taxing authorities. X 1 1 0 1 0 0 0 0 0 0 0 Audrey S Weiner President and CEO 6543 683040 0 0 6674 696728 439 45857 174 18130 13830 1443755 0 0 Thomas J Gilmartin Chief Financial Officer 4993 491966 0 0 446 43927 655 64526 504 49673 6598 650092 0 0 Bridget Gallagher Director/Senior VP Community Svs 0 243043 0 0 0 119354 0 19213 0 108363 0 489973 0 0 Rita Morgan Director/Administrator of Bronx 0 159112 0 0 0 147 0 0 0 21 0 159280 0 0 Audrey Wathen Senior VP Human Resources 2600 230315 0 0 44 3913 193 17059 157 13913 2994 265200 0 0 Bruce Nathanson Senior VP Marketing 845 201057 0 0 9 2047 64 15244 116 27529 1034 245877 0 0 Nancy Stoddard Vice President IT 2880 255099 0 0 15 1325 214 18999 321 28438 3430 303861 0 0 Firouzeh Naima Director of Finance 2142 189726 0 0 15 1325 158 13973 135 11936 2450 216960 0 0 Dale Cooper Associate General Counsel 1948 172545 0 0 23 2033 136 12069 184 16337 2291 202984 0 0 Regina Melly VP Business Development 2875 254640 0 0 8 709 165 14642 249 22026 3297 292017 0 0 Maryanne Morgan Director of Finance 1909 169084 0 0 8 709 143 12640 254 22511 2314 204944 0 0 Elizabeth Weingast VP of Clinical Excellence 1846 163477 0 0 5 462 147 12976 522 46224 2520 223139 0 0 Robert Lanfranchi Director of IT 2265 200677 0 0 8 709 130 11539 0 0 2403 212925 0 0 Svetlana DeBellis VP Managed Care 3119 200340 0 0 5 457 0 0 418 37068 3542 237865 0 0 Antonio Pilgrim Director of Internal Audit 1715 151890 0 0 23 2033 0 0 301 26620 2039 180543 0 0 Part I, Line 1a 1) Tax indemnification and gross-up payment 2) Audrey S. Weiner and Thomas J. Gilmartin 3) The amounts were treated as taxable compensation Part I, Line 4b Audrey S. Weiner participated in a supplemental defined benefit retirement plan. The accrual for the year was $27,083. During 2015, Audrey vested in the plan and as a result $699,701 was included in Ms. Weiner's W-2 reportable compensation. Thomas J. Gilmartin participated in a supplemental defined contribution retirement plan. The accrual for the year was $45,968. During 2015, Mr. Gilmartin's vesting in the plan resulted in an additional $42,004 of W-2 reportable compensation for Mr. Gilmartin. Bridget Gallagher participated in a supplemental defined contribution retirement plan. During 2015, Ms. Gallagher's vesting in the plan resulted in an additional $118,797 of W-2 reportable compensation for Ms. Gallagher and $95,205 of non-taxable benefit. Form 990, Part VI, Section A, line 3 Management responsibilities are fulfilled by administrative personnel employed by a related entity, JHL Corporate Services, Inc. In 2015, costs incurred by JHL Corporate Services, Inc. were allocated to individual Jewish Home Lifecare's entities in accordance with expense-based methodology. The organization periodically reviews the method by which administrative overhead expenses are allocated. Form 990, Part VI, Section A, line 6 The sole member of the organization is Jewish Home Lifecare, a New York not-for-profit corporation. Form 990, Part VI, Section A, line 7a Jewish Home Lifecare may elect one or more members of the governing body. Form 990, Part VI, Section B, line 11 A draft of the completed return was reviewed by Management. Any comments arised from the review were discussed and and changes were made. The draft was submitted to the Audit and Compliance Committee of Jewish Home Lifecare and Subsidiaries for their review and approval. Audit and Compliance Committee completed their reviews and a copy of the return was provided to all board members prior filing with IRS. Form 990, Part VI, Section B, line 12c Annually all Board members, officers, and key employees are provided a copy of the conflict of interest policy and are asked to review the policy and to disclose any potential or actual conflicts that may have occurred since the last disclosure. The Audit and Compliance Committee of the Board reviews the disclosures as summarized by the Compliance department. All identified conflicts of interest are discussed and either approved or rejected by the Board. If the Board of Directors or the Governance Committee determines that a conflict of interest exists, the Director with the conflict may not take part in the decision process to which the conflict relates. Such disclosure and the fact that the Director did not vote or participate in the deliberations is recorded in the relevant minutes. Form 990, Part VI, Section B, line 15 Annually, the Chairman of the Board of Jewish Home Lifecare, in consultation with the Compensation Committee, reviews and evaluates the President/CEO, officers and key employees' performance against a series of goals and objectives for the year. In establishing compensation levels for the CEO/President, officers and key employees, the Board Chair and the Compensation Committee of the Board use performance and periodic compensation surveys of other similar type organizations, completed by an external consultant, to inform their decisions. Minutes of the meeting are maintained in a confidential file. The meeting of the compensation committee at which this took place was held in November 2013. Form 990, Part VI, Section C, line 19 The governing documents and financial statements are available to the public upon request. Form 990, Part IX, line 11g Home health aide: Program service expenses 341,606. Management and general expenses 0. Fundraising expenses 0. Total expenses 341,606. RN and LPN agencies: Program service expenses 59,376. Management and general expenses 0. Fundraising expenses 0. Total expenses 59,376. Recreation services: Program service expenses 3,847. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,847. Nutritionalist: Program service expenses 6,945. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,945. Social worker fees: Program service expenses 58,653. Management and general expenses 0. Fundraising expenses 0. Total expenses 58,653. Contract services: Program service expenses 127,231. Management and general expenses 0. Fundraising expenses 0. Total expenses 127,231. Laundry services: Program service expenses 5,131. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,131. Electrical Repairs: Program service expenses 2,142. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,142. Extermination Services: Program service expenses 278. Management and general expenses 0. Fundraising expenses 0. Total expenses 278. Form 990, Part XII, Line 2c: The Audit and Compliance Committee of the organization has the oversight responsibility for the audit of the organization's financial statements. As part of the financial statement audit process, the Audit and Compliance Committee is responsible to: 1. Select the independent audit firm 2. Review and approve audit scope and fees 3. Oversee the financial reporting process 4. Ensure open communications between management, audit firm, and the Audit and Compliance Committee 5. Review of independent audit firm's annual performance 6. Meet in Executive Session (absent management) with the audit firm to discuss any potential concerns with management's performance Jewish Home Lifecare 120 West 106th Street New York NY 10025 133267073 Provides care for the elderly NY 501(c)(3) 11, type ii N/A 0 Jewish Home Lifecare Manhattan 120 West 106th Street New York NY 10025 131624033 Provides care for the elderly NY 501(c)(3) 3 Jewish Home Lifecare 0 Jewish Home Lifecare Harry and Jeanette Weinberg Campus Bronx 120 West 106th Street New York NY 10025 237071900 Provides care for the elderly NY 501(c)(3) 9 Jewish Home Lifecare 0 Fund for the Aged Inc 120 West 106th Street New York NY 10025 133603516 Solicit and distribute contributions for care to the elderly NY 501(c)(3) 7 Jewish Home Lifecare 0 Jewish Home Lifecare Sarah Neuman Center Westchester 845 Palmer Avenue Mamaroneck NY 10543 133620568 Provides care for the elderly NY 501(c)(3) 9 Jewish Home Lifecare 0 Kittay House Jewish Home Lifecare Inc 100 West Kingsbridge Road Bronx NY 10468 132619576 Provides housing to the elderly NY 501(c)(3) 9 Jewish Home Lifecare Harry and Jeanette Weinberg Campus Bronx 0 WK Diagnostic and Treatment Center 100 West Kingsbridge Road Bronx NY 10468 133527664 Provides healthcare services NY 501(c)(3) pf Jewish Home Lifecare Harry and Jeanette Weinberg Campus Bronx 0 Jewish Home Lifecare Receivership Corp 120 West 106th Street New York NY 10025 133500285 Manages housing organizations NY 501(c)(3) 11, type i Jewish Home Lifecare 0 Lifecare Property Holding Corp 120 West 106th Street New York NY 10025 205945618 Owns property NY 501(c)(2) n/a Jewish Home Lifecare 0 Harry and Jeanette Weinberg Riverdale HouseHousing Development Fund Co Inc 120 West 106th Street New York NY 10025 133865179 Provides subsidized housing for the elderly NY 501(c)(3) 9 Jewish Home Lifecare Harry and Jeanette Weinberg Campus Bronx 0 Kenneth Gladstone Building Housing Development Fund Company Inc 120 West 106th Street New York NY 10025 134078893 Provides subsidized housing for the elderly NY 501(c)(3) 9 Jewish Home Lifecare Harry and Jeanette Weinberg Campus Bronx 0 Harry and Jeanette Weinberg Gardens Housing Development Fund Company Inc 120 West 106th Street New York NY 10468 204981328 Provides subsidized housing for the elderly NY 501(c)(3) 7 Jewish Home Lifecare Harry and Jeanette Weinberg Campus Bronx 0 JHL Corporate Services Inc 120 West 106th Street New York NY 10025 263385174 Management services DE 501(c)(3) 11, type i Jewish Home Lifecare 0 Lifecare Manhattan Property Holding Corp 120 West 106th Street New York NY 10025 263070863 Owns property DE 501(c)(3) 11, type i Jewish Home Lifecare Manhattan 0 Jewish Home Lifecare Community Services Inc 120 West 106th Street New York NY 10025 270158524 Provides community services NY 501(c)(3) 9 Jewish Home Lifecare 0 Jewish Home Lifecare Development Corp 120 West 106th Street New York NY 10025 262054641 Owns property NY 501(c)(3) 11, type i Jewish Home Lifecare Manhattan 0 Lifecare Manhattan Supporting Corp 120 West 106th Street New York NY 10025 262634853 Owns property DE 501(c)(3) 11, type i Jewish Home Lifecare Manhattan 0 156 West 106th Street Holding Corp 120 West 106th Street New York NY 10025 270308650 Owns property NY 501(c)(2) n/a Jewish Home Lifecare 0 Geriatric Career Development Program Inc 120 West 106th Street New York NY 10025 462452619 To operate programs for at-risk youth DE 501(c)(3) 7 Jewish Home Lifecare 0 2614 Kingsbridge Corp 120 West 106th Street New York NY 10025 132749776 Provides parking facilities NY N/A C 0 Jewish Home Lifecare Home Assistance Personnel Inc 120 West 106th Street New York NY 10025 133267068 Provides long term home health care NY N/A C 0 JHHA Medical Group PC 120 West 106th Street New York NY 10025 133364558 Provides health care services NY N/A C 0 102 West 107TH Street Corp 120 West 106th Street New York NY 10025 132760057 Provides parking facilities NY N/A C 0 Jewish Home Lifecare Spectrum Services Inc 120 West 106th Street New York NY 10025 453563804 Holding company for for-profit affiliates NY N/A C 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 Jewish Home Lifecare Home Assistance Personnel Inc M 400259 cost