2014-10-07T19:22:10-05:00 2013-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2013-01-01 800517818 ELDERSERVE HEALTH INC ELDE 7185811000 5901 PALISADE AVENUE BRONX NY 10471 DANIEL REINGOLD PRESIDENT & CEO 7185811000 2014-10-03 1 ISRAEL TANNENBAUM P01589203 2128674000 2013 2015-11-30 17:44:51Z DANIEL REINGOLD 5901 PALISADE AVENUE BRONX NY 10471 422443549 0 X N/A X 2009 NY MANAGED LONG TERM CARE 5 3 196 3 0 0 0 0 259076154 410578722 651250 873820 496595 637258 260223999 412089800 0 0 0 0 10948981 15732609 0 0 0 239135791 380525648 250084772 396258257 10139227 15831543 72080831 114855108 55447982 83192111 16632849 31662997 SEE SCHEDULE O.TO SERVE FRAIL ELDERLY AND DISABLED INDIVIDUALS WITH HIGH QUALITY SERVICES TO HELP THEM MAINTAIN MAXIMUM INDEPENDENCE AND QUALITY OF LIFE. 0 0 377053771 410578722 MANAGED LONG TERM CARE FOR 10,202 FRAIL ELDERLY AND DISABLED INDIVIDUALS WITH HIGH QUALITY SERVICES TO HELP THEM MAINTAIN MAXIMUM INDEPENDENCE AND QUALITY OF LIFE. 377053771 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 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 50 0 196 1 0 0 0 0 0 0 0 0 0 0 X 5 3 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 NY X LUZ LIEBESKIND 7185811317 5901 PALISADE AVENUE BRONX NY 10471 DANIEL REINGOLD CHAIRMAN AND CEO 1.00 34.00 X X 0 682073 271393 DAVID POMERANZ VICE CHAIRMAN AND SECRETARY 25.00 10.00 X X 0 443608 88480 JOSEPH WYGODA TREASURER 1.00 8.00 X X 0 0 0 ISADORE KREEL MD DIRECTOR 1.00 3.00 X 0 0 0 JAMES SHIFREN DIRECTOR 1.00 3.00 X 0 0 0 SUSAN ALDRICH EXECUTIVE VICE PRESIDENT 35.00 X 534035 0 38628 LUZ LIEBESKIND CFO 5.00 30.00 X 0 317979 34110 JOHN MCKEON VICE PRESIDENT OF FINANCE 40.00 X 236325 0 38437 ANNA MARIA ETIENNE SENIOR VICE PRESIDENT 40.00 X 324830 0 23772 IRINA VAINRIB DIRECTOR OF OUTREACH AND E 35.00 X 183239 0 35255 CAMILLE SANDS REGIONAL CLINICAL DIRECTOR 35.00 X 180829 0 29863 JENNY LING DIRECTOR OF REGULATORY AFF 35.00 X 246529 0 17815 ANDREW J CAVALIERE JR ASSISTANT VP OF FINANCE 35.00 X 196237 0 34934 PAMELA BRYANT ASSISTANT VP OF NURSING 35.00 X 171825 0 19694 2073849 1443660 632381 40 0 1 0 RELAY HEALTH 1564 NORTHEAST EXPRESSWAY ATLANTA GA 30329 PROVIDER CONSULTING 1201716 CYRUSXP PO BOX 393 WYNNEWOOD PA 19096 IT CONSULTING 787500 ROPES & GRAY LLP 1211 AVENUE OF THE AMERICAS NEW YORK NY 10036 LEGAL 478718 QUALITY CODING SPECIALISTS LLC 11 PARKVIEW DRIVE BRONXVILLE NY 10708 CODING CONSULTANT 210498 ROLF KARL 245 HENRY STREET BROOKLYN NY 11201 ARCHITECT 158760 5 MEDICAID CAPITATION 623000 409838552 409838552 OTHER MEDICAID 623000 740170 740170 410578722 771137 771137 10456432 10353749 102683 102683 102683 SURPLUS MEMBER INCOME 900099 637258 637258 637258 412089800 410578722 0 1511078 X 1196027 1196027 11928829 10624340 1304489 419566 396584 22982 1238004 1044780 193224 950183 778863 171320 8199627 8199627 573541 573541 160000 160000 165739 165739 335126906 334156683 970223 420433 52604 367829 10374035 8662334 1711701 2194940 2194940 756631 756631 21417696 21321920 95776 496660 496660 550451 15663 534788 BAD DEBT 88989 88989 396258257 377053771 19204486 0 918788 32505365 45504974 481063 6407065 47472 1350959 3341685 850616 1261117 2491069 36718558 56949027 1067256 1233226 72080831 114855108 52312102 76338879 109683 157190 91880 78022 2934317 6618020 55447982 83192111 X 16632849 31662997 16632849 31662997 72080831 114855108 15831543 -801395 0 X X 0 1 X 1 0 X 1602448 49471387 259076154 410578722 720728711 1602448 49471387 259076154 410578722 720728711 0 0 0 720728711 70373 119752 528624 771137 1489886 70373 119752 528624 771137 1489886 42337 496595 637258 1176190 1672821 49633476 260101373 411987117 723394787 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: SURPLUS MEMBER INCOME 813333 197833 615500 2423352 612621 1810731 105000 40162 64838 2491069 DUE TO THE HEBREW HOME FOR THE AGED AT RIVERDALE 2188137 DUE TO THIRD PARTIES 4429883 6618020 X 411122666 -801395 -801395 411924061 165739 165739 412089800 396092518 0 396092518 165739 165739 396258257 PART X, LINE 2: EHI HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2010 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. X X X X 0 1 0 0 0 0 0 1 0 DANIEL REINGOLD CHAIRMAN AND CEO 0 678719 0 0 0 3354 0 246356 0 25037 0 953466 0 0 DAVID POMERANZ VICE CHAIRMAN AND SECRETARY 0 441814 0 0 0 1794 0 64009 0 24471 0 532088 0 0 SUSAN ALDRICH EXECUTIVE VICE PRESIDENT 508458 0 20825 0 4752 0 35824 0 2804 0 572663 0 0 0 LUZ LIEBESKIND CFO 0 316358 0 0 0 1621 0 31176 0 2934 0 352089 0 0 JOHN MCKEON VICE PRESIDENT OF FINANCE 234106 0 0 0 2219 0 14378 0 24059 0 274762 0 0 0 ANNA MARIA ETIENNE SENIOR VICE PRESIDENT 320078 0 0 0 4752 0 14049 0 9723 0 348602 0 0 0 IRINA VAINRIB DIRECTOR OF OUTREACH AND E 182334 0 0 0 905 0 11337 0 23918 0 218494 0 0 0 CAMILLE SANDS REGIONAL CLINICAL DIRECTOR 178310 0 0 0 2519 0 7314 0 22549 0 210692 0 0 0 JENNY LING DIRECTOR OF REGULATORY AFF 243638 0 0 0 2891 0 14976 0 2839 0 264344 0 0 0 ANDREW J CAVALIERE JR ASSISTANT VP OF FINANCE 195271 0 0 0 966 0 10981 0 23953 0 231171 0 0 0 PAMELA BRYANT ASSISTANT VP OF NURSING 170292 0 0 0 1533 0 10375 0 9319 0 191519 0 0 0 PART I, LINE 4B DANIEL REINGOLD - $226,010 LUZ LIEBESKIND - $15,965 DAVID POMERANZ - $43,775 DAVID WEINSTEIN - $16,995 PART I, LINE 7 BONUSES GIVEN ARE AT THE DISCRETION OF THE COMPENSATION COMMITTEE UP TO 10% OF EXECUTIVE'S SALARY DEPENDING ON WHETHER OR NOT TRIGGERS ESTABLISHED EVERY YEAR ARE MET. FORM 990, PART VI, SECTION A, LINE 6 HEBREW HOME HOLDING CORP. IS THE SOLE MEMBER OF ELDERSERVE HEALTH, INC.. FORM 990, PART VI, SECTION B, LINE 11 THE AUDIT COMMITTEE REVIEWS THE 990 WITH THE CHIEF FINANCIAL OFFICER AND THE PREPARER, AND REPORTS THEIR FINDINGS TO THE FULL BOARD OF DIRECTORS. THE COMPLETE 990 IS ALSO MADE AVAILABLE FOR THE ENTIRE BOARD OF DIRECTORS TO REVIEW AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C ON A YEARLY BASIS, THE COMPLIANCE OFFICER, WORKING WITH ADMINISTRATION, DISTRIBUTES CONFLICT OF INTEREST QUESTIONNAIRES TO BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES WITH INSTRUCTIONS TO COMPLETE THE FORMS AND RETURN THEM TO THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER REVIEWS ALL SUBMITTED FORMS AND IDENTIFIES ANY CONFLICTS WHICH NEED TO BE REPORTED, CONSULTING WITH LEGAL COUNSEL, IF NECESSARY. THE COMPLIANCE OFFICER NOTIFIES THE CHAIRMAN OF THE BOARD AND THE CEO OF ANY CONFLICTS SO THAT CONFLICTED INDIVIDUALS APPROPRIATELY RECUSE THEMSELVES FROM DISCUSSIONS AND VOTING ON MATTERS ON WHICH THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND OFFICERS AND KEY EMPLOYEES' COMPENSATION IS PAID THROUGH A RELATED MANAGEMENT SERVICE ORGANIZATION; HHAR SERVICES CORP. COMPENSATION IS ALLOCATED TO EACH RELATED ENTITY BASED ON AN APPROVED METHODOLOGY. DETERMINATION OF THE COMPENSATION IS BASED ON INDEPENDENT COMPARATIVE ANALYSIS OF COMPENSATION LEVELS FOR OTHER CEO'S AND OFFICERS IN ORGANIZATIONS OF SIMILAR SIZE IN THE LONG-TERM CARE INDUSTRY IN THE NY METROPOLITAN AREA. THIS IS DONE BY AN INDEPENDENT COMPENSATION CONSULTANT AND THE INFORMATION IS THEN REVIEWED BY A COMPENSATION COMMITTEE AND APPROVED BY THE FULL BOARD OF THE RELATED ENTITIES PAYING THE COMPENSATION. THIS PROCESS WAS LAST DONE IN 2013. FORM 990, PART VI, SECTION C, LINE 18 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G NURSING: PROGRAM SERVICE EXPENSES 33,486,764. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,486,764. PERSONAL CARE WORKERS: PROGRAM SERVICE EXPENSES 281,358,113. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 281,358,113. OTHER: PROGRAM SERVICE EXPENSES 6,919,721. MANAGEMENT AND GENERAL EXPENSES 970,223. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,889,944. SOCIAL DAY CARE FEES: PROGRAM SERVICE EXPENSES 12,392,085. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,392,085. FORM 990, PART XII, LINE 2C PROCESS HAS NOT CHANGED FROM PRIOR YEAR. PALISADE NURSING HOME COMPANY INC 5901 PALISADE AVENUE RIVERDALE NY 10471 132668331 NURSING HOME NY 501(C)(3) 3 HEBREW HOME HOLDING CORP 0 HEBREW HOME HOUSING DEVELOPMENT FUND CO INC 5901 PALISADE AVENUE RIVERDALE NY 10471 132956755 HOUSING NY 501(C)(3) 9 HEBREW HOME HOLDING CORP 0 ELDERSERVE LICENSED HOME CARE SERVICE AGENCY INC 3547 JOHNSON AVENUE BRONX NY 10463 133900644 SERVICE AGENCY NY 501(C)(3) 9 HEBREW HOME HOLDING CORP 0 RIVERDALE TERRACE HOUSING DEVELOPMENT FUND CO INC 5901 PALISADE AVENUE RIVERDALE NY 10471 133900256 HOUSING NY 501(C)(3) 9 HEBREW HOME HOLDING CORP 0 HEBREW HOME FOR THE AGED AT RIVERDALE FOUNDATION INC 5901 PALISADE AVENUE RIVERDALE NY 10471 204352212 FOUNDATION FOR HHAR NY 501(C)(3) 7 N/A 0 HEBREW HOME FOR THE AGED AT RIVERDALE INC 5901 PALISADE AVENUE RIVERDALE NY 10471 131739971 NURSING HOME NY 501(C)(3) 9 HEBREW HOME HOLDING CORP 0 HEBREW HOME HOLDING CORP 5901 PALISADE AVENUE RIVERDALE NY 10471 270996795 TO SUPPORT HEALTHCARE SERVICES NY 501(C)(3) 11 TYPE 1 N/A 0 NATIONAL ALZHEIMER'S CENTER INC 5901 PALISADE AVENUE RIVERDALE NY 10471 133403753 TO PROMOTE ALZHEIMER'S CARE NY 501(C)(3) 11 TYPE 1 HEBREW HOME HOLDING CORP 0 HUDSON HOUSE HOUSING DEVELOPMENT FUND CO INC 5901 PALISADE AVENUE RIVERDALE NY 10471 275547643 HOUSING NY 501(C)(3) 9 HEBREW HOME HOLDING CORP 0 HHAR SERVICES CORP 5901 PALISADE AVENUE RIVERDALE NY 10463 461763915 MANAGEMENT COMPANY NY 501(C)(3) 11 TYPE II HEBREW HOME HOLDING CORP 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 1 0 0 0