2014-07-18T06:44:01-05:00 2013-12-31 042684828 FEELEY & DRISCOLL PC 200 PORTLAND STREET BOSTON MA 02114 990 2013-01-01 043138403 JEWISH NURSING HOME OF WESTERN MASSACHUSETTS INC JEWI 4135676211 770 CONVERSE STREET LONGMEADOW MA 011061786 A EDWARD ROMAN CFO 4135676211 2014-07-11 1 JEFFREY T ROGERS P01074284 6177427788 2013 2015-11-30 17:44:51Z A EDWARD ROMAN 770 CONVERSE STREET LONGMEADOW MA 01106 18902607 0 X WWW.JEWISHGERIATRIC.ORG X 1992 MA TO CARE FOR THE FRAIL ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 4 3 365 92 0 0 0 0 18589592 18731232 -1214 202 228374 171173 18816752 18902607 0 0 0 0 10753379 10808858 0 0 0 8026060 7997751 18779439 18806609 37313 95998 11007049 10841774 10870639 10609366 136410 232408 TO CARE FOR THE FRAIL ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 0 0 16203831 18901680 THE HOME IS A NON-PROFIT ORGANIZATION WHICH OWNS AND OPERATES A 200 BED SKILLED NURSING FACILITY AND ADULT DAY CARE CENTER. 16203831 1 0 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 11 0 1 365 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X JEWISH GERIATRIC SERVICES INC A EDWARD ROMAN JR CFO 4135675211 770 CONVERSE STREET LONGMEADOW MA 01106 MARTIN BAICKER PRESIDENT AND CEO 1.00 40.00 X X 0 278280 42493 STUART ANFANG BOARD MEMBER 1.00 X 0 0 0 DONALD FRANK BOARD MEMBER 1.00 X 0 0 0 MICHAEL GINSBURG BOARD MEMBER 1.00 X 0 0 0 EDWARD ROMAN CFO 1.00 40.00 X 0 135359 27647 0 413639 70140 0 0 1 0 HARRY GRODSKY & COMPANY INC 33 SHAWS LANE SPRINGFIELD MA 01101 MECHANICAL CONSTRUCTION 183266 1 NURSING HOME 623000 18028111 18028111 DAY CARE REVENUE 624100 650515 650515 MEALS PROGRAM 624100 52606 52606 18731232 2 2 129204 0 129204 129204 129204 200 0 200 200 200 EMPLOYEE MEALS REVENUE 722210 29629 29629 COFFEE, BEAUTY, GIFT SHOPS 453220 11415 11415 MISC REVENUE 900099 925 925 41969 18902607 18901680 0 927 8638151 8449260 188891 218301 213096 5205 1301887 1262189 39698 650519 617144 33375 1941467 73263 1868204 676356 570582 105774 347797 344321 3476 7632 7632 480603 480603 1572 1321 251 522262 522262 883693 883693 131478 131478 USER FEE 1210181 1210181 FOOD FUNCTIONS 622281 622281 PHARMACY 262463 262463 MISCELLANEOUS 236371 197209 39162 673595 493963 179632 18806609 16203831 2602778 0 1574753 1314911 1845872 2546781 39092 64345 25655006 18740769 7545832 6914237 1500 1500 11007049 10841774 1383935 1768175 48858 49890 188702 156259 9249144 8635042 10870639 10609366 X 136410 232408 136410 232408 11007049 10841774 95998 0 X 0 1 X 1 0 X 17311003 17015566 18537699 18589592 18731232 90185092 17311003 17015566 18537699 18589592 18731232 90185092 0 0 0 90185092 453 2718 14 32 129206 132423 453 2718 14 32 129206 132423 40834 41044 81878 17311456 17018284 18578547 18589624 18901482 90399393 0.99760 0.99940 0.00150 0.00010 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: ENDOWMENT SUPPORT - 2011 AMOUNT: $ 40,834. MISCELLANEOUS INCOME - 2013 AMOUNT: $ 41,044. 0 1 X 343078 343078 13205053 10061033 3144020 7043947 4740613 2303334 4907323 3829804 1077519 155605 109319 46286 6914237 DUE TO AFFILIATES 8314282 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 295748 ASSET RETIREMENT OBLIGATION 25012 8635042 X 18902607 0 18902607 0 18902607 18806609 0 18806609 0 18806609 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: THE ORGANIZATION ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIAL POSITION. TAX YEARS FROM 2010 THROUGH THE CURRENT YEAR REMAIN OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. PART X LINE 2 THE ORGANIZATION ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIAL POSITION. TAX YEARS FROM 2010 THROUGH THE CURRENT YEAR REMAIN OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X X 0 0 0 0 0 0 0 0 0 MARTIN BAICKER PRESIDENT AND CEO 0 253280 0 25000 0 0 0 0 0 42493 0 320773 0 0 EDWARD ROMAN CFO 0 135250 0 0 0 109 0 0 0 27647 0 163006 0 0 FORM 990, PART VI, SECTION B, LINE 11 AS PART OF ITS EXISTING CHARTER, THE FINANCE COMMITTEE (ALL INDEPENDENT MEMBERS) WERE ASKED BY THE BOARD TO REVIEW REQUIRED DISCLOSURES IN THE FORM 990 AND, IF APPROVED, RECOMMEND THE RETURN FOR FILING. THE CFO DISCUSSED IN DETAIL WITH THE FINANCE COMMITTEE THE PREPARATION, COMPLETION AND FINALIZATION OF THE FORM 990 WITH EMPHASIS ON THE NEWLY REQUIRED DISCLOSURES OF: ACTIVITIES IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSE; GOVERNANCE, FINANCIAL TRANSACTIONS AMONG INSIDERS AND COMPENSATION; COMMUNITY BENEFIT, BONDS, AND CORPORATE POLICIES AND PROCEDURES; DISCLOSURE OF KEY GOVERNANCE, FINANCIALS AND MISSION POLICIES. BASED ON ITS REVIEW AND FINDINGS, THE FINANCE COMMITTEE RECOMMENDED THE FILING OF THE FORM 990. A COPY OF THE RETURN IS MADE AVAILABLE AND REVIEWED WITH THE BOARD MEMBERS PRIOR TO 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 APPROVED SALARIES OF TOP MANAGEMENT FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST GENESIS HOUSE III INC 770 CONVERSE STREET LONGMEADOW MA 01106 000739159 ELDERLY HOUSING MA 501 (C) (3) 9 N/A 0 JEWISH GERIATRIC SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 01106 042129128 GERIATRIC/NURSING PROVIDER MA 501 (C) (3) 9 N/A 0 JGS ADMINISTRATIVE SERVICES 770 CONVERSE STREET LONGMEADOW MA 01106 043295014 MANAGERIAL & ADMIN MA 501 (C) (3) 9 N/A 0 JGS HOUSING SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 01106 043321157 ASSISTED LIVING MA 501 (C) (3) 9 N/A 0 SPECTRUM HOME HEALTH AND HOSPICE CARE INC 770 CONVERSE STREET LONGMEADOW MA 01106 043237982 PATIENT TRANSISTION MA 501 (C) (3) 9 N/A 0 SPECTRUM HOME CARE INC 770 CONVERSE STREET LONGMEADOW MA 01106 043399549 NONCERT HOME CARE MA 501 (C) (3) 9 N/A 0 GENESIS HOUSE INC 770 CONVERSE STREET LONGMEADOW MA 01106 042817295 ELDERLY HOUSING MA 501 (C) (3) 9 N/A 0 GENESIS HOUSE II INC 770 CONVERSE STREET LONGMEADOW MA 01106 222611647 ELDERLY HOUSING MA 501 (C) (3) 9 N/A 0 0 0 0 1 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0