2014-11-17T12:45:44-07:00 2013-12-31 990 2013-01-01 150539103 JEWISH HOME OF CENTRAL NEW YORK INC JEWI 3154469111 4101 E GENESEE STREET SYRACUSE NY 13214 Robert Wood CFO 3154469111 2014-11-14 2013 2015-11-30 17:44:51Z Mary Ellen Bloodgood 4101 E Genesee Street Syracuse NY 13214 17364145 0 X menorahparkcny.com X 1937 NY Provide skilled nursing, home care services,adult day care 12 12 323 10 0 0 673104 1225914 14587710 15755582 3198 211057 0 171592 15264012 17364145 0 0 0 0 9404632 10197697 0 0 0 5704231 5651319 15108863 15849016 155149 1515129 16976786 17033626 18706665 17170706 -1729879 -137080 Provided 47,608 patient days of skilled nursing home services, 6,805 adult day care visits and 8,765 home health care visits. 0 0 14584078 0 15755582 Provided 46,515 patient days of skilled nursing home services, 7,169 adult day care visits, and 8,765 home health care visits. 0 0 0 14584078 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 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 0 0 0 0 1 14 0 1 323 1 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 NY X Mary Ellen Bloodgood CEO 3154469111 4101 E Genesee Street Syracuse NY 13214 Michael Balanoff Director 1 0 X 0 0 0 Neil Bronstein Director 1 0 X 0 0 0 Andy Fox Vice President 1 0 X X 0 0 0 Joseph Greenman Director 1 0 X 0 0 0 Jon Maloff Treasurer 1 0 X X 0 0 0 Gary Zausmer Director 1 0 X 0 0 0 Jeffry Berman Director 1 0 X 0 0 0 Phylis LaVine Secretary 1 0 X X 0 0 0 Jeffrey Scheer President 1 0 X X 0 0 0 Jeffery Meyer Director 1 0 X 0 0 0 Mark Shulman Director 1 0 X 0 0 0 Bruce Smith Director 1 0 X 0 0 0 Mary Ellen Bloodgood CEO 40 X 221672 0 5500 Robert Wood CFO 50 39 X 120676 0 0 342348 0 5500 1 0 1 1 Sodexo Inc 9801 Washingtonian Bld Gaithersburg MD 20878 Dietary Service Contract 855627 Health Direct PO Box 62246 Baltimore MD 21264 Pharmacy Services 132386 Mckesson PO Box 630693 Cincinnati OH 45263 Disposible Laundry 109250 3 0 0 0 0 0 1225914 0 1225914 Resident Services 623000 15339886 15339886 0 0 Rental Income 623990 415696 415696 0 0 0 0 0 0 15755582 211057 211057 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171592 171592 0 0 171592 17364145 16138231 0 0 7401081 6780712 620369 284455 284455 1961967 1895058 66909 550194 504076 46118 25095 24027 1068 50573 50573 32447 32447 128768 128768 1394 574 820 91619 11550 80069 1281445 1281445 12939 5415 7524 94108 94108 0 725307 725307 0 139732 139732 Dietary Service Contract 855627 855627 0 0 All Other Purchased Services 454695 329987 124708 0 NYS Cash Receipts Assesments 795890 795890 0 0 Medical Supplies, Drugs, All Other Supplies 605630 581744 23886 0 356050 285335 70715 0 15849016 14584078 1264938 0 -2456 138493 2160960 1515020 15192 12513 331152 104778 22585661 14496942 8508815 8088719 5963123 7174103 16976786 17033626 4062568 2888488 13079892 12748542 1564205 1533676 18706665 17170706 X -2963379 -1435778 335365 400563 898135 898135 -1729879 -137080 16976786 17033626 X 1515129 0 0 0 0 77670 X 0 1 1 0 X 646437 104466 195274 673104 1225914 2845195 13776391 14616869 14323617 14587710 15755582 73060169 0 14422828 14721335 14518891 15260814 16981496 75905364 75905364 95696 270 577 3198 211057 310798 95696 270 577 3198 211057 310798 0 0 171592 171592 14518524 14721605 14519468 15264012 17364145 76387754 0.99368 0.9983 0.00407 0.00136 X Schedule A, Part I, Line 9 General Explanation - Skilled nursing home Schedule A, Part III, Line 12 Insurance Reimbursement from boiler claim RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1286001 0 12698 0 0 0 1298699 1131180 0 154821 0 0 0 1286001 1073272 0 57908 0 0 0 1131180 1218097 0 -144825 0 0 0 1073272 1801301 0 -583204 0 0 0 1218097 0 0.73 0.27 0 1 0 6903 0 6903 19395985 0 12059994 7335991 0 0 0 0 2159808 0 1822966 336842 1022965 0 613982 408983 8088719 Due from Affiliates 1649357 Resident Deposits Held in Truts 20588 Assests Limited As To USe 3541013 Benificial Interest in Net Assets of Foundation 1298699 Deferred Financing Costs, net 664446 7174103 0 Estimated Third Party Settlements, net 1008088 Notes Payable to Affiliate 505000 Resident Deposits Hel in Trust 20588 1533676 17364145 0 0 0 0 0 17364145 0 0 0 17364145 15849016 0 0 0 0 0 15849016 0 0 0 15849016 Schedule D, Part V, Line 4 Funds are used for the operation of the skilled nursing home. X 0 0 0 0 0 0 0 0 0 Mary Ellen Bloodgood CEO 203172 0 18500 0 0 0 0 0 0 0 221672 0 0 0 Robert Wood CFO 120676 0 0 0 0 0 0 0 0 0 120676 0 0 Schedule J, Part II The CEO is paid from the Jewish Home of Central New York, and a W-2 is issued. However, portions of the CEO compensation are allocated to five affiliates. Of the W-2 amount of 221,672, 167,540 has been allocated to the Jewish Home, and 54,132 allocated to the other affiliates. IRS instructions require that the entire W-2 amounted be listed in col (d). The same is true for the CFO, 94,127 was allocated to Jewish Home and 26,549 to the affiliates. Form 990, Part VI, Section B, Line 11b The 990 return is reviewed by members of the Finance Committee, and then distributed to the Board members before being filed with the IRS/ Form 990, Part VI, Section B, Line 12c The conflict of interest policy is reviewed by the Corporate Compliance Committee annually, and disclosure statements are signed, reviewed, and acted upon if required Form 990, Part VI, Section B, Line 15 The compensation of the CEO is Approved by the Board of Directors There is a five year contract, and performance bonuses, if any, are reviewed annually. Form 990, Part VI, Section C, Line 19 The governing documents, conflict of interest documents, and financial statements are available to the public in the Administration office, upon request. Form 990, Part XI, Line 9 Form 990, Part XI, Line 9 - Change in beneficial interest in net assets of Jewish Home of Central New York Foundation, 65,198. Use of these funds is to assists with the mission of the Jewish Home. Also, 12,472 is equity transfer to affiliate. Total on Part XI line 9 = 77,670.