2013-08-08T13:48:21-05:00 2012-12-31 042684828 FEELEY & DRISCOLL PC 200 PORTLAND STREET BOSTON MA 02114 990 2012-01-01 043138403 JEWISH NURSING HOME OF WESTERN MASSACHUSETTS INC JEWI 4135676211 770 CONVERSE STREET LONGMEADOW MA 011061786 A EDWARD ROMAN 4135676211 2013-08-01 1 JEFFREY T ROGERS P01074284 6177427788 2012 2016-02-24 21:20:13Z A EDWARD ROMAN 770 CONVERSE STREET LONGMEADOW MA 01106 18817998 0 X WWW.JEWISHGERIATRIC.ORG X 1992 MA TO CARE FOR THE FRAIL ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 4 3 358 93 0 0 0 0 18537699 18589592 -60535 -1214 227195 228374 18704359 18816752 0 0 0 0 10705097 10753379 0 0 0 8237277 8026060 18942374 18779439 -238015 37313 9435731 11007049 9336634 10870639 99097 136410 TO CARE FOR THE FRAIL ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 0 0 16004842 18763494 THE HOME IS A NON-PROFIT ORGANIZATION WHICH OWNS AND OPERATES A 200 BED SKILLED NURSING FACILITY AND ADULT DAY CARE CENTER. 16004842 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 13 0 1 358 1 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 1.00 40.00 X X 0 180694 10913 PAUL SAVAGE 1.00 X 0 0 0 DONALD FRANK 1.00 X 0 0 0 RICHARD CHASE 1.00 X 0 0 0 LINDA DONOGHUE 1.00 40.00 X 0 182462 7142 EDWARD ROMAN 1.00 40.00 X 0 137215 18751 0 500371 36806 0 0 1 0 0 NURSING HOME 623000 17907681 17907681 DAY CARE REVENUE 624100 628359 628359 MEALS PROGRAM 624100 53552 53552 18589592 32 32 130200 0 130200 130200 130200 1246 -1246 -1246 -1246 MISC REVENUE 900099 53226 53226 EMPLOYEE MEALS REVENUE 722210 34682 34682 COFFEE, BEAUTY, GIFT SHOPS 453220 10266 10266 98174 18816752 18763494 0 53258 8616874 8457824 159050 200462 196313 4149 1291102 1190190 100912 644941 614020 30921 2030449 76621 1953828 37200 37200 473777 355193 118584 651854 636187 15667 7632 7632 483090 483090 5414 3357 2057 525471 525471 894681 894681 127619 127619 USER FEE 1241386 1241386 FOOD FUNCTIONS 617778 617778 PHARMACY 199262 199262 TRANSPORTATION 158428 158428 572019 355041 216978 18779439 16004842 2774597 0 235302 1574753 1606365 1845872 27339 39092 25410978 17865146 7565225 7545832 1500 1500 9435731 11007049 1268450 1383935 45526 48858 219364 188702 7803294 9249144 9336634 10870639 X 99097 136410 99097 136410 9435731 11007049 37313 0 X 0 1 X 1 0 X 17866853 17311003 17015566 18537699 18589592 89320713 17866853 17311003 17015566 18537699 18589592 89320713 0 0 0 89320713 5665 453 2718 14 32 8882 5665 453 2718 14 32 8882 40834 40834 17872518 17311456 17018284 18578547 18589624 89370429 0.99940 0.99930 0.00010 0.00020 X 0 1 X 343078 343078 13205053 10167030 3038023 6785278 3904061 2881217 4782762 3686359 1096403 294807 107696 187111 7545832 DUE TO AFFILIATES 8928384 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 295748 ASSET RETIREMENT OBLIGATION 25012 9249144 X PART IV, LINE 2B: THE ORGANIZATION HOLDS FUNDS ON BEHALF OF ITS RESIDENTS TO BE USED AS DIRECTED BY THE RESIDENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 2009 THROUGH THE CURRENT YEAR REMAIN OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. THE ORGANIZATION ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIAL POSITION. TAX YEARS FROM 2009 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 0 161485 0 0 0 19209 0 0 0 10913 0 191607 0 0 LINDA DONOGHUE 0 175880 0 0 0 6582 0 5285 0 1857 0 189604 0 0 EDWARD ROMAN 0 129989 0 0 0 7226 0 3944 0 14807 0 155966 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