2012-05-22T12:38:08-05:00 2011-06-30 SEILER LLP THREE LAGOON DRIVE STE 400 REDWOOD CITY CA 94065 990 2010-07-01 940545320 HEBREW HOME FOR AGED DISABLED HEBR 4153342500 302 SILVER AVENUE SAN FRANCISCO CA 941121510 KEVIN POTTER 4153342500 2012-05-10 true DEBRA K MCCALL 6503654646 2010 2016-02-24 21:20:13Z JEWISH HOME OF SAN FRANCISCO DANIEL RUTH CEO 302 SILVER AVENUE SAN FRANCISCO CA 94112 73721248 false X www.jhsf.org X 1871 CA WE ARE A LICENSED NURSING HOME THAT PROVIDES TO SENIORS LIFE ENRICHING SERVICES THAT PROMOTE INDIVIDUAL DIGNITY, ENCOURAGE INDEPENDENCE, AND REFLECT THE SOCIAL, CULTURAL AND SPIRITUAL VALUES OF JEWISH TRADITION. 16 16 869 190 0 0 10672722 11467323 55155909 61773468 18564 1640 -172770 176322 65674425 73418753 0 0 0 0 48517400 50236580 0 0 451238 17202109 20334417 65719509 70570997 -45084 2847756 114389986 123604099 46228867 45612430 68161119 77991669 X THE ORGANIZATION IS A LICENSED SKILLED NURSING FACILITY SPECIALIZING IN PROGRAMS, SERVICES, AND CARE FOR OLDER ADULTS. THE ORGANIZATION IS A NINE-ACRE COMPREHENSIVE SENIOR CARE CENTER WITH FIVE DISTINCT BUILDINGS, SERVING MORE THAN 420 RESIDENTS WITH DIVERSE CARE NEEDS, AND PROVIDING REHABILITATION SERVICES TO NUMEROUS OTHERS SEEKING SHORT-TERM CARE STAYS. OUR MISSION IS TO BECOME A REGIONAL RESOURCE AS AN INTEGRAL PART OF A CONTINUUM OF CARE THROUGHOUT THE BAY AREA THAT PROVIDES SENIOR ADULTS WITH A VARIETY OF LIFE ENRICHING PROGRAMS AND SERVICES THAT ARE ACCESSIBLE, PROMOTE INDIVIDUAL DIGNITY, ENCOURAGE INDEPENDENCE, CONNECT THEM TO THEIR COMMUNITY, AND REFLECT THE SOCIAL, CULTURAL, AND SPIRITUAL VALUES OF JEWISH TRADITION. NON-RESIDENTIAL CARE IS OFFERED THROUGH THE HOME'S SHORT-TERM AND REHABILITATION SERVICES UNIT (STARS) AND ACUTE PSYCHIATRIC SERVICES. false false 62938160 61773468 The organization provides long-term care, short-term rehabilitation, and acute psych care services. It provides professional and comprehensive programs that include personal and health care to residents in its over 400-bed facility. In the current fiscal year, the organization served an average of 424 residents a day. There were 104 new admissions for long-term care, 337 short-term care patients and 17 patients that required acute psych hospitalization. 62938160 true true false true false false false false true true false false true true true true false false false false false false false false false true true false false true true false false false false false true false false false false false false false false false true false false false false true 58 0 true 869 true false false false false false false false false false false X 16 16 false false false false false false false true true false false true true true true true true true true false CA X KEVIN POTTER 4155622505 302 SILVER AVENUE SAN FRANCISCO CA 94112 X MICHAEL W ADLER 2.0 X X 0 0 0 STEPHAN KRIEGER 2.0 X X 0 0 0 ALAN SILVERMAN 2.0 X X 0 0 0 DAVID J ARRICK 2.0 X X 0 0 0 ERIC B FASTIFF 2.0 X X 0 0 0 BENJAMIN ANIXTER THRU 101010 2.0 X 0 0 0 RICHARD BAUM 2.0 X 0 0 0 BENJAMIN EISLER THRU 101010 2.0 X 0 0 0 SUSAN FOLKMAN PHD 2.0 X 0 0 0 MARK L MYERS THRU 10910 2.0 X 0 0 0 BILL POMERANZ 1.0 X 0 0 0 CAROL S ROBERTS THRU 101010 2.0 X 0 0 0 JOEL I ROOS 2.0 X 0 0 0 MATTHEW SLEPIN 2.0 X 0 0 0 JEFFERY STEIN 2.0 X 0 0 0 MICHAEL STRUNSKY 2.0 X 0 0 0 DANIEL R RUTH 50.0 X 512103 0 108508 KEVIN POTTER 50.0 X 226636 0 20585 EDWIN CABIGAO 40.0 X 194043 0 12555 SHERIE A KOSHOVER 50.0 X 206142 0 85641 JAY S LUXENBERG 40.0 X 179546 0 47148 SANDRA C SIMON 50.0 X 240727 0 48445 JANICE B SCHWARTZ 32.0 X 153038 0 36620 IDA SLEPNYOV 40.0 X 137214 0 13251 SHIRLEY HUAN 50.0 X 145128 0 6497 NAMITA KANSAL 40.0 X 144000 0 0 MICHAEL GEISER MD 32.0 X 141056 0 22856 RICHARD NAVARRO 40.0 X 138496 0 28984 2418129 0 431090 38 false true false MANATT PHELPS PHILLIPS LLP 1841 Page Mill Rd SUITE 200 PALO ALTO CA 94304 LEGAL SERVICES 167388 MARYLEE MADDEN-BOST 2025 AVON AVE CAMBRIA CA 93429 CONSULTING SERVICES 217752 CAROL MARACCINI 428 NORTHWOOD DRIVE SOUTH SAN FRANCISCO CA 94080 TRANSCRIPTION SERVCS 128198 SEILER LLP 3 LAGOON DRIVE SUITE 400 REDWOOD CITY CA 94065 ACCOUNTING SERVICES 127065 4 487306 10980017 5220 11467323 PROGRAM SERVICE REVENUE 623000 61773468 61773468 61773468 1640 0 1640 0 0 0 0 0 144020 302495 -158475 0 -158475 SETTLEMENT INCOME 900099 200000 200000 PARKING REVENUE 900099 62237 62237 REIMBURSEMENTS FOR SHARED FACILITIES 900099 56000 56000 16560 16560 334797 73418753 61773468 0 177962 0 0 0 0 2045212 662088 1281998 101126 0 36366662 35030080 1148329 188253 2173255 2146218 17087 9950 6906688 6711230 157644 37814 2744763 2598317 133701 12745 0 226767 183518 43249 76693 76693 39797 39797 0 0 647391 325868 305998 15525 113542 6226 102911 4405 5502936 5380877 118554 3505 0 0 1910132 1546579 363553 0 0 0 1496942 1017921 479021 0 3309303 2722305 583761 3237 468525 468525 CONTRACT SERVICES 4613696 2530824 2026365 56507 EQUIPMENT RENTAL & MTNCE 674677 396687 276535 1455 TAX & LICENSES 165428 163845 1583 COST REIMBURSEMENTS -251522 -251522 AMORTIZATION OF BOND COSTS 538783 538783 801327 508269 276342 16716 70570997 62938160 7181599 451238 17641 14889 5772382 7601492 1339028 2576649 5598277 7310439 800000 800000 294097 303926 492241 396825 99050203 42481325 58468185 56568878 41608135 48031001 114389986 123604099 6939583 6734285 750000 750000 34840000 34205000 1000000 1000000 2699284 2923145 46228867 45612430 X 22679686 28141858 9382130 13695722 36099303 36154089 68161119 77991669 114389986 123604099 X 2847756 6982794 X false true true X false X 1655627 27652647 11036508 10672721 11467323 62484826 1655627 27652647 11036508 10672721 11467323 62484826 1555776 60929050 650520 270701 60906 11987 1640 995754 63480580 259474458 0.95981 0.94075 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 39794 false false 39794 false 32381562 689786 5010245 0 635000 37446593 29666200 122775 3192587 0 600000 0 32381562 38484514 30425 -5085714 0 3763025 0 29666200 0.18630 0.81370 false true true 90849 90849 79797425 32909571 46887854 16069636 8601649 7467987 3092293 970105 2122188 56568878 BENEFICIAL INTEREST IN JHSLF 40065797 TRUSTEE ACCOUNTS 5264514 OTHER ASSETS 582336 BOND ISSUANCE COSTS, NET 894834 INTEREST IN NET ASSETS-JHSLF 1223520 48031001 0 DERIVATIVE FINANCIAL INSTRUMEN 1494037 RESIDENTS' TRUST ACCOUNT 225180 RESIDENTS' MAINTENANCE ACCOUNT 85438 SPLIT INTEREST LIABILITY 26619 DEFERRED COMPENSATION PAYABLE 211015 RESERVE FOR MEDI-CAL RATE ADJ 863090 OTHER LIABILITIES 17766 2923145 73418753 70570997 2847756 6982794 6982794 9830550 80659846 7241093 7241093 73418753 73418753 70974296 403299 403299 70570997 70570997 INTENDED USE OF ENDOWMENT FUNDS PART V, LINE 4 THE ORGANIZATION'S ENDOWMENT ASSETS CONSIST OF FUNDS ESTABLISHED TO GENERATE OPERATING SUPPORT TO THE ORGANIZATION AND CAPITAL CAMPAIGN FUNDS WHICH THE BOARD OF TRUSTEES MAY USE TO REPAY THE PRINCIPAL PORTION OF THE CONSTRUCTION DEBT AND INCLUDES ACCUMULATED EARININGS THEREON THAT HAVE NOT YET BEEN EXPENDED. AS REQUIRED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. RECONCILIATION OF CHANGES IN NET ASSETS PART XI, LINE 8 INCREASE IN VALUE OF SPLIT INTEREST AGREEMENTS $594,530 INCREASE IN BENEFICIAL INTEREST IN JEWISH HOME & SENIOR LIVING FOUNDATION (JHSLF) $5,700,031 BOOK TO TAX ADJUSTMENT CHANGE IN NET ASSETS OF JEWISH HOME & SENIOR LIVING FOUNDATION (JHSLF) $145,000 UNREALIZED GAIN ON DERIVATIVE FINANCIAL INSTRUMENT $637,004 CONTRIBUTION EXPENSE - LOAN DISCOUNT ($100,804) IMPUTED INTEREST ON OTHER RECEIVABLES 7,033 ----------- TOTAL $6,982,794 =========== RECONCILIATION OF REVENUE PART XII, LINE 2D INCREASE IN VALUE OF SPLIT INTEREST AGREEMENTS $594,530 INCREASE IN BENEFICIAL INTEREST IN JEWISH HOME & SENIOR LIVING FOUNDATION (JHSLF) $5,700,031 UNREALIZED GAIN ON DERIVATIVE FINANCIAL INSTRUMENT $637,004 COST OF SALE - GARDEN CAFE AND GIFT SHOP $302,495 IMPUTED INTEREST ON OTHER RECEIVABLES 7,033 ----------- TOTAL $7,241,093 =========== RECONCILIATION OF EXPENSES PART XIII, LINE 2D CONTRIBUTION EXPENSE - LOAN DISCOUNT $100,804 COST OF SALE - GARDEN CAFE AND GIFT SHOP $302,495 ---------- TOTAL $403,299 ========== UNCERTAIN TAX POSITION, PART X PART X, LINE 2 THE ORGANIZATION ADOPTED THE FASB ASC TOPIC 740-10 "INCOME TAXES" REGARDING ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THIS ACCOUNTING STANDARD PROVIDES DETAILED GUIDANCE FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, AND DISCLOSURE OF UNCERTAIN TAX POSITIONS RECOGNIZED IN THE FOUNDATION'S FINANCIAL STATEMENTS. THE STANDARD REQUIRES AN ENTITY TO RECOGNIZE THE FINANACIAL STATEMENT IMPACT OF A TAX POSITION WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL NOT BE SUSTAINED UPON EXAMINATION. THE ORGANIZATION HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN TAX YEARS AND BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR THE TAX POSITIONS TAKEN. THEREFORE, NO LIABILITY HAS BEEN RECORDED. true true true X true X true true false true true 0 0 0 0.00000 51166139 45529270 5636869 0.07990 0 0 0 0.00000 51166139 45529270 5636869 0.07990 948423 487306 461117 0.00650 948423 487306 461117 0.00650 52114562 46016576 6097986 0.08640 true 258252 0 10177966 9013392 1164574 X true true 1 1 ACUTE PSYCHIATRIC HOSPITAL

302 SILVER AVENUE SAN FRANCISCO CA 94112

X NONE ACUTE PSYCHIATRIC HOSPITAL 1 PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE BAD DEBT EXPENSE IS REPORTED AS A NET ADJUSTMENT TO PATIENT CHARGES AND THEREFORE NOT INCLUDED AS PART OF TOTAL EXPENSES FROM PART IX, LINE 25, COLUMN A. PART I, LINE 7 COST TO CHARGE RATIO The cost to charge ratio as determined by worksheet 2 was used to calculate the amounts reported on Line 7b. The costing methodology used on Line 7h was calculated based on actual costs from the organization's general ledger. PART III, LINE 4 Uncollected resident accounts are analyzed based on standard procedures for all resident accounts. The result of the analysis is what is recognized as bad debt expense. The organization follows HFMA Statement 15 and therefore no part of bad debt, as defined by statement 15, represents amounts attributable to patients eligible to receive financial assistance. The audited financial statements do not contain a footnote that describes bad debt expense. The audited financial statements contain a footnote describing patient service revenues and charity care which reads as follows: Patient service revenues are recorded on the accrual basis in the period services are provided at established rates regardless of whether collection in full is anticipated. Contractual allowances and the provision for uncollectible accounts are reported as deductions from patient service revenues. Contractual allowances include differences between established billing rates and amounts estimated by management as payable under various contractual arrangements in effect, including those with the Medicare and Medi-Cal programs. Estimation differences between final settlements and amounts accrued in previous years are reported as adjustments to the current year's contractual allowances. The Home accepts residents of the San Francisco Bay Area who meet certain requirements regardless of their ability to pay. A resident is classified as a charity resident by reference to established policies of the Home. Essentially, these policies define charity services as those services for which lesser payment is anticipated. Charity care is included in gross patient service revenue and a corresponding allowance is reflected in determining net patient service revenue. PART III, LINE 8 Medicare allowable costs were calculated using a cost-to-charge ratio. The amounts reported in lines 5, 6 and 7 come from the Hospital's filed Medicare Cost report. The total revenue equates to Medicare payments and the Medicare Allowable Costs are determined on the Medicare Cost Report that utilized cost to charge ratios applied to covered Medicare Revenues. NEEDS ASSESSMENT The organization is a member of Building a Healthier San Francisco (BHSF), a collaboration of San Francisco hospitals, the Department of Public Health, United Way, human services providers, philanthropic foundations, and numerous community-based organizations. BHSF is committed to working toward improving the health status of all people in San Francisco. To that end, BHSF needs-assessment process utilizes the best secondary data available on selected indicators of the health or conditions affecting the well-being of San Francisco's population and subpopulations, and seeks feedback and input from the community to guide the assessment and direct the call to action. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE A Resident Services Coordinator staff is available to assist residents and/or their family members or legal representatives through the process of determining their eligibility for all government programs and assist them in the application process. COMMUNITY INFORMATION The organization serves the most medically/cognitively frail, as well as financially indigent elders (85 percent of the organization residents are indigent and/or Medi-Cal recipients who do not pay the full cost of care), with an average age of 86. It provides professional and comprehensive programs that include personal and health care to the elderly who primarily reside in the greater San Francisco Bay Area. PROMOTION OF COMMUNITY HEALTH The Organization is involved in numerous community building activities to promote the health and well-being of the communities it serves as well as to provide training and internship opportunities to the future caretakers and leaders of the communities. Following is a list of some of those activities: The organization's staff attended and presented in conferences related to issues on the care for the elderly. Over the past 38 years, the organization has partnered with San Francisco City College in offering several adult education classes to the general community. Approximately 20 to 25 students enroll each semester in the Creative Arts class. The organization partners with local high schools that aim to involve youth in their community by encouraging them to fulfill needs in their respective milieus. Mutual goals include the promotion of civic responsibility and the development of leadership skills. Students from University of California, San Francisco, Samuel Merritt College, Dominican University, San Jose State University, and San Francisco State University continue to intern with the Organization's physical, occupational, and speech therapists. The organization regularly opens its doors to professional organizations and community groups, offering them free meeting space, and continuing education credits. Staff supported the efforts of the San Francisco Food Bank by hosting and participating in a food drive at the end of 2010. The organization's efforts helped the San Francisco Food Bank supply food to over 400 food programs operated by partnering community service agencies and food partners throughout the city that serve low-income families, senior citizens, and other individuals in need. The organization partners with local organizations, fostering dialogue, collaborations, and ongoing communications with its neighbors. Geriatric fellows from the University of California, San Francisco receive training at the organization. Fourth-year pharmacy students at UCSF spend 12 hours a week, in 12-week rotations, in the Organization's Pharmacy department. Through its affiliation with the Organization, six to seven Touro University School of Pharmacy students per academic year receive six-week's training in long-term care pharmacy. They learn how the geriatric patient processes drugs differently from a younger population, are exposed to how drugs are dispensed and utilized, and gain an understanding of third-party payers. The Organization collaborates with Jewish Family and Children's Services and the San Francisco Jewish Community Center to provide hot, nutritious meals to Jewish seniors. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI California X X X X X false true false false false false false false false DANIEL R RUTH 498179 0 0 0 13924 0 77948 0 30560 0 620611 0 0 0 EDWIN CABIGAO 176442 0 17601 0 0 0 7058 0 5497 0 206598 0 0 0 SHERIE A KOSHOVER 206142 0 0 0 0 0 73266 0 12375 0 291783 0 0 0 JAY S LUXENBERG 179546 0 0 0 0 0 16159 0 30989 0 226694 0 0 0 KEVIN POTTER 205876 0 20760 0 0 0 8235 0 12350 0 247221 0 0 0 SANDRA C SIMON 224350 0 16377 0 0 0 15705 0 32740 0 289172 0 0 0 IDA SLEPNYOV 137214 0 0 0 0 0 12349 0 902 0 150465 0 0 0 SHIRLEY HUAN 145128 0 0 0 0 0 5505 0 992 0 151625 0 0 0 JANICE B SCHWARTZ 153038 0 0 0 0 0 13773 0 22847 0 189658 0 0 0 MICHAEL GEISER MD 141056 0 0 0 0 0 14106 0 8750 0 163912 0 0 0 RICHARD NAVARRO 138496 0 0 0 0 0 5191 0 23793 0 167480 0 0 0 CONTRIBUTIONS TO 457(F) PLAN PART I, LINE 4A CONTRIBUTION TO THE ORGANIZATION'S 457(F) PLAN SHERIE A. KOSHOVER $37,266 DANIEL RUTH $41,848 ABAG FINANCE AUTHORITY FOR NON-PROFIT CORPORATIONS 942832478 00037CGX2 2005-12-01 35440000 SEE PART V false false false 1235000 0 35440000 0 2120489 0 755428 0 0 32564083 0 0 2008 false false true true false false false false true 0.00000 0.00000 0.00000 true false true true WELLSFARGO BANK 7.3 true false true AIG MATCHED FUNDING 1.3 true false true PURPOSE OF TAX-EXEMPT BONDS SCHEDULE K, PART I, LINE A (f) TO FINANCE THE CONSTRUCTION OF THE EAST WING WHICH WAS COMPLETED IN 2007. TERM OF HEDGE PART IV LINE 3C DURING THE TAX YEAR, THE ORGANIZATION REFINANCED ITS HEDGE WITH WELLSFARGO BANK WITH SIMILAR TERMS. DANIEL R RUTH COMPENSATION PACKAGE X 800000 800000 false true true 800000 REVIEW OF FORM 990 FORM 990, PART VI,LINE 11A A COPY OF THE FORM 990 IS PROVIDED TO ALL BOARD OF TRUSTEES PRIOR TO FILING. MANAGEMENT OF THE ORGANIZATION REVIEWS THE COMPLETED FORM 990 AND FOLLOWS UP WITH THE TAX RETURN PREPARATION FIRM TO ANSWER ANY QUESTIONS PRIOR TO FILING. MONITORING AND ENFORCEMENT OF COMPLIANCE FORM 990, PART VI, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. EACH TRUSTEE AND PRINCIPAL OFFICER OF THE ORGANIZATION AND EACH MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS ANNUALLY SIGNS THE CONFLICT OF INTEREST STATEMENT AND DISCLOSURE FORM. THE BOARD OF TRUSTEES REVIEWS AND DETERMINES IF ANY CONFLICTS OF INTEREST EXIST AND TAKES THE APPROPRIATE ACTION AS OUTLINED IN THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. DETERMINATION, REVIEW AND APPROVAL OF OFFICERS' COMPENSATION FORM 990, PART VI, LINE 15b THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE ANNUAL COMPENSATION PACKAGE FOR THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER BASED ON VARIOUS FACTORS SUCH AS: COMPENSATION DATA OBTAINED FROM SURVEYS, PERFORMANCE APPRAISALS AND NON-PROFIT RESOURCES FOR SIMILAR ORGANIZATIONS IN THE SAME GEOGRAPHICAL AREA. THE BOARD OF TRUSTEES APPROVES THE CHIEF EXECUTIVE OFFICER'S EMPLOYMENT CONTRACT. THE CHIEF EXECUTIVE OFFICER REVIEWS AND APPROVES THE ANNUAL COMPENSATION FOR THE OTHER EXECUTIVE TEAM MEMBERS BASED ON VARIOUS FACTORS SUCH AS ANNUAL COMPENSATION SURVEYS, PERFORMANCE APPRAISALS AND OTHER NON-PROFIT RESOURCES FOR SIMILAR ORGANIZATIONS. THE BOARD OF TRUSTEES APPROVES THE ANNUAL BUDGET THAT INCLUDES COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. AVAILABILITY OF DOCUMENTS FOR PUBLIC INSPECTION FORM 990, PART VI, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN OR ORAL REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST. AUDIT OVERSIGHT FORM 990, PART XII, LINE 2C THE ROLE AND THE PROCESS OF THE AUDIT COMMITTEE HAS NOT CHANGED. PURPOSE OF A LOAN TO THE CHIEF EXECUTIVE OFFICER SCHEDULE L, PART II, COL (A) THE ORGANIZATION MADE A LOAN OF $800,000 IN SEPTEMBER 2002 TO THE CHIEF EXECUTIVE OFFICER AS PART OF HIS COMPENSATION PACKAGE THAT REQUIRED HIM TO RELOCATE TO CALIFORNIA. THE COMPENSATION PACKAGE WHICH INCLUDED THE LOAN WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES AS REASONABLE AND FAIR. THE LOAN IS INTEREST FREE AND IS SECURED BY A SECOND DEED OF TRUST. INTEREST EXPENSE IS IMPUTED ANNUALLY USING THE APPLICABLE FEDERAL RATE (AFR) FOR DEMAND LOANS AND REPORTED AS COMPENSATION BY THE OFFICER. RECONCILIATION OF CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 INCREASE IN VALUE OF SPLIT INTEREST AGREEMENTS $594,530 INCREASE IN BENEFICIAL INTEREST IN JEWISH HOME & SENIOR LIVING FOUNDATION (JHSLF) $5,700,031 BOOK TO TAX ADJUSTMENT CHANGE IN NET ASSETS OF JEWISH HOME & SENIOR LIVING FOUNDATION (JHSLF) $145,000 UNREALIZED GAIN ON DERIVATIVE FINANCIAL INSTRUMENT $637,004 CONTRIBUTION EXPENSE - LOAN DISCOUNT ($100,804) IMPUTED INTEREST ON OTHER RECEIVABLES 7,033 ----------- TOTAL $6,982,794 =========== HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL W. ADLER TITLE:CHAIR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DANIEL R. RUTH TITLE:CHIEF EXECUTIVE OFFICER HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEVIN POTTER TITLE:CHIEF FINANCIAL OFFICER HOURS:50 JEWISH SENIOR LIVING GROUP 302 SILVER AVENUE SAN FRANCISCO CA 94112 800291740 SEE PART VII CA 501(C)(3) 11A false CHARITABLE REMAINDER TRUSTS (5) CA VARIOUS TRUSTS 5236130 false false false false false false false false false false false true true true true false true false PART II, LINE 1, COL (B) JEWISH SENIOR LIVING GROUP PRIMARY ACTIVITY TO PROMOTE THE PROVISION OF JEWISH LIVING SERVICES, FACILITIES AND AGING SERVICES IN NORTHERN CALIFORNIA BY PROVIDING SERVICES DESIGNED TO ASSIST THE SUPPORTED CHARITIES IN THEIR OWN OPERATIONS AND ASSIST WITH DEVELOPING NEW SERVICES AND FACILITIES IN THE AFFILIATED NETWORK.