2024-02-29T19:07:07-06:00 2023-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-07-01 800291740 JEWISH SENIOR LIVING GROUP JEWI 4155622600 302 SILVER AVENUE SAN FRANCISCO CA 94112 MARY CONNICK TREASURER AND CFO 4155622600 2024-02-28 1 MARY CONNICK 999009999 0 MICHAEL LUMSDEN P01262236 4159561500 2024-02-28 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JIM KOSHLAND 302 SILVER AVENUE SAN FRANCISCO CA 94112 4842446 0 X N/A X 2008 CA 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. 5 5 54 5 0 0 0 0 7917019 4607877 -4448 0 2424 2595 7914995 4610472 0 0 0 0 7683144 2835236 0 0 0 1566471 1480603 9249615 4315839 -1334620 294633 2174158 842841 2686082 1060132 -511924 -217291 X SEE SCHEDULE O 0 1 3741573 0 4607877 THE ORGANIZATION PROVIDES ADMINISTRATIVE, FINANCE AND ACCOUNTING, IT, PUBLIC RELATIONS, COMMUNICATIONS, AND HUMAN RESOURCES FUNCTIONS VIA SERVICE AGREEMENTS WITH THE FOLLOWING NONPROFIT PUBLIC BENEFIT CORPORATIONS: HEBREW HOME FOR AGED DISABLED DBA SAN FRANCISCO CAMPUS FOR JEWISH LIVING; AND THE JEWISH HOME AND SENIOR LIVING FOUNDATION. 3741573 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 1 0 0 1 10 0 1 54 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X MARY CONNICK 4155622650 302 SILVER AVENUE SAN FRANCISCO CA 94112 JAMES KOSHLAND CHAIR, INTERIM PRESIDENT & CEO 1.00 0.00 X X 0 0 0 DAVID FRIEDMAN SECRETARY, IMMEDIATE PAST CHAIR 1.00 1.00 X X 0 0 0 MICHAEL EISLER TRUSTEE 1.00 0.00 X 0 0 0 STEVE FAYNE TRUSTEE 1.00 1.00 X 0 0 0 REBECCA MACIEIRA KAUFMAN TRUSTEE 1.00 0.00 X 0 0 0 MARY CONNICK TREASURER AND CFO 4.00 36.00 X 625506 0 10807 MICHAEL SKAFF CIO (THROUGH 2/2023) 5.00 35.00 X 358783 0 18755 KEVIN BEUTLER CHIEF HUMAN RESOURCES OFFICER 2.00 38.00 X 239997 0 4560 TERRENCE SCOTT CONTROLLER (THROUGH 7/2022) 4.00 36.00 X 207940 0 7926 ROSABELLA BRAY DIRECTOR, PATIENT FINANCIAL SERVICES 2.00 38.00 X 168100 0 23782 HELEN TAM DIRECTOR, FP&A 2.00 38.00 X 168918 0 20407 GLORIA CATTERALL RECRUITING MANAGER 1.00 39.00 X 144186 0 5367 JOHN PIOTROWSKI IT PROGRAM OFFICE MANAGER 4.00 36.00 X 139354 0 6486 DANIEL RUTH FORMER PRES. & CEO (THROUGH 2/2022) 0.00 0.00 X 805770 0 7023 SHERIE KOSHOVER FORMER CAO (THROUGH 3/2021) 0.00 0.00 X 347821 0 0 3206375 0 105113 19 1 1 0 SHI INTERNATIONAL CORP PO BOX 952121 DALLAS TX 753952121 IT SERVICES 399102 MOSS ADAMS LLP PO BOX 101822 PASADENA CA 911891822 AUDIT/TAX SERVICES 172452 HEDRICK & STRUGGLES INC 1133 PAYSPHERE CIRCLE CHICAGO IL 606741010 LEGAL SERVICES 139001 NETSMART TECHNOLOGIES INC PO BOX 713519 PHILADELPHIA PA 19171 IT SERVICES 103950 4 SERVICE FEES REVENUE 541900 4607877 4607877 4607877 231974 231974 0 0 PARKING REVENUE 812930 2595 2595 2595 4610472 4607877 0 2595 X 621945 577399 44546 229494 213090 16404 1718310 1595568 122742 5019 4651 368 189101 174930 14171 71367 65855 5512 19042 17613 1429 39503 39503 835375 773460 61915 97603 59280 38323 23883 22098 1785 216759 48759 168000 5267 5267 2705 2502 203 22826 21114 1712 119407 110452 8955 MINOR EQUIPMENT 53658 49634 4024 LICENSES & FEES 3086 2855 231 DUES & FEES 2983 2064 919 38506 249 38257 4315839 3741573 574266 0 1282493 305362 108427 86891 116760 107136 264244 9624 397651 428218 121343 12746 2174158 842841 1034717 192662 1651365 867470 2686082 1060132 X -511924 -217291 -511924 -217291 2174158 842841 294633 0 X 0 1 X 1 0 X X X 2 HEBREW HOME FOR AGED DISABLED 940545320 7 1 0 4339353 THE JEWISH HOME & SENIOR LIVING FOUNDATION 020724278 7 1 0 162500 2 0 4501853 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART I, LINE 12G, COLUMN (VI): THE ORGANIZATION PROVIDES FINANCE AND ACCOUNTING, HUMAN RESOURCE, INFORMATION TECHNOLOGY, AND OTHER ADMINISTRATIVE BACK-OFFICE SERVICES TO THE SUPPORTED ORGANIZATIONS LISTED IN SCHEDULE A, PART I, LINE 12G, COLUMN (VI). 99946 99946 0 16814 7190 9624 9624 457 SUPPLEMENTAL EXECUTIVE PLAN LIABILITY 428218 DUE TO RELATED ORGANIZATIONS 439252 867470 X 4610472 0 4610472 0 4610472 4315839 0 4315839 0 4315839 PART X, LINE 2: U.S. GAAP REQUIRES THE ORGANIZATION TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAX AUTHORITY. 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. X X X 1 1 0 0 0 0 0 0 0 DANIEL RUTH FORMER PRES. & CEO (THROUGH 2/2022) 147878 0 0 0 657892 0 4175 0 2848 0 812793 0 77903 0 MARY CONNICK TREASURER AND CFO 549520 0 50000 0 25986 0 9300 0 1507 0 636313 0 0 0 MICHAEL SKAFF CIO (THROUGH 2/2023) 358683 0 100 0 0 0 9300 0 9455 0 377538 0 0 0 SHERIE KOSHOVER FORMER CAO (THROUGH 3/2021) 0 0 0 0 347821 0 0 0 0 0 347821 0 347821 0 KEVIN BEUTLER CHIEF HUMAN RESOURCES OFFICER 205757 0 30000 0 4240 0 1210 0 3350 0 244557 0 0 0 TERRENCE SCOTT CONTROLLER (THROUGH 7/2022) 116468 0 30000 0 61472 0 7085 0 841 0 215866 0 0 0 ROSABELLA BRAY DIRECTOR, PATIENT FINANCIAL SERVICES 167900 0 200 0 0 0 0 0 23782 0 191882 0 0 0 HELEN TAM DIRECTOR, FP&A 168818 0 100 0 0 0 2460 0 17947 0 189325 0 0 0 PART I, LINES 4A-B DANIEL RUTH RECEIVED A TAXABLE SEVERANCE PAYMENT OF $365,108 DURING THE 2022 CALENDAR YEAR, WHICH HAS BEEN REPORTED WITHIN "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III). DURING THE 2022 CALENDAR YEAR, DANIEL RUTH AND SHERIE KOSHOVER WERE PARTICIPANTS IN A SUPPLEMENTAL 457(F) PLAN SPONSORED BY THE ORGANIZATION. THERE WERE NO EMPLOYER CONTRIBUTIONS TO THE 457(F) PLAN DURING THE 2022 CALENDAR YEAR, HOWEVER, DUE TO VESTING OF THE 457(F) PLAN, DANIEL RUTH AND SHERRIE KOSHOVER RECOGNIZED $77,903 AND $347,281 OF TAXABLE INCOME, RESPECTIVELY, WHICH HAS BEEN REPORTED WITHIN "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III) AS WELL AS ON SCHEDULE J, PART II, COLUMN (F). FORM 990, PART III, LINE 1 TO CONDUCT OR SUPPORT ACTIVITIES FOR THE BENEFIT, OR TO CARRY OUT THE PURPOSES, OF A CLASS OF ORGANIZATIONS (COLLECTIVELY, THE "SUPPORTED CHARITIES"): (I) THAT ARE DESCRIBED IN CODE SECTIONS 501(C)(3) AND 509(A)(1) OR (A)(2), AND (II) THAT PROVIDE, OR PROMOTE THE PROVISION OF JEWISH LIVING SERVICES, FACILITIES AND/OR AGING SERVICES IN NORTHERN CALIFORNIA. THE SUPPORTED CHARITIES INCLUDE, WITHOUT LIMITATION, HEBREW HOME FOR AGED DISABLED DBA SAN FRANCISCO CAMPUS FOR JEWISH LIVING AND THE JEWISH HOME AND SENIOR LIVING FOUNDATION. THE ORGANIZATION PROVIDES SERVICES DESIGNED TO ASSIST THE SUPPORTED CHARITIES IN THEIR OWN OPERATIONS. BY PROVIDING THE SERVICES, THE ORGANIZATION WILL HELP THE SUPPORTED CHARITIES MAXIMIZE UTILIZATION OF AVAILABLE RESOURCES, REDUCE FUNCTIONAL OVERLAPS AND DUPLICATION OF EFFORT, PROMOTE ECONOMIES OF SCALE, AND ENHANCE ADMINISTRATIVE EFFICIENCY. THE SERVICES ARE PROVIDED TO THE SUPPORTED CHARITIES ON TERMS THAT ARE MORE FAVORABLE THAN THE SUPPORTED CHARITIES COULD OBTAIN IN THE MARKETPLACE. FORM 990, PART III, LINE 3 IN DECEMBER 2022, IN ANTICIPATION OF WINDING DOWN THE BUSINESS, ALL EMPLOYEES WERE TRANSFERRED TO HEBREW HOME FOR AGED DISABLED, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS; HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE A "MEMBER" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WHO HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE, INCLUDING ELECTING MEMBERS OF THE GOVERNING BODY. AS SUCH, IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS, JSLG HAS TWO MEMBERS: (I) HEBREW HOME FOR AGED DISABLED DBA THE SAN FRANCISCO CAMPUS FOR JEWISH LIVING (SFCJL) AND (II) THE JEWISH HOME AND SENIOR LIVING FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A A MAJORITY OF THE TRUSTEES SERVING ON THE BOARD OF JSLG AT ANY GIVEN TIME SHALL BE TRUSTEES APPOINTED BY THE HEBREW HOME FOR AGED DISABLED AND THE JEWISH HOME AND SENIOR LIVING FOUNDATION. THE REMAINING TRUSTEES OF JSLG ARE THEN APPOINTED BY HEBREW HOME FOR AGED DISABLED AND THE JEWISH HOME AND SENIOR LIVING FOUNDATION ACTING JOINTLY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE TAX PROFESSIONAL IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE STAFF. MANAGEMENT OF THE ORGANIZATION THEN REVIEWS THE COMPLETED FORM 990 AND FOLLOWS-UP WITH THE TAX PREPARATION FIRM TO RESOLVE ANY OUTSTANDING QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. EACH PERSON WHO IS DEEMED TO HAVE SUBSTANTIAL INFLUENCE OVER THE ORGANIZATION (INCLUDING TRUSTEES, OFFICERS, AND KEY EMPLOYEES) SIGNS AN ANNUAL DISCLOSURE STATEMENT WHICH AFFIRMS THAT THE PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTOOD THE POLICY, AND HAS AGREED TO COMPLY WITH THE POLICY, AND DISCLOSES ANY DIRECT OR INDIRECT AFFILIATIONS. ALL ANNUAL DISCLOSURE STATEMENTS ARE SUBMITTED TO THE SECRETARY. EACH EMPLOYEE DISCLOSES TO THE CHIEF EXECUTIVE OFFICER ALL MATERIAL FACTS REGARDING THE AFFILIATION OF SUCH EMPLOYEE WITH ANY PERSON WITH WHOM THE ORGANIZATION IS CONSIDERING ENTERING A TRANSACTION; THE CHIEF EXECUTIVE OFFICER THEN DETERMINES WHETHER A CONFLICT OF INTEREST EXISTS FOR THESE EMPLOYEES. THE CHIEF EXECUTIVE OFFICER AND ANY OTHER PERSON WITH SUBSTANTIAL INFLUENCE OVER THE ORGANIZATION SHALL DISCLOSE TO THE BOARD ALL MATERIAL FACTS REGARDING HIS OR HER AFFILIATION WITH ANY PERSON WITH WHOM THE JEWISH HOME IS CONSIDERING ENTERING A TRANSACTION; THE BOARD THEN DETERMINES IF A CONFLICT OF INTEREST EXISTS FOR THE CHIEF EXECUTIVE OFFICER OR PERSON WITH SUBSTANTIAL INFLUENCE OVER THE ORGANIZATION. IF A BOARD MEMBER IS THE INDIVIDUAL WITH WHICH A CONFLICT OF INTEREST IS BEING DETERMINED, THE BOARD MEMBER IS NOT ALLOWED TO VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE ANNUAL COMPENSATION PACKAGE FOR THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER BASED ON VARIOUS FACTORS, INCLUDING DATA COLLECTED FROM AN INDEPENDENT COMPENSATION CONSULTANT (WHO UTILIZES 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 AND CHIEF FINANCIAL OFFICER'S EMPLOYMENT CONTRACT. THE CHIEF EXECUTIVE OFFICER REVIEWS AND APPROVES THE ANNUAL COMPENSATION FOR THE OTHER EXECUTIVE TEAM MEMBERS BASED ON VARIOUS FACTORS, INCLUDING DATA COLLECTED FROM AN INDEPENDENT COMPENSATION CONSULTANT (DEPENDING ON POSITION) WHO UTILIZES COMPENSATION DATA OBTAINED FROM SURVEYS, 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. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 425,514. MANAGEMENT AND GENERAL EXPENSES 34,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 460,014. CONSULTING AND PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 44,928. MANAGEMENT AND GENERAL EXPENSES 2,846. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,774. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 303,018. MANAGEMENT AND GENERAL EXPENSES 24,569. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 327,587. HEBREW HOME FOR AGED DISABLED 302 SILVER AVE SAN FRANCISCO CA 94112 940545320 SEE PART VII CA 501(C)(3) LINE 7 N/A 0 THE JEWISH HOME AND SENIOR LIVING FOUNDATION 302 SILVER AVE SAN FRANCISCO CA 94112 020724278 SEE PART VII CA 501(C)(3) LINE 7 N/A 0 BAY AREA JEWISH SENIOR LIFE 302 SILVER AVE SAN FRANCISCO CA 94112 455092344 SEE PART VII CA 501(C)(3) LINE 12A, I JEWISH SENIOR LIVING GROUP 1 BAY AREA SENIOR HEALTH SERVICES INC 302 SILVER AVENUE SAN FRANCISCO CA 94015 454293287 MANAGEMENT CO CA JSLG C 1.00000 1 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 PART II, COLUMN (B) THE JEWISH HOME AND SENIOR LIVING FOUNDATION PRIMARY ACTIVITY: TO PROMOTE AND SUPPORT THE PROVISION OF JEWISH AGING SERVICES, INCLUDING THE MISSION AND ACTIVITIES ASSOCIATED WITH THE HEBREW HOME FOR AGED DISABLED. PART II, COLUMN (B) HEBREW HOME FOR AGED DISABLED PRIMARY ACTIVITY: 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. NON-RESIDENTIAL CARE IS OFFERED THROUGH THE HOME'S SHORT-TERM AND REHABILITATION SERVICES (STARS) AND ACUTE PSYCHIATRIC SERVICES. PART II, COLUMN (B) BAY AREA JEWISH SENIOR LIFE PRIMARY ACTIVITY: TO ASSIST THE SUPPORTED CHARITIES IN THEIR OWN OPERATIONS AND ASSIST WITH DEVELOPING NEW SERVICES AND FACILITIES IN THE AFFILIATED NETWORK.