2023-08-15T12:32:45-05:00 2022-09-30 111986323 MARCUM LLP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 990 2021-10-01 060846991 JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INC DBA MOZAIC SENIOR LIFE JEWI 2033656400 4200 PARK AVENUE BRIDGEPORT CT 06604 SIGNING OFFICER CFO 2033656400 2023-08-15 1 SIGNING OFFICER 999009999 MARY ANTONETTI P00431862 2037819600 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ANDREW H BANOFF 4200 PARK AVENUE BRIDGEPORT CT 06604 67394868 0 X HTTPS://WWW.MOZAICSL.ORG X 1967 CT NON-PROFIT HEALTH CARE FACILITY PROVIDING REST HOME AND SKILLED NURSING CARE TO THE AGED AND INFIRM. 35 35 968 174 12228 0 2073550 2451494 54571524 61810817 600831 237825 1490387 1972078 58736292 66472214 0 0 0 0 37862922 38996979 0 0 757645 21911996 25816573 59774918 64813552 -1038626 1658662 107317417 106288141 62968933 61828776 44348484 44459365 X CONSISTENT WITH JEWISH VALUES AND TRADITIONS, THE MISSION OF THE JEWISH HOME IS TO ASSURE JEWISH SENIORS THE HEALTH CARE, HOUSING AND GERIATRIC SERVICES REQUIRED TO ACHIEVE THE HIGHEST POSSIBLE QUALITY OF LIFE REASONABLY ATTAINABLE FOR THEM. (SEE SCHEDULE O) ADMISSION TO THESE SERVICES WILL BE AVAILABLE TO JEWISH SENIORS ON A PRIORITY BASIS. 0 0 45291518 50379939 SKILLED NURSING FACILITY: A MODERN 294 BED SKILLED NURSING FACILITY PROVIDING SHORT TERM POST ACUTE CARE, LONG TERM CARE, SPECIAL CARE FOR MEMORY, AND COGNITIVE DISORDERS. 3158566 3894165 NON-MEDICAL HOME CARE SERVICES, ALSO KNOWN AS COMPASSIONATE CARE COMPANIONS, PROVIDES CAREGIVERS OFFERING SERVICES TAILORED TO INDIVIDUAL NEEDS IN CLIENT'S HOME. SERVICES INCLUDE: COMPANIONSHIP AND SOCIALIZATION; MEAL PREPARATION; LIGHT HOUSEKEEPING; TRANSPORTATION; ERRAND AND GROCERY SHOPPING; ASSISTANCE WITH PERSONAL CARE; SUPERVISION OF DRESSING AND GROOMING; AND RECREATIONAL ACTIVITIES. 24 HOUR LIVE-IN CARE SERVICES ARE AVAILABLE. 2064697 2173488 MEDICAL HOME CARE PROVIDES CLIENTS WITH COMPREHENSIVE HOME CARE SERVICES. IN COORDINATION WITH THE CLIENT'S PHYSICIAN, THE TEAM WILL DEVELOP A PLAN OF CARE THAT PROMOTES RESTORATION OF HEALTH AND INDEPENDENCE DURING AN ILLNESS, OR FOLLOWING AN INJURY OR SURGICAL PROCEDURE IN HIS OR HER HOME SETTING. THE TEAM ALSO WORKS WITH INDIVIDUALS WHO ARE FACING CHALLENGES MEETING THE PHYSICAL DEMANDS OF DAILY LIVING AND CAN BENEFIT FROM SKILLED CARE IN THEIR HOMES. 6426597 5363225 INCLUDES THE INSTITUTE ON AGING GERIATRIC ASSESSMENT SERVICE, THECENTER FOR ELDER ABUSE PREVENTION, ADULT DAY CARE, HOSPICE, WORKACTIVITY CENTER, THERAPY. 6426597 5363225 56941378 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 127 0 1 968 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 35 35 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CT X ROGER SLIBY 2033656400 4200 PARK AVE BRIDGEPORT CT 06604 ALAN PHILLIPS CHAIRPERSON OF THE BOARD 0.50 X X 0 0 0 AMANDA SHAPIRO APRN DIRECTOR (TO 10/2021) 0.50 X 0 0 0 AMY RICH DIRECTOR 0.50 X 0 0 0 ART SPINNER DIRECTOR 0.50 X 0 0 0 BRIAN MILES DIRECTOR 0.50 1.00 X 0 0 0 CARL BENNETT HONORARY DIRECTOR FOR LIFE (TO 10/2021) 0.50 X 0 0 0 CAROL SPINNER DIRECTOR (TO 10/2021) 0.50 X 0 0 0 ED FRIEDLAND DIRECTOR 0.50 X 0 0 0 EDWARD BURGER DIRECTOR 0.50 1.00 X 0 0 0 ELLEN HYDE PHILLIPS WOMEN'S AUXILIARY PRESIDENT 0.50 1.00 X 0 0 0 EMIL MESHBERG TREASURER 0.50 X X 0 0 0 ERIC KATZ MD DIRECTOR 0.50 X 0 0 0 ERIC N HENDLIN DIRECTOR 0.50 X 0 0 0 FRANK MORSE DIRECTOR (TO 10/2021) 0.50 X 0 0 0 GERALD LUTERMAN DIRECTOR 0.50 X 0 0 0 HAROLD ROSNICK ESQ HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 JANET FREEDMAN DIRECTOR 0.50 X 0 0 0 JAY GOLDSTEIN DIRECTOR 0.50 X 0 0 0 JEFF RADLER DIRECTOR; PAST CHAIRPERSON 0.50 X 0 0 0 JENNIFER KANFER DIRECTOR 0.50 X 0 0 0 JERRY MINSKY DIRECTOR, FORMER MEN'S CLUB 0.50 1.00 X 0 0 0 JIM BENNETT DIRECTOR 0.50 X 0 0 0 JON AUGUST VICE CHAIRPERSON OF THE BOARD 0.50 X X 0 0 0 KENNETH I WIRFEL ESQ PAST CHAIRPERSON 0.50 X 0 0 0 MARC LEVEY DIRECTOR 0.50 X 0 0 0 MARK A LAPINE HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 MARTIN F WOLF ESQ HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 MICHAEL FLEISCHER DIRECTOR 0.50 X 0 0 0 MICHAEL MARCUS DIRECTOR; PAST CHAIRPERSON 0.50 X 0 0 0 MIKE WOLFSON ESQ DIRECTOR 0.50 X 0 0 0 MILTON SUTIN HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 MITCHELL ADELSTEIN MEN'S CLUB PRESIDENT 0.50 1.00 X 0 0 0 MITCHELL KORNBLIT DIRECTOR 0.50 X 0 0 0 NANCY MAGIDA SECRETARY 0.50 X X 0 0 0 NATHANIEL NEVAS DIRECTOR (TO 10/2021) 0.50 X 0 0 0 PHILIP SCHAEFER DIRECTOR 0.50 X 0 0 0 ROSLYN GOLDSTEIN HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 ROY FRIEDMAN HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 RUSSELL BEITMAN DIRECTOR (TO 10/2021) 0.50 X 0 0 0 SCOTT SERELS MD DIRECTOR 0.50 X 0 0 0 WILLIAM SIMS DIRECTOR; PAST CHAIRPERSON 0.50 X 0 0 0 ANDREW H BANOFF PRESIDENT OF JHE & CEO 40.00 1.00 X 672483 0 33186 ELIZABETH ZICARI VP & COMMUNITY SERVICES AND BUSINESS 40.00 X 173865 0 644 LAWRENCE CONDON SENIOR VP & ADMINISTRATOR 40.00 X 228817 0 40030 LINDA C CISZKOWSKI VP OF EMPLOYEE RELATIONS 40.00 X 158475 0 19444 ROGER SLIBY VP & CHIEF FINANCIAL OFFICER 40.00 X 226278 0 12714 1459918 0 106018 21 0 1 0 DEPENDABLE NURSING 1162 WEST WOODS ROAD HAMDEN CT 06518 TEMPORARY STAFFING 992086 FLAGSHIP NETWORKS 100 BEARD SAWMILL ROAD SHELTON CT 06484 PROFESSIONAL SERVICES 448823 FORVIS LLC 910 E ST LOUIS STREET SUITE 200 SPRINGFIELD MO 658011190 MEDICAL BILLING 309296 JP AMERICAN STAFFING 1825 BARNUM AVE STRATFORD CT 06614 TEMPORARY STAFFING 295343 HOMECARE BY RVNA 27 GOVERNOR STREET RIDGEFIELD CT 06877 HOMECARE COMPANION SERVICES 247545 8 465000 840696 1145798 2451494 RESIDENT CARE SERVICES 623000 50379939 50379939 COMPASSIONATE CARE 621610 3894165 3894165 MEDICAL HOME CARE 623000 2173488 2173488 HOME TOGETHER 623000 1802445 1802445 SENIOR CHOICE AT HOME 623000 1418363 1418363 2142417 2142417 61810817 281978 281978 32167 0 32167 32167 32167 878501 892171 30483 -13670 -30483 -44153 -44153 FITNESS CENTER 900099 801702 801702 MISCELLANEOUS 900099 719051 719051 CHILD CARE CENTER 900099 406930 406930 12228 12228 1939911 66472214 61810817 12228 2197675 X 1771452 1693298 78154 30769561 28453581 1945370 370610 940248 939661 587 3413223 3062872 302246 48105 2102495 1843888 229172 29435 455608 154348 300926 334 151058 61735 89323 83333 83333 352623 352623 8051488 7490575 557330 3583 138449 88208 50206 35 1417465 1010297 367519 39649 499352 438253 38902 22197 1925124 1786858 123979 14287 131375 119741 11391 243 292394 138733 153466 195 2249694 2088116 144882 16696 3668455 3404979 236251 27225 733423 680747 47233 5443 FOOD EXPENSE 1803548 1452841 350393 314 NURSING HOME TAX 1499267 1462749 36518 SUPPLIES 1422357 1422189 168 BAD DEBT 841007 841007 100553 100553 64813552 56941378 7114529 757645 4677427 8195924 139527 68395 679270 822642 5019966 5230470 133995 131632 77282 102950 104777866 24947614 82103289 79830252 14022236 11574780 464425 331096 107317417 106288141 5163007 5657968 4872510 6148069 51863016 49658500 217727 177473 203999 4631 648674 182135 62968933 61828776 X 30422584 31897625 13925900 12561740 44348484 44459365 107317417 106288141 X 1658662 -2351771 803990 X 0 1 X 1 1 1 X 2069424 1028712 1171889 2073550 2451494 8795069 54025218 55548099 56138697 54571524 61810817 282094355 56094642 56576811 57310586 56645074 64262311 290889424 241500 241500 0 241500 241500 290647924 459108 480721 607967 576976 314145 2438917 459108 480721 607967 576976 314145 2438917 12228 12228 1855364 1693260 1211629 1476889 1927683 8164825 58409114 58750792 59130182 58698939 66516367 301505394 0.96400 0.96370 0.00810 0.00890 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 12000 12000 0 PART II-B, LINE 1, LOBBYING ACTIVITIES: THE JEWISH HOME ENGAGES A LOBBYIST TO MAINTAIN CONTACT WITH STATE LEGISLATION ON ISSUES AFFECTING THE HOME. 0 0 13706174 66000 -1334705 446624 11990845 12471683 33036 1670227 468772 13706174 11866399 329408 790952 515076 12471683 12072985 186517 386048 779151 11866399 11960405 410764 664495 962679 12072985 0.01000 0.92000 0.07000 0 0 5000000 5000000 92566507 20500275 72066232 5765282 4087619 1677663 1446077 359720 1086357 79830252 SPLIT INTEREST AGREEMENT 146833 INTEREST RATE SWAP AGREEMENT 35302 182135 X 64823877 -2351771 820382 -1531389 66355266 77340 39608 116948 66472214 64712996 0 64712996 100556 100556 64813552 PART X, LINE 2: THE HOME ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS SEPTEMBER 30, 2022 AND 2021, THERE ARE NO TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOME IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS PENDING OR IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENTS 75,987. CHANGE IN PENSION LIABILITY 744,395. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION EXPENSE RECLASS 23,216. CHANGE IN LIABILITY UNDER SPLIT-INTEREST AGREEMENTS 16,392. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT MANAGEMENT FEES 77,340. CONTRIBUTION EXPENSE RECLASS 23,216. X X 0 0 0 0 0 0 0 1 0 ANDREW H BANOFF PRESIDENT OF JHE & CEO 532323 0 135000 0 5160 0 25300 0 7886 0 705669 0 0 0 LAWRENCE CONDON SENIOR VP & ADMINISTRATOR 213817 0 15000 0 0 0 24275 0 15755 0 268847 0 0 0 ROGER SLIBY VP & CHIEF FINANCIAL OFFICER 211278 0 15000 0 0 0 4828 0 7886 0 238992 0 0 0 LINDA C CISZKOWSKI VP OF EMPLOYEE RELATIONS 158475 0 0 0 0 0 3689 0 15755 0 177919 0 0 0 ELIZABETH ZICARI VP & COMMUNITY SERVICES AND BUSINESS 166365 0 7500 0 0 0 0 0 644 0 174509 0 0 0 PART I, LINE 7 BONUSES RECEIVED BY THE LISTED OFFICERS ARE APPROVED BY THE BOARD OF DIRECTORS OF THE ORGANIZATION. A CITY OF BRIDGEPORT 066001865 2014-04-29 55500000 FACILITY CONSTRUCTION 0 0 0 B CITY OF BRIDGEPORT 066001865 2014-04-29 6500000 FACILITY CONSTRUCTION 0 0 0 A 8162500 55500000 55500000 2016 0 0 1 1 B 3480000 6500000 6500000 2016 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 1 0 1 1 M&T BANK 10.000000000000 0 0 0 0 1 B 0 0 1 0 0 1 M&T BANK 10.000000000000 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: CITY OF BRIDGEPORT, CT (F) DESCRIPTION OF PURPOSE: SENIOR LIVING FACILITY REVENUE BONDS, SERIES 2014A SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: CITY OF BRIDGEPORT, CT (F) DESCRIPTION OF PURPOSE: SENIOR LIVING FACILITY REVENUE BONDS, SERIES 2014B FORM 990, PART VI, SECTION A, LINE 2 ART SPINNER AND CAROL SPINNER ARE MARRIED. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PROVIDED TO THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 12C AFTER THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED, A DETERMINATION WOULD BE MADE BETWEEN THE ORGANIZATION AND BOARD MEMBER ON WHETHER THERE IS A SIGNIFICANT CONFLICT AFFECTING THE BOARD MEMBER'S JUDGEMENT. ANY MEMBER OF THE BOARD HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. FORM 990, PART VI, SECTION B, LINE 15 SENIOR MANAGEMENT COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITEE (WITH DATA FROM HR ADVANTAGE) AND REVIEWED BY THE EXECUTIVE COMMITTEE AN INDEPENDENT COMPENSATION CONSULTANT IS ALSO USED. FORM 990, PART VI, SECTION C, LINE 18 FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PROVIDED TO THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE JEWISH HOME DOES NOT MAKE ITS GOVERNING DOCUMENTS AND OTHER DOCUMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,749,109. MANAGEMENT AND GENERAL EXPENSES 35,338. FUNDRAISING EXPENSES 3,465. TOTAL EXPENSES 6,787,912. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 741,466. MANAGEMENT AND GENERAL EXPENSES 521,992. FUNDRAISING EXPENSES 118. TOTAL EXPENSES 1,263,576. FORM 990, PART XI, LINE 9: CHANGE IN SPLIT INTEREST AGREEMENTS -16,392. CHANGE IN INTEREST RATE SWAP AGREEMENTS 75,987. CHANGE IN PENSION LIABILITY 744,395. TJH SENIOR LIVING 4200 PARK AVE BRIDGEPORT CT 06604 INDEPENDENT LIVING PROJECT CT 0 913862 JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY DBA MOZAIC SENIOR LIFE TJH HOLDINGS 4200 PARK AVE BRIDGEPORT CT 06604 HOLDING COMPANY CT 0 0 JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY DBA MOZAIC SENIOR LIFE MEN'S CLUB OF JHE OF FAIRFIELD COUNTY 4200 PARK AVE BRIDGEPORT CT 06604 222522138 FUNDRAISING ACTIVITIES TO SUPPORT JEWISH HOME FOR THE ELDERLY OF FFLD COUNTY CT 501(C)(3) LINE 10 0 THE WOMEN'S AUXILIARY OF JHE OF FAIRFIELD COUNTY 4200 PARK AVE BRIDGEPORT CT 06604 061055236 FUNDRAISING ACTIVITIES TO SUPPORT JEWISH HOME FOR THE ELDERLY OF FFLD COUNTY CT 501(C)(3) LINE 10 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0