2022-05-13T14:53:24-05:00 2021-06-30 263753134 CBIZ MHM LLC 500 BOYLSTON STREET BOSTON MA 02116 990 2020-07-01 208411287 BRYN MAWR TERRACE BRYN 6105258300 773 E HAVERFORD ROAD BRYN MAWR PA 19010 KEVIN ROSS PRESIDENT & CEO 6105258300 2022-05-13 1 KEVIN ROSS 999009999 BRENDA L BOOTH P01342395 6177610600 2022-05-13 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KEVIN ROSS 773 E HAVERFORD ROAD BRYN MAWR PA 19010 7813669 0 X WWW.BRYNMAWRTERRACE.ORG X 2007 PA PROVIDE SKILLED NURSING, REHABILIATION, AND PERSONAL CARE SERVICES. 13 12 153 50 0 0 573021 1432699 7685568 6379838 13985 1132 0 0 8272574 7813669 0 0 0 0 5677126 6173301 0 0 0 4128277 3365289 9805403 9538590 -1532829 -1724921 14327781 9525391 12179922 11702453 2147859 -2177062 PROVIDE SKILLED NURSING, REHABILITATION, AND PERSONAL CARE SERVICES. 0 0 8793807 6379838 BRYN MAWR TERRACE SERVES AS A CONTINUING CARE RETIREMENT COMMUNITY, OFFERING A RANGE OF SERVICES INCLUDING SHORT-TERM REHABILITATION THERAPY, TRADITIONAL NURSING CARE, INDEPENDENT LIVING, PERSONAL CARE, MEMORY CARE, RESTORATIVE CARE AND RESPITE CARE, ALL IN A SETTING THAT IS WARM, WELCOMING AND NURTURING.OUR PURPOSE IS TO SERVE THE COMMUNITY BY PROVIDING QUALITY CARE AND SERVICES AND TO USE OUR RESOURCES IN A COST EFFECTIVE AND COMMUNITY RESPONSIVE MANNER. WE STRIVE TO ACCOMPLISH THIS IN AN ENVIRONMENT THAT IS RESPECTFUL OR RESIDENTS AND STAFF. 8793807 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 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 9 0 1 153 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X MAIN LINE SENIOR CARE 6106585100 100 E LANCASTER AVENUE WYNNEWOOD PA 19096 KEVIN ROSS PRESIDENT & CEO 10.00 30.00 X X 0 364884 25481 BOB BERGEN SECRETARY 1.00 2.00 X X 0 0 0 GORDON MOTT CHAIRMAN 1.00 2.00 X X 0 0 0 A LOUIS DENTON VICE CHAIRMAN 1.00 2.00 X X 0 0 0 PHILLIP D ROBINSON BOARD MEMBER 1.00 2.00 X 0 0 0 PAUL BOSTON BOARD MEMBER 1.00 2.00 X 0 0 0 DAVID R DUGERY TREASURER 1.00 2.00 X X 0 0 0 DAVIS PEARSON BOARD MEMBER 1.00 2.00 X 0 0 0 LIZ ROGAN BOARD MEMBER 1.00 2.00 X 0 0 0 LAUREN S ROSEN MD BOARD MEMBER 1.00 2.00 X 0 0 0 TIM RUBIN BOARD MEMBER 1.00 2.00 X 0 0 0 SARA SENIOR BOARD MEMBER 1.00 2.00 X 0 0 0 MARY ANN STETZER BOARD MEMBER 1.00 2.00 X 0 0 0 JENNIFER NAM CFO 10.00 30.00 X 0 173380 7152 JOY BANNERMAN DIRECTOR OF NURSING 40.00 0.00 X 122194 0 6750 122194 538264 39383 1 0 1 0 RN PLUS INC 515 PENNSYLVANIA AVE FORT WASHINGTON PA 19034 MEDICAL STAFFING 601616 SELECT REHABILITATION INC PO BOX 71985 CHICAGO IL 606941985 THERAPY SVCS - RESIDENTS 439126 US FOODS PO BOX 33101 NEWARK NJ 071880101 FOOD - RESIDENTS 199629 CONTRACT PHARMACY SERVICES 125 TITUS AVENUE WARRINGTON PA 18976 PHARMACY SERVICES 182105 4 1424950 7749 1432699 RESIDENT CARE/ADMINIST 623000 6379838 6379838 6379838 1132 1132 7813669 6379838 0 1132 5450856 5250511 200345 408495 391138 17357 313950 297093 16857 506600 506600 212487 209804 2683 28761 28761 112915 112915 9838 9838 285198 285198 426590 426590 464819 464819 MEDICAL AND ANCILLARY S 446433 446433 UTILITIES/PLANT OPS 310846 310846 REAL ESTATE TAXES 292332 292332 FOOD AND SUPPLEMENTS 166823 166823 101647 100706 941 9538590 8793807 744783 0 2260519 694464 476352 427871 56439 56120 314373 156740 12042702 4928570 9883633 7114132 1336465 1076064 14327781 9525391 504357 512816 188772 125893 8558634 7269481 2928159 3794263 12179922 11702453 X 2147859 -2177062 2147859 -2177062 14327781 9525391 X -1724921 -2600000 X 0 1 X 1 0 X 22275 13965 14098 573021 1432699 2056058 11438393 11181980 9681987 7685568 6379838 46367766 11460668 11195945 9696085 8258589 7812537 48423824 5100 7400 6715 1940 900 22055 0 5100 7400 6715 1940 900 22055 48401769 7599 11080 11063 13985 1132 44859 7599 11080 11063 13985 1132 44859 78956 38307 18445 135708 11547223 11245332 9725593 8272574 7813669 48604391 0.99580 0.99520 0.00090 0.00090 X PART III, 12 MISCELLANEOUS INCOME : 2016 : $78,956 2017 : $38,307 2018 : $18,445 2019 : $0 2020 : $0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3312684 3312684 6743939 3440958 3302981 260753 230016 30737 1725326 1257596 467730 7114132 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 34088 ASSETS WHOSE USE IS LIMITED 1039900 SECURITY DEPOSITS 2076 1076064 DUE TO AFFILIATE 3794263 3794263 X 5213669 -2600000 -2600000 7813669 0 7813669 9538590 0 9538590 0 9538590 PART X, LINE 2: THE ORGANIZATION IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AMENDED, AND FROM STATE INCOME TAXES UNDER THE NOT-FOR-PROFIT ORGANIZATION LAWS OF THE COMMONWEALTH OF PENNSYLVANIA. ACCORDINGLY, NO PROVISION FOR INCOME TAXES FOR THE ORGANIZATION HAS BEEN PROVIDED. THE ORGANIZATION ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON A "MORE LIKELY THAN NOT" THRESHOLD APPLIED TO THE RECOGNITION OF THE TAX POSITIONS BEING SUSTAINED BASED ON THE TECHNICAL MERITS OF THE POSITION UNDER SCRUTINY BY THE APPLICABLE TAXING AUTHORITY. IF A TAX POSITION OR POSITIONS ARE DEEMED TO RESULT IN UNCERTAINTIES OF THOSE POSITIONS, THE UNRECOGNIZED TAX BENEFIT IS ESTIMATED BASED ON A "CUMULATIVE PROBABILITY ASSESSMENT" THAT AGGREGATES THE ESTIMATED TAX LIABILITY FOR ALL UNCERTAIN TAX POSITIONS. INTEREST AND PENALTIES ASSESSED, IF ANY, ARE ACCRUED AS INCOME TAX EXPENSE. THE ORGANIZATION HAS IDENTIFIED ITS TAX STATUS, AS A TAX-EXEMPT ENTITY, AS A TAX POSITION. THE ORGANIZATION HAS DETERMINED THAT SUCH TAX POSITION DOES NOT RESULT IN AN UNCERTAINTY REQUIRING RECOGNITION. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: IMPAIRMENT LOSS -2,600,000. X X X 0 0 0 0 0 0 0 1 0 KEVIN ROSS PRESIDENT & CEO 0 332384 0 25000 0 7500 0 752 0 24729 0 390365 0 0 JENNIFER NAM CFO 0 173380 0 0 0 0 0 1315 0 5837 0 180532 0 0 PART I, LINE 3 THE ORGANIZATION USED CONVERGE, AN INDEPENDENT CONTRACTOR, TO CONDUCT A REVIEW OF KEY EMPLOYEE COMPENSATION WITH ASSISTANCE FROM COMPENSATION CONSULTING ALTERNATIVES, INC. THEY COMPILE AND ANALYZE DATA FROM SEVERAL HEALTHCARE SURVEY SOURCES. THIS DATA WAS PROVIDED TO THE BOARD CHAIR WHO REVIEWED IT, MADE A DECISION AND REVIEWED THAT DECISION WITH THE BOARD MEMBERS. PART I, LINE 7 KEVIN ROSS RECEIVED A DISCRETIONARY BONUS IN 2020 THAT IS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(II). FORM 990, PART VI, SECTION A, LINE 3 MAIN LINE SENIOR CARE, A NOT-FOR-PROFIT CORPORATION, IS THE CONTROLLING ENTITY OF BRYN MAWR TERRACE AND PROVIDES MANAGEMENT AND OVERSIGHT SERVICES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS DISTRIBUTED AND REVIEWED BY ALL BOARD MEMBERS PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALY WITH EACH BOARD MEMBER. BOARD MEMBERS ARE EXPECTED TO IDENIFY ANY CONFLICTS OR POTENTIAL CONFLICTS AND MUST SIGN THE DOCUMENT. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USED CONVERGE, AN INDEPENDENT CONTRACTOR, TO CONDUCT A REVIEW OF KEY EMPLOYEE COMPENSATION WITH ASSISTANCE FROM COMPENSATION CONSULTING ALTERNATIVES, INC. THEY COMPILE AND ANALYZE DATA FROM SEVERAL HEALTHCARE SURVEY SOURCES. THIS DATA WAS PROVIDED TO THE BOARD CHAIR WHO REVIEWED IT, MADE A DECISION AND REVIEWED THAT DECISION WITH THE BOARD MEMBERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE, UP IN-PERSON, VERBAL OR WRITTEN REQUEST, DOCUMENTS RELATING TO THE GOVERNANCE, CONFLICTS OF INTEREST AND FINANCIAL STATEMENTS TO THE PUBLIC. FORM 990, PART XI, LINE 9: IMPAIRMENT LOSS -2,600,000. SAUNDERS HOUSE 100 LANCASTER AVENUE WYNNEWOOD PA 19096 231352250 NURSING HOME PA 501(C)(3) LINE 10 MAIN LINE SENIOR CARE 1 MAIN LINE SENIOR CARE 100 LANCASTER AVENUE WYNNEWOOD PA 19096 455110022 MANAGEMENT SERVICES PA 501(C)(3) LINE 12B, II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0