CHELSEA JEWISH NURSING HOME INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CHELSEA JEWISH NURSING HOME INC (EIN 04-2200583)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202213199349319261
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T14:41:12-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 BATTERYMARCH PARK SUITE 100 | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02169 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042200583 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHELSEA JEWISH NURSING HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHEL | BusinessNameControlTxt |
| Phone | 6178870001 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LAFAYETTE AVENUE | AddressLine1Txt |
| City | CHELSEA | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02150 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNIFER SANTERRE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9784715118 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JENNIFER | PersonFirstNm |
| Person Last | SANTERRE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIELLE NIHILL | PreparerPersonNm |
| PTIN | P01350943 | PTIN |
| Phone | 7819821001 | PhoneNum |
| Preparation | 2022-11-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KATZMAN FAMILY CENTER FOR LIVING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ADAM BERMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 240 LYNNFIELD STREET | AddressLine1Txt |
| City | PEABODY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01960 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,970,798 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHELSEAJEWISH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1919 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE THE HIGHEST LEVEL OF SKILLED NURSING AND REHABILITATION SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,202,301 | PYContributionsGrantsAmt |
| CY Contributions Grants | $509,318 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,679,998 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,459,693 | CYProgramServiceRevenueAmt |
| PY Investment Income | $906 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,787 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $15,883,205 | PYTotalRevenueAmt |
| CY Total Revenue | $14,970,798 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,338,821 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,797,872 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $128,205 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,725,000 | PYOtherExpensesAmt |
| CY Other Expenses | $7,858,050 | CYOtherExpensesAmt |
| PY Total Expenses | $15,063,821 | PYTotalExpensesAmt |
| CY Total Expenses | $16,655,922 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $819,384 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,685,124 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,377,174 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,526,060 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,041,545 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,791,572 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,335,629 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $734,488 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION'S MISSION IS TO PROVIDE INDIVIDUALS THROUGHOUT THE GREATER BOSTON AREA WITH THE HIGHEST LEVEL OF SKILLED NURSING, REHABILITATION AND ASSISTED LIVING SERVICES WITHOUT REGARD TO ABILITY TO PAY. THE GOAL IS TO ENSURE BOTH CLIENTS AND FAMILIES RETAIN HEALTH, INDEPENDENCE, AND WELL-BEING THROUGH OUR SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,719,691 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $14,459,693 | RevenueAmt |
| Desc | NURSING HOME - OPERATION OF A 120-BED SKILLED NURSING FACILITY PROVIDING NURSING CARE, REHABILITATION THERAPIES AND OTHER SKILLED SERVICES TO FRAIL ELDERLY. | Desc |
| Total Program Service Expenses | $12,719,691 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNIFER SANTERRE | PersonNm |
| Phone | 9784715118 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 240 LYNNFIELD STREET | AddressLine1Txt |
| City | PEABODY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01960 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BARRY BERMAN | ||||||||
| TREASURER | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $711,685 | $20,397 | |
| ADAM BERMAN | ||||||||
| PRESIDENT AND CEO | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $455,719 | $27,541 | |
| JEFFREY LANDA | ||||||||
| CFO | 1.00 | 39.00 | Yes (X) | $0 | $276,879 | $29,524 | ||
| ELIZABETH MULLEN | ||||||||
| COO AND CLERK | 1.00 | 39.00 | Yes (X) | $0 | $252,926 | $11,000 | ||
| RONILO ANGLO | ||||||||
| CHIEF CLINICAL OFFICER | 1.00 | 39.00 | $0 | $215,993 | $27,422 | Yes (X) | ||
| KAREN PETRUCCELLI | ||||||||
| VP CLINICAL QUALITY IMPROVEMENT | 1.00 | 39.00 | $0 | $198,950 | $12,738 | Yes (X) | ||
| KATHERINE SANTOS | ||||||||
| VP OF STRATEGY & OPERATION | 1.00 | 39.00 | $0 | $192,277 | $2,229 | Yes (X) | ||
| ROGELIO MARTIN CALAUNAN | ||||||||
| REGISTERED NURSE | 40.00 | 0.00 | $0 | $181,339 | $9,183 | Yes (X) | ||
| THERESA HALLIDAY-BURRI | ||||||||
| CHIEF BUSINESS DEVELOPMENT OFFICER | 1.00 | 39.00 | $0 | $172,926 | $11,038 | Yes (X) | ||
| GILDA RICHMAN | ||||||||
| CHAIR | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $77,866 | $58 | |
| JUDY WEISS | ||||||||
| DIRECTOR | 1.00 | 7.00 | Yes (X) | $0 | $0 | $0 | ||
| JOEL MAZER | ||||||||
| VICE CHAIR | 1.00 | 7.00 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,736,560 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $151,130 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CHELSEA JEWISH LIFECARE INC | |||||
| 165 CAPTAINS ROW | CHELSEA | MA | 02150 | MANAGEMENT SERVICES | $867,308 |
| PROEMS SOLUTIONS | |||||
| 31 SMITH PL | CAMBRIDGE | MA | 02138 | COVID-19 TESTING | $413,850 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $509,318 | GovernmentGrantsAmt |
| Total Contributions | $509,318 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PROGRAM SERVICE REVENUE | 623990 | $14,443,139 | $14,443,139 |
| OTHER INCOME | 623990 | $16,554 | $16,554 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,459,693 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,787 | TotalRevenueColumnAmt |
| Exclusion | $1,787 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,970,798 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,459,693 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,787 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,818,783 | TotalAmt |
| Program Services | $6,807,919 | ProgramServicesAmt |
| Management And General | $882,659 | ManagementAndGeneralAmt |
| Fundraising | $128,205 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,833 | TotalAmt |
| Program Services | $12,024 | ProgramServicesAmt |
| Management And General | $809 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $412,638 | TotalAmt |
| Program Services | $399,881 | ProgramServicesAmt |
| Management And General | $12,757 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $553,618 | TotalAmt |
| Program Services | $518,729 | ProgramServicesAmt |
| Management And General | $34,889 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $867,308 | TotalAmt |
| Management And General | $867,308 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,632 | TotalAmt |
| Management And General | $13,632 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,888 | TotalAmt |
| Management And General | $77,888 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,867 | TotalAmt |
| Program Services | $226,437 | ProgramServicesAmt |
| Management And General | $63,430 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,610 | TotalAmt |
| Program Services | $104,471 | ProgramServicesAmt |
| Management And General | $69,139 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,741 | TotalAmt |
| Program Services | $75,925 | ProgramServicesAmt |
| Management And General | $3,816 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $462,196 | TotalAmt |
| Program Services | $425,433 | ProgramServicesAmt |
| Management And General | $36,763 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $452 | TotalAmt |
| Management And General | $452 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552,290 | TotalAmt |
| Program Services | $510,949 | ProgramServicesAmt |
| Management And General | $41,341 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,017,729 | TotalAmt |
| Program Services | $941,548 | ProgramServicesAmt |
| Management And General | $76,181 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $352,117 | TotalAmt |
| Program Services | $328,683 | ProgramServicesAmt |
| Management And General | $23,434 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| LOSS ON REFINANCING | $1,420,619 | $0 | $1,420,619 |
| USER FEE | $814,127 | $814,127 | |
| SUPPLIES & EXPENSE | $715,092 | $715,092 | $0 |
| FOOD | $384,782 | $384,782 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $636,600 | TotalAmt |
| Program Services | $453,691 | ProgramServicesAmt |
| Management And General | $182,909 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,655,922 | TotalAmt |
| Program Services | $12,719,691 | ProgramServicesAmt |
| Management And General | $3,808,026 | ManagementAndGeneralAmt |
| Fundraising | $128,205 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,934,374 | BOYAmt |
| EOY | $4,583,270 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,371,551 | BOYAmt |
| EOY | $2,649,958 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,667 | BOYAmt |
| EOY | $138,798 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,773,900 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,186,890 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,487,564 | BOYAmt |
| EOY | $11,587,010 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,000 | BOYAmt |
| EOY | $500,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,889,018 | BOYAmt |
| EOY | $4,067,024 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,377,174 | BOYAmt |
| EOY | $23,526,060 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,634,737 | BOYAmt |
| EOY | $2,091,368 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,745 | BOYAmt |
| EOY | $5,855 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,022,855 | BOYAmt |
| EOY | $17,343,671 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,489,375 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,374,208 | BOYAmt |
| EOY | $1,861,303 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,041,545 | BOYAmt |
| EOY | $22,791,572 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$47,588 | BOYAmt |
| EOY | -$1,732,712 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,383,217 | BOYAmt |
| EOY | $2,467,200 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,335,629 | BOYAmt |
| EOY | $734,488 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,377,174 | BOYAmt |
| EOY | $23,526,060 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,685,124 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $83,983 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $94,524 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $49,290 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,207 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,202,301 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $509,318 | CurrentTaxYearAmt |
| Total | $2,882,640 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,979,510 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,283,031 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,319,721 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,679,998 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,459,693 | CurrentTaxYearAmt |
| Total | $67,721,953 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,074,034 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,332,321 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,346,928 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,882,299 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,969,011 | CurrentTaxYearAmt |
| Total | $70,604,593 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,676 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,207 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $65,220 | CurrentTaxYearMinus1YearAmt |
| Total | $184,103 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,676 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,207 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $65,220 | CurrentTaxYearMinus1YearAmt |
| Total | $184,103 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $70,420,490 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,428 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,778 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $906 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,787 | CurrentTaxYearAmt |
| Total | $15,710 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,428 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,778 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $906 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,787 | CurrentTaxYearAmt |
| Total | $15,710 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,084,462 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,334,099 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,347,739 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,883,205 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,970,798 | CurrentTaxYearAmt |
| Total | $70,620,303 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99720 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99640 | PublicSupportPY509Pct |
| Investment Income CY | 0.00020 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00020 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $84,442 | BeginningBalanceAmt |
| Additions During Year | $676,690 | AdditionsDuringYearAmt |
| Distributions During Year | $637,730 | DistributionsDuringYearAmt |
| Ending Balance | $123,402 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,383,217 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $83,983 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,467,200 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,328,708 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $119,729 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $65,220 | OtherExpendituresAmt |
| End Year Balance | $2,383,217 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,192,078 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $163,837 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $27,207 | OtherExpendituresAmt |
| End Year Balance | $2,328,708 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,806,059 | BeginningYearBalanceAmt |
| Contributions | $500,000 | ContributionsAmt |
| Investment Earnings Or Losses | -$65,981 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $48,000 | OtherExpendituresAmt |
| End Year Balance | $2,192,078 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,762,383 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $43,676 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,806,059 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | 0 | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,575 | OtherCostOrOtherBasisAmt |
| Book Value | $13,575 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,006,197 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,875,768 | DepreciationAmt |
| Book Value | $11,130,429 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,754,128 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,311,122 | DepreciationAmt |
| Book Value | $443,006 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,587,010 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| REPLACEMENT RESERVE | $597,770 |
| ESCROW AGREEMENT | $810,688 |
| CONSTRUCTION IN PROGRESS | $126,232 |
| BENEFICIAL INTEREST IN RELATED PART | $500,000 |
| BENEFICIAL INTEREST DONOR RESTR. TE | $1,967,200 |
| OTHER ASSETS | $65,134 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,067,024 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $1,640,209 |
| DUE TO THIRD-PARTY PAYORS | $221,094 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,861,303 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $14,970,798 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $14,970,798 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $14,970,798 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,655,922 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $16,655,922 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $16,655,922 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | THE ORGANIZATION IS CUSTODIAN FOR PERSONAL NEEDS ACCOUNTS MAINTAINED FOR RESIDENTS OF THE SKILLED NURSING FACILITY. |
| PART V, LINE 4: | THE ORGANIZATION IS THE SOLE BENEFICIARY OF A CHARITABLE TESTAMENTARY TRUST THAT IS ADMINISTERED BY UNRELATED FINANCIAL INSTITUTIONS. THE UNRELATED FINANCIAL INSTITUTIONS SET FORTH THE INVESTMENT POLICIES FOR THE TRUST. THE ORGANIZATION RECEIVED INCOME GENERATED BY THE TRUST FOR GENERAL PURPOSES AND IS INCLUDED AS CONTRIBUTION INCOME ON THAT STATEMENT OF ACTIVITIES. GAINS AND LOSSES ARE CONSIDERED RESTRICTED. THE ORGANIZATION HAS A BENEFICIAL INTEREST IN ASSETS THAT ARE HELD BY A RECIPIENT ORGANIZATION, CHELSEA JEWISH CHARITABLE FOUNDATION (THE FOUNDATION), A RELATED PARTY, IN THE AMOUNT OF $500,000 AT DECEMBER 31, 2021 AND 2020. THE ASSETS WILL BE TRANSFERRED TO THE ORGANIZATION WITH THE APPROVAL OF THE FOUNDATION. THE DONORS DID NOT GRANT VARIANCE POWER TO THE FOUNDATION. THE ORGANIZATION'S INTEREST IN NET ASSETS OF RECIPIENT ORGANIZATION IS REPORTED AT FAIR VALUE. |
| PART X, LINE 2: | THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) AND APPLICABLE STATE STATUTES; ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BARRY BERMAN | ||||||||||||||
| TREASURER | $0 | $677,007 | $0 | $0 | $0 | $34,678 | $0 | $800 | $0 | $19,597 | $0 | $732,082 | $0 | $0 |
| ADAM BERMAN | ||||||||||||||
| PRESIDENT AND CEO | $0 | $428,158 | $0 | $0 | $0 | $27,561 | $0 | $800 | $0 | $26,741 | $0 | $483,260 | $0 | $0 |
| JEFFREY LANDA | ||||||||||||||
| CFO | $0 | $276,879 | $0 | $0 | $0 | $0 | $0 | $800 | $0 | $28,724 | $0 | $306,403 | $0 | $0 |
| ELIZABETH MULLEN | ||||||||||||||
| COO AND CLERK | $0 | $252,926 | $0 | $0 | $0 | $0 | $0 | $800 | $0 | $10,200 | $0 | $263,926 | $0 | $0 |
| RONILO ANGLO | ||||||||||||||
| CHIEF CLINICAL OFFICER | $0 | $215,993 | $0 | $0 | $0 | $0 | $0 | $800 | $0 | $26,622 | $0 | $243,415 | $0 | $0 |
| KAREN PETRUCCELLI | ||||||||||||||
| VP CLINICAL QUALITY IMPROVEMENT | $0 | $198,950 | $0 | $0 | $0 | $0 | $0 | $800 | $0 | $11,938 | $0 | $211,688 | $0 | $0 |
| KATHERINE SANTOS | ||||||||||||||
| VP OF STRATEGY & OPERATION | $0 | $192,277 | $0 | $0 | $0 | $0 | $0 | $800 | $0 | $1,429 | $0 | $194,506 | $0 | $0 |
| ROGELIO MARTIN CALAUNAN | ||||||||||||||
| REGISTERED NURSE | $0 | $181,339 | $0 | $0 | $0 | $0 | $0 | $800 | $0 | $8,383 | $0 | $190,522 | $0 | $0 |
| THERESA HALLIDAY-BURRI | ||||||||||||||
| CHIEF BUSINESS DEVELOPMENT OFFICER | $0 | $172,926 | $0 | $0 | $0 | $0 | $0 | $800 | $0 | $10,238 | $0 | $183,964 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE CEO IS PAID FROM A RELATED ORGANIZATION. PRIOR TO MAJOR SALARY ADJUSTMENTS FOR THE CEO, THE ORGANIZATION'S BOARD OF DIRECTORS COMPENSATION COMMITTEE ARRANGES FOR A SALARY STUDY TO BE PERFORMED. THE STUDY INCLUDES THE EXECUTIVE SALARIES OF COMPARABLY-SIZED COMPANIES IN THE INDUSTRY. THE BOARD OF DIRECTORS THEN CONSIDERS THE FINDINGS OF THE STUDY IN SETTING THE CEO'S COMPENSATION. 2021 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. SOME OFFICERS AND KEY EMPLOYEES ARE PAID FROM A RELATED ORGANIZATION. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED THROUGH THE USE OF SALARY STUDIES OR OTHER DATA AND ADJUSTED BASED ON THE EMPLOYEE'S YEARS OF EXPERIENCE AND RESPONSIBILITIES BY A RELATED ORGANIZATION'S BOARD OF DIRECTORS COMPENSATION COMMITTEE AND THE ORGANIZATION'S BOARD OF DIRECTORS COMPENSATION COMMITTEE. 2021 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART IV, SECTION A, LINE 28C: | JEFFREY BRUDNICK, DIRECTOR OF CHELSEA JEWISH LIFECARE, INC., HAS A BUSINESS RELATIONSHIP WITH THE ORGANIZATION; HOWEVER TRANSACTION AMOUNTS ARE BELOW SCHEDULE L REPORTING THRESHOLDS. |
| FORM 990, PART V, LINE 2A: | THIS ORGANIZATION USES A COMMON PAYMASTER, AS SUCH, ALL EMPLOYEES ARE LISTED UNDER THE COMMON PAYMASTER, CHELSEA JEWISH LIFECARE, INC. OF THE 1239 EMPLOYEES PAID BY THE COMMON PAYMASTER, 206 EMPLOYEES HAD A PORTION OR ALL OF THEIR TIME ALLOCATED TO THIS ORGANIZATION DURING 2021. |
| FORM 990, PART VI, SECTION A, LINE 2 | ADAM BERMAN, PRESIDENT AND CEO, AND BARRY BERMAN, TREASURER, HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION ENTERED INTO A MANAGEMENT AGREEMENT WITH CHELSEA JEWISH LIFECARE EFFECTIVE JANUARY 1, 2017. CHELSEA JEWISH LIFECARE, INC. PROVIDED MANAGEMENT SERVICES WHICH INCLUDED THE FOLLOWING RESPONSIBILITIES: 1) KEY PERSONNEL MANAGEMENT 2) PERSONNEL OVERSIGHT (EMPLOYEES & ADMINISTRATION) 3) FINANCIAL RESPONSIBILITIES 4) MANAGEMENT REPORTS 5) REGULATORY COMPLIANCE 6) QUALITY ASSURANCE 7) PURCHASING & CONTRACTING 8) BANK ACCOUNTS |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS A RELATED ORGANIZATION, CHELSEA JEWISH LIFECARE, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE APPROVAL OF THE MEMBER, CHELSEA JEWISH LIFECARE, INC., IS REQUIRED TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE APPROVAL OF THE MEMBER, CHELSEA JEWISH LIFECARE, INC., IS REQUIRED BEFORE THE BOARD OF DIRECTOR'S ACTION ON ANY OF THE FOLLOWING BECOMES EFFECTIVE: (A) TO AMEND OR TO REPEAL THE ARTICLES OF ORGANIZATION OR THE BYLAWS OF THE CORPORATION; (B) TO APPROVE ALL PLANS OF MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, OR THE SALE, LEASE, ASSIGNMENT OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PURCHASE OR ACQUISITION BY THE CORPORATION OF THE CORPORATION OF AN INTEREST IN ANY CORPORATION, PARTNERSHIP, JOINT VENTURE OR OTHER ENTITY, WHETHER NEWLY CREATED OR PREVIOUSLY EXISTING, WHICH INTEREST, IN THE CASE OF A FOR-PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT (25%) OR MORE OF THE VOTING POWER THEREOF OR EQUITY INTEREST THEREIN, OR, IN THE CASE OF A NON-PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT (25%) OR MORE OF THE VOTING POWER THEREOF OR MEMBERSHIP INTEREST THEREIN; (C) TO APPROVE ALL GIFTS, GRANTS, DONATIONS OR SIMILAR TRANSFERS OF FUNDS OF THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OR ITS SUBSIDIARIES; (D) TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION; (E) TO APPROVE THE FORMATION OF ANY SUBSIDIARY OF THE CORPORATION; AND (F) TO APPOINT THE CORPORATION'S AUDITORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S COMPLETE FORM 990 IS REVIEWED BY THE TOP MANAGEMENT PRIOR TO FILING WITH THE IRS. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS, ALL BOARD MEMBERS ARE INSTRUCTED TO INFORM THE REST OF THE BOARD IF ANY CONFLICT OF INTEREST EXISTS PERTAINING TO THEIR MEMBERSHIP ON THE BOARD. ANY POTENTIAL CONFLICT OF INTEREST IS THEN DISCUSSED AND ASSESSED BY THE REMAINING BOARD MEMBERS. IF A CONFLICT EXISTS, IT MUST BE DISCLOSED AND HELD TO A HIGHER LEVEL OF SCRUTINY IN ORDER TO VERIFY THAT ALL TRANSACTIONS ARE AT ARMS-LENGTH. ANY BOARD MEMBER DEEMED TO HAVE A CONFLICT OF INTEREST WILL ABSTAIN FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. THE PRESIDENT AND CEO ARE RESPONSIBLE FOR OVERSEEING THAT THE CONFLICT OF INTEREST PROCESS TAKES PLACE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO IS PAID FROM A RELATED ORGANIZATION. PRIOR TO MAJOR SALARY ADJUSTMENTS FOR THE CEO, THE ORGANIZATION'S BOARD OF DIRECTORS COMPENSATION COMMITTEE ARRANGES FOR A SALARY STUDY TO BE PERFORMED. THE STUDY INCLUDES THE EXECUTIVE SALARIES OF COMPARABLY-SIZED COMPANIES IN THE INDUSTRY. THE BOARD OF DIRECTORS THEN CONSIDERS THE FINDINGS OF THE STUDY IN SETTING THE CEO'S COMPENSATION. 2021 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. FORM 990, PART VI, SECTION B, LINE 15B: SOME OFFICERS AND KEY EMPLOYEES ARE PAID FROM A RELATED ORGANIZATION. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED THROUGH THE USE OF SALARY STUDIES OR OTHER DATA AND ADJUSTED BASED ON THE EMPLOYEE'S YEARS OF EXPERIENCE AND RESPONSIBILITIES BY BOARD OF DIRECTORS CONPENSATION COMMITTEE. 2021 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | OTHER CHANGES IN NET ASSETS-990 CHANGE IN BENEFICIAL INTEREST 83,983. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CHELSEA JEWISH LIFECARE INC | |||||||||||
| 165 CAPTAINS ROW | CHELSEA | MA | 02150 | 510141617 | MANAGEMENT | MA | 501(C)(3) | LINE 7 | LEGACY LIFECARE INC | 0 | |
| ADMIRAL'S HILL ASSISTED LIVING CORP II | |||||||||||
| 165 CAPTAINS ROW | CHELSEA | MA | 02150 | 043538833 | ASSISTED LIVING | MA | 501(C)(3) | PF | CHELSEA JEWISH LIFECARE INC | 0 | |
| CHELSEA JEWISH COMMUNITY INC | |||||||||||
| 165 CAPTAINS ROW | CHELSEA | MA | 02150 | 271756594 | MANAGEMENT, HOMECARE, AND HOSPICE | MA | 501(C)(3) | LINE 10 | CHELSEA JEWISH LIFECARE INC | 0 | |
| CHELSEA JEWISH CHARITABLE FOUNDATION INC | |||||||||||
| 240 LYNNFIELD STREET | PEABODY | MA | 01960 | 261244471 | SUPPORT SERVICES & FUNDRAISING | MA | 501(C)(3) | LINE 12B, II | CHELSEA JEWISH LIFECARE INC | 0 | |
| CHELSEA JEWISH GREEN HOUSE INC | |||||||||||
| 165 CAPTAINS ROW | CHELSEA | MA | 02150 | 043326727 | ASSISTED LIVING & NURSING HOME | MA | 501(C)(3) | LINE 10 | CHELSEA JEWISH LIFECARE INC | 0 | |
| CHELSEA JEWISH NORTH SHORE ASSISTED LIVING INC | |||||||||||
| 240 LYNNFIELD STREET | PEABODY | MA | 01960 | 043274643 | ASSISTED LIVING | MA | 501(C)(3) | LINE 10 | CHELSEA JEWISH LIFECARE INC | 0 | |
| LEGACY LIFECARE INC | |||||||||||
| 240 LYNNFIELD STREET | PEABODY | MA | 01960 | 223102199 | SUPPORT SERVICES & FUNDRAISING | MA | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| JEWISH REHABILITATION CENTER FOR AGED OF THE NORTH SHORE INC | |||||||||||
| 240 LYNNFIELD STREET | PEABODY | MA | 01960 | 042106768 | SKILLED NURSING & ADH | MA | 501(C)(3) | LINE 10 | CHELSEA JEWISH LIFECARE INC | 0 | |
| JGS LIFECARE CORPORATION | |||||||||||
| 770 CONVERSE STREET | LONGMEADOW | MA | 01106 | 042129128 | GERIATRIC/NURSING PROVIDER | MA | 501(C)(3) | LINE 7 | CHELSEA JEWISH LIFECARE INC | 0 | |
| JGS ADMINISTRATIVE SERVICES | |||||||||||
| 770 CONVERSE STREET | LONGMEADOW | MA | 01106 | 043295014 | ADMIN SUPPORT TO JEWISH GERIATRIC SERVICES | MA | 501(C)(3) | LINE 10 | JGS LIFECARE CORPORATION | 0 | |
| JEWISH NURSING HOME OF WESTERN MA INC | |||||||||||
| 770 CONVERSE STREET | LONGMEADOW | MA | 01106 | 043138403 | SKILLED NURSING FACILITY | MA | 501(C)(3) | LINE 10 | JGS LIFECARE CORPORATION | 0 | |
| JGS HOUSING SERVICES INC | |||||||||||
| 770 CONVERSE STREET | LONGMEADOW | MA | 01106 | 043321157 | ASSISTED LIVING | MA | 501(C)(3) | LINE 10 | JGS LIFECARE CORPORATION | 0 | |
| SPECTRUM HOME HEALTH & HOSPICE | |||||||||||
| 770 CONVERSE STREET | LONGMEADOW | MA | 01106 | 043237982 | HOME HEALTH & HOSPICE CARE | MA | 501(C)(3) | LINE 10 | JGS LIFECARE CORPORATION | 0 | |
| SPECTRUM HOME CARE INC | |||||||||||
| 770 CONVERSE STREET | LONGMEADOW | MA | 01106 | 043399549 | NON-CERTIFIED HOME HEALTH AGENCY | MA | 501(C)(3) | LINE 10 | JGS LIFECARE CORPORATION | 0 | |
| DEUTSCHES ALTENHEIM INC | |||||||||||
| 2222 CENTRE STREET | WEST ROXBURY | MA | 02132 | 042104144 | SKILLED NURSING & ADH | MA | 501(C)(3) | LINE 10 | LEGACY LIFECARE INC | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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