2021-11-12T10:03:57-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2020-01-01 042200583 CHELSEA JEWISH NURSING HOME INC CHEL 6178870001 17 LAFAYETTE AVENUE CHELSEA MA 02150 JEFFREY LANDA CFO 6178870001 2021-11-10 1 JEFFREY LANDA 999009999 DOUGLAS FIEBELKORN P00173341 7819821001 2021-11-09 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z KATZMAN FAMILY CENTER FOR LIVING ADAM BERMAN 240 LYNNFIELD STREET PEABODY MA 01960 15883205 0 X WWW.CHELSEAJEWISH.ORG X 1919 MA TO PROVIDE THE HIGHEST LEVEL OF SKILLED NURSING AND REHABILITATION SERVICES. 6 2 201 3 0 0 27207 2202301 13322047 13679998 811 906 3275 0 13353340 15883205 0 0 0 0 7755395 8338821 0 0 124862 6122999 6725000 13878394 15063821 -525054 819384 20848387 22377174 19386651 20041545 1461736 2335629 X 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. 0 0 12625435 13679998 NURSING HOME - OPERATION OF A 120-BED SKILLED NURSING FACILITY PROVIDING NURSING CARE, REHABILITATION THERAPIES AND OTHER SKILLED SERVICES TO FRAIL ELDERLY. 12625435 1 1 0 0 0 0 0 0 0 1 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 1 0 0 0 0 0 0 1 0 0 0 1 15 0 201 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 2 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X JEFFREY LANDA 9784715100 240 LYNNFIELD STREET PEABODY MA 01960 BARRY BERMAN CEO AND TREASURER 1.00 39.00 X X 0 708781 10885 ADAM BERMAN PRESIDENT 1.00 39.00 X X 0 405889 19653 ELIZABETH MULLEN COO AND CLERK 1.00 39.00 X X 0 252721 8658 GILDA RICHMAN CHAIR 1.00 39.00 X X 0 75278 110 JOEL MAZER DIRECTOR 1.00 7.00 X 0 0 0 JUDY WEISS DIRECTOR 1.00 7.00 X 0 0 0 JEFFREY LANDA CFO 1.00 39.00 X 0 308473 18060 RONILO ANGLO CHIEF CLINICAL OFFICER 1.00 39.00 X 0 240736 18449 KATHERINE SANTOS VP OF STRATEGY & OPERATIONAL EXCELLENCE 1.00 39.00 X 0 212816 1578 ESTHER KAIRU LPN 0.00 40.00 X 0 187788 13747 THERESA HALLIDAY-BURRI CHIEF DEVELOPMENT OFFICER 1.00 39.00 X 0 189904 7532 ARTHUR SCHUNCK SINDONI SR. VP OF FINANCE 1.00 39.00 X 0 183771 2327 0 2766157 100999 6 0 1 0 PROEMS SOLUTIONS 31 SMITH PL CAMBRIDGE MA 02138 COVID-19 TESTING 163560 1 2137081 65220 2202301 PROGRAM SERVICE REVENUE 623990 13679992 13679992 OTHER INCOME 623990 6 6 13679998 906 906 15883205 13679998 0 906 7585518 6552317 908339 124862 27658 27658 185433 161084 24349 540212 540108 104 820795 759356 61439 4409 4128 281 58909 55154 3755 301058 274121 26937 167 162 5 130262 103226 27036 24818 24818 401445 358240 43205 2159 2090 69 360 348 12 661278 611327 49951 1025083 948352 76731 698685 663530 35155 SUPPLIES & EXPENSE 1059255 1054055 5200 USER FEE ASSESSMENT 687883 687883 FOOD 343905 343905 BAD DEBT EXPENSE 270738 270738 233791 193932 39859 15063821 12625435 2313524 124862 1357321 2934374 2317135 2371551 191746 194667 23656724 11169160 13415863 12487564 500000 3566322 3889018 20848387 22377174 1425538 1634737 29529 9745 16227077 16022855 1704507 2374208 19386651 20041545 X -866972 -47588 2328708 2383217 1461736 2335629 20848387 22377174 X 819384 54509 X 0 1 X 1 1 1 X 41055 94524 49290 27207 2202301 2414377 11834736 12979510 13283031 13319721 13679998 65096996 11875791 13074034 13332321 13346928 15882299 67511373 41055 43676 48000 27207 65220 225158 0 41055 43676 48000 27207 65220 225158 67286215 1714 10428 1778 811 906 15637 1714 10428 1778 811 906 15637 11877505 13084462 13334099 13347739 15883205 67527010 0.99640 0.99680 0.00020 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2328708 119729 65220 2383217 2192078 163837 27207 2328708 1806059 500000 -65981 48000 2192078 1762383 43676 1806059 1721328 41055 1762383 0.00000 0.00000 1.00000 1 1 0 13575 13575 21997219 9947031 12050188 1645930 1222129 423801 12487564 REPLACEMENT RESERVE 510482 MORTGAGE ESCROW ACCOUNTS 810995 CONSTRUCTION IN PROGRESS 126232 BENEFICIAL INTEREST IN NET ASSETS OF RELATED PARTY 500000 BENEFICIAL INTEREST IN TESTAMENTARY TRUST 1883217 MISCELLANEOUS OTHER ASSETS 58092 3889018 DUE TO RELATED PARTIES 1706880 DUE TO THIRD-PARTY PAYORS 667328 2374208 X 15883205 0 15883205 0 15883205 15063821 0 15063821 0 15063821 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, 2020 AND 2019. 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 IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FILES AS A TAX-EXEMPT ENTITY. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ITS 2017 THROUGH 2020 TAX YEARS ARE OPEN FOR EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES. THE ORGANIZATION FOLLOWS THE POLICY FOR UNCERTAINTY IN INCOME TAXES TO BE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE POLICY PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. NO UNCERTAIN INCOME TAX POSITIONS WERE IDENTIFIED FOR THE YEAR ENDED DECEMBER 31, 2020. THE ORGANIZATION EVALUATES TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN ITS TAX RETURNS TO DETERMINE WHETHER THE TAX POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITY. TAX POSITIONS NOT DEEMED TO MEET THE MORE LIKELY THAN NOT THRESHOLD, ALONG WITH ACCRUED INTEREST AND PENALTY THEREON WOULD BE RECORDED AS AN EXPENSE IN THE CURRENT YEAR FINANCIAL STATEMENTS. AT DECEMBER 31, 2020, MANAGEMENT BELIEVES THAT IT HAS NO UNCERTAIN TAX POSITIONS WITH ANY OF ITS OPEN TAX YEARS. X X 0 0 0 0 0 0 0 0 0 BARRY BERMAN CEO AND TREASURER 0 681362 0 0 0 27419 0 1455 0 9430 0 719666 0 0 ADAM BERMAN PRESIDENT 0 390424 0 0 0 15465 0 1960 0 17693 0 425542 0 0 JEFFREY LANDA CFO 0 308473 0 0 0 0 0 1430 0 16630 0 326533 0 0 ELIZABETH MULLEN COO AND CLERK 0 252721 0 0 0 0 0 1573 0 7085 0 261379 0 0 RONILO ANGLO CHIEF CLINICAL OFFICER 0 240736 0 0 0 0 0 979 0 17470 0 259185 0 0 KATHERINE SANTOS VP OF STRATEGY & OPERATIONAL EXCELLE 0 212816 0 0 0 0 0 0 0 1578 0 214394 0 0 ESTHER KAIRU LPN 0 187788 0 0 0 0 0 731 0 13016 0 201535 0 0 THERESA HALLIDAY-BURRI CHIEF DEVELOPMENT OFFICER 0 189904 0 0 0 0 0 874 0 6658 0 197436 0 0 ARTHUR SCHUNCK SINDONI SR. VP OF FINANCE 0 183771 0 0 0 0 0 1060 0 1267 0 186098 0 0 JEFFREY BRUDNICK (LOUIS J BRUDNICK & SONS) JEFFREY BRUDNICK IS A DIRECTOR OF THE BOARD OF CHELSEA JEWISH LIFECARE 30728 INSURANCE BROKER/AGENT 0 FORM 990, PART VI, SECTION A, LINE 2 ADAM BERMAN, PRESIDENT, 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 MANAGEMENT TEAM WILL CONDUCT A REVIEW OF THE FORM 990 AFTER IT HAS BEEN FINALIZED, INCLUDING READING AND REVIEWING THE KEY INFORMATION. MANAGEMENT WILL REPORT TO THE BOARD IF THERE ARE ANY MAJOR DEVIATIONS FROM THE PROVIDED DATA. 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. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS PAID FROM A RELATED ORGANIZATION. PRIOR TO MAJOR SALARY ADJUSTMENTS FOR THE CEO, A RELATED ORGANIZATION'S BOARD OF DIRECTORS 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. 2019 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: 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. 2019 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 -65,220. CHANGE IN BENEFICIAL INTEREST IN TESTAMENTARY TRUST 119,729. CHELSEA JEWISH LIFECARE INC 165 CAPTAINS ROW CHELSEA MA 02150 510141617 MANAGEMENT MA 501(C)(3) LINE 7 N/A 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 7 N/A 0 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 WINTHROP APARTMENTS LLC 165 CAPTAINS ROW CHELSEA MA 02150 463739775 REAL ESTATE MA N/A 0 0 0 0 1 1 0 0 0 0 0 1 0 1 1 1 0 0 0 0