2020-05-22T08:32:59-05:00 2019-09-30 061009205 BLUM SHAPIRO & COMPANY PC ONE INTERNATIONAL PLACE 16TH FLOOR BOSTON MA 02110 990 2018-10-01 205096169 SEABURY AT HOME INCORPORATED SEAB 8602860243 200 SEABURY DRIVE BLOOMFIELD CT 060022650 A RAYMOND MADORIN DIRECTOR 8602860243 2020-05-11 1 LAURA J KENNEY P00202198 6177170831 2020-05-11 64.251.63.131 2020-05-11 16:06:36 ED P 212D4AA7D86991E97AAA9C7923B382683810470F F655607A01BC9414CB150F5C2D5B642F4B7C09E6 2018 2020-09-23 17:36:50Z A RAYMOND MADORIN 200 SEABURY DRIVE BLOOMFIELD CT 060022650 2885272 0 X N/A X 2006 CT TO PROVIDE HOME HEALTH SERVICES TO THE ELDERLY. 4 3 0 3 0 0 0 0 2106299 2681082 26838 91455 248108 51888 2381245 2824425 0 0 0 0 0 0 0 0 0 2551978 2811936 2551978 2811936 -170733 12489 11159982 13028316 11732378 13588223 -572396 -559907 TO PROVIDE HOME HEALTH SERVICES TO THE ELDERLY. 0 0 1696702 2732970 TO PROVIDE, SPONSOR, INITIATE, DEVELOP, OPERATE AND MAINTAIN FACILITIES AND PROGRAMS FOR THE DELIVERY OF HEALTH CARE, PERSONAL CARE AND SUPPORT SERVICES TO THE ELDERLY DESIGNED TO PROMOTE AND EXTEND OPPORTUNITIES FOR INDEPENDENT LIVING AND PERSONAL HEALTH AND TO PROVIDE NON-MEDICAL HOME CARE SERVICES TO SENIORS AND INDIVIDUALS WITH DISABILITIES. 1696702 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 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 1 1 0 0 1 13 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 3 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X DAVID GREENBLATT CONTROLLER 8602860243 200 SEABURY DRIVE BLOOMFIELD CT 060022650 GALE A MATTISON CHAIR 0.30 0.90 X 0 0 0 RENEE J BERNASCONI PRESIDENT (AS OF JUNE 2019) 0.30 40.30 X X 0 257172 47358 JOHN F KEARNS III VICE PRESIDENT 0.30 0.00 X X 0 0 0 A RAYMOND MADORIN TREASURER & SECRETARY 0.30 0.30 X X 0 0 0 RICHARD HEATH PRESIDENT (UNTIL JUNE 2019) 0.30 40.30 X X 0 385775 47358 0 642947 94716 0 0 1 0 CHURCH HOME OF HARTFORD INCORPORATED 200 SEABURY DR BLOOMFIELD CT 06002 CONTRACTED STAFFING 1992282 ALWAYS THERE HOME CARE 35 TOMLINSON AVENUE PLAINVILLE CT 06062 CONTRACTED STAFFING 442765 HEARST MEDIA SERVICES PO BOX 80064 PRESCOTT AZ 86304 ADVERTISING 175632 3 HOME HEALTH SERV. FEES 621610 1687951 1687951 AMORT OF ENTRANCE FEES 621610 737895 737895 LTC INSURANCE REIMBURS 621610 255236 255236 2681082 152302 152302 60847 -60847 -60847 -60847 MISCELLANEOUS 900099 51888 51888 51888 2824425 2732970 0 91455 225 225 8950 8950 436996 436996 78436 78436 23538 23538 52080 52080 24753 24753 CONTRACTED SERVICES 1553248 1553248 OTHER CONTRACTED SERVIC 572362 85974 486388 TAXES AND LICENSES 35481 35481 MISCELLANEOUS 25867 5400 20467 2811936 1696702 1115234 0 91032 520252 6255967 8162765 1755563 1342063 7610 7853 960722 424977 587825 535745 2461985 2459638 11159982 13028316 307807 469703 8262389 9153098 3162182 3965422 11732378 13588223 X -572396 -559907 -572396 -559907 11159982 13028316 12489 0 X 0 1 X 1 0 X 1490820 1681091 1653822 2354407 2732970 9913110 1490820 1681091 1653822 2354407 2732970 9913110 0 0 0 9913110 20729 36989 63074 90662 152302 363756 20729 36989 63074 90662 152302 363756 1511549 1718080 1716896 2445069 2885272 10276866 0.96460 0.97300 0.03540 0.02700 X 315692 315692 545793 353666 192127 99237 71311 27926 535745 SEABURY AT POWDER FOREST 2459638 C 2459638 ENTRANCE FEES REFUNDS PAYABLE 3965422 3965422 2824425 0 2824425 0 2824425 2811936 0 2811936 0 2811936 0 0 0 0 0 0 0 0 0 RENEE J BERNASCONI PRESIDENT (AS OF JUNE 2019) 0 257172 0 0 0 0 0 31111 0 16247 0 304530 0 0 RICHARD HEATH PRESIDENT (UNTIL JUNE 2019) 0 309617 0 76158 0 0 0 18500 0 28858 0 433133 0 0 PART I, LINE 3 THE PRESIDENT IS COMPENSATED BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH HER COMPENSATION: A COMPENSATION COMMITTEE, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR A COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 2 OFFICER RENEE J. BERNASCONI HAS A BUSINESS RELATIONSHIP WITH BOARD MEMBERS GALE A. MATTISON AND A. RAYMOND MADORIN. SHE IS EMPLOYED BY A RELATED ORGANIZATION OF WHICH THEY ARE ALSO BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 SEABURY, INC., IS THE SOLE MEMBER OF SEABURY AT HOME, INC. AND THE BOARD OF SEABURY, INC. ELECTS THE BOARD OF SEABURY AT HOME, INC. FORM 990, PART VI, SECTION A, LINE 7A SEABURY, INC., IS THE SOLE MEMBER OF SEABURY AT HOME, INC. AND THE BOARD OF SEABURY, INC. ELECTS THE BOARD OF SEABURY AT HOME, INC. FORM 990, PART VI, SECTION A, LINE 7B CHANGES TO BYLAWS AND ARTICLES OF ORGANIZATION MUST BE APPROVED BY MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AFTER IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REVIEWING THE POLICY AT BOARD ORIENTATION AND AT BOARD MEETINGS THROUGHOUT THE YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO IS COMPENSATED BY CHURCH HOME OF HARTFORD, INCORPORATED, THEREFORE, HER COMPENSATION IS DETERMINED BY THE BOARD OF CHURCH HOME OF HARTFORD. COMPENSATION IS DETERMINED USING A REVIEW OF LIKE ORGANIZATIONS, FORM 990 REPORT FOR TOP PAID EMPLOYEES, AND USE OF ASSOCIATION WAGE SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE DOCUMENTS ARE RETAINED IN SEABURY'S LIBRARY AND ARE AVAILABLE UPON REQUEST. SEABURY INC 200 SEABURY DRIVE BLOOMFIELD CT 06002 842187536 TO PROVIDE SUPPORT TO THE SUPPORTED ORGANIZATIONS CT 501(C)(3) LINE 12A, I 0 CHURCH HOME OF HARTFORD INCORPORATED 200 SEABURY DRIVE BLOOMFIELD CT 06002 060293500 TO PROVIDE HOUSING AND SUPPLEMENTAL SERVICES TO THE ELDERLY CT 501(C)(3) LINE 10 SEABURY INC 1 SEABURY CHARITABLE FOUNDATIONINC 200 SEABURY DRIVE BLOOMFIELD CT 06002 061458630 TO PROVIDE SUPPORT TO CHURCH HOME OF HARTFORD, INCORPORATED CT 501(C)(3) LINE 12A, I SEABURY INC 1 SEABURY AT POWDER FOREST LLC 200 SEABURY DRIVE BLOOMFIELD CT 06002 474481221 REAL ESTATE CT N/A RELATED -60847 2459638 0 0 0.50000 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 1 0 0 0 CHURCH HOME OF HARTFORD INC K 58092 FMV CHURCH HOME OF HARTFORD INC M 1553248 FMV CHURCH HOME OF HARTFORD INC E 385246 FMV