2020-07-15T11:51:00-05:00 2019-06-30 593070669 MSL PA 500 E BROWARD BLVD SUITE 1550 FORT LAUDERDALE FL 33394 990 2018-07-01 273293469 DGN III INC DGNI 3057518626 5200 NE 2ND AVENUE MIAMI FL 33137 DAN O'DONNELL CHIEF FINANCIAL OFFICER 3057518626 2020-07-15 1 HEIDI G ALLES P02149266 9548478910 68.95.178.125 2020-07-15 11:41:20 ED P 7FC0E18F63597829422D687723989F114BEB8769 ED790DDA320950C8CA808C751220ABE6F56A1A3D 2018 2021-01-29 14:40:06Z JEFFREY FREIMARK 5200 NE 2ND AVENUE MIAMI FL 33137 896271 0 X WWW.MIAMIJEWISHHEALTHSYSTEMS.ORG X 2010 FL SEE SCHEDULE O.THE ORGANIZATION OPERATES A 75-UNIT MULTI-FAMILY APARTMENT COMPLEX TO HOUSE LOW-INCOME ELDERLY PERSONS UNDER SECTION 202 OF THE NATIONAL HOUSING ACT. 5 5 0 5 0 0 263952 263952 555711 621148 208 226 10489 10945 830360 896271 0 0 0 0 0 0 0 0 0 886759 937949 886759 937949 -56399 -41678 9482914 9161020 9437685 9157469 45229 3551 X THE ORGANIZATION OPERATES A 75-UNIT MULT-FAMILY APARTMENT COMPLEX TO HOUSE LOW INCOME ELDERLY PERSONS UNDER SECTION 202 OF THE NATIONAL HOUSING ACT. 0 0 822549 632093 SEE SCHEDULE O.THE ORGANIZATION WAS FORMED TO BE A SINGLE ASSET CORPORATION FOR FUNDING THE DEVELOPMENT, CONSTRUCTION AND OPERATION OF A LOWER-INCOME ELDERLY PERSONS HOUSING FACILITY THROUGH SECTION 202 PROGRAM OF THE HOUSING ACT OF 1959 WITH RENTAL SUBSIDY THROUGH THE SECTION 8 PROGRAM. THE PROJECT WILL BE AN INDEPENDENT LIVING COMPLEX DESIGNED WHOLLY FOR LOWER-INCOME, ELDERLY PERSONS. THE ORGANIZATION IS SPONSORED BY MIAMI JEWISH HEALTH SYSTEMS, INC., A FLORIDA NON-PROFIT CORPORATION, AND IS AN OUTREACH OF ITS HOUSING COMMITMENT.THE ORGANIZATION WILL PROVIDE HOUSING FOR LOWER-INCOME ELDERLY PERSONS AS REGULATED UNDER THE SECTION 202 AND SECTION 8 PROGRAMS AS ADMINISTERED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT BY INCREASING THE AVAILABILITY OF HOUSING FOR SUCH INDIVIDUALS AND PROVIDING AN ALTERNATIVE TO THE SUBSTANDARD AND INSTITUTIONAL TYPE OF HOUSING IN WHICH MANY LOWER-INCOME ELDERLY PEOPLE NOW RESIDE. 822549 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 12 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X DAN O'DONNELL 3057518626 5200 NE 2ND AVENUE MIAMI FL 33137 ALFRED J KATZIN CHAIR 1.00 6.00 X X 0 0 0 LESLIE TORRES SECRETARY 1.00 39.00 X X 0 78550 10880 RICHARD SKELLY TREASURER/CFO 1.00 41.00 X X 0 569301 7800 ROBERT J BECHT TREASURER/CFO 1.00 36.00 X X 0 0 0 JEFFREY FREIMARK MEMBER 1.00 43.00 X 0 1480872 7800 RONALD FIELDSTONE MEMBER 1.00 5.00 X 0 0 0 DR RITA GUGEL DIRECTOR 1.00 2.00 X 0 0 0 RENEE LEFTON DIRECTOR 1.00 2.00 X 0 0 0 ISMAEL MONROIG JR DIRECTOR 1.00 2.00 X 0 0 0 JASON PINCUS MEMBER 1.00 10.00 X 0 227773 7800 ELLIOT SKLAR PHD DIRECTOR 1.00 2.00 X 0 0 0 0 2356496 34280 0 0 1 0 0 263952 263952 RENTAL ASSISTANCE CONT 623990 372244 372244 RESIDENTIAL RENTAL REV 623990 248904 248904 621148 226 226 LAUNDRY REVENUE 900099 10945 10945 10945 896271 632093 0 226 X 52800 52800 12056 8493 3563 103856 103716 140 551 388 163 18527 13051 5476 3000 2113 887 256959 256959 3440 2423 1017 313013 313013 7672 5404 2268 SALARY AND BENEFIT ALLO 164605 115953 48652 UNIFORMS 1250 881 369 SUPPLIES 137 97 40 FOOD 83 58 25 937949 822549 115400 0 46907 9242 403640 402111 205 27636 34332 10665715 1951385 8984448 8714330 20283 800 9482914 9161020 60946 51744 9376739 9105725 9437685 9157469 X 45229 3551 45229 3551 9482914 9161020 -41678 0 X X 0 1 X 1 1 1 X 263952 263952 263952 263952 263952 1319760 263952 263952 263952 263952 263952 1319760 1319760 691 703 251 208 226 2079 10350 10605 11066 10489 10945 53455 1375294 0.95960 0.96950 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: LAUNDRY REVENUE - 2014 AMOUNT: $ 10,350. 2015 AMOUNT: $ 10,605. 2016 AMOUNT: $ 11,066. 2017 AMOUNT: $ 10,489. 2018 AMOUNT: $ 10,945. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9776726 1561240 8215486 888989 390145 498844 8714330 DUE TO/FROM AFFILIATES 153339 HUD CAPITAL ADVANCE 8952386 9105725 X 896271 0 896271 0 896271 937949 0 937949 0 937949 PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION EXEMPT FROM INCOME TAXES, AS DESCRIBED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO INCOME TAX LIABILITY OR PROVISION FOR INCOME TAXES IS INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. 0 1 0 0 0 0 0 1 0 RICHARD SKELLY TREASURER/CFO 0 380051 0 189250 0 0 0 0 0 12194 0 581495 0 0 JEFFREY FREIMARK MEMBER 0 980872 0 500000 0 0 0 760600 0 11014 0 2252486 0 0 JASON PINCUS MEMBER 0 189773 0 38000 0 0 0 8000 0 11160 0 246933 0 0 PART I, LINE 3 MIAMI JEWISH HEALTH SYSTEMS, INC., A RELATED ORGANIZATION, UTILIZES THE COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, THE FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OF DIRECTORS OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE PRESIDENT/CEO. PART I, LINE 4B MIAMI JEWISH HEALTH SYSTEMS, INC., A RELATED ORGANIZATION, OFFERS A NONQUALIFIED EXECUTIVE PENSION BENEFIT THROUGH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") AGREEMENT. THE CEO PARTICIPATES IN THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. PART I, LINE 7 BONUSES ARE DETERMINED AT THE DISCRETION OF MANAGEMENT. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP CONSISTS OF THE DIRECTORS OF MIAMI JEWISH HEALTH SYSTEMS, INC., A RELATED ORGANIZATION. MEMBERS HAVE THE POWER TO ELECT AND REMOVE DIRECTORS FROM THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER, MIAMI JEWISH HEALTH SYSTEMS, INC., HAS THE AUTHORITY TO ELECT AND REMOVE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE ORGANIZATION'S BOARD OF DIRECTORS ARE SUBJECT TO THE APPROVAL OF ITS SOLE MEMBER, MIAMI JEWISH HEALTH SYSTEMS, INC. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF FINANCIAL OFFICER AND CONTROLLER OF MIAMI JEWISH HEALTH SYSTEMS, INC. CONDUCT A COMPREHENSIVE REVIEW OF THE FORM 990 AND, THEREAFTER, A COMPLETE COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS, EACH OF WHOM IS REQUIRED TO COMPLETE AND SUBMIT A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. THE COMPLIANCE OFFICERS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY, AND REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE ANNUAL DISCLOSURE PROCESS. OFFICERS AND DIRECTORS ARE PROHIBITED FROM VOTING WHERE ACTUAL CONFLICTS OF INTEREST EXIST. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO IS COMPENSATED BY MIAMI JEWISH HEALTH SYSTEMS, INC. (MJHS), A RELATED ORGANIZATION. THE CEO REPORTS DIRECTLY TO THE BOARD OF DIRECTORS, AND THE COMPENSATION COMMITTEE OF THE BOARD IS RESPONSIBLE FOR APPROVING THE CEO'S COMPENSATION ADJUSTMENTS. THE COMPENSATION COMMITTEE REVIEWS AND APPROVES ANY CHANGES IN BASE COMPENSATION AS WELL AS BONUSES AND OTHER COMPONENTS ON AN ANNUAL BASIS. ALL OTHER OFFICERS AND KEY EMPLOYEES ARE COMPENSATED BY MJHS. COMPENSATION OF ALL OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO AND IS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. FORMAL COMPENSATION STUDIES ARE REQUESTED AND CONDUCTED AS NEEDED. THE MINUTES OF THE COMPENSATION COMITTEE DOCUMENT THE DECISIONS AND DELIBERATIONS OF THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 103,381. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 103,381. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 335. MANAGEMENT AND GENERAL EXPENSES 140. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 475. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT OF THE COMPILATION OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. MIAMI JEWISH HEALTH SYSTEMS INC 5200 NE 2ND AVENUE MIAMI FL 33137 590624414 HEALTHCARE FL 501(C)(3) LINE 10 0 DGN II INC 5200 NE 2ND AVENUE MIAMI FL 33137 651270932 LOW INCOME HOUSING FOR THE ELDERLY FL 501(C)(3) LINE 7 MIAMI JEWISH HEALTH SYSTEMS INC 0 DGN INC 5200 NE 2ND AVENUE MIAMI FL 33137 113672256 LOW INCOME HOUSING FOR THE ELDERLY FL 501(C)(3) LINE 7 MIAMI JEWISH HEALTH SYSTEMS INC 0 DOUGLAS GARDENS ACQUISITION 5200 NE 2ND AVENUE MIAMI FL 33137 650799424 HOLD TITLE TO PROPERTY AND COLLECT RENT FL 501(C)(2) MIAMI JEWISH HEALTH SYSTEMS INC 0 STEIN GERONTOLOGICAL INSTITUTE INC 5200 NE 2ND AVENUE MIAMI FL 33137 650289632 GERONTOLOGICAL RESEARCH FL 501(C)(3) LINE 10 MIAMI JEWISH HEALTH SYSTEMS INC 0 DOUGLAS GARDENS HOLDING CORP INC 5200 NE 2ND AVENUE MIAMI FL 33137 237302931 SUPPORT MIAMI JEWISH HEALTH SYSTEMS, INC. FL 501(C)(2) MIAMI JEWISH HEALTH SYSTEMS INC 0 FLORIDA PATHWAYS INC 5200 NE 2ND AVENUE MIAMI FL 33137 650198276 HOLDING PROPERTY LEASE FL 501(C)(3) LINE 7 MIAMI JEWISH HEALTH SYSTEMS INC 0 DOUGLAS GARDENS THRIFT SHOP INC 5200 NE 2ND AVENUE MIAMI FL 33137 650856154 SUPPORT MIAMI JEWISH HEALTH SYSTEMS, INC. & AFFILIATES FL 501(C)(3) LINE 12A, I MIAMI JEWISH HEALTH SYSTEMS INC 0 DOUGLAS GARDENS HOME CARE INC 5200 NE 2ND AVENUE MIAMI FL 33137 651151478 NURSE REGISTRY PROGRAM/HEALTHCARE FL 501(C)(3) LINE 10 MIAMI JEWISH HEALTH SYSTEMS INC 0 DOUGLAS GARDENS SENIOR HOUSING INC 5200 NE 2ND AVENUE MIAMI FL 33137 650838183 MANAGEMENT SERVICES TO RELATED ORGANIZATIONS FL 501(C)(3) LINE 12A, I MIAMI JEWISH HEALTH SYSTEMS INC 0 MIAMI JEWISH HEALTH SYSTEMS FOUNDATION INC 5200 NE 2ND AVENUE MIAMI FL 33137 200267158 SOLICIT & INVEST CONTRIBUTIONS ON BEHALF OF MIAMI JEWISH HEALTH SYSTEMS, INC FL 501(C)(3) LINE 10 MIAMI JEWISH HEALTH SYSTEMS INC 0 FLORIDA PACE CENTERS INC 5200 NE 2ND AVENUE MIAMI FL 33137 651051439 HEALTHCARE FL 501(C)(3) LINE 10 MIAMI JEWISH HEALTH SYSTEMS INC 0 WOLFCYPEN FOUNDATION 5200 NE 2ND AVENUE MIAMI FL 33137 656417244 INVESTMENT OF CONTRIBUTIONS FL 501(C)(3) LINE 12A, I MIAMI JEWISH HEALTH SYSTEMS INC 0 DOUGLAS GARDENS MIAMI LAKES HOLDING CORPORATION 5200 NE 2ND AVENUE MIAMI FL 33137 824481718 SUPPORT MIAMI JEWISH HEALTH SYSTEMS, INC. FL 501(C)(3) LINE 12A, I MIAMI JEWISH HEALTH SYSTEMS INC 0 MIAMI JEWISH HOME HEALTH AGENCY LLC 5200 NE 2ND AVENUE MIAMI FL 33137 300757717 HEALTHCARE FL 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0