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 061458630 SEABURY CHARITABLE FOUNDATION INC SEAB 8602860243 200 SEABURY DRIVE BLOOMFIELD CT 060022650 MARIAN MOORE TREASURER 8602860243 2020-05-19 1 LAURA J KENNEY P00202198 6177170831 2020-05-19 64.251.63.131 2020-05-19 19:55:35 ED P 212D4AA7D86991E97AAA9C7923B382683810470F F655607A01BC9414CB150F5C2D5B642F4B7C09E6 2018 2020-09-22 18:59:49Z MARIAN MOORE 200 SEABURY DRIVE BLOOMFIELD CT 060022650 290870 0 X N/A X 1996 CT TO SUPPORT CHURCH HOME OF HARTFORD, WHICH PROVIDES HOUSING AND SERVICES TO THE ELDERLY. 8 7 0 12 0 0 375724 87795 0 0 356131 160402 23000 -11707 754855 236490 1220582 193628 0 0 0 0 0 0 0 271745 215760 1492327 409388 -737472 -172898 6996768 6770541 206475 225887 6790293 6544654 TO SUPPORT CHURCH HOME OF HARTFORD, WHICH PROVIDES HOUSING AND SUPPLEMENTAL SERVICES TO THE ELDERLY. 0 0 400056 193628 TO SUPPORT CHURCH HOME OF HARTFORD, INC. WHICH OPERATES A HEALTH CARE AND INDEPENDENT LIVING COMMUNITY FOR THE ELDERLY AS WELL AS AN ASSISTED LIVING ALZHEIMER FACILITY. CHURCH HOME OF HARTFORD, INC. IS AFFILIATED WITH THE EPISCOPAL DIOCESE OF CONNECTICUT. 400056 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 8 7 1 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 1 0 0 0 X DAVID GREENBLATT CONTROLLER 8602860243 200 SEABURY DRIVE BLOOMFIELD CT 060022650 JAMES TRAIL MEMBER 0.30 0.00 X 0 0 0 A RAYMOND MADORIN MEMBER 0.30 0.30 X 0 0 0 GALE A MATTISON VICE CHAIR 0.30 0.90 X 0 0 0 MARIAN MOORE MEMBER 0.30 0.00 X 0 0 0 RENEE J BERNASCONI PRESIDENT & CEO (AS OF JUNE 2019) 0.30 40.30 X X 0 257172 30077 REV ERL G PURNELL CHAIR 0.30 0.60 X X 0 0 0 ROBERT STANWOOD TREASURER 0.30 0.00 X X 0 0 0 ANN WINSHIP SECRETARY 0.30 0.00 X X 0 0 0 RICHARD HEATH PRESIDENT & CEO (UNTIL JUNE 2019) 0.30 40.30 X X 0 385775 47358 0 642947 77435 0 0 1 0 CHURCH HOME OF HARTFORD INC 200 SEABURY DRIVE BLOOMFIELD CT 06002 CONTRACTED STAFFING 185737 1 79661 8134 87795 46349 46349 114053 0 114053 114053 114053 21943 79661 32953 -11010 -11010 20730 21427 -697 -697 236490 0 0 148695 193628 193628 2950 2950 12053 12053 6382 6382 1035 1035 4592 4592 CONTRACTED SERVICES 177222 177222 MISCELLANEOUS 9732 9732 PUBLICATIONS 1610 1610 POSTAGE 184 184 409388 400056 9332 0 74929 43317 5856 15224 85448 68888 37470 4091 77333 9185 32054 68148 4299026 4111235 2461985 2459638 6996768 6770541 12025 40790 194450 185097 206475 225887 X 6689019 6431586 101274 113068 6790293 6544654 6996768 6770541 -172898 -72741 0 X 0 1 X 1 0 X X 1 CHURCH HOME OF HARTFORD INCORPORATED 060293500 10 1 193628 0 1 193628 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4299025 109738 133563 193628 237464 4111234 4948719 431617 446127 1232481 294957 4299025 3640032 1748395 360261 121979 677990 4948719 3834917 374285 569170 3640032 6441101 196385 2802569 3834917 1.00000 0.00000 0.00000 0 0 77333 9185 68148 68148 SEABURY AT POWDER FOREST 2459638 C 2459638 ANNUITY PAYMENT LIABILITY 185097 185097 218129 -72741 54380 -18361 236490 0 236490 463768 54380 54380 409388 0 409388 PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO SUPPORT CHURCH HOME OF HARTFORD, INCORPORATED AND ITS SUBSIDIARIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: GOLF TOURNAMENT EXPENSES 32,953. VILLAGE STORE COST OF GOODS SOLD 21,427. PART XII, LINE 2D - OTHER ADJUSTMENTS: GOLF TOURNAMENT EXPENSES 32,953. VILLAGE STORE COST OF GOODS SOLD 21,427. GOLF TOURNAMENT 101604 79661 21943 2200 18354 12399 101604 79661 21943 2200 18354 12399 32953 -11010 1 CHURCH HOME OF HARTFORD INCORPORATED 200 SEABURY DRIVE BLOOMFIELD CT 06002 060293500 501(C)(3) 193628 RESIDENT SCHOLARSHIPS AND OTHER CHARITABLE 1 SCHEDULE I, PART I, LINE 2 THE SEABURY CHARITABLE FOUNDATION, INC. BOARD OF DIRECTORS CONSIDERS GIFT/GRANT REQUESTS OF ITS SUPPORTED ORGANIZATION, CHURCH HOME OF HARTFORD, INCORPORATED, AND VOTES WHETHER OR NOT TO FUND EACH REQUEST. TO DATE THE FOUNDATION HAS ONLY FUNDED VERY SPECIFIC REQUESTS. 0 0 0 0 0 0 0 0 0 RENEE J BERNASCONI PRESIDENT & CEO (AS OF JUNE 2019) 0 257172 0 0 0 0 0 18500 0 11577 0 287249 0 0 RICHARD HEATH PRESIDENT & CEO (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 BOARD MEMBER/OFFICER RENEE J. BERNASCONI HAS A BUSINESS RELATIONSHIP WITH BOARD MEMBERS JAMES TRAIL, A. RAYMOND MADORIN, GALE A. MATTISON AND REV. ERL G. PURNELL. 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 CHARITABLE FOUNDATION, INC. AND THE BOARD OF SEABURY, INC. ELECTS THE BOARD OF SEABURY CHARITABLE FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A SEABURY, INC., IS THE SOLE MEMBER OF SEABURY CHARITABLE FOUNDATION, INC. AND THE BOARD OF SEABURY, INC. ELECTS THE BOARD OF SEABURY CHARITABLE FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7B CHANGES TO BYLAWS AND ARTICLES OF ORGANIZATION MUST BE APPROVED BY THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOCUMENTED THE MEETINGS HELD AND WRITTEN ACTIONS UNDERTAKEN DURING THE YEAR BY THE GOVERNING BODY ONLY, AS THE SEABURY CHARITABLE FOUNDATION DOES NOT HAVE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. 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 AT HOME INCORPORATED 200 SEABURY DRIVE BLOOMFIELD CT 06002 205096169 TO PROVIDE HOME HEALTH SERVICES TO THE ELDERLY CT 501(C)(3) LINE 10 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 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0 CHURCH HOME OF HARTFORD INC B 193628 AMOUNT OF SUPPORT CHURCH HOME OF HARTFORD INC M 177222 FMV