2020-05-14T15:37:29-05:00 2019-06-30 593070669 MSL PA 201 E KENNEDY BLVD SUITE 650 TAMPA FL 33602 990 2018-07-01 592269292 MENORAH MANOR INC MENO 7273452775 255 59TH STREET NORTH ST PETERSBURG FL 33710 ROBERT GOLDSTEIN CHIEF EXECUTIVE OFFICER 7273452775 2020-05-14 1 NORMAN B NEAL CPA P00071411 8133142600 73.179.45.151 2020-05-14 15:22:46 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 2018 2021-01-29 14:40:06Z ROBERT GOLDSTEIN 255 59TH STREET NORTH ST PETERSBURG FL 33710 21247835 0 X WWW.MENORAHMANOR.ORG X 1981 FL THE ORGANIZATION'S MISSION IS TO OPERATE AND MAINTAIN A HOME AND PROVIDE OTHER SERVICES TO SHELTER, PROTECT AND PROVIDE SERVICES TO THE AGED. 17 16 479 17 0 0 917225 821743 20033150 20326372 1484 5903 784869 93817 21736728 21247835 3312 0 0 0 10704158 10753025 0 0 0 9962688 10192677 20670158 20945702 1066570 302133 11341706 10401829 15439444 15223227 -4097738 -4821398 THE ORGANIZATION'S MISSION IS TO OPERATE AND MAINTAIN A HOME AND PROVIDE OTHER SERVICES TO SHELTER, PROTECT AND PROVIDE SERVICES TO THE AGED. 0 0 18265216 0 20420189 SEE SCHEDULE O 18265216 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 15 0 1 479 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DONNA PERRYMAN 7273023702 255 59TH STREET NORTH ST PETERSBURG FL 33710 ROBERT WEISBERG PHD CHAIR 1.00 X X 0 0 0 HOWARD MILLER VICE CHAIR & CHAIR ELECT 1.00 X X 0 0 0 DAVID DELRAHIM ESQ TREASURER 1.00 X X 0 0 0 ADAM ABELSON SECRETARY 1.00 X X 0 0 0 BERNARD KANNER ESQ TRUSTEE 1.00 X 0 0 0 COLBY MASTERSON TRUSTEE 1.00 X 0 0 0 BARBARA BAUGHMAN TRUSTEE 1.00 1.00 X 0 0 0 SUSIE BERMAN TRUSTEE 1.00 1.00 X 0 0 0 RUTH GLICKMAN TRUSTEE 1.00 X 0 0 0 SAUL RACHELSON TRUSTEE 1.00 X 0 0 0 LINDA REIMER TRUSTEE 1.00 X 0 0 0 ERIC LUDIN ESQ TRUSTEE 1.00 X 0 0 0 DAVID MARGER TRUSTEE 1.00 X 0 0 0 BERNIE SAPPERSTEIN TRUSTEE 1.00 X 0 0 0 STEVEN WARREN MD TRUSTEE 1.00 1.00 X 0 0 0 DAVID WEIN MD TRUSTEE 1.00 X 0 0 0 ROBERT GOLDSTEIN CHIEF EXECUTIVE OFFICER 40.00 10.00 X X 172124 58968 30462 DONNA PERRYMAN CHIEF FINANCIAL OFFICER 40.00 10.00 X 144465 29712 18332 JUDY LUDIN CHIEF DEVELOPMENT OFFICER 20.00 20.00 X 47947 89725 7630 GREG YANN CONTROLLER 40.00 0.00 X 113744 0 2161 478280 178405 58585 5 0 1 0 ACCOUNTABLE HEALTHCARE STAFFING PO BOX 732800 DALLAS TX 75373 CONTRACTED SERVICES - NURSE AGENCY 1762603 FUNCTIONAL PATHWAYS OF TENNESSEE LLC 10133 SHERRILL BLVD SUITE 200 KNOXVILLE TN 37932 CONTRACTED SERVICES - REHABILITATION THE 1040929 MMI DINING SYSTEMS 1000 RED FERN PLACE FLOWOOD MS 39232 CONTRACTED SERVICES - DIETARY SERVICES 323274 NURSE CORE PO BOX 650823 DALLAS TX 75265 CONTRACTED SERVICES - MEDICAL STAFFING 195133 TAMPA BAY TEMPS INC 2441 FIFTH AVE N SAINT PETERSBURG FL 33713 CONTRACTED SERVICES - MEDICAL STAFFING 106951 5 21185 800558 821743 NET RESIDENT SERVICE R 623000 19234883 19234883 ASSISTED LIVING REVENU 623000 997560 997560 OTHER OPERATING REVENU 900099 93929 93929 20326372 5903 5903 OTHER INCOME 999999 63003 63003 WORKERS COMP REBATE 999999 30814 30814 93817 21247835 20420189 0 5903 X 327589 327589 8949763 7900956 1048807 110896 110896 675880 175228 500652 688897 564160 124737 94293 94293 31008 31008 4885198 4804174 81024 7470 4372 3098 432367 190566 241801 602696 602696 4004 1733 2271 42352 12383 29969 554261 522871 31390 757845 714924 42921 323779 323779 QUALITY ASSESSMENT FEE 1214105 1214105 SUPPLIES 1000739 1000739 EQUIPMENT RENTAL & MAIN 213248 203218 10030 COMMUNITY EDUCATION 29312 29312 20945702 18265216 2680486 0 2410 2410 852411 555967 1513017 1645408 88618 83301 395780 295869 25619519 19149385 6706240 6470134 1783230 1348740 11341706 10401829 1584998 1522411 10987962 9979447 1891787 1754852 974697 1966517 15439444 15223227 X -4097738 -4821398 -4097738 -4821398 11341706 10401829 302133 -1025793 0 X X 0 1 X 1 0 X 682330 628464 172206 917225 821743 3221968 682330 628464 172206 917225 821743 3221968 3221968 491 415 60 97 462 1525 33002 62855 36255 132112 3355605 110894140 0.96020 0.96650 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 243076 33124 276200 0 922761 922761 14976642 10989114 3987528 9651601 8160271 1491330 68515 68515 6470134 ASSETS WHOSE USE IS LIMITED 1345719 OTHER ASSETS 3021 1348740 RESIDENT DEPOSITS 140678 DUE TO(FROM) RELATED PARTY 80414 EMPLOYEE BENEFIT LIABILITY 745719 INTEREST RATE SWAP AGREEMENT 999706 1966517 20222042 -1025793 -1025793 21247835 0 21247835 20945702 0 20945702 0 20945702 PART IV, LINE 1B: THE ORGANIZATION OFFERS CASH MANAGEMENT SERVICES TO ITS RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF THE RESIDENTS AND ARE DISBURSED AS REQUESTED. THE ORGANIZATION ACTS ONLY AS A CUSTODIAN. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -1,025,793. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP X X X X X X 0 1 0 0 0 0 0 0 0 ROBERT GOLDSTEIN CHIEF EXECUTIVE OFFICER 0 58968 172124 0 0 0 24462 0 6000 0 202586 58968 0 0 DONNA PERRYMAN CHIEF FINANCIAL OFFICER 0 29712 144465 0 0 0 13332 0 5000 0 162797 29712 0 0 JUDY LUDIN CHIEF DEVELOPMENT OFFICER 0 89725 47947 0 0 0 0 2630 5000 0 52947 92355 0 0 PART I, LINE 4B ROBERT GOLDSTEIN PARTICIPATED IN A 457(F) PLAN - $19,856. DONNA PERRYMAN PARTICIPATED IN A 457(B) PLAN - $10,000. A CITY OF ST PETERSBURG HEALTH FACILITIES AUTHORITY 2014-10-01 32100000 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 3243163 32100000 200000 28656837 2014 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 0 0 NA 0 0 0 NA 0 0 0 A 1 SCHEDULE K, PART I, A,COLUMN(F) THE BOND PROCEEDS WILL BE USED FOR (1) FINANCING AND REFINANCING, INCLUDING THROUGH REIMBURSEMENT, OF ALL OR A PORTION OF THE COST OF THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF CERTAIN CAPITAL PROJECTS TO BE OWNED AND OPERATED BY MANORAH MANOR, INC, (2) REFINANCING CERTAIN LOANS FROM SUNTRUST BANK, (3) REFUNDING THE REFUNDING REVENUE AND REVENUE BONDS, SERIES 2009 AND 2012 PREVIOUSLY ISSUED BY THE AUTHORITY, (4) FUNDING AN OPERATING RESERVE AND REGULATORY RESERVE FUND AND, (5) FINANCING THE COSTS OF ISSUANCE OF THE SERIES 2014 BONDS. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND A MEMBER OF THE EXECUTIVE COMMITTEE, AS DESIGNEES OF THE GOVERNING BOARD, CONDUCT A COMPREHENSIVE REVIEW OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT-OF-INTEREST POLICY COVERS ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS, ALL LEVELS OF STAFF, CONSULTANTS AND VOLUNTEERS, AND ANY OTHER INDIVIDUAL WITH FIDUCIARY RESPONSIBILITY TO THE ORGANIZATION. IT IS THE RESPONSIBILITY OF ALL PERSONS COVERED TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES WHEN DETERMINED. THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD OF TRUSTEES REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE DISCLOSURE PROCESS AND DETERMINES WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO THE ORGANIZATION. THE PERSON WITH THE CONFLICT OF INTEREST WILL BE EXCLUDED FROM DISCUSSION AND APPROVAL OF SUCH TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES DETERMINES THE COMPENSATION AND BENEFITS OF THE CHIEF EXECUTIVE OFFICER AND OTHER TOP MANAGEMENT OFFICIALS. THE BOARD OF TRUSTEES IS INDEPENDENT WITH RESPECT TO COMPENSATION ARRANGEMENTS BEING CONSIDERED. THE BOARD OF TRUSTEES UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, SALARY SURVEYS AND REVIEWS THE FORM 990 OF OTHER COMPARABLE ORGANIZATIONS. THE REVIEW AND APPROVAL PROCESS IS DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G THERAPY AND MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 3,891,416. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,891,416. CONSULTING FEES: PROGRAM SERVICE EXPENSES 31,900. MANAGEMENT AND GENERAL EXPENSES 81,024. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 112,924. DIETARY SERVICES: PROGRAM SERVICE EXPENSES 880,858. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 880,858. FORM 990, PART XII, LINE 2C THE FINANCE COMMITTEE IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF THE INDEPENDENT AUDIT FIRM AND OVERSIGHT OF THE AUDIT. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE FINALIZED AND ISSUED SUBJECT TO THE APPROVAL OF THE BOARD OF TRUSTEES. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. MENORAH MANOR SENIOR LIVING LLC 255 59TH STREET NORTH ST PETERSBURG FL 33710 274697879 RESIDENTIAL LIVING FOR SENIOR CITIZENS FL 1097840 1131301 MENORAH MANOR INC MENORAH MANOR FOUNDATION INC 255 59TH STREET NORTH ST PETERSBURG FL 33710 592653608 PROVIDE SUPPORT FOR CHARITIES CARING FOR THE ELDERLY. FL 501(C)(3) LINE 12C, III-FI N/A 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0