2019-07-12T11:24:02-05:00 2018-09-30 061009205 BLUM SHAPIRO & COMPANY PC ONE INTERNATIONAL PLACE 16TH FLOOR BOSTON MA 02110 990 2017-10-01 205096169 SEABURY AT HOME INCORPORATED SEAB 8602860243 200 SEABURY DRIVE BLOOMFIELD CT 060022650 A RAYMOND MADORIN DIRECTOR 8602860243 2019-06-30 1 LAURA J KENNEY P00202198 6177170831 2019-06-30 64.251.63.131 2019-06-30 14:37:20 ED P C2A8F68C24BA4106533A6CD8C72FD917E7C6626D 212D4AA7D86991E97AAA9C7923B382683810470F 2017 2019-02-21 02:37:17Z A RAYMOND MADORIN 200 SEABURY DRIVE BLOOMFIELD CT 060022650 2445069 0 X N/A X 2006 CT TO PROVIDE HOME HEALTH SERVICES TO THE ELDERLY. 4 3 0 3 0 0 0 0 1460326 2106299 -194525 26838 212977 248108 1478778 2381245 0 0 0 0 0 0 0 0 0 1848666 2551978 1848666 2551978 -369888 -170733 11138048 11159982 11539711 11732378 -401663 -572396 TO PROVIDE HOME HEALTH SERVICES TO THE ELDERLY. 0 0 2181857 2354407 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. 2181857 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 7 0 1 0 0 0 0 0 0 0 0 0 0 0 X 4 3 1 0 1 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 DIRECTOR 0.30 0.90 X 0 0 0 RICHARD C HEATH PRESIDENT 0.30 40.30 X X 0 355520 40370 JOHN F KEARNS III VICE PRESIDENT 0.30 0.00 X X 0 0 0 A RAYMOND MADORIN TREASURER & SECRETARY 0.30 0.90 X X 0 0 0 0 355520 40370 0 0 1 0 CHURCH HOME OF HARTFORD INCORPORATED 200 SEABURY DR BLOOMFIELD CT 06002 CONTRACTED STAFFING 1912298 ALWAYS THERE HOME CARE 35 TOMLINSON AVENUE PLAINVILLE CT 06062 CONTRACTED STAFFING 409227 HEARST MEDIA SERVICES PO BOX 80064 PRESCOTT AZ 86304 ADVERTISING 121182 3 HOME HEALTH SERV. FEES 621610 1704739 1704739 AMORT OF ENTRANCE FEES 621610 401560 401560 2106299 90662 90662 63824 -63824 -63824 -63824 MISCELLANEOUS 900099 248108 248108 248108 2381245 2354407 0 26838 1208 1208 8330 8330 314035 314035 62316 31158 31158 23858 23858 51694 51694 20981 20981 CONTRACTED SERVICES 1575197 1575197 OTHER CONTRACTED SERVIC 429480 429480 MISCELLANEOUS 33312 17922 15390 TAXES AND LICENSES 31011 31011 556 556 2551978 2181857 370121 0 523351 91032 6230988 6255967 1256060 1755563 33808 7610 960722 372897 631032 587825 2462809 2461985 11138048 11159982 432226 307807 7608799 8262389 3498686 3162182 11539711 11732378 X -401663 -572396 -401663 -572396 11138048 11159982 -170733 0 X 0 1 X 1 0 X 1153112 1490820 1681091 1653822 2354407 8333252 1153112 1490820 1681091 1653822 2354407 8333252 0 0 0 8333252 20119 20729 36989 63074 90662 231573 20119 20729 36989 63074 90662 231573 1173231 1511549 1718080 1716896 2445069 8564825 0.97300 0.97650 0.02700 0.02350 X 315692 315692 545793 315124 230669 99237 57773 41464 587825 SEABURY AT POWDER FOREST 2461985 C 2461985 ENTRANCE FEES REFUNDS PAYABLE 3162182 3162182 2381245 0 2381245 0 2381245 2551978 0 2551978 0 2551978 0 0 0 0 0 0 0 0 0 RICHARD C HEATH PRESIDENT 0 355520 0 0 0 0 0 27006 0 13364 0 395890 0 0 PART I, LINE 3 THE PRESIDENT IS COMPENSATED BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH HIS 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 RICHARD C. HEATH HAS A BUSINESS RELATIONSHIP WITH BOARD MEMBERS GALE A. MATTISON AND A. RAYMOND MADORIN. HE IS EMPLOYED BY A RELATED ORGANIZATION OF WHICH THEY ARE ALSO BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE AS OF 10/1/17, CHURCH HOME OF HARTFORD, INC. CEASED TO BE A MEMBER OF SEABURY AT HOME, INC. AND A NEWLY FORMED ENTITY, SEABURY, INC., BECAME THE SOLE MEMBER OF SEABURY AT HOME, INC. FORM 990, PART VI, SECTION A, LINE 6 EFFECTIVE AS OF 10/1/17, 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 EFFECTIVE AS OF 10/1/17, 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 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, HIS 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 -63823 2461986 0 0 0.50000 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 CHURCH HOME OF HARTFORD INC K 27702 FMV CHURCH HOME OF HARTFORD INC M 1575197 FMV