2018-11-13T14:24:24-06:00 2017-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2017-01-01 200670083 CEDARBROOK VILLAGE INCORPORATED CEDA 3157973114 2050 TILDEN AVE NEW HARTFORD NY 134133630 CHRISTA SERAFIN CEO 3157973114 2018-11-08 1 DEBORAH STUCK P01281391 3154463600 2018-11-08 24.39.85.114 2018-11-08 12:53:42 ES P 95BF4D66B926A32327CE7D91ADC759B9DBEEFFE9 B8C5F40B2B3D88A0A8DAC4C2F3911A4184EEA169 2017 2019-02-21 02:37:17Z CHRISTA SERAFIN 2050 TILDEN AVE NEW HARTFORD NY 134133630 2156689 0 X WWW.SITRIN.COM X 2004 NY SENIOR ENRICHED HOUSING AND ASSISTED LIVING PROGRAM. 8 7 73 0 0 0 9902 3047 2109859 2112639 3879 11291 16925 17053 2140565 2144030 0 0 0 0 1077519 1072795 0 0 0 958026 1035950 2035545 2108745 105020 35285 7295269 7259702 2817198 2659974 4478071 4599728 CEDARBROOK IS A LICENSED ASSISTED LIVING PROVIDER REGULATED BY THE NEW YORK STATE DEPARTMENT OF HEALTH. CEDARBROOK IS AFFILIATED WITH SITRIN HEALTH CARE CENTER. 0 0 1959339 2129692 CEDARBROOK PROVIDES VARIOUS LEVELS OF CARE TO INDIVIDUALS 62 YEARS OF AGE AND OLDER SO THAT THEY MAY LIVE INDEPENDENTLY WITH SUPPORT SERVICES AVAILABLE AS THEIR NEEDS CHANGE.IN 2017, CEDARBROOK'S TOTAL RESIDENT DAYS WERE 18,789 WITH A TOTAL OF 71 SENIORS SERVED. 1959339 1 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 73 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X CHRISTA SERAFIN 3157973114 2050 TILDEN AVE NEW HARTFORD NY 13413 MICHAEL DAMSKY DIRECTOR 0.50 2.00 X 0 0 0 MARSHA SILVERMAN SECRETARY 2.00 6.00 X X 0 0 0 EDWARD KOWALSKY DIRECTOR 0.50 6.50 X 0 0 0 MICHAEL COMINSKY TREASURER 2.00 9.00 X X 0 0 0 DR SUSAN BLATT VICE CHAIRPERSON 2.00 3.50 X X 0 25385 0 MICHAEL SILVERMAN CHAIRMAN 2.00 9.00 X X 0 0 0 MARK SMITH DIRECTOR 0.50 2.00 X 0 0 0 ADELE SOSSEN DIRECTOR 0.50 2.50 X 0 0 0 RICHARD WILSON VP OF STRATEGIC PLANNI 1.00 37.50 X 0 71135 0 CHRISTA SERAFIN CHIEF EXECUTIVE OFFICER 1.00 37.50 X 0 209958 12480 BRENDA COBANE VP OF ASSISTED LIVING THROUGH 4/17 32.50 5.00 X 37179 66491 16221 ANDREA FOX VP OF ASSISTED LIVING 37.50 0.00 X 47743 27465 7797 84922 400434 36498 0 0 1 0 0 2717 330 3047 RESIDENT SERVICES 623311 2082640 2082640 SHARED SERVICES 561000 9025 9025 GUEST MEALS 623311 6504 6504 APPLICATION REVENUE 623311 6000 6000 GUEST ROOM REVENUE 623311 4570 4570 3900 3900 2112639 11282 11282 11824 844 11880 779 -56 65 9 9 CABLE REVENUE 623311 15195 15195 MISCELLANEOUS 623311 1783 1783 FORFEITED SECURITY DEP 623311 75 75 17053 2144030 2129692 0 11291 95735 95735 772200 748218 23982 8477 7906 571 135382 130102 5280 61001 52312 8689 140000 140000 2024 2024 10337 10337 13839 13839 6735 6735 228976 228976 8626 6410 2216 417442 417442 FOOD/BEVERAGE EXPENSE 133198 133198 REPAIRS & MAINTENANCE E 23522 23522 HOUSEKEEPING & LAUNDRY 10628 10628 DURABLE/DISPOSABLE DIET 9823 9823 30800 28204 2596 2108745 1959339 149406 0 397419 289889 663623 1002813 29379 27892 248485 241103 8361 9009 6306 1850 9231212 3558803 5924385 5672409 17311 14737 7295269 7259702 130574 109771 2452950 2382420 233674 167783 2817198 2659974 X 4478071 4599728 4478071 4599728 7295269 7259702 X 35285 21637 64735 X X 0 1 X 1 0 X 1155 50 9902 3047 14154 1930112 2035849 2031065 2109859 2112639 10219524 1930112 2037004 2031115 2119761 2115686 10233678 0 0 0 10233678 764 680 742 3978 11282 17446 764 680 742 3978 11282 17446 18136 21891 19732 16925 17053 93737 1949012 2059575 2051589 2140664 2144021 10344861 0.98930 0.98920 0.00170 0.00070 X 12660 12660 8330526 2994496 5336030 856509 559374 297135 31517 4933 26584 5672409 CASH HELD IN TRUST FOR RESIDENTS 14737 SECURITY DEPOSITS FROM RESIDENTS 118279 INTEREST RATE SWAP LIABILITY 34767 167783 X 2230402 21637 64735 86372 2144030 0 2144030 2108745 0 2108745 0 2108745 PART X, LINE 2: CEDARBROOK IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AS OF DECEMBER 31, 2017 AND 2016, CEDARBROOK DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2014 THROUGH 2017. CEDARBROOK DOES NOT ANTICIPATE ANY UNRECOGNIZED TAX BENEFITS TO CHANGE IN THE NEXT TWELVE MONTHS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 64,735. X 1 1 X X 0 0 0 0 0 0 0 0 0 CHRISTA SERAFIN CHIEF EXECUTIVE OFFICER 0 209958 0 0 0 0 0 0 0 12480 0 222438 0 0 A ONEIDA COUNTY INDUSTRIAL DEVELOPMENT AGENCY 090210781 682465CD9 2007-06-28 3000000 TO CONSTRUCT ENRICHED HOUSING ASSISTED LIVING APARTMENTS 0 0 0 A 3105333 169177 93146 23031 2819979 2009 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 1 FIRST NIAGARA BANK 10.000000000000 0 0 0 0 0 A 0 PART I LINE A, PART II LINE 3 THE DIFFERENCE BETWEEN PART I'S LISTED ISSUE PRICE OF $3,000,000 AND PART II'S, LINE 3, TOTAL PROCEEDS OF ISSUE, IS THE RESULT OF INVESTMENT EARNINGS ON THE PROCEEDS DURING THE CONSTRUCTION PHASE OF THE PROJECT. ALL EARNINGS WERE SPENT ON THE PROJECT AS SHOWN IN PART II, LINES 5-12. FORM 990, PART VI, SECTION A, LINE 6 THE CHARLES T. SITRIN NETWORK OF HOMES & SERVICES, INC. IS THE SOLE MEMBER OF CEDARBROOK VILLAGE INCORPORATED. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER, THE CHARLES T. SITRIN NETWORK OF HOMES & SERVICES, INC. APPOINTS THE BOARD OF DIRECTORS OF CEDARBROOK VILLAGE INCORPORATED. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD MEMBERS REVIEWED THE 990 AT THE NOVEMBER 2018 BOARD MEETING PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS ARE REQUIRED TO UPDATE AND RE-SIGN THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS COLLECTIVELY REVIEWS AND APPROVES THE CEO'S SALARY AND BENEFITS. COMPARATIVE DATA FROM OTHER LIKE ORGANIZATIONS IS USED. THIS MEETING IS DOCUMENTED THROUGH EXECUTIVE SESSION MINUTES OF THE BOARD MEETING. FORM 990, PART VI, SECTION C, LINE 19 ALL OF THESE DOCUMENTS ARE AVAILABLE TO THE PUBLIC. COPIES WILL BE PROVIDED UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 64,735. FORM 990, PAGE 7, PART VII THE FOLLOWING OFFICER IS ALSO AN OFFICER OF RELATED ENTITY, CHARLES T. SITRIN HEALTH CARE CENTER, INC. -CHRISTA SERAFIN CHARLES T SITRIN HEALTH CARE CENTER INC 2050 TILDEN AVE NEW HARTFORD NY 13413 223100745 SKILLED NURSING/OUTPATIENT REHAB FACILITY NY 501(C)3 LINE 11 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 2050 TILDEN AVE NEW HARTFORD NY 13413 150543936 SOLE MEMBER OF OTHER CORPORATIONS NY 501(C)3 LINE 7 N/A 0 GEORGIAN COURT ESTATES SENIOR HOUSING CORP 2050 TILDEN AVE NEW HARTFORD NY 13413 204288247 SENIOR HOUSING NY 501(C)3 LINE 11 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 GAN KAVOD INC PO BOX 634 NEW HARTFORD NY 13413 223032483 INTERMEDIATE CARE FACILITY & INDIVIDUALIZED RESIDENTIAL ALTERNATIVE NY 501(C)3 LINE 11 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 SITRIN CHILD DAY CARE FACILITY INC 3 KAVOD ROAD NEW HARTFORD NY 13413 161484534 CHILD DAY CARE CENTER NY 501(C)3 LINE 11 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 SITRIN FOUNDATION INC 2050 TILDEN AVE NEW HARTFORD NY 13413 300098393 FOUNDATION NY 501(C)3 LINE 12B, II CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0