2018-07-16T18:31:19-05:00 2017-08-31 910189318 Moss Adams LLP 10960 Wilshire Blvd Suite 1100 Los Angeles CA 90024 990 2016-09-01 953510024 LOS ANGELES JEWISH HOME FOR THE AGING LOSA 8187743372 7150 TAMPA AVE RESEDA CA 913353700 Ilene Silberman CFO 8187743372 2018-07-13 1 Lauren A Haverlock P00545829 3104770450 2018-07-10 2016 2022-09-23 18:48:47Z Ilene Silberman 7150 TAMPA AVE RESEDA CA 913353700 33158138 0 X www.jha.org X 1912 CA NURSING, RESIDENTIAL AND CLINICAL CARE FOR THE ELDERLY. 18 18 120 18 0 0 12343472 19967337 13095309 12709464 69730 303203 -193253 -251930 25315258 32728074 0 0 0 0 10461461 13892862 0 0 2334991 14020081 21046420 24481542 34939282 833716 -2211208 269338110 304593101 278304087 315445386 -8965977 -10852285 Excellence in senior care reflective of Jewish values. 0 0 19536633 0 9390150 Funding organization and management services for related organizations: Eisenberg Village of the Los Angeles Jewish Home for the Aging, Grancell Village of the Los Angeles Jewish Home for the Aging, JHA Geriatric Services, Annenberg School of Nursing and Brandman Centers for Senior Care, Inc. 8162941 0 3319314 Development and operations of an independent living facility that provides memory care services. 27699574 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 370 0 1 120 1 0 0 0 0 0 1 1 0 0 0 0 X 18 18 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Ilene Silberman 8187743336 7150 Tampa Avenue RESEDA CA 91335 R BENDER DIRECTOR 2.00 0.00 X 0 0 0 A BERMAN VICE CHAIR 2.00 0.00 X 0 0 0 J BRANDMAN DIRECTOR 2.00 4.00 X 0 0 0 J EISENBERG-KEEFER DIRECTOR 2.00 0.00 X X 0 0 0 J GLASSMAN DIRECTOR 2.00 0.00 X 0 0 0 S GOOD DIRECTOR, PAST CHAIR 2.00 0.00 X 0 0 0 L GRANOW DIRECTOR 2.00 0.00 X 0 0 0 I HALPERN VICE CHAIR 2.00 4.00 X X 0 0 0 J HELD DIRECTOR 2.00 0.00 X 0 0 0 M HESLOV VICE CHAIR 2.00 0.00 X X 0 0 0 R HIRSCH DIRECTOR, PAST CHAIR 2.00 2.00 X 0 0 0 B MILLER-FOX ABRAMOFF DIRECTOR, PAST CHAIR 2.00 0.00 X 0 0 0 A PRICE DIRECTOR 2.00 0.00 X X 0 0 0 D ROSETT SECRETARY, VICE-CHAIR 2.00 4.00 X 0 0 0 P RUBIN DIRECTOR 2.00 0.00 X 0 0 0 DR E SCHNEIDER DIRECTOR 2.00 4.00 X 0 0 0 D SWARTZ CHAIR 2.00 0.00 X X 0 0 0 J Seidel Director 2.00 0.00 X 0 0 0 M FORREST CEO-PRESIDENT 30.00 10.00 X 856390 0 15161 I SILBERMAN CFO 30.00 10.00 X 273662 0 4921 L STEPANIANS COO 38.00 2.00 X 300048 0 2052 S GINCHANSKY VP HR (through 12/31/17) 38.00 2.00 X 262141 0 7864 N MARCO CMO 38.00 2.00 X 368480 0 17882 A POSSICK Chief Strategy Officer 40.00 0.00 X 296419 0 13480 S CUNNINGHAM VICE PRESIDENT 38.00 2.00 X 377181 0 15713 I SCHRECK FOUNDATION SENIOR VP 40.00 0.00 X 296234 0 7482 A Alderman Director HR/VP HR (start 4/30/17) 38.00 2.00 X 120235 0 8975 J ERBE DIRECTOR INFO SYSTEMS 40.00 0.00 X 227763 0 18550 C SLAVIN VP FUND DEVELOPMENT 40.00 0.00 X 208991 0 12428 L NUSSBAUM DIRECTOR of MARKETING, Fountainview 40.00 0.00 X 223449 0 19687 B POLISHUK DIRECTOR OF COMMUNITY RELATIONS 40.00 0.00 X 190209 0 14507 L PLACHTA DIRECTOR OF DEVELOPMENT 40.00 0.00 X 186255 0 15140 4187457 0 173842 30 0 1 0 Snell & Wilmer LLP One Arizona Center Phoenix AZ 85004 LEGAL SERVICES 837391 DIAGNOSTIC LABORATORIES LLC 2820 N ONTARIO ST BURBANK CA 91504 LABORATORY SERVICES 341330 Universal Protection Service LP PO BOX 101034 Pasadena CA 91189 Security Services 229863 MOSS ADAMS LLP PO BOX 748369 LOS ANGELES CA 90074 AUDIT, TAX 206536 Playa Capital Company 12045 E waterfront drive ste 400 Playa Vista CA 90094 Real Estate Development 189959 13 1016444 18950893 31500 19967337 FUNDING FROM RELATED ORGS 900099 7091254 7091254 CCRC Revenue 900099 3319314 3319314 SERVICE TO BCSC 900099 1716605 1716605 Rent from BCSC 900099 465000 465000 Service to Hospice 900099 60000 60000 57291 57291 12709464 295681 295681 4000 -3522 7522 7522 7522 112938 1016444 433586 -320648 -320648 Other Revenue 900099 68718 68718 68718 32728074 12709464 0 51273 3679248 2807603 567929 303716 8358780 5949735 1203529 1205516 206472 125599 41041 39832 1027062 804881 162813 59368 621300 407408 120486 93406 556153 446064 91244 18845 249718 249718 1166465 612968 427339 126158 234305 182980 51325 1240764 583159 347414 310191 2219457 1664593 554864 445660 424150 21510 41986 30799 11187 506190 433224 72966 6951014 6765266 185748 4001091 4001091 160783 160783 RECRUITMENT COSTS 283621 283621 DUES & LICENSES 147977 129751 12643 5583 FINANCING - ADMIN COSTS 48113 48113 2793123 2693685 62540 36898 34939282 27699574 4904717 2334991 1759501 27624555 2775040 2943901 24085893 21296257 -2928 4681209 4613897 189100815 15511263 160160985 173589552 12008917 11814247 63866565 62713620 269338110 304593101 21781985 10860071 111692553 234070459 180300682 5900000 6385000 16551643 6207080 278304087 315445386 X -46072045 -48290162 27111124 26146775 9994944 11291102 -8965977 -10852285 269338110 304593101 -2211208 324900 0 X 0 1 X 1 0 X 25368588 12736945 21996052 12343472 19967337 92412394 25368588 12736945 21996052 12343472 19967337 92412394 36907768 55504626 488196 209603 150225 95885 295681 1239590 434030 861416 149230 229939 68718 1743333 95395317 70745003 0.58180 0.56520 X Schedule A, Part II, Line 10, Explanation of Other Income: SETTLEMENT OTHER INCOME - 2012 Amount: $ 280,591. 2013 Amount: $ 265,846. 2014 Amount: $ 149,230. 2015 Amount: $ 229,939. 2016 Amount: $ 68,718. Service to Hospice - 2012 Amount: $ 60,000. 2013 Amount: $ 60,000. Service to BCSC - 2012 Amount: $ 93,439. 2013 Amount: $ 535,570. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 37106068 3894535 16793 3579519 37437877 39870912 1251419 6243 4022506 37106068 34999704 12955007 9610 8093409 39870912 40120625 1523058 7572 6651551 34999704 30582315 17683688 7665 8153043 40120625 0.00000 0.30000 0.70000 0 0 21551123 21551123 150622783 5550050 145072733 15162263 9816113 5346150 1764646 145100 1619546 173589552 Funds held by Trustee under debt agreement 46931162 DEBT ISSUANCE COSTS, NET OF ACCUMULATED AMORTIZATION 8999809 CHARITABLE REMAINDER TRUST RECEIVABLES 419428 ASSETS HELD IN ESCROW FOR CCRC DEPOSITS 4881912 Other Assets 82000 ArtWork 121042 GOODWILL 600000 Due from Related Parties 649090 Deposits 29177 62713620 Annuity OBLIGATIONS 1028270 other 277145 CCRC ESCROW DEPOSITS 4881911 Obligation fo provide future snf 19754 6207080 X Part V, Line 4: ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS. Part X, Line 2: With the exception of the IPA, the Home is exempt from taxation under Section 501(c)(3) of the Internal Revenue Code and Section 23701d of the California Revenue and Taxation Code and is generally not subject to federal or state income taxes. However, the Home is subject to income taxes on any net income that is derived from a trade or business, regularly carried on, and not in furtherance of the purposes for which it was granted exemption. No income tax provision has been recorded as the net income, if any, from any unrelated trade or business, in the opinion of management, is not material to the consolidated financial statements taken as a whole. The Home recognizes the tax benefit from uncertain tax positions only if it is more likely than not that the tax positions will be sustained on examination by the tax authorities, based on the technical merits of the position. The tax benefit is measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. There were no uncertain tax positions as of August 31, 2017 or 2016. Middle East and North Africa - Algeria, Bahrain, Djibouti, Egypt, 0 0 Investments 2006000 0 0 0 0 0 0 2006000 0 2006000 0 0 0 0 0 0 Reflections Dinner 345500 310950 34550 161032 Circle of Life 275277 247749 27528 84515 5 508605 457745 50860 188039 1129382 1016444 112938 433586 433586 -320648 X X X X X 0 0 0 0 0 0 0 1 0 M FORREST CEO-PRESIDENT 565650 0 290740 0 0 0 6664 0 8497 0 871551 0 0 0 I SILBERMAN CFO 273662 0 0 0 0 0 4921 0 0 0 278583 0 0 0 L STEPANIANS COO 300048 0 0 0 0 0 2052 0 0 0 302100 0 0 0 S GINCHANSKY VP HR (through 12/31/17) 262141 0 0 0 0 0 7864 0 0 0 270005 0 0 0 N MARCO CMO 368480 0 0 0 0 0 5880 0 12002 0 386362 0 0 0 A POSSICK Chief Strategy Officer 296419 0 0 0 0 0 7487 0 5993 0 309899 0 0 0 S CUNNINGHAM VICE PRESIDENT 305197 0 71984 0 0 0 5615 0 10098 0 392894 0 0 0 I SCHRECK FOUNDATION SENIOR VP 296234 0 0 0 0 0 7482 0 0 0 303716 0 0 0 J ERBE DIRECTOR INFO SYSTEMS 227763 0 0 0 0 0 6521 0 12029 0 246313 0 0 0 C SLAVIN VP FUND DEVELOPMENT 208991 0 0 0 0 0 6076 0 6352 0 221419 0 0 0 L NUSSBAUM DIRECTOR of MARKETING, Fountainview 213449 0 10000 0 0 0 5010 0 14677 0 243136 0 0 0 B POLISHUK DIRECTOR OF COMMUNITY RELATIONS 190209 0 0 0 0 0 5483 0 9024 0 204716 0 0 0 L PLACHTA DIRECTOR OF DEVELOPMENT 186255 0 0 0 0 0 4946 0 10194 0 201395 0 0 0 Part I, Line 7 bonuses are discretionary or based on individual goals but not formalized in contracts. A CA Statewide Communities Development Authority 680164610 130795qq3 2008-02-14 60907828 Construction of a 108-bed continuing care retirement facility 0 0 0 B CA Statewide Communities Development Authority 680164610 000000000 2013-12-20 71155000 Refund outstanding debt issued 12/1/2003 0 0 0 C CA Statewide Communities Development Authority 680164610 13081AAN2 2014-08-27 150100266 See Part VI 0 0 0 A 41490000 63047242 2010696 2139414 1039504 2932482 47479331 2010 0 0 1 1 B 7505000 71155000 7702011 1302898 2270808 62473253 1 0 1 1 C 49840000 150100267 6632379 2321805 5418729 121026624 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 1 Transamerica Occidental Life 5.800000000000 1 0 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 A 0 B 0 C 0 Date Rebate Computation Performed Issuer Name: CA Statewide Communities Development Authority Date the Rebate Computation was Performed: 02/13/2013 SCHEDULE K, PART II, LINE 3 THE TOTAL PROCEEDS OF ISSUE PER BOND IS GREATER THAN THE BOND ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO BOND PREMIUMS AND CAPITALIZED INTEREST INCOME RELATED TO THE BONDS. SCHEDULE K, PART I, ROW C, COLUMN (F) - DESCRIPTION OF PURPOSE: Construction of a 175-bed continuing care retirement facility and 24 assisted living and memory care units. X 1 31500 Fair market Value 1 0 1 1 Form 990, Part VI, Section A, line 2 D Swartz and J Glassman have a business relationship. Form 990, Part VI, Section B, line 11b The Form 990 will be reviewed by the voting members of the Board of Directors prior to submission. Form 990, Part VI, Section B, line 12c The conflict of interest form specifies actions that would be considered conflicts of interest and explains the organization's procedures to report any suspected conflicts of interest. Form 990, Part VI, Section B, line 15 Policy for determination of executive compensation, officers and top management includes reviewing comparability data from numerous salary and compensation surveys and the Form 990 data of similar organizations. The compensation for top management is determined by the Executive Review committee and approved by the full Executive Committee of the Board. Compensation is reviewed for officers and top management on an annual basis. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy and financial statements are available to the public upon request. JHA WEST 16 LLC 7150 TAMPA AVENUE RESEDA CA 91335 263639876 Continuing care retirement community CA 3339313 198204425 LOS ANGELES JEWISH HOME FOR THE AGING JHA Geriatric Services Inc 7150 Tampa Ave Reseda CA 91335 954407317 CLINiCAL AND HOSPICE SERVICES FOR THE ELDERLY CA 501(c)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 Eisenberg Village of the Los Angeles Jewish Home for the Aging 7150 Tampa Ave Reseda CA 91335 951691015 RESiDENTIAL CARE AND SKILLED NURSING FACILITY CA 501(c)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 Annenberg School of Nursing 7150 Tampa Ave Reseda CA 91335 208449705 VOCATIONAL NURSE EDUCATION CA 501(c)(3) 2 LOS ANGELES JEWISH HOME FOR THE AGING 1 GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING 7150 Tampa Ave reseda CA 91335 951831045 RESiDENTIAL CARE AND SKILLED NURSING FACILITY CA 501(c)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 Brandman Centers for Senior Care Inc 7150 Tampa Ave reseda CA 91335 264023159 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY CA 501(c)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 JEWISH HOME FOUNDATION 7150 Tampa Ave reseda CA 91335 800927200 FUNDRAISING CA 501(c)(3) LINE 12A, I LOS ANGELES JEWISH HOME FOR THE AGING 1 JHA Educational and Gerontological Research Organization 7150 Tampa Ave reseda CA 91335 954414031 Gerontological Reseach CA 501(c)(3) 10 LOS ANGELES JEWISH HOME FOR THE AGING 1 1 0 0 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 Eisenberg Village of the Los Angeles Jewish Home for the Aging Q 4147045 FMV eisenberg Village of the Los Angeles Jewish Home for the Aging R 2498553 fMV grancell Village of the Los Angeles Jewish Home for the Aging R 7590183 fMV Annenberg School of Nursing Q 368660 FMV JHA geriatric services Q 2176559 FMV Brandman Centers for Senior Care Inc A 465000 FMV