2016-11-11T10:51:25-06:00 2015-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2015-01-01 200670083 CEDARBROOK VILLAGE INCORPORATED CEDA 3157973114 2050 TILDEN AVE NEW HARTFORD NY 134133630 CHRISTA SERAFIN CEO 3157973114 2016-11-03 1 JOSEPH J SCHLEGEL P00301329 3154463600 2015 2017-02-10 21:41:12Z CHRISTA SERAFIN 2050 TILDEN AVE NEW HARTFORD NY 134133630 2051589 0 X WWW.SITRIN.COM X 2004 NY SENIOR ENRICHED HOUSING AND ASSISTED LIVING PROGRAM. 7 6 76 0 0 0 1155 50 2035849 2031065 680 742 21891 19732 2059575 2051589 0 0 0 0 1012523 1047245 0 0 0 999010 954450 2011533 2001695 48042 49894 7828455 7361525 3625504 3058949 4202951 4302576 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 1824110 2050797 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 2015, CEDARBROOK'S TOTAL RESIDENT DAYS WERE 17,860 WITH A TOTAL OF 75 SENIORS SERVED. 1824110 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 1 0 1 76 1 0 0 0 0 0 0 0 0 0 0 X 7 6 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 4.50 X X 0 0 0 EDWARD KOWALSKY DIRECTOR 0.50 6.50 X 0 0 0 MICHAEL COMINSKY TREASURER 2.00 8.00 X X 0 0 0 DR SUSAN BLATT VICE CHAIRPERSON 2.00 19.00 X X 0 60000 0 NEIL COHEN DIRECTOR 0.50 1.00 X 0 0 0 MICHAEL SILVERMAN CHAIRMAN 2.00 9.00 X X 0 0 0 RICHARD WILSON VP OF STRATEGIC PLANNI 1.00 37.50 X 0 117531 5520 CHRISTA SERAFIN CHIEF EXECUTIVE OFFICER 1.00 37.50 X 0 185053 13800 BRENDA COBANE VP OF ASSISTED LIVING 32.50 5.00 X 96340 0 14027 96340 362584 33347 0 0 1 0 0 50 50 RESIDENT SERVICES 623311 1980925 1980925 SHARED SERVICES 561000 26286 26286 GUEST MEALS 623311 9189 9189 APPLICATION REVENUE 623311 8250 8250 GUEST ROOM REVENUE 623311 3640 3640 2775 2775 2031065 742 742 CABLE REVENUE 623311 15000 15000 FORFEITED SECURITY DEP 623311 2544 2544 MISCELLANEOUS 623311 34 34 2154 2154 19732 2051589 2050797 0 742 96340 96340 755667 719509 36158 10286 6773 3513 127708 112252 15456 57244 47797 9447 77903 77903 3133 3133 8812 8812 6467 6467 1452 1452 9073 9073 240427 240427 8638 7657 981 413923 413923 FOOD/BEVERAGE EXPENSE 115335 115335 REPAIRS & MAINTENANCE E 19650 19650 HOUSEKEEPING & LAUNDRY 10963 10963 DURABLE/DISPOSABLE DIET 6883 6883 31791 26365 5426 2001695 1824110 177585 0 336710 147689 368760 544847 159778 23826 181838 219832 6760 6465 1850 6253 9028456 2726230 6658920 6302226 113839 110387 7828455 7361525 121828 125298 2685000 2615000 818676 318651 3625504 3058949 X 4202951 4302576 4202951 4302576 7828455 7361525 X 49894 49731 X X 0 1 X 1 0 X 150 1155 50 1355 1796604 1833633 1930112 2035849 2031065 9627263 1796754 1833633 1930112 2037004 2031115 9628618 0 0 0 9628618 638 994 764 680 742 3818 638 994 764 680 742 3818 22815 25182 18136 21891 19732 107756 1820207 1859809 1949012 2059575 2051589 9740192 0.98850 0.98780 0.00040 0.00030 X 12660 12660 8317920 2316121 6001799 684866 408266 276600 13010 1843 11167 6302226 CASH HELD IN TRUST FOR RESIDENTS 13866 SECURITY DEPOSITS FROM RESIDENTS 107781 INTEREST RATE SWAP LIABILITY 167004 NOTE PAYABLE - CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 30000 318651 X 2051589 0 2051589 0 2051589 2001695 0 2001695 0 2001695 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, 2015 AND 2014, CEDARBROOK DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OF ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2012 THROUGH 2015. CEDARBROOK DOES NOT ANTICIPATE ANY UNRECOGNIZED TAX BENEFITS TO CHANGE IN THE NEXT TWELVE MONTHS. X 1 1 X X 0 0 0 0 0 0 0 0 0 CHRISTA SERAFIN CHIEF EXECUTIVE OFFICER 0 185053 0 0 0 0 0 0 13800 0 13800 185053 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 11 THE BOARD MEMBERS REVIEWED THE 990 AT THE NOVEMBER 2015 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 49,731. 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 9 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 9 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 9 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 9 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 11A, I 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