2016-09-13T15:55:35-05:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2015-01-01 042200583 CHELSEA JEWISH NURSING HOME INC C/O CHELSEA JEWISH COMMUNITY INC CHEL 6178870001 165 CAPTAINS ROW CHELSEA MA 02150 BARRY BERMAN CEO & TREASURER 6178870001 2016-08-31 1 JUDY DALEY P01294075 6179848100 2016-08-31 2015 2017-02-10 21:41:12Z BARRY BERMAN 165 CAPTAINS ROW CHELSEA MA 02150 11836417 0 X WWW.CJNH.ORG X 1975 MA THE ORGANIZATION'S MISSION IS TO PROVIDE EXCEPTIONAL SKILLED NURSING CARE FOR THEIR RESIDENTS WITH UNWAVERING COMPASSION, DIGNITY AND RESPECT. THE HIGH STANDARD OF CARE AT CHELSEA JEWISH NURSING HOME (CJNH) ENSURES RESIDENTS RECEIVE EXCELLENT ATTENTION AND SERVICE FROM A TEAM OF COMPASSIONATE AND PROFESSIONALLY TRAINED HEALTHCARE STAFF. CJNH RESPECTS EACH INDIVIDUAL AND UNDERSTANDS THE IMPORTANCE OF MAKING RESIDENTS AND THEIR FAMILIES FEEL AT HOME. 9 6 190 13 0 0 46263 25000 12000000 11808515 227 2254 23207 648 12069697 11836417 0 0 0 0 6646875 6822179 0 0 0 5135877 5068734 11782752 11890913 286945 -54496 7897416 12891528 5402321 10480253 2495095 2411275 X THE ORGANIZATION'S MISSION IS TO PROVIDE EXCEPTIONAL SKILLED NURSING CARE FOR THEIR RESIDENTS WITH UNWAVERING COMPASSION, DIGNITY AND RESPECT. THE HIGH STANDARD OF CARE AT CHELSEA JEWISH NURSING HOME (CJNH) ENSURES RESIDENTS RECEIVE EXCELLENT ATTENTION AND SERVICE FROM A TEAM OF COMPASSIONATE AND PROFESSIONALLY TRAINED HEALTHCARE STAFF. CJNH RESPECTS EACH INDIVIDUAL AND UNDERSTANDS THE IMPORTANCE OF MAKING RESIDENTS AND THEIR FAMILIES FEEL AT HOME. 0 0 9384733 11809163 NURSING HOME: OPERATION OF A 123-BED SKILLED NURSING FACILITY PROVIDING NURSING CARE, REHABILITATION THERAPIES AND OTHER SKILLED SERVICES TO FRAIL ELDERLY AND DISABLED. 9384733 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 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 0 0 0 1 15 0 1 190 1 0 0 0 0 0 0 0 0 0 0 X 9 6 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X ELLEN SHONER 6178870001 165 CAPTAINS ROW CHELSEA MA 02150 ADAM BERMAN PRESIDENT 1.00 39.00 X X 0 316573 26443 BARRY BERMAN CEO & TREASURER 1.00 39.00 X X 0 584016 32181 ELIZABETH MULLEN SECRETARY & CLERK 1.00 39.00 X X 0 196619 20662 JOEL MAZER CHAIR 1.00 2.00 X 0 0 0 SHARON FORMAN DIRECTOR 1.00 2.00 X 0 0 0 ROBERT RICHMAN DIRECTOR 1.00 2.00 X 0 0 0 SUSAN BRUDNICK DIRECTOR 1.00 2.00 X 0 0 0 CHARLOTTE FLORENCE DIRECTOR 1.00 2.00 X 0 0 0 SHELLY KATZ DIRECTOR 1.00 2.00 X 0 0 0 EDWARD STEWART EXECUTIVE DIRECTOR 40.00 0.00 X 117260 0 5479 ELIZABETH S PAGE RN 52.00 0.00 X 105397 0 8959 NORINE PASQUARELLO RN 55.00 0.00 X 104620 0 15039 327277 1097208 108763 3 0 1 0 CHELSEA JEWISH THERAPY 165 CAPTAINS ROW CHELSEA MA 02150 THERAPY SERVICES 533093 CHELSEA JEWISH COMMUNITY INC 165 CAPTAINS ROW CHELSEA MA 02150 MANAGEMENT SERVICES 185433 DIMELLA SHAFFER 281 SUMMER STREET BOSTON MA 02210 ARCHITECTURAL DESIGN SERVICES 129882 3 25000 25000 25000 PROGRAM SERVICE REVENUE 623000 11808515 11808515 11808515 2254 2254 OTHER INCOME 623000 648 648 648 11836417 11809163 0 2254 122739 122739 5632171 5467221 164950 78653 74792 3861 524975 504417 20558 463641 440883 22758 709076 709076 44160 44160 47750 47750 931876 836967 94909 2504 2504 130581 102 130479 725467 560171 165296 14978 14978 205 205 9 9 357939 356791 1148 USER FEE ASSESSMENT 780586 780586 FOOD 441436 441436 SUPPLIES & EXPENSE 437031 437031 PATIENT ANCILLARY SERVI 264922 264922 180214 180214 11890913 9384733 2506180 0 627812 810183 1383762 1592735 204295 176610 9974810 7987776 1964330 1987034 3717217 8324966 7897416 12891528 1018335 2195452 2715090 6625078 1668896 1659723 5402321 10480253 X 744443 689947 1750652 1721328 2495095 2411275 7897416 12891528 X -54496 -29324 X 0 1 X 0 1 1 X 176906 170000 20000 46263 25000 438169 12785895 11716155 11484194 12023207 11809163 59818614 12962801 11886155 11504194 12069470 11834163 60256783 176906 170000 20000 98918 25000 490824 0 176906 170000 20000 98918 25000 490824 59765959 32958 6010 203 227 2254 41652 32958 6010 203 227 2254 41652 12995759 11892165 11504397 12069697 11836417 60298435 0.99120 0.98930 0.00070 0.00120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1750652 -29324 1721328 1698000 52652 1750652 1650000 48000 1698000 1650000 1650000 1650000 1650000 0.00000 0.00000 1.00000 1 0 13575 13575 7247293 5558408 1688885 2713942 2429368 284574 1987034 DEFERRED FINANCING COSTS, NET 574793 CONSTRUCTION IN PROGRESS 5506597 DEBT SERVICE RESERVE 454404 SOFTWARE, NET 4804 BENEFICIAL INTEREST IN TESTAMENTARY TRUST 1721328 REPLACEMENT RESERVE 63040 8324966 DUE TO RELATED PARTIES 1659723 1659723 X 11836417 0 11836417 0 11836417 11890913 0 11890913 0 11890913 PART V, LINE 4: THE ORGANIZATION IS THE SOLE BENEFICIARY OF A CHARITABLE TESTAMENTARY TRUST THAT IS ADMINISTERED BY UNRELATED FINANCIAL INSTITUTIONS. THE UNRELATED FINANCIAL INSTITUTIONS SET FORTH THE INVESTMENT POLICIES FOR THE TRUST. THE ORGANIZATION RECEIVED INCOME GENERATED BY THE TRUST FOR GENERAL PURPOSES AND CLASSIFIED AS UNRESTRICTED NET ASSETS. GAINS AND LOSSES ARE CONSIDERED RESTRICTED. PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FILES AS A TAX-EXEMPT ENTITY. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S 2012 THROUGH 2015 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. 0 0 0 0 0 0 0 0 0 ADAM BERMAN PRESIDENT 0 316573 0 0 0 0 0 0 0 26443 0 343016 0 0 BARRY BERMAN CEO & TREASURER 0 584016 0 0 0 0 0 0 0 32181 0 616197 0 0 ELIZABETH MULLEN SECRETARY & CLERK 0 196619 0 0 0 0 0 0 0 20662 0 217281 0 0 FORM 990, PART VI, SECTION A, LINE 2 BARRY BERMAN, CEO, AND ADAM BERMAN, PRESIDENT, HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS A RELATED ORGANIZATION, CHELSEA JEWISH NURSING HOME FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A THE APPROVAL OF THE MEMBER, CHELSEA JEWISH NURSING HOME FOUNDATION, INC., IS REQUIRED TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE APPROVAL OF THE MEMBER, CHELSEA JEWISH NURSING HOME FOUNDATION, INC., IS REQUIRED BEFORE THE BOARD OF DIRECTOR'S ACTION ON ANY OF THE FOLLOWING BECOMES EFFECTIVE: (A) TO AMEND OR TO REPEAL THE ARTICLES OF ORGANIZATION OR THE BYLAWS OF THE CORPORATION; (B) TO APPROVE ALL PLANS OF MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, OR THE SALE, LEASE, ASSIGNMENT OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PURCHASE OR ACQUISITION BY THE CORPORATION OF THE CORPORATION OF AN INTEREST IN ANY CORPORATION, PARTNERSHIP, JOINT VENTURE OR OTHER ENTITY, WHETHER NEWLY CREATED OR PREVIOUSLY EXISTING, WHICH INTEREST, IN THE CASE OF A FOR-PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT (25%) OR MORE OF THE VOTING POWER THEREOF OR EQUITY INTEREST THEREIN, OR, IN THE CASE OF A NON-PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT (25%) OR MORE OF THE VOTING POWER THEREOF OR MEMBERSHIP INTEREST THEREIN; (C) TO APPROVE ALL GIFTS, GRANTS, DONATIONS OR SIMILAR TRANSFERS OF FUNDS OF THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OR ITS SUBSIDIARIES; (D) TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION; (E) TO APPROVE THE FORMATION OF ANY SUBSIDIARY OF THE CORPORATION; AND (F) TO APPOINT THE CORPORATION'S AUDITORS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S MANAGEMENT TEAM WILL CONDUCT A REVIEW OF THE FORM 990 AFTER IT HAS BEEN FINALIZED, INCLUDING READING AND REVIEWING THE KEY INFORMATION. MANAGEMENT WILL REPORT TO THE BOARD IF THERE ARE ANY MAJOR DEVIATIONS FROM THE PROVIDED DATA. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, ALL BOARD MEMBERS ARE INSTRUCTED TO INFORM THE REST OF THE BOARD IF ANY CONFLICT OF INTEREST EXISTS PERTAINING TO THEIR MEMBERSHIP ON THE BOARD. ANY POTENTIAL CONFLICT OF INTEREST IS THEN DISCUSSED AND ASSESSED BY THE REMAINING BOARD MEMBERS. IF A CONFLICT EXISTS IT MUST BE DISCLOSED AND HELD TO HIGHER LEVEL OF SCRUTINY IN ORDER TO VERIFY THAT ALL TRANSACTIONS ARE ARMS LENGTH. ANY BOARD MEMBER DEEMED TO HAVE A CONFLICT OF INTEREST WILL ABSTAIN FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS PAID FROM A RELATED ORGANIZATION. PRIOR TO MAJOR SALARY ADJUSTMENTS FOR THE CEO, A RELATED ORGANIZATION'S BOARD OF DIRECTORS ARRANGES FOR A SALARY STUDY TO BE PERFORMED. THE STUDY INCLUDES THE EXECUTIVE SALARIES OF COMPARABLY-SIZED COMPANIES IN THE INDUSTRY. THE BOARD OF DIRECTORS THEN CONSIDERS THE FINDINGS OF THE STUDY IN SETTING THE CEO'S COMPENSATION. 2014 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. OFFICERS AND KEY EMPLOYEES ARE PAID FROM A RELATED ORGANIZATION. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED THROUGH THE USE OF SALARY STUDIES OR OTHER DATA AND ADJUSTED BASED ON THE EMPLOYEE'S YEARS OF EXPERIENCE AND RESPONSIBILITIES BY A RELATED ORGANIZATION'S BOARD OF DIRECTORS. 2014 WAS THE MOST RECENT YEAR IN WHICH THE PROCESS INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN TESTAMENTARY TRUST -29,324. CHELSEA JEWISH NURSING HOME FOUNDATION INC 165 CAPTAINS ROW CHELSEA MA 02150 510141617 FUNDRAISING AND SUPPORT TO NURSING HOME MA 501(C)(3) LINE 7 0 CHELSEA JEWISH GREEN HOUSE INC 165 CAPTAINS ROW CHELSEA MA 02150 043326727 NURSING HOME, HOME CARE, HOSPICE, AND PERSONAL CARE AGENCY MA 501(C)(3) LINE 9 CHELSEA JEWISH NURSING HOME FOUNDATION INC 1 CHELSEA JEWISH COMMUNITY INC 165 CAPTAINS ROW CHELSEA MA 02150 271756594 MANAGEMENT COMPANY, ACADEMY FOR TRAINING CERTIFIED NURSING ASSISTANTS MA 501(C)(3) LINE 9 CHELSEA JEWISH NURSING HOME FOUNDATION INC 1 ADMIRAL'S HILL ASSISTED LIVING LP 165 CAPTAINS ROW CHELSEA MA 02150 043255842 ASSISTED LIVING MA N/A ADMIRAL'S HILL ASSISTED LIVING II LLC 165 CAPTAINS ROW CHELSEA MA 02150 043538835 ASSISTED LIVING MA N/A ASAR ELDER SERVICES INC 165 CAPTAINS ROW CHELSEA MA 02150 043289287 MANAGEMENT COMPANY & THERAPY SERVICES MA N/A C 0 ADMIRALS HILL ASSISTED LIVING CORP 165 CAPTAINS ROW CHELSEA MA 02150 043255840 MANAGEMENT COMPANY & THERAPY SERVICES MA N/A C 0 ADMIRALS HILL ASSISTED LIVING II CORP 165 CAPTAINS ROW CHELSEA MA 02150 043538833 MANAGEMENT COMPANY & THERAPY SERVICES MA N/A C 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0