2016-11-11T10:11:36-06:00 2015-12-31 135381590 BDO USA LLP 2 INTERNATIONAL PLACE 4TH FLOOR BOSTON MA 02110 990 2015-01-01 043138403 JEWISH NURSING HOME OF WESTERN MASSACHUSETTS INC JEWI 4135676211 770 CONVERSE STREET LONGMEADOW MA 011061786 BETH CHAGUE CFO 4135676211 2016-10-04 1 JEFFREY T ROGERS P01074284 6177427788 2015 2017-02-10 21:41:12Z BETH CHAGUE 770 CONVERSE STREET LONGMEADOW MA 01106 18424462 0 X WWW.JGSLIFECARE.ORG X 1992 MA TO CARE FOR THE FRAIL ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 4 3 420 87 0 0 0 0 17744387 18270873 -87 33 256018 153556 18000318 18424462 0 0 0 0 10900267 10215846 0 0 0 8480707 9800827 19380974 20016673 -1380656 -1592211 9454640 8342514 10602888 11082973 -1148248 -2740459 TO CARE FOR THE FRAIL ELDERLY AND INFIRMED ACCORDING TO JEWISH TRADITIONS. 0 0 15795514 18424429 THE HOME IS A NON-PROFIT ORGANIZATION WHICH OWNS AND OPERATES A 200 BED SKILLED NURSING FACILITY AND ADULT DAY CARE CENTER. 15795514 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 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 0 0 0 1 12 0 1 420 1 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X JGS LIFECARE CORPORATION BETH CHAGUE CFO 4135675211 770 CONVERSE STREET LONGMEADOW MA 01106 MARTIN BAICKER PRESIDENT AND CEO 1.00 40.00 X X 0 287008 21236 STUART ANFANG BOARD MEMBER 1.00 X 0 0 0 DONALD FRANK BOARD MEMBER UNTIL 5/31/15 1.00 X 0 0 0 MICHAEL GINSBURG BOARD MEMBER UNTIL 5/31/15 1.00 X 0 0 0 ERIC BERG BOARD MEMBER 1.00 X 0 0 0 JIM GORDON BOARD MEMBER 1.00 X 0 0 0 A EDWARD ROMAN JR FORMER CFO 1.00 40.00 X 0 169967 12773 BETH CHAGUE CFO 1.00 40.00 X 0 36079 3511 LORI A YOUNG DIRECTOR OF NURSING 1.00 40.00 X 121554 0 7540 121554 493054 45060 1 0 1 0 HEALTHPRO REHABILITATION 307 INTERNATIONAL CIRCLE SUITE 100 HUNT VALLEY MD 21030 THERAPY 686466 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 HOUSEKEEPING 623553 WORLDWIDE STAFFING 1200 CONVERSE STREET SUITE L-4 LONGMEADOW MA 01106 NURSING 129929 EXPERT STAFFING 120 STAFFORD STREET SUITE 202 WORCESTER MA 01603 NURSING 117354 CLINICAL RESOURCES LLC 3338 PEACHTREE ROAD NE SUITE 102 ATLANTA GA 30326 NURSING 115488 5 NURSING HOME 623000 17661415 17661415 DAY CARE REVENUE 624100 552877 552877 MEALS PROGRAM 624100 56581 56581 18270873 33 33 73200 0 73200 73200 73200 COFFEE, BEAUTY, GIFT SHOPS 453220 28576 28576 EMPLOYEE MEALS REVENUE 722210 26998 26998 MISC REVENUE 900099 24782 24782 80356 18424462 18424429 0 33 X 8471122 8264986 206136 1099172 929684 169488 645552 615838 29714 2285584 79425 2206159 2535965 2336666 199299 411568 391184 20384 5724 5724 706453 706453 134369 126054 8315 500723 500723 863767 863767 151687 151687 USER FEE 1152080 1152080 FOOD FUNCTIONS 688398 688398 PHARMACY 256052 256052 MISCELLANEOUS 108457 36284 72173 20016673 15795514 4221159 0 178362 966481 2789428 1758138 70919 54412 26039078 20477095 6414431 5561983 1500 1500 9454640 8342514 1865872 2546853 40604 63614 121990 85739 8574422 8386767 10602888 11082973 X -1148248 -2740459 -1148248 -2740459 9454640 8342514 -1592211 0 X 0 1 X 1 0 X 18537699 18589592 18731232 17744387 18270873 91873783 18537699 18589592 18731232 17744387 18270873 91873783 0 0 0 91873783 14 32 129206 73207 73233 275692 14 32 129206 73207 73233 275692 40834 41044 182818 80356 345052 18578547 18589624 18901482 18000412 18424462 92494527 0.99330 0.99480 0.00300 0.00230 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: ENDOWMENT SUPPORT - 2011 AMOUNT: $ 40,834. MISCELLANEOUS INCOME - 2013 AMOUNT: $ 41,044. 2014 AMOUNT: $ 182,818. 2015 AMOUNT: $ 80,356. 0 1 X 344934 344934 13205053 11563832 1641221 7061913 4684489 2377424 5044416 4119455 924961 382762 109319 273443 5561983 DUE TO AFFILIATES 8051189 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 295748 ASSET RETIREMENT OBLIGATION 39830 8386767 X PART IV, LINE 2B: THE ORGANIZATION HOLDS FUNDS ON BEHALF OF ITS RESIDENTS TO BE USED AS DIRECTED BY THE RESIDENTS. PART X, LINE 2: THE ORGANIZATION ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIAL POSITION. TAX YEARS FROM 2012 THROUGH THE CURRENT YEAR REMAIN OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X X 0 0 0 0 0 0 0 0 0 MARTIN BAICKER PRESIDENT AND CEO 0 287008 0 0 0 0 0 0 0 21236 0 308244 0 0 A EDWARD ROMAN JR FORMER CFO 0 169967 0 0 0 0 0 0 0 12773 0 182740 0 0 FORM 990, PART VI, SECTION B, LINE 11 AS PART OF ITS EXISTING CHARTER, THE FINANCE COMMITTEE (ALL INDEPENDENT MEMBERS) WERE ASKED BY THE BOARD TO REVIEW REQUIRED DISCLOSURES IN THE FORM 990 AND, IF APPROVED, RECOMMEND THE RETURN FOR FILING. THE CFO DISCUSSED IN DETAIL WITH THE FINANCE COMMITTEE THE PREPARATION, COMPLETION AND FINALIZATION OF THE FORM 990 WITH EMPHASIS ON THE NEWLY REQUIRED DISCLOSURES OF: ACTIVITIES IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSE; GOVERNANCE, FINANCIAL TRANSACTIONS AMONG INSIDERS AND COMPENSATION; COMMUNITY BENEFIT, BONDS, AND CORPORATE POLICIES AND PROCEDURES; DISCLOSURE OF KEY GOVERNANCE, FINANCIALS AND MISSION POLICIES. BASED ON ITS REVIEW AND FINDINGS, THE FINANCE COMMITTEE RECOMMENDED THE FILING OF THE FORM 990. A COPY OF THE RETURN IS MADE AVAILABLE AND REVIEWED WITH THE BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICTS OF INTEREST POLICY- THE CORPORATE COMPLIANCE OFFICER CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH ANNUAL CORPORATE COMPLIANCE TRAINING AND CONFIRMATIONS SIGNED BY ALL EMPLOYEES AND BY OBTAINING ANNUAL WRITTEN CONFIRMATIONS FROM INDEPENDENT BOARD MEMBERS. THE POLICY STATES THAT EMPLOYEES OR DIRECTORS MUST SEEK GUIDANCE FROM APPROPRIATE MANAGEMENT PERSONNEL PRIOR TO PURSUING ANY BUSINESS OR PERSONAL ACTIVITY THAT MAY CONSTITUTE A CONFLICT OF INTEREST. ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO APPROPRIATE PERSONNEL. FORM 990, PART VI, SECTION B, LINE 15A THE HUMAN RESOURCES COMMITTEE REVIEWS AND APPROVED SALARIES OF TOP MANAGEMENT FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 195,786. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 195,786. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 176,682. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 176,682. ADMINISTRATIVE/BUSINESS OFFICE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 197,334. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 197,334. PHYISCAL THERAPY: PROGRAM SERVICE EXPENSES 896,118. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 896,118. LAUNDRY AND HOUSEKEEPING: PROGRAM SERVICE EXPENSES 680,196. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 680,196. NURSING: PROGRAM SERVICE EXPENSES 197,452. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 197,452. ENGINEERING: PROGRAM SERVICE EXPENSES 138,837. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 138,837. OTHER: PROGRAM SERVICE EXPENSES 51,595. MANAGEMENT AND GENERAL EXPENSES 1,965. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 53,560. GENESIS HOUSE III INC 770 CONVERSE STREET LONGMEADOW MA 01106 000739159 ELDERLY HOUSING MA 501 (C) (3) 9 N/A 0 JGS LIFECARE CORPORATION 770 CONVERSE STREET LONGMEADOW MA 01106 042129128 GERIATRIC/NURSING PROVIDER MA 501 (C) (3) 9 N/A 0 JGS ADMINISTRATIVE SERVICES 770 CONVERSE STREET LONGMEADOW MA 01106 043295014 MANAGERIAL & ADMIN MA 501 (C) (3) 9 N/A 0 JGS HOUSING SERVICES INC 770 CONVERSE STREET LONGMEADOW MA 01106 043321157 ASSISTED LIVING MA 501 (C) (3) 9 N/A 0 SPECTRUM HOME HEALTH AND HOSPICE CARE INC 770 CONVERSE STREET LONGMEADOW MA 01106 043237982 PATIENT TRANSISTION MA 501 (C) (3) 9 N/A 0 SPECTRUM HOME CARE INC 770 CONVERSE STREET LONGMEADOW MA 01106 043399549 NONCERT HOME CARE MA 501 (C) (3) 9 N/A 0 GENESIS HOUSE INC 770 CONVERSE STREET LONGMEADOW MA 01106 042817295 ELDERLY HOUSING MA 501 (C) (3) 9 N/A 0 GENESIS HOUSE II INC 770 CONVERSE STREET LONGMEADOW MA 01106 222611647 ELDERLY HOUSING MA 501 (C) (3) 9 N/A 0 0 0 0 1 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 JGS LIFECARE CORPORATION 13341881 COST JGS HOUSING SERVICES INC 1735464 COST JGS ADMINISTRATIVE SERVICES 3573710 COST SPECTRUM HOME HEALTH AND HOSPICE CARE 2001243 COST SPECTRUM HOME CARE INC 82511 COST