2016-05-11T13:38:59-07:00 2015-09-30 990 2014-10-01 223012385 JOHNSON EVERGREEN CORPORATION JOHN 8606846341 205 Chestnut Hill Road Stafford Springs CT 060760549 Stuart Rosenberg CEO 8606848235 2016-05-11 2014 2016-08-17 19:52:53Z Evergreen Health Care Center Stuart E Rosenberg 201 Chestnut Hill Road Stafford Springs CT 06076 16567765 0 X www.jmmc.com X 1989 CT To develop, operate ,and maintain programs directed toward improving the efficiency of utiliztion of Health Care Facilities and Services in the State of CT, and in Hartford and Tolland Counties and surrouding areas in particular, and reducing the cost of health care to the public while maintaining a high quality of care. Evergreen is skilled nursing facility with 120 long-term-care beds, a 30-bed Subacute unit for patients in need of extensive therapy and care before returning home, and a 30 bed MSU. 15 15 350 62 0 0 8324 3551 16658078 16507384 0 0 53968 56830 16720370 16567765 0 0 0 0 11045293 11386159 0 0 0 8785015 6779836 19830308 18165995 -3109938 -1598230 5622950 4946323 17441962 18363565 -11819012 -13417242 To develop, operate ,and maintain programs directed toward improving the efficiency of utiliztion of Health Care Facilities and Services in the State of CT, and in Hartford and Tolland Counties and surrouding areas in particular, and reducing the cost of health care to the public while maintaining a high quality of care. Evergreen is a Skilled Nursing Facility with 120 long term beds, a 30 bed Subacute Rehabilitation unit and a 30 bed MSU. Services include: 24 hour nursing care, long term care, cardiac recovery, subacute rehabilitation, dental care, hospice care, respite care, iv therapies, medically complex care, mental health services, oncology/cancer care, optometry and opthalmology, orthopedic care, pain management, wound care, podiatry and other special services, postoperative care, pulmonary/respiratory care, social services and therapeutic recreation. 0 0 16091985 0 16567765 Nursing Home Care: Johnson Evergreen Corporation, DBA Evergreen Health Care Center maintains a 180 bed SNF with 24 hour skilled nursing care for residnets. During Fy 14 the facility maintained a high occupancy and high quality care in the facility. The cost shown represents the necessary salary, supplies, and overhead essential for caring for residents at Evergreen. (51886 resident days) 0 0 0 16091985 1 0 0 0 0 0 0 0 0 0 1 0 0 1 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 1 1 0 0 1 29 0 1 350 1 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Tia Riedel 8606848742 201 Chestnut Hill Road Stafford Springs CT 06076 Patrick Mahon Chairman 2 0 X 0 0 0 James M Makuch Vice Chairman 2 0 X 0 0 0 Evelyne A Parizek Secretary 2 0 X 0 0 0 David O'connor Treasurer 2 0 X 0 0 0 Christopher Dadlez Director 2 0 X 0 0 0 Cathryn-Jean Fleming ESQ Director 2 0 X 0 0 0 Joseph Ianello MD Director 2 0 X 0 0 0 Michael P Krol Director 2 0 X 0 0 0 Younus F Masih MD Director 2 0 X 0 0 0 John W Patton Director 2 0 X 0 0 0 Kevin Sullivan Director 2 0 X 0 0 0 Christopher Hartley Director 2 0 X 0 0 0 John Rodis MD Director 2 0 X 0 0 0 Phil Tartsinis Director 2 0 X 0 0 0 David Bittner Director 2 0 X 0 0 0 Stuart E Rosenberg President/CEO 0 50 X 0 0 0 John Grish Chief Financial Officer 0 50 X 0 298519 18890 Damien R Eilerman Nursing Supervisor 50 X 113463 0 15456 Jennifer Bessette PT Manager 50 X 103929 0 14727 Mary Denunzio Director of Nursing 50 X 101654 0 14553 Henrietta Florius LTC CNA 50 X 103623 0 14703 422669 298519 78329 4 0 1 1 0 0 0 0 0 0 3551 0 3551 Resident Revenues 623000 16507384 16507384 0 0 0 0 0 0 16507384 0 0 0 0 0 Title 19 Application fees 561000 5000 5000 0 0 Miscellaneous Revenues 900099 51830 51830 0 0 0 0 0 0 56830 16567765 16564214 0 0 9329951 9010905 319046 1375575 1355246 20329 680633 656225 24408 2409 2409 35000 35000 621158 366258 254900 661965 661965 18446 14261 4185 477492 477492 994476 994476 296504 296504 870045 770215 99830 Patient Care/supplies/food 1560058 1560058 0 0 Chapter 11 expenses, net 310992 0 310992 0 Bad Debt expense 25876 25876 0 0 Provider Taxes 896980 896980 0 0 8435 0 8435 0 18165995 16091985 2074010 0 300 300 1598868 1580143 29503 26625 396799 250948 19853091 17086235 3000000 2766856 597480 321451 5622950 4946323 2275637 3212641 14213697 14213697 952628 937227 17441962 18363565 X -11819012 -13417242 0 0 0 0 -11819012 -13417242 5622950 4946323 -1598230 0 0 0 0 0 X 0 1 X 1 0 X 24258 8629 10420 8324 3551 55182 17547583 16798928 16121923 16658078 16507384 83633896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17571841 16807557 16132343 16666402 16510935 83689078 0 0 0 0 0 0 0 0 0 0 0 0 83689078 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108544 43968 21028 53968 56830 284338 17680385 16851525 16153371 16720370 16567765 83973416 0.99661 0.99083 0 0 X Schedule A, Part III, Line 12 Other income of 56830 is Title 19 Applications fees and various Misc. Revenues 0 0 0 15747543 0 13830689 1916854 0 0 0 0 2579181 0 2400123 179058 1526367 0 855423 670944 2766856 Other Receivables 134451 Deferred Costs 120137 Patient Trust Fund 66863 321451 0 Other Liabilities 642296 Patient Trust Fund 66863 Payments Due under Plan of Reorganization 224486 Due to Affiliated Corporations -170998 Estimated Amounts due to Third-Party Payers 174580 937227 X Schedule D, Part X, Line 2 Management has analyzed the tax provisions taken and has concluded that as of September 30, 2015, there are no uncertain tax provisions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Corporation and its subsidiaries are subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Organization's tax returns are subject to examination generally for three years from the date of filing and the current and prior three years remain subject to examination as of September 30, 2015. 0 0 0 0 0 0 0 0 0 John Grish Chief Financial Officer 0 298519 0 0 0 18890 0 0 0 0 0 317409 0 Form 990, Part VI, Section A, Line 6 Article 3 of the Johnson Memorial Medical Center Bylaws stipulates there will be not less thank 30 nor more than 60 Members Form 990, Part VI, Section A, Line 7a Members are elected by the Board as recommended by the Governance and Nominating Committee Form 990, Part VI, Section B, Line 11b Board policy provides that Members of the Finance Committee are provided opportunity to review and comment to Executive leadership before the 990 is filed. All members of the Board have access to any copy of the Form 990 and the Chief Financial Officer provides a summary of the 990 at the Board meeting following the filing of the Form 990. Form 990, Part VI, Section B, Line 12c An annual disclosure statement is required. Executives, Managers, and Board Members are required on an annual basis to disclose interests that may give rise to a conflict of interest. Form 990, Part VI, Section B, Line 15 A Board committee reviews compensation for the executive team and recommends compensation for Board approval. Comparability data is reviewed and may include surveys, documented comparisons of persons holding similar positions in similar organizations, and expert compensation schedules. Form 990, Part VI, Section C, Line 19 The Johnson Memorial Medical Center maintains these documents in Administration and are available for viewing upon request during normal business hours. Johnson Memorial Medical Center 201 Chestnut Hill Road Stafford Springs CT 06076 222541974 Parent Corporation CT 501 c 3 11 N/A 0 Johnson Memorial Hospital 201 Chestnut Hill Road Stafford Springs CT 06076 060646696 Acute Care Hospital CT 501 c 3 3 N/A 0 Johnson Health Care Inc 201 Chestnut Hill Road Stafford Springs CT 06076 222541981 Occupational Medicine CT 501 c 3 9 N/A 0 Home and Community Health Services 101 Phoenix Avenue Enfield CT 06083 060646620 Visiting Nurse Association CT 501 c 3 9 N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 Johnson Memorial Hospital k 95175 Reasonable Cost Johnson Memorial Hospital p 994476 Reasonable Cost N/A