2015-11-13T09:18:50-07:00 2014-12-31 990 2014-01-01 150539103 JEWISH HOME OF CENTRAL NEW YORK INC JEWI 3154469111 4101 E GENESEE STREET SYRACUSE NY 13214 Robert Wood CFO 3154469111 2015-11-13 2014 2016-03-07 17:11:31Z Mary Ellen Bloodgood 4101 E Genesee St Syracuse NY 13214 15892021 0 X menorahparkcny.com X 1937 NY Provide skilled nursing services, home care services, adult day care. 14 14 384 20 0 0 1225914 248548 15755582 15493835 211057 123173 171592 26465 17364145 15892021 0 0 0 0 10197697 10462822 0 0 0 5651319 5705915 15849016 16168737 1515129 -276716 17033626 16576077 17170706 17695063 -137080 -1118986 Provided 47,568 patient days of skilled nursing home services, 6,455 adult day care visits and 14,000 home health care visits. 0 0 14814506 15447219 Provided 47,568 patient days of skilled nursing home services, 6,455 adult day care visits, and 14,000 home health care visits. 0 0 0 14814506 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 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 0 0 0 0 1 21 0 1 384 1 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 NY X Mary Ellen Bloodgood CEO 3154469111 4101 E Genesee Street Syracuse NY 13214 X Michael Balanoff Director 1 0 X 0 0 0 Neil Bronstein Director 1 0 X 0 0 0 Joseph Greenman Director 1 0 X 0 0 0 Jon Maloff Treasurer 1 0 X X 0 0 0 Gary Zausmer Director 1 0 X 0 0 0 Jeffry Berman Director 1 0 X 0 0 0 Phylis LaVine Secretary 1 0 X X 0 0 0 Jeffrey Scheer President 1 0 X X 0 0 0 Jeffery Meyer Director 1 0 X 0 0 0 Mark Shulman Director 1 0 X 0 0 0 Bruce Smith Director 1 0 X 0 0 0 Art Diamond Director 1 0 X 0 0 0 Arthur Liberman Director 1 0 X X 0 0 0 David Newman Vice President 1 0 X X 0 0 0 Mary Ellen Bloodgood CEO 40 25.00 X X 234840 0 6573 Robert Wood CFO 50 25 X X 129816 0 0 Catherine Reeves Director of Nursing 48 0 X 107673 0 0 472329 0 6573 3 0 1 1 Sodexo Inc 9801 Washingtonian Bld Gaithersburg MD 20878 Dietary Service Contract 855716 Health Direct PO Box 62246 Baltimore MD 21264 Pharmacy Services 132970 2 0 0 0 0 0 248548 0 248548 Resident Care 623000 15098629 15098629 0 0 Rental Income 623990 395206 395206 0 0 0 0 0 0 15493835 123173 123173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Insurance Proceeds 900099 26465 26465 0 0 0 0 0 0 26465 15892021 15643473 0 0 364656 364656 7236055 6981269 254786 291373 291373 0 2003395 1925310 78085 567343 521106 46237 30747 23138 7609 56420 0 56420 22520 0 22520 12881 0 12881 160316 160316 0 826 826 0 114158 21426 92732 1211207 1211207 0 13990 5566 8424 110220 110220 0 728216 728216 0 143691 0 143691 Dietary Service Contract 855717 855717 0 All Other Purchased Services 552828 446253 106575 NYS Cash Receipts Assessments 774362 774362 0 Supplies: Medical, Drugs, Linen, Cleaning, All Other 555550 549370 6180 362266 208831 153435 16168737 14814506 1354231 0 138493 14473 1515020 1505524 12513 10164 104778 221764 22774678 15137329 8088719 7637349 7174103 7186803 17033626 16576077 2888488 3143388 0 91035 12748542 12958319 1533676 1502321 17170706 17695063 X -1435778 -2348718 400563 331597 898135 898135 -137080 -1118986 17033626 16576077 X -276716 0 0 0 0 -705190 X 0 1 X 1 0 X 104466 195274 673104 1225914 123173 2321931 14616869 14323617 14587710 15755582 15447219 74730997 14721335 14518891 15260814 16981496 15570392 77052928 77052928 270 577 3198 211057 123173 338275 270 577 3198 211057 123173 338275 0 0 0 171592 73081 244673 14721605 14519468 15264012 17364145 15766646 77635876 0.99249 0.99368 0.00436 0.00407 X Schedule A, Part III, Line 12 Insurance proceeds of 171,592 in 2013 and 26,465 in 2014. Schedule A, Part III, Line 13(f) Insurance Proceeds of 171,592 in 2013 & 26,465 in 2014. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1298699 0 -68966 0 0 0 1229733 1286001 0 12698 0 0 0 1298699 1131180 0 154821 0 0 0 1286001 1073272 0 57908 0 0 0 1131180 1218097 0 -144825 0 0 0 1073272 0 0.73 0.27 0 1 0 6903 0 6903 19459255 0 12595314 6863941 0 0 0 0 2251692 0 1885433 366259 1056828 0 656582 400246 7637349 Due from Affiliates 2312841 Residents Deposits Held in Trust 22787 Assets Limited As To Use 2973677 Beneficial Interest in Net Asssets of Foundations 1229733 Deferred Financing Costs, net 647765 7186803 0 Estimated Third Party Settlements, net 974534 Note Payable to Affiliate 505000 Resident Deposits Held in Trust 22787 1502321 15892021 0 0 0 0 0 15892021 0 0 0 15892021 16168737 0 0 0 0 0 16168737 0 0 0 16168737 Schedule D, Part V, Line 4 Funds are used for the operation and mission of the skilled nursing home. X X 0 0 0 0 0 0 0 0 0 Mary Ellen Bloodgood CEO 210340 0 24500 0 0 0 0 0 6573 0 241413 0 0 0 Robert Wood CFO 129816 0 0 0 0 0 0 0 0 0 129816 0 0 0 Schedule J, Part II The CEO is paid from the Jewish Home of Central New York, and a W-2 is issued. However, portions of the CEO's compensation are allocated to six affiliates. Of the W-2 amount of 234,840, 178,175 was allocated to the Jewish Home, and 56,665 was allocated to the other five affiliates. IRS instructions require that the entire W-2 amount be reported on Form 990, Part VII, col. (D). The same is true for the CFO; 99,569 was allocated to the Jewish Home, and 30,247 to the other affiliates. A Onondaga Civic Development Corporation 800458240 682832CJ7 2014-11-04 12937386 Refinancing of original Series 2001 Bonds 0 0 0 A 12397500 0 12937386 1173166 0 0 595199 0 0 0 0 0 2014 1 0 1 1 A 0 0 0 0 0 0 0 1 0 1 A 0 0 0 0 0 0 0 0 1 A 1 Schedule K, Part I-11/04/2014 12,937,386 Onondaga Civic Development Corporation Series 2014 Bonds were issued in the amount of $20,410,000 to refund the existing bonds of three related 501(c)(3) companies, referred to in the bond documents as the "Obligated Group". These companies consist of a nursing home, an assisted living facility, and an independent living facility, and they are located on one campus. 63.4% of the 2014 Bond obligations are allocated to the Jewish Home of Central New York. The main purpose of the 2014 bond issue was to retire the prior bonds issued in 2001 & 2005, which were at higher interest rates. Form 990, Part VI, Section B, Line 11b The 990 return is reviewed by members of the Finance Committee, and then distributed to the Board members before being filed with the IRS. Form 990, Part VI, Section B, Line 12c The conflict of interest policy is reviewed by the Corporate Compliance Committee annually, and disclosure statements are signed, reviewed, and acted upon if required. Form 990, Part VI, Section B, Line 15 The compensation of the CEO is approved by the Board of Directors. There is a five year contract, and performance bonuses, if any, are review each year. Form 990, Part VI, Section C, Line 19 The governing documents, conflict of interest documents, and audited financial statements are available to the public in the Administration office, upon request. Form 990, Part XI, Line 9 Change in beneficial interest net assets of Jewish Home of Central New York Foundation, is -68,966. Also, -21,500 is an equity transfer to affiliate (also a 501c3 corp.). Also, -614,724 is for loss on bond refinancing. The 2001 original bonds were retired with proceeds from a Series 2014 bond issue, to save interest expense going forward. The 614,724 was for the deferred 2001 financing costs that were written off. Combining all above items, equals - 705,190 on Line 9.