2015-07-15T13:46:09-05:00 2014-08-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192367 990 2013-09-01 953510024 LOS ANGELES JEWISH HOME FOR THE AGING LOSA 8187743372 7150 TAMPA AVE RESEDA CA 913353700 SHERRI CUNNINGHAM CFO 8187743372 2015-07-13 1 JOUA V LO P01225144 2099556100 2013 2016-02-25 16:41:14Z SHERRI CUNNINGHAM 7150 TAMPA AVE RESEDA CA 913353700 25006126 0 X WWW.JHA.ORG X 1912 CA NURSING, RESIDENTIAL AND CLINICAL CARE FOR THE ELDERLY. 18 17 95 10 0 0 25368588 12736945 27251185 9435428 577183 205242 -20393 356780 53176563 22734395 0 0 0 0 8157270 8381936 0 0 2399085 17284077 27820902 25441347 36202838 27735216 -13468443 105693385 254671431 105983927 267572732 -290542 -12901301 EXCELLENCE IN SENIOR CARE REFLECTIVE OF JEWISH VALUES. 0 0 29465272 0 9435428 FUNDING ORGANIZATION AND MANAGEMENT SERVICES FOR RELATED ORGANIZATIONS: EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING, GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING, JHA GERIATRIC SERVICES, ANNENBERG SCHOOL OF NURSING AND BRANDMAN CENTERS FOR SENIOR CARE, INC. 70146 0 0 DEVELOPMENT OF CAMPUS IN WEST LOS ANGELES. 29535418 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 207 0 1 95 1 0 0 0 0 0 1 1 0 0 0 0 X 18 17 1 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X ELAINE KAMIEL 8187743372 7150 TAMPA AVENUE RESEDA CA 91335 R BENDER DIRECTOR 2.00 X 0 0 0 L BLANKSTEIN VICE CHAIR 2.00 X X 0 0 0 J BRANDMAN DIRECTOR 2.00 4.00 X 0 0 0 J EISENBERG-KEEFER DIRECTOR 2.00 X 0 0 0 J GLASSMAN CHAIR 2.00 X X 0 0 0 E GREINITZ DIRECTOR 2.00 2.00 X 0 0 0 L GRANOW DIRECTOR 2.00 X 0 0 0 J HELD VICE CHAIR 2.00 X X 0 0 0 C HERSHON DIRECTOR 2.00 X 0 0 0 B HIRSCH DIRECTOR 2.00 X 0 0 0 M HESLOV DIRECTOR 2.00 X 0 0 0 S GOOD DIRECTOR 2.00 X 0 0 0 B MILLER-FOX ABRAMOFF VICE-CHAIR, SECRETARY 2.00 X X 0 0 0 D SWARTZ DIRECTOR 2.00 X 0 0 0 S REISSMAN DIRECTOR 2.00 X 0 0 0 P RUBIN DIRECTOR 2.00 X 0 0 0 A PRICE DIRECTOR 2.00 X 0 0 0 M POLIER SWARTZ DIRECTOR (THROUGH 6/30/14) 2.00 X 0 0 0 M FORREST CEO-PRESIDENT 30.00 10.00 X X 646683 0 17380 M GLUCHOW DIRECTOR (THROUGH 4/6/14) 2.00 X 0 0 0 S CUNNINGHAM CFO 34.00 8.00 X 348747 0 25269 L STEPANIANS COO 40.00 X 224778 0 1721 S GINCHANSKY VP, HUMAN RESOURCES 38.00 2.00 X 211496 0 1950 A POSSICK VP OF PLANNING & COMMUNITY BASED SVCES 20.00 20.00 X 276628 0 19047 I SCHRECK FOUNDATION SENIOR VP 40.00 X 276444 0 8860 J ERBE DIRECTOR INFO SYSTEMS 40.00 X 211244 0 5890 C SLAVIN VP OF FUND DEVELOPMENT 40.00 X 185536 0 15379 A HOFFER DIRECTOR OF DEVELOPMENT 40.00 X 177277 0 11052 L NUSSBAUM DIRECTOR OF MARKETING, FOUNTAINVIEW AT GONDA WESTS 40.00 X 166006 0 21335 B POLISHUK DIRECTOR OF MARKETING 40.00 X 167064 0 15262 2891903 0 143145 20 0 1 0 DIAGNOSTIC LABORATORIES LLC 2820 N ONTARIO ST BURBANK CA 91504 LABORATORY SERVICES 415788 ALSTON & BYRD PO BOX 933124 ATLANTA GA 31193 LEGAL SERVICES 259189 SOS SECURITY LLC 1915 ROUTE 46 PARSIPPANY NJ 07054 SECURITY SERVICES 236442 LOOPBACK LLC 14900 LANDMARK BLVD DALLAS TX 75254 SOFTWARE PURCHASE & DEVELOPMENT 221895 MOSS ADAMS LLP 10960 WILSHIRE BLVD 1100 LOS ANGELES CA 90024 ACCOUNTING SERVICES 198353 10 1188825 11548120 12736945 FUNDING FROM RELATED ORGS 900099 9435428 9435428 9435428 209603 209603 1626892 1622028 9225 4864 -9225 -4361 -4361 132092 1188825 638303 -506211 -506211 3750 2175 1575 1575 SERVICE TO BCSC 900099 535570 535570 SERVICE TO HOSPICE 900099 60000 60000 SERVICE TO HHLTH & CARE T 900099 48717 48717 217129 217129 861416 22734395 9435428 0 562022 2059003 1330274 443425 285304 4860219 2819009 939670 1101540 119019 70555 23518 24946 874488 603497 201166 69825 469207 286556 95519 87132 438259 272393 125370 40496 155000 155000 1053993 207719 703030 143244 198337 176067 22270 966876 451035 266995 248846 1276440 957330 319110 188054 141041 47013 72566 63643 8923 440729 87658 353071 7575127 7531903 43224 1216218 1216218 88878 88878 FUNDING TO RELATED ORGA 13446735 13446735 RECRUITMENT COSTS 121715 121715 DUES & LICENSES 42717 38557 4160 FINANCING ADMINISTRATIV 40366 40366 498892 79438 410126 9328 36202838 29535418 4268335 2399085 368155 2650004 2719962 27155254 22240211 1394710 2615674 45054323 8110622 35616571 36943701 12956628 12234735 25552063 177917148 105693385 254671431 8999815 8713092 89848703 240988813 2645000 7135409 15225827 105983927 267572732 X -40411167 -47901005 30194976 25054479 9925649 9945225 -290542 -12901301 105693385 254671431 -13468443 857684 0 X 0 1 X 1 0 X 23718338 6958012 9231864 25368588 12736945 78013747 23718338 6958012 9231864 25368588 12736945 78013747 31658719 46355028 674566 543097 469865 488196 209603 2385327 4579881 101968 200510 434030 861416 6177805 86576879 115476972 0.53540 0.55430 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SETTLEMENT OTHER INCOME - 2009 AMOUNT: $ 4,531,881. 2010 AMOUNT: $ 53,968. 2011 AMOUNT: $ 152,510. 2012 AMOUNT: $ 280,591. 2013 AMOUNT: $ 265,846. SERVICE TO HOSPICE - 2009 AMOUNT: $ 48,000. 2010 AMOUNT: $ 48,000. 2011 AMOUNT: $ 48,000. 2012 AMOUNT: $ 60,000. 2013 AMOUNT: $ 60,000. SERVICE TO BCSC - 2012 AMOUNT: $ 93,439. 2013 AMOUNT: $ 535,570. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 40120624 1523058 7572 6651551 34999703 30582315 17683688 7664 8153043 40120624 34350424 2919077 7453 6694639 30582315 38683420 2054121 8952 6396069 34350424 31086102 16998055 8802 9409539 38683420 0.00000 0.28420 0.71580 0 0 21480859 21480859 4649259 2609519 2039740 11840672 5429082 6411590 7083533 72021 7011512 36943701 FUNDS HELD BY TRUSTEE UNDER DEBT AGREEMENT 150187406 DEBT ISSUANCE COSTS, NET OF ACCUMULATED AMORTIZATION 12195053 CHARITABLE REMAINDER TRUST RECEIVABLES 408380 INTEREST IN NET ASSETS OF RECIPIENT ORGANIZATION 711180 ASSETS HELD IN ESCROW FOR CCRC DEPOSITS 13339861 OTHER ASSETS 385725 ARTWORK 89543 GOODWILL 600000 177917148 ANNUITY OBLIGATIONS 1259127 OTHER 112831 CCRC ESCROW DEPOSITS 13339861 CASH OVERDRAFT 514008 15225827 X PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS. PART X, LINE 2: THE HOME RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF AUGUST 31, 2014 OR 2013. MIDDLE EAST AND NORTH AFRICA - ALGERIA, BAHRAIN, DJIBOUTI, EGYPT, 0 0 INVESTMENTS 2011000 0 0 0 0 0 0 2011000 0 2011000 0 0 0 0 0 0 REFLECTIONS DINNER 569028 512125 56903 289360 WALK OF AGES 259695 233726 25969 100595 5 492194 442975 49219 248347 1320917 1188826 132091 638302 638302 -506211 X X X X X X 0 0 0 0 0 0 0 0 0 M FORREST CEO-PRESIDENT 511683 0 135000 0 0 0 7061 0 10319 0 664063 0 0 0 S CUNNINGHAM CFO 333747 0 15000 0 0 0 6978 0 18291 0 374016 0 0 0 L STEPANIANS COO 224778 0 0 0 0 0 0 0 1721 0 226499 0 0 0 S GINCHANSKY VP, HUMAN RESOURCES 211496 0 0 0 0 0 511 0 1439 0 213446 0 0 0 A POSSICK VP OF PLANNING & COMMUNITY BASED SVC 264628 0 12000 0 0 0 7089 0 11958 0 295675 0 0 0 I SCHRECK FOUNDATION SENIOR VP 271444 0 5000 0 0 0 7084 0 1776 0 285304 0 0 0 J ERBE DIRECTOR INFO SYSTEMS 202344 0 8900 0 0 0 5890 0 0 0 217134 0 0 0 C SLAVIN VP OF FUND DEVELOPMENT 185536 0 0 0 0 0 5748 0 9631 0 200915 0 0 0 A HOFFER DIRECTOR OF DEVELOPMENT 177277 0 0 0 0 0 415 0 10637 0 188329 0 0 0 L NUSSBAUM DIRECTOR OF MARKETING, FOUNTAINVIEW 166006 0 0 0 0 0 0 0 21335 0 187341 0 0 0 B POLISHUK DIRECTOR OF MARKETING 167064 0 0 0 0 0 5081 0 10181 0 182326 0 0 0 A CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 130795QQ3 2008-02-14 60907828 CONSTRUCTION OF A 108-BED CONTINUING CARE RETIREMENT FACILITY 0 0 0 B CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2013-12-20 71155000 REFUND OUTSTANDING DEBT ISSUED 12/1/2003 0 0 0 C CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13081AAN2 2014-08-27 150100266 SEE PART VI 0 0 0 A 40075000 63047242 2357127 2139414 1039504 2932482 47479331 2010 0 0 1 1 B 71155000 7616314 1302898 2270808 62473256 1 0 1 1 C 150100266 140213965 2321805 5418729 2300000 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 1 TRANSAMERICA OCCIDENTAL LIFE 5.800000000000 1 0 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/13/2013 SCHEDULE K, PART II, LINE 3 THE TOTAL PROCEEDS OF ISSUE PER BOND IS GREATER THAN THE BOND ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO BOND PREMIUMS AND CAPITALIZED INTEREST INCOME RELATED TO THE BONDS. SCHEDULE K, PART I, ROW C, COLUMN (F) - DESCRIPTION OF PURPOSE: CONSTRUCTION OF A 175-BED CONTINUING CARE RETIREMENT FACILITY AND 24 ASSISTED LIVING AND MEMORY CARE UNITS. FORM 990, PART VI, SECTION A, LINE 2 D SWARTZ AND J GLASSMAN - BUSINESS D SWARTZ AND M POLIER SWARTZ - FAMILY FORM 990, PART VI, SECTION A, LINE 4 CHANGE WAS MADE TO DISSOLUTION CLAUSE OF THE ARTICLES OF INCORPORATION TO STATE THAT ASSET DISTRIBUTION MUST BE TO A SUBSIDIARY OR IF NO SUBSIDIARY EXISTS, TO ANOTHER ORGANIZATION, WHICH IS ORGANIZED AND OPERATED EXCLUSIVELY FOR ONE OR MORE QUALIFYING EXEMPT PURPOSES THAT MEET CURRENT REVENUE & TAXATION CODES AND ARE 501(C)(3) TAX EXEMPT. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE REVIEWED BY THE VOTING MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST FORM SPECIFIES ACTIONS THAT WOULD BE CONSIDERED CONFLICTS OF INTEREST AND EXPLAINS THE ORGANIZATION'S PROCEDURES TO REPORT ANY SUSPECTED CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 POLICY FOR DETERMINATION OF EXECUTIVE COMPENSATION, OFFICERS AND TOP MANAGEMENT INCLUDES REVIEWING COMPARABILITY DATA FROM NUMEROUS SALARY AND COMPENSATION SURVEYS AND THE FORM 990 DATA OF SIMILAR ORGANIZATIONS. THE COMPENSATION FOR TOP MANAGEMENT IS DETERMINED BY THE EXECUTIVE REVIEW COMMITTEE AND APPROVED BY THE FULL EXECUTIVE COMMITTEE OF THE BOARD. COMPENSATION IS REVIEWED FOR OFFICERS AND TOP MANAGEMENT ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. 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