2014-05-06T08:59:36-07:00 2013-09-30 990 2012-10-01 223012385 JOHNSON EVERGREEN CORPORATION JOHN 8606846341 205 Chestnut Hill Road Stafford Springs CT 060760549 John Grish 8606848152 2014-05-06 2012 2015-11-30 17:44:51Z Evergreen Health Care Center Stuart E rosenberg 289 Hill Street Bristol CT 06010 16153371 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 Memory Support unit for residents with Alzheimers's disease and similiar forms of dimentia. 16 16 309 73 0 0 8629 10420 16798928 16121923 0 0 43968 21028 16851525 16153371 0 0 0 0 11716653 11003418 0 0 0 6201793 8469002 17918446 19472420 -1066921 -3319049 11723027 8172681 17113052 16881755 -5390025 -8709074 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 Memory Support unity. 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 18681363 0 16142951 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 12 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. (52019 resident days) 0 0 0 18681363 1 0 0 0 0 0 0 0 0 0 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 1 1 0 0 1 27 0 1 309 1 0 0 0 0 0 0 0 0 0 1 1 0 X 16 16 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 2 X 0 0 0 James M Makuch 2 X 0 0 0 Evelyne A Parizek 2 X 0 0 0 David O'connor 2 X 0 0 0 James Baum 2 X 0 0 0 Christopher Dadlez 2 X 0 0 0 Arthur DeTore MD 2 X 0 0 0 Cathryn-Jean Fleming ESQ 2 X 0 0 0 John Giamalis 2 X 0 0 0 Joseph Ianello MD 2 X 0 0 0 Michael P Krol 0 X 0 0 0 Younus F Masih MD 2 X 0 0 0 John W Patton 2 X 0 0 0 Kathleen M Roche MS RN 2 X 0 0 0 Kevin Sullivan 2 X 0 0 0 Phil Tartsinis 2 X 0 0 0 Stuart E Rosenberg 50 X 0 0 114097 John Grish 50 X 0 270973 20007 James Fidanza 50 X 165246 0 38499 Damien R Eilerman 50 X 145315 0 34706 David Morgan 50 X 0 438844 23952 310561 709817 231261 2 1 1 1 0 0 0 0 0 0 10420 0 10420 Resident Revenues 623000 16121923 16121923 0 0 0 0 0 0 16121923 0 0 0 0 0 Title 19 application fees 561000 7550 7550 0 0 Miscellaneous Revenues 900099 13478 13478 0 0 0 0 0 0 21028 16153371 16142951 0 0 203745 203745 8572609 8427294 145315 1600105 1574554 25551 626959 617803 9156 2436 2436 30200 30200 872119 852119 20000 711008 711008 9329 8640 689 479837 479837 224472 224472 3156396 3156396 466781 346434 120347 Food 420561 420561 0 0 Patient Care and General Supplies 1137195 1137195 0 0 Provision for Uncollectible Accounts 50053 50053 0 0 Provider Taxes 899469 899469 0 0 9146 9146 19472420 18681363 791057 0 300 300 1772253 1560623 42908 34435 109498 84479 19792639 13792639 9140216 6000000 657852 492844 11723027 8172681 1540139 1856808 14431156 14213697 1141757 811250 17113052 16881755 X -5390025 -8709074 0 0 0 0 -5390025 -8709074 11723027 8172681 -3319049 0 0 0 0 0 X 0 1 X 1 0 X 17413 24292 24258 8629 10420 85012 15862663 16970737 17547583 16798928 16121923 83301834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15880076 16995029 17571841 16807557 16132343 83386846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83386846 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 529585 551751 108544 43968 21028 1254876 16409661 17546780 17680385 16851525 16153371 84641722 0.98517 0.98449 0 0 X Other Income of 21,028 is comprised of Revenues from Title 19 Applications of 7,550 and Various Misc. Revenues of 13,478 0 0 0 15733693 0 10807906 4925787 0 0 0 0 2532579 0 2292188 240391 1526367 0 692545 833822 6000000 Other Receivable 296162 Deferred Costs 126923 Patient Trust Fund 69759 492844 0 Other Liabilities 296162 Patient Trust Fund 69759 Payments due under Plan of Reorganization 188740 Due to Affiliated Corporations 79991 Estimated Amounts due to Third-Party Payers 176598 811250 X 16103318 0 0 0 0 0 16103318 0 50053 50053 16153371 19422367 0 0 0 0 0 19422367 0 50053 50053 19472420 SchD_P10_S00_L02 Schedule D, Part X, Line 2 Management has analyzed the tax positions taken and has concluded that as of September 30, 2013, there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Company is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Management believes the Company is no longer subject to income tax examininations prior to 2010. SchD_P11_S00_L04b Schedule D, Part XI, Line 4b Bad debt expense SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Bad Debt expense on audited financial statements is a deduction from revenue X X X X X 1 0 0 0 0 0 0 0 0 David Morgan 0 438844 0 0 0 23952 0 0 0 0 0 462796 0 0 John Grish 0 270973 0 0 0 20007 0 0 0 0 0 290980 0 0 James Fidanza 165246 0 0 0 38499 0 0 0 0 0 203745 0 0 0 Damien R Eilerman 145315 0 0 0 34706 0 0 0 0 0 180021 0 0 0 SchJ_P01_S00_L04 Schedule J, Part I, Line 4 David Morgan received a severence package in the amount of 286795 which is included in the 438844 on Partll line 1e of Schedule J. These amounts were paid by Johnson Memorial Hospital (EIN#06-0646696) which is a subsidiary of Johnson Memorial Medical Center. The severence period was 10 months in 2013. Stuart Rosenberg succeeded David Morgan as President/CEO on March 1, 2013 F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 Article 3 of the Johnson Memorial Medical Center Bylaws stipulates there will be not less than 30 nor more than 60 members. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a Members are elected by the Board as recommended by the Governance and Nominating Committee F990_P06_S0B_L11b 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 files. 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 meetign following the filing of Form 990. F990_P06_S0B_L12c 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. F990_P06_S0B_L15 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 similiar positions in similiar organizations, and expert compensation schedules. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The Johnson Memorial Medical Center maintains these documents in Administratoin 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 Johnson Memorial Hospital 201 Chestnut Hill Road Stafford Springs CT 06076 060646696 Acute Care Hospital CT 501 c 3 3 N/A Johnson Development Fund Inc 201 Chestnut Hill Road Stafford Springs CT 06076 222541977 Fund Raising CT 501 c 3 11 N/A Johnson Health Care Inc 201 Chestnut Hill Road Stafford Springs CT 06076 222541981 Occupational Medicine CT 501 c 3 9 N/A Home and Community Health Services 101 Phoenix Avenue Enfield CT 06083 060646620 Visiting Nurse Association CT 501 c 3 9 N/A Wellcare Inc 201 Chestnut Hill Road stafford Springs CT 06076 222541983 Inactive For Profit Corporation CT N/A C 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 Johnson Memorial Hospital k 180000 Reasonable cost Johnson Memorial Hospital p 224472 Reasonable cost N/A