2014-07-11T18:01:53-05:00 2013-08-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192303 990 2012-09-01 953510024 LOS ANGELES JEWISH HOME FOR THE AGING LOSA 8187743372 7150 TAMPA AVE RESEDA CA 913353700 SHERRI CUNNINGHAM 8187743372 2014-07-09 1 JOUA V LO P01225144 2099556100 2012 2015-11-30 17:44:51Z SHERRI CUNNINGHAM 7150 TAMPA AVE RESEDA CA 913353700 54675931 0 X WWW.JHA.ORG X 1912 CA NURSING, RESIDENTIAL AND CLINICAL CARE FOR THE ELDERLY. 15 14 86 10 0 0 9231864 25368588 57520326 27251185 491063 577183 -32269 -20393 67210984 53176563 0 0 0 0 7581469 8157270 0 0 2080029 16801912 17284077 24383381 25441347 42827603 27735216 96008025 105693385 124280217 105983927 -28272192 -290542 EXCELLENCE IN SENIOR CARE REFLECTIVE OF JEWISH VALUES. 0 0 19714340 0 27251185 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. 89134 0 0 DEVELOPMENT OF CAMPUS IN WEST LOS ANGELES. 19803474 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 1 177 0 1 86 1 0 0 0 0 0 1 1 0 0 0 0 X 15 14 1 0 0 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 X M FORREST 30.00 10.00 X X 624672 0 17002 J GLASSMAN 2.00 X X 0 0 0 J HELD 2.00 X X 0 0 0 L BLANKSTEIN 2.00 X X 0 0 0 B MILLER-FOX ABRAMOFF 2.00 X X 0 0 0 M HESLOV 2.00 X 0 0 0 S ASHER 2.00 X 0 0 0 R BENDER 2.00 X 0 0 0 J BRANDMAN 2.00 4.00 X 0 0 0 J EISENBERG-KEEFER 2.00 X 0 0 0 M GLUCHOW 2.00 X 0 0 0 G GOLDFEIN 2.00 X 0 0 0 C HERSHON 2.00 X 0 0 0 M POLIER SWARTZ 2.00 X 0 0 0 A PRICE 2.00 X 0 0 0 S REISSMAN 2.00 X 0 0 0 P RUBIN 2.00 X 0 0 0 D SWARTZ 2.00 X 0 0 0 S CUNNINGHAM 32.00 8.00 X 363704 0 29633 J GRAHAM 36.00 4.00 X 334551 0 11398 L STEPANIANS 36.00 4.00 X 0 0 0 S RYAN 38.00 2.00 X 258051 0 12450 S GINCHANSKY 38.00 2.00 X 16404 0 0 A POSSICK 20.00 20.00 X 235048 0 22978 I SCHRECK 40.00 X 268232 0 7067 J ERBE 40.00 X 193035 0 5666 H SABET 40.00 X 162664 0 8907 E KAMIEL 40.00 X 165139 0 9134 C SLAVIN 40.00 X 181161 0 14976 B POLISHUK 40.00 X 162052 0 19313 2964713 0 158524 20 0 1 0 DIAGNOSTIC LABORATORIES LLC 2820 N ONTARIO ST BURBANK CA 91504 LABORATORY SERVICES 289532 MONTGOMERY MARKETING 1429 N NAOMI ST BURBANK CA 91505 MEDICAL SUPPLIES 226774 MOSS ADAMS LLP 3130 WILSHIRE BLVD SANTA MONICA CA 90403 AUDIT & ACCOUNTING SERVICES 209111 ARENT FOX LLP 1050 CONNECTICUT AVE N W WASHINGTON DC 20036 LEGAL SERVICES 205870 HYATT REGENCY CENTURY PLAZA 2025 AVENUE OF THE STARS LOS ANGELES CA 90067 FUNDRAISING EVENT 149954 8 1063236 24305352 25368588 FUNDING FROM RELATED ORGS 900099 27251185 27251185 27251185 488196 488196 1000000 7500 918513 0 81487 7500 88987 88987 118137 1063236 576707 -458570 -458570 8295 4148 4147 4147 JHA WEST TRANSFER 900100 183613 183613 SERVICE TO BCSC 900099 93439 93439 SERVICE TO HOSPICE 900099 60000 60000 96978 96978 434030 53176563 27251185 0 556790 2201190 1444418 481473 275299 4710378 2781944 927314 1001120 98163 57802 19267 21094 706706 481306 160436 64964 440833 267951 89317 83565 736081 544972 174722 16387 120000 120000 883484 193496 547132 142856 139979 137519 2460 930597 431290 267186 232121 960830 720623 240207 128567 96425 32142 55396 47373 8023 285988 69749 216239 6170864 6167813 3051 1483571 1483571 97938 97938 FUNDING TO RELATED ORGA 4753717 4753717 RECRUITMENT COSTS 289643 289643 PURCHASED SERVICES 48387 43496 4891 RESTRICTED PROGRAMS 46052 46052 152983 42451 99522 11010 25441347 19803474 3557844 2080029 21331579 368155 3654565 2650004 17253417 27155254 293874 1394710 42573182 6956611 14194233 35616571 11976228 12956628 27304129 25552063 96008025 105693385 9072165 8999815 113991533 89848703 1216519 7135409 124280217 105983927 X -58854508 -40411167 20657551 30194976 9924765 9925649 -28272192 -290542 96008025 105693385 27735216 246434 0 X 0 1 X 1 0 X 30509893 23718338 6958012 9231864 25368588 95786695 30509893 23718338 6958012 9231864 25368588 95786695 37961534 57825161 404895 674566 543097 469865 488196 2580619 177991 4696689 223707 298145 560462 5956994 104324308 0.55430 0.62860 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SETTLEMENT OTHER INCOME SPECIAL EVENT GROSS RECEIPTS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 30582315 17683688 7664 8153043 40120624 34350424 2919077 7453 6694639 30582315 38683420 2054121 8952 6396069 34350424 31086102 16998055 8802 9409539 38683420 32041482 16941417 40620 17937417 31086102 0.00000 0.24740 0.75260 0 0 21480859 21480859 8023611 2759192 5264419 9792589 4142379 5650210 3276123 55040 3221083 35616571 FUNDS HELD BY TRUSTEE UNDER DEBT AGREEMENT 11301249 DEBT ISSUANCE COSTS, NET OF ACCUMULATED AMORTIZATION 4785005 CHARITABLE REMAINDER TRUST RECEIVABLES 383177 INTEREST IN NET ASSETS OF RECIPIENT ORGANIZATION 1277938 ASSETS HELD IN ESCROW FOR CCRC DEPOSITS 5742366 OTHER ASSETS 83997 ARTWORK 89543 FUNDS DUE FROM RELATED ORGANIZATIONS 1636630 HOME HEALTH AGENCY ACQUISITION COSTS 252158 25552063 ANNUITY OBLIGATIONS 1322712 OTHER 70331 CCRC ESCROW DEPOSITS 5742366 7135409 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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, 2013 OR 2012. MIDDLE EAST AND NORTH AFRICA 0 0 INVESTMENTS 2011000 0 0 0 0 0 0 2011000 0 2011000 0 0 0 0 0 0 REFLECTIONS DINNER 437681 393913 43768 286768 WALK OF AGES 176922 159230 17692 44003 6 566770 510093 56677 245936 1181373 1063236 118137 576707 576707 -458570 X X X X X X 0 0 0 0 0 0 0 0 0 M FORREST 501741 0 122931 0 0 0 6809 0 10193 0 641674 0 0 0 S CUNNINGHAM 321204 0 42500 0 0 0 5964 0 23669 0 393337 0 0 0 J GRAHAM 334551 0 0 0 0 0 3476 0 7922 0 345949 0 0 0 S RYAN 243051 0 15000 0 0 0 6500 0 5950 0 270501 0 0 0 A POSSICK 227548 0 7500 0 0 0 7030 0 15948 0 258026 0 0 0 I SCHRECK 263232 0 5000 0 0 0 5393 0 1674 0 275299 0 0 0 J ERBE 190535 0 2500 0 0 0 5666 0 0 0 198701 0 0 0 H SABET 162664 0 0 0 0 0 4516 0 4391 0 171571 0 0 0 E KAMIEL 162639 0 2500 0 0 0 4743 0 4391 0 174273 0 0 0 C SLAVIN 181161 0 0 0 0 0 5543 0 9433 0 196137 0 0 0 B POLISHUK 158552 0 3500 0 0 0 4867 0 14446 0 181365 0 0 0 A CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 130911UM0 2003-12-01 80464884 CONSTRUCTION OF A 249-BED ACUTE PSYCH. HOSPITAL & SKILLED NURSING FACILITY 0 0 0 B CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 130795QQ3 2008-02-14 60907828 CONSTRUCTION OF A 108-BED CONTINUING CARE RETIREMENT FACILITY 0 0 0 A 10175000 82981231 8181873 2516347 1224500 5288005 45773951 2007 1 0 1 1 B 40050000 63047242 3119376 2139414 1039504 2932482 47479331 2010 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 1 TRANSAMERICA OCCIDENTAL LIFE 10.000000000000 1 0 0 B 0 0 0 1 0 0 1 TRANSAMERICA OCCIDENTAL LIFE 5.800000000000 1 0 0 A 0 B 0 SCHEDULE K PART IV, ARBITRAGE, LINE 2C DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/17/2013 ISSUER NAME: CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/13/2013 SCHEDULE K, PART II, LINE 3 TOTAL PROCEEDS OF ISSUE 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. FORM 990, PART VI, SECTION A, LINE 2 M POLIER SWARTZ AND D SWARTZ - FAMILY D SWARTZ AND J GLASSMAN - BUSINESS 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. FORM 990, PART VII: AS REQUIRED, THE REPORTABLE COMPENSATIONS ON PART VII, COLUMNS D, E AND F WERE BASED ON COMPENSATIONS REPORTED ON FORMS W-2 OR 1099-MISC FOR CALENDAR YEAR 2012. LARISSA STEPANIANS STARTED AS COO EFFECTIVE ON 2/4/2013, THEREFORE, THERE WERE NO SUCH REPORTABLE COMPENSATIONS FOR HER DURING CALENDAR YEAR 2012. JHA WEST 16 LLC 7150 TAMPA AVENUE RESEDA CA 91335 263639876 RAISE FUNDS TO BUY LAND FOR A WEST LA CAMPUS FOR A CCRC AND ASSISTED LIVING CA 32000 25677560 N/A JHA GERIATRIC SERVICES INC 7150 TAMPA AVE RESEDA CA 91335 954407317 CLINICAL AND HOSPICE SERVICES FOR THE ELDERLY CA 501(C)(3) 9 N/A 1 EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING 7150 TAMPA AVE RESEDA CA 91335 951691015 RESIDENTIAL CARE AND SKILLED NURSING FACILITY CA 501(C)(3) 9 N/A 1 ANNENBERG SCHOOL OF NURSING 7150 TAMPA AVE RESEDA CA 91335 208449705 VOCATIONAL NURSE EDUCATION CA 501(C)(3) 2 N/A 1 GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING 7150 TAMPA AVE RESEDA CA 91335 951831045 RESIDENTIAL CARE AND SKILLED NURSING FACILITY CA 501(C)(3) 9 N/A 1 BRANDMAN CENTERS FOR SENIOR CARE INC 7150 TAMPA AVE RESEDA CA 91335 264023159 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY CA 501(C)(3) 9 N/A 1 JEWISH HOME FOUNDATION 7150 TAMPA AVE RESEDA CA 91335 800927200 FUNDRAISING CA 501(C)(3) LINE 11A, I N/A 1 0 0 0 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 JHA GERIATRIC SERVICES Q 1296115 FMV EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING P 3241964 FMV EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING Q 15896144 FMV GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING P 1436444 FMV GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING Q 10058926 FMV ANNENBERG SCHOOL OF NURSING P 75308 FMV JHA WEST 16 P 19808716 FMV