2013-11-11T09:39:55-06:00 2012-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2012-01-01 112625096 ELDERPLAN INC ELDE 7189217742 6323 SEVENTH AVENUE BROOKLYN NY 11220 ALEX BALKO 7189217742 2013-10-30 1 FREDERICK H ROTHMAN P01275277 2128674000 2012 2016-02-24 21:20:13Z ALEX BALKO 6323 SEVENTH AVENUE BROOKLYN NY 11220 616870388 0 X WWW.MJHS.ORG X 1982 NY A MEDICARE MANAGED CARE AND MEDICAID MANAGED LONG TERM CARE PROGRAM 8 7 413 7 0 0 0 0 399877926 527051784 1400409 1490983 2886 0 401281221 528542767 4000000 0 0 0 38131358 40538604 0 0 0 370903515 485940499 413034873 526479103 -11753652 2063664 148020075 153912205 66153127 69424271 81866948 84487934 X ELDERPLAN, A MEDICARE ADVANTAGE ORGANIZATION WITH A MEDICARE CONTRACT, SERVES OVER 15,000 SENIORS AND ADULTS WITH DISABILITIES IN THE BRONX, BROOKLYN, MANHATTAN, QUEENS AND STATEN ISLAND. A NOT-FOR-PROFIT ORGANIZATION, ELDERPLAN OFFERS A VARIETY OF HEALTH PLANS FOR MEDICARE AND MEDICAID BENEFICIARIES. 0 0 451028030 527051784 ELDERPLAN STARTED AS ONE OF THE FOUR ORIGINAL SOCIAL HEALTH MAINTENANCE ORGANIZATIONS (SHMOS) IN THE COUNTRY. NEARLY 30 YEARS LATER, ELDERPLAN, A MEDICARE ADVANTAGE ORGANIZATION WITH A MEDICARE CONTRACT, SERVES OVER 15,000 SENIORS AND ADULTS WITH DISABILITIES IN THE BRONX, BROOKLYN, QUEENS, MANHATTAN AND STATEN ISLAND. THEY OPERATE A MANAGED LONG-TERM CARE PLAN, WHICH PROVIDES SERVICES TO MEDICAID-ELIGIBLE NEW YORKERS, AGE 18 AND OLDER, WHO ARE QUALIFIED FOR A NURSING HOME LEVEL OF CARE ACCORDING TO NEW YORK STATE ASSESSMENT CRITERIA. ELDERPLAN OFFERS A VARIETY OF PLANS THAT ARE DESIGNED TO ADDRESS THE HEALTH CARE NEEDS OF SENIORS AND PEOPLE WITH DISABILITIES. AS A NOT-FOR-PROFIT ORGANIZATION, WE REINVEST EARNINGS TO BRING OUR MEMBERS IMPROVED BENEFITS AND SERVICES. AS A RESULT, EACH YEAR NEW PLANS ARE DEVELOPED TO BETTER SERVE THE NEEDS OF THIS COMMUNITY. 451028030 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 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 0 0 0 1 4707 0 413 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X PEGGY GUNDERMAN 7189217742 6323 SEVENTH AVENUE BROOKLYN NY 11220 ELI S FELDMAN 15.50 17.80 X X 641062 619148 263416 ARTHUR GOSHIN MD 0.50 X X 0 0 0 RONALD B MILCH 0.50 X X 0 0 0 CLARA WILLIAMS 0.50 X 0 0 0 HOWARD GREENBERG 0.50 X 0 0 0 DIANE P POLLARD 0.50 X 0 0 0 BURTON ESRIG 0.50 X 0 0 0 HILDA RAYAS 0.50 X 0 0 0 ROBERT LEAMER 15.50 17.80 X 211786 204546 125319 ALEX BALKO 16.00 17.30 X 365420 346708 166374 ELLIOT BROOKS 6.50 26.60 X 82505 331279 107054 RONALD CHAFFIN 33.50 1.50 X 584787 17457 207898 VINCENT MARCHELLO 16.00 19.00 X 175539 208843 42691 RANDALL KLEIN 35.00 X 282411 0 24657 GERALD ANELLO 35.00 X 210196 0 40563 FRANCISCO POLANCO 35.00 X 231422 0 32114 LYNDA MONTELLA 35.00 X 246272 0 24075 KAYE MORROW 35.00 X 246223 0 44739 FELICIA DYER-JOHNSON 35.00 X 214517 0 38424 3492140 1727981 1117324 39 0 1 0 ENVISION PHARMACEUTICAL SERVICES 8921 CANYON FALLS BLVD TWINSBURG OH 44087 PHARMACEUTICAL 32597521 SPECIAL TOUCH HOME CARE 2091 CONEY ISLAND BROOKLYN NY 11223 HOME HEALTH AGENCY 29600181 BESTCARE INC 3000 HEMPSTEAD TURNPIKE PO BOX 9 LEVITTOWN NY 11756 HOME HEALTH AGENCY 24396858 COMMUNITY HOME CARE REFERRAL SERVICE 3920 13TH AVE BROOKLYN NY 11218 HOME HEALTH AGENCY 16569284 METROPOLITAN JEWISH HOME CARE INC 440 9TH AVE 14 NEW YORK NY 10001 HOME HEALTH AGENCY 15675419 268 CAPITATION PAYMENTS 524114 518899561 518899561 MEMBER SURPLUS INCOME 524114 4197451 4197451 RECRUITMENT AND RETENTION FUNDS 525990 3382301 3382301 REINSURANCE RECOVERY 524298 572471 572471 527051784 932856 932856 88885748 88327621 558127 558127 558127 528542767 527051784 0 1490983 X 2915586 2915586 32091299 32091299 229048 229048 3742982 3742982 1559689 1559689 205186 205186 315079 315079 350582 350582 411552662 403062264 8490398 7648632 7648632 45246020 37950646 7295374 2153883 2153883 1089319 1089319 9027996 8920266 107730 277561 277561 1687117 1687117 303103 303103 BAD DEBT EXPENSE 4530303 4530303 STOP LOSS INSURANCE 1094854 1094854 458202 458202 526479103 451028030 75451073 0 1611780 1424357 22336264 26810907 19795096 24391346 470541 109817 12534413 7760845 5816833 4773568 87128362 88760698 10861199 7641512 148020075 153912205 63371045 66124325 732093 2049989 3299946 66153127 69424271 X 81866948 84487934 81866948 84487934 148020075 153912205 2063664 557322 0 X X 0 1 X 1 0 X 250343676 239006743 227569986 399877926 527051784 1643850115 250343676 239006743 227569986 399877926 527051784 1643850115 0 0 0 1643850115 3727198 2244888 1411422 1125780 932856 9442144 3727198 2244888 1411422 1125780 932856 9442144 197 323 5040 2886 8446 254071071 241251954 228986448 401006592 527984640 1653300705 0.99430 0.99010 0.00570 0.00990 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISC INCOME 321629 237801 83828 12212784 7523044 4689740 4773568 DUE TO MEDICAID 1989850 UNCLAIMED DISBURSEMENTS 17335 DUE TO PARTICIPATING AGENCIES OF THE METROPOLITAN JEWISH HEALTH SYSTEM 1292761 3299946 X 528749507 557322 557322 528192185 350582 350582 528542767 526479103 0 526479103 0 526479103 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE COMPANY HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2009 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. 0 1 0 0 0 0 0 1 0 ELI S FELDMAN 494679 477769 0 0 146383 141379 116228 112255 17770 17163 775060 748566 94988 91741 ROBERT LEAMER 181021 174833 5419 5234 25346 24479 48710 47045 15039 14525 275535 266116 0 0 ALEX BALKO 322915 306379 9618 9126 32887 31203 70194 66600 15179 14401 450793 427709 0 0 ELLIOT BROOKS 70869 284557 2107 8459 9529 38263 18999 76285 2347 9423 103851 416987 0 0 RONALD CHAFFIN 517224 15440 15428 461 52135 1556 172223 5141 29649 885 786659 23483 0 0 VINCENT MARCHELLO 168485 201273 0 0 7054 7570 18125 0 11233 13333 204897 222176 0 0 RANDALL KLEIN 257454 0 12907 0 12050 0 18125 0 6532 0 307068 0 0 0 GERALD ANELLO 206122 0 0 0 4074 0 15217 0 25346 0 250759 0 0 0 FRANCISCO POLANCO 117672 0 113236 0 514 0 8667 0 23447 0 263536 0 0 0 LYNDA MONTELLA 207745 0 20000 0 18527 0 15073 0 9002 0 270347 0 0 0 KAYE MORROW 229390 0 0 0 16833 0 17038 0 27701 0 290962 0 0 0 FELICIA DYER-JOHNSON 192925 0 20394 0 1198 0 11143 0 27281 0 252941 0 0 0 PART I, LINE 3 THE SALARIES FOR THE EXECUTIVES ARE DETERMINED BY METROPOLITAN JEWISH HEALTH SYSTEM, INC., A RELATED ORGANIZATION. THE METHODS UTILIZED INCLUDE A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANTS, REVIEW OF THE FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEYS OR STUDIES AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE BOARD. PART I, LINE 4B PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ALEXANDER BALKO - $17,782 ELLIOT BROOKS - $17,782 RON CHAFFIN - $17,782 ROBERT LEAMER - $17,782 PART I, LINE 7 BONUS ELIGIBILITY IS BASED ON THE EXTENT THAT EACH EXECUTIVE AND EMPLOYEE HAS ACHIEVED HIS/HER GOAL. FORM 990, PART VI, SECTION A, LINE 6 ALL MEMBERS HAVE THE SAME VOTING RIGHTS. THE MEMBERS HAVE THE RIGHT TO ELECT THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS SHALL BE ELECTED BY THE MEMBERS OF THE ORGANIZATION. ALL MEMBERS HAVE THE SAME VOTING RIGHTS. FORM 990, PART VI, SECTION B, LINE 11 DRAFTS OF THE COMPLETED RETURNS ARE REVIEWED BY THE EXECUTIVE VP/CFO, SENIOR VP/GENERAL COUNSEL AND THEIR STAFF. ANY COMMENTS ARISING FROM THEIR REVIEW ARE DISCUSSED AND IF REQUIRED, CHANGES ARE MADE TO THE DRAFT. THAT DRAFT WILL BE SUBMITTED TO THE MJHS EXECUTIVE COMMITTEE FOR ITS REVIEW AND APPROVAL. ONCE THE COMMITTEE HAS COMPLETED ITS REVIEW COPIES OF THE RETURNS WILL BE PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS MUST FILE AND MAINTAIN CURRENT THE ORGANIZATION'S DIRECTORS BIOGRAPHICAL INFORMATION FORM AND, ON AN ANNUAL BASIS, COMPLETE THE ORGANIZATION'S DIRECTORS CONFLICT OF INTEREST STATEMENT AND ACKNOWLEDGEMENT WHICH ACKNOWLEDGES THAT EACH INDIVIDUAL HAS DISCLOSED ANY POTENTIAL CONFLICT OF INTEREST; RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; READ AND UNDERSTANDS THE CONFLICTS OF INTEREST POLICY; AND AGREED TO COMPLY WITH THE CONFLICTS OF INTEREST POLICY. THE SENIOR VICE PRESIDENT/GENERAL COUNSEL SUPERVISES THE DISTRIBUTION, COLLECTION AND REVIEW OF THE ANNUAL DIRECTORS CONFLICT OF INTEREST STATEMENT AND ACKNOWLEDGEMENT. FROM TIME TO TIME, DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES AND/OR COMMITTEE MEMBERS ARE REMINDED OF THEIR OBLIGATION TO DISCLOSE POTENTIAL OR ACTUAL CONFLICTS OF INTEREST WHEN AND IF THEY ARISE. PROCEDURES FOR MANAGING IDENTIFIED CONFLICTS: EACH DIRECTOR, PRINCIPAL OFFICER, KEY EMPLOYEE AND MEMBER OF A BOARD COMMITTEE IS REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST TO THE INDIVIDUAL CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. IN THE EVENT OF SUCH A DISCLOSURE, THE INTERESTED PARTY IS EXCUSED FROM THE MEETING AND THE BOARD/COMMITTEE DETERMINES WHETHER A CONFLICT EXISTS. IF THE BOARD/COMMITTEE DETERMINES THAT A CONFLICT EXISTS, THE CHAIRPERSON OF THE BOARD OR DESIGNEE (IF APPROPRIATE) WILL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE AND REPORT TO THE BOARD OF DIRECTORS ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. BASED ON THE INFORMATION FURNISHED BY THE DISINTERESTED PERSON OR COMMITTEE, THE BOARD OF DIRECTORS WILL MAKE A DETERMINATION OF WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR MORE REASONABLE ARRANGEMENTS FROM AN ENTITY OR PERSON THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST IS NOT REASONABLY ATTAINABLE UNDER THE CIRCUMSTANCES, THE BOARD OF DIRECTORS WILL DETERMINE, BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS, WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION. ALL OF THE ACTIONS STATED ABOVE SHALL BE REFLECTED IN THE BOARD/COMMITTEE MINUTES. IN THE EVENT THAT A DIRECTOR, PRINCIPAL OFFICER, KEY EMPLOYEE OR MEMBER OF A BOARD COMMITTEE FAILS TO DISCLOSE A POTENTIAL OR ACTUAL CONFLICT OF INTEREST, THE BOARD/COMMITTEE, AFTER AFFORDING THE INDIVIDUAL DUE PROCESS, SHALL DETERMINE WHETHER THE INDIVIDUAL VIOLATED THE CONFLICT OF INTEREST POLICY BY FAILING TO DISCLOSE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND, IN THE EVENT OF A DETERMINATION THAT A VIOLATION OCCURRED, TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 METROPOLITAN JEWISH HEALTH SYSTEM, INC., A RELATED ORGANIZATION RETAINS THE SERVICES OF A MAJOR EXECUTIVE COMPENSATION FIRM TO REVIEW MARKET PAY PRACTICES AND AVERAGE SALARY MOVEMENT AMONG SIMILARLY SITUATED EXECUTIVES. THE EXECUTIVE COMPENSATION FIRM IS ASKED TO DEVELOP A COMPARATIVE BASE THAT IS AS CLOSE AS POSSIBLE TO OUR ORGANIZATION. DIFFERENT COMPARATIVE GROUPS ARE CONSIDERED FOR EACH POSITION, CEO AND SENIOR VP'S AS APPROPRIATE. THIS WAS LAST COMPLETED IN SEPTEMBER 2012. THIS MARKET ANALYSIS IS THEN REVIEWED BY THE COMPENSATION COMMITTEE IN DETERMINING SALARY ADJUSTMENTS FROM THE PERSPECTIVE OF MARKET COMPETITIVENESS AND PRIOR YEAR PERFORMANCE. PERFORMANCE IS BASED ON THE EXTENT THAT EACH EXECUTIVE HAS ACHIEVED HIS/HER GOALS. BONUS ELIGIBILITY IS DONE IN A SIMILAR MANNER. OTHER KEY EMPLOYEES ARE MANAGED IN SIMILAR MANNER THROUGH THE HUMAN RESOURCES DEPARTMENT UNDER THE DIRECTION OF THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES IN CONJUNCTION WITH THE CEO, USING LOCAL SURVEYS TO ENSURE MARKET COMPETITIVENESS. FORM 990, PART VI, SECTION C, LINE 18 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST TO THE OFFICE OF THE PRESIDENT. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST TO THE OFFICE OF THE PRESIDENT. OTHER FEES FORM 990, PART IX, LINE 11G MEDICAL FEES: PROGRAM SERVICE EXPENSES 403,062,264. MANAGEMENT AND GENERAL EXPENSES 7,804,403. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 410,866,667. RECRUITING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 685,995. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 685,995. FORM 990 PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. METROPOLITAN JEWISH HEALTH SYSTEM INC 6323 7TH AVENUE BROOKLYN NY 11220 113538697 ADMINISTRATIVE SERVICES NY 501(C)(3) 7 N/A 0 MJG NURSING HOME CO INC 6323 7TH AVENUE BROOKLYN NY 11220 237123076 NURSING HOME NY 501(C)(3) 3 N/A 0 MENORAH HOME AND HOSPITAL FOR THE AGED AND INFIRM 6323 7TH AVENUE BROOKLYN NY 11220 111672777 NURSING HOME, ADULT DAY CARE NY 501(C)(3) 3 METROPOLITAN JEWISH HEALTH SYSTEM INC 1 SHOREFRONT JEWISH GERIATRIC CENTER INC 6323 7TH AVENUE BROOKLYN NY 11220 113072153 NURSING HOME, ADULT DAY CARE NY 501(C)(3) 9 METROPOLITAN JEWISH HEALTH SYSTEM INC 1 METROPOLITAN JEWISH HOME CARE INC 6323 7TH AVENUE BROOKLYN NY 11220 320060822 HOME CARE, HOSPICE NY 501(C)(3) 9 METROPOLITAN JEWISH HEALTH SYSTEM INC 1 MENORAH FOUNDATION INC 6323 7TH AVENUE BROOKLYN NY 11220 113471173 FUNDRAISING NY 501(C)(3) 11 TYPE I METROPOLITAN JEWISH HEALTH SYSTEM FOUNDATION 1 HOMEFIRST LHCSA INC 6323 7TH AVENUE BROOKLYN NY 11220 611501623 HOME CARE NY 501(C)(3) 11 TYPE I METROPOLITAN JEWISH HEALTH SYSTEM INC 1 SHOREFRONT TOWERS HOUSING DEVELOPMENT FUND CORPORATION 6323 7TH AVENUE BROOKLYN NY 11220 113200785 HOUSING NY 501(C)(3) 9 N/A 0 METROPOLITAN JEWISH HEALTH SYSTEM FOUNDATION 6323 7TH AVENUE BROOKLYN NY 11220 111630753 FUNDRAISING NY 501(C)(3) 7 N/A 0 JACOB PERLOW HOSPICE CORPORATION 6323 7TH AVENUE BROOKLYN NY 11220 133438643 HOSPICE SERVICES NY 501(C)(3) 3 METROPOLITAN JEWISH HEALTH SYSTEM INC 1 MJHS MEDICAL ASSOCIATES PC 6323 7TH AVENUE BROOKLYN NY 11220 275273404 PROVIDING HEALTH CARE SERVICES FOR AFFILIATES OF MJHS NY 501(C)(3) 9 METROPOLITAN JEWISH HEALTH SYSTEM INC 1 0 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0