2013-08-14T08:53:11-05:00 2012-09-30 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2011-10-01 060293500 CHURCH HOME OF HARTFORD INC CHUR 8602860243 200 SEABURY DRIVE BLOOMFIELD CT 06002 A RAYMOND MADORIN 8602860243 2013-08-13 1 ELIZABETH SOLECKI P00235171 8605614000 2011 2016-02-24 21:20:13Z SEABURY RETIREMENT COMMUNITY A RAYMOND MADORIN 200 SEABURY DRIVE BLOOMFIELD CT 06002 25408582 0 X WWW.SEABURYRETIREMENT.COM X 1876 CT TO PROVIDE HOUSING AND SUPPLEMENTAL SERVICES TO THE ELDERLY. 18 18 436 75 0 0 45049 159367 23368120 23809606 364599 1190749 183083 225669 23960851 25385391 0 0 0 0 13198507 14005987 0 0 0 9205216 9911166 22403723 23917153 1557128 1468238 60147851 60059939 54224753 51914058 5923098 8145881 TO PROVIDE HOUSING AND SUPPLEMENTAL SERVICES TO THE ELDERLY. 0 0 17951692 23809606 CHURCH HOME OF HARTFORD, INC. OPERATES A HEALTH CARE AND INDEPENDENT LIVING COMMUNITY FOR THE ELDERLY. CHURCH HOME IS AFFILIATED WITH THE EPISCOPAL DIOCESE OF CONNECTICUT AND ALSO OEPRATES A HOME FOR RETIRED CLERGY. CHURCH HOME PROVIDES ASSISTED LIVING SERVICES TO SEABURY MEMORY CARE CENTER, A RELATED FACILITY FOR ELDERLY ALZHEIMER PATIENTS. CHURCH HOME ALSO OPERATES ITS OWN HOME HEALTH AGENCY. 17951692 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 19 0 1 436 1 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 CT X STEVEN YANOFSKY VP FINANCE 8602860243 200 SEABURY DRIVE BLOOMFIELD CT 06002 THOMAS E ANDERSEN 0.60 X 0 0 0 REV CANON WILBORNE A AUSTIN 0.60 X 0 0 0 CONNIE BAIN 0.60 X 0 0 0 DONALD C BERRY JR 0.60 X 0 0 0 REV PAUL R BRIGGS II 0.60 X 0 0 0 DR H DAVID CROMBIE 0.60 X 0 0 0 DAVID O ELLIOTT 0.60 X 0 0 0 DR DONNA R GALLUZZO 0.60 X 0 0 0 MILTON L HOWARD 0.60 X 0 0 0 JOSEPH P MERRITT 0.60 X 0 0 0 THOMAS MOORE III 0.60 X 0 0 0 WILLIAM R PEELLE JR 0.60 X 0 0 0 ROBERT STANWOOD 0.60 X 0 0 0 A RAYMOND MADORIN 0.60 X X 0 0 0 GALE A MATTISON 0.60 X X 0 0 0 WILLIAM J THOMPSON 0.60 X X 0 0 0 BETTE-JANE HARDERSEN 0.60 X X 0 0 0 DR LAURA D HARCKHAM 0.60 X X 0 0 0 PRISCILLA B VIETS 0.60 X X 0 0 0 RIGHT REV IAN T DOUGLAS 0.60 X X 0 0 0 RICHARD HEATH 40.00 X 0 0 0 JOHN S MOBLEY 40.00 X 222194 0 29261 MARJORIE SULLIVAN 40.00 X 158849 0 4498 STEVEN YANOFSKY 40.00 X 143927 0 19142 PAMELA KLAPPROTH 40.00 X 109547 0 15178 634517 0 68079 4 0 1 0 PENNWOOD BUIDERS LLC 8 PLANK HILL ROAD SIMSBURY CT 06070 BUILDING RENOVATIONS 348840 ACCESS TECHNOLOGY 30 GEORGE WASHINGTON TURNPIKE BURLINGTON CT 06013 COMPUTER SERVICES 225452 PROPERTY MANAGEMENT PLUS 145 WEST DUDLEY TOWN ROAD BLOOMFIELD CT 06002 OUTDOOR MAINTENANCE 204080 D SAYDOFF & COMPANY PO BOX 966 BLOOMFIELD CT 06002 BUILDING RENOVATIONS 202990 ACTION CARPET 8B HERMAN DRIVE SIMSBURY CT 06070 BUILDING RENOVATIONS 163263 7 149445 9922 159367 RESIDENT SERVICE REV. 623000 9888714 9888714 HEALTH CENTER REV. 623000 7018334 7018334 AMORT. OF DEFERRED REV 900099 2562516 2562516 MEMORY CARE SERV. REV. 623000 2360540 2360540 HOME HEALTH SERV. REV. 621610 1046651 1046651 932851 932851 23809606 317841 317841 894599 1500 23191 0 871408 1500 872908 872908 OTHER INCOME 900099 204226 204226 FINANCE CHARGES 900099 16943 16943 ADMISSIONS 900099 4500 4500 225669 25385391 23809606 0 1416418 674672 674672 10342865 9514760 828105 167699 109004 58695 2041777 275965 1765812 778974 677707 101267 8370 2095 6275 70710 70710 23750 10925 12825 283491 14175 269316 2023973 951267 1072706 83039 830 82209 628501 628501 2540976 2540976 195457 25409 170048 REPAIRS 885890 885890 FOOD 821371 821371 REAL ESTATE TAXES 562496 281248 281248 CONTRACTED SERVICES 524668 330541 194127 1258474 881028 377446 23917153 17951692 5965461 0 4977407 4621531 1310714 1215319 1802427 1802427 684792 225353 67024107 32667576 35386571 34356531 10521617 14500015 5464323 3338763 60147851 60059939 1465124 1760261 31374586 30874273 19520000 17690000 1865043 1589524 54224753 51914058 X 3514053 5397050 376299 510627 2032746 2238204 5923098 8145881 60147851 60059939 X 1468238 754545 X 0 1 1 X 0 X 193215 495337 193476 45049 159367 1086444 20956784 22326596 22473610 23368120 23809606 112934716 21149999 22821933 22667086 23413169 23968973 114021160 0 0 0 114021160 849978 353533 473422 353239 317841 2348013 849978 353533 473422 353239 317841 2348013 121790 102137 181504 183083 225669 814183 22121767 23277603 23322012 23949491 24512483 117183356 0.97300 0.95020 0.02000 0.02580 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12165099 561211 1773705 14500015 11851657 391121 -77679 12165099 9406361 1477764 1118368 150836 11851657 9146869 35683 223809 9406361 0.93970 0.02550 0.03480 0 0 4471760 4471760 57388723 28964271 28424452 4716849 3582340 1134509 446775 120965 325810 34356531 ENTRANCE FEE DEPOSITS 449823 BENEFICIAL INTEREST IN PERPETUAL TRUST 1868205 DEFERRED COSTS 338997 ENTRANCE FEES RECEIVABLE 664738 DEFERRED COMPENSATION 17000 3338763 ACCRUED BOND INTEREST 49163 ENTRANCE FEE DEPOSITS 453323 DEFERRED COMPENSATION 17000 INTEREST RATE SWAP OBLIGATION 1070038 1589524 25385391 23917153 1468238 661210 93335 754545 2222783 26138432 661210 93331 754541 25383891 1500 1500 25385391 23915649 -1500 -1500 23917149 4 4 23917153 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO SUPPORT THE MISSION OF CHURCH HOME OF HARTFORD, INCORPORATED, WHICH IS TO PROVIDE HOUSING AND HEALTH CARE SERVICES TO THE ELDERLY. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN PERPETUAL TRUSTS 205,458. CHANGE IN INTEREST RATE SWAP OBLIGATION -112,127. ROUNDING 4. TOTAL TO SCHEDULE D, PART XI, LINE 8: 93,335. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN PERPETUAL TRUST 205,458. CHANGE IN INTEREST RATE SWAP OBLIGATION -112,127. PART XII, LINE 4B - OTHER ADJUSTMENTS: GAIN ON ASSET DISPOSAL 1,500. PART XIII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON ASSET DISPOSAL -1,500. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING 4. X X X X X 0 0 0 0 0 0 0 0 0 JOHN S MOBLEY 222194 0 0 0 0 0 20640 0 8621 0 251455 0 0 0 MARJORIE SULLIVAN 158849 0 0 0 0 0 3736 0 762 0 163347 0 0 0 STEVEN YANOFSKY 143927 0 0 0 0 0 3500 0 15642 0 163069 0 0 0 CONNECTICUT HEALTH & EDUCATIONAL FACILITIES AUTHORITY 060806186 2010-12-23 21000000 REFINANCE SERIES 1998 BONDS 0 0 0 23370000 21000000 21000000 1992 1 0 1 1 0 1 0 0 0.00000 0.00000 0.00000 1 0 1 1 TD BANK 10.000000000000 0 0 0 0 1 X KATHLEEN MOBLEY WIFE OF JOHN MOBLEY, EXECUTIVE VICE PRESIDENT AND CEO 10650 EMPLOYMENT 0 MOBILE HEALTH TECHNOLOGIES INC ENTITY OWNED BY SON OF MARJORIE SULLIVAN 209941 PURCHASE AND RENTAL OF HEALTH MONITORING EQUIPMENT 0 FORM 990, PART VI, SECTION A, LINE 6 UP TO THREE MEMBERS ARE APPOINTED BY HARTFORD COUNTY PARISHES INCLUDING THE RECTOR OF THE EPISCOPAL PARISH WITH NO TERM LIMIT. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ELECT DIRECTORS AT THE ANNUAL BOARD MEETING. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS APPROVE CHANGES TO THE ARTICLES OF INCORPORATION, CHANGES TO THE BY-LAWS, AND THE APPOINTMENT OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AFTER FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REVIEWING THE POLICY AT ORIENTATION AND AT MEETINGS THROUGHOUT THE YEAR. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION IS DETERMINED USING A REVIEW OF LIKE ORGANIZATIONS, 990 REPORT FOR TOP PAID EMPLOYEES, AND USE OF ASSOCIATION WAGE SURVEYS. IN ADDITION, THE ORGANIZATION HAS HIRED A CONSULTANT FOR A REVIEW OF MARKET WAGES. THE CEO DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES USING COMPARABLE DATA. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE DOCUMENTS ARE KEPT IN OUR LIBRARY AND THEY ARE GIVEN TO PROSPECTS. OUR ANNUAL REPORT IS ON OUR WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 661,210. CHANGE IN PERPETUAL TRUSTS 205,458. CHANGE IN INTEREST RATE SWAP OBLIGATION -112,127. ROUNDING 4. TOTAL TO FORM 990, PART XI, LINE 5: 754,545. SEABURY CHARITABLE FOUNDATION INC 200 SEABURY DRIVE BLOOMFIELD CT 06002 061458630 SUPPORT CHURCH HOME OF HARTFORD, INCORPORATED CT 501(C)3 509(A)(3) - TYPE 1 1 SEABURY MEMORY CARE CENTER INC 200 SEABURY DRIVE BLOOMFIELD CT 06002 200158017 PROVIDE HOUSING AND HEALTH SERVICES TO ALZHEIMER'S PATIENTS CT 501(C)3 509(A)(2) 1 SEABURY AT HOME INCORPORATED 200 SEABURY DRIVE BLOOMFIELD CT 06002 205096169 TO PROVIDE HOME HEALTH SERVICES TO THE ELDERLY CT 501(C)3 509(A)(2) 1 1 0 1 1 0 0 0 0 0 1 1 1 0 0 0 1 0 0 SEABURY AT HOME INCORPORATED K 525976 FMV SEABURY CHARITABLE FOUNDATION INC C 149445 AMOUNT GIFTED SEABURY MEMORY CARE CENTER INC K 2360540 FMV SEABURY MEMORY CARE CENTER INC L 895706 FMV SEABURY CHARITABLE FOUNDATION INC K 62583 FMV SEABURY AT HOME INCORPORATED D 1900617 AMOUNT LOANED SEABURY MEMORY CARE CENTER INC A 76682 FMV SEABURY MEMORY CARE CENTER INC D 220970 AMOUNT LOANED