2013-11-14T09:57:03-06:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2012-01-01 043274643 AVIV ASSISTED LIVING INC F/K/A JRC ASSISTED LIVING INC AVIV 9784715100 240 LYNNFIELD STREET PEABODY MA 019605055 KIM JOYCE 9784715100 2013-11-12 1 ROBERT DILLAN P01688008 6179848100 2013-11-12 2012 2016-02-25 16:41:14Z WOODBRIDGE ASSISTED LIVING KIM JOYCE 240 LYNNFIELD STREET PEABODY MA 019605055 7991578 0 X WWW.AVIVLIVING.ORG X 1995 MA TO ENRICH THE LIFE OF EACH OF OUR RESIDENTS AND PROGRAM PARTICIPANTS SO THAT EACH MAY CONTINUE TO LIVE HIS OR HER LIFE WITH A SENSE OF MEANING AND PURPOSE. WE PROVIDE ASSISTED LIVING UNITS FOR OUR TENANTS. 8 5 169 4 0 0 0 0 7222895 7991527 843 51 0 0 7223738 7991578 0 0 0 0 3673985 3630866 0 0 0 3855404 3770221 7529389 7401087 -305651 590491 17482238 18114927 17535666 17479656 -53428 635271 TO ENRICH THE LIFE OF EACH OF OUR RESIDENTS AND PROGRAM PARTICIPANTS SO THAT EACH MAY CONTINUE TO LIVE HIS OR HER LIFE WITH A SENSE OF MEANING AND PURPOSE. WE PROVIDE ASSISTED LIVING UNITS FOR OUR TENANTS. 0 0 6419830 7991527 PROVIDE 130 UNITS OF ASSISTED LIVING TO THE ELDERLY. 6419830 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 23 0 169 1 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 MA X KIM JOYCE CFO 9784715100 240 LYNNFIELD STREET PEABODY MA 01960 STEPHEN H NEFF 0.00 40.00 X X 0 360732 41338 ERIC LEVY 2.00 5.00 X X 0 0 0 DAVID VARSANO 1.00 3.00 X X 0 0 0 WAYNE SHERIDAN 1.00 3.00 X X 0 0 0 NATALIE LEDERMAN 1.00 2.00 X X 0 0 0 MATTHEW WEINSTOCK 20.00 20.00 X X 0 194000 16282 KIM JOYCE 0.00 40.00 X X 0 160000 16110 DAVID PLINER 1.00 3.00 X 0 0 0 ANDREW KATZ 1.00 3.00 X X 0 0 0 JEFF GOPEN 0.00 40.00 X 0 137556 19131 MICHAEL HAMMERSCHMIDT 0.00 40.00 X 0 135079 9433 KATY AHERN-TAVARES 40.00 0.00 X 121208 0 10066 ETTA DIAZ 0.00 40.00 X 0 111864 14897 THERESA HALLIDAY BURRI 0.00 40.00 X 0 152538 10358 121208 1251769 137615 1 0 1 0 SODEXO 8011 34TH AVENUE SOUTH MINNEAPOLIS MN 55425 DIETARY/MANAGEMENT 230000 1 RESIDENT RENTAL FEES 623000 7621571 7621571 OTHER INCOME 623000 186907 186907 SERVICE INCOME 623000 183049 183049 7991527 51 51 7991578 7991527 0 51 3149819 2985109 164710 5183 4912 271 199176 188761 10415 276688 262219 14469 750000 750000 7025 7025 2684 2684 318831 287148 31683 47629 47629 116875 116875 367557 367557 17096 17096 8992 8992 676150 676150 549579 549579 104000 104000 FOOD 524123 524123 SUPPLIES 238625 238625 BAD DEBTS 22000 22000 LICENSE, DUES, & SUBSCR 16402 16402 2653 2653 7401087 6419830 981257 0 462205 456160 80193 93878 1200 1200 23783 12893 18892275 5430479 13426900 13461796 3487957 4089000 17482238 18114927 581669 602129 175997 123050 15665562 15508700 1112438 1245777 17535666 17479656 X -53428 635271 -53428 635271 17482238 18114927 X 590491 98208 X X 0 1 X 1 0 X 43 43 7754184 7570859 7399271 7222895 7991528 37938737 7754227 7570859 7399271 7222895 7991528 37938780 0 0 0 37938780 24160 7173 3603 843 51 35830 24160 7173 3603 843 51 35830 7778387 7578032 7402874 7223738 7991579 37974610 0.99910 0.99760 0.00090 0.00240 X 1771258 1771258 15390179 4109992 11280187 1730838 1320487 410351 13461796 UNAMORTIZED MORTGAGE ACQUISITION CO 427500 DUE FROM RELATED PARTY 2721994 DEPOSITS 7283 FUNDED RESERVES 340026 SECURITY DEPOSITS 592197 4089000 SECURITY DEPOSITS 583330 ADMISSION DEPOSITS 3000 FAIR VALUE OF INTEREST RATE SWAP 659447 1245777 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SEC 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE TAXES. THE 2009 THROUGH 2012 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X 1 0 1 0 0 0 0 0 0 0 0 STEPHEN H NEFF 0 324288 0 0 0 36444 0 0 0 41338 0 402070 0 0 MATTHEW WEINSTOCK 0 194000 0 0 0 0 0 0 0 16282 0 210282 0 0 KIM JOYCE 0 160000 0 0 0 0 0 0 0 16110 0 176110 0 0 JEFF GOPEN 0 137556 0 0 0 0 0 0 0 19131 0 156687 0 0 THERESA HALLIDAY BURRI 0 152538 0 0 0 0 0 0 0 10358 0 162896 0 0 PART I, LINE 1A STEPHEN NEFF, PRESIDENT & CEO, RECEIVED A HOUSING ALLOWANCE OF $36,444 IN CALENDAR YEAR 2012 AS INCLUDED IN OTHER REPORTABLE INCOME ON FORM 990, PART VII AND SCHEDULE J, COL. B(III). PART I, LINE 4A MICHAEL HAMMERSCHMIDT, CHIEF DEVELOPMENT OFFICER, RETIRED ON 11/16/2012 AND RECEIVED APPROXIMATELY $5,000 AS A SEVERANCE PAYMENT IN CALENDAR YEAR 2012. A MASS DEVELOPMENT FINANCE AGENCY 043431814 57583UBR8 2011-04-29 15446112 TO REFUND OLD BONDS AND REPLACE EXISTING FACILITY. 0 0 0 A 15026111 15446112 230600 189401 1 0 0 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 M&T BANK 5.000000000000 0 0 0 0 0 A 0 SCHEDULE K SUPPLENTAL INFORMATION THIS ORGANIZATION IS REPORTING THEIR RESPECTIVE SHARE OF THE $50M BOND ISSUED ON 4/29/11. SEE JEWISH REHABILITATION CENTER FOR AGED OF THE NORTH SHORE, INC. (EIN 04-2106768) FOR THE REMAINING PORTION. 990, SCHEDULE K, PART III, LINE 9, PART IV, LINE 7 & PART V POLICIES AND PROCEDURES RELATING TO COMPLIANCE THE ORGANIZATION DID NOT HAVE FORMAL WRITTEN POLICIES AND PROCEDURES IN PLACE DURING THE 2012 TAX YEAR. HOWEVER, THE ORGANIZATION WAS IN COMPLIANCE DURING THE TAX YEAR AND PLAN TO ADOPT WRITTEN POLICIES AND PROCEDURES DURING 2013. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT REVIEWS CPA PREPARED FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS AND EXECUTIVE MANAGERS ARE REQUIRED ANNUALLY TO COMPLETE A CONFLICT OF INTEREST STATEMENT. STATEMENTS ARE REVIEWED BY A SUBCOMMITTEE OF BOARD MEMBERS AND THE CEO. MONTHLY COMPLIANCE COMMITTEE MEETINGS INCLUDE REVIEW AND MONITORING OF ANY POTENTIAL OR ACTUAL CONFLICTS. DETERMINING THE LEVEL OF CONFLICT FOR REVIEW IS BASED ON POTENTIAL FINANCIAL OR LEGAL RISK TO THE ORGANIZATION. IF A CONFLICT (ACTUAL OR POTENTIAL) IS RAISED FOR A BOARD MEMBER, HE/SHE IS REFRAINED FROM VOTING ON RELATED TOPICS. MANAGERS WITH CONFLICT (ACTUAL OR POTENTIAL) ARE BANNED FROM OVERSIGHT AND DECISION MAKING FOR THAT SUBJECT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION'S MANAGEMENT PERFORMS MANAGEMENT DUTIES WHICH INCLUDE, BUT ARE NOT LIMITED TO, HIRING, FIRING,AND SUPERVISING PERSONNEL, PLANNING OR EXECUTING BUDGETS OR FINANCIAL OPERATIONS, OR SUPERVISING EXEMPT OPERATIONS OR UNRELATED TRADES OR BUSINESSES OF THE ORGANIZATION FOR SEVERAL RELATED ENTITIES. MANAGEMENT CONTROL IS NOT CONSIDERED DELEGATED AND MANAGEMENT PERSONNEL ARE PAID FROM A CENTRALIZED MANAGEMENT ORGANIZATION, AVIV CENTERS FOR LIVING, INC. PLEASE SEE FORM 990, PART VII FOR COMPENSATION DETAIL. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: EQUITY TRANSFER 168,693. CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS -70,485. OVERSEE AUDIT AND SELECTION OF AUDITOR FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT OVERSEES THE AUDIT AND SELECTS THE AUDITOR. AVIV FOUNDATION INC 240 LYNNFIELD STREET PEABODY MA 01960 223102199 FUNDRAISING MA 501(C)(3) LINE 7 AVIV CENTERS FOR LIVING INC 1 JEWISH REHABILITATION CTR FOR THE AGED OF THE NORTH SHORE INC 240 LYNNFIELD STREET PEABODY MA 01960 042106768 SKILLED NURSING CARE MA 501(C)(3) LINE 9 AVIV CENTERS FOR LIVING INC 1 AVIV CENTERS FOR LIVING INC 240 LYNNFIELD STREET PEABODY MA 01960 261244471 MANAGEMENT MA 501(C)(3) LINE 11B, II 0 JRCL HOMECARE LLC 240 LYNNFIELD STREET PEABODY MA 01960 262743823 HOME BASED SKILLED NURSING MA N/A JRC REALTY CORP 240 LYNNFIELD PEABODY MA 01960 043321272 REAL ESTATE MA N/A C 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0