FURP.ORG / PUBLIC DATA EXPLORER

MJHS HOSPICE AND PALLIATIVE CARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MJHS HOSPICE AND PALLIATIVE CARE INC (EIN 13-3438643)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-11
IRS object ID
201333169349301588
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-11T09:46:17-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN131517563EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LOEB & TROPER LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1655 THIRD AVENUE 12TH FLOORAddressLine1
CityNEW YORKCity
StateNYState
ZIP Code10017ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN133438643EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1JACOB PERLOW HOSPICE CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlJACONameControl
Phone7189217742Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16323 7TH AVENUEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameALEX BALKOName
TitleEXECUTIVE VP/COOTitle
Phone7189217742Phone
Date Signed2013-10-30DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameFREDERICK H ROTHMANName
PTINP01275277PTIN
Phone2128674000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1MJHS HOSPICE AND PALLIATIVE CAREBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonALEX BALKONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16323 7TH AVENUEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode
FieldValueIRS element (for citing)
Gross Receipts61389526GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HOSPICE SERVICES ON BOTH AN INPATIENT AND OUTPATIENT BASIS.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees278TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1068639ContributionsGrantsPriorYear
Contributions Grants Current Year4821493ContributionsGrantsCurrentYear
Program Service Revenue Prior Year41447443ProgramServiceRevenuePriorYear
Program Service Revenue CY56527894ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year5765InvestmentIncomeCurrentYear
Other Revenue Prior Year106464OtherRevenuePriorYear
Other Revenue Current Year34374OtherRevenueCurrentYear
Total Revenue Prior Year42622546TotalRevenuePriorYear
Total Revenue Current Year61389526TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year17728539SalariesEtcPriorYear
Salaries Etc Current Year22232452SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year28733926OtherExpensePriorYear
Other Expenses Current Year37685391OtherExpensesCurrentYear
Total Expenses Prior Year46462465TotalExpensesPriorYear
Total Expenses Current Year59917843TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3839919RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1471683RevenuesLessExpensesCY
Total Assets BOY11620621TotalAssetsBOY
Total Assets EOY16850309TotalAssetsEOY
Total Liabilities BOY16387100TotalLiabilitiesBOY
Total Liabilities EOY20145105TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-4766479NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-3294796NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionJACOB PERLOW IS A NFP ORGANIZATION PROVIDING HOSPICE AND PALLIATIVE CARE SERVICES FOR ADULTS AND CHILDREN. CARE IS PROVIED IN A BROAD CROSS SECTION OF SETTINGS FROM THE COMFORT OF A PATIENT'S OWN HOME TO IN-PATIENT UNITS, NURSING HOMES AND ASSISTED LIVING FACILITIES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense53479421Expense
Revenue56527894Revenue
DescriptionJACOB PERLOW IS A NOT-FOR-PROFIT ORGANIZATION PROVIDING HOSPICE AND PALLIATIVE CARE SERVICES. PERLOW IS COMMITTED TO SERVING THE NEEDS OF ADULTS AND CHILDREN FACING LIFE LIMITING ILLNESSES AS WELL AS THEIR FAMILIES. IN ADDITION TO OFFERING OUR PATIENTS MEDICAL SUPPORT FROM PHYSICIANS AND NURSES CERTIFIED IN HOSPICE OR PALLIATIVE CARE, WE ALSO PROVIDE EMOTIONAL AND SPIRITUAL SUPPORT FOR PATIENTS AND THEIR FAMILIES THROUGH OUR SOCIAL WORKERS, PASTORAL STAFF AND MUSIC AND ART THERAPISTS. IN ORDER TO SERVE OUR PATIENTS AND FAMILIES WHEN AND WHERE THEY NEED IT MOST, JACOB PERLOW PROVIDES CARE IN THE COMFORT OF A PATIENT'S OWN HOME, OUR DEDICATED IN-PATIENT UNIT AT BETH ISRAEL HOSPITAL, A NUMBER OF HOSPITALS ACROSS GREATER NEW YORK, NURSING HOMES, ASSISTED LIVING FACILITIES AND OUR MOLLIE AND JACK ZICKLIN RESIDENCE IN RIVERDALE. IN 2012, JACOB PERLOW PROVIDED 57,874 HOSPICE DAYS, 166,385 CONTINUOUS HOME CARE DAYS, 145,602 ROUTINE HOME CARE DAYS, 36 INPATIENT RESPITE CARE DAYS AND 12,936 GENERAL INPATIENT CARE DAYS.Description
Total Program Service Expense53479421TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096116NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees278NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PEGGY GUNDERMANBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7189217742TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16323-7TH AVEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ELI S FELDMAN
CEO/PRESIDENT/DIRECTOR2.0031.00XX827181177493263416
SHMUEL LEFKOWITZ
CHAIRPERSON/DIRECTOR0.503.00XX000
DAVID WIENER
DIRECTOR/TREASURER/SECRETA0.501.00XX000
RONALD MILCH
DIRECTOR0.503.50X000
JASON YU
DIRECTOR0.500.00X000
ESTERE DUBOULAY
DIRECTOR0.501.00X000
IRVING DAYAN
DIRECTOR0.501.00X000
BURTON ESRIG
DIRECTOR0.501.50X000
SUZANNE CUTLER
DIRECTOR0.50X000
MARTIN MARCUS
DIRECTOR0.50X000
STEVEN ROTTER
DIRECTOR0.50X000
ROBERT LEAMER
SENIOR VP, GENERAL COUNSEL2.0031.00X27327389004125321
ALEX BALKO
EXECUTIVE VP/COO2.5031.0053505658622166373X
ELLIOT BROOKS
SENIOR VP HUMAN RESOURCES3.0030.0041252372531107053X
SUSAN CAPUTO
PRESIDENT HOME AND CONTINU7.5024.00117508361454172034X
BARBARA HINEY
EXEC. VP HOSPICE35.00282050028541X
BERNARD LEE
PHYSICIAN35.00323321042691X
OLGA BARATT
PHYSICIAN35.00208263038327X
IRINA BELKINA
PHYSICIAN35.00195081012520X
JOYCE PALMIERIE
AVP PATIENT SERVICES35.00183144012462X
MARA LUGASSY
PHYSICIAN35.0016811503477X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1682284TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2959104TotalReportableCompFrmRltdOrgs
Total Other Compensation972215TotalOtherCompensation
Number Individuals GT100 K36NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
TOTAL HEALTHCARE STAFFING
PO BOX 823461PHILADELPHIAPA191823461TEMP STAFFING1983743
GOUVERNEUR NURSING HOME
227 MADISON AVENUENYNY10002NURSING HOME1631123
SHOREFRONT JEWISH GERIATRIC CENTER
3015 W 29TH STNEW YORKNY11224NURSING HOME1211157
DEWITT REHABILITATION & NURSING
211 EAST 79TH STREETNEW YORKNY10075NURSING HOME1024203
ATRIA SENIOR LIVING FROUP
PO BOX 70469LOUISVILLEKY40270SENIOR LIVING836182
FieldValueIRS element (for citing)
Number Of Contractors GT100 K47NumberOfContractorsGT100K
Related Organizations4300000RelatedOrganizations
All Other Contributions521493AllOtherContributions
Total Contributions4821493TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionHOSPICE AND PALLIATIVE CAREDescription
Business Code623000BusinessCode
Total Revenue Column56527894TotalRevenueColumn
Related Or Exempt Function Income56527894RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue56527894TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5765TotalRevenueColumn
Exclusion$5,765ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column34374TotalRevenueColumn
Exclusion$34,374ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue34374TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column61389526TotalRevenueColumn
Related Or Exempt Function Income56527894RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$40,139ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total723795Total
Program Services310591ProgramServices
Management And General413204ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total16878725Total
Program Services15411631ProgramServices
Management And General1467094ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total865765Total
Program Services725641ProgramServices
Management And General140124ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2261537Total
Program Services1875332ProgramServices
Management And General386205ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1502630Total
Program Services1366189ProgramServices
Management And General136441ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total121998Total
Management And General121998ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total45468Total
Management And General45468ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total30751224Total
Program Services30566557ProgramServices
Management And General184667ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1624587Total
Program Services247010ProgramServices
Management And General1377577ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total854330Total
Program Services412573ProgramServices
Management And General441757ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total434320Total
Program Services346142ProgramServices
Management And General88178ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1820312Total
Program Services1493300ProgramServices
Management And General327012ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total466737Total
Program Services460569ProgramServices
Management And General6168ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total58610Total
Program Services32870ProgramServices
Management And General25740ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3766Total
Management And General3766ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total319183Total
Management And General319183ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total328227Total
Management And General328227ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
PROVISION FOR BAD DEBTS625613625613
OTHER FEES231016231016

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total59917843Total
Program Services53479421ProgramServices
Management And General6438422ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY27000BOY
EOY71700EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1486021BOY
EOY1697032EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9048610BOY
EOY11428982EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1969566LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1496847LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY515351BOY
EOY472719EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY543639BOY
EOY3179876EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY11620621BOY
EOY16850309EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9174961BOY
EOY12317829EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7212139BOY
EOY7827276EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY16387100BOY
EOY20145105EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-5316479BOY
EOY-3844796EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY550000BOY
EOY550000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-4766479BOY
EOY-3294796EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11620621BOY
EOY16850309EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1471683ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance550000BeginningOfYearBalance
Investment Earnings Or Losses1629InvestmentEarningsOrLosses
Other Expenditures1629OtherExpenditures
End Of Year Balance550000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance550000BeginningOfYearBalance
End Of Year Balance550000EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance550000BeginningOfYearBalance
End Of Year Balance550000EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance550000BeginningOfYearBalance
End Of Year Balance550000EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis449386OtherCostOrOtherBasis
Depreciation58566Depreciation
Book Value390820BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1470764OtherCostOrOtherBasis
Depreciation1438281Depreciation
Book Value32483BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis49416OtherCostOrOtherBasis
Book Value49416BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings472719TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM METROPOLITAN JEWISH HEALTH SYSTEM FOUNDATION114661
DUE FROM PARTICIPATING AGENCIES OF METROPOLITAN JEWISH HEALTH SYSTEM3065215
FieldValueIRS element (for citing)
Total Book Value Other Assets3179876TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO PARTICIPATING AGENCIES OF MJHSDescription
Amount$7,827,276Amount
FieldValueIRS element (for citing)
Total Of Amounts7827276TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt60763913TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal60763913RevenueSubtotal
Other Revenues Not Included625613OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt625613RevenueNotRptdOnFinStmt
Total Revenue Per Form99061389526TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt59292230TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal59292230ExpensesSubtotal
Other Expenses Not Included625613OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt625613ExpensesNotRptdOnFinStmt
Total Expenses Per Form99059917843TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE HOSPICE 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.
PART XI, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS 625,613.
PART XII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS 625,613.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ELI S FELDMAN
CEO/PRESIDENT/DIRECTOR63830908618001888826887514997213486229332640100008142361912257174472
ROBERT LEAMER
SENIOR VP, GENERAL COUNSEL2335833249769999533270465546285894711941276243555350609900
ALEX BALKO
EXECUTIVE VP/COO47282582012140817336481559274102781265162222273576600581249500
ELLIOT BROOKS
SENIOR VP HUMAN RESOURCES35434319991105395124765430289499857851173105965192446891200
SUSAN CAPUTO
PRESIDENT HOME AND CONTINU1039963198923105955010407320123558410945866222037015971449128200
BARBARA HINEY
EXEC. VP HOSPICE265318000167320181250104160310591000
BERNARD LEE
PHYSICIAN32108800022330181250245660366012000
OLGA BARATT
PHYSICIAN20658200016810119460263810246590000
IRINA BELKINA
PHYSICIAN19431300076801190806120207601000
JOYCE PALMIERIE
AVP PATIENT SERVICES17111508500035290123700920195606000
MARA LUGASSY
PHYSICIAN167811000304033850920171592000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 3THE 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 4BPARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ALEXANDER BALKO - $17,782 ELLIOT BROOKS - $17,782 ROBERT LEAMER - $17,782 SUSAN CAPUTO - $17,782
PART I, LINE 7BONUS ELIGIBILITY IS BASED ON THE EXTENT THAT EACH EXECUTIVE AND EMPLOYEE HAS ACHIEVED HIS/HER GOAL.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6METROPOLITAN JEWISH HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF JACOB PERLOW HOSPICE CORPORATION
FORM 990, PART VI, SECTION A, LINE 7AMETROPOLITAN JEWISH HEALTH SYSTEM, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11DRAFTS 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 12CEACH 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 15METROPOLITAN 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 18THESE DOCUMENTS ARE AVAILABLE UPON REQUEST TO THE OFFICE OF THE PRESIDENT.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST TO THE OFFICE OF THE PRESIDENT.
FORM 990, PART IX, LINE 11GCONSULTING: PROGRAM SERVICE EXPENSES 193,096. MANAGEMENT AND GENERAL EXPENSES 74,396. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 267,492. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 208,278. MANAGEMENT AND GENERAL EXPENSES 56,375. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 264,653. HHA AGENCIES: PROGRAM SERVICE EXPENSES 4,097,028. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,097,028. INPATIENT HOSPICE EXPENSE: PROGRAM SERVICE EXPENSES 20,905,334. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,905,334. MEDICAL EXPENSES: PROGRAM SERVICE EXPENSES 5,147,622. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,147,622. RECRUITMENT FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 50,619. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,619. TEMP SERVICES: PROGRAM SERVICE EXPENSES 15,199. MANAGEMENT AND GENERAL EXPENSES 3,277. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,476.OTHER FEES
FORM 990 PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
METROPOLITAN JEWISH HEALTH SYSTEM INC
6323 7TH AVENUEBROOKLYNNY11220113538697ADMINISTRATIVE ACTIVITIESNY501(C)(3)7N/A0
MJG NURSING HOME CO INC
6323 7TH AVENUEBROOKLYNNY11220237123076NURSING HOMENY501(C)(3)3N/A0
MENORAH HOME AND HOSPITAL FOR THE AGED AND INFIRM
6323 7TH AVENUEBROOKLYNNY11220111572777NURSING HOME, ADULT DAYNY501(C)(3)31METROPOLITAN JEWISH HEALTH SYSTEM INC
SHOREFRONT JEWISH GERIATRIC CENTER INC
6323 7TH AVENUEBROOKLYNNY11220113072153NURSING HOME, ADULT DAYNY501(C)(3)91METROPOLITAN JEWISH HEALTH SYSTEM INC
METROPOLITAN JEWISH HOME CARE INC
6323 7TH AVENUEBROOKLYNNY11220320060822HOME CARE, HOSPICENY501(C)(3)91METROPOLITAN JEWISH HEALTH SYSTEM INC
ELDERPLAN INC
6323 7TH AVENUEBROOKLYNNY11220112625096MEDICARE ADVANTAGE SPECIAL NEEDS PLAN / MEDICAID MANAGED LONG TERM CARE PLANNY501(C)(3)9N/A0
MENORAH FOUNDATION INC
6323 7TH AVENUEBROOKLYNNY11220113471173FUNDRAISINGNY501(C)(3)11 TYPE I1METROPOLITAN JEWISH HEALTH SYSTEM FOUNDATION
HOMEFIRST LHCSA INC
6323 7TH AVENUEBROOKLYNNY11220611501623HOME CARENY501(C)(3)11 TYPE I1METROPOLITAN JEWISH HEALTH SYSTEM INC
METROPOLITAN JEWISH HEALTH SYSTEM FOUNDATION
6323 7TH AVENUEBROOKLYNNY11220111630753FUNDRAISINGNY501(C)(3)7N/A0
SHOREFRONT TOWERS HOUSING DEVELOPMENT FUND CORPORATION
6323 7TH AVENUEBROOKLYNNY11220113200785HOUSINGNY501(C)(3)9N/A0
MJHS MEDICAL ASSOCIATES PC
6323 7TH AVENUEBROOKLYNNY11220275273404PROVIDING HEALTH CARE SERVICES FOR AFFILIATES OF MJHSNY501(C)(3)91METROPOLITAN JEWISH HEALTH SYSTEM INC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg