2013-11-15T13:25:54-07:00 2012-12-31 990 2012-01-01 150539103 JEWISH HOME OF CENTRAL NEW YORK INC JEWI 3154469111 4101 E GENESEE STREET SYRACUSE NY 13214 Robert Wood 3154469111 2013-11-15 2012 2016-03-07 17:11:31Z Mary Ellen Bloodgood 4101 E Genesee Street Syracuse NY 13214 15264012 0 X menorahparkcny.com X 1937 NY Provide skilled nursing, home care services,adult day care 12 12 323 14 0 0 195274 673104 14323617 14587710 577 3198 0 0 14519468 15264012 0 0 0 0 9380373 9404632 0 0 0 5933367 5704231 15313740 15108863 -794272 155149 16233564 16976786 18273413 18706665 -2039849 -1729879 Provided 46,515 patient days of skilled nursing home services, 7,169 adult day care visits and 8,765 home health care visits. 0 0 13687645 0 14590908 Provided 46,515 patient days of skilled nursing home services, 7,169 adult day care visits, and 8,765 home health care visits. 0 0 0 13687645 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 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 0 0 0 0 1 14 0 1 323 1 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 NY X Mary Ellen Bloodgood CEO 3154469111 4101 E Genesee Street Syracuse NY 13214 X Michael Balanoff 1 0 X 0 0 0 Neil Bronstein 1 0 X 0 0 0 Andy Fox 1 0 X X 0 0 0 Joseph Greenman 1 0 X 0 0 0 Jon Maloff 1 0 X X 0 0 0 Gary Zausmer 1 0 X 0 0 0 Jeffry Berman 1 0 X 0 0 0 Phylis LaVine 1 0 X X 0 0 0 Jeffrey Scheer 1 0 X X 0 0 0 Jeffery Meyer 1 0 X 0 0 0 Mark Shulman 1 0 X 0 0 0 Bruce Smith 1 0 X 0 0 0 Mary Ellen Bloodgood 15 25 X 194485 0 5500 194485 0 5500 1 0 1 0 Sodexo Inc 9801 Washingtonian Bld Gaithersburg MD 20878 Dietary Service Contract 841810 Health Direct PO Box 62246 Baltimore MD 21264 Pharmacy Services 114260 Mckesson PO Box 630693 Cincinnati OH 45263 Disposible Laundry 118115 3 0 0 0 0 0 673104 0 673104 Resident Services 623000 14123011 14123011 0 0 Rental Income 623990 464699 464699 0 0 0 0 0 0 14587710 3198 3198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15264012 14590908 0 0 7094416 6564450 529966 0 251510 251510 0 0 1515770 1445880 69890 0 542936 496406 46530 0 50574 0 50574 0 48631 0 48631 0 2488 241 2247 0 108964 22788 86176 0 1347961 1316629 31332 0 15754 11300 4454 0 85940 85940 0 0 759146 759146 0 0 106779 0 106779 0 Dietary Service Contract 841810 841810 0 0 All Other Purchased Services 614446 458523 155923 0 NYS Cash Receipts Assessments 739398 739398 0 0 Medical Supplies, Drugs, Other Supplies 627413 597944 29469 0 354927 95680 259247 0 15108863 13687645 1421218 0 36315 -2456 1677714 2160960 21842 15192 59170 331152 22926984 14418169 8941298 8508815 5497225 5963123 16233564 16976786 3240666 4062568 13389492 13079892 1643255 1564205 18273413 18706665 X -3171028 -2963379 233044 335365 898135 898135 -2039849 -1729879 16233564 16976786 X 155149 0 0 0 0 154821 X 0 1 X 1 0 X 0 646437 104466 195274 673104 1619281 14072065 13776391 14616869 14323617 14587710 71376652 14072065 14422828 14721335 14518891 15260814 72995933 72995933 0 95696 270 577 3198 99741 0 95696 270 577 3198 99741 27788 0 0 27788 14099853 14518524 14721605 14519468 15264012 73123462 0.99826 0.99542 0.00136 0.00376 X Skilled nursing home RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1131180 0 154821 0 0 0 1286001 1073272 0 57908 0 0 0 1131180 1218097 0 -144825 0 0 0 1073272 1801301 0 -583204 0 0 0 1218097 1913597 0 -112296 0 0 0 1801301 0 0.5 0.5 0 1 0 0 6903 6903 0 19391863 11757672 7634191 0 0 0 0 0 2262431 2088086 174345 0 1265787 572411 693376 8508815 Due from Affilates 744723 Deposits Held in Trust 17164 Assets Limited As To Use 3241466 Beneficial Interest in Net Assets of Foundation 1286001 Deferred Financing Costs, net 673769 5963123 0 Estimated Third Party Payor Settlements, net 921499 Notes Payable to Affiliate 625542 Deposits Held in Trust 17164 1564205 15264012 0 0 0 0 0 15264012 0 0 0 15264012 15108863 0 0 0 0 0 15108863 0 0 0 15108863 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Change in Beneficial Assets of Foundation was 154,821. Use of these funds is to assist with the mission of the Jewish Home. X 0 0 0 0 0 0 0 0 0 Mary Ellen Bloodgood 194485 0 0 0 5500 0 0 0 0 0 199985 0 205637 0 F990_P06_S0A_L01a Form 990, Part VI, Section A, Line 1a The CEO is paid from this company, and a W-2 is issued. However, portions of the CEO compensation is allocated to five affiliates. Of the W-2 amount of 194,485, 74,371 has been allocated to the Jewish Home, and 120,114 allocated to the affiliates. IRS instructions require that the entire W-2 amount be listed in col (d). F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The 990 return is reviewed by members of the Finance Committee, and then distributed to the Board menbers before being filed with the IRS. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The conflict of interest policy is reviewed by the Board annually, and disclosure statements are signed. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The compensation of the CEO is reviewed by the Board of Directors. There is a five year contract, and performance is reviewed annually. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The governing documents, conflict of interest documents, and financial statements are available to the public in the Administration office, upon request. F990_P11_S00_L09 Form 990, Part XI, Line 9 Change in beneficial interest in net assets of Jewish Home of Central New York Foundation, 154,821. Use of these funds is to assist with the mission of the Jewish Home.