VP OF FINANCE

2012-11-13T05:11:07-06:00 2011-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2011-01-01 111694718 SEPHARDIC HOME FOR THE AGED INC SEPH 7182666100 2266 CROPSEY AVENUE BROOKLYN NY 11214 JAY MOSTEL VP OF FINANCE 7182666100 2012-11-01 1 FREDERICK H ROTHMAN P01275277 2128674000 2011 2016-02-24 21:20:13Z SEPHARDIC SKILLED NURSING AND REHABILITATION CENTER JAY MOSTEL 2266 CROPSEY AVENUE BROOKLYN NY 11214 36360578 0 X WWW.SEPHARDICHOME.ORG X 1949 NY TO OPERATE A 271-BED NURSING HOME IN BROOKLYN, NEW YORK 20 20 395 20 0 0 100265 74386 33511223 35958898 293580 303619 -631 8839 33904437 36345742 0 0 0 0 24750186 23604576 0 0 10990 11243617 11986548 35993803 35591124 -2089366 754618 50554117 50403649 7233313 6328227 43320804 44075422 TO PROVIDE THE ELDERLY WITH THE BEST QUALITY OF LIFE IN A RESPECTFUL, DIGNIFIED, SAFE AND COMPASSIONATE ENVIRONMENT IN ACCORDANCE WITH JEWISH TRADITION. 0 0 31053930 35958898 THE ORGANIZATION PROVIDED 95,526 DAYS OF CARE/REHABILITATIVE SERVICES IN ITS NURSING FACILITY AND 14,705 ADULT DAY HEALTH CARE VISITS IN 2011. 31053930 1 1 0 1 0 0 0 0 0 1 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 0 0 0 0 0 1 74 0 395 1 0 0 0 0 0 0 0 0 0 0 X 20 20 1 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 1 1 1 0 NY X JAY MOSTEL VP OF FINANCE 7182666100 2266 CROPSEY AVENUE BROOKLYN NY 11214 MICHAEL LOPEZ CHAIRMAN OF THE BOARD 1.00 X X 0 0 0 LAURIE KAMHI PRESIDENT 1.00 X X 0 0 0 LOUIS ROUSSO FIRST VICE PRESIDENT 1.00 X X 0 0 0 RAYMOND COHEN SECOND VICE PRESIDENT 1.00 X X 0 0 0 NEIL CRESPI TREASURER 1.00 X X 0 0 0 JOE HALIO SECRETARY 1.00 X X 0 0 0 ALAN MATARASSO BOARD MEMBER 1.00 X 0 0 0 ALBERT MALEH BOARD MEMBER 1.00 X 0 0 0 CLIFTON RUSSO BOARD MEMBER 1.00 X 0 0 0 EDWARD ALCOSSER BOARD MEMBER 1.00 X 0 0 0 HENRY PERAKIA BOARD MEMBER 1.00 X 0 0 0 IRA ROUSSO BOARD MEMBER 1.00 X 0 0 0 JAMES CASPI BOARD MEMBER 1.00 X 0 0 0 JAMES KHANI BOARD MEMBER 1.00 X 0 0 0 JOEL WEIDMAN BOARD MEMBER 1.00 X 0 0 0 MARC TENZER BOARD MEMBER 1.00 X 0 0 0 MORRIS ADWAR BOARD MEMBER 1.00 X 0 0 0 REGINALD MATSIL BOARD MEMBER 1.00 X 0 0 0 ROBERT COHEN BOARD MEMBER 1.00 X 0 0 0 VICTOR HAZEN BOARD MEMBER 1.00 X 0 0 0 MICHAEL NEW EXECUTIVE DIRECTOR 35.00 X 310653 0 68506 JAY MOSTEL VICE PRESIDENT OF FINANCE 35.00 X 203869 0 67371 NORMAN COHEN SENIOR VICE PRESIDENT 35.00 X 208648 0 60210 GERTRUDES DE GUZMAN DIRECTOR OF NURSING 35.00 X 144612 0 28666 NEIL SCHLISSEL CONTROLLER 35.00 X 134400 0 28114 ARLENE KAKOULAS ASST. DIRECTOR OF NURSING 35.00 X 132344 0 21607 LINDA HUNTER DIRECTOR OF HUMAN RESOURCE 35.00 X 137118 0 22754 PHYLLIS CHIN DIRECTOR OF QUALITY MANAGE 35.00 X 123612 0 14163 1395256 0 311391 11 0 1 0 SELECT REHABILITATION PO BOX 809056 CHICAGO IL 60680 THERAPY SERVICES 1767199 SPRING ROC LLC 104 CHARLTON STREET ST1W NEW YORK NY 10014 CONSTRUCTION SERVICES 1214172 PARK AVENUE MEDICAL ASSOCIATES PC 3 BARKER AVENUE WHITE PLAINS NY 10601 MEDICAL SERVICES 691332 TOWNE NURSING STAFF 129 SOUTH 8TH STREET BROOKLYN NY 11211 NURSING SERVICES 440661 ID MEDICAL 501 5TH AVENUE NEW YORK NY 10017 MEDICAL SERVICES 292110 14 74386 74386 MEDICAID 623000 21643953 21643953 MEDICARE - PART A 623000 7714653 7714653 PRIVATE 623000 3631583 3631583 ADULT DAY CARE 623000 2335769 2335769 MEDICARE - PART B 623000 632940 632940 35958898 303619 303619 23675 14836 8839 8839 8839 36345742 35958898 0 312458 919257 919257 16000862 14517198 1483664 1194959 1129724 65235 4157817 3686936 470881 1331681 1155958 175723 36967 36967 40458 40458 3803 3301 502 5223639 4713370 508446 1823 43362 43362 2392055 1940700 443017 8338 724634 628982 95652 6894 3639 2426 829 25243 12956 12287 1438906 1248970 189936 290842 252451 38391 CASH RECEIPTS ASSESSMT. 1759745 1759745 35591124 31053930 4526204 10990 2862 3943997 31576431 29490915 97170 7537999 5145986 33943 33943 116739 140827 30867102 19863875 10396601 11003227 792372 644754 50554117 50403649 5007892 4986996 2225421 1341231 7233313 6328227 X 41740261 41494742 1000137 1580543 1580543 43320804 44075422 50554117 50403649 754618 0 X X 0 1 1 X 0 X 760625 217106 231769 100265 74386 1384151 31674102 32915659 34019512 33511223 35958898 168079394 32434727 33132765 34251281 33611488 36033284 169463545 0 0 0 169463545 1272916 897967 434761 407747 327294 3340685 1272916 897967 434761 407747 327294 3340685 33707643 34030732 34686042 34019235 36360578 172804230 0.98070 0.97410 0.01930 0.02410 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3803 3803 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION HOLDS MEMBERSHIP IN NYAHSA AND CCLC ORGANIZATIONS AND HAS ENGAGED IN LOBBYING ACTIVITIES CARRIED ON BY THOSE ORGANIZATIONS. 1580543 8024 8024 1580543 1580543 21761 21761 1580543 1580543 59959 59959 1580543 1580543 59959 59959 1580543 1.00000 0 0 506140 506140 15219279 10908832 4310447 13005688 8551184 4454504 2135995 403859 1732136 11003227 ESTIMATED AMOUNTS DUE TO THIRD PARTY PAYORS 716457 RESIDENT PERSONAL FUNDS 624774 1341231 36345742 35591124 754618 754618 36360578 14836 14836 36345742 0 36345742 35605960 14836 14836 35591124 0 35591124 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE IS TO SUPPORT ACTIVITIES RELATED TO HEALTH CARE SERVICES - MEDICAL RESEARCH AND EDUCATION PROGRAMS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOME HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2008 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 14,836. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 14,836. X X X 0 0 0 0 0 0 0 0 0 MICHAEL NEW 303234 0 0 0 7419 0 32500 0 36006 0 379159 0 0 0 JAY MOSTEL 199931 0 0 0 3938 0 41500 0 25871 0 271240 0 0 0 NORMAN COHEN 205840 0 0 0 2808 0 32500 0 27710 0 268858 0 0 0 GERTRUDES DE GUZMAN 144612 0 0 0 0 0 7823 0 20843 0 173278 0 0 0 NEIL SCHLISSEL 134400 0 0 0 0 0 7271 0 20843 0 162514 0 0 0 ARLENE KAKOULAS 132344 0 0 0 0 0 7174 0 14433 0 153951 0 0 0 LINDA HUNTER 133531 0 0 0 3587 0 7224 0 15530 0 159872 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 LOUIS ROUSSO AND IRA ROUSSO HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. THE BOARD OF DIRECTORS REVIEWS THE FORM 990 AND APPROVES IT FOR SUBMISSION. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE SALARIES AND BENEFITS ARE SUBJECT TO APPROVAL BY THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE. IN 2009 THE EXECUTIVE COMPENSATION COMMITTEE GATHERED COMPARATIVE SALARY AND BENEFITS INFORMATION FROM AN INDEPENDENT SOURCE AS PART OF ITS REVIEW AND APPROVAL OF EXECUTIVE COMPENSATION. 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. AUDIT OVERSIGHT FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.