2012-12-20T13:58:39-06:00 2011-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2011-01-01 133438643 JACOB PERLOW HOSPICE CORPORATION JACO 7189217742 6323 7TH AVENUE BROOKLYN NY 11220 ALEX BALKO 7189217742 2012-12-04 1 FREDERICK H ROTHMAN P01275277 2128674000 2011 2016-02-24 21:20:13Z MJHS HOSPICE AND PALLIATIVE CARE ALEX BALKO 6323 7TH AVENUE BROOKLYN NY 11220 42622546 0 X N/A X 1987 NY TO PROVIDE HOSPICE SERVICES ON BOTH AN INPATIENT AND OUTPATIENT BASIS. 10 9 297 8 0 0 2881036 1068639 20669719 41447443 0 0 194296 106464 23745051 42622546 0 0 0 0 9664449 17728539 0 0 0 14624905 28733926 24289354 46462465 -544303 -3839919 8141751 11620621 9026439 16387100 -884688 -4766479 X JACOB 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. 0 0 40503335 41447443 JACOB 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 2011, JACOB PERLOW PROVIDED 39,867 HOSPICE DAYS, 82,136 CONTINUOUS HOME CARE DAYS, 110,132 ROUTINE HOME CARE DAYS, 115 INPATIENT RESPITE CARE DAYS AND 10,234 GENERAL INPATIENT CARE DAYS. 40503335 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 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 1 0 0 0 0 1 111 0 297 1 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X PEGGY GUNDERMAN 7189217742 6323-7TH AVE BROOKLYN NY 11220 ELI S FELDMAN 2.00 X X 76963 1173679 274708 SHMUEL LEFKOWITZ 0.50 X X 0 0 0 DAVID WIENER 0.50 X X 0 0 0 RONALD MILCH 0.50 X 0 0 0 ESTERE DUBOULAY 0.50 X 0 0 0 IRVING DAYAN 0.50 X 0 0 0 BURTON ESRIG 0.50 X 0 0 0 SUZANNE CUTLER 0.50 X 0 0 0 MARTIN MARCUS 0.50 X 0 0 0 STEVEN ROTTER 0.50 X 0 0 0 ROBERT LEAMER 2.00 X 24948 380470 130179 ALEX BALKO 2.00 X 42795 663324 172874 ELLIOT BROOKS 3.00 X 37298 366767 111407 SUSAN CAPUTO 6.50 X 95339 410689 198021 BARBARA HINEY 35.00 X 282653 0 28731 WENDI LOVENVIRTH 35.00 X 180994 0 23767 BERNARD LEE 35.00 X 338836 0 43915 OLGA BARATT 35.00 X 198910 0 32929 IRINA BELKINA 35.00 X 201156 0 3782 MILDRED GAMBLE 35.00 X 197737 0 10013 1677629 2994929 1030326 29 0 1 0 BETH ISRAEL MEDICAL CENTER 555 WEST 57TH STREET NEW YORK NY 10019 HOSPITAL 3041461 JEWISH HOME & HOSPITAL FOR THE AGED BRON 100 W KINGSBRIDGE ROAD BRONX NY 10471 HOSPICE PATIENTS 1640715 HEBREW HOME FOR THE AGED AT RIVERDALE 5901 PALISADE AVE RIVERDALE NY 10471 NURSING HOME 1140490 PALISADE NURSING HOME COMPANY INC 5901 PALISADE AVE RIVERDALE NY 10471 NURSING HOME 934220 ENCLARA HEALTH PO BOX 105328 ATLANTA GA 303485328 DRUGS 859940 36 525000 543639 1068639 HOSPICE AND PALLIATIVE 623000 41447443 41447443 41447443 OTHER REVENUE 900099 106464 106464 106464 42622546 41447443 0 106464 671712 311384 360328 13555615 12629311 926304 621747 516441 105306 1701890 1505049 196841 1177575 1074275 103300 129669 121595 8074 45630 40000 5630 19046809 18894988 151821 2188096 22552 2165544 3645665 3097889 547776 13700 13700 2078156 1754919 323237 397676 391136 6540 43041 13511 29530 2610 2610 287745 287745 152200 152200 BAD DEBT 515289 515289 187640 130285 57355 46462465 40503335 5959130 0 3134642 27000 1486021 3787139 9048610 1693015 1177664 681823 515351 538147 543639 8141751 11620621 5263902 9174961 3762537 7212139 9026439 16387100 X -1494688 -5316479 60000 0 550000 550000 -884688 -4766479 8141751 11620621 X -3839919 -41872 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 550000 550000 550000 550000 550000 550000 1.00000 0 0 355521 41326 314195 1318272 1136338 181934 19222 19222 515351 ESTIMATED AMOUNT DUE TO THIRD PARTIES 2300000 DUE TO PARTICIPATING AGENCIES OF MJHS 4912139 7212139 42622546 46462465 -3839919 -41872 -41872 -3881791 42580674 -41872 -41872 42622546 0 42622546 46462465 0 46462465 0 46462465 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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, 2008 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. X X X X X X 0 1 0 0 0 0 0 1 0 ELI S FELDMAN 70740 1078777 0 0 6223 94902 14469 220650 2436 37153 93868 1431482 0 0 ROBERT LEAMER 21837 333021 0 0 3111 47449 5916 90218 2095 31950 32959 502638 0 0 ALEX BALKO 38757 600734 0 0 4038 62590 8414 130415 2063 31982 53272 825721 0 0 ELLIOT BROOKS 32748 322023 0 0 4550 44744 8837 86895 1447 14228 47582 467890 0 0 SUSAN CAPUTO 86718 373554 0 0 8621 37135 29974 129118 7334 31595 132647 571402 0 0 BARBARA HINEY 265156 0 0 0 17497 0 17763 0 10968 0 311384 0 0 0 WENDI LOVENVIRTH 180431 0 0 0 563 0 13175 0 10592 0 204761 0 0 0 BERNARD LEE 307314 0 30000 0 1522 0 17763 0 26152 0 382751 0 0 0 OLGA BARATT 197268 0 0 0 1642 0 2966 0 29963 0 231839 0 0 0 IRINA BELKINA 200405 0 0 0 751 0 3176 0 606 0 204938 0 0 0 MILDRED GAMBLE 185557 0 9167 0 3013 0 0 0 10013 0 207750 0 0 0 PART I, LINE 4B PART I, LINE 4B: PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ALEXANDER BALKO - $17,333 ELLIOT BROOKS - $17,333 ROBERT LEAMER - $17,333 SUSAN CAPUTO - $17,333 PART I, LINE 7 BONUS ELIGIBILITY IS BASED ON THE EXTENT THAT EACH EXECUTIVE AND EMPLOYEE HAS ACHIEVED HIS/HER GOAL. FORM 990, PART VI, SECTION A, LINE 6 METROPOLITAN JEWISH HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF JACOB PERLOW HOSPICE CORPORATION FORM 990, PART VI, SECTION A, LINE 7A METROPOLITAN JEWISH HEALTH SYSTEM, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 DRAFTS 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 FINANCE AND INVESTMENT COMMITTEE FOR ITS REVIEW AND APPROVAL. ONCE THE FINANCE AND INVESTMENT COMMITTEE HAS COMPLETED ITS REVIEW COPIES OF THE RETURNS WILL BE PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C EACH 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 15 EACH YEAR, THE METROPOLITAN JEWISH HEALTH SYSTEM, INC. 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 JANUARY 2011. 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 18 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST TO THE OFFICE OF THE PRESIDENT. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST TO THE OFFICE OF THE PRESIDENT. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -41,872. FORM 990, PART XII, LINE 2C PROCESS HAS NOT CHANGED FROM PRIOR YEAR. HOURS WORKED FOR RELATED ORGANIZATIONS FORM 990, PART VII ELI S. FELDMAN - 31 ALEXANDER BALKO - 31 ROBERT LEAMER - 31 ELLIOT BROOKS - 30.5 IRVING DAYAN - 0.5 SHMUEL LEFKOWITZ - 3.5 ESTERE DUBOULAY - 1 RONALD B. MILCH - 4 BURTON ESRIG - 1.5 SUSAN CAPUTO - 23.5 DAVID WIENER - 1 METROPOLITAN JEWISH HEALTH SYSTEM INC 6323 7TH AVENUE BROOKLYN NY 11220 113538697 ADMINISTRATIVE ACTIVITIES NY 501(C)(3) 7 N/A 0 MJG NURSING HOME CO INC 6323 7TH AVENUE BROOKLYN NY 11220 237123076 NURSING HOME NY 501(C)(3) 3 N/A 0 MENORAH HOME AND HOSPITAL FOR THE AGED AND INFIRM 6323 7TH AVENUE BROOKLYN NY 11220 111572777 NURSING HOME, ADULT DAY NY 501(C)(3) 3 METROPOLITAN JEWISH HEALTH SYSTEM INC 1 SHOREFRONT JEWISH GERIATRIC CENTER INC 6323 7TH AVENUE BROOKLYN NY 11220 113072153 NURSING HOME, ADULT DAY NY 501(C)(3) 9 METROPOLITAN JEWISH HEALTH SYSTEM INC 1 METROPOLITAN JEWISH HOME CARE INC 6323 7TH AVENUE BROOKLYN NY 11220 320060822 HOME CARE, HOSPICE NY 501(C)(3) 9 METROPOLITAN JEWISH HEALTH SYSTEM INC 1 ELDERPLAN INC 6323 7TH AVENUE BROOKLYN NY 11220 112625096 MEDICARE ADVANTAGE SPECIAL NEEDS PLAN / MEDICAID MANAGED LONG TERM CARE PLAN NY 501(C)(3) 9 N/A 0 MENORAH FOUNDATION INC 6323 7TH AVENUE BROOKLYN NY 11220 113471173 FUNDRAISING NY 501(C)(3) 11 TYPE I METROPOLITAN JEWISH HEALTH SYSTEM FOUNDATION 1 HOMEFIRST LHCSA INC 6323 7TH AVENUE BROOKLYN NY 11220 611501623 HOME CARE NY 501(C)(3) 11 TYPE I N/A 0 METROPOLITAN JEWISH HEALTH SYSTEM FOUNDATION 6323 7TH AVENUE BROOKLYN NY 11220 111630753 FUNDRAISING NY 501(C)(3) 7 N/A 0 SHOREFRONT TOWERS HOUSING DEVELOPMENT FUND CORPORATION 6323 7TH AVENUE BROOKLYN NY 11220 113200785 HOUSING NY 501(C)(3) 9 N/A 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0