2012-08-14T11:54:40-05:00 2011-09-30 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2010-10-01 200158017 SEABURY MEMORY CARE CENTER INC SEAB 8602860243 200 SEABURY DRIVE BLOOMFIELD CT 060022650 JOSEPH H WALTON 8602860243 2012-08-14 1 ELIZABETH SOLECKI 8605614000 2010 2016-02-24 21:20:13Z SEABURY MEADOWS JOSEPH H WALTON 200 SEABURY DRIVE BLOOMFIELD CT 060022650 3272763 0 X N/A X 2003 CT TO PROVIDE HOUSING AND SUPPLEMENTAL SERVICES TO THE ELDERLY. 8 7 0 35 0 0 130290 101053 3178654 3162350 10184 9360 0 0 3319128 3272763 0 0 0 0 0 0 0 0 0 3067313 3112933 3067313 3112933 251815 159830 4060547 3965137 2421382 2166142 1639165 1798995 TO PROVIDE HOUSING AND SUPPLEMENTAL SERVICES TO THE ELDERLY WITH ALZHEIMER'S DISEASE. 0 0 2989024 3162350 TO PROVIDE HOUSING AND SUPPLEMENTAL ASSISTED LIVING SERVICES TO THE ELDERLY AFFLICTED WITH ALZHEIMER'S DISEASE. SEABURY MEMORY CARE CONSISTS OF 44 ASSISTED LIVING DEMENTIA BEDS AND 14 RESIDENTIAL CARE HOME BEDS. 2989024 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 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 1 0 1 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 0 1 1 0 0 X STEVEN YANOFSKY CHURCH HOME VP FIN 8602860243 200 SEABURY DR BLOOMFIELD CT 060020243 REV BORDEN W PAINTER JR 0.30 X X 0 0 0 A RAYMOND MADORIN 0.30 X X 0 0 0 JAMES C ERVIN JR 0.30 X X 0 0 0 WINIFRED GRANGER 0.30 X 0 0 0 JOHN S MOBLEY 0.30 X X 0 328829 36085 RAYMOND J PAYNE 0.30 X X 0 0 0 JOSEPH H WALTON 0.30 X X 0 0 0 DONALD F HARRIS JR 0.30 X 0 0 0 0 328829 36085 0 0 1 0 CHURCH HOME OF HARTFORD INCORPORATED 200 SEABURY DR BLOOMFIELD CT 06002 CONTRACT STAFFING 2433108 1 100891 162 101053 ASSISTED LIVING SERV. 623000 3095886 3095886 OTHER RESIDENT SERV. 623000 66464 66464 3162350 9360 9360 3272763 3162350 0 9360 240 240 2100 2100 5780 5780 268051 184143 83908 1232 1232 111793 111793 160254 160254 24498 24498 CONTRACTED SERVICES 2257948 2257948 SUPPLIES 174396 170908 3488 EQUIP. RENTAL & MAINT. 60702 60702 REMOVAL SERVICES 18339 18339 RESIDENT ACTIVITIES 11011 11011 16589 6914 9675 3112933 2989024 123909 0 901249 970407 118180 105562 141661 127242 3910515 1166337 2878979 2744178 20478 17748 4060547 3965137 265249 249199 2156133 1916943 2421382 2166142 X 1639165 1798995 1639165 1798995 4060547 3965137 159830 0 X 0 1 1 X 0 X 37181 1570 44701 130290 101053 314795 3395864 3306442 3149191 3178654 3162350 16192501 3433045 3308012 3193892 3308944 3263403 16507296 0 0 0 16507296 12285 10184 9360 31829 12285 10184 9360 31829 3433045 3308012 3206177 3319128 3272763 16539125 0.99810 0.99870 0.00190 0.00130 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3799066 1095547 2703519 111449 70790 40659 2744178 3272763 3112933 159830 0 159830 3272763 0 3272763 0 3272763 3112933 0 3112933 0 3112933 X X X X X 0 0 0 0 0 0 0 0 0 JOHN S MOBLEY 0 328829 0 0 0 0 0 22522 0 13563 0 364914 0 0 FORM 990, PART VI, SECTION A, LINE 6 CHURCH HOME OF HARTFORD, INCORPORATED BOARD OF DIRECTORS ARE MEMBERS BY POSITION. FORM 990, PART VI, SECTION A, LINE 7A CHURCH HOME OF HARTFORD, INCORPORATED BOARD OF DIRECTORS ARE MEMBERS BY POSITION. AS MEMBERS, THEY ELECT THE BOARD OF DIRECTORS FOR SEABURY MEMORY CARE CENTER. FORM 990, PART VI, SECTION A, LINE 7B CHANGES TO BY-LAWS AND ARTICLES MUST BE APPROVED BY THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AFTER FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REVIEWING THE POLICY AT ORIENTATION AND AT MEETINGS THROUGHOUT THE YEAR. FORM 990, PART VI, SECTION B, LINE 15A JOHN MOBLEY IS COMPENSATED BY CHURCH HOME OF HARTFORD, INCORPORATED, THEREFORE, HIS COMPENSATION IS DETERMINED BY THE BOARD OF CHURCH HOME OF HARTFORD. COMPENSATION IS DETERMINED USING A REVIEW OF LIKE ORGANIZATIONS, 990 REPORT FOR TOP PAID EMPLOYEES AND USE OF ASSOCIATION WAGE SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE DOCUMENTS ARE RETAINED IN SEABURY'S LIBRARY. CHURCH HOME OF HARTFORD INCORPORATED 200 SEABURY DRIVE BLOOMFIELD CT 06002 060293500 TO PROVIDE HOUSING AND SUPPLEMENTAL SERVICES TO THE ELDERLY CT 501(C)3 509(A)(2) 0 SEABURY AT HOME INCORPORATED 200 SEABURY DRIVE BLOOMFIELD CT 06002 205096169 TO PROVIDE HOME HEALTH SERVICES TO THE ELDERLY CT 501(C)3 509(A)(2) 0 SEABURY CHARITABLE FOUNDATION INC 200 SEABURY DRIVE BLOOMFIELD CT 06002 061458630 TO SUPPORT CHURCH HOME OF HARTFORD CT 501(C)3 509(A)(3) - TYPE I 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0