2012-11-15T15:05:33-06:00 2011-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2011-01-01 042106768 JEWISH REHABILITATION CENTER FOR AGED OF THE NORTH SHORE INC JEWI 7815985310 330 PARADISE ROAD SWAMPSCOTT MA 019072941 STEPHEN H NEFF 7815985310 2012-11-13 1 DOUGLAS FIEBELKORN P00173341 6179848100 2012-11-13 2011 2016-02-24 21:20:13Z STEPHEN H NEFF 330 PARADISE ROAD SWAMPSCOTT MA 019072941 19622574 0 X WWW.AVIVLIVING.ORG X 1944 MA THE ORGANIZATION OPERATES A 180 BED NURSING HOME WITH AN ADULT DAY CARE CENTER 18 16 362 25 0 0 738 2543654 16742872 17078920 0 0 0 0 16743610 19622574 0 0 0 0 11102865 11437877 0 0 0 6791844 6758872 17894709 18196749 -1151099 1425825 6898108 46119499 4656409 43795833 2241699 2323666 THE ORGANIZATION OPERATES A 180 BED NURSING HOME WITH AN ADULT DAY CARE CENTER 0 0 15304683 16319107 PROVIDE QUALITY SKILLED NURSING CARE & THERAPY FOR 180 ELDERLY RESIDENTS. 620518 759813 PROVIDE DAY CARE FOR THE ELDERLY 15925201 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 17 0 1 362 1 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X X KIM RICHARDSON CFO 7815985310 330 PARADISE ROAD SWAMPSCOTT MA 019072941 STEPHEN H NEFF 40.00 X X 0 399057 30417 MATTHEW WEINSTOCK 40.00 X X 0 182324 11969 KIM RICHARDSON 40.00 X X 0 159423 6058 ANDREW KATZ 1.00 X X 0 0 0 DAVID VARSANO 1.00 X X 0 0 0 NATALIE LEDERMAN 1.00 X X 0 0 0 WAYNE SHERIDAN 1.00 X X 0 0 0 TOM DICKER 1.00 X 0 0 0 JAY GOLDMAN 1.00 X 0 0 0 ELLEN GORDON 1.00 X 0 0 0 MARK JAFFE 1.00 X 0 0 0 ERIC LEVY 1.00 X 0 0 0 NEAL MIZNER 1.00 X 0 0 0 DAVID PLINER 1.00 X 0 0 0 RONALD ROSEN MD 1.00 X 0 0 0 SEYMOUR SCHWARTZ 1.00 X 0 0 0 DEBRA SLOAN 1.00 X 0 0 0 ROBERT SMITH 1.00 X 0 0 0 JEFFREY GOPEN 40.00 X 118452 0 9205 MARY OGAH 40.00 X 114704 0 160 LETICIA ASIA 40.00 X 106144 0 7430 JEAN CICATELLI 40.00 X 110278 0 720 LISA A VAN ECK 40.00 X 103533 0 3952 553111 740804 69911 5 0 1 0 AVIV CENTERS FOR LIVING INC 330 PARADISE ROAD SWAMPSCOTT MA 01907 MANAGEMENT 1530000 APPLIED LINEN SERVICES PO BOX 61 MERRIMAC MA 01860 LINEN/LAUNDRY 184797 KONINGISOR CONSULTING 23 LAKEVIEW ROAD FRAMINGHAM MA 01701 CONSTRUCTION MGMT 142755 KANALSTEIN DANTON ASSOCIATES 227 LAURA RD STE 200 VOORHEES NJ 08043 ARCHITECT 104338 4 2543654 2543654 PROGRAM SERVICE REVENU 623000 17078920 17078920 17078920 19622574 17078920 0 0 9892695 9516161 376534 22827 21958 869 692419 666064 26355 829936 798347 31589 1623000 1623000 19042 19042 51450 51450 711250 568541 142709 30654 30654 142846 142846 557375 557375 127863 127863 44982 44982 3486 3486 652066 652066 12600 12600 USER FEE 893088 893088 FOOD 605117 605117 SUPPLIES 532318 532318 ANCILLARIES 529819 529819 221916 221916 18196749 15925201 2271548 0 600206 573740 500 20483567 20756 0 1524800 1888026 20118 20263 324861 275152 14561903 10119501 4064457 4442402 342410 18436349 6898108 46119499 1364964 4801829 20440 46916 1839559 34553888 1431446 4393200 4656409 43795833 X 2233430 2323666 8269 0 2241699 2323666 6898108 46119499 X 1425825 -1343857 X X 0 1 1 X 0 X 123291 5813 5462 738 1607943 1743247 15864963 16692051 17109731 16742872 17078920 83488537 15988254 16697864 17115193 16743610 18686863 85231784 1607943 1607943 0 1607943 1607943 83623841 935711 935711 935711 935711 15988254 16697864 17115193 16743610 19622574 86167495 0.97050 0.99470 0.01090 X 8270 8270 9000 730 8270 74547 65547 9000 0.00000 0.00000 0.00000 0 1 1 284419 284419 5237068 3433347 1803721 4958072 3445969 1512103 4024783 3193197 831586 57561 46988 10573 4442402 CONSTRUCTION IN PROGRESS 15597705 SOFTWARE, NET 31524 UNAMORTIZED MORTGAGE ACQUISITION CO 1024458 CAPITAL INTEREST FUND 1768686 SECURITY DEPOSITS 13976 18436349 DUE TO RELATED PARTIES 2230978 FAIR VALUE OF INTEREST RATE SWAPS 1374246 ASSET RETIREMENT OBLIGATION 774000 SECURITY DEPOSITS 13976 4393200 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: USE OF FUNDS IN ACCORDANCE WITH DONORS' RESTRICTIONS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION UNDER SEC 501(C)(3) OF THE INTERNAL REVENUE CODE. THE 2008 THROUGH 2011 TAX YEARS ARE OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 STEPHEN H NEFF 0 399057 0 0 0 0 0 0 0 30417 0 429474 0 0 MATTHEW WEINSTOCK 0 182324 0 0 0 0 0 0 0 11969 0 194293 0 0 KIM RICHARDSON 0 159423 0 0 0 0 0 0 0 6058 0 165481 0 0 MASS DEVELOPMENT FINANCE AGENCY 043431814 57583UBR8 2011-04-29 345553888 TO REFUND OLD BONDS AND REPLACE EXISTING FACILITY 0 0 0 1601175 34553888 1314672 690823 529178 7941703 22476337 1 0 0 1 0 0 0 0 1 0 1 1 M&T BANK 5.000000000000 0 0 0 0 0 SCHEDULE K SUPPLENTAL INFORMATION THIS ORGANIZATION IS REPORTING THEIR RESPECTIVE SHARE OF THE $50M BOND ISSUED ON 4/29/11. SEE AVIV ASSISTED LIVING, INC. (EIN 04-3274643) FOR THE REMAINING PORTION. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT REVIEWS CPA PREPARED FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE CONSULTANT WHOSE INFORMATION IS POSTED THROUGHOUT THE ORGANIZATION AND COMPLIANCE COMMITTEE TO OVERSEE AND REVIEW ISSUES. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION COMMITTEE TO OVERSEE COMPENSATION FOR MANAGEMENT AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 30,384. CHANGE IN FAIR VALUE OF INTEREST RA -1,374,241. TOTAL TO FORM 990, PART XI, LINE 5: -1,343,857. OVERSEE AUDIT AND SELECTION OF AUDITOR FORM 990, PART IX, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT OVERSEES THE AUDIT AND SELECTS THE AUDITOR. AVIV FOUNDATION INC 330 PARADISE ROAD SWAMPSCOTT MA 01907 223102199 FUNDRAISING MA 501(C)(3) LINE 7 AVIV CENTERS FOR LIVING 1 AVIV ASSISTED LIVING INC 240 LYNNFIELD STREET PEABODY MA 01960 043274643 ASSISTED LIVING MA 501(C)(3) LINE 9 AVIV CENTERS FOR LIVING 1 AVIV CENTERS FOR LIVING INC 330 PARADISE ROAD SWAMPSCOTT MA 01907 261244471 MANAGEMENT MA 501(C)(3) LINE 11B, II 0 JRCL HOMECARE LLC 330 PARADISE RD SWAMPSCOTT MA 01907 262743823 HOME BASED SKILLED NURSING MA N/A JRC REALTY CORP 330 PARADISE ROAD SWAMPSCOTT MA 01907 043321272 REAL ESTATE MA N/A C 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1