2011-11-07T20:06:51-06:00 2010-12-31 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2010-01-01 133438643 JACOB PERLOW HOSPICE CORPORATION JACO 7189217742 6323 7TH AVENUE BROOKLYN NY 11220 ALEX BALKO 7189217742 2011-11-04 1 FREDERICK H ROTHMAN 2128674000 2010 2016-03-07 17:11:31Z MJHS HOSPICE AND PALLIATIVE CARE ALEX BALKO 6323 7TH AVENUE BROOKLYN NY 11220 23745051 0 X N/A X 1987 NY TO PROVIDE HOSPICE SERVICES ON BOTH AN INPATIENT AND OUTPATIENT BASIS. 8 7 129 0 0 0 299383 2881036 21595496 20669719 6748 0 139457 194296 22041084 23745051 0 0 0 0 12314543 9664449 0 0 0 14729744 14624905 27044287 24289354 -5003203 -544303 4572159 8141751 8216135 9026439 -3643976 -884688 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 23662040 20669719 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 2010, JACOB PERLOW PROVIDED 54,503 HOSPICE DAYS, 301 CONTINUOUS HOME CARE DAYS, 48,165 ROUTINE HOME CARE DAYS, 16 INPATIENT RESPITE CARE DAYS AND 5,281 GENERAL INPATIENT CARE DAYS. 23662040 1 1 0 0 0 0 0 0 0 1 0 0 1 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 63 0 1 129 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 1 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 1.00 X X 43189 1360438 78183 ISAAC ASSAEL 0.50 X 0 0 0 PAUL FINKELSTEIN MD 0.50 X 0 0 0 SHMUEL LEFKOWITZ 0.50 X 0 0 0 JACOB FRIEDMAN 0.50 X 0 0 0 RONALD MILCH 0.50 X 0 0 0 STEVEN TOPAL 0.50 X 0 0 0 ARTHUR GOSHIN MD 0.50 X 0 0 0 ALEX BALKO 1.00 X 21474 676414 70939 ROBERT LEAMER 1.00 X 13147 414158 69639 ELLIOT BROOKS 1.00 X 12874 405527 53550 WENDI LOVENVIRTH 35.00 X 102728 0 11438 ALLISON MAUGHN 35.00 X 132143 0 20767 325555 2856537 304516 2 0 1 0 BETH ISRAEL MEDICAL CENTER 555 WEST 57TH STREET NEW YORK NY 10019 HOSPITAL 1941386 SIMIONE CONSULTANTS 4130 WHITNEY AVENUE HAMDEN CT 06518 CONSULTATION 544987 HEBREW HOME FOR THE AGED AT RIVERDALE 5901 PALISADE AVE RIVERDALE NY 10471 NURSING HOME 541731 BETH ISRAEL MEDICAL CENTER 555 WEST 57TH STREET 5TH FLOOR NEW YORK NY 10019 OCCUPANCY 403712 ATRIA SENIOR LIVING GROUP PO BOX 70469 LOUISVILLE KY 40270 NURSING HOME 395303 12 2800000 81036 2881036 HOSPICE AND PALLIATIVE 623000 20669719 20669719 20669719 OTHER REVENUE 900099 194296 194296 194296 23745051 20669719 0 194296 99060 99060 7861038 7861038 120052 120052 1315015 1315015 269284 262347 6937 158904 2477 156427 40833 40833 2197407 2197407 5151 5151 361244 354047 7197 1579786 1560068 19718 95100 95100 32063 32063 249616 249616 INPATIENT HOSPICE EXPEN 8515065 8515065 MEDICAL SUPPLIES 1162433 1162433 BAD DEBT 82899 82899 144404 138944 5460 24289354 23662040 627314 0 3134642 3557509 3787139 14516 1571744 889921 592816 681823 407318 538147 4572159 8141751 3655758 5263902 4560377 3762537 8216135 9026439 X -4280742 -1494688 86766 60000 550000 550000 -3643976 -884688 4572159 8141751 X -544303 3303591 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 550000 550000 550000 550000 1.00000 0 0 345473 40579 304894 1226271 849342 376929 681823 DUE FROM BETH ISRAEL MEDICAL CENTER 517739 ESTIMATED AMOUNT DUE FROM THIRD PARTIES 20408 538147 ESTIMATED AMOUNT DUE TO THIRD PARTIES 2300000 DUE TO PARTICIPATING AGENCIES OF MJHS 1462537 3762537 23745051 24289354 -544303 -776 3304367 3303591 2759288 23745051 0 23745051 0 23745051 24289354 0 24289354 0 24289354 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPICE ADOPTED THE PROVISION PERTAINING TO UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2007 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: WRITE OFF DUE TO BETH ISRAEL MEDICAL CENTER 3,304,367. WRITE OFF DUE TO BETH ISRAEL MEDICAL CENTER. X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 ELI S FELDMAN 30581 963289 0 0 12608 397149 1300 40962 1105 34816 45594 1436216 0 0 ALEX BALKO 18654 587602 1595 50240 1225 38572 1300 40962 882 27795 23656 745171 0 0 ROBERT LEAMER 11085 349187 986 31072 1076 33899 1300 40962 842 26535 15289 481655 0 0 ELLIOT BROOKS 10977 345760 890 28050 1007 31717 1300 40962 347 10941 14521 457430 0 0 ALLISON MAUGHN 117997 0 13846 0 300 0 8159 0 12608 0 152910 0 0 0 PART I, LINE 1A SENIOR EXECUTIVES SHALL BE REIMBURSED FOR BUSINESS/FIRST CLASS AIR TRAVEL FOR FLIGHTS OF FOUR AND ONE-HALF HOURS OR LONGER. THIS BENEFIT IS NONTAXABLE TO THE RECIPIENTS. PART I, LINE 4B PART I, LINE 4B: PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ELI FELDMAN- $378,183- THIS AMOUNT WAS PAID OUT IN 2010 AND HAD BEEN ACCRUED OVER THE PREVIOUS 3 YEARS. ALEXANDER BALKO - $17,426 ELLIOT BROOKS - $17,426 ROBERT LEAMER - $17,426 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 4 THE ORGANIZATION AMENDED ITS BYLAWS TO MAKE METROPOLITAN JEWISH HEALTH SYSTEM, INC., A CORPORATION EXEMPT FROM TAXATION PURSUANT TO IRS CODE SECTION 501(C)(3), ITS SOLE VOTING MEMBER. PRIOR TO JUNE 1, 2010, BETH ISRAEL MEDICAL CENTER WAS ITS SOLE VOTING MEMBER. 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 ORGANIZATION 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 2010. 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: PRIOR PERIOD ADJUSTMENTS: -776. WRITE OFF DUE TO BETH ISRAEL MEDICAL CENTER 3,304,367. TOTAL TO FORM 990, PART XI, LINE 5: 3,303,591. 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 - 32 ALEXANDER BALKO - 32 ROBERT LEAMER - 32 ELLIOT BROOKS - 32 ISSAC ASSAEL - 3 PAUL FINKELSTEIN, MD - 3 SHMUEL LEFKOWITZ - 3 STEVEN TOPAL - 4 ARTHUR GOSHIN - 3 JACOB FRIEDMAN - 3.5 RONALD B. MILCH - 4.5 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, HOME CARE, ADULT DAY 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 0 SHOREFRONT JEWISH GERIATRIC CENTER INC 6323 7TH AVENUE BROOKLYN NY 11220 113072153 NURSING HOME NY 501(C)(3) 9 METROPOLITAN JEWISH HEALTH SYSTEM INC 0 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 0 ELDERPLAN INC 6323 7TH AVENUE BROOKLYN NY 11220 112625096 MEDICARE ADVANTAGE SPECIAL NEEDS PLAN NY 501(C)(3) 9 N/A 0 HOMEFIRST INC 6323 7TH AVENUE BROOKLYN NY 11220 113325280 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 0 HOMEFIRST LHCSA INC 6323 7TH AVENUE BROOKLYN NY 11220 611501623 HOME CARE NY 501(C)(3) 9 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 METROPOLITAN JEWISH HEALTH SYSTEM FOUNDATION C 2800000 CASH METROPOLITAN JEWISH HEALTH SYSTEM INC J 729754 CASH