2024-08-15T11:03:33-05:00 2023-09-30 111986323 MARCUM LLP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 990 2022-10-01 060846991 JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INC JEWI 2033656400 4200 PARK AVENUE BRIDGEPORT CT 06604 SIGNING OFFICER PRESIDENT & CEO 2033656400 2024-08-12 1 1 MARY ANTONETTI P00431862 2037819600 2024-08-12 2022 2024-08-08 14:25:15Z MOZAIC SENIOR LIFE ANDREW H BANOFF 4200 PARK AVENUE BRIDGEPORT CT 06604 72117775 0 X HTTPS://WWW.MOZAICSL.ORG X 1967 CT NON-PROFIT HEALTH CARE FACILITY PROVIDING REST HOME AND SKILLED NURSING CARE TO THE AGED AND INFIRM. 37 37 1002 184 11610 0 2451494 4868620 61810817 64277514 237825 539482 1972078 2227667 66472214 71913283 0 0 0 0 38996979 42731695 0 0 684377 25816573 29140560 64813552 71872255 1658662 41028 106288141 138822095 61828776 92174404 44459365 46647691 X CONSISTENT WITH JEWISH VALUES AND TRADITIONS, THE MISSION OF THE JEWISH HOME IS TO ASSURE JEWISH SENIORS THE HEALTH CARE, HOUSING AND GERIATRIC SERVICES REQUIRED TO ACHIEVE THE HIGHEST POSSIBLE QUALITY OF LIFE REASONABLY ATTAINABLE FOR THEM. (SEE SCHEDULE O) ADMISSION TO THESE SERVICES WILL BE AVAILABLE TO JEWISH SENIORS ON A PRIORITY BASIS. 0 0 48046141 51412796 SKILLED NURSING FACILITY: A MODERN 294 BED SKILLED NURSING FACILITY PROVIDING SHORT TERM POST ACUTE CARE, LONG TERM CARE, SPECIAL CARE FOR MEMORY, AND COGNITIVE DISORDERS. 4194143 5256457 NON-MEDICAL HOME CARE SERVICES, ALSO KNOWN AS COMPASSIONATE CARE COMPANIONS, PROVIDES CAREGIVERS OFFERING SERVICES TAILORED TO INDIVIDUAL NEEDS IN CLIENT'S HOME. SERVICES INCLUDE: COMPANIONSHIP AND SOCIALIZATION; MEAL PREPARATION; LIGHT HOUSEKEEPING; TRANSPORTATION; ERRAND AND GROCERY SHOPPING; ASSISTANCE WITH PERSONAL CARE; SUPERVISION OF DRESSING AND GROOMING; AND RECREATIONAL ACTIVITIES. 24 HOUR LIVE-IN CARE SERVICES ARE AVAILABLE. 2239789 2197983 MEDICAL HOME CARE PROVIDES CLIENTS WITH COMPREHENSIVE HOME CARE SERVICES. IN COORDINATION WITH THE CLIENT'S PHYSICIAN, THE TEAM WILL DEVELOP A PLAN OF CARE THAT PROMOTES RESTORATION OF HEALTH AND INDEPENDENCE DURING AN ILLNESS, OR FOLLOWING AN INJURY OR SURGICAL PROCEDURE IN HIS OR HER HOME SETTING. THE TEAM ALSO WORKS WITH INDIVIDUALS WHO ARE FACING CHALLENGES MEETING THE PHYSICAL DEMANDS OF DAILY LIVING AND CAN BENEFIT FROM SKILLED CARE IN THEIR HOMES. 7293454 5410278 7293454 5410278 61773527 1 1 0 1 0 0 0 0 0 1 1 0 0 0 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 1 0 0 0 0 1 0 0 0 0 1 117 0 1 1002 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 37 37 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CT X ROGER SLIBY 2033656400 4200 PARK AVE BRIDGEPORT CT 06604 ALAN PHILLIPS DIRECTOR 0.50 X 0 0 0 AMY RICH DIRECTOR 0.50 X 0 0 0 ART SPINNER DIRECTOR 0.50 X 0 0 0 BRIAN MILES DIRECTOR 0.50 X 0 0 0 ED FRIEDLAND DIRECTOR 0.50 X 0 0 0 EDWARD BURGER DIRECTOR 0.50 X 0 0 0 EMIL MESHBERG VICE CHAIRPERSON 0.50 X X 0 0 0 ERIC KATZ MD DIRECTOR 0.50 X 0 0 0 ERIC N HENDLIN DIRECTOR 0.50 X 0 0 0 GERALD LUTERMAN TREASURER 0.50 X X 0 0 0 HAROLD ROSNICK ESQ HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 JANET FREEDMAN DIRECTOR 0.50 X 0 0 0 JEFF RADLER DIRECTOR 0.50 X 0 0 0 JENNIFER KANFER DIRECTOR 0.50 X 0 0 0 JERRY MINSKY DIRECTOR 0.50 X 0 0 0 JIM BENNETT DIRECTOR 0.50 X 0 0 0 JON AUGUST CHAIRPERSON 0.50 X X 0 0 0 KENNETH I WIRFEL ESQ DIRECTOR 0.50 X 0 0 0 MARC LEVEY DIRECTOR 0.50 X 0 0 0 MARK A LAPINE HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 MARTIN F WOLF ESQ HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 MICHAEL FLEISCHER DIRECTOR 0.50 X 0 0 0 MICHAEL MARCUS DIRECTOR 0.50 X 0 0 0 MIKE WOLFSON ESQ DIRECTOR 0.50 X 0 0 0 MILTON SUTIN HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 NANCY MAGIDA SECRETARY 0.50 X X 0 0 0 PHILIP SCHAEFER DIRECTOR 0.50 X 0 0 0 ROSLYN GOLDSTEIN HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 ROY FRIEDMAN HONORARY DIRECTOR FOR LIFE 0.50 X 0 0 0 SCOTT SERELS MD DIRECTOR 0.50 X 0 0 0 WILLIAM SIMS DIRECTOR 0.50 X 0 0 0 MOIRA COLANGELO DIRECTOR 0.50 X 0 0 0 CINDY EPSTEIN DIRECTOR 0.50 X 0 0 0 NEIL LIPPMAN DIRECTOR 0.50 X 0 0 0 RENEE NOREN DIRECTOR 0.50 X 0 0 0 MANDY STANTON DIRECTOR 0.50 X 0 0 0 JAY GOLDSTEIN DIRECTOR (LEFT 9/2023) 0.00 X 0 0 0 MITCHELL ADELSTEIN DIRECTOR (LEFT 9/2023) 0.00 X 0 0 0 MITCHELL KORNBLIT DIRECTOR (LEFT 9/2023) 0.00 X 0 0 0 ELLEN HYDE PHILLIPS DIRECTOR (LEFT 9/2023) 0.00 X 0 0 0 ANDREW H BANOFF PRESIDENT OF JHE & CEO 40.00 X 875053 0 41126 ELIZABETH ZICARI VP & COMMUNITY SERVICES & BUSINESS 40.00 X 184448 0 576 LAWRENCE CONDON SENIOR VP & ADMINISTRATOR 40.00 X 256546 0 66432 ROGER SLIBY VP & CHIEF FINANCIAL OFFICER 40.00 X 229485 0 14726 KARA RODRIGUEZ VP EMPLOYEE RELATIONS 40.00 X 178176 0 12876 1723708 0 135736 34 0 1 0 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 DINING SERVICES 3042149 ALWAYS CARING OF CT 256 EAST MAIN ST WESTPORT CT 06804 HOMECARE COMPANION SERVICES 1364071 DEPENDABLE NURSING 1162 WEST WOODS ROAD HAMDEN CT 06518 TEMPORARY STAFFING 1253090 FORVIS LLC 910 E ST LOUIS STREET SUITE 200 SPRINGFIELD MO 658011190 MEDICAL BILLING 373098 JP AMERICAN STAFFING 1825 BARNUM AVE STRATFORD CT 06614 TEMPORARY STAFFING 371930 18 840000 4028620 4868620 RESIDENT CARE SERVICES 623000 51412796 51412796 COMPASSIONATE CARE 621610 5256457 5256457 MEDICAL HOME CARE 623000 2197983 2197983 SENIOR CHOICE AT HOME 623000 1940763 1940763 HOME TOGETHER 623000 1563707 1563707 1905808 1905808 64277514 487305 487305 26500 0 26500 26500 26500 256669 186209 18283 70460 -18283 52177 52177 FITNESS CENTER 900099 1014892 1014892 CHILD CARE CENTER 900099 520642 520642 CAFE 900099 245401 245401 420232 11610 408622 2201167 71913283 64277514 11610 2755539 X 1883176 1874991 8185 33091611 30550740 2197310 343561 892207 816118 66923 9166 4546438 4060597 440495 45346 2318263 2035435 259645 23183 595836 177221 418249 366 270253 102504 167749 117651 117651 69626 69626 10383738 9144383 1235302 4053 256149 70420 185729 1909062 1128776 726595 53691 722630 631196 67831 23603 1937368 1798222 124768 14378 137290 124585 10714 1991 13301 4719 8582 2469413 2005449 447839 16125 3697814 3433665 236854 27295 706623 656003 45389 5231 FOOD EXPENSE 1858294 1599239 253600 5455 NURSING HOME TAX 1528298 1478298 50000 SUPPLIES 1490780 1490780 BAD DEBT 360930 360930 615504 104247 408509 102748 71872255 61773527 9414351 684377 8195924 5255314 68395 201725 822642 1151507 5230470 6232924 131632 116114 102950 161266 130981189 28587469 79830252 102393720 11574780 21881481 0 380000 331096 1048044 106288141 138822095 5657968 5147523 6148069 6129766 49658500 80481597 177473 170286 4631 0 182135 245232 61828776 92174404 X 31897625 33482099 12561740 13165592 44459365 46647691 106288141 138822095 X 41028 975772 1171526 X X 0 1 X 1 1 1 X 1028712 1171889 2073550 2451494 4868620 11594265 55548099 56138697 54571524 61810817 64277514 292346651 56576811 57310586 56645074 64262311 69146134 303940916 241500 385500 627000 0 241500 385500 627000 303313916 480721 607967 576976 314145 513805 2493614 480721 607967 576976 314145 513805 2493614 12228 11610 23838 1693260 1211629 1476889 1927683 2189557 8499018 58750792 59130182 58698939 66516367 71861106 314957386 0.96300 0.96400 0.00790 0.00810 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: FITNESS CENTER - 2021 AMOUNT: $ 801,702. 2022 AMOUNT: $ 1,014,892. CAFE - 2022 AMOUNT: $ 245,401. CHILD CARE CENTER - 2021 AMOUNT: $ 406,930. 2022 AMOUNT: $ 520,642. OTHER INCOME - 2018 AMOUNT: $ 1,693,260. 2019 AMOUNT: $ 1,211,629. 2020 AMOUNT: $ 1,476,889. 2021 AMOUNT: $ 719,051. 2022 AMOUNT: $ 408,622. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 12000 12000 0 PART II-B, LINE 1, LOBBYING ACTIVITIES: THE JEWISH HOME ENGAGES A LOBBYIST TO MAINTAIN CONTACT WITH STATE LEGISLATION ON ISSUES AFFECTING THE HOME. 0 0 11990845 68518 527235 280585 12306013 13706174 66000 -1334705 446624 11990845 12471683 33036 1670227 468772 13706174 11866399 329408 790952 515076 12471683 12072985 186517 386048 779151 11866399 0.01984 0.90338 0.07677 0 0 26578337 26578337 92838179 23837567 69000612 6124566 4374191 1750375 5440107 375711 5064396 102393720 SPLIT INTEREST AGREEMENT 137799 DUE TO AFFILIATES 433 SECURITY DEPOSITS 107000 245232 X PART X, LINE 2: THE HOME AND TJH SENIOR LIVING, LLC ACCOUNT FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2023 AND 2022, THERE ARE NO TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS PENDING OR IN PROGRESS. AS TJH SENIOR LIVING, LLC IS DISREGARDED FOR TAX PURPOSES, ITS ACTIVITY IS REPORTED ON THE HOME'S FORM 990, AND IS SUBJECT TO ANY AUDITS THAT AFFECT THE HOME. X X 0 0 0 0 0 0 0 1 0 ANDREW H BANOFF PRESIDENT OF JHE & CEO 584853 0 285000 0 5200 0 32583 0 8543 0 916179 0 0 0 LAWRENCE CONDON SENIOR VP & ADMINISTRATOR 241546 0 15000 0 0 0 49264 0 17168 0 322978 0 0 0 ROGER SLIBY VP & CHIEF FINANCIAL OFFICER 214485 0 15000 0 0 0 6183 0 8543 0 244211 0 0 0 KARA RODRIGUEZ VP EMPLOYEE RELATIONS 163176 0 15000 0 0 0 0 0 12876 0 191052 0 0 0 ELIZABETH ZICARI VP & COMMUNITY SERVICES & BUSINESS 169448 0 15000 0 0 0 0 0 576 0 185024 0 0 0 PART I, LINE 7 BONUSES RECEIVED BY THE LISTED OFFICERS ARE APPROVED BY THE BOARD OF DIRECTORS OF THE ORGANIZATION. A CITY OF BRIDGEPORT 066001865 2014-04-29 55500000 FACILITY CONSTRUCTION 0 0 0 B CITY OF BRIDGEPORT 066001865 2014-04-29 6500000 FACILITY CONSTRUCTION 0 0 0 C THE HOUSING AUTHORITY OF THE CITY OF STAMFORD 066000416 852640AB7 2022-12-01 31695000 FACILITY CONSTRUCTION 0 0 0 A 45692500 55500000 55500000 2016 0 0 1 1 B 2321667 6500000 6500000 2016 0 0 1 1 C 31695000 31695000 0 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 0 0 1 0 1 1 M&T BANK 10.000000000000 0 0 0 0 1 B 0 0 1 0 0 1 M&T BANK 10.000000000000 0 0 0 0 1 C 0 1 0 0 0 0 0 0 0 A 1 B 1 C 1 SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: CITY OF BRIDGEPORT, CT (F) DESCRIPTION OF PURPOSE: SENIOR LIVING FACILITY REVENUE BONDS, SERIES 2014A SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: CITY OF BRIDGEPORT, CT (F) DESCRIPTION OF PURPOSE: SENIOR LIVING FACILITY REVENUE BONDS, SERIES 2014B SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: THE HOUSING AUTHORITY OF THE CITY OF STAMFORD. (F) DESCRIPTION OF PURPOSE: PURCHASE OF LAND AND DEVELOPMENT OF A NEW CONTINUING CARE RETIREMENT COMMUNITY OR LIFE PLAN COMMUNITY ON APPROXIMATELY 15 ACRES OF LAND IN STAMFORD, CONNECTICUT. SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 20465897 LAND PURCHASE 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 706623 INSURANCE BROKER SERVICES PROVIDED BY SUBSTANTIAL CONTRIBUTOR 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PROVIDED TO THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 12C AFTER THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED, A DETERMINATION WOULD BE MADE BETWEEN THE ORGANIZATION AND BOARD MEMBER ON WHETHER THERE IS A SIGNIFICANT CONFLICT AFFECTING THE BOARD MEMBER'S JUDGEMENT. ANY MEMBER OF THE BOARD HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. FORM 990, PART VI, SECTION B, LINE 15 SENIOR MANAGEMENT COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITEE (WITH DATA FROM HR ADVANTAGE) AND REVIEWED BY THE EXECUTIVE COMMITTEE AN INDEPENDENT COMPENSATION CONSULTANT IS ALSO USED. FORM 990, PART VI, SECTION C, LINE 18 FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PROVIDED TO THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE JEWISH HOME DOES NOT MAKE ITS GOVERNING DOCUMENTS AND OTHER DOCUMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,324,151. MANAGEMENT AND GENERAL EXPENSES 95,481. FUNDRAISING EXPENSES 3,944. TOTAL EXPENSES 8,423,576. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 820,232. MANAGEMENT AND GENERAL EXPENSES 364,603. FUNDRAISING EXPENSES 109. TOTAL EXPENSES 1,184,944. AGENCY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 775,218. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 775,218. FORM 990, PART XI, LINE 9: CHANGE IN SPLIT INTEREST AGREEMENTS 872,505. CHANGE IN INTEREST RATE SWAP AGREEMENTS -11,256. CHANGE IN PENSION LIABILITY 310,277. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. TJH SENIOR LIVING 4200 PARK AVE BRIDGEPORT CT 06604 INDEPENDENT LIVING PROJECT CT 2383388 35957597 JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY DBA MOZAIC SENIOR LIFE TJH HOLDINGS 4200 PARK AVE BRIDGEPORT CT 06604 HOLDING COMPANY CT 0 0 JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY DBA MOZAIC SENIOR LIFE