2024-01-31T11:58:18-06:00 2022-06-30 341884125 CBIZ MHM LLC 4722 N 24TH ST STE 300 PHOENIX AZ 85016 990 2021-07-01 455110022 MAIN LINE SENIOR CARE INC MAIN 6106585100 100 E LANCASTER AVENUE WYNNEWOOD PA 19096 JOHN FREDERICKS CFO 6105258300 2024-01-30 1 JOHN FREDERICKS XXX-XX-XXXX KRISTEN BASS P01247587 6022646835 2024-01-29 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z JOHN FREDERICKS 100 E LANCASTER AVENUE WYNNEWOOD PA 19096 1174078 0 X N/A X 2011 PA TO PROVIDE SUPPORT TO AFFILIATED ENTITIES, PARTICULARLY SAUNDERS HOUSE, BRYN MAWR TERRACE, AND... TO PROVIDE SUPPORT TO AFFILIATED ENTITIES, PARTICULARLY SAUNDERS HOUSE, BRYN MAWR TERRACE, AND SUCH OTHER LONG TERM CARE PROVIDERS AS MAY BECOME PART OF THE AFFILIATED SYSTEM. 9 8 13 8 0 0 180800 0 1216776 1174078 0 0 0 0 1397576 1174078 0 0 0 0 1125391 1084647 0 0 0 272185 210789 1397576 1295436 0 -121358 116612 196618 183269 386681 -66657 -190063 ORGANIZATION IS TO PROVIDE SUPPORT TO AFFILIATED ENTITIES, PARTICULARLY SAUNDERS HOUSE, BRYN MAWR TERRACE, AND SUCH OTHER LONG TERM CARE PROVIDERS AS MAY BECOME PART OF THE AFFILIATED SYSTEM. 0 0 1295436 1174078 ORGANIZATION IS TO PROVIDE SUPPORT TO AFFILIATED ENTITIES, PARTICULARLY SAUNDERS HOUSE, BRYN MAWR TERRACE, AND SUCH OTHER LONG TERM CARE PROVIDERS AS MAY BECOME PART OF THE AFFILIATED SYSTEM. 1295436 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 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 1 0 0 0 1 16 0 1 13 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 PA X MARK HENRY 6106585100 100 E LANCASTER AVE WYNNEWOOD PA 19096 KEVIN ROSS PRESIDENT & CEO 20.00 20.00 X X 286652 0 25687 GORDON MOTT CHAIR 1.00 2.00 X X 0 0 0 A LOUIS DENTON ESQ VICE CHAIR 1.00 2.00 X X 0 0 0 DAVID DUGERY TREASURER 1.00 2.00 X X 0 0 0 ROBERT BOB BERGEN SECRETARY 1.00 2.00 X X 0 0 0 ELIZABETH LIZ ROGAN BOARD MEMBER 1.00 2.00 X 0 0 0 TIM RUBIN BOARD MEMBER 1.00 2.00 X 0 0 0 PAUL BOSTON BOARD MEMBER 1.00 2.00 X 0 0 0 ROSELLA HARVEY BOARD MEMBER 1.00 2.00 X 0 0 0 JENNIFER NAM CFO (THRU JUN 2021) 20.00 20.00 X 189841 0 2669 MARK HENRY CFO (AS OF JUN 2021) 20.00 20.00 X 92885 0 0 569378 0 28356 2 0 1 0 APEX INTEGRATED SOLUTIONS LLC 550 STATE RD SUITE 102 BENSALEM PA 19020 ACCOUNTING SERVICES 107937 1 SUPPORT SERVICES 561000 1174078 1174078 1174078 1174078 1174078 0 0 X 405224 405224 536854 536854 2079 2079 73343 73343 67147 67147 194486 194486 3478 3478 517 517 5697 5697 6611 6611 1295436 1295436 0 0 97789 153428 18823 35731 1574 0 1574 0 5885 116612 196618 121582 14912 0 61687 371769 183269 386681 X -66657 -190063 -66657 -190063 116612 196618 -121358 -2048 0 X 0 0 0 X X 2 SAUNDERS HOUSE 231352250 10 1 0 1018317 BRYN MAWR TERRACE 208411287 10 1 0 277119 2 0 1295436 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 SCHEDULE A, PART 1, LINE 12B THE ORGANIZATION PROVIDES MANAGEMENT SERVICES TO THE BRYN MAWR TERRACE, A 509(A)(2) ORGANIZATION, AND OLD MAN'S HOME OF PHILADELPHIA, DBA SAUNDERS HOUSE, A 509(A)(2) ORGANIZATION. MANAGEMENT SERVICES CONSIST OF PERSONNEL SUPPORT AND OTHER ADMINISTRATIVE FUNCTIONS. 1574 1574 1574 DUE TO AFFILIATE 371769 371769 X X X 0 0 0 0 0 0 0 1 0 KEVIN ROSS PRESIDENT & CEO 286652 0 0 0 0 0 0 0 25687 0 312339 0 0 0 JENNIFER NAM CFO (THRU JUN 2021) 130900 0 0 0 58941 0 0 0 2669 0 192510 0 0 0 PART I, LINE 3 THE ORGANIZATION USED CONVERGE, AN INDEPENDENT CONTRACTOR, TO CONDUCT A REVIEW OF KEY EMPLOYEE COMPENSATION WITH ASSISTANCE FROM COMPENSATION CONSULTING ALTNERNATIVES, INC. THEY COMPILE AND ANALYZE DATA FROM SEVERAL HEALTHCARE SURVEY SOURCES. THIS DATA WAS PROVIDED TO THE BOARD CHAIR WHO REVIEWED IT, ASKED QUESTIONS, MADE A DECISION AND REVIEWED THAT DECISION WITH THE BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS DISTRIBUTED AND REVIEWED BY ALL BOARD MEMBERS PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C INQUIRIES ARE MADE OF ALL INDIVIDUALS THAT SERVE ON THE BOARD OF DIRECTORS, AND THEY ARE INFORMED OF THE REQUIREMENT TO DISCLOSE ANY RELATIONSHIPS WHICH MAY GIVE RISE TO AN A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION USED CONVERGE, AN INDEPENDENT CONTRACTOR, TO CONDUCT A REVIEW OF KEY EMPLOYEE COMPENSATION WITH ASSISTANCE FROM COMPENSATION CONSULTING ALTNERNATIVES, INC. THEY COMPILE AND ANALYZE DATA FROM SEVERAL HEALTHCARE SURVEY SOURCES. THIS DATA WAS PROVIDED TO THE BOARD CHAIR WHO REVIEWED IT, ASKED QUESTIONS, MADE A DECISION AND REVIEWED THAT DECISION WITH THE BOARD MEMBERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE, UPON IN-PERSON, VERBAL OR WRITTEN REQUEST, DOCUMENTS RELATING TO THE GOVERNANCE, CONFLICTS OF INTEREST AND FINANCIAL STATEMENTS TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONTRACTED SALARIES: PROGRAM SERVICE EXPENSES 151,759. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 151,759. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 42,727. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,727. BRYN MAWR TERRACE 773 E HAVERFORD ROAD BRYN MAWR PA 19010 208411287 NURSING HOME PA 501(C)(3) LINE 10 MAIN LINE SENIOR CARE 1 SAUNDERS HOUSE 100 LANCASTER AVENUE WYNNEWOOD PA 19096 231352250 NURSING HOME PA 501(C)(3) LINE 10 MAIN LINE SENIOR CARE 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 SAUNDERS HOUSE L 152882 FMV SAUNDERS HOUSE O 850986 FMV BRYN MAWR TERRACE L 41604 FMV BRYN MAWR TERRACE O 231582 FMV