2024-05-15T14:21:27-05:00 2023-06-30 341884125 CBIZ MHM LLC 4722 N 24TH ST STE 300 PHOENIX AZ 85016 990 2022-07-01 455110022 MAIN LINE SENIOR CARE INC MAIN 2152007389 PO BOX 26804 COLLEGEVILLE PA 19426 MARK HENRY CFO 6105258300 2024-05-15 1 MARK HENRY XXX-XX-XXXX 1 KRISTEN BASS P01247587 6022646835 2024-05-15 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X JOHN FREDERICKS PO BOX 26804 COLLEGEVILLE PA 19426 1997694 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 0 833964 1174078 1163730 0 0 0 0 1174078 1997694 0 0 0 0 1084647 1128143 0 0 0 210789 423349 1295436 1551492 -121358 446202 196618 299842 386681 43703 -190063 256139 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 1551492 1163730 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. 1551492 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 12 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 2152007389 PO BOX 26804 COLLEGEVILLE PA 19426 KEVIN ROSS PRESIDENT & CEO 20.00 20.00 X X 403384 0 25687 MARK HENRY CFO 20.00 20.00 X 225680 0 0 JOHN FREDERICKS PRESIDENT & CEO (STARTING IN 2023) 20.00 20.00 X 0 0 0 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 629064 0 25687 2 0 1 0 0 833964 833964 833964 SUPPORT SERVICES 561000 1163730 1163730 1163730 1997694 1163730 0 0 X 980971 980971 4277 4277 73438 73438 69457 69457 42450 42450 258689 258689 4200 4200 4266 4266 22216 22216 75150 75150 3753 3753 4823 4823 SUPPLIES 5342 5342 BANK SERVICE CHARGES 1310 1310 REPAIRS/MAINTENANCE 1150 1150 1551492 1551492 0 0 153428 184432 35731 6888 28987 3753 1574 25234 5885 83288 196618 299842 14912 0 371769 43703 386681 43703 X -190063 256139 -190063 256139 196618 299842 446202 0 X 0 0 0 X X 2 BRYN MAWR TERRACE 208411287 10 1 292596 0 SAUNDERS HOUSE 231352250 10 1 1255143 0 2 1547739 0 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 28987 3753 25234 25234 SECURITY EXPENSES 5885 REFUND CLEARING 2342 OTHER ASSETS 75061 83288 DUE TO AFFILIATE 43703 43703 X X X 0 0 0 0 0 0 0 0 0 KEVIN ROSS PRESIDENT & CEO 403384 0 0 0 0 0 0 0 25687 0 429071 0 0 0 MARK HENRY CFO 225680 0 0 0 0 0 0 0 0 0 225680 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. X DEBT FORGIVENESS 1 833964 BOOK VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CEO AND CFO PRIOR TO FILING. A COPY WILL BE DISTRIBUTED TO 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 246,732. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 246,732. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 11,957. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,957. BRYN MAWR TERRACE PO BOX 26804 COLLEGEVILLE PA 19426 208411287 NURSING HOME PA 501(C)(3) LINE 10 MAIN LINE SENIOR CARE 1 SAUNDERS HOUSE PO BOX 26804 COLLEGEVILLE PA 19426 231352250 NURSING HOME PA 501(C)(3) LINE 10 MAIN LINE SENIOR CARE 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 SAUNDERS HOUSE L 247615 FMV SAUNDERS HOUSE O 914871 FMV BRYN MAWR TERRACE L 57724 FMV BRYN MAWR TERRACE O 213272 FMV SAUNDERS HOUSE N 64854 FMV