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← CENTRASTATE ASSISTED LIVING INC

Form 990 for tax year 2022

Filed by CENTRASTATE ASSISTED LIVING INC.

Totals

Total revenue
$5,411,060
Total expenses
$6,703,350
Contributions and grants received
$708,424
Grants paid
$0
Program service revenue
$4,697,373
Investment income
$5,263
Other revenue
$0
Total assets, end of year
$6,396,685
Total liabilities, end of year
$7,597,710
Net assets or fund balances, end of year
-$1,201,025
Program services expenses (Part IX)
$6,033,017
Management and general expenses
$670,333
Fundraising expenses
$0
Program service expenses (Part III)
$6,033,017

Program services were 90.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $13,691

  • 1e · Government grants (contributions)

    $694,733

  • 2a · Program service revenue: RESIDENTIAL/COMMUNITY FEE

    total $3,985,817 · related or exempt $3,985,817

  • 2b · Program service revenue: OTHER SERVICES TO RESIDENTS

    total $554,070 · related or exempt $554,070

  • 2c · Program service revenue: RESPITE INCOME

    total $157,486 · related or exempt $157,486

  • 3 · Investment income

    total $5,263 · unrelated business $0 · excluded $5,263

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 6d · Net rental income or loss

    total $0

  • 7d · Net gain or loss

    total $0

  • 8a · Fundraising events: gross income

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $0

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $0

  • 5 · Compensation of officers, directors and key employees

    total $176,078 · program services $158,470 · management and general $17,608

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $3,442,291 · program services $3,098,062 · management and general $344,229

  • 8 · Pension plan contributions

    total $118,204 · program services $106,384 · management and general $11,820

  • 9 · Other employee benefits

    total $536,559 · program services $482,903 · management and general $53,656

  • 10 · Payroll taxes

    total $314,946 · program services $283,451 · management and general $31,495

  • 11a · Fees: management

    total $0

  • 11b · Fees: legal

    total $18,981 · program services $17,083 · management and general $1,898

  • 11c · Fees: accounting

    total $25,320 · program services $22,788 · management and general $2,532

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $282,347 · program services $254,112 · management and general $28,235 · fundraising $0

  • 12 · Advertising and promotion

    total $126,623 · program services $113,961 · management and general $12,662

  • 13 · Office expenses

    total $163,852 · program services $147,467 · management and general $16,385

  • 14 · Information technology

    total $27,075 · program services $24,368 · management and general $2,707

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $213,413 · program services $192,072 · management and general $21,341

  • 17 · Travel

    total $2,542 · program services $2,288 · management and general $254

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $0

  • 20 · Interest

    total $56,988 · program services $51,289 · management and general $5,699

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $456,963 · program services $411,267 · management and general $45,696

  • 23 · Insurance

    total $47,208 · program services $42,487 · management and general $4,721

  • 24a · Other expenses: FOOD COSTS

    total $334,623 · program services $301,161 · management and general $33,462

  • 24b · Other expenses: REPAIRS & MAINTENANCE

    total $135,532 · program services $121,979 · management and general $13,553

  • 24c · Other expenses: CORPORATE DIRECT COSTS

    total $70,944 · program services $63,850 · management and general $7,094

  • 24d · Other expenses: MEDICAL SUPPLIES

    total $22,734 · program services $20,461 · management and general $2,273

  • 24e · All other expenses

    total $130,127 · program services $117,114 · management and general $13,013

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $650 · end of year $650

  • 2 · Savings and temporary cash investments

    beginning of year $1,971,678 · end of year $1,235,434

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $43,522 · end of year $174,200

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $12,973 · end of year $17,301

  • 10a · Land, buildings and equipment: cost or other basis

    $5,689,098

  • 10b · Land, buildings and equipment: accumulated depreciation

    $727,186

  • 10c · Land, buildings and equipment, net

    beginning of year $5,330,859 · end of year $4,961,912

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0 · end of year $0

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $6,418 · end of year $7,188

  • 17 · Accounts payable and accrued expenses

    beginning of year $721,272 · end of year $926,138

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $3,016,864 · end of year $3,016,864

  • 25 · Other liabilities

    beginning of year $3,375,860 · end of year $3,654,708

  • 27 · Net assets without donor restrictions

    beginning of year $245,900 · end of year -$1,207,025

  • 28 · Net assets with donor restrictions

    beginning of year $6,204 · end of year $6,000

Mission and programs · 2022

Mission

PROVIDING HOME-LIKE ENVIRONMENT, PERSONALIZED SUPPORTIVE SERVICES AND HEALTHCARE DESIGNED TO RESPOND TO INDIVIDUAL NEEDS OF THOSE WHO REQUIRE HELP IN DAILY ACTIVITIES.

  • MONMOUTH CROSSING OWNS AND OPERATES AN ASSISTED LIVING FACILITY FOR THE ELDERLY CONSISTING OF 76 UNITS WITH 16 UNITS FOR MEMORY CARE. THE FACILITY PROVIDES RESIDENTS WITH SPECIAL NEEDS AND MEMORY-RELATED DISEASES: RECEIVE COMPREHENSIVE, ATTENTIVE SERVICES IN A SAFE ENVIRONMENT WHERE SPECIALIZED ACTIVITIES AND PROGRAMMING ARE PROVIDED. MONMOUTH CROSSING OFFERS SERVICES TO RESIDENTS OF LOW AND MODERATE MEANS AND THOSE ON MEDICAID AS WELL.

    Expenses $6,033,017 · Revenue $4,697,373

As filed on the 2022 return.

Listed in Part VII

  • THOMAS W SCOTT

    VC-TRST/CSMC PRES/CEO(EFF.4/9)

    Total calculated
    $1,224,857
    From this org
    $0
    From related orgs
    $1,104,034
    Other
    $120,823
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $620,583 related
    Bonus
    $0 + $119,344 related
    Other
    $0 + $364,107 related
    Deferred
    $0 + $106,304 related
    Nontaxable benefits
    $0 + $14,519 related
    Filer's total
    $0 + $1,224,857 related

  • JOHN T GRIBBIN

    VC-TRST/CSMC PRES/CEO(RET.4/8)

    Total calculated
    $928,129
    From this org
    $0
    From related orgs
    $899,967
    Other
    $28,162
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $338,084 related
    Bonus
    $0 + $557,319 related
    Other
    $0 + $4,564 related
    Deferred
    $0 + $27,000 related
    Nontaxable benefits
    $0 + $1,162 related
    Filer's total
    $0 + $928,129 related

  • JOHN A DELLOCONO

    TRUSTEE - CSMC SVP/CFO

    Total calculated
    $660,031
    From this org
    $0
    From related orgs
    $619,526
    Other
    $40,505
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $486,717 related
    Bonus
    $0 + $125,285 related
    Other
    $0 + $7,524 related
    Deferred
    $0 + $20,500 related
    Nontaxable benefits
    $0 + $20,005 related
    Filer's total
    $0 + $660,031 related

  • HELEYNE GLADSTEIN

    TRUSTEE - DIRECTOR

    Total calculated
    $176,078
    From this org
    $145,615
    From related orgs
    $0
    Other
    $30,463
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $134,154
    Bonus
    $10,836
    Other
    $625
    Deferred
    $26,000
    Nontaxable benefits
    $4,463
    Filer's total
    $176,078

  • GINA N AKABA

    LPN

    Total calculated
    $173,543
    From this org
    $153,038
    From related orgs
    $0
    Other
    $20,505
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $136,353
    Bonus
    $16,670
    Other
    $15
    Deferred
    $17,983
    Nontaxable benefits
    $2,522
    Filer's total
    $173,543

  • MYRA SOGBE

    RESIDENT SERVICE ASSOCIATE

    Total calculated
    $133,840
    From this org
    $124,171
    From related orgs
    $0
    Other
    $9,669
    Hours/week
    40

  • PAMELA CURTIS

    DIRECTOR OF NURSING-LTC

    Total calculated
    $128,586
    From this org
    $121,397
    From related orgs
    $0
    Other
    $7,189
    Hours/week
    40

  • TRACY TAYLOR RN

    REGISTERED NURSE

    Total calculated
    $125,688
    From this org
    $114,128
    From related orgs
    $0
    Other
    $11,560
    Hours/week
    40

  • NATHALIE SHOSTAK-LEVY

    LPN

    Total calculated
    $120,604
    From this org
    $109,197
    From related orgs
    $0
    Other
    $11,407
    Hours/week
    40

  • KENNETH J REILLY CWS

    CHAIR - TRUSTEE

    Total calculated
    $0
    Hours/week
    1

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

SCHEDULE J, PART I; QUESTION 4B
THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUAL INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN HIS 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: THOMAS W. SCOTT, $361,485. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN HIS 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: THOMAS W. SCOTT, $79,304.
SCHEDULE J, PART I; QUESTION 7
THE INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2022 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
SCHEDULE J, PART II; COLUMN F
THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDE VESTED BENEFITS IN A DEFERRED COMPENSATION PLAN AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR YEARS' FORMS 990 AND ARE NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. THESE HAVE BEEN TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
9 November 2023
IRS schema version
2022v5.0
Source object
202303179349306740

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