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ObjectId: 201922249349301622 - Submission: 2019-08-12
TIN: 04-2104298
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for the latest information.
OMB No. 1545-0047
20
17
Open to Public Inspection
Name of the organization
Hebrew Rehabilitation Center
Employer identification number
04-2104298
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
ORCHARD COVE INC
ONE DEL POND DRIVE
CANTON
,
MA
02021
22-3080006
CONT. CARE
MA
501(C)(3)
10
HSL
Yes
(2)
HRCA SENIOR HOUSING INC
1200 CENTRE STREET
BOSTON
,
MA
02131
04-2765428
ELDER HOUSING
MA
501(C)(3)
10
HSL
Yes
(3)
CENTER COMMUNITIES OF BROOKLINE INC
1200 CENTRE STREET
BOSTON
,
MA
02131
01-0569404
ELDER HOUSING
MA
501(C)(3)
10
HSL
Yes
(4)
HRCA BROOKLINE HOUSING 112-120 CENTRE
1200 CENTRE STREET
BOSTON
,
MA
02131
03-0372998
ELDER HOUSING
MA
501(C)(3)
10
HSL
Yes
(5)
HRCA BROOKLINE HOUSING 1550 BEACON
1200 CENTRE STREET
BOSTON
,
MA
02131
01-0569403
ELDER HOUSING
MA
501(C)(3)
10
HSL
Yes
(6)
HRCA HOUSING FOR ELDERLY INC
1200 CENTRE STREET
BOSTON
,
MA
02131
04-2543731
ELDER HOUSING
MA
501(C)(3)
10
HSL
Yes
(7)
NEWBRIDGE ON THE CHARLES INC
1200 CENTRE STREET
BOSTON
,
MA
02131
38-3707573
ELDER HOUSING
MA
501(C)(3)
10
HSL
Yes
(8)
HRCA BROOKLINE HOUSING 108 CENTRE
1200 CENTRE STREET
BOSTON
,
MA
02131
81-0612222
ELDER HOUSING
MA
501(C)(3)
12b
HSL
Yes
(9)
HEBREW SENIORLIFE HOSPICE CARE INC
1200 CENTRE STREET
BOSTON
,
MA
02131
46-1309228
HOSPICE SERV.
MA
501(C)(3)
10
HSL
Yes
(10)
HEBREW SENIORLIFE INC
1200 CENTRE STREET
BOSTON
,
MA
02131
90-0183119
MGMT SERVICES
MA
501(C)(3)
7
NA
No
(11)
HEBREW SENIORLIFE AFFILIATED MED GROUP
1200 CENTRE STREET
BOSTON
,
MA
02131
82-3654673
PHYSICIAN SVC
MA
501(C)(3)
10
HSL
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2017
Page 2
Schedule R (Form 990) 2017
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
ccb cohen 112 centre mm llc
1200 centre st
boston
,
MA
02131
82-1763395
elder housing
MA
na
N/A
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
HSL PAYROLL SERVICES INC
100 CENTRE STREET
BROOKLINE
,
MA
02446
04-2684823
PAYROLL SERVICES
MA
na
C-CORP
0
0
No
(2)
HEBREW SENIORLIFE REAGE SOLUTIONS INC
1200 CENTRE STREET
BOSTON
,
MA
02131
81-4906048
MGMT & Cons. SVCS
DE
na
C-CORP
0
0
No
Schedule R (Form 990) 2017
Page 3
Schedule R (Form 990) 2017
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
No
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
No
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
Hebrew SeniorLife Inc
S
23,787,000
actual
(2)
Hebrew SeniorLife Hospice Care Inc
S
11,005,000
actual
(3)
Hebrew SeniorLife Inc
M
2,819,273
actual
(4)
Hebrew SeniorLife Inc
P
429,847
actual
(5)
Hebrew SeniorLife Inc
M
5,237,353
Contract
(6)
NewBridge on the Charles Inc
R
9,596,965
actual
(7)
NewBridge on the Charles Inc
K
9,481,247
Contract
(8)
Hebrew SeniorLife Inc
J
300,000
Contract
(9)
Center Communities of Brookline Inc
K
70,398
Contract
(10)
Hebrew SeniorLife Inc
P
284,016
actual
(11)
NewBridge on the Charles Inc
P
6,055,745
actual
(12)
Orchard Cove Inc
P
492,799
actual
(13)
Center Communities of Brookline Inc
Q
198,849
actual
(14)
HRCA Brookline Housing 1550 Beacon Plaza Inc
Q
152,605
actual
(15)
HRCA Brookline Housing 112-120 Centre Inc
Q
110,985
actual
(16)
Hebrew SeniorLife Inc
Q
781,475
actual
(17)
HRCA HOUSING FOR ELDERLY INC
Q
357,327
actual
(18)
NewBridge on the Charles Inc
Q
2,875,236
actual
(19)
Orchard Cove Inc
Q
1,705,488
actual
(20)
HRCA senior housing INC
Q
156,207
actual
(21)
Hebrew SeniorLife Hospice Care Inc
Q
459,568
actual
(22)
NewBridge on the Charles Inc
L
471,128
Contract
Schedule R (Form 990) 2017
Page 4
Schedule R (Form 990) 2017
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2017
Page 5
Schedule R (Form 990) 2017
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2017
Additional Data
Software ID:
Software Version: