SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

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OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
DAUGHTERS OF SARAH NURSING CENTER INC
 
Employer identification number

23-7120570
Return Reference Explanation
Form 990, Part VI, Section B, Line 11b THE ORGANIZATION'S BOARD OF DIRECTORS (ITS GOVERNING BODY) HAS DELEGATED REVIEW OF THE FORM 990 TO ITS FINANCE/AUDIT COMMITTEE, WHICH COMMITTEE HAS REVIEWED THE FORM IN ITS ENTIRETY PRIOR TO ITS FILING. THE FINANCE/AUDIT COMMITTEE HAS REVIEWED THIS FORM WITH THE BOARD OF DIRECTORS PRIOR TO ITS FILING AND HAS MADE COPIES OF THE FORM AVAILABLE TO BOARD MEMBERS.
Form 990, Part VI, Section B, Line 12c THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS EXPLAINED AND DISCUSSED DURING ORIENTATION FOR ALL NEW BOARD MEMBERS. COPIES OF THE POLICY ARE PROVIDED TO ALL BOARD MEMBERS. THE POLICY IS ALSO REVIEWED WITH ALL BOARD MEMBERS AT THE FIRST BOARD MEETING OF EACH YEAR. ANNUALLY, BOARD MEMBERS ARE REQUIRED TO COMPLETE A DISCLOSURE FORM, DISCLOSING PERSONAL AND FINANCIAL BUSINESS INTERESTS AND ANY DEALINGS THEY OR FAMILY MEMBERS HAVE WITH THE ORGANIZATION OR WITH EACH OTHER. IN ADDITION, ALL NOMINEES FOR BOARD POSITIONS ARE REQUIRED TO COMPLETE A DISCLOSURE FORM PRIOR TO THEIR ELECTION. A COMPILATION OF THE DISCLOSED INFORMATION FOR THE ENTIRE BOARD IS SHARED WITH ALL BOARD MEMBERS TO ALERT THEM TO POSSIBLE CONFLICT SITUATIONS. THE COMPILATION IS UPDATED AND RE-CIRCULATED PERIODICALLY THROUGHOUT THE YEAR, WHEN WARRANTED. BOARD MEMBERS ARE EXPECTED TO DISCLOSE KNOWN OR POTENTIAL CONFLICTS, AS WELL AS PERCEIVED CONFLICTS INVOLVING OTHERS. PERCEIVED CONFLICTS ARE REVIEWED BY THE FINANCE/AUDIT COMMITTEE AND EXECUTIVE COMMITTEE, ADDRESSED WITH THE MEMBER(S) INVOLVED, AND REPORTED TO THE BOARD.
Form 990, Part VI, Section B, Line 15 CEO COMPENSATION IS REVIEWED BY A SPECIAL COMMITTEE ON CEO PERFORMANCE REVIEW, COMPRISING OF THE PRESIDENTS OF EACH OF THE THREE ORGANIZATIONS COMPRISING THE DAUGHTERS OF SARAH SENIOR COMMUNITY (ONE OF WHICH IS THIS ORGANIZATION), WHICH COMMITTEE IS CHAIRED BY AN INDIVIDUAL JOINTLY SELECTED BY THE THREE PRESIDENTS. UPON CONTRACT RENEWAL, THE COMMITTEE EVALUATES THE CEO PERFORMANCE, COLLECTS COMPARATIVE DATA ON CEO COMPENSATION FROM INDUSTRY SOURCES AND FORMS 990 OF SIMILAR ORGANIZATIONS, AND FORMULATES A COMPENSATION AND EMPLOYMENT CONTRACT RECOMMENDATION THAT IS FAIR AND EQUITABLE IN LIGHT OF THE CIRCUMSTANCES OF THE CEO PERFORMANCE, FACILITY BUDGETS, AND THE COMPARABLE INFORMATION. THE COMMITTEE MAINTAINS CONTEMPORANEOUS SUBSTANTIATION OF ITS DELIBERATION AND DECISIONS, WHICH ARE REPORTED TO EACH OF THE BOARDS OF DIRECTORS FOR APPROVAL AND IMPLEMENTATION. THE BOARDS REVIEW AND RATIFY THE COMMITTEE'S RECOMMENDATIONS ON EMPLOYMENT CONTRACT DURATION, COMPENSATION, AND RELATED TERMS. THIS PROCESS WAS LAST DONE IN 2022. COMPENSATION AND PERFORMANCE EVALUATIONS FOR OTHER TOP MANAGEMENT STAFF ARE PERFORMED BY THE CEO, AND THEN REVIEWED BY THE CEO WITH REPRESENTATIVES OF THE ORGANIZATIONS SELECTED BY THE PRESIDENTS. COMPARATIVE DATA ON COMPENSATION IS COLLECTED FROM INDUSTRY SOURCES AND FORMS 990 OF SIMILAR ORGANIZATIONS, AND A FAIR AND EQUITABLE DECISION IS FORMULATED IN LIGHT OF THE CIRCUMSTANCES OF JOB PERFORMANCE, FACILITY BUDGETS AND THE COMPARABLE INFORMATION. CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATIONS AND DECISIONS IS MAINTAINED. THE CEO REPORTS THE DELIBERATIONS, DECISIONS AND THE BASIS THEREFORE TO THE ORGANIZATION'S BOARD OF DIRECTORS. IF THE RECOMMENDED COMPENSATION LEVEL EXCEEDS THE LIMITS BUDGETED BY THE BOARD, FURTHER BOARD OF DIRECTOR APPROVAL OF THE COMPENSATION IS REQUIRED.
Form 990, Part VI, Section C, Line 19 DISCLOSURE OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
Form 990, Part VII, Section A, Line 1a MARK KOBLENZ, CEO, DEVOTES 16 HOURS PER WEEK TO DAUGHTERS OF SARAH JEWISH FOUNDATION AND 9.5 HOURS PER WEEK TO DAUGHTERS OF SARAH HOUSING COMPANY, BOTH RELATED ORGANIZATIONS. COURTNEY MULSON, CFO, DEVOTES 2 HOURS PER WEEK TO DAUGHTERS OF SARAH JEWISH FOUNDATION AND 5 HOURS TO DAUGHTERS OF SARAH HOUSING COMPANY, BOTH RELATED PARTIES. THE DAUGHTERS OF SARAH NURSING HOME FILES ALL EMPLOYMENT TAX FORMS WITH RESPECT TO THESE INDIVIDUALS. THE SALARY COST ASSOCIATED WITH THE HOURS ALLOCATED TO THE DAUGHTERS OF SARAH NURSING HOME IS AS FOLLOWS: MARK KOBLENZ - $99,024, COURTNEY MULSON - $189,170.
Form 990, Part XI, Line 9 NET RESTRICTED DONATIONS
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2022


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