SCHEDULE O
(Form 990)

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
JEWISH HOME FOR THE ELDERLY OF FAIRFIELD
COUNTY INC DBA MOZAIC SENIOR LIFE
Employer identification number

06-0846991
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2 ART SPINNER AND CAROL SPINNER ARE MARRIED.
FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PROVIDED TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 12C AFTER THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED, A DETERMINATION WOULD BE MADE BETWEEN THE ORGANIZATION AND BOARD MEMBER ON WHETHER THERE IS A SIGNIFICANT CONFLICT AFFECTING THE BOARD MEMBER'S JUDGEMENT. ANY MEMBER OF THE BOARD HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION.
FORM 990, PART VI, SECTION B, LINE 15 SENIOR MANAGEMENT COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITEE (WITH DATA FROM HR ADVANTAGE) AND REVIEWED BY THE EXECUTIVE COMMITTEE AN INDEPENDENT COMPENSATION CONSULTANT IS ALSO USED.
FORM 990, PART VI, SECTION C, LINE 18 FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PROVIDED TO THE FULL BOARD.
FORM 990, PART VI, SECTION C, LINE 19 THE JEWISH HOME DOES NOT MAKE ITS GOVERNING DOCUMENTS AND OTHER DOCUMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,749,109. MANAGEMENT AND GENERAL EXPENSES 35,338. FUNDRAISING EXPENSES 3,465. TOTAL EXPENSES 6,787,912. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 741,466. MANAGEMENT AND GENERAL EXPENSES 521,992. FUNDRAISING EXPENSES 118. TOTAL EXPENSES 1,263,576.
FORM 990, PART XI, LINE 9: CHANGE IN SPLIT INTEREST AGREEMENTS -16,392. CHANGE IN INTEREST RATE SWAP AGREEMENTS 75,987. CHANGE IN PENSION LIABILITY 744,395.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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