BERKSHIRE RETIREMENT HOME INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- BERKSHIRE RETIREMENT HOME INC (EIN 04-2103875)
- Tax period
- 2022-06-01 to 2023-05-31
- Filed
- 2024-02-22
- IRS object ID
- 202420539349301602
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-02-22T16:06:05-06:00 | ReturnTs |
| Tax Period End | 2023-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 BATTERYMARCH PARK SUITE 100 | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02169 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042103875 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERKSHIRE RETIREMENT HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BERK | BusinessNameControlTxt |
| Phone | 4134454056 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 290 SOUTH STREET | AddressLine1Txt |
| City | PITTSFIELD | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOROTHY MARA | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 4134454056 | PhoneNum |
| Signature | 2024-02-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DOROTHY | PersonFirstNm |
| Person Last | MARA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATARZYNA O PADZIK | PreparerPersonNm |
| PTIN | P02268641 | PTIN |
| Phone | 7819821001 | PhoneNum |
| Preparation | 2024-02-20 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERKSHIRE PLACE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | NELSON FURLANO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 290 SOUTH STREET | AddressLine1Txt |
| City | PITTSFIELD | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,619,553 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BERKSHIREPLACE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1890 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | TO BETTER SERVE THE HEALTHCARE NEEDS OF OUR COMMUNITY. OUR SERVICES FOCUS ON EXCEPTIONAL CARE AND SERVICES WITH AN EMPHASIS ON RETAINING A PERSONALIZED, HOME-LIKE ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 113 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $68,540 | PYContributionsGrantsAmt |
| CY Contributions Grants | $39,495 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,736,512 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,378,867 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$6,988 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,433 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$203,836 | PYOtherRevenueAmt |
| CY Other Revenue | $179,758 | CYOtherRevenueAmt |
| PY Total Revenue | $6,594,228 | PYTotalRevenueAmt |
| CY Total Revenue | $6,619,553 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,419,416 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,393,148 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,356,477 | PYOtherExpensesAmt |
| CY Other Expenses | $2,526,461 | CYOtherExpensesAmt |
| PY Total Expenses | $5,775,893 | PYTotalExpensesAmt |
| CY Total Expenses | $5,919,609 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $818,335 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $699,944 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,020,326 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,156,670 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,739,492 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,377,867 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,280,834 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,778,803 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO BETTER SERVE HEALTHCARE NEEDS OF OUR COMMUNITY. OUR SERVICES FOCUS ON EXCEPTIONAL CARE AND SERVICES WITH AN EMPHASIS ON RETAINING A PERSONALIZED, HOME-LIKE ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,114,065 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,558,625 | RevenueAmt |
| Desc | BERKSHIRE PLACE PROVIDES SKILLED NURSING AND REHABILITATION CARE, LONG TERM CARE RESIDENCY, MEMORY CARE SUPPORT, PALLIATIVE CARE/COMFORT CARE, OUTPATIENT REHABILITATION AND RESPITE CARE. 210 CLIENTS WERE SERVED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $5,114,065 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 113 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDWARD FORFA | PersonNm |
| Phone | 4134454056 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 290 SOUTH STREET | AddressLine1Txt |
| City | PITTSFIELD | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| EDWARD A FORFA | ||||||||
| EXECUTIVE DIRECTOR | 20.00 | 20.00 | Yes (X) | $0 | $256,462 | $13,175 | ||
| TERRIE CHOQUETTE | ||||||||
| ADMINISTRATOR | 40.00 | $119,072 | $0 | $4,910 | Yes (X) | |||
| PATRICIA MEADER | ||||||||
| CERTIFIED NURSING ASSISTANT | 40.00 | $112,963 | $0 | $0 | Yes (X) | |||
| ELIZABETH SHEPARD | ||||||||
| REGISTERED NURSE | 40.00 | $106,607 | $0 | $0 | Yes (X) | |||
| NELSON FURLANO | ||||||||
| PRESIDENT | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOHN MURPHY | ||||||||
| VICE-PRESIDENT | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DOROTHY MARA | ||||||||
| TREASURER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARK GILLIGAN | ||||||||
| SECRETARY/CLERK | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RICHARD HERRICK | ||||||||
| MEMBER - IMMEDIATE PAST PRESIDENT | 0.50 | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| KEVIN BISACCIO | ||||||||
| MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| ELIZABETH KIRBY | ||||||||
| MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| SHELLEY GUYETTE | ||||||||
| MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| CRAIG KAHN | ||||||||
| MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| VINCENT MARINARO | ||||||||
| MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| JACQUELINE MCNINCH | ||||||||
| MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| RICHARD PATTERSON | ||||||||
| MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $338,642 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $256,462 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $18,085 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PREFERRED THERAPY SOLUTIONS | |||||
| 850 SILAS DEANE HWY 2 | WETHERSFIELD | CT | 06109 | PHYSICAL THERAPY | $312,107 |
| INTELYCARE INC | |||||
| 1250 HANCOCK ST 501N | QUINCY | MA | 02169 | NURSING AGENCY | $227,975 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $39,495 | AllOtherContributionsAmt |
| Total Contributions | $39,495 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 623000 | $6,304,314 | $6,304,314 |
| USER FEE | 623000 | $60,799 | $60,799 |
| MISCELLANEOUS INCOME | 623000 | $13,754 | $13,754 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,378,867 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,433 | TotalRevenueColumnAmt |
| Exclusion | $21,433 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CHANGE IN FUTURE SERVICE OBLIGATI | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $179,758 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $179,758 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $179,758 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,619,553 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,558,625 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $21,433 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,819 | TotalAmt |
| Management And General | $134,819 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,779,118 | TotalAmt |
| Program Services | $2,491,760 | ProgramServicesAmt |
| Management And General | $287,358 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,183 | TotalAmt |
| Program Services | $33,703 | ProgramServicesAmt |
| Management And General | $6,480 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,206 | TotalAmt |
| Program Services | $184,502 | ProgramServicesAmt |
| Management And General | $34,704 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,822 | TotalAmt |
| Program Services | $112,579 | ProgramServicesAmt |
| Management And General | $107,243 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100 | TotalAmt |
| Management And General | $100 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,533 | TotalAmt |
| Management And General | $46,533 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,475 | TotalAmt |
| Management And General | $11,475 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,326 | TotalAmt |
| Management And General | $30,326 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,406 | TotalAmt |
| Management And General | $74,406 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,851 | TotalAmt |
| Program Services | $122,948 | ProgramServicesAmt |
| Management And General | $2,903 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,528 | TotalAmt |
| Program Services | $351,045 | ProgramServicesAmt |
| Management And General | $8,483 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,589 | TotalAmt |
| Program Services | $327,670 | ProgramServicesAmt |
| Management And General | $7,919 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,954 | TotalAmt |
| Program Services | $148,724 | ProgramServicesAmt |
| Management And General | $3,230 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| NURSING SERVICES | $607,371 | $607,371 | |
| ANCILLARIES | $388,172 | $388,172 | |
| DIETARY EXPENSE | $166,258 | $166,258 | |
| PLANT OPERATIONS | $79,541 | $78,019 | $1,522 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,357 | TotalAmt |
| Program Services | $101,314 | ProgramServicesAmt |
| Management And General | $48,043 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,919,609 | TotalAmt |
| Program Services | $5,114,065 | ProgramServicesAmt |
| Management And General | $805,544 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $348,477 | BOYAmt |
| EOY | $204,773 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $638,946 | BOYAmt |
| EOY | $371,450 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $312,572 | BOYAmt |
| EOY | $205,468 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $329 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,139,022 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,406,810 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,067,803 | BOYAmt |
| EOY | $10,732,212 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,008,683 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $652,528 | BOYAmt |
| EOY | $633,755 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,020,326 | BOYAmt |
| EOY | $13,156,670 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $306,287 | BOYAmt |
| EOY | $330,159 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,908,661 | BOYAmt |
| EOY | $10,702,921 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $524,544 | BOYAmt |
| EOY | $344,787 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,739,492 | BOYAmt |
| EOY | $11,377,867 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,236,832 | BOYAmt |
| EOY | $1,739,341 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,002 | BOYAmt |
| EOY | $39,462 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,280,834 | BOYAmt |
| EOY | $1,778,803 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,020,326 | BOYAmt |
| EOY | $13,156,670 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $699,944 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,975 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$200,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,883 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,723 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $841,764 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $68,540 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $39,495 | CurrentTaxYearAmt |
| Total | $986,405 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,157,957 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,782,022 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,654,519 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,736,512 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,378,867 | CurrentTaxYearAmt |
| Total | $33,709,877 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,174,840 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,801,745 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,496,283 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,805,052 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,418,362 | CurrentTaxYearAmt |
| Total | $34,696,282 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,200 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,950 | CurrentTaxYearAmt |
| Total | $3,150 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,462,930 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,688,195 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,095,949 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,904,533 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,079,471 | CurrentTaxYearAmt |
| Total | $8,231,078 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,462,930 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,688,195 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,095,949 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,905,733 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,081,421 | CurrentTaxYearAmt |
| Total | $8,234,228 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $26,462,054 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,662 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,425 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,553 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | -$6,988 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,434 | CurrentTaxYearAmt |
| Total | $67,086 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,662 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,425 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,553 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | -$6,988 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,434 | CurrentTaxYearAmt |
| Total | $67,086 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $328,972 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | -$203,836 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $179,757 | CurrentTaxYearAmt |
| Total | $304,893 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,194,502 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,156,142 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,503,836 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,594,228 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,619,553 | CurrentTaxYearAmt |
| Total | $35,068,261 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.75460 | PublicSupportCY509Pct |
| Public Support PY509 | 0.76870 | PublicSupportPY509Pct |
| Investment Income CY | 0.00190 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00510 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $264,543 | OtherCostOrOtherBasisAmt |
| Book Value | $264,543 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,281,621 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,826,394 | DepreciationAmt |
| Book Value | $10,455,227 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $592,858 | OtherCostOrOtherBasisAmt |
| Depreciation | $580,416 | DepreciationAmt |
| Book Value | $12,442 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,732,212 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESERVE FOR OBLIGATION TO PROVIDE FUTURE SERVICES | Desc |
| Amt | $344,787 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $344,787 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | BERKSHIRE RETIREMENT HOME, INC. AND 89 SOUTH CARE SUPPORT, INC. ARE EXEMPT FROM FEDERAL TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND STATE TAXES UNDER APPLICABLE STATE LAW. IN ADDITION, 89 SOUTH CARE SUPPORT, INC. QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 509(A)(3) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. AT HOME WITH BERKSHIRE PLACE, LLC HAS BEEN ORGANIZED AS A LIMITED LIABILITY COMPANY AND A PASS-THROUGH ENTITY AND IS INCLUDED WITHIN THE CONSOLIDATED TAX RETURN OF 89 SOUTH CARE SUPPORT, INC. MANAGEMENT HAS EVALUATED SIGNIFICANT TAX POSITIONS AGAINST THE CRITERIA ESTABLISHED BY PROFESSIONAL STANDARDS AND BELIEVES THERE ARE NO SUCH TAX POSITIONS REQUIRING ACCOUNTING RECOGNITION. GENERALLY, THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO EXAMINATION BY TAXING AUTHORITIES FOR THE PRIOR THREE FILING YEARS. THERE ARE CURRENTLY NO EXAMINATIONS PENDING OR IN PROGRESS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDWARD A FORFA | PersonNm |
| Title | EXECUTIVE DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $206,462 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $50,000 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $10,258 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $2,917 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $269,637 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S EXECUTIVE DIRECTOR IS PAID BY A RELATED ORGANIZATION. THE ORGANIZATION USED THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR: 1) FORM 990 OF OTHER ORGANIZATIONS AND 2) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND IS PROVIDED TO THE AUDIT COMMITTEE AND THEN TO THE BOARD OF DIRECTORS FOR AUTHORIZATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | A QUESTIONNAIRE MUST BE COMPLETED ANNUALLY BY OFFICERS, DIRECTORS AND KEY EMPLOYEES DISCLOSING ANY RELATIONSHIPS PRESENTING POTENTIAL CONFLICT OF INTEREST. ALL MEMBERS OF THE BOARD, TRUSTEES AND OFFICERS THAT ARE MAKING PURCHASES OR FUTURE RELATED PARTY TRANSACTIONS, MUST EXECUTE A CONFLICT OF INTEREST DISCLOSURE FORM. CONFLICTS OF INTEREST ARE MONITORED BY THE EXECUTIVE DIRECTOR AND ARE REVIEWED AND ENFORCED BY THE BOARD OF DIRECTORS. THE PERSON WITH THE CONFLICT MUST BE ABSTAIN FROM ANY DISCUSSION REGARDING THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S EXECUTIVE DIRECTOR IS PAID BY A RELATED ORGANIZATION, 89 SOUTH CARE SUPPORT, INC. AND A PORTION OF THE EXECUTIVE DIRECTOR'S SALARY AND BENEFITS IS ALLOCATED TO THIS ORGANIZATION. ANNUALLY, THE PRESIDENT, VICE PRESIDENT, COMMITTEE CHAIR, TREASURER AND SECRETARY REVIEW COMPENSATION BASED UPON GOALS, RESULTS, ACCOMPLISHMENTS AND COMPARABLE WAGE/BENEFITS DATA. THE PROCESS WAS COMPLETED MOST RECENTLY IN 2022. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE FORM 990 IS AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFER TO 89 SOUTH CARE SUPPORT, INC. -200,000. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AT HOME WITH BERKSHIRE PLACE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 89 SOUTH STREET | AddressLine1Txt |
| City | PITTSFIELD | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 274015376 | EIN |
| Primary Activities | HOME CARE AND OTHER SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Total Income | $94,131 | TotalIncomeAmt |
| End Of Year Assets | $285,276 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 89 SOUTH CARE SUPPORT INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 89 SOUTH CARE SUPPORT INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 89 SOUTH STREET | AddressLine1Txt |
| City | PITTSFIELD | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 823380934 | EIN |
| Primary Activities | SUPPORTIVE RESIDENTIAL AND HEALTHCARE SERVICES TO OLDER ADULTS | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERKSHIRE RETIREMENT HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| 89 SOUTH CARE SUPPORT INC | ||
| O | $134,819 | FMV |
| 89 SOUTH CARE SUPPORT INC | ||
| R | $200,000 | FMV |