2024-11-15T09:17:05-06:00 2023-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 66 HUDSON BLVD E SUITE 2200 NEW YORK NY 10001 990 2023-01-01 800687948 SOUTH COVE MANOR AT QUINCY POINT REHABILITATION CENTER INC SOUT 6174230590 288 WASHINGTON STREET QUINCY MA 02169 SIGNING OFFICER PRESIDENT & CEO 6174230590 2024-11-14 1 1 MARY-EVELYN ANTONETTI P00431862 2126976900 2024-11-14 2023 2024-10-15 13:58:12Z WILLIAM GRAVES 288 WASHINGTON STREET QUINCY MA 02169 18274496 0 X WWW.SOUTHCOVEMANOR.COM X 2011 MA TO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES. 22 22 222 24 0 0 892366 63312 16333129 18151094 1454 9150 17900 32626 17244849 18256182 0 1500 0 0 10561303 11695203 0 0 2126 5570988 5261336 16132291 16958039 1112558 1298143 31184018 33945046 17773297 19184860 13410721 14760186 X THE ORGANIZATION'S MISSION IS TO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES. THE ORGANIZATION'S CORE VALUES INCLUDE: 1. RESPECTING THE PEOPLE WE SERVE, THEIR TRADITIONS, AND THEIR PREFERENCES, (SEE SCHEDULE O)2. PROVIDING EXCELLENT LEADING EDGE CARE AND SERVICES, 3. INVESTING IN OUR EMPLOYEES, AND 4. SERVING OUR COMMUNITY. 0 0 14733450 1500 18167539 NURSING & REHABILITATION SERVICES - THE ORGANIZATION'S MISSION IS TO PROVIDE INDIVIDUALIZED NURSING AND REHABILITATION CARE THAT REFLECTS ASIAN CULTURAL VALUES THROUGH THE OPERATION OF A 141-BED LONG-TERM CARE FACILITY IN QUINCY, MASSACHUSETTS. 14733450 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 7 0 1 222 1 0 0 0 0 0 0 0 0 0 0 0 0 X 22 22 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X SCOTT HANSON DIRECTOR OF FINANCE 6174230590 288 WASHINGTON STREET QUINCY MA 02169 JASON QU CHAIRMAN OF THE BOARD 2.00 1.00 X X 0 0 0 MAY CHIN VICE PRESIDENT 2.00 1.00 X X 0 0 0 CINDY LAW TREASURER 2.00 1.00 X X 0 0 0 HEMMIE CHANG CLERK 2.00 1.00 X X 0 0 0 MARIANNE BOWLER HONORABLE DIRECTOR 2.00 1.00 X 0 0 0 ALICE ROSE RN DIRECTOR 2.00 1.00 X 0 0 0 THOMAS CHIN DIRECTOR 2.00 1.00 X 0 0 0 DAVID TING DIRECTOR 2.00 1.00 X 0 0 0 LEONARD LAI MD DIRECTOR 2.00 1.00 X 0 0 0 STANLEY ELKERTON DIRECTOR 2.00 1.00 X 0 0 0 HELEN CHIN SCHLICHTE DIRECTOR 2.00 1.00 X 0 0 0 HON HOI YEE DIRECTOR 2.00 1.00 X 0 0 0 SUSAN LUO CFA DIRECTOR 2.00 1.00 X 0 0 0 EDWARD CHENG ESQ DIRECTOR 2.00 1.00 X 0 0 0 LISA MUI DIRECTOR 2.00 1.00 X 0 0 0 HEATHER O'SULLIVAN DIRECTOR 2.00 1.00 X 0 0 0 RICHARD LUI DIRECTOR 2.00 1.00 X 0 0 0 ERIC SCHLICHTE DIRECTOR 2.00 1.00 X 0 0 0 JIM HSU DIRECTOR 2.00 1.00 X 0 0 0 DAVID CHIU MD DIRECTOR 2.00 1.00 X 0 0 0 OLIVIA WONG DIRECTOR 2.00 1.00 X 0 0 0 PHILIP CHENG AG DIRECTOR 2.00 1.00 X 0 0 0 WILLIAM GRAVES PRESIDENT/CEO 41.00 1.00 X 290477 0 11974 SCOTT HANSON DIRECTOR OF FINANCE 41.00 1.00 X 165417 0 4286 LI CHEN ADMINISTRATOR 40.00 0.00 X 183383 0 21317 MICHAEL O'BRIEN DON 40.00 0.00 X 169922 0 8692 MARY LOU FALLETTI LPN 40.00 0.00 X 154906 0 8894 SUNNY LAW RN 40.00 0.00 X 128092 0 8152 ELAINE CHI SDC NURSE 40.00 0.00 X 117405 0 12473 1209602 0 75788 12 0 1 0 SYNCHRONY REHAB 2701 CHESTNUT STATION COURT LOUISVILLE KY 40299 REHAB THERAPIST 405648 INTELYCARE INC 1250 HANCOCK ST 501N QUINCY MA 02169 AGENCY NURSING 384449 US FOODS PO BOX 3115 BOSTON MA 02241 FOOD SERVICES 317112 3 63312 63312 NET PATIENT SERVICE REVENUE 623000 18151094 18151094 18151094 9150 9150 34495 18314 16181 16181 16181 OTHER INCOME 623000 16445 16445 16445 18256182 18167539 0 25331 1500 1500 472154 472154 9372423 8220597 1151826 184479 157887 26592 917617 777528 140089 748530 626085 122445 16361 2691 13670 41841 10460 31381 627963 591628 36335 67578 67578 51904 35229 16630 45 196300 185431 8788 2081 556410 531501 24909 42457 42086 371 526763 503469 23294 909969 869233 40736 199106 114649 84457 DIETARY 506900 506900 MEDICAL SUPPLIES 491935 484266 7669 THERAPY EXPENSE 414620 414620 USER FEE 346930 346930 264299 243182 21117 16958039 14733450 2222463 2126 2008302 926857 286596 445611 2602205 2484346 185600 482657 38295188 8941507 25881111 29353681 72219 65859 147985 186035 31184018 33945046 1161840 1080529 36373 36373 15547669 14990287 0 1732830 1027415 1344841 17773297 19184860 X 13410721 14760186 13410721 14760186 31184018 33945046 X 1298143 51322 X X 0 1 X 1 0 X 38024 3658316 1319464 892366 63312 5971482 15279074 13802856 15413645 16333129 18151094 78979798 15317098 17461172 16733109 17225495 18214406 84951280 0 0 0 84951280 386612 31592 781 1454 43645 464084 386612 31592 781 1454 43645 464084 18419 4410 20 17900 16445 57194 15722129 17497174 16733910 17244849 18274496 85472558 0.99390 0.98870 0.00540 0.01070 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2019 AMOUNT: $ 18,419. 2020 AMOUNT: $ 4,410. 2021 AMOUNT: $ 20. 2022 AMOUNT: $ 17,900. 2023 AMOUNT: $ 16,445. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 25841 241334 232944 34231 0 77932 5000 8773 13405 78300 73297 25811 -9676 11500 77932 126625 7190 60518 73297 130942 11750 6508 22575 126625 179306 7261 41103 130942 0.00000 0.38314 0.61686 0 1 1 5530140 5530140 29899146 6930837 22968309 675974 126891 549083 1982716 1743260 239456 207212 140519 66693 29353681 DUE TO RELATED PARTIES 1194398 DEFERRED COMP LIABILITY 150443 1344841 X PART IV, LINE 1B: THE ORGANIZATION HAS FIDUCIARY CONTROL OF THE PERSONAL NEEDS ACCOUNT HELD FOR THE BENEFIT OF THE RESIDENTS. PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT IS HELD BY A RELATED ORGANIZATION, SOUTH COVE NURSING FACILITIES FOUNDATION, INC. IN ACCORDANCE WITH THE DONOR REQUIREMENTS, THE ENDOWMENT FUNDS ARE HELD IN PERPETUITY. ENDOWMENT RETURNS MAY BE USED FOR THE APPRECIATION EVENTS FOR THE EMPLOYEES OF THE NURSING HOME OPERATOR. PART X, LINE 2: BELOW IS AN EXCERPT FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR SOUTH COVE MANOR NURSING AND REHABILITATION CENTER, INC. AND SUBSIDIARIES: THE FOUNDATION, WASHINGTON MILLS, AND THE PARENT ARE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FOLLOWS THE GUIDANCE OF ACCOUNTING STANDARDS CODIFICATION (ASC) 740, ACCOUNTING FOR INCOME TAXES, RELATED TO THE UNCERTAINTIES IN INCOME TAXES, WHICH PRESCRIBES A THRESHOLD OF MORE LIKELY THAN NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS EVALUATED THE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN, IF ANY, ON ITS EXEMPT ORGANIZATION FILINGS, AND THE LIKELIHOOD THAT UPON EXAMINATION THOSE POSITIONS WOULD BE SUSTAINED. BASED ON THE RESULTS OF THIS EVALUATION, MANAGEMENT DETERMINED THERE ARE NO POSITIONS THAT NECESSITATE DISCLOSURES AND/OR ADJUSTMENTS. THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES DURING THE PERIODS COVERED BY THESE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX RETURNS COULD BE SUBJECT TO EXAMINATION BY TAXING AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO SUCH EXAMINATIONS PENDING OR IN PROGRESS. X X X 0 1 0 0 0 0 0 1 0 WILLIAM GRAVES PRESIDENT/CEO 233985 0 56000 0 492 0 0 0 11974 0 302451 0 0 0 LI CHEN ADMINISTRATOR 156232 0 26750 0 401 0 9343 0 11974 0 204700 0 0 0 MICHAEL O'BRIEN DON 142614 0 27000 0 308 0 4126 0 4566 0 178614 0 0 0 SCOTT HANSON DIRECTOR OF FINANCE 142116 0 23000 0 301 0 4286 0 0 0 169703 0 0 0 MARY LOU FALLETTI LPN 148584 0 4000 0 2322 0 4328 0 4566 0 163800 0 0 0 PART I, LINE 4B LI CHEN RECEIVED $4,673 FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. PART I, LINE 7 THE AMOUNTS REPORTED IN PART II, COLUMN (B)(II) WERE ALL NON-FIXED PAYMENTS. A MASS DEVELOPMENT FINANCE AGENCY 043431814 NONEAVAIL 2012-10-30 19000000 LAND ACQUISITION AND FACILITY COSTS 0 0 0 A 4009713 19000000 252483 100640 18600277 46600 2014 0 0 1 1 A 0 0 1 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 PART II, LINE 11 THE AMOUNT OF OTHER SPENT PROCEEDS ON LINE 11 REPRESENT ISSUER'S ADMINISTRATIVE FEE PART III, LINE 3A MANAGEMENT AND SERVICE CONTRACTS IN THE BOND FINANCED SPACE FALL UNDER THE SAFE HARBOR PROVIDED BY REVENUE PROCEDURE 2016-44 AND WILL NOT RESULT IN PRIVATE BUSINESS USE. PART III, LINE 3C THE ORGANIZATION HAS BOND COUNSEL WHICH IT USES TO REVIEW CONTRACTS ON AN AS NEEDED BASIS. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSISTS OF ALL VOTING DIRECTORS WHO ARE ALSO OFFIERS OR COMMITTEE CHAIRS. THE EXECUTIVE COMMITTEE HAS FULL AUTHORITY BETWEEN BOARD SESSIONS, IF NEEDED. FORM 990, PART VI, SECTION A, LINE 2 A FAMILY RELATIONSHIP EXISTS BETWEEN MAY CHIN, VICE PRESIDENT; THOMAS CHIN, DIRECTOR; HELEN CHIN SCHLICHTE, DIRECTOR; AND ERIC SCHLICHTE, DIRECTOR FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S AUDIT COMMITTEE REVIEWS AND APPROVES THE DRAFT FORM 990. THE COMPLETE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS PART OF THE ORGANIZATION'S BY-LAWS AND IS DISCUSSED BY THE BOARD OF DIRECTORS AND TOP MANAGEMENT PERSONNEL AT THE FIRST BOARD METTING EACH YEAR REGARDING ANY/ALL SIGNIFICANT TRANSACTIONS. THE CONFLICT OF INTEREST POLICY COVERS DIRECTORS, OFFICERS, AND EMPLOYEES. ANY CONFLICTS OF INTEREST ARE DISCLOSED TO THE BOARD PRIOR TO APPROVAL OR RATIFICATION OF THE CONTRACT OR TRANSACTION BY MAJORITY VOTE OF THE DISINTERESTED PERSONS. THE CEO, ADMINISTRATOR AND FINANCE DIRECTOR ARE TASKED WITH OVERSEEING THE DISBURSEMENTS AND CONTRACT MANGAEMENT FUNCTIONS AND MONITORING FOR ANY CONFLICTING RELATIONSHIP WITH THE ORGANIZATION. ALL BOARD MEMBERS ARE AWARE OF THE NEED TO NOTIFY THE BOARD AND MANAGEMENT TEAM OF ANY CONFLICTS. THE BOARD IS NOTIFIED WHEN A CONFLICT OF INTEREST MIGHT OCCUR. SHOULD AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST PRESENT ITSELF, THE MANAGEMENT TEAM IS FULLY PREPARED TO ASK THE BOARD TO CONSIDER APPROPRIATE ACTION FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CEO AND TOP MANAGEMENT INCLUDES APPROVAL BY THE COMPENSATION COMMITTEE AND DOCUMENTATION OF THE DELIBERATION OF THE DECISION DONE IN EXECUTIVE SESSION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER 51,322. FORM 990, PART XII, LINE 2C: PROCESS IS UNCHANGED FROM PRIOR YEAR. WASHINGTON MILLS QUINCY INC 288 WASHINGTON STREET QUINCY MA 02169 923044391 TO SUPPORT SCMN & RC MA 34495 4397304 SOUTH COVE MANOR NURSING AND REHABILITATION SOUTH COVE NURSING FACILITIES FOUNDATION INC 288 WASHINGTON STREET QUINCY MA 02169 046406242 NURSING AND CARE FACILITIES MA 501(C)(3) LINE 12A, I SOUTH COVE MANOR NURSING AND REHABILITATION 1 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 0 1 SOUTH COVE NURSING FACILITIES FOUNDATION INC S 51322 SEE ATTACHED STMT SOUTH COVE NURSING FACILITIES FOUNDATION INC Q 71708 SEE ATTACHED STMT SOUTH COVE NURSING FACILITIES FOUNDATION INC E 2900000 SEE ATTACHED STMT FORM R, PART V, LINE 1 AMOUNT REPRESENTED ON LINE 2, COLUMN B, TRANSACTION TYPE, IS THE TOTAL AMOUNT FOR LINES 1L, M, N, O, Q.