2024-10-29T13:25:06-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2023-01-01 042676008 HENRY C NEVINS HOME INC HENR 9786827611 10 INGALLS COURT METHUEN MA 01844 JAMES MOCERA TREASURER 9786727611 2024-10-29 1 0 KATARZYNA O PADZIK P02268641 7819821001 2024-10-29 2023 2024-10-15 13:58:12Z JOYCE SHANNON 10 INGALLS COURT METHUEN MA 01844 18650874 0 X WWW.NEVINSFAMILY.ORG X 1979 MA TO PROVIDE MEDICAL, NURSING & REHAB CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED. 9 9 292 13 0 0 802250 682544 14923144 17112344 403 650111 0 84176 15725797 18529175 0 0 0 0 10873564 12298062 0 0 0 6686621 8189046 17560185 20487108 -1834388 -1957933 13842744 12506374 11397669 12019232 2445075 487142 THE HENRY C. NEVINS HOME, INC.'S MISSION IS TO PROVIDE COMPREHENSIVE MEDICAL, NURSING AND REHABILITATIVE CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED BY INJURY, ILLNESS OR AGING. 0 0 17120956 0 17112344 NURSING HOME OPERATION - NEVINS NURSING & REHABILITATION CENTRE PROVIDES COMPREHENSIVE MEDICAL, NURSING AND REHABILITATIVE CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED BY INJURY, ILLNESS OR AGING. 17120956 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 13 0 292 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 1 0 MA X SHARON A WALSH 9786452444 10 INGALLS CT METHUEN MA 01844 JOYCE SHANNON PRESIDENT & CEO 15.00 15.00 X 87286 87287 8233 SHARON WALSH CFO 37.00 3.00 X 131439 0 10218 JEFFREY GANGI ADMINISTATOR 40.00 0.00 X 150217 0 40484 DOREEN SIMMONDS-BROWN LPN 56.09 0.00 X 144790 0 11966 EMMY KIMORI LPN 54.47 0.00 X 141721 0 9701 SUSAN HECK DIRECTOR OF NURSING 40.00 0.00 X 140217 0 14690 EMMANUELLA VOLNEY UNIT MANAGER LPN 53.85 0.00 X 132447 0 15006 PATRICIA DEMERS CHAIRPERSON & CLERK 0.40 0.60 X X 0 0 0 JAMES MOCERA TREASURER 0.40 0.60 X X 0 0 0 HUNTER BARRETT DIRECTOR 0.40 0.60 X 0 0 0 MARIA BONANNO DIRECTOR 0.40 0.60 X 0 0 0 CAROLINE GLYNN DIRECTOR 0.40 0.60 X 0 0 0 THERESE LEONE DIRECTOR 0.40 0.60 X 0 0 0 STEVEN MANSHIP DIRECTOR 0.40 0.60 X 0 0 0 NOREEN WRIGHT DIRECTOR 0.40 0.60 X 0 0 0 RAYMOND WROBEL DIRECTOR (UNTIL 9/23) 0.40 0.60 X 0 0 0 SAMUEL MCLEANNAN DIRECTOR (AS OF 12/23) 0.40 0.60 X 0 0 0 928117 87287 110298 12 0 1 0 PREFERRED THERAPY SOLUTIONS LLC 850 SILAS DEANE HWY WETHERSHIELD CT 06109 THERAPY SERVICES PROVIDER 597340 US FOOD SERVICE INC PO BOX 3155 BOSTON MA 02241 FOOD DISTRIBUTOR 532509 PERFORMANCE HEALTHCARE SERVICES INC 47R RIVER STREET SUITE 200R WELLESLEY MA 02481 HOUSEKEEPING SERVICES 304952 MCKESSON MEDICAL-SURGICAL INC 9954 MARYLAND DR SUITE 5176A HENRICO VA 23233 MEDICAL SUPPLIES 254055 TRELYNE STAFFING 70 PELCZAR RD DRACUT MA 23233 NURSE STAFFING AGENCY 233635 8 600000 78144 4400 682544 NURSING HOME REVENUE 623000 17112344 17112344 17112344 76802 76802 695008 121699 573309 573309 573309 INSURANCE CLAIM PROCEEDS 900099 84176 84176 84176 18529175 17112344 0 734287 233060 233060 10317507 9799049 518458 988287 933005 55282 759208 706477 52731 46533 46533 155991 155991 1612016 1391021 220995 68102 63204 4898 157119 64233 92886 370528 338393 32135 960 960 460378 415713 44665 647271 584474 62797 192407 176160 16247 CREDIT LOSSES 1829105 1829105 MA STATE USER FEE ASSES 1100498 1100498 SUPPLIES AND EXPENSES 1065575 1065575 ANCILLARY EXPENSES 399739 399739 82824 82455 369 20487108 17120956 3366152 0 557143 450601 1757661 0 1955175 2481150 69041 63674 19186686 10796429 8812000 8390257 691724 1120692 13842744 12506374 1567438 2466967 0 9616009 9397730 214222 154535 11397669 12019232 X 2445075 487142 2445075 487142 13842744 12506374 -1957933 0 X X 0 1 X 1 1 1 X 5640 3730616 3796182 802250 682544 9017232 14411992 13121899 12991711 14923144 17112344 72561090 14417632 16852515 16787893 15725394 17794888 81578322 0 0 0 81578322 2037 862 494 403 76802 80598 2037 862 494 403 76802 80598 19633 15452 11456 84176 130717 14439302 16868829 16799843 15725797 17955866 81789637 0.99740 0.99920 0.00100 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2019 AMOUNT: $ 19,633. 2020 AMOUNT: $ 15,452. 2021 AMOUNT: $ 11,456. INSURANCE CLAIM PROCEEDS - 2023 AMOUNT: $ 84,176. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5665 5665 0 PART II-B, LINE 1: MEMBERSHIP DUES PAID TO HEALTH CARE ASSOCIATIONS WHERE A PORTION OF DUES IS RELATED TO LOBBYING. 200247 200247 4706022 4629125 76897 10273373 2704588 7568785 4007044 3462716 544328 8390257 FUNDED RESERVES 919712 OPERATING RIGHT-OF-USE ASSET 147875 DUE FROM RELATED PARTIES 34651 OTHER ASSETS 17015 SOFTWARE, NET 1439 1120692 LEASE LIABILITY 154535 154535 X 18529175 0 18529175 0 18529175 20487108 0 20487108 0 20487108 PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S RETURNS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES FOR THREE YEARS AFTER FILING. THE ORGANIZATION FOLLOWS THE POLICY FOR UNCERTAINTY IN INCOME TAXES TO BE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE POLICY PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. NO UNCERTAIN INCOME TAX POSITIONS WERE IDENTIFIED FOR THE YEAR ENDED DECEMBER 31, 2023. X X 0 0 0 0 0 0 0 0 0 JOYCE SHANNON PRESIDENT & CEO 87286 87287 0 0 0 0 0 0 4117 4116 91403 91403 0 0 JEFFREY GANGI ADMINISTATOR 150217 0 0 0 0 0 0 0 40484 0 190701 0 0 0 DOREEN SIMMONDS-BROWN LPN 144790 0 0 0 0 0 0 0 11966 0 156756 0 0 0 EMMY KIMORI LPN 141721 0 0 0 0 0 0 0 9701 0 151422 0 0 0 SUSAN HECK DIRECTOR OF NURSING 140217 0 0 0 0 0 0 0 14690 0 154907 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY TAX ADVISORS OF A NATIONAL ACCOUNTING FIRM WITH INFORMATION PROVIDED BY MANAGEMENT. THE COMPLETE FORM 990 IS REVIEWED AND PROVIDED TO THE BOARD BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, EMPLOYEE, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, SHALL COMPLETE, SIGN AND DELIVER TO THE CHAIR OF THE BOARD, A CONFLICT OF INTEREST POLICY ANNUAL STATEMENT AT THE TIME OF HIS OR HER INITIAL ELECTION OR APPOINTMENT AND ANNUALLY THEREAFTER. THE CONFLICTS OF INTEREST POLICY ANNUAL STATEMENT SHALL BE IN SUCH FORM AS IS DEEMED APPROPRIATE BY THE PRESIDENT WITH ADVICE FROM THE ORGANIZATION'S COUNSEL AS NEEDED. BOARD OF DIRECTORS MEMBERS REVIEW AND SIGN THE POLICY ANNUALLY; THERE HAVE BEEN NO CONFLICTS (NO BOARD OF DIRECTORS MEMBERS DO ANY BUSINESS WITH NEVINS OR RECEIVE ANY COMP FROM NEVINS) BUT MONITORING WOULD BE THROUGH YEARLY ATTESTATION BY BOARD AND CONFLICTS WOULD BE DEALT WITH AT THAT LEVEL. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW FOR CEO, EXECUTIVE DIRECTOR, OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY INDEPENDENT PERSONS WITH THE USE OF COMPARABILITY DATA AND APPROVED BY THE BOARD OF DIRECTORS. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION DID NOT CHANGE EITHER ITS OVERSIGHT OR SELECTION PROCESS DURING 2023. NEVINS COMMUNITY SERVICES INC 12 INGALLS COURT METHUEN MA 01844 042210743 ELDERLY HOUSING MA 501(C)(3) LINE 10 N/A 0 NEVINS MANOR INC 10 INGALLS COURT METHUEN MA 01844 043265310 ELDERLY HOUSING MA 501(C)(3) LINE 10 N/A 0 NEVINS FAMILY OF SERVICES INC 10-12 INGALLS COURT METHUEN MA 01844 464006584 ELDERLY HOUSING MA 501(C)(3) LINE 10 N/A 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 NEVINS COMMUNITY SERVICES INC C 600000 FMV