2023-08-18T10:51:08-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2022-01-01 042104414 ODD FELLOWS HOME OF MASSACHUSETTS INC ODDF 5088536687 104 RANDOLPH ROAD WORCESTER MA 01606 CLARENCE PLANT CEO AND BOARD SECRETARY 5088536687 2023-08-17 1 CLARENCE PLANT 999009999 0 DANIELLE NIHILL P01350943 7819821001 2023-08-17 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z CLARENCE PLANT 104 RANDOLPH ROAD WORCESTER MA 01606 9840079 0 X WWW.ODDFELLOWSHOMEMA.COM X 1898 MA TO PROVIDE OUR RESIDENTS WITH THE FINEST SKILLED NURSING AND REHABILITATIVE SERVICES. 15 14 155 24 0 0 920930 815155 7251077 8948382 19060 26507 12473 25052 8203540 9815096 0 0 0 0 5164585 5717284 0 0 0 3104787 3812634 8269372 9529918 -65832 285178 4585254 6201723 2419819 3849145 2165435 2352578 TO PROVIDE OUR RESIDENTS WITH THE FINEST SKILLED NURSING AND REHABILITATIVE SERVICES. DEDICATED TO THE BASIC TENENTS OF FRIENDSHIP, LOVE AND TRUTH, OUR HIGHLY TRAINED STAFF PROVIDES COMPASSIONATE CARE IN A COMFORTABLE, SECURE ENVIRONMENT. 0 0 8132817 8968807 PROVIDE QUALITY SKILLED NURSING CARE AND THERAPY FOR 100 ELDERLY RESIDENTS. 8132817 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 19 0 155 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X CLARENCE PLANT 5088536687 104 RANDOLPH ROAD WORCESTER MA 01606 GRACE OWUSO LPN 59.00 X 130043 0 4485 GEORGINA BOTUO CNA 95.00 X 120782 0 0 OPHELIA ASARE LPN 56.00 X 117622 0 0 LINDA OMANE LPN 50.00 X 111067 0 3828 GLORIA BOAKYE LPN 50.00 X 113419 0 0 CLARENCE PLANT CEO AND SECRETARY 40.00 X X 108981 0 0 MARY G VITIELLO PRESIDENT 1.00 X X 0 0 0 WAYNE LEBLANC VICE PRESIDENT 1.00 X X 0 0 0 WENDY E BAKER TRUSTEE 1.00 X 0 0 0 DONNA FIFE TRUSTEE 1.00 X 0 0 0 DOREEN A SLANEY TRUSTEE 1.00 X 0 0 0 DWIGHT L CROW TRUSTEE 1.00 X 0 0 0 ERIK FEARING TRUSTEE 1.00 X 0 0 0 GEORGE E SHAW TRUSTEE 1.00 X 0 0 0 GERALD GILMORE JR TRUSTEE 1.00 X 0 0 0 GREGORY MULLEN TRUSTEE 1.00 X 0 0 0 LOUANNE BOWERS TRUSTEE 1.00 X 0 0 0 JOHN G SLANEY TRUSTEE 1.00 X 0 0 0 ROBERT E WALSH TRUSTEE 1.00 X 0 0 0 SUSAN NEEDLE TRUSTEE 1.00 X 0 0 0 701914 0 8313 7 0 0 0 INTELYCARE INC PO BOX 200413 PITTSBURGH PA 152510413 NURSING AGENCY 748641 1 51817 754057 9281 815155 PROGRAM SERVICE REVENUE 623000 8932114 8932114 CABLE/TV/PHONE/MISC 900099 16268 16268 8948382 25987 25987 520 0 520 520 520 29610 51817 24983 4627 4627 MISC. INCOME 900099 20425 20425 20425 9815096 8968807 0 31134 X 108981 108981 4812241 4154337 657904 371594 309607 61987 424468 362403 62065 75698 75698 38588 38588 956129 937369 18760 34718 34718 31942 31942 57135 57135 268048 228165 39883 5908 200 5708 1849 1849 53625 53625 182509 154068 28441 134755 115051 19704 USER FEE ASSESSMENT 725720 725720 DIETARY EXPENSE 336366 336366 ANCILLARY EXPENSES 299173 299173 COVID EXPENSES (PPE & T 153830 153830 456641 356528 100113 9529918 8132817 1397101 0 620696 816070 1257367 2579026 804570 1037132 2700 2700 91637 87079 6377989 5070032 1294158 1307957 25734 20771 488392 350988 4585254 6201723 758879 922234 233999 0 90853 109003 433386 2000000 49794 852908 817908 2419819 3849145 X 1733488 2018666 431947 333912 2165435 2352578 4585254 6201723 X 285178 -4963 -93072 X 0 1 X 1 0 X 5032 17537 1813660 920930 815155 3572314 7589045 7873924 7401216 7251076 8948382 39063643 7594077 7891461 9214876 8172006 9763537 42635957 0 0 0 42635957 48389 47266 26656 18405 25987 166703 48389 47266 26656 18405 25987 166703 2769 20425 23194 7642466 7938727 9241532 8193180 9809949 42825854 0.99560 0.99530 0.00390 0.00460 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2021 AMOUNT: $ 2,769. 2022 AMOUNT: $ 20,425. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 406212 1511 6438 101020 313141 374484 4651 49320 22243 406212 25897 345878 28606 25897 374484 24967 930 25897 25199 -232 24967 0 0 45080 45080 5065140 3991935 1073205 1157726 977119 180607 110043 100978 9065 1307957 SELF-FUNDED INSURANCE RECEIVABLE 24674 OTHER RECEIVABLES 13173 BENEFICIAL INTEREST IN PERPETUAL TRUST 313141 350988 ACCRUED INTEREST - RELATED PARTIES 111970 NOTES PAYABLE - RELATED PARTIES 705938 817908 X 9717061 -4963 -93072 -98035 9815096 0 9815096 9529918 0 9529918 0 9529918 PART V, LINE 4: THE ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE INCOME TO THE ORGANIZATION OVER TIME. PART X, LINE 2: THE FINANCIAL STATEMENTS DO NOT INCLUDE A PROVISION FOR INCOME TAXES BECAUSE THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES IN ACCORDANCE WITH PRESCRIBED STATUTES. THE ORGANIZATION HAS NOT BEEN EXAMINED FOR ANY OPEN YEARS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST -93,072. BLACK TIE GALA 61102 40852 20250 3126 6750 6562 GOLF TOURNAMENT 20325 10965 9360 2425 1497 4623 81427 51817 29610 5551 8247 11185 24983 4627 CLARENCE PLANT CEO AND BOARD SECRETARY EMPLOYEE LOAN X 2700 2700 0 1 1 2700 FORM 990, PART VI, SECTION A, LINE 1A THE GOVERNING BODY DELEGATES AUTHORITY TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, VICE PRESIDENT, SECRETARY AND TREASURER AND THREE (3) DIRECTORS ELECTED BY THE BOARD AT THE ANNUAL MEETING. THE EXECUTIVE COMMITTEE HAVE AND MAY EXERCISE, WHEN THE BOARD IS NOT IN SESSION, ALL OF THE POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE ORGANIZATION EXCEPT THE AUTHORITY TO AMEND THE BYLAWS; ADOPT A PLAN OF MERGER OR CONSOLIDATION; SELL, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR MAKE ANY OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES JOHN SLANEY AND DOREEN SLANEY ARE MARRIED. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE CEO AND EXECUTIVE DIRECTOR OF ODD FELLOWS HOME OF MASSACHUSETTS, INC. REVIEW THE DRAFT FORM 990. PRIOR TO FILING WITH THE IRS, A COMPLETE COPY OF THE FINAL FORM 990 IS PROVIDED TO EACH BOARD MEMBER VIA ELECTRONIC COMMUNICATION. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES SHALL NOT HAVE ANY UNDISCLOSED CONFLICTS OF INTEREST WITH THE CORPORATION. ANY CONFLICT OF INTEREST ON THE PART OF ANY TRUSTEE SHALL BE DISCLOSED TO THE OTHER TRUSTEES AND MADE A MATTER OF RECORD WHEN ANY MATTER TO WHICH THE INTEREST RELATES BECOMES THE SUBJECT OF ACTION BY THE BOARD. THE CONFLICT OF INTEREST DISCLOSURE FORM IS SIGNED OFF EVERY YEAR BY ALL BOARD MEMBERS, A PROCESS FOR WHICH THE BOARD SECRETARY ACTIVELY LEADS AND MONITORS. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE COMMITTEE HOLDS AN ANNUAL MEETING WITH THE BOARD OF TRUSTEES TO DISCUSS THE COMPENSATION. THE COMMITTEE REVIEWS DUTIES, PERFORMANCE, COMPARATIVE WAGE AND BENEFIT DATA, AND DOCUMENTS ALL COMPENSATION DELIBERATIONS AND DECISIONS IN THE MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G NURSING AGENCY FEES: PROGRAM SERVICE EXPENSES 889,245. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 889,245. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 48,124. MANAGEMENT AND GENERAL EXPENSES 18,760. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,884. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST -93,072. GRAND LODGE OF THE INDEPENDENT ORDER OF ODD FELLOWS 104 RANDOLPH ROAD WORCESTER MA 01606 041383604 FRATERNAL ORGANIZATION MA 501(C)(8) & (C)(10) 0 INDEPENDENT ORDER OF ODD FELLOWS WORCESTER LODGE #56 104 RANDOLPH ROAD WORCESTER MA 01606 237144681 FRATERNAL ORGANIZATION MA 501(C)(8) & (C)(10) 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 GRAND LODGE OF THE INDEPENDENT ORDER OF ODD FELLOWS E 517519 LOAN DOCUMENT INDEPENDENT ORDER OF ODD FELLOWS WORCESTER LODGE #56 E 188419 LOAN DOCUMENT GRAND LODGE OF THE INDEPENDENT ORDER OF ODD FELLOWS C 5000 CASH CONTRIBUTION