2023-11-10T13:38:53-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2022-01-01 042104321 SHERRILL HOUSE INC SHER 6177312400 135 SOUTH HUNTINGTON AVENUE BOSTON MA 02130 PATRICK STAPLETON CHIEF EXECUTIVE OFFICER 6177312400 2023-11-10 1 PATRICK STAPLETON 999009999 0 DANIELLE NIHILL P01350943 7819821001 2023-11-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PATRICK STAPLETON 135 SOUTH HUNTINGTON AVENUE BOSTON MA 02130 39139110 0 X N/A X 1907 MA HIGH QUALITY MEDICAL, NURSING, AND REHABILITATION SERVICES ON AN IN-PATIENT BASIS TO MEN AND WOMEN. 14 14 314 35 0 0 3108332 5452080 17910936 20796561 335082 394856 83732 153539 21438082 26797036 0 0 0 0 16156738 18566770 0 0 287823 8313236 9024184 24469974 27590954 -3031892 -793918 30843900 28355041 14909918 14723462 15933982 13631579 X SHERRILL HOUSE IS A NON-PROFIT, SKILLED NURSING HOME MAINTAINED AND OPERATED BY SHERRILL HOUSE, INC. AN EXTENSION OF THE MINISTRY OF TRINITY CHURCH, COPLEY SQUARE, BOSTON, AND THE EPISCOPAL DIOCESE OF MASSACHUSETTS, ITS MISSION HAS BEEN ENHANCED WITH THE MERGER OF ASSETS OF ST. LUKE'S HOME FOR CONVALESCENTS AND THE FRANK WOOD CONVALESCENTS HOME.SHERRILL HOUSE PROVIDES HIGH-QUALITY MEDICAL, NURSING AND REHABILITATION SERVICES ON AN INPATIENT BASIS TO MEN AND WOMEN WITHOUT DISTINCTION AS TO RACE, CREED, COLOR OR NATIONAL ORIGIN. SHERRILL HOUSE HAS ESTABLISHED A REFERRAL SYSTEM WITH OTHER HEALTH CARE FACILITIES IN THE AREA TO ENSURE COMPLETE HEALTH SERVICES AT ALL LEVELS. IT OFFERS TO LOCAL PHYSICIANS AND HOUSE STAFF A SETTING IN WHICH TO RENDER THE BEST SKILLED CARE ON A SHORT-TERM OR LONG-TERM BASIS. IN ITS CONCERN FOR THE INDIVIDUAL, SHERRILL HOUSE AIMS TO BE AS BROAD AND DIVERSE AS THE NEEDS OF THOSE IT SERVES. 0 0 20951504 20796561 SHERRILL HOUSE IS A NONPROFIT CORPORATION THAT OWNS AND OPERATES A 196-BED SKILLED NURSING FACILITY LOCATED IN JAMAICA PLAIN, MASSACHUSETTS. EFFECTIVE SEPTEMBER 1, 2011, EIGHT LICENSED BEDS WERE TAKEN OUT OF SERVICE. SHERRILL HOUSE HAS ESTABLISHED A REFERRAL SYSTEM WITH OTHER HEALTH CARE FACILITIES IN THE AREA TO ENSURE COMPLETE HEALTH SERVICES AT ALL LEVELS. IT OFFERS LOCAL PHYSICIANS AND HOUSE STAFF A SETTING IN WHICH TO RENDER THE BEST SKILLED CARE ON A SHORT-TERM OR LONG-TERM BASIS. IN ITS CONCERN FOR THE INDIVIDUAL, SHERRILL HOUSE AIMS TO BE AS BROAD AND DIVERSE AS THE NEEDS OF THOSE IT SERVES. 20951504 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 48 0 1 314 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MA X MARK ALTENWEG 6177312400 135 SOUTH HUNTINGTON AVENUE BOSTON MA 02130 PATRICK STAPLETON CEO 40.00 X 338558 0 16344 JAMES DAME REHAB DIRECTOR 40.00 X 302702 0 11175 IVY LEUNG RN - STAFF NURSE 76.00 X 232142 0 17196 CHANTAL LOISEAU RN - RESIDENT CARE MANAGER 60.00 X 200921 0 16658 OLYMPIA CELIS RN - STAFF NURSE 74.00 X 187897 0 2826 BEATRICE AWUOR RN - STAFF NURSE 64.00 X 186728 0 7603 MARK ALTENWEG CFO 40.00 X 171731 0 10507 RICHARD W BENKA PRESIDENT 2.00 X X 0 0 0 DAVID A KIRCHNER CO-VICE PRESIDENT 1.00 X X 0 0 0 BARBARA BAUMAN CO-VICE PRESIDENT 1.00 X X 0 0 0 FREDERICA SEE TREASURER 2.00 X X 0 0 0 THE REV THOMAS B KENNEDY CHAIRMAN 2.00 X X 0 0 0 LISTO FISHER CLERK 1.00 X X 0 0 0 ALEXANDER T BOK TRUSTEE 1.00 X 0 0 0 STEVE HENDRICKSON TRUSTEE 1.00 X 0 0 0 ROBERT S HULBURT JR TRUSTEE 1.00 X 0 0 0 PAUL ZINTL TRUSTEE 1.00 X 0 0 0 WILLIAM STEUL TRUSTEE 1.00 X 0 0 0 CHERYL WHITFIELD TRUSTEE 1.00 X 0 0 0 GRACE CLARK TRUSTEE 1.00 X 0 0 0 ALLENE RUSSELL PIERSON TRUSTEE 1.00 X 0 0 0 1620679 0 82309 36 0 1 0 BETH ISRAEL DEACONESS 330 BROOKLINE AVE BOSTON MA 02215 COVID TESTING 249758 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 AUDIT & TAX SERVICES 193814 2 4856377 595703 122956 5452080 PATIENT SERVICE REVENUE 623000 20796561 20796561 20796561 135871 135871 12141827 459232 11872457 469617 269370 -10385 258985 258985 OTHER INCOME 623000 153539 153539 153539 26797036 20796561 0 548395 537170 537170 15130020 12817643 2138116 174261 57634 52200 5434 1726358 1496903 229455 1115588 954341 161247 103294 103294 151248 151248 15368 15368 1500214 1028643 471001 570 191072 191072 449485 449485 636076 547179 87757 1140 10162 10162 12449 12449 949 816 131 2 1587906 1365984 219077 2845 280079 245288 34280 511 MEDICAL & OTHER PROGRAM 2194267 2116481 77484 302 USER FEE EXPENSE 1123850 1123850 DEBT SERVICE EXPENSE 333398 286803 45998 597 OTHER OPERATING EXPENSE 195772 39223 156549 238595 131000 107595 27590954 20951504 6351627 287823 484733 1047765 25154 42962 2061288 2301363 60817 10556 50911269 37597695 14413093 13313574 12923644 6842349 875171 4796472 30843900 28355041 5213882 5456895 85992 56177 9446479 9210390 163565 0 14909918 14723462 X 13332515 11375650 2601467 2255929 15933982 13631579 30843900 28355041 X -793918 -1903284 394799 X 0 1 X 1 1 1 X 688279 688434 7348769 3108332 5452080 17285894 19885206 20464840 16593343 17910936 20796561 95650886 20573485 21153274 23942112 21019268 26248641 112936780 377504 346427 1740058 315000 149616 2928605 0 377504 346427 1740058 315000 149616 2928605 110008175 173728 148168 111852 171607 135871 741226 173728 148168 111852 171607 135871 741226 289336 219040 98007 83732 153539 843654 21036549 21520482 24151971 21274607 26538051 114521660 0.96060 0.95520 0.00650 0.00670 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 289,336. 2019 AMOUNT: $ 219,040. 2020 AMOUNT: $ 98,007. 2021 AMOUNT: $ 83,732. 2022 AMOUNT: $ 153,539. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3243 3243 0 PART II-B, LINE 1: PART OF MEMBERSHIP DUES PAID TO STATE HEALTHCARE ORGANIZATIONS ARE RELATED TO INDIRECT LOBBYING EXPENDITURES. 2601467 23508 -344188 24858 2255929 2288081 166793 302947 -156354 2601467 1991115 37734 407512 -148280 2288081 1842585 28443 253481 133394 1991115 1979274 51418 -134580 53527 1842585 0.92280 0.07720 0 0 860636 860636 15486233 8150895 7335338 25744062 21950399 3793663 8198033 7043085 1154948 622305 453316 168989 13313574 BENEFICIAL INTEREST IN PERPETUAL TR 718156 OTHER RECEIVABLES 3690068 SWAP ASSET 388248 4796472 X 25273183 -1903284 394799 -1508485 26781668 15368 15368 26797036 27575586 0 27575586 15368 15368 27590954 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO BE USED FOR CHAPLAINCY, VOLUNTEER, FUND FACILITY AND VARIOUS OTHER PROGRAMS. PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. THE FINANCIAL STATEMENTS DO NOT INCLUDE A PROVISION FOR INCOME TAXES BECAUSE THE ORGANIZATION IS A TAX-EXEMPT ORGANIZATION. 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 -157,014. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 551,813. X X X 0 0 0 0 0 0 0 0 0 PATRICK STAPLETON CEO 338558 0 0 0 0 0 3386 0 12958 0 354902 0 0 0 JAMES DAME REHAB DIRECTOR 302702 0 0 0 0 0 2 0 11173 0 313877 0 0 0 IVY LEUNG RN - STAFF NURSE 232142 0 0 0 0 0 2321 0 14875 0 249338 0 0 0 CHANTAL LOISEAU RN - RESIDENT CARE MANAGER 200921 0 0 0 0 0 2009 0 14649 0 217579 0 0 0 OLYMPIA CELIS RN - STAFF NURSE 187897 0 0 0 0 0 1879 0 947 0 190723 0 0 0 BEATRICE AWUOR RN - STAFF NURSE 186728 0 0 0 0 0 1867 0 5736 0 194331 0 0 0 MARK ALTENWEG CFO 171731 0 0 0 0 0 0 0 10507 0 182238 0 0 0 X 122956 FURNITURE (DESK, CHAIR) X 23 5237 FAIR VALUE 0 0 0 PART I, COLUMN (B): 23 SHARES OF LPL FINANCIAL STOCK FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND WILL BE REVIEWED BY THE CFO AND CEP TO ENSURE ACCURACY. THE NEXT PHASE OF REVIEW IS AT THE BOARD LEVEL AS ALL BOD ARE SENT AN ELECTRONIC COPY FOR REVIEW. THE FINAL PRODUCT IS VOTED INTO EXISTENCE AT A BOARD MEETING BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, EACH MEMBER OF THE BOARD IS PROVIDED A CONFLICT OF INTEREST QUESTIONNAIRE FORM TO BE COMPLETED, SIGNIFYING THAT THEY OBTAINED A COPY OF THE POLICY, HAVE READ AND COMPREHEND THE POLICY, AND AGREE TO COMPLY WITH THE POLICY. THE BOARD REVIEWS AND MONITORS ANY CONFLICTS DISCLOSED. THE CFO IS RESPONSIBLE FOR OVERSEEING THE ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS. 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 MAY BE SEEN BY THE BOARD AND CONFLICTS ARE DETERMINED AND REVIEWED BY THE BOARD. THE PERSON WITH THE CONFLICT MUST BE ABSTAIN FROM ANY DISCUSSION REGARDING THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 A STUDY IS CONDUCTED BY AN OUTSIDE CONSULTING COMPANY, WHICH USES COMPARABILITY DATA ON SALARIES WITHIN THE INDUSTRY. USING THESE REPORTS, AS WELL AS OTHER FACTORS, THE APPROVAL OF COMPENSATION IS DISCUSSED AND VOTED ON BY THE BOARD, AND DOCUMENTED WITHIN THE BOARD MEETING MINUTES. THIS PROCESS WAS LAST COMPLETED IN 2022. 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 XI, LINE 9: CHANGE IN BENEFICIAL INTEREST -157,014. FV OF INTEREST RATE SWAP AGREEMENT 551,813. LONGWOOD HOSPICE LLC 637 WASHINGTON STREET BROOKLINE MA 02446 873882559 HOSPICE CARE MA N/A 0 0 0.50000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0