2022-11-02T14:26:36-05:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2021-01-01 042106771 WILLIAM B RICE EVENTIDE HOME INC WILL 7816605000 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 KENNETH STRONG EXECUTIVE DIRECTOR 7816605000 2022-10-26 1 KENNETH STRONG 999009999 DANIELLE NIHILL P01350943 7819821001 2022-10-26 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DWYER HOME AND FAIRING WAY KENNETH STRONG 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 12436067 0 X WWW.FAIRINGWAY.ORG X 1924 MA A LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED SUPPORTIVE SERVICES. 11 11 149 11 0 0 553770 1278378 8912336 10327801 104450 365585 0 0 9570556 11971764 0 0 0 0 4465222 5518544 0 20000 20000 8759573 9051464 13224795 14590008 -3654239 -2618244 89102741 85714038 86334424 85661789 2768317 52249 TO MAINTAIN A UNIQUE LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED AND CARING SUPPORTIVE SERVICES IN A HOME-LIKE ATMOSPHERE WHICH ALLOWS THE RESIDENTS TO MAINTAIN INDEPENDENT LIVES WITH DIGNITY. 0 0 11560943 10327801 THE HOME PROVIDES SECURE HOUSING, QUALITY NURSING CARE, MEANINGFUL ACTIVITIES, OPPORTUNITIES FOR SOCIALIZATION, AND A WIDE VARIETY OF SUPPORTIVE & REHABILITATION SERVICES TO APPROXIMATELY 50 FRAIL ELDERS UNABLE TO LIVE INDEPENDENTLY IN THE COMMUNITY, WITHOUT REGARD FOR THEIR ABILITY TO PAY. 11560943 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 7 0 1 149 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 MA X JESSICA GOUVEIA 7816605000 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 AMY ROSS VICE PRESIDENT 0.00 X X 0 0 0 JOHN SPILLANE PRESIDENT 0.00 X X 0 0 0 DONALD POWELL TREASURER 5.00 X X 0 0 0 SUSAN BELISLE CLERK 5.00 X X 0 0 0 WILLIAM JACKSON DIRECTOR 5.00 X 0 0 0 KEVIN KIRBY DIRECTOR 5.00 X 0 0 0 ANNE MARCHETTA DIRECTOR 5.00 X 0 0 0 STEVEN DWYER DIRECTOR 5.00 X 0 0 0 JOHN DORIO DIRECTOR 5.00 X 0 0 0 MARY DOHERTY DIRECTOR 5.00 X 0 0 0 MEGAN FISHER DIRECTOR 5.00 X 0 0 0 KENNETH STRONG EXECUTIVE DIRECTOR 40.00 X 180250 0 3640 ROCHELLE ROLFE DIRECTOR OF NURSING 40.00 X 117536 0 12064 KIMBERLY MCGRATH PHYSICAL THERAPIST 40.00 X 109571 0 3258 407357 0 18962 3 0 1 0 PHARMERICA 1123 PEARL ST BROCKTON MA 02301 PHARMACY 179804 MAKO MEDICAL SUPPLIES 8461 GARVEY DRIVE RALEIGH NC 27616 MEDICAL SUPPLY 119085 INTELYCARE INC PO BOX 200413 PITTSBURG PA 15251 AGENCY 112716 MEDLINE INDUSTRIES PO BOX 121080 DALLAS TX 75312 MEDICAL SUPPLY 108204 PARAMOUNT HEALTH SERVICES INC 3 COURTHOUSE LANE CHELMSFORD MA 02184 AGENCY 101132 5 1260923 17455 1278378 MEDICARE RESIDENTS 623000 3858085 3858085 INDEPENDENT LIVING SERVICE REVENU 623000 2868711 2868711 PRIVATE RESIDENTS 623000 1567452 1567452 PUBLICLY-AIDED RESIDENTS 623000 1539789 1539789 OTHER OPERATING INCOME 623000 410416 410416 83348 83348 10327801 51765 51765 778123 464303 313820 313820 313820 11971764 10327801 0 365585 183890 183890 4420490 3838664 581826 66481 53582 12899 601219 412747 188472 246464 246464 239109 239109 2500 2500 69429 69429 20000 20000 21029 21029 121345 121345 10160 10160 294396 294396 33545 33545 1071041 999057 71984 1968 1968 1803953 1771011 32942 2357332 2144370 212962 88682 74150 14532 PATIENT CARE EXPENSES 1967456 1967456 PROJECT COSTS 532856 532856 USER FEE EXPENSE 207387 207387 BAD DEBT EXPENSE 135457 135457 93819 51474 42345 14590008 11560943 3009065 20000 2079277 1152731 82406 139975 564183 703447 77573 49931 87781636 8964088 80988187 78817548 2310234 2057931 3000881 2792475 89102741 85714038 2335683 2251830 1191343 1000274 450326 155000 30660971 21635761 902103 0 50793998 60618924 86334424 85661789 X 2708417 -7651 59900 59900 2768317 52249 89102741 85714038 -2618244 -97824 0 X X 0 1 X 1 0 X 1435 2976 553770 1278378 1836559 6899339 8118162 8820550 8912336 10327801 43078188 6900774 8121138 8820550 9466106 11606179 44914747 0 0 0 44914747 66149 55279 57798 43878 51765 274869 66149 55279 57798 43878 51765 274869 211522 211522 7178445 8176417 8878348 9509984 11657944 45401138 0.98930 0.98660 0.00610 0.00790 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 828 828 0 PART II-B, LINE 1: DURING 2021, THE ORGANIZATION PAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATIONS OF WHICH $828 WAS THE PORTION RELATED TO LOBBYING. 0 1 X 59900 59900 59900 59900 59900 59900 59900 59900 59900 59900 0.68450 0.31550 0 0 3493296 3493296 80820776 7703240 73117536 393925 113026 280899 3038790 1112973 1925817 34849 34849 0 78817548 RESIDENT REFUNDABLE ENTRANCE DEPOSI 60618924 60618924 X PART IV, LINE 2B: PROSPECTIVE RESIDENTS ENTER INTO AGREEMENTS TO RESERVE A SPECIFIC UNIT IN THE INDEPENDENT LIVING COMMUNITY, WITH A 10% UNIT DEPOSIT OR $10,000 UNIT DEPOSIT, OR RESERVE A POSITION ON A PRIORITY LIST WITH A PRIORITY LIST DEPOSIT. THE PRIORITY LIST AND 10% UNIT DEPOSITS ARE FULLY REFUNDABLE UPON REQUEST AT ANY TIME, PLUS ACCUMULATED INTEREST INCOME EARNED ON THE DEPOSIT, LESS AN ADMINISTRATIVE FEE. THE $10,000 UNIT DEPOSITS ARE NONREFUNDABLE, UNLESS THE ORGANIZATION IS UNABLE TO DELIVER THE RIGHT TO OCCUPY THE UNIT ON THE CLOSING DATE. THE RESERVATION DEPOSITS ARE BEING HELD BY RICE SOUTHFIELD, LLC (DISREGARDED ENTITY OF RICE EVENTIDE). PART V, LINE 4: RESTRICTED ENDOWMENT FUNDS ARE TO BE USED FOR NEW RESIDENT BEDS. THE PERMANENT ENDOWMENT FUND'S INCOME IS USED FOR THE GENERAL PURPOSES OF THE HOME. PART X, LINE 2: RICE EVENTIDE 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. RICE SOUTHFIELD IS A SINGLE MEMBER LLC. EARNINGS AND LOSSES ARE INCLUDED IN THE MEMBER'S INCOME. RICE SOUTHFIELD'S ACTIVITY IS INCLUDED ON RICE EVENTIDE'S TAX RETURN. RICE EVENTIDE FILES AS A TAX-EXEMPT ORGANIZATION. THE ORGANIZATIONS FOLLOW 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 YEARS ENDED DECEMBER 31, 2021 AND 2020. X 1 LISA GRAHAM 200 WASHINGTON STREET TROY NY 12180 MAIL SOLICITATIONS 0 0 20000 -20000 20000 -20000 X X X 0 0 0 0 0 0 0 0 0 KENNETH STRONG EXECUTIVE DIRECTOR 180250 0 0 0 0 0 0 0 0 3640 180250 3640 0 0 FORM 990, PART VI, SECTION A, LINE 8B NO MINUTES ARE TAKEN FOR COMMITTEE MEETINGS AS ALL INFORMATION COMMUNICATED IN THESE MEETINGS IS COMMUNICATED TO THE BOARD BY A REPRESENTATIVE. ALL BOARD MEETINGS REQUIRE THAT MINUTES BE TAKEN. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR WILL REVIEW THE FORM 990 WITH MEMBERS OF THE BOARD'S EXECUTIVE COMMITTEE. IT WILL THEN BE DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY, COVERING THE BOARD OF DIRECTORS, THAT IS ENFORCED ANNUALLY BY DISTRIBUTION OF THE POLICY AND FOLLOW UP TO CONFIRM NO ONE IS IN CONFLICT OF THE POLICY. ANY POTENTIAL CONFLICTS OF INTEREST ARE REQUIRED TO BE REPORTED TO THE PRESIDENT IMMEDIATELY. IF A DIRECTOR HAS A SUSPECTED OR REPORTED CONFLICT OF INTEREST, THEY WILL BE PROHIBITED FROM VOTING ON MATTERS INVOLVING THAT CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT OF THE BOARD AND MEMBERS OF THE EXECUTIVE COMMITTEE APPROVE CEO'S SALARY. THEY REGULARLY REVIEW SALARY STUDIES DONE BY STATE HEALTHCARE ASSOCIATIONS. APPROVAL IS DOCUMENTED IN THE BOARD OF DIRECTORS' MINUTES. THE REVIEW WAS LAST COMPLETED IN 2021. THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION OF KEY EMPLOYEES AFTER REVIEWING SALARY STUDIES DONE BY STATE AND NATIONAL HEALTHCARE ASSOCIATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS AUDIT OVERSIGHT PROCESS OR AUDITOR SELECTION PROCESS. RICE SOUTHFIELD LLC 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 273136975 REAL ESTATE INVESTMENT MA 3251325 34848916 WILLIAM B RICE EVENTIDE HOME INC