2022-11-15T14:43:39-06:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2021-01-01 222575208 BETHANY HOME FOUNDATION INC BETH 4018312870 111 SOUTH ANGELL STREET PROVIDENCE RI 02906 STEPHANIE IGOE EXECUTIVE DIRECTOR 4018312870 2022-11-15 1 STEPHANIE IGOE 999009999 DANIELLE NIHILL P01350943 6177170831 2022-11-14 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z STEPHANIE IGOE 111 SOUTH ANGELL STREET PROVIDENCE RI 02906 554108 0 X N/A X 1985 RI TO PROVIDE AN INDEPENDENT LIVING PROGRAM FOR THE ELDERLY AND TO SUPPORT BETHANY HOME OF RHODE ISLAND. 7 6 0 6 0 0 0 0 529752 551902 5522 2206 0 0 535274 554108 46715 69463 0 0 134549 141128 0 0 0 340065 384846 521329 595437 13945 -41329 344146 308269 95177 91048 248969 217221 TO PROVIDE AN INDEPENDENT LIVING PROGRAM FOR THE ELDERLY AND TO SUPPORT BETHANY HOME OF RI, AN EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. 0 0 411742 69463 551902 BETHANY HOME FOUNDATION MANAGES A 30-UNIT CONDOMINIUM RETIREMENT COMMUNITY HOME TO INDEPENDENT OLDER ADULTS IN SUPPORT OF BETHANY HOME OF RI, A 501(C)(3) NURSING FACILITY. 411742 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X STEPHANIE IGOE 4018312870 111 SOUTH ANGELL STREET PROVIDENCE RI 02906 X MARK CHAFEE TREASURER 0.50 0.50 X X 0 0 0 W PARISH LENTZ CHAIRMAN OF BOARD (UNTIL 10/2021) 0.50 0.50 X X 0 0 0 STEPHANIE BASILE BOARD MEMBER 0.50 0.50 X 0 0 0 DONALD BLOUGH BOARD MEMBER 0.50 0.50 X 0 0 0 CAROLINE CORNWELL CO-CHAIRMAN (STARTING 10/2021) 0.50 0.50 X X 0 0 0 KEVIN LENIHAN BOARD MEMBER (UNTIL 3/2021) 0.50 0.50 X 0 0 0 RICHARD C SULLIVAN BOARD MEMBER (UNTIL 8/2021) 0.50 0.50 X 0 0 0 ALAN LAWSON BOARD MEMBER 0.50 0.50 X 0 0 0 HELAINE SCHUPACK CO-CHAIRMAN (STARTING 10/2021) 0.50 0.50 X X 0 0 0 STEPHANIE IGOE ADMINISTRATOR 4.00 36.00 X X 11786 110706 6193 ELIZABETH SARRO ADMINISTRATOR (UNTIL 3/2021) 4.00 36.00 X 3929 86291 10646 IRINA KRICHEVSKIY RN MDS/QI COORDINATOR 0.50 56.00 X 0 141775 12945 MICHAEL DESVEAUX DIRECTOR OF NURSING 0.50 40.00 X 0 121699 11633 15715 460471 41417 0 0 1 0 0 COMMON FEES 532000 480239 480239 APPRECIATION INCOME ON 531390 69463 69463 PARKING FEES 531390 2200 2200 551902 2206 2206 554108 551902 0 2206 69463 69463 17078 17078 92325 92325 16272 16272 4018 4018 11435 11435 21484 21484 7376 7376 465 465 6477 6477 237980 237980 46899 42939 3960 CAPITAL PURCHASES 61360 61360 MISCELLANEOUS EXPENSE 1845 1845 PAYROLL PROCESSING 960 960 595437 411742 183695 0 71283 63498 23092 2668 15230 16497 234541 225606 344146 308269 32787 28361 62390 62687 95177 91048 X 248969 217221 248969 217221 344146 308269 -41329 9581 0 X X 1 X 0 1 0 X X 1 BETHANY HOME OF RHODE ISLAND 050258941 10 1 69463 0 1 69463 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 SCHEDULE A, PART I, LINE 12G, COLUMN VI BETHANY HOME OF RHODE ISLAND PROVIDES MANAGEMENT SERVICES TO BETHANY HOME FOUNDATION, INCLUDING ADMINISTRATIVE, MAINTENANCE, AND SECURITY SERVICES. 234541 56080 11396 76411 225606 234125 58080 1372 59036 234541 232252 69420 11372 78919 234125 210661 84080 -454 62035 232252 362455 173540 14165 339499 210661 1.00000 0 0 0 MEMBERSHIP DEPOSITS 24500 DUE TO AFFILIATE 38187 62687 X PART V, LINE 4: THE FUNDS ARE SET ASIDE FOR THE SUPPORT OF THE GENERAL OPERATIONS OF BETHANY HOME FOUNDATION. PART X, LINE 2: NO PROVISION FOR FEDERAL AND STATE INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS SINCE THE FOUNDATION QUALIFIES AS A TAX-EXEMPT ORGANIZATION AS PROVIDED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE (IRS) HAS CLASSIFIED THE FOUNDATION AS A PUBLIC CHARITY. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FOUNDATION RECOGNIZES INTEREST AND PENALTIES, IF APPLICABLE, AS A COMPONENT OF ADMINISTRATIVE AND GENERAL EXPENSES. 1 BETHANY HOME OF RI INC 111 SOUTH ANGELL STREET PROVIDENCE RI 02906 050258941 501(C)(3) 69463 0 TO PROVIDE FINANCIAL SUPPORT TO BETHANY HOME OF RI, INC. 1 PART II, LINE 1(A): THE ORGANIZATION MAKES GRANTS TO BETHANY HOME OF RHODE ISLAND, INC., A RELATED SECTION 501(C)(3) ORGANIZATION THAT IS ITS SUPPORTED ORGANIZATION. THE GRANT FUNDS ARE MONITORED SINCE THE SAME OFFICERS AND BOARD MEMBERS SERVE BOTH ORGANIZATIONS. X 0 0 0 0 0 0 0 0 0 IRINA KRICHEVSKIY RN MDS/QI COORDINATOR 0 141775 0 0 0 0 0 5605 0 7340 0 154720 0 0 FORM 990, PART V, LINE 2A: COMPENSATION AND RELATED EXPENSES ARE PAID BY BETHANY HOME OF RHODE ISLAND. BETHANY HOME FOUNDATION REIMBURSES BETHANY HOME OF RHODE ISLAND FOR THE EXPENSES. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS THE FORM 990 PRIOR TO ITS FILING AND THE PRESIDENT/ADMINISTRATOR OF BETHANY FOUNDATION, INC. HAS THE AUTHORITY TO SIGN THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY. THE POLICY IS MAINTAINED AND UPDATED WHEN NECESSARY BY THE ADMINISTRATOR. THE ADMINISTRATOR MONITORS ANY POSSIBLE CONFLICTS AT ALL TIME IN PARTICULAR IF THERE ARE ANY CHANGES IN BOARD MEMBERS OR KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: ELIZABETH SARRO WAS THE ADMINISTRATOR OF BETHANY HOME FOUNDATION, INC. UNTIL JULY, 2021. SHE WAS ALSO THE PRESIDENT/ADMINISTRATOR OF BETHANY HOME OF RHODE ISLAND UNTIL JULY, 2021. HER TIME WAS SPLIT BETWEEN THE TWO ORGANIZATIONS. COMPENSATION AND BENEFITS WERE REIMBURSED BY BETHANY HOME FOUNDATION TO BETHANY HOME FOR THE TIME SPENT ON BETHANY HOME FOUNDATION. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT OF THE ANNUAL COMPILATION OF BETHANY HOME FOUNDATION'S FINANCIAL STATEMENTS. BETHANY HOME OF RHODE ISLAND 111 SOUTH ANGELL STREET PROVIDENCE RI 02906 050258941 PROVISION OF LONG TERM CARE FOR THE ELDERLY RI 501(C)(3) LINE 10 BETHANY HOME FOUNDATION INC 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 BETHANY HOME OF RHODE ISLAND INC O 25321 CASH BETHANY HOME OF RHODE ISLAND INC P 25321 CASH BETHANY HOME OF RHODE ISLAND INC B 69463 CASH BETHANY HOME OF RHODE ISLAND INC E 38187 CASH