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SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC (EIN 80-0687948)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202243199349301874
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-15T07:27:00-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN111986323PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MARCUM LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1555 LONG WHARF DRIVEAddressLine1Txt
CityNEW HAVENCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06511ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN800687948EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE MANOR AT QUINCY POINTBusinessNameLine1Txt
Business Name Line2REHABILITATION CENTER INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSOUTBusinessNameControlTxt
Phone6174230590PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1288 WASHINGTON STREETAddressLine1Txt
CityQUINCYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02169ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSIGNING OFFICERPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone6174230590PhoneNum
Signature2022-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSIGNINGPersonFirstNm
Person LastOFFICERPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARY ANTONETTIPreparerPersonNm
PTINP00431862PTIN
Phone2037819600PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer0TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerWILLIAM GRAVESPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1288 WASHINGTON STREETAddressLine1Txt
CityQUINCYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02169ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$16,733,910GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SOUTHCOVEMANOR.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2011FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee224TotalEmployeeCnt
Total Volunteers22TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,658,316PYContributionsGrantsAmt
CY Contributions Grants$1,319,464CYContributionsGrantsAmt
PY Program Service Revenue$13,802,856PYProgramServiceRevenueAmt
CY Program Service Revenue$15,413,645CYProgramServiceRevenueAmt
PY Investment Income$31,592PYInvestmentIncomeAmt
CY Investment Income-$78,314CYInvestmentIncomeAmt
PY Other Revenue$4,410PYOtherRevenueAmt
CY Other Revenue$20CYOtherRevenueAmt
PY Total Revenue$17,497,174PYTotalRevenueAmt
CY Total Revenue$16,654,815CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,772,618PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,762,113CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$5,108CYTotalFundraisingExpenseAmt
PY Other Expenses$5,383,854PYOtherExpensesAmt
CY Other Expenses$5,998,446CYOtherExpensesAmt
PY Total Expenses$16,156,472PYTotalExpensesAmt
CY Total Expenses$15,760,559CYTotalExpensesAmt
PY Revenues Less Expenses$1,340,702PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$894,256CYRevenuesLessExpensesAmt
Total Assets BOY$34,039,222TotalAssetsBOYAmt
Total Assets EOY$32,159,189TotalAssetsEOYAmt
Total Liabilities BOY$22,722,021TotalLiabilitiesBOYAmt
Total Liabilities EOY$19,902,090TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,317,201NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,257,099NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE ORGANIZATION'S MISSION IS TO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES. THE ORGANIZATION'S CORE VALUES INCLUDE: 1. RESPECTING THE PEOPLE WE SERVE, THEIR TRADITIONS, AND THEIR PREFERENCES, (SEE SCHEDULE O)2. PROVIDING EXCELLENT LEADING EDGE CARE AND SERVICES, 3. INVESTING IN OUR EMPLOYEES, AND 4. SERVING OUR COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,112,974ExpenseAmt
Revenue$15,413,665RevenueAmt
DescNURSING & REHABILITATION SERVICES - THE OGRANIZATION'S MISSION IS TO PROVIDE INDIVIDUALIZED NURSING AND REHABILITATION CARE THAT REFLECTS ASIAN CULTURAL VALUES THROUGH THE OPERATION OF A 141-BED LONG-TERM CARE FACILITY IN QUINCY, MASSACHUSETTS.Desc
Total Program Service Expenses$14,112,974TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee224EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSCOTT HANSON DIRECTOR OF FINANCEPersonNm
Phone6174230590PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1288 WASHINGTON STREETAddressLine1Txt
CityQUINCYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02169ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JASON QU
CHAIRMAN OF THE BOARD2.001.00Yes (X)Yes (X)$0$0$0
MAY CHIN
VICE PRESIDENT2.001.00Yes (X)Yes (X)$0$0$0
CINDY LAW
TREASURER2.001.00Yes (X)Yes (X)$0$0$0
HEMMIE CHANG
CLERK2.001.00Yes (X)Yes (X)$0$0$0
MARIANNE BOWLER HONORABLE
DIRECTOR2.001.00Yes (X)$0$0$0
ALICE ROSE RN
DIRECTOR2.001.00Yes (X)$0$0$0
THOMAS CHIN
DIRECTOR2.001.00Yes (X)$0$0$0
DAVID TING
DIRECTOR2.001.00Yes (X)$0$0$0
LEONARD LAI MD
DIRECTOR2.001.00Yes (X)$0$0$0
STANLEY ELKERTON
DIRECTOR2.001.00Yes (X)$0$0$0
HELEN CHIN SCHLICHTE
DIRECTOR2.001.00Yes (X)$0$0$0
HON HOI YEE
DIRECTOR2.001.00Yes (X)$0$0$0
SUSAN LUO CFA
DIRECTOR2.001.00Yes (X)$0$0$0
EDWARD CHENG ESQ
DIRECTOR2.001.00Yes (X)$0$0$0
LISA MUI
DIRECTOR2.001.00Yes (X)$0$0$0
HEATHER O'SULLIVAN
DIRECTOR2.001.00Yes (X)$0$0$0
RICHARD LUI
DIRECTOR2.001.00Yes (X)$0$0$0
ERIC SCHLICHTE
DIRECTOR2.001.00Yes (X)$0$0$0
JIM HSU
DIRECTOR2.001.00Yes (X)$0$0$0
WILLIAM GRAVES
PRESIDENT/CEO41.001.00Yes (X)$254,800$0$11,215
SCOTT HANSON
DIRECTOR OF FINANCE41.001.00Yes (X)$126,319$0$14,909
LI CHEN
ADMINISTRATOR40.00$157,319$0$19,247Yes (X)
SHINJA CHOI
RN40.00$153,283$0$7,538Yes (X)
MARY LOU FALLETTI
LPN40.00$137,220$0$8,215Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$828,941TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$61,124TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PRO EMS SOLUTIONS INC
31 SMITH PLACECAMBRIDGEMA02138COVID TESTING$634,875
PARAGON REHABILITATION
303 N HURSTBOURNE PKWYLOUISVILLEKY40222THERAPY SERIVCES$470,155
US FOODS
PO BOX 3115BOSTONMA02241FOOD SERVICES$300,831
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$1,319,464GovernmentGrantsAmt
Total Contributions$1,319,464TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business623000BusinessCd
Total Revenue Column$15,413,645TotalRevenueColumnAmt
Related Or Exempt Func Income$15,413,645RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$15,413,645TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$781TotalRevenueColumnAmt
Exclusion$781ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$79,095OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$79,095OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$79,095TotalRevenueColumnAmt
Exclusion-$79,095ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business623000BusinessCd
Total Revenue Column$20TotalRevenueColumnAmt
Related Or Exempt Func Income$20RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$20OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,654,815TotalRevenueColumnAmt
Related Or Exempt Func Income$15,413,665RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$78,314ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$421,361TotalAmt
Management And General$421,361ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,748,492TotalAmt
Program Services$7,064,890ProgramServicesAmt
Management And General$683,602ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$143,625TotalAmt
Program Services$124,200ProgramServicesAmt
Management And General$19,425ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$761,445TotalAmt
Program Services$658,460ProgramServicesAmt
Management And General$102,985ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$687,190TotalAmt
Program Services$594,248ProgramServicesAmt
Management And General$92,942ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$14,076TotalAmt
Management And General$14,076ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$44,708TotalAmt
Program Services$15,855ProgramServicesAmt
Management And General$28,853ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$310,241TotalAmt
Program Services$234,319ProgramServicesAmt
Management And General$75,922ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$24,009TotalAmt
Management And General$24,009ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$72,325TotalAmt
Program Services$62,182ProgramServicesAmt
Management And General$10,143ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$106,099TotalAmt
Program Services$96,362ProgramServicesAmt
Management And General$4,750ManagementAndGeneralAmt
Fundraising$4,987FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$347,792TotalAmt
Program Services$332,222ProgramServicesAmt
Management And General$15,570ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$10,831TotalAmt
Program Services$10,768ProgramServicesAmt
Management And General$63ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$18,401TotalAmt
Program Services$17,593ProgramServicesAmt
Management And General$808ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$550,264TotalAmt
Program Services$525,631ProgramServicesAmt
Management And General$24,633ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$918,902TotalAmt
Program Services$877,766ProgramServicesAmt
Management And General$41,136ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$158,379TotalAmt
Program Services$97,332ProgramServicesAmt
Management And General$61,047ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES AND DR$1,206,976$1,206,976
USER FEE$994,032$994,032
DIETARY$477,423$477,423
THERAPY EXPENSE$472,004$472,004

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$271,984TotalAmt
Program Services$250,711ProgramServicesAmt
Management And General$21,152ManagementAndGeneralAmt
Fundraising$121FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,760,559TotalAmt
Program Services$14,112,974ProgramServicesAmt
Management And General$1,642,477ManagementAndGeneralAmt
Fundraising$5,108FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,247,923BOYAmt
EOY$2,136,589EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,811,651BOYAmt
EOY$1,269,219EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,050,365BOYAmt
EOY$1,578,075EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$162,421BOYAmt
EOY$205,769EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$33,857,270LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,108,933LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$27,565,255BOYAmt
EOY$26,748,337EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$81,362BOYAmt
EOY$68,427EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$120,245BOYAmt
EOY$152,773EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$34,039,222BOYAmt
EOY$32,159,189EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,151,931BOYAmt
EOY$1,065,604EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$443,902BOYAmt
EOY$45,373EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,607,816BOYAmt
EOY$16,086,659EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,518,372BOYAmt
EOY$2,704,454EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,722,021BOYAmt
EOY$19,902,090EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,317,201BOYAmt
EOY$12,257,099EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,317,201BOYAmt
EOY$12,257,099EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$34,039,222BOYAmt
EOY$32,159,189EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$894,256ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$45,642OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$120,819CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$124,202CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$38,024CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,658,316CurrentTaxYearMinus1YearAmt
Current Tax Year$1,319,464CurrentTaxYearAmt
Total$5,260,825TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,602,746CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,036,223CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,279,074CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,802,856CurrentTaxYearMinus1YearAmt
Current Tax Year$15,413,645CurrentTaxYearAmt
Total$74,134,544TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,723,565CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,160,425CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,317,098CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17,461,172CurrentTaxYearMinus1YearAmt
Current Tax Year$16,733,109CurrentTaxYearAmt
Total$79,395,369TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$79,395,369PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$465,159CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$463,020CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$386,612CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,592CurrentTaxYearMinus1YearAmt
Current Tax Year$781CurrentTaxYearAmt
Total$1,347,164TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$465,159CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$463,020CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$386,612CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,592CurrentTaxYearMinus1YearAmt
Current Tax Year$781CurrentTaxYearAmt
Total$1,347,164TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,844CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,094CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,419CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,410CurrentTaxYearMinus1YearAmt
Current Tax Year$20CurrentTaxYearAmt
Total$44,787TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,199,568CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,634,539CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,722,129CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17,497,174CurrentTaxYearMinus1YearAmt
Current Tax Year$16,733,910CurrentTaxYearAmt
Total$80,787,320TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98280PublicSupportCY509Pct
Public Support PY5090.97650PublicSupportPY509Pct
Investment Income CY0.01670InvestmentIncomeCYPct
Investment Income PY0.02290InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcYes (1)AgentTrusteeEtcInd
Beginning Balance$47,485BeginningBalanceAmt
Additions During Year$30,333AdditionsDuringYearAmt
Distributions During Year$23,398DistributionsDuringYearAmt
Ending Balance$54,420EndingBalanceAmt
Incl Escrow Custodial Acct Liab0InclEscrowCustodialAcctLiabInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$126,625BeginningYearBalanceAmt
Investment Earnings Or Losses$7,190InvestmentEarningsOrLossesAmt
Administrative Expenses$60,518AdministrativeExpensesAmt
End Year Balance$73,297EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$130,942BeginningYearBalanceAmt
Contributions$11,750ContributionsAmt
Investment Earnings Or Losses$6,508InvestmentEarningsOrLossesAmt
Administrative Expenses$22,575AdministrativeExpensesAmt
End Year Balance$126,625EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$179,306BeginningYearBalanceAmt
Investment Earnings Or Losses$7,261InvestmentEarningsOrLossesAmt
Administrative Expenses$41,103AdministrativeExpensesAmt
End Year Balance$130,942EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$146,584BeginningYearBalanceAmt
Contributions$67,500ContributionsAmt
Investment Earnings Or Losses$4,475InvestmentEarningsOrLossesAmt
Administrative Expenses$39,253AdministrativeExpensesAmt
End Year Balance$179,306EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$166,440BeginningYearBalanceAmt
Contributions$17,500ContributionsAmt
Investment Earnings Or Losses$3,648InvestmentEarningsOrLossesAmt
Administrative Expenses$41,004AdministrativeExpensesAmt
End Year Balance$146,584EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.40929PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.59071TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,437,032OtherCostOrOtherBasisAmt
Book Value$2,437,032BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$28,646,355OtherCostOrOtherBasisAmt
Depreciation$5,478,002DepreciationAmt
Book Value$23,168,353BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$675,974OtherCostOrOtherBasisAmt
Depreciation$85,154DepreciationAmt
Book Value$590,820BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,928,773OtherCostOrOtherBasisAmt
Depreciation$1,406,039DepreciationAmt
Book Value$522,734BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$169,136OtherCostOrOtherBasisAmt
Depreciation$139,738DepreciationAmt
Book Value$29,398BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$26,748,337TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO RELATED PARTIES$2,545,158
DUE TO THIRD PARTY$60,726
DEFERRED COMP LIABILITY$98,570
FieldValueIRS element (for citing)
Total Liability$2,704,454TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$16,733,910TotalRevEtcAuditedFinclStmtAmt
Other Revenue$79,095OtherRevenueAmt
Revenue Not Reported$79,095RevenueNotReportedAmt
Revenue Subtotal$16,654,815RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$16,654,815TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$15,839,654TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$79,095OtherExpensesIncludedAmt
Expenses Not Reported$79,095ExpensesNotReportedAmt
Expenses Subtotal$15,760,559ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$15,760,559TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 1B:THE ORGANIZATION HAS FIDUCIARY CONTROL OF THE PERSONAL NEEDS ACCOUNT HELD FOR THE BENEFIT OF THE RESIDENTS.
PART V, LINE 4:THE ORGANIZATION'S ENDOWMENT IS HELD BY A RELATED ORGANIZATION, SOUTH COVE NURSING FACILITIES FOUNDATION, INC. IN ACCORDANCE WITH THE DONOR REQUIREMENTS, THE ENDOWMENT FUNDS ARE HELD IN PERPETUITY. ENDOWMENT RETURNS MAY BE USED FOR THE APPRECIATION EVENTS FOR THE EMPLOYEES OF THE NURSING HOME OPERATOR.
PART X, LINE 2:BELOW IS AN EXCERPT FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR SOUTH COVE MANOR NURSING AND REHABILITATION CENTER, INC. AND SUBSIDIARIES: THE FOUNDATION, PARENT, AND QALICB ARE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INVESTMENT FUND IS A SINGLE MEMBER LLC AND ANY EARNINGS OR LOSSES ARE INCLUDED ON THE PARENT'S TAX-EXEMPT TAX RETURN. THE ORGANIZATION FOLLOWS THE GUIDANCE OF ACCOUNTING STANDARDS CODIFICATION (ASC) 740, ACCOUNTING FOR INCOME TAXES, RELATED TO THE UNCERTAINTIES IN INCOME TAXES, WHICH PRESCRIBES A THRESHOLD OF MORE LIKELY THAN NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS EVALUATED THE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN, IF ANY, ON ITS EXEMPT ORGANIZATION FILINGS, AND THE LIKELIHOOD THAT UPON EXAMINATION THOSE POSITIONS WOULD BE SUSTAINED. BASED ON THE RESULTS OF THIS EVALUATION, MANAGEMENT DETERMINED THERE ARE NO POSITIONS THAT NECESSITATE DISCLOSURES AND/OR ADJUSTMENTS. THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES DURING THE PERIODS COVERED BY THESE FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX RETURNS COULD BE SUBJECT TO EXAMINATION BY TAXING AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO SUCH EXAMINATIONS PENDING OR IN PROGRESS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:LOSS FROM EARLY RETIREMENT OF HOT WATER HEATER 79,095.
PART XII, LINE 2D - OTHER ADJUSTMENTS:LOSS FROM EARLY RETIREMENT OF HOT WATER HEATER 79,095.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WILLIAM GRAVES
PRESIDENT/CEO$208,800$0$46,000$0$0$0$0$0$11,215$0$266,015$0$0$0
LI CHEN
ADMINISTRATOR$137,319$0$20,000$0$0$0$8,032$0$11,215$0$176,566$0$0$0
SHINJA CHOI
RN$153,283$0$0$0$0$0$3,262$0$4,276$0$160,821$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationLI CHEN RECEIVED $4,011 FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MASS DEVELOPMENT FINANCE AGENCYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN043431814BondIssuerEIN
CUSIPNONEAVAILCUSIPNum
Bond Issued2012-10-30BondIssuedDt
Issue Price$19,000,000IssuePriceAmt
PurposeLAND ACQUISITION AND FACILITY COSTSPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$2,913,341RetiredAmt
Total Proceeds$19,000,000TotalProceedsAmt
In Reserve Fund$252,483InReserveFundAmt
Issuance Costs From Proceeds$100,640IssuanceCostsFromProceedsAmt
Capital Expenditures$18,600,277CapitalExpendituresAmt
Other Spent Proceeds$46,600OtherSpentProceedsAmt
Substantial Completion2014SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts0EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART II, LINE 11THE AMOUNT OF OTHER SPENT PROCEEDS ON LINE 11 REPRESENT ISSUER'S ADMINISTRATIVE FEE
PART III, LINE 3AMANAGEMENT AND SERVICE CONTRACTS IN THE BOND FINANCED SPACE FALL UNDER THE SAFE HARBOR PROVIDED BY REVENUE PROCEDURE 2016-44 AND WILL NOT RESULT IN PRIVATE BUSINESS USE.
PART III, LINE 3CTHE ORGANIZATION HAS BOND COUNSEL WHICH IT USES TO REVIEW CONTRACTS ON AN AS NEEDED BASIS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE CONSISTS OF ALL VOTING DIRECTORS WHO ARE ALSO OFFIERS OR COMMITTEE CHAIRS. THE EXECUTIVE COMMITTEE HAS FULL AUTHORITY BETWEEN BOARD SESSIONS, IF NEEDED.
FORM 990, PART VI, SECTION A, LINE 2A FAMILY RELATIONSHIP EXISTS BETWEEN MAY CHIN, VICE PRESIDENT; THOMAS CHIN, DIRECTOR; AND HELEN CHIN SCHLICHTE, DIRECTOR.
FORM 990, PART VI, SECTION B, LINE 11BTHE ORGANIZATION'S AUDIT COMMITTEE REVIEWS AND APPROVES THE DRAFT FORM 990. THE COMPLETE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS BEFORE FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS PART OF THE ORGANIZATION'S BY-LAWS AND IS DISCUSSED BY THE BOARD OF DIRECTORS AND TOP MANAGEMENT PERSONNEL AT THE FIRST BOARD METTING EACH YEAR REGARDING ANY/ALL SIGNIFICANT TRANSACTIONS. THE CONFLICT OF INTEREST POLICY COVERS DIRECTORS, OFFICERS, AND EMPLOYEES. ANY CONFLICTS OF INTEREST ARE DISCLOSED TO THE BOARD PRIOR TO APPROVAL OR RATIFICATION OF THE CONTRACT OR TRANSACTION BY MAJORITY VOTE OF THE DISINTERESTED PERSONS. THE CEO, ADMINISTRATOR AND FINANCE DIRECTOR ARE TASKED WITH OVERSEEING THE DISBURSEMENTS AND CONTRACT MANGAEMENT FUNCTIONS AND MONITORING FOR ANY CONFLICTING RELATIONSHIP WITH THE ORGANIZATION. ALL BOARD MEMBERS ARE AWARE OF THE NEED TO NOTIFY THE BOARD AND MANAGEMENT TEAM OF ANY CONFLICTS. THE BOARD IS NOTIFIED WHEN A CONFLICT OF INTEREST MIGHT OCCUR. SHOULD AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST PRESENT ITSELF, THE MANAGEMENT TEAM IS FULLY PREPARED TO ASK THE BOARD TO CONSIDER APPROPRIATE ACTION
FORM 990, PART VI, SECTION B, LINE 15THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CEO AND TOP MANAGEMENT INCLUDES A COMPARABILITY STUDY, APPROVAL BY THE COMPENSATION COMMITTEE, AND DOCUMENTATION OF THE DELIBERATION OF THE DECISION DONE IN EXECUTIVE SESSION.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:EQUITY TRANSFER 45,642.
FORM 990, PART XII, LINE 2C:PROCESS IS UNCHANGED FROM PRIOR YEAR

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE INVESTMENT FUND LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1288 WASHINGTON STREETAddressLine1Txt
CityQUINCYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02169ZIPCd
FieldValueIRS element (for citing)
EIN461020387EIN
Primary ActivitiesNMTC FINANCING VEHICLEPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE MANOR NURSING AND REHABILITATION CENTERBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE NURSING FACILITIES FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1288 WASHINGTON STREETAddressLine1Txt
CityQUINCYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02169ZIPCd
FieldValueIRS element (for citing)
EIN046406242EIN
Primary ActivitiesNURSING AND CARE FACILITIESPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12A, IPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE MANOR NURSING AND REHABILITATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE REALTY COMPANY LIMITED PARTNERSHIPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1288 WASHINGTON STREETAddressLine1Txt
CityQUINCYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02169ZIPCd
FieldValueIRS element (for citing)
EIN042820700EIN
Primary ActivitiesREAL ESTATE - OPERATIONS CEASED 2014PrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE NURSING FACILITIES FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE MANOR INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1288 WASHINGTON STREETAddressLine1Txt
CityQUINCYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02169ZIPCd
FieldValueIRS element (for citing)
EIN042820772EIN
Primary ActivitiesNURSING HOMEPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SOUTH COVE NURSING FACILITIESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SOUTH COVE NURSING FACILITIES FOUNDATION INC
C$45,642INTERCOMPANY TRANSFER
SOUTH COVE NURSING FACILITIES FOUNDATION INC
N$1,905,652INTERCOMPANY LOAN

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM R, PART IIISOUTH COVE REALTY COMPANY LIMITED PARTNERSHIP WAS DISSOLVED IN JANUARY 2021.
FORM R, PART IVSOUTH COVE MANOR WAS DISOLVED IN JANUARY 2021.
FORM R, PART V, LINE 1AMOUNT REPRESENTED ON LINE 2, COLUMN B, TRANSACTION TYPE, IS THE TOTAL AMOUNT FOR LINES 1L, M, N, O, Q, R, S.