2025-07-21T11:22:35-05:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2024-01-01 042135768 THE HANNAH BG SHAW HOME INC HANN 5089471184 299 WAREHAM STREET MIDDLEBORO MA 02346 DAVID WYLIE PRESIDENT 5089471184 2025-07-18 1 0 KATARZYNA O PADZIK P02268641 7819821001 2025-07-18 2024 2025-03-06 01:10:19Z DAVID WYLIE 299 WAREHAM STREET MIDDLEBORO MA 02346 16796191 0 X WWW.THESHAWHOME.ORG X 1938 MA TO PROVIDE SKILLED NURSING, REHABILITATIVE, MEMORY CARE, AND RESIDENTIAL CARE. 5 5 226 20 0 0 1008436 904514 12431494 13246533 215519 1042850 92990 0 13748439 15193897 0 0 0 0 9011276 8792290 0 0 0 5522125 5664195 14533401 14456485 -784962 737412 21240567 20294107 12228688 10590795 9011879 9703312 X THE HANNAH BG SHAW HOME, INC. IS A NON-PROFIT COMMUNITY DEDICATED TO PROVIDING THE HIGHEST QUALITY SKILLED NURSING, REHABILITATIVE, MEMORYCARE, AND RESIDENTIAL CARE TO LEND COMFORT AND SUPPORT TO FAMILIES. INKEEPING WITH THE VALUES AND TRADITION OF OUR FOUNDER, HANNAH B.G. SHAW, WE ARE COMMITTED TO PROVIDING COMPASSIONATE CARE AND RECOGNIZINGINDIVIDUAL NEEDS WHILE RESPECTING THE DIGNITY AND PERSONAL CHOICES OFEACH MEMBER OF OUR COMMUNITY. 0 0 12846193 0 13246533 THE HANNAH BG SHAW HOME, INC. IS A 40-BED RESIDENTIAL CARE AND 67-BED SKILLED NURSING FACILITY LOCATED IN MIDDLEBORO, MASSACHUSETTS. FOUNDED UPON THE DEATH OF ITS BENEFACTRESS, THE LATE HANNAH BARTLETT GRIFFITH SHAW, THE HOME OPENED ITS DOORS TO FIFTEEN RESIDENTS IN 1941 AS A NOT-FOR-PROFIT CORPORATION. THE WILL OF HANNAH SHAW STATED THAT THE HOME WAS TO BENEFIT SENIORS WHO WERE UNABLE TO CARE FOR THEMSELVES. 12846193 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 15 0 226 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 1 0 MA X KRISTINE DONNELLY 5089470332 299 WAREHAM STREET MIDDLEBORO MA 02346 DAVID WYLIE PRESIDENT 3.00 1.00 X X 11500 3750 0 TIMOTHY COE TREASURER 1.00 1.00 X X 8500 3750 0 DEBRA BLAIS DIRECTOR 1.00 1.00 X 2500 3750 0 SUSAN OKOLITA DIRECTOR 1.00 0.00 X 2500 0 0 BARBARA HOWARD SECRETARY 1.00 0.00 X X 7500 0 0 KRISTINE DONNELLY EXECUTIVE DIRECTOR 40.00 0.00 X 164352 0 56350 NANCY ALPHONSE DIRECTOR OF NURSING SERVICES 40.00 0.00 X 131852 0 11724 328704 11250 68074 1 0 1 0 PREFERRED THERAPY SOLUTIONS LLC PO BOX 69363 BALTIMORE MD 212649363 THERAPY SERVICES 577810 INTELYCARE INC PO BOX 787317 PHILADELPHIA PA 191787317 AGENCY NURSING 572147 DIAMOND MECHANICAL INC 723 WASHINGTON STREET WEYMOUTH MA 02188 HVAC SERVICES 409683 DALTO CONSULTING INC 32100 TELEGRAPH ROAD SUITE 145 BINGHAM FARMS MI 48025 MANAGEMENT & FINANCIAL 212694 CONNECTRN INC PO BOX 8086 CAROL STREAM IL 601978086 AGENCY NURSING 205384 5 881894 22620 904514 PATIENT REVENUE 623000 13185500 13185500 HAIRDRESSER REVENUE 623000 47398 47398 13635 13635 13246533 115835 115835 1532362 996947 1252654 349640 279708 647307 927015 927015 15193897 13246533 0 1042850 253202 253202 7200391 6688199 512192 19933 19379 554 734154 713376 20778 584610 528574 56036 241644 241644 51050 51050 79695 79695 35250 35250 1162647 1159209 3438 8679 8679 137282 25045 112237 145654 144198 1456 318618 315432 3186 407056 402985 4071 745068 737617 7451 181722 167204 14518 ANCILLARIES & OTHER MED 1269441 1269441 FOOD 434309 434309 USER FEES 151030 151030 PROVISION FOR CREDIT LO 94834 94834 200216 90195 110021 14456485 12846193 1610292 0 246035 567086 92036 241581 889705 913226 152663 160151 27660021 13021181 15306912 14638840 3760974 3174068 118291 118291 673951 480864 21240567 20294107 1049724 730402 11178964 9860393 12228688 10590795 X 9011879 9703312 9011879 9703312 21240567 20294107 X 737412 -14898 -31081 X 0 1 X 1 0 X 1192672 2441025 907128 1008436 904514 6453775 10238139 9968885 11277415 12431494 13246533 57162466 11430811 12409910 12184543 13439930 14151047 63616241 288189 267748 296278 911423 881894 2645532 0 288189 267748 296278 911423 881894 2645532 60970709 112777 152997 118970 113395 115385 613524 112777 152997 118970 113395 115385 613524 26177 30703 63443 92990 213313 11569765 12593610 12366956 13646315 14266432 64443078 0.94610 0.95110 0.00950 0.00970 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 26,177. 2021 AMOUNT: $ 30,703. 2022 AMOUNT: $ 63,443. 2023 AMOUNT: $ 92,990. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18608097 2630698 943504 20295291 17320538 2256547 968988 18608097 20317202 -2689335 307329 17320538 17044098 3551607 278503 20317202 15505977 1836890 298769 17044098 0.04750 0.95250 0 1 1 10500 10500 23739962 10020088 13719874 1752685 1617647 135038 2156874 1383446 773428 14638840 X PART V, LINE 4: IN ACCORDANCE WITH THE DONOR REQUIREMENTS, THE ENDOWMENT FUNDS ARE HELD IN PERPETUITY BY TRUSTEES UW HANNAH B.G. SHAW, A RELATED ORGANIZATION, UNTIL APPROPRIATED FOR EXPENDITURE TO BE USED FOR GENERAL PURPOSES OF THE ORGANIZATION. PART X, LINE 2: THE CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A PROVISION FOR INCOME TAXES BECAUSE THE ORGANIZATIONS HAVE BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND APPLICABLE STATE CODES. 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, 2024 AND 2023. X X 0 0 0 0 0 0 0 0 0 KRISTINE DONNELLY EXECUTIVE DIRECTOR 154352 0 10000 0 0 0 1500 0 54850 0 220702 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES THAT CAN ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY TAX ADVISORS OF A NATIONAL ACCOUNTING FIRM WITH INFORMATION PROVIDED BY MANAGEMENT. THE BOARD IS RESPONSIBLE AND REVIEWS THE 990 FOR COMPLETENESS AND ACCURACY. THE COMPLETE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S POLICY IS THAT NO INDIVIDUAL ON THE BOARD OF DIRECTORS SHOULD HAVE ANY UNDISCLOSED CONFLICT OF INTEREST WITH THE ORGANIZATION. ACTIVE MONITORING THROUGHOUT THE YEAR IS CONDUCTED BY THE EXECUTIVE DIRECTOR, WHO REPORTS WHEN ANY CONFLICT OF INTEREST IS IDENTIFIED FOR PROPER RESOLUTION BY THE EXECUTIVE DIRECTOR OR BOARD OF DIRECTORS. MONITORING IS ALSO DONE VIA YEARLY ATTESTATION BY ALL BOARD MEMBERS AND CONFLICTS WOULD BE DEALT WITH AT THAT LEVEL. THE BOARD OF DIRECTORS' CLERK WILL COLLECT ALL ATTESTATIONS AND REVIEW. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST, THAT INDIVIDUAL MUST ABSTAIN FROM VOTING ON ANY MATTERS RELATED TO THAT CONFLICT. IN ANY MATTER THAT WOULD RESULT IN A CONFLICT OF INTEREST, SUCH INDIVIDUALS ARE NOT PERMITTED TO PARTICIPATE IN THE DECISION MAKING PROCESS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR'S SALARY IS REVIEWED ANNUALLY BY THE ENTIRE BOARD, THE BOARD UTILIZES COMPARABILITY DATA AND THERE IS CONTEMPORANEOUS DOCUMENTATION OF DECISION. THE EXECUTIVE DIRECTOR RECOMMENDS OTHER OFFICER SALARIES THROUGH UTILIZING THE SAME TYPE OF INFORMATION FOR COMPENSATION ANALYSIS AND THESE AMOUNTS ARE THEN REVIEWED AND APPROVED BY THE BOARD. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: LOSS ON DERIVATIVE FINANCIAL INSTRUMENT -31,081. TRUSTEES UW HANNAH BG SHAW 299 WAREHAM STREET MIDDLEBORO MA 02346 046045460 SUPPORTING ORGANIZATION FOR THE BENEFIT OF THE HANNAH BG SHAW HOME, INC. MA 501(C)(3) LINE 12C, III-FI THE HANNAH BG SHAW HOME INC 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TRUSTEES UW HANNAH BG SHAW C 881894 COST TRUSTEES UW HANNAH BG SHAW D 161388 COST