2021-11-15T10:43:32-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2020-01-01 208745264 FAIRHAVEN HEALTHCARE CENTER INC C/O ATHENA HEALTH CARE ASSOCIATES FAIR 9784583388 476 VARNUM AVE LOWELL MA 01854 RAYMOND DENEHEY PRESIDENT 9784583388 2021-11-15 1 RAYMOND DENEHEY 999009999 JONATHAN LANGFIELD P00562148 7819821001 2021-11-15 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z RAYMOND DENEHEY 476 VARNUM AVE LOWELL MA 01854 14216975 0 X WWW.FAIRHAVEN-NURSING.COM X 2007 MA IT IS THE MISSION OF FAIRHAVEN HEALTHCARE CENTER, INC. TO PROVIDE ELDERS WITH DYNAMIC, MEANINGFUL AND SUPPORTIVE LIVING ENVIRONMENTS, INTEGRATING QUALITY CARE, EDUCATION AND RESEARCH, RESPECT FOR INDIVIDUALITY AND THE HUMAN SPIRIT, AND INNOVATIVE APPPROACHES TO MEET THE EVER CHANGING NEEDS OF THE COMMUNITIES WE SERVE. 7 5 229 7 0 0 0 2016075 15073050 12189866 70201 11034 0 0 15143251 14216975 0 0 0 0 9407606 9500658 0 0 0 7715547 7312703 17123153 16813361 -1979902 -2596386 23100413 25516833 29270544 34283350 -6170131 -8766517 X IT IS THE MISSION OF FAIRHAVEN HEALTHCARE CENTER, INC. TO PROVIDE ELDERS WITH DYNAMIC, MEANINGFUL AND SUPPORTIVE LIVING ENVIRONMENTS, INTEGRATING QUALITY CARE, EDUCATION AND RESEARCH, RESPECT FOR INDIVIDUALITY AND THE HUMAN SPIRIT, AND INNOVATIVE APPROACHES TO MEET THE EVER CHANGING NEEDS OF THE COMMUNITIES WE SERVE. 0 0 15042203 0 12189866 FAIRHAVEN HEALTHCARE CENTER IS A 169-BED, JCAHO ACCREDITED AND MEDICARE CERTIFIED HEALTHCARE FACILITY OFFERING TRADITIONAL SKILLED NURSING CARE, SHORT-TERM REHABILITATION, PLUS A VARIETY OF SPECIALIZED TREATMENT PROGRAMS. 15042203 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 17 0 229 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 5 1 1 0 0 1 1 1 1 1 0 0 1 0 0 0 0 0 0 MA X MICHAEL MOSIER 8607513900 135 SOUTH RD FARMINGTON CT 06032 MICHAEL TAKESIAN ADMINISTRATOR 40.00 X 169860 0 10496 EMILY GETCHELL DNS 40.00 X 149089 0 0 GEORGE BARBUZZI ADMINISTRATOR 40.00 X 0 125215 0 DEBORAH LISIECKI REHAB DIRECTOR 40.00 X 119869 0 0 SUSAN BREEN PHYSICAL THERAPIST 40.00 X 115696 0 9740 RAYMOND DENNEHY PRESIDENT 1.00 2.00 X X 0 60000 0 DAVID O'DONNELL TREASURER 1.00 2.00 X X 0 0 0 GINA QUEIROS DIRECTOR 1.00 2.00 X 0 0 0 JOEL KIRCHIK DIRECTOR 1.00 2.00 X 0 0 0 MICHAEL MOORE DIRECTOR 1.00 2.00 X 0 0 0 JEFFREY WITHERELL DIRECTOR 1.00 2.00 X 0 0 0 ROBERT GREER VANTUYL DIRECTOR 1.00 2.00 X 0 0 0 554514 185215 20236 8 0 1 0 ATHENA HEALTH CARE SYSTEMS 35 AVCO ROAD HAVERHILL MA 01835 MANAGEMENT COMPANY 622030 CLEAN FACILITY 846 LEXINGTON STREET 6 WALTHAM MA 02452 HOUSEKEEPING AND LAUNDRY SERVICES 615501 PARTNERS PHARMACY 6 THOMPSON RD EAST WINDSOR CT 06088 PHARMACY SERVICES 336361 3 2016075 2016075 PROGRAM SERVICE REVENUE 623000 12189866 12189866 12189866 11034 11034 14216975 12189866 0 11034 8435681 7995425 440256 455626 431847 23779 609351 577549 31802 365537 365537 99710 99710 37466 37466 780657 647944 132713 2013 2013 232330 42242 190088 222514 222514 233 233 1800603 1800603 751649 751649 227582 31180 196402 MEDICAL SUPPLIES 1436248 1436248 STATE ASSSESSMENT 906207 906207 BAD DEBTS 231277 231277 FOOD 198795 198795 19882 19882 16813361 15042203 1771158 0 449215 701 140 2983908 486112 892636 92696 164104 23799444 8255075 16089766 15544369 2932083 2932083 3050401 2999032 23100413 25516833 2775029 4203200 25734717 25785976 760798 760798 1675968 0 1857408 29270544 34283350 X -6170131 -8766517 -6170131 -8766517 23100413 25516833 -2596386 0 X 0 0 0 X 2016875 2016875 14740246 14712230 15418194 15073050 12189866 72133586 14740246 14712230 15418194 15073050 14206741 74150461 0 0 0 74150461 26985 26901 61220 70201 11034 196341 26985 26901 61220 70201 11034 196341 14767231 14739131 15479414 15143251 14217775 74346802 0.99740 0.99730 0.00260 0.00270 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1958000 1958000 20048645 6840406 13208239 1653005 1274875 378130 139794 139794 0 15544369 ESCROW 2514444 TRUSTEE FUNDS HELD - BOND INDENTURE 484588 2999032 MEDICARE COST SETTLEMENT 450000 DUE FROM RELATED PARTY 1407408 1857408 X 0 0 0 0 0 0 0 0 0 MICHAEL TAKESIAN ADMINISTRATOR 169860 0 0 0 0 0 0 0 10496 0 180356 0 0 0 A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A 043431814 57585AAA8 2007-10-25 1982687 PURCHASE FACILITIES 0 0 0 B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A 043431814 57585AAB6 2007-10-25 8051140 PURCHASE FACILITIES 0 0 0 C MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A 043431814 57585AAC4 2007-10-25 14755407 PURCHASE FACILITIES 0 0 0 D MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007D 043431814 2007-10-25 2038290 PURCHASE FACILITIES 0 0 0 A 200439 1982687 1189273 793414 2007 0 0 1 1 B 801757 8051140 2867753 5183387 2007 0 0 1 1 C 1503295 14755407 14755407 2007 0 0 1 1 D 2038290 19338 2018952 2007 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 D 0 1 0 0 0 0 0 0 A 0 B 0 C 0 D 0 A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2010 043431818 2010-07-14 2640000 PROJECT REHAB 0 0 0 A 2640000 2640000 2010 0 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 A 0 JOEL KIRCHIK BOD MEMBER 4898 BOD MEMBER IS AN OWNER OF MOBILEX WHICH PROVIDES MEDICAL SERVICES TO THE ORGANIZATION. 0 FORM 990, PART VI, SECTION A, LINE 2 DIRECTOR, JOEL KIRCHIK HAS A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 IN MAY 1, 2018 THE ORGANIZATION HAS ENTERED INTO A MANAGEMENT AGREEMENT, WITH ATHENA HEALTH CARE ASSOCIATES INC TO MANAGE THE OPERATIONS OF FAIRHAVEN HEALTHCARE CENTER, INC. ACTING THROUGH THE NURSING FACILITY EMPLOYEES, TO SUPERVISE, DIRECT AND CONTROL THE DAY-TO-DAY BUSINESS ACTIVITIES AND MANAGEMENT OF THE NURSING FACILITY. ATHENA HEALTH CARE ASSOCIATES INC PREPARE AND FILE, ALL COST REPORTS, PAYROLL TAX AND REAL ESTATE TAX FILINGS REQUIRED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS A RELATED ORGANIZATION, ADVENTCARE, INC. FORM 990, PART VI, SECTION A, LINE 7A THE APPROVAL OF THE MEMBER, ADVENTCARE, INC., IS REQUIRED TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS AND RESPONSIBILITIES ARE EXPRESSLY RESERVED TO ADVENTCARE, INC., THE MEMBER OF THE CORPORATION: (A) TO ELECT AND REMOVE DIRECTORS OF THE CORPORATION WITH OR WITHOUT CAUSE. ANY VACANCY OCCURRING AMONG THE DIRECTORS WILL BE FILLED BY ACTION OF THE MEMBER; (B) TO APPROVE THE ANNUAL OPERATING BUDGET OF THE CORPORATION; (C) TO CONDUCT FINANCIAL PLANNING, MONITOR AND ASSURE LONG-TERM FINANCIAL PERFORMANCE OF THE CORPORATION; (D) TO APPROVE THE PURCHASE, ACQUISITION, ASSIGNN1ENT, SALE, CONVEYANCE OR MORTGAGE OF REAL PROPERTY; (E) TO APPROVE THE INCURRENCE BY THE CORPORATION OF ANY INDEBTEDNESS FOR BORROWED MONEY; (F) TO APPROVE CONTRACTS FOR MANAGEMENT SERVICES; (G) TO APPROVE ANY CAPITAL EXPENDITURES NOT SHOWN ON THE ANNUAL BUDGET WHICH EXCEED $10,000 FOR ANY EXPENDITURE; (H) TO APPROVE ALL CORPORATE REORGANIZATIONS AND THE ESTABLISHMENT OF OR INVESTMENT IN JOINT VENTURES, CORPORATIONS, PARTNERSHIPS, OTHER ENTITIES OR AFFILIATIONS; (I) TO APPROVE INITIATION OR SETTLEMENT OF LITIGATION OR ADMINISTRATIVE PROCEEDINGS TO WHICH THE CORPORATION IS OR MAY BE A PARTY; (J) TO APPROVE ANY AMENDMENTS TO THE ARTICLES OF ORGANIZATION OR BY-LAWS OF THE CORPORATION; (K) TO ENSURE THAT THE CORPORATION PURSUES A MISSION, PHILOSOPHY AND GOALS CONSISTENT WITH THOSE OF THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B A COMPLETE COPY OF THE FORM 990 TAX RETURN (INCLUDING ALL REQUIRED SCHEDULES) IS PROVIDED TO EACH PERSON WHO IS A VOTING MEMBER OF THE BOARD OF DIRECTORS AT THE TIME THE FORM 990 IS PROVIDED, EITHER IN PAPER OR ELECTRONIC FORM, BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE MSRB ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE. ADVENTCARE INC 476 VARNUM AVE LOWELL MA 01854 321012491 MANAGEMENT COMPANY MA 501(C)(3) LINE 10 N/A 0 LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY 25 LAFAYETTE STREET MARBLEHEAD MA 01945 208745166 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 ADVENTCARE INC 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0