2021-11-15T13:37:46-06:00 2020-12-31 111986323 MARCUM LLP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 990 2020-01-01 222843194 OVERLOOK MASONIC HEALTH CENTER INC OVER 5082487344 88 MASONIC HOME ROAD CHARLTON MA 01507 TAMERYN CAMPBELL CEO/PRESIDENT 5082487344 2021-11-12 1 TAMERYN CAMPBELL 999009999 MARY ANTONETTI P00431862 2037819600 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z TAMERYN CAMPBELL 88 MASONIC HOME ROAD CHARLTON MA 01507 25202285 0 X HTTP://OVERLOOK-MASS.ORG X 1987 MA THE PROVISION OF LONG-TERM RESIDENTIAL AND REHABILITATIVE CARE TO RESIDENTS OF THE COMMUNITY. 9 8 423 17 0 0 190513 306839 22875495 23306946 349674 673663 2357083 383977 25772765 24671425 16949 2500 0 0 14125404 14753998 0 0 0 12013187 12208021 26155540 26964519 -382775 -2293094 147898889 147982116 11521453 11700155 136377436 136281961 TO PROVIDE THE RESIDENTS OF THE HEALTH CENTER WITH THE HIGHEST LEVEL OF COMPREHENSIVE MEDICAL CARE SERVICES WITH A CONSIDERATE AND PERSONAL TOUCH. 0 0 17576187 2500 23399935 OPERATION OF A LONG-TERM AND RESIDENTIAL CARE FACILITY IN CHARLTON, MA. TOTAL PATIENT DAYS OF CARE, TOTAL REST HOME DAYS OF CARE, AND TOTAL FIELDSTONE (ALMC) DAYS OF CARE FOR THE YEAR ENDED DECEMBER 31, 2020 AMOUNTED TO 38,662, 9,901, AND 4,447, RESPECTIVELY, FOR A TOTAL DAYS OF CARE OF 52,200. 17576187 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 123 0 1 423 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X X TAMERYN CAMPBELL 5084342412 88 MASONIC HOME ROAD CHARLTON MA 01507 RICHARD MAGGIO GRAND MASTER (FROM 1/1/2020) 0.15 0.45 X 0 0 0 KENNETH BLAKE MHS BOARD CHAIR 0.15 0.45 X 0 0 0 MASON RUSSELL GRAND TREASURER 0.15 0.45 X 0 0 0 ROBERT JOLLY CHAIR 0.15 0.30 X X 0 0 0 JACK MULHALL VICE CHAIR 0.15 0.15 X X 0 0 0 WILLIAM HOLLAND TREASURER 0.15 0.45 X X 0 0 0 DAVID PACE SECRETARY 0.15 0.45 X X 0 0 0 ROBERT SCHREMSER CLERK (FROM 1/1/2020) 0.15 0.45 X X 0 0 0 TAMERYN CAMPBELL PRESIDENT & CEO 40.00 0.45 X X 398990 0 66881 PAUL BOWLER PRESIDENT & CEO, BRIARWOOD 40.00 X 209387 0 18389 TED WILBUR CHIEF INFORMATION OFFICER 40.00 X 159004 0 24331 JOE SAVIDGE CHIEF FINANCIAL OFFICER 40.00 X 167999 0 21106 SUSAN EHRLICH-KEDMI CHIEF HUMAN RESOURCES (FROM 06/19/19) 40.00 X 154225 0 11138 1089605 0 141845 6 0 1 0 PREFERRED THERAPY SOLUTIONS 850 SILAS DEAN HIGHWAY WETHERSFIELD CT 06109 THERAPY/REHAB SERVICES 909152 PROFESSIONAL NURSES HEALTH SERVICES INC 425 SUNDERLAND ROAD WORCESTER MA 06104 AGENCY RN AND LPN LABOR 516843 CUSTOM COMPUTER SPECIALISTS INC PO BOX 29786 NEW YORK NY 100879786 IT SUPPORT 385895 PRO EMS SOLUTIONS INC 31 SMITH PLACE CAMBRIDGE MA 02138 BILLING, TECH, ADMIN SERVICES 198420 CLAY & ASSOCIATES 257 TURNPIKE ROAD SUITE 310 SOUTHBOROUGH MA 01772 LTC CONSULTING SERVICES 155316 8 306839 33126 306839 NET PATIENT REVENUE 623000 17916429 17916429 AFFILIATE MANAGEMENT FEE 900099 3665099 3665099 CARES ACT PROVIDER RELIEF FUNDS 624230 1725418 1725418 23306946 69663 69663 290988 0 290988 290988 290988 1134860 530860 604000 604000 604000 CAFETERIA REVENUE 900099 19921 19921 OTHER TENANT REVENUE 900099 17783 17783 GUEST MEALS REVENUE 900099 2622 2622 52663 52663 92989 24671425 23399935 0 964651 X 2500 2500 1183451 1183451 11089168 9243346 1845822 253708 200223 53485 1174345 952124 222221 1053326 797555 255771 1459311 1459311 102209 102209 47704 47704 110912 110912 3373020 228084 3144936 144343 144343 1762581 1236456 526125 841882 841882 22839 838 22001 62237 4289 57948 82712 82712 1417066 1372696 44370 347821 347821 NURSING PURCHASING SERV 839547 839547 DIETARY SERVICES 753544 753544 EQUIP RENTAL & MAINT 402351 351120 51231 BAD DEBT EXPENSE 314332 314332 123610 89830 33780 26964519 17576187 9388332 0 568076 41371 1678438 1279774 371421 747013 64254525 46780172 18218306 17474353 22094151 24272112 104968497 104167493 147898889 147982116 2889599 2451684 1291553 1292218 7340301 7956253 11521453 11700155 X 123267000 121326971 13110436 14954990 136377436 136281961 147898889 147982116 X -2293094 2299621 -102002 X X 0 1 X 1 0 X 192183 157742 345475 190513 306839 1192752 24459645 20985319 21483512 22875495 23306946 113110917 24651828 21143061 21828987 23066008 23613785 114303669 0 0 0 114303669 452638 531163 573397 455869 360651 2373718 452638 531163 573397 455869 360651 2373718 2058583 92989 2151572 25104466 21674224 22402384 25580460 24067425 118828959 0.96190 0.96430 0.02000 0.01670 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISC INCOME - 2019 AMOUNT: $ 2,058,583. 2020 AMOUNT: $ 92,989. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22109679 329674 2868492 1020205 24287640 19644993 805705 3140400 1481419 22109679 55155848 1664971 -1508578 35667248 19644993 54967835 178526 24740 15253 55155848 54967835 54967835 0.38362 0.23594 0.38045 0 0 336084 336084 46452051 33126218 13325833 9957162 7972599 1984563 7509228 5681355 1827873 17474353 MASONIC EDUCATION AND CHARITY TRUST INVESTMENT FUND 24272112 C 24272112 DUE FROM AFFILIATES 103940539 OTHER RECEIVABLES 225719 DUE FROM GRAND LODGE 1235 104167493 DUE TO AFFILIATES 5624158 DUE TO RESIDENTS 50890 ASSET RETIREMENT OBLIGATION 888543 PENSION LIABILITY 1392662 7956253 X 24701248 2299621 -314332 1985289 22715959 110912 1844554 1955466 24671425 26539275 0 26539275 110912 314332 425244 26964519 PART V, LINE 4: THE ORGANIZATION HAS AN ENDOWMENT WHICH IS HELD IN THE MASONIC EDUCATION AND CHARITY TRUST. FUNDS ARE SPENT FROM THE ENDOWMENT WHEN NEEDED FOR OPERATIONS OR CAPITAL IMPROVEMENTS. PART X, LINE 2: BELOW IS AN EXCERPT FROM FOOTNOTE 2 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. MHS, HEALTH CENTER, OVNA, COMMUNITIES, AND NORTHAMPTON HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2020 AND 2019, THERE ARE NO TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS PENDING OR IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -314,332. PART XI, LINE 4B - OTHER ADJUSTMENTS: DONOR RESTRICTED ACTIVITY 1,844,554. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 314,332. X X X X 0 0 0 0 0 0 0 0 0 TAMERYN CAMPBELL PRESIDENT & CEO 345512 0 50640 0 2838 0 5700 0 13181 48000 417871 48000 0 0 PAUL BOWLER PRESIDENT & CEO, BRIARWOOD 174272 0 27452 0 7663 0 0 0 18389 0 227776 0 0 0 TED WILBUR CHIEF INFORMATION OFFICER 144142 0 12790 0 2072 0 3342 0 20989 0 183335 0 0 0 JOE SAVIDGE CHIEF FINANCIAL OFFICER 155159 0 11522 0 1318 0 0 0 21106 0 189105 0 0 0 SUSAN EHRLICH-KEDMI CHIEF HUMAN RESOURCES (FROM 06/19/19 152243 0 640 0 1342 0 1684 0 9454 0 165363 0 0 0 PART I, LINE 1A TAMERYN CAMPBELL RECEIVED A HOUSING ALLOWANCE FROM A RELATED ORGANIZATION (OC) WITH AN ESTIMATED VALUE OF $48,000 DURING THE YEAR ENDING DECEMBER 31, 2020. THIS WAS REPORTED AS A NONTAXABLE BENEFIT TO TAMERYN. X 8 33126 COMPARABLE INVOICES FROM 0 0 0 0 PART I, COLUMN (B): THE NUMBER IN COLUMN B IS THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION A, LINE 6 THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. IS THE SOLE MEMBER OF THE ORGANIZATION AND ELECTS THE BOARD OF DIRECTORS. THERE ARE NO CLASSES OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. HAS THE POWER TO REMOVE DIRECTORS, TO FILL VACANCIES, AND TO INCREASE OR DECREASE THE SIZE OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. HAS THE POWER TO REMOVE DIRECTORS, TO FILL VACANCIES, AND TO INCREASE OR DECREASE THE SIZE OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT WORKS WITH THE ORGANIZATION'S TAX ADVISOR (CPA FIRM) TO PREPARE THE FINANCIAL INFORMATION AND COMPILE THE DISCLOSURES REQUIRED OF THE FORM 990. UPON ITS COMPLETION, SENIOR MANAGEMENT PROVIDES A DRAFT OF THE FORM 990 TO THE BOARD OF DIRECTORS PRIOR TO ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY VIA ANNUAL EXECUTION OF THE CONFLICT OF INTEREST POLICY. THIS CONFLICTS POLICY IS INTENDED TO SUPPLEMENT, BUT NOT REPLACE, ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE CORPORATIONS. THIS CONFLICTS POLICY HAS BEEN ADOPTED BY THE BOARD OF DIRECTORS OF MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. (MHS). THIS CONFLICTS POLICY SHALL APPLY WITH EQUAL FORCE TO ALL CORPORATIONS RELATED TO, OR AFFILIATED WITH, MHS. ON AN ANNUAL BASIS THE DIRECTORS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REVIEWED BY THE PRESIDENT'S OFFICE. IF A CONFLICT ARISES, THE INDIVIDUAL WOULD RECUSE THEMSELVES FROM ALL DISCUSSION ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S SOLE MEMBER, MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. MAINTAINS AN EXECUTIVE COMMITTEE, WHICH AMONG OTHER THINGS, REVIEWS THE COMPENSATION AND TERMS OF THE AGREEMENT WITH ITS EXECUTIVE OFFICER. THE COMMITTEE REVIEWS THE COMPENSATION OF THE INDIVDIUAL IN RELATION TO THE SALARY LEVEL OF OTHER COMPARABLE POSITIONS IN THE MARKET AND THEIR PERFORMANCE. ONCE REASONABLE COMPENSATION IS DETERMINED, IT IS APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST AND CAN BE FOUND ONLINE VIA THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 170,384. MANAGEMENT AND GENERAL EXPENSES 165,832. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 336,216. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 55,200. MANAGEMENT AND GENERAL EXPENSES 56,231. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 111,431. RECRUITMENT FEES: PROGRAM SERVICE EXPENSES 2,500. MANAGEMENT AND GENERAL EXPENSES 38,775. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,275. MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 80,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,000. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 101,387. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 101,387. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,218,244. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,218,244. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 484,467. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 484,467. FORM 990, PART XI, LINE 9: ADJUSTMENT TO MINIMUM PENSION LIABILITY -102,002. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC 88 MASONIC HOME ROAD CHARLTON MA 01507 043515688 PARENT MA 501(C)(3) LINE 12C, III-FI N/A 0 OVERLOOK VISITING NURSES ASSOCIATION 88 MASONIC HOME ROAD CHARLTON MA 01507 043515687 VNA MA 501(C)(3) LINE 10 MASONIC HEALTH SYSTEM OF MASSACHUSETTS 0 OVERLOOK COMMUNITES INC 88 MASONIC HOME ROAD CHARLTON MA 01507 043515686 NURSING FACILITY MA 501(C)(3) LINE 10 MASONIC HEALTH SYSTEM OF MASSACHUSETTS 0 0 0 0 1 1 0 0 0 0 1 0 1 1 1 1 0 0 0 0