2025-09-08T13:21:16-05:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP TWO INTERNATIONAL PLACE 22ND FLOOR BOSTON MA 02110 990 2024-01-01 050275443 SAINT ANTOINE RESIDENCE SAIN 4017673500 10 RHODES AVENUE NORTH SMITHFIELD RI 02896 GARRETT SULLIVAN EXECUTIVE DIRECTOR 4017673500 2025-09-08 1 0 KATARZYNA O PADZIK P02268641 7819821001 2025-09-08 2024 2025-03-06 01:10:19Z MSGR ALBERT A KENNEY ONE CATHEDRAL SQUARE PROVIDENCE RI 02903 21830623 0 X WWW.STANTOINE.NET X 1913 RI THE MISSION OF SAINT ANTOINE RESIDENCE IS TO CARE FOR THE SICK AND ELDERLY IN ADDITION TO REFLECTING THE CHURCH'S COMMITMENT AND SUPPORT FOR ALL HUMAN LIFE AND AFFIRMATION OF THE VALUE OF EACH PERSON REGARDLESS OF AGE OR PHYSICAL CONDITION IN A COMPASSIONATE, CARING AND CHRISTIAN ENVIRONMENT. 4 0 310 2 0 0 297231 447722 19269655 21245023 328298 83616 52583 7456 19947767 21783817 0 0 0 0 13992843 14034574 0 0 0 8755505 9626113 22748348 23660687 -2800581 -1876870 19368109 19538499 5659162 7693168 13708947 11845331 X THE MISSION OF SAINT ANTOINE RESIDENCE IS TO CARE FOR THE SICK AND ELDERLY IN ADDITION TO REFLECTING THE CHURCH'S COMMITMENT AND SUPPORT FOR ALL HUMAN LIFE AND AFFIRMATION OF THE VALUE OF EACH PERSON REGARDLESS OF AGE OR PHYSICAL CONDITION IN A COMPASSIONATE, CARING AND CHRISTIAN ENVIRONMENT. 1 0 20318182 0 20732168 SKILLED NURSING FACILITY: THE OPERATION OF A LONG-TERM CARE FACILITY FOR THE ELDERLY AND OTHER NEEDY INDIVIDUALS. DURING 2024, ST. ANTOINE RESIDENCE PROVIDED A TOTAL 62,530 OF PATIENT BED DAYS, INCLUDING 52,052 BED DAYS TO MEDICAID AND MEDICARE PATIENTS. 678896 0 512855 MEMORY CARE SERVICES:EFFECTIVE JULY 2024, THE ORGANIZATION PLACED A 10-UNIT 22-BED MEMORY CARE FACILITY INTO SERVICE, PROVIDING A TOTAL OF 1,870 PATIENT BED DAYS. 20997078 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 15 0 310 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 4 0 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X GARRETT SULLIVAN 4017673500 10 RHODES WAY NORTH SMITHFIELD RI 028966999 MOST REV RICHARD HENNING PRESIDENT/TREASURER UNTIL 10/24 1.00 39.00 X X 0 39150 26376 REV MSGR ALBERT A KENNEY VP UNTIL 10/24, PRESIDENT/TREASURER 1.00 39.00 X X 0 56963 31742 REV TIMOTHY D REILLY SECRETARY 1.00 39.00 X X 0 33096 20942 LAURA DOS SANTOS ASSISTANT TREASURER 12.00 28.00 X X 0 226011 19547 JAMES JAHNZ DIRECTOR 1.00 39.00 X 0 147677 14693 GARRETT E SULLIVAN EXECUTIVE DIRECTOR 40.00 0.00 X 191695 0 48294 KATHY KEELING DIRECTOR OF NURSING 40.00 0.00 X 140579 0 26616 VICTORIA ELUWA LICENSED PRACTICAL NURSE 40.00 0.00 X 114150 0 16286 RICHARD BERGERON LICENSED PRACTICAL NURSE 40.00 0.00 X 131077 0 32601 TAMMY DUQUETTE REGISTERED NURSE SUPERVISOR 40.00 0.00 X 110862 0 34516 PENNY FUCHS REGISTERED NURSE 40.00 0.00 X 115708 0 11288 804071 502897 282901 6 0 1 0 BENTLEY BUILDERS LLC 1160 POST RD WARWICK RI 02888 MEMORY CARE UNIT RENOVATIONS 1639893 CARELINK INC 400 MASSASOIT AVE 300 EAST PROVIDENCE RI 02914 THERAPY SERVICES 1388311 HEALTHCARE SERVICES GROUP INC 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 HOUSEKEEPING AND LAUNDRY SERVICES 826200 DIOCESE ADMINSTRATION CORPORATION 1 CATHEDRAL SQUARE PROVIDENCE RI 02903 MANAGEMENT SERVICES 457232 OMNICARE INC 2 TECHNOLOGY DR PEABODY MA 01960 PHARMACEUTICAL SERVICES 401482 11 47150 284317 116255 447722 MEDICAID & MEDICARE REVENUES 623000 14653933 14653933 NURSING HOME FEES 623000 5930415 5930415 MEMORY CARE REVENUE 623000 512855 512855 MANAGEMENT FEE INCOME 623000 100000 100000 47820 47820 21245023 47926 47926 12000 0 12000 12000 12000 35690 0 35690 35690 35690 42262 47150 46806 -4544 -4544 21783817 21245023 0 91072 239989 239989 10818164 10007990 810174 697825 656258 41567 1451229 1341857 109372 827367 752350 75017 484197 484197 6074 6074 57333 57333 41107 41107 153953 153953 46033 46033 158748 158748 232735 232735 1366579 1276782 89797 7935 7935 95149 95125 24 1030233 968398 61835 304332 304332 RESIDENT SERVICE EXPENS 3518371 3518371 HEALTH CARE PROVIDER AS 1053564 1053564 FOOD 579770 579770 CREDIT LOSSES EXPENSE 426365 426365 63635 15916 47719 23660687 20997078 2663609 0 1400 1400 2107030 2711978 2685700 3282381 1737715 655424 75763 77773 182060 11667 31152069 18815661 12041760 12336408 409516 440993 127165 20475 19368109 19538499 4246301 4211055 91363 183052 1321498 3298130 0 931 5659162 7693168 X 13570741 11708657 138206 136674 13708947 11845331 19368109 19538499 -1876870 13254 0 X X 0 1 X 1 0 X 6623933 6000721 1110482 297231 447722 14480089 21011201 16948724 18574125 19269655 21287285 97090990 12000 11787 11894 35681 27647134 22949445 19696394 19578780 21735007 111606760 0 0 0 111606760 12247 42871 66998 328298 59926 510340 12247 42871 66998 328298 59926 510340 40986 11134 21314 11866 85300 27700367 23003450 19784706 19918944 21794933 112202400 0.99470 0.99500 0.00450 0.00420 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 9,739. 2021 AMOUNT: $ 11,134. 2022 AMOUNT: $ 21,314. 2023 AMOUNT: $ 11,866. DISCOUNTS EARNED - 2020 AMOUNT: $ 31,247. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 409516 53041 21564 440993 375461 54781 20726 409516 452534 10000 -67302 19771 375461 415334 55024 17824 452534 375774 58048 18488 415334 0.69020 0.10450 0.20530 0 0 216000 216000 23677119 12894773 10782346 7218581 5880519 1338062 40369 40369 0 12336408 DUE TO RELATED ORGANIZATION 931 931 X 21755520 13254 13254 21742266 41107 444 41551 21783817 23619136 0 23619136 41107 444 41551 23660687 PART X, LINE 2: NO PROVISION FOR FEDERAL AND STATE INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS SINCE THE ORGANIZATION QUALIFIES AS A TAX-EXEMPT ORGANIZATION AS PROVIDED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES, IF APPLICABLE, AS A COMPONENT OF INTEREST AND AMORTIZATION EXPENSE. PART XI, LINE 4B - OTHER ADJUSTMENTS: SUBSIDIARY EXPENSES 444. PART XII, LINE 4B - OTHER ADJUSTMENTS: SUBSIDIARY EXPENSES 444. GOLF TOURNAMENT 89412 47150 42262 41102 5704 89412 47150 42262 41102 5704 46806 -4544 X X 0 0 0 0 0 0 0 0 0 LAURA DOS SANTOS ASSISTANT TREASURER 0 226011 0 0 0 0 0 4566 0 14981 0 245558 0 0 GARRETT E SULLIVAN EXECUTIVE DIRECTOR 191695 0 0 0 0 0 23869 0 24425 0 239989 0 0 0 KATHY KEELING DIRECTOR OF NURSING 140579 0 0 0 0 0 16727 0 9889 0 167195 0 0 0 RICHARD BERGERON LICENSED PRACTICAL NURSE 131077 0 0 0 0 0 8742 0 23859 0 163678 0 0 0 JAMES JAHNZ DIRECTOR 0 147677 0 0 0 0 0 2772 0 11921 0 162370 0 0 FORM 990, PART III, LINE 2 IN JULY 2024, A NEW 22 BED ASSISTED LIVING DEMENTIA CARE COMMUNITY WAS OPENED. FORM 990, PART VI, SECTION A, LINE 2 OFFICERS BISHOP RICHARD G. HENNING, PRESIDENT/TREASURER UNTIL 10/24, MSGR. ALBERT A. KENNEY, VICE PRESIDENT UNTIL 10/24 AND THEN PRESIDENT AND TREASURER FROM 10/24, REV. TIMOTHY D. REILLY, SECRETARY, AND LAURA DOS SANTOS, ASST. TREASURER, HAVE A BUSINESS RELATIONSHIP AMONG EACH OTHER AND WITH DIRECTOR JAMES JAHNZ BECAUSE THEY ARE EMPLOYED BY A RELATED ORGANIZATION,THE ROMAN CATHOLIC DIOCESE OF PROVIDENCE, OF WHICH THE OFFICERS AND BOARD MEMBERS ALSO SERVE. 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 DIOCESE'S HEALTH FACILITIES MANAGEMENT SERVICE GROUP AND THE EXECUTIVE DIRECTOR REVIEW THE 990 PRIOR TO FILING. THE 990 IS ALSO MADE AVAILABLE TO ALL MEMBERS OF GOVERNANCE FOR REVIEW BEFORE FILING. UPON REVIEW AND APPROVAL, THE RETURN IS FILED WITH THE IRS. A COPY IS SUBMITTED TO THE FISCAL OFFICE AT THE DIOCESE OF PROVIDENCE AND ONE IS KEPT AT THE BUSINESS OFFICE. FORM 990, PART VI, SECTION B, LINE 12C ALL KEY EMPLOYEES AND MEMBERS OF THE BOARD OF DIRECTORS ARE ASKED TO READ THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND ANNUALLY THEY ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. THE EXECUTIVE DIRECTOR AND THE FINANCE DIRECTOR REVIEW ALL POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY KEY EMPLOYEES AND DETERMINE IF A TRUE CONFLICT EXISTS. IF AN INDIVIDUAL HAS A CONFLICT, THE EXECUTIVE DIRECTOR AND THE DIRECTOR OF FINANCE REPORT THIS INFORMATION TO THE BOARD OF DIRECTORS. ALL MEMBERS OF THE BOARD ARE ASKED TO DISCLOSE ANY CONFLICTS OF INTEREST, AND DEPENDING UPON THE CONFLICT, THEY ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS AND VOTING ON THE RELATED ISSUE. ALL DECISIONS ARE RECORDED IN THE MINUTES OF THE BOARD OF DIRECTORS' MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS FUNCTIONS AS A COMPENSATION COMMITTEE IN DETERMINING COMPENSATION FOR THE ADMINISTRATOR AND OTHER OFFICERS. IN MAKING ITS DECISION ON COMPENSATION, IT TAKES INTO ACCOUNT THE COMPENSATION PAID TO SIMILAR ADMINISTRATORS AT COMPARABLE NON-PROFIT ORGANIZATIONS IN THE AREA. THE COMMITTEE CONSIDERS THE PERFORMANCE OF THE ORGANIZATION DURING THE REVIEW PERIOD AND CONSIDERS THE ADMINISTRATOR'S SUCCESS IN ACHIEVING ORGANIZATIONAL GOALS. THE ADMINISTRATOR REVIEWS COMPENSATION OF ALL OTHER EMPLOYEES. IN MAKING A DECISION ON THE AMOUNT OF COMPENSATION, THE ADMINISTRATOR TAKES INTO ACCOUNT THE COMPENSATION PAID TO SIMILAR EXECUTIVES, PERFORMING SIMILAR TYPES OF DUTIES, AT COMPARABLE NON-PROFIT ORGANIZATIONS IN THE RHODE ISLAND AREA. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART XII, LINE 2C: THE DIOCESE HEALTH MANAGEMENT SERVICES GROUP AND THE EXECUTIVE DIRECTOR ARE RESPONSIBLE FOR OVERSIGHT OF THE COMPLETION OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE DIOCESE HEALTH MANAGEMENT SERVICES GROUP AND THE EXECUTIVE DIRECTOR AND SUBMITTED TO THE ADVISORY BOARD AND CORPORATE BOARD. 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