2020-11-10T15:31:44-06:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 801 CHERRY ST SUITE 1400 FORT WORTH TX 76102 990 2019-01-01 042106771 WILLIAM B RICE EVENTIDE HOME INC WILL 7816605000 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 AMY ROSS PRESIDENT 7816605000 2020-11-03 1 MICHAELA J CROMAR CPA P00895728 8178775000 2020-11-03 75.144.160.101 2020-11-03 16:22:56 ES P 7F79EBEF70B52A6617C4AF05089A677303FDB297 8691CE57B3CA54F67807ABE18706F5E1A699ECB4 2019 2021-01-29 14:40:06Z FAIRING WAY AMY ROSS 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 8878348 0 X WWW.FAIRINGWAY.ORG X 1924 MA A LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED SUPPORTIVE SERVICES. 10 10 124 30 0 0 2976 0 8118162 8820550 92590 57798 0 0 8213728 8878348 0 0 0 0 3967189 3855501 0 0 0 7261046 6584413 11228235 10439914 -3014507 -1561566 64947843 79600169 55101374 73374636 9846469 6225533 TO MAINTAIN A UNIQUE LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED AND CARING SUPPORTIVE SERVICES IN A HOME-LIKE ATMOSPHERE WHICH ALLOWS THE RESIDENTS TO MAINTAIN INDEPENDENT LIVES WITH DIGNITY. 0 0 8168401 8820550 THE HOME PROVIDES SECURE HOUSING, QUALITY NURSING CARE, MEANINGFUL ACTIVITIES, OPPORTUNITIES FOR SOCIALIZATION, AND A WIDE VARIETY OF SUPPORTIVE & REHABILITATION SERVICES TO APPROXIMATELY 50 FRAIL ELDERS UNABLE TO LIVE INDEPENDENTLY IN THE COMMUNITY, WITHOUT REGARD FOR THEIR ABILITY TO PAY. 8168401 1 0 0 1 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 12 0 124 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 MA X BARBARA MCLAREN 7816605000 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 AMY ROSS PRESIDENT 5.00 X X 0 0 0 JOHN SPILLANE VICE PRESIDENT 5.00 X X 0 0 0 DONALD POWELL TREASURER 5.00 X X 0 0 0 KEVIN CALLANAN CLERK 5.00 X X 0 0 0 SUSAN BELISLE DIRECTOR 5.00 X 0 0 0 RICHARD MEADE DIRECTOR 5.00 X 0 0 0 STEVEN DWYER DIRECTOR 5.00 X 0 0 0 ANNE MARCHETTA DIRECTOR 5.00 X 0 0 0 WILLIAM JACKSON DIRECTOR 5.00 X 0 0 0 KEVIN KIRBY DIRECTOR 5.00 X 0 0 0 KENNETH STRONG EXECUTIVE DIRECTOR 40.00 X 125861 0 3380 125861 0 3380 1 0 0 0 DELLBROOK CONSTRUCTION 859 WILLARD ST QUINCY MA 02169 CONSTRUCTION 13041581 ROGERSON COMMUNITIES 1 FLORENCE ST ROSLINDALE MA 02131 MANAGEMENT & ACCOUNTING 269159 NIXON PEABODY 53 STATE ST BOSTON MA 02109 LEGAL 215262 LWDA DESIGN 45 WALDEN ST COCORD MA 01740 ARCHITECT 153512 4 MEDICARE RESIDENTS 623000 2514424 2514424 PUBLICLY-AIDED RESIDENTS 623000 2083964 2083964 PRIVATE RESIDENTS 623000 2017948 2017948 INDEPENDENT LIVING SERVICE REVENU 623000 1812952 1812952 OTHER OPERATING INCOME 623000 251588 251588 139674 139674 8820550 57798 57798 8878348 8820550 0 57798 129241 129241 3031135 2711538 319597 44357 36295 8062 352216 288196 64020 298552 244286 54266 174996 174996 2997 2997 78598 78598 19595 19595 45101 45101 261450 261450 168546 168546 15758 15758 658638 559814 98824 1332 1332 1024758 856839 167919 1432795 1217815 214980 46877 39843 7034 PATIENT CARE EXPENSES 2160040 2160040 PROJECT COSTS 394739 394739 LICENSES AND DUES 52403 52403 BAD DEBT EXPENSE 45790 45790 10439914 8168401 2271513 0 1088320 1168771 118742 101481 898599 877129 79055 88545 54691728 4643530 51412612 50048198 2246544 2379657 9103971 24936388 64947843 79600169 2262750 8668816 1387049 1241813 797695 885500 17333607 29184789 33320273 33393718 55101374 73374636 X 9786569 6165633 59900 59900 9846469 6225533 64947843 79600169 -1561566 386625 -2445995 0 X X 0 1 X 1 0 X 1435 2976 4411 6386192 5175057 6899339 8118162 8820550 35399300 6386192 5175057 6900774 8121138 8820550 35403711 0 0 0 35403711 85334 86441 66149 55279 57798 351001 85334 86441 66149 55279 57798 351001 211522 211522 6471526 5261498 7178445 8176417 8878348 35966234 0.98440 0.97510 0.00980 0.01860 X 0 0 0 0 0 0 0 0 1 836 836 0 PART II-B, LINE 1: DURING 2019, THE ORGANIZATION PAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATIONS OF WHICH $836 WAS THE PORTION RELATED TO LOBBYING. 0 1 X 59900 59900 59900 59900 59900 59900 59900 59900 50726 9174 59900 0.68450 0.31550 0 0 3493296 3493296 48984202 4002401 44981801 355533 39536 315997 1823848 566744 1257104 34849 34849 0 50048198 DEVELOPMENT COSTS 21535203 SOFTWARE, NET 3376 RESERVATION DEPOSITS 885500 LOAN AGREEMENT - ESCROWS 2438251 OTHER ASSETS 21089 ASSETS LIMITED TO USE 52969 24936388 RESIDENT REFUNDABLE ENTRANCE DEPOSIT 33200502 DEPOSITS HELD PAYABLE TO CONTRACTORS 193216 33393718 X PART IV, LINE 2B: RICE EVENTIDE ACCEPTED PRECONSTRUCTION DEPOSITS FOR PHASE 1 OF ITS FAIRING WAY PROJECT. PROSPECTIVE RESIDENTS ENTERED INTO AN AGREEMENT TO RESERVE A SPECIFIC UNIT IN THE COMPLETED PROJECT. FOR PHASE 2, THE $10,000/UNIT DEPOSITS ARE NONREFUNDABLE, UNLESS RICE EVENTIDE IS UNABLE TO DELIVER THE RIGHT TO OCCUPY THE RESIDENCE ON THE CLOSING DATE. THE RESERVATION DEPOSITS ARE BEING HELD BY RICE SOUTHFIELD, LLC (DISREGARDED ENTITY OF RICE EVENTIDE). PART V, LINE 4: RESTRICTED ENDOWMENT FUNDS ARE TO BE USED FOR NEW RESIDENT BEDS. THE PERMANENT ENDOWMENT FUND'S INCOME IS USED FOR THE GENERAL PURPOSES OF THE HOME. PART X, LINE 2: RICE EVENTIDE IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. RICE SOUTHFIELD IS A SINGLE MEMBER LLC. EARNINGS AND LOSSES ARE INCLUDED IN THE MEMBER'S INCOME. RICE SOUTHFIELD'S ACTIVITY IS INCLUDED ON RICE EVENTIDE'S TAX RETURN. RICE EVENTIDE FILES AS A TAX-EXEMPT ORGANIZATION. 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, 2019 AND 2018. FORM 990, PART VI, SECTION A, LINE 8B NO MINUTES ARE TAKEN FOR COMMITTEE MEETINGS AS ALL INFORMATION COMMUNICATED IN THESE MEETINGS ARE COMMUNICATED TO THE BOARD BY A REPRESENTATIVE. ALL BOARD MEETINGS REQUIRE THAT MINUTES BE TAKEN. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR WILL REVIEW THE FORM 990 WITH MEMBERS OF THE BOARD'S EXECUTIVE COMMITTEE. IT WILL THEN BE DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY, COVERING THE BOARD OF DIRECTORS, THAT IS ENFORCED ANNUALLY BY DISTRIBUTION OF THE POLICY AND FOLLOW UP TO CONFIRM NO ONE IS IN CONFLICT OF THE POLICY. ANY POTENTIAL CONFLICTS OF INTEREST ARE REQUIRED TO BE REPORTED TO THE PRESIDENT IMMEDIATELY. IF A DIRECTOR HAS A SUSPECTED OR REPORTED CONFLICT OF INTEREST, THEY WILL BE PROHIBITED FROM VOTING ON MATTERS INVOLVING THAT CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT OF THE BOARD AND MEMBERS OF THE EXECUTIVE COMMITTEE APPROVES CEO'S SALARY. THEY REGULARLY REVIEW SALARY STUDIES DONE BY STATE HEALTHCARE ASSOCIATIONS. APPROVAL IS DOCUMENTED IN THE BOARD OF DIRECTORS' MINUTES. THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION OF KEY EMPLOYEES AFTER REVIEWING SALARY STUDIES DONE BY STATE AND NATIONAL HEALTHCARE ASSOCIATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS AUDIT OVERSIGHT PROCESS OR AUDITOR SELECTION PROCESS. RICE SOUTHFIELD LLC 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 273136975 REAL ESTATE INVESTMENT MA 2068835 25815430 WILLIAM B RICE EVENTIDE HOME INC