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FAIRHAVEN HEALTHCARE CENTER INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
FAIRHAVEN HEALTHCARE CENTER INC (EIN 20-8745264)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201903189349309085
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-14T14:18:27-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 CROWN COLONY DRIVE SUITE 310AddressLine1Txt
CityQUINCYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02169ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN208745264EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FAIRHAVEN HEALTHCARE CENTER INCBusinessNameLine1Txt
Business Name Line2C/O ATHENA HEALTH CARE ASSOCIATESBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlFAIRBusinessNameControlTxt
Phone9784583388PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1476 VARNUM AVEAddressLine1Txt
CityLOWELLCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01854ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRAYMOND DENEHEYPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone9784583388PhoneNum
Signature2019-11-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJONATHAN LANGFIELDPreparerPersonNm
PTINP01294075PTIN
Phone6179848100PhoneNum
Preparation2019-11-04PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-07IPDt
IP Tm10:50:45IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id40B1045984B6BD7CE0CB919AAE2F7A412AF27D98AtSubmissionCreationDeviceId
At Submission Filing Device Id7F0C7E16D6C643755E980097E2E998FDCB8BA366AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRAYMOND DENEHEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1476 VARNUM AVEAddressLine1Txt
CityLOWELLCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01854ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$15,479,414GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FAIRHAVEN-NURSING.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2007FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionIT 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.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee316TotalEmployeeCnt
Total Volunteers7TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$14,712,230PYProgramServiceRevenueAmt
CY Program Service Revenue$15,418,194CYProgramServiceRevenueAmt
PY Investment Income$26,901PYInvestmentIncomeAmt
CY Investment Income$61,220CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$14,739,131PYTotalRevenueAmt
CY Total Revenue$15,479,414CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,450,695PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,096,266CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,827,878PYOtherExpensesAmt
CY Other Expenses$7,238,676CYOtherExpensesAmt
PY Total Expenses$16,278,573PYTotalExpensesAmt
CY Total Expenses$16,334,942CYTotalExpensesAmt
PY Revenues Less Expenses-$1,539,442PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$855,528CYRevenuesLessExpensesAmt
Total Assets BOY$25,575,514TotalAssetsBOYAmt
Total Assets EOY$24,985,465TotalAssetsEOYAmt
Total Liabilities BOY$28,892,592TotalLiabilitiesBOYAmt
Total Liabilities EOY$29,208,371TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$3,317,078NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$4,222,906NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIT 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,689,380ExpenseAmt
Revenue$15,418,194RevenueAmt
DescFAIRHAVEN 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.Desc
Total Program Service Expenses$14,689,380TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document18IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee316EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ATHENA HEALTH CAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8607513900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 SOUTH RDAddressLine1Txt
CityFARMINGTONCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06032ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
RAYMOND DENNEHY
PRESIDENT1.002.00Yes (X)Yes (X)$0$0$0
DAVID O'DONNELL
TREASURER1.002.00Yes (X)Yes (X)$0$0$0
GINA QUEIROS
DIRECTOR1.002.00Yes (X)$0$0$0
JOEL KIRCHIK
DIRECTOR1.002.00Yes (X)$0$0$0
MICHAEL MOORE
DIRECTOR1.002.00Yes (X)$0$0$0
ROBERT GREER VANTUYL
DIRECTOR1.002.00Yes (X)$0$0$0
JEFFREY WITHERELL
DIRECTOR1.002.00Yes (X)$0$0$0
THOMAS GOMES
ADMINISTRATOR40.00$127,817$0$8,110Yes (X)
GEORGIA WAYNE
DIRECTOR OF NURSING40.00$127,424$0$8,085Yes (X)
TERESA ROCK
MDS NURSE40.00$105,347$0$6,684Yes (X)
SUSAN BREEN
PHYSICAL THERAPIST40.00$101,352$0$14,921Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$461,940TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$37,800TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HEALTHCARE SERVICES GROUP INC
3220 TILLMAN DRIVEBENSALEMPA19020HOUSEKEEPING AND LAUNDRY SERVICES$454,512
PREFERRED PHARMACY SOLUTIONS LLC
35 AVCO ROADHAVERHILLMA01835PHARMACY SERVICES$314,926
PLATINUM CARE LLC
35 AVCO ROADHAVERHILLMA01835MANAGEMENT COMPANY$173,566
ATHENA HEALTH CARE SYSTEMS
35 AVCO ROADHAVERHILLMA01835MANAGEMENT COMPANY$154,938
THURSTON FOODS INC
30 THURSTON DRIVEWALLINGFORDCT06492FOOD & DIETRY SUPPLIES$112,810
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM SERVICE REVENUEDesc
Business623000BusinessCd
Total Revenue Column$15,418,194TotalRevenueColumnAmt
Related Or Exempt Func Income$15,418,194RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$15,418,194TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$61,220TotalRevenueColumnAmt
Exclusion$61,220ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,479,414TotalRevenueColumnAmt
Related Or Exempt Func Income$15,418,194RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$61,220ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,023,046TotalAmt
Program Services$7,684,496ProgramServicesAmt
Management And General$338,550ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$497,725TotalAmt
Program Services$476,722ProgramServicesAmt
Management And General$21,003ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$575,495TotalAmt
Program Services$551,211ProgramServicesAmt
Management And General$24,284ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$444,288TotalAmt
Management And General$444,288ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$106,596TotalAmt
Management And General$106,596ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,578TotalAmt
Management And General$23,578ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$713,246TotalAmt
Program Services$505,536ProgramServicesAmt
Management And General$207,710ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,263TotalAmt
Management And General$9,263ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$178,579TotalAmt
Program Services$3,012ProgramServicesAmt
Management And General$175,567ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$256,267TotalAmt
Program Services$256,267ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$14,086TotalAmt
Management And General$14,086ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,995,138TotalAmt
Program Services$1,995,138ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$737,056TotalAmt
Program Services$737,056ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$128,026TotalAmt
Program Services$18,986ProgramServicesAmt
Management And General$109,040ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$1,405,087$1,405,087
STATE ASSSESSMENT$1,055,869$1,055,869
BAD DEBT EXPENSE$142,000$142,000
DUES$20,484$20,484

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$9,113TotalAmt
Management And General$9,113ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$16,334,942TotalAmt
Program Services$14,689,380ProgramServicesAmt
Management And General$1,645,562ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$620,804BOYAmt
EOY$568,811EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$449,485BOYAmt
EOY$214,244EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$794,407BOYAmt
EOY$698,834EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$72,501BOYAmt
EOY$12,777EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$23,529,502LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,812,649LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$17,344,802BOYAmt
EOY$16,716,853EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$2,932,083BOYAmt
EOY$2,932,083EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,361,432BOYAmt
EOY$3,841,863EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$25,575,514BOYAmt
EOY$24,985,465EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,927,848BOYAmt
EOY$2,726,261EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$37,854EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,203,946BOYAmt
EOY$25,683,458EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$760,798BOYAmt
EOY$760,798EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,892,592BOYAmt
EOY$29,208,371EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$3,317,078BOYAmt
EOY-$4,222,906EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$3,317,078BOYAmt
EOY-$4,222,906EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,575,514BOYAmt
EOY$24,985,465EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$855,528ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$50,303NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$3OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,809,285CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,800,784CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,740,246CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,712,230CurrentTaxYearMinus1YearAmt
Current Tax Year$15,418,194CurrentTaxYearAmt
Total$74,480,739TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,809,285CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,800,784CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,740,246CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,712,230CurrentTaxYearMinus1YearAmt
Current Tax Year$15,418,194CurrentTaxYearAmt
Total$74,480,739TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$74,480,739PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,342CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,959CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,985CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,901CurrentTaxYearMinus1YearAmt
Current Tax Year$61,220CurrentTaxYearAmt
Total$153,407TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,342CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,959CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,985CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,901CurrentTaxYearMinus1YearAmt
Current Tax Year$61,220CurrentTaxYearAmt
Total$153,407TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,827,627CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,820,743CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,767,231CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,739,131CurrentTaxYearMinus1YearAmt
Current Tax Year$15,479,414CurrentTaxYearAmt
Total$74,634,146TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99790PublicSupportCY509Pct
Public Support PY5090.99830PublicSupportPY509Pct
Investment Income CY0.00210InvestmentIncomeCYPct
Investment Income PY0.00170InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,958,000OtherCostOrOtherBasisAmt
Book Value$1,958,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,966,766OtherCostOrOtherBasisAmt
Depreciation$5,702,928DepreciationAmt
Book Value$14,263,838BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,519,417OtherCostOrOtherBasisAmt
Depreciation$1,024,810DepreciationAmt
Book Value$494,607BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$85,319OtherCostOrOtherBasisAmt
Depreciation$84,911DepreciationAmt
Book Value$408BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$16,716,853TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
SOFTWARE, NET$331
TRUSTEE FUNDS HELD UNDER BOND INDENTURE$1,128,311
ESCROW$2,713,221
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,841,863TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS A MASSACHUSETTS NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
A04343181457585AAA82007-10-25$1,982,687PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
B04343181457585AAB62007-10-25$8,051,140PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
C04343181457585AAC42007-10-25$14,755,407PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007D
D0434318142007-10-25$2,038,290PURCHASE FACILITIES000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIn Reserve FundInReserveFundAmt
A$200,439$1,982,687$1,189,273$793,414200700Yes (1)Yes (1)
B$801,757$8,051,140$5,183,387200700Yes (1)Yes (1)$2,867,753
C$1,503,295$14,755,407$14,755,407200700Yes (1)Yes (1)
D$2,038,290$2,018,952200700Yes (1)Yes (1)$19,338

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B0000000
C0000000
D0000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)000000
B0Yes (1)000000
C0Yes (1)000000
D0Yes (1)000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0
C0
D0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2010BusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN043431818BondIssuerEIN
Bond Issued2010-07-14BondIssuedDt
Issue Price$2,640,000IssuePriceAmt
PurposePROJECT REHABPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$2,640,000TotalProceedsAmt
Capital Expenditures$2,640,000CapitalExpendituresAmt
Substantial Completion2010SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOEL KIRCHIKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionBOD MEMBERRelationshipDescriptionTxt
Transaction$11,547TransactionAmt
TransactionBOD MEMBER IS AN EMPLOYEE OF MOBILEX WHICH PROVIDES MEDICAL SERVICES TO THE ORGANIZATION.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2DIRECTOR, JOEL KIRCHIK HAS A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION ENTERED INTO A FIFTEEN-YEAR MANAGEMENT AGREEMENT, EXPIRING OCTOBER 2022, WITH PLATINUM CARE, LLC 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. PLATINUM CARE, LLC PREPARE AND FILE, ALL COST REPORTS, PAYROLL TAX AND REAL ESTATE TAX FILINGS REQUIRED. THIS AGREEMENT WAS TERMINATED EFFECTIVE MAY 1, 2018, AND A NEW MANGAEMENT AGREEMENT WAS ENTERED INTO WITH ATHENA HEALTH CARE ASSOCIATES INC.
FORM 990, PART VI, SECTION B, LINE 11BA 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 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE MSRB ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE.
FORM 990, PART XI, LINE 9:ROUNDING 3.
FORM 990, PART XII, LINE 2C:NO CHANGE IN PROCESS FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ADVENTCARE INC
476 VARNUM AVELOWELLMA01854321012491MANAGEMENT COMPANYMA501(C)(3)LINE 10N/A0
LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY
25 LAFAYETTE STREETMARBLEHEADMA01945208745166SKILLED NURSING FACILITYMA501(C)(3)LINE 100ADVENTCARE INC
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd