2018-02-02T13:36:42-06:00 2017-09-30 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2016-10-01 060763898 CHURCH HOMES INC CONGREGATIONAL CHUR 8605279126 217 AVERY HEIGHTS HARTFORD CT 061064200 RAYMOND A GASPERINI VICE PRESIDENT/CFO 8605279126 2018-01-30 1 ELIZABETH SOLECKI P00235171 8605614000 2018-01-26 50.200.120.74 2018-01-30 14:50:53 ES P E5DC2E8C5A6F06775D8258D48A2A9A4AD94197C7 66876C9D7A8912D94FE5179D9C72F3F6E6F290C8 2016 2021-01-29 14:40:06Z RAYMOND A GASPERINI 217 AVERY HEIGHTS HARTFORD CT 06106 40665247 0 X WWW.CHURCHHOMES.ORG X 1957 CT TO PROVIDE, ON A NOT-FOR-PROFIT BASIS AND WITHOUT DISCRIMINATION, A FULL RANGE OF RESIDENTIAL LIVING AND HEALTH CARE SERVICES FOR OLDER ADULTS. 12 11 500 200 0 0 2430717 1153420 37874870 38881918 74310 319441 499202 272716 40879099 40627495 11887 15891 0 0 22516269 22891872 0 0 74748 17194522 17024741 39722678 39932504 1156421 694991 56370256 57206056 18285417 17154544 38084839 40051512 X TO PROVIDE, ON A NOT-FOR-PROFIT BASIS AND WITHOUT DISCRIMINATION, A FULL RANGE OF RESIDENTIAL LIVING AND HEALTH CARE SERVICES FOR OLDER ADULTS BY PROMOTING AND IMPLEMENTING SYSTEMS THAT MAINTAIN AND SUPPORT EVERY INDIVIDUAL'S OPTIMAL INDEPENDENCE AND LIFE WISHES IN A SAFE, DIGNIFIED ATMOSPHERE CONDUCIVE TO QUALITY RETIREMENT, BY ASSURING KNOWLEDGEABLE AND CONSISTENT LEADERSHIP IN RETIREMENT LIVING, LONG-TERM CARE, HOME CARE AND SUPPORT SERVICES AND BY DEVELOPING INNOVATIVE PROGRAMS AND SERVICES WHICH RESPOND TO THE CHANGING NEEDS OF ITS RESIDENTS AND CLIENTS AND THE SOCIETY IT SERVES. 0 0 36601806 15891 39149234 CHURCH HOMES, INC. CONGREGATIONAL IS A NOT-FOR-PROFIT CORPORATION, WHICH OWNS AND OPERATES RETIREMENT AND HEALTH CARE FACILITIES IN HARTFORD, CT (AVERY HEIGHTS) AND SALISBURY, CT (NOBLE HORIZONS). AVERY HEIGHTS CONSISTS OF 130 SKILLED NURSING BEDS, 69 INTERMEDIATE CARE BEDS, 58 INDEPENDENT LIVING COTTAGES, 127 INDEPENDENT LIVING APARTMENTS, 36 ASSISTED LIVING APARTMENTS AND 20 MEMORY CARE UNITS. IN ADDITION, AVERY HEIGHTS OPERATES A HOME HEALTH AGENCY. NOBLE HORIZONS CONSISTS OF 61 SKILLED NURSING BEDS, 30 INTERMEDIATE CARE BEDS, 50 INDEPENDENT LIVING COTTAGES, AND 19 ACCOMMODATIONS IN A HOME FOR THE AGED. 36601806 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 126 0 1 500 1 0 0 0 0 0 1 1 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 CT X RAYMOND A GASPERINI 8605279126 217 AVERY HEIGHTS HARTFORD CT 061064200 PATRICK GILLAND PRESIDENT/CEO 40.00 5.00 X X 271761 0 51385 PATRICK Y YUNG DIRECTOR 1.00 X 0 0 0 THOMAS P KELLEY DIRECTOR 1.00 X 0 0 0 JOSEPH C BLACK JR DIRECTOR 1.00 X 0 0 0 DAVID E CANUEL CHAIRMAN 1.00 X X 0 0 0 ELIZABETH S GAGNE DIRECTOR 1.00 X 0 0 0 HENRY B MCNULTY VICE CHAIRMAN 1.00 X X 0 0 0 DAVID E POLK DIRECTOR 1.00 X 0 0 0 GERARD J BALDWIN DIRECTOR 1.00 X 0 0 0 PETER B MATTHEWS DIRECTOR 1.00 X 0 0 0 MERCEDESE E LARGE DIRECTOR 1.00 X 0 0 0 PETER L HOLLAND DIRECTOR 1.00 X 0 0 0 PATRICK S GILLIGAN DIRECTOR 1.00 X 0 0 0 RAYMOND GASPERINI VICE PRESIDENT/CFO 40.00 X 177841 0 34476 EILEEN MULLIGAN VICE PRESIDENT 40.00 X 169064 0 29000 MARJORIE K TESSMAN SECRETARY 20.00 X 34939 0 4984 WILLIAM THOMPSON VICE PRESIDENT 40.00 X 91658 0 4765 BONITA GANIM DIRECTOR OF NURSING SERVICES 40.00 X 109138 0 18715 ANNA LUKAS NURSE MANAGER 40.00 X 132208 0 33721 MICHELLE PASCETTA DIR BUDGETING AND REIMBURSEMENT 40.00 X 110659 0 25822 MARY MILLER MARKETING DIRECTOR 40.00 X 104181 0 21670 MIRIAM PARKER RETIRED VICE PRESIDENT 40.00 X 110849 0 20748 1312298 0 245286 8 1 1 0 HEALTHCARE SERVICES GROUP INC 3220 TILLMAN DR STE 300 BENSALEM PA 19020 HOUSEKEEPING/LAUNDRY/DIETARY SERVICES 2749275 ALLIANCE REHAB OF CT 1520 KENSINGTON RD STE 110 OAK BROOKE IL 60523 REHAB THERAPY 1484610 CE FLOYD COMPANY INC 135 SOUTH RD BEDFORD MA 01730 CONTRACTOR FOR MEMORY CARE UNIT 641929 AMENTA EMMA ARCHITECTS PC 242 TRUMBULL ST HARTFORD CT 06103 ARCHITECT FOR MEMORY CARE UNIT 168278 H&H LINEN SERVICES 60 BELAMOSE AVE UNIT A10 ROCKY HILL CT 06067 LINEN SERVICE 164294 12 59274 1094146 1153420 RESIDENT SERVICES 623000 38772384 38772384 OTHER SERVICES 623000 109534 109534 38881918 332856 332856 5400 0 5400 5400 5400 13415 -13415 -13415 -13415 24337 59274 24337 0 OTHER INCOME 900099 264459 264459 FEES INCOME 900099 2857 2857 267316 40627495 39149234 0 324841 X 15891 15891 932080 932080 16375471 14326399 2032590 16482 1151312 1013730 136546 1036 3170194 2769573 397604 3017 1262815 1111908 149770 1137 7244 7244 84743 84743 71575 71575 6068940 6030394 31150 7396 185046 183247 1799 243675 138468 95290 9917 160443 70440 78653 11350 2514570 2484008 30562 9502 3654 5848 1460 1037 423 97 97 2583818 2583818 254132 254132 PROVIDER TAX 1634726 1634726 SUPPLIES 716195 696865 19330 FOOD 679672 679672 PRESCRIPTIONS & DRUGS 514497 514497 1294406 1157170 112823 24413 39932504 36601806 3255950 74748 2131806 2578081 399070 308379 2633104 3175540 207297 205624 352653 200199 86736371 58872499 26742366 27863872 22826950 21933360 1036816 836641 40194 104360 56370256 57206056 3021134 2893142 14933006 13935907 331277 325495 18285417 17154544 X 26664397 29215230 8768177 8184017 2652265 2652265 38084839 40051512 56370256 57206056 694991 1271682 0 X 0 1 X 1 0 X 371877 593147 402859 2430717 1153420 4952020 40366544 40130440 39859295 38368672 39149234 197874185 40738421 40723587 40262154 40799389 40302654 202826205 0 0 0 202826205 158361 487434 189677 143712 332856 1312040 158361 487434 189677 143712 332856 1312040 18000 18000 17400 5400 5400 64200 40914782 41229021 40469231 40948501 40640910 204202445 0.99330 0.99340 0.00640 0.00620 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10369650 65976 1193533 635960 10993200 9692954 87798 960411 371513 10369650 10152116 131662 -262110 328714 9692954 9297884 354207 680438 180413 10152116 8485427 83398 904516 175457 9297884 0.52000 0.24000 0.24000 0 0 3347618 3347618 51943152 35009610 16933542 27357339 20868553 6488786 4088262 2994336 1093926 27863872 ANNUITIES PAYABLE 21863 RESIDENT FUNDS AND DEPOSITS 232061 DUE TO THIRD PARTY REIMBURSEMENT AG 52157 MISCELLANEOUS 19414 325495 41689399 1271682 -209778 1061904 40627495 0 40627495 39722726 0 39722726 209778 209778 39932504 PART V, LINE 4: INVESTMENT INCOME UTILIZED TO SUPPORT OPERATIONS PART XI, LINE 2D - OTHER ADJUSTMENTS: DIRECT RESIDENT SUPPORT -3,806. BAD DEBTS -205,972. PART XII, LINE 4B - OTHER ADJUSTMENTS: DIRECT RESIDENT SUPPORT 3,806. BAD DEBTS 205,972. GOLF OUTING 67160 48560 18600 18600 FESTIVAL OF TREES 16451 10714 5737 5737 83611 59274 24337 24337 24337 0 1 SCHOLARSHIPS 7 15878 PART I, LINE 2: SCHOLARSHIP ASSISTANCE IS OFFERED TO EMPLOYEES OR THEIR CHILDREN WHO WISH TO PURSUE PROFESSIONAL AND VOCATIONAL COURSES OF STUDY THAT ARE RELATED TO THE EMPLOYEE'S POTENTIAL FOR PROMOTION OR MINIMUM JOB REQUIREMENTS. ALL COURSES MUST BE OFFERED THROUGH AN ACCREDITED INSTITUTION OF HIGHER LEARNING OR BE APPROVED FOR CONTINUING EDUCATION UNITS. TO QUALIFY, THE EMPLOYEE MUST BE EMPLOYED 32 HOURS OR MORE AND HAVE COMPLETED ONE YEAR OF CONTINUOUS EMPLOYMENT. THE EMPLOYEE MUST HAVE A GOOD WORK ATTENDANCE RECORD. THE EMPLOYEE OR THEIR CHILD MUST MEET THE REQUIREMENTS OF THE INSTITUTION OR AGENCY OFFERING THE COURSE. THE SCHOLARSHIP ASSISTANCE IS AVAILABLE IF THE APPLICANT IS NOT ELIGIBLE FOR ASSISTANCE FROM OTHER SOURCES OF REIMBURSEMENT. X X X X 0 0 0 0 0 0 0 1 0 PATRICK GILLAND PRESIDENT/CEO 251761 0 20000 0 0 0 31716 0 19669 0 323146 0 0 0 RAYMOND GASPERINI VICE PRESIDENT/CFO 175841 0 2000 0 0 0 20599 0 13877 0 212317 0 0 0 EILEEN MULLIGAN VICE PRESIDENT 167064 0 2000 0 0 0 19051 0 9949 0 198064 0 0 0 ANNA LUKAS NURSE MANAGER 132208 0 0 0 0 0 13930 0 19791 0 165929 0 0 0 MIRIAM PARKER RETIRED VICE PRESIDENT 108849 0 2000 0 0 0 10949 0 9799 0 131597 0 0 0 PART I, LINE 7 BONUSES ARE AWARDED BASED ON THE ACHIEVEMENT OF SPECIFIC PERFORMANCE GOALS. A STATE OF CONNECTICT HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 060806186 2015-11-18 15282000 REFUND PRIOR ISSUE 0 0 0 A 15282000 134222 15147778 1 0 1 1 A 0 0 0 0 0.01680 0.00000 0.01680 0 0 0 A 0 0 0 1 0 0 0 0 0 A 0 PART II, LINE 11, OTHER SPENT PROCEEDS: OTHER SPENT PROCEEDS OF $15,147,778 WERE USED TO REFUND A PRIOR ISSUE. X 1 662547 BROKER 0 0 0 PART I, COLUMN (B): ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED WITH THE BOARD OF DIRECTORS AT REGULARLY SCHEDULED BOARD OF DIRECTORS MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE PRESIDENT OF CHURCH HOMES, INC. REVIEWS THE RESPONSES TO THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE WITH THE COMMITTEE ON DIRECTORS. WHERE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE COMMITTEE ON DIRECTORS IS AUTHORIZED TO TAKE APPROPRIATE CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 CHURCH HOMES, INC. PERSONNEL COMMITTEE REVIEWS AND APPROVES OFFICER COMPENSATION ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G MEDICAL THERAPY: PROGRAM SERVICE EXPENSES 1,502,975. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,502,975. DIETARY SERVICES: PROGRAM SERVICE EXPENSES 1,838,791. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,838,791. HOUSEKEEPING: PROGRAM SERVICE EXPENSES 814,925. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 814,925. TEMPORARY NURSING: PROGRAM SERVICE EXPENSES 277,744. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 277,744. SECURITY: PROGRAM SERVICE EXPENSES 145,035. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 145,035. LAUNDRY: PROGRAM SERVICE EXPENSES 480,227. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 480,227. MAINTENANCE & REPAIRS: PROGRAM SERVICE EXPENSES 561,687. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 561,687. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 409,010. MANAGEMENT AND GENERAL EXPENSES 31,150. FUNDRAISING EXPENSES 7,396. TOTAL EXPENSES 447,556. CONNECTICUT ALLIANCE FOR LONG TERM CARE 217 AVERY HEIGHTS HARTFORD CT 06106 061465316 ADMINISTER PROVIDER BASED NETWORK TO PROVIDE COST-EFFECTIVE HEALTH CARE CT 501(C)(3) LINE 12A, I N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0