2017-11-14T09:52:15-06:00 2016-12-31 042513210 GERALD T REILLY & COMPANY 424 ADAMS STREET MILTON MA 02186 990 2016-01-01 042173054 MARIAN MANOR FOR THE AGED AND INFIRM INC MARI 6172683333 130 DORCHESTER STREET SOUTH BOSTON MA 02127 SR M STEPHEN PEREIRA TREASURER 6172683333 2017-08-29 1 DAVID KEYO CPA P00953902 6176968900 173.14.170.162 2017-08-29 07:25:16 ED P 626F99FDE7D1E88DD9505553D501834A6099106E 8C2237CD060B4E91E9E715FD88FD277A9ECA0C31 2016 2017-02-10 21:41:12Z SR M STEPHEN PEREIRA 130 DORCHESTER STREET SOUTH BOSTON MA 02127 23705259 0 X WWW.MARIANMANOR.ORG X 1953 MA TO PROVIDE CARE AND SERVICES TO THE COMMUNITY IN CONFORMANCE WITH THE THEOLOGY, PHILOSOPHY, TEACHINGS AND DOCTRINES OF THE ROMAN CATHOLIC CHURCH, RESPECTING AND BUILDING ON THE MISSION, PHILOSOPHY AND VALUES OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM. PLEASE SEE SCHEDULE O FOR DETAILS OF OUR OPERATIONS. 15 15 425 40 0 0 10455 105091 17033754 18095374 869808 384617 92116 71847 18006133 18656929 0 0 0 0 12409050 12338112 0 0 0 5076543 6557632 17485593 18895744 520540 -238815 11679068 7562161 8274562 4396470 3404506 3165691 X THE HOME OPERATES A 201 BED LICENSED NURSING HOME. THE HOME PROVIDES PROFESSIONAL AND PERSONAL SERVICES IN A COMPASSIONATE AND CARING MANNER TO MEMBERS OF THE CITY OF BOSTON, SURROUNDING COMMUNITIES AND OTHER LOCATIONS THAT SEEK OUR SERVICES. DURING 2016 THE HOME PROVIDED 68,437 DAYS OF NURSING CARE FOR THE ELDERLY AND INFIRM, WITHOUT REGARD TO THEIR ETHNIC, RELIGIOUS OR FINANCIAL BACKGROUND. 0 0 15528408 18479991 `NURSING CARE FOR THE AGED & INFIRMTOTAL BEDS 01/01/2016 - 12-31/2016: 201 X 366 (# OF DAYS) = 73,566 MAX PATIENT BEDS IN 2016 BASED UPON BEDS IN SERVICE = 73,566TOTAL PATIENT DAYS = 68,437% OF OCCUPANCY = 93% 15528408 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 22 0 1 425 1 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X X DAVID HINES 6172683333 130 DORCHESTER STREET S BOSTON MA 02127 X MR ROBERT GRIFFIN CHAIRMAN 1.00 X X 0 0 0 SR JEANNE FRANCIS HALEY PRESIDENT 1.00 X X 0 0 0 SR MARY ROSE HEERY VICE PRESIDENT 1.00 X X 0 0 0 MR KEVIN CASEY DIRECTOR 1.00 X 0 0 0 MR FRANCES CROSBY DIRECTOR 1.00 X 0 0 0 MR PETER DONADIO DIRECTOR 1.00 X 0 0 0 MR FRANCIS DOYLE DIRECTOR 1.00 X 0 0 0 SR M SEAN DAMIEN FLYNN DIRECTOR 1.00 X 0 0 0 SR M SHAWN BERNADETTE FLYNN DIRECTOR 1.00 X 0 0 0 SR JEANETTE DAVID LINDSAY DIRECTOR 1.00 X 0 0 0 SR MAUREEN DE LOURDES MCDONOUGH DIRECTOR 1.00 X 0 0 0 JOHN J MOONEY DIRECTOR 1.00 X 0 0 0 MR JOHN PAGLIUCA DIRECTOR 1.00 X 0 0 0 SR MR JOSEPH CATHERINE RAYMOND DIRECTOR 1.00 X 0 0 0 MR JAMES PHILBIN DIRECTOR 1.00 X 0 0 0 SR M STEPHEN PEREIRA TREASURER 40.00 X 0 0 0 LEEANNE SMEGOSKI ASSISTANT DIRECTOR OF NURSING 38.00 X 104146 0 12446 LESLIE VICKERS DIRECTOR OF NURSING 38.00 X 129820 0 12197 SHAD CARTER NURSE LIASON 35.00 X 107886 0 5665 EDWINA ROMERO FERNANDEZ REGISTERED NURSE 48.00 X 101688 0 5571 443540 0 35879 4 0 0 0 PREFERRED THERAPY SOLUTIONS 800 SILAS DEANE HWY 2 WETHERSFIELD CT 06109 REHAB SERVICES 817946 PARAMOUNT HEALTHCARE SERVICES 2 COURTHOUSE LANE UNIT 6 CHELMSFORD MA 01824 NURSING CONTRACT LABOR 355947 MAXIM STAFFING SOLUTIONS 110 2ND AVE NEEDHAM MA 02494 NURSING CONTRACT LABOR 213249 3 105091 105091 NURSING CARE-ELDERLY 623000 17758878 17758878 336496 336496 18095374 658 5397598 901 5012738 -243 384860 384617 384617 106538 34691 71847 71847 18656929 18479991 0 71847 10253369 8606329 1647040 1262309 1065163 197146 822434 690323 132111 75080 75080 134613 134613 289 289 21240 21240 115540 26766 88774 122749 122749 643848 591025 52823 28039 22584 5455 234 234 151118 151118 293741 269642 24099 179103 164409 14694 PURCHASED SERVICES 2204760 1966506 238254 PROGRAM SUPPLIES 1006748 1006748 FOOD 536600 536600 BAD DEBT EXPENSE 289406 289406 754524 292907 461617 18895744 15528408 3367336 0 1550849 1779134 442946 307153 1670981 2612837 194602 191481 25793242 23121686 2806952 2671556 5012738 0 11679068 7562161 1145962 1197069 171471 97520 6957129 3101881 8274562 4396470 X 3248144 3009332 106362 106359 50000 50000 3404506 3165691 11679068 7562161 -238815 0 X X 0 1 X 1 0 X 134903 114823 70500 102571 176938 599735 23702398 23057974 18640606 17033754 18095374 100530106 23837301 23172797 18711106 17136325 18272312 101129841 0 0 0 101129841 2368 22 19 3 2412 2368 22 19 3 2412 23839669 23172819 18711125 17136328 18272312 101132253 1.00000 0.99990 0.00000 0.00010 X 0 1 X 50000 50000 50000 50000 50000 50000 50000 50000 50000 50000 0 0 396138 396138 20832789 19112555 1720234 4564315 4009131 555184 2671556 LINES OF CREDIT FROM RELATED PARTY 3045768 ACCRUED INTEREST ON RELATED PARTY DEBT 29571 DUE TO CARMELITE SYSTEM AND HOME 26542 3101881 18656929 0 18656929 0 18656929 18895744 0 18895744 0 18895744 PART IV, LINE 2B: RESIDENT FUNDS HELD BY THE CORPORATION ON THE BEHALF OF PATIENTS MAY NOT BE UTILIZED IN OPERATIONS, AND ARE DIRECTLY RELATED TO THE RESIDENTS FUNDS PAYABLE AND PATIENT ROOM DEPOSIT LIABILITIES. PART V, LINE 4: ENDOWMENT CONSISTS OF ONE INDIVIDUAL FUND THAT IS PERMANENTLY RESTRICTED, WITH ALL OF THE RELATED INVESTMENT INCOME TO BE USED TO SUPPORT THE PROGRAMS, CAPITAL PURCHASES AND FACILITIES RENOVATIONS. GOLF OUTING 51300 51300 1914 9375 6273 2403 300 CLUB 31315 31315 8300 1410 3019 1 23923 23923 1997 106538 106538 8300 1914 10785 6273 7419 34691 71847 X X 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS THE CARMELITE SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBERS RETAIN THE RIGHT TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW. THE FINANCE COMMITTEE REPORTS TO THE BOARD OF DIRECTORS REGARDING THE REVIEW AND A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD AT IT'S NEXT ANNUAL MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST DISCLOSURE POLICY REQUIRES ALL OFFICERS AND BOARD MEMBERS TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. IN ADDITION, SHOULD AN OFFICER OR BOARD MEMBER ASSUME NEW EXTERNAL INTERESTS THAT POTENTIALLY CONFLICT WITH HIS/HER ROLE WITH THE ORGANIZATION, SUCH INDIVIDUAL IS REQUIRED TO DISCLOSE IN WRITING THE NATURE OF SUCH EXTERNAL INTERESTS. THE DISCLOSURE STATEMENT IS PROVIDED TO THE BOARD FOR REVIEW. CONFLICTS ARE RESOLVED BY MAKING A REQUIRED DISCLOSURE, AND MAY RESULT IN RESTRICTING THE OFFICER OR BOARD MEMBER IN ANY RELATED ACTIVITY OR PROCESS AS DETERMINED APPROPRIATE TO THE CIRCUMSTANCES OF THE CONFLICT. FAILURE TO DISCLOSE A CONFLICT OF INTEREST IS IN VIOLATION OF THE ADOPTED POLICY AND CAN RESULT IN DISCIPLINARY ACTION OR REMOVAL. FORM 990, PART VI, SECTION B, LINE 15 A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION FOR COVERED INDIVIDUALS BASED ON RELEVANT DATA INCLUDING COMPARABILITY COMPENSATION FOR SIMILARLY SITUATED ENTITIES AND INDEPENDENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS AS DEEMED NECESSARY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS; CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND TAX FILINGS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION ALSO FILES REPORTS WITH VARIOUS GOVERNMENTAL AGENCIES AS A REQUIREMENT FOR PARTICIPATION IN GOVERNMENT PROGRAMS, WHICH THE AGENCIES MAY MAKE AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S FORM 990 IS AVAILABLE TO THE PUBLIC ON GUIDESTAR'S WEBSITE. IN ADDITION THE FORM 990, FORM PC AND AUDITED FINANCIAL STATEMENT ARE AVAILABLE ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART XII, LINE 2C: THE CARMELITE SYSTEM, INC. APPROVES THE ENGAGEMENT OF THE INDEPENDENT AUDITORS FOR THE CORPORATION. THE SYSTEM AUDIT COMMITTEE MEETS WITH THE SYSTEM'S MANAGEMENT AND THE INDEPENDENT AUDITORS TO REVIEW THE ENGAGEMENT PROPOSAL, RESULTS OF THE AUDIT, DRAFT AUDIT REPORT AND MANAGEMENT LETTERS. THE AUDIT COMMITTEE MAY MEET WITH THE INDEPENDENT AUDITORS IN EXECUTIVE SESSION BEFORE CONCLUDING ITS REVIEW AND ACCEPTANCE OF THE ANNUAL AUDIT REPORT. THE AUDIT COMMITTEE REPORTS ITS FINDINGS AND MAKES ITS RECOMMENDATIONS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 14 THE ORGANIZATION HAS A FORMAL RECORD RETENTION AND DESTRUCTION POLICY WHICH COMPLIES WITH FEDERAL AND STATE LAW AND WITH THE REQUIREMENTS OF VARIOUS REGULATORY AGENCIES. FORM 990, PART VII, SECTION A, LINE 1A, COLUMN F SR. M. STEPHEN PEREIRA AS A MEMBER OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM, INC. HAS TAKEN A VOW OF POVERTY. THE COMPENSATION ESTABLISHED FOR THE SISTER ON BEHALF OF SERVICES PROVIDED TO THE FACILITY FOR SR. M. STEPHEN PEREIRA IS PAID DIRECTLY TO THE CARMELITE SISTERS FOR THE AGED AND INFIRM, INC. RATHER THAN THE INDIVIDUAL SISTER. FORM 990, PART VI, SECTION B, LINE 13 THE ORGANIZATION HAS A CORPORATE COMPLIANCE POLICY IN PLACE, WHICH INCLUDES A POLICY ON WHISTLEBLOWER PROTECTION. CARMELITE SISTERS FOR THE AGED AND INFIRM INC 600 WOODS ROAD GERMANTOWN NY 12526 141369151 TO SPONSOR NURSING HOMES FOR THE AGED AND INFIRM NY 501(C)3 509(A)(2) N/A 0 THE CARMELITE SYSTEM INC 646 WOODS ROAD GERMANTOWN NY 12526 141810368 MANAGEMENT OF AFFILIATED FACILITIES NY 501(C)3 509(A)(2) N/A 0 CARMEL MANOR INC 100 CARMEL MANOR ROAD FORT THOMAS KY 41075 610523290 SKILLED NURSING FACILITY KY 501(C)3 509(A)(2) N/A 0 CARMEL TERRACE INC 933 CENTRAL STREET FRAMINGHAM MA 01701 043210051 ASSISTED LIVING FACILITY MA 501(C)3 509(A)(2) N/A 0 KAHL HOME FOR THE AGED AND INFIRM 6701 JERSEY RIDGE ROAD DAVENPORT IA 52807 420760833 SKILLED NURSING FACILITY IA 501(C)3 509(A)(2) N/A 0 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE INC 315 SOUTH FLAGLER DRIVE WEST PALM BEACH FL 33401 590879342 SKILLED, ASSISTED AND INDEPENDENT LIVING FACILITY FL 501(C)3 509(A)(2) N/A 0 MOTHER ANGELINE MCCRORY MANOR INC 5199 EAST BROAD STREET COLUMBUS OH 43213 912134683 SKILLED NURSING FACILITY OH 501(C)3 509(A)(2) N/A 0 MOUNT CARMEL CARE CENTER INC 320 PITTSFIELD ROAD LENOX MA 01240 383902709 SKILLED NURSING FACILITY MA 501(C)3 509(A)(2) N/A 0 ST MARGARET HALL INC 1960 MADISON ROAD CINCINNATI OH 45206 310655031 SKILLED NURSING AND ASSISTED LIVING FACILITY OH 501(C)3 509(A)(2) N/A 0 ST PATRICK'S HOME FOR THE AGED AND INFIRM INC 66 VAN CORTLAND PARK SOUTH BRONX NY 10463 121740033 SKILLED NURSING FACILITY NY 501(C)3 509(A)(2) N/A 0 ST PATRICK'S MANOR INC 863 CENTRAL STREET FRAMINGHAM MA 01701 042157057 SKILLED NURSING FACILITY MA 501(C)3 509(A)(2) N/A 0 ST PATRICK'S RESIDENCE 1400 BROOKDALE ROAD NAPERVILLE IL 60563 362527011 SKILLED NURSING FACILITY IL 501(C)3 509(A)(2) N/A 0 VILLAS AT SAINT THERESE INC 5253 EAST BROAD STREET COLUMBUS OH 43213 472021696 INDEPENDENT LIVING FACILITY OH 501(C)3 509(A)(2) N/A 0 OZANAM HALL 4241 201ST STREET BAYSIDE NY 11361 112167809 SKILLED NURSING FACILITY NY 501(C)3 509(A)(2) N/A 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 CARMELITE SISTERS FOR THE AGED AND INFIRM INC E 3075339 PER BOOKS AND RECORDS THE CARMELITE SYSTEM INC M 910405 PER BOOKS AND RECORDS THE CARMELITE SYSTEM INC M 316894 PER BOOKS AND RECORDS THE CARMELITE SYSTEM INC M 166617 PER BOOKS AND RECORDS THE CARMELITE SYSTEM INC E 26542 PER BOOKS AND RECORDS CARMELITE SISTERS FOR THE AGED AND INFIRM INC P 253784 PER BOOKS AND RECORDS CARMELITE SISTERS FOR THE AGED AND INFIRM INC Q 105029 PER BOOKS AND RECORDS