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CHS OF WALTHAM INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CHS OF WALTHAM INC (EIN 04-3333609)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-10-19
IRS object ID
201742929349300109
Schema version
2016v3.0
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)
Return2017-10-19T08:03:19-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN043333609EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHS of Waltham IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHSOBusinessNameControlTxt
Phone7818930240PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 Newton StreetAddressLine1Txt
CityWalthamCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02453ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOSEPH DEVEAUPersonNm
Person TitleADMINISTRATORPersonTitleTxt
Phone7818930240PhoneNum
Signature2017-10-19SignatureDt
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MARISTHILL NURSING & REHABILTATIONBusinessNameLine1Txt
Business Name Line2CENTERBusinessNameLine2Txt
FieldValueIRS element (for citing)
Principal OfficerJOSEPH DEVEAUPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 Newton StreetAddressLine1Txt
CityWalthamCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02453ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,540,370GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addressmaristhill.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionMARISTHILL IS A CATHOLIC SKILLED NURSING AND REHABILITATION FACILITY THAT CONTINUES THE HEALING MINISTRY OF CHRIST BY PROVIDING HEALTH CARE SERVICES THAT FOSTER EACH INDIVIDUAL'S PHYSICAL, SPIRITUAL, EMOTIONAL AND INTELLECTUAL WELL-BEING.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee154TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$47,972PYContributionsGrantsAmt
CY Contributions Grants$17,752CYContributionsGrantsAmt
PY Program Service Revenue$10,301,039PYProgramServiceRevenueAmt
CY Program Service Revenue$10,478,750CYProgramServiceRevenueAmt
PY Investment Income$49,643PYInvestmentIncomeAmt
CY Investment Income$40,443CYInvestmentIncomeAmt
PY Other Revenue$910PYOtherRevenueAmt
CY Other Revenue$3,425CYOtherRevenueAmt
PY Total Revenue$10,399,564PYTotalRevenueAmt
CY Total Revenue$10,540,370CYTotalRevenueAmt
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$6,025,959PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,102,853CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,438,777PYOtherExpensesAmt
CY Other Expenses$4,667,514CYOtherExpensesAmt
PY Total Expenses$10,464,736PYTotalExpensesAmt
CY Total Expenses$10,770,367CYTotalExpensesAmt
PY Revenues Less Expenses-$65,172PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$229,997CYRevenuesLessExpensesAmt
Total Assets BOY$11,566,102TotalAssetsBOYAmt
Total Assets EOY$11,538,061TotalAssetsEOYAmt
Total Liabilities BOY$9,481,202TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,594,296TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,084,900NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,943,765NetAssetsOrFundBalancesEOYAmt
MissionMARISTHILL IS A CATHOLIC SKILLED NURSING AND REHABILITATION FACILITY THAT CONTINUES THE HEALING MINISTRY OF CHRIST BY PROVIDING HEALTH CARE SERVICES THAT FOSTER EACH INDIVIDUAL'S PHYSICAL, SPIRITUAL, EMOTIONAL AND INTELLECTUAL WELL-BEING.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$10,518,658ExpenseAmt
Revenue$10,482,175RevenueAmt
DescMARISTHILL NURSING AND REHABILITATION CENTER PROVIDED 36,186 DAYS OF SKILLED NURSING SERVICES DURING 2016 OF WHICH 25,252 WERE TO MEDICAID RECIPIENTS.Desc
Total Program Service Expenses$10,518,658TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
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 LiabilitiesYes (1)ReportOtherLiabilitiesInd
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 RequiredYes (1)ScheduleJRequiredInd
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 Mem0BusinessRlnWithFamMemInd
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 Document8IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee154EmployeeCnt
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
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOSEPH DEVEAUADMINISTRATORBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7818930240PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 NEWTON STREETAddressLine1Txt
CityWALTHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02453ZIPCd

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
KENNETH FERRON
TREASURER1.0039.00Yes (X)Yes (X)$0$370,135$41,271
KELLY HILL
CHAIR1.00Yes (X)Yes (X)$0$0$0
JUDITH ALLEN
TRUSTEE1.00Yes (X)Yes (X)$0$0$0
NANCY SMITH
TRUSTEE1.00Yes (X)$0$0$0
SRJOYCE ANN EDELMANN
TRUSTEE1.00Yes (X)$0$0$0
SUSAN STRANG
TRUSTEE1.00Yes (X)$0$0$0
JOSEPH CUZZUPOLI
TRUSTEE1.00Yes (X)$0$0$0
CAROLYN FENN
CEO/ADMINISTRATOR40.00Yes (X)Yes (X)$104,711$0$13,841
DR FELIX JZOLLO JR
TRUSTEE1.00Yes (X)$0$0$0
STEPHEN VERA
DIRECTOR1.00Yes (X)$0$0$0
SHIRLY YELLAMATY
RN MANAGER40.00$114,205$0$10,344Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$218,916TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$370,135TotReportableCompRltdOrgAmt
Total Other Compensation$65,456TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
REHABCARE GROUP INC
PO BOX 503534STLOUISMO631503534REHABILITATION SERVICES$696,280
PERFORMANCE HEALTH CARE SERVICES
47R RIVER STREETWELLESLEYMA02481HOUSEKEEPING$342,000
OMNICARE
PO BOX 7800DETROITMI482781668PHARMACY$237,890
US FOOD
PO BOX 3155BOSTONMA022413155FOOD SERVICE$235,613
MCKESSON
PO BOX 630693CINCINNATIOH452630693MEDICAL SUPPLIES$148,440
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$17,752AllOtherContributionsAmt
Total Contributions$17,752TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUDesc
Business623000BusinessCd
Total Revenue Column$10,478,750TotalRevenueColumnAmt
Related Or Exempt Func Income$10,478,750RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,478,750TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$40,443TotalRevenueColumnAmt
Exclusion$40,443ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
miscellaneous income623000$2,640$2,640
Vending Machine623000$715$715
cafeteria income623000$40$40

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$30TotalRevenueColumnAmt
Related Or Exempt Func Income$30RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$3,425OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,540,370TotalRevenueColumnAmt
Related Or Exempt Func Income$10,482,175RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$40,443ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$104,711TotalAmt
Program Services$104,711ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,118,340TotalAmt
Program Services$5,118,340ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$19,912TotalAmt
Program Services$19,912ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$479,170TotalAmt
Program Services$479,170ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$380,720TotalAmt
Program Services$380,720ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$131,133TotalAmt
Management And General$131,133ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$15,317TotalAmt
Management And General$15,317ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$105,259TotalAmt
Management And General$105,259ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$10,939TotalAmt
Program Services$10,939ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$54,953TotalAmt
Program Services$54,953ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$174,241TotalAmt
Program Services$174,241ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$14,273TotalAmt
Program Services$14,273ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,683TotalAmt
Program Services$1,683ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$368,851TotalAmt
Program Services$368,851ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$537,158TotalAmt
Program Services$537,158ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$101,234TotalAmt
Program Services$101,234ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
PURCHASED SERVICES$1,418,168$1,418,168
NURSING HOME SUPPLIES A$878,907$878,907
MEDICAID USER FEE$585,259$585,259
UTILITIES$270,139$270,139

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,770,367TotalAmt
Program Services$10,518,658ProgramServicesAmt
Management And General$251,709ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$66,181BOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$420,648BOYAmt
EOY$376,379EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$953,396BOYAmt
EOY$1,091,452EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$45,507BOYAmt
EOY$39,029EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,883,510LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,287,176LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,091,238BOYAmt
EOY$6,596,334EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,760,109BOYAmt
EOY$2,438,643EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,229,023BOYAmt
EOY$996,224EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,566,102BOYAmt
EOY$11,538,061EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$664,908BOYAmt
EOY$836,539EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,195,018BOYAmt
EOY$8,091,553EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$621,276BOYAmt
EOY$666,204EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,481,202BOYAmt
EOY$9,594,296EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,084,900BOYAmt
EOY$1,943,765EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,084,900BOYAmt
EOY$1,943,765EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,566,102BOYAmt
EOY$11,538,061EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$229,997ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$88,862NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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 Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,940CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,170CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,820CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$47,972CurrentTaxYearMinus1YearAmt
Current Tax Year$17,752CurrentTaxYearAmt
Total$128,654TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,268,103CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,142,271CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,480,889CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,301,949CurrentTaxYearMinus1YearAmt
Current Tax Year$10,482,175CurrentTaxYearAmt
Total$51,675,387TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,291,043CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,163,441CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,499,709CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,349,921CurrentTaxYearMinus1YearAmt
Current Tax Year$10,499,927CurrentTaxYearAmt
Total$51,804,041TotalAmt

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$51,804,041PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$25,301CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,064CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$50,454CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$49,643CurrentTaxYearMinus1YearAmt
Current Tax Year$40,443CurrentTaxYearAmt
Total$184,905TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$25,301CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,064CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$50,454CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$49,643CurrentTaxYearMinus1YearAmt
Current Tax Year$40,443CurrentTaxYearAmt
Total$184,905TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,316,344CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,182,505CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,550,163CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,399,564CurrentTaxYearMinus1YearAmt
Current Tax Year$10,540,370CurrentTaxYearAmt
Total$51,988,946TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99640PublicSupportCY509Pct
Public Support PY5090.99720PublicSupportPY509Pct
Investment Income CY0.00360InvestmentIncomeCYPct
Investment Income PY0.00280InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$485,000OtherCostOrOtherBasisAmt
Book Value$485,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,311,273OtherCostOrOtherBasisAmt
Depreciation$3,220,136DepreciationAmt
Book Value$5,091,137BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,951,272OtherCostOrOtherBasisAmt
Depreciation$3,067,040DepreciationAmt
Book Value$884,232BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$135,965OtherCostOrOtherBasisAmt
Book Value$135,965BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,596,334TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Resident Funds$27,349
Debt Service Reserve Fund$713,546
Debt Service Sinking Fund (NET)$255,329
FieldValueIRS element (for citing)
Total Book Value Other Assets$996,224TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Deferred Expenses$260,711
Medicaid User Fees$166,450
Professional Liabilitty Loss Reserves$25,599
Due To Affiliates$187,445
Residents Funds$25,999
FieldValueIRS element (for citing)
Total Liability$666,204TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationCovenant and its member organizations are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code, except as noted below. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated the position taken on its filed tax returns. The System has concluded no uncertain income tax positions exist at December 31, 2016. Under Internal Revenue Service regulations, the System's tax years from 2013 through 2016 are open and subject to examination.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonKENNETH FERRONPersonNm
TitleTREASURERTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$319,237CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$50,898OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$10,600DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$30,671NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$411,406TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF COVENANT HEALTH'S BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003 THE COMPENSATION COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. THE SPECIFIC OBJECTIVES OF THE ANALYSIS ARE TO ASSESS THE COMPETITIVENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR LEADERSHIP TEAM; DEVELOP MARKET COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPROTUNITIES, IF ANY, ARE COMPETITIVE AND REASONABLE.
Part I, Line 4bThe related organization, Covenant Health, maintains a supplemental executive retirement program for certain executives under which the organization makes a contribution to a grantor trust for the benefit of the executive that is intended to provide a specified level of retirement benefits at retirement age commensurate with retirement benefits provided to executives in comparable positions by similarly situated organizations. Amounts contributed to the grantor trust are held for the benefit of the executive until he or she reaches age 60, at which time they are released to the executive. The full amount paid into the grantor trust is taxable to the executive when so paid, and is included in the executive's reported compensation.
Part I, Line 7The related organization, Covenant Health, maintains an incentive compensation plan for executives that is administered by the organization's Compensation Committee. The plan provides executives with the opportunity to earn reasonable incentive compensation based on the performance of the organization and the performance of the individual executive, as measured against goals that are set at the beginning of the year. The entitlement to awards for a particular year is not determined until early the following year. The organization paid no incentive compensation awards in 2014 to Kenneth Ferron based on performance during 2013.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
MA HEALTH & EDUCATION FACILITIES AUTHORITY
A04245601157586DBF92007-10-30$7,221,865TO FINANCE THE PURCHASE OF YOUVILLE PLACEYes (1)00
MA HEALTH & EDUCATION FACILITIES AUTHORITY
B04245601157584qaa42012-06-27$1,720,000Capital equipment and projects000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$7,221,865$712,880$55,862$6,117,244Yes (1)Yes (1)Yes (1)Yes (1)
B$1,720,000$54,82800Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueInd
AYes (1)00000
B000000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart IV, #7 & Part V:FormAndLineReferenceDesc
ExplanationBoth bonds are carefully and consistently monitored for potential violations of federal tax requirements, but the procedures were not written as of the end of the year covered by this tax return. However, the Organization is considering adopting formal policies that set forth the Organization's methodology for ensuring post-issuance compliance with IRS requirements pertaining to tax-exempt debt and contain specific language regarding organizational responsibility, record retention, private business use, arbitrage rebate, and remedial action. Although formal policies are not in place in regards to the remediation of our bonds, the monitoring requirements of Section 148, and procedures to ensure that violations are timely identified and corrected, the Organization has compliance checks in place that substantiate these requirements.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6COVENANT HEALTH iS THE SOLE MEMBER OF THE ORGANIZATION OF THE BOARD. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS OVER BOARD DECISIONS AND BOARD COMPOSITION.
Form 990, Part VI, Section A, line 7aCOVENANT HEALTH IS THE SOLE MEMBER OF THE ORGANIZATION. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS OVER CORPORATE DECISIONS AND BOARD COMPOSITION.
Form 990, Part VI, Section A, line 7bCOVENANT HEALTH IS THE SOLE MEMBERS OF THE ORGANIZATION. AS SUCH IT RETAINS CERATIN RESERVE RIGHTS OVER BOARD DECISIONS AND BOARD COMPOSITION.
Form 990, Part VI, Section B, line 11bTHE FORM 990 IS PROVIDED TO AND REVIEWED WITH THE BOARD PRIOR TO FILING
Form 990, Part VI, Section B, line 12cTHE ORGANIZATION HAS A FULL-TIME OPERATIONAL INTEGRITY OFFICER THAT MONITORS ALL AREAS FOR POTENTIAL CONFLICTS OF INTEREST.
Form 990, Part VI, Section B, line 15EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003 THE COMPENSATION COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. THE SPECIFIC OBJECTIVES OF THE ANALYSIS ARE TO ASSESS THE COMPETITIVENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR LEADERSHIP TEAM; DEVELOP MARKET COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF ANY, ARE COMPETITIVE AND REASONABLE.
Form 990, Part VI, Section C, line 19THE FORM 990 AND GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HEALTHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 AMES POND DRIVEAddressLine1Txt
CityTEWKSBURYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01876ZIPCd
FieldValueIRS element (for citing)
EIN222484505EIN
Primary ActivitiesHEALTH CARE MANAGEMENT AND RESOURCE ORGANIZATIONPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
Exempt Code Section501(C)ExemptCodeSectionTxt
Public Charity Status9PublicCharityStatusTxt
Controlled Organization0ControlledOrganizationInd
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 OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd