2016-11-10T10:08:02-06:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2015-01-01 042106771 WILLIAM B RICE EVENTIDE HOME INC WILL 6174728300 215 ADAMS STREET QUINCY MA 02169 DONALD POWELL PRESIDENT 6174728300 2016-11-08 1 JUDY DALEY P01294075 6179848100 2016-08-04 2015 2017-02-10 21:41:12Z DONALD POWELL 215 ADAMS STREET QUINCY MA 02169 11234275 0 X WWW.EVENTIDEHOME.ORG X 1924 MA TO MAINTAIN A UNIQUE LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED AND CARING SUPPORTIVE SERVICES IN A HOME-LIKE ATMOSPHERE WHICH ALLOWS THE RESIDENTS TO MAINTAIN INDEPENDENT LIVES WITH DIGNITY. 11 11 144 15 0 0 0 0 6243432 6361508 490526 413063 32388 24684 6766346 6799255 0 0 0 0 4600132 4498466 0 0 0 3027175 2953900 7627307 7452366 -860961 -653111 22087848 43994126 4069029 27016633 18018819 16977493 TO MAINTAIN A UNIQUE LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED AND CARING SUPPORTIVE SERVICES IN A HOME-LIKE ATMOSPHERE WHICH ALLOWS THE RESIDENTS TO MAINTAIN INDEPENDENT LIVES WITH DIGNITY. 0 0 6860273 6386192 THE HOME PROVIDES SECURE HOUSING, QUALITY NURSING CARE, MEANINGFUL ACTIVITIES, OPPORTUNITIES FOR SOCIALIZATION, AND A WIDE VARIETY OF SUPPORTIVE SERVICES TO APPROXIMATELY 60 FRAIL ELDERS UNABLE TO LIVE INDEPENDENTLY IN THE COMMUNITY, WITHOUT REGARD FOR THEIR ABILITY TO PAY. 6860273 1 0 0 1 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 10 0 1 144 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X JANICE FARIA 6174728300 215 ADAMS STREET QUINCY MA 02169 DONALD POWELL PRESIDENT (AS OF 03/2015) 5.00 X X 0 0 0 RICHARD MEADE PRESIDENT (THRU 03/2015) 5.00 X X 0 0 0 BRIAN GOTTA VICE PRESIDENT (AS OF 03/2015) 5.00 X X 0 0 0 AMY ROSS TREASURER 5.00 X X 0 0 0 MICHAEL MCFARLAND CLERK 5.00 X X 0 0 0 RUTH DOBBIE DIRECTOR 5.00 X 0 0 0 ROBERT DOLBEC DIRECTOR 5.00 X 0 0 0 ROBERT FOY DIRECTOR 5.00 X 0 0 0 WILLIAM JACKSON DIRECTOR 5.00 X 0 0 0 SHEILA MCINTYRE DIRECTOR 5.00 X 0 0 0 CHARLES RIPPBERGER MD DIRECTOR 5.00 X 0 0 0 PRISCILLA URANN DIRECTOR 5.00 X 0 0 0 ROBERT DWYER DIRECTOR (THRU 03/2015) 5.00 X 0 0 0 WILLIAM SMITH DIRECTOR (THRU 03/2015) 5.00 X 0 0 0 JOYCE HAGLUND EXECUTIVE DIRECTOR 40.00 X 169468 0 8750 PAULA O'CONNOR DIRECTOR OF NURSES 40.00 X 103609 0 19040 JANICE FARIA BUSINESS/HR DIRECTOR 40.00 X 101730 0 8113 374807 0 35903 3 0 1 0 DELLBROOK CONTRUCTION 1 ADAM PLACE QUINCY MA 02169 CONTRUCTION 13538420 VERTEC CORPORATION 180 MAIN STREET NORTH EASTON MA 02356 CONTRUCTION 611977 ROGERSON COMMUNITIES 1 FLORENCE STREET ROSLINDALE MA 02131 MANAGEMENT SERVICES 447683 CREATING RESULTS LLC 1400 CROWN COURT SUITE 211 WOODBRIDGE VA 22193 ADVERTISING 227427 BC ZIEGLER & CO 200 SOUTH WACKER DRIVE CHICAGO IL 60606 FINANCIAL CONSULTANT 184000 12 PUBLICLY-AIDED RESIDENTS 623000 3355459 3355459 PRIVATE RESIDENTS 623000 2011794 2011794 MEDICARE RESIDENTS 623000 590260 590260 ANCILLARY INCOME 623000 403995 403995 6361508 85334 85334 4762749 4435020 327729 327729 327729 OTHER INCOME 623000 24684 24684 24684 6799255 6386192 0 413063 178218 178218 3461380 3251131 210249 41308 38361 2947 513104 476495 36609 304456 282734 21722 30179 30179 42142 42142 1380 1380 32870 32870 31625 31625 369144 369144 80204 74672 5532 441517 441517 251334 251334 50176 50176 PATIENT CARE EXPENSES 1093794 1093794 NURSING USER FEE 365089 365089 205 ADAMS STREET 103386 103386 BAD DEBTS 48967 48967 12093 12093 7452366 6860273 592093 0 256208 316725 483432 298854 528714 554559 117310 114116 11643021 6492796 5177231 5150225 5994321 3301926 9530632 34257721 22087848 43994126 348265 3323868 1468517 1783693 2252247 18213636 0 3695436 4069029 27016633 X 17958919 16917593 18900 18900 41000 41000 18018819 16977493 22087848 43994126 -653111 -388215 0 X X 0 1 X 1 0 X 9497 10643 20140 5894246 6010482 5901237 6275820 6386192 30467977 5894246 6019979 5911880 6275820 6386192 30488117 0 0 0 30488117 314663 243762 176369 157684 85334 977812 314663 243762 176369 157684 85334 977812 6208909 6263741 6088249 6433504 6471526 31465929 0.96890 0.92200 0.03110 0.07800 X 0 0 0 0 0 0 1 525 0 1 855 1380 0 PART II-B, LINE 1: DURING 2015, THE ORGANIZATION PAID NIXON PEABODY, A LAW FIRM, FOR GOVERNMENT RELATIONS SERVICES OF $525 AND PAID LOBBYING MEMBERSHIP DUES OF $865 TO STATE HEALTHCARE ORGANIZATIONS. 0 1 X 50726 9174 59900 49431 3436 2001 140 50726 47012 4658 2172 67 49431 45695 2577 1227 33 47012 44177 2914 1358 38 45695 0.00000 0.68450 0.31550 0 0 3151077 3151077 6897173 5054238 1842935 1559922 1414163 145759 34849 24395 10454 5150225 INVESTMENT INTEREST RECEIVABLE 1832 DEFERRED FINANCING COSTS, NET 698533 DEVELOPMENT COSTS 23753935 DEFERRED ADVERTISING COSTS 2529342 OTHER ASSETS 1798855 LOAN AGREEMENT ESCROWS 5475224 34257721 SALE DEPOSIT LIABILITY 3695436 3695436 X 6766385 0 6766385 32870 32870 6799255 7419496 0 7419496 32870 32870 7452366 PART IV, LINE 2B: RICE EVENTIDE IS ACCEPTING PRECONSTRUCTION DEPOSITS FOR ITS FAIRING WAY PROJECT. PROSPECTIVE RESIDENTS MAY ENTER INTO ONE OF TWO TYPES OF AGREEMENTS TO RESERVE EITHER A POSITION ON A PRIORITY LIST OR RESERVE A SPECIFIC UNIT IN THE COMPLETED PROJECT. THE PRIORITY LIST DEPOSITS ARE FULLY REFUNDABLE UPON REQUEST AT ANY TIME. THE 10% UNIT DEPOSITS ARE ALSO REFUNDABLE UPON REQUEST AT ANY TIME PLUS ACCUMULATE INTEREST INCOME EARNED ON THE DEPOSIT, LESS AN ADMINISTRATIVE FEE. THE $10,000/UNIT DEPOSITS ARE NONREFUNDABLE, UNLESS RICE EVENTIDE IS UNABLE TO DELIVER THE RIGHT TO OCCUPY THE RESIDENCE ON THE CLOSING DATE. THE RESERVATION DEPOSITS ARE BEING HELD BY RICE SOUTHFIELD, LLC (DISREGARDED ENTITY OF RICE EVENTIDE). PART V, LINE 4: TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE TO BE USED FOR NEW RESIDENT BEDS. THE PERMANENT ENDOWMENT FUND'S INCOME IS USED FOR THE GENERAL PURPOSES OF THE HOME. PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. SHOULD THE STATUS BE CHALLENGED IN THE FUTURE, THE ENTITIES 2012 THROUGH 2015 TAX YEARS ARE OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X X 0 0 0 0 0 0 0 0 0 JOYCE HAGLUND EXECUTIVE DIRECTOR 169468 0 0 0 0 0 7800 0 950 0 178218 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR WILL REVIEW THE FORM 990 WITH MEMBERS OF THE BOARD'S EXECUTIVE COMMITTEE. IT WILL THEN BE DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT IS ENFORCED ANNUALLY BY DISTRIBUTION OF THE POLICY AND FOLLOW UP TO CONFIRM NO ONE IS IN CONFLICT OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT OF THE BOARD AND MEMBERS OF THE EXECUTIVE COMMITTEE APPROVES EXECUTIVE DIRECTOR'S SALARY. THEY REGULARLY REVIEW SALARY STUDIES DONE BY STATE HEALTHCARE ASSOCIATIONS. APPROVAL IS DOCUMENTED IN THE BOARD OF DIRECTORS' MINUTES. THIS WAS LAST DONE IN 2015. AN EMPLOYMENT AGREEMENT WAS SIGNED WITH THE EXECUTIVE DIRECTOR FOR 3 YEARS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS AUDIT OVERSIGHT PROCESS OR AUDITOR SELECTION PROCESS. RICE SOUTHFIELD LLC 215 ADAMS STREET QUINCY MA 02169 273136975 REAL ESTATE INVESTMENT MA 0 2543064 WILLIAM B RICE EVENTIDE HOME INC