MI NURSING-RESTORATIVE CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MI NURSING-RESTORATIVE CENTER INC (EIN 04-2104851)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-08-05
- IRS object ID
- 201612189349300601
- Schema version
- 2015v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-05T06:36:47-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010494526 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER NEWMAN & NOYES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 650 ELM STREET SUITE 302 | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042104851 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MI NURSING RESTORATIVE CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MINU | BusinessNameControlTxt |
| Phone | 9786856321 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 172 LAWRENCE STREET | AddressLine1Txt |
| City | LAWRENCE | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01841 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GERARD FOLEY | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 9786856321 | PhoneNum |
| Signature | 2016-07-25 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | E DREW CHENEY | PreparerPersonNm |
| PTIN | P00182972 | PTIN |
| Phone | 8002447444 | PhoneNum |
| Preparation | 2016-07-25 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GERARD FOLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 172 LAWRENCE STREET | AddressLine1Txt |
| City | LAWRENCE | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01841 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,696,615 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | MIHCS.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1875 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF MI NURSING RESTORATIVE CENTER, INC. IS TO RESPOND WITH COMPASSIONATE CARE AND DIGNITY TO THE HEALTH, SOCIAL AND SPIRITUAL NEEDS OF WELL, SICK, AND FRAIL ELDERS. MI ALSO OFFERS AND EXTENDS SUPPORTIVE PRESENCE AND PROGRAMS TO THE FAMILIES OF RESIDENTS. THE QUALITY OF OUR SERVICES ARE ACHIEVED THROUGH EMBRACING CORE VALUES THAT INCLUDE COMPASSION, COMPETENCE AND COLLABORATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 495 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,281,572 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,771 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,395,741 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,377,701 | CYProgramServiceRevenueAmt |
| PY Investment Income | $311,045 | PYInvestmentIncomeAmt |
| CY Investment Income | $295,640 | CYInvestmentIncomeAmt |
| PY Other Revenue | $34,620 | PYOtherRevenueAmt |
| CY Other Revenue | $18,503 | CYOtherRevenueAmt |
| PY Total Revenue | $24,022,978 | PYTotalRevenueAmt |
| CY Total Revenue | $19,696,615 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,828,400 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,889,110 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,728,665 | PYOtherExpensesAmt |
| CY Other Expenses | $5,427,599 | CYOtherExpensesAmt |
| PY Total Expenses | $18,557,065 | PYTotalExpensesAmt |
| CY Total Expenses | $18,316,709 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,465,913 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,379,906 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,170,216 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,304,510 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,664,943 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,959,002 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,505,273 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $31,345,508 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF MI NURSING RESTORATIVE CENTER, INC. IS TO RESPOND WITH COMPASSIONATE CARE AND DIGNITY TO THE HEALTH, SOCIAL AND SPIRITUAL NEEDS OF WELL, SICK, AND FRAIL ELDERS. MI ALSO OFFERS AND EXTENDS SUPPORTIVE PRESENCE AND PROGRAMS TO THE FAMILIES OF RESIDENTS. THE QUALITY OF OUR SERVICES ARE ACHIEVED THROUGH EMBRACING CORE VALUES THAT INCLUDE COMPASSION, COMPETENCE AND COLLABORATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,457,940 | ExpenseAmt |
| Revenue | $19,396,204 | RevenueAmt |
| Desc | THE PROVISION OF ELDERCARE THROUGH THE OPERATION OF A 231 BED SKILLED NURSING FACILITY, THE PROVISION OF 80,147 RESIDENT DAYS OF SKILLED NURSING CARE, REHABILIATION SERVICES, DIETARY, LAUNDRY AND HOUSEKEEPING SERVICES AND NUMEROUS SOCIAL ACTIVITIES. MEDICAID DAYS REPRESENT 66,859 OF THE 80,147 TOTAL RESIDENT DAYS. | Desc |
| Total Program Service Expenses | $16,457,940 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 495 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GERARD FOLEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9786856321 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 172 LAWRENCE STREET | AddressLine1Txt |
| City | LAWRENCE | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01841 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| FRED SHAHEEN | ||||||||
| DIRECTOR EX COMM | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN NICEFORO JR MD | ||||||||
| CHAIRPERSON THUR 4/15/15 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| KELLY SULLIVAN ESQ | ||||||||
| CLERK | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARGARET SHAHEEN | ||||||||
| CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| REV WILLIAM DONNELLY OSA | ||||||||
| DIRECTOR 4/15 TO 9/15 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RAISA CARRASCO-VELEZ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SR SUZANNE FORGET SGM | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| REV PETER GORI OSA JCD | ||||||||
| DIRECTOR AS OF 4/15/15 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KAREN MILLER | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARY LOUISE RETELLE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY ALICE ROCK | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| EFRAIN ROLON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL MILLER ESQ | ||||||||
| DIRECTOR AS OF 4/15/15 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROSEMARIE A CONNOLLY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GERARD J FOLEY | ||||||||
| PRESIDENT/CEO | 20.00 | Yes (X) | $236,919 | $0 | $54,470 | Yes (X) | 20.00 | |
| ARLINE EL-ASHKAR MSN RN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DEBORAH L TURIANOMD | ||||||||
| VICE CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEWART GOFF | ||||||||
| ADMINISTRATOR | 39.00 | $135,556 | $0 | $50,039 | 1.00 | Yes (X) | ||
| JEANNE LEYDON | ||||||||
| ADMINISTRATOR | 8.00 | $132,980 | $0 | $27,953 | 32.00 | Yes (X) | ||
| CHRISTINE PIERRE | ||||||||
| DIRECTOR OF NURSING | 39.00 | $109,639 | $0 | $38,929 | 1.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $615,094 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $171,391 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| REHABCARE | |||||
| 7733 FORSYTH BLVD STE 2300 | ST LOUIS | MO | 63105 | REHABILITATION SERVICES | $866,127 |
| COVENANT HEALTH | |||||
| 100 AMES POND SUITE 102 | TEWKSBURY | MA | 01876 | HEALTH CARE MGMT CO. | $407,489 |
| OMNICARE | |||||
| PO BOX 78000 | DETROIT | MI | 482781668 | PHARMACEUTICALS | $337,890 |
| MCKESSON | |||||
| PO BOX 630693 | CINCINNATI | OH | 452630693 | MEDICAL SUPPLIES | $279,486 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $4,771 | AllOtherContributionsAmt |
| Total Contributions | $4,771 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $19,377,701 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,377,701 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,377,701 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $295,640 | TotalRevenueColumnAmt |
| Exclusion | $295,640 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $18,503 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,503 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $18,503 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,696,615 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,396,204 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $295,640 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,919 | TotalAmt |
| Program Services | $208,489 | ProgramServicesAmt |
| Management And General | $28,430 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,690,347 | TotalAmt |
| Program Services | $9,407,505 | ProgramServicesAmt |
| Management And General | $1,282,842 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,473 | TotalAmt |
| Program Services | $56,736 | ProgramServicesAmt |
| Management And General | $7,737 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,094,947 | TotalAmt |
| Program Services | $963,553 | ProgramServicesAmt |
| Management And General | $131,394 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $802,424 | TotalAmt |
| Program Services | $706,133 | ProgramServicesAmt |
| Management And General | $96,291 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,673 | TotalAmt |
| Management And General | $236,673 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,438 | TotalAmt |
| Management And General | $42,438 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,964 | TotalAmt |
| Management And General | $32,964 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,360 | TotalAmt |
| Program Services | $17,360 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,393 | TotalAmt |
| Program Services | $202,393 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,566 | TotalAmt |
| Program Services | $212,566 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,290 | TotalAmt |
| Program Services | $347,290 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,409 | TotalAmt |
| Program Services | $4,409 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $648,855 | TotalAmt |
| Program Services | $648,855 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,393 | TotalAmt |
| Program Services | $193,393 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PURCHASED SERVICES | $1,650,955 | $1,650,955 |
| SUPPLIES | $1,644,400 | $1,644,400 |
| MEDICAID USER FEE | $137,154 | $137,154 |
| EDUCATION & TRAINING | $56,749 | $56,749 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,316,709 | TotalAmt |
| Program Services | $16,457,940 | ProgramServicesAmt |
| Management And General | $1,858,769 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,197,942 | BOYAmt |
| EOY | $1,727,586 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,470,390 | BOYAmt |
| EOY | $236,138 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,080,271 | BOYAmt |
| EOY | $1,836,294 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $153,542 | BOYAmt |
| EOY | $186,694 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,439,476 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,136,667 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,618,427 | BOYAmt |
| EOY | $5,302,809 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,996,141 | BOYAmt |
| EOY | $23,185,288 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $653,503 | BOYAmt |
| EOY | $829,701 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,170,216 | BOYAmt |
| EOY | $33,304,510 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $956,886 | BOYAmt |
| EOY | $1,246,572 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $708,057 | BOYAmt |
| EOY | $712,430 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,664,943 | BOYAmt |
| EOY | $1,959,002 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,505,273 | BOYAmt |
| EOY | $31,345,508 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,505,273 | BOYAmt |
| EOY | $31,345,508 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,170,216 | BOYAmt |
| EOY | $33,304,510 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,379,906 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$539,671 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $38,520 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,304 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,998 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,281,572 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,771 | CurrentTaxYearAmt |
| Total | $4,332,165 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,729,651 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,965,465 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,283,914 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,430,361 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,396,204 | CurrentTaxYearAmt |
| Total | $98,805,595 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,768,171 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,968,769 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,287,912 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,711,933 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,400,975 | CurrentTaxYearAmt |
| Total | $103,137,760 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $103,137,760 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $152,263 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $173,627 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $202,308 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $311,045 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $295,640 | CurrentTaxYearAmt |
| Total | $1,134,883 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $152,263 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $173,627 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $202,308 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $311,045 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $295,640 | CurrentTaxYearAmt |
| Total | $1,134,883 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,920,434 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,142,396 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,490,220 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,022,978 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,696,615 | CurrentTaxYearAmt |
| Total | $104,272,643 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98910 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99200 | PublicSupportPY509Pct |
| Investment Income CY | 0.01090 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00800 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,020 | BeginningYearBalanceAmt |
| Grants Or Scholarships | $1,020 | GrantsOrScholarshipsAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,020 | BeginningYearBalanceAmt |
| Grants Or Scholarships | $2,000 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,020 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,020 | BeginningYearBalanceAmt |
| End Year Balance | $3,020 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,000 | BeginningYearBalanceAmt |
| Grants Or Scholarships | $6,980 | GrantsOrScholarshipsAmt |
| End Year Balance | $3,020 | EndYearBalanceAmt |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $104,779 | OtherCostOrOtherBasisAmt |
| Book Value | $104,779 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,034,052 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,648,381 | DepreciationAmt |
| Book Value | $4,385,671 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,300,645 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,488,286 | DepreciationAmt |
| Book Value | $812,359 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,302,809 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INVESTMENTS | Desc |
| Book Value | $23,185,288 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $23,185,288 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED EXPENSES | $529,777 |
| RESIDENT FUNDS LIABILITY | $66,710 |
| PROFESSIONAL LIABILITY LOSS RESERVE | $63,657 |
| DUE TO MEDICAID | $52,286 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $712,430 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | COVENANT 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, 2015. UNDER INTERNAL REVENUE SERVICE REGULATIONS, THE SYSTEM'S TAX YEARS FROM 2012 THROUGH 2015 ARE OPEN AND SUBJECT TO EXAMINATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GERARD J FOLEY | ||||||||||||||
| PRESIDENT/CEO | $221,100 | $0 | $15,819 | $0 | $0 | $0 | $21,704 | $0 | $32,766 | $0 | $291,389 | $0 | $0 | $0 |
| STEWART GOFF | ||||||||||||||
| ADMINISTRATOR | $125,318 | $0 | $10,000 | $0 | $238 | $0 | $13,904 | $0 | $36,135 | $0 | $185,595 | $0 | $0 | $0 |
| JEANNE LEYDON | ||||||||||||||
| ADMINISTRATOR | $122,910 | $0 | $9,812 | $0 | $258 | $0 | $12,694 | $0 | $15,259 | $0 | $160,933 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH'S BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKETS DATA FROM VARIOUS 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. OBJECTIVES ARE TO ASSESS THE COMPOSITENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS OF THE SENIOR LEADERSHIP TEAM, DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE. |
| PART I, LINE 7 | THE RELATED ORGANIZATION, COVENANT HEALTH, MAINTAINS AN INCENTIVE COMPENSATION PLAN FOR EXECUTIVES THAT IS ADMINISTERED BY THAT 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 ESTABLISHED AT THE BEGINNING OF THE YEAR. THE ENTITLEMENT TO AWARDS FOR A PARTICULAR YEAR IS NOT DETERMINED UNTIL EARLY THE FOLLOWING YEAR. AMOUNTS PAID UNDER THE PLAN ARE REPORTED ON SCHEDULE J, PART II, COLUMN (B)(II). |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| FRED SHAHEEN | |||
| DIRECTOR | $214,932 | FOOD SUPPLIES ARE PURCHASED FROM SHAHEEN BROTHERS, INC. FRED SHAHEEN IS AN OWNER OF THE COMPANY. SHAHEEN BROTHERS, INC. IS ONE OF SEVERAL VENDORS USED BY THE ORGANIZATION AND ALL TRANSACTIONS ARE CONDUCTED AT FAIR MARKET VALUE. | 0 |
| MARGARET SHAHEEN | |||
| DIRECTOR | MARGARET IS THE WIFE OF AN OWNER OF SHAHEEN BROTHERS, INC. SHAHEEN BROTHERS, INC. TRANSACTIONS ARE LISTED ABOVE. | 0 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | FRED SHAHEEN, DIRECTOR AND MARGARET SHAHEEN, DIRECTOR, ARE IN LAWS. |
| FORM 990, PART VI, SECTION A, LINE 6 | COVENANT HEALTH IS THE SOLE MEMBER OF THE ORGANIZATION. ACCORDINGLY, IT RETAINS CERTAIN RESERVE RIGHTS OVER CORPORATE DECISIONS AND BOARD COMPOSITION. |
| FORM 990, PART VI, SECTION A, LINE 7A | COVENANT 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 7B | COVENANT HEALTH IS THE SOLE MEMBER OF THE ORGANIZATION. ACCORDINGLY IT RETAINS CERTAIN RESERVE RIGHTS OVER CORPORATE DECISIONS AND BOARD COMPOSITION. |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS PROVIDED TO THE BOARD MEMBERS AND REVIEWED AT THAT TIME. |
| FORM 990, PART VI, SECTION B, LINE 12C | THIS PROCESS IS THE RESPONSIBILITY OF THE COMPLIANCE OFFICER. A FORM IS SUBMITTED TO ALL LEADERSHIP, BOARD MEMBERS, BOARD COMMITTEE MEMBERS, EMPLOYED PHYSICIANS, MEDICAL DIRECTORS AND CERTAIN EMPLOYEES IN KEY POSITIONS ANNUALLY TO BE COMPLETED. REMINDERS ARE SENT OUT TO MAKE CERTAIN THAT ALL CONFLICT OF INTEREST FORMS ARE RETURNED. |
| FORM 990, PART VI, SECTION B, LINE 15 | EVERY 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. OBJECTIVES ARE TO ASSESS THE COMPOSITENESS OF THE TOTAL CASH COMPENSATION LEVELS OF THE SENIOR LEADERSHIP TEAM, DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION PROVIDES FORM 990 AND ACCESS TO GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS UPON REQUEST. THE FORM 990 IS POSTED ON COVENANT HEALTH'S WEBSITE ALSO. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MI RESIDENTIAL COMMUNITY III INC | ||||||||||
| 193 MAPLE ST | LAWRENCE | MA | 01841 | 042686043 | PROVIDER OF LOW INCOME HOUSING (HUD) TO ELDERLY AND DISABLED RESIDENTS | MA | 501 (C) (3) | LINE 9 | COVENANT HEALTH | 0 |
| MI TRANSPORTATION INC | ||||||||||
| 189 MAPLE ST | LAWRENCE | MA | 01841 | 042921889 | PROVIDER OF TRANSPORTATION SERVICES TO ELDERLY, SICK AND DISABLED RESIDENTS | MA | 501 (C) (3) | LINE 9 | COVENANT HEALTH | 0 |
| COVENANT HEALTH INC | ||||||||||
| 100 AMES POND SUITE 102 | TEWKSBURY | MA | 01876 | 222484505 | HEALTHCARE MANAGEMENT AND RESOURCE ORGANIZATION | MA | 501 (C) (3) | LINE 9 | 0 | |
| MI MANAGEMENT INC | ||||||||||
| 172 LAWRENCE ST | LAWRENCE | MA | 01841 | 042857794 | PROVIDER OF ASSISTED LIVING SERVICES TO THE ELDERLY | MA | 501 (C) (3) | LINE 11A, I | COVENANT HEALTH | 0 |
| MI ADULT DAY HEALTH CARE CENTER INC | ||||||||||
| 189 MAPLE ST | LAWRENCE | MA | 01841 | 042921888 | ADULT DAY CARE FOR ELDERLY, SICK AND HANDICAPPED | MA | 501 (C) (3) | LINE 9 | COVENANT HEALTH | 0 |
| MI RESIDENTIAL COMMUNITY II INC | ||||||||||
| 191 MAPLE ST | LAWRENCE | MA | 01841 | 042679954 | PROVIDER OF LOW INCOME HOUSING (HUD) TO ELDERLY AND DISABLED RESIDENTS | MA | 501 (C) (3) | LINE 9 | COVENANT HEALTH | 0 |
| MI RESIDENTIAL COMMUNITY INC | ||||||||||
| 189 MAPLE ST | LAWRENCE | MA | 01841 | 042647207 | PROVIDER OF ASSISTED LIVING SERVICES TO THE ELDERLY | MA | 501 (C) (3) | LINE 9 | COVENANT HEALTH | 0 |
| MARY IMMACULATE GUILD INC | ||||||||||
| 172 LAWRENCE ST | LAWRENCE | MA | 01841 | 463073987 | PROVIDER OF SERVICES TO MI AND AFFILIATED ORGANIZATIONS | MA | 501 (C) (3) | LINE 11A, I | MI NURSING RESTORATIVE CENTER INC | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MI GUILD INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | P | TransactionTypeTxt |
| Involved | $4,644 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |