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CHS OF WALTHAM INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
CHS OF WALTHAM INC (EIN 04-3333609)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-08-11
IRS object ID
201412239349301726
Schema version
2013v3.0
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)
Return2014-08-11T15:12:51-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN020383073PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WILLIAM STEELE & ASSOCIATES PCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line140 STARK STREETAddressLine1
CityMANCHESTERCity
StateNHState
ZIP Code03101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN043333609EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHS OF WALTHAM INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlCHSOBusinessNameControlTxt
Phone7818930240PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 NEWTON STREETAddressLine1
CityWALTHAMCity
StateMAState
ZIP Code02453ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCAROLYN FENNPersonNm
Person TitleCEOPersonTitleTxt
Phone7818930240PhoneNum
Signature2014-08-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM G STEELE JR CPAPreparerPersonNm
PTINP00233103PTIN
Phone6036228881PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MARISTHILL NURSING & REHABILTATIONBusinessNameLine1
Business Name Line2CENTERBusinessNameLine2
FieldValueIRS element (for citing)
Principal OfficerCAROLYN FENNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 NEWTON STREETAddressLine1
CityWALTHAMCity
StateMAState
ZIP Code02453ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$10,182,505GrossReceiptsAmt
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 Employee147TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$22,940PYContributionsGrantsAmt
CY Contributions Grants$21,170CYContributionsGrantsAmt
PY Program Service Revenue$10,242,485PYProgramServiceRevenueAmt
CY Program Service Revenue$10,137,877CYProgramServiceRevenueAmt
PY Investment Income-$37,791PYInvestmentIncomeAmt
CY Investment Income$19,064CYInvestmentIncomeAmt
PY Other Revenue$25,618PYOtherRevenueAmt
CY Other Revenue$4,394CYOtherRevenueAmt
PY Total Revenue$10,253,252PYTotalRevenueAmt
CY Total Revenue$10,182,505CYTotalRevenueAmt
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$5,945,374PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,799,699CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,315,150PYOtherExpensesAmt
CY Other Expenses$4,391,567CYOtherExpensesAmt
PY Total Expenses$10,260,524PYTotalExpensesAmt
CY Total Expenses$10,191,266CYTotalExpensesAmt
PY Revenues Less Expenses-$7,272PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$8,761CYRevenuesLessExpensesAmt
Total Assets BOY$11,999,662TotalAssetsBOYAmt
Total Assets EOY$11,996,011TotalAssetsEOYAmt
Total Liabilities BOY$9,915,763TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,838,555TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,083,899NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,157,456NetAssetsOrFundBalancesEOYAmt
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$9,944,310ExpenseAmt
Revenue$10,137,877RevenueAmt
DescMARISTHILL NURSING AND REHABILITATION CENTER PROVIDED 34,870 DAYS OF SKILLED NURSING SERVICES DURING 2013 OF WHICH 22,292 WERE TO MEDICAID RECIPIENTS.Desc
Total Program Service Expenses$9,944,310TotalProgramServiceExpensesAmt
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 Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee147EmployeeCnt
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
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
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 Line1CAROLYN FENN CEOBusinessNameLine1
FieldValueIRS element (for citing)
Phone7818930240PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 NEWTON STREETAddressLine1
CityWALTHAMCity
StateMAState
ZIP Code02453ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (12 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$293,473$108,650
LUKE STANTON ESQ
TRUSTEE1.00Yes (X)$0$0$0
CAROL EAST MSWLCSW
TRUSTEE1.00Yes (X)$0$0$0
MARY ELIZABETH SCANLON RN
TRUSTEE1.00Yes (X)$0$0$0
MICHAEL DELANEY ESQ
TRUSTEE1.00Yes (X)$0$0$0
LISA LORGEREE
CHAIR1.00Yes (X)Yes (X)$0$0$0
NANCY SMITH
TRUSTEE1.00Yes (X)$0$0$0
JOSEPH SGRO
CHIEF FINANCIAL OFFICER40.00Yes (X)Yes (X)$88,873$0$1,112
CAROLYN FENN
CEO/ADMINISTRATOR40.00Yes (X)Yes (X)$104,320$0$9,606
KELLY MCDADE
TRUSTEE1.00Yes (X)$0$0$0
JUDITH ALLEN
TRUSTEE1.00Yes (X)$0$0$0
SHIRLY YELLAMATY
NURSING SUPERVISOR40.00$116,974$0$21,459Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$310,167TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$293,473TotReportableCompRltdOrgAmt
Total Other Compensation$140,827TotalOtherCompensationAmt
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/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
REHAB CARE INC
PO BOX 277365ATLANTAGA30384REHABILTATION SERVICES$797,893
HEALTHCARE SERVICES
1565 MAIN STREETTEWKSBURYMA01888HOUSEKEEPING$342,316
US FOODS
PO BOX 3155BOSTONMA02241FOOD SERVICE$332,752
PARTNERS PHARMACY OF MA
181 CEDAR HILL ROADMARLBOROMA01752PHARMACY$266,945
GULF SOUTH
14 N WENTWORTH AVENUELONDONDERRYNH03053MEDICAL SUPPLIES$141,245
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$21,170AllOtherContributionsAmt
Total Contributions$21,170TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business623000BusinessCd
Total Revenue Column$10,137,877TotalRevenueColumnAmt
Related Or Exempt Func Income$10,137,877RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,137,877TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,064TotalRevenueColumnAmt
Exclusion$19,064ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA623000$2,556$2,556
VENDING MACHINE623000$1,838$1,838
FieldValueIRS element (for citing)
Other Revenue Total$4,394OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,182,505TotalRevenueColumnAmt
Related Or Exempt Func Income$10,137,877RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$23,458ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$108,305TotalAmt
Program Services$108,305ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,836,753TotalAmt
Program Services$4,836,753ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$19,662TotalAmt
Program Services$19,662ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$464,357TotalAmt
Program Services$464,357ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$370,622TotalAmt
Program Services$370,622ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$183,116TotalAmt
Management And General$183,116ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$39,083TotalAmt
Management And General$39,083ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,757TotalAmt
Management And General$24,757ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$10,348TotalAmt
Program Services$10,348ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$126,263TotalAmt
Program Services$126,263ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$89,494TotalAmt
Program Services$89,494ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$340,775TotalAmt
Program Services$340,775ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$806TotalAmt
Program Services$806ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$343,131TotalAmt
Program Services$343,131ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$445,173TotalAmt
Program Services$445,173ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$65,640TotalAmt
Program Services$65,640ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
PURCHASED SERVICES$1,330,297$1,330,297
NURSING HOME SUPPLIES A$874,513$874,513
MEDICAID USER FEE$515,001$515,001
EDUCATION AND TRAINING$3,170$3,170

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,191,266TotalAmt
Program Services$9,944,310ProgramServicesAmt
Management And General$246,956ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$194,966BOYAmt
EOY$142,325EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,877,553BOYAmt
EOY$2,079,331EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$957,247BOYAmt
EOY$935,629EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$49,497BOYAmt
EOY$29,132EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$10,522,481LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,870,618LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,570,391BOYAmt
EOY$5,651,863EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$829,322BOYAmt
EOY$924,377EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,520,686BOYAmt
EOY$2,233,354EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,999,662BOYAmt
EOY$11,996,011EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$693,584BOYAmt
EOY$695,102EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,583,828BOYAmt
EOY$8,515,290EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$638,351BOYAmt
EOY$628,163EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,915,763BOYAmt
EOY$9,838,555EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,083,899BOYAmt
EOY$2,157,456EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,083,899BOYAmt
EOY$2,157,456EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,999,662BOYAmt
EOY$11,996,011EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$8,761ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$82,319NetUnrlzdGainsLossesInvstAmt
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 CommitteeYes (1)AuditCommitteeInd
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$5,997CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$44,938CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,945CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$22,940CurrentTaxYearMinus1YearAmt
Current Tax Year$21,170CurrentTaxYearAmt
Total$121,990TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,925,173CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,027,802CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,746,498CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,268,103CurrentTaxYearMinus1YearAmt
Current Tax Year$10,142,271CurrentTaxYearAmt
Total$53,109,847TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,931,170CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,072,740CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,773,443CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,291,043CurrentTaxYearMinus1YearAmt
Current Tax Year$10,163,441CurrentTaxYearAmt
Total$53,231,837TotalAmt

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$53,231,837PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$35,704CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$28,185CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,660CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,301CurrentTaxYearMinus1YearAmt
Current Tax Year$19,064CurrentTaxYearAmt
Total$109,914TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$35,704CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$28,185CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,660CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,301CurrentTaxYearMinus1YearAmt
Current Tax Year$19,064CurrentTaxYearAmt
Total$109,914TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,966,874CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,100,925CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,775,103CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,316,344CurrentTaxYearMinus1YearAmt
Current Tax Year$10,182,505CurrentTaxYearAmt
Total$53,341,751TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99790PublicSupportCY509Pct
Public Support PY5090.99790PublicSupportPY509Pct
Investment Income CY0.00210InvestmentIncomeCYPct
Investment Income PY0.00210InvestmentIncomePYPct
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$6,552,717OtherCostOrOtherBasisAmt
Depreciation$2,492,855DepreciationAmt
Book Value$4,059,862BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,316,072OtherCostOrOtherBasisAmt
Depreciation$2,377,763DepreciationAmt
Book Value$938,309BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$168,692OtherCostOrOtherBasisAmt
Book Value$168,692BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,651,863TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDescBook ValueBookValueAmt
RESIDENT FUNDS$12,667
DEBT SERVICE RESERVE FUND$713,069
BOND ISSUE COSTS (NET)$39,756
BOND UNDERWRITING COSTS (NET)$16,818
BOND DISCOUNT (NET)$41,221
DEBT SERVICE SINKING FUND (NET)$1,347,864
CAPITALIZED FINANCING COSTS (NET)$61,959
FieldValueIRS element (for citing)
Total Book Value Other Assets$2,233,354TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
DEFERRED EXPENSES$241,811
MEDICAID USER FEES$128,391
PROFESSIONAL LIABILITY LOSS RESERVES$22,795
DUE TO AFFILIATES$192,503
RESIDENT FUNDS$11,667
ORIGINAL ISSUE DISCOUNT$30,996
FieldValueIRS element (for citing)
Total Liability$628,163TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationINCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS IS THE FOLLOWING "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. THE SYSTEM HAS EVALUATED THE POSITIONS TAKEN ON ITS FILED TAX RETURNS, AND HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT DECEMBER 31, 2013."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 OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
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$247,200CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$46,273OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$80,685DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$27,965NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$402,123TotalCompensationRltdOrgsAmt
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 1AEVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF OF THE COVENANT HEALTH SYSTEMS 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 SYSTEMS, 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 6THE RELATED ORGANIZATION, COVENANT HEALTH SYSTEMS, 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 2013 TO KENNETH FERRON BASED ON PERFORMANCE DURING 2012.

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 AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.00000000
B00000.000000.000000.00000000

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6COVENANT HEALTH SYSTEMS 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 SYSTEMS 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 SYSTEMS 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 11THE 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 SYSTEMS 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 HEALTH SYSTEMSBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 AMES POND DRIVEAddressLine1
CityTEWKSBURYCity
StateMAState
ZIP Code01876ZIPCode
FieldValueIRS element (for citing)
EIN222484505EIN
Primary ActivitiesHEALTH CARE MANAGEMENT AND RESOURCE ORGANIZATIONPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
Exempt Code Section501(C)ExemptCodeSectionTxt
Public Charity Status509(A)PublicCharityStatusTxt
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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HEALTH SYSTEMSBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeMTransactionTypeTxt
Involved$183,116InvolvedAmt
Method Of Amount DeterminationCOSTMethodOfAmountDeterminationTxt