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BETHANY HEALTH CARE CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BETHANY HEALTH CARE CENTER INC (EIN 04-2104039)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201323189349306017
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2013-11-14T15:48:09-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1300 CROWN COLONY DRIVE SUITE 310AddressLine1
CityQUINCYCity
StateMAState
ZIP Code02169ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042104039EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BETHANY HEALTH CARE CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBETHNameControl
Phone5082708673Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line197 BETHANY ROADAddressLine1
CityFRAMINGHAMCity
StateMAState
ZIP Code01702ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSR JACQUELYN MCCARTHYName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone5082708673Phone
Date Signed2013-11-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameROBERT DILLANName
PTINP01688008PTIN
Phone6179848100Phone
Date Prepared2013-11-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSR JACQUELYN MCCARTHYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line197 BETHANY ROADAddressLine1
CityFRAMINGHAMCity
StateMAState
ZIP Code01702ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11453465GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.BETHANYHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionOPERATION OF A SKILLED NURSING FACILITY, RESIDENT CARE FACILITY, AND CLINIC SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees250TotalNbrEmployees
Total Nbr Volunteers40TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year651077ContributionsGrantsPriorYear
Contributions Grants Current Year311143ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10639344ProgramServiceRevenuePriorYear
Program Service Revenue CY10991941ProgramServiceRevenueCY
Investment Income Prior Year20998InvestmentIncomePriorYear
Investment Income Current Year58058InvestmentIncomeCurrentYear
Other Revenue Prior Year10599OtherRevenuePriorYear
Other Revenue Current Year24181OtherRevenueCurrentYear
Total Revenue Prior Year11322018TotalRevenuePriorYear
Total Revenue Current Year11385323TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8101231SalariesEtcPriorYear
Salaries Etc Current Year8240099SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year187963TotalFundrsngExpCurrentYear
Other Expense Prior Year4231259OtherExpensePriorYear
Other Expenses Current Year4300607OtherExpensesCurrentYear
Total Expenses Prior Year12332490TotalExpensesPriorYear
Total Expenses Current Year12540706TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1010472RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1155383RevenuesLessExpensesCY
Total Assets BOY7668872TotalAssetsBOY
Total Assets EOY7537453TotalAssetsEOY
Total Liabilities BOY6445293TotalLiabilitiesBOY
Total Liabilities EOY6085808TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1223579NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1451645NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE QUALITY HEALTHCARE IN A MANNER THAT HELPS RESIDENTS TO BE CONNECTED WITH GOD, WITH OTHER PEOPLE AND WITH THE WORLD IN WHICH THEY LIVE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11490253Expense
Revenue10991941Revenue
DescriptionSKILLED NURSING FACILITY, RESIDENT CARE FACILITY, AND CLINIC SERVICESDescription
Total Program Service Expense11490253TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10969NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees250NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJAMES MCGOWANNamePerson
Telephone Number5088726750TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line197 BETHANY ROADAddressLine1
CityFRAMINGHAMCity
StateMAState
ZIP Code01072ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
SR MARYLOU CASSIDY
TRUSTEE1.00X000
SR LEE HOGAN
VICE CHAIR/CLERK/SECRETARY1.00X000X
MARY KILCOMMONS
TRUSTEE1.00X000
SR ROSEMARY BRENNAN
CHAIRMAN1.00X000
CHRISTINE ALESSANDRO
TRUSTEE1.00X000
THOMAS E GUNNOUD
TRUSTEE1.00X000
LORI FERRANTE
TRUSTEE1.00X000
MICHAEL CONKLIN
TRUSTEE1.00X000
WILLIAM MCGINLEY
TRUSTEE1.00X000
SR ROSEANN AMICO
TRUSTEE1.00X000
SR MAUREEN DOHERTY
TRUSTEE1.00X000
SR GAIL DONAHUE
TRUSTEE1.00X000
SR PATRICIA MCCARTHY
TRUSTEE1.00X000
SR KATHLEEN MORAN
TRUSTEE1.00X000
SR PATRICIA QUINN
TRUSTEE1.00X000
SR MARGARET SULLIVAN
TRUSTEE1.00X000
JAIME LONG
TRUSTEE1.00X000
SR MARY MURPHY
TRUSTEE (THROUGH MARCH 2012)1.00X000
SR BRENDA FORRY
TRUSTEE (THROUGH MARCH 2012)1.00X000
SR MARILYN MCGOLDRICK
TRUSTEE (THROUGH MARCH 2012)1.00X000
SR ELLEN POWERS
TRUSTEE (THROUGH MARCH 2012)1.00X000
SR HELEN SULLIVAN
TRUSTEE (THROUGH MARCH 2012)1.00X000
SR JACQUELYN MCCARTHY
CEO/ADMINISTRATOR40.00126348012247X
FieldValueIRS element (for citing)
Total Reportable Comp From Org126348TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation12247TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXO
PO BOX 81049WOBURNMA01913DIETARY, HOUSEKEEPING, & LAUNDRY612545
QUALITY REHABILITATION SERVICES
42 LANDAU ROADPLAINVILLEMA01746REHABILITATION SERVICES246756
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Fundraising Events207334FundraisingEvents
All Other Contributions103809AllOtherContributions
Total Contributions311143TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUESDescription
Business Code623000BusinessCode
Total Revenue Column10991941TotalRevenueColumn
Related Or Exempt Function Income10991941RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue10991941TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column27251TotalRevenueColumn
Exclusion$27,251ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities30807Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities30807Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column30807TotalRevenueColumn
Exclusion$30,807ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events92323GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events207334CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses68142FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column24181TotalRevenueColumn
Exclusion$24,181ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column11385323TotalRevenueColumn
Related Or Exempt Function Income10991941RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$82,239ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total128257Total
Management And General128257ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6469230Total
Program Services5858030ProgramServices
Management And General477054ManagementAndGeneral
Fundraising134146Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total236950Total
Program Services215210ProgramServices
Management And General21740ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total950135Total
Program Services832004ProgramServices
Management And General84047ManagementAndGeneral
Fundraising34084Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total455527Total
Program Services413733ProgramServices
Management And General41794ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1250Total
Management And General1250ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total67200Total
Management And General67200ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total372342Total
Program Services372342ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total10112Total
Program Services10112ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total83131Total
Program Services77521ProgramServices
Fundraising5610Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total15062Total
Program Services15062ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total393370Total
Program Services393370ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total6031Total
Program Services5939ProgramServices
Fundraising92Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total16311Total
Program Services5432ProgramServices
Fundraising10879Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total193714Total
Program Services193714ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total748863Total
Program Services748863ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total31989Total
Program Services31989ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PATIENT CARE EXPENSES11782661178266
USER FEES626768626768
REPAIR & MAINTENNANCE331165331165
BAD DEBTS9190791907

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total133126Total
Program Services88826ProgramServices
Management And General41148ManagementAndGeneral
Fundraising3152Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12540706Total
Program Services11490253ProgramServices
Management And General862490ManagementAndGeneral
Fundraising187963Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY273091BOY
EOY22897EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY306257BOY
EOY896630EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY10000BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY705631BOY
EOY695019EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY64710BOY
EOY38129EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14315438LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9138289LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5658242BOY
EOY5177149EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY612417BOY
EOY675784EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY38524BOY
EOY31845EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7668872BOY
EOY7537453EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1833834BOY
EOY1740057EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY206275BOY
EOY211142EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4398278BOY
EOY4127667EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6906BOY
EOY6942EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6445293BOY
EOY6085808EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1223579BOY
EOY1113749EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY337896EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1223579BOY
EOY1451645EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7668872BOY
EOY7537453EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1155383ReconcilationRevenueExpenses
Reconciliation Unrealized Invest5683ReconciliationUnrealizedInvest
Reconcilation Other Changes1377766ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years776850CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2058316CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years600108CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year651077CurrentTaxYearMinus1Year
Current Tax Year644210CurrentTaxYear
Total4730561Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10810532CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10376513CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10557028CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10639344CurrentTaxYearMinus1Year
Current Tax Year10991941CurrentTaxYear
Total53375358Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11587382CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12434829CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11157136CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11290421CurrentTaxYearMinus1Year
Current Tax Year11636151CurrentTaxYear
Total58105919Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years247889CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years590000CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years492004CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year446436CurrentTaxYearMinus1Year
Current Tax Year120000CurrentTaxYear
Total1896329Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years247889CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years590000CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years492004CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year446436CurrentTaxYearMinus1Year
Current Tax Year120000CurrentTaxYear
Total1896329Total
FieldValueIRS element (for citing)
Public Support Total50956209590PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11107CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4174CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4932CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20998CurrentTaxYearMinus1Year
Current Tax Year27251CurrentTaxYear
Total68462Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11107CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4174CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4932CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20998CurrentTaxYearMinus1Year
Current Tax Year27251CurrentTaxYear
Total68462Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years49451CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years35796CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21589CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10599CurrentTaxYearMinus1Year
Current Tax Year28882CurrentTaxYear
Total146317Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11647940CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12474799CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11183657CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11322018CurrentTaxYearMinus1Year
Current Tax Year11692284CurrentTaxYear
Total58320698Total
FieldValueIRS element (for citing)
Public Support Percentage5090.96380PublicSupportPercentage509
Prior Year Support Percentage0.94030PriorYearSupportPercentage
Investment Income Percentage0.00120InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00090PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$1,270OtherActivitiesAmount
Total Lobbying Expenditures IIB1270TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPART OF MEMBERSHIP DUES PAID TO STATE HEALTHCARE ORGANIZATIONSExplanation

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis10815459OtherCostOrOtherBasis
Depreciation6670389Depreciation
Book Value4145070BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3499979OtherCostOrOtherBasis
Depreciation2467900Depreciation
Book Value1032079BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5177149TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionINV HELD BY CONG-DONAT-BDescription
Book Value675784BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities675784TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionOTHER LIABILITIESDescription
Amount$6,942Amount
FieldValueIRS element (for citing)
Total Of Amounts6942TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt12511611TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments5683NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities80603DonatedSrvcAndUseOfFacilities
Other Revenues1040002OtherRevenues
Revenue Not Rptd F9901126288RevenueNotRptdF990
Revenue Subtotal11385323RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99011385323TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt12621312TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities80603DonatedServicesUseOfFacilities
Other Expenses Included3OtherExpensesIncluded
Expenses Not Rptd F99080606ExpensesNotRptdF990
Expenses Subtotal12540706ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99012540706TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. SHOULD THE STATUS OF THE ORGANIZATION BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S TAX YEARS PRIOR TO 2009 ARE OPEN FOR EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:EQUITY TRANSFER INCLUDED IN REVENUE 1,040,000. FUNDRAISING EVENT EXPENSE NETTED AGAINST REVENUES ROUNDING 2.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EVENT EXPENSE NETTED AGAINST REVENUES ROUNDING 3.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event194306GrossReceiptsEvent1
Charitable Contributions Event112925CharitableContributionsEvent1
Gross Revenue Event181381GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event116333NonCashPrizesEvent1
Rent Facility Costs Event110440RentFacilityCostsEvent1
Food And Beverage Event114391FoodAndBeverageEvent1
Other Direct Expenses Event111335OtherDirectExpensesEvent1
Name Of Event2DINNERNameOfEvent2
Gross Receipts Event2205351GrossReceiptsEvent2
Charitable Contributions Event2194409CharitableContributionsEvent2
Gross Revenue Event210942GrossRevenueEvent2
Food And Beverage Event210942FoodAndBeverageEvent2
Other Direct Expenses Event24701OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Total299657GrossReceiptsTotal
Charitable Contributions Total207334CharitableContributionsTotal
Gross Revenue Total Events92323GrossRevenueTotalEvents
Non Cash Prizes Total Events16333NonCashPrizesTotalEvents
Rent Facility Costs Total Events10440RentFacilityCostsTotalEvents
Food And Beverage Total Events25333FoodAndBeverageTotalEvents
Other Direct Expenses Total Events16036OtherDirectExpensesTotalEvents
Direct Expense Summary Events68142DirectExpenseSummaryEvents
Net Income Summary24181NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2SR. JACQUELINE MCCARTHY AND SR. PATRICIA MCCARTHY HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 7ATHE TRUSTEES ELECT MEMBERS OF THE GOVERNING BOARD.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF THE GOVERNING BOARD ARE SUBJECT TO APPROVAL BY THE TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES BEGINS WITH AN ANALYSIS PERFORMED BY THE HR DIRECTOR, COMPARING COMPENSATION TO SIMILAR POSITIONS LOCATED IN SIMILAR ORGANIZATIONS, WHICH IS THEN PRESENTED TO THE BOARD FOR REVIEW AND APPROVAL. ALL DECISIONS REGARDING COMPENSATION ARRANGEMENTS ARE DOCUMENTED IN THE CORPORATE MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:EQUITY TRANSFER 1,040,000. TEMPORARY RESTRICTED NET ASSETS 337,766.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT POLICY OR SELECTION POLICY DURING THE TAX YEAR.OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE RELATED ORGANIZATION IS RELIGIOUS BASED AND HAVE NO FILING REQUIREMENTBusinessNameLine1
FieldValueIRS element (for citing)
EIN999999999EIN
Legal Domicile StateMALegalDomicileState
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1THE RELATED ORGANIZATION IS RELIGIOUS BASED AND HAVE NO FILING REQUIREMENTBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionType