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MASONICARE HOME HEALTH AND HOSPICE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MASONICARE HOME HEALTH AND HOSPICE INC (EIN 06-1101924)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-14
IRS object ID
201342269349301189
Schema version
2011v1.5
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)
Timestamp2013-08-14T08:16:01-07:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN061101924EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Masonicare Home Health and Hospice IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMASONameControl
Phone2036787857Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line133 North Plains RoadAddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameR Scott ThelenName
TitleAsst. TreasurerTitle
Date Signed2013-08-14DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts37747714GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.MASONICARE.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1999YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionSee Schedule OActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees596TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year195070ContributionsGrantsPriorYear
Contributions Grants Current Year139618ContributionsGrantsCurrentYear
Program Service Revenue Prior Year34840576ProgramServiceRevenuePriorYear
Program Service Revenue CY37607400ProgramServiceRevenueCY
Investment Income Prior Year467InvestmentIncomePriorYear
Investment Income Current Year618InvestmentIncomeCurrentYear
Other Revenue Prior Year111OtherRevenuePriorYear
Other Revenue Current Year78OtherRevenueCurrentYear
Total Revenue Prior Year35036224TotalRevenuePriorYear
Total Revenue Current Year37747714TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year143352GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY85056GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year22942957SalariesEtcPriorYear
Salaries Etc Current Year24344440SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8992252OtherExpensePriorYear
Other Expenses Current Year9592097OtherExpensesCurrentYear
Total Expenses Prior Year32078561TotalExpensesPriorYear
Total Expenses Current Year34021593TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2957663RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3726121RevenuesLessExpensesCY
Total Assets BOY6882531TotalAssetsBOY
Total Assets EOY6957846TotalAssetsEOY
Total Liabilities BOY4584309TotalLiabilitiesBOY
Total Liabilities EOY4994154TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2298222NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1963692NetAssetsOrFundBalancesEOY
Mission DescriptionSee Schedule OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense26984358Expense
Grants139618Grants
Revenue34163432Revenue
DescriptionMasonicare Home Health and Hospice, Inc. provides home health services to clients of all ages including: skilled nursing care, hospice, physical, speech and occupational therapies, medical social work and home health aid services. The total MHH&H, Inc care of sick visits for the period ended September 30, 2012 were 201,812 and total visits for Hospice were 53,363. Total patients served were 5,287 for Care of Sick and 1,318 for Hospice.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Revenue3444664Revenue
DescriptionMHH&H, Inc. provides management services to Masonicare Partners Home Health and Hospice, Inc. Partners is an affiliate that is jointly owed with St. Francis Medical Center. The mission of Partners is to provide home health servies to clients of all ages in the greater Hartford area.Description
FieldValueIRS element (for citing)
Total Program Service Expense26984358TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109694NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees596NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonR Scott ThelenNamePerson
Telephone Number2036787857TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line122 Masonic AvenueAddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Susan Koty
Member1.00X000
Alexander Jarvis
Member1.00X000
Bradley K Cooney
Member1.00X000
Donald Gladding
Member1.00X000
Newton Buckner
Member1.00X000
Steven Allison
Member1.00X000
Paul L Chello
Member1.00X000
R Scott Thelen
Asst. Treasurer40.00X032753823924X
Stephen B McPherson
Asst Secretary40.00X087008917886X
Francine A Bailey
Member1.00X000
Steven Abati
Treasurer1.00X000X
Geoffrey L Ice
Secretary1.00X000X
Christopher Earle
Vice Chairman1.00X000X
Francis X Conlon
Chairman1.00X000X
William C Phinney
Supervisor Hospice40.00152068013331X
Susan Shikoluk
Per Visit40.0014694705560X
Edwin Azu
RN Per Visit40.0013721600X
Shawn Mathewson
RN Per Visit40.009852900X
Louanna Wilkinson
Regional Director40.0095304015058X
Mary Lou Roos
President40.00178445014195X
William Piper
Senior VP COO40.006459036600823856X
FieldValueIRS element (for citing)
Total Reportable Comp From Org873099TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1563635TotalReportableCompFrmRltdOrgs
Total Other Compensation113810TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Smithhouse Skilled Nursing Facility
88 Rock Rimmon RoadStamfordCT06903Hospice302244
PMA
PO Box 8500PhiladelphiaPA191783855Workers Compensatin290251
Masonicare Inc
PO Box 70WallingfordCT06492Management services2671500
Kindred Nursing Centers East LLC
89 Viets StNew LondonCT06320Hospice262486
Cigna
900 Cottage Grove RodHartfordCT06152Insurance services2535212
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations85056RelatedOrganizations
All Other Contributions54562AllOtherContributions
Total Contributions139618TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient Service Revenue6216103416273634162736
Management fees62161034446643444664
FieldValueIRS element (for citing)
Total Program Service Revenue37607400TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column618TotalRevenueColumn
Exclusion$618ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionVending MachineDescription
Total Revenue Column78TotalRevenueColumn
Related Or Exempt Function Income78RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue78TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column37747714TotalRevenueColumn
Related Or Exempt Function Income37607478RelatedOrExemptFunctionIncome
Exclusion$618ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total85056Total
Program Services85056ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total885847Total
Management And General885847ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total18443497Total
Program Services16935902ProgramServices
Management And General1507595ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3594421Total
Program Services3086053ProgramServices
Management And General508368ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1420675Total
Program Services1217328ProgramServices
Management And General203347ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2671500Total
Management And General2671500ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total26944Total
Management And General26944ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total38646Total
Management And General38646ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1549255Total
Program Services1454652ProgramServices
Management And General94603ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total444864Total
Program Services444864ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total893007Total
Program Services841474ProgramServices
Management And General51533ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total233850Total
Management And General233850ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total235844Total
Management And General235844ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Purchased Services378814274135104679
I/P General Hospice450421450421
Repairs & maintenance65717563367323502
Other Professional Fees971905971905

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1039872Total
Program Services588895ProgramServices
Management And General450977ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total34021593Total
Program Services26984358ProgramServices
Management And General7037235ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1950BOY
EOY1950EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3796896BOY
EOY4017573EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY219209BOY
EOY210072EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6552435LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5376155LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1107659BOY
EOY1176280EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1756817BOY
EOY1551971EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6882531BOY
EOY6957846EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1684560BOY
EOY2049622EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY782871BOY
EOY823688EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2116878BOY
EOY2120844EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4584309BOY
EOY4994154EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2298222BOY
EOY1963692EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2298222BOY
EOY1963692EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6882531BOY
EOY6957846EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3726121ReconcilationRevenueExpenses
Reconcilation Other Changes-4060651ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years114636CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years105110CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years72921CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year195070CurrentTaxYearMinus1Year
Current Tax Year139618CurrentTaxYear
Total627355Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years37974054CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38048639CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years33500476CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year34840576CurrentTaxYearMinus1Year
Current Tax Year34162736CurrentTaxYear
Total178526481Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years38088690CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38153749CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years33573397CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year35035646CurrentTaxYearMinus1Year
Current Tax Year34302354CurrentTaxYear
Total179153836Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509179153836PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3246CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3246CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3140CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year467CurrentTaxYearMinus1Year
Current Tax Year618CurrentTaxYear
Total10717Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year111CurrentTaxYearMinus1Year
Current Tax Year78CurrentTaxYear
Total189Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3246CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3246CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3140CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year578CurrentTaxYearMinus1Year
Current Tax Year696CurrentTaxYear
Total10906Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years38091936CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38156995CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years33576537CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year35036224CurrentTaxYearMinus1Year
Current Tax Year34303050CurrentTaxYear
Total179164742Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99990PublicSupportPercentage509
Prior Year Support Percentage0.99990PriorYearSupportPercentage
Investment Income Percentage0.00010InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00010PriorYrInvestIncomePercentage
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 D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1333429OtherCostOrOtherBasis
Depreciation653315Depreciation
Book Value680114BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis352250OtherCostOrOtherBasis
Depreciation346828Depreciation
Book Value5422BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4613130OtherCostOrOtherBasis
Depreciation4137836Depreciation
Book Value475294BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis253626OtherCostOrOtherBasis
Depreciation238176Depreciation
Book Value15450BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1176280TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Rounding2
Other receivables9105
Investments1542864
FieldValueIRS element (for citing)
Total Book Value Other Assets1551971TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionMedicare tplDescription
Amount$2,120,844Amount
FieldValueIRS element (for citing)
Total Of Amounts2120844TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8Identifier
Return ReferencePart XI, Line 8: Other Changes in Net Assets or Fund BalancesReturnReference
Explanation$ -4060651Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
No Grant More Than5000XNoGrantMoreThan5000
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
Quality of Life745056Market ValuesHome Health Care Equipment
Charity Care7740000Market ValueHome Health & Hospice

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgs
William Piper
4922027891615293866577743535782027868168386286
William C Phinney
144381768713331165399
Susan Shikoluk
1469475560152507
Stephen B McPherson
5087216500029636817886887975
R Scott Thelen
29327632500176223924351462
Mary Lou Roos
17844514195192640

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 7Identifier
Return ReferencePart I, Line 7: Non-Fixed payments not listed aboveReturnReference

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part X, Line 20 TE Bond LiabilitesMasonicare Home Health and Hospice, Inc is a memeber of the Masonicare obligated group that is responsible for the repayment of the Series C and Series E bonds issued by Masonicare, Inc. in 2007 in 2012 respectively. The current outstanding bond blance is $104,245,000.
Form 990, Part III, Line 1 OrganizationMasonicare Home Health and Hospice, a team of highly qualified and caring individuals, is dedicated to excellence in home health and hospice care. We continually strive to improve the health and wellness of patients and families throughout Connecticut with our responsive, accessible and quality-driven approach to care at home and in the community.As the largest non-profit home care and hospice provider in the state, we are dedicated and committed to quality care and excellent customer service. We cover the entire state while maintaining a local feel,with an intense focus on raising the awareness of the home care benefit, we are innovative leaders in developing new programs for home care deliver.We are the provider and employer of choice. Everyone associated with us understands our mission and we effectively communicate, to our stakeholders, the contributions we provide to our communities. Because we are present in all of the communities we serve, well-respected in our profession and recognized on a national basis, we influence how home care and hospice is delivered throughout the state.We use technology to improve both the quality of our care and the efficiency of our care delivery. Our continuing efforts to recruit, develop and retain the best people in our markets mean we have a waiting list of highly qualified people ready to work for us.We reach out to the entire Masonic Family, because we believe the Masonic values of faith, hope, charity, temperance, fortitude and justice, Masons throughout the state are proud of our organization.As a result of our strategic focus and hard work, we are a caring, growing, fiscally responsible organization and a powerful force within our state.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe financial statements are publicly available throught EMMA and public securities markets. The statements are included in the Masonicare Corporation consolidated financial statements. The governing documents (certificate of incorporation) is filed with the Ct Secretary of State. The conflict of interest policy is currently available upon request.Form 990, Part VI, Line 19
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAnnually, officers, directors and senior employees are required to complete a conflict of interest disclosure questionnaire. the results of the officers' and directors' disclosures are reported at the board meetings. Senior employee disclosures are reported to the President. The entire process is coordinated by the Corporate Compliance Officer. All respondents are advised to report any changes during the year that may present a conflict of interest.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessMasonicare Corporation and Masonicare Home Health and Hospice review the tax return for completeness and accuracy. It is also reviewed by the chief executive officer and chairman of the board. The review process is then discussed with full board. After responding to comments/questions, changes are made as appropriate and the return is finalized and filed.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersPursuant to the Certificate of Incorporation of the organization, reserved powers to take or approve certain actions of the governing body. These powers include the prior approval of amendments to the organization's certificate of incorporation and bylaws, approval of long range plans, budgets and material changes in budgets, mission statements and policies (including investment policies) as well as sales or transfer of assets, mergers and/or dissolutions and Certificate of Need applications. The sole corporate member's powers also include the appointment and removal of directors, the company's board chair and independent audit firm.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyMasonicare Corporation, a sole corporate member, annually appoints the members of the affiliate board.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe organization has a sole corporate member, Masonicare Corporation, with the right to appoint the members of the governing body and to participate in the organizations governance.Form 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Masonicare at Home
PO Box 70WallingfordCT06492202377783Providecompanion/homemaker/personal care services to elderlyCT501(c)(3)9NAfalse
Masonicare at Newtown Inc
PO Box 70WallingfordCT06492061070285Provide skilled nursing/assisted living services to elderlyCT501(c)(3)9NAfalse
Keystone Indemnity Company Ltd
126 College Street Suite 400BurlingtonVT05401030371612Provide insurance services to Masonicare affilatesVT501(c)(3)11aNAfalse
Masonicare Partners HomeHealth & Hospice
111 Founders Plaza Suite 200East HartfordCT06492260758992Provide home/health/hospice services to clients of all agesCT501(c)(3)9NAfalse
Masonicare at Ashlar Village Inc
PO Box 70WallingfordCT06492061050830Continuing care retirement and assisted living communityCT501(c)(3)9NAfalse
Masonicare Health Center
PO Box 70WallingfordCT06492060655131Provide comprehensive medical services to the elderlyCT501(c)(3)9NAfalse
Masonic Charity Foundation of CT
PO Box 70WallingfordCT06492061435920Provide planned giving and development support to affiliatesCT501(c)(3)7NAfalse
Masonicare Inc
PO Box 70WallingfordCT06492061435920Parent holding and support organization of affilate corp.CT501(c)(3)11cNAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntity
Masonicare Behavioral Healh
67 Masonic AveWallingfordCT06492061483276Drs Practice Psychiatric SvsCTN/AC
Masonicare Primary Care Physicians PC
67 Masonic AveWallingfordCT06492061491820Physician medical practiceCTN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg