2012-08-08T09:49:55-05:00 2011-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2011-01-01 042106771 WILLIAM B RICE EVENTIDE HOME INC WILL 6174728300 215 ADAMS STREET QUINCY MA 02169 RICHARD MEADE 6174728300 2012-07-26 1 BARBARA J MORRISON P00173340 6179848100 2012-07-26 2011 2016-02-24 21:20:13Z RICHARD MEADE 215 ADAMS STREET QUINCY MA 02169 21055309 0 X WWW.EVENTIDEHOME.ORG X 1924 MA OPERATION OF A NURSING HOME PROVIDING ROOM AND BOARD AND NURSING SERVICES TO THE ELDERLY. 17 17 153 35 0 0 8775 0 5949078 5876985 1725652 1663212 19316 17261 7702821 7557458 0 0 0 0 4377206 4420771 0 0 0 2078405 2224980 6455611 6645751 1247210 911707 24025400 22544776 3130701 2651604 20894699 19893172 TO MAINTAIN A UNIQUE LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED AND CARING SUPPORTIVE SERVICES IN A HOME-LIKE ATMOSPHERE WHICH ALLOWS THE RESIDENTS TO MAINTAIN INDEPENDENT LIVES WITH DIGNITY. 0 0 6008408 5894246 THE HOME PROVIDES SECURE HOUSING, QUALITY NURSING CARE, MEANINGFUL ACTIVITIES, OPPORTUNITIES FOR SOCIALIZATION, AND A WIDE VARIETY OF SUPPORTIVE SERVICES TO SIXTY FRAIL ELDERS UNABLE TO LIVE INDEPENDENTLY IN THE COMMUNITY, WITHOUT REGARD FOR THEIR ABILITY TO PAY. 6008408 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 153 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X JANICE FARIA 6174728300 215 ADAMS STREET QUINCY MA 02169 GAYLE DAVIS 5.00 X X 0 0 0 RICHARD MEADE 5.00 X X 0 0 0 DONALD POWELL 5.00 X X 0 0 0 MICHAEL MCFARLAND 5.00 X X 0 0 0 RUTH DOBBIE 5.00 X 0 0 0 ROBERT DOLBEC 5.00 X 0 0 0 ROBERT DWYER 5.00 X 0 0 0 ROBERT FOY 5.00 X 0 0 0 ROBERT GUARNIERI 5.00 X 0 0 0 LYNNE HOUGHTON 5.00 X 0 0 0 WILLIAM JACKSON 5.00 X 0 0 0 SHEILA MCINTYRE 5.00 X 0 0 0 CHARLES RIPPBERGER MD 5.00 X 0 0 0 WILLIAM SMITH 5.00 X 0 0 0 PRISCILLA URANN 5.00 X 0 0 0 BRIAN GOTTA 5.00 X 0 0 0 AMY ROSS 5.00 X X 0 0 0 JOYCE HAGLUND 40.00 X 144871 0 6938 144871 0 6938 1 0 1 0 SHESKEY ARCHITECTS FRANKLIN ST QUINCY MA 02169 ARCHITECTURAL SERVICES 1207058 ROGERSON COMMUNITIES FLORENCE ST BOSTON MA 02131 DEVELOPMENT CONSULTANT 450000 CREATING RESULTS 1400 CROWN COURT SUITE 211 WOODBRIDGE VA 22193 ADVERTISING 278925 NIXON PEABODY SUMMER ST BOSTON MA 02110 LEGAL 117847 STONE TRUST PARTNERS 86 WASHBURN RD CANTON CT 06019 ADVERTISING 103688 5 PUBLICLY AIDED 623000 3103397 3103397 PRIVATE 623000 1799369 1799369 MEDICARE 623000 819732 819732 ANCILLARY INCOME 623000 154487 154487 5876985 314663 314663 14846400 13497851 1348549 1348549 1348549 MISC. REVENUE-RELATED- 623000 17261 17261 17261 7557458 5894246 0 1663212 3619991 3174301 445690 52104 45689 6415 424598 372322 52276 324078 284178 39900 13225 13225 42549 42549 403990 369729 34261 9083 9083 81215 78188 3027 433421 433421 1355 1355 268270 268270 43063 43063 PATIENT CARE EXPENSES 846095 846095 205 ADAMS STREET 68009 68009 BAD DEBTS 11764 11764 MISCELLANEOUS 2941 2941 6645751 6008408 637343 0 82310 131316 3409712 786807 680167 647415 66310 87092 11397906 5547477 6085550 5850429 11783187 9604472 1918164 5437245 24025400 22544776 728608 284217 2402093 2367387 3130701 2651604 X 20834799 19833272 18900 18900 41000 41000 20894699 19893172 24025400 22544776 X 911707 -1913234 X X 0 1 1 X 0 X 1894 2495 41866 8775 55030 5618337 5823211 5805048 5968394 5894246 29109236 5620231 5825706 5846914 5977169 5894246 29164266 0 0 0 29164266 501078 470096 325401 1650976 314663 3262214 501078 470096 325401 1650976 314663 3262214 6121309 6295802 6172315 7628145 6208909 32426480 0.89940 0.89400 0.10060 0.10600 X 59900 59900 51125 8775 59900 41000 10125 51125 0.67000 0.33000 0 0 3151077 3151077 6768506 4262539 2505967 1465563 1272178 193385 12760 12760 0 5850429 INTEREST RECEIVABLE 30393 MORTGAGE ACQUISITION COSTS, NET 23150 CONSTRUCTION IN PROGRESS 4458667 SOFTWARE, NET 9532 DEFERRED ADVERTISING COSTS 915503 5437245 7557458 6645751 911707 -1913234 -1913234 -1001527 5601675 -1913234 -1913234 7514909 42549 42549 7557458 6603202 0 6603202 42549 42549 6645751 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TERM ENDOWMENT FUNDS ARE TO BE USED FOR NEW RESIDENT BEDS. THE PERMANENT ENDOWMENT FUND'S INCOME IS USED FOR THE GENERAL PURPOSES OF THE HOME. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NOT-FOR-PROFIT AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. SHOULD THE STATUS BE CHALLENGED IN THE FUTURE, THE ENTITIES 2008 THROUGH 2011 TAX YEARS ARE OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X 0 0 0 0 0 0 0 0 0 JOYCE HAGLUND 144871 0 0 0 0 0 0 0 6938 0 151809 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE ADMINISTRATOR WILL REVIEW FORM 990 WITH MEMBERS OF THE BOARD'S EXECUTIVE COMMITTEE PRIOR TO ITS FILING WITH THE IRS. THE EXECUTIVE COMMITTEE WILL REPORT ON IT'S REVIEW TO THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT IS ENFORCED ANNUALLY BY DISTRIBUTION OF THE POLICY AND FOLLOW UP TO CONFIRM NO ONE IS IN CONFLICT OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT OF THE BOARD AND MEMBERS OF THE EXECUTIVE COMMITTEE APPROVES CEO'S SALARY. THEY REGULARLY REVIEW SALARY STUDIES DONE BY STATE HEALTHCARE ASSOCIATIONS. APPROVAL IS DOCUMENTED IN THE BOARD OF DIRECTORS MINUTES. THIS WAS LAST DONE IN 2011. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,913,234. PROCEDURES FOR REVIEW OF AUDITED FINANCIAL STATEMENT & SELECTION OF AUDITOR FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND APPOINTS THE AUDITOR.