2011-11-15T15:03:59-06:00 2010-12-31 LARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2010-01-01 042106771 WILLIAM B RICE EVENTIDE HOME INC WILL 6174728300 215 ADAMS STREET QUINCY MA 02169 GAYLE DAVIS 6174728300 2011-11-10 1 BARBARA J MORRISON 6179848100 2011-11-01 2010 2016-02-24 21:20:13Z GAYLE DAVIS 215 ADAMS STREET QUINCY MA 02169 8803144 0 X WWW.EVENTIDEHOME.ORG X 1924 MA OPERATION OF A NURSING HOME PROVIDING ROOM AND BOARD AND NURSING SERVICES TO THE ELDERLY. 16 16 142 35 0 0 41866 8775 5780157 5949078 359467 1725652 24891 19316 6206381 7702821 0 0 0 0 4450365 4377206 0 0 0 1832380 2078405 6282745 6455611 -76364 1247210 20743136 24025400 915478 3130701 19827658 20894699 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 5780064 5968394 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. 5780064 1 0 0 0 0 0 0 0 1 1 0 0 1 0 0 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 1 142 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 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 5.00 X 0 0 0 WILLIAM SMITH 5.00 X 0 0 0 PRISCILLA URANN 5.00 X 0 0 0 RICHARD WELCH 5.00 X 0 0 0 JOYCE HAGLUND 40.00 X 153138 0 0 PAULA O'CONNOR 40.00 X 136259 0 0 289397 0 0 2 0 1 0 ROGERSON COMMUNITIES FLORENCE ST BOSTON MA 02131 DEVELOPMENT CONSULTANT 375000 SHESKEY ARCHITECTS FRANKLIN ST QUINCY MA 02169 ARCHITECTURAL SERVICES 374668 NIXON PEABODY SUMMER ST BOSTON MA 02110 LEGAL 270449 3 8775 8775 PUBLICALY AIDED 623000 3244661 3244661 PRIVATE 623000 2201391 2201391 MEDICARE 623000 341349 341349 ANCIALLARY INCOME 623000 161677 161677 5949078 1650975 1650975 1175000 1100323 74677 74677 74677 MISC. REVENUE 623000 19316 19316 19316 7702821 5968394 0 1725652 3598692 3148332 450360 55443 48505 6938 418278 365932 52346 304793 266650 38143 55342 55342 37099 37099 418671 387108 31563 5880 5880 75188 71432 3756 355635 355635 284 284 6149 6149 279901 279901 42446 42446 PATIENT CARE EXPENSES 710423 710423 205 ADAMS STREET 75724 75724 BAD DEBTS 15431 15431 MISCELLANEOUS 232 232 6455611 5780064 675547 0 204441 82310 3165656 3409712 321420 680167 68902 66310 11359710 5274160 3756751 6085550 12537866 11783187 688100 1918164 20743136 24025400 230368 728608 685110 2402093 915478 3130701 X 19776533 20834799 10125 18900 41000 41000 19827658 20894699 20743136 24025400 X 1247210 -180169 X X 0 1 1 X 0 X 2314 1894 2495 41866 8775 57344 5300897 5618337 5823211 5805048 5968394 28515887 5303211 5620231 5825706 5846914 5977169 28573231 0 0 0 28573231 441955 501078 470096 325401 1650976 3389506 441955 501078 470096 325401 1650976 3389506 5745166 6121309 6295802 6172315 7628145 31962737 0.89400 0.92360 0.10600 0.07640 X 51125 8775 59900 41000 10125 51125 0.86000 0.14000 0 0 3151077 3151077 3143250 1492783 1650467 3638252 2561105 1077147 1414371 1207512 206859 12760 12760 0 6085550 INTEREST RECEIVABLE 45341 MORTGAGE ACQUISITION COSTS, NET 27860 CONSTRUCTION IN PROGRESS 1826138 SOFTWARE, NET 18825 1918164 7702821 6455611 1247210 -180169 -180169 1067041 7485553 -180169 -180169 7665722 37099 37099 7702821 6418512 0 6418512 37099 37099 6455611 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. 0 0 0 0 0 0 0 0 0 JOYCE HAGLUND 146200 0 0 0 6938 0 0 0 0 0 153138 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 15B THE EXECUTIVE COMMITTEE APPROVES ADMINISTRATOR'S SALARY. THEY REGULARLY REVIEW SALARY STUDIES DONE BY STATE HEALTHCARE ASSOCIATIONS. APPROVAL IS DOCUMENETED IN THE BOARD OF DIRECTORS MINUTES. THIS WAS LAST DONE IN 2010. 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: -180,169. PROCEDURES FOR REVIEW OF AUDITED STATEMENTS FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND APPOINTS THE AUDITOR.