PRESIDENT/CEO

2011-07-12T12:55:05-05:00 2010-12-31 LARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2010-01-01 237090088 PENACOOK PLACE INC PENA 9783740707 150 WATER STREET HAVERHILL MA 01830 JULIAN RICH PRESIDENT/CEO 9783740707 2011-06-27 1 BARBARA J MORRISON 6179848100 2011-06-01 2010 2016-02-24 21:20:13Z JULIAN RICH 150 WATER STREET HAVERHILL MA 01830 13239928 0 X WWW.PENACOOKPLACE.ORG X 1969 MA TO PROMOTE THE HIGHEST POSSIBLE QUALITY OF LIFE FOR OUR RESIDENTS IN A CLEAN, SAFE AND ATTRACTIVE ENVIRONMENT. TO CARE FOR OUR RESIDENTS AS WE WOULD WANT TO BE CARED FOR-THE GOLDEN RULE OF PENACOOK PLACE. TO MEET OR EXCEED THE EXPECTATIONS OF OUR RESIDENTS, AS WELL AS OTHERS WITH WHOM WE COME IN CONTACT. TO SHOW HOSPITALITY, COURTESY, COOPERATION AND RESPECT TO ALL RESIDENTS, FAMILY MEMBERS, FELLOW EMPLOYEES, VOLUNTEERS AND VISITORS. TO BE AN INTEGRAL, CONTRIBUTING PART OF THE GREATER HAVERHILL BUSINESS, EDUCATIONAL AND CULTURAL COMMUNITIES. 20 20 327 5 0 0 114724 105111 12315685 13109590 35017 25227 0 0 12465426 13239928 0 0 0 0 8615350 9267702 0 0 0 3609362 3858135 12224712 13125837 240714 114091 6811191 6921192 4969566 4957672 1841625 1963520 X TO PROMOTE THE HIGHEST POSSIBLE QUALITY OF LIFE FOR OUR RESIDENTS IN A CLEAN, SAFE AND ATTRACTIVE ENVIRONMENT. TO CARE FOR OUR RESIDENTS AS WE WOULD WANT TO BE CARED FOR-THE GOLDEN RULE OF PENACOOK PLACE. TO MEET OR EXCEED THE EXPECTATIONS OF OUR RESIDENTS, AS WELL AS OTHERS WITH WHOM WE COME IN CONTACT. TO SHOW HOSPITALITY, COURTESY, COOPERATION AND RESPECT TO ALL RESIDENTS, FAMILY MEMBERS, FELLOW EMPLOYEES, VOLUNTEERS AND VISITORS. TO BE AN INTEGRAL, CONTRIBUTING PART OF THE GREATER HAVERHILL BUSINESS, EDUCATIONAL AND CULTURAL COMMUNITIES. 0 0 12021017 13134817 PENACOOK PLACE, INC. IS A NOT FOR PROFIT FACILITY PROVIDING SERVICE TO PRIVATE AND PUBLICLY AIDED PATIENTS AS LEVELS II & III. IT OPERATES A 160 BED NURSING HOME FACILITY. 12021017 1 1 0 0 0 0 0 0 0 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 1 0 1 0 0 0 0 0 0 0 0 0 0 1 28 0 327 1 0 0 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X CHARLES CARROZZA 9783740707 150 WATER STREET HAVERHILL MA 01830 CINDY M RYAN IMMEDIATE PAST CHAIR 2.00 X 0 0 0 WILLIAM J KLUEBER CHAIR 2.00 X 0 0 0 THOMAS L MORTIMER 1ST VICE CHAIR 2.00 X 0 0 0 FRANCIS W CLEARY JR CLERK 2.00 X 0 0 0 MARJORIE A BREWER CLERK EMERITA 2.00 X 0 0 0 HOWARD H BROWN MEMBER 2.00 X 0 0 0 FRANK NOVAK MEMBER 2.00 X 0 0 0 JOAN HULL 2ND VICE CHAIR 2.00 X 0 0 0 JULIAN RICH PRESIDENT/CEO 31.60 X X 161486 0 0 WILLIAM HART MD MEMBER/MEDICAL DIRECTOR 2.00 X 9600 0 0 JANIS CORDISCHI MEMBER 2.00 X 0 0 0 ROBERT BARANELLO MEMBER 2.00 X 0 0 0 LISA SALTERIO D.O.N 37.10 X X 100264 0 0 FAITH DELANEY MEMBER 2.00 X 0 0 0 KALISTER GREEN-BYRD MEMBER 2.00 X 0 0 0 RICHARD SUNDELL TREASURER 2.00 X 0 0 0 ELAINE DALTON MEMBER 2.00 X 0 0 0 GAIL EDELSTEIN MEMBER 2.00 X 0 0 0 LUCINDA NOLET MEMBER 2.00 X 0 0 0 C CARY REA MEMBER 2.00 X 0 0 0 CHARLES CARROZZA CHIEF FINANCIAL OFFICER 31.20 X 83435 0 0 TANYA SULLIVAN LPN 50.00 X 103637 0 0 MARK KAUFMAN RN 40.00 X 109951 0 0 568373 0 0 4 0 1 0 MORRISON MANAGEMENT SPECIALIST PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICES 589771 1 105111 105111 MCD INCOME 623000 5650254 5650254 PROG.SERV.REVENUE-RELA 623000 3503151 3503151 MCR A INCOME 623000 2430187 2430187 PRIVATE REVENUE 623000 1312470 1312470 PVH INCOME 623000 124430 124430 89098 89098 13109590 25227 25227 13239928 13109590 0 25227 244921 244921 7450401 7000173 450228 1010088 923260 86828 562292 513957 48335 19823 19823 40000 40000 2051 2051 612381 612381 16869 16869 806241 677567 128674 587009 515503 71506 6007 2873 3134 9320 9320 96 96 297185 297185 105826 105826 USER FEE 892253 892253 FOOD 396640 396640 BAD DEBTS 39000 39000 LICENSE AND DUES 11255 11255 TUITION AND EDUCATION 10759 10759 5420 5420 13125837 12021017 1104820 0 49722 283073 353398 441668 1881848 1877964 277520 231698 8207204 5567132 2731587 2640072 646763 532401 870353 914316 6811191 6921192 1354566 1451372 3615000 3505000 1300 4969566 4957672 X 1758899 1904520 82726 59000 1841625 1963520 6811191 6921192 X 114091 7804 X X 0 1 1 X 1 1 X 50188 104636 120916 114724 105111 495575 11734604 11295644 11802514 12315685 13109591 60258038 11784792 11400280 11923430 12430409 13214702 60753613 0 0 0 60753613 102586 87138 75528 35017 25227 325496 102586 87138 75528 35017 25227 325496 11887378 11487418 11998958 12465426 13239929 61079109 0.99470 0.99200 0.00530 0.00800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 30859 30859 5994462 3887142 2107320 2139584 1657760 481824 42299 22230 20069 2640072 FUNDED RESERVE 682594 INTEREST RECEIVABLE 10819 DEPOSITS 43352 SOFTWARE, NET 2856 BOND ISSUE COSTS, NET 174695 914316 13239928 13125837 114091 7804 7804 121895 13247732 7804 7804 13239928 0 13239928 13125837 0 13125837 0 13125837 X 0 0 0 0 0 0 0 0 0 JULIAN RICH 146486 0 15000 0 0 0 0 0 0 0 161486 0 0 0 LANDMARK HEALTH SOLUTIONS A OWNER IS A DIRECTOR OF ORGANIZATION 113480 CONSULTING SERVICES 0 FORM 990, PART VI, SECTION B, LINE 11 CFO INITIALLY REVIEWS THE FORM 990 AND THEN REVIEWS IT WITH THE PRESIDENT/CEO OF THE ORGANIZATION, BOTH PARTIES APPROVE THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C AT THE SEPTEMBER BOARD OF DIRECTOR'S MEETING, EVERY BOARD MEMBER IS GIVEN A COPY OF THE CONFLICT OF INTEREST STATEMENT TO READ AND SIGN. ALL BOARD MEMBERS ARE REQUIRED TO SIGN. THE POLICY OUTLINES THE RESTRICTIONS IMPOSED UPON THE BOARD IF ANY CONFLICT SHOULD EXIST. ALL STAFF MEMBERS ARE PRESENTED INFORMATION REGARDING ORGANIZATIONAL INTEGRITY UPON HIRE AND DURING THEIR ANNUAL ORIENTATION. CONFLICT OF INTEREST IS INCLUDED IN OUR O.I. PROGRAM AND STAFF IS REQUIRED TO REVIEW AS PART OF THEIR CONTINUED EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 A PERSONNEL COMMITTEE WAS ESTABLISHED AS A SUB-COMMITTEE OF THE BOARD OF DIRECTORS. THE FOCUS OF THIS GROUP IS TO REVIEW AND EVALUATE THE PRESIDENT/CEO ON AN ANNUAL BASIS, THE PERSONNEL COMMITTEE RECEIVES INPUT FROM ALL BOARD MEMBERS AND DEPARTMENT HEADS. THE PERSONNEL COMMITTEE THEN MAKES THEIR RECOMMENDATION TO THE FULL BOARD FOR FINAL APPROVAL. THIS PROCESS IS CONDUCTED ANNUALLY AND TAKES PLACE STARTING IN JANUARY OF EACH YEAR TO EVALUATE THE PERFORMANCE OF THE PRESIDENT/CEO FOR YEAR JUST COMPLETED. THE LAST TIME THIS PROCESS WAS CONDUCTED WAS JANUARY 2011 FOR THE 2010 CALENDAR YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC, UPON REQUEST. THE FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 7,804. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.