2011-11-11T14:35:55-06:00 2010-12-31 FEELEY & DRISCOLL PC 200 PORTLAND STREET BOSTON MA 02114 990 2010-01-01 222843194 OVERLOOK MASONIC HEALTH CENTER INC OVER 5082487344 88 MASONIC HOME ROAD CHARLTON MA 015071000 PAM JONES 5082487344 2011-09-22 1 ALAN GAROFALO 6177427788 2011-09-22 2010 2016-03-07 17:11:31Z PAMELA JONES 88 MASONIC HOME ROAD CHARLTON MA 015071000 22816360 0 X THEMASONICHOME.ORG X 1987 MA CHARITABLE - THE PROVISION OF LONG-TERM RESIDENTIAL AND REHABILITATIVE CARE TO RESIDENTS OF THE COMMUNITY. 12 10 487 40 0 0 1036308 1382093 15186533 15683831 896410 5058941 690788 691495 17810039 22816360 0 0 0 0 12079684 12259597 0 0 0 9481351 9028225 21561035 21287822 -3750996 1528538 184962230 192453459 40791725 42007251 144170505 150446208 TO PROVIDE THE RESIDENTS OF THE HEALTH CENTER WITH THE HIGHEST LEVEL OF COMPREHENSIVE MEDICAL CARE SERVICES WITH A CONSIDERATE AND PERSONAL TOUCH. 0 0 18635679 16375326 OPERATION OF A LONG-TERM CARE AND RESIDENTIAL CARE FACILITY IN CHARLTON, MA. TOTAL PATIENT DAYS OF CARE AND TOTAL REST HOME DAYS OF CARE FOR THE YEAR ENDED DECEMBER 31, 2010 AMOUNTED TO 49,351 AND 14,868, RESPECTIVELY, FOR A TOTAL DAYS OF CARE OF 64,219. 18635679 1 1 0 0 0 0 1 0 1 1 0 0 1 1 1 0 1 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 1 0 0 0 0 1 39 0 1 487 1 0 0 0 0 0 0 0 0 0 0 X 12 10 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 MA X X PAMELA JONES 5082487344 88 MASONIC HOME ROAD CHARLTON MA 01507 DONALD HICKS 1.00 X 0 0 0 JAY JOLICOUER 1.00 X 0 0 0 ROBERT JOLLY 1.00 X 0 0 0 ROBERT GRATTAROTI 1.00 X 0 0 0 JACK MULHALL 1.00 X 0 0 0 JAMES TRACY 1.00 X 0 0 0 JEFFREY GARDINER 1.00 X 0 0 0 LUDWIG ALBAN 1.00 X 0 0 0 RICHARD STEWART 1.00 X 0 0 0 BRIAN MARSH 1.00 X 0 0 0 PAMELA JONES 1.00 X X 0 199511 20376 DAVID C TURNER 1.00 X X 0 300257 15691 TOBY SHEA 1.00 X 0 186118 9713 PAUL BOWLER 40.00 X 173628 0 9236 173628 685886 55016 1 0 1 0 BLUE CROSS BLUE SHIELD OF MA 401 PARK DRIVE BOSTON MA 02115 INSURANCE 1740254 SYSCO 380 SOUTH WORCHESTER STREET NORTON MA 02766 FOOD SERVICES 604899 FLYNN PETROLEUM 307 HARTFORD PIKE SHREWSBURY MA 01545 UTILITIES 494543 TRANSCANADA POWER MARKETING LTD 110 TURNPIKE ROAD WESTBOROUGH MA 01581 UTILITIES 419789 NATHAN SALLOP INSURANCE AGENCY 25 NEW CHARDON STREET BOSTON MA 02114 INSURANCE 393982 5 1382093 1382093 NET PATIENT REVENUE 623000 15683831 15683831 15683831 1843345 1843345 3215596 3215596 3215596 3215596 MISCELLANEOUS 812900 547358 547358 CAFETERIA REVENUE 721310 67002 67002 BARBER/BEAUTY 812900 22864 22864 54271 54271 691495 22816360 16375326 0 5058941 182864 182864 9609995 9312359 297636 414215 393504 20711 1157244 1099382 57862 895279 850515 44764 200004 200004 12873 12873 36250 36250 368908 368908 336999 320149 16850 1201003 1140953 60050 18059 18059 994330 994330 2472684 2349050 123634 401627 381546 20081 MEDICAL SUPPLIES 849082 849082 RESIDENT BED TAX 741346 741346 DIETARY SERVICES 707902 707902 REPAIRS AND MAINTENANCE 515675 489891 25784 PROVISION FOR BAD DEBT 143483 143483 28000 28000 21287822 18635679 2652143 0 71400 63801 655783 1057831 1009025 957474 486686 396444 65484215 25700172 41870564 39784043 101938118 102908170 38930654 47285696 184962230 192453459 1553627 1585149 55640 36246441 35205926 1903175 4129475 1032842 1086701 40791725 42007251 X 116788025 122372108 21676450 22367735 5706030 5706365 144170505 150446208 184962230 192453459 X 1528538 4747165 X 0 1 1 X 0 X 580071 495441 1020056 860861 1171950 4128379 11222918 8487408 14758017 15186533 15683831 65338707 11802989 8982849 15778073 16047394 16855781 69467086 0 155617 155334 41159 352110 155617 155334 41159 352110 69114976 3030996 5746992 533262 909773 4855132 15076155 3030996 5746992 533262 909773 4855132 15076155 727728 803522 712846 690788 691495 3626379 15561713 15533363 17024181 17647955 22402408 88169620 0.78390 0.79970 0.17100 0.15200 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 211501 X X 0 96602400 3472073 9393039 10684515 98782997 98483745 735867 21433488 24050700 96602400 133769784 878300 -29315371 6848968 98483745 0.72000 0.06000 0.22000 0 0 336962 336962 57449186 20762703 36686483 6321403 4597299 1724104 1376664 340170 1036494 39784043 DUE FROM AFFILIATES 46217969 DEFERRED FINANCING COSTS 1067727 47285696 DUE TO AFFILIATES 480844 DUE TO RESIDENTS 55278 ASSET RETIREMENT OBLIGATION 550579 1086701 22816360 21287822 1528538 4747165 4747165 6275703 27563525 4747165 4747165 22816360 0 22816360 21287822 0 21287822 0 21287822 PART III, LINE 4: THE ORGANIZATION HAS TWO NON-DEPRECIABLE FIXED ASSETS: STAINED GLASS WINDOWS VALUED AT $72,700 AND RAILROAD EQUIPMENT AND TRACK VALUED AT $87,600 FOR A TOTAL $160,300. THESE TWO ASSETS FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION BY ADDING TO THE SOCIAL AND SPIRITUAL WELL BEING OF THE PATIENTS. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT INCLUDES BOTH DONOR RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE ORGANIZATION ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIAL POSITION. X X X X 0 0 0 0 0 0 0 0 0 PAMELA JONES 0 199511 0 0 0 0 0 3886 0 16490 0 219887 0 0 DAVID C TURNER 0 300257 0 0 0 0 0 3361 0 12330 0 315948 0 0 TOBY SHEA 0 186118 0 0 0 0 0 0 0 9713 0 195831 0 0 PAUL BOWLER 173628 0 0 0 0 0 0 0 9236 0 182864 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION'S MANAGEMENT DUTIES ARE HANDLED BY ONE OF IT'S RELATED ENTITIES, MASONIC HEALTH SYSTEMS OF MASSACHUSETTS, INC. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION'S MANAGEMENT DUTIES ARE HANDLED BY ONE OF IT'S RELATED ENTITIES, THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. FORM 990, PART VI, SECTION A, LINE 6 MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. IS THE SOLE CORPORATE MEMBER OF OVERLOOK MASONIC HEALTH CENTER, INC. AS SUCH, THE HEALTH SYSTEM HAS THE RIGHT TO APPROVE ACTIONS TAKEN BY THE BOARD MEMBERS OF OVERLOOK MASONIC HEALTH CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. IS THE SOLE CORPORATE MEMBER OF OVERLOOK MASONIC HEALTH CENTER, INC. AS SUCH, THE HEALTH SYSTEM HAS THE RIGHT TO ELECT AND APPROVE BOARD MEMBERS OF OVERLOOK MASONIC HEALTH CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7B MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. IS THE SOLE CORPORATE MEMBER OF OVERLOOK MASONIC HEALTH CENTER, INC. AS SUCH, THE HEALTH SYSTEM HAS THE RIGHT TO APPROVE ACTIONS TAKEN BY THE BOARD MEMBERS OF OVERLOOK MASONIC HEALTH CENTER, INC. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT WORKS WITH THE ORGANIZATION'S EXTERNAL AUDITORS TO PREPARE THE FINANCIAL INFORMATION AND COMPILE THE DISCLOSURES REQUIRED OF THE FORM 990. UPON ITS COMPLETION, SENIOR MANAGEMENT PROVIDES A DRAFT OF THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY VIA ANNUAL EXECUTION OF THE CONFLICT OF INTEREST POLICY. THIS CONFLICTS POLICY IS INTENDED TO SUPPLEMENT, BUT NOT REPLACE, ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE CORPORATIONS. THIS CONFLICTS POLICY HAS BEEN ADOPTED BY THE BOARD OF DIRECTORS OF MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. (MHS) THIS CONFLICTS POLICY SHALL APPLY WITH EQUAL FORCE TO ALL CORPORATIONS RELATED TO, OR AFFILIATED WITH, MHS. FORM 990, PART VI, SECTION A, LINE 13:IS THE POLICY OF MHS TO ACTIVELY WORK TO PREVENT FRAUD, WASTE, OR ABUSE OF PROCEDURE. ALL EMPLOYEES, CONTRACTORS, AGENTS, AND VOLUNTEERS OF MHS MUST IMMEDIATELY REPORT ANY SUSPICION OF FRAUD, WASTE, OR ABUSE OF PROCEDURE IN CONNECTION WITH MHS OPERATIONS TO HIS OR HER SUPERVISOR. MHS ENGAGES IN A CORPORATE COMPLIANCE PROGRAM FOR THE PURPOSE OF DETECTING AND PREVENTING FRAUD, WASTE, AND ABUSE OF PROCEDURE. FORM 990, PART VI, SECTION A, LINE 14: MANAGEMENT AND THE BOARD ARE IN THE PROCESS OF INITIATING A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION MAINTAINS A PERSONNEL COMMITTEE TO ANNUALLY REVIEW THE PERFORMANCE AND COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES. THE PERSONNEL COMMITTEE DETERMINES THE COMPENSATION FOR OFFICERS AND KEY EMPLOYEES ANNUALLY BASED ON COMPARABLE INDUSTRY DATA AND THROUGH A CONSULTATION AGREEMENT WITH TOWERS PERRIN, A NATIONAL HUMAN RESOURCES CONSULTANT. THE DETERMINATION OF COMPENSATION IS SUBSTANTIATED IN THE ORGANIZATION'S MINUTES OF THE PERSONNEL COMMITTEE FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST AND CAN BE FOUND AT THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 4,747,165. THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS 88 MASONIC HOME ROAD CHARLTON MA 01507 043515688 SOLE MEMBER MA 501(C)(3) 501(C)(3) 0 OVERLOOK VISITING NURSES ASSOCIATION INC 88 MASONIC HOME ROAD CHARLTON MA 01507 043515687 HOME HEALTHCARE MA 501(C)(3) 501(C)(3) 0 OVERLOOK COMMUNITIES INC 88 MASONIC HOME ROAD CHARLTON MA 01507 043515686 RESIDENTIAL & ASSISTED LIVING MA 501(C)(3) 501(C)(3) 0 THE GROVES IN LINCOLN INC 88 MASONIC HOME ROAD CHARLTON MA 01507 260300778 SENIOR LIVING MA 501(C)(3) 501(C)(3) 0 OVERLOOK HEALTH CENTER AT NORTHAMPTON INC 88 MASONIC HOME ROAD CHARLTON MA 01507 270451701 SKILLED NURSING FACILITY MA 501(C)(3) 501(C)(3) 0 THE APARTMENTS AT THE GROVES INC 88 MASONIC HOME ROAD CHARLTON MA 01507 260300696 SENIOR LIVING MA 501(C)(3) 501(C)(3) 0 OVERLOOK CATERING INC 88 MASONIC HOME ROAD CHARLTON MA 01507 271472010 CATERING SERVICES MA C 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0