2011-07-15T12:11:11-05:00 2010-12-31 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2010-01-01 043333609 CHS OF WALTHAM INC CHSO 7818930240 66 NEWTON STREET WALTHAM MA 02453 CAROLYN FENN 7818930240 2011-07-13 1 MICHAEL A BARBARITA 6036228881 2010 2016-02-24 21:20:13Z MARISTHILL NUSING HOME CAROLYN FENN 66 NEWTON STREET WALTHAM MA 02453 11115417 0 0928 X MARISTHILL.ORG X 1996 MA MARISTHILL IS A CATHOLIC SKILLED NURSING AND REHABILITATION FACILITY THAT CONTINUES THE HEALING MINISTRY OF CHRIST BY PROVIDING HEALTH CARE SERVICES THAT FOSTER EACH INDIVIDUAL'S PHYSICAL,SPIRITUAL, EMOTIONAL AND INTELLECTUAL WELL-BEING. 9 8 164 0 0 0 28596 27590 10916975 11038749 21304 17238 0 17348 10966875 11100925 0 0 0 0 5868560 6286134 0 0 0 4681061 4504014 10549621 10790148 417254 310777 9956254 10351680 8422652 8446659 1533602 1905021 MARISTHILL IS A CATHOLIC SKILLED NURSING AND REHABILITATION FACILITY THAT CONTINUES THE HEALING MINISTRY OF CHRIST BY PROVIDING HEALTH CARE SERVICES THAT FOSTER EACH INDIVIDUAL'S PHYSICAL, SPIRITUAL, EMOTIONAL AND INTELLECTUAL WELL-BEING. 0 0 10649210 11017954 MARISTHILL NURSING AND REHABILITATION CENTER PROVIDED 42,618 DAYS OF SKILLED NURSING SERVICES DURING 2010 OF WHICH 28,627 WERE TO MEDICAID RECIPIENTS 10649210 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 13 0 1 164 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X CAROLYN FENN 7818930240 66 NEWTON STREET WALTHAM MA 02453 KENNETH FERRON 1.00 X X 0 299240 96315 LUKE STANTON ESQ 1.00 X 0 0 0 CAROL EAST MSWLCSW 1.00 X 0 0 0 MARY ELIZABETH SCANLON 1.00 X 0 0 0 MICHAEL J DELANEY ESQ 1.00 X 0 0 0 LISA LORGEREE 3.00 X X 0 0 0 MARIE LABOLLITA SC 1.00 X X 0 0 0 BRENDA CAPELLO 1.00 X 0 0 0 CAROLYN FENN 40.00 X X 96211 0 0 JOSEPH SGRO 40.00 X 82908 0 0 179119 299240 96315 0 0 1 0 PEOPLEFIRST REHAB PO BOX 277365 ATLANTA GA 30384 REHABILITATION SERVICES 527900 BLUE CROSS BLUE SHIELD PO BOX 4701 WOBURN MA 01888 HEALTH INSURER 384605 NEHM CORPORATION 1565 MAIN STREET TEWKSBURY MA 01876 HOUSEKEEPING 315984 US FOODS PO BOX 3155 BOSTON MA 02241 FOOD SERVICE 294027 NEIGHBORHOOD HEALTH PLAN PO BOX 4106 WOBURN MA 01888 HEALTH INSURER 274132 5 27590 27590 PROGRAM SERVICE REVENU 623000 11017954 11017954 20795 20795 11038749 17238 17238 31840 14492 17348 17348 11100925 11038749 0 34586 179119 179119 5248094 5248094 8805 8805 470216 470216 379900 379900 128424 128424 24250 24250 12514 12514 330294 330294 352788 352788 330099 330099 93603 93603 PURCHASED SERVICES 1469073 1469073 FOOD AND SUPPLIES 971641 971641 PROVIDER TAX 687328 687328 BAD DEBTS 104000 104000 10790148 10649210 140938 0 588988 1088563 953250 505175 1101818 1251461 47756 33831 9281267 3674473 5280833 5606794 663034 740912 1320575 1124944 9956254 10351680 708950 759579 7048758 7018389 664944 668691 8422652 8446659 X 1533602 1905021 1533602 1905021 9956254 10351680 X 310777 60642 X 0 1 1 X 0 X 19010 17211 32861 5997 44938 120017 9470884 10142791 11133664 10925173 11027802 52700314 9489894 10160002 11166525 10931170 11072740 52820331 0 0 0 52820331 61208 54486 22158 35704 28185 201741 61208 54486 22158 35704 28185 201741 9551102 10214488 11188683 10966874 11100925 53022072 0.99620 0.99580 0.00380 0.00420 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 485000 485000 5579220 1892363 3686857 2521898 1767237 754661 695149 14873 680276 5606794 EST, 3RD PARTY SETTLEMENT 46357 RESIDENT TRUST FUND 23952 DEBT SERVICE RESERVE FUND 712883 BOND ISSUE COSTS (NET) 48387 BOND UNDERWRITING COSTS (NET) 19702 BOND DISCOUNT (NET) 48287 ALL OTHER ASSETS 225376 1124944 DEFERRED EXPENSES 222911 MEDICAID USER FEES 171710 PROFESSIONAL LIABILITY LOSS RESERVES 50854 DUE TO AFFILIATES 198031 DUE TO 3RD PARTY PAYER 1233 RESIDENT FUNDS 23952 668691 11100925 10790148 310777 60642 60642 371419 11161566 60642 60642 11100924 0 11100924 10790148 0 10790148 0 10790148 40TH ANNIVERSARY DINNER 31840 31840 12031 2461 31840 31840 12031 2461 14492 17348 X X X X 0 0 0 0 0 0 0 1 0 KENNETH FERRON 0 266282 0 0 0 32958 0 71189 0 25126 0 395555 0 0 PART I, LINE 7 THE RELATED ORGANIZATION, COVENANT HEALTH SYSTEM, MAINTAINS AN INCENTIVE COMPENSATION PLAN FOR EXECUTIVES THAT IS ADMINISTERED BY THAT ORGANIZATION'S COMPENSATION COMMITTEE. THE PLAN PROVIDES EXECUTIVES WITH THE OPPORTUNITY TO EARN REASONABLE INCENTIVE COMPENSATION BASED ON THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE INDIVIDUAL EXECUTIVE, AS MEASURED AGAINST GOALS ESTABLISHED AT THE BEGINNING OF THE YEAR. THE ENTITLEMENT TO AWARDS FOR A PARTICULAR YEAR IS NOT DETERMINED UNTIL EARLY THE FOLLOWING YEAR. THE ORGANIZATION PAID NO INCENTIVE COMPENSATION AWARDS IN 2010 BASED ON PERFORMANCE IN 2009. MA HEALTH & EDUCATION FACILITIES AUTHORITY 042456011 57586DBF9 2007-10-30 7221865 TO FINANCE THE PURCHASE OF YOUVILLE PLACE 1 0 0 7221865 712880 55862 6117244 2008 1 1 1 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 1 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 COVENANT HEALTH SYSTEMS IS THE SOLE MEMBER OF THE ORGANIZATION. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS OVER CORPORATE DECISIONS AND COMPOSITION OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7A COVENANT HEALTH SYSTEMS IS THE SOLE MEMBER OF THE ORGANIZATION. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS OVER CORPORATE DECISIONS AND VOARD COMPOSITION. FORM 990, PART VI, SECTION A, LINE 7B COVENANT HEALTH SYSTEMS IS THE SOLE MEMBER OF THE BOARD. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS OVER BOARD DECISIONS AND BORAD COMPOSITION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO AND REVIEWED WITH THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A FULL-TIME OPERATIONAL INTEGRITY OFFICER THAT MONITORS ALL AREAS FOR POTENTIAL CONFLICTS OF INTERETS. FORM 990, PART VI, SECTION B, LINE 15 EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH SYSTEMS BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003 THE COMPENSATION COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. THE SPECIFIC OBJECTIVES OF THE ANALYSIS ARE TO ASSESS THE COMPETITIVENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR LEADERSHIP TEAM; DEVELOP MARKET COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF ANY, ARE COMPETITIVE AND REASONABLE. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS ALSO POSTED ON COVENANT HEALTH SYSTEMS' WEBSITE. FORM 990, PART VI, SECTION C, LINE 19 THE FORM 990 AND GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 60,642. COVENANT HEALTH SYSTEMS 100 AMES POND DRIVE TEWKSBURY MA 01876 222484505 HEALTH CARE MANAGEMENT AND RESOURCE ORGANIZATION MA 501(C) 509(A) 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 COVENANT HEALTH SYSTEM L 128424 CASH