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MASONICARE HEALTH CENTER: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MASONICARE HEALTH CENTER (EIN 06-0655131)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-12
IRS object ID
201142249349301004
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-12T06:16:47-07:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN060655131EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Masonicare Health CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMASONameControl
Phone2036787857Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 70AddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameR Scott ThelenName
TitleAsst. TreasurerTitle
Date Signed2011-08-12DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts63800670GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web SiteWWW.MASONICARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1889YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionProvide comprehensive medical services to the elderly.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees1039TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year76576ContributionsGrantsPriorYear
Contributions Grants Current Year140588ContributionsGrantsCurrentYear
Program Service Revenue Prior Year61095773ProgramServiceRevenuePriorYear
Program Service Revenue CY62145963ProgramServiceRevenueCY
Investment Income Prior Year-62767InvestmentIncomePriorYear
Investment Income Current Year23911InvestmentIncomeCurrentYear
Other Revenue Prior Year1432278OtherRevenuePriorYear
Other Revenue Current Year1490208OtherRevenueCurrentYear
Total Revenue Prior Year62541860TotalRevenuePriorYear
Total Revenue Current Year63800670TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year41195919SalariesEtcPriorYear
Salaries Etc Current Year38981135SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year20819147OtherExpensePriorYear
Other Expenses Current Year21678639OtherExpensesCurrentYear
Total Expenses Prior Year62015066TotalExpensesPriorYear
Total Expenses Current Year60659774TotalExpensesCurrentYear
Revenues Less Expenses Prior Year526794RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3140896RevenuesLessExpensesCY
Total Assets BOY45802913TotalAssetsBOY
Total Assets EOY43027131TotalAssetsEOY
Total Liabilities BOY8234311TotalLiabilitiesBOY
Total Liabilities EOY6639171TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY37568602NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY36387960NetAssetsOrFundBalancesEOY
Mission DescriptionProvide comprehensive medical services to the elderly.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense52547589Expense
Revenue62145963Revenue
DescriptionMasonicare Health Center is multi-level care facility. In 2010, it operated at a 97.0% occupancy rate providing 182,302 patient days. The independent living units operated at a 100% occupancy rate. Masonicare Health Center provides services in the following areas: long-term care, acute care, geriatric medical psychiatric services, hospital based outpatient services and independent living apartments.Description
Total Program Service Expense52547589TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109654NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1039NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonR Scott ThelenNamePerson
Telephone Number2036787857TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line122 Masonic AvenueAddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
William T Viola Jr
Member1.00X000
William R Deickler Vice Chair
Vice Chairman1.00X000X
William Morrow
Member1.00X000
William C Piper
President40.00X292930023221X
Thomas M Maxwell III
Member1.00X000
Stephen P Shapiro
Member1.00X000
Stephen B McPherson
Asst Secretary40.00X082261518755X
Sherwin M Borsuk MD
Member1.00X000
Robert A Simon Chairman
Chairman1.00X000X
Richard Ruggiano
Member1.00X000
R Scott Thelen
Asst. Treasurer40.0001204381251X
Melinda Schoen
VP-Nursing40.00123103018657X
Martin Deflorio
Dir-Pharmacy40.0011049808902X
Mark D Winne Secretary
Secretary1.00X000X
John R Hall
Member1.00X000
James Standish
Sr Vice President/CFO0.038848714765X
Irene Morris
ADON/Infect Contro0.105503011250X
Howard W Orr
Member1.00X000
Deena Williamson
Director Acute/Psy40.0010202901491X
Beatrice Coulombe
VP-Admin40.00164106015849X
Barbara F Lott
Member1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org898169TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1331540TotalReportableCompFrmRltdOrgs
Total Other Compensation114141TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Morrison Management Specialists Inc
PO BOX 102289AtlantaGA30268Dietary Management2445527
Mckesson Drug Company
1801 Royal LaneDallasTX75229Pharmaceuticals2072732
Masonicare Inc
PO Box 70WallingfordCT06492Management services3298680
LINA
PO Box 13701PhiladelphiaPA191013701Emp STD,Life Ins332248
FIP Construction
10 Mckee PlaceCheshireCT06410Construction Servcie1619085
FieldValueIRS element (for citing)
Number Of Contractors GT100 K13NumberOfContractorsGT100K
Related Organizations140588RelatedOrganizations
Total Contributions140588TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Skilling nursing6230003993341639933416
Resident fees-apartments62300018491711849171
Home for aged62300041433444143344
Geriatric med psychiatric62300091923899192389
Acute hospital62300055305835530583

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column1497060TotalRevenueColumn
Related Or Exempt Function Income1497060RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue62145963TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column23911TotalRevenueColumn
Exclusion$23,911ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Shops/stores203843$203,843
Other,net963609$417,909545700
Dietary194395$194,395

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column128361TotalRevenueColumn
Exclusion$128,361ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1490208TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column63800670TotalRevenueColumn
Related Or Exempt Function Income62691663RelatedOrExemptFunctionIncome
Exclusion$968,419ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total483163Total
Management And General483163ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total29335736Total
Program Services28299197ProgramServices
Management And General1036539ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6979531Total
Program Services6722726ProgramServices
Management And General256805ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2182705Total
Program Services2147338ProgramServices
Management And General35367ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3298680Total
Management And General3298680ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total64940Total
Management And General64940ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total27819Total
Management And General27819ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total679695Total
Program Services679695ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total18184Total
Program Services18158ProgramServices
Management And General26ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total103112Total
Program Services95011ProgramServices
Management And General8101ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total444828Total
Management And General444828ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total607170Total
Program Services598976ProgramServices
Management And General8194ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2955769Total
Program Services2932406ProgramServices
Management And General23363ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total461028Total
Management And General461028ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Utilities19064421906442
Supplies Other1810196179612814068
Purchased Services2705935261878687149
Pharmacy21415962141596
All other Expenses289723310620931835140

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1556012Total
Program Services1529037ProgramServices
Management And General26975ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total60659774Total
Program Services52547589ProgramServices
Management And General8112185ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2070BOY
EOY2070EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9288995BOY
EOY8064456EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY165989BOY
EOY152569EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY228708BOY
EOY240805EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis82639197LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec48623503LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY35356328BOY
EOY34015694EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY760823BOY
EOY551537EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY45802913BOY
EOY43027131EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3509433BOY
EOY2301983EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4724878BOY
EOY4337188EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8234311BOY
EOY6639171EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY37568602BOY
EOY36387960EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY37568602BOY
EOY36387960EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY45802913BOY
EOY43027131EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteefalseAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis59864285OtherCostOrOtherBasis
Depreciation34096274Depreciation
Book Value25768011BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3841145OtherCostOrOtherBasis
Depreciation1610378Depreciation
Book Value2230767BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis12698842OtherCostOrOtherBasis
Depreciation10955104Depreciation
Book Value1743738BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6234925OtherCostOrOtherBasis
Depreciation1961747Depreciation
Book Value4273178BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings34015694TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
Rounding$1
Estimated Third Party$1,514,456
Deposits$167,943
Deferred Patient Revenue$67,810
Custodial Liabilities$532,051
Asbestos Removal$607,427
Accrued employee compensation$1,434,789
Accrued Employee Benefits Current$12,711
FieldValueIRS element (for citing)
Total Of Amounts4337188TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage150.000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CarefalseAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense15001TotalCommunityBenefitExpense
Net Community Benefit Expense15001NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense15001TotalCommunityBenefitExpense
Net Community Benefit Expense15001NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense15001TotalCommunityBenefitExpense
Net Community Benefit Expense15001NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1100PersonsServed
Total Community Building Expense7250TotalCommunityBuildingExpense
Net Community Building Expense7250NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served661PersonsServed
Total Community Building Expense28537TotalCommunityBuildingExpense
Net Community Building Expense28537NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served175PersonsServed
Total Community Building Expense4025TotalCommunityBuildingExpense
Net Community Building Expense4025NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served1936PersonsServed
Total Community Building Expense39812TotalCommunityBuildingExpense
Net Community Building Expense39812NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$34,055BadDebtExpenseAmount
Amount Reimbursed By Medicare21551096AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare17766674CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall3784422MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Masonicare Health CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line122 Masonic AvenueAddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based Criteria150% of FPG are used to determine the income threshold that a patient must meet or fall below to qualify for discounted medical care.IncomeBasedCriteria
Bad Debt FootnoteMasonicare Health Center uses the indirect method to record bad debts. Masonicare Health Center Records an allowance for doubtful accounts, which is based on its estimation of bad debts, against its outstanding patient accounts receivable. This estimate is based on Masonicare Health Center's past experience with collecting its receivables and an analysis of current accounts receivable.BadDebtFootnote
Shortfall As Community BenefitThe costing method used for line 6 is as reported in the annual Medicare Cost Report (CMS 2552)ShortfallAsCommunityBenefit
Debt Collection PolicyMasonicare Health Center provides care to patients who meet certain criteria under the charity care policy without charge, or at amounts less than established rates. It does not pursue collection of amounts determined to be charity care and these amounts are not reported as net patient service revenues.DebtCollectionPolicy
Number Of Facility Type Explnskilled nursing and rehabilitation unitsindependent living unitsresidential care unitsoutpatient speciality clinicsNumberOfFacilityTypeExpln
Needs AssessmentMasonicare is in the process of collecting information through a short questionnaire in order to better understand the communities that we serve. The survery purpose is to uncover the top 3 unmet needs of the older adults (60+) in the Wallingford/Meriden area. Hebrew Health Care, the Wallingford Health Department and the United Way of Meriden and Wallingford shared with us previous community surveys they had conducted in order to form the creation of our survey instrument.NeedsAssessment
Community InformationMasonicare Health Center (MHC) is part of the consolidated group of affiliates, Masonicare. MHC offers a wide variety of services that include:a. 382 skilled nursing and rehabilitation unitsb. 93 independent living unitsc. 86 residential care unitsd. 21 outpatient speciality clinics (Ambulatory Care Services)e. 30 acute Medical Hospital Bedsf. 29 acute psychiatric hospital bedsMHC is licensed as a chronic disease hospital and as such does not have emergency or surgical services. The revenues for the hospital portion of the business represent approximately 24% of the program service revenues of MHC.Masonicare, the parent company of Masonicare Health Center (MHC), serves the entire state of Connecticut through its separate affiliates. MHC, located in Wallingford CT services the greater Wallingford area. MHC is centrally located in the state providing easy access to the surrounding towns. Its outpatient specialty clinics provide easy access and high quality services to the town of Wallingford and the surrounding towns.As a non-profit 501(c)(3) organization, Masonicare is proud to provide free education programs and services to individuals and families throughout Connecticut. For the year ended Sep.30,2010 Masonicare and all of its affiliates across our continuum donated 2,477 hours of their time to benefit the community through home visits and educational programs. These donated staff hours had a monetary value of $115,482 and touched 12,476 members of the community. Masonicare also has 11 home health and hospice branches throughout the state that service the entire state of Connecticut.CommunityInformation
Affiliated Health Care SystemMasonicare of Wallingford, Connecticut, is the state's leading provider of healthcare and retirement living communities for seniors. We are not-for-profit and have more that 100 years of experience behind us. We're recognized for the quality, compassionate care and steadfast support we provide to our residents and patients. Masonicare encompasses a broad range of healthcare and senior living options: Skilled nursing and rehabilitation facilities- Masonicare Health Center in Wallingford and Masonicare at Newtown.Independent living options - A continuing care retirement community, Masonicare at Ashlar Village, and the Johnson, Wells, and Hawkins Apartments for individuals 55 and over located in Wallingford.Assisted living communities - Pond Ridge in Wallingford and Lockwood Lodge in Newtown.A residential care home - the Leslie G. Wright Residence in Wallingford. Masonicare Home Health & Hospice, a statewide home healthcare and hospice provider that touches 3,000 patients each month through its 11 offices. Masonicare offers free education programs and services to individuals and families throughout Connecticut that include:Lunch and Learn - this program is designed to provide seniors and others with education on health and wellness. Speakers are typically medical professionals from throughout the Masonicare continuum. Masonicare has coordinated with the senior centers and libraries in the towns of Enfield, Hamden, Meriden, Monroe, Newtown, North Haven, Southbury, Trumbull, Wallingford and Woodbury.Masonicare Community Services - is a statewide outreach program available to all Connecticut residents and offers information and guidance on a variety of programs and services including:- ConnPace (Connecticut's pharmaceutical program)- Medicare, Medicaid (Title 19), and Medicare Part D- Benefits eligibility- Caregiver assistance programs- State and Federal programs- Housing OptionsThese services are available over the phone or in the comfort of the resident's home.The Masonicare Help Line - is a toll free phone service assisting seniors and families with a broad range of questions about senior healthcare, retirement living and much more. In addition, we offer assistance in locating and utilizing service agencies and programs in Connecticut. Masonicare frequently holds blood pressure screenings and senior health fairs throughout the state, and makes its facilities available to many community organizations including the Commission on Aging, Senior Resources - Agency on Aging, M-Team, Healthy Wallingford, the Alzheimer's Association, Heritage Quilters and the Wallingford Education Foundation.AffiliatedHealthCareSystem

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
William C Piper
2458984681721523221316151
Stephen B McPherson
4661633207263572618755841370
James Standish
3232016514314314765403252
Beatrice Coulombe
14225620729112115849179955

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part III, Additional InformationPart III, Additional InformationPart 1 Line 7- Non Fixed PaymentsCompensation to reward senior managers for achieving annual quality, strategic, and financial goals for the organization
Sch J, Part I, Line 7Part I, Line 7: Non-Fixed payments not listed above

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe Financial Statements are publicly available through EMMA and public securities markets. The governing documents, certificate of incorporation and related documents are on file with the CT Secretary of State's office. The conflict of interest policy is available upon request.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAnnually, officers, directors and senior employees are required to complete a conflict of interest disclosure questionnaire. The results of the officers' and directors' disclosures are reported to the President. The entire process is coordinated by the Corporate Compliance Officer. All respondents are advised to report any changes during the year that may present a conflict of interest.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessMasonicare Corporation and Masonicare Health Center review the tax return for completeness and accuracy. It is also reviewed by the chief executive officer and chairman of the board. The review process is then discussed with the full board. After responding to comments/questions, changes are made as appropriate and the return is finalized and filed.
Form 990, Part VI, Line 7aForm 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyMasonicare Corporation, as a sole corporate member, annually appoints the members of the governing body.
Form 990, Part VI, Line 6Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe organization has a sole corporate member, Masonicare Corporation, with the right to appoint the members of the governing body and to participate in the organization's governance.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Masonicare at Home Inc
PO Box 70WallingfordCT06492202377783Provide companion/homemaker/personalcare services to elderlyCT501(c)(3)9NA
Keystone Indemnity Company Ltd
126 College Street Suite 400BurlingtonVT05401060371612Provide insurance services to Masonicare affiliatesVT501(c)(3)11aNA
Masonicare Partners HomeHealth & Hospice
111 Founders Plaza Suite 200East HartfordCT06108260758992Provide home health services to clients of all agesCT501(c)(3)9NA
Masonicare Home Health and Hospice Inc
33 North Plains RoadWallingfordCT06492061101924Provided home health services to clients of all agesCT501(c)(3)9NA
Masonicare at Ashlar Village Inc
PO Box 70WallingfordCT06492061050830Continuing care retirement and assisted living communityCT501(c)(3)9NA
Masonicare at Newtown Inc
PO Box 70WallingfordCT06492061070285Provide skilled nursing/assisted living services to elderlyCT501(c)(3)9NA
Masonic Charity Foundation of CT
PO Box 70WallingfordCT06492061435920Provide planned giving and development support to affiliatesCT501(c)(3)11aNA
Masonicare Inc
PO Box 70WallingfordCT06492061435919Parent holding and support organization for affilate corps.CT501(c)(3)11bNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
Masonic Management Services
67 Masonic AveWallingfordCT06492061468972Provides management servicesCTNAC
Masonicare Primary Care Physicians PC
67 Masonic AveWallingfordCT06492061491820Physician medical practiceCTNAC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Masonicare Home Health and Hospice Inc
r1492273
Masonicare at Ashlar Village Inc
r248974
Masonicare at Newtown Inc
r450353
Masonic Charity Foundation of CT
r689100
Masonicare Inc
q2510230