2024-08-15T07:30:23-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2023-01-01 042106771 WILLIAM B RICE EVENTIDE HOME INC WILL 7816605000 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 JOHN MONIZ CHIEF EXECUTIVE OFFICER 7816605000 2024-08-01 1 0 KATARZYNA O PADZIK P02268641 7819821001 2024-08-01 2023 2024-08-08 14:25:15Z DWYER HOME AND FAIRING WAY JOHN MONIZ 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 14333343 0 X WWW.FAIRINGWAY.ORG X 1924 MA A LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED SUPPORTIVE SERVICES. 9 9 151 13 0 0 720459 38164 11911214 13006133 139598 119091 0 0 12771271 13163388 0 0 0 0 6239051 6784470 22000 0 5625 8339586 8149372 14600637 14933842 -1829366 -1770454 87530296 87267317 89731098 91210598 -2200802 -3943281 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 12130763 0 13006133 THE HOME PROVIDES SECURE HOUSING, QUALITY NURSING CARE, MEANINGFUL ACTIVITIES, OPPORTUNITIES FOR SOCIALIZATION, AND A WIDE VARIETY OF SUPPORTIVE & REHABILITATION SERVICES TO APPROXIMATELY 50 FRAIL ELDERS UNABLE TO LIVE INDEPENDENTLY IN THE COMMUNITY, WITHOUT REGARD FOR THEIR ABILITY TO PAY. 12130763 1 1 0 1 0 0 0 0 1 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 1 0 0 0 0 1 8 0 151 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 MA X BRIAN FREEDMAN 7816605000 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 KENNETH STRONG EXECUTIVE DIRECTOR (THROUGH DEC 2023) 40.00 X 181385 0 9432 ROCHELLE ROLFE DIRECTOR OF NURSING 40.00 X 126534 0 9848 BUOI THI TRAN CNA 40.00 X 107933 0 17240 JESSICA GOUVEIA DIRECTOR OF FINANCE 40.00 X 106025 0 12110 MARCIA ASTUTO NURSING SUPERVISOR/SDC 40.00 X 103557 0 9159 KIMBERLY MCGRATH PHYSICAL THERAPIST 40.00 X 104000 0 3228 AMY ROSS PRESIDENT 5.00 X X 0 0 0 DONALD POWELL TREASURER 5.00 X X 0 0 0 SUSAN BELISLE CLERK 5.00 X X 0 0 0 KEVIN KIRBY DIRECTOR 5.00 X 0 0 0 ANNE MARCHETTA DIRECTOR 5.00 X 0 0 0 JOHN DIORIO DIRECTOR 5.00 X 0 0 0 MARY DOHERTY DIRECTOR 5.00 X 0 0 0 JOHN MONIZ III DIRECTOR 5.00 X 0 0 0 ADITI SHARMA DIRECTOR 5.00 X 0 0 0 STEVEN DWYER DIRECTOR (THROUGH JAN 2023) 5.00 X 0 0 0 MEGAN FISHER DIRECTOR (THROUGH JAN 2023) 5.00 X 0 0 0 JOSEPH BURNIEIKA DIRECTOR (THROUGH FEB 2023) 5.00 X 0 0 0 WILLIAM JACKSON DIRECTOR (THROUGH APR 2023) 5.00 X 0 0 0 729434 0 61017 8 0 1 0 PHARMERICA 1123 PEARL ST BROCKTON MA 02301 PHARMACY 282381 SYSCO BOSTON 99 SPRING ST PLYMPTON MA 02367 FOOD VENDOR 217820 INTELYCARE 1250 HANCOCK ST 501N QUINCY MA 02169 STAFFING AGENCY 215521 INFORMATIX HEALTH 55 KNAPP CENTER BROCKTON MA 02301 STAFFING AGENCY 121331 4 34656 3508 38164 MEDICARE RESIDENTS 623000 4664894 4664894 INDEPENDENT LIVING SERVICE REVENU 623000 4290942 4290942 PUBLICLY-AIDED RESIDENTS 623000 1941057 1941057 PRIVATE RESIDENTS 623000 1333833 1333833 AMORTIZATION OF ENTRANCE FEES 623000 575867 575867 199540 199540 13006133 32174 32174 1256872 1169955 86917 86917 86917 13163388 13006133 0 119091 190817 190817 5516308 4724004 792304 98701 87415 11286 572271 482977 89294 406373 338038 68335 253674 253674 20365 20365 78033 78033 12498 12498 63542 57917 5625 147640 147640 87621 34096 53525 179965 179965 1595738 1556012 39726 805 805 768272 642381 125891 2418489 2200673 217816 297626 276597 21029 PATIENT CARE EXPENSES 1528625 1528625 REAL ESTATE TAXES 302781 253167 49614 USER FEE EXPENSE 247745 247745 LICENSES AND DUES 54786 54786 91167 6778 84389 14933842 12130763 2797454 5625 1405352 3977252 76408 34196 776235 987133 90013 114064 88230442 13740139 76713600 74490303 1715225 775261 6753463 6889108 87530296 87267317 1981999 984990 2469150 2334013 141000 99000 16136365 15811920 69002584 71980675 89731098 91210598 X -2260702 -4003181 59900 59900 -2200802 -3943281 87530296 87267317 -1770454 27975 0 X X 0 1 X 1 0 X 553770 1278378 720459 38164 2590771 8820550 8912336 10327801 11911214 13006133 52978034 8820550 9466106 11606179 12631673 13044297 55568805 1400 1400 0 1400 1400 55567405 57798 43878 51765 44329 32174 229944 57798 43878 51765 44329 32174 229944 8878348 9509984 11657944 12676002 13076471 55798749 0.99590 0.99500 0.00410 0.00500 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1477 1477 0 PART II-B, LINE 1: DURING 2023, THE ORGANIZATION PAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATIONS OF WHICH $1,477 WAS THE PORTION RELATED TO LOBBYING. 0 1 X 59900 59900 59900 59900 59900 59900 59900 59900 59900 59900 0.68450 0.31550 0 0 3493296 3493296 81315589 11956591 69358998 3361460 1759510 1601950 60097 24038 36059 74490303 ESCROW 6703838 RESERVATION DEPOSITS 124644 ASSETS LIMITED TO DONOR ENDOWMENT 57400 OTHER ASSETS 3226 6889108 RESIDENT REFUNDABLE ENTRANCE DEPOSI 71980675 71980675 X 13178865 27975 27975 13150890 12498 12498 13163388 14921344 0 14921344 12498 12498 14933842 PART IV, LINE 2B: PROSPECTIVE RESIDENTS ENTER INTO AGREEMENTS TO RESERVE A SPECIFIC UNIT IN THE INDEPENDENT LIVING COMMUNITY, WITH A 10% UNIT DEPOSIT OR $10,000 UNIT DEPOSIT, OR RESERVE A POSITION ON A PRIORITY LIST WITH A PRIORITY LIST DEPOSIT. THE PRIORITY LIST AND 10% UNIT DEPOSITS ARE FULLY REFUNDABLE UPON REQUEST AT ANY TIME, PLUS ACCUMULATED INTEREST INCOME EARNED ON THE DEPOSIT, LESS AN ADMINISTRATIVE FEE. THE $10,000 UNIT DEPOSITS ARE NONREFUNDABLE, UNLESS THE ORGANIZATION IS UNABLE TO DELIVER THE RIGHT TO OCCUPY THE UNIT ON THE CLOSING DATE. THE RESERVATION DEPOSITS ARE BEING HELD BY RICE SOUTHFIELD, LLC (DISREGARDED ENTITY OF RICE EVENTIDE). PART V, LINE 4: RESTRICTED 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. PART X, LINE 2: RICE EVENTIDE IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. RICE SOUTHFIELD IS A SINGLE MEMBER LLC. EARNINGS AND LOSSES ARE INCLUDED IN THE MEMBER'S INCOME. RICE SOUTHFIELD'S ACTIVITY IS INCLUDED ON RICE EVENTIDE'S TAX RETURN. RICE EVENTIDE FILES AS A TAX-EXEMPT ORGANIZATION. THE ORGANIZATIONS FOLLOW THE POLICY FOR UNCERTAINTY IN INCOME TAXES TO BE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE POLICY PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. NO UNCERTAIN INCOME TAX POSITIONS WERE IDENTIFIED FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022. X X X 0 0 0 0 0 0 0 0 0 KENNETH STRONG EXECUTIVE DIRECTOR (THROUGH DEC 2023 181385 0 0 0 0 0 3380 0 6052 0 190817 0 0 0 PART I, LINE 3 THE BOARD OF DIRECTORS APPROVES THE SALARY FOR THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION A, LINE 8B NO MINUTES ARE TAKEN FOR COMMITTEE MEETINGS AS ALL INFORMATION COMMUNICATED IN THESE MEETINGS IS COMMUNICATED TO THE BOARD BY A REPRESENTATIVE. ALL BOARD MEETINGS REQUIRE THAT MINUTES BE TAKEN. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR WILL REVIEW THE FORM 990 WITH MEMBERS OF THE BOARD'S EXECUTIVE COMMITTEE. IT WILL THEN BE DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY, COVERING THE BOARD OF DIRECTORS, THAT IS ENFORCED ANNUALLY BY DISTRIBUTION OF THE POLICY AND FOLLOW UP TO CONFIRM NO ONE IS IN CONFLICT OF THE POLICY. ANY POTENTIAL CONFLICTS OF INTEREST ARE REQUIRED TO BE REPORTED TO THE PRESIDENT IMMEDIATELY. IF A DIRECTOR HAS A SUSPECTED OR REPORTED CONFLICT OF INTEREST, THEY WILL BE PROHIBITED FROM VOTING ON MATTERS INVOLVING THAT CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT OF THE BOARD AND MEMBERS OF THE EXECUTIVE COMMITTEE APPROVE CEO'S SALARY. THEY REGULARLY REVIEW SALARY STUDIES DONE BY STATE HEALTHCARE ASSOCIATIONS. APPROVAL IS DOCUMENTED IN THE BOARD OF DIRECTORS' MINUTES. THE REVIEW WAS LAST COMPLETED IN 2023. THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION OF KEY EMPLOYEES AFTER REVIEWING SALARY STUDIES DONE BY STATE AND NATIONAL HEALTHCARE ASSOCIATIONS. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS AUDIT OVERSIGHT PROCESS OR AUDITOR SELECTION PROCESS. RICE SOUTHFIELD LLC 25 STONEHAVEN DRIVE SOUTH WEYMOUTH MA 02190 273136975 REAL ESTATE INVESTMENT MA 5022368 40425743 WILLIAM B RICE EVENTIDE HOME INC