EDGAR P BENJAMIN HEALTHCARE CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
EDGAR P BENJAMIN HEALTHCARE CENTER INC (EIN 04-2104452)
Tax period
2021-01-01 to 2021-12-31
Filed
2024-11-29
IRS object ID
202423349349300612
Schema version
2021v4.2
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)
Return2024-11-29T03:43:39-00:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN352259475PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Pegasus Solutions IncBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1693 East Central StreetAddressLine1Txt
CityFranklinCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02038ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN042104452EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Edgar P Benjamin Healthcare Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEDGABusinessNameControlTxt
Phone6177381500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 Fisher AvenueAddressLine1Txt
CityROXBURY CROSSINGCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02120ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOSEPH D FEASTER JRPersonNm
Person TitleCOURT APPOINTED RECEIVERPersonTitleTxt
Phone6177381500PhoneNum
Signature2024-11-29SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTheresa L HorkyPreparerPersonNm
PTINP01439977PTIN
Phone5085704908PhoneNum
Preparation2024-11-29PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2024-10-15 13:58:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnYes (X)AmendedReturnInd
Principal OfficerJOSEPH D FEASTER JRPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1175 FEDERAL STREET STE 1500AddressLine1Txt
CityBOSTONCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02110ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,849,332GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EPBHC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1927FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTo provide a home or shelter for, and to otherwise assist, indigent people without regard to race, creed or color through the operation of a 93 bed nursing homeActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee117TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$4,050,995PYContributionsGrantsAmt
CY Contributions Grants$1,870,409CYContributionsGrantsAmt
PY Program Service Revenue$11,684,943PYProgramServiceRevenueAmt
CY Program Service Revenue$9,939,289CYProgramServiceRevenueAmt
PY Investment Income$7,545PYInvestmentIncomeAmt
CY Investment Income$2,078CYInvestmentIncomeAmt
PY Other Revenue-$29,521PYOtherRevenueAmt
CY Other Revenue$37,188CYOtherRevenueAmt
PY Total Revenue$15,713,962PYTotalRevenueAmt
CY Total Revenue$11,848,964CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$9,126,125PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,054,449CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,832,638PYOtherExpensesAmt
CY Other Expenses$2,899,372CYOtherExpensesAmt
PY Total Expenses$12,958,763PYTotalExpensesAmt
CY Total Expenses$10,953,821CYTotalExpensesAmt
PY Revenues Less Expenses$2,755,199PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$895,143CYRevenuesLessExpensesAmt
Total Assets BOY$4,096,544TotalAssetsBOYAmt
Total Assets EOY$4,890,464TotalAssetsEOYAmt
Total Liabilities BOY$5,343,781TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,242,558TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$1,247,237NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$352,094NetAssetsOrFundBalancesEOYAmt
MissionTo provide a home or shelter for, and to otherwise assist, indigent people without regard to race, creed or color through the operation of a 93 bed nursing home in Boston, Massachusetts as a supporting service. Provide educational opportunities and training for individuals who work in long term care facilities or otherwise care for the elderly.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$8,613,710ExpenseAmt
Revenue$11,809,330RevenueAmt
DescSKILLED NURSING CARE AND EDUCATIONAL SERVICES PROVIDE NURSING CARE TO THE ELDERLY THROUGH THE OPERATION OF A 93 BED NURSING HOME AND PROVIDE EDUCATIONAL SUPPORT SERVICES AS A SUPPORTING SERVICE. THE ORGANIZATION ALSO PROVIDES EDUCATIONAL OPPORTUNITIES AND VOCATIONAL TRAINING FOR INDIVIDUALS WHO WORK IN LONG TERM CARE FACILITIES OR OTHERWISE CARE FOR THE ELDERLY. ADDITIONALLY, THE ORGANIZATION PROVIDES SCHOOL-AGED CHILDREN WITH INTERGENERATIONAL LEARNING OPPORTUNITIES THAT ALLOW THEM TO GAIN SKILLS KNOWLEDGE FROM THE OLDER DENERATION.Desc
Total Program Service Expenses$8,613,710TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingYes (true)LoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredfalseScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee117EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDELECIA MARKPersonNm
Phone6177381500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 FISHER AVENUEAddressLine1Txt
CityBOSTONCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02120ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
TONY FRANCIS
PRESIDENT ADMINISTRATOR040.00Yes (X)$628,592$0$0
EXAMA WIELER
REGISTERED NURSE040.00$143,034$0$0Yes (X)
MARISE COLSOUL
DIRECTOR OF NURSING040.00$132,065$0$0Yes (X)
ENIDE NOEL
LPN NURSE050.00$131,926$0$0Yes (X)
ERIN SHANLEY
DIRECTOR OF REHAB040.00$126,720$0$0Yes (X)
BLESSING ONUIGBO
LPN NURSE050.00$123,191$0$0Yes (X)
ROYAL BOLLING
CHAIR DIRECTOR$0$0$0Yes (X)
EVAN TOBASKY
SECRETARY TREASURERYes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,285,528TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$1,870,409GovernmentGrantsAmt
Total Contributions$1,870,409TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmt
PATIENT SERVICE REVENUE623000$9,074,103
EDUCATION SERVICES616000$865,186
FieldValueIRS element (for citing)
Total Program Service Revenue$9,939,289TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,078TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Direct Expenses$368FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$368TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business812900BusinessCd
Total Revenue Column$37,556TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$37,556OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,848,964TotalRevenueColumnAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$635,166TotalAmt
Management And General$635,166ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,677,274TotalAmt
Program Services$5,766,258ProgramServicesAmt
Management And General$911,016ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$23,933TotalAmt
Management And General$23,933ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$204,765TotalAmt
Program Services$174,107ProgramServicesAmt
Management And General$30,657ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$513,311TotalAmt
Program Services$443,277ProgramServicesAmt
Management And General$70,034ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$31,046TotalAmt
Management And General$31,046ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$24,950TotalAmt
Program Services$240ProgramServicesAmt
Management And General$24,710ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,503TotalAmt
Program Services$4,417ProgramServicesAmt
Management And General$5,086ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$30,490TotalAmt
Management And General$30,490ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$251,410TotalAmt
Program Services$251,410ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$612TotalAmt
Management And General$612ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,623TotalAmt
Management And General$1,623ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$95,258TotalAmt
Management And General$95,258ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$240,237TotalAmt
Program Services$189,027ProgramServicesAmt
Management And General$51,210ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$895,166$895,166
UTILITIES$385,487$385,487
FOOD EXPENSE$297,675$297,675
UNEMPLOYMENT EXPENSE$217,055$217,055

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$418,860TotalAmt
Program Services$375,078ProgramServicesAmt
Management And General$43,784ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,953,821TotalAmt
Program Services$8,613,710ProgramServicesAmt
Management And General$2,340,112ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$436,422BOYAmt
EOY$585,386EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$519,600BOYAmt
EOY$522,281EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$783,346BOYAmt
EOY$1,203,380EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$1,251,159EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$1,406,728BOYAmt
EOY$401,817EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$77,212BOYAmt
EOY$68,980EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,044,848LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,225,649LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$831,737BOYAmt
EOY$819,199EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$33,240BOYAmt
EOY$33,143EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$8,259BOYAmt
EOY$5,119EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,096,544BOYAmt
EOY$4,890,464EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,570,603BOYAmt
EOY$2,459,545EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$159,900BOYAmt
EOY$159,900EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$2,371,765BOYAmt
EOY$2,386,440EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$241,513BOYAmt
EOY$236,673EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,343,781BOYAmt
EOY$5,242,558EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$1,247,237BOYAmt
EOY-$352,094EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$1,247,237BOYAmt
EOY-$352,094EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,096,544BOYAmt
EOY$4,890,464EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$895,143ReconcilationRevenueExpnssAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind
Public Support Total170$0PublicSupportTotal170Amt
Public Support CY1700.00000PublicSupportCY170Pct

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$61,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,375CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$49,651CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,050,995CurrentTaxYearMinus1YearAmt
Current Tax Year$1,870,409CurrentTaxYearAmt
Total$6,034,430TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,621,596CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,047,247CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,157,536CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,685,336CurrentTaxYearMinus1YearAmt
Current Tax Year$9,938,921CurrentTaxYearAmt
Total$56,450,636TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year-$29,915CurrentTaxYearMinus1YearAmt
Current Tax Year$37,556CurrentTaxYearAmt
Total$7,641TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,682,596CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,049,622CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,207,187CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,706,416CurrentTaxYearMinus1YearAmt
Current Tax Year$11,846,886CurrentTaxYearAmt
Total$62,492,707TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$61,000CurrentTaxYearMinus4YearsAmt
Total$61,000TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$61,000CurrentTaxYearMinus4YearsAmt
Total$61,000TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$62,431,707PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$519,699CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$573,727CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,831CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,545CurrentTaxYearMinus1YearAmt
Current Tax Year$2,078CurrentTaxYearAmt
Total$1,114,880TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$519,699CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$573,727CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,831CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,545CurrentTaxYearMinus1YearAmt
Current Tax Year$2,078CurrentTaxYearAmt
Total$1,114,880TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$12,202,295CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,623,349CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,219,018CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,713,961CurrentTaxYearMinus1YearAmt
Current Tax Year$11,848,964CurrentTaxYearAmt
Total$63,607,587TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98150PublicSupportCY509Pct
Public Support PY5090.96700PublicSupportPY509Pct
Investment Income CY0.01750InvestmentIncomeCYPct
Investment Income PY0.02450InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind
Facts And Circumstances TestPart III Section A Line 1 2020 AMOUNTS REPORTED FOR GRANTS IN CONTRIBUTIONS RELATE TO MASSACHUSETTS COVID RELEIF FUNDS, FEDERAL PRF FUNDS, AND FEDERAL PPP LOAN CONTRIBUTIONS. 2021 AMOUNTS REPORTED ARE THE REMAINING FEDERAL PPP LOAN CONTRIBUTIONS AND MASSACHUSETTS STIMULUS FUNDSFactsAndCircumstancesTestTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Incl Escrow Custodial Acct LiabfalseInclEscrowCustodialAcctLiabInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$200,000OtherCostOrOtherBasisAmt
Book Value$200,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,496,437OtherCostOrOtherBasisAmt
Depreciation$2,496,437DepreciationAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,388,181OtherCostOrOtherBasisAmt
Depreciation$1,022,611DepreciationAmt
Book Value$365,570BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,960,230OtherCostOrOtherBasisAmt
Depreciation$1,706,601DepreciationAmt
Book Value$253,629BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$819,199TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc
Financial derivatives and other financial products
Closely-held equity interests

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Federal income taxes
PAYROLL CLEARING$13,045
PAYROLL WITHHOLDINGS PAYABLE$3,132
ASSET RETIREMENT OBLIGATION$150,000
RESIDENT TRUST LIABILITY$70,496
FieldValueIRS element (for citing)
Total Liability$236,673TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelYes (X)FirstClassOrCharterTravelInd
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredfalseSubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonTONY FRANCISPersonNm
TitlePRESIDENT ADMINISTRATORTitleTxt
Base Compensation Filing Org$230,769BaseCompensationFilingOrgAmt
Bonus Filing Organization$397,823BonusFilingOrganizationAmount
Total Compensation Filing Org$628,592TotalCompensationFilingOrgAmt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I Line 7NON FIXED PAYMENTS ARE RELATED TO PERIODIC NON-INCENTIVE BASED BONUS PAYMENTS, VACATION TIME PAYOUTS AND SICK TIME PAYOUTS.
Part I Line 1Gym membership for CEO and plane tickets and hotel stays paid for on behalf of the CEO and companions. Disclosure regarding travel costs - these were not approved, and pending investigation may deemed costs owed back to the Filer. These costs presently sit in a balance sheet account
Part I Line 6Executive was paid the gross amount of fifteen percent of the net patient charges received by the organization from patients referred by sources originated from the Executive.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan From OrganizationLoanFromOrganizationIndBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
RESTHAVEN CORPORATION
REALTY HOLDINGSINTERCOMPANYYes (X)$401,817falseYes (true)false
TONY FRANCIS
OFFICERDETAILS UPON REQUESTYes (X)$1,251,159falsefalsefalse
FieldValueIRS element (for citing)
Total Balance Due$1,652,976TotalBalanceDueAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part II Line 1Intercompany transaction account between the Filer and related party supporting organization Resthaven Corporation
Part II Line 2Receivable account related to funds allegedly misappropriated by the CEO, pending legal proceedings. This value indicates the assumed net amount due back to the Filer from the CEO. These amounts include unauthorized additional compensation and personal expenses paid with Filers funds.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part XII, Line 3No Federal Awards received
Form 990, Part VI, Section A, Line 6The organizations sole member is its related non profit organization, resthaven corporation
Form 990, Part VI, Section A, Line 7AThe directors of the sole member, resthaven corporation, shall automatically serve as the board of directors of the organization
Form 990, Part VI, Section B, Line 11BAT THE TIME OF THIS FILING THERE IS NO GOVERNING BODY FOR THE ORGANIZATION DUE TO A TRANSITIONAL PERIOD OF RECEIVERSHIP
Form 990, Part VI, Section B, Line 15ACEO/Administrator compensation is determined through the use of a written employment contract, compensation study as well as approval by the board of directors. Compensation is also ducumented in writing in the meeting minutes of the board.
Form 990, Part VI, Section C, Line 19All documents of the organization are made available to the public through open sources and upon request
Form 990, Part VI, Section A, Line 2OFFICER T. FRANCIS HAD A BUSINESS RELATIONSHIP WITH OFFICER E. TOBASKY. BOTH WERE OFFICERS IN A MASSACHUSETTS LLC NAMED AURORA HEALTH SERVICES, LLC. OFFICER T. FRANCIS ALSO HAD A BUSINESS RELATIONSHIP WITH OFFICER R. BOLLING. THEY WERE BOTH OFFICERS IN A MASSACHUSETTS NONPROFIT ORGANIZATION NAMED CENTORIAN INC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1RESTHAVEN CORPORATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 FISHER AVEAddressLine1Txt
CityROXBURYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02120ZIPCd
FieldValueIRS element (for citing)
EIN043448700EIN
Primary ActivitiesSUPPORTINGPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Public Charity StatusLINE 11PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1RESTHAVEN CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeeTransactionTypeTxt
Involved$2,300,000InvolvedAmt
Method Of Amount DeterminationCOSTMethodOfAmountDeterminationTxt

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