2023-05-12T13:47:20-05:00 2022-06-30 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2021-07-01 042982927 LUTHERAN HOUSING CORPORATION - BROCKTON LUTH 5085885324 26 HARVARD STREET WORCESTER MA 01609 ANGELA BOVILL PRESIDENT & CEO 5085885324 2023-05-10 1 ANGELA BOVILL 999009999 DANIELLE NIHILL P01350943 7819821001 2023-05-01 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z EMMANUEL HOUSE RESIDENCE ANGELA BOVILL 26 HARVARD STREET WORCESTER MA 01609 14169061 0 6011 X WWW.ASCENTRIA.ORG X 1987 MA OPERATES AN ASSISTED LIVING FACILITY THAT OFFERS SAFE AND AFFORDABLE HOUSING FOR SENIORS. 13 12 209 12 0 0 0 706367 0 13057052 0 2205 0 403437 0 14169061 0 0 0 0 0 8034640 0 0 0 0 5716712 0 13751352 0 417709 0 31680817 0 28877915 0 2802902 WE ARE CALLED TO STRENGTHEN COMMUNITIES BY EMPOWERING PEOPLE TO RESPOND TO LIFE'S CHALLENGES. 0 0 11019269 13057052 THE ORGANIZATION OPERATES A 107-BED NURSING FACILITY AND A 43-BED REST HOME WHICH PROVIDE SKILLED NURSING AND REHABILITATIVE SERVICES TO THE ELDERLY. 11019269 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 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 1 7 0 1 209 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X ANGELA BOVILL 7742433900 11 SHATTUCK STREET WORCESTER MA 01605 ANGELA BOVILL PRESIDENT & CEO 4.00 36.00 X X 0 397934 13939 THE REV ROSS GOODMAN VICE CHAIR 2.00 20.00 X X 0 0 0 SCOTT HAMILTON DIRECTOR 0.50 5.00 X 0 0 0 STACEY LUSTER DIRECTOR 0.50 5.00 X 0 0 0 KEITH ROBERTSON DIRECTOR 0.50 5.00 X 0 0 0 BARBARA RUHE DIRECTOR 0.50 5.00 X 0 0 0 PETER SCHMIDT DIRECTOR 0.50 5.00 X 0 0 0 WILLIAM MAYO CHAIR 2.00 20.00 X X 0 0 0 FREDERICK JENOURE CHAIR 2.00 20.00 X X 0 0 0 KAREN GAYLIN DIRECTOR 0.50 5.00 X 0 0 0 GARTH GREIMANN FINANCIAL SECRETARY 1.00 10.00 X X 0 0 0 ALEXANDER BARTHOLOMEW FINANCIAL SECRETARY 0.50 5.00 X X 0 0 0 ASHISH COWLAGI SECRETARY 0.50 5.00 X X 0 0 0 AIMEE MITCHELL CHIEF COMMUNITY SERVICE OFFICER 0.50 39.50 X 0 160307 13879 JEFFREY KINNEY CHIEF OF STRATEGIC DEVELOPMENT 4.00 36.00 X 0 210484 16458 JEANETTE WADE EXECUTIVE VP/CFO 4.00 36.00 X 0 273181 204 NANCY MEEGAN CHIEF HUMAN SERVICES OFFICER 4.00 36.00 X 0 216504 16383 NICHOLAS RUSSO TREASURER 4.00 36.00 X 0 138288 6320 TARA BROWNE CLERK/EXECUTIVE ASSISTANT 4.00 36.00 X 0 75842 13677 MICHELLE BETTIGOLE CHIEF SENIOR CARE OFFICER 5.00 35.00 X 0 240516 13937 RUTH MAENZANISE LICENSED PRACTICAL NURSE 40.00 0.00 X 217032 0 5013 SAMUEL MBATIA REGISTERED NURSE 40.00 0.00 X 216599 0 5013 ROBIN HIGH ADMINISTRATOR 40.00 0.00 X 136301 0 0 AMINTA TRUJILLO STAFF DEVELOPMENT COORDINATOR 40.00 0.00 X 122041 0 5013 KIMBERLY DILLON REHABILITATION MANAGER 40.00 0.00 X 107820 0 0 799793 1713056 109836 6 0 1 0 CUTLER ASSOCIATES 43 HARVARD ST WORCESTER MA 01609 CONTRACTOR 1747388 ASCENTRIA CARE ALLIANCE 11 SHATTUCK STREET WORCESTER MA 01605 MANAGEMENT SERVICES 341604 PRO EMS SOLUTIONS 31 SMITH PL CAMBRIDGE MA 02138 COVID TESTING 277425 HEALTH NEW ENGLAND 1414 MAIN STREET ONE MONARCH PLACE SPRINGFIELD MA 01144 INSURANCE 274364 HARVARD PILGRIM 1 WELLNESS WAY CANTON MA 02021 INSURANCE 269010 11 703367 3000 706367 RESIDENT SERVICE REVENUE 623000 13057052 13057052 13057052 2205 2205 MISCELLANEOUS 900099 364602 364602 PURCHASE DISCOUNTS 900099 23437 23437 TELEPHONE & TV 900099 15398 15398 403437 14169061 13057052 0 405642 7040737 5601689 1439048 372015 295979 76036 621888 494781 127107 746493 746493 10126 10126 36000 36000 103325 103325 49037 45389 3648 88865 88865 424292 392725 31567 381 381 3166 3166 1024375 948162 76213 521110 453886 67224 206971 191572 15399 PROGRAM EXPENSES 778837 778837 MISCELLANEOUS EXPENSE 709153 630528 78625 MEDICAID USER FEES 688606 688606 ANCILLARY EXPENSES 301378 301378 24597 24597 13751352 11019269 2732083 0 1233947 3312229 49464 60590 22189610 490369 0 21699241 0 5325346 0 31680817 1752952 10672 24189135 0 2925156 0 28877915 X 2802902 0 0 2802902 0 31680817 X 417709 2385193 X 0 1 X 1 1 1 X 706367 706367 1602493 13057052 14659545 1602493 13763419 15365912 0 0 0 15365912 87 2205 2292 87 2205 2292 299417 48845 658 403437 752357 1901997 48845 658 14169061 16120561 0.95320 0.92620 0.00010 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2017 AMOUNT: $ 299,417. 2018 AMOUNT: $ 48,845. 2019 AMOUNT: $ 658. 2021 AMOUNT: $ 403,437. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4503936 4503936 16204218 386670 15817548 1068040 103699 964341 413416 413416 21699241 BOND ESCROW FUNDS 5032370 GOODWILL 290034 DUE TO RELATED PARTIES 2942 5325346 DUE TO RELATED PARTIES 2925156 2925156 0 0 0 0 0 0 0 0 0 ANGELA BOVILL PRESIDENT & CEO 0 397934 0 0 0 0 0 0 0 13939 0 411873 0 0 JEANETTE WADE EXECUTIVE VP/CFO 0 273181 0 0 0 0 0 0 0 204 0 273385 0 0 MICHELLE BETTIGOLE CHIEF SENIOR CARE OFFICER 0 240516 0 0 0 0 0 0 0 13937 0 254453 0 0 NANCY MEEGAN CHIEF HUMAN SERVICES OFFICER 0 216504 0 0 0 0 0 0 0 16383 0 232887 0 0 JEFFREY KINNEY CHIEF OF STRATEGIC DEVELOPMENT 0 210484 0 0 0 0 0 0 0 16458 0 226942 0 0 RUTH MAENZANISE LICENSED PRACTICAL NURSE 217032 0 0 0 0 0 0 0 5013 0 222045 0 0 0 SAMUEL MBATIA REGISTERED NURSE 216599 0 0 0 0 0 0 0 5013 0 221612 0 0 0 AIMEE MITCHELL CHIEF COMMUNITY SERVICE OFFICER 0 160307 0 0 0 0 0 0 0 13879 0 174186 0 0 PART I, LINE 3 ASCENTRIA CARE ALLIANCE, INC. (ACA) IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. THE COMPENSATION OF THE ORGANIZATION'S CEO IS DETERMINED AND PAID BY ACA. THE CEO OF ACA IS THE PRINCIPAL REPRESENTATIVE OF ASCENTRIA CARE ALLIANCE, INCLUDING ITS AFFILIATES AND SUBSIDIARIES, AND IS THE PERSON RESPONSIBLE FOR THE EFFICIENT OPERATION OF THE ACA, ITS AFFILIATES, AND ITS SUBSIDIARIES. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF ACA ANNUALLY EVALUATES THE CEO ON HIS/HER PERFORMANCE. THE CHAIR OF ACA'S BOARD OF DIRECTORS, AN UNCOMPENSATED VOLUNTEER, IS THE CHAIR OF THE EXECUTIVE COMMITTEE AND IS INDEPENDENT WITHOUT UNDUE INFLUENCE FROM THE CEO. THE EXECUTIVE COMMITTEE WILL OBTAIN RESEARCH TO MAKE A RECOMMENDATION FOR THE COMPENSATION OF THE CEO. A REVIEW OF COMPARABILITY DATA MAY INCLUDE THE FOLLOWING: COMPENSATION STUDIES BY INDEPENDENT SOURCES, WRITTEN JOB OFFERS FOR POSITIONS AT SIMILAR ORGANIZATIONS, DOCUMENTED PHONE CALLS ABOUT SIMILAR CEO POSITIONS, AND INFORMATION OBTAINED FROM THE IRS FORM 990 FILINGS OF SIMILAR ORGANIZATIONS. THE EXECUTIVE COMMITTEE WILL DOCUMENT ITS DECISIONS IN THE MINUTES OF THE MEETING. THE DOCUMENTATION OF THE CEO'S COMPENSATION INCLUDES: A DISCUSSION OF THE CEO'S RESPONSIBILITIES; ANNUAL PERFORMANCE REVIEW; DESCRIPTION OF THE COMPENSATION, BENEFITS, AND APPROVAL DATE; LIST OF COMMITTEE MEMBERS PRESENT DURING THE DISCUSSION; ACTIONS TAKEN WITH RESPECT TO ANY CONFLICTS OF INTEREST BY ANY MEMBER WITH RESPECT TO THE DECISION ON THE COMPENSATION; AND A RECORD OF THE RESULT OF THE COMPENSATION VOTE. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584YQ51 2021-07-15 62091558 BUILDING CONSTRUCTION AND REFUNDING SERIES 2015 BONDS 0 0 1 A 24836623 1407200 494860 12616194 10318369 1 1 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS ASCENTRIA CARE ALLIANCE, INC. (FKA LUTHERAN SOCIAL SERVICES OF NEW ENGLAND, INC.). FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF ASCENTRIA CARE ALLIANCE, INC.'S GOVERNING BOARD ELECT ALL THE MEMBERS OF THIS ORGANIZATION'S GOVERNING BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE TRANSACTIONS SUBJECT TO MEMBER APPROVAL ARE ACQUISITIONS OF DEBT, SALE OF ASSETS, ANNUAL BUDGET, MERGERS AND BYLAW REVISIONS. FORM 990, PART VI, SECTION B, LINE 11B FINANCIAL MANAGEMENT WILL REVIEW THE FORM 990 WHEN IT IS COMPLETED. ASCENTRIA CARE ALLIANCE, INC.'S (ACA) AUDIT COMMITTEE PROVIDES SECONDARY REVIEW AND APPROVAL PRIOR TO SUBMISSION TO THE IRS. THE COMPLETE FORM 990 IS POSTED TO THE BOARD INTRANET FOR REVIEW BY THE ACA FINANCE COMMITTEE AS WELL AS ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL THE MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY TO DISCLOSE ANY CONFLICTS. CONFLICTS ARE REVIEWED BY THE CEO AND THE GOVERNANCE COMMITTEE. BOARD MEMBERS WITH CONFLICTS ARE RESTRICTED ON VOTING ON ANY ACTIONS RELATED TO THE CONFLICT. 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 XI, LINE 9: EQUITY TRANSFER 2,385,193. RELATED ORGANIZATIONS FILE UNDER GROUP EXEMPTION 6011 - DISCLOSURE NOT REQ MA 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0