2023-08-03T11:35:39-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2022-01-01 050275443 SAINT ANTOINE RESIDENCE SAIN 4017673500 10 RHODES AVENUE NORTH SMITHFIELD RI 02896 GARRETT SULLIVAN EXECUTIVE DIRECTOR 4017673500 2023-08-02 1 GARRETT SULLIVAN 999009999 0 DANIELLE NIHILL P01350943 7819821001 2023-08-01 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z THOMAS J TOBIN 10 RHODES AVENUE NORTH SMITHFIELD RI 02896 19848070 0 X WWW.STANTOINE.NET X 1913 RI THE MISSION OF SAINT ANTOINE RESIDENCE IS TO CARE FOR THE SICK AND ELDERLY IN ADDITION TO REFLECTING THE CHURCH'S COMMITMENT AND SUPPORT FOR ALL HUMAN LIFE AND AFFIRMATION OF THE VALUE OF EACH PERSON REGARDLESS OF AGE OR PHYSICAL CONDITION IN A COMPASSIONATE, CARING AND CHRISTIAN ENVIRONMENT. 5 2 284 2 0 0 6000721 1110482 16948724 18574125 31399 66998 35782 42214 23016626 19793819 0 0 0 0 12807249 13287584 0 0 0 8378030 8267342 21185279 21554926 1831347 -1761107 20938269 20112906 2602543 3657913 18335726 16454993 X THE MISSION OF SAINT ANTOINE RESIDENCE IS TO CARE FOR THE SICK AND ELDERLY IN ADDITION TO REFLECTING THE CHURCH'S COMMITMENT AND SUPPORT FOR ALL HUMAN LIFE AND AFFIRMATION OF THE VALUE OF EACH PERSON REGARDLESS OF AGE OR PHYSICAL CONDITION IN A COMPASSIONATE, CARING AND CHRISTIAN ENVIRONMENT. 0 0 18860636 18574125 THE OPERATION OF A LONG-TERM CARE FACILITY FOR THE ELDERLY AND OTHER NEEDY INDIVIDUALS. DURING 2022, ST. ANTOINE RESIDENCE PROVIDED A TOTAL OF 62,053 PATIENT BED DAYS, INCLUDING 51,202 BED DAYS TO MEDICAID AND MEDICARE PATIENTS. 18860636 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 18 0 1 284 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 5 2 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X GARRETT SULLIVAN 4017673500 10 RHODES AVENUE NORTH SMITHFIELD RI 028966999 MOST REV THOMAS J TOBIN PRESIDENT / TREASURER 1.00 39.00 X X 0 45818 30342 REV MSGR ALBERT A KENNEY VICE PRESIDENT 1.00 39.00 X X 0 52279 30342 REV TIMOTHY D REILLY SECRETARY 1.00 39.00 X X 0 31268 19542 LAURA DOS SANTOS ASST. TREASURER 39.00 1.00 X X 0 212629 18309 GARRETT E SULLIVAN EXECUTIVE DIRECTOR 40.00 0.00 X 197187 0 20950 REV MSGR GEORGE FRAPPIER DIRECTOR 1.00 1.00 X 0 0 0 JAMES JAHNZ DIRECTOR 1.00 1.00 X 0 0 0 RICHARD BERGERON EMPLOYEE 40.00 0.00 X 125531 0 27850 STEPHEN COURTEAU EMPLOYEE 40.00 0.00 X 107132 0 29439 TAMMY DUQUETTE NURSING SUPERVISOR 40.00 0.00 X 132939 0 30692 ALIOUNE KONTE EMPLOYEE 40.00 0.00 X 111827 0 0 TRACY MCCARTHY ASST. DIRECTOR OF NURSING 40.00 0.00 X 137114 0 16362 811730 341994 223828 6 0 1 0 CARELINK INC 400 MASSASOIT AVE 300 EAST PROVIDENCE RI 02914 THERAPY 940798 HEALTH SERVICES GROUP INC 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 HOUSEKEEPING 693831 DIOCESE ADMINSTRATION CORPORATION 1 CATHEDRAL SQUARE PROVIDENCE RI 02903 MANAGEMENT SERVICES 513264 CLIFTONLARSONALLEN 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 ACCOUNTING & AUDIT 183324 A ESPOSITO LANDSCAPING & NURSERY INC 127 SNAKE HILL RD NORTH SCITUATE RI 02857 LANDSCAPING 132516 5 27000 957200 126282 1110482 MEDICAID & MEDICARE REVENUES 623000 13496322 13496322 NURSING HOME FEES 623000 4995603 4995603 MANAGEMENT FEE INCOME 623000 82200 82200 18574125 66998 66998 12000 213 11787 11787 11787 63151 27000 54038 9113 9113 OTHER INCOME 900099 21314 21314 21314 19793819 18574125 0 109212 218137 218137 10379094 9562538 816556 701544 634301 67243 1106686 1019551 87135 882123 797571 84552 543180 543180 12374 12374 65824 65824 36364 36364 158207 158207 75071 75071 89872 89872 218454 218454 1349969 1272303 77666 8084 8084 2462 2320 142 870959 820851 50108 259665 259665 RESIDENT RELATED PURCHA 2744849 2707187 37662 PROVIDER TAXES 985929 985929 FOOD 581254 581254 BAD DEBT EXPENSE 203197 203197 61628 13969 47659 21554926 18860636 2694290 0 1800 1400 3660077 3124159 1885442 2199265 80582 78238 147887 179208 27056165 16837502 9527213 10218663 452534 375460 5182734 3936513 20938269 20112906 2602543 3590846 67067 2602543 3657913 X 18114146 16317649 221580 137344 18335726 16454993 20938269 20112906 X -1761107 -86630 -32996 X X 0 1 X 1 0 X 164860 165608 6623933 6000721 1110482 14065604 25019988 25694695 21011201 16948724 18574125 107248733 11500 12000 12000 11787 47287 25196348 25872303 27647134 22949445 19696394 121361624 0 0 0 121361624 48864 34221 12247 42871 66998 205201 48864 34221 12247 42871 66998 205201 18138 16779 40986 11134 21314 108351 25263350 25923303 27700367 23003450 19784706 121675176 0.99740 0.99580 0.00170 0.00130 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 1,966. 2019 AMOUNT: $ 12,145. 2020 AMOUNT: $ 9,739. 2021 AMOUNT: $ 11,134. 2022 AMOUNT: $ 21,314. DISCOUNTS EARNED - 2018 AMOUNT: $ 16,172. 2019 AMOUNT: $ 4,634. 2020 AMOUNT: $ 31,247. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 452534 10000 -67302 19771 375461 415334 55024 17824 452534 375774 58048 18488 415334 335019 59274 18519 375774 375049 -21740 18290 335019 0.63000 0.11000 0.26000 0 0 216000 216000 19624484 11501616 8122868 6888469 5315703 1572766 327212 20183 307029 10218663 ACCOUNTS RECEIVABLE - OTHER 38248 DUE FROM AFFILIATES 77949 ERC RECEIVABLE 3103016 DEMAND NOTE RECEIVABLE 707300 CLOSING COSTS 10000 3936513 X 19637829 -86630 -86630 19724459 36364 32996 69360 19793819 21518562 0 21518562 36364 36364 21554926 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RETROSPECTIVE ADJUSTMENT 32,871. SUBSIDIARY EXPENSES 125. GOLF TOURNAMENT 90151 27000 63151 45098 8940 90151 27000 63151 45098 8940 54038 9113 X X 0 0 0 0 0 0 0 0 0 LAURA DOS SANTOS ASST. TREASURER 0 212629 0 0 0 0 0 4200 0 14109 0 230938 0 0 GARRETT E SULLIVAN EXECUTIVE DIRECTOR 197187 0 0 0 0 0 0 0 20950 0 218137 0 0 0 RICHARD BERGERON EMPLOYEE 125531 0 0 0 0 0 7494 0 20356 0 153381 0 0 0 TAMMY DUQUETTE NURSING SUPERVISOR 132939 0 0 0 0 0 10234 0 20458 0 163631 0 0 0 TRACY MCCARTHY ASST. DIRECTOR OF NURSING 137114 0 0 0 0 0 15756 0 606 0 153476 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE DIOCESE HEALTH FACILITIES MANAGEMENT SERVICES GROUP AND THE EXECUTIVE DIRECTOR REVIEW THE FORM 990 PRIOR TO FILING. UPON REVIEW AND APPROVAL THE RETURN IS FILED WITH THE IRS. A COPY IS SUBMITTED TO THE FISCAL OFFICE AT THE DIOCESE OF PROVIDENCE AND ONE IS KEPT AT THE BUSINESS OFFICE. FORM 990, PART VI, SECTION B, LINE 12C ALL KEY EMPLOYEES AND MEMBERS OF THE BOARD OF DIRECTORS ARE ASKED TO READ THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND ANNUALLY THEY ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. THE EXECUTIVE DIRECTOR AND THE FINANCE DIRECTOR REVIEW ALL POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY KEY EMPLOYEES AND DETERMINE IF A TRUE CONFLICT EXISTS. IF AN INDIVIDUAL HAS A CONFLICT, THE EXECUTIVE DIRECTOR AND THE DIRECTOR OF FINANCE REPORT THIS INFORMATION TO THE BOARD OF DIRECTORS. ALL MEMBERS OF THE BOARD ARE ASKED TO DISCLOSE ANY CONFLICTS OF INTEREST, AND DEPENDING UPON THE CONFLICT, THEY ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS AND VOTING ON THE RELATED ISSUE. ALL DECISIONS ARE RECORDED IN THE MINUTES OF THE BOARD OF DIRECTORS' MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS FUNCTIONS AS A COMPENSATION COMMITTEE IN DETERMINING COMPENSATION FOR THE ADMINISTRATOR AND OTHER OFFICERS. IN MAKING ITS DECISION ON COMPENSATION, IT TAKES INTO ACCOUNT THE COMPENSATION PAID TO SIMILAR ADMINISTRATORS AT COMPARABLE NON-PROFIT ORGANIZATIONS IN THE AREA. THE COMMITTEE CONSIDERS THE PERFORMANCE OF THE ORGANIZATION DURING THE REVIEW PERIOD AND CONSIDERS THE ADMINISTRATOR'S SUCCESS IN ACHIEVING ORGANIZATIONAL GOALS. THE ADMINISTRATOR REVIEWS COMPENSATION OF ALL OTHER EMPLOYEES. IN MAKING A DECISION ON THE AMOUNT OF COMPENSATION, THE ADMINISTRATOR TAKES INTO ACCOUNT THE COMPENSATION PAID TO SIMILAR EXECUTIVES, PERFORMING SIMILAR TYPES OF DUTIES, AT COMPARABLE NON-PROFIT ORGANIZATIONS IN THE RHODE ISLAND AREA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: RETROSPECTIVE ADJUSMENT -32,871. SUBSIDIARY EXPENSES -125. FORM 990 PART XII, LINE 2C: THE DIOCESE HEALTH MANAGEMENT SERVICES GROUP AND THE EXECUTIVE DIRECTOR ARE RESPONSIBLE FOR OVERSIGHT OF THE COMPLETION OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE DIOCESE HEALTH MANAGEMENT SERVICES GROUP AND THE EXECUTIVE DIRECTOR AND SUBMITTED TO THE ADVISORY BOARD AND CORPORATE BOARD. DAURAY LLC 10 RHODES AVENUE NORTH SMITHFIELD RI 02896 050275443 REAL ESTATE RI -125 110000 SAINT ANTOINE RESIDENCE THE FRASSATI RESIDENCE DBA THE VILLA AT SAINT ANTOINE 400 MENDON ROAD NORTH SMITHFIELD RI 02896 050511505 OPERATION OF A 76-UNIT ASSISTED LIVING FACILITY. RI 501(C)(3) LINE 11 SAINT ANTOINE RESIDENCE 1 DIOCESAN SERVICE CORPORATION 1 CATHEDRAL SQUARE PROVIDENCE RI 02903 050493814 ROMAN CATHOLIC ORGANIZATION RI 501(C)(3) LINE 1 SAINT ANTOINE RESIDENCE 1 DIOCESAN ADMINISTRATION CORPORATION 1 CATHEDRAL SQUARE PROVIDENCE RI 02903 050508345 ROMAN CATHOLIC ORGANIZATION RI 501(C)(3) LINE 1 SAINT ANTOINE RESIDENCE 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 THE VILLA AT SAINT ANTOINE L 80000 CASH