2023-09-19T11:50:49-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2022-01-01 042676008 HENRY C NEVINS HOME INC HENR 9786827611 10 INGALLS COURT METHUEN MA 01844 JAMES MOCERA TREASURER 9786727611 2023-09-14 1 JAMES MOCERA 999009999 0 DANIELLE NIHILL P01350943 7819821001 2023-09-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOYCE SHANNON 10 INGALLS COURT METHUEN MA 01844 15725797 0 X WWW.NEVINSFAMILY.ORG X 1979 MA TO PROVIDE MEDICAL, NURSING & REHAB CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED. 9 9 291 9 0 0 3793182 802250 12991711 14923144 494 403 11456 0 16796843 15725797 0 0 0 0 9482857 10873564 0 0 0 6431476 6686621 15914333 17560185 882510 -1834388 14553297 13842744 11123834 11397669 3429463 2445075 THE HENRY C. NEVINS HOME, INC.'S MISSION IS TO PROVIDE COMPREHENSIVE MEDICAL, NURSING AND REHABILITATIVE CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED BY INJURY, ILLNESS OR AGING. 0 0 15494148 0 14923144 NURSING HOME OPERATION - NEVINS NURSING & REHABILITATION CENTRE PROVIDES COMPREHENSIVE MEDICAL, NURSING AND REHABILITATIVE CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED BY INJURY, ILLNESS OR AGING. 15494148 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 291 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 0 0 1 1 0 MA X SHARON WALSH 9786827611 10 INGALLS COURT METHUEN MA 01844 JOYCE SHANNON PRESIDENT & CEO 20.00 20.00 X 105509 98275 11109 EMMY KIMORI LPN 67.00 X 165765 0 11901 BRIAN EARNSHAW INFECTION PREVENTIONIST 39.00 X 140899 0 19317 SUSAN HECK DIRECTOR OF NURSING 40.00 X 140217 0 14518 DOREEN SIMMONDS-BROWN LPN 54.00 X 125904 0 11660 SHARON WALSH CFO 37.00 3.00 X 115604 0 12828 JEFFREY GANGI ADMINISTRATOR 40.00 X 112717 0 25767 PATRICIA DEMERS CHAIRPERSON & CLERK 0.40 0.60 X X 0 0 0 JAMES MOCERA TREASURER 0.40 0.60 X X 0 0 0 HUNTER BARRETT DIRECTOR 0.40 0.60 X 0 0 0 MARIA BONANNO DIRECTOR 0.40 0.60 X 0 0 0 CAROLINE GLYNN DIRECTOR 0.40 0.60 X 0 0 0 THERESE LEONE DIRECTOR 0.40 0.60 X 0 0 0 STEVEN MANSHIP DIRECTOR 0.40 0.60 X 0 0 0 NOREEN WRIGHT DIRECTOR 0.40 0.60 X 0 0 0 RAYMOND WROBEL DIRECTOR 0.40 0.60 X 0 0 0 CHRISTOPHER NOBILE DIRECTOR (THROUGH AUG 2022) 0.40 0.60 X 0 0 0 DIANE SHIKRALLAH CLERK (THROUGH AUG 2022) 0.40 0.60 X X 0 0 0 906615 98275 107100 10 0 1 0 PREFERRED THERAPY SOLUTIONS LLC 850 SILAS DEANE HWY WETHERSHIELD CT 06109 THERAPY SERVICES PROVIDER 665208 US FOOD SERVICE INC PO BOX 3155 BOSTON MA 02241 FOOD DISTRIBUTOR 471151 PERFORMANCE HEALTHCARE SERVICES INC 47R RIVER STREET SUITE 200R WELLESLEY MA 02481 HOUSEKEEPING SERVICES 288951 PRO-EMS SOLUTIONS INC 31 SMITH PLACE CAMBRIDGE MA 02138 SURVEILLANCE TESTING FEES 280845 MCKESSON MEDICAL-SURGICAL INC 9954 MARYLAND DR SUITE 5176A HENRICO VA 23233 MEDICAL SUPPLIES 227073 8 789391 12859 802250 NURSING HOME REVENUE 623000 14923027 14923027 OTHER INCOME 900099 117 117 14923144 403 403 15725797 14923144 0 403 239513 239513 9129873 8603072 526801 850290 799363 50927 653888 601660 52228 32213 32213 159551 159551 483746 290436 193310 61305 55941 5364 171781 75947 95834 355010 323807 31203 471 471 461798 416995 44803 618800 558765 60035 218806 199551 19255 SUPPLIES AND EXPENSE 1476616 1476616 MASS. STATE USER FEE AS 837704 837704 PURCHASED SERVICES 728612 728612 BAD DEBTS 555000 555000 525208 525208 17560185 15494148 2066037 0 814589 557143 1757661 1757661 1876514 1955175 49483 69041 18963158 10151158 9447390 8812000 607660 691724 14553297 13842744 1299549 1567438 9824285 9616009 0 214222 11123834 11397669 X 3429463 2445075 3429463 2445075 14553297 13842744 X -1834388 850000 X X 0 1 X 1 1 1 X 490 5640 3730616 3796182 802250 8335178 14462618 14411992 13121899 12991711 14923144 69911364 14463108 14417632 16852515 16787893 15725394 78246542 0 0 0 78246542 720 2037 862 494 403 4516 720 2037 862 494 403 4516 10526 19633 15452 11456 57067 14474354 14439302 16868829 16799843 15725797 78308125 0.99920 0.99910 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2018 AMOUNT: $ 10,526. 2019 AMOUNT: $ 19,633. 2020 AMOUNT: $ 15,452. 2021 AMOUNT: $ 11,456. 2022 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5442 5442 0 PART II-B, LINE 1: MEMBERSHIP DUES PAID TO HEALTH CARE ASSOCIATIONS WHERE A PORTION OF DUES IS RELATED TO LOBBYING. 200247 200247 4695322 4511385 183937 10260953 2310154 7950799 3806636 3329619 477017 8812000 LEASE LIABILITY 214222 214222 X 15725797 0 15725797 0 15725797 17560185 0 17560185 0 17560185 PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S RETURNS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES FOR THREE YEARS AFTER FILING. THE ORGANIZATION FOLLOWS 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 YEAR ENDED DECEMBER 31, 2022. X X 0 0 0 0 0 0 0 0 0 JOYCE SHANNON PRESIDENT & CEO 105509 98275 0 0 0 0 0 0 5572 5537 111081 103812 0 0 EMMY KIMORI LPN 165765 0 0 0 0 0 0 0 11901 0 177666 0 0 0 BRIAN EARNSHAW INFECTION PREVENTIONIST 140899 0 0 0 0 0 0 0 19317 0 160216 0 0 0 SUSAN HECK DIRECTOR OF NURSING 140217 0 0 0 0 0 0 0 14518 0 154735 0 0 0 PART I, LINE 3 COMPENSATION REVIEW FOR CEO, EXECUTIVE DIRECTOR, OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY INDEPENDENT PERSONS WITH THE USE OF COMPARABILITY DATA AND APPROVED BY THE BOARD OF DIRECTORS. THIS WAS LAST PERFORMED AT THE DECEMBER 2022 BOARD MEETING FOR YEAR ENDED 2022. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE COMPLETE FORM 990 IS REVIEWED AND PROVIDED TO THE BOARD BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, EMPLOYEE, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, SHALL COMPLETE, SIGN AND DELIVER TO THE CHAIR OF THE BOARD, A CONFLICT OF INTEREST POLICY ANNUAL STATEMENT AT THE TIME OF HIS OR HER INITIAL ELECTION OR APPOINTMENT AND ANNUALLY THEREAFTER. THE CONFLICTS OF INTEREST POLICY ANNUAL STATEMENT SHALL BE IN SUCH FORM AS IS DEEMED APPROPRIATE BY THE PRESIDENT WITH ADVICE FROM THE ORGANIZATION'S COUNSEL AS NEEDED. BOARD OF DIRECTORS MEMBERS REVIEW AND SIGN THE POLICY ANNUALLY; THERE HAVE BEEN NO CONFLICTS (NO BOARD OF DIRECTORS MEMBERS DO ANY BUSINESS WITH NEVINS OR RECEIVE ANY COMP FROM NEVINS) BUT MONITORING WOULD BE THROUGH YEARLY ATTESTATION BY BOARD AND CONFLICTS WOULD BE DEALT WITH AT THAT LEVEL. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW FOR CEO, EXECUTIVE DIRECTOR, OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY INDEPENDENT PERSONS WITH THE USE OF COMPARABILITY DATA AND APPROVED BY THE BOARD OF DIRECTORS. APPROVED COMPENSATION IS NOTED IN THE DECEMBER 2022 BOARD OF DIRECTORS' MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER FROM AFFILIATE 850,000. FORM 990, PART XII, LINE 2C THE ORGANIZATION DID NOT CHANGE EITHER ITS OVERSIGHT OR SELECTION PROCESS DURING 2022. NEVINS COMMUNITY SERVICES INC 12 INGALLS COURT METHUEN MA 01844 042210743 ELDERLY HOUSING MA 501(C)(3) LINE 10 NO 0 NEVINS MANOR INC 10 INGALLS COURT METHUEN MA 01844 043265310 ELDERLY HOUSING MA 501(C)(3) LINE 10 NO 0 NEVINS FAMILY OF SERVICES INC 10-12 INGALLS COURT METHUEN MA 01844 464006584 ELDERLY HOUSING MA 501(C)(3) LINE 10 NO 0 0 0 1 1 1 0 0 0 0 0 0 1 1 1 1 0 1 0 0 NEVINS COMMUNITY SERVICES INC D 141743 FMV NEVINS COMMUNITY SERVICES INC C 850000 FMV