2023-11-14T13:43:38-06:00 2022-12-31 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2022-01-01 042857794 MI Management Inc MIMA 9786856321 172 Lawrence Street Lawrence MA 01841 William Shaheen CPA Treasurer 9786856321 2023-11-10 1 William Shaheen CPA 999009999 0 Connor Smart P02285543 2078792100 2023-11-10 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z Gerard Foley 172 Lawrence Street Lawrence MA 01841 3423602 0 X www.mihcs.org/ X 1984 MA Mary Immaculate Management exists to develop and implement innovative, compassionate, competent, and responsive services and programs to address unmet needs of community elders. 10 9 0 9 0 0 143297 141552 2722612 2901550 1379929 16842 0 0 4245838 3059944 0 0 0 0 2146327 2272011 0 0 0 1039373 1055081 3185700 3327092 1060138 -267148 8237230 7356255 339461 495742 7897769 6860513 X Mary Immaculate Management exists to develop and implement innovative, compassionate, competent, and responsive services and programs to address unmet needs of community elders. 0 0 2770291 0 2901550 Marguerite D'Youville, Mother of Universal Charity, began a rich tradition of caring for the most vulnerable. The Grey Nuns have continued this tradition by focusing on programs that service the poor and the underserved. In the spirit of Marguerite D'Youville and the Grey Nuns, the community of Mary Immaculate continues to serve those most vulnerable through its sponsorship of a wide variety of good neighbor activities. These activities are organized and facilitated by our mission department.The entire Mary Immaculate group of entities, colectively Mary Immaculate Healthcare Services (MIHCS), follows the methodology that is recommended by the Catholic Health Association for calculating the cost of support for the broader community. In this methodology, the cost of providing services is reduced by payments received for services, resulting in net cost. It is the net cost that MIHCS reports as its community benefit, and it includes the net cost of programs directed to the poor and unpaid costs of the Medicaid program. 2770291 1 1 0 0 0 0 0 0 0 0 1 1 0 0 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 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X X Fredericka Baker Controller 9786856321 172 Lawrence Street Lawrence MA 01841 Gerald Foley President & CEO (start 8/2022) 1.00 39.00 X X 0 286838 31606 Jeanne Leydon President & CEO (end 8/2022) 1.00 39.00 X X 0 129388 9639 Raisa T Carrasco-Velez Director 1.00 4.00 X 0 0 0 Rev John Delaney Director 1.00 4.00 X 0 0 0 Roger Desjardins Director 1.00 4.00 X 0 0 0 Samer Obeid Esq Director 1.00 4.00 X 0 0 0 Deacon Eric Peabody Director 1.00 4.00 X 0 0 0 Sr Marcia Wiley Director 1.00 4.00 X 0 0 0 Deborah L Turiano MD Chair 1.00 4.00 X X 0 0 0 William Shaheen CPA Treasurer 1.00 4.00 X X 0 0 0 Karen Gallagher Giangrande Clerk 1.00 4.00 X X 0 0 0 Anne Alvino RN 40.00 0.00 X 100467 0 2159 100467 416226 43404 1 0 1 0 Covenant Health Inc 100 Ames Pond Drive Tewksbury MA 01876 Management Services 141846 1 110544 31008 141552 Patient services 623000 2616535 2616535 Management fees 541610 285015 285015 2901550 101226 101226 279274 363658 -84384 -84384 -84384 3059944 2901550 0 16842 1921458 1654373 267085 25253 21642 3611 174187 149279 24908 151113 129504 21609 235180 235180 4408 4408 64135 64135 9284 9284 68654 68654 3240 3240 80 80 14074 14074 49500 49500 54391 54391 Nutrition and dining 534630 534630 Medical supplies 9166 9166 Repairs and Maintance 8339 8339 3327092 2770291 556801 0 412591 195122 509561 509778 85584 152395 971228 308084 530833 663144 6695393 5831672 3268 4144 8237230 7356255 95306 108557 244155 387185 339461 495742 X 7897769 6860513 7897769 6860513 8237230 7356255 -267148 -880347 110239 0 X X 0 1 X 1 1 1 X X 5 Covenant Health Inc 222484505 10 1 0 0 MI Residential Community Inc 042647207 10 1 0 191043 MI Nursing Restorative Center Inc 042104851 10 1 0 0 MI Adult Day Health Care Center Inc 042921888 10 0 0 93333 MI Transportation Inc 042921889 10 0 0 639 5 0 285015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Schedule A, Line 12g, Column (vi): The Organization was established to function as an integral part of the Covenant Health System, and in connection therewith to engage in the delivery, and activities that further or are related to or associated with the delivery, of health and human services, either directly through facilities or programs owned or controlled by the Corporation or indirectly by assisting and supporting (financially and otherwise) the entities within the Covenant Health System. The Organization accomplishes this by providing services to elderly, sick, and handicapped persons; promoting, encouraging, stimulating, and advancing the well-being of elderly, sick, and handicapped persons; providing a vehicle for fundraising to assist its affiliated organizations in the management of their facilities; providing management services to such organizations; and, by providing religious, spiritual, health, social, cultural, educational, and recreational programs, services, and opportunities to the elderly, sick and handicapped. But for the existence of MI Management, Inc. these activities and functions would be carried out by one or more of its supported organizations. Accordingly, the Organization has listed in Schedule A, Line 12g, Column (vi) the amount of program service revenue collected in connection with carrying out the above functions. Part IV, Section A, Line 1: Two of the Organization's supported organizations, MI Adult Day Health Care Center, Inc. (EIN: 04-2921888) and MI Transportation, Inc. (EIN: 04-2921889), are not listed by name in the Organization's governing documents. However, both are part of a charitable class of organizations so named in those documents. According to its bylaws, the Organization's purpose is to to embody the mission of the healing Ministry of Jesus in the Roman Catholic Church through participation in the Roman Catholic health care system (the "System") sponsored by Covenant Health Systems, a public juridic person of pontifical right under the laws of the Roman Catholic Church; to function as an integral part of the System, and in connection therewith to engage in the delivery, and activities that further or are related to or associated with the delivery, of health and human services, either directly through facilities or programs owned or controlled by the Corporation or indirectly by assisting and supporting (financially and otherwise) Covenant Health Systems, Inc. and other organizations within or affiliated or associated with the System. As both MI Adult Day Health Care Center, Inc. and MI Transportation, Inc. are affiliates in the Health System, the function as part of a charitable class of organizations that the Organization was established to support. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 50 50 11155 11105 50 5000 14855 8700 11155 11000 11000 0.00000 0.00000 0.00000 358722 103531 255191 434351 204553 229798 178155 178155 663144 Investment in Covenant Health Investment Trust 5831672 F 5831672 Due to affiliates 383042 Resident funds and deposits 4143 387185 X Part V, Line 4: All of the Organization's previously restricted endowment funds were expended on community programs, operating support, and facilities as of the year ending December 31, 2022. Part X, Line 2: Covenant and its member organizations are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated the position taken on its filed tax returns. The System has concluded no uncertain income tax positions exist at December 31, 2022. 0 0 0 0 0 0 0 0 0 Gerald Foley President & CEO (start 8/2022) 0 278830 0 2500 0 5508 0 5408 0 26198 0 318444 0 0 Part I, Line 3 Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable. Form 990, Part VI, Section A, line 6 Covenant Health is the sole corporate member of the Organization. Form 990, Part VI, Section A, line 7a As the sole corporate member of the Organization, Covenant Health, Inc. retains the ability to elect and remove the Organization's board of directors with or without cause. Form 990, Part VI, Section A, line 7b As the sole corporate member of the Organization, Covenant Health, Inc. has the following powers and rights over the Organization and its subsidiaries as outlined in the Organization's bylaws: 1. To approve any change in the written statements of philosophy and mission; 2. To amend and to repeal the organizing and governing documents; 3. To elect the Board of Directors or remove them with or without cause; 4. To appoint and remove the president; 5. To ratify the Board of Director's election of the Chair of the Board; 6. To approve all plans of merger, consolidation, reorganization, dissolution, or the sale, lease assignment, or transfer of substantially all of the assets, or the purchase or acquisition of an interest in any corporation, partnership, joint venture, or other entity; 7. To approve all long-range strategic plans before implementation; 8. To approve the acquisition, sale, or encumbrance of any real estate valued in excess of an amount set by the Member in writing; 9. To approve all capital budgets and non-budgeted expenses in excess of an amount set by the Member in writing; 10. To approve all debt in excess of limits set by the Member in writing; 11. To appoint the auditors; 12. To approve the sale, assignment, or transfer of any equity interest or membership interest in any subsidiary; 13. To approve any reclassification or other change of any capital stock or other equity security; and, 14. To approve the issuance of, or the creation of any obligation to issue, any equity security. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing body for their review and approval prior to filing. Form 990, Part VI, Section B, line 12c This process is the responsibility of the Compliance Officer. A conflict of interest disclosure form is submitted to all leadership, board members, board committee members, employed physicians, medical directors and certain employees in key positions annually to be completed. Reminders are sent to all persons of interest to ensure that all conflict of interest disclosure forms are completed and collected. Form 990, Part VI, Section B, line 15 Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable. Form 990, Part VI, Section C, line 19 The Organization's Form 990, governing documents, conflict of interest policy, and financial statements are made available to the public upon request. The Organization's Form 990 is also made available on the website of its parent organization, Covenant Health, at the following web address: https://www.covenanthealth.net/financials Form 990, Part XII, Line 2c: The audit process has not changed from the previous year. Alternative Health Services 360 Broadway Bangor ME 04402 010422885 Home health and hospice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Bangor Nursing and Rehabilitation Center 103 Texas Avenue Bangor ME 04401 010538534 Long-term care nursing facility ME 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Waltham Inc dba Maristhill Nursing & Rehab Center 66 Newton Street Waltham MA 02453 043333609 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Worcester Inc dba St Mary Care Center 39 Queen Street Worchester MA 01610 043419625 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Community Clinical Services PO Box 7291 Lewiston ME 04243 010409788 Physician practice ME 501(c)(3) Line 10 St Mary's Health System 0 Covenant Health Foundation Inc 100 Ames Pond Drive Tewksbury MA 01876 800199674 Charitable foundation MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Covenant Health Investment Trust 420 Bedford Street Lexington MA 02420 046835128 Investment trust MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Covenant Health Inc 100 Ames Pond Drive Tewksbury MA 01876 222484505 Health care management and resource organization MA 501(c)(3) Line 10 N/A 0 Fanny Allen Corporation Inc 790 College Parkway Colchester VT 05446 222495808 Charitable foundation VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Fanny Allen Holdings Inc 790 College Parkway Colchester VT 05446 030181052 Real estate holding company VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Helping Hands of St Marguerite Inc 799 Concord Avenue Cambridge MA 02138 800199674 Private home-care health services MA 501(c)(3) Line 10 Covenant Health Inc 0 M & J Company 360 Broadway Bangor ME 04402 222480150 Lease holding company ME 501(c)(2) St Joseph Healthcare Foundation 0 Mary Immaculate Guild Inc 172 Lawrence Street Lawrence MA 01841 463073987 Supporting grants and donations MA 501(c)(3) Line 12a, I Covenant Health Inc 0 MI Adult Day Health Care Center Inc 189 Maple Street Lawrence MA 01841 042921888 Adult Day Care Services MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Nursing Restorative Center Inc 172 Lawrence Street Lawrence MA 01841 042104851 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community Inc 189 Maple Street Lawrence MA 01841 042647207 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Transportation Inc 189 Maple Street Lawrence MA 01841 042921889 Elderly transportation services MA 501(c)(3) Line 10 Covenant Health Inc 0 Mount St Rita Health Centre 15 Sumner Brown Road Cumberland RI 02864 050342330 Nursing home RI 501(c)(3) Line 10 Covenant Health Inc 0 Neighborhood Housing Initiative PO Box 7291 Lewiston ME 04243 010539730 Affordable housing services ME 501(c)(3) Line 10 St Mary's Health System 0 Penacook Place Inc 150 Water Street Haverhill MA 01830 237090088 Nursing home MA 501(c)(3) Line 10 Covenant Health Inc 0 Souhegan Nursing Association 24 North River Road Milford NH 03055 020222795 Home health and hospice NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 0 St Joseph Ambulatory Care Inc 360 Broadway Bangor ME 04402 222480373 Physician practice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 St Andre Health Care 407 Pool Street Biddeford ME 04005 010342399 Nursing home and restorative facility ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Healthcare Foundation 360 Broadway Bangor ME 04402 222480149 Healthcare foundation ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Hospital 360 Broadway Bangor ME 04402 010212435 Hospital and health care facility ME 501(c)(3) Line 3 St Joseph Healthcare Foundation 0 St Joseph Manor Health Care 215 Thatcher Street Brockton MA 02302 042565937 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph's Hospital of Nashua NH Inc 172 Kinsley Street Nashua NH 03061 020222215 Hospital and health care facility NH 501(c)(3) Line 3 Covenant Health Inc 0 St Mary's D'Youville Pavilion PO Box 7291 Lewiston ME 04243 010211558 Nursing home and restorative facility ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Health System PO Box 7291 Lewiston ME 04243 222504349 Hospital and health care facility ME 501(c)(3) Line 12a, I Covenant Health Inc 0 St Mary's Regional Medical Center PO Box 7291 Lewiston ME 04243 010211551 Hospital and health care facility ME 501(c)(3) Line 3 St Mary's Health System 0 St Mary's Residences PO Box 7291 Lewiston ME 04243 222504356 Low income housing ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Villa Nursing Home Inc 675 St Marys Villa Road Moscow PA 18444 232057177 Nursing home and restorative facility PA 501(c)(3) Line 10 Covenant Health Inc 0 The Surgicenter at St Joseph Hospital Inc 172 Kinsley Street Nashua NH 03061 020222215 Healthcare and surgery center NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 0 Youville Hospital and Rehabilitation Center Inc 1575 Cambridge Street Cambridge MA 02138 043239563 Hospital and health care facility MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville House Inc 1573 Cambridge Street Cambridge MA 02138 043239593 Assisted living services MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville Lifecare Inc 1575 Cambridge Street Cambridge MA 02138 042103582 Hospital and health care facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Youville Place 10 Pelham Road Lexington MA 02421 043297834 Assisted living services MA 501(c)(3) Line 10 Covenant Health Inc 0 Campus Holding PO Box 7291 Lewiston ME 04240 010406049 Holding company ME N/A C 0 Covenant Health Insurance LTD PO Box 69 Grand Cayman CJ KY1-1102 043360127 Self-insurance company CJ N/A C 0 GNM Corporation 172 Kinsley Street Nashua NH 03060 020400550 Real estate holding company NH N/A C 0 SJ Physicians Services 172 Kinsley Street Nashua NH 03060 020522234 Physician practice NH N/A C 0 St Joseph Corporate Services Inc 172 Kinsley Street Nashua NH 03060 020405197 Holding company NH N/A C 0 Strauss Incorporated 360 Broadway Bangor ME 04402 010391369 Repairs and transcriptions ME N/A C 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0