MASONICARE HEALTH CENTER: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
MASONICARE HEALTH CENTER (EIN 06-0655131)
Tax period
2020-10-01 to 2021-09-30
Filed
2022-08-11
IRS object ID
202232239349300338
Schema version
2020v4.0
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)
Return2022-08-11T14:32:17-05:00ReturnTs
Tax Period End2021-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line162 Memorial Road Suite 100AddressLine1Txt
CityWest HartfordCityNm
State AbbreviationCTStateAbbreviationCd
ZIP061072207ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN060655131EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Masonicare Health CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMASOBusinessNameControlTxt
Phone2036786310PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 70AddressLine1Txt
CityWallingfordCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06492ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEVEN D BEAULIEUPersonNm
Person TitleCFOPersonTitleTxt
Signature2022-08-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSTEVEN DPersonFirstNm
Person LastBEAULIEUPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRACHEL SPURLOCKPreparerPersonNm
PTINP00520729PTIN
Phone8606789200PhoneNum
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1STEVEN BEAULIEUBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 70AddressLine1Txt
CityWallingfordCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06492ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$51,314,223GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.masonicare.org/services/health-wellnessWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1889FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionThe Mission of Masonicare Health Center is to provide comprehensive medical services to the elderly.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee1053TotalEmployeeCnt
Total Volunteers76TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$847,355PYContributionsGrantsAmt
CY Contributions Grants$1,533,285CYContributionsGrantsAmt
PY Program Service Revenue$59,304,829PYProgramServiceRevenueAmt
CY Program Service Revenue$49,435,178CYProgramServiceRevenueAmt
PY Investment Income$3,687PYInvestmentIncomeAmt
CY Investment Income$2,186CYInvestmentIncomeAmt
PY Other Revenue$411,397PYOtherRevenueAmt
CY Other Revenue$343,574CYOtherRevenueAmt
PY Total Revenue$60,567,268PYTotalRevenueAmt
CY Total Revenue$51,314,223CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$42,848,808PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$33,407,165CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$23,415,323PYOtherExpensesAmt
CY Other Expenses$22,106,727CYOtherExpensesAmt
PY Total Expenses$66,264,131PYTotalExpensesAmt
CY Total Expenses$55,513,892CYTotalExpensesAmt
PY Revenues Less Expenses-$5,696,863PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,199,669CYRevenuesLessExpensesAmt
Total Assets BOY$34,560,093TotalAssetsBOYAmt
Total Assets EOY$30,328,856TotalAssetsEOYAmt
Total Liabilities BOY$10,752,182TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,855,480TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$23,807,911NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$21,473,376NetAssetsOrFundBalancesEOYAmt
MissionProvide comprehensive medical services to the elderly. In furtherance of our traditional Masonic values, the mission of Masonicare Health Center is to enhance the quality of life by providing health, social and spiritual care throughout an individual's lifetime with emphasis on the needs of older persons. Masonicare Health Center will be recognized as an organization committed to establishing healthcare centers for excellence in all of its affiliates through the development of an integrated, person-centered healthcare system. Dedicated to our values and in partnership with our communities, we are committed to meeting the total needs of those we serve...mind, body and spiritMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$49,304,927ExpenseAmt
Revenue$49,435,178RevenueAmt
DescMasonicare Health Center is a multi-level care facility. Masonicare Health Center provides services in the following areas: skilled nursing care (long-term care including memory care and rehabilitation care), geriatric medical psychiatric hospital services and assisted living and independent living apartments. During 2021, the facility's services were utilized as follows: skilled nursing, 357 licensed beds at 62.9% occupancy; geriatric medical psychiatric care, 29 licensed beds at 85.2% occupancy; assisted living, 86 apartments at 84.3% occupancy; and independent living, 93 apartments at 88.8% occupancy.Desc
Total Program Service Expenses$49,304,927TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingYes (true)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
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 OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document50IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1053EmployeeCnt
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 Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STEVEN D BEAULIEUBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2036787857PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line122 MASONIC AVENUEAddressLine1Txt
CityWALLINGFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06492ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Christopher J Earle
Vice Chairman1.08.0Yes (X)Yes (X)$0$0$0
Janet S Berry
Secretary1.06.0Yes (X)Yes (X)$0$0$0
Newton Buckner
Treasurer1.07.0Yes (X)Yes (X)$0$0$0
Robert F Polito Jr
Chairman1.07.0Yes (X)Yes (X)$0$0$0
Bonnie McWain
Director1.06.0Yes (X)$0$0$0
Bruce R Bellmore
Director1.06.0Yes (X)$0$0$0
David A Gessert
Director1.06.0Yes (X)$0$0$0
Francis X Conlon
Director1.06.0Yes (X)$0$0$0
Howard W Orr
Director1.07.0Yes (X)$0$0$0
Joseph J Porco
Director (effective 04/01/2021)1.07.0Yes (X)$0$0$0
Patrick Birney
Director1.06.0Yes (X)$0$0$0
Robert J Furce
Director1.07.0Yes (X)$0$0$0
Stephen W Petri III
Director (thru 03/31/2021)1.06.0Yes (X)$0$0$0
Susan Koty
Director1.06.0Yes (X)$0$0$0
Thaddeus M Stewart
Director1.06.0Yes (X)$0$0$0
William E Bohman
Director1.06.0Yes (X)$0$0$0
Courtney Wood
Administrator Skilled Nursing40.00Yes (X)$40,020$0$371
Jon-Paul Venoit
President and CEO, Assistant Secretary1.047.0Yes (X)$0$614,105$44,498
Steven D Beaulieu
CFO & Assistant Treasurer (effective 10/12/2020)1.047.0Yes (X)$0$56,308$3,059
Barbara Piper
Nursing Supervisor40.00$123,106$0$28,326Yes (X)
Francis Martowski
Licensed Practical Nurse40.00$130,351$0$19,179Yes (X)
Heidi Slade
Registered Nurse40.00$116,645$0$40,721Yes (X)
Patricia Sedaille
Nursing Supervisor (thru 07/08/21)40.00$129,548$0$31,635Yes (X)
Shannon Hernandez
Assistant Director of Nursing40.00$146,049$0$3,640Yes (X)
James R Rude
Former CFO and Assistant Treasurer0.024.0$0$300,411$38,143Yes (X)
Jeffrey Bukowski
Former Licensed Practical Nurse0.00$127,702$0$9,357Yes (X)
William O'Brien
Former Pharmacist0.00$124,475$0$17,250Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$937,896TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$970,824TotReportableCompRltdOrgAmt
Total Other Compensation$236,180TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtAddress Line2ContractorAddress/USAddress/AddressLine2TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
West Haven Medical Group
32 East Main StreetSuite 1BBranfordCT06405Physician Services$1,004,313
Diamond Healthcare Corp
701 E Byrd St Fl 15RichmondVA23219Medical Consulting Services$627,661
Morrison Management Specialists
PO BOX 102289ATLANTAGA30368Food Service$602,000
HealthPRO Heritage
PO Box 69268BaltimoreMD21264Therapy Services$423,758
Quest Diagnostics LLC
PO B0x 844217BostonMA02284Laboratory Services$333,106
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K28CntrctRcvdGreaterThan100KCnt
Related Organizations$665,702RelatedOrganizationsAmt
Government Grants$867,583GovernmentGrantsAmt
Total Contributions$1,533,285TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
SKILLED NURSING623311$33,555,440$33,555,440
GERIATRIC MED PSYCHIATRIC623311$9,832,975$9,832,975
HOME FOR AGED623311$3,389,770$3,389,770
RESIDENT FEES-APARTMENTS623311$2,365,007$2,365,007
Other Program Services623311$291,986$291,986

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$49,435,178TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,186TotalRevenueColumnAmt
Exclusion$2,186ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$143,501RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$143,501RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$143,501TotalRevenueColumnAmt
Exclusion$143,501ExclusionAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
DIETARY900099$148,341$148,341
SHOPS / STORAGE900099$6,599$6,599
VENDING MACHINES900099$634$634

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$44,499TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$44,499ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$200,073OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$51,314,223TotalRevenueColumnAmt
Related Or Exempt Func Income$49,435,178RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$345,760ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$302,278TotalAmt
Management And General$302,278ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,135,388TotalAmt
Program Services$23,537,528ProgramServicesAmt
Management And General$597,860ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,188,091TotalAmt
Program Services$2,188,091ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,382,093TotalAmt
Program Services$4,220,682ProgramServicesAmt
Management And General$161,411ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,399,315TotalAmt
Program Services$2,310,938ProgramServicesAmt
Management And General$88,377ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$135,151TotalAmt
Program Services$87,260ProgramServicesAmt
Management And General$47,891ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$25,500TotalAmt
Management And General$25,500ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,914,575TotalAmt
Program Services$4,941,188ProgramServicesAmt
Management And General$2,973,387ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$32,298TotalAmt
Program Services$31,993ProgramServicesAmt
Management And General$305ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,623,499TotalAmt
Program Services$1,341,447ProgramServicesAmt
Management And General$282,052ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,515TotalAmt
Program Services$2,419ProgramServicesAmt
Management And General$96ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,870TotalAmt
Program Services$4,720ProgramServicesAmt
Management And General$150ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$795,416TotalAmt
Management And General$795,416ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,000,969TotalAmt
Program Services$1,967,969ProgramServicesAmt
Management And General$33,000ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$554,642TotalAmt
Program Services$554,642ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES OTHER$3,539,691$3,539,691$0
REPAIRS$2,457,569$2,246,110$211,459
PHARMACY$810,666$810,666
PROVIDER TAX-CONNECTICUT$1,339,494$1,339,494

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$869,872TotalAmt
Program Services$180,089ProgramServicesAmt
Management And General$689,783ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$55,513,892TotalAmt
Program Services$49,304,927ProgramServicesAmt
Management And General$6,208,965ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,327BOYAmt
EOY$6,200EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,790,099BOYAmt
EOY$7,500,095EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$40,005BOYAmt
EOY$40,005EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$310,591BOYAmt
EOY$257,395EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$94,773,120LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$73,963,749LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$21,566,059BOYAmt
EOY$20,809,371EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,852,012BOYAmt
EOY$1,715,790EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$34,560,093BOYAmt
EOY$30,328,856EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,663,524BOYAmt
EOY$5,787,187EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,790,000BOYAmt
EOY$818,985EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$429,325BOYAmt
EOY$511,032EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,869,333BOYAmt
EOY$1,738,276EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,752,182BOYAmt
EOY$8,855,480EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$23,807,911BOYAmt
EOY$21,473,376EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,807,911BOYAmt
EOY$21,473,376EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$34,560,093BOYAmt
EOY$30,328,856EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$4,199,669ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1,865,134OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$742,765CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$733,194CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$712,196CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$847,355CurrentTaxYearMinus1YearAmt
Current Tax Year$1,533,285CurrentTaxYearAmt
Total$4,568,795TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$65,461,166CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$64,154,770CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$61,088,476CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$59,304,829CurrentTaxYearMinus1YearAmt
Current Tax Year$49,435,178CurrentTaxYearAmt
Total$299,444,419TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$432,868CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$366,865CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$367,084CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$268,810CurrentTaxYearMinus1YearAmt
Current Tax Year$200,073CurrentTaxYearAmt
Total$1,635,700TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$66,636,799CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$65,254,829CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$62,167,756CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$60,420,994CurrentTaxYearMinus1YearAmt
Current Tax Year$51,168,536CurrentTaxYearAmt
Total$305,648,914TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$305,648,914PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$61,125CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$74,396CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$83,673CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$146,274CurrentTaxYearMinus1YearAmt
Current Tax Year$145,687CurrentTaxYearAmt
Total$511,155TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$61,125CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$74,396CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$83,673CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$146,274CurrentTaxYearMinus1YearAmt
Current Tax Year$145,687CurrentTaxYearAmt
Total$511,155TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$194CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$194TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$66,698,118CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$65,329,225CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$62,251,429CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$60,567,268CurrentTaxYearMinus1YearAmt
Current Tax Year$51,314,223CurrentTaxYearAmt
Total$306,160,263TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9983PublicSupportCY509Pct
Public Support PY5090.9987PublicSupportPY509Pct
Investment Income CY0InvestmentIncomeCYPct
Investment Income PY0.0013InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12 Other IncomeFormAndLineReferenceDesc
ExplanationDESCRIPTION - RECYCLING, COLUMN A - 194.0, COLUMN B - , COLUMN C - , COLUMN D - , COLUMN E - , COLUMN F - 194.0;ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$6,715OtherActivitiesAmt
Total Lobbying Expenditures$6,715TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYFormAndLineReferenceDesc
ExplanationMasonicare Health Center paid membership dues to LeadingAge, The Connecticut Hospital Association and The American Hospital Association for the fiscal year ended September 30, 2021, $6,715 of the membership dues paid was used for lobbying on issues relevant to the Organization's exempt purpose.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (true)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$84,884,852BeginningYearBalanceAmt
Contributions$457,427ContributionsAmt
Investment Earnings Or Losses$3,659,627InvestmentEarningsOrLossesAmt
Grants Or Scholarships$192,064GrantsOrScholarshipsAmt
Other Expenditures$327,375OtherExpendituresAmt
End Year Balance$88,482,467EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$84,052,687BeginningYearBalanceAmt
Contributions$574,456ContributionsAmt
Investment Earnings Or Losses$610,214InvestmentEarningsOrLossesAmt
Grants Or Scholarships$170,327GrantsOrScholarshipsAmt
Other Expenditures$182,178OtherExpendituresAmt
End Year Balance$84,884,852EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$84,388,408BeginningYearBalanceAmt
Contributions$737,160ContributionsAmt
Investment Earnings Or Losses-$937,362InvestmentEarningsOrLossesAmt
Grants Or Scholarships$127,004GrantsOrScholarshipsAmt
Other Expenditures$8,515OtherExpendituresAmt
End Year Balance$84,052,687EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$83,999,562BeginningYearBalanceAmt
Contributions$90,734ContributionsAmt
Investment Earnings Or Losses$823,968InvestmentEarningsOrLossesAmt
Grants Or Scholarships$108,031GrantsOrScholarshipsAmt
Other Expenditures$417,825OtherExpendituresAmt
End Year Balance$84,388,408EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$81,951,634BeginningYearBalanceAmt
Contributions$113,749ContributionsAmt
Investment Earnings Or Losses$2,055,426InvestmentEarningsOrLossesAmt
Grants Or Scholarships$104,759GrantsOrScholarshipsAmt
Other Expenditures$16,488OtherExpendituresAmt
End Year Balance$83,999,562EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.0BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.9559PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.0441TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$71,366,021OtherCostOrOtherBasisAmt
Depreciation$53,039,383DepreciationAmt
Book Value$18,326,638BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,141,756OtherCostOrOtherBasisAmt
Depreciation$3,516,744DepreciationAmt
Book Value$625,012BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,438,828OtherCostOrOtherBasisAmt
Depreciation$13,915,703DepreciationAmt
Book Value$523,125BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,826,515OtherCostOrOtherBasisAmt
Depreciation$3,491,919DepreciationAmt
Book Value$1,334,596BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$20,809,371TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
OTHER ASSETS$369,133
COVID-19 FUNDING$1,346,657
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,715,790TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
RESERVE FOR ASBESTOS REMOVAL$913,000
ESTIMATED THIRD PARTY LIABILITY$492,239
OTHER LIABILITIES$333,037
FieldValueIRS element (for citing)
Total Liability$1,738,276TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part IV, Line 2b Explanation of escrow agreementTrust accounts for long term residents. Financial account into which money can be deposited to be used for personal preference items. Trust account depositors are regularly provided the status and activity of their accounts.
Schedule D, Part V, Line 4 Intended uses of endowment fundsThe endowment funds are used to support the philanthropic mission and activities of Masonicare Corporation and its affiliates.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteMASONICARE ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH CERTAIN PROVISIONS OF FASB ASC 740, WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. UNDER FASB ASC 740, MASONICARE MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IT IF IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. MASONICARE DID NOT RECORD ANY UNRECOGNIZED TAX BENEFITS FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020. MASONICARE ANTICIPATES THAT IT WILL NOT HAVE A CHANGE IN UNRECOGNIZED TAX BENEFITS DURING THE NEXT TWELVE MONTHS THAT WOULD HAVE A MATERIAL IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS. ALL U.S. FEDERAL TAX YEARS FROM FISCAL 2018 ONWARDS ARE ELIGIBLE FOR AUDIT BY THE IRS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetfalseFinancialAssistanceBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$30,536,412TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,374,895DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,161,517NetCommunityBenefitExpnsAmt
Total Expense0.1650TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$30,536,412TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,374,895DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,161,517NetCommunityBenefitExpnsAmt
Total Expense0.1650TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$107,514TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$107,514NetCommunityBenefitExpnsAmt
Total Expense0.0019TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$107,514TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$107,514NetCommunityBenefitExpnsAmt
Total Expense0.0019TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$30,643,926TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,374,895DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,269,031NetCommunityBenefitExpnsAmt
Total Expense0.1670TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$773,271BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$4,708,207ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,301,132CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,592,925MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Masonicare Health CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line122 Masonic AVenueAddressLine1Txt
CityWallingfordCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06492ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.masonicare.org/services/health-wellnessWebsiteAddressTxt
State License11-CD, H0008StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Masonicare Health CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.masonicare.org/about-us/community-impactOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLwww.masonicare.org/services/health-wellness/behavioral-healthStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.0FPGFamilyIncmLmtFreeCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.masonicare.org/resource/financial-optionsFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.masonicare.org/resources/financail-optionsFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.masonicare.org/resources/financial-optionsFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3EThe Masonicare Health Center assessment questionnaire was designed to ask respondents for prioritize the "most important, 2nd most important, 3rd most important" unmet need. Masonicare leadership reviewed the prioritization for reasonableness and discussed which items were appropriate for MHC follow-up. The items considered included the severity of the need, the urgency of the need and the importance of the need to the community. Based on the survey, three significant needs were identified: Access to wellness, disease prevention and on-gong mental health service; Homecare for those with limitation in their daily activities of living as it relates to mental health needs; Transportation to mental health services for those who no longer drive and/or are unable to use public transportation. With MHC's limited hospital services for the geriatric population only, the significant health needs identified are not as broad as for a typical acute care hospital.
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - Masonicare Health Center. Members of the collaborative team representing the community included the Director of the Wallingford Health Department, the Director of the Wallingford Senior Center and the Director of the Wallingford YMCA. Each provided input into the development of the survey questions based on first-hand knowledge of the Wallingford community. With MHC's limited hospital services for the geriatric population only, the solicitation of the input from the community is more targeted than a typical acute care hospital.
Schedule H, Part V, Section B, Line 7 Facility , 1Facility , 1 - Masonicare Health Center. The 2020 Community Health needs Assessment and Implementation Plan for Hospital Services was adopted by the Board of Directors on September 23, 2020. This document is available at www.masonicare.org by taking the following steps: - On the "home" page, click services going across the top of the page, to be directed to the "our services" page. - On the "our services" page under "Health and Wellness" click on Behavioral Health, scroll down to the heading "Forms and Information", and click Community Health Needs Assessment to be directed to the most current document.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - Masonicare Health Center. The significant needs identified in the most recently conducted CHNA included the following: (1) Access to wellness, disease prevention, and ongoing mental health services (Need being addressed by MHC) - Masonicare Health Center (MHC) is a provider of the following hospital services: geriatric medical inpatient psychiatric services, particularly with a planned expansion of these services from 29 to 43 beds, received CON Approval on September 28, 2020. MHC does not have an emergency room and does not provide emergency services. MHC is continually working with local acute care hospitals, local skilled nursing facilities and local physicians to be the location of choice for seniors who need the geriatric psychiatric hospital service provided. Although currently on hold due to COVID-19 restrictions Masonicare promotes the availability of its services through various media outlets (television and radio advertisements, social media and the Masonicare website), as well as through the statewide outreach programs and the toll-free Help Line. MHC is a frequent participant in events promoting health care services a the local senior centers, and meetings are held periodically with representatives from the local Department of Health and Housing Authority. Participation, membership and representation on Boards of organizations such as the United Way, LeadingAge CT and the Connecticut Alzheimer's Association support the work of identifying resources and connecting residents to new and ongoing programs. (2) Homecare for those with limitation in their daily activities of living as it relates to mental health needs. Ongoing identification by Masonicare Health Center of available homecare resources for mental health needs is underway. Relationships are being developed with various State and Federal funded programs, the Veteran's Administration, the Connecticut Homecare Program for Elders, Connecticut Agency on Aging and Various homecare agencies to gather more complete information on available at-home resources for distribution to the community. (3) Transportation to mental health services for those who no longer drive and/or are unable to use public transportation. Ongoing identification by Masonicare Health Center of available transportation programs is underway. Relationships are being developed with various organizations with resources to support transportation initiatives, including the Connecticut Department of Transportation, Age Well CT, HARTransit . My Place CT, REACH Disability Services and other to gather more complete information on available transportation services. The remainder of the needs identified by the questionnaire were not deemed to be significant.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - MASONICARE HEALTH CENTER. A 100% discount is also available for all medically necessary Hospital Services where for the patient responsibility in excess of 20% of the family household income.
Schedule H, Part V, Section B, Line 15 Facility , 1Facility , 1 - Masonicare Health Center. Billing statements and follow-up correspondence note the availability of Financial Assistance Programs as one of the available "payment options". Current information regarding the Financial Assistance Policy for Hospital Services (and the related plain language summary and application form) are available at www.masonicare.org by taking the following steps: - On the "home" page, click Services going across the top of the page. - On the "our services" page,under "Health and Wellness" click Behavioral Health. - On the "Behavioral Health" page, scroll down to 'Forms and Information" and click on the link for the Financial Assistance Application and Policy for Hospital Services.
Schedule H, Part V, Section B, Line 16 Facility , 1Facility , 1 - Masonicare Health Center. Translations of the Financial Assistance Policy for Hospital Services, Financial Assistance Application for Hospital Services and the Plain Language Summary documents will be made available if and when the Limited English Proficiency requirements are met.
FieldValueIRS element (for citing)
Facility0FacilityNum

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part III, Line 9b Provisions on Collection Practices for Qualified PatientsMasonicare Health Center (MHC) provides financial assistance to patients who meet certain criteria under the financial assistance policy without charge, or at amounts less than established rates. According to its Financial Assistance Policy, Masonicare Health Center does not pursue extraordinary collection actions against any patients in the collection of amounts billed for hospital services.
Schedule H, Part I, Line 5a Schedule H, Part I, LIne 5aWith approximately 0.5% of total revenue coming from private pay/self pay sources, MHC does not explicitly budget for financial assistance costs.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted careA 100% discount is also available for all medically necessary Hospital Services where for the patient responsibility in excess of 20% of the family household income.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountMasonicare Health Center (MHC) calculates the estimated allowance for doubtful accounts by applying the appropriate reserve factors based upon historical collection percentages to the various aging categories of patient accounts receivable. The provision for bad debts is the amount required to have the allowance for doubtful accounts stated at the calculated value.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyThe Hospital is unable to estimate accurately the amount of bad debt expense attributable to patients eligible for free services under the financial assistance policy. Although a portion of bad debt expense may relate to patients who would qualify for charity care, a reportable figure can not be reasonable estimated
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteSubsequent changes that are determined to be the result of an adverse change in the patient's ability to pay are recorded as bad debt expense. Bad debt expense for the years ending September 30, 2021 and 2020 was not significant.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsThe hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. The IRS does not classify this shortfall in Medicare payments as Community Benefits. However, we believe it is an important contribution made by the hospital to the health and well being of the community. The source for the amount reported on Line 6 was the Medicare cost report.
Schedule H, Part V, Section B, Line 16a FAP website- Masonicare Health Center: Line 16a URL: www.masonicare.org/resource/financial-options;
Schedule H, Part V, Section B, Line 16b FAP Application website- Masonicare Health Center: Line 16b URL: www.masonicare.org/resources/financail-options;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- Masonicare Health Center: Line 16c URL: www.masonicare.org/resources/financial-options;
Schedule H, Part VI, Line 2 Needs assessmentVarious committees and groups at Masonicare meet periodically to discuss the needs of the community we serve as well as the resources and services available at Masonicare and other agencies in the area. The Organization is represented at community level organizations and groups that are involved with the assessment of community needs. The Organization's resources are called upon to participate in programs and projects put together to address those needs.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceMasonicare Health Center (MHC) informs patients and their families about financial assistance during the admission process for all hospital services. Information is posted throughout the hospital as well as on Masonicare's website and on the patient billing statement.
Schedule H, Part VI, Line 4 Community informationThe community served by Masonicare Health Center's Geriatric Hospital Services is the senior population (age 60 and older) in the Wallingford and Meriden Connecticut area. Many of the individuals served by the geriatric hospital facility come from the larger senior care environment at Masonicare Health Center, with the geriatric hospital services only a small component of Masonicare Health Center's overall operation. With limited hospital services for the geriatric population only, the definition of the community served is more targeted than for a typical acute care hospital.
Schedule H, Part VI, Line 5 Promotion of community healthA majority of the organization's governing body is comprised of persons who reside in the organization's primary service area who are neither employees nor independent contractors of the organization, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties. Masonicare provides various health promotion and community assistance activities, including the following: Free education programs and services to individuals and families throughout Connecticut. Lunch and Learn - This program is designed to provide seniors and others with education on health and wellness. speakers are typically clinical professional from throughout the Masonicare continuum and community experts. Masonicare has coordinated with the senior centers and libraries in the Connecticut towns of Cheshire, Cromwell, Mansfield, Meriden, North Haven, Southbury, Windsor, Groton, Old Lyme and Wallingford. Masonicare Community Services - This is a statewide outreach program available to all Connecticut residents and offers information and guidance on a variety of programs and services including: - Medicare, Medicaid (Title 19), and Medicare Part D - Benefits eligibility - Caregiver assistance programs - State and Federal programs - Housing options These services are available over the phone or in the comfort of the resident's home. Masonicare Community Services also provides assistance through a Choices certified counselor for all Medicare questions regarding Medicare Advantage Plans, Part D Prescription Drug Plans and Traditional Medicare coverages. Masonicare Help Line (888) 679-9997 - This is a toll free informational phone service assisting seniors and families with a broad range of questions about senior healthcare, retirement living and much more. In addition, assistance is offered in locating and utilizing service agencies and programs in Connecticut. In the fiscal year ended September 2021 the Help Line responded to 3,060 calls from seniors and families requesting assistance. Other activities - Masonicare frequently holds blood pressure screenings and senior health fairs throughout the state, and makes its facilities available to many community organizations including the CT Commission on Aging, Senior Resources - Agency on Aging, M-Team, Healthy Wallingford, the Alzheimer's Association, Parkinson's Support Groups, Veterans Coffee Houses, and CT Department of Mental Health and Addiction Services.
Schedule H, Part VI, Line 6 Affiliated health care systemMasonicare of Wallingford, Connecticut, is the state's leading provider of healthcare and retirement living communities for seniors. A not-for-profit with more than 100 years of experience, Masonicare is recognized for quality, compassionate care and steadfast support provided to residents and patients. Masonicare encompasses a broad range of geriatric healthcare and senior living options: Skilled nursing and rehabilitation facility - Masonicare Health Center (MHC) located in Wallingford CT. Home health and hospice services - Masonicare Home Health & Hospice, our statewide healthcare and hospice affiliate, provided services to 7,439 patients in the fiscal year ended September 30, 2021 through its 5 offices (located in Derby, CT, Danielson, CT, East Hartford, CT, Mystic, CT, and Wallingford, CT). Independent living options - Continuing care retirement communities, Masonicare at Ashlar Village (MAV) and Masonicare at Chester Village (MCV), and the Johnson, Wells, and Hawkins Apartments for individuals 55 and over located at MHC in Wallingford CT. Assisted living community - Pond Ridge located at MAV in Wallingford CT. Personal care at home - Live in, personal care attendant and homemaker services are provided in an individual's home by affiliate Masonicare at Home (MAH). A residential care home - the Leslie G. Wright Residence located at MHC in Wallingford CT.
Schedule H, Part VI, Line 7 State filing of community benefit reportCT

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
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 OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
James R Rude
Former CFO and Assistant Treasurer$0$296,125$0$2,500$0$1,787$0$9,501$0$28,642$0$338,554$0$0
Jon-Paul Venoit
President and CEO, Assistant Secretary$0$601,771$0$2,835$0$9,499$0$10,424$0$34,075$0$658,604$0$0
William O'Brien
Former Pharmacist$66,917$0$0$0$57,559$0$2,252$0$14,998$0$141,726$0$0$0
Jeffrey Bukowski
Former Licensed Practical Nurse$69,707$0$0$0$57,995$0$2,694$0$6,662$0$137,058$0$0$0
Heidi Slade
Registered Nurse$115,796$0$750$0$99$0$5,020$0$35,702$0$157,366$0$0$0
Patricia Sedaille
Nursing Supervisor (thru 07/08/21)$124,434$0$4,888$0$226$0$5,374$0$26,261$0$161,182$0$0$0
Barbara Piper
Nursing Supervisor$122,605$0$120$0$381$0$4,139$0$24,188$0$151,433$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationThe organizations CEO, Jon-Paul Venoit, is compensated by a related organization, Masonicare Corporation which uses the following methods to establish his compensation; Compensation Committee, Independent Compensation Consultant, Compensation Survey or Study, and Approval by the Board or Compensation Committee.
Schedule J, Part I, Line 4a Severance or change-of-control paymentCertain executives and employees are eligible to receive severance payments upon termination of employment in certain circumstances. During calendar year 2020 severance payments made are reported as a component of the value reported in Schedule J Part II Column B(iii) "Other Reportable Compensation" for the following individuals - Jeffrey Bukowski ($57,995) and William O'Brien ($57,559)
Schedule J, Part I, Line 7 Non-fixed paymentsCOMPENSATION TO REWARD SENIOR MANAGEMENT FOR ACHIEVING ANNUAL QUALITY, STRATEGIC AND FINANCIAL GOALS FOR THE ORGANIZATION FOR AMOUNTS REPORTED ON SCHEDULE J, PART II, COLUMN (B)(II) "BONUS AND INCENTIVE COMPENSATION".

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15a Compensation of top management officialForm 990, Part VI, Line 15a checked "no" in accordance with the IRS instructions since the filing organization does not compensate the top management official.
Form 990, Part VI, Line 15b Compensation of the Organization's Officers and Key EmployeesThe CEO recommends any salary adjustments of the executive leadership, using the results of the valuation study and his assessment of individual performance or other pertinent information. The proposed executive salary changes are provided to the Compensation Committee. The process was completed in May 2021 for the following positions: Chief Financial Officer, Chief Information Officer, Chief Human Resources Officer, Vice President of Mission Effectiveness, Vice President of Strategy & Business Development, Executive Director of Masonicare at Mystic, Executive Director of Masonicare at Chester Village, Executive Director of Masonic Charity Foundation, Executive Director of Masonicare at Home, Health and Hospice, Director of Masonicare at Home, LTC Administrator of Masonicare Health Center.
Form 990, Part VI, Line 6 Classes of members or stockholdersThe organization has a sole corporate member, Masonicare Corporation, with the right to appoint members of the governing body and to participate in the organization's governance.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyMasonicare Corporation, as sole corporate member, annually appoints the members of the governing body.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersPursuant to the Certificate of Incorporation of the organization, Masonicare Corporation, as the sole corporate member, has certain reserved powers to take or approve certain actions of the governing body. These powers include the prior approval of amendments to the organization's certificate of incorporation and bylaws, approval of long range plans, budgets and material changes in budgets, mission statements and policies (including investment policies) as well as sales or transfer of assets, mergers and/or dissolutions and Certificate of Need applications. The sole corporate member's powers also include the appointment and removal of directors, the organization's Board Chair and independent audit firm.
Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing bodyMasonicare Health Center does not have any committees with authority to act on behalf of the governing body during the tax year.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyMasonicare management and our external accountants review the tax return for completeness and accuracy. It is reviewed by the chief executive officer and chairman of the board. The tax return is also placed on a secured website that can be accessed by all board members for their review. At a full board meeting a discussion is held regarding comments/questions from board members. The tax return is then finalized and filed.
Form 990, Part VI, Line 12c Conflict of interest policyAnnually, officers, directors and senior employees are required to complete a conflict of interest disclosure questionnaire. The Corporate Compliance Officer annotates the results to determine if, and to what extent, a conflict of interest exists. The results of the officer and Board Member disclosures are first reviewed by the Board Chairman and then reported at the board meetings. Any officer or board member shall not make or second motions or vote (other than abstain) on matters if a conflict of interest exists, whether or not the officer or board member had an opportunity to make a written disclosure through the formalized process. Senior employee disclosures are reported to the President and Chief Executive Officer. The entire process is coordinated by the Corporate Compliance Officer. All respondents are advised of their continuing duty to disclose any possible conflict of interest that may arise during the course of their service.
Form 990, Part VI, Line 19 Required documents available to the publicThe Organization provides required documents upon request.
Form 990, Part VII, Section A, Line 1a TrusteesHours related for volunteer trustees (column B) are the estimated hours per week that the volunteer trustees contribute to this and all other related exempt organizations, not necessarily equally but in the proportion required for which they receive no compensation. Related organizations include, Masonicare Corporation, Masonic Charity Foundation of CT, Masonicare at Ashlar Village Inc., Masonicare Home Health and Hospice Inc., Masonicare at Home Inc., Masonicare at Mystic Inc., Masonicare at Chester Village Inc. and Keystone Indemnity Company LTD.
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueMiscellaneous - Total Revenue: 44499, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 44499;
Form 990, Part IX, Line 11g Other FeesPROFESSIONAL FEES - Total Expense: 824917, Program Service Expense: 824917, Management and General Expenses: , Fundraising Expenses: ; PURCHASE SERVICES - Total Expense: 4150027, Program Service Expense: 4116271, Management and General Expenses: 33756, Fundraising Expenses: ; SHARED SERVICES - Total Expense: 2939631, Program Service Expense: , Management and General Expenses: 2939631, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesCAPITAL CONTRIBUTIONS FROM RELATED ENTITIES - 1865134;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
MASONICARE CORPORATION
PO BOX 70WALLINGFORDCT06492061435919PARENT HOLDING AND SUPPORT ORGANIZATIONCT501(c)(3)Type III-FINAfalse
MASONIC CHARITY FOUNDATION OF CT
PO BOX 70WALLINGFORDCT06492061435920PROVIDE PLANNED GIVING AND DEVELOPMENTCT501(c)(3)7MASONICARE CORPORATIONfalse
MASONICARE AT ASHLAR VILLAGE INC
PO BOX 70WALLINGFORDCT06492061050830CCRC AND ASSISTED LIVING COMMUNITYCT501(c)(3)10MASONICARE CORPORATIONfalse
MASONICARE AT CHESTER VILLAGE INC
PO BOX 70WALLINGFORDCT06492822936624CONTINUING CARE RETIREMENT COMMUNITYCT501(c)(3)10MASONICARE CORPORATIONfalse
MASONICARE HOME HEALTH AND HOSPICE INC
PO BOX 70WALLINGFORDCT06492061101924PROVIDE HOME HEALTH/HOSPICE SERVICESCT501(c)(3)10MASONICARE CORPORATIONfalse
MASONICARE AT HOME INC
PO BOX 70WALLINGFORDCT06492202377783PROVIDE HOME SERVICES TO THE ELDERLYCT501(c)(3)10MASONICARE CORPORATIONfalse
KEYSTONE INDEMNITY COMPANY LTD
126 COLLEGE STREET SUITE 400BURLINGTONVT05401030371612PROVIDE INSURANCE SERVICES TO MASONICARECT501(c)(3)Type III-FIMASONICARE CORPORATIONfalse
MASONICARE AT MYSTIC INC
PO BOX 70WALLINGFORDCT06492464656008MANAGE SENIOR LIVING FACILITYCT501(c)(3)10MASONICARE AT ASHLAR VILLAGE INCfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
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 OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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