2022-11-09T15:38:00-06:00 2021-12-31 042536173 LIVINGSTON & HAYNES PC 40 GROVE STREET WELLESLEY MA 024827711 990 2021-01-01 042596550 MADONNA MANOR INC MADO 5086798154 85 NORTH WASHINGTON STREET NORTH ATTLEBORO MA 02760 EDGAR M DA CUNHA PRESIDENT AND TREASURER 5086751311 2022-10-31 1 EDGAR DA CUNHA 999009999 MARIA BUNKER P00652618 7812373339 2022-10-31 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z EDGAR M DA CUNHA 394 HIGHLAND AVENUE FALL RIVER MA 02720 9186999 0 X WWW.DHFO.ORG X 1966 MA PROVIDES SKILLED NURSING & REHABILITATIVE CARE FOR THE FRAIL AND THE ELDERLY. 8 1 186 1 0 0 1413348 1584042 8725903 7000040 3398 2736 2089726 600181 12232375 9186999 0 0 0 0 8151680 6703135 0 0 0 3361145 3184170 11512825 9887305 719550 -700306 4573428 3390766 3411566 2929210 1161862 461556 TO PROVIDE EXTENDED CARE TO THE CHRONICALLY ILL AND DISABLED, WITH SPECIAL EMPHASIS ON THE CARE OF THE FRAIL ELDERLY. 0 0 8983937 7000040 TO PROVIDE NURSING AND/OR REHABILITATION SERVICES TO THE AGED AND INFIRM FOR 26,545 PATIENT DAYS. 8983937 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 8 0 1 186 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 8 1 1 1 0 0 1 1 0 0 0 0 0 1 1 1 1 1 1 1 1 0 MA X LAURA MITCHELL 5086798154 368 NORTH MAIN STREET FALL RIVER MA 02720 X VERY REVEREND GREGORY A MATHIAS M + VICE PRESIDENT 1.00 X X 0 0 0 REVEREND DAVID A PIGNATO M + SECRETARY 1.00 X X 0 0 0 REVEREND DAVID COSTA M + DIRECTOR 1.00 X 0 0 0 REVEREND THOMAS L RITA M + DIRECTOR 1.00 X 0 0 0 REVEREND MARK P TREMBLAY M + DIRECTOR 1.00 X 0 0 0 MOST REVEREND EDGAR M DA CUNHA M + PRESIDENT & TREASURER 1.00 X X 0 0 0 KEVIN KILEY DIRECTOR 1.00 X 0 0 0 ELIZABETH POIRIER DIRECTOR 1.00 X 0 0 0 DENISE WAINWRIGHT LPN CHARGE 40.00 X 126467 0 22437 126467 0 22437 1 0 0 0 SYMBRIA REHABINC 28100 TORCH PARKWAY WARRENVILLE IL 60555 THERAPY SERVICES 552259 DIOCESAN HEALTH FACILITIES 368 NORTH MAIN STREET FALL RIVER MA 02720 MANAGEMENT SERVICES 293192 2 1559130 24912 1584042 MEDICARE/MEDICAID 623000 4945250 4945250 ROOM & BOARD FEES 623000 2054790 2054790 7000040 2736 2736 OTHER REVENUE 900099 600181 600181 600181 9186999 7000040 0 602917 5616830 5306651 310179 176285 166551 9734 497611 470131 27480 412409 389634 22775 270639 270639 4067 4067 13250 13250 842915 825573 17342 12648 12648 161126 161126 206803 181014 25789 2173 2173 1685 1685 17898 17898 154942 137943 16999 110377 101393 8984 SUPPLIES 393535 393535 COVID-19 TESTING 376671 376671 FOOD 233542 233542 USER FEE 225703 225703 156196 156013 183 9887305 8983937 903368 0 1854 1900 1842851 1013200 757196 686735 52238 40554 61540 54771 5357366 4267974 1110244 1089392 482 0 747023 504214 4573428 3390766 1681798 1292772 1729768 1636438 3411566 2929210 X 1161862 461556 1161862 461556 4573428 3390766 -700306 0 X X 0 1 X 1 1 1 X 13091 17887 5845 8214 24912 69949 11079038 11150140 10704854 8725903 7000040 48659975 11092129 11168027 10710699 8734117 7024952 48729924 0 0 0 48729924 9625 5476 1049 3398 2736 22284 9625 5476 1049 3398 2736 22284 72447 102196 293040 2089726 600181 3157590 11174201 11275699 11004788 10827241 7627869 51909798 0.93870 0.95250 0.00040 0.00050 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2017 AMOUNT: $ 56,843. 2018 AMOUNT: $ 82,821. 2019 AMOUNT: $ 266,857. 2020 AMOUNT: $ 2,089,726. 2021 AMOUNT: $ 600,181. FUNDRAISING INCOME - 2017 AMOUNT: $ 15,604. 2018 AMOUNT: $ 19,375. 2019 AMOUNT: $ 26,183. 2020 AMOUNT: $ 0. 2021 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 37500 37500 3671361 2852516 818845 1624486 1392252 232234 24019 23206 813 1089392 DUE FROM AFFILIATES 504214 504214 DUE TO AFFILIATES 942192 UNSECURED LOAN PAYABLE TO RELATED THIRD PARTY 694246 1636438 X 9186999 0 9186999 0 9186999 9887305 0 9887305 0 9887305 PART X, LINE 2: THE HOME RECOGNIZES THE TAX BENEFIT FROM ANY UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE TAX POSITION. ANY TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE RESOLUTION. MANAGEMENT HAS ANALYZED THE HOME'S TAX POSITIONS, AND HAS CONCLUDED THAT NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS SHOULD BE RECORDED RELATED TO UNCERTAIN TAX POSITIONS TAKEN ON RETURNS FILED FOR OPEN YEARS (2018-2020) OR EXPECTED TO BE TAKEN IN THE HOME'S 2021 TAX RETURNS. THE HOME IDENTIFIES ITS MAJOR TAX JURISDICTIONS AS U.S. FEDERAL AND THE COMMONWEALTH OF MASSACHUSETTS; HOWEVER, THE HOME IS NOT AWARE OF ANY TAX POSITIONS FOR WHICH IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL CHANGE MATERIALLY IN THE NEXT TWELVE MONTHS. THE HOME ALSO FOLLOWS THE POLICY TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS (IF ANY) IN INCOME TAX EXPENSE. NO SUCH INTEREST AND PENALTIES HAVE BEEN RECORDED AS OF DECEMBER 31, 2021 AND 2020. FORM 990, PART VI, SECTION A, LINE 2 MOST REVEREND EDGAR DA CUNHA, REVEREND DAVID A. PIGNATO, VERY REVEREND MONSIGNOR GREGORY A. MATHIAS, REVEREND MARC P. TREMBLAY, REVEREND DAVID COSTA, REVEREND THOMAS L. RITA, AND KEVIN KILEY HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED MANAGEMENT DUTIES TO THE DIOCESAN HEALTH FACILITIES OFFICE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 8A THERE WERE NO BOARD MEETINGS HELD BY THE GOVERNING BODY DURING 2021. FORM 990, PART VI, SECTION A, LINE 8B THERE WERE NO COMMITTEE MEETINGS WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY HELD DURING 2021. FORM 990, PART VI, SECTION B, LINE 11B THE CFO OF THE MANAGEMENT COMPANY REVIEWS AND APPROVES THE 990. THEN THE PRESIDENT OF THE BOARD OF DIRECTORS REVIEWS AND SIGNS THE 990. FORM 990, PART VI, SECTION B, LINE 12C EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO DISCLOSE ALL CONFLICTS OF INTEREST ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE COMPENSATION OF THE ADMINISTRATOR OF THE HOME AND ANY KEY EMPLOYEES INVOLVES EXAMINING SIMILAR SALARIES OF OTHER EMPLOYEES IN SIMILAR POSITIONS IN OTHER NURSING HOME FACILITIES. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST PART XI, LINE 26 THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT CATHOLIC MEMORIAL HOME INC 2446 HIGHLAND AVENUE FALL RIVER MA 02720 042106393 SKILLED NURSING FACILITY MA 501(C)(3) 9 N/A 0 MARIAN MANOR INC 33 SUMMER STREET TAUNTON MA 02780 042277710 SKILLED NURSING FACILITY MA 501(C)(3) 9 N/A 0 OUR LADY'S HAVEN OF FAIRHAVEN INC 71 CENTER STREET FAIRHAVEN MA 02719 042106632 SKILLED NURSING FACILITY MA 501(C)(3) 9 N/A 0 SACRED HEART HOME INC 359 SUMMER STREET NEW BEDFORD MA 02740 042140119 SKILLED NURSING FACILITY MA 501(C)(3) 9 N/A 0 ROMAN CATHOLIC BISHOP OF FALL RIVER 450 HIGHLAND AVENUE FALL RIVER MA 02720 043000709 RELIGIOUS ORGANIZATION MA 501(C)(3) 1 N/A 0 DIOCESAN FACILITIES SELF-INSURANCE GROUP 55 WALKERS BROOK DRIVE SUITE 402 READING MA 01867 043212416 SELF-INSURED INSURANCE GROUP MA 501(C)(3) 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 1 1 1 1 1 CATHOLIC MEMORIAL HOME INC M 17297 COST OF SERVICES PURCHASED CATHOLIC MEMORIAL HOME INC O 42385 COST OF SERVICES PROVIDED MARIAN MANOR INC P 5664 BASED ON ACTUAL AMOUNTS PAID DIOCESAN HEALTH FACILITIES OFFICE P 11533 BASED ON ACTUAL AMOUNTS PAID DIOCESAN HEALTH FACILITIES OFFICE Q 125774 COST OF SERVICES PROVIDED SACRED HEART HOME INC P 12702 BASED ON ACTUAL AMOUNTS PAID ROMAN CATHOLIC BISHOP OF FALL RIVER M 24472 COST OF SERVICES PURCHASED OUR LADY'S HAVEN INC Q 32403 BASED ON ACTUAL AMOUNTS RECEIVED ROMAN CATHOLIC BISHOP OF FALL RIVER M 76209 COST OF SERVICES PURCHASED CATHOLIC MEMORIAL HOME INC P 53818 BASED ON ACTUAL AMOUNTS PAID CATHOLIC MEMORIAL HOME INC Q 18716 BASED ON ACTUAL AMOUNTS RECEIVED DIOCESAN HEALTH FACILITIES OFFICE S 120000 REPAYMENT OF LOAN OUR LADY'S HAVEN INC P 6385 BASED ON ACTUAL AMOUNTS PAID SACRED HEART HOME INC Q 175 BASED ON ACTUAL AMOUNTS RECEIVED MARIAN MANOR INC Q 44048 BASED ON ACTUAL AMOUNTS RECEIVED MARIAN MANOR INC S 43000 REPAYMENT OF LOAN OUR LADY'S HAVEN INC S 24343 REPAYMENT OF LOAN ROMAN CATHOLIC BISHOP OF FALL RIVER M 176285 COST OF SERVICES PURCHASED ROMAN CATHOLIC BISHOP OF FALL RIVER M 509392 COST OF SERVICES PURCHASED MARIAN MANOR INC O 14538 COST OF SERVICES PROVIDED ROMAN CATHOLIC BISHOP OF FALL RIVER R 45256 REPAYMENT OF LOAN ROMAN CATHOLIC BISHOP OF FALL RIVER R 17898 INTEREST PAYMENTS ON LOAN DIOCESAN HEALTH FACILITIES OFFICE M 270639 COST OF SERVICES PURCHASED CATHOLIC MEMORIAL HOME INC R 22948 REPAYMENT OF LOAN CATHOLIC MEMORIAL HOME INC L 25088 COST OF SERVICES PROVIDED MARIAN MANOR INC L 14538 COST OF SERVICES PROVIDED DIOCESAN FACILITIES SELF-INSURANCE GROUP F 45896 DIVIDENDS RECEIVED