2022-10-19T08:38:29-05:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2021-01-01 042066524 SANCTA MARIA HOSPITAL INC SANC 6178682200 799 CONCORD AVENUE CAMBRIDGE MA 02138 THOMAS GOMES ADMINISTRATOR 6178682200 2022-10-13 1 THOMAS GOMES 999009999 DANIELLE NIHILL P01350943 7819821001 2022-10-13 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z SANCTA MARIA NURSING FACILITY MOTHER MARY JANICE DM 799 CONCORD AVENUE CAMBRIDGE MA 02138 22260004 0 X HTTP://SANCTAMARIA.ORG X 1948 MA SKILLED NURSING SERVICES TO INDIVIDUALS DUE TO PHYSICAL CONDITION OR INFIRMITY. 8 8 234 9 0 0 1744929 2814896 16241971 17524958 194052 127040 769138 870039 18950090 21336933 0 0 0 0 12722004 12441725 0 0 0 5748962 5846582 18470966 18288307 479124 3048626 13379859 14706612 7927273 5976030 5452586 8730582 X FAITHFUL TO THE SPIRIT OF THE CONGREGATION OF THE DAUGHTERS OF MARY, SANCTA MARIA NURSING FACILITY'S MISSION IS TO WITNESS CHRIST'S COMPASSION, CARING AND LOVE, REFLECTING THE CATHOLIC CHURCH'S ROLE IN THE CONTINUATION OF CHRIST'S HEALING MINISTRY. COMMITTED TO THE VALUES OF DIGNITY AND RESPECT, LIFE, SERVICE AND SOCIAL JUSTICE, SANCTA MARIA STRIVES TO PROVIDE QUALITY HEALTH CARE TO ALL OF ITS PATIENTS/RESIDENTS. 0 0 15865733 17525268 PROVISION OF CHARITABLE HEALTH CARE SERVICES TO THE SURROUNDING COMMUNITY SUFFERING FROM ILLNESS OR DISABILITIES REQUIRING NURSING HOME CARE THROUGH A CATHOLIC, NON-PROFIT FACILITY COMMITTED TO THE HIGHEST STANDARDS OF MEDICAL CARE AND PRACTICE. THE FACILITY IS LICENSED FOR 141 BEDS OF WHICH, 135 BEDS WERE IN SERVICE AT YEAR-END RESULTING IN AN OCCUPANCY OF 92.44%. 15865733 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 10 0 1 234 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X THOMAS GOMES 6178682200 799 CONCORD AVENUE CAMBRIDGE MA 02138 SISTER MARY THERESA TINANA DM VICE PRESIDENT 32.00 X X 48374 0 3730 MOTHER MARY JENNIFER DM PRESIDENT THRU 08/2021 30.00 X X 0 0 0 JOSEPH BARRELL JR CHAIR 2.00 X X 0 0 0 JOSEPH CONNARTON VICE CHAIR 1.00 X X 0 0 0 JAMES F FERREIRA TREASURER THRU 08/2021 1.00 X X 0 0 0 SHEILA HICKEY SECRETARY 1.00 X X 0 0 0 NORMAN MCIVER DIRECTOR THRU 08/2021 1.00 X 0 0 0 MICHAEL GULESERIAN DIRECTOR 1.00 X 0 0 0 JOSEPH R NOLAN JR DIRECTOR 1.00 X 0 0 0 SISTER MARY JANICE DM PRESIDENT A/O 09/2021 2.00 X X 0 0 0 MARTINA N ALIBRANDI TREASURER A/O 09/2021 2.00 X X 0 0 0 THOMAS GOMES ADMINISTRATOR 40.00 X 188094 0 16042 GEORGIA WAYNE DIR. OF NURSING 40.00 X 153201 0 897 ADAM CHAMBERS DIR. OF REHAB 40.00 X 150659 0 0 JEAN CITARELLA DIR. OF HUMAN RESOURCES 40.00 X 135720 0 16042 TERESA ROCK DIR. CLINICAL REIMBURSEMEN 40.00 X 140380 0 0 816428 0 36711 19 0 1 0 ADVOCATE HEALTHCARE MANAGEMENT 35 AVCO RD HAVERHILL MA 01835 MANAGEMENT SERVICES 814466 PRO EMS SOLUTIONS 31 SMITH PL CAMBRIDGE MA 02138 COVID TESTING 506835 PREFERRED PHARMACY SOLUTIONS 35 AVCO RD HAVERHILL MA 01835 PHARMACY 371507 US FOODS PO BOX 3155 BOSTON MA 022413155 FOOD SUPPLIES 278347 EMCOR SERVICES 80 HAWES WY STOUGHTON MA 02072 HVAC 265276 12 2814296 600 2814896 NET PATIENT SERVICE REVENUE 623000 17524958 17524958 17524958 64060 64060 1329235 459506 869729 869729 869729 526545 463565 62980 62980 62980 OTHER SERVICE INCOME 623000 310 310 310 21336933 17525268 0 996769 256240 256240 10266002 9905754 360248 1107202 1044493 62709 812281 765120 47161 897049 897049 114392 114392 38934 38934 25147 25147 328811 328811 20456 20456 188293 188293 75725 75725 578316 548139 30177 613 613 114090 114090 346427 329106 17321 103506 41444 62062 PROGRAM EXPENSES 1701837 1700346 1491 USER FEE 837634 837634 BAD DEBT EXPENSES 211136 211136 SUPPLIES AND EXPENSES 137897 129766 8131 126319 121030 5289 18288307 15865733 2422574 0 64951 438909 4610633 4615011 2447867 2706054 76073 71794 90944 113787 12783321 9093110 3403852 3690211 2678364 2998828 7175 72018 13379859 14706612 1832275 1984055 21373 0 6073625 3991975 7927273 5976030 X 5417839 8695835 34747 34747 5452586 8730582 13379859 14706612 3048626 229370 0 X 0 1 X 1 1 1 X 574771 12868 2775 1744929 2814896 5150239 11749177 12479542 15768854 16241971 17524958 73764502 12323948 12492410 15771629 17986900 20339854 78914741 0 0 0 78914741 992959 1063956 1236232 1413108 1456275 6162530 992959 1063956 1236232 1413108 1456275 6162530 2514 310 2824 13316907 13556366 17007861 19402522 21796439 85080095 0.92750 0.92500 0.07240 0.07500 X PART III, LINE 12 THE ORGANIZATION HAS REPORTED OTHER INCOME OF $310 FOR YEAR-END DECEMBER 31, 2021. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 34747 34747 34747 34747 47695 12948 34747 54389 5262 11956 47695 55888 4361 5860 54389 0.68000 0.32000 0 0 335323 335323 7475538 5884504 1591034 4737336 3029360 1707976 235124 179246 55878 3690211 ASSETS RETIREMENT AGREEMENT 696033 DUE TO RELATED PARTY 2852237 SECURITY DEPOSITS LIABILITY 29310 DUE TO/FROM THIRD-PARTY 414395 3991975 X 22025809 229370 229370 21796439 -459506 -459506 21336933 18747813 459506 459506 18288307 0 18288307 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO BE USED FOR EDUCATIONAL PURPOSES, THE ORGANIZATION'S CHAPEL EXPENSES, AND FURTHERING THE ORGANIZATION'S MISSION. PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FOLLOWS THE POLICY FOR UNCERTAINTY IN INCOME TAXES TO BE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE POLICY PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. NO UNCERTAIN INCOME TAX POSITIONS WERE IDENTIFIED FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -459,506. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 459,506. X X 0 0 0 0 0 0 0 0 0 THOMAS GOMES ADMINISTRATOR 188094 0 0 0 0 0 0 0 16042 0 204136 0 0 0 GEORGIA WAYNE DIR. OF NURSING 153201 0 0 0 0 0 0 0 897 0 154098 0 0 0 JEAN CITARELLA DIR. OF HUMAN RESOURCES 135720 0 0 0 0 0 0 0 16042 0 151762 0 0 0 ADAM CHAMBERS DIR. OF REHAB 150659 0 0 0 0 0 0 0 0 0 150659 0 0 0 PART I, LINE 3 THE BOARD CHAIRMAN ANNUALLY REVIEWS THE COMPENSATION OF THE ADMINISTRATOR BASED ON HIS/HER PERFORMANCE AND THROUGH THE USE OF A COMPENSATION SURVEY. THE MEMBERS OF THE BOARD REVIEW, DOCUMENT, AND APPROVE THE ANNUAL BUDGET. ARRELL CORPORATION BOARD MEMBER'S BUSINESS PROVIDING SERVICES 11351 PLUMBING SERVICES 0 MARTINA ALIBRANDI BOARD MEMBER'S BUSINESS PROVIDING SERVICES 12741 RENTAL/TENANT SERVICES COMP 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS CONSISTS OF THE CHAIRPERSON OF THE BOARD AND THE PRESIDENT, WHO SHALL BE AN EX OFFICIO MEMBER OF THE COMMITTEE, AND FROM TWO TO FOUR ADDITIONAL DIRECTORS APPOINTED BY THE BOARD OF DIRECTORS UPON THE RECOMMENDATION OF THE CHAIRPERSON OF THE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED CONTROL OVER MANAGEMENT DUTIES TO A THIRD-PARTY, ADVOCATE HEALTHCARE MANAGEMENT. THE ADMINISTRATOR IS AN EMPLOYEE OF ADVOCATE HEALTHCARE MANAGEMENT. FORM 990, PART VI, SECTION A, LINE 6 AS DEFINED IN THE BY-LAWS, THE ORGANIZATION HAS MEMBERS OF THE ORGANIZATION REFERRED TO AS SUPERIOR GENERAL AND MEMBERS OF THE GENERAL COUNCIL. THESE INDIVIDUALS MENTIONED ABOVE SHALL REMAIN A MEMBER OF THE OF THE CONGREGATION OF THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION AS LONG AS SHE SERVES AS THE SUPERIOR GENERAL OR A MEMBER OF THE GENERAL COUNCIL OF THE CONGREGATION OF THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION. FORM 990, PART VI, SECTION A, LINE 7A AS DEFINED IN THE BY-LAWS, THE SUPERIOR GENERAL OF THE CONGREGATIONS SHALL SERVE AS A THE CHAIR OF THE MEMBERS AND HAS THE AUTHORITY TO APPOINT A SECRETARY OF THE MEMBERS FROM AMONG THE MEMBERS. THE MEMBERS HAVE THE RIGHT TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF THE ORGANIZATION HAVE THE POWERS AND RIGHTS TO APPROVE OR CHANGE (1) THE PHILOSOPHY, MISSION AND OBJECTIVES, (2) APPOINT OR REMOVE DIRECTORS, (3) APPOINT THE PRESIDENT, (4) AMEND BY-LAWS, (5) APPROVE MERGERS, REORGANIZATION, AND CONSOLIDATIONS, (6) APPROVE ACQUISITION, SALE, LEASE, AND TRANSFERS, AND (7) APPROVE ANY INCREMENT OR ADDITIONS IN CAPITAL DEBT. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION PROVIDES A COPY OF THE COMPLETE FORM 990 TO THE BOARD MEMBERS AND REVIEWS THE FORM 990 IN AN OFFICIAL MEETING WITH ITS FINANCE COMMITTEE BEFORE SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C NO INDIVIDUAL ON THE BOARD SHOULD HAVE ANY UNDISCLOSED CONFLICT OF INTEREST WITH THE ORGANIZATION. ACTIVE MONITORING IS CONDUCTED BY THE COMPLIANCE OFFICER, WHICH REPORTS WHEN ANY CONFLICT OF INTEREST IS DETECTED FOR PROPER RESOLUTION BY THE COMPLIANCE OFFICER, ADMINISTRATOR OR BOARD OF DIRECTORS. FURTHERMORE, MONITORING IS ALSO DONE VIA YEARLY ATTESTATION BY BOARD AND CONFLICTS WOULD BE DEALT WITH AT THAT LEVEL. IF AN INDIVIDUAL ON THE BOARD HAS A CONFLICT OF INTEREST, THAT INDIVIDUAL MUST ABSTAIN FROM VOTING ON ANY MATTERS RELATED TO THAT CONFLICT. IN ANY MATTER THAT WOULD RESULT IN A CONFLICT OF INTEREST, SUCH INDIVIDUALS ARE NOT PERMITTED TO FACTOR IN THE DECISION-MAKING PROCESS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD CHAIRMAN ANNUALLY REVIEWS THE COMPENSATION OF THE ADMINISTRATOR BASED ON HIS/HER PERFORMANCE AND THROUGH THE USE OF A MASS SENIOR CARES COMPENSATION SURVEY. THE MEMBERS OF THE BOARD REVIEW, DOCUMENT, AND APPROVE THE ANNUAL BUDGET. FORM 990, PART VI, SECTION C, LINE 19 AN INTERESTED PARTY CAN MAKE A DIRECT REQUEST TO SEE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS OF THE ORGANIZATION. DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION 314 OSGOOD AVE SUITE 408 NEW BRITAN CT 06053 RELIGIOUS COMMUNITY CT 501(C)(3) LINE 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION E 2875000 FMV