LAFAYETTE REHABILITATION AND SKILLED: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: LAFAYETTE REHABILITATION AND SKILLED (EIN 20-8745166)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-14
IRS object ID: 202233189349313943
Schema version: 2021v4.2
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-14T15:25:34-06:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4 BATTERYMARCH PARK SUITE 100	AddressLine1Txt
City	QUINCY	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02169	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	208745166	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LAFAYETTE REHABILITATION AND SKILLED	BusinessNameLine1Txt
Business Name Line2	NURSING FACILITY INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	LAFA	BusinessNameControlTxt
Phone	9784583388	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	25 LAFAYETTE STREET	AddressLine1Txt
City	MARBLEHEAD	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01945	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	RAYMOND DENNEHY	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	9784583388	PhoneNum
Signature	2022-11-10	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	RAYMOND	PersonFirstNm
Person Last	DENNEHY	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DANIELLE NIHILL	PreparerPersonNm
PTIN	P01350943	PTIN
Phone	7819821001	PhoneNum
Preparation	2022-11-10	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	RAYMOND DENNEHY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	25 LAFAYETTE STREET	AddressLine1Txt
City	MARBLEHEAD	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01945	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$6,503,946	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.THELAFAYETTE.NET	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2007	FormationYr
Legal Domicile State	MA	LegalDomicileStateCd
Activity Or Mission	IT IS THE MISSION OF LAFAYETTE REHABILITATION AND SKILLED NURSINIG FACILITY, INC. TO PROVIDE ELDERS WITH DYNAMIC, MEANINGFUL AND SUPPORTIVE LIVING ENVIRONMENTS, INTEGRATING QUALITY CARE, EDUCATION AND RESEARCH, RESPECT FOR INDIVIDUALITY AND THE HUMAN SPIRIT, AND INNOVATIVE APPROACHES TO MEET THE EVER CHANGING NEEDS OF THE COMMUNITIES WE SERVE.	ActivityOrMissionDesc
Voting Members Governing Body	6	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	115	TotalEmployeeCnt
Total Volunteers	6	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$816,680	PYContributionsGrantsAmt
CY Contributions Grants	$183,243	CYContributionsGrantsAmt
PY Program Service Revenue	$4,862,714	PYProgramServiceRevenueAmt
CY Program Service Revenue	$5,576,363	CYProgramServiceRevenueAmt
PY Investment Income	$17,167	PYInvestmentIncomeAmt
CY Investment Income	$10,807	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$733,533	CYOtherRevenueAmt
PY Total Revenue	$5,696,561	PYTotalRevenueAmt
CY Total Revenue	$6,503,946	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$4,034,473	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$3,943,575	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$2,439,605	PYOtherExpensesAmt
CY Other Expenses	$2,615,640	CYOtherExpensesAmt
PY Total Expenses	$6,474,078	PYTotalExpensesAmt
CY Total Expenses	$6,559,215	CYTotalExpensesAmt
PY Revenues Less Expenses	-$777,517	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$55,269	CYRevenuesLessExpensesAmt
Total Assets BOY	$10,321,991	TotalAssetsBOYAmt
Total Assets EOY	$9,818,426	TotalAssetsEOYAmt
Total Liabilities BOY	$10,408,783	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$9,971,164	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$86,792	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$152,738	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	IT IS THE MISSION OF LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY, INC. TO PROVIDE ELDERS WITH DYNAMIC, MEANINGFUL AND SUPPORTIVE LIVING ENVIRONMENTS, INTEGRATING QUALITY CARE, EDUCATION AND RESEARCH, RESPECT FOR INDIVIDUALITY AND THE HUMAN SPIRIT, AND INNOVATIVE APPROACHES TO MEET THE EVER CHANGING NEEDS OF THE COMMUNITIES WE SERVE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$5,880,122	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$6,309,896	RevenueAmt
Desc	LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY, INC. IS A 65-BED, JCAHO ACCREDITED AND MEDICARE CERTIFIED HEALTHCARE FACILITY OFFERING TRADITIONAL SKILLED NURSING CARE, SHORT-TERM REHABILITATION, PLUS A VARIETY OF SPECIALIZED TREATMENT PROGRAMS.	Desc
Total Program Service Expenses	$5,880,122	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (1)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	9	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	115	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	6	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	0	ConflictOfInterestPolicyInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MICHAEL MOSIER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8607503900	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	135 SOUTH ROAD	AddressLine1Txt
City	FARMINGTON	CityNm
State Abbreviation	CT	StateAbbreviationCd
ZIP	06032	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd
GEORGE BARBUZZI
ADMINISTRATOR	40.00	Yes (X)	$121,624	$0	$0
TALBOT FALL
THERAPY DIRECTOR	40.00	Yes (X)	$107,224	$0	$12,058
DEBORAH GRAF
RN	40.00	Yes (X)	$106,833	$0	$0
KATHY DELISLE
LPN	40.00	Yes (X)	$102,151	$0	$5,185
CATHERINE MICHAUED
ADNS	40.00	Yes (X)	$100,266	$0	$9,693
RAYMOND DENNEHY
PRESIDENT	1.00		$16,800	$43,200	$0	2.00	Yes (X)	Yes (X)
JOEL KIRCHICK
DIRECTOR	1.00		$0	$0	$0	2.00	Yes (X)	Yes (X)
GINA QUEIROS
MEMBER	1.00		$0	$0	$0	2.00	Yes (X)
MICHAEL MOORE
DIRECTOR	1.00		$0	$0	$0	2.00	Yes (X)
ROBERT GREER VANTUYL
MEMBER	1.00		$0	$0	$0	2.00	Yes (X)
JEFFREY WITHERELL
DIRECTOR	1.00		$0	$0	$0	2.00	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$554,898	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$43,200	TotReportableCompRltdOrgAmt
Total Other Compensation	$26,936	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	5	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
PERFORMANCE HEALTHCARE
47 RIVER STREET	WELLESLEY	MA	02481	HOUSEKEEPING/LAUNDRY CONTRACT SERVICES	$211,594
ATHENA HEALTH CARE SYSTEMS
35 AVCO ROAD	HAVERHILL	MA	01835	MANAGEMENT COMPANY	$165,341
NIXON PEABODY
53 STATE STREET	BOSTON	MA	02109	LEGAL SERVICES	$157,091

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	3	CntrctRcvdGreaterThan100KCnt
Government Grants	$183,243	GovernmentGrantsAmt
Total Contributions	$183,243	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PROGRAM SERVICE REVENUE	Desc
Business	623000	BusinessCd
Total Revenue Column	$5,576,363	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,576,363	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$5,576,363	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,807	TotalRevenueColumnAmt
Exclusion	$10,807	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	PPP LOAN FORGIVENESS	Desc
Business	623000	BusinessCd
Total Revenue Column	$733,533	TotalRevenueColumnAmt
Related Or Exempt Func Income	$733,533	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$733,533	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,503,946	TotalRevenueColumnAmt
Related Or Exempt Func Income	$6,309,896	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$10,807	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$16,800	TotalAmt
Management And General	$16,800	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,421,525	TotalAmt
Program Services	$3,233,416	ProgramServicesAmt
Management And General	$188,109	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$234,020	TotalAmt
Program Services	$220,073	ProgramServicesAmt
Management And General	$13,947	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$271,230	TotalAmt
Program Services	$255,066	ProgramServicesAmt
Management And General	$16,164	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$167,244	TotalAmt
Management And General	$167,244	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$73,334	TotalAmt
Management And General	$73,334	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$19,024	TotalAmt
Management And General	$19,024	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$300,073	TotalAmt
Program Services	$249,089	ProgramServicesAmt
Management And General	$50,984	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$7,706	TotalAmt
Management And General	$7,706	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$133,873	TotalAmt
Program Services	$78,544	ProgramServicesAmt
Management And General	$55,329	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$36,047	TotalAmt
Management And General	$36,047	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$106,803	TotalAmt
Program Services	$106,803	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$524,243	TotalAmt
Program Services	$522,269	ProgramServicesAmt
Management And General	$1,974	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$221,894	TotalAmt
Program Services	$221,894	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$81,939	TotalAmt
Program Services	$81,939	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL EXPENSES	$426,535	$426,535
STATE ASSESSMENT	$339,486	$339,486
DIETARY EXPENSES	$145,008	$145,008
BAD DEBTS	$26,835		$26,835

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,596	TotalAmt
Management And General	$5,596	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$6,559,215	TotalAmt
Program Services	$5,880,122	ProgramServicesAmt
Management And General	$679,093	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$598	BOYAmt
EOY	$600	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,374,709	BOYAmt
EOY	$457,302	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$315,648	BOYAmt
EOY	$730,529	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$43,103	BOYAmt
EOY	$45,310	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$7,213,365	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,720,421	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$4,678,174	BOYAmt
EOY	$4,492,944	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,513,333	BOYAmt
EOY	$1,513,333	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,396,426	BOYAmt
EOY	$2,578,408	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,321,991	BOYAmt
EOY	$9,818,426	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,366,970	BOYAmt
EOY	$1,829,505	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$7,770,566	BOYAmt
EOY	$7,784,327	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$250,306	BOYAmt
EOY	$250,306	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$743,533	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$277,408	BOYAmt
EOY	$107,026	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,408,783	BOYAmt
EOY	$9,971,164	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$86,792	BOYAmt
EOY	-$152,738	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$86,792	BOYAmt
EOY	-$152,738	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$10,321,991	BOYAmt
EOY	$9,818,426	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$55,269	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$10,677	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	$816,680	CurrentTaxYearMinus1YearAmt
Current Tax Year	$183,243	CurrentTaxYearAmt
Total	$999,923	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$6,066,070	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$5,745,860	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,808,391	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,862,714	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,576,363	CurrentTaxYearAmt
Total	$28,059,398	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$6,066,070	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$5,745,860	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,808,391	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,679,394	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,759,606	CurrentTaxYearAmt
Total	$29,059,321	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$29,059,321	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$60,582	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$89,433	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$37,982	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$17,167	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,807	CurrentTaxYearAmt
Total	$215,971	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$60,582	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$89,433	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$37,982	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$17,167	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,807	CurrentTaxYearAmt
Total	$215,971	TotalAmt

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year	$733,533	CurrentTaxYearAmt
Total	$733,533	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$6,126,652	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$5,835,293	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,846,373	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,696,561	CurrentTaxYearMinus1YearAmt
Current Tax Year	$6,503,946	CurrentTaxYearAmt
Total	$30,008,825	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.96840	PublicSupportCY509Pct
Public Support PY509	0.99080	PublicSupportPY509Pct
Investment Income CY	0.00720	InvestmentIncomeCYPct
Investment Income PY	0.00920	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$584,000	OtherCostOrOtherBasisAmt
Book Value	$584,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,970,160	OtherCostOrOtherBasisAmt
Depreciation	$2,207,316	DepreciationAmt
Book Value	$3,762,844	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$604,636	OtherCostOrOtherBasisAmt
Depreciation	$458,536	DepreciationAmt
Book Value	$146,100	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$54,569	OtherCostOrOtherBasisAmt
Depreciation	$54,569	DepreciationAmt
Book Value	$0	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$4,492,944	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
ASSETS WHOSE USE IS LIMITED	$149,638
TRUSTEE FUNDS HELD UNDER BOND INDEN	$825,114
DUE FROM RELATED PARTY	$1,603,656

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$2,578,408	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	MEDICARE COST SETTLEMENT	Desc
Amt	$107,026	Amt

Field	Value	IRS element (for citing)
Total Liability	$107,026	TotalLiabilityAmt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
A	043431814	57585AAA8	2007-10-25	$652,313	PURCHASE FACILITIES	0	0	0
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
B	043431814	57585AAB6	2007-10-25	$2,648,860	PURCHASE FACILITIES	0	0	0
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
C	043431814	57585AAC4	2007-10-25	$4,854,593	PURCHASE FACILITIES	0	0	0
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007C
D	043431814		2007-10-25	$670,606	PURCHASE FACILITIES	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	In Reserve FundInReserveFundAmt
A	$65,961	$652,313	$391,271	$261,042	2007	Yes (1)	Yes (1)
B	$255,597	$2,648,860		$1,671,106	2007	Yes (1)	Yes (1)	$977,754
C	$502,950	$4,854,593		$4,854,593	2007	Yes (1)	Yes (1)
D		$670,606		$664,242	2007	Yes (1)	Yes (1)	$6,364

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	0	0	0	0	0	0
B	0	0	0	0	0	0	0
C	0	0	0	0	0	0	0
D	0	0	0	0	0	0	0

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	0	Yes (1)	0	0	0	0	0	0
B	0	Yes (1)	0	0	0	0	0	0
C	0	Yes (1)	0	0	0	0	0	0
D	0	Yes (1)	0	0	0	0	0	0

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	0
B	0
C	0
D	0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RAYMOND DENNEHY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	BOD - PRESIDENT	RelationshipDescriptionTxt
Transaction	$60,000	TransactionAmt
Transaction	BOD MEMBER IS OWNER OF HEALTH CARE VALUATION ADVISORS WHICH PROVIDES CONSULTING SERVICES TO THE ORGANIZATION.	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	PRESIDENT, RAYMOND DENNEHY AND DIRECTOR, JOEL KIRCHICK HAVE A BUSINESS RELATIONSHIP WITH ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 3	IN MAY 1, 2018 THE ORGANIZATION HAS ENTERED INTO A MANAGEMENT AGREEMENT, WITH ATHENA HEALTH CARE ASSOCIATES INC TO MANAGE THE OPERATIONS OF LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY, INC. ACTING THROUGH THE NURSING FACILITY EMPLOYEES, TO SUPERVISE, DIRECT AND CONTROL THE DAY-TO-DAY BUSINESS ACTIVITIES AND MANAGEMENT OF THE NURSING FACILITY. ATHENA HEALTH CARE ASSOCIATES INC PREPARE AND FILE, ALL COST REPORTS, PAYROLL TAX AND REAL ESTATE TAX FILINGS REQUIRED.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF THE ORGANIZATION IS A RELATED ORGANIZATION, ADVENTCARE, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE APPROVAL OF THE MEMBER, ADVENTCARE, INC., IS REQUIRED TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7B	THE FOLLOWING POWERS AND RESPONSIBILITIES ARE EXPRESSLY RESERVED TO ADVENTCARE, INC., THE MEMBER OF THE CORPORATION: (A) TO ELECT AND REMOVE DIRECTORS OF THE CORPORATION WITH OR WITHOUT CAUSE. ANY VACANCY OCCURRING AMONG THE DIRECTORS WILL BE FILLED BY ACTION OF THE MEMBER; (B) TO APPROVE THE ANNUAL OPERATING BUDGET OF THE CORPORATION; (C) TO CONDUCT FINANCIAL PLANNING, MONITOR AND ASSURE LONG-TERM FINANCIAL PERFORMANCE OF THE CORPORATION; (D) TO APPROVE THE PURCHASE, ACQUISITION, ASSIGNN1ENT, SALE, CONVEYANCE OR MORTGAGE OF REAL PROPERTY; (E) TO APPROVE THE INCURRENCE BY THE CORPORATION OF ANY INDEBTEDNESS FOR BORROWED MONEY; (F) TO APPROVE CONTRACTS FOR MANAGEMENT SERVICES; (G) TO APPROVE ANY CAPITAL EXPENDITURES NOT SHOWN ON THE ANNUAL BUDGET WHICH EXCEED $10,000 FOR ANY EXPENDITURE; (H) TO APPROVE ALL CORPORATE REORGANIZATIONS AND THE ESTABLISHMENT OF OR INVESTMENT IN JOINT VENTURES, CORPORATIONS, PARTNERSHIPS, OTHER ENTITIES OR AFFILIATIONS; (I) TO APPROVE INITIATION OR SETTLEMENT OF LITIGATION OR ADMINISTRATIVE PROCEEDINGS TO WHICH THE CORPORATION IS OR MAY BE A PARTY; (J) TO APPROVE ANY AMENDMENTS TO THE ARTICLES OF ORGANIZATION OR BY-LAWS OF THE CORPORATION; (K) TO ENSURE THAT THE CORPORATION PURSUES A MISSION, PHILOSOPHY AND GOALS CONSISTENT WITH THOSE OF THE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. A COMPLETE COPY OF THE FORM 990 TAX RETURN (INCLUDING ALL REQUIRED SCHEDULES) IS PROVIDED TO EACH PERSON WHO IS A VOTING MEMBER OF THE BOARD OF DIRECTORS AT THE TIME THE FORM 990 IS PROVIDED, EITHER IN PAPER OR ELECTRONIC FORM, BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE MSRB ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ADVENTCARE INC
476 VARNUM AVENUE	LOWELL	MA	01854	321012491	MANAGEMENT COMPANY	MA	501(C)(3)	LINE 10	N/A	0
FAIRHAVEN HEALTHCARE CENTER INC
476 VARNUM AVENUE	LOWELL	MA	01854	208745264	SKILLED NURSING FACILITY	MA	501(C)(3)	LINE 10		0	ADVENTCARE INC

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd