2020-06-02T08:29:13-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2019-01-01 042066524 SANCTA MARIA HOSPITAL INC SANC 6178682200 799 CONCORD AVENUE CAMBRIDGE MA 02138 THOMAS GOMES ADMINISTRATOR 6178682200 2020-06-01 1 JOHN NORMAN P01506766 7049985200 2020-05-28 67.137.57.251 2020-06-01 14:27:00 ED P 9A5FD5A28186C0237ADF311F402C5D3C3A194CA8 D5200A471BA06D6F05ED3C2FDF6728AC96601B45 2019 2021-01-29 14:40:06Z SANCTA MARIA NURSING FACILITY MOTHER MARY JENNIFER DM 799 CONCORD AVENUE CAMBRIDGE MA 02138 17411364 0 X HTTP://SANCTAMARIA.ORG X 1948 MA THE PROVISION OF INPATIENT SKILLED NURSING SERVICES TO INDIVIDUALS REQUIRING SUCH CARE DUE TO PHYSICAL CONDITION OR INFIRMITY. 10 9 305 20 1364 0 12868 2775 12427554 15766811 479600 89915 599081 729329 13519103 16588830 0 0 0 0 9429851 11147777 0 0 0 5635921 4991298 15065772 16139075 -1546669 449755 9338347 10296780 5277177 5488793 4061170 4807987 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 14346220 15768854 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 95.14%. 14346220 1 0 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 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 305 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 MA X THOMAS GOMES 6178682200 799 CONCORD AVENUE CAMBRIDGE MA 02138 JOSEPH BARRELL JR CHAIR 1.00 X X 0 0 0 JOSEPH CONNARTON VICE CHAIR 1.00 X X 0 0 0 MOTHER MARY JENNIFER DM PRESIDENT 30.00 X X 0 0 0 SHEILA HICKEY CLERK 1.00 X X 0 0 0 NORMAN MCIVER DIRECTOR 1.00 X 0 0 0 JAMES F FERREIRA DIRECTOR 1.00 X 0 0 0 SISTER MARY THERESA TINANA DM DIRECTOR 32.00 X 49372 0 0 MICHAEL GULESERIAN DIRECTOR 1.00 X 0 0 0 JOSEPH R NOLAN JR DIRECTOR 1.00 X 0 0 0 THOMAS GOMES ADMINISTRATOR 40.00 X 180032 0 16407 ADAM CHAMBERS DIRECTOR OF REHAB 40.00 X 140518 0 0 GEORGIA WAYNE DIRECTOR OF NURSING 40.00 X 140341 0 0 TERRI ROCK DIRECTOR OF CLINICAL REIMB 40.00 X 130807 0 16 JEAN CITARELLA HUMAN RESOURCES 40.00 X 127680 0 16428 KELLY HARDY PHYS. THERAPIST/ASST. DIRECTOR REHAB 40.00 X 116574 0 0 885324 0 32851 8 0 1 0 ADVOCATE HEALTHCARE MANAGEMENT 111 ORIENT AVE EAST BOSTON MA 02128 MANAGEMENT SERVICES 415437 PHARMERICA PO BOX 409251 ATLANTA GA 30384 PHARMACY 323352 US FOOD SERVICE INC PO BOX 3155 BOSTON MA 02241 FOOD PRODUCTS 229991 MEDLINE PO BOX 121080 DALLAS TX 75312 MEDICAL SUPPLIES 223566 PREFERRED PHARMACY SOLUTIONS 35 AVCO RD HAVERHILL MA 01835 PHARMACY 167015 7 2775 2775 NET PATIENT SERVICE REVENUE 623000 15766811 15766811 15766811 52861 52861 1183371 456085 727286 727286 1364 725922 403503 366449 37054 37054 37054 OTHER INCOME 623000 2043 2043 2043 16588830 15768854 1364 815837 245811 245811 9116978 8805317 311661 1067852 989298 78554 717136 674489 42647 14322 14322 34098 34098 19969 19969 903026 468920 434106 23094 23094 189833 21909 167924 76057 76057 579610 550630 28980 3475 3475 116788 116788 386155 366847 19308 95129 41996 53133 PROGRAM EXPENSES 1251135 1249579 1556 USER FEE 847274 847274 OTHER EXPENSES 196849 128018 68831 BAD DEBT EXPENSES 166500 0 166500 87984 85155 2829 16139075 14346220 1792855 0 685593 1463449 82663 34747 2351019 2597556 7323 13766 107530 86247 14927744 11148611 4156383 3779133 1947836 2321882 9338347 10296780 1848406 1606391 3428771 3882402 5277177 5488793 X 4013475 4773240 47695 34747 4061170 4807987 9338347 10296780 449755 297062 0 X 0 1 X 1 0 X 22670 29859 574771 12868 2775 642943 11088472 11645161 11749177 12479542 15768854 62731206 11111142 11675020 12323948 12492410 15771629 63374149 0 0 0 63374149 881291 990766 992959 1063956 1236232 5165204 881291 990766 992959 1063956 1236232 5165204 11992433 12665786 13316907 13556366 17007861 68539353 0.92460 0.92680 0.07540 0.07320 X 47695 12948 34747 54389 5262 11956 47695 55888 4361 5860 54389 35592 25279 4983 55888 35081 511 35592 0.68000 0.32000 0 0 322500 322500 9610582 8148692 1461890 4556831 2656765 1900066 437831 343154 94677 3779133 ASSETS RETIREMENT AGREEMENT 619467 DUE TO RELATED PARTY 2852238 PREPAID TENANT RENT 44563 SECURITY DEPOSITS LIABILITY 33503 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 332631 3882402 X 17341977 297062 297062 17044915 -456085 -456085 16588830 16595160 456085 456085 16139075 0 16139075 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, 2019 AND 2018. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -456,085. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 456,085. X X 0 0 0 0 0 0 0 0 0 THOMAS GOMES ADMINISTRATOR 180032 0 0 0 0 0 0 0 16407 0 196439 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. FORM 990, PART VI, SECTION A, LINE 1 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. 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 ORGANIZATION AS LONG AS SHE SERVES AS THE SUPERIOR GENERAL OR A MEMBER OF THE GENERAL COUNCIL OF THE CONGREGATION OF SANCTA MARIA. 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. FORM 990, PART VI, SECTION A, LINE 7B BOARD MEMBERS EACH HAS SAME VOTING RIGHTS AND REQUIRE VOTING APPROVAL OF ALL FORMAL BOARD DECISIONS. 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 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. THE FORM 990 CAN ALSO BE FOUND ON THE MASSACHUSETTS ATTORNEY GENERAL'S PUBLIC CHARITIES WEBSITE. DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION 314 OSGOOD AVE SUITE 408 NEW BRITAN CT 06053 RELIGIOUS COMMUNITY CT 501(C)(3) LINE 1 YES 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0