2020-06-22T15:15:24-05:00 2019-06-30 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2018-07-01 042496563 ASCENTRIA CARE ALLIANCE INC ASCE 7742433900 14 EAST WORCESTER STREET NO 300 WORCESTER MA 01604 ANGELA BOVILL PRESIDENT & CEO 7742433900 2020-05-26 1 LAUREN BALLARD CPA P01451787 6179848100 2020-05-21 67.137.57.251 2020-05-26 14:05:26 ED P 70545651873736B39CE34854CE8383AE7E7A4B44 3EEEC8B090C07D7EECF61F1A8A191FC1967D2E7A 2018 2020-11-06 18:47:13Z ANGELA BOVILL 14 EAST WORCESTER STREET NO 300 WORCESTER MA 01604 6169889 0 6011 X WWW.ASCENTRIA.ORG X 1872 MA WE ARE CALLED TO STRENGTHEN COMMUNITIES BY EMPOWERING PEOPLE TO RESPOND TO LIFE'S CHALLENGES. 11 10 65 15 0 0 144459 333650 7301793 5776159 14051 56028 1609 4052 7461912 6169889 0 0 0 0 4948339 4692968 0 0 0 3415726 2910178 8364065 7603146 -902153 -1433257 8725263 10352798 3788365 3627646 4936898 6725152 WE ARE CALLED TO STRENGTHEN COMMUNITIES BY EMPOWERING PEOPLE TO RESPOND TO LIFE'S CHALLENGES. 0 0 6865320 0 5776159 THE ORGANIZATION PROVIDES BOARD DEVELOPMENT, PUBLIC RELATIONS, CHURCH RELATIONS, HUMAN RESOURCE MANAGEMENT, WORKER'S COMPENSATION AND UNEMPLOYMENT CLAIMS MANAGEMENT, GROUP PURCHASING, DEBT MANAGEMENT, ACCOUNTING, COMPLIANCE, AND BENEFITS MANAGEMENT TO ITS RELATED ORGANIZATIONS. 6865320 1 1 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 1 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 1 1 0 0 1 17 0 65 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X ANGELA BOVILL 7742433900 14 EAST WORCESTER STREET SUITE 300 WORCESTER MA 01604 WILLIAM MAYO CHAIR 0.30 4.20 X X 0 0 0 MICHAEL BALINKSKAS VICE CHAIR 0.30 4.20 X X 0 0 0 KAREN GAYLIN SECRETARY 0.30 4.20 X X 0 0 0 GARTH GREIMANN FINANCIAL SECRETARY 0.30 4.20 X X 0 0 0 THE REV ROSS GOODMAN DIRECTOR 0.30 4.20 X 0 0 0 BARBARA RUHE DIRECTOR 0.30 4.20 X 0 0 0 THE REV LAURA EVERETT DIRECTOR 0.30 4.20 X 0 0 0 SCOTT HAMILTON DIRECTOR 0.30 4.20 X 0 0 0 PETER SCHMIDT DIRECTOR 0.30 4.20 X 0 0 0 KIM SALMON DIRECTOR 0.30 4.20 X 0 0 0 JEFF KINNEY DIRECTOR UNTIL 7/14/2019 0.30 4.20 X 0 0 0 ANGELA BOVILL PRESIDENT/CEO 2.40 37.60 X X 276027 0 38751 JAMES COYLE EXECUTIVE VP/CFO 2.40 37.60 X 195982 0 17537 JEANETTE WADE EXECUTIVE VP/CFO 2.40 37.60 X 0 0 0 TIM JOHNSTONE EXECUTIVE VP/COO 2.40 37.60 X 179582 0 18311 TARA BROWNE CLERK/EXECUTIVE ASSISTANT 2.40 37.60 X 21752 0 4182 ELENA GARCIAS-KETNOUVONG CLERK/EXECUTIVE ASSISTANT 2.40 37.60 X 42145 0 9753 DANA RAMISH EXECUTIVE VP, RESIDENTIAL SERVICES 2.40 37.60 X 184465 0 22732 NICK RUSSO TREASURER 2.40 37.60 X 127895 0 5450 MICHAEL ALDEN VP AND GENERAL MANAGER OF SOCIAL ENTERPRISE 2.40 37.60 X 112371 0 35384 ANN DANCY VP FOR NH OPERATIONS 2.40 37.60 X 105837 0 24685 JODIE JUSTOFIN VP FOR STRATEGIC MARKETING & 2.40 37.60 X 148457 0 4813 NANCY MEEGAN VP OF HUMAN RESOURCES 2.40 37.60 X 154011 0 11365 PATRICK WILLIAMS VP OF QUALITY AND COMPLIANCE 2.40 37.60 X 130221 0 16301 1678745 0 209264 10 0 1 0 0 333650 333650 PROGRAM SERVICE REVENU 561000 5776159 5776159 5776159 56028 56028 MISCELLANEOUS INCOME 561000 4052 4052 4052 6169889 5776159 0 60080 1163444 1030963 132481 2955565 2619015 336550 251226 225696 25530 322733 288988 33745 38015 22700 15315 43750 43750 76525 76525 755334 689480 65854 84278 42941 41337 274183 255121 19062 302821 280066 22755 894263 894263 104143 94134 10009 24689 23265 1424 95015 95015 76859 76859 56625 50292 6333 83678 56247 27431 7603146 6865320 737826 0 2785989 2563704 3503064 7096 7096 2982 610000 519844 382869 2536691 2365593 228434 171098 1414572 1415852 9542 9542 586082 4860295 8725263 10352798 822752 696179 383 3435 2550824 2517169 414406 410863 3788365 3627646 X -605983 1145265 4609001 4646007 933880 933880 4936898 6725152 8725263 10352798 X -1433257 -18531 3240042 X 0 1 X 1 0 X 847624 244218 430022 144460 333650 1999974 5907534 6438688 6885339 7301793 5776159 32309513 6755158 6682906 7315361 7446253 6109809 34309487 13596 14940 29883 58419 16937 16937 16937 13596 14940 29883 75356 34234131 61955 66925 70279 14051 56028 269238 61955 66925 70279 14051 56028 269238 25412 86479 10060 1606 4052 127609 6842525 6836310 7395700 7461910 6169889 34706334 0.98640 0.99010 0.00780 0.00640 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2014 AMOUNT: $ 25,412. 2015 AMOUNT: $ 86,479. 2016 AMOUNT: $ 10,060. 2017 AMOUNT: $ 1,606. 2018 AMOUNT: $ 4,052. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 933880 933880 906134 27746 906134 664415 200000 41719 906134 710815 -46400 664415 733709 -22894 710815 0.00000 1.00000 0.00000 1 0 1 1 303344 213430 89914 824893 768536 56357 1408453 1383627 24826 171098 ELCA ENDOWMENT FUND 721966 C INVESTMENT HELD IN TRUST 693886 F 1415852 DUE FROM RELATED PARTIES 4474842 PENSION ASSET 293485 SECURITY DEPOSITS 30893 BENEFICIAL INTEREST IN LIFE INSURAN 61075 4860295 TRAVELERS PENSION PLAN 410863 410863 PART V, LINE 4: IN ACCORDANCE WITH THE DONOR REQUIREMENTS THE ENDOWMENT FUNDS ARE HELD IN PERPETUITY UNTIL APPROPRIATED FOR EXPENDITURE TO BE USED FOR GENERAL PURPOSES OF THE ORGANIZATION. X X X 0 0 0 0 0 0 0 0 0 ANGELA BOVILL PRESIDENT/CEO 276027 0 0 0 0 0 12661 0 26090 0 314778 0 0 0 JAMES COYLE EXECUTIVE VP/CFO 161367 0 0 0 34615 0 15192 0 2345 0 213519 0 0 0 TIM JOHNSTONE EXECUTIVE VP/COO 179582 0 0 0 0 0 0 0 18311 0 197893 0 0 0 DANA RAMISH EXECUTIVE VP, RESIDENTIAL SERVICES 184465 0 0 0 0 0 16900 0 5832 0 207197 0 0 0 JODIE JUSTOFIN VP FOR STRATEGIC MARKETING & 148457 0 0 0 0 0 0 0 4813 0 153270 0 0 0 NANCY MEEGAN VP OF HUMAN RESOURCES 154011 0 0 0 0 0 0 0 11365 0 165376 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B FINANCIAL MANAGEMENT WILL REVIEW THE FORM 990 WHEN IT IS COMPLETED. ASCENTRIA CARE ALLIANCE, INC.'S (ACA) AUDIT COMMITTEE PROVIDES SECONDARY REVIEW AND APPROVAL PRIOR TO SUBMISSION TO THE IRS. THE COMPLETE FORM 990 IS POSTED TO THE BOARD INTRANET FOR REVIEW BY THE ACA FINANCE COMMITTEE AS WELL AS ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, OFFICER, EMPLOYEE, COMMITTEE MEMBER, OR VOLUNTEER OF LSSNE OR ITS SUBSIDIARIES, WHETHER BECAUSE OF HIS/HER EMPLOYMENT, BUSINESS INTERESTS, INVESTMENTS, OR OTHERWISE, WHO HAS INTERESTS THAT DO OR MAY, DIRECTLY OR INDIRECTLY, COMPETE WITH OR BE IN CONFLICT WITH THE INTERESTS OF LSSNE SHALL PROMPTLY DISCLOSE ALL MATERIAL FACTS OF SUCH CONFLICT OF INTEREST IN WRITING TO THE CHAIRPERSON OF THE BOARD OF DIRECTORS AND/OR TO THE PRESIDENT OF LSSNE. SUCH PERSON SHALL ALSO ANNOUNCE THE SAME AT ANY MEETING OR DISCUSSION IN WHICH HE/SHE IS A PARTICIPANT AND AT WHICH SUCH CONFLICT ARISES AND SHALL REFRAIN FROM ACTING THEREON. AFTER DISCLOSURE OF A FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER LSSNE CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN LSSNE'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15A THE CEO OF ASCENTRIA CARE ALLIANCE (ACA) IS THE PRINCIPAL REPRESENTATIVE OF ASCENTRIA CARE ALLIANCE, INCLUDING ITS AFFILIATES AND SUBSIDIARIES, AND IS THE PERSON RESPONSIBLE FOR THE EFFICIENT OPERATION OF THE ACA, ITS AFFILIATES, AND ITS SUBSIDIARIES. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF ACA ANNUALLY EVALUATES THE CEO ON HIS/HER PERFORMANCE. THE CHAIR OF ACA'S BOARD OF DIRECTORS, AN UNCOMPENSATED VOLUNTEER, IS THE CHAIR OF THE EXECUTIVE COMMITTEE AND IS INDEPENDENT WITHOUT UNDUE INFLUENCE FROM THE CEO. THE EXECUTIVE COMMITTEE WILL OBTAIN RESEARCH TO MAKE A RECOMMENDATION FOR THE COMPENSATION OF THE CEO. A REVIEW OF COMPARABILITY DATA MAY INCLUDE THE FOLLOWING: COMPENSATION STUDIES BY INDEPENDENT SOURCES, WRITTEN JOB OFFERS FOR POSITIONS AT SIMILAR ORGANIZATIONS, DOCUMENTED PHONE CALLS ABOUT SIMILAR CEO POSITIONS, AND INFORMATION OBTAINED FROM THE IRS FORM 990 FILINGS OF SIMILAR ORGANIZATIONS. THE EXECUTIVE COMMITTEE WILL DOCUMENT ITS DECISIONS IN THE MINUTES OF THE MEETING. THE DOCUMENTATION OF THE CEO'S COMPENSATION INCLUDES: A DISCUSSION OF THE CEO'S RESPONSIBILITIES; ANNUAL PERFORMANCE REVIEW; DESCRIPTION OF THE COMPENSATION, BENEFITS, AND APPROVAL DATE; LIST OF COMMITTEE MEMBERS PRESENT DURING THE DISCUSSION; ACTIONS TAKEN WITH RESPECT TO ANY CONFLICTS OF INTEREST BY ANY MEMBER WITH RESPECT TO THE DECISION ON THE COMPENSATION; AND A RECORD OF THE RESULT OF THE COMPENSATION VOTE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER OF EQUITY 3,240,042. RELATED ORGANIZATIONS FILE UNDER GROUP EXEMPTION 6011 - DISCLOSURE NOT REQ MA 1 0 0 0 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 ASCENTRIA COMMUNITY SERVICESINC R 80000 EQUITY TRANSFER ASCENTRIA COMMUNITY SERVICESINC M 196019 MANAGEMENT FEE ASCENTRIA COMMUNITY SERVICESINC J 454395 RENT ASCENTRIA COMMUNITY SERVICESINC P 112719 REIMBURSED EXPENSES ASCENTRIA COMMUNITY SERVICESINC Q 136647 REIMBURSED EXPENSES ASCENTRIA COMMUNITY CARE INC L 965389 MANAGEMENT FEE EMANUEL DEVELOPMENT CORPORATION S 102750 EQUITY TRANSFER EMANUEL DEVELOPMENT CORPORATION P 2840354 REIMBURSED EXPENSES GOOD NEWS GARAGE - LSS INC L 67909 MANAGEMENT FEE GOOD NEWS GARAGE - LSS INC S 117671 EQUITY TRANSFER LUTHER RIDGE AT MIDDLETOWN INC R 161000 EQUITY TRANSFER LUTHERAN HOUSING CORPORATION BROCKTON P 50243 REIMBURSED EXPENSES