2020-11-09T09:27:12-06:00 2019-12-31 061009205 BLUM SHAPIRO & COMPANY PC TWO INTERNATIONAL PLACE 22ND FLOOR BOSTON MA 02110 990 2019-01-01 050258990 THE SAINT CLARE HOME SAIN 4018493204 309 SPRING STREET NEWPORT RI 02840 MARY BETH DAIGNEAULT ADMINISTRATOR/ASSISTANT TREASURER 4018493204 2020-11-05 1 LAURA J KENNEY P00202198 6177170831 64.251.63.131 2020-11-05 11:48:48 ES P C2A8F68C24BA4106533A6CD8C72FD917E7C6626D 212D4AA7D86991E97AAA9C7923B382683810470F 2019 2021-01-29 14:40:06Z MARY BETH DAIGNEAULT 309 SPRING STREET NEWPORT RI 02840 9152280 0 X STCLARENEWPORT.COM X 1909 RI TO IMPROVE THE QUALITY OF LIFE FOR OUR FAMILY AND COMMUNITY THROUGH CARE AND SERVICE. 3 0 188 1 0 0 263905 642545 7503233 8411775 2048 1186 45075 96774 7814261 9152280 0 0 0 0 5299434 5612011 0 0 116749 3916655 4456460 9216089 10068471 -1401828 -916191 20474806 20067780 20442664 20974996 32142 -907216 TO IMPROVE THE QUALITY OF LIFE FOR OUR FAMILY AND COMMUNITY THROUGH CARE AND SERVICE. 0 0 6450285 5777664 SKILLED NURSING FACILITY:ST CLARE SKILLED NURSING FACILITY WORKS TO MEET THE CHANGING NEEDS OF TODAY'S ELDERLY BY PROVIDING MORE THAN A HOME TO MEMBERS OF NEWPORT AND THE SURROUNDING COMMUNITIES. EACH RESIDENT RECEIVES THE SHORT-TERM REHABILITATION OR LONG-TERM CARE THAT BEST SUITS HIS OR HER NEEDS AND COMFORTS. THE FACILITY ACCOMMODATES 60 RESIDENTS.LONG-TERM NURSING CARE SERVICES PROVIDED TOTAL PATIENT BED DAYS OF 20,095. INCLUDED IN THIS AMOUNT ARE MEDICAID PATIENT DAYS TOTALING 13,235 AND MEDICARE PATIENT DAYS TOTALING 1,012. 2382609 2563138 ASSISTED LIVING FACILITY:ST CLARE ASSISTED LIVING FACILITY IS AN ASSISTED LIVING COMMUNITY WHERE SENIORS FIND THE SERVICES AND SECURITY THEY NEED WITHOUT GIVING UP THE TRADITIONS AND INDEPENDENCE THEY CHERISH. THE ASSISTED LIVING CREATES AN ENVIRONMENT WHERE RESIDENTS MAINTAIN THEIR DIGNITY, PRIDE AND INDIVIDUALITY NO MATTER WHAT LEVEL OF ASSISTANCE THEY MAY REQUIRE. THE MEMORY-IMPAIRMENT PROGRAM SERVES INDIVIDUALS WITH ALZHEIMER'S DISEASE AND RELATED DEMENTIAS. THE ASSISTED LIVING OFFERS 40 BEAUTIFULLY DESIGNED STUDIOS, ONE AND TWO-BEDROOM APARTMENTS. 286588 70973 ADULT DAY HEALTH:ST CLARE ADULT DAY HEALTH PROGRAM OFFERS ADULTS WITH DISABILITIES AND DEMENTIA THE CARE, COMPANIONSHIP AND SUPPORT SERVICES THEY NEED IN A SETTING DESIGNED FOR THEM. 9119482 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 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 1 1 0 0 1 1 0 1 188 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 1 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 1 1 0 0 X MARY BETH DAIGNEAULT 4018493204 309 SPRING STREET NEWPORT RI 02840 LEILANY PALAYA REGISTERED NURSE 57.00 X 144685 0 8042 MARY BETH DAIGNEAULT ADMINISTRATOR/ASST TREASUR 40.00 X 96003 0 31765 VALERIE JASMINE AROWOKOKO C.N.A. 93.00 X 100852 0 11683 MSGR ALBERT A KENNEY VICE PRESIDENT 1.00 39.00 X X 0 43849 30799 BISHOP THOMAS J TOBIN PRESIDENT/TREASURER 1.00 39.00 X X 0 42828 30799 REV TIMOTHY D REILLY SECRETARY 1.00 39.00 X X 0 36168 19999 341540 122845 133087 2 0 1 0 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 MAINTENANCE, HOUSEKEEPING & LAUNDRY SERV 490566 CARELINK 1 VIRGINIA AVENUE PROVIDENCE RI 02905 THERAPY SERVICES 452912 STRATEGIC CARE SOLUTIONS 92 MONTVALE AVENUE SUITE 2300 STONEHAM MA 02180 FINANCIAL AND OPERATIONAL CONSULTING 220625 3 642545 642545 NURSING HOME 623000 8411775 8411775 8411775 1186 1186 MISCELLANEOUS INCOME 623000 89074 89074 DISTRIB. FROM CUTTING TRUST 623000 7700 7700 96774 9152280 8411775 0 97960 127768 127768 4532695 4208847 229646 94202 217110 207929 4557 4624 346819 333125 6351 7343 387619 351371 28378 7870 1076 1076 70300 70300 376299 366498 9801 13660 13660 30732 30732 17400 17400 451142 343316 107826 9987 9987 3931 3931 743657 734917 8740 503294 497745 5549 247103 234554 9839 2710 SUPPLIES 774996 774996 PURCHASED SERVICES 596743 488731 108012 PROVIDER TAX 288154 288154 BAD DEBTS 266162 266162 61824 13150 48674 10068471 9119482 832240 116749 351509 172583 5266 5269 78837 44454 1194209 1072867 2930 82334 20078682 3333469 17083352 16745213 36019 52416 1722684 1892644 20474806 20067780 3576120 4244386 85349 40916 15016285 14874784 1764910 1814910 20442664 20974996 X -1867667 -2867467 1899809 1960251 32142 -907216 20474806 20067780 X -916191 16397 -209524 169960 X X 1 X 0 0 0 X 159462 784931 91917 263905 642545 1942760 4250965 4373093 5937091 7503233 8411775 30476157 4410427 5158024 6029008 7767138 9054320 32418917 0 0 0 32418917 634 255 318 991 1186 3384 634 255 318 991 1186 3384 42719 7140 520831 45075 96774 712539 4453780 5165419 6550157 7813204 9152280 33134840 0.97840 0.97790 0.00010 0.00020 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2015 AMOUNT: $ 42,719. 2016 AMOUNT: $ 7,140. 2017 AMOUNT: $ 95,831. 2018 AMOUNT: $ 45,075. 2019 AMOUNT: $ 89,074. CUTTING TRUST - 2017 AMOUNT: $ 425,000. 2019 AMOUNT: $ 7,700. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 214009 214009 18833198 2428088 16405110 1024975 905381 119594 6500 6500 16745213 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 1892644 1892644 LOANS PAYABLE 1814910 1814910 X 9338637 16397 169960 186357 9152280 0 9152280 10068471 0 10068471 0 10068471 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES, IF APPLICABLE, AS A COMPONENT OF INTEREST EXPENSE. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN ON BENEFICIAL INTEREST IN PERPETUAL TRUST 0 0 0 0 0 0 0 0 0 LEILANY PALAYA REGISTERED NURSE 144685 0 0 0 0 0 8042 0 0 0 152727 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 BISHOP THOMAS J. TOBIN, PRESIDENT/TREASURER, MSGR. ALBERT A. KENNEY, VICE PRESIDENT, AND REV. TIMOTHY D. REILLY, SECRETARY, ALL ARE PART OF THE ROMAN CATHOLIC DIOCESE OF PROVIDENCE. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS REVIEWED BY MARY BETH DAIGNEAULT, ADMINISTRATOR/ASSISTANT TREASURER. MARY BETH DAIGNEAULT REVIEWS AND SIGNS THE FORM 990 BEFORE IT IS FILED. A COPY OF THE FORM 990 IS PROVIDED TO THE CONTROLLER AT THE DIOCESE OF PROVIDENCE. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS USED FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT ENTAILS COMPARING WHAT IS PAID FOR THE SAME POSITION IN SIMILAR ENTITIES. COMPENSATION IS EVALUATED BY JOHN BARRY, AN INDEPENDENT MEMBER TO THE BOARD OF DIRECTORS, AND THE DECISION IS DOCUMENTED. MR. BARRY USES A STANDARD APPROACH AND FORM TO PERFORM THE EVALUATION FOR THE ADMINISTRATOR AND RELATED ORGANIZATIONS OF THE DIOCESE OF PROVIDENCE. MR. BARRY SUBMITS THE RESULTS OF HIS ANALYSES WITH A RECOMMENDATION TO THE BOARD OF DIRECTORS FOR APPROVAL. THERE IS NO MERIT INCREASE ASSOCIATED WITH THE COMPENSATION EVALUATION. 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: INCREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 169,960. FORM 990, PART XII, LINE 2C OVERSIGHT-FINANCIAL STATEMENTS REVIEW & SELECTION OF INDEPENDENT ACCOUNTANT: MARY BETH DAIGNEAULT, ADMINISTRATOR/ASSISTANT TREASURER, OVERSEES REVIEW OF THE FINANCIAL STATEMENTS AND SUBMITS REVIEWED COPY TO THE CORPORATE BOARD DURING THE ANNUAL MEETING. THE ADVISORY BOARD OVERSEES SELECTION OF AN INDEPENDENT ACCOUNTANT. DIOCESAN SERVICE CORPORATION 1 CATHEDRAL SQUARE PROVIDENCE RI 02903 050493814 ROMAN CATHOLIC ORGANIZATION RI 501(C)(3) LINE 1 THE SAINT CLARE HOME 1 DIOCESAN ADMINISTRATION CORPORATION 1 CATHEDRAL SQUARE PROVIDENCE RI 02903 050508345 ROMAN CATHOLIC ORGANIZATION RI 501(C)(3) LINE 1 THE SAINT CLARE HOME 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 DIOCESAN SERVICE CORPORATION E 2475021 CASH