2020-08-12T10:53:31-05:00 2019-09-30 061009205 BLUM SHAPIRO & COMPANY PC ONE INTERNATIONAL PLACE 16TH FLOOR BOSTON MA 02110 990 2018-10-01 061241982 SAINT JOSEPH'S LIVING CENTER INC SAIN 8604561107 14 CLUB ROAD WINDHAM CT 062801000 GINNY PERSON ADMINISTRATOR 8604561107 2020-07-23 1 LAURA J KENNEY P00202198 6177170831 2020-07-23 64.251.63.131 2020-07-23 13:13:58 ED P 212D4AA7D86991E97AAA9C7923B382683810470F 3C3F3A9A6A2C4A7FAF67B2138946307825C80BAE 2018 2020-09-23 17:36:50Z GINNY PERSON 14 CLUB ROAD WINDHAM CT 06280 12107690 0 X WWW.SJLIVINGCENTER.ORG X 1987 CT LONG-TERM SKILLED NURSING CARE AND REHABILITATION SERVICES. 13 13 294 92 0 0 14475 29616 11910833 12062843 5284 1871 19616 8389 11950208 12102719 0 0 0 0 8578104 8977997 0 0 0 3537036 3497390 12115140 12475387 -164932 -372668 6938347 6456423 4560651 4557751 2377696 1898672 SAINT JOSEPH'S LIVING CENTER WAS ORGANIZED FOR THE PURPOSE OF PROVIDING LONG-TERM SKILLED NURSING CARE AND REHABILITATION SERVICES TO ITS RESIDENTS AND PATIENTS. 0 0 11284903 12062843 THE ORGANIZATION PROVIDED LONG-TERM SKILLED NURSING CARE AND REHABILITATION SERVICE TO 301 RESIDENTS AND PATIENTS DURING THE YEAR ENDED SEPTEMBER 30, 2019. 11284903 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 42 0 1 294 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X JOY GILL 8604561107 14 CLUB ROAD WINDHAM CT 06280 SR M JACINTA ANDERSON RN DIRECTOR 1.00 X 0 0 0 SR MICHELE BISAILLON DIRECTOR 1.00 X 0 0 0 MR BRUCE DOUGHERTY DDS SECRETARY 2.00 X X 0 0 0 MR DONALD DUBIEL DIRECTOR 2.00 X 0 0 0 MR JAMES DUFFY DIRECTOR 1.00 X 0 0 0 MS LORRAINE BROWN GALLUP TREASURER 2.00 X X 0 0 0 MS SUSAN LESTER HUMES DIRECTOR 1.00 X 0 0 0 MR TIMOTHY KILLEEN DIRECTOR 2.00 X 0 0 0 REV LAURENCE AM LAPOINTE CHAIRMAN 3.00 X X 0 0 0 MR JOHN F MALONE DIRECTOR 1.00 X 0 0 0 MR MICHAEL T PAULHUS VICE CHAIR 2.00 X X 0 0 0 DR EDWARD SAWICKI DIRECTOR 1.00 X 0 0 0 MS LINDA RIQUIER DIRECTOR 1.00 X 0 0 0 JOY M GILL CFO 40.00 X 124994 0 5026 GINNY PERSON ADMINISTRATOR (AS OF 6/17) 40.00 X 136542 0 27877 PAULA M HANEY DIRECTOR OF REHABILITATION 40.00 X 108343 0 14438 VALERIE OLIVER ASSISTANT DIRECTOR OF NURS 40.00 X 118999 0 30011 488878 0 77352 4 0 1 0 0 29616 2390 29616 MEDICARE/MEDICAID PAYMENTS 623000 9415762 9415762 PATIENT SERVICE FEES 623000 2647081 2647081 12062843 6842 6842 4971 -4971 -4971 -4971 MISCELLANEOUS REVENUE 900099 8389 8389 8389 12102719 12062843 0 10260 304623 170695 133928 6675019 6233453 441566 151715 139263 12452 1327853 1218871 108982 518787 476208 42579 5603 5603 37547 37547 110628 103858 6770 33465 30718 2747 129996 32288 97708 316592 310434 6158 11264 11264 100200 100200 536191 525761 10430 329133 313030 16103 PROVIDER TAX 737844 737844 MEDICAL SUPPLIES 513522 513522 FOOD 328808 328808 ALL OTHER 172214 17723 154491 134383 132427 1956 12475387 11284903 1190484 0 2637157 2576046 331491 313155 949301 1051563 62549 64510 80739 89427 14366593 12004871 2785890 2361722 91220 0 6938347 6456423 1799900 1875090 82751 13355 2678000 2597000 0 72306 4560651 4557751 X 2277781 1803253 99915 95419 2377696 1898672 6938347 6456423 X -372668 -106356 X 1 X 0 1 0 X 107210 108664 11767 14475 29616 271732 11222588 11253456 12188655 11910833 12062843 58638375 11329798 11362120 12200422 11925308 12092459 58910107 0 0 0 58910107 9868 8451 2868 5545 6842 33574 9868 8451 2868 5545 6842 33574 1920 15979 13086 19616 8389 58990 11341586 11386550 12216376 11950469 12107690 59002671 0.99840 0.99850 0.00060 0.00060 X SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: OTHER INCOME: 2014: $1,920 2015: $15,979 2016: $13,086 2017: $19,616 2018: $8,389 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 99915 20795 25291 95419 116209 13314 29608 99915 112476 12836 9103 116209 109447 9252 6223 112476 62639 60120 13312 109447 0.00000 0.00000 1.00000 0 0 1220000 1220000 10363039 9729399 633640 2703554 2275472 428082 80000 80000 2361722 INTEREST RATE SWAP OBLIGATION 72306 72306 12008664 -99026 -99026 12107690 -4971 -4971 12102719 12487687 4971 4971 12482716 -7330 -7330 12475386 PART V, LINE 4: THE TERM ENDOWMENT FUNDS ARE COMPRISED OF DONATIONS THAT HAVE DONOR IMPOSED DESIGNATIONS ON THEIR INTENDED USE FROM THE DONOR. THESE DESIGNATIONS ARE COMPRISED OF HOSPICE SUITE DONATIONS, CHAPEL SERVICES, RECREATIONAL PROGRAMS AND COURTYARD UPKEEP. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED LOSS ON INTEREST RATE SWAP -106,356. BAD DEBT EXPENSE 7,330. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF LOSS ON FIXED ASSET DISPOSAL -4,971. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFICATION OF LOSS ON FIXED ASSET DISPOSAL 4,971. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -7,330. 0 0 0 0 0 0 0 0 0 GINNY PERSON ADMINISTRATOR (AS OF 6/17) 136542 0 0 0 0 0 2603 0 25274 0 164419 0 0 0 A CONNECTICUT HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 060806186 2016-06-15 2840000 2013 SERIES B REVENUE BONDS REISSUANCE 0 0 0 A 243000 2840000 2840000 2016 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 1 KEY BANK 4.291667000000 0 0 0 0 1 A 1 PART II, LINE 11 - OTHER SPENT PROCEEDS: OTHER SPENT PROCEEDS WERE USED TO REFUND A PRIOR ISSUE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE ADMINISTRATOR AND THE CHIEF FINANCIAL OFFICER PRIOR TO REVIEW BY THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL CONFLICTS OF INTEREST STATEMENTS ARE REVIEWED BY THE ADMINISTRATIVE ASSISTANT AND THE ADMINISTRATOR. NONCOMPLIANCE ISSUES ARE REFERRED TO THE CHAIRMAN OF THE BOARD BY THE ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 15A AN EVALUATION OF THE ADMINISTRATOR IS CONDUCTED BY THE EXECUTIVE COMMITTEE, WHICH IS COMPRISED OF MEMBERS INDEPENDENT OF THE ORGANIZATION. COMPARABLE COMPENSATION DATA IS UTILIZED FROM THE LEADING AGE ANNUAL SALARY SURVEY. COMPENSATION DECISIONS VOTED ON BY THE EXECUTIVE COMMITTEE ARE MADE BASED ON THE OUTCOME OF THIS PROCESS, AS WELL AS FACILITY FINANCIAL PERFORMANCE. THE PROCESS WAS LAST CONDUCTED IN 2016. THE DELIBERATION AND DECISION PROCESS IS DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 ANY INQUIRIES REGARDING GOVERNING DOCUMENTS WILL BE REFERRED TO THE ADMINISTRATOR AND MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: UNREALIZED LOSS ON INTEREST RATE SWAP -106,356. NORWICH ROMAN CATHOLIC DIOCESAN CORP 213 BROADWAY NORWICH CT 06360 CHURCH SVCS CT 501(C)(3) 1 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0