2020-11-10T14:34:48-06:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2019-01-01 043108782 NOTRE DAME HEALTH CARE CENTER INC NOTR 5088523011 559 PLANTATION STREET WORCESTER MA 01605 KAREN LAGANELLI CEO 5088523011 2020-11-09 1 JOHN NORMAN P01506766 7049985200 50.210.64.33 2020-11-09 13:46:42 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 38F20A76F3E8C60D9DEF24157DEB90708B107CBE 2019 2021-01-29 14:40:06Z NOTRE DAME LONG TERM CARE CENTER NOTRE DAME DU LAC NOTRE DAME AT HOME NOTRE DAME EDUCATIONAL BRIDGE CENTER KAREN LAGANELLI 559 PLANTATION STREET WORCESTER MA 01605 30377629 0 X WWW.NOTREDAMEHEALTHCARE.ORG X 1990 MA TO PROVIDE QUALITY NURSING CARE FOR THE ELDERLY AND POOR RESIDENTS OF THE COMMUNITY. 18 18 543 120 0 0 136627 162017 24782158 25844314 727803 1180023 207731 177969 25854319 27364323 0 0 0 0 17220889 17490062 0 0 99356 7504005 7648823 24724894 25138885 1129425 2225438 36928105 40243397 15207175 14478215 21720930 25765182 X NOTRE DAME HEALTH CARE CENTER (NDHCC), ROOTED IN THE HERITAGE OF SAINT JULIE BILLIART AND SPONSORED BY THE SISTERS OF NOTRE DAME DE NAMUR, IS DEDICATED TO THE HEALING MINISTRY PROCLAIMED IN THE GOSPEL AND BY THE CATHOLIC CHURCH. 0 0 21368621 25900058 NURSING HOME, ASSISTED LIVING, HOSPICE, PEDIATRIC PALLIATIVE CARE, AND CARE MANAGEMENT PROGRAMS:NOTRE DAME LONG TERM CARE AND REHABILITATION CENTER IS A LICENSED SKILLED NURSING FACILITY THAT PROVIDES TRADITIONAL LONG TERM CARE, POST-ACUTE AND SHORT TERM REHABILITATION, SPECIALIZED MEMORY CARE, AND END OF LIFE CARE TO ACHIEVE THE INDIVIDUAL'S MAXIMUM QUALITY OF LIFE AND WELL-BEING WITHIN THE CHARITABLE MISSION OF THE SISTERS OF NOTRE DAME DE NAMUR. INDIVIDUALIZED CARE PLANS INCLUDE PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY, THERAPEUTIC RECREATIONAL PROGRAMS, INTRAVENOUS THERAPY, SPIRITUAL CARE, AND MEDICALLY RELATED SOCIAL SERVICES. (SEE SCHEDULE O)LICENSED NURSING SERVICES ARE PROVIDED 24 HOURS PER DAY TO NURSING HOME CAPACITY OF 123 INDIVIDUALS, AND THE FACILITY IS CERTIFIED BY THE CENTERS FOR MEDICAID AND MEDICARE SERVICES AS A PROVIDER, AND HOLDS CONTRACTS WITH A NUMBER OF HMOS.NOTRE DAME DU LAC ASSISTED LIVING RESIDENCE IS A CARING COMMUNITY THAT PROVIDES ASSISTED LIVING AND MEMORY SUPPORT FOR SENIORS. CHOICE, CONVENIENCE AND PEACE OF MIND ARE THE HALLMARKS OF THIS PROGRAM. NOTRE DAME DU LAC IS A HOME WHERE INDIVIDUAL NEEDS ARE MET AND COMMUNAL LIFE IS HONORED THROUGH A RICH AND DIVERSE RANGE OF PROGRAMS THAT ARE DESIGNED TO ENHANCE THE LIVES OF OUR RESIDENTS AND FAMILIES THROUGH ACTIVITIES, MEALS, AND PERSONAL ASSISTANCE. OUR MISSION OF CARE AND COMPASSION EXTENDS TO CARING FOR THOSE WITH MEMORY LOSS. THE HARMONY PROGRAM AT NOTRE DAME DU LAC IS DESIGNED TO MEET THE UNIQUE NEEDS OF THOSE WITH MEMORY LOSS, ALZHEIMER'S DISEASE, AND OTHER FORMS OF DEMENTIA. WE PROVIDE A COMFORTABLE, HOMELIKE SETTING, AS WELL AS THE SUPPORTIVE CARE NECESSARY TO INSURE SAFETY, DIGNITY, AND INDIVIDUALITY, WHEREBY RESIDENTS HAVE THE RIGHT TO MAKE CHOICES IN ALL ASPECTS OF THEIR LIVES. OUR FACILITY IS CERTIFIED BY THE EXECUTIVE OFFICE OF ELDER AFFAIRS OF THE COMMONWEALTH OF MASSACHUSETTS, AND PARTICIPATES IN THE MASSACHUSETTS GROUP ADULT FOSTER CARE (GAFC) PROGRAM.THE AT HOME DIVISION OF NOTRE DAME HEALTH CARE PROVIDES COMMUNITY BASED SERVICES TO INDIVIDUALS IN NEED IN THEIR OWN HOMES OR THAT OF A LOVED ONE, AS WELL AS IN FACILITIES INCLUDING ASSISTED LIVING, SKILLED NURSING, AND REST HOMES, IN GREATER WORCESTER COUNTY. THESE SERVICES INCLUDE NOTRE DAME HOSPICE, PEDI PALS, AND AFFINITY CARE MANAGEMENT.NOTRE DAME HOSPICE CONSISTS OF A TEAM OF SPECIALISTS WITH EXPERTISE DEVOTED TO COMPASSIONATE AND PROFESSIONAL END-OF-LIFE CARE. NOTRE DAME ASSISTS PATIENTS WITH TERMINAL ILLNESS FIND DIGNITY, MEANING, AND PEACE DURING HIS OR HER FINAL MONTHS, WEEKS, AND DAYS. NOTRE DAME CAN PROVIDE HOSPICE SERVICES TO ALL AGE GROUPS, STARTING AT BIRTH. THESE SERVICES ARE COVERED BY MEDICARE, MEDICAID AND MOST PRIVATE INSURANCES.NOTRE DAME PEDI PALS IS A CONTRACT PROVIDER FOR THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH PEDIATRIC PALLIATIVE CARE NETWORK, AND IT IS A COST-BASED REIMBURSEMENT PROGRAM. ND PEDI PALS ENHANCES EXISTING SERVICES TO MEET THE NEEDS OF ELIGIBLE CHILDREN WITH ANY LIFE-LIMITING ILLNESS, EVEN WHEN A CURE REMAINS POSSIBLE. THE GOAL OF THE PEDIATRIC PALLIATIVE CARE NETWORK IS TO IMPROVE THE QUALITY OF LIFE FOR THE ENTIRE FAMILY THROUGH ITS SUPPORT SERVICES. 297725 136752 EDUCATION PROGRAM:THE EDUCATIONAL BRIDGE CENTER AT NOTRE DAME HEALTH CARE IS A LIFELINE SUPPORTING ADULT LEARNERS PSYCHOLOGICALLY AND FINANCIALLY, AND HELPING THEM TO OVERCOME OVERWHELMING CHALLENGES. STAFF ARE DEVELOPED BY HEALTH CARE SKILLS CLASSES TO MEET THE NEEDS OF RESIDENTS AND PATIENTS HERE AND AT OTHER HEALTH CARE FACILITIES IN THE REGION. ADULT BASIC EDUCATION, TUTORING, CAREER AND LIFE COACHING, AND CITIZENSHIP SERVICES ENABLE PEOPLE TO EARN CERTIFICATIONS AND DEGREES, AND OBTAIN FAMILY-SUSTAINING WAGES. 21666346 1 1 0 1 0 0 1 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 28 0 543 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 18 18 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X STEPHEN TOTINO EXEC DIR FINANCE 5088523011 559 PLANTATION STREET WORCESTER MA 01605 SR ELAINE BAIN SND PRESIDENT 1.00 X X 0 0 0 SR LORRAINE CONNELL SND CHAIR 1.00 X X 0 0 0 SR EILEEN BURNS SND CLERK 1.00 X X 0 0 0 MS JENNIFER CAREY BOARD MEMBER 1.00 X 0 0 0 MR ROBERT LIAN BOARD MEMBER 1.00 X 0 0 0 SR ELLEN AGRITELLEY SND BOARD MEMBER 1.00 X 0 0 0 MS RACHEL EGAN BOARD MEMBER 1.00 X 0 0 0 DR MARY DOYLE ROCHE BOARD MEMBER 1.00 X 0 0 0 MR KEVIN MCGOVERN BOARD MEMBER 1.00 X 0 0 0 MS BRENDA RIVARD BOARD MEMBER 1.00 X 0 0 0 MS MARIA BUNKER BOARD MEMBER 1.00 X 0 0 0 SR MARY ROSE CROWLEY SND BOARD MEMBER 1.00 X 0 0 0 MR JOHN MANNILA BOARD MEMBER 1.00 X 0 0 0 SR EVELYN MCKENNA SND BOARD MEMBER 1.00 X 0 0 0 DR DAVID MCMANUS BOARD MEMBER 1.00 X 0 0 0 MR KEVIN KOZAK BOARD MEMBER 1.00 X 0 0 0 MR THOMAS MANNING BOARD MEMBER 1.00 X 0 0 0 SR SARA-ANN BUCKLEY SND BOARD MEMBER (UNTIL 11/19) 1.00 X 0 0 0 MS KAREN LAGANELLI CEO & EX-OFFICIO 40.00 X 181250 0 27280 MR STEPHEN TOTINO EXEC. DIR. OF FINANCE 40.00 X 111935 0 33192 MR EMMANUEL IKOMI EXEC. DIR. OF ND LONG TERM CARE 40.00 X 140965 0 1950 MS SUSAN KEEFE EXEC. DIR. OF ND AT HOME 40.00 X 107870 0 18724 MS SHARON BLAINE DIR.OF NURSING FOR ND 40.00 X 111784 0 15409 MR STEPHEN SMALL EXEC. DIR. OF HR 40.00 X 107793 0 5037 MS IRINA LOVEN REHAB. DIR. OF ND LONG TERM CARE 40.00 X 100132 0 4622 861729 0 106214 7 0 1 0 0 63053 98964 162017 PATIENT SERVICE REVENUE 623000 19638150 19638150 RESIDENT SERVICE REVENUE 623000 6069412 6069412 EDUCATION CENTER 611430 136752 136752 25844314 526704 526704 3652098 2998779 653319 653319 653319 0 63053 14527 -14527 -14527 COMMUNITY FEES 623000 105000 105000 OTHER INCOME 623000 87496 87496 192496 27364323 26036810 0 1165496 353657 353657 14301130 12291261 1955420 54449 52033 45739 6294 1681445 1560615 91864 28966 1101797 1007766 88438 5593 16759 8354 8405 89566 16293 73273 1603 1603 130920 130920 208558 8829 199729 166407 103195 63212 244336 85372 148616 10348 236247 236247 1058588 1004976 53612 23519 15197 8322 635476 623685 11791 1100172 1091950 8222 153025 117537 35488 PATIENT CARE EXPENSES 1819521 1819521 USER FEE 882586 882586 FOOD 313425 313425 HOSPICE EXPENSES 296970 296970 271145 136828 134317 25138885 21666346 3373183 99356 42916 47108 2247140 2716659 1587792 1647021 58925 37391 156974 187537 36780039 19325547 17739421 17454492 15065196 18089018 29741 64171 36928105 40243397 2110414 1954132 12000 22500 11390321 10599913 1694440 1901670 15207175 14478215 X 21678341 25722642 42589 42540 21720930 25765182 36928105 40243397 X 2225438 1978249 -159435 X 0 1 X 1 0 X 60165 50483 106594 100306 162017 479565 22524395 25528126 24656561 24782158 25844314 123335554 22584560 25578609 24763155 24882464 26006331 123815119 10000 10000 15000 35000 0 10000 10000 15000 35000 123780119 329810 365536 333903 506765 526704 2062718 329810 365536 333903 506765 526704 2062718 233312 226080 175157 212674 192496 1039719 23147682 26170225 25272215 25601903 26725531 126917556 0.97530 0.97430 0.01630 0.01470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1603 1603 0 PART II-B, LINE 1: A PORTION OF MEMBERSHIP DUES PAID TO STATE HEALTHCARE ORGANIZATIONS IS DEVOTED TO LOBBYING. X 1 3.20 0 0 0 1 0 52.00 0 2417703 2456 5850 64 2414245 2418807 -1029 75 2417703 2420712 1647 3500 52 2418807 2423826 948 4000 62 2420712 2404000 19826 2423826 1.00000 0.00000 0.00000 0 0 2625000 2625000 28659535 15233568 13425967 5190190 3852817 1337373 305314 239162 66152 17454492 FAIR VALUE OF INTEREST RATE SWAP 1552950 DEPOSITS FROM TENANTS 348720 1901670 X 28655136 1978249 -258791 1719458 26935678 130920 297725 428645 27364323 24610884 0 24610884 130920 397081 528001 25138885 PART II, LINE 9: CONSERVATION EASEMENTS ARE NOT REPORTED. PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT IS INTENDED FOR FUNDED DEPRECIATION OF ASSETS AND EMPLOYEE SCHOLARSHIPS. PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT 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. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ITS 2016 THROUGH 2019 TAX YEARS ARE OPEN FOR EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES. 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 YEAR ENDED DECEMBER 31, 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -99,356. UNREALIZED LOSS ON INTEREST RATE SWAP -159,435. PART XI, LINE 4B - OTHER ADJUSTMENTS: EDUCATION CENTER EXPENSE NETTED WITH REVENUE 297,725. PART XII, LINE 4B - OTHER ADJUSTMENTS: EDUCATION CENTER EXPENSE NETTED WITH REVENUE 297,725. FUNDRAISING EXPENSES 99,356. EDUCATIONAL FORUM 63053 63053 6349 3000 5178 63053 63053 6349 3000 5178 14527 -14527 X X X X 0 0 0 0 0 0 0 0 0 MS KAREN LAGANELLI CEO & EX-OFFICIO 181250 0 0 0 0 0 2080 0 25200 0 208530 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION'S GOVERNING BODY DELEGATES CERTAIN AUTHORITY TO ACT ON ITS BEHALF TO SEVERAL COMMITTEES WHICH INCLUDE: GOVERNANCE, HUMAN RESOURCES, ETHICS, FINANCE, INVESTMENT, MISSION, ADVANCEMENT, NOMINATING, AND STRATEGIC DEVELOPMENT COMMITTEES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE SISTERS OF NOTRE DAME DE NAMUR ARE THE GOVERNING MEMBERS OF THE NOTRE DAME HEALTH CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S MEMBERS ELECT THE BOARD OF DIRECTORS ANNUALLY. FORM 990, PART VI, SECTION A, LINE 7B THERE ARE ORGANIZATION GOVERNANCE DECISIONS THAT ARE SUBJECT TO THE APPROVAL BY MEMBERS OTHER THAN THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE DIRECTOR WILL SEND A DRAFT COPY OF THE TAX RETURN TO EACH BOARD MEMBER FOR REVIEW. THE COMPLETE REVISED FORM 990 IS PRESENTED AT A SCHEDULED MEETING TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL BY THE CEO/BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE ORGANIZATION'S POLICY NOT TO ENGAGE IN TRANSACTIONS OR ARRANGEMENTS WITH DIRECTORS, OFFICERS, COMMITTEE MEMBERS, OR KEY EMPLOYEES. NO TRANSACTION OR ARRANGEMENT BETWEEN THE CORPORATION AND ANY DIRECTOR, OFFICER, COMMITTEE MEMBER, KEY EMPLOYEE OR A MEMBER OF HIS OR HER IMMEDIATE FAMILY, OR ANY ENTITY WITH WHICH ANY SUCH PERSON HAS A PERSONAL INTEREST, WILL BE ENTERED INTO OR CONTINUED UNLESS IT HAS BEEN THOROUGHLY REVIEWED AND CONSIDERED BY THE BOARD OR THE FINANCE/GOVERNANCE COMMITTEE AND HAS BEEN FOUND TO BE OF CLEAR BENEFIT TO THE CORPORATION. THE ORGANIZATION'S CEO COLLECTS SIGNED CONFLICTS OF INTEREST POLICIES FROM BOD MEMBERS AND REVIEWS THEM ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS USED TO ESTABLISH THE COMPENSATION OF THE CEO INCLUDES REVIEW AND APPROVAL OF DATA BY THE BOARD OF DIRECTORS. THIS PROCESS IS DONE ON AN ANNUAL BASIS BY THE BOARD OF DIRECTORS AND CHAIR. OTHER EMPLOYEE SALARIES AND BENEFITS ARE REVIEWED ANNUALLY BY THE CEO, COMPARED TO OTHER SIMILAR ENTITIES IN THE REGION, AND DOCUMENTED AS PART OF THE ANNUAL REVIEW PROCESS, WHICH IS DONE ON THE ANNIVERSARY DATE. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FED FORM 990 IS AVAILABLE ON GUIDESTAR.ORG AND THE MA ATTORNEY GENERAL'S OFFICE WEBSITE. 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: UNREALIZED LOSS ON INTEREST RATE SW -159,435. BOSTON PROVINCE SISTERS OF NOTRE DAME DE NAMUR 351 BROADWAY EVERETT MA 02149 RELIGIOUS ORGANIZATION MA 501(C)(3) LINE 1 N/A 0 NOTRE DAME TRAINING SCHOOL INC 30 JEFFREYS NECK ROAD IPSWICH MA 01938 RELIGIOUS ORGANIZATION MA 501(C)(3) LINE 1 N/A 0 SISTERS OF NOTRE DAME DE NAMUR US EAST-WEST PROVINCE 30 JEFFREYS NECK ROAD IPSWICH MA 01938 RELIGIOUS ORGANIZATION MA 501(C)(3) LINE 1 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0