FURP.ORG / PUBLIC DATA EXPLORER

CHS OF WALTHAM INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
CHS OF WALTHAM INC (EIN 04-3333609)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-10-01
IRS object ID
201912749349301126
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-10-01T13:41:58-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN043333609EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHS OF WALTHAM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHSOBusinessNameControlTxt
Phone7818930240PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 NEWTON STREETAddressLine1Txt
CityWALTHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02453ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOSEPH DEVEAUPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone7818930240PhoneNum
Signature2019-10-01SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address155.212.6.161IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-10-01IPDt
IP Tm14:41:45IPTm
IP TimezoneUSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdAEC35488C4CD91AC8DD9FF49E81978A397244AF0AtSubmissionCreationDeviceId
At Submission Filing Device IdA744FCA080835C7073C58A40247746B207170AF7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-01-14 16:20:31ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MARISTHILL NURSING & REHABILATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJOSEPH DEVEAUPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 NEWTON STREETAddressLine1Txt
CityWALTHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02453ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,033,130GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressMARISTHILL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionMARISTHILL IS A CATHOLIC SKILLED NURSING AND REHABILITATION FACILITY THAT CONTINUES THE HEALING MINISTRY OF CHRIST BY PROVIDING HEALTH CARE SERVICES THAT FOSTER EACH INDIVIDUAL'S PHYSICAL, SPIRITUAL, EMOTIONAL AND INTELLECTUAL WELL-BEING.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee143TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$14,115PYContributionsGrantsAmt
CY Contributions Grants$10,317CYContributionsGrantsAmt
PY Program Service Revenue$10,195,541PYProgramServiceRevenueAmt
CY Program Service Revenue$10,922,851CYProgramServiceRevenueAmt
PY Investment Income$46,019PYInvestmentIncomeAmt
CY Investment Income$73,954CYInvestmentIncomeAmt
PY Other Revenue$42,155PYOtherRevenueAmt
CY Other Revenue$26,008CYOtherRevenueAmt
PY Total Revenue$10,297,830PYTotalRevenueAmt
CY Total Revenue$11,033,130CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,052,552PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,295,238CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,818,605PYOtherExpensesAmt
CY Other Expenses$4,771,000CYOtherExpensesAmt
PY Total Expenses$10,871,157PYTotalExpensesAmt
CY Total Expenses$11,066,238CYTotalExpensesAmt
PY Revenues Less Expenses-$573,327PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$33,108CYRevenuesLessExpensesAmt
Total Assets BOY$10,887,258TotalAssetsBOYAmt
Total Assets EOY$10,605,123TotalAssetsEOYAmt
Total Liabilities BOY$9,361,046TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,260,915TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,526,212NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,344,208NetAssetsOrFundBalancesEOYAmt
MissionMARISTHILL IS A CATHOLIC SKILLED NURSING AND REHABILITATION FACILITY THAT CONTINUES THE HEALING MINISTRY OF CHRIST BY PROVIDING HEALTH CARE SERVICES THAT FOSTER EACH INDIVIDUAL'S PHYSICAL, SPIRITUAL, EMOTIONAL AND INTELLECTUAL WELL-BEING.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$10,759,177ExpenseAmt
Revenue$10,948,859RevenueAmt
DescMARISTHILL NURSING AND REHABILITATION CENTER PROVIDED 35,154 DAYS OF SKILLED NURSING SERVICES DURING 2018 OF WHICH 22,593 WERE TO MEDICAID RECIPIENTS.Desc
Total Program Service Expenses$10,759,177TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee143EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOSEPH DEVEAU PRESIDENTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7818930240PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line166 NEWTON STREETAddressLine1Txt
CityWALTHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02453ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
KELLY HILL
CHAIR1.00Yes (X)Yes (X)$0$0$0
JUDITH ALLEN
TRUSTEE1.00Yes (X)Yes (X)$0$0$0
ELLEN LEITER
TRUSTEE FROM 6/181.00Yes (X)$0$0$0
SRJOYCE ANN EDELMANN
TRUSTEE1.00Yes (X)$0$0$0
SUSAN STRANG
TRUSTEE1.00Yes (X)$0$0$0
JOSEPH CUZZUPOLI
TRUSTEE1.00Yes (X)$0$0$0
JOSEPH DEVEAU
CEO/ADMINSTRATOR40.00Yes (X)Yes (X)$140,685$0$2,169
DAVID BECKER
DIRECTOR1.00Yes (X)$0$176,706$2,77839.00
SHIRLY YELLAMATY
RN SUPERVISOR40.00$130,438$0$12,222Yes (X)
MORIMA COMPERE
LPN SUPERVISOR40.00$108,029$0$7,892Yes (X)
LUANN DEAGLE
DIRECTOR OF NURSING40.00$116,344$0$7,556Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$495,496TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$176,706TotReportableCompRltdOrgAmt
Total Other Compensation$32,617TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
REHABCARE GROUP INC
PO BOX 503534ST LOUISMO631503534REHABILITATION SERVICE$711,449
PERFORMANCE HEALTH CARE SERVICE
47R RIVER RIVER STREETWELLESLEYMA02481HOUSEKEEPING$366,360
OMNICARE
PO BOX 7800DETROITMI482781668PHARMACY$282,254
US FOOD
PO BOX 3155BOSTONMA024413155FOOD SERVICE$235,175
MCKESSON
PO BOX 630693CINCINNATIOH452630693MEDICAL SUPPLIES$163,495
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$10,317AllOtherContributionsAmt
Total Contributions$10,317TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business623000BusinessCd
Total Revenue Column$10,922,851TotalRevenueColumnAmt
Related Or Exempt Func Income$10,922,851RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,922,851TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$73,954TotalRevenueColumnAmt
Exclusion$73,954ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business623000BusinessCd
Total Revenue Column$26,008TotalRevenueColumnAmt
Related Or Exempt Func Income$26,008RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$26,008OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,033,130TotalRevenueColumnAmt
Related Or Exempt Func Income$10,948,859RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$73,954ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$140,685TotalAmt
Program Services$140,685ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,154,082TotalAmt
Program Services$5,154,082ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$23,614TotalAmt
Program Services$23,614ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$593,467TotalAmt
Program Services$593,467ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$383,390TotalAmt
Program Services$383,390ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$202,848TotalAmt
Management And General$202,848ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$50,541TotalAmt
Management And General$50,541ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$53,672TotalAmt
Management And General$53,672ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$12,053TotalAmt
Program Services$12,053ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$43,132TotalAmt
Program Services$43,132ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$232,219TotalAmt
Program Services$232,219ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,834TotalAmt
Program Services$1,834ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,993TotalAmt
Program Services$5,993ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$385,575TotalAmt
Program Services$385,575ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$413,620TotalAmt
Program Services$413,620ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$54,098TotalAmt
Program Services$54,098ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
PURCHASE SERVICE$1,505,910$1,505,910
NURSING HOME SUPPLIES$828,503$828,503
MEDICAID USER FEE$611,835$611,835
UTILITIES$369,167$369,167

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,066,238TotalAmt
Program Services$10,759,177ProgramServicesAmt
Management And General$307,061ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$386,874BOYAmt
EOY$316,406EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$907,266BOYAmt
EOY$1,082,273EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$50,017BOYAmt
EOY$44,139EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$13,103,652LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,200,105LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,203,630BOYAmt
EOY$5,903,547EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,284,040BOYAmt
EOY$2,199,127EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,055,431BOYAmt
EOY$1,059,631EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,887,258BOYAmt
EOY$10,605,123EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$712,960BOYAmt
EOY$658,247EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,989,760BOYAmt
EOY$7,950,951EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$658,326BOYAmt
EOY$651,717EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,361,046BOYAmt
EOY$9,260,915EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,520,212BOYAmt
EOY$1,344,208EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,000BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,526,212BOYAmt
EOY$1,344,208EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,887,258BOYAmt
EOY$10,605,123EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$33,108ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$142,896NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$6,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,820CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$47,972CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,752CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,115CurrentTaxYearMinus1YearAmt
Current Tax Year$10,317CurrentTaxYearAmt
Total$108,976TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,480,889CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,301,949CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,482,175CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,195,541CurrentTaxYearMinus1YearAmt
Current Tax Year$10,922,851CurrentTaxYearAmt
Total$52,383,405TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,499,709CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,349,921CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,499,927CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,209,656CurrentTaxYearMinus1YearAmt
Current Tax Year$10,933,168CurrentTaxYearAmt
Total$52,492,381TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$52,492,381PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$50,454CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$49,643CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$40,443CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$46,019CurrentTaxYearMinus1YearAmt
Current Tax Year$73,954CurrentTaxYearAmt
Total$260,513TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$50,454CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$49,643CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$40,443CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$46,019CurrentTaxYearMinus1YearAmt
Current Tax Year$73,954CurrentTaxYearAmt
Total$260,513TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,550,163CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,399,564CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,540,370CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,255,675CurrentTaxYearMinus1YearAmt
Current Tax Year$11,007,122CurrentTaxYearAmt
Total$52,752,894TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99510PublicSupportCY509Pct
Public Support PY5090.99380PublicSupportPY509Pct
Investment Income CY0.00490InvestmentIncomeCYPct
Investment Income PY0.00620InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,000BeginningYearBalanceAmt
Other Expenditures$6,000OtherExpendituresAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Contributions$6,000ContributionsAmt
End Year Balance$6,000EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$485,000OtherCostOrOtherBasisAmt
Book Value$485,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,412,643OtherCostOrOtherBasisAmt
Depreciation$3,741,433DepreciationAmt
Book Value$4,671,210BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,910,974OtherCostOrOtherBasisAmt
Depreciation$3,167,666DepreciationAmt
Book Value$743,308BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$295,035OtherCostOrOtherBasisAmt
Depreciation$291,006DepreciationAmt
Book Value$4,029BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,903,547TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
RESIDENT FUNDS$13,379
DEBT SERVICE RESERVE FUND$731,373
DEBT SERVICE SINKING FUND (NET)$314,879
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,059,631TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
DEFERRED EXPENSES$273,311
MEDICAID USER FEES$153,783
PROFESSIONAL LIABILITY LOSS RESERVES$29,180
DUE TO AFFILIATES$174,691
RESIDENTS FUNDS$20,752
FieldValueIRS element (for citing)
Total Liability$651,717TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationCOVENANT AND ITS MEMBER ORGANIZATIONS ARE CONSIDERED NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3)OF THE INTERNAL REVENU CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, EXCEPT AS NOTED BELOW. TAX- EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. UNDER GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDANDS BOARD, ASSETS AND LIABILITIES ARE ESTABLISHED FOR UNCERTAIN TAX POSITIONS TAKEN OR POSITIONS EXPECTED TO BE TAKEN IN INCOME TAX RETURNS WHEN SUCH POSITIONS ARE JUDGED TO NOT MEET THE "MORE-LIKELY-THAN-NOT" THERSHOLD, BASED UPON THE TECHNICAL MERITS OF THE POSITION. ESTIMATED INTEREST AND PENALTIES, IF APPLICABLE, RELATED TO UNCERTAIN TAX POSITIONS ARE INCLUDED AS A COMPONENT OF INCOME TAX EXPENSE. THE SYSTEM HAS EVALUATED THE POSITION TAKEN ON ITS FILLED TAX RETURNS. THE SYSTEM HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT DECEMBER 31, 2018. UNDER INTERNAL REVENUE SERVICE REGULATIONS, THE SYSTEM'S TAX YEARS FROM 2015 THROUGH 2018 ARE OPEN AND SUBJECT TO EXAMINATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonDAVID BECKERPersonNm
TitleDIRECTORTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$176,706CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$1,761DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$1,017NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$179,484TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationEVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH'S BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003, THE COMPENSATION COMMITTEE HAS ENGAGED A HUMAN RESOURCES CONSULTANT TO CONDUCT THIS ANALYSIS. OBJECTIVES ARE TO ASSESS THE COMPOSITENESS OF THE TOTAL CASH COMPENSATION LEVELS OF THE SENIOR LEADERSHIP TEAM, DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
MA HEALTH & EDUCATION FACILITIES AUTHORITY
A04245601157586DBF92007-10-30$7,221,865TO FINANCE THE PURCHASE OF YOUVILLE PLACEYes (1)00
MA HEALTH & EDUCATION FACILITIES AUTHORITY
B04245601157584QAA42012-06-27$1,720,000CAPITAL EQUIPMENT AND PROJECTS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$7,221,865$712,880$55,862$6,117,244Yes (1)Yes (1)Yes (1)Yes (1)
B$1,720,000$54,82800Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceBBondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueInd
AYes (1)00000
B000000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, #7 & PART V:FormAndLineReferenceDesc
ExplanationBOTH BONDS ARE CAREFULLY AND CONSISTENTLY MONITORED FOR POTENTIAL VIOLATIONS OF FEDERAL TAX REQUIREMENTS, BUT THE PROCEDURES WERE NOT WRITTEN AS OF THE END OF THE YEAR COVERED BY THIS TAX RETURN. HOWEVER, THE ORGANIZATION IS CONSIDERING ADOPTING FORMAL POLICIES THAT SET FORTH THE ORGANIZATION'S METHODOLOGY FOR ENSURING POST-ISSUANCE COMPLIANCE WITH IRS REQUIREMENTS PERTAINING TO TAX-EXEMPT DEBT AND CONTAIN SPECIFIC LANGUAGE REGARDING ORGANIZATIONAL RESPONSIBILITY, RECORD RETENTION, PRIVATE BUSINESS USE, ARBITRAGE REBATE, AND REMEDIAL ACTION. ALTHOUGH FORMAL POLICIES ARE NOT IN PLACE IN REGARDS TO THE REMEDIATION OF OUR BONDS, THE MONITORING REQUIREMENTS OF SECTION 148, AND PROCEDURES TO ENSURE THAT VIOLATIONS ARE TIMELY IDENTIFIED AND CORRECTED, THE ORGANIZATION HAS COMPLIANCE CHECKS IN PLACE THAT SUBSTANTIATE THESE REQUIREMENTS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6COVENANT HEALTH IS THE SOLE MEMBER OF THE ORGANIZATION OF THE BOARD. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS OVER BOARD DECISIONS AND BOARD COMPOSITION.
FORM 990, PART VI, SECTION A, LINE 7ACOVENANT HEALTH IS THE SOLE MEMBER OF THE ORGANIZATION. AS SUCH IT RETAINSCERTAIN RESERVE RIGHTS OVER CORPORATE DECISIONS AND BOARD COMPOSITION.
FORM 990, PART VI, SECTION A, LINE 7BCOVENANT HEALTH IS THE SOLE MEMBER OF THE ORGANIZATION. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS OVER BOARD DECISIONS AND BOARD COMPOSITION.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PROVIDED TO AND REVIEWED WITH THE BOARD PRIOR TO FILING
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A FULL-TIME OPERATIONAL INTEGRITY OFFICER THAT MONITORS ALL AREAS FOR POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF COVENANT HEALTH BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003 THE COMPENSATION COMMITTEE HAS ENGAGED A HUMAN RESOURCE CONSULTANT TO CONDUCT THIS ANALYSIS. THE SPECIFIC OBJECTIVES OF THE ANALYSIS ARE TO ASSESS THE COMPETITIVENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELSFOR THE SENIOR LEADERSHIP TEAM; DEVELOP MARKET COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF ANY, ARE COMPETITIVE AND REASONABLE.
FORM 990, PART VI, SECTION C, LINE 19THE FORM 990 AND GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMNTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:RELEASE OF ASSETS WITH DONOR RESTRICTIONS -6,000.
PART VI LINE 6COVENANT HEALTH IS THE SOLE MEMBER OF THE ORGANIZATION OF THE BOARD. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS OVER BOARD DECISIONS AND BOARD COMPOSITION.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HEALTHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 AMES POND DRIVEAddressLine1Txt
CityTEWKSBURYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01876ZIPCd
FieldValueIRS element (for citing)
EIN222484505EIN
Primary ActivitiesHEALTH CARE MANAGEMENT AND RESOURCE ORGANIZATIONPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
Exempt Code Section501(C)ExemptCodeSectionTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd