FURP.ORG / PUBLIC DATA EXPLORER

PENACOOK PLACE INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
PENACOOK PLACE INC (EIN 23-7090088)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-10-03
IRS object ID
201912769349300916
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)
Return2019-10-03T11:09:47-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237090088EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PENACOOK PLACE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPENABusinessNameControlTxt
Phone9783740707PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 WATER STREETAddressLine1Txt
CityHAVERHILLCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01830ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDavid BeckerPersonNm
Person TitleAdministratorPersonTitleTxt
Phone9783740707PhoneNum
Signature2019-10-03SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address155.212.6.161IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-10-03IPDt
IP Tm12:09:40IPTm
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

FieldValueIRS element (for citing)
Principal OfficerPaula DrelickPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 Water StreetAddressLine1Txt
CityHaverhillCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01830ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,580,936GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressCovenanthealth.netWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1969FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTO PROMOTE THE HIGHEST POSSIBLE QUALITY OF LIFE FOR OUR RESIDENTS IN A CLEAN, SAFE AND ATTACTIVE ENVIROMENT. TO CARE FOR OUR RESIDENTS AS WE WOOULD WANT TO BE CARED FOR-THE GOLDEN RULE OF PENACOOK PLACE. TO MEET OR EXCEDD THE EXPECTATIONS OF OUR RESIDENTS, AS WELL AS OTHERSWITH WHOM WE COME IN CONTACT. TO SHOW HOSITALITY,COURTESY, COOPERATION AND RESPECT TO ALL RESIDENTS, FAMILY MEMBERS, FELLOW EMPLOYEES, VOLUNTEERS AND VISITORS. TO BE AN INTEGRAL, CONTRIBUTING PART OF THE GREATER HAVERHILL BUSINESS, EDUCATIONAL AND CULTURAL COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee310TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$106,151PYContributionsGrantsAmt
CY Contributions Grants$70,911CYContributionsGrantsAmt
PY Program Service Revenue$12,483,147PYProgramServiceRevenueAmt
CY Program Service Revenue$12,474,592CYProgramServiceRevenueAmt
PY Investment Income$2,193PYInvestmentIncomeAmt
CY Investment Income$82CYInvestmentIncomeAmt
PY Other Revenue$3,403PYOtherRevenueAmt
CY Other Revenue$35,351CYOtherRevenueAmt
PY Total Revenue$12,594,894PYTotalRevenueAmt
CY Total Revenue$12,580,936CYTotalRevenueAmt
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$8,077,061PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,690,709CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,364,336PYOtherExpensesAmt
CY Other Expenses$4,258,154CYOtherExpensesAmt
PY Total Expenses$12,441,397PYTotalExpensesAmt
CY Total Expenses$12,948,863CYTotalExpensesAmt
PY Revenues Less Expenses$153,497PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$367,927CYRevenuesLessExpensesAmt
Total Assets BOY$4,986,275TotalAssetsBOYAmt
Total Assets EOY$4,553,131TotalAssetsEOYAmt
Total Liabilities BOY$3,884,521TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,797,496TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,101,754NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$755,635NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROMOTE THE HIGHEST POSSIBLE QUALITY OF LIFE FOR OUR RESIDENTS IN A CLEAN, SAFE, AND ATTRACTIVE ENVIROMENT. TO CARE FOR OUR RESIDENTS AS WE WOULD WANT TO BE CARED FOR - THE GOLDERN RULE OF PENACOOK PLACE. TO MEET OR EXCEED THE EXPECTATIONS OF OUR RESIDENTS, AS WELL AS OTHERS WITH WHOM WE COME IN CONTACT. TO SHOW HOSPITALITY, COURTRESY, COOPERATION AND RESPECT TO ALL RESIDENTS, FAMILY MEMBERS, FELLOW EMPLOYEES, VOLUNTEERS AND VISTORS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$12,037,460ExpenseAmt
Revenue$12,509,943RevenueAmt
DescPENACOOK PLACE IS AN INDEPENDENT, NON-PROFIT, 160 BED HAVERHILL, MA BASED NURSING HOME AND REHABILITATION FACILITY THAT STRIVES TO OFFER THE FINEST CARE AND BEST QUALITY OF LIFE FOR ITS RESIDENTS. THE FACILITY'S TEAM OF PROFESSIONALS IS SPECIALLY TRAINED TO MEET THE MEDICAL, SOCIAL, PHYCHOLOGICAL, AND THERAPEUTIC NEEDS OF THOSE THEY SERVE. THEIR DEDICATED CAREGIVERS ARE HIGHLY TRAINED, COMPASSINATE, AND HELP MAKE PENACOOK PLACE A WARM AND WELCOMING FACILITY.Desc
Total Program Service Expenses$12,037,460TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
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 Required0ScheduleJRequiredInd
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 Document17IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee310EmployeeCnt
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 Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
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 Committees0MinutesOfCommitteesInd
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 Line1Paula DrelickBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9783740707PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 Water StreetAddressLine1Txt
CityHaverhillCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01830ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Scott Wheeler
President & CEO to 7/201838.00Yes (X)Yes (X)$102,981$0$6,869
Thomas L Mortimer
Chair2.00Yes (X)Yes (X)$0$0$0
William Klueber
Treasurer2.00Yes (X)Yes (X)$0$0$0
Frank Novak
Clerk2.00Yes (X)Yes (X)$0$0$0
Janis Cordischi
Member2.00Yes (X)$0$0$0
Andrew Desrosiers
Member2.00Yes (X)$0$0$0
Diane Lovallo
Member2.00Yes (X)$0$0$0
John Sarro
Member2.00Yes (X)$0$0$0
Gregory Shaw
Member2.00Yes (X)$0$0$0
Dr J Soma
Member from 8/172.00Yes (X)$0$0$0
Paula Drelick
President & CEO from 11/1838.00Yes (X)Yes (X)$11,026$0$800
Caitlyn Mays
Member2.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$114,007TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$7,669TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Rehabcare
7733 Forsyth BouevardSt LouisMO63105Rehabilitation$840,478
US Foods
PO Box 3155BostonMA02241Dietary Services$227,769
Omnicare
PO Box 78000DetriotMI48278Pharmacy$213,448
New Hampshire Employers Insurance Co
PO Box 4131WoburnMA01888Worker Comp Insurance$207,587
McKesson Medical Surgical
PO Box 20786DallasTX75320Medical Supplies$151,326
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$70,911AllOtherContributionsAmt
Total Contributions$70,911TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service RevenuDesc
Business623000BusinessCd
Total Revenue Column$12,474,592TotalRevenueColumnAmt
Related Or Exempt Func Income$12,474,592RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$12,474,592TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$82TotalRevenueColumnAmt
Exclusion$82ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Other Income623000$32,523$32,523
Other Income623000$2,828$2,828
FieldValueIRS element (for citing)
Other Revenue Total$35,351OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,580,936TotalRevenueColumnAmt
Related Or Exempt Func Income$12,509,943RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$82ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$114,135TotalAmt
Program Services$103,863ProgramServicesAmt
Management And General$10,272ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,072,444TotalAmt
Program Services$6,435,924ProgramServicesAmt
Management And General$636,520ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$7,863TotalAmt
Program Services$7,155ProgramServicesAmt
Management And General$708ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$953,354TotalAmt
Program Services$867,552ProgramServicesAmt
Management And General$85,802ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$542,913TotalAmt
Program Services$494,051ProgramServicesAmt
Management And General$48,862ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$39,270TotalAmt
Management And General$39,270ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$89,969TotalAmt
Management And General$89,969ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$15,641TotalAmt
Program Services$15,641ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$136,700TotalAmt
Program Services$136,700ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$108,004TotalAmt
Program Services$108,004ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$275,873TotalAmt
Program Services$275,873ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,248TotalAmt
Program Services$6,248ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$94,903TotalAmt
Program Services$94,903ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$275,984TotalAmt
Program Services$275,984ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$94,696TotalAmt
Program Services$94,696ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Purchase Services$1,392,268$1,392,268
User Fee$866,123$866,123
Supplies$543,192$543,192
Food$315,611$315,611

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,672TotalAmt
Program Services$3,672ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,948,863TotalAmt
Program Services$12,037,460ProgramServicesAmt
Management And General$911,403ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$850,085BOYAmt
EOY$832,051EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$356,869BOYAmt
EOY$8,040EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,454,162BOYAmt
EOY$1,208,550EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$126,893BOYAmt
EOY$135,786EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,562,159LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,210,306LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,089,917BOYAmt
EOY$2,351,853EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$108,349BOYAmt
EOY$16,851EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,986,275BOYAmt
EOY$4,553,131EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,059,493BOYAmt
EOY$925,796EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,423,825BOYAmt
EOY$2,460,174EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$401,203BOYAmt
EOY$411,526EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,884,521BOYAmt
EOY$3,797,496EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,036,754BOYAmt
EOY$671,635EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$65,000BOYAmt
EOY$84,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,101,754BOYAmt
EOY$755,635EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,986,275BOYAmt
EOY$4,553,131EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$367,927ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,808NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$19,000OtherChangesInNetAssetsAmt
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$146,094CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$51,202CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$53,378CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$106,151CurrentTaxYearMinus1YearAmt
Current Tax Year$70,911CurrentTaxYearAmt
Total$427,736TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,170,781CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,486,410CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,526,438CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,483,147CurrentTaxYearMinus1YearAmt
Current Tax Year$1,247,592CurrentTaxYearAmt
Total$46,914,368TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,316,875CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,537,612CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,579,816CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,589,298CurrentTaxYearMinus1YearAmt
Current Tax Year$1,318,503CurrentTaxYearAmt
Total$47,342,104TotalAmt

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$47,342,104PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,792CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,764CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,149CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,193CurrentTaxYearMinus1YearAmt
Current Tax Year$82CurrentTaxYearAmt
Total$45,980TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,792CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,764CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,149CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,193CurrentTaxYearMinus1YearAmt
Current Tax Year$82CurrentTaxYearAmt
Total$45,980TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,536CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$112,121CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,704CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,403CurrentTaxYearMinus1YearAmt
Current Tax Year$35,351CurrentTaxYearAmt
Total$195,115TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,359,203CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,665,497CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,609,669CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,594,894CurrentTaxYearMinus1YearAmt
Current Tax Year$1,353,936CurrentTaxYearAmt
Total$47,583,199TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99490PublicSupportCY509Pct
Public Support PY5090.99630PublicSupportPY509Pct
Investment Income CY0.00100InvestmentIncomeCYPct
Investment Income PY0.00090InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Total Lobbying Expenditures$0TotalLobbyingExpendituresAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePArt II-B, Line 1, Lobbying ActivitiesFormAndLineReferenceDesc
ExplanationThe organization pays dues to various membership organizations. These organizations may conduct lobbying activities on behalf of their members. However, the organization does not directly participate in these lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$65,000BeginningYearBalanceAmt
Contributions$84,000ContributionsAmt
Other Expenditures$65,000OtherExpendituresAmt
End Year Balance$84,000EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Contributions$65,000ContributionsAmt
End Year Balance$65,000EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Contributions$44,784ContributionsAmt
Other Expenditures$44,784OtherExpendituresAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$47,808BeginningYearBalanceAmt
Contributions$30,586ContributionsAmt
Other Expenditures$78,394OtherExpendituresAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$31,269BeginningYearBalanceAmt
Contributions$47,808ContributionsAmt
Other Expenditures$31,269OtherExpendituresAmt
End Year Balance$47,808EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$30,859InvestmentCostOrOtherBasisAmt
Book Value$30,859BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$7,133,850InvestmentCostOrOtherBasisAmt
Depreciation$5,264,069DepreciationAmt
Book Value$1,869,781BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$5,363,426InvestmentCostOrOtherBasisAmt
Depreciation$4,920,700DepreciationAmt
Book Value$442,726BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$34,024InvestmentCostOrOtherBasisAmt
Depreciation$25,537DepreciationAmt
Book Value$8,487BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,351,853TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Due to third party payors$60,000
Asset Retirement Obligation$66,000
Professional Loss Liability Reserve$34,210
Due to Medicaid$234,465
Resident Funds Liability$16,851
FieldValueIRS element (for citing)
Total Liability$411,526TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:FUNDS ARE USED TO PROVIDE SERVICES,SUPPLIES AND FACILITIES TO RESIDENTS & THE POOR IN THE COMMUNITY
Part X, Line 2:Covenant and its member organizations are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue 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 Standards 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" threshold, 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 filed 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.

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

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

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Massachusetts Development Finance AgencyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN043431814BondIssuerEIN
Bond Issued2017-03-21BondIssuedDt
Issue Price$2,530,707IssuePriceAmt
PurposeRedeem Bank Debt, Renovations & ImprovementsPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$2,530,707TotalProceedsAmt
Issuance Costs From Proceeds$80,707IssuanceCostsFromProceedsAmt
Other Spent Proceeds$2,223,845OtherSpentProceedsAmt
Unspent$226,155UnspentAmt
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart IV, #7 & Part V:FormAndLineReferenceDesc
ExplanationThe bond is 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 bond, 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, INC. IS THE SOLE MEMBER OF THE ORGANIZATION. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS CONCERNING CORPORATE DECISIONS AND BOARD COMPOSITION.
Form 990, Part VI, Section A, line 7aCOVENANT HEALTH, Inc. IS THE SOLE MEMBER OF THE ORGANIZATION. AS SUCH IT RETAINS CERTAIN RESERVE RIGHTS CONCERNING CORPORATE DECISIONS AND BOARD COMPOSITION.
Form 990, Part VI, Section A, line 7bCOVENANT HEALTH, Inc. 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 A, line 8bCOVENANT HEALTH, Inc. 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 THE BOARD FOR REVIEW PRIOR TO ITS BEING FILED.
Form 990, Part VI, Section B, line 12cTHE ORGANIZATION REQUIRES CONFLICT OF INTEREST STATEMENTS TO BE SIGNED BY BOARD MEMBERS AND KEY EMPLOYEES REMINDING THEM OF THE DUTIES AND OBLIGATIONS TO REPORT REAL OR POTENTIAL CONFLICTS OF INTEREST.
Form 990, Part VI, Section B, line 15EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF 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 COVENANT COMPENSATION COMMITTEE HAS ENGAGED A HUMAN RESOURCES CONSULTANT TO CONDUCT THIS ANALYSIS. OBJECTIVES ARE TO ASSESS THE COMPOSITENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS OF THE SENIOR LEADERSHIP TEAM, DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE.
Form 990, Part VI, Section C, line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS ALSO POSTED ON COVENANT HEALTH'S WEBSITE.
Form 990, Part XI, line 9:Change in Temporarily Restricted Assets 19000.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HEALTH IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 AMES POND DRIVEAddressLine1Txt
CityTEWKSBURYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01876ZIPCd
FieldValueIRS element (for citing)
EIN222484505EIN
Primary ActivitiesHEALTHCARE MANAGEMENT AND RESOURCE ORGANIZATIONPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
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