2019-04-10T11:28:38-05:00 2018-05-31 205711238 ADELSON & COMPANY PC 100 NORTH STREET PITTSFIELD MA 01201 990 2017-11-09 823380934 89 SOUTH CARE SUPPORT INC 89SO 4134454056 89 SOUTH ST PITTSFIELD MA 01201 NELSON FURLANO TREASURER 4134454056 2019-04-05 1 CAROL J LEIBINGER-HEALEY CPA P00849882 4134436408 2019-04-05 208.125.165.90 2019-04-05 22:07:58 ED P 5A2396D270A1348226874D48F461CB8E5D142AA7 669C075B83163D396F89A99B7FFFB17903546D0E 2017 2019-02-21 02:37:17Z X NELSON FURLANO 89 SOUTH ST PITTSFIELD MA 01201 15614265 0 X N/A X 2017 MA TO ENHANCE AND IMPROVE THE QUALITY OF LIFE OF OLDER ADULTS SUPPORTED BY BERKSHIRE RETIREMENT HOME, INC., AND PROVIDING HOME CARE SERVICES AND RESIDENCY FOR OLDER ADULTS. 4 4 0 4 0 0 14324454 183713 11962 0 14520129 0 0 131718 0 0 73450 205168 14314961 14088276 101570 13986706 TO ENHANCE AND IMPROVE THE QUALITY OF LIFE OF OLDER ADULTS SUPPORTED BY BERKSHIRE RETIREMENT HOME, INC., AND PROVIDING HOME CARE SERVICES AND RESIDENCY FOR OLDER ADULTS. 0 0 22744 89 SOUTH CARE SUPPORT PROVIDES SUPPORTIVE SERVICES FOR BERKSHIRE PLACE, WHICH PROVIDES SKILLED NURSING AND REHABILITATION CARE, LONG-TERM RESIDENCY, MEMORY CARE SUPPORT, PALLIATIVE CARE/COMFORT CARE, OUTPATIENT REHABILITATION AND RESPITE CARE. 172 CLIENTS WERE SERVED DURING THE YEAR. 147324 183713 AT HOME WITH BERKSHIRE PLACE PROVIDES HOME CARE AND OTHER SERVICES IN A PERSON'S HOME OR WHEREVER THEY MAY CALL HOME. 161 CLIENTS WERE SERVED DURING THE YEAR. 170068 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X X THE ORGANIZATION 4134454056 89 SOUTH ST PITTSFIELD MA 01201 ELIZABETH KIRBY PRESIDENT 1.00 X X 0 0 0 SHELLEY GUYETTE VICE PRESIDENT 0.50 X X 0 0 0 NELSON FURLANO TREASURER 0.50 X X 0 0 0 MATTHEW SCARAFONI SECRETARY/CLERK 0.50 X X 0 0 0 EDWARD FORFA DIRECTOR 1.00 40.00 X 0 191931 12152 0 191931 12152 0 0 1 0 ALLEGRONE CONSTRUCTION 150 PITTSFIELD RD LENOX MA 01240 CONTRACTOR 122123 1 14324454 11444723 14324454 HOMEMAKER, PERSONAL CARE, NON-HOM 621610 183713 183713 183713 80186 80186 1025912 1094136 -68224 -68224 -68224 14520129 183713 0 11962 120447 120447 1625 1625 9646 9646 35100 35100 11725 11725 21156 21156 575 575 4894 4894 205168 170068 35100 0 57400 2864182 58765 969841 3667 0 966174 9926182 199849 0 15724 0 14088276 76109 0 25461 0 101570 X 13970982 15724 0 13986706 0 14088276 14314961 -328255 0 X 0 1 X 1 1 1 X X 1 BERKSHIRE RETIREMENT HOME INC 042103875 7 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 15724 15724 1.00000 0 0 280000 280000 465000 465000 10320 3667 6653 214521 214521 966174 DUE TO AFFILIATE 25461 25461 X 14156774 -328255 -328255 14485029 35100 35100 14520129 170068 0 170068 35100 35100 205168 PART X, LINE 2: MANAGEMENT HAS EVALUATED SIGNIFICANT TAX POSITIONS AGAINST THE CRITERIA ESTABLISHED BY PROFESSIONAL STANDARDS AND BELIEVES THERE ARE NO SUCH TAX POSITIONS REQUIRING ACCOUNTING RECOGNITION. THE AGENCY'S AND ITS AFFILIATE'S TAX RETURNS ARE SUBJECT TO EXAMINATION BY TAXING AUTHORITIES FOR ALL YEARS ENDING ON OR AFTER MAY 31, 2018. 0 0 0 0 0 0 0 0 0 EDWARD FORFA DIRECTOR 0 191931 0 0 0 0 0 0 0 12152 0 204083 0 0 PART I, LINE 3 THE RELATED ORGANIZATION, BERKSHIRE RETIREMENT HOME, INC, ESTABLISHES COMPENSATION OF THE CEO/DIRECTOR THROUGH APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. X 1 10558642 FAIR MARKET VALUE X 1 745000 APPRAISED VALUE X INVESTMENT IN AFFILIATE 1 109839 FAIR MARKET VALUE X CONSTRUCTION COSTS 1 18000 FAIR MARKET VALUE X ACCRUED INTEREST 1 13242 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE AND THEN THE BOARD FOR AUTHORIZATION. FORM 990, PART VI, SECTION B, LINE 12C A QUESTIONNAIRE MUST BE COMPLETED ANNUALLY BY OFFICERS, DIRECTORS AND KEY EMPLOYEES DISCLOSING ANY RELATIONSHIPS PRESENTING POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 18 FORM 990 IS AVAILABLE AT GUIDE STAR WEBSITE AND PROVIDED UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. AT HOME WITH BERKSHIRE PLACE 89 SOUTH ST PITTSFIELD MA 01201 274015376 HOME CARE AND OTHER SERVICES MA 183744 143874 89 SOUTH CARE SUPPORT INC BERKSHIRE RETIREMENT HOME INC 290 SOUTH ST PITTSFIELD MA 01201 042103875 RESIDENTIAL AND HEALTHCARE SERVICES TO OLDER ADULTS MA 501(C)(3) LINE 10 BERKSHIRE RETIREMENT HOME INC 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 BERKSHIRE RETIREMENT HOME INC C 14324454 FAIR MARKET VALUE