2018-11-14T16:39:21-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2017-01-01 800687948 SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC SOUT 6174230590 288 WASHINGTON STREET QUINCY MA 02169 WILLIAM GRAVES PRESIDENT & CEO 6174230590 2018-11-13 1 DAVID TRIMNER P00444822 6179848100 67.137.57.251 2018-11-13 17:03:05 ES P 839A7130264BF8A4AA8E0E9B35915F0C6C2A2968 839A7130264BF8A4AA8E0E9B35915F0C6C2A2968 2017 2019-02-21 02:37:17Z WILLIAM GRAVES 288 WASHINGTON STREET QUINCY MA 02169 15199568 0 X WWW.SOUTHCOVEMANOR.COM X 2011 MA TO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES. 16 16 291 22 0 0 32365 120819 14509492 14602746 465113 465159 3525 10844 15010495 15199568 0 0 0 0 8940647 9652689 0 0 0 6138430 6042132 15079077 15694821 -68582 -495253 24761260 24416768 21476319 21411080 3284941 3005688 X THE ORGANIZATION'S MISSION IS TO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES. THE ORGANIZATION'S CORE VALUES INCLUDE: 1.RESPECTING THE PEOPLE WE SERVE, THEIR TRADITIONS, AND THEIR PREFERENCES, 2.PROVIDING EXCELLENT, LEADING EDGE CARE AND SERVICES, 3.INVESTING IN OUR EMPLOYEES, AND 4.SERVING OUR COMMUNITY. 0 0 12485707 14602746 NURSING & REHABILITATION SERVICES - THE ORGANIZATION'S MISSION IS TO PROVIDE INDIVIDUALIZED NURSING AND REHABILITATION CARE THAT REFLECTS ASIAN CULTURAL VALUES THROUGH THE OPERATION OF A 141-BED LONG-TERM CARE FACILITY IN QUINCY, MASSACHUSETTS. 12485707 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 1 0 0 1 16 0 291 1 0 0 0 0 0 0 0 0 0 0 X 16 16 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X SCOTT HANSON DIRECTOR OF FINANCE 6174230590 288 WASHINGTON STREET QUINCY MA 02169 RICHARD LUI CHAIRMAN OF THE BOARD 1.00 2.00 X X 0 0 0 MAY CHIN RN VICE PRESIDENT 1.00 2.00 X X 0 0 0 JASON QU MD TREASURER 1.00 2.00 X X 0 0 0 HEMMIE CHANG ESQ CLERK 1.00 2.00 X X 0 0 0 EDWARD CHENG DIRECTOR 1.00 2.00 X 0 0 0 THOMAS CHIN DIRECTOR 1.00 2.00 X 0 0 0 STANLEY ELKERTON DIRECTOR 1.00 2.00 X 0 0 0 LEONARD LAI DIRECTOR 1.00 2.00 X 0 0 0 SUSAN LUO DIRECTOR 1.00 2.00 X 0 0 0 PAUL MACKINNON DIRECTOR 1.00 2.00 X 0 0 0 LISA MUI DIRECTOR 1.00 2.00 X 0 0 0 ALICE L ROSE RN DIRECTOR 1.00 2.00 X 0 0 0 HELEN CHIN SCHLICHTE DIRECTOR 1.00 2.00 X 0 0 0 DAVID T TING DIRECTOR 1.00 2.00 X 0 0 0 HON HOI YEE DIRECTOR 1.00 2.00 X 0 0 0 MARIANNE BOWLER DIRECTOR 1.00 2.00 X 0 0 0 KATHRYN PLAZAK PRESIDENT & CEO 40.00 2.00 X 0 0 0 SCOTT HANSON DIRECTOR OF FINANCE 40.00 2.00 X 117162 0 12670 WENDY LEE PRESIDENT & CEO 40.00 2.00 X 68801 0 8636 LI CHEN ADMINISTRATOR 40.00 2.00 X 132631 0 17703 318594 0 39009 2 0 1 0 PARAGON REHABILITATION 303 N HURSTBOURNE PKWY LOUISVILLE KY 40222 THERAPY SERVICES 561530 PLAZAK ASSOCIATES 18 TREMONT ST 1010 BOSTON MA 02108 INTERIM CEO 102335 2 120819 71663 120819 NET PATIENT SERVICE REVENUE 623000 14602746 14602746 14602746 465159 465159 10844 10844 10844 15199568 14602746 0 476003 205469 205469 7687581 6705503 982078 124469 106004 18465 940086 817236 122850 695084 591968 103116 77876 77876 103831 103831 986781 837036 149745 48881 48881 174515 174515 1684802 1684802 900 900 7609 7609 621845 621845 257210 257210 128625 33993 94632 USER FEES 990074 990074 DIETARY 496067 496067 MEDICAL SUPPLIES AND EX 207720 207720 PROVISION FOR BAD DEBTS 108000 108000 147396 126323 21073 15694821 12485707 3209114 0 2641120 1762721 362970 646813 1383503 1814256 18600277 18600277 183728 104950 2274520 847821 1534987 1426699 54675 61052 24761260 24416768 1191142 1570952 172429 18396076 17949569 1889101 1718130 21476319 21411080 X 3284941 3005688 3284941 3005688 24761260 24416768 X -495253 216000 X 0 1 X 1 0 X 1416608 546712 194355 32365 120819 2310859 8307173 14622812 14513017 14602746 52045748 1416608 8853885 14817167 14545382 14723565 54356607 1022500 122220 87040 1231760 0 1022500 122220 87040 1231760 53124847 464038 462251 464690 465113 465159 2321251 464038 462251 464690 465113 465159 2321251 10844 10844 1880646 9316136 15281857 15010495 15199568 56688702 0.93710 0.92400 0.04090 0.04320 X PART III, LINE 12 OTHER INCOME OF $10,844 REPRESENTS ANCILLARY FEES. 368339 358039 10300 1906181 489782 1416399 1426699 DUE TO RELATED PARTIES 178482 DEFERRED RENT 1539648 1718130 X X X X 1 0 0 0 0 0 0 0 0 LI CHEN ADMINISTRATOR 132631 0 0 0 0 0 0 0 17703 0 150334 0 0 0 PART I, LINE 4A WENDY LEE, FORMER PRESIDENT AND CEO, WAS PAID $20,000 IN SEVERANCE WAGES. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 2012-10-30 19000000 LAND ACQUISITION AND FACILITY CONSTRUCTION AND FURNISHING 0 0 0 A 931771 19000000 252483 147240 18600277 2015 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 HEMMIE CHANG BOARD MEMBER 77876 PARTNER AT FOLEY AND HOAG WHO PROVIDES LEGAL SERVICES TO THE FILING ORGANIZATION 0 X 55469 ONLINE SEARCH OF COMPARA X BOOKCASES 12 16194 ONLINE SEARCH OF COM 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 A FAMILY RELATIONSHIP EXISTS BETWEEN MAY CHIN, VICE PRESIDENT; THOMAS CHIN, DIRECTOR; AND HELEN CHIN SCHLICHTE, DIRECTOR. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S AUDIT COMMITTEE REVIEWS AND APPROVES THE DRAFT FORM 990. THE COMPLETE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS PART OF THE ORGANIZATION'S BY-LAWS AND IS DISCUSSED BY THE BOARD OF DIRECTORS AND TOP MANAGEMENT PERSONNEL AT THE FIRST BOARD MEETING EACH YEAR REGARDING ANY/ALL SIGNIFICANT TRANSACTIONS. THE CONFLICT OF INTEREST POLICY COVERS DIRECTORS, OFFICERS, AND EMPLOYEES. ANY CONFLICTS OF INTEREST ARE DISCLOSED TO THE BOARD PRIOR TO APPROVAL OR RATIFICATION OF THE CONTRACT OR TRANSACTION BY MAJORITY VOTE OF THE DISINTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CEO AND TOP MANAGEMENT INCLUDES THE USE OF A COMPENSATION COMMITTEE, FORM 990S OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS, AND THE APPROVAL OF THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER 216,000. SOUTH COVE NURSING FACILITIES FOUNDATION INC 288 WASHINGTON STREET QUINCY MA 02169 046406242 NURSING AND CARE FACILITIES MA 501(C)(3) LINE 12A, I SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC 1 SOUTH COVE MANOR NURSING AND REHABILITATION CENTER QALICB INC 288 WASHINGTON STREET QUINCY MA 02169 352419744 TO SUPPORT ACTIVITIES OF SOUTH COVE MANOR NURSING AND REHAB CENTER, INC. MA 501(C)(3) LINE 11 SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC 1 SOUTH COVE MANOR INC 288 WASHINGTON STREET QUINCY MA 02169 042820772 NURSING HOME MA SOUTH COVE NURSING FACILITIES FOUNDATION INC C 1 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 1 0 1 SOUTH COVE MANOR NURSING & REHAB CENTER QALICB INC S 216000 FMV SOUTH COVE NURSING FACILITIES FOUNDATION INC E 130557 FMV SOUTH COVE MANOR NURSING & REHAB CENTER QALICB INC K 791004 FMV SOUTH COVE MANOR NURSING & REHAB CENTER QALICB INC D 105531 FMV