2018-07-31T12:58:25-05:00 2017-09-30 060903326 WHITTLESEY PC 280 TRUMBULL ST 24TH FL HARTFORD CT 06103 990 2016-10-01 060907212 MONSIGNOR BOJNOWSKI MANOR INC MONS 8602290336 50 PULASKI STREET NEW BRITAIN CT 06053 MOTHER MARY JENNIFER CARROLL PRESIDENT 8602290336 2018-07-09 1 LISA WILLS CPA P01828548 8605223111 2016 2022-09-23 18:48:47Z MOTHER MARY JENNIFER CARR 50 PULASKI STREET NEW BRITAIN CT 06053 7138976 0 X N/A X 1975 CT THE PROVIDING OF ROOM, BOARD AND CARE FOR ALL RESIDENTS OF THE FACILITY WHICH CARES FOR THE GENERAL PUBLIC IN CONNECTION WITH THE MISSION OF THE DAUGHTERS OF THE IMMACULATE CONCEPTION AND THE ROMAN CATHOLIC CHURCH. 14 13 131 0 0 0 109946 779116 6695950 6358240 1144 1620 6284 0 6813324 7138976 0 0 0 0 4397595 4475380 0 0 0 2170935 2094886 6568530 6570266 244794 568710 2196324 2585433 2589935 2410334 -393611 175099 THE PROVIDING OF ROOM, BOARD AND CARE FOR ALL RESIDENTS OF THE FACILITY WHICH CARES FOR THE GENERAL PUBLIC IN CONNECTION WITH THE MISSION OF THE DAUGHTERS OF THE IMMACULATE CONCEPTION AND THE ROMAN CATHOLIC CHURCH. 0 0 5881642 6358240 SIXTY BED SKILLED NURSING FACILITY FOR THE AGED PROVIDED 20,115 DAYS OF CARE TO THE GENERAL PUBLIC FURTHERING THE MISSION OF THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION AND THE ROMAN CATHOLIC CHURCH. 5881642 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 3 0 1 131 1 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X CAROL ANNE SALVIETTI 8602290336 50 PULASKI STREET NEW BRITAIN CT 06053 MOTHER MARY JENNIFER CARROLL PRESIDENT OF DMICC 1.00 X X 0 0 0 SISTER MARY CATHERINE SIROTNAK DM SECRETARY/TREASURER 40.00 X X 67743 0 11217 LEONARD GIZA CHAIRPERSON 1.00 X X 0 0 0 ROBERT STORY DIRECTOR 1.00 X 0 0 0 JADWIGA PANUS DIRECTOR 1.00 X 0 0 0 DORIS RUDNICKI DIRECTOR 1.00 X 0 0 0 STANISLAW JANKOWSKI DIRECTOR 1.00 X 0 0 0 MSGR DANIEL PLOCHARCZYK DIRECTOR 1.00 X 0 0 0 CAROL ANNE SALVIETTI ADMINISTRATOR 40.00 X X 100390 0 32190 CLAIRS PIETRAS DIRECTOR 1.00 X 0 0 0 SHIELA AMARAL DIRECTOR 1.00 X 0 0 0 SISTER MARY LUCILLE BAMACH VP/TREASURER OF DMICC 1.00 X X 0 0 0 SISTER MARY CLAIRE MILEWSKI SECRETARY OF DMICC 1.00 X X 0 0 0 SISTER MARY JANICE ZDUCZYK COUNSELOR OF DMICC 1.00 X X 0 0 0 168133 0 43407 1 0 0 0 GENESIS HEALTH VENTURES PO BOX 7247-6524 PHILADELPHIA PA 19170 THERAPY 384567 PREFERRED THERAPY 850 SILAS DEANE HIGHWAY WETHERSFIELD CT 06109 THERAPY 138719 2 779116 779116 MEDICARE/MEDICAID PAYM 623110 4448240 4448240 PATIENT REVENUE 623110 1910000 1910000 6358240 1620 1620 7138976 6359860 0 0 157659 157659 3184756 3100510 84246 8942 8295 647 885105 821046 64059 238918 221626 17292 4109 4109 23300 23300 25753 25753 100178 100178 58389 58389 246121 221509 24612 3918 3526 392 3580 3580 122250 122250 261182 261182 49092 49092 THERAPY AND MEDICAL 708297 708297 PROVIDER TAX 336783 336783 FOOD 130356 130356 21578 19420 2158 6570266 5881642 688624 0 882122 761746 44751 44764 540412 408741 11678 21513 16225 17179 6632424 5300934 701136 1331490 2196324 2585433 383431 326105 3259 3259 2203245 2080970 2589935 2410334 X -393611 175099 -393611 175099 2196324 2585433 568710 0 X 0 1 X 0 0 X 6080 25347 16347 118892 779116 945782 5963840 6357250 6708955 6706889 6358240 32095174 5969920 6382597 6725302 6825781 7137356 33040956 0 0 0 33040956 1552 1386 1319 1144 1620 7021 1552 1386 1319 1144 1620 7021 5971472 6383983 6726621 6826925 7138976 33047977 0.99980 0.99980 0.00020 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5059634 3981026 1078608 106376 100462 5914 1466414 1219446 246968 1331490 LOAN DUE TO THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION 82462 NOTES PAYABLE TO THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION 1981197 RESIDENT FUNDS 17311 2080970 7138976 0 7138976 0 7138976 6570266 0 6570266 0 6570266 FORM 990, PART VI, SECTION B, LINE 11B THE ADMININSTRATOR OF THE MANOR WILL REVIEW THE 990 AND APPROVE THE FORM TO BE FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS MONITORS AND REVIEWS RELATIONSHIPS ANNUALLY AND ANY CONFLICTS ARE BROUGHT TO THE ATTENTION OF THE BOARD. THE BOARD WILL REVIEW THE CONFLICTS TO DETERMINE THEIR AFFECTS ON THE MANOR. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION FOR THE ADMINISTRATOR WILL BE BASED ON A FAIR MARKET RATE. THIS WILL BE ACCOMPLISHED BY COMPARING COMPENSATION PACKAGES OF SIMILIAR SIZE HEALTH CARE FACILITIES BY GATHERING COMPENSATION DATA FROM ONLINE RESOURCES AND TRADE ASSOCIATIONS. ADDITIONALLY, THE EXPERIENCE OF THE CANDIDATE IS CONSIDERED AS PART OF THE COMPENSATION DETERMINATION. THE COMPENSATION PACKAGE WILL BE REVIEWED BY THE BOARD OF DIRECTORS AND APPROVED BY THE PRESIDENT OF THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION, INC. FORM 990, PART VI, SECTION C, LINE 18 DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION 314 OSGOOD AVE NEW BRITAIN CT 06053 060995128 CHURCH CT 501(C)(3) LINE 1 N/A 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION E 2063970 HISTORICAL COST THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION C 742203 HISTORICAL COST