DON ORIONE NURSING HOME: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: DON ORIONE NURSING HOME (EIN 04-2171194)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-07
IRS object ID: 201723119349301212
Schema version: 2016v3.0
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
Form 990
Schedule A
Schedule D
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-07T09:31:16-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	300 CROWN COLONY DRIVE SUITE 310	AddressLine1Txt
City	QUINCY	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02169	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	042171194	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DON ORIONE NURSING HOME	BusinessNameLine1Txt
Business Name Line2	SONS OF DIVINE PROVIDENCE INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	SONS	BusinessNameControlTxt
Phone	6175692100	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	111 ORIENT AVENUE	AddressLine1Txt
City	EAST BOSTON	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02128	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	REV MIREK KOWALCZYK	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	6175692100	PhoneNum
Signature	2017-10-25	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JUDY DALEY	PreparerPersonNm
PTIN	P01294075	PTIN
Phone	6179848100	PhoneNum
Preparation	2017-10-17	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	67.137.57.251	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2017-10-25	IPDt
IP Tm	16:15:05	IPTm
IP Timezone	ED	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	499B49BEE9E95068E93680D69C996EB6A62D8814	AtSubmissionCreationDeviceId
At Submission Filing Device Id	841D42CDB55AA9E3247DE7607DFCD4A54B7F94D0	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2018-03-14 21:41:22Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	REV MIREK KOWALCZYK	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	111 ORIENT AVENUE	AddressLine1Txt
City	EAST BOSTON	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02128	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$11,714,373	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1949	FormationYr
Legal Domicile State	MA	LegalDomicileStateCd
Activity Or Mission	TO ESTABLISH AND MAINTAIN HOMES FOR THE AGED AND FOR THE NEEDY.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	282	TotalEmployeeCnt
Total Volunteers	7	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$266,589	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$8,837,867	PYProgramServiceRevenueAmt
CY Program Service Revenue	$11,669,817	CYProgramServiceRevenueAmt
PY Investment Income	$482	PYInvestmentIncomeAmt
CY Investment Income	$827	CYInvestmentIncomeAmt
PY Other Revenue	$329,085	PYOtherRevenueAmt
CY Other Revenue	$43,729	CYOtherRevenueAmt
PY Total Revenue	$9,434,023	PYTotalRevenueAmt
CY Total Revenue	$11,714,373	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$6,180,759	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$7,439,791	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$4,060,210	PYOtherExpensesAmt
CY Other Expenses	$4,737,954	CYOtherExpensesAmt
PY Total Expenses	$10,240,969	PYTotalExpensesAmt
CY Total Expenses	$12,177,745	CYTotalExpensesAmt
PY Revenues Less Expenses	-$806,946	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$463,372	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,080,537	TotalAssetsBOYAmt
Total Assets EOY	$3,082,457	TotalAssetsEOYAmt
Total Liabilities BOY	$6,933,081	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$7,398,373	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$3,852,544	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$4,315,916	NetAssetsOrFundBalancesEOYAmt
Mission	THE ORGANIZATION'S MISSION IS TO ESTABLISH AND MAINTAIN HOMES FOR THE AGED AND FOR THE NEEDY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$10,889,291	ExpenseAmt
Revenue	$11,713,546	RevenueAmt
Desc	THE ORGANIZATION IS A NOT-FOR-PROFIT MASSACHUSETTS CORPORATION WHICH PERFORMS RELIGIOUS ACTIVITIES AS WELL AS OPERATES A 190-BED SKILLED NURSING HOME AND AN ADULT DAY CARE PROGRAM LOCATED IN EAST BOSTON, MASSACHUSETTS.	Desc
Total Program Service Expenses	$10,889,291	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	14	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	282	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	REV MIREK KOWALCZYK	PersonNm
Phone	6175692100	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	111 ORIENT AVENUE	AddressLine1Txt
City	EAST BOSTON	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02128	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
REV MIREK KOWALCZYK
PRESIDENT	40.00	Yes (X)	Yes (X)	$0	$0	$0
REV MARCELLO BOSCHI
TREASURER	40.00	Yes (X)	Yes (X)	$0	$0	$0
REV GINO MARCHESANI
CLERK	10.00	Yes (X)	Yes (X)	$0	$0	$0
REV FLAVIO PELOSO
DIRECTOR	10.00	Yes (X)		$0	$0	$0
REV ANGELO QUANDRINI
DIRECTOR	10.00	Yes (X)		$0	$0	$0
REV MIGUEL ALVAMIR GONCALVES
DIRECTOR	10.00	Yes (X)		$0	$0	$0
REV ORESTE FERRARI
DIRECTOR	10.00	Yes (X)		$0	$0	$0
THOMAS LYNCH
ADMINISTRATOR	40.00		Yes (X)	$174,993	$0	$14,541
ZHU MAO
RN	40.00			$124,519	$0	$14,541	Yes (X)
JANICE MORRISON
ADON	40.00			$103,389	$0	$0	Yes (X)
COURTNEY NASH
DON	40.00			$100,346	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$503,247	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$29,082	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	4	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
PREFERRED THERAPY SOLUTIONS
850 SILAS DEAN HIGHWAY 2ND FLOOR	WETHERSFIELD	CT	06109	REHABILITATION SERVICES	$607,310
HPC FOOD
625 NUTMEG ROAD NORTH	SOUTH WINDSOR	CT	06074	FOOD SERVICES	$358,321
ADVOCATE HEALTHCARE MANAGEMENT
35 AVCO ROAD	HAVERHILL	MA	01835	MANAGEMENT SERVICES	$256,149
MEDLINE INDUSTRIES
DEPT 1080 BOX 121080	DALLAS	TX	75312	MEDICAL SUPPLIES	$161,864
PLATINUM BUILDERS
109 OAK STREET SUITE 202	NEWTON	MA	02464	CONTRACTOR	$112,815

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	7	CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	623000	$11,335,291	$11,335,291
ADULT DAY HEALTH REVENUE	621400	$334,526	$334,526

Field	Value	IRS element (for citing)
Total Program Service Revenue	$11,669,817	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$827	TotalRevenueColumnAmt
Exclusion	$827	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	OTHER INCOME	Desc
Business	623000	BusinessCd
Total Revenue Column	$43,729	TotalRevenueColumnAmt
Related Or Exempt Func Income	$43,729	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$43,729	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,714,373	TotalRevenueColumnAmt
Related Or Exempt Func Income	$11,713,546	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$827	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$189,534	TotalAmt
Management And General	$189,534	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$6,283,086	TotalAmt
Program Services	$5,876,852	ProgramServicesAmt
Management And General	$406,234	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$485,372	TotalAmt
Program Services	$454,921	ProgramServicesAmt
Management And General	$30,451	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$481,799	TotalAmt
Program Services	$438,437	ProgramServicesAmt
Management And General	$43,362	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$479,568	TotalAmt
Management And General	$479,568	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$89,230	TotalAmt
Management And General	$89,230	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$99,923	TotalAmt
Program Services	$90,223	ProgramServicesAmt
Management And General	$9,700	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$687,300	TotalAmt
Program Services	$646,925	ProgramServicesAmt
Management And General	$40,375	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$8,531	TotalAmt
Program Services	$8,531	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$116,507	TotalAmt
Program Services	$116,507	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$745,269	TotalAmt
Program Services	$745,269	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$105,480	TotalAmt
Program Services	$105,480	ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$1,041	TotalAmt
Program Services	$1,041	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$224,726	TotalAmt
Program Services	$224,726	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$102,299	TotalAmt
Program Services	$102,299	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$45,004	TotalAmt
Program Services	$45,004	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
SUPPLIES	$977,301	$977,301
USER FEE ASSESSMENT	$685,070	$685,070
PATIENT ANCILLARY SERVI	$209,011	$209,011
MISCELLANEOUS EXPENSE	$86,045	$86,045

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$75,649	TotalAmt
Program Services	$75,649	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,177,745	TotalAmt
Program Services	$10,889,291	ProgramServicesAmt
Management And General	$1,288,454	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$248,107	BOYAmt
EOY	$406,135	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,205,024	BOYAmt
EOY	$1,605,035	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$55,332	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$6,588,517	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$5,608,848	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,080,806	BOYAmt
EOY	$979,669	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$491,268	BOYAmt
EOY	$91,618	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,080,537	BOYAmt
EOY	$3,082,457	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,650,263	BOYAmt
EOY	$3,076,424	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$12,525	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$1,028,909	BOYAmt
EOY	$1,074,566	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$1,489,491	BOYAmt
EOY	$1,489,370	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,751,893	BOYAmt
EOY	$1,758,013	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$6,933,081	BOYAmt
EOY	$7,398,373	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$3,857,643	BOYAmt
EOY	-$4,321,015	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$5,099	BOYAmt
EOY	$5,099	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$3,852,544	BOYAmt
EOY	-$4,315,916	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,080,537	BOYAmt
EOY	$3,082,457	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$463,372	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$31,050	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$619,593	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$231,482	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$266,589	CurrentTaxYearMinus1YearAmt
Current Tax Year	$46,303	CurrentTaxYearAmt
Total	$1,195,017	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$8,010,579	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$7,667,095	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$8,750,855	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$8,837,867	CurrentTaxYearMinus1YearAmt
Current Tax Year	$11,621,014	CurrentTaxYearAmt
Total	$44,887,410	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$8,041,629	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$8,286,688	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$8,982,337	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$9,104,456	CurrentTaxYearMinus1YearAmt
Current Tax Year	$11,667,317	CurrentTaxYearAmt
Total	$46,082,427	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$46,082,427	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$467	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$347	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$348	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$482	CurrentTaxYearMinus1YearAmt
Current Tax Year	$827	CurrentTaxYearAmt
Total	$2,471	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$467	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$347	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$348	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$482	CurrentTaxYearMinus1YearAmt
Current Tax Year	$827	CurrentTaxYearAmt
Total	$2,471	TotalAmt

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,662	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$85,930	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$218,792	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$329,085	CurrentTaxYearMinus1YearAmt
Current Tax Year	$43,729	CurrentTaxYearAmt
Total	$679,198	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$8,043,758	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$8,372,965	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$9,201,477	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$9,434,023	CurrentTaxYearMinus1YearAmt
Current Tax Year	$11,711,873	CurrentTaxYearAmt
Total	$46,764,096	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.98540	PublicSupportCY509Pct
Public Support PY509	0.98250	PublicSupportPY509Pct
Investment Income CY	0.00010	InvestmentIncomeCYPct
Investment Income PY	0.00010	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$96,159	OtherCostOrOtherBasisAmt
Book Value	$96,159	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,187,861	OtherCostOrOtherBasisAmt
Depreciation	$4,394,827	DepreciationAmt
Book Value	$793,034	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,304,497	OtherCostOrOtherBasisAmt
Depreciation	$1,214,021	DepreciationAmt
Book Value	$90,476	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$979,669	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	DUE TO RELATED PARTIES	Desc
Amt	$1,758,013	Amt

Field	Value	IRS element (for citing)
Total Liability	$1,758,013	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. SHOULD THE STATUS OF THE ORGANIZATION BE CHALLENGED IN THE FUTURE, ITS 2013 THROUGH 2016 TAX YEARS ARE OPEN FOR EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	THOMAS LYNCH	PersonNm
Title	ADMINISTRATOR	TitleTxt
Base Compensation Filing Org	$174,993	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$0	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$0	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$0	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$14,541	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$0	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$189,534	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$0	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3	MANAGEMENT DUTIES WERE PERFORMED BY THE MANAGEMENT COMPANY, ADVOCATE HEALTHCARE MANAGEMENT. THE MANAGEMENT COMPANY IS RESPONSIBLE FOR DAY-TO-DAY PROGRAMS, OPERATIONS, AND BUSINESS AFFAIRS; MAINTAINING COMPLIANCE WITH ALL MATERIAL GOVERNMENTAL AND OTHER REQUIREMENTS FOR A NURSING HOME; AND ESTABLISHING POLICIES AND PROCEDURES FOR THE OPERATION OF THE FACILITY.
FORM 990, PART VI, SECTION B, LINE 11B	THE COMPLETE FORM 990 IS REVIEWED BY THE ORGANIZATION'S PRESIDENT, REV. MIREK KOWALCZYK AND THE BOARD OF DIRECTORS FOR APPROVAL, PRIOR TO BEING FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	EACH DIRECTOR, OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED AUTHORITY SHALL ANNUALLY SIGN A STATEMENT. A DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS MUST DISCLOSE THE EXISTENCE OF A DIRECT OR INDIRECT FINANCIAL INTEREST AND DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS, MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS. AFTER DISCLOSURE, THE PERSON WITH A FINANCIAL INTEREST SHALL NOT BE PRESENT WHILE THE GOVERNING BOARD DETERMINES IF A CONFLICT OF INTEREST EXISTS. IF THE GOVERNING BOARD OR COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS OR A MEMBER FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
FORM 990, PART VI, SECTION B, LINE 15B	THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S EMPLOYEES IS DETERMINED BY THE ADMINISTRATOR THROUGH STATE WAGE ANALYSIS AND AN ACCEPTED PAY SCALE.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
SONS OF DIVINE PROVIDENCE MADONNA SHRINE INC
150 ORIENT AVENUE	EAST BOSTON	MA	02128	800663723	RELIGIOUS	MA	501(C)(3)	LINE 1	0
SONS OF DIVINE PROVIDENCE MOTHER OF THE CHURCH
					RELIGIOUS		501(C)(3)	LINE 1	0	VIA ETRURIA 6	ROMA	ROMA	IT	00183	IT

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (1)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd