2017-11-07T09:31:16-06:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2016-01-01 042171194 DON ORIONE NURSING HOME SONS OF DIVINE PROVIDENCE INC SONS 6175692100 111 ORIENT AVENUE EAST BOSTON MA 02128 REV MIREK KOWALCZYK PRESIDENT 6175692100 2017-10-25 1 JUDY DALEY P01294075 6179848100 2017-10-17 67.137.57.251 2017-10-25 16:15:05 ED P 499B49BEE9E95068E93680D69C996EB6A62D8814 841D42CDB55AA9E3247DE7607DFCD4A54B7F94D0 2016 2018-03-14 21:41:22Z REV MIREK KOWALCZYK 111 ORIENT AVENUE EAST BOSTON MA 02128 11714373 0 X X 1949 MA TO ESTABLISH AND MAINTAIN HOMES FOR THE AGED AND FOR THE NEEDY. 7 7 282 7 0 0 266589 0 8837867 11669817 482 827 329085 43729 9434023 11714373 0 0 0 0 6180759 7439791 0 0 0 4060210 4737954 10240969 12177745 -806946 -463372 3080537 3082457 6933081 7398373 -3852544 -4315916 THE ORGANIZATION'S MISSION IS TO ESTABLISH AND MAINTAIN HOMES FOR THE AGED AND FOR THE NEEDY. 0 0 10889291 11713546 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. 10889291 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 14 0 1 282 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 1 0 MA X REV MIREK KOWALCZYK 6175692100 111 ORIENT AVENUE EAST BOSTON MA 02128 REV MIREK KOWALCZYK PRESIDENT 40.00 X X 0 0 0 REV MARCELLO BOSCHI TREASURER 40.00 X X 0 0 0 REV GINO MARCHESANI CLERK 10.00 X X 0 0 0 REV FLAVIO PELOSO DIRECTOR 10.00 X 0 0 0 REV ANGELO QUANDRINI DIRECTOR 10.00 X 0 0 0 REV MIGUEL ALVAMIR GONCALVES DIRECTOR 10.00 X 0 0 0 REV ORESTE FERRARI DIRECTOR 10.00 X 0 0 0 THOMAS LYNCH ADMINISTRATOR 40.00 X 174993 0 14541 ZHU MAO RN 40.00 X 124519 0 14541 JANICE MORRISON ADON 40.00 X 103389 0 0 COURTNEY NASH DON 40.00 X 100346 0 0 503247 0 29082 4 0 1 0 PREFERRED THERAPY SOLUTIONS 850 SILAS DEAN HIGHWAY 2ND FLOOR WETHERSFIELD CT 06109 REHABILITATION SERVICES 607310 HPC FOOD 625 NUTMEG ROAD NORTH SOUTH WINDSOR CT 06074 FOOD SERVICES 358321 ADVOCATE HEALTHCARE MANAGEMENT 35 AVCO ROAD HAVERHILL MA 01835 MANAGEMENT SERVICES 256149 MEDLINE INDUSTRIES DEPT 1080 BOX 121080 DALLAS TX 75312 MEDICAL SUPPLIES 161864 PLATINUM BUILDERS 109 OAK STREET SUITE 202 NEWTON MA 02464 CONTRACTOR 112815 7 NET PATIENT SERVICE REVENUE 623000 11335291 11335291 ADULT DAY HEALTH REVENUE 621400 334526 334526 11669817 827 827 OTHER INCOME 623000 43729 43729 43729 11714373 11713546 0 827 189534 189534 6283086 5876852 406234 485372 454921 30451 481799 438437 43362 479568 479568 89230 89230 99923 90223 9700 687300 646925 40375 8531 8531 116507 116507 745269 745269 105480 105480 1041 1041 224726 224726 102299 102299 45004 45004 SUPPLIES 977301 977301 USER FEE ASSESSMENT 685070 685070 PATIENT ANCILLARY SERVI 209011 209011 MISCELLANEOUS EXPENSE 86045 86045 75649 75649 12177745 10889291 1288454 0 248107 406135 1205024 1605035 55332 0 6588517 5608848 1080806 979669 491268 91618 3080537 3082457 2650263 3076424 12525 0 1028909 1074566 1489491 1489370 1751893 1758013 6933081 7398373 X -3857643 -4321015 5099 5099 -3852544 -4315916 3080537 3082457 -463372 0 X 0 0 0 X 31050 619593 231482 266589 46303 1195017 8010579 7667095 8750855 8837867 11621014 44887410 8041629 8286688 8982337 9104456 11667317 46082427 0 0 0 46082427 467 347 348 482 827 2471 467 347 348 482 827 2471 1662 85930 218792 329085 43729 679198 8043758 8372965 9201477 9434023 11711873 46764096 0.98540 0.98250 0.00010 0.00010 X 96159 96159 5187861 4394827 793034 1304497 1214021 90476 979669 DUE TO RELATED PARTIES 1758013 1758013 X PART X, LINE 2: 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. 0 0 0 0 0 0 0 0 0 THOMAS LYNCH ADMINISTRATOR 174993 0 0 0 0 0 0 0 14541 0 189534 0 0 0 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. 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 VIA ETRURIA 6 ROMA ROMA IT 00183 RELIGIOUS IT 501(C)(3) LINE 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0