2017-11-13T14:52:57-06:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2016-01-01 800687948 SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC SOUT 6174230590 288 WASHINGTON STREET QUINCY MA 02169 KATHRYN PLAZAK PRESIDENT & CEO 6174230590 2017-11-07 1 JUDY DALEY P01294075 6179848100 2017-11-07 67.137.57.251 2017-11-07 11:32:40 ES P D1ECA57A6B2E25FD1BF1F84BA5BB5DD4C2FC09DC DB979484B03525D8111AE7C1A10965ABCD2EA500 2016 2017-02-10 21:41:12Z KATHRYN PLAZAK 288 WASHINGTON STREET QUINCY MA 02169 15010495 0 X WWW.SOUTHCOVEMANOR.COM X 2011 MA TO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES. 16 16 260 19 0 0 194355 32365 14618745 14509492 464690 465113 4067 3525 15281857 15010495 0 0 0 0 8729324 8940647 0 0 5352 6236696 6138430 14966020 15079077 315837 -68582 27002929 24761260 23865406 21476319 3137523 3284941 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 11899922 14513317 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. 11899922 1 0 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 0 0 0 0 0 0 0 0 1 1 1 0 0 1 11 0 1 260 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 0 1 1 1 1 1 1 0 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 WENDY LEE PRESIDENT & CEO 40.00 2.00 X 176088 0 0 SCOTT HANSON DIRECTOR OF FINANCE 40.00 2.00 X 116193 0 3319 LI CHEN ADMINISTRATOR 40.00 0.00 X 141068 0 15022 ROULAN ZHAO DIRECTOR OF NURSING 40.00 0.00 X 107916 0 14424 541265 0 32765 4 0 1 0 PARAGON REHABILITATION 303 N HURSTBOURNE PARKWAY LOUISVILLE KY 40222 THERAPY SERVICES 671774 1 32365 32365 NET PATIENT SERVICE REVENUE 623000 14509492 14509492 14509492 465113 465113 OTHER REVENUE 623000 3525 3525 3525 15010495 14513017 0 465113 451690 451690 6968731 6276979 691752 111028 94152 16876 670483 584124 86359 738715 626432 112283 1353 1353 73988 73988 928227 892885 30825 4517 31144 31144 161660 161660 1688330 1688330 885 885 18031 18031 637599 637599 241967 241967 127416 31735 95681 USER FEES 910743 910743 DIETARY 480324 480324 PROVISION FOR BAD DEBTS 457025 457025 MEDICAL SUPPLIES AND EX 234896 234896 144842 110499 33508 835 15079077 11899922 3173803 5352 3590165 2641120 1350025 362970 266113 0 1205850 1383503 18600277 18600277 98132 183728 2125598 590611 1705994 1534987 186373 54675 27002929 24761260 1285770 1191142 18963217 18396076 3616419 1889101 23865406 21476319 X 2871410 3284941 266113 0 3137523 3284941 27002929 24761260 X -68582 216000 X 0 1 X 1 0 X 2561500 1416608 546712 194355 32365 4751540 8307173 14622812 14513017 37443002 2561500 1416608 8853885 14817167 14545382 42194542 300500 1022500 122220 1445220 0 300500 1022500 122220 1445220 40749322 50406 464038 462251 464690 465113 1906498 50406 464038 462251 464690 465113 1906498 2611906 1880646 9316136 15281857 15010495 44101040 0.92400 0.90360 0.04320 0.04810 X 356710 318024 38686 1768888 272587 1496301 1534987 DUE TO RELATED PARTIES 350616 OTHER LIABILITIES 1538485 1889101 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. X X X X 0 0 0 0 0 0 0 0 0 WENDY LEE PRESIDENT & CEO 176088 0 0 0 0 0 0 0 0 0 176088 0 0 0 LI CHEN ADMINISTRATOR 141068 0 0 0 0 0 0 0 15022 0 156090 0 0 0 A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 2012-10-30 19000000 LAND ACQUISITION AND FACILITY CONSTRUCTION AND FURNISHING 0 0 0 A 603924 19000000 19000000 2015 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 1 0 0 0 1 A 0 FORM 990, PART VI, SECTION A, LINE 1 THE MANAGEMENT/COMPENSATION COMMITTEE IS MADE OF BOARD DIRECTORS. 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. A BUSINESS RELATIONSHIP EXISTS WITH HEMMIE CHANG WHO WORKS FOR THE ORGANIZATION'S LEGAL FIRM, FOLEY AND HOAG. 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 AFTER 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 15A 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 10 SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC 1 SOUTH COVE MANOR INC 288 WASHINGTON STREET QUINCY MA 02169 042820772 NURSING HOME MA N/A C 0 0 0 1 1 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 SOUTH COVE MANOR NURSING & REHAB CENTER QALICB INC C 216000 FMV SOUTH COVE MANOR NURSING & REHAB CENTER QALICB INC D 37097 FMV SOUTH COVE NURSING FACILITIES FOUNDATION INC E 387713 FMV SOUTH COVE MANOR NURSING & REHAB CENTER QALICB INC K 1215734 FMV SOUTH COVE MANOR NURSING & REHAB CENTER QALICB INC K 1114917 FMV