2017-11-15T10:58:22-06:00 2016-12-31 420714325 RSM US LLP 80 CITY SQUARE BOSTON MA 021293742 990 2016-01-01 042105844 CARLETON-WILLARD HOMES INC CARL 7812758700 100 OLD BILLERICA ROAD BEDFORD MA 01730 BARBARA A DOYLE PRESIDENT & CEO 7812758700 2017-11-15 1 LYNNE JOHNSON P00757336 6179129000 108.171.131.186 2017-11-15 11:39:02 ES P 797C4527DD8FA635CA18458D5F36AC81F3168434 808B1D28703E5C3EA38D0C6AFAC88E3156F3957D 2016 2021-01-29 14:40:06Z CARLETON-WILLARD VILLAGE BARBARA A DOYLE 100 OLD BILLERICA ROAD BEDFORD MA 01730 47043533 0 X WWW.CWVILLAGE.ORG X 1980 MA CARLETON-WILLARD VILLAGE IS A CONTINUING CARE RETIREMENT COMMUNITY OFFERING A COMPLETE RANGE OF SERVICES FROM INDEPENDENT LIVING APARTMENTS AND CLUSTER HOMES TO ASSISTANCE IN LIVING, SKILLED NURSING AND REHABILITATION SERVICES IN A COMMUNITY OF 350 RESIDENTS. 20 20 404 25 0 0 404403 593470 29081910 29123515 856676 826634 0 0 30342989 30543619 168223 160600 0 0 17380382 17967959 0 0 5000 12922482 13067590 30471087 31196149 -128098 -652530 64523536 67650445 40996173 44088513 23527363 23561932 X CONTINUING THE LEGACY FROM 1884, CARLETON-WILLARD HAS BEEN A RESPECTED AND PROGRESSIVE LEADER IN PROVIDING COMPREHENSIVE SERVICES AND SUPPORT FOR OLDER ADULTS. WE PROVIDE OUTSTANDING FACILITIES AND SERVICES, A CARING AND DEDICATED STAFF AND AN ACTIVE AND VIBRANT COMMUNITY BUILT IN COLLABORATION WITH THOSE WE SERVE. 0 0 6894717 54630 10571071 OPERATES A COMMUNITY WITH 148 INDEPENDENT LIVING UNITS SERVICING APPROXIMATELY 189 RESIDENTS. ACCOMMODATIONS INCLUDE DAILY MEALS, WEEKLY HOUSEKEEPING AND LINEN SERVICES, TRANSPORTATION TO MEDICAL APPOINTMENTS, LOCAL SHOPPING AND ONSITE ACTIVITIES, MOST UTILITIES, TRASH REMOVAL AND RECYCLING, PARKING, 24/7 SECURITY, IN-UNIT EMERGENCY MONITORING SYSTEM, FITNESS CENTER, CRAFT STUDIO, WOODWORKING SHOP, COMPUTER CENTER, LIBRARY AND AN EXTENSIVE ACTIVITY PROGRAM. ADDITIONALLY, RESIDENTS HAVE THE CONVENIENCE OF ON-SITE BANKING, AN INDOOR POOL, GENERAL STORE/GIFT SHOP, FLORIST, BEAUTY SALON AND ACCESS TO ORGANIZED ACTIVITIES BEYOND THE COMMUNITY. 19001534 105970 18349697 OPERATING A 100 BED SKILLED NURSING FACILITY AND A 79 BED REST HOME FOR APPROXIMATELY 161 RESIDENTS. SKILLED NURSING PROVIDES LONG TERM CARE, SHORT TERM STAYS/REHABILITATION AND DEMENTIA/ALZHEIMER CARE IN A DISTINCT, AWARD WINNING UNIT. ASSISTANCE IN LIVING CARE IS PROVIDED IN THE REST HOME AREA OF THE VILLAGE TO THOSE REQUIRING VARIOUS SUPPORTIVE SERVICES WHILE NOT INFRINGING ON RESIDENT'S CAPABILITIES. BOTH SKILLED NURSING AND ASSISTANCE IN LIVING SERVICES ARE AVAILABLE TO INDEPENDENT RESIDENTS OF CARLETON-WILLARD AND TO SENIORS FROM SURROUNDING COMMUNITIES. 760950 202747 OPERATES AN ON-SITE OUTPATIENT CLINIC SERVING APPROXIMATELY 250 RESIDENTS FROM CARLETON-WILLARD'S INDEPENDENT AND ASSISTANCE IN LIVING PROGRAMS. COMPREHENSIVE SERVICES AVAILABLE THROUGH THE CLINIC INCLUDE ROUTINE AND URGENT OUTPATIENT CARE, SCHEDULED APPOINTMENTS IN A VARIETY OF SPECIALTIES INCLUDING OPHTHALMOLOGY, PODIATRY, DERMATOLOGY, PSYCHIATRY, AUDIOLOGY AND PHYSICAL, SPEECH AND OCCUPATIONAL THERAPIES. STAFFED BY A FULLTIME NURSE PRACTITIONER AND OTHER CLINIC STAFF. 26657201 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 81 0 1 404 1 0 0 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MA X JANET D SILVERMAN CFO 7812758700 100 OLD BILLERICA ROAD BEDFORD MA 01730 JOHN E CUPPLES CHAIRMAN 8.00 0.10 X X 0 0 0 THOMAS WOODHOUSE VICE-CHAIRMAN 8.00 0.00 X X 0 0 0 PETER G BROWN TREASURER 8.00 0.00 X X 0 0 0 ADRIENNE SMITH CLERK 8.00 0.00 X X 0 0 0 BARBARA A CLIFFORD TRUSTEE 2.00 0.60 X 0 0 0 ROBERT G CROCKER TRUSTEE 2.00 0.60 X 0 0 0 CATHERINE B DAMON TRUSTEE 2.00 0.10 X 0 0 0 WILLIAM W GALLAGHER III TRUSTEE 2.00 0.60 X 0 0 0 ROBIN GRACE TRUSTEE 2.00 0.00 X 0 0 0 PAUL HARRISON JR TRUSTEE 2.00 0.00 X 0 0 0 WILLIAM C HAYS ESQ TRUSTEE 2.00 0.60 X 0 0 0 JUDITH D HOOD TRUSTEE 2.00 0.10 X 0 0 0 WILLIAM W JACKSON TRUSTEE 2.00 0.60 X 0 0 0 REV JOHN C LOMBARD D MIN TRUSTEE 2.00 0.60 X 0 0 0 RUTH W PIPER TRUSTEE 2.00 1.10 X 0 0 0 JAMES A SALTONSTALL TRUSTEE 2.00 0.60 X 0 0 0 ANN MARIE TEUBER LMFT TRUSTEE 2.00 0.10 X 0 0 0 CHARLES A WELCH MD TRUSTEE 2.00 0.10 X 0 0 0 CHRISTOPHER F WOLF TRUSTEE 2.00 0.10 X 0 0 0 JEFFREY J SKERRY TRUSTEE 2.00 0.00 X 0 0 0 BARBARA A DOYLE PRESIDENT & CEO 60.00 5.50 X 363922 0 44958 JANET D SILVERMAN CFO 50.00 2.50 X 197887 0 18537 VALERIE GINGRAS ADMINISTRATOR 50.00 0.00 X 193122 0 20521 BRENDA MORGAN DIRECTOR OF NURSING 40.00 0.00 X 139873 0 14330 GARY SAWIN DIRECTOR OF HR 50.00 0.00 X 163583 0 32418 SUSAN CUSSON CLINIC DIRECTOR 40.00 0.00 X 136158 0 10750 PAUL LUND DIRECTOR OF FACILITIES 40.00 0.00 X 135068 0 30808 CHRISTINE CHAMBERS NURSE MANAGER 60.00 0.00 X 119275 0 16429 1448888 0 188751 12 0 1 0 CE FLOYD 135 SOUTH STREET BEDFORD MA 01730 CONTRACTOR 4651662 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 HOUSEKEEPING/ LAUNDRY 962550 NORTON AND ASSOCIATES INC 34 ELM STREET COHASSET MA 02025 REHABILITATION SERVICES 548162 TSOMIDES ASSOCIATES 389 ELLIOT ST NEWTON UPPER FALLS MA 02464 ARCHITECT 493431 PAGE ASSOCIATES INC PO BOX 64 BEDFORD MA 01730 CONTRACTOR 406725 14 593470 31757 593470 NURSING REV & CLIN SVS 623000 14543181 14543181 RESIDENTIAL FEES 623990 7266564 7266564 MEDICAID/MEDICARE PMTS 900099 3370071 3370071 ENTRANCE FEES 900099 3303391 3303391 REHAB SERVICES 624310 184427 184427 455881 455881 29123515 645334 645334 16681214 16435205 64709 246009 -64709 181300 181300 30543619 29123515 0 826634 11807 11807 148793 148793 844290 844290 14092901 13148323 939578 5000 444467 413354 31113 1531713 1424493 107220 1054588 980767 73821 57409 57409 100810 100810 135628 135628 2699323 2502424 196899 89082 89082 1911433 1679617 231816 224320 224320 1865350 1865350 2983 1399 1584 22167 14987 7180 786244 786244 90000 90000 3117634 3117634 142966 142966 FOOD 1290778 1282812 7966 BAD DEBTS EXPENSES 367185 367185 USER FEE 58481 58481 UNIFORMS 53849 53849 51948 11592 40356 31196149 26657201 4533948 5000 3800 3800 1436727 2016861 1291888 1656698 51549 46129 483627 344455 85811578 53791814 26550010 32019764 32968042 29831100 116740 118824 1621153 1612814 64523536 67650445 3402543 4197669 23008958 25296806 14185880 13603342 398792 990696 40996173 44088513 X 20667222 20666488 1825209 1858192 1034932 1037252 23527363 23561932 64523536 67650445 X -652530 695587 -8488 X 0 1 X 1 0 X 279082 226041 282109 404403 593470 1785105 25927002 26866264 29271639 29081910 29123515 140270330 26206084 27092305 29553748 29486313 29716985 142055435 5047 5047 0 5047 5047 142050388 646114 567651 762067 607111 645334 3228277 646114 567651 762067 607111 645334 3228277 26852198 27659956 30315815 30093424 30362319 145283712 0.97770 0.97670 0.02220 0.02330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 28689367 52876 1234562 5374073 24602732 30006163 194786 -640246 871336 28689367 29641281 121110 1059101 815329 30006163 25641801 2066555 2660024 727099 29641281 24110375 23579 2211758 703911 25641801 0.90560 0.03730 0.05710 1 0 1436988 1436988 64748751 44413937 20334814 12209966 9377877 2832089 7415873 7415873 32019764 LIABILITY UNDER SWAP AGREEMENTS 131067 DUE TO CARLETON-WILLARD FOUNDATION, INC. 73614 REFUNDABLE ENTRANCE FEE DEPOSITS 288415 LINE OF CREDIT 497039 DUE TO CARLETON-WILLARD AT HOME 561 990696 X 31230718 695587 -8488 687099 30543619 0 30543619 31060521 0 31060521 135628 135628 31196149 PART V, LINE 4: THE ORGANIZATION INTENDS TO USE THE ENDOWMENT FUNDS FOR THE FOLLOWING ACTIVITIES: 1) PROVIDING ASSISTANCE TO RESIDENTS WITH FINANCIAL NEED 2) COMMUNITY OUTREACH PROGRAMS 3) REALIZATION OF THE ORGANIZATION'S GOALS/MISSION PART X, LINE 2: THE ORGANIZATION FOLLOWS FASB ASC 740, "INCOME TAXES", WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES BY PRESCRIBING THE RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION RECOGNIZES A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD NO MATERIAL UNCERTAINTIES IN INCOME TAXES AS OF DECEMBER 31, 2016 AND 2015. THE ORGANIZATION WILL ACCOUNT FOR INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IF ANY, AS PART OF TAX EXPENSE. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN ON INVOLUNTARY CONVERSION OF NONMONETARY ASSETS 149,947. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 2,084. LOSS ON SWAP AGREEMENT -91,988. OTHER THAN TEMPORARILY IMPAIRMENT LOSS -68,531. 1 CONCORD MUSEUM PO BOK 146 CONCORD MA 01742 042104035 501(C)(3) 10000 GENERAL PURPOSE 1 SCHOLARSHIPS 4 11600 SCHOLARSHIPS FOR EMPLOYEES FURTHERING HEALTHCARE EDUCATION; DINING STAFF FINANCIAL ASSISTANCE 3 137193 FMV FINANCIAL ASSISTANCE TO RESIDENTS OF CARLETON-WILLARD HOMES. MONTHLY FEE REDUCTION. PART I, LINE 2: GRANTS AND DONATIONS ARE MADE BASED ON WRITTEN REQUESTS AND EVALUATION BY THE PRESIDENT/CEO OF THE ORGANIZATION. GRANTS ARE GENERALLY TO ORGANIZATIONS WITH MISSIONS SIMILAR OR RELATED TO CARLETON-WILLARD OR IN SUPPORT OF THE LOCAL COMMUNITY. MOST GRANTS ARE VIEWED AS A PART OF OUR COMMUNITY OUTREACH/SOCIAL ACCOUNTABILITY PROGRAM. GRANTS TO RESIDENTS ARE BASED ON AN APPLICATION PROCESS DEMONSTRATING FINANCIAL NEED. X 1 1 X X X X X 1 0 0 0 0 0 0 1 0 BARBARA A DOYLE PRESIDENT & CEO 314235 0 42767 0 6920 0 10600 0 34358 0 408880 0 0 0 JANET D SILVERMAN CFO 191065 0 5771 0 1051 0 8050 0 10487 0 216424 0 0 0 VALERIE GINGRAS ADMINISTRATOR 185159 0 5880 0 2083 0 7858 0 12663 0 213643 0 0 0 BRENDA MORGAN DIRECTOR OF NURSING 87255 0 0 0 52618 0 2524 0 11806 0 154203 0 0 0 GARY SAWIN DIRECTOR OF HR 157216 0 4685 0 1682 0 5611 0 26807 0 196001 0 0 0 PAUL LUND DIRECTOR OF FACILITIES 134026 0 600 0 442 0 4351 0 26457 0 165876 0 0 0 PART I, LINE 1A THE BOARD OF TRUSTEES HAS APPROVED SPOUSAL TRAVEL AS A BENEFIT FOR BARBARA DOYLE, PRESIDENT/CEO. THIS BENEFIT IS TAXABLE TO THE PRESIDENT/CEO. PART I, LINE 4A DURING THE YEAR THERE WERE SEVERANCE PAYMENTS MADE TO BRENDA MORGAN, DIRECTOR OF NURSING. ALL AMOUNTS PAID HAVE BEEN REPORTED ON FORM W-2 AS TAXABLE INCOME AND ARE PROPERLY DISCLOSED IN PART VII, AND SCHEDULE J PART II AS REQUIRED BY THE INSTRUCTIONS TO FORM 990 AND SCHEDULE J. THE TERMS AND CONDITIONS OF SUCH AGREEMENT ARE CONFIDENTIAL AND WILL BE MADE AVAILABLE TO THE IRS UPON ITS REQUEST. PART I, LINE 7 BONUSES FOR THE CFO, ADMINISTRATOR, DIRECTOR OF HR, AND DIRECTOR OF FACILITIES ARE AT THE DISCRETION OF THE PRESIDENT AND CEO. FOR THE PRESIDENT AND CEO'S BONUS, A PORTION OF THE BONUS IS AT THE DISCRETION OF THE BOARD OF TRUSTEES AND THE REMAINING PORTION IS A FIXED FORMULA PER CONTRACT. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57583RX26 2010-03-18 17800000 REFUND PRIOR ISSUE (5/25/2000) 0 0 0 A 3835000 17730158 1386928 15899627 443603 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 0 1 MORGAN STANLEY 28.000000000000 0 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/31/2016 X 2 31757 FMV 0 0 0 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTIONS REPRESENTS THE NUMBER OF GIFTS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY THE ORGANIZATION'S ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY THE ORGANIZATION'S MANAGEMENT. A DRAFT IS REVIEWED BY THE PRESIDENT/CEO AND CFO AND NECESSARY CHANGES ARE MADE. A FINAL DRAFT IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES. AFTER APPROVAL BY THE FINANCE COMMITTEE, THE FORM 990 IS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, TRUSTEES AND KEY EMPLOYEES (PRESIDENT/CEO, CFO, ADMINISTRATOR AND HR DIRECTOR) ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. THE DISCLOSURES ARE REVIEWED BY THE PRESIDENT/CEO AND ANY CONFLICT OF INTEREST IS REPORTED TO THE BOARD OF TRUSTEES. PERSONS WITH A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE RELATED TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE, COMPRISED OF INDEPENDENT TRUSTEES, HAS THE RESPONSIBILITY OF OVERSEEING THE PROCESS OF ESTABLISHING COMPENSATION FOR THE PRESIDENT/CEO ON AN ANNUAL BASIS. ALONG WITH A REVIEW OF PERFORMANCE, THE COMMITTEE (PERIODICALLY) UTILIZES THE SERVICES OF AN INDEPENDENT, THIRD PARTY EMPLOYMENT SPECIALIST IN DETERMINING APPROPRIATE COMPENSATION COMPARABILITY DATA CONSIDERING THE INDIVIDUAL'S RESPONSIBILITIES, EDUCATION BACKGROUND, EXPERIENCE, LONGEVITY AND INDUSTRY STANDING. THE COMPENSATION COMMITTEE PRESENTS THE COMPENSATION RECOMMENDATION TO THE BOARD OF TRUSTEES FOR APPROVAL. THIS PROCESS WAS LAST UNDERTAKEN IN 2016, EXCEPT FOR THE USE OF AN EMPLOYMENT SPECIALIST. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS BASED ON AN ANNUAL EVALUATION. THIS ANNUAL REVIEW OF COMPENSATION IS COMPRISED OF A PERFORMANCE EVALUATION AND SALARY COMPARISON TO LIKE ORGANIZATIONS. THE EMPLOYEE EXPERIENCE AND LONGEVITY IS ALSO TAKEN INTO CONSIDERATION. FINAL COMPENSATION FOR THESE POSITIONS IS DETERMINED BY THE PRESIDENT/CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FORM 990 AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). IN ADDITION, THE FORM 990 WITHOUT SCHEDULE B CAN BE ACCESSED VIA GUIDESTAR AND THE MASSACHUSETTS ATTORNY GENERAL WEBSITE. FORM 990, PART XI, LINE 9: LOSS ON SWAP AGREEMENT -91,988. GAIN ON INVOLUNTARY CONVERSION OF NONMONETARY ASSETS 149,947. OTHER THAN TEMPORARILY IMPAIRMENT LOSS -68,531. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 2,084. CARLETON-WILLARD FOUNDATION INC 100 OLD BILLERICA ROAD BEDFORD MA 01730 205785760 SUPPORTING ORGANIZATION MA 501(C)(3) LINE 12B, II CARLETON-WILLARD HOMES INC 1 CARLETON-WILLARD AT HOME INC 100 OLD BILLERICA ROAD BEDFORD MA 01730 264153105 PROVIDING SERVICES TO ELDERS LIVING AT HOME MA 501(C)(3) LINE 10 CARLETON-WILLARD HOMES INC 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 CARLETON-WILLARD AT HOME INC B 90000 FAIR MARKET VALUE