2017-07-25T10:44:15-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2016-01-01 042066524 SANCTA MARIA HOSPITAL INC SANC 6178682200 799 CONCORD AVENUE CAMBRIDGE MA 02138 ROBERT KELLEY DIRECTOR OF FINANCE 6178682200 2017-06-27 1 JUDY DALEY P01294075 6179848100 2017-06-16 67.137.57.251 2017-06-27 13:21:31 ED P 29F87A9D39E1AF1CE74A79087F12977789B3302A E54F94374F221F7E7B33A99DBD17B932AED3BD09 2016 2021-01-29 14:40:06Z SANCTA MARIA NURSING FACILITY MARY JANE NOTTONSON 799 CONCORD AVENUE CAMBRIDGE MA 02138 13553581 0 X HTTP://SANCTAMARIA.ORG X 1948 MA THE PROVISION OF INPATIENT SKILLED NURSING SERVICES TO INDIVIDUALS REQUIRING SUCH CARE DUE TO PHYSICAL CONDITION OR INFIRMITY. 10 8 243 9 -119794 -119794 22670 29859 10791334 11628803 127403 80515 790436 558702 11731843 12297879 0 0 0 0 8571040 8918054 0 0 0 4795496 4285012 13366536 13203066 -1634693 -905187 8403630 9001468 2074149 3545333 6329481 5456135 X FAITHFUL TO THE SPIRIT OF THE CONGREGATION OF THE DAUGHTERS OF MARY, SANCTA MARIA NURSING FACILITY'S MISSION IS TO WITNESS CHRIST'S COMPASSION, CARING AND LOVE, REFLECTING THE CATHOLIC CHURCH'S ROLE IN THE CONTINUATION OF CHRIST'S HEALING MINISTRY. COMMITTED TO THE VALUES OF DIGNITY AND RESPECT, LIFE, SERVICE AND SOCIAL JUSTICE, SANCTA MARIA STRIVES TO PROVIDE QUALITY HEALTH CARE TO ALL OF ITS PATIENTS/RESIDENTS. 0 0 11851524 11660624 PROVISION OF CHARITABLE HEALTH CARE SERVICES TO THE SURROUNDING COMMUNITY SUFFERING FROM ILLNESS OR DISABILITIES REQUIRING NURSING HOME CARE THROUGH A CATHOLIC, NON-PROFIT FACILITY COMMITTED TO THE HIGHEST STANDARDS OF MEDICAL CARE AND PRACTICE. 11851524 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 10 0 1 243 1 1 1 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 MA X MARY JANE NOTTONSON 6178682200 799 CONCORD AVENUE CAMBRIDGE MA 02138 JOHN O'NEILL CHAIRMAN 1.00 X 0 0 0 NORMAN MCIVER VICE CHAIRMAN 1.00 X 0 0 0 ROY PUBLICOVER PAST CHAIR 1.00 X 0 0 0 SHEILA HICKEY CLERK 1.00 X 0 0 0 JAMES HAWKINS DIRECTOR 1.00 X 0 0 0 JOSEPH BARRELL JR DIRECTOR 1.00 X 0 0 0 JOSEPH CONNARTON DIRECTOR 1.00 X 0 0 0 MICHAEL GULESERIAN DIRECTOR 1.00 X 0 0 0 JAMES F FERREIRA DIRECTOR 1.00 X 0 0 0 SISTER LUCILLE BANACH DIRECTOR 30.00 X X 48745 0 3046 MARY JANE NOTTONSON ADMINISTRATOR 40.00 X X 138905 0 22410 MARILOU LAGMAN DIRECTOR OF NURSING 40.00 X X 126519 0 22408 314169 0 47864 2 0 1 0 PARAGON REHABILITATION 2701 CHESTNUT STATION COURT LOUSIVILLE KY 40299 PT,OT,ST,RT CONSULTANTS 492170 US FOODSERVICE INC 10 CAUSEWAY STREET BOSTON MA 02222 PATIENT FOOD 335555 PHARMAMERICA 1901 CAMPUS PLACE LOUSIVILLE KY 40299 LTC PATIENT DRUGS 210937 MCKESSON MEDICAL SUPPLY 275 GROVE STREET 1-110 AUBURNDALE MA 02466 PATIENT MEDICAL SUPPLIES 186840 LIMBACH COMPANY 180 NEW BOSTON STREET WOBURN MA 01801 HVAC EQUIP/SERVICE 117129 5 29859 29859 NET PATIENT SERVICE REVENUE 623000 11628803 11628803 11628803 64554 64554 926212 399331 526881 526881 -119794 646675 872332 856371 15961 15961 15961 OTHER INCOME 623000 31821 31821 31821 12297879 11660624 -119794 727190 362031 362031 7045053 6601697 443356 960436 809418 151018 550534 550534 14003 14003 57085 57085 27851 27851 90584 90584 9479 9479 57675 57675 73183 73183 525912 525912 2064 1538 526 29441 29441 449218 449218 92658 92658 PROGRAM EXPENSES 1406219 1406219 USER FEE 784670 784670 BAD DEBT EXPENSES 379057 379057 SUPPLIES AND EXPENSES 123155 123155 162758 100081 62677 13203066 11851524 1351542 0 883201 1685579 53503 42456 1389208 1445842 19180 21000 29448 23818 20631430 17404935 3083610 3226495 2945480 2556278 8403630 9001468 1096968 1645789 977181 1899544 2074149 3545333 X 6293889 5400247 12122 32418 23470 23470 6329481 5456135 8403630 9001468 -905187 31841 0 X 0 1 X 1 0 X 10085 12883 1119777 22670 29859 1195274 14234443 13571275 12188962 11088472 11645161 62728313 14244528 13584158 13308739 11111142 11675020 63923587 0 0 0 63923587 725116 700327 879415 881291 990766 4176915 725116 700327 879415 881291 990766 4176915 -108500 -119794 -228294 14969644 14284485 14188154 11883933 12545992 67872208 0.94180 0.94650 0.06150 0.05500 X 35592 25279 4983 55888 35081 511 35592 35081 35081 35081 35081 35047 34 35081 0.00000 0.41990 0.58000 0 0 322500 322500 9909897 8934103 975794 9717852 7951633 1766219 681181 519199 161982 3226495 SECURITY DEPOSIT LIABILITY 6450 ASSET RETIREMENT OBLIGATION 520117 ESTIMATED THIRD PARTY PAYER SETTLEMENTS 572977 DUE TO AN AFFILIATE 800000 1899544 X 12697210 0 12697210 -399331 -399331 12297879 13602397 399331 399331 13203066 0 13203066 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO BE USED FOR EDUCATIONAL PURPOSES, THE ORGANIZATION'S CHAPEL EXPENSES, AND FURTHERING THE ORGANIZATION'S MISSION. 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. THE ORGANIZATION FOLLOWS THE POLICY FOR UNCERTAINTY IN INCOME TAXES TO BE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE POLICY PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. NO UNCERTAIN INCOME TAX POSITIONS WERE IDENTIFIED FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF RENTAL EXPENSES -399,331. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASS OF RENTAL EXPENSES 399,331. X X 0 0 0 0 0 0 0 0 0 MARY JANE NOTTONSON ADMINISTRATOR 138905 0 0 0 0 0 0 0 22410 0 161315 0 0 0 PART I, LINE 3 THE BOARD CHAIRMAN ANNUALLY REVIEWS THE COMPENSATION OF THE ADMINISTRATOR BASED ON HIS/HER PERFORMANCE AND THROUGH THE USE OF A COMPENSATION SURVEY. THE MEMBERS OF THE BOARD REVIEW, DOCUMENT, AND APPROVE THE ANNUAL BUDGET. JOSEPH BARRELL JR DIRECTOR & PRESIDENT OF ARRELL CORPORATION 15928 THE ORGANIZATION PURCHASED SERVICES FROM THE ARRELL CORPORATION FOR THE YEAR ENDED DECEMBER 31, 2016. 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION PROVIDES A COPY OF THE COMPLETE FORM 990 TO THE BOARD MEMBERS AND REVIEWS THE FORM 990 IN AN OFFICIAL MEETING WITH ITS FINANCE COMMITTEE BEFORE SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C IF AN INDIVIDUAL ON THE BOARD HAS A CONFLICT OF INTEREST, THAT INDIVIDUAL MUST ABSTAIN FROM VOTING ON ANY MATTERS RELATED TO THAT CONFLICT. IN ANY MATTER THAT WOULD RESULT IN A CONFLICT OF INTEREST, SUCH INDIVIDUALS ARE NOT PERMITTED TO FACTOR IN THE DECISION-MAKING PROCESS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD CHAIRMAN ANNUALLY REVIEWS THE COMPENSATION OF THE ADMINISTRATOR BASED ON HIS/HER PERFORMANCE AND THROUGH THE USE OF A COMPENSATION SURVEY. THE MEMBERS OF THE BOARD REVIEW, DOCUMENT, AND APPROVE THE ANNUAL BUDGET. FORM 990, PART VI, SECTION C, LINE 19 AN INTERESTED PARTY CAN MAKE A DIRECT REQUEST TO SEE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS OF THE ORGANIZATION. THE FORM 990 CAN ALSO BE FOUND ON THE MASSACHUSETTS ATTORNEY GENERAL'S PUBLIC CHARITIES WEBSITE.