2017-06-02T12:55:34-05:00 2016-09-30 060903326 WHITTLESEY & HADLEY PC 280 TRUMBULL ST 24TH FL HARTFORD CT 06103 990 2015-10-01 060907212 MONSIGNOR BOJNOWSKI MANOR INC MONS 8602290336 50 PULASKI STREET NEW BRITAIN CT 06053 MOTHER MARY JENNIFER CARROLL PRESIDENT 8602290336 2017-06-02 1 LISA WILLS CPA P01828548 8605223111 2015 2021-01-29 14:40:06Z MOTHER MARY JENNIFER CARR 50 PULASKI STREET NEW BRITAIN CT 06053 6815986 0 X N/A X 1975 CT THE PROVIDING OF ROOM, BOARD AND CARE FOR ALL RESIDENTS OF THE FACILITY WHICH CARES FOR THE GENERAL PUBLIC IN CONNECTION WITH THE MISSION OF THE DAUGHTERS OF THE IMMACULATE CONCEPTION AND THE ROMAN CATHOLIC CHURCH. 14 13 132 0 0 0 5421 109946 6759449 6695950 1319 1144 10926 6284 6777115 6813324 0 0 0 0 4598315 4397595 0 0 0 2210787 2170935 6809102 6568530 -31987 244794 1987361 2196324 2625766 2589935 -638405 -393611 THE PROVIDING OF ROOM, BOARD AND CARE FOR ALL RESIDENTS OF THE FACILITY WHICH CARES FOR THE GENERAL PUBLIC IN CONNECTION WITH THE MISSION OF THE DAUGHTERS OF THE IMMACULATE CONCEPTION AND THE ROMAN CATHOLIC CHURCH. 0 0 5897534 6695950 SIXTY BED SKILLED NURSING FACILITY FOR THE AGED PROVIDED 20,115 DAYS OF CARE TO THE GENERAL PUBLIC FURTHERING THE MISSION OF THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION AND THE ROMAN CATHOLIC CHURCH. 5897534 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 132 1 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X CAROL ANNE SALVIETTI 8602290336 50 PULASKI STREET NEW BRITAIN CT 06053 MOTHER MARY JENNIFER CARROLL PRESIDENT OF DMICC 1.00 X X 0 0 0 SISTER MARY CATHERINE SIROTNAK DM SECRETARY/TREASURER 40.00 X X 67502 0 10417 LEONARD GIZA CHAIRPERSON 1.00 X X 0 0 0 ROBERT STORY DIRECTOR 1.00 X 0 0 0 JADWIGA PANUS DIRECTOR 1.00 X 0 0 0 DORIS RUDNICKI DIRECTOR 1.00 X 0 0 0 STANISLAW JANKOWSKI DIRECTOR 1.00 X 0 0 0 MSGR DANIEL PLOCHARCZYK DIRECTOR 1.00 X 0 0 0 CAROL ANNE SALVIETTI ADMINISTRATOR 40.00 X X 98719 0 41164 CLAIRS PIETRAS DIRECTOR 1.00 X 0 0 0 SHIELA AMARAL DIRECTOR 1.00 X 0 0 0 SISTER MARY LUCILLE BAMACH VP/TREASURER OF DMICC 1.00 X X 0 0 0 SISTER MARY CLAIRE MILEWSKI SECRETARY OF DMICC 1.00 X X 0 0 0 SISTER MARY JANICE ZDUCZYK COUNSELOR OF DMICC 1.00 X X 0 0 0 166221 0 51581 0 0 0 0 GENESIS HEALTH VENTURES PO BOX 7247-6524 PHILADELPHIA PA 19170 THERAPY 526818 1 109946 109946 MEDICARE/MEDICAID PAYM 623110 4700291 4700291 PATIENT REVENUE 623110 1995659 1995659 6695950 1144 1144 8946 2662 6284 6284 6813324 6695950 0 7428 159473 159473 3152553 3069141 83412 7722 7156 566 842839 781030 61809 235008 217774 17234 5235 5235 23200 23200 23382 23382 96371 96371 36108 36108 268782 241904 26878 2265 2038 227 8888 8888 126412 126412 126000 126000 51741 51741 THERAPY AND MEDICAL 916661 916661 PROVIDER TAX 330582 330582 FOOD 137295 137295 18013 16212 1801 6568530 5897534 670996 0 730993 882122 44714 44751 363051 540412 24774 11678 14085 16225 5740888 5039752 809744 701136 1987361 2196324 370650 383431 3259 3259 2251857 2203245 2625766 2589935 X -638405 -393611 -638405 -393611 1987361 2196324 244794 0 X 0 1 X 1 0 X 13450 6080 25347 16347 118892 180116 6175656 5963840 6357250 6708955 6706889 31912590 6189106 5969920 6382597 6725302 6825781 32092706 0 0 0 32092706 514 1552 1386 1319 1144 5915 514 1552 1386 1319 1144 5915 6189620 5971472 6383983 6726621 6826925 32098621 0.99980 0.99980 0.00020 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5740888 5039752 701136 701136 LOAN DUE TO THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION 82462 NOTES PAYABLE TO THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION 2063699 RESIDENT FUNDS 57084 2203245 6813324 0 6813324 0 6813324 6568530 0 6568530 0 6568530 FORM 990, PART VI, SECTION B, LINE 11 THE ADMININSTRATOR OF THE MANOR WILL REVIEW THE 990 AND APPROVE THE FORM TO BE FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS MONITORS AND REVIEWS RELATIONSHIPS ANNUALLY AND ANY CONFLICTS ARE BROUGHT TO THE ATTENTION OF THE BOARD. THE BOARD WILL REVIEW THE CONFLICTS TO DETERMINE THEIR AFFECTS ON THE MANOR. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION FOR THE ADMINISTRATOR WILL BE BASED ON A FAIR MARKET RATE. THIS WILL BE ACCOMPLISHED BY COMPARING COMPENSATION PACKAGES OF SIMILIAR SIZE HEALTH CARE FACILITIES BY GATHERING COMPENSATION DATA FROM ONLINE RESOURCES AND TRADE ASSOCIATIONS. ADDITIONALLY, THE EXPERIENCE OF THE CANDIDATE IS CONSIDERED AS PART OF THE COMPENSATION DETERMINATION. THE COMPENSATION PACKAGE WILL BE REVIEWED BY THE BOARD OF DIRECTORS AND APPROVED BY THE PRESIDENT OF THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION, INC. FORM 990, PART VI, SECTION C, LINE 18 DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION 314 OSGOOD AVE NEW BRITAIN CT 06053 060995128 CHURCH CT 501(C)(3) LINE 1 N/A 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 THE DAUGHTERS OF MARY OF THE IMMACULATE CONCEPTION E 2146161 HISTORICAL COST