2017-11-09T14:25:05-06:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2016-01-01 043108782 NOTRE DAME HEALTH CARE CENTER INC NOTR 5088523011 559 PLANTATION STREET WORCESTER MA 01605 KAREN LAGANELLI CEO 5088523011 2017-11-08 1 JUDY DALEY P01294075 6179848100 2017-11-08 67.137.57.251 2017-11-08 15:18:02 ES P 499B49BEE9E95068E93680D69C996EB6A62D8814 A78F1062FA74E90C671D16910DB17AD2D08C9BAB 2016 2021-01-29 14:40:06Z NOTRE DAME LONG TERM CARE CENTER NOTRE DAME DU LAC NOTRE DAME AT HOME NOTRE DAME EDUCATIONAL BRIDGE SR EDIE DALY SND 559 PLANTATION STREET WORCESTER MA 01605 30667403 0 X WWW.NOTREDAMEHEALTHCARE.ORG X 1990 MA NOTRE DAME HEALTH CARE CENTER, ROOTED IN THE HERITAGE OF SAINT JULIE BILLIART AND SPONSORED BY THE SISTERS OF NOTRE DAME DE NAMUR, IS DEDICATED TO THE HEALING MINISTRY PROCLAIMED IN THE GOSPEL AND BY THE CATHOLIC CHURCH.- WE DEMONSTRATE CONCERN FOR THE WHOLE PERSON IN CARING FOR THE SPIRITUAL, SOCIAL, PHYSICAL, AND PSYCHOLOGICAL WELL-BEING OF OUR RESIDENTS, THEIR FAMILIES, AND THE COMMUNITY WE SERVE.- WE HONOR THE PERSONAL DIGNITY OF ALL INDIVIDUALS WITH COMPASSION AND WITHOUT DISTINCTION OF GENDER, AGE, ETHNICITY, SEXUAL ORIENTATION, RACE, OR CREED. WE STRIVE TO CREATE A WORK ENVIRONMENT WHERE EACH PERSON IS VALUED, RESPECTED, AND GIVEN AN OPPORTUNITY FOR PERSONAL, EDUCATIONAL, AND PROFESSIONAL GROWTH.- WE USE OUR RESOURCES WITH A PARTICULAR CONCERN FOR THE ELDERLY, THE POOR, AND THE VULNERABLE.- WE MAKE KNOWN GOD'S GOODNESS TO THE ENTIRE NDHCC COMMUNITY. 15 6 542 100 0 0 60165 50483 22524395 25473125 745897 513890 233312 226029 23563769 26263527 0 0 0 0 15020074 17088057 0 0 92257 7589159 9057035 22609233 26145092 954536 118435 37641925 37222213 18955807 17511309 18686118 19710904 X SEE SCHEDULE O 0 0 22864618 25078747 NURSING HOME, ASSISTED LIVING, HOME CARE, AND HOSPICE PROGRAMS:NOTRE DAME LONG TERM CARE AND REHABILITATION CENTER IS A LICENSED SKILLED NURSING FACILITY THAT PROVIDES TRADITIONAL LONG TERM CARE, POST-ACUTE AND SHORT TERM REHABILITATION, SPECIALIZED MEMORY CARE, AND END OF LIFE CARE TO ACHIEVE THE INDIVIDUAL'S MAXIMUM QUALITY OF LIFE AND WELL BEING WITHIN THE CHARITABLE MISSION OF THE SISTERS OF NOTRE DAME DE NAMUR. INDIVIDUALIZED CARE PLANS INCLUDE PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY, THERAPEUTIC RECREATIONAL PROGRAMS, INTRAVENOUS THERAPY, SPIRITUAL CARE, AND MEDICALLY RELATED SOCIAL SERVICES. LICENSED NURSING SERVICES ARE PROVIDED 24 HOURS PER DAY TO OUR CAPACITY OF 123 INDIVIDUALS, AND THE FACILITY IS CERTIFIED BY THE CENTERS FOR MEDICAID AND MEDICARE SERVICES AS A PROVIDER, AND HOLDS CONTRACTS WITH A NUMBER OF HMO'S.NOTRE DAME DU LAC ASSISTED LIVING RESIDENCE IS A CARING COMMUNITY THAT PROVIDES ASSISTED LIVING AND MEMORY SUPPORT FOR SENIORS. CHOICE, CONVENIENCE AND PEACE OF MIND ARE THE HALLMARKS OF THIS PROGRAM. NOTRE DAME DU LAC IS A HOME WHERE INDIVIDUAL NEEDS ARE MET AND COMMUNAL LIFE IS HONORED THROUGH A RICH AND DIVERSE RANGE OF PROGRAMS THAT ARE DESIGNED TO ENHANCE THE LIVES OF OUR RESIDENTS AND FAMILIES THROUGH ACTIVITIES, MEALS, AND PERSONAL ASSISTANCE. OUR MISSION OF CARE AND COMPASSION EXTENDS TO CARING FOR THOSE WITH MEMORY LOSS. THE HARMONY PROGRAM AT NOTRE DAME DU LAC IS DESIGNED TO MEET THE UNIQUE NEEDS OF THOSE WITH MEMORY LOSS, ALZHEIMER'S DISEASE, AND OTHER FORMS OF DEMENTIA. WE PROVIDE A COMFORTABLE, HOMELIKE SETTING, AS WELL AS THE SUPPORTIVE CARE NECESSARY TO INSURE SAFETY, DIGNITY, AND INDIVIDUALITY, WHEREBY RESIDENTS HAVE THE RIGHT TO MAKE CHOICES IN ALL ASPECTS OF THEIR LIVES. OUR FACILITY IS CERTIFIED BY THE EXECUTIVE OFFICE OF ELDER AFFAIRS OF THE COMMONWEALTH OF MASSACHUSETTS, AND PARTICIPATES IN THE MASSACHUSETTS GROUP ADULT FOSTER CARE (GAFC) PROGRAM.THE AT HOME DIVISION OF NOTRE DAME HEALTH CARE PROVIDES COMMUNITY BASED SERVICES TO INDIVIDUALS IN NEED IN THEIR OWN HOMES OR THAT OF A LOVED ONE, AS WELL AS IN FACILITIES INCLUDING ASSISTED LIVING, SKILLED NURSING, AND REST HOMES, IN GREATER WORCESTER COUNTY. THESE SERVICES INCLUDE NOTRE DAME HOSPICE, PEDI PALS, AND AFFINITY CARE MANAGEMENT.NOTRE DAME HOSPICE CONSISTS OF A TEAM OF SPECIALISTS WITH EXPERTISE DEVOTED TO COMPASSIONATE AND PROFESSIONAL END-OF-LIFE CARE. NOTRE DAME ASSISTS PATIENTS WITH TERMINAL ILLNESS FIND DIGNITY, MEANING, AND PEACE DURING HIS OR HER FINAL MONTHS, WEEKS, AND DAYS. NOTRE DAME CAN PROVIDE HOSPICE SERVICES TO ALL AGE GROUPS, STARTING AT BIRTH. THESE SERVICES ARE COVERED BY MEDICARE, MEDICAID AND MOST PRIVATE INSURANCES. 804111 620458 PEDIATRIC PALLIATIVE CARE, CARE MANAGEMENT & EDUCATION PROGRAMS:NOTRE DAME PEDI PALS IS A CONTRACT PROVIDER FOR THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH PEDIATRIC PALLIATIVE CARE NETWORK, AND IT IS A COST-BASED REIMBURSEMENT PROGRAM. ND PEDI PALS ENHANCES EXISTING SERVICES TO MEET THE NEEDS OF ELIGIBLE CHILDREN WITH ANY LIFE-LIMITING ILLNESS, EVEN WHEN A CURE REMAINS A POSSIBLE. THE GOAL OF THE PEDIATRIC PALLIATIVE CARE NETWORK IS TO IMPROVE THE QUALITY OF LIFE FOR THE ENTIRE FAMILY THROUGH ITS SUPPORT SERVICES.NOTRE DAME AFFINITY CARE MANAGEMENT IS A FEE FOR SERVICE COORDINATED CARE PROGRAM WHICH PROVIDES A WIDE RANGE OF SERVICES THAT ARE HOLISTIC AND MAXIMIZE THE HEALTH AND WELL-BEING OF THOSE SERVED. CARE MANAGERS COORDINATE NECESSARY AND DESIRED SERVICES FOR CLIENTS AND FAMILIES WHILE ADDRESSING BOTH MEDICAL AND NON-MEDICAL NEEDS.THE EDUCATIONAL BRIDGE CENTER AT NOTRE DAME HEALTH CARE IS A LIFELINE SUPPORTING ADULT LEARNERS PSYCHOLOGICALLY AND FINANCIALLY, AND HELPING THEM TO OVERCOME OVERWHELMING CHALLENGES. HEALTH CARE SKILLS CLASSES DEVELOP STAFF TO MEET THE NEEDS OF RESIDENTS AND PATIENTS HERE AND AT OTHER HEALTH CARE FACILITIES IN THE REGION. ADULT BASIC EDUCATION, TUTORING, CAREER AND LIFE COACHING, AND CITIZENSHIP SERVICES ENABLE PEOPLE TO EARN CERTIFICATIONS AND DEGREES, AND OBTAIN FAMILY-SUSTAINING WAGES. 23668729 1 1 0 1 0 0 1 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 542 1 0 0 0 0 0 0 0 0 0 0 X 15 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X STEPHEN TOTINO DIRECTOR OF FINANCE 5088523011 559 PLANTATION STREET WORCESTER MA 01605 SR EDIE DALY SND PRESIDENT 1.00 X X 0 0 0 SR ELLEN AGRITELLEY SND CHAIRMAN 1.00 X X 0 0 0 SR ANN MALONE SND CLERK 1.00 X X 0 0 0 MS JENNIFER DAVIS CAREY BOARD MEMBER 1.00 X 0 0 0 MS KATHLEEN FISHER BOARD MEMBER 1.00 X 0 0 0 MR PAUL GRIBBONS BOARD MEMBER 1.00 X 0 0 0 SR BARBARA-JEAN KUBIK SND BOARD MEMBER 1.00 X 0 0 0 MR ROBERT LIAN BOARD MEMBER 1.00 X 0 0 0 SR MARGARET MCCARTHY SND BOARD MEMBER 1.00 X 0 0 0 MS KATHLEEN O'CONNOR BOARD MEMBER 1.00 X 0 0 0 MR DAVID PUTNAM BOARD MEMBER 1.00 X 0 0 0 SR LORRAINE CONNELL SND BOARD MEMBER 1.00 X 0 0 0 MR GARTH JOHNSON BOARD MEMBER 1.00 X 0 0 0 MS MARIA BUNKER BOARD MEMBER 1.00 X 0 0 0 SR MARY ROSE CROWLEY SND BOARD MEMBER 1.00 X 0 0 0 SR MARY FARREN SND TREASURER 1.00 X 0 0 0 MS KAREN LAGANELLI CEO 40.00 X 162146 0 17248 MR STEPHEN TOTINO EXEC. DIR. OF FINANCE 40.00 X 108183 0 27866 MS CAROL KAPOLKA EXEC. DIR. OF LTC 40.00 X 115955 0 11726 MS SUSAN BENOIT DIRECTOR OF NURSING - LTC 40.00 X 109400 0 12096 MS SUSAN KEEFE EXEC. DIR. OF ND AT HOME 40.00 X 109330 0 12656 MS MARGARET COFFIN EXEC. DIR. OF ASSISTED LIVING 40.00 X 108661 0 25007 MS CAROL SMITH EXEC. DIR. OF ENVIRONMENTAL & IT SERVICES 40.00 X 104167 0 31920 817842 0 138519 7 0 1 0 HEALTHPRO MANAGEMENT INC 10600 YORK ROAD SUITE 105 COCKEYVILLE MD 21030 REHAB THERAPY SERVICES 459976 1 50483 11955 50483 PATIENT SERVICE REVENUE 623000 19354451 19354451 RESIDENT SERVICE REVENUE 623000 5840328 5840328 EDUCATION CENTER 611430 278346 278346 25473125 365536 365536 4497178 4348824 148354 148354 148354 53501 54552 -1051 -1051 1500 500 1000 1000 OTHER OPERATING INCOME 623000 226080 226080 226080 26263527 25699205 0 513839 315443 315443 14152147 13316453 779402 56292 72846 67253 5309 284 1501843 1420779 74730 6334 1045778 965476 76221 4081 35971 35971 85994 85994 705 705 378871 23158 355713 129819 1438 128381 346894 116104 205524 25266 1470740 1470740 24622 24622 6207 6207 1049407 1049407 99068 99068 PATIENT CARE EXPENSES 3003634 3003634 HOSPICE EXPENSES 1184000 1184000 USER FEE 789706 789706 BAD DEBTS 321418 321418 129979 129979 26145092 23668729 2384106 92257 32678 71835 1863992 1578533 2137961 3229758 46335 40503 225308 170055 34727450 16226333 19118931 18501117 13514369 13428972 702351 201440 37641925 37222213 1949662 2329037 35624 1354 14000000 12786337 2970521 2394581 18955807 17511309 X 18669466 19665484 16652 45420 18686118 19710904 37641925 37222213 X 118435 345111 561240 X 0 1 X 1 0 X 91216 99777 103156 60165 50483 404797 20357982 20944496 21525111 22757707 25754206 111339502 20449198 21044273 21628267 22817872 25804689 111744299 43900 37500 54500 38500 30500 204900 0 43900 37500 54500 38500 30500 204900 111539399 427974 521423 255556 329810 365536 1900299 427974 521423 255556 329810 365536 1900299 20877172 21565696 21883823 23147682 26170225 113644598 0.98150 0.97980 0.01670 0.01740 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 705 705 0 PART II-B, LINE 1: A PORTION OF MEMBERSHIP DUES PAID TO STATE HEALTHCARE ORGANIZATIONS IS DEVOTED TO LOBBYING. X 1 3.20 0 0 0 1 0 52.00 0 2423826 948 4000 62 2420712 2404000 19826 2423826 2380628 23372 2404000 2411529 -30901 2380628 2431355 -19826 2411529 1.00000 0.00000 0.00000 1 1 0 2625000 2625000 27524094 12955458 14568636 4451822 3179460 1272362 126534 91415 35119 18501117 FAIR VALUE OF INTEREST RATE SWAP 2015381 DEPOSITS FROM TENANTS 379200 2394581 26550458 0 26550458 -286931 -286931 26263527 25870783 0 25870783 274309 274309 26145092 PART II, LINE 9: CONSERVATION EASEMENTS ARE NOT REPORTED. PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT IS INTENDED FOR FUNDED DEPRECIATION OF ASSETS AND EMPLOYEE SCHOLARSHIPS. PART XI, LINE 4B - OTHER ADJUSTMENTS: UNREALIZED GAIN ON INTEREST RATE SWAP -561,240. RECLASS OF FUNDRAISING EVENT EXPENSE -55,052. RECLASS OF EDUCATION CENTER EXPENSES 329,361. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF EDUCATION CENTER EXPENSES 329,361. RECLASS OF FUNDRAISING EVENT EXPENSE -55,052. EDUCATIONAL FORUM 53501 53501 5033 11976 24910 12633 53501 53501 5033 11976 24910 12633 54552 -1051 X X X X 0 0 0 0 0 0 0 0 0 MS KAREN LAGANELLI CEO 162146 0 0 0 0 0 0 0 17248 0 179394 0 0 0 DAVID PUTNAM BOD MEMBER 57019 BOARD MEMBER IS AN EMPLOYEE OF F.L. PUTNAM INVESTMENTS WHICH PROVIDED INVESTMENT MANAGEMENT SERVICES TO THE ORGANIZATION. 0 GARTH JOHNSON BOD MEMBER 14500 BOARD MEMBER IS AN EMPLOYEE OF CUTLER ASSOCIATES WHICH PROVIDED CONSTRUCTION SERVICES TO THE ORGANIZATION. 0 FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: NOTRE DAME HEALTH CARE CENTER, ROOTED IN THE HERITAGE OF SAINT JULIE BILLIART AND SPONSORED BY THE SISTERS OF NOTRE DAME DE NAMUR, IS DEDICATED TO THE HEALING MINISTRY PROCLAIMED IN THE GOSPEL AND BY THE CATHOLIC CHURCH. PART OF OUR MISSION AT NOTRE DAME HEALTH CARE CENTER IS CONTINUED EDUCATION FOR THE STAFF AND MEMBERS IN THE COMMUNITY. WE OPERATE AN EDUCATIONAL BRIDGE CENTER ON THE CAMPUS AND THE TOTAL NET LOSS FOR THE YEAR IS $51,015. OUR ASSISTED LIVING FACILITY OFFERS REDUCED OR CHARITY CARE TO SOME RESIDENTS WHICH HAVE EXHAUSTED THEIR PERSONAL FUNDS. THE TOTAL REDUCED RENT OR CHARITY CARE AMOUNT INCURRED BY THE OPERATIONS OF THE ASSISTED LIVING FOR THE YEAR IS $69,022. FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION'S GOVERNING BODY DELEGATE BROAD AUTHORITY TO ACT ON ITS BEHALF TO SEVERAL COMMITTEES WHICH INCLUDE: HUMAN RESOURCES, ETHICS, FINANCE, INVESTMENT, MISSION, ADVANCEMENT, NOMINATING, AND STRATEGIC DEVELOPMENT COMMITTEES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE SISTERS OF NOTRE DAME DE NAMUR ARE THE GOVERNING MEMBERS OF THE NOTRE DAME HEALTH CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S MEMBERS ELECT THE BOARD OF DIRECTORS ANNUALLY. FORM 990, PART VI, SECTION A, LINE 7B THERE ARE ORGANIZATION GOVERNANCE DECISIONS THAT ARE SUBJECT TO THE APPROVAL BY MEMBERS OTHER THAN THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE DIRECTOR WILL SEND A DRAFT COPY OF THE TAX RETURN TO EACH BOARD MEMBER FOR REVIEW. THE COMPLETE REVISED FORM 990 IS PRESENTED AT A SCHEDULED MEETING TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL BY THE CEO/BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE ORGANIZATION'S POLICY NOT TO ENGAGE IN TRANSACTIONS OR ARRANGEMENTS WITH DIRECTORS, OFFICERS, COMMITTEE MEMBERS, OR KEY EMPLOYEES. NO TRANSACTION OR ARRANGEMENT BETWEEN THE CORPORATION AND ANY DIRECTOR, OFFICER, COMMITTEE MEMBER, KEY EMPLOYEE OR A MEMBER OF HIS OR HER IMMEDIATE FAMILY, OR ANY ENTITY WITH WHICH ANY SUCH PERSON HAS A PERSONAL INTEREST, WILL BE ENTERED INTO OR CONTINUED UNLESS IT HAS BEEN THOROUGHLY REVIEWED AND CONSIDERED BY THE BOARD OR THE FINANCE/GOVERNANCE COMMITTEE AND HAS BEEN FOUND TO BE OF CLEAR BENEFIT TO THE CORPORATION. THE ORGANIZATION'S BOD COLLECTS SIGNED CONFLICTS OF INTEREST POLICY AND REVIEWS THEM ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS USED TO ESTABLISH THE COMPENSATION OF THE CEO INCLUDES REVIEW AND APPROVAL OF DATA BY THE BOARD OF DIRECTORS. THIS PROCESS IS DONE ON AN ANNUAL BASIS BY THE BOARD OF DIRECTORS AND CHAIRMAN. OTHER EMPLOYEE SALARIES AND BENEFITS ARE REVIEWED ANNUALLY BY THE CEO, COMPARED TO OTHER SIMILAR ENTITIES IN THE REGION, AND DOCUMENTED AS PART OF THE ANNUAL REVIEW PROCESS, WHICH IS DONE ON THE ANNIVERSARY DATE. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FED FORM 990 IS AVAILABLE ON GUIDESTAR.ORG AND THE MA ATTORNEY GENERAL'S OFFICE WEBSITE. 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. FORM 990, PART XI, LINE 9: UNREALIZED LOSS ON INTEREST RATE SWAP 561,240. SISTERS OF NOTRE DAME DE NAMUR 351 BROADWAY EVERETT MA 02149 RELIGIOUS ORGANIZATION OC 501(C)(3) LINE 1 N/A 0 NOTRE DAME TRAINING SCHOOL INC 351 BROADWAY EVERETT MA 02149 RELIGIOUS ORGANIZATION OC 501(C)(3) LINE 1 SISTERS OF NOTRE DAME DE NAMUR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0