2015-09-29T15:22:53-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2014-01-01 042676008 HENRY C NEVINS HOME INC HENR 9786827611 10 INGALLS COURT METHUEN MA 01844 ALAN P SHAFER TREASURER 9786727611 2015-08-31 1 JUDY DALEY 6179848100 2015-08-31 2014 2016-03-07 17:11:31Z JOYCE SHANNON 10 INGALLS COURT METHUEN MA 01844 13655212 0 X WWW.NEVINSFAMILY.ORG X 1979 MA HENRY C. NEVINS HOME, INC.'S MISSION IS TO PROVIDE COMPREHENSIVE MEDICAL, NURSING AND REHABILITATIVE CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED BY INJURY, ILLNESS OR AGING. 8 8 327 25 0 0 5155 112 14195217 13459281 145017 144158 45335 15082 14390724 13618633 0 0 0 0 9842624 9378861 0 0 0 4387812 4216608 14230436 13595469 160288 23164 6973596 6442799 5907468 5353507 1066128 1089292 HENRY C. NEVINS HOME, INC.'S MISSION IS TO PROVIDE COMPREHENSIVE MEDICAL, NURSING AND REHABILITATIVE CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED BY INJURY, ILLNESS OR AGING. 0 0 12692145 13474363 NURSING HOME OPERATION - NEVINS NURSING & REHABILITATION CENTER PROVIDES COMPREHENSIVE MEDICAL, NURSING AND REHABILITATIVE CARE FOR INDIVIDUALS WHOSE FUNCTION HAS BEEN IMPAIRED BY INJURY, ILLNESS OR AGING. 12692145 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 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 0 0 0 1 42 0 1 327 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 1 1 0 MA X SHARON WALSH 9786827611 10 INGALLS COURT METHUEN MA 01844 KAREN NEMETH CHAIRPERSON 0.40 0.60 X X 0 0 0 PATRICIA DEMERS CO-CHAIRPERSON 0.40 0.60 X X 0 0 0 ALAN P SHAFER TREASURER & DIRECTOR 0.40 0.60 X X 0 0 0 MARC D KLEIN CLERK & DIRECTOR 0.40 0.60 X X 0 0 0 ELIZABETH FAWCETT DIRECTOR 0.40 0.60 X 0 0 0 THERESE LEONE DIRECTOR 0.40 0.60 X 0 0 0 BARBARA HOGAN DIRECTOR 0.40 0.60 X 0 0 0 RAYMOND WROBEL DIRECTOR 0.40 0.60 X 0 0 0 JOYCE SHANNON PRESIDENT & CEO 12.00 28.00 X 182354 0 21758 JEANNE BOYLE EXECUTIVE DIRECTOR 40.00 0.00 X 120516 0 8310 BARBARA STRZYKALSKI DIRECTOR OF REHAB. 40.00 0.00 X 105519 0 13249 408389 0 43317 3 0 1 0 US FOOD SERVICE BOX D 3155 BOSTON MA 02241 FOOD SERVICE 424363 PARTNERS PHARMACY 70 JACKSON DRIVE CRANFORD NJ 07016 PHARMACEUTICALS 347881 LEVI & WONG DESIGN ASSOC 45 WALDEN STREET CONCORD MA 01742 ARCHITECTURAL FIRM 262290 GERIATRIC MEDICAL SUPPLY PO BOX 2503 WOBURN MA 01888 MEDICAL SUPPLIES 252743 FIRESIDE STAFFING 17 GAUDET LANE PELHAM NH 03076 AGENCY NURSES 135090 5 112 112 NET PATIENT SERVICE REVENUE 623000 13459281 13459281 13459281 196 196 180541 36579 143962 143962 143962 OTHER REVENUE 900099 15082 15082 15082 13618633 13474363 0 144158 332938 332938 7539569 7355420 184149 869553 821069 48484 636801 595603 41198 62089 62089 78500 78500 3755 864 2891 347714 231565 116149 8796 1966 6830 131247 124379 6868 302457 302457 7435 7435 262302 262302 301776 301776 82415 82415 SUPPLIES AND EXPENSE 968701 968701 MASS. STATE USER FEE AS 821546 821546 BAD DEBT EXPENSE 383638 383638 ANCILLARIES 382297 382297 71940 48712 23228 13595469 12692145 903324 0 2166376 1706068 80196 80348 1757202 1541907 42019 82755 8966502 6695894 2515046 2270608 412757 761113 6973596 6442799 1426697 1116576 21390 4140000 4035000 16268 0 324503 180541 5907468 5353507 X 985720 1008732 80408 80560 1066128 1089292 6973596 6442799 23164 0 X 0 1 X 1 0 X 67999 24792 23321 5155 112 121379 13911245 14135269 14057137 14240552 13474363 69818566 13979244 14160061 14080458 14245707 13474475 69939945 0 0 0 69939945 56711 37906 40631 145017 180736 461001 56711 37906 40631 145017 180736 461001 14035955 14197967 14121089 14390724 13655211 70400946 0.99350 0.99570 0.00650 0.00430 X 0 0 0 0 0 0 0 0 1 3755 3755 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUE TO A NUMBER OF HEALTH CARE ASSOCIATIONS. A PORTION OF THOSE DUES ARE USED FOR LOBBYING. 80408 152 80560 80395 13 80408 80173 222 80395 79882 291 80173 71050 8452 380 79882 0.00000 0.00000 1.00000 0 0 295146 295146 4695322 3572321 1123001 1329441 1018804 310637 2646593 2104769 541824 2270608 INTEREST RECEIVABLE 5637 DEFERRED FINANCING COSTS, NET 13338 SOFTWARE, NET 7488 DUE FROM RELATED PARTIES 141587 CONSTRUCTION IN PROGRESS 446066 OTHER RECEIVABLES 7008 ASSETS LIMITED AS TO USE 139989 761113 FAIR VALUE OF INTEREST RATE SWAP 180541 180541 X 13618633 0 13618633 0 13618633 13595469 0 13595469 0 13595469 PART V, LINE 4: THE ORGANIZATION HAS TEMPORARILY RESTRICTED NET ASSETS TO BE USED FOR DIETARY RENOVATIONS. 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'S 2011 THROUGH 2014 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X 0 0 0 0 0 0 0 0 0 JOYCE SHANNON PRESIDENT & CEO 182354 0 0 0 0 0 13000 0 8758 0 204112 0 0 0 PART I, LINE 3 COMPENSATION REVIEW FOR CEO, EXECUTIVE DIRECTOR, OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY INDEPENDENT PERSONS WITH THE USE OF COMPARABILITY DATA AND APPROVED BY THE BOARD OF DIRECTORS. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 042608195 461473209 2005-02-01 4800000 TO FINANCE COST OF ELIGIBLE PROJECTS. 0 0 0 A 765000 4800000 68384 88868 279438 4363310 2005 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 CITIZENS BANK 11.000000000000 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE BOARD TREASURER AND PRESIDENT PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, EMPLOYEE, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, SHALL COMPLETE, SIGN AND DELIVER TO THE CHAIR OF THE BOARD A CONFLICTS OF INTEREST POLICY ANNUAL STATEMENT AT THE TIME OF HIS OR HER INITIAL ELECTION OR APPOINTMENT AND ANNUALLY THEREAFTER. THE CONFLICTS OF INTEREST POLICY ANNUAL STATEMENT SHALL BE IN SUCH FOR AS IS DEEMED APPROPRIATE BY THE PRESIDENT WITH ADVICE FROM THE NEVIN'S COUNSEL AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW FOR CEO, EXECUTIVE DIRECTOR, OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY INDEPENDENT PERSONS WITH THE USE OF COMPARABILITY DATA AND APPROVED BY THE BOARD OF DIRECTORS. THIS WAS LAST PERFORMED DURING 2014 AND NOTED IN THE BOARD OF DIRECTORS MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. NEVINS COMMUNITY SERVICES INC 12 INGALLS COURT METHUEN MA 01844 042210743 ADULT DAY CARE MA 501(C)(3) LINE 9 0 NEVINS MANOR INC 12 INGALLS COURT METHUEN MA 01844 043265310 ELDERLY HOUSING MA 501(C)(3) LINE 9 0 NEVINS FAMILY OF SERVICES INC 10-12 INGALLS COURT METHUEN MA 01844 464006584 ELDERLY HOUSING MA 501(C)(3) LINE 9 0 0 0 0 1 1 0 0 0 0 0 0 1 0 1 1 0 0 0 0