2015-11-13T13:13:18-06:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2014-01-01 043108782 NOTRE DAME HEALTH CARE CENTER INC NOTR 5088523011 559 PLANTATION STREET WORCESTER MA 01605 SR EDIE DALY SND PRESIDENT 5088523011 2015-11-09 1 JUDY DALEY P01294075 6179848100 2015-11-09 2014 2016-02-25 16:41:14Z NOTRE DAME LONG TERM CARE CENTER NOTRE DAME DU LAC NOTRE DAME AT HOME KAREN LAGANELLI 559 PLANTATION STREET WORCESTER MA 01605 24766776 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.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 CENTER ON THE CAMPUS AND THE TOTAL NET LOSS FOR THIS YEAR IS $150,714.OUR ASSISTED LIVING FACILITY OFFERS REDUCED OR CHARITY CARE TO SOME RESIDENTS WHICH HAVE EXHAUSTED THEIR PERSONAL FUNDS. THE TOTAL REDUCED OR CHARITY CARE AMOUNT INCURRED BY THE OPERATIONS OF THE ASSISTED LIVING FACILITY FOR 2014 IS $253,332. - 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, RA 15 15 443 100 0 0 150682 103156 20831455 21238755 521422 445478 30844 286356 21534403 22073745 0 0 0 0 13237127 14361399 0 0 104783 7446629 7245704 20683756 21607103 850647 466642 38178929 38359314 20114564 19811931 18064365 18547383 X 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 CENTER ON THE CAMPUS AND THE TOTAL NET LOSS FOR THIS YEAR IS $150,714.OUR ASSISTED LIVING FACILITY OFFERS REDUCED OR CHARITY CARE TO SOME RESIDENTS WHICH HAVE EXHAUSTED THEIR PERSONAL FUNDS. THE TOTAL REDUCED OR CHARITY CARE AMOUNT INCURRED BY THE OPERATIONS OF THE ASSISTED LIVING FACILITY FOR 2014 IS $253,332. - 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, RA 0 0 19630295 21710883 NOTRE DAME LONG TERM CARE CENTER/NOTRE DAME DU LAC/HOSPICE - PROVIDE SKILLED NURSING HOME CARE TO THE ELDERLY AND DISABLED.NOTRE DAME LONG TERM CARE CENTER/NOTRE DAME DU LAC/HOSPICE - PEDIPAL PROGRAM - PROVIDES HOME CARE TO CHILDREN WITH LIFE LIMITING ILLNESSES. 19630295 1 1 0 1 0 0 1 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 19 0 1 443 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X SR ELIZABETH MCLAUGHLIN SND TREASURER 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 ANDREA WALSH SND CLERK 1.00 X X 0 0 0 SR ELIZABETH MCLAUGHLIN SND TREASURER 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 MR THOMAS LUCAS 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 MS VIRGINA RYAN BOARD MEMBER 1.00 X 0 0 0 MS SUSANNE STAUFFER BOARD MEMBER 1.00 X 0 0 0 SR FRANCIS ELLEN ULRICH SND BOARD MEMBER 1.00 X 0 0 0 MS PATRICIA CAMPBELL BOARD MEMBER & EX-OFFICIO 40.00 X 83067 0 0 MS MARGARET COFFIN BOARD MEMBER & EX-OFFICIO 40.00 X 97074 0 0 MS KARYN COONEY BOARD MEMBER & EX-OFFICIO 40.00 X 165566 0 0 MS KATHERINE LEMAY BOARD MEMBER & EX-OFFICIO 40.00 X 189952 0 0 MR STEPHEN TOTINO DIRECTOR OF FINANCE 40.00 X 119294 0 0 MS DEBRA FORSS DIRECTOR OF NURSING 40.00 X 139365 0 0 MS BEVERLY AMOSAH ASST. DIRECTOR OF NURSING & NURSING MANAGER 40.00 X 115113 0 0 MS CAROL SMITH DIRECTOR OF ENVIRONMENTAL & IT SERVICES 40.00 X 125145 0 0 1034576 0 0 6 0 1 0 HEALTHPRO MANAGEMENT INC 10600 YORK ROAD SUITE 105 COCKEYSILLE MD 21030 REHAB THERAPY SERVICES 408107 CUTLER ASSOCIATES 43 HARVARD STREET WORCESTER MA 01615 CONSTRUCTION CONTRACTOR 184941 RETROFIT TECHNOLOGIES INC 455 FORTUNE BOULEVARD MILFORD MA 01757 COMPUTER PURCHASES & SERVICES 114429 3 44500 58656 103156 PATIENT SERVICE REVENUE 623000 15689588 15689588 RESIDENT SERVICE REVENUE 623000 5523207 5523207 EDUCATION CENTER 611430 25960 25960 21238755 255556 255556 2882953 2693031 189922 189922 189922 4150 0 4150 4150 OTHER INCOME 623000 282206 282206 282206 22073745 21710883 0 259706 1034576 462690 571886 10852387 10149098 643251 60038 61761 61761 1523442 1523442 889233 833845 50839 4549 12683 12683 89489 89489 1255 1255 348779 195863 152916 122888 29636 93252 390176 176923 173057 40196 1599241 1599241 78392 78392 16891 16891 981875 981875 88492 88492 PATIENT CARE EXPENSES 2448534 2448534 USER FEE 777307 777307 BAD DEBTS 86824 86824 MANAGEMENT SERVICES 82527 82527 120351 118226 2125 21607103 19630295 1872025 104783 3132633 2040630 1681456 2283656 7300 17355 196263 180051 33984257 14335076 19227147 19649181 12260584 13426618 1673546 761823 38178929 38359314 1970441 1859511 100358 119638 15390000 14710000 2653765 3122782 20114564 19811931 X 17970238 18509972 94127 37411 18064365 18547383 38178929 38359314 X 466642 474193 -457817 X 0 1 X 1 0 X 67437 60770 91216 99777 103156 422356 19244665 20174779 20357982 20944496 21525111 102247033 19312102 20235549 20449198 21044273 21628267 102669389 35000 25000 43900 37500 54500 195900 0 35000 25000 43900 37500 54500 195900 102473489 342949 344127 427974 521423 255556 1892029 342949 344127 427974 521423 255556 1892029 19655051 20579676 20877172 21565696 21883823 104561418 0.98000 0.98020 0.01810 0.01880 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1255 1255 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 2625000 2625000 27296124 11450781 15845343 3930292 2763251 1167041 132841 121044 11797 19649181 FAIR VALUE OF INTEREST RATE SWAP 2755432 DEPOSITS FROM TENANTS 367350 3122782 X 21351446 -457817 -457817 21809263 264482 264482 22073745 21342621 0 21342621 264482 264482 21607103 PART II, LINE 9: CONSERVATION EASEMENTS NOT REPORTED. PART X, LINE 2: THE COMPANY 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 COMPANY FILES AS A TAX-EXEMPT ORGANIZATION. THE ENTITY'S 2011 THROUGH 2014 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED GAIN (LOSS) ON INTEREST RATE SWAP -457,817. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF NON-OPERATING EXPENSES 264,482. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF NON-OPERATING EXPENSES 264,482. X X 0 0 0 0 0 0 0 0 0 MS KARYN COONEY BOARD MEMBER & EX-OFFICIO 144024 0 520 0 21022 0 0 0 0 0 165566 0 0 0 MS KATHERINE LEMAY BOARD MEMBER & EX-OFFICIO 174020 0 3849 0 12083 0 0 0 0 0 189952 0 0 0 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, FINANCE, INVESTMENT, DEVELOPMENT, MISSION & ETHICS, AND NOMINATING COMMITTEES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS WHICH INCLUDES EX -OFFICIO AND ALL THE MEMBERS OF THE ADMINISTRATIVE TEAMS OF THE BOSTON, IPSWICH AND CONNECTICUT PROVINCES OF THE CONGREGATION. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S MEMBERS ELECT THE BOARD OF DIRECTORS ANNUALLY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS EMAILED IN ADVANCE TO BOD MEMBERS AND THEN PRESENTED AT THE SCHEDULED BOARD OF DIRECTORS MEETING. 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 OR 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 COMMITTEE AND HAS BEEN FOUND TO BE OF CLEAR BENEFIT TO THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS USED TO ESTABLISH THE COMPENSATION OF THE ADMINISTRATOR AND EXECUTIVE DIRECTOR INCLUDES, REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THIS IS DONE ON AN ANNUAL BASIS BY THE FINANCE COMMITTEE AND BOARD OF DIRECTORS. SALARIES & 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 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 -457,817.