2015-11-16T13:15:36-06:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2014-01-01 042105741 THE SOMERVILLE HOME INC SOME 6177760260 117 SUMMER STREET SOMERVILLE MA 02143 EDWIN J SMITH PRESIDENT 6176256094 2015-11-02 1 JUDY DALEY P01294075 6179848100 2015-10-08 2014 2016-02-25 16:41:14Z EDWIN J SMITH 117 SUMMER STREET SOMERVILLE MA 02143 2214018 0 X WWW.SOMERVILLEHOME.ORG X 1898 MA PROVIDING QUALITY RESIDENTIAL CARE TO THE ELDERLY FROM SOMERVILLE AND SURROUNDING COMMUNITIES. 16 16 49 19 0 0 61345 53061 1627245 1891059 44795 107693 14450 22425 1747835 2074238 0 0 0 0 1031032 845815 0 0 0 959392 1200678 1990424 2046493 -242589 27745 3709313 3753860 1150617 1095969 2558696 2657891 X SINCE 1898, THE SOMERVILLE HOME, A PRIVATE NONPROFIT ORGANIZATION, HAS PROVIDED LONG-TERM RESIDENTIAL CARE TO ELDERLY MEN AND WOMEN FROM SOMERVILLE AND SURROUNDING COMMUNITIES. WE ARE COMMITTED TO OFFERING SENIOR CITIZENS A REASONABLY PRICED OPTION FOR QUALITY RESIDENTIAL SERVICES. WE BELIEVE THAT OUR RESIDENTS SHOULD BE ENCOURAGED TO UTILIZE THEIR BODIES, MINDS AND SPIRITS TO THE MAXIMUM WITHIN THE LIMITS OF THEIR POTENTIAL. 0 0 1723200 1906138 REST HOME - OPERATION OF A 59-BED REST HOME LOCATED IN SOMERVILLE, MASSACHUSETTS LOCATED AT 117 SUMMER STREET. THE REST HOME'S CHARACTER AND CHARM HAS RESPONDED TO THE DOMESTIC NEEDS OF RETIRED PERSONS FOR THE PAST 70 YEARS AND INTENDS TO DO SO FOR MANY MORE YEARS. THE ORGANIZATION'S LONG-TERM PLAN IS TO PROVIDE A SAFE AND SECURE HOMELIKE ENVIRONMENT WHILE ASSURING DIGNITY TO AND PROMOTING THE INDIVIDUAL WORTH OF ALL RESIDENTS. 1723200 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 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 0 0 0 0 1 9 0 1 49 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X KELLEY SFERRAZZA 6177760260 117 SUMMER STREET SOMERVILLE MA 02143 X EDWIN J SMITH PRESIDENT 5.00 X X 0 0 0 ROD LAURENZ VICE PRESIDENT 5.00 X X 0 0 0 ROBERT H COSTELLO JR TREASURER 5.00 X X 0 0 0 SANDRA L MCGOLDRICK CLERK 5.00 X X 0 0 0 SALVATORE BERTOLAMI TRUSTEE 5.00 X 0 0 0 BRIAN BRADY TRUSTEE 5.00 X 0 0 0 AGNES M CAMERON TRUSTEE 5.00 X 0 0 0 JOSEPH K CIAMPA TRUSTEE 5.00 X 0 0 0 JOHN M CONNOLLY TRUSTEE 5.00 X 0 0 0 FRANCES GAYRON TRUSTEE 5.00 X 0 0 0 ARNOLD J KNOX JR TRUSTEE 5.00 X 0 0 0 SUZANNE MARSHALL TRUSTEE 5.00 X 0 0 0 GEORGE F MCLEAN TRUSTEE 5.00 X 0 0 0 DAVID F O'BRIEN TRUSTEE 5.00 X 0 0 0 JOSEPH J SULLIVAN TRUSTEE 5.00 X 0 0 0 JEANNETTE AMAZEEN THOMAS TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 UNIDINE PO BOX 60479 CHARLOTTE NC 28260 DINING SERVICES 263294 PREMIER MEDICAL STAFFING 339 MAIN STREET NASHUA NH 03060 NURSING PURCHASED SERVICES 145482 2 53061 2483 53061 NET PATIENT SERVICE REVENUE 623000 1891059 1891059 1891059 45739 45739 174880 112926 61954 61954 61954 34200 26854 7346 7346 OTHER INCOME 623000 15079 15079 15079 2074238 1906138 0 115039 X 700572 493508 207064 19779 14526 5253 69109 50754 18355 56355 41388 14967 29841 29841 27375 27375 10634 10634 576048 571445 4603 2274 2274 47627 42426 5201 25212 25212 116406 116406 3566 3566 39676 39676 216489 216489 19197 19197 SUPPLIES 37347 37347 MAINTENANCE 23939 23939 BAD DEBT 8887 8887 FOOD 7335 7335 8825 8825 2046493 1723200 323293 0 22045 36134 66346 106000 63422 72609 51180 63452 5229978 3152162 2141843 2077816 1359489 1392375 4988 5474 3709313 3753860 104653 175327 1042689 918076 3275 2566 1150617 1095969 X 1880683 1971699 508249 516428 169764 169764 2558696 2657891 3709313 3753860 27745 71450 0 X 0 1 X 1 0 X 41136 11775 27814 61345 53061 195131 1830691 1752920 1650985 1627245 1891059 8752900 1871827 1764695 1678799 1688590 1944120 8948031 0 710097 692316 635281 599665 667577 3304936 710097 692316 635281 599665 667577 3304936 5643095 27485 32939 36131 38621 45739 180915 27485 32939 36131 38621 45739 180915 6603 14450 49279 70332 1899312 1797634 1721533 1741661 2039138 9199278 0.61340 0.61890 0.01970 0.01780 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 678013 48825 40646 686192 638378 86733 47098 678013 600006 77823 39451 638378 676230 -41014 35210 600006 635575 72655 32000 676230 0.00000 0.24740 0.75260 0 0 30460 30460 250789 250789 0 4492415 2585988 1906427 416496 275567 140929 39818 39818 0 2077816 DUE TO THIRD-PARTY PAYERS 2566 2566 X 2135054 71450 71450 2063604 10634 10634 2074238 2035859 0 2035859 10634 10634 2046493 PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE INTENDED TO BE USED FOR PERMANENTLY RESTRICTED NET ASSET APPRECIATION LIMITED AS TO EXPENDITURE BY STATE LAW, THE LUXURY FUND AND VARIOUS OTHER USES. THE INCOME EARNED ON THE PERMANENTLY RESTRICTED NET ASSETS IS INTENDED TO BE USED TO IMPROVE THE QUALITY OF CARE AND QUALITY OF LIFE OF THE RESIDENTS. THE CORPUS IS INVESTED IN PERPETUITY. 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 FILES AS A TAX-EXEMPT ORGANIZATION. THE ENTITY'S 2011 THROUGH 2014 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE AUTHORITIES. FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION DELEGATES BROAD AUTHORITY OF DISCRETIONARY VOTING OVER FINANCIAL AND FIDUCIARY MATTERS TO AN EXECUTIVE COMMITTEE (COMPOSED OF BOARD MEMBERS INCLUDING FOUR OFFICERS AND FOUR VOTING MEMBERS). FORM 990, PART VI, SECTION B, LINE 11 THE BOARD IS PROVIDED A COMPLETE COPY OF FORM 990. THE FORM 990 IS THEN DISCUSSED AT THE NEXT BOARD MEETING WHERE THE IT IS SIGNED BY THE TREASURER AFTER IT HAS BEEN VOTED FOR APPROVAL. THE APPROVAL IS THEN RECORDED IN MINUTES OF THE MEETING. FORM 990, PART VI, SECTION B, LINE 12C ANY INSTANCES OF A CONFLICT OF INTEREST WOULD GO THROUGH AN INVESTIGATION OF THE EXECUTIVE COMMITTEE AND THEN PRESENTED TO THE FULL BOARD. IF NEEDED THE BOARD MEMBER COULD BE REMOVED BY VOTE AND LEGAL ACTION TAKEN IF NEEDED. ROD LAURENZ, VICE PRESIDENT, MUST LEAVE ROOM DURING ANY DISCUSSION AND ABSTAIN FROM ANY VOTE CONCERNING INVESTMENT PORTFOLIO. FORM 990, PART VI, SECTION B, LINE 15 THE INDEPENDENT BOARD REVIEWS COMPARABLE COMPENSATION DATA TO DETERMINE AN APPROPRIATE SALARY. A VOTE IS CAST BY THE BOARD TO APPROVE OR DENY THE SALARY AND THE OUTCOME IS RECORDED IN THE MINUTES OF THE MEETING. 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 IX, LINE 11G PLANT CONTRACTED SERVICES : PROGRAM SERVICE EXPENSES 38,732. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,732. DIETARY SERVICES : PROGRAM SERVICE EXPENSES 351,194. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 351,194. MEDICAL WASTE FEES : PROGRAM SERVICE EXPENSES 564. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 564. NURSING PURCHASE SERVICE : PROGRAM SERVICE EXPENSES 180,955. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,955. PAYROLL SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,603. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,603.