2015-07-22T13:22:54-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2014-01-01 043455405 ALLIANCE HEALTH OF BROCKTON INC ALLI 6173323366 134 RUMFORD AVENUE NO 306 NEWTON MA 02466 FRANCIS J GRADY TREASURER 5085836000 2015-07-08 1 BARBARA MORRISON P00173340 6179848100 2015-07-08 2014 2016-02-25 16:41:14Z MARY A MCCARTHY 134 RUMFORD AVENUE 306 NEWTON MA 02466 11125252 0 X WWW.ALLIANCEHHS.ORG X 1999 MA THE COMPANY SHALL PROMOTE AND PROVIDE SAFE, HEALTHY, QUALITY SERVICES AND LIVING ENVIRONMENTS FOR THE ELDERS WHO CANNOT CARE FOR THEMSELVES. 8 7 245 10 0 0 0 0 11159003 11090462 46633 28219 18805 6571 11224441 11125252 0 0 0 0 6303127 6422587 0 0 0 5166253 5706037 11469380 12128624 -244939 -1003372 9502587 7237857 10383806 7966579 -881219 -728722 THE COMPANY SHALL PROMOTE AND PROVIDE SAFE, HEALTHY, QUALITY SERVICES AND LIVING ENVIROMENTS FOR ELDERS WHO CANNOT CARE FOR THEMSELVES. 0 0 10401814 11097033 OUR SKILLED NURSING AND REHABILITATION FACILITY PROVIDES A WIDE RANGE OF MEDICAL AND REHABILITATIVE SERVICES, INCLUDING POST ACUTE CARE, SHORT-TERM REHABILITATION, RESPITE CARE, HOSPICE CARE, AND LONG-TERM CARE. WORKING DIRECTLY WITH EACH RESIDENT AND THEIR FAMILY MEMBERS, OUR STAFF WILL CUSTOMIZE A COMPREHENSIVE PLAN OF CARE DESIGNED TO TREAT MEDICAL COMPLICATIONS AND ACHIEVE FUNCTIONAL INDEPENDENCE. OUR FACILITY PROVIDES THE HIGHEST STANDARDS OF CARE AND RESIDENTS ENJOY AN ACTIVE AND FULFILLING LIFESTYLE IN AN ATMOSPHERE OF WARMTH, RESPECT AND UNDERSTANDING. 10401814 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 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 1 0 0 0 1 20 0 1 245 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X ALLIANCE HEALTH MANAGEMENT SERVICES LLC 7743482000 153 CORDAVILLE RD SUITE 320 SOUTHBOROUGH MA 01772 WILLIAM P MCDERMOTT ESQ DIRECTOR 1.00 1.00 X 0 0 0 REV JEROME J JANISKO DIRECTOR 1.00 1.00 X 0 0 0 JAMES BRUCE RILEY CPA DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL O JENNINGS ESQ CHAIRMAN 1.00 1.00 X 0 0 0 CHRISTOPHER ROBBINS DIRECTOR 1.00 1.00 X 0 0 0 MARY MCCARTHY DIRECTOR AND PRESIDENT 1.00 40.00 X X 0 309991 33504 LINDA CORRIDAN RN DIRECTOR 1.00 1.00 X 0 0 0 ARTHUR MOURTIZINOS MD DIRECTOR 1.00 1.00 X 0 0 0 FRANCIS J GRADY TREASURER AND CLERK 1.00 40.00 X 0 326435 21256 MICHAEL DODOS CONTROLLER 1.00 40.00 X 0 207242 234 RICHARD CANTY VICE PRESIDENT 1.00 40.00 X 0 159951 21680 DORIS DAVILA VICE PRESIDENT 0.00 40.00 X 0 162635 1282 PAUL KEMP CHIEF FINANCIAL OFFICER 1.00 40.00 X 0 272529 21035 THOMAS LAVALLEE CHIEF OPERATING OFFICER 1.00 40.00 X 0 203047 20759 MARIE COLAS RN, NIGHT SUPERVISOR 40.00 0.00 X 113937 0 15617 SUSAN MCGOURTY DON 40.00 0.00 X 108374 0 16171 222311 1641830 151538 2 0 1 0 GENESIS REHABILITATION SERVICES INC 101 E STATE ST KENNETT SQUARE PA 19348 THERAPY SERVICES 811296 WELCH HEALTHCARE AND RETIREMENT GROUP 52 ACCORD PARK DR NORWELL MA 02061 MANAGEMENT SERVICES 444922 2 PROGRAM SERVICE 623000 11090462 11090462 11090462 35862 35862 -7643 -7643 OTHER INCOME 623000 4341 4341 LAUNDRY INCOME 623000 2230 2230 6571 11125252 11097033 0 28219 5585474 5288684 296790 18522 17570 952 382084 363408 18676 436507 414072 22435 623846 623846 13199 13199 28825 28825 4887 4887 436914 274550 162364 14025 14025 86999 86999 16213 16213 231264 231264 6940 6940 551830 551830 348763 348763 231294 146991 84303 ANCILLARY EXPENSES 1187893 1187893 PROVIDER USER FEE 626584 626584 NURSING SUPPLIES AND EX 420791 420791 LOSS ON REFINANCING 341949 341949 533821 529414 4407 12128624 10401814 1726810 0 696092 889798 1030252 1104248 102859 42279 8371618 4386093 4247770 3985525 3425614 1216007 9502587 7237857 2206294 1133466 34437 80463 7865000 5250000 278075 1502650 10383806 7966579 X -881219 -728722 -881219 -728722 9502587 7237857 X -1003372 1155869 X 0 1 X 1 0 X 11386799 11306974 10926245 11177808 11090462 55888288 11386799 11306974 10926245 11177808 11090462 55888288 0 0 0 55888288 8998 24612 37105 46633 28219 145567 8998 24612 37105 46633 28219 145567 6571 6571 11395797 11331586 10963350 11224441 11125252 56040426 0.99730 0.99780 0.00260 0.00220 X 300000 300000 6321000 3218970 3102030 210057 85361 124696 1540561 1081762 458799 3985525 DEPOSITS 19931 GOODWILL, NET 907350 DEFERRED FINANCE FEES, NET 213980 CONSTRUCTION IN PROGRESS 24803 ESCROW FUNDS 43043 REPLACEMENT RESERVE 6900 1216007 DUE TO RELATED-PARTY 1423559 PAYROLL TAXES PAYABLE 79091 1502650 X 11125252 0 11125252 0 11125252 12128624 0 12128624 0 12128624 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. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S 2011 THROUGH 2014 TAX YEARS ARE OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X X X 0 1 0 0 0 0 0 0 0 MARY MCCARTHY DIRECTOR AND PRESIDENT 0 309991 0 0 0 0 0 33400 0 104 0 343495 0 0 FRANCIS J GRADY TREASURER AND CLERK 0 263935 0 62500 0 0 0 0 0 21256 0 347691 0 0 MICHAEL DODOS CONTROLLER 0 179485 0 27757 0 0 0 0 0 234 0 207476 0 0 RICHARD CANTY VICE PRESIDENT 0 147951 0 12000 0 0 0 0 0 21680 0 181631 0 0 DORIS DAVILA VICE PRESIDENT 0 152635 0 10000 0 0 0 0 0 1282 0 163917 0 0 PAUL KEMP CHIEF FINANCIAL OFFICER 0 232029 0 40500 0 0 0 0 0 21035 0 293564 0 0 THOMAS LAVALLEE CHIEF OPERATING OFFICER 0 184797 0 18250 0 0 0 0 0 20759 0 223806 0 0 PART I, LINE 4B MARY MCCARTHY PARTICIPATES IN DEFERRED COMP PLAN, BUT DID NOT RECIEVE ANY PAYMENTS FOR THE YEAR ENDED DECEMBER 31, 2014. FORM 990, PART VI, SECTION A, LINE 3 WELCH HEALTHCARE AND RETIREMENT GROUP, INC., 52 ACCORD PARK DRIVE, NORWELL, MA 02061, PROVIDES MANAGEMENT AND FINANCIAL SERVICES. FORM 990, PART VI, SECTION B, LINE 11 THE AUDIT COMMITTEE SHALL REVIEW AND APPROVE THE IRS FORM 990 ANNUAL TAX FILINGS PRIOR TO SUBMISSION, AND THE BOARD SHALL RECEIVE A COPY AND REVIEW THE IRS FORM 990 TAX FILINGS WITHIN 30 DAYS LEADING UP TO ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR MUST PROVIDE THE BOARD OF DIRECTORS WITH AN ANNUAL WRITTEN DISCLOSURE OF THE FOLLOWING: (I) THE DIRECTOR'S BUSINESS INVOLVEMENTS WITH THE ORGANIZATION AND RELATED ORGANIZATIONS; (II) THE DIRECTOR'S OTHER BOARD MEMBERSHIPS, WHETHER OF FOR-PROFIT OR NON-PROFIT CORPORATIONS; AND (III) THE TOTAL AMOUNT RECEIVED BY THE DIRECTOR FROM THE ORGANIZATION AND RELATED ORGANIZATIONS FOR SERVICES RENDERED AS A VENDOR OF GOODS OR SERVICES TO THE RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD SHALL CONDUCT A PERFORMANCE EVALUATION OF THE CHIEF EXECUTIVE OFFICER OF THE COMPANY ON AN ANNUAL BASIS. SUCH EVALUATION SHALL BE USED AS THE BASIS FOR DETERMINING COMPENSATION AND SHALL INCLUDE AN ASSESSMENT OF COMPANY GOALS AND PERFORMANCE. THE BOARD WILL REVIEW YEAR OVER YEAR PERFORMANCE AND EVALUATE COMPANY RESULTS WITH RESPECT TO FINANCIAL PERFORMANCE, ATTAINMENT OF GOALS, PROGRAM AND OPERATIONAL QUALITY AND GOVERNANCE. THE BOARD WILL ALSO CONSIDER ORGANIZATIONAL STRENGTH AND DEVELOPMENT AND BOARD-CEO RELATIONSHIP MANAGEMENT. IN MAKING A COMPENSATION DETERMINATION, THE BOARD SHALL CONSIDER CURRENT INDEPENDENT MARKET ASSESSMENT OF AND RELIABLE DATA FROM COMPARABLE ORGANIZATIONS. THE BOARD MAY FROM TIME TO TIME SPECIFICALLY ENGAGE THIRD PARTY PROFESSIONALS TO CONDUCT COMPENSATION STUDIES OR TO REVIEW AND ASSESS CURRENT PRACTICES WHEN DEEMED USEFUL TO KEEP ITS KNOWLEDGE AND INFORMATION CURRENT. ALL EXTERNAL STUDIES WILL FOLLOW THE IRS GUIDELINES FOR DETERMINING "EXCESS BENEFIT". THE BOARD SHALL APPOINT A COMPENSATION COMMITTEE WHO WILL BE RESPONSIBLE FOR LEADING THE COMPENSATION AND EVALUATION PROCESS. THE COMMITTEE WILL REPORT ITS RECOMMENDATIONS TO THE BOARD, WHICH WILL PARTICIPATE IN FULL IN THE DECISION MAKING. THE CEO SHALL CONDUCT A PERFORMANCE EVALUATION OF THE CHIEF FINANCIAL OFFICER OF THE COMPANY ON AN ANNUAL BASIS. SUCH EVALUATION SHALL BE USED AS THE BASIS FOR DETERMINING COMPENSATION AND SHALL INCLUDE AN ASSESSMENT OF COMPANY GOALS AND PERFORMANCE. THE CEO WILL REVIEW YEAR OVER YEAR PERFORMANCE AND EVALUATE COMPANY RESULTS WITH RESPECT TO FINANCIAL PERFORMANCE, ATTAINMENT OF GOALS, PROGRAM AND OPERATIONAL QUALITY AND GOVERNANCE. IN MAKING A COMPENSATION DETERMINATION, THE CEO SHALL CONSIDER CURRENT INDEPENDENT MARKET ASSESSMENT OF AND RELIABLE DATA FROM COMPARABLE ORGANIZATIONS. THE CEO WILL ADVISE THE BOARD OF HER DECISION. 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: TRANSFER FROM PARENT ORGANIZATION 1,155,869. ALLIANCE HEALTH INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 043468274 SUPPORTING ORGANIZATION MA 501(C)(3) LINE 11A, I 0 ALLIANCE HUMAN SERVICES INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 043476887 FOSTER CARE CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE CHILDREN'S SERVICES INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 042691041 FOSTER CARE CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HUMAN SERVICES INC 0 ALLIANCE OF THE CHESAPEAKE BAY INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 010672105 FOSTER CARE CORPORATION MA 501(C)(3) LINE 7 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF MASSACHUSETTS INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 311712039 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF QUINCY INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 043468149 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF SOUTHEASTERN MASSACHUSETTS INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 043582078 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF BRAINTREE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 651310230 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 7 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF CENTERVILLE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249886 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF DANVERS INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249854 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF LOWELL INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249859 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF PLYMOUTH INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249891 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF SANDWICH INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249868 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF SOUTHBRIDGE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249840 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF WORCESTER INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249850 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF PROVIDENCE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249901 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF EAST PROVIDENCE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249896 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 ALLIANCE SPECIALTY HOSPITAL INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249832 HOSPITAL CORPORATION MA 501(C)(3) LINE 3 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH MANAGEMENT SERVICES LLC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 364639819 SUPPORTING ORGANIZATION MA 501(C)(3) LINE 11B, II ALLIANCE HEALTH INC 0 THE HOSPITAL COTTAGES FOR CHILDREN 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 042104323 SKILLED NURSING CORPORATION MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 DEPOT POND VILLAGE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 203883388 RESIDENTIAL FACILITY FOR THE ELDERLY MA 501(C)(3) LINE 9 ALLIANCE HEALTH INC 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0