PIERCE MEMORIAL BAPTIST HOME INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PIERCE MEMORIAL BAPTIST HOME INC (EIN 06-0677159)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-06-11
IRS object ID
201411629349300436
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-06-11T14:20:48-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN271728945EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1O'Connor Davies LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1100 Great Meadow Road Suite 401AddressLine1
CityWethersfieldCity
StateCTState
ZIP Code06109ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN060677159EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Pierce Memorial Baptist Home IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPIERNameControl
Phone8607749050Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 326AddressLine1
CityBrooklynCity
StateCTState
ZIP Code06234ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePatty MorseName
TitlePresident/CEOTitle
Phone8607749050Phone
Date Signed2014-06-04DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameThomas O Marien CPA MBA CVAName
PTINP01064007PTIN
Phone8602571870Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1PierceCareBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonPatty MorseNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line144 Canterbury RoadAddressLine1
CityBrooklynCity
StateCTState
ZIP Code06234ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13037775GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.piercecare.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1951YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionTo provide a continuum of care to residents at a level of independence appropriate to their needs.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees252TotalNbrEmployees
Total Nbr Volunteers45TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year17637ContributionsGrantsPriorYear
Contributions Grants Current Year14297ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9004303ProgramServiceRevenuePriorYear
Program Service Revenue CY10271545ProgramServiceRevenueCY
Investment Income Prior Year208774InvestmentIncomePriorYear
Investment Income Current Year623957InvestmentIncomeCurrentYear
Other Revenue Prior Year-2712OtherRevenuePriorYear
Other Revenue Current Year8604OtherRevenueCurrentYear
Total Revenue Prior Year9228002TotalRevenuePriorYear
Total Revenue Current Year10918403TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5127981SalariesEtcPriorYear
Salaries Etc Current Year5684262SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year4867TotalFundrsngExpCurrentYear
Other Expense Prior Year3675404OtherExpensePriorYear
Other Expenses Current Year4834035OtherExpensesCurrentYear
Total Expenses Prior Year8803385TotalExpensesPriorYear
Total Expenses Current Year10518297TotalExpensesCurrentYear
Revenues Less Expenses Prior Year424617RevenuesLessExpensesPriorYear
Revenues Less Expenses CY400106RevenuesLessExpensesCY
Total Assets BOY24375917TotalAssetsBOY
Total Assets EOY24099232TotalAssetsEOY
Total Liabilities BOY14478060TotalLiabilitiesBOY
Total Liabilities EOY13765781TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9897857NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10333451NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPierceCare provids a continuum of quality care by making available independent and assisted living, rehabiltative therapy, long-term nursing, respite, adult day care and other services in a Christ-centered environment. Residents are encouraged to grow spirtually as they live their lives at a level of independence appropriate to their needs. These services are provided to all as an extension of the ministry of the American Baptist Churches of Conecticut.MissionDescription
Significant New Program Services1SignificantNewProgramServices
Significant Change0SignificantChange
Expense6475234Expense
Revenue7450162Revenue
DescriptionLong Term Care and Short Term Rehabilitation Center - The approximately 55,000 square foot facility contains 80 beds, therapy space and common living, dining, and recreation areas. Long term residents enjoy a variety of programs such as daily exercise, games, music, bingo, parties, and baking, as well as a wide variety of intellectually stimulating programs. The facility provides comprehensive services to those persons in need of short term rehabilitation following surgery or acute illnesses. These include physical, occupational and speech therapies as well as 24 hour nursing care, teaching, education, etc. prior to returning home in the community.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1724115Expense
Revenue2437309Revenue
DescriptionIndependent Living - This consists of 83 apartments and 10 cottages. This program is designed to be a community for retired people who seek the ease and security of gracious and exceptional living amidst familiar surroundings and friends.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense359218Expense
Revenue351974Revenue
DescriptionAssisted Living - This program provides the freedom and flexibility of an independent home enviroment partnered with high-quality, individualized assisted living services. Assisted living services are designed to provide residents with assistance with basic activites of daily living such as bathing, grooming, dressing, and more.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense29338Expense
Revenue40362Revenue
DescriptionAdult Day Care: Two days a week elderly individuals meet at PMBH in the recreation room to socialize, listen to music and participate in other activities. They are supervised for 6 hours by professionals and are given a hot lunch at noon. This is designed for caregivers to have a day off. The price is $50 a day. Adult Day Care expenses amounted to $29,339 while revenues amount to $32,100.Vending machines and convenience items available for sale to the residents. The revenues for this activity amounted to $8,262.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp29338TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev40362TotalOfOtherProgramServiceRev
Total Program Service Expense8587905TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees252NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCTStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Diana Baule Office ManagerBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8607749050TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1Route 169AddressLine1
CityBrooklynCity
StateCTState
ZIP Code06234ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Robert Avena Esq
Board Member5.00X000
Rev Michael A Crane
Board Member5.00X000
David Jones
Board Member5.00X000
Mark Kane
Board Member5.00X000
Bill McMunn
Board Member5.00X000
Scot Rapoza
Board Member5.00X000
Sandy Stevens
Board Member5.00X000
Charles Wyand
Board Member5.00X000
Rev Judy G Allbee
Ex-Officio Board Member0.20X000
Rev Bill Sutton
Ex-Officio Board Member0.20X000
John Riesen
Chairman10.00000X
William Smith
Vice Chairman10.00000X
Shirley DeFlavis
Secretary10.00000X
Timothy Bates
Treasurer10.00000X
Leonard Goldberg
President/CEO50.0018541605567X
Frances Cote RN
Director of Nursing40.001104900450X
FieldValueIRS element (for citing)
Total Reportable Comp From Org295906TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation6017TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Select Rehabilitation Inc
550 Frontage RoadNorthfieldIL60093Provides PTOT and ST services to residen324588
RehabCare Group Inc
PO Box 503534St LouisMO63150Provides PTOT and ST services to residen165614
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions14297AllOtherContributions
Total Contributions14297TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Long Term Care & ST Rehab62300074501627450162
Independent Living53111024373092437309
Assisted Living531110351974351974
Adult Day Care Program6241003210032100
FieldValueIRS element (for citing)
Total Program Service Revenue10271545TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column312216TotalRevenueColumn
Exclusion$312,216ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2417172Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2105431Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities311741Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column311741TotalRevenueColumn
Exclusion$311,741ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events1625GrossIncomeFundraisingEvents
Fundraising Direct Expenses1283FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column342TotalRevenueColumn
Exclusion$342ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory20920GrossSalesOfInventory
Cost Of Goods Sold12658CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column8262TotalRevenueColumn
Related Or Exempt Function Income8262RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10918403TotalRevenueColumn
Related Or Exempt Function Income10279807RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$624,299ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total355129Total
Program Services231014ProgramServices
Management And General119248ManagementAndGeneral
Fundraising4867Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4406614Total
Program Services4062366ProgramServices
Management And General344248ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total15383Total
Program Services11591ProgramServices
Management And General3792ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total570831Total
Program Services462611ProgramServices
Management And General108220ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total336305Total
Program Services299025ProgramServices
Management And General37280ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total9275Total
Management And General9275ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total67971Total
Management And General67971ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total130Total
Management And General130ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total41759Total
Management And General41759ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total821728Total
Program Services770732ProgramServices
Management And General50996ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total115830Total
Management And General115830ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total521337Total
Program Services328919ProgramServices
Management And General192418ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total12405Total
Management And General12405ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total493756Total
Program Services468050ProgramServices
Management And General25706ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total27914Total
Program Services248ProgramServices
Management And General27666ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total12276Total
Program Services8527ProgramServices
Management And General3749ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total223888Total
Program Services223888ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total516294Total
Program Services501502ProgramServices
Management And General14792ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total129713Total
Program Services35991ProgramServices
Management And General93722ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Licenses, dues and fees55522445778297442
Bond Refinancing Costs470277470277
Food384817384817
Property Taxes151440151440

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total278001Total
Program Services189402ProgramServices
Management And General88599ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total10518297Total
Program Services8587905ProgramServices
Management And General1925525ManagementAndGeneral
Fundraising4867Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1203810BOY
EOY1552359EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3294008BOY
EOY1853921EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1041755BOY
EOY1343667EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY219150BOY
EOY219150EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2185BOY
EOY1708EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY79808BOY
EOY70494EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis18896575LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9720629LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9505106BOY
EOY9175946EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5952740BOY
EOY5603131EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY497420BOY
EOY287817EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2579935BOY
EOY3991039EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY24375917BOY
EOY24099232EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY602629BOY
EOY819711EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1378389BOY
EOY1333998EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY12270000BOY
EOY11306725EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY227042BOY
EOY305347EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14478060BOY
EOY13765781EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7524012BOY
EOY7986943EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY21823BOY
EOY44940EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2352022BOY
EOY2301568EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9897857BOY
EOY10333451EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24375917BOY
EOY24099232EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses400106ReconcilationRevenueExpenses
Reconciliation Unrealized Invest35493ReconciliationUnrealizedInvest
Reconcilation Other Changes-5ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years70378CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years183693CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23190CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year17823CurrentTaxYearMinus1Year
Current Tax Year14639CurrentTaxYear
Total309723Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8899606CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9443192CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9540083CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8941956CurrentTaxYearMinus1Year
Current Tax Year10279913CurrentTaxYear
Total47104750Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8969984CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9626885CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9563273CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8959779CurrentTaxYearMinus1Year
Current Tax Year10294552CurrentTaxYear
Total47414473Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years194516CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years215911CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years154568CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year128122CurrentTaxYearMinus1Year
Current Tax Year172772CurrentTaxYear
Total865889Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years194516CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years215911CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years154568CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year128122CurrentTaxYearMinus1Year
Current Tax Year172772CurrentTaxYear
Total865889Total
FieldValueIRS element (for citing)
Public Support Total50946548584PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years230565CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years219365CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years243999CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year231076CurrentTaxYearMinus1Year
Current Tax Year312216CurrentTaxYear
Total1237221Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years230565CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years219365CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years243999CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year231076CurrentTaxYearMinus1Year
Current Tax Year312216CurrentTaxYear
Total1237221Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5495CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3388CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9033CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year72401CurrentTaxYearMinus1Year
Total90317Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9206044CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9849638CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9816305CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9263256CurrentTaxYearMinus1Year
Current Tax Year10606768CurrentTaxYear
Total48742011Total
FieldValueIRS element (for citing)
Public Support Percentage5090.95500PublicSupportPercentage509
Prior Year Support Percentage0.95350PriorYearSupportPercentage
Investment Income Percentage0.02540InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.02620PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$130OtherActivitiesAmount
Total Lobbying Expenditures IIB130TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationThe organization supported lobbying expenses through payment of dues to Connecticut Association of Healthcare Facilities.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance5952740BeginningOfYearBalance
Investment Earnings Or Losses150720InvestmentEarningsOrLosses
Other Expenditures672400OtherExpenditures
Administrative Expenses31651AdministrativeExpenses
End Of Year Balance5614110EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance5170296BeginningOfYearBalance
Investment Earnings Or Losses965143InvestmentEarningsOrLosses
Other Expenditures152400OtherExpenditures
Administrative Expenses30299AdministrativeExpenses
End Of Year Balance5952740EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5239270BeginningOfYearBalance
Investment Earnings Or Losses113474InvestmentEarningsOrLosses
Other Expenditures151835OtherExpenditures
Administrative Expenses30613AdministrativeExpenses
End Of Year Balance5170296EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4047765BeginningOfYearBalance
Contributions130297Contributions
Investment Earnings Or Losses1245051InvestmentEarningsOrLosses
Other Expenditures154660OtherExpenditures
Administrative Expenses29183AdministrativeExpenses
End Of Year Balance5239270EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4140428BeginningOfYearBalance
Contributions26006Contributions
Investment Earnings Or Losses61876InvestmentEarningsOrLosses
Other Expenditures154660OtherExpenditures
Administrative Expenses25885AdministrativeExpenses
End Of Year Balance4047765EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.84980BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.15020PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16807620OtherCostOrOtherBasis
Depreciation8475274Depreciation
Book Value8332346BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1927618OtherCostOrOtherBasis
Depreciation1123711Depreciation
Book Value803907BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis161337OtherCostOrOtherBasis
Depreciation121644Depreciation
Book Value39693BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9175946TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Construction in Progress177732
Interest in Trust1458229
Restricted Investments and Cash2355078
FieldValueIRS element (for citing)
Total Book Value Other Assets3991039TotalBookValueOtherAssets
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt10964148TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments35494NetUnrealizedGainsInvestments
Other Revenues10251OtherRevenues
Revenue Not Rptd F99045745RevenueNotRptdF990
Revenue Subtotal10918403RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99010918403TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt10528548TotExpensesEtcAuditedFinclStmt
Other Expenses Included10251OtherExpensesIncluded
Expenses Not Rptd F99010251ExpensesNotRptdF990
Expenses Subtotal10518297ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99010518297TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 2b:Security Deposits and Restricted Trust Funds
Part V, Line 4:To provide interest and earnings to support operating and capital needs.Description of Intended Use of Endowment Funds:
Part X, Line 2:The Home recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Management has determined that the Home had no uncertain tax positions that would require financial statement recognition or disclosure. The Home is no longer subject to U.S. federal, state or local income tax examinations for periods prior to September 30, 2010.Description of Uncertain Tax Positions Under FIN 48:
Portions of COGS shown net/gross in financials 8,968. Special Events shown gross in financials 1,283.Part XI, Line 2d - Other Adjustments:
Portions of COGS shown net/gross in financials 8,968. Special Events shown gross in financials 1,283.Part XII, Line 2d - Other Adjustments:
Part XI 8 Rounding adjustments Part XII 2d Effect of showing the costs of goods sold and special events gross in the financial statements Part XIII 2d Effect of showing the costs of goods sold and special events gross in the financial statements, effect of depreciation error Part XIII 4b Rounding adjustments

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Leonard Goldberg
President/CEO179750056660000055670190983000
Frances Cote RN
Director of Nursing10718303307000004500110940000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 7ReturnReference
ExplanationThe CEO received a bonus in the amount of $5,666. The Head of Nursing received a bonus in the amount of $3,307.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1State of CT Health & Ed Facilities AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN060806186IssuerEIN
CUSIP NumberNoneAvailCUSIPNumber
Date Issued2013-03-13DateIssued
Issue Price11454000IssuePrice
Description Of PurposeRefinance of existing BondsDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired11228076AmountRetired
Total Proceeds11454000TotalProceeds
Issuance Costs From Proceeds225924IssuanceCostsFromProceeds
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action0ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
New Program ServicesForm 990, Part III, line 2Assisted living services designed to provide residents with assistance with basic actvities of daily living such as bathing, grooming, dressing, and more.
Form 990, Part VI, Section A, line 8bThe Board of Trustess, which makes the final decisions, keeps minutes regarding each meeting and action taken. Committee's may hold a meeting that is not documented, but any actions agreed upon are sent to the Board of Trustees for final approval.
Form 990, Part VI, Section B, line 11A copy of the 990 is made available to each Board Member prior to filing. Any questions are then addressed by the President and CEO or the Independent Accounting Firm prior to filing the 990.
Form 990, Part VI, Section B, line 12cAnnually all empoyees are infomed about ethics and how to report any issues they become aware of. The ethics includes conflicts of interest.
Form 990, Part VI, Section B, line 15aCompensation of the CEO is reviewed annually to outside sources such as, other form 990's of comparable facilities and independent compensation consultants recommendations and established with a compensation committee, approval of the board and a written employment contract.
Form 990, Part VI, Section C, line 19Governing documents, financial statements and the conflict of interest statement are available at the Facility's office.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 9:Rounding -5.
The facility has a committee that assumes responsibility for oversight of the financial statements and the selection of the CPA. There was no change in the process from last year.

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