Masonicare Partners Home Health and Hospice Inc: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Masonicare Partners Home Health and Hospice Inc (EIN 26-0758992)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-15
IRS object ID
201432279349300928
Schema version
2012v2.0
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)
Timestamp2014-08-15T06:33:48-07:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN260758992EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Masonicare Partners Home Health andBusinessNameLine1
Business Name Line2Hospice IncBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMASONameControl
Phone8605282273Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1111 Founders Plaza Suite 200AddressLine1
CityEast HartfordCity
StateCTState
ZIP Code06108ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCYNTHIA GIBBONSName
TitleSecretaryTitle
Date Signed2014-08-15DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts23632612GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.MASONICARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2007YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionMasonicare Partners Home Health and Hospice, Inc. is a partnership formed between Masonicare Home Health and Hospice, Inc. and St Francis Hospital and Medical Center to provide home health and hospice services to clients of all ages in the greater Hartford area.ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees282TotalNbrEmployees
Total Nbr Volunteers91TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year74132ContributionsGrantsPriorYear
Contributions Grants Current Year46576ContributionsGrantsCurrentYear
Program Service Revenue Prior Year23014673ProgramServiceRevenuePriorYear
Program Service Revenue CY23585883ProgramServiceRevenueCY
Investment Income Prior Year609InvestmentIncomePriorYear
Investment Income Current Year153InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year23089414TotalRevenuePriorYear
Total Revenue Current Year23632612TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year27640GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year15002246SalariesEtcPriorYear
Salaries Etc Current Year14989121SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8210384OtherExpensePriorYear
Other Expenses Current Year8175731OtherExpensesCurrentYear
Total Expenses Prior Year23240270TotalExpensesPriorYear
Total Expenses Current Year23164852TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-150856RevenuesLessExpensesPriorYear
Revenues Less Expenses CY467760RevenuesLessExpensesCY
Total Assets BOY2859784TotalAssetsBOY
Total Assets EOY3627166TotalAssetsEOY
Total Liabilities BOY3119623TotalLiabilitiesBOY
Total Liabilities EOY3083927TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-259839NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY543239NetAssetsOrFundBalancesEOY
Mission DescriptionMasonicare Partners Home Health and Hospice, Inc. is a partnership formed between Masonicare Home Health and Hospice, Inc. and St Francis Hospital and Medical Center to provide home health and hospice services to clients of all ages in the greater Hartford area.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense17774873Expense
Revenue23585908Revenue
DescriptionMasonicare Partners Home Health and Hospice, Inc. provides home health services to clients of all ages including: wound care, oncology(in conjunction with Saint Francis/Mount Sinai Regional Cancer Center), behavioral health, rehabiliation, skilled nursing care, intravenous therapy services, physical therapy services, medical social services and nutritional services. The total visits for the period ended September 30,2013 were 166,963. Total patients served were 5,232.Description
Total Program Service Expense17774873TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109660NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees282NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members4NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonR Scott ThelenNamePerson
Telephone Number2036787857TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line122 Masonic AvenueAddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
STEPHEN B MCPHERSON
ALT DIRECTOR1.0040.00X085776230646
ALAN SILVERMAN MD
ALT DIRECTOR1.000.00X000
DAVID BITTNER
Treasurer1.000.00X000X
KAREN BEAUCHESNE
VICE-CHAIRMAN1.0040.00X000X
JON-PAUL VENOIT
CHAIRPERSON1.0040.00X016370226613X
CYNTHIA GIBBONS
Secretary1.0040.00012713313485X
Jennifer Rich
Dir-Administration40.000.00114860012187X
Kieutien Nguyen
Superv.Hospice40.000.00102231030845X
Kimberly Hull
Hospice-RN40.000.00108388027992X
Scott Ivens
Superv-Phys Therap40.000.00102184028457X
Mary Marchant
Physical Therapist40.000.0089921027252X
R Scott Thelen
Former Alt Director0.0040.00031243936385X
William Piper
Former Vice Chairperson0.0040.00045627625273X
FieldValueIRS element (for citing)
Total Reportable Comp From Org517584TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1917312TotalReportableCompFrmRltdOrgs
Total Other Compensation259135TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Saint Francis Hospital
114 Woodland StreetHarfordCT06105Inpatient services3755656
Riverside Health and Rehab
745 Main StreetEast HartfordCT06108Inpatient services592856
Merchant 99-1111 Founders LLC
One Hatfield BlvdEast WindsorCT06088Rent364404
Masonicare Inc
PO Box 70WallingfordCT06492Management services3345996
Hospice Pharmacia
PO Box 510818PhiladelphiaPA19175Pharmacy services468883
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
All Other Contributions46576AllOtherContributions
Total Contributions46576TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient service revenueDescription
Business Code621610BusinessCode
Total Revenue Column23585883TotalRevenueColumn
Related Or Exempt Function Income23585883RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue23585883TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column153TotalRevenueColumn
Exclusion$153ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column23632612TotalRevenueColumn
Related Or Exempt Function Income23585883RelatedOrExemptFunctionIncome
Exclusion$153ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total11751184Total
Program Services10421893ProgramServices
Management And General1329291ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2529027Total
Program Services2242944ProgramServices
Management And General286083ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total708910Total
Program Services628718ProgramServices
Management And General80192ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3345996Total
Management And General3345996ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2361Total
Management And General2361ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total7500Total
Management And General7500ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total52763Total
Program Services600ProgramServices
Management And General52163ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total276649Total
Program Services276649ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total470905Total
Program Services453357ProgramServices
Management And General17548ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total16397Total
Program Services16397ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total207013Total
Program Services185163ProgramServices
Management And General21850ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debts141227141227
Purchased Services406914205555201359
Supplies -other12007621200414348
Inpatient hospice18156471815647

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total231597Total
Program Services186309ProgramServices
Management And General45288ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total23164852Total
Program Services17774873ProgramServices
Management And General5389979ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1000BOY
EOY358815EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2759886BOY
EOY3144673EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY32866BOY
EOY53677EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis868086LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec798085LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY66032BOY
EOY70001EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2859784BOY
EOY3627166EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2070416BOY
EOY1906005EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY450285BOY
EOY476771EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY598922BOY
EOY701151EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3119623BOY
EOY3083927EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-259839BOY
EOY543239EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-259839BOY
EOY543239EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2859784BOY
EOY3627166EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses467760ReconcilationRevenueExpenses
Reconcilation Other Changes335318ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years126648CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years260054CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years53179CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year74132CurrentTaxYearMinus1Year
Current Tax Year46576CurrentTaxYear
Total560589Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22631417CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years22456709CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23101927CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23014673CurrentTaxYearMinus1Year
Current Tax Year23585908CurrentTaxYear
Total114790634Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22758065CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years22716763CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23155106CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23088805CurrentTaxYearMinus1Year
Current Tax Year23632484CurrentTaxYear
Total115351223Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509115351223PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1152CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years638CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years95CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year609CurrentTaxYearMinus1Year
Current Tax Year153CurrentTaxYear
Total2647Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1152CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years638CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years95CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year609CurrentTaxYearMinus1Year
Current Tax Year153CurrentTaxYear
Total2647Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22759217CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years22717401CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23155201CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23089414CurrentTaxYearMinus1Year
Current Tax Year23632637CurrentTaxYear
Total115353870Total
FieldValueIRS element (for citing)
Public Support Percentage5091.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis111797OtherCostOrOtherBasis
Depreciation89348Depreciation
Book Value22449BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis136089OtherCostOrOtherBasis
Depreciation105061Depreciation
Book Value31028BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis620200OtherCostOrOtherBasis
Depreciation603676Depreciation
Book Value16524BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings70001TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
THIRD PARTY SETTLEMENTS$9,900
ACCRUED PAYROLL$691,251
FieldValueIRS element (for citing)
Total Of Amounts701151TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
William Piper
Former Vice Chairperson4156734041319025273481549
STEPHEN B MCPHERSON
ALT DIRECTOR5210741500032168830646888408
R Scott Thelen
Former Alt Director3019671000047236385348824
JON-PAUL VENOIT
CHAIRPERSON14160015000710226613190315

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part III, Additional InformationPart III, Additional InformationPart 1, Line 3A related organization, uses a compensation committee, an independent compensation consultant and approval by the compensation committee to establish compensation for the officers and senior leaders of the parent organization and its subsidiaries.
Sch J, Part I, Line 7Part I, Line 7: Non-Fixed payments not listed aboveCompensation to reward senior managers for achieving annual quality, strategic and financial goals for the organization.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part XI, Line 9Other Changes In Net Assets Or Fund Balances - Other DecreasesReturn of capital-Masonicare = -$195000
Form 990, Part XI, Line 9Other Changes In Net Assets Or Fund Balances - Other IncreasesIntercompany = $530318
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe financial statements are publicly availiable through EMMA and public securities markets. The certificate of incorporation and related documents are on file with the Connecticut Secretary of State's office. The conflict of interest policy is avaliable upon request.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAnnually, officers, board members and senior employees are required to complete a conflict of interest disclosure. The Corporate Compliance Officer annotates the results to determine if, and to what extent, a conflict of interest exists. The results of the officer and board member disclosures are first reviewed by the board chairman and then reported at the board meetings. Any officer or board member shall not make or second motions or vote(other than abstain) on matters if a conflict of interest exists, whether or not the officer or board member had an opportunity to make a written disclosure through the formalized process. Senior employee disclosures are reported to the President and Chief Executive Officer of Masonicare. The entire process is coordinated by the Corporate Compliance Officer. All respondents are advised of their continuing duty to disclose any possible conflict of interest that may arise during the course of their service.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessMasonicare Management reviews the tax return for completeness and accuracy. After responding to all comments/questions, changes are made as appropriate. At a full board meeting a discussion is held regarding the changes that were made. The tax return is then finalized and filed.
Form 990, Part VI, Line 7bForm 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersPursuant to the bylaws of the corporation, the members have certain reserved powersto take or approve certain actions of the governing body. These powers include theappointment and removal of directors as well as the suspension of a governing boardaction that has a materially adverse affect on a member's interest.
Form 990, Part VI, Line 7aForm 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyEach class or member annually appoints two directors and one alternate director
Form 990, Part VI, Line 6Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe organization has two classes of members, each class consisting of one member:Masonicare Home,Health and Hospice, Inc. constitutes one class and Saint Francis Hospital and Medical Center constitutes the other class.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Masonicare at Home Inc
PO Box 70WallingfordCT06492202377783Providecompanion/homemaker/personal care services to elderlyCT501(c)(3)9NAfalse
Keystone Indemnity Company Ltd
126 College Street Suite 400BurlingtonVT05401030371612Provide insurance servicesto Masonicare affiliatesVT501(c)(3)11aNAfalse
Masonicare Home Health and Hospice Inc
PO Box 70WallingfordCT06492061101924Provide home health services to clients of all agesCT501(c)(3)9NAfalse
Masonicare at Ashlar Village Inc
PO Box 70WallingfordCT06492061050830Continuing care retirement and assisted living communityCT501(c)(3)9NAfalse
Masonicare at Newtown Inc
PO Box 70WallingfordCT06492061070285Provide skilled nursing/assisted living services to elderlyCT501(c)(3)9NAfalse
MASONICARE HEALTH CENTER
PO Box 70WallingfordCT06492060655131Provide comprehensive medical services to the elderlyCT501(c)(3)9NAfalse
Masonic Charity Foundation of CT
PO Box 70WallingfordCT06492061435920Provide planned giving and development support to affiliatesCT501(c)(3)7NAfalse
Masonicare Inc
PO Box 70WallingfordCT06492061435919Parent holding and support organization for affiliate corp.CT501(c)(3)11cNAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
Masonic Management Services
PO Box 70WallingfordCT06492061468972Provides management servicesCTNAC CORPfalse
Masonicare Primary Care Physicians PC
PO Box 70WallingfordCT06492061491820Physician medical practiceCTC CORPfalseN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

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