MASONICARE HOME HEALTH AND HOSPICE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MASONICARE HOME HEALTH AND HOSPICE INC (EIN 06-1101924)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-15
IRS object ID
201442279349300929
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)
Timestamp2014-08-15T06:34:23-07:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN061101924EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Masonicare Home Health and Hospice IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMASONameControl
Phone2036787857Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line133 North Plains RoadAddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameR Scott ThelenName
TitleAsst. TreasurerTitle
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 Receipts38530763GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.MASONICARE.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1999YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionSee Schedule OActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees607TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year139618ContributionsGrantsPriorYear
Contributions Grants Current Year186462ContributionsGrantsCurrentYear
Program Service Revenue Prior Year37607400ProgramServiceRevenuePriorYear
Program Service Revenue CY38367522ProgramServiceRevenueCY
Investment Income Prior Year618InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year78OtherRevenuePriorYear
Other Revenue Current Year-23221OtherRevenueCurrentYear
Total Revenue Prior Year37747714TotalRevenuePriorYear
Total Revenue Current Year38530763TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year85056GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY84598GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year24344440SalariesEtcPriorYear
Salaries Etc Current Year24732428SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9592097OtherExpensePriorYear
Other Expenses Current Year9659889OtherExpensesCurrentYear
Total Expenses Prior Year34021593TotalExpensesPriorYear
Total Expenses Current Year34476915TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3726121RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4053848RevenuesLessExpensesCY
Total Assets BOY6957846TotalAssetsBOY
Total Assets EOY7477461TotalAssetsEOY
Total Liabilities BOY4994154TotalLiabilitiesBOY
Total Liabilities EOY3607286TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1963692NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3870175NetAssetsOrFundBalancesEOY
Mission DescriptionSee Schedule OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense28035567Expense
DescriptionMasonicare Home Health and Hospice, Inc. provides home health services to clients of all ages including: skilled nursing care, hospice, physical, speech and occupational therapies, medical social work and home health aid services. The total MHH&H, Inc care of sick visits for the period ended September 30, 2013 were 189,580 and total visits for Hospice were 59,638. Total patients served were 5,875 for Care of Sick and 1,137 for Hospice.Description

Activity2 Activity2

FieldValueIRS element (for citing)
DescriptionMHH&H, Inc. provides management services to Masonicare Partners Home Health and Hospice, Inc. Partners is an affiliate that is jointly owed with St. Francis Medical Center. The mission of Partners is to provide home health servies to clients of all ages in the greater Hartford area.Description
FieldValueIRS element (for citing)
Total Program Service Expense28035567TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
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 AssetstrueReportOtherAssets
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 IndividualstrueGrantsToIndividuals
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 With109688NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees607NumberOfEmployees
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 Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
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 ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
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 (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Brian Beals
Member0.000.00000
Susan Koty
Member1.000.00000X
Alexander Jarvis
Member1.000.00000X
Arthur W Davis MD
Member1.000.00000X
Donald Gladding
Member1.000.00000X
Arnold Freedman
Member1.000.00000X
Jon-Paul Venoit
Vice President1.0040.00016370226613X
Patricia A Sweet
Member1.000.00000X
R Scott Thelen
Asst. Treasurer1.0040.00031243936385XX
Stephen B McPherson
Asst Secretary1.0040.00085776230646XX
Francine A Bailey
Member1.000.00000X
Newton Buckner
Treasurer1.000.00000XX
Geoffrey L Ice
Secretary1.000.00000XX
Christopher Earle
Vice Chairman1.000.00000XX
Francis X Conlon
Chairman1.000.00000XX
Susan Adams
Supervisor Hospice40.000.00138581021255X
David Yearick
RN40.000.00106347018939X
Susan Fagan
RN40.000.00102004027164X
Doreen Brown Wade
RN40.000.0099372017586X
Edna Roig
RN40.000.009710605529X
FieldValueIRS element (for citing)
Total Reportable Comp From Org543410TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1333903TotalReportableCompFrmRltdOrgs
Total Other Compensation184117TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers ListedfalseFormersListed
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
Masonicare Inc
PO Box 70WallingfordCT06492Management services2708452
Hospice Pharmacia
1601 Cherry StreetPhiladelphiaPA19102Drugs and Medication484979
Carolton Convalescent
400 Mill Plain RdFairfieldCT06824Hospice110995
Byram
120 Bloomingdale RdWhite PlainsNY10605Medical Supplies287249
Apple Rehab
220 Scoville RdAvonCT06001Hospice205799
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations139924RelatedOrganizations
All Other Contributions46538AllOtherContributions
Total Contributions186462TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient Service Revenue6216103502152635021526
Management fees62161033459963345996
FieldValueIRS element (for citing)
Total Program Service Revenue38367522TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Vending Machine195195
Interest Income508508

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-23924TotalRevenueColumn
Related Or Exempt Function Income-23924RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue-23221TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column38530763TotalRevenueColumn
Related Or Exempt Function Income38344301RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total84598Total
Program Services84598ProgramServices

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)
Total19256317Total
Program Services17017296ProgramServices
Management And General2239021ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4058928Total
Program Services4057318ProgramServices
Management And General1610ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1417183Total
Program Services1417183ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2708452Total
Management And General2708452ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total14239Total
Management And General14239ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total38117Total
Management And General38117ManagementAndGeneral

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)
Total972825Total
Program Services972825ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total120272Total
Program Services6853ProgramServices
Management And General113419ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total438577Total
Program Services430838ProgramServices
Management And General7739ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total964334Total
Program Services892133ProgramServices
Management And General72201ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total10768Total
Program Services2280ProgramServices
Management And General8488ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total253447Total
Management And General253447ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total291281Total
Management And General291281ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
I/P General Hospice378700378700
Purchased Services507384307140200244
Repairs & maintenance66252264788014642
Supplies125718712509726215

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1041784Total
Program Services569551ProgramServices
Management And General472233ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total34476915Total
Program Services28035567ProgramServices
Management And General6441348ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1950BOY
EOY1850EOY

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)
BOY4017573BOY
EOY4186524EOY

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)
BOY210072BOY
EOY344635EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis7060292LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5498687LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1176280BOY
EOY1561605EOY

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)
BOY1551971BOY
EOY1382847EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6957846BOY
EOY7477461EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2049622BOY
EOY1606090EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY823688BOY
EOY835164EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2120844BOY
EOY1166032EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4994154BOY
EOY3607286EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1963692BOY
EOY3870175EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1963692BOY
EOY3870175EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6957846BOY
EOY7477461EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4053848ReconcilationRevenueExpenses
Reconcilation Other Changes-2147365ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
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 Years105110CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years72921CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years195070CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year139618CurrentTaxYearMinus1Year
Current Tax Year186482CurrentTaxYear
Total699201Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years38048639CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years33500476CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years34840576CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year34162736CurrentTaxYearMinus1Year
Current Tax Year35021526CurrentTaxYear
Total175573953Total

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 Years38153749CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years33573397CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years35035646CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year34302354CurrentTaxYearMinus1Year
Current Tax Year35208008CurrentTaxYear
Total176273154Total

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 Total509176273154PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3246CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3140CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years467CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year618CurrentTaxYearMinus1Year
Total7471Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years111CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year78CurrentTaxYearMinus1Year
Current Tax Year-23221CurrentTaxYear
Total-23032Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3246CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3140CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years578CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year696CurrentTaxYearMinus1Year
Current Tax Year-23221CurrentTaxYear
Total-15561Total

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 Years38156995CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years33576537CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years35036224CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year34303050CurrentTaxYearMinus1Year
Current Tax Year35184787CurrentTaxYear
Total176257593Total
FieldValueIRS element (for citing)
Public Support Percentage5091.00000PublicSupportPercentage509
Prior Year Support Percentage0.99990PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00010PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1377438OtherCostOrOtherBasis
Depreciation715407Depreciation
Book Value662031BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis352250OtherCostOrOtherBasis
Depreciation349001Depreciation
Book Value3249BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4701750OtherCostOrOtherBasis
Depreciation4196103Depreciation
Book Value505647BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis628854OtherCostOrOtherBasis
Depreciation238176Depreciation
Book Value390678BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1561605TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Other receivables34983
Investments1347864
FieldValueIRS element (for citing)
Total Book Value Other Assets1382847TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Other$96,390
Medicare tpl$1,069,642
FieldValueIRS element (for citing)
Total Of Amounts1166032TotalOfAmounts

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
Quality of Life7Market ValuesHome Health Care Equipment
Charity Care77Market ValueHome Health & Hospice

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
Susan Adams
Supervisor Hospice13769688521255159836
Stephen B McPherson
Asst Secretary5210741500032168830646888408
R Scott Thelen
Asst. Treasurer3024391000036385348824
Jon-Paul Venoit
Vice President14160015000710226613190315

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part X, Line 20 TE Bond LiabilitesMasonicare Home Health and Hospice, Inc is a memeber of the Masonicare obligated group that is responsible for the repayment of the Series C and Series E bonds issued by Masonicare, Inc. in 2007 in 2011 respectively. The current outstanding bond blance is $101,556,000.
Form 990, Part III, Line 1 OrganizationMasonicare Home Health and Hospice, a team of highly qualified and caring individuals, is dedicated to excellence in home health and hospice care. We continually strive to improve the health and wellness of patients and families throughout Connecticut with our responsive, accessible and quality-driven approach to care at home and in the community.As the largest non-profit home care and hospice provider in the state, we are dedicated and committed to quality care and excellent customer service. We cover the entire state while maintaining a local feel,with an intense focus on raising the awareness of the home care benefit, we are innovative leaders in developing new programs for home care deliver.We are the provider and employer of choice. Everyone associated with us understands our mission and we effectively communicate, to our stakeholders, the contributions we provide to our communities. Because we are present in all of the communities we serve, well-respected in our profession and recognized on a national basis, we influence how home care and hospice is delivered throughout the state.We use technology to improve both the quality of our care and the efficiency of our care delivery. Our continuing efforts to recruit, develop and retain the best people in our markets mean we have a waiting list of highly qualified people ready to work for us.We reach out to the entire Masonic Family, because we believe the Masonic values of faith, hope, charity, temperance, fortitude and justice, Masons throughout the state are proud of our organization.As a result of our strategic focus and hard work, we are a caring, growing, fiscally responsible organization and a powerful force within our state.
Other Changes In Net Assets Or Fund Balances - Other DecreasesRELATED COMPANIES = -$2147365Form 990, Part XI, Line 9
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe financial statements are publicly available throught EMMA and public securities markets. The statements are included in the Masonicare Corporation consolidated financial statements. The governing documents (certificate of incorporation) is filed with the Ct Secretary of State. The conflict of interest policy is currently available upon request.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementThe Compensation Committee of the sole corporate member, Masonicare Corporation, engages an independent firm to certify the reasonableness of the compensation of the president and executive management group of the organization annually.Form 990, Part VI, Line 15a
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAnnually, officers, directors and senior employees are required to complete a conflict of interest disclosure questionnaire. the results of the officers' and directors' disclosures are reported at the board meetings. Senior employee disclosures are reported to the President. The entire process is coordinated by the Corporate Compliance Officer. All respondents are advised to report any changes during the year that may present a conflict of interest.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessMasonicare Corporation and Masonicare Home Health and Hospice review the tax return for completeness and accuracy. It is also reviewed by the chief executive officer and chairman of the board. The review process is then discussed with full board. After responding to comments/questions, changes are made as appropriate and the return is finalized and filed.Form 990, Part VI, Line 11b
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersPursuant to the Certificate of Incorporation of the organization, reserved powers to take or approve certain actions of the governing body. These powers include the prior approval of amendments to the organization's certificate of incorporation and bylaws, approval of long range plans, budgets and material changes in budgets, mission statements and policies (including investment policies) as well as sales or transfer of assets, mergers and/or dissolutions and Certificate of Need applications. The sole corporate member's powers also include the appointment and removal of directors, the company's board chair and independent audit firm.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyMasonicare Corporation, a sole corporate member, annually appoints the members of the affiliate board.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe organization has a sole corporate member, Masonicare Corporation, with the right to appoint the members of the governing body and to participate in the organizations governance.Form 990, Part VI, Line 6

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
PO Box 70WallingfordCT06492202377783Providecompanion/homemaker/personal care services to elderlyCT501(c)(3)9NAfalse
Masonicare at Newtown Inc
PO Box 70WallingfordCT06492061070285Provide skilled nursing/assisted living services to elderlyCT501(c)(3)9NAfalse
Keystone Indemnity Company Ltd
126 College Street Suite 400BurlingtonVT05401030371612Provide insurance services to Masonicare affilatesVT501(c)(3)11aNAfalse
Masonicare Partners HomeHealth & Hospice
111 Founders Plaza Suite 200East HartfordCT06492260758992Provide home/health/hospice 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 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 70WallingfordCT06492061435920Parent holding and support organization of affilate corp.CT501(c)(3)11cNAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
Masonicare Behavioral Healh
Masonic AveWallingfordCT06492061483276Drs Practice Psychiatric SvsCTN/ACfalse
Masonicare Primary Care Physicians PC
Masonic AveWallingfordCT06492061491820Physician medical practiceCTN/ACfalse
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 OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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