2013-07-26T10:01:20-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2012-01-01 043455405 ALLIANCE HEALTH OF BROCKTON INC ALLI 6173323366 134 RUMFORD AVENUE NO 306 NEWTON MA 02466 FRANCIS J GRADY 5085836000 2013-07-18 1 ROBERT DILLAN P01688008 6179848100 2013-07-18 2012 2016-02-24 21:20:13Z MARY A MCCARTHY 134 RUMFORD AVENUE 306 NEWTON MA 02466 11105059 0 X WWW.ALLIANCEHHS.ORG X 1999 MA THE COMPANY SHALL PROMOTE AND PROVIDE SAFE, HEALTHY, QUALITY SERVICES AND LIVING ENVIRONMENTS FOR THE ELDERS WHO CANNOT CARE FOR THEMSELVES. 8 7 228 0 0 0 0 0 11306974 10894654 25043 36917 6497 31591 11338514 10963162 0 0 0 0 6299237 6023109 0 0 0 5108961 5069643 11408198 11092752 -69684 -129590 9741653 9660314 10210666 10261193 -469013 -600879 THE COMPANY SHALL PROMOTE AND PROVIDE SAFE, HEALTHY, QUALITY SERVICES AND LIVING ENVIROMENTS FOR ELDERS WHO CANNOT CARE FOR THEMSELVES. 0 0 9861942 10926245 OUR SKILLED NURSING AND REHABILITATION FACILITY PROVIDES A WIDE RANGE OF MEDICAL AND REHABILITATIVE SERVICES, INCLUDING POST ACUTE CARE, SHORT-TERM REHABILITATION, RESPITE CARE, HOSPICE CARE, AND LONG-TERM CARE. WORKING DIRECTLY WITH EACH RESIDENT AND THEIR FAMILY MEMBERS, OUR STAFF WILL CUSTOMIZE A COMPREHENSIVE PLAN OF CARE DESIGNED TO TREAT MEDICAL COMPLICATIONS AND ACHIEVE FUNCTIONAL INDEPENDENCE. OUR FACILITY PROVIDES THE HIGHEST STANDARDS OF CARE AND RESIDENTS ENJOY AN ACTIVE AND FULFILLING LIFESTYLE IN AN ATMOSPHERE OF WARMTH, RESPECT AND UNDERSTANDING. 9861942 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 1 228 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X WELCH HEALTHCARE AND RETIREMENT GROUP INC 7878786700 52 ACCORD PARK DRIVE NORWELL MA 02061 WILLIAM P MCDERMOTT ESQ 1.00 1.00 X 0 0 0 REV JEROME J JANISKO 1.00 1.00 X 0 0 0 JAMES BRUCE RILEY CPA 1.00 1.00 X 0 0 0 MICHAEL O JENNINGS ESQ 1.00 1.00 X 0 0 0 CHRISTOPHER ROBBINS 1.00 1.00 X 0 0 0 MARY MCCARTHY 1.00 40.00 X X 0 386139 114147 LINDA CORRIDAN RN 1.00 1.00 X 0 0 0 JOAN FALLON 1.00 1.00 X 0 0 0 FRANCIS J GRADY 1.00 40.00 X 0 282843 15998 MICHAEL DODOS 1.00 40.00 X 0 165140 16528 DORIS DAVILA 0.00 40.00 X 0 155581 1087 RICHARD CANTY 1.00 40.00 X 0 149613 16691 PAUL MAHONEY 0.00 40.00 X 0 123932 30228 JEAN FOLAN 0.00 50.00 X 0 106661 12857 FRANCES ELLISON 0.00 50.00 X 0 107253 8184 SUSAN MCGOURTY 40.00 0.00 X 101322 0 8215 101322 1477162 223935 1 0 1 0 GENESIS REHABILITIONS SERVICES INC 101 E STATE ST KENNETT SQUARE PA 19348 THERAPY SERVICES 543305 WELCH HEALTHCARE AND RETIREMENT GROUP 52 ACCORD PARK DR NORWELL MA 02061 MANAGEMENT SERVICES 484332 2 PROG.SERV.REVENUE 623000 10894654 10894654 10894654 37105 37105 141709 141897 -188 -188 -188 OTHER INCOME 623000 28861 28861 LAUNDRY INCOME 623000 1950 1950 BARBER & BEAUTY INCOME 623000 780 780 31591 10963162 10926245 0 36917 5229062 4962099 266963 16899 16036 863 371585 352614 18971 405563 384857 20706 604944 604944 111221 111221 27500 27500 4500 4500 1046717 871575 175142 19109 19109 62236 62236 14832 14832 220902 220902 8516 8516 599592 599592 322753 322753 228942 228942 PROVIDER USER FEE 697905 697905 NURSING SUPPLIES AND EX 341954 341954 FOOD 291011 291011 SOCIAL SERVICES 238384 238384 228625 228625 11092752 9861942 1230810 0 841810 962302 857063 881315 98789 90586 8185529 3760259 4582430 4425270 3361561 3300841 9741653 9660314 1704667 1876630 8315000 8100000 150000 150000 40999 134563 10210666 10261193 X -469013 -600879 -469013 -600879 9741653 9660314 X -129590 -2277 1 X 0 1 X 1 0 X 10984963 10828493 11386799 11306974 10926245 55433474 10984963 10828493 11386799 11306974 10926245 55433474 0 0 0 55433474 77059 2755 8998 24612 37105 150529 77059 2755 8998 24612 37105 150529 11062022 10831248 11395797 11331586 10963350 55584003 0.99730 0.99540 0.00270 0.00460 X 300000 300000 6321000 2797570 3523430 202152 64839 137313 1362377 897850 464527 4425270 DEPOSITS 19931 GOODWILL, NET 907350 DEFERRED FINANCE FEES, NET 386224 TRUSTEE FUNDS HELD UNDER BOND INDEN 1958900 CONSTRUCTION IN PROGRESS 14803 INTEREST RECEIVABLE 13633 3300841 DUE TO RELATED-PARTY 134563 134563 X 10960885 -2277 -2277 10963162 0 10963162 11092752 0 11092752 0 11092752 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S 2009 THROUGH 2012 TAX YEARS ARE OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X X X 0 1 0 0 0 0 0 0 0 MARY MCCARTHY 0 287021 0 0 0 99118 0 114147 0 0 0 500286 0 0 FRANCIS J GRADY 0 240843 0 42000 0 0 0 0 0 15998 0 298841 0 0 MICHAEL DODOS 0 147890 0 17250 0 0 0 0 0 16528 0 181668 0 0 DORIS DAVILA 0 140581 0 15000 0 0 0 0 0 1087 0 156668 0 0 RICHARD CANTY 0 139613 0 10000 0 0 0 0 0 16691 0 166304 0 0 PAUL MAHONEY 0 123932 0 0 0 0 0 0 0 30228 0 154160 0 0 PART I, LINE 4B MARY MCCARTHY PARTICIPATES IN DEFERRED COMP PLAN,RECIEVED $99,118 AS OF DECEMBER 31, 2012. FORM 990, PART VI, SECTION A, LINE 3 WELCH HEALTHCARE AND RETIREMENT GROUP, INC., 52 ACCORD PARK DRIVE, NORWELL, MA 02061 FORM 990, PART VI, SECTION B, LINE 11 THE AUDIT COMMITTEE SHALL REVIEW AND APPROVE THE IRS FORM 990 ANNUAL TAX FILINGS PRIOR TO SUBMISSION, AND THE BOARD SHALL RECEIVE A COPY AND REVIEW THE IRS FORM 990 TAX FILINGS WITHIN 30 DAYS OF ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR MUST PROVIDE THE BOARD OF DIRECTORS WITH AN ANNUAL WRITTEN DISCLOSURE OF THE FOLLOWING: (I) THE DIRECTOR'S BUSINESS INVOLVEMENTS WITH THE ORGANIZATION AND RELATED ORGANIZATIONS; (II) THE DIRECTOR'S OTHER BOARD MEMBERSHIPS, WHETHER OF FOR-PROFIT OR NON-PROFIT CORPORATIONS; AND (III) THE TOTAL AMOUNT RECEIVED BY THE DIRECTOR FROM THE ORGANIZATION AND RELATED ORGANIZATIONS FOR SERVICES RENDERED AS A VENDOR OF GOODS OR SERVICES TO THE RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 15 PERFORMANCE EVALUATION OF THE CHIEF EXECUTIVE OFFICER OF THE COMPANY ON AN ANNUAL BASIS. SUCH EVALUATION SHALL BE USED AS THE BASIS FOR DETERMINING COMPENSATION AND SHALL INCLUDE AN ASSESSMENT OF COMPANY GOALS AND PERFORMANCE. THE BOARD WILL REVIEW YEAR OVER YEAR PERFORMANCE AND EVALUATE COMPANY RESULTS WITH RESPECT TO FINANCIAL PERFORMANCE, ATTAINMENT OF GOALS, PROGRAM AND OPERATIONAL QUALITY AND GOVERNANCE. THE BOARD WILL ALSO CONSIDER ORGANIZATIONAL STRENGTH AND DEVELOPMENT AND BOARD-CEO RELATIONSHIP MANAGEMENT. IN MAKING A COMPENSATION DETERMINATION, THE BOARD SHALL CONSIDER CURRENT INDEPENDENT MARKET ASSESSMENT OF AND RELIABLE DATA FROM COMPARABLE ORGANIZATIONS. THE BOARD MAY FROM TIME TO TIME SPECIFICALLY ENGAGE THIRD PARTY PROFESSIONALS TO CONDUCT COMPENSATION STUDIES OR TO REVIEW AND ASSESS CURRENT PRACTICES WHEN DEEMED USEFUL. THE CEO SHALL CONDUCT A PERFORMANCE EVALUATION OF THE CHIEF FINANCIAL OFFICER OF THE COMPANY ON AN ANNUAL BASIS. SUCH EVALUATION SHALL BE USED AS THE BASIS FOR DETERMINING COMPENSATION AND SHALL INCLUDE AN ASSESSMENT OF COMPANY GOALS AND PERFORMANCE. THE CEO WILL REVIEW YEAR OVER YEAR PERFORMANCE AND EVALUATE COMPANY RESULTS WITH RESPECT TO FINANCIAL PERFORMANCE, ATTAINMENT OF GOALS, PROGRAM AND OPERATIONAL QUALITY AND GOVERNANCE. IN MAKING A COMPENSATION DETERMINATION, THE CEO SHALL CONSIDER CURRENT INDEPENDENT MARKET ASSESSMENT OF AND RELIABLE DATA FROM COMPARABLE ORGANIZATIONS. THE CEO WILL ADVISE THE BOARD OF HER DECISION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: ROUNDING 1. ALLIANCE HEALTH INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 043468274 SUPPORTING ORGANIZATION MA 501(C)(3) 11 0 ALLIANCE HUMAN SERVICES INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 043476887 FOSTER CARE CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE CHILDREN'S SERVICES INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 042691041 FOSTER CARE CORPORATION MA 501(C)(3) 9 ALLIANCE HUMAN SERVICES INC 0 ALLIANCE OF THE CHESAPEAKE BAY INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 010672105 FOSTER CARE CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF MASSACHUSETTS INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 311712039 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF QUINCY INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 043468149 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF SOUTHEASTERN MASSACHUSETTS INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 043582078 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF BRAINTREE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 651310230 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF CENTERVILLE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249886 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF DANVERS INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249854 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF LOWELL INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249859 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF PLYMOUTH INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249891 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF SANDWICH INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249868 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF SOUTHBRIDGE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249840 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF WORCESTER INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249850 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF PROVIDENCE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249901 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH OF EAST PROVIDENCE INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249896 SKILLED NURSING CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE SPECIALTY HOSPITAL INC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 800249832 HOSPITAL CORPORATION MA 501(C)(3) 9 ALLIANCE HEALTH INC 0 ALLIANCE HEALTH MANAGEMENT SERVICES LLC 134 RUMFORD AVE SUITE 306 NEWTON MA 02466 344639819 SUPPORTING ORGANIZATION MA 501(C)(3) 11 ALLIANCE HEALTH INC 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 ALLIANCE HEALTH INC M 120612 ALLIANCE HEALTH INC E 140729 ALLIANCE HEALTH INC E 150000