FURP.ORG / PUBLIC DATA EXPLORER

FAIRHAVEN HEALTHCARE CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FAIRHAVEN HEALTHCARE CENTER INC (EIN 20-8745264)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-10-29
IRS object ID
201303029349300025
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)
Timestamp2013-10-29T10:15:05-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1300 CROWN COLONY DRIVE SUITE 310AddressLine1
CityQUINCYCity
StateMAState
ZIP Code02169ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN208745264EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FAIRHAVEN HEALTHCARE CENTER INCBusinessNameLine1
Business Name Line2C/O PLATINUM CARE LLCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlFAIRNameControl
Phone9784201500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line135 AVCO ROADAddressLine1
CityHAVERHILLCity
StateMAState
ZIP Code01835ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOEL E KIRCHICKName
TitlePRESIDENTTitle
Phone9784201500Phone
Date Signed2013-10-04DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameROBERT DILLANName
PTINP01688008PTIN
Phone6179848100Phone
Date Prepared2013-10-04DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOEL E KIRCHIKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line135 AVCO ROADAddressLine1
CityHAVERHILLCity
StateMAState
ZIP Code01835ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14299963GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.FAIRHAVEN-NURSING.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2007YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE LONG-TERM NURSING CARE TO THE ELDERLY.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees262TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year20000ContributionsGrantsPriorYear
Contributions Grants Current Year25019ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14201583ProgramServiceRevenuePriorYear
Program Service Revenue CY14220321ProgramServiceRevenueCY
Investment Income Prior Year75193InvestmentIncomePriorYear
Investment Income Current Year54623InvestmentIncomeCurrentYear
Other Revenue Prior Year46602OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14343378TotalRevenuePriorYear
Total Revenue Current Year14299963TotalRevenueCurrentYear
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 Year7436241SalariesEtcPriorYear
Salaries Etc Current Year7098607SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6812376OtherExpensePriorYear
Other Expenses Current Year7426419OtherExpensesCurrentYear
Total Expenses Prior Year14248617TotalExpensesPriorYear
Total Expenses Current Year14525026TotalExpensesCurrentYear
Revenues Less Expenses Prior Year94761RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-225063RevenuesLessExpensesCY
Total Assets BOY32417540TotalAssetsBOY
Total Assets EOY31794126TotalAssetsEOY
Total Liabilities BOY32252065TotalLiabilitiesBOY
Total Liabilities EOY31847859TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY165475NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-53733NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionIT IS OUR MISSION TO PROVIDE ELDERS WITH DYNAMIC, MEANINGFUL AND SUPPORTIVE LIVING ENVIRONMENTS, INTEGRATING QUALITY CARE, EDUCATION AND RESEARCH, RESPECT FOR INDIVIDUALITY AND THE HUMAN SPIRIT, AND INNOVATIVE APPROACHES TO MEET THE EVER CHANGING NEEDS OF THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense12232981Expense
Revenue14220321Revenue
DescriptionA 169-BED SKILLED NURSING FACILITY PROVIDING NURSING CARE TO THE ELDERLY.Description
Total Program Service Expense12232981TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
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 Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10966NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees262NumberOfEmployees
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
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
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 Committees1MinutesOfCommittees
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 Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RICHARD ATKINSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9784201500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line135 AVCO ROADAddressLine1
CityHAVERHILLCity
StateMAState
ZIP Code01835ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JOEL KIRCHIK
PRESIDENT1.002.00XX000
JOHN REGAN
SECRETARY1.002.00XX000
PATRICIA TORTELLA
DIRECTOR1.002.00X000
RAYMOND DENNEHY
TREASURER1.002.00XX000
JOANNE FREEDMAN SPECTOR
DIRECTOR1.002.00X000
DAVID O'DONNELL
DIRECTOR1.002.00X000
JOSEPH DEVEAU
ADMINISTRATOR40.00X11540006197
FieldValueIRS element (for citing)
Total Reportable Comp From Org115400TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation6197TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HEALTHCARE SERVICES GROUP
3220 TILLMAN DR STE 300BENSALEMPA19020HSKG, LAUNDRY, DIETARY1196747
PLATINUM CARE LLC
35 AVCO ROADHAVERHILLMA01835MANAGEMENT815529
PREFERRED PHARMACY SOLUTIONS
35 AVCO ROADHAVERHILLMA01835PHARMACY SERVICES478105
GERIATRIC MEDICAL
PO BOX 6027CHELSEAMA02150MEDICAL SUPPLIES153214
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Fundraising Events25019FundraisingEvents
Total Contributions25019TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROG.SERV.REVENUE-RELADescription
Business Code623000BusinessCode
Total Revenue Column14220321TotalRevenueColumn
Related Or Exempt Function Income14220321RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue14220321TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column54623TotalRevenueColumn
Exclusion$54,623ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events0GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events25019CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses0FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14299963TotalRevenueColumn
Related Or Exempt Function Income14220321RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$54,623ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total121597Total
Management And General121597ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5997067Total
Program Services5844328ProgramServices
Management And General152739ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total471088Total
Program Services456346ProgramServices
Management And General14742ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total508855Total
Program Services486532ProgramServices
Management And General22323ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total758472Total
Management And General758472ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total46191Total
Management And General46191ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total27832Total
Management And General27832ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1438831Total
Program Services1438831ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total44349Total
Program Services44349ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total94922Total
Management And General94922ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2313208Total
Program Services2313208ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total12466Total
Management And General12466ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total691606Total
Program Services691606ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total85070Total
Management And General85070ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
USER FEE949680949680
MEDICAL SUPPLIES908043908043
BAD DEBTS3638236382
DUES1768917689

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1678Total
Program Services32049ProgramServices
Management And General-30371ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14525026Total
Program Services12232981ProgramServices
Management And General2292045ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4478BOY
EOY30308EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1323244BOY
EOY1240258EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1894036BOY
EOY1977163EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY46131BOY
EOY71508EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis22751636LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2703621LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY18145942BOY
EOY20048015EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1046897BOY
EOY1057543EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2932083BOY
EOY2932083EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7024729BOY
EOY4437248EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32417540BOY
EOY31794126EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1523342BOY
EOY1466838EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY29411117BOY
EOY29413301EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1317606BOY
EOY967720EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY32252065BOY
EOY31847859EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY165475BOY
EOY-53733EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY165475BOY
EOY-53733EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32417540BOY
EOY31794126EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-225063ReconcilationRevenueExpenses
Reconciliation Unrealized Invest5855ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee0AuditCommittee
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 Minus1 Year20000CurrentTaxYearMinus1Year
Current Tax Year25019CurrentTaxYear
Total45019Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years14081534CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14201583CurrentTaxYearMinus1Year
Current Tax Year14220321CurrentTaxYear
Total42503438Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years14081534CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14221583CurrentTaxYearMinus1Year
Current Tax Year14245340CurrentTaxYear
Total42548457Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50942548457PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years62947CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year75193CurrentTaxYearMinus1Year
Current Tax Year54623CurrentTaxYear
Total192763Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years62947CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year75193CurrentTaxYearMinus1Year
Current Tax Year54623CurrentTaxYear
Total192763Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years29194CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year46602CurrentTaxYearMinus1Year
Total75796Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years14173675CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14343378CurrentTaxYearMinus1Year
Current Tax Year14299963CurrentTaxYear
Total42817016Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1958000OtherCostOrOtherBasis
Book Value1958000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17622000OtherCostOrOtherBasis
Depreciation2276175Depreciation
Book Value15345825BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2066154OtherCostOrOtherBasis
Depreciation95185Depreciation
Book Value1970969BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1076482OtherCostOrOtherBasis
Depreciation330522Depreciation
Book Value745960BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis29000OtherCostOrOtherBasis
Depreciation1739Depreciation
Book Value27261BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings20048015TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCING COSTS, NET1281557
OTHER RECEIVABLES28286
BOND ESCROWS3127405
FieldValueIRS element (for citing)
Total Book Value Other Assets4437248TotalBookValueOtherAssets
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE ORGANIZATION IS A MASSACHUSETTS 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. THIS ENTITY'S 2009 THROUGH 2012 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event125019GrossReceiptsEvent1
Charitable Contributions Event125019CharitableContributionsEvent1
Gross Receipts Total25019GrossReceiptsTotal
Charitable Contributions Total25019CharitableContributionsTotal

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
A04343181457585AAA82007-10-251982687PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
B04343181457585AAB62007-10-258051140PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
C04343181457585AAC42007-10-2514755407PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007B
D04343181457585AAD22007-10-251685472PURCHASE FACILITIES000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFund
A1982687118927379341420070011
B80511405183387200700112867753
C147554071475540720070011
D1885472168547220070011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A0000000
B0000000
C0000000
D0000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A00010000
B00010000
C00010000
D00010000

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K PART IV, ARBITRAGE, LINE 2CIdentifier
Return ReferenceDATE REBATE COMPUTATION PERFORMEDReturnReference
ExplanationISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2012 ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2012 ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2012 ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007B DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2012 ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007D DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2012 ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007F DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2012 ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2010 DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2012Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007D
A0434318142007-10-252038290PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007F
B0434318142007-10-25760798PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2010
C0434318182010-07-142640000PROJECT REHAB000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A203829019338201895220070011
B76079876079820070011
C2640000264000020100011

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A0000000
B0000000
C0000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A00010000
B00010000
C00010000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION HAS ENTERED INTO A FIFTEEN-YEAR MANAGEMENT AGREEMENT, EXPIRING OCTOBER 2022, WITH PLATINUM CARE, LLC TO MANAGE THE OPERATIONS OF FAIRHAVEN HEALTHCARE CENTER, INC. ACTING THROUGH THE NURSING FACILITY EMPLOYEES, TO SUPERVISE, DIRECT AND CONTROL THE DAY-TO-DAY BUSINESS ACTIVITIES AND MANAGEMENT OF THE NURSING FACILITY. PLATINUM CARE, LLC PREPARE AND FILE, ALL COST REPORTS, PAYROLL TAX AND REAL ESTATE TAX FILINGS REQUIRED
FORM 990, PART VI, SECTION B, LINE 11A COMPLETE COPY OF THE FORM 990 TAX RETURN (INCLUDING ALL REQUIRED SCHEDULES) IS PROVIDED TO EACH PERSON WHO IS A VOTING MEMBER OF THE BOARD OF DIRECTORS AT THE TIME THE FORM 990 IS PROVIDED, EITHER IN PAPER OR ELECTRONIC FORM, BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CORPORATE COMPLIANCE PLAN WHICH INCLUDES THE MONITORING OF ITS CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE MSRB EMMA WEBSITE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
ADVENTCARE INC
35 AVCO ROADHAVERHILLMA01835321012491MANAGEMENT COMPANYMA501(C)(3)LINE 90
LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY
25 LAFAYETTE STREETMARBLEHEADMA01945208745166SKILLED NURSING FACILITYMA501(C)(3)LINE 90ADVENTCARE INC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg