2013-10-24T17:41:19-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2012-01-01 042106771 WILLIAM B RICE EVENTIDE HOME INC WILL 6174728300 215 ADAMS STREET QUINCY MA 02169 RICHARD MEADE 6174728300 2013-10-03 1 ROBERT DILLAN P01688008 6179848100 2013-10-03 2012 2016-02-24 21:20:13Z RICHARD MEADE 215 ADAMS STREET QUINCY MA 02169 17193868 0 X WWW.EVENTIDEHOME.ORG X 1924 MA TO MAINTAIN A UNIQUE LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED AND CARING SUPPORTIVE SERVICES IN A HOME-LIKE ATMOSPHERE WHICH ALLOWS THE RESIDENTS TO MAINTAIN INDEPENDENT LIVES WITH DIGNITY. 15 15 146 35 0 0 0 9497 5876985 5992403 1663212 914594 17261 18080 7557458 6934574 0 0 0 0 4420771 4598464 0 0 0 2224980 2911568 6645751 7510032 911707 -575458 22544776 22518546 2651604 2926999 19893172 19591547 TO MAINTAIN A UNIQUE LIFE-CARE RETIREMENT COMMUNITY THAT PROVIDES INDIVIDUALIZED AND CARING SUPPORTIVE SERVICES IN A HOME-LIKE ATMOSPHERE WHICH ALLOWS THE RESIDENTS TO MAINTAIN INDEPENDENT LIVES WITH DIGNITY. 0 0 6829670 6010483 THE HOME PROVIDES SECURE HOUSING, QUALITY NURSING CARE, MEANINGFUL ACTIVITIES, OPPORTUNITIES FOR SOCIALIZATION, AND A WIDE VARIETY OF SUPPORTIVE SERVICES TO SIXTY FRAIL ELDERS UNABLE TO LIVE INDEPENDENTLY IN THE COMMUNITY, WITHOUT REGARD FOR THEIR ABILITY TO PAY. 6829670 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 5 0 146 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X JANICE FARIA 6174728300 215 ADAMS STREET QUINCY MA 02169 GAYLE DAVIS 5.00 X X 0 0 0 RICHARD MEADE 5.00 X X 0 0 0 DONALD POWELL 5.00 X X 0 0 0 MICHAEL MCFARLAND 5.00 X X 0 0 0 RUTH DOBBIE 5.00 X 0 0 0 ROBERT DOLBEC 5.00 X 0 0 0 ROBERT DWYER 5.00 X 0 0 0 ROBERT FOY 5.00 X 0 0 0 ROBERT GUARNIERI 5.00 X 0 0 0 LYNNE HOUGHTON 5.00 X 0 0 0 WILLIAM JACKSON 5.00 X 0 0 0 SHEILA MCINTYRE 5.00 X 0 0 0 CHARLES RIPPBERGER MD 5.00 X 0 0 0 WILLIAM SMITH 5.00 X 0 0 0 PRISCILLA URANN 5.00 X 0 0 0 BRIAN GOTTA 5.00 X 0 0 0 AMY ROSS 5.00 X X 0 0 0 JOYCE HAGLUND 40.00 X 150625 0 22907 150625 0 22907 1 0 1 0 CREATING RESULTS 1400 CROWN COURT SUITE 211 WOODBRIDGE VA 22193 ADVERTISING 574171 ROGERSON COMMUNITIES FLORENCE ST BOSTON MA 02131 DEVELOPMENT CONSULTANT 337500 SHESKEY ARCHITECTS FRANKLIN ST QUINCY MA 02169 ARCHITECTURAL SERVICES 190628 STONE TRUST PARTNERS 86 WASHBURN RD CANTON CT 06019 ADVERTISING 149717 4 9497 9497 PUBLICLY AIDED 623000 3064978 3064978 PRIVATE 623000 2122437 2122437 MEDICARE 623000 594571 594571 ANCILLARY INCOME 623000 210417 210417 5992403 243762 243762 10930126 10259294 670832 670832 670832 REVENUE - OTHER 623000 10513 10513 REVENUE - MEALS SOLD 623000 7567 7567 18080 6934574 6010483 0 914594 173532 173532 3608790 3294100 314690 49330 45028 4302 433979 396048 37931 332833 303810 29023 960 960 37875 37875 42679 42679 36988 36988 518788 518788 92340 89958 2382 487778 487778 264376 264376 44032 44032 PATIENT CARE EXPENSES 915349 915349 NURSING USER FEE 361904 361904 205 ADAMS STREET 70486 70486 BAD DEBTS 28785 28785 9228 9228 7510032 6829670 680362 0 131316 205038 786807 647233 647415 359726 87092 71660 11458647 5804122 5850429 5654525 9604472 8820362 5437245 6760002 22544776 22518546 284217 312094 284000 2367387 2330905 2651604 2926999 X 19833272 19531647 18900 18900 41000 41000 19893172 19591547 22544776 22518546 -575458 273833 0 X X 0 1 X 1 0 X 2495 41866 8775 9497 62633 5823211 5805048 5968394 5894246 6010482 29501381 5825706 5846914 5977169 5894246 6019979 29564014 0 0 0 29564014 470096 325401 1650976 314663 243762 3004898 470096 325401 1650976 314663 243762 3004898 6295802 6172315 7628145 6208909 6263741 32568912 0.90770 0.89940 0.09230 0.10060 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 389 389 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATION 0 1 X 59900 59900 59900 59900 51125 8775 59900 41000 10125 51125 0.68000 0.32000 0 0 3151077 3151077 6788452 4510427 2278025 1489269 1290210 199059 29849 3485 26364 5654525 INTEREST RECEIVABLE 9628 MORTGAGE ACQUISITION COSTS, NET 18420 CONSTRUCTION IN PROGRESS 5070291 SOFTWARE, NET 4787 DEFERRED ADVERTISING COSTS 1372876 DEPOSITS 284000 6760002 X 7165728 273833 273833 6891895 42679 42679 6934574 7467353 0 7467353 42679 42679 7510032 PART IV, LINE 2B: RICE EVENTIDE IS ACCEPTING PRECONSTRUCTION DEPOSITS FOR ITS FAIRING WAY PROJECT. PROSPECTIVE RESIDENTS MAY ENTER INTO ONE OF TWO TYPES OF AGREEMENTS TO RESERVE EITHER A POSITION ON A PRIORITY LIST OR RESERVE A SPECIFIC UNIT IN THE COMPLETED PROJECT. THE PRIORITY LIST DEPOSITS ARE FULLY REFUNDABLE UPON REQUEST AT ANYTIME. THE 10% UNIT DEPOSITS ARE ALSO REFUNDABLE UPON REQUEST AT ANYTIME PLUS ACCUMULATE INTEREST INCOME EARNED ON THE DEPOSIT, LESS AN ADMINISTRATIVE FEE. THE $10,000 UNIT DEPOSITS ARE NONREFUNDABLE, UNLESS RICE EVENTIDE IS UNABLE TO DELIVER THE RIGHT TO OCCUPY THE RESIDENCE ON THE CLOSING DATE. THE RESERVATION DEPOSITS ARE BEING HELD BY RICE SOUTHFIELD, LLC (DISREGARDED ENTITY OF RICE EVENTIDE. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE TO BE USED FOR NEW RESIDENT BEDS. THE PERMANENT ENDOWMENT FUND'S INCOME IS USED FOR THE GENERAL PURPOSES OF THE HOME. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. SHOULD THE STATUS BE CHALLENGED IN THE FUTURE, THE ENTITIES 2009 THROUGH 2012 TAX YEARS ARE OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X X 0 0 0 0 0 0 0 0 0 JOYCE HAGLUND 150625 0 0 0 0 0 0 0 22907 0 173532 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR WILL REVIEW THE FORM 990 WITH MEMBERS OF THE BOARD'S EXECUTIVE COMMITTEE. IT WILL THEN BE DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT IS ENFORCED ANNUALLY BY DISTRIBUTION OF THE POLICY AND FOLLOW UP TO CONFIRM NO ONE IS IN CONFLICT OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT OF THE BOARD AND MEMBERS OF THE EXECUTIVE COMMITTEE APPROVES EXECUTIVE DIRECTOR'S SALARY. THEY REGULARLY REVIEW SALARY STUDIES DONE BY STATE HEALTHCARE ASSOCIATIONS. APPROVAL IS DOCUMENTED IN THE BOARD OF DIRECTORS MINUTES. THIS WAS LAST DONE IN 2012. AN EMPLOYMENT AGREEMENT WAS SIGNED WITH THE EXECUTIVE DIRECTOR FOR 3 YEARS. 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. OVERSIGHT OF THE AUDIT AND AUDITOR SELECTION PROCESS FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED EITHER ITS AUDIT OVERSIGHT PROCESS OR AUDITOR SELECTION PROCESS. RICE SOUTHFIELD LLC 215 ADAMS ST QUINCY MA 02169 273136975 REAL ESTATE INVESTMENT MA 0 284000 WILLIAM B RICE EVENTIDE HOME INC RICE EVENTIDE FOUNDATION INC 215 ADAMS STREET QUINCY MA 02169 SUPPORTING ORGANIZATION MA 501(C)(3) LINE 11B, II 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0