2013-07-22T08:49:53-05:00 2012-12-31 043582157 GRAHAM SHEPHERD PC 446 MAIN STREET 10TH FLOOR WORCESTER MA 01608 990 2012-01-01 042104414 ODD FELLOWS HOME OF MASSACHUSETTS INC ODDF 5088536687 104 RANDOLPH ROAD WORCESTER MA 01606 JAMES TRACY 5088536687 2013-07-15 1 JOHN E GRAHAM CPA P00516241 5087548512 2012 2016-02-24 21:20:13Z JAMES TRACY 104 RANDOLPH ROAD WORCESTER MA 01606 5943456 0 X WWW.ODDFELLOWSHOMEMA.COM X 1898 MA TO PROVIDE OUR RESIDENTS WITH THE FINEST SKILLED NURSING AND REHABILITATIVE SERVICES. 12 11 200 0 0 0 34535 57853 6094323 5817200 71811 65853 0 2550 6200669 5943456 0 0 0 0 4680385 3812906 0 0 0 2302900 2213311 6983285 6026217 -782616 -82761 4088246 4133012 3354343 3481870 733903 651142 TO PROVIDE OUR RESIDENTS WITH THE FINEST SKILLED NURSING AND REHABILITATIVE SERVICES. DEDICATED TO THE BASIC TENENTS OF FRIENDSHIP, LOVE AND TRUTH, OUR HIGHLY TRAINED STAFF PROVIDES COMPASSIONATE CARE IN A COMFORTABLE, SECURE ENVIRONMENT. 0 0 5166550 5817200 PROVIDE QUALITY SKILLED NURSING CARE AND THERAPY FOR 100 ELDERLY RESIDENTS. 5166550 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1 9 0 200 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X JAMES TRACY 5088536687 104 RANDOLPH ROAD WORCESTER MA 01606 RUTH GARCIA 1.00 X X 0 0 0 SAMUEL C WHITE 1.00 X X 0 0 0 CLARENCE PLANT 20.00 X X 43287 0 0 DAVID LABONTE 1.00 X X 0 0 0 ROBERT WALSH 1.00 X 0 0 0 BARRY G RECTOR 1.00 X 0 0 0 WENDY E BAKER 1.00 X 0 0 0 GERARD GILMORE JR 1.00 X 0 0 0 JOHN SLANEY 1.00 X 0 0 0 ROBERT COMER 1.00 X 0 0 0 PAUL E SLANEY 1.00 X 0 0 0 MARY G VITEILLO 1.00 X 0 0 0 CRAIG CELLITTI 1.00 X 0 0 0 43287 0 0 1 0 0 0 0 15000 42853 57853 PATIENT REVENUE 623000 5817200 5817200 5817200 65853 65853 2550 0 2550 2550 5943456 5817200 0 68403 164058 120771 43287 3162571 2761785 400786 162320 140652 21668 323957 280712 43245 2108 2108 19631 19631 36789 36789 6249 6249 15112 15112 4738 4738 141492 141492 185003 160307 24696 70406 61007 9399 USER FEE EXPENSE 447455 447455 SUPPLIES AND EXPENSES 348463 348463 MEDICAL SUPPLIES AND DR 308930 308930 THERAPY SERVICES 191735 191735 435200 338484 96716 6026217 5166550 859667 0 134458 105789 456610 591198 28298 42122 5680003 3380800 2404298 2299203 1000016 1011720 64566 82980 4088246 4133012 1089960 1399734 25795 50185 16795 5651 1385000 1069998 836793 956302 3354343 3481870 X 707577 624352 26326 26790 733903 651142 4088246 4133012 -82761 0 X X 0 1 X 1 0 X 19671 21217 29399 34535 57853 162675 7106156 6456528 6183934 6094323 5822237 31663178 7125827 6477745 6213333 6128858 5880090 31825853 0 0 0 31825853 87724 90864 113968 71811 65853 430220 87724 90864 113968 71811 65853 430220 7213551 6568609 6327301 6200669 5945943 32256073 0.98670 0.98480 0.01330 0.01520 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 16795 462831 473975 5651 1 X 26326 464 26790 95221 68895 26326 466394 -44710 326463 95221 901567 32198 467371 466394 901567 1.00000 0 0 45080 45080 4058124 2578382 1479742 705511 87323 618188 792414 638212 154202 78874 76883 1991 2299203 X 5943456 0 5943456 0 5943456 6026217 0 6026217 0 6026217 PART IV, LINE 1B: THE ORGANIZATION IS THE CUSTODIAN OF THE RESIDENTS PERSONAL NEEDS ACCOUNT. PART IV, LINE 2B: RESIDENTS HAVE FUNDS DEPOSITED INTO ACCOUNT AND WITHDRAW FOR PERSONAL EXPENSES. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE INCOME TO THE ORGANIZATION OVER TIME. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: PART X, LINE 2: ODD FELLOWS HOME OF MASSACHUSETTS 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 IS REQUIRED TO RECOGNIZE IN ITS FINANCIAL STATEMENTS THE IMPACT OF A TAX POSITION, IF THAT POSITION IS MORE LIKELY THAN NOT OF NOT BEING SUSTAINED ON AUDIT BASED ON THE TECHNICAL MERITS OF THE POSITION. THE COMPANY FILES FEDERAL AND MASSACHUSETTS INCOME TAX RETURNS. THE INCOME TAX RETURNS FOR TAX YEARS 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND THE MASSACHUSETTS DEPARTMENT OF REVENUE. THE COMPANY DID NOT HAVE UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2012 AND 2011 AND DOES NOT EXPECT THIS TO CHANGE SIGNIFICANTLY OVER THE NEXT 12 MONTHS. THE COMPANY WILL RECOGNIZE INTEREST AND PENALTIES ACCRUED ON ANY UNRECOGNIZED TAX BENEFITS AS A COMPONENT OF INCOME TAX EXPENSE. X 0 0 0 0 0 0 0 0 0 X LOBBY FRUNITURE 1 35799 FAIR MARKET VALUE 0 0 0 LIST OF STATES WITH QUALIFIED HEALTH PLANS FORM 990, PART V, LINE 13A MA FORM 990, PART VI, SECTION B, LINE 11 THE 2012 FORM 990 WAS PRESENTED TO AND APPROVED BY THE EXECUTIVE COMMITTEE AND THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES SHALL NOT HAVE ANY UNDISCLOSED CONFLICTS OF INTEREST WITH THE CORPORATION. ANY CONFLICT OF INTEREST ON THE PART OF ANY TRUSTEE SHALL BE DISCLOSED TO THE OTHER TRUSTEES AND MADE A MATTER OF RECORD WHEN ANY MATTER TO WHICH THE INTEREST RELATES BECOMES THE SUBJECT OF ACTION BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMMITTEE HOLDS AN ANNUAL MEETING WITH THE BOARD OF TRUSTEES TO DISCUSS THE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. 990 PART XII, 2C NO CHANGE IN OVERSIGHT OF SELECTION PROCESS. GRAND LODGE OF THE INDEPENDENT ORDER OF ODD FELLOWS 104 RANDOLPH ROAD WORCESTER MA 01606 041383604 FRATERNAL ORGANIZATION MA 501(C)(8) & (C)(10) 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 GRAND LODGE OF THE INDEPENDENT ORDER OF ODD FELLOWS E 910087 LOAN DOCUMENTS