2013-11-14T09:57:03-06:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2012-01-01 042104452 EDGAR P BENJAMIN HEALTHCARE CENTER INC FKA RESTHAVEN CORPORATION EDGA 6177381500 120 FISHER AVENUE ROXBURY MA 02120 MYRNA WYNN 6177381500 2013-11-13 1 ROBERT DILLAN P01688008 6179848100 2013-11-06 2012 2016-02-24 21:20:13Z PERRY SMITH 120 FISHER AVENUE ROXBURY MA 02120 12668589 0 X WWW.BENJAMINHEALTHCARE.COM X 1927 MA PROVIDE NURSING CARE TO THE ELDERLY, AND TO PROVIDE HELP TO EDUCATION SERVICES. 9 8 256 150 0 0 71831 1865 11721074 11903131 13311 6266 498161 532639 12304377 12443901 0 0 0 0 9004493 8883467 0 0 0 3618268 3691211 12622761 12574678 -318384 -130777 4679099 4461667 4505989 4408664 173110 53003 X TO PROVIDE A HOME OR SHELTER FOR AND TO OTHERWISE ASSIST INDIGENT PEOPLE WITHOUT REGARD TO RACE, CREED OR COLOR. TO PROVIDE EDUCATIONAL OPPORTUNITIES AND VOCATIONAL TRAINING FOR INDIVIDUALS WHO WORK IN LONG-TERM CARE FACILITIES OR OTHERWISE CARE FOR THE ELDERLY. TO PROVIDE SCHOOL-AGED CHILDREN WITH INTERGENERATIONAL LEARNING OPPORTUNITIES THAT ALLOW THEM TO GAIN SKILLS AND KNOWLEDGE FROM OLDER GENERATIONS. TO CARRY ON ANY ACTIVITY CONNECTED WITH OR INCIDENTAL TO THE FOREGOING PURPOSE. 0 0 11365300 12426960 OPERATING A 205-BED NURSING HOME 11365300 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5 0 256 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 1 1 0 0 MA X MYRNA E WYNN 6177381500 120 FISHER AVE ROXBURY MA 02120 PERRY SMITH 0.90 0.10 X X 0 0 0 SANDY JACKSON 0.90 0.10 X X 0 0 0 DELORIS TUGGLE 0.90 0.10 X 0 0 0 EVAN TOBASKY 0.90 0.10 X X 0 0 0 LUZ QUINCHIA 0.90 0.10 X 0 0 0 REV GREGORY FERNANDES 0.90 0.10 X 0 0 0 MYRNA WYNN 39.20 0.80 X X 165556 0 10389 REV EVAN C HINES 0.90 0.10 X 0 0 0 ROSALINDA MIDENCE 0.90 0.10 X 0 0 0 NUNOTTE ZAMA 0.90 0.10 X 0 0 0 BERTHELINA SPRIGGS 40.00 0.00 X 125890 0 5853 MARILYN LIGUID 40.00 0.00 X 100969 0 7857 392415 0 24099 3 0 1 0 0 1865 1865 PATIENT SERVICE REVENUE 623000 11855768 11855768 47363 47363 11903131 6266 6266 666400 142571 523829 523829 523829 90927 82117 8810 8810 12443901 12426960 0 15076 175955 175955 7058123 6492062 566061 163731 150880 12851 941903 866362 75541 543755 488683 55072 28303 28303 63010 63010 264556 118238 146318 10383 10383 110801 110801 446770 446770 21514 21514 1595 1595 107499 107499 86267 86267 USER FEES 996920 996920 SUPPLIES AND EXPENSE 799103 799103 FOOD 361725 361725 REPAIRS AND MAINTENANCE 162804 162804 229961 229961 12574678 11365300 1209378 0 201663 604709 2113499 1495525 1174080 1131808 107125 86052 5127610 4549846 607889 577764 97571 208242 377272 357567 4679099 4461667 1459000 1361675 2300000 2300000 746989 746989 4505989 4408664 X 173110 53003 173110 53003 4679099 4461667 X -130777 10671 -1 X X 0 1 X 1 0 X 119106 130328 241095 78718 92792 662039 13136702 13525989 12549099 11721074 11903131 62835995 13255808 13656317 12790194 11799792 11995923 63498034 362884 18814 1865 383563 0 362884 18814 1865 383563 63114471 428884 377177 728387 698671 672666 2905785 428884 377177 728387 698671 672666 2905785 13684692 14033494 13518581 12498463 12668589 66403819 0.95050 0.95550 0.04380 0.03880 X 0 0 0 0 0 0 0 0 1 3019 3019 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATION 200000 200000 3504355 3230980 273375 1423255 1318866 104389 577764 CONSTRUCTION IN PROGRESS 122576 RENT RECEIVABLE 234991 357567 ACCRUED INTEREST PAYABLE 596989 ASSET RETIREMENT OBLIGATION 150000 746989 X 12679260 10671 224688 235359 12443901 0 12443901 12799367 224689 224689 12574678 0 12574678 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SEC 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATIONS 2009 THROUGH 2012 TAX RETURNS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES, PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE NETTED AGAINST INCOME 142,571. FUNDRAISING EXPENSES NETTED AGAINST INCOME 82,117. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE NETTED AGAINST INCOME 142,571. FUNDRAISING EXPENSES NETTED AGAINST INCOME 82,117. ROUNDING 1. GOLF TOURNAMENT 15450 15450 10600 7869 2314 GALA CELEBRATION 75477 75477 11473 34522 2500 12839 90927 90927 22073 42391 2500 15153 82117 8810 X X X 0 0 0 0 0 0 0 0 0 MYRNA WYNN 165556 0 0 0 0 0 3500 0 6889 0 175945 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS IS GIVEN A COPY OF THE FORM 990 TO REVIEW AND IT IS DISCUSSED AT A BOARD MEETING PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS APPROVES ANY CHANGES TO THE CEO'S COMPENSATION. INDUSTRY COMPENSATION DATA AVAILABLE THROUGH THE STATE AND CONSULTANTS IS REVIEWED. ANY ADJUSTMENTS TO THE CEO'S COMPENSATION ARE DOCUMENTED IN WRITING IN THE MEETING MINUTES 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 ON AN UPON REQUEST BASIS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: ROUNDING -1. OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. RESTHAVEN CORPORATION 120 FISHER AVENUE ROXBURY MA 02120 043448700 OWNS MORTGAGE MA 501(C)(3) LINE 11C, III-FI 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0