2013-10-02T12:25:51-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2012-01-01 043108782 NOTRE DAME HEALTH CARE CENTER INC NOTR 5088523011 559 PLANTATION STREET WORCESTER MA 01605 SR EDIE DALY SND 5088523011 2013-09-24 1 ROBERT DILLAN P01688008 6179848100 2013-09-24 2012 2016-02-24 21:20:13Z NOTRE DAME LONG TERM CARE CENTER NOTRE DAME DU LAC NOTRE DAME HOSPICE KATHERINE LEMAY 559 PLANTATION STREET WORCESTER MA 01605 22849055 0 X NOTREDAMELTCC.ORG X 1990 MA NOTRE DAME HEALTH CARE CENTER, ROOTED IN THE HERITAGE OF SAINT JULIE BILLIART AND SPONSORED BY THE SISTERS OF NOTRE DAME DE NAMUR, IS DEDICATED TO THE HEALING MINISTRY PROCLAIMED IN THE GOSPEL AND BY THE CATHOLIC CHURCH. -WE DEMONSTRATE CONCERN FOR THE WHOLE PERSON IN CARING FOR THE SPIRITUAL, SOCIAL, PHYSICAL AND PSYCHOLOGICAL WELL-BEING OF OUR RESIDENTS, THEIR FAMILIES AND THE COMMUNITY WE SERVE. -WE HONOR THE PERSONAL DIGNITY OF ALL INDIVIDUALS WITH COMPASSION AND WITHOUT DISTINCTION OF GENDER, AGE, ETHNICITY, SEXUAL ORIENTATION, RACE OR CREED. WE STRIVE TO CREATE A WORK ENVIRONMENT WHERE EACH PERSON IS VALUED, RESPECTED AND GIVEN AN OPPORTUNITY FOR PERSONAL, EDUCATIONAL AND PROFESSIONAL GROWTH. -WE USE OUR RESOURCES WITH A PARTICULAR CONCERN FOR THE ELDERLY, THE POOR AND THE VULNERABLE. -WE MAKE KNOWN GOD'S GOODNESS TO THE ENTIRE NDHCC COMMUNITY. 16 16 420 50 0 0 103085 91216 20117740 20294741 344127 427974 14723 63241 20579675 20877172 0 0 0 0 12119498 12532173 0 0 0 7238876 7204753 19358374 19736926 1221301 1140246 36144510 37102716 22352296 21898031 13792214 15204685 NOTRE DAME HEALTH CARE CENTER, ROOTED IN THE HERITAGE OF SAINT JULIE BILLIART AND SPONSORED BY THE SISTERS OF NOTRE DAME DE NAMUR, IS DEDICATED TO THE HEALING MINISTRY PROCLAIMED IN THE GOSPEL AND BY THE CATHOLIC CHURCH. 0 0 18236141 20470048 PROVIDE SKILLED NURSING HOME CARE TO THE ELDERLY AND DISABLED 18236141 1 1 0 1 0 0 1 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 21 0 1 420 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MA X SR ELIZABETH MCLAUGHLIN SND TREASURER 5088523011 559 PLANTATION ST WORCESTER MA 01605 SR BARBARA-JEAN KUBIK SND 1.00 X 0 0 0 SR EDIE DALY SND 1.00 X X 0 0 0 SR ELIZABETH MCLAUGHLIN SND 1.00 X X 0 0 0 MS MARY CULHANE 1.00 X 0 0 0 SR MARGARET MCCARTHY - SND 1.00 X 0 0 0 MS KATHLEEN O'CONNOR 1.00 X 0 0 0 MS LEE NORTON KELLY 1.00 X 0 0 0 MS KATHLEEN FISHER 1.00 X 0 0 0 MS MARGARET COFFIN 40.00 X X 85713 0 19132 MS KATHERINE LEMAY 40.00 X X 160098 0 14694 MR JOHN LIND 1.00 X 0 0 0 MR GARTH JOHNSON 1.00 X 0 0 0 MS JACQUELYN MCCARTHY 1.00 X 0 0 0 ROBERT LIAN 1.00 X 0 0 0 SR ANDREA WALSH SND 1.00 X X 0 0 0 MS MELISSA MOORE 1.00 X 0 0 0 SR ELLEN AGRITELLEY SND 1.00 X X 0 0 0 MS KAREN RIZZO 40.00 X X 137340 0 16915 SR FRANCIS ELLEN ULRICH SND 1.00 X 0 0 0 SUSANNE STAUFFER 1.00 X 0 0 0 PATRICIA CAMPBELL 32.00 X X 72542 0 6389 JENNIFER DAVIS CAREY 1.00 X 0 0 0 PAUL GRIBBONS 1.00 X 0 0 0 STEVEN HALL 40.00 X X 51778 0 8059 THOMAS LUCAS 1.00 X 0 0 0 VIRGINA RYAN 1.00 X 0 0 0 MR STEPHEN TOTINO 40.00 X 92648 0 11882 MS DEBRA FORSS 40.00 X 127808 0 2105 727927 0 79176 3 0 1 0 HEALTHPRO MANAGEMENT INC 10600 YORK ROAD SUITE 105 COCKEYSILLE MD 21030 REHAB THERAPY SERVICES 429125 1 1869 41099 48248 91216 NURSING HOME REVENUE 623000 13276190 13276190 ASSISTED LIVING REVENUE 623000 5524761 5524761 HOSPICE REVENUE 623000 1452563 1452563 EDUCATION CENTER 623000 41227 41227 20294741 315908 315908 2083949 1971883 112066 112066 112066 0 1869 0 0 MISC. REVENUE-RELATED-990 623000 63241 63241 63241 20877172 20470048 0 315908 677190 78931 598259 9899411 9368351 531060 39698 37689 2009 1143148 1085305 57843 772726 704958 67768 1195 1195 83559 83559 292646 183821 108825 103901 103901 292522 292522 1516406 1516406 41180 41180 9191 9191 919716 919716 374135 327776 46359 PATIENT CARE EXPENSES 2206440 2206440 USER FEE 785868 785868 HOSPICE EXPENSES 304892 304892 EDUCATION CENTER 89788 89788 183314 179406 3908 19736926 18236141 1500785 0 3205362 4171853 1249073 988957 1834263 1438858 25505 161128 199951 31983495 12540118 19933621 19443377 9984122 8928890 832173 850093 36144510 37102716 1561443 1779084 112431 9662 16525000 16040000 4153422 4069285 22352296 21898031 X 13720085 15124774 72129 79911 13792214 15204685 36144510 37102716 X 1140246 176289 95936 X X 0 1 X 1 0 X 36642 29398 67437 60770 91216 285463 17804725 18342745 19244665 20174779 20357982 95924896 17841367 18372143 19312102 20235549 20449198 96210359 35000 25000 43900 103900 0 35000 25000 43900 103900 96106459 305680 263905 342949 344127 427974 1684635 305680 263905 342949 344127 427974 1684635 18147047 18636048 19655051 20579676 20877172 97894994 0.98170 0.98140 0.01720 0.01800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1915 1915 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATION X 1 3.20 0 0 0 1 0 104.00 0 72129 7782 79911 41131 30998 72129 14839 26292 41131 8966 9367 3494 14839 1.00000 0 0 2625000 2625000 26054200 10013494 16040706 3171454 2419618 751836 132841 107006 25835 19443377 INTEREST RATE SWAP 3690385 DEPOSITS FROM TENANTS 378900 4069285 X 20927580 176289 95937 272226 20655354 221818 221818 20877172 19515109 3 3 19515106 221820 221820 19736926 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE TO BE USED FOR CHAPEL WINDOWS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE COMPANY 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 COMPANY FILES AS A TAX-EXEMPT ORGANIZATION. THE ENTITY'S 2009 THROUGH 2012 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED GAIN ON INTEREST RATE SWAP 95,937. PART XI, LINE 4B - OTHER ADJUSTMENTS: NON OPERATING REVENUE NET AGAINST EXPENSES 221,820. ROUNDING -2. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 3. PART XII, LINE 4B - OTHER ADJUSTMENTS: NON OPERATING REVENUE NET AGAINST EXPENSES 221,820. X X 0 0 0 0 0 0 0 0 0 MS KATHERINE LEMAY 160098 0 0 0 0 0 3922 0 10772 0 174792 0 0 0 MS KAREN RIZZO 137340 0 0 0 0 0 1560 0 15355 0 154255 0 0 0 SUSANNE STAUFFER MEMBER OF THE FINANCE COMMITTEE 21045 IS EMPLOYED BY AN INVESTMENT FIRM WHICH RECEIVED FEES FROM THE ORGANIZATION. 0 MARY CULHANE DIRECTOR OF THIS ORGANIZATION 13150 IS EMPLOYED BY A CONSULTING FIRM WHICH RECEIVED FEES FROM THE ORGANIZATION. 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE PRESENTED AT THE SCHEDULED MEETING TO THE BOARD OF DIRECTORS. THE CONTROLLER WILL SEND A DRAFT COPY OF THE TAX RETURN TO EACH BOARD MEMBER. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES AND BOARD OF DIRECTORS ARE SUBJECT TO THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. DETERMINATIONS ARE MADE AT THE MANAGEMENT LEVEL AND REVIEWED WITH THE ORGANIZATIONAL INTEGRITY OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS USED TO ESTABLISH THE COMPENSATION OF THE ADMINISTRATOR AND EXECUTIVE DIRECTOR INCLUDES, REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THIS IS DONE ON AN ANNUAL BASIS BY THE BOARD OF DIRECTORS. 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. UNREALIZED LOSS ON INTEREST RATE SW 95,937. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT OR REVIEW PROCESS FROM THE PRIOR YEAR.