2012-07-16T11:24:45-05:00 2011-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2011-01-01 043455405 ALLIANCE HEALTH OF BROCKTON INC ALLI 6173323366 134 RUMFORD AVENUE NO 306 NEWTON MA 02466 FRANCIS J GRADY 5085836000 2012-06-21 1 DOUGLAS FIEBELKORN P00173341 6179848100 2012-05-31 2011 2016-02-24 21:20:13Z MARY A MCCARTHY 134 RUMFORD AVENUE 306 NEWTON MA 02466 11338514 0 X WWW.ALLIANCEHHS.ORG X 1999 MA THE COMPANY SHALL PROMOTE AND PROVIDE SAFE, HEALTHY, QUALITY SERVICES AND LIVING ENVIRONMENTS FOR THE ELDERS WHO CANNOT CARE FOR THEMSELVES. 7 6 241 0 0 0 0 0 11386779 11306974 8998 25043 8010 6497 11403787 11338514 0 0 0 0 6250621 6299237 0 0 0 5016829 5108961 11267450 11408198 136337 -69684 10063797 9741653 10487202 10210666 -423405 -469013 THE COMPANY SHALL PROMOTE AND PROVIDE SAFE, HEALTHY, QUALITY SERVICES AND LIVING ENVIROMENTS FOR ELDERS WHO CANNOT CARE FOR THEMSELVES. 0 0 10294578 11313471 OUR SKILLED NURSING AND REHABILITATION FACILITY PROVIDES A WIDE RANGE OF MEDICAL AND REHABILITATIVE SERVICES, INCLUDING POST ACUTE CARE, SHORT-TERM REHABILITATION, RESPITE CARE, HOSPICE CARE, AND LONG-TERM CARE. WORKING DIRECTLY WITH EACH RESIDENT AND THEIR FAMILY MEMBERS, OUR STAFF WILL CUSTOMIZE A COMPREHENSIVE PLAN OF CARE DESIGNED TO TREAT MEDICAL COMPLICATIONS AND ACHIEVE FUNCTIONAL INDEPENDENCE. OUR FACILITY PROVIDES THE HIGHEST STANDARDS OF CARE AND RESIDENTS ENJOY AN ACTIVE AND FULFILLING LIFESTYLE IN AN ATMOSPHERE OF WARMTH, RESPECT AND UNDERSTANDING. 10294578 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 10 0 1 241 1 0 0 0 0 0 0 0 0 0 0 X 7 6 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X WELCH HEALTHCARE AND RETIREMENT GROUP INC 7878786700 52 ACCORD PARK DRIVE NORWELL MA 02061 WILLIAM P MCDERMOTT ESQ 1.00 X 0 0 0 REV JEROME J JANISKO 1.00 X 0 0 0 JAMES BRUCE RILEY CPA 1.00 X 0 0 0 MICHAEL O JENNINGS ESQ 1.00 X 0 0 0 CHRISTOPHER ROBBINS 1.00 X 0 0 0 MARY MCCARTHY 1.00 X X 0 342143 0 LINDA CORRIDAN RN 1.00 X 0 0 0 FRANCIS J GRADY 1.00 X 0 257389 15596 MICHAEL DODOS 1.00 X 0 160187 17670 RICHARD CANTY 1.00 X 0 146435 16432 PAUL MAHONEY 0.00 X 0 124054 29835 PAMELA HILTZ 0.00 X 0 111851 16778 NORMAN PEREZ 0.00 X 0 109007 16351 FRANCES ELLISON 0.00 X 0 108038 8027 0 1359104 120689 1 0 1 0 GENESIS REHABILITIONS SERVICES INC 101 E STATE ST KENNETT SQUARE PA 19348 THERAPY SERVICES 634223 WELCH HEALTHCARE AND RETIREMENT GROUP 52 ACCORD PARK DR NORWELL MA 02061 MANAGEMENT SERVICES 470640 2 PROG.SERV.REVENUE 623000 11306974 11306974 11306974 24612 24612 431 431 431 431 OTHER INCOME 623000 3019 3019 BARBER & BEAUTY INCOME 623000 1828 1828 LAUNDRY INCOME 623000 1650 1650 6497 11338514 11313471 0 25043 5406173 5139626 266547 18739 17815 924 382702 363833 18869 491623 467384 24239 587846 587846 13020 13020 27500 27500 4500 4500 1043324 873149 170175 14562 14562 60441 60441 14430 14430 263610 263610 11195 11195 613616 613616 314171 314171 205932 205932 PROVIDER USER FEE 734283 734283 NURSING SUPPLIES AND EX 379293 379293 FOOD 330481 330481 MISCELLANEOUS 269724 269724 221033 221033 11408198 10294578 1113620 0 962153 841810 975909 857063 81735 98789 8043033 3460603 4764808 4582430 3279192 3361561 10063797 9741653 1775656 1704667 8515000 8315000 150000 150000 46546 40999 10487202 10210666 X -423405 -469013 -423405 -469013 10063797 9741653 X -69684 24076 X 0 1 1 X 0 X 11607036 10984963 10828493 11386799 11306974 56114265 11607036 10984963 10828493 11386799 11306974 56114265 0 0 0 56114265 146786 77059 2755 8998 24612 260210 146786 77059 2755 8998 24612 260210 11753822 11062022 10831248 11395797 11331586 56374475 0.99540 0.99350 0.00460 0.00650 X 300000 300000 6321000 2586870 3734130 190156 55021 135135 1231877 818712 413165 4582430 DEPOSITS 19931 GOODWILL, NET 907350 DEFERRED FINANCE FEES, NET 409320 TRUSTEE FUNDS HELD UNDER BOND INDEN 2003910 CONSTRUCTION IN PROGRESS 10803 INTEREST RECEIVABLE 10247 3361561 DUE TO RELATED-PARTY 40999 40999 11338514 11408198 -69684 24076 24076 -45608 11338514 0 11338514 0 11338514 11408198 0 11408198 0 11408198 X X X X X 0 1 0 0 0 0 0 0 0 MARY MCCARTHY 0 320106 0 22037 0 0 0 0 0 0 0 342143 0 0 FRANCIS J GRADY 0 230889 0 26500 0 0 0 0 0 15596 0 272985 0 0 MICHAEL DODOS 0 143444 0 16743 0 0 0 0 0 17670 0 177857 0 0 RICHARD CANTY 0 137435 0 9000 0 0 0 0 0 16432 0 162867 0 0 PAUL MAHONEY 0 124054 0 0 0 0 0 0 0 29835 0 153889 0 0 PART I, LINE 4B MARY MCCARTHY PARTICIPATES IN DEFERRED COMP PLAN BUT HAS NOT RECIEVED ANY PAYMENTS AS OF DECEMBER 31, 2011 . FORM 990, PART VI, SECTION A, LINE 3 WELCH HEALTHCARE AND RETIREMENT GROUP, INC., 52 ACCORD PARK DRIVE, NORWELL, MA 02061 FORM 990, PART VI, SECTION B, LINE 11 THE AUDIT COMMITTEE SHALL REVIEW AND APPROVE THE IRS FORM 990 ANNUAL TAX FILINGS PRIOR TO SUBMISSION, AND THE BOARD SHALL RECEIVE A COPY AND REVIEW THE IRS FORM 990 TAX FILINGS WITHIN 30 DAYS OF ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR MUST PROVIDE THE BOARD OF DIRECTORS WITH AN ANNUAL WRITTEN DISCLOSURE OF THE FOLLOWING: (I) THE DIRECTOR'S BUSINESS INVOLVEMENTS WITH THE ORGANIZATION AND RELATED ORGANIZATIONS; (II) THE DIRECTOR'S OTHER BOARD MEMBERSHIPS, WHETHER OF FOR-PROFIT OR NON-PROFIT CORPORATIONS; AND (III) THE TOTAL AMOUNT RECEIVED BY THE DIRECTOR FROM THE ORGANIZATION AND RELATED ORGANIZATIONS FOR SERVICES RENDERED AS A VENDOR OF GOODS OR SERVICES TO THE RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 15 PERFORMANCE EVALUATION OF THE CHIEF EXECUTIVE OFFICER OF THE COMPANY ON AN ANNUAL BASIS. SUCH EVALUATION SHALL BE USED AS THE BASIS FOR DETERMINING COMPENSATION AND SHALL INCLUDE AN ASSESSMENT OF COMPANY GOALS AND PERFORMANCE. THE BOARD WILL REVIEW YEAR OVER YEAR PERFORMANCE AND EVALUATE COMPANY RESULTS WITH RESPECT TO FINANCIAL PERFORMANCE, ATTAINMENT OF GOALS, PROGRAM AND OPERATIONAL QUALITY AND GOVERNANCE. THE BOARD WILL ALSO CONSIDER ORGANIZATIONAL STRENGTH AND DEVELOPMENT AND BOARD-CEO RELATIONSHIP MANAGEMENT. IN MAKING A COMPENSATION DETERMINATION, THE BOARD SHALL CONSIDER CURRENT INDEPENDENT MARKET ASSESSMENT OF AND RELIABLE DATA FROM COMPARABLE ORGANIZATIONS. THE BOARD MAY FROM TIME TO TIME SPECIFICALLY ENGAGE THIRD PARTY PROFESSIONALS TO CONDUCT COMPENSATION STUDIES OR TO REVIEW AND ASSESS CURRENT PRACTICES WHEN DEEMED USEFUL. THE CEO SHALL CONDUCT A PERFORMANCE EVALUATION OF THE CHIEF FINANCIAL OFFICER OF THE COMPANY ON AN ANNUAL BASIS. SUCH EVALUATION SHALL BE USED AS THE BASIS FOR DETERMINING COMPENSATION AND SHALL INCLUDE AN ASSESSMENT OF COMPANY GOALS AND PERFORMANCE. THE CEO WILL REVIEW YEAR OVER YEAR PERFORMANCE AND EVALUATE COMPANY RESULTS WITH RESPECT TO FINANCIAL PERFORMANCE, ATTAINMENT OF GOALS, PROGRAM AND OPERATIONAL QUALITY AND GOVERNANCE. IN MAKING A COMPENSATION DETERMINATION, THE CEO SHALL CONSIDER CURRENT INDEPENDENT MARKET ASSESSMENT OF AND RELIABLE DATA FROM COMPARABLE ORGANIZATIONS. THE CEO WILL ADVISE THE BOARD OF HER DECISION. 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 5: NET UNREALIZED GAINS ON INVESTMENTS: 24,076. 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