ST ANDRE HEALTH CARE FACILITY: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ST ANDRE HEALTH CARE FACILITY (EIN 01-0342399)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-08-10
- IRS object ID
- 201202239349300640
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-10T11:00:33-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020383073 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILLIAM STEELE & ASSOCIATES PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 40 STARK STREET | AddressLine1 |
| City | MANCHESTER | City |
| State | NH | State |
| ZIP Code | 03101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010342399 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANDRE HEALTH CARE FACILITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAN | NameControl |
| Phone | 2072825171 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 407 POOL STREET | AddressLine1 |
| City | BIDDEFORD | City |
| State | ME | State |
| ZIP Code | 04005 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANDREA OTIS-HIGGINS | Name |
| Title | CEO ADMINISTRATOR | Title |
| Phone | 2072825171 | Phone |
| Date Signed | 2012-08-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL A BARBARITA CPA | Name |
| PTIN | P00801253 | PTIN |
| Phone | 6036228881 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ANDREA OTIS-HIGGINS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 407 POOL STREET | AddressLine1 |
| City | BIDDEFORD | City |
| State | ME | State |
| ZIP Code | 04005 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 8034123 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | STANDRE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1946 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | ST. ANDRE HEALTH CARE FACILITY ANSWERS GOD'S CALL TO PROMOTE A HIGH QUALITY, COMPASSIONATE HEALTH CARE COMMUNITY WHERE ALL PEOPLE FLOURISH. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 226 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 13647 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 6481 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 7786228 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 8002979 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 30157 | InvestmentIncomePriorYear |
| Investment Income Current Year | 17286 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5608 | OtherRevenuePriorYear |
| Other Revenue Current Year | 7377 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7835640 | TotalRevenuePriorYear |
| Total Revenue Current Year | 8034123 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4333630 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4106705 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3668127 | OtherExpensePriorYear |
| Other Expenses Current Year | 3710866 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8001757 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7817571 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -166117 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 216552 | RevenuesLessExpensesCY |
| Total Assets BOY | 5645951 | TotalAssetsBOY |
| Total Assets EOY | 5300854 | TotalAssetsEOY |
| Total Liabilities BOY | 2962022 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2418789 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2683929 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2882065 | NetAssetsOrFundBalancesEOY |
| Mission Description | ST ANDRE HEALTH CARE FACILITY ANSWERS GOD'S CALL TO PROMOTE A HIGH QUALITY,COMPASSIONATE HEALTH CARE COMMUNITY WHERE ALL PEOPLE FLOURISH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7711391 | Expense |
| Revenue | 8010356 | Revenue |
| Description | ST ANDRE HEALTH CARE FACILITY PROVIDED 31,129 SKILLED NURSING CARE DAYS OF SERVICE OF WHICH 22,295 DAYS WERE REIMBURSED BY MEDICAID AT WELL BELOW COST. | Description |
| Total Program Service Expense | 7711391 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 20 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 226 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ME | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREA OTIS-HIGGINS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2072825171 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 407 POOL STREET | AddressLine1 |
| City | BIDDEFORD | City |
| State | ME | State |
| ZIP Code | 04005 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| SR PRISCILLE ROY | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| ANDREA OTIS-HIGGINS | ||||||
| PRESIDENT/EX-OFFICIO | 40.00 | X | 114086 | 0 | 2836 | X |
| RENEE O'NEIL | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| PAT CAMIRE | ||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | X |
| KENNETH FARLEY | ||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X |
| ROLAND GAGNE | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| MARILYN GUGLIUCCI | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| ROLAND CRONKHITE JR | ||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X |
| NANCY DRAPEAU | ||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | X |
| HELENE GIRARD KENNEDY | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| KIM DENNIS | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 114086 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2836 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| REHABCARE GROUP INC | |||||
| PO BOX 503534 | ST LOUIS | MO | 63150 | PATIENT REHABILIATION SERVICES | 539799 |
| ANTHEM BLUE CROSS BLUE SHIELD | |||||
| PO BOX 591 | LEWISTON | ME | 04243 | HEALTH INSURANCE | 387686 |
| MAINLAND STRUCTURES CORP | |||||
| 11A BARTLETT RD | GORHAM | ME | 04038 | CONSTRUCTION | 343444 |
| OMNICARE INC | |||||
| PO BOX 715268 | ST LOUIS | MO | 63150 | PHARMACY | 217245 |
| US FOODSERVICE | |||||
| PO BOX 3155 | BOSTON | MA | 02241 | PATIENT FOOD | 172508 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| All Other Contributions | 6481 | AllOtherContributions |
| Total Contributions | 6481 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENU | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 8002979 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8002979 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 8002979 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17286 | TotalRevenueColumn |
| Exclusion | $17,286 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAFETERIA SALES | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 7377 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7377 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 7377 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8034123 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8010356 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $17,286 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114086 | Total |
| Program Services | 114086 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3663200 | Total |
| Program Services | 3663200 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8828 | Total |
| Program Services | 8828 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53867 | Total |
| Program Services | 53867 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 266724 | Total |
| Program Services | 266724 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80592 | Total |
| Management And General | 80592 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16728 | Total |
| Program Services | 16728 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25588 | Total |
| Management And General | 25588 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70143 | Total |
| Program Services | 70143 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 209269 | Total |
| Program Services | 209269 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7997 | Total |
| Program Services | 7997 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78274 | Total |
| Program Services | 78274 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269775 | Total |
| Program Services | 269775 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 424434 | Total |
| Program Services | 424434 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| PATIENT CARE PURCH SERV | 1111429 | 1111429 |
| MEDICAL & OTHER SUPPLIE | 630177 | 630177 |
| MEDICAID USER FEE | 449281 | 449281 |
| BAD DEBT EXPENSE | 174369 | 174369 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162810 | Total |
| Program Services | 162810 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7817571 | Total |
| Program Services | 7711391 | ProgramServices |
| Management And General | 106180 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 139685 | BOY |
| EOY | 256488 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14219 | BOY |
| EOY | 15910 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1192956 | BOY |
| EOY | 828793 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12896 | BOY |
| EOY | 13134 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88118 | BOY |
| EOY | 76534 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7001772 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4184965 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2356315 | BOY |
| EOY | 2816807 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1181243 | BOY |
| EOY | 1182309 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 660519 | BOY |
| EOY | 110879 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5645951 | BOY |
| EOY | 5300854 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 946400 | BOY |
| EOY | 771575 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1244216 | BOY |
| EOY | 1085982 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150000 | BOY |
| EOY | 49500 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 621406 | BOY |
| EOY | 511732 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2962022 | BOY |
| EOY | 2418789 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2683929 | BOY |
| EOY | 2882065 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2683929 | BOY |
| EOY | 2882065 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5645951 | BOY |
| EOY | 5300854 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 216552 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -18416 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 16619 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 49692 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 27499 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 16355 | CurrentTaxYearMinus1Year |
| Current Tax Year | 6481 | CurrentTaxYear |
| Total | 116646 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7113549 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7396408 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7903490 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7789128 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8010356 | CurrentTaxYear |
| Total | 38212931 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7130168 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7446100 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7930989 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7805483 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8016837 | CurrentTaxYear |
| Total | 38329577 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 38329577 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 179835 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3610 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 33103 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30157 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17286 | CurrentTaxYear |
| Total | 263991 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 179835 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3610 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 33103 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30157 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17286 | CurrentTaxYear |
| Total | 263991 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7310003 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7449710 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7964092 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7835640 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8034123 | CurrentTaxYear |
| Total | 38593568 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99320 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.98930 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00680 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01070 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1268 | OtherCostOrOtherBasis |
| Book Value | 1268 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2774199 | OtherCostOrOtherBasis |
| Depreciation | 1999274 | Depreciation |
| Book Value | 774925 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2969655 | OtherCostOrOtherBasis |
| Depreciation | 2185691 | Depreciation |
| Book Value | 783964 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1256650 | OtherCostOrOtherBasis |
| Book Value | 1256650 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2816807 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATE | $2,400 |
| OTHER NOTES PAYABLE | $488,202 |
| RESIDENT PERSONAL FUNDS | $21,130 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 511732 | TotalOfAmounts |
| Total Revenue | 8034123 | TotalRevenue |
| Total Expenses | 7817571 | TotalExpenses |
| Excess Or Deficit For Year | 216552 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -18416 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -18416 | TotalAdjustments |
| Excess Or Deficit Per FS | 198136 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 8015705 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -18418 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -18418 | RevenueNotRptdF990 |
| Revenue Subtotal | 8034123 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 8034123 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7817571 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7817571 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7817571 | TotalExpensesPerForm990 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | COVENANT HEALTH SYSTEMS, INC. IS THE SOLE MEMBER OF ST. ANDRE AND AS SUCH HAS CERTAIN RESERVED RIGHTS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | COVENANT HEALTH SYSTEMS, INC. IS THE SOLE MEMBER OF ST ANDRE AND AS SUCH HAS CERTAIN RESERVED RIGHTS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO IT'S BEING FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ST ANDRE HELATH CARE FACILITY HAS A FORMAL, WRITTEN ORGANIZATIONAL INTEGRITY POLICY ADMINISTERED BY A FULL-TIME ORGANIZATIONAL INTEGRITY OFFICER. | |
| FORM 990, PART VI, SECTION B, LINE 15 | EVERY 2 TO 3 YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH SYSTEMS BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003, THE COMPENSATION COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. OBJECTIVES ARE TO ASSESS THE COMPOSITENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS OF THE SENIOR LEADERSHIP TEAM; DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE. | |
| FORM 990, PART VI, SECTION C, LINE 19 | ST ANDRE HEALTH CARE FACILITY MAKES IT'S GOVERNING BODY DOCUMENTS AND POLICIES AVAILABLE TO INTERESTED PARTIES UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -18,416. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANT HEALTH SYSTEMS INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 AMES POND DRIVE | AddressLine1 |
| City | TEWKSBURY | City |
| State | MA | State |
| ZIP Code | 01876 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222484505 | EIN |
| Primary Activities | MANAGEMENT | PrimaryActivities |
| Legal Domicile State | MA | LegalDomicileState |
| Exempt Code Section | 501(C)3 | ExemptCodeSection |
| Public Charity Status | 509A2 | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANT HEALTH SYSTEMS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionType |
| Amount Involved | 155309 | AmountInvolved |
| Method Of Amt Determination | ACTUAL COST | MethodOfAmtDetermination |
Comments