2012-11-15T09:08:00-06:00 2011-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2011-01-01 042104452 EDGAR P BENJAMIN HEALTHCARE CENTER INC FKA RESTHAVEN CORPORATION EDGA 6177381500 120 FISHER AVENUE ROXBURY MA 02120 MYRNA WYNN 6177381500 2012-11-08 1 BARBARA MORRISON P00173340 6179848100 2012-11-03 2011 2016-02-24 21:20:13Z PERRY SMITH 120 FISHER AVE ROXBURY MA 02110 12498463 0 X BENJAMINHEALTHCARE.COM X 1927 MA PROVIDING NURSING CARE TO THE ELDERLY. 9 8 242 150 0 0 368252 71831 12549097 11721074 7179 13311 431793 498161 13356321 12304377 0 0 0 0 9277813 9004493 0 0 0 4131383 3618268 13409196 12622761 -52875 -318384 4883857 4679099 4387851 4505989 496006 173110 TO PROVIDE NURSING CARE TO THE ELDERLY, AND TO PROVIDE HELP THROUGH EDUCATION SERVICES. 0 0 11418361 12239965 OPERATING A 205-BED NURSING HOME 11418361 1 1 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 0 1 4 0 242 1 0 0 0 0 0 1 1 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 MA X MYRNA E WYNN 6177381500 120 FISHER AVE ROXBURY MA 02120 PERRY SMITH 1.00 X X 0 0 0 SANDY JACKSON 1.00 X X 0 0 0 DELORIS TUGGLE 1.00 X 0 0 0 EVAN TOBASKY 1.00 X X 0 0 0 LUZ QUINCHIA 1.00 X 0 0 0 REV GREGORY FERNANDES 1.00 X 0 0 0 MYRNA WYNN 40.00 X X 176255 0 10242 REV EVAN C HINES 1.00 X 0 0 0 ROSALINDA MIDENCE 1.00 X 0 0 0 BERTHELINA SPRIGGS 40.00 X 143759 0 4423 320014 0 14665 2 0 1 0 0 27800 24400 19631 71831 PATIENT SERVICE REVENU 623000 11708805 11708805 12269 12269 11721074 13311 13311 685360 166469 518891 518891 518891 6887 27800 27617 -20730 -20730 12304377 12239965 0 -7419 186497 186497 6936138 6342319 593819 230424 210997 19427 1120912 1024948 95964 530522 473081 57441 22184 22184 40000 40000 212269 116262 96007 19477 19477 101668 101668 445705 445705 15984 15984 53 53 106794 106794 93061 93061 USER FEES 953969 953969 SUPPLIES AND EXPENSE 815508 815508 FOOD 357887 357887 REPAIRS AND MAINTENANCE 171670 171670 262039 262039 12622761 11418361 1204400 0 609534 201663 2182134 2113499 1251814 1174080 101139 107125 5050236 4442347 666554 607889 97571 72682 377272 4883857 4679099 1340862 1459000 2300000 2300000 746989 746989 4387851 4505989 X 496006 173110 496006 173110 4883857 4679099 X -318384 -4512 X X 0 1 1 X 0 X 116878 119106 130328 241095 78718 686125 13298369 13136702 13525989 12549099 11721074 64231233 13415247 13255808 13656317 12790194 11799792 64917358 362884 18814 381698 0 362884 18814 381698 64535660 390656 428884 377177 728387 698671 2623775 390656 428884 377177 728387 698671 2623775 13805903 13684692 14033494 13518581 12498463 67541133 0.95550 0.96600 0.03880 0.03400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2458 2458 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATION 200000 200000 3480786 3137659 343127 1369450 1304688 64762 607889 CONSTRUCTION IN PROGRESS 122576 RENT RECEIVABLE 254696 377272 ACCRUED INTEREST PAYABLE 596989 ENVIRONMENTAL REMEDIATION LIABILITY 150000 746989 12304377 12622761 -318384 -4512 -4512 -322896 12466334 -4512 166469 161957 12304377 0 12304377 12789230 166469 166469 12622761 0 12622761 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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 2008 THROUGH 2011 TAX RETURNS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES, PART XI, LINE 8 - OTHER ADJUSTMENTS: UNREALIZED LOSS ON SECURITIES -4,512. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE NETTED AGAINST INCOME 166,469. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST INCOME 166,469. GOLF TOURNAMENT 34687 27800 6887 19077 2445 2 6095 34687 27800 6887 19077 8540 27617 -20730 X X X 0 0 0 0 0 0 0 0 0 MYRNA WYNN 140005 0 16300 0 19950 0 0 0 10242 0 186497 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS ARE GIVEN A COPY OF THE FORM 990 TO REVIEW AND IT IS DISCUSSED AT A BOARD MEETING PRIOR TO FILING. THE BOARD OF DIRECTORS MET TO DETERMINE THE COMPENSATION OF THE CEO WITH A VOTE IN 2008. 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 5: UNREALIZED LOSS ON SECURITIES -4,512. TOTAL TO FORM 990, PART XI, LINE 5: -4,512. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND APPROVES THE AUDITOR. RESTHAVEN CORPORATION 120 FISHER AVENUE ROXBURY MA 02120 043448700 OWNS MORTGAGE MA 501(C)(3) LINE 11C, III-FI 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0