FURP.ORG / PUBLIC DATA EXPLORER

FAIRHAVEN HEALTHCARE CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
FAIRHAVEN HEALTHCARE CENTER INC (EIN 20-8745264)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201213209349306391
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

FieldValueIRS element (for citing)
Timestamp2012-11-15T15:05:33-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1300 CROWN COLONY DRIVE SUITE 310AddressLine1
CityQUINCYCity
StateMAState
ZIP Code02169ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN208745264EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FAIRHAVEN HEALTHCARE CENTER INCBusinessNameLine1
Business Name Line2C/O PLATINUM CARE LLCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlFAIRNameControl
Phone9784201500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line135 AVCO ROADAddressLine1
CityHAVERHILLCity
StateMAState
ZIP Code01835ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOEL E KIRCHICKName
TitlePRESIDENTTitle
Phone9784201500Phone
Date Signed2012-11-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBARBARA MORRISONName
PTINP00173340PTIN
Phone6179848100Phone
Date Prepared2012-11-08DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOEL E KIRCHIKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line135 AVCO ROADAddressLine1
CityHAVERHILLCity
StateMAState
ZIP Code01835ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14343378GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.FAIRHAVEN-NURSING.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2007YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE LONG-TERM NURSING CARE TO THE ELDERLY.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees283TotalNbrEmployees
Total Nbr Volunteers6TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year20000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14081534ProgramServiceRevenuePriorYear
Program Service Revenue CY14201583ProgramServiceRevenueCY
Investment Income Prior Year62947InvestmentIncomePriorYear
Investment Income Current Year75193InvestmentIncomeCurrentYear
Other Revenue Prior Year29194OtherRevenuePriorYear
Other Revenue Current Year46602OtherRevenueCurrentYear
Total Revenue Prior Year14173675TotalRevenuePriorYear
Total Revenue Current Year14343378TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7421992SalariesEtcPriorYear
Salaries Etc Current Year7436241SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6675253OtherExpensePriorYear
Other Expenses Current Year6812376OtherExpensesCurrentYear
Total Expenses Prior Year14097245TotalExpensesPriorYear
Total Expenses Current Year14248617TotalExpensesCurrentYear
Revenues Less Expenses Prior Year76430RevenuesLessExpensesPriorYear
Revenues Less Expenses CY94761RevenuesLessExpensesCY
Total Assets BOY32585468TotalAssetsBOY
Total Assets EOY32417540TotalAssetsEOY
Total Liabilities BOY32536918TotalLiabilitiesBOY
Total Liabilities EOY32252065TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY48550NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY165475NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionIT IS OUR MISSION TO PROVIDE ELDERS WITH DYNAMIC, MEANINGFUL AND SUPPORTIVE LIVING ENVIRONMENTS, INTEGRATING QUALITY CARE, EDUCATION AND RESEARCH, RESPECT FOR INDIVIDUALITY AND THE HUMAN SPIRIT, AND INNOVATIVE APPROACHES TO MEET THE EVER CHANGING NEEDS OF THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11878950Expense
Revenue14248185Revenue
DescriptionA 169-BED SKILLED NURSING FACILITY PROVIDING NURSING CARE TO THE ELDERLY.Description
Total Program Service Expense11878950TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees283NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PLATINUM CARE LLCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9784201500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line135 AVCO ROADAddressLine1
CityHAVERHILLCity
StateMAState
ZIP Code01835ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JOEL KIRCHIK
PRESIDENT1.00XX000
JOHN REGAN
SECRETARY1.00XX000
PATRICIA TORTELLA
DIRECTOR1.00X000
RAYMOND DENNEHY
TREASURER1.00XX000
JOANNE FREEDMAN SPECTOR
DIRECTOR1.00X000
DAVID O'DONNELL
DIRECTOR1.00X000
ALEX STRUZZIERO
ADMINISTRATOR40.0012202606553X
FieldValueIRS element (for citing)
Total Reportable Comp From Org122026TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation6553TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
PLATINUM CARE LLC
35 AVCO ROADHAVERHILLMA01835MANAGEMENT1133073
HEALTHCARE SERVICES GROUP
3220 TILLMAN DR STE 300BENSALEMPA19020HSKG, LAUNDRY, DIETARY420755
PREFERRED PHARMACY SOLUTIONS
35 AVCO ROADHAVERHILLMA01835PHARMACY SERVICES410469
GERIATRIC MEDICAL
PO BOX 6027CHELSEAMA02150MEDICAL SUPPLIES175981
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Fundraising Events20000FundraisingEvents
Total Contributions20000TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROG.SERV.REVENUE-RELADescription
Business Code623000BusinessCode
Total Revenue Column14201583TotalRevenueColumn
Related Or Exempt Function Income14201583RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue14201583TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column75193TotalRevenueColumn
Exclusion$75,193ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events0GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events20000CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses0FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS INCOMEDescription
Business Code623000BusinessCode
Total Revenue Column46602TotalRevenueColumn
Related Or Exempt Function Income46602RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue46602TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14343378TotalRevenueColumn
Related Or Exempt Function Income14248185RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$75,193ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6478672Total
Program Services6210070ProgramServices
Management And General268602ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total453210Total
Program Services434423ProgramServices
Management And General18787ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total504359Total
Program Services483449ProgramServices
Management And General20910ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total736380Total
Management And General736380ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total80664Total
Management And General80664ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total26200Total
Management And General26200ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total749705Total
Program Services749705ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total37294Total
Program Services37294ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total92500Total
Management And General92500ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2186330Total
Program Services2186330ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total16708Total
Management And General16708ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total553939Total
Program Services553939ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total85822Total
Management And General85822ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES906540906540
USER FEE886331886331
FOOD271521271521
MISCELLANEOUS9634996349

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total86093Total
Program Services45679ProgramServices
Management And General40414ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14248617Total
Program Services11878950ProgramServices
Management And General2369667ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY11861BOY
EOY4478EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2425579BOY
EOY1323244EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1712265BOY
EOY1894036EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY40215BOY
EOY46131EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis20207031LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2061089LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY18598068BOY
EOY18145942EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4901206BOY
EOY1046897EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2932083BOY
EOY2932083EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1964191BOY
EOY7024729EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32585468BOY
EOY32417540EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1490591BOY
EOY1523342EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY29408933BOY
EOY29411117EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1637394BOY
EOY1317606EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY32536918BOY
EOY32252065EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY48550BOY
EOY165475EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY48550BOY
EOY165475EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32585468BOY
EOY32417540EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses94761ReconcilationRevenueExpenses
Reconcilation Other Changes22164ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year20000CurrentTaxYear
Total20000Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year14081534CurrentTaxYearMinus1Year
Current Tax Year14201583CurrentTaxYear
Total28283117Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year14081534CurrentTaxYearMinus1Year
Current Tax Year14221583CurrentTaxYear
Total28303117Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50928303117PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year62947CurrentTaxYearMinus1Year
Current Tax Year75193CurrentTaxYear
Total138140Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year62947CurrentTaxYearMinus1Year
Current Tax Year75193CurrentTaxYear
Total138140Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year29194CurrentTaxYearMinus1Year
Current Tax Year46602CurrentTaxYear
Total75796Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year14173675CurrentTaxYearMinus1Year
Current Tax Year14343378CurrentTaxYear
Total28517053Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509
Public Support Percentage5090.00000PublicSupportPercentage509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1958000OtherCostOrOtherBasis
Book Value1958000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17622000OtherCostOrOtherBasis
Depreciation1835625Depreciation
Book Value15786375BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis46540OtherCostOrOtherBasis
Depreciation3935Depreciation
Book Value42605BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis580491OtherCostOrOtherBasis
Depreciation221529Depreciation
Book Value358962BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18145942TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCING COSTS, NET1330631
CONSTRUCTION IN PROCESS2356264
OTHER RECEIVABLES15227
BOND ESCROWS3322607
FieldValueIRS element (for citing)
Total Book Value Other Assets7024729TotalBookValueOtherAssets

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHIS ENTITY IS A MASSACHUSETTS 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. THIS ENTITY'S 2008 THROUGH 2011 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event120000GrossReceiptsEvent1
Charitable Contributions Event120000CharitableContributionsEvent1
Gross Receipts Total20000GrossReceiptsTotal
Charitable Contributions Total20000CharitableContributionsTotal

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
04343181457585AAA82007-10-251982687PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
04343181457585AAB62007-10-258051140PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A
04343181457585AAC42007-10-2514755407PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007B
04343181457585AAD22007-10-251685472PURCHASE FACILITIES000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFund
1982687118927379341420070011
80511405183387200700112867753
147554071475540720070011
1885472168547220070011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICException To RebateExceptionToRebate
00000
00000
00000
00000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007D
0434318142007-10-252038290PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007F
0434318142007-10-25760798PURCHASE FACILITIES000
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2010
0434318182010-07-142640000PROJECT REHAB000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
203829019338201895220070011
76079876079820070011
2640000264000020100011

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICException To RebateExceptionToRebate
00000
00000
00000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION IS MANAGED BY PLATINUM CARE LLC.
FORM 990, PART VI, SECTION B, LINE 11A COMPLETE COPY OF THE FORM 990 TAX RETURN (INCLUDING ALL REQUIRED SCHEDULES) IS PROVIDED TO EACH PERSON WHO IS A VOTING MEMBER OF THE BOARD OF DIRECTORS AT THE TIME THE FORM 990 IS PROVIDED, EITHER IN PAPER OR ELECTRONIC FORM, BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CORPORATE COMPLIANCE PLAN WHICH INCLUDES THE MONITORING OF ITS CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE MSRB EMMA WEBSITE.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 22,164.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
ADVENTCARE INC
35 AVCO ROADHAVERHILLMA01835321012491MANAGEMENT COMPANYMA501(C)(3)LINE 90
LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY
25 LAFAYETTE STREETMARBLEHEADMA01945208745166SKILLED NURSING FACILITYMA501(C)(3)LINE 90ADVENTCARE INC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg