2012-08-13T09:31:52-05:00 2011-12-31 043582157 GRAHAM SHEPHERD PC 446 MAIN STREET 10TH FLOOR WORCESTER MA 01608 990 2011-01-01 042104414 ODD FELLOWS HOME OF MASSACHUSETTS INC ODDF 5088536687 104 RANDOLPH ROAD WORCESTER MA 01606 JAMES TRACY 5088536687 2012-08-13 1 MARIE M SHEPHERD CPA P00516248 5087548512 2011 2016-02-24 21:20:13Z JAMES TRACY 104 RANDOLPH ROAD WORCESTER MA 01606 6263192 0 X WWW.ODDFELLOWSHOMEMA.COM X 1898 MA TO PROVIDE OUR RESIDENTS WITH THE FINEST SKILLED NURSING AND REHABILITATIVE SERVICES. 12 11 204 0 0 0 29399 34535 6209182 6094323 113968 71811 247 0 6352796 6200669 1100 0 0 0 4742398 4680385 0 0 0 2274334 2302900 7017832 6983285 -665036 -782616 4649505 4088246 3132986 3354343 1516519 733903 TO PROVIDE OUR RESIDENTS WITH THE FINEST SKILLED NURSING AND REHABILITATIVE SERVICES. DEDICATED TO THE BASIC TENENTS OF FRIENDSHIP, LOVE AND TRUTH, OUR HIGHLY TRAINED STAFF PROVIDES COMPASSIONATE CARE IN A COMFORTABLE, SECURE ENVIRONMENT. 0 0 6090705 6094323 PROVIDE QUALITY SKILLED NURSING CARE AND THERAPY FOR 100 ELDERLY RESIDENTS. 6090705 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 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 1 0 1 13 0 1 204 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X JAMES TRACY 5088536687 104 RANDOLPH ROAD WORCESTER MA 01606 RUTH GARCIA 1.00 X X 0 0 0 SAMUEL C WHITE 1.00 X X 0 0 0 CLARENCE PLANT 20.00 X X 42723 0 0 DAVID LABONTE 1.00 X X 0 0 0 CRAIG CELLITTI 1.00 X 0 0 0 ROBERT WALSH 1.00 X 0 0 0 BARRY G RECTOR 1.00 X 0 0 0 WENDY E BAKER 1.00 X 0 0 0 GERARD GILMORE JR 1.00 X 0 0 0 JOHN SLANEY 1.00 X 0 0 0 ROBERT COMER 1.00 X 0 0 0 PAUL E SLANEY 1.00 X 0 0 0 MARY G VITEILLO 1.00 X 0 0 0 JAMES DIVVER 32.00 X 66375 0 0 ROSEMARY CARLSON 32.00 X 45584 0 0 154682 0 0 0 1 0 0 0 14150 20385 34535 PATIENT REVENUE 623000 6094323 6094323 6094323 69816 69816 64518 62523 1995 1995 1995 6200669 6094323 0 71811 109098 42723 66375 3964895 3578309 386586 229839 204285 25554 376553 334687 41866 40314 40314 41400 41400 3508 3508 27754 27754 5626 5626 114932 114932 188539 167577 20962 179600 159631 19969 USER FEE EXPENSE 494345 494345 SUPPLIES AND EXPENSES 388611 388611 MEDICAL SUPPLIES AND DR 298915 298915 UTILITES 197109 177592 19517 322247 240522 81725 6983285 6090705 892580 0 126579 134458 702925 456610 38911 28298 5618312 3214014 2550076 2404298 1148232 1000016 82782 64566 4649505 4088246 1110666 1089960 25795 31545 16795 1685000 1385000 281493 836793 24282 0 3132986 3354343 X 1421298 707577 95221 26326 1516519 733903 4649505 4088246 -782616 0 X X 0 1 1 X 0 X 27062 19671 21217 29399 34535 131884 7217667 7106156 6456528 6183934 6094323 33058608 7244729 7125827 6477745 6213333 6128858 33190492 0 0 0 33190492 147748 87724 90864 113968 71811 512115 147748 87724 90864 113968 71811 512115 7392477 7213551 6568609 6327301 6200669 33702607 0.98480 0.98350 0.01520 0.01650 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 31545 447886 496226 16795 1 95221 68895 26326 466394 -44710 326463 95221 901567 32198 467371 466394 901567 1.00000 0 0 45080 45080 4058124 2156902 1901222 690090 374549 315541 772744 633385 139359 52274 49178 3096 2404298 6200669 6983285 -782616 -782616 6200669 0 6200669 0 6200669 6983285 0 6983285 0 6983285 PART IV, LINE 1B: THE ORGANIZATION IS THE CUSTODIAN OF THE RESIDENTS PERSONAL NEEDS ACCOUNT. PART IV, LINE 2B: RESIDENTS HAVE FUNDS DEPOSITED INTO ACCOUNT AND WITHDRAW FOR PERSONAL EXPENSES. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE INCOME TO THE ORGANIZATION OVER TIME. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: PART X, LINE 2: ODD FELLOWS HOME OF MASSACHUSETTS 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 ORGANIZATION IS REQUIRED TO RECOGNIZE IN ITS FINANCIAL STATEMENTS THE IMPACT OF A TAX POSITION, IF THAT POSITION IS MORE LIKELY THAN NOT OF NOT BEING SUSTAINED ON AUDIT BASED ON THE TECHNICAL MERITS OF THE POSITION. THE COMPANY FILES FEDERAL AND MASSACHUSETTS INCOME TAX RETURNS. THE INCOME TAX RETURNS FOR TAX YEARS 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND THE MASSACHUSETTS DEPARTMENT OF REVENUE. THE COMPANY DID NOT HAVE UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2011 AND 2010 AND DOES NOT EXPECT THIS TO CHANGE SIGNIFICANTLY OVER THE NEXT 12 MONTHS. THE COMPANY WILL RECOGNIZE INTEREST AND PENALTIES ACCRUED ON ANY UNRECOGNIZED TAX BENEFITS AS A COMPONENT OF INCOME TAX EXPENSE. REALIZED GAIN ON THE SALE OF INVESTMENT: 1,995 CONTRIBUTIONS: 34,535 INVESTMENT INCOME: 69,753 X 0 0 0 0 0 0 0 0 0 JAMES DIVVER 66375 0 0 0 0 0 0 0 0 0 66375 0 0 0 ROSEMARY CARLSON 45584 0 0 0 0 0 0 0 0 0 45584 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE 2011 FORM 990 WAS PRESENTED TO AND APPROVED BY THE EXECUTIVE COMMITTEE AND THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES SHALL NOT HAVE ANY UNDISCLOSED CONFLICTS OF INTEREST WITH THE CORPORATION. ANY CONFLICT OF INTEREST ON THE PART OF ANY TRUSTEE SHALL BE DISCLOSED TO THE OTHER TRUSTEES AND MADE A MATTER OF RECORD WHEN ANY MATTER TO WHICH THE INTEREST RELATES BECOMES THE SUBJECT OF ACTION BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMMITTEE HOLDS AN ANNUAL MEETING WITH THE BOARD OF TRUSTEES TO DISCUSS THE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. 990 PART XII, 2C NO CHANGE IN OVERSIGHT OF SELECTION PROCESS. GRAND LODGE OF THE INDEPENDENT ORDER OF ODD FELLOWS 104 RANDOLPH ROAD WORCESTER MA 01606 041383604 FRATERNAL ORGANIZATION MA 501(C)(8) & (C)(10) 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 GRAND LODGE OF THE INDEPENDENT ORDER OF ODD FELLOWS E 752863 LOAN DOCUMENTS