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 043108782 NOTRE DAME HEALTH CARE CENTER INC NOTR 5088523011 559 PLANTATION STREET WORCESTER MA 01605 SR EDIE DALY SND 5088523011 2012-11-08 1 BARBARA MORRISON P00173340 6179848100 2012-11-07 2011 2016-02-24 21:20:13Z NOTRE DAME LT CARE CENTER NOTRE DAME DU LAC NOTRE DAME HOSPICE KATHERINE LEMAY 559 PLANTATION STREET WORCESTER MA 01605 22434932 0 X NOTREDAMELTCC.ORG X 1990 MA TO PROVIDE NURSING & RELATED HEALTHCARE SERVICES TO THE ELDERLY 21 17 434 40 0 0 67437 103085 19244665 20117740 414501 344127 0 14723 19726603 20579675 0 0 0 0 11494184 12119498 0 0 0 7032059 7238876 18526243 19358374 1200360 1221301 35537901 36144510 21623555 22352296 13914346 13792214 PROVIDE NURSING & RELATED HEALTHCARE SERVICES TO THE ELDERLY; NURSING HOME; ASSISTED LIVING AND HOSPICE SERVICES 0 0 18039379 20132463 PROVIDE SKILLED NURSING HOME CARE TO THE ELDERLY AND DISABLED 18039379 1 1 0 1 0 0 1 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 26 0 434 1 0 0 0 0 0 0 0 0 0 0 X 21 17 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 0 1 1 0 MA X SR ELIZABETH MCLAUGHLIN SND TREASURER 5088523011 559 PLANTATION ST WORCESTER MA 01605 SR BARBARA-JEAN KUBIK SND 1.00 X 0 0 0 SR EDIE DALY SND 1.00 X X 0 0 0 SR ELIZABETH MCLAUGHLIN 1.00 X X 0 0 0 MS MARY CULHANE 1.00 X 0 0 0 SR MARGARET MCCARTHY - SND 1.00 X 0 0 0 MS KATHLEEN O'CONNOR 1.00 X 0 0 0 MS LEE NORTON KELLY 1.00 X 0 0 0 MS KATHLEEN FISHER 1.00 X 0 0 0 MS MARGARET COFFIN 40.00 X X 81143 0 1050 MS KATHERINE LEMAY 40.00 X X 153648 0 12464 MR JOHN LIND 1.00 X 0 0 0 MR GARTH JOHNSON 1.00 X 0 0 0 MS JACQUELYN MCCARTHY 1.00 X 0 0 0 ROBERT LIAN 1.00 X 0 0 0 SR ANDREA WALSH SND 1.00 X X 0 0 0 MS MELISSA MOORE 1.00 X 0 0 0 SR ELLEN AGRITELLEY SND 1.00 X X 0 0 0 MS KAREN RIZZO 40.00 X 144997 0 9587 SR FRANCIS ELLEN ULRICH SND 1.00 X 0 0 0 SUSANNE STAUFFER 1.00 X 0 0 0 PATRICIA CAMPBELL 32.00 X 67513 0 3472 MR STEPHEN TOTINO 40.00 X 89212 0 10364 MS DEBRA FORSS 40.00 X 132166 0 2093 BEVERLY AMOSAH 40.00 X 103414 0 11553 772093 0 50583 4 0 1 0 HEALTHPRO MANAGEMENT INC 10600 YORK ROAD SUITE 105 COCKEYSILLE MD 21030 REHAB THERAPY SERVICES 583462 1 103085 103085 NURSING HOME REVENUE 623000 13321289 13321289 ASSISTED LIVING REVENU 623000 5301675 5301675 HOSPICE REVENUE 623000 1385531 1385531 EDUCATION CENTER 623000 109245 109245 20117740 310453 310453 1888931 1855257 33674 33674 33674 MISC. REVENUE-RELATED- 623000 14723 14723 14723 20579675 20132463 0 344127 431189 70985 360204 9631153 9062595 568558 31830 29471 2359 1295870 1220580 75290 729456 661033 68423 8376 8376 74650 74650 291632 176739 114893 94129 94129 254076 252478 1598 1599629 1599629 32275 32275 9144 9144 881809 881809 341732 297089 44643 PATIENT CARE EXPENSES 2298018 2298018 USER FEE 769299 769299 HOSPICE EXPENSES 335606 335606 EDUCATION CENTER 98283 98283 150218 150218 19358374 18039379 1318994 0 1801405 3205362 1385470 1249073 2297984 1834263 0 0 153045 161128 31636388 11702767 19922615 19933621 8418555 8928890 1558827 832173 35537901 36144510 1951807 1561443 15077 112431 17250000 16525000 2406671 4153422 21623555 22352296 X 13873215 13720085 41131 72129 13914346 13792214 35537901 36144510 X 1221301 -1343433 X X 0 1 1 X 0 X 12357 36642 29398 67437 60770 206604 16637473 17804725 18342745 19244665 20174779 92204387 16649830 17841367 18372143 19312102 20235549 92410991 35000 25000 60000 0 35000 25000 60000 92350991 432517 305680 263905 342949 344127 1689178 432517 305680 263905 342949 344127 1689178 17082347 18147047 18636048 19655051 20579676 94100169 0.98140 0.99230 0.01800 0.00770 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1800 1800 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATION X 1 3.20 0 0 0 1 0 104.00 0 41131 30998 72129 14839 26292 41131 8966 9367 3494 14839 0.00000 0.00000 1.00000 0 0 2625000 2625000 25517339 9150761 16366578 2996304 2293749 702555 497745 258257 239488 19933621 EQUITIES 2303076 F FIXED INCOME SECURITIES 6483395 F GOLD - FUND 142419 F 8928890 UNREALIZED LOSS - INTEREST RATE SWAP 3786322 DEPOSITS FROM TENNANTS 367100 4153422 20579675 19358374 1221301 36220 -1379653 -1343433 -122132 20405973 36220 36220 20369753 209922 209922 20579675 20528105 1379654 1379654 19148451 209923 209923 19358374 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE TO BE USED FOR CHAPEL WINDOWS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE COMPANY 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 COMPANY FILES AS A TAX-EXEMPT ORGANIZATION. THE ENTITY'S 2008 THROUGH 2011 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: UNREALIZED LOSS ON INTEREST RATE SWAP -1,379,651. ROUNDING -2. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,379,653. PART XII, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED GAIN ON INTEREST RATE SWAP PART XII, LINE 4B - OTHER ADJUSTMENTS: NON OPERATING REVENUE NET AGAINST EXPENSES 209,923. ROUNDING -1. PART XIII, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED LOSS ON INTEREST RATE SWAP 1,379,651. ROUNDING 3. PART XIII, LINE 4B - OTHER ADJUSTMENTS: NON OPERATING REVENUE NET AGAINST EXPENSES 209,923. ROUNDING X X 0 0 0 0 0 0 0 0 0 MS KATHERINE LEMAY 153648 0 0 0 0 0 0 0 12464 0 166112 0 0 0 MS KAREN RIZZO 144997 0 0 0 0 0 0 0 9587 0 154584 0 0 0 GARTH JOHNSON DIRECTOR OF THIS ORGANIZATION 201737 IS EMPLOYED BY A CONTRACTOR WHICH RECEIVED FEES FROM THE ORGANIZATION. 0 DAVID PUTNAM MEMBER OF THE FINANCE COMMITTEE 24380 IS EMPLOYED BY AN INVESTMENT FIRM WHICH RECEIVED FEES FROM THE ORGANIZATION. 0 MARY CULHANE DIRECTOR OF THIS ORGANIZATION 16250 IS EMPLOYED BY A CONSULTING FIRM WHICH RECEIVED FEES FROM THE ORGANIZATION. 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S CONTROLLER REVIEWS THE FORM 990 AND SENDS A COPY OF THE DRAFT TAX RETURN TO EACH BOARD MEMBER BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES AND BOARD OF DIRECTORS ARE SUBJECT TO THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. DETERMINATIONS ARE MADE AT THE MANAGEMENT LEVEL AND REVIEWED WITH THE ORGANIZATIONAL INTEGRITY OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS USED TO ESTABLISH THE COMPENSATION OF THE ADMINISTRATOR AND EXECUTIVE DIRECTOR INCLUDES, REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THIS IS DONE ON AN ANNUAL BASIS BY THE BOARD OF DIRECTORS. 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: 36,220. UNREALIZED LOSS ON INTEREST RATE SWAP -1,379,651. ROUNDING -2. TOTAL TO FORM 990, PART XI, LINE 5: -1,343,433. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT OR REVIEW PROCESS FROM THE PRIOR YEAR.