2011-08-04T12:27:13-05:00 2010-12-31 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2010-01-01 042565937 ST JOSEPH MANOR HEALTH CARE INC STJO 5085835834 215 THATCHER STREET BROCKTON MA 023023949 JOHN CORLISS 5085835834 2011-07-27 1 MICHAEL A BARBARITA 6036228881 2010 2016-03-07 17:11:31Z JOHN CORLISS 215 THATCHER STREET BROCKTON MA 023023949 11381775 0 X SJMBROCKTON.ORG X 1975 MA OUR CATHOLIC MINISTRY OF COMPASSIONATE HEALTHCARE PROVIDES PERSON-CENTERED SERVICES TO PEOPLE OF ALL FAITHS IN OUR HOME AND WITHIN OUR COMMUNITY. 14 13 281 15 0 0 8963 29563 10283451 11232303 28403 50434 14713 37290 10335530 11349590 0 0 0 0 6669067 6506933 0 0 0 3968605 4395183 10637672 10902116 -302142 447474 4961570 5210806 1159901 862681 3801669 4348125 OUR CATHOLIC MINISTRY OF COMPASSIONATE HEALTHCARE PROVIDES PERSON-CENTERED SERVICES TO PEOPLE OF ALL FAITHS IN OUR HOME AND WITHIN OUR COMMUNITY. 0 0 10625088 11244583 ST. JOSEPH MANOR PROVIDED 40,707 DAYS OF SKILLED NURSING CARE TO PATIENTS FROM ALL ECONOMIC, RELIGIOUS AND ETHNIC GROUPS DURING 2010. A TOTAL OF 29,289 DAYS WERE PROVIDED TO MEDICAID RESIDENTS. 10625088 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 15 0 281 1 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X X JOHN CORLISS INTERIM CEO 5085835834 215 THATCHER STREET BROCKTON MA 02302 SR MARY VALLIERE 1.00 X X 0 0 0 PATRICIA SHAHEEN 3.00 X X 0 0 0 DAVID KELLIHER 1.00 X X 0 0 0 VANESSA TIERNEY 1.00 X X 0 0 0 SR RUTH DAUGINIKAS 1.00 X X 0 0 0 SR EUGENIA GLINECKIS 1.00 X 0 0 0 PAUL ARENBURG 1.00 X 0 0 0 AISHA BONNY 1.00 X 0 0 0 ANNA WILLIAMS COTE 1.00 X 0 0 0 JOHN DRUSINSKAS 1.00 X 0 0 0 PEG FEODOROFF 1.00 X 0 0 0 JEAN MACNEILL CRRN 1.00 X 0 0 0 KENNETH OLIVIERI 1.00 X 0 0 0 ANNE DEMINICO 40.00 X X 105448 0 30393 SR ELIZABETH ZEMAITIS 1.00 X 0 0 0 REV JOSEPH MCGLONE 1.00 X 0 0 0 105448 0 30393 1 0 0 0 PEOPLEFIRST REHABILITATION 680 SOUTH FOURTH ST LOUISVILLE KY 40202 PATIENT REHABILITATION THERAPY 553178 PHARMERICA 1123 PEARL STREET BROCKTON MA 02301 PHARMACY SERVICES 294847 ADVANCED LINEN SERVICE 65 MANCHESTER ST LAWRENCE MA 01841 LAUNDRY SERVICES 193867 COVENANT HEALTH SYSTEMS 100 AMES POND SUITE 102 TEWKSBURY MA 01876 MANAGEMWNT SERVICES 189511 SOUTH SHORE COMMUNITY ACTION COUNCIL 265 SO MEADOW ROAD PLYMOUTH MA 02360 TRANSPORTATION SERVICES 166605 5 29563 29563 PATIENT SERVICE REVENU 623000 11232303 11232303 11232303 50434 50434 57195 32185 25010 25010 ADMINISTRATIVE FEES 623000 6500 6500 REBATES / OTHER INCOME 623000 5780 5780 12280 11349590 11244583 0 75444 105448 105448 5493053 5493053 16594 16594 473511 473511 418327 410227 8100 130404 130404 7874 7874 17539 17539 7663 7663 1324447 1324447 15989 15989 53614 53614 35237 35237 458013 458013 8283 8283 9894 9894 221129 221129 141322 141322 PATIENT RELATED SUPPLIE 1061676 1061676 MEDICAID PROVIDER TAX 663712 663712 BAD DEBT EXPENSE 216000 216000 FEES 18187 18187 CONTRIBUTIONS 4200 4200 10902116 10625088 277028 0 106982 255403 1192674 1146730 7350 10650 146459 37903 4822765 2849633 1859580 1973132 1622362 1759101 26163 27887 4961570 5210806 936770 834794 200000 23131 27887 1159901 862681 X 3789750 4331213 11919 16912 3801669 4348125 4961570 5210806 X 447474 98982 X 0 1 0 X 0 X 40707 66873 30405 8963 13963 160911 9498313 10338800 10660763 10283451 11232303 52013630 9539020 10405673 10691168 10292414 11246266 52174541 0 0 0 52174541 42126 61576 38669 46547 50434 239352 42126 61576 38669 46547 50434 239352 18220 17296 65809 104 12280 113709 9599366 10484545 10795646 10339065 11308980 52527602 0.99330 0.99410 0.00460 0.00420 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11919 15600 10607 16912 1.00000 0 0 2697671 1344483 1353188 1801101 1441909 359192 323993 63241 260752 1973132 MANAGED INVESTMENTS 1759101 F 1759101 RESIDENT FUNDS 27887 27887 11349590 10902116 447474 93989 4993 98982 546456 11443579 93989 93989 11349590 0 11349590 10902116 0 10902116 0 10902116 PART XI, LINE 8 - OTHER ADJUSTMENTS: INCREASE IN TEMP RESTRICTED NET ASSETS 4,993. GOLF TOURNEMENT 20875 20875 8200 LABOR DAY PICNIC 29406 29406 18277 2 6914 6914 5707 57195 57195 32184 32184 25011 BART MURPHY 215 THATCHER STREET BROCKTON MA 02302 EXPLANATION OF FUNDRAISING PAYMENTS SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE ORGANIZATION DOES NOT USE A PROFESSIONAL FUNDRAISER X X X X 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 ST JOSEPH MANOR IS RELATED TO THE POOR SISTERS OF JESUS CRUCIFIED AND THE SORROWFUL MOTHER, INC. WHO IS A CLASS A MEMBER. FORM 990, PART VI, SECTION A, LINE 7A ST JOSEPH MANOR IS RELATED TO THE POOR SISTERS OF JESUS CRUCIFIED AND THE SORROWFUL MOTHER, INC. WHO IS A CLASS A MEMBER FORM 990, PART VI, SECTION A, LINE 7B ST. JOSEPH MANOR IS RELATED TO THE POOR SISTERS OF JESUS CRUCIFIED AND THE SORROWFUL MOTHER, INC. WHO IS A CLASS A MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED IN DETAIL BY THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A FULL-TIME DESIGNATED ORGANIZATIONAL INTEGRITY OFFICER THAT MONITORS OPERATIONS TO DETECT AND/OR RESOLVE CONFLICT OF INTEREST ISSUES. FORM 990, PART VI, SECTION B, LINE 15 EVERY TWO TO THREE 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. THE SPECIFIC OBJECTIVES OF THE ANALYSIS ARE TO ASSESS THE COMPETITIVENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR LEADERSHIP TEAM; DEVELOP MARKET COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF ANY, ARE COMPETITIVE AND REASONABLE. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS POSTED ON COVENANT HEALTH SYSTEMS' WEBSITE. IT IS ALSO AVAILABLE AT THE FACILITY UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 ST. JOSEPH MANOR 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: 93,989. INCREASE IN TEMP RESTRICTED NET ASSETS 4,993. TOTAL TO FORM 990, PART XI, LINE 5: 98,982. COVENANT HEALTH SYSTEMS 100 AMES POND SUITE 102 TEWKSBURY MA 01876 222484505 MANAGEMENT MA 501(C) 509(A)(2) 0 POOR SISTERS OF JESUS CRUCIFIED AND THE SORROWFUL MOTHER 261 THATCHER ST BROCKTON MA 02302 LESSOR OF FACILITY MA EXEMPT RELIGIOUS 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 COVENANT HEALTH SYSTEMS A 189511 CASH SISTERS OF JESUS CRUCIFIED AND THE SORROWFUL MOTHER J 282004 CASH