FAIRHAVEN HEALTHCARE CENTER INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
FAIRHAVEN HEALTHCARE CENTER INC (EIN 20-8745264)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201123189349304492
Schema version
2010v3.4
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)
Timestamp2011-11-14T14:11:21-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LARSONALLEN 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 Date2010-01-01TaxPeriodBeginDate

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 Signed2011-11-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBARBARA J MORRISONName
Phone6179848100Phone
Date Prepared2011-10-28DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line135 AVCO ROADAddressLine1
CityHAVERHILLCity
StateMAState
ZIP Code01835ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14173675GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
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 Employees324TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14053991ProgramServiceRevenuePriorYear
Program Service Revenue CY14081534ProgramServiceRevenueCY
Investment Income Prior Year40060InvestmentIncomePriorYear
Investment Income Current Year62947InvestmentIncomeCurrentYear
Other Revenue Prior Year32301OtherRevenuePriorYear
Other Revenue Current Year29194OtherRevenueCurrentYear
Total Revenue Prior Year14126352TotalRevenuePriorYear
Total Revenue Current Year14173675TotalRevenueCurrentYear
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 Year7419144SalariesEtcPriorYear
Salaries Etc Current Year7421992SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6764960OtherExpensePriorYear
Other Expenses Current Year6675253OtherExpensesCurrentYear
Total Expenses Prior Year14184104TotalExpensesPriorYear
Total Expenses Current Year14097245TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-57752RevenuesLessExpensesPriorYear
Revenues Less Expenses CY76430RevenuesLessExpensesCY
Total Assets BOY30229531TotalAssetsBOY
Total Assets EOY32585468TotalAssetsEOY
Total Liabilities BOY30212150TotalLiabilitiesBOY
Total Liabilities EOY32536918TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY17381NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY48550NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE LONG-TERM NURSING CARE TO THE ELDERLYMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11625051Expense
Revenue14110728Revenue
DescriptionA 169-BED SKILLED NURSING FACILITY PROVIDING NURSING CARE TO THE ELDERLY.Description
Total Program Service Expense11625051TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Footnote0ReportFin48Footnote
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 Activities0FundraisingActivities
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 With109611NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees324NumberOfEmployees
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 CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
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
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

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
ADMINISTRATOR40.0010153000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org101530TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
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 ROADHAVERHILLMA01835MANAGEMENT COMPANY782901
PREFERRED PHARMACY SOLUTIONS
35 AVCO ROADHAVERHILLMA01835PHARMACY SERVICES385678
PERFORMANCE HEALTHCARE SOLUTIONS
47 RIVER STREETWELLESLEYMA02481LAUNDRY/HOUSEKEEPING PURCHASED SERVICE353287
GERIATRIC MEDICAL
PO BOX 6027CHELSEAMA02150MEDICAL SUPPLIES194068
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROG.SERV.REVENUE-RELADescription
Business Code623000BusinessCode
Total Revenue Column14081534TotalRevenueColumn
Related Or Exempt Function Income14081534RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue14081534TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column62947TotalRevenueColumn
Exclusion$62,947ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS INCOMEDescription
Business Code623000BusinessCode
Total Revenue Column29194TotalRevenueColumn
Related Or Exempt Function Income29194RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue29194TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14173675TotalRevenueColumn
Related Or Exempt Function Income14110728RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$62,947ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6457533Total
Program Services6173626ProgramServices
Management And General283907ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total472439Total
Program Services451668ProgramServices
Management And General20771ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total492020Total
Program Services470388ProgramServices
Management And General21632ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total729084Total
Management And General729084ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total151805Total
Management And General151805ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total24250Total
Management And General24250ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total633873Total
Program Services633873ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total33834Total
Program Services33834ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total83656Total
Management And General83656ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2195648Total
Program Services2195648ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total18510Total
Management And General18510ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total548191Total
Program Services548191ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total89248Total
Management And General89248ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
USER FEE953114953114
MEDICAL SUPPLIES764611764611
FOOD308548308548
BAD DEBTS7422674226
MISCELLANEOUS2199121991

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total44664Total
Program Services44664ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14097245Total
Program Services11625051ProgramServices
Management And General2472194ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3070BOY
EOY11861EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2486789BOY
EOY2425579EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1496604BOY
EOY1712265EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY37986BOY
EOY40215EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis20154294LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1556226LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY62791BOY
EOY18598068EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2887091BOY
EOY4901206EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2932083BOY
EOY2932083EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY20323117BOY
EOY1964191EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY30229531BOY
EOY32585468EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1514554BOY
EOY1490591EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY26766749BOY
EOY29408933EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1930847BOY
EOY1637394EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY30212150BOY
EOY32536918EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY17381BOY
EOY48550EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17381BOY
EOY48550EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY30229531BOY
EOY32585468EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses76430ReconcilationRevenueExpenses
Reconcilation Other Changes-45261ReconcilationOtherChanges
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
Public Support Total5090PublicSupportTotal509

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Total0Total
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
Depreciation1395076Depreciation
Book Value16226924BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis29248OtherCostOrOtherBasis
Depreciation2190Depreciation
Book Value27058BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis545046OtherCostOrOtherBasis
Depreciation158960Depreciation
Book Value386086BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18598068TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCING COSTS1379706
CONSTRUCTION IN PROCESS584485
FieldValueIRS element (for citing)
Total Book Value Other Assets1964191TotalBookValueOtherAssets

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 FundAmountInReserveFundAmount RetiredAmountRetired
1982687118927379341420070011
80511405183387200700112867753
147554071475540720070011
1685472168547220070011808859

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00000
00000
00000
00000

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
00000
00000
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

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

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION IS MANAGED BY PLATINUM CARE LLC.
FORM 990, PART VI, SECTION B, LINE 11PRIOR TO FILING, THE TAX RETURN IS REVIEWED BY THE CFO AND ACCOUNTING MANAGER OF THE MANAGEMENT COMPANY FOR FAIRHAVEN. ONCE APPROVED, THE TAX RETURN IS SENT TO THE PRESIDENT OF THE BOARD OF DIRECTORS FOR REVIEW AND SIGNATURE.
THE ORGANIZATION HAS A CORPORATE COMPLIANCE PLAN WHICH INCLUDES THE MONITORING OF ITS CONFLICT OF INTEREST POLICY.FORM 990, PART VI, SECTION B, LINE 12C
COMPENSATION IS DETERMINED BY THE MANAGEMENT COMPANY.FORM 990, PART VI, SECTION B, LINE 15
FINANCIAL STATEMENTS ONLY ARE MADE AVAILABLE ON MSRB EMMA WEBSITE.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED LOSSES ON INVESTMENTS: -45,261.FORM 990, PART XI, LINE 5:

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 ROADHAVERHILLMA01835321012491LONG-TERM CAREMA501(C)(3)LINE 90
LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY
25 LAFAYETTE STREETMARBLEHEADMA01945208745166SKILLED NURSING FACILITYMA501(C)(3)LINE 91ADVENTCARE 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 Org1OtherTransferFromOtherOrg

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