2011-11-14T14:11:21-06:00 2010-12-31 LARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2010-01-01 208745264 FAIRHAVEN HEALTHCARE CENTER INC C/O PLATINUM CARE LLC FAIR 9784201500 35 AVCO ROAD HAVERHILL MA 01835 JOEL E KIRCHICK 9784201500 2011-11-10 1 BARBARA J MORRISON 6179848100 2011-10-28 2010 2016-02-24 21:20:13Z JOEL E KIRCHICK 35 AVCO ROAD HAVERHILL MA 01835 14173675 0 X N/A X 2007 MA TO PROVIDE LONG-TERM NURSING CARE TO THE ELDERLY. 6 6 324 0 0 0 0 0 14053991 14081534 40060 62947 32301 29194 14126352 14173675 0 0 0 0 7419144 7421992 0 0 0 6764960 6675253 14184104 14097245 -57752 76430 30229531 32585468 30212150 32536918 17381 48550 TO PROVIDE LONG-TERM NURSING CARE TO THE ELDERLY 0 0 11625051 14110728 A 169-BED SKILLED NURSING FACILITY PROVIDING NURSING CARE TO THE ELDERLY. 11625051 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 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 0 0 1 0 0 0 0 1 11 0 324 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X PLATINUM CARE LLC 9784201500 35 AVCO ROAD HAVERHILL MA 01835 X JOEL KIRCHIK 1.00 X X 0 0 0 JOHN REGAN 1.00 X X 0 0 0 PATRICIA TORTELLA 1.00 X 0 0 0 RAYMOND DENNEHY 1.00 X X 0 0 0 JOANNE FREEDMAN SPECTOR 1.00 X 0 0 0 DAVID O'DONNELL 1.00 X 0 0 0 ALEX STRUZZIERO 40.00 X 101530 0 0 101530 0 0 1 0 0 0 PLATINUM CARE LLC 35 AVCO ROAD HAVERHILL MA 01835 MANAGEMENT COMPANY 782901 PREFERRED PHARMACY SOLUTIONS 35 AVCO ROAD HAVERHILL MA 01835 PHARMACY SERVICES 385678 PERFORMANCE HEALTHCARE SOLUTIONS 47 RIVER STREET WELLESLEY MA 02481 LAUNDRY/HOUSEKEEPING PURCHASED SERVICE 353287 GERIATRIC MEDICAL PO BOX 6027 CHELSEA MA 02150 MEDICAL SUPPLIES 194068 4 PROG.SERV.REVENUE-RELA 623000 14081534 14081534 14081534 62947 62947 MISCELLANEOUS INCOME 623000 29194 29194 29194 14173675 14110728 0 62947 6457533 6173626 283907 472439 451668 20771 492020 470388 21632 729084 729084 151805 151805 24250 24250 633873 633873 33834 33834 83656 83656 2195648 2195648 18510 18510 548191 548191 89248 89248 USER FEE 953114 953114 MEDICAL SUPPLIES 764611 764611 FOOD 308548 308548 BAD DEBTS 74226 74226 MISCELLANEOUS 21991 21991 44664 44664 14097245 11625051 2472194 0 3070 11861 2486789 2425579 1496604 1712265 37986 40215 20154294 1556226 62791 18598068 2887091 4901206 2932083 2932083 20323117 1964191 30229531 32585468 1514554 1490591 26766749 29408933 1930847 1637394 30212150 32536918 X 17381 48550 17381 48550 30229531 32585468 X 76430 -45261 X 0 1 0 X 0 X 0 0 X 0.00000 1958000 1958000 17622000 1395076 16226924 29248 2190 27058 545046 158960 386086 18598068 DEFERRED FINANCING COSTS 1379706 CONSTRUCTION IN PROCESS 584485 1964191 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A 043431814 57585AAA8 2007-10-25 1982687 PURCHASE FACILITIES 0 0 0 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A 043431814 57585AAB6 2007-10-25 8051140 PURCHASE FACILITIES 0 0 0 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007A 043431814 57585AAC4 2007-10-25 14755407 PURCHASE FACILITIES 0 0 0 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007B 043431814 57585AAD2 2007-10-25 1685472 PURCHASE FACILITIES 0 0 0 1982687 1189273 793414 2007 0 0 1 1 8051140 2867753 5183387 2007 0 0 1 1 14755407 14755407 2007 0 0 1 1 808859 1685472 1685472 2007 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007D 043431814 2007-10-25 2038290 PURCHASE FACILITIES 0 0 0 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2007F 043431814 2007-10-25 760798 PURCHASE FACILITIES 0 0 0 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY - SERIES 2010 043431818 2010-07-14 2640000 PROJECT REHAB 0 0 0 2038290 19338 2018952 2007 0 0 1 1 760798 760798 2007 0 0 1 1 2640000 2640000 2010 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION IS MANAGED BY PLATINUM CARE LLC. FORM 990, PART VI, SECTION B, LINE 11 PRIOR 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. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CORPORATE COMPLIANCE PLAN WHICH INCLUDES THE MONITORING OF ITS CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY THE MANAGEMENT COMPANY. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ONLY ARE MADE AVAILABLE ON MSRB EMMA WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -45,261. ADVENTCARE INC 35 AVCO ROAD HAVERHILL MA 01835 321012491 LONG-TERM CARE MA 501(C)(3) LINE 9 0 LAFAYETTE REHABILITATION AND SKILLED NURSING FACILITY 25 LAFAYETTE STREET MARBLEHEAD MA 01945 208745166 SKILLED NURSING FACILITY MA 501(C)(3) LINE 9 ADVENTCARE INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1