MASONICARE HOME HEALTH AND HOSPICE INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MASONICARE HOME HEALTH AND HOSPICE INC (EIN 06-1101924)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-10
IRS object ID
201132229349301328
Schema version
2009v1.7
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)
Timestamp2011-08-10T11:10:55-07:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN061101924EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Masonicare Home Health and Hospice IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMASONameControl
Phone2036787857Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line133 North Plains RoadAddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameR Scott ThelenName
TitleAsst. TreasurerTitle
Date Signed2011-08-10DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts33576580GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web SiteWWW.MASONICARE.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1999YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionSee Schedule OActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees648TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year105110ContributionsGrantsPriorYear
Contributions Grants Current Year72921ContributionsGrantsCurrentYear
Program Service Revenue Prior Year38048639ProgramServiceRevenuePriorYear
Program Service Revenue CY33500476ProgramServiceRevenueCY
Investment Income Prior Year-4696InvestmentIncomePriorYear
Investment Income Current Year3061InvestmentIncomeCurrentYear
Other Revenue Prior Year189OtherRevenuePriorYear
Other Revenue Current Year122OtherRevenueCurrentYear
Total Revenue Prior Year38149242TotalRevenuePriorYear
Total Revenue Current Year33576580TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year96728GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY47782GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year28560654SalariesEtcPriorYear
Salaries Etc Current Year24552649SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8637279OtherExpensePriorYear
Other Expenses Current Year6778393OtherExpensesCurrentYear
Total Expenses Prior Year37294661TotalExpensesPriorYear
Total Expenses Current Year31378824TotalExpensesCurrentYear
Revenues Less Expenses Prior Year854581RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2197756RevenuesLessExpensesCY
Total Assets BOY10175816TotalAssetsBOY
Total Assets EOY6886205TotalAssetsEOY
Total Liabilities BOY5407934TotalLiabilitiesBOY
Total Liabilities EOY4892213TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4767882NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1993992NetAssetsOrFundBalancesEOY
Mission DescriptionSee Schedule OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense26355954Expense
Revenue30341014Revenue
DescriptionMasonicare Home Health and Hospice, Inc. provides home health services to clients of all ages including: skilled nursing care, hospice, physical, speech and occupational therapies, medical social work and home health aid services. The total MHH&H, Inc care of sick visits for the period ended September 30, 2010 were 205,693 and total visits for Hospice were 36,768. Total patients served were 4,633 for Care of Sick and 1,042 for Hospice.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Revenue3094000Revenue
DescriptionMHH&H, Inc. provides management services to Masonicare Partners Home Health and Hospice, Inc. Partners is an affiliate that is jointly owed with St. Francis Medical Center. The mission of Partners is to provide home health servies to clients of all ages in the greater Hartford area.Description
FieldValueIRS element (for citing)
Total Program Service Expense26355954TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109638NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees648NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledCTStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonR Scott ThelenNamePerson
Telephone Number2036787857TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line122 Masonic AvenueAddressLine1
CityWallingfordCity
StateCTState
ZIP Code06492ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Theodore Nelson
Treasurer1.00XX000
Susan Shikoluk
RN Per Visit40.0011630900X
Steven Abati
Member1.00X000
Stephen B McPherson
Asst Secretary40.00XX082253618755
R Scott Thelen
Asst. Treasurer40.00X01204381251
Paul L Chello
Member1.00X000
Paul Dinwoodie
Physical Therapist0.10530000X
Paul A Edberg
Member1.00X000
Merri Chartier
RN-Case Manager40.0012123300X
Maura McQueeney
President,Home Care0.0154822231X
Mary Lou Roos
President40.00XX7247202018
Lori Perry
RN-Case Manager40.0013945500X
Kris Azu
RN Per Visit40.0013467200X
Jeff Flynn
Member1.00X000
James Standish
Senior VP/CFO0.038848714765X
Geoffrey L Ice
Member1.00X000
Francis X Conlon
Chairman1.00XX000
Edgar Albuja
Secretary1.00XX000
Donald Gladding
Member1.00X000
Christopher Earle
Vice Chairman1.00XX000
Alexander Jarvis
Member1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org689441TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1486283TotalReportableCompFrmRltdOrgs
Total Other Compensation37020TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MCKESSON
PO BOX 98347ChicagoIL606960398COMPUTER SUPPORT294254
Masonicare Inc
PO Box 70WallingfordCT06492Management services441612
LARSON ALLEN
300 CROWN COLONY DRIVEQUINCYMA02169CONSULTING SERVICES272765
Delta Dental Plan of New Jersey
PO Box 23700NewarkNJ071890001Dental Ins. Services269406
CGLIC-BLOOMFIELD EASC
5082 Collection Center DriveChicagoIL60693Insurance services428675
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Related Organizations23938RelatedOrganizations
All Other Contributions48983AllOtherContributions
Total Contributions72921TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient Service Revenue6216103040647630406476
Management fees62161030940003094000
FieldValueIRS element (for citing)
Total Program Service Revenue33500476TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3140TotalRevenueColumn
Exclusion$3,140ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities-79Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-79Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-79TotalRevenueColumn
Exclusion-$79ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionVending MachineDescription
Total Revenue Column122TotalRevenueColumn
Exclusion$122ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue122TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column33576580TotalRevenueColumn
Related Or Exempt Function Income33500476RelatedOrExemptFunctionIncome
Exclusion$3,183ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total47782Total
Program Services47782ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total99380Total
Management And General99380ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total19235125Total
Program Services16910476ProgramServices
Management And General2324649ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3962808Total
Program Services3960613ProgramServices
Management And General2195ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1255336Total
Program Services1097950ProgramServices
Management And General157386ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total441612Total
Management And General441612ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total9224Total
Management And General9224ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total26562Total
Management And General26562ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total98232Total
Management And General98232ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total10756Total
Program Services514ProgramServices
Management And General10242ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total485939Total
Program Services485939ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total729500Total
Program Services682337ProgramServices
Management And General47163ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total460783Total
Program Services460783ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total254442Total
Program Services251963ProgramServices
Management And General2479ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Supplies Other89341181427779134
Repairs & maintenance40125031309388157
Purchased Services508811231755277056
Other Professional Fees930750930750
I/P General Hospice349430349430

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1177691Total
Program Services749042ProgramServices
Management And General428649ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total31378824Total
Program Services26355954ProgramServices
Management And General5022870ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2385BOY
EOY1950EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3897500BOY
EOY3042608EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY237539BOY
EOY241288EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6188945LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4866064LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1725081BOY
EOY1322881EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4313311BOY
EOY2277478EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY10175816BOY
EOY6886205EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2421353BOY
EOY1927585EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY805274BOY
EOY852215EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2181307BOY
EOY2112413EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5407934BOY
EOY4892213EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4767882BOY
EOY1993992EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4767882BOY
EOY1993992EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10175816BOY
EOY6886205EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years292410CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years306251CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years114636CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year105110CurrentTaxYearMinus1Year
Current Tax Year72921CurrentTaxYear
Total891328Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years47618687CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years39407179CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years37974054CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year38048639CurrentTaxYearMinus1Year
Current Tax Year33500476CurrentTaxYear
Total196549035Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years47911097CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years39713430CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years38088690CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year38153749CurrentTaxYearMinus1Year
Current Tax Year33573397CurrentTaxYear
Total197440363Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509197440363PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8199CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4091CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3246CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3246CurrentTaxYearMinus1Year
Current Tax Year3140CurrentTaxYear
Total21922Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8199CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4091CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3246CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3246CurrentTaxYearMinus1Year
Current Tax Year3140CurrentTaxYear
Total21922Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Total197462285Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99990PublicSupportPercentage509
Prior Year Support Percentage1.00000PriorYearSupportPercentage
Investment Income Percentage0.00010InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1297102OtherCostOrOtherBasis
Depreciation522561Depreciation
Book Value774541BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis352250OtherCostOrOtherBasis
Depreciation340660Depreciation
Book Value11590BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4269694OtherCostOrOtherBasis
Depreciation3764722Depreciation
Book Value504972BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis269899OtherCostOrOtherBasis
Depreciation238121Depreciation
Book Value31778BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1322881TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Other receivables4421
OTHER
Investments2273057
FieldValueIRS element (for citing)
Total Book Value Other Assets2277478TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Rounding$2
Reserve for third party settlements$2,112,411
FieldValueIRS element (for citing)
Total Of Amounts2112413TotalOfAmounts

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
No Grant More Than5000XNoGrantMoreThan5000
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
Quality of Life3478Market ValuesHome Health Care Equipment
Charity Care9433755Market ValueHome Health & Hospice

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
Stephen B McPherson
4661633207263564718755841291
Maura McQueeney
154822231155053
James Standish
3232016514314314765403252

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 7Identifier
Return ReferencePart I, Line 7: Non-Fixed payments not listed aboveReturnReference

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe financial statements are publicly available throught EMMA and public securities markets. The statements are included in the Masonicare Corporation consolidated financial statements. The governing documents (certificate of incorporation) is filed with the Ct Secretary of State. The conflict of interest policy is currently available upon request.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAnnually, officers, directors and senior employees are required to complete a conflict of interest disclosure questionnaire. the results of the officers' and directors' disclosures are reported at the board meetings. Senior employee disclosures are reported to the President. The entire process is coordinated by the Corporate Compliance Officer. All respondents are advised to report any changes during the year that may present a conflict of interest.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessMasonicare Corporation and Masonicare Home Health and Hospice review the tax return for completeness and accuracy. It is also reviewed by the chief executive officer and chairman of the board. The review process is then discussed with full board. After responding to comments/questions, changes are made as appropriate and the return is finalized and filed.
Form 990, Part VI, Line 7aForm 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyMasonicare Corporation, a sole corporate member, annually appoints the members of the affiliate board.
Form 990, Part VI, Line 6Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe organization has a sole corporate member, Masonicare Corporation, with the right to appoint the members of the governing body and to participate in the organizations governance.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Masonicare at Home
PO Box 70WallingfordCT06492202377783Providecompanion/homemaker/personal care services to elderlyCT501(c)(3)9NA
Masonicare at Newtown Inc
PO Box 70WallingfordCT06492061070285Provide skilled nursing/assisted living services to elderlyCT501(c)(3)9NA
Keystone Indemnity Company Ltd
126 College Street Suite 400BurlingtonVT05401030371612Provide insurance services to Masonicare affilatesVT501(c)(3)11aNA
Masonicare Partners HomeHealth & Hospice
111 Founders Plaza Suite 200East HartfordCT06492260758992Provide home/health/hospice services to clients of all agesCT501(c)(3)9NA
Masonicare at Ashlar Village Inc
PO Box 70WallingfordCT06492061050830Continuing care retirement and assisted living communityCT501(c)(3)9NA
Masonicare Health Center
PO Box 70WallingfordCT06492060655131Provide comprehensive medical services to the elderlyCT501(c)(3)3NA
Masonic Charity Foundation of CT
PO Box 70WallingfordCT06492061435920Provide planned giving and development support to affiliatesCT501(c)(3)11aNA
Masonicare Inc
PO Box 70WallingfordCT06492061435920Parent holding and support organization of affilate corp.CT501(c)(3)11aNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntity
Masonicare Behavioral Healh
67 Masonic AveWallingfordCT06492061483276Drs Practice Psychiatric SvsCTN/AC
Masonicare Primary Care Physicians PC
67 Masonic AveWallingfordCT06492061491820Physician medical practiceCTN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Masonicare at Home
r82803
Masonicare at Newtown Inc
r183311
Masonicare Health Center
r1492273
Masonic Charity Foundation of CT
q37331
Masonicare Inc
q10941060

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