2011-11-15T12:36:00-06:00 2010-12-31 LARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2010-01-01 042696489 SALEM COMMUNITY CORPORATION SALE 5088522670 65 BRIARWOOD CIRCLE WORCESTER MA 01606 JOHN ZOLTOWSKI 5088522670 2011-11-10 1 BARBARA J MORRISON 6179848100 2011-11-08 2010 2016-03-07 17:11:31Z JOHN ZOLTOWSKI 65 BRIARWOOD CIRCLE WORCESTER MA 01606 20138120 0 X WWW.BRIARWOODRETIREMENT.COM X 1974 MA PROVIDES HOUSING, HEALTH, WELLNESS AND SUPPORTIVE SERVICES FOR THE ELDERLY. 20 20 277 99 0 0 34705 139899 12103028 12785030 440513 1194052 0 28032 12578246 14147013 0 0 0 0 6937139 7040245 0 0 0 6779851 6926111 13716990 13966356 -1138744 180657 44791168 45615440 56009915 58145402 -11218747 -12529962 BRIARWOOD'S MISSION IS TO ENHANCE THE WELL-BEING, INDEPENDENCE AND PERSONAL FULFILLMENT OF ITS RESIDENTS AND OTHER SENIORS BY PROVIDING EXCELLENT HOUSING, HEALTH, WELLNESS AND SUPPORTIVE SERVICES CONSISTENT WITH THE CARING SPIRIT OF THE FOUNDING CHURCHES. 0 0 12798106 13672594 OPERATION OF AN 82 BED SKILLED NURSING FACILITY AND A 198 UNIT CONTINUING CARE RETIREMENT & ASSISTED LIVING FACILITY 12798106 1 1 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 25 0 277 1 0 0 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 MA X RICHARD CALVERT CFO 5088522670 65 BRIARWOOD CIRCLE WORCESTER MA 01606 DAVID DILL 1.00 X X 0 0 0 ROBERT EVANS 1.00 X X 0 0 0 PAUL WILLIAMS 1.00 X X 0 0 0 FRANCIS HARVEY JR 1.00 X X 0 0 0 ERVA BERG 1.00 X 0 0 0 JANICE BJORK 1.00 X 0 0 0 NANCY BROWN 1.00 X 0 0 0 ROBERT CHASE 1.00 X 0 0 0 DIX DAVIS 1.00 X 0 0 0 ELLEN FERRANTE 1.00 X 0 0 0 RODNEY FERRIS 1.00 X 0 0 0 ALLEN KRAUSE 1.00 X 0 0 0 VALERIE LORING 1.00 X 0 0 0 JULIA MARKS 1.00 X 0 0 0 PATRICIA KEANE MARTIN 1.00 X 0 0 0 DR E MALCOLM PARKINSON 1.00 X 0 0 0 MARY SCHWARTZ 1.00 X 0 0 0 SHARON SMITH VILES 1.00 X 0 0 0 REV DR THOMAS MCKIBBENS 1.00 X 0 0 0 REV MARK FRYKHOLM 1.00 X 0 0 0 JOHN ZOLTOWSKI 40.00 X 150248 0 21350 RICHARD CALVERT 40.00 X 103200 0 7928 253448 0 29278 2 0 1 0 MJK CARPENTRY PO BOX 60716 WORCESTER MA 01606 REMODELING 510540 NORTON ASSOCIATES 24 ELM STREET COHASSET MA 02025 REHAB SERVICES 443250 DELPHI CONSTRUCTION 130 OVERLAND ROAD WALTHAM MA 02451 CONSTRUCTION 313770 3 139899 139899 PROG.SERV.REVENUE-RELA 623000 12717381 12717381 67649 67649 12785030 306488 306488 6860751 5896126 77061 964625 -77061 887564 887564 45952 17920 28032 28032 14147013 13672594 0 334520 171598 171598 5858715 4948389 910326 520626 446318 74308 489306 402944 86362 18557 18557 78697 78697 123953 123953 96107 96107 292155 292155 17481 17481 2400618 2400618 269 269 6456 6456 1405570 1405570 103554 103554 DIETARY 784760 784760 ANCILLARIES 683318 683318 MAINTENANCE 479326 479326 BAD DEBTS 138290 138290 HOUSEKEEPING 94347 94347 202653 202653 13966356 12798106 1168250 0 521839 1209 629612 961586 20000 10000 1407356 1934907 81232 111963 216029 48910340 15263574 33889903 33646766 7491697 7688019 637566 1156924 44791168 45615440 1508374 1742168 1786536 1930476 27283974 27275000 25431031 27197758 56009915 58145402 X -11999161 -13477993 780414 457934 0 490097 -11218747 -12529962 44791168 45615440 X 180657 -1491872 X X 0 1 1 X 0 X 47312 188471 281122 34705 167931 719541 11667600 11778872 12215399 12103029 12785030 60549930 11714912 11967343 12496521 12137734 12952961 61269471 242500 15600 122874 380974 0 242500 15600 122874 380974 60888497 414606 619399 421360 323273 306488 2085126 414606 619399 421360 323273 306488 2085126 -6955 128727 121772 12122563 12715469 12917881 12461007 13259449 63476369 0.95920 0.95950 0.03280 0.03340 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 780414 108784 66275 7442 948031 0.00000 0.51700 0.48300 0 0 1819250 1819250 42155501 12904295 29251206 3212005 925276 2286729 1420049 1165156 254893 303535 268847 34688 33646766 ENTRANCE DEPOSITS PAYABLE 22137381 FAIR VALUE OF INTEREST RATE SWAP 2349377 REFUNDABLE ENTRANCE FEES 2711000 27197758 14147013 13966356 180657 -704869 -787003 -1491872 -1311215 14229147 -704869 -704869 14934016 -787003 -787003 14147013 13966356 0 13966356 0 13966356 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE RESIDENT ASSISTANCE FUND IS RESTRICTED TO HELPING RESIDENTS (NOT IN NH) PAY THEIR BILLS. THE WOODBURY FUND IS RESTRICTED FOR UNANTICIPATED CAPITAL EXPENDITURES. THE LOAN FUND IS RESTRICTED FOR HELPING A RESIDENT THAT MIGHT HAVE THE INCOME TO COVER THE MONTHLY FEE BUT NOT THE CAPITAL TO FUND THE ENTRY. THE STAFF DEVELOPMENT FUND WAS DONATED IN 2008 AND IS TOWARDS STAFF DEVELOPMENT. PART XI, LINE 8 - OTHER ADJUSTMENTS: INTEREST RATE SWAP - FMV ADJUSTMENT -787,003. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST RATE SWAP - FMV ADJUSTMENT -787,003. GOLF TOURNAMENT 45952 45952 2475 6779 8666 45952 45952 2475 6779 8666 17920 28032 X X 0 0 0 0 0 0 0 0 0 JOHN ZOLTOWSKI 150248 0 0 0 0 0 0 0 21350 0 171598 0 0 0 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 042608195 57583F5P2 2004-09-01 28310000 TO REFUND OUTSTANDING AMOUNT OF PREVIOUS BONDS, PAY OUTSTANDING DEBT, 0 0 0 28310000 27106663 1203337 2004 1 0 1 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 1 SOVEREIGN BANK 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT WILL REVIEW A DRAFT OF THE FORM 990 UPON PREPARATION AND GIVE APPROVAL BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CEO SERVES AS COMPLIANCE OFFICER. ALL SERVICES INVOLVING CONTRACTS WITH THE CORPORATION WILL BE REVIEWED AND APPROVED BY THE CEO. ALL MEMBERS OF THE CORPORATION AND MANAGERS INVOLVED IN CORPORATE PURCHASES, WILL COMPLETE AN ANNUAL DISCLOSURE AND CONFLICT OF INTEREST DOCUMENT TO ASSURE ALL PROFESSIONAL, BUSINESS AND PERSONAL RELATIONSHIPS THAT MAY AFFECT PURCHASING OR SERVICE TO RESIDENTS ARE IDENTIFIED. ANY MEMBER OF THE CORPORATION OF MANAGER IDENTIFIED AS HAVING SUCH A PROFESSIONAL, BUSINESS OR PERSONAL RELATIONSHIP SHALL AT A MINIMUM, BE PROHIBITED FROM VOTING ON CONTRACTS. ISSUES THAT CAN NOT BE RESOLVED ON THE IMMEDIATE OPERATIONAL LEVEL WILL BE REFERRED TO THE ETHICS SUB-COMMITTEE OF THE BOARD'S HEALTH AND WELLNESS COMMITTEE. ISSUES REMAINING SHALL BE REFERRED TO THE BOARD'S EXECUTIVE COMMITTEE FOR A FINAL DECISION. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS WAS USED IN 2008 TO DETERMINE THE COMPENSATION FOR CEO. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -704,869. INTEREST RATE SWAP - FMV ADJUSTMENT -787,003. TOTAL TO FORM 990, PART XI, LINE 5: -1,491,872. FORM 990, PART XI, LINE 2C THE PROCESS HAS NOT CHANGED FOR THE COMMITTEE ASSUMING RESPONSIBILITY. THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.