2011-11-14T13:56:41-06:00 2010-12-31 SULLIVAN & COMPANY CPAS LLP 50 HOLDEN STREET PROVIDENCE RI 02908 990 2010-01-01 050275443 ST ANTOINE RESIDENCE SAIN 4017673500 10 RHODES AVENUE NORTH SMITHFIELD RI 02896 WENDY FARGNOLI 4017673500 2011-11-03 1 DONALD SULLIVAN 4012725600 X 2010 2016-03-07 17:11:31Z WENDY FARGNOLI 10 RHODES AVENUE NORTH SMITHFIELD RI 028966999 21996934 0 0928 X WWW.STANTOINE.NET X 1913 RI THE MISSION OF SAINT ANTOINE RESIDENCE IS TO CARE FOR THE SICK AND ELDERLY IN ADDITION TO REFLECTING THE CHURCH'S COMMITMENT AND SUPPORT FOR ALL HUMAN LIFE AND AFFIRMATION OF THE VALUE OF EACH PERSON REGARDLESS OF AGE OR PHYSICAL CONDITION IN A COMPASSIONATE, CARING AND CHRISTIAN ENVIRONMENT. 6 5 484 85 0 0 248403 389282 21097651 21359483 26985 51113 104806 106303 21477845 21906181 0 0 0 0 12524830 12809896 0 0 0 7579264 7688752 20104094 20498648 1373751 1407533 18117280 18884073 11459144 10872261 6658136 8011812 X THE MISSION OF SAINT ANTOINE RESIDENCE IS TO CARE FOR THE SICK AND ELDERLY IN ADDITION TO REFLECTING THE CHURCH'S COMMITMENT AND SUPPORT FOR ALL HUMAN LIFE AND AFFIRMATION OF THE VALUE OF EACH PERSON REGARDLESS OF AGE OR PHYSICAL CONDITION IN A COMPASSIONATE, CARING AND CHRISTIAN ENVIRONMENT. 0 0 18835802 21359483 THE OPERATION OF A LONG-TERM CARE FACILITY FOR THE ELDERLY AND OTHER NEEDY INDIVIDUALS. DURING 2010 ST. ANTOINE'S PROVIDED A TOTAL 93,778 PATIENT BED DAY, OF WHICH 75,875 BED DAYS TO MEDICAID AND MEDICARE PATIENTS. 18835802 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 6 0 1 484 1 0 0 0 0 0 1 1 0 0 0 0 X 6 5 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 1 0 X MARIO MACERA 4017673500 10 RHODES AVENUE NORTH SMITHFIELD RI 028966999 WENDY FARGNOLI 40.00 X X 120538 0 9348 MOST REV THOMAS TOBIN 1.00 X X 0 0 0 REV MSGR ROBERT EVANS 1.00 X X 0 0 0 REV TIMOTHY D REILLY 1.00 X X 0 0 0 REV MSGR GEORGE L FRAPPIER 1.00 X 0 0 0 JOHN BARRY 1.00 X 0 0 0 MARIO MACERA 40.00 X 91836 0 23492 212374 0 32840 1 0 0 0 0 256960 132322 389282 MEDICAID & MEDICARE RE 623000 15466881 15466881 NURSING HOME FEES 623000 5804802 5804802 MANAGEMENT FEE INCOME 623000 87800 87800 21359483 51113 51113 12000 4072 7928 7928 7928 132116 86681 45435 45435 OTHER INCOME 900099 30260 30260 DISCOUNTS EARNED 900099 16310 16310 HAIRDRESSER REVENUE 900099 6370 6370 52940 21906181 21359483 0 157416 245214 14713 230501 9174321 8556938 617383 627871 578437 49434 2042946 1880733 162213 719544 649771 69773 56879 56879 10885 10885 62423 62423 51681 51681 1253657 1229327 24330 78112 78112 620877 583624 37253 9764 9764 390498 367068 23430 648129 611526 36603 525559 508324 17235 PURCHASED SERVICES 1732776 1732776 PROVIDER TAXES 1176038 1176038 FOOD 732750 732750 MISCELLANEOUS 287562 105736 181826 BAD DEBTS 51162 51162 20498648 18835802 1662846 0 1996 2000 3989267 4956968 2186550 2079595 663149 648754 53458 57678 123947 155735 18490838 8598553 10304574 9892285 338876 356341 455463 734717 18117280 18884073 1760084 1970248 9135000 8260000 564060 642013 11459144 10872261 X 6303111 7711875 323525 268437 31500 31500 6658136 8011812 18117280 18884073 X 1407533 -53857 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 166000 166000 14439520 5877675 8561845 3795527 2720878 1074649 89791 89791 9892285 INTEREST RATE SWAP 642013 642013 21906181 20498648 1407533 24096 -77953 -53857 1353676 21674065 24096 3567 27663 21646402 259779 259779 21906181 20320389 3567 3567 20316822 181826 181826 20498648 PART XI, LINE 8 - OTHER ADJUSTMENTS: UNREALIZED LOSS ON INTEREST RATE SWAP CONTRACT -77,953. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL PROPERTY DEPRECIATION 3,567. PART XII, LINE 4B - OTHER ADJUSTMENTS: UNITED WAY GRANT EXPENSES NETTED ON FINANCIAL STATEMENTS 181,826. UNREALIZED LOSS ON INTEREST RATE SWAP CONTRACT 77,953. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL PROPERTY DEPRECIATION 3,567. PART XIII, LINE 4B - OTHER ADJUSTMENTS: UNITED WAY GRANT EXPENSES NETTED ON FINANCIAL STATEMENTS 181,826. GOLF TOURNAMENT 98386 98386 74735 ANNUAL FUND 33730 33730 11946 132116 132116 86681 86681 45435 RHODE ISLAND HEALTH AND EDUCATIONAL BUILDING CORPORATION 521300173 762243ZA4 2009-11-12 9135000 BOND REFUNDING 0 0 0 9135000 345000 1994 1 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 1 1 BANK OF AMERICA MERRILL LYNCH 9.000000000000 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 MARIO MACERA, DIRECTOR OF FINANCE AND WENDY FARGNOLI, ASSISTANT TREASURER REVIEW THE FORM 990 PRIOR TO FILING. UPON REVIEW AND APPROVAL, THE RETURN IS SIGNED BY WENDY FARGNOLI AND FILED WITH THE IRS. IN THE EVENT THAT WENDY FARGNOLI IS NOT ABLE TO SIGN THE 990 INFORMATION RETURN, MARIO MACERA IS AUTHORIZED TO DO SO. A COPY IS SUBMITTED TO THE FISCAL OFFICE AT THE DIOCESE OF PROVIDENCE AND ONE IS KEPT AT THE BUSINESS OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS FUNCTIONS AS A COMPENSATION COMMITTEE IN DETERMINING SALARY FOR THE ADMINISTRATOR AND KEY EMPLOYEES. IN MAKING ITS DECISION ON COMPENSATION, IT TAKES INTO ACCOUNT THE COMPENSATION PAID TO SIMILAR ADMINISTRATORS AT COMPARABLE NON-PROFIT ORGANIZATIONS IN THE AREA. THE COMMITTEE CONSIDERS THE PERFORMANCE OF THE ORGANIZATION DURING THE REVIEW PERIOD AND CONSIDERS THE ADMINISTRATOR'S SUCCESS IN ACHIEVING ORGANIZATIONAL GOALS. THE ADMINISTRATOR REVIEWS SALARY OF ALL OTHER EMPLOYEES. IN MAKING A DECISION ON THE AMOUNT OF COMPENSATION, SHE TAKES INTO ACCOUNT THE COMPENSATION PAID TO SIMILAR EXECUTIVES, PERFORMING SIMILAR TYPES OF DUTIES, AT COMPARABLE NON-PROFIT ORGANIZATIONS IN THE RHODE ISLAND AREA. COMPENSATION RELATED DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ALL GOVERNING DOCUMENTS 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: 24,096. UNREALIZED LOSS ON INTEREST RATE SWAP CONTRACT -77,953. TOTAL TO FORM 990, PART XI, LINE 5: -53,857. FINANCIAL STATEMENTS AUDIT OVERSIGHT FORM 990 PART XII, LINE 2C THE FINANCE COMMITTEE IS RESPONSIBLE FOR OVERSIGHT OF THE COMPLETION OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE FINANCE COMMITTEE AND SUBMITTED TO THE ADVISORY BOARD AND CORPORATE BOARD. DAURAY LLC 10 RHODES AVENUE NORTH SMITHFIELD RI 02896 050275443 REAL ESTATE RI 0 110000 THE FRASSATI RESIDENCE DBA THE VILLA AT SAINT ANTOINE 400 MENDON ROAD NORTH SMITHFIELD RI 02896 050511505 OPERATION OF A 76-UNIT ASSISTED LIVING FACILITY. RI 501(C)(3) LINE 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0