2023-11-15T15:08:10-06:00 2022-12-31 111986323 MARCUM LLP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 990 2022-01-01 043515688 MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC MASO 5082487344 88 MASONIC HOME ROAD CHARLTON MA 015071000 NICHOLAS PUGLIESE CFO 5082487344 2023-11-15 1 NICHOLAS PUGLIESE 999009999 1 MARY ANTONETTI P00431862 2037819600 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z TAMERYN CAMPBELL 88 MASONIC HOME ROAD CHARLTON MA 015071000 175836 0 X THEMASONICHOME.ORG X 2000 MA CHARITABLE - DEVELOPS AND OFFERS SERVICE AND PROGRAMS TO THE RESIDENTS OF THE COMMUNITY. 8 7 0 7 0 0 0 0 0 0 209205 119176 0 56660 209205 175836 0 0 0 0 0 0 0 0 0 973 796 973 796 208232 175040 18557399 18726274 77632604 77632604 -59075205 -58906330 X TO SPONSOR, DEVELOP, OFFER AND/OR PROMOTE SERVICES AND PROGRAMS RELATING TO THE CARE, TREATMENT AND HEALING OF HUMANS, WHICH SERVICES AND PROGRAMS ARE CHARITABLE, SCIENTIFIC, AND/OR EDUCATIONAL AND WHICH ADDRESS THE PHYSICAL AND MENTAL NEEDS OF EVERY RACE, COLOR AND RELIGION, AND THEIR WIDOWS AND FAMILY MEMBERS, AS WELL AS MEMBERS OF THE COMMUNITY AT LARGE. 0 0 0 0 TO ESTABLISH, MAINTAIN AND OPERATE EXCLUSIVELY FOR CHARITABLE PURPOSES A RETIREMENT AND CONVALESCENT HOME TO AID, ASSIST AND/OR SUPPORT AGED, SICK AND INFIRM FREEMASONS AND THE WIDOWS AND WIVES OF FREEMASONS ALONG WITH THE GENERAL PUBLIC. 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 1 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 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X TAMERYN CAMPBELL 5084342414 88 MASONIC HOME ROAD CHARLTON MA 01507 MASON RUSSELL TREASURER 0.15 1.30 X 0 0 0 KENNETH BLAKE CHAIR 0.15 1.30 X X 0 0 0 DONALD LALIBERTE VICE CHAIR 0.15 0.00 X X 0 0 0 ROBERT SCHREMSER CLERK 0.15 1.30 X X 0 0 0 TAMERYN CAMPBELL PRESIDENT & CEO 0.15 41.15 X X 0 572431 71506 LAWRENCE BETHUNE SECRETARY 0.15 1.30 X 0 0 0 ROBERT JOLLY DIRECTOR 0.15 0.30 X 0 0 0 REV DR RICHARD HALEY DIRECTOR (FROM 1/1/22) 0.15 0.00 X 0 0 0 JOE SAVIDGE CHIEF FINANCIAL OFFICER (TO 4/1/22) 0.15 41.15 X 0 90283 4874 SHAWN M BERTRAM COO 0.15 41.15 X 0 279091 32217 TED WILBUR CHIEF INFORMATION OFFICER 0.15 41.15 X 0 175029 13085 0 1116834 121682 0 0 1 0 0 119176 119176 OTHER SERVICES 900099 56660 56660 56660 175836 56660 0 119176 796 796 796 0 796 0 30534 19918 18526865 18706356 18557399 18726274 77632604 77632604 77632604 77632604 X -59081370 -58906330 6165 0 -59075205 -58906330 18557399 18726274 X 175040 -6165 X X 0 1 X 1 0 X X 3 OVERLOOK COMMUNITIES INC 043515686 10 1 0 0 OVERLOOK VISITING NURSES ASSOCIATION INC 043515687 10 1 0 0 OVERLOOK MASONIC HEALTH CENTER INC 222843194 10 1 0 0 3 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 SCHEDULE A PART IV SECTION E MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC. IS THE SOLE MEMBER OF OVERLOOK MASONIC HEALTH CENTER INC, OVERLOOK COMMUNITIES INC, AND OVERLOOK VISITING NURSES ASSOCIATION INC., AS SUCH ITS RIGHTS INCLUDE THE APPOINTMENT OF BOARD MEMBERS FOR ITS MEMBER ORGANIZATIONS. SCHEDULE A PART IV SECTION E ITS RESPONSIBILITIES ALSO INCLUDE THE OVERALL DIRECTION OF PROGRAMS AND SERVICES FOR ITS MEMBER ORGANIZATIONS. 6165 6165 6165 6165 6165 6165 6165 6165 93219 87054 6165 0.00000 0.00000 0.00000 0 0 0 DUE FROM AFFILIATES 18706356 18706356 DUE TO AFFILIATES 77498547 DUE TO RELATED PARTY 134057 77632604 X 175836 0 175836 0 175836 796 0 796 0 796 PART X, LINE 2: BELOW IS AN EXCERPT FROM FOOTNOTE 2 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. MHS, HEALTH CENTER, OVNA AND COMMUNITIES HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2022 AND 2021, THERE ARE NO TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS PENDING OR IN PROGRESS. PART V LINE 4 THE ORGANIZATION'S ENDOWMENT INCLUDES BOTH DONOR RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. X 0 0 X X X 0 0 0 0 0 0 0 0 0 TAMERYN CAMPBELL PRESIDENT & CEO 0 394593 0 175000 0 2838 0 6100 0 65406 0 643937 0 0 SHAWN M BERTRAM COO 0 261903 0 16288 0 900 0 0 0 32217 0 311308 0 0 TED WILBUR CHIEF INFORMATION OFFICER 0 161014 0 12604 0 1411 0 3537 0 9548 0 188114 0 0 PART I, LINE 1A TAMERYN CAMPBELL RECEIVED A HOUSING ALLOWANCE FROM A RELATED ORGANIZATION (OC) WITH AN ESTIMATED VALUE OF $50,640 DURING THE YEAR ENDING DECEMBER 31, 2022. THIS WAS REPORTED AS A NONTAXABLE BENEFIT TO TAMERYN. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT WORKS WITH THE ORGANIZATION'S EXTERNAL AUDITORS TO PREPARE THE FINANCIAL INFORMATION AND COMPILE THE DISCLOSURES REQUIRED OF THE FORM 990. UPON ITS COMPLETION SENIOR MANAGEMENT PROVIDES A DRAFT OF THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY VIA ANNUAL EXECUTION OF THE CONFLICT OF INTEREST POLICY. THIS CONFLICTS POLICY IS INTENDED TO SUPPLEMENT, BUT NOT REPLACE, ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE CORPORATIONS. THIS CONFLICTS POLICY HAS BEEN ADOPTED BY THE BOARD OF DIRECTORS OF MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. (MHS) THIS CONFLICTS POLICY SHALL APPLY WITH EQUAL FORCE TO ALL CORPORATIONS RELATED TO OR AFFILIATED WITH MHS. THE POLICY IS SIGNED BY ALL BOARD MEMBERS ANNUALLY. ON AN ANNUAL BASIS THE DIRECTORS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REVIEWED BY THE PRESIDENT'S OFFICE. IF A CONFLICT ARISES, THE INDIVIDUAL WOULD RECUSE THEMSELVES FROM ALL DISCUSSION ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S SOLE MEMBER, MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. MAINTAINS AN EXECUTIVE COMMITTEE, WHICH AMONG OTHER THINGS, REVIEWS THE COMPENSATION AND TERMS OF THE AGREEMENT WITH ITS EXECTUIVE OFFICER. THE COMMITTEE REVIEWS THE COMPENSATION OF THE INDIVDIUAL IN RELATION TO THE SALARY LEVEL OF OTHER COMPARABLE POSITIONS IN THE MARKET AND THEIR PERFORMANCE. ONCE REASONABLE COMPENSATION IS DETERMINED, IT IS APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST AND CAN ALSO BE FOUND ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER OF UNCLAIMED PROPERTY TO OMHC -6,165. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. OVERLOOK MASONIC HEALTH CENTER INC 88 MASONIC HOME ROAD CHARLTON MA 01507 222843194 NURSING FACILITY MA 501(C)(3) LINE 10 MASONIC HEALTH SYSTEM OF MASSACHUSETTS 1 OVERLOOK VISITING NURSES ASSOCIATION 88 MASONIC HOME ROAD CHARLTON MA 01507 043515687 VNA MA 501(C)(3) LINE 10 MASONIC HEALTH SYSTEM OF MASSACHUSETTS 1 OVERLOOK COMMUNITIES INC 88 MASONIC HOME ROAD CHARLTON MA 01507 043515686 RESIDENT & ASSISTED LIVING FACILITY MA 501(C)(3) LINE 10 MASONIC HEALTH SYSTEM OF MASSACHUSETTS 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 OVERLOOK MASONIC HEALTH CENTER N 71751 CASH OVERLOOK MASONIC HEALTH CENTER E 73753605 CASH OVERLOOK VISITING NURSE ASSOCIATION N 113905 CASH OVERLOOK VISITING NURSE ASSOCIATION A 113052 CASH OVERLOOK VISITING NURSE ASSOCIATION E 2384640 CASH OVERLOOK COMMUNITIES E 1360302 CASH