2023-11-15T15:02:31-06:00 2022-12-31 111986323 MARCUM LLP 555 LONG WHARF DRIVE NEW HAVEN CT 06511 990 2022-01-01 043515687 OVERLOOK VISITING NURSE ASSOCIATION INC OVER 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 14195500 0 X WWW.OVERLOOK-MASS.ORG X 2000 MA PROVISION OF HOME HEALTH AND HOSPICE CARE (SEE SCHEDULE O) CHARITABLE - THE PROVISION OF HOME HEALTH AND HOSPICE FOR RESIDENTS OF THE COMMONWEALTH OF MASSACHUSETTS WITH AN EMPHASIS ON HEALTH AND WELL BEING. 8 7 206 13 0 0 3889153 286760 14973465 13890276 246 17 54185 18447 18917049 14195500 0 0 0 0 12345355 11836692 0 0 0 4847959 4703625 17193314 16540317 1723735 -2344817 6671533 4276981 19310734 19260999 -12639201 -14984018 TO PROMOTE AND PROVIDE EFFICIENT HOME HEALTH AND HOSPICE SERVICES ACROSS THE CONTINUUM FOR RESIDENTS OF THE COMMONWEALTH OF MASSACHUSETTS WITH EMPHASIS ON HEALTH AND WELL BEING. 0 0 9839488 13908723 OPERATION OF HOME HEALTH AND HOSPICE PROVIDER BASED IN CHARLTON, MA. 9839488 1 1 0 0 0 0 0 0 0 0 1 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 40 0 1 206 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X TAMERYN CAMPBELL 5084342412 88 MASONIC HOME ROAD CHARLTON MA 01507 MASON RUSSELL CHAIR 1.00 0.45 X X 0 0 0 ROBERT SCHREMSER VICE CHAIR, CLERK 1.00 0.45 X X 0 0 0 JAMES TRACY TREASURER 1.00 0.30 X X 0 0 0 LAWRENCE BETHUNE SECRETARY 1.00 0.45 X X 0 0 0 TAMERYN CAMPBELL PRESIDENT & CEO 1.00 40.30 X X 0 572431 71506 WAYNE SZRETTER DIRECTOR 1.00 0.00 X 0 0 0 KENNETH BLAKE MHS BOARD CHAIR 1.00 0.45 X 0 0 0 RICHARD MAGGIO GRAND MASTER 1.00 0.30 X 0 0 0 JOE SAVIDGE CHIEF FINANCIAL OFFICER (TO 4/1/22) 1.00 40.30 X 0 90283 4874 SHAWN M BERTRAM COO 1.00 40.30 X 0 279091 32217 TED WILBUR CHIEF INFORMATION OFFICER 1.00 40.30 X 0 175029 13085 SHARON WRIGHT EXECUTIVE DIRECTOR OF HOME HEALTH & HOSPICE 40.00 0.00 X 171911 0 6279 KRISTINE M BRADLEY REGIONAL ADMINISTRATOR 40.00 0.00 X 152747 0 13084 RUSSELL CHAMBERLAIN PHYSICAL THERAPIST 46.70 0.00 X 152348 0 3047 CAROL PARECE DIRECTOR OF QAPI 40.00 0.00 X 128119 0 17651 JONATHAN MARTINS PHYSICAL THERAPIST 46.50 0.00 X 134735 0 2695 739860 1116834 164438 17 0 1 0 OVERLOOK MASONIC HEALTH CENTER INC 88 MASONIC HOME ROAD CHARLTON MA 01507 MANAGEMENT SERVICES 1092083 HOMECARE HOMEBASE PO BOX 678637 DALLAS TX 75222 SOFTWARE 187972 MCGEE WILLIAM PO BOX 140 FISKDALE MA 01518 HOSPICE MEDICAL DIRECTOR 132000 MCBEE ASSOCIATES PO BOX 713519 PHILADELPHIA PA 19171 CONSULTING SERVICES 104828 NETSMART TECHNOLOGIES INC PO BOX 713519 PHILADELPHIA PA 19171 CONSULTING SERVICES 101000 5 280360 6400 286760 NET PATIENT REVENUE 621610 13890276 13890276 13890276 17 17 OTHER SERVICES 900099 18447 18447 18447 14195500 13908723 0 17 9694589 6638605 3055984 104691 63479 41212 1236870 753784 483086 800542 549556 250986 1092083 1092083 37850 37850 663373 3192 660181 59421 59421 94183 94183 371508 371508 290269 244772 45497 402685 358369 44316 6438 6438 115481 115481 856 856 198105 127901 70204 MEDICAL SUPPLIES 992656 992656 VIDEO AND DATA 202353 202353 BAD DEBT EXPENSE 107172 107172 REPAIRS & MAINTENANCE 21654 21654 47538 2 47536 16540317 9839488 6700829 0 1109614 142329 1719734 1597823 195634 410285 2677315 2676138 2033 1177 3644518 2125367 6671533 4276981 854485 881485 278950 267533 18177299 18111981 19310734 19260999 X -12639201 -14984018 -12639201 -14984018 6671533 4276981 -2344817 0 X X 0 1 X 1 0 X 5010 6430 3210 3889153 286760 4190563 20116220 23919649 20396158 14973465 13890276 93295768 20121230 23926079 20399368 18862618 14177036 97486331 0 0 0 97486331 837 246 17 1100 837 246 17 1100 48425 54000 32081 54185 18447 207138 20169655 23980079 20432286 18917049 14195500 97694569 0.99790 0.99810 0.00000 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER SERVICES - 2018 AMOUNT: $ 48,425. 2019 AMOUNT: $ 54,000. 2020 AMOUNT: $ 32,081. 2021 AMOUNT: $ 54,185. 2022 AMOUNT: $ 18,447. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2677315 2676138 1177 1177 DUE FROM AFFILIATES 2105022 OTHER ASSETS 20345 2125367 DUE TO AFFILIATES 18111981 18111981 X 14088328 -107172 -107172 14195500 0 14195500 16433145 0 16433145 107172 107172 16540317 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 XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -107,172. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 107,172. 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 SHARON WRIGHT EXECUTIVE DIRECTOR OF HOME HEALTH & 165702 0 5416 0 793 0 3494 0 2785 0 178190 0 0 0 KRISTINE M BRADLEY REGIONAL ADMINISTRATOR 144644 0 7840 0 263 0 0 0 13084 0 165831 0 0 0 RUSSELL CHAMBERLAIN PHYSICAL THERAPIST 151975 0 0 0 373 0 3047 0 0 0 155395 0 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 IN PART II, COLUMN C. FORM 990, PART VI, SECTION A, LINE 6 THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC, IS THE SOLE MEMBER OF THE ORGANIZATION AND ELECTS THE BOARD OF DIRECTORS. THERE ARE NO CLASSES OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC HAS THE POWER TO REMOVE DIRECTORS, TO FILL VACANCIES, AND TO INCREASE OR DECREASE THE SIZE OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B ANY GOVERNANCE DECISIONS OF THE ORGANIZATION ARE RESERVED TO THE MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT WORKS WITH THE ORGANIZATION'S TAX ADVISOR (CPA FIRM) 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 TO 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 CONFLICT POLICY IS INTENDED TO SUPPLEMENT, BUT NOT REPLACE ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE CORPORATIONS. THIS CONFLICT POLICY HAS BEEN ADOPTED BY THE BOARD OF DIRECTORS OF MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC, (MHS) THIS CONFLICT POLICY SHALL APPLY WITH EQUAL FORCE TO ALL CORPORATIONS RELATED TO, OR AFILIATED WITH MHS. 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 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 XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC 88 MASONIC HOME ROAD CHARLTON MA 01507 043515688 PARENT MA 501(C)(3) LINE 12C, III-FI N/A 0 OVERLOOK COMMUNITIES INC 88 MASONIC HOME ROAD CHARLTON MA 01507 043515686 NURSING FACILITY MA 501(C)(3) LINE 10 MASONIC HEALTH SYSTEM OF MASSACHUSETTS 1 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 0 0 0 1 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 MASONIC HEALTH SYSTEM OF MASSACHUSETTS D 2384640 CASH MASONIC HEALTH SYSTEM OF MASSACHUSETTS N 113905 CASH OVERLOOK COMMUNITIES E 448233 CASH OVERLOOK COMMUNITIES N 211349 CASH OVERLOOK MASONIC HEALTH CENTER D 168616 CASH OVERLOOK MASONIC HEALTH CENTER E 2635022 CASH OVERLOOK MASONIC HEALTH CENTER K 159000 CASH OVERLOOK MASONIC HEALTH CENTER M 1092083 CASH