2025-10-10T11:01:01-05:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2024-01-01 050258818 HATTIE IDE CHAFFEE NURSING HOME INC HATT 4014341520 200 WAMPANOAG TRAIL EAST PROVIDENCE RI 02915 BARRY ZELTZER CEO 4014341520 2025-10-09 1 1 DANIELLE NIHILL P01350943 7819821001 2025-10-09 2024 2025-03-06 01:10:19Z BARRY ZELTZER 200 WAMPANOAG TRAIL EAST PROVIDENCE RI 02915 13672288 0 X HATTIEIDECHAFFEE.ORG X 1948 RI PROVISION OF LONG TERM CARE FOR THE ELDERLY. 11 11 203 20 0 0 154815 183131 7703177 11330293 327563 785866 26092 2698 8211647 12301988 0 0 0 0 6538568 7766304 0 0 0 2994605 4049644 9533173 11815948 -1321526 486040 22731580 23629966 6866843 6768618 15864737 16861348 X IT'S THE MISSION OF HATTIE IDE CHAFFEE HOME TO ENSURE THE BEST QUALITY CARE. THIS COMES FROM HAVING THE FINEST IN STAFF. HATTIE IDE CHAFFEE'S HIGHLY TRAINED STAFF IS EQUIPPED TO RESPOND TO THE MOST COMPLEX MEDICAL PROBLEM. THE HOME'S FREQUENT REVIEWS CONTINUE TO MEET OR EXCEED THE HIGHEST STANDARDS SET BY THE STATE OF RHODE ISLAND. THE FACILITY HAS BEEN LICENSED BY THE STATE OF RHODE ISLAND, AND CERTIFIED BY THE STATE MEDICAID AND THE FEDERAL MEDICARE PROGRAMS. IN ADDITION, THE FACILITY ALSO OFFERS PHYSICAL, OCCUPATIONAL, SPEECH AND LANGUAGE THERAPY. THROUGH ITS NONPROFIT STATUS, VOLUNTEER BOARD OF DIRECTORS, PHYSICIAN INVOLVEMENT, AND GENEROUS BEQUESTS, THE ORGANIZATION CONTINUES TO THRIVE. TRUE TO ITS 70+ YEAR HISTORY, THE HOME OFFERS SKILLED AND RESPITE CARE FOR THOSE IN NEED. FOR FAMILIES WHO SEEK THE BEST FOR THEIR LOVED ONES, HATTIE IDE CHAFFEE OFFERS COMFORT, SATISFACTION, AND ASSURANCE THAT COME FROM THE ATTENTIVE AND PROFESSIONAL STAFF. 0 0 10257276 0 11330293 THE FACILITY IS MEDICARE AND MEDICAID CERTIFIED TO PROVIDE LONG-TERM NURSING CARE. HATTIE IDE CHAFFEE'S SERVICES ALSO INCLUDE PHYSICAL, OCCUPATIONAL, SPEECH AND LANGUAGE THERAPY. 10257276 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 12 0 1 203 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 RI X BARRY ZELTZER 4014341520 200 WAMPANOAG TRAIL RIVERSIDE RI 02915 DAVID MATERNE PRESIDENT 1.00 X X 0 0 0 KAREN RICE VICE PRESIDENT 1.00 X X 0 0 0 TEDFORD B RADWAY SECRETARY 1.00 X X 0 0 0 AMY GULDHAUGE TREASURER 1.00 X X 0 0 0 SHARLEEN BOWEN DIRECTOR 1.00 X 0 0 0 BEN CHWALK DIRECTOR 1.00 X 0 0 0 JAY GREGORY DIRECTOR 1.00 X 0 0 0 PETER MINIATI DIRECTOR 1.00 X 0 0 0 MICHAEL REUTER DIRECTOR 1.00 X 0 0 0 KIMBERLY SERRA DIRECTOR 1.00 X 0 0 0 CHRISTINA SCOLA DIRECTOR 1.00 X 0 0 0 BARRY ZELTZER ADMINISTRATOR/CEO 40.00 X 191119 0 28230 RALPH SANTORO OFFICER / MEDICAL DIRECTOR 4.00 X 24000 0 0 MARLENE VERRIER DIRECTOR OF NURSING 40.00 X 128973 0 26660 LISA BELL CFO 40.00 X 115567 0 4600 CHANTEL WORTHING INFECTION PREVENTIONIST RN 40.00 X 112071 0 19516 KATE PYNE DIRECTOR OF REHAB 40.00 X 110719 0 4462 GERARD DUVERNE CNA 40.00 X 109199 0 8007 791648 0 91475 8 0 1 0 0 35919 147212 18345 183131 PATIENT SERVICE REVENUE 623000 11330293 11330293 11330293 220534 220534 1912086 1346754 565332 565332 565332 17511 35919 23546 -6035 -6035 MISCELLANEOUS 561300 8733 8733 8733 12301988 11330293 0 788564 219349 25666 193683 6208279 5791768 416511 170822 77959 92863 684857 684857 482997 444252 38745 52947 52947 111941 111941 97907 97907 45207 37781 7426 26156 26156 171115 47721 123394 110171 110171 354930 354930 3557 3557 256233 256233 563737 563737 124758 124758 PURCHASED SERVICES 627626 627626 HEALTHCARE PROVIDER TAX 614663 614663 FOOD & DRUG 475564 475564 SUPPLIES 270250 270250 142882 112187 30695 11815948 10257276 1558672 0 734856 992757 2769 185193 940271 1041257 8634 8634 77007 52893 18920886 6183292 13054550 12737594 7900448 8592982 13045 18656 22731580 23629966 1168396 882174 5698447 5886444 6866843 6768618 X 15184642 16051834 680095 809514 15864737 16861348 22731580 23629966 486040 510571 0 X X 0 1 X 1 0 X 840691 314754 235825 154815 183131 1729216 6050808 6210241 6741210 7703177 11330293 38035729 44360 23059 22052 17511 106982 6935859 6524995 7000094 7880044 11530935 39871927 0 672501 908602 1581103 672501 908602 1581103 38290824 193814 215913 219420 220534 849681 193814 215913 219420 220534 849681 9481 13286 8212 30312 8733 70024 7139154 6538281 7224219 8129776 11760202 40791632 0.93870 0.95570 0.02080 0.02350 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2020 AMOUNT: $ 9,481. 2021 AMOUNT: $ 13,286. 2022 AMOUNT: $ 8,212. 2023 AMOUNT: $ 30,312. 2024 AMOUNT: $ 8,733. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 146 2814 2874 86 0 7913493 1198145 500000 8611638 8297540 860953 1245000 7913493 10546165 -1523625 725000 8297540 10864476 1618658 2000000 10546165 9830946 1033530 10864476 0.90850 0.00000 0.09150 0 0 41732 41732 16934211 4666532 12267679 1753076 1399113 353963 191867 117647 74220 12737594 X 12738198 510571 23546 534117 12204081 97907 97907 12301988 11741587 23546 23546 11718041 97907 97907 11815948 PART IV, LINE 1B: THE ORGANIZATION HOLDS CERTAIN CASH ACCOUNTS FOR THE BENEFIT OF ITS RESIDENTS. PART V, LINE 4: DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: THE UNRESTRICTED ENDOWMENT FUNDS ARE SET ASIDE FOR THE SUPPORT OF THE GENERAL OPERATIONS OF HATTIE IDE CHAFFEE NURSING HOME'S FACILITY AND ITS VARIOUS PROGRAMS. TERMPORARILY RESTRICTED ENDOWMENT FUNDS ARE RESTRICTED FOR THE PURPOSES STIPULATED BY THE DONOR. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOME AND RECOGNIZE A TAX LIABILITY IF THE HOME HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOME IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE HOME RECOGNIZES INTEREST AND PENALTIES, IF ANY, AS A COMPONENT OF OTHER INCOME (EXPENSE). PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 23,546. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 23,546. HIC 2023 GOLF TOURNAMENT 53430 35919 17511 900 14860 6101 1685 53430 35919 17511 900 14860 6101 1685 23546 -6035 X X 0 0 0 0 0 1 0 1 0 BARRY ZELTZER ADMINISTRATOR/CEO 190000 0 1119 0 0 0 7600 0 20630 0 219349 0 0 0 MARLENE VERRIER DIRECTOR OF NURSING 128406 0 567 0 0 0 5314 0 21346 0 155633 0 0 0 PART I, LINE 3 DISCUSSION AND APPROVAL BY BOARD MEMBERS. PART I, LINE 6 THE ADMINISTRATOR RECEIVES COMPENSATION IN THE FORM OF A BONUS WHICH IS CONTINGENT, IN PART, UPON THE LEVEL OF OPERATING INCOME EARNED BY THE FACILITY. PART I, LINE 7 THE ADMINISTRATOR IS AWARDED A BONUS BASED ON PERFORMANCE. FORM 990, PART VI, SECTION A, LINE 1A EXECUTIVE COMMITTEE THE BOARD OF DIRECTORS MAY APPOINT AN EXECUTIVE COMMITTEE, WHICH SHALL HAVE ALL THE POWERS OF THE BOARD OF DIRECTORS, IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, AND SUCH OTHER COMMITTEES AS IT SHALL SEE FIT, AND HAVING SUCH POWERRS AS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B IT IS THE HATTIE IDE CHAFFEE NURSING HOME BOARD OF DIRECTORS' POLICY TO REVIEW THE IRS FORM 990 PRIOR TO FILING. THE CEO AND DOF ALONG WITH THE BOARD WILL REVIEW WITH THE AUDITORS. FORM 990, PART VI, SECTION B, LINE 12C AT THE FIRST BOARD MEETING OF EACH CALENDAR YEAR, THE CONFLICT OF INTEREST POLICY IS READ AND EACH BOARD MEMBER AND OFFICER IS ASKED TO SIGN THE CONFLICT OF INTEREST POLICY. THE TERMS OF THE POLICY REQUIRE THEM TO DISCLOSE ANY CONFLICTS. THIS IS OVERSEEN BY THE COMPLIANCE OFFICER AND LEGAL COUNSEL AS NECESSARY. THE COMPLIANCE OFFICER WILL BE AVAILABLE ON A TIMELY BASIS FOR DISCUSSION WITH HATTIE IDE CHAFFE HOME PERSONNELL REGARDING THEIR POTENTIAL CONFLICTS OF INTEREST. THE DISCUSSIONS WILL BE KEPT CONFIDENTIAL TO THE EXTENT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES, UNLESS THE INDIVIDUAL FAILS TO ELIMINATE THE CONFLICT WITHIN A REASONABLE PERIOD OF TIME. FORM 990, PART VI, SECTION B, LINE 15A THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FUNCTIONS AS A COMPENSATION COMMITTEE IN DETERMINING SALARY AND BONUSES ANNUALLY FOR THE ADMINISTRATOR. THE COMMITTEE MEETS WITH THE ADMINISTRATOR TO REVIEW HIS PERFORMANCE DURING THE PAST YEAR. IN MAKING ITS DECISION ON COMPENSATION, THE COMMITTEE 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 ORGANIZATION HAS CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION DELIBERATION AND DECISION. THIS PROCESS WAS LAST COMPLETED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. PART XII LINE 2C THE AUDIT/FINANCE COMMITTEE OF THE BOARD OF DIRECTORS CONTINUES TO BE RESPONSIBLE FOR THE OVERSIGHT OF THE ANNUAL AUDIT.