2024-12-03T11:09:19-06:00 2024-05-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2023-06-01 823380934 89 SOUTH CARE SUPPORT INC 89SO 4134454056 89 SOUTH STREET PITTSFIELD MA 01201 RICHARD HERRICK TREASURER 4134454056 2024-12-02 1 0 KATARZYNA O PADZIK P02268641 7819821001 2024-12-02 2023 2024-10-15 13:58:12Z NELSON FURLANO 89 SOUTH STREET PITTSFIELD MA 01201 22790486 0 X WWW.BERKSHIREPLACE.COM X 2017 MA TO ENHANCE AND IMPROVE THE QUALITY OF LIFE OF OLDER ADULTS SUPPORTED BY BERKSHIRE RETIREMENT HOME, INC. AND PROVIDING HOME CARE SERVICES AND RESIDENCY FOR OLDER ADULTS. 5 5 52 6 0 0 1820 902045 1075888 1384216 489337 1476029 0 0 1567045 3762290 0 0 0 0 730139 764497 0 0 0 692389 744386 1422528 1508883 144517 2253407 26683866 30755011 4373983 4239087 22309883 26515924 X THE MISSION IS TO BETTER SERVE THE SENIOR HEALTHCARE AND SERVICE NEEDS AT OUR COMMUNITY. OUR SERVICES FOCUS ON EXCEPTIONAL CARE AND SERVICES IN THE HOME OR OTHER SETTINGS WHERE SENIORS MAY CALL HOME AND AT THE RESIDENCES OF 89 SOUTH. OUR SERVICES AND PROGRAMS ARE DESIGNED TO PROMOTE INDEPENDENCE AND WELL BEING. 0 0 639470 0 566658 89 SOUTH CARE SUPPORT PROVIDES LEADERSHIP, DIRECTION AND PHYSICAL SPACE TO SUPPORT BERKSHIRE RETIREMENT HOME, INC., WHICH IS A SKILLED NURSING FACILITY PROVIDING SHORT-TERM REHABILITATION, LONG-TERM CARE RESIDENCY, MEMORY CARE SUPPORT, PALLIATIVE CARE/CONFORT CARE, OUTPATIENT REHABILITATION AND RESPITE CARE. IN ADDITION, 89 SOUTH PROVIDES HOUSING AND SUPPORT SERVICES TO SENIORS THROUGH AN 18 UNIT CONTINUING CARE RETIREMENT COMMUNITY. 16 CLIENTS WERE SERVED DURING THE YEAR. 426718 0 817558 AT HOME WITH BERKSHIRE PLACE PROVIDES HOME CARE AND OTHER SERVICES IN A PERSON'S HOME OR WHEREVER THEY MAY CALL HOME. 136 CLIENTS WERE SERVED DURING THE YEAR. 1066188 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 1 1 0 0 0 1 0 0 52 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X EDWARD FORFA 4134454056 89 SOUTH STREET PITTSFIELD MA 01201 EDWARD A FORFA EXECUTIVE DIRECTOR 20.00 20.00 X 139979 139980 21408 NELSON FURLANO PRESIDENT 0.50 0.50 X X 0 0 0 JOHN MURPHY VICE-PRESIDENT 0.50 0.50 X X 0 0 0 DOROTHY MARA TREASURER 0.50 0.50 X X 0 0 0 MARK GILLIGAN SECRETARY/CLERK 0.50 0.50 X X 0 0 0 RICHARD HERRICK MEMBER - IMMEDIATE PAST PRESIDENT 0.50 0.50 X 0 0 0 139979 139980 21408 1 0 1 0 0 900000 2045 902045 HOMEMAKER & PERSONAL CARE 621610 801203 801203 PATIENT SERVICE REVENUE 623000 562429 562429 MISC. INCOME 623000 20584 20584 1384216 513364 513364 19990861 19028196 962665 962665 962665 3762290 1384216 0 1476029 150683 150683 509952 483334 26618 51157 43256 7901 52705 38992 13713 9508 9508 171695 171695 6931 6931 19308 19308 28148 27627 521 129511 128245 1266 217301 215177 2124 24518 24518 PLANT OPERATIONS 72880 72207 673 DIETARY EXPENSE 47070 47070 RESIDENT SUPPLIES & EXP 5793 5793 HOUSEKEEPING & LAUNDRY 4302 4302 7421 185 7236 1508883 1066188 442695 0 19858 55583 254815 400631 82021 136480 8030439 2169856 6057984 5860583 20269188 24301734 26683866 30755011 52553 61520 4337 0 3690285 3579012 626808 598555 4373983 4239087 X 22309883 26515924 22309883 26515924 26683866 30755011 2253407 1952634 0 X 0 1 X 1 1 1 X X X 1 BERKSHIRE RETIREMENT HOME INC 042103875 10 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7500 7500 7876491 2160735 5715756 146448 9121 137327 5860583 REFUNDABLE AND UNEARNED ENTRANCE FEE LIABILITIES 598555 598555 X PART X, LINE 2: BERKSHIRE RETIREMENT HOME, INC. AND 89 SOUTH CARE SUPPORT, INC. ARE EXEMPT FROM FEDERAL TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND STATE TAXES UNDER APPLICABLE STATE LAW. IN ADDITION, 89 SOUTH CARE SUPPORT, INC. QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 509(A)(3) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. AT HOME WITH BERKSHIRE PLACE, LLC HAS BEEN ORGANIZED AS A LIMITED LIABILITY COMPANY AND A PASS-THROUGH ENTITY AND IS INCLUDED WITHIN THE CONSOLIDATED TAX RETURN OF 89 SOUTH CARE SUPPORT, INC. MANAGEMENT HAS EVALUATED SIGNIFICANT TAX POSITIONS AGAINST THE CRITERIA ESTABLISHED BY PROFESSIONAL STANDARDS AND BELIEVES THERE ARE NO SUCH TAX POSITIONS REQUIRING ACCOUNTING RECOGNITION. GENERALLY, THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO EXAMINATION BY TAXING AUTHORITIES FOR THE PRIOR THREE FILING YEARS. THERE ARE CURRENTLY NO EXAMINATIONS PENDING OR IN PROGRESS. X X X 0 0 0 0 0 0 0 0 0 EDWARD A FORFA EXECUTIVE DIRECTOR 109979 109980 30000 30000 0 0 9100 9100 1604 1604 150683 150684 0 0 FORM 990, PART VI, SECTION A, LINE 1A AUTHORITY IS GRANTED TO AN EXECUTIVE COMMITTEE TO ACT ON BEHALF OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF THE FOUR OFFICERS OF THE BOARD OF DIRECTORS AND TWO CHAIRPERSONS OF STANDING COMMITTEES, WHICH ARE ALSO MEMBERS OF THE BOARD OF DIRECTORS. NO DECISIONS WERE MADE BY THE EXECUTIVE COMMITTEE DURING THE CURRENT YEAR, HOWEVER ALL DECISIONS MADE BY THE EXECUTIVE COMMITTEE WOULD BE REPORTED TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS A RELATED ORGANIZATION, BERKSHIRE RETIREMENT HOME, INC. FORM 990, PART VI, SECTION A, LINE 7A THE APPROVAL OF THE MEMBER, BERKSHIRE RETIREMENT HOME, INC., IS REQUIRED TO ELECT OR REMOVE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER, BERKSHIRE RETIREMENT HOME, INC., SHALL HAVE OTHER POWERS AND RIGHTS AS PROVIDED BY LAW, THE ARTICLES OF ORGANIZATION OR THE BY-LAWS, AND SUCH OTHER POWERS AND RIGHTS AS THE DIRECTORS MAY DESIGNATE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY TAX ADVISORS OF A NATIONAL ACCOUNTING FIRM WITH INFORMATION PROVIDED BY MANAGEMENT, AND IS PROVIDED TO THE AUDIT COMMITTEE AND THEN TO THE BOARD OF DIRECTORS FOR AUTHORIZATION. FORM 990, PART VI, SECTION B, LINE 12C A QUESTIONNAIRE MUST BE COMPLETED ANNUALLY BY OFFICERS, DIRECTORS AND KEY EMPLOYEES DISCLOSING ANY RELATIONSHIPS PRESENTING POTENTIAL CONFLICT OF INTEREST. ALL MEMBERS OF THE BOARD, TRUSTEES AND OFFICERS THAT ARE MAKING PURCHASES OR FUTURE RELATED PARTY TRANSACTIONS, MUST EXECUTE A CONFLICT OF INTEREST DISCLOSURE FORM. CONFLICTS OF INTEREST ARE MONITORED BY THE EXECUTIVE DIRECTOR AND ARE REVIEWED AND ENFORCED BY THE BOARD OF DIRECTORS. THE PERSON WITH THE CONFLICT MUST BE ABSTAIN FROM ANY DISCUSSION REGARDING THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 A PORTION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR'S SALARY AND BENEFITS IS ALLOCATED TO BERKSHIRE RETIREMENT HOME, INC. ANNUALLY, THE PRESIDENT, VICE PRESIDENT, COMMITTEE CHAIR, TREASURER AND SECRETARY REVIEW COMPENSATION BASED UPON GOALS, RESULTS, ACCOMPLISHMENTS AND COMPARABLE WAGE/BENEFITS DATA. THE PROCESS WAS COMPLETED MOST RECENTLY IN 2023. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS UPON REQUEST. AT HOME WITH BERKSHIRE PLACE 89 SOUTH STREET PITTSFIELD MA 01201 274015376 HOME CARE AND OTHER SERVICES MA 226328 415099 89 SOUTH CARE SUPPORT INC BERKSHIRE RETIREMENT HOME INC 290 SOUTH STREET PITTSFIELD MA 01201 042103875 RESIDENTIAL AND HEALTHCARE SERVICES TO OLDER ADULTS MA 501(C)(3) LINE 10 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0