2024-06-25T08:51:41-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2023-01-01 050275443 SAINT ANTOINE RESIDENCE SAIN 4017673500 10 RHODES AVENUE NORTH SMITHFIELD RI 02896 GARRETT SULLIVAN EXECUTIVE DIRECTOR 4017673500 2024-06-24 1 GARRETT SULLIVAN 999009999 0 KATARZYNA O PADZIK P02268641 7819821001 2024-06-24 2 AAL1 IAL1 2023 2023-04-26 12:10:37Z RICHARD G HENNING 10 RHODES AVENUE NORTH SMITHFIELD RI 02896 19994555 0 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 2 286 2 0 0 1110482 297231 18574125 19269655 66998 328298 42214 52583 19793819 19947767 0 0 0 0 13287584 13992843 0 0 0 8267342 8755505 21554926 22748348 -1761107 -2800581 20112906 19368109 3657913 5659162 16454993 13708947 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 20041630 0 19269655 THE OPERATION OF A LONG-TERM CARE FACILITY FOR THE ELDERLY AND OTHER NEEDY INDIVIDUALS. DURING 2023, ST. ANTOINE RESIDENCE PROVIDED A TOTAL 61,949 OF PATIENT BED DAYS, INCLUDING 51,620 BED DAYS TO MEDICAID AND MEDICARE PATIENTS. 20041630 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 15 0 286 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 6 2 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X GARRETT SULLIVAN 4017673500 10 RHODES AVENUE NORTH SMITHFIELD RI 028966999 MOST REV RICHARD HENNING PRESIDENT / TREASURER (AS OF 05/23) 1.00 39.00 X X 0 39998 20725 MOST REV THOMAS J TOBIN PRESIDENT / TREASURER (THROUGH 05/23) 1.00 39.00 X X 0 15148 10156 REV MSGR ALBERT A KENNEY VICE PRESIDENT 1.00 39.00 X X 0 47022 30882 REV TIMOTHY D REILLY SECRETARY 1.00 39.00 X X 0 31710 20082 LAURA DOS SANTOS ASST. TREASURER 1.00 40.00 X X 0 218950 18661 GARRETT E SULLIVAN EXECUTIVE DIRECTOR 40.00 0.00 X 199052 0 34200 KATHY KEELING DON 40.00 0.00 X 142527 0 25604 TRACY MCCARTHY ASST. DIRECTOR OF NURSING 40.00 0.00 X 139273 0 16687 RICHARD BERGERON LPN 40.00 0.00 X 130649 0 29867 TAMMY DUQUETTE RN SUPERVISOR 40.00 0.00 X 120895 0 32265 PENNY FUCHS RN 40.00 0.00 X 107797 0 10407 JAMES JAHNZ DIRECTOR 1.00 1.00 X 0 0 0 REV MSGR GEORGE FRAPPIER DIRECTOR 1.00 1.00 X 0 0 0 840193 352828 249536 7 0 1 0 BENTLEY BUILDERS LLC 1160 POST RD WARWICK RI 02888 MEMORY CARE UNIT RENOVATIONS 1519833 CARELINK INC 400 MASSASOIT AVE 300 EAST PROVIDENCE RI 02914 THERAPY SERVICES 1513479 HEALTH SERVICES GROUP INC 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 HOUSEKEEPING AND LAUNDRY SERVICES 1033733 DIOCESE ADMINSTRATION CORPORATION 1 CATHEDRAL SQUARE PROVIDENCE RI 02903 MANAGEMENT SERVICES 559341 OMNICARE INC 2 TECHNOLOGY DR PEABODY MA 01960 PHARMACEUTICAL SERVICES 444770 12 32900 100000 59567 104764 297231 MEDICAID & MEDICARE REVENUES 623000 14118390 14118390 NURSING HOME FEES 623000 5071265 5071265 MANAGEMENT FEE INCOME 623000 80000 80000 19269655 328298 328298 12000 106 11894 11894 11894 75505 32900 46682 28823 28823 OTHER INCOME 900099 11866 11866 11866 19947767 19269655 0 380881 233252 233252 10823950 9934942 889008 788161 721120 67041 1249092 1145864 103228 898388 809710 88678 525990 525990 10158 10158 55692 55692 50872 50872 156413 156413 23094 23094 100623 100623 193193 193193 1360204 1281754 78450 6275 6275 5687 5360 327 947922 893386 54536 287949 287949 RESIDENT RELATED PURCHA 2984229 2946027 38202 HEALTH CARE PROVIDER AS 1006022 1006022 FOOD 570156 570156 CREDIT LOSSES EXPENSE 444321 444321 26705 -4981 31686 22748348 20041630 2706718 0 1400 1400 3124159 2107030 2199265 2685700 78238 75763 179208 182060 29827188 17785428 10218663 12041760 375460 409516 3936513 1864880 20112906 19368109 3590846 4246301 67067 91363 1321498 3657913 5659162 X 16317649 13570741 137344 138206 16454993 13708947 20112906 19368109 -2800581 54535 0 X X 0 1 X 1 0 X 165608 6623933 6000721 1110482 297231 14197975 25694695 21011201 16948724 18574125 19269655 101498400 12000 12000 11787 11894 47681 25872303 27647134 22949445 19696394 19578780 115744056 0 0 0 115744056 34221 12247 42871 66998 328298 484635 34221 12247 42871 66998 328298 484635 16779 40986 11134 21314 11866 102079 25923303 27700367 23003450 19784706 19918944 116330770 0.99500 0.99740 0.00420 0.00170 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2019 AMOUNT: $ 12,145. 2020 AMOUNT: $ 9,739. 2021 AMOUNT: $ 11,134. 2022 AMOUNT: $ 21,314. 2023 AMOUNT: $ 11,866. DISCOUNTS EARNED - 2019 AMOUNT: $ 4,634. 2020 AMOUNT: $ 31,247. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 375461 0 54781 20726 409516 452534 10000 -67302 19771 375461 415334 55024 17824 452534 375774 58048 18488 415334 335019 59274 18519 375774 0.66000 0.11000 0.23000 0 0 216000 216000 19638124 12157058 7481066 6940479 5594729 1345750 3032585 33641 2998944 12041760 DUE FROM AFFILIATES 127165 DEMAND NOTE RECEIVABLE 1737715 1864880 X 19951106 54535 54535 19896571 50872 324 51196 19947767 22697152 0 22697152 50872 324 51196 22748348 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: SUBSIDIARY EXPENSES 324. PART XII, LINE 4B - OTHER ADJUSTMENTS: SUBSIDIARY EXPENSES 324. X X X 0 GOLF TOURNAMENT 108405 32900 75505 39403 7274 108405 32900 75505 39403 7274 46677 28828 X X 0 0 0 0 0 0 0 0 0 LAURA DOS SANTOS ASST. TREASURER 0 218950 0 0 0 0 0 4370 0 14291 0 237611 0 0 GARRETT E SULLIVAN EXECUTIVE DIRECTOR 199052 0 0 0 0 0 11935 0 22265 0 233252 0 0 0 KATHY KEELING DON 142527 0 0 0 0 0 16561 0 9043 0 168131 0 0 0 TRACY MCCARTHY ASST. DIRECTOR OF NURSING 139273 0 0 0 0 0 16072 0 615 0 155960 0 0 0 RICHARD BERGERON LPN 130649 0 0 0 0 0 8197 0 21670 0 160516 0 0 0 TAMMY DUQUETTE RN SUPERVISOR 120895 0 0 0 0 0 10483 0 21782 0 153160 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 BISHOP RICHARD G. HENNING, PRESIDENT/TREASURER, MSGR. ALBERT A. KENNEY, VICE PRESIDENT, REV. TIMOTHY D. REILLY, SECRETARY, AND LAURA DOS SANTOS, ASST. TREASURER, ARE ALL PART OF THE ROMAN CATHOLIC DIOCESE OF PROVIDENCE. FORM 990, PART VI, SECTION B, LINE 11B THE DIOCESE'S HEALTH FACILITIES MANAGEMENT SERVICE GROUP AND THE EXECUTIVE DIRECTOR REVIEW THE 990 PRIOR TO FILING. THE 990 IS ALSO MADE AVAILABLE TO ALL MEMBERS OF GOVERNANCE FOR REVIEW BEFORE FILING. UPON REVIEW AND APPROVAL, THE RETURN IS FILED WITH THE IRS. 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 12C ALL KEY EMPLOYEES AND MEMBERS OF THE BOARD OF DIRECTORS ARE ASKED TO READ THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND ANNUALLY THEY ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. THE EXECUTIVE DIRECTOR AND THE FINANCE DIRECTOR REVIEW ALL POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY KEY EMPLOYEES AND DETERMINE IF A TRUE CONFLICT EXISTS. IF AN INDIVIDUAL HAS A CONFLICT, THE EXECUTIVE DIRECTOR AND THE DIRECTOR OF FINANCE REPORT THIS INFORMATION TO THE BOARD OF DIRECTORS. ALL MEMBERS OF THE BOARD ARE ASKED TO DISCLOSE ANY CONFLICTS OF INTEREST, AND DEPENDING UPON THE CONFLICT, THEY ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS AND VOTING ON THE RELATED ISSUE. ALL DECISIONS ARE RECORDED IN THE MINUTES OF THE BOARD OF DIRECTORS' MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS FUNCTIONS AS A COMPENSATION COMMITTEE IN DETERMINING COMPENSATION FOR THE ADMINISTRATOR AND OTHER OFFICERS. 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 COMPENSATION OF ALL OTHER EMPLOYEES. IN MAKING A DECISION ON THE AMOUNT OF COMPENSATION, THE ADMINISTRATOR TAKES INTO ACCOUNT THE COMPENSATION PAID TO SIMILAR EXECUTIVES, PERFORMING SIMILAR TYPES OF DUTIES, AT COMPARABLE NON-PROFIT ORGANIZATIONS IN THE RHODE ISLAND AREA. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART XII, LINE 2C: THE DIOCESE HEALTH MANAGEMENT SERVICES GROUP AND THE EXECUTIVE DIRECTOR ARE 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 DIOCESE HEALTH MANAGEMENT SERVICES GROUP AND THE EXECUTIVE DIRECTOR AND SUBMITTED TO THE ADVISORY BOARD AND CORPORATE BOARD. 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