2024-09-27T13:05:35-05:00 2023-12-31 872525370 CITRIN COOPERMAN ADVISORS LLC 500 EXCHANGE STREET SUITE 9-100 PROVIDENCE RI 02903 990 2023-01-01 050382511 JOHN CLARKE RETIREMENT CENTER JOHN 4018460743 600 VALLEY ROAD MIDDLETOWN RI 02846 JOAN M WOODS CEO 4018460743 2024-09-27 1 1 MICHAEL CRISCIONE P01456801 4014214800 2024-09-27 2023 2024-10-15 13:58:12Z JOHN CLARKE SENIOR LIVING JOAN M WOODS 600 VALLEY ROAD MIDDLETOWN RI 02846 8544697 0 X WWW.JOHNCLARKESENIORLIVING.ORG X 1979 RI OPERATION OF NURSING HOME AND RETIREMENT CENTER 11 11 103 1 0 0 860561 253217 6525383 7495479 58417 228826 31794 119190 7476155 8096712 0 0 0 0 4037736 4675595 0 0 0 2939537 3112099 6977273 7787694 498882 309018 6985858 7433185 2661352 2652832 4324506 4780353 X JOHN CLARKE RETIREMENT AND NURSING CENTER ("THE CENTER") WILL ENDEAVOR TO IMPROVE THE LIVES WE SERVE WITH RESPECT, COMPASSION AND KINDNESS. OUR VISION IS TO BE THE SENIOR LIVING PROVIDER OF CHOICE.THE CENTER COMPLIES WITH CIVIL RIGHTS LAW & DOES NOT EXCLUDE, DENY BENEFITS TO, OR OTHERWISE DISCRIMINATE AGAINST ANY PERSON (I.E. PATIENTS, EMPLOYEES, OR VISITORS) BECAUSE OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, GENDER, GENDER EXPRESSION, GENDER IDENTITY, SEXUAL ORIENTATION, HIV STATUS, AGE, DISABILITY, MARITAL STATUS, PREGNANCY, ANCESTRY, GENETIC INFORMATION, AMNESTY OR VETERAN STATUS IN HIRING, ADMISSION TO, PARTICIPATION IN, OR RECEIPT OF THE SERVICES & BENEFITS UNDER ANY OF ITS PROGRAMS & ACTIVITIES WHETHER CARRIED OUT BY THE LOCATION DIRECTLY, OR THROUGH A CONTRACTOR OR ANY OTHER ENTITY. 0 0 6139931 6621723 THE CENTER'S OPERATIONS INCLUDES A NURSING CENTER AND RETIREMENT CENTER FOR THE ELDERLY AND NEEDY. THE NURSING HOME IS A 60 BED FACILITY THAT IS MEDICARE AND MEDICAID CERTIFIED. THE NURSING HOME ALSO PROVIDED PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY. DURING 2023 THERE WERE 19,698 BED DAYS PROVIDED. INCLUDED IN THIS TOTAL WERE 10,039 MEDICAID AND 1,646 MEDICARE BED DAYS PROVIDED. 654163 873756 THE RETIREMENT CENTER IS A TWO LEVEL 50 APARTMENT FACILITY FEATURING A LIVING ROOM, BEDROOM, FULL BATH AND ALL-ELECTRIC KITCHENS. 6794094 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 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 0 0 0 0 1 9 0 1 103 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 X JOAN WOODS 4018460743 600 VALLEY ROAD MIDDLETOWN RI 02846 JOHN THORPE PRESIDENT 5.00 X X 0 0 0 KAREN PIACENTINI VICE PRESIDENT 5.00 X X 0 0 0 HUGH J HALL TREASURER 5.00 X X 0 0 0 DAVID MAINE SECRETARY 5.00 X X 0 0 0 JENNIFER FAIRBANK DIRECTOR 5.00 X 0 0 0 RACHEL CARPENTER DIRECTOR 5.00 X 0 0 0 MARY ELLEN GROSVENOR DIRECTOR THROUGH 10/03/2023 5.00 X 0 0 0 JOE MARION DIRECTOR 5.00 X 0 0 0 VIRGINIA BUTTERWORTH DIRECTOR THROUGH 05/31/2023 5.00 X 0 0 0 PETER CHATELLIER DIRECTOR 5.00 X 0 0 0 JOHN BAGWILL DIRECTOR 5.00 X 0 0 0 JOHN SWEENEY DIRECTOR 5.00 X 0 0 0 CHRISTINE MCGUIRE DIRECTOR 5.00 X 0 0 0 CINDY MACIOCI EXECUTIVE DIRECTOR 40.00 X 108556 0 9614 JOAN M WOODS CEO/ADMINISTRATOR 40.00 X 175215 0 3259 KIMBERLY DOUGHERTY DIRECTOR OF NURSING 40.00 X 110975 0 7386 SHARON BIRD REGISTERED NURSE 40.00 X 110430 0 18676 GENTLE GUINGUING MEDTECH 40.00 X 109463 0 10100 JOB C PALAYA REGISTERED NURSE 40.00 X 117070 0 8576 DIONNE S WILLIAMS-ROSSI REGISTERED NURSE 40.00 X 120820 0 8600 852529 0 66211 5 0 1 0 0 57100 196117 253217 NURSING CENTER 623990 6621723 6621723 RETIREMENT CENTER 623000 873756 873756 7495479 214799 214799 462012 447985 14027 14027 14027 MISCELLANEOUS INCOME 900099 119190 119190 119190 8096712 7495479 0 348016 309098 271955 37143 3524960 3101375 423585 27403 24110 3293 531256 467416 63840 282878 248885 33993 1463 1463 48596 48596 16207 16207 298532 87442 211090 16952 16952 18294 18294 43832 43832 410617 410617 4219 4219 81689 81689 327227 327227 135361 135361 RESIDENT RELATED PURCHA 1269121 1269121 HEALTHCARE PROVIDER ASS 364677 364677 PROVISION FOR LOSSES ON 75312 75312 7787694 6794094 993600 0 1205115 2501071 1342203 683101 517325 45030 114535 10564619 7946682 2225776 2617937 1484633 1682317 6985858 7433185 533392 587234 1684610 1641120 443350 424478 2661352 2652832 X 3814515 4756662 509991 23691 4324506 4780353 6985858 7433185 309018 146829 0 X X 0 1 X 1 0 X 30351 1239876 1808828 681358 253217 4013630 6377762 6282812 6298863 6525383 7495479 32980299 6408113 7522688 8107691 7206741 7748696 36993929 0 0 0 36993929 65928 40168 36598 36797 214799 394290 65928 40168 36598 36797 214799 394290 3713 211556 31794 119190 366253 6477754 7562856 8355845 7275332 8082685 37754472 0.97990 0.98570 0.01040 0.00750 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2019 AMOUNT: $ 3,713. 2021 AMOUNT: $ 211,556. 2022 AMOUNT: $ 31,794. 2023 AMOUNT: $ 119,190. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 120000 120000 8173469 6084380 2089089 2236952 1862302 374650 34198 34198 2617937 DUE TO THIRD-PARTY PAYORS 424478 424478 X 8227334 146829 146829 8080505 16207 16207 8096712 7771487 0 7771487 16207 16207 7787694 PART X, LINE 2: NO PROVISION FOR FEDERAL AND STATE INCOME TAXES HAS BEEN REFLECTED IN THE FINANCIAL STATEMENTS SINCE THE CENTER QUALIFIES AS A TAX-EXEMPT ORGANIZATION AS PROVIDED UNDER THE INTERNAL REVENUE CODE SECTION 501(C)(3). THE INTERNAL REVENUE SERVICE HAS CLASSIFIED THE CENTER AS AN ORGANIZATION WHICH IS A PUBLIC CHARITY. U.S. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE CENTER RECOGNIZES INTEREST AND PENALTIES, IF APPLICABLE, AS A COMPONENT OF INTEREST EXPENSE. THE CENTER FILES AN INCOME TAX RETURN IN THE U.S. FEDERAL JURISDICTION. X 0 0 0 0 0 0 0 0 0 JOAN M WOODS CEO/ADMINISTRATOR 165004 0 10211 0 0 0 3259 0 0 0 178474 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS WILL REVIEW THE FORM 990. THEY WILL THEN REPORT TO THE BOARD OF DIRECTORS AND PROVIDE THEM WITH A COPY OF THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CENTER HAS ADOPTED A CONFLICT OF INTEREST POLICY. THE POLICY REQUIRES ALL MEMBERS OF THE BOARD OF DIRECTORS TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. THE BOARD OF DIRECTORS WILL REVIEW ALL INFORMATION AND DECIDE WHAT ACTION WILL BE NECESSARY BECAUSE OF THE POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATOR'S COMPENSATION IS DETERMINED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE TAKES INTO ACCOUNT THE COMPENSATION PAID TO SIMILAR ADMINISTRATORS AT COMPARABLE NON-PROFIT ORGANIZATIONS IN THE AREA. THE COMMITTEE ALSO CONSIDERS THE CENTER'S PERFORMANCE DURING THE REVIEW PERIOD AND THE ADMINISTRATOR'S SUCCESS IN ACHIEVING THE CENTER'S GOALS. THE DISCUSSIONS AND DECISION OF THE ADMINISTRATOR COMPENSATION ARE DOCUMENTED BY THE BOARD OF DIRECTORS DURING THE BOARD MEETING. THE ADMINISTRATOR REVIEWS ALL OTHER EMPLOYEES FOR COMPENSATION. THE ADMINISTRATOR CONSIDERS THE PERFORMANCE OF EACH INDIVIDUAL EMPLOYEE DURING THE REVIEW PERIOD AND CONSIDERS THE EMPLOYEE'S SUCCESS IN ACHIEVING THE CENTER'S GOALS. ALSO, THE ADMINISTRATOR COMPARES COMPENSATION OF COMPARABLE NON-PROFIT ORGANIZATIONS IN THE AREA. FORM 990, PART VI, SECTION C, LINE 19 THE CENTER'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE BODY OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT OF THE ANNUAL AUDIT.