2024-02-22T16:05:33-06:00 2023-05-31 410746749 CLIFTONLARSONALLEN LLP 4 BATTERYMARCH PARK SUITE 100 QUINCY MA 02169 990 2022-06-01 823380934 89 SOUTH CARE SUPPORT INC 89SO 4134454056 89 SOUTH STREET PITTSFIELD MA 01201 DOROTHY MARA TREASURER 4134454056 2024-02-20 1 DOROTHY MARA 999009999 0 KATARZYNA O PADZIK P02268641 7819821001 2024-02-20 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z NELSON FURLANO 89 SOUTH STREET PITTSFIELD MA 01201 13266654 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 63 6 0 0 2490 1820 1059392 1075888 723592 489337 0 0 1785474 1567045 0 0 0 0 728264 730139 0 0 0 661441 692389 1389705 1422528 395769 144517 26959750 26683866 4814568 4373983 22145182 22309883 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 606419 0 408641 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. NINE CLIENTS WERE SERVED DURING THE YEAR. 397269 0 667247 AT HOME WITH BERKSHIRE PLACE PROVIDES HOME CARE AND OTHER SERVICES IN A PERSON'S HOME OR WHEREVER THEY MAY CALL HOME. 149 CLIENTS WERE SERVED DURING THE YEAR. 1003688 1 0 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 63 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 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 EDWARD A FORFA EXECUTIVE DIRECTOR 20.00 20.00 X 256462 0 13175 256462 0 13175 1 0 1 0 0 1820 1820 HOMEMAKER & PERSONAL CARE 621610 609448 609448 PATIENT SERVICE REVENUE 623000 408470 408470 MISC. INCOME 623000 57970 57970 1075888 393158 393158 11795788 11699609 96179 96179 96179 1567045 1075888 0 489337 134819 134819 497101 448150 48951 49332 41250 8082 48887 35120 13767 10182 10182 143994 143994 2711 2711 19881 19881 51355 50785 570 133043 131742 1301 214005 211913 2092 12040 11154 886 MISCELLANEOUS 45234 13929 31305 DIETARY EXPENSE 32643 32643 PLANT OPERATIONS 20246 19947 299 RESIDENT SERVICES 6492 6492 563 563 1422528 1003688 418840 0 54403 19858 506838 254815 70320 82021 8010593 1952609 6272366 6057984 20055823 20269188 26959750 26683866 61083 52553 9265 4337 3798026 3690285 946194 626808 4814568 4373983 X 22145182 22309883 22145182 22309883 26959750 26683866 X 144517 -179816 200000 X 0 1 X 1 1 1 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 20559 20559 7853183 1943488 5909695 136851 9121 127730 6057984 REFUNDABLE AND UNEARNED ENTRANCE FEE LIABILITIES 626808 626808 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 206462 0 50000 0 0 0 10258 0 2917 0 269637 0 0 0 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 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM 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 2022. 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. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER FROM BERKSHIRE RETIREMENT HOME, INC. 200,000. AT HOME WITH BERKSHIRE PLACE 89 SOUTH STREET PITTSFIELD MA 01201 274015376 HOME CARE AND OTHER SERVICES MA 94131 285276 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 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1