Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 411,148 | 357,839 | 480,186 | 466,533 | 260,163 | 1,975,869 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 15,267,499 | 15,558,915 | 15,507,040 | 15,287,415 | 13,715,974 | 75,336,843 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 15,678,647 | 15,916,754 | 15,987,226 | 15,753,948 | 13,976,137 | 77,312,712 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 77,312,712 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 15,678,647 | 15,916,754 | 15,987,226 | 15,753,948 | 13,976,137 | 77,312,712 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2,550,889 | 1,672,125 | 299,677 | 314,224 | 247,312 | 5,084,227 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 2,550,889 | 1,672,125 | 299,677 | 314,224 | 247,312 | 5,084,227 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 1,020,863 | 951,841 | 1,016,096 | 1,526,953 | 854,093 | 5,369,846 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 19,250,399 | 18,540,720 | 17,302,999 | 17,595,125 | 15,077,542 | 87,766,785 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990 - REASON FOR AMENDMENT: | THE ORGANIZATION AMENDED IT'S FORM 990 TO REFLECT THE FOLLOWING CHANGES - FORM 990, PART VIII, LINES 1F, 3, 6, 7 AND 11 - THE AMOUNTS REPORTED IN THESE LINES WERE UPDATED TO TIE TO THE AUDITED FINANCIAL STATEMENTS. FORM 990, PART IX, LINES 5 AND 7 - THE AMOUNTS IN THESE LINES WERE UPDATED TO BREAKOUT COMPENSATION RECIEVED BY THE ORGANIZATION'S CURRENT OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES. Form 990, Part IX, Line 24e - THE AMOUNT REPORTED IN THIS LINE WAS WAS UPDATED TO TIE TO THE AUDITED FINANCIAL STATEMENTS. FORM 990, PART X, LINES 1, 4, 9, 10C, 11, 15, 17, 25, 27, 29 AND PART XI, LINE 9 - THE AMOUNTS IN THESE LINES WERE UPDATED TO TIE TO THE AUDITED FIANCIAL STATEMENTS, AS WELL AS, REFLECT THE IMPACT OF THE ASSET IMPAIRMENT AS PER THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. FORM 990 PART VI SECTION A LINE 3: THE ORGANIZATION'S MANAGEMENT DUTIES ARE HANDLED BY ONE OF IT'S RELATED ENTITIES, MASONIC HEALTH SYSTEMS OF MASSACHUSETTS, INC. FORM 990 PART VI SECTION A LINE 3: THE ORGANIZATION'S MANAGEMENT DUTIES ARE HANDLED BY ONE OF IT'S RELATED ENTITIES, MASONIC HEALTH SYSTEMS OF MASSACHUSETTS, INC. ENTITIES, MASONIC HEALTH SYSTEMS OF MASSACHUSETTS, INC. |
| FORM 990 PART VI SECTION A LINE 6: | MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC. IS THE SOLE CORPORATE MEMBER OF OVERLOOK MASONIC HEALTH CENTER INC. AS SUCH THE HEALTH SYSTEM HAS THE RIGHT TO APPROVE ACTIONS TAKEN BY THE BOARD MEMBERS OF OVERLOOK MASONIC HEALTH CENTER INC. |
| FORM 990 PART VI SECTION A LINE 7A: | MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. IS THE SOLE CORPORATE MEMBER OF OVERLOOK MASONIC HEALTH CENTER, INC. AS SUCH, THE HEALTH SYSTEM HAS THE RIGHT TO ELECT AND APPROVE BOARD MEMBERS OF OVERLOOK MASONIC HEALTH CENTER, INC. |
| FORM 990 PART VI SECTION A LINE 7B: | MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. IS THE SOLE CORPORATE MEMBER OF OVERLOOK MASONIC HEALTH CENTER, INC. AS SUCH, THE HEALTH SYSTEM HAS THE RIGHT TO APPROVE ACTIONS TAKEN BY THE BOARD MEMBERS OF OVERLOOK MASONIC HEALTH CENTER, INC. |
| FORM 990 PART VI SECTION B LINE 11: | MANAGEMENT WORKS WITH THE ORGANIZATION'S EXTERNAL AUDITORS TO PREPARE THE FINANCIAL INFORMATION AND COMPILE THE DISCLOSURES REQUIRED OF THE FORM 990. UPON ITS COMPLETION, SENIOR MANAGEMENT PROVIDES A DRAFT OF THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO ITS SUBMISSION. |
| FORM 990 PART VI SECTION B LINE 12C: | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY VIA ANNUAL EXECUTION OF THE CONFLICT OF INTEREST POLICY. THIS CONFLICTS POLICY IS INTENDED TO SUPPLEMENT, BUT NOT REPLACE, ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE CORPORATIONS. THIS CONFLICTS POLICY HAS BEEN ADOPTED BY THE BOARD OF DIRECTORS OF MASONIC HEALTH SYSTEM OF MASSACHUSETTS, INC. (MHS} THIS CONFLICTS POLICY SHALL APPLY WITH EQUAL FORCE TO ALL CORPORATIONS RELATED TO, OR AFFILIATED WITH MHS. |
| FORM 990 PART VI SECTION B LINE 13: | IT IS THE POLICY OF MHS TO ACTIVELY WORK TO PREVENT FRAUD, WASTE, OR ABUSE OF PROCEDURE. ALL EMPLOYEES CONTRACTORS, AGENTS, AND VOLUNTEERS OF MHS MUST IMMEDIATELY REPORT ANY SUSPICION OF FRAUD, WASTE, OR ABUSE OF PROCEDURE IN CONNECTION WITH MHS OPERATIONS TO HIS OR HER SUPERVISOR. MHS ENGAGES IN A CORPORATE COMPLIANCE PROGRAM FOR THE PURPOSE OF DETECTING AND PREVENTING FRAUD, WASTE, AND ABUSE OF PROCEDURE. |
| FORM 990 PART VI SECTION B LINE 14: | MANAGEMENT AND THE BOARD ARE IN THE PROCESS OF INITIATING A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. |
| FORM 990 PART VI SECTION B LINE 15: | THE ORGANIZATION'S SOLE MEMBER MASONIC HEALTH SYSTEM OF MASSACHUSETTS INC. MAINTAINS AN EXECUTIVE COMMITTEE TO ANNUALLY REVIEW THE PERFORMANCE AND COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES. THE EXECUTIVE COMMITTEE DETERMINES THE COMPENSATION FOR OFFICERS AND KEY EMPLOYEES ANNUALLY BASED ON COMPARABLE INDUSTRY DATA AND THROUGH A CONSULTATION AGREEMENT WITH TOWERS PERRIN, A NATIONAL HUMAN RESOURCES CONSULTANT. THE DETERMINATION OF COMPENSATION IS SUBSTANTIATED IN THE ORGANIZATION'S MINUTES OF THE EXECUTIVE COMMITTEE. |
| FORM 990 PART VI SECTION C LINE 18: | THE ORGANIZATION'S FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST AND CAN BE FOUND AT THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. |
| FORM 990 PART VI SECTION C LINE 19: | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990 PART VI SECTION C LINE 19: | THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. |
| FORM 990 PART XI LINE 9 CHANGES IN NET ASSETS: | TRANSFER TO THE GRAND LODGE OF MASONS -2,246,414 TEMP RESTRICTED UNREALIZED GAINS/LOSSES -2,086,825 ___________ TOTAL -4,333,239 |
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