efile Public Visual Render
ObjectId: 202031479349300503 - Submission: 2020-05-26
TIN: 04-2518575
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
18
Open to Public Inspection
Name of the organization
BAY COVE HUMAN SERVICES INC
Employer identification number
04-2518575
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
BAY COVE HIGH SCHOOL
66 CANAL ST
BOSTON
,
MA
02114
04-2718729
INACTIVE CORPORATION
MA
501(C)(3)
LINE 7
BAY COVE HUMAN SERVICES
Yes
(2)
BAY COVE MOSELEY GROUP HOME INC
66 CANAL ST
BOSTON
,
MA
02114
04-3123008
RESIDENTIAL RENTAL
MA
501(C)(3)
LINE 10
BAY COVE HUMAN SERVICES
Yes
(3)
JULIETTE CORPORATION
66 CANAL ST
BOSTON
,
MA
02114
04-2646806
RESIDENTIAL RENTAL
MA
501(C)(2)
BAY COVE HUMAN SERVICES
Yes
(4)
BAY COVE ORCHARDFIELD RESIDENCE INC
66 CANAL ST
BOSTON
,
MA
02114
04-3501357
RESIDENTIAL RENTAL
MA
501(C)(3)
LINE 7
BAY COVE HUMAN SERVICES
Yes
(5)
BAY COVE HAMILTON GROUP HOME
66 CANAL ST
BOSTON
,
MA
02114
04-3211683
RESIDENTIAL RENTAL
MA
501(C)(3)
LINE 10
BAY COVE HUMAN SERVICES
Yes
(6)
CASPAR INC
66 CANAL ST
BOSTON
,
MA
02114
23-7193288
HUMAN SERVICES AGENCY
MA
501(C)(3)
LINE 7
BAY COVE HUMAN SERVICES
Yes
(7)
BAY COVE WOODWARD PARK RESIDENCE INC
66 CANAL ST
BOSTON
,
MA
02114
04-3184824
RESIDENTIAL RENTAL
MA
501(C)(3)
LINE 10
BAY COVE HUMAN SERVICES
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Page 2
Schedule R (Form 990) 2018
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
COMMUNITY CARE PARTNERS LLC
66 CANAL STREET
BOSTON
,
MA
02114
82-1301095
HEALTH SERVICES
MA
BAY COVE HUMAN SERVICES
RELATED
1,455,435
No
No
47.500 %
(2)
LTSS CARE PARTNERS LLC
950 CAMBRIDGE STREET
CAMBRIDGE
,
MA
02141
82-1331783
HEALTH SERVICES
MA
BAY COVE HUMAN SERVICES
RELATED
383,523
No
No
47.500 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
Schedule R (Form 990) 2018
Page 3
Schedule R (Form 990) 2018
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
Yes
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
Yes
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
JULIETTE CORPORATION
Q
148,124
FMV
(2)
CASPAR INC
L
392,976
FMV
(3)
CASPAR INC
C
2,478,509
FMV
(4)
BAY COVE WOODWARD PARK RESIDENCE INC
Q
80,607
FMV
Schedule R (Form 990) 2018
Page 4
Schedule R (Form 990) 2018
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2018
Page 5
Schedule R (Form 990) 2018
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2018
Additional Data
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