2024-08-14T07:31:35-05:00 2023-09-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2022-10-01 611508839 Alliance Health Services ALLI 6036683545 100 McGregor Street Manchester NH 03102 Pamela J Martel Vice President & CFO 6036683545 2024-08-01 1 0 Connor Smart P02285543 2078792100 2024-08-01 2022 2024-08-08 14:25:15Z Alexander Walker Jr Esq 100 McGregor Street Manchester NH 03102 11412862 0 0928 X www.catholicmedicalcenter.org X 2007 NH To promote health care programs from the greater Manchester, New Hampshire community. 9 4 0 4 0 0 168470 0 16402679 11412862 0 -6214 0 0 16571149 11406648 0 0 0 0 0 0 0 0 0 23117029 15876124 23117029 15876124 -6545880 -4469476 4054077 2682682 4016535 1814616 37542 868066 To promote health care programs for a broad cross-section of the greater Manchester, New Hampshire community. 0 0 15550217 0 11412862 To promote health care programs for a broad cross-section of the greater Manchester, New Hampshire community. 15550217 1 0 0 0 0 0 0 0 0 0 0 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 0 1 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NH X Pamela J Martel VP & CFO 6036683545 100 McGregor Street Manchester NH 03102 William B Clutterbuck MD Secretary/Treasurer 0.10 40.00 X X 0 371702 34460 Patricia Furey MD Director 0.10 41.80 X 0 505822 52436 Michael Gilbert MD Director 0.10 40.30 X 0 556392 54703 Jason Cole Esq Director 0.10 40.40 X 0 315468 52112 Alexander Walker Jr Esq President & CEO/Vice Chair 0.10 43.90 X 0 705005 397339 Robert Capodilupo MD Interim Trustee, Vice President 0.10 40.80 X X 0 686462 45682 Craig Beck Director 0.10 0.00 X 0 0 0 Stephen LeBlanc Director 0.10 0.00 X 0 0 0 Maria Padin MD Director 0.10 0.00 X 0 0 0 John G Cronin Esq Chair 0.10 1.30 X X 0 0 0 Edward Dudley III Executive VP & CFO (end 2/2023) 0.10 40.10 X 0 548250 278328 Pamela Martel Executive VP & CFO 0.10 40.40 X 0 179495 18897 Joseph Pepe MD Former President & CEO (end 6/2022) 0.00 0.50 X 0 733333 1338 0 4601929 935295 0 1 1 0 Dartmouth Hitchcock Clinic 1 Medical Center Drive Lebanon NH 03756 Medical Services 20008417 1 Patient service revenue 621400 10792346 10792346 Rental income 532000 620516 620516 11412862 6214 -6214 -6214 -6214 11406648 11412862 0 -6214 X 325907 325907 12370831 12370831 25843 25843 1479044 1479044 17468 17468 662 662 2608 2608 103482 103482 Medical/pharmaceutical 1107721 1107721 Provision for bad debts 389402 389402 Equipment rental 48380 48380 Forms and supplies 4776 4776 15876124 15550217 325907 0 1485359 122041 2470916 917909 88979 107276 0 8823 1535456 4054077 2682682 3774400 31355 237163 0 4972 1783261 4016535 1814616 X 37542 868066 37542 868066 4054077 2682682 X -4469476 5300000 X X 0 1 X 1 0 X 478188 168470 646658 16862758 16976395 17372223 16402679 11412862 79026917 16862758 17454583 17372223 16571149 11412862 79673575 0 0 0 79673575 16862758 17454583 17372223 16571149 11412862 79673575 1.00000 1.00000 0.00000 X 0 Due to affiliates 10641 Operating lease liabilities 1772620 1783261 X 11017246 0 11017246 389402 389402 11406648 15486722 0 15486722 389402 389402 15876124 Part X, Line 2: The Organization is part of the Catholic Medical Center Healthcare System. The System and all related entities, with the exception of Enterprises and DMA, are not-for-profit corporations as described in Section 501(c)(3) of the Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the System's tax positions and concluded the System has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to the consolidated financial statements. Part XI, Line 4b - Other Adjustments: Provision for bad debts 389,402. Part XII, Line 4b - Other Adjustments: Provision for bad debts 389,402. 1 1 0 0 0 0 0 0 0 Alexander Walker Jr Esq President & CEO/Vice Chair 0 627831 0 0 0 77174 0 292846 0 104493 0 1102344 0 0 Edward Dudley III Executive VP & CFO (end 2/2023) 0 494403 0 338 0 53509 0 222434 0 55894 0 826578 0 0 Joseph Pepe MD Former President & CEO (end 6/2022) 0 0 0 0 0 733333 0 0 0 1338 0 734671 0 0 Robert Capodilupo MD Interim Trustee, Vice President 0 550015 0 136447 0 0 0 15250 0 30432 0 732144 0 0 Michael Gilbert MD Director 0 547460 0 0 0 8932 0 9150 0 45553 0 611095 0 0 Patricia Furey MD Director 0 466939 0 38883 0 0 0 12200 0 40236 0 558258 0 0 William B Clutterbuck MD Secretary/Treasurer 0 371702 0 0 0 0 0 12200 0 22260 0 406162 0 0 Jason Cole Esq Director 0 308957 0 0 0 6511 0 9212 0 42900 0 367580 0 0 Pamela Martel Executive VP & CFO 0 178567 0 0 0 928 0 7491 0 11406 0 198392 0 0 Part I, Line 3 The Organization's President & CEO's compensation was established by a related organization, Catholic Medical Center. That organization used a compensation committee, independent compensation consultant, Form 990 of other organizations, a compensation survey/study, and approval by their board of directors/compensation committee to determine the President & CEO's compensation and benefits. Part I, Lines 4a-b Schedule J, Page 1, Line 4a, severance payments: Dr. Joseph Pepe, who previously served as the Organization's President and CEO, retired in June, 2021. As part of his retirement, Dr. Pepe became entitled to severance compensation, as per his employment agreement, from the Catholic Medical Center (a related organization). Dr. Pepe received severance compensation of $733,333 during calendar year 2022, after his formal retirement in June, 2021. This severance was included in his 2022 Form W-2 wages, and is also included in the amount of compensation reported on this Schedule J, Part II, Column B(iii). Schedule J, Page 1, Line 4b, supplemental non-qualified retirement plans: The following individuals take part in a section 457(f) forfeitable nonqualified deferred compensation plan. The amounts listed represent calendar year 2022 contributions for many years of service, and are included in the total deferred compensation reported on this Schedule J, Part II, Column C. - Edward Dudley, III: $211,145 - Alexander Walker, Jr., Esq.: $280,646 Form 990, Part VI, Section A, line 6 The sole member of Alliance Health Services is CMC Healthcare System. Form 990, Part VI, Section A, line 7a The directors are appointed by the sole member. Form 990, Part VI, Section A, line 7b The sole member has reserved powers over Alliance Health Services but does not approve each separate action taken by the board. Form 990, Part VI, Section B, line 11b Form 990 is prepared by an independent tax accounting firm (Baker Newman Noyes). Upon completion, a draft of the Form 990 is sent to the Organization, where the Executive Director of Finance and Assistant Controller perform a final in-house review prior to submission to the Board of Directors for final approval. Upon approval from Board, the Form 990 is filed with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c Officers and directors are required to complete a conflict of interest questionnaire annually. Form 990, Part VI, Section B, line 15 A related organization, Catholic Medical Center, utilizes a compensation committee of the board of directors to set compensation levels and determine bonus potential for its senior leadership team. The committee is assisted by an independent consultant who surveys like-sized and performing institutions to benchmark relevant salary scales for each position. The consultant's findings are presented to the compensation committee who considers that external data with actual performance against a list of pre-established goals per senior leaders to set prospective compensation levels and bonus values. Bonus amounts are determined by how well an executive achieves a pre-defined set of goals. These goals, in general, are tied to the achievement of a specific task or project. Some goals are attached to achieve overall financial performance and mission performance, not solely revenue generation. Form 990, Part VI, Section C, line 19 The governing documents, the conflict of interest policy, and the financial statements are available upon request. Form 990, Part IX, line 11g Physician fees: Program service expenses 12,370,831. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,370,831. Form 990, Part XI, line 9: Transfers from affiliates 5,300,000. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Alliance Ambulatory Services 100 McGregor Street Manchester NH 03102 020519436 Ambulatory Surgical Center NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Resources 100 McGregor Street Manchester NH 03102 020398138 Real Estate NH 501(c)(3) Line 12b, II CMC Healthcare System 0 Catholic Medical Center 100 McGregor Street Manchester NH 03102 020315693 Hospital NH 501(c)(3) Line 3 CMC Healthcare System and GraniteOne Health 0 CMC Healthcare System 100 McGregor Street Manchester NH 03102 010568516 Parent NH 501(c)(3) Line 12b, II N/A 0 CMC Physician Practice Associates 100 McGregor Street Manchester NH 03102 020460245 Practices NH 501(c)(3) Line 10 CMC Healthcare System 0 GraniteOne Health 100 McGregor Street Manchester NH 03102 814663563 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Huggins Hospital 240 South Main Street Wolfeboro NH 03894 020223332 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 Monadnock Community Hospital 452 Old Street Road Peterborough NH 03458 020222157 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 St Peter's Home 100 McGregor Street Manchester NH 03102 020222228 Day Care Services NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Urgent Care Services LLC 100 McGregor Street Manchester NH 03102 831238167 Health Care Services NH N/A 0 0 Bedford Ambulatory Surgical Center LLC 11 Washington Place Bedford NH 03110 020519727 Surgical Center NH N/A 0 0 Alliance Enterprises 100 McGregor Street Manchester NH 03102 020386795 Real Estate NH N/A C 0 Doctors' Medical Association 100 McGregor Street Manchester NH 03102 020340690 Medical Office Building NH N/A C 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1