ATHOL MEMORIAL HOSPITAL NMTC HOLDINGS INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
ATHOL MEMORIAL HOSPITAL NMTC HOLDINGS INC (EIN 82-2171549)
Tax period
2020-10-01 to 2021-09-30
Filed
2022-08-15
IRS object ID
202242279349301994
Schema version
2020v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-08-15T11:26:39-05:00ReturnTs
Tax Period End2021-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010523282PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12211 Congress StAddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04102ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN822171549EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Athol Memorial Hospital NMTC HoldingsBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlATHOBusinessNameControlTxt
Phone9786306106PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1242 Green StreetAddressLine1Txt
CityGardnerCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01440ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWinfield BrownPersonNm
Person TitleCEOPersonTitleTxt
Phone9786306106PhoneNum
Signature2022-08-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstWinfieldPersonFirstNm
Person LastBrownPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBarbara J McGuan CPAPreparerPersonNm
PTINP00219457PTIN
Phone2077752387PhoneNum
Preparation2022-08-12PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerWinfield BrownPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1242 Green StreetAddressLine1Txt
CityGardnerCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01440ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$919,979GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.heywood.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2017FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTo support the operations and purposes or Athol Memorial Hospital, including leasing land, constructing a new medical office building and emergency department, and purchasing equipment.ActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$155,531PYContributionsGrantsAmt
CY Contributions Grants$131,723CYContributionsGrantsAmt
PY Program Service Revenue$100,000PYProgramServiceRevenueAmt
CY Program Service Revenue$788,256CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$332,973PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$588,504PYTotalRevenueAmt
CY Total Revenue$919,979CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$204,362PYOtherExpensesAmt
CY Other Expenses$747,098CYOtherExpensesAmt
PY Total Expenses$204,362PYTotalExpensesAmt
CY Total Expenses$747,098CYTotalExpensesAmt
PY Revenues Less Expenses$384,142PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$172,881CYRevenuesLessExpensesAmt
Total Assets BOY$19,611,581TotalAssetsBOYAmt
Total Assets EOY$19,292,712TotalAssetsEOYAmt
Total Liabilities BOY$17,151,750TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,660,000TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,459,831NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,632,712NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTo support the operations and purposes of Athol Memorial Hospital, including leasing land, constructing a new medical office building and emergency room, purchasing equipment and leasing office space to medical offices.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$747,080ExpenseAmt
Revenue$788,256RevenueAmt
DescThe specific purpose of the corporation is limited to the support of the operations and purposes of Athol Memorial Hospital, a MA non-profit tax-exempt hospital. Such support shall include (I) leasing land from AMH, (II) designing, permitting, and constructing a new medical office building on the land, comprised of an emergency department, physician practice space and lobby. Additional commercial office space, parking areas adjacent to the MOB, and utilities and other infrastructure. (III) Renovating the AMH Imaging Department, (IV) aquiring certain medical equipment, (V) leasing the ED, physician practice space, the parking areas and equipment to AMH, (VI) leasing the additional office space and parking areas to a non-profit, tax-exempt corporation, and (VII) all other purposes permitted by law that further the corporation's support of AMH.Desc
Total Program Service Expenses$747,080TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTom SullivanPersonNm
Phone9786306157PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1242 Green StreetAddressLine1Txt
CityGardnerCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01440ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Glenn Hunt
Chairman0.201.40Yes (X)Yes (X)$0$0$0
Roy Lake
Vice Chairman0.201.40Yes (X)$0$0$0
Cheney Castine
Treasurer0.201.40Yes (X)Yes (X)$0$0$0
JoAnne Parks
Clerk0.201.40Yes (X)Yes (X)$0$0$0
Bob Chauvin
Trustee/Past Chairman0.201.40Yes (X)$0$0$0
Andrew Cocchiarella
Trustee0.201.40Yes (X)$0$884,650$27,654
Joyce Fletcher
Trustee0.201.40Yes (X)$0$0$0
Thomas Kane
Trustee0.201.40Yes (X)$0$0$0
Jim Meehan
Trustee0.201.40Yes (X)$0$0$0
Nicole Moorshead
Trustee0.201.40Yes (X)$0$0$0
Craig Napolitano
Trustee0.201.40Yes (X)$0$0$0
Michelle Parker
Trustee0.201.40Yes (X)$0$0$0
Kenneth Pierce
Trustee0.201.40Yes (X)$0$0$0
Albert Rose
Trustee0.201.40Yes (X)$0$0$0
Tina Sbrega
Trustee0.201.40Yes (X)$0$0$0
Joel Shaughnessy
Trustee0.201.40Yes (X)$0$0$0
David Spackman
Trustee0.201.40Yes (X)$0$0$0
John Skrzypczak
Trustee0.201.40Yes (X)$0$0$0
Craig Twohey
Trustee0.201.40Yes (X)$0$0$0
Debra Vescovi
Trustee0.201.40Yes (X)$0$0$0
Winfield Brown
President/CEO0.2041.40Yes (X)Yes (X)$0$911,680$66,625
Elizabeth Nottleson
Past Trustee0.2029.40Yes (X)$0$276,879$7,342
John Flick
Past Trustee0.201.40Yes (X)$0$0$0
Michael Abbatiello
Chief Financial Officer1.0040.00Yes (X)$0$430,232$45,413
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,503,441TotReportableCompRltdOrgAmt
Total Other Compensation$147,034TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Hutter Construction CorpBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 257AddressLine1Txt
CityNew IpswichCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03071ZIPCd
FieldValueIRS element (for citing)
ServicesConstructionServicesDesc
Compensation$1,169,720CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$131,723RelatedOrganizationsAmt
Total Contributions$131,723TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescOffice RentalsDesc
Business531120BusinessCd
Total Revenue Column$788,256TotalRevenueColumnAmt
Related Or Exempt Func Income$788,256RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$788,256TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$919,979TotalRevenueColumnAmt
Related Or Exempt Func Income$788,256RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$18TotalAmt
Management And General$18ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1TotalAmt
Program Services$1ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$239,343TotalAmt
Program Services$239,343ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$507,736TotalAmt
Program Services$507,736ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$747,098TotalAmt
Program Services$747,080ProgramServicesAmt
Management And General$18ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$554,775BOYAmt
EOY$539,679EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$27,748EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$26,594EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$19,089,037LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$539,967LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,056,806BOYAmt
EOY$18,549,070EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$149,621EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$19,611,581BOYAmt
EOY$19,292,712EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$464,002BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$27,748BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$16,660,000BOYAmt
EOY$16,660,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,151,750BOYAmt
EOY$16,660,000EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,459,831BOYAmt
EOY$2,632,712EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,459,831BOYAmt
EOY$2,632,712EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,611,581BOYAmt
EOY$19,292,712EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$172,881ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Athol Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN042126583EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$747,098SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$747,098SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,931,690OtherCostOrOtherBasisAmt
Depreciation$477,948DepreciationAmt
Book Value$18,453,742BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$157,347OtherCostOrOtherBasisAmt
Depreciation$62,019DepreciationAmt
Book Value$95,328BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$18,549,070TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationHeywood Healthcare, Heywood Hospital, Athol, HMGI, Charitable Foundation, Quabbin, and NMTC have been determined to be not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the "Code"), and the Realty Corp. has been determined to be a not-forprofit corporation as described in Section 501(c)(2) of the Code. All of the entities are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The Organization annually evaluates its tax status and tax positions taken with respect to its operations and financial position. Under Accounting Standards Codification ("ASC") 740, an organization must recognize the financial statement effects of a tax position taken for tax return purposes when it is more likely than not that the position will not be sustained upon examination by a taxing authority. The Organization does not believe it has taken any material uncertain tax positions, and accordingly, it has not recorded any liability for unrecognized tax benefits. Additionally, the Organization has filed IRS Form 990 information returns, as required, and all other applicable returns in jurisdictions where so required. For the years ended September 30, 2021 and 2020, there were no interest or penalties recorded or included in the consolidated statements of operations.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Winfield Brown
President/CEO$0$588,587$0$72,782$0$250,311$0$25,100$0$41,525$0$978,305$0$0
Andrew Cocchiarella
Trustee$0$848,900$0$35,750$0$0$0$4,449$0$23,205$0$912,304$0$0
Michael Abbatiello
Chief Financial Officer$0$368,247$0$61,985$0$0$0$19,500$0$25,913$0$475,645$0$0
Elizabeth Nottleson
Past Trustee$0$276,879$0$0$0$0$0$5,537$0$1,805$0$284,221$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 3FormAndLineReferenceDesc
ExplanationThe related organization, Henry Heywood Memorial Hospital, uses the following methods to establish the compensation of the organization's CEO: - Compensation committee - Independent compensation consultant - Form 990 of other ogranizations - Written employment contract - Compensation survey or study - Approval by the board or compensation committeeExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11bThe Form 990 is prepared by a third-party accounting firm with the assistance of the Accounting Department. The Form 990 is reviewed by the Director of Finance and CFO. Then the return is uploaded to the Hospital cyber board for the Board of Trustees to review prior to filing.
Form 990, Part VI, Section B, line 12cThe Board of Trustees review the Organization's Conflict of Interest policy annually in order to ensure that the Organization's Board of Trustees and Officers are regularly and consistently monitoring and enforcing it.
Form 990, Part VI, Section B, line 15All Officers and the CEO's salaries are paid by related corporations. The salaries are determined by the Board of Trustees, considering comparable salary information for Officers of other entities of similar size and level of activity.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy and financial statements available to the public by providing completed copies to the Executive Assistant, who provides copies upon request.
Form 990, Part X, Line 10: Land, Buildings, and Equipment:Section 1.263(a)-3(n) Election: Athol Memorial Hospital NMTC Holdings 242 Green Street Gardner, MA 01440 EIN: 82-2171549 Athol Memorial Hospital NMTC Holdings is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDirect Controlling NADirectControllingNACd
Heywood Healthcare Inc
242 Green StreetGardnerMA01440222720658Parent CorpMA501(c)(3)Line 12b, II0
Henry Heywood Memorial Hospital
242 Green StreetGardnerMA01440042103581Acute Care HospitalMA501(c)(3)Line 30Heywood Healthcare Inc
Athol Memorial Hospital
2033 Main StreetAtholMA01331042126583Critical Access HospitalMA501(c)(3)Line 30Heywood Healthcare Inc
Heywood Medical Group
242 Green StreetGardnerMA01440043163589Multi-Spec. PhysiciansMA501(c)(3)Line 100Heywood Healthcare Inc
Quabbin Healthcare Inc
242 Green StreetGardnerMA01440812053488Behavioral HealthMA501(c)(3)Line 12b, II0Heywood Healthcare Inc
Heywood Realty Corp
242 Green StreetGardnerMA01440043327447Prop. Holding CorpMA501(c)(2)0Heywood Healthcare Inc
Heywood Healthcare Charitable Foundation Inc
242 Green StreetGardnerMA01440222720562Charitable FoundationMA501(c)(3)Line 70Heywood Healthcare Inc
Winchendon Health Foundation Inc
55 Hospital DriveWinchendonMA01475042113276Community Health CareMA501(c)(3)Line 12d, III-O0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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