2020-06-22T11:17:59-05:00 2019-06-30 221478099 COHNREZNICK LLP 350 CHURCH STREET 12TH FLOOR HARTFORD CT 06103 990 2018-07-01 042610447 NORTH SHORE COMMUNITY HEALTH INC NORT 9788251109 27 CONGRESS ST NO 504 SALEM MA 01970 MARGARET BRENNAN CHIEF EXECUTIVE OFFICER 9788251109 2020-06-09 1 LORI ROTHE YOKOBOSKY CPA P01273422 9592007000 2020-06-08 209.59.242.35 2020-06-09 15:53:32 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 3A16AF227DFFBEB6A54D665AEE301AB9EC7A606C 2018 2020-09-22 18:59:49Z MARGARET BRENNAN 27 CONGRESS ST NO 504 SALEM MA 01970 16706527 0 X WWW.NSCHI.ORG X 1977 MA NORTH SHORE COMMUNITY HEALTH'S (NSCH) MISSION IS TO BUILD HEALTHY COMMUNITIES BY PROVIDING EXCEPTIONAL CARE TO ALL. 13 13 198 0 0 0 4744203 4631267 12072634 12062781 809 723 202395 11756 17020041 16706527 0 0 0 0 10130235 11066272 0 0 0 7651753 7128287 17781988 18194559 -761947 -1488032 5381097 4463702 2383273 2953910 2997824 1509792 X NORTH SHORE COMMUNITY HEALTH'S (NSCH) MISSION IS TO BUILD HEALTHY COMMUNITIES BY PROVIDING EXCEPTIONAL CARE TO ALL. 0 0 11127433 8923384 MEDICAL SERVICES - MEDICAL SERVICES ARE PROVIDED TO THE RESIDENTS OF THE NORTH SHORE AND CAPE ANN, BUT WE WILL CARE FOR ANYONE WHO PRESENTS TO US REGARDLESS OF WHERE THEY LIVE. MEDICAL SERVICES ARE PROVIDED TO BOTH ADULTS AND CHILDREN, AND INCLUDE:- PRIMARY CARE- MAT (MEDICATION ASSISTED TREATMENT): SERVICES OFFERED INCLUDE EDUCATION FOR DISEASE ADN OVERDOSE PREVENTION, NARCAN (NALOXONE) TRAINING AND COMPREHENSIVE BEHAVIORAL HEALTH SERVICES. THERE WERE 37,519 MEDICAL VISITS DURING THE TAX YEAR. 2630448 2142613 DENTAL SERVICES - DENTAL SERVICES PROVIDED PRIMARILY TO THE RESIDENTS OF THE NORTH SHORE AND CAPE ANN, BUT WE WILL CARE FOR ANYONE WHO PRESENTS TO US REGARDLESS OF WHERE THEY LIVE. THERE WERE 15,004 DENTAL VISITS DURING THE TAX YEAR. 1061646 677419 SCHOOL BASED HEALTH CENTERS - PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES WERE PROVIDED TO STUDENTS AT THE FOLLOWING SCHOOLS:- SALEM HIGH SCHOOL- PEABODY VETERANS MEMORIAL HIGH SCHOOLADDITIONALLY, BEHAVIORAL HEALTH SERVICES ONLY ARE PROVIDED AT THE FOLLOWING SCHOOLS:- COLLINS MIDDLE SCHOOL- BENTLEY ELEMENTARY SCHOOL- BATES ELEMENTARY SCHOOL- NATHANIEL BOWDITCH SCHOOL THERE WERE 6,444 SCHOOL BASED HEALTH CENTER VISITS DURING THE TAX YEAR. 826371 328121 BEHAVIORAL HEALTH: THE BEHAVIORAL HEALTH DEPARTMENT OFFERS SERVICES TO OUR PATIENTS AT ALL OF OUR HEALTH CARE SITES FOR PERSONS OF ALL AGES OFFERING AFFORDABLE, COMPREHENSIVE, AND ACCESSIBLE BEHAVIORAL HEALTH CARE. 826371 328121 15645898 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 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 0 0 0 0 1 21 0 1 198 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X MARGARET BRENNAN 9788251109 27 CONGRESS ST NO 504 SALEM MA 01970 AMY LEACH BOARD MEMBER 2.00 X 0 0 0 CHARLOTTE OHANNESSIAN BOARD MEMBER 2.00 X 0 0 0 JACK VONDRAS CHAIR 2.00 X X 0 0 0 LUCY CORCHADO VICE CHAIR 2.00 X X 0 0 0 MARION WINFREY BOARD MEMBER 2.00 X 0 0 0 MAUREEN AYLWARD BOARD MEMBER 2.00 X 0 0 0 MICHAEL BABB BOARD MEMBER 2.00 X 0 0 0 PAMELA PAINE BOARD MEMBER 2.00 X 0 0 0 PETER KENT BOARD MEMBER 2.00 X 0 0 0 ROBERT TOLU BOARD MEMBER 2.00 X 0 0 0 RYAN VIATOR BOARD MEMBER 2.00 X 0 0 0 TAMMY LAMONDE BOARD MEMBER 2.00 X 0 0 0 VENUTRA LAMONDE OUTGOING BOARD MEMBER 2.00 X 0 0 0 WILLIAM SULLIVAN TREASURER 2.00 X X 0 0 0 CHRISTINE MALAGRIDA COO 50.00 X 137207 0 2879 MARC BOURASSA CFO 50.00 X 121619 0 27285 MARGARET BRENNAN CEO 50.00 X 204540 0 29183 AZRA ALI FAMILY PRACTICE PHYSICIAN 50.00 X 188180 0 0 DAMIAN ARCHER CMO 50.00 X 207917 0 15892 JENNIFER FEMINO NURSE PRACTIONER 40.00 X 123625 0 2697 LAURA HOLLAND PHYSICIAN & CO- CMO 40.00 X 147881 0 16424 PAUL FORTE DENTIST 50.00 X 150226 0 1956 1281195 0 96316 16 0 1 0 CPA MEDICAL BILLING 20-1 THOMPSON RD BRANFORD CT 06405 MEDICAL BILLING 297100 CLEMENTINE LIVE ANSWERING SERVICE 1992 KELLY RD HARPER WOODS MO 48225 ANSWERING SERVICE 171705 2 4512453 118814 4631267 MEDICAID 621110 5907310 5907310 PHARMACY REVENUE 621110 3118870 3118870 MEDICARE 621110 1038837 1038837 HEALTH SAFETY NET 621110 930482 930482 THIRD-PARTY PAYORS 621110 732915 732915 334367 334367 12062781 723 723 3000 0 3000 3000 3000 OTHER INCOME 621110 6155 6155 MEDICAL RECORD FEES 621110 2601 2601 8756 16706527 12071537 0 3723 488402 404738 83664 8710418 7231846 1478572 1191426 916792 274634 676026 520196 155830 46495 43955 2540 13520 12781 739 964266 911591 52675 175 175 542061 498096 43965 668286 547994 120292 555553 400015 155538 51818 43043 8775 46969 38515 8454 225105 184564 40541 80115 65694 14421 PHARMACY AND RELATED FE 2163660 2163660 HOUSEKEEPING SERVICES A 801159 779145 22014 PROVISION FOR UNCOLLECT 481628 481628 MISCELLANEOUS 155600 127592 28008 331877 273878 57999 18194559 15645898 2548661 0 140854 0 744655 527715 2339345 1686291 25971 53176 127048 151475 6350453 4305408 2003224 2045045 5381097 4463702 1619825 1487439 763448 1437247 0 29224 2383273 2953910 X 2079493 790137 918331 719655 2997824 1509792 5381097 4463702 -1488032 0 X X 0 1 X 1 1 1 X 3919087 4722271 5593771 4744203 4631267 23610599 3919087 4722271 5593771 4744203 4631267 23610599 23610599 10336 6111 6492 5559 3723 32221 170319 209240 221438 197645 8756 807398 24450218 48862525 0.96570 0.95110 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 69,447. 2015 AMOUNT: $ 99,052. 2016 AMOUNT: $ 134,363. 2017 AMOUNT: $ 19,950. 2018 AMOUNT: $ 6,155. EMR INCENTIVE - 2014 AMOUNT: $ 93,500. 2015 AMOUNT: $ 30,158. 2017 AMOUNT: $ 55,125. MEDICAL RECORDS FEES - 2014 AMOUNT: $ 7,372. 2015 AMOUNT: $ 3,546. 2017 AMOUNT: $ 14,961. 2018 AMOUNT: $ 2,601. MBHP - 2015 AMOUNT: $ 76,484. 2016 AMOUNT: $ 87,075. PRIOR PERIOD - 2017 AMOUNT: $ 107,609. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1415592 1206327 209265 2913472 1606522 1306950 1778621 1492559 286062 242768 242768 2045045 OTHER LIABILITIES 29224 29224 X 16261799 36900 -481628 -444728 16706527 0 16706527 17749831 36900 36900 17712931 481628 481628 18194559 PART X, LINE 2: THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2019 AND 2018. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2016 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CENTER HAS UNRELATED BUSINESS INCOME TAXES, IT WILL RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENTS OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS -481,628. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 481,628. X X X X 0 0 0 0 0 0 0 0 0 MARGARET BRENNAN CEO 197621 0 6797 0 122 0 0 0 29183 0 233723 0 0 0 AZRA ALI FAMILY PRACTICE PHYSICIAN 187042 0 1031 0 107 0 0 0 0 0 188180 0 0 0 DAMIAN ARCHER CMO 207243 0 559 0 115 0 0 0 15892 0 223809 0 0 0 LAURA HOLLAND PHYSICIAN & CO- CMO 137819 0 10000 0 62 0 0 0 16424 0 164305 0 0 0 PAUL FORTE DENTIST 149585 0 563 0 78 0 0 0 1956 0 152182 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 INITIAL COMPLETION IS DONE BY OUR AUDITORS. THE FORM 990 IS THEN SENT TO THE NORTH SHORE COMMUNITY HEALTH MANAGEMENT TEAM AND THEN FORWARDED TO THE MEMBERS OF THE BOARD OF DIRECTORS, WHO ARE ABLE TO SUBMIT ANY QUESTIONS, COMMENTS, OR OBSERVATIONS THAT THEY HAVE. THEN MANAGEMENT DISCUSSES ANY CHANGES THEY ARE GOING TO MAKE TO THE 990 FORM. IF CHANGES ARE DEEMED NECESSARY, THEY ARE MADE IMMEDIATELY. THE FORM 990 IS THEN APPROVED FOR SUBMISSION BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH EMPLOYEE, VOLUNTEER, AND BOARD MEMBER WILL ACKNOWLEDGE THAT THEY HAVE READ AND UNDERSTAND NORTH SHORE COMMUNITY HEALTH'S CONFLICT OF INTEREST POLICY UPON BEGINNING THEIR EMPLOYMENT OR TENURE WITH NORTH SHORE COMMUNITY HEALTH BY SIGNING AN ACKNOWLEDGEMENT FORM. THIS IS UPDATED ON A YEARLY BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE HEALTH CENTER'S OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE BOARD OF DIRECTORS UTILIZING A SALARY SURVEY. THE EXECUTIVE DIRECTOR SETS THE OTHER EMPLOYEES' SALARIES BASED ON A SALARY SURVEY IN ACCORDANCE WITH THE HEALTH CENTER'S BUDGET PARAMETERS. FORM 990, PART VI, SECTION C, LINE 19 NORTH SHORE COMMUNITY HEALTH, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS AVAILABLE TO THE GENERAL PUBLIC THROUGH WWW.GUIDESTAR.ORG. FORM 990, PART XII, LINE 2C: THERE HAVE BEEN NO CHANGES MADE TO THE ORGANIZATION'S OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.