2019-11-13T06:48:05-06:00 2018-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2018-01-01 020325847 Salemhaven Inc SALE 6038935586 23 Geremonty Drive Salem NH 03079 Beverly Collins President 6038935586 2019-09-17 1 Barbara J McGuan CPA P00219457 2077752387 2019-09-17 69.49.157.66 2019-09-17 17:06:12 ED P B6CABA93EC29A130F91389D5843EEEAA10181012 2822CCB165EE8EB222BC1A8C889357795F91400A 2018 2020-03-31 21:24:44Z Beverly Collins 23 Geremonty Drive Salem NH 03079 12119705 0 X salemhaven.com X 1977 NH Healthcare services for the elderly 12 12 208 37 82946 81946 15332 36125 11398001 11846112 122752 98275 0 82946 11536085 12063458 0 0 0 0 7443627 8027192 0 0 0 4615050 4581845 12058677 12609037 -522592 -545579 10887018 10130104 4138293 4058700 6748725 6071404 X In February, 1972, a group of Salem, NH residents founded the organization with the goal of developing a facility to provide health care and related services for the community's elderly population. 0 0 11141981 11846112 The Salemhaven complex provides comprehensive healthcare services, resources and accomodations (110 bed facility) for senior citizens, including the operation of a medical day care service. Salemhaven services include providing long term care, rehabilitation including PT, OT Speech, social services for residents and families, meeting of Spiritual needs, activities, supporting many local charities and community services, hospice services and respite care. We employ over 150 workers from the local area, we subsidized Medicaid over 1 million dollars annually, and we are a participant in the local and state emergency planning programs.Silverthorne Adult Medical Day Center provides to participants: Health care monitoring, Social services, Therapeutic and recreational activities, Health Care Education to participants, families and the community. We also provide respite care for caregivers and a Caregiver Support Group monthly for families and community members. 11141981 1 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 39 0 1 208 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 NH X Ray Milliard Administrator 6038935586 23 Geremonty Drive Salem NH 03079 Beverly Collins Board President 1.00 X X 0 0 0 Michael Collins Board Treasurer 1.00 X X 0 0 0 Philip Cammarata Vice President 1.00 X X 0 0 0 Robert Slein Board Member 1.00 X 0 0 0 Sonny Tylus Board Member/ Past Board President 1.00 X 0 0 0 Jeffrey Scionti Board Member 1.00 X 0 0 0 Jamie Santo Board Member 1.00 X 0 0 0 Ralph Glynn Board Member 1.00 X 0 0 0 Rev David Yasenka Board Member 1.00 X 0 0 0 Michael Carney Jr Board Member 1.00 X 0 0 0 Frank Monteiro Board Member 1.00 X 0 0 0 Amy White Board Member 1.00 X 0 0 0 Dwight Feeney Past Board Member 1.00 X 0 0 0 Thomas Lynch Past Board Member 1.00 X 0 0 0 Raymond Milliard Administrator 40.00 X 125177 0 42744 125177 0 42744 1 0 1 0 Kindred Rehab Services LLC PO Box 277365 Atlanta GA 30384 Rehab Services 897287 Brightstar Care of Bedford 602 Riverway Place Suite B Bedford NH 03110 Care Services 339268 PharMerica 38 Locke Road Concord NH 03301 Pharmacy Services 296453 Sysco Food Service 99 Spring Street Plympton MA 02367 Food Services 241650 Northeast Medical Staff 221 Chelmsford Street Chelmsford MA 01824 Staffing Services 166909 5 36125 36125 Net Long-Term Care Services 623000 11666387 11666387 Adult Daycare Services 623000 172007 172007 Miscellaneous Income 623000 7093 7093 Guest Meals 623000 625 625 11846112 71547 71547 82975 56247 26728 26728 26728 82946 0 82946 82946 12063458 11846112 82946 98275 167921 167921 6561101 6180296 380805 66627 61422 5205 829913 765079 64834 401630 370254 31376 17042 17042 45818 2573 43245 71633 69743 1890 70576 3133 67443 233456 171708 61748 102656 261 102395 370670 329379 41291 9974 5568 4406 133494 128068 5426 497995 479295 18700 238544 133786 104758 Purchased Services 953652 908395 45257 Food/Drug/Med. Supplies 897731 897731 0 NH Quality Assessment 616172 616172 Bad Debt 275728 275728 46704 19118 27586 12609037 11141981 1467056 0 40350 40350 2845946 2833351 1029700 861906 41469 43031 202566 152026 10959297 6953359 4446805 4005938 1995201 1835838 284981 357664 10887018 10130104 943438 1047353 12747 4548 3182108 3006799 4138293 4058700 X 6748725 6071404 6748725 6071404 10887018 10130104 -545579 -131742 0 X 0 1 X 1 0 X 13170 10686 7772 15332 36125 83085 11322961 11977869 11564571 11398001 11846112 58109514 11336131 11988555 11572343 11413333 11882237 58192599 100 100 11469 76376 149219 133568 370632 100 11469 76376 149219 133568 370732 57821867 56238 54254 57913 59157 71547 299109 65737 65737 56238 54254 57913 59157 137284 364846 11392369 12042809 11630256 11472490 12019521 58557445 0.98740 0.99100 0.00620 0.00490 X 0 0 0 0 0 0 0 0 1 1986 1986 0 Form 990, Schedule C, Part II-B, Line 1i Lobbying portion of NHHCA Dues 15%; Lobbying portion of American Health Care Association Dues 28% 0 1 X 41189 41189 9328044 5690950 3637094 1357116 1114984 242132 232948 147425 85523 4005938 11927938 -131742 -131742 12059680 3778 3778 12063458 12605259 0 12605259 3778 3778 12609037 Part IV, Line 2b: The Organization holds funds for residents and provides these funds to the resident, as needed, for various common expenses. Part XI, Line 4b - Other Adjustments: Loss on abandoment of fixed assets 3,778. Part XII, Line 4b - Other Adjustments: Loss on abandoment of fixed assets 3,778. 82946 0 82946 82946 NH 1 0 1 0 1.00000 1 82946 Chasers Poker 7 Veterans Memorial Parkway Salem NH 03079 0 X X X 0 0 0 0 0 0 0 0 0 Raymond Milliard Administrator 125177 0 0 0 0 0 0 0 42744 0 167921 0 0 0 Form 990, Part VI, Section B, line 11b The 990 is sent to all board members and reviewed at a board meeting. If necessary the auditors that prepared the 990 are requested to give a presentation. Form 990, Part VI, Section B, line 12c Board members fill out a disclosure form and are given a policy regarding disclosure and conflicts of interest. The administrator and business office monitor for potential conflicts and then report findings to the board of directors. Part of the annual financial audit is a review of potential conflicts and findings that are reported to the board. Form 990, Part VI, Section B, line 15a Ray Milliard, Administrator, worked for Covenant Health Systems, as an independent contractor through June 30, 2017. They pulled demographic reports and surveys for the Board to review and decide on compensation. When Ray became an employee of Salemhaven they continued with his compensation level. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Salemhaven, Inc. 23 Geremonty, Salem, NH 03079 EIN 02-0325847 Salemhaven, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).