2019-01-31T10:31:33-06:00 2018-06-30 010523282 Berry Dunn McNeil & Parker LLC 1000 Elm Street 4th Floor Manchester NH 03101 990 2017-07-01 020350051 Coos County Family Health Services Inc COOS 6037522040 133 Pleasant Street Berlin NH 03570 H Guyford Stever Jr Board President 6037527719 2019-01-18 1 Dimitrios Panacopoulos CPA P01603705 6036697337 2019-01-18 69.49.157.66 2019-01-18 15:06:27 ES P 8B04EC08AF02322EA9ED1307B74D8AF8BDCA5114 BCE379EC6B2F882893C3F02DE0A5A3D951B1B2ED 2017 2019-02-21 02:37:17Z Ken Gordon 133 Pleasant Street Berlin NH 03570 13567385 0 X www.coosfamilyhealth.org X 1980 NH Coos County Family Health Services, Inc. is a community-based organization providing innovative, personalized, comprehensive health care and social services of the highest quality to everyone, regrdless of economic status. 15 15 162 35 0 0 3633495 3437218 9426533 10118769 4267 3586 8304 7812 13072599 13567385 0 0 0 0 8782282 9259273 0 0 3325 3562530 3605636 12344812 12864909 727787 702476 7322352 7698350 1406945 1078639 5915407 6619711 Coos County Family Health Services, Inc. is a community-based organization providing innovative, personalized, comprehensive health care and social services of the highest quality to everyone, regardless of economic status. 0 0 11257691 10118769 Provision of primary care services to the community. 11257691 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 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 34 0 1 162 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X X X Ken Gordon 6037522040 133 Pleasant Street Berlin NH 03570 Robert Pelchat Board Member 1.00 X 0 0 0 Joan Merrill Imm. Past President 1.00 X X 0 0 0 Aline Boucher Treasurer 1.00 X X 0 0 0 Marge McClellan Board Member 1.00 X 0 0 0 H Guyford Stever Jr President 1.00 X X 0 0 0 Andrea Brochu Board Member 1.00 X 0 0 0 Roland Olivier Board Member 1.00 X 0 0 0 David Morin Board Member 1.00 X 0 0 0 Robert Thompson Board Member 1.00 X 0 0 0 Dawn Cross Vice President 1.00 X X 0 0 0 Timothy Beaulac Board Member 1.00 X 0 0 0 Patti Stolte Board Member 1.00 X 0 0 0 Pauline Tibbetts Secretary 1.00 X X 0 0 0 Claudette Morneau Board Member 1.00 X 0 0 0 Melanie Maynor Esq Board Member 1.00 X 0 0 0 Melissa Frenette CFO 40.00 X 105570 0 5758 Ken Gordon CEO 40.00 X 139786 0 15980 Brian Beals Physician 40.00 X 200348 0 5816 Thomas Temme Physician 32.00 X 118757 0 33813 Elaine Chappell Physician 32.00 X 145066 0 7257 Traci Wagner Physician 30.00 X 155314 0 13296 Samuel McCreedy Physician 40.00 X 237984 0 0 1102825 0 81920 12 0 1 0 Androscoggin Valley Hospital 59 Page Hill Rd Berlin NH 03570 Rent/Physicians/OB 204400 Capture RX 10100 Reunion Pl 700 San Antonio TX 78216 340b Administration Services 194991 2 4000 2832917 600301 3437218 Patient Service Revenue 621110 10118769 10118769 10118769 3586 3586 7812 0 7812 7812 7812 13567385 10118769 0 11398 392978 152238 240740 6669540 6002586 666954 209121 182688 26433 1425226 1245078 180148 562408 491320 71088 18592 18592 47850 47850 518240 518240 41329 41329 157499 137591 19908 198376 198376 396580 346452 50128 31357 27393 3964 152402 152402 820 716 104 249132 217642 31490 66227 57856 8371 Program Supplies 1372705 1372705 Other Expenses 135649 118503 17146 Printing & Publications 77792 67959 9833 Telephone 73065 63830 9235 68021 56518 8178 3325 12864909 11257691 1603893 3325 2367938 1973813 226011 272269 1542290 1664499 87916 80577 5516076 3242688 2365430 2273388 750000 732767 683804 7322352 7698350 1105468 1047139 31500 301477 0 1406945 1078639 X 5757854 6496643 132113 94880 25440 28188 5915407 6619711 7322352 7698350 X 702476 1828 X 0 1 X 1 1 1 X 3305345 2846003 2915021 3633495 3437218 16137082 7773326 8248232 9481369 9426533 10118769 45048229 11078671 11094235 12396390 13060028 13555987 61185311 0 0 0 61185311 4707 3061 3183 12571 11398 34920 4707 3061 3183 12571 11398 34920 11083378 11097296 12399573 13072599 13567385 61220231 0.99940 0.99950 0.00060 0.00050 X 25440 920 1828 28188 22990 2006 444 25440 24297 -1307 22990 23930 125 1066 824 24297 22026 1267 1699 1062 23930 1.00000 0 0 153257 153257 3233370 1525601 1707769 2129449 1717087 412362 2273388 Investment in Bank of New Hampshire 750000 C 750000 Due from Third Party Payers 45000 Assets Limited as to Use 612624 Beneficial Interest in Perpetual Trust Held by Others 26180 683804 X 13579378 10165 1828 11993 13567385 0 13567385 12875074 10165 10165 12864909 0 12864909 Part V, Line 4: Income earned is used for operations. Part X, Line 2: The Organization is a public charity under Section 501(c)(3) of the Internal Revenue Code. As a public charity, the Organization is exempt from state and federal income taxes on income earned in accordance with its tax exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Organization's tax positions and concluded that the Organization has no unrelated business income or uncertain tax positions that require adjustment to the financial statements. Part XI, Line 2d - Other Adjustments: Change in Fair Market Value in Beneficial Interest 1,828. X X X X 0 0 0 0 0 0 0 1 0 Ken Gordon CEO 138123 0 0 0 1663 0 5653 0 10327 0 155766 0 0 0 Brian Beals Physician 158948 0 40691 0 709 0 0 0 5816 0 206164 0 0 0 Thomas Temme Physician 107082 0 10000 0 1675 0 4750 0 29063 0 152570 0 0 0 Elaine Chappell Physician 114252 0 30638 0 176 0 5803 0 1454 0 152323 0 0 0 Traci Wagner Physician 153981 0 0 0 1333 0 4207 0 9089 0 168610 0 0 0 Samuel McCreedy Physician 237406 0 0 0 578 0 0 0 0 0 237984 0 0 0 Part I, Line 7 Physicians are provided incentive payments based on number of patients seen, complexity of patient acuity, timely documentation, patient satisfication, and quality of care provided. Form 990, Part VI, Section B, line 11b The CFO compares the Form 990 to the audited financial statements and prior year 990. A copy is given to the Finance Committee to review and then a copy is given to the board of directors to review and approve. Form 990, Part VI, Section B, line 12c Annually, the board re-affirms their compliance with the conflict of interest policy with a written compliance document. Form 990, Part VI, Section B, line 15 HR currently participates in a salary survey with a national health center organization and utilizes the results to assist with setting market rates of pay for the CEO, COO, and CFO. The CEO sets the COO and CFO salaries based upon these results. The board of directors approves and sets the salary of the CEO. Form 990, Part VI, Section C, line 19 Documents are posted to the Organization's website and are available upon request. Form 990, Part XI, line 9: Change in Fair Value of Interest in Beneficial Trust 1,828.