2019-05-10T07:48:12-05:00 2018-06-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2017-07-01 020512229 Mary and John Elliot Charitable Foundation MARY 6036638977 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 Jeffrey Rooney CFO 6036638977 2019-03-20 1 Nicholas E Porto P01310283 8002447444 2019-03-20 208.105.168.164 2019-03-20 14:25:08 ED P 89E582745F398AB9123794375B037D04AD0E63E3 86AD5A998A217BD7885303F5109AB5202568ED7D 2017 2019-02-21 02:37:17Z William G Baxter 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 10083634 0 X N/A X 2001 NH To support the immediate and ongoing resource needs of the Elliot Health System. 16 14 0 40 0 0 1642060 5117551 0 0 228334 373878 695807 1120373 2566201 6611802 1428832 3498493 0 0 0 0 0 182429 182429 761196 894479 2190028 4575401 376173 2036401 8855201 12764856 336872 175550 8518329 12589306 The Mary and John Elliot Foundation's mission is to support the immediate and ongoing resource needs of the Elliot Health System. 0 0 4274390 3498493 1036222 Support of the fundraising activities of The Elliot Hospital of the City of Manchester and its related tax exempt organizations. 4274390 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 12 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 16 14 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Michael S Turilli 6036638977 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 X Sidney Baines Trustee 1.00 0.00 X 0 0 0 Cathy Champagne Trustee 1.00 0.00 X 0 0 0 Louise G Forseze Trustee 1.00 0.00 X 0 0 0 Charles S Goodwin Trustee 1.00 0.00 X 0 0 0 Stephen Langan Trustee 1.00 2.00 X 0 0 0 Paul J Leyden Trustee 1.00 0.00 X 0 0 0 Selma Naccach-Hoff Trustee 1.00 2.50 X 0 0 0 Richard Rawlings Trustee 1.00 0.00 X 0 0 0 Kurt W Strandson Trustee 1.00 0.00 X 0 0 0 Renee Walsh Trustee 1.00 0.00 X 0 0 0 James J Tenn Jr Esq Secretary (end 3/18)/Chair 1.00 2.00 X X 0 0 0 Charles F Rolecek Chair (end 3/18)/Trustee 1.00 2.00 X X 0 0 0 Holly P Mintz MD Vice Chair/Trustee 1.00 44.00 X X 0 444335 42113 John A Hession Vice Chair (end 3/18)/Trustee 1.00 5.50 X X 0 0 0 David Bellman Secretary/Trustee 1.00 0.00 X X 0 0 0 Douglas F Dean President & CEO 1.00 45.50 X X 0 966430 60453 Michael S Turilli CFO 1.00 44.60 X 0 0 0 Joseph Ingold CFO (end 6/18) 1.00 44.60 X 0 579817 0 Nicholas Zaharias VP, Development 40.00 2.00 X 0 250942 26390 Jeffrey Rooney Former CFO 0.00 0.00 X 0 109920 0 0 2351444 128956 0 1 1 0 Elliot Hospital of the City of Mancheste One Elliot Way Manchester NH 03103 Staff and Operations 602800 Ghiorsi and Sorrenti 255 Madison Avenue Wyckoff NJ 07481 Fundraising Consultant 161517 2 386422 2109585 87402 2534142 150387 5117551 160013 160013 3481392 3267527 213865 213865 213865 279706 386422 204305 75401 75401 8750 0 8750 8750 Reimbursed Expenses 561000 1036222 1036222 1036222 6611802 1036222 0 458029 3498493 3498493 4000 4000 182429 182429 76620 76620 639410 602800 36610 1352 1352 135968 135968 30762 30762 1561 1561 4645 4645 161 161 4575401 4274390 118582 182429 1005893 965285 33745 1148334 998 998 10496 10235 422 261 7184214 9828265 603560 776193 26369 45520 8855201 12764856 9671 15549 87200 0 240001 160001 336872 175550 X 6599791 8513907 1918538 4075399 8518329 12589306 8855201 12764856 X 2036401 244551 1790025 X X 0 1 X 1 0 X 3158445 1718143 1959427 1642060 5117551 13595626 3158445 1718143 1959427 1642060 5117551 13595626 962454 12633172 153440 135908 142262 146288 160013 737911 84151 84151 14417688 3065596 0.87620 0.83870 X 1918538 2219772 -62911 4075399 1363908 527394 27236 1918538 935396 391254 37258 1363908 2078542 484442 -109697 1517891 935396 1629528 349989 99025 2078542 0.00000 0.00000 1.00000 0 0 10496 10235 261 261 Alternative Investments through Elliot Common Trust Fund 776193 F 776193 X 3884366 244551 244551 3639815 76620 2895367 2971987 6611802 1603414 0 1603414 76620 2895367 2971987 4575401 Part V, Line 4: Endowment funds are used to further the missions of the Elliot Health System's not-for-profit entities. Part X, Line 2: The System and all related entities, with the exception of Elliot Health System Holdings, Inc. and Subsidiaries, are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue 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: Reclassed Grant Expenses 2,895,367. Part XII, Line 4b - Other Adjustments: Reclassed Grant Expenses 2,895,367. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Investments through Elliot Common Trust Fund 547000 0 0 0 0 0 0 547000 0 547000 0 0 1 1 0 0 Schedule F, Part I, Line 3: The legal owner of Mary and John Elliot Charitable Foundation's foreign investments is a related organization, Elliot Common Trust Fund. Since a portion of the total foreign investments are allocated to the Foundation's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, Line 3 of the Foundation's Form 990. Schedule F, Part IV, Line 3: The Mary and John Elliot Charitable Foundation did not have an ownership interest in any foreign corporation that is greater than the 10% filing threshold. Accordingly, IRS Form(s) 5471 is not required to be filed. Schedule F, Part IV, Line 4: The Mary and John Elliot Charitable Foundation meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Foundation. X X X X X X 1 Ghiorsi & Sorrenti Inc 255 Madison Avenue New York NY 07481 Capital Campaign Consultant 0 4412636 182429 4230207 4412636 182429 4230207 NH Gala 391021 147205 243816 25603 33828 4600 88105 Golf Classic 190318 157589 32729 7521 11327 750 18676 2 84789 81628 3161 1500 7238 400 4757 666128 386422 279706 9021 44168 34578 5000 111538 204305 75401 1 Child & Family Services of New Hampshire (Waypoint) 464 Chestnut Street Box 448 Manchester NH 03105 020222164 501(c)(3) 45000 Home visits to low income seniors to assess needs, coordinate benefits, develop care plans Easter Seals of New Hampshire 555 Auburn Street Manchester NH 03103 020272825 501(c)(3) 34000 Establish caregiver coaching model that maximizes independence and quality of life The Elliot Hospital of the City of Manchester 1 Elliot Way Manchester NH 03101 020232673 501(c)(3) 3340971 Elliot Regional Cancer Center Capital Campaign Elliot Professional Services Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 331003630 501(c)(3) 34268 General Operating Support Future in Sight (NH Association for the Blind) McGreal Sight Center 25 Walker Street Concord NH 03301 020223606 02-0223606 30000 Expansion of vision services through the Lives and Thrives program The Granite YMCA 117 Market Street Manchester NH 03101 020222248 501(c)(3) 10000 Fund Healthy Living for Seniors program at the new local Teen and Senior Center Granite United Way 22 Concord Street Floor 2 Manchester NH 03101 026006033 501(c)(3) 20000 Grow the organziation's 2-1-1 service Manchester Community Health Center 145 Hollis Street Manchester NH 03101 020458174 501(c)(3) 35000 Reduce barriers to care for uninsured and underinsured elder patients The Mental Health Center of Greater Manchester 401 Cypress Street Manchester NH 03103 020258994 501(c)(3) 25000 3rd phase of the Senior Experience and Community Resource Awareness Initiative Program New Hampshire Legal Assistance 117 North State Street Concord NH 03301 020300897 501(c)(3) 20000 Provide free legal services to needy seniors in the Greater Manchester area St Joseph Community Services PO Box 910 Merrimack NH 03054 020335003 501(c)(3) 25000 Provide meals to current and incoming Meals on Wheels clients. The Way Home 214 Spruce Street Manchester NH 03103 223004892 501(c)(3) 10000 Fund the elder housing assistance program VNA Home Health and Hospice Services 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020222241 501(c)(3) 83254 Expansion of Telehealth Program for patients with congestive heart failure, and general operating support. 13 0 Part I, Line 2: The Foundation's Pearl Manor Advisory Committee meets to review requests for grants, meet leaders of organizations requesting grant funding, and requires updates on the use of funds in many instances, both written and presentation. For allocations of support to related organizations, additional monitoring is not deemed necessary. 0 1 0 0 0 0 0 0 0 Holly P Mintz MD Vice Chair/Trustee 0 444030 0 0 0 305 0 26315 0 15798 0 486448 0 0 Douglas F Dean President & CEO 0 876188 0 17913 0 72329 0 45977 0 14476 0 1026883 0 0 Joseph Ingold CFO (end 6/18) 0 572317 0 0 0 7500 0 0 0 0 0 579817 0 0 Nicholas Zaharias VP, Development 0 210887 0 29055 0 11000 0 13039 0 13351 0 277332 0 0 Jeffrey Rooney Former CFO 0 109920 0 0 0 0 0 0 0 0 0 109920 0 0 Part I, Line 3 The President and CEO of Mary and John Elliot Charitable Foundation is compensated by a related organization, The Elliot Hospital of the City of Manchester. The Hospital uses a compensation committee, an independent compensation consultant, Forms 990 of other organizations, compensation studies, and approval by the Board or a compensation committee to establish the compensation for the President and CEO. Part I, Line 4b The System maintains a defined benefit pension plan for certain employees, the Elliot Health System Pension Plan (the Plan). Effective July 1, 2006, the Plan was amended to close the Plan to employees hired after June 30, 2006. Eligible employees hired prior to July 1, 2006 are grandfathered under the Plan and will continue to accrue benefits as long as they remain at a participating System entity and in an eligible status. The System's funding policy is to contribute amounts to the Plan sufficient to meet minimum funding requirements set forth in the Employee Retirement Income Security Act of 1974, plus such additional amounts as might be determined to be appropriate from time to time. The Plan is intended to constitute a plan described in Section 414(k) of the Internal Revenue Code, under which benefits derived from employer contributions are based on the separate account balances of participants in addition to the defined benefits under the Plan. During calendar year 2017, Douglas F. Dean, an officer of the filing organization, participated in the plan. A defined contribution in the amount of $28,041 was made to his plan, which is included in Mr. Dean's total compensation reported in Schedule J, Part II, Column B(iii) and Form 990, Part VII-A, Column E. Additionally, defined benefit amounts of $45,977, which includes the actuarial change in value for the year, was included in Schedule J, Part II, Column C and Form 990, Part VII-A, Column F as deferred compensation. Additionally, defined benefit amounts for Holly Mintz of $26,315 is included in Schedule J, Part II, Column C and Form 990, Part VII-A, Column F as deferred compensation. Form 990, Part VII-A and Schedule J, Part II: Jeffrey Rooney, who served as Chief Financial Officer until January 2017, and Joseph Ingold, who took over as Chief Financial Officer at that time until June 2018, were both contracted employees through Martinville Dunn, LLC and Ingold & Associates, LLC, respectively. Both LLCs are unrelated to the filing organization and its affiliates. Compensation in the amount of $109,920 was paid to Martinville, Dunn, LLC during calendar year 2017 by the Hospital for Mr. Rooney's services. The total compensation paid to Mr. Ingold's LLC for his services during 2017 was $579,817. Additionally, Mr. Ingold received a housing allowance in the amount of $7,500 during the calendar year, which is included in the amount paid to Ingold & Associates, LLC. As the fees paid to each LLC were paid for services to the entire related party system, an accurate breakdown of the fees relative to the filing organization is not readily determinable. In accordance with IRS instructions, these fees have been reported as compensation on Form 990, Part VII-A and Schedule J, Part II and further disclosed in Schedule O for Form 990, Part VI, Line 3. See also Schedule L. Form 990, Part VII-A and Schedule J, Part II: Mr. Turilli did not begin working for the filing organization and its related entities as Chief Financial Officer until 2018. In accordance with IRS instructions, which stipulate that compensation is to be reported for individuals listed in Form 990, Part VII, Section A based on the calendar year ending within the reportable fiscal year, no compensation has been listed for Mr. Turilli in Form 990, Part VII-A or Schedule J, Part II. Compensation information for Mr. Turilli will be reported on the Organization's Form 990 for the fiscal year ending June 30, 2019. Ingold & Associates LLC Chief Financial Officer 579817 Joseph Ingold, who served as Chief Financial Officer during the reporting period, was an officer of Ingold & Associates, LLC, an unrelated organization paid by Elliot Hospital for Mr. Ingold's services as CFO to the entire health system. As the fees paid by the Hospital were for Mr. Ingold's services to the entire related party system, an accurate breakdown of this fee relative to the filing organization is not readily determinable. Therefore, the entire payment made to Ingold & Associates, LLC and the related housing allowance for Mr. Ingold have been disclosed here. 0 X 4 56267 X Event Prizes and Gifts 5 93370 Fair Market Value X Food and Beverages 2 750 Fair Market Value 0 1 1 Part I, Line 32b: The Organization sells contributions of securities through the investment management group of its financial institution. All gifts of securities are sold as soon as administratively possible. Form 990, Part VI, Section A, line 3 Jeffrey Rooney, who served as Chief Financial Officer until January 2017, and Joseph Ingold, who took over as Chief Financial Officer at that time until June 2018, were both contracted employees through Martinville Dunn, LLC and Ingold & Associates, LLC, respectively. Both LLCs are unrelated to the filing organization and its affiliates. Compensation in the amount of $109,920 was paid to Martinville, Dunn, LLC during calendar year 2017 by the Hospital for Mr. Rooney's services. The total compensation paid to Mr. Ingold's LLC for his services during 2017 was $579,817. Additionally, Mr. Ingold received a housing allowance in the amount of $7,500 during the calendar year, which is included in the amount paid to Ingold & Associates, LLC. As the fees paid to each LLC were paid for services to the entire related party system, an accurate breakdown of the fees relative to the filing organization is not readily determinable. In accordance with IRS instructions, these fees have been reported as compensation on Form 990, Part VII-A and Schedule J, Part II and further disclosed in Schedule O for Form 990, Part VI, Line 3. See also Schedule L. Form 990, Part VI, Section A, line 6 Elliot Health System is the sole member of the reporting organization. Form 990, Part VI, Section A, line 7a Elliot Health System, the sole member of the reporting organization, has the right to ratify the election of all Board members of the Mary & John Elliot Charitable Foundation. The Foundation's Board of Trustees shall be comprised of not more than half and not less than 1/3 of present or former members of the Elliot Health System Board of Directors. Form 990, Part VI, Section A, line 7b The sole member, Elliot Health System, has the right to the following governance decisions: approval of Mary & John Elliot Charitable Foundation's annual budget; approval of Bylaws and Articles of Organization and amendments of same; approval of strategic plans. Form 990, Part VI, Section B, line 11b The completed Form 990 is presented to the full Board prior to filing. Board members can review the draft and bring any questions forward for discussion prior to filing. Form 990, Part VI, Section B, line 12c Officers, directors, and key employees are required annually to sign a conflict of interest form which requires reporting any potential conflict of interest arrangements with the organization. Form 990, Part VI, Section B, line 15 The compensation committee of the Board utilizes outside compensation consultants to evaluate the salaries for the CEO, CFO, and COO. The consultants utilize their internal data along with national and local benchmark data from the industry to develop salary levels. Recommendations of the consultant are reviewed by the compensation committee, who recommends compensation levels to the full Board for approval. An outside consulting firm is also used by the organization to review the compensation of the remainder of the Vice Presidents. Again, national and local benchmarks for salaries are consulted to determine salary levels for these positions. Form 990, Part VI, Section C, line 19 Each of these documents is filed with the New Hampshire Secretary of State and is available upon request. Form 990, Part VII-A and Schedule J, Part II: Mr. Turilli did not begin working for the filing organization and its related entities as Chief Financial Officer until 2018. In accordance with IRS instructions, which stipulate that compensation is to be reported for individuals listed in Form 990, Part VII, Section A based on the calendar year ending within the reportable fiscal year, no compensation has been listed for Mr. Turilli in Form 990 Part VII-A or Schedule J, Part II. Compensation information for Mr. Turilli will be reported on the Organization's Form 990 for the fiscal year ending June 30, 2019. Form 990, Part XI, line 9: Transfers from Affiliates 1,790,025. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Elliot Health System 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509911 Management NH 501(c)(3) Line 12b, II SolutionHealth 0 Elliot Health System Professional & General LIT 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 016217452 Insurance Trust NH 501(c)(3) Line 12a, I Elliot Hospital 0 Elliot Hospital 1 Elliot Way Manchester NH 03103 020232673 Medical Services NH 501(c)(3) Line 3 Elliot Health System 0 Elliot Hospital Associates 1 Elliot Way Manchester NH 031033599 026006214 Auxilary NH 501(c)(3) Line 12d, III-O N/A 0 Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509589 Physician Services NH 501(c)(3) Line 3 Elliot Hospital 0 Elliot Professional Services Network Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 331003630 Physician Services NH 501(c)(3) Line 10 Elliot Hospital 0 2 1 Medical Center Drive Lebanon NH 03756 352506275 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Foundation Medical Partners Inc 8 Prospect Street Nashua NH 03060 020456218 Physician Services NH 501(c)(3) Line 10 Southern New Hampshire Health System 0 SolutionHealth 360 Route 101 Unit 8 Manchester NH 03110 830741190 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Southern New Hampshire Health System 8 Prospect Street Nashua NH 03060 020509221 Medical Services NH 501(c)(3) Line 12b, II SolutionHealth 0 Southern New Hampshire Medical Center 8 Prospect Street Nashua NH 03060 020483054 Medical Services NH 501(c)(3) Line 3 Southern New Hampshire Health System 0 VNA Community Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020396549 Nursing Services NH 501(c)(3) Line 7 Elliot Health System 0 VNA Home Health and Hospice Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020222241 Home Care and Hospice NH 501(c)(3) Line 10 Elliot Health System 0 VNA of Manchester & Southern NH & Subs 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395296 VNA Holding Company NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA Personal Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395295 Private Health and Homemaker Services NH 501(c)(3) Line 10 Elliot Health System 0 VNA of Southern New Hampshire Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 223313877 Supporting Organization NH 501(c)(3) Line 12b, II Elliot Health System 0 Elliot Common Trust Fund LLC 1 Elliot Way Manchester NH 03103 203653624 Investments NH N/A Elliot Health System Holdings & Subsidiaries 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512224 Management NH N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 Schedule R, Part II: Everwell, Inc. was formed in 2014 as a 501(c)(3) organization. It is a joint venture between Elliot Health System and Dartmouth Hitchcock Health, with each entity having equal representation on the Board of Directors. The organization terminated during the fiscal year ended June 30, 2018.