2019-09-09T07:38:27-05:00 2019-03-31 010523282 Berry Dunn Mcneil & Parker LLC 1000 Elm Street 15th Floor Manchester NH 03101 990 2018-04-01 510199559 Northern Counties Health Care Inc NORT 8027489405 165 Sherman Drive St Johnsbury VT 05819 Michael Costa Chief Executive Officer 8027489405 2019-09-06 1 Dimitrios Panacopoulos CPA P01603705 6036697337 2019-09-06 69.49.157.66 2019-09-06 10:04:37 ED P E7B858A5D43A1C12EA56452E98FB06825C34A804 C86B3C3384E7B30FA9F9EB149CE7FBCC333204C6 2018 2019-02-21 02:37:17Z Michael Costa 165 Sherman Drive St Johnsbury VT 05819 27474748 0 X www.nchcvt.org X 1976 VT To provide high-quality, accessible, patient-centered health care. 15 15 421 15 0 0 4015868 4057377 20355216 22751119 196588 170988 0 0 24567672 26979484 0 0 0 0 17544966 18850483 0 0 0 5936254 6867257 23481220 25717740 1086452 1261744 15912445 16811978 2884947 2522736 13027498 14289242 X Mission: To provide high-quality, accessible, patient-centered health care. Vision: NCHC is a key partner in building healthy families and thriving communities. Values:We pursue quality in all that we do and are committed to: Mutual Respect and Trust - working together and providing care that respects every individual's dignity, privacy, and culture. Excellence -- investing in our most valuable asset, our employees, is crucial to delivering high quality care. Teamwork and Collaboration -- working within NCHC and with community partners to provide a continuum of health care and social support. Stewardship and Spirit of Service - serving our communities with integrity and intention in all our interactions. Resilience - approaching every challenge as an opportunity to pursue creative solutions, achieve financial sustainability, and deepen our resolve. 0 0 12076179 15027921 To provide primary care, dental care, behavioral health and community health services to residents in the Northeast Kingdom Region. 5963177 7723198 To provide home health, hospice and homemaker services to residents in the Northeast Kingdom Region. 18039356 1 1 0 0 0 0 0 0 0 1 1 0 0 1 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 1 0 0 0 1 94 0 1 421 1 0 0 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 0 0 X X Tom Pitts 8027489405 165 Sherman Drive St Johnsbury VT 05819 Karena Shippee Board Member 1.00 X 0 0 0 Thad Richardson President 2.00 X X 0 0 0 Marie Waring Vice President 2.00 X X 0 0 0 Laural Ruggles Board Member 1.00 X 0 0 0 Caroline Frey Board Member 1.00 X 0 0 0 Kathy Gent Board Member 1.00 X 0 0 0 Cynthia Stuart Secretary 2.00 X X 0 0 0 Al Cronauer Treasurer 2.00 X X 0 0 0 Nancy Reynolds Board Member 1.00 X 0 0 0 Ann Creaven Board Member 1.00 X 0 0 0 Ellen Moore Board Member 1.00 X 0 0 0 Ray Small Board Member 1.00 X 0 0 0 Ron Steen Board Member 1.00 X 0 0 0 Laura Newell Board Member 1.00 X 0 0 0 Jennifer Gus Board Member 1.00 X 0 0 0 Shawn Tester CEO 40.00 X 163898 0 28077 Thomas Pitts CFO 40.00 X 115716 0 13198 Timothy Tanner Physician 40.00 X 196717 0 24182 Linda Bisson Physician 40.00 X 191403 0 16242 Robert Primeau Physician 38.00 X 173871 0 26275 Sarah Morgan Physician 40.00 X 173485 0 31139 John Raser Physician 40.00 X 193317 0 31958 1208407 0 171071 20 0 1 0 St Johnsbury Health and Rehabilitation 1248 Hospital Drive StJohnsbury VT 05819 Nursing Home-Hospice 109668 Core Medical Group 3000 Goffs Falls Road Suite 101 Manchester NH 03103 Temporary Staffing 101753 Casamba LLC 60 Concord Street Wilmington MA 01887 Billing Software & Support 100706 3 4000418 56959 4057377 Primary Care 624100 15027921 15027921 Home Care 621610 7723198 7723198 22751119 117881 117881 548371 495264 53107 53107 53107 26979484 22751119 0 170988 320889 320889 14446745 9712633 4734112 466274 307508 158766 2438466 1608168 830298 1178109 776963 401146 27524 27524 71350 71350 807968 532855 275113 42253 27866 14387 83233 54892 28341 480003 316562 163441 656812 578346 78466 9982 6583 3399 526808 347430 179378 43895 28949 14946 Program Supplies 2751633 2751633 Other Expenses 760280 501405 258875 Other Tax 259103 259103 Printing and Publicatio 234101 154390 79711 112312 74070 38242 25717740 18039356 7678384 0 4855866 5342062 82461 92015 1923662 2330466 33338 48238 205021 187271 11158890 6809809 4177934 4349081 2900218 3019191 1733945 1443654 15912445 16811978 2116020 2291707 134235 204398 610187 24505 26631 2884947 2522736 X 13009174 14274703 5645 1860 12679 12679 13027498 14289242 15912445 16811978 1261744 0 X 0 1 X 1 1 1 X 2614895 2904895 3755009 4015868 4057377 17348044 16917920 18406556 19882016 20355217 22751119 98312828 19532815 21311451 23637025 24371085 26808496 115660872 0 0 0 115660872 49795 46756 53565 67691 117881 335688 49795 46756 53565 67691 117881 335688 19582610 21358207 23690590 24438776 26926377 115996560 0.99710 0.99740 0.00290 0.00260 X 12679 12679 12679 12679 12679 12679 12679 12679 12679 12679 1.00000 0 0 431847 431847 6875432 4056058 2819374 3769904 2753751 1016153 81707 81707 4349081 Due From Third Party Payers 1389862 Investment In Limited Liability Corporation 53792 1443654 Due to Third Party Payers 26631 26631 X 26979484 0 26979484 0 26979484 25717740 0 25717740 0 25717740 Part V, Line 4: Income used for operations. Part X, Line 2: The Organizations 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 position and concluded that the Organization has no unrelated business income or uncertain tax positions that require adjustment to the financial statements. 1 X X 0 0 0 1 0 0 0 0 0 Shawn Tester CEO 163898 0 0 0 0 0 6799 0 21278 0 191975 0 0 0 Timothy Tanner Physician 196717 0 0 0 0 0 7980 0 16202 0 220899 0 0 0 Linda Bisson Physician 191403 0 0 0 0 0 7705 0 8537 0 207645 0 0 0 Robert Primeau Physician 173871 0 0 0 0 0 7160 0 19115 0 200146 0 0 0 Sarah Morgan Physician 173485 0 0 0 0 0 7242 0 23897 0 204624 0 0 0 John Raser Physician 193317 0 0 0 0 0 8061 0 23897 0 225275 0 0 0 Part I, Line 5 Robert Primeau is paid for on-call services at North Country Hospital based on net billing at the hospital. Sarah Morgan is paid for on-call services at Copley Hospital based on payments associated with billing at the hospital. Form 990, Part VI, Section B, line 11b The 990 is reviewed by management prior to signing. Form 990, Part VI, Section B, line 12c At the end of each fiscal year each Director completes a questionnaire to report on conflicts of interest. Form 990, Part VI, Section B, line 15a The Executive Director's compensation is established and approved by the Organization's governing board. The Board of Directors establishes this salary based on salary surveys completed within Northern Counties' market. The Executive Director is salaried similar to other employees and is not a contracted employee. Form 990, Part VI, Section C, line 19 Upon request. Pharmacy Network LLC 44 Main Street Suite 200 Richford VT 05476 223002077 Pharmacy VT N/A Related -29929 53792 0 0 0.20000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0