2018-05-10T08:50:30-05:00 2017-06-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2016-07-01 020512229 Mary and John Elliot Charitable Foundation MARY 6036638977 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 Jeffrey Rooney CFO 6036638977 2018-05-03 1 Nicholas E Porto P01310283 8002447444 2018-05-03 2016 2022-09-23 18:48:47Z Douglas F Dean 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 4658002 0 X N/A X 2001 NH To support the immediate and ongoing resource needs of the Elliot Health System. 13 12 0 50 0 0 1959427 1642060 0 0 244452 228334 476597 695807 2680476 2566201 1631087 1428832 0 0 0 0 0 0 0 560255 761196 2191342 2190028 489134 376173 8153844 8855201 411999 336872 7741845 8518329 The Mary and John Elliot Foundation's mission is to support the immediate and ongoing resource needs of the Elliot Health System. 0 0 2063287 1428832 701579 Support of the fundraising activities of The Elliot Hospital of the City of Manchester and its related tax exempt organizations. 2063287 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 1 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 7 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 13 12 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Joseph Ingold 6036638977 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 Sidney Baines Trustee 1.00 0.00 X 0 0 0 David Bellman Trustee 1.00 0.00 X 0 0 0 Cathy Champagne Trustee 1.00 0.00 X 0 0 0 Louise Forseze Trustee 1.00 0.00 X 0 0 0 Charles Goodwin Trustee 1.00 0.00 X 0 0 0 Selma Naccach-Hoff Trustee 1.00 1.50 X 0 0 0 Richard Rawlings Trustee 1.00 0.00 X 0 0 0 Renee Walsh Trustee 1.00 0.00 X 0 0 0 Richard I Winneg Trustee 1.00 2.00 X 0 0 0 Charles F Rolecek Chair 1.00 2.00 X X 0 0 0 John A Hession Vice Chair 1.00 3.50 X X 0 0 0 James J Tenn Esq Secretary 1.00 0.00 X X 0 0 0 Douglas F Dean CEO 1.00 45.50 X X 0 246376 46945 Arnold Gary Mueller Interim CEO (end 8/16) 1.00 45.50 X X 0 256360 0 James L Woodward CEO (end 7/16) 1.00 45.50 X X 0 372236 84714 Joseph Ingold CFO 1.00 44.60 X 0 368380 0 Jeffrey Rooney Interim CFO (end 1/17) 1.00 44.60 X 0 682824 0 Richard A Elwell Former CFO 0.00 0.00 X 0 976002 22748 0 2902178 154407 0 1 1 0 Elliot Hospital of the City of Mancheste One Elliot Way Manchester NH 03103 Staff and Operations 443756 1 344747 174816 72105 1050392 63887 1642060 146288 146288 2114411 2032365 82046 82046 82046 53164 344747 59436 -6272 -6272 500 0 500 500 Reimbursed Expenses 561000 701579 701579 701579 2566201 701579 0 222562 1428832 1428832 750 750 59385 59385 508577 443756 64821 1785 1785 176944 176944 10579 10579 1485 1485 1462 1462 229 229 2190028 2063287 126741 0 1062435 1005893 36893 33745 998 10496 10074 651 422 6470813 7184214 569449 603560 13603 26369 8153844 8855201 8299 9671 83700 87200 320000 240001 411999 336872 X 6377937 6599791 1363908 1918538 7741845 8518329 8153844 8855201 376173 400311 0 X X 0 1 X 1 0 X 2227206 3158445 1718143 1959427 1642060 10705281 2227206 3158445 1718143 1959427 1642060 10705281 1117982 9587299 148561 153440 135908 142262 146288 726459 11431740 2409661 0.83870 0.81450 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1363908 527394 27236 1918538 935396 391254 37258 1363908 2078542 484442 -109697 1517891 935396 1629528 349989 99025 2078542 1067605 558367 3556 1629528 0.00000 0.00000 1.00000 0 0 10496 10074 422 422 Alternative Investments through Elliot Common Trust Fund 603560 F 603560 X 1786295 400311 400311 1385984 59385 1120832 1180217 2566201 1009811 0 1009811 59385 1120832 1180217 2190028 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. Elliot Health System Holdings, Inc. is a holding company and its subsidiaries are for-profit companies subject to federal and state taxation. Income taxes are recorded based upon the asset and liability method. At June 30, 2017, the System has recorded $254,565 of prepaid federal and state income taxes in other current assets and, at June 30, 2016 the System has recorded $117,577 of accrued federal and state income taxes recorded in accounts payable and accrued expenses. The total provision for federal and state current tax expense is recorded in other nonoperating (losses) gains and is $240,258 and $110,936 at June 30, 2017 and 2016, respectively. At June 30, 2017, the System has a deferred tax asset of $3,064,832 which is included in other assets, mainly relating to depreciation differences between book and tax on property, plant and equipment. A valuation allowance that was previously established to offset the deferred tax asset was reversed in 2017, as a history of cumulative taxable income indicating the realizability of the deferred tax asset in future years became probable. As a result of the valuation allowance reversal, the System recognized a deferred tax benefit of $3,064,382 in nonoperating (losses) gains. Elliot Health System Holdings, Inc. believes that it has appropriate support for the income tax positions taken and to be taken on tax returns, and that their accruals for tax liabilities are adequate for all open tax years based on an assessment of many factors including experience and interpretations of tax laws applied to the facts of each matter. Elliot Health System Holdings, Inc. has concluded there are no significant uncertain tax positions requiring disclosure and there is no material liability for unrecognized tax benefits. Elliot Health System Holdings, Inc.'s policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in income tax expense. Part XI, Line 4b - Other Adjustments: Reclassed Grant Expenses 1,120,832. Part XII, Line 4b - Other Adjustments: Reclassed Grant Expenses 1,120,832. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Investments through Elliot Common Trust Fund 418000 0 0 0 0 0 0 418000 0 418000 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. Gala 229872 193357 36515 8254 18550 1850 12833 Golf Classic 168039 151390 16649 5297 11304 1348 397911 344747 53164 5297 19558 18550 1850 14181 59436 -6272 1 The Caregivers Inc 19 Harvey Road Bedford NH 03110 020395429 501(c)(3) 10000 Caring Cupboard Program Child & Family Services of New Hampshire 464 Chestnut Street Box 448 Manchester NH 03105 020222164 501(c)(3) 40000 Coordination of services to low income senior citizens through the Homecare Program Easter Seals of New Hampshire 555 Auburn Street Manchester NH 03103 020272825 501(c)(3) 40000 Develop a Caregiver Coaching Model The Elliot Hospital of the City of Manchester 1 Elliot Way Manchester NH 03101 020232673 501(c)(3) 912891 Programmatic and capital needs Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020232673 501(c)(3) 21059 General Operating Support Elliot Professional Services Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 331003630 501(c)(3) 13634 General Operating Support Granite State Independent Living 21 Chenell Drive Concord NH 03301 020350170 501(c)(3) 8000 Assist with longterm support for senior citizens to live independently The Granite YMCA 117 Market Street Manchester NH 03101 020222248 501(c)(3) 50000 Expand services that improve quality of life for area low income seniors Granite United Way 22 Concord Street Floor 2 Manchester NH 03101 026006033 501(c)(3) 50000 Increase socialization and independent living opportunities for area seniors Manchester Community Health Center 145 Hollis Street Manchester NH 03101 020458174 501(c)(3) 30000 Reduce barriers to care and provide care coordination/management to seniors The Mental Health Center of Greater Manchester 401 Cypress Street Manchester NH 03103 020258994 501(c)(3) 25000 Senior Experience Community Resources Awareness Initiative New Hampshire Association for the Blind McGreal Sight Center 25 Walker Street Concord NH 03301 020223606 501(c)(3) 25000 Address unmet needs of senior citizens with vision loss. New Hampshire Legal Assistance 117 North State Street Concord NH 03301 020300897 501(c)(3) 10000 Provide free legal services for needy senior citizens St Joseph Community Services PO Box 910 Merrimack NH 03054 020335003 501(c)(3) 20000 Support restoration of fifth delivery day for Meals on Wheels VNA of Southern New Hampshire Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020222241 501(c)(3) 103392 General Operating Support 15 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. 1 1 0 0 0 0 0 0 0 Douglas F Dean CEO 0 157118 0 0 0 89258 0 33692 0 13253 0 293321 0 70740 Arnold Gary Mueller Interim CEO (end 8/16) 0 37500 0 0 0 218860 0 0 0 0 0 256360 0 0 James L Woodward CEO (end 7/16) 0 355214 0 0 0 17022 0 76040 0 8674 0 456950 0 0 Joseph Ingold CFO 0 325088 0 0 0 43292 0 0 0 0 0 368380 0 0 Jeffrey Rooney Interim CFO (end 1/17) 0 645970 0 0 0 36854 0 0 0 0 0 682824 0 0 Richard A Elwell Former CFO 0 281823 0 68200 0 625979 0 16563 0 6185 0 998750 0 607979 Part I, Line 3 The 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 CEO. Part I, Lines 4a-b Arnold Gary Muller, an officer of the filing organization who was compensated by a related organization, The Elliot Hospital of the City of Manchester, received a severance payment of $130,000 during calendar year 2016. This amount is reported in Schedule J, Part II, Column B(iii). 2016 contributions to the 457(f) plan of The Elliot Hospital of the City of Manchester, a related organization, during the year were: James Woodward-$70,740; Richard Elwell-$16,563. Schedule J, Part II: During the year, Mr. Dean and Mr. Elwell withdrew funds from their deferred compensation plans ($70,740 and $607,979, respectively). These amounts are reported as taxable compensation in Part III, Column B(iii). It should be noted that, when appropriate, these amounts were reported, or would have been reported if the individual was required to be reported in Form 990, Part VII, in prior years as deferred compensation in Part II, Column C. Accordingly, these amounts are also reflected in Part II, Column F so as to not overstate compensation in the current year that was earned over a period of years. 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, were both contracted employees through Martinville Dunn, LLC and Ingold & Associates, LLC, respectively. Both LLCs are unrelated to Mary and John Elliot Charitable Foundation and were paid by The Elliot Hospital of the City of Manchester, a related organization. Compensation in the amount of $645,970 was paid to Martinville, Dunn, LLC by the Hospital for Mr. Rooney's services. The total compensation paid to Mr. Ingold's LLC for his services, both as a CFO and in a non-officer capacity prior to his role as CFO, during 2016 was $325,088. Additionally, Mr. Rooney received a housing allowance in the amount of $36,854 during 2016 from the Hospital and Mr. Ingold received a similar housing allowance in the amount of $43,292 during the calendar year. 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. Martinville Dunn LLC Chief Financial Officer 682824 Jeffrey Rooney, who served as Chief Financial Officer during a portion of the reporting period, was an officer of Martinville Dunn, LLC, an unrelated organization paid by Elliot Hospital for Mr. Rooney's services as CFO to the entire health system. As the fees paid to Martinville Dunn, LLC were paid by the Hospital for Mr. Rooney'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 Martinville Dunn, LLC has been disclosed here. 0 Ingold & Associates LLC Chief Financial Officer 386380 Joseph Ingold, who served as Chief Financial Officer during a portion of 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 to Martinville Dunn, LLC were paid by the Hospital for Mr. Rooney'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 Martinville Dunn, LLC has been disclosed here. 0 X 8000 Fair Market Value X Event Prizes and Gifts 4 54387 Fair Market Value X Food and Beverages 2 1500 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, were both contracted employees through Martinville Dunn, LLC and Ingold & Associates, LLC, respectively. Both LLCs are unrelated to Mary and John Elliot Charitable Foundation and were paid by The Elliot Hospital of the City of Manchester, a related organization. Compensation in the amount of $645,970 was paid to Martinville, Dunn, LLC by the Hospital for Mr. Rooney's services. The total compensation paid to Mr. Ingold's LLC for his services, both as a CFO and in a non-officer capacity prior to his role as CFO, during 2016 was $325,088. Additionally, Mr. Rooney received a housing allowance in the amount of $36,854 during 2016 from the Hospital and Mr. Ingold received a similar housing allowance in the amount of $43,292 during the calendar year. 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 50% 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 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 N/A 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 Health System 0 Elliot Hospital 1 Elliot Way Manchester NH 03103 020232673 Physician Services NH 501(c)(3) Line 3 Elliot Health System 0 Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 331003630 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 Elliot Hospital Associates 1 Elliot Way Manchester NH 031033599 026006214 Auxilary NH 501(c)(3) Line 12d, III-O N/A 0 Everwell Inc 1 Medical Center Drive Lebanon NH 03756 352506275 Supporting Organization NH 501(c)(3) Line 12a, I N/A 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 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.