2018-08-13T08:59:32-05:00 2018-03-31 010523282 Berry Dunn Mcneil & Parker LLC 1000 Elm Street 15th Floor Manchester NH 03101 990 2017-04-01 510199559 Northern Counties Health Care Inc NORT 8027489405 165 Sherman Drive St Johnsbury VT 05819 Shawn Tester Chief Executive Officer 8027489405 2018-07-31 1 Dimitrios Panacopoulos CPA P01603705 6036697337 2018-07-31 2017 2022-09-23 18:48:47Z Shawn Tester 165 Sherman Drive St Johnsbury VT 05819 25387414 0 X www.nchcvt.org X 1976 VT We believe that quality health care is a basic human right which must be accessible and affordable. We believe that programs must be coordinated with other human services and planned so that care is continuous throughout the system of health care and is provided in the most cost-effective way possible.In carrying out our beliefs, we will provide preventive, primary care, home-based, and hospice services. It is our intention to treat people at all times with respect and dignity, and primary emphasis placed on communication, education, and confidentiality. 13 13 361 13 0 0 3755009 4015868 19882016 20355216 214922 196588 0 0 23851947 24567672 0 0 0 0 16255671 17544966 0 0 0 5944985 5936254 22200656 23481220 1651291 1086452 15039707 15912445 3098661 2884947 11941046 13027498 To provide high-quality, accessible, patient-centered health care. 0 0 14099388 12764341 To provide primary care, dental care, behavioral health and community health services to residents in the Northeast Kingdom Region. 7446800 7590875 To provide home health, hospice and homemaker services to residents in the Northeast Kingdom Region. 21546188 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 75 0 1 361 1 0 0 0 0 0 0 0 0 0 0 X 13 13 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 Secretary 2.00 X X 0 0 0 Thad Richardson Treasurer 2.00 X X 0 0 0 Lucy Hickey Board Member 1.00 X 0 0 0 Joe Wood President 2.00 X X 0 0 0 Marie Waring Vice President 2.00 X X 0 0 0 Jelena Gervais Board Member 1.00 X 0 0 0 Laural Ruggles Board Member 1.00 X 0 0 0 Caroline Frey Board Member 1.00 X 0 0 0 Luke Fontaine Board Member 1.00 X 0 0 0 Kathy Gent Board Member 1.00 X 0 0 0 Ron Steen Board Member 1.00 X 0 0 0 Cynthia Stuart Board Member 1.00 X 0 0 0 Al Cronauer Board Member 1.00 X 0 0 0 Thomas Pitts CFO 40.00 X 105853 0 12816 Shawn Tester CEO 40.00 X 139517 0 29749 Timothy Tanner Physician 40.00 X 198510 0 24275 Sharon Fine Physician 40.00 X 183745 0 31514 Sarah Morgan Physician 38.00 X 160963 0 30619 Robert Primeau Physician 38.00 X 166619 0 25982 John Raser Physician 40.00 X 194286 0 25975 1149493 0 180930 19 0 1 0 Core Medical Group 3000 Goffs Falls Road Suite 101 Manchester NH 03103 Temporary Staffing 194634 St Johnsbury Health and Rehabilitation 1248 Hospital Drive StJohnsbury VT 05819 Nursing Home-Hospice 114122 Healthwyse LLC 60 Concord Street Wilmington MA 01887 Billing Software & Support 104532 3 3880371 135497 4015868 Primary Care 624100 12764341 12764341 Home Care 621610 7590875 7590875 20355216 67691 67691 948639 819742 128897 128897 128897 24567672 20355216 0 196588 287935 287935 13719603 12950343 769260 392772 364235 28537 2142629 2068388 74241 1002027 929224 72803 36840 36840 68275 68275 116606 116606 451489 397064 54425 23795 23795 530574 468174 62400 Other Expenses 1973631 1683401 290230 Program Supplies 1315148 1315148 Staff Reimbursements 638383 564903 73480 Professional Fees and C 543658 543658 237855 237855 23481220 21546188 1935032 0 4825817 4855866 319633 82461 1619349 1923662 29987 33338 163406 205021 10720733 6542799 4330890 4177934 2636058 2900218 1114567 1733945 15039707 15912445 2092678 2116020 364001 134235 627512 610187 14470 24505 3098661 2884947 X 11917210 13009174 11157 5645 12679 12679 11941046 13027498 15039707 15912445 1086452 0 X 0 1 X 1 1 1 X 2646028 2614895 2904895 3755009 4015868 15936695 15981345 16917920 18406556 19882016 20355217 91543054 18627373 19532815 21311451 23637025 24371085 107479749 0 0 0 107479749 57424 49795 46756 53565 67691 275231 57424 49795 46756 53565 67691 275231 18684797 19582610 21358207 23690590 24438776 107754980 0.99740 0.99740 0.00260 0.00260 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12679 12679 12679 12679 12679 12679 12679 12679 12679 12679 1.00000 0 0 412347 412347 6548140 3826652 2721488 3760246 2716147 1044099 4177934 Due From Third Party Payers 1652224 Investment In Limited Liability Corporation 81721 1733945 Due to Third Party Payers 24505 24505 X 24567672 0 24567672 0 24567672 23481220 0 23481220 0 23481220 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 1 0 Shawn Tester CEO 139517 0 0 0 0 0 5852 0 23897 0 169266 0 0 0 Timothy Tanner Physician 198510 0 0 0 0 0 8073 0 16202 0 222785 0 0 0 Sharon Fine Physician 183745 0 0 0 0 0 7617 0 23897 0 215259 0 0 0 Sarah Morgan Physician 160963 0 0 0 0 0 6722 0 23897 0 191582 0 0 0 Robert Primeau Physician 166619 0 0 0 0 0 6867 0 19115 0 192601 0 0 0 John Raser Physician 194286 0 0 0 0 0 2078 0 23897 0 220261 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. Part I, Line 7 The physicians are eligible to earn an incentive based on number of encounters and number of RVU's, however there were no payments for this incentive in FY 2018. 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 5254 81721 0 0 0.20000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0