Northern New Hampshire Healthcare: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- Northern New Hampshire Healthcare (EIN 46-2459559)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-10
- IRS object ID
- 201723149349301767
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-10T10:31:30-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 462459559 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern New Hampshire Healthcare | BusinessNameLine1Txt |
| Business Name Line2 | Collaborative Inc | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 6034445317 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 59 Page Hill Road | AddressLine1Txt |
| City | Berlin | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03570 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Russell Keene | PersonNm |
| Person Title | Vice President | PersonTitleTxt |
| Phone | 6034445317 | PhoneNum |
| Signature | 2017-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne CPA | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2017-11-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.49.157.66 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-09 | IPDt |
| IP Tm | 13:32:35 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 195DD2390B87809A4F2C1BC02D65E16960466FA1 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 53CA451596873B86A1E24CFE6767DCEC9A681D0F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwoods Home Health & Hospice | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Michael Counter | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 536 Cottage Street | AddressLine1Txt |
| City | Littleton | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03561 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,959,280 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | northcountryhomehealth-hospice.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | To provide home health, hospice, and homemaking services to patients in Coos County, New Hampshire. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 73 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $164,780 | PYContributionsGrantsAmt |
| CY Contributions Grants | $126,855 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,848,474 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,717,244 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,993 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,582 | CYInvestmentIncomeAmt |
| PY Other Revenue | $19,182 | PYOtherRevenueAmt |
| CY Other Revenue | $1,089,041 | CYOtherRevenueAmt |
| PY Total Revenue | $4,035,429 | PYTotalRevenueAmt |
| CY Total Revenue | $4,937,722 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,111,716 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,766,908 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,194,170 | PYOtherExpensesAmt |
| CY Other Expenses | $1,586,243 | CYOtherExpensesAmt |
| PY Total Expenses | $4,305,886 | PYTotalExpensesAmt |
| CY Total Expenses | $4,353,151 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$270,457 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $584,571 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,058,881 | TotalAssetsBOYAmt |
| Total Assets EOY | $907,061 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,373,195 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $635,566 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$314,314 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $271,495 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Northern New Hampshire Healthcare Collaborative, Inc. will ensure access to quality care within the communities in which our patients live, provide local and high quality care with positive outcomes to our patients in Coos County while controlling the cost of care through innovative programs and the use of shared resources. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,358,232 | ExpenseAmt |
| Revenue | $2,656,049 | RevenueAmt |
| Desc | Northwoods Home Health (NHH) is committed to providing quality, personalized in-home care to anyone in need of everyday assistance after an acute illness or injury, or living with a chronic illness. NHH provides an array of in-home medical and personal care services throughout Coos County including: Skilled Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Social Worker, Patient Care Coordination, Home Health Aides, as well as Homemaker services. NHH recorded a total of 28,343 visits during 2016. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $582,560 | ExpenseAmt |
| Revenue | $1,061,195 | RevenueAmt |
| Desc | Northwoods Hospice provides services throughout Coos County to assist patients to enhance their quality of life and achieve personal goals in the months and weeks near the end of life by providing comfort and support as well as the highest level of skilled medical and personal care for the patient and their family.The staff help develop a comprehensive personal care plan that involves the patient, the family, physicians, nurses, counselors, and aides; providing care in the patient's home, nursing homes, assisted living residences, as well as hospitals. Patient care services available include: Hospice Care Coordinator, Skilled Nursing, management of necessary medical equipment and medications, Physical Therapy, Occupational Therapy, Speech Therapy, Social Worker, Home Health Aides, as well as Homemaker services. Volunteers are available for companionship, reading, recreation, as well as assistance with household activities. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $2,940,792 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 73 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Claudette Audette | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6034445317 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 59 Page Hill Road | AddressLine1Txt |
| City | Berlin | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03570 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Scott Howe | |||||||
| Past President/Chairman/Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Michael Peterson | |||||||
| Director, President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Russell Keene | |||||||
| Director, Vice President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Patrick Kelly | |||||||
| Director, Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Michael Lee | |||||||
| Director, Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Eric Stohl | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Bruce Bean | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jim Tibbetts | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Sarah Desrochers | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| William Jackson | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| David Atkinson | |||||||
| Past Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Donald Noyes | |||||||
| Past Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Gail Tattan-Giampaolo | |||||||
| Past Executive Director | 40.00 | Yes (X) | $106,198 | $0 | $8,601 | ||
| Michael Counter | |||||||
| President | 16.00 | Yes (X) | $0 | $0 | $0 | ||
| Claudette Audette | |||||||
| Finance Director | 40.00 | Yes (X) | $101,667 | $0 | $23,357 | ||
| Lorene Zammuto | |||||||
| Interim Executive Director | 40.00 | Yes (X) | $161,294 | $0 | $0 | ||
| Jim Berube | |||||||
| Physical Therapist | 40.00 | $180,674 | $0 | $14,374 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $549,833 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $46,332 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Leaders for Today | |||||
| 981 Worcester St Suite 1C | Wellesley | MA | 02482 | Professional Services | $155,551 |
| American Healthcare Services Association | |||||
| PO Box 945 | Traverse City | MI | 49685 | Professional Services | $151,652 |
| Weeks Medical Center | |||||
| 173 Middle Street | Lancaster | NH | 03584 | Professional Services | $103,060 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $10,502 | FundraisingAmt |
| Government Grants | $75,381 | GovernmentGrantsAmt |
| All Other Contributions | $40,972 | AllOtherContributionsAmt |
| Total Contributions | $126,855 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Resident Service Revenue | 621400 | $4,479,163 | $4,479,163 |
| Miscellaneous Revenue | 900099 | $15,674 | $15,674 |
| Contractual/Char. Adj. | 621400 | -$777,593 | -$777,593 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,717,244 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,582 | TotalRevenueColumnAmt |
| Exclusion | $4,582 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $24,385 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $10,502 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $21,558 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,827 | TotalRevenueColumnAmt |
| Exclusion | $2,827 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Forgiveness of Debt | Desc |
| Business | 900000 | BusinessCd |
| Total Revenue Column | $1,086,214 | TotalRevenueColumnAmt |
| Exclusion | $1,086,214 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,086,214 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,937,722 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,717,244 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,093,623 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,117 | TotalAmt |
| Program Services | $151,851 | ProgramServicesAmt |
| Management And General | $249,266 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,871,653 | TotalAmt |
| Program Services | $1,366,671 | ProgramServicesAmt |
| Management And General | $504,982 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,159 | TotalAmt |
| Program Services | $28,766 | ProgramServicesAmt |
| Management And General | $11,393 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $292,451 | TotalAmt |
| Program Services | $212,789 | ProgramServicesAmt |
| Management And General | $79,662 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,528 | TotalAmt |
| Program Services | $109,121 | ProgramServicesAmt |
| Management And General | $52,407 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,913 | TotalAmt |
| Program Services | $1,968 | ProgramServicesAmt |
| Management And General | $945 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,873 | TotalAmt |
| Program Services | $19,505 | ProgramServicesAmt |
| Management And General | $9,368 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $725,179 | TotalAmt |
| Program Services | $489,897 | ProgramServicesAmt |
| Management And General | $235,282 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,360 | TotalAmt |
| Program Services | $919 | ProgramServicesAmt |
| Management And General | $441 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,196 | TotalAmt |
| Program Services | $35,937 | ProgramServicesAmt |
| Management And General | $17,259 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,542 | TotalAmt |
| Program Services | $73,326 | ProgramServicesAmt |
| Management And General | $35,216 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,747 | TotalAmt |
| Program Services | $57,927 | ProgramServicesAmt |
| Management And General | $27,820 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,669 | TotalAmt |
| Program Services | $139,616 | ProgramServicesAmt |
| Management And General | $67,053 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,429 | TotalAmt |
| Program Services | $2,316 | ProgramServicesAmt |
| Management And General | $1,113 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,819 | TotalAmt |
| Program Services | $19,819 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,203 | TotalAmt |
| Program Services | $35,266 | ProgramServicesAmt |
| Management And General | $16,937 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $211,445 | $142,843 | $68,602 |
| Miscellaneous Expenses | $61,440 | $35,077 | $26,363 |
| Dues and Subscriptions | $24,754 | $16,723 | $8,031 |
| Bad Debt Expense | $674 | $455 | $219 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,353,151 | TotalAmt |
| Program Services | $2,940,792 | ProgramServicesAmt |
| Management And General | $1,412,359 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $216 | BOYAmt |
| EOY | $150 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,803 | BOYAmt |
| EOY | $180,369 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $639,292 | BOYAmt |
| EOY | $439,274 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,940 | BOYAmt |
| EOY | $6,663 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $59,457 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $49,547 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,729 | BOYAmt |
| EOY | $9,910 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,901 | BOYAmt |
| EOY | $270,695 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,058,881 | BOYAmt |
| EOY | $907,061 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,181 | BOYAmt |
| EOY | $322,008 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,228 | BOYAmt |
| EOY | $166,522 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,004,786 | BOYAmt |
| EOY | $147,036 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,373,195 | BOYAmt |
| EOY | $635,566 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$570,215 | BOYAmt |
| EOY | $800 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,801 | BOYAmt |
| EOY | $119,595 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,100 | BOYAmt |
| EOY | $151,100 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$314,314 | BOYAmt |
| EOY | $271,495 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,058,881 | BOYAmt |
| EOY | $907,061 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $584,571 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,238 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $98,697 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $164,780 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $126,855 | CurrentTaxYearAmt |
| Total | $390,332 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $3,816,014 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,867,656 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,720,071 | CurrentTaxYearAmt |
| Total | $11,403,741 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $3,914,711 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,032,436 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,846,926 | CurrentTaxYearAmt |
| Total | $11,794,073 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $11,794,073 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $19 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,533 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,993 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,582 | CurrentTaxYearAmt |
| Total | $11,127 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $19 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,533 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,993 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,582 | CurrentTaxYearAmt |
| Total | $11,127 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $1,086,214 | CurrentTaxYearAmt |
| Total | $1,086,214 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $19 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,918,244 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,035,429 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,937,722 | CurrentTaxYearAmt |
| Total | $12,891,414 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part III, Line 12, Explanation of Other Income: | FormAndLineReferenceDesc |
| Explanation | Forgiveness of Debt - 2016 Amount: $ 1,086,214. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,011 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,011 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The organization pays dues to associations of which a portion is attributable to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $179,112 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,998 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $184,110 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $120,466 | BeginningYearBalanceAmt |
| Contributions | $50,000 | ContributionsAmt |
| Investment Earnings Or Losses | $8,646 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $179,112 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $107,399 | ContributionsAmt |
| Investment Earnings Or Losses | $13,067 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $120,466 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.82070 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.17930 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $59,457 | OtherCostOrOtherBasisAmt |
| Depreciation | $49,547 | DepreciationAmt |
| Book Value | $9,910 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,910 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Assets Whose Use is Limited | Desc |
| Book Value | $270,695 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $270,695 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to AVH | $21,601 |
| Due to UCVH | $1,973 |
| Due to Weeks Medical Center | $123,462 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $147,036 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $4,938,960 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,238 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $1,238 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,937,722 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,937,722 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,353,151 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,353,151 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,353,151 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Hospice Ball | Event1Nm |
| Gross Receipts Event1 | $34,887 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $10,502 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $24,385 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $50 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $2,000 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $14,146 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $2,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $3,362 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $34,887 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $10,502 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $24,385 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $50 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $2,000 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $14,146 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $2,000 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $3,362 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $21,558 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $2,827 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lorene Zammuto | ||||||||||||||
| Interim Executive Director | $161,294 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $161,294 | $0 | $0 | $0 |
| Jim Berube | ||||||||||||||
| Physical Therapist | $180,674 | $0 | $0 | $0 | $0 | $0 | $3,735 | $0 | $10,639 | $0 | $195,048 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 4a | During 2016, Gail Tattan-Giampaolo, Past Executive Director of the Organization, received a severance payment in the amount of $48,390. |
| Part I, Line 7 | Claudette Audette, Finance Director, received a $2,500 bonus during 2016. The bonus payment was based on individual performance and was not contingent on the revenues or net earnings of the Organization. |
| Form 990, Part VII, line 5: | Lorene Zammuto, Interim Executive Director, was compensated by Leaders for Today, an unrelated organization, for services rendered to the Organization. Amounts paid to Leaders for Today by the Organization for services rendered by Ms. Zammuto totaled $161,294 during 2016. Ms. Zammuto's actual compensation from Leaders for Today is not known to the Organization. Per IRS instructions, the Organization has reported the amounts paid to Leaders for Today for services rendered by Ms. Zammuto ($161,294) on Form 990, Part VII & Schedule J, Part II. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The Corporation may have any number of members, provided, however, that each member shall be a nonprofit organization that is exempt from taxation under section 501(c)(3) of the Internal Revenue Code, and that is licensed to provide hospital services by the State of New Hampshire pursuant to RSA Chapter 151. |
| Form 990, Part VI, Section A, line 7a | Each Member shall appoint three Directors of the Corporation. At least one of the Directors appointed by each Member shall be a Director or Trustee of that Member. |
| Form 990, Part VI, Section A, line 7b | The Members shall have the sole authority with respect to the following matters, and the Board of Directors may not take any action on behalf of this Corporation with respect to such matters except as expressly authorized by a unanimous vote of the Members: 1. Amending the Articles or Bylaws of the Corporation; 2. Filing any petition for voluntary dissolution or voluntary bankruptcy of the Corporation; 3. Affiliation, consolidation, or merger with, or acquisition of, any other organization; 4. Adoption of annual operating and capital budgets, or substantial changes thereto; 5. Unbudgeted debt instruments, notes, guarantees, mortgages, or pledges in excess of such limits as the Members shall specify from time to time; 6. Authorization or material amendment of contracts for the sale, lease, exchange, or other disposition or acquisition or divesture of substantial assets of the Corporation in excess of such amounts as the Members shall specify from time to time; 7. Selection of any outside auditor or legal counsel; 8. Permitting the withdrawl of a Member; or 9. Admitting a new Member. |
| Form 990, Part VI, Section B, line 11b | The Form 990 will be reviewed and approved by the Finance Director, the President of the Agency as well as the President, the Vice President, and the Treasurer of the Board prior to filing. The Form 990 will be forwarded to the governing body for review prior to filing. |
| Form 990, Part VI, Section B, line 12c | NNHHC requires officers, directors, and key employees to review the Conflict of Interest Policy and to complete a Conflict of Interest Disclosure Statement which asks them to disclose any interests that could give rise to a conflict. The Policy is periodically reviewed. |
| Form 990, Part VI, Section B, line 15 | NNHHC determines compensation of its Management team through an annual comparable data source: New Hampshire Hospital Association - Wage Survey Reports & Management Personnel Salary Report. Any salary increases must be approved by the governing body. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. |
| Form 990, Part IX, line 11g | Skilled Nursing Contract Services: Program service expenses 124,351. Management and general expenses 59,722. Fundraising expenses 0. Total expenses 184,073. Administration Purchased Services: Program service expenses 260,492. Management and general expenses 125,105. Fundraising expenses 0. Total expenses 385,597. Other Contract Services: Program service expenses 45,844. Management and general expenses 22,018. Fundraising expenses 0. Total expenses 67,862. Hospice Care Services: Program service expenses 59,210. Management and general expenses 28,437. Fundraising expenses 0. Total expenses 87,647. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Northern New Hampshire Healthcare Collaborative, Inc. 59 Page Hill Road Berlin, NH 03570 EIN 46-2459559 Northern New Hampshire Healthcare Collaborative, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |