2017-01-16T10:03:51-06:00 2016-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2015-10-01 020222122 Concord Regional Visiting Nurse Association Inc CONC 6032244093 30 Pillsbury Street Concord NH 03301 Beth J Slepian President & CEO 6032244093 2017-01-16 1 Joseph R Byrne CPA P01289281 2077752387 2017-01-16 2015 2021-01-29 14:40:06Z Beth J Slepian 30 Pillsbury Street Concord NH 03301 38067638 0 X www.crvna.org X 1899 NH Concord Regional Visiting Nurse Association, incorporated in 1899, is a home health and hospice care provider, offering both preventive and supportive health care services. Our mission is to provide and facilitate comprehensive care in the home and community to optimize health, well-being and independence. Our services include: Skilled Nursing; Physical Therapy, Occupational Therapy, & Speech Therapy; Homemaking; Maternal/Child Health; Social Work; Hospice Care; Palliative Care, Personal Home Services; Pediatric Care; Nutritional Counseling; Senior Health Clinics; Flu Immunization Clinics; Immunization Clinics; Blood Pressure Clinics; and Community Education. 16 14 473 116 0 0 528572 461999 28638715 29949882 636341 192000 -4740 -4471 29798888 30599410 0 0 0 0 22233879 23613405 0 0 97651 6258855 6319377 28492734 29932782 1306154 666628 31597825 33837489 3543295 3803670 28054530 30033819 X The Organization provides and facilitates comprehensive care in the home and community to optimize health, well-being and independence. 0 0 14527992 18927078 Home Health Care - provides skilled care services to patients who qualify for care in their home. Services were rendered to 5,424 patients including 120,361 chargable visits and 9,854 additional service hours for indigent patients. Charity care is provided to individuals who are uninsured, underinsured, or otherwise unable to pay the published fee for service. 8410073 9314740 Hospice - supportive care for the terminally ill on a 24 hour basis. Services were rendered to 833 patients providing 43,903 hospice care days. Hospice care is provided in a ten bed house for those who require twenty four hour skilled nursing care for symptom management and in the community. Charity care is provided to individuals who are uninsured, underinsured, or otherwise unable to pay the published fee for services or for the house room and board. 1733206 1498201 Personal Care Services - Provides care and support primarily to frail elders who need assistance to stay living independently in their own homes. 571473 209863 Community Health Services - provides community based health care services in individual homes and clinic setting including senior health clinics, immunization clinics, and community health education including "Better Choices, Better Health" a program that assists older adults in learning more effective ways of self-managing their chronic condition to improve their quality of life and "A Matter of Balance" a program that assists older adults in reducing their fear of falling and improving their activity levels. "Powerful Tools for Caregivers" is also an educational program offered for caregivers who are caring for someone with advance dementia or other cognitive impairments; in addition, a monthly Capital Area Memory Cafe is offered to support those who are caring for someone with advance dementia to help connect them with others for peer group support. Monthly walk in clinics and our "Dying to Talk Cafe's" are offered to help those living with a chronic illness, life limiting illness or anyone in the community who would like to explore how to begin having the conversation about advanced care planning and their end of life wishes.In 2014, a new program was launched providing a community health worker to work with elderly (over 65 years of age) who are living with complex and/or chronic illness. The Community Health worker works to improve health outcomes and health care utilization of the target population while increasing the client/consumers knowledge and ability to self-manage while improving awareness of their health issues. Funding for services is subsidized by agency and community funding. PALLIATIVE CARE - A specialized team who works with a person with a serious illness to address their physical, emotional, social, and spiritual needs to improve symptoms such as pain, shortness of breath, fatigue, and stress. 571473 209863 25242744 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 11 0 1 473 1 0 0 0 0 0 0 0 0 0 0 X 16 14 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Violet Rounds 6032244093 30 Pillsbury Street Concord NH 03301 X Mary B DeVeau Past President & CEO 50.00 X X 755073 0 26034 Christopher Parkinson Trustee 1.00 X 0 0 0 Kathleen Ames Past Trustee 1.00 X 0 0 0 Mark T Broth Esq Vice Chair 1.00 X X 0 0 0 Vera Buck Trustee 1.00 X 0 0 0 Charles J Fanaras RPh Trustee 1.00 X 0 0 0 Marianne Fleischman MD Chair 1.00 X X 0 0 0 Jessica S Pollack APRN Trustee 1.00 X 0 0 0 Melvin J Severance CFP Treasurer 1.00 X X 0 0 0 Deacon Winton DeRosia Trustee 1.00 X 0 0 0 Andrew B Eills Esq Secretary 1.00 X X 0 0 0 Patricia Bourgault Trustee 1.00 X 0 0 0 Paul Greenan Trustee 1.00 X 0 0 0 Amelia Larsen Curti Past Trustee 1.00 X 0 0 0 Michelline Dufort Trustee 1.00 X 0 0 0 Tim Lesko Trustee 1.00 X 0 0 0 James Mullins Trustee 1.00 X 0 0 0 Beth J Slepian President & CEO 50.00 X X 121736 0 9338 Andrea M Stevenson Trustee 1.00 X 0 0 0 Violet Rounds Chief Finance Officer 50.00 X 193731 0 38112 Linda Flewelling VP Human Resources 45.00 X 142983 0 12561 Deborah Mullen Chief Information Officer 45.00 X 137704 0 24152 Laurie Farmer VP Hospice House 45.00 X 122674 0 23309 Andrew Westbrook Medical Director 40.00 X 187596 0 22670 Art Savage PT 45.00 X 128157 0 5126 1789654 0 161302 16 0 1 0 0 11685 169644 6375 274295 461999 Home Care Revenue 621610 18927078 18927078 Hospice Revenue 623000 9314740 9314740 Personal Home Services Revenue 621610 1498201 1498201 Community Services Revenue 621990 209863 209863 29949882 477495 477495 7161182 7446677 -285495 -285495 -285495 17080 169644 21551 -4471 -4471 30599410 29949882 0 187529 1144024 1052806 91218 17653932 16422592 1231340 578799 556150 22649 2874042 2584517 289525 1362608 1195096 161079 6433 19632 19632 68200 68200 107461 107461 1231614 1190943 40671 2342454 1920668 421786 509765 509765 468118 196606 271512 752139 726628 25511 141370 141370 423593 313702 109891 96605 96605 Dues & Subscriptions 85902 66823 19079 Bad Debt Expense 69019 69019 Equipment Rental 3505 3505 29932782 25242744 4592387 97651 X 200 6719 6018929 7043997 101539 114815 3963178 4085662 177267 210011 6327147 1808860 1787093 4518287 18270058 16573567 1279561 1284431 31597825 33837489 2304679 2531858 1166267 1193161 72349 78651 3543295 3803670 X 21566638 24032927 1898111 1412543 4589781 4588349 28054530 30033819 31597825 33837489 X 666628 1314093 -1432 X 0 1 X 1 0 X 652383 817617 2620614 528572 461999 5081185 23493083 23516044 26352267 28633975 29945411 131940780 24145466 24333661 28972881 29162547 30407410 137021965 5485 5485 0 5485 5485 137016480 407721 354480 350877 549402 477495 2139975 407721 354480 350877 549402 477495 2139975 24553187 24688141 29323758 29711949 30884905 139161940 0.98460 0.98470 0.01540 0.01530 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7439 7439 0 Part II-B, Line 1: The Organization pays dues to various organizations, some to which a portion of the dues are attributable to lobbying expenses. 3407569 3407569 3395569 12000 89216 89216 3407569 2400248 995321 21940 21940 3395569 2151083 249165 40009 40009 2400248 2073418 77665 91186 91186 2151083 0.00000 1.00000 0.00000 0 0 4825622 639704 4185918 1501525 1169156 332369 4518287 Deferred Compensation 78651 78651 31907615 1314093 21551 1335644 30571971 26007 1432 27439 30599410 29928326 21551 21551 29906775 26007 26007 29932782 Part V, Line 4: The Endowment funds are used to subsidize charitable care, support community programs that have no outside funding, provide seed money for program expansion and new programs and to make capital improvements to the Hospice House. Programs and Services supported by the Agency's funds include Community Health Education including "Better Choices, Better Health" a program that assists older adults in learning more effective ways of self-managing their chronic condition to improve their quality of life and "A Matter of Balance" a program that assists older adults in reducing their fear of falling and improving their activity levels, health clinics for seniors that provide screenings, footcare, ear wax removal, and other related services and immunization clinics. In addition, the Hospice Program and the Hospice House are supported through charitable funds to provide subsidized or free services; bereavement support groups, Hospice volunteer training and community education. Funds also would be used to support CRVNA's Home Care Program's Telehealth Program and to subsidize charitable care for patients that are uninsured or underinsured in the Home Care Program. Part XI, Line 2d - Other Adjustments: Fundraising Expenses 21,551. Part XI, Line 4b - Other Adjustments: Change in Fair Value of Beneficial Interest in Perpetual Trusts 1,432. Part XII, Line 2d - Other Adjustments: Fundraising Expenses 21,551. Lights of Life 75530 75530 5181 Annual Appeal 63455 63455 9461 1 47739 30659 17080 2857 565 3487 186724 169644 17080 2857 565 18129 21551 -4471 X X X X X 0 1 0 0 0 0 0 1 0 Mary B DeVeau Past President & CEO 290677 0 25716 0 438680 0 24000 0 2034 0 781107 0 0 0 Violet Rounds Chief Finance Officer 180497 0 8834 0 4400 0 24000 0 14112 0 231843 0 0 0 Linda Flewelling VP Human Resources 136396 0 6587 0 0 0 8822 0 3739 0 155544 0 0 0 Deborah Mullen Chief Information Officer 131379 0 6325 0 0 0 15296 0 8856 0 161856 0 0 0 Andrew Westbrook Medical Director 178894 0 8702 0 0 0 20636 0 2034 0 210266 0 0 0 Part I, Line 4b In 2015, Ms. Mary B. DeVeau, Past President & CEO, became fully vested in the Organization's 457(f) plan, and accordingly, that plan was terminated and assets were distributed to the President/CEO. In calendar year 2015, Ms. Deveau received a $438,680 pension distribution from the 457(f) plan as a result of the plan termination. This pension distribution was included in Ms. DeVeau's 2015 Form W-2 and is reported in Schedule J, Part II, Column B(iii). Part I, Line 7 The bonus compensation paid to Mary DeVeau, & Violet Rounds are determined based on a compensation survey conducted by the Organization, and therefore are non-fixed in nature. The bonus compensation paid to Linda Flewelling, Deborah Mullen & Dr. Andrew Westbrook was part of a 5% management bonus which was given to all managers. Part II, Column B(iii): In 2015, Ms. Mary B. DeVeau, Past President & CEO, became fully vested in the Organization's 457(f) plan, and accordingly, that plan was terminated and assets were distributed to the President/CEO. In calendar year 2015, Ms. Deveau received a $438,680 pension distribution from the 457(f) plan as a result of the plan termination. This pension distribution was included in Ms. DeVeau's 2015 Form W-2 and is reported in Schedule J, Part II, Column B(iii). The Prescription Center and Northeast Pharmacy Vendor of Organization 647448 Charles Fanaras, a member of the Board of Trustees of the Organization is the sole owner of The Prescription Center and Northeast Pharmacy. The Organization purchases prescriptions and pharmacy services from this organization. All transactions are at arm's length. 0 Form 990, Part I, Line 1 Description of Organization Mission (Cont'd): The agency's service area includes Merrimack County and portions of Hillsborough County, representing more than 40 communities in central New Hampshire. Concord Regional VNA serves 7,000 patients annually and provides 150,000 homecare hours and more than 43,900 hospice days annually, including a 10-bed Hospice House. Patients who are uninsured, underinsured, or otherwise unable to pay the published fees for services are provided charity care. In the Fiscal Year 2016, the CRVNA Home Care Program provided care to 5,424 patients. Thirteen percent (13%) of the patients served in the Home Care Program were uninsured or received funding from Medicaid. In addition, 65.2% of the Home Care patients had Medicare or Medicare replacement plans as their insurance plan. The Hospice program provided care to 833 patients. Eighty seven percent of the Hospice patients had Medicare and 3.2% of the patients were uninsured or received funding from Medicaid. We are a 501(c)(3) non-profit agency and a subsidiary of Capital Region Health Care. Concord Regional VNA is a Medicare and Medicaid Certified Home Health and Hospice Provider and is licensed by the State of New Hampshire Bureau of Health Care Facilities. In addition, Concord Regional VNA's Hospice House, an inpatient setting providing care and comfort for the terminally ill, is licensed by the State of New Hampshire as a Supportive Residential Care Facility. Form 990, Part VI, Section A, line 6 Capital Region HealthCare Corporation is the sole member of the Concord Regional VNA. Form 990, Part VI, Section A, line 7a Capital Region HealthCare Corporation accepts any changes made to the bylaws by the governing body. Form 990, Part VI, Section B, line 11 The role of Concord Regional Visiting Nurse Association's Audit Committee has expanded to include review of the agency's 990. The accounting firm of Berry, Dunn, McNeil and Parker presented the 990 to the Audit Committee prior to filing the form. The Audit Committee engages the auditors and receives the audit and the 990 Report. The Audit Committee receives a complete copy of the 990 including all schedules. The initial presentation of the FY2016 audit and the 990 Form will occur at the November 16, 2016 meeting of the Audit/Finance Committee meeting. Subsequent Audit Committee meetings will occur if necessary to complete the review. The Audit Committee will report to the Board of Trustees that the 990 review has occurred. The Board of Trustees accepts the Audit Committee reports, the audit, and the 990 documents. All members of the Board will have access to the reports. The Form 990 is available to the public upon request. Form 990, Part VI, Section B, line 12c The Conflict of Interest, Statement of Conflict of Interest with Respect to a Relationship, Transaction and/or Financial Interest form was revised by the Audit Committee in February 2010 and approved by the Board in March 2010. The form was revised to ensure compliance with the State of NH Pecuniary Benefit Law (Chapter 7: RSA 7:19a) and the revised IRS 990 disclosure requirements. The Chief Executive Officer/President reviewed the form and the regulation requirements at the April 12, 2016 Board Meeting. Trustees at the meeting were requested to complete the forms and return them to management. The Executive Administrative Manager worked with Board members to ensure each member had returned the Conflict of Interest Forms. In FY2016, 100% of the Board of Trustees returned the signed conflict of interest forms. The Audit Committee at its June 2, 2016 meeting reviewed the forms for those Trustees that reported a conflict of interest. The Audit Committee reported to the full Board the conflict of interest transactions that had been disclosed on the conflict of interest forms. The Board at its June 14, 2016 meeting approved the conflict of interest disclosures. The approved transactions over $5,000 were reported as required by law to the State of New Hampshire's Director of Charitable Trust at the Attorney General's office and a notice was published in the Concord Monitor. In addition to the annual completion of the form, Trustees were asked at every Board meeting during Fiscal Year 2016, if there were any conflicts that they have identified that should be reported to Management and the Board. Form 990, Part VI, Section B, line 15 The Board at its November 10, 2009 meeting adopted an Executive Compensation policy for the CEO/CFO positions. The Executive Committee's compensation philosophy is to pay the CEO and CFO at the appropriate level of compensation based on market data and surveys such as the compensation report noted above. The compensation will be performance based using the salary information available. In October 2012, the Executive Committee in collaboration with other VNAs affiliated with the Visiting Nurse Association of Northern New England engaged Gallagher Surveys to complete an executive compensation analysis/review that would be used to determine the compensation for the Chief Executive Officer and the Chief Financial Officer for a three year period. The results of this report were presented to the CRVNA Executive Committee in March of 2013. The Executive Committee members decided at this meeting to accept the report as the appropriate tool to use to set the compensation for the CEO and CFO positions. The Executive Committee of the Board of Trustees using the Gallagher compensation survey recommended the annual compensation for the CEO and CFO at the December 8, 2015 Board meeting. The Board unanimously approved the compensation recommendation. In addition, the CEO resigned her CEO position effective December 17, 2015. The Executive Committee retained the search firm, Philips and Dipisa, Associates to help with the CEO recruitment effort. A candidate was selected as a result of the search by the Executive Committee and the candidate was unanimously approved by the Board of Trustees on November 10, 2015. The Executive compensation for the new CEO was determined based on the Salary Survey completed by the Hospital & Healthcare Compensation Service for the National Association of Home Care, dated October 2015. The CEO salary recommendation was unanimously approved by the Board of Trustees on December 8, 2015. 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 VII, Section A: In 2015, Ms. Mary B. DeVeau, Past President & CEO, became fully vested in the Organization's 457(f) plan, and accordingly, that plan was terminated and assets were distributed to the President/CEO. In calendar year 2015, Ms. Deveau received a $438,680 pension distribution from the 457(f) plan as a result of the plan termination. This pension distribution was included in Ms. DeVeau's 2015 Form W-2 and is reported in Schedule J, Part II, Column B(iii). Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Concord Regional Visiting Nurse Association, Inc. 30 Pillsbury Street Concord, NH 03301 EIN 02-0222122 Concord Regional Visiting Nurse Association, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Change in Fair Value of Beneficial Interest in Perpetual Trusts -1,432. Capital Region Health Care Corporation 250 Pleasant Street Concord NH 03301 020222123 Health Care Services NH 501(c)(3) Line 11a, I N/A 0 Concord Hospital Inc 250 Pleasant Street Concord NH 03301 222594672 Patient Care Services NH 501(c)(3) Line 3 N/A 0 Riverbend Community Mental Health Inc 3-5 North State Street PO Box 2032 Concord NH 03302 020264383 Mental Health Services NH 501(c)(3) Line 7 N/A 0 Capital Region Health Care Development Corporation 250 Pleasant Street Concord NH 03301 020429749 Management of Real Estate Holdings NH 501(c)(2) N/A 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0