COOS COUNTY FAMILY HEALTH SERVICES INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
COOS COUNTY FAMILY HEALTH SERVICES INC (EIN 02-0350051)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-02-10
IRS object ID
201710419349300846
Schema version
2015v3.0
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

FieldValueIRS element (for citing)
Return2017-02-10T10:25:19-06:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010523282PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11000 Elm Street 15th FloorAddressLine1Txt
CityManchesterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03101ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020350051EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Coos County Family Health Services IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOOSBusinessNameControlTxt
Phone6037522040PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 Pleasant StreetAddressLine1Txt
CityBerlinCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03570ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJoan MerrillPersonNm
Person TitleBoard PresidentPersonTitleTxt
Phone6037527719PhoneNum
Signature2017-02-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDimitrios Panacopoulos CPAPreparerPersonNm
PTINP01603705PTIN
Phone6036697337PhoneNum
Preparation2017-02-01PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKen GordonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 Pleasant StreetAddressLine1Txt
CityBerlinCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03570ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,399,573GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.coosfamilyhealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1980FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionCoos County Family Health Services, Inc. is a community-based organization providing innovative, personalized, comprehensive health care and social services of the highest quality to everyone, regrdless of economic status.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee140TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,846,003PYContributionsGrantsAmt
CY Contributions Grants$2,915,021CYContributionsGrantsAmt
PY Program Service Revenue$8,248,232PYProgramServiceRevenueAmt
CY Program Service Revenue$9,481,369CYProgramServiceRevenueAmt
PY Investment Income$3,061PYInvestmentIncomeAmt
CY Investment Income$3,183CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$11,097,296PYTotalRevenueAmt
CY Total Revenue$12,399,573CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,507,353PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,878,140CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$7,237CYTotalFundraisingExpenseAmt
PY Other Expenses$2,871,285PYOtherExpensesAmt
CY Other Expenses$3,206,812CYOtherExpensesAmt
PY Total Expenses$10,378,638PYTotalExpensesAmt
CY Total Expenses$11,084,952CYTotalExpensesAmt
PY Revenues Less Expenses$718,658PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,314,621CYRevenuesLessExpensesAmt
Total Assets BOY$5,445,033TotalAssetsBOYAmt
Total Assets EOY$6,878,015TotalAssetsEOYAmt
Total Liabilities BOY$1,570,727TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,690,395TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,874,306NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,187,620NetAssetsOrFundBalancesEOYAmt
MissionCoos County Family Health Services, Inc. is a community-based organization providing innovative, personalized, comprehensive health care and social services of the highest quality to everyone, regardless of economic status.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$9,668,272ExpenseAmt
Revenue$9,481,369RevenueAmt
DescProvision of primary care services to the community.Desc
Total Program Service Expenses$9,668,272TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document23IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee140EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ken GordonBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6037522040PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 Pleasant StreetAddressLine1Txt
CityBerlinCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03570ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Robert Pelchat
Imm. Past President1.00Yes (X)Yes (X)$0$0$0
Joan Merrill
President1.00Yes (X)Yes (X)$0$0$0
Aline Boucher
Board Member1.00Yes (X)$0$0$0
Marge McClellan
Board Member1.00Yes (X)$0$0$0
H Guyford Stever Jr
Vice President1.00Yes (X)Yes (X)$0$0$0
Andrea Brochu
Board Member1.00Yes (X)$0$0$0
Roland Olivier
Secretary1.00Yes (X)Yes (X)$0$0$0
David Morin
Board Member1.00Yes (X)$0$0$0
Robert Thompson
Board Member1.00Yes (X)$0$0$0
Dawn Fountain
Treasurer1.00Yes (X)Yes (X)$0$0$0
Timothy Beaulac
Board Member1.00Yes (X)$0$0$0
Hunter Coulombe
Board Member1.00Yes (X)$0$0$0
Pauline Tibbetts
Board Member1.00Yes (X)$0$0$0
Adele Woods
CEO40.00Yes (X)$70,654$0$3,891
Melissa Frenette
CFO40.00Yes (X)$98,532$0$24,021
Ken Gordon
CEO40.00Yes (X)$108,053$0$11,997
Brian Beals
Physician38.00$228,482$0$36,985Yes (X)
Thomas Temme
Physician30.00$129,657$0$34,352Yes (X)
Elaine Chappell
Physician32.00$134,626$0$8,061Yes (X)
Josee Bourbeau MD
Physician30.00$138,457$0$34,334Yes (X)
Amy Lucas
Physician Assistant40.00$107,123$0$12,843Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,015,584TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$166,484TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Androscoggin Valley Hospital
59 Page Hill RdBerlinNH03570Rent/Physicians/OB$277,117
Capture RX
10100 Reunion Pl 700San AntonioTX78216340b Administration Services$192,385
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Federated Campaigns$2,319FederatedCampaignsAmt
Government Grants$2,384,607GovernmentGrantsAmt
All Other Contributions$528,095AllOtherContributionsAmt
Total Contributions$2,915,021TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service RevenueDesc
Business621110BusinessCd
Total Revenue Column$9,481,369TotalRevenueColumnAmt
Related Or Exempt Func Income$9,481,369RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$9,481,369TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,183TotalRevenueColumnAmt
Exclusion$3,183ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,399,573TotalRevenueColumnAmt
Related Or Exempt Func Income$9,481,369RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3,183ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$521,111TotalAmt
Program Services$289,100ProgramServicesAmt
Management And General$232,011ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,411,045TotalAmt
Program Services$4,869,941ProgramServicesAmt
Management And General$541,104ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$168,356TotalAmt
Program Services$146,032ProgramServicesAmt
Management And General$22,324ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,304,133TotalAmt
Program Services$1,131,205ProgramServicesAmt
Management And General$172,928ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$473,495TotalAmt
Program Services$410,710ProgramServicesAmt
Management And General$62,785ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$29,376TotalAmt
Management And General$29,376ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$42,000TotalAmt
Management And General$42,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$579,820TotalAmt
Program Services$579,820ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$34,434TotalAmt
Management And General$34,434ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$119,207TotalAmt
Program Services$103,400ProgramServicesAmt
Management And General$15,807ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$144,500TotalAmt
Program Services$144,500ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$308,214TotalAmt
Program Services$267,345ProgramServicesAmt
Management And General$40,869ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$32,529TotalAmt
Program Services$28,216ProgramServicesAmt
Management And General$4,313ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$131,494TotalAmt
Management And General$131,494ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$24,621TotalAmt
Program Services$21,356ProgramServicesAmt
Management And General$3,265ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$219,928TotalAmt
Program Services$190,766ProgramServicesAmt
Management And General$29,162ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$63,266TotalAmt
Program Services$54,877ProgramServicesAmt
Management And General$8,389ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Program Supplies$1,184,944$1,184,944
Other Expenses$87,645$74,664$12,981
Printing & Publications$72,979$63,302$9,677
Telephone$62,456$54,174$8,282

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$69,399TotalAmt
Program Services$53,920ProgramServicesAmt
Management And General$8,242ManagementAndGeneralAmt
Fundraising$7,237FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,084,952TotalAmt
Program Services$9,668,272ProgramServicesAmt
Management And General$1,409,443ManagementAndGeneralAmt
Fundraising$7,237FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$836,038BOYAmt
EOY$1,777,082EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$298,215BOYAmt
EOY$671,106EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,064,656BOYAmt
EOY$1,308,326EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$71,972BOYAmt
EOY$76,676EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,159,016LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,818,707LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,460,244BOYAmt
EOY$2,340,309EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$713,908BOYAmt
EOY$704,516EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,445,033BOYAmt
EOY$6,878,015EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$854,875BOYAmt
EOY$1,034,972EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$715,852BOYAmt
EOY$655,423EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,570,727BOYAmt
EOY$1,690,395EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,750,548BOYAmt
EOY$5,079,949EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$99,461BOYAmt
EOY$84,681EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$24,297BOYAmt
EOY$22,990EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,874,306BOYAmt
EOY$5,187,620EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,445,033BOYAmt
EOY$6,878,015EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,314,621ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$1,307OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,785,222CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,761,749CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,305,345CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,846,003CurrentTaxYearMinus1YearAmt
Current Tax Year$2,915,021CurrentTaxYearAmt
Total$14,613,340TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,687,797CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,014,105CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,773,326CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,248,232CurrentTaxYearMinus1YearAmt
Current Tax Year$9,481,369CurrentTaxYearAmt
Total$37,204,829TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,473,019CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,775,854CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,078,671CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,094,235CurrentTaxYearMinus1YearAmt
Current Tax Year$12,396,390CurrentTaxYearAmt
Total$51,818,169TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$51,818,169PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,881CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,664CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,707CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,061CurrentTaxYearMinus1YearAmt
Current Tax Year$3,183CurrentTaxYearAmt
Total$18,496TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,881CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,664CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,707CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,061CurrentTaxYearMinus1YearAmt
Current Tax Year$3,183CurrentTaxYearAmt
Total$18,496TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,476,900CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,779,518CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,083,378CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,097,296CurrentTaxYearMinus1YearAmt
Current Tax Year$12,399,573CurrentTaxYearAmt
Total$51,836,665TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99960PublicSupportCY509Pct
Public Support PY5090.99960PublicSupportPY509Pct
Investment Income CY0.00040InvestmentIncomeCYPct
Investment Income PY0.00040InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$24,297BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses-$1,307InvestmentEarningsOrLossesAmt
End Year Balance$22,990EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$23,930BeginningYearBalanceAmt
Contributions$125ContributionsAmt
Investment Earnings Or Losses$1,066InvestmentEarningsOrLossesAmt
Other Expenditures$824OtherExpendituresAmt
End Year Balance$24,297EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$22,026BeginningYearBalanceAmt
Contributions$1,267ContributionsAmt
Investment Earnings Or Losses$1,699InvestmentEarningsOrLossesAmt
Other Expenditures$1,062OtherExpendituresAmt
End Year Balance$23,930EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$19,107BeginningYearBalanceAmt
Contributions$2,113ContributionsAmt
Investment Earnings Or Losses$806InvestmentEarningsOrLossesAmt
End Year Balance$22,026EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$17,623BeginningYearBalanceAmt
Contributions$1,657ContributionsAmt
Investment Earnings Or Losses-$173InvestmentEarningsOrLossesAmt
End Year Balance$19,107EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$153,257OtherCostOrOtherBasisAmt
Book Value$153,257BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,209,070OtherCostOrOtherBasisAmt
Depreciation$1,281,551DepreciationAmt
Book Value$1,927,519BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,796,689OtherCostOrOtherBasisAmt
Depreciation$1,537,156DepreciationAmt
Book Value$259,533BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,340,309TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Due from Third Party Payers$45,250
Assets Limited as to Use$640,358
Beneficial Interest in Perpetual Trust Held by Others$18,908
FieldValueIRS element (for citing)
Total Book Value Other Assets$704,516TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$12,398,266TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$1,307OtherRevenueAmt
Revenue Not Reported-$1,307RevenueNotReportedAmt
Revenue Subtotal$12,399,573RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$12,399,573TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$11,084,952TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$11,084,952ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$11,084,952TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Income earned is used for operations.
Part X, Line 2:The Organization is 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 positions and concluded that the Organization has no unrelated business income or uncertain tax positions that require adjustment to the financial statements.
Part XI, Line 2d - Other Adjustments:Change in Fair value of Beneficial Interest -1,307.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Brian Beals
Physician$147,283$0$74,532$0$6,667$0$0$0$36,985$0$265,467$0$0$0
Thomas Temme
Physician$116,769$0$10,000$0$2,888$0$0$0$34,352$0$164,009$0$0$0
Josee Bourbeau MD
Physician$84,128$0$53,388$0$941$0$0$0$34,334$0$172,791$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 7FormAndLineReferenceDesc
ExplanationPhysicians are provided incentive payments based on number of patients seen, complexity of patient acuity, timely documentation, patient satisfication, and quality of care provided.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11The CFO compares the Form 990 to the audited financial statements and prior year 990. A copy is given to the Finance Committee to review and then a copy is given to the board of directors to review and approve.
Form 990, Part VI, Section B, line 12cAnnually, the board re-affirms their compliance with the conflict of interest policy with a written compliance document.
Form 990, Part VI, Section B, line 15The compensation process for the CEO, COO and CFO includes an independent compensation consultant completing a compensation survey or study. The compensation amount is then approved by the board of directors.
Form 990, Part VI, Section C, line 19Documents are posted to the Organization's website and are available upon request.
Form 990, Part XI, line 9:Change in fair value of beneficial interest in perpetual trust -1,307.

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