2017-11-14T16:20:05-06:00 2017-06-30 010523282 Berry Dunn McNeil & Parker LLC 1000 Elm Street 15th Floor Manchester NH 03101 990 2016-07-01 020350051 Coos County Family Health Services Inc COOS 6037522040 133 Pleasant Street Berlin NH 03570 Joan Merrill Board President 6037527719 2017-11-10 1 Dimitrios Panacopoulos CPA P01603705 6036697337 2017-11-10 69.49.157.66 2017-11-10 15:32:06 ES P A008E2FD9533E1BBB31C63A12AF0D0E643CE99E5 2F6A6628984E28F532C67895704E4F1F38634DDA 2016 2021-01-29 14:40:06Z Ken Gordon 133 Pleasant Street Berlin NH 03570 13072599 0 X www.coosfamilyhealth.org X 1980 NH Coos 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. 13 13 146 20 0 0 2915021 3633495 9481369 9426533 3183 4267 0 8304 12399573 13072599 0 0 0 0 7878140 8782282 0 0 2185 3206812 3562530 11084952 12344812 1314621 727787 6878015 7322352 1690395 1406945 5187620 5915407 Coos 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. 0 0 10807363 9426533 Provision of primary care services to the community. 10807363 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 33 0 1 146 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X X X Ken Gordon 6037522040 133 Pleasant Street Berlin NH 03570 Robert Pelchat Imm. Past President 1.00 X X 0 0 0 Joan Merrill President 1.00 X X 0 0 0 Aline Boucher Board Member 1.00 X 0 0 0 Marge McClellan Board Member 1.00 X 0 0 0 H Guyford Stever Jr Vice President 1.00 X X 0 0 0 Andrea Brochu Board Member 1.00 X 0 0 0 Roland Olivier Board Member 1.00 X 0 0 0 David Morin Board Member 1.00 X 0 0 0 Robert Thompson Board Member 1.00 X 0 0 0 Dawn Cross Treasurer 1.00 X X 0 0 0 Timothy Beaulac Board Member 1.00 X 0 0 0 Patti Stolte Board Member 1.00 X 0 0 0 Pauline Tibbetts Secretary 1.00 X X 0 0 0 Melissa Frenette CFO 40.00 X 99812 0 23744 Ken Gordon CEO 40.00 X 132614 0 15554 Brian Beals Physician 38.00 X 222537 0 36622 Thomas Temme Physician 30.00 X 126816 0 34062 Elaine Chappell Physician 32.00 X 126860 0 6871 Josee Bourbeau MD Physician 30.00 X 155158 0 34532 Patricia Couture COO 40.00 X 111697 0 6520 975494 0 157905 6 0 1 0 Androscoggin Valley Hospital 59 Page Hill Rd Berlin NH 03570 Rent/Physicians/OB 215401 Capture RX 10100 Reunion Pl 700 San Antonio TX 78216 340b Administration Services 207782 8 3784 2700151 929560 3633495 Patient Service Revenue 621110 9426533 9426533 9426533 4267 4267 8304 0 8304 8304 8304 13072599 9434837 0 4267 526403 279900 246503 6221390 5599251 622139 182073 159405 22668 1317471 1153446 164025 534945 468344 66601 35440 35440 49350 49350 767385 767385 36370 36370 130601 114341 16260 151962 151962 375461 328716 46745 29259 25616 3643 142496 142496 13635 11937 1698 258710 226501 32209 64499 56469 8030 Program Supplies 1175164 1175164 Other Expenses 121991 106803 15188 Printing & Publications 73694 64519 9175 Telephone 72843 63774 9069 63670 53830 7655 2185 12344812 10807363 1535264 2185 1777082 2367938 671106 226011 1308326 1542290 76676 87916 5385662 3020232 2340309 2365430 704516 732767 6878015 7322352 1034972 1105468 655423 301477 1690395 1406945 X 5079949 5757854 84681 132113 22990 25440 5187620 5915407 6878015 7322352 727787 0 X 0 1 X 1 1 1 X 2761749 3305345 2846003 2915021 3633495 15461613 6014105 7773326 8248232 9481369 9426533 40943565 8775854 11078671 11094235 12396390 13060028 56405178 0 0 0 56405178 3664 4707 3061 3183 12571 27186 3664 4707 3061 3183 12571 27186 8779518 11083378 11097296 12399573 13072599 56432364 0.99950 0.99960 0.00050 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22990 2006 444 25440 24297 -1307 22990 23930 125 1066 824 24297 22026 1267 1699 1062 23930 19107 2113 806 22026 1.00000 0 0 153257 153257 3233370 1403576 1829794 1999035 1616656 382379 2365430 Due from Third Party Payers 55000 Assets Limited as to Use 658415 Beneficial Interest in Perpetual Trust Held by Others 19352 732767 X 13069152 -3447 -3447 13072599 0 13072599 12341365 -3447 -3447 12344812 0 12344812 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. X X X X 0 0 0 0 0 0 0 1 0 Brian Beals Physician 155533 0 66298 0 706 0 0 0 36622 0 259159 0 0 0 Thomas Temme Physician 116816 0 10000 0 0 0 0 0 34062 0 160878 0 0 0 Josee Bourbeau MD Physician 84524 0 69942 0 692 0 0 0 34532 0 189690 0 0 0 Part I, Line 7 Physicians are provided incentive payments based on number of patients seen, complexity of patient acuity, timely documentation, patient satisfication, and quality of care provided. Form 990, Part VI, Section B, line 11b The 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 12c Annually, the board re-affirms their compliance with the conflict of interest policy with a written compliance document. Form 990, Part VI, Section B, line 15 HR currently participates in a salary survey with a national health center organization and utilizes the results to assist with setting market rates of pay for the CEO, COO, and CFO. The CEO sets the COO and CFO salaries based upon these results. The board of directors approves and sets the salary of the CEO. Form 990, Part VI, Section C, line 19 Documents are posted to the Organization's website and are available upon request.