2017-02-03T08:50:45-06:00 2016-06-30 010523282 Berry Dunn McNeil & Parker LLC 1000 Elm Street 15th Floor Manchester NH 03101 990 2015-07-01 510137745 Ammonoosuc Community Health Services Inc AMMO 6034442464 25 Mt Eustis Road Littleton NH 03561 Edward Shanshala CEO 6034442464 2017-02-01 1 Dimitrios Panacopoulos CPA P01603705 6036697337 2017-02-01 2015 2021-01-29 14:40:06Z Edward Shanshala 25 Mt Eustis Road Littleton NH 03561 12221967 0 X N/A X 1975 NH It is the mission of Ammonoosuc Community Health Services to provide a stable network of comprehensive Primary Health Care Services to individuals and families throughout the communities we serve. In support of this mission, ACHS provides evidence based, outcome specific, systematic care that is patient centered, focused on prevention, and accessible and affordable to all. 12 12 134 12 0 0 2460713 2492877 7600777 9706444 271 3017 13510 14524 10075271 12216862 0 0 0 0 6376719 7475142 0 0 9267 3352541 4305511 9729260 11780653 346011 436209 6451057 6788237 2431507 2336464 4019550 4451773 X It is the mission of Ammonoosuc Community Health Services to provide a stable network of comprehensive Primary Health Care Services to individuals and families throughout the communities we serve. In support of this mission, ACHS provides evidence based, outcome specific, systematic care that is patient centered, focused on prevention, and accessible and affordable to all. 0 0 9752481 9706444 Primary Care - To provide medical and educational services to the local community.Family Planning - To provide counceling in family planning to the local community.Family Support - To provide counseling in family support to the local community.Oral Health Program - To provide dental and oral health services to the local community. 9752481 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 1 134 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 1 1 0 0 NH X Ken Riebel 6034442464 25 Mt Eustis Road Littleton NH 03561 Beth Harwood Vice President 1.00 X X 0 0 0 Al Smith Board Member 1.00 X 0 0 0 Lynn Davis Secretary 1.00 X X 0 0 0 Inga Johnson President 1.00 X X 0 0 0 Ned Densmore Board Member 1.00 X 0 0 0 Judy Day Board Member 1.00 X 0 0 0 Mark Secord Treasurer 1.00 X X 0 0 0 John Rapoport Board Member 1.00 X 0 0 0 Ronald Spaulding Board Member 1.00 X 0 0 0 Doug Harman Board Member 1.00 X 0 0 0 Blaine Hall Board Member 1.00 X 0 0 0 Betsy Harman Board Member 1.00 X 0 0 0 Edward Shanshala CEO 40.00 X 140356 0 11020 Kenneth Riebel CFO 40.00 X 114615 0 9545 Particia Pratt MD Physician 40.00 X 197710 0 12280 David Nelson DO Medical Director 32.00 X 146802 0 280 Imelyn Fernandez MD Physician 40.00 X 188165 0 11020 Damian Anthony-Canuto Pharmacist 40.00 X 144781 0 2096 Sarah Young-Xu Physician 40.00 X 141093 0 1646 1073522 0 47887 15 0 1 0 0 2397137 95740 2492877 Patient Revenue 621110 9706444 9706444 9706444 3017 3017 19629 5105 14524 14524 12216862 9706444 0 17541 275536 37844 237692 5896040 4875030 1021010 810748 646490 164258 492818 392973 99845 15399 15399 30000 30000 359236 250925 108311 33463 33463 77621 61895 15726 199783 199783 318973 254349 64624 19545 15585 3960 84941 84941 54171 43196 10975 250285 199577 50708 61949 49398 12551 Program Supplies 2467861 2467861 Other Expenses 127605 101754 25851 Printing & Publications 66351 52908 13443 Telephone 55484 44243 11241 82844 58670 14907 9267 11780653 9752481 2018905 9267 X 346441 660596 31901 39793 828736 896913 278389 236704 80484 131877 6802375 2103560 4731331 4698815 153775 123539 6451057 6788237 839667 831198 25000 15000 1566840 1490266 2431507 2336464 X 3957249 4389472 62301 62301 4019550 4451773 6451057 6788237 X 436209 -3986 X 0 1 X 1 1 1 X 1871460 1792569 1965585 2460713 2492877 10583204 4456042 5356854 6227742 7600777 9706444 33347859 6327502 7149423 8193327 10061490 12199321 43931063 0 0 0 43931063 634 540 91 271 3017 4553 634 540 91 271 3017 4553 6328136 7149963 8193418 10061761 12202338 43935616 0.99990 0.99990 0.00010 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5564215 1170902 4393313 1238160 932658 305502 4698815 X 12212876 -3986 -3986 12216862 0 12216862 11780653 0 11780653 0 11780653 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 in Perpetual Trusts -3,986. Amble 19629 19629 5105 19629 19629 5105 5105 14524 X X X 0 0 0 0 0 0 0 1 0 Edward Shanshala CEO 137091 0 2005 0 1260 0 0 0 11020 0 151376 0 0 0 Particia Pratt MD Physician 185719 0 11991 0 0 0 0 0 12280 0 209990 0 0 0 Imelyn Fernandez MD Physician 177271 0 4375 0 6519 0 0 0 11020 0 199185 0 0 0 Part I, Line 7 Physicians received bonus compensation calculated by quality measures, patient satisfaction, citizenship and work RVUs. Form 990, Part VI, Section B, line 11 A copy of the 990 was provided to and approved by the board of directors prior to filing. Form 990, Part VI, Section B, line 15a CEO compensation is reviewed and approved by the Executive Committee using comparability data. Form 990, Part VI, Section C, line 19 Ammonoosuc Community Health Services, Inc. makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Ammonoosuc Community Health Services, Inc. 25 Mt. Eustis Road Littleton, NH 03561 Ammonoosuc Community Health Services, 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 -3,986.