2016-11-14T10:53:49-06:00 2015-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2015-01-01 462459559 Northern New Hampshire Healthcare Collaborative Inc NORT 6037522200 59 Page Hill Road Berlin NH 03570 Russell Keene Vice President & Treasurer 6037522200 2016-11-11 1 Joseph R Byrne CPA P01289281 2077752387 2016-11-11 2015 2017-02-10 21:41:12Z Northwoods Home Health & Hospice Russell Keene 59 Page Hill Road Berlin NH 03570 4046596 0 X www.nnhhc.com X 2013 NH To provide home health, hospice, and homemaking services to patients in Coos County, New Hampshire. 8 8 83 30 0 0 98697 164780 3803445 3848474 3533 2993 12569 19182 3918244 4035429 0 0 0 0 2990269 3111716 0 0 0 1130712 1194170 4120981 4305886 -202737 -270457 1381527 1058881 1432051 1373195 -50524 -314314 X 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. 0 0 2454096 2981510 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 31,296 visits during 2015. 662993 866964 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. 3117089 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 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 0 0 0 0 0 1 23 0 1 83 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Claudette Audette 6037522200 59 Page Hill Rd Berlin NH 03570 Scott Howe President/Chairman/Secretary 2.00 X X 0 0 0 Russell Keene Vice President & Treasurer 2.00 X X 0 0 0 David Atkinson Director 1.00 X 0 0 0 Patrick Kelley Director 1.00 X 0 0 0 Eric Stohl Director 1.00 X 0 0 0 Bruce Bean Director 1.00 X 0 0 0 Jim Tibbetts Director 1.00 X 0 0 0 Donald Noyes Director 1.00 X 0 0 0 Gail Tattan-Giampaolo Executive Director 40.00 X 101246 0 8937 Claudette Audette Finance Director 40.00 X 91581 0 22590 Heather Alnwick Physical Therapist 39.00 X 107096 0 21760 299923 0 53287 2 0 0 0 Weeks Medical Center 173 Middle Street Lancaster NH 03584 Professional Services 108056 1 8944 74125 81711 164780 Resident Service Reven 621400 4736689 4736689 Miscellaneous Revenue 900099 4377 4377 Contractual/Char. Adj. 621400 -892592 -892592 3848474 2993 2993 30349 8944 11167 19182 19182 4035429 3848474 0 22175 224354 60601 163753 2274423 1730390 544033 37670 29000 8670 393478 301021 92457 181791 131601 50190 28400 20559 7841 399905 289497 110408 10887 7881 3006 32125 23256 8869 85523 61911 23612 116856 84594 32262 197516 142984 54532 10084 7300 2784 19818 19818 44448 32177 12271 Medical Supplies 186954 135339 51615 Dues and Subscriptions 24702 17882 6820 Miscellaneous Expenses 22775 11015 11760 Bad Debt Expense 14177 10263 3914 4305886 3117089 1188797 0 X 150 216 384110 92803 743845 639292 24551 40940 59457 29728 49547 29729 179324 255901 1381527 1058881 120189 205181 141444 163228 1170418 1004786 1432051 1373195 X -229848 -570215 78224 104801 101100 151100 -50524 -314314 1381527 1058881 -270457 6667 0 X 0 1 X 1 0 X 98697 164780 263477 3816014 3867656 7683670 3914711 4032436 7947147 0 0 0 7947147 19 3533 2993 6545 19 3533 2993 6545 19 3918244 4035429 7953692 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1747 1747 0 Part II-B, Line 1: The organization pays dues to associations of which a portion is attributable to lobbying activities. 120466 50000 8646 179112 107399 13067 120466 0.00000 0.84360 0.15640 1 0 59457 29728 29729 29729 Assets Whose Use is Limited 255901 255901 Due to AVH 175000 Due to UCVH 171259 Due to Weeks Medical Center 658527 1004786 4042096 6667 6667 4035429 0 4035429 4305886 0 4305886 0 4305886 Hospice Ball 39293 8944 30349 8170 2000 997 39293 8944 30349 8170 2000 997 11167 19182 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 11 The Form 990 will be reviewed and approved by the Finance Director, the President, the Vice President/Treasurer, as well as the Board Chair prior to filing. The Form 990 will then be presented to the governing body at the next scheduled board meeting. 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 Executive Director and 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 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).