2016-03-09T10:24:01-06:00 2015-09-30 010523282 Berry Dunn McNeil & Parker LLC 1000 Elm Street 15th Floor Manchester NH 03101 990 2014-10-01 237305106 Lamprey Health Care Inc LAMP 6036592494 207 South Main Street Newmarket NH 03857 Greg White Chief Executive Officer 6032927214 2016-03-02 1 Dimitrios Panacopoulos P01603705 6036697337 2016-03-02 2014 2016-08-17 19:52:53Z Gregory White 207 South Main Street Newmarket NH 03857 13341808 0 X www.lampreyhealth.org X 1971 NH The mission of Lamprey Health Care, Inc. is to provide high quality medical care and health related services to our communities regardless of the patients ability to pay. 10 10 187 10 0 0 4102931 4240528 8026337 9100224 650 1056 0 0 12129918 13341808 0 0 0 0 9259609 9417792 0 0 10543 2851386 3228458 12110995 12646250 18923 695558 13283870 14673768 5795461 6521107 7488409 8152661 The mission of Lamprey Health Care, Inc. is to provide high quality medical care and health related services to our communities regardless of the patients ability to pay. 0 0 10767460 9100224 To provide medical, dental, health, behavioral health, transportation and referral related services to all members of the community regardless of ability to pay. 10767460 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 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 1 1 1 0 0 1 55 0 1 187 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NH X Evalie M Crosby CPA FHFMA 6032927215 207 South Main Street Newmarket NH 03857 Audrey Ashton-Savage President 1.00 X X 0 0 0 Carol LaCross Treasurer 1.00 X X 0 0 0 Janis Reams Secretary 1.00 X X 0 0 0 Elizabeth Crepeau Board Member 1.00 X 0 0 0 Thomas Chris Drew Board Member 1.00 X 0 0 0 Raymond Goodman III Board Member 1.00 X 0 0 0 Frank Goodspeed Board Member 1.00 X 0 0 0 Mark E Howard Esq Board Member 1.00 X 0 0 0 Amanda Pears Kelly Board Member 1.00 X 0 0 0 Michael Merenda Board Member 1.00 X 0 0 0 Sandra Pardus CFO 35.00 1.00 X 119638 0 11287 Gregory White CEO 40.00 1.00 X 168919 0 5894 Sirona Pruna Physician 40.00 X 289609 0 17420 Paul Friedrichs Physician 35.00 X 175897 0 16984 Vasuki Nagaraj Physician 40.00 X 209024 0 11153 Ana Goubert Physician 35.00 X 169690 0 1532 Jeremy James Physician 25.00 X 161158 0 14343 1293935 0 78613 14 0 1 0 Community Health Access Network 207 S Main Street Newmarket NH 03857 Technology Services 288431 Partners for Womens Health 3 Alumni Drive Suite 302 Exeter NH 03833 Physician Services 136800 2 3122 3857406 380000 4240528 Health Care 621110 8006486 8006486 Other Operating Rev. 621110 1093738 1093738 9100224 1056 1056 13341808 9100224 0 1056 305738 305738 7646708 6764298 882410 830525 707969 122556 634821 541144 93677 14192 14192 46500 46500 541046 461207 79839 37598 32050 5548 103003 87803 15200 406005 346093 59912 676806 576933 99873 49340 42059 7281 102911 87725 15186 66465 56657 9808 271677 231587 40090 135628 115614 20014 Program Supplies 425039 425039 Other Expenses 120457 102682 17775 Printing & Publications 101006 86101 14905 Telephone 72734 62001 10733 58051 40498 7010 10543 12646250 10767460 1868247 10543 1230606 1897354 3314851 4148143 989558 1051734 94731 103264 9488605 3862892 5793927 5625713 1860197 1847560 13283870 14673768 1121703 1336397 3125597 3729307 1474911 1455403 73250 0 5795461 6521107 X 7099125 7785788 389284 366873 7488409 8152661 13283870 14673768 X 695558 -31306 X 0 1 X 1 1 1 X 8099328 4516339 4002901 4102931 4240528 24962027 7766542 7718361 8870431 8026337 9100224 41481895 15865870 12234700 12873332 12129268 13340752 66443922 0 0 0 66443922 3093 1593 1746 650 1056 8138 3093 1593 1746 650 1056 8138 15868963 12236293 12875078 12129918 13341808 66452060 0.99990 0.99970 0.00010 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 909237 909237 6686461 2411879 4274582 1892907 1451013 441894 5625713 Assets Limited as to Use 1847560 1847560 X 13352808 11000 11000 13341808 0 13341808 12646250 0 12646250 0 12646250 Part X, Line 2: Lamprey Health Care 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 organizations tax position and concluded that there is no unrelated business income or uncertain tax positions that require adjustment to the financial statements. Part XI, Line 2d - Other Adjustments: Uncollectible pledges 11,000. X X X X X X 0 0 0 0 0 0 0 1 0 Gregory White CEO 153919 0 15000 0 0 0 0 0 5894 0 174813 0 0 0 Sirona Pruna Physician 264555 0 25054 0 0 0 13000 0 4420 0 307029 0 0 0 Paul Friedrichs Physician 164793 0 11104 0 0 0 13000 0 3984 0 192881 0 0 0 Vasuki Nagaraj Physician 176138 0 32886 0 0 0 8828 0 2325 0 220177 0 0 0 Ana Goubert Physician 155158 0 14532 0 0 0 0 0 1532 0 171222 0 0 0 Jeremy James Physician 118087 0 43071 0 0 0 8684 0 5659 0 175501 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 satisfaction, quality of care provided, and call coverage responsibilities. Form 990, Part VI, Section B, line 11 The 990 will be reviewed by the CEO and CFO. The Finance Committee will review and approve the 990 on behalf of the full Board prior to filing. Form 990, Part VI, Section B, line 12c Annually, the board of directors sign a conflict of interest form, on which they disclose any conflicts of interest. Board members will abstain from any votes related to a conflict. Form 990, Part VI, Section B, line 15 The Board hires a firm to do a CEO analysis periodically. In between, the National Association of Community Health Centers (NACHC) Benefits and Compensation survey results are used. The NACHC study is also used for other key employees, as well as other local studies (including the Medical Group Management Association (MGMA) salary survey), as they are available. 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 XI, line 9: Change in fair value of financial instrument -31,306. Friends of Lamprey Health Care Inc 207 South Main Street Newmarket NH 03857 020348630 Support Lamprey Health Care, Inc. NH 501(c)(3) 509(a)(3) Type III Lamprey Health Care Inc 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 Friends of Lamprey Health Care Inc K 227916 FMV