2016-08-11T16:14:08-05:00 2015-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2015-01-01 020325847 Salemhaven Inc SALE 6038935586 23 Geremonty Drive Salem NH 03079 Owen Williams President 6038935586 2016-08-04 1 Barbara J McGuan CPA P00219457 2077752387 2016-08-04 2015 2016-12-15 16:53:06Z Owen Williams 23 Geremonty Drive Salem NH 03079 14945757 0 X salemhaven.com X 1977 NH Healthcare services for the elderly 15 15 245 15 0 0 13170 10686 11322961 11977869 -12571 121417 0 0 11323560 12109972 0 0 0 0 6774078 7138806 0 0 0 4333437 4893441 11107515 12032247 216045 77725 12246052 12006051 4953571 4800362 7292481 7205689 X In February, 1972, a group of Salem, NH residents founded the organization with the goal of developing a facility to provide health care and related services for the community's elderly population. 0 0 9816020 11977869 The Salemhaven complex provides comprehensive healthcare services, resources and accomodations (110 bed facility) for senior citizens, including the operation of a medical day care service. Salemhaven services include providing long term care, rehabilitation including PT, OT Speech, social services for residents and families, meeting of Spiritual needs, activities, supporting many local charities and community services, hospice services and respite care. We employ over 150 workers from the local area, we subsidized Medicaid over 1 million dollars annually, and we are a participant in the local and state emergency planning programs.Silverthorne Adult Medical Day Center provides to participants: Health care monitoring, Social services, Therapeutic and recreational activities, Health Care Education to participants, families and the community. We also provide respite care for caregivers and a Caregiver Support Group monthly for families and community members. 9816020 1 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 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 64 0 1 245 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 NH X Paul Ercolini Covenant Health Systems 9786546363 100 Ames Pond Drive Suite 102 Tewksbury MA 01876 Rev David Yasenka Board Member 1.00 X 0 0 0 Thomas Lynch Board Member 1.00 X 0 0 0 Michael Collins Board Treasurer 1.00 X X 0 0 0 Owen Williams Board President 1.00 X X 0 0 0 Beverly Collins Board Member 1.00 X 0 0 0 Frank Monteiro Board Member 1.00 X 0 0 0 Jeffrey Scionti Board Member 1.00 X 0 0 0 Robert Slein Board Member 1.00 X 0 0 0 Sonny Tylus Board Vice President 1.00 X X 0 0 0 Amy White Board Member 1.00 X 0 0 0 Jamie Santo Board Member 1.00 X 0 0 0 Nadine Catalfimo Esq Board Member 1.00 X 0 0 0 Michael Carney Jr Board Member 1.00 X 0 0 0 Dwight Feeney Board Member 1.00 X 0 0 0 Ralph Glynn Board Member 1.00 X 0 0 0 Raymond Milliard Administrator 40.00 X 122196 0 33068 122196 0 33068 1 0 1 1 Rehabcare Group Inc PO Box 277365 Atlanta GA 30384 Rehab Services 851131 Covenant Health Inc 100 Ames Pond Rd Suite 102 Tewksbury MA 01876 Management Services 442784 Bonnette Page & Stone Corp 91 Bisson Ave Laconia NH 03246 Construction 117215 Lintech 201 West Passaic St Rochelle Park NJ 07662 Software Services 102475 4 10686 10686 Net Long-Term Care Services 623000 11806034 11806034 Adult Daycare Services 623000 161914 161914 Miscellaneous Income 623000 7885 7885 Guest Meals 623000 2036 2036 11977869 54254 54254 2902948 2835454 331 67494 -331 67163 67163 12109972 11977869 0 121417 155264 155264 5757498 5323716 433782 34065 31498 2567 788966 729523 59443 403013 372649 30364 46992 46992 1685 1685 117254 155 117099 83635 78283 5352 27998 75 27923 189250 135756 53494 51242 51242 353924 327917 26007 11192 7040 4152 177944 177944 507391 507391 424457 302826 121631 Food/Drug/Med. Supplies 957329 957329 Purchased Services 882547 861413 21134 New Hampshire Quality A 640851 640851 Bad Debt Expense 393018 393018 26732 2505 24227 12032247 9816020 2216227 0 31725 31725 3055791 2932658 892584 1027990 43920 45915 191207 273941 10836176 5550239 5594079 5285937 2150287 2162863 286459 245022 12246052 12006051 1049819 844920 25316 35873 3878436 3919569 4953571 4800362 X 7292481 7205689 7292481 7205689 12246052 12006051 77725 -164517 0 X 0 1 X 1 0 X 25060 12144 19029 13170 10686 80089 10194253 9922022 10521957 11322961 11977869 53939062 10219313 9934166 10540986 11336131 11988555 54019151 100 100 11469 11469 100 11469 11569 54007582 89382 60384 51075 56238 54254 311333 89382 60384 51075 56238 54254 311333 10308695 9994550 10592061 11392369 12042809 54330484 0.99410 0.99350 0.00570 0.00650 X 0 0 0 0 0 0 0 0 1 1333 1333 0 Form 990, Schedule C, Part II-B, Line 1i Lobbying portion of NHHCA Dues 13%; Lobbying portion of American Health Care Association Dues 25% 0 1 X 41189 41189 9195405 4586461 4608944 1336268 859723 476545 263314 104055 159259 5285937 11945455 -164517 -164517 12109972 0 12109972 12032247 0 12032247 0 12032247 Part IV, Line 2b: The Organization holds funds for residents and provides these funds to the resident, as needed, for various common expenses. X X X 0 0 0 0 0 0 0 0 0 Raymond Milliard Administrator 117489 0 4164 0 543 0 3819 0 29249 0 155264 0 0 0 Form 990, Page 10, line 5 Raymond Milliard is the Administrator of Salemhaven, Inc. and is compensated by Covenant Health Systems. Salemhaven reimburses Covenant Health Systems for Raymond's compensation package totaling $155,264. Form 990, Part VI, Section A, line 3 Raymond Milliard is the Administrator of Salemhaven, Inc. He is compensated through Covenant Health Systems, who provides management services to Salemhaven and is not a related organization. Form 990, Part VI, Section B, line 11 The Board of Directors reviews a copy of the 990 before it is filed with the IRS. Form 990, Part VI, Section B, line 12c Annually or Monthly as required Form 990, Part VI, Section B, line 15a Ray Milliard, Administrator, works for Covenant Health Systems, an independent contractor. They pull demographic reports and surveys for the Board to review and decide on compensation. 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: Salemhaven, Inc. 23 Geremonty, Salem, NH 03079 EIN 02-0325847 Salemhaven, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).