2015-04-08T10:27:54-05:00 2014-06-30 221478099 COHNREZNICK LLP 350 CHURCH STREET 12TH FLOOR HARTFORD CT 06103 990 2013-07-01 042610447 NORTH SHORE COMMUNITY HEALTH INC NORT 9788251152 27 CONGRESS ST NO 504 SALEM MA 01970 MARGARET BRENNAN CHIEF EXECUTIVE OFFICER 9788251152 2015-03-31 1 PAUL BALLASY P00852868 9592007000 2013 2016-02-25 16:41:14Z MARGARET BRENNAN 27 CONGRESS ST NO 504 SALEM MA 01970 11671183 0 X WWW.NSCHI.ORG X 1977 MA THE HEALTH CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE PRIMARY CARE THAT IS ACCESSIBLE, CULTURALLY AND LINGUISTICALLY COMPETENT, AND COMMUNITY DIRECTED FOR ALL RESIDENTS OF MASSACHUSETTS' NORTH SHORE AND CAPE ANN COMMUNITIES REGARDLESS OF ABILITY TO PAY. 11 11 130 0 0 0 3384843 3824937 6671705 7172324 5223 -1847 290840 338482 10352611 11333896 0 0 0 0 7572329 8143484 0 0 0 4068578 3833549 11640907 11977033 -1288296 -643137 6315762 6250266 2073212 2652805 4242550 3597461 THE HEALTH CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE PRIMARY CARE THAT IS ACCESSIBLE, CULTURALLY AND LINGUISTICALLY COMPETENT, AND COMMUNITY DIRECTED FOR ALL RESIDENTS OF MASSACHUSETTS' NORTH SHORE AND CAPE ANN COMMUNITIES REGARDLESS OF ABILITY TO PAY. 0 0 8601083 5183499 MEDICAL SERVICES - MEDICAL SERVICES PROVIDED TO THE RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. SERVICES INCLUDE MEDICAL SERVICES TO ADULTS AND CHILDREN, HIV COUNSELING AND OTHER. THERE WERE 38,585 MEDICAL VISITS DURING THE TAX YEAR. 1267061 2253352 DENTAL SERVICES - DENTAL SERVICES PROVIDED TO THE RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. THERE WERE 16,057 DENTAL VISITS DURING THE TAX YEAR. 130450 73955 SCHOOL BASED HEALTH CENTER - HEALTH SERVICES PROVIDED TO STUDENTS AT SALEM HIGH SCHOOL. THERE WERE 456 SCHOOL BASED HEALTH CENTER VISITS DURING THE TAX YEAR. 9998594 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 5 0 1 130 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X THOMAS DOWLEY 9788251152 27 CONGRESS ST NO 504 SALEM MA 01970 MARION WINFREY PRESIDENT 2.00 X X 0 0 0 JACK VONDRAS VICE PRESIDENT 2.00 X X 0 0 0 PAMELA PAINE SECRETARY 2.00 X X 0 0 0 LUCY CORCHADO BOARD MEMBER 2.00 X 0 0 0 GABRIELLE ROSS BOARD MEMBER 2.00 X 0 0 0 MATTHEW VENO BOARD MEMBER 2.00 X 0 0 0 EDWARD BAILEY BOARD MEMBER 2.00 X 0 0 0 CHARLOTTE OHANNESSIAN BOARD MEMBER 2.00 X 0 0 0 BEVERLY WHITE OUTGOING VICE PRESIDENT 2.00 X X 0 0 0 GEORGE KAPLAN OUTGOING TREASURER 2.00 X X 0 0 0 CALVIN YOUNG OUTGOING TRUSTEE 2.00 X 0 0 0 JACKIE DEBERNARDI OUTGOING TRUSTEE 2.00 X 0 0 0 ELLEN LIN TREASURER 2.00 X 0 0 0 VENTURA LOREDO BOARD MEMBER 2.00 X 0 0 0 STEPHEN MEUNIER BOARD MEMBER 2.00 X 0 0 0 GINA FLYNN BOARD MEMBER 2.00 X X 0 0 0 MARGARET BRENNAN CEO 40.00 X 180869 0 23091 THOMAS DOWLEY CFO 40.00 X 123090 0 7943 KIAME MAHANIAH CMO 40.00 X 217497 0 19954 AZRA ALI FAMILY PRACTICE MD 40.00 X 169259 0 0 JAY PANDEY FAMILY PRACTICE MD 40.00 X 165908 0 18512 MARIE CONSTANT FAMILY PRACTICE MD 40.00 X 164758 0 6967 RACHAEL CONSOLI OBGYN PRACTICE MD 40.00 X 216335 0 6967 1237716 0 83434 10 0 1 0 NORTH SHORE PHYSICIANS GROUP TWO CORPORATE WAY SUITE 180 PEABODY MA 01960 OB/GYN PROVIDER SERVICES 314652 ACCOUNTING MANAGEMENT SOLUTIONS 800 SOUTH STREET SUITE 195 WALTHAM MA 02453 ACCOUNTING CONSULTING SERVICES 126775 2 2511090 1313847 3824937 NET PATIENT SERVICE 621110 6104287 6104287 NET PHARMACY 621110 1068037 1068037 7172324 7414 7414 328026 337287 -9261 -9261 -9261 MISCELLANEOUS 621110 236482 236482 EMR INCENTIVE 621110 102000 102000 338482 11333896 7510806 0 -1847 327418 292325 35093 6445696 5777091 668605 916805 764640 152165 453565 406676 46889 43908 43908 42742 42742 3807 3807 542528 256318 286210 22210 4422 17788 211378 193797 17581 281160 33230 247930 456581 398901 57680 36748 12841 23907 31802 16595 15207 304544 282644 21900 52324 45021 7303 MEDICAL SUPPLIES 708135 695930 12205 DISPENSING FEES 440907 440907 MISCELLANEOUS 313396 97431 215965 PROVISION FOR UNCOLLECT 186817 186817 154562 93008 61554 11977033 9998594 1978439 0 454276 530982 2483 574239 992347 979905 1422905 1118696 27225 107185 194106 5464920 2639807 3007168 2825113 329398 6315762 6250266 1111108 1711911 962104 940894 2073212 2652805 X 2224684 1457606 2017866 2139855 4242550 3597461 6315762 6250266 -643137 -1952 0 X X 0 1 X 1 1 1 X 2707564 2199539 4048532 3384843 3824937 16165415 2707564 2199539 4048532 3384843 3824937 16165415 16165415 12855 10234 8862 5223 7414 44588 130174 66540 546091 290840 338482 1372127 17582130 31418540 0.91940 0.96670 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2009 AMOUNT: $ 130,174. 2010 AMOUNT: $ 66,540. 2011 AMOUNT: $ 546,091. 2012 AMOUNT: $ 290,840. 2013 AMOUNT: $ 338,482. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1415592 269803 1145789 2567291 1413640 1153651 1340598 956364 384234 141439 141439 2825113 X 11182027 -1952 36900 -186817 -151869 11333896 0 11333896 11827116 36900 36900 11790216 186817 186817 11977033 PART X, LINE 2: THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2014 AND 2013. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2011 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CENTER HAS UNRELATED BUSINESS INCOME TAXES, IT WILL RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENTS OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS -186,817. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 186,817. X X X X 0 0 0 0 0 0 0 1 0 MARGARET BRENNAN CEO 180794 0 75 0 0 0 0 0 23091 0 203960 0 0 0 KIAME MAHANIAH CMO 217422 0 75 0 0 0 0 0 19954 0 237451 0 0 0 AZRA ALI FAMILY PRACTICE MD 169184 0 75 0 0 0 0 0 0 0 169259 0 0 0 JAY PANDEY FAMILY PRACTICE MD 165833 0 75 0 0 0 0 0 18512 0 184420 0 0 0 MARIE CONSTANT FAMILY PRACTICE MD 164683 0 75 0 0 0 0 0 6967 0 171725 0 0 0 RACHAEL CONSOLI OBGYN PRACTICE MD 216260 0 75 0 0 0 0 0 6967 0 223302 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 INITIAL COMPLETION IS DONE BY OUR AUDITORS. THE FORM 990 IS THEN SENT TO THE NORTH SHORE COMMUNITY HEALTH MANAGEMENT TEAM AND THEN FORWARDED TO THE MEMBERS OF THE BOARD OF DIRECTORS, WHO ARE GIVEN A WEEK TO SUBMIT ANY QUESTIONS, COMMENTS, OR OBSERVATIONS THAT THEY HAVE. THEN MANAGEMENT DISCUSSES ANY CHANGES THEY ARE GOING TO MAKE TO THE 990 FORM. IF CHANGES ARE DEEMED NECESSARY, THEY ARE MADE IMMEDIATELY. THE FORM 990 IS THEN APPROVED FOR SUBMISSION BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH EMPLOYEE, VOLUNTEER, AND BOARD MEMBER WILL ACKNOWLEDGE THAT THEY HAVE READ AND UNDERSTAND NORTH SHORE COMMUNITY HEALTH'S CONFLICT OF INTEREST POLICY UPON BEGINNING THEIR EMPLOYMENT OR TENURE WITH NORTH SHORE COMMUNITY HEALTH BY SIGNING AN ACKNOWLEDGEMENT FORM. THIS IS UPDATED ON A YEARLY BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE HEALTH CENTER'S OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE BOARD OF DIRECTORS UTILIZING A SALARY SURVEY. THE EXECUTIVE DIRECTOR AND FINANCE COMMITTEE SET THE OTHER EMPLOYEES' SALARIES BASED ON A SALARY SURVEY IN ACCORDANCE WITH THE HEALTH CENTER'S BUDGET PARAMETERS. FORM 990, PART VI, SECTION C, LINE 19 NORTH SHORE COMMUNITY HEALTH, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS AVAILABLE TO THE GENERAL PUBLIC THROUGH WWW.GUIDESTAR.ORG. FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES MADE TO THE ORGANIZATION'S OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.