2015-05-14T14:42:06-05:00 2014-06-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2013-07-01 020512229 MARY AND JOHN ELLIOT CHARITABLE FOUNDATION MARY 6036638977 1070 HOLT AVENUE UNIT 1 SUITE 2100 MANCHESTER NH 03109 RICHARD ELWELL CFO 6036638977 2015-05-13 1 WILLIAM G STEELE JR P00233103 8002447444 2015-05-13 2013 2016-02-25 16:41:14Z RICHARD ELWELL 1070 HOLT AVENUE UNIT 1 SUITE 2100 MANCHESTER NH 03109 3946464 0 X N/A X 2001 NH THE FOUNDATION'S MISSION IS TO SUPPORT THE IMMEDIATE AND ONGOING RESOURCE NEEDS OF THE ELLIOT HEALTH SYSTEM. 12 11 0 0 0 0 1728985 2904287 0 0 328424 393394 587978 575967 2645387 3873648 1241795 2612023 0 0 0 0 0 0 0 424501 376046 1666296 2988069 979091 885579 7552850 9109282 576011 520927 6976839 8588355 THE FOUNDATION'S MISSION IS TO SUPPORT THE IMMEDIATE AND ONGOING RESOURCE NEEDS OF THE ELLIOT HEALTH SYSTEM. 0 0 2988069 2612023 394625 SUPPORT OF THE FUNDRAISING ACTIVITIES OF THE ELLIOT HOSPITAL AND ITS RELATED TAX EXEMPT ORGANIZATIONS 2988069 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 8 0 1 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X MARC CULLEROT 6036635809 1070 HOLT AVENUE UNIT 1 SUITE 2100 MANCHESTER NH 03101 JAMES J TENN ESQUIRE SECRETARY 1.00 0.00 X X 0 0 0 ANN G REMUS VICE CHAIR 1.00 2.00 X X 0 0 0 DOUGLAS F DEAN CHIEF EXECUTIVE OFFICER 1.00 43.00 X X 0 1123034 49296 RICHARD I WINNEG TRUSTEE 1.00 2.00 X 0 0 0 SID BAINES TRUSTEE 1.00 0.00 X 0 0 0 RENEE WALSH TRUSTEE 1.00 0.00 X 0 0 0 DAVID BELLMAN TRUSTEE 1.00 0.00 X 0 0 0 CATHY CHAMPAGNE TRUSTEE 1.00 0.00 X 0 0 0 CHARLES GOODWIN TRUSTEE 1.00 0.00 X 0 0 0 CHARLES F ROLECEK TRUSTEE 1.00 2.00 X 0 0 0 RICHARD RAWLINGS TRUSTEE 1.00 0.00 X 0 0 0 SELMA NACCACH-HOFF CHAIR 1.00 2.00 X X 0 0 0 RICHARD A ELWELL CFO 1.00 43.00 X 0 487314 228846 RICHARD PHELPS OFFICER 1.00 43.00 X 0 606201 102457 0 2216549 380599 0 0 1 0 0 2904287 2904287 153440 153440 239954 0 239954 239954 239954 254158 72816 181342 181342 MANAGEMENT FEE INCOME 561000 394625 394625 394625 3873648 394625 0 574736 2612023 2612023 1238 1238 9385 9385 2077 2077 540 540 PURCHASED SERVICES 234160 234160 TRUST FUND FEES 52460 52460 CONSULTING FEES 46977 46977 PRINTING/PUBLICATIONS 9351 9351 19858 19858 2988069 2988069 0 0 859156 1081627 85402 37143 10496 8926 1636 1570 6577807 7964482 28849 24460 7552850 9109282 9811 35927 6200 5000 560000 480000 576011 520927 X 5347311 6509813 1629528 2078542 6976839 8588355 7552850 9109282 X 885579 769225 -43288 X 0 1 X 1 0 X 1184977 918380 1844041 2227206 3158445 9333049 1184977 918380 1844041 2227206 3158445 9333049 9333049 188299 135741 139957 148561 153440 765998 10099047 1728838 0.92420 0.89800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1629528 349989 99025 2078542 1067605 558367 3556 1629528 775945 282540 9120 1067605 2337619 190477 18083 1770234 775945 1582058 670870 84691 2337619 1.00000 0 0 10496 8926 1570 1570 SECURITIES AND OTHER INVESTMENTS 7964482 F 7964482 X 2139867 769225 769225 1370642 2503006 2503006 3873648 485063 0 485063 2503006 2503006 2988069 PART V, LINE 4: TO FURTHER THE MISSIONS OF THE ELLIOT HEALTH SYSTEM'S NOT-FOR-PROFIT ENTITIES. PART X, LINE 2: PART X, INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS WAS THE FOLLOWING, "MANAGEMENT HAS EVALUATED THE SYSTEM'S TAX POSITIONS AND CONCLUDED THE SYSTEM HAS MAINTAINED ITS TAX-EXEMPT STATUS, DOES NOT HAVE ANY SIGNIFICANT UNRELATED BUSINESS INCOME AND HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS." PART XI, LINE 4B - OTHER ADJUSTMENTS: EXPENSE RECLASS 2,503,006. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSE RECLASS 2,503,006. ELLIOT GOLF CLASSIC 108370 108370 3963 9693 1119 ELLIOT HOSPTL GALA 145788 145788 30118 27923 254158 254158 3963 39811 29042 72816 181342 1 THE CAREGIVERS INC 020395429 501(C)(3) 10000 TO SUPPORT A MARKETING INITIATIVE TO RECRUIT NEW VOLUNTEERS EASTER SEALS OF NEW HAMPSHIRE 020272825 501(C)(3) 15000 TO PROVIDE RESOURCE SHARING, EDUCATION AND SUPPORT FOR CAREGIVERS OF FRAIL SENIOR CITIZENS ELLIOT HOSPITAL 020232673 501(C)(3) 1495386 TO SUPPORT THE CAPITAL AND PROGRAM NEEDS OF THE HOSPITAL NEW HAMPSHIRE ASSOCIATION FOR THE BLIND 020223606 501(C)(3) 15000 TO PROVIDE COMPREHENSIVE VISION REHAB SERVICES FOR BLIND AND VISUALLY IMPAIRED ELDERLY MEN ST JOSEPH COMMUNITY SERVICES 020335003 501(C)(3) 10000 TO ASSIST IN THE PROVISION OF NO FEWER THAN 7,500 MEALS TO OLDER ADULTS CHILD & FAMILY SERVICES 020222164 501(C)(3) 15000 TO PROVIDE CARE MGMT AND IN-HOME SUPPORT & SERVICES FOR IMPOVERISHED, FRAIL SENIORS ELLIOT PHYSICIAN NETWORK 020509589 501(C)(3) 5000 TO SUPPORT THE CAPITAL AND PROGRAM NEEDS OF THE ORGANIZATION ELLIOT PROFESSIONAL SERVICES NETWORK 331003630 501(C)(3) 26709 TO SUPPORT THE CAPITAL AND PROGRAM NEEDS OF THE ORGANIZATION VNA OF MANCHESTER & SOUTHERN NH 020395296 501(C)(3) 401200 TO SUPPORT THE CAPITAL AND PROGRAM NEEDS OF THE ORGANIZATION VNA HOME HEALTH & HOSPICE SERVICES INC 020222241 501(C)(3) 499054 TO SUPPORT THE CAPITAL AND PROGRAM NEEDS OF THE ORGANIZATION 6 PART I, LINE 2: THE PEARL MANOR ADVISORY COMMITTEE MEETS TO REVIEW REQUESTS FOR GRANTS, MEET LEADERS OF ORGANIZATIONS REQUESTING GRANT FUNDING, AND REQUIRES UPDATES ON THE USE OF FUNDS IN MANY INSTANCES, BOTH WRITTEN AND PRESENTATION. ALSO, MEMBERS OF THE FOUNDATION'S BOARD OF DIRECTORS ARE IN COMMUNICATION WITH THE BOARDS AND MANAGEMENT OF RECIPIENT ORGANIZATIONS DURING THE YEAR. 0 1 0 0 0 0 0 1 0 DOUGLAS F DEAN CHIEF EXECUTIVE OFFICER 0 581126 0 184359 0 357549 0 38245 0 11051 0 1172330 0 306534 RICHARD A ELWELL CFO 0 349013 0 89820 0 48481 0 217795 0 11051 0 716160 0 0 RICHARD PHELPS OFFICER 0 453482 0 112219 0 40500 0 87122 0 15335 0 708658 0 0 PART I, LINE 4B RICK PHELPS - $79,472; RICHARD ELWELL - $175,913 PART I, LINE 7 THE ORGANIZATION HAS ADOPTED AN INCENTIVE PAY PROGRAM THAT PROVIDES DESIGNATED MANAGEMENT EMPLOYEES AN OPPORTUNITY TO EARN A DESIGNATED PERCENTAGE OF SALARY BASED ON THE ACHIEVEMENT BY THE ORGANIZATION OF A NUMBER OF CRITICAL SUCCESS FACTORS. THE CRITICAL SUCCESS FACTORS ARE ESTABLISHED ANNUALLY BY THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES WITH ASSISTANCE FROM AN INDEPENDENT NATIONAL COMPENSATION CONSULTING COMPANY. THE MAXIMUM POTENTIAL INCENTIVE PAYMENTS UNDER THE PLAN ARE CONSIDERED BY THE COMPENSATION CONSULTANT IN ENSURING THAT MANAGEMENT COMPENSATION IS REASONABLE. PART II THE SALARIES OF DOUGLAS DEAN, RICK PHELPS, AND RICHARD ELWELL REPRESENT SERVICES PROVIDED TO ALL RELATED ENTITIES. PART II LINE 1 DURING THE YEAR MR DEAN WITHDREW FUNDS FROM HIS DEFERRED COMPENSATION PLAN ($306,534) AS SUCH THIS AMOUNT IS REPORTED IN COLUMN B(III) AND IN PRIOR YEARS CONTRIBUTIONS TO HIS DEFERRED COMPENSATION PLAN WHICH SUPPORT THE CURRENT DISTRIBUTION WERE REPORTED IN COLUMN C. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED 990 IS PRESENTED TO THE BOARD PRIOR TO FILING. SPECIFIC KEY SECTIONS OF THE 990 ARE SINGLED OUT FOR ADDITIONAL DISCUSSION AND INPUT FROM BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED ANNUALLY TO SIGN A CONFLICT OF INTEREST FORM WHICH REQUIRES REPORTING ANY POTENTIAL CONFLICT OF INTEREST ARRANGEMENTS WITH THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD UTILIZES OUTSIDE COMPENSATION CONSULTANTS TO EVALUATE THE SALARIES FOR THE CEO, CFO, AND COO. THE CONSULTANTS UTILIZE THEIR INTERNAL DATA ALONG WITH NATIONAL AND LOCAL BENCHMARK DATA FROM THE INDUSTRY TO DEVELOP SALARY LEVELS. RECOMMENDATIONS OF THE CONSULTANT ARE REVIEWED BY THE COMPENSATION COMMITTEE, WHO RECOMMENDS COMPENSATION LEVELS TO THE FULL BOARD FOR APPROVAL. AN OUTSIDE CONSULTING FIRM IS ALSO USED BY THE ORGANIZATION TO REVIEW THE COMPENSATION OF THE REMAINDER OF THE VP'S. AGAIN NATIONAL AND LOCAL BENCHMARKS FOR SALARIES ARE CONSULTED TO DETERMINE SALARY LEVELS FOR THESE VP'S. FORM 990, PART VI, SECTION C, LINE 19 EACH OF THESE DOCUMENTS IS FILED WITH THE NEW HAMPSHIRE SECRETARY OF STATE AND IS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFERS TO AFFILIATES -43,288. ELLIOT HEALTH SYSTEM PROFESSIONAL & GENERAL LIABILITY INSURANCE TRUST 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 016217452 INSURANCE TRUST NH 501(C)3 LINE 11, TYPE II ELLIOT HOSPITAL 0 ELLIOT HOSPITAL 1 ELLIOT WAY MANCHESTER NH 03103 020232673 PHYSICIAN SERVICES NH 501(C)3 LINE 3 ELLIOT HEALTH SYSTEM 0 ELLIOT PHYSICIAN NETWORK 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 020509589 PHYSICIAN SERVICES NH 501(C)3 LINE 3 ELLIOT HOSPITAL 0 ELLIOT HEALTH SYSTEM 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 020509911 MANAGEMENT NH 501(C)3 LINE 11, TYPE II 0 VNA OF MANCHESTER & SOUTHERN NH & SUBS 33 SOUTH COMMERCIAL STREET SUITE 40 MANCHESTER NH 03101 020395296 VNA HOLDING COMPANY NH 501(C)3 LINE 7 ELLIOT HEALTH SYSTEM 0 ELLIOT PROFESSIONAL SERVICES NETWORK 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 331003630 PHYSICIAN SERVICES NH 501(C)3 LINE 7 ELLIOT HOSPITAL 0 VNA HOME HEALTH & HOSPICE SERVICES INC 33 SOUTH COMMERCIAL STREET SUITE 40 MANCHESTER NH 03101 020222241 HOME CARE & HOSPICE SERVICES NH 501(C)3 LINE 11, TYPE II ELLIOT HEALTH SYSTEM 0 VNA COMMUNITY SERVICES INC 33 SOUTH COMMERCIAL STREET SUITE 40 MANCHESTER NH 03101 020396549 NURSING SERVICES NH 501(C)3 LINE 11, TYPE II ELLIOT HEALTH SYSTEM 0 VNA PERSONAL SERVICES INC 33 SOUTH COMMERCIAL STREET SUITE 40 MANCHESTER NH 03101 020395295 PRIVATE HEALTH & HOMEMAKER SERVICES NH 501(C)3 LINE 11, TYPE II ELLIOT HEALTH SYSTEM 0 ELLIOT COMMON TRUST FUND LLC 1 ELLIOT WAY MANCHESTER NH 03103 203653624 INVESTMENTS NH N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0