2015-08-06T07:05:54-05:00 2014-12-31 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2014-01-01 208404257 DH FAMILY MEDICINE OF NASHUA DHFA 6038823000 172 KINSLEY ST NASHUA NH 03061 RICHARD BOEHLER PRESIDENT/CEO 6038823000 2015-07-30 E DREW CHENEY P00182972 8002447444 2015-07-30 2014 2016-04-25 22:37:26Z RICHARD BOEHLER 172 KINSLEY ST NASHUA NH 03061 2799828 0 X N/A X 2007 NH PROVIDE PHYSICIAN AND ALLIED HEALTHCARE SERVICES TO THE GREATER NASHUA COMMUNITY 5 1 0 0 0 0 0 0 5636081 2799828 0 0 0 0 5636081 2799828 0 0 0 0 0 0 0 0 0 6657057 3284592 6657057 3284592 -1020976 -484764 796549 0 545956 0 250593 0 X PROVIDE PHYSICIAN AND ALLIED HEALTHCARE SERVICES TO THE GREATER NASHUA COMMUNITY 0 1 3284592 2799828 PROVIDE HEALTHCARE TO PATIENTS IN THE NASHUA AREA, REGARDLESS OF THE ABILITY TO PAY. 3284592 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 1 0 1 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X X RICHARD PLAMONDON 6038823000 172 KINSLEY ST NASHUA NH 03061 RICHARD J PLAMONDON TREASURER 1.00 39.00 X X 0 318003 32550 RICHARD BOEHLER MD PRESIDENT 1.00 39.00 X X 0 457177 38456 STEWARD BLACKWOOD MD PHYSICIAN 1.00 39.00 X 0 329491 26400 SANDERS BERNSTEIN DIRECTOR 1.00 X 0 0 0 MELISSA SEARS SECRETARY 1.00 39.00 X X 0 194407 23291 0 1299078 120697 0 0 1 0 DARTMOUTH HITCHCOCK CLINIC ONE BEDFORD FARMS BEDFORD NH 03110 PROFESSIONAL 3284592 1 PATIENT SERVICE 621111 2799828 2799828 2799828 2799828 2799828 0 0 PROVIDER SERVICES AGREE 3284592 3284592 3284592 3284592 0 0 35880 0 313989 0 446680 0 796549 0 545956 0 545956 0 X 250593 0 250593 0 796549 0 X -484764 234171 X X 0 1 X 1 0 X 8578365 8348995 6007402 5636081 2799828 31370671 8578365 8348995 6007402 5636081 2799828 31370671 0 0 0 31370671 8578365 8348995 6007402 5636081 2799828 31370671 1.00000 1.00000 0.00000 X 0 X PART X, LINE 2: COVENANT AND ITS MEMBER ORGANIZATIONS ARE CONSIDERED NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, EXCEPT AS NOTED BELOW. TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. UNDER GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD, ASSETS AND LIABILITIES ARE ESTABLISHED FOR UNCERTAIN TAX POSITIONS TAKEN OR POSITIONS EXPECTED TO BE TAKEN IN INCOME TAX RETURNS WHEN SUCH POSITIONS ARE JUDGED TO NOT MEET THE "MORE-LIKELY-THAN-NOT" THRESHOLD, BASED UPON THE TECHNICAL MERITS OF THE POSITION. ESTIMATED INTEREST AND PENALTIES, IF APPLICABLE, RELATED TO UNCERTAIN TAX POSITIONS ARE INCLUDED AS A COMPONENT OF INCOME TAX EXPENSE. THE SYSTEM HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE SYSTEM HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT DECEMBER 31, 2014. UNDER INTERNAL REVENUE SERVICE REGULATIONS, THE SYSTEM'S TAX YEARS FROM 2011 THROUGH 2014 ARE OPEN AND SUBJECT TO EXAMINATION. 0 0 0 0 0 0 0 0 0 RICHARD J PLAMONDON TREASURER 0 292230 0 0 0 25773 0 7021 0 25529 0 350553 0 0 RICHARD BOEHLER MD PRESIDENT 0 409794 0 0 0 47383 0 6317 0 32139 0 495633 0 0 STEWARD BLACKWOOD MD PHYSICIAN 0 297597 0 0 0 31894 0 0 0 26400 0 355891 0 0 MELISSA SEARS SECRETARY 0 193850 0 0 0 557 0 0 0 23291 0 217698 0 0 PART I, LINE 3 EVERY 2-3 YEARS, THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH'S BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003 THE COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. OBJECTIVES OF THIS ANALYSIS ARE TO: ASSESS THE COMPOSITENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR MANAGEMENT TEAM, DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF ANY, ARE COMPETITIVE AND REASONABLE. CASH 2014-12-31 5156 FMV 020222215 ST JOSEPH HOSPITAL 172 KINSLEY STREET NASHUA NH 03061 501 (C) (3) ACCOUNTS RECEIVABLE NET 2014-12-31 43996 FMV 020222215 ST JOSEPH HOSPITAL 172 KINSLEY STREET NASHUA NH 03061 501 (C) (3) 0 0 0 0 FORM 990, PART III, LINE 3 AS OF JUNE 30, 2014 WE ARE NO LONGER OFFERING THESE SERVICES FORM 990, PART VI, SECTION A, LINE 3 DARTMOUTH HITCHCOCK NASHUA DIVISION PROVIDES MANAGEMENT SERVICES SUBJECT TO REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 ST. JOSEPH HOSPITAL IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 990'S ARE PREPARED BY THE FINANCE DEPARTMENT, THEN REVIEWED BY AN IDEPENDENT TAX ACCOUNTANT AS WELL AS THE ST. JOSEPH HOSPITAL FINANCE COMMITTEE AND BOARD. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR ST. JOSEPH HOSPITAL CONDUCTS A SURVEY OF THE BOARD MEMBERS AND KEY MANAGEMENT MEMBERS TO DETERMINE WHETHER THERE ARE CONFLICTS OF INTEREST (ACTUAL OR POTENTIAL), BOARD MEMBERS AND KEY EMPLOYEES HAVE A CONTINUING OBLIGATION TO REPORT ANY PROPOSED TRANSACTIONS WHICH MAY BE PERCEIVED AS A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 EVERY 2-3 YEARS, THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH'S BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003 THE COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. OBJECTIVES OF THIS ANALYSIS ARE TO: ASSESS THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR MANAGEMENT TEAM, DEVELOP MARKET BASED COMPETITIVE SALARY LEVELS FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF ANY, ARE COMPETITIVE AND REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST THE ORGANIZATION WILL MAKE AVAILABLE CORPORATE DOCUMENTS AND FINANCIAL STATEMENTS. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATE 234,171. FORM 990, PART XII, LINE 2C AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS. ST JOSEPH HOSPITAL 172 KINSLEY ST NASHUA NH 030612013 020222215 HEALTHCARE MANAGEMENT SERVICES NH 501(C)(3) 4 COVENANT HEALTH 0 COVENANT HEALTH 100 AMES POND ROAD TEWKSBURY MA 01876 222484505 HEALTHCARE SERVICES MA 501(C)(3) 9 0 SOUHEGAN NURSING ASSOCIATION 24 NORTH RIVER ROAD MILFORD NH 03055 020222795 HOME HEALTH AND HOSPICE SERVICES NH 501(C)(3) 9 ST JOSEPH HOSPITAL 0 THE SURGICENTER AT ST JOSEPH HOSPITAL INC 172 KINSLEY ST NASHUA NH 03061 020470528 OUTPATIENT SURGERY SERVICES NH 501(C)(3) 9 ST JOSEPH HOSPITAL 0 ST JOSEPH CORPORATE SERVICES 172 KINSLEY ST NASHUA NH 030612013 020405197 HOLDING COMPANY FOR FOR-PROFIT ENTITIES NH ST JOSEPH HOSPITAL C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0