2014-07-18T12:02:32-05:00 2013-12-31 020383073 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2013-01-01 208404257 DH FAMILY MEDICINE OF NASHUA DHFA 6038823000 172 KINSLEY ST NASHUA NH 03061 RICHARD BOEHLER PRESIDENT/CEO 6038823000 2014-06-25 1 WILLIAM G STEELE JR CPA P00233103 6036228881 2013 2015-11-30 17:44:51Z RICHARD BOEHLER 172 KINSLEY ST NASHUA NH 03061 5636081 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 6007402 5636081 0 0 0 0 6007402 5636081 0 0 0 0 0 0 0 0 0 6744460 6657057 6744460 6657057 -737058 -1020976 690370 796549 525972 545956 164398 250593 PROVIDE PHYSICIAN AND ALLIED HEALTHCARE SERVICES TO THE GREATER NASHUA COMMUNITY 0 0 6657057 5636081 PROVIDE HEALTHCARE TO PATIENTS IN THE NASHUA AREA, REGARDLESS OF THE ABILITY TO PAY. 6657057 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 0 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 300186 31338 RICHARD BOEHLER MD PRESIDENT 1.00 39.00 X X 0 340027 25184 STEWART BLACKWOOD MD PHYSICIAN 1.00 39.00 X 0 336945 24593 SANDERS BERNSTEIN DIRECTOR 1.00 0.00 X 0 0 0 MELISSA SEARS SECRETARY 1.00 39.00 X X 0 187067 20565 0 1164225 101680 0 0 1 0 DARTMOUTH HITCHCOCK CLINIC ONE BEDFORD FARMS BEDFORD NH 03110 PROFESSIONAL 6657057 1 PATIENT SERVICE 621111 5636081 5636081 5636081 5636081 5636081 0 0 PROVIDER SERVICES AGREE 6657057 6657057 6657057 6657057 0 0 48284 35880 240156 313989 401930 446680 690370 796549 525972 545956 525972 545956 X 164398 250593 164398 250593 690370 796549 X -1020976 1107171 X X 0 1 X 1 0 X 8065523 8578365 8348995 6007402 5636081 36636366 8065523 8578365 8348995 6007402 5636081 36636366 0 0 0 36636366 8065523 8578365 8348995 6007402 5636081 36636366 1.00000 1.00000 0.00000 X 0 X PART X, LINE 2: INCLUDED IN THE AUDITED FINANCIAL STATEMENTS IS THE FOLLOWING "TAX EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS A RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNREALTED BUSINESS INCOME OR TAX STATUS. THE SYSTEM HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE SYSTEM HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AS OF DECEMBER 31, 2013. THE SYSTEM'S TAX YEARS FROM 2010 THROUGH 2013 ARE OPEN AND SUBJECT TO EXAMINATION." 0 0 0 0 0 0 0 0 0 RICHARD J PLAMONDON TREASURER 0 274562 0 0 0 25624 0 7650 0 23688 0 331524 0 0 RICHARD BOEHLER MD PRESIDENT 0 297952 0 0 0 42075 0 0 0 25184 0 365211 0 0 STEWART BLACKWOOD MD PHYSICIAN 0 305717 0 0 0 31228 0 0 0 24593 0 361538 0 0 MELISSA SEARS SECRETARY 0 186709 0 0 0 358 0 0 0 20565 0 207632 0 0 PART I, LINE 3 EVERY 2-3 YEARS, THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH SYSTEM'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. PART I, LINE 4 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 AN INDEPENDENT TAX ACCOUNTANT, THEN REVIEWED BY 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 SYSTEM'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 1,107,171. 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) 509(A)(1) COVENANT HEALTH SYSTEMS 0 COVENANT HEALTH SYSTEMS 100 AMES POND ROAD TEWKSBURY MA 01876 222484505 HEALTHCARE SERVICES MA 501(C)(3) 509(A)(2) 0 SOUHEGAN NURSING ASSOCIATION 24 NORTH RIVER ROAD MILFORD NH 03055 020222795 HOME HEALTH AND HOSPICE SERVICES NH 501(C)(3) 509(A)(2) 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) 509(A)(2) 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 ST JOSEPH HOSPITAL R 1107171 CASH