ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE (EIN 02-0274905)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-05-15
- IRS object ID
- 201431359349302403
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-15T08:38:08-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020383073 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILLIAM STEELE & ASSOCIATES PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 40 STARK STREET | AddressLine1 |
| City | MANCHESTER | City |
| State | NH | State |
| ZIP Code | 03101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020274905 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ROCK | NameControl |
| Phone | 6035806695 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 ALUMNI DRIVE | AddressLine1 |
| City | EXETER | City |
| State | NH | State |
| ZIP Code | 03833 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | OFFICER | Name |
| Title | TREASURER | Title |
| Phone | 6035806692 | Phone |
| Date Signed | 2014-05-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM G STEELE JR CPA | Name |
| PTIN | P00233103 | PTIN |
| Phone | 6036228881 | Phone |
| Date Prepared | 2014-05-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEVIN CALLAHAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 ALUMNI DRIVE | AddressLine1 |
| City | EXETER | City |
| State | NH | State |
| ZIP Code | 03833 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12990536 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF ROCKINGHAM VNA & HOSPICE , A HOME HEALTH AGENCY, IS TO ASSIST IN IMPROVING THE HEALTH OF THE COMMUNITY. THIS MISSION IS PRINCIPALLY ACCOMPLISHED THROUGH THE PROVISION OF HEALTH SERVICES AND INFORMATION TO THE COMMUNITY. ROCKINGHAM VNA AND HOSPICE WORKS TO ACCOMPLISH THIS MISSION BY PROMOTING WELL BEING AND INDEPENDENCE BY PROVIDING PATIENT-CENTERED HEALTH CARE SERVICES IN THE COMFORT OF THE HOME AND WITHIN THE COMMUNITIES SERVED. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 170 | TotalNbrEmployees |
| Total Nbr Volunteers | 45 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 49287 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 54479 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 12614400 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 12927688 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6309 | InvestmentIncomePriorYear |
| Investment Income Current Year | 8369 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12669996 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12990536 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9488089 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9821222 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3207959 | OtherExpensePriorYear |
| Other Expenses Current Year | 3269630 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12696048 | TotalExpensesPriorYear |
| Total Expenses Current Year | 13090852 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -26052 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -100316 | RevenuesLessExpensesCY |
| Total Assets BOY | 3422622 | TotalAssetsBOY |
| Total Assets EOY | 3422863 | TotalAssetsEOY |
| Total Liabilities BOY | 1847904 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1932490 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1574718 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1490373 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF ROCKINGHAM VNA & HOSPICE, A HOME HEALTH AGENCY, IS TO ASSIST IN IMPROVING THE HEALTH OF THE COMMUNITY. THIS MISSION IS PRINCIPALLY ACCOMPLISHED THROUGH THE PROVISION OF HEALTH SERVICES AND INFORMATION TO THE COMMUNITY. ROCKINGHAM VNA AND HOSPICE WORKS TO ACCOMPLISH THIS MISSION BY PROMOTING WELL BEING AND INDEPENDENCE BY PROVIDING PATIENT-CENTERED HEALTH CARE SERVICES IN THE COMFORT OF THE HOME AND WITHIN THE COMMUNITIES SERVED. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 12157568 | Expense |
| Revenue | 12927688 | Revenue |
| Description | ROCKINGHAM VNA & HOSPICE'S HOME CARE PROGRAM PROVIDES COMPREHENSIVE SKILLED SERVICES TO THE ADULT POPULATION. THE GOAL OF THESE SERVICES IS TO IMPROVE THE HEALTH AND INDEPENDENCE OF THE PATIENTS WE SERVE. OUR SERVICES INCLUDE SKILLED NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, SOCIAL WORK SERVICES, HOME HEALTH AIDE, DIETICIAN, IV SPECIALIST, WOUND SPECIALIST, CERTIFIED DIABETES EDUCATOR, TELEHEALTH SERVICES, AND AN ADVANCED ILLNESS PROGRAM. ROCKINGHAM VNA AND HOSPICE PROVIDED 61,097 VISITS TO 3,230 HOME CARE PATIENTS DURING FY 2013, AND ALSO INCURRED $164,719 IN COSTS TO PROVIDE CHARITY CARE TO PATIENTS THROUGHOUT THE COMMUNITIES SERVED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ROCKINGHAM VNA & HOSPICE'S HOSPICE PROGRAM PROVIDES A COMPREHENSIVE, MEDICALLY DIRECTED, TEAM ORIENTED PROGRAM OF CARE. THE ESSENTIAL COMPONENTS INCLUDE CARE OF THE PATIENT AND FAMILY AS ONE UNIT, PAIN AND SYMPTOM MANAGEMENT, 24 HOUR ON-CALL AVAILABILITY, MEDICAL AND NURSING CARE, HOME HEALTH AIDE, SOCIAL WORK SERVICES, BEREAVEMENT CARE, VOLUNTEERS, REHAB SERVICES, AND COORDINATION OF MEDICATIONS, MEDICAL SUPPLIES, AND DURABLE MEDICAL EQUIPMENT. ROCKINGHAM VNA AND HOSPICE PROVIDED 15,766 VISITS TO 387 PATIENTS WHO RECEIVED 20,370 DAYS OF PATIENT CARE DURING FY 2013. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ROCKINGHAM VNA & HOSPICE'S COMMUNITY OUTREACH PROGRAM IS DEDICATED TO ASSISTING IN IMPROVING THE HEALTH OF THE COMMUNITIES SERVED THROUGH OFFERING A VARIETY OF WELLNESS CLINICS AND EDUCATIONAL OPPORTUNITIES. COMMUNITY PROGRAMS INCLUDE COMMUNITY FOOT CLINICS, COMMUNITY BLOOD PRESSURE CLINICS, FLU VACCINATION CLINICS, DIABETES SUPPORT GROUPS, AND HEALTH EDUCATION PROGRAMS. IN FY 2013, RVNA&H SUPPORTED ITS MISSION BY SUPPORTING $556,734 IN COMMUNITY OUTREACH, BENEFITS AND FINANCIAL SUPPORT TO THE COMMUNITY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 12157568 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 18 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 170 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN J O'LEARY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6035806695 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 ALUMNI DRIVE | AddressLine1 |
| City | EXETER | City |
| State | NH | State |
| ZIP Code | 03833 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (7 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| KEVIN J O'LEARY | ||||||||
| TREASURER/TRUSTEE | 1.00 | 45.00 | X | X | 0 | 349585 | 100989 | |
| SUSAN BURNS-TISDALE | ||||||||
| TRUSTEE | 1.00 | 41.30 | X | 0 | 276872 | 42613 | ||
| KEVIN CALLAHAN | ||||||||
| CHAIRMAN/TRUSTEE | 1.00 | 45.00 | X | X | 0 | 603669 | 194576 | |
| MARY PALMER | ||||||||
| PRESIDENT/SECRETARY | 1.00 | 40.00 | X | X | 0 | 169320 | 20167 | |
| KAREN MICHEL | ||||||||
| EXEC DIR/TRUSTEE | 40.00 | 0.00 | X | X | 134718 | 0 | 28437 | |
| ELIZABETH SMITH MD | ||||||||
| TRUSTEE | 1.00 | 40.00 | X | 0 | 290501 | 38943 | ||
| CHRISTOPHER WHALEN | ||||||||
| FINANCE DIRECTOR | 40.00 | 0.00 | 104647 | 0 | 27693 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 239365 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1689947 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 453418 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EXETER HEALTH RESOURCES INC | |||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | ADMIN MANAGEMENT SERVICES | 335085 |
| EXETER HOSPITAL | |||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | SUPPORT SERVICES | 223646 |
| CREEKSIDE THERAPY LLC | |||||
| 212 OAK HILL ROAD | BARRINGTON | NH | 03825 | CONTRACTED THERAPISTS | 190311 |
| HBO & COMPANY | |||||
| PO BOX 98347 | CHICAGO | IL | 60693 | SERVICE CONTRACTS | 148192 |
| PALLIATIVE CARE SERVICE INC | |||||
| 99 HIGH STREET | SOMERSWORTH | NH | 03878 | PHYSICIAN SERVICES | 106136 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| All Other Contributions | 54479 | AllOtherContributions |
| Total Contributions | 54479 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE | Description |
| Business Code | 621610 | BusinessCode |
| Total Revenue Column | 12927688 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12927688 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 12927688 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8369 | TotalRevenueColumn |
| Exclusion | $8,369 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12990536 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12927688 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $8,369 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 134718 | Total |
| Program Services | 127982 | ProgramServices |
| Management And General | 6736 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7617162 | Total |
| Program Services | 7236304 | ProgramServices |
| Management And General | 380858 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103993 | Total |
| Program Services | 98793 | ProgramServices |
| Management And General | 5200 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1402438 | Total |
| Program Services | 1332316 | ProgramServices |
| Management And General | 70122 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 562911 | Total |
| Program Services | 534765 | ProgramServices |
| Management And General | 28146 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3261 | Total |
| Management And General | 3261 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33310 | Total |
| Management And General | 33310 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3233 | Total |
| Management And General | 3233 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5215 | Total |
| Management And General | 5215 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 301548 | Total |
| Program Services | 286471 | ProgramServices |
| Management And General | 15077 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121079 | Total |
| Program Services | 115025 | ProgramServices |
| Management And General | 6054 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57568 | Total |
| Program Services | 54690 | ProgramServices |
| Management And General | 2878 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 357128 | Total |
| Program Services | 339272 | ProgramServices |
| Management And General | 17856 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 335135 | Total |
| Management And General | 335135 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89364 | Total |
| Program Services | 84896 | ProgramServices |
| Management And General | 4468 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24576 | Total |
| Program Services | 23347 | ProgramServices |
| Management And General | 1229 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 606704 | 606704 | |
| CONTRACT SERVICES | 433823 | 433823 | |
| TECHNICAL SUPPLIES | 235597 | 223817 | 11780 |
| MEDICAL FEES | 219265 | 219265 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 442824 | Total |
| Program Services | 440098 | ProgramServices |
| Management And General | 2726 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13090852 | Total |
| Program Services | 12157568 | ProgramServices |
| Management And General | 933284 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 918036 | BOY |
| EOY | 868685 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1669140 | BOY |
| EOY | 1787489 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40168 | BOY |
| EOY | 44804 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2484579 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2096965 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 476978 | BOY |
| EOY | 387614 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 318300 | BOY |
| EOY | 334271 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3422622 | BOY |
| EOY | 3422863 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1118129 | BOY |
| EOY | 1177487 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 524993 | BOY |
| EOY | 562343 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 204782 | BOY |
| EOY | 192660 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1847904 | BOY |
| EOY | 1932490 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1256418 | BOY |
| EOY | 1156102 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 318300 | BOY |
| EOY | 334271 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1574718 | BOY |
| EOY | 1490373 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3422622 | BOY |
| EOY | 3422863 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -100316 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 15971 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 50209 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 37917 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 39719 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 49287 | CurrentTaxYearMinus1Year |
| Current Tax Year | 54479 | CurrentTaxYear |
| Total | 231611 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11442175 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 12696322 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 12069957 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12614400 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12927688 | CurrentTaxYear |
| Total | 61750542 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11492384 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 12734239 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 12109676 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12663687 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12982167 | CurrentTaxYear |
| Total | 61982153 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 61982153 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6956 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9365 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 12176 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6309 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8369 | CurrentTaxYear |
| Total | 43175 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6956 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9365 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 12176 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6309 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8369 | CurrentTaxYear |
| Total | 43175 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11499340 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 12743604 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 12121852 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12669996 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12990536 | CurrentTaxYear |
| Total | 62025328 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99930 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99920 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00070 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00080 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $195 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $3,038 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 3233 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | A PORTION OF MEMBERSHIP DUES AND MANAGEMENT FEES ARE CONSIDERED LOBBYING EXPENSES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 318300 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 15971 | InvestmentEarningsOrLosses |
| End Of Year Balance | 334271 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 316344 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1956 | InvestmentEarningsOrLosses |
| End Of Year Balance | 318300 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 306804 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 9540 | InvestmentEarningsOrLosses |
| End Of Year Balance | 316344 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 277416 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 29388 | InvestmentEarningsOrLosses |
| End Of Year Balance | 306804 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 314463 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -37047 | InvestmentEarningsOrLosses |
| End Of Year Balance | 277416 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 471906 | OtherCostOrOtherBasis |
| Depreciation | 175581 | Depreciation |
| Book Value | 296325 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2012673 | OtherCostOrOtherBasis |
| Depreciation | 1921384 | Depreciation |
| Book Value | 91289 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 387614 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BENEFICIAL INTEREST IN TRUSTS | Description |
| Book Value | 334271 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 334271 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO AFFILIATES | Description |
| Amount | $192,660 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 192660 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 12990536 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 12990536 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 12990536 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 13090852 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 13090852 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 13090852 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | ENDOWMENT FUNDS ARE HELD BY THE TOWN OF DERRY, NEW HAMPSHIRE. THE INCOME EARNED FROM THE FUND IS USED TO FUND THE ORGANIZATION'S OPERATIONS. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | INCLUDED IN THE AUDITED FINANCIAL STATEMENTS IS THE FOLLOWING, "MANAGEMENT HAS EVALUATED THE ASSOCIATION'S TAX POSITION AND CONCLUDED THAT THE ASSOCIATION HAS NO UNRELATED BUSINESS INCOME OR UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS." |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | 0 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Survey | X | CompensationSurvey |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN J O'LEARY | ||||||||||||||
| TREASURER/TRUSTEE | 0 | 296066 | 0 | 0 | 0 | 53519 | 0 | 83000 | 0 | 17989 | 0 | 450574 | 0 | 0 |
| SUSAN BURNS-TISDALE | ||||||||||||||
| TRUSTEE | 0 | 245658 | 0 | 0 | 0 | 31214 | 0 | 15000 | 0 | 27613 | 0 | 319485 | 0 | 0 |
| KEVIN CALLAHAN | ||||||||||||||
| CHAIRMAN/TRUSTEE | 0 | 509869 | 0 | 0 | 0 | 93800 | 0 | 167500 | 0 | 27076 | 0 | 798245 | 0 | 0 |
| MARY PALMER | ||||||||||||||
| PRESIDENT/SECRETARY | 0 | 133552 | 0 | 0 | 0 | 35768 | 0 | 10141 | 0 | 10026 | 0 | 189487 | 0 | 0 |
| KAREN MICHEL | ||||||||||||||
| EXEC DIR/TRUSTEE | 122851 | 0 | 8880 | 0 | 2987 | 0 | 2789 | 0 | 25648 | 0 | 163155 | 0 | 0 | 0 |
| ELIZABETH SMITH MD | ||||||||||||||
| TRUSTEE | 0 | 237804 | 0 | 0 | 0 | 52697 | 0 | 7500 | 0 | 31443 | 0 | 329444 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | TAX INDEMNIFICATION AND GROSS UP PAYMENTS WERE PROVIDED TO KEVIN CALLAHAN, KEVIN O'LEARY, SUSAN BURNS-TISDALE, MARY PALMER AND ELIZABETH SMITH, MD (FOR ACQUISITION OF SUPPLEMENTAL LONG TERM DISABILITY INSURANCE). THE BENEFIT WAS TREATED AS TAXABLE INCOME. |
| PART I, LINE 1B | THERE WAS NO EXISTING POLICY CONCERNING TAX INDEMNIFICATION AND GROSS UP PAYMENTS. HOWEVER, IN THE INSTANCE OF SUCH ACTION RELATED TO THE ACQUISITION OF LONG TERM DISABILITY INSURANCE DESCRIBED ABOVE, THE TAX INDEMNIFICATION AND GROSS UP PAYMENTS WERE APPROVED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES EXECUTIVE COMMITTEE COMPRISED OF DISINTERESTED PERSONS. |
| PART I, LINE 4B | THE ORGANIZATION'S PARENT (EXETER HEALTH RESOURCES) MAINTAINS A SPLIT DOLLAR SUPPLEMENTAL RETIREMENT PLAN FOR 2 EXECUTIVES (LISTED BELOW WITH AMOUNTS) SELECTED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. THE PLAN IS CLOSED TO FUTURE PARTICIPANTS. THE PLAN PROVIDES FOR ANNUAL PAYMENTS OF PREMIUMS FOR LIFE INSURANCE POLICIES INSURING THE LISTED INDIVIDUALS. THOSE LIFE INSURANCE PREMIUMS ARE COLLATERALLY ASSIGNED TO THE CORPORATION AND ANY EXCESS ACCUMULATED VALUE IN THE POLICIES (NET OF ACCUMULATED PREMIUM PAYMENTS) ARE AVAILABLE TO BE PAID TO THE PARTICIPANT ONCE VESTED AT AGE 62. KEVIN CALLAHAN - EXCESS ACCUMULATED VALUE = $1,118,815 KEVIN O'LEARY - EXCESS ACCUMULATED VALUE = $466,844 CERTAIN OF THE LISTED EMPLOYEES PARTICIPATE IN A NONQUALIFIED DEFERRED COMPENSATION PLAN AS DESCRIBED IN INTERNAL REVENUE CODE SECTION 457(F) SPONSORED BY EXETER HEALTH RESOURCES. IN THE CALENDAR YEAR ENDED DEC 31, 2012 THE CONTRIBUTION TO THE PLAN FOR THE NON-VESTED BENEFIT OF KEVIN CALLAHAN WAS $160,000 AND THE CONTRIBUTION TO THE PLAN FOR THE NON-VESTED BENEFIT OF KEVIN O'LEARY WAS $68,000. PARTICIPANTS IN THE 457(F) PLAN DO NOT VEST UNTIL AGE 62. |
| PART I, LINE 7 | THE ORGANIZATION'S PARENT (EXETER HEALTH RESOURCES, INC.) PROVIDES AN ANNUAL INCENTIVE COMPENSATION PLAN FOR EXECUTIVES SELECTED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. THESE EXECUTIVES INCLUDE KEVIN CALLAHAN, KEVIN O'LEARY, SUSAN BURNS-TISDALE AND MARY PALMER. THE EXETER HEALTH RESOURCES BOARD AND / OR ITS EXECUTIVE COMMITTEE APPROVES MEASURABLE ACHIEVEMENT CRITERIA FOR QUALITY, PATIENT SATISFACTION, PROCESS IMPROVEMENT, FINANCIAL PERFORMANCE, SERVICES INNOVATION AND OTHER COMPELLING AREAS OF STRATEGIC AND OPERATIONAL INTEREST. ADDITIONALLY, THE EXETER HEALTH RESOURCES BOARD AND /OR ITS EXECUTIVE COMMITTEE ESTABLISHES MINIMUM, TARGETED AND MAXIMUM LEVELS FOR INCENTIVE AWARDS AND APPROVES ALL INCENTIVE AWARDS FOR PARTICIPATING EXECUTIVES. CORE PHYSICIANS HAS A COMPENSATION PLAN THAT IS BASED UPON COMPETITIVE MARKET RATES RELATIVE TO A PHYSICIAN'S SPECIALTY. THE ORGANIZATION UTILIZES THE SERVICES OF AN OUTSIDE COMPENSATION CONSULTANT TO DETERMINE MARKET BENCHMARKS. TOTAL COMPENSATION CONSISTS OF A BASE SALARY, A POTENTIAL FOR A PRODUCTIVITY BONUS, AN ON-CALL STIPEND (IF APPLICABLE), A MEDICAL DIRECTORSHIP STIPEND (IF APPLICABLE), A CITIZENSHIP AND QUALITY PAYMENT THAT IS EARNED BASED UPON THE ACHIEVEMENT OF OBJECTIVES SET IN ADVANCE. THE PRODUCTIVITY BONUS IS BASED ON WORK RELATIVE VALUE UNITS (WRVU) PRODUCTION AND WOULD BE ELIGIBLE TO ANYONE WHO PRODUCES WRVU'S ABOVE HIS OR HER BASE SALARY WRVU LEVEL. BASE COMPENSATION IS ALSO ADJUSTED IF WORK RELATIVE VALUE UNITS FALL BELOW THE BASE SALARY WRVU EQUIVALENCY LEVEL. THE PHYSICIANS' COMPENSATION IS APPROVED BY CORE PHYSICIANS, LLC'S COMPENSATION COMMITTEE WHICH IS COMPRISED OF SYSTEM MANAGERS WHO ARE APPROVED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. ELIZABETH SMITH IS COMPENSATED BY CORE PHYSICIANS. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | EXETER HEALTH RESOURCES, INC. A CHARITABLE ORGANIZATION ACTING THROUGH ITS BOARD OF TRUSTEES IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | EXETER HEALTH RESOURCES, INC., AS SOLE MEMBER, ELECTS THE MAJORITY OF THE BOARD OF TRUSTEES OF RVNA&H, IN ADDITION TO ONE OF ITS OFFICERS WHO SERVES AS EX-OFFICIO TRUSTEE. |
| FORM 990, PART VI, SECTION A, LINE 7B | AS SOLE MEMBER, EXETER HEALTH RESOURCES HAS CERTAIN RESERVED RIGHTS AS REFLECTED IN THE BY-LAWS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS PREPARED BY AN OUTSIDE TAX ACCOUNTANT WITH INFORMATION PROVIDED BY THE ORGANIZATION. THE 990 IS REVIEWED BY THE ORGANIZATION'S TREASURER AND THEN PRESENTED TO THE BOARD OF TRUSTEES BEFORE IT IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF TRUSTEES HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT REQUIRES THE DISCLOSURE OF CONFLICTS OF INTEREST EITHER WHEN THE INTEREST BECOMES A MATTER OF POSSIBLE ACTION BY THE BOARD OR DURING AN ANNUAL DISCLOSURE PROCESS. TRUSTEES, OFFICERS, AND KEY EMPLOYEES, AS WELL AS ALL MEMBERS OF SENIOR MANAGEMENT, ARE PART OF THE ANNUAL DISCLOSURE PROCESS, WHICH IS INITIATED BY THE ISSUANCE OF A MEMORANDUM AND ACCOMPANYING QUESTIONNAIRE BY THE PRESIDENT OF THE MEMBER (I.E., EXETER HEALTH RESOURCES, INC.). ALL DISCLOSURES ARE REVIEWED. ANY TRUSTEE WITH A CONFLICT OF INTEREST IS REQUIRED TO ABSTAIN FROM VOTING AND IS NOT INCLUDED IN A QUORUM DETERMINATION ON THE MATTER AND ANY OFFICER, KEY EMPLOYEE, OR MEMBER OF SENIOR MANAGEMENT WITH A CONFLICT DOES NOT TAKE PART IN MAKING AND IS NOT PRESENT FOR ANY DECISION REGARDING THE MATTER. THE POLICY IS MONITORED AND ENFORCED BY BOTH THE PRESIDENT AND THE FULL BOARD. A SEPARATE ORGANIZATIONAL POLICY REQUIRES ALL EMPLOYEES TO DISCLOSE ANY CONFLICT OF INTEREST IN WRITING UPON HIRE. THEREAFTER, ON AN ANNUAL BASIS, ALL EMPLOYEES AND CONTRACTED STAFF MUST MAKE A FULL AND COMPLETE DISCLOSURE IN WRITING OF ANY CONFLICT OF INTEREST, CONFLICT OF COMMITMENT, AND/OR PERSONAL INTEREST. EMPLOYEES ARE OTHERWISE REQUIRED TO MAKE ANY FURTHER WRITTEN DISCLOSURE AT THE TIME SUCH CONFLICT ARISES. THIS POLICY IS MONITORED AND ENFORCED BY THE DEPARTMENT OF HUMAN RESOURCES, AS WELL AS THE AGENCY'S EXECUTIVE DIRECTOR AND COMPLIANCE OFFICER. ANY CONFLICT OF INTEREST IS MANAGED UNDER THIS POLICY BY DISCLOSURE, RECUSAL, OR DIVESTITURE OF THE INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15B | THE ORGANIZATION'S PARENT (EXETER HEALTH RESOURCES) HAS A FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CHAIRMAN AND OTHER LISTED OFFICERS THAT IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACHIEVING THE ORGANIZATION'S MISSION, TO RECOGNIZE INDIVIDUAL AND TEAM PERFORMANCE AND TO COMPLY WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE EXECUTIVE COMMITTEE OF THE EXETER HEALTH RESOURCES' BOARD OF TRUSTEES CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE CHAIRMAN AND OTHER LISTED OFFICERS. IN DOING SO, THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE MARKET RANGES OF BASE, INCENTIVE, AND TOTAL CASH COMPENSATION, AND TO PROVIDE ADVICE CONCERNING THE REASONABLENESS OF THE COMPENSATION OF THE CHAIRMAN AND OTHER LISTED OFFICERS. THE COMMITTEE UTILIZES THAT ANALYSIS AND OTHER APPROPRIATE INFORMATION IN CONNECTION WITH ITS ANNUAL REVIEW AND MAKES RECOMMENDATIONS TO THE FULL BOARD OF EXETER HEALTH RESOURCES FOR ADJUSTMENT OF THE CHAIRMAN'S COMPENSATION AND THE COMPENSATION FOR OTHER LISTED OFFICERS. INFORMATION WHICH THE COMMITTEE MAY CONSIDER CAN INCLUDE BUT IS NOT LIMITED TO THE PERFORMANCE OF AN INDIVIDUAL AND/OR THAT INDIVIDUAL'S CONTRIBUTIONS TO A TEAM, THE PERFORMANCE OF THE ORGANIZATION IN WHOLE AND IN PART, THE ELEMENTS OF TOTAL COMPENSATION AND SALARY HISTORY, THE ORGANIZATION'S COMPENSATION TARGETS AND COMPARABILITY DATA, INCLUDING THE DATA PREPARED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE COMMITTEE. THE COMMITTEE INCORPORATES A PERFORMANCE APPRAISAL PROCESS IN THE CHAIRMAN'S AND THE OTHER LISTED OFFICERS' COMPENSATION REVIEW. THE CHAIRMAN AND OTHER LISTED OFFICERS ARE NOT PRESENT WHEN THE COMMITTEE DISCUSSES THEIR RESPECTIVE COMPENSATION. IN ADDITION, THE COMMITTEE DETERMINES IF THE THRESHOLD REQUIREMENTS FOR INCENTIVE AWARDS ARE MET, CONSISTING OF THE ORGANIZATION'S PERFORMANCE RESULTS FOR QUALITY, OPERATING SYSTEM EXCELLENCE AND FINANCIAL PERFORMANCE. THE RESULTS OF THE COMMITTEE'S DELIBERATIONS ARE PRESENTED TO THE EXETER HEALTH RESOURCES BOARD AND INCLUDE RECOMMENDATIONS CONCERNING SALARY RANGE ADJUSTMENTS AND INCENTIVE AWARDS AND THE BASIS FOR THE COMMITTEE'S DECISIONS / RECOMMENDATIONS. THE DELIBERATIONS OF THE EXETER HEALTH RESOURCES BOARD ARE CONDUCTED IN EXECUTIVE SESSION WITH THE INDEPENDENT MEMBERS OF THE BOARD BUT DO INCLUDE THE CHAIRMAN ONLY FOR THAT PERIOD OF TIME IN WHICH THE EXETER HEALTH RESOURCES BOARD HAS QUESTIONS CONCERNING THE PERFORMANCE OF ANY LISTED OFFICER OTHER THAN THE CHAIRMAN. THE EXETER HEALTH RESOURCES BOARD REVIEWS THE CHAIRMAN'S PERFORMANCE AND DETERMINES IF THE ADJUSTMENTS AND AWARDS RECOMMENDED BY THE COMMITTEE FOR THE CHAIRMAN ARE IN THE ORGANIZATION'S BEST INTEREST AND FOR THE BENEFIT OF THE ORGANIZATION AND THE PARENT ORGANIZATION. FOR THE OTHER LISTED OFFICER POSITIONS, ADJUSTMENTS AND INCENTIVE AWARDS ARE APPROVED UPON RECOMMENDATION OF THE CHAIRMAN BY THE EXECUTIVE COMMITTEE WITHIN THE EXETER HEALTH RESOURCES BOARD APPROVED PARAMETERS AND RATIFIED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. FOR THE EXECUTIVE DIRECTOR OF ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE, COMPENSATION IS DETERMINED BY CONSULTING WITH THE ORGANIZATION'S PARENT HUMAN RESOURCE DEPARTMENT. COMPARISON COMPENSATION SURVEYS AND EXTERNAL BENCHMARKS ARE USED IN THE PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| EXETER HEALTH RESOURCES INC | ||||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 020222126 | MANAGEMENT AND SUPPORTING ORGANIZATION; HOLDING COMPANY | NH | 501C3 | 11 | 0 | |
| EXETER HOSPITAL INC | ||||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 222674014 | HOSPITAL | NH | 501C3 | 3 | 0 | EXETER HEALTH RESOURCES INC |
| CORE PHYSICIANS LLC | ||||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 870807914 | PHYSICIAN PRACTICES | NH | 501C3 | 9 | 0 | EXETER HEALTH RESOURCES INC |
| EXETER HEALTHCARE INC | ||||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 020360966 | SUBACUTE NURSING FACILITY | NH | 501C3 | 9 | 0 | EXETER HEALTH RESOURCES INC |
| MATRIX HEALTH INC | ||||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 020473737 | MANAGE RESOURCES | NH | 501C3 | 11 | 0 | EXETER HEALTH RESOURCES INC |
| EXETER MED REAL INC | ||||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 020418718 | REAL ESTATE HOLDING | NH | 501C25 | 0 | EXETER HEALTH RESOURCES INC | |
| EXETER HEALTH RESOURCES INC SELF-INSURANCE TRUST | ||||||||||
| 5 ALUMNI DRIVE | EXETER | NE | 03833 | 200753662 | SELF INSURANCE TRUST | NH | 501C3 | 11 | 0 | EXETER HEALTH RESOURCES INC |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|---|
| CONVERGENT HEALTH SYSTEMS INC | |||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 020469711 | WELLNESS CENTER | NH | EXETER HEALTH RESOURCES INC | 0 | |
| VX HEALTH SERVICES INC | |||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 020469712 | FITNESS CENTER | NH | CONVERGENT HEALTH SYSTEMS | 0 | C |
| EXETER MEDICAL SERVICES INC | |||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 020419850 | INACTIVE PHYSICIAN PRACTICE | NH | CONVERGENT HEALTH SYSTEMS | 0 | C |
| CORE HEALTH SERVICES OF MA | |||||||||
| 5 ALUMNI DRIVE | EXETER | NH | 03833 | 201598042 | INACTIVE PHYSICIAN PRACTICE | MA | EXETER HEALTH RESOURCES INC | 0 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| EXETER HEALTH RESOURCES | ||
| M | 304359 | CASH |
| EXETER HEALTH RESOURCES INC SELF-INSURANCE TRUST | ||
| Q | 21358 | CASH |
| EXETER HOSPITAL | ||
| M | 223646 | CASH |
| EXETER HEALTH RESOURCES | ||
| O | 30726 | CASH |
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