2013-04-30T10:10:54-05:00 2012-09-30 020400296 BRAD BORBIDGE PA 197 LOUDON ROAD STE 350 CONCORD NH 03301 990 2011-10-01 237305106 Lamprey Health Care Inc LAMP 6036592494 207 South Main Street Newmarket NH 03857 Ann Peters 6032927214 2013-04-30 1 DIMITRIOS PANACOPOULOS CPA P01603705 6032240849 2011 2016-03-07 17:11:31Z Ann Peters 207 South Main Street Newmarket NH 03857 12236293 0 X www.lampreyhealth.org X 1971 NH The mission of Lamprey Health Care is to provide high quality primary medical care and health related services with an emphasis on prevention and lifestyle management to all individuals regardless of ability to pay. 12 12 180 20 0 0 8099328 4516339 7766542 7718361 3093 1593 0 0 15868963 12236293 0 0 0 0 9625810 8893431 0 0 8081 3427809 3381889 13053619 12275320 2815344 -39027 12599759 12290267 5533103 5322316 7066656 6967951 The mission of Lamprey Health Care is to provide high quality primary medical care and health related services with an emphasis on prevention and lifestyle management to all individuals regardless of ability to pay. 0 0 10834454 7718361 To provide medical, dental, health, transportation and referral related services to all members of the community regardless of ability to pay. 10834454 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 48 0 1 180 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NH X X Sandra Pardus CFO 6032927215 207 South Main Street Newmarket NH 03857 Elizabeth Crepeau 0.00 X 0 0 0 Carol LaCross 0.00 X 0 0 0 Audrey Ashton-Savage 0.00 X 0 0 0 George D Donovan Jr 0.00 X 0 0 0 Raymond Goodman III 0.00 X 0 0 0 Michael Merenda 0.00 X 0 0 0 Jean Ragonese 0.00 X 0 0 0 Colette D Tilton 0.00 X 0 0 0 Thomas Chris Drew 0.00 X 0 0 0 Cynthia Giguere-Unrein 0.00 X 0 0 0 Jazmin Miranda-Smith 0.00 X 0 0 0 Janis Reams 0.00 X 0 0 0 Ann Peters 40.00 X 154944 0 23884 Sandra Pardus 35.00 X 103622 0 11939 Sirona Pruna 40.00 X 284551 0 30541 Paul Friedrichs 40.00 X 195631 0 40233 Vasuki Nagaraj 40.00 X 185027 0 27461 Ajay Sharma 40.00 X 193194 0 22468 Christopher Heatherton 40.00 X 148360 0 7423 1265329 0 163949 7 0 1 0 North Branch Construction 76 Old Turnpike Rd Concord NH 03301 Construction Services 570280 Community Health Access Network 207 S Main Street Newmarket NH 03857 Technology Services 301407 Partners for Womans Health 3 Alumni Drive Suite 302 Exeter NH 03833 Physician Services 136800 Dennis Mires PA 697 Union Street Manchester NH 03104 Architect Services 105000 4 3575104 941235 4516339 Primary Health Care 621110 7718361 7718361 7718361 1593 1593 12236293 7718361 0 1593 294389 294389 7089406 6501451 587955 921798 815603 106195 587838 520116 67722 20180 20180 42200 42200 457134 404470 52664 14985 13259 1726 75102 66450 8652 314075 277892 36183 802800 710314 92486 51911 45931 5980 207431 183534 23897 61861 54734 7127 285237 252376 32861 126213 111673 14540 Bad Debts 324237 324237 Program Supplies 260353 260353 Printing & Publications 110258 97556 12702 Telephone 98381 87047 11334 129531 107458 13992 8081 12275320 10834454 1432785 8081 1201265 1168284 3050302 2624177 739004 770908 126306 109491 9295400 3180075 6114347 6115325 1368535 1502082 12599759 12290267 1405162 1169510 2450789 2457045 1603902 1622511 73250 73250 5533103 5322316 X 6670703 6472850 395953 495101 7066656 6967951 12599759 12290267 X -39027 -59678 X 0 1 1 X 1 1 X 4813074 4931132 5632850 8099328 4516339 27992723 6780413 7217100 7688374 7766542 7718361 37170790 11593487 12148232 13321224 15865870 12234700 65163513 10000 10000 0 10000 10000 65153513 35837 16007 4027 3093 1593 60557 35837 16007 4027 3093 1593 60557 11629324 12164239 13325251 15868963 12236293 65224070 0.99890 0.99840 0.00090 0.00140 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 858193 858193 6578434 1720899 4857535 1858773 1459176 399597 6115325 Assets Limited as to Use 1502082 1502082 Due to Third Parties 73250 73250 12236293 12275320 -39027 -59678 -59678 -98705 12176615 -59678 -59678 12236293 0 12236293 12275320 0 12275320 0 12275320 Part XI, Line 8 - Other Adjustments: Change in Fair Value of Financial Instrument -59,678. Part IV, line 11f - Lamprey Health Care is a public charity under Section 501(c)(3) of the Internal Revenue Code. As public charities, the entities are exempt from state and federal income taxes on income earned in accordance with its tax exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated each entity's tax position and concluded that there is no unrelated business income or uncertain tax positions that require adjustment to the consolidated financial statements. X X X X X X 0 0 0 0 0 0 0 1 0 Ann Peters 154944 0 0 0 0 0 0 0 23884 0 178828 0 0 0 Sirona Pruna 249238 0 35313 0 0 0 0 0 30541 0 315092 0 0 0 Paul Friedrichs 171529 0 24102 0 0 0 0 0 40233 0 235864 0 0 0 Vasuki Nagaraj 145231 0 39796 0 0 0 0 0 27461 0 212488 0 0 0 Ajay Sharma 144671 0 48523 0 0 0 0 0 22468 0 215662 0 0 0 Christopher Heatherton 143725 0 4635 0 0 0 0 0 7423 0 155783 0 0 0 Part I, Line 7 Physicians are provided incentive payments based on number of patients seen, complexity of patient acuity, timely documentation, patient satisifaction, quality of care provided, and call coverage responsibilities. Ann Peters Lamprey Health Care's CEO is a member of the board of directors of CHAN 286938 Transactions include dues paid to Community Health Access Network(CHAN) in the amount of $18,150. Lamprey also contracted with CHAN for IT and other consulting services in the amount of $268,788. 0 Ann Peters Lamprey Health Care's CEO is a member of the board of directors of CHAN 356037 Transactions include employees leased to CHAN in the amount of $316,873 and facilities(including utilities) in the amount of $39,164. 0 Form 990, Part VI, Section A, line 7b The US Department of Health and Human Services Health Resources and Services Administration and the NH Division of Charitable Trusts must approve the decision to dissolve the organization. Form 990, Part VI, Section B, line 11 The 990 will be reviewed by the CEO and CFO. The Finance Committee will review and approve the 990 on behalf of the full Board prior to filing. Form 990, Part VI, Section B, line 12c Annually, the board of directors sign a conflict of interest form, on which they disclose any conflicts of interest. Board members will abstain from any votes related to a conflict. Form 990, Part VI, Section B, line 15 The Board hires a firm to do a CEO analysis periodically. In between, the National Association of Community Health Centers (NACHC) Benefits and Compensation survey results are used. The NACHC study is also used for other key employees, as well as other local studies (including the Medical Group Management Association (MGMA) salary survey), as they are available. Form 990, Part VI, Section C, line 19 Upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Change in Fair Value of Financial Instrument -59,678. Total to Form 990, Part XI, Line 5: -59,678. Friends of Lamprey Health Care Inc 207 South Main Street Newmarket NH 03857 020348630 Support LHC NH 501(c)(3) 509(a)(3) type iii N/A 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 Friends of Lamprey Health Care Inc J 227916 FMV