2013-05-10T10:12:27-05:00 2012-06-30 020383073 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2011-07-01 020512229 MARY AND JOHN ELLIOT CHARITABLE FOUNDATION MARY 6036638977 1070 HOLT AVENUE UNIT 1 SUITE 2100 MANCHESTER NH 03109 RICHARD ELWELL 6036638977 2013-05-08 1 WILLIAM G STEELE JR CPA P00233103 6036228881 2011 2016-02-25 16:41:14Z RICHARD ELWELL 1070 HOLT AVENUE UNIT 1 SUITE 2100 MANCHESTER NH 03109 2384257 0 X N/A X 2001 NH THE FOUNDATION'S MISSION IS TO SUPPORT THE IMMEDIATE AND ONGOING RESOURCE NEEDS OF THE ELLIOT HOSPITAL. 10 8 0 0 0 0 924388 1739361 0 0 589924 208767 340979 421559 1855291 2369687 599090 1696012 0 0 0 0 0 0 0 385712 348561 984802 2044573 870489 325114 7130550 6584489 724470 661947 6406080 5922542 THE FOUNDATION'S MISSION IS TO SUPPORT THE IMMEDIATE AND ONGOING RESOURCE NEEDS OF THE ELLLIOT HOSPITAL. 0 0 2044573 1696012 331449 SUPPORT OF THE FUNDRAISING ACTIVITIES OF THE ELLIOT HOSPITAL AND ITS RELATED TAX EXEMPT ORGANIZATIONS 2044573 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 8 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 MARY ELLEN BISER 1.00 X X 0 22808 4331 JAMES F CONWAY JR MD 1.00 X 0 0 0 DOUGLAS F DEAN 40.00 X X 0 775340 337512 SELMA NACCACH-HOFF 1.00 X X 0 0 0 RICHARD I WINNEG 1.00 X 0 0 0 RICHARD RAWLINGS 1.00 X 0 0 0 WAYNE ROBINSON 1.00 X 0 0 0 RUTH ANSELL ESQUIRE 1.00 X 0 0 0 SID BAINES 1.00 X 0 0 0 RENEE WALSH 1.00 X 0 0 0 RICHARD A ELWELL 40.00 X 0 711978 127871 RICHARD PHELPS 40.00 X 0 686077 69674 0 2196203 539388 0 0 1 0 0 1739361 1739361 139957 139957 68810 0 68810 68810 68810 104680 14570 90110 90110 MANAGEMENT FEE INCOME 561000 325169 325169 OTHER REVENUE 900099 6280 6280 331449 2369687 331449 0 298877 1696012 1696012 1523 1523 8908 8908 770 770 470 470 PURCHASED SERVICES 224192 224192 CONSULTING FEES 35307 35307 TRUST FUND FEES 27289 27289 PRINTING/PUBLICATIONS 17607 17607 32495 32495 2044573 2044573 0 0 895971 773856 602484 148416 125200 16000 9991 7886 2575 2105 5491120 5632528 13200 11584 7130550 6584489 4470 21947 720000 640000 724470 661947 X 5630135 4854937 775945 1067605 6406080 5922542 7130550 6584489 X 325114 -808652 X 0 1 1 X 0 X 2137287 1013593 1184977 918380 1844041 7098278 2137287 1013593 1184977 918380 1844041 7098278 7098278 147115 204092 188299 135741 139957 815204 7913482 1739134 0.89700 0.88170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 775945 282540 9120 1067605 2337619 190477 18083 1770234 775945 1582058 670870 84691 2337619 1097517 413069 71472 1582058 1.00000 0 0 9991 7886 2105 2105 SECURITIES AND OTHER INVESTMENTS 5632528 F 5632528 2369687 2044573 325114 -136775 -671877 -808652 -483538 603942 -136775 -136775 740717 1628970 1628970 2369687 415603 0 415603 1628970 1628970 2044573 PART XI, LINE 8 - OTHER ADJUSTMENTS: TRANSFERS TO AFFILIATES -671,877. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSE RECLASS 1,628,970. PART XIII, LINE 4B - OTHER ADJUSTMENTS: EXPENSE RECLASS 1,628,970. RECLASSIFICATION OF EXPENSES 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." GOLF TOURNAMENT 104680 104680 3945 9884 741 104680 104680 3945 9884 741 14570 90110 1 THE CAREGIVERS INC 020395429 501(C)(3) 10000 SUPPORTED EXPANSION AND ENHANCEMENT EFFORTS OF THE CARING CUPBOARD CHILD AND FAMILY SERVICES 020222164 501(C)(3) 30000 PROVIDED HOME CARE SERVICES FOR TWENTY LOW INCOME ELDERLY INDIVIDUALS EASTER SEALS OF NEW HAMPSHIRE 020272825 501(C)(3) 25000 PROVIDED DENTAL SERVICES TO INDIGENT, FRAIL SENIORS IN THE GREATER MANCHESTER AREA THE MOORE CENTER 020261136 501(C)(3) 25000 ASSISTED THE MOORE OPTIONS FOR SENIORS PROGRAM IN DEVELOPING SHARED HOUSING FOR ELDERLY 4 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, 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. 1 X X X X X X 0 1 0 0 0 0 0 1 0 DOUGLAS F DEAN 0 529809 0 191570 0 53961 0 325293 0 12219 0 1112852 0 0 RICHARD A ELWELL 0 338211 0 105377 0 268390 0 116187 0 11684 0 839849 0 221290 RICHARD PHELPS 0 374367 0 120426 0 191284 0 53493 0 16181 0 755751 0 149684 PART I, LINE 4B DOUGLAS DEAN - $287,928; RICK PHELPS - $51,158; RICHARD ELWELL - $75,929; WILLIAM BAXTER - $33,960 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. SUPPLEMENTAL INFORMATION PART III THE SALARIES OF DOUGLAS DEAN, RICK PHELPS, AND RICHARD ELWELL REPRESENT SERVICES PROVIDED TO ALL RELATED ENTITIES. SUPPLEMENTAL INFORMATION PART III PART II LINE 2 AND 3 - DURING THE YEAR MR ELWELL AND DR PHELPS EACH WITHDREW FUNDS FROM THEIR DEFERRED COMPENSATION PLANS ($221,290 AND $149,684 RESPECTIVELY) AS SUCH THESE AMOUNTS ARE REPORTED IN COLUMN B(III) AND IN PRIOR YEARS CONTRIBUTIONS TO THEIR DEFERRED COMPENSATION PLANS WHICH SUPPORT THE CURRENT DISTRIBUTION 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -136,775. TRANSFERS TO AFFILIATES -671,877. TOTAL TO FORM 990, PART XI, LINE 5: -808,652. 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 HEALTH SYSTEM 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 HEALTH SYSTEM 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 HOSPITAL 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 HEALTH SYSTEM 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 VNA OF MANCHESTER & SOUTHERN NH INC 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 VNA OF MANCHESTER & SOUTHERN NH INC 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 VNA OF MANCHESTER & SOUTHERN NH INC 0 ELLIOT COMMON TRUST FUND LLC 1 ELLIOT WAY MANCHESTER NH 03103 203653624 INVESTMENTS NH N/A 161514 5685104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0