2013-08-15T08:15:19-05:00 2012-09-30 020400296 Brad Borbidge PA 197 Loudon Road Concord NH 03301 990 2011-10-01 222757446 Noble Visiting Nurse & Hospice Services Inc NOBL 4135627049 77 Mill Street No 207 Westfield MA 01085 David Mol 4135627049 2013-08-15 1 Dimitrios Panacopoulos CPA P01603705 6032240849 2011 2016-02-25 16:41:14Z David Mol 77 Mill Street No 207 Westfield MA 01085 5390150 0 X www.noblehospice.org X 1986 MA To provide comprehensive home care services, including skilled nursing, medical social services, with the provision of necessary supplies, to individuals and families in their places of residence for the purpose of promoting, maintaining or restoring health, minimizing the effects of illness and disability, and maximizing the level of independence. 12 10 66 25 0 0 123097 100254 4989317 5242651 2654 253 15672 24276 5130740 5367434 0 0 0 0 3152753 3695253 0 0 34199 1752242 1789731 4904995 5484984 225745 -117550 1274562 1249580 759244 851812 515318 397768 X To provide comprehensive home care services, including skilled nursing, medical social services, with the provision of necessary supplies, to individuals and families in their places of residence for the purpose of promoting, maintaining or restoring health, minimizing the effects of illness and disability, and maximizing the level of independence. 0 0 4589967 5242651 Provides home health care and hospice including nursing, therapy, and home health aide services. 4589967 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 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 1 0 0 0 0 1 5 0 1 66 1 0 0 0 0 0 1 1 0 0 0 0 X 12 10 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MA X David Mol 4135627049 77 Mill Street Westfield MA 01085 John Liptak 0.00 X 0 0 0 Mary C O'Neil 0.00 X 0 0 0 Greg Jerome 0.00 X 0 0 0 Jeanne Chistolini 0.00 X 0 0 0 Ted Cassell 0.00 X 0 0 0 Stanley Strzempko MD 1.00 X 0 315000 527 Robert J O'Brien 0.00 X 0 0 0 Holly Lewis 0.00 X 0 0 0 Dawn Thomas 0.00 X 0 0 0 Ronald Bryant 1.00 X 0 246642 19847 Meghan Hibner 0.00 X 0 0 0 Robert Wilcox 0.00 X 0 0 0 David Mol 40.00 X 103566 0 11932 103566 561642 32306 1 0 1 0 Allscripts LLC 24630 Network Place Chicago IL 60673 Computer Services 134240 1 3740 96514 100254 Home Care 621610 5242651 5242651 5242651 253 253 46992 22716 24276 24276 5367434 5242651 0 24529 115498 115498 3007903 2623533 384370 77762 65569 12193 245172 206729 38443 248918 209888 39030 31120 31120 156331 64645 91686 241382 203533 37849 77886 65673 12213 304381 256654 47727 74098 62479 11619 154777 154616 161 3594 3030 564 4172 3518 654 46336 39071 7265 18084 15248 2836 Program Supplies 381203 381203 Telephone 78039 65802 12237 Hospice Program Expense 49676 49676 Other Expenses 42562 35888 6674 126090 83212 8679 34199 5484984 4589967 860818 34199 246630 20727 597616 784084 37130 31136 667925 284451 372378 383474 20808 30159 1274562 1249580 520202 631920 229142 197612 9900 22280 759244 851812 X 494510 367609 20808 30159 515318 397768 1274562 1249580 -117550 0 X 0 1 1 X 0 X 114450 70662 130402 123097 100254 538865 2709969 3521966 3940210 4989317 5242651 20404113 2824419 3592628 4070612 5112414 5342905 20942978 0 0 0 20942978 5126 2919 2695 2654 253 13647 5126 2919 2695 2654 253 13647 2829545 3595547 4073307 5115068 5343158 20956625 0.99930 0.99910 0.00070 0.00090 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17780 14280 3500 650145 270171 379974 383474 Due To Affiliates 22280 22280 5367434 5484984 -117550 -117550 5367434 0 5367434 0 5367434 5484984 0 5484984 0 5484984 Part IV, line 11f: The Association is a public charity under Section 501(c)(3) of the Internal Revenue Code. As a public charity, the Association is 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 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. Wine Tasting 33095 33095 15551 Golf Tournament 13897 13897 7165 46992 46992 22716 22716 24276 0 0 0 0 0 0 0 0 0 Stanley Strzempko MD 0 315000 0 0 0 0 0 0 0 527 0 315527 0 0 Ronald Bryant 0 246642 0 0 0 0 0 0 0 19847 0 266489 0 0 Form 990, Part VI, Section A, line 6 The sole member of the corporation shall be Noble Health Systems, Inc. Form 990, Part VI, Section A, line 7a The sole member elects the board of trustees memebers. Form 990, Part VI, Section A, line 7b The member shall have all rights and powers conferred on members of non-profit corporations under the laws of the commonwealth of Massachusetts. The member shall have such other powers as specified in the articles of Organization and bylaws. Form 990, Part VI, Section B, line 11 A copy of this Form 990 was provided to the Finance Committee of the Organization's affiliate, Noble Health Systems, Inc., for their review, discussion and comment prior to filing. It was also distributed to the full Boards of Trustees of both Noble Health Systems, Inc. and Noble Visiting Nurse & Hospice Services, Inc. prior to filing. Form 990, Part VI, Section B, line 12c Conflict of interest is discussed at the annual meeting after the election of officers and board members and each year at this meeting all board members signed a conflict of interest and confidentiality statement. Form 990, Part VI, Section B, line 15 Compensation for the Executive Director is complete by Board Committee with the use of compensation & benefits Survey completed by the Massachusetts Foundation for Home Health. Form 990, Part VI, Section C, line 19 Upon request. Westfield Medical Corporation 115 West Silver Street Westfield MA 01086 043127730 Physician Services MA 501 (c)(3) 509 (a)(3) type I N/A 0 Trustees Of Noble Hospital Inc 115 West Silver Street Westfield MA 01086 222537523 Hospital MA 501 (c)(3) 3 N/A 0 Silvermill Realty Corporation 115 West Silver Street Westfield MA 01086 222552923 Real Estate Holding MA 501 (c)(3) 509 (a)(3) type II N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0