2013-03-15T15:20:42-05:00 2012-06-30 221478099 COHNREZNICK LLP 180 GLASTONBURY BOULEVARD GLASTONBURY CT 06033 990 2011-07-01 042610447 NORTH SHORE COMMUNITY HEALTH INC NORT 9788251109 27 CONGRESS ST NO 504 SALEM MA 01970 MARGARET BRENNAN 9788251109 2013-03-18 1 PAUL BALLASY P00852868 8606333000 2011 2016-02-25 16:41:14Z MARGARET BRENNAN 27 CONGRESS ST NO 504 SALEM MA 01970 10703656 0 X WWW.NSCHI.ORG X 1977 MA THE HEALTH CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE PRIMARY CARE THAT IS ACCESSIBLE, CULTURALLY AND LINGUISTICALLY COMPETENT, AND COMMUNITY DIRECTED FOR ALL RESIDENTS OF MASSACHUSETTS' NORTH SHORE AND CAPE ANN COMMUNITIES REGARDLESS OF ABILITY TO PAY. 9 9 95 0 0 0 2199539 4048532 5834130 6100171 10234 8862 66540 546091 8110443 10703656 0 0 0 0 5022654 5615427 0 0 0 3561674 3289909 8584328 8905336 -473885 1798320 5448832 6933051 1753206 1439105 3695626 5493946 THE HEALTH CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE PRIMARY CARE THAT IS ACCESSIBLE, CULTURALLY AND LINGUISTICALLY COMPETENT, AND COMMUNITY DIRECTED FOR ALL RESIDENTS OF MASSACHUSETTS' NORTH SHORE AND CAPE ANN COMMUNITIES REGARDLESS OF ABILITY TO PAY. 0 0 6252390 5309985 MEDICAL SERVICES - MEDICAL SERVICES PROVIDED TO THE RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. SERVICES INCLUDE MEDICAL SERVICES TO ADULTS AND CHILDREN, HIV COUNSELING AND OTHER. THERE WERE 30,751 MEDICAL VISITS DURING THE TAX YEAR. 1152195 1152195 DENTAL SERVICES - DENTAL SERVICES PROVIDED TO THE RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. THERE WERE 14,366 DENTAL VISITS DURING THE TAX YEAR. 136309 105186 SCHOOL BASED HEALTH CENTER - HEALTH SERVICES PROVIDED TO STUDENTS AT SALEM HIGH SCHOOL. THERE WERE 651 SCHOOL BASED HEALTH CENTER VISITS DURING THE TAX YEAR. 7540894 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 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 0 0 0 0 0 1 17 0 1 95 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X JOHN HILDRETH 9788251109 27 CONGRESS ST NO 504 SALEM MA 01970 MARION WINFREY 2.00 X X 0 0 0 BEVERLY WHITE 2.00 X X 0 0 0 PAMELA PAINE 2.00 X X 0 0 0 GEORGE KAPLAN 2.00 X X 0 0 0 LUCY CORCHADO 2.00 X 0 0 0 RICKY GANAISHLAL 2.00 X 0 0 0 GABRIELLE ROSS 2.00 X 0 0 0 JACK VONDRAS 2.00 X 0 0 0 CALVIN YOUNG 2.00 X 0 0 0 MARGARET BRENNAN 40.00 X 48465 0 8489 GLORIA RILEY 40.00 X 131146 0 26210 ROBERT HENDERSHOTT 40.00 X 148077 0 4231 GABRIELLE DEMILLE 40.00 X 132279 0 21887 AZRA ALI 40.00 X 143406 0 13000 JAY PANDEY 40.00 X 149815 0 17902 LUCAS MIKULIC 40.00 X 136344 0 18067 889532 0 109786 9 0 1 0 D&Y STAFFING PO BOX 635715 CINCINATTI OH 45263 STAFFING AGENCY 199074 NORTH SHORE PHYSICIANS GROUP 35 CONGRESS ST SALEM MA 01970 OB/GYN STAFFING AGENCY 120881 READY NURSE PO BOX 200528 HOUSTON TX 77216 STAFFING AGENCY 115900 STAFF CARE PO BOX 281923 ATLANTA GA 30384 STAFFING AGENCY 102071 4 2488948 1559584 4048532 NET PATIENT SERVICE 621110 5441772 5441772 NET PHARMACY 621110 658399 658399 6100171 8862 8862 EMR INCENTIVE 621110 425000 425000 MISCELLANEOUS 621110 121091 42195 78896 546091 10703656 6567366 0 87758 279360 279360 4311300 3862745 448555 40495 39456 1039 659125 584435 74690 325147 290645 34502 64613 5335 59278 50200 50200 458779 423320 35459 106785 220 106565 109223 78098 31125 214374 176182 38192 365878 317594 48284 23673 10160 13513 31263 30032 1231 231525 221261 10264 40123 37868 2255 MEDICAL SUPPLIES 530297 526300 3997 DISPENSING FEES 380830 380830 BAD DEBT 314927 314927 DUES AND SUBSCRIPTIONS 86530 40248 46282 280889 201238 79651 8905336 7540894 1364442 0 309989 1408050 333995 138298 848456 676424 1572545 1454021 0 70017 144755 5124087 2012584 2313830 3111503 5448832 6933051 1013058 792875 740148 646230 1753206 1439105 X 3121116 3872805 574510 1621141 3695626 5493946 5448832 6933051 1798320 0 X X 0 1 1 X 1 1 X 1344767 1692982 2707564 2199539 4048532 11993384 1344767 1692982 2707564 2199539 4048532 11993384 11993384 26850 13988 12855 10234 8862 72789 4990 44714 130174 66540 121091 367509 12433682 0.96460 0.96360 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1412101 175797 1236304 1221467 1059020 162447 1704939 777767 927172 785580 785580 3111503 10703656 8905336 1798320 1798320 10896278 192622 192622 10703656 0 10703656 9097958 192622 192622 8905336 0 8905336 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2012. THE CORPORATION'S U.S. FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2009 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CORPORATION HAD UNRELATED BUSINESS INCOME TAXES, IT WOULD RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH ANY TAX MATTERS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENTS OF FINANCIAL POSITION. 1 X X X X 1 0 0 0 0 0 0 0 0 GLORIA RILEY 131146 0 0 0 0 0 19500 0 6710 0 157356 0 0 0 ROBERT HENDERSHOTT 35577 0 0 0 112500 0 4231 0 0 0 152308 0 0 0 GABRIELLE DEMILLE 132279 0 0 0 0 0 5520 0 16367 0 154166 0 0 0 AZRA ALI 143406 0 0 0 0 0 13000 0 0 0 156406 0 0 0 JAY PANDEY 149815 0 0 0 0 0 0 0 17902 0 167717 0 0 0 LUCAS MIKULIC 136344 0 0 0 0 0 2300 0 15767 0 154411 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 INITIAL COMPLETION IS DONE BY OUR AUDITORS. THE FORM 990 IS THEN SENT TO THE NORTH SHORE COMMUNITY HEALTH MANAGEMENT TEAM AND THEN FORWARDED TO THE MEMBERS OF THE BOARD OF DIRECTORS, WHO ARE GIVEN A WEEK TO SUBMIT ANY QUESTIONS, COMMENTS, OR OBSERVATIONS THAT THEY HAVE. THEN MANAGEMENT DISCUSSES ANY CHANGES THEY ARE GOING TO MAKE TO THE 990 FORM. IF CHANGES ARE DEEMED NECESSARY, THEY ARE MADE IMMEDIATELY. THE FORM 990 IS THEN APPROVED FOR SUBMISSION BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH EMPLOYEE, VOLUNTEER, AND BOARD MEMBER WILL ACKNOWLEDGE THAT THEY HAVE READ AND UNDERSTAND NORTH SHORE COMMUNITY HEALTH'S CONFLICT OF INTEREST POLICY UPON BEGINNING THEIR EMPLOYMENT OR TENURE WITH NORTH SHORE COMMUNITY HEALTH BY SIGNING AN ACKNOWLEDGEMENT FORM. THIS IS UPDATED ON A YEARLY BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE HEALTH CENTER'S OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE BOARD OF DIRECTORS UTILIZING A SALARY SURVEY. THE EXECUTIVE DIRECTOR AND FINANCE COMMITTEE SET THE OTHER EMPLOYEES' SALARIES BASED ON A SALARY SURVEY IN ACCORDANCE WITH THE HEALTH CENTER'S BUDGET PARAMETERS. FORM 990, PART VI, SECTION C, LINE 19 NORTH SHORE COMMUNITY HEALTH, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS AVAILABLE TO THE GENERAL PUBLIC THROUGH WWW.GUIDESTAR.ORG. FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO THE ORGANIZATION'S SELECTION OR OVERSIGHT PROCESS DURING THE TAX YEAR.