2012-03-09T16:44:35-06:00 2011-06-30 ALEXANDER ARONSON FINNING & CO PC 21 EAST MAIN STREET WESTBORO MA 01581 990 2010-07-01 042610447 NORTH SHORE COMMUNITY HEALTH INC NORT 9787448388 27 CONGRESS STREET NO 103 SALEM MA 01970 GLORIA RILEY 9787448388 2012-03-07 1 DANA J MARKS CPA 5083669100 2012-03-07 2010 2016-02-24 21:20:13Z MARGARET BRENNAN 27 CONGRESS STREET SALEM MA 01970 8110443 0 X WWW.NSCHI.ORG X 1977 MA PROVIDES PRIMARY AND PREVENTATIVE HEALTH CARE, INCLUDING RELATED HEALTH CARE SERVICES SUCH AS DENTAL SERVICES TO THE RESIDENTS OF SALEM, PEABODY AND GLOUCESTER, MASSACHUSETTS, AND THE SURROUNDING AREAS. 8 8 98 0 0 0 2707564 2199539 5640210 5834130 12855 10234 130174 66540 8490803 8110443 0 0 0 0 4490839 5022654 0 0 0 2953014 3561674 7443853 8584328 1046950 -473885 5884992 5448832 1715481 1753206 4169511 3695626 TO DEVELOP AND OPERATE A PRIMARY CARE HEALTH CENTER TO SERVE THE RESIDENTS OF SALEM, MASSACHUSETTS AND THE SURROUNDING COMMUNITIES. 0 0 5828689 3992716 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. (31,486 VISITS) 1553900 1238343 DENTAL SERVICES - DENTAL SERVICES PROVIDED TO RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. (13,946 VISITS) 78899 79168 SCHOOL BASED HEALTH CENTER - HEALTH SERVICES PROVIDED TO STUDENTS AT SALEM HIGH SCHOOL (870 VISITS) 7461488 1 1 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 1 0 0 0 0 0 0 0 0 0 0 1 0 0 98 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MA X X JOHN HILDRETH 9787448388 27 CONGRESS STREET SALEM MA 01970 MARION WINFREY 2.00 X X 0 0 0 BEVERLY WHITE 1.00 X X 0 0 0 PAUL O'SHEA 2.00 X X 0 0 0 PAMELA PAINE 1.00 X X 0 0 0 GEORGE KAPLAN 1.00 X 0 0 0 JACK VONDRAS 1.00 X 0 0 0 LUCY CORCHADO 1.00 X 0 0 0 CALVIN YOUNG 1.00 X 0 0 0 JAY PANDEY 40.00 X X 131912 0 13657 LUCAS MIKULIC 40.00 X X 128143 0 13657 GABRIELLE DEMILLE 40.00 X X 105444 0 12515 GLORIA RILEY 40.00 X 80462 0 0 KEVIN RUBNICH 40.00 X 93885 0 5311 DR ROBERT HENDERSHOTT 40.00 X 205668 0 125345 651629 0 165174 5 1 1 0 D & Y STAFFING 27 CONGRESS STREET SALEM MA 01970 STAFFING AGENCY - MEDICAL 335305 NORTH SHORE PHYSICIANS GROUP INC 61 ELM ST DANVERS MA 01923 OB/GYN SERVICES 109654 2 1674256 525283 2199539 PATIENT SERVICE FEES 621110 3032132 3032132 MEDICARE/MEDICAID PAYM 621110 2338569 2338569 PHARMACY SALES, NET 621110 463429 463429 5834130 10234 10234 MISCELLANEOUS REVENUE 621110 66540 66540 66540 8110443 5900670 0 10234 119927 119927 4008451 3532162 476289 611135 502791 108344 283141 248913 34228 53913 53913 24437 24437 15804 15804 82178 82178 345501 330198 15303 142239 130415 11824 374747 342951 31796 42223 22531 19692 41774 31748 10026 281359 235061 46298 47932 39189 8743 CONTRACTED SERVICES 964431 963509 922 MEDICAL SUPPLIES 357194 357194 DISPENSING FEES 355599 355599 BAD DEBTS 303827 303827 DUES AND SUBSCRIPTIONS 69641 41229 28412 58875 24171 34704 8584328 7461488 1122840 0 723958 309989 824808 333995 838688 848456 1136295 1572545 19095 81603 70017 4093566 1779736 2260545 2313830 5884992 5448832 478170 1013058 1237311 740148 1715481 1753206 X 3595041 3121116 574470 574510 4169511 3695626 5884992 5448832 -473885 0 X 0 1 1 X 1 1 X 1197957 1344767 1692982 2707564 2199539 9142809 1197957 1344767 1692982 2707564 2199539 9142809 9142809 32434 26850 13988 12855 10234 96361 2286 4990 44714 130174 66540 248704 9487874 18356796 0.96360 0.96420 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART II, LINE 10, EXPLANATION FOR OTHER INCOME: RENTAL INCOME AND MISCELLANEOUS REVENUE. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1412101 62834 1349267 1946015 1119443 826572 735450 597459 137991 0 2313830 8110443 8584328 -473885 0 -473885 8347576 237133 237133 8110443 0 8110443 8821461 237133 237133 8584328 0 8584328 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HEALTH CENTER FOLLOWS THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES STANDARD WHICH REQUIRES THE HEALTH CENTER TO REPORT UNCERTAIN TAX POSITIONS, RELATED INTEREST AND PENALTIES, AND TO ADJUST ITS ASSETS AND LIABILITIES RELATED TO UNRECOGNIZED TAX BENEFITS AND ACCRUED INTEREST AND PENALTIES ACCORDINGLY. AS OF JUNE 30, 2011, THE HEALTH CENTER DETERMINED THAT THERE ARE NO MATERIAL UNRECOGNIZED TAX BENEFITS TO REPORT. INFORMATION RETURNS FILED FOR FISCAL YEARS PRIOR TO JUNE 30, 2008 ARE NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND COMMONWEALTH OF MASSACHUSETTS. THE HEALTH CENTER DOES NOT EXPECT THAT THE AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL CHANGE SIGNIFICANTLY WITHIN THE NEXT TWELVE MONTHS. 1 X X X X 0 0 0 0 0 0 0 0 0 DR ROBERT HENDERSHOTT 205668 0 0 0 0 0 0 0 345 0 206013 0 0 0 PAUL O'SHEA BOARD TREASURER 18124 PAUL O'SHEA IS THE PRESIDENT OF AN ORGANIZATION THAT IS ENGAGED BY NORTH SHORE COMMUNITY HEALTH IN THE PROVISION OF CLINICAL CONSULTANT SERVICES. PAUL RESIGNED AS TREASURER IN APRIL, 2011. 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 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 EMPLOYEE'S SALARY 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.