2012-05-15T07:35:37-05:00 2011-09-30 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2010-10-01 870807914 CORE PHYSICIANS LLC CORE 6035806695 5 ALUMNI DRIVE EXETER NH 03833 OFFICER 6035806695 2012-05-09 1 MICHAEL A BARBARITA CPA 6036228881 2010 2016-02-24 21:20:13Z DEBRA CRESTA 5 ALUMNI DRIVE EXETER NH 03833 65020302 0 X WWW.COREPHYSICIANS.ORG X LIMITED LIABILITY CORPORATION 2007 NH THE MISSION OF CORE PHYSICIANS IS TO IMPROVE THE HEALTH OF THE COMMUNITY. THIS MISSION IS PRINCIPALLY ACCOMPLISHED THROUGH THE PROVISION OF HEALTH SERVICES AND INFORMATION TO THE COMMUNITY. AS A MULTI-SPECIALTY GROUP PRACTICE, CORE PHYSICIANS PROVIDES COMMUNITY ACCESS TO PRIMARY CARE PHYSICIANS, SPECIALTY PHYSICIAN SERVICES, ADULT AND PEDIATRIC DENTAL SERVICES, OFFICE BASED LABORATORY SERVICE, AS WELL CONTRACTED PHYSICIANS TO SUPPORT EXETER HOSPITAL'S 24/7 INTENSIVEST COVERAGE PROGRAM IN ITS ICU, AND INPATIENT HOSPITALIST PROGRAM. CORE PHYSICIANS SUPPORTS ACCESS TO ITS PHYSICIANS AND MEDICAL SERVICES THROUGH A ROBUST FINANCIAL ASSISTANCE PROGRAM THAT UNDERWRITES UP TO 100% OF THE COST OF MEDICAL CARE PROVIDED BY ITS PHYSICIANS BASED ON FAMILY SIZE AND INCOME FOR RESIDENTS OF THE SERVICE AREA. 9 0 594 0 46764 21090 0 0 55395352 59122869 2966 1626 3310212 5895807 58708530 65020302 0 0 0 0 52414885 57743388 0 0 0 18816206 19327414 71231091 77070802 -12522561 -12050500 12152030 12427990 7834770 8420348 4317260 4007642 X THE MISSION OF CORE PHYSICIANS IS TO IMPROVE THE HEALTH OF THE COMMUNITY. THIS MISSION IS PRINCIPALLY ACCOMPLISHED THROUGH THE PROVISION OF HEALTH SERVICES AND INFORMATION TO THE COMMUNITY. AS A MULTI-SPECIALTY GROUP PRACTICE, CORE PHYSICIANS PROVIDES COMMUNITY ACCESS TO PRIMARY CARE PHYSICIANS, SPECIALTY PHYSICIAN SERVICES, ADULT AND PEDIATRIC DENTAL SERVICES, OFFICE BASED LABORATORY SERVICE, AS WELL CONTRACTED PHYSICIANS TO SUPPORT EXETER HOSPITAL'S 24/7 INTENSIVEST COVERAGE PROGRAM IN ITS ICU, AND INPATIENT HOSPITALIST PROGRAM. CORE PHYSICIANS SUPPORTS ACCESS TO ITS PHYSICIANS AND MEDICAL SERVICES THROUGH A ROBUST FINANCIAL ASSISTANCE PROGRAM THAT UNDERWRITES UP TO 100% OF THE COST OF MEDICAL CARE PROVIDED BY ITS PHYSICIANS BASED ON FAMILY SIZE AND INCOME FOR RESIDENTS OF THE SERVICE AREA. 0 0 65207666 64971912 CORE PHYSICIANS PROVIDES ACCESS TO PRIMARY CARE SERVICES TO MORE THAN 50,000 SEACOAST AREA RESIDENTS OF ALL AGES AND ALL DEMOGRAPHIC AND SOCIO-ECONOMIC BACKGROUNDS REGARDLESS OF THEIR ABILITY TO PAY. CORE PHYSICIANS HAS OVER 59 PRIMARY CARE PHYSICIANS LOCATED IN 15 LOCATIONS ACROSS THE SEACOAST. IN 2011 CORE PHYSICIANS SUPPORTED ITS MISSION BY SUPPORTING $6,966,405 IN COMMUNITY OUTREACH, BENEFITS AND FINANCIAL SUPPORT TO THE COMMUNITY EXCLUDING $12,228,186 IN UNCOVERED MEDICARE EXPENSES. PHYSICIANS PRIMARY CARE SERVICES ARE BROKEN DOWN INTO THREE SPECIALTIES INCLUDING PEDIATRICS, FAMILY PRACTICE AND INTERNAL MEDICINE. CORE PHYSICIANS PEDIATRIC PRACTICE HAS RECEIVED NATIONAL RECOGNITION FOR ITS PIONEERING WORK IN THE DEVELOPMENT OF THE PATIENT CENTERED MEDICAL HOME MODEL. CORE PHYSICIANS PEDIATRICIANS ALSO SUPPORT THE REGION'S ONLY FORMALIZED MEDICAL EVALUATION SERVICE FOR VICTIMS OF CHILD ABUSE. CORE PHYSICIANS PROVIDES FINANCIAL ASSISTANCE TO INDIVIDUALS WHO ARE UNABLE TO PAY FOR ALL OR PART OF THE COST OF THEIR MEDICAL CARE. CORE PHYSICIANS FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE TO ALL INDIVIDUALS WHO MEET THE FINANCIAL ELIGIBILITY REQUIREMENTS AND WHO LIVE WITHIN CORE PHYSICIANS' SPECIFIED SERVICE AREA FOR MEDICALLY NECESSARY SERVICES. CORE PHYSICIANS' FINANCIAL ASSISTANCE PROGRAM IS ALSO PROMOTED IN THE COMMUNITY THROUGH ITS LONG TERM AFFILIATION WITH SEACARE, AN INDEPENDENT, COMMUNITY NOT-FOR PROFIT THAT IS COMMITTED TO CREATING ACCESS TO MEDICAL AND SOCIAL SUPPORT SERVICES FOR RESIDENTS WHO NEED THE SUPPORT. IN ORDER TO SUPPORT THE MORE COMPLEX MEDICAL NEEDS OF OUR PRIMARY CARE PATIENTS AND THOSE OF UNAFFILIATED PATIENTS FROM ACROSS OUR SERVICE AREA, CORE PHYSICIANS PROVIDES A FULL RANGE OF MEDICAL AND SURGICAL SPECIALTIES. OUR AREAS OF SPECIALIZATION INCLUDE DIABETES, WOMEN'S HEALTH, COLORECTAL SURGERY, PLASTIC SURGERY, GENERAL SURGERY, VASCULAR SURGERY, NEUROLOGY, ORTHOPEDIC SURGERY, PHYSIATRY, RHEUMATOLOGY, UROLOGY, MEDICAL AND INVASIVE CARDIOLOGY, PULMONOLOGY AND SLEEP MEDICINE. OUR SPECIALTY SERVICES CONTINUE TO EXPAND IN ORDER TO REFLECT THE CHANGING AND GROWING HEALTHCARE NEEDS OF OUR COMMUNITY. CORE PHYSICIAN SPECIALISTS ARE BOARD CERTIFIED. CORE PHYSICIANS FINANCIAL ASSISTANCE PROGRAM ALSO EXTENDS TO COVER MEDICALLY NECESSARY SPECIALIST PROFESSIONAL SERVICES FOR INDIVIDUALS WHO MEET OUR ELIGIBILITY REQUIREMENTS. THE DENTAL PROGRAM WHICH IS PART OF CORE PHYSICIANS WAS ORIGINALLY INITIATED AS A SEPARATE AFFILIATED ENTITY IN RESPONSE TO A DOCUMENTED GAP IN THE COMMUNITY RELATED TO THE AVAILABILITY OF DENTAL SERVICES FOR CHILDREN AND ADULTS EITHER WITHOUT INSURANCE OR ON MEDICAID. THE DENTAL PROGRAM IS ONE OF SEVERAL MISSION BASED SPECIALTY MEDICAL SERVICES CORE PHYSICIANS PROVIDES IN THE GREATER SEACOAST COMMUNITY. CORE PHYSICIANS HAS FOUR DENTISTS AND FIVE DENTAL HYGIENISTS WHO PROVIDE DENTAL CARE TO PATIENTS. IN ADDITION TO OPERATING A VERY ACTIVE PEDIATRIC PRACTICE CORE PHYSICIANS ALSO OPERATES A MOBILE DENTAL VAN THAT PARTNERS WITH THE SCHOOL SYSTEMS TO PROVIDE ON-SITE PEDIATRIC DENTAL EVALUATIONS AND CARE. THIS HAS BEEN A HIGHLY SUCCESSFUL PROGRAM THAT HAS HAD A DOCUMENTED IMPACT ON THE AVAILABILITY OF DENTAL SERVICES TO CHILDREN IN THE NEW HAMPSHIRE SEACOAST AREA REGARDLESS OF THEIR ABILITY TO PAY. 65207666 1 0 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 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 1 0 0 1 0 1 91 0 1 594 1 1 1 0 0 0 0 0 0 0 0 0 X 9 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X KEVIN J O'LEARY 6035806695 5 ALUMNI DRIVE EXETER NH 03833 DEBRA CRESTA 40.00 X X 0 312760 37916 MICHAEL PANGAN MD 40.00 X X 239022 0 35388 KEVIN J O'LEARY 1.00 X X 0 407282 100431 KEVIN J CALLAHAN 1.00 X 0 763615 196848 TARANEH AZAR MD 40.00 X X 625209 0 28442 NICHOLAS GARCIA MD 40.00 X 445758 0 28553 RICHARD HOLLISTER MD 40.00 X 416810 0 29678 MARTIN PRUSS MD 40.00 X 173619 0 27376 ALEXANDRA BONESHO MD 40.00 X 186754 0 27593 PETER IHM 40.00 X 578394 0 33529 ALLISON CASASSA 1.00 X 0 146478 14661 CONSTANCE SPRAUER 1.00 X 0 294345 32331 THOMAS MCGOVERN 40.00 X 649219 0 29829 ROGER NOWAK 40.00 X 585741 0 22773 KIMBERLY MARBLE 40.00 X 786632 0 37829 AARON COLMAN MD 40.00 X 497341 0 28499 JAMES GLENNON MD X 237511 0 25973 5422010 1924480 737649 108 1 1 0 EXETER HOSPITAL 5 ALUMNI DRIVE EXETER NH 03833 SUPPORT SERVICES 1261012 EXETER HEALTH RESOURCES 5 ALUMNI DRIVE EXETER NH 03833 ADMINISTRATIVE MANAGEMENT SERVICES 870736 NEXTGEN HEALTHCARE 18111 VON KARMAN AVE IRVINE CA 92612 BILLING SOFTWARE & SUPPORT 745636 PHYTEL INC 11511 LUNA ROAD DALLAS TX 75234 APPT REMINDERS 160139 MEDICAL CALL CENTER PO BOX 635013 CINCINNATI OH 45263 AFTER HOURS CALL CENTER 141070 8 NET PATIENT SERVICE RE 621110 59122869 59122869 59122869 1626 1626 OTHER OPERATING INCOME 621110 5134443 5134443 MEDICAL DIRECTOR FEES 621110 687995 687995 PHYSICIAN PRACTICE MGM 621110 46764 46764 26605 26605 5895807 65020302 64971912 46764 1626 2665568 2220151 445417 45181588 37631745 7549843 907912 756200 151712 6500485 5414254 1086231 2487835 2072118 415717 51667 51667 6240 6240 352736 349209 3527 503174 419094 84080 370292 308416 61876 4068183 3388390 679793 487215 405801 81414 12065 10049 2016 2217813 2217813 1214245 1011345 202900 1499360 1499360 SUPPLIES 2375180 1978287 396893 BAD DEBTS 1998672 1998672 OUTSIDE FEES/CONSULTING 1542826 1285020 257806 SERVICE CONTRACTS 1199435 999009 200426 TELEPHONE 448364 373442 74922 979947 869291 110656 77070802 65207666 11863136 0 1192500 261556 3958161 4884821 1047569 2062317 14711533 10755132 4739058 3956401 358066 358066 856676 904829 12152030 12427990 5467671 6032499 2367099 2387849 7834770 8420348 X 4317260 4007642 4317260 4007642 12152030 12427990 X -12050500 11740882 X X 0 1 0 X 0 X 33078064 52046692 58705564 65020302 208850622 33078064 52046692 58705564 65020302 208850622 0 0 0 208850622 5638 12725 2966 1626 22955 5638 12725 2966 1626 22955 35682 80389 37021 46764 199856 33119384 52139806 58745551 65068692 209073433 0.99890 0.00010 X 0 1 0 0 0 0 1 6240 0 0 6240 0 367457 235770 131687 2375646 1864950 510696 11968430 8654412 3314018 3956401 INVESTMENT - DEFERRED COMP 904829 904829 DUE TO RELATED ENTITIES 1380104 DEFERRED COMPENSATION 904829 DUE TO THIRD PARTY PAYERS 102916 2387849 X 0 1 X X X X 0 1 0 0 0 0 0 1 0 DEBRA CRESTA 0 219453 0 66085 0 27222 0 14700 0 23216 0 350676 0 0 MICHAEL PANGAN MD 171626 0 50252 0 17144 0 7350 0 28038 0 274410 0 0 0 KEVIN J O'LEARY 0 267031 0 90019 0 50232 0 82700 0 17731 0 507713 0 0 KEVIN J CALLAHAN 0 490965 0 175136 0 97514 0 174700 0 22148 0 960463 0 0 TARANEH AZAR MD 402810 0 205243 0 17156 0 7350 0 21092 0 653651 0 0 0 NICHOLAS GARCIA MD 408166 0 20611 0 16981 0 7350 0 21203 0 474311 0 0 0 RICHARD HOLLISTER MD 303732 0 96040 0 17038 0 7350 0 22328 0 446488 0 0 0 MARTIN PRUSS MD 165141 0 1111 0 7367 0 5303 0 22073 0 200995 0 0 0 ALEXANDRA BONESHO MD 159170 0 10676 0 16908 0 5728 0 21865 0 214347 0 0 0 PETER IHM 355942 0 205243 0 17209 0 7350 0 26179 0 611923 0 0 0 ALLISON CASASSA 0 105783 0 39242 0 1453 0 8930 0 5731 0 161139 0 0 CONSTANCE SPRAUER 0 198860 0 52636 0 42849 0 14700 0 17631 0 326676 0 0 THOMAS MCGOVERN 510444 0 105145 0 33630 0 7350 0 22479 0 679048 0 0 0 ROGER NOWAK 523908 0 44703 0 17130 0 7350 0 15423 0 608514 0 0 0 KIMBERLY MARBLE 396286 0 372928 0 17418 0 7350 0 30479 0 824461 0 0 0 AARON COLMAN MD 455265 0 8680 0 33396 0 7350 0 21149 0 525840 0 0 0 JAMES GLENNON MD 136112 0 81277 0 20122 0 7135 0 18838 0 263484 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS UP PAYMENTS WERE PROVIDED TO DEBRA CRESTA, CONSTANCE SPRAUER, KEVIN CALLAHAN, KEVIN O'LEARY, ALLISON CASSASSA, ALL CORE CLINICAL MANAGERS, AARON COLMAN AND KIMBERLY MARBLE (FOR ACQUISITION OF SUPPLEMENTAL LONG TERM DISABILITY INSURANCE). THE BENEFIT WAS TREATED AS TAXABLE INCOME. PART I, LINE 1B THERE WAS NO EXISTING POLICY CONCERNING TAX INDEMNIFICATION AND GROSS UP PAYMENTS. HOWEVER, IN THE INSTANCE OF SUCH ACTION RELATED TO THE ACQUISITION OF LONG TERM DISABILITY INSURANCE DESCRIBED ABOVE, THE TAX INDEMNIFICATION AND GROSS UP PAYMENTS WERE APPROVED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES EXECUTIVE COMMITTEE COMPRISED OF DISINTERESTED PERSONS. PART I, LINE 4B THE ORGANIZATION'S PARENT (EXETER HEALTH RESOURCES, INC.) MAINTAINS A SPLIT DOLLAR SUPPLEMENTAL RETIREMENT PLAN FOR 2 EXECUTIVES (LISTED BELOW WITH AMOUNTS) SELECTED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. THE PLAN IS CLOSED TO FUTURE PARTICIPANTS. THE PLAN PROVIDES FOR ANNUAL PAYMENTS OF PREMIUMS FOR LIFE INSURANCE POLICIES INSURING THE LISTED INDIVIDUALS. THOSE LIFE INSURANCE PREMIUMS ARE COLLATERALLY ASSIGNED TO THE CORPORATION AND ANY EXCESS ACCUMULATED VALUE IN THE POLICIES (NET OF ACCUMULATED PREMIUM PAYMENTS) ARE AVAILABLE TO BE PAID TO THE PARTICIPANT ONCE VESTED AT AGE 62. KEVIN CALLAHAN - EXCESS ACCUMULATED VALUE - $37,726 KEVIN O'LEARY - EXCESS ACCUMULATED VALUE - $10,615 CERTAIN OF THE LISTED EMPLOYEES PARTICIPATE IN A NONQUALIFIED DEFERRED COMPENSATION PLAN AS DESCRIBED IN INTERNAL REVENUE CODE SECTION 457(F) SPONSORED BY EHR. IN THE CALENDAR YEAR ENDED DEC 31, 2010 THE CONTRIBUTION TO THE PLAN FOR THE NON-VESTED BENEFIT OF KEVIN CALLAHAN WAS $168,000 AND THE CONTRIBUTION TO THE PLAN FOR THE NON-VESTED BENEFIT OF KEVIN O'LEARY WAS $68,000. PARTICIPANTS IN THE 457(F) PLAN DO NOT VEST UNTIL AGE 62. PART I, LINE 7 THE PARENT ORGANIZATION (EXETER HEALTH RESOURCES, INC) PROVIDES AN ANNUAL INCENTIVE COMPENSATION PLAN FOR EXECUTIVES SELECTED BY THE EXETER HEALTH RESOURCES BOARD. THESE EXECUTIVES INCLUDE: KEVIN CALLAHAN, KEVIN O'LEARY, CONSTANCE SPRAUER, ALLISON CASSASA, DEBRA CRESTA. THE EXETER HEALTH RESOURCES BOARD AND/OR ITS EXECUTIVE COMMITTEE APPROVES MEASUREABLE ACHIEVEMENT CRITERIA FOR QUALITY, PATIENT SATISFACTION, PROCESS IMPROVEMENT, FINANCIAL PERFORMANCE, SERVICES INNOVATION AND OTHER COMPELLING AREAS OF STRATEGIC AND OPERATIONAL INTEREST. ADDITIONALLY THE EXETER HEALTH RESOURCES BOARD AND/OR ITS EXECUTIVE COMMITTEE ESTABLISHES MINIMUM, TARGETED AND MAXIMUM LEVELS FOR INCENTIVE AWARDS AND APPROVES ALL AWARDS FOR PARTICIPATING EXECUTIVES. CORE PHYSICIANS HAS A COMPENSATION PLAN THAT IS BASED UPON COMPETITIVE MARKET RATES RELATIVE TO A PHYSICIAN'S SPECIALTY. THE ORGANIZATION UTILIZES THE SERVICES OF AN OUTSIDE COMPENSATION CONSULTANT TO DETERMINE MARKET BENCHMARKS. TOTAL COMPENSATION CONSISTS OF A BASE SALARY, A POTENTIAL FOR A PRODUCTIVITY BONUS, AN ON-CALL STIPEND (IF APPLICABLE), A MEDICAL DIRECTORSHIP STIPEND(IF APPLICABLE), A CITIZENSHIP AND QUALITY PAYMENT THAT IS EARNED BASED UPON THE ACHIEVEMENT OF OBJECTIVES SET IN ADVANCE. THE PRODUCTIVITY BONUS IS BASED ON WORK RELATIVE VALUE UNITS (WRVU) PRODUCTION AND WOULD BE ELIGIBLE TO ANYONE WHO PRODUCES WRVU'S ABOVE HIS BASE SALARY WRVU LEVEL. BASE COMPENSATION IS ALSO ADJUSTED IF WORK RELATIVE VALUE UNITS FALL BELOW THE BASE SALARY WRVU EQUIVALENCY LEVEL. THE PHYSICIANS' COMPENSATION IS APPROVED BY CORE PHYSICIANS, LLC'S COMPENSATION COMMITTEE WHICH IS COMPRISED OF SYSTEM MANAGERS WHO ARE APPROVED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 6 EXETER HEALTH RESOURCES, INC. IS THE SOLE MEMBER OF CORE PHYSICIANS, LLC FORM 990, PART VI, SECTION A, LINE 7A CORE'S GOVERNING BODY IS MADE UP OF 2 CLASSES OF MANAGERS: SYSTEM MANAGERS AND CLINICIAN MANAGERS. THE 3 SYSTEM MANAGERS ARE THE PRESIDENT (EX-OFFICIO), AND TREASURER (EX-OFFICIO), OF EXETER HEALTH RESOURCES, INC. CORE'S SOLE MEMBER, AND CORE'S CEO (EX-OFFICIO), WHO ARE APPOINTED BY THE EXETER HEALTH RESOURCES, INC BOARD OF TRUSTEES. THE CLINICIAN MANAGERS ARE NOMINATED BY THE CORE CLINICIANS AND APPOINTMENT AS A CLINICIAN MANAGER IS SUBJECT TO THE APPROVAL OF THE EXTETER HEALTH RESOURCES, INC BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE AUTHORITY TO APPROVE BUDGETS, AUTHORIZE MAJOR NON-OPERATIONAL TRANSACTIONS, DISSOLVE THE LLC, DESIGNATE THE FISCAL YEAR AND APPOINT A CPA FOR THE CONDUCT OF AN AUDIT, CHANGE THE LLC'S NAME, AMEND THE OPERATING AGREEMENT AND REQUIRE THE LLC TO COMPLY WITH CERTAIN POLICIES AND PROCEDURES OF THE MEMBER FOR GOVERNANCE OF THE SYSTEM. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PREPARED BY AN OUTSIDE TAX ACCOUNTANT WITH INFORMATION PROVIDED BY THE ORGANIZATION. THE 990 IS REVIEWED BY THE ORGANIZATION'S TREASURER AND THEN PRESENTED TO THE CLINICAL MANAGERS AND SYSTEM MANAGERS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE SYSTEM MANAGERS HAVE ADOPTED A CONFLICT OF INTEREST POLICY THAT REQUIRES THE DISCLOSURE OF CONFLICTS OF INTEREST EITHER WHEN THE INTEREST BECOMES A MATTER OF POSSIBLE ACTION BY THE BOARD OR DURING AN ANNUAL DISCLOSURE PROCESS. DIRECTORS (A/K/A MANAGERS), OFFICERS, AND KEY EMPLOYEES, AS WELL AS ALL MEMBERS OF SENIOR MANAGEMENT, ARE PART OF THE ANNUAL DISCLOSURE PROCESS, WHICH IS INITIATED BY THE ISSUANCE OF A MEMORANDUM AND ACCOMPANYING QUESTIONNAIRE BY THE PRESIDENT. ALL DISCLOSURES ARE REVIEWED. ANY MANAGER WITH A CONFLICT OF INTEREST IS REQUIRED TO ABSTAIN FROM VOTING OR A QUORUM DETERMINATION ON THE MATTER AND ANY OFFICER, KEY EMPLOYEE, OR MEMBER OF SENIOR MANAGEMENT WITH A CONFLICT DOES NOT TAKE PART IN MAKING AND IS NOT PRESENT FOR ANY DECISION REGARDING THE MATTER. THE POLICY IS MONITORED AND ENFORCED BY BOTH THE PRESIDENT AND THE FULL BOARD. A SEPARATE ORGANIZATIONAL POLICY REQUIRES ALL EMPLOYEES TO DISCLOSE ANY CONFLICT OF INTEREST IN WRITING UPON HIRE. THEREAFTER, ON AN ANNUAL BASIS STAFF WITHIN HUMAN RESOURCES SURVEY (A) ALL PROVIDERS, (B) ALL EMPLOYEES AND CONTRACTED STAFF SERVING IN A MANAGERIAL ROLE, AND (C) ALL MEMBERS OF ANY COMMITTEES WHICH MAKE RECOMMENDATIONS OR DECISIONS REGARDING THE PURCHASE OF GOODS OR SERVICES AS A MEANS TO ENSURE THAT ANY CONFLICT OF INTEREST IS APPROPRIATELY DISCLOSED AND MANAGED. EMPLOYEES OTHERWISE ARE REQUIRED TO SUPPLEMENT OR MAKE ANY FURTHER WRITTEN DISCLOSURE AT THE TIME A CONFLICT ARISES. THIS POLICY IS MONITORED AND ENFORCED BY THE DEPARTMENT OF HUMAN RESOURCES, AS WELL AS CORE'S PRESIDENT AND COMPLIANCE OFFICER. ANY CONFLICT OF INTEREST IS MANAGED UNDER THIS POLICY BY DISCLOSURE, RECUSAL, OR DIVESTITURE OF THE INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S PARENT(EXETER HEALTH RESOURCES) HAS A FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CORE PRESIDENT AND OTHER SYSTEM MANAGERS THAT IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACHIEVING THE ORGANIZATION'S MISSION, TO RECOGNIZE INDIVIDUAL AND TEAM PERFORMANCE, AND TO COMPLY WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE EXECUTIVE COMMITTEE OF THE EXETER HEALTH RESOURCES' BOARD OF TRUSTEES CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE CORE PRESIDENT AND OTHER LISTED SYSTEM MANAGERS. IN DOING SO, THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE MARKET RANGES OF BASE, INCENTIVE, AND TOTAL CASH COMPENSATION, AND TO PROVIDE ADVICE CONCERNING THE REASONABLENESS OF THE COMPENSATION OF THE CORE PRESIDENT AND OTHER SYSTEM MANAGERS. THE EXETER HEALTH RESOURCES EXECUTIVE COMMITTEE UTILIZES THAT ANALYSIS AND OTHER APPROPRIATE INFORMATION IN CONNECTION WITH ITS ANNUAL REVIEW OF THE COMPENSATION OF THE CORE PRESIDENT AND CORE'S OTHER SYSTEM MANAGERS. INFORMATION WHICH THE COMMITTEE MAY CONSIDER CAN INCLUDE BUT IS NOT LIMITED TO THE PERFORMANCE OF THE CORE PRESIDENT AND OTHER SYSTEM MANAGERS INDIVIDUALLY OR COLLECTIVELY AS EXECUTIVE MANAGEMENT TEAM MEMBERS, THE PERFORMANCE OF THE ORGANIZATION IN WHOLE OR IN PART, THE ELEMENTS OF TOTAL COMPENSATION AND SALARY HISTORY, THE ORGANIZATION'S COMPENSATION TARGETS AND COMPARABILITY DATA, INCLUDING THE DATA PREPARED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE COMMITTEE. THE COMMITTEE INCORPORATES A PERFORMANCE APPRAISAL PROCESS FOR THE CORE PRESIDENT AND OTHER SYSTEM MANAGERS' COMPENSATION REVIEW. CORE'S PRESIDENT AND OTHER SYSTEM MANAGERS ARE NOT PRESENT WHEN THE EXECUTIVE COMMITTEE DISCUSSES THEIR RESPECTIVE COMPENSATION. IN ADDITION, THE EXECUTIVE COMMITTEE DETERMINES IF THE THRESHOLD REQUIREMENTS FOR INCENTIVE AWARDS ARE MET CONSISTING OF THE ORGANIZATION'S PERFORMANCE RESULTS FOR QUALITY, OPERATING SYSTEM EXCELLENCE AND FINANCIAL PERFORMANCE. FOR THE PRESIDENT OF CORE, THE EXECUTIVE COMMITTEE CONSIDERS THE RECOMMENDATIONS OF THE SYSTEM MANAGER WHO IS THE PRESIDENT OF THE MEMBER (EXETER HEALTH RESOURCES, INC.) CONCERNING COMPENSATION ADJUSTMENTS AND INCENTIVE AWARDS; THE EXECUTIVE COMMITTEE THEN DETERMINES CORE'S PRESIDENT'S COMPENSATION. FOR THE SYSTEM MANAGER WHO IS THE TREASURER OF THE MEMBER (EXETER HEALTH RESOURCES, INC.), THAT SYSTEM MANAGER'S COMPENSATION IS CONSIDERED BY THE EXECUTIVE COMMITTEE UPON RECOMMENDATION OF THE MEMBER'S (EXETER HEALTH RESOURCES, INC.) PRESIDENT. THE EXECUTIVE COMMITTEE THEN DETERMINES THAT SYSTEM MANAGER'S COMPENSATION WHICH IS SUBSEQUENTLY RATIFIED BY THE BOARD OF TRUSTEES OF THE MEMBER (EXETER HEALTH RESOURCES, INC.). FOR THE SYSTEM MANAGER WHO IS THE PRESIDENT OF THE MEMBER (EXETER HEALTH RESOURCES, INC.), THAT SYSTEM MANAGER'S COMPENSATION IS CONSIDERED BY THE EXECUTIVE COMMITTEE AND THE COMMITTEE MAKES RECOMMENDATIONS CONCERNING THAT SYSTEM MANAGER'S COMPENSATION TO THE BOARD OF TRUSTEES OF THE MEMBER (EXETER HEALTH RESOURCES, INC.) FOR ITS APPROVAL. THE EXECUTIVE COMMITTEE OF THE MEMBER'S BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF THE MEMBER CONSIDER WHETHER THE COMPENSATION ADJUSTMENTS AND PERFORMANCE AWARDS ARE IN THE ORGANIZATION'S BEST INTEREST AND BENEFIT AND COMPLY WITH BOARD OF TRUSTEES APPROVED PARAMETERS. THE COMPENSATION OF THE CORE PHYSICIANS' CHAIRMAN AND OTHER CLINICIAN MANAGERS IS GOVERNED BY THE CORE PHYSICIANS' COMPENSATION PLAN WHICH IS APPROVED SOLELY BY THE SYSTEM MANAGERS (CORE'S PRESIDENT, PRESIDENT OF THE MEMBER AND TREASURER OF THE MEMBER). THE SYSTEM MANAGERS REVIEW COMPARABILITY DATA PREPARED BY A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT WHEN APPROVING COMPENSATION OF THE CLINICIAN MANAGERS INCLUDING THE CHAIRMAN OF CORE. THE SYSTEM MANAGERS CONSIDER WHETHER THE COMPENSATION OF THE CLINICIAN MANAGERS (INCLUDING THE CHAIRMAN OF CORE) AND ANY ADJUSTMENTS TO COMPENSATION ARE IN THE ORGANIZATION'S BEST INTEREST AND BENEFIT AND IN COMPLIANCE WITH CORE PHYSICIAN'S COMPENSATION PLAN. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: TRANSFER FROM AFFILIATE 11,740,882. TOTAL TO FORM 990, PART XI, LINE 5: 11,740,882. FORM 990, PART XII, LINE 2C ORGANIZATION IS PART OF THE CONSOLIDATED OPERATIONS OF EXETER HEALTH RESOURCES, INC. THE EXETER HEALTH RESOURCES EXECUTIVE COMMITTEE IS RESPONSIBLE FOR THE OVERSITE OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. EXETER HEALTH RESOURCES INC 5 ALUMNI DRIVE EXETER NH 03833 020222126 MANAGEMENT AND SUPPORTING ORGANIZATION, HOLDING COMPANY NH 501(C)(3) 11 0 EXETER HOSPITAL 5 ALUMNI DRIVE EXETER NH 03833 222674014 HOSPITAL NH 501(C)(3) 3 EXETER HEALTH RESOURCES INC 0 EXETER HEALTHCARE 5 ALUMNI DRIVE EXETER NH 03833 020360966 SUBACUTE NURSING FACILITY NH 501(C)(3) 9 EXETER HEALTH RESOURCES INC 0 ROCKINGHAM VISITING NURSE ASSOC 5 ALUMNI DRIVE EXETER NH 03833 020274905 HOME CARE, HOSPICE NH 501(C)(3) 9 EXETER HEALTH RESOURCES INC 0 MATRIX HEALTH 5 ALUMNI DRIVE EXETER NH 03833 020473737 MANAGE RESOURCES NH 501(C)(3) 11 EXETER HEALTH RESOURCES INC 0 EXETER MED REAL 5 ALUMNI DRIVE EXETER NH 03833 020418718 REAL ESTATE HOLDING NH 501(C)(25) EXETER HEALTH RESOURCES INC 0 EXETER HEALTH RESOURCES SELF INS TRUST 5 ALUMNI DRIVE EXETER NH 03833 200753662 SELF INSURANCE TRUST NH 501(C)(3) 11 EXETER HEALTH RESOURCES INC 0 CONVERGENT HEALTH SYSTEMS INC 5 ALUMNI DRIVE EXETER NH 03833 021469711 WELLNESS CENTER NH EXETER HEALTH RESOURCES INC C VX HEALTH SERVICES 5 ALUMNI DRIVE EXETER NH 03833 020469712 FITNESS CENTER NH CONVERGENT HEALTH SYSTEMS INC C EXETER MEDICAL SERVICES 5 ALUMNI DRIVE EXETER NH 03833 020419850 INACTIVE PHYSICIAN PRACTICE NH CONVERGENT HEALTH SYSTEMS INC C CORE HEALTH SERVICES OF MA 5 ALUMNI DRIVE EXETER NH 03833 201598042 INACTIVE PHYSICIAN PRACTICE MA EXETER HEALTH RESOURCES INC C 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1 0 1 EXETER HEALTH RESOURCES SELF INS TRUST P 397530 CASH EXETER HEALTH RESOURCES INC R 5950050 CASH EXETER HOSPITAL R 5790883 CASH EXETER HOSPITAL L 1261012 CASH EXETER HEALTH RESOURCES INC L 543174 CASH EXETER MED REAL J 2015149 CASH EXETER HEALTH RESOURCES INC N 327562 CASH EXETER HOSPITAL I 13988 CASH EXETER HOSPITAL K 3644847 CASH