2011-12-09T12:32:42-06:00 2011-06-30 BRAD BORBIDGE PA 197 LOUDON ROAD STE 350 CONCORD NH 03301 990 2010-07-01 020458174 MANCHESTER COMMUNITY HEALTH CENTER MANC 6036269500 145 HOLLIS STREET 2ND FLOOR MANCHESTER NH 03101 EDWARD GEORGE 6036269500 2011-11-25 DIMITRIOS PANACOPOULOS CPA 6032240849 2010 2016-02-24 21:20:13Z EDWARD GEORGE 145 HOLLIS STREET 2ND FLOOR MANCHESTER NH 03101 5025323 0 X WWW.MCHC-NH.ORG X 1992 NH THE MISSION OF MANCHESTER COMMUNITY HEALTH CENTER IS TO FOSTER, BOTH THROUGH DIRECT SERVICES AND COLLABORATION, HIGH-QUALITY, COMPREHENSIVE FAMILY ORIENTED PRIMARY HEALTH-CARE SERVICES, WHICH MEET THE NEEDS OF A DIVERSE COMMUNITY REGARDLESS OF AGE, ETHNICITY OR INCOME. OUR FOCUS IS TO PROVIDE ACCESS TO THOSE WHO CANNOT ACCESS PRIMARY HEALTH CARE SERVICES. 17 17 77 12 0 0 2312308 2298960 2844277 2721545 7898 4818 0 0 5164483 5025323 0 0 0 0 3352805 3882936 0 0 65812 1333620 1588042 4686425 5470978 478058 -445655 5387805 4743590 2118523 1900581 3269282 2843009 X THE MISSION OF MANCHESTER COMMUNITY HEALTH CENTER IS TO FOSTER, BOTH THROUGH DIRECT SERVICES AND COLLABORATION, HIGH-QUALITY, COMPREHENSIVE FAMILY ORIENTED PRIMARY HEALTH-CARE SERVICES, WHICH MEET THE NEEDS OF A DIVERSE COMMUNITY REGARDLESS OF AGE, ETHNICITY OR INCOME. OUR FOCUS IS TO PROVIDE ACCESS TO THOSE WHO CANNOT ACCESS PRIMARY HEALTH CARE SERVICES. 0 0 4015273 2721545 TO PROVIDE PRIMARY OUTPATIENT MEDICAL CARE, COUNSELING SERVICES AND NUTRITIONAL CONSULTATION TO INDIVIDUALS IN THE MANCHESTER NH AREA. 4015273 1 1 0 0 0 0 0 0 0 1 0 0 1 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 27 0 1 77 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NH X EDWARD GEORGE 6036269500 145 HOLLIS STREET 2ND FLOOR MANCHESTER NH 03101 JAMES BURNETT X 0 0 0 ANTHONY CHISMARK X 0 0 0 CAROLE O'KEEFE X 0 0 0 HELEN MAURIZIO X 0 0 0 MYRA NIXON X 0 0 0 ELIZABETH CLEARY X 0 0 0 NANCY LOISELLE X 0 0 0 JEFFREY MICHAELSON X 0 0 0 MARIA MARIANO X 0 0 0 MUKHTAR IDHOW X 0 0 0 GERMANO MARTINS X 0 0 0 KATHLEEN PROULX X 0 0 0 GERRI PROVOST X 0 0 0 DOMINIQUE RUST X 0 0 0 SONIA STAGEN X 0 0 0 GLORIA YOUNG X 0 0 0 TONI PAPPAS X 0 0 0 EDWARD GEORGE 40.00 X 139811 0 15362 ANN-MARIE MILLER 40.00 X 73203 0 8669 J GAVIN MUIR MD 40.00 X 202166 0 15000 LAURA FRY MD 40.00 X 180284 0 12007 PETER KIPROP 40.00 X 153159 0 13619 FADI WEHBI 40.00 X 148599 0 10579 897222 0 75236 5 0 1 0 0 2245804 53156 2298960 PRIMARY MEDICAL CARE S 621110 2721545 2721545 2721545 4818 4818 5025323 2721545 0 4818 454211 217166 237045 2879420 2202705 628931 47784 285737 208559 73035 4143 263568 192378 67368 3822 17952 17952 31667 31667 482431 352126 130305 12626 12626 38075 27791 9732 552 158897 115979 40614 2304 5339 894 4445 26034 16904 9130 72563 52964 18547 1052 170261 124274 43518 2469 31416 22931 8029 456 PROGRAM SUPPLIES 168532 168532 BAD DEBTS 149446 149446 OTHER EXPENSES 84295 61527 21546 1222 PRINTING AND PUBLICATIO 65022 47460 16619 943 EQUIPMENT RENTAL/REPAIR 29889 21816 7640 433 43597 31821 11144 632 5470978 4015273 1389893 65812 445786 42014 298845 503580 237894 323558 208849 68178 3622245 615023 2939124 3007222 442062 442971 815245 356067 5387805 4743590 543975 381611 1574548 1518970 2118523 1900581 X 2562783 2421290 706499 421719 3269282 2843009 5387805 4743590 X -445655 19382 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 81000 81000 2680810 210567 2470243 860435 404456 455979 3007222 ASSETS LIMITED AS TO USE 181638 DUE FROM THIRD PARTY PAYERS 174429 356067 5025323 5470978 -445655 19382 19382 -426273 5044705 19382 19382 5025323 0 5025323 5470978 0 5470978 0 5470978 THE HEALTH CENTER IS A PUBLIC CHARITY UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. AS A PUBLIC CHARITY, THE HEALTH CENTER 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 HEALTH CENTERS TAX POSITIONS AND CONCLUDED THAT THE HEALTH CENTER HAS NO UNRELATED BUSINESS INCOME OR UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. 1 X X X X 0 0 0 0 0 0 0 1 0 EDWARD GEORGE 139811 0 0 0 0 0 0 0 15362 0 155173 0 0 0 J GAVIN MUIR MD 168755 0 0 0 33411 0 0 0 15000 0 217166 0 0 0 LAURA FRY MD 141154 0 0 0 39130 0 0 0 12007 0 192291 0 0 0 PETER KIPROP 120054 0 0 0 33105 0 0 0 13619 0 166778 0 0 0 FADI WEHBI 126394 0 0 0 22205 0 0 0 10579 0 159178 0 0 0 PART I, LINE 7 PHYSICIANS ARE ELIGIBLE TO PARTICIPATE IN THE INCENTIVIZED VARIABLE COMPENSATION PLAN, WHICH PROVIDES FOR VARIABLE PAYMENTS TO BASED UPON CLINICAL VOLUME, COMPLEXITY AND QUALITY MEASURES. EDWARD GEORGE MCHC CEO SERVES AS MEMBER OF THE BOARD OF COMMUNITY HEALTH ACCESS NETWORK 202926 TRANSACTIONS INCLUDE PURCHASE OF IT SYSTEM: $102,381, SHARED IT SERVICES: $82,395, AND ANNUAL MEMBERSHIP DUES OF $18,150. 0 EDWARD GEORGE MCHC CEO SERVES AS BOARD CHAIR OF BI-STATE PRIMARY CARE ASSOCIATION 110196 MCHC RECEIVES GRANT FUNDS PASSED THROUGH THIS ENTITY, WHICH WAS FORMED FOR ADVOCACY AND TECHNICAL ASSISTANCE FOR SIMILAR ORGANIZATIONS IN NH AND VT $102,733 AND PAID ANNUAL MEMBERSHIP DUES OF $7,463. 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS AND ALL MEMBERS OF THE BOARD OF DIRECTORS FOR REVIEW AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY INCLUDES AN ANNUAL DISCLOSURE AND MONITORING PROCESS REGARDING EXTERNAL INTERESTS OF BOARD MEMBERS AND KEY MANAGEMENT THAT COULD GIVE RISE TO CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE DIRECTOR COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 19,382. REASON FOR PUBLIC CHARITY STATUS SCHEDULE A, PART I THE ORGANIZATION IS EXEMPT UNDER 170(B)(1)(A)(III), AS A HOSPITAL. THE ORGANIZATION OPERATES A FEDERALLY QUALIFIED HEALTH CENTER. THE HEALTH CENTER IS NOT REGISTERED WITH THE STATE OF NEW HAMPSHIRE AS A HOSPITAL. ACCORDINGLY NO SCHEDULE H IS ATTACHED.