COOS COUNTY FAMILY HEALTH SERVICES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
COOS COUNTY FAMILY HEALTH SERVICES INC (EIN 02-0350051)
Tax period
2010-07-01 to 2011-06-30
Filed
2011-10-31
IRS object ID
201113049349300711
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-10-31T09:44:17-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BRAD BORBIDGE PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1197 LOUDON ROAD STE 350AddressLine1
CityCONCORDCity
StateNHState
ZIP Code03301ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN020350051EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COOS COUNTY FAMILY HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOOSNameControl
Phone6037522040Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PLEASANT STREETAddressLine1
CityBERLINCity
StateNHState
ZIP Code03570ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT PELCHATName
TitleBOARD PRESIDENTTitle
Phone6037527719Phone
Date Signed2011-09-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDIMITRIOS PANACOPOULOS CPAName
Phone6032240849Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonADELE WOODSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1133 PLEASANT STREETAddressLine1
CityBERLINCity
StateNHState
ZIP Code03570ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9261774GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.COOSFAMILYHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1980YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionCOOS COUNTY FAMILY HEALTH SERVICES, INC. IS A COMMUNITY-BASED ORGANIZATION PROVIDING INNOVATIVE, PERSONALIZED, COMPREHENSIVE HEALTH CARE AND SOCIAL SERVICES OF THE HIGHEST QUALITY TO EVERYONE, REGRDLESS OF ECONOMIC STATUS.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees133TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3420596ContributionsGrantsPriorYear
Contributions Grants Current Year3560033ContributionsGrantsCurrentYear
Program Service Revenue Prior Year5664361ProgramServiceRevenuePriorYear
Program Service Revenue CY5699859ProgramServiceRevenueCY
Investment Income Prior Year1273InvestmentIncomePriorYear
Investment Income Current Year1882InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year9086230TotalRevenuePriorYear
Total Revenue Current Year9261774TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6525009SalariesEtcPriorYear
Salaries Etc Current Year6521850SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year104TotalFundrsngExpCurrentYear
Other Expense Prior Year2020691OtherExpensePriorYear
Other Expenses Current Year2226632OtherExpensesCurrentYear
Total Expenses Prior Year8545700TotalExpensesPriorYear
Total Expenses Current Year8748482TotalExpensesCurrentYear
Revenues Less Expenses Prior Year540530RevenuesLessExpensesPriorYear
Revenues Less Expenses CY513292RevenuesLessExpensesCY
Total Assets BOY3271243TotalAssetsBOY
Total Assets EOY3675928TotalAssetsEOY
Total Liabilities BOY1767760TotalLiabilitiesBOY
Total Liabilities EOY1659153TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1503483NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2016775NetAssetsOrFundBalancesEOY
Mission DescriptionCOOS COUNTY FAMILY HEALTH SERVICES, INC. IS A COMMUNITY-BASED ORGANIZATION PROVIDING INNOVATIVE, PERSONALIZED, COMPREHENSIVE HEALTH CARE AND SOCIAL SERVICES OF THE HIGHEST QUALITY TO EVERYONE, REGARDLESS OF ECONOMIC STATUS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense7630922Expense
Revenue5699859Revenue
DescriptionPROVISION OF PRIMARY CARE SERVICES TO THE COMMUNITY.Description
Total Program Service Expense7630922TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109624NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees133NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ADELE WOODSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6037522040TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1133 PLEASANT STREETAddressLine1
CityBERLINCity
StateNHState
ZIP Code03570ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ROBERT PELCHAT
PRESIDENTX000
DENNIS COX
VICE PRESIDENTX000
BETTY GOSSELIN
SECRETARYX000
ALINE BOUCHER
TREASURERX000
MARGE MCCLELLAN
BOARD OF DIRECTORSX000
ASA BROSNAN
BOARD OF DIRECTORSX000
LINDA SLOWIK
BOARD OF DIRECTORSX000
MICHAEL POULIN
BOARD OF DIRECTORSX000
BRENDA GOLDEN HALLISEY
BOARD OF DIRECTORSX000
H GUYFORD STEVER JR
BOARD OF DIRECTORSX000
KENNETH CARGILL
BOARD OF DIRECTORSX000
JOAN MERRILL
BOARD OF DIRECTORSX000
ADELE WOODS
CEO1257250739840.00X
MELISSA FRENETTE
CFO823090630040.00X
PATRICIA COUTURE
COO941650572340.00X
MITCHELL SULLIVAN MD
MEDICAL DIRECTOR15993202851740.00X
BRIAN BEALS
PHYSICIAN16947503207737.50X
GEOFFREY KAMEN
PHYSICIAN11545602137537.50X
KEERTHY KRISHNAMANI
PHYSICIAN15302702465133.50X
THOMAS TEMME
PHYSICIAN12778203005230.50X
JOSEE BOURBEAU MD
PHYSICIAN14715002783034.00X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1175021TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation183923TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ANDROSCOGGIN VALLEY HOSPITALBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line159 PAGE HILL RDAddressLine1
CityBERLINCity
StateNHState
ZIP Code03570ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesRENT/PHYSICIANS/OBDescriptionOfServices
Compensation334325Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Government Grants2355605GovernmentGrants
All Other Contributions1204428AllOtherContributions
Total Contributions3560033TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionHOME HEALTH CARE SRVCSDescription
Business Code621610BusinessCode
Total Revenue Column5699859TotalRevenueColumn
Related Or Exempt Function Income5699859RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue5699859TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1882TotalRevenueColumn
Exclusion$1,882ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9261774TotalRevenueColumn
Related Or Exempt Function Income5699859RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,882ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total510069Total
Program Services311630ProgramServices
Management And General198439ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4639793Total
Program Services4175814ProgramServices
Management And General463979ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total150426Total
Program Services131262ProgramServices
Management And General19164ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total813408Total
Program Services709780ProgramServices
Management And General103628ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total408154Total
Program Services356155ProgramServices
Management And General51999ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total12381Total
Management And General12381ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total42549Total
Management And General42549ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total362484Total
Program Services362484ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total15284Total
Management And General15284ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total79330Total
Program Services69223ProgramServices
Management And General10107ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total135916Total
Program Services135916ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total387732Total
Program Services338335ProgramServices
Management And General49397ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total33839Total
Program Services29528ProgramServices
Management And General4311ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total72177Total
Management And General72177ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total42385Total
Program Services36985ProgramServices
Management And General5400ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total224577Total
Program Services195966ProgramServices
Management And General28611ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total44839Total
Program Services39127ProgramServices
Management And General5712ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROGRAM SUPPLIES281966281966
BAD DEBT EXPENSE221700221700
OTHER EXPENSES70765617509015
PRINTING AND PUBLICATIO66064576478417
TELEPHONE63389553138076

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total69255Total
Program Services60341ProgramServices
Management And General8810ManagementAndGeneral
Fundraising104Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total8748482Total
Program Services7630922ProgramServices
Management And General1117456ManagementAndGeneral
Fundraising104Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY186504BOY
EOY290233EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY173796BOY
EOY129460EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY420749BOY
EOY417670EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY74982BOY
EOY84769EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3903806LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1803639LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1971228BOY
EOY2100167EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY443984BOY
EOY653629EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3271243BOY
EOY3675928EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY799594BOY
EOY784415EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY968166BOY
EOY874738EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1767760BOY
EOY1659153EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY513490BOY
EOY813154EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY975076BOY
EOY1186701EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY14917BOY
EOY16920EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1503483BOY
EOY2016775EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3271243BOY
EOY3675928EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses513292ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3057203CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2988706CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3089355CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3420596CurrentTaxYearMinus1Year
Current Tax Year3560033CurrentTaxYear
Total16115893Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5874315CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5955938CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5860487CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5664361CurrentTaxYearMinus1Year
Current Tax Year5699859CurrentTaxYear
Total29054960Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8931518CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8944644CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8949842CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9084957CurrentTaxYearMinus1Year
Current Tax Year9259892CurrentTaxYear
Total45170853Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50945170853PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2780CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1992CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1477CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1273CurrentTaxYearMinus1Year
Current Tax Year1882CurrentTaxYear
Total9404Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2780CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1992CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1477CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1273CurrentTaxYearMinus1Year
Current Tax Year1882CurrentTaxYear
Total9404Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8934298CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8946636CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8951319CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9086230CurrentTaxYearMinus1Year
Current Tax Year9261774CurrentTaxYear
Total45180257Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99980PublicSupportPercentage509
Prior Year Support Percentage0.99980PriorYearSupportPercentage
Investment Income Percentage0.00020InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00020PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance15874BeginningOfYearBalance
Contributions2003Contributions
Investment Earnings Or Losses-254InvestmentEarningsOrLosses
End Of Year Balance17623EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance12919BeginningOfYearBalance
Contributions2917Contributions
Investment Earnings Or Losses38InvestmentEarningsOrLosses
End Of Year Balance15874EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance11446BeginningOfYearBalance
Contributions1173Contributions
Investment Earnings Or Losses300InvestmentEarningsOrLosses
End Of Year Balance12919EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.96000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.04000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis108555OtherCostOrOtherBasis
Book Value108555BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2272825OtherCostOrOtherBasis
Depreciation737748Depreciation
Book Value1535077BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1522426OtherCostOrOtherBasis
Depreciation1065891Depreciation
Book Value456535BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2100167TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM THIRD PARTY PAYERS41407
ASSETS LIMITED AS TO USE612222
FieldValueIRS element (for citing)
Total Book Value Other Assets653629TotalBookValueOtherAssets
Total Revenue9261774TotalRevenue
Total Expenses8748482TotalExpenses
Excess Or Deficit For Year513292ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS513292ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt9261774TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal9261774RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9909261774TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt8748482TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal8748482ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9908748482TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:INCOME EARNED IS USED FOR OPERATIONS.
THE ORGANIZATION IS A PUBLIC CHARITY UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A PUBLIC CHARITY, THE ORGANIZATION 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 ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAS NO UNRELATED BUSINESS INCOME OR UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation Required1SubstantiationRequired
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MITCHELL SULLIVAN MD
13952502040700000285170188449000
BRIAN BEALS
14906802040700000320770201552000
KEERTHY KRISHNAMANI
13334001968700000246510177678000
THOMAS TEMME
1277820000000300520157834000
JOSEE BOURBEAU MD
1397720737800000278300174980000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11THE CFO COMPARES THE FORM 990 TO THE AUDITED FINANCIAL STATEMENTS AND PRIOR YEAR 990. A COPY IS GIVEN TO THE FINANCE COMMITTEE TO REVIEW AND THEN A COPY IS GIVEN TO THE BOARD OF DIRECTORS TO REVIEW AND APPROVE.
ANNUALLY, THE BOARD RE-AFFIRMS THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY WITH A WRITTEN COMPLIANCE DOCUMENT.FORM 990, PART VI, SECTION B, LINE 12C
THE COMPENSATION PROCESS FOR THE CEO, COO AND CFO INCLUDES AN INDEPENDENT COMPENSATION CONSULTANT COMPLETING A COMPENSATION SURVEY OR STUDY. THE COMPENSATION AMOUNT IS THEN APPROVED BY THE BOARD OF DIRECTORS.FORM 990, PART VI, SECTION B, LINE 15
DOCUMENTS ARE POSTED TO THE ORGANIZATION'S WEBSITE AND ARE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
NO CHANGE FROM PRIOR YEAR.FORM 990. PART XII, LINE 2C.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.