2011-10-31T09:44:17-05:00 2011-06-30 BRAD BORBIDGE PA 197 LOUDON ROAD STE 350 CONCORD NH 03301 990 2010-07-01 020350051 COOS COUNTY FAMILY HEALTH SERVICES INC COOS 6037522040 133 PLEASANT STREET BERLIN NH 03570 ROBERT PELCHAT 6037527719 2011-09-15 1 DIMITRIOS PANACOPOULOS CPA 6032240849 2010 2016-03-07 17:11:31Z ADELE WOODS 133 PLEASANT STREET BERLIN NH 03570 9261774 0 X WWW.COOSFAMILYHEALTH.ORG X 1980 NH COOS 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. 12 12 133 20 0 0 3420596 3560033 5664361 5699859 1273 1882 0 0 9086230 9261774 0 0 0 0 6525009 6521850 0 0 104 2020691 2226632 8545700 8748482 540530 513292 3271243 3675928 1767760 1659153 1503483 2016775 COOS 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. 0 0 7630922 5699859 PROVISION OF PRIMARY CARE SERVICES TO THE COMMUNITY. 7630922 1 1 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 0 0 0 0 1 24 0 1 133 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X X X ADELE WOODS 6037522040 133 PLEASANT STREET BERLIN NH 03570 ROBERT PELCHAT X 0 0 0 DENNIS COX X 0 0 0 BETTY GOSSELIN X 0 0 0 ALINE BOUCHER X 0 0 0 MARGE MCCLELLAN X 0 0 0 ASA BROSNAN X 0 0 0 LINDA SLOWIK X 0 0 0 MICHAEL POULIN X 0 0 0 BRENDA GOLDEN HALLISEY X 0 0 0 H GUYFORD STEVER JR X 0 0 0 KENNETH CARGILL X 0 0 0 JOAN MERRILL X 0 0 0 ADELE WOODS 40.00 X 125725 0 7398 MELISSA FRENETTE 40.00 X 82309 0 6300 PATRICIA COUTURE 40.00 X 94165 0 5723 MITCHELL SULLIVAN MD 40.00 X 159932 0 28517 BRIAN BEALS 37.50 X 169475 0 32077 GEOFFREY KAMEN 37.50 X 115456 0 21375 KEERTHY KRISHNAMANI 33.50 X 153027 0 24651 THOMAS TEMME 30.50 X 127782 0 30052 JOSEE BOURBEAU MD 34.00 X 147150 0 27830 1175021 0 183923 8 0 1 0 ANDROSCOGGIN VALLEY HOSPITAL 59 PAGE HILL RD BERLIN NH 03570 RENT/PHYSICIANS/OB 334325 1 2355605 1204428 3560033 HOME HEALTH CARE SRVCS 621610 5699859 5699859 5699859 1882 1882 9261774 5699859 0 1882 510069 311630 198439 4639793 4175814 463979 150426 131262 19164 813408 709780 103628 408154 356155 51999 12381 12381 42549 42549 362484 362484 15284 15284 79330 69223 10107 135916 135916 387732 338335 49397 33839 29528 4311 72177 72177 42385 36985 5400 224577 195966 28611 44839 39127 5712 PROGRAM SUPPLIES 281966 281966 BAD DEBT EXPENSE 221700 221700 OTHER EXPENSES 70765 61750 9015 PRINTING AND PUBLICATIO 66064 57647 8417 TELEPHONE 63389 55313 8076 69255 60341 8810 104 8748482 7630922 1117456 104 186504 290233 173796 129460 420749 417670 74982 84769 3903806 1803639 1971228 2100167 443984 653629 3271243 3675928 799594 784415 968166 874738 1767760 1659153 X 513490 813154 975076 1186701 14917 16920 1503483 2016775 3271243 3675928 513292 0 X X 0 1 1 X 1 1 X 3057203 2988706 3089355 3420596 3560033 16115893 5874315 5955938 5860487 5664361 5699859 29054960 8931518 8944644 8949842 9084957 9259892 45170853 0 0 0 45170853 2780 1992 1477 1273 1882 9404 2780 1992 1477 1273 1882 9404 8934298 8946636 8951319 9086230 9261774 45180257 0.99980 0.99980 0.00020 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15874 2003 -254 17623 12919 2917 38 15874 11446 1173 300 12919 0.96000 0.04000 0 0 108555 108555 2272825 737748 1535077 1522426 1065891 456535 2100167 DUE FROM THIRD PARTY PAYERS 41407 ASSETS LIMITED AS TO USE 612222 653629 9261774 8748482 513292 0 513292 9261774 0 9261774 0 9261774 8748482 0 8748482 0 8748482 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. 1 X X X 0 0 0 0 0 0 0 0 0 MITCHELL SULLIVAN MD 139525 0 20407 0 0 0 0 0 28517 0 188449 0 0 0 BRIAN BEALS 149068 0 20407 0 0 0 0 0 32077 0 201552 0 0 0 KEERTHY KRISHNAMANI 133340 0 19687 0 0 0 0 0 24651 0 177678 0 0 0 THOMAS TEMME 127782 0 0 0 0 0 0 0 30052 0 157834 0 0 0 JOSEE BOURBEAU MD 139772 0 7378 0 0 0 0 0 27830 0 174980 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE 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. FORM 990, PART VI, SECTION B, LINE 12C 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 15 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 C, LINE 19 DOCUMENTS ARE POSTED TO THE ORGANIZATION'S WEBSITE AND ARE AVAILABLE UPON REQUEST. FORM 990. PART XII, LINE 2C. NO CHANGE FROM PRIOR YEAR.