2011-02-10T16:04:43-06:00 2010-06-30 ALEXANDER ARONSON FINNING & CO PC 21 EAST MAIN STREET WESTBORO MA 01581 990 2009-07-01 042610447 NORTH SHORE COMMUNITY HEALTH INC NORT 9787448388 27 CONGRESS STREET No 103 SALEM MA 01970 GLORIA RILEY 9787448388 2011-02-08 1 DANA J MARKS CPA 5083669100 2011-02-08 2009 2016-02-24 21:20:13Z dr robert hendershott 27 CONGRESS STREET SALEM MA 01970 8490803 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. 9 9 89 0 0 0 1692982 2707564 4512763 5640210 13988 12855 123881 130174 6343614 8490803 0 0 3700225 4490839 0 0 2725098 2953014 6425323 7443853 -81709 1046950 5116876 5884992 1994315 1715481 3122561 4169511 to develop and operate a primary care health center to serve the residents of Salem, MAssachusetts and the surrounding communities. 0 0 4717384 3796226 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. (31,603 VISITS) 1191429 1103556 DENTAL SERVICES - DENTAL SERVICES PROVIDED TO THE ADULTS & CHILDREN RESIDENTS OF SALEM, PEABODY, gloucester AND SURROUNDING COMMUNITIES. (11,598 VISITS) 492978 530414 PHARMACEUTICAL SERVICES - PROVIDE PHARMACY SERVICES TO PATIENTS OF THE HEALTH CENTER, INCLUDING BUT NOT LIMITED TO UNDER AND UNINSURED PATIENTS. (26,757 Prescriptions) 164356 340188 school based health center and other - health services provided to students at salem high school. (750 visits) 164356 340188 6566147 1 1 0 0 0 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 1 0 0 89 1 0 0 0 0 0 0 0 0 0 9 9 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 Paul Passeri 1.00 X 0 0 0 DR ROBERT HENDERSHOTT 40.00 X X 169897 0 20488 gloria riley 40.00 X 89527 0 11000 dr Azra Ali 40.00 X 122628 0 13000 dr Katarzyna Gilek-seib 40.00 X 123783 0 6500 dr gabrille demille 40.00 X 115409 0 4622 621244 0 55610 4 0 1 0 North shore physicians group inc 61 elm st danvers MA 01923 OB/GYN Services 171762 RC Griffin 49 Central St Peabody MA 01960 Construction 153723 2 2216128 491436 2707564 PATIENT SERVICE Fees 621110 3506453 3506453 Medicare/Medicaid Paym 621110 2133757 2133757 5640210 12855 12855 debt forgiveness 621110 79167 79167 Miscellaneous Revenue 621110 51007 51007 130174 8490803 5770384 0 12855 314055 314055 3441531 3271493 170038 454047 428218 25829 281206 251552 29654 33692 475 33217 64808 64808 25435 25435 323255 312667 10588 139906 99591 40315 310251 290920 19331 41247 4327 36920 64104 48719 15385 232437 205425 27012 75175 64263 10912 Medical Supplies 653489 653489 Contracted Services 373156 368156 5000 Bad Debts 240685 240685 Dispensing Fees 211099 211099 dues and subscriptions 66105 41385 24720 98170 73683 24487 7443853 6566147 877706 0 391401 723958 580947 824808 782865 838688 880638 1136295 69045 19095 113783 81603 3758918 1498373 1938116 2260545 360081 0 5116876 5884992 651833 478170 1342482 1237311 1994315 1715481 X 2528956 3595041 593605 574470 3122561 4169511 5116876 5884992 X 0 1 1 X 1 1 X 869761 1197957 1344767 1692982 2707564 7813031 869761 1197957 1344767 1692982 2707564 7813031 7813031 10170 32434 26850 13988 12855 96297 11391 2286 4990 44714 130174 193555 8102883 21752038 0.96420 0.97510 X Schedule A, Part II, Line 10, Explanation of Other Income: rental income, debt forgiveness & miscellaneous revenue RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1409274 35678 1373596 1691348 981644 709704 658296 481051 177245 2260545 8490803 7443853 1046950 0 1046950 8759186 268383 268383 8490803 0 8490803 7712236 268383 268383 7443853 0 7443853 1 X X X X 0 0 0 0 0 0 0 0 0 DR ROBERT HENDERSHOTT 169897 0 0 0 0 0 20488 0 0 0 190385 0 0 0 paul o'shea board treasurer 27206 paul o'shea is the president of an organization that is engaged by north shore community health in the provision of clinical consultant services. 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.