GRANITE VNA INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
GRANITE VNA INC (EIN 02-0222122)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-01-24
IRS object ID
201130249349300408
Schema version
2009v1.7
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)
Timestamp2011-01-24T12:45:25-06:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11000 Elm Street 15th FloorAddressLine1
CityManchesterCity
StateNHState
ZIP Code03101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN020222122EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Concord Regional Visiting Nurse Association IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCONCNameControl
Phone6032244093Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line130 Pillsbury StreetAddressLine1
CityConcordCity
StateNHState
ZIP Code03301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMary B DeveauName
TitlePresidentTitle
Phone6032244093Phone
Date Signed2011-01-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRachel L Williamson CPAName
Phone6036697337Phone
Date Prepared2011-01-10DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMary B DeveauNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line130 Pillsbury StreetAddressLine1
CityConcordCity
StateNHState
ZIP Code03301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts28710619GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.crvna.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1899YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionConcord Regional Visiting Nurse Association, incorporated in 1899, is a home health and hospice care provider, offering both preventive and supportive health care services. Our mission is to provide and facilitate comprehensive care in the home and community to optimize health, well-being and independence. Our services include: Skilled Nursing; Physical Therapy, Occupational Therapy, & Speech Therapy; Homemaking; Maternal/Child Health; Social Work; Hospice Care; Personal Home Services; Pediatric Care; Nutritional Counseling; Senior Health Clinics; Flu Immunization Clinics; Immunization Clinics; Blood Pressure Clinics; and Community Education.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees377TotalNbrEmployees
Total Nbr Volunteers126TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year650949ContributionsGrantsPriorYear
Contributions Grants Current Year594292ContributionsGrantsCurrentYear
Program Service Revenue Prior Year21208606ProgramServiceRevenuePriorYear
Program Service Revenue CY22575714ProgramServiceRevenueCY
Investment Income Prior Year320944InvestmentIncomePriorYear
Investment Income Current Year-80350InvestmentIncomeCurrentYear
Other Revenue Prior Year-12580OtherRevenuePriorYear
Other Revenue Current Year-26432OtherRevenueCurrentYear
Total Revenue Prior Year22167919TotalRevenuePriorYear
Total Revenue Current Year23063224TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year14143268SalariesEtcPriorYear
Salaries Etc Current Year15719466SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year24948TotalFundrsngExpCurrentYear
Other Expense Prior Year5876641OtherExpensePriorYear
Other Expenses Current Year6388468OtherExpensesCurrentYear
Total Expenses Prior Year20019909TotalExpensesPriorYear
Total Expenses Current Year22107934TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2148010RevenuesLessExpensesPriorYear
Revenues Less Expenses CY955290RevenuesLessExpensesCY
Total Assets BOY20574990TotalAssetsBOY
Total Assets EOY22570849TotalAssetsEOY
Total Liabilities BOY2531992TotalLiabilitiesBOY
Total Liabilities EOY2795152TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY18042998NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19775697NetAssetsOrFundBalancesEOY
Mission DescriptionThe Organization provides and facilitates comprehensive care in the home and community to optimize health, well-being and independence.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11443908Expense
Revenue15062580Revenue
DescriptionHome Health Care - provides skilled care services to patients who qualify for care in their home. Services were rendered to 4,032 patients including 84,834 chargable visits and 19,402 additional service hours for indigent patients. Charity care is provided to individuals who are uninsured, underinsured, or otherwise unable to pay the published fee for service.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4775008Expense
Revenue5671030Revenue
DescriptionHospice - supportive care for the terminally ill on a 24 hour basis. Services were rendered to 633 patients providing 25,814 hospice care days. Charity care is provided to individuals who are uninsured, underinsured, or otherwise unable to pay the published fee for services.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1744030Expense
Revenue1463884Revenue
DescriptionPersonal Care Services - Provides care and support primarily to frail elders who need assistance to stay living independently in their own homes.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense769920Expense
Revenue378220Revenue
DescriptionCommunity Health Services - provides community based health care services in individual homes and clinic setting including Parent Friend Program (a mentoring program for at risk families), senior health clinics, immunization clinics, children dental clinics, head lice services and community health education. Funding for services is subsidized by agency and community funding.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp769920TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev378220TotalOfOtherProgramServiceRev
Total Program Service Expense18732866TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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 Activities1FundraisingActivities
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 Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109611NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees377NumberOfEmployees
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
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
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
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Violet RoundsBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6032244093TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line130 Pillsbury StreetAddressLine1
CityConcordCity
StateNHState
ZIP Code03301ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Mary B Deveau
President & CEO50.00XX217214043074
Richard Holden
Chair1.00XX000
Steven Lauwers
Vice Chair1.00XX000
Christopher Parkinson
Treasurer1.00XX000
Kathleen Ames
Secretary1.00XX000
Mark Broth
Trustee1.00X000
Vera Buck
Trustee1.00X000
Charles J Fanaras
Trustee1.00X000
Marianne Fleischman MD
Representative at Large1.00X000
Susan Heinecke
Trustee1.00X000
Brian LaRoche
Trustee1.00X000
Marcia Matthews
Trustee1.00X000
Leslie K Melby
Trustee1.00X000
Jessica Pollack
Trustee1.00X000
Douglas Sampson
Trustee1.00X000
Douglas Black MD
Trustee1.00X000
Melvin Severance
Trustee1.00X000
Michael Timm
Trustee1.00X000
Janet DeVito
Representative at Large1.00X000
Mark E LaValle
Representative at Large1.00X000
Glenn F Currie
Trustee1.00X000
Violet Rounds
Chief Finance Officer50.00X144044014960
Lois Ferguson
VP Hospice House45.00106273011594X
Linda Flewelling
VP Human Resources45.0010170305595X
Deborah Mullen
VP IT45.00105542011444X
Arthur Savage
PT55.0010533504213X
FieldValueIRS element (for citing)
Total Reportable Comp From Org780111TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation90880TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns42642FederatedCampaigns
Fundraising Events173515FundraisingEvents
Government Grants155516GovernmentGrants
All Other Contributions222619AllOtherContributions
Noncash Contributions1985NoncashContributions
Total Contributions594292TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Home Care Revenue6216101506258015062580
Hospice Revenue62300056710305671030
Personal Home Services62161014638841463884
Community Services Rev621990378220378220
FieldValueIRS element (for citing)
Total Program Service Revenue22575714TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column304370TotalRevenueColumn
Exclusion$304,370ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5236243Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5620963Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-384720Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-384720TotalRevenueColumn
Exclusion-$384,720ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events0GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events173515CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses26432FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-26432TotalRevenueColumn
Exclusion-$26,432ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column23063224TotalRevenueColumn
Related Or Exempt Function Income22575714RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$106,782ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total390983Total
Management And General367785ManagementAndGeneral
Fundraising23198Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total12291798Total
Program Services10977097ProgramServices
Management And General1314701ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total409704Total
Program Services367068ProgramServices
Management And General42636ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1655708Total
Program Services1495357ProgramServices
Management And General160351ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total971273Total
Program Services842623ProgramServices
Management And General126900ManagementAndGeneral
Fundraising1750Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total9752Total
Management And General9752ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total59725Total
Management And General59725ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total29880Total
Management And General29880ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total495608Total
Program Services455871ProgramServices
Management And General39737ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1448430Total
Program Services1078163ProgramServices
Management And General370267ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total368698Total
Management And General368698ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total485194Total
Program Services162147ProgramServices
Management And General323047ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total531557Total
Program Services521551ProgramServices
Management And General10006ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total109245Total
Management And General109245ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total340451Total
Program Services300349ProgramServices
Management And General40102ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total48875Total
Management And General48875ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Contractual Allowances24840182484018
Dues & Subscriptions653884862216766
Equipment Rental13121312
Bad Debt Expense-89665-89665

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total22107934Total
Program Services18732866ProgramServices
Management And General3350120ManagementAndGeneral
Fundraising24948Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5733355BOY
EOY1040582EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3991620BOY
EOY6422126EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY27581BOY
EOY24921EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2894195BOY
EOY2672770EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY97812BOY
EOY108195EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2682855LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1354059LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1465481BOY
EOY1328796EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5240134BOY
EOY9554417EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1124812BOY
EOY1419042EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY20574990BOY
EOY22570849EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1761414BOY
EOY2041261EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY770578BOY
EOY753891EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2531992BOY
EOY2795152EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY13711944BOY
EOY15526893EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1138001BOY
EOY1020344EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3193053BOY
EOY3228460EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18042998BOY
EOY19775697EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20574990BOY
EOY22570849EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1106869CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1050938CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1726440CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year650949CurrentTaxYearMinus1Year
Current Tax Year594292CurrentTaxYear
Total5129488Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years16761249CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15498108CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years17033058CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21208606CurrentTaxYearMinus1Year
Current Tax Year22575714CurrentTaxYear
Total93076735Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years17868118CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16549046CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18759498CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21859555CurrentTaxYearMinus1Year
Current Tax Year23170006CurrentTaxYear
Total98206223Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24652CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17014CurrentTaxYearMinus3Years
Current Tax Year Minus1 Year7500CurrentTaxYearMinus1Year
Current Tax Year8250CurrentTaxYear
Total57416Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24652CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17014CurrentTaxYearMinus3Years
Current Tax Year Minus1 Year7500CurrentTaxYearMinus1Year
Current Tax Year8250CurrentTaxYear
Total57416Total
FieldValueIRS element (for citing)
Public Support Total50998148807PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years296748CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years422074CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years462707CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year335538CurrentTaxYearMinus1Year
Current Tax Year304370CurrentTaxYear
Total1821437Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years296748CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years422074CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years462707CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year335538CurrentTaxYearMinus1Year
Current Tax Year304370CurrentTaxYear
Total1821437Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years10971CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13599CurrentTaxYearMinus2Years
Total24570Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years18164866CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16982091CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19235804CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22195093CurrentTaxYearMinus1Year
Current Tax Year23474376CurrentTaxYear
Total100052230Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98100PublicSupportPercentage509
Prior Year Support Percentage0.98050PriorYearSupportPercentage
Investment Income Percentage0.01820InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01840PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationSchedule A, Part II, Line 12, Explanation of Other Income: Recovery of bad debtGeneralExplanation

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$5,712OtherActivitiesAmount
Total Lobbying Expenditures IIB5712TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationThe Organization pays dues to various organizations, some to which a portion of the dues are attributable to lobbying expenses.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2068241BeginningOfYearBalance
Investment Earnings Or Losses5177InvestmentEarningsOrLosses
End Of Year Balance2073418EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1987202BeginningOfYearBalance
Investment Earnings Or Losses81039InvestmentEarningsOrLosses
End Of Year Balance2068241EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis964815OtherCostOrOtherBasis
Depreciation282784Depreciation
Book Value682031BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1667580OtherCostOrOtherBasis
Depreciation1038837Depreciation
Book Value628743BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis50460OtherCostOrOtherBasis
Depreciation32438Depreciation
Book Value18022BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1328796TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Beneficial Interest in Perpetual Trust1155042
Deposits - Worker's Compensation264000
FieldValueIRS element (for citing)
Total Book Value Other Assets1419042TotalBookValueOtherAssets
Total Revenue23063224TotalRevenue
Total Expenses22107934TotalExpenses
Excess Or Deficit For Year955290ExcessOrDeficitForYear
Net Unrealized GL On Investments747179NetUnrealizedGLOnInvestments
Other$30,230OtherAmount
Total Adjustments777409TotalAdjustments
Excess Or Deficit Per FS1732699ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt21383047TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments747179NetUnrealizedGainsInvestments
Other Revenues56662OtherRevenues
Revenue Not Rptd F990803841RevenueNotRptdF990
Revenue Subtotal20579206RevenueSubtotal
Other Revenues Not Included2484018OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2484018RevenueNotRptdOnFinStmt
Total Revenue Per Form99023063224TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt19650348TotExpensesEtcAuditedFinclStmt
Other Expenses Included26432OtherExpensesIncluded
Expenses Not Rptd F99026432ExpensesNotRptdF990
Expenses Subtotal19623916ExpensesSubtotal
Other Expenses Not Included2484018OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt2484018ExpensesNotRptdOnFinStmt
Total Expenses Per Form99022107934TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:The Endowment funds are used to subsidize charitable care, support community programs that have no outside funding, provide seed money for program expansion and new programs and to make capital improvements to the Hospice House. Programs and Services supported by the Agency's funds include a Parent Child Mentoring program for at risk children, health clinics for seniors that provide screenings, foot care, ear wax removal, and other related services, head lice prevention and screening and immunization clinics. In addition, the Hospice Program and the Hospice House are supported through charitable funds to provide subsidized or free services; bereavement support groups, Hospice volunteer training and community education. Funds also would be used to support CRVNA's Home Care Program's Telehealth Program and to subsidize charitable care for patients that are uninsured or underinsured in the Home Care Program.
Part XI, Line 8 - Other Adjustments:Change in market value of perpetual trust: 30230.
Part XII, Line 2d - Other Adjustments:Change in market value of perpetual trust: 30230. Fundraising Expenses: 26432.
Part XII, Line 4b - Other Adjustments:Contractual Allowances: 2484018.
Part XIII, Line 2d - Other Adjustments:Fundraising Expenses: 26432.
Part XIII, Line 4b - Other Adjustments:Contractual Allowances: 2484018.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Lights of LifeNameOfEvent1
Gross Receipts Event160585GrossReceiptsEvent1
Charitable Contributions Event160585CharitableContributionsEvent1
Other Direct Expenses Event115974OtherDirectExpensesEvent1
Name Of Event2Annual AppealNameOfEvent2
Gross Receipts Event259142GrossReceiptsEvent2
Charitable Contributions Event259142CharitableContributionsEvent2
Other Direct Expenses Event25079OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events53788GrossReceiptsOtherEvents
Charitable Contrib Other Events53788CharitableContribOtherEvents
Other Direct Expenses Other Events5379OtherDirectExpensesOtherEvents
Gross Receipts Total173515GrossReceiptsTotal
Charitable Contributions Total173515CharitableContributionsTotal
Other Direct Expenses Total Events26432OtherDirectExpensesTotalEvents
Direct Expense Summary Events26432DirectExpenseSummaryEvents
Net Income Summary-26432NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
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 (2 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
Mary B Deveau
193214019200048000735728308740902319802830800
Violet Rounds
132244070000480006050089100159004000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Jennifer Brechtel
Employee of the Organization.58200Compensation paid for services as community liason of the Organization. She is the daughter of Mark Lavalle, a board member of the Organization.0
The Prescription Center
Vendor of Organization320869Charles Fanares, a member of the Board of Trustees of the Organization is the sole owner of The Prescription Center. Douglas Sampson is an officer of The Prescription Center and serves as a Trustee of the Organization. The Organization purchases prescriptions from this organization. All transactions are at arm's length.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2Douglas Sampson, a trustee of the Organization, is an employee of The Prescription Center, an entity owned 100% by Charles J. Fanares, a trustee of the Organization.
Form 990, Part VI, Section A, line 6Capital Region HealthCare Corporation is the sole member of the Concord Regional VNA.
Form 990, Part VI, Section A, line 7aCapital Region HealthCare Corporation accepts any changes made to the bylaws by the governing body.
Form 990, Part VI, Section B, line 11The role of Concord Regional Visiting Nurse Association's Audit Committee has expanded to include review of the agency's 990. The auditing firm of Berry, Dunn, McNeil and Parker presented the 990 to the Audit Committee prior to filing the form. The Audit Committee engages the auditors and receives the audit and the 990 Report. The Audit Committee receives a complete copy of the 990 including all schedules. The initial presentation of the FY2010 audit and the 990 Form will occur at the November 23, 2010 meeting of the Audit/Finance Committee meeting. Subsequent Audit Committee meetings will occur if necessary to complete the review. The Audit Committee will report to the Board of Trustees that the 990 review has occurred. The Board of Trustees accepts the Audit Committee reports, the audit, and the 990 documents. All members of the Board will have access to the reports. The Form 990 is available to the public upon request.
Form 990, Part VI, Section B, line 12cThe Conflict of Interest, Statement of Conflict of Interest with Respect to a Relationship, Transaction and/or Financial Interest form was revised by the Audit Committee in February 2010 and approved by the Board in March 2010. The form was revised to ensure compliance with the State of NH Pecuniary Benefit Law (Chapter 7: RSA 7:19a) and the revised IRS 990 disclosure requirements. The Chief Executive Officer/President reviewed the form and the regulation requirements at the March 9, 2010 Board Meeting. Trustees at the meeting were requested to complete the forms and return them to management. The Executive Administrative Manager worked with Board members to ensure each member had returned the Conflict of Interest Forms. In FY2010, 100% of the Board of Trustees returned the signed conflict of interest forms. The Audit Committee at its May 2010 meeting reviewed the forms for those Trustees that reported a conflict of interest. The Audit Committee reported to the full Board the conflict of interest transactions that had been disclosed on the conflict of interest forms. The Board at its May 2010 meeting approved the conflict of interest disclosures. The approved transactions over $5,000 were reported as required by law to the State of New Hampshire's Director of Charitable Trust at the Attorney General's office and a notice was published in the Concord Monitor. In addition to the annual completion of the form, Trustees are asked at every Board meeting beginning with the June 2010, if there are any conflicts that they have identified that should be reported to Management and the Board.
Form 990, Part VI, Section B, line 15In August 2009, the Executive Committee in collaboration with other VNAs affiliated with the Visiting Nurse Association Health System of Northern New England engaged Skeates Consulting, LLC and Olney/HR Advantage to complete an executive compensation analysis/review that would be used to determine the compensation for the Chief Executive Officer and the Chief Financial Officer. The results of this report were presented to the CRVNA Executive Committee on September 3, 2009. The Executive committee members decided at this meeting to accept the report as the appropriate tool to use to set the compensation for the CEO and CFO positions. The Board at its November 10, 2009 meeting adopted an Executive Compensation policy for the CEO/CFO positions. The Executive Committee's compensation philosophy is to pay the CEO and CFO at the appropriate level of compensation based on market data and surveys such as the compensation report noted above. The compensation will be performance based using the salary information available. The Executive Committee of the Board of Trustees recommended the annual compensation for the CEO and CFO at the December 2009 Board meeting. The Board unanimously approved the compensation recommendation.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request.
Part XI, Line 2c; Oversight and Selection ProcessThe Organization has not changed its oversight process or selection process during the tax year.
Form 990, Part I, Line 1The agency's service area includes Merrimack County and portions of Hillsborough County, representing more than 30 communities in central New Hampshire. Concord Regional VNA serves 7,000 patients annually and provides 150,000 homecare hours and more than 25,000 hospice days annually, including a 10-bed Hospice House. Patients who are uninsured, underinsured, or otherwise unable to pay the published fees for services are provided charity care. In the Fiscal Year 2010, the CRVNA Home Care Program provided care to 4,032 patients. Thirteen percent (13%) of the patients served in the Home Care Program were uninsured or received funding from Medicaid or low income grants. In addition, 65% of the Home Care patients had Medicare or Medicare replacement plans as their insurance plan. We are a 501(c)(3) non-profit agency and a subsidiary of Capital Region Health Care. Concord Regional VNA is a Medicare and Medicaid Certified Home Health and Hospice Provider and is licensed by the State of New Hampshire Bureau of Health Care Facilities. In addition, Concord Regional VNA's Hospice House, an inpatient setting providing care and comfort for the terminally ill, is licensed by the State of New Hampshire as a Supportive Residential Care Facility.Description of Organization Mission, continued

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Capital Region Health Care Corporation
250 Pleasant StreetConcordNH03301020222123Health Care ServicesNH501(c)(3)Line 11a, IN/A
Concord Hospital Inc
250 Pleasant StreetConcordNH03301222594672Patient Care ServicesNH501(c)(3)Line 3N/A
Monadnock Community Hospital
452 Old Street RoadPeterboroughNH03458020222157Patient Care ServicesNH501(c)(3)Line 3N/A
Riverbend Community Mental Health Inc
3-5 North State Street PO Box 2032ConcordNH03302020264383Mental Health ServicesNH501(c)(3)Line 7N/A
Capital Region Health Care Development Corporation
250 Pleasant StreetConcordNH03301020429749Management of Real Estate HoldingsNH501(c)(2)N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org1PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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