2011-05-13T07:33:53-05:00 2010-09-30 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2009-10-01 020222126 EXETER HEALTH RESOURCES INC EXET 6035806695 5 Alumni Drive EXETER NH 03833 officer 6035806695 2011-05-10 1 Michael A Barbarita 6036228881 2009 2016-02-24 21:20:13Z KEVIN CALLAHAN 5 Alumni Drive EXETER NH 03833 7134381 0 X WWW.exeterhospital.COM X 1985 NH EXETER HEALTH RESOURCES, INC. IS THE HOLDING COMPANY FOR EXETER HOSPITAL, INC., A TAX-EXEMPT 100-BED ACUTE CARE HOSPITAL; EXETER HEALTHCARE, INC., A TAX-EXEMPT 26-BED SUB ACUTE NURSING FACILITY; ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE, INC., A TAX-EXEMPT HOME HEALTH AND HOSPICE AGENCY; VX HEALTH SERVICES (SYNERGY), A WELLNESS/FITNESS CENTER; CORE PHYSICIANS LLC, A TAX-EXEMPT MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE; AND EXETER MED REAL, INC, A TAX-EXEMPT REAL ESTATE HOLDING COMPANY. 13 10 24 0 61543 0 45744 6066923 6597199 -892154 -321449 46120 5174769 6367614 21500 80823 0 4714138 5355615 0 0 1383974 1348560 6119612 6784998 -944843 -417384 235202693 252220216 7888955 7752108 227313738 244468108 THE MISSION OF EXETER HEALTH RESOURCES IS TO IMPROVE THE HEALTH OF THE COMMUNITY. THIS MISSION IS PRINCIPALLY SUPPORTED THROUGH THE PROVISION OF HEALTH SERVICES AND INFORMATION TO THE COMMUNITY.EXETER HEALTH RESOURCES AND ITS AFFILIATES ARE COMMITTED TO PROVIDING HEALTH CARE SERVICES THAT ARE INNOVATIVE, PROGRESSIVE AND FOCUSED ON QUALITY AND THE WELL-BEING OF PATIENTS. 0 0 6553134 6581776 EXETER HEALTH RESOURCES, INC. IS THE HOLDING COMPANY FOR EXETER HOSPITAL, INC., A TAX-EXEMPT 100-BED ACUTE CARE HOSPITAL; EXETER HEALTHCARE, INC., A TAX-EXEMPT 26-BED SUB ACUTE NURSING FACILITY; ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE, INC., A TAX-EXEMPT HOME HEALTH AND HOSPICE AGENCY; VX HEALTH SERVICES (SYNERGY), A WELLNESS/FITNESS CENTER; CORE PHYSICIANS LLC, A TAX-EXEMPT MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE; AND EXETER MED REAL, INC, A TAX-EXEMPT REAL ESTATE HOLDING COMPANY. 6553134 1 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 29 0 1 24 1 1 1 0 0 0 0 0 0 0 0 13 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X KEVIN J O'LEARY 6035806695 5 ALUMNI DRIVE EXETER NH 03833 KEVIN J CALLAHAN 40.00 X X 704207 0 36720 gLENN mCKENZIE 1.00 X X 0 0 0 sTEVE HERMANS ESQ 1.00 X X 0 0 0 RICHARD L LEVY MD 1.00 X 0 0 0 LARRY S PRESSMAN MD 1.00 X 0 154700 20343 ROBERT A EBERLE 1.00 X 0 0 0 REV JOHN E DENSON JR 1.00 X 0 0 0 AMY CASE 1.00 X 0 0 0 ross gittell phd 1.00 X 0 0 0 katie delahaye paine 1.00 X 0 0 0 JOSEPH ARMY 1.00 X 0 0 0 WILLIAM SCHEYLER 1.00 X 0 0 0 J BONNIE NEWMAN 1.00 X 0 0 0 MAJ GEN JOSEPH SIMIONE 1.00 X 0 0 0 NANCY BRAESE DO 1.00 X 0 166142 27375 KEVIN J O'LEARY 40.00 X 401588 0 32262 coNSTANCE D SPRAUER 40.00 X 261244 0 34298 GLENN D KLINK 40.00 X 251551 0 39457 DEBRA CRESTA 40.00 X 302196 0 38445 SUSAN BURNS-TISDALE 40.00 X 308809 0 36568 cHRISTOPHER CALLAHAN 40.00 X 252876 0 38483 MARK WHITNEY 40.00 X 239463 0 36394 2721934 320842 340345 14 0 1 0 CAMBRIDGE ASSOCIATES LLC PO BOX 10317 UNIONDALE NY 11555 INVESTMENT CONSULTANT 144748 BENNETT GROUP INC 150 SPEEN ST FRAMINGHAM MA 01701 ADVERTISING CONSULTANT 140255 NUTTER MCCLENNEN & FISH LLP 155 SEAPORT BLVD BOSTON MA 02110 LEGAL SERVICES 117485 3 45744 45744 MANAGEMENT FEES 541610 6597199 6535656 61543 6597199 425389 425389 59424 19929 39495 39495 39495 746838 -746838 -746838 -746838 miscellaneous revenue 541610 6625 6625 6625 6367614 6581776 61543 -321449 80823 80823 1367039 1367039 2973058 2973058 278185 278185 553340 553340 183993 183993 185764 185764 46100 46100 409204 409204 37222 37222 6827 6827 96874 96874 72134 72134 75431 75431 154320 154320 miscellaneous 75965 75965 Outside Services 75594 75594 Consulting 56101 56101 Refreshments 46921 46921 service contract 10103 10103 6784998 6553134 231864 0 658988 213987 403717 375427 187034 1316302 651544 611949 664758 227117968 244065253 6034644 7089184 235202693 252220216 802854 672750 7086101 7079358 7888955 7752108 X 206521744 223623202 1258526 1282050 19533468 19562856 227313738 244468108 235202693 252220216 X 0 1 1 X 0 X X X 0 0 0 EXETER HOSPITAL INC 222674014 3 1 1 1 0 EXETER HEALTHCARE INC 020360966 9 0 1 1 0 RVNA 020274905 9 0 1 1 0 CORE PHYSICIANS LLC 870807914 9 0 1 1 0 matrix health inc 020473737 509(A)(3) 0 1 1 0 5 0 3931063 8311 17855 3921519 4265621 7182 341740 3931063 0.18730 0.81270 0 0 204202 204202 896360 538735 357625 215740 112809 102931 664758 CASH & SHORT-TERM INVESTMENTS 5764061 F Investment in Subsidiaries 208731276 C FIXED INCOME SECURITIES 12304277 F LIMITEd PARTNERSHIPS 10105078 F MARKETABLE EQUITY SECURITIES 7160561 F 244065253 accrued pension 608765 self insured trust liability 4889767 deferred compensation 300959 other 1279867 7079358 Part V, Line 4: Description of Intended Use of Endowment Funds: The goal of the Endowment Funds is to support future capital expenditures and other major program needs, and to generally increase the financial strength of the corporation. The QUASI-ENDOWMENTS ARE FUNDS WHICH HAVE BEEN DONATED TO THE ORGANIZATION FOR A PURPOSE SPECIFIED BY THE DONOR. THESE FUNDS ARE HELD UNTIL USED FOR THE PURPOSES INTENDED BY THE DONOR. 1 american heart associaton 20 merrimack street manchester NH 03101 135613797 501(C)(3) 50000 SUPPORT 2010 NEW HAMPSHIRE GO RED FOR WOMEN LUNCHEON. REVENUE FROM THE LUNCHEON SUPPORTS HEART DISEASE AWARENESS, RESEARCH, EDUCATION AND COMMUNITY PROGRAMS FOR WOMEN. TRAVIS ROY FOUNDATION 60 STATE STREET BOSTON MA 02109 043327883 501(C)(3) 5000 HELP SPINAL CORD INJURY SURVIVORS PROMOTE RESEARCH INTO A CURE 2 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: ALL Requests for grants, contributions, or sponsorships over $5,000 require the approval of at least the Vice President of Strategy, Community Relations and Development to ensure that they are consistent with our mission, values and strategic plan. Larger grants are also reviewed by the Chief Financial Officer and Chief Executive Officer prior to approval. Each of those requesting organizations either provides a written summary of how they have used our previous support as well as their specific plans for any new requested funding or they make a presentation in person usually to the Chief Financial Officer, the Chief Executive Officer and the Vice President of Strategy, Community Relations and Development. Each year a subcommittee of Exeter Health Resources' Board of Trustees is charged with overseeing our Community Benefits program and our community needs assessment and reviews a detailed report on the previous year's grants/ contributions/sponsorships and approves the current year's plan for community support. That subcommittee and the full Exeter Health Resources Board of Trustees are regularly updated on our community support initiatives. X X 0 1 X X X X 0 1 0 0 0 0 0 1 0 KEVIN J CALLAHAN 456384 0 161136 0 86687 0 14700 0 22020 0 740927 0 0 0 LARRY S PRESSMAN MD 0 123444 0 13336 0 17920 0 3916 0 16427 0 175043 0 0 NANCY BRAESE DO 0 118945 0 24393 0 22804 0 4289 0 23086 0 193517 0 0 KEVIN J O'LEARY 257446 0 95136 0 49006 0 14700 0 17562 0 433850 0 0 0 coNSTANCE D SPRAUER 168704 0 52636 0 39904 0 14700 0 19598 0 295542 0 0 0 GLENN D KLINK 163745 0 44596 0 43210 0 14696 0 24761 0 291008 0 0 0 DEBRA CRESTA 201656 0 77146 0 23394 0 14700 0 23745 0 340641 0 0 0 SUSAN BURNS-TISDALE 205638 0 74397 0 28774 0 14700 0 21868 0 345377 0 0 0 cHRISTOPHER CALLAHAN 170657 0 60976 0 21243 0 14698 0 23785 0 291359 0 0 0 MARK WHITNEY 179139 0 56731 0 3593 0 14628 0 21766 0 275857 0 0 0 Part I, Line 1a TAX INDEMNIFICATION AND GROSS UP PAYMENTS WERE PROVIDED TO LISTED INDIVIDUALS WITH THE EXCEPTION OF PRESSMAN(FOR ACQUISITION OF SUPPLEMENTAL LONG TERM DISABILITY INSURANCE). THE BENEFIT WAS TREATED AS TAXABLE INCOME. TRUSTEES ARE ELIGIBLE FOR DISCOUNTED MEMBERSHIP FEES AT A WELLNESS CENTER OWNED BY A SUBSIDIARY OF EXETER HEALTH RESOURCES. THE BENEFIT IS REPORTED AS TAXABLE INCOME TO THE TRUSTEE. Part I, Line 1b THERE WAS NO EXISTING POLICY CONCERNING TAX INDEMNIFICATION AND GROSS UP PAYMENTS. HOWEVER, IN THE INSTANCE OF SUCH ACTION RELATED TO THE ACQUISITION OF LONG TERM DISABILITY INSURANCE DESCRIBED ABOVE, THE TAX INDEMNIFICATION AND GROSS UP PAYMENTS WERE APPROVED BY A BOARD OF TRUSTEES COMMITTEE COMPRISED OF DISINTERESTED PERSONS. Part I, Line 4a THE ORGANIZATION MAINTAINS A SPLIT DOLLAR SUPPLEMENTAL RETIREMENT PLAN FOR 2 EXECUTIVES(LISTED BELOW WITH AMOUNTS)SELECTED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. THE PLAN IS CLOSED TO FUTURE PARTICIPANTS. THE PLAN PROVIDES FOR ANNUAL PAYMENTS OF PREMIUMS FOR LIFE INSURANCE POLICIES INSURING THE LISTED INDIVIDUALS. THOSE LIFE INSURANCE PREMIUMS ARE COLLATERALLY ASSIGNED TO THE CORPORATION AND ANY EXCESS ACCUMULATED VALUE IN THE POLICIES (NET OF ACCUMULATED PREMIUM PAYMENTS) ARE AVAILABLE TO BE PAID TO THE PARTICIPANT ONCE VESTED. KEVIN CALLAHAN - EXCESS ACCUMULATED VALUE - $55,376 kEVIN 0'LEARY - EXCESS ACCUMULATED VALUE - $30,243 Part I, Line 7 The organization provides an annual incentive compensation plan for executives selected by the EXETER HEALTH RESOURCES board OF TRUSTEES. tHESE EXECUTIVES INCLUDE: KEVIN CALLAHAN, KEVIN O'LEARY, CONSTANCE SPRAUER, SUSAN BURNS-TISDALE, GLENN KLINK, DEBRA CRESTA, MARK WHITNEY, CHRISTOPHER CALLAHAN. The board and/or its executive committee approves measureable achievement criteria for quality, patient satisfaction, process improvement, financial performance, services innovation and other compelling areas of strategic and operational interest. Additionally the Board and/or its executive committee establishes minimum, targeted and maximum levels for incentive awards and approves all awards for participating executives. LARRY PRESSMAN MD AND NANCY BRAESE DO ARE COMPENSATED UNDER CORE PHYSICIANS, LLC'S COMPENSATION PROGRAM. COMPENSATION IS DETERMINED USING SURVEYS OF CURRENT COMPENSATION WITHIN COMPARABLE MARKETS AND THE ADVICE OF OUTSIDE CONSULTANTS. THE PHYSICIANS' COMPENSATION IS APPROVED BY CORE PHYSICIANS, LLC'S COMPENSATION COMMITTEE WHICH IS COMPRISED OF SYSTEM MANAGERS WHO ARE APPROVED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. Form 990, Part VI, Section A, line 6 THE MEMBERS OF THE ORGANIZATION ARE THE PERSONS SERVING AS TRUSTEES, EX-OFFICIO AND OTHERS SELeCTED BY THE MEMBERS. Form 990, Part VI, Section A, line 7a THE MEMBERS HAVE THE RIGHT TO ELECT THE "ELECTED TRUSTEES" Form 990, Part VI, Section A, line 7b THE DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS OF THE ORGANIZATION Form 990, Part VI, Section B, line 11 The 990 is prepared by AN outside tax accountant with information provided by the organization. THE 990 is reviewed by the organization's TREASURER then presented to THE board of trustees before it is filed with THE IRS. Form 990, Part VI, Section B, line 12c The Board of Trustees has adopted a Conflict of Interest Policy that requires the disclosure of conflicts of interest either when the interest becomes a matter of possible action by the Board or during an annual disclosure process. Trustees, officers, and key employees, as well as all members of senior management, are part of the annual disclosure process, which is initiated by the issuance of a memorandum and accompanying questionnaire by the President and Chief Executive Officer (CE0). All disclosures are reviewed. Any trustee with a conflict of interest is required to abstain from voting and is not included in a quorum determination on the matter and any officer, key employee, or member of senior management with a conflict does not take part in making and is not present for any decision regarding the matter. The policy is monitored and enforced by both the President and CEO and the full Board. A separate organizational policy requires all employees to disclose any conflict of interest in writing upon hire and, thereafter, make any further written disclosure at the time a conflict arises. This policy is monitored and enforced by the Vice President of Human Resources and the Vice President of Corporate Integrity and Compliance. Any identified conflict of interest is managed by disclosure, recusal, or divestiture of the interest. Form 990, Part VI, Section B, line 15 THE ORGANIZATIONS FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CEO AND OTHER LISTED OFFICERS IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACHIEVING THE ORGANIZATIONS MISSION, TO RECOGNIZE INDIVIDUAL AND TEAM PERFORMANCE, AND TO COMPLY WITH THE ORGANIZATIONS OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE EXECUTIVE COMMITTEE OF THE ORGANIZATIONS BOARD OF TRUSTEES CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE CEO AND OTHER LISTED OFFICERS. IN DOING SO, THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE MARKET RANGES OF BASE, INCENTIVE AND TOTAL CASH COMPENSATION, AND TO PROVIDE ADVICE CONCERNING THE REASONABLENESS OF THE COMPENSATION OF THE CEO AND OTHER LISTED OFFICERS. THE COMMITTEE UTILIZES THAT ANALYSIS AND OTHER APPROPRIATE INFORMATION IN CONNECTION WITH ITS ANNUAL REVIEW AND makes RECOMMENDATIONS TO THE FULL BOARD FOR ADJUSTMENT OF THE CEOS COMPENSATION AND THE COMPENSATION FOR OTHER LISTED OFFICERS. INFORMATION WHICH THE COMMITTEE MAY CONSIDER CAN INCLUDE BUT IS NOT LIMITED TO THE PERFORMANCE OF AN INDIVIDUAL AND/OR THAT INDIVIDUALS CONTRIBUTIONS TO A TEAM, THE PERFORMANCE OF THE ORGANIZATION IN WHOLE AND IN PART, THE ELEMENTS OF TOTAL COMPENSATION AND SALARY HISTORY, THE ORGANIZATIONS COMPENSATION TARGETS AND COMPARABILITY DATA,INCLUDING THE DATA PREPARED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE COMMITTEE. THE COMMITTEE INCORPORATES A PERFORMANCE APPRAISAL PROCESS IN THE CEOS, AND THE LISTED OFFICERS' COMPENSATION REVIEW. THE CEO AND LISTED OFFICERS ARE NOT PRESENT WHEN THE COMMITTEE DISCUSSES THEIR RESPECTIVE COMPENSATION. IN ADDITION, THE COMMITTEE DETERMINES IF THE THRESHOLD REQUIREMENTS FOR INCENTIVE AWARDS ARE MET, CONSISTING OF THE ORGANIZATIONS PERFORMANCE RESULTS FOR QUALITY, OPERATING SYSTEM EXCELLENCE AND FINANCIAL PERFORMANCE. THE RESULTS OF THE COMMITTEES DELIBERATIONS ARE PRESENTED TO THE BOARD AND INCLUDE RECOMMENDATIONS CONCERNING SALARY RANGE ADJUSTMENTS AND INCENTIVE AWARDS AND THE BASIS FOR THE COMMITTEES DECISIONS / RECOMMENDATIONS. THE DELIBERATIONS OF THE BOARD ARE CONDUCTED IN EXECUTIVE SESSION WITH THE INDEPENDENT MEMBERS OF THE BOARD BUT DO INCLUDE THE CEO ONLY FOR THAT PERIOD OF TIME IN WHICH THE BOARD HAS QUESTIONS CONCERNING THE PERFORMANCE OF ANY LISTED OFFICER OTHER THAN THE CEO. THE BOARD REVIEWS THE CEOS PERFORMANCE AND DETERMINES IF THE ADJUSTMENTS AND AWARDS RECOMMENDED BY THE COMMITTEE FOR THE CEO ARE IN THE ORGANIZATIONS BEST INTEREST AND FOR ITS BENEFIT. FOR THE OTHER LISTED OFFICER POSITIONS, ADJUSTMENTS AND INCENTIVE AWARDS ARE APPROVED UPON RECOMMENDATION OF THE CEO BY THE EXECUTIVE COMMITTEE WITHIN BOARD APPROVED PARAMETERS AND RATIFIED BY THE BOARD OF TRUSTEES. Form 990, Part VI, Section C, line 19 These documents are available upon request. EXETER HOSPITAL 5 ALUMNI DR EXETER NH 03833 020555126 HOSPITAL NH 501(C)(3) 3 exeter health resOurces inc core physicians llc 5 ALUMNI DR eXETER NH 03833 870807914 physician practices NH 501(C)(3) 9 exeter health resOurces inc exeter healthcare 5 ALUMNI DR eXETER NH 03833 020360966 subacute nursing facility NH 501(C)(3) 9 exeter health resOurces inc rockingham visiting nurse assoc 5 ALUMNI DR eXETER NH 03833 020274905 home care hospice NH 501(C)(3) 9 exeter health resOurces inc MATRIX HEALTH 5 ALUMNI DR EXETER NH 03833 020473737 MANAGE resources NH 501(C)(3) 11 Exeter health resOurces inc EXETER MED REAL 5 ALUMNI DR EXETER NH 03833 020418718 REAL ESTATE HOLDING NH 501(C)(25) Exeter health resOurces inc EXETER HEALTH RESOURCES SELF INS TRUST 5 ALUMNI DR EXETER NE 03833 200753662 SELF INSURANCE trust NH 501(C)(3) 11 Exeter health resOurces inc CONVERGENT HEALTH SYSTEMS INC 5 ALUMNI DRIVE EXETER NH 03833 021469711 WELLNESS CENTER NH EXETER HEALTH RESOURCES INC C -4578 270560 1.00000 VX HEALTH SERVICES 5 ALUMNI DRIVE EXETER NH 03833 020469712 FITNESS CENTER NH CONVERGENT HEALTH SYSTEMS C 3110 548001 1.00000 EXETER MEDICAL SERVICES 5 ALUMNI DRIVE EXETER NH 03833 020419850 INACTIVE PHYSICIAN PRACTICE NH CONVERGENT HEALTH SYSTEMS C 1000 1.00000 CORE HEALTH SERVICES OF ma 5 ALUMNI DRIVE EXETER NH 03833 201598042 INACTIVE PHYSICIAN PRACTICE MA EXETER HEALTH RESOURCES INC C 1.00000 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 1 CORE PHYSICIANS LLC Q 6752323 EXETER HEALTHCARE Q 1650000 EXETER HOSPITAL R 8300000 EXETER HOSPITAL K 5354248 EXETER HEALTHCARE K 246172 CORE PHYSICIANS LLC K 246172 ROCKINGHAM VISITING NURSE ASSN K 246172 EXETER HEALTHCARE J 30888 EXETER MED REAL J 57737 EXETER HEALTH RESOURCES SELF INS TRUST P 8835 VX HEALTH SERVICES K 61543 EXETER HOSPITAL I 59424 EXETER HOSPITAL N 113988 CORE PHYSICIANS LLC N 303951 ROCKINGHAM VISITING NURSE ASSN N 31622