GRANITE VNA INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
GRANITE VNA INC (EIN 02-0222122)
Tax period
2010-10-01 to 2011-09-30
Filed
2011-12-20
IRS object ID
201143549349300014
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)
Timestamp2011-12-20T11:51:39-06:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

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 Date2010-10-01TaxPeriodBeginDate

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 Signed2011-12-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRachel Williamson CPAName
Phone6036697337Phone
Date Prepared2011-11-22DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
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 Receipts26879699GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
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 Members16NbrIndependentVotingMembers
Total Nbr Employees392TotalNbrEmployees
Total Nbr Volunteers143TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year594292ContributionsGrantsPriorYear
Contributions Grants Current Year661035ContributionsGrantsCurrentYear
Program Service Revenue Prior Year22575714ProgramServiceRevenuePriorYear
Program Service Revenue CY21986458ProgramServiceRevenueCY
Investment Income Prior Year-80350InvestmentIncomePriorYear
Investment Income Current Year626888InvestmentIncomeCurrentYear
Other Revenue Prior Year-26432OtherRevenuePriorYear
Other Revenue Current Year-20918OtherRevenueCurrentYear
Total Revenue Prior Year23063224TotalRevenuePriorYear
Total Revenue Current Year23253463TotalRevenueCurrentYear
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 Year15719466SalariesEtcPriorYear
Salaries Etc Current Year17166781SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year26082TotalFundrsngExpCurrentYear
Other Expense Prior Year6388468OtherExpensePriorYear
Other Expenses Current Year4821805OtherExpensesCurrentYear
Total Expenses Prior Year22107934TotalExpensesPriorYear
Total Expenses Current Year21988586TotalExpensesCurrentYear
Revenues Less Expenses Prior Year955290RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1264877RevenuesLessExpensesCY
Total Assets BOY22570849TotalAssetsBOY
Total Assets EOY22771611TotalAssetsEOY
Total Liabilities BOY2795152TotalLiabilitiesBOY
Total Liabilities EOY2418190TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY19775697NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY20353421NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
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
Expense10222881Expense
Revenue13460676Revenue
DescriptionHome Health Care - provides skilled care services to patients who qualify for care in their home. Services were rendered to 4,157 patients including 85,832 chargable visits and 17,457 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)
Expense4754867Expense
Revenue6861560Revenue
DescriptionHospice - supportive care for the terminally ill on a 24 hour basis. Services were rendered to 656 patients providing 35,006 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)
Expense1627728Expense
Revenue1430913Revenue
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)
Expense794795Expense
Revenue233309Revenue
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 Exp794795TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev233309TotalOfOtherProgramServiceRev
Total Program Service Expense17400271TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
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 Footnote0ReportFin48Footnote
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 Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109614NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees392NumberOfEmployees
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 Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
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 (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Mary B Deveau
President & CEO50.00XX225969047823
Richard Holden
Past Chair/Rep. at Large1.00XX000
Steven Lauwers Esq
Chair1.00XX000
Christopher Parkinson
Treasurer1.00XX000
Kathleen Ames
Vice Chair1.00XX000
Mark T Broth Esq
Trustee1.00X000
Vera Buck
Representative at Large1.00X000
Charles J Fanaras RPh
Trustee1.00X000
Marianne Fleischman MD
Secretary1.00XX000
Susan Heinecke
Trustee1.00X000
Brian LaRoche
Trustee1.00X000
Marcia M Matthews
Trustee1.00X000
Leslie K Melby
Past Trustee1.00X000
Jessica S Pollack APRN
Trustee1.00X000
Douglas Sampson
Trustee1.00X000
Douglas Black MD
Trustee1.00X000
Melvin J Severance CFP
Trustee1.00X000
Michael L Timm
Trustee1.00X000
Deacon Winton DeRosia
Trustee1.00X000
Andrew B Eills Esq
Trustee1.00X000
Violet Rounds
Chief Finance Officer50.00X159249017803
Lois Ferguson
VP Hospice House45.00109232012706X
Linda Flewelling
VP Human Resources45.0010531305740X
Deborah Mullen
VP IT45.00104990012417X
Arthur Savage
PT55.0010396404159X
FieldValueIRS element (for citing)
Total Reportable Comp From Org808717TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation100648TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events198546FundraisingEvents
Government Grants145359GovernmentGrants
All Other Contributions317130AllOtherContributions
Noncash Contributions2037NoncashContributions
Total Contributions661035TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Home Care Revenue6216101346067613460676
Hospice Revenue62300068615606861560
Personal Home Services62161014309131430913
Community Services Rev621990233309233309
FieldValueIRS element (for citing)
Total Program Service Revenue21986458TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column400809TotalRevenueColumn
Exclusion$400,809ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3831397Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3605318Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities226079Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column226079TotalRevenueColumn
Exclusion$226,079ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events0GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events198546CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses20918FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-20918TotalRevenueColumn
Exclusion-$20,918ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column23253463TotalRevenueColumn
Related Or Exempt Function Income21986458RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$605,970ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total420043Total
Management And General395744ManagementAndGeneral
Fundraising24299Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total13380017Total
Program Services11319459ProgramServices
Management And General2060558ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total459932Total
Program Services390001ProgramServices
Management And General69931ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1882254Total
Program Services1618001ProgramServices
Management And General264253ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1024535Total
Program Services842497ProgramServices
Management And General180255ManagementAndGeneral
Fundraising1783Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total21167Total
Management And General21167ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total58775Total
Management And General58775ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total81492Total
Management And General81492ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total613191Total
Program Services570920ProgramServices
Management And General42271ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1885997Total
Program Services1488879ProgramServices
Management And General397118ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total361837Total
Management And General361837ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total515489Total
Program Services193870ProgramServices
Management And General321619ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total601573Total
Program Services584383ProgramServices
Management And General17190ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total124234Total
Management And General124234ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total338805Total
Program Services257988ProgramServices
Management And General80817ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total64600Total
Management And General64600ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt Expense8500085000
Dues & Subscriptions696454927320372

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total21988586Total
Program Services17400271ProgramServices
Management And General4562233ManagementAndGeneral
Fundraising26082Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1040582BOY
EOY150120EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6422126BOY
EOY6088168EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY24921BOY
EOY54451EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2672770BOY
EOY2737440EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY108195BOY
EOY130972EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2524542LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1257336LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1328796BOY
EOY1267206EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9554417BOY
EOY11003471EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1419042BOY
EOY1339783EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY22570849BOY
EOY22771611EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2041261BOY
EOY1678799EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY753891BOY
EOY739391EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2795152BOY
EOY2418190EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY15526893BOY
EOY16295663EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1020344BOY
EOY908557EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3228460BOY
EOY3149201EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY19775697BOY
EOY20353421EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22570849BOY
EOY22771611EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1264877ReconcilationRevenueExpenses
Reconcilation Other Changes-687153ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
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 Years1050938CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1726440CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years650949CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year594292CurrentTaxYearMinus1Year
Current Tax Year661035CurrentTaxYear
Total4683654Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15498108CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17033058CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21208606CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22575714CurrentTaxYearMinus1Year
Current Tax Year24570961CurrentTaxYear
Total100886447Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years16549046CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18759498CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21859555CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23170006CurrentTaxYearMinus1Year
Current Tax Year25231996CurrentTaxYear
Total105570101Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years17014CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years7500CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8250CurrentTaxYearMinus1Year
Total32764Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years17014CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years7500CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8250CurrentTaxYearMinus1Year
Total32764Total
FieldValueIRS element (for citing)
Public Support Total509105537337PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years422074CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years462707CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years335538CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year304370CurrentTaxYearMinus1Year
Current Tax Year397473CurrentTaxYear
Total1922162Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years422074CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years462707CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years335538CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year304370CurrentTaxYearMinus1Year
Current Tax Year397473CurrentTaxYear
Total1922162Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10971CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13599CurrentTaxYearMinus3Years
Total24570Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years16982091CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years19235804CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22195093CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23474376CurrentTaxYearMinus1Year
Current Tax Year25629469CurrentTaxYear
Total107516833Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98160PublicSupportPercentage509
Prior Year Support Percentage0.98100PriorYearSupportPercentage
Investment Income Percentage0.01790InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01820PriorYrInvestIncomePercentage
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 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$5,972OtherActivitiesAmount
Total Lobbying Expenditures IIB5972TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Other Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1i: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 Balance2073418BeginningOfYearBalance
Investment Earnings Or Losses37759InvestmentEarningsOrLosses
Other Expenditures37759OtherExpenditures
End Of Year Balance2073418EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

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 Basis1014853OtherCostOrOtherBasis
Depreciation370550Depreciation
Book Value644303BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1459229OtherCostOrOtherBasis
Depreciation847140Depreciation
Book Value612089BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis50460OtherCostOrOtherBasis
Depreciation39646Depreciation
Book Value10814BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1267206TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Beneficial Interest in Perpetual Trust1075783
Deposits - Worker's Compensation264000
FieldValueIRS element (for citing)
Total Book Value Other Assets1339783TotalBookValueOtherAssets
Total Revenue23253463TotalRevenue
Total Expenses21988586TotalExpenses
Excess Or Deficit For Year1264877ExcessOrDeficitForYear
Net Unrealized GL On Investments-607894NetUnrealizedGLOnInvestments
Other-$79,259OtherAmount
Total Adjustments-687153TotalAdjustments
Excess Or Deficit Per FS577724ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt22587228TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-607894NetUnrealizedGainsInvestments
Other Revenues20918OtherRevenues
Revenue Not Rptd F990-586976RevenueNotRptdF990
Revenue Subtotal23174204RevenueSubtotal
Other Revenues Not Included79259OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt79259RevenueNotRptdOnFinStmt
Total Revenue Per Form99023253463TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt22009504TotExpensesEtcAuditedFinclStmt
Other Expenses Included20918OtherExpensesIncluded
Expenses Not Rptd F99020918ExpensesNotRptdF990
Expenses Subtotal21988586ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99021988586TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4: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 -79,259.
Part XII, Line 2d - Other Adjustments:Fundraising Expenses 20,918.
Part XII, Line 4b - Other Adjustments:Change in Market Value of Perpetual Trusts 79,259.
Part XIII, Line 2d - Other Adjustments:Fundraising Expenses 20,918.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Lights of LifeNameOfEvent1
Gross Receipts Event167635GrossReceiptsEvent1
Charitable Contributions Event167635CharitableContributionsEvent1
Other Direct Expenses Event18591OtherDirectExpensesEvent1
Name Of Event2Annual AppealNameOfEvent2
Gross Receipts Event268820GrossReceiptsEvent2
Charitable Contributions Event268820CharitableContributionsEvent2
Other Direct Expenses Event24362OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events62091GrossReceiptsOtherEvents
Charitable Contrib Other Events62091CharitableContribOtherEvents
Other Direct Expenses Other Events7965OtherDirectExpensesOtherEvents
Gross Receipts Total198546GrossReceiptsTotal
Charitable Contributions Total198546CharitableContributionsTotal
Other Direct Expenses Total Events20918OtherDirectExpensesTotalEvents
Direct Expense Summary Events20918DirectExpenseSummaryEvents
Net Income Summary-20918NetIncomeSummary

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
201219019950048000877730801824502429913080100
Violet Rounds
1445160993304800055590122440177052000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental InformationIdentifier
Return ReferencePart IIIReturnReference
ExplanationMary B. Deveau, President, participates in the Concord Hospital Cash Balance plan. Concord Hospital is a related organization through CRVNA's sole corporate member, Capital Region HealthCare Corporation. The deferred tax benefit received totalled $30,801, as reported on Schedule J, page 2, column (C)(ii).Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1The Prescription Center and Northeast PharmacyBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipVendor of OrganizationRelationship
Amount Of Transaction500797AmountOfTransaction
Description Of TransactionCharles Fanares, a member of the Board of Trustees of the Organization is the sole owner of The Prescription Center and Northeast Pharmacy. 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.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 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 FY2011 audit and the 990 Form will occur at the November 22, 2011 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.
The 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 8, 2011 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 FY2011, 100% of the Board of Trustees returned the signed conflict of interest forms. The Audit Committee at its April 28, 2011 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 10, 2011 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 12c
In 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 14, 2010 Board meeting. The Board unanimously approved the compensation recommendation.Form 990, Part VI, Section B, line 15
The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request.Form 990, Part VI, Section C, line 19
Changes in Net Assets or Fund Balances:Net unrealized losses on investments: -607,894. Change in market value of perpetual trust -79,259. Total to Form 990, Part XI, Line 5: -687,153.Form 990, Part XI, line 5:
The organization has not changed its oversight or selection process during the tax year.Form 990, Part XII, Line 2c
Description of Organization Mission, continuedThe 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 35,000 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 2011, the CRVNA Home Care Program provided care to 4,157 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, 68% 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.Form 990, Part I, Line 1

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Capital Region Health Care Corporation
250 Pleasant StreetConcordNH03301020222123Health Care ServicesNH501(c)(3)Line 11a, IN/A0
Concord Hospital Inc
250 Pleasant StreetConcordNH03301222594672Patient Care ServicesNH501(c)(3)Line 3N/A0
Riverbend Community Mental Health Inc
3-5 North State Street PO Box 2032ConcordNH03302020264383Mental Health ServicesNH501(c)(3)Line 7N/A0
Capital Region Health Care Development Corporation
250 Pleasant StreetConcordNH03301020429749Management of Real Estate HoldingsNH501(c)(2)N/A0
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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