2023-05-12T12:29:21-05:00 2022-06-30 010523282 Berry Dunn McNeil & Parker LLC 1000 Elm Street 4th Floor Manchester NH 03101 990 2021-07-01 020360640 VNA at HCS Inc VNAA 6033522253 312 Marlboro Street Keene NH 03431 Dawn Michelizzi Chief Financial Officer 6033522253 2023-05-11 1 Dawn Michelizzi XXX-XX-XXXX Melissa Magoon CPA P01712842 6036697337 2023-05-11 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Maura McQueeney 312 Marlboro Street Keene NH 03431 16326461 0 X www.hcsservices.org X 1981 NH To provide services which enable people to function throughout life at their optimal level of health, well-being, and independence according to their personal beliefs and choices. 15 14 176 14 0 0 2972211 827747 15125898 15442380 4116 35761 22661 3988 18124886 16309876 8913 1500 0 0 9206912 10683817 0 0 0 6671840 6862302 15887665 17547619 2237221 -1237743 9766426 8719556 2502986 2721094 7263440 5998462 To provide services which will enable people to function throughout life at their optimal level of health, well-being, and independence according to their personal beliefs and choices. 0 0 7668542 1500 8403756 Homecare Service - Objective is to help residents of southwestern New Hampshire to recover at home after a hospitilization or rehabilitation stay in a facility. Skilled care provided by nurses, rehabilitation therapists are available to residents of all ages with the goal of comfort, care and support at home. Private duty services are also offered to customize care to individual needs. 3776439 4138502 Hospice Care - Is offered to those who would like to remain in the comfort and dignity of their own home at the end of life. A care team of nurses, social workers, chaplain and volunteers provide comfort measures to the patient and support for their family members. Bereavement support is also offered to families and to the community at no charge. 2646401 2900122 Community Service - Conduct events such as Meals on Wheels, adult day care, and door to door transportation. Provide additional help for those who need short or long term supportive services to remain safely at home. Other community services, such as the healthy starts maternal and child health program, nurse is in clinics, and age in motion promote the health and well-being of the communities we serve. 14091382 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 14 0 1 176 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NH X Dawn Michelizzi 6033522253 312 Marlboro Street Keene NH 03431 Jane Larmon Chair 1.00 1.00 X X 0 0 0 David Therrien Vice Chair 1.00 1.00 X X 0 0 0 Eric Horne Treasurer 1.00 1.00 X X 0 0 0 Julie Green Secretary 1.00 1.00 X X 0 0 0 Michael Chelstowski Director 1.00 1.00 X 0 0 0 Mary Ann Davis Director 1.00 1.00 X 0 0 0 Bonnie Fecowicz Director 1.00 1.00 X 0 0 0 Ann Heffernon Director 1.00 1.00 X 0 0 0 Virginia Jordan Director 1.00 1.00 X 0 0 0 Allen Mendelson Director 1.00 1.00 X 0 0 0 Judy Sakoski Director 1.00 1.00 X 0 0 0 David Stinson Director 1.00 1.00 X 0 0 0 Julie Tweksbury Director 1.00 1.00 X 0 0 0 Julie Greenwood Director, Past Chair 1.00 1.00 X 0 0 0 Susan Abert Past Director 1.00 1.00 X 0 0 0 Dianne Bolton Past Director 1.00 1.00 X 0 0 0 Brian Reilly Past Director 1.00 1.00 X 0 0 0 William Schofield Past Director 1.00 1.00 X 0 0 0 Maura McQueeney President & CEO 8.00 32.00 X X 0 185571 4865 Dawn Michelizzi CFO 8.00 37.50 X 0 174272 11841 Laura Brow Director -Clinical Operations 37.50 0.00 X 124669 0 5306 Christine White Rehab Leader/PT 37.50 0.00 X 102910 0 12440 227579 359843 34452 2 0 1 0 Lindley Acquisition Corp PO Box 743074 Atlanta GA 30374 Food supplier 471150 Dartmouth-Hitchcock One Medical Center Drive Lebanon NH 03756 Physician services 336901 SimiTree Healthcare Consulting 4130 Whitney Avenue Hamden CT 065180248 Contracted Staffing (Director, Coding, B 167652 Trio Community Meals P O Box 742992 Atlanta GA 303742992 Food supplier 132096 Core Medical Group 655 South Willow Street Suite 125 Manchester NH 03103 Contracted Nursing 124437 5 18749 502365 306633 827747 Net Patient Service Revenue 621610 13018339 13018339 Other Operating Revenue 621610 2424041 2424041 15442380 974 974 487 34300 0 0 487 34300 34787 34787 0 18749 9085 -9085 -9085 20573 7500 13073 13073 16309876 15442380 0 39749 1500 1500 8805493 8805493 115403 115403 1120253 1120253 642668 642668 3454738 3454738 1400 1400 99 99 1330194 1330194 42413 42413 307496 307496 288257 288257 40854 40854 448040 448040 35814 35814 1096 1096 Program supplies 537910 537910 Equipment rental & repa 327439 327439 Other expenses 46552 46552 17547619 14091382 3456237 0 X 448127 744984 1423812 16126 1622214 1633508 1812373 1588146 249230 224227 32784 28754 5990259 6071957 9766426 8719556 2469404 2473071 248023 33582 0 2502986 2721094 X 7110466 5968930 152974 29532 7263440 5998462 9766426 8719556 -1237743 -2942 -24293 0 X 0 1 X 1 1 1 X 2284254 2442189 875265 2972211 827747 9401666 14952213 13521785 13876665 15125898 15442380 72918941 17236467 15963974 14751930 18098109 16270127 82320607 7441 12140 9865 8487 37933 0 7441 12140 9865 8487 37933 82282674 4742 1197 1307 563 974 8783 4742 1197 1307 563 974 8783 4771 22661 3988 31420 17241209 15965171 14758008 18121333 16275089 82360810 0.99910 0.99920 0.00010 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18623 18623 18623 18623 18623 18623 18623 18623 18623 18623 1.00000 0 0 28312 16381 11931 1220641 1031279 189362 563420 540486 22934 224227 Due From Affiliate 6071957 6071957 X Part V, Line 4: Income used for operations and to support hospice. Part X, Line 2: The Association is a public charity under Section 501(c)(3) of the Internal Revenue Code (IRC). As a public charity, the Association is exempt from state and federal income taxes on income earned in accordance with its tax-exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Association's tax positions and concluded that the Association has no unrelated business income or uncertain tax positions that require adjustment to the consolidated financial statements. Butterfly Event 18749 18749 9085 18749 18749 9085 9085 -9085 20573 7500 0 20573 7500 7500 13073 NH 1 0 1 0 1.00000 Dawn Michelizzi CFO VNA at HCS Inc 312 Marlboro St Keene NH 03431 1 20573 7500 Emerald Gaming LLC dba Wonder Casino 172 Emerald Street Suite 101 Keene NH 03431 Dawn Michelizzi Chief Financial Of 0 Dawn Michelizzi, Chief Financial Officer, supervises the event as part of her job responsibilities. Ms. Michelizzi oversees all fundraising event related activitie, including organizing staff and volunteers and recordkeeping for the event. Total compensation paid to Ms. Michelizzi was in her capacity as an employee of Home Healthcare Hospice & Community Services, a related organization. Services related to the event were a very small portion of the total services she provided to the Organization during the fiscal year, so no reasonable basis for the amount of her compensation related to the gaming activities can be established. X 0 Schedule G, Part III, Line 15a The Organization had an agreement where Emerald Gaming, LLC d/b/a Wonder Casino would provide VNA at HCS, Inc. a percentage of revenue from Emerald Gaming, LLC's games of chance proceeds. VNA at HCS, Inc. never paid Emerald Gaming, LLC directly and was not directly involved in administrating any of the games of chance. VNA at HCS, Inc. was charged $750 a day for the ten day event which was taken directly out of the proceeds earned by Emerald Gaming, LLC which then donated the remaining $13,073 of proceeds to VNA at HCS, Inc. X X X X X 0 0 0 0 0 0 0 0 0 Maura McQueeney President & CEO 0 185571 0 0 0 0 0 0 0 4865 0 190436 0 0 Dawn Michelizzi CFO 0 162172 0 12100 0 0 0 7800 0 4041 0 186113 0 0 Form 990, Part VI, Section A, line 6 Home Healthcare, Hospice and Community Services, Inc. (HCS) shall be the sole member of the corporation. Form 990, Part VI, Section A, line 7a The sole member of the corportation shall be entitled to vote. Form 990, Part VI, Section A, line 7b The Board of Directors shall have and exercise all of the powers of the corporation provided by law, subject to the reservation to Home HealthCare, Hospice and Community Services, the sole member of the corporation, of the right to approve certain matters set forth in these bylaws before they may become effective: (a) the annual operating and capital budgets of the corporation; (b) any amendment, repeal, replacement or additional to these bylaws or to the articles of agreement of the corporation; and (c) the employment of the CEO of the corporation. Form 990, Part VI, Section B, line 11b The Chief Financial Officer reviews the 990 with the Finance Committee of the Board of Directors for approval prior to filing. Form 990, Part VI, Section B, line 12c A conflict of interest disclosure form is completed and signed annually by each member of the Board of Directors. Form 990, Part VI, Section B, line 15 The practice states that the CEO submits an annual self-evaluation to the board, a written evaluation of the CEO be completed by the board and use of a comparable compensation survey report to set compensation level. Comparable compensation surveys are updated every three to five years. The CEO determines the salary of the CFO using performance evaluation and a comparable compensation survey report to set compensation levels. Comparable compensation surveys are updated every three to five years. Form 990, Part VI, Section C, line 19 The organziation's governing documents, conflict of interest policy, and finacial statements are made available to the public upon request. Form 990, Part X, Line 10: Land, Buildings, and Equipment: Section 1.263(a)-3(n) Election: VNA at HCS, Inc. 312 Marlboro Street Keene, NH 03431 EIN: 02-0360640 Section 1.263(a)-3(n) Election: VNA at HCS, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Home Health Care Hospice & Community Services Inc 312 Marlboro Street Keene NH 03431 020464932 Support to VNA at HCS, Inc. NH 501(c)(3) Line 12b, II N/A 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0