2023-07-13T09:12:16-05:00 2022-12-31 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2022-01-01 020325847 Salemhaven Inc SALE 6038935586 23 Geremonty Drive Salem NH 03079 Ray Milliard Administrator 6038935586 2023-07-11 1 Ray Milliard XXX-XX-XXXX 1 Barbara J McGuan CPA P00219457 2077752387 2023-07-11 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Ray Milliard 23 Geremonty Drive Salem NH 03079 13939577 0 X salemhaven.com X 1977 NH Healthcare services for the elderly 13 13 138 13 0 0 216733 62662 12122205 10838706 123801 544855 81556 107016 12544295 11553239 0 0 0 0 6597400 6418766 0 0 0 6717756 8066459 13315156 14485225 -770861 -2931986 10755688 7113100 3565973 3607943 7189715 3505157 X In February, 1972, a group of Salem, NH residents founded the organization with the goal of developing a facility to provide health care and related services for the community's elderly population. 0 0 12980802 10838706 The Salemhaven complex provides comprehensive healthcare services, resources and accommodations (110 bed facility) for senior citizens, including the operation of a medical day care service. Salemhaven services include providing long term care, rehabilitation including PT, OT Speech, social services for residents and families, meeting of Spiritual needs, activities, supporting many local charities and community services, hospice services and respite care. We employ over 150 workers from the local area, we subsidized Medicaid over 1 million dollars annually, and we are a participant in the local and state emergency planning programs.Silverthorne Adult Medical Day Center provides to participants: Health care monitoring, Social services, Therapeutic and recreational activities, Health Care Education to participants, families and the community. We also provide respite care for caregivers and a Caregiver Support Group monthly for families and community members. 12980802 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 38 0 1 138 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 NH X Ray Milliard Administrator 6038935586 23 Geremonty Drive Salem NH 03079 Phillip Cammarata Board President 1.00 X X 0 0 0 Brendan Slein Board Vice President 1.00 X X 0 0 0 Michael Collins Board Treasurer 1.00 X X 0 0 0 Greg Brown Board Secretary 1.00 X X 0 0 0 Kevin Breen Board Member 1.00 X 0 0 0 Michael Carney Jr Board Member 1.00 X 0 0 0 Beverly Collins Board Member 1.00 X 0 0 0 Ralph Glynn Board Member 1.00 X 0 0 0 Frank Monteiro Board Member 1.00 X 0 0 0 Jamie Santo Board Member 1.00 X 0 0 0 Robert Slein Board Member 1.00 X 0 0 0 Amy White Board Member 1.00 X 0 0 0 Rev David Yasenka Board Member 1.00 X 0 0 0 Raymond Milliard Administrator 40.00 X 150597 0 52869 Joanne Consolazio MDS Coordinator 40.00 X 113798 0 12070 Carolyn Farhadian Assistant Director of Nursin 40.00 X 109459 0 37375 373854 0 102314 3 0 1 0 MAS Medical Staffing 156 Harvey Road Londonderry NH 03053 Temporary Staffing 573715 Select Rehabiliation dba Rehabcare PO Box 71985 Chicago IL 60694 Rehab Services 535605 Northeast Med Staff 3 Courthouse Lane Unit 11 Chelmsford MA 01824 Temporary Staffing 490810 Encore Rehabilitation Services 33533 W 12 Mile Road Farmington Hills MI 48331 Rehab Services 281891 Medical Solutions LLC PO Box 850737 Minneapolis MN 554857037 Staffing Agency 274327 7 4000 52056 6606 62662 Net Long-Term Care Services 623000 10558945 10558945 Adult Daycare Services 623000 276786 276786 Miscellaneous Income 623000 2592 2592 Guest Meals 623000 383 383 10838706 22628 22628 2903315 2381088 522227 522227 522227 112266 5250 107016 107016 11553239 10838706 0 651871 203467 203467 5004645 4360515 644130 71203 60226 10977 763549 690560 72989 375902 317953 57949 25000 25000 48225 13354 34871 49549 3469 46080 8522 8522 97579 97579 41516 2531 38985 196093 137167 58926 98193 98193 321617 276513 45104 7288 7096 192 108671 104254 4417 426023 409997 16026 177143 167693 9450 Unrelated Business Inco 16838 9790 7048 Purchased Services 4974852 4868283 106569 Food/Drug/Med. Supplies 884897 884897 NH Quality Assessment 560781 560781 23672 8144 15528 14485225 12980802 1504423 0 40350 40350 2598993 2188034 872149 1036759 123740 108872 192136 110046 11870264 8545756 3594018 3324508 3034687 299615 304531 10755688 7113100 1123769 1294168 11962 11423 2430242 2302352 3565973 3607943 X 7189715 3505157 7189715 3505157 10755688 7113100 -2931986 -752572 0 X 0 1 X 1 0 X 36125 76284 3100034 216733 62662 3491838 11846112 11568229 11417611 12122205 10838706 57792863 11882237 11644513 14517645 12338938 10901368 61284701 0 133568 120090 100290 99285 453233 133568 120090 100290 99285 453233 60831468 71547 98483 77051 65381 22628 335090 65737 57112 51374 63640 237863 137284 155595 128425 129021 22628 572953 6335 107016 113351 12019521 11806443 14646070 12467959 11031012 61971005 0.98160 0.98210 0.00920 0.00980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1815 1815 0 Form 990, Schedule C, Part II-B, Line 1i Lobbying portion of NHHCA Dues 15%. 0 1 X 41189 41189 10045102 6990650 3054452 1534775 1359337 175438 249198 195769 53429 3324508 10797395 -752572 5250 -747322 11544717 8522 8522 11553239 14481953 5250 5250 14476703 8522 8522 14485225 Part IV, Line 2b: The Organization holds funds for residents and provides these funds to the resident, as needed, for various common expenses. Part XI, Line 2d - Other Adjustments: Gaming Expense 5,250. Part XII, Line 2d - Other Adjustments: Gaming Expense 5,250. 112266 5250 0 112266 5250 5250 107016 NH 1 0 1 0 1.00000 Ray Milliard 23 Geremonty Drive Salem NH 03079 1 112266 5000 Chasers Poker 7 Veterans Memorial Parkway Salem NH 03079 Ray Milliard Ray Milliard is an Officer of Salemhaven and the amount of compensation related to gaming activities is indeterminable. X 0 Schedule G, Part III, Line 15a: Salemhaven participates in State of NH charitable donations from gaming halls. Salemhaven annually fills out a State application to participate with Chasers Poker Hall. Per State of NH rules Chasers provides Salemhaven, Inc. a percentage of revenue from Chasers Poker's games of chance proceeds of a particular day. Charities may have up to 10 days per year where they partner with a gaming hall. Salemhaven, Inc. nor any of its employees are ever directly involved in administrating any of the games of chance. Salemhaven is charged a state approved room fee by Chasers of $500 a day for each day Salemhaven is the benefiting charity. X X X 0 0 0 0 0 0 0 1 0 Raymond Milliard Administrator 144911 0 5686 0 0 0 0 0 52869 0 203466 0 0 0 Part I, Line 7 All bonus's were determinded by the board of directors. All staff were given bonus's. Form 990, Part VI, Section A, line 2 Board members Robert Slein and Brendan Slein have a family relationship. Form 990, Part VI, Section B, line 11b The 990 is sent to all board members and reviewed at a board meeting. If necessary, the auditors that prepared the 990 are requested to give a presentation. Form 990, Part VI, Section B, line 12c Board members fill out a disclosure form and are given a policy regarding disclosure and conflicts of interest. The administrator and business office monitor for potential conflicts and then report findings to the board of directors. Part of the annual financial audit is a review of potential conflicts and findings that are reported to the board. Form 990, Part VI, Section B, line 15a Salemhaven pulls demographic reports and surveys for the Board to review and decide on compensation for Administrator, Ray Milliard. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Salemhaven, Inc. 23 Geremonty, Salem, NH 03079 EIN 02-0325847 Salemhaven, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).