NORTH COUNTRY HEALTHCARE INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- NORTH COUNTRY HEALTHCARE INC (EIN 81-2225283)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-15
- IRS object ID
- 202302279349303970
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-15T15:11:49-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2211 Congress St | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 812225283 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | North Country Healthcare Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 6033892205 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8 Clover Lane | AddressLine1Txt |
| City | Whitefield | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03598 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Matthew Streeter | PersonNm |
| Person Title | System CFO | PersonTitleTxt |
| Phone | 6033892205 | PhoneNum |
| Signature | 2023-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Matthew | PersonFirstNm |
| Person Last | Streeter | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Barbara J McGuan CPA | PreparerPersonNm |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2023-08-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Thomas Mee | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8 Clover Lane | AddressLine1Txt |
| City | Whitefield | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03598 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,592,242 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.northcountryhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2016 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | Healthcare Management | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 58 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $30,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,049,958 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,312,123 | CYProgramServiceRevenueAmt |
| PY Investment Income | $27,792 | PYInvestmentIncomeAmt |
| CY Investment Income | $41,567 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,107,750 | PYTotalRevenueAmt |
| CY Total Revenue | $16,353,690 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $50,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $25,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,762,650 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,398,296 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,267,308 | PYOtherExpensesAmt |
| CY Other Expenses | $8,711,250 | CYOtherExpensesAmt |
| PY Total Expenses | $7,079,958 | PYTotalExpensesAmt |
| CY Total Expenses | $17,134,546 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $27,792 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$780,856 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,297,109 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,583,910 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,076,950 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,946,035 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $220,159 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,637,875 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of NCH is to improve lives by assuring consistently excellent, integrated healthcare. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $15,672,484 | ExpenseAmt |
| Grant | $25,000 | GrantAmt |
| Revenue | $16,312,123 | RevenueAmt |
| Desc | The main focus of NCH is management oversight and development of common administrative and clinical processes and practices between its healthcare affiliates. It is the intent to develop synergies and shared services to increase efficiency, lower cost and increase quality and patient satisfaction for the entire region. | Desc |
| Total Program Service Expenses | $15,672,484 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 58 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Matthew Streeter | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6033265610 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8 Clover Lane | AddressLine1Txt |
| City | Whitefield | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03598 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Donald Crane | ||||||||
| Chair | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Donna Goodrich | ||||||||
| Vice Chair | 1.00 | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Greg Placy | ||||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Roxie Severance | ||||||||
| Secretary | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Lynn Brewer | ||||||||
| Director | 1.00 | 39.00 | Yes (X) | $0 | $5,481 | $0 | ||
| JJ Bujeaud | ||||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Corinne Cascadden | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Alta Chase | ||||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| James Hamblin | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Richard Kardell DO | ||||||||
| Director | 1.00 | 39.00 | Yes (X) | $0 | $368,266 | $55,765 | ||
| Mark Kelley | ||||||||
| Director | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Elisabeth Moore MD | ||||||||
| Director | 1.00 | 40.00 | Yes (X) | $0 | $408,575 | $50,674 | ||
| Mark Russell | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Keith Young | ||||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Odette Crawford | ||||||||
| Past Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Nicholas Delaney NP | ||||||||
| Past Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sarah Descrochers | ||||||||
| Past Director | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Eric Stohl | ||||||||
| Past Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Thomas Mee | ||||||||
| System CEO | 40.00 | 6.00 | Yes (X) | $677,301 | $0 | $39,588 | ||
| Matthew Streeter | ||||||||
| System CFO | 40.00 | 6.00 | Yes (X) | $167,302 | $0 | $26,546 | ||
| Darrell Bodnar | ||||||||
| CIO | 40.00 | 1.00 | $254,388 | $0 | $32,958 | Yes (X) | ||
| Kate E Pina | ||||||||
| Chief Human Resources Officer | 40.00 | 0.00 | $147,989 | $0 | $32,378 | Yes (X) | ||
| Jesse M Raimer | ||||||||
| System Director Materials Management | 40.00 | 0.00 | $107,205 | $0 | $40,142 | Yes (X) | ||
| Maryanne A St Jean | ||||||||
| Executive Administrative Assistant | 40.00 | 0.00 | $102,500 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,456,685 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $782,322 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $278,051 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Sean Tracey Associates | |||||
| 401 State St Suite 3 | Portsmouth | NH | 03801 | Marketing Services | $669,164 |
| Coos North Country Radiology PLLC | |||||
| 1 Hardy Road 1204 | Bedford | NH | 03110 | Radiology Services | $469,651 |
| BerryDunn | |||||
| 2211 Congress Street | Portland | ME | 04102 | Accounting Services | $335,961 |
| Medical Information Technology | |||||
| PO Box 74569 | Chicago | IL | 60696 | IT Services | $249,021 |
| Quorum Health Resources LLC | |||||
| 1573 Mallory Lane Suite 200 | Brentwood | TN | 37027 | GPO Services | $135,714 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Management Fees | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $16,312,123 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,312,123 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,312,123 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,676 | TotalRevenueColumnAmt |
| Exclusion | $11,676 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $268,443 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $238,552 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $29,891 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,891 | TotalRevenueColumnAmt |
| Exclusion | $29,891 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,353,690 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,312,123 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $41,567 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,000 | TotalAmt |
| Program Services | $25,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $910,737 | TotalAmt |
| Program Services | $910,737 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,122,112 | TotalAmt |
| Program Services | $5,543,918 | ProgramServicesAmt |
| Management And General | $578,194 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,322 | TotalAmt |
| Program Services | $94,282 | ProgramServicesAmt |
| Management And General | $9,040 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $879,483 | TotalAmt |
| Program Services | $801,467 | ProgramServicesAmt |
| Management And General | $78,016 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $382,642 | TotalAmt |
| Program Services | $350,885 | ProgramServicesAmt |
| Management And General | $31,757 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,319 | TotalAmt |
| Program Services | $286,046 | ProgramServicesAmt |
| Management And General | $28,273 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $590,848 | TotalAmt |
| Program Services | $590,848 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,903,932 | TotalAmt |
| Program Services | $2,607,952 | ProgramServicesAmt |
| Management And General | $295,980 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,021,231 | TotalAmt |
| Program Services | $929,370 | ProgramServicesAmt |
| Management And General | $91,861 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,121 | TotalAmt |
| Program Services | $25,591 | ProgramServicesAmt |
| Management And General | $2,530 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,890,379 | TotalAmt |
| Program Services | $2,630,386 | ProgramServicesAmt |
| Management And General | $259,993 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,776 | TotalAmt |
| Program Services | $26,188 | ProgramServicesAmt |
| Management And General | $2,588 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,706 | TotalAmt |
| Program Services | $65,256 | ProgramServicesAmt |
| Management And General | $6,450 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,749 | TotalAmt |
| Program Services | $19,793 | ProgramServicesAmt |
| Management And General | $1,956 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,840 | TotalAmt |
| Program Services | $20,027 | ProgramServicesAmt |
| Management And General | $1,813 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,432 | TotalAmt |
| Program Services | $22,234 | ProgramServicesAmt |
| Management And General | $2,198 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Minor Equipment | $464,932 | $423,111 | $41,821 |
| Recruitment Expense | $177,310 | $161,361 | $15,949 |
| Other Expenses | $88,444 | $80,489 | $7,955 |
| Education Center | $63,231 | $57,543 | $5,688 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,134,546 | TotalAmt |
| Program Services | $15,672,484 | ProgramServicesAmt |
| Management And General | $1,462,062 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $503,328 | BOYAmt |
| EOY | $1,256,465 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,860 | BOYAmt |
| EOY | $24,838 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $750,554 | BOYAmt |
| EOY | $2,047,778 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $238,510 | BOYAmt |
| EOY | $1,240,360 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,148,914 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,840 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,374 | BOYAmt |
| EOY | $1,127,074 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,333,733 | BOYAmt |
| EOY | $1,101,527 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $393,750 | BOYAmt |
| EOY | $785,868 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,297,109 | BOYAmt |
| EOY | $7,583,910 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $559,773 | BOYAmt |
| EOY | $2,160,167 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,123,427 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $393,750 | BOYAmt |
| EOY | $785,868 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,076,950 | BOYAmt |
| EOY | $2,946,035 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $220,159 | BOYAmt |
| EOY | $4,637,875 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $220,159 | BOYAmt |
| EOY | $4,637,875 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,297,109 | BOYAmt |
| EOY | $7,583,910 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$780,856 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$276,795 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $640,468 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $4,834,899 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 4 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (4 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| Androscoggin Valley Hospital Inc | ||||
| 020280367 | 3 | Yes (1) | $7,261,304 | $0 |
| Weeks Medical Center | ||||
| 020222242 | 3 | Yes (1) | $6,749,543 | $0 |
| Upper Connecticut Valley Hospital | ||||
| 020276210 | 3 | Yes (1) | $2,698,784 | $0 |
| North Country Home Health & Hospice Agency Inc | ||||
| 020300637 | 10 | Yes (1) | $207,961 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 4 | SupportedOrganizationsTotalCnt |
| Support Sum | $16,917,592 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part IV, Section B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Androscoggin Valley Hospital, Inc., Weeks Medical Center, and Upper Connecticut Valley Hospital are all listed in the Organization's governing documents. Effective January 2017, the Organization became the sole member of North Country Home Health & Hospice Agency, Inc. Three directors are appointed from AVH, two directors are appointed from WMC, one director is appointed from UCVH, and two directors are appointed from NCHHHA. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $822,408 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,707 | DepreciationAmt |
| Book Value | $808,701 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,639 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,133 | DepreciationAmt |
| Book Value | $102,506 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $215,867 | OtherCostOrOtherBasisAmt |
| Book Value | $215,867 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,127,074 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Deferred Compensation | Desc |
| Book Value | $785,868 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $785,868 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Deferred Compensation | Desc |
| Amt | $785,868 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $785,868 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $16,051,895 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$276,795 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$276,795 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,328,690 | RevenueSubtotalAmt |
| Other Revenues Not Included | $25,000 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $25,000 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $16,353,690 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $17,109,546 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $17,109,546 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $25,000 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $25,000 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $17,134,546 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 4b - Other Adjustments: | Other Nonoperating Expense 25,000. |
| Part XII, Line 4b - Other Adjustments: | Other Nonoperating Expense 25,000. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Granite United Way | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 Concord Street Floor 2 | AddressLine1Txt |
| City | Manchester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 026006033 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $25,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | NH Ukraine Relief Fund | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Additional grant monitoring is not deemed necessary for funding provided to confirmed public charities. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Thomas Mee | ||||||||||||||
| System CEO | $538,642 | $0 | $126,000 | $0 | $12,659 | $0 | $5,597 | $0 | $33,991 | $0 | $716,889 | $0 | $0 | $0 |
| Elisabeth Moore MD | ||||||||||||||
| Director | $0 | $377,915 | $0 | $30,300 | $0 | $360 | $0 | $8,420 | $0 | $42,254 | $0 | $459,249 | $0 | $0 |
| Richard Kardell DO | ||||||||||||||
| Director | $0 | $345,440 | $0 | $20,450 | $0 | $2,376 | $0 | $14,390 | $0 | $41,375 | $0 | $424,031 | $0 | $0 |
| Darrell Bodnar | ||||||||||||||
| CIO | $194,186 | $0 | $52,020 | $0 | $8,182 | $0 | $7,736 | $0 | $25,222 | $0 | $287,346 | $0 | $0 | $0 |
| Matthew Streeter | ||||||||||||||
| System CFO | $157,136 | $0 | $10,000 | $0 | $166 | $0 | $0 | $0 | $26,546 | $0 | $193,848 | $0 | $0 | $0 |
| Kate E Pina | ||||||||||||||
| Chief Human Resources Officer | $147,327 | $0 | $0 | $0 | $662 | $0 | $1,837 | $0 | $30,541 | $0 | $180,367 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Thomas Mee, System CEO, receives a housing allowance from the Organization as part of his compensation package. The housing is reported as taxable wages to Mr. Mee, who began his employment during calendar year 2019. |
| Part I, Lines 4a-b | Maryanne St. Jean, Executive Administrative Assistant, received a change in control payment of $102,500 during the calendar year 2021. Thomas Mee, System CEO, participated in a 457(f) plan. |
| Part I, Line 7 | Part of the compensation program overseen by the Compensation Committee and approved by the Corporation Board and Affiliate Boards includes variable incentive compensation for executives. This variable compensation is a withhold of total compensation and earned back by executives based on strategic goal performance. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 3 | During the year ended September 30, 2022 the shared services provided by NCH were expanded to include human resources, information technology, and marketing. |
| Form 990, Part VI, Section A, line 7a | Each member of the Corporation Board shall be nominated by action of an Affiliate Board, or by the Corporation Board, as the case may be, in accordance with the nomination powers indicated in the Corporation's Bylaws. |
| Form 990, Part VI, Section A, line 7b | The Corporation Bylaws include Major Matters which include specific duties and responsibilities which are shared by the Corporation Board and the Affiliate Boards. These Major Matters are further distinguished between Major Organizational Matters and Major Operational Matters. In both cases, the Bylaws contain the provisions for the approval of these matters including whether they are approved by a majority vote or super majority vote of all boards. In all cases, the Major Matters require approval by the Corporation Board and the Affiliate Boards. |
| Form 990, Part VI, Section B, line 11b | A copy of the Form 990 will be shared electronically with the entire NCH Board and Finance committee before filing, with adequate time for questions to be asked. |
| Form 990, Part VI, Section B, line 12c | Conflict of Interest Process: - Conflict of Interest Disclosure completed via BoardPaq (electronic means) - Results compiled into Conflict Matrix which is reviewed and approved by the Board - Conflicts that meet the Pecuniary Benefit criteria are identified, shared with the Board and approved. - Disclosure notices are placed in local papers. - The NH Division of Charitable Trusts is notified of the Pecuniary Benefit and copies of the public notices are attached. |
| Form 990, Part VI, Section B, line 15 | The Compensation Committee is a subcommittee of the Finance Committee of the Corporation Board. This Committee oversees the executive compensation policy and practices of the organization including the CEO, the Affiliate Presidents, and the CEO Cabinet which includes key executive positions for the organization. The Compensation Committee engages with an outside consultant to determine compensation benchmarks and best practices which guide the compensation processes for these executive positions. The comparison benchmark data and guidance are reviewed by the Committee and recommendations are made to the Corporation Board and Affiliate Boards, as applicable. |
| Form 990, Part VI, Section C, line 19 | The Organization has implemented all policies and the governing documents and financial statements are available to the public upon request. |
| Form 990, Part IX, line 11g | Consulting: Program service expenses 112,797. Management and general expenses 69,550. Fundraising expenses 0. Total expenses 182,347. Contract Labor: Program service expenses 2,422,558. Management and general expenses 219,254. Fundraising expenses 0. Total expenses 2,641,812. Other Professional Services: Program service expenses 72,597. Management and general expenses 7,176. Fundraising expenses 0. Total expenses 79,773. |
| Form 990, Part XI, line 9: | Equity Transfers from Affiliates 4,834,899. |
| Form 990, Part XI, Line 8: | The Organization's financial statements for the year ended September 30, 2021 were restated to properly reflect the recognition of income related to the settlement from the litigation with Littleton Regional Heathcare previously reported as deferred revenues of $1,080,427. Additionally, amounts previously included in due from affiliates of $439,959 were recognized as an equity transfer to the Organization. The impact of the restatement was a net increase to beginning net assets of $640,468. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Androscoggin Valley Hospital Inc | ||||||||||
| 59 Page Hill Road | Berlin | NH | 03570 | 020280367 | Critical Access Hospital | NH | 501(c)(3) | Line 3 | North Country Healthcare Inc | Yes (1) |
| Weeks Medical Center | ||||||||||
| 173 Middle Street | Lancaster | NH | 03584 | 020222242 | Critical Access Hospital | NH | 501(c)(3) | Line 3 | North Country Healthcare Inc | Yes (1) |
| Upper Connecticut Valley Hospital | ||||||||||
| Corliss lane | Colebrook | NH | 03576 | 020276210 | Critical Access Hospital | NH | 501(c)(3) | Line 3 | North Country Healthcare Inc | Yes (1) |
| North Country Home Health & Hospice Agency Inc | ||||||||||
| 536 Cottage Street | Littleton | NH | 03561 | 020300637 | Home Health Agency | NH | 501(c)(3) | Line 10 | North Country Healthcare Inc | Yes (1) |
| Northcare Inc | ||||||||||
| 59 Page Hill Road | Berlin | NH | 03570 | 521596952 | Supporting Services | NH | 501(c)(3) | Line 12b, II | Androscoggin Valley Hospital Inc | Yes (1) |
| Androscoggin Valley Hospital Foundation | ||||||||||
| 59 Page Hill Road | Berlin | NH | 03570 | 223035216 | Management and Financial Support | NH | 501(c)(3) | Line 12b, II | Androscoggin Valley Hospital Inc | Yes (1) |
| Great Northwoods Community Foundation | ||||||||||
| 59 Page Hill Road | Berlin | NH | 03570 | 020452547 | Healthcare Services | NH | 501(c)(3) | Line 12b, II | Androscoggin Valley Hospital Inc | Yes (1) |
| Lancaster Patient Care Center | ||||||||||
| 173 Middle Street | Lancaster | NH | 03584 | 832130386 | Supporting Organization | NH | 501(c)(3) | Line 12a, I | Weeks Medical Center | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (9 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Androscoggin Valley Hospital | ||
| L | $7,053,091 | FMV |
| North Country Home Health & Hospice Agency | ||
| L | $164,184 | FMV |
| Upper Connecticut Valley Hospital | ||
| L | $2,626,932 | FMV |
| Weeks Medical Center | ||
| L | $6,467,899 | FMV |
| Weeks Medical Center | ||
| M | $328,016 | FMV |
| North Country Home Health & Hospice Agency | ||
| S | $185,409 | FMV |
| Upper Connecticut Valley Hospital | ||
| S | $705,964 | FMV |
| Weeks Medical Center | ||
| S | $2,037,482 | FMV |
| Androscoggin Valley Hospital | ||
| S | $1,906,044 | FMV |