2025-08-15T12:56:08-05:00 2024-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-10-01 812225283 NORTH COUNTRY HEALTHCARE INC NORT 6033892205 8 CLOVER LANE WHITEFIELD NH 03598 MATTHEW STREETER SYSTEM CFO 6033892205 2025-08-15 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-08-15 2023 2025-03-06 01:10:19Z THOMAS MEE 8 CLOVER LANE WHITEFIELD NH 03598 32516113 0 X WWW.NORTHCOUNTRYHEALTH.ORG X 2016 NH HEALTHCARE MANAGEMENT 15 13 292 15 0 0 0 8085 30515747 32399787 44021 7 51589 108234 30611357 32516113 0 0 0 0 19704058 21360694 0 0 0 10575097 11093366 30279155 32454060 332202 62053 13379867 26080474 3516415 16154969 9863452 9925505 THE MISSION OF NCH IS TO IMPROVE LIVES BY ASSURING CONSISTENTLY EXCELLENT, INTEGRATED HEALTHCARE. 0 0 30717512 0 32399787 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. 30717512 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 53 0 292 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 13 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X MATTHEW STREETER 6033265610 8 CLOVER LANE WHITEFIELD NH 03598 RICHARD KARDELL DO DIRECTOR 1.00 39.00 X 0 588424 11495 ELISABETH MOORE MD DIRECTOR 1.00 40.00 X 0 530237 28825 LYNN BREWER DIRECTOR (THRU DEC. '23) 1.00 39.00 X 0 0 0 DONALD CRANE CHAIR (TERMED) 1.00 1.00 X X 0 0 0 GREG PLACY CHAIR 1.00 X X 0 0 0 DONNA GOODRICH VICE CHAIR (THRU OCT. '23) 1.00 1.50 X X 0 0 0 ROXIE SEVERANCE VICE CHAIR 1.00 1.00 X X 0 0 0 TOM MCCUE TREASURER 1.00 X X 0 0 0 CHARLIE COTTON SECRETARY 1.00 X X 0 0 0 DAVID BACKLER DIRECTOR 1.00 X 0 0 0 JJ BUJEAUD DIRECTOR 1.00 1.00 X 0 0 0 CORINNE CASCADDEN DIRECTOR 1.00 X 0 0 0 HARLAN CONNARY DIRECTOR 1.00 X 0 0 0 RODERICK DE GREEF DIRECTOR 1.00 X 0 0 0 SARAH DESCROCHERS DIRECTOR 1.00 X 0 0 0 JAMES HAMBLIN DIRECTOR 1.00 X 0 0 0 MARK KELLEY DIRECTOR 1.00 0.50 X 0 0 0 MARK RUSSELL DIRECTOR (TERMED) 1.00 0.50 X 0 0 0 DAVE THATCHER DIRECTOR 1.00 X 0 0 0 THOMAS MEE SYSTEM CEO 40.00 6.00 X 706230 0 18318 MATTHEW STREETER SYSTEM CFO 40.00 6.00 X 357595 0 20804 DARRELL BODNAR CIO 40.00 X 245902 0 14238 BERNARD ADAMS CQO 40.00 X 216928 0 6664 JOSEPH CARISTI VP, FINANCE 40.00 X 187821 0 12317 BARRET RHOADS VP, REV CYCLE 40.00 X 186410 0 11167 JAMES PATRY VP, MARKETING 40.00 X 184808 0 9534 JOEL SANFORD PHARMACY SYSTEMS ANALYST 40.00 X 174707 0 12685 LINDA GAUTHIER HR DIRECTOR 40.00 X 157421 0 11353 DENIS DELISLE DIRECTOR, INFO SYS 1.00 X 140942 0 9828 JESSE RAIMER DIRECTOR, MM 1.00 X 127556 0 14431 KATE E PINA CHIEF HUMAN RESOURCES OFFICER 40.00 X 258639 0 16882 2944959 1118661 198541 36 1 1 0 OS INC PO BOX 311 PEWAUKEE WI 53072 PAT ACCESS PURCH SERVICES 352363 E MANAGEMENT ASSOCIATES PO BOX 473 AMHERST NH 03031 PFS PURCH SERVICES 331218 SECURED NETWORK SERVICES 125 MAIN ST SUITE 300 LITTLETON NH 03561 ADMIN/IT PURCHASED SERVICES 302387 WIPFLI LLP 4890 OWEN AYRES COURT STE 200 EAU CLAIRE WI 54701 ACCOUNTING PURCHASED SERVICES 219040 CHANGE HEALTHCARE PO BOX 98347 CHICAGO IL 60693 PFS PURCHASED SERVICES 207279 11 8085 8085 8085 RELATED PARTY MGMT FEES 541610 32399787 32399787 32399787 7 7 108234 108234 108234 32516113 32399787 0 108241 X 1226640 1225886 754 14683737 13933010 750727 361800 345800 16000 3978259 3802326 175933 1110258 1061158 49100 94694 94694 259100 259100 4637486 4090968 546518 462624 458694 3930 406793 400256 6537 3926822 3926822 43553 43553 140631 94641 45990 51752 21634 30118 402190 368802 33388 MINOR EQUIPMENT 201172 201172 DUES & SUBSCRIPTIONS 188956 183550 5406 REPAIRS AND MAINTENANCE 20038 20038 MEDICAL SUPPLIES 4444 4444 253111 180964 72147 32454060 30717512 1736548 0 4248645 4515582 1618800 1862485 4913747 607962 3612809 4305785 992 0 3898621 15396622 13379867 26080474 2503581 3038200 1012834 13116769 3516415 16154969 X 9863452 9925505 9863452 9925505 13379867 26080474 62053 0 X X 0 1 X 1 1 1 X X X 4 ANDROSCOGGIN VALLEY HOSPITAL INC 020280367 3 1 13930666 0 WEEKS MEDICAL CENTER 020222242 3 1 12948863 0 UPPER CONNECTICUT VALLEY HOSPITAL 020276210 3 1 5177562 0 NORTH COUNTRY HOME HEALTH & HOSPICE AG 020300637 10 1 398969 0 4 32456060 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 361859 361859 460548 59762 400786 3147261 548200 2599061 944079 944079 4305785 DEFERRED COMPENSATION 13116769 DUE FROM AFFILIATES 2279853 15396622 DEFERRED COMPENSATION 13116769 13116769 32516113 0 32516113 0 32516113 32454060 0 32454060 0 32454060 X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 THOMAS MEE SYSTEM CEO 559584 0 133893 0 12753 0 6394 0 11924 0 724548 0 0 0 RICHARD KARDELL DO DIRECTOR 0 446947 0 89083 0 52394 0 0 0 11495 0 599919 0 0 ELISABETH MOORE MD DIRECTOR 0 409855 0 78500 0 41882 0 9701 0 19124 0 559062 0 0 MATTHEW STREETER SYSTEM CFO 290340 0 66580 0 675 0 8934 0 11870 0 378399 0 0 0 KATE E PINA CHIEF HUMAN RESOURCES OFFICER 55270 0 43851 0 159518 0 2695 0 14187 0 275521 0 0 0 DARRELL BODNAR CIO 197167 0 47741 0 994 0 6081 0 8157 0 260140 0 0 0 BERNARD ADAMS CQO 184910 0 31110 0 908 0 4247 0 2417 0 223592 0 0 0 JOSEPH CARISTI VP, FINANCE 178108 0 9375 0 338 0 433 0 11884 0 200138 0 0 0 BARRET RHOADS VP, REV CYCLE 155203 0 19739 0 11468 0 3932 0 7235 0 197577 0 0 0 JAMES PATRY VP, MARKETING 155545 0 28731 0 532 0 3059 0 6475 0 194342 0 0 0 JOEL SANFORD PHARMACY SYSTEMS ANALYST 160117 0 4141 0 10449 0 5154 0 7531 0 187392 0 0 0 LINDA GAUTHIER HR DIRECTOR 128720 0 50 0 28651 0 4323 0 7030 0 168774 0 0 0 DENIS DELISLE DIRECTOR, INFO SYS 129165 0 3189 0 8588 0 4292 0 5536 0 150770 0 0 0 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, LINE 4B THOMAS MEE, SYSTEM CEO, PARTICIPATED IN A 457(F) PLAN. THERE WERE NO CONTRIBUTIONS OR DISTRIBUTIONS IN 2023. 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. 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 THE FORM 990 IS REVIEWED CLOSELY BY THE CFO OF THE SYSTEM AFTER CAREFUL PREPARATION IS PERFORMED IN CONNECTION WITH THE INTERNAL TEAM AND PAID PREPARER. A COPY IS MADE AVAILABLE TO THE BOARD PRIOR TO SUBMISSION TO THE IRS. 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 OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 4,090,968. MANAGEMENT AND GENERAL EXPENSES 546,518. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,637,486. FORM 990, PART XII, LINE 2C: THERE WERE NO CHANGES MADE FROM PRIOR YEAR. 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 1 WEEKS MEDICAL CENTER 173 MIDDLE STREET LANCASTER NH 03584 020222242 CRITICAL ACCESS HOSPITAL NH 501(C)(3) LINE 3 NORTH COUNTRY HEALTHCARE INC 1 UPPER CONNECTICUT VALLEY HOSPITAL 181 CORLISS LANE COLEBROOK NH 03576 020276210 CRITICAL ACCESS HOSPITAL NH 501(C)(3) LINE 3 NORTH COUNTRY HEALTHCARE INC 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 1 NORTHCARE INC 59 PAGE HILL ROAD BERLIN NH 03570 521596952 SUPPORTING SERVICES NH 501(C)(3) LINE 12B, II ANDROSCOGGIN VALLEY HOSPITAL INC 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 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 1 LANCASTER PATIENT CARE CENTER 173 MIDDLE STREET LANCASTER NH 03584 832130386 SUPPORTING ORGANIZATION NH 501(C)(3) LINE 12A, I WEEKS MEDICAL CENTER 1 0 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 ANDROSCOGGIN VALLEY HOSPITAL L 13708265 FMV ANDROSCOGGIN VALLEY HOSPITAL S 977468 FMV UPPER CONNECTICUT VALLEY HOSPITAL L 4733617 FMV UPPER CONNECTICUT VALLEY HOSPITAL S 336754 FMV WEEKS MEDICAL CENTER L 13254894 FMV WEEKS MEDICAL CENTER S 1035500 FMV NORTH COUNTRY HOME HEALTH & HOSPICE L 694724 FMV NORTH COUNTRY HOME HEALTH & HOSPICE S 72879 FMV