2020-05-11T12:51:15-05:00 2019-06-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2018-07-01 331003630 Elliot Professional Services Network Inc ELLI 6036638914 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 Michael S Turilli CFO 6036638914 2020-04-22 1 Nicholas E Porto P01310283 8002447444 2020-04-22 208.105.168.164 2020-04-22 09:31:39 ED P 3452BD8595D9AC820B41F271E29CE8BF50AD3EDC C5776562590C3A5EE30B3770250D94B4E643E30E 2018 2020-09-23 17:36:50Z William G Baxter 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 60581416 0 X N/A X 2004 NH To promote the charitable, medical and scientific, and educational purposes of the Elliot Health System and its affiliated organizations through the employment of physicians and other professional personnel to provide medical care to those in need. 10 5 289 5 0 0 34268 49946 57386060 60531470 27589 -209 0 0 57447917 60581207 0 0 0 0 80458022 86076892 0 0 0 10419713 9266417 90877735 95343309 -33429818 -34762102 6689672 5651299 12224341 13224802 -5534669 -7573503 X The Elliot Professional Services Network is a group of highly specialized physicians and care providers, which are dedicated to the promotion of highest quality, compassionate and accessible health care. We realize the importance of each patient and each physician in the patient/physician relationship. We are guided by the desire to work within the larger Elliot Health System to create a healthy community. 0 0 93504522 0 60531470 To provide qualified professional personnel and make the services of such health care professionals available to such persons, including indigent persons, requiring medical care 93504522 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 30 0 1 289 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 5 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Michael S Turilli 6036638914 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 Loretta LC Brady PhD Trustee 1.00 3.00 X 0 0 0 Christopher Calhoun MD Trustee 40.00 1.00 X 0 217557 47310 Manish Chopra MD Trustee (end 3/19) 40.00 1.00 X 0 321072 35664 David Cuzzi Trustee 1.00 3.00 X 0 0 0 Michelle Decelle Trustee 1.00 1.00 X 0 0 0 Carl Fier MD Trustee 40.00 1.00 X 819602 0 22447 Mark Integlia MD Trustee 40.00 1.00 X 376681 0 33860 Steve Langan Trustee 1.00 4.00 X 0 0 0 Bryan Lawless MD Trustee 40.00 1.00 X 729790 0 35867 Holly P Mintz MD Trustee (end 9/18) 1.00 44.00 X 0 389538 45261 Mary Sargent Trustee (end 8/18) 1.00 3.00 X 0 0 0 Paul W Hoff PhD Chair 1.00 3.00 X X 0 0 0 William G Baxter President & CEO 2.00 50.00 X X 0 530857 97486 Douglas F Dean President & CEO (end 8/18) 2.00 48.00 X X 0 840304 16281 Michael S Turilli CFO 2.00 48.00 X 0 151272 10052 Elizabeth Soukup MD Physician 40.00 2.00 X 1438721 0 34270 Lawrence Hoepp Physician 40.00 1.00 X 852691 0 28704 Robert C Parisien MD Physician 40.00 0.00 X 849902 0 34890 Marina Feldman MD Physician 40.00 0.00 X 1113767 0 35604 Carla De Venecia Physician 40.00 0.00 X 871554 0 21477 Joseph Ingold Former CFO 0.00 0.00 X 0 323444 0 7052708 2774044 499173 185 1 1 0 Elliot Hospital of the City of Mancheste 1 Elliot Way Manchester NH 03103 Management and Administration 1838787 Medicus Surgery LLC 22 Roulston Road Windham NH 03087 Physician Services 1021397 LocumTenenscom LLC 2655 Northwinds Parkway Alpharetta GA 30009 Physician Services 414348 NH Neurospine Institute 4 Hawthorne Drive Lebanon NH 037560001 Medical Services 394794 Mary Hitchcock Memorial Hospital 1 Medical Center Drive Lebanon NH 037560001 Medical Services 374043 10 49946 49946 Patient services 621110 57328013 57328013 Other medical services 621110 3203457 3203457 60531470 209 -209 -209 -209 60581207 60531470 0 -209 2018247 2018247 72779821 72779821 2298761 2298761 5528465 5528465 3451598 3451598 19476 19476 2115549 296238 1819311 6726 6726 1706425 1706425 1742063 1742063 8742 8742 13779 13779 162741 162741 11970 11970 Provision for bad debt 1736266 1736266 Medical supplies 1592672 1592672 Medical services 146090 146090 Provision for UBI taxes 3918 3918 95343309 93504522 1838787 0 780 880 1589349 1719218 4568811 3373152 199212 222427 1487162 1151540 331520 335622 6689672 5651299 9049236 9130635 3175105 4094167 12224341 13224802 X -5534669 -7573503 -5534669 -7573503 6689672 5651299 X -34762102 32723268 X X 0 1 X 1 0 X 27641 26124 37392 34273 49946 175376 58454479 59473877 57535250 57386055 60531470 293381131 58482120 59500001 57572642 57420328 60581416 293556507 0 0 0 293556507 453 133 127 53 0 766 453 133 127 53 766 58482573 59500134 57572769 57420381 60581416 293557273 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1487162 1151540 335622 335622 Due to affiliates 1374885 Due to third party payors 11763 Accrued pension obligations 2707519 4094167 X 59819475 -761732 -761732 60581207 0 60581207 95343309 0 95343309 0 95343309 Part X, Line 2: Elliot Hospital, EPN and EPS are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code, and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Hospital's tax positions and concluded the Hospital has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to the financial statements. Part XI, Line 2d - Other Adjustments: Net periodic pension adjustment -761,732. 0 1 0 0 0 0 0 1 0 Christopher Calhoun MD Trustee 0 211148 0 5646 0 763 0 26569 0 20741 0 264867 0 0 Manish Chopra MD Trustee (end 3/19) 0 302577 0 0 0 18495 0 21998 0 13666 0 356736 0 0 Carl Fier MD Trustee 818589 0 0 0 1013 0 8100 0 14347 0 842049 0 0 0 Mark Integlia MD Trustee 351300 0 5000 0 20381 0 13600 0 20260 0 410541 0 0 0 Bryan Lawless MD Trustee 689901 0 20488 0 19401 0 13600 0 22267 0 765657 0 0 0 Holly P Mintz MD Trustee (end 9/18) 0 381461 0 7292 0 785 0 27659 0 17602 0 434799 0 0 William G Baxter President & CEO 0 441672 0 66575 0 22610 0 76548 0 20938 0 628343 0 0 Douglas F Dean President & CEO (end 8/18) 0 798224 0 0 0 42080 0 0 0 16281 0 856585 0 0 Michael S Turilli CFO 0 135742 0 15225 0 305 0 0 0 10052 0 161324 0 0 Elizabeth Soukup MD Physician 1188050 0 250000 0 671 0 13600 0 20670 0 1472991 0 0 0 Lawrence Hoepp Physician 829256 0 0 0 23435 0 13600 0 15104 0 881395 0 0 0 Robert C Parisien MD Physician 808147 0 22448 0 19307 0 13600 0 21290 0 884792 0 0 0 Marina Feldman MD Physician 761311 0 351370 0 1086 0 13600 0 22004 0 1149371 0 0 0 Carla De Venecia Physician 732997 0 119276 0 19281 0 13600 0 7877 0 893031 0 0 0 Joseph Ingold Former CFO 0 310944 0 0 0 12500 0 0 0 0 0 323444 0 0 Part I, Line 3 The President & CEO of Elliot Professional Services Network is compensated by a related organization, The Elliot Hospital of the City of Manchester. The Hospital uses a compensation committee, an independent compensation consultant, Forms 990 of other organizations, compensation studies, and approval by the Board or a compensation committee to establish the compensation for the President & CEO. Part I, Line 4b 2018 contributions to William G. Baxter's 457(f) plan during the year totaled $62,948. The System maintains a defined benefit pension plan for certain employees, the Elliot Health System Pension Plan (the Plan). Effective July 1, 2006, the Plan was amended to close the Plan to employees hired after June 30, 2006. Eligible employees hired prior to July 1, 2006 are grandfathered under the Plan and will continue to accrue benefits as long as they remain at a participating System entity and in an eligible status. The System's funding policy is to contribute amounts to the Plan sufficient to meet minimum funding requirements set forth in the Employee Retirement Income Security Act of 1974, plus such additional amounts as might be determined to be appropriate from time to time. The Plan is intended to constitute a plan described in Section 414(k) of the Internal Revenue Code, under which benefits derived from employer contributions are based on the separate account balances of participants in addition to the defined benefits under the Plan. Douglas F. Dean, an officer of the filing organization, resigned from his position with the Hospital in calendar year 2018. Historically, Dean received defined contributions under the 414(K) plan, due to being grandfathered into the pension system. However, in calendar year 2018, neither Dean nor any other officers or employees of Elliot Hospital received defined contributions under the now-closed 414(K) plan. Additionally, defined benefit amounts for Christopher Calhoun of $26,569, Manish Chopra of $21,998, and Holly Mintz of $27,659, which includes the actuarial change in value for the year, are included in Schedule J, Part II, Column C and Form 990, Part VII-A, Column F as deferred compensation for each respective individual. Part I, Line 7 The Organization has adopted an incentive pay program that provides designated management employees an opportunity to earn a designated percentage of salary based on the achievement by the Organization of a number of critical success factors. The critical success factors are established annually by the independent executive compensation committee of the Board of Trustees with assistance from an independent national compensation consulting company. The maximum potential incentive payments under the plan are considered by the compensation consultant in ensuring that management compensation is reasonable. Form 990, Part VII-A and Schedule J, Part II: Joseph Ingold, who served as the interim Chief Financial Officer until June 2018, was a contracted employee through Ingold & Associates, LLC. The LLC is unrelated to the filing organization and its affiliates. The total compensation paid to Mr. Ingold's LLC for his services during 2018 was $310,944. Additionally, Mr. Ingold received a housing allowance in the amount of $12,500 during the 2018 calendar year, which is included in the amount paid to Ingold & Associates, LLC. As the fees paid to the LLC were paid for services to the entire related party system, an accurate breakdown of the fees relative to the filing organization is not readily determinable. In accordance with IRS instructions, these fees have been reported as compensation on Form 990, Part VII-A and Schedule J, Part II and further disclosed in Schedule O for Form 990, Part VI, Line 3. See also Schedule L. Ingold & Associates LLC Chief Financial Officer 323944 Joseph Ingold, who served as Chief Financial Officer during the previous reporting period, was an officer of Ingold & Associates, LLC, an unrelated organization paid by Elliot Hospital for Mr. Ingold's services as CFO to the entire health system. As the fees paid by the Hospital were for Mr. Ingold's services to the entire related party system, an accurate breakdown of this fee relative to the filing organization is not readily determinable, though Mr. Ingold was paid both compensation for his services and provided a housing allowance. Joseph Ingold did not serve the Elliot Healthcare System during the period ending June 30, 2019, but he was compensated during the 2018 calendar year. Therefore, this relationship and the associated compensation and housing allowance paid to Mr. Ingold has been disclosed on the fiscal year 2019 Form 990, on Part VII, Schedule L, and Schedule J. 0 Form 990, Part VI, Section A, line 3 Joseph Ingold, who served as the interim Chief Financial Officer until June 2018, was a contracted employee through Ingold & Associates, LLC. The LLC is unrelated to the filing organization and its affiliates. The total compensation paid to Mr. Ingold's LLC for his services during 2018 was $310,944. Additionally, Mr. Ingold received a housing allowance in the amount of $12,500 during the 2018 calendar year, which is included in the amount paid to Ingold & Associates, LLC. As the fees paid to the LLC were paid for services to the entire related party system, an accurate breakdown of the fees relative to the filing organization is not readily determinable. In accordance with IRS instructions, these fees have been reported as compensation on Form 990, Part VII-A and Schedule J, Part II and further disclosed in Schedule O for Form 990, Part VI, Line 3. See also Schedule L. Form 990, Part VI, Section A, line 6 Elliot Hospital is the sole member of the reporting organization. Form 990, Part VI, Section A, line 7a Elliot Hospital, the sole member of the reporting organization, has the right to ratify the election of all Board members of Elliot Professional Services Network. Additionally, representatives from the sole member share equal representation on the Board of Trustees with the filing organization. Form 990, Part VI, Section A, line 7b The sole member, Elliot Hospital, has the right to the following governance decisions: approval of Elliot Professional Services Network's annual budget, approval of Bylaws and Articles of Organization and amendments of same, and approval of strategic plans. Form 990, Part VI, Section B, line 11b The completed Form 990 is presented to the full Board prior to filing. Board members can review the draft and bring any questions forward for discussion prior to filing. Form 990, Part VI, Section B, line 12c Officers, directors and key employees are required annually to sign a conflict of interest form which requires reporting any potential conflict of interest arrangements with the organization. Form 990, Part VI, Section B, line 15 The compensation committee of the board utilizes outside compensation consultants to evaluate the salaries for the CEO, CFO, and COO. The consultants utilize their internal data along with national and local benchmark data from the industry to develop salary levels. Recommendations of the consultant are reviewed by the compensation committee, who recommends compensation levels to the full Board for approval. An outside consulting firm is also used by the organization to review the compensation of the remainder of the Vice Presidents. Again, national and local benchmarks for salaries are consulted to determine salary levels for these positions. Form 990, Part VI, Section C, line 19 Each of these documents is filed with the New Hampshire Secretary of State and is available upon request. Form 990, Part XI, line 9: Transfers from affiliates 33,485,000. Net periodic pension adjustment -761,732. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Elliot Health System 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509911 Management NH 501(c)(3) Line 12b, II SolutionHealth 0 Elliot Health System Professional & General LIT 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 016217452 Insurance Trust NH 501(c)(3) Line 12a, I Elliot Hospital 0 Elliot Hospital Associates 1 Elliot Way Manchester NH 031033599 026006214 Auxiliary NH 501(c)(3) Line 12d, III-O N/A 0 Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509589 Physician Services NH 501(c)(3) Line 3 Elliot Hospital 0 Elliot Hospital 1 Elliot Way Manchester NH 03103 020232673 Medical Services NH 501(c)(3) Line 3 Elliot Health System 0 Foundation Medical Partners Inc 8 Prospect Street Nashua NH 03060 020456218 Physician Services NH 501(c)(3) Line 10 Southern New Hampshire Health System 0 Mary and John Elliot Charitable Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512229 Fundraising NH 501(c)(3) Line 7 Elliot Health System 0 SolutionHealth 360 Route 101 Unit 8 Manchester NH 03110 830741190 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Southern New Hampshire Health System 8 Prospect Street Nashua NH 03060 020509221 Medical Services NH 501(c)(3) Line 12b, II SolutionHealth 0 Southern New Hampshire Medical Center 8 Prospect Street Nashua NH 03060 020483054 Medical Services NH 501(c)(3) Line 3 Southern New Hampshire Health System 0 VNA Community Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020396549 Nursing Services NH 501(c)(3) Line 7 Elliot Health System 0 VNA Home Health and Hospice Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020222241 Home Care and Hospice NH 501(c)(3) Line 10 Elliot Health System 0 VNA of Manchester & Southern NH Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395296 VNA Holding Company NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA of Southern New Hampshire Foundation 1070 Holt Avenue Unit 1 Suite 1400 Manchester NH 03109 223313877 Supporting Organization NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA Personal Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395295 Private Health and Homemaker Services NH 501(c)(3) Line 10 Elliot Health System 0 Elliot Common Trust Fund LLC 1 Elliot Way Manchester NH 03103 203653624 Investments NH N/A Elliot Health System Holdings & Subsidiaries 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512224 Management NH N/A C 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 The Elliot Hospital of the City of Manchester O 18709033 The Elliot Hospital of the City of Manchester P 10183040