2019-05-15T08:28:56-05:00 2018-06-30 221478099 COHNREZNICK LLP 350 CHURCH STREET 12TH FLOOR HARTFORD CT 06103 990 2017-07-01 042610447 NORTH SHORE COMMUNITY HEALTH INC NORT 9788251109 27 CONGRESS ST NO 504 SALEM MA 01970 MARGARET BRENNAN CHIEF EXECUTIVE OFFICER 9788251109 2019-05-14 1 PAUL BALLASY P00852868 9592007000 2019-05-12 209.3.217.20 2019-05-14 10:45:52 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 90CC17281F34CD083B051E620E31C1B2A26173FC 2017 2019-02-21 02:37:17Z MARGARET BRENNAN 27 CONGRESS ST NO 504 SALEM MA 01970 17020041 0 X WWW.NSCHI.ORG X 1977 MA NORTH SHORE COMMUNITY HEALTH'S (NSCH) MISSION IS TO BUILD HEALTHY COMMUNITIES BY PROVIDING EXCEPTIONAL CARE TO ALL. 13 13 177 0 0 0 5593771 4744203 8473824 12072634 492 809 227438 202395 14295525 17020041 0 0 0 0 9402802 10130235 0 0 0 4483812 7651753 13886614 17781988 408911 -761947 5603986 5381097 1844215 2383273 3759771 2997824 X NORTH SHORE COMMUNITY HEALTH'S (NSCH) MISSION IS TO BUILD HEALTHY COMMUNITIES BY PROVIDING EXCEPTIONAL CARE TO ALL. 0 0 12119722 9475084 MEDICAL SERVICES - MEDICAL SERVICES ARE PROVIDED TO THE RESIDENTS OF THE NORTH SHORE AND CAPE ANN, BUT WE WILL CARE FOR ANYONE WHO PRESENTS TO US REGARDLESS OF WHERE THEY LIVE. MEDICAL SERVICES ARE PROVIDED TO BOTH ADULTS AND CHILDREN, AND INCLUDE:- PRIMARY CARE- MAT (MEDICATION ASSISTED TREATMENT): SERVICES OFFERED INCLUDE EDUCATION FOR DISEASE ADN OVERDOSE PREVENTION, NARCAN (NALOXONE) TRAINING AND COMPREHENSIVE BEHAVIORAL HEALTH SERVICES. THERE WERE 29,139 MEDICAL VISITS DURING THE TAX YEAR. 1880310 1594463 DENTAL SERVICES - DENTAL SERVICES PROVIDED PRIMARILY TO THE RESIDENTS OF THE NORTH SHORE AND CAPE ANN, BUT WE WILL CARE FOR ANYONE WHO PRESENTS TO US REGARDLESS OF WHERE THEY LIVE. THERE WERE 15,688 DENTAL VISITS DURING THE TAX YEAR. 639379 793445 SCHOOL BASED HEALTH CENTERS - PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES WERE PROVIDED TO STUDENTS AT THE FOLLOWING SCHOOLS:- SALEM HIGH SCHOOL- PEABODY VETERANS MEMORIAL HIGH SCHOOLADDITIONALLY, BEHAVIORAL HEALTH SERVICES ONLY ARE PROVIDED AT THE FOLLOWING SCHOOLS:- COLLINS MIDDLE SCHOOL- BENTLEY ELEMENTARY SCHOOL- BATES ELEMENTARY SCHOOL- NATHANIEL BOWDITCH SCHOOL THERE WERE 6,903 SCHOOL BASED HEALTH CENTER VISITS DURING THE TAX YEAR. 685410 407287 BEHAVIORAL HEALTH: THE BEHAVIORAL HEALTH DEPARTMENT OFFERS SERVICES TO OUR PATIENTS AT ALL OF OUR HEALTH CARE SITES FOR PERSONS OF ALL AGES OFFERING AFFORDABLE, COMPREHENSIVE, AND ACCESSIBLE BEHAVIORAL HEALTH CARE. THERE WERE 8,882 VISITS DURING THE TAX YEAR. 685410 407287 15324821 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 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 0 0 0 0 1 22 0 1 177 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X MARGARET BRENNAN 9788251109 27 CONGRESS ST NO 504 SALEM MA 01970 AMY LEACH BOARD MEMBER 2.00 X 0 0 0 CHARLOTTE OHANNESSIAN BOARD MEMBER 2.00 X 0 0 0 JACK VONDRAS CHAIR 2.00 X X 0 0 0 JACKSON MICHAEL FRIEDMAN BOARD MEMBER 2.00 X 0 0 0 LUCY CORCHADO VICE CHAIR 2.00 X X 0 0 0 MARION WINFREY BOARD MEMBER 2.00 X 0 0 0 MATTHEW VENO OUTGOING BOARD MEMBER 2.00 X 0 0 0 MAUREEN AYLWARD BOARD MEMBER 2.00 X 0 0 0 MICHAEL BABB BOARD MEMBER 2.00 X 0 0 0 PAMELA PAINE BOARD MEMBER 2.00 X 0 0 0 PETER KENT BOARD MEMBER 2.00 X 0 0 0 RITA BADAMI OUTGOING VICE PRESIDENT 2.00 X X 0 0 0 ROBERT TOLU TREASURER 2.00 X X 0 0 0 VENTURA LOREDO BOARD MEMBER 2.00 X 0 0 0 WILLIAM SULLIVAN BOARD MEMBER 2.00 X 0 0 0 CHRISTINE MALAGRIDA COO 50.00 X 121014 0 46 FAITH BAIGELMAN CFO THRU 8/17 50.00 X 100596 0 6420 MARC BOURASSA CFO 50.00 X 24345 0 1655 MARGARET BRENNAN CEO 50.00 X 198026 0 28245 AZRA ALI FAMILY PRACTICE PHYSICIAN 50.00 X 182904 0 0 DAMIAN ARCHER CMO 50.00 X 200291 0 9957 ESTHER DONO DE QUIUSKY PHYSICIAN 50.00 X 160350 0 25563 KATHERINE HOLLET PHYSICIAN 50.00 X 147855 0 28216 PAUL FORTE DENTIST 50.00 X 138144 0 2400 1273525 0 102502 11 0 1 0 INSOURCE SERVICES INC PO BOX 427 NEWTON MA 02464 IT SERVICES 293738 GE HEALTHCARE IITS USA CORP 15724 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CENTRICITY EHS VENDOR 155776 HR CONCEPTS LLC 111 CHARLES STREET MANCHESTER NH 03101 CONTRACTED HR SPECIALIST 118674 3 4620470 123733 4744203 MEDICAID 621110 5550855 5550855 PHARMACY REVENUE 621110 3518948 3518948 MEDICARE 621110 1080648 1080648 HEALTH SAFETY NET 621110 840485 840485 THIRD-PARTY PAYORS 621110 590480 590480 491218 491218 12072634 809 809 4750 0 4750 4750 4750 OTHER INCOME 621110 127559 127559 INCENTIVE PAYMENTS 621110 55125 55125 MEDICAL RECORD FEES 621110 14961 14961 197645 17020041 12270279 0 5559 471120 385870 85250 7932875 6480334 1452541 1109625 968272 141353 616615 538066 78549 71266 58438 12828 632018 529026 102992 600 492 108 317698 260514 57184 475496 389906 85590 524808 376749 148059 41034 33649 7385 22334 18314 4020 30950 25379 5571 248955 204144 44811 61540 50464 11076 PHARMACY AND RELATED FE 2405734 2405734 PROVISION FOR UNCOLLECT 1610302 1610302 HOUSEKEEPING SERVICES A 719404 589911 129493 BUILDING REPAIRS AND MA 119456 97954 21502 370158 301303 68855 17781988 15324821 2457167 0 177056 140854 205589 0 1123603 744655 1741733 2339345 37918 25971 210910 127048 6083527 4080303 2107177 2003224 5603986 5381097 1080450 1619825 763765 763448 1844215 2383273 X 2412040 2079493 1347731 918331 3759771 2997824 5603986 5381097 -761947 0 X X 0 1 X 1 1 1 X 3824937 3919087 4722271 5593771 4744203 22804269 3824937 3919087 4722271 5593771 4744203 22804269 22804269 7414 10336 6111 6492 5559 35912 338482 170319 209240 221438 197645 1137124 23977305 43972068 0.95110 0.94430 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2013 AMOUNT: $ 236,482. 2014 AMOUNT: $ 69,447. 2015 AMOUNT: $ 99,052. 2016 AMOUNT: $ 134,363. 2017 AMOUNT: $ 19,950. EMR INCENTIVE - 2013 AMOUNT: $ 102,000. 2014 AMOUNT: $ 93,500. 2015 AMOUNT: $ 30,158. 2017 AMOUNT: $ 55,125. MEDICAL RECORDS FEES - 2014 AMOUNT: $ 7,372. 2015 AMOUNT: $ 3,546. 2017 AMOUNT: $ 14,961. MBHP - 2015 AMOUNT: $ 76,484. 2016 AMOUNT: $ 87,075. 2017 AMOUNT: $ 0. PRIOR PERIOD - 2017 AMOUNT: $ 107,609. 1415592 1077054 338538 2913472 1589876 1323596 1661111 1413373 247738 93352 93352 2003224 X 15446639 36900 -1610302 -1573402 17020041 0 17020041 16208586 36900 36900 16171686 1610302 1610302 17781988 PART X, LINE 2: THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2018 AND 2017. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2015 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CENTER HAS UNRELATED BUSINESS INCOME TAXES, IT WILL RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENTS OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS -1,610,302. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 1,610,302. X X X X 0 0 0 0 0 0 0 0 0 MARGARET BRENNAN CEO 197904 0 0 0 122 0 0 0 28245 0 226271 0 0 0 AZRA ALI FAMILY PRACTICE PHYSICIAN 182803 0 0 0 101 0 0 0 0 0 182904 0 0 0 DAMIAN ARCHER CMO 200166 0 0 0 125 0 0 0 9957 0 210248 0 0 0 ESTHER DONO DE QUIUSKY PHYSICIAN 160260 0 0 0 90 0 0 0 25563 0 185913 0 0 0 KATHERINE HOLLET PHYSICIAN 147776 0 0 0 79 0 0 0 28216 0 176071 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 INITIAL COMPLETION IS DONE BY OUR AUDITORS. THE FORM 990 IS THEN SENT TO THE NORTH SHORE COMMUNITY HEALTH MANAGEMENT TEAM AND THEN FORWARDED TO THE MEMBERS OF THE BOARD OF DIRECTORS, WHO ARE ABLE TO SUBMIT ANY QUESTIONS, COMMENTS, OR OBSERVATIONS THAT THEY HAVE. THEN MANAGEMENT DISCUSSES ANY CHANGES THEY ARE GOING TO MAKE TO THE 990 FORM. IF CHANGES ARE DEEMED NECESSARY, THEY ARE MADE IMMEDIATELY. THE FORM 990 IS THEN APPROVED FOR SUBMISSION BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH EMPLOYEE, VOLUNTEER, AND BOARD MEMBER WILL ACKNOWLEDGE THAT THEY HAVE READ AND UNDERSTAND NORTH SHORE COMMUNITY HEALTH'S CONFLICT OF INTEREST POLICY UPON BEGINNING THEIR EMPLOYMENT OR TENURE WITH NORTH SHORE COMMUNITY HEALTH BY SIGNING AN ACKNOWLEDGEMENT FORM. THIS IS UPDATED ON A YEARLY BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE HEALTH CENTER'S OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE BOARD OF DIRECTORS UTILIZING A SALARY SURVEY. THE EXECUTIVE DIRECTOR SETS THE OTHER EMPLOYEES' SALARIES BASED ON A SALARY SURVEY IN ACCORDANCE WITH THE HEALTH CENTER'S BUDGET PARAMETERS. FORM 990, PART VI, SECTION C, LINE 19 NORTH SHORE COMMUNITY HEALTH, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS AVAILABLE TO THE GENERAL PUBLIC THROUGH WWW.GUIDESTAR.ORG. FORM 990, PART XII, LINE 2C: THERE HAVE BEEN NO CHANGES MADE TO THE ORGANIZATION'S OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.