ELLIOT PROFESSIONAL SERVICES: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ELLIOT PROFESSIONAL SERVICES (EIN 33-1003630)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-10
- IRS object ID
- 201801309349301250
- Schema version
- 2016v3.0
- 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 | 2018-05-10T08:49:02-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010494526 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER NEWMAN & NOYES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 650 ELM STREET SUITE 302 | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 331003630 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Elliot Professional Services | BusinessNameLine1Txt |
| Business Name Line2 | Network Inc | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ELLI | BusinessNameControlTxt |
| Phone | 6036638914 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1070 Holt Avenue Unit 1 No 2100 | AddressLine1Txt |
| City | Manchester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03109 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Joseph Ingold | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6036638914 | PhoneNum |
| Signature | 2018-05-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Nicholas E Porto | PreparerPersonNm |
| PTIN | P01310283 | PTIN |
| Phone | 8002447444 | PhoneNum |
| Preparation | 2018-05-03 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Douglas F Dean | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1070 Holt Avenue Unit 1 No 2100 | AddressLine1Txt |
| City | Manchester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03109 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $57,572,769 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 257 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $26,124 | PYContributionsGrantsAmt |
| CY Contributions Grants | $37,392 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $59,473,877 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $57,535,250 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$169 | PYInvestmentIncomeAmt |
| CY Investment Income | -$13,491 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $59,499,832 | PYTotalRevenueAmt |
| CY Total Revenue | $57,559,151 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $72,780,827 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $73,674,770 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,510,957 | PYOtherExpensesAmt |
| CY Other Expenses | $11,078,408 | CYOtherExpensesAmt |
| PY Total Expenses | $83,291,784 | PYTotalExpensesAmt |
| CY Total Expenses | $84,753,178 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$23,791,952 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$27,194,027 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,211,241 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,107,623 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,763,963 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,839,923 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$3,552,722 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$4,732,300 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $82,477,448 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $57,535,250 | RevenueAmt |
| Desc | To provide qualified professional personnel and make the services of such health care professionals available to such persons, including indigent persons, requiring medical care | Desc |
| Total Program Service Expenses | $82,477,448 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 257 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | 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 | Joseph Ingold | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6036638914 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1070 Holt Avenue Unit 1 No 2100 | AddressLine1Txt |
| City | Manchester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03109 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Loretta LC Brady PhD | |||||||||
| Trustee | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| Howard Brodsky | |||||||||
| Trustee | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| Christopher Calhoun MD | |||||||||
| Trustee | 1.00 | 41.00 | Yes (X) | $0 | $219,015 | $40,256 | |||
| Manish Chopra MD | |||||||||
| Trustee | 1.00 | 41.00 | Yes (X) | $0 | $275,036 | $35,327 | |||
| Carl Fier MD | |||||||||
| Trustee | 41.00 | 1.00 | Yes (X) | $877,066 | $0 | $19,793 | |||
| Mark Integlia MD | |||||||||
| Trustee | 41.00 | 1.00 | Yes (X) | $389,169 | $0 | $25,378 | |||
| Holly P Mintz MD | |||||||||
| Trustee | 1.00 | 43.00 | Yes (X) | $0 | $420,952 | $33,912 | |||
| Sean Owen | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Ann G Remus | |||||||||
| Trustee (end 12/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Mary Sargent | |||||||||
| Trustee | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| John F Weeks | |||||||||
| Trustee (end 1/17) | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| Paul W Hoff PhD | |||||||||
| Chair | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Douglas F Dean | |||||||||
| CEO | 1.00 | 45.50 | Yes (X) | $0 | $246,376 | $46,945 | Yes (X) | ||
| Arnold Gary Muller | |||||||||
| CEO (end 8/16) | 1.00 | 45.50 | Yes (X) | $0 | $256,350 | $0 | Yes (X) | ||
| James L Woodward | |||||||||
| CEO (end 7/16) | 1.00 | 45.50 | Yes (X) | $0 | $372,236 | $84,714 | Yes (X) | ||
| Joseph Ingold | |||||||||
| CFO | 1.00 | 44.60 | $0 | $368,380 | $0 | Yes (X) | |||
| Jeffrey Rooney | |||||||||
| Interim CFO (end 1/17) | 1.00 | 44.60 | $0 | $682,824 | $0 | Yes (X) | |||
| Lawrence M Hoepp MD | |||||||||
| Physician | 40.00 | 2.00 | $871,110 | $0 | $26,252 | Yes (X) | |||
| Robert C Parisien MD | |||||||||
| Physician | 40.00 | 0.00 | $1,023,740 | $0 | $31,087 | Yes (X) | |||
| Marina Feldman MD | |||||||||
| Physician | 40.00 | 0.00 | $820,127 | $0 | $31,278 | Yes (X) | |||
| Curtis Kloc MD | |||||||||
| Physician | 40.00 | 0.00 | $746,024 | $0 | $30,729 | Yes (X) | |||
| Elizabeth Soukup MD | |||||||||
| Physician | 40.00 | 0.00 | $769,902 | $0 | $30,874 | Yes (X) | |||
| Richard A Elwell | |||||||||
| Former CFO | 0.00 | 0.00 | $0 | $976,002 | $22,748 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,497,138 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,817,171 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $459,293 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 172 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | 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 |
|---|---|---|---|---|---|
| Elliot Hospital of the City of Mancheste | |||||
| 1 Elliot Way | Manchester | NH | 03103 | Management and Administration | $2,268,679 |
| Locum Tenens | |||||
| 2655 Northwinds Parkway | Alpharetta | GA | 30009 | Physician Services | $482,319 |
| Mass General Physician Organization | |||||
| PO Box 3662 | Boston | MA | 02241 | Surgery Program Development | $416,051 |
| Bedford Commons OB-GYN PA | |||||
| 201 Riverway Place | Bedford | NH | 03110 | OB/GYN On Call Coverage | $295,000 |
| Faith Minard ARNP | |||||
| 88 Blanford Place | Bedford | NH | 03110 | Nursing Services | $248,848 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $13,634 | RelatedOrganizationsAmt |
| All Other Contributions | $23,758 | AllOtherContributionsAmt |
| Total Contributions | $37,392 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Services | 621110 | $54,743,943 | $54,743,943 |
| Other Medical Services | 621110 | $2,791,307 | $2,791,307 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $57,535,250 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $127 | TotalRevenueColumnAmt |
| Exclusion | $127 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $13,618 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$13,618 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$13,618 | TotalRevenueColumnAmt |
| Exclusion | -$13,618 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,559,151 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $57,535,250 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$13,491 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,311,406 | TotalAmt |
| Program Services | $1,311,406 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,583,257 | TotalAmt |
| Program Services | $63,583,257 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,065,563 | TotalAmt |
| Program Services | $2,065,563 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,008,959 | TotalAmt |
| Program Services | $4,008,959 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,705,585 | TotalAmt |
| Program Services | $2,705,585 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,097 | TotalAmt |
| Management And General | $20,097 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,402,749 | TotalAmt |
| Program Services | $154,167 | ProgramServicesAmt |
| Management And General | $2,248,582 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,051 | TotalAmt |
| Management And General | $7,051 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,392,388 | TotalAmt |
| Program Services | $1,392,388 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,647,509 | TotalAmt |
| Program Services | $1,647,509 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,166 | TotalAmt |
| Program Services | $4,166 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,976 | TotalAmt |
| Program Services | $17,976 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,545 | TotalAmt |
| Program Services | $155,545 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Provision for Bad Debt | $4,347,677 | $4,347,677 |
| Medical Supplies | $974,027 | $974,027 |
| Medical Services | $109,223 | $109,223 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,753,178 | TotalAmt |
| Program Services | $82,477,448 | ProgramServicesAmt |
| Management And General | $2,275,730 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $680 | BOYAmt |
| EOY | $680 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,201,946 | BOYAmt |
| EOY | $802,558 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,801,911 | BOYAmt |
| EOY | $5,039,017 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,500 | BOYAmt |
| EOY | $157,798 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,129,173 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,021,603 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,094 | BOYAmt |
| EOY | $107,570 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,110 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,211,241 | BOYAmt |
| EOY | $6,107,623 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,300,840 | BOYAmt |
| EOY | $7,365,949 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,463,123 | BOYAmt |
| EOY | $3,473,974 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,763,963 | BOYAmt |
| EOY | $10,839,923 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,552,722 | BOYAmt |
| EOY | -$4,732,300 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,552,722 | BOYAmt |
| EOY | -$4,732,300 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,211,241 | BOYAmt |
| EOY | $6,107,623 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$27,194,027 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $26,014,449 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,629 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $50,961 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,641 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,124 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,392 | CurrentTaxYearAmt |
| Total | $152,747 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,170,917 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57,236,894 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $58,454,479 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,473,877 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $57,535,250 | CurrentTaxYearAmt |
| Total | $287,871,417 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,181,546 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57,287,855 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $58,482,120 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,500,001 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $57,572,642 | CurrentTaxYearAmt |
| Total | $288,024,164 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $288,024,164 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,366 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,789 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $453 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $133 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $127 | CurrentTaxYearAmt |
| Total | $9,868 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,366 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,789 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $453 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $133 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $127 | CurrentTaxYearAmt |
| Total | $9,868 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,186,912 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57,291,644 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $58,482,573 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,500,134 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $57,572,769 | CurrentTaxYearAmt |
| Total | $288,034,032 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,129,173 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,021,603 | DepreciationAmt |
| Book Value | $107,570 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $107,570 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due To Affiliates | $1,264,974 |
| Due to Third Party Payors | $11,763 |
| Accrued Pension | $2,197,237 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,473,974 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $58,068,600 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $509,449 | OtherRevenueAmt |
| Revenue Not Reported | $509,449 | RevenueNotReportedAmt |
| Revenue Subtotal | $57,559,151 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $57,559,151 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $84,753,178 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $84,753,178 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $84,753,178 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 consolidated financial statements. |
| Part XI, Line 2d - Other Adjustments: | Pension Adjustment 509,449. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Christopher Calhoun MD | ||||||||||||||
| Trustee | $0 | $218,868 | $0 | $0 | $0 | $147 | $0 | $22,159 | $0 | $18,097 | $0 | $259,271 | $0 | $0 |
| Manish Chopra MD | ||||||||||||||
| Trustee | $0 | $258,413 | $0 | $0 | $0 | $16,623 | $0 | $17,834 | $0 | $17,493 | $0 | $310,363 | $0 | $0 |
| Carl Fier MD | ||||||||||||||
| Trustee | $876,486 | $0 | $0 | $0 | $580 | $0 | $7,950 | $0 | $11,843 | $0 | $896,859 | $0 | $0 | $0 |
| Mark Integlia MD | ||||||||||||||
| Trustee | $370,313 | $0 | $0 | $0 | $18,856 | $0 | $7,950 | $0 | $17,428 | $0 | $414,547 | $0 | $0 | $0 |
| Holly P Mintz MD | ||||||||||||||
| Trustee | $0 | $420,848 | $0 | $0 | $0 | $104 | $0 | $22,378 | $0 | $11,534 | $0 | $454,864 | $0 | $0 |
| Douglas F Dean | ||||||||||||||
| CEO | $0 | $157,118 | $0 | $0 | $0 | $89,258 | $0 | $33,692 | $0 | $13,253 | $0 | $293,321 | $0 | $70,740 |
| Arnold Gary Muller | ||||||||||||||
| CEO (end 8/16) | $0 | $37,500 | $0 | $0 | $0 | $218,850 | $0 | $0 | $0 | $0 | $0 | $256,350 | $0 | $0 |
| James L Woodward | ||||||||||||||
| CEO (end 7/16) | $0 | $355,214 | $0 | $0 | $0 | $17,022 | $0 | $76,040 | $0 | $8,674 | $0 | $456,950 | $0 | $0 |
| Joseph Ingold | ||||||||||||||
| CFO | $0 | $325,088 | $0 | $0 | $0 | $43,292 | $0 | $0 | $0 | $0 | $0 | $368,380 | $0 | $0 |
| Jeffrey Rooney | ||||||||||||||
| Interim CFO (end 1/17) | $0 | $645,970 | $0 | $0 | $0 | $36,854 | $0 | $0 | $0 | $0 | $0 | $682,824 | $0 | $0 |
| Lawrence M Hoepp MD | ||||||||||||||
| Physician | $846,789 | $0 | $0 | $0 | $24,321 | $0 | $13,250 | $0 | $13,002 | $0 | $897,362 | $0 | $0 | $0 |
| Robert C Parisien MD | ||||||||||||||
| Physician | $1,005,143 | $0 | $0 | $0 | $18,597 | $0 | $13,250 | $0 | $17,837 | $0 | $1,054,827 | $0 | $0 | $0 |
| Marina Feldman MD | ||||||||||||||
| Physician | $819,883 | $0 | $0 | $0 | $244 | $0 | $13,250 | $0 | $18,028 | $0 | $851,405 | $0 | $0 | $0 |
| Curtis Kloc MD | ||||||||||||||
| Physician | $727,653 | $0 | $0 | $0 | $18,371 | $0 | $13,250 | $0 | $17,479 | $0 | $776,753 | $0 | $0 | $0 |
| Elizabeth Soukup MD | ||||||||||||||
| Physician | $769,603 | $0 | $0 | $0 | $299 | $0 | $13,250 | $0 | $17,624 | $0 | $800,776 | $0 | $0 | $0 |
| Richard A Elwell | ||||||||||||||
| Former CFO | $0 | $281,823 | $0 | $68,200 | $0 | $625,979 | $0 | $16,563 | $0 | $6,185 | $0 | $998,750 | $0 | $607,979 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | The 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 CEO. |
| Part I, Lines 4a-b | Arnold Gary Muller, an officer of the filing organization who was compensated by a related organization, The Elliot Hospital of the City of Manchester, received a severance payment of $130,000 during calendar year 2016. This amount is reported in Schedule J, Part II, Column B(iii). 2016 contributions to the 457(f) plan of The Elliot Hospital of the City of Manchester, a related organization, during the year were: James Woodward-$70,740; Richard Elwell-$16,563. |
| Schedule J, Part II: | During the year, Mr. Dean and Mr. Elwell withdrew funds from their deferred compensation plans ($70,740 and $607,979, respectively). These amounts are reported as taxable compensation in Part III, Column B(iii). It should be noted that, when appropriate, these amounts were reported, or would have been reported if the individual was required to be reported in Form 990, Part VII, in prior years as deferred compensation in Part II, Column C. Accordingly, these total amounts are reflected in Part II, Column F so as to not overstate compensation in the current year that was earned over a period of years. |
| Form 990, part VII-A and Schedule J, Part II: | Jeffrey Rooney, who served as Chief Financial Officer until January 2017, and Joseph Ingold, who took over as Chief Financial Officer at that time, were both contracted employees through Martinville Dunn, LLC and Ingold & Associates, LLC, respectively. Both LLCs are unrelated to Elliot Professional Services Network, Inc. and were paid by The Elliot Hospital of the City of Manchester, a related organization. Compensation in the amount of $645,970 was paid to Martinville, Dunn, LLC by the Hospital for Mr. Rooney's services. The total compensation paid to Mr. Ingold's LLC for his services, both as CFO and in a non-officer capacity prior to his role as CFO, during 2016 was $325,088. Additionally, Mr. Rooney received a housing allowance in the amount of $36,854 during 2016 from the Hospital and Mr. Ingold received a similar housing allowance in the amount of $43,292 during the calendar year. As the fees paid to each 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. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Martinville Dunn LLC | |||
| Chief Financial Officer | $682,824 | Jeffrey Rooney, who served as Chief Financial Officer during a portion of the reporting period, was an officer of Martinville Dunn, LLC, an unrelated organization paid by Elliot Hospital for Mr. Rooney's services as CFO to the entire health system. As the fees paid by the Hospital were for Mr. Rooney's services to the entire related party system, an accurate breakdown of this fee relative to the filing organization is not readily determinable. Therefore, the entire payment made to Martinville Dunn, LLC and the related housing allowance for Mr. Rooney have been disclosed here. | 0 |
| Ingold & Associates LLC | |||
| Chief Financial Officer | $368,380 | Joseph Ingold, who served as Chief Financial Officer during a portion of the 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. Therefore, the entire payment made to Ingold & Associates, LLC and the related housing allowance for Mr. Ingold have been disclosed here. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | Jeffrey Rooney, who served as Chief Financial Officer until January 2017, and Joseph Ingold, who took over as Chief Financial Officer at that time, were both contracted employees through Martinville Dunn, LLC and Ingold & Associates, LLC, respectively. Both LLCs are unrelated to Elliot Physician Network and were compensated by The Elliot Hospital of the City of Manchester, a related organization. Compensation in the amount of $645,970 was paid to Martinville, Dunn, LLC by the Hospital for Mr. Rooney's services. The total compensation paid to Mr. Ingold's LLC for his services, both as CFO and in a non-officer capacity prior to his role as CFO, during 2016 was $325,088. Additionally, Mr. Rooney received a housing allowance in the amount of $36,854 during 2016 from the Hospital and Mr. Ingold received a similar housing allowance in the amount of $43,292 during the calendar year. As the fees paid to each 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: | Transfer from Affiliates 25,505,000. Pension Adjustment 509,449. |
| Form 990, Part XII, Line 2c: | The audit process has not changed from the prior year. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Elliot Health System | |||||||||||
| 1070 Holt Avenue Unit 1 Suite 2100 | Manchester | NH | 03109 | 020509911 | Management | NH | 501(c)(3) | Line 12b, II | N/A | 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 | 0 | Elliot Hospital | |
| Elliot Hospital | |||||||||||
| 1 Elliot Way | Manchester | NH | 03103 | 020232673 | Physician Services | NH | 501(c)(3) | Line 3 | 0 | Elliot Health System | |
| Elliot Physician Network | |||||||||||
| 1070 Holt Avenue Unit 1 Suite 2100 | Manchester | NH | 03109 | 020509589 | Physician Services | NH | 501(c)(3) | Line 3 | 0 | Elliot Hospital | |
| Everwell Inc | |||||||||||
| 1 Medical Center Drive | Lebanon | NH | 03756 | 352506275 | Supporting Organization | NH | 501(c)(3) | Line 12a, I | N/A | 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 | 0 | Elliot Health System | |
| VNA Community Services Inc | |||||||||||
| 1070 Holt Avenue Unit 1 Suite 2100 | Manchester | NH | 03109 | 020396549 | Nursing Services | NH | 501(c)(3) | Line 7 | 0 | Elliot Health System | |
| 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 | 0 | Elliot Health System | |
| VNA of Manchester & Southern NH Inc | |||||||||||
| 1070 Holt Avenue Unit 1 Suite 2100 | Manchester | NH | 03109 | 030395296 | VNA Holding Company | NH | 501(c)(3) | Line 12b, II | 0 | Elliot Health System | |
| 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 | 0 | Elliot Health System | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Elliot Common Trust Fund LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Elliot Way | AddressLine1Txt |
| City | Manchester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203653624 | EIN |
| Primary Activities | Investments | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Elliot Health System Holdings & Subsidiaries | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1070 Holt Avenue Unit 1 Suite 2100 | AddressLine1Txt |
| City | Manchester | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03109 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020512224 | EIN |
| Primary Activities | Management | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | 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 | Yes (1) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part II: | FormAndLineReferenceDesc |
| Explanation | Everwell, Inc. was formed in 2014 as a 501(c)(3) organization. It is a joint venture between Elliot Health System and Dartmouth Hitchcock Health, with each entity having equal representation on the Board of Directors. | ExplanationTxt |