2018-07-16T07:49:11-05:00 2017-09-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2016-10-01 020274905 Rockingham Visiting Nurse Association and Hospice ROCK 6035806695 5 Alumni Drive Exeter NH 03833 Kevin J O'Leary Treasurer 6035806695 2018-06-26 1 Timothy R Hepburn P00182393 8002447444 2018-06-26 2016 2022-09-23 18:48:47Z Kevin J Callahan 5 Alumni Drive Exeter NH 03833 17031305 0 X N/A X 1996 NH The mission of Rockingham VNA & Hospice, a home health agency, is to assist in improving the health of the community. This mission is principally accomplished through the provision of health services and information to the community. Rockingham VNA & Hospice works to accomplish this mission by promoting well being and independence by providing patient-centered health care services in the comfort of the home and within the communities served. 7 0 191 55 0 0 141336 48126 16380834 16975309 6858 7870 0 0 16529028 17031305 0 4713 0 0 11949498 13460818 0 0 0 4073673 4010648 16023171 17476179 505857 -444874 5778007 5650889 2410201 2698723 3367806 2952166 X The mission of Rockingham VNA & Hospice, a home health agency, is to assist in improving the health of the community. This mission is principally accomplished through the provision of health services and information to the community. Rockingham VNA & Hospice works to accomplish this mission by promoting well being and independence by providing patient-centered health care services in the comfort of the home and within the communities served. 0 0 15957741 4713 16975309 Rockingham VNA & Hospice's Home Care Program provides comprehensive skilled services to the adult population. The goal of these services is to improve the health and independence of the patients we serve. Our services include Skilled Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Social Work services, Home Health Aide, Dietician, IV Specialist, Wound/Ostomy Specialist, Certified Diabetes Educator, Lymphedema Specialist and an Advanced Illness Program. Rockingham VNA and Hospice provided 79,800 visits to 3,680 Home Care patients during fiscal year 2017, and also incurred $6,247 in costs to provide charity care to patients throughout the communities served. Rockingham VNA & Hospice's Hospice Program provides a comprehensive, medically directed, team oriented program of care. The essential components include care of the patient and family as one unit, pain and symptom management, 24 hour on-call availability, medical and nursing care, Home Health Aide, Social Work services, Bereavement and Spiritual care, Volunteers, Rehab services, and coordination of medications, medical supplies, and durable medical equipment. Rockingham VNA & Hospice provided 20,017 visits to 483 patients who received 22,724 days of patient care during fiscal year 2017. Rockingham VNA & Hospice's Community Outreach Program is dedicated to assisting in improving the health of the communities served through offering a variety of wellness clinics and educational opportunities. Community programs include Community Foot Clinics, Diabetes Support Groups, and Health Education Programs. In fiscal year 2017, RVNA & Hospice supported its mission by supporting $202,523 in community outreach, benefits and financial support to the community excluding $210,520 in uncovered Medicaid expenses. 15957741 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 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 0 0 0 1 25 0 1 191 1 0 0 0 0 0 0 0 0 0 0 X 7 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Kevin J O'Leary 6035806695 5 Alumni Drive Exeter NH 03833 Jennifer Costain Trustee 1.00 40.00 X 0 184947 11345 Eliot DeSilvaMD Trustee 1.00 40.00 X 0 227443 24997 Neil Meehan DO Trustee (begin 4/17) 1.00 40.00 X 0 155619 8027 Kevin J Callahan Chairman/Trustee/Ex-Officio 1.00 44.00 X X 0 2348957 192874 Kevin J O'Leary Treasurer/Trustee/Ex-Officio 1.00 44.00 X X 0 514025 93114 Susan Burns-Tisdale Secretary (begin 6/17)/Trustee 1.00 40.30 X X 0 407129 40824 Mary Palmer Secretary/Trustee (end 5/17) 1.00 40.00 X X 0 235530 22262 Karen Michel President/Trustee 40.00 0.00 X X 160741 0 21710 Lois Ferguson Hospice Director 40.00 0.00 X 130704 0 20088 Sherry Ovens Burleigh Clinical Manager 40.00 0.00 X 122559 0 3928 Mary Arnault Finance Director 40.00 0.00 X 116029 0 20315 Linda Taylor Clinical Services Director 40.00 0.00 X 111443 0 16127 Catherine Sartorelli Physical Therapist 40.00 0.00 X 101997 0 16127 743473 4073650 491738 7 0 1 0 Exeter Health Resources Inc 5 Alumni Drive Exeter NH 03833 Administrative Management Fees 352264 Exeter Hospital Inc 5 Alumni Drive Exeter NH 03833 Support Services 327410 McBee Associates 14 Penn Plaza Suite 2110 New York NY 10122 Outside Services 284646 HBO & Company PO Box 98347 Chicago IL 60693 Service Contracts 173654 Core Physicians LLC 5 Alumni Drive Exeter NH 03833 Physician Services 151793 6 48126 48126 Net Patient Services 621610 16975309 16975309 16975309 7870 7870 17031305 16975309 0 7870 4713 4713 182451 182451 10523235 10182772 340463 149722 147371 2351 1841278 1770943 70335 764132 728294 35838 2500 2500 36650 36650 1102808 353797 749011 3933 3749 184 320385 305359 15026 62258 59338 2920 82738 78858 3880 430945 404048 26897 123682 117881 5801 43601 41556 2045 Medical Supplies 801119 801119 Other Supplies 530003 487917 42086 Medical Fees 420026 420026 Bad Debt Expense 50000 50000 17476179 15957741 1518438 0 2977366 2213561 1779335 2408615 53785 44568 2988586 2419506 585438 569080 382083 415065 5778007 5650889 1493810 1818672 675130 689083 241261 190968 2410201 2698723 X 2985723 2537101 3748 382083 411317 3367806 2952166 5778007 5650889 -444874 29234 0 X X 0 1 X 1 0 X 54479 54252 59326 141336 48126 357519 12927688 14227824 15072334 16380834 16975309 75583989 12982167 14282076 15131660 16522170 17023435 75941508 0 0 0 75941508 8369 7789 8668 6858 7870 39554 8369 7789 8668 6858 7870 39554 12990536 14289865 15140328 16529028 17031305 75981062 0.99950 0.99950 0.00050 0.00050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2663 2663 0 Part II-B, Line 1: A portion of Home Care Association of New Hampshire and NHPCO dues are considered lobbying expenses. For the fiscal year ending September 30, 2017, the amounts deemed lobbying were $2,513 and $150, respectively. 382083 8461 29234 4713 415065 369670 12413 382083 365854 3816 369670 334271 31583 365854 318300 15971 334271 0.01000 0.99000 1 0 649115 297211 351904 300695 300695 0 2038776 1821600 217176 569080 Beneficial Interest in Trusts 411317 Assets Limited as to Use 3748 415065 Due to Affiliates 190968 190968 X 17060539 29234 29234 17031305 0 17031305 17476179 0 17476179 0 17476179 Part V, Line 4: Endowment funds are held by the Town of Derry, New Hampshire. The income earned from the funds are used to fund the organization's operations. The quasi-endowments are funds which have been donated to the organization for a purpose specified by the donor. These funds are held until used for the purpose intended by the donor. Part X, Line 2: The Association is a public charity under Section 501(c)(3) of the Internal Revenue Code. As a public charity, the Association is exempt from state and federal income taxes on income earned in accordance with its tax exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Association's tax positions and concluded that the Association has no unrelated business income or uncertain tax positions that require adjustment to the financial statements. X 0 1 0 0 0 0 0 1 0 Jennifer Costain Trustee 0 165527 0 15100 0 4320 0 11345 0 0 0 196292 0 0 Eliot DeSilvaMD Trustee 0 184923 0 33883 0 8637 0 7029 0 17968 0 252440 0 0 Neil Meehan DO Trustee (begin 4/17) 0 135302 0 20000 0 317 0 0 0 8027 0 163646 0 0 Kevin J Callahan Chairman/Trustee/Ex-Officio 0 609697 0 210000 0 1529260 0 167950 0 24924 0 2541831 0 1120000 Kevin J O'Leary Treasurer/Trustee/Ex-Officio 0 382929 0 116625 0 14471 0 75950 0 17164 0 607139 0 0 Susan Burns-Tisdale Secretary (begin 6/17)/Trustee 0 299602 0 98638 0 8889 0 15900 0 24924 0 447953 0 0 Mary Palmer Secretary/Trustee (end 5/17) 0 180465 0 46658 0 8407 0 14187 0 8075 0 257792 0 0 Karen Michel President/Trustee 143993 0 10557 0 6191 0 4901 0 16809 0 182451 0 0 0 Lois Ferguson Hospice Director 117229 0 10713 0 2762 0 4098 0 15990 0 150792 0 0 0 Part I, Line 4b The organization's parent (Exeter Health Resources, Inc.) maintains a split dollar supplemental retirement plan for two executives (listed below with amounts) selected by the Exeter Health Resources, Inc. Board of Trustees. The plan is closed to future participants. The Plan provides for annual payments of premiums for life insurance policies insuring the listed individuals. Those life insurance premiums are collaterally assigned to the corporation and any excess accumulated value in the policies (net of accumulated premium payments which are returned to the organization upon the executive attaining the age of 70 or at the death of the participant) is available to be paid to the participant once vested at age 62 and upon retirement from the organization. Note that the split-dollar arrangement is part of an employee benefit program and economically not a direct extension of credit. Furthermore, the reportable compensation of the respective employees includes the annual value of the life insurance provided. Life insurance premium payments during tax year: Kevin Callahan $130,022 Kevin O'Leary $ 70,894 Excess Accumulated Value: Kevin Callahan $2,583,976 Kevin O'Leary $1,047,139 Certain of the listed employees participate in a nonqualified deferred compensation plan as described in Internal Revenue Code Section 457(f) sponsored by Exeter Health Resources, Inc. In the calendar year ended December 31, 2016, the contribution to the plan for the vested benefit of Kevin Callahan was $160,000 and the contribution to the plan for the non-vested benefit of Kevin O'Leary was $68,000. The contributions are intended to provide a forfeitable supplemental retirement benefit. Participants in the 457(f) plan do not vest until age 62 when it is payable to the participant. During the calendar year ended December 31, 2016, Kevin Callahan reached the age of 62 and received a total distribution equal to $1,487,265 from the 457(f) plan. It should be noted that this distribution includes plan contributions reported on prior years' Forms 990, Part VII, Column F and also on Schedule J, Column C as deferred compensation. Accordingly, the total amount of previously reported plan contributions, $1,120,000, is reflected in Schedule J, Part II, Column F so as to not overstate compensation in the current year that was earned over a period of many years. Part I, Line 7 Karen Michel is also provided incentive bonus payments under a plan aligned with the strategic interests of RVNA. These incentive awards are approved by operating management and Human Resources. Form 990, Part VI, Section A, line 6 Exeter Health Resources, Inc., a charitable organization acting through its Board of Trustees, is the sole member of the organization. Form 990, Part VI, Section A, line 7a Exeter Health Resources, Inc. as sole member elects five (5) persons to the Board of Trustees of Rockingham VNA & Hospice, which also includes two (2) of its officers who serve as ex-officio Trustees (with vote). Form 990, Part VI, Section A, line 7b As sole member, Exeter Health Resources, Inc. has certain reserved rights as reflected in the bylaws of the organization. Form 990, Part VI, Section B, line 11b The Form 990 is prepared by an outside tax accountant with information provided by the organization. The Form 990 is reviewed by the organization's Treasurer and then presented to the Board of Trustees before it is filed with the IRS. Form 990, Part VI, Section B, line 12c The Board of Trustees has adopted a Conflict of Interest Policy that requires the disclosure of conflicts of interest either when the interest becomes a matter of possible action by the Board or during an annual disclosure process. Trustees, officers, and key employees, as well as all members of senior management, are part of the annual disclosure process, which is initiated by the issuance of a memorandum and accompanying questionnaire by the President of the Member (i.e., Exeter Health Resources, Inc.). All disclosures are reviewed. Any trustee with a conflict of interest is required to abstain from voting and is not included in a quorum determination on the matter and any officer, key employee, or member of senior management with a conflict does not take part in making and is not present for any decision regarding the matter. The policy is monitored and enforced by both the President and the full Board. A separate organizational policy requires all employees to disclose any conflict of interest in writing upon hire. Thereafter, on an annual basis, all employees and contracted staff must make a full and complete disclosure in writing of any conflict of interest, conflict of commitment, and/or Personal Interest. Employees are otherwise required to make any further written disclosure at the time such conflict arises. This policy is monitored and enforced by the Department of Human Resources, as well as the agency's Executive Director and Compliance Officer. Any conflict of interest is managed under this policy by disclosure, recusal, or divestiture of the interest. Form 990, Part VI, Section B, line 15 The organization's parent (Exeter Health Resources, Inc.) has a formal process for determining total compensation for the Chairman of Rockingham Visiting Nurse Association and Hospice (RVNA&H) and other listed officers that is intended to provide reasonable compensation for achieving the organization's mission, to recognize individual and team performance and to comply with the organization's obligations as a tax-exempt charitable organization. The Executive Committee of the Exeter Health Resources, Inc.'s Board of Trustees conducts an annual review of the compensation of the Chairman of RVNA&H and other listed officers. In doing so, the committee retains a qualified independent compensation consultant to conduct competitive market analysis of the market ranges of base, incentive, and total cash compensation, and to provide advice concerning the reasonableness of the compensation of the Chairman and other listed officers. The Committee utilizes that analysis and other appropriate information in connection with its annual review and makes recommendations to the full Board of Exeter Health Resources, Inc. for adjustment of the Chairman's compensation and the compensation for other listed officers. Information which the Committee may consider can include but is not limited to the performance of an individual and/or that individual's contributions to a team, the performance of the organization in whole and in part, the elements of total compensation and salary history, the organization's compensation targets and comparability data, including the data prepared by the independent consultant and reviewed with the Committee. The Committee incorporates a performance appraisal process in the Chairman's and the other listed officers' compensation review. The Chairman and other listed officers are not present when the committee discusses their respective compensation. In addition, the Committee determines if the threshold requirements for incentive awards are met, consisting of the organization's performance results for quality, operating system excellence and financial performance. The results of the committee's deliberations are presented to the Exeter Health Resources, Inc. Board and include recommendations concerning salary range adjustments and incentive awards and the basis for the committee's decisions/recommendations. The deliberations of the Exeter Health Resources, Inc. Board are conducted in executive session with the independent members of the Board but do include the Chairman only for that period of time in which the Exeter Health Resources, Inc. Board has questions concerning the performance of any listed officer other than the Chairman. The Exeter Health Resources, Inc. Board reviews the Chairman's performance and determines if the adjustments and awards recommended by the committee for the Chairman are in the organization's best interest and for the benefit of the organization and the parent organization. For the other listed officer positions, adjustments and incentive awards are approved upon recommendation of the Chairman by the Executive Committee within the Exeter Health Resources, Inc. board approved parameters and ratified by the Exeter Health Resources, Inc. Board of Trustees. For the Executive Director of Rockingham Visiting Nurse Association and Hospice, compensation is determined by consulting with the organization's parent Human Resources department. Comparison compensation surveys and external benchmarks are used in the process. Form 990, Part VI, Section C, line 19 The documents are available upon request. Form 990, Part XII, Line 2c: The audit process has not changed since the prior year. Exeter Health Resources Inc 5 Alumni Drive Exeter NH 03833 020222126 Management and Supporting Organization; Holding Company NH 501(c)(3) Line 12a, I N/A 0 Exeter Hospital Inc 5 Alumni Drive Exeter NH 03833 222674014 Hospital NH 501(c)(3) Line 3 Exeter Health Resources Inc 0 Core Physicians LLC 5 Alumni Drive Exeter NH 03833 870807914 Physician Practices NH 501(c)(3) Line 10 Exeter Health Resources Inc 0 Matrix Health Inc 5 Alumni Drive Exeter NH 03833 020473737 Manage Resources NH 501(c)(3) Line 12b, II Exeter Health Resources Inc 0 Exeter Med Real Inc 5 Alumni Drive Exeter NH 03833 020418718 Real Estate Holding NH 501(c)(25) Exeter Health Resources Inc 0 Exeter Health Resources Inc Self-Insurance Trust 5 Alumni Drive Exeter NH 03833 200753662 Self Insurance Trust NH 501(c)(3) Line 12a, I Exeter Health Resources Inc 0 Core Health Services of MA 5 Alumni Drive Exeter NH 03833 201598042 Inactive Physician Practice MA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0