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Catholic Medical Center Physicians: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
Catholic Medical Center Physicians (EIN 02-0460245)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-11
IRS object ID
201701319349303690
Schema version
2015v3.0
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

FieldValueIRS element (for citing)
Return2017-05-11T14:04:44-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman & NoyesBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 507AddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020460245EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Catholic Medical Center PhysiciansBusinessNameLine1Txt
Business Name Line2Practice AssociatesBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCATHBusinessNameControlTxt
Phone6036683545PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 McGregor StreetAddressLine1Txt
CityManchesterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03102ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEdward L Dudley IIIPersonNm
Person TitleExec. VP & CFOPersonTitleTxt
Phone6036683545PhoneNum
Signature2017-04-25SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNicholas E PortoPreparerPersonNm
PTINP01310283PTIN
Phone2078792100PhoneNum
Preparation2017-04-25PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJoseph Pepe MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 McGregor StreetAddressLine1Txt
CityManchesterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03102ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$20,963,741GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.catholicmedicalcenter.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionThe heart of Catholic Medical Center is to provide health, healing and hope in a manner that offers innovative high quality services, compassion, and respect for the human dignity of every individual who seeks or needs our care as part of Christ's healing ministry through the Catholic Church.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee158TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$19,732,200PYProgramServiceRevenueAmt
CY Program Service Revenue$20,963,741CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$19,732,200PYTotalRevenueAmt
CY Total Revenue$20,963,741CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$33,744,024PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$40,607,442CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,707,777PYOtherExpensesAmt
CY Other Expenses$1,844,496CYOtherExpensesAmt
PY Total Expenses$35,451,801PYTotalExpensesAmt
CY Total Expenses$42,451,938CYTotalExpensesAmt
PY Revenues Less Expenses-$15,719,601PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$21,488,197CYRevenuesLessExpensesAmt
Total Assets BOY$1,724,731TotalAssetsBOYAmt
Total Assets EOY$1,914,427TotalAssetsEOYAmt
Total Liabilities BOY$12,219,871TotalLiabilitiesBOYAmt
Total Liabilities EOY$20,290,060TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$10,495,140NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$18,375,633NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe heart of Catholic Medical Center is to provide health, healing and hope in a manner that offers innovative high quality services, compassion, and respect for the human dignity of every individual who seeks or needs our care as part of Christ's healing ministry through the Catholic Church.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$33,495,038ExpenseAmt
Revenue$20,963,741RevenueAmt
DescTo provide physician and hospital care, both inpatient and outpatient, to persons in the service area of Catholic Medical Center. Physicians participate in Medicare and Medicaid programs.Desc
Total Program Service Expenses$33,495,038TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee158EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Edward L Dudley IIIBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6036683545PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 McGregor StreetAddressLine1Txt
CityManchesterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03102ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
William B Clutterbuck MD
Director & Phy (end 12/15)40.004.00Yes (X)$366,772$0$44,214
Powen Hsu MD
Director & Physician1.003.00Yes (X)$0$0$0
Fr Patrick Sullivan OSB RN
Director1.003.00Yes (X)$0$0$0
Adele Boufford Baker
Director1.003.00Yes (X)$0$0$0
Carolyn Claussen MD
Director40.003.00Yes (X)$99,551$0$7,518
Harry E Dumay PhD
Director1.003.00Yes (X)$0$0$0
Louis I Fink MD
Chair & Cardiologist40.003.00Yes (X)$610,287$0$28,002Yes (X)
Keith A Stahl MD
Secretary & Treasurer40.003.00Yes (X)$322,835$0$23,254Yes (X)
Joseph Pepe MD
President & CEO, Vice Chai1.0044.00Yes (X)$0$725,390$281,003Yes (X)
Edward Dudley III
Director/Exec. VP & CFO1.0043.00Yes (X)$0$478,103$184,819Yes (X)
Benjamin Westbrook MD
Cardiologist40.000.00$1,051,816$0$41,635Yes (X)
Yvon Baribeau MD
Cardiologist40.000.00$1,051,428$0$33,447Yes (X)
David Goldberg MD
Cardiologist40.000.00$667,170$0$40,545Yes (X)
Jamie Kim MD
Cardiologist40.000.00$630,024$0$42,085Yes (X)
Jeffrey Bleakley MD
Cardiologist40.000.00$618,589$0$42,085Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,418,472TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,203,493TotReportableCompRltdOrgAmt
Total Other Compensation$768,607TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K90IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHG Companies IncBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line16440 Millrock Drive 175AddressLine1Txt
CitySalt Lake CityCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84121ZIPCd
FieldValueIRS element (for citing)
ServicesLaborServicesDesc
Compensation$141,972CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue621110$20,499,996$20,499,996
Miscellaneous Revenue621110$463,745$463,745
FieldValueIRS element (for citing)
Total Program Service Revenue$20,963,741TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,963,741TotalRevenueColumnAmt
Related Or Exempt Func Income$20,963,741RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,502,433TotalAmt
Program Services$1,185,436ProgramServicesAmt
Management And General$316,997ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$34,499,593TotalAmt
Program Services$27,220,552ProgramServicesAmt
Management And General$7,279,041ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,721,016TotalAmt
Program Services$1,357,900ProgramServicesAmt
Management And General$363,116ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,715,401TotalAmt
Program Services$1,353,470ProgramServicesAmt
Management And General$361,931ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,168,999TotalAmt
Program Services$922,353ProgramServicesAmt
Management And General$246,646ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$171,972TotalAmt
Program Services$135,688ProgramServicesAmt
Management And General$36,284ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$92,087TotalAmt
Program Services$72,658ProgramServicesAmt
Management And General$19,429ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$331,452TotalAmt
Program Services$261,519ProgramServicesAmt
Management And General$69,933ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$52,485TotalAmt
Program Services$41,411ProgramServicesAmt
Management And General$11,074ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$370,696TotalAmt
Program Services$292,483ProgramServicesAmt
Management And General$78,213ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$825,804TotalAmt
Program Services$651,568ProgramServicesAmt
Management And General$174,236ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$42,451,938TotalAmt
Program Services$33,495,038ProgramServicesAmt
Management And General$8,956,900ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$331,293BOYAmt
EOY$319,629EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$33,800LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$33,800LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,393,438BOYAmt
EOY$1,594,798EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,724,731BOYAmt
EOY$1,914,427EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,230,474BOYAmt
EOY$3,321,583EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,989,397BOYAmt
EOY$16,968,477EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,219,871BOYAmt
EOY$20,290,060EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$10,495,140BOYAmt
EOY-$18,375,633EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$10,495,140BOYAmt
EOY-$18,375,633EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,724,731BOYAmt
EOY$1,914,427EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$21,488,197ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$13,607,704OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,458,010CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,320,969CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,486,214CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,732,200CurrentTaxYearMinus1YearAmt
Current Tax Year$20,963,741CurrentTaxYearAmt
Total$85,961,134TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,458,010CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,320,969CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,486,214CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,732,200CurrentTaxYearMinus1YearAmt
Current Tax Year$20,963,741CurrentTaxYearAmt
Total$85,961,134TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$85,961,134PublicSupportTotal509Amt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,458,010CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,320,969CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,486,214CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,732,200CurrentTaxYearMinus1YearAmt
Current Tax Year$20,963,741CurrentTaxYearAmt
Total$85,961,134TotalAmt
FieldValueIRS element (for citing)
Public Support CY5091.00000PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,800OtherCostOrOtherBasisAmt
Depreciation$33,800DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDue from AffiliatesDesc
Book Value$1,594,798BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,594,798TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescAccrued Pension & Other LiabilitiesDesc
Amt$16,968,477Amt
FieldValueIRS element (for citing)
Total Liability$16,968,477TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$14,133,945TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$14,133,945RevenueSubtotalAmt
Other Revenues Not Included$6,829,796OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$6,829,796RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$20,963,741TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$42,451,938TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$42,451,938ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$42,451,938TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The System and all related entities, with the exception of Enterprises, DMA and CAHS, are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the System's tax positions and concluded the System 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. Enterprises, DMA and CAHS are for-profit organizations and, in accordance with federal and state tax laws, file income tax returns, as applicable. There was no provision for income taxes for each of the years ended June 30, 2016 and 2015. There are no significant deferred tax assets or liabilities. These entities have concluded there are no significant uncertain tax positions requiring disclosure and there is no material liability for unrecognized tax benefits. It is the policy of these entities to recognize interest related to unrecognized tax benefits in interest expense and penalties in income tax expense.
Part XI, Line 4b - Other Adjustments:Net Change in Pension Liability 6,829,796.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
William B Clutterbuck MD
Director & Phy (end 12/15)$366,772$0$0$0$0$0$21,150$0$23,064$0$410,986$0$0$0
Louis I Fink MD
Chair & Cardiologist$446,263$0$123,024$0$41,000$0$23,800$0$4,202$0$638,289$0$0$0
Keith A Stahl MD
Secretary & Treasurer$296,920$0$0$0$25,915$0$21,200$0$2,054$0$346,089$0$0$0
Joseph Pepe MD
President & CEO, Vice Chai$0$537,600$0$134,680$0$53,110$0$250,934$0$30,069$0$1,006,393$0$0
Edward Dudley III
Director/Exec. VP & CFO$0$346,789$0$84,000$0$47,314$0$130,118$0$54,701$0$662,922$0$0
Benjamin Westbrook MD
Cardiologist$787,482$0$244,334$0$20,000$0$15,900$0$25,735$0$1,093,451$0$0$0
Yvon Baribeau MD
Cardiologist$787,094$0$244,334$0$20,000$0$15,900$0$17,547$0$1,084,875$0$0$0
David Goldberg MD
Cardiologist$442,308$0$107,362$0$117,500$0$18,550$0$21,995$0$707,715$0$0$0
Jamie Kim MD
Cardiologist$439,912$0$125,112$0$65,000$0$18,550$0$23,535$0$672,109$0$0$0
Jeffrey Bleakley MD
Cardiologist$447,931$0$103,658$0$67,000$0$18,550$0$23,535$0$660,674$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3The Organization's President and CEO's compensation was established by a related organization, Catholic Medical Center. That organization used a compensation committee, independent compensation consultant, the Form 990 of other organizations, a compensation study/survey, and approval by their board of directors/compensation committee to determine the President and CEO's compensation and benefits.
Part I, Line 4bThe following individuals take part in a section 457(f) forfeitable nonqualified deferred compensation plan. The following represents contributions for many years of service: Joseph Pepe: $229,734 Edward Dudley, III: $114,218
Part I, Line 7A portion of compensation is at-risk and vairable, and payment depends on the quality of job performance.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6The sole member of CMC Physician Practice Associates is CMC Healthcare System.
Form 990, Part VI, Section A, line 7aThe directors of CMC Physician Practice Associates are appointed by the sole member.
Form 990, Part VI, Section A, line 7bThe sole member has reserved powers over CMC Physician Practice Associates but does not approve each separate action taken by the CMC Physician Practice Associates board.
Form 990, Part VI, Section B, line 11Form 990 is prepared by an independent tax accounting firm (Baker, Newman, Noyes). Upon completion, a draft of the Form 990 is sent to the Organization, where the CFO, Controller, and Director of Accounting perform a final in-house review prior to submission to the Board of Directors for final approval. Upon approval from Board, Form 990 is filed with the Internal Revenue Service.
Form 990, Part VI, Section B, line 12cOfficers and directors are required to complete a conflict of interest questionnaire annually.
Form 990, Part VI, Section B, line 15A related organization, Catholic Medical Center, utilizes a compensation committee of the board of directors to set compensation levels and determine bonus potential for its senior leadership team. The committee is assisted by an independent consultant who surveys like-sized and performing institutions to benchmark relevant salary scales for each position. The consultant's findings are presented to the compensation committee who considers that external data with actual performance against a list of pre-established goals per senior leaders to set prospective compensation levels and bonus values. Bonus amounts are determined by how well an executive achieves a pre-defined set of goals. These goals, in general, are tied to the achievement of a specific task or project. Some goals are attached to achieve overall financial performance and mission performance, not solely revenue generation.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part XI, line 9:Transfer from Affiliates 20,437,500. Net Change in Pension Liability -6,829,796.
Form 990, Part XII, Line 2c:The audit process has not changed from the prior year.
Form 990, Part X, Lines 17 and 25, Column A:The beginning of year balance sheet has been partially restated in order to more closely conform to the IRS guidelines for the breakdown of accounts payable and accrued expenses. Part X, Column A, Line 17 and 25 were updated as follows: Line 17 was updated from $12,219,871 to $2,230,474. Line 25 was updated from $0 to $9,989,397. Liabilities in total as reported on Form 990, Part X, Column A, Line 26 remain unchanged from prior year Form 990, Part X, Column B.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Alliance Health Services
100 McGregor StreetManchesterNH03102611508839PracticesNH501(c)(3)Line 9CMC Healthcare System0
Catholic Medical Center
100 McGregor StreetManchesterNH03102020315693HospitalNH501(c)(3)Line 3CMC Healthcare System0
CMC Healthcare System
100 McGregor StreetManchesterNH03102010568516ParentNH501(c)(3)Line 11b, II0N/A
Alliance Resources Inc
100 McGregor StreetManchesterNH03102020398138Real EstateNH501(c)(3)Line 11b, IICMC Healthcare System0
St Peter's Home
100 McGregor StreetManchesterNH03102020222228HomeNH501(c)(3)Line 9CMC Healthcare System0
Alliance Ambulatory Services
100 McGregor StreetManchesterNH03102020519436Ambulatory Surgical CenterNH501(c)(3)Line 9CMC Healthcare System0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
McGregor Steet MOB LLC
100 McGregor StreetManchesterNH03102134347316Medical Office BuildingNHN/A
Bedford Ambulatory Surgical Center LLC
11 Washington PlaceBedfordNH03110020519727Surgical CenterNHN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Doctors' Medical Association
100 McGregor StreetManchesterNH03102020340690Medical Office BuildingNHN/AC0
Alliance Enterprises
100 McGregor StreetManchesterNH03102020386795Real EstateNHN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd