2015-08-13T06:02:53-05:00 2014-09-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2013-10-01 020418718 EXETER MED REAL INC EXET 6035806695 5 ALUMNI DRIVE EXETER NH 03833 KEVIN J O'LEARY TREASURER 6035806695 2015-08-05 TIMOTHY R HEPBURN CPA P00182393 8002447444 2015-08-05 2013 2016-03-07 17:11:31Z KEVIN CALLAHAN 5 ALUMNI DRIVE EXETER NH 03833 3940414 0 X N/A X 1989 NH EXETER MED REAL IS A NOT-FOR-PROFIT SUBSIDIARY OF EXETER HEALTH RESOURCES WHICH HOLDS AND MANAGES REAL ESTATE ASSETS FOR THE BENEFIT OF EXETER HEALTH RESOURCES AND ITS' SUBSIDIARIES. EXETER MED REAL OWNS AND LEASES LAND AND BUILDINGS TO THESE ORGANIZATIONS. 5 0 0 0 0 0 0 0 3768731 3938977 13 -173426 14 1427 3768758 3766978 0 0 0 0 0 0 0 0 0 4538403 4640300 4538403 4640300 -769645 -873322 27546588 26548838 613335 488907 26933253 26059931 EXETER MED REAL IS A NOT-FOR-PROFIT SUBSIDIARY OF EXETER HEALTH RESOURCES WHICH HOLDS AND MANAGES REAL ESTATE ASSETS FOR THE BENEFIT OF EXETER HEALTH RESOURCES AND ITS' SUBSIDIARIES. EXETER MED REAL OWNS AND LEASES LAND AND BUILDINGS TO THESE ORGANIZATIONS. 0 0 4640300 3766968 EXETER MED REAL IS ORGANIZED AS A SECTION 501(C)(25) ORGANIZATION WHOSE SOLE PURPOSE IS TO HOLD TITLE TO PROPERTY AND TO DISTRIBUTE THE INCOME THEREFROM TO EXETER HEALTH RESOURCES, A RELATED 501(C)(3) ORGANIZATION. 4640300 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 15 0 1 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 NH X KEVIN J O'LEARY 6035806695 5 ALUMNI DRIVE EXETER NH 03833 KEVIN J CALLAHAN PRESIDENT/SECRETARY/TRUSTEE 1.00 44.00 X X 0 739793 198420 KEVIN J O'LEARY TREASURER/TRUSTEE 1.00 44.00 X X 0 422773 96596 SUSAN BURNS-TISDALE TRUSTEE 0.30 41.00 X 0 347365 48469 DEBRA CRESTA TRUSTEE 0.30 40.00 X 0 360987 47469 MARK WHITNEY TRUSTEE 0.30 40.00 X 0 274317 47910 0 2145235 438864 0 0 1 0 HUTTER CONSTRUCTION CORP PO BOX 257 810 TURNPIKE RD NEW IPSWICH NH 03071 BUILDING CONTRACTOR 609881 EXETER HOSPITAL INC 5 ALUMNI DRIVE EXETER NH 03833 CONSTRUCTION, ENGINEERING, CLEANING SERI 277284 HARVEY CONSTRUCTION 10 HARVEY ROAD BEDFORD NH 03110 BUILDING CONTRACTOR 133580 LAVALLEBRENSINGER 155 DOW STREET SUITE 400 MANCHESTER NH 03101 ARCHITECTURAL SERVICES 132269 PISCATAQUA LANDSCAPING CO 26 MACCLELLAN LANE ELIOT ME 03903 LANDSCAPING CONTRACTOR 105033 5 RENTAL INCOME 531120 3938977 3938977 3938977 10 10 173436 -173436 -173436 -173436 MISCELLANEOUS REVENUE 531120 1393 1393 CASH DISCOUNTS 531120 34 34 1427 3766978 3766968 0 10 33938 1657807 152 279896 2477132 24799 OUTSIDE FEES 131498 REPAIRS/MAINTENANCE 31460 DESIGN/RELOCATION FEES 2855 MISCELLANEOUS 763 4640300 555606 1314063 38929 156620 45924468 20846313 26952053 25078155 27546588 26548838 609407 477850 3928 11057 613335 488907 X 26933253 26059931 26933253 26059931 27546588 26548838 -873322 0 X X 0 1 X 0 0 186241 186241 42662652 20283904 22378748 290468 104028 186440 2785107 458381 2326726 25078155 DUE TO AFFILIATES 11057 11057 X PART X, LINE 2: RESOURCES, THE HOSPITAL, RVNA&H, CORE AND MATRIX ARE NOT-FOR-PROFIT ORGANIZATIONS 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. MED REAL IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(25) OF THE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. MANAGEMENT EVALUATED THE TAX POSITIONS OF THESE ENTITIES AND HAS CONCLUDED THAT THEY HAVE MAINTAINED THEIR TAX-EXEMPT STATUS, DO NOT HAVE ANY SIGNIFICANT UNRELATED BUSINESS INCOME, AND HAVE TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS. CONVERGENT, VX AND SERVICES ARE FOR-PROFIT ORGANIZATIONS AND, IN ACCORDANCE WITH FEDERAL AND STATE TAX LAWS, FILE RETURNS SEPARATE FROM THAT OF RESOURCES. IN 2014 AND 2013, NO FEDERAL INCOME TAXES WERE CHARGED TO OPERATIONS DUE TO CONVERGENT, VX AND SERVICES EITHER INCURRING AN OPERATING LOSS OR UTILIZING NET OPERATING LOSS CARRYFORWARDS FROM PRIOR YEARS. MANAGEMENT BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR THE INCOME TAX POSITIONS TAKEN AND TO BE TAKEN ON TAX RETURNS, AND THAT THEIR ACCRUALS FOR TAX LIABILITIES ARE ADEQUATE FOR ALL OPEN TAX YEARS BASED ON AN ASSESSMENT OF MANY FACTORS INCLUDING EXPERIENCE AND INTERPRETATIONS OF TAX LAWS APPLIED TO THE FACTS OF EACH MATTER. 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 OR ANY PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN INCOME TAX EXPENSE. WITH FEW EXCEPTIONS, THE CORPORATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATION BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2011. 0 1 0 KEVIN J CALLAHAN PRESIDENT/SECRETARY/TRUSTEE 0 543852 0 121000 0 74941 0 167650 0 30770 0 938213 0 0 KEVIN J O'LEARY TREASURER/TRUSTEE 0 297107 0 70620 0 55046 0 75650 0 20946 0 519369 0 0 SUSAN BURNS-TISDALE TRUSTEE 0 252317 0 61040 0 34008 0 15300 0 33169 0 395834 0 0 DEBRA CRESTA TRUSTEE 0 255295 0 71122 0 34570 0 15300 0 32169 0 408456 0 0 MARK WHITNEY TRUSTEE 0 193329 0 67620 0 13368 0 15300 0 32610 0 322227 0 0 PART I, LINE 4B CLINICAL MANAGERTHE 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 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) IS AVAILABLE TO BE PAID TO THE PARTICIPANT ONCE VESTED AT AGE 62 AND UPON RETIREMENT FROM THE ORGANIZATION. LIFE INSURANCE PREMIUM PAYMENTS DURING THE TAX YEAR: KEVIN CALLAHAN-$312,478 KEVIN O'LEARY-$146,277 KEVIN CALLAHAN - EXCESS ACCUMULATED VALUE - $1,618,484 KEVIN O'LEARY - EXCESS ACCUMULATED VALUE - $674,148 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. IN THE CALENDAR YEAR ENDED DEC 31, 2013 THE CONTRIBUTION TO THE PLAN FOR THE NON-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. PARTICIPANTS IN THE 457(F) PLAN DO NOT VEST UNTIL AGE 62 WHEN IT IS PAYABLE TO THE PARTICIPANT. 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 AS SOLE SHAREHOLDER, EXETER HEALTH RESOURCES ELECTS THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE STOCKHOLDER HAS THE RIGHT TO APPROVE A DISSOLUTION OF THE CORPORATION AND TO REMOVE THE DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY AN OUTSIDE TAX ACCOUNTANT WITH INFORMATION PROVIDED BY THE ORGANIZATION. THE 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 AND CHIEF EXECUTIVE OFFICER (CEO). 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 CEO AND THE FULL BOARD. A SEPARATE ORGANIZATIONAL POLICY REQUIRES ALL EMPLOYEES TO DISCLOSE ANY CONFLICT OF INTEREST IN WRITING UPON HIRE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S PARENT (EXETER HEALTH RESOURCES) HAS A FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE PRESIDENT 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' BOARD OF TRUSTEES CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE PRESIDENT 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 PRESIDENT 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 FOR ADJUSTMENT OF THE PRESIDENT'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 PRESIDENT'S AND THE OTHER LISTED OFFICERS' COMPENSATION REVIEW. THE PRESIDENT 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 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 BOARD ARE CONDUCTED IN EXECUTIVE SESSION WITH THE INDEPENDENT MEMBERS OF THE BOARD BUT DO INCLUDE THE PRESIDENT ONLY FOR THAT PERIOD OF TIME IN WHICH THE EXETER HEALTH RESOURCES BOARD HAS QUESTIONS CONCERNING THE PERFORMANCE OF ANY OTHER LISTED OFFICER OTHER THAN THE PRESIDENT. THE EXETER HEALTH RESOURCES BOARD REVIEWS THE PRESIDENT'S PERFORMANCE AND DETERMINES IF THE ADJUSTMENTS AND AWARDS RECOMMENDED BY THE COMMITTEE FOR THE PRESIDENT ARE IN THE ORGANIZATION'S BEST INTEREST AND FOR THE BENEFIT OF THE ORGANIZATION AND THE PARENT ORGANIZATION. FOR THE EXETER MED REAL LISTED OFFICER POSITIONS AND TRUSTEES; ADJUSTMENTS AND INCENTIVE AWARDS ARE APPROVED UPON RECOMMENDATION OF THE PRESIDENT BY THE EXECUTIVE COMMITTEE WITHIN THE EXETER HEALTH RESOURCES BOARD APPROVED PARAMETERS AND RATIFIED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, QUESTION 2C THE ORGANIZATION IS PART OF THE CONSOLIDATED OPERATIONS OF EXETER HEALTH RESOURCES, INC. THE EXETER HEALTH RESOURCES EXECUTIVE COMMITTEE IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. EXETER HEALTH RESOURCES INC 5 ALUMNI DRIVE EXETER NH 03833 020222126 MANAGEMENT AND SUPPORTING ORGANIZATION; HOLDING COMPANY NH 501C3 11 0 EXETER HOSPITAL INC 5 ALUMNI DRIVE EXETER NH 03833 222674014 HOSPITAL NH 501C3 3 EXETER HEALTH RESOURCES INC 0 CORE PHYSICIANS LLC 5 ALUMNI DRIVE EXETER NH 03833 870807914 PHYSICIAN PRACTICES NH 501C3 9 EXETER HEALTH RESOURCES INC 0 ROCKINGHAM VISITING NURSE ASSOCIATION 5 ALUMNI DRIVE EXETER NH 03833 020274905 HOME CARE, HOSPICE NH 501C3 9 EXETER HEALTH RESOURCES INC 0 MATRIX HEALTH INC 5 ALUMNI DRIVE EXETER NH 03833 020473737 MANAGE RESOURCES NH 501C3 11 EXETER HEALTH RESOURCES INC 0 EXETER HEALTH RESOURCES INC SELF-INSURANCE TRUST 5 ALUMNI DRIVE EXETER NH 03833 200753662 SELF INSURANCE TRUST NH 501C3 11 EXETER HEALTH RESOURCES INC 0 CONVERGENT HEALTH SYSTEMS INC 5 ALUMNI DRIVE EXETER NH 03833 020469711 WELLNESS CENTERS NH EXETER HEALTH RESOURCES INC C 0 VX HEALTH SERVICES INC 5 ALUMNI DRIVE EXETER NH 03833 020469712 INACTIVE FITNESS CENTER NH CONVERGENT HEALTH SYSTEMS INC C 0 EXETER MEDICAL SERVICES INC 5 ALUMNI DRIVE EXETER NH 03833 020419850 INACTIVE PHYSICIAN PRACTICE NH CONVERGENT HEALTH SYSTEMS INC C 0 CORE HEALTH SERVICES OF MA 5 ALUMNI DRIVE EXETER NH 03833 201598042 INACTIVE PHYSICIAN PRACTICE MA EXETER HEALTH RESOURCES INC C 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0