CROTCHED MOUNTAIN COMMUNITY CARE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CROTCHED MOUNTAIN COMMUNITY CARE INC (EIN 02-0404562)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-04-15
- IRS object ID
- 201431069349300113
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-04-15T12:48:25-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010523282 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020404562 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Crotched Mountain Community Care Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CROT | NameControl |
| Phone | 6035473311 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Verney Drive | AddressLine1 |
| City | Greenfield | City |
| State | NH | State |
| ZIP Code | 03047 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Thomas A Zubricki | Name |
| Title | CFO | Title |
| Phone | 6035473311 | Phone |
| Date Signed | 2014-04-02 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Barbara J McGuan CPA | Name |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | Phone |
| Date Prepared | 2014-04-02 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Donald L Shumway | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Verney Drive | AddressLine1 |
| City | Greenfield | City |
| State | NH | State |
| ZIP Code | 03047 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 2821427 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.cmf.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1986 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | Crotched Mountain Community Care provides care management and care coordination services to seniors and adults with disabilities so that they can continue to live in their own homes. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 43 | TotalNbrEmployees |
| Total Nbr Volunteers | 3 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 19939 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 94611 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2694768 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 2726816 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2714707 | TotalRevenuePriorYear |
| Total Revenue Current Year | 2821427 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1771021 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1807696 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1017058 | OtherExpensePriorYear |
| Other Expenses Current Year | 895157 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 2788079 | TotalExpensesPriorYear |
| Total Expenses Current Year | 2702853 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -73372 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 118574 | RevenuesLessExpensesCY |
| Total Assets BOY | 850663 | TotalAssetsBOY |
| Total Assets EOY | 971388 | TotalAssetsEOY |
| Total Liabilities BOY | 155817 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 163868 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 694846 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 807520 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | The mission of Crotched Mountain Community Care, Inc. is to provide quality support, advocacy, and community connections to residents of New Hampshire, including caregivers, their family members, and individuals who are seeking to achieve and maintain a safe and healthy lifestyle at home in their community. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2117449 | Expense |
| Revenue | 2257409 | Revenue |
| Description | Crotched Mountain began our Community Care program in 1986. CMCC provides quality support, advocacy, and community connections to residents of New Hampshire, including caregivers, their family members, and individuals who are seeking to achieve and maintain a safe and healthy lifestyle at home in their community. Our care management services include: in-home assessment; development of a plan of care; referrals to home care agencies to provide the care needed to continue living independently and safely in your home; ongoing monitoring of the care plan; ongoing advocacy and care coordination with the home care agencies providing care, the client's physician and any other community resources needed to meet client needs; arrangement for transportation to medical appointments as needed; a liaison to the family who may live at a distance to keep them updated and informed as to their relative's well being; assistance with applications and benefit management when necessary including state assistance programs; ongoing support, advocacy, and community connections; a sliding fee scale based on income. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 404779 | Expense |
| Revenue | 469407 | Revenue |
| Description | Crotched Mountain is the fiscal agent for the ServiceLink Resource Center of Rockingham County, NH. ServiceLink Resource Centers are New Hampshire's resource for information and much more. ServiceLink Resource Centers are dedicated to helping older adults, adults with disabilities or chronic illness, and their families solve problems with a personal touch. There are no fees for eligibility for these services. ServiceLink was established in 2000 as a statewide network of locally administered programs serving every community in New Hampshire. There are 10 programs throughout the state and over 50 satellite sites. ServiceLink Centers have developed local partnerships with community organizations, businesses, and individuals to address the needs of residents and identify the concerns for older adults, adults with disabilities and/or chronic illness, and family caregivers. ServiceLink Resource Center of Rockingham County serves all residents of Rockingham County as well as anyone in need of information regarding this area. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 2522228 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 5 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 43 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Thomas Zubricki | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6035473311 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Verney Drive | AddressLine1 |
| City | Greenfield | City |
| State | NH | State |
| ZIP Code | 03047 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|---|
| Deanna S Howard | |||||||
| Chairman | 0.50 | 4.50 | X | X | 0 | 0 | 0 |
| Cynthia Yuknewicz | |||||||
| Vice Chairman | 0.50 | 4.50 | X | X | 0 | 0 | 0 |
| Benjamin F Gayman | |||||||
| Secretary | 0.50 | 4.50 | X | X | 0 | 0 | 0 |
| David H Barnes | |||||||
| Director | 0.50 | 4.50 | X | 0 | 0 | 0 | |
| James W Varnum | |||||||
| Trustee | 0.50 | 4.50 | X | 0 | 0 | 0 | |
| Donald L Shumway | |||||||
| President/CEO | 0.50 | 44.00 | X | X | 0 | 203512 | 0 |
| Michael Redmond | |||||||
| Vice President | 0.50 | 44.00 | X | 0 | 160756 | 14648 | |
| Margaret Lins | |||||||
| Vice President | 0.50 | 0.00 | X | 85728 | 0 | 6911 | |
| Joseph Fermano | |||||||
| Past CFO/Past Treasurer | 0.50 | 44.00 | X | 0 | 220312 | 0 | |
| Deborah DeCicco | |||||||
| Assistant Secretary | 0.50 | 4.00 | X | 0 | 0 | 0 | |
| Thomas Zubricki | |||||||
| CFO & Treasurer | 0.50 | 44.00 | X | 0 | 116734 | 16287 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 85728 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 701314 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 37846 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Personal Touch | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Dartmouth Drive Suite 302 | AddressLine1 |
| City | Londonderry | City |
| State | NH | State |
| ZIP Code | 03053 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Nursing Services | DescriptionOfServices |
| Compensation | 195464 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Related Organizations | 14413 | RelatedOrganizations |
| All Other Contributions | 80198 | AllOtherContributions |
| Total Contributions | 94611 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Care Management Fees | 624310 | 2706739 | 2706739 |
| Other Income | 624310 | 20077 | 20077 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 2726816 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2821427 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2726816 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92639 | Total |
| Program Services | 86448 | ProgramServices |
| Management And General | 6191 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1368129 | Total |
| Program Services | 1276700 | ProgramServices |
| Management And General | 91429 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 240349 | Total |
| Program Services | 224287 | ProgramServices |
| Management And General | 16062 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106579 | Total |
| Program Services | 99457 | ProgramServices |
| Management And General | 7122 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 176563 | Total |
| Program Services | 164764 | ProgramServices |
| Management And General | 11799 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 388785 | Total |
| Program Services | 362803 | ProgramServices |
| Management And General | 25982 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5531 | Total |
| Program Services | 5161 | ProgramServices |
| Management And General | 370 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81103 | Total |
| Program Services | 75683 | ProgramServices |
| Management And General | 5420 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1782 | Total |
| Program Services | 1663 | ProgramServices |
| Management And General | 119 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140898 | Total |
| Program Services | 131482 | ProgramServices |
| Management And General | 9416 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68415 | Total |
| Program Services | 63843 | ProgramServices |
| Management And General | 4572 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 619 | Total |
| Program Services | 578 | ProgramServices |
| Management And General | 41 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4062 | Total |
| Program Services | 3791 | ProgramServices |
| Management And General | 271 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Miscellaneous Expense | 26900 | 25102 | 1798 |
| Supplies | 499 | 466 | 33 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2702853 | Total |
| Program Services | 2522228 | ProgramServices |
| Management And General | 180625 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128133 | BOY |
| EOY | 43008 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 78035 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 325620 | BOY |
| EOY | 442257 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7574 | BOY |
| EOY | 7574 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 294086 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 282994 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15154 | BOY |
| EOY | 11092 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 374182 | BOY |
| EOY | 389422 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 850663 | BOY |
| EOY | 971388 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155817 | BOY |
| EOY | 163868 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155817 | BOY |
| EOY | 163868 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 550388 | BOY |
| EOY | 668962 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89913 | BOY |
| EOY | 97187 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54545 | BOY |
| EOY | 41371 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 694846 | BOY |
| EOY | 807520 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 850663 | BOY |
| EOY | 971388 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 118574 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -5900 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 103354 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 103965 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 21684 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 19939 | CurrentTaxYearMinus1Year |
| Current Tax Year | 94611 | CurrentTaxYear |
| Total | 343553 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2777894 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2835316 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2871230 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2694768 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2726816 | CurrentTaxYear |
| Total | 13906024 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2881248 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2939281 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2892914 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2714707 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2821427 | CurrentTaxYear |
| Total | 14249577 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 14249577 | PublicSupportTotal509 |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2881248 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2939281 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2892914 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2714707 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2821427 | CurrentTaxYear |
| Total | 14249577 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 1.00000 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 1.00000 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 294086 | OtherCostOrOtherBasis |
| Depreciation | 282994 | Depreciation |
| Book Value | 11092 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11092 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Interest in Net Assets of Crotched Mountain Foundation | 138558 |
| Due from Affiliates | 250864 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 389422 | TotalBookValueOtherAssets |
| Tot Revenue Etc Audited Fincl Stmt | 2815527 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 2815527 | RevenueSubtotal |
| Other Revenues Not Included | 5900 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 5900 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 2821427 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 2702853 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 2702853 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 2702853 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part XI, Line 4b - Other Adjustments: | Identifier |
| Explanation | Change in Interest in Net Assets of CMF 5,900. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Donald L Shumway | ||||||||||||||
| President/CEO | 0 | 203512 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 203512 | 0 | 0 |
| Michael Redmond | ||||||||||||||
| Vice President | 0 | 160756 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 14648 | 0 | 175404 | 0 | 0 |
| Joseph Fermano | ||||||||||||||
| Past CFO/Past Treasurer | 0 | 220312 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 220312 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | All officer's compensation reported as paid by a related organization was paid by Crotched Mountain Foundation. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Benjamin Gayman and David Barnes are both Shareholders and Directors of Devine, Millimet & Branch. | |
| Form 990, Part VI, Section B, line 11 | Form 990 is reviewed by the Organization's Board of Directors before it is filed. | |
| Form 990, Part VI, Section B, line 12c | An Annual Disclosure statement is requested by the Secretary of the Board of Directors. The Secretary follows up with all the Board members to ensure the form is submitted. Conflicts of interest, if any, are published in the local papers. The public is able to comment on disclosures that they are aware of but that may not have not been included in the publication. | |
| Form 990, Part VI, Section B, line 15 | The Organization's CEO and other officers are compensated by the parent organization, Crotched Mountain Foundation. There is no compensation review conducted by the filing organization; however, Crotched Mountain Foundation's Board of Directors approve the CEO's compensation annually. They request information from compensation consultants and review other market data. For other officers, and key employees, the human resource director reviews market data in order to set salary ranges. The HR director and the CEO determine compensation. | |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. | |
| Form 990, Part IX, line 11g | Other Fees: Program service expenses 362,803. Management and general expenses 25,982. Fundraising expenses 0. Total expenses 388,785. | Other Fees |
| Form 990, Part XI, line 9: | Change in Interest in Net Assets of CMF -5,900. | Changes in Net Assets or Fund Balances: |
| Form 990, Part XII, Line 2c | The audit process has not changed from the prior year. | Oversight of Audit |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Crotched Mountain Rehabilitation Center | |||||||||||
| 1 Verney Drive | Greenfield | NH | 03047 | 222541478 | Rehabilitative Care Facility | NH | 501(c)(3) | Line 2 | Crotched Mountain Foundation | 0 | |
| CMRS Inc | |||||||||||
| 1 Verney Drive | Greenfield | NH | 03047 | 222849875 | Care Management Facility | NH | 501(c)(3) | Line 9 | Crotched Mountain Foundation | 0 | |
| CMRS II Inc | |||||||||||
| 1 Verney Drive | Greenfield | NH | 03047 | 222540660 | Residential and Day Support | NH | 501(c)(3) | Line 9 | Crotched Mountain Foundation | 0 | |
| CMRS IV Inc | |||||||||||
| 1 Verney Drive | Greenfield | NH | 03047 | 223292356 | Residential and Day Support | NH | 501(c)(3) | Line 9 | Crotched Mountain Foundation | 0 | |
| CMRS Whitefield Inc | |||||||||||
| 1 Verney Drive | Greenfield | NH | 03047 | 222540983 | Residential and Day Support | NH | 501(c)(3) | Line 9 | Crotched Mountain Foundation | 0 | |
| Crotched Mountain of New York I East Greenbush Inc | |||||||||||
| 1 Verney Drive | Greenfield | NH | 03047 | 141785202 | Residential and Day Support | NH | 501(c)(3) | Line 9 | Crotched Mountain Foundation | 0 | |
| NH Assistive Technology Center | |||||||||||
| 67 Communications Drive | Laconia | NH | 03246 | 020488042 | Home Healthcare Services Delivery | NH | 501(c)(3) | Line 7 | Crotched Mountain Foundation | 0 | |
| Sunnyfield Farm Inc | |||||||||||
| 1 Verney Drive | Greenfield | NH | 03047 | 201700093 | Vocational and Social Support | NH | 501(c)(3) | Line 11a, I | Crotched Mountain Foundation | 0 | |
| Crotched Mountain Foundation | |||||||||||
| 1 Verney Drive | Greenfield | NH | 03047 | 020222168 | Rehabilitative and Residential Support | NH | 501(c)(3) | Line 7 | 0 | N/A | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | C-MAT Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Verney Drive | AddressLine1 |
| City | Greenfield | City |
| State | NH | State |
| ZIP Code | 03047 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550838643 | EIN |
| Primary Activity | Medical Equipment Wholesaler | PrimaryActivity |
| Legal Domicile State | NH | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Crotched Mountain Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |