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EXETER MED REAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
EXETER MED REAL INC (EIN 02-0418718)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-05-13
IRS object ID
201311339349303291
Schema version
2011v1.5
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)
Timestamp2013-05-13T14:17:31-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN020383073EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WILLIAM STEELE & ASSOCIATES PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line140 STARK STREETAddressLine1
CityMANCHESTERCity
StateNHState
ZIP Code03101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN020418718EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1EXETER MED REAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlEXETNameControl
Phone6035806695Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15 ALUMNI DRIVEAddressLine1
CityEXETERCity
StateNHState
ZIP Code03833ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN J O'LEARYName
TitleTREASURERTitle
Phone6035806695Phone
Date Signed2013-05-07DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWILLIAM G STEELE JR CPAName
PTINP00233103PTIN
Phone6036228881Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEVIN CALLAHANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15 ALUMNI DRIVEAddressLine1
CityEXETERCity
StateNHState
ZIP Code03833ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3725923GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1989YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionEXETER 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3720483ProgramServiceRevenuePriorYear
Program Service Revenue CY3725882ProgramServiceRevenueCY
Investment Income Prior Year33InvestmentIncomePriorYear
Investment Income Current Year24InvestmentIncomeCurrentYear
Other Revenue Prior Year35OtherRevenuePriorYear
Other Revenue Current Year17OtherRevenueCurrentYear
Total Revenue Prior Year3720551TotalRevenuePriorYear
Total Revenue Current Year3725923TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4467268OtherExpensePriorYear
Other Expenses Current Year4491184OtherExpensesCurrentYear
Total Expenses Prior Year4467268TotalExpensesPriorYear
Total Expenses Current Year4491184TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-746717RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-765261RevenuesLessExpensesCY
Total Assets BOY27366729TotalAssetsBOY
Total Assets EOY26414406TotalAssetsEOY
Total Liabilities BOY839162TotalLiabilitiesBOY
Total Liabilities EOY662014TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY26527567NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY25752392NetAssetsOrFundBalancesEOY
Mission DescriptionHOLDS TITLE TO PROPERTY AND DISTRIBUTES THE INCOME THEREFROM TO EXETER HEALTH RESOURCES, A RELATED 501(C)(3) ORGANIZATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense4491184Expense
Revenue3725899Revenue
DescriptionEXETER 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) ORGANIZATIONDescription
Total Program Service Expense4491184TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109613NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KEVIN J O'LEARYBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6035806695TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15 ALUMNI DRIVEAddressLine1
CityEXETERCity
StateNHState
ZIP Code03833ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KEVIN J CALLAHAN
PRESIDENT/SECRETARY/TRUSTEE1.00XX0766738192568
KEVIN J O'LEARY
TREASURER/TRUSTEE1.00XX0405438100033
SUSAN BURNS-TISDALE
TRUSTEE0.30X033297942292
DEBRA CRESTA
TRUSTEE0.30X033316343650
MARK WHITNEY
TRUSTEE0.30X025402744157
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2092345TotalReportableCompFrmRltdOrgs
Total Other Compensation422700TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HUTTER CONSTRUCTION CORP
PO BOX 257 810 TURNPIKE RDNEW IPSWICHNH03071BUILDING CONTRACTOR1346728
LAVALLEBRENSINGER
155 DOW STREET SUITE 400MANCHESTERNH03101ARCHITECTURAL SERVICES438258
EXETER HOSPITAL INC
5 ALUMNI DRIVEEXETERNH03833CONSTRUCTION, ENGINEERING, CLEANING SERI256895
JONES & BEACH ENGINEERING INC
85 PORTSMOUTH AVE PO BOX 219STRATHAMNH03855ENGINEERING SERVICES119755
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRENTAL INCOMEDescription
Business Code531120BusinessCode
Total Revenue Column3725882TotalRevenueColumn
Related Or Exempt Function Income3725882RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue3725882TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column24TotalRevenueColumn
Exclusion$24ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCASH DISCOUNTSDescription
Business Code531120BusinessCode
Total Revenue Column17TotalRevenueColumn
Related Or Exempt Function Income17RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue17TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3725923TotalRevenueColumn
Related Or Exempt Function Income3725899RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$24ExclusionAmount

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total12419Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1376920Total

Interest Interest

FieldValueIRS element (for citing)
Total22338Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total257220Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2652061Total

Insurance Insurance

FieldValueIRS element (for citing)
Total27544Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
OUTSIDE FEES115434
REPAIRS/MAINTENANCE15816
DESIGN/RELOCATION FEES11346
MISCELLANEOUS86

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4491184Total

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3182264BOY
EOY2658908EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY59586BOY
EOY77893EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis47065843LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec23407327LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY24056846BOY
EOY23658516EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY68033BOY
EOY19089EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY27366729BOY
EOY26414406EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY230107BOY
EOY234353EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY609055BOY
EOY408622EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY19039EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY839162BOY
EOY662014EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY26527567BOY
EOY25752392EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY26527567BOY
EOY25752392EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27366729BOY
EOY26414406EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-765261ReconcilationRevenueExpenses
Reconcilation Other Changes-9914ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis186241OtherCostOrOtherBasis
Book Value186241BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis43346571OtherCostOrOtherBasis
Depreciation23102519Depreciation
Book Value20244052BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis129862OtherCostOrOtherBasis
Depreciation64679Depreciation
Book Value65183BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3403169OtherCostOrOtherBasis
Depreciation240129Depreciation
Book Value3163040BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings23658516TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$19,039Amount
FieldValueIRS element (for citing)
Total Of Amounts19039TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationEXETER MED REAL IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF EXETER HEALTH RESOURCES, INC. INCLUDED IN THOSE CONSOLIDATED AUDITED FINANCIAL STATEMENTS IS THE FOLLOWING "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."Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E Expenses0WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEVIN J CALLAHAN
0491486017500001002520167350025218095930600
KEVIN J O'LEARY
0272025082095051318082700017333050547100
SUSAN BURNS-TISDALE
0225335077420030224014700027592037527100
DEBRA CRESTA
0229110072240031813014700028950037681300
MARK WHITNEY
019742405400002603014700029457029818400

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATAX INDEMNIFICATION AND GROSS UP PAYMENTS WERE PROVIDED TO KEVIN CALLAHAN, KEVIN O'LEARY, SUSAN BURNS-TISDALE, DEBRA CRESTA AND MARK WHITNEY (FOR ACQUISITION OF SUPPLEMENTAL LONG TERM DISABILITY INSURANCE). THE BENEFIT WAS TREATED AS TAXABLE INCOME.
PART I, LINE 1BTHERE WAS NO EXISTING POLICY CONCERNING TAX INDEMNIFICATION AND GROSS UP PAYMENTS. HOWEVER, IN THE INSTANCE OF SUCH ACTION RELATED TO THE ACQUISITION OF LONG TERM DISABILITY INSURANCE DESCRIBED ABOVE, THE TAX INDEMNIFICATION AND GROSS UP PAYMENTS WERE APPROVED BY THE EXETER HEALTH RESOURCES BOARD OF TRUSTEES EXECUTIVE COMMITTEE COMPRISED OF DISINTERESTED PERSONS.
PART I, LINE 4BTHE 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) ARE AVAILABLE TO BE PAID TO THE PARTICIPANT ONCE VESTED AT AGE 62. KEVIN CALLAHAN - EXCESS ACCUMULATED VALUE - $531,215 KEVIN O'LEARY - EXCESS ACCUMULATED VALUE - $214,807 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, 2011 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.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6EXETER 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 7AAS SOLE SHAREHOLDER, EXETER HEALTH RESOURCES ELECTS THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7BTHE STOCKHOLDER HAS THE RIGHT TO APPROVE A DISSOLUTION OF THE CORPORATION AND TO REMOVE THE DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11THE 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 12CTHE 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. THEREAFTER, ON AN ANNUAL BASIS, STAFF WITHIN HUMAN RESOURCES WILL SURVEY ALL EMPLOYEES AND CONTRACTED STAFF SERVING IN A MANAGERIAL ROLE, AS WELL AS ALL MEMBERS OF ANY COMMITTEES THAT MAKE RECOMMENDATIONS OR DECISIONS REGARDING THE PURCHASE OF GOODS OR SERVICES BY EXETER MED REAL AS A MEANS TO ENSURE THAT ANY CONFLICT OF INTEREST, CONFLICT OF COMMITMENT AND/OR PERSONAL INTEREST IS DISCLOSED AND APPROPRIATELY MANAGED. EMPLOYEES OTHERWISE ARE REQUIRED TO MAKE ANY FURTHER WRITTEN DISCLOSURE AT THE TIME A CONFLICT ARISES. THIS POLICY IS MONITORED AND ENFORCED BY THE VICE PRESIDENT OF HUMAN RESOURCES AND THE VICE PRESIDENT OF CORPORATE INTEGRITY AND COMPLIANCE. ANY IDENTIFIED CONFLICT OF INTEREST IS MANAGED BY DISCLOSURE, RECUSAL, OR DIVESTITURE OF THE INTEREST.
FORM 990, PART VI, SECTION B, LINE 15THE 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 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:TRANSFERS BETWEEN RELATED ENTITIES -9,914. TOTAL TO FORM 990, PART XI, LINE 5: -9,914.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, QUESTION 2CTHE 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
EXETER HEALTH RESOURCES INC
5 ALUMNI DRIVEEXETERNH03833020222126MANAGEMENT AND SUPPORTING ORGANIZATION; HOLDING COMPANYNH501C3110
EXETER HOSPITAL INC
5 ALUMNI DRIVEEXETERNH03833222674014HOSPITALNH501C330EXETER HEALTH RESOURCES INC
CORE PHYSICIANS LLC
5 ALUMNI DRIVEEXETERNH03833870807914PHYSICIAN PRACTICESNH501C390EXETER HEALTH RESOURCES INC
ROCKINGHAM VISITING NURSE ASSOCIATION
5 ALUMNI DRIVEEXETERNH03833020274905HOME CARE, HOSPICENH501C390EXETER HEALTH RESOURCES INC
MATRIX HEALTH INC
5 ALUMNI DRIVEEXETERNH03833020473737MANAGE RESOURCESNH501C3110EXETER HEALTH RESOURCES INC
EXETER HEALTHCARE INC
5 ALUMNI DRIVEEXETERNH03833020360966SUBACUTE NURSING FACILITYNH501C390EXETER HEALTH RESOURCES INC
EXETER HEALTH RESOURCES INC SELF-INSURANCE TRUST
5 ALUMNI DRIVEEXETERNH03833200753662SELF INSURANCE TRUSTNH501C3110EXETER HEALTH RESOURCES INC

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
CONVERGENT HEALTH SYSTEMS INC
5 ALUMNI DRIVEEXETERNH03833020469711WELLNESS CENTERSNHEXETER HEALTH RESOURCES INCC
VX HEALTH SERVICES INC
5 ALUMNI DRIVEEXETERNH03833020469712FITNESS CENTERNHCONVERGENT HEALTH SYSTEMS INCC
EXETER MEDICAL SERVICES INC
5 ALUMNI DRIVEEXETERNH03833020419850INACTIVE PHYSICIAN PRACTICENHCONVERGENT HEALTH SYSTEMS INCC
CORE HEALTH SERVICES OF MA
5 ALUMNI DRIVEEXETERNH03833201598042INACTIVE PHYSICIAN PRACTICEMAEXETER HEALTH RESOURCES INCC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
EXETER HEALTH RESOURCES INC
I81837CASH
EXETER HOSPITAL INC
I1106775CASH
CORE PHYSICIANS LLC
I1969373CASH
VX HEALTH SERVICES INC
I448163CASH
EXETER HEALTH RESOURCES INC SELF-INSURANCE TRUST
P6093CASH
EXETER HOSPITAL INC
L256895CASH
EXETER HEALTH RESOURCES INC
R9914