2013-11-15T10:41:51-06:00 2013-06-30 020471217 LEONE MCDONNELL & ROBERTS PA 10 DUPREY ROAD NORTH CONWAY NH 03860 990 2012-07-01 020300994 NORTHERN HUMAN SERVICES INC NORT 6034473347 87 WASHINGTON STREET CONWAY NH 03818 DALE HEON 6034473347 2013-11-06 1 JOHN D CALLAHAN JR P00224470 6033566358 2013-11-06 2012 2015-11-30 17:44:51Z DALE HEON 87 WASHINGTON STREET CONWAY NH 03818 33598556 0 X WWW.NORTHERNHS.ORG X 1971 NH ASSIST PEOPLE AFFECTED BY MENTAL ILLNESS, DEVELOPMENTAL DISABILITIES AND RELATED DISORDERS. 10 10 902 0 0 0 1269317 1766328 31265397 31442014 2257 1108 592423 389106 33129394 33598556 0 0 0 0 19638383 19100582 0 0 0 13427516 14412899 33065899 33513481 63495 85075 8903246 10467242 1957082 3447017 6946164 7020225 TO PROVIDE PROFESSIONAL SUPPORT AND SERVICES TO PEOPLE AFFECTED BY MENTAL ILLNESS, DEVELOPMENTAL DISABILITIES, SUBSTANCE ABUSE, ACQUIRED BRAIN INJURY OR RELATED DISORDERS. 0 0 11290116 11018128 PROVIDED VARIOUS SERVICES TO MENTALLY ILL CLIENTS IN ALL OF NORTHERN NEW HAMPSHIRE, INCLUDING PSYCHIATRIC EMERGENCY SERVICES, OUTPATIENT THERAPY, PSYCHIATRIC EMERGENCY CARE, SUBSTANCE ABUSE TREATMENT AND OUTREACH. 20001249 20812992 PROVIDED SERVICES TO DEVELOPMENTALLY DISABLED CLIENTS IN ALL OF NORTHERN NEW HAMPSHIRE, INCLUDING COMPREHENSIVE DAY SERVICES, PERSONAL HYGIENE, COMMUNITY INTEGRATION, RESIDENTIAL SERVICES AND NURSING. 31291365 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 170 0 902 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 0 1 1 1 1 0 NH X RICK BUCKLER CONTROLLER 6034473801 71 HOBBS STREET 3RD FLOOR CONWAY NH 03818 MARGARET MCCLELLAN 1.00 X X 0 0 0 STEPHEN MICHAUD 1.00 X 0 0 0 JAMES SALMON 1.00 X X 0 0 0 MADELENE COSTELLO 1.00 X X 0 0 0 JUDY HOUGHTON 1.00 X 0 0 0 MARTI FAULKNER 1.00 X X 0 0 0 BOB FINK 1.00 X 0 0 0 LOUISE VALLIERE 1.00 X 0 0 0 JENN PINEO 1.00 X 0 0 0 AMY MITZ 1.00 X 0 0 0 DENNIS MACKAY 40.00 X 144844 0 6643 ERIC JOHNSON 40.00 X 78258 0 10134 DALE HEON 40.00 X 81322 0 6643 PAUL LIDSTROM 35.00 X 179074 0 12970 LESTER NICHOLSON 40.00 X 177349 0 7471 ERINN FELLNER 40.00 X 144263 0 18785 MELLISSA MYERS 40.00 X 127801 0 18785 ERIC VAN LEUVEN 40.00 X 184840 0 15964 1117751 0 97395 6 0 1 0 KELLY MOULTON PO BOX 512 OSSIPEE NH 03814 CLIENT CARE 109158 1 908600 857728 1766328 CLIENT SERVICE FEES 624100 30986713 30986713 CLIENT PRODUCTION INCOME 624100 455301 455301 31442014 1108 1108 OTHER REVENUE 624100 389106 389106 389106 33598556 31831120 0 1108 X 15006231 13659670 1346561 2915657 2706191 209466 1178694 1094140 84554 9343144 9077003 266141 1248020 1162592 85428 1130149 1121994 8155 132952 122732 10220 ALL OTHER EXPENSES 948283 887826 60457 CONSUMABLE SUPPLIES 550502 516068 34434 COMMUNICATIONS 384822 333350 51472 CLIENT WAGES 369041 369041 305986 240758 65228 33513481 31291365 2222116 0 5309916 7033038 48749 58068 2887702 2921773 199982 213832 3330699 3269225 157557 61474 35265 299340 143792 8903246 10467242 1922739 1818317 16533 32557 17810 1596143 1957082 3447017 X 6691811 6765570 1936 2238 252417 252417 6946164 7020225 8903246 10467242 X 85075 -11014 X X 0 1 X 1 1 1 X 1706821 1812337 1594310 1296317 1766328 8176113 32039287 32508520 32729096 31265397 31442014 159984314 33746108 34320857 34323406 32561714 33208342 168160427 0 0 0 168160427 11899 15559 7105 2257 1108 37928 11899 15559 7105 2257 1108 37928 106216 106216 33864223 34336416 34330511 32563971 33209450 168304571 0.99910 0.99800 0.00020 0.00050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2744980 2694168 50812 585719 575057 10662 61474 MEDICAID CONTINGENCY PAYMENTS - STATE OF NEW HAMPSHIRE 1596143 1596143 33598556 0 33598556 0 33598556 33513481 0 33513481 0 33513481 X X 0 0 0 0 0 0 0 0 0 DENNIS MACKAY 144844 0 0 0 0 0 0 0 6643 0 151487 0 0 0 PAUL LIDSTROM 179074 0 0 0 0 0 0 0 12970 0 192044 0 0 0 LESTER NICHOLSON 177349 0 0 0 0 0 0 0 7471 0 184820 0 0 0 ERINN FELLNER 144263 0 0 0 0 0 0 0 18785 0 163048 0 0 0 ERIC VAN LEUVEN 184840 0 0 0 0 0 0 0 15964 0 200804 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY MANAGEMENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15 NORTHERN HUMAN SERVICES INC. HIRES AN INDEPENDENT CONSULTANT TO REVIEW COMPENSATION DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 NORTHERN HUMAN SERVICES INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 9,077,003. MANAGEMENT AND GENERAL EXPENSES 266,141. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,343,144. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN SPLIT INTEREST AGREEMENT -34,096. CHANGE IN CASH VALUE OF LIFE INSURANCE 23,082. MANAGEMENT AND THE BOARD OF DIRECTORS ARE RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. SHALLOW RIVER PROPERTIES INC 87 WASHINGTON STREET CONWAY NH 03818 020426312 OWN & MANAGE REAL PROPERTY FOR NORTHERN HUMAN SERVICES NH 501(C)2 N/A 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 SHALLOW RIVER PROPERTIES C 221310 SHALLOW RIVER PROPERTIES K 742743