NORTH SHORE COMMUNITY HEALTH INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: NORTH SHORE COMMUNITY HEALTH INC (EIN 04-2610447)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-03-15
IRS object ID: 201340779349300414
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-03-15T15:20:42-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	221478099	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	COHNREZNICK LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	180 GLASTONBURY BOULEVARD	AddressLine1
City	GLASTONBURY	City
State	CT	State
ZIP Code	06033	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	042610447	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	NORTH SHORE COMMUNITY HEALTH INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	NORT	NameControl
Phone	9788251109	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	27 CONGRESS ST NO 504	AddressLine1
City	SALEM	City
State	MA	State
ZIP Code	01970	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MARGARET BRENNAN	Name
Title	CHIEF EXECUTIVE OFFICER	Title
Phone	9788251109	Phone
Date Signed	2013-03-18	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	PAUL BALLASY	Name
PTIN	P00852868	PTIN
Phone	8606333000	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MARGARET BRENNAN	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	27 CONGRESS ST NO 504	AddressLine1
City	SALEM	City
State	MA	State
ZIP Code	01970	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	10703656	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.NSCHI.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1977	YearFormation
State Legal Domicile	MA	StateLegalDomicile
Activity Or Mission Description	THE HEALTH CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE PRIMARY CARE THAT IS ACCESSIBLE, CULTURALLY AND LINGUISTICALLY COMPETENT, AND COMMUNITY DIRECTED FOR ALL RESIDENTS OF MASSACHUSETTS' NORTH SHORE AND CAPE ANN COMMUNITIES REGARDLESS OF ABILITY TO PAY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	95	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	2199539	ContributionsGrantsPriorYear
Contributions Grants Current Year	4048532	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	5834130	ProgramServiceRevenuePriorYear
Program Service Revenue CY	6100171	ProgramServiceRevenueCY
Investment Income Prior Year	10234	InvestmentIncomePriorYear
Investment Income Current Year	8862	InvestmentIncomeCurrentYear
Other Revenue Prior Year	66540	OtherRevenuePriorYear
Other Revenue Current Year	546091	OtherRevenueCurrentYear
Total Revenue Prior Year	8110443	TotalRevenuePriorYear
Total Revenue Current Year	10703656	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	5022654	SalariesEtcPriorYear
Salaries Etc Current Year	5615427	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	3561674	OtherExpensePriorYear
Other Expenses Current Year	3289909	OtherExpensesCurrentYear
Total Expenses Prior Year	8584328	TotalExpensesPriorYear
Total Expenses Current Year	8905336	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-473885	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1798320	RevenuesLessExpensesCY
Total Assets BOY	5448832	TotalAssetsBOY
Total Assets EOY	6933051	TotalAssetsEOY
Total Liabilities BOY	1753206	TotalLiabilitiesBOY
Total Liabilities EOY	1439105	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	3695626	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	5493946	NetAssetsOrFundBalancesEOY
Mission Description	THE HEALTH CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE PRIMARY CARE THAT IS ACCESSIBLE, CULTURALLY AND LINGUISTICALLY COMPETENT, AND COMMUNITY DIRECTED FOR ALL RESIDENTS OF MASSACHUSETTS' NORTH SHORE AND CAPE ANN COMMUNITIES REGARDLESS OF ABILITY TO PAY.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	6252390	Expense
Revenue	5309985	Revenue
Description	MEDICAL SERVICES - MEDICAL SERVICES PROVIDED TO THE RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. SERVICES INCLUDE MEDICAL SERVICES TO ADULTS AND CHILDREN, HIV COUNSELING AND OTHER. THERE WERE 30,751 MEDICAL VISITS DURING THE TAX YEAR.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	1152195	Expense
Revenue	1152195	Revenue
Description	DENTAL SERVICES - DENTAL SERVICES PROVIDED TO THE RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. THERE WERE 14,366 DENTAL VISITS DURING THE TAX YEAR.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	136309	Expense
Revenue	105186	Revenue
Description	SCHOOL BASED HEALTH CENTER - HEALTH SERVICES PROVIDED TO STUDENTS AT SALEM HIGH SCHOOL. THERE WERE 651 SCHOOL BASED HEALTH CENTER VISITS DURING THE TAX YEAR.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	7540894	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	0	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	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	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	17	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	95	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	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	0	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	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	MA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	JOHN HILDRETH	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	9788251109	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	27 CONGRESS ST NO 504	AddressLine1
City	SALEM	City
State	MA	State
ZIP Code	01970	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
MARION WINFREY
PRESIDENT, BOARD OF DIRECTORS	2.00	X	X	0	0	0
BEVERLY WHITE
VP, BOARD OF DIRECTORS	2.00	X	X	0	0	0
PAMELA PAINE
SECRETARY	2.00	X	X	0	0	0
GEORGE KAPLAN
TREASURER	2.00	X	X	0	0	0
LUCY CORCHADO
BOARD MEMBER	2.00	X		0	0	0
RICKY GANAISHLAL
BOARD MEMBER	2.00	X		0	0	0
GABRIELLE ROSS
BOARD MEMBER	2.00	X		0	0	0
JACK VONDRAS
BOARD MEMBER	2.00	X		0	0	0
CALVIN YOUNG
BOARD MEMBER	2.00	X		0	0	0
MARGARET BRENNAN
CEO	40.00		X	48465	0	8489
GLORIA RILEY
COO	40.00		X	131146	0	26210
ROBERT HENDERSHOTT
CEO - FORMER	40.00		X	148077	0	4231
GABRIELLE DEMILLE
DENTAL DIRECTOR	40.00			132279	0	21887	X
AZRA ALI
FAMILY PRACTICE MD	40.00			143406	0	13000	X
JAY PANDEY
FAMILY PRACTICE MD	40.00			149815	0	17902	X
LUCAS MIKULIC
INTERNAL MEDICINE MD	40.00			136344	0	18067	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	889532	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	109786	TotalOtherCompensation
Number Individuals GT100 K	9	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
D&Y STAFFING
PO BOX 635715	CINCINATTI	OH	45263	STAFFING AGENCY	199074
NORTH SHORE PHYSICIANS GROUP
35 CONGRESS ST	SALEM	MA	01970	OB/GYN STAFFING AGENCY	120881
READY NURSE
PO BOX 200528	HOUSTON	TX	77216	STAFFING AGENCY	115900
STAFF CARE
PO BOX 281923	ATLANTA	GA	30384	STAFFING AGENCY	102071

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
Government Grants	2488948	GovernmentGrants
All Other Contributions	1559584	AllOtherContributions
Total Contributions	4048532	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE	621110	5441772	5441772
NET PHARMACY	621110	658399	658399

Field	Value	IRS element (for citing)
Total Program Service Revenue	6100171	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	8862	TotalRevenueColumn
Exclusion	$8,862	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
EMR INCENTIVE	621110	425000	425000
MISCELLANEOUS	621110	121091	42195	$78,896

Field	Value	IRS element (for citing)
Total Other Revenue	546091	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	10703656	TotalRevenueColumn
Related Or Exempt Function Income	6567366	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$87,758	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	279360	Total
Management And General	279360	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	4311300	Total
Program Services	3862745	ProgramServices
Management And General	448555	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	40495	Total
Program Services	39456	ProgramServices
Management And General	1039	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	659125	Total
Program Services	584435	ProgramServices
Management And General	74690	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	325147	Total
Program Services	290645	ProgramServices
Management And General	34502	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	64613	Total
Program Services	5335	ProgramServices
Management And General	59278	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	50200	Total
Management And General	50200	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	458779	Total
Program Services	423320	ProgramServices
Management And General	35459	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	106785	Total
Program Services	220	ProgramServices
Management And General	106565	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	109223	Total
Program Services	78098	ProgramServices
Management And General	31125	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	214374	Total
Program Services	176182	ProgramServices
Management And General	38192	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	365878	Total
Program Services	317594	ProgramServices
Management And General	48284	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	23673	Total
Program Services	10160	ProgramServices
Management And General	13513	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	31263	Total
Program Services	30032	ProgramServices
Management And General	1231	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	231525	Total
Program Services	221261	ProgramServices
Management And General	10264	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	40123	Total
Program Services	37868	ProgramServices
Management And General	2255	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	530297	526300	3997
DISPENSING FEES	380830	380830
BAD DEBT	314927	314927
DUES AND SUBSCRIPTIONS	86530	40248	46282

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	280889	Total
Program Services	201238	ProgramServices
Management And General	79651	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	8905336	Total
Program Services	7540894	ProgramServices
Management And General	1364442	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	309989	BOY
EOY	1408050	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	333995	BOY
EOY	138298	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	848456	BOY
EOY	676424	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	1572545	BOY
EOY	1454021	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	0	BOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	70017	BOY
EOY	144755	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	5124087	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2012584	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	2313830	BOY
EOY	3111503	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	5448832	BOY
EOY	6933051	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1013058	BOY
EOY	792875	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	740148	BOY
EOY	646230	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	1753206	BOY
EOY	1439105	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3121116	BOY
EOY	3872805	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	574510	BOY
EOY	1621141	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3695626	BOY
EOY	5493946	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5448832	BOY
EOY	6933051	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	1798320	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	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
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1344767	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	1692982	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2707564	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2199539	CurrentTaxYearMinus1Year
Current Tax Year	4048532	CurrentTaxYear
Total	11993384	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1344767	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	1692982	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2707564	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2199539	CurrentTaxYearMinus1Year
Current Tax Year	4048532	CurrentTaxYear
Total	11993384	Total

Field	Value	IRS element (for citing)
Public Support Total170	11993384	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	26850	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	13988	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	12855	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	10234	CurrentTaxYearMinus1Year
Current Tax Year	8862	CurrentTaxYear
Total	72789	Total

Other Income170 OtherIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4990	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	44714	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	130174	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	66540	CurrentTaxYearMinus1Year
Current Tax Year	121091	CurrentTaxYear
Total	367509	Total

Field	Value	IRS element (for citing)
Total Support	12433682	TotalSupport
Public Support Pertcentage170	0.96460	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.96360	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170

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

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1412101	OtherCostOrOtherBasis
Depreciation	175797	Depreciation
Book Value	1236304	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1221467	OtherCostOrOtherBasis
Depreciation	1059020	Depreciation
Book Value	162447	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1704939	OtherCostOrOtherBasis
Depreciation	777767	Depreciation
Book Value	927172	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	785580	OtherCostOrOtherBasis
Book Value	785580	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	3111503	TotalOfBookValueLandBuildings
Total Revenue	10703656	TotalRevenue
Total Expenses	8905336	TotalExpenses
Excess Or Deficit For Year	1798320	ExcessOrDeficitForYear
Excess Or Deficit Per FS	1798320	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	10896278	TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities	192622	DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990	192622	RevenueNotRptdF990
Revenue Subtotal	10703656	RevenueSubtotal
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	10703656	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	9097958	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	192622	DonatedServicesUseOfFacilities
Expenses Not Rptd F990	192622	ExpensesNotRptdF990
Expenses Subtotal	8905336	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	8905336	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	Identifier
Return Reference	PART X:	ReturnReference
Explanation	THE CORPORATION HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2012. THE CORPORATION'S U.S. FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2009 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CORPORATION HAD UNRELATED BUSINESS INCOME TAXES, IT WOULD RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH ANY TAX MATTERS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENTS OF FINANCIAL POSITION.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Substantiation Required	1	SubstantiationRequired
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	1	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 (6 entries)

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
GLORIA RILEY
131146	0	0	0	0	0	19500	0	6710	0	157356	0	0	0
ROBERT HENDERSHOTT
35577	0	0	0	112500	0	4231	0	0	0	152308	0	0	0
GABRIELLE DEMILLE
132279	0	0	0	0	0	5520	0	16367	0	154166	0	0	0
AZRA ALI
143406	0	0	0	0	0	13000	0	0	0	156406	0	0	0
JAY PANDEY
149815	0	0	0	0	0	0	0	17902	0	167717	0	0	0
LUCAS MIKULIC
136344	0	0	0	0	0	2300	0	15767	0	154411	0	0	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReference	ExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 INITIAL COMPLETION IS DONE BY OUR AUDITORS. THE FORM 990 IS THEN SENT TO THE NORTH SHORE COMMUNITY HEALTH MANAGEMENT TEAM AND THEN FORWARDED TO THE MEMBERS OF THE BOARD OF DIRECTORS, WHO ARE GIVEN A WEEK TO SUBMIT ANY QUESTIONS, COMMENTS, OR OBSERVATIONS THAT THEY HAVE. THEN MANAGEMENT DISCUSSES ANY CHANGES THEY ARE GOING TO MAKE TO THE 990 FORM. IF CHANGES ARE DEEMED NECESSARY, THEY ARE MADE IMMEDIATELY. THE FORM 990 IS THEN APPROVED FOR SUBMISSION BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	EACH EMPLOYEE, VOLUNTEER, AND BOARD MEMBER WILL ACKNOWLEDGE THAT THEY HAVE READ AND UNDERSTAND NORTH SHORE COMMUNITY HEALTH'S CONFLICT OF INTEREST POLICY UPON BEGINNING THEIR EMPLOYMENT OR TENURE WITH NORTH SHORE COMMUNITY HEALTH BY SIGNING AN ACKNOWLEDGEMENT FORM. THIS IS UPDATED ON A YEARLY BASIS.
FORM 990, PART VI, SECTION B, LINE 15	THE COMPENSATION OF THE HEALTH CENTER'S OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE BOARD OF DIRECTORS UTILIZING A SALARY SURVEY. THE EXECUTIVE DIRECTOR AND FINANCE COMMITTEE SET THE OTHER EMPLOYEES' SALARIES BASED ON A SALARY SURVEY IN ACCORDANCE WITH THE HEALTH CENTER'S BUDGET PARAMETERS.
FORM 990, PART VI, SECTION C, LINE 19	NORTH SHORE COMMUNITY HEALTH, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS AVAILABLE TO THE GENERAL PUBLIC THROUGH WWW.GUIDESTAR.ORG.
FORM 990, PART XII, LINE 2C	THERE HAVE BEEN NO CHANGES TO THE ORGANIZATION'S SELECTION OR OVERSIGHT PROCESS DURING THE TAX YEAR.