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LAMPREY HEALTH CARE INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
LAMPREY HEALTH CARE INC (EIN 23-7305106)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-04-20
IRS object ID
201201119349300210
Schema version
2010v3.4
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)
Timestamp2012-04-20T14:22:32-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BRAD BORBIDGE PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1197 LOUDON ROAD STE 350AddressLine1
CityCONCORDCity
StateNHState
ZIP Code03301ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237305106EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LAMPREY HEALTH CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLAMPNameControl
Phone6036592494Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1207 SOUTH MAIN STREETAddressLine1
CityNEWMARKETCity
StateNHState
ZIP Code03857ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameANN PETERSName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone6032927214Phone
Date Signed2012-04-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDIMITRIOS PANACOPOULOS CPAName
Phone6032240849Phone
Date Prepared2012-03-29DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonANN PETERSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1207 SOUTH MAIN STREETAddressLine1
CityNEWMARKETCity
StateNHState
ZIP Code03857ZIPCode
FieldValueIRS element (for citing)
Gross Receipts15868963GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.LAMPREYHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1971YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF LAMPREY HEALTH CARE IS TO PROVIDE HIGH QUALITY PRIMARY MEDICAL CARE AND HEALTH RELATED SERVICES WITH AN EMPHASIS ON PREVENTION AND LIFESTYLE MANAGEMENT TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees187TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5632850ContributionsGrantsPriorYear
Contributions Grants Current Year8099328ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7688374ProgramServiceRevenuePriorYear
Program Service Revenue CY7766542ProgramServiceRevenueCY
Investment Income Prior Year4027InvestmentIncomePriorYear
Investment Income Current Year3093InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year13325251TotalRevenuePriorYear
Total Revenue Current Year15868963TotalRevenueCurrentYear
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 Year9255215SalariesEtcPriorYear
Salaries Etc Current Year9625810SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year13117TotalFundrsngExpCurrentYear
Other Expense Prior Year3338974OtherExpensePriorYear
Other Expenses Current Year3427809OtherExpensesCurrentYear
Total Expenses Prior Year12594189TotalExpensesPriorYear
Total Expenses Current Year13053619TotalExpensesCurrentYear
Revenues Less Expenses Prior Year731062RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2815344RevenuesLessExpensesCY
Total Assets BOY8893350TotalAssetsBOY
Total Assets EOY12599759TotalAssetsEOY
Total Liabilities BOY4642038TotalLiabilitiesBOY
Total Liabilities EOY5533103TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4251312NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7066656NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF LAMPREY HEALTH CARE IS TO PROVIDE HIGH QUALITY PRIMARY MEDICAL CARE AND HEALTH RELATED SERVICES WITH AN EMPHASIS ON PREVENTION AND LIFESTYLE MANAGEMENT TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11530933Expense
Revenue7766542Revenue
DescriptionTO PROVIDE MEDICAL, DENTAL, HEALTH, TRANSPORTATION AND REFERRAL RELATED SERVICES TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF ABILITY TO PAY.Description
Total Program Service Expense11530933TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Assets1ReportOtherAssets
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
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109655NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees187NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSANDRA PARDUSNamePerson
Telephone Number6032927215TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1207 SOUTH MAIN STREETAddressLine1
CityNEWMARKETCity
StateNHState
ZIP Code03857ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
THOMAS CHRIS DREW
BOARD OF DIRECTORSX000
ELIZABETH CREPEAU
BOARD PRESIDENTX000
CAROL LACROSS
BOARD TREASURERX000
AUDREY ASHTON-SAVAGE
BOARD SECRETARYX000
STEPHEN DENSBERGER
BOARD VICE PRESIDENTX000
GEORGE D DONOVAN JR
BOARD OF DIRECTORSX000
MICHAEL MERENDA
BOARD OF DIRECTORSX000
JEAN RAGONESE
BOARD OF DIRECTORSX000
COLETTE D TILTON
BOARD OF DIRECTORSX000
CYNTHIA GIGUERE-UNREIN
BOARD OF DIRECTORSX000
JANIS REAMS
BOARD OF DIRECTORSX000
JAZMIN MIRANDA-SMITH
BOARD OF DIRECTORSX000
PAUL M DECAROLIS
BOARD OF DIRECTORSX000
ANN PETERS
CHIEF EXECUTIVE OFFICER14320402266540.00X
SANDRA PARDUS
CHIEF FINANCIAL OFFICER9641001109535.00X
PAUL FRIEDRICHS
FAMILY PHYSICIAN18783503886140.00X
SIRONA PRUNA
OBGYN27959002801840.00X
VASUKI NAGARAJ
FAMILY PHYSICIAN18571702167540.00X
AJAY SHARMA
FAMILY PHYSICIAN18308902114540.00X
EDWARD SCULLY
FAMILY PHYSICIAN13241803007032.00X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1208263TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation173529TotalOtherCompensation
Number Individuals GT100 K10NumberIndividualsGT100K
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
NORTH BRANCH CONSTRUCTION
76 OLD TURNPIKE RDCONCORDNH03301CONSTRUCTION SERVICES2134152
COMMUNITY HEALTH ACCESS NETWORK
207 S MAIN STREETNEWMARKETNH03857TECHNOLOGY SERVICES216210
PARTNERS FOR WOMANS HEALTH
3 ALUMNI DRIVE SUITE 302EXETERNH03833PHYSICIAN SERVICES136800
DENNIS MIRES PA
697 UNION STREETMANCHESTERNH03104ARCHITECT SERVICES118410
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Government Grants6642722GovernmentGrants
All Other Contributions1456606AllOtherContributions
Total Contributions8099328TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPRIMARY HEALTH CAREDescription
Business Code621110BusinessCode
Total Revenue Column7766542TotalRevenueColumn
Related Or Exempt Function Income7766542RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue7766542TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3093TotalRevenueColumn
Exclusion$3,093ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15868963TotalRevenueColumn
Related Or Exempt Function Income7766542RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,093ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total273374Total
Management And General273374ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7752037Total
Program Services7093088ProgramServices
Management And General658949ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total961067Total
Program Services853007ProgramServices
Management And General108060ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total639332Total
Program Services567447ProgramServices
Management And General71885ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total47454Total
Management And General47454ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total45873Total
Management And General45873ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total335363Total
Program Services297656ProgramServices
Management And General37707ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total27321Total
Program Services24249ProgramServices
Management And General3072ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total61742Total
Program Services54800ProgramServices
Management And General6942ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total302064Total
Program Services268101ProgramServices
Management And General33963ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total827129Total
Program Services734128ProgramServices
Management And General93001ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total58716Total
Program Services52114ProgramServices
Management And General6602ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total285670Total
Program Services253550ProgramServices
Management And General32120ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total69100Total
Program Services61331ProgramServices
Management And General7769ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total182043Total
Program Services161574ProgramServices
Management And General20469ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total125232Total
Program Services111151ProgramServices
Management And General14081ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROGRAM SUPPLIES329458329458
BAD DEBTS288422288422
OTHER EXPENSES16213614390618230
PRINTING & PUBLICATIONS1123439971112632
TELEPHONE957418497610765

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total72002Total
Program Services52264ProgramServices
Management And General6621ManagementAndGeneral
Fundraising13117Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13053619Total
Program Services11530933ProgramServices
Management And General1509569ManagementAndGeneral
Fundraising13117Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1264631BOY
EOY1201265EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3367355BOY
EOY3050302EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY546283BOY
EOY739004EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY121230BOY
EOY126306EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9019423LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2905076LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1822362BOY
EOY6114347EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1771489BOY
EOY1368535EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8893350BOY
EOY12599759EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1042693BOY
EOY1405162EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2868163BOY
EOY2450789EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY630932BOY
EOY1603902EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY100250BOY
EOY73250EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4642038BOY
EOY5533103EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3839736BOY
EOY6670703EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY411576BOY
EOY395953EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4251312BOY
EOY7066656EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8893350BOY
EOY12599759EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses2815344ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4699057CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4813074CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4931132CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5632850CurrentTaxYearMinus1Year
Current Tax Year8099328CurrentTaxYear
Total28175441Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5711511CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6780413CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7217100CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7688374CurrentTaxYearMinus1Year
Current Tax Year7766542CurrentTaxYear
Total35163940Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10410568CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11593487CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12148232CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13321224CurrentTaxYearMinus1Year
Current Tax Year15865870CurrentTaxYear
Total63339381Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year10000CurrentTaxYearMinus1Year
Total10000Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year10000CurrentTaxYearMinus1Year
Total10000Total
FieldValueIRS element (for citing)
Public Support Total50963329381PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years31132CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years35837CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16007CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4027CurrentTaxYearMinus1Year
Current Tax Year3093CurrentTaxYear
Total90096Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years31132CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years35837CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16007CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4027CurrentTaxYearMinus1Year
Current Tax Year3093CurrentTaxYear
Total90096Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10441700CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11629324CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12164239CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13325251CurrentTaxYearMinus1Year
Current Tax Year15868963CurrentTaxYear
Total63429477Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99840PublicSupportPercentage509
Prior Year Support Percentage0.99810PriorYearSupportPercentage
Investment Income Percentage0.00140InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00170PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis827246OtherCostOrOtherBasis
Book Value827246BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6461486OtherCostOrOtherBasis
Depreciation1473216Depreciation
Book Value4988270BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1730691OtherCostOrOtherBasis
Depreciation1431860Depreciation
Book Value298831BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6114347TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionASSETS LIMITED AS TO USEDescription
Book Value1368535BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets1368535TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO THIRD PARTIESDescription
Amount$73,250Amount
FieldValueIRS element (for citing)
Total Of Amounts73250TotalOfAmounts
Total Revenue15868963TotalRevenue
Total Expenses13053619TotalExpenses
Excess Or Deficit For Year2815344ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS2815344ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt15868963TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal15868963RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99015868963TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13053619TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal13053619ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013053619TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
ExplanationFORM 990. PART IV, LINE 11F: LAMPREY HEALTH CARE IS A PUBLIC CHARITY UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS PUBLIC CHARITIES, THE ENTITIES ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES ON INCOME EARNED IN ACCORDANCE WITH ITS TAX EXEMPT PURPOSE. UNRELATED BUSINESS INCOME IS SUBJECT TO STATE AND FEDERAL INCOME TAX. MANAGEMENT HAS EVALUATED EACH ENTITY'S TAX POSITION AND CONCLUDED THAT THERE IS NO UNRELATED BUSINESS INCOME OR UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 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
ANN PETERS
1432040000000226650165869000
PAUL FRIEDRICHS
16683402100100000388610226696000
SIRONA PRUNA
22377205581800000280180307608000
VASUKI NAGARAJ
14354904216800000216750207392000
AJAY SHARMA
14024304284600000211450204234000
EDWARD SCULLY
12002201239600000300700162488000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 7ReturnReference
ExplanationPHYSICIANS ARE PROVIDED INCENTIVE PAYMENTS BASED ON NUMBER OF PATIENTS SEEN, COMPLEXITY OF PATIENT ACUITY, TIMELY DOCUMENTATION, PATIENT SATISIFACTION, AND QUALITY OF CARE PROVIDED.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ANN PETERS
LAMPREY HEALTH CARE'S CEO IS A MEMBER OF THE BOARD OF DIRECTORS OF CHAN280932TRANSACTIONS INCLUDE DUES PAID TO COMMUNITY HEALTH ACCESS NETWORK(CHAN) IN THE AMOUNT OF $18,150. LAMPREY ALSO CONTRACTED WITH CHAN FOR IT AND OTHER CONSULTING SERVICES IN THE AMOUNT OF $222,315. LAMPREY ALSO PASSED THROUGH $40,467 OF THE CIP GRANT TO CHAN TO UPGRADE CHAN'S IT INFRASTRUCTURE.0
ANN PETERS
LAMPREY HEALTH CARE'S CEO IS A MEMBER OF THE BOARD OF DIRECTORS OF CHAN371939TRANSACTIONS INCLUDE EMPLOYEES LEASED TO CHAN IN THE AMOUNT OF $320,153 AND FACILITIES(INCLUDING UTILITIES) IN THE AMOUNT OF $51,786.0
ANN PETERS
LAMPREY HEALTH CARE'S CEO IS A MEMBER OF THE BOARD OF DIRECTORS OF BI-STATE123517LAMPREY HEALTH CARE IS A MEMBER OF BI-STATE AND RECEIVED GRANT PASS THROUGH FUNDS IN THE AMOUNT OF $123,517.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 7BTHE US DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES AND SERVICES ADMINISTRATION AND THE NH DIVISION OF CHARITABLE TRUSTS MUST APPROVE THE DECISION TO DISSOLVE THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11THE 990 WILL BE REVIEWED BY THE CEO AND CFO. THE FINANCE COMMITTEE WILL REVIEW AND APPROVE THE 990 ON BEHALF OF THE FULL BOARD PRIOR TO FILING.
ANNUALLY, THE BOARD OF DIRECTORS SIGN A CONFLICT OF INTEREST FORM, ON WHICH THEY DISCLOSE ANY CONFLICTS OF INTEREST. BOARD MEMBERS WILL ABSTAIN FROM ANY VOTES RELATED TO A CONFLICT.FORM 990, PART VI, SECTION B, LINE 12C
THE BOARD HIRES A FIRM TO DO A CEO ANALYSIS PERIODICALLY. IN BETWEEN, THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) BENEFITS AND COMPENSATION SURVEY RESULTS ARE USED. THE NACHC STUDY IS ALSO USED FOR OTHER KEY EMPLOYEES, AS WELL AS OTHER LOCAL STUDIES (INCLUDING THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) SALARY SURVEY), AS THEY ARE AVAILABLE.FORM 990, PART VI, SECTION B, LINE 15
UPON REQUESTFORM 990, PART VI, SECTION C, LINE 19
NO CHANGES FROM PRIOR YEAR.FORM 990. PART XII, LINE 2C.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1FRIENDS OF LAMPREY HEALTH CARE INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1207 SOUTH MAIN STAddressLine1
CityNEWMARKETCity
StateNHState
ZIP Code03857ZIPCode
FieldValueIRS element (for citing)
EIN020348630EIN
Primary ActivitiesSUPPORT LHCPrimaryActivities
Legal Domicile StateNHLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status509(A)(3) TYPE IIIPublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
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 Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1FRIENDS OF LAMPREY HEALTH CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeJTransactionType
Amount Involved227916AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination