2011-05-12T05:04:06-05:00 2010-06-30 BAKER NEWMAN & NOYES LLC BOX 507 PORTLAND ME 04112 990 2009-07-01 020460245 CATHOLIC MEDICAL CENTER PHYSICIANS PRACTICE ASSOCIATES CATH 6036683545 100 MCGREGOR STREET MANCHESTER NH 03102 EDWARD DUDLEY 6036683545 2011-04-29 1 2078792100 2009 2016-02-24 21:20:13Z ALYSON PITMAN GILES 100 MCGREGOR STREET MANCHESTER NH 03102 15349355 0 0928 X N/A X 1992 NH TO PROVIDE HEALTH, HEALING, AND HOPE TO ALL BY OFFERING QUALITY HEALTHCARE. 8 4 77 8 0 0 0 11603154 15071285 3654 0 1355544 278070 12962352 15349355 0 0 17210926 20627668 0 0 1218148 1294470 18429074 21922138 -5466722 -6572783 1715736 2080410 6793640 9403778 -5077904 -7323368 THE MISSION IS TO PROVIDE HEALTH, HEALING, AND HOPE TO ALL BY OFFERING QUALITY HEALTHCARE IN A COMPASSIONATE ENVIRONMENT THAT IS BUILT ON TRUST AND RESPECT. 0 0 17217646 15349355 TO PROVIDE PHYSICIAN AND HOSPITAL CARE, BOTH INPATIENT AND OUTPATIENT, TO PERSONS IN THE SERVICE AREA OF CATHOLIC MEDICAL CENTER. PHYSICIANS PARTICIPATE IN MEDICARE AND MEDICAID PROGRAMS. 17217646 1 0 0 0 0 0 0 0 0 1 0 1 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 0 0 1 0 0 77 1 0 0 0 0 0 0 0 0 0 8 4 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 NH X EDWARD DUDLEY 6036683545 100 MCGREGOR STREET MANCHESTER NH 03102 REV GAYLE WHITTEMORE 1.00 X X 0 0 0 RONALD RIOUX 1.00 X X 0 0 0 ALYSON PITMAN GILES 1.00 X X 0 719720 358237 MARIA MONGAN 1.00 X 0 0 0 CONNOR HAUGH 40.00 X 550274 0 27462 STEPHEN CAMANN 1.00 X 0 0 0 KEITH STAHL 40.00 X 232478 0 11697 WILLIAM CLUTTERBUCK 40.00 X 227748 0 17401 KEVIN KILDAY 1.00 X 0 324382 37525 LOUIS FINK 40.00 X 580540 0 27462 DAVID GOLDBERG 40.00 X 583868 0 27462 ROBERT DEWEY 40.00 X 547079 0 26814 ROBERT CAPODILUPO 40.00 X 539374 0 26814 DANIEL PHILBIN 40.00 X 520824 0 26814 3782185 1044102 587688 56 0 1 0 CHG COMPANIES INC pO bOX 972625 dALLAS TX 75397 cardiology 136464 1 PATIENT SERVICE REV. 621110 15071285 15071285 15071285 MISCELLANEOUS INCOME 621110 278070 278070 278070 15349355 15349355 0 0 1010500 793647 216853 16737530 13145656 3591874 979497 769297 210200 1170902 919626 251276 729239 572744 156495 187259 147073 40186 51418 40384 11034 124052 97430 26622 84066 66025 18041 719632 565199 154433 Miscellaneous 64095 50340 13755 dues & memberships 63948 50225 13723 21922138 17217646 4704492 0 12097 104279 48117 643729 538687 149074 22342 33800 28165 16901 5635 950860 1304425 1715736 2080410 6793640 9403778 6793640 9403778 X -5077904 -7323368 -5077904 -7323368 1715736 2080410 X 0 1 1 X 0 X X 0 0 0 CMC 020315693 3 0 1 1 0 1 0 33800 28165 5635 5635 due from affiliates 1122425 Goodwill 182000 1304425 15349355 21922138 -6572783 4327319 4327319 -2245464 15349355 0 15349355 0 15349355 21922138 0 21922138 0 21922138 Part XI, Line 8 - Other Adjustments: transfer from affiliates: 6,219,375 pension liability: -1,892,056 X X X X X 0 1 0 0 0 0 0 1 0 ALYSON PITMAN GILES 0 582248 0 137472 0 0 0 254893 0 103344 0 1077957 0 0 CONNOR HAUGH 426305 0 123969 0 0 0 9800 0 17662 0 577736 0 0 0 KEITH STAHL 232478 0 0 0 0 0 0 0 11697 0 244175 0 0 0 WILLIAM CLUTTERBUCK 227748 0 0 0 0 0 0 0 17401 0 245149 0 0 0 KEVIN KILDAY 0 279832 0 44550 0 0 0 5814 0 31711 0 361907 0 0 LOUIS FINK 460075 0 120465 0 0 0 0 0 27462 0 608002 0 0 0 DAVID GOLDBERG 471097 0 112771 0 0 0 0 0 27462 0 611330 0 0 0 ROBERT DEWEY 441230 0 105849 0 0 0 0 0 26814 0 573893 0 0 0 ROBERT CAPODILUPO 442008 0 97366 0 0 0 0 0 26814 0 566188 0 0 0 DANIEL PHILBIN 410489 0 110335 0 0 0 0 0 26814 0 547638 0 0 0 Part I, Line 4a THE FOLLOWING INDIViDUAL TAKES PART IN A SECTION 457(F) FORFEITABLE NONQUALIFIED DEFERRED COMPENSATION PLAN. THIS REPRESENTS CONTRIBUTIONS IN ARREARS FOR MANY YEARS OF SERVICE. ALYSON PITMAN GILES: $245,093 Part I, Line 7 a SIGNIFICANT PORTION OF THE CARDIOLOGISTS' COMPENSATION IS BASED UPON THEIR PRODUCTIVITY. Form 990, Part VI, Section A, line 6 THE SOLE MEMBER OF CMC PHYSICIAN PRACTICE ASSOCIATES IS CMC HEALTHCARE SYSTEM. Form 990, Part VI, Section A, line 7a THE DIRECTORS OF CMC PHYSICIAN PRACTICE ASSOCIATES ARE APPOINTED BY THE SOLE MEMBER. Form 990, Part VI, Section A, line 7b THE SOLE MEMBER HAS RESERVED POWERS OVER CMCPPA BUT DOES NOT APPROVE EACH SEPARATE ACTION TAKEN BY THE CMCPPA BOARD. Form 990, Part VI, Section B, line 11 FORM 990 IS PRESENTED TO THE BOARD BEFORE IT IS FINALIZED. Form 990, Part VI, Section B, line 12c OFFICERS AND DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. Form 990, Part VI, Section C, line 19 THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENT ARE ALL AVAILABLE UPON REQUEST. FORM 990, PART VII, LINE 1B: AVERAGE HOURS PER WEEK FOR A RELATED ORGANIZATION ALYSON GILES: 60 HRS KEVIN KILDAY: 50 HRS Catholic Medical center 100 mcgregor street manchester NH 03102 020315693 hospital NH 501(c)(3) 3 N/A Alliance health Services 100 mcgregor street manchester NH 03102 611508839 Practices NH 501(c)(3) 11, Type II N/A alliance resources 100 mcgregor street manchester NH 03102 020398138 real estate NH 501(c)(3) 11, Type II N/A CMC healthcare systems 100 mcgregor street manchester NH 03102 010568516 parent NE 501(c)(3) 11, Type II N/A CMC Associates 100 mcgregor street manchester NH 03102 020344786 support NH 501(c)(3) 11, Type II N/A St Peter's Home 100 mcgregor street manchester NH 03102 020222228 home NH 501(c)(3) 9 N/A NEHI Foundation 100 mcgregor street manchester NH 03102 223041916 support NH 501(c)(3) 7 N/A Alliance Ambulatory Services 100 mcgregor street manchester NH 03102 020519436 practices NH 501(c)(3) 11, Type II N/A McGregor St Mob LLC 100 MCGREGOR ST MANCHESTER NH 03102 134347316 MEDICAL OFFICE BLDG NH N/A Alliance Enterprises 100 McGregor Street manchester NH 03102 020386795 real estate NH N/A C 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1