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Nonprofiteer
← ANDROSCOGGIN VALLEY HOSPITAL FOUNDATION

Form 990 for tax year 2022

Filed by ANDROSCOGGIN VALLEY HOSPITAL FOUNDATION.

Totals

Total revenue
$68,595
Total expenses
$79,605
Contributions and grants received
$69,802
Grants paid
$65,974
Program service revenue
$0
Investment income
-$1,207
Other revenue
$0
Total assets, end of year
$3,111,132
Total liabilities, end of year
$123,284
Net assets or fund balances, end of year
$2,987,848
Program services expenses (Part IX)
$74,360
Management and general expenses
$5,245
Fundraising expenses
$0
Program service expenses (Part III)
$74,360

Program services were 93.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • MICHAEL PETERSON

    PRESIDENT

    Total calculated
    $413,024
    From this org
    $0
    From related orgs
    $406,469
    Other
    $6,555
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $305,165 related
    Bonus
    $0 + $77,489 related
    Other
    $0 + $23,815 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $6,555 related
    Filer's total
    $0 + $413,024 related

  • BRIAN O'HEARN

    DIRECTOR

    Total calculated
    $269,878
    From this org
    $0
    From related orgs
    $232,123
    Other
    $37,755
    Hours/week
    0.5 + 40.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $189,788 related
    Bonus
    $0 + $31,318 related
    Other
    $0 + $11,017 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $37,755 related
    Filer's total
    $0 + $269,878 related

  • MARK KELLEY

    CHAIR

    Total calculated
    $0
    Hours/week
    0.5 + 1 related

  • PAMELA LAFLAMME

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    0.5 + 1 related

  • THOMAS MCCUE

    TREASURER

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • THOMAS MEE

    SYSTEM CEO

    Total calculated
    $710,333
    From this org
    $0
    From related orgs
    $681,354
    Other
    $28,979
    Hours/week
    0.5 + 45.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $537,600 related
    Bonus
    $0 + $131,095 related
    Other
    $0 + $12,659 related
    Deferred
    $0 + $1,891 related
    Nontaxable benefits
    $0 + $27,088 related
    Filer's total
    $0 + $710,333 related

  • MATTHEW STREETER

    SYSTEM CFO

    Total calculated
    $311,729
    From this org
    $0
    From related orgs
    $300,812
    Other
    $10,917
    Hours/week
    0.5 + 45.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $276,715 related
    Bonus
    $0 + $23,655 related
    Other
    $0 + $442 related
    Deferred
    $0 + $2,631 related
    Nontaxable benefits
    $0 + $8,286 related
    Filer's total
    $0 + $311,729 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
NORTH COUNTRY HEALTHCARE, A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B
THOMAS MEE, SYSTEM CEO, PARTICIPATED IN A 457(F) PLAN ADMINISTERED BY NORTH COUNTRY HEALTHCARE, A RELATED ORGANIZATION. THERE WERE NO CONTRIBUTIONS OR DISTRIBUTIONS IN 2022.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
15 August 2024
IRS schema version
2022v5.0
Source object
202442289349302549

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