Totals
- Total revenue
- $179,000
- Total expenses
- $593,293
- Contributions and grants received
- $0
- Grants paid
- $0
- Program services expenses (Part IX)
- $543,543
- Management and general expenses
- $49,750
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $543,543
Program services were 91.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Listed in Part VII
-
MICHAEL D LEE
CHAIR & PRESIDENT/CEO - WMC
- Total calculated
- $366,558
- From this org
- $0
- From related orgs
- $361,347
- Other
- $5,211
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $289,772 related
- Bonus
- $0 + $65,825 related
- Other
- $0 + $5,750 related
- Deferred
- $0
- Nontaxable benefits
- $0 + $5,211 related
- Filer's total
- $0 + $366,558 related
-
MATTHEW STREETER
VICE CHAIR & 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
-
DAVID HILL
TREASURER
- Total calculated
- $0
- Hours/week
- 1
-
LISA TETREAULT
SECRETARY
- Total calculated
- $92,129
- From this org
- $0
- From related orgs
- $86,144
- Other
- $5,985
- Hours/week
- 1 + 39 related
-
SARAH DESROCHERS
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1 + 2 related
-
JON FREEMAN
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
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
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 — 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
No itemized grants to organizations 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.
-
ANDROSCOGGIN VALLEY HOSPITAL INC
501(C)(3) · CRITICAL ACCESS HOSPITAL · NH · controlled entity
Directly controlled by NORTH COUNTRY HEALTHCARE INC
-
501(C)(3) · CRITICAL ACCESS HOSPITAL · NH · controlled entity
Directly controlled by NORTH COUNTRY HEALTHCARE INC
-
UPPER CONNECTICUT VALLEY HOSPITAL
501(C)(3) · CRITICAL ACCESS HOSPITAL · NH · controlled entity
Directly controlled by NORTH COUNTRY HEALTHCARE INC
-
NORTH COUNTRY HOME HEALTH & HOSPICE AGENCY INC
501(C)(3) · HOME HEALTH AGENCY · NH · controlled entity
Directly controlled by NORTH COUNTRY HEALTHCARE INC
-
501(C)(3) · SUPPORTING SERVICES · NH · controlled entity
Directly controlled by ANDROSCOGGIN VALLEY HOSPITAL INC
-
ANDROSCOGGIN VALLEY HOSPITAL FOUNDATION
501(C)(3) · MANAGEMENT AND FINANCIAL SUPPORT · NH · controlled entity
Directly controlled by ANDROSCOGGIN VALLEY HOSPITAL INC
-
GREAT NORTHWOODS COMMUNITY FOUNDATION
501(C)(3) · HEALTHCARE SERVICES · NH · controlled entity
Directly controlled by ANDROSCOGGIN VALLEY HOSPITAL INC
-
501(C)(3) · HEALTHCARE MANAGEMENT · NH
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 15 August 2024
- IRS schema version
- 2022v5.0
- Source object
- 202412289349303456
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