2024-08-14T07:34:31-05:00 2023-09-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2022-10-01 020460245 Catholic Medical Center Physicians Practice Associates CATH 6036683545 100 McGregor Street Manchester NH 03102 Pamela J Martel Vice President & CFO 6036683545 2024-08-01 1 1 Connor Smart P02285543 2078792100 2024-08-01 2022 2024-08-08 14:25:15Z Alexander Walker Jr Esq 100 McGregor Street Manchester NH 03102 19907001 0 0928 X www.catholicmedicalcenter.org X 2002 NH The heart of Catholic Medical Center Physicians Practice Associates is to carry out Christ's healing ministry by offering health, healing, and hope to every individual who seeks our care. 6 1 225 1 0 0 0 0 22155539 19907001 0 0 0 0 22155539 19907001 0 0 0 0 62602945 63483609 0 0 0 3537043 3277155 66139988 66760764 -43984449 -46853763 1277749 567764 11584753 8940326 -10307004 -8372562 The heart of Catholic Medical Center Physicians Practice Associates is to carry out Christ's healing ministry by offering health, healing, and hope to every individual who seeks our care. 0 0 53408979 0 19907001 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. 53408979 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 10 0 1 225 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 1 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 NH X Pamela J Martel VP & CFO 6036683545 100 McGregor Street Manchester NH 03102 Alexander Walker Jr Esq President & CEO/Vice Chair 0.20 0.00 X X 0 705005 397339 Andrea Rathbone Director 0.10 40.00 X 0 156385 30305 Carolyn Claussen MD Secretary/Treasurer 40.20 1.60 X X 252296 0 11658 Edward Dudley III Executive VP & CFO (end 2/2023) 0.20 40.60 X X 0 548250 278328 Louis I Fink MD Chair/Cardiologist (end 7/2023) 40.20 1.70 X X 688177 0 19799 Patricia Furey MD Director 40.00 1.80 X 505822 0 52436 Robert Capodilupo MD Interim Trustee/Exec Med Dir NEHI 40.20 0.00 X X 686462 0 45682 Marie McKay CPA Director 0.20 1.60 X 0 0 0 Pamela Martel Executive VP & CFO 0.00 40.40 X 0 179495 18897 Benjamin Westbrook MD FACS Physician 40.00 0.00 X 1066553 0 49347 David Caparrelli MD FACS Physician 40.00 0.00 X 962523 0 52402 Gerald Sardella MD FACS Physician 40.00 0.00 X 896914 0 47427 Jeffrey Bleakley MD FACS Physician 40.00 0.00 X 740526 0 57707 James Flynn MD FACC FSCAI Physician 40.00 0.00 X 737446 0 53070 Joseph Pepe MD Former President & CEO (end 6/2021) 0.00 0.50 X 0 733333 1338 6536719 2322468 1115735 164 1 1 0 0 Patient service revenue 621110 19420126 19420126 Miscellaneous revenue 621110 486875 486875 19907001 19907001 19907001 0 0 2262332 1809866 452466 54327494 43461995 10865499 1342121 1073697 268424 3042423 2433938 608485 2509239 2007391 501848 422224 337779 84445 1341 1073 268 248042 198434 49608 9366 7493 1873 260619 208495 52124 95470 76376 19094 15852 12682 3170 2222404 1777923 444481 Medical supplies 1837 1837 66760764 53408979 13351785 0 105860 60207 4214 4439 3750 3750 33800 33800 0 0 1163925 499368 1277749 567764 6301958 5584913 5282795 3355413 11584753 8940326 X -10307004 -8372562 -10307004 -8372562 1277749 567764 X -46853763 48788205 X X 0 1 X 1 0 X 21730371 19130225 16272810 22155539 19907001 99195946 21730371 19130225 16272810 22155539 19907001 99195946 0 0 0 99195946 27 153 180 27 153 180 21730371 19130252 16272963 22155539 19907001 99196126 1.00000 1.00000 0.00000 X 33800 33800 0 0 Net due from affiliates 499368 499368 Accrued pension & other liabilities 3355413 3355413 X 19919933 12932 12932 19907001 0 19907001 66760764 0 66760764 0 66760764 Part X, Line 2: The System and all related entities, with the exception of Enterprises, are not-for-profit corporations as described in Section 501(c)(3) of the Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the System's tax positions and concluded the System has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to the consolidated financial statements. Part XI, Line 2d - Other Adjustments: Net periodic pension gains, net of nonoperating costs 12,932. 1 1 0 0 0 0 0 1 0 Benjamin Westbrook MD FACS Physician 976264 0 81042 0 9247 0 12200 0 37147 0 1115900 0 0 0 Alexander Walker Jr Esq President & CEO/Vice Chair 0 627831 0 0 0 77174 0 292846 0 104493 0 1102344 0 0 David Caparrelli MD FACS Physician 886971 0 75552 0 0 0 12200 0 40202 0 1014925 0 0 0 Gerald Sardella MD FACS Physician 846587 0 50327 0 0 0 9150 0 38277 0 944341 0 0 0 Edward Dudley III Executive VP & CFO (end 2/2023) 0 494403 0 338 0 53509 0 222434 0 55894 0 826578 0 0 Jeffrey Bleakley MD FACS Physician 556906 0 178718 0 4902 0 15250 0 42457 0 798233 0 0 0 James Flynn MD FACC FSCAI Physician 539443 0 193101 0 4902 0 15250 0 37820 0 790516 0 0 0 Joseph Pepe MD Former President & CEO (end 6/2021) 0 0 0 0 0 733333 0 0 0 1338 0 734671 0 0 Robert Capodilupo MD Interim Trustee/Exec Med Dir NEHI 550015 0 136447 0 0 0 15250 0 30432 0 732144 0 0 0 Louis I Fink MD Chair/Cardiologist (end 7/2023) 543154 0 145023 0 0 0 15250 0 4549 0 707976 0 0 0 Patricia Furey MD Director 466939 0 38883 0 0 0 12200 0 40236 0 558258 0 0 0 Carolyn Claussen MD Secretary/Treasurer 232669 0 19627 0 0 0 11648 0 10 0 263954 0 0 0 Pamela Martel Executive VP & CFO 0 178567 0 0 0 928 0 7491 0 11406 0 198392 0 0 Andrea Rathbone Director 0 156385 0 0 0 0 0 4068 0 26237 0 186690 0 0 Part I, Line 3 The Organization's President & CEO's compensation was established by a related organization, Catholic Medical Center. That organization used a compensation committee, independent compensation consultant, Form 990 of other organizations, a compensation survey/study, and approval by their board of directors/compensation committee to determine the President & CEO's compensation and benefits. Part I, Lines 4a-b Schedule J, Page 1, Line 4a, severance payments: Dr. Joseph Pepe, who previously served as the Organization's President and CEO, retired in June, 2021. As part of his retirement, Dr. Pepe became entitled to severance compensation, as per his employment agreement, from the Catholic Medical Center (a related organization). Dr. Pepe received severance compensation of $733,333 during calendar year 2022, after his formal retirement in June, 2021. This severance was included in his 2022 Form W-2 wages, and is also included in the amount of compensation reported on this Schedule J, Part II, Column B(iii). Schedule J, Page 1, Line 4b, supplemental non-qualified retirement plans: The following individuals take part in a section 457(f) forfeitable nonqualified deferred compensation plan. The amounts listed represent calendar year 2022 contributions for many years of service, and are included in the total deferred compensation reported on this Schedule J, Part II, Column C. - Edward Dudley, III: $211,145 - Alexander Walker, Jr., Esq.: $280,646 Part I, Line 7 A portion of compensation is at-risk and variable, and payment depends on the quality of job performance. Carolyn Claussen MD Secretary/Treasurer 259264 Dr. Carolyn Claussen is the Secretary and Treasurer on the Practice's board of directors. Dr. Claussen's husband was employed by the Practice as a contracted physician. Dr. Claussen's husband received $216,961 in compensation, as reported on his 2022 Form W-2, Box 5; deferred compensation of $9,931; and other non-taxable benefits of $32,372, all as an employee of the Practice. Compensation paid to Dr. Claussen's husband was considered in line with the salary structure for similarly employed persons at the Practice and does not represent higher than market rate compensation due to her familial relationship with Dr. Claussen. 0 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 CMC Physician Practice Associates but does not approve each separate action taken by the CMC Physician Practice Associates board. Form 990, Part VI, Section B, line 11b Form 990 is prepared by an independent tax accounting firm (Baker Newman Noyes). Upon completion, a draft of the Form 990 is sent to the Organization, where the Executive Director of Finance and Assistant Controller perform a final in-house review prior to submission to the Board of Directors for final approval. Upon approval from Board, the Form 990 is filed with the Internal Revenue Service. 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 B, line 15 A related organization, Catholic Medical Center, utilizes a compensation committee of the board of directors to set compensation levels and determine bonus potential for its senior leadership team. The committee is assisted by an independent consultant who surveys like-sized and performing institutions to benchmark relevant salary scales for each position. The consultant's findings are presented to the compensation committee who considers that external data with actual performance against a list of pre-established goals per senior leaders to set prospective compensation levels and bonus values. Bonus amounts are determined by how well an executive achieves a pre-defined set of goals. These goals, in general, are tied to the achievement of a specific task or project. Some goals are attached to achieve overall financial performance and mission performance, not solely revenue generation. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part XI, line 9: Transfers from affiliates 46,733,000. Pension-related changes other than net periodic pension cost 2,042,273. Net periodic pension gains, net of nonoperating costs 12,932. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Alliance Ambulatory Services 100 McGregor Street Manchester NH 03102 020519436 Ambulatory Surgical Center NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Health Services 100 McGregor Street Manchester NH 03102 611508839 Practices NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Resources Inc 100 McGregor Street Manchester NH 03102 020398138 Real Estate NH 501(c)(3) Line 12b, II CMC Healthcare System 0 Catholic Medical Center 100 McGregor Street Manchester NH 03102 020315693 Hospital NH 501(c)(3) Line 3 CMC Healthcare System and GraniteOne Health 0 CMC Healthcare System 100 McGregor Street Manchester NH 03102 010568516 Parent NH 501(c)(3) Line 12b, II N/A 0 GraniteOne Health 100 McGregor Street Manchester NH 03102 814663563 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Huggins Hospital 240 South Main Street Wolfeboro NH 03894 020223332 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 Monadnock Community Hospital 452 Old Street Road Peterborough NH 03458 020222157 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 St Peter's Home 100 McGregor Street Manchester NH 03102 020222228 Day Care Services NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Urgent Care Services LLC 100 McGregor Street Manchester NH 03102 831238167 Health Care Services NH N/A 0 0 Bedford Ambulatory Surgical Center LLC 11 Washington Place Bedford NH 03110 020519727 Surgical Center NH N/A 0 0 Alliance Enterprises 100 McGregor Street Manchester NH 03102 020386795 Real Estate NH N/A C 0 Doctors' Medical Association 100 McGregor Street Manchester NH 03102 020340690 Medical Office Building NH N/A C 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1