2025-08-15T12:54:25-05:00 2024-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-10-01 020300637 NORTH COUNTRY HOME HEALTH & HOSPICE AGENCY INC NORT 6034445317 536 COTTAGE STREET LITTLETON NH 03561 MATTHEW STREETER SYSTEM CFO 6034445317 2025-08-15 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-08-15 2023 2025-03-06 01:10:19Z JESSICA FOSTER-HEBERT 536 COTTAGE STREET LITTLETON NH 03561 12137889 0 X WWW.NORTHCOUNTRYHOMEHEALTH-HOSPICE.ORG X 1971 NH TO PROVIDE QUALITY HOME HEALTH AND HOSPICE CARE, UTILIZING A HOLISTIC APPROACH, WHILE WORKING IN COLLABORATION WITH ALL COMMUNITY RESOURCES, TO MEET THE COMPREHENSIVE NEEDS OF THE CLIENTS AND THEIR FAMILIES, IN A COST EFFECTIVE MANNER. 10 9 125 15 0 0 766788 338367 11201376 11585260 37309 69219 64021 145043 12069494 12137889 0 0 0 0 7469361 8056234 0 0 0 2837543 3320937 10306904 11377171 1762590 760718 6754380 7436098 934082 780824 5820298 6655274 TO PROVIDE QUALITY HOME HEALTH AND HOSPICE CARE, UTILIZING A HOLISTIC APPROACH, WHILE WORKING IN COLLABORATION WITH ALL COMMUNITY RESOURCES, TO MEET THE COMPREHENSIVE NEEDS OF THE CLIENTS AND THEIR FAMILIES, IN A COST EFFECTIVE MANNER. 0 0 7530278 0 11585260 HOME CARE: PROVIDES HOME HEALTH, HOSPICE, AND HEALTH PROMOTION SERVICES TO RESIDENTS OF UPPER GRAFTON AND COOS COUNTIES OF NEW HAMPSHIRE. 7530278 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 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 1 0 0 0 1 18 0 125 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X MATTHEW STREETER 6033265610 536 COTTAGE STREET LITTLETON NH 03561 DARRELL BODNAR TRUSTEE 1.00 40.00 X 0 245902 14238 BRIAN O'HEARN TRUSTEE 1.00 40.00 X 0 229911 10924 JJ BUJEAUD CHAIR 1.00 1.00 X X 0 0 0 HOLLY MCCORMACK VICE CHAIR 1.00 X X 0 0 0 CHAD STERNS TREASURER 1.00 X X 0 0 0 CHRISSY SMITH SECRETARY 1.00 X X 0 0 0 JULIE COTE TRUSTEE 1.00 X 0 0 0 GREG EASTMAN TRUSTEE 1.00 X 0 0 0 KIMBERLY FORCE TRUSTEE 1.00 X 0 0 0 HEATHER NEWFIELD TRUSTEE 1.00 X 0 0 0 ROXIE SEVERANCE TRUSTEE 1.00 1.00 X 0 0 0 MATTHEW STREETER SYSTEM CFO 1.00 45.00 X 0 357595 20804 JESSICA C FOSTER-HEBERT PRESIDENT/CEO (BEG SEP. '24) 40.00 X 155260 0 8642 THOMAS MEE SYSTEM CEO 1.00 45.00 X 0 706230 18318 MARY VANALSTYNE APRN 40.00 X 126911 0 9332 GWENDOLYN DOVHOLUK RN 40.00 X 113909 0 5555 AMY REMICK PT MANAGER 40.00 X 112145 0 2029 KELLEY CORCORAN RN 40.00 X 109930 0 6023 CARISA GIRDWOOD RN 40.00 X 109590 0 11026 TIFFANY HAYNES PRESIDENT/CEO (THRU SEP. '24) 40.00 X 229337 0 16511 957082 1539638 123402 12 1 1 0 BERRY DUNN MCNEIL & PARKER 1000 ELM ST 4TH FLOOR MANCHESTER NH 03101 AUDIT, BILLING, AND CODING 208396 MCBEE ASSOCIATES PO BOX 823519 PHILADELPHIA PA 19182 ACCOUNTS RECEIVABLE MGMT 164459 2 153211 185156 338367 HOSPICE CARE 621610 6125312 6125312 HOME HEALTH CARE 621610 5260755 5260755 DURABLE MEDICAL EQUIPMENT 621610 116351 116351 SHARED STAFF REVENUE 621610 82842 82842 11585260 68514 68514 28950 0 28950 28950 28950 705 0 705 705 705 116093 116093 116093 12137889 11585260 0 214262 172360 172360 5942246 4691749 1250497 73325 56317 17008 1429614 1102537 327077 438689 336932 101757 7249 7249 748770 283159 465611 13582 13582 66455 66455 184361 184361 124504 36474 88030 351069 332278 18791 54394 7687 46707 1407 1179 228 147273 123401 23872 234690 234690 MEDICAL SUPPLIES 647673 509962 137711 INTERCOMPANY ALLOCATION 498529 498529 REPAIRS AND MAINTENANCE 46567 16630 29937 DUES & SUBSCRIPTIONS 29857 139 29718 164557 31834 132723 11377171 7530278 3846893 0 3589371 0 131896 4362823 1526807 1477168 52094 147013 178793 194171 2313653 1482887 917398 830766 274347 348843 67273 75314 16401 0 6754380 7436098 783165 688864 24172 12884 46905 0 79840 79076 934082 780824 X 5526825 6353760 293473 301514 5820298 6655274 6754380 7436098 X 760718 66217 8041 X 0 1 X 1 1 1 X 1216713 720620 743488 766788 338367 3785976 7651151 8299303 9551973 11201376 11585260 48289063 2850 35071 116093 154014 8867864 9022773 10295461 12003235 12039720 52229053 0 0 0 52229053 7958 40804 39982 66259 97464 252467 7958 40804 39982 66259 97464 252467 8875822 9063577 10335443 12069494 12137184 52481520 0.99520 0.99670 0.00480 0.00330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 306243 78673 75 384841 268295 38042 94 306243 319611 56620 2959 268295 265950 18327 2469 265950 250092 7476 2402 250092 0.41251 0.58749 0.00000 0 0 168203 168203 1150721 875645 275076 986204 607242 378962 8525 8525 830766 DUE TO RELATED PARTIES 79076 79076 12204106 66217 66217 12137889 0 12137889 11377171 0 11377171 0 11377171 PART V, LINE 4: ALL INCOME OF THE ENDOWMENT ASSETS EARNED IS TO BE USED FOR THE GENERAL OPERATIONS OF THE AGENCY. X X 0 1 0 0 0 0 0 0 0 THOMAS MEE SYSTEM CEO 0 559584 0 133893 0 12753 0 6394 0 11924 0 724548 0 0 MATTHEW STREETER SYSTEM CFO 0 290340 0 66580 0 675 0 8934 0 11870 0 378399 0 0 DARRELL BODNAR TRUSTEE 0 197167 0 47741 0 994 0 6081 0 8157 0 260140 0 0 TIFFANY HAYNES PRESIDENT/CEO (THRU SEP. '24) 174606 0 47484 0 7247 0 5091 0 11420 0 245848 0 0 0 BRIAN O'HEARN TRUSTEE 0 187858 0 31779 0 10274 0 0 0 10924 0 240835 0 0 JESSICA C FOSTER-HEBERT PRESIDENT/CEO (BEG SEP. '24) 126733 0 25847 0 2680 0 4374 0 4268 0 163902 0 0 0 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 - FORM 990 OF OTHER ORGANIZATIONS - INDEPENDENT COMPENSATION CONSULTANT - 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 2023. FORM 990, PART VI, SECTION A, LINE 6 NORTH COUNTRY HEALTHCARE, INC. IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A EACH MEMBER OF THE CORPORATION BOARD SHALL BE NOMINATED BY ACTION OF AN AFFILIATE BOARD, OR BY THE CORPORATION BOARD, AS THE CASE MAY BE, IN ACCORDANCE WITH THE NOMINATION POWERS INDICATED IN THE CORPORATION'S BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATION BYLAWS INCLUDE MAJOR MATTERS WHICH INCLUDE SPECIFIC DUTIES AND RESPONSIBILITIES WHICH ARE SHARED BY THE CORPORATION BOARD AND THE AFFILIATE BOARDS. THESE MAJOR MATTERS ARE FURTHER DISTINGUISHED BETWEEN MAJOR ORGANIZATIONAL MATTERS AND MAJOR OPERATIONAL MATTERS. IN BOTH CASES, THE BYLAWS CONTAIN THE PROVISIONS FOR THE APPROVAL OF THESE MATTERS INCLUDING WHETHER THEY ARE APPROVED BY A MAJORITY VOTE OR SUPER MAJORITY VOTE OF ALL BOARDS. IN ALL CASES, THE MAJOR MATTERS REQUIRE APPROVAL BY THE CORPORATION BOARD AND THE AFFILIATE BOARDS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED CLOSELY BY THE CFO OF THE SYSTEM AFTER CAREFUL PREPARATION IS PERFORMED IN CONNECTION WITH THE INTERNAL TEAM AND PAID PREPARER. A COPY IS MADE AVAILABLE TO THE BOARD PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST PROCESS: - CONFLICT OF INTEREST DISCLOSURE COMPLETED VIA BOARDPAQ (ELECTRONIC MEANS). - RESULTS COMPILED INTO CONFLICT MATRIX WHICH IS REVIEWED AND APPROVED BY THE BOARD. - CONFLICTS THAT MEET THE PECUNIARY BENEFIT CRITERIA ARE IDENTIFIED, SHARED WITH THE BOARD AND APPROVED. - DISCLOSURE NOTICES ARE PLACED IN LOCAL PAPERS. - THE NH DIVISION OF CHARITABLE TRUSTS IS NOTIFIED OF THE PECUNIARY BENEFIT AND COPIES OF THE PUBLIC NOTICES ARE ATTACHED. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE IS A SUBCOMMITTEE OF THE FINANCE COMMITTEE OF THE CORPORATION BOARD. THIS COMMITTEE OVERSEES THE EXECUTIVE COMPENSATION POLICY AND PRACTICES OF THE ORGANIZATION INCLUDING THE CEO, THE AFFILIATE PRESIDENTS, AND THE CEO CABINET WHICH INCLUDES KEY EXECUTIVE POSITIONS FOR THE ORGANIZATION. THE COMPENSATION COMMITTEE ENGAGES WITH AN OUTSIDE CONSULTANT TO DETERMINE COMPENSATION BENCHMARKS AND BEST PRACTICES WHICH GUIDE THE COMPENSATION PROCESSES FOR THESE EXECUTIVE POSITIONS. THE COMPARISON BENCHMARK DATA AND GUIDANCE ARE REVIEWED BY THE COMMITTEE AND RECOMMENDATIONS ARE MADE TO THE CORPORATION BOARD AND AFFILIATE BOARDS. THIS IS DONE ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION HAS IMPLEMENTED ALL POLICIES AND THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST OF BENEFICIAL TRUST 8,041. ANDROSCOGGIN VALLEY HOSPITAL INC 59 PAGE HILL ROAD BERLIN NH 03570 020280367 CRITICAL ACCESS HOSPITAL NH 501(C)(3) LINE 3 NORTH COUNTRY HEALTHCARE INC 1 WEEKS MEDICAL CENTER 173 MIDDLE STREET LANCASTER NH 03584 020222242 CRITICAL ACCESS HOSPITAL NH 501(C)(3) LINE 3 NORTH COUNTRY HEALTHCARE INC 1 UPPER CONNECTICUT VALLEY HOSPITAL 181 CORLISS LANE COLEBROOK NH 03576 020276210 CRITICAL ACCESS HOSPITAL NH 501(C)(3) LINE 3 NORTH COUNTRY HEALTHCARE INC 1 NORTH COUNTRY HEALTHCARE INC 8 CLOVER LANE WHITEFIELD NH 03598 812225283 HEALTHCARE MANAGEMENT NH 501(C)(3) LINE 12A, I N/A 0 NORTHCARE INC 59 PAGE HILL ROAD BERLIN NH 03570 521596952 SUPPORTING SERVICES NH 501(C)(3) LINE 12B, II ANDROSCOGGIN VALLEY HOSPITAL INC 1 ANDROSCOGGIN VALLEY HOSPITAL FOUNDATION 59 PAGE HILL ROAD BERLIN NH 03570 223035216 MANAGEMENT AND FINANCIAL SUPPORT NH 501(C)(3) LINE 12B, II ANDROSCOGGIN VALLEY HOSPITAL INC 1 GREAT NORTHWOODS COMMUNITY FOUNDATION 59 PAGE HILL ROAD BERLIN NH 03570 020452547 HEALTHCARE SERVICES NH 501(C)(3) LINE 12B, II ANDROSCOGGIN VALLEY HOSPITAL INC 1 LANCASTER PATIENT CARE CENTER 173 MIDDLE STREET LANCASTER NH 03584 832130386 SUPPORTING ORGANIZATION NH 501(C)(3) LINE 12A, I WEEKS MEDICAL CENTER 1 0 0 1 0 1 0 0 0 0 1 1 0 1 0 1 0 0 1 0