Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 6,428,878 | 7,887,447 | 9,314,995 | 8,656,086 | 10,859,041 | 43,146,447 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 10,143,633 | 10,328,394 | 11,120,041 | 12,462,570 | 11,111,025 | 55,165,663 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 16,572,511 | 18,215,841 | 20,435,036 | 21,118,656 | 21,970,066 | 98,312,110 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 98,312,110 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 16,572,511 | 18,215,841 | 20,435,036 | 21,118,656 | 21,970,066 | 98,312,110 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 238,389 | 203,804 | 191,775 | 188,254 | 261,432 | 1,083,654 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 238,389 | 203,804 | 191,775 | 188,254 | 261,432 | 1,083,654 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | 1,751 | 6,624 | 8,375 | |||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 16,812,651 | 18,419,645 | 20,633,435 | 21,306,910 | 22,231,498 | 99,404,139 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Section A, line 4 | During fiscal year 10/1/22-9/30/23 the organization amended their bylaws to update Article 2.1 General Powers of the Board of Directions and add Article 6 Indeminification. Below are the changes: ARTICLE 2.1 General Powers: The Board of Directors (the "Board") is the governing body of the Corporation, and as such, has control and management of the Corporation's property, affairs and funds with authority to do all acts not inconsistent with these Bylaws, the Articles of Agreement, and applicable federal and state laws. No individual, entity or committee reserves approval authority or veto power over Lamprey Health Care's Board with regard to the required authorities and functions of the Board. On behalf of the Corporation, the Board may buy and hold properties, and give mortgages and security interests in real and personal property; and through its designees, may sign and deliver promissory notes, security agreements, loan agreements, financing statements and real estate mortgages. In furtherance of the purposes of this Corporation, the Directors of the Corporation shall possess all powers and authority granted to nonprofit corporations under applicable law. Subject to these by-laws, the Board may adopt such rules and regulations as may be required by regulatory authorities and shall exercise the rights, powers, duties and responsibilities conferred on governing bodies of non-profit organizations as set forth in Section 330 of the Public Health Service Act, 42 USC 254b, as amended 1996, including but not limited to the following functions: (a) Employment and annual evaluation of the Chief Executive Officer/s (CEO/s) of the Corporation and as necessary the dismissal of the CEO/s. (b) Developing, adopting and periodically updating the Corporation's personnel policies and procedures, including on-going employment requirements and grievance procedures, salary and benefits, and equal opportunity practices. (c) Developing, adopting and periodically updating the Corporation's financial management practices, including a system to assure accountability for corporate resources and long range financial planning. (d) Developing, adopting and periodically updating the Corporation's health care policies, including scope and availability of services, location and hours of services, patient confidentiality, patient bill of rights and a process for resolving patient grievances, and quality assurance activities and procedures. (e) Evaluating the Corporation's activities on a monthly, quarterly and annual basis including service utilization patterns, productivity and achievement of project objectives, patient satisfaction and evaluating the resolution of patient grievances. (f) Developing and approving the annual project budget and revisions, priorities and eligibility for services (sliding fee scale schedules and procedures), the annual business plan and health plan. (g) Selection of the Corporate Auditor and the acceptance of the annual report. (h) Assuring the Corporation's activities are conducted in compliance with applicable Federal, State and Local laws. (i) Developing, adopting, implementing and evaluating the Corporation's Strategic Plan. ARTICLE 6 - Indemnification Every person who is or shall be or shall have been a Director or Officer of this Corporation shall be indemnified by the Corporation against all costs and expenses reasonably incurred by or imposed upon him or her arising out of, in connection with, and/or resulting from any action, suit, or proceeding to which he or she may be a party by reason of his or her being or having been a Director or Officer of the Corporation or of any subsidiary or affiliate thereof, except: (i) in connection with an action, suit or proceeding by or in the right of the Corporation in which the Director or Officer was adjudged liable to the Corporation, (ii) in any action, suit or proceeding charging improper personal benefit to the Director or Officer, whether or not involving an action in his official capacity, in which the Director or Officer was adjudged liable on the basis that personal benefit was improperly received by the Director or Officer, or (iii) in relation to any other such matters as to which he or she shall finally be adjudicated in such action, suit, or proceeding to have acted in bad faith and to have been liable by reason of willful misconduct in the performance of his or her duty as Director of Officer. Costs and expenses of actions for which this Article provides indemnification shall include, among other things, attorney's fees, damages, and reasonable amounts paid in settlement. |
| Form 990, Part VI, Section B, line 11b | The 990 will be reviewed by the CEO and CFO and presented to the Finance Committee. The Finance Committee will review the 990 and recommend approval by the full Board of Directors who then approve and authorize the filing of the 990. The full Board is provided access to a full copy of the 990. |
| Form 990, Part VI, Section B, line 12c | Annually, all members of the board of directors sign a conflict of interest form on which they disclose any conflicts of interest. Board members abstain from any votes related to a conflict. |
| Form 990, Part VI, Section B, line 15 | On a periodic basis the Board of Directors engages an independent third party to conduct a review of CEO compensation. In between, the National Association of Community Health Centers (NACHC) Benefits and Compensation survey results are used. The NACHC study is also used for other key employees, as well as other local studies (including the Medical Group Management Association (MGMA) salary survey), as they are available. |
| 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 IX, line 11g | Other Professional Fees: Program service expenses 2,224,195. Management and general expenses 1,263,760. Fundraising expenses 0. Total expenses 3,487,955. |
| Form 990, Part X, Line 10: Land, Building, and Equipment | Section 1.263(a)-3(n) Election: Lamprey Health Care Inc. 207 South Main Street Newmarket, NH 03857 EIN: 23-7305106 Lamprey Health Care, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
| Form 990, Part XI, line 9: | Change in FV of Interest Rate Swaps 21,172. |
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| Software Version: |