Civic Intelligence

Northern Berkshire Medical PC

990 • Fiscal year 2017 • EIN 81-4023607

Oct 01, 2016 to Sep 30, 2017 • Filed on Jan 26, 2018

375 Main StWilliamstown, MA 01267

(413) 458-4452

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

96th percentile

1.44x

Higher debt load relative to assets than 96% of similar nonprofits.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2017

Liabilities / Revenue

92nd percentile

1.53x

Higher debt load relative to revenue than 92% of similar nonprofits.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2017

Net Margin

6th percentile

-47%

Higher net margin than 6% of similar nonprofits.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2017

Top Officer Pay

99th percentile

$414,289

Higher top officer pay than 99% of similar nonprofits.

Top officer pay equals 49.5% of source-year revenue.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2017

Asset Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2017

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2017

Assets

$885,108

No earlier filing loaded for comparison.

Net Assets

-$393,290

No earlier filing loaded for comparison.

Liabilities

$1,278,398

No earlier filing loaded for comparison.

Revenue

$837,194

No earlier filing loaded for comparison.

Expenses

$1,230,484

No earlier filing loaded for comparison.

Net Income

-$393,290

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$2.0M$1.0M$0-$1.0M-$2.0MAssets 2017: $885,108Liabilities 2017: $1,278,398Net Assets 2017: -$393,2902017Assets 2018: $751,238Liabilities 2018: $664,313Net Assets 2018: $86,9252018Assets 2019: $603,537Liabilities 2019: $945,006Net Assets 2019: -$341,4692019Assets 2020: $478,529Liabilities 2020: $1,201,201Net Assets 2020: -$722,6722020Assets 2021: $682,225Liabilities 2021: $1,042,762Net Assets 2021: -$360,5372021Assets 2022: $620,552Liabilities 2022: $1,428,303Net Assets 2022: -$807,7512022Assets 2023: $491,201Liabilities 2023: $1,092,158Net Assets 2023: -$600,9572023Assets 2024: $428,121Liabilities 2024: $1,689,317Net Assets 2024: -$1,261,1962024

Highlighted filing

2017

Assets$885,108
Liabilities$1,278,398
Net Assets-$393,290

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$2.0M$1.0M$0-$1.0MRevenue 2017: $837,194Expenses 2017: $1,230,484Net Income 2017: -$393,2902017Revenue 2018: $988,143Expenses 2018: $1,246,950Net Income 2018: -$258,8072018Revenue 2019: $847,592Expenses 2019: $1,275,986Net Income 2019: -$428,3942019Revenue 2020: $551,300Expenses 2020: $932,503Net Income 2020: -$381,2032020Revenue 2021: $701,041Expenses 2021: $1,045,776Net Income 2021: -$344,7352021Revenue 2022: $797,068Expenses 2022: $1,244,282Net Income 2022: -$447,2142022Revenue 2023: $813,444Expenses 2023: $1,215,677Net Income 2023: -$402,2332023Revenue 2024: $763,555Expenses 2024: $1,423,794Net Income 2024: -$660,2392024

Highlighted filing

2017

Revenue$837,194
Expenses$1,230,484
Net Income-$393,290
Jump To
Filing Snapshot
Filing Period
Oct 1, 2016 to Sep 30, 2017
Signed
Jan 26, 2018
Return Version
2016v3.1
Gross Receipts
$837,194
Mission and Program Overview

Mission

NONE.

Northern berkshire medical pc operates an orthopedic office in williamstown, ma.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$0$660,648▲ $660,648
Accounts Receivable$0$136,692▲ $136,692
Cash and Non-Interest-Bearing Accounts$0$67,684▲ $67,684
Savings and Temporary Cash Investments$0$17,892▲ $17,892
Prepaid Expenses and Deferred Charges$0$2,192▲ $2,192
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$0$885,108▲ $885,108
Other Assets Total$0$0→ $0
Liabilities
Other Liabilities$0$1,256,031▲ $1,256,031
Accounts Payable and Accrued Expenses$0$22,367▲ $22,367
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$0$1,278,398▲ $1,278,398
Net Assets / Fund Balance
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Unrestricted Net Assets$0$-393,290▼ $393,290
Total Net Assets Fund Balance$0$-393,290▼ $393,290
Total Liabilities and Net Assets / Fund Balance$0$885,108▲ $885,108

Asset Categories

AssetBook ValueDepreciationBasis
Leasehold Improvements$359,286$14,454$373,740
Equipment$289,083$27,187$316,270
Other Land Buildings$12,279$646$12,925
Compensation and Service Providers

Board Members and Trustees

NameTitle
Carl DobsonPresident
Stephen MajetichCFO
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$836,983
Investment Income
$211
Other Revenue
$0
Change in Net Assets
$-393,290

Audited Revenue Reconciliation

Revenue per Audited Statements
$837,194
Revenue Not Reported on Form 990
$-36,095
Total Revenue per Audited Statements
$801,099
Total Revenue per Form 990
$837,194
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$937,019
Salaries, Compensation, and Employee Benefits$293,465
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$680,730--$680,730
Other Salaries and Wages$233,286--$233,286
Occupancy$55,204$6,256-$61,460
Office Expenses$45,921$5,204-$51,125
Depreciation Depletion$37,983$4,304-$42,287
Other Employee Benefits$29,751--$29,751
Payroll Taxes$21,226--$21,226
Pension Plan Contributions$9,202--$9,202
Travel$1,430$162-$1,592
Information Technology$1,078$122-$1,200
Other Expenses$800--$800
Conferences and Meetings$647$73-$720
Fees for Services Accounting-$710-$710
Total Functional Expenses$1,213,653$16,831$0$1,230,484

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Form 990$1,230,484
Expenses per Audited Statements$1,194,389
Total Expenses per Audited Statements$1,194,389
Expenses Not Reported on Financial Statements$36,095
Other Expense Adjustments$36,095
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Affiliate$1,256,031
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6, 7A & 7B

Members, stockholders, or other persons: northern berkshire medical pc is organized as a stock corporation. The corporation has one authorized shareholder. The sole shareholder/director is authorized to take such actions and execute such documents as they deem necessary and appropriate to carry out the purpose of the organization. The affairs of the corporation shall be managed and conducted by a sole director, subject to the authority and direction of the svmc board. The sole holder of the issued and outstanding shares of the corporation shall be that individual who is (i) licensed to practice of medicine in the commonwealth of massachusetts; (ii) designated by southwestern vermont medical center or its successor ("svmc") to be a shareholder of the corporation; (iii) is the chief medical officer or an employee of svmc or an affiliated entity or is deployed to svmc or an affiliated entity under a professional services agreement with svmc or an affiliated entity; and (iv) subscribes to and complies with the stock transfer and indemnification agreement with svmc or its successor (hereinafter referred to as the "eligible shareholder"). No such individual may be an officer, shareholder, director or employee of any other corporation engaged in the practice of medicine without the written prior approval of the president of svmc or its successor. The shareholder shall not issue or authorize the issuance of any additional shares or amend the certificate of incorporation or bylaws in a manner adverse to the purposes set forth in this agreement, the certificate of incorporation, the bylaws or without the prior written consent of the corporation and svmc. All by-laws of the corporation shall be subject to alteration or repeal, and new by-laws may be adopted either by the vote of a majority of the outstanding shares of the corporation entitled to vote in respect thereof, or by the vote of the board of directors, provided that in each case notice of the proposed alteration or repeal or of the proposed new by-laws be included in the notice of the meeting at which such alteration, repeal or adoption is acted upon, and provided further that any such action by the board of directors may be changed by the shareholders, except that no such change shall affect the validity of any actions theretofore taken pursuant to the by-laws as altered, repealed or adopted by the board of directors, and provided still further than any amendment of article xi shall require the written prior approval of the president of southwestern vermont medical center or its successor.

Form 990, Part VI, Section B, Line 11B

Form 990 review process: the form 990 is prepared by an independent accounting firm based on the audited financial statements and information provided by the accounting department of the organization. Prior to filing with the irs, the draft 990 is reviewed by the sole director of northern berkshire medical pc as well as the board of directors of southwestern vermont health care corp, a related organization.

Form 990, Part VI, Section B, Line 12C

Conflict of interest policy: officers, directors, trustees, and key employees are required to annually disclose interests which could result in conflicts. The compliance officer maintains records on the completion of the conflict of interest forms, any potential conflicts are discussed at the audit and compliance meeting and then recommendations are brought before the full board for a vote. In the case of a potential conflict of interest, the board member abstains from all discussion and consideration of the item that presents the potential conflict. The board of directors of a related organization, svhc, monitors the compliance of northern berkshire medical pc through the work of the svhc compliance program.

Form 990, Part VI, Section C, Line 19

Document disclosure: the organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.

Filing and Contact Details

Filer

Filer Name
Northern Berkshire Medical Pc
EIN
81-4023607
In Care Of
% STEPHEN MAJETICH
Phone
4134584452
Address
375 MAIN ST, WILLIAMSTOWN, MA 01267
Doing Business As
Northern Berkshire Orthopedics Pc

Signing Officer

Name
Stephen Majetich
Title
CFO
Signed
2018-01-26
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Carl Dobson
Formed
2016
Legal Domicile
Ma
Voting Board Members
1
Independent Board Members
1
Employees
0

Preparer

Firm
Bkd Llp
Address
910 E ST LOUIS 200/PO BOX 1190, SPRINGFIELD, MO 65806-2523
Preparer
Brian D Todd
Phone
4178658701
Supplemental Narrative

Additional Explanations

Form 990 Part IX Line 11G

Description:psa fees total fees:588917

Form 990 Part IX Line 11G

Description:purchased services total fees:86575

Form 990 Part IX Line 11G

Description:service contracts total fees:5238

Financial Statement Notes

Schedule D, Part X, Line 2

Uncertain tax positions: management has evaluated their income tax positions under the guidance included in asc 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.

Schedule D, Part XI, Line 2D

Amounts included on line 1, but not on form 990, part viii, line 12: $ ( 36,095) bad debt expense

Schedule D, Part XII, Line 4B

Amounts included on form 990, part ix, line 25, but not on line 1: $ 36,095 bad debt expense

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This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/RentalIncomeOrLossGrp/RealAmt00
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IRS990/ReportLandBuildingEquipmentInd0true
IRS990/ReportOtherAssetsInd0false
IRS990/ReportOtherLiabilitiesInd0true
IRS990/ReportProgramRelatedInvstInd0false
IRS990/RevenueAmt0836983
IRS990/RoyaltiesGrp/TotalAmt00
IRS990/RoyaltiesRevenueGrp/TotalRevenueColumnAmt00
IRS990/SavingsAndTempCashInvstGrp/BOYAmt00
IRS990/SavingsAndTempCashInvstGrp/EOYAmt017892
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IRS990ScheduleA/GrossInvestmentIncome509Grp/TotalAmt0211
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearAmt0836983
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt0836983
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IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt00
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt00
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt00
IRS990ScheduleA/Total509Grp/TotalAmt0836983
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt0837194
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt00
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt00
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt00
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt00
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt0837194
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IRS990ScheduleD/EquipmentGrp/BookValueAmt0289083
IRS990ScheduleD/EquipmentGrp/DepreciationAmt027187
IRS990ScheduleD/EquipmentGrp/OtherCostOrOtherBasisAmt0316270
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IRS990ScheduleD/FederalIncomeTaxLiabilityAmt00
IRS990ScheduleD/LeaseholdImprovementsGrp/BookValueAmt0359286
IRS990ScheduleD/LeaseholdImprovementsGrp/DepreciationAmt014454
IRS990ScheduleD/LeaseholdImprovementsGrp/OtherCostOrOtherBasisAmt0373740
IRS990ScheduleD/OtherExpensesNotIncludedAmt036095
IRS990ScheduleD/OtherLandBuildingsGrp/BookValueAmt012279
IRS990ScheduleD/OtherLandBuildingsGrp/DepreciationAmt0646
IRS990ScheduleD/OtherLandBuildingsGrp/OtherCostOrOtherBasisAmt012925
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt01256031
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0DUE TO AFFILIATE
IRS990ScheduleD/OtherRevenueAmt0-36095
IRS990ScheduleD/RevenueNotReportedAmt0-36095
IRS990ScheduleD/RevenueSubtotalAmt0837194
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt1AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ ( 36,095) BAD DEBT EXPENSE
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt2AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 36,095 BAD DEBT EXPENSE
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE D, PART X, LINE 2
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc1SCHEDULE D, PART XI, LINE 2D
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc2SCHEDULE D, PART XII, LINE 4B
IRS990ScheduleD/TotalBookValueLandBuildingsAmt0660648
IRS990ScheduleD/TotalExpensesPerForm990Amt01230484
IRS990ScheduleD/TotalLiabilityAmt01256031
IRS990ScheduleD/TotalRevenuePerForm990Amt0837194
IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt0801099
IRS990ScheduleD/TotExpnsEtcAuditedFinclStmtAmt01194389
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IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd0false
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IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd0false
IRS990ScheduleJ/EquityBasedCompArrngmInd0false
IRS990ScheduleJ/InitialContractExceptionInd0false
IRS990/ScheduleJRequiredInd0true
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount00
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt025632
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt02774
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0STEPHEN MAJETICH
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0CFO
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt0414289
IRS990ScheduleJ/SeverancePaymentInd0false
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0TOP MANAGEMENT OFFICIAL COMPENSATION DETERMINATION: SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt1CONTRIBUTIONS TO NONQUALIFIED PLANS: $ 20,240 STEPHEN MAJETICH
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt2BONUS DETERMINATION: THE AMOUNT OF INCENTIVE COMPENSATION IS CALCULATED IN ACCORDANCE WITH THE FORMAL INCENTIVE COMPENSATION PROGRAM THAT WAS DEVELOPED BY SVHC'S HUMAN RESOURCE DEPARTMENT IN CONJUNCTION WITH OUR COMPENSATION CONSULTANT MIKE MACIEKOWICH OF ASTRON SOLUTIONS. THE ESSENCE OF THE PROGRAM IS TO REWARD OUR CEO FOR ACHIEVING POSITIVE RESULTS ON BOTH ORGANIZATIONAL AND INDIVIDUAL GOALS. GOALS ARE ESTABLISHED BY THE GOVERNANCE COMMITTEE PRIOR TO THE BEGINNING OF THE FISCAL YEAR. TYPICALLY THERE WILL BE FIVE TO SIX ORGANIZATIONAL GOALS AND EIGHT TO TEN INDIVIDUAL GOALS. SUCCESSFUL ACHIEVEMENT OF THESE GOALS RESULTS IN ADDITIONAL COMPENSATION FOR THE CEO; HOWEVER, NO PAYOUT IS MADE UNLESS SVHC'S FINANCIAL GOAL IS ACHIEVED.
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE J, PART I, LINE 3
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc1SCHEDULE J, PART I, LINE 4B
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc2SCHEDULE J, PART II, COLUMN B(II)
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd0true
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: NORTHERN BERKSHIRE MEDICAL PC IS ORGANIZED AS A STOCK CORPORATION. THE CORPORATION HAS ONE AUTHORIZED SHAREHOLDER. THE SOLE SHAREHOLDER/DIRECTOR IS AUTHORIZED TO TAKE SUCH ACTIONS AND EXECUTE SUCH DOCUMENTS AS THEY DEEM NECESSARY AND APPROPRIATE TO CARRY OUT THE PURPOSE OF THE ORGANIZATION. THE AFFAIRS OF THE CORPORATION SHALL BE MANAGED AND CONDUCTED BY A SOLE DIRECTOR, SUBJECT TO THE AUTHORITY AND DIRECTION OF THE SVMC BOARD. THE SOLE HOLDER OF THE ISSUED AND OUTSTANDING SHARES OF THE CORPORATION SHALL BE THAT INDIVIDUAL WHO IS (I) LICENSED TO PRACTICE OF MEDICINE IN THE COMMONWEALTH OF MASSACHUSETTS; (II) DESIGNATED BY SOUTHWESTERN VERMONT MEDICAL CENTER OR ITS SUCCESSOR ("SVMC") TO BE A SHAREHOLDER OF THE CORPORATION; (III) IS THE CHIEF MEDICAL OFFICER OR AN EMPLOYEE OF SVMC OR AN AFFILIATED ENTITY OR IS DEPLOYED TO SVMC OR AN AFFILIATED ENTITY UNDER A PROFESSIONAL SERVICES AGREEMENT WITH SVMC OR AN AFFILIATED ENTITY; AND (IV) SUBSCRIBES TO AND COMPLIES WITH THE STOCK TRANSFER AND INDEMNIFICATION AGREEMENT WITH SVMC OR ITS SUCCESSOR (HEREINAFTER REFERRED TO AS THE "ELIGIBLE SHAREHOLDER"). NO SUCH INDIVIDUAL MAY BE AN OFFICER, SHAREHOLDER, DIRECTOR OR EMPLOYEE OF ANY OTHER CORPORATION ENGAGED IN THE PRACTICE OF MEDICINE WITHOUT THE WRITTEN PRIOR APPROVAL OF THE PRESIDENT OF SVMC OR ITS SUCCESSOR. THE SHAREHOLDER SHALL NOT ISSUE OR AUTHORIZE THE ISSUANCE OF ANY ADDITIONAL SHARES OR AMEND THE CERTIFICATE OF INCORPORATION OR BYLAWS IN A MANNER ADVERSE TO THE PURPOSES SET FORTH IN THIS AGREEMENT, THE CERTIFICATE OF INCORPORATION, THE BYLAWS OR WITHOUT THE PRIOR WRITTEN CONSENT OF THE CORPORATION AND SVMC. ALL BY-LAWS OF THE CORPORATION SHALL BE SUBJECT TO ALTERATION OR REPEAL, AND NEW BY-LAWS MAY BE ADOPTED EITHER BY THE VOTE OF A MAJORITY OF THE OUTSTANDING SHARES OF THE CORPORATION ENTITLED TO VOTE IN RESPECT THEREOF, OR BY THE VOTE OF THE BOARD OF DIRECTORS, PROVIDED THAT IN EACH CASE NOTICE OF THE PROPOSED ALTERATION OR REPEAL OR OF THE PROPOSED NEW BY-LAWS BE INCLUDED IN THE NOTICE OF THE MEETING AT WHICH SUCH ALTERATION, REPEAL OR ADOPTION IS ACTED UPON, AND PROVIDED FURTHER THAT ANY SUCH ACTION BY THE BOARD OF DIRECTORS MAY BE CHANGED BY THE SHAREHOLDERS, EXCEPT THAT NO SUCH CHANGE SHALL AFFECT THE VALIDITY OF ANY ACTIONS THERETOFORE TAKEN PURSUANT TO THE BY-LAWS AS ALTERED, REPEALED OR ADOPTED BY THE BOARD OF DIRECTORS, AND PROVIDED STILL FURTHER THAN ANY AMENDMENT OF ARTICLE XI SHALL REQUIRE THE WRITTEN PRIOR APPROVAL OF THE PRESIDENT OF SOUTHWESTERN VERMONT MEDICAL CENTER OR ITS SUCCESSOR.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING WITH THE IRS, THE DRAFT 990 IS REVIEWED BY THE SOLE DIRECTOR OF NORTHERN BERKSHIRE MEDICAL PC AS WELL AS THE BOARD OF DIRECTORS OF SOUTHWESTERN VERMONT HEALTH CARE CORP, A RELATED ORGANIZATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2CONFLICT OF INTEREST POLICY: OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE INTERESTS WHICH COULD RESULT IN CONFLICTS. THE COMPLIANCE OFFICER MAINTAINS RECORDS ON THE COMPLETION OF THE CONFLICT OF INTEREST FORMS, ANY POTENTIAL CONFLICTS ARE DISCUSSED AT THE AUDIT AND COMPLIANCE MEETING AND THEN RECOMMENDATIONS ARE BROUGHT BEFORE THE FULL BOARD FOR A VOTE. IN THE CASE OF A POTENTIAL CONFLICT OF INTEREST, THE BOARD MEMBER ABSTAINS FROM ALL DISCUSSION AND CONSIDERATION OF THE ITEM THAT PRESENTS THE POTENTIAL CONFLICT. THE BOARD OF DIRECTORS OF A RELATED ORGANIZATION, SVHC, MONITORS THE COMPLIANCE OF NORTHERN BERKSHIRE MEDICAL PC THROUGH THE WORK OF THE SVHC COMPLIANCE PROGRAM.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4DESCRIPTION:PSA FEES TOTAL FEES:588917
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5DESCRIPTION:PURCHASED SERVICES TOTAL FEES:86575
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:5238
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990 PART IX LINE 11G
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990 PART IX LINE 11G
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6FORM 990 PART IX LINE 11G
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