FMH Wind-Down Company: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
FMH Wind-Down Company (EIN 02-0222131)
Tax period
2021-10-01 to 2022-09-30
Filed
2023-03-16
IRS object ID
202320759349300832
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-03-16T14:27:37-05:00ReturnTs
Tax Period End2022-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman & NoyesBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 507AddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222131EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FMH Wind-Down CompanyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFMHWBusinessNameControlTxt
Phone6032256641PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1CO NHCF 37 Pleasant StreetAddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBrian HughesPersonNm
Person TitleBoard of Trustees ChairmanPersonTitleTxt
Phone6032256641PhoneNum
Signature2023-03-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstBrianPersonFirstNm
Person LastHughesPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonConnor SmartPreparerPersonNm
PTINP02285543PTIN
Phone2078792100PhoneNum
Preparation2023-03-08PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerBrian HughesPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O NHCF 37 Pleasant StreetAddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03301ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$48,872GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.fmhwdc.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1941FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionFormer hospital undergoing divestiture.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee1TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$603,176PYProgramServiceRevenueAmt
CY Program Service Revenue$46,515CYProgramServiceRevenueAmt
PY Investment Income$964,755PYInvestmentIncomeAmt
CY Investment Income$2,357CYInvestmentIncomeAmt
PY Other Revenue$538,450PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,106,381PYTotalRevenueAmt
CY Total Revenue$48,872CYTotalRevenueAmt
PY Grants And Similar Paid$576PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,175,681PYOtherExpensesAmt
CY Other Expenses$278,429CYOtherExpensesAmt
PY Total Expenses$4,176,257PYTotalExpensesAmt
CY Total Expenses$278,429CYTotalExpensesAmt
PY Revenues Less Expenses-$2,069,876PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$229,557CYRevenuesLessExpensesAmt
Total Assets BOY$3,971,416TotalAssetsBOYAmt
Total Assets EOY$3,696,872TotalAssetsEOYAmt
Total Liabilities BOY$6,516,586TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,439,092TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$2,545,170NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$2,742,220NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWhile the Organization is undergoing divestiture and wind down operations at this time, the Organization's eventual termination and transfer of its assets and activities into other institutions will ultimately improve the quality of and the access to care in its community.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$32,335ExpenseAmt
Grant$0GrantAmt
Revenue$46,515RevenueAmt
DescIn January 2019, the Organization and HCA Healthcare, Inc. signed an intent to affiliate the organizations. Expected benefits of the affiliation include expanding the Organization's services in New Hampshire, expanding access to health care in rural communities, and increasing competition by delivering higher-quality, lower cost care. Since the affiliation, the Organization has ceased operating as a state-licensed hospital, no longer has any employees, and ceased to provide healthcare services. The operations of the Organization currently consist of wind down activities only. Remaining assets of the Organization consist of cash which will be used to settle the Organization's wind-down operations and to support the Greater Rochester Community Health Foundation (f/k/a Frisbie Foundation).Desc
Total Program Service Expenses$32,335TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Rebecca Carr CPA CMABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6032256641PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O NHCF 37 Pleasant StreetAddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03301ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
Frank Jones
Trustee3.00Yes (X)$0$0$0
Brian Hughes
Chair, Trustee3.00Yes (X)$0$0$0Yes (X)
James Jalbert
Vice Chair, Trustee3.00Yes (X)$0$0$0Yes (X)
William Cormier
Secretary, Trustee3.00Yes (X)$0$0$0Yes (X)
John Hall
Treasurer, Trustee3.00Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Warbird Consulting PartnersBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 Galleria Pkwy SE Ste 1400AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30339ZIPCd
FieldValueIRS element (for citing)
ServicesConsulting and managementServicesDesc
Compensation$238,572CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescWind-down collectionsDesc
Business621110BusinessCd
Total Revenue Column$46,515TotalRevenueColumnAmt
Related Or Exempt Func Income$46,515RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$46,515TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,357TotalRevenueColumnAmt
Exclusion$2,357ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$48,872TotalRevenueColumnAmt
Related Or Exempt Func Income$46,515RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,357ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$22,515TotalAmt
Management And General$22,515ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$9,815TotalAmt
Management And General$9,815ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$203,061TotalAmt
Management And General$203,061ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,965TotalAmt
Management And General$3,965ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Cost reports$32,292$32,292
Tax settlements$4,567$4,567
Abandoned properties$2,171$2,171
Benefit payouts$43$43

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$278,429TotalAmt
Program Services$32,335ProgramServicesAmt
Management And General$246,094ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,809,963BOYAmt
EOY$3,696,872EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$161,453BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,971,416BOYAmt
EOY$3,696,872EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$249,355BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,267,231BOYAmt
EOY$6,439,092EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,516,586BOYAmt
EOY$6,439,092EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$2,545,170BOYAmt
EOY-$2,742,220EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$2,545,170BOYAmt
EOY-$2,742,220EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,971,416BOYAmt
EOY$3,696,872EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$229,557ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$32,507OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,568,813BeginningYearBalanceAmt
Investment Earnings Or Losses$543,386InvestmentEarningsOrLossesAmt
Other Expenditures$4,112,199OtherExpendituresAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,614,425BeginningYearBalanceAmt
Contributions$93,845ContributionsAmt
Investment Earnings Or Losses$253,844InvestmentEarningsOrLossesAmt
Other Expenditures$6,052,305OtherExpendituresAmt
Administrative Expenses$340,996AdministrativeExpensesAmt
End Year Balance$3,568,813EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,647,540BeginningYearBalanceAmt
Contributions$21,325ContributionsAmt
Investment Earnings Or Losses$33,680InvestmentEarningsOrLossesAmt
Other Expenditures$5,009,104OtherExpendituresAmt
Administrative Expenses$79,016AdministrativeExpensesAmt
End Year Balance$9,614,425EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$17,792,984BeginningYearBalanceAmt
Contributions$206,456ContributionsAmt
Investment Earnings Or Losses$1,327,943InvestmentEarningsOrLossesAmt
Other Expenditures$4,600,638OtherExpendituresAmt
Administrative Expenses$79,205AdministrativeExpensesAmt
End Year Balance$14,647,540EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescEstimated third party payor settlementsDesc
Amt$6,439,092Amt
FieldValueIRS element (for citing)
Total Liability$6,439,092TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart V, Line 4:FormAndLineReferenceDesc
ExplanationThe Organization's endowment funds were originally used in furtherance of the Former Hospital's charitable mission. As of the year ending September 30, 2021, all donor restricted and endowment funds held by the Organization had been either liquidated, or had been transferred out to the Greater Rochester Community Health Foundation, formerly the Frisbie Foundation. The amount reported on this Schedule D, Part V, Prior Year, for other expenditures for facilities and programs ($4,112,199) is the net amount of funds consolidated and transferred to the Foundation. The Foundation is to maintain these funds as permanent endowments in furtherance of its new exempt mission: to promote the health and well-being of the citizens of Strafford County, New Hampshire. As of the year ending September 30, 2022, the Organization did not hold any Endowment Funds.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11bThe Form 990 is prepared with the assistance of the Organization's independent public accounting firm, and is thoroughly reviewed by the governing body and the Organization's liquidating trustees prior to filing. In its final years of operations, the Organization transferred the vast majority of its assets to the Greater Rochester Community Health Foundation, an affiliate of the New Hampshire Community Foundation. During these final wind-down years, senior accounting and finance personnel of the New Hampshire Community Foundation will also review the Form 990 prior to its filing with the IRS.
Form 990, Part VI, Section B, line 12cIn accordance with the written conflict of interest policy, the office of the President annually secures a signed copy of the Trustee/Officer Conflict of Interest Statement and maintains them on file.
Form 990, Part VI, Section B, line 15In January 2019, the Organization and HCA Healthcare, Inc. (HCA) signed a non-binding letter of intent (LOI) to affiliate the organizations. The transaction was approved by the New Hampshire Office of the Attorney General's Charitable Trust Unit and finalized effective February 29, 2020. Accordingly, the Organization only filed payroll forms for services rendered through the end of February, 2020, at which point the Organization ceased to maintain any employees and began to perform solely wind-down activities. Prior to this transaction, the executive compensation committee comprised of four members of the Company's Board reviewed the Hospital CEO performance and compensation. The VP of Human Resources presented the compensation committee with comparative salary and benefit data. Senior management compensation was also reviewed by the committee, but their compensation was determined by the CEO.
Form 990, Part VI, Section C, line 19Documents that are required to be open for public inspection are made available upon request within the timeframe required by law.
Form 990, Part IX, line 11gWind-down consulting and contractors: Program service expenses 0. Management and general expenses 203,061. Fundraising expenses 0. Total expenses 203,061.
Form 990, Part XI, line 9:Reduction in insurance claims 5,370. Reduction in tax settlements 27,137.

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