2023-05-09T14:00:18+00:00 2022-06-30 350921680 CROWE LLP 9600 Brownsboro Road Suite 400 Louisville KY 402413902 990 2021-07-01 222519596 Dartmouth-Hitchcock Clinic DART 6036531154 One Medical Center Drive Lebanon NH 03756 Wendy E Fielding CFO 2023-05-09 true Wendy E Fielding 999009999 Rachel Spurlock P00520729 5023263996 2021 2023-04-26 12:10:37Z Joanne M Conroy MD One Medical Center Drive Lebanon NH 03756 611637719 false X www.dartmouth-hitchcock.org X 1983 NH Advancing health through research, education, clinical practice, and community partnerships; providing each person the best care in the right place, at the right time, every time. 21 15 6084 429 674861 0 74843390 39587886 407746462 431755697 995284 -31124 139794708 140312712 623379844 611625171 3877220 3939176 0 0 346742249 364509067 0 0 165674 241103374 292073756 591722843 660521999 31657001 -48896828 263269510 244752235 510349111 558910192 -247079601 -314157957 WE ADVANCE HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME. false false 529150773 3939176 567650962 Dartmouth-Hitchcock Clinic (DHC) is a not-for-profit organization as described in Section 501(c)(3) of the Internal Revenue Code (Code) and is exempt from federal income taxes on related income, pursuant to Section 501(a) of the Code. DHC and its subsidiaries form a multispecialty physician practice group which operates throughout New Hampshire and Vermont and provides both medical services to patients and medical education and research. Health care services provided during fiscal year 2022 resulted in 1,365,500 office visits recorded by DHC personnel, with 337,086 unique patients served . The promotion of health through the medical practice activities of DHC provides the basis for the organization's tax-exempt status. DHC operates as an integral component of (and is fully owned by) Dartmouth-Hitchcock Health (D-HH), a New Hampshire not-for-profit corporation organized to support medical organizations like DHC. DHC provides the physician and advanced practice provider staff to a related affiliate, Mary Hitchcock Memorial Hospital (MHMH, also a fully-owned member of D-HH) and the related sophistication essential for the development and operations of the Hospital as the largest and only teaching hospital in New Hampshire and the designation by the federal government as a rural referral center for northern New England. The shared mission of DHC and MHMH is to advance health through research, education, clinical practice, and community partnerships, providing each person the best care, in the right place, at the right time, every time. Consistent with this mission, and in partnership with MHMH, DHC provides high-quality, cost-effective, comprehensive, and integrated health care to individuals, families, and the communities it serves regardless of a patient's ability to pay. DHC actively supports community-based health care, and promotes the coordination of services among health care providers and social services organizations within the regions it serves. DHC also seeks to work collaboratively with other area health care providers to improve the health status of residents in the region. DHC, MHMH, and Cheshire Medical Center (Cheshire) played key roles in the state-wide federally-funded delivery system reform incentive program (DSRIP) from 2016 - 2021. This NH program was funded from 2016 - 2020, but grant funding was able to be carried over for an additional year of interventions and all work was completed by 31st of December, 2021. Dartmouth-Hitchcock Clinic and Cheshire Medical Center co-sponsored the development of an integrated delivery network which brought health systems, community mental health centers, and social service organizations together to collaborate on improving health for Medicaid beneficiaries with mental health diseases and/or substance use disorders. While DSRIP funding has now expired, this work laid the foundation for ongoing programming and in August 2021, MHMH was awarded a HRSA grant to develop the behavioral workforce in rural New Hampshire. In addition to the alternative payment models and integrated care delivery relationships noted above, DHC has several shared risk contracts with the largest commercial insurance carriers in its market. DHC was responsible for managing the cost of care and health of approximately 100,000 members across these patient populations during fiscal year 2022. The Jack Byrne Center for Palliative & Hospice Care coordinates the clinical, education, and research efforts of DHC and Visiting Nurse alliances around the region. This effort provides much-needed end-of-life care for patients in a clinical setting that meets the needs of patients and their families. Due to increased patient demand in the southern part of New Hampshire, DHC commenced a major construction project to expand the Manchester clinic site to increase patient capacity. The 94,000 square-foot addition includes a state-of-the-art, six-room extended-stay (23-hour) ambulatory surgery center, expanded medical office space to support primary and specialty care outpatient clinics, and a fixed magnetic resonance imaging (MRI) unit, among other uses. The addition opened in the spring of 2021. DHC and MHMH jointly file an annual community benefits report with the State of New Hampshire which outlines the community and charitable benefits DHC and MHMH provide. The complete and updated community benefits reports are available upon request; these reports can also be found on the organization's website. The broad categories used in the community benefit report to summarize the benefits mentioned here include: "financial assistance" (formerly called "charity care"), which represents services provided to patients who cannot afford health care services due to inadequate financial resources which result from being uninsured or underinsured. For the year ended June 30, 2022, DHC provided financial assistance to 18,349 patients in the amount of $12,950,295 as measured by gross charges. The cost of providing this care for the year ended June 30, 2021, was $11,671,808. DHC also routinely provides services to Medicaid patients at reimbursement levels that are well below the cost of the care provided. The uncompensated cost of care for Medicaid patients for the year ended June 30, 2022 was $49,529,910. Community health activities include the cost or value of several different types of programs, including the cost of community-based education, health fairs, health screenings, support groups, and programs and materials that promote wellness and prevent illness. Examples of these types of efforts include Granite State Fit Kids Health Program for elementary schools, the Women's Health Resource Centers in Lebanon, NH, and Smoking Prevention and Cessation programs. This category also includes financial contributions and the contribution of time and services to community programs, hospitals, and agencies. DHC also provides a significant amount of uncompensated care to its patients that is reported as "provision for bad debts," which is not included in the amounts reported above. For the fiscal year ended June 30, 2022, DHC reported a provision for bad debts of approximately $30,158,857. 38143433 2428232 As a component of an integrated academic medical center, Dartmouth-Hitchcock Clinic (DHC) provides significant support for academic and research programs through its support of the Geisel School of Medicine at Dartmouth College (GSM). DHC provides support for physicians' unpaid teaching time as part of its community benefit initiatives, consisting of the time physicians spend providing clinical supervision and education for residents and medical students. In addition, DHC provides in-kind support for research and other grants representing costs in excess of awards for numerous grant-funded health research and service initiatives awarded to Mary Hitchcock Memorial Hospital (MHMH) and GSM. Other community benefit initiatives include subsidizing the costs of providing medical and clinical education to professionals across New Hampshire, Vermont, and beyond as well as uncompensated costs of academic and medical research activities. 567294206 true true false true false false false false true true true false true true false false true false true true true false false false false false true true true false false false true false false true false false false false false true true true true false false true 0 0 6084 true true true false false false false false false false false false true false X 21 15 false false false false true true true true true false false true true true true true true true true false NH X Wendy E Fielding 6036531154 One Medical Center Drive Lebanon NH 03756 Charles G Plimpton MBA Trustee/Secretary(Through 12/31/21)/Treasurer 1.5 2.5 X X 0 0 0 David P Paul Trustee / Secretary (as of 1/1/22) 0.8 1.8 X X 0 0 0 Edward H Stansfield III MA Trustee / Chair (through 8/9/21) 0.8 2.3 X X 0 0 0 Joanne M Conroy MD Trustee, Ex-Officio, CEO 16.2 39.9 X X 1683133 0 45655 ROBERTA L HINES MD TRUSTEE/Chair (As of 1/1/22) 1.5 2.0 X X 0 0 0 Aaron J Mancuso MD Trustee / Physician 12.0 28.0 X 454460 0 55566 Carl W Dobson MD Trustee/ Medical Director 0.8 40.0 X 0 480091 58579 Duane A Compton PHD Trustee / Ex-Officio 0.8 1.7 X 0 0 0 Elof Eriksson MD PhD Trustee 0.8 0.8 X 0 0 0 Gary L Freed MD Trustee/ Physician 12.0 28.0 X 742525 0 24978 Geraldine Bednash PHD RN FAAN Trustee 0.8 1.3 X 0 0 0 Jarvis A Green Trustee (As of 1/1/22) 0.8 0.8 X 0 0 0 Jennifer L Moyer MBA Trustee 0.8 1.3 X 0 0 0 Jocelyn Chertoff MD Trustee(Through 12/31/21)/VP Svc Ln & Dept Chair-Rad 12.0 28.0 X 725915 0 47697 KURT K RHYNHART MD TRUSTEE(Through 12/31/21)/Section Chief 12.0 28.0 X 489274 0 52403 Laura K Landy MBA Trustee (Through 12/31/21) 0.8 1.3 X 0 0 0 Marc B Wolpow JDMBA Trustee 0.8 1.3 X 0 0 0 Mark W Begor MBA Trustee 0.8 1.3 X 0 0 0 Nancy M Dunbar MD Trustee (As of 1/1/22) / Physician 12.0 28.0 X 384274 0 66767 Pamela Thompson MSRNCENP Trustee 0.8 1.3 X 0 0 0 Paul P Danos PHD Trustee 0.8 1.3 X 0 0 0 Robert SD Higgins MD Trustee (Through 9/1/21) 0.8 0.8 X 0 0 0 Sandra L Wong MD Trustee (as of 3/25/22)/SVP Svc Ln & Dept Chair 12.0 28.0 X 722357 0 37499 Sherri C Oberg Trustee (As of 1/1/22) 0.8 0.8 X 0 0 0 Thomas Glynn PHD Trustee 0.8 0.8 X 0 0 0 Thomas Raffio Trustee 0.8 0.8 X 0 0 0 Aimee M Claiborne Chief Human Resource Officer 12.0 28.5 X 0 471589 42267 DANIEL P JANTZEN Chief Financial Officer (through 10/31/21) 12.0 31.0 X 0 1021339 63190 EDWARD MERRENS Chief Clinical Officer 12.0 29.0 X 796359 0 48247 JOHN KACAVAS Chief Legal Officer 12.0 31.0 X 0 769932 68891 Matthew Haag Chief Development Officer 12.0 28.0 X 0 444677 18061 Patrick F Jordan III MBA Chief Operating Officer 12.0 31.0 X 0 809680 62619 Stephen Leblanc Chief Strategy Officer 12.0 31.0 X 813774 0 59990 Susan A Reeves EDDRN Executive VP (medical center) 12.0 28.0 X 0 738583 68953 Wendy Fielding Chief Financial Officer (as of 10/31/21) 12.0 28.5 X 0 324365 65195 David F Duncan System VP - Facilities Mgmt 12.0 28.5 X 0 297369 22803 Jeffrey Obrien MHA Chief Operating Officer - DHMC 12.0 28.5 X 0 385605 67953 Karen Clements RNBSNMSB Chief Nursing Officer 12.0 28.0 X 0 377769 37252 Martin Purcell MBA Chief Information Officer 12.0 28.0 X 0 491599 31225 Simon Hillier Dept Chair ANESTHESIOLOGY 12.0 28.0 X 610733 0 64796 Staci Hermann PHARMDMS CHIEF PHARMACY OFFICER 12.0 28.0 X 0 299896 30725 Daniel Stewart MD Physician 12.0 28.0 X 1189796 0 66598 Jock Mccullough MD Physician 12.0 28.0 X 910840 0 69522 John Nigriny Physician 40.0 0 X 1017053 0 66096 Matthew LeBoeuf Physician 12.0 28.0 X 925012 0 57364 Timothy Ryken Physician 12.0 28.0 X 1119921 0 63772 David Gladstone MD CHF CLNCL PHYSCN - RADIOLOGY 12.0 28.0 X 0 232134 36978 GEORGE T BLIKE MD Former/ Chief Quality & Value Officer 10.0 11.5 X 245035 0 20819 Maria Padin MD Chief Medical Officer, CGP 12.0 30.0 X 522010 0 64127 Peter D Solberg MD Chief Health Information Officer 12.0 28.0 X 447053 0 71976 Richard I Rothstein MD Former Dept Chair/Srvc LN LDR - MED 12.0 28.0 X 662998 0 64517 14462522 7144628 1723080 1771 true true false 0 0 0 0 0 24969107 14618779 0 39587886 NET PATIENT SERVICE REVENUE 621300 431755697 431755697 0 0 0 0 431755697 24900 2005 22895 872802 67759 7919 4629 864883 63130 928013 928013 -56024 -56024 0 -56024 -56024 CONTRACTED REVENUE 621300 115892063 115219207 672856 CAFETERIA INCOME 722514 388346 388346 OTHER REVENUE 621300 23104290 23104290 0 0 0 0 139384699 611625171 570079194 674861 1283230 3604134 3604134 308814 308814 26228 26228 5442909 1741796 3535538 165575 645082 294996 350086 284525944 250819250 33706694 21253176 18702795 2550381 33671634 29666306 4005328 18970322 16713753 2256569 1043554 66099 977455 273343 33875 239468 59019394 52057507 6961887 0 1094152 44921 1049231 7124095 6149443 974652 9614860 865337 8749523 9308850 665898 8642952 1260573 588875 671698 32149 31714 435 7345899 661131 6684768 3200646 1258996 1941650 8836154 4543618 4292536 MEDICAL SUPPLIES 167788331 167280072 508259 EQUIP REPAIR & MAINTENANCE 7364656 4614103 2750553 ACADEMIC, GME, TEACHING & SUPPORT 3358662 2874681 483981 RECRUITMENT COSTS 956994 73602 883392 4451444 3606262 845083 99 660521999 567294206 93062119 165674 0 154050 57728406 50805627 167353 172807 0 0 1301911 410959 630609 5616432 126324369 109902825 17615187 16421544 470236 356287 56544609 53655396 1746404 1706081 127064795 115453052 263269510 244752235 262741134 317098927 0 0 0 2516936 2034494 245091041 239776771 510349111 558910192 X -248853383 -315748181 1773782 1590224 -247079601 -314157957 263269510 244752235 X -48896828 -347101 -17834427 X false true X true true true X 0 8020230 24093904 74843390 39587886 146545410 454429030 501802116 472942824 545666182 570079194 2544919346 0 0 0 454429030 509822346 497036728 620509572 609667080 2691464756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2691464756 770344 1008778 989972 909298 963456 4641848 0 770344 1008778 989972 909298 963456 4641848 150042 3882 4453 0 0 158377 425353 485850 421974 338902 388346 2060425 455774769 511320856 498453127 621757772 611018882 2698325406 0.9975 0.9974 0 0.0 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - OTHER INCOME, COLUMN A - 425353.0, COLUMN B - 485850.0, COLUMN C - 421974.0, COLUMN D - 338902.0, COLUMN E - 388346.0, COLUMN F - 2060425.0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 52199 52199 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LINE 1I DHC PAYS DUES TO VARIOUS ORGANIZATIONS RELATED TO ITS EXEMPT MISSION. THE AMOUNT REPORTED UNDER OTHER ACTIVITIES ON LINE 1I REFERS TO THE AMOUNT OF LOBBYING ACTIVITIES IDENTIFIED IN DUES PAYMENTS TO OUTSIDE ORGANIZATIONS. 1705532 -116575 66888 1522069 1360094 368174 22736 1705532 1345817 28397 14120 1360094 1340985 61035 56203 1345817 1284444 1105 55436 1340985 0.0 0.656 0.344 false false 2505032 7215859 9720891 72481325 65783580 6697745 27567760 27567321 439 16554393 16551924 2469 16421544 Investment in Pooled Funds 1533111 F INVESTMENT IN CAPTIVE 52122285 F 53655396 DHC 457(B) PLAN ASSETS 110345800 DUE FROM AFFILIATE 5106868 OTHER MISC ASSETS 384 ESTIMATED THIRD PARTY SETTLEMENT 115453052 ACCRUED POST RETIREMENT PENSION 159580959 RESERVES FOR INSURANCE RELATED LOSS 79762608 ESTIMATED THIRD PARTY SETTLEMENT 433204 239776771 Schedule D, Part X, Line 2 ASC 740 (FIN 48) FOOTNOTE NO ASC 740 (FIN 48) FOOTNOTE WAS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS AS THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT OR SINCE ADOPTION. Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUND WAS ESTABLISHED TO PROVIDE RESEARCH AND CLINICAL SUPPORT FOR THE CARDIOTHORACIC SURGERY CHAIR AT DARTMOUTH-HITCHCOCK CLINIC true Central America and the Caribbean 0 0 Grant to recipients located in the region 22110 Central America and the Caribbean 0 0 Investments 52122285 South Asia 0 0 Grant to recipients located in the region 4118 Europe (Including Iceland and Greenland) 0 0 Fundraising 28919 North America (Canada & Mexico only) 0 0 Fundraising 12269 0 0 0 0 0 0 52189701 0 52189701 Central America and the Caribbean Program Support 22110 Cash FMV South Asia Program Support 4118 Cash FMV 2 0 true false true false true false Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds THE CLINIC PROVIDES UNRESTRICTED PROGRAM SUPPORT FOR CERTAIN FOREIGN ORGANIZATIONS. PROGRAM SUPPORT TO SPECIFIC ORGANIZATIONS IS CHOSEN AND DIRECTED BY THE PHYSICIANS AND/OR RESEARCHERS WORKING DIRECTLY WITH THE CHARITY. Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual; EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; NORTH AMERICA (CANADA & MEXICO ONLY)-Accrual; SOUTH ASIA-Accrual Schedule F, Part II, Line 1 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual; SOUTH ASIA-Accrual true Advance Transit PO BOX 1027 WILDER VT 05088 222558708 501(c)3 36600 FMV PROGRAM SUPPORT Alice Peck Day Memorial Hospital 10 ALICE PECK DAY DRIVE LEBANON NH 03766 020222791 501(c)3 7500 FMV PROGRAM SUPPORT Amoskeag Health 145 HOLLIS STREET MANCHESTER NH 03101 020458174 501(c)3 13500 FMV PROGRAM SUPPORT BAYLOR COLLEGE OF MEDICINE PO BOX 301207 DALLAS TX 753031207 741613878 501(c)3 27625 FMV CHARITABLE EDUCATIONAL SERVICES BOSTON MEDICAL CENTER ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 043314093 501(c)3 7288 FMV CHARITABLE RESEARCH BOSTON UNIVERSITY PO BOX 28763 NEW YORK 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CHARITABLE PROGRAM SUPPORT CREARE LLC 16 GREAT HOLLOW RD HANOVER NH 03755 020259551 For Profit 9504 FMV EXPLORATORY/DEVELOPMENTAL RESEARCH DUKE UNIVERSITY ACCOUNTS RECEIVABLE LOCKBOX CHARLOTTE NC 282602651 560532129 501(c)3 5827 FMV CHARITABLE EDUCATIONAL SERVICES Families Flourish Northeast PO BOX 20 ENFIELD CENTER NH 037489998 844591232 501(c)3 12091 FMV PROGRAM SUPPORT Families in Transition NEW HORIZONS 199 MANCHESTER STREET MANCHESTER NH 03103 020475414 501(c)3 9000 FMV PROGRAM SUPPORT FAMILY PLACE INC 319 US ROUTE 5 SOUTH NORWICH VT 05055 030305264 501(c)4 15943 FMV CHARITABLE PROGRAM SUPPORT Foundation for Healthy Communities (NHHA) 125 AIRPORT ROAD CONCORD NH 03301 020275078 501(c)3 512513 FMV PROGRAM SUPPORT Girls Incorporated of New Hampshire 1711 SOUTH WILLOW STREET UNIT 5 MANCHESTER NH 03103 237416090 501(c)3 6750 FMV PROGRAM SUPPORT Good Neighbor Health Clinic 70 NORTH MAIN STREET WHITE RIVER JCT VT 05001 030346949 501(c)3 28500 FMV PROGRAM SUPPORT Grafton County Senior 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BIRMINGHAM AL 352940109 636005396 Section 115 55432 FMV EDUCATIONAL SERVICES UNIVERSITY OF COLORADO OFFICE OF GRANTS/CONTRACTS-F428 DENVER CO 802910238 846000555 Section 115 10280 FMV EDUCATIONAL SERVICES UNIVERSITY OF MARYLAND ACCOUNTING AND COMPLIANCE BALTIMORE MD 212011531 526002033 Section 115 49070 FMV EDUCATIONAL SERVICES UNIVERSITY OF MIAMI DEPARTMENT OF PATHOLOGY ATLANTA GA 303845776 592695890 Section 115 6704 FMV EDUCATIONAL SERVICES UNIVERSITY OF NEBRASKA MEDICAL CTR 985100 NEBRASKA MED CTR OMAHA NE 681985100 470491233 Section 115 6693 FMV EDUCATIONAL SERVICES UNIVERSITY OF PITTSBURGH FORBES ALLIES BUILDING STE 300 PITTSBURGH PA 15213 250965591 Section 115 69630 FMV EDUCATIONAL SERVICES UNIVERSITY OF UTAH GRANTS CONTRACTS ACCOUNTING SALT LAKE CITY UT 841129020 876000525 Section 115 8215 FMV EDUCATIONAL SERVICES UNIVERSITY OF WASHINGTON GRANT CONTRACT ACCOUNTING CHICAGO IL 60693 916001537 Section 115 10899 FMV EDUCATIONAL SERVICES Upper Valley Community Nursing Project PO BOX 1302 LEBANON NH 03766 831224873 501(c)3 6000 FMV PROGRAM SUPPORT Upper Valley Haven 713 HARTFORD AVE WHITE RIVER JCT VT 05001 030277908 501(c)3 22500 FMV PROGRAM SUPPORT VANDERBILT UNIVERSITY MEDICAL CENTER VUMC FINANCE DEPT 1236 DALLAS TX 753121236 352528741 501(c)3 18466 FMV CHARITABLE EDUCATIONAL SERVICES VIRGINIA COMMONWEALTH UNIVERSITY 800 E Leigh Street Suite 3200 RICHMOND VA 23219 546001758 Section 115 15025 FMV EDUCATIONAL SERVICES Vision for Creative Housing Solutions 8 SUNRISE FARM LANE ENFIELD NH 03748 800868234 501(c)3 7500 FMV PROGRAM SUPPORT Vital Communities 195 NORTH MAIN STREET WHITE RIVER JCT VT 05001 030355283 501(c)3 7500 FMV PROGRAM SUPPORT West Central Behavioral Health 85 MECHANIC STREET SUITE C2-1 LEBANON NH 03766 222645978 501(c)3 15000 FMV PROGRAM SUPPORT Willing Hands Enterprises 198 CHURCH STREET NORWICH VT 05055 202204811 501(c)3 9450 FMV PROGRAM SUPPORT Women's Information Service of the Upper Valley 38 BANK STREET LEBANON NH 03766 020346512 501(c)3 6000 FMV PROGRAM SUPPORT Hitchcock Foundation One Medical Center Drive LEBANON NH 03756 020222139 501(c)3 236380 FMV PROGRAM SUPPORT 79 3 Awards and Educational Assistance 26 264333 FMV Patient Assistance 1377 44481 FMV Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. EACH AWARD ESTABLISHED BY DARTMOUTH-HITCHCOCK CLINIC (DHC) HAS WRITTEN GUIDELINES AND PROCEDURES. AWARD PAYMENTS ARE PROCESSED IN ACCORDANCE WITH THE SPECIFIC TERMS OF EACH AWARD. THE DARTMOUTH INSTITUTE SCHOLARSHIPS (TDI) ARE PAID DIRECTLY TO DARTMOUTH COLLEGE ON BEHALF OF THE INDIVIDUALS RECEIVING THE AWARD. THE COORDINATORS OF THE PROGRAMS ARE RESPONSIBLE FOR ASSURING THAT ALL TERMS ARE MET, INCLUDING PROPER DOCUMENTATION OF EXPENSES WITH RECEIPTS. X true true X X X X false true false false false false false false false Joanne M Conroy MD Trustee, Ex-Officio, CEO 1306313 0 208100 0 168720 0 27660 0 17995 0 1728788 0 0 0 Jocelyn Chertoff MD Trustee(Through 12/31/21)/VP Svc Ln & Dept Chair-Rad 653561 0 0 0 72354 0 27660 0 20037 0 773612 0 0 0 Sandra L Wong MD Trustee (as of 3/25/22)/SVP Svc Ln & Dept Chair 660736 0 0 0 61621 0 21860 0 15639 0 759856 0 0 0 KURT K RHYNHART MD TRUSTEE(Through 12/31/21)/Section Chief 444702 0 0 0 44572 0 27660 0 24743 0 541677 0 0 0 Carl W Dobson MD Trustee/ Medical Director 0 395389 0 65000 0 19702 0 14500 0 44079 0 538670 0 0 Gary L Freed MD Trustee/ Physician 678773 0 100 0 63652 0 21860 0 3118 0 767503 0 0 0 Aaron J Mancuso MD Trustee / Physician 443611 0 0 0 10849 0 13116 0 42450 0 510026 0 0 0 Nancy M Dunbar MD Trustee (As of 1/1/22) / Physician 352687 0 0 0 31587 0 21860 0 44907 0 451041 0 0 0 Maria Padin MD Chief Medical Officer, CGP 468432 0 0 0 53578 0 27660 0 36467 0 586137 0 0 0 Richard I Rothstein MD Former Dept Chair/Srvc LN LDR - MED 612935 0 0 0 50063 0 27660 0 36857 0 727515 0 0 0 David Gladstone MD CHF CLNCL PHYSCN - RADIOLOGY 0 200050 0 0 0 32084 0 20060 0 16918 0 269112 0 0 Wendy Fielding Chief Financial Officer (as of 10/31/21) 0 286135 0 0 0 38230 0 22361 0 42834 0 389560 0 0 Aimee M Claiborne Chief Human Resource Officer 0 414416 0 40500 0 16673 0 21860 0 20407 0 513856 0 0 DANIEL P JANTZEN Chief Financial Officer (through 10/31/21) 0 799582 0 85000 0 136757 0 27660 0 35530 0 1084529 0 0 Patrick F Jordan III MBA Chief Operating Officer 0 693656 0 70100 0 45924 0 21860 0 40759 0 872299 0 0 JOHN KACAVAS Chief Legal Officer 0 589512 0 62100 0 118320 0 27660 0 41231 0 838823 0 0 Stephen Leblanc Chief Strategy Officer 662682 0 67100 0 83992 0 27660 0 32330 0 873764 0 0 0 EDWARD MERRENS Chief Clinical Officer 659793 0 67000 0 69566 0 27660 0 20587 0 844606 0 0 0 Susan A Reeves EDDRN Executive VP (medical center) 0 595393 0 60250 0 82940 0 27660 0 41293 0 807536 0 0 Matthew Haag Chief Development Officer 0 382093 0 38625 0 23959 0 0 0 18061 0 462738 0 0 GEORGE T BLIKE MD Former/ Chief Quality & Value Officer 222135 0 0 0 22900 0 20819 0 0 0 265854 0 0 0 Peter D Solberg MD Chief Health Information Officer 407250 0 0 0 39803 0 27660 0 44316 0 519029 0 0 0 Karen Clements RNBSNMSB Chief Nursing Officer 0 347266 0 350 0 30153 0 21860 0 15392 0 415021 0 0 Staci Hermann PHARMDMS CHIEF PHARMACY OFFICER 0 273428 0 0 0 26468 0 13116 0 17609 0 330621 0 0 Simon Hillier Dept Chair ANESTHESIOLOGY 551555 0 0 0 59178 0 27660 0 37136 0 675529 0 0 0 Jeffrey Obrien MHA Chief Operating Officer - DHMC 0 343830 0 0 0 41775 0 27660 0 40293 0 453558 0 0 Martin Purcell MBA Chief Information Officer 0 420844 0 0 0 70755 0 27660 0 3565 0 522824 0 0 David F Duncan System VP - Facilities Mgmt 0 291879 0 100 0 5390 0 17400 0 5403 0 320172 0 0 Jock Mccullough MD Physician 816184 0 0 0 94656 0 27660 0 41862 0 980362 0 0 0 Daniel Stewart MD Physician 1082444 0 0 0 107352 0 21860 0 44738 0 1256394 0 0 0 John Nigriny Physician 925942 0 0 0 91111 0 21860 0 44236 0 1083149 0 0 0 Timothy Ryken Physician 1014752 0 0 0 105169 0 27660 0 36112 0 1183693 0 0 0 Matthew LeBoeuf Physician 867758 0 0 0 57254 0 13116 0 44248 0 982376 0 0 0 Schedule J, Part I, Line 1a Discretionary spending account THE ORGANIZATION HAS IN PLACE A PLAN TO SUPPORT CONTINUING MEDICAL EDUCATION. THE PLAN PROVIDES FIXED DOLLAR LIMITS PER PROVIDER PER 2-YEAR PERIOD THAT CAN BE USED TO DEFRAY THE COSTS OF OBTAINING AND ATTENDING CONTINUING MEDICAL EDUCATION EVENTS AND RELATED TRAVEL. ADDITIONALLY, THESE MONIES CAN BE USED FOR PROFESSIONAL BOOKS, LICENSES, MEMBERSHIPS, AND RELATED EXPENSES. AMOUNTS MUST BE SUBMITTED FOR APPROVAL PRIOR TO REIMBURSEMENT. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Dartmouth Hitchcock Clinic (DHC) and Mary Hitchcock Memorial Hospital (MHMH) sponsor a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable DHC and MHMH to attract and retain quality executive personnel, improve the physicians' post-retirement life insurance benefits, and to replace an increasingly costly retiree life insurance program. The plan was frozen to new participants in 1998. The number of participants and dollar value continues to dwindle as individuals retire/leave the organization. THE FOLLOWING INDIVIDUALS HAVE A SPLIT DOLLAR LIFE PLAN ARRANGEMENT AND RESPECTIVE EMPLOYER PREMIUMS: DANIEL JANTZEN $139,653 STEPHEN LEBLANC $63,791 RICHARD ROTHSTEIN $109,016 Schedule J, Part I, Line 3 ESTABLISHING COMPENSATION CEO The process for determining compensation of the CEO is the responsibility of the Compensation Committee of Dartmouth Hitchcock Health (DHH). The compensation committee consists of the Chairperson of the Board and three or more members of the board who are elected by the board, acting upon the recommendation of the chairperson and are not employees of DHH, a related organization or a subsidiary organization of a related organization. The compensation committee determines the compensation of the CEO of DHC within ranges established by the board. Schedule J, Part II NOTE REGARDING COMPENSATION SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY DHC AND RELATED ORGANIZATIONS. THESE AMOUNTS ARE REPORTED TO EMPLOYEES ON THEIR ANNUAL W-2 FORMS AS COMPENSATION. COLUMNS C AND D REPRESENT ITEMS EARNED, HOWEVER, NOT PAID DIRECTLY TO THE EMPLOYEE AS CASH PAYMENTS DURING THE CALENDAR YEAR. COLUMN C INCLUDES RETIREMENT BENEFITS IN A CALENDAR YEAR. COLUMN D REPRESENTS NONTAXABLE BENEFITS SUCH AS THE COST OF HEALTHCARE COVERAGE PROVIDED BY D-H ON BEHALF OF ITS EMPLOYEES. Stephen Leblanc Officer Split Dollar Life X 0 63791 false true true Richard Rothstein Former Officer Split Dollar Life X 0 109016 false true true 172807 Amy Stansfield Family member of Trustee 192311 Employment Compensation false Patrick J O'Brien Family member of Trustee 72564 Employment compensation false James Ebert Family member of a former officer 58000 Employment compensation false Samuel L Brown Family member of former officer 12540 Employment Compensation false Form 990, Part VI, Line 1a Delegate broad authority to a committee The DARTMOUTH-HITCHCOCK CLINIC (DHC) board has a Governance Committee who has the authority/responsibility of the DHC Board to ensure that DHC continues to fulfill its central mission and vision. This committee has authority to act on behalf of the full Board when the need arises. The chairs of the following committees and the CEO serve on the governance committee: Board committee, Talent Development and Compensation Committee, Research and Education Committee, Finance Committee, and Value Committee. Form 990, Part VI, Line 6 Classes of members or stockholders DARTMOUTH-HITCHCOCK HEALTH (D-HH) IS THE SOLE CORPORATE MEMBER OF DARTMOUTH-HITCHCOCK CLINIC (DHC). D- HH HAS SPECIFIC AUTHORITY AND RESERVED POWERS, INCLUDING THE POWER TO CONFIRM THE ELECTION OF MEMBERS OF DHC'S BOARD OF TRUSTEES AND THE POWER TO APPROVE SIGNIFICANT GOVERNANCE, FINANCIAL AND OPERATIONAL DECISIONS OF DHC'S TRUSTEES. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body DARTMOUTH-HITCHCOCK HEALTH (D-HH) IS THE SOLE CORPORATE MEMBER OF DARTMOUTH-HITCHCOCK CLINIC (DHC). D-HH HAS SPECIFIC AUTHORITY AND RESERVED POWERS, INCLUDING THE POWER TO CONFIRM THE ELECTION OF MEMBERS OF DHC'S BOARD OF TRUSTEES AND THE POWER TO APPROVE SIGNIFICANT GOVERNANCE, FINANCIAL AND OPERATIONAL DECISIONS OF DHC'S TRUSTEES. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders IN ADDITION TO RESERVED POWERS, DARTMOUTH-HITCHCOCK HEALTH (D-HH) SHALL HAVE THE AUTHORITY TO TAKE ACTIONS TO ESTABLISH, MANAGE, AND GOVERN THE SYSTEM AS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM IN FURTHERANCE OF DHC'S MISSION. THESE POWERS INCLUDE BUT ARE NOT LIMITED TO ITEMS SUCH AS THE ABILITY TO APPROVE, DISAPPROVE, OR MODIFY ALL MATERIAL GOVERNANCE, PROGRAMMATIC, AND FINANCIAL DECISIONS OF DHC'S BOARD OF TRUSTEES, TO APPOINT OR REMOVE A MEMBER OF DHC'S BOARD OF TRUSTEES, ASSESS DHC A MONETARY AMOUNT FOR THE PAYMENT OF THE EXPENSES OF D-HH, APPROVE DHC'S BUDGET, APPROVE THE BORROWINGS OR DISPOSITIONS OF ASSETS BY DHC, APPROVE KEY STRATEGIC RELATIONSHIPS, APPROVE THE ELIMINATION OR ADDITION OF ANY MATERIAL HEALTH CARE SERVICE OR PROGRAM, AND OTHER AUTHORITY TO TAKE ACTION ON BEHALF OF DHC. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORMS 990 AND 990-T ARE REVIEWED BY THE DIRECTOR OF FINANCIAL COMPLIANCE, VICE PRESIDENT OF CORPORATE FINANCE, AND THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURN. ONCE THE RETURN HAS BEEN FULLY PREPARED, A FINAL 990 AND 990-T IS SENT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS AND RESPONSES PRIOR TO OFFICIAL FILING OF THE FORMS. Form 990, Part VI, Line 12c Conflict of interest policy THE DARTMOUTH-HITCHCOCK CLINIC (DHC) BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. DARTMOUTH-HITCHCOCK HEALTH'S COMPLIANCE AND AUDIT SERVICES DEPARTMENT CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS, TRUSTEES, AND KEY EMPLOYEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL INVOLVED MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION-MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE COMPENSATION FOR THE CEO IS EVALUATED BY AN INDEPENDENT THIRD PARTY FIRM FOR REASONABLENESS AND NATIONAL DATA BENCHMARKING. THE TALENT DEVELOPMENT AND COMPENSATION COMMITTEE, ALONG WITH INDEPENDENT TRUSTEES, APPROVE THE FINAL COMPENSATION IN CONSULTATION WITH THE INDEPENDENT THIRD PARTY FIRM'S RECOMMENDATIONS AND SUGGESTIONS. THIS PROCESS WAS CONTEMPORANEOUSLY DOCUMENTED AND LAST UNDERTAKEN IN 2022. Form 990, Part VI, Line 15b Process to establish compensation of other employees COMPENSATION FOR OFFICERS AND KEY EMPLOYEES ARE EVALUATED BY INTERNAL HUMAN RESOURCES STAFF USING NATIONAL BENCHMARKING DATA, ALONG WITH ONGOING EVALUATIONS BY AN INDEPENDENT THIRD PARTY FIRM FOR REASONABLENESS, WITH THE LAST FORMAL PROCESS IN 2022. THIS PROCESS WAS CONTEMPORANEOUSLY DOCUMENTED. EXTERNAL BENCHMARKING FROM AN INDEPENDENT THIRD PARTY HAS BEEN USED FOR ANY OFFICER WHO WAS HIRED OR RECEIVED A COMPENSATION ADJUSTMENT SINCE THE LAST FORMAL PROCESS. COMPENSATION RATES ARE DETERMINED BY FOLLOWING THE GUIDELINES OF THE COMPENSATION COMMITTEE CHARTER AND PHILOSOPHY DOCUMENTS AND A FORMAL REVIEW BY COMPENSATION COMMITTEE MEMBERS. THE PROCESS DESCRIBED ABOVE TO ESTABLISH COMPENSATION WAS USED FOR THE FOLLOWING POSITIONS: Chief Financial Officer, Chief Strategy Officer, Chief Clinical Officer, Chief Legal Officer, Chief Human Resources Officer, Chief Operating Officer, Chief Nursing - Executive, Chief Nursing Officer, Chief Pharmacy Officer, Chief Quality & Value Officer, Department Chair - Anesthesia, Department Chair - Pathology, and similar positions. Form 990, Part VI, Line 19 Required documents available to the public DHC'S GOVERNING DOCUMENTS ARE AVAILABLE THROUGH THE NEW HAMPSHIRE SECRETARY OF STATE. CERTAIN FINANCIAL INFORMATION IS DISCLOSED THROUGH THE COMMUNITY BENEFITS ANNUAL REPORT. THE AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST EITHER IN ELECTRONIC OR HARD COPY FORM. Form 990, Part VII, Section A, Line 1a, Column (B) AVERAGE HOURS PER WEEK AS PART OF DARTMOUTH-HITCHCOCK CLINIC'S (DHC) AND MARY HITCHCOCK MEMORIAL HOSPITAL'S (MHMH) AFFILIATION AGREEMENT, THE TWO ORGANIZATIONS SHARE OFFICERS. AS SUCH, THE AVERAGE HOURS PER WEEK ARE ALLOCATED BETWEEN THE TWO ORGANIZATIONS ON THEIR FORM 990'S EVEN THOUGH COMPENSATION REPORTED IN PART VII IS BASED ON THE ENTITY ISSUING THE W-2. IN ADDITION, CERTAIN OFFICERS SPEND TIME ON DARTMOUTH-HITCHCOCK HEALTH (D-HH), THE SOLE CORPORATE MEMBER OF BOTH MHMH AND DHC, ALONG WITH TWO SUPPORTING ORGANIZATIONS: DARTMOUTH-HITCHCOCK MEDICAL CENTER (DHMC) AND HAMDEN RISK RETENTION GROUP (HAMDEN). CERTAIN OFFICERS ALSO SPEND TIME ON RELATED ENTITIES, INCLUDING ALICE PECK DAY MEMORIAL HOSPITAL (APD), WINDSOR HOSPITAL CORPORATION (DBA MOUNT ASCUTNEY HOSPITAL AND HEALTH CENTER) (MAHHC), MOUNT ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION, HISTORIC HOMES OF RUNNEMEDE, CHESHIRE MEDICAL CENTER (CHESHIRE), CHESHIRE HEALTH FOUNDATION, CHESHIRE HEALTH SERVICES, THE NEW LONDON HOSPITAL ASSOCIATION (NLH), VISITING NURSE ASSOCIATION & HOSPICE OF VT AND NH (VNA), AND THE HITCHCOCK FOUNDATION (THF). Form 990, Part VII, Section B, Line 1 INDEPENDENT CONTRACTORS DARTMOUTH-HITCHCOCK CLINIC (DHC) IS PART OF THE DARTMOUTH-HITCHCOCK HEALTH (D-HH) SYSTEM, WHICH INCLUDES DHC, MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH), AND ITS SUBSIDIARIES. MHMH RECEIVED AUTHORITY FROM THE INTERNAL REVENUE SERVICE TO ACT AS DHC'S PAY AGENT AND IMPLEMENTED THIS PROCESS AT THE BEGINNING OF FISCAL YEAR 2010. ALL EXPENSES ARE PAID DIRECTLY BY MHMH AND REIMBURSED BY DHC. MHMH MANAGES ALL REQUIRED IRS REPORTING RELATED TO THESE DISBURSEMENTS. Form 990, Part IX, Column (A) STATEMENT OF FUNCTIONAL EXPENSES MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) AND DARTMOUTH-HITCHCOCK CLINIC (DHC) OPERATE UNDER AN AFFILIATION AGREEMENT AS DIRECTED BY DARTMOUTH-HITCHCOCK HEALTH (D-HH), THE SOLE CORPORATE MEMBER OF BOTH ENTITIES. DUE TO THE INTEGRATED OPERATING STRUCTURE, RELATED MISSION, AND CLOSE RELATIONSHIP OF DHC AND MHMH, EXPENSES ARE SHARED BETWEEN THE TWO ENTITIES. ALL EXPENSES REPORTED WITHIN THIS FORM 990 ARE DHC'S SHARE OF EXPENSES AS DESIGNATED BY THE AFFILIATION AGREEMENT. Form 990, Part XI, Line 9 Other changes in net assets or fund balances NET ASSET RELEASED FROM RESTRICTED - -17834427; RENAISSANCE PSYCHIATRY OF NEW ENGLAND ONE MEDICAL CENTER DRIVE LEBANON NH 03756 813076466 PSYCHIATRY SERVICES NH -183866 710570 Dartmouth-Hitchcock Clinic MARY HITCHCOCK MEMORIAL HOSPITAL ONE MEDICAL CENTER DRIVE LEBANON NH 03756 020222140 HOSPITAL NH 501(c)(3) 3 D-HH false HITCHCOCK FOUNDATION ONE MEDICAL CENTER DRIVE LEBANON NH 03756 020222139 HeaLTH CaRE ReSeaRCH NH 501(c)(3) 7 DHC true HAMDEN ASSURANCE RISK RETENTION GROUP INC 30 MAIN STREET STE 330 BURLINGTON VT 05401 208530788 SELF INSURANCE VT 501(c)(3) Type I DHC true DARTMOUTH-HITCHCOCK HEALTH ONE MEDICAL CENTER DRIVE LEBANON NH 03756 264812335 PARENT ORGANIZATION NH 501(c)(3) 7 NA false THE NEW LONDON HOSPITAL ASSOCIATION INC 273 COUNTY ROAD NEW LONDON NH 03257 020222171 HOSPITAL NH 501(c)(3) 3 D-HH false WINDSOR HOSPITAL CORPORATION 289 COUNTY ROAD WINDSOR VT 05089 030183721 HOSPITAL VT 501(c)(3) 3 D-HH false CHESHIRE MEDICAL CENTER 580 COURT STREET KEENE NH 03431 020354549 HOSPITAL NH 501(c)(3) 3 D-HH false ALICE PECK DAY MEMORIAL HOSPITAL 10 ALICE PECK DAY DRIVE LEBANON NH 03766 020222791 HOSPITAL NH 501(c)(3) 3 D-HH false Visiting Nurse Association AND HOSPICE OF VERMONT AND NEW HAMPSHIRE INC 88 Prospect Street White River Junction VT 05001 036006494 HOSPICE VT 501(c)(3) 10 D-HH false POMPANOOSUC INVESTMENT CORPORATION ONE MEDICAL CENTER DRIVE LEBANON NH 03756 020352330 REAL ESTATE HOLDING NH Dartmouth-Hitchcock Clinic C Corporation -128 75632 1 true HAMDEN ASSURANCE CO LTD 980121409 LIABILITY INSURANCE BD Dartmouth-Hitchcock Clinic C Corporation 0 48845301 0.702 true false true true false true false false false false true true true true true true true true true true Hitchcock Foundation O 390934 FMV HAMDEN ASSURANCE RISK RETENTION GROUP INC M 8272252 FMV Hitchcock Foundation B 236380 FMV