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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Scott Toothaker</PersonNm>
        <TitleTxt>Director</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Stephanie Wolf-Rosenblum MD</PersonNm>
        <TitleTxt>Director (end 6/2024)</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Scott Flegal</PersonNm>
        <TitleTxt>Past Chair</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tim Lafferty</PersonNm>
        <TitleTxt>Chair</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jeanine Kilgallen</PersonNm>
        <TitleTxt>Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Elizabeth Cote</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kathie McIntyre</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Brad Kreick</PersonNm>
        <TitleTxt>CEO of SolutionHealth</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>49.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>1269289</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>197518</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Michael S Turilli</PersonNm>
        <TitleTxt>CFO of SolutionHealth</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>43.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>597609</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>110268</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Patricia Green</PersonNm>
        <TitleTxt>Physical Therapist</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromOrgAmt>128580</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27557</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Anica Naprta MD</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
        <AverageHoursPerWeekRt>36.10</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7052</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Heather Ogbunamiri RN CHPN</PersonNm>
        <TitleTxt>Clinical Manager</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Anita Andrade RN BSN</PersonNm>
        <TitleTxt>Director of Philanthropy</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>4301</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Angela Colford</PersonNm>
        <TitleTxt>Physical Therapist</TitleTxt>
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        <OtherCompensationAmt>17621</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John Getts</PersonNm>
        <TitleTxt>Former CEO/President</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18131</OtherCompensationAmt>
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      <TotalReportableCompFromOrgAmt>1097098</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>1866898</TotReportableCompRltdOrgAmt>
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      <IndivRcvdGreaterThan100KCnt>31</IndivRcvdGreaterThan100KCnt>
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      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SolutionHealth</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1070 Holt Avenue Unit 1 2100</AddressLine1Txt>
            <CityNm>Manchester</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>03109</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Administrative services</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Elliot Hospital</BusinessNameLine1Txt>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1070 Holt Avenue Unit 1 2100</AddressLine1Txt>
            <CityNm>Manchester</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>03109</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Administrative services</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Home Care Specialists Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 8237</AddressLine1Txt>
            <CityNm>Haverhill</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01835</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Home care solutions</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ProCare RX</BusinessNameLine1Txt>
          </BusinessName>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1267 Professional Parkway</AddressLine1Txt>
            <CityNm>Gainesville</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>30507</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Cardinal Health at Home</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1810 Summit Commerce Park</AddressLine1Txt>
            <CityNm>Twinburg</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44087</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <RelatedOrganizationsAmt>180373</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>77770</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>2154630</AllOtherContributionsAmt>
      <NoncashContributionsAmt>55721</NoncashContributionsAmt>
      <TotalContributionsAmt>2840354</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient and Service Revenue</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>21055020</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>21055020</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Other Program Revenue</Desc>
        <BusinessCd>621810</BusinessCd>
        <TotalRevenueColumnAmt>76111</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>76111</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>21131131</TotalProgramServiceRevenueAmt>
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        <TotalRevenueColumnAmt>176630</TotalRevenueColumnAmt>
        <ExclusionAmt>176630</ExclusionAmt>
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      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>344094</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>84635</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>259459</SecuritiesAmt>
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      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>259459</TotalRevenueColumnAmt>
        <ExclusionAmt>259459</ExclusionAmt>
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      <FundraisingGrossIncomeAmt>76623</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>427581</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>132279</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-55656</TotalRevenueColumnAmt>
        <ExclusionAmt>-55656</ExclusionAmt>
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      <GamingGrossIncomeAmt>128065</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>12864</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
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        <ExclusionAmt>115201</ExclusionAmt>
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        <RelatedOrExemptFuncIncomeAmt>21131131</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>495634</ExclusionAmt>
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      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>172064</ProgramServicesAmt>
        <ManagementAndGeneralAmt>69670</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>10842421</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4390184</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>498589</ProgramServicesAmt>
        <ManagementAndGeneralAmt>201883</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1450066</ProgramServicesAmt>
        <ManagementAndGeneralAmt>587142</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>818686</ProgramServicesAmt>
        <ManagementAndGeneralAmt>331493</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>1321388</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
        <TotalAmt>24400</TotalAmt>
        <ManagementAndGeneralAmt>24400</ManagementAndGeneralAmt>
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      <FeesForServicesLobbyingGrp>
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        <ManagementAndGeneralAmt>4218</ManagementAndGeneralAmt>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>36685</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
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        <ProgramServicesAmt>206790</ProgramServicesAmt>
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        <ProgramServicesAmt>32865</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27301</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>201579</ProgramServicesAmt>
        <ManagementAndGeneralAmt>163224</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>116550</ProgramServicesAmt>
        <ManagementAndGeneralAmt>96816</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>204345</ProgramServicesAmt>
        <ManagementAndGeneralAmt>169745</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>199414</ProgramServicesAmt>
        <ManagementAndGeneralAmt>165649</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>23083</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19174</ManagementAndGeneralAmt>
        <FundraisingAmt>14625</FundraisingAmt>
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        <ProgramServicesAmt>352385</ProgramServicesAmt>
        <ManagementAndGeneralAmt>142684</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>58010</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48188</ManagementAndGeneralAmt>
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        <Desc>Program/med supplies</Desc>
        <TotalAmt>1159448</TotalAmt>
        <ProgramServicesAmt>1159448</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>Provision for bad debts</Desc>
        <TotalAmt>58501</TotalAmt>
        <ProgramServicesAmt>58501</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>16394796</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7971620</ManagementAndGeneralAmt>
        <FundraisingAmt>14625</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>5423028</BOYAmt>
        <EOYAmt>4193036</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>408535</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>2827742</BOYAmt>
        <EOYAmt>3122560</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>115101</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>11045967</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4793160</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>5305602</BOYAmt>
        <EOYAmt>6252807</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
        <BOYAmt>11900023</BOYAmt>
        <EOYAmt>13898023</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>85302</BOYAmt>
        <EOYAmt>65391</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>26559603</BOYAmt>
        <EOYAmt>28055453</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1894306</BOYAmt>
        <EOYAmt>2034852</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>6500</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>85302</BOYAmt>
        <EOYAmt>65391</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>2011235</BOYAmt>
        <EOYAmt>2106743</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>17793364</BOYAmt>
        <EOYAmt>20727527</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>6755004</BOYAmt>
        <EOYAmt>5221183</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>24548368</BOYAmt>
        <EOYAmt>25948710</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>26559603</BOYAmt>
        <EOYAmt>28055453</EOYAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
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      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
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      <TotalLobbyingExpendituresAmt>4218</TotalLobbyingExpendituresAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II-B, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization was a member of the Home Care Hospice &amp; Palliative Care Alliance of New Hampshire (HCHPCA) during the year covered by this Form 990. A portion of the dues paid to HCHPCA was available for lobbying expenditures on behalf of the Organization and its fellow members and in furtherance of their mission purposes. The portion of dues paid to HCHPCA by the Organization during this tax year that was available for lobbying was $4,218.</ExplanationTxt>
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        <EndYearBalanceAmt>3757282</EndYearBalanceAmt>
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        <AdministrativeExpensesAmt>18781</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>4257054</EndYearBalanceAmt>
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        <OtherExpendituresAmt>142241</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>20922</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3319042</EndYearBalanceAmt>
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      <LandGrp>
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        <BookValueAmt>707414</BookValueAmt>
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      <BuildingsGrp>
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        <DepreciationAmt>3654098</DepreciationAmt>
        <BookValueAmt>4227568</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
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        <DepreciationAmt>1139062</DepreciationAmt>
        <BookValueAmt>1317825</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>6252807</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred Compensation Plan Liabilities</Desc>
        <Amt>65391</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>65391</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>25828790</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>1314264</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>142593</OtherRevenueAmt>
      <RevenueNotReportedAmt>1456857</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>24371933</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>36685</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>58501</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>95186</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>24467119</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>24428448</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>142593</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>142593</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>24285855</ExpensesSubtotalAmt>
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      <OtherExpensesNotIncludedAmt>58501</OtherExpensesNotIncludedAmt>
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      <TotalExpensesPerForm990Amt>24381041</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Home Health and Hospice Care ("HHHC") is committed to prudent, fiscally responsible investment strategies and spending policies. The Association has adopted investment and spending policies for endowment assets that attempt to provide a predictable stream of funding to programs supported by its endowment while seeking to maintain the purchasing power of the endowment assets. The majority of the Organization's deemed endowment funds are board designated for the purpose of generating income to support ongoing operations. Restricted net assets are reserved for a variety of programmatic functions, including the provision of care services and capital improvements. Under this policy, as approved by the Board the endowment assets are invested in a manner that is intended to produce results that meet or exceed designated benchmarks while incurring a reasonable and prudent level of investment risk. The growth and success of the funds is due not only to the generosity of thousands of patrons, but also to the careful stewardship provided by knowledgeable and dedicated directors who have invested these funds wisely. Careful management of the assets ensures a total return necessary to preserve and enhance the real-dollar principal of the funds, while providing a dependable source of income for the Agency's current operations and programs. The investment policy has been designed as a guide to a disciplined process that seeks to add value and minimize risk for those who participate in, or benefit from, these investments.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The System and all related entities, with the exception of Elliot Health System Holdings, Inc. and Subsidiaries, are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code.Management evaluated the System's tax positions and concluded the System has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to the consolidated financial statements. Elliot Health System Holdings, Inc. is a holding company and its subsidiaries are for-profit companies subject to federal and state taxation. Income taxes are recorded based upon the asset and liability method.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Fundraising event expenses 132,279. Charitable gaming expenses 10,314.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Provision for bad debts 58,501.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Fundraising event expenses 132,279. Charitable gaming expenses 10,314.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Provision for bad debts 58,501.</ExplanationTxt>
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    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041300001">
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        <Event1Nm>Champagne Luncheon</Event1Nm>
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        <CharitableContriEvent1Amt>199555</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>42513</GrossRevenueEvent1Amt>
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        <FoodAndBeverageEvent1Amt>77</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>1800</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>14582</OtherDirectExpensesEvent1Amt>
        <Event2Nm>Golf Tournament</Event2Nm>
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        <CharitableContriEvent2Amt>128816</CharitableContriEvent2Amt>
        <GrossRevenueEvent2Amt>18610</GrossRevenueEvent2Amt>
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        <RentFacilityCostsEvent2Amt>40520</RentFacilityCostsEvent2Amt>
        <FoodAndBeverageEvent2Amt>334</FoodAndBeverageEvent2Amt>
        <EntertainmentEvent2Amt>0</EntertainmentEvent2Amt>
        <OtherDirectExpensesEvent2Amt>3219</OtherDirectExpensesEvent2Amt>
        <OtherEventsTotalCnt>1</OtherEventsTotalCnt>
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        <CharitableContriOtherEventsAmt>99210</CharitableContriOtherEventsAmt>
        <GrossRevenueOtherEventsAmt>15500</GrossRevenueOtherEventsAmt>
        <RentFcltyCostsOtherEventsAmt>9145</RentFcltyCostsOtherEventsAmt>
        <OthDirectExpnssOtherEventsAmt>6439</OthDirectExpnssOtherEventsAmt>
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        <EntertainmentTotalEventsAmt>1800</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>24240</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>132279</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-55656</NetIncomeSummaryAmt>
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        <RentFacilityCostsPullTabsAmt>2500</RentFacilityCostsPullTabsAmt>
        <OtherDirectExpensesPullTabsAmt>50</OtherDirectExpensesPullTabsAmt>
        <VolunteerLaborPullTabsInd>0</VolunteerLaborPullTabsInd>
        <VolunteerLaborPullTabsPct>0.00000</VolunteerLaborPullTabsPct>
        <GrossRevenueOtherGamingAmt>18950</GrossRevenueOtherGamingAmt>
        <CashPrizesOtherGamingAmt>10000</CashPrizesOtherGamingAmt>
        <OthDirectExpnssOtherGamingAmt>314</OthDirectExpnssOtherGamingAmt>
        <VolunteerLaborOtherGamingInd>1</VolunteerLaborOtherGamingInd>
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        <OthDirectExpnssTotalGamingAmt>364</OthDirectExpnssTotalGamingAmt>
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        <NetGamingIncomeSummaryAmt>115201</NetGamingIncomeSummaryAmt>
      </GamingInformationGrp>
      <StatesWhereGamingConductedCd>NH</StatesWhereGamingConductedCd>
      <LicensedInd>1</LicensedInd>
      <LicenseSuspendedEtcInd>0</LicenseSuspendedEtcInd>
      <GamingWithNonmembersInd>1</GamingWithNonmembersInd>
      <MemberOfOtherEntityInd>0</MemberOfOtherEntityInd>
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      <IndividualWithBooksNm>Tina Andrade Director of Developme</IndividualWithBooksNm>
      <PersonsWithBooksUSAddress>
        <AddressLine1Txt>7 Executive Park Drive</AddressLine1Txt>
        <CityNm>Nashua</CityNm>
        <StateAbbreviationCd>NH</StateAbbreviationCd>
        <ZIPCd>03054</ZIPCd>
      </PersonsWithBooksUSAddress>
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      <GamingRevenueRtnBy3PrtyAmt>2500</GamingRevenueRtnBy3PrtyAmt>
      <ThirdPartyBusinessName>
        <BusinessNameLine1Txt>Gates City Casino</BusinessNameLine1Txt>
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        <AddressLine1Txt>55 Northeastern Boulevard</AddressLine1Txt>
        <CityNm>Nashua</CityNm>
        <StateAbbreviationCd>NH</StateAbbreviationCd>
        <ZIPCd>03062</ZIPCd>
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        <BusinessNameLine1Txt>Gates City Casino</BusinessNameLine1Txt>
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      <GamingManagerServicesProvTxt>See supplemental information.</GamingManagerServicesProvTxt>
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        <FormAndLineReferenceDesc>Form 990, Schedule G, Part III, Gaming:</FormAndLineReferenceDesc>
        <ExplanationTxt>Home Health and Hospice Care ("HHHC") is reporting gaming activity income on this Form 990, Schedule G, from two distinct activities with different disclosure requirements. Under New Hampshire Law RSA 287-D, NH-based institutions may conduct gaming, casino, and gambling activities within New Hampshire State borders if a portion of income from such activity is redistributed to qualified and registered charitable institutions. During the year ending June 30, 2024, and in accordance with RSA 287-D, HHHC filed an application with the NH Gaming Regulatory Oversight Authority and the applicable filing fee to be eligible to receive a percentage of registered gaming income over a 10-day period. HHHC then contracted with Gates City Casino (the "Casino") to engage in such an arrangement. The Casino generated gross revenue during this period of $109,115, of which $106,565 was retained by the Organization. HHHC did not oversee, manage, coordinate, or participate in any of the Casino's gaming operations. HHHC employees and management were also not required to be physical present at the gaming facilities. Aside from registering with the applicable State Departments and complying with RSA 287-D, HHHC had very minimal interaction in this activity. Accordingly, the Casino would meet the definition of a third-party engaged gaming manager, as required to be reported on this Form 990, Schedule G, Part III. Additionally, and independent of the aforementioned Casino activity, HHHC held charitable raffles during the year ending June 30, 2024, as part of its fundraising events. The raffles were conducted entirely by volunteers of HHHC, subject to the oversight of HHHC fundraising coordinators and staff, and the drawings were held at HHHC's Merrimack, NH offices. HHHC obtained all applicable municipal permits and licenses to conduct these raffles in accordance with NH State gaming laws. HHHC does not designate any specific staff to oversee such gaming activities; furthermore, as the raffles represent such a small portion of HHHC's operations, the allocation of employee time to these activities is so minimal that it is administratively impractical to do so. Tina Andrade is HHHC's Director of Development, and has been deemed the most appropriate person to disclose as preparing the Organization's gaming books and records.</ExplanationTxt>
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        <TitleTxt>CEO of SolutionHealth</TitleTxt>
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        <PersonNm>Michael S Turilli</PersonNm>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <PersonNm>Anica Naprta MD</PersonNm>
        <TitleTxt>Medical Director</TitleTxt>
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        <TotalCompensationFilingOrgAmt>277528</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Barbara Lafrance</PersonNm>
        <TitleTxt>CEO/President</TitleTxt>
        <BaseCompensationFilingOrgAmt>177670</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>21500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>22818</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3967</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15779</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>241734</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Patricia Green</PersonNm>
        <TitleTxt>Physical Therapist</TitleTxt>
        <BaseCompensationFilingOrgAmt>127684</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>525</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>371</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>156137</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>John Getts</PersonNm>
        <TitleTxt>Former CEO/President</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>121184</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation for the Organization's President &amp; CEO was evaluated and established by the officers of the board of directors, based on guidance from an outside compensation consultant and market survey data. Additinoally, The SolutionHealth CEO, the Chief Executive of HHHC's parent-organization and sole corporate member, shall manage the development of any proposal to adopt or modify the compensation or benefit programs of HHHC, with the assistance of the HHHC President/CEO and in consultation with the HHHC Executive Committee. Any action to approve such an adoption or modification of compensation or benefit plans must be initiated by a recommendation by the SolutionHealth CEO to the SolutionHealth Board and shall be authorized solely by a majority vote of the SolutionHealth Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Elliot Health System and SolutionHealth, the parent-organization of the System, maintain 457(f) deferred compensation plans. The following individuals, each of whom qualify as either an officer, director, trustee, key employee, or highest compensated employee on this Form 990, Part VII, received contributions to their 457(f) deferred compensation plans during the 2023 calendar year as follows: - Michael Turilli: $80,692 - Brad Kreick: $195,181 These amounts have been reported within the named individuals' deferred compensation figures as shown on this Schedule J, Part II, Column C. The System historically maintained a defined benefit pension plan for certain employees, the Elliot Health System Pension Plan (the Plan). Effective July 1, 2006, the Plan was amended to close the Plan to employees hired after June 30, 2006. Eligible employees hired prior to July 1, 2006 are grandfathered under the Plan and will continue to accrue benefits as long as they remain at a participating System entity and in an eligible status. The System's funding policy is to contribute amounts to the Plan sufficient to meet minimum funding requirements set forth in the Employee Retirement Income Security Act of 1974, plus such additional amounts as might be determined to be appropriate from time to time. The Plan is intended to constitute a plan described in Section 414(k) of the Internal Revenue Code, under which benefits derived from employer contributions are based on the separate account balances of participants in addition to the defined benefits under the Plan. In calendar year 2023, no officers or other employees of Elliot Hospital received defined contributions under the now-closed 414(K) plan. Additionally, there were no defined benefit accrual adjustments for any of the Organization's listed individuals for the 2023 calendar year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>At risk compensation, which is subject to review and paid annually. It is based on several predefined metrics.</ExplanationTxt>
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    </IRS990ScheduleJ>
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        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>5</ContributionCnt>
        <NoncashContributionsRptF990Amt>5658</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Value per books</MethodOfDeterminingRevenuesTxt>
      </WorksOfArtGrp>
      <ClothingAndHouseholdGoodsGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <NoncashContributionsRptF990Amt>9241</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Value per books</MethodOfDeterminingRevenuesTxt>
      </ClothingAndHouseholdGoodsGrp>
      <FoodInventoryGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>7</ContributionCnt>
        <NoncashContributionsRptF990Amt>17005</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Value per books</MethodOfDeterminingRevenuesTxt>
      </FoodInventoryGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>Plants</Desc>
        <ContributionCnt>5</ContributionCnt>
        <NoncashContributionsRptF990Amt>18279</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Value per books</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>Jewelry</Desc>
        <ContributionCnt>7</ContributionCnt>
        <NoncashContributionsRptF990Amt>5538</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Value per books</MethodOfDeterminingRevenuesTxt>
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      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>1</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>1</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 32b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization maintains relationships with investment brokerages and wealth advisors to assist in the processing, management, and disposal of any received donations of financial securities. Gifts of tangible non-cash property and assets are either incorporated into the Organization's programs and functions, or, in the case of fundraising gifts-in-kind, put up for auction or utilized as a part of charitable events to generate funding for the Organization's exempt purposes.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The sole member of the Organization shall be SolutionHealth, a New Hampshire voluntary corporation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>SolutionHealth is the sole member and parent of Home Health and Hospice Care ("HHHC"). Accordingly, SolutionHealth has the ability to influence and exercise the following powers over HHHC's governing body: - Any action to elect an HHHC Director shall be initiated by the HHHC Board through nominating a candidate to fill the vacancy and shall be authorized by a majority vote of each the HHHC Board and the SolutionHealth Board. - Any action to remove an HHHC Director may be initiated by either the HHHC Board or the SolutionHealth Board and shall be authorized by a majority vote of each of the HHHC Board and the SolutionHealth Board. - SolutionHealth's Chief Executive Officer ("CEO") shall manage the process of recruiting and presenting candidates for President/CEO of HHHC in consultation with the HHHC Board. Any action to appoint the HHHC President/CEO shall be authorized by a majority vote of each of the HHHC Board and the SolutionHealth Board. - SolutionHealth's CEO shall consult with, and conduct a due diligence performance review with, the HHHC Board to determine whether there is a basis to recommend removal of the HHHC President/CEO. Any action to remove the HHHC President/CEO must be initiated by a recommendation of the SolutionHealth CEO and shall be authorized by a majority vote of each of the HHHC Board and the SolutionHealth Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>SolutionHealth is the sole member and parent of Home Health and Hospice Care ("HHHC"). Accordingly, SolutionHealth has the ability to influence and exercise the following powers over HHHC's governing body: - Any action to amend the HHHC Articles of Agreement or its Bylaws may be initiated by action of either the HHHC Board or SolutionHealth Board and shall be authorized by a two-thirds vote of each the HHHC Board and the SolutionHealth Board. - Any action to effect a legal dissolution of HHHC as a corporate entity, or any action to form or to dissolve an affiliate of HHHC, shall be initiated by a proposal of either the HHHC Board or the SolutionHealth Board, and shall be authorized by a two-thirds (2/3) vote of each of the HHHC Board and the SolutionHealth Board. - The SolutionHealth Board shall have sole authority to propose that HHHC merge, acquire, consolidate or affiliate with another hospital, health system, or other like professional entity. - Any action to create, incur or assume any indebtedness for money or any lien by HHHC that exceeds $100,000.00 in the aggregate per year shall be proposed only by the SolutionHealth Board, and such action shall be authorized by a majority vote of each of the HHHC Board and the SolutionHealth Board. - Any action to purchase, sell, lease or transfer assets of HHHC in excess of $100,000.00 in the aggregate in any year shall be proposed only by the SolutionHealth Board, and such action shall be authorized by a majority vote of each of the HHHC Board and the SolutionHealth Board - The SolutionHealth CEO shall, with the assistance of the HHHC President/CEO, manage the development of HHHC's annual operating and capital budgets in consultation with the HHHC Board. - The SolutionHealth CEO shall, with the assistance of the HHHC President/CEO and in consultation with the HHHC Board, manage the development of any proposal to deviate from HHHC's annual operating or capital budget whenever the proposed deviation is greater than five percent (5%). - The SolutionHealth CEO shall manage the development of any proposal to adopt or modify the compensation or benefit programs of HHHC, with the assistance of the HHHC President/CEO and in consultation with the HHHC Executive Committee. - The SolutionHealth CEO shall manage the development of any information technology programs or systems with the assistance of the HHHC President/CEO. - The SolutionHealth CEO shall manage the development of the financial accounting systems of HHHC, and the engagement of HHHC's independent financial auditors, with the assistance of the HHHC President/CEO. - The HHHC President/CEO shall manage clinical/health care service program development and delivery by HHHC. Any action to add, eliminate, or materially modify a HHHC clinical/health care service program shall be authorized by a majority vote of each of the HHHC Board and the SolutionHealth Board. - The SolutionHealth CEO shall manage the development and implementation of the HHHC financial and investment management policies with the assistance of the HHHC President/CEO. - Any action taken by the HHHC Executive Committee involving the exercise of the powers of the Board of Directors shall be reported promptly to the Board, and ratified at the next meeting of the Board of Directors following such action subject to the above powers of SolutionHealth. - The Finance Committee shall have general surveillance over the finances of the Corporation subject to the above powers of SolutionHealth; and the Finance Committee shall review all financial policies annually and make recommendations for changes to these policies, as necessary, subject to the above powers of SolutionHealth.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is provided to all board members for review and comment. This review is performed prior to the filing of the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Home Health and Hospice Care (the "Corporation") shall adopt, implement, enforce and regularly review Policies and Procedures governing conflicts of interest and pecuniary benefits transactions. The Policy and Procedures shall, at a minimum, meet the requirements of New Hampshire law as then in effect, and comply with Guidelines established by the Office of the NH Attorney General, Charitable Trust Unit. Each Director, Officer or Committee member shall have an affirmative duty to disclose to the Corporation each transaction with the Corporation that would be a Pecuniary Benefit Transaction (as defined by RSA 7:19-a) as to that Officer, Director or committee member, and shall be prohibited from participation in the discussion or voting on the transaction. Transactions that provide a direct or indirect pecuniary benefit to any Officer, Director, and the Corporation or any member of his or her immediate family; his or her employer; or, any person or organization of which he or she is a Proprietor, Partner, Officer, Director, or Trustee, are prohibited unless specific exemptions are met (such exemptions are outlined in the Corporate Bylaws and are in accordance with not-for-profit best practices and applicable state law).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation for the Organization's President &amp; CEO was evaluated and established by the officers of the board of directors, based on guidance from an outside compensation consultant and market survey data. Additinoally, The SolutionHealth CEO, the Chief Executive of HHHC's parent-organization and sole corporate member, shall manage the development of any proposal to adopt or modify the compensation or benefit programs of HHHC, with the assistance of the HHHC President/CEO and in consultation with the HHHC Executive Committee. Any action to approve such an adoption or modification of compensation or benefit plans must be initiated by a recommendation by the SolutionHealth CEO to the SolutionHealth Board and shall be authorized solely by a majority vote of the SolutionHealth Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Upon request, Home Health and Hospice Care makes its governing documents, conflict of interest policy, or financial statements available to the public. The organization's most recent Form 990 is also available on their website.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, line 2c:</FormAndLineReferenceDesc>
        <ExplanationTxt>The audit process has not changed from the prior year.</ExplanationTxt>
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          <StateAbbreviationCd>NH</StateAbbreviationCd>
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        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Legacy Trust of Southern New Hampshire Health Inc</BusinessNameLine1Txt>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Mary and John Elliot Charitable Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1070 Holt Avenuu Unit 1 Suite 2100</AddressLine1Txt>
          <CityNm>Manchester</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03109</ZIPCd>
        </USAddress>
        <EIN>020512229</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Elliot Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Southern New Hampshire Health System</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>8 Prospect Street</AddressLine1Txt>
          <CityNm>Nashua</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03060</ZIPCd>
        </USAddress>
        <EIN>020509221</EIN>
        <PrimaryActivitiesTxt>Medical Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Solution Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Southern New Hampshire Medical Center</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>8 Prospect Street</AddressLine1Txt>
          <CityNm>Nashua</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03060</ZIPCd>
        </USAddress>
        <EIN>020483054</EIN>
        <PrimaryActivitiesTxt>Medical Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Southern New Hampshire Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>The Surgery Center of Greater Nashua</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>10 Prospect Street</AddressLine1Txt>
          <CityNm>Nashua</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03060</ZIPCd>
        </USAddress>
        <EIN>461084049</EIN>
        <PrimaryActivitiesTxt>Medical Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Southern New Hampshire Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA Home Health and Hospice Services Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1070 Holt Avenuu Unit 1 Suite 2100</AddressLine1Txt>
          <CityNm>Manchester</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03109</ZIPCd>
        </USAddress>
        <EIN>020222241</EIN>
        <PrimaryActivitiesTxt>Home Care and Hospice</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Elliot Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA of Manchester and Southern New Hampshire Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1070 Holt Avenuu Unit 1 Suite 2100</AddressLine1Txt>
          <CityNm>Manchester</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03109</ZIPCd>
        </USAddress>
        <EIN>020395296</EIN>
        <PrimaryActivitiesTxt>VNA Holding Company</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Elliot Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA Personal Services Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1070 Holt Avenuu Unit 1 Suite 2100</AddressLine1Txt>
          <CityNm>Manchester</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03109</ZIPCd>
        </USAddress>
        <EIN>020395295</EIN>
        <PrimaryActivitiesTxt>Private Health and Homemaker Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Elliot Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SolutionHealth</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>360 Route 101 Unit 8</AddressLine1Txt>
          <CityNm>Bedford</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03110</ZIPCd>
        </USAddress>
        <EIN>830741190</EIN>
        <PrimaryActivitiesTxt>Supporting Organization</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12a, I</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Elliot Common Trust Fund LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1 Elliot Way</AddressLine1Txt>
          <CityNm>Manchester</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03103</ZIPCd>
        </USAddress>
        <EIN>203653624</EIN>
        <PrimaryActivitiesTxt>Investments</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Elliot Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Excluded</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>180842</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>10149059</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.05980</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Elliot Health System Holdings and Subsidiaries</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1070 Holt Avenue Unit 1 Suite 2100</AddressLine1Txt>
          <CityNm>Manchester</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03109</ZIPCd>
        </USAddress>
        <EIN>020512224</EIN>
        <PrimaryActivitiesTxt>Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>