2022-08-11T09:40:39-05:00 2021-09-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2020-10-01 020397338 Valley Regional Healthcare Inc VALL 6035427771 243 Elm Street Claremont NH 03743 Jean Shaw CFO 6035427771 2022-08-02 1 Jean Shaw 999009999 Joseph R Byrne P01289281 2077752387 2022-08-02 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Jocelyn Caple 243 Elm Street Claremont NH 03743 2677931 0 X www.vrh.org X 1986 NH Parent organization to Valley Regional Hospital, Inc. 16 12 3 14 0 0 0 0 2080766 2112863 58277 157402 0 0 2139043 2270265 0 0 0 0 769161 461705 0 0 0 2434632 2519606 3203793 2981311 -1064750 -711046 13950750 13445921 19031390 18685235 -5080640 -5239314 Valley Regional Healthcare, Inc. is organized to coordinate and support the activities of health care organizations, including Valley Regional Hospital, Inc. 0 0 1917411 2112863 Valley Regional Healthcare is the parent organization for Valley Regional Hospital. In this role, Valley Regional Healthcare provides integrated management and support services for the Hospital. 1917411 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 9 0 1 3 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 12 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 NH X Jean Shaw 6035427771 243 Elm Street Claremont NH 03743 Patricia Putnam Chair 0.10 0.90 X X 0 0 0 Terri Decker Vice Chair 0.10 0.90 X X 0 0 0 Lisa Richmond Treasurer 0.10 0.90 X X 0 0 0 Cynthia L Burr Secretary 0.10 0.90 X X 0 0 0 Juliann Barrett DO Trustee 0.10 39.90 X 0 259464 151 James Borchert Trustee 0.10 0.90 X 0 0 0 Scott Bouranis Trustee 0.10 0.90 X 0 0 0 Eric Crainich Trustee 0.10 0.90 X 0 0 0 Bryan Huot Trustee 0.10 0.90 X 0 0 0 Katherine Lajoie Trustee 0.10 0.90 X 0 0 0 Alex Scott Trustee 0.10 0.90 X 0 0 0 Samuel Shields Trustee 0.10 0.90 X 0 0 0 Tom Sullivan Trustee 0.10 0.90 X 0 0 0 John Tomlinson Trustee 0.10 0.90 X 0 35323 0 Gailyn Thomas MD Trustee 0.10 19.90 X 0 194843 0 Steve LeBlanc Past Trustee 0.10 0.90 X 0 0 0 Jocelyn Caple Interim President & CEO 1.60 38.40 X X 127317 0 0 Jean Shaw CFO 2.80 37.20 X 159394 0 36201 Deanna Howard Former Interim CEO 1.60 38.40 X 253333 0 0 540044 489630 36352 3 1 1 1 Dartmouth Hitchcock Clinic One Medical Center Drive Lebanon NH 03756 CEO Contract Services 321720 1 Management Services 621610 1082862 1082862 Rental Income 531120 950456 950456 Miscellaneous Revenue 900099 79545 79545 2112863 67331 67331 497335 402 399451 8215 97884 -7813 90071 90071 2270265 2112863 0 157402 X 322912 286644 36268 117415 104228 13187 1769 1570 199 19609 17407 2202 5498 5498 40985 40985 23569 23569 398547 353785 44762 115249 115249 12646 11226 1420 217 193 24 20721 18394 2327 852 756 96 598861 598861 1231332 1093036 138296 37138 37138 Dues and Subscriptions 22406 19889 2517 Miscellaneous 11585 10283 1302 2981311 1917411 1063900 0 X 270249 157181 870539 999998 6512 84065 14009 22622 43892152 35496927 9624839 8395225 3062121 3735014 12950 12950 89531 38866 13950750 13445921 210186 163858 116935 117027 18259225 17938844 445044 465506 19031390 18685235 X -5080716 -5239390 76 76 -5080640 -5239314 13950750 13445921 -711046 552372 0 X 0 1 X 1 1 1 X X 1 Valley Regional Hospital Inc 020222118 3 1 1917411 0 1 1917411 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15931744 11442900 4488844 119313 117016 2297 26807642 23079445 3728197 1033453 857566 175887 8395225 Due to Affiliates 463477 Reserve for Self-Funded Insurance 2029 465506 X X X X 0 0 0 0 0 0 0 0 0 Juliann Barrett DO Trustee 0 243221 0 12500 0 3743 0 0 0 151 0 259615 0 0 Deanna Howard Former Interim CEO 253333 0 0 0 0 0 0 0 0 0 253333 0 0 0 Jean Shaw CFO 159068 0 0 0 326 0 0 0 36201 0 195595 0 0 0 Gailyn Thomas MD Trustee 0 194843 0 0 0 0 0 0 0 0 0 194843 0 0 Jocelyn Caple Interim President & CEO 127317 0 0 0 0 0 0 0 0 0 127317 0 0 0 Form 990, Part VII, line 5: Jocelyn F. Caple, Interim President & CEO, is paid by Mary Hitchcock Memorial Hospital, an unrelated organization via a professional services agreement. Ms. Caple's 2020 compensation is as follows: Salary: $127,317 Deanna Howard, Former Interim CEO, is paid by Mary Hitchcock Memorial Hospital, an unrelated organization via a professional services agreement. Ms. Howard left the organization on September 4, 2020. Ms. Howard's 2020 compensation is as follows: Salary: $253,333 Form 990, Part VI, Section A, line 4 During the year, the Organization revised its bylaws and as a result made the following significant changes: 1. Decreased the minimum number of Trustees on the Board of Trustees from 13 to 11. 2. Increased the maximum number of consecutive terms for Trustees from 3 to 4. Form 990, Part VI, Section A, line 6 The Corporation has an assembly of Overseers. Form 990, Part VI, Section A, line 7a The Overseers elect directors to the Board. Additionally, the CEO of Dartmouth Hitchcock Medical Center has the right to appoint one representative to the Board of Directors. Form 990, Part VI, Section A, line 7b The power to alter, amend or repeal the bylaws or to adopt new bylaws shall be vested in the Assembly of Overseers. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the CFO and a full copy is shared and reviewed with the CEO and the Finance Committee members. The Finance Committee members are given an opportunity for comment prior to filing. The review is conducted by the CFO. Form 990, Part VI, Section B, line 12c The Risk & Compliance Office requires annual review of the conflict of interest policy. All Officers, Directors, Trustees, and Key Employees must sign an acknowledgment of the policy and disclose any interests that could give rise to conflicts. The signed forms are held in the following locations: Officers and Trustees - Executive Assistant office Directors and Key Employees - In the Elsevier Human Resources system Contracted Services - within or alongside any contract in the corresponding administration or materials area Form 990, Part VI, Section B, line 15 The executive committee of the board of trustees convenes two to four times annually to review the compensation of the CEO. The amount of compensation shall be reviewed by the D-H independent compensation consultant for purposes of determining compliance with the rebuttable presumption, if necessary. The CEO compensation is tied to the strategic planning goals of the Organization. Regional compensation of like-sized organizations is used for comparison purposes. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Purchased Services: Program service expenses 280,823. Management and general expenses 35,531. Fundraising expenses 0. Total expenses 316,354. Other Professional Fees: Program service expenses 72,962. Management and general expenses 9,231. Fundraising expenses 0. Total expenses 82,193. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Valley Regional Healthcare, Inc. 243 Elm Street Claremont, NH 03743 EIN: 02-0397338 Valley Regional Healthcare, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Valley Regional Hospital Inc 243 Elm Street Claremont NH 03743 020222118 Critical Access Hospital NH 501(c)(3) 3 Valley Regional Healthcare Inc 1 Charitable Remainder Trusts (3) Charitable Trust NH Valley Regional Hospital Inc 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 Valley Regional Hospital Inc L 1082862 Amounts Received Valley Regional Hospital Inc A 928872 Amounts Received