2022-05-13T07:13:37-05:00 2021-06-30 010494526 Baker Newman & Noyes 650 Elm Street Suite 302 Manchester NH 03101 990 2020-07-01 020232673 The Elliot Hospital of the City of Manchester ELLI 6036632033 1 Elliot Way Manchester NH 03103 Joseph Felkner Executive VP & CFO 6036632033 2022-05-06 1 Joseph Felkner 999009999 Connor Smart P02285543 6036262200 2022-04-19 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z William G Baxter 1 Elliot Way Manchester NH 03103 605036435 0 X www.elliothospital.org X 1942 NH Hospital Services 23 16 4187 70 8477686 0 24792963 14445481 469225640 544960931 4701532 30109690 4887286 5262785 503607421 594778887 1066062 1070264 0 0 233476522 236084337 0 0 0 211097951 249617512 445640535 486772113 57966886 108006774 588879146 676110969 437011139 388564695 151868007 287546274 The Elliot Hospital of the City of Manchester, a leader in healthcare, is dedicated to providing its community with excellent services offered with dignity, caring, and respect. 0 0 377891235 0 536527747 Medical services provided to 14,028 inpatients and 515,135 outpatients including free care in the amount of $7,156,966 (at cost) and contributions to community programs. 1070264 1070264 0 Contributions to employee assistance and relief programs, as well as to community organizations including Amoskeag Health (formerly Manchester Community Health Center); City of Manchester, NH; Easter Seals New Hampshire; and Foundation for Healthy Communities in Manchester, New Hampshire. 1334716 0 8068 Community benefits including educational programs, health screenings, health publications and other health information services, and cash and in-kind contributions to community agencies. 380296215 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 263 0 1 4187 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 23 16 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Joseph Felkner 6033146628 360 Route 101 Unit 8 Bedford NH 03110 Elizabeth Sailhamer Soukup MD Trustee 1.00 41.00 X 0 674880 28074 Marina Feldman MD Trustee 1.00 41.00 X 0 833326 29188 William G Baxter President & CEO 41.00 8.00 X X 694863 0 143793 Stephen Loosigian DO Trustee 1.00 42.00 X 0 568720 28974 Matt Dayno MD Trustee 1.00 41.00 X 0 376105 28677 Sherry Hausmann President & CEO, SolutionHealth 1.00 42.00 X 0 1016634 208054 Linda Kornfeld MD Trustee 1.00 44.00 X 0 261711 14415 Reverend John A Cerrato Jr Trustee 1.00 1.00 X 0 0 0 Susan Critz Trustee 1.00 1.00 X 0 0 0 David Cuzzi Trustee 1.00 3.00 X 0 0 0 John A Hession Trustee 1.00 2.00 X 0 0 0 Paul W Hoff PhD Trustee 1.00 2.00 X 0 0 0 James C Hood Esq Trustee 1.00 1.00 X 0 0 0 Joseph T Hyatt MD Trustee 1.00 1.00 X 0 0 0 Dottie Kelley Trustee 1.00 1.00 X 0 0 0 Stephen Langan Trustee 1.00 3.00 X 0 0 0 Peter van der Meer MD Trustee 1.00 1.00 X 0 0 0 Charles F Rolecek Trustee 1.00 2.00 X 0 0 0 Philip Taub Trustee 1.00 1.00 X 0 0 0 Daniel M Monfried Chair/Trustee 1.00 1.00 X X 0 0 0 James J Tenn Jr Esq Vice Chair/Trustee 1.00 4.00 X X 0 0 0 John Mercier Treasurer/Trustee 1.00 1.00 X X 0 0 0 Loretta LC Brady PhD Secretary/Trustee 1.00 3.00 X X 0 0 0 Michael S Turilli CFO (end 4/2021) 41.00 7.00 X 461619 0 23287 Joseph Felkner Executive VP & CFO 1.00 47.00 X 0 206989 4788 Kevin Desrosiers MD Physician 40.00 0.00 X 438119 0 28709 Holly P Mintz MD Physician 40.00 1.00 X 435397 0 24370 Joseph T Curti COO 40.00 0.00 X 413760 0 28661 L John Klunk MD Physician 40.00 0.00 X 299954 0 28002 Martha Leighton CNO 40.00 0.00 X 262671 0 13119 3006383 3938365 632111 198 0 1 0 Orchestrate Healthcare Consulting PO Box 913076 Denver CO 80291 Healthcare IT consulting 2078313 ARUP Laboratories Inc 500 Chipeta Way Salt Lake City UT 84108 Lab services 2037089 Amoskeag Anesthesia PLLC 1 Elliot Way Manchester NH 03103 Medical services 1618280 NH Oncology-Hematology PA 11 Kimball Drive Unit 125 Hooksett NH 03106 Physician services 1423528 Ettain Group LLC 127 W Worthington Avenue Suite 10 Charlotte NC 28203 Recruitment and staffing 1109960 99 1115523 12294668 1035290 65396 14445481 Patient services 621110 258699803 258699803 Pharmacy services 623000 134143922 130361619 3782303 Laboratory services 621500 121153237 117714044 3439193 Disproportionate share funding 722511 15940765 15940765 Hospital Aux Services 621990 11696092 10492472 1203620 3327112 3327112 544960931 6520342 33723 6486619 5262785 0 5262785 5262785 18847 5243938 33846896 10256526 1022 23590370 -1022 23589348 23589348 594778887 536535815 8477686 35319905 X 1031471 1031471 38793 38793 2548249 1894142 654107 180681477 134302614 46378863 6041537 4490744 1550793 36180795 26893600 9287195 10632279 7903095 2729184 25371349 25371349 119712 119712 140592 140592 40253 40253 902603 902603 25087145 20998997 4088148 430962 430962 6797421 4568943 2228478 3645844 1582555 2063289 12976487 9732365 3244122 265975 237719 28256 233940 175455 58485 6271971 4703978 1567993 20341035 15255776 5085259 1821905 1366429 455476 Medical supplies 99440847 99440847 NH MET 22236061 22236061 Provision for bad debts 19264660 19264660 Patient expenses 4025634 4025634 203116 152337 50779 486772113 380296215 106475898 0 106979352 141091060 7158479 9797387 333805 44419916 38172392 839731 809087 4851014 5625234 5466185 3265683 503616958 321507338 187079069 182109620 123083510 151182603 82093816 92958105 784521 784521 64689 23833 26058864 49957639 588879146 676110969 51118253 48327649 15791 10142 535929 236247 174182678 165923068 350000 1441432 210808488 172626157 437011139 388564695 X 136655251 270481406 15212756 17064868 151868007 287546274 588879146 676110969 X 108006774 14533584 13137909 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 40253 45574 40253 45574 486731860 650754066 486772113 650799640 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 103907 59067 73421 45574 281969 250000 250000 250000 250000 1000000 1500000 15212757 50000 1802111 17064868 15039613 28666 144478 15212757 14804968 234645 15039613 14662555 142413 14804968 14186751 496610 20806 14662555 0.00000 0.90390 0.09610 0 0 4156178 4156178 221051921 103269080 117782841 2149777 2138404 11373 257418074 216099854 41318220 18841008 18841008 182109620 Alternative Investments 12690812 F Fixed income securities 80267293 F 92958105 Pension Cash Surrender Value 1258317 Deposits 10000 Employee Benefit Plans 29554709 Due from Affiliates 19134613 49957639 Payable to third party payors 62606269 Accrued interest 1641668 Accrued pension and retirement obligations 88089180 Workers comp reserves & other 6513540 Medicare obligations 3921195 Due to related organizations 9854305 172626157 X 587978464 14533584 2855688 17389272 570589192 916988 23272707 24189695 594778887 466953678 1394684 1394684 465558994 916988 20296131 21213119 486772113 Part V, Line 4: Income from the endowment funds can be used for operating and capital expenditures. Part X, Line 2: Elliot Hospital, EPN and EPS 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 Hospital's tax positions and concluded the Hospital 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 financial statements. Part XI, Line 2d - Other Adjustments: Revenue allocated to EHS Prof. and Gen. Liability Insurance Trust 2,559,659. Unrealized gain allocated to EHS Prof. and Gen. Liability Insurance Trust 296,029. Part XI, Line 4b - Other Adjustments: Provision for bad debts 19,264,660. Net periodic pension adjustment 2,976,576. Grants included with revenue in the Audited Financial Statements 1,027,971. State Taxes included with revenue per Audited Financial Statements 3,500. Part XII, Line 2d - Other Adjustments: Expenses Allocated to EHS Prof. and Gen. Liability Insurance Trust 1,394,684. Part XII, Line 4b - Other Adjustments: Provision for bad debts 19,264,660. Grants included with revenue in the Audited Financial Statements 1,027,971. State Taxes included with revenue per Audited Financial Statements 3,500. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Investments through Elliot Common Trust Fund 1027000 North America - Canada and Mexico, but not the United States 0 0 Investments through Elliot Common Trust Fund 330000 0 0 0 0 0 0 1357000 0 1357000 0 0 1 1 1 0 Part III Accounting Method: Schedule F, Part I, Line 3: The legal owner of Elliot Hospital's foreign investments is a related organization, Elliot Common Trust Fund. Since a portion of the total foreign investments are allocated to the Hospital's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, Line 3 of Elliot Hospital's Form 990. Schedule F, Part IV, Line 3: The Elliot Hospital of the City of Manchester did not have an ownership interest in any foreign corporation that is greater than the 10% filing threshold. Accordingly, IRS Form(s) 5471 is not required to be filed. Schedule F, Part IV, Line 4: The Elliot Hospital of the City of Manchester meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Hospital. Schedule F, Part IV, Line 5: The Elliot Hospital of the City of Manchester did not have an ownership interest in any foreign partnership that was greater than the 10% Form 8865 filing threshold, nor did the Hospital have claim to $100,000 or more of transfers to any foreign partnership during the year. Accordingly, The Hospital is not required to file any Form 8865 for this filing period. 1 1 1 X 225.000000000000 1 X 1 1 1 0 1 1 22214 7156966 0 7156966 0.01530 65889 107701839 47641267 60060572 0.12850 88103 114858805 47641267 67217538 0.14380 10 857 799724 8068 791656 0.00170 6 222 354256 354256 0.00080 7 16205558 7126843 9078715 0.01940 1 31893 31893 0.00010 7 622 1219107 1219107 0.00260 31 1701 18610538 7134911 11475627 0.02460 31 89804 133469343 54776178 78693165 0.16840 1219017 0 0.00000 1219017 0 0.00000 0 19264660 0 148203151 201667908 -53464757 X 1 1 1 1 Elliot Hospital of City of Manchester 1 Elliot Way Manchester NH 03103 www.elliothospital.org 0018 X X X X Elliot Hospital of City of Manchester 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X See Part V, Section C X See Part V, Section C X 1 18 1 See Part V, Section C 0 1 X 225.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 Elliot Hospital of City of Manchester Part V, Section B, Line 5: As part of the fiscal year 2019 Greater Manchester Community Health Needs Assessment (CHNA), qualitative and quantitative data was compiled, with interviews of key community leaders (12) from the greater Manchester Community were conducted. Key leaders represented government, education, health delivery, nonprofit, social service, and police. A list of those interviews is available in the 2019 CHNA appendix 1 located at:https://www.elliothospital.org/website/downloads/Manchester-Report-Final-compressed.pdf Elliot Hospital of City of Manchester Part V, Section B, Line 6a: Catholic Medical Center, Manchester, NH Elliot Hospital of City of Manchester Part V, Section B, Line 6b: Manchester Health Department, Manchester, NH Elliot Hospital of City of Manchester Part V, Section B, Line 11: Elliot Hospital has developed a 3 year implementation strategy to address key social determinants of heath impacting the residents of Manchester. This strategy has guided our work around issues of substance use disorder and behavioral health, obesity and physical activity, aging population needs, length of life, and disease prevention, and has been expanded to address reading proficiency in Manchester schools and food insecurity issues in greater Manchester. Our full implementation strategy document is available at: https://www.elliothospital.org/website/downloads/Community-Health-Needs-Assessment-With-Section-C-11-2019.pdf Schedule H, Part V, Section B, Line 7a & 7b: The CHNA available at the Hospital facility's website at:https://www.elliothospital.org/website/downloads/Manchester-Report-Final-compressed.pdfAdditionally, it is also available on Catholic Medical Center's website at:https://www.catholicmedicalcenter.org/CatholicMedicalCenter/media/CMCE-Media-Library/AboutUs/GreaterManchesterCommunityNeedsHealthAssessment_1019.pdf Schedule H, Part V, Section B, Line 10: In addition to being posted on Elliot Hospital's own website, the CHNA is available on Catholic Medical Center's website at:https://www.catholicmedicalcenter.org/about-cmc/in-the-community/community-health-needs-assessmentThe Hospital's Implementation Plan is available on the website at: www.elliothospital.org/website/downloads/Community-Health-Needs-Assessment-With-Section-C-11-2019.pdf Schedule H, Part V, Section B, Line 13: Elliot's Financial Assistance Policy is available via Elliot's website(www.elliothospital.org) or free copies are available at hospitallocations. Also, Patient Financial Advocates are available to assist inperson or via telephone. The policy is for people who are underinsured,uninsured, or do not qualify for governmental assistance (Medicare orMedicaid), or who are otherwise unable to pay for medically necessary care and meet the criteria for financial assistance. Schedule H, Part V, Section B, Line 16a, 16b, & 16c: The Hospital's Financial Assistance Policy, Plain Language Summary, and Financial Assistance Application can be found at:https://www.elliothospital.org/website/pay-my-bill-charitable-care-policy.php 21 1 - Elliot 1-Day Srgry CenterRivers Edge 185 Queen City Avenue Manchester NH 03101 Ambulatory Surgical Center 2 - Elliot Urgent Care At River's Edge 185 Queen City Avenue Manchester NH 03101 Non-Emergency Walk-In Care Center 3 - Elliot Hospital of Manchester NH 1050 Holt Ave Ste 5 175 Queen City Manchester NH 03109 LRDD Medical Gases/Prescription Devices, Home Care - Durable Medical 4 - Elliot Pharmacy At River's Edge 185 Queen City Avenue Manchester NH 03101 In-State Pharmacy 5 - Elliot Urgent Care Londonderry 40 Buttrick Road Londonderry NH 03053 Non-Emergency Walk-In Care Center 6 - Elliot Urgent Care at Bedford 25 Leavy Drive Bedford NH 03110 Non-Emergency Walk-In Care Center 7 - Elliot Stat LabCollection Station 40 Buttrick Road Londonderry NH 03053 Laboratory 8 - Elliot Pharmacy at Bedford 25 Leavy Drive Bedford NH 03110 In-State Pharmacy 9 - Elliot Coumadin Clinic 40 Buttrick 40 Buttrick Road Londonderry NH 03053 Laboratory 10 - Elliot Coumadin Clinic 138 Webster 138 Webster Street Manchester NH 03104 Laboratory 11 - Elliot Poc LabCollection Station145 145 Hollis Street Manchester NH 03101 Laboratory 12 - Elliot Coumadin Clinic 15 Freetown 15 Freetown Road 8 Raymond NH 03077 Laboratory 13 - Elliot Collection Station 185 Queen 185 Queen City Avenue Manchester NH 03101 Collecting Station 14 - Elliot One Day Srgry Center185 Queen 185 Queen City Avenue Manchester NH 03101 Laboratory 15 - Elliot One Day Surgery Center 185 Queen City Avenue Manchester NH 03101 Practitioner Office 16 - Elliot Collection Station 4 Elliot 4 Elliot Way Manchester NH 03103 Collecting Station 17 - Elliot Collect'n Stat'n190 Tarrytow 275 Mammoth Road Manchester NH 03103 Collecting Station 18 - Elliot Collection Station20 Chambers 20 Chambers Road Hooksett NH 03106 Collecting Station 19 - Elliot Urgent Care Lab185 Queen City 185 Queen City Avenue Manchester NH 03101 Laboratory 20 - Elliot Urgent Care Lab 40 Buttrick 40 Buttrick Road Londonderry NH 03053 Laboratory 21 - Elliot Urgent Care Lab Bedford 25 Leavy Drive Bedford NH 03110 Laboratory Part I, Line 7: Financial assistance and means tested costs used RCC derived from Medicarecost report; other benefits costs derived from actual costs and internalcost accounting system. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 19,264,660. Part II, Community Building Activities: For the fiscal year ending June 30, 2021, Elliot Hospital provided $791,656 in community and program support to local organizations. These organizations included Foundations for Healthy Communities, Amoskeag Health, Valley Street Jail, (medical care for Hillsborough County and State Inmates) Easter Seals NH, and Families in Transition. Elliot Hospital also provided an additional $1,219,017 in sponsorship/partnership support to community organizations such as Greater Manchester Boys and Girls Club, YWCA NH, American Heart Association and Friends of Aine. Part III, Line 2: Bad debt expense is determined based on analysis of historical activity.Self-pay accounts are given an automatic 55% discount off charges;self-pay accounts that do not make payment are transferred to bad debt.Cost of bad debt is derived from an internal cost accounting system. Part III, Line 3: Self-pay accounts are given an automatic 55% discount off charges; self-pay accounts that do not make payments are transferred to bad debt. Organization is not currently determining bad debt accounts that may have been charitable care. Part III, Line 4: See Footnote 2 of the attached audited financial statements. Part III, Line 8: Allowable costs are determined using CMS methodology utilized incompleting cost report; Medicare shortfall from Part III, Line 7 should beincluded in community benefits as costs are not fully reimbursed. Part III, Line 9b: Collections are not pursued on charity care patients. Collection agenciesare supplied information that allows them to identify only those accountsupon which collection efforts should be pursued. Part VI, Line 2: In order to assess the health needs of the community on an ongoing basis, Elliot Health System partners closely with Catholic Medical Center, Amoskeag Health, City of Manchester Public Health Department and other community organizations. As a member of the Manchester Health Advisory Committee, Manchester CoC for Homelessness, Manchester SUD Collaborative, Elliot Health System works collaboratively with the primary goal of assessing community needs and developing health improvement strategies for the City of Manchester, NH. The work for addressing CHNA priorities is coordinated under the discretion of the City of Manchester Public Health Department. During FY21, we additionally coordinated COVID-19 response for the community in partnership with these key organizations.In addition to the ongoing work completed related to the CHNA and various working groups in Manchester, Elliot also uses CHNA, CHiP and other community data (example, overdose and SUD reports from AMR and SUD Collaborative). Other sources include US Census, Behavioral Risk Factor Survey and NH State agency publications and the Healthcare Advisory Board. Part VI, Line 3: Elliot's Financial Assistance Policy is available via Elliot's website (www.elliothospital.org) or free copies are available at hospital locations. Also, Patient Financial Advocates are available to assist in person or via telephone. The policy is for people who are underinsured, uninsured, or do not qualify for governmental assistance (Medicare or Medicaid), or who are otherwise unable to pay for medically necessary care and meet the criteria for financial assistance. Part VI, Line 4: The 2019 Greater Manchester Community Health Needs Assessment focused on the City of Manchester, and the surrounding Greater Manchester Community. Greater Manchester includes both the Greater Manchester Public Health Region (Auburn, Bedford, Candia, Deerfield, Goffstown, Manchester, and New Boston), as well as the Hospital Service Area (Public Health Region Towns plus Londonderry). These eight communities are home to approximately 195,000 residents. The City of Manchester is not only home to over half of the Greater Manchester Community but it is the largest city in the State of New Hampshire. The population of the Greater Manchester Area is aging and becoming a more diverse population, with residents reflecting a variety of nationalities, languages, ethnic traditions, religious beliefs, and ideologies. New Hampshire has the second highest median age in the nation with 19% of the state population over the age of 65. Thirteen percent of the City of Manchester residents (over 14,000) are ages 65 or older. Part VI, Line 5: Elliot Hospital promotes the health of the Greater Manchester community through many ways including the following:- EH offers free health education and support group programs to the community- EH provides financial support to local Federally Qualified Health Centers and other non-profit organizations in the community. Additionally, we provide partnership programs with community organizations like the Wellness On Wheels program which brought over 10 community agencies and non-profits together in underserved neighborhoods.- EH maintains an open medical staff- EH management and staff participate on board of other nonprofits such as Waypoint, Easter Seals NH as well as local and state public health committees.- EH continue to be a host partner and location for many community events including National Drug Take Back Day with the Manchester Police Department, DEA and Makin' It Happen and we are one of the largest sites for community blood drives with the American Red Cross.- EH staff and providers attend community events and partner with local schools and organizations to provide awareness, screening and educational materials. This has been limited due to COVID-19 but when able in FY 21 have attended events or provided impactful health information.- EH participate in community emergency response preparedness drills. - EH also focuses on our Implementation Strategies, which are developed from the key SoDH from the Community Health Needs Assessment. Part VI, Line 6: EHS is the umbrella organization under which Elliot Hospital (EH), Elliot Physician Network (EPN), Elliot Professional Services (EPS), the Visiting Nurse Association of Manchester and Southern NH (VNA), and the Mary & John Elliot Charitable Foundation operate. Elliot Health System is a health care system that provides care to residents of southern NH serving a regional population of over 250,000 residents, making it one of the largest providers of comprehensive health care services in southern NH. Each of these organizations plays a critical role in the continuum of care EHS delivers to the community thus promoting health. The cornerstone of EHS is Elliot Hospital (EH), a 296-bed acute care facility located at the hospital's main campus. EH and the surrounding campus is home to Elliot Emergency and Trauma services which includes a dedicated pediatric emergency department and the ACS verified Level II Trauma Center, inpatient and outpatient behavioral health services, a Level III Newborn Intensive Care Unit, and the Solinsky Regional Cancer Center. Elliot Hospital also services the community through various ambulatory care centers located throughout the Greater Manchester area including the Towns of Bedford, Londonderry, and Hooksett. In addition, EH offers specialty services at 250,000 square foot ambulatory care center, The Elliot at River's Edge, which houses the Elliot Breast Health Centr, Urgent Care, Wound Care, Pain Management, and Surgical Services. In addition, EH offers the community a dedicated senior center also located in the City of Manchester.EHS, through the Elliot Physician Network (EPN) and Elliot Professional Services (EPS), both not for profit physician groups, provide primary care and specialty care to the Greater Manchester area. Combined, EPN and EPS employ over 200 physicians as far north as Hooksett, east to Raymond, and south to Windham. The Elliot Physician Network has 17 primary care practices in the Greater Manchester area. EHS has a robust electronic medical record (EMR) linking all of the system providers with EH allowing the provider immediate access to all medical care that happened within EHS. The EMR is complete with the latest laboratory results, diagnostic images, and other test results that may affect care given in the local provider's office.EH and Affiliates (collectively EHS), work collaboratively and collectively (through the EMR) allowing EHS to serve the health care needs of people in the most efficient manner and has provided a platform for proactive plans for health management.On April 30, 2018 Elliot Health System became part of the new non-profit healthcare organization named SolutionHealth. This new non-profit healthcare entity is the combination of two New Hampshire non-profit health care organizations, Elliot Health System (EHS) and Southern New Hampshire Health System (SNHHS), combining together to protect the future sustainability of accessible, comprehensive, value-based clinical care. SolutionHealth is a regional healthcare system with a governing body with members from both EHS and SNHHS. This new organization services over 400,000 community members, is located in the two largest and most diverse cities in New Hampshire and employs over 700 physicians and advanced practice providers in New Hampshire. Part VI, Line 7, Reports Filed With States NH 1 Amoskeag Health 1415 Elm Street Manchester NH 03101 020458174 501(c)(3) 340000 To assist in meeting the funding needs for daily operations and staffing City of Manchester New Hampshire One City Hall Plaza Manchester NH 03101 Government 40495 Contribution for retention of Behealthe Consulting Easter Seals New Hampshire 555 Auburn Street Manchester NH 03103 020272825 501(c)(3) 53919 Support Veterans Count program Foundation for Healthy Communities 125 Airport Road Concord NH 03301 020275078 501(c)(3) 597057 Provide support for the reauthorization of the NH Medicaid expansion fund 4 0 Employee relief and assistance funds 19 38793 Part I, Line 2: Elliot Hospital maintains members on the board of directors for Amoskeag Health (formerly Manchester Community Health Center). Activities of this organization align with the Hospital's mission in the community and with the Hospital's Implementation Plan developed from its most recent CHNA. The grant to Foundation for Healthy Communities helps support the State's reauthorization of NH Medicaid expansion which is important to providing insurance coverage for many of our most vulnerable citizens. The grants to the City of Manchester and Easter Seals New Hampshire support programs that provide health and wellness support for some of the region's most vulnerable populations. Additionally, the Hospital operates a system of assistance funds and employee relief programs for its valuable employees and team members who can demonstrate a legitimate and qualified financial or health need. X X X X X 0 1 0 0 0 0 0 1 0 Sherry Hausmann President & CEO, SolutionHealth 0 813820 0 183750 0 19064 0 185100 0 22954 0 1224688 0 0 Marina Feldman MD Trustee 0 811522 0 21243 0 561 0 5700 0 23488 0 862514 0 0 William G Baxter President & CEO 554339 0 120120 0 20404 0 120305 0 23488 0 838656 0 0 0 Elizabeth Sailhamer Soukup MD Trustee 0 674319 0 0 0 561 0 5700 0 22374 0 702954 0 0 Stephen Loosigian DO Trustee 0 548503 0 0 0 20217 0 5700 0 23274 0 597694 0 0 Michael S Turilli CFO (end 4/2021) 409938 0 50320 0 1361 0 5700 0 17587 0 484906 0 0 0 Kevin Desrosiers MD Physician 393905 0 43803 0 411 0 5700 0 23009 0 466828 0 0 0 Holly P Mintz MD Physician 382126 0 43803 0 9468 0 5700 0 18670 0 459767 0 0 0 Joseph T Curti COO 340804 0 53096 0 19860 0 5700 0 22961 0 442421 0 0 0 Matt Dayno MD Trustee 0 324328 0 38329 0 13448 0 5700 0 22977 0 404782 0 0 L John Klunk MD Physician 273504 0 26047 0 403 0 5230 0 22772 0 327956 0 0 0 Linda Kornfeld MD Trustee 0 243318 0 0 0 18393 0 12770 0 1645 0 276126 0 0 Martha Leighton CNO 228216 0 34130 0 325 0 4444 0 8675 0 275790 0 0 0 Joseph Felkner Executive VP & CFO 0 161529 0 25000 0 20460 0 0 0 4788 0 211777 0 0 Part I, Line 4b 2020 contributions to William G. Baxter's 457(f) plan during the year totaled $106,205, and contributions to Sherry Hausmann's 457(f) plan totaled $171,000 (paid by SolutionHealth, a related organization). 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 2020, 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 2020 calendar year. Part I, Line 7 The Organization has adopted an incentive pay program that provides designated management employees an opportunity to earn a designated percentage of salary based on the achievement by the Organization of a number of critical success factors. The critical success factors are established annually by the independent executive compensation committee of the Board of Trustees with assistance from an independent national compensation consulting company. The maximum potential incentive payments under the plan are considered by the compensation consultant in ensuring that management compensation is reasonable. A NH Health & Education Facilities Authority 020279866 2013-09-30 17021000 Refund outstanding prinicipal of 2003 revenue bonds; finance capital project 0 0 0 B NH Health & Education Facilities Authority 020279866 6446148D4 2016-11-15 147020000 advance refund 2009 bonds; finance capital expenditures; pay issuance costs 0 0 0 C NH Health & Education Facilities Authority 020279866 2019-08-30 20500000 Lease equipment for the purpose of equipping projects 0 0 0 A 2567884 17021000 132029 1 0 1 1 B 2875000 147020000 132348714 1560329 30000000 2018 1 1 1 1 C 1562155 20462431 37569 20500000 2020 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 Date Rebate Computation Performed Issuer Name: NH Health & Education Facilities Authority Date the Rebate Computation was Performed: 09/30/2020 Issuer Name: NH Health & Education Facilities Authority Date the Rebate Computation was Performed: 09/30/2020 X 6 65396 Gift Date FMV 0 1 1 Part I, Line 32b: The Organization sells contributions of securities through the investment management group of its financial institution. All gifts of securities are sold as soon as administratively possible. Form 990, Part VI, Section A, line 6 Elliot Health System is the sole member of The Elliot Hospital of the City of Manchester. Form 990, Part VI, Section A, line 7a Elliot Hospital is governed by a Board of Trustees identical in composition to its sole member, Elliot Health System. Form 990, Part VI, Section B, line 11b The completed Form 990 is presented to the full Board prior to filing. Board members can review the draft and bring any questions forward for discussion prior to filing. Form 990, Part VI, Section B, line 12c Officers, directors, and key employees are required to sign a conflict of interest form annually, which reports any potential conflict of interest arrangements with the organization. Form 990, Part VI, Section B, line 15 The compensation committee of the Board utilizes outside compensation consultants to evaluate the salaries for the CEO, CFO, and COO. The consultants utilize their internal data along with national and local benchmark data from the industry to develop salary levels. Recommendations of the consultant are reviewed by the compensation committee, who recommends compensation levels to the full Board for approval. An outside consulting firm is also used by the organization to review the compensation of the remainder of the Vice Presidents. Again, national and local benchmarks for salaries are consulted to determine salary levels for these positions. Form 990, Part VI, Section C, line 19 Each of these documents is filed with the New Hampshire Secretary of State and is available upon request. Form 990, Part IX, Column D: The Mary and John Elliot Charitable Foundations performs all fundraising activities on behalf of The Elliot Hospital of the City of Manchester. All fundraising expenses are reported on the Foundation's separate Form 990. Form 990, Part XI, line 9: Net periodic pension adjustment 56,795,481. Transfer to affiliates -43,657,572. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Form 990, Parts VIII-XI: The consolidated audited financial statements for The Elliot Hospital of the City of Manchester and subsidiaries report various revenue, expense, asset, and net asset amounts for the Hospital inclusive of a related organization, Elliot Health System Professional & General Liability Trust (EIN: 01-6217452). All revenue, expense, and balance sheet items related to Elliot Health System Professional & General Liability Trust have been extracted from amounts reported for the Hospital on this Form 990 and all accompanying schedules. Elliot Health System Professional & General Liability Trust is a separate legal entity filing its own Form 990, and items related to it have been reported there. Elliot Health System 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509911 Management NH 501(c)(3) Line 12b, II SolutionHealth 0 Elliot Health System Professional & General LIT 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 016217452 Insurance Trust NH 501(c)(3) Line 12a, I Elliot Hospital 1 Elliot Hospital Associates 1 Elliot Way Manchester NH 031033599 026006214 Auxiliary NH 501(c)(3) Line 12d, III-O N/A 0 Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509589 Physician Services NH 501(c)(3) Line 3 Elliot Hospital 1 Elliot Professional Services Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 331003630 Physician Services NH 501(c)(3) Line 10 Elliot Hospital 1 Foundation Medical Partners Inc 8 Prospect Street Nashua NH 03060 020456218 Physician Services NH 501(c)(3) Line 10 Southern New Hampshire Health System 0 Legacy Trust of Southern New Hampshire Health Inc 8 Prospect Street Nashua NH 03060 844779887 Fundraising NH 501(c)(3) Line 7 Southern New Hampshire Health System 0 Mary and John Elliot Charitable Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512229 Fundraising NH 501(c)(3) Line 7 Elliot Health System 0 SolutionHealth 360 Route 101 Unit 8 Manchester NH 03110 830741190 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Southern New Hampshire Health System 8 Prospect Street Nashua NH 03060 020509221 Medical Services NH 501(c)(3) Line 12b, II SolutionHealth 0 Southern New Hampshire Medical Center 8 Prospect Street Nashua NH 03060 020483054 Medical Services NH 501(c)(3) Line 3 Southern New Hampshire Health System 0 The Surgery Center of Greater Nashua 10 Prospect Street Nashua NH 03060 461084049 Medical Services NH 501(c)(3) Line 3 Southern New Hampshire Health System 0 VNA Community Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020396549 Nursing Services NH 501(c)(3) Line 7 Elliot Health System 0 VNA Home Health and Hospice Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020222241 Home Care and Hospice NH 501(c)(3) Line 10 Elliot Health System 0 VNA of Manchester & Southern NH Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395296 VNA Holding Company NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA Personal Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395295 Private Health and Homemaker Services NH 501(c)(3) Line 10 Elliot Health System 0 Elliot Common Trust Fund LLC 1 Elliot Way Manchester NH 03103 203653624 Investments NH Elliot Hospital Excluded 12921226 109981406 0 33723 0 0.78800 Elliot Health System Holdings & Subsidiaries 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512224 Management NH N/A C 0 0 0 1 0 0 0 0 0 0 1 1 0 1 0 1 1 1 1 0 Elliot Professional Services Network Inc J 1777727 Cash Value Elliot Physician Network Inc J 26526 Cash Value Elliot Professional Services Network Inc P 5819024 Cash Value Elliot Physician Network Inc P 7306875 Cash Value Elliot Professional Services Network Inc Q 17509248 Cash Value Elliot Physician Network Inc Q 19472725 Cash Value Elliot Professional Services Network Inc R 36080000 Cash Value Elliot Physician Network Inc R 4745000 Cash Value Elliot Common Trust Fund LLC B 85442 Cash Value Elliot Health System 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509911 0 0 0 79 79 16 4 0 0 0 VNA of Manchester & Southern New Hampshire Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020395296 0 5321 5321 1964583 1969904 248495 62124 0 0 0 The Elliot Hospital of the City of Manchester 1 Elliot Way Manchester NH 03103 020232673 X 0 40253 40253 486731860 486772113 1000000 250000 0 0 0 Elliot Professional Services Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 331003630 0 0 0 101446491 101446491 1000000 250000 0 0 0 Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509589 0 0 0 40386045 40386045 1000000 250000 0 0 0 Mary and John Elliot Charitable Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512229 0 0 0 2596805 2596805 279840 69960 0 0 0 Elliot Health System Professional & General Liability Insurance Trust 1 Elliot Way Manchester NH 03101 016217452 0 0 0 1394684 1394684 214468 53617 0 0 0 VNA Personal Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020395295 0 0 0 828129 828129 149219 37305 0 0 0 VNA Home Health & Hospice Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020222241 0 0 0 15405390 15405390 920270 230068 0 0 0 VNA Community Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020396549 0 0 0 0 0 0 0 0 0 0