2022-08-15T07:34:31-05:00 2021-09-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2020-10-01 020315693 Catholic Medical Center CATH 6036683545 100 McGregor Street Manchester NH 031023770 Edward L Dudley III Executive VP & CFO 6036683545 2022-07-28 1 Edward Dudley III 999009999 Connor Smart P02285543 2078792100 2022-07-28 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Alexander Walker Jr Esq 100 McGregor Street Manchester NH 031023770 617284063 0 0928 X www.catholicmedicalcenter.org X 1974 NH The heart of Catholic Medical Center is to carry out Christ's healing ministry by offering health, healing, and hope to every individual who seeks our care. 14 10 3378 57 10534 8109 38230311 26512137 417005470 475141947 3986664 47114507 15238 -44354 459237683 548724237 621472 657201 0 0 211070965 190463658 90119 106831 684494 229390535 263130035 441173091 454357725 18064592 94366512 530592222 518751919 482212995 400268947 48379227 118482972 The heart of Catholic Medical Center is to carry out Christ's healing ministry by offering health, healing, and hope to every individual who seeks our care. 0 0 399774555 657201 471343183 Medical and surgical services provided to 11,769 inpatients and 436,760 outpatients during the year. 3215117 0 3790695 Various other services. Please see Schedule H.Catholic Medical Center (CMC), as an agency of the Roman Catholic Church, shall provide health care in a manner consistent with the ethical and religious directives for Catholic health care services as interpreted by the Roman Catholic Bishop of Manchester. CMC shall employ the highest quality health care professionals and the most appropriate technology to deliver an array of services either directly or through strategic alliances with compatible health care providers. With dignity and compassion, CMC shall treat the body, mind, and spirit of all who seek or provide care and comfort. Additional details provided in Schedule H. 402989672 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 1 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 272 0 1 3378 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 14 10 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 NH X Edward Dudley 6036683545 c/o Finance Dept 100 McGregor Manchester NH 031023770 Alexander Walker Jr Esq President & CEO 40.90 0.80 X X 519813 0 236608 Carolyn Claussen MD Director 1.20 40.80 X 0 198788 7133 Joseph Pepe MD President & CEO (end 6/2021) 42.10 1.20 X X 838893 0 441652 Louis I Fink MD Director 1.40 40.80 X 0 704518 19259 Patricia Furey MD Director 1.20 40.50 X 0 516481 48213 Matthew Albuquerque Director 0.20 0.40 X 0 0 0 Susan M Kinney Director 1.20 0.70 X 0 0 0 Derek McDonald Director/Bishop's Delegate 2.20 0.40 X 0 0 0 Marie McKay CPA Director 0.80 1.20 X 0 0 0 John J Munoz MD President of Medical Staff 1.00 0.40 X 0 0 0 Catherine Provencher Director (end 6/21) 0.90 0.00 X 0 0 0 Timothy Riley Director 2.10 0.40 X 0 0 0 John G Cronin Esq Chair 1.80 0.50 X X 0 0 0 Neil Levesque Vice Chair 1.20 0.40 X X 0 0 0 Pamela Diamantis Treasurer 2.20 0.20 X X 0 0 0 Matthew Kfoury Secretary 1.00 0.40 X X 0 0 0 Edward Dudley III Executive VP & CFO 40.20 1.10 X 491606 0 229130 Thomas Della Flora VP, Chief Information Officer 40.00 0.00 X 261062 0 52497 Carolanne O'Sullivan Senior VP Provider Network 40.00 0.00 X 304370 0 58869 David Folks MD Medical Director 40.00 0.00 X 301287 0 42371 Ivan Ip Chief Medical Information Officer 40.00 0.00 X 312714 0 38321 Keith Stahl MD Physician 40.00 0.00 X 376675 0 26460 Merryll Rosenfeld VP Human Resources 40.00 0.00 X 248466 0 48700 William Goodman Former VP, Medical Affairs/CMO 0.00 0.00 X 156313 0 13987 Tina-Marie Legere Senior VP Operations 0.00 0.00 X 322463 0 21483 4133662 1419787 1284683 196 1 1 0 Dartmouth Hitchcock Clinic 1 Medical Center Drive Lebanon NH 03756 Medical services 28773168 Harvey Construction Corp 10 Harvey Road Bedford NH 03110 Construction and renovations 7546046 The Chartis Group LLC Department 5925 Carol Stream IL 60122 Healthcare advisory 5586955 Anesthesia Care Group PC PO Box 9514 Manchester NH 03101 Medical services 5548203 Synergy Surgicalists Inc 280 W Kagy Boulevard Suite D Bozeman MT 59715 Medical services 1594413 84 260808 19163201 7088128 121750 26512137 Patient services 621400 449859489 449859489 Disproportionate Share Funding 621400 21483694 21483694 Lab clients 621500 2124554 2124554 Cafeteria and dining 722210 1244269 1244269 Program-related rents 532000 429941 429941 475141947 2988625 10534 2978091 112589566 68388629 75055 44200937 -75055 44125882 44125882 38449 260808 74734 -36285 -36285 13339 21408 -8069 -8069 548724237 475133878 10534 47067688 586345 586345 70856 70856 3071261 2573061 498200 152865300 127744808 24734170 386322 4838633 4044525 783108 11000 20780491 17409612 3370879 8907973 7440413 1440626 26934 82197 82197 269457 269457 177509 177509 60175 60175 106831 106831 127978 127978 16080872 13203267 2854905 22700 1455207 1196493 258714 8483422 6929568 1498360 55494 9002229 7401766 1600463 17286709 14213224 3073285 200 338880 278381 60193 306 472162 378870 81922 11370 4659054 3873112 785942 12067385 7038102 5029283 3250737 2672804 577933 Medical supplies 110302575 108698962 1603613 Physician fees 40052055 38809280 1242775 NH Medicaid Tax 19248461 19248461 Provision for bad debt 16010077 16010077 3702894 3167685 471872 63337 454357725 402989672 50683559 684494 143987899 103062431 30902145 26807333 7028642 7362804 70177619 74021117 4836875 3912718 5226465 7176703 305923539 183582072 124241261 122341467 82207736 152435646 50862486 9828460 11121094 11803240 530592222 518751919 89591946 69263294 1065325 1065320 110427602 107787474 46059909 49255136 235068213 172897723 482212995 400268947 X 21383269 87915051 26995958 30567921 48379227 118482972 530592222 518751919 X 94366512 -22251027 -2011740 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 37412 0 0 1 60175 97587 0 Part II-B, Line 1: Catholic Medical Center (CMC) is a member of the New Hampshire Hospital Association (NHHA) and the American Hospital Association (AHA). A portion of the dues paid to these organizations in the fiscal year ending September 30, 2021 was available for lobbying expenditures on behalf of CMC and the other member-organizations in furtherance of their exempt purposes. The portion of the dues paid that constituted lobbying was as follows: NHHA: $25,267 AHA: $12,145 Also in the 2021 fiscal year, the Hospital paid the Diocese of Manchester for lobbying services, which included providing information regarding public policy pending before the legislature. The Diocese participated in the administrative rule-making process with respect to rules concerning the certificate of needs board. They also provided general communication with elected officials. CMC paid the Diocese $60,175 for these services. 26995958 2854022 1834839 1116898 30567921 11244891 16173712 203284 625929 26995958 10426818 1536316 -63353 654890 11244891 9726007 646924 430243 376356 10426818 9492810 169811 112670 49284 9726007 0.00000 0.34550 0.65450 0 0 672812 672812 110846008 53473685 57372323 9694467 7258552 2435915 157430064 115012422 42417642 27280188 7837413 19442775 122341467 Accrued pension & other liabilities 136210565 Due to affiliates 715593 Interest rate swap liability 277022 Medicare advances 35694543 172897723 X 557653102 -22251027 46371395 24120368 533532734 127978 15063525 15191503 548724237 439262364 96142 96142 439166222 127978 15063525 15191503 454357725 Part V, Line 4: Proceeds from the Organization's endowment funds are used in operations. Part X, Line 2: The Medical Center is a not-for-profit corporation as described in Section 501(c)(3) of the Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Medical Center's tax positions and concluded the Medical Center 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: Special event expenses 74,734. Gift Shop cost of goods sold 21,408. Changes in FMV of perpetual trust 1,546,976. Pension related changes net of periodic costs 44,523,638. Change in FMV of interest rate swap agreement 204,639. Part XI, Line 4b - Other Adjustments: Donations to others included in audited revenues 521,804. Provision for bad debts 14,541,721. Part XII, Line 2d - Other Adjustments: Special event expenses 74,734. Gift Shop cost of goods sold 21,408. Part XII, Line 4b - Other Adjustments: Provision for bad debts net against revenues 14,541,721. Donations to others included in audited revenues 521,804. X X X X X X 1 Accordant Philanthropy 105 Teal Nest Center Ponte Vedra Beach FL 32082 Fundraising research and capital campaigns 0 3906831 106831 3800000 3906831 106831 3800000 NH Gala 201752 174703 27049 4000 9401 18246 153 21326 Retirement Celebration 97505 86105 11400 8785 12568 255 299257 260808 38449 4000 18186 30814 153 21581 74734 -36285 Schedule G, Part I, Lines 2b(iv) and 2b(vi): In the tax period covered by this return, the Hospital engaged an independent professional fundraiser to assist the Hospital in its capital campaign and fundraising efforts. Due to the nature in which contributions were raised over past year, the Hospital cannot reasonably determine an exact allocation of the total receipts that were generated directly from the professional fundraiser. However, while an absolute exact dollar-figure cannot be determined, the Hospital appropriately estimates that it was able to retain approximately $3,800,000 as a result of the professional fundraiser's efforts, net of the fees paid for their services. 1 1 1 X 225.000000000000 1 X 1 1 0 1 1 4536863 4536863 0.01030 61809311 43708521 18100790 0.04130 66346174 43708521 22637653 0.05160 12 231 1784536 81261 1703275 0.00390 3 1167342 1167342 0.00270 4 9402892 3564073 5838819 0.01330 2 9743 1719 8024 0.00000 3 591302 182290 409012 0.00090 24 231 12955815 3829343 9126472 0.02080 24 231 79301989 47537864 31764125 0.07240 1 2479 2479 0.00000 2 28808 28808 0.00010 1 40770 40770 0.00010 1 2717 2717 0.00000 5 74774 74774 0.00020 1 4128394 104489294 142636939 -38147645 X 1 1 1 1 Catholic Medical Center 100 McGregor Street Manchester NH 03102 00646 X X X Catholic Medical Center 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 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 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 X 1 X 0 X X X X 1 X 0 0 Catholic Medical Center Part V, Section B, Line 5: A variety of different secondary data sources were accessed. They included but were not limited to the Centers for Disease Control and Prevention (CDC), New Hampshire Department of Health and Human Services (NHDHHS), Youth Behavioral Risk Factor Surveillance Survey, City of Manchester, Census data, and local town data. Representatives from CMC, Elliot Health System (EHS) and Manchester Health Department interviewed key leaders from towns in our service area to ascertain the key health related issues that they were facing and dealing with in their local communities. The towns that were included in the interview process were Auburn, Bedford, Candia, Hooksett, Goffstown, Deerfield, and New Boston. Though the overall needs were similar the priority of them varies between the towns. Overall, the common themes were substance use, the availability of behavioral health services, transportation (especially in the elderly populations and the more rural areas of New Boston and Deerfield), self-care and management of chronic disease, and access to health care for the low income populations and communities. Communications on community needs were collected via discussions with local leaders in the health care field. These leaders consisted of individuals from: Catholic Medical Center, Dartmouth-Hitchcock Clinic, Public Health Department - City of Manchester, NH, Elliot Health System, and Community Health & Mission. Catholic Medical Center Part V, Section B, Line 6a: Elliot Health System in Manchester, NH. Catholic Medical Center Part V, Section B, Line 6b: Manchester Health Department. Catholic Medical Center Part V, Section B, Line 7d: The Catholic Medical Center "Healthy Living News", the Medical Center's community newsletter, provides a summary report of the community benefits that the Medical Center provides. The Healthy Living News is distributed to our primary and secondary service areas, approximately 120,000 people. Catholic Medical Center Part V, Section B, Line 11: Catholic Medical Center has addressed the needs identified in the June 30, 2019 CHNA through the implementation of programs and services throughout the Manchester health service area (HSA). Mental illness and violence are often intrinsically intertwined. CMC has increased services within our Behavioral Health Department and developed the Opioid Use/Misuse Resource. This is an online tool available to all CMC staff to create consistency of care in the treatment and recovery of this public health epidemic. Health Care for the Homeless (HCH) of CMC provides behavioral health services and substance abuse counseling to the homeless throughout the Manchester HSA. CMC has improved the mental health assessment tool in Primary Care, a key component in the early identification and treatment of mental illness. In collaboration with Governor Hassan's Senior Director of Substance Misuse and Behavioral Health and Boston University School of Medicine, CMC conducted the fourth annual "State-of-the Art Management of the Opiate-dependent Patient, Pain Treatment and the Heroin Epidemic". The targeted audience for this conference included prescribers, nurses, allied health professionals, pharmacists and social service agencies. The program addressed many facets of substance abuse within our community, hospitals, and practices. In addition, CMC hosted the Annual Summit on the Treatment of Opioid-Dependent Patients and Pain, added an Addiction Medicine Practice, and increased the number of providers utilizing medication assisted treatment.The Doorway of Greater Manchester: In May 2020, CMC, assumed leadership of The Doorway Program of Greater Manchester. The NH Doorway system was launched in January 2019 with funding from the State Opioid Response grant from the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA) and is designed to be an access point for those seeking services for substance use disorder (SUD). A 2018 study from SAMHSA found that 20.3 million people aged 12 or older, or 7.4% of this population had a SUD. SUD continues to be an area of concern identified in the Greater Manchester Community Health Needs Assessment. Of those with an addiction-related condition, only 11% received treatment. By operating the Doorway, CMC is committed to assisting those with SUD by connecting them with clinical treatment and wrap-around services to break the cycle of addiction. Wilson Street Integrated Health: Continuing its mission of caring for the region's most vulnerable neighbors, CMC opened Wilson Street Integrated Health (WSIH), located within the Manchester Recovery and Treatment Center (MRTC). Wilson Street Integrated Health is a service of the Health Care for the Homeless Program of Manchester, a collaboration between CMC and the City of Manchester Health Department. The new practice offers primary care, social work, counseling and medication assisted treatment to our most vulnerable patients, as well as providing our patients with easy access to our MRTC partners: Hope for New Hampshire Recovery, The Willows Substance Use Treatment Center, and the Mental Health Center of Greater Manchester's Mobile Crisis Response Team. Ambulatory care, chronic disease, including asthma and aging issues have all been addressed through various means. Catholic Medical Center's Primary Care has implemented The Patient-Centered Medical Home (PCMH) Model, a proactive approach to preventative medicine through the introduction of care coordinators to the primary care practices. All care managers work with the practices' most high risk patients (asthma, diabetes, COPD, etc) to ensure they understand their medications and follow-up care. The PCMH Model encourages patients to become involved and educated in their personal care plan. CMC offers free health screenings, chronic disease, and self-management classes to the community. These programs provide the opportunity for early detection of chronic disease; referral based follow-up care and education on adopting healthy lifestyle behaviors, communicating with the healthcare team, problem solving, and goal setting. To aid with aging issues, CMC's Parish Nurse program provides nurse consultations, education, referrals, and screenings at Parishes throughout the Greater Manchester Area.In order to address the barriers to access of health care services related to poverty (lack of insurance, cost, transportation and education on accessing care, and lack of medical home) CMC provides comprehensive care to Manchester's underserved and refugee populations. Health Care for the Homeless provides primary medicine and behavioral health care to over 1,700 homeless patients. CMC's Certified Application Counselors (CAC) provide outreach and enrollment services to the communities' uninsured. CACs provide information on a full range of qualified health plan (QHP) options and assist individuals in applying for coverage through a QHP in the ACA's Marketplace Exchange. CMC has staffed the emergency department with a community health worker to improve primary care access for the homeless population, provide education on accessing care, and transportation support. CMC provides shuttle support at no cost to patients with offsite appointments such as primary care, outpatient PT, and other services that are not available at the Hospital. CMC assists patients through the Medication Assistance program to obtain medications they would otherwise not be able to afford and has developed a prescription delivery program with Rite Aid Pharmacy to assist patients with filling their medications upon discharge.CMC's Poisson Dental Facility has expanded access to oral health services to patients of the Pregnancy Care Center and Manchester Community Health Center (MCHC). The Poisson Dental Facility provides access to exams and treatment planning for women from the Pregnancy Care Center and access to oral health care during the first post-partum year until their treatment plan has been completed. CMC's Poisson Dental facility provides oral health services to not-for-profit agencies in our community including Mental Health Center of Greater Manchester, Moore Center Services, Manchester Health Department, and Health Care for the Homeless (HCH). The majority of HCH patients often arrive with very poor oral health. In an effort to meet the growing need for oral health services, CMC's Poisson Dental expanded services to include school-based dental care for children in need attending Manchester elementary, middle, and high schools. This school-based program is made possible through collaboration with the City of Manchester Health Department and Easter Seals NH. Poisson Dental also provides onsite dentistry at Dartmouth Hitchcock Manchester by integrating these services within their pediatric practice. This allows for ease of access for the patients and direct communication amongst the providers of care.CMC's Fertility Education provides teens at local schools and parishes educational opportunities such as The Cradle Within, Ideal Dating, Sexual Risk Behavior, and Conflict Resolution. The goal is to equip adolescents with the tools to identify healthy relationships and the benefits of choosing sexual risk avoidance behaviors. The Pregnancy Care Center provides supportive prenatal care to all women, including teens, regardless of their ability to pay. Their mission is to improve pregnancy outcomes by serving those most in need and unable to access services in a traditional prenatal setting. The Pregnancy Care Center expanded services, adding Centering Group Prenatal Care; this program is a multifaceted model of group care that integrates the three major components of care: health assessment, education, and support. Visits promote greater patient engagement, personal empowerment, and community-building. Veteran's Support: In June of 2018, Easter Seals and Catholic Medical Center launched a pilot program to provide Easter Seals' Military & Veteran Services (MVS) care coordination services onsite to veterans, service members, and their immediate family members (including CMC staff members). Easter Seals MVS provides care coordination services to veterans of all eras, regardless of branch, active duty status, length of service, or discharge status. Among other things, Easter Seals MVS can help patients (and staff members who are veterans) to determine eligibility for and connect to military and civilian benefits and resources, stabilize housing, and find employment support.Breast & Cervical Cancer Screening: Regular screenings and follow-up care can help prevent or more effectively treat breast and cervical cancers. The Let No Woman Be Overlooked Breast and Cervical Cancer Program allows women throughout New Hampshire who do not have access to essential, basic, preventive care access free screenings.(Explanation is continued later in Part V, Facility Information) Catholic Medical Center Part V, Section B, Line 16j: Signs are posted throughout the hospital facility and physician practices that list the financial programs available and contact information for assistance. Part V, Line 7a & 7b: Hospital's Website URL for Community Health Needs Assessment: www.catholicmedicalcenter.org/about-cmc/in-the-community/community-health-needs-assessment The CHNA can also be found at:https://www.elliothospital.org/website/downloads/Manchester-Report-Final-compressed.pdf Part V, Line 10a: Hospital's Website URL for Community Health Implementation Plan:www.catholicmedicalcenter.org/about-cmc/in-the-community/community-health-implementation Schedule H, Part V, Section B, Line 16a-16c: The financial assistance policy, application, and plain language summary are available online: https://www.catholicmedicalcenter.org/patients-visitors/financial-assistance Part V, Section B, Line 11 (continued): Catholic Medical Center has a long history of providing services to the community and currently has programs in place to meet every identified need in the most recent CHNA. In addition to the programs we currently offer, we will expand many of our services in response to the needs of the community that have not been addressed. 45 1 - New England Heart Institute 100 McGregor Street Manchester NH 03102 Cardiovascular Health 2 - Hospital Medicine 100 McGregor Street Manchester NH 03102 Hospital Medicine 3 - Cardiothoracic Surgical Associates 100 McGregor Street Manchester NH 03102 Cardiothoracic Surgical Associates 4 - Women's Wellness & Fertility Center 88 McGregor Street Suite 201 Manchester NH 03102 Women's Health 5 - Surgical Care Group 87 McGregor Street Suite 3100 Manchester NH 03102 Surgical Care 6 - Amoskeag Family Practice 1750 Elm Street Suite 201A Manchester NH 03101 Family Medicine 7 - Bedford Center Int Med & Pediatric 188 Route 101 Bedford NH 03110 Internal Medicine and Pediatrics 8 - Outpatient Rehabilitation 188 Route 101 Bedford NH 03110 Outpatient Rehabilitation 9 - Family Physicians of Manchester 57 Webster Street Suite 110 Manchester NH 03104 Family Medicine 10 - Goffstown Family Practice 17A Tatro Drive Suite 201 Goffstown NH 03045 Family Medicine 11 - Granite State Internal Medicine 188 Route 101 Bedford NH 03110 Internal Medicine 12 - Hooksett Internal Medicine 11 Kimball Drive Unit 132 Hooksett NH 03103 Internal Medicine 13 - Highlander Way Internal Medicine 1 Highlander Way Manchester NH 03103 Internal Medicine 14 - Lakeview Internal Medicine 27 Londonderry Turnpike Hooksett NH 03106 Internal Medicine 15 - Outpatient Rehabilitation 27 Londonderry Turnpike Hooksett NH 03106 Outpatient Rehabilitation 16 - Queen City Medical Associates 775 South Main Street Manchester NH 03102 Skilled Practitioners 17 - Willowbend Family Practice 5 Washington Place Suite 1A Bedford NH 03110 Family Medicine 18 - Webster Street Internal Medicine 57 Webster Street Manchester NH 03104 Internal Medicine 19 - Urgent Care at Bedford Medical Park 5 Washington Place Suite 1B Bedford NH 03110 Urgent Care 20 - New England Heart Institute 59 Page Hill Road Berlin NH 03570 Heart and Vascular services 21 - Vein and Vascular Specialists 59 Page Hill Road Berlin NH 03570 Vascular Surgery services 22 - Comprehensive Neurological Care 59 Page Hill Road Berlin NH 03570 TeleNeurology services 23 - New England Heart Institute 452 Old Street Road Suite 107 Peterborough NH 03458 Heart and Vascular services 24 - Vein and Vascular Specialists 452 Old Street Road Peterborough NH 03458 Vascular Surgery services 25 - Hospital Medicine Services 452 Old Street Road Peterborough NH 03458 Hospitalists 26 - New England Heart Institute 173 Middle Street Lancaster NH 03584 Heart and Vascular services 27 - Vein and Vascular Specialists 173 Middle Street Lancaster NH 03584 Vascular Surgery services 28 - Comprehensive Neurological Care CMC 775 S Main Street Manchester NH 03102 Comprehensive Neurological Care 29 - Outpatient Rehabilitation 769 South Main Street Suite 201 Manchester NH 03102 Outpatient Rehabilitation 30 - New England Heart Institute 181 Corliss Lane Colebrook NH 03576 Heart and Vascular services 31 - Hospital Medicine services 181 Corliss Lane Colebrook NH 03576 Hospitalists 32 - Cholesterol Management Center 195 McGregor Street Suite 312 Manchester NH 03102 Cholesterol Management services 33 - New England Heart Institute 6 Tsienneto Road Suite 301 Derry NH 03038 Heart and Vascular services 34 - Vein and Vascular Specialists 160 South River Road Suite 100 Bedford NH 03110 Vein and Vascular Specialists 35 - New England Heart Institute 3 Alumni Drive Suite 101 Exeter NH 03833 Heart and Vascular services 36 - New England Heart Institute 240 S Main Street Suite K Wolfeboro NH 03894 Heart and Vascular services 37 - Vein and Vascular Specialists 240 S Main Street Wolfeboro NH 03894 Vascular Surgery services 38 - New England Heart Institute-Nashua 166 Kinsley Street Suite 301 Nashua NH 03060 NEHI Nashua 39 - Bedford Ambulatory Surgical Center 9 Washington Place Suite 204 Bedford NH 03110 Gastroenterology services 40 - New England Heart Institute 1 Parkland Drive Derry NH 03038 Heart and Vascular services 41 - Vein and Vascular Specialists 172 Kinsley Street Nashua NH 03060 Vascular Surgery services 42 - New England Heart Institute 16 Hospital Road Plymouth NH 03264 Heart and Vascular services 43 - Vein and Vascular Specialists 103 Boulder Point Plymouth NH 03264 Vascular Surgery services 44 - North End Internal Medicine 1750 Elm Street Suite 201A Manchester NH 03101 Internal Medicine 45 - New England Heart Institute 15 US Route 302 Suite 1 Glenn NH 03838 Vascular Surgery services 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 $ 16,010,077. Part II, Community Building Activities: Catholic Medical Center participates in a wide range of community building activities, committees, boards, and partnerships to promote the health of the communities it serves, including City Year, Granite United Way, and New Hampshire Charities, among others. The Medical Center sponsors emergency service efforts through planning hours for emergency preparedness and bioterrorism preparedness safety management.COVID-19: During the unprecedented COVID-19 pandemic, CMC was an integral part of the community's response activities. Early on in the pandemic, CMC partnered with the City of Manchester at the City's first COVID testing center located at the NH State Armory. Shortly thereafter, CMC collaborated with the City of Manchester, NH National Guard, and other healthcare partners to stand up the Greater Manchester Alternative Care Site (GMACS), a 250-bed field hospital located at Southern New Hampshire University (SNHU). CMC's Incident Command Center held weekly calls with the City's Emergency Operations Center, ensuring constant communication and updated information sharing. Finally, CMC has provided clinical and non-clinical staff to support the State's fixed Covid Vaccine site at SNHU as well as super clinics held at the New Hampshire Motor Speedway. Part III, Line 2: Costing methodology ratio of cost to charge is used to arrive at cost of bad debt expense. Part III, Line 3: Patients deemed eligible for financial asssistance follow CMC's charity care policies. Therefore, no bad debt expense related to patients eligible under the Hospital's financial assistance policy is included as a community benefit. Part III, Line 4: See Footnote 2 on Page 11 of the attached audited financial statements. Part III, Line 8: The entire Medicare shortfall is reported in our Community Benefit Report to the State of New Hampshire. The Medicare shortfall represents costs incured by the Hospital for providing care to Medicare patients in the Hospital's service area that were not reimbursed by the federal government. The Hospital considers this amount to be a significant shortfall for providing healthcare-related services to these patients which ultimately benefits the community it serves. Part III, Line 9b: CMC is a charitable healthcare organization that treats patients for emergency or medically necessary care regardless of their financial status. CMC's Collections Policy and Procedures addresses the procedures for patients who choose not to make payment or work with CMC to make payment arrangements for their bill. The policy contains specific language that applies to those patients who may qualify for financial assistance. CMC will hold collection activities where the patient has submitted a completed financial assistance application. CMC makes reasonable efforts to determine whether an individual is eligible for financial assistance under our Financial Assistance Policy (FAP). In order to determine whether a patient is eligible for financial assistance, CMC provides written notice that indicates the availability of financial assistance, provides a plain-language summary of the FAP, and attempts to notify the individual orally about the FAP and how the patient may get assistance with the application process. CMC also publishes the policy on our website, at patient registration locations, and provides notice to the community. Part VI, Line 2: In collaboration with the city of Manchester and other health care and social service agencies, Catholic Medical Center participates in a community needs assessment as required by the New Hampshire Attorney General's Office Division of Charitable Trusts.Since hospitals are required to assess the needs of their community every three years, CMC has completed a 2019 Needs Assessment and approved by the board and made widely available to the public during the fiscal year covered by the Hospital's 2018 Form 990. The previous Needs Assessment was completed in fiscal year 2016 by CMC and the Elliot Hospital of the City of Manchester. Additional information is obtained on an ongoing basis to assist the Organization in evaluating progress towards meeting our goals and the identification of new areas of need. This information is collected through community surveys, focus groups and discussions with community leaders, program evaluations and communication with those in the community who interact with our vulnerable populations.As of the time of this return's filing, the Catholic Medical Center is currently working on the 2022 Community Health Needs Assessment. Part VI, Line 3: Patients are notified of CMC's FAP via notices upon registration, discharge, postings to our website, in the hospital, and physician practices. Signage is posted throughout the Hospital and physician practices highlighting Catholic Medical Center's financial assistance. CMC also communicates the policy to the community via mailings and other postings in relevant local support organizations. CMC also contacts patients verbally to inform them of the programs available. Part VI, Line 4: Catholic Medical Center's primary service area consists of the following towns and cities: Allenstown, Auburn, Bedford, Goffstown, Hooksett, Manchester, and New Boston. Our secondary service area is made up of Amherst, Concord, Derry, Litchfield, Londonderry, Merrimack, Milford, Nashua, Peterborough, Raymond, Salem and Weare. Part VI, Line 5: Catholic Medical Center is involved in numerous community initiatives to improve the health outcomes of our community, including, but not limited to the following: DSRIP 1115 Waiver, N4H a federally funded program with the state of New Hampshire to transform care by integrating primary and behavioral health care to improve health outcomes; a collaboration with The Manchester Health Department, Easter Seals, and Catholic Medical Center to provide school-based dental care to school-aged children in need. Services are provided at all Manchester elementary and middle schools along with one of the high schools; partnership with Dartmouth Hitchcock Clinic for the integration of dental care within a pediatric clinic setting, improving oral health and overall health and a partnership with Amoskeag Health Center to provide oral health exams and hygiene and a referral to a dental home for children ages 1-5; 500 Cities initiative with CMC's Parish Nurse Program and Manchester Health Department to offer assessments and services to high risk populations located within neighborhoods; primary care, specialty care and care coordination the homeless population via the HRSA grant; Medication Assistance Program offering free or reduced cost medication through the pharmaceutical companies and other low cost resources; emergency bioterrorism preparedness safety management. Part VI, Line 6: Catholic Medical Center operates as part of CMC Healthcare System. Under the System, CMC offers a range of healthcare services to the community. The System includes CMC as a licensed, 330 bed full-service, acute care hospital, physician practices, general care surgical capabilities, and advanced care for cardiac needs. Catholic Medical Center offers full medical-surgical care with more than 25 subspecialties, comprehensive orthopedic care, inpatient and outpatient rehabilitation services, a 24-hour emergency department, outpatient behavioral health services, and diagnostic imaging. In addition, Catholic Medical Center has the Special Care Nursery which is a state-of-the-art neonatal facility designed to meet the distinct needs of our babies and their families. Catholic Medical Center is also home to the nationally recognized New England Heart and Vascular Institute (NEHVI), which provides a full-range of cardiac services, and is a pioneer in offering innovative surgical procedures. The Institute is also a national center for advanced clinical trials and cardiovascular rehabilitation and wellness education to help patients recover in a multi-step program of exercise, education, risk factor management, and the development of healthy lifestyles. The System also participates in two joint ventures, Bedford Ambulatory Surgical Center and Alliance Urgent Care Services, through its wholly-owned entity, and Alliance Ambulatory Services through the Granite Health Network.CMC has a deeply rooted history of providing care to those most in need through the Community Health and Mission department. CMC reaches beyond the walls of the hospital and into the community, assisting underserved individuals with health information and access to care. Community Health and Mission provides a wide variety of education, clinical services and resources for those in our primary and secondary markets. It is the home of the Pregnancy Care Center, the Poisson Dental Facility, the Health Care for the Homeless program, and the Parish Nurse program. We provide medication assistance, breast and cervical cancer screenings, and health screenings. Part VI, Line 7, Reports Filed With States NH 1 Foundation for Healthy Communities 125 Airport Road Concord NH 03301 020275078 501(c)(3) 525073 NH Hospital Association, NH Medicaid Expansion, Drug and Alcohol Abuse Prevention Initiatives Amoskeag Health (formerly Manchester Community Health Center) 145 Hollis Street Manchester NH 03101 020458174 501(c)(3) 31272 Book value Medical equipment and supplies Funding and equipment for health care services and initiatives Community College System of New Hampshire 26 College Drive Concord NH 03301 900531902 GOV 30000 Funding for educational programs to promote and advance health care professionals. 3 0 Hermsdorf Scholarships - financial assistance for the training of worthy and needy students who are employees of CMC. 4 1900 Sister Margaret Scholarships - financial assistance for individuals pursuing a career in medical and/or health services. 3 2116 BSN or Higher Scholarships - financial assistance to employees who wish to improve their performance and proficiency in the nursing field. 1 200 Caring for Co-workers program to provide general assistance to individuals in need. 60 55140 Citizens LNA Program - financial assistance for individuals pursuing a career in medical and/or health services. 19 11500 Part I, Line 2: The Hospital will only makes donations to 501(c)(3) public charities or governmental municipalities. The Hospital may award grants to individuals living in the United States if the recipient-individuals are employees of the Catholic Medical Center system, and if the recipient-individuals meet certain merit and financial-need eligibility requirements. Grants to individuals are awarded in the form of scholarships to pursue higher education and skills in the healthcare field while also working for the Hospital. X 1 1 X X X X X 1 1 0 0 0 0 0 1 0 Joseph Pepe MD President & CEO (end 6/2021) 788582 0 0 0 50311 0 402330 0 39322 0 1280545 0 0 0 Alexander Walker Jr Esq President & CEO 458699 0 0 0 61114 0 165437 0 71171 0 756421 0 0 0 Louis I Fink MD Director 0 560838 0 112526 0 31154 0 14250 0 5009 0 723777 0 0 Edward Dudley III Executive VP & CFO 448437 0 0 0 43169 0 171760 0 57370 0 720736 0 0 0 Patricia Furey MD Director 0 486825 0 21676 0 7980 0 11400 0 36813 0 564694 0 0 Keith Stahl MD Physician 376675 0 0 0 0 0 14250 0 12210 0 403135 0 0 0 Carolanne O'Sullivan Senior VP Provider Network 277197 0 0 0 27173 0 14250 0 44619 0 363239 0 0 0 Ivan Ip Chief Medical Information Officer 301665 0 0 0 11049 0 8550 0 29771 0 351035 0 0 0 Tina-Marie Legere Senior VP Operations 193394 0 0 0 129069 0 4354 0 17129 0 343946 0 0 0 David Folks MD Medical Director 266287 0 15000 0 20000 0 7724 0 34647 0 343658 0 0 0 Thomas Della Flora VP, Chief Information Officer 254802 0 0 0 6260 0 10455 0 42042 0 313559 0 0 0 Merryll Rosenfeld VP Human Resources 241713 0 0 0 6753 0 10060 0 38640 0 297166 0 0 0 Carolyn Claussen MD Director 0 177768 0 21020 0 0 0 7111 0 22 0 205921 0 0 William Goodman Former VP, Medical Affairs/CMO 151471 0 0 0 4842 0 4692 0 9295 0 170300 0 0 0 Part I, Line 1a Catholic Medical Center provides certain fringe benefits that have gross-up calculations to cover taxes for a select few officers and/or highly compensated employees. In no case did this amount exceed $15,000 during the year for any one individual. Part I, Lines 4a-b Schedule J, Page 1, Line 4a, serverance payments: In August of 2020, Tina-Marie Legere, Catholic Medical Center's Senior VP of Operations and one of the Hospital's former top-five highest compensated employees, began receiving severance payments. Ms. Legere received $116,160 in severance payments during calendar year 2020. Accordingly, the $116,160 in severance is included in her reported compensation on Schedule J, Part II. This amount is also included in Ms. Legere's 2020 Form W-2, Box 5 wages. Additionally, Dr. Joseph Pepe, who served as the Organization's President and CEO, retired in June, 2021. As part of his retirement, Dr. Pepe is entitled to severance compensation as per his employment agreement. Dr. Pepe did not receive any severance payments until after his formal retirement in June, 2021. Therefore, reportable severance-compensation paid to him will be reflected on his 2021 Form W-2, and will be disclosed as required and applicable in full detail on the Hospital's Form 990 for the year ending September 30, 2022, as Schedule J, Part II, Column B(iii) Other Income. Schedule J, Page 1, Line 4b, supplemental non-qualified retirement plans: The following individuals take part in a section 457(f) forfeitable nonqualified deferred compensation plan. The amounts listed represent calendar year 2020 contributions for many years of service: Joseph Pepe: $388,080 Edward Dudley, III: $160,956 Alexander Walker, Jr., Esq.: $154,037 Part I, Line 7 A portion of compensation is at-risk and variable, and payment depends on the quality of job performance. A New Hampshire Health And Education Facilities Authority 020279866 644614x79 2012-12-19 38249382 See Part VI 0 0 0 B New Hampshire Health And Education Facilities Authority 020279866 2015-09-03 32720000 See Part VI 0 0 0 C New Hampshire Health And Education Facilities Authority 020279866 64461XBT1 2017-09-21 65363417 See Part VI 0 0 0 A 19775000 38249517 34643460 597089 3008968 2013 1 0 1 1 B 4680000 32779646 28696341 257332 3825973 2016 1 1 1 1 C 66661885 785623 66661885 2021 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 1 1 0 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 1 0 1 0 0 0 0 1 A 1 B 1 C 1 Date Rebate Computation Performed Issuer Name: New Hampshire Health And Education Facilities Authority Date the Rebate Computation was Performed: 06/19/2014 Issuer Name: New Hampshire Health And Education Facilities Authority Date the Rebate Computation was Performed: 09/03/2020 Issuer Name: New Hampshire Health And Education Facilities Authority Date the Rebate Computation was Performed: 06/30/2020 Schedule K, Part I, Line A(f): Refinance of Series 2002A Bonds Refinance of Series 2002B Bank Placement Refinance of Series 2012 Capital Note Routine Capital Improvements Schedule K, Part I, Line B(f): Advance & Current refunding of Series 2006 Bonds, and Construction Schedule K, Part I, Line C(f): To finance various construction projects. Thomas Della Flora Family Member Compensation 25522 The wife of Thomas Della Flora, an officer of the Hospital, received $25,522 in compensation and benefits as an employee (Registered Nurse) of the Hospital. Compensation paid to Mr. Della Flora's wife is in line with the salary structure for similarly employed persons at the Hospital and does not represent higher than market rate compensation due to her familial relationship with Mr. Della Flora. 0 X 4000 Per books X 2 106253 Gift Date FMV X 1 100 Per books X 7 10244 Per books X Office goods 2 1153 Per books 0 1 0 Form 990, Part VI, Section A, line 6 The members of Catholic Medical Center are CMC Healthcare System and GraniteOne Health. Form 990, Part VI, Section A, line 7a Directors of CMC are appointed by the members. Form 990, Part VI, Section A, line 7b The members have reserved powers over CMC but do not approve each separate action taken by the CMC board. Form 990, Part VI, Section B, line 11b Form 990 is prepared by an independent tax accounting firm (Baker Newman Noyes). Upon completion, a draft of the Form 990 is sent to the Organization, where the CFO, Controller, and Director of Accounting perform a final in-house review prior to submission to the Board of Directors for final approval. Upon approval from Board, the Form 990 is filed with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c Officers and directors are required to complete a conflict of interest questionnaire annually. Form 990, Part VI, Section B, line 15 CMC utilizes a compensation committee of the board of directors to set compensation levels and determine bonus potential for its senior leadership team. The committee is assisted by an independent consultant who surveys like-sized and performing institutions to benchmark relevant salary scales for each position. The consultant's findings are presented to the compensation committee who considers that external data with actual performance against a list of pre-established goals per senior leaders to set prospective compensation levels and bonus values. Bonus amounts are determined by how well an executive achieves a pre-defined set of goals. These goals, in general, are tied to the achievement of a specific task or project. Some goals are attached to achieve overall financial performance and mission performance, not solely revenue generation. Form 990, Part VI, Section C, line 19 CMC makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part XI, line 9: Pension related changes net of periodic costs 44,523,638. Change in fair market value of perpetual trust 1,546,976. Change in fair market value of interest rate swap 204,639. Net assets released for operations -1,046,594. Net transfers to affiliates -47,240,399. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Alliance Ambulatory Services 100 McGregor Street Manchester NH 03102 020519436 Ambulatory Surgical Center NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Health Services 100 McGregor Street Manchester NH 03102 611508839 Practices NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Resources 100 McGregor Street Manchester NH 03102 020398138 Real Estate NH 501(c)(3) Line 12b, II CMC Healthcare System 0 CMC Healthcare System 100 McGregor Street Manchester NH 03102 010568516 Parent NH 501(c)(3) Line 12b, II N/A 0 CMC Physician Practice Associates 100 McGregor Street Manchester NH 03102 020460245 Practices NH 501(c)(3) Line 10 CMC Healthcare System 0 GraniteOne Health 100 McGregor Street Manchester NH 03102 814663563 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Huggins Hospital 240 South Main Street Wolfeboro NH 03894 030223332 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 Monadnock Community Hospital 452 Old Street Road Peterborough NH 03458 020222157 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 St Peter's Home 100 McGregor Street Manchester NH 03102 020222228 Day Care Services NH 501(c)(3) Line 10 CMC Healthcare System 0 Bedford Ambulatory Surgical Center LLC 11 Washington Place Bedford NH 03110 020519727 Surgical Center NH N/A 0 0 Alliance Urgent Care Services 100 McGregor Street Manchester NH 03102 831238167 Health Care Services NH N/A 0 0 NH Value Care ACO LLC 100 McGregor Street Manchester NH 03102 832029076 Health Care Services NH N/A 0 0 Alliance Enterprises 100 McGregor Street Manchester NH 03102 020386795 Real Estate NH N/A C 1 Doctors' Medical Association Inc 100 Mcgregor Street Manchester NH 03102 020340690 Medical Office Building NH N/A C 0 0 0 1 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 1