MONADNOCK COMMUNITY HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
MONADNOCK COMMUNITY HOSPITAL (EIN 02-0222157)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-08-13
IRS object ID
202112259349300516
Schema version
2019v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-08-13T07:39:06-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER NEWMAN & NOYESBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1BOX 507AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222157EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Monadnock Community HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMONABusinessNameControlTxt
Phone6039247191PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1452 Old Street RoadAddressLine1Txt
CityPeterboroughCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03458ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRichard D ScheinblumPersonNm
Person TitleVP of Finance/CFOPersonTitleTxt
Phone6039247191PhoneNum
Signature2021-08-06SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNicholas E PortoPreparerPersonNm
PTINP01310283PTIN
Phone2078792100PhoneNum
Preparation2021-08-06PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCynthia K McGuirePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1452 Old Street RoadAddressLine1Txt
CityPeterboroughCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03458ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$103,082,260GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.monadnockcommunityhospital.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1919FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionCritical access hospital serving the Monadnock region of the State of New HampshireActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee688TotalEmployeeCnt
Total Volunteers109TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$568,681PYContributionsGrantsAmt
CY Contributions Grants$8,140,662CYContributionsGrantsAmt
PY Program Service Revenue$95,385,881PYProgramServiceRevenueAmt
CY Program Service Revenue$83,029,314CYProgramServiceRevenueAmt
PY Investment Income$547,589PYInvestmentIncomeAmt
CY Investment Income$11,912,284CYInvestmentIncomeAmt
PY Other Revenue$7,975PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$96,510,126PYTotalRevenueAmt
CY Total Revenue$103,082,260CYTotalRevenueAmt
PY Grants And Similar Paid$33,223PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$42,838CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$46,717,343PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$43,900,382CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$349,391CYTotalFundraisingExpenseAmt
PY Other Expenses$50,374,716PYOtherExpensesAmt
CY Other Expenses$48,145,825CYOtherExpensesAmt
PY Total Expenses$97,125,282PYTotalExpensesAmt
CY Total Expenses$92,089,045CYTotalExpensesAmt
PY Revenues Less Expenses-$615,156PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$10,993,215CYRevenuesLessExpensesAmt
Total Assets BOY$136,807,429TotalAssetsBOYAmt
Total Assets EOY$165,576,325TotalAssetsEOYAmt
Total Liabilities BOY$56,560,968TotalLiabilitiesBOYAmt
Total Liabilities EOY$78,163,000TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$80,246,461NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$87,413,325NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMonadnock Community Hospital is committed to improving the health and well-being of our community. We will elevate the health of our community by providing accessible, high quality and value based care.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$82,246,528ExpenseAmt
Grant$42,838GrantAmt
Revenue$83,029,314RevenueAmt
DescThe primary purpose of Monadnock Community Hospital (MCH) is to ensure access to quality health care for patients in our community, regardless of their ability to pay. The following is a summary of the services MCH provides in an effort to fulfill its mission, together with key program statistics for fiscal year 2020.Inpatient Services - Includes: intensive care unit, adult stays, maternity/births, and skilled nursing. During the fiscal year, the Hospital admitted 1,213 patients and recorded 3,806 patient days. Emergency Services - MCH offers health services 24 hours per day, 7 days per week. Responsible for the immediate treatment of any medical or surgical emergency; for initiating life saving procedures in all types of emergency situations; and for providing emergency and initial evaluations and treatment for other conditions including minor illnesses and injuries, and sub-acute medical problems. During the year, there were 12,020 visits to the ER. Physician Practices - Family health services, programs, and education are integral components of healthcare at MCH. Inpatient and outpatient primary care includes: medical, surgical, psychological and specialist services, provided by physicians and mid-level practitioners. These are located at the Hospital and its four satellite practices located in Antrim, Jaffrey, New Ipswich, and Rindge. During the year, 56,789 primary care office visits were recorded. Surgical Services - Includes same day and short-term inpatient surgery. MCH provides surgery in the areas of orthopaedics, general surgery, OB/GYN, ophthalmology, urology, ENT, and podiatry. In addition, the Hospital offers some non-surgical procedures including colonoscopies, gastroscopies, and pain management injections. During the fiscal year, 2,343 procedures were performed. Radiology and Diagnostics - MCH provides advanced radiological technology and extensive imaging services including: bone density, MRI, CT, nuclear medicine, ultrasound, mammography, and other diagnostic procedures, both inpatient and outpatient. During the fiscal year, 26,671 exams were performed. Rehabilitation Services - Additionally, MCH serves the people of the Monadnock Region through its medical rehabilitation and fitness services. MCH offers rehabilitation programs for cardiac and diabetic rehabilitation, along with pulmonary fitness, which feature educational and exercise components. We also provide physical and occupational therapy, as well as speech rehabilitation. During the fiscal year 47,353 procedures were recorded for these services. Wellness Services - Community members wanting to improve and maintain their health have access to an award-winning, medically-based fitness facility. During the fiscal year, 9,788 member months were recorded. Due to the COVID-19 pandemic, the Bond Wellness Center was closed to members in mid-March as has since not re-opened.Monadnock Community Hospital's Financial Grant Program provides assistance with hospital and/or physician bills for qualifying patients. In fiscal year 2020, the Organization recorded $1,344,000 in charges foregone based on established rates. The estimated cost incurred to provide these services was $763,199. In addition, Monadnock Community Hospital provided other services to the community at no cost or reduced cost, such as screenings and clinics. The cost of providing these services was approximately $4,503,000 in 2020.Desc
Total Program Service Expenses$82,246,528TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document122IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee688EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Richard D ScheinblumBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6039247191PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1452 Old Street RoadAddressLine1Txt
CityPeterboroughCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03458ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndOfficerOfficerInd
Joseph Pepe MD
Ex-Officio (voting)3.0043.40Yes (X)$0$866,957$420,805
Alexander J Walker Esq
Trustee3.0040.60Yes (X)$0$537,215$221,123
William White MD
Physician23.200.00$619,450$0$22,833Yes (X)
Ronald Michalak MD
Physician50.000.00$484,646$0$28,322Yes (X)
Terrence McNamara DO
Physician50.000.00$445,189$0$32,075Yes (X)
Shawn Harrington MD
Ex-Officio (voting)50.000.00Yes (X)$431,433$0$28,233
Jennifer Peppers MD
Physician22.500.00$402,247$0$22,313Yes (X)
Cynthia McGuire
Chief Executive Officer55.001.00Yes (X)$356,642$0$50,908Yes (X)
Michele Gunning MD
Physician50.000.00$337,495$0$5,490Yes (X)
Lucas Shippee DO
Ex-Officio (voting)50.000.00Yes (X)$309,906$0$4,382
Elizabeth Cooley MD
Ex-Officio (voting) (end 5/20)50.000.00Yes (X)$235,874$0$27,528
Richard D Scheinblum
VP Finance/CFO50.000.00$210,733$0$14,160Yes (X)
Lara Niemela MD
Ex-Officio (voting)27.800.00Yes (X)$164,953$0$26,506
Robert Boyd
Trustee3.000.00Yes (X)$0$0$0
Peter Cerroni DMD
Trustee3.000.00Yes (X)$0$0$0
Jeffrey R Crocker Esq
Trustee3.000.00Yes (X)$0$0$0
Barbara R Duckett RN
Trustee (end 12/19)3.000.00Yes (X)$0$0$0
Paul Faber
Trustee3.000.00Yes (X)$0$0$0
Carolyn Garretson
Trustee3.000.00Yes (X)$0$0$0
William James Jr
Trustee3.000.00Yes (X)$0$0$0
Leslie Lewis
Trustee3.000.00Yes (X)$0$0$0
Marcia Ober
Chair (end 1/20)/Trustee3.000.50Yes (X)$0$0$0Yes (X)
Michael Shea
Vice Chair (end 1/20)/Chair3.000.00Yes (X)$0$0$0Yes (X)
Thomas S Bates CPA
Treasurer3.000.00Yes (X)$0$0$0Yes (X)
James Callahan Esq
Secretary (end 1/20)/Vice Chair3.000.00Yes (X)$0$0$0Yes (X)
Patricia Shuster
Trustee/Secretary (begin 1/20)3.000.00Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,998,568TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,404,172TotReportableCompRltdOrgAmt
Total Other Compensation$904,678TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K59IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Catholic Medical Center
195 McGregor StreetManchesterNH03102Contract Physician and Lab Services$3,032,653
Monadnock Region Emergency Physicians PL
380 Lafayette RoadHamptonNH03842Contract Emergency Physician Group$2,572,500
Monadnock Anesthesia Association
c/o Surgical SuitePeterboroughNH03458Contract Anesthesia Group$1,471,992
Hutter Construction Corporation
PO Box 257New IpswichNH03071General Contractor$1,251,771
Blue Oak Wellness Strategies LLC
901 Sonterra Boulevard Suite 311San AntoniaTX78258Contract Fitness Group$891,826
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Government Grants$7,604,551GovernmentGrantsAmt
All Other Contributions$536,111AllOtherContributionsAmt
Noncash Contributions$15,470NoncashContributionsAmt
Total Contributions$8,140,662TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net patient service revenue621400$73,646,587$73,646,587
Other operating revenue621400$4,744,731$4,744,731
Disproportionate share funding621400$4,325,004$4,325,004
Cafeteria/vending machine722210$247,729$247,729
Employee pharmacy sales446110$65,263$65,263
FieldValueIRS element (for citing)
Total Program Service Revenue$83,029,314TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,073,909TotalRevenueColumnAmt
Exclusion$1,073,909ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$10,838,375SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$10,838,375SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,838,375TotalRevenueColumnAmt
Exclusion$10,838,375ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$103,082,260TotalRevenueColumnAmt
Related Or Exempt Func Income$83,029,314RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$11,912,284ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$23,000TotalAmt
Program Services$23,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$19,838TotalAmt
Program Services$19,838ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,873,201TotalAmt
Program Services$1,205,300ProgramServicesAmt
Management And General$667,901ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$33,768,127TotalAmt
Program Services$30,244,638ProgramServicesAmt
Management And General$3,301,105ManagementAndGeneralAmt
Fundraising$222,384FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$22,635TotalAmt
Program Services$2,653ProgramServicesAmt
Management And General$18,816ManagementAndGeneralAmt
Fundraising$1,166FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,943,668TotalAmt
Program Services$5,101,673ProgramServicesAmt
Management And General$806,799ManagementAndGeneralAmt
Fundraising$35,196FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,292,751TotalAmt
Program Services$2,019,610ProgramServicesAmt
Management And General$256,691ManagementAndGeneralAmt
Fundraising$16,450FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$128,357TotalAmt
Management And General$128,357ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$64,076TotalAmt
Management And General$64,076ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$322TotalAmt
Program Services$322ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$190,019TotalAmt
Management And General$190,019ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,571,637TotalAmt
Program Services$6,407,138ProgramServicesAmt
Management And General$164,499ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$116,528TotalAmt
Program Services$116,528ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,166,298TotalAmt
Program Services$1,119,232ProgramServicesAmt
Management And General$1,032,920ManagementAndGeneralAmt
Fundraising$14,146FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,266,614TotalAmt
Program Services$1,110,465ProgramServicesAmt
Management And General$156,149ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,467,126TotalAmt
Program Services$2,155,823ProgramServicesAmt
Management And General$311,303ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$38,431TotalAmt
Program Services$26,434ProgramServicesAmt
Management And General$11,603ManagementAndGeneralAmt
Fundraising$394FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$35,385TotalAmt
Program Services$25,756ProgramServicesAmt
Management And General$5,242ManagementAndGeneralAmt
Fundraising$4,387FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$978,295TotalAmt
Management And General$978,295ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,389,444TotalAmt
Program Services$4,162,073ProgramServicesAmt
Management And General$227,371ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$962,373TotalAmt
Program Services$784,682ProgramServicesAmt
Management And General$177,691ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Med & Pharm Supplies$12,801,762$12,797,639$4,123
Other Medical Services$5,865,214$5,227,739$600,287$37,188
Provision for Bad Debt$4,780,507$4,780,507
NH Medicaid Enhancement$4,091,850$4,091,850

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,231,587TotalAmt
Program Services$823,628ProgramServicesAmt
Management And General$389,879ManagementAndGeneralAmt
Fundraising$18,080FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$92,089,045TotalAmt
Program Services$82,246,528ProgramServicesAmt
Management And General$9,493,126ManagementAndGeneralAmt
Fundraising$349,391FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,980BOYAmt
EOY$8,010EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$14,651,294BOYAmt
EOY$34,302,272EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$190,308BOYAmt
EOY$91,623EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,907,681BOYAmt
EOY$5,656,967EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$104,741BOYAmt
EOY$209,396EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,326,143BOYAmt
EOY$1,346,349EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,018,003BOYAmt
EOY$923,324EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$104,446,880LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$66,998,415LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$37,239,466BOYAmt
EOY$37,448,465EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$67,656,314BOYAmt
EOY$76,221,160EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$4,862,084BOYAmt
EOY$5,229,526EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$843,415BOYAmt
EOY$4,139,233EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$136,807,429BOYAmt
EOY$165,576,325EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,652,072BOYAmt
EOY$11,731,567EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,284,323BOYAmt
EOY$23,210,435EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$44,000BOYAmt
EOY$358,858EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,580,573BOYAmt
EOY$42,862,140EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$56,560,968BOYAmt
EOY$78,163,000EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$66,538,580BOYAmt
EOY$72,755,146EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13,707,881BOYAmt
EOY$14,658,179EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$80,246,461BOYAmt
EOY$87,413,325EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$136,807,429BOYAmt
EOY$165,576,325EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$10,993,215ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$3,265,920NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$560,431OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$14,602GrantsOtherOrganizationsAmt
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$322DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$14,924TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationMonadnock Community Hospital 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 is available for lobbying expenditures on behalf of Monadnock Hospital in furtherance of its exempt purpose. Monadnock Hospital does not directly perform any lobbying activities. NHHA, Portion of dues available for lobbying: $10,769 AHA, Portion of dues available for lobbying: $3,833 In addition, MCH hosts an annual legislative breakfast, which is a bipartisan event to which legislators, local politicians, and other public officials are invited to discuss health care issues in New Hampshire. Discussion topics for the 2020 breakfast focused on the current and proposed healthcare legislation, its impact on MCH, and collaboration to advocate for the growing health needs of the Monadnock region. The cost of this forum was $322.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,707,881BeginningYearBalanceAmt
Contributions$205,145ContributionsAmt
Investment Earnings Or Losses$1,372,618InvestmentEarningsOrLossesAmt
Other Expenditures$627,465OtherExpendituresAmt
End Year Balance$14,658,179EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,417,044BeginningYearBalanceAmt
Contributions$169,256ContributionsAmt
Investment Earnings Or Losses$750,558InvestmentEarningsOrLossesAmt
Other Expenditures$628,977OtherExpendituresAmt
End Year Balance$13,707,881EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,277,040BeginningYearBalanceAmt
Contributions$493,404ContributionsAmt
Investment Earnings Or Losses$1,411,813InvestmentEarningsOrLossesAmt
Other Expenditures$765,213OtherExpendituresAmt
End Year Balance$13,417,044EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,739,947BeginningYearBalanceAmt
Contributions$205,969ContributionsAmt
Investment Earnings Or Losses$1,073,757InvestmentEarningsOrLossesAmt
Other Expenditures$742,633OtherExpendituresAmt
End Year Balance$12,277,040EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,053,734BeginningYearBalanceAmt
Contributions$498,812ContributionsAmt
Investment Earnings Or Losses$708,687InvestmentEarningsOrLossesAmt
Other Expenditures$521,286OtherExpendituresAmt
End Year Balance$11,739,947EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.64460PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.35540TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$964,622OtherCostOrOtherBasisAmt
Book Value$964,622BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$35,456,923OtherCostOrOtherBasisAmt
Depreciation$21,729,893DepreciationAmt
Book Value$13,727,030BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$842,848OtherCostOrOtherBasisAmt
Depreciation$749,810DepreciationAmt
Book Value$93,038BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$65,565,373OtherCostOrOtherBasisAmt
Depreciation$44,518,712DepreciationAmt
Book Value$21,046,661BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,617,114OtherCostOrOtherBasisAmt
Book Value$1,617,114BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$37,448,465TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Interest rate swap agreements$3,956,634
Estimated third-party settlements$29,638,779
CARES Act Medicare Advances$9,266,727
FieldValueIRS element (for citing)
Total Liability$42,862,140TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$93,935,993TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$3,265,920NetUnrealizedGainsInvstAmt
Other Revenue-$560,431OtherRevenueAmt
Revenue Not Reported-$3,826,351RevenueNotReportedAmt
Revenue Subtotal$97,762,344RevenueSubtotalAmt
Investment Expenses Not Incld$190,019InvestmentExpensesNotIncldAmt
Other Revenues Not Included$5,129,897OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$5,319,916RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$103,082,260TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$86,769,129TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$86,769,129ExpensesSubtotalAmt
Investment Expenses Not Incld2$190,019InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$5,129,897OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$5,319,916ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$92,089,045TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Temporarily restricted assets are available for health care services, including the purchase of equipment and providing health education and programs. The income and dividends on permanently restricted net assets are generally used to support health care services and for capital purchases of property and equipment.
Part X, Line 2:The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is 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 or disclosure in the accompanying financial statements.
Part XI, Line 2d - Other Adjustments:Decrease in fair value of interest rate swap agreement -927,873. Increase in fair value of perpetual trust 367,442.
Part XI, Line 4b - Other Adjustments:Fundraising expenses 349,390. Bad debt expense netted with revenue on audited financial statements 4,780,507.
Part XII, Line 4b - Other Adjustments:Fundraising expenses 349,390. Bad debt expense netted with revenue on audited financial statements 4,780,507.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other275.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$763,199TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$763,199NetCommunityBenefitExpnsAmt
Total Expense0.00870TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,590,702TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,831,347DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,759,355NetCommunityBenefitExpnsAmt
Total Expense0.03160TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,353,901TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,831,347DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,522,554NetCommunityBenefitExpnsAmt
Total Expense0.04030TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$402,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$402,000NetCommunityBenefitExpnsAmt
Total Expense0.00460TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,000NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,848,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,848,000NetCommunityBenefitExpnsAmt
Total Expense0.04410TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$247,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$247,000NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,503,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,503,000NetCommunityBenefitExpnsAmt
Total Expense0.05160TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,856,901TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,831,347DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,025,554NetCommunityBenefitExpnsAmt
Total Expense0.09190TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,714,640BadDebtExpenseAmt
Bad Debt Expense Attributable$122,918BadDebtExpenseAttributableAmt
Reimbursed By Medicare$26,065,179ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$25,873,938CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$191,241MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Monadnock Community HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1452 Old Street RoadAddressLine1Txt
CityPeterboroughCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03458ZIPCd
FieldValueIRS element (for citing)
State License02507StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Monadnock Community HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted17CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLsee Part V, Section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Section CStrategyWebsiteURLTxt
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care275.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Section CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Section CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Monadnock Community HospitalPart V, Section B, Line 5: Monadnock Community Hospital (MCH) used a methodology that was highly focused on identifying needs among underserved populations. The approach used was designed to elicit perspective from a broad range of community stakeholders - especially those representing higher risk groups. MCH used a multi-phased methodology to achieve the objectives of the assessment. The methodology included the following stages: establishing a leadership team to provide project guidance and insight regarding local health resources and perspectives of community needs; strategic secondary research; conducting qualitative research through group discussions and surveying community stakeholders representing high-risk populations in the service area; needs prioritization process. Establishing a Leadership Team - MCH benefits from having a highly stable group of community leaders - many of whom have participated in CHNA processes and worked collaboratively with MCH to address prioritized need for many years. The benefit of this is that a broad section of the MCH region service providers remain engaged and highly insightful about emerging needs, as well as the impact of existing strategies. The Leadership Group, though retaining a core group of highly experienced participants - is continually enhanced with the addition of new participants who bring creative insight and unique perspectives. The result is a MCH-led CHNA Leadership Group that is highly effective, quickly transitions "assessed needs" to implementation strategies, and is sensitive to evolving needs and opportunities for improving health and wellbeing. The Group offered critical feedback on the project work plan, critiqued quantitative data, helped to refine the list of community needs, helped develop the database of available resources, and participated in quantitative and qualitative research methods to build the prioritized list of identified community needs. Qualitative (Primary) Research - Leadership meetings and one-on-one interviews were conducted with a broad range of MCH leaders, community stakeholders, other community service providers, and healthcare consumers in the service area. The primary research also included quantitative and qualitative feedback provided from 33 community leaders and stakeholders via an electronic survey. The research approach was designed to "cast a broad net: and engage underserved populations and other stakeholders highly knowledgeable about resources and service gaps that those communities face. The research goals were (1) to flesh out a high-level list of community needs, and (2) to gain insight and granularity regarding specific subpopulations impacted by higher priority needs. The discussion group included leaders from community service providers who represent at-risk groups such as (but not limited to) adults and children suffering from behavioral health problems, chronic disease patients and those at-risk of acquiring a chronic condition, economically challenged populations including children living in poverty and/or near-poverty, homeless individuals and families, individuals and families in engaging in risky lifestyles, populations requiring integrated care service, senior citizens, and other frequent users of the healthcare system.
Monadnock Community HospitalPart V, Section B, Line 11: Please see attached implementation plan for how the Hospital is addressing (or any needs it is not addressing and why) the significant needs of the community in which it serves.
Monadnock Community HospitalPart V, Section B, Line 16j: The complete financial assistance policy is available upon request and in the waiting rooms. Instructions on how to find out more about financial assistance are posted on the Hospital's website, on the back of all billing invoices, and published in a brochure that is available around the Hospital and in the admissions office.
Monadnock Community HospitalPart V, Section B, Line 20e: The Hospital Patient Financial Services (PFS) Department shall develop and implement billing and collection procedures designed to maintain an adequate cash flow, keep accounts receivable at an acceptable level, and identify and write-off bad debts in a timely fashion. Monadnock Community Hospital contracts with an agency to process all self-pay accounts and self-pay after insurance balance statements/letters.I. Self-pay accounts and self-pay balances remaining after insurance adjudication shall be transferred to the agency on a weekly basis. The cycle for collections is three (3) statements and/or letters and two phone call series spaced approximately thirty (30) days apart. The statements shall include:a. Previous balance (unless this is the first statement).b. Activity since last statement (except those accounts that went to a $0.00 balance).c. Current balance due.d. Telephone number(s) for inquiries concerning the statement.e. Status or reminder message where appropriate.f. Availability for the use of a credit card for payment.g. Information regarding Financial Assistance and Medication Bridge Programs.h. Return envelope.II. In the event that statements or letters are returned by the postal service as undeliverable for reasons such as "moved, left no forwarding address," "forwarding order expired, or "no such address" the agency will indicate on the daily report "mail returned." PFS staff will review system for the correct address and will make corrections within the computer system and correspondence will be re-mailed. If no correct or current information can be obtained, the specific account(s) shall be flagged for referral to an outside collection agency equipped to handle this type of situation (see bad debt processing footnote).In addition, on a weekly basis, the FAP staff run system reports to identify emergency room visits classified as self-pay. Based on the information in these reports, the guarantor of each visit is sent a financial assistance application in the mail. Determination of eligibility is contingent upon receiving a completed application and required documentation from the patient and/or guarantor.
Schedule H, Part V, Section B, Line 7a & 10a:The Hospital's Community Health Needs and Benefits web-page can be found at the following address:https://monadnockcommunityhospital.com/about-us/community-health-needs-and-benefits/The Hospital's previous CHNA, for the year ending September 30, 2015, can be found at the following address:https://monadnockcommunityhospital.com/wp-content/uploads/2018/12/CHNA_2015.pdfThe Hospital's current CHNA, for the year ending September 30, 2018, can be found at the following address: https://monadnockcommunityhospital.com/wp-content/uploads/2018/12/2018-CHNA-Report-FINAL-1.pdfThe Hospital's Implementation Plan, for the period covering 2019-2021, can be found at the following address:http://monadnockcommunityhospital.com/wp-content/uploads/2019/06/MCH-Implementation-Plan-2019.pdf
Schedule H, Part V, Section B, Line 16b:The complete financial assistance policy is available upon request and in the waiting rooms. Instructions on how to find out more about financial assistance are posted on the Hospital's website, on the back of all billing invoices, and published in a brochure that is available around the Hospital and in the admissions office.The Hospital's Financial Assistance Policy is available on the Hospital's website at:http://monadnockcommunityhospital.com/wp-content/uploads/2020/11/MCH-FAP-Policy.pdfThe Hospital's Financial Assistance Policy Application is available at:http://monadnockcommunityhospital.com/wp-content/uploads/2021/03/MCH-FAP-Application.pdfThe Hospital's Financial Assistance Plain Language Summary is available at:http://monadnockcommunityhospital.com/wp-content/uploads/2021/03/FAP_Plain_Language_Summary-2021.pdfAdditional Financial Assistance information may be found at:https://monadnockcommunityhospital.com/financial-services/financial-assistance/
FieldValueIRS element (for citing)
Facility11FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Bond Wellness Center
458 Old Street Road Wellness CenterPeterboroughNH03458Fitness center and rehabilitation services
2 - Monadnock Orthopedic Associates
458 Old Street Road Wellness CenterPeterboroughNH03458Physician practice
3 - Jaffrey Family MedicinePT Satellite
82 Peterborough RoadJaffreyNH03452Physician practice with PT services
4 - Monadnock Regional Pediatrics
454 Old Street Road MAB BuildingPeterboroughNH03458Physician practice
5 - Monadnock Internal Medicine
454 Old Street Road MAB BuildingPeterboroughNH03458Physician practice
6 - Monadnock Surgical Associates
454 Old Street Road MAB BuildingPeterboroughNH03458Physician practice
7 - Monadnock Behavioral Health
458 Old Street Road Wellness CenterPeterboroughNH03458Physician practice
8 - Monadnock Family Care
454 Old Street Road MAB BuildingPeterboroughNH03458Physician practice
9 - Antrim Rural Health Clinic
12 Elm StreetAntrimNH03440Physician practice
10 - Rindge Family Practice
145 US Route 202RindgeNH03461Physician practice
11 - New Ipswich Family Medicine
821 Turnpike RoadNew IpswichNH03071Physician practice

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:N/A
Part I, Line 6a:N/A
Part I, Line 7:Charity care and means tested programs use the cost to charge ratio as their methodology. This Hospital calculates the ratio in a manner consistent with worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of cost to charges.
Part I, Line 7g:Included in the subsidized health services activities reported for FY 2020 are unreimbursed costs of $400,000 attributed to an outpatient behavioral health practice and $3,311,000 related to emergency and trauma services.
Part I, Ln 7 Col(f):The Bad Debt expense included on Form 990, PartIX, Line 25(A), but subtracted for purposes of calculating the percentage in this column is $4,780,507.
Part II, Community Building Activities:See previous footnotes.
Part III, Line 2:The amount reported on Part III, Line 2 was derived by applying the cost to charge ratio against the amount of bad debt expense reported on Form 990, Part IX, Line 25, Column (A) ($4,780,507). Accounts written off to bad debt include gross charges being written off less any payments received against those charges. Any cash collected on accounts previously written off is included as an offset to bad debt expense as recoveries of bad debt. The Hospital calculates the ratio in a manner consistent with Worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of costs to charges.
Part III, Line 3:The estimated amount of charity care included in bad debt expense is based on the number of applications for charity care denied due to lack of complete documentation against the average charity care write off at cost per qualified patient. We believe the amount is minimal based on our extensive efforts to educate patients and staff about our various payment plans and financial grant programs to ensure that patients who qualify for any of our programs utilize them. Depending on the specific circumstances, a patient may be eligible for charity care, discounted care, payment programs, or a combination of the above. Due to these efforts, we believe that amounts written off to bad debt that could qualify as charity care is minimal.
Part III, Line 4:Please see footnote 1 on page 8 of the attached audited financial statements.
Part III, Line 8:Medicare allowable costs for the Medicare cost report are reported in accordance with CMS guidelines using the cost to charge ratio methodology.
Part III, Line 9b:As of 9/30/2011 Monadnock Community Hospital has a written credit and collection policy. Described within that policy are the collection practices and bad debt processes that are followed for patients who are known to qualify for charity care or financial assistance. The Organization utilizes a Financial Assistance Program (FAP) file which is maintained by the Patient Financial Assistance Department of MCH. The Patient Financial Services (PFS) staff reference this file for approval status and eligibility amounts, identifying any account(s) where the discount will apply. Internal FAP insurance plans are applied to those accounts and related discount amounts are adjusted in the billing system. Remaining balances are expected to be paid in full by the patient. Payment plans may be requested by the patient and are established by the Financial Grant Coordinator based on the patient's available income and assets. Accounts are annotated to reflect payment arrangements. During bad debt processing, designated staff evaluate accounts listed as collection review for potential bad debt write off. This process includes an examination of account history for indication of FAP application.
Part VI, Line 2:The State of NH, under RSA 7:32-f, requires every healthcare charitable trust, either alone or in conjunction with other healthcare charitable trusts in its community, to conduct a Community Health Needs Assessment to assist in determining the activities to be included in its community benefits plan. The needs assessment process includes consultation with members of the public, community organizations, service providers, and local government officials in the entity's service area to identify and prioritize the community needs that the health care entity can address directly or in collaboration with others. The Community Health Needs Assessment is updated at least every three years, most recently in 2018. In 2007, the Regional Community Benefits Steering Committee was first formed to prepare a single Community Benefits Needs Assessment for the Monadnock Region. The work group consisted of representatives from multiple organizations, including Monadnock Community Hospital. Based on the needs assessment and community engagement process, the priority needs and health concerns of the community MCH serves include access to care - driven by financial barriers and/or availability of primary care, availability of behavioral health care, general socioeconomic issues, and transportation services. This collaboration is continued today, through a similar process for the CHNA. In mid-2018, MCH completed its most recent CHNA and successfully identified and prioritized service gaps in the region. Utilizing a consulting group along with community organizations, the team collaborated to not only identify these gaps but to work together to identify and implement a plan to decrease these service gaps and improve the overall health of the community. Monadnock Community Hospital uses this information to help focus its Community Benefit efforts to meet the priority needs identified in the Community Benefit Plan. In addition, other needs or services not specifically identified in the Community Health Needs Assessment, but addressed under the Organization's Community Benefit Plan include availability of dental or oral health care (via the Organization's Monadnock Healthy Teeth to Toes program which focuses on dental hygiene and care, nutrition, and daily physical activity for children ages kindergarten to third grade) and availability of prescription medication (via the Organization's Medication Bridge program designed to help eligible patients apply for assistance programs that provide free or discounted prescription medications). Pursuant to State of NH RSA 7:32-c-1, a Community Benefits Reporting Form is filed annually with the Office of the Attorney General Charitable Trusts Unit.
Part VI, Line 3:MCH is committed to providing quality healthcare to anyone in need of services, regardless of ability to pay. We understand patients may not have the finances to pay for their healthcare services and medications, and do not want this to prevent anyone from receiving necessary treatment. As part of the Hospital's mission to the communities we serve, we have developed programs to help meet the needs of our patients who meet income eligibility. Through our Financial Assistance and Medication Bridge Programs, we have been providing financial assistance to those qualifying for many years. We reach out to our patients in many different ways to ensure that they are aware that help is available and to guide them through the process. Brochures and signage are posted in high traffic areas and all employees of MCH are informed about the Financial Assistance Program during orientation. When a patient goes through the registration process at the Hospital the staff are trained to inform uninsured or underinsured patients about the Monadnock Community Hospital Financial Assistance and the New Hampshire Health Access programs and that there is assistance available within the Hospital to help with the application process. In addition, any time a patient calls customer service, the representative is trained to help identify and offer support to patients who may require financial assistance. Patients may qualify for free care, discounted care, payment plans or a combination of the above. Assistance is also provided in applying to federal and state programs for those who qualify.
Part VI, Line 4:The Hospital's primary service area consists of 13 towns, including Antrim, Bennington, Dublin, Francestown, Greenfield, Greenville, Hancock, Jaffrey, New Ipswich, Peterborough, Rindge, Sharon, and Temple. The Hospital serves the general population of the primary service area referenced above.
Part VI, Line 5:Monadnock Community Hospital is a critical access hospital located in the Monadnock Region of NH. Our mission is to improve the health and well-being of our community. The Hospital is served by a board of trustees consisting of local citizens active in their community and its organizations. The majority of the board is not employed by the Hospital and consists of local community and business representatives as well as medical staff. Each year, MCH seeks to make the Monadnock Region a healthier place to live by identifying new and changing healthcare needs, then developing a strategy to address some of the most pressing issues. In addition, no one is turned away who is in need of medical care. Our mission is to provide health care for everyone in our community, regardless of their ability to pay. The Hospital is committed to giving back to the community to the greatest extent possible. Monadnock Community Hospital supports thousands of individuals and families with free or reduced-fee services and programs. Our Financial Assistance Program administered by the Social Services Department helps families and individuals in need with access to health care and other available community services such as catastrophic care, fuel assistance, meals on wheels, food banks, and visiting nurses. Other examples of the Hospital's effort to reach our patients beyond traditional hospital services include access to free or reduced cost medications through our Medication Bridge program; educating children on the importance of good oral hygiene through our Monadnock Healthy Teeth program which helps children in preschool through high school to get off to a good start regardless of family access to dental health care; training for community agencies such as local volunteer fire and rescue personnel; offering prevention and wellness education including nutrition, smoking cessation and dealing with stress; providing regular community seminars regarding timely health topics; screenings and clinics for important health issues such as breast cancer; offer behavioral health (substance use & mental health) trainings to the community through Be The Change; and offer space for community organizations to meet, including local support groups. These are just a few of the many areas where we are reaching out to others to assure they are cared for well.
Part VI, Line 6:GraniteOne Health is a non-profit, New Hampshire-based healthcare system consisting of Catholic Medical Center (CMC) in Manchester, Huggins Hospital (HH) in Wolfeboro, and Monadnock Community Hospital (MCH) in Peterborough. GraniteOne Health draws on the resources and expertise of these strong, trusted hospitals to enhance collaboration, strengthen clinical partnerships and meet the health needs of the communities by providing greater access to high-quality care and a seamless patient experience. The organization will enable the hospitals to grow their clinical relationships, build economies of scale, and improve value to patients.Both Huggins and Monadnock have long-standing clinical relationships with CMC in specialty areas such as cardiology and vascular care. GraniteOne allows the hospitals to explore further collaborations in clinical areas as well as other services that could benefit from economies of scale, all while maintaining a seamless patient experience.GraniteOne Health offers access points throughout New Hampshire to advanced clinical services such as open heart surgery, angioplasty, minimally invasive heart valve and vascular surgery, cancer care, comprehensive weight loss management, orthopedics, innovative maternal health services and over 30 other medical and surgical subspecialties. GraniteOne Health gives patients access to high-quality, coordinated care across the continuum of health.
Part VI, Line 7, Reports Filed With StatesNH

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtRecipient EINRecipientEIN
Town of Peterborough
1 Grove StreetPeterboroughNH03458Government$15,000For the benefit of the Peterborough Ambulance
Community Volunteer Transportation Company
375 Jaffrey Road Suite 3PeterboroughNH03458501(c)(3)$8,000Support no-fee transportation to those in need in the Monadnock Region262838428
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
Employee Tuition Assistance Fund - COVID-1911$12,644
Dr. Mark Luedke Memorial Scholarship Fund2$7,194

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationDuring the fiscal year ending September 30, 2020, the Hospital made contributions to a governmental entity, the Town of Peterborough, and a 501(c)(3) organization located in the Hospital's geographic region. In 2018, the Hospital established the Dr. Mark Luedke Memorial Scholarship Fund in memory of the organization's Radiology Medical Director. The fund is to support clinical education and certification for members of MCH's Radiology Department, and is disbursed with the input of the Director of Radiology, the Chief Nursing Officer, and VP of Human Resources. In fiscal year 2020, the Hospital continued to contribute to the Luedke Scholarship Fund.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Joseph Pepe MD
Ex-Officio (voting)$0$816,646$0$0$0$50,311$0$384,974$0$35,831$0$1,287,762$0$0
Alexander J Walker Esq
Trustee$0$476,101$0$0$0$61,114$0$164,660$0$56,463$0$758,338$0$0
William White MD
Physician$596,471$0$20,999$0$1,980$0$5,600$0$17,233$0$642,283$0$0$0
Ronald Michalak MD
Physician$477,065$0$6,551$0$1,030$0$5,600$0$22,722$0$512,968$0$0$0
Terrence McNamara DO
Physician$429,281$0$14,792$0$1,116$0$5,600$0$26,475$0$477,264$0$0$0
Shawn Harrington MD
Ex-Officio (voting)$429,927$0$0$0$1,506$0$5,600$0$22,633$0$459,666$0$0$0
Jennifer Peppers MD
Physician$401,557$0$0$0$690$0$5,080$0$17,233$0$424,560$0$0$0
Cynthia McGuire
Chief Executive Officer$275,545$0$58,198$0$22,899$0$23,100$0$27,808$0$407,550$0$17,500$0
Michele Gunning MD
Physician$272,134$0$65,061$0$300$0$5,490$0$0$0$342,985$0$0$0
Lucas Shippee DO
Ex-Officio (voting)$307,706$0$1,750$0$450$0$4,382$0$0$0$314,288$0$0$0
Elizabeth Cooley MD
Ex-Officio (voting) (end 5/20)$232,584$0$2,000$0$1,290$0$4,806$0$22,722$0$263,402$0$0$0
Richard D Scheinblum
VP Finance/CFO$209,417$0$0$0$1,316$0$4,271$0$9,889$0$224,893$0$0$0
Lara Niemela MD
Ex-Officio (voting)$163,123$0$1,380$0$450$0$3,408$0$23,098$0$191,459$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4bCynthia McGuire, President & CEO, participates in a 457(f) plan with Monadnock Community Hospital. After a three year vesting period, amounts previously contributed to her by Monadnock Community Hospital are reported as part of her W-2 wages. In calendar year 2019, a total of $17,500 was deposited into Ms. McGuire's 457(f) plan account, which is included in the amount reported on Schedule J, Part II, Column C for this current fiscal year Form 990 filing. Additionally, $20,238 of compensation is reported in Column B(iii), which represents the vested 2016 contribution of $17,500 and earnings of $2,738. The following individuals take part in a section 457(f) forfeitable nonqualified deferred compensation plan administered by Catholic Medical Center, their employer, which is a related organization. The amounts listed represent calendar year 2019 contributions for many years of service: Joseph Pepe: $361,904 Alexander Walker: $143,960
Part I, Line 7MCH compensates physicians utilizing productivity targets based on RVU (relative value units). In addition, the Compensation Committee recommends to the full board, annually, the variable pay award that may be issued to the Hospital's CEO. The payment of the award is discretionary and is subject to meeting the pre-determined goals of the Organization.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NHBFA Revenue Bonds Series 2013BusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN021304598BondIssuerEIN
Bond Issued2013-01-01BondIssuedDt
Issue Price$27,240,000IssuePriceAmt
Purposerefinance existing Series 2007 and 2009 bondsPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$27,240,000TotalProceedsAmt
Refunding Escrow$27,057,466RefundingEscrowAmt
Issuance Costs From Proceeds$182,534IssuanceCostsFromProceedsAmt
Substantial Completion2013SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable BondsYes (1)RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule K, Part III, Line 9, Part IV, line 7 and Part V:FormAndLineReferenceDesc
ExplanationAlthough formal policies are not in place in regards to the remediation of our bond, the monitoring requirements of section 148, and procedures to ensure that violations are timely identified and corrected, Mondanock Community Hospital has compliance checks in place that substantiate these requirements. Below is a list of all compliance checks that Monadnock Community Hospital has in place to monitor the 2013 Bond Issue: 1. Covenant calculations performed monthly as part of the Financial Scorecard preparation which is reviewed by the MCH Board of Trustees; 2. Covenant calculations are performed for each quarter and reported to the bond issuer, TD Bank; 3. Covenant certificate is signed each quarter by the CFO and reported to the bond issuer, TD Bank; 4. Financial statements and statistical reports are sent to the bond issuer, TD Bank, on a quarterly basis; 5. Annual Operating and Capital budgets are reported to the bond issuer, TD Bank; 6. A No Event of Default certificate is signed by the CFO annually and reported to the bond issuer, TD Bank; 7. Annual Audited Financial statements are reported to the bond issuer, TD Bank. Each of these items that are reported to TD Bank has a specific deadline for completion as outlined in the bond documents.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Peter Cerroni
Wife of Board Member$35,140Peter Cerroni serves as a trustee on the Hospital's board of directors. Peter Cerroni's spouse is also employed by Monadnock Community Hospital. In 2019, she received wages of $17,414, deferred compensation of $388 and nontaxable benefits of $17,337, for a total of $35,140 in compensation, which is consistent with employee compensation for all employees at similar levels at the Hospital.0
Michael Shea
Lessor of Rental Property$138,121Michael Shea served as the Vice Chair and then Chair of the Hospital's board of directors. Mr. Shea is also the president and part owner of Belletetes, Inc. Monadnock Community Hospital leases a building in Jaffrey, NH for the Jaffrey Family Medicine Practice which is owned by Belletetes, Inc. Terms are at arms-length. The total amount reported in Column C represents rental payments ($138,121) as well as payments for property taxes and common area maintenance.0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule L, Part IV:FormAndLineReferenceDesc

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 4The bylaws were updated to require one active member of the medical staff and the Director of Monadnock Health Partners serve as voting ex-officio members instead of two active members of the medical staff. The change will take effect when upon a vacancy of one of the currently appointed medical staff members.
Form 990, Part VI, Section A, line 6The sole Member of MCH shall be GraniteOne Health, a New Hampshire voluntary corporation that is exempt from taxation under section 501(c)(3) of the Internal Revenue Code.
Form 990, Part VI, Section A, line 7aGraniteOne Health shall elect the elected members of MCH's Board of Trustees who are nominated as set forth in Article II of MCH's governing documents. GraniteOne Health shall also have the powers reserved to it as described in the following narrative for Form 990, Part VI, Line 7b. Vacancies on the Board of Elected Trustees occurring prior to the end of any Elected trustee's term shall be elected by GraniteOne Health from nominations by either vote of the Board at a meeting of the Board, for which notice has been given of the nomination process, or by GraniteOne Health if the vacancy is from the group of Elected Trustees nominated by GraniteOne Health.
Form 990, Part VI, Section A, line 7bThe following actions initiated by MCH shall require GraniteOne Health's approval: a. Adoption of the annual capital and operating budgets, provided that the expenditure of any of the cash reserves, board-designated reserves, surplus assets and other assets held by MCH on the Affiliation Date and recorded on MCH's financial statements as unrestricted assets, as well as certain parcels of real estate not required for the operation of MCH (the "Pre-Affiliation Assets") contemplated by such budgets and proposed in accordance with those powers reserved to MCH, will not be subject to the approval of GraniteOne; b. Approval of any strategic plans or material nonclinical programming and marketing plans, including material modifications thereof; c. Authorization of debt incurred, assumed, or guaranteed by the hospital in excess of Five Hundred Thousand Dollars ($500,000.00), other than as provided for in any approval annual capital or operating budget; d. Authorization of any material acquisition, disposition, formation, organization or investment by MCH of or in any other corporation, partnership, limited liability company, other entity or joint venture, other than an acquisition funded with Pre- Affiliation Assets proposed in accordance with those powers reserved to MCH will not be subject to the approval of GraniteOne; e. Authorization of the sale, disposition, mortgage, or encumbrance of any assets dedicated to the operations of MCH involving assets of Five Hundred Thousand Dollars ($500,000.00) or more, with the exception of real estate identified prior to the Affiliation; f. Authorization of MCH to enter into any merger, consolidation or joint venture; or to sell or dispose of substantially all of the assets of MCH or any of its respective subsidiaries; or to create or acquire any subsidiary organization; g. Authorization of MCH to institute any bankruptcy, insolvency or reorganization proceedings for itself or any subsidiary; h. Authorization of a capital investment by MCH or any of its subsidiaries in any individual entity or project in the form of cash or either tangible or intangible property in excess of Five Hundred Thousand Dollars ($500,000.00), except as provided in any approved annual capital or operating budget or to the extended funded by the Restricted Assets or the Pre-Affiliation Assets; i. Authorization to develop, implement or terminate clinical programs and clinical procedures by MCH or its subsidiaries; j. The amendment of the Articles of Agreement or Bylaws of MCH or its subsidiaries to the extent that it would (a) impact the Reserved Powers; or (b) reasonably be expected to have a material strategic, competitive or financial impact on the System or any of its members; and k. The MCH Board of Trustees' appointment or reappointment of the MCH CEO and the determination of the CEO's compensation.
Form 990, Part VI, Section B, line 11bThe Hospital's Form 990 is prepared with assistance by an independent public accounting firm. A draft of the Form 990 is initially reviewed in detail by key finance employees. Thereafter, the final draft is made available to the full board prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cOn an annual basis, the Organization provides all administrators/directors/managers, Board Members, and medical staff members with the conflict of interest policy. Said individuals are required to complete a new conflict of interest disclosure on an annual basis. Any conflicts of interest noted are reviewed by the Chair of the Board, in conjunction with the Corporate Compliance Officer. If the conflict of interest appears to meet the policy definitions requiring full Board review, the Chair of the Board takes this to the full Board meeting, and it is discussed, and appropriate action is taken (in compliance with state and federal requirements). The conflict of interest statement requires signatories to inform the Hospital of any conflict of interest that occurs at any time throughout the year. If a conflict of interest arises during the year, it is reviewed by the Compliance Officer, and if necessary, is taken to the Board Chair/Board. The Compliance Officer confers with legal counsel with regard to conflicts of interest, if there is any question regarding the potential conflict.
Form 990, Part VI, Section B, line 15The Organization has a written executive compensation policy and procedure. Under this policy, the Compensation Committee, comprised of delegated representatives of the Board of Trustees, has the power and responsibility to determine the Hospital's approach to executive compensation and review the performance of the CEO. The Compensation Committee has the responsibility to set, monitor and review the base salary of the CEO. The Committee maintains minutes of sessions and final recommendations and determinations in accordance with the Board of Trustee guidelines. Annually, market data is reviewed by the Committee to determine the appropriate salary for the Hospital's CEO based upon identified standards. At the end of the time period, the Committee reviews to what extent stated goals were met and recommends an amount for the variable pay award to be approved by the full board.
Form 990, Part VI, Section C, line 19Monadnock Community Hospital files audited financial statements annually with the New Hampshire Attorney General's Charitable Trust Unit and informs the Director of Charitable Trusts of pecuniary benefit transactions that have occurred between MCH and a board member or officer. Notices of such transactions of $5,000 or more are also published in the local newspaper in accordance with NH RSA 7:19-A, II(D). Current copies of the bylaws, conflict of interest policy and Form 990 are on file with the Charitable Trust Unit. The Hospital also makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part VII, Section A, Column D: Director CompensationThe 2019 compensation reported for Dr. Cooley, Dr. Harrington, Dr. Shippee, and Dr. Niemela was paid by Monadnock Community Hospital for their services as physicians. No part of their compensation was remuneration for their services as an ex-officio voting members of MCH's Board of Trustees.
Form 990, Part VIII, Line 7: Realized Capital GainsThe amount reported on lines 7c and 7d as realized gains agrees to reporting from the Hospital's custodian bank and third party investment managers. Due to the volume of investment activity, the Hospital relies on the custodian bank and third party investment managers to track the sale of investments at the individual asset level. Therefore the ability to track and report proceeds and basis of the sales is extremely difficult.
Form 990, Part XI, line 9:Change in fair value of interest rate swap agreements -927,873. Change in perpetual trust 367,442.
Form 990, Part XI, Line 2c: Audit Review ProcessThe Audit Committee oversees the audit process for Monadnock Hospital. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit for the fiscal years ended 9/30/19 and 9/30/20.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Alliance Ambulatory Services
100 McGregor StreetManchesterNH03102020519436Ambulatory Surgical CenterNH501(c)(3)Line 10CMC Healthcare System0
Alliance Health Services
100 McGregor StreetManchesterNH03102611508839PracticesNH501(c)(3)Line 10CMC Healthcare System0
Alliance Resources
100 McGregor StreetManchesterNH03102020398138Real EstateNH501(c)(3)Line 12b, IICMC Healthcare System0
Catholic Medical Center
100 McGregor StreetManchesterNH03102020315693HospitalNH501(c)(3)Line 3GraniteOne Health0
CMC Healthcare System
100 McGregor StreetManchesterNH03102010568516ParentNH501(c)(3)Line 12b, II0N/A
CMC Physician Practice Associates
100 McGregor StreetManchesterNH03102020460245PracticesNH501(c)(3)Line 10CMC Healthcare System0
GraniteOne Health
100 McGregor StreetManchesterNH03102814663563Supporting OrganizationNH501(c)(3)Line 12a, I0N/A
Huggins Hospital
240 South Main StreetWolfeboroNH03894030223332HospitalNH501(c)(3)Line 3GraniteOne Health0
Monadnock Health Services - INACTIVE
452 Old Street RoadPeterboroughNH03458020420789InactiveNH501(c)(3)Line 12a, IMonadnock Community HospitalYes (1)
St Peter's Home
100 McGregor StreetManchesterNH03102020222228Day Care ServicesNH501(c)(3)Line 10CMC Healthcare System0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Alliance Urgent Services
100 McGregor StreetManchesterNH03102831238167Health Care ServicesNHN/A
Bedford Ambulatory Surgical Center LLC
11 Washington PlaceBedfordNH03110020519727Surgical CenterNHN/A
NH Value Care ACO LLC
100 McGregor StreetManchesterNH03102832029076Health Care ServicesNHN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Alliance Enterprises
100 McGregor StreetManchesterNH03102020386795Real EstateNHN/AC0
Doctors' Medical Association Inc
100 McGregor StreetManchesterNH03102020340690Medical Office BuildingNHN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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