MARY HITCHCOCK MEMORIAL HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
MARY HITCHCOCK MEMORIAL HOSPITAL (EIN 02-0222140)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-12
IRS object ID
202141329349302039
Schema version
2019v5.0
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)
Return2021-05-12T11:33:21-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19600 Brownsboro Road Suite 400AddressLine1Txt
CityLouisvilleCityNm
State AbbreviationKYStateAbbreviationCd
ZIP402411122ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222140EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mary Hitchcock Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMARYBusinessNameControlTxt
Phone6036505000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Medical Center DriveAddressLine1Txt
CityLebanonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDaniel P Jantzen CPAPersonNm
Person TitleCFOPersonTitleTxt
Signature2021-05-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim ScifresPreparerPersonNm
PTINP01316095PTIN
Phone5023263996PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1JOANNE M CONROY MDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Medical Center DriveAddressLine1Txt
CityLebanonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,455,466,797GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.DARTMOUTH-HITCHCOCK.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1889FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionADVANCING HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, COMMUNITY PARTNERSHIPS; PROVIDING EACH PERSON THE BEST CARE IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.ActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee6541TotalEmployeeCnt
Total Volunteers497TotalVolunteersCnt
Total Gross UBI$11,938,304TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$28,349,009PYContributionsGrantsAmt
CY Contributions Grants$34,484,885CYContributionsGrantsAmt
PY Program Service Revenue$1,295,829,353PYProgramServiceRevenueAmt
CY Program Service Revenue$1,295,443,322CYProgramServiceRevenueAmt
PY Investment Income$20,877,294PYInvestmentIncomeAmt
CY Investment Income$18,523,480CYInvestmentIncomeAmt
PY Other Revenue$44,780,872PYOtherRevenueAmt
CY Other Revenue$106,532,953CYOtherRevenueAmt
PY Total Revenue$1,389,836,528PYTotalRevenueAmt
CY Total Revenue$1,454,984,640CYTotalRevenueAmt
PY Grants And Similar Paid$4,155,379PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,933,352CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$746,284,236PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$818,348,129CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$264,966CYTotalFundraisingExpenseAmt
PY Other Expenses$575,126,652PYOtherExpensesAmt
CY Other Expenses$650,046,324CYOtherExpensesAmt
PY Total Expenses$1,325,566,267PYTotalExpensesAmt
CY Total Expenses$1,479,327,805CYTotalExpensesAmt
PY Revenues Less Expenses$64,270,261PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$24,343,165CYRevenuesLessExpensesAmt
Total Assets BOY$1,550,625,147TotalAssetsBOYAmt
Total Assets EOY$2,041,764,780TotalAssetsEOYAmt
Total Liabilities BOY$868,932,139TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,392,639,404TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$681,693,008NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$649,125,376NetAssetsOrFundBalancesEOYAmt
MissionWE ADVANCE HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,091,368,698ExpenseAmt
Grant$10,933,352GrantAmt
Revenue$1,324,784,331RevenueAmt
DescMARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) IS AN ACUTE AND TERTIARY CARE TEACHING HOSPITAL LOCATED IN LEBANON, NEW HAMPSHIRE. MHMH PROVIDES A BROAD RANGE OF PATIENT SERVICES AND HEALTH-RELATED COMMUNITY SERVICES, CONSISTENT WITH ITS ROLE AS A MAJOR TEACHING HOSPITAL, A TERTIARY CARE REFERRAL HOSPITAL, AND AS A PROSPECTIVE PAYMENT SYSTEM HOSPITAL (AS DEFINED BY CMS). MHMH PROVIDES A FULL RANGE OF SERVICES IN BOTH ACUTE AND CRITICAL MEDICINE, SURGERY, PSYCHIATRY AND REHABILITATION FOR INFANTS, CHILDREN AND ADULTS. DURING FY 2020, MHMH PROVIDED 126,638 ACUTE PATIENT DAYS OF INPATIENT SERVICE AND HAD 27,309 TOTAL ACUTE CARE DISCHARGES, WHILE MHMH'S EMERGENCY ROOM WAS OPEN TO THE PUBLIC 24 HOURS PER DAY, 7 DAYS PER WEEK AND HAD 28,774 DISCHARGES. DARTMOUTH-HITCHCOCK CLINIC (DHC) PROVIDES THE PHYSICIAN STAFF FOR THE HOSPITAL AND THE SOPHISTICATION ESSENTIAL FOR THE DEVELOPMENT OF THE HOSPITAL AS THE LARGEST AND ONLY TEACHING HOSPITAL IN NEW HAMPSHIRE AND THE DESIGNATION BY THE FEDERAL GOVERNMENT AS A RURAL REFERRAL CENTER FOR NORTHERN NEW ENGLAND. THE SHARED MISSION OF MHMH AND DHC IS TO ADVANCE HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME. CONSISTENT WITH THIS MISSION AND IN PARTNERSHIP WITH DHC, MHMH PROVIDES HIGH-QUALITY, COST-EFFECTIVE, COMPREHENSIVE, AND INTEGRATED HEALTH CARE TO INDIVIDUALS, FAMILIES, AND THE COMMUNITIES IT SERVES, REGARDLESS OF A PATIENT'S ABILITY TO PAY. THROUGH FORMAL AFFILIATIONS AND OTHER CLINICAL COLLABORATIONS, MHMH ALSO SEEKS TO PARTNER WITH OTHER AREA HEALTH CARE PROVIDERS TO IMPROVE THE HEALTH STATUS OF THE REGION. THE JACK BYRNE CENTER FOR PALLIATIVE & HOSPICE CARE COORDINATES MHMH'S CLINICAL, EDUCATIONAL, AND RESEARCH EFFORTS AND VISITING NURSE ALLIANCES AROUND THE REGION TO OFFER MUCH-NEEDED END-OF-LIFE CARE FOR PATIENTS IN A CLINICAL SETTING THAT MEETS THE NEEDS OF PATIENTS AND THEIR FAMILIES. MHMH ALSO CONTINUES TO BUILD ITS TELE-MEDICINE PROGRAM TO PROVIDE CARE ACROSS ITS RURAL REGION AND IN PARTICULAR TO MAKE SPECIALIST CONSULTATION AND CARE AVAILABLE TO CRITICAL ACCESS AND COMMUNITY HOSPITALS. THIS ALLOWS CAREGIVERS AT REMOTE LOCATIONS TO ACCESS SPECIALISTS AT MHMH AND DHC AND TO BRING THEM "VIRTUALLY" TO THE PATIENT'S BEDSIDE. MHMH'S CONNECTED CARE CENTER FOR TELE-HEALTH IN LEBANON OFFERS A 24/7 TEAM OF PHYSICIANS, PHARMACISTS, AND NURSES SUPPORTING THE FOLLOWING ACUTE CARE TELE-HEALTH SERVICE LINES: TELE-EMERGENCY, TELE-PHARMACY, TELE-NEUROLOGY, TELE-ICU, TELE-PSYCHIATRY, AND TELE-NEONATOLOGY; OUTPATIENT TELE-URGENT CARE 7 DAYS/WEEK; AND OUTPATIENT VIRTUAL VISITS IN PEDIATRICS AND MORE THAN 30 SPECIALTY SERVICES TO PATIENTS IN 17 CLINICAL LOCATIONS ALONG WITH PATIENT HOMES. IN AN EFFORT TO INTEGRATE BEHAVIORAL HEALTH AND PRIMARY CARE, MHMH CONTINUES TO BE THE LEAD CONVENER FOR THE STATE OF NEW HAMPSHIRE'S DELIVERY SYSTEM REFORM INCENTIVE PROGRAM ("DSRIP") FOR THE REGION 1 INTEGRATED DELIVERY NETWORK. THIS PROGRAM IS FUNDED THROUGH A SECTION 1115 WAIVER RESEARCH AND DEMONSTRATION TRANSFORMATION WAIVER THAT THE STATE OF NEW HAMPSHIRE RECEIVED FROM CMS. THE WAIVER ENABLES HEALTH CARE PROVIDERS AND COMMUNITY PARTNERS WITHIN A REGION TO FORM RELATIONSHIPS FOCUSED ON TRANSFORMING CARE, TO COMBAT THE OPIOID CRISIS, AND STRENGTHEN THE STATE'S STRAINED MENTAL HEALTH SYSTEM. THIS WORK BEGAN IN JULY 2016 AND WILL CONTINUE THROUGH DECEMBER 31, 2020. IN ADDITION TO MHMH, DARTMOUTH-HITCHCOCK CLINIC (DHC) AND CHESHIRE MEDICAL CENTER (CHESHIRE) ARE PLAYING LEADERSHIP ROLES IN THIS INITIATIVE. MHMH has also partnered with Colby-Sawyer College to provide nursing education to both Colby-Sawyer students and to MHMH staff. MHMH also sponsors numerous training programs through the Workforce Readiness Institute, a department of MHMH focused on providing training pathways for entry-level staff to gain the necessary education and certifications to move into higher-paying roles. Along with providing flu clinics to bring vaccinations to area communities, MHMH also created a community COVID testing center during the latter part of FY '20. Additionally, MHMH and DHC have served both the State of New Hampshire and area communities as "subject matter experts" during the COVID pandemic. During FY '20, MHMH commenced construction of a new Patient Pavilion, expanding its current in-patient capacity at the Lebanon campus. (For the last three years, MHMH has turned away almost 2,500 patients per year because the hospital was at full capacity during the patients' time of need.) Expected to be completed early in FY '23, the project will cost in excess of $100 million and will expand in-patient capacity to more fully meet the acute-care needs of the region. MHMH FILES AN ANNUAL COMMUNITY BENEFITS REPORT WITH THE STATE OF NEW HAMPSHIRE WHICH OUTLINES THE COMMUNITY AND CHARITABLE BENEFITS IT PROVIDES. THE MOST RECENT COMMUNITY BENEFITS REPORT IS AVAILABLE BY REQUEST. FINANCIAL ASSISTANCE (FORMERLY CALLED "CHARITY CARE") REPRESENTS SERVICES PROVIDED TO PATIENTS WHO CANNOT AFFORD HEALTH CARE SERVICES DUE TO INADEQUATE FINANCIAL RESOURCES WHICH RESULT FROM BEING UNINSURED OR UNDERINSURED. FOR THE YEAR ENDED JUNE 30, 2020, MHMH PROVIDED FINANCIAL ASSISTANCE TO 17,000 PATIENTS IN THE AMOUNT OF $23,299,566 AS MEASURED BY GROSS CHARGES. THE ESTIMATED COST OF PROVIDING THIS CARE FOR THE YEAR ENDED JUNE 30, 2019 WAS $7,545,627. MHMH ALSO ROUTINELY PROVIDES SERVICES TO MEDICAID PATIENTS AT REIMBURSEMENT LEVELS THAT ARE BELOW THE COST OF THE CARE PROVIDED. THE COMMUNITY HEALTH ACTIVITIES NOTED INCLUDE THE COST OR VALUE OF SEVERAL DIFFERENT TYPES OF PROGRAMS INCLUDING THE COST OF COMMUNITY-BASED EDUCATION, HEALTH FAIRS, HEALTH SCREENINGS, SUPPORT GROUPS, AND PROGRAMS AND MATERIALS THAT PROMOTE WELLNESS AND PREVENT ILLNESS. EXAMPLES OF THESE TYPES OF EFFORTS INCLUDE PARTNERING WITH THE HEALTHY EATING ACTIVE LIVING NH INITIATIVE, THE WOMEN'S HEALTH RESOURCE CENTER, AND SMOKING PREVENTION AND CESSATION. THIS CATEGORY OF SUPPORT ALSO INCLUDES FINANCIAL CONTRIBUTIONS AND THE CONTRIBUTION OF TIME AND SERVICES TO COMMUNITY PROGRAMS, HOSPITALS AND AGENCIES. MHMH ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE TO ITS PATIENTS THAT IS REPORTED AS PROVISION FOR BAD DEBT, WHICH IS NOT INCLUDED IN THE AMOUNTS REPORTED ABOVE. DURING THE YEAR ENDED JUNE 30, 2020, THE HOSPITAL REPORTED A PROVISION FOR BAD DEBT OF $43,174,978.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$92,037,219ExpenseAmt
Revenue$62,081,886RevenueAmt
DescAS A COMPONENT OF NEW HAMPSHIRE'S ONLY INTEGRATED ACADEMIC MEDICAL CENTER, MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) PROVIDES THE GEISEL SCHOOL OF MEDICINE AT DARTMOUTH (GSM) SUPPORT FOR PHYSICIANS' UNPAID TEACHING TIME AS PART OF ITS COMMUNITY BENEFIT INITIATIVES. THIS SUPPORT CONSISTS OF THE TIME PHYSICIANS SPEND PROVIDING CLINICAL SUPERVISION AND EDUCATION FOR RESIDENTS AND MEDICAL STUDENTS. IN ADDITION, THE HOSPITAL PROVIDES IN-KIND SUPPORT FOR RESEARCH AND OTHER GRANTS REPRESENTING COSTS IN EXCESS OF AWARDS FOR NUMEROUS GRANT-FUNDED HEALTH RESEARCH AND SERVICE INITIATIVES AWARDED TO DARTMOUTH-HITCHCOCK CLINIC (DHC) AND GSM. OTHER COMMUNITY BENEFIT INITIATIVES INCLUDE SUBSIDIZING THE COSTS OF PROVIDING MEDICAL AND CLINICAL EDUCATION TO PROFESSIONALS ACROSS NEW HAMPSHIRE, VERMONT AND BEYOND AS WELL AS UNCOMPENSATED COSTS OF ACADEMIC AND MEDICAL RESEARCH ACTIVITIES. IN FY20, MHMH CONTINUED THE TRANSITION OF RESEARCH ACTIVITIES AND MANAGEMENT FROM GSM TO MHMH UNDER THE LEADERSHIP OF THE VICE PRESIDENT FOR RESEARCH OPERATIONS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,183,405,917TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgYes (true)MoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingYes (true)LoanOutstandingInd
Grant To Related PersonYes (true)GrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1406IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee6541EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DANIEL P JANTZEN CPABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6036505634PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE MEDICAL CENTER DRIVEAddressLine1Txt
CityLEBANONCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (50 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Charles G Plimpton MBA
Trustee/Secretary/Treasurer1.52.5Yes (X)Yes (X)$0$0$0
Joanne M Conroy MD
Trustee, Ex-Officio, CEO37.818.3Yes (X)Yes (X)$0$1,356,521$53,900
Vincent S Conti MHA
Trustee/Board Chair (Through 12/31/19)0.81.8Yes (X)Yes (X)$0$0$0
Cherie Holmes MD
Trustee28.013.0Yes (X)$0$485,345$55,299
David P Paul
Trustee (effective 1/1/20)0.80.8Yes (X)$0$0$0
Duane A Compton PHD
Trustee / Ex-Officio0.81.7Yes (X)$0$0$0
Edward H Stansfield III MA
Trustee/ Chair (effective 1/1/20)0.82.3Yes (X)$0$0$0
Elof Eriksson MD PhD
Trustee (effective 1/1/20)0.80.8Yes (X)$0$0$0
Jennifer L Moyer MBA
Trustee (effective 1/1/20)0.80.8Yes (X)$0$0$0
Jocelyn Chertoff MD
VP Service Line / DPT CHR Diagnostic Radiology28.012.0Yes (X)$0$702,848$42,604
Jon Wahrenberger MDFAHAFAC
Trustee28.012.0Yes (X)$0$355,485$65,268
JONATHAN HUNTINGTON MD PhD MPH
TRUSTEE (EFFECTIVE 1/1/20)0.540.0Yes (X)$0$417,979$57,113
Kari M Rosenkranz MD
Trustee (through 12/2019) / Physician28.012.0Yes (X)$0$522,969$36,344
KURT K RHYNHART MD
TRUSTEE28.012.0Yes (X)$0$491,637$42,285
Laura K Landy MBA
Trustee0.81.3Yes (X)$0$0$0
Marc B Wolpow JDMBA
Trustee0.81.3Yes (X)$0$0$0
Mark W Begor MBA
Trustee (effective 1/1/20)0.80.8Yes (X)$0$0$0
Pamela Thompson MSRNCENP
Trustee0.81.3Yes (X)$0$0$0
Paul P Danos PHD
Trustee0.81.3Yes (X)$0$0$0
Robert A Oden Jr PHD
Trustee1.52.5Yes (X)$0$0$0
ROBERTA L HINES MD
TRUSTEE1.51.5Yes (X)$0$0$0
Senator Judd A Greg
Trustee (through 6/2020)0.80.8Yes (X)$0$0$0
Thomas Raffio
Trustee (effective 1/1/20)0.80.8Yes (X)$0$0$0
William J Conaty
Trustee0.81.3Yes (X)$0$0$0
Aimee M Claiborne
Chief HR Officer28.012.0Yes (X)$452,838$0$48,214
DANIEL P JANTZEN CPA
Chief Financial Officer39.018.0Yes (X)$821,761$0$56,733
EDWARD MERRENS
Chief Clinical Officer28.013.0Yes (X)$0$794,781$43,222
JOHN KACAVAS
Chief Legal Officer28.015.0Yes (X)$714,988$0$57,857
Maria Padin MD
Chief Medical Officer28.014.0Yes (X)$0$430,924$64,642
Martin Purcell MBA
Chief Information Officer28.012.0Yes (X)$411,454$0$53,030
Matthew Haag
VP Development28.012.0Yes (X)$371,795$0$35,780
Patrick F Jordan III MBA
Chief Operating Officer39.018.0Yes (X)$770,233$0$64,134
Stephen Leblanc
Chief Strategy Officer28.014.5Yes (X)$0$828,259$52,333
Susan A Reeves EDDRN
Chief Nursing Executive28.012.5Yes (X)$577,922$0$56,445
GEORGE T BLIKE MD
Chief Quality & Value Officer28.013.5$0$474,747$64,154Yes (X)
Jeffrey Obrien MHA
VP Clinical Operations28.012.0$370,955$0$59,933Yes (X)
Karen Clements RNBSNMSB
Chief Nursing Officer28.012.0$360,969$0$33,521Yes (X)
Peter D Solberg MD
Chief Medical Information Officer28.012.0$0$390,772$60,729Yes (X)
Simon Hillier
Dept. Chair - Anesthesiology28.012.0$0$565,423$57,356Yes (X)
Staci Hermann PHARMDMS
Chief Pharmacy Officer28.012.0$285,277$0$27,090Yes (X)
BRUCE KING
PRES/CEO NEW LNDN HOSPITAL (Through 3/2020)40.00.0$368,277$1,219$56,614Yes (X)
David Gladstone MD
CHF CLNCL PHYSCN - RADIOLOGY28.00$334,203$0$54,963Yes (X)
Kimberly Troland JD
Deputy Gen Counsel28.012.0$397,737$0$42,204Yes (X)
Leigh Burgess
VP RESEARCH OPS28.00$346,934$0$51,981Yes (X)
Tina E Naimie CPA
VP CORP FINANCE28.014.0$284,775$0$23,176Yes (X)
Christine Schon MPA
FMR KEY EMP/ ADM VP PRMRY CARE0.040.5$0$294,491$56,219Yes (X)
Richard I Rothstein MD
Former Dept. Chair / Service Line LDR - MED28.012.0$0$681,373$57,240Yes (X)
Sandra Wong MD
SVP SVC LN & Chair of Surgery28.012.0$0$720,339$33,203Yes (X)
Wendy Fielding MBA
FMR KEY EMP / VP FINANCE PLANNING28.013.0$282,795$0$54,116Yes (X)
Wendy Wells MD
FMR KEY EMP / DPT CHR PATHOLOGY28.012.0$0$596,868$50,558Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,152,913TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$10,111,980TotReportableCompRltdOrgAmt
Total Other Compensation$1,668,260TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K554IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Conifer Revenue Cycle Solutions LLC
1500 S Douglas Rd Ste 200AnanheimCA92806Revenue Management Services$38,837,394
Harvey Construction
10 Harvey RdBedfordNH03110Construction$21,294,910
Huron Consulting Services LLC
550 West Van Buren StChicagoIL60607Consulting Services$9,626,557
Triage LLC
7200 World Communication DrOmahaNE68122Staffing Services$7,599,043
HP Cumming Construction Company
25 Crossroad Route 100WaterfordVT05676Construction$6,195,493
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K161CntrctRcvdGreaterThan100KCnt
Government Grants$22,604,501GovernmentGrantsAmt
All Other Contributions$11,880,384AllOtherContributionsAmt
Noncash Contributions$4,327,833NoncashContributionsAmt
Total Contributions$34,484,885TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE622110$1,141,938,206$1,141,938,206
RESEARCH RELATED ACTIVITIES622110$7,509,476$7,509,476
PHARMACY INCOME446110$144,135,762$138,985,717$5,150,045
NEAH & PROGRAM RELATED INVESTMENTS541990$1,859,878$689,023$1,170,855

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,295,443,322TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,523,480TotalRevenueColumnAmt
Unrelated Business Revenue-$153,530UnrelatedBusinessRevenueAmt
Exclusion$18,677,010ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$742,422RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$482,157RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$260,265RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$260,265TotalRevenueColumnAmt
Exclusion$260,265ExclusionAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
STIMULUS PAYMENT622110$53,788,038$53,788,038
MEANINGFUL USE REFUND622110$554,741$554,741
CAFETERIA722212$2,757,959$2,757,959

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,171,950TotalRevenueColumnAmt
Related Or Exempt Func Income$43,401,016RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$5,770,934UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$106,272,688OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,454,984,640TotalRevenueColumnAmt
Related Or Exempt Func Income$1,386,866,217RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$11,938,304UnrelatedBusinessRevenueAmt
Exclusion$21,695,234ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$8,961,820TotalAmt
Program Services$8,961,820ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$1,825,930TotalAmt
Program Services$1,825,930ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$145,602TotalAmt
Program Services$145,602ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$10,931,123TotalAmt
Program Services$3,019,460ProgramServicesAmt
Management And General$7,713,174ManagementAndGeneralAmt
Fundraising$198,489FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$2,297,215TotalAmt
Program Services$745,023ProgramServicesAmt
Management And General$1,500,952ManagementAndGeneralAmt
Fundraising$51,240FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$647,940,760TotalAmt
Program Services$564,083,012ProgramServicesAmt
Management And General$83,857,748ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$42,719,581TotalAmt
Program Services$37,166,035ProgramServicesAmt
Management And General$5,553,546ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$74,117,932TotalAmt
Program Services$46,645,491ProgramServicesAmt
Management And General$27,472,441ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$40,341,518TotalAmt
Program Services$21,204,548ProgramServicesAmt
Management And General$19,121,733ManagementAndGeneralAmt
Fundraising$15,237FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,783,232TotalAmt
Program Services$35,761ProgramServicesAmt
Management And General$1,747,471ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$725,905TotalAmt
Management And General$725,905ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$39,600TotalAmt
Management And General$39,600ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$101,305,796TotalAmt
Program Services$83,076,758ProgramServicesAmt
Management And General$18,229,038ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,684,131TotalAmt
Program Services$66,049ProgramServicesAmt
Management And General$2,618,082ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$17,656,927TotalAmt
Program Services$12,677,676ProgramServicesAmt
Management And General$4,979,251ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$17,148,987TotalAmt
Program Services$1,543,409ProgramServicesAmt
Management And General$15,605,578ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$18,019,239TotalAmt
Program Services$1,304,863ProgramServicesAmt
Management And General$16,714,376ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,137,205TotalAmt
Program Services$2,081,807ProgramServicesAmt
Management And General$2,055,398ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$163,398TotalAmt
Program Services$163,398ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$16,845,507TotalAmt
Program Services$1,516,096ProgramServicesAmt
Management And General$15,329,411ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$67,108,563TotalAmt
Program Services$20,150,290ProgramServicesAmt
Management And General$46,958,273ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$19,713,148TotalAmt
Program Services$7,167,448ProgramServicesAmt
Management And General$12,545,700ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$288,838,575$286,685,296$2,153,279
MEDICAID ENHANCEMENT TAX$59,707,877$59,707,877
EQUIPMENT RENTAL & MAINT$15,923,947$10,806,353$5,117,594
ACADEMIC, GME, TEACHING & EDUCATIONAL$7,948,408$6,408,855$1,539,553

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$10,295,879TotalAmt
Program Services$6,217,060ProgramServicesAmt
Management And General$4,078,819ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,479,327,805TotalAmt
Program Services$1,183,405,917ProgramServicesAmt
Management And General$295,656,922ManagementAndGeneralAmt
Fundraising$264,966FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$47,978,831BOYAmt
EOY$210,295,802EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$639,155BOYAmt
EOY$639,751EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$162,813,811BOYAmt
EOY$156,019,685EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$372,244BOYAmt
EOY$196,023EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$11,722,180BOYAmt
EOY$11,563,390EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$19,562,504BOYAmt
EOY$26,883,997EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$10,655,043BOYAmt
EOY$23,928,953EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,302,580,327LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$854,517,613LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$411,951,103BOYAmt
EOY$448,062,714EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$554,941,393BOYAmt
EOY$573,546,581EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$157,549,243BOYAmt
EOY$160,162,539EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$6,282,288BOYAmt
EOY$7,665,894EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$166,157,352BOYAmt
EOY$422,799,451EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,550,625,147BOYAmt
EOY$2,041,764,780EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$180,227,192BOYAmt
EOY$208,215,387EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,113,693BOYAmt
EOY$171,284,403EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$37,885,000EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$581,142,070BOYAmt
EOY$42,315,447EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$103,449,184BOYAmt
EOY$932,939,167EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$868,932,139BOYAmt
EOY$1,392,639,404EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$591,992,644BOYAmt
EOY$551,126,847EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$89,700,364BOYAmt
EOY$97,998,529EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$681,693,008BOYAmt
EOY$649,125,376EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,550,625,147BOYAmt
EOY$2,041,764,780EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$24,343,165ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,559,348NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$10,783,815OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

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)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementYes (true)PaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (true)DirectContactLegislatorsInd
Direct Contact Legislators$238,915DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$105,038OtherActivitiesAmt
Total Lobbying Expenditures$343,953TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYFormAndLineReferenceDesc
ExplanationLINES IB & 1G MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) EMPLOYS THREE FULL TIME STAFF WHOSE DUTIES INCLUDE LOBBYING. TYPICAL EXPENSES ASSOCIATED WITH THE LOBBYING ACTIVITIES INCLUDE STAFF SALARY, TRAVEL, MEMBERSHIP FEES AND DUES. FROM TIME TO TIME, MARY HITCHCOCK MEMORIAL HOSPITAL, THROUGH ITS EMPLOYEES AND THE USE OF CONSULTANTS, CONTACTS GOVERNMENT OFFICIALS AND LEGISLATORS. THIS CONTACT IS FOR THE PURPOSE OF PROPOSING LEGISLATION OR EXPRESSING AN OPINION ON CHANGES IN LEGISLATION THAT AFFECT MHMH AND ITS ABILITY TO CARRY OUT ITS MISSION. THE ACTIVITIES INCLUDE SENDING LETTERS TO, CALLING, AND MEETING WITH GOVERNMENT OFFICIALS AND LEGISLATORS. FOR THE FISCAL YEAR ENDED JUNE 30, 2020, MARY HITCHCOCK MEMORIAL HOSPITAL INCURRED $238,915 IN CONJUCTION WITH THESE ACTIVITIES. LINE 1I MHMH PAYS DUES TO VARIOUS ORGANIZATIONS RELATED TO ITS EXEMPT MISSION. THE AMOUNT REPORTED UNDER OTHER ACTIVITIES ON LINE 1I REFERS TO THE AMOUNT OF LOBBYING ACTIVITIES IDENTIFIED IN DUES PAYMENTS TO OUTSIDE ORGANIZATIONS.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$59,733,699BeginningYearBalanceAmt
Contributions$2,989,578ContributionsAmt
Investment Earnings Or Losses$698,013InvestmentEarningsOrLossesAmt
Other Expenditures$1,592,623OtherExpendituresAmt
End Year Balance$61,828,667EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$58,012,839BeginningYearBalanceAmt
Contributions$1,209,274ContributionsAmt
Investment Earnings Or Losses$1,592,942InvestmentEarningsOrLossesAmt
Other Expenditures$1,081,356OtherExpendituresAmt
End Year Balance$59,733,699EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$56,795,299BeginningYearBalanceAmt
Contributions$338,335ContributionsAmt
Investment Earnings Or Losses$2,065,129InvestmentEarningsOrLossesAmt
Other Expenditures$1,185,924OtherExpendituresAmt
End Year Balance$58,012,839EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,754,800BeginningYearBalanceAmt
Contributions$137,888ContributionsAmt
Investment Earnings Or Losses$2,553,792InvestmentEarningsOrLossesAmt
Other Expenditures$651,181OtherExpendituresAmt
End Year Balance$56,795,299EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$72,720,335BeginningYearBalanceAmt
Contributions$378,941ContributionsAmt
Investment Earnings Or Losses-$377,000InvestmentEarningsOrLossesAmt
Other Expenditures$17,967,476OtherExpendituresAmt
End Year Balance$54,754,800EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.2664BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.5735PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.1601TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,342,245OtherCostOrOtherBasisAmt
Book Value$50,342,245BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$586,991,081OtherCostOrOtherBasisAmt
Depreciation$376,904,695DepreciationAmt
Book Value$210,086,386BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,111,615OtherCostOrOtherBasisAmt
Depreciation$3,944,444DepreciationAmt
Book Value$167,171BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$584,868,473OtherCostOrOtherBasisAmt
Depreciation$473,668,474DepreciationAmt
Book Value$111,199,999BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$76,266,913OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$76,266,913BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$448,062,714TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
PRIVATE EQUITIES$71,351,212F
HEDGE FUNDS$30,194,747F
OTHER INVESTMENTS$58,616,580F
FieldValueIRS element (for citing)
Total Book Value Securities$160,162,539TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
INVESTMENT IN CAPTIVE$24,827,511
DUE FROM AFFILIATES$347,750,949
CAPITAL LEASE RECEIVABLE$41,654,847
OTHER MISC ASSETS$8,054,136
UNAMORTIZED BOND ISSUANCE COSTS$512,008
FieldValueIRS element (for citing)
Total Book Value Other Assets$422,799,451TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
THIRD PARTY RESERVES$27,435,440
ACCRUED POST RETMNT PENS & MED$90,978,646
Payable to Dartmouth Hitchcock Health$814,525,081
FieldValueIRS element (for citing)
Total Liability$932,939,167TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part X, Line 2 ASC 740 (FIN 48) FOOTNOTENO ASC 740 (FIN 48) FOOTNOTE WAS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS AS THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT OR SINCE ADOPTION.
Schedule D, Part V, Line 4 Intended uses of endowment fundsTHE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROMOTE AND ADVANCE THE FOLLOWING MISSION-RELATED PROGRAMS: HEALTHCARE SERVICES, RESEARCH, CHARITY CARE, COMMUNITY OUTREACH AND ADVOCACY, EQUIPMENT PURCHASES, AND HEALTH EDUCATION.

Schedule F IRS990ScheduleF

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

Account Activities Outside US AccountActivitiesOutsideUSGrp (6 entries)

RegionRegionTxtOfficesOfficesCntEmployeeEmployeeCntType Of Activities ConductedTypeOfActivitiesConductedTxtSpecific Services ProvidedSpecificServicesProvidedTxtRegion Total ExpendituresRegionTotalExpendituresAmt
East Asia and the Pacific01Program ServicesMedical program$5,900
Central America and the Caribbean01Program ServicesMedical Services$1,252
Sub-Saharan Africa06Program ServicesMedical Services$34,439
Europe (Including Iceland and Greenland)00Program ServicesProgram Support$55,861
Central America and the Caribbean00Program ServicesProgram Support$89,741
Central America and the Caribbean00InvestmentsInvestments in captive$24,827,511
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees8SubtotalEmployeesCnt
Continuation Total Office0ContinuationTotalOfficeCnt
Continuation Total Employee0ContinuationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee8TotalEmployeeCnt
Subtotal Spent$25,014,704SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$25,014,704TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp (3 entries)

RegionRegionTxtPurpose Of GrantPurposeOfGrantTxtCash GrantCashGrantAmtManner Of Cash DisbursementMannerOfCashDisbursementTxtValuation Method UsedValuationMethodUsedDesc
Europe (Including Iceland and Greenland)Program Support$21,600CashFMV
Central America and the CaribbeanProgram Support$89,741CashFMV
Europe (Including Iceland and Greenland)Program Support$34,261CashFMV
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt
Transfer To Foreign CorpYes (true)TransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipYes (true)ForeignCorpOwnershipInd
Passive Foreign Investmest CoYes (true)PassiveForeignInvestmestCoInd
Foreign PartnershipYes (true)ForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule F, Part I, Line 2 Procedures for monitoring use of grant fundsTHE HOSPITAL PROVIDES UNRESTRICTED PROGRAM SUPPORT FOR CERTAIN FOREIGN ORGANIZATIONS CHOSEN AND DIRECTED BY THE PHYSICIANS AND/OR RESEARCHERS WORKING DIRECTLY WITH THE CHARITY.
Schedule F, Part I, Line 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDSTHE HOSPITAL PROVIDES UNRESTRICTED PROGRAM SUPPORT FOR CERTAIN FOREIGN ORGANIZATIONS CHOSEN AND DIRECTED BY THE PHYSICIANS AND/OR RESEARCHERS WORKING DIRECTLY WITH THE CHARITY.

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other225FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,650,339TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,650,339NetCommunityBenefitExpnsAmt
Total Expense0.0065TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$252,268,589TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$127,270,423DirectOffsettingRevenueAmt
Net Community Benefit Expns$124,998,166NetCommunityBenefitExpnsAmt
Total Expense0.0845TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$261,918,928TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$127,270,423DirectOffsettingRevenueAmt
Net Community Benefit Expns$134,648,505NetCommunityBenefitExpnsAmt
Total Expense0.0910TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,796,926TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,201,521DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,595,405NetCommunityBenefitExpnsAmt
Total Expense0.0058TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$52,192,530TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,450,425DirectOffsettingRevenueAmt
Net Community Benefit Expns$37,742,105NetCommunityBenefitExpnsAmt
Total Expense0.0255TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,599,001TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,104,017DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,494,984NetCommunityBenefitExpnsAmt
Total Expense0.0037TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,879,364TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,797,436DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,081,928NetCommunityBenefitExpnsAmt
Total Expense0.0034TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,741,749TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$500DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,741,249NetCommunityBenefitExpnsAmt
Total Expense0.0019TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$129,209,570TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$69,553,899DirectOffsettingRevenueAmt
Net Community Benefit Expns$59,655,671NetCommunityBenefitExpnsAmt
Total Expense0.0403TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$391,128,498TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$196,824,322DirectOffsettingRevenueAmt
Net Community Benefit Expns$194,304,176NetCommunityBenefitExpnsAmt
Total Expense0.1313TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,800TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,800NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$924,078TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$924,078NetCommunityBenefitExpnsAmt
Total Expense0.0006TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$102,191TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$102,191NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,037,069TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,037,069NetCommunityBenefitExpnsAmt
Total Expense0.0007TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$0BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$337,697,070ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$341,843,717CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,146,647MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARY HITCHCOCK MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE MEDICAL CENTER DRIVEAddressLine1Txt
CityLEBANONCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.DARTMOUTH-HITCHCOCK.ORGWebsiteAddressTxt
State License01799StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Childrens HospitalYes (X)ChildrensHospitalInd
Teaching HospitalYes (X)TeachingHospitalInd
Research FacilityYes (X)ResearchFacilityInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPSYCH UNIT AND TRANSPLANT UNIT CANCER CENTEROtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MARY HITCHCOCK MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)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 Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.dartmouth-hitchcock.org/about-dhh/community-health.htmlOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.dartmouth-hitchcock.org/about-dhh/community-health.htmlStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care225.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.0FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.dartmouth-hitchcock.org/billing-charges/financial_assistance.htmlFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.dartmouth-hitchcock.org/billing-charges/financial_assistance.htmlFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.dartmouth-hitchcock.org/billing-charges/financial_assistance.htmlFAPSummaryOnWebsiteURLTxt
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 (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) AND DARTMOUTH-HITCHCOCK CLINIC (DHC, COLLECTIVELY KNOWN AS D-H) ARE ACTIVELY ENGAGED IN THE DEVELOPMENT OF THE UPPER VALLEY REGIONAL PUBLIC HEALTH ADVISORY COUNCIL AND GREATER SULLIVAN COUNTY PUBLIC HEALTH ADVISORY COUNCIL (WITH 60+ COMMUNITY REPRESENTATIVES). MEMBERS OF THESE TWO COMMUNITY HEALTH ADVISORY GROUPS HAVE HAD THE OPPORTUNITY TO REVIEW AND COMMENT ON DRAFTS OF DARTMOUTH-HITCHOCK'S COMMUNITY HEALTH IMPROVEMENT PLAN. THE PLAN DOCUMENT HAS ALSO BEEN CIRCULATED TO PUBLIC HEALTH OFFICIALS IN NEW HAMPSHIRE AND VERMONT FOR THEIR COMMENT. IN ADDITION, DARTMOUTH-HITCHCOCK REPRESENTATIVES SERVE ON NUMEROUS BOARDS, TASK FORCES, MUNICIPAL HEALTH LEADERSHIP AND PLANNING TEAMS, AND OTHER COMMUNITY HEALTH LEADERSHIP ENTITIES IN ORDER TO ENSURE THAT BOTH ORGANIZATIONS PARTICIPATE IN AND BETTER-UNDERSTAND THE NEEDS OF OUR COMMUNITY. MHMH CONTRACTED WITH JOHN SNOW RESEARCH AND TRAINING INSTITUTE/COMMUNITY HEALTH INSTITUTE TO PROVIDE CONSULTATION AND TECHNICAL EXPERTISE TO OUR ASSESSMENT PROCESS. JOHN SNOW RESEARCH AND TRAINING INSTITUTE IS A PUBLIC HEALTH MANAGEMENT CONSULTING AND RESEARCH ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF INDIVIDUALS AND COMMUNITIES THROUGHOUT THE WORLD. DURING THE PERIOD MARCH THROUGH AUGUST 2018, A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY DARTMOUTH-HITCHCOCK AND ALICE PECK DAY MEMORIAL HOSPITAL IN PARTNERSHIP WITH NEW LONDON HOSPITAL, VALLEY REGIONAL HOSPITAL, MT. ASCUTNEY HOSPITAL AND HEALTH CENTER, AND VISITING NURSE & HOSPICE OF VT/NH. THE PURPOSE OF THE ASSESSMENT WAS TO IDENTIFY COMMUNITY HEALTH CONCERNS, PRIORITIES, AND OPPORTUNITIES FOR COMMUNITY HEALTH AND HEALTH CARE DELIVERY SYSTEMS IMPROVEMENT. WHILE DARTMOUTH-HITCHCOCK MEDICAL CENTER SERVES AS A TERTIARY REFERRAL MEDICAL CENTER FOR A LARGE, MULTI-STATE AREA, THE GEOGRAPHIC AREA OF INTEREST FOR THE PURPOSES OF THIS ASSESSMENT WAS THE PRIMARY SERVICE AREA OF MARY HITCHCOCK MEMORIAL HOSPITAL AND ALICE PECK DAY MEMORIAL HOSPITAL. THIS PRIMARY SERVICE AREA WAS DEFINED AS 19 MUNICIPALITIES COMPRISING THE UPPER VALLEY OF NEW HAMPSHIRE AND VERMONT WITH A TOTAL RESIDENT POPULATION OF APPROXIMATELY 70,000 PEOPLE. METHODS EMPLOYED IN THE ASSESSMENT INCLUDED A SURVEY OF AREA RESIDENTS MADE AVAILABLE THROUGH DIRECT MAIL AND WEBSITE LINKS, A SURVEY OF KEY COMMUNITY STAKEHOLDERS WHO ARE AGENCY, MUNICIPAL OR COMMUNITY LEADERS, A SERIES OF COMMUNITY DISCUSSION GROUPS CONVENED IN THE PRIMARY SERVICE AREA, AND A REVIEW OF AVAILABLE POPULATION DEMOGRAPHICS AND HEALTH STATUS INDICATORS. IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), POPULATIONS EXPERIENCING HEALTH DISPARITIES OR VULNERABLE TO POOR HEALTH OUTCOMES ARE PRIMARILY DEFINED AS THOSE POPULATIONS FACING SIGNIFICANT INCOME AND SOCIAL DETERMINANTS CHALLENGES, WHICH IN THIS REGION ARE MORE STRONGLY ASSOCIATED WITH NEGATIVE IMPACTS ON HEALTH THAN RACE OR ETHNICITY. ENHANCED EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THESE POPULATIONS THROUGH TARGETED SURVEYS AND COMMUNITY CONVERSATIONS, INCLUDING FACILITATED SURVEYS AND DISCUSSIONS AT COMMUNITY SUPPERS, A REGIONAL FREE CLINIC, HOMELESS PROGRAMS, AND OTHER COMMUNITY SETTINGS SERVING ECONOMICALLY-VULNERABLE RESIDENTS. IN ADDITION, WE CONVENED A FOCUS GROUP OF BLACK AND AFRICAN-AMERICAN COMMUNITY MEMBERS. FINDINGS OF THIS ASSESSMENT HAVE BEEN SHARED WITH PUBLIC HEALTH OFFICIALS IN NH AND VT, AS WELL AS WITH THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY. DURING THIS ASSESSMENT, MARY HITCHCOCK MEMORIAL HOSPITAL USED SURVEYS FROM MARCH 2018 THROUGH AUGUST 2018 TO GENERATE INPUT FROM 2,100 RESIDENTS. SURVEYS WERE MADE AVAILABLE THROUGH PRIMARY CARE CLINICS, FREE CARE CLINICS, A SHELTER FOR THE HOMELESS, A FREE COMMUNITY DINNER, ANNUAL TOWN MEETINGS/ELECTIONS, AND NUMEROUS OTHER COMMUNITY LOCATIONS. VISITING NURSES AND OTHERS PROVIDED PRE-PAID MAILERS AND SURVEYS TO HOMEBOUND RESIDENTS. RESIDENTS COMPLETING SURVEYS INCLUDED MEMBERS OF AFRICAN-AMERICAN, HISPANIC, NATIVE AMERICAN, AND ASIAN POPULATIONS. SURVEYS WERE DISTRIBUTED THROUGH REGIONAL HEALTH CLINICS, THE REGION'S SHELTER FOR HOMELESS POPULATIONS; THE REGION'S LOW-INCOME HOUSING TRUST; SENIOR CENTERS; SUBSTANCE USE DISORDER TREATMENT PROGRAMS, DELIVERED DIRECTLY TO RESIDENT HOMES, AND OTHER LOCATIONS WHERE POPULATIONS MOST AFFECTED BY HEALTH DISPARITIES CONGREGATE. MARY HITCHCOCK MEMORIAL HOSPITAL DISSEMINATED THE SURVEY TOGETHER WITH MULTIPLE COMMUNITY ORGANIZATIONS THAT SERVE LOW-INCOME, FRAIL, AND HEALTH DISPARITY POPULATIONS. COMMUNITY PARTNERS, PROVIDED ASSISTANCE DISSEMINATING THE SURVEY, INCLUDING THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY, WHOSE MEMBERSHIP INCLUDES COMMUNITY MENTAL HEALTH SERVICES, SUBSTANCE USE SERVICES, MENTAL HEALTH PEER LEADERS, WIC PROVIDERS, SENIOR SERVICES ADVOCATES, SERVICES WORKING WITH PEOPLE WITH PHYSICAL AND DEVELOPMENTAL DISABILITIES, COMMUNITY NURSING, VISITING NURSES, AND OTHER CORE HUMAN SERVICES. IN ADDITION TO ASSISTING IN SURVEY DISSEMINATION, THESE PROVIDERS ADVOCATED FOR UNDERSERVED AND VULNERABLE POPULATIONS IN OUR REGION AS A PART OF THE CHNA PROCESS. DURING THIS CHNA PROCESS, OUR CHNA COLLABORATIVE TEAM CONVENED ONE REGIONAL DISCUSSION GROUP OF PERSONS IDENTIFYING AS BLACK/AFRICAN-AMERICAN (MAY 10, 2018); WE MADE RESIDENT SURVEYS WIDELY AVAILABLE TO COMMUNITY RESIDENTS THROUGH PUBLIC LIST SERVES, DIRECT E-MAIL INVITATIONS TO PATIENTS OF OUR PRIMARY CARE CLINICS, SURVEY LINKS ON TOWN WEB SITES AND E-NEWS, EMPLOYEE E-NEWS IN MAJOR EMPLOYERS, AND THROUGH OTHER SYSTEMS THAT PROVIDED WIDESPREAD ACCESS TO OUR SURVEYS. WE ALSO REVIEWED MEETING MINUTES FROM TWO REGIONAL COMMUNITIES (HARTFORD, VT, AND CLAREMONT, NH), WHERE ISSUES OF RACIAL EQUITY AND RACISM HAVE BEEN EXPLORED AT TOWN AND SCHOOL GOVERNANCE LEVELS. WE PARTNERED CLOSELY WITH ORGANIZATIONS SERVING POPULATIONS AFFECTED BY POVERTY, LACK OF INSURANCE, HOMELESSNESS, BEHAVIORAL HEALTH CONDITIONS, AND SERIOUS AND CHRONIC ILLNESSES IN ORDER TO SURVEY THESE MEMBERS OF POPULATIONS IN OUR COMMUNITY, AND HOSTED MULTIPLE DISCUSSION GROUPS WITH PEOPLE AFFECTED BY POVERTY AND CHRONIC ILLNESS. WE RECOGNIZE THE LIMITATIONS OF OUR ENGAGEMENT OF RACIAL AND ETHNIC MINORITY MEMBERS OF OUR COMMUNITY, AND ARE WORKING TO IMPROVE THIS PART OF OUR CHNA PROCESS. OUR MINORITY POPULATION IS QUITE SMALL: 0.9% OF THE POPULATION OF GRAFTON COUNTY, NH IDENTIFIES AS AFRICAN AMERICAN, 0.4% AS NATIVE AMERICAN, 1.8% AS HISPANIC/LATINO, 3.0% AS ASIAN. 92.1% OF THE MHMH HOSPITAL SERVICE AREA'S RESIDENTS IDENTIFY AS CAUCASIAN. WIDE DISPERSAL OF THIS POPULATION ACROSS A LARGE GEOGRAPHY FURTHER COMPLICATES ENGAGEMENT EFFORTS. OUR SUMMER 2018 DISCUSSION GROUP WITH COMMUNITY MEMBERS IDENTIFYING AS BLACK/AFRICAN AMERICAN WAS A POSITIVE, BUT LIMITED IMPROVEMENT OVER PRIOR YEARS. HOUSEHOLD MEDIAN INCOME, INSURANCE STATUS, AND OTHER INDICATORS OF POVERTY ARE SIGNIFICANT DRIVERS OF DISPARITY IN OUR REGION. POVERTY RATES RANGE WIDELY BY TOWN, WITH A RANGE BY TOWN OF 2.9% TO 31.7% OF HOUSEHOLDS LIVING ON INCOMES BELOW 200% OF FEDERAL POVERTY LEVEL. THESE POPULATIONS FACE NOTABLE HEALTH DISPARITY CONDITIONS ASSOCIATED WITH POVERTY AND OTHER SOCIAL DETERMINANTS OF HEALTH NEEDS. DURING OUR ASSESSMENT PROCESS, MHMH MADE SPECIFIC EFFORTS TO CONTACT AND RECEIVE INPUT FROM MEMBERS OF INCOME-VULNERABLE POPULATIONS, INCLUDING: * A DISCUSSION GROUP WITH PREGNANT AND PARENTING TEENS PARTICIPATING IN AN ALTERNATIVE HIGH SCHOOL ENVIRONMENT AT THE FAMILY PLACE PARENT CHILD CENTER (MAY 1, 2018). * A DISCUSSION GROUP WITH ADULTS LIVING WITH DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES/CAREGIVERS (MAY 4TH, 2018). * A DISCUSSION GROUP WITH PREGNANT WOMEN IN TREATMENT FOR SUBSTANCE USE DISORDERS (APRIL 9, 2018). * A DISCUSSION GROUP WITH COMMUNITY NURSES SERVING CHRONICALLY ILL, HOMEBOUND, AND OTHERWISE VULNERABLE OLDER ADULTS IN REGIONAL TOWNS (MAY 8, 2018). * A DISCUSSION GROUP WITH THE BOARD AND LEADERSHIP OF THE MASCOMA COMMUNITY HEALTH CLINIC, A COMMUNITY HEALTH CLINIC SEEKING FQHC-LOOKALIKE STATUS AND SERVING A SET OF COMMUNITIES WITH HEALTH DISPARITIES (MAY 14, 2018) * WORKING WITH THE GOOD NEIGHBOR HEALTH CLINIC AND MASCOMA COMMUNITY HEALTH CENTER TO DISSEMINATE SURVEYS TO PATIENTS WHO ARE UNINSURED AND LOW-INCOME. DISSEMINATING SURVEYS AT THE HAVEN (SHELTER); LISTEN COMMUNITY SERVICES (BASIC NEED SUPPORT, FOOD SHELF, AND COMMUNITY DINNERS); TO PARENTS OF CHILDREN IN DARTMOUTH-HITCHCOCK AND ALICE PECK DAY'S PEDIATRICS CLINICS; VIA WOMEN, INFANTS, AND CHILDREN'S CLINICS; THROUGH GRAFTON COUNTY SENIOR CITIZENS COUNCIL (HOME-DELIVERED MEALS AND CONGREGATE MEALS); THROUGH VISITING NURSE AND HOSPICE OF VT AND NH (HOME-VISITING PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FOR SENIORS WITH COMPLEX HEALTH NEEDS); AND THROUGH OTHER COMMUNITY ORGANIZATIONS SERVING PEOPLE AFFECTED BY POVERTY AND POOR HEALTH.
Schedule H, Part V, Section B, Line 6a Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. DURING MARCH 2018 - JUNE 2019, MHMH PARTNERED WITH ALICE PECK DAY MEMORIAL HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT. WE ALSO PARTNERED WITH NEIGHBORING HOSPITALS AND ORGANIZATIONS INCLUDING VALLEY REGIONAL HOSPITAL, NEW LONDON HOSPITAL, MOUNT ASCUTNEY HOSPITAL AND HEALTH CENTER, AND VISITING NURSE & HOSPICE OF VT/NH. USING SIMILAR COMMUNITY HEALTH NEEDS ASSESSMENT TOOLS AND APPROACHES, ALLOWING US TO COMPARE COMMUNITY HEALTH NEEDS ACROSS A BROAD GEOGRAPHIC, MULTI-HOSPITAL REGION.
Schedule H, Part V, Section B, Line 6b Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. DURING MARCH 2018- JUNE 2019, IN ADDITION TO WORKING WITH DARTMOUTH-HITCHCOCK CLINIC, MHMH WORKED CLOSELY WITH THE MEMBER ORGANIZATIONS OF THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY (60+ MEMBER ORGANIZATIONS) AND GREATER SULLIVAN COUNTY PUBLIC HEALTH ADVISORY COUNCIL TO DISSEMINATE SURVEYS, SERVE AS KEY INFORMANTS, AND TO PROVIDE OVERALL REVIEW AND FEEDBACK RE: FINDINGS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT
Schedule H, Part V, Section B, Line 7 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. THE NEEDS ASSESSMENT WAS DISTRIBUTED TO NON-PROFIT ORGANIZATIONS THROUGHOUT THE REGION INCLUDING THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY, WHICH IS A MEMBERSHIP GROUP OF REIGONAL NON-PROFIT, MUNICIPAL, SAFETY, HUMAN SERVICE, AND PUBLIC HEALTH ORGANIZATIONS. IT IS ALSO AVAILABLE FROM THE ORGANIZATION UPON REQUEST AND IS POSTED ON THE MHMH WEB PAGE.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MHMH IS INCREASING COMMUNITY BENEFITS SPENDING TO ADDRESS IDENTIFIED COMMUNITY NEEDS BASED ON THE MOST RECENT CHNA IN AREAS OF TRAUMA AND VIOLENCE, SOCIAL DETERMINANTS OF HEALTH, IMPROVING ACCESS TO HEALTH CARE, AND NEEDS OF OLDER ADULTS, AS WELL AS MAINTAINING ONGOING INVESTMENTS IN BEHAVIORAL HEALTH AND SUBSTANCE USE NEEDS, STRENGTHENING FAMILIES AND CHILDREN, AND CANCER CARE AND TREATMENT. IN FY 2020, MARY HITCHCOCK MEMORIAL HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT STRATEGIES WERE CONSISTENT WITH THE INTENTIONS IDENTIFIED IN OUR FY2016 AND FY2019 COMMUNITY HEALTH IMPROVEMENT PLANS. AREAS WERE ANALYZED AND MHMH RESPONDED BY INCREASING INVESTMENTS, MAINTAINING SIMILAR LEVELS OF INVESTMENTS FOR SERVICES AND INITIATIVES, OR LIMITING INVESTMENT IN AREAS WHERE OTHER COMMUNITY ORGANIZATIONS ALREADY PROVIDE LEADERSHIP AND SERVICES TO ADDRESS THE NEED, AND/OR WHERE THE IDENTIFIED NEED IS SIGNIFICANTLY OUTSIDE THE MISSION/SERVICES/SCOPE OF MHMH. MARY HITCHCOCK MEMORIAL HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN IS A 3-YEAR DOCUMENT IDENTIFYING ANTICIPATED INVESTMENTS AND ACTIVITIES THAT IT WILL TAKE TO ADDRESS NEEDS IDENTIFIED IN THE MOST RECENT UPPER VALLEY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). WITH THE ONSET OF COVID-19 IN FEBRUARY-MARCH 2020, MHMH HAS ADDED AND PRIORITIZED COVID-19 DRIVEN COMMUNITY NEEDS TO OUR OTHER CHNA PRIORITIES. THIS HAS INCLUDED PROVIDING SIGNIFICANT FUNDING AND STAFF SUPPORT TO HELP COMMUNITY FOOD SUPPORT PROGRAMS, BEHAVIORAL HEALTH PROVIDERS, NURSING HOMES, AND OTHER COMMUNITY ORGANIZATIONS ADAPT TO AND MAINTAIN BASIC SOCIAL SERVICES SAFELY DURING THE PANDEMIC.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - MARY HTCHCOCK MEMORIAL HOSPITAL. PATIENTS WHOSE FAMILY INCOME EXCEEDS 300% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF MHMH.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MHMH HAS A SEPARATE UNINSURED DISCOUNT POLICY THAT OUTLINES HOW THE DISCOUNT IS CALCULATED ANNUALLY AND IS APPLIED PRIOR TO BILLING ANY UNINSURED PATIENT. THIS ASSURES A PATIENT IS NOT BILLED AT AN AMOUNT GREATER THAN THE AMOUNT GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS POLICY IS REFERENCED IN THE FINANCIAL ASSISTANCE POLICY.
Schedule H, Part V, Section B, Line 16 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON MHMH'S WEBSITE, INCLUDING THE VERBATIM POLICY AND A SHORTER, MORE PATIENT-FRIENDLY PLAIN-LANGUAGE SUMMARY. MHMH PROVIDES THE PLAIN-LANGUAGE SUMMARY BROCHURE TO ALL INPATIENTS, EMERGENCY DEPARTMENT INTAKES, UNINSURED, AND SELF-PAY INDIVIDUALS. MHMH CONTINUES TO NOTIFY PATIENTS ON THE BACK OF THE BILLING STATEMENT ABOUT FINANCIAL ASSISTANCE AVAILABLE TO THEM. ADDITIONALLY, MHMH POSTS INFORMATION ABOUT THE POLICY IN PUBLIC AREAS THROUGHOUT THE FACILITIES INCLUDING ADMISSION OFFICES, PUBLIC AREA BOARDS THROUGHOUT THE FACILITIES, THE EMERGENCY ROOMS, AND FINANCIAL ASSISTANCE POLICY BROCHURES IN PATIENT AREAS. MHMH SCREENS 100% OF UNINSURED INPATIENT AND SAME-DAY PATIENTS PRIOR TO ADMISSION. AS PART OF THIS PROCESS, MHMH CHECKS ALL STATE AND FEDERAL PROGRAMS TO SEE IF INDIVIDUALS ARE ELIGIBLE FOR ASSISTANCE. PATIENTS ARE ALSO SCREENED TO DETERMINE QUALIFICATION FOR FINANCIAL ASSISTANCE AND THE APPLICATION IS PROVIDED AND/OR COMPLETED AT THIS TIME.
FieldValueIRS element (for citing)
Facility0FacilityNum

Supplemental Information Detail SupplementalInformationDetail (21 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section C MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICYTHE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY CAN BE FOUND AT HTTPS://WWW.DARTMOUTHHITCHCOCK.ORG/BILLINGCHARGES/FINANCIAL_ASSISTANCE.HTML. MHMH HAS PLAIN LANGUAGE SUMMARY BROCHURES AVAILABLE AT ALL ADMISSION SITES AS WELL AS PLAIN LANGUAGE SUMMARY POSTERS AT ALL PHYSICAL LOCATIONS.
Schedule H, Part VI, Line 2 FACILITY INFORMATIONTHE HOSPITAL HAS A 2ND CANCER TREATMENT CENTER LOCATED IN SAINT JOHNSBURY, VERMONT. THIS LOCATION IS REGISTERED UNDER THE SAME LICENSE AS THE ORGANIZATION'S MAIN CAMPUS LOCATED IN LEBANON, NEW HAMPSHIRE.
Schedule H, Part I, Line 3c OTHER FACTORS USED IN DETERMINING ELIGIBILITY OTHER THAN FPGMHMH USES THE FPG GUIDELINES IN DETERMINING THE INITIAL LEVEL OF FINANCIAL ASSISTANCE PROVIDED. IN ADDITION, MHMH ALLOWS FOR CATASTROPHIC ASSISTANCE CONSIDERATION BASED ON A CALCULATION OF 10% OF TWO YEARS INCOME PLUS 10% OF AMOUNT OVER SHELTERED ASSETS. IF THE PROJECTED OR CURRENT SELF-PAY BALANCE IS GREATER THAN THIS CALCULATION, THE SELF-PAY BALANCE IS REDUCED TO THE SUM OF 10% OF TWO YEARS INCOME PLUS 10% OF ASSETS. EACH HOUSEHOLD IS ALLOWED CERTAIN SHELTERED ASSETS WHICH ARE NOT USED WHEN CALCULATING HOUSEHOLD INCOME OR ASSETS SAVINGS IS SHELTERED UP TO 100% OF FPL BASED ON FAMILY SIZE, EQUITY IN PRIMARY RESIDENCE UP TO $200,000 UP TO 55 AND $250,000 FOR AGED 55 AND OLDER, AND A RETIREMENT SHELTER OF UP TO $100,000 IN RETIREMENT ASSETS AS LONG AS IT IS EMPLOYER BASED CONTRIBUTIONS IF WORKING OR IRA IF SELF-EMPLOYED. IF A PATIENT IS RETIRED, PRIOR RETIREMENT ACCOUNTS WOULD BE INCLUDED AS A SHELTERED ASSET.
Schedule H, Part I, Line 6a COMMUNITY BENEFITS REPORTMARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH-HITCHCOCK CLINIC (COLLECTIVELY REFERRED TO AS DARTMOUTH-HITCHCOCK (D-H)) SHARE COMMON BOARD MEMBERS AND OPERATE UNDER AN AFFILIATION AGREEMENT. D-H PERFORMS A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND FILES A CONSOLIDATED COMMUNITY BENEFITS REPORT WITH THE STATE OF NEW HAMPSHIRE. FOR PURPOSES OF IRS FORM 990, SCHEDULE H, ONLY MHMH HOSPITAL NUMBERS WERE USED. ALL AMOUNTS RELATING TO DHC WERE EXCLUDED. THE NEW HAMPSHIRE COMMUNITY BENEFITS REPORT FILED FOR FISCAL YEAR 2020, DHC AND MHMH COMBINED, TOTALED $250,399,871.
Schedule H, Part I, Line 7g Subsidized Health ServicesThe organization did not include any subsidized health service costs attributable to a physician clinic on part I, line 7G.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe costing methodology used to calculate the amounts reported was a cost-to-charge ratio derived from worksheet 2, ratio of patient care to cost-to-charges.
Schedule H, Part II Community Building ActivitiesCommunity building activities include expenses related to coalitions that address regional public health networks, improvement in systems of care for substance use and mental health disorders, prevention of substance abuse, falls reduction for older adults, and prescription drug misuse.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountAS A RESULT OF NEW ACCOUNTING GUIDANCE, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyThe hospital is unable to estimate accurately the amount of bad debt expense attributable to patients eligible for financial assistance. Although a portion of bad debt expense may be related to patients who would qualify for charity care, a reportable figure cannot be reasonably estimated.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteMHMH FILES A CONSOLIDATED AUDITED FINANCIAL STATEMENT WITH DARTMOUTH-HITCHCOCK CLINIC AND OTHER SUBSIDIARIES. MHMH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR FINANCIAL ASSISTANCE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. BECAUSE MHMH DOES NOT ANTICIPATE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. MHMH GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS. MOST ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY ARRANGEMENTS. FOR FINANCIAL STATEMENT PURPOSES, Dartmouth Hitchcock Health HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsThe costing methodology used to calculate the amounts reported as Medicare shortfalls was derived from the Internal Revenue Service's Worksheet B as provided for Part III calculations. MHMH had revenues of $64,886,809 and costs of $88,702,476 for services not included on the Medicare Cost Report (Ambulance Services, Laboratory and other fee screens, and Medicare Part C & D services) MHMH incurred a net loss of $23,815,667 on the provision of these services. Because of the central role of the organization in serving the healthcare needs of its community and the demographic characteristics of the community served, it is likely that a portion of the medicare shortfall should be considered community benefit expenditure. MHMH has not identified a specific amount of medicare shortfall that should be reported as such.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceMHMH HAS A CREDIT AND COLLECTION POLICY THAT ADDRESSES THE PROCEDURES FOR PATIENTS WHO QUALIFY FOR REDUCED-COST CARE. THE POLICY PROHIBITS USING EXTRAORDINARY COLLECTION PRACTICES OR PLACING AMOUNTS WITH COLLECTION AGENCIES. IF A FINANCIAL ASSISTANCE POLICY ELIGIBLE PATIENT HAS A BALANCE FOR WHICH THEY ARE RESPONSIBLE AFTER A FINANCIAL ASSISTANCE DISCOUNT IS APPLIED, THE STANDARD PRACTICES ARE FOLLOWED AS OUTLINED IN THE D-H CREDIT AND COLLECTIONS POLICY.
Schedule H, Part V, Section B, Line 16a FAP website- MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16a URL: https://www.dartmouth-hitchcock.org/billing-charges/financial_assistance.html;
Schedule H, Part V, Section B, Line 16b FAP Application website- MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16b URL: https://www.dartmouth-hitchcock.org/billing-charges/financial_assistance.html;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16c URL: https://www.dartmouth-hitchcock.org/billing-charges/financial_assistance.html;
Schedule H, Part VI, Line 2 Needs assessmentMARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH HITCHCOCK CLINIC (COLLECTIVELY REFERRED TO AS DARTMOUTH-HITCHCOCK (D-H)) SHARE COMMON BOARD MEMBERS AND OPERATE UNDER AN AFFILIATION AGREEMENT. D-H PERFORMS A JOINT COMMUNITY NEEDS ASSESSMENT AND FILES A CONSOLIDATED COMMUNITY BENEFITS REPORT. DARTMOUTH-HITCHCOCK PARTICIPATES WITH OTHER HEALTH CARE CHARITABLE TRUSTS AND COMMUNITY PARTNERS IN EACH OF OUR SERVICE AREAS TO COMPLETE COMMUNITY HEALTH NEEDS ASSESSMENTS. DURING FY2019, MHMH PARTNERED WITH ALICE PECK DAY MEMORIAL HOSPITAL, TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT. WE ALSO WORKED TOGETHER WITH NEIGHBORING HOSPITALS, INCLUDING MOUNT ASCUTNEY HOSPITAL AND HEALTH CARE, VALLEY REGIONAL HOSPITAL, NEW LONDON HOSPITAL , AND VISITING NURSE & HOSPICE OF VT & NH TO USE SIMILAR COMMUNITY HEALTH NEEDS ASSESSMENTS TOOLS AND APPROACH, TO ALLOW COMPARABILITY OF HEALTH DATA ACROSS A WIDER GEOGRAPHIC REGION. COLLECTIVELY D-H AND PARTNERED HOSPITALS HIRED COMMUNITY HEALTH INSTITUTE/JOHN SNOW RESEARCH AND TRAINING INSTITUTE, A PUBLIC HEALTH CONSULTING FIRM, TO PROVIDE TECHNICAL ASSISTANCE AND ANALYSIS RELATED TO OUR COMMUNITY HEALTH NEEDS ASSESSMENTS. THE NEEDS ASSESSMENT INCLUDED REVIEWING SELECTED SERVICE AREA DEMOGRAPHICS; PUBLIC HEALTH DATA AVAILABLE THROUGH NH AND VT HEALTH DEPARTMENTS, HOSPITAL DISCHARGE DATA, BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY AND YOUTH RISK BEHAVIOR SURVEYS; FOCUS GROUPS WITH EMPLOYERS AND WITH COMMUNITY MEMBERS RECEIVING SERVICES AT REGIONAL SAFETY NET SERVICE ORGANIZATIONS; ELECTRONIC SURVEYS OF PROFESSIONAL HEALTH AND SOCIAL SERVICE PROVIDERS; AS WELL AS PAPER AND ELECTRONIC CONVENIENCE SURVEYS OF COMMUNITY RESIDENTS. THE FY2019 COMMUNITY HEALTH NEEDS ASSESSMENT WAS REVIEWED AT 3 LARGE COMMUNITY MEETING (100+ TOTAL STAKEHOLDERS) HOSTED IN CONCERT WITH THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY AND OTHERS FOR FURTHER COMMENTS AND FEEDBACK. ADDITIONALLY, MHMH COMMUNITY HEALTH STAFF PARTICIPATE IN OR LEAD MULTIPLE COMMUNITY COALITIONS AND PROJECTS CONNECTING US TO A WIDE ARRAY OF COMMUNITY-BASED HEALTH, MUNICIPAL, SCHOOL, SERVICE ORGANIZATION, REGIONAL PLANNING AND STATE PUBLIC HEALTH STAKEHOLDERS. WE REGULARLY REVIEW EMERGING NH & VT STATE HEALTH DATA; QUANTITATIVE AND QUALITATIVE DATA FROM LOCAL SOURCES (NEWSPAPERS, REGIONAL PLANNING OFFICES, COMMUNITY FORUMS), AND CONVERSATIONS WITH COMMUNITY PARTNERS TO IDENTIFY CONCERNS THAT ARE EMERGING, INTENSIFYING, OR ARE THE SOURCE OF LOCAL ATTENTION SINCE THE LAST CHNA WAS CONDUCTED.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceALL UNINSURED INPATIENTS, SAME DAY SURGERY, OBSERVATION, AND EMERGENCY DEPARTMENT PATIENTS ARE PRO-ACTIVELY SCREENED USING PAPER AND/OR AN AUTOMATED TOOL TO IDENTIFY POTENTIAL QUALIFICATION FOR OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. IN ADDITION, SPECIFIC OUTPATIENT ACTIVITIES DEEMED TO HAVE A HIGHER RATE OF NEED ARE SCREENED AS PART OF REGULAR PROTOCOL. IF A PATIENT APPEARS TO BE ELIGIBLE, ON-SITE FINANCIAL COUNSELORS ASSIST THE PATIENT IN COMPLETING THE APPROPRIATE PAPERWORK/APPLICATIONS AND PROVIDE INSTRUCTION REGARDING HOW TO COMPLETE THE QUALIFICATION PROCESS. IN SOME CASES A FINANCIAL COUNSELOR WILL ACT ON BEHALF OF THE PATIENT, AT THEIR SIGNED CONSENT, IN ORDER TO COMPLETE THE APPLICATION PROCESS (FOR EXAMPLE, IN NEW HAMPSHIRE A PATIENT MUST BE PHYSICALLY PRESENT AT THE DISTRICT OFFICE). IF A PATIENT DOESN'T QUALIFY FOR SPECIFIC PROGRAMS, THEY ARE ALSO CONSIDERED FOR FINANCIAL ASSISTANCE AS PART OF THEIR SCREENING. FOR OUTPATIENT SERVICES THAT ARE NOT ROUTINELY SCREENED, STAFF INTERACTING WITH PATIENTS ARE INSTRUCTED TO PROVIDE EITHER A FINANCIAL ASSISTANCE APPLICATION OR CONTACT INFORMATION FOR A FINANCIAL COUNSELOR WHEN A PATIENT EXPRESSES THEIR INABILITY TO MAKE PAYMENT. EVERY APPLICATION IS SCREENED FOR COMPLETED INCOME AND ASSET DOCUMENTATION. APPLICATIONS ARE ALSO SCREENED TO ASSURE THERE ARE NO OTHER POTENTIAL OPTIONS OF FEDERAL, STATE, OR LOCAL PROGRAMS. THE WEBSITE, PATIENT STATEMENTS, AND FINANCIAL BROCHURES ALL INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE AND HOW TO APPLY.
Schedule H, Part VI, Line 4 Community informationTHE ORGANIZATION DEFINES ITS SERVICE REGION AS NEW HAMPSHIRE AND EASTERN VERMONT, WITH THE LARGEST PRESENCE IN A 19-TOWN REGION ADJOINING LEBANON, NEW HAMPSHIRE, SITE OF DARTMOUTH-HITCHCOCK MEDICAL CENTER WHICH INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH-HITCHCOCK CLINIC'S MAIN NORTHERN CLINIC. THE REGION HAS A POPULATION OF 70,000 PEOPLE, WITH TOWNS RANGING IN POPULATION FROM 200-14,000 PEOPLE. THESE TOWNS ARE GENERALLY CONSIDERED RURAL, THOUGH THE HANOVER, AND LEBANON, NH AND HARTFORD, VT COMMUNITIES ARE CONSIDERED TO BE A MICROPOLITAN AREA. AMONG THE REGION'S 19 TOWNS, MEDIAN HOUSEHOLD INCOME VARIES WIDELY, FROM $50K-$120K ANNUALLY 17.5% OF THE POPULATION IS OVER THE AGE OF 65; 11% OF CHILDREN LIVE IN HOUSEHOLDS WHOSE MEDIAN HOUSEHOLD INCOME IS LESS THAN 100% OF FEDERAL POVERTY LEVEL, 26.8% OF CHILDREN LIVE IN HOUSEHOLDS WITH INCOME LESS THAN 200% OF FEDERAL POVERTY LEVEL; 1.5% OF THE REGION'S RESIDENTS HAVE LIMITED ENGLISH PROFICIENCY; AND 7.1% LACKED HEALTH INSURANCE. 11.8% OF NH RESIDENTS AND 24.9% OF VERMONT RESIDENTS ARE MEDICAID BENEFICIARIES. THE REGION IS SERVED BY MHMH AND BY ALICE PECK DAY MEMORIAL HOSPITALS. THERE ARE NO FEDERALLY QUALIFIED HEALTH CENTERS OPERATING WITHIN THE REGION. THE GOOD NEIGHBOR HEALTH CLINIC, IN HARTFORD, VT, OFFERS CARE TO UNINSURED COMMUNITY MEMBERS. TWO MINOR CIVIL DIVISIONS IN OUR REGION, DORCHESTER NH AND PIERMONT NH, ARE CONSIDERED MEDICALLY UNDERSERVED AREAS. MHMH SERVES THE GENERAL POPULATION WITH A WIDE RANGE OF SERVICES. IN ADDITION TO GENERAL HOSPITAL POPULATIONS, THE ORGANIZATION PROVIDES SERVICES TO PATIENTS WITH HIGHLY-SPECIALIZED NEEDS THAT ARE NOT AVAILABLE ELSEWHERE IN NEW HAMPSHIRE. MHMH IS THE STATE'S ONLY TERTIARY REFERRAL CENTER, PROVIDES THE STATE'S ONLY COMPREHENSIVE CANCER CENTER (NORRIS COTTON CANCER CENTER ~ NCCC), OPERATES THE ONLY LEVEL I TRAUMA CENTER IN NEW HAMPSHIRE, OPERATES THE ONLY COMPREHENSIVE CHILDREN'S HOSPITAL AND ACCREDITED PEDIATRIC TRAUMA CENTER IN NEW HAMPSHIRE (CHILDREN'S HOSPITAL AT DARTMOUTH - CHAD), HOSTS THE ONLY LEVEL IV NEONATAL INTENSIVE CARE NURSERY AND ONE OF TWO PEDIATRIC INTENSIVE CARE UNITS IN NEW HAMPSHIRE, AND OPERATES THE ONLY HELICOPTER TRANSPORT SERVICE IN THE STATE. AS SUCH, THE SERVICE POPULATION IS BOTH THE GENERAL PUBLIC SEEKING PRIMARY HEALTH CARE SERVICES AS WELL AS RESIDENTS WITH UNIQUE AND HIGHLY-SPECIALIZED HEALTH CARE NEEDS.
Schedule H, Part VI, Line 5 Promotion of community healthMHMH SUPPORTS ORGANIZATIONS AND INITIATIVES THAT FURTHER HEALTH BY STRENGTHENING AND DEVELOPING KEY COMMUNITY CAPACITIES TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS. THIS INCLUDES HOSTING OR LEADING COMMUNITY PARTNERSHIPS TO ADDRESS SUBSTANCE MISUSE AND TREATMENT AND TO IMPROVE PUBLIC HEALTH; PROVIDING FUNDING FOR CHILD AND ADULT ORAL HEALTH INITIATIVES, AND PARTICIPATION OF OUR STAFF IN OTHER PARTNERSHIPS INCLUDING THE OUTPATIENT FALLS PREVENTION TASK FORCE, THE TRANSPORTATION MANAGEMENT ASSOCIATION, AND THE UPPER VALLEY HOUSING COALITION. IN ADDITION, MHMH OPERATES HEALTH EDUCATION AND SUPPORT SERVICES SUCH AS A WOMEN'S HEALTH RESOURCE CENTER, THE AGING RESOURCE CENTER, AND A HEALTH EDUCATION CENTER. MHMH USES CASH CONTRIBUTIONS, CONTRACTED SERVICES, AND IN KIND CONTRIBUTION OF STAFF TIME AND EXPERTISE, TO SUPPORT THESE STRATEGIES WHICH IMPROVE COMMUNITY HEALTH. AT MHMH'S LEBANON, NH CAMPUS, THE HOSPITAL EXTENDS PROFESSIONAL STAFF PRIVILEGES TO QUALIFIED AND APPROPRIATE PHYSICIANS WHO ARE EMPLOYEES OF DARTMOUTH HITCHCOCK CLINIC, MARY HITCHCOCK MEMORIAL HOSPITAL, AND DARTMOUTH COLLEGE, WHO ALSO HOLD A FACULTY APPOINTMENT AT GEISEL SCHOOL OF MEDICINE. MARY HITCHCOCK'S TRUSTEES ANNUALLY SET STRATEGIC PRIORITIES FOR THE INSTITUTION AND APPROVE OPERATING AND CAPITAL BUDGETS WHICH SUPPORT IMPROVEMENTS, PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH. EXAMPLES OF THESE INVESTMENTS INCLUDE THE DEVELOPMENT OF MARY HITCHCOCK'S PATIENT SAFETY AND TRAINING CENTER; ONGOING QUALITY AND PATIENT SAFETY INITIATIVES; PURCHASES OF NEW AND EMERGING MEDICAL TECHNOLOGIES; SUPPORT TRANSLATIONAL RESEARCH, AND MEDICAL EDUCATION OF THE 21 VOTING MEMBERS OF THE MARY HITCHCOCK BOARD OF TRUSTEES AT FY20 END, 14 ARE NEITHER CONTRACTORS NOR EMPLOYEES OF MHMH .
Schedule H, Part VI, Line 6 Affiliated health care systemCOMMUNITY BENEFITS ARE PROVIDED BY THE DARTMOUTH HITCHCOCK HEALTH CARE SYSTEM, WHICH INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL, DARTMOUTH-HITCHCOCK CLINIC, AND OTHER RELATED ORGANIZATIONS WHOSE PRIMARY MISSION IS HEALTH CARE. MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) IN LEBANON IS NEW HAMPSHIRE'S LARGEST HOSPITAL. IN FISCAL YEAR 2020 MHMH HAD 396 LICENSED INPATIENT BEDS. THE DARTMOUTH-HITCHCOCK CLINIC (DHC) IS A MULTI-SPECIALTY PHYSICIAN PRACTICE WITH A NETWORK OF PROVIDERS ACROSS NEW HAMPSHIRE AND VERMONT. WHILE DHC'S MAIN OFFICES ARE LOCATED IN LEBANON, THE CLINIC ALSO HAS MULTI-SPECIALTY PRACTICES IN MANCHESTER, NASHUA, CONCORD, AND KEENE, NH AREAS AS WELL AS BENNINGTON, VT. IN ADDITION, THE CLINIC PROVIDES PRIMARY CARE IN RURAL COMMUNITIES IN VERMONT AND NORTHERN NEW HAMPSHIRE. THE HOSPITAL AND CLINIC OPERATE JOINTLY THROUGH INTERLOCKING DIRECTORATES, STRATEGIC PLANNING AND MANAGEMENT AND SHARE IDENTICAL MISSIONS. THE MEDICAL SCHOOL, WHICH WORKS CLOSELY WITH THE HOSPITAL AND CLINIC, IS FOCUSED ON MEDICAL EDUCATION AND RESEARCH.
Schedule H, Part VI, Line 7 State filing of community benefit reportNH

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (120 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxtAddress Line2USAddress/AddressLine2Txt
Alice Peck Day Memorial Hospital
10 Alice Peck Day DriveLebanonNH03766020222791501(c)(3)$91,445FMVPROGRAM SUPPORT
American Cancer Society
2 Commerce Drive Suite 110BedfordNH03110131788491501(c)(3)$28,440FMVPROGRAM SUPPORT
American Heart Association
PO Box 4002012Des MoinesIA503402012135613797501(c)(3)$24,840FMVPROGRAM SUPPORT
Amoskeag Health
145 Hollis StreetManchesterNH03101020458174501(c)(3)$39,600FMVPROGRAM SUPPORT
ANDERSON ORTHOPEDIC RESEARCH INSTITUTE
2501 PARKERS LNALEXANDRIAVA22306237162048501(c)(3)$12,114FMVCHARITABLE RESEARCH
APPLIED GEOSOLUTIONS LLC
15 NEWMARKET ROADDURHAMNH03824020518753$22,550FMVPROGRAM SUPPORT
ATRIUM HEALTH
CAROLINAS HEALTHCARE SYSTEMCHARLOTTENH282601979560529945501(c)(3)$31,140FMVCHARITABLE RESEARCH
Bipartisan Policy Center Inc
1225 I Street NWWashingtonDC02005731628382501(c)(3)$18,000FMVPROGRAM SUPPORT
BOSTON MEDICAL CENTER
52 RATTLESNAKE HILL RDANDOVERMA01810043314093501(c)(3)$20,074FMVCHARITABLE RESEARCH
BOSTON UNIVERSITY
PO BOX 28763NEW YORKNY100878763042103547501(c)(3)$173,863FMVCHARITABLE RESEARCH
BRD OF REGENTS UNIV OF OK HLTH SCIENCE
ROOM 2B02TULSAOK741352512731563627St. of OK$40,875FMVEDUCATIONAL SERVICES
BRIGHAM AND WOMEN'S HOSPITAL INC
NURSING PROF DEVELOPMENTBOSTONMA02115042312909501(c)(3)$140,909FMVCHARITABLE RESEARCH
Business and Industry Association
122 North Main StreetConcordNH03301020172300501(c)(3)$9,720FMVPROGRAM SUPPORT
CASE WESTERN RESERVE UNIVERSITY
DEPT OF GENETICS GENOME SCIENCESCLEVELANDOH441064948341018992501(c)(3)$8,805FMVCHARITABLE EDUCATIONAL SERVICES
CEDARS-SINAI MEDICAL CENTER
6500 WILSHIRE BLVD SUITE 1150LOS ANGELESCA90048951644600501(c)(3)$204,162FMVCHARITABLE RESEARCH
CENTERSTONE OF KENTUCKY INC
10101 LINN STATION RDLOUISVILLEKY40223310939757501(c)(3)$43,313FMVCHARITABLE RESEARCH
CENTERSTONE RESEARCH INSTITUTE
44 VANTAGE WAY SUITE 280NASHVILLETN37228262505456501(c)(3)$153,906FMVCHARITABLE RESEARCH
Cheshire Medical Center
580 Court St 590KeeneNH03431020354549501(c)(3)$383,753FMVPROGRAM SUPPORT
CLEVELAND CLINIC FOUNDATION
ATTN STACIE PALLOTTACLEVELANDOH44195340714585501(c)(3)$82,940FMVCHARITABLE RESEARCH
Colby Sawyer College
541 Main StreetNew LondonNH03257020222120501(c)(3)$750,000FMVPROGRAM SUPPORT
COMMONWEALTH OF MASSACHUSETTS
DEPT OF REVENUEBOSTONMA022055140046002284St. of MA$222,875FMVEDUCATIONAL SERVICES
COMMUNITY MENTAL HEALTH AFFILIATES INC
270 JOHN DOWNEY DRNEW BRITAINCT06051060934544501(c)(3)$28,873FMVCHARITABLE PROGRAM SUPPORT
CONCORD HOSPITAL
250 PLEASANT STCONCORDNH03301222594672501(c)(3)$8,509FMVCHARITABLE PROGRAM SUPPORT
COOS COUNTY FAMILY HEALTH SERVICES
133 PLEASANT STREETBERLINNH03570020350051501(c)(3)$12,593FMVCHARITABLE PROGRAM SUPPORT
Counseling Assoc of New London LLC
35 Newport RoadNew LondonNH03257201917474501(c)(3)$111,874FMVPROGRAM SUPPORT
CREARE LLC
16 GREAT HOLLOW RDHANOVERNH03755020259551$7,191FMVPROGRAM SUPPORT
Crotched Mountain
1 Verney DriveGreenfieldNH03047222541478501(c)(3)$14,256FMVPROGRAM SUPPORT
Easter Seals of NH
555 Auburn StreetManchesterNH03103020272825501(c)(3)$37,168FMVPROGRAM SUPPORT
Families Flourish Northeast
235 Whitford StreetManchesterNH03104844591232501(c)(3)$36,000FMVPROGRAM SUPPORT
Families in Transition
122 Market StManchesterNH03101020475414501(c)(3)$63,810FMVPROGRAM SUPPORT
Family Place Inc
319 US Route 5 SouthNorwichVT05055030305264501(c)(3)$42,521FMVPROGRAM SUPPORT
FEINSTEIN INSTITUTES FOR MEDICAL RESEARC
350 COMMUNITY DRIVEMANHASSETNY11030112673595501(c)(3)$23,777FMVCHARITABLE RESEARCH
Foundation for Healthy Communities (NHHA)
125 Airport RoadConcordNH03301020275078501(c)(3)$1,004,346FMVPROGRAM SUPPORT
Good Neighbor Health Clinic
70 North Main StreetWhite River JunctionVT05001030346949501(c)(3)$46,800FMVPROGRAM SUPPORT
Grafton County Senior Citizens Council
10 Campbell StLebanonNH03766237248316501(c)(3)$12,960FMVPROGRAM SUPPORT
Grafton Regional Development Corporation
131 Main StreetPlymouthNH03264043373604501(c)(3)$10,440FMVPROGRAM SUPPORT
Granite United Way
22 Concord StreetManchesterNH03101026006033501(c)(3)$14,400FMVPROGRAM SUPPORTFloor 2
GREATER NASHUA MENTAL HEALTH CENTER
100 WEST PEARL STREETNASHUANH03060020222121501(c)(3)$37,747FMVCHARITABLE PROGRAM SUPPORT
GREATER SEACOAST COMMUNITY HEALTH
311 ROUTE 108SOMERSWORTHNH03878020304203501(c)(3)$5,868FMVCHARITABLE PROGRAM SUPPORT
HARVARD UNIVERSITY
HARVARD MED-CMEBOSTONMA021170825042103580501(c)(3)$5,405FMVCHARITABLE EDUCATIONAL SERVICES
Headrest Inc
141 Mascoma StLebanonNH03766237256865501(c)(3)$33,722FMVPROGRAM SUPPORT
HIVHCV Resource Center
2 Blacksmith StreetLebanonNH03766223104237501(c)(3)$7,200FMVPROGRAM SUPPORT
John Hopkins University
Rubenstein BuildingBaltimoreMD21287520595110501(c)(3)$44,885FMVPROGRAM SUPPORT
Keene Serenity Center
34 Mechanic StreetKeeneNH03431463123664501(c)(3)$24,473FMVPROGRAM SUPPORT
MAINE MEDICAL CENTER
22 BRAMHALL STREETPORTLANDME04102010238552501(c)(3)$87,348FMVCHARITABLE RESEARCH
MAPS COUNSELING SERVICES
19 FEDERAL STREETKEENENH03431020312473501(c)(3)$8,957FMVCHARITABLE PROGRAM SUPPORT
Mascoma Community Healthcare Inc
18 Roberts Road PO Box 550CanaanNH03741465672753501(c)(3)$10,800FMVPROGRAM SUPPORT
MASSACHUSETTS GENERAL HOSPITAL
100 CHARLES RIVER PLAZA STE 600BOSTONMA021142792042697983501(c)(3)$84,872FMVCHARITABLE RESEARCH
MAYFLOWER MEDICAL OUTREACH INC
PO BOX 75449OKLAHOMA CITYOK73147271245528501(c)(3)$19,803FMVCHARITABLE RESEARCH
MAYO CLINIC
200 FIRST STREET SWROCHESTERMN55905416011702501(c)(3)$107,521FMVCHARITABLE RESEARCH
MEDICAL UNIVERSITY OF SO CAROLINA
1 SOUTH PARK CIRCLECHARLESTONSC29407576000722St. of SC$136,796FMVEDUCATIONAL SERVICES
MENTAL HLTH CTR OF GRTR MANCHESTER
ATTN JOANN BATTY STAFF DEVMANCHESTERNH03101020258994501(c)(3)$14,767FMVCHARITABLE PROGRAM SUPPORT
MICHIGAN STATE UNIVERSITY
426 AUDITORIUM ROADEAST LANSINGMI48824386005984St. of MI$25,606FMVEDUCATIONAL SERVICES
Monadnock Area Peer Support Agency
64 Beaver StreetKeeneNH03431020484723501(c)(3)$26,705FMVPROGRAM SUPPORT
Monadnock Community Hospital
452 Old Street RdPeterboroughNH03458020222157501(c)(3)$118,968FMVPROGRAM SUPPORT
Monadnock Family Services
17 93rd StreetKeeneNH03431026012230501(c)(3)$198,847FMVPROGRAM SUPPORT
Monadnock United Way
23 Center StreetKeeneNH03431020236885501(c)(3)$14,400FMVPROGRAM SUPPORT
Mt Ascutney Hospital and Health Center
289 County RdWindsorVT05089030183721501(c)(3)$16,200FMVPROGRAM SUPPORT
National Alliance on Mental Illness NH (NAMI)
85 No State StreetConcordNH03301222760743501(c)(3)$81,931FMVPROGRAM SUPPORT
NEUROLOGY ASSOCIATES PA
331 N MAITLAND AVEMAITLANDFL32751591931548$24,684FMVCHARITABLE RESEARCH
New Hampshire Catholic Charities
215 Myrtle StreetManchesterNH03104020222163501(c)(3)$10,800FMVPROGRAM SUPPORT
New Hampshire Charitable Foundation
37 Pleasant StreetConcordNH03301026005625501(c)(3)$43,200FMVPROGRAM SUPPORT
New Hampshire Coalition Against Domestic Violence
PO Box 353ConcordNH03302020360151501(c)(3)$18,000FMVPROGRAM SUPPORT
New Hampshire Public Broadcast
268 Mast RoadDurhamNH03824943443883501(c)(3)$14,400FMVPROGRAM SUPPORT
New Hampshire Women's Foundation
18 Low AvenueConcordNH03301020495092501(c)(3)$5,616FMVPROGRAM SUPPORTSuite 205
New London Hospital
273 Country RdNew LondonNH03257020222171501(c)(3)$133,209FMVPROGRAM SUPPORT
NORTHWESTERN UNIVERSITY
DEPT OF MEDICAL SOCIAL SERVICESCHICAGOIL60611362167817501(c)(3)$11,876FMVCHARITABLE EDUCATIONAL SERVICES
OREGON CLINIC PC
847 NE 19TH AVENUEPORTLANDOR97232931127856$59,242FMVPROGRAM SUPPORT
OREGON HEALTH & SCIENCE UNIVERSITY
PO BOX 575PORTLANDOR97207931176109St. of OR$26,466FMVEDUCATIONAL SERVICES
PENNSYLVANIA STATE UNIVERSITY
500 UNIVERSITY DRIVEHERSHEYPA170330850246000376St. of PA$25,746FMVEDUCATIONAL SERVICES
Planned Parenthood of Northern NE
784 Hercules DriveColchesterVT05446030222941501(c)(3)$7,370FMVPROGRAM SUPPORT
PROVIDENCE CENTER
528 NORTH MAIN STREETPROVIDENCERI02860050316969501(c)(3)$61,962FMVCHARITABLE RESEARCH
PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY
ONE COURT STREETLEBANONNH03766752991608501(c)(3)$28,862FMVCHARITABLE PROGRAM SUPPORT
Reality Check Inc
17 Turnpike RoadJaffreyNH03452263344553501(c)(3)$30,977FMVPROGRAM SUPPORT
RECTOR & VISITORS OF UNIV OF VIRGINIA
JOHN W STEINKECHARLOTTESVILLEVA229081355546001796St. of VA$36,154FMVEDUCATIONAL SERVICES
REGENTS OF THE UNIVERSITY OF CALIFORNIA
UNIVERSITY OF CALIFORNIA SAN DIEGOLA JOLLACA920930009943067788St. of CA$35,829FMVEDUCATIONAL SERVICES
REGENTS OF UNIV OF MICHIGAN
DEPT OF PATHOLOGY BILLINGANN ARBORMI48109386006309St. of MI$117,406FMVEDUCATIONAL SERVICES
RESEARCH INSTITUTE AT NATIONWIDE CHILDRENS HOSPITAL
PO BOX 781653DETROITMI48278316056230501(c)(3)$53,484FMVCHARITABLE RESEARCH
Rock On Foundation
175 Canal StreetManchesterNH03101461600795501(c)(3)$7,200FMVPROGRAM SUPPORT
Schwartz Center for Compassionate Health
205 Portland St 6th FloorBostonMA02114041564655501(c)(3)$5,040FMVPROGRAM SUPPORT
SEATTLE CHILDREN'S HOSPITAL
PO BOX 24728SEATTLEWA981240728910564748501(c)(3)$45,978FMVCHARITABLE RESEARCH
SECOND GROWTH INC
PO BOX 206HANOVERNH03755020519093501(c)(3)$20,714FMVCHARITABLE PROGRAM SUPPORT
SINAI HOSPITAL OF BALTIMORE INC
2401 W BELVEDERE AVENUEBALTIMOREMD21215520486540501(c)(3)$23,031FMVCHARITABLE RESEARCH
Southwestern Community Services
PO Box 603 / 63 Community WayKeeneNH03431026013808501(c)(3)$42,338FMVPROGRAM SUPPORT
STANFORD UNIVERSITY
3145 PORTER DRIVEPALO ALTOCA94305941156365501(c)(3)$30,000FMVCHARITABLE EDUCATIONAL SERVICES
StayWorkPlay NH
235 Hanover StreetManchesterNH03101270327032501(c)(3)$10,800FMVPROGRAM SUPPORTSuite 1
Sullivan County
14 Main StreetNewportNH03773026000870501(c)(3)$86,400FMVPROGRAM SUPPORT
The ALS Association
10 Ferry StreetConcordNH03301133271855501(c)(3)$5,400FMVPROGRAM SUPPORT
THOMAS JEFFERSON UNIVERSITY
901 WALNUT STPHILADELPHIAPA19107231352651501(c)(3)$54,921FMVCHARITABLE EDUCATIONAL SERVICES
TLC Family Resource Center
PO Box 1098ClaremontNH03743522439830501(c)(3)$53,896FMVPROGRAM SUPPORT
Tri-Valley Transit
279 Creek RoadMiddleburyVT05753030335768501(c)(3)$30,600FMVPROGRAM SUPPORT
TRUSTEES OF DARTMOUTH COLLEGE
7 LEBANON STREETHANOVERNH03755020222111501(c)(3)$1,137,577FMVCHARITABLE EDUCATIONAL SERVICES
TRUSTEES OF THE UNIV OF PENNSYLVANIA
THE WHARTON SCHOOLPHILADELPHIAPA191789726231352685St. of PA$24,268FMVEDUCATIONAL SERVICES
Turning Points Network
11 School StreetClaremontNH03743020350899501(c)(3)$70,181FMVPROGRAM SUPPORT
Twin Pines Housing Trust
226 Holiday Drive Suite 20White River JunctionVT05001222809527501(c)(3)$28,800FMVPROGRAM SUPPORT
UNIVERSITY OF ALABAMA AT BIRMINGHAM
UAB SCHOOL OF NURSINGBIRMINGHAMAL352941210636005396St. of AL$58,574FMVEDUCATIONAL SERVICES
UNIVERSITY OF ARIZONA
PROJECTS CONTRACTING SERVICESTUCSONAZ857190521742652689St. of AZ$13,899FMVEDUCATIONAL SERVICES
UNIVERSITY OF COLORADO
UCHSC DNA DIAGNOSTIC LABAURORACO80045846000555St. of CO$29,475FMVEDUCATIONAL SERVICES
UNIVERSITY OF MARYLAND BALTIMORE
220 ARCH STREETBALTIMOREMD212011531526002033St. of MA$59,139FMVEDUCATIONAL SERVICES
UNIVERSITY OF MIAMI
DEPARTMENT OF PATHOLOGYATLANTAGA303845776592695890St. of FL$22,035FMVEDUCATIONAL SERVICES
UNIVERSITY OF NEBRASKA MEDICAL CTR
985045 NEBRASKA MED CTROMAHANE681985045470491233St. of NE$21,020FMVEDUCATIONAL SERVICES
UNIVERSITY OF NEW HAMPSHIRE
51 COLLEGE ROADDURHAMNH03824026000937St. of NH$27,113FMVEDUCATIONAL SERVICES
UNIVERSITY OF TEXAS AT AUSTIN
VALUE INSTITUTE ATTN ROBERT CROSSAUSTINTX78712746002003St. of TX$50,864FMVEDUCATIONAL SERVICES
UNIVERSITY OF VERMONT
DEPT OF PEDIATRICSBURLINGTONVT054050068030179440St. of VT$172,897FMVEDUCATIONAL SERVICES
UNIVERSITY OF WASHINGTON
GRANT CONTRACT ACCOUNTINGCHICAGOIL60693916001537St. of WA$53,041FMVEDUCATIONAL SERVICES
Upper Valley Community Nursing Project
PO Box 1302LebanonNH03766831224873501(c)(3)$10,800FMVPROGRAM SUPPORT
Upper Valley Habitat for Humanity
PO Box 1038White River JunctionVT05001030306081501(c)(3)$15,404FMVPROGRAM SUPPORT
Upper Valley Haven
713 Hartford AveWhite River JunctionVT05001030277908501(c)(3)$58,050FMVPROGRAM SUPPORT
Valley Regional Hospital
243 Elm StreetClaremontNH03743020222118501(c)(3)$239,538FMVPROGRAM SUPPORT
Vermont Medical Society
134 Main StreetMontpelierVT05601030164911501(c)(6)$5,040FMVPROGRAM SUPPORT
VETERANS EDUCATION & RESEARCH ASSN OF
NORTHERN NEW ENGLANDWHITE RIVER JUNCTIONVT05001223091219501(c)(3)$11,470FMVCHARITABLE RESEARCH
VINFEN CORPORATION
950 CAMBRIDGE STCAMBRIDGEMA02141042632219501(c)(3)$61,225FMVCHARITABLE PROGRAM SUPPORT
VIRGINIA COMMONWEALTH UNIVERSITY
800 E LEIGH STREETRICHMONDVA23219546001758St. of VA$24,577FMVEDUCATIONAL SERVICES
Vital Communities
195 North Main StreetWhite River JunctionVT05001030355283501(c)(3)$24,840FMVPROGRAM SUPPORT
West Central Behavioral Health
9 Hanover StreetLebanonNH03766222645978501(c)(3)$231,755FMVPROGRAM SUPPORT
WEST VIRGINIA UNIVERSITY RESEARCH CORPOR
ONE WATERFRONT PLACEMORGANTOWNWV265066001550665758St. of WV$16,434FMVEDUCATIONAL SERVICES
Willing Hands Enterprises
PO Box 172LebanonNH03766202204811501(c)(3)$43,560FMVPROGRAM SUPPORT
Women's Information Service of the Upper Valley
38 Bank StreetLebanonNH03766020346512501(c)(3)$50,400FMVPROGRAM SUPPORT
Woodstock Area Council on Aging
99 Senior LaneWoodstockVT05091030295419501(c)(3)$14,400FMVPROGRAM SUPPORT
Visiting Nurse Association and Hospice of Vermont and New Hampshire Inc
88 Prospect StWhite River JunctionVT05001036006494501(c)3$132,200FMVPROGRAM SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org116Total501c3OrgCnt
Total Other Org4TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (4 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDesc
Awards and Educational Assistance78$896,752FMV
D-H tuition Reimbursement Programs400$833,859FMV
Patient Assistance792$42,727FMV
CHARITABLE RESEARCH1$52,592FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant funds.FormAndLineReferenceDesc
ExplanationEACH AWARD ESTABLISHED BY MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) HAS WRITTEN GUIDELINES AND PROCEDURES. AWARD PAYMENTS ARE PROCESSED IN ACCORDANCE WITH THE SPECIFIC TERMS OF EACH AWARD. THE DARTMOUTH INSTITUTE SCHOLARSHIPS (TDI) ARE PAID DIRECTLY TO DARTMOUTH COLLEGE ON BEHALF OF THE INDIVIDUALS RECEIVING THE AWARDS. THE COORDINATORS OF THE PROGRAM ARE RESPONSIBLE FOR ASSURING THAT ALL TERMS ARE MET, INCLUDING PROPER DOCUMENTATION OF EXPENSES WITH RECEIPTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (33 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
Joanne M Conroy MD
Trustee, Ex-Officio, CEO$0$1,030,023$0$184,500$0$141,998$0$26,955$0$26,945$0$1,410,421$0$0
Jocelyn Chertoff MD
VP Service Line / DPT CHR Diagnostic Radiology$0$644,951$0$0$0$57,897$0$26,955$0$15,649$0$745,452$0$0
Cherie Holmes MD
Trustee$0$446,943$0$1,000$0$37,402$0$26,955$0$28,344$0$540,644$0$0
Kari M Rosenkranz MD
Trustee (through 12/2019) / Physician$0$500,097$0$0$0$22,872$0$21,355$0$14,989$0$559,313$0$0
Jon Wahrenberger MDFAHAFAC
Trustee$0$336,765$0$0$0$18,720$0$26,955$0$38,313$0$420,753$0$0
KURT K RHYNHART MD
TRUSTEE$0$453,257$0$0$0$38,380$0$21,355$0$20,930$0$533,922$0$0
JONATHAN HUNTINGTON MD PhD MPH
TRUSTEE (EFFECTIVE 1/1/20)$0$384,586$0$0$0$33,393$0$21,355$0$35,758$0$475,092$0$0
Richard I Rothstein MD
Former Dept. Chair / Service Line LDR - MED$0$593,894$0$0$0$87,479$0$26,955$0$30,285$0$738,613$0$0
Aimee M Claiborne
Chief HR Officer$371,431$0$45,600$0$35,807$0$12,813$0$35,401$0$501,052$0$0$0
DANIEL P JANTZEN CPA
Chief Financial Officer$643,403$0$80,400$0$97,958$0$26,955$0$29,778$0$878,494$0$0$0
Patrick F Jordan III MBA
Chief Operating Officer$654,825$0$80,400$0$35,008$0$21,355$0$42,779$0$834,367$0$0$0
JOHN KACAVAS
Chief Legal Officer$586,982$0$74,400$0$53,606$0$23,617$0$34,240$0$772,845$0$0$0
Stephen Leblanc
Chief Strategy Officer$0$662,188$0$80,400$0$85,671$0$26,955$0$25,378$0$880,592$0$0
EDWARD MERRENS
Chief Clinical Officer$0$648,460$0$80,400$0$65,921$0$26,955$0$16,267$0$838,003$0$0
Maria Padin MD
Chief Medical Officer$0$394,016$0$0$0$36,908$0$26,955$0$37,687$0$495,566$0$0
Susan A Reeves EDDRN
Chief Nursing Executive$493,481$0$60,350$0$24,091$0$26,955$0$29,490$0$634,367$0$0$0
Martin Purcell MBA
Chief Information Officer$385,271$0$0$0$26,183$0$26,955$0$26,075$0$464,484$0$0$0
Matthew Haag
VP Development$352,781$0$0$0$19,014$0$21,355$0$14,425$0$407,575$0$0$0
Wendy Fielding MBA
FMR KEY EMP / VP FINANCE PLANNING$263,381$0$0$0$19,414$0$21,355$0$32,761$0$336,911$0$0$0
Christine Schon MPA
FMR KEY EMP/ ADM VP PRMRY CARE$0$262,978$0$2,000$0$29,513$0$26,955$0$29,264$0$350,710$0$0
Wendy Wells MD
FMR KEY EMP / DPT CHR PATHOLOGY$0$548,491$0$0$0$48,377$0$26,955$0$23,603$0$647,426$0$0
Sandra Wong MD
SVP SVC LN & Chair of Surgery$0$653,814$0$0$0$66,525$0$21,355$0$11,848$0$753,542$0$0
GEORGE T BLIKE MD
Chief Quality & Value Officer$0$433,049$0$0$0$41,698$0$26,955$0$37,199$0$538,901$0$0
Karen Clements RNBSNMSB
Chief Nursing Officer$333,940$0$250$0$26,779$0$21,355$0$12,166$0$394,490$0$0$0
Staci Hermann PHARMDMS
Chief Pharmacy Officer$260,616$0$0$0$24,661$0$12,813$0$14,277$0$312,367$0$0$0
Simon Hillier
Dept. Chair - Anesthesiology$0$516,806$0$0$0$48,617$0$26,955$0$30,401$0$622,779$0$0
Jeffrey Obrien MHA
VP Clinical Operations$343,917$0$0$0$27,038$0$26,955$0$32,978$0$430,888$0$0$0
Peter D Solberg MD
Chief Medical Information Officer$0$369,462$0$0$0$21,310$0$25,455$0$35,274$0$451,501$0$0
Tina E Naimie CPA
VP CORP FINANCE$273,632$0$0$0$11,143$0$21,355$0$1,821$0$307,951$0$0$0
Kimberly Troland JD
Deputy Gen Counsel$365,343$0$0$0$32,394$0$21,355$0$20,849$0$439,941$0$0$0
BRUCE KING
PRES/CEO NEW LNDN HOSPITAL (Through 3/2020)$319,769$0$0$0$48,508$1,219$26,955$0$29,659$0$424,891$1,219$0$0
David Gladstone MD
CHF CLNCL PHYSCN - RADIOLOGY$308,219$0$0$0$25,984$0$26,955$0$28,008$0$389,166$0$0$0
Leigh Burgess
VP RESEARCH OPS$332,384$0$0$0$14,550$0$21,355$0$30,626$0$398,915$0$0$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part II NOTE REGARDING COMPENSATIONFORM 990, SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY MHMH AND RELATED ORGANIZATIONS. THESE AMOUNTS ARE REPORTED TO EMPLOYEES ON THEIR ANNUAL W-2 FORMS AS COMPENSATION. COLUMNS C AND D REPRESENT ITEMS EARNED, HOWEVER, NOT PAID DIRECTLY TO THE EMPLOYEE AS CASH PAYMENTS DURING THE CALENDAR YEAR. COLUMN C INCLUDES RETIREMENT BENEFITS IN A CALENDAR YEAR. COLUMN D REPRESENTS NONTAXABLE BENEFITS SUCH AS THE COST OF HEALTHCARE COVERAGE PROVIDED BY D-H ON BEHALF OF ITS EMPLOYEES.
Schedule J, Part III SPLIT DOLLAR LIFE PLANMHMH SPONSORS A SPLIT DOLLAR LIFE PLAN FOR CERTAIN LONG-TERM EMPLOYEES. THE ORIGINAL OBJECTIVES FOR OFFERING THESE PLANS WERE TO BETTER ENABLE MHMH TO ATTRACT AND RETAIN QUALITY EXECUTIVE PERSONNEL, IMPROVE THE PHYSICIANS' POST-RETIREMENT LIFE INSURANCE BENEFITS, AND TO REPLACE AN INCREASINGLY COSTLY RETIREE LIFE INSURANCE PROGRAM. THE PLAN WAS FROZEN IN 1998 AND THEREFORE NO FURTHER COSTS OF THE INDIVIDUAL EMPLOYEE INSURANCE PREMIUMS HAVE BEEN FUNDED BY THE ORGANIZATION. THE NUMBER OF PARTICIPANTS AND DOLLAR VALUE CONTINUES TO DWINDLE AS INDIVIDUALS RETIRE/LEAVE THE ORGANIZATION. THE FOLLOWING INDIVIDUALS HAVE A SPLIT DOLLAR LIFE PLAN ARRANGEMENT: DANIEL JANTZEN $130,828 STEPHEN LEBLANC $59,434 RICHARD ROTHSTEIN $102,290
Schedule J, Part I, Line 3 Compensation of the CEOThe CEO is paid by Dartmouth Hitchcock Clinic, a related organization, which uses a compensation committee, an independent compensation consultant, a compensation survey or study, and approval by the board or compensation committee to establish the CEO's compensation.
Schedule J, Part I, Line 1a Health or social club dues or initiation feesTHE ORGANIZATION HAS IN PLACE A MANAGEMENT SELF DEVELOPMENT PLAN (MSDP) DESIGNED TO PROMOTE PROFESSIONAL AND PERSONAL DEVELOPMENT. THE MSDP IS CAPPED AT 2% OF GROSS PAY AND MAY BE UTILIZED FOR EXPENSES SUCH AS PROFESSIONAL DUES, MEETINGS AND SEMINARS, TUITION REIMBURSEMENT, AND OTHER MISCELLANEOUS ITEMS THAT PROMOTE PROFESSIONAL KNOWLEDGE. THE MONIES MAY ALSO BE USED FOR UP TO A 50% REIMBURSEMENT OF THE COST OF A FITNESS/WELLNESS PROGRAM DESIGNED TO MAINTAIN THE HEALTH OF MANAGEMENT PERSONNEL. ALL EXPENSES ARE SUBMITTED FOR APPROVAL BEFORE REIMBURSEMENT.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationTHE CEO IS PAID BY DARTMOUTH-HITCHCOCK CLINIC (DHC), A RELATED ORGANIZATION, WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE CEO'S COMPENSATION.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planDartmouth Hitchcock Clinic (DHC) and Mary Hitchcock Memorial Hospital (MHMH) sponsor a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable DHC and MHMH to attract and retain quality executive personnel, improve the physicians' post-retirement life insurance benefits, and to replace an increasingly costly retiree life insurance program. The plan was frozen to new participants in 1998. The number of participants and dollar value continues to dwindle as individuals retire/leave the organization. THE FOLLOWING INDIVIDUALS HAVE A SPLIT DOLLAR LIFE PLAN ARRANGEMENT: DANIEL JANTZEN $130,828 STEPHEN LEBLANC $59,434 RICHARD ROTHSTEIN $102,290

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
NH HEALTH AND ED FACILITIES AUTHORITY
A0202798666646142B42014-08-13$41,242,990REFUND ISSUE DATED 08/19/2009falsefalsefalse
NH HEALTH AND ED FACILITIES AUTHORITY
B0202798660000000002016-07-01$35,575,000SEE PART VIfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndCapital ExpendituresCapitalExpendituresAmt
A$7,195,000$41,242,990$352,990$40,890,0002014Yes (true)falseYes (true)Yes (true)
B$24,605,000$35,575,000$408,058$19,230,3262017Yes (true)falseYes (true)Yes (true)$15,936,616

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
Afalsefalsefalsefalse0.00.00.0falsefalseYes (true)
BfalseYes (true)falsefalse0.00.00.0falsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
AfalseYes (true)falsefalsefalsefalsefalsefalseYes (true)
BfalseYes (true)falsefalsefalsefalsefalsefalseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule K, Part I, Column (f) Bond BFormAndLineReferenceDesc
ExplanationTHE PURPOSE OF THE ISSUE WAS TO REFUND AN ISSUE DATED 10/24/2013 AND FINANCE CAPITAL PROJECTS.ExplanationTxt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan From OrganizationLoanFromOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
DANIEL JANTZEN
OFFICERSPLIT DOLLAR LIFEYes (X)$0$130,828falseYes (true)Yes (true)
DEBORAH JANTZEN
FAMILY MEMBERSPLIT DOLLAR LIFEYes (X)$0$65,195falseYes (true)Yes (true)
FieldValueIRS element (for citing)
Total Balance Due$196,023TotalBalanceDueAmt

Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Aimee ClaiborneBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship With OrgOfficer of MHMHRelationshipWithOrgTxt
Cash Grant$12,500CashGrantAmt
Type Of AssistanceTuition AssistanceTypeOfAssistanceTxt
Assistance PurposeEducationAssistancePurposeTxt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution12ContributionCnt
Noncash Contributions Rpt F990$4,327,833NoncashContributionsRptF990Amt
Method Of Determining RevenuesMarket valueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedYes (true)ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule M, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributionsTHE ORGANIZATION USES DARTMOUTH-HITCHCOCK HEALTH, MHMH'S PARENT ORGANIZATION, FOR SOLICITATION OF CONTRIBUTIONS AND ANNUAL FUND ACTIVITIES.
Schedule M, Part I Explanations of reporting method for number of contributionsSecurities - Publicly traded - MHMH is reporting the number of contributors of stock.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15a OFFICES & POSITIONS FOR WHICH PROCESS WAS USED & YEAR UNDERTAKENALTHOUGH PAID BY A RELATED ORGANIZATION, DARTMOUTH-HITCHCOCK CLINIC, THE COMPENSATION FOR THE CEO IS EVALUATED BY AN INDEPENDENT THIRD PARTY FIRM FOR REASONABLENESS AND NATIONAL DATA BENCHMARKING. THE TALENT DEVELOPMENT AND COMPENSATION COMMITTEE, ALONG WITH INDEPENDENT TRUSTEES, APPROVE THE FINAL COMPENSATION IN CONSIDERATION WITH THE INDEPENDENT THIRD PARTY FIRM'S RECOMMENDATIONS AND SUGGESTIONS. THIS PROCESS WAS CONTEMPORANEOUSLY DOCUMENTED AND LAST UNDERTAKEN IN 2020.
Form 990, Part VI, Line 1a Delegate broad authority to a committeeThe Mary Hitchcock Memorial Hospital (MHMH) board has a Governance Committee who has the authority/responsibility of the MHMH Board to ensure that MHMH continues to fulfill its central mission and vision. This committee has authority to act on behalf of the full Board when the need arises. Members include the following who are all members of the governing board: Edward H. Stansfield, III, MA (Board Chair and Chair of Governance Committee) William J. Conaty (Chair - Talent Development and Compensation Committee) Roberta L. Hines, MD (Chair - Research and Education Committee) Charles G. Plimpton, MBA (Chair- Finance Committee) Pamela A. Thompson, MS, RN, CENP, FAAN (Chair - Value Committee) Ex Officio member: Dr. Joanne Conroy (CEO)
Form 990, Part VI, Line 6 Classes of members or stockholdersDARTMOUTH-HITCHCOCK HEALTH (D-HH) IS THE SOLE CORPORATE MEMBER OF MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH).
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyD-HH HAS SPECIFIC AUTHORITY AND RESERVED POWERS, INCLUDING THE POWER TO CONFIRM THE ELECTION OF MEMBERS OF MHMH'S BOARD OF TRUSTEES AND THE POWER TO APPROVE SIGNIFICANT GOVERNANCE, FINANCIAL, AND OPERATIONAL DECISIONS OF MHMH'S TRUSTEES.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersIN ADDITION TO RESERVED POWERS, DARTMOUTH-HITCHCOCK HEALTH (D-HH) SHALL HAVE THE AUTHORITY TO TAKE ACTIONS TO ESTABLISH, MANAGE, AND GOVERN MHMH TO CREATE AND MAINTAIN AN INTEGRATED HEALTH CARE DELIVERY SYSTEM IN FURTHERANCE OF THE MISSION OF MHMH AND OTHER ORGANIZATIONS WITHIN THE SYSTEM. THESE POWERS INCLUDE BUT ARE NOT LIMITED TO ITEMS SUCH AS THE ABILITY TO APPROVE, DISAPPROVE, OR MODIFY ALL MATERIAL GOVERNANCE, PROGRAMMATIC, AND FINANCIAL DECISIONS OF MHMH'S BOARD OF TRUSTEES, TO APPOINT OR REMOVE A MEMBER OF MHMH'S BOARD OF TRUSTEES, ASSESS MHMH A MONETARY AMOUNT FOR THE PAYMENT OF THE EXPENSES OF D-HH, APPROVE MHMH'S BUDGET, APPROVE THE BORROWINGS OR DISPOSITIONS OF ASSETS BY MHMH, APPROVE KEY STRATEGIC RELATIONSHIPS, APPROVE THE ELIMINATION OR ADDITION OF ANY MATERIAL HEALTH CARE SERVICE OR PROGRAM, AND OTHER AUTHORITY TO TAKE ACTION ON BEHALF OF MHMH.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyTHE FORM 990 IS REVIEWED BY EXTERNAL TAX ADVISORS, THE DIRECTOR OF CORPORATE FINANCE, THE VICE PRESIDENT OF CORPORATE FINANCE, AND THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURN. ONCE THE RETURN HAS BEEN FULLY PREPARED A FINAL FORM 990 IS SENT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS AND RESPONSES PRIOR TO OFFICIAL FILING.
Form 990, Part VI, Line 12c Conflict of interest policyTHE MARY HITCHCOCK MEMORIAL HOSPITAL BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF-DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. THE DARTMOUTH-HITCHCOCK HEALTH (D-HH) COMPLIANCE AND AUDIT SERVICES DEPARTMENT CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS, TRUSTEES, AND KEY EMPLOYEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION-MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesCOMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS EVALUATED BY INTERNAL HUMAN RESOURCES STAFF USING NATIONAL BENCHMARKING DATA (ALONG WITH ONGOING EVALUATIONS BY AN INDEPENDENT THIRD-PARTY FIRM FOR REASONABLENESS). THE LAST FORMAL PROCESS WAS COMPLETED IN 2020. EXTERNAL BENCHMARKING FROM AN INDEPENDENT THIRD PARTY HAS BEEN USED FOR ANY OFFICER WHO WAS HIRED OR RECEIVED A COMPENSATION ADJUSTMENT SINCE THE LAST FORMAL PROCESS. COMPENSATION RATES ARE DETERMINED BY FOLLOWING THE GUIDELINES OF THE COMPENSATION COMMITTEE CHARTER AND PHILOSOPHY DOCUMENTS AND A FORMAL REVIEW BY COMPENSATION COMMITTEE MEMBERS. THE PROCESS DESCRIBED ABOVE TO ESTABLISH COMPENSATION WAS USED FOR THE FOLLOWING POSITIONS: Chief Financial Officer, Chief Strategy Officer, Chief Clinical Officer, Chief Legal Officer, Chief Human Resources Officer, Chief Operating Officer, Chief Nursing - Executive, Chief Nursing Officer, Chief Pharmacy Officer, Chief Quality & Value Officer, Department Chair - Anesthesia, Department Chair - Radiology, Department Chair - Pathology and similar positions.
Form 990, Part VI, Line 19 Required documents available to the publicMHMH'S GOVERNING DOCUMENTS ARE AVAILABLE THROUGH THE NEW HAMPSHIRE SECRETARY OF STATE. THE AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST EITHER IN ELECTRONIC OR HARD COPY FORM.
Form 990, Part VII, Section A, Line 1a, Column (B) AVERAGE HOURS PER WEEKAS PART OF DARTMOUTH-HITCHCOCK CLINIC AND MARY HITCHCOCK MEMORIAL HOSPITAL'S AFFILIATION AGREEMENT, THE TWO ORGANIZATIONS SHARE OFFICERS. AS SUCH, THE AVERAGE HOURS PER WEEK ARE ALLOCATED BETWEEN THE TWO ORGANIZATIONS' FORMS 990 EVEN THOUGH COMPENSATION REPORTED IN PART VII IS BASED ON THE ENTITY ISSUING THE W-2. IN ADDITION, CERTAIN OFFICERS SPEND TIME ON DARTMOUTH-HITCHCOCK HEALTH (THE SOLE CORPORATE MEMBER OF BOTH MHMH AND DHC), AND/OR DARTMOUTH-HITCHCOCK CLINIC ALONG WITH OTHER AFFILIATED ORGANIZATIONS: DARTMOUTH-HITCHCOCK MEDICAL CENTER, HAMDEN RISK RETENTION GROUP (AND RELATED ENTITIES), ALICE PECK DAY MEMORIAL HOSPITAL, WINDSOR HOSPITAL CORPORATION (DBA MT ASCUTNEY HOSPITAL AND HEALTH CENTER), MT. ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION, HISTORIC HOMES OF RUNNEMEDE, CHESHIRE MEDICAL CENTER, CHESHIRE HEALTH FOUNDATION, CHESHIRE HEALTH SERVICES, THE NEW LONDON HOSPITAL ASSOCIATION, VNA & HOSPICE OF VT AND NH, AND THE HITCHCOCK FOUNDATION.
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueAll Other - Total Revenue: 49171950, Related or Exempt Function Revenue: 43401016, Unrelated Business Revenue: 5770934, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesNET ASSET TRANSFER FROM AFFILIATES - 6410826; PENSION-RELATED AND OTHER CHANGES - -17194641;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
NEW ENGLAND ALLIANCE FOR HEALTH LLC
ONE MEDICAL CENTER DRIVELEBANONNH03756264232401HLTH IMPROVMTNH$122,629$968,403MHMH
D-H SPECIALTY SERVICES LLC
ONE MEDICAL CENTER DRIVELEBANONNH03756460876427SHD SVGS PRGMNH$0$0MHMH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
DARTMOUTH-HITCHCOCK CLINIC
ONE MEDICAL CENTER DRIVELEBANONNH03756222519596PHYS SVCSNH501(c)(3)10D-HHfalse
DARTMOUTH-HITCHCOCK HEALTH
ONE MEDICAL CENTER DRIVELEBANONNH03756264812335PARENT ORGNH501(c)(3)7NAfalse
THE NEW LONDON HOSPITAL ASSOCIATION INC
273 COUNTY ROADNEW LONDONNH03257020222171HOSPITALNH501(c)(3)3D-HHfalse
WINDSOR HOSPITAL CORPORATION
289 COUNTY ROADWINDSORVT05089030183721HOSPITALVT501(c)(3)3D-HHfalse
CHESHIRE MEDICAL CENTER
580 COURT STREETKEENENH03431020354549HOSPITALNH501(c)(3)3D-HHfalse
ALICE PECK DAY MEMORIAL HOSPITAL
10 ALICE PECK DAY DRIVELEBANONNH03766020222791HOSPITALNH501(c)(3)3D-HHfalse
VISITING NURSE AND HOSPICE FOR VERMONT AND NEW HAMPSHIRE
88 Prospect StreetWhite River JuctionVT05001036006494HOSPICEVT501(c)(3)10D-HHfalse
DARTMOUTH -HITCHCOCK MEDICAL CENTER
ONE MEDICAL CENTER DRIVELEBANONNH03756222715483SUPPORTING ORG.NH501(c)(3)Type INAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1DARTMOUTH-HITCHCOCK MASTER INVESTMENT PROGRAM OF POOLED INVESTMENT ACCOUNTSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 MED CTR DRAddressLine1Txt
CityLEBANONCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd
FieldValueIRS element (for citing)
EIN020205863EIN
Primary ActivitiesPOOLED INVESTPrimaryActivitiesTxt
Legal Domicile StateNHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MHMHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeExcludedPredominantIncomeTypeTxt
Share Of Total Income$16,299,826ShareOfTotalIncomeAmt
Share Of EOY Assets$675,012,810ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
UBI Code V-$210,862UBICodeVAmt
General Or Managing PartnerYes (true)GeneralOrManagingPartnerInd
Ownership0.7575OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgYes (true)AssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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