MONADNOCK COMMUNITY HOSPITAL: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
MONADNOCK COMMUNITY HOSPITAL (EIN 02-0222157)
Tax period
2023-10-01 to 2024-09-30
Filed
2025-08-13
IRS object ID
202532259349303103
Schema version
2023v6.0
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)
Return2025-08-13T16:00:15-05:00ReturnTs
Tax Period End2024-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1BOX 507AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222157EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRichard D ScheinblumPersonNm
Person TitleVP of Finance/CFOPersonTitleTxt
Phone6039247191PhoneNum
Signature2025-08-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonConnor SmartPreparerPersonNm
PTINP02285543PTIN
Phone2078792100PhoneNum
Preparation2025-08-11PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCynthia K McGuirePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1452 Old Street RoadAddressLine1Txt
CityPeterboroughCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03458ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$128,843,194GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://monadnockcommunityhospital.com/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1919FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionCritical access hospital serving the Monadnock region of the State of New HampshireActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee687TotalEmployeeCnt
Total Volunteers83TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,549,679PYContributionsGrantsAmt
CY Contributions Grants$829,431CYContributionsGrantsAmt
PY Program Service Revenue$108,750,614PYProgramServiceRevenueAmt
CY Program Service Revenue$122,697,106CYProgramServiceRevenueAmt
PY Investment Income$2,995,931PYInvestmentIncomeAmt
CY Investment Income$4,431,300CYInvestmentIncomeAmt
PY Other Revenue$54,045PYOtherRevenueAmt
CY Other Revenue$50,897CYOtherRevenueAmt
PY Total Revenue$114,350,269PYTotalRevenueAmt
CY Total Revenue$128,008,734CYTotalRevenueAmt
PY Grants And Similar Paid$42,599PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$105,510CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$51,084,911PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$57,617,208CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$672,528CYTotalFundraisingExpenseAmt
PY Other Expenses$56,169,084PYOtherExpensesAmt
CY Other Expenses$64,529,690CYOtherExpensesAmt
PY Total Expenses$107,296,594PYTotalExpensesAmt
CY Total Expenses$122,252,408CYTotalExpensesAmt
PY Revenues Less Expenses$7,053,675PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,756,326CYRevenuesLessExpensesAmt
Total Assets BOY$178,215,506TotalAssetsBOYAmt
Total Assets EOY$203,243,687TotalAssetsEOYAmt
Total Liabilities BOY$58,809,075TotalLiabilitiesBOYAmt
Total Liabilities EOY$57,037,087TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$119,406,431NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$146,206,600NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMonadnock Community Hospital is committed to improving the health and well-being of our community. We will elevate the health of our community by providing accessible, high quality and value based care.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$108,962,532ExpenseAmt
Grant$105,510GrantAmt
Revenue$122,697,106RevenueAmt
DescThe primary purpose of Monadnock Community Hospital (MCH) is to ensure access to quality health care for patients in our community, regardless of their ability to pay. The following is a summary of the services MCH provides in an effort to fulfill its mission, together with key program statistics for fiscal year 2024.Inpatient Services - Includes: adult stays, maternity/births, and swing bed nursing. During the fiscal year, the Hospital admitted 1,177 patients and recorded 3,325 patient days. Emergency Services - MCH offers health services 24 hours per day, 7 days per week. Responsible for the immediate treatment of any medical or surgical emergency; for initiating life saving procedures in all types of emergency situations; and for providing emergency and initial evaluations and treatment for other conditions including minor illnesses and injuries, and sub-acute medical problems. During the year, there were 13,400 visits to the ER. Physician Practices - Family health services, programs, and education are integral components of healthcare at MCH. Inpatient and outpatient primary care includes: medical, surgical, psychological and specialist services, provided by physicians and mid-level practitioners. These are located at the Hospital and its four satellite practices located in Antrim, Jaffrey, New Ipswich, and Rindge. During the year, 58,818 primary care office visits were recorded. Surgical Services - Includes same day and short-term inpatient surgery. MCH provides surgery in the areas of orthopaedics, general surgery, OB/GYN, ophthalmology, urology, ENT, and podiatry. In addition, the Hospital offers some non-surgical procedures including colonoscopies, gastroscopies, and pain management injections. During the fiscal year, 3,461 procedures were performed. Radiology and Diagnostics - MCH provides advanced radiological technology and extensive imaging services including: bone density, MRI, CT, nuclear medicine, ultrasound, mammography, and other diagnostic procedures, both inpatient and outpatient. During the fiscal year, 34,644 exams were performed. Rehabilitation Services - Additionally, MCH serves the people of the Monadnock Region through its medical rehabilitation and fitness services. MCH offers rehabilitation programs for cardiac and diabetic rehabilitation, along with pulmonary fitness, which feature educational and exercise components. We also provide physical and occupational therapy, as well as speech rehabilitation. During the fiscal year, 73,151 procedures were recorded for these services. Monadnock Community Hospital's Financial Grant Program provides assistance with hospital and/or physician bills for qualifying patients. In fiscal year 2024, the Organization recorded $891,000 in charges foregone based on established rates. The estimated cost incurred to provide these services was $ . In addition, Monadnock Community Hospital provided other services to the community at no cost or reduced cost, such as screenings and clinics. The cost of providing these services was approximately $17,260,000 in fiscal year 2024.Desc
Total Program Service Expenses$108,962,532TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document112IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee687EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Alexander J Walker Esq
Ex-Officio (voting) (end 3/2024)3.0043.20Yes (X)$0$717,524$351,171
Terrence McNamara DO
Trustee/Physician41.500.00Yes (X)$455,080$0$37,929
Cynthia McGuire
Chief Executive Officer55.000.60Yes (X)$435,263$0$52,064Yes (X)
Peter Cerroni DMD
Trustee3.000.00Yes (X)$0$0$0
Casandra Clark
Trustee3.000.00Yes (X)$0$0$0
Jeffrey R Crocker Esq
Trustee3.000.00Yes (X)$0$0$0
Carolyn Garretson
Trustee3.000.00Yes (X)$0$0$0
Steve Kim
Trustee (start 1/2024)3.000.00Yes (X)$0$0$0
Eric Lasky MD
Ex-Officio (voting)3.000.00Yes (X)$0$0$0
Leslie Lewis
Trustee3.000.00Yes (X)$0$0$0
Stephen Lehmkuhl DO
Ex-Officio (voting)3.000.00Yes (X)$0$0$0
Ed Madigan
Trustee (start 1/2024)3.000.00Yes (X)$0$0$0
Greg Neilley MD
Trustee (start 1/2024)3.000.00Yes (X)$0$0$0
Michael Shea
Trustee (end 1/2024)3.000.00Yes (X)$0$0$0
Iris Waitt
Trustee3.000.00Yes (X)$0$0$0
James Callahan Esq
Chair (end 1/2024); Trustee3.000.00Yes (X)$0$0$0Yes (X)
Paul Faber
VC (end 1/24); Chair (start 1/24)3.000.00Yes (X)$0$0$0Yes (X)
Paula Hunter
Trustee; Vice Chair (start 1/2024)3.000.00Yes (X)$0$0$0Yes (X)
Thomas S Bates CPA
Treasurer3.000.00Yes (X)$0$0$0Yes (X)
Patricia Shuster
Clerk3.000.00Yes (X)$0$0$0Yes (X)
Richard D Scheinblum
VP Finance/CFO50.000.00$287,766$0$25,884Yes (X)
Vache Hambardzumyan MD
Physician41.500.00$596,287$0$29,310Yes (X)
Derek Anderson MD
Physician41.500.00$436,575$0$39,479Yes (X)
Daniel Perli MD
Physician/Chief Medical Officer50.000.00$442,753$0$18,202Yes (X)
Shawn Harrington MD
Physician41.500.00$401,907$0$36,429Yes (X)
Dmitry Tarasevich MD
Physician41.500.00$396,554$0$18,073Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,452,185TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$717,524TotReportableCompRltdOrgAmt
Total Other Compensation$608,541TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K68IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Catholic Medical Center
195 McGregor StreetManchesterNH03102Contract Physician and Lab Services$2,924,273
Monadnock Region Emergency Physicians PL
107 Locke RoadHamptonNH03842Contract Emergency Physician Group$2,662,000
AHSA LLC
PO Box 70529DallasTX75267Contract Staffing Group$1,955,794
Hutter Construction Corp
PO Box 257New IpswichNH03071General Contractor$1,809,236
Caring Nurses Staffing Agency LLC
PO Box 278New BostonNH03070Contract Staffing Group$1,519,407
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K37CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Fundraising$39,265FundraisingAmt
All Other Contributions$790,166AllOtherContributionsAmt
Noncash Contributions$16,982NoncashContributionsAmt
Total Contributions$829,431TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net patient service revenue621400$113,101,031$113,101,031
Disproportionate share funding621400$4,790,808$4,790,808
Other operating revenue621400$4,166,271$4,166,271
Cafeteria/vending machine722514$362,893$362,893
Employee pharmacy sales456110$276,103$276,103
FieldValueIRS element (for citing)
Total Program Service Revenue$122,697,106TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,674,917TotalRevenueColumnAmt
Exclusion$4,674,917ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$118,826RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$67,152RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$51,674RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$51,674TotalRevenueColumnAmt
Exclusion$51,674ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$495,724SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$739,341SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$243,617SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$243,617TotalRevenueColumnAmt
Exclusion-$243,617ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$25,640FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$39,265ContriRptFundraisingEventAmt
Fundraising Direct Expenses$27,889FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$2,249TotalRevenueColumnAmt
Exclusion-$2,249ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$1,550GamingGrossIncomeAmt
Gaming Direct Expenses$78GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,472TotalRevenueColumnAmt
Exclusion$1,472ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$128,008,734TotalRevenueColumnAmt
Related Or Exempt Func Income$122,697,106RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$4,482,197ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$41,693TotalAmt
Program Services$41,693ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$63,817TotalAmt
Program Services$63,817ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,293,986TotalAmt
Program Services$493,009ProgramServicesAmt
Management And General$800,977ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$45,039,569TotalAmt
Program Services$40,220,909ProgramServicesAmt
Management And General$4,497,419ManagementAndGeneralAmt
Fundraising$321,241FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$543,340TotalAmt
Program Services$504,268ProgramServicesAmt
Management And General$36,070ManagementAndGeneralAmt
Fundraising$3,002FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,955,249TotalAmt
Program Services$7,039,800ProgramServicesAmt
Management And General$859,073ManagementAndGeneralAmt
Fundraising$56,376FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,785,064TotalAmt
Program Services$2,468,279ProgramServicesAmt
Management And General$293,725ManagementAndGeneralAmt
Fundraising$23,060FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$106,681TotalAmt
Management And General$106,681ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$118,883TotalAmt
Management And General$118,883ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$18,073TotalAmt
Management And General$18,073ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$262,097TotalAmt
Management And General$262,097ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,014,583TotalAmt
Program Services$8,116,259ProgramServicesAmt
Management And General$898,324ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$154,923TotalAmt
Program Services$139,485ProgramServicesAmt
Management And General$15,438ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,633,253TotalAmt
Program Services$3,271,192ProgramServicesAmt
Management And General$335,128ManagementAndGeneralAmt
Fundraising$26,933FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,398,373TotalAmt
Program Services$1,259,022ProgramServicesAmt
Management And General$139,351ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,001,464TotalAmt
Program Services$2,702,361ProgramServicesAmt
Management And General$299,103ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$65,636TotalAmt
Program Services$59,095ProgramServicesAmt
Management And General$6,252ManagementAndGeneralAmt
Fundraising$289FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$221,191TotalAmt
Program Services$134,450ProgramServicesAmt
Management And General$22,042ManagementAndGeneralAmt
Fundraising$64,699FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$955,110TotalAmt
Management And General$955,110ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,885,924TotalAmt
Program Services$4,568,950ProgramServicesAmt
Management And General$316,974ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,287,614TotalAmt
Program Services$1,134,623ProgramServicesAmt
Management And General$152,991ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Med. supplies/services$25,500,417$22,959,242$2,390,803$150,372
Provision for bad debt$7,623,534$7,623,534
NH medicaid enhancement$5,118,534$5,118,534
Food/dietary supplies$387,732$349,094$38,638

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$775,668TotalAmt
Program Services$694,916ProgramServicesAmt
Management And General$54,196ManagementAndGeneralAmt
Fundraising$26,556FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$122,252,408TotalAmt
Program Services$108,962,532ProgramServicesAmt
Management And General$12,617,348ManagementAndGeneralAmt
Fundraising$672,528FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,682BOYAmt
EOY$4,731EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$30,354,114BOYAmt
EOY$26,649,849EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,105,689BOYAmt
EOY$11,076,250EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$940,993BOYAmt
EOY$861,377EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,462,118BOYAmt
EOY$1,557,225EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,290,843BOYAmt
EOY$1,780,257EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$111,907,015LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$70,799,544LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$38,954,948BOYAmt
EOY$41,107,471EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$89,688,993BOYAmt
EOY$113,120,776EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$5,919,721BOYAmt
EOY$6,791,711EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$289,509BOYAmt
EOY$87,144EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$206,896BOYAmt
EOY$206,896EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$178,215,506BOYAmt
EOY$203,243,687EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,912,425BOYAmt
EOY$11,718,260EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$10,945BOYAmt
EOY$9,336EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,265,883BOYAmt
EOY$20,551,113EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$145,664BOYAmt
EOY$24,520EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$27,474,158BOYAmt
EOY$24,733,858EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$58,809,075BOYAmt
EOY$57,037,087EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$104,705,702BOYAmt
EOY$128,694,052EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,700,729BOYAmt
EOY$17,512,548EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$119,406,431BOYAmt
EOY$146,206,600EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$178,215,506BOYAmt
EOY$203,243,687EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,756,326ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$20,455,492NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$588,351OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$18,073GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$18,073TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationMonadnock Community Hospital is a member of the New Hampshire Hospital Association (NHHA) and the American Hospital Association (AHA). A portion of the dues paid to these organizations was made available for lobbying expenditures on behalf of Monadnock Hospital in furtherance of its exempt purpose. Monadnock Hospital does not directly perform any lobbying activities. A detail of dues paid to these associations by the Hospital during this tax year is as follows: - NHHA, portion of dues available for lobbying: $11,372 - AHA, portion of dues available for lobbying: $6,701 In addition, MCH hosts an annual legislative breakfast, which is a bipartisan event to which legislators, local politicians, and other public officials are invited to discuss health care issues in New Hampshire. The breakfast was held virtually this year and therefore did not incur any related expenses.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,700,729BeginningYearBalanceAmt
Contributions$171,128ContributionsAmt
Investment Earnings Or Losses$3,369,979InvestmentEarningsOrLossesAmt
Other Expenditures$729,288OtherExpendituresAmt
End Year Balance$17,512,548EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,791,242BeginningYearBalanceAmt
Contributions$169,000ContributionsAmt
Investment Earnings Or Losses$1,687,615InvestmentEarningsOrLossesAmt
Other Expenditures$947,128OtherExpendituresAmt
End Year Balance$14,700,729EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$17,052,611BeginningYearBalanceAmt
Contributions$595,517ContributionsAmt
Investment Earnings Or Losses-$2,789,108InvestmentEarningsOrLossesAmt
Other Expenditures$1,067,778OtherExpendituresAmt
End Year Balance$13,791,242EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,658,179BeginningYearBalanceAmt
Contributions$320,443ContributionsAmt
Investment Earnings Or Losses$2,714,995InvestmentEarningsOrLossesAmt
Other Expenditures$641,006OtherExpendituresAmt
End Year Balance$17,052,611EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,707,881BeginningYearBalanceAmt
Contributions$205,145ContributionsAmt
Investment Earnings Or Losses$1,372,618InvestmentEarningsOrLossesAmt
Other Expenditures$627,465OtherExpendituresAmt
End Year Balance$14,658,179EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.62966PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.37034TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$36,412,050OtherCostOrOtherBasisAmt
Depreciation$24,520,690DepreciationAmt
Book Value$11,891,360BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$842,848OtherCostOrOtherBasisAmt
Depreciation$842,536DepreciationAmt
Book Value$312BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$68,798,684OtherCostOrOtherBasisAmt
Depreciation$45,436,318DepreciationAmt
Book Value$23,362,366BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,888,811OtherCostOrOtherBasisAmt
Book Value$4,888,811BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$41,107,471TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Estimated third-party settlements$24,284,840
Operating lease liabilities$87,622
Interest rate swap agreements$293,936
Fianance lease liabilities$67,460
FieldValueIRS element (for citing)
Total Liability$24,733,858TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$140,561,795TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$20,455,492NetUnrealizedGainsInvstAmt
Other Revenue$655,728OtherRevenueAmt
Revenue Not Reported$21,111,220RevenueNotReportedAmt
Revenue Subtotal$119,450,575RevenueSubtotalAmt
Investment Expenses Not Incld$262,097InvestmentExpensesNotIncldAmt
Other Revenues Not Included$8,296,062OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$8,558,159RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$128,008,734TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$113,761,626TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$67,377OtherExpensesIncludedAmt
Expenses Not Reported$67,377ExpensesNotReportedAmt
Expenses Subtotal$113,694,249ExpensesSubtotalAmt
Investment Expenses Not Incld2$262,097InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$8,296,062OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$8,558,159ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$122,252,408TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Temporarily restricted assets are available for health care services, including the purchase of equipment and providing health education and programs. The income and dividends on permanently restricted net assets are generally used to support health care services and for capital purchases of property and equipment.
Part X, Line 2:The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Hospital's tax positions and concluded the Hospital has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to or disclosure in the accompanying financial statements.
Part XI, Line 2d - Other Adjustments:Increase in fair value of perpetual trust interest 1,222,837. Decrease in fair value of interest rate swap agreement -644,783. Rental property expenses 67,152. Increase in fair value of equipment due to lease-transfer 10,297. Combination expenses to Part IX 225.
Part XI, Line 4b - Other Adjustments:Provision for bad debt, net against revenues 7,623,534. Fundraising expenses, unrelated to fundraising events 672,528.
Part XII, Line 2d - Other Adjustments:Rental property expenses 67,152. Combination expenses to Part IX 225.
Part XII, Line 4b - Other Adjustments:Provision for bad debt, net against revenues 7,623,534. Fundraising expenses, unrelated to fundraising events 672,528.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1MCH Golf ClassicEvent1Nm
Gross Receipts Event1$64,905GrossReceiptsEvent1Amt
Charitable Contri Event1$39,265CharitableContriEvent1Amt
Gross Revenue Event1$25,640GrossRevenueEvent1Amt
Cash Prizes Event1$1,080CashPrizesEvent1Amt
Non Cash Prizes Event1$9,566NonCashPrizesEvent1Amt
Rent Facility Costs Event1$7,132RentFacilityCostsEvent1Amt
Food And Beverage Event1$5,758FoodAndBeverageEvent1Amt
Entertainment Event1$0EntertainmentEvent1Amt
Other Direct Expenses Event1$4,353OtherDirectExpensesEvent1Amt
Gross Receipts Total$64,905GrossReceiptsTotalAmt
Charitable Contributions Tot$39,265CharitableContributionsTotAmt
Gross Revenue Total Events$25,640GrossRevenueTotalEventsAmt
Cash Prizes Total Events$1,080CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$9,566NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$7,132RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$5,758FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$4,353OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$27,889DirectExpenseSummaryEventsAmt
Net Income Summary-$2,249NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$444,508TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$444,508NetCommunityBenefitExpnsAmt
Total Expense0.00390TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,311,678TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,983,952DirectOffsettingRevenueAmt
Net Community Benefit Expns$327,726NetCommunityBenefitExpnsAmt
Total Expense0.00290TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,756,186TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,983,952DirectOffsettingRevenueAmt
Net Community Benefit Expns$772,234NetCommunityBenefitExpnsAmt
Total Expense0.00680TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$492,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$492,000NetCommunityBenefitExpnsAmt
Total Expense0.00430TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$28,951,841TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,517,814DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,434,027NetCommunityBenefitExpnsAmt
Total Expense0.14340TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$300,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$300,000NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,743,841TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,517,814DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,226,027NetCommunityBenefitExpnsAmt
Total Expense0.15030TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$35,500,027TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,501,766DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,998,261NetCommunityBenefitExpnsAmt
Total Expense0.15710TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,803,702BadDebtExpenseAmt
Bad Debt Expense Attributable$75,300BadDebtExpenseAttributableAmt
Reimbursed By Medicare$26,309,050ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$26,739,090CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$430,040MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Monadnock Community HospitalBusinessNameLine1Txt

US Address USAddress

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Monadnock Community HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted23CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLsee Part V, Section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt23ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Section CStrategyWebsiteURLTxt
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care275.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Section CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Section CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Monadnock Community HospitalPart V, Section B, Line 5: Monadnock Community Hospital (MCH) used a methodology that was highly focused on identifying needs among underserved populations. The approach used was designed to elicit perspective from a broad range of community stakeholders - especially those representing higher risk groups. MCH used a multi-phased methodology to achieve the objectives of the assessment. MCH reached out to a group of individuals to participate in its Community Health Needs Assessment (CHNA) to contribute insights from patients, community service organizations, and staff. Each person provided project feedback regarding perceptions of area health needs, data evaluation, and other guidance during the CHNA process. The individuals had a breadth of community health vision, knowledge, and leadership to impact the well-being of the service area.The CHNA methodology includes a combination of quantitative and qualitative research methods designed to evaluate perspectives and opinions of area stakeholders and healthcare consumers - especially those from underserved populations. The methodology used helped prioritize the needs and establish a basis for continued community engagement - in addition to simply developing a broad, community-based list of needs. The major sections of the methodology include the following: - Strategic Secondary Research. A comprehensive analysis of previously published materials and existing data to provide insight into the community profiles and health-related measures. - Stakeholder Interviews and Focus Groups. Qualitative, primary research involving one-on-one interviews and focus group discussions with the MCH CHNA Leadership Group, community service providers, and healthcare consumers representing diverse perspectives across the service area. - Community Survey. Crescendo conducted an online survey with over 530 community members. The survey results and analysis are included in this report. - Needs Prioritization Process. The needs prioritization methodology included a Modified Delphi Technique. First, MCH CHNA Leadership Group met to review early research results and the potential list of community needs. Second, after completing the secondary research, interviews, focus groups, and community survey, a list of 33 key community health issues was formalized. The Leadership Group then participated in a two-phase prioritization process in which they quantitatively evaluated (i.e., ranked) each of the 33 identified needs and shared insight regarding their rationale for the ranking priorities. This process resulted in a prioritized analysis of community needs.To ensure broad and deep community engagement in the CHNA, MCH compiled a group of community leaders, which represented public health and diverse community interests.To complement the Environmental Analysis, extensive qualitative research was conducted throughout the MCH service area. The interviews provided an opportunity to have in-depth discussions with community members to better understand the community, its strengths and valued resources, prioritized needs, and other insights. To review the Interview Guide (interviews) and Moderator's Guide (focus group discussions), please see Appendix B and Appendix C.The qualitative research included five focus group discussions and interviews with over 20 stakeholders. In total, across both qualitative research stages, participants from various sectors, including those listed below, contributed valuable insights: - Referring Partners - Healthcare Providers - Non-Profit Agencies - Social Service Organizations - Faith-Based Institutions - Educators - Community Volunteers - Users of Monadnock Community Hospital services - Higher-risk Community Representatives.The community survey was made available online in English and Spanish from July 17 through August 22, 2024. The questionnaire included closed-ended need-specific questions, open-ended questions, and demographic questions. Invitations to participate were distributed by Monadnock Community Hospital and its partners through channels including email and social media. Strategic outreach was conducted to ensure maximum participation from community members, especially in vulnerable communities.In total, there were 536 valid survey responses, all of which (100.0%) were to the English language survey. Special care was exercised to minimize the amount of non-sampling error through the assessment of design effects (e.g., question order, question-wording, response alternatives). The survey was designed to maximize accessibility and comprehensively evaluate respondents' insights. The survey served as a practical tool for capturing insights of individuals across Monadnock Community Hospital's service area. This was not a random sample, and findings should not be interpreted as representative of the full population.
Monadnock Community HospitalPart V, Section B, Line 11: Please see attached implementation plan for how the Hospital is addressing (or any needs it is not addressing and why) the significant needs of the community in which it serves.
Monadnock Community HospitalPart V, Section B, Line 16j: The complete financial assistance policy is available upon request and in the waiting rooms. Instructions on how to find out more about financial assistance are posted on the Hospital's website, on the back of all billing invoices, and published in a brochure that is available around the Hospital and in the admissions office.
Monadnock Community HospitalPart V, Section B, Line 20e: The Hospital Patient Financial Services (PFS) Department shall develop and implement billing and collection procedures designed to maintain an adequate cash flow, keep accounts receivable at an acceptable level, and identify and write-off bad debts in a timely fashion. Monadnock Community Hospital contracts with an agency to process all self-pay accounts and self-pay after insurance balance statements/letters.I. Self-pay accounts and self-pay balances remaining after insurance adjudication shall be transferred to the agency on a weekly basis. The cycle for collections is three (3) statements and/or letters and two phone call series spaced approximately thirty (30) days apart. The statements shall include: a. Previous balance (unless this is the first statement). b. Activity since last statement (except those accounts that went to a $0.00 balance). c. Current balance due. d. Telephone number(s) for inquiries concerning the statement. e. Status or reminder message where appropriate. f. Availability for the use of a credit card for payment. g. Information regarding Financial Assistance and Medication Assistance Programs. h. Return envelope.II. In the event that statements or letters are returned by the postal service as undeliverable for reasons such as "moved, left no forwarding address," "forwarding order expired, or "no such address" the agency will indicate on the daily report "mail returned." PFS staff will review system for the correct address and will make corrections within the computer system and correspondence will be re-mailed. If no correct or current information can be obtained, the specific account(s) shall be flagged for referral to an outside collection agency equipped to handle this type of situation (see bad debt processing footnote).In addition, during an emergency room visit if a patient is classified as self-pay, a Financial Assistance application is either given to the patient and/or guarantor at the visit or a Financial Assistance application is put in the mail to the patient and/or guarantor. Determination of eligibility is contingent upon receiving a completed application and required documentation from the patient and/or guarantor.
Schedule H, Part V, Section B, Line 7a & 10a:The Hospital's current and prior Community Health Needs Assessments and Implementation Plans can be found at the following address:https://monadnockcommunityhospital.com/about-us/community-health-needs-and-benefits/A direct link to the 2023 CHNA (for fiscal years ending in 2024-2026) is:https://monadnockcommunityhospital.com/wp-content/uploads/2024/11/2024-MCH-CHNA-FINAL.pdfA direct link to the 2020 CHNA (for fiscal years ending 2021-2023) is:https://monadnockcommunityhospital.com/wp-content/uploads/2022/08/2021CHNA-FINAL.pdfA direct link to the 2023 CHNA Implementation Plan (for fiscal years ending in 2024-2026) is:https://monadnockcommunityhospital.com/wp-content/uploads/2025/06/2024-MCH-Implementation-Plan-12.20.24.pdfA direct link to the 2020 CHNA Implementation Plan (for fiscal years ending in 2021-2023) is:https://monadnockcommunityhospital.com/wp-content/uploads/2022/08/MCH-Implementation-Plan-FINAL.pdf
Schedule H, Part V, Section B, Line 16b:The complete financial assistance policy is available upon request and in the waiting rooms. Instructions on how to find out more about financial assistance are posted on the Hospital's website, on the back of all billing invoices, and published in a brochure that is available around the Hospital and in the admissions office.The Hospital's Financial Assistance Policy, Plain Language Summary, Financial Assistance Application, and additional financial assistance information is available on the Hospital's website at:https://monadnockcommunityhospital.com/financial-services/financial-assistance/A direct link to the Hospital's assistance policy is:http://monadnockhosp.wpenginepowered.com/wp-content/uploads/2020/11/MCH-FAP-Policy.pdfA direct link to the Hospital's assistance application is:http://monadnockhosp.wpenginepowered.com/wp-content/uploads/2023/03/MCH-FAP-Application-FY23.pdfA direct link to the Hospital's plain language summary is:http://monadnockhosp.wpenginepowered.com/wp-content/uploads/2023/03/Financial-Assistance-Eligibility-Summary-Plain-Language-Summary-FY23.pdfA direct link to the Hospital's statement and explanation for Amounts Generally Billed ("AGB") is:https://monadnockcommunityhospital.com/wp-content/uploads/2024/03/Appendix-A-Amount-Generally-Billed.pdfA direct link to the Hospital's statement of participating providers under the financial assistance policy is:https://monadnockcommunityhospital.com/wp-content/uploads/2024/03/Appendix-C-Participating-Providers.pdfLastly, a direct link to a statement of services ineligble for charity care under the Hospital's financial assistance policy is:https://monadnockcommunityhospital.com/wp-content/uploads/2024/03/Appendix-B-Ineligible-Services.pdf
FieldValueIRS element (for citing)
Facility13FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Monadnock Orthopedic Associates
458 Old Street Road Wellness CenterPeterboroughNH03458Physician practice
2 - Monadnock Regional Pediatrics
454 Old Street Road MAB BuildingPeterboroughNH03458Physician practice
3 - Monadnock Internal Medicine
454 Old Street Road MAB BuildingPeterboroughNH03458Physician practice
4 - Jaffrey Family Medicine
82 Peterborough RoadJaffreyNH03452Physician practice
5 - Monadnock Behavioral Health
458 Old Street Road Wellness CenterPeterboroughNH03458Physician practice
6 - Antrim Rural Health Clinic
12 Elm StreetAntrimNH03440Physician practice
7 - Monadnock Family Care
454 Old Street Road MAB BuildingPeterboroughNH03458Physician practice
8 - Rindge Family Practice
145 US Route 202RindgeNH03461Physician practice
9 - Monadnock Surgical Associates
454 Old Street Road MAB BuildingPeterboroughNH03458Physician practice
10 - New Ipswich Family Medicine
821 Turnpike RoadNew IpswichNH03071Physician practice
11 - Monadnock Gastroenterology Associates
454 Old Street Road 107PeterboroughNH03458Physician practice
12 - Monadnock Rheumatology Associates
458 Old Street Road Wellness CenterPeterboroughNH03458Physician practice
13 - Monadnock Cardiology Associates
454 Old Street Road 207PeterboroughNH03458Physician practice

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:N/A
Part I, Line 6a:N/A
Part I, Line 7:Charity care and means tested programs use the cost to charge ratio as their methodology. This Hospital calculates the ratio in a manner consistent with worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of cost to charges.
Part I, Line 7g:Monadnock Community Hospital has several hospital clinical services and hospital-owned physician practices. In accordance with IRS Instructions for the Form 990, Schedule H, Worksheet 6, organizations may include any applicable physician practices that are subsidized during the completion of Schedule H. Furthermore, the definitions for Schedule H, Worksheet 6 indicate that operating a service at a loss may constitute subsidizing a health service. Therefore, the Hospital has included the following hospital clinical services and hospital-owned physician practices that operated at a loss, and their associated costs, in the calculations for the Hospital's total subsidized health services, as reported on this Schedule H.a - Hospital based rural health clinicb - Cardiac Rehabc - Monadnock Family Cared - New Ipswich Family Medicinee - Jaffrey Family Medicinef - Monadnock Behavioral Healthg - Monadnock Regional Pediatricsh - Monadnock Surgical Associatesi - Anticoag Clinicj - Orthopaedicsk - Rindge Family Practicel - Internal Medicinem - Monadnock Gastro Associatesn - Monadnock Rheumatology Associates o - Oncologyp - RivermeadThe above-listed hospital clinical services and hospital-owned physician practices have a community benefit (i.e. aggregate loss or subsidy from the Hospital) of approximately $16.4 million. In addition, this community benefit-figure does not take into account bad debts, charity care, or contractual adjustments. Thus, this community benefit of approximately $16.4 million is a conservative figure that reconciles to the community benefit information reported on IRS Form 990, Schedule H, Part I, Line 7g, Column e.Form 990, Schedule H instructions and guidance contains a template (Worksheet 2) that may be used to determine the overall cost to charge ratio that could be applied throughout Schedule H in order to convert charges to a cost-of-service basis. Where applicable, the Hospital has utilized Worksheet 2 for various calculations. The only areas where Worksheet 2 was not utilized was in the preparation of this Schedule H, Part 1, Line 7, were the following:a. Schedule H Worksheet 6, Subsidized Health Services (the supporting worksheet for Part I, Line 7g): the Hospital did not utilize Worksheet 2 when calculating the percentage used when determining the profit or loss of each hospital clinical service and hospital-owned physician practice. Instead, when compiling the subsidized hospital clinical services and hospital-owned physician practices listed in 1c, the Hospital utilized the actual estimated costs on the modified Medicare cost report instead of applying the Worksheet 2 cost to charge percentage. b. Schedule H, Worksheet 3, Unreimbursed Medicaid and Other Means Tested Government Programs (the supporting schedule for Part I, Lines 7b and 7c); and Worksheet 6, Medicaid Allowable Costs for Subsidized Health Services, listed in line 1c above (which is part of the line 7g costs): the Hospital did not utilize the Worksheet 2 cost to charge percentage when calculating the Medicaid allowable cost. Instead, the Hospital utilized the actual, filed Medicaid cost report for the allowable costs.
Part I, Line 7, Column (f):The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 7,623,534.
Part II, Community Building Activities:Monadnock Community Hospital, a not-for-profit hospital, has a primary care network of physicians, nurse practitioners, psychiatrists, psychologists, and social workers. This network provides a wide range of primary and behavioral health care services for individuals and families with offices in Peterborough, Antrim, Jaffrey, New Ipswich and Rindge.Each year, MCH seeks to make the Monadnock Region a healthier place to live by identifying new and changing healthcare needs, then developing a strategy to address some of the most pressing issues. In addition, no one is turned away who is in need of medical care. Our mission is to provide health care for everyone in our community, regardless of their ability to pay. Some examples of our efforts to reach beyond traditional hospital services include: - Providing services to patients unable to pay - Offering access to medication, free or at reduced cost - millions of dollars in medicine has been dispensed since the Medication Assistance program was started in 2002. - Improving community access to dental care resources. - Provide training for community agencies, such as local volunteer fire and rescue personnel. - Offer prevention and wellness education, from smoking cessation to dealing with stress. - Screenings and clinics for important health issues such as breast cancer. - Supplying information and support regarding timely health topics. - Offer behavioral health (Substance use & mental health) trainings to the community through Be The Change - Offer space for community organization to meet, including local support groups. - The hospital has a Mobile Integrated Health department.MCH also offers a robust system of volunteer programs and services to engage its stakeholders, to bring people together in civic action, and to promote the wellbeing and success of its community. Volunteer Services responds to department requests for volunteer help and works with the requesting department to develop a written service description, if necessary. Every effort is made to fill the position(s) with qualified volunteers. Volunteers assist with all levels of the Hospital's operations, including materials management, blood drives, emergency department assistance, general support and maintenance, recycling, shuttle and transportation, and other related services. Lastly, the Hospital remains committed to improving not just the physical health but also the quality of life in its community. The Monadnock Region has a rich and vibrant history of support for the Arts. Here at Monadnock Community Hospital, we are in a unique position to help connect the world of healing and the world of art. Our intent is to host a venue for artists to exhibit in varied mediums, resulting in a visual experience which promotes the proven healing and restorative benefits of beautiful artwork. Our vision is to eventually develop a permanent art collection for the hospital which will be enjoyed for generations by patients and visitors to our campus. Our Healing Arts Committee is comprised of individuals representing a strong interest in the Healing Arts initiative and has convened to create and develop all aspects of the MCH Healing Arts Gallery as an established and vital venue going forward. The gallery holds three shows per year displaying work from all local artists.
Part III, Line 2:The amount reported on Part III, Line 2 was derived by applying the cost to charge ratio against the amount of bad debt expense reported on Form 990, Part IX, Line 25, Column (A) ($7,623,534). Accounts written off to bad debt include gross charges being written off less any payments received against those charges. Any cash collected on accounts previously written off is included as an offset to bad debt expense as recoveries of bad debt. The Hospital calculates the ratio in a manner consistent with Worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of costs to charges.
Part III, Line 3:The estimated amount of charity care included in bad debt expense is based on the number of applications for charity care denied due to lack of complete documentation against the average charity care write off at cost per qualified patient. We believe the amount is minimal based on our extensive efforts to educate patients and staff about our various payment plans and financial assistance programs to ensure that patients who qualify for any of our programs utilize them. Depending on the specific circumstances, a patient may be eligible for charity care, discounted care, payment programs, or a combination of the above. Due to these efforts, we believe that amounts written off to bad debt that could qualify as charity care is minimal.
Part III, Line 4:Please see footnote 1 on page 8 of the attached audited financial statements.
Part III, Line 8:Medicare allowable cost of care was calculated from the Medicare cost report for the fiscal year ending September 30, 2024. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. The Medicare cost report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.As a critical access hospital, Monadnock Community Hospital is reimbursed at 101% of Medicare allowable cost. This greater than 100% reimbursement rate may from time-to-time result in reported revenue received from Medicare in excess of total Medicare allowable costs.
Part III, Line 9b:As of September 30, 2011, Monadnock Community Hospital has a written credit and collection policy. Described within that policy are the collection practices and bad debt processes that are followed for patients who are known to qualify for charity care or financial assistance. The Organization utilizes a Financial Assistance Program (FAP) file which is maintained by the Patient Financial Assistance Program of MCH. Internal FAP insurance plans are applied to those accounts and related discount amounts are adjusted in the billing system. Remaining balances are expected to be paid in full by the patient. Payment plans may be requested by the patient and are established by the Patient Financial Services staff according to established criteria. Accounts are annotated to reflect payment arrangements. During bad debt processing, designated staff evaluate accounts listed as collection review for potential bad debt write off. This process includes an examination of account history for indication of FAP application.
Part VI, Line 2:Monadnock Community Hospital (MCH) conducted a Community Health Needs Assessment (CHNA) to gather input from patients, community organizations, and staff. Participants shared perspectives on local health needs, helped evaluate data, and provided guidance throughout the process. Their collective knowledge shaped the assessment and its community impact.As required by the Affordable Care Act, non-profit hospitals must complete a CHNA every three years. The goal of MCH's CHNA is to identify and prioritize community health needs. This assessment will serve as a foundation for analyzing population health, refining outreach, fostering collaboration, and enhancing community health initiatives while meeting IRS requirements.In practical terms, the CHNA provides a research-based platform to guide hospital efforts, allowing MCH to address the most pressing health needs and make a meaningful impact.The major strength of MCH is found in the ability of our physicians and staff to offer extensive services utilizing state-of-the-art technology, while maintaining the personalized care of a community hospital. MCH is a 25-bed Critical Access Hospital offering Medical, Surgical and Intensive Care; Obstetrics; Pediatrics; and Mental Health services. In addition, a wide variety of outpatient services are available, including Pulmonary, Cardiac and Physical Rehabilitation; 24-hour Emergency Care; a fully equipped laboratory; and an extensive Radiology department. MCH is fortunate to have strong leadership and a dedicated community that allows us to meet the ever-changing requirements of today's healthcare environment. As that environment changes, MCH is also committed to changing and providing the communities we serve with appropriate and innovative programs.The top ways respondents find out about health care are through a physician or other healthcare worker (50.0%), a hospital's website (34.9%), medical websites including WebMD or Mayo Clinic (34.1%), and/or via word of mouth from friends or relatives (28.2%).MCH also utilizes secondary data resources, such as income, education, demographics, geographic location, and employment data to evaluate and estimate its community's access to care, healthcare literacy, and general wellbeing.The MCH CHNA Leadership Group worked to prioritize 33 community health-related needs, as identified in the primary and secondary research phases of the CHNA process. Based on the results of the Modified Delphi Technique, the ten highest priority community health-related needs include the following: 1. Mental health services for children 2. Mental health crisis care services 3. Urgent care and walk-in clinics 4. Doctors and others to provide primary care to adults and families 5. Mental health services for adults 6. Workforce development to help recruit and retain healthcare workforce 7. Public transportation (not necessarily for medical care) 8. Affordable housing 9. School and hospital collaboration to identify and care for students with medical or mental health needs 10. Economic development - job creation and training At a higher level, the top ten needs can be categorized into four groups: - Mental health care - Urgent care - Access to primary care (i.e., more primary care providers and school / hospital collaboration) - Social and community-based issues (e.g., economic development issues, housing, public transportation). Though not explicit in the prioritization survey, community leaders also include "Quality, affordable childcare" as a higher-priority community need.MCH currently addresses all, or most, of the community needs identified in the CHNA in some way. For each of the top 10 needs identified in the CHNA, MCH examined its current programs, outreach efforts and collaborations, as well as consideration for new initiatives such that each of the needs was assigned to one of the following groups: - Needs that are not part of MCH's purview (e.g., better addressed by other organizations). In this case, MCH will support and advocate for addressing the need but are not able to address the need directly. - Needs that MCH will address through collaboration with community partners. - Needs for which MCH will enhance existing programs or establish new ones. The hospital has current activities that may be able to be modified or expanded to address the community health need, or newly created activities or initiatives may be required to do so.
Part VI, Line 3:MCH is committed to providing quality healthcare to anyone in need of services, regardless of ability to pay. We understand patients may not have the finances to pay for their healthcare services and medications, and do not want this to prevent anyone from receiving necessary treatment. As part of the Hospital's mission to the communities we serve, we have developed programs to help meet the needs of our patients who meet income eligibility. Through our Financial Assistance and Medication Assistance Programs, we have been providing financial assistance for many years to those who qualify. We reach out to our patients in many different ways to ensure that they are aware that help is available and to guide them through the process. Brochures and signage are posted in high traffic areas and all employees of MCH are informed about the Financial Assistance Program during orientation. When a patient goes through the registration process at the Hospital the staff are trained to inform uninsured or underinsured patients about the Monadnock Community Hospital Financial Assistance program and that there is assistance available within the Hospital to help with the application process. In addition, any time a patient calls customer service, the representative is trained to help identify and offer support to patients who may require financial assistance. Patients may qualify for free care, discounted care, payment plans or a combination of the above. Resources are also provided in applying to federal and state programs for those who qualify.
Part VI, Line 4:Monadnock Community Hospital is a 25-bed acute care facility serving a geographically distinctive market in the Greater Monadnock region of New Hampshire, whose population of 38,371 includes 13 towns in Cheshire and Hillsborough counties.The Social Vulnerability Index (SVI) was developed by the U.S. Centers for Disease Control and Prevention as a metric for analyzing population data to identify vulnerable populations. The SVI may be used to rank overall population well-being and mobility relative to county and state QA data. The SVI can also be used to determine the most vulnerable populations during disaster preparedness and public health emergencies, including pandemics.The Hospital's most recent CHNA indicates the following findings from the SVI: - The Monadnock service area is defined by its high senior citizen population. 20% of Monadnock service area residents are age 65 and over, a slightly higher percentage than the state (19%) and county (16.3%) average. - Median incomes are strong in the Monadnock service area ($92,476), and poverty rates are slightly lower (5.4%) than the Hillsborough County average (6.9%). By town, high poverty rates are noteworthy in Temple (13%), Dublin (9.8%), Greenfield (8.1%), Greenville (7.8%), Francestown (7.7%). Poverty rates are low in Hancock (3.3%), New Ipswich (3.4%), and Peterborough (3.2%). - While Hillsborough County experiences higher population diversity compared with the New Hampshire average, which is not reflected in the Monadnock service area. Just 8.7% of the service area population identifies as an ethnic minority, well below county (18.1%) and state (11.7%) averages. - Youth (i.e., age 17 or younger) make up 20.6% of the Monadnock service area population similar to the county average (20.0%) and slightly higher than the state average (18.6%).
Part VI, Line 5:Monadnock Community Hospital is a critical access hospital located in the Monadnock Region of NH. Our mission is to improve the health and well-being of our community. The Hospital is served by a board of trustees consisting of local citizens active in their community and its organizations. The majority of the board is not employed by the Hospital and consists of local community and business representatives as well as medical staff. Each year, MCH seeks to make the Monadnock Region a healthier place to live by identifying new and changing healthcare needs, then developing a strategy to address some of the most pressing issues. In addition, no one is turned away who is in need of medical care. Our mission is to provide health care for everyone in our community, regardless of their ability to pay. The Hospital is committed to giving back to the community to the greatest extent possible. Monadnock Community Hospital supports thousands of individuals and families with free or reduced-fee services and programs. Our Financial Assistance Program administered by the Social Services Department helps families and individuals in need with access to health care and other available community services such as catastrophic care, fuel assistance, meals on wheels, food banks, and visiting nurses. Other examples of the Hospital's effort to reach our patients beyond traditional hospital services include access to free or reduced cost medications through our Medication Assistance program; training for community agencies such as local volunteer fire and rescue personnel; offering prevention and wellness education including nutrition, smoking cessation and dealing with stress; providing regular community seminars regarding timely health topics; screenings and clinics for important health issues such as breast cancer; offer behavioral health (substance use & mental health) trainings to the community through Be The Change. These are just a few of the many areas where we are reaching out to others to assure they are cared for well.
Part VI, Line 6:GraniteOne Health was a non-profit, New Hampshire-based healthcare system consisting of Catholic Medical Center (CMC) in Manchester, Huggins Hospital (HH) in Wolfeboro, and Monadnock Community Hospital (MCH) in Peterborough. GraniteOne Health drew on the resources and expertise of these strong, trusted hospitals to enhance collaboration, strengthen clinical partnerships and meet the health needs of the communities by providing greater access to high-quality care and a seamless patient experience.However, On June 16, 2023, the parties submitted a Joint Notice to the Director of Charitable Trusts pursuant to New Hampshire RSA 7:19-b to the State of New Hampshire and received the Director of Charitable Trusts no action report on December 1, 2023, clearing the way for the parties to complete the disaffiliation. The parties' respective boards each approved changes to their governing documents to unwind the reserved powers and dissolve GraniteOne. On May 30, 2024, the parties filed amendments to their respective governing documents with the New Hampshire Secretary of State as well as the Statement of Dissolution of GraniteOne to complete the wind-down requirements of the GraniteOne system. Accordingly, as of the end of the period covered by this Form 990, Monadnock Community Hospital is no longer part of this Affiliated Health Care System, though the Hospital was a member of this System at the beginning and through and a portion of this tax year.
Part VI, Line 7, Reports Filed With StatesNH

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxtRecipient EINRecipientEIN
Town of Peterborough
1 Grove StreetPeterboroughNH03458Government$15,000$0For the benefit of the Peterborough Ambulance
Contoocook Valley School District
106 Hancock RoadPeterboroughNH03458Government$8,693$0Support the Hope Squad Basic Program
Community Volunteer Transportation Company
375 Jaffrey Road Suite 3PeterboroughNH03458501(c)(3)$8,000$0Support no-fee transportation to those in need in the Monadnock Region262838428
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
Dr. Mark Luedke Memorial Scholarship Fund1$4,317
Dr. Herbert E. Flewelling Scholarship2$4,000
Norma A. Houghton Nursing Scholarship1$1,500
Nursing Education Fund13$52,500
Peter L Gosline Scholarship1$1,500

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationDuring the fiscal year ending September 30, 2024, the Hospital made contributions to governmental entities and 501(c)(3) public charities located in the Hospital's geographic region. The Hospital continued the Dr. Mark Luedke Memorial Scholarship Fund in memory of the Organization's former Radiology Medical Director. The fund is to support clinical education and certification for members of MCH's Radiology Department, and is disbursed with the input of the Director of Radiology, the Chief Nursing Officer, and the VP of Human Resources. The Hospital also continued the Dr. Herbert E. Flewelling Scholarship to honor the memory of Dr. Flewelling, who practiced both in Peterborough and Jaffrey. Scholarships are usually awarded each year to graduates of local area high schools. The scholarships are given to outstanding students who are furthering their education in the medical field. The actual cash award is made upon satisfactory completion of six months of education. The Hospital also continued the Norma A. Houghton Nursing Scholarship to honor the memory of Norma A. Houghton, who devoted her profession to being an RN certified as a lactation consultant, and who served the birthing suite at the Hospital from 1977-2006. Scholarships are usually awarded each year to graduates of local area high schools. The scholarships are given to outstanding students who are furthering their education in the nursing field. The Hospital also continued the Peter L. Gosline Employee Education Scholarship Fund to honor Peter Gosline, the president and CEO of the Hospital from 1998 to 2014. The Scholarship provides financial assistance to eligible employees pursuing higher education and skills development within health services professions.ExplanationTxt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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
Alexander J Walker Esq
Ex-Officio (voting) (end 3/2024)$0$649,284$0$0$0$68,240$0$270,586$0$80,585$0$1,068,695$0$0
Vache Hambardzumyan MD
Physician$594,337$0$1,000$0$950$0$0$0$29,310$0$625,597$0$0$0
Terrence McNamara DO
Trustee/Physician$436,058$0$18,572$0$450$0$6,600$0$31,329$0$493,009$0$0$0
Cynthia McGuire
Chief Executive Officer$343,108$0$69,719$0$22,436$0$24,100$0$27,964$0$487,327$0$17,500$0
Derek Anderson MD
Physician$434,625$0$1,000$0$950$0$6,600$0$32,879$0$476,054$0$0$0
Daniel Perli MD
Physician/Chief Medical Officer$440,953$0$1,000$0$800$0$6,558$0$11,644$0$460,955$0$0$0
Shawn Harrington MD
Physician$399,717$0$1,000$0$1,190$0$6,600$0$29,829$0$438,336$0$0$0
Dmitry Tarasevich MD
Physician$395,104$0$1,000$0$450$0$6,600$0$11,473$0$414,627$0$0$0
Richard D Scheinblum
VP Finance/CFO$263,630$0$23,446$0$690$0$5,396$0$20,488$0$313,650$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4bSchedule J, Page 1, Line 4b, supplemental non-qualified retirement plans: Cynthia McGuire, President & CEO, participates in a 457(f) plan with Monadnock Community Hospital. After a three year vesting period, amounts previously contributed to her by Monadnock Community Hospital are reported as part of her W-2 wages. In calendar year 2023, a total of $17,500 was deposited into Ms. McGuire's 457(f) plan account, which is included in the amount reported on Schedule J, Part II, Column C for this current fiscal year Form 990 filing. Additionally, $18,626 of compensation is reported in Column B(iii), which represents the vested 2020 contribution of $17,500 and earnings of $1,126. The $17,500 has also been reported on this Schedule J, Part II, Column F, as compensation deferred in a previous period which became taxable during this filing period (calendar year 2023 for purposes of income and benefit reporting). Alexander Walker, Jr. takes part in a section 457(f) forfeitable nonqualified deferred compensation plan administered by Catholic Medical Center. In calendar year 2023, Mr. Walker received contributions of $258,386 from Catholic Medical Center into his 457(f) Plan. Such contributions are included in the total deferred compensation reported for Mr. Walker on this Schedule J, Part II, Column C.
Part I, Line 7MCH may from time-to-time compensate physicians utilizing quality and productivity targets based on WRVU (work relative value units). In addition, the Compensation Committee may recommend to the full board, annually, the variable pay award that may be issued to the Hospital's CEO. The payment of any such awards are discretionary and are subject to meeting the pre-determined goals of the Organization.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$6,688,887RetiredAmt
Total Proceeds$27,240,000TotalProceedsAmt
Refunding Escrow$27,057,466RefundingEscrowAmt
Issuance Costs From Proceeds$182,534IssuanceCostsFromProceedsAmt
Substantial Completion2013SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable BondsYes (1)RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

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

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

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

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMichael SheaPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionLessor of Rental PropertyRelationshipDescriptionTxt
Transaction$141,220TransactionAmt
TransactionMichael Shea served as a Trustee on the Hospital's board of directors. Mr. Shea is also the president and part owner of Belletetes, Inc. Monadnock Community Hospital leases a building in Jaffrey, NH for the Jaffrey Family Medicine Practice which is owned by Belletetes, Inc. Terms are at arms-length. The total amount reported in Column C represents rental payments ($141,220) as well as payments for property taxes and common area maintenance.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 3On December 30, 2016, the Hospital became affiliated with Catholic Medical Center (CMC), a 330-bed acute care hospital in Manchester, New Hampshire, and Huggins Hospital (HH), a 25-bed critical access hospital in Wolfeboro, New Hampshire, through the formation of a common parent, GraniteOne Health (GraniteOne). GraniteOne is a New Hampshire voluntary corporation that is recognized as being a Section 501(c)(3) tax-exempt and "supporting organization" within the meaning of Section 509(a)(3). However, pursuant to the Affiliation Agreement that formed GraniteOne, the CMC, HH and MCH each had a right, after two years of participation in GraniteOne, to evaluate whether they would continue participation in the system. Upon review, each participant within GraniteOne concluded it was best to withdraw from GraniteOne and subsequently provided the required notice on October 28, 2022. On June 16, 2023, the parties submitted a Joint Notice to the Director of Charitable Trusts pursuant to New Hampshire RSA 7:19-b to the State of New Hampshire and received the Director of Charitable Trusts no action report on December 1, 2023, clearing the way for the parties to complete the disaffiliation. The parties' respective boards each approved changes to their governing documents to unwind the reserved powers and dissolve GraniteOne. On May 30, 2024, the parties filed amendments to their respective governing documents with the New Hampshire Secretary of State as well as the Statement of Dissolution of GraniteOne to complete the wind-down requirements of the GraniteOne system.
Form 990, Part VI, Section A, line 2James Callahan, Esq., and Michael Shea, who each served on the Hospital's Board during this tax year, share a business relationship.
Form 990, Part VI, Section A, line 4During the period covered by this Form 990 tax return, Monadnock Community Hospital ("MCH") adopted the following significant changes to its governing bylaws: 1. Effective February 2024, MCH is no longer part of the GraniteOne Health hospital system. Previously, GraniteOne Health was the sole member of MCH. 2. Previously, as the sole member, GraniteOne Health was able to exercise certain powers and responsibilities over MCH's governance and operations. Upon its dissociation from GraniteOne Health, the responsibilities and duties for all MCH governance and Board composition decisions became vested with the MCH Board of Trustees, and GraniteOne Health ceased to have influence over such duties within MCH. 3. The former bylaws previously allowed that the GraniteOne Health CEO would be an ex-officio of the MCH Board of Trustees. The amended and newly adopted bylaws removed such privileges from the GraniteOne Health CEO. Additionally, the newly adopted bylaws update the terms for ex-officio trustees in general, stating that there shall now be allowed two members of the active MCH Medical Staff to be ex-officio Trustees (previously one was allowed), and that the Monadnock Health Partners Medical Director is not necessarily by default treated as such an ex-officio Trustee of the Board (previously, such privileges were given to the Medical Director).
Form 990, Part VI, Section B, line 11bThe Hospital's Form 990 is prepared with assistance by an independent public accounting firm. A draft of the Form 990 is initially reviewed in detail by key finance employees. Thereafter, the draft is made available to the full board for review and comment prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cOn an annual basis, the Organization provides all administrators/directors/managers, Board Members, and medical staff members with the conflict of interest policy. Said individuals are required to complete a new conflict of interest disclosure on an annual basis. Any conflicts of interest noted are reviewed by the Chair of the Board, in conjunction with the Corporate Compliance Officer. If the conflict of interest appears to meet the policy definitions requiring full Board review, the Chair of the Board takes this to the full Board meeting, and it is discussed, and appropriate action is taken (in compliance with state and federal requirements). The conflict of interest statement requires signatories to inform the Hospital of any conflict of interest that occurs at any time throughout the year. If a conflict of interest arises during the year, it is reviewed by the Compliance Officer, and if necessary, is taken to the Board Chair/Board. The Compliance Officer confers with legal counsel with regard to conflicts of interest, if there is any question regarding the potential conflict.
Form 990, Part VI, Section B, line 15The Organization has a written executive compensation policy and procedure. Under this policy, the Compensation Committee, comprised of delegated representatives of the Board of Trustees, has the power and responsibility to determine the Hospital's approach to executive compensation and review the performance of the CEO. The Compensation Committee has the responsibility to set, monitor and review the base salary of the CEO. The Committee maintains minutes of sessions and final recommendations and determinations in accordance with the Board of Trustee guidelines. Annually, market data is reviewed by the Committee to determine the appropriate salary for the Hospital's CEO based upon identified standards. At the end of the time period, the Committee reviews to what extent stated goals were met and recommends an amount for the variable pay award to be approved by the full board.
Form 990, Part VI, Section C, line 19Monadnock Community Hospital files audited financial statements annually with the New Hampshire Attorney General's Charitable Trust Unit and informs the Director of Charitable Trusts of pecuniary benefit transactions that have occurred between MCH and a board member or officer. Notices of such transactions of $5,000 or more are also published in the local newspaper in accordance with NH RSA 7:19-A, II(D). Current copies of the bylaws, conflict of interest policy and Form 990 are on file with the Charitable Trust Unit. The Hospital also makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part VII, Section A, Column D: Director CompensationThe 2023 compensation reported for Terrence McNamara, DO, as paid by Monadnock Community Hospital, was paid in return for medical services provided by Terrence McNamara as an employee of the Hospital. No part of Terrence McNamara's compensation was remuneration in return for services as a voting member of the Hospital's Board of Trustees.
Form 990, Part VIII, Line 7: Realized Capital GainsThe amount reported on lines 7c and 7d as realized gains agrees to reporting from the Hospital's custodian bank and third party investment managers. Due to the volume of investment activity, the Hospital relies on the custodian bank and third party investment managers to track the sale of investments at the individual asset level. Therefore the ability to track and report proceeds and basis of the sales is extremely difficult.
Form 990, Part XI, line 9:Decrease in fair value of interest rate swap agreement -644,783. Increase in fair value of perpetual trust interest 1,222,837. Increase in fair value of equipment due to lease-transfer 10,297.
Form 990, Part XI, Line 2c: Audit Review ProcessThe Audit Committee oversees the audit process for Monadnock Hospital. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit for the fiscal years ended 9/30/2023 and 9/30/2024.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

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

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
Alliance Urgent Services
100 McGregor StreetManchesterNH03102831238167Health Care ServicesNHN/A00
Bedford Ambulatory Surgical Center LLC
11 Washington PlaceBedfordNH03110020519727Surgical CenterNHN/A00
NH Value Care ACO LLC
100 McGregor StreetManchesterNH03102832029076Health Care ServicesNHN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Alliance EnterprisesBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 McGregor StreetAddressLine1Txt
CityManchesterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03102ZIPCd
FieldValueIRS element (for citing)
EIN020386795EIN
Primary ActivitiesReal EstatePrimaryActivitiesTxt
Legal Domicile StateNHLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990, Schedule R, Parts II and IV:FormAndLineReferenceDesc
ExplanationMany of the entities listed as related organizations of Monadnock Community Hospital ("MCH") on this Form 990, Schedule R, are related to MCH through shared memberships and associations with GraniteOne Health. However, during the period covered by this Form 990, MCH ended its relationship with GraniteOne Health, and GraniteOne Health ceased to be the sole member of MCH. As a result, as of the end of this tax year ending September 30, 2024, are, in fact, no longer connected or related to MCH. In accordance with IRS Instructions for the Form 990 and Schedule R, these entities have still been disclosed as related organizations, though the dissociation occurred in February 2024.ExplanationTxt

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