2020-05-11T12:51:15-05:00 2019-06-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2018-07-01 020232673 The Elliot Hospital of the City of Manchester ELLI 6036632033 1 Elliot Way Manchester NH 03103 Michael S Turilli CFO 6036632033 2020-04-22 1 Nicholas E Porto P01310283 8002447444 2020-04-22 208.105.168.164 2020-04-22 08:40:34 ED P 3452BD8595D9AC820B41F271E29CE8BF50AD3EDC C5776562590C3A5EE30B3770250D94B4E643E30E 2018 2021-01-29 14:40:06Z William G Baxter 1 Elliot Way Manchester NH 03103 543294559 0 X www.elliothospital.org X 1942 NH Hospital Services 21 16 4092 275 7863629 0 3604754 4367177 474338411 505192226 5065448 12123038 4822854 5003946 487831467 526686387 975311 1430569 0 0 224469751 229356693 0 0 0 214537737 220740304 439982799 451527566 47848668 75158821 476544250 504316382 317724792 341359794 158819458 162956588 The Elliot Hospital of the City of Manchester, a leader in healthcare, is dedicated to providing its community with excellent services offered with dignity, caring, and respect. 0 0 361425717 0 497358131 Medical services provided to 15,254 inpatients and 510,685 outpatients including free care in the amount of $7,903,932 (at cost) and contributions to community programs. 1430569 1430569 0 Contributions to Amoskeag Health (formerly Manchester Community Health Center) and Foundation for Healthy Communities in Manchester, New Hampshire. 541036 0 8068 Community benefits including educational programs, health screenings, health publications and other health information services, and cash and in-kind contributions to community agencies. 363397322 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 345 0 1 4092 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 21 16 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Michael S Turilli 6036632033 1 Elliot Way Manchester NH 03103 Loretta LC Brady PhD Trustee 1.00 3.00 X 0 0 0 Reverend John A Cerrato Jr Trustee 1.00 1.00 X 0 0 0 Susan Critz Trustee 1.00 1.00 X 0 0 0 David Cuzzi Trustee 1.00 3.00 X 0 0 0 Matt Dayno MD Trustee 1.00 41.00 X 0 370782 32513 Kevin P Desrosiers MD Trustee (end 1/19) 1.00 41.00 X 0 403242 36177 John A Hession Trustee 1.00 5.00 X 0 0 0 Joseph T Hyatt MD Trustee 1.00 1.00 X 0 0 0 Dottie Kelley Trustee 1.00 1.00 X 0 0 0 Linda Kornfeld MD Trustee 1.00 44.00 X 0 227617 9693 Stephen Langan Trustee 1.00 4.00 X 0 0 0 Stephen Loosigian DO Trustee 1.00 42.00 X 0 548548 47083 Peter van der Meer MD Trustee 1.00 1.00 X 0 0 0 Holly P Mintz MD Trustee (end 1/19) 1.00 43.00 X 0 389538 45261 Ann G Remus Trustee 1.00 1.00 X 0 0 0 Mary Sargent Trustee (end 12/18) 1.00 3.00 X 0 0 0 Elizabeth Soukup MD Trustee 1.00 41.00 X 0 1438721 34270 Philip Taub Trustee 1.00 1.00 X 0 0 0 James J Tenn Jr Esq Trustee 1.00 2.00 X 0 0 0 James C Hood Esq Chair (end 1/19) 1.00 1.00 X X 0 0 0 Charles F Rolecek Chair/Trustee 1.00 2.00 X X 0 0 0 Daniel M Monfried Vice Chair/Trustee 1.00 1.00 X X 0 0 0 Paul W Hoff PhD Secretary/Trustee 1.00 3.00 X X 0 0 0 John Mercier Treasurer/Trustee 1.00 1.00 X X 0 0 0 William G Baxter President & CEO 40.00 12.00 X X 530857 0 97486 Douglas F Dean President & CEO (end 8/18) 41.00 5.50 X X 840304 0 16281 Michael S Turilli CFO 40.00 10.00 X 151272 0 10052 John E Friberg Jr Senior VP, General Counsel 40.00 0.00 X 593059 0 80243 Alexander W Petron MD VP, Information Technology 40.00 0.00 X 368835 0 35685 James Kulle Chief Information Officer 40.00 0.00 X 364751 0 35190 Samantha L O'Neill VP, Human Resources 40.00 0.00 X 319647 0 15259 Annmarie Tenn Esq Associate General Counsel 40.00 0.00 X 299223 0 13124 Brennan MacDonald Chief Medical Physicist 40.00 0.00 X 288402 0 50432 Joseph Ingold Former CFO (end 6/18) 0.00 0.00 X 323444 0 0 4079794 3378448 558749 155 1 1 0 Medical Solutions Inc 1010 North 102nd Street Suite 300 Omaha NE 68114 Medical Staffing and Placement 5523281 ARUP Laboratories Inc 500 Chipeta Way Salt Lake City UT 84108 Lab Services 1660138 Presidio Networked Solutions LLC 1 Penn Plaza Suite 2832 New York NY 10119 IT Services 1055369 Avant Healthcare Professionals 1211 Semoran Boulevard Suite 227 Casselberry FL 32707 Medical Staffing and Placement 1011903 Amoskeag Anesthesia PLLC 1 Elliot Way Manchester NH 03103 Medical Services 880022 48 2840049 1527128 4367177 Net patient services 621110 335179995 335179995 0 Laboratory services 621500 87814872 83586672 4228200 Pharmacy services 623000 63452034 61231526 2220508 Management and consulting 541610 4039431 3480675 558756 Catering and restaurants 722511 3235497 3092788 142709 11470397 10794543 675854 505192226 5522138 19437 5502701 5003946 0 5003946 5003946 18165 4985781 23209072 16608172 6600900 6600900 6600900 526686387 497366199 7863629 17089382 X 1430569 1430569 2319554 1739665 579889 179031301 133891067 45140234 12701868 9499303 3202565 22705967 16981395 5724572 12598003 9448502 3149501 5828517 5828517 399092 399092 120000 120000 55802 55802 944851 944851 25671204 22563605 3107599 1988943 4054 1984889 10820363 7043574 3776789 8986851 5709760 3277091 14295448 10721586 3573862 333154 299589 33565 871332 653499 217833 6885935 5164451 1721484 18628351 13971263 4657088 1656728 1242546 414182 Medical supplies 70439963 70439963 Provision for bad debts 24944071 24944071 Medicaid enhancement ta 22564148 22564148 Patient expenses 4198990 4198990 1106561 829920 276641 451527566 363397322 88130244 0 28041259 50109588 47515981 17949245 44788605 49966116 894509 868147 3443050 4002497 6740604 6503256 453604046 282317288 159991418 171286758 56165818 76236608 105643534 104742195 1700100 1485174 146401 105545 21472971 21061253 476544250 504316382 46972745 49338533 67468 16819 703672 640408 166458315 161076493 11248 0 103511344 130287541 317724792 341359794 X 144014490 147916975 1343852 1377915 13461116 13661698 158819458 162956588 476544250 504316382 X 75158821 -3165491 -67856200 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 55802 59067 55802 59067 451471764 619354302 451527566 619413369 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 267256 242175 103907 59067 672405 250000 250000 250000 250000 1000000 1500000 14804968 234645 15039613 14662555 142413 14804968 14186751 496610 20806 14662555 14337465 -136806 13908 14186751 15425677 182 131222 1219616 14337465 0.00000 0.90840 0.09160 0 0 4156178 4156178 203695459 90371026 113324433 2135559 2106669 28890 234628501 189839593 44788908 8988349 8988349 171286758 Alternative investments 12300904 F Private investment funds 92441291 F 104742195 Payable to third party payors 20500569 Accrued interest 1737267 Accrued pension 85305724 Workers comp reserves & other 2830968 Employee benefit plans 19813013 Security deposit 100000 130287541 X 524452981 -3165491 3326869 161378 524291603 964215 1430569 2394784 526686387 454122904 4990122 4990122 449132782 964215 1430569 2394784 451527566 Part V, Line 4: Income from the endowment funds can be used for operating and capital expenditures. Part X, Line 2: Elliot Hospital, EPN and EPS are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code, and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Hospital's tax positions and concluded the Hospital has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to the financial statements. Part XI, Line 2d - Other Adjustments: Revenue allocated to EHS Professional & General Liability Insurance Trust 938,682. Unrealized gains to EHS Professional & General Liability Insurance Trust 118,033. Net periodic pension adjustment 2,270,154. Part XI, Line 4b - Other Adjustments: Grants netted against revenue per the Audited Financial Statements 1,430,569. Part XII, Line 2d - Other Adjustments: Expenses allocated to EHS Professional & General Liability Insurance Trust 4,990,122. Part XII, Line 4b - Other Adjustments: Grants netted against revenue per the Audited Financial Statements 1,430,569. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Investments through Elliot Common Trust Fund 8049000 East Asia and the Pacific - Australia, Brunei, Burma, Cambodia, 0 0 Investments through Elliot Common Trust Fund 9910000 Europe (Including Iceland & Greenland) - Albania, Andorra, Austria, Belgium 0 0 Investments through Elliot Common Trust Fund 15475000 Middle East and North Africa - Algeria, Bahrain, Djibouti, Egypt, 0 0 Investments through Elliot Common Trust Fund 380000 North America 0 0 Investments through Elliot Common Trust Fund 955000 0 0 0 0 0 0 34769000 0 34769000 1 0 1 1 0 0 Schedule F, Part I, Line 3: The legal owner of Elliot Hospital's foreign investments is a related organization, Elliot Common Trust Fund. Since a portion of the total foreign investments are allocated to the Hospital's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, Line 3 of Elliot Hospital's Form 990. Schedule F, Part IV, Line 1: In the fiscal year ending June 30, 2019, the Elliot Common Trust Fund disposed of a portion of its holdings in Landsdowne European Absolute Opportunities Fund Limited, a foreign investment. Due to its related-organization status with Elliot Hospital, a segment this disposal is allocated to the Hospital. Elliot Hospital's share of the sales value from the Landsdowne disposal is approximately $16,000 and is therefore below the filing threshold for Form 926. Accordingly, Form 926 has not been prepared or included with this tax return. The disclosure of this transaction is provided purely for transparency purposes. Elliot Hospital was not a part of any other transfers of property to a foreign country during the tax year. Schedule F, Part IV, Line 3: The Elliot Hospital of the City of Manchester did not have an ownership interest in any foreign corporation that is greater than the 10% filing threshold. Accordingly, IRS Form(s) 5471 is not required to be filed. Schedule F, Part IV, Line 4: The Elliot Hospital of the City of Manchester meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Hospital. 1 1 1 X 225.000000000000 1 X 1 1 1 0 1 1 29098 7903932 7903932 0.01850 58128 80727976 38373715 42354261 0.09930 87226 88631908 38373715 50258193 0.11780 11 2863 681192 8068 673124 0.00160 9 415 401591 401591 0.00090 5 10681772 5188610 5493162 0.01290 1 85985 85985 0.00020 10 1249 802837 802837 0.00190 36 4527 12653377 5196678 7456699 0.01750 36 91753 101285285 43570393 57714892 0.13530 1215130 1215130 0.00280 1215130 1215130 0.00280 0 24944071 0 125022872 157987638 -32964766 X 1 1 1 1 Elliot Hospital of City of Manchester 1 Elliot Way Manchester NH 03103 www.elliothospital.org 0018 X X X X Elliot Hospital of City of Manchester 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X See Part V, Section C X See Part V, Section C X 1 18 1 See Part V, Section C 1 0 1 X 225.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 Elliot Hospital of City of Manchester Part V, Section B, Line 5: As part of the 2019 Greater Manchester Community Health Needs Assessment, during the months of April and May, 2019 key leader interviews were conducted with 12 community leaders from the Greater Manchester Community. The key leader interviews represented city and town government, the education system, the health delivery system, non-profit social organizations, and police. A list of those interviewed as part of this process is available in Appendix 1 of the Greater Manchester Community Needs Assessment 2019 located at the following URL: https://www.elliothospital.org/website/downloads/Manchester-Report-Final-compressed.pdfIn addition, the Hospital's previous CHNA, as issued in the tax year ending June 30, 2016, can also be found online at the following URL:https://www.elliothospital.org/website/downloads/QualitativeNeedsAssessment.pdf Elliot Hospital of City of Manchester Part V, Section B, Line 6a: Catholic Medical Center, Manchester, NH Elliot Hospital of City of Manchester Part V, Section B, Line 6b: Manchester Health Department, Manchester, NH Elliot Hospital of City of Manchester Part V, Section B, Line 11: Elliot Hospital develops an implementation strategy every three years based on the most recent community health needs assessment. Please see the attached, 2019 Community health Needs Implementation Strategy document which describes the steps being taken by EH and other community partners to address identified needs. Schedule H, Part V, Section B, Line 7a & 7b: The CHNA available at the Hospital facility's website at:https://www.elliothospital.org/website/downloads/Manchester-Report-Final-compressed.pdfAdditionally, it is also available on Catholic Medical Center's website at:https://www.catholicmedicalcenter.org/CatholicMedicalCenter/media/CMCE-Media-Library/AboutUs/GreaterManchesterCommunityNeedsHealthAssessment_1019.pdf Schedule H, Part V, Section B, Line 13: Elliot's Financial Assistance Policy is available via Elliot's website (www.elliothospital.org) or free copies are available at hospital locations. Also, Patient Financial Advocates are available to assist in person or via telephone. The policy is for people who are underinsured, uninsured, or do not qualify for governmental assistance (Medicare or Medicaid), or who are otherwise unable to pay for medically necessary care and meet the criteria for financial assistance. Schedule H, Part V, Section B, Line 16a, 16b, & 16c: The Hospital's Financial Assistance Policy, Plain Language Summary, and Financial Assistance Application can be found at:https://www.elliothospital.org/website/pay-my-bill-charitable-care-policy.php Schedule H, Part V, Section B, Line 10: In addition to being posted on Elliot Hospital's own webiste, the CHNA is available on Catholic Medical Center's website at:https://www.catholicmedicalcenter.org/CatholicMedicalCenter/media/CMCE-Media-Library/AboutUs/GreaterManchesterCommunityNeedsHealthAssessment _1019.pdf 26 1 - Elliot 1-Day Surgery Ctr at Rivers Edge 185 Queen City Avenue Manchester NH 03101 Ambulatory Surgical Center 2 - Elliot Urgent Care at River's Edge 185 Queen City Avenue Manchester NH 03101 Non-Emergency Walk-In Care Center 3 - Elliot Hospital (HME Manc So NH) 1050 Holt Avenue Suite 5 Manchester NH 03109 LRDD Medical Gases/Prescription Devices 4 - Elliot Pharmacy at River's Edge 185 Queen City Avenue Manchester NH 03101 In-State Pharmacy 5 - Elliot Urgent Care at Londonderry 40 Buttrick Road Londonderry NH 03053 Non-Emergency Walk-In Care Center 6 - Elliot Urgent Care at Bedford 25 Leavy Drive Bedford NH 03110 Non-Emergency Walk-In Care Center 7 - Elliot Hospital (HME Manc So NH) 1050 Holt Avenue Suite 5 Manchester NH 03109 LRDD Medical Gases/Prescription Devices 8 - Elliot Stat Lab 200 Technology Dr 200 Technology Drive Hooksett NH 03106 Laboratory 9 - Elliot Stat Lab 40 Buttrick Rd 40 Buttrick Road Londonderry NH 03053 Laboratory 10 - Elliot Coumadin Clinic 138 Webster St 138 Webster Street Manchester NH 03104 Laboratory 11 - Elliot Coumadin Clinic 40 Buttrick Rd 40 Buttrick Road Londonderry NH 03053 Laboratory 12 - Elliot Pharmacy at Bedford 25 Leavy Drive Bedford NH 03110 In-State Pharmacy 13 - Elliot Poc Lab 145 Hollis Street 145 Hollis Street Manchester NH 03101 Laboratory 14 - HM Medical Equip and Infusion Services 175 Queen City Avenue Manchester NH 03101 Home Care - Durable Medical 15 - Elliot Collection Station 185 Queen Cr 185 Queen City Avenue Manchester NH 03101 Collecting Station 16 - Elliot Coumadin Clinic 15 Freetown Rd 15 Freetown Road 8 Raymond NH 03077 Laboratory 17 - Elliot 1 Day Surg Ctr 185 Queen City 185 Queen City Avenue Manchester NH 03101 Laboratory 18 - Elliot One Day Surgery Center 185 Queen City Avenue Manchester NH 03101 Practitioner Office 19 - Elliot Collection Sta 4 Elliot Way 4 Elliot Way Manchester NH 03103 Collecting Station 20 - Elliot Collection Sta 190 Tarrytown Rd 275 Mammoth Road Manchester NH 03103 Collecting Station 21 - Elliot Collection Sta 20 Chambers Road 20 Chambers Road Hooksett NH 03106 Collecting Station 22 - Elliot Collection Sta 25 Leavy Drive 25 Leavy Drive Bedford NH 03110 Collecting Station 23 - Elliot Lab NE Rehab Hospital-Salem 70 Butler Street Salem NH 03079 Collecting Station 24 - Elliot Urgent Care Lab 185 Queen City 185 Queen City Avenue Manchester NH 03101 Laboratory 25 - Elliot Urgent Care Lab 40 Buttrick Rd 40 Buttrick Road Londonderry NH 03053 Laboratory 26 - Elliot Urgent Care Lab Bedford 25 Leavy Drive Bedford NH 03110 Laboratory Part I, Line 7: Financial assistance and means tested costs used RCC derived from medicare cost report; other benefits costs derived from actual costs and internal cost accounting system. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 24,944,071. Part II, Community Building Activities: In the fiscal year ending June 30, 2019, Elliot Hospital provided $1,215,130 in community support to local organizations. These organizations included Foundations for Health Communities, Child Advocacy Center of Hillsborough County, Easter Seals, Alzheimer's Association and the American Heart Association. These dollars also went to the medical care of the New Hampshire Hillsborough County & State inmates. Part III, Line 2: Bad debt expense is determined based on analysis of historical activity.Self-pay accounts are given an automatic 53% discount off charges;self-pay accounts that do not make payment are transferred to bad debt.Cost of bad debt is derived from an internal cost accounting system. Part III, Line 3: Bad debt and charity care cost determined using an internal costaccounting system; self-pay accounts are given an automatic 53% discountoff charges; self-pay accounts that do not make payments are transferredto bad debt. Organization is not currently determining bad debt accounts that may have been charitable care. Part III, Line 4: See Footnote 2 of the attached audited financial statements. Part III, Line 8: Allowable costs are determined using CMS methodology utilized incompleting cost report; Medicare shortfall from Part III, Line 7 should beincluded in community benefits as costs are not fully reimbursed. Part III, Line 9b: Collections are not pursued on charity care patients. Collection agenciesare supplied information that allows them to identify only those accountsupon which collection efforts should be pursued. Part VI, Line 2: In order to assess the healthcare needs of the community for the community health needs assessment, and on an ongoing basis, Elliot Health System partners closely with Catholic Medical Center, the City of Manchester Health Department, and other community providers. As a member of the Manchester Health Advisory Council, Elliot has access to a network of 30 community organizations with a primary goal of assessing community needs and developing health improvement strategies for the City of Manchester, New Hampshire. This collaborative effort is coordinated under the direction of the City of Manchester Health Department and the Greater Manchester Regional Public Health Network. In addition to the work completed by the Manchester Health Advisory Council (see details in Schedule H, Part V, Section C, Line 5) Elliot also gathered and reviewed data from a variety of other sources to complete the CHNA. These sources included the US Census Bureau, the Behavioral Risk Factor Surveillance System, New Hampshire State agency publications, NH HealthWRQS, americashealthrankings.com, and the Healthcare Advisory Board. Part VI, Line 3: Elliot's Financial Assistance Policy is available via Elliot's website (www.elliothospital.org) or free copies are available at hospital locations. Also, Patient Financial Advocates are available to assist in person or via telephone. The policy is for people who are underinsured, uninsured, or do not qualify for governmental assistance (Medicare or Medicaid), or who are otherwise unable to pay for medically necessary care and meet the criteria for financial assistance. Part VI, Line 4: The 2019 Greater Manchester Community Health Needs Assessment focused on the City of Manchester, and the surrounding Greater Manchester Community. Greater Manchester includes both the Greater Manchester Public Health Region (Auburn, Bedford, Candia, Deerfield, Goffstown, Manchester, and New Boston), as well as the Hospital Service Area (Public Health Region Towns plus Londonderry). These eight communities are home to approximately 195,000 residents. The City of Manchester is not only home to over half of the Greater Manchester Community but it is the largest city in the State of New Hampshire. The population of the Greater Manchester Area is aging and becoming a more diverse population, with residents reflecting a variety of nationalities, languages, ethnic traditions, religious beliefs, and ideologies. New Hampshire has the second highest median age in the nation with 20% of the state population age 60+. Thirteen percent of the City of Manchester residents (over 14,000) are ages 65 or older Part VI, Line 5: Elliot Hospital promotes the health of the Greater Manchester community through many ways including the following:- EH offers free health education and support groups to the community- EH provides financial support to local federally qualified health centers and other non-profit organizations in the community- EH provides space for nonprofit organizations that are in need of a location for operation- EH maintains an open medical staff- EH management and staff participate on the boards of many other nonprofit organizations- EH continues to be a host site for many community events including National Drug Take Back Day- EH staff attend community events and provide screenings and educational materials to the local communities- EH participates in community emergency response preparedness drills Part VI, Line 6: EHS is the umbrella organization under which Elliot Hospital (EH), Elliot Physician Network (EPN), Elliot Professional Services (EPS), the Visiting Nurse Association of Manchester and Southern NH (VNA), and the Mary & John Elliot Charitable Foundation operate. Elliot Health System is a health care system that provides care to residents of southern NH serving a regional population of over 250,000 residents, making it one of the largest providers of comprehensive health care services in southern NH. Each of these organizations plays a critical role in the continuum of care that EHS delivers to the community thus promoting health. The cornerstone of EHS is Elliot Hospital (EH), a 296-bed acute care facility located at the Hospital's main campus. EH and the surrounding campus is home to Elliot Emergency and Trauma services which includes a dedicated pediatric emergency department and the ACS verified Level II Trauma Center, inpatient and outpatient behavioral health services, a Level III Newborn Intensive Care Unit, and the Elliot Regional Cancer Center. Elliot Hospital also services the community through various ambulatory care centers located throughout the Greater Manchester area including the Towns of Bedford, Londonderry, and Hooksett. In addition, EH offers specialty services a 250,000 square foot medical center, The Elliot at River's Edge, which houses the Elliot Breast Health Center, Urgent Care, Wound Care, Pain Management, and Surgical Services. In addition, EH offers the community a dedicated senior center also located in the City of Manchester and a Memory and Mobility Center in Londonderry.EHS, through the Elliot Physician Network (EPN) and Elliot Professional Services (EPS), both not for profit physician groups, provide primary care and specialty care to the Greater Manchester area. Combined, EPN and EPS employ over 200 physicians as far north as Hooksett, east to Raymond, and south to Windham. The Elliot Physician Network has 20 primary care practices in the Greater Manchester area. EHS has a robust electronic medical record (EMR) linking all of the system providers with EH allowing the provider immediate access to all medical care that happened within EHS. The EMR is complete with the latest laboratory results, diagnostic images, and other test results that may affect care given in the local provider's office.EH and Affiliates (collectively EHS), work collaboratively and collectively (through the EMR) allowing EHS to serve the health care needs of people in the most efficient manner and has provided a platform for proactive plans for health management.On April 30, 2018 Elliot Health System became part of the new non-profit healthcare organization named SolutionHealth. This new non-profit healthcare entity is the combination of two New Hampshire non-profit health care organizations, Elliot Health System (EHS) and Southern New Hampshire Health System (SNHHS), combining together to protect the future sustainability of accessible, comprehensive, value-based clinical care. SolutionnHealth is a regional healthcare system with a governing body with members from both EHS and SNHHS. This new organization services over 400,000 community members, is located in the two largest and most diverse cities in New Hampshire and employs over 700 physicians and advanced practice providers in New Hampshire. Part VI, Line 7, Reports Filed With States NH 1 Foundation for Healthy Communities 125 Airport Road Concord NH 03301 020275078 501(c)(3) 848254 Provide support for the reauthorization of the NH Medicaid expansion fund Manchester Community Health Center 1415 Elm Street Manchester NH 03101 020458174 501(c)(3) 397610 To assist in meeting the funding needs for daily operations Granite State Children's Alliance 72 S River Road Suite 202 Bedford NH 03110 743186259 501(c)(3) 160000 Funding for child services and daily operations 3 0 Part I, Line 2: Elliot Hospital maintains members on the board of directors for the Manchester Community Health Center. Activities of this organization align with the Hospital's mission in the community and with the Hospital's Implementation Plan developed from its most recent CHNA. The grant to Foundation for Healthy Communities helps support the State's reauthorization of NH Medicaid expansion which is important to providing insurance coverage for many of our most vulnerable citizens. The grant to the Granite State Children's Alliance, which sponsors the Child Advocacy Center of Hillsborouh County, supports the organization's goal to improve child health, security, and safety, both at home and in the community. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 Matt Dayno MD Trustee 0 340023 0 29967 0 792 0 13600 0 18913 0 403295 0 0 Kevin P Desrosiers MD Trustee (end 1/19) 0 348075 0 20198 0 34969 0 13600 0 22577 0 439419 0 0 Linda Kornfeld MD Trustee 0 221650 0 0 0 5967 0 7592 0 2101 0 237310 0 0 Stephen Loosigian DO Trustee 0 522240 0 6563 0 19745 0 24991 0 22092 0 595631 0 0 Holly P Mintz MD Trustee (end 1/19) 0 381461 0 7292 0 785 0 27659 0 17602 0 434799 0 0 Elizabeth Soukup MD Trustee 0 1188050 0 250000 0 671 0 13600 0 20670 0 1472991 0 0 William G Baxter President & CEO 441672 0 66575 0 22610 0 76548 0 20938 0 628343 0 0 0 Douglas F Dean President & CEO (end 8/18) 798224 0 0 0 42080 0 0 0 16281 0 856585 0 0 0 Michael S Turilli CFO 135742 0 15225 0 305 0 0 0 10052 0 161324 0 0 0 John E Friberg Jr Senior VP, General Counsel 376376 0 193921 0 22762 0 58067 0 22176 0 673302 0 0 0 Alexander W Petron MD VP, Information Technology 265345 0 50067 0 53423 0 13600 0 22085 0 404520 0 0 0 James Kulle Chief Information Officer 310589 0 50553 0 3609 0 13387 0 21803 0 399941 0 0 0 Samantha L O'Neill VP, Human Resources 296641 0 22206 0 800 0 2392 0 12867 0 334906 0 0 0 Annmarie Tenn Esq Associate General Counsel 199044 0 100000 0 179 0 12254 0 870 0 312347 0 0 0 Brennan MacDonald Chief Medical Physicist 280621 0 7134 0 647 0 30000 0 20432 0 338834 0 0 0 Joseph Ingold Former CFO (end 6/18) 310944 0 0 0 12500 0 0 0 0 0 323444 0 0 0 Part I, Line 1a Douglas Dean, President & CEO, received a housing allowance of $23,580 during calendar year 2018. The aforementioned benefit amounts are additional taxable compensation for each contracted officer. Part I, Line 4b 2018 contributions to the 457(f) plan during the year were made to the following individuals: William G. Baxter, $62,948 and John E. Friberg, Jr., $44,467. The System maintains a defined benefit pension plan for certain employees, the Elliot Health System Pension Plan (the Plan). Effective July 1, 2006, the Plan was amended to close the Plan to employees hired after June 30, 2006. Eligible employees hired prior to July 1, 2006 are grandfathered under the Plan and will continue to accrue benefits as long as they remain at a participating System entity and in an eligible status. The System's funding policy is to contribute amounts to the Plan sufficient to meet minimum funding requirements set forth in the Employee Retirement Income Security Act of 1974, plus such additional amounts as might be determined to be appropriate from time to time. The Plan is intended to constitute a plan described in Section 414(k) of the Internal Revenue Code, under which benefits derived from employer contributions are based on the separate account balances of participants in addition to the defined benefits under the Plan. Douglas F. Dean, an officer of the filing organization, resigned from his position with the Hospital in calendar year 2018. Historically, Dean received defined contributions under the 414(K) plan, due to being grandfathered into the pension system. However, in calendar year 2018, neither Dean nor any other officers or employees of Elliot Hospital received defined contributions under the now-closed 414(K) plan. Additionally, defined benefit amounts for Holly Mintz, Stephen Loosigan, and Brennan MacDonald of $27,659, $24,991, and $30,000, respectively, are included in Schedule J, Part II, Column C and Form 990, Part VII-A, Column F as deferred compensation. Part I, Line 7 The Organization has adopted an incentive pay program that provides designated management employees an opportunity to earn a designated percentage of salary based on the achievement by the Organization of a number of critical success factors. The critical success factors are established annually by the independent executive compensation committee of the Board of Trustees with assistance from an independent national compensation consulting company. The maximum potential incentive payments under the plan are considered by the compensation consultant in ensuring that management compensation is reasonable. Form 990, Part VII-A and Schedule J, Part II: Joseph Ingold, who served as the interim Chief Financial Officer until June 2018, was a contracted employee through Ingold & Associates, LLC. The LLC is unrelated to the filing organization and its affiliates. The total compensation paid to Mr. Ingold's LLC for his services during 2018 was $310,944. Additionally, Mr. Ingold received a housing allowance in the amount of $12,500 during the 2018 calendar year, which is included in the amount paid to Ingold & Associates, LLC. As the fees paid to the LLC were paid for services to the entire related party system, an accurate breakdown of the fees relative to the filing organization is not readily determinable. In accordance with IRS instructions, these fees have been reported as compensation on Form 990, Part VII-A and Schedule J, Part II and further disclosed in Schedule O for Form 990, Part VI, Line 3. See also Schedule L. A NH Health & Education Facilities Authority 020279866 2013-09-30 17021000 Refund outstanding prinicipal of 2003 revenue bonds; finance capital project 0 0 0 B NH Health & Education Facilities Authority 020279866 6446148D4 2016-11-15 147020000 advance refund 2009 bonds; finance capital expenditures; pay issuance costs 0 0 0 A 13584441 17021000 132029 1 0 1 1 B 5275000 147020000 126932217 1560329 31047794 1 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: NH Health & Education Facilities Authority Date the Rebate Computation was Performed: 09/30/2018 Issuer Name: NH Health & Education Facilities Authority Date the Rebate Computation was Performed: 09/30/2018 Joseph Ingold LLC Former Chief Financial Officer 323444 Joseph Ingold, who served as Chief Financial Officer during the previous reporting period, was an officer of Ingold & Associates, LLC, an unrelated organization paid by Elliot Hospital for Mr. Ingold's services as CFO to the entire health system. As the fees paid by the Hospital were for Mr. Ingold's services to the entire related party system, an accurate breakdown of this fee relative to the filing organization is not readily determinable, though Mr. Ingold was paid both compensation for his services and provided a housing allowance. Joseph Ingold did not serve the Elliot Healthcare System during the period ending June 30, 2019, but he was compensated during the 2018 calendar year. Therefore, this relationship and the associated compensation and housing allowance paid to Mr. Ingold has been disclosed on the fiscal year 2019 Form 990, on Part VII, Schedule L, and Schedule J. 0 Form 990, Part VI, Section A, line 2 Diane Mercier, who served as a Trustee until April 2018, and John Mercier, who began serving as a Trustee in January 2018, have a family relationship. Dianne Mercier and Daniel Monfried have a business relationship. Form 990, Part VI, Section A, line 3 Joseph Ingold, who served as the interim Chief Financial Officer until June 2018, was a contracted employee through Ingold & Associates, LLC. The LLC is unrelated to the filing organization and its affiliates. The total compensation paid to Mr. Ingold's LLC for his services during 2018 was $310,944. Additionally, Mr. Ingold received a housing allowance in the amount of $12,500 during the 2018 calendar year, which is included in the amount paid to Ingold & Associates, LLC. As the fees paid to the LLC were paid for services to the entire related party system, an accurate breakdown of the fees relative to the filing organization is not readily determinable. In accordance with IRS instructions, these fees have been reported as compensation on Form 990, Part VII-A and Schedule J, Part II and further disclosed in Schedule O for Form 990, Part VI, Line 3. See also Schedule L. Form 990, Part VI, Section A, line 6 Elliot Health System is the sole member of The Elliot Hospital of the City of Manchester. Form 990, Part VI, Section A, line 7a Elliot Hospital is governed by a Board of Trustees identical in composition to its sole member, Elliot Health System. Form 990, Part VI, Section B, line 11b The completed Form 990 is presented to the full Board prior to filing. Board members can review the draft and bring any questions forward for discussion prior to filing. Form 990, Part VI, Section B, line 12c Officers, directors, and key employees are required to sign a conflict of interest form annually, which reports any potential conflict of interest arrangements with the organization. Form 990, Part VI, Section B, line 15 The compensation committee of the Board utilizes outside compensation consultants to evaluate the salaries for the CEO, CFO, and COO. The consultants utilize their internal data along with national and local benchmark data from the industry to develop salary levels. Recommendations of the consultant are reviewed by the compensation committee, who recommends compensation levels to the full Board for approval. An outside consulting firm is also used by the organization to review the compensation of the remainder of the Vice Presidents. Again, national and local benchmarks for salaries are consulted to determine salary levels for these positions. Form 990, Part VI, Section C, line 19 Each of these documents is filed with the New Hampshire Secretary of State and is available upon request. Form 990, Part IX, Column D: The Mary and John Elliot Charitable Foundations performs all fundraising activities on behalf of The Elliot Hospital of the City of Manchester. All fundraising expenses are reported on the Foundation's separate Form 990. Form 990, Part XI, line 9: Net periodic pension adjustment -19,466,768. Transfer to affiliates -48,389,432. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Form 990, Parts VIII-XI: The consolidated audited financial statements for The Elliot Hospital of the City of Manchester and subsidiaries report various revenue, expense, asset, and net asset amounts for the Hospital inclusive of a related organization, Elliot Health System Professional & General Liability Trust (EIN: 01-6217452). All revenue, expense, and balance sheet items related to Elliot Health System Professional & General Liability Trust have been extracted from amounts reported for the Hospital on this Form 990 and all accompanying schedules. Elliot Health System Professional & General Liability Trust is a separate legal entity filing its own Form 990, and items related to it have been reported there. Elliot Health System 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509911 Management NH 501(c)(3) Line 12b, II SolutionHealth 0 Elliot Health System Professional & General LIT 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 016217452 Insurance Trust NH 501(c)(3) Line 12a, I Elliot Hospital 1 Elliot Hospital Associates 1 Elliot Way Manchester NH 031033599 026006214 Auxiliary NH 501(c)(3) Line 12d, III-O N/A 0 Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509589 Physician Services NH 501(c)(3) Line 3 Elliot Hospital 1 Elliot Professional Services Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 331003630 Physician Services NH 501(c)(3) Line 10 Elliot Hospital 1 Foundation Medical Partners Inc 8 Prospect Street Nashua NH 03060 020456218 Physician Services NH 501(c)(3) Line 10 Southern New Hampshire Health System 0 Mary and John Elliot Charitable Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512229 Fundraising NH 501(c)(3) Line 7 Elliot Health System 0 SolutionHealth 360 Route 101 Unit 8 Manchester NH 03110 830741190 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Southern New Hampshire Health System 8 Prospect Street Nashua NH 03060 020509221 Medical Services NH 501(c)(3) Line 12b, II SolutionHealth 0 Southern New Hampshire Medical Center 8 Prospect Street Nashua NH 03060 020483054 Medical Services NH 501(c)(3) Line 3 Southern New Hampshire Health System 0 VNA Community Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020396549 Nursing Services NH 501(c)(3) Line 7 Elliot Health System 0 VNA Home Health and Hospice Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020222241 Home Care and Hospice NH 501(c)(3) Line 10 Elliot Health System 0 VNA of Manchester & Southern NH Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395296 VNA Holding Company NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA of Southern New Hampshire Foundation 1070 Holt Avenue Unit 1 Suite 1400 Manchester NH 03109 223313877 Supporting Organization NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA Personal Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395295 Private Health and Homemaker Services NH 501(c)(3) Line 10 Elliot Health System 0 Elliot Common Trust Fund LLC 1 Elliot Way Manchester NH 03103 203653624 Investments NH Elliot Hospital Excluded 7095241 100982197 0 19437 0 0.86000 Elliot Health System Holdings & Subsidiaries 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512224 Management NH N/A C 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 Elliot Professional Services Network Inc O 10183040 Cash Elliot Physician Network Inc O 8481332 Cash Elliot Professional Services Network Inc P 18709033 Cash Elliot Physician Network Inc P 23347486 Cash Elliot Health System 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509911 0 0 0 76 76 15 4 0 0 0 VNA of Manchester & Southern New Hampshire Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020395296 0 3265 3265 2027039 2030304 251515 62879 0 0 0 The Elliot Hospital of the City of Manchester 1 Elliot Way Manchester NH 03103 020232673 X 0 55802 55802 451471764 451527566 1000000 250000 0 0 0 Elliot Professional Services Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 331003630 0 0 0 95343309 95343309 1000000 250000 0 0 0 Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509589 0 0 0 44056999 44056999 1000000 250000 0 0 0 Mary and John Elliot Charitable Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512229 0 0 0 4346804 4346804 367340 91835 0 0 0 Elliot Health System Professional & General Liability Insurance Trust 1 Elliot Way Manchester NH 03101 016217452 0 0 0 4990122 4990122 399506 99877 0 0 0 VNA Personal Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020395295 0 0 0 808523 808523 146278 36570 0 0 0 VNA Home Health & Hospice Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020222241 0 0 0 16309666 16309666 965483 241371 0 0 0 VNA Community Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03101 020396549 0 0 0 0 0 0 0 0 0 0