MONADNOCK COMMUNITY HOSPITAL: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- MONADNOCK COMMUNITY HOSPITAL (EIN 02-0222157)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-12
- IRS object ID
- 202032259349301543
- Schema version
- 2018v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-12T12:33:16-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010494526 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER NEWMAN & NOYES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BOX 507 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04112 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222157 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Monadnock Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONA | BusinessNameControlTxt |
| Phone | 6039247191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 452 Old Street Road | AddressLine1Txt |
| City | Peterborough | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03458 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Richard D Scheinblum | PersonNm |
| Person Title | VP of Finance/CFO | PersonTitleTxt |
| Phone | 6039247191 | PhoneNum |
| Signature | 2020-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Nicholas E Porto | PreparerPersonNm |
| PTIN | P01310283 | PTIN |
| Phone | 2078792100 | PhoneNum |
| Preparation | 2020-08-11 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 208.105.168.164 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-11 | IPDt |
| IP Tm | 09:21:01 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BC8AE4E166BFDF24A7972DDCC457CE4FCF4C8ABA | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | DA1D1F22D002DE74304CAE64996AD19EA354FE22 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-22 18:59:49Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Cynthia K McGuire | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 452 Old Street Road | AddressLine1Txt |
| City | Peterborough | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03458 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $96,629,150 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.monadnockcommunityhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1919 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | Critical access hospital serving the Monadnock region of the State of New Hampshire | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 718 | TotalEmployeeCnt |
| Total Volunteers | 142 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,019,530 | PYContributionsGrantsAmt |
| CY Contributions Grants | $568,681 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $92,947,961 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $95,385,881 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,773,593 | PYInvestmentIncomeAmt |
| CY Investment Income | $547,589 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,252 | PYOtherRevenueAmt |
| CY Other Revenue | $7,975 | CYOtherRevenueAmt |
| PY Total Revenue | $101,747,336 | PYTotalRevenueAmt |
| CY Total Revenue | $96,510,126 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $32,136 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $33,223 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $44,704,519 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $46,717,343 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $460,510 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $48,859,814 | PYOtherExpensesAmt |
| CY Other Expenses | $50,374,716 | CYOtherExpensesAmt |
| PY Total Expenses | $93,596,469 | PYTotalExpensesAmt |
| CY Total Expenses | $97,125,282 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,150,867 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$615,156 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $130,171,265 | TotalAssetsBOYAmt |
| Total Assets EOY | $136,807,429 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $52,257,757 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $56,560,968 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $77,913,508 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $80,246,461 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Monadnock 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $86,394,029 | ExpenseAmt |
| Grant | $33,223 | GrantAmt |
| Revenue | $95,385,881 | RevenueAmt |
| Desc | The 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 2019.Inpatient Services - Includes: intensive care unit, adult stays, maternity/births, and skilled nursing. During the fiscal year, the Hospital admitted 1,373 patients and recorded 4,186 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 13,823 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, 73,737 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, 3,234 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, 32,293 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 54,453 procedures were recorded for these services. Wellness Services - Community members wanting to improve and maintain their health have access to an award-winning, medically-based fitness facility. During the fiscal year, 19,046 member months were recorded.Monadnock Community Hospital's Financial Grant Program provides assistance with hospital and/or physician bills for qualifying patients. In fiscal year 2019, the Organization recorded $1,832,000 in charges foregone based on established rates. The estimated cost incurred to provide these services was $938,018. In addition, Monadnock Community Hospital provided other services to the community at no cost or reduced cost, such as screenings and clinics. The cost of providing these services was approximately $4,062,000 in 2019. | Desc |
| Total Program Service Expenses | $86,394,029 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 118 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 718 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nicole Humphrey | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6039247191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 452 Old Street Road | AddressLine1Txt |
| City | Peterborough | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03458 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Anne Baddour | ||||||||
| Trustee (end 12/18) | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Robert Boyd | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Peter Cerroni DMD | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Elizabeth Cooley MD | ||||||||
| Ex-Officio (voting) | 50.00 | 0.00 | Yes (X) | $216,055 | $0 | $23,682 | ||
| Jeffry Crocker | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Barbara R Duckett RN | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Paul Faber | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Carolyn Garretson | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Shawn Harrington MD | ||||||||
| Ex-Officio (voting) | 50.00 | 0.00 | Yes (X) | $421,001 | $0 | $24,672 | ||
| William James Jr | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Gregory Kriebel MD | ||||||||
| Ex-Officio (voting) (end 12/18) | 50.00 | 0.00 | Yes (X) | $285,361 | $0 | $25,599 | ||
| Leslie Lewis | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Fay Migotsky MD | ||||||||
| Ex-Officio (voting) (end 4/19) | 50.00 | 0.00 | Yes (X) | $157,326 | $0 | $24,524 | ||
| Lara Niemela MD | ||||||||
| Ex-Officio (voting) | 50.00 | 0.00 | Yes (X) | $173,928 | $0 | $24,277 | ||
| Joseph Pepe MD | ||||||||
| Trustee | 3.00 | 49.00 | Yes (X) | $0 | $966,705 | $400,783 | ||
| Pat Shuster | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sheldon Spector | ||||||||
| Ex-Officio (voting) (end 12/18) | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Alexander Walker Esq | ||||||||
| Trustee | 3.00 | 42.00 | Yes (X) | $0 | $605,080 | $212,505 | ||
| Marcia Ober | ||||||||
| Chair | 3.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Michael Shea | ||||||||
| Vice Chair | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Thomas S Bates CPA | ||||||||
| Treasurer | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| James Callahan Esq | ||||||||
| Secretary | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Norman A Makechnie Esq | ||||||||
| Secretary (end 12/18) | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Cynthia McGuire | ||||||||
| Chief Executive Officer | 55.00 | 1.00 | Yes (X) | $286,202 | $0 | $46,892 | Yes (X) | |
| Richard D Scheinblum | ||||||||
| VP Finance/CFO | 50.00 | 0.00 | $192,555 | $0 | $12,391 | Yes (X) | ||
| Ronald Michalak MD | ||||||||
| Physician | 50.00 | 0.00 | $520,775 | $0 | $24,739 | Yes (X) | ||
| Terrence McNamara DO | ||||||||
| Physician | 50.00 | 0.00 | $448,565 | $0 | $28,031 | Yes (X) | ||
| William White MD | ||||||||
| Physician | 50.00 | 0.00 | $403,602 | $0 | $19,203 | Yes (X) | ||
| Robert C Knowles MD | ||||||||
| Physician | 50.00 | 0.00 | $353,282 | $0 | $19,505 | Yes (X) | ||
| Michael Lindberg MD | ||||||||
| Physician | 50.00 | 0.00 | $334,274 | $0 | $23,130 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,792,926 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,571,785 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $909,933 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 54 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Catholic Medical Center | |||||
| 195 McGregor Street | Manchester | NH | 03102 | Contract Physician and Lab Services | $2,922,109 |
| Monadnock Region Emergency Physicians PL | |||||
| 380 Lafayette Road | Hampton | NH | 03842 | Contract Emergency Physician Group | $2,575,833 |
| Monadnock Anesthesia Association | |||||
| c/o Surgical Suite | Peterborough | NH | 03458 | Contract Anesthesia Group | $1,473,879 |
| Hutter Construction Corporation | |||||
| PO Box 257 | New Ipswich | NH | 03071 | General Contractor | $1,412,743 |
| Blue Oak Wellness Strategies LLC | |||||
| 901 Sonterra Boulevard Suite 311 | San Antonia | TX | 78258 | Contract Fitness Group | $845,041 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $43,825 | FundraisingAmt |
| All Other Contributions | $524,856 | AllOtherContributionsAmt |
| Noncash Contributions | $60,424 | NoncashContributionsAmt |
| Total Contributions | $568,681 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient service revenue | 621400 | $85,434,255 | $85,434,255 |
| Other operating revenue | 621400 | $5,195,836 | $5,195,836 |
| Disproportionate share funding | 621400 | $4,325,004 | $4,325,004 |
| Cafeteria/vending machine | 722210 | $348,950 | $348,950 |
| Employee pharmacy sales | 446110 | $81,836 | $81,836 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $95,385,881 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $308,825 | TotalRevenueColumnAmt |
| Exclusion | $308,825 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $333,401 | SecuritiesAmt |
| Other | $5,492 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $100,129 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $233,272 | SecuritiesAmt |
| Other | $5,492 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $238,764 | TotalRevenueColumnAmt |
| Exclusion | $238,764 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $26,870 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $43,825 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $18,895 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,975 | TotalRevenueColumnAmt |
| Exclusion | $7,975 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $96,510,126 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $95,385,881 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $555,564 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Program Services | $15,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,223 | TotalAmt |
| Program Services | $18,223 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,887,823 | TotalAmt |
| Program Services | $1,288,207 | ProgramServicesAmt |
| Management And General | $599,616 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,073,702 | TotalAmt |
| Program Services | $31,510,402 | ProgramServicesAmt |
| Management And General | $3,320,453 | ManagementAndGeneralAmt |
| Fundraising | $242,847 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,842 | TotalAmt |
| Program Services | $422,956 | ProgramServicesAmt |
| Management And General | $73,864 | ManagementAndGeneralAmt |
| Fundraising | $2,022 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,923,894 | TotalAmt |
| Program Services | $5,936,393 | ProgramServicesAmt |
| Management And General | $945,750 | ManagementAndGeneralAmt |
| Fundraising | $41,751 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,333,082 | TotalAmt |
| Program Services | $2,065,688 | ProgramServicesAmt |
| Management And General | $248,980 | ManagementAndGeneralAmt |
| Fundraising | $18,414 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,120 | TotalAmt |
| Management And General | $108,120 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,500 | TotalAmt |
| Management And General | $61,500 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322 | TotalAmt |
| Program Services | $322 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,505 | TotalAmt |
| Management And General | $164,505 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,388,175 | TotalAmt |
| Program Services | $6,904,724 | ProgramServicesAmt |
| Management And General | $483,451 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,381 | TotalAmt |
| Program Services | $53,381 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,427,286 | TotalAmt |
| Program Services | $1,210,011 | ProgramServicesAmt |
| Management And General | $1,197,657 | ManagementAndGeneralAmt |
| Fundraising | $19,618 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,129,249 | TotalAmt |
| Program Services | $985,676 | ProgramServicesAmt |
| Management And General | $138,193 | ManagementAndGeneralAmt |
| Fundraising | $5,380 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,480,915 | TotalAmt |
| Program Services | $2,180,002 | ProgramServicesAmt |
| Management And General | $300,913 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,548 | TotalAmt |
| Program Services | $64,120 | ProgramServicesAmt |
| Management And General | $20,033 | ManagementAndGeneralAmt |
| Fundraising | $2,395 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,081 | TotalAmt |
| Program Services | $56,921 | ProgramServicesAmt |
| Management And General | $6,370 | ManagementAndGeneralAmt |
| Fundraising | $41,790 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,030,574 | TotalAmt |
| Management And General | $1,030,574 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,469,830 | TotalAmt |
| Program Services | $4,273,126 | ProgramServicesAmt |
| Management And General | $196,704 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $513,475 | TotalAmt |
| Program Services | $414,520 | ProgramServicesAmt |
| Management And General | $98,955 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Med & Pharm Supplies | $14,411,055 | $14,408,617 | $2,438 | |
| Other medical services | $5,768,386 | $4,990,469 | $724,155 | $53,762 |
| Provision for Bad Debt | $4,959,196 | $4,959,196 | ||
| NH Medicaid Enhancement | $4,035,270 | $4,035,270 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,181,848 | TotalAmt |
| Program Services | $600,805 | ProgramServicesAmt |
| Management And General | $548,512 | ManagementAndGeneralAmt |
| Fundraising | $32,531 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,125,282 | TotalAmt |
| Program Services | $86,394,029 | ProgramServicesAmt |
| Management And General | $10,270,743 | ManagementAndGeneralAmt |
| Fundraising | $460,510 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,779 | BOYAmt |
| EOY | $7,980 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,302,423 | BOYAmt |
| EOY | $14,651,294 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,658 | BOYAmt |
| EOY | $190,308 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,473,219 | BOYAmt |
| EOY | $8,907,681 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,592 | BOYAmt |
| EOY | $104,741 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,410,000 | BOYAmt |
| EOY | $1,326,143 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,103,571 | BOYAmt |
| EOY | $1,018,003 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $99,866,990 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $62,627,524 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,250,391 | BOYAmt |
| EOY | $37,239,466 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,664,565 | BOYAmt |
| EOY | $67,656,314 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,819,945 | BOYAmt |
| EOY | $4,862,084 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $642,122 | BOYAmt |
| EOY | $843,415 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,171,265 | BOYAmt |
| EOY | $136,807,429 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,829,522 | BOYAmt |
| EOY | $9,652,072 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,233,041 | BOYAmt |
| EOY | $24,284,323 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,132 | BOYAmt |
| EOY | $44,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,006,062 | BOYAmt |
| EOY | $22,580,573 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,257,757 | BOYAmt |
| EOY | $56,560,968 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,496,464 | BOYAmt |
| EOY | $66,538,580 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,377,657 | BOYAmt |
| EOY | $4,626,355 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,039,387 | BOYAmt |
| EOY | $9,081,526 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,913,508 | BOYAmt |
| EOY | $80,246,461 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,171,265 | BOYAmt |
| EOY | $136,807,429 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$615,156 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,757,155 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,809,046 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $14,224 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $322 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $14,546 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Monadnock Community Hospital is a member of the New Hampshire Hospital Association (NHHA) and the American Hospital Association (AHA). A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Monadnock Hospital in furtherance of its exempt purpose. Monadnock Hospital does not directly perform any lobbying activities. NHHA, Portion of dues available for lobbying: $10,503 AHA, Portion of dues available for lobbying: $3,721 In addition, MCH hosts an annual legislative breakfast, which is a bipartisan event to which legislators, local politicians, and other public officials are invited to discuss health care issues in New Hampshire. Discussion topics for the 2019 breakfast focused on the current and proposed healthcare legislation, its impact on MCH, and collaboration to advocate for the growing health needs of the Monadnock region. The cost of this forum was $322. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,417,044 | BeginningYearBalanceAmt |
| Contributions | $169,256 | ContributionsAmt |
| Investment Earnings Or Losses | $750,558 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $628,977 | OtherExpendituresAmt |
| End Year Balance | $13,707,881 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,277,040 | BeginningYearBalanceAmt |
| Contributions | $493,404 | ContributionsAmt |
| Investment Earnings Or Losses | $1,411,813 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $765,213 | OtherExpendituresAmt |
| End Year Balance | $13,417,044 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,739,947 | BeginningYearBalanceAmt |
| Contributions | $205,969 | ContributionsAmt |
| Investment Earnings Or Losses | $1,073,757 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $742,633 | OtherExpendituresAmt |
| End Year Balance | $12,277,040 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,053,734 | BeginningYearBalanceAmt |
| Contributions | $498,812 | ContributionsAmt |
| Investment Earnings Or Losses | $708,687 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $521,286 | OtherExpendituresAmt |
| End Year Balance | $11,739,947 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,410,548 | BeginningYearBalanceAmt |
| Contributions | $1,026,702 | ContributionsAmt |
| Investment Earnings Or Losses | $489,797 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,873,313 | OtherExpendituresAmt |
| End Year Balance | $11,053,734 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.66250 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.33750 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $964,622 | OtherCostOrOtherBasisAmt |
| Book Value | $964,622 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,299,771 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,007,617 | DepreciationAmt |
| Book Value | $12,292,154 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,394,124 | OtherCostOrOtherBasisAmt |
| Depreciation | $692,863 | DepreciationAmt |
| Book Value | $701,261 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,208,473 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,927,044 | DepreciationAmt |
| Book Value | $23,281,429 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $37,239,466 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Interest rate swap agreements | $3,028,761 |
| Estimated third-party settlements | $19,551,812 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $22,580,573 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $98,833,220 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,757,155 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$1,809,046 | OtherRevenueAmt |
| Revenue Not Reported | $2,948,109 | RevenueNotReportedAmt |
| Revenue Subtotal | $95,885,111 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $164,505 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $460,510 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $625,015 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $96,510,126 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $96,500,267 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $96,500,267 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $164,505 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $460,510 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $625,015 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $97,125,282 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Temporarily restricted assets are available for health care services, including the purchase of equipment and providing health education and programs. The income and dividends on permanently restricted net assets are generally used to support health care services and for capital purchases of property and equipment. |
| Part X, Line 2: | The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Hospital's tax positions and concluded the Hospital has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to or disclosure in the accompanying financial statements. |
| Part XI, Line 2d - Other Adjustments: | Decrease in fair value of interest rate swap agreement -1,851,185. Increase in fair value of perpetual trust 42,139. |
| Part XI, Line 4b - Other Adjustments: | Fundraising expenses 460,510. |
| Part XII, Line 4b - Other Adjustments: | Fundraising expenses 460,510. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | MCH Golf Classic | Event1Nm |
| Gross Receipts Event1 | $70,695 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $43,825 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $26,870 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $240 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $6,517 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $5,760 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $4,195 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $0 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $2,183 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $70,695 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $43,825 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $26,870 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $240 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $6,517 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $5,760 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $4,195 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,183 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $18,895 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $7,975 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $938,018 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $938,018 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01020 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,047,512 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,862,007 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,185,505 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02370 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,985,530 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,862,007 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,123,523 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03390 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $604,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $604,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,886,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,886,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03130 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $567,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $567,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,062,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,062,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04420 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,047,830 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,862,007 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,185,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07810 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,538,761 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $70,800 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $27,976,705 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,772,644 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $204,061 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Monadnock Community Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 452 Old Street Road | AddressLine1Txt |
| City | Peterborough | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03458 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 02507 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Monadnock Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | see Part V, Section C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Section C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Monadnock Community Hospital | Part V, Section B, Line 5: Monadnock Community Hospital (MCH) used a methodology that was highly focused on identifying needs among underserved populations. The approach used was designed to elicit perspective from a broad range of community stakeholders - especially those representing higher risk groups. MCH used a multi-phased methodology to achieve the objectives of the assessment. The methodology included the following stages: establishing a leadership team to provide project guidance and insight regarding local health resources and perspectives of community needs; strategic secondary research; conducting qualitative research through group discussions and surveying community stakeholders representing high-risk populations in the service area; needs prioritization process. Establishing a Leadership Team - MCH benefits from having a highly stable group of community leaders - many of whom have participated in CHNA processes and worked collaboratively with MCH to address prioritized need for many years. The benefit of this is that a broad section of the MCH region service providers remain engaged and highly insightful about emerging needs, as well as the impact of existing strategies. The Leadership Group, though retaining a core group of highly experienced participants - is continually enhanced with the addition of new participants who bring creative insight and unique perspectives. The result is a MCH-led CHNA Leadership Group that is highly effective, quickly transitions "assessed needs" to implementation strategies, and is sensitive to evolving needs and opportunities for improving health and wellbeing. The Group offered critical feedback on the project work plan, critiqued quantitative data, helped to refine the list of community needs, helped develop the database of available resources, and participated in quantitative and qualitative research methods to build the prioritized list of identified community needs. Qualitative (Primary) Research - Leadership meetings and one-on-one interviews were conducted with a broad range of MCH leaders, community stakeholders, other community service providers, and healthcare consumers in the service area. The primary research also included quantitative and qualitative feedback provided from 33 community leaders and stakeholders via an electronic survey. The research approach was designed to "cast a broad net: and engage underserved populations and other stakeholders highly knowledgeable about resources and service gaps that those communities face. The research goals were (1) to flesh out a high-level list of community needs, and (2) to gain insight and granularity regarding specific subpopulations impacted by higher priority needs. The discussion group included leaders from community service providers who represent at-risk groups such as (but not limited to) adults and children suffering from behavioral health problems, chronic disease patients and those at-risk of acquiring a chronic condition, economically challenged populations including children living in poverty and/or near-poverty, homeless individuals and families, individuals and families in engaging in risky lifestyles, populations requiring integrated care service, senior citizens, and other frequent users of the healthcare system. |
| Monadnock Community Hospital | Part 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 Hospital | Part 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.Interpreter services are available for limited English proficient individuals and for the hard of hearing and/or visually impaired. |
| Monadnock Community Hospital | Part V, Section B, Line 20e: The Hospital Patient Financial Services (PFS) Department shall develop and implement billing and collection procedures designed to maintain an adequate cash flow, keep accounts receivable at an acceptable level, and identify and write-off bad debts in a timely fashion. Monadnock Community Hospital contracts with an agency to process all self-pay accounts and self-pay after insurance balance statements/letters.I. Self-pay accounts and self-pay balances remaining after insurance adjudication shall be transferred to the agency on a weekly basis. The cycle for collections is three (3) statements and/or letters and two phone call series spaced approximately thirty (30) days apart. The statements shall include:a. Previous balance (unless this is the first statement).b. Activity since last statement (except those accounts that went to a $0.00 balance).c. Current balance due.d. Telephone number(s) for inquiries concerning the statement.e. Status or reminder message where appropriate.f. Availability for the use of a credit card for payment.g. Information regarding Financial Assistance and Medication Bridge Programs.h. Return envelope.II. In the event that statements or letters are returned by the postal service as undeliverable for reasons such as "moved, left no forwarding address," "forwarding order expired, or "no such address" the agency will indicate on the daily report "mail returned." PFS staff will review system for the correct address and will make corrections within the computer system and correspondence will be re-mailed. If no correct or current information can be obtained, the specific account(s) shall be flagged for referral to an outside collection agency equipped to handle this type of situation (see bad debt processing footnote).In addition, on a weekly basis, the FAP staff run system reports to identify emergency room visits classified as self-pay. Based on the information in these reports, the guarantor of each visit is sent a financial assistance application in the mail. Determination of eligibility is contingent upon receiving a completed application and required documentation from the patient and/or guarantor. |
| Schedule H, Part V, Section B, Line 7a & 10a: | The Hospital's Community Health Needs and Benefits web-page can be found at the following address:https://monadnockcommunityhospital.com/about-us/community-health-needs-and-benefits/The Hospital's previous CHNA, for the year ending September 30, 2015, can be found at the following address:https://monadnockcommunityhospital.com/wp-content/uploads/2018/12/CHNA_2015.pdfThe Hospital's current CHNA, for the year ending September 30, 2018, can be found at the following address: https://monadnockcommunityhospital.com/wp-content/uploads/2018/12/2018-CHNA-Report-FINAL-1.pdfThe Hospital's Implementation Plan, for the period covering 2019-2021, can be found at the following address:http://monadnockcommunityhospital.com/wp-content/uploads/2019/06/MCH-Implementation-Plan-2019.pdf |
| Schedule H, Part V, Section B, Line 16b: | The complete financial assistance policy is available upon request and in the waiting rooms. Instructions on how to find out more about financial assistance are posted on the Hospital's website, on the back of all billing invoices, and published in a brochure that is available around the Hospital and in the admissions office.The Hospital's Financial Assistance Policy is available on the Hospital's website at:http://monadnockcommunityhospital.com/wp-content/uploads/2019/04/MCH-FAP-Policy.pdfThe Hospital's Financial Assistance Policy Application is available at:https://monadnockcommunityhospital.com/wp-content/uploads/2018/11/MCH_FAP_Application.pdfThe Hospital's Financial Assistance Plain Language Summary is available at:http://monadnockcommunityhospital.com/wp-content/uploads/2019/04/FAP_Plain_Language_Summary-2019.pdf |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 12 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Bond Wellness Center | ||||
| 458 Old Street Road Wellness Center | Peterborough | NH | 03458 | Fitness center and rehabilitation services |
| 2 - Monadnock Orthopedic Associates | ||||
| 458 Old Street Road Wellness Center | Peterborough | NH | 03458 | Physician practice |
| 3 - Jaffrey Family MedicinePT Satellite | ||||
| 82 Peterborough Road | Jaffrey | NH | 03452 | Physician practice with PT services |
| 4 - Monadnock Regional Pediatrics | ||||
| 454 Old Street Road MAB Building | Peterborough | NH | 03458 | Physician practice |
| 5 - Monadnock Internal Medicine | ||||
| 454 Old Street Road MAB Building | Peterborough | NH | 03458 | Physician practice |
| 6 - Monadnock Family Care | ||||
| 454 Old Street Road MAB Building | Peterborough | NH | 03458 | Physician practice |
| 7 - Monadnock Surgical Associates | ||||
| 454 Old Street Road MAB Building | Peterborough | NH | 03458 | Physician practice |
| 8 - Antrim Medical Group | ||||
| 12 Elm Street | Antrim | NH | 03440 | Physician practice |
| 9 - Monadnock Behavioral Health | ||||
| 458 Old Street Road Wellness Center | Peterborough | NH | 03458 | Physician practice |
| 10 - Rindge Family Practice | ||||
| 145 US Route 202 | Rindge | NH | 03461 | Physician practice |
| 11 - New Ipswich Family Medicine | ||||
| 821 Turnpike Road | New Ipswich | NH | 03071 | Physician practice |
| 12 - Neurology | ||||
| 454 Old Street Road MAB Building | Peterborough | NH | 03458 | Physician practice |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | N/A |
| Part I, Line 6a: | N/A |
| Part I, Line 7: | Charity care and means tested programs use the cost to charge ratio as their methodology. This Hospital calculates the ratio in a manner consistent with worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of cost to charges. |
| Part I, Line 7g: | Included in the subsidized health services activities reported for FY 2019 are unreimbursed costs of $703,000 attributed to an outpatient behavioral health practice and $1,986,000 related to emergency and trauma services. |
| Part I, Ln 7 Col(f): | The Bad Debt expense included on Form 990, PartIX, Line 25(A), but subtracted for purposes of calculating the percentage in this column is $4,959,196. |
| Part II, Community Building Activities: | See previous footnotes. |
| Part III, Line 2: | The amount reported on Part III, Line 2 was derived by applying the cost to charge ratio against the amount of bad debt expense reported on Form 990, Part IX, Line 25, Column (A) ($4,959,196). Accounts written off to bad debt include gross charges being written off less any payments received against those charges. Any cash collected on accounts previously written off is included as an offset to bad debt expense as recoveries of bad debt. The Hospital calculates the ratio in a manner consistent with Worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of costs to charges. |
| Part III, Line 3: | The estimated amount of charity care included in bad debt expense is based on the number of applications for charity care denied due to lack of complete documentation against the average charity care write off at cost per qualified patient. We believe the amount is minimal based on our extensive efforts to educate patients and staff about our various payment plans and financial grant programs to ensure that patients who qualify for any of our programs utilize them. Depending on the specific circumstances, a patient may be eligible for charity care, discounted care, payment programs, or a combination of the above. Due to these efforts, we believe that amounts written off to bad debt that could qualify as charity care is minimal. |
| Part III, Line 4: | Please see footnote 1 on page 8 of the attached audited financial statements. |
| Part III, Line 8: | Medicare allowable costs for the Medicare cost report are reported in accordance with CMS guidelines using the cost to charge ratio methodology. |
| Part III, Line 9b: | As of 9/30/2011 Monadnock Community Hospital has a written credit and collection policy. Described within that policy are the collection practices and bad debt processes that are followed for patients who are known to qualify for charity care or financial assistance. The Organization maintains a Financial Assistance Program (FAP) database which is maintained by the Social Services Department of MCH. The Patient Financial Services (PFS) staff reference this database for approval status and eligibility amounts, identifying any account(s) where the discount will apply. Internal FAP insurance plans are applied to those accounts and related discount amounts are adjusted in the billing system. Remaining balances are expected to be paid in full by the patient. Payment plans may be requested by the patient and are established by the Financial Grant Coordinator based on the patient's available income and assets. Accounts are annotated to reflect payment arrangements. During bad debt processing, designated staff evaluate accounts listed as collection review for potential bad debt write off. This process includes an examination of account history for indication of FAP application. |
| Part VI, Line 2: | The State of NH, under RSA 7:32-f, requires every healthcare charitable trust, either alone or in conjunction with other healthcare charitable trusts in its community, to conduct a Community Health Needs Assessment to assist in determining the activities to be included in its community benefits plan. The needs assessment process includes consultation with members of the public, community organizations, service providers, and local government officials in the entity's service area to identify and prioritize the community needs that the health care entity can address directly or in collaboration with others. The Community Health Needs Assessment is updated at least every three years, most recently in 2018. In 2007, the Regional Community Benefits Steering Committee was first formed to prepare a single Community Benefits Needs Assessment for the Monadnock Region. The work group consisted of representatives from multiple organizations, including Monadnock Community Hospital. Based on the needs assessment and community engagement process, the priority needs and health concerns of the community MCH serves include access to care - driven by financial barriers and/or availability of primary care, availability of behavioral health care, general socioeconomic issues, and transportation services. This collaboration is continued today, through a similar process for the CHNA. In mid-2018, MCH completed its most recent CHNA and successfully identified and prioritized service gaps in the region. Utilizing a consulting group along with community organizations, the team collaborated to not only identify these gaps but to work together to identify and implement a plan to decrease these service gaps and improve the overall health of the community. Monadnock Community Hospital uses this information to help focus its Community Benefit efforts to meet the priority needs identified in the Community Benefit Plan. In addition, other needs or services not specifically identified in the Community Health Needs Assessment, but addressed under the Organization's Community Benefit Plan include availability of dental or oral health care (via the Organization's Monadnock Healthy Teeth to Toes program which focuses on dental hygiene and care, nutrition, and daily physical activity for children ages kindergarten to third grade) and availability of prescription medication (via the Organization's Medication Bridge program designed to help eligible patients apply for assistance programs that provide free or discounted prescription medications). Pursuant to State of NH RSA 7:32-c-1, a Community Benefits Reporting Form is filed annually with the Office of the Attorney General Charitable Trusts Unit. |
| Part VI, Line 3: | MCH is committed to providing quality healthcare to anyone in need of services, regardless of ability to pay. We understand patients may not have the finances to pay for their healthcare services and medications, and do not want this to prevent anyone from receiving necessary treatment. As part of the Hospital's mission to the communities we serve, we have developed programs to help meet the needs of our patients who meet income eligibility. Through our Financial Assistance and Medication Bridge Programs, we have been providing financial assistance to those qualifying for many years. We reach out to our patients in many different ways to ensure that they are aware that help is available and to guide them through the process. Brochures and signage are posted in high traffic areas and all employees of MCH are informed about the Financial Assistance Program during orientation. When a patient goes through the registration process at the Hospital the staff are trained to inform uninsured or underinsured patients about the Monadnock Community Hospital Financial Assistance and the New Hampshire Health Access programs and that there is assistance available within the Hospital to help with the application process. In addition, any time a patient calls customer service, the representative is trained to help identify and offer support to patients who may require financial assistance. Patients may qualify for free care, discounted care, payment plans or a combination of the above. Assistance is also provided in applying to federal and state programs for those who qualify. |
| Part VI, Line 4: | The Hospital's primary service area consists of 13 towns, including Antrim, Bennington, Dublin, Francestown, Greenfield, Greenville, Hancock, Jaffrey, New Ipswich, Peterborough, Rindge, Sharon, and Temple. The Hospital serves the general population of the primary service area referenced above. |
| Part VI, Line 5: | Monadnock Community Hospital is a critical access hospital located in the Monadnock Region of NH. Our mission is to improve the health and well-being of our community. The Hospital is served by a board of trustees consisting of local citizens active in their community and its organizations. The majority of the board is not employed by the Hospital and consists of local community and business representatives as well as medical staff. Each year, MCH seeks to make the Monadnock Region a healthier place to live by identifying new and changing healthcare needs, then developing a strategy to address some of the most pressing issues. In addition, no one is turned away who is in need of medical care. Our mission is to provide health care for everyone in our community, regardless of their ability to pay. The Hospital is committed to giving back to the community to the greatest extent possible. Monadnock Community Hospital supports thousands of individuals and families with free or reduced-fee services and programs. Our Financial Assistance Program administered by the Social Services Department helps families and individuals in need with access to health care and other available community services such as catastrophic care, fuel assistance, meals on wheels, food banks, and visiting nurses. Other examples of the Hospital's effort to reach our patients beyond traditional hospital services include access to free or reduced cost medications through our Medication Bridge program; educating children on the importance of good oral hygiene through our Monadnock Healthy Teeth program which helps children in preschool through high school to get off to a good start regardless of family access to dental health care; training for community agencies such as local volunteer fire and rescue personnel; offering prevention and wellness education including nutrition, smoking cessation and dealing with stress; providing regular community seminars regarding timely health topics; screenings and clinics for important health issues such as breast cancer; offer behavioral health (substance use & mental health) trainings to the community through Be The Change; and offer space for community organizations to meet, including local support groups. These are just a few of the many areas where we are reaching out to others to assure they are cared for well. |
| Part VI, Line 6: | GraniteOne Health is a non-profit, New Hampshire-based healthcare system consisting of Catholic Medical Center (CMC) in Manchester, Huggins Hospital (HH) in Wolfeboro, and Monadnock Community Hospital (MCH) in Peterborough. GraniteOne Health draws on the resources and expertise of these strong, trusted hospitals to enhance collaboration, strengthen clinical partnerships and meet the health needs of the communities by providing greater access to high-quality care and a seamless patient experience. The organization will enable the hospitals to grow their clinical relationships, build economies of scale, and improve value to patients.Both Huggins and Monadnock have long-standing clinical relationships with CMC in specialty areas such as cardiology and vascular care. GraniteOne allows the hospitals to explore further collaborations in clinical areas as well as other services that could benefit from economies of scale, all while maintaining a seamless patient experience.GraniteOne Health offers access points throughout New Hampshire to advanced clinical services such as open heart surgery, angioplasty, minimally invasive heart valve and vascular surgery, cancer care, comprehensive weight loss management, orthopedics, innovative maternal health services and over 30 other medical and surgical subspecialties. GraniteOne Health gives patients access to high-quality, coordinated care across the continuum of health. |
| Part VI, Line 7, Reports Filed With States | NH |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Town of Peterborough | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Grove Street | AddressLine1Txt |
| City | Peterborough | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03458 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | Government | IRCSectionDesc |
| Cash Grant | $15,000 | CashGrantAmt |
| Purpose Of Grant | Cash contribution for the benefit of the Peterborough Ambulance. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| The Peter L. Gosline Employee Education Scholarship | 5 | $6,000 |
| The Dr. Mark Luedke Memorial Scholarship Fund | 6 | $12,223 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | During the fiscal year ending September 30, 2019, the Hospital made contributions to a governmental entity, the Town of Peterborough. Additionally, during the fiscal year, the Hospital continued to support the Peter L. Gosline Employee Education Scholarship to support professional growth of Hospital employees. Both full and part-time employees are eligible to submit an application. The applicant must be a current Hospital employee in good standing who has been employed at MCH for at least 12 months. The applicant must also be currently enrolled in a degree or certificate program, provide a letter of recommendation from their current Hospital manager, as well provide a copy of their current college transcript. In 2018, the Hospital established the Dr. Mark Luedke Memorial Scholarship Fund in memory of the organization's Radiology Medical Director. The fund is to support clinical education and certification for members of MCH's Radiology Department, and is disbursed with the input of the Director of Radiology, the Chief Nursing Officer, and VP of Human Resources. In 2019, the Hospital continued to contribute to the Luedke Scholarship Fund. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Elizabeth Cooley MD | ||||||||||||||
| Ex-Officio (voting) | $214,765 | $0 | $0 | $0 | $1,290 | $0 | $4,443 | $0 | $19,239 | $0 | $239,737 | $0 | $0 | $0 |
| Shawn Harrington MD | ||||||||||||||
| Ex-Officio (voting) | $419,803 | $0 | $0 | $0 | $1,198 | $0 | $5,500 | $0 | $19,172 | $0 | $445,673 | $0 | $0 | $0 |
| Gregory Kriebel MD | ||||||||||||||
| Ex-Officio (voting) (end 12/18) | $283,873 | $0 | $0 | $0 | $1,488 | $0 | $5,500 | $0 | $20,099 | $0 | $310,960 | $0 | $0 | $0 |
| Fay Migotsky MD | ||||||||||||||
| Ex-Officio (voting) (end 4/19) | $144,380 | $0 | $10,000 | $0 | $2,946 | $0 | $2,549 | $0 | $21,975 | $0 | $181,850 | $0 | $0 | $0 |
| Lara Niemela MD | ||||||||||||||
| Ex-Officio (voting) | $173,478 | $0 | $0 | $0 | $450 | $0 | $3,625 | $0 | $20,652 | $0 | $198,205 | $0 | $0 | $0 |
| Joseph Pepe MD | ||||||||||||||
| Trustee | $0 | $713,027 | $0 | $213,513 | $0 | $40,165 | $0 | $372,862 | $0 | $27,921 | $0 | $1,367,488 | $0 | $0 |
| Alexander Walker Esq | ||||||||||||||
| Trustee | $0 | $421,127 | $0 | $132,968 | $0 | $50,985 | $0 | $156,267 | $0 | $56,238 | $0 | $817,585 | $0 | $0 |
| Cynthia McGuire | ||||||||||||||
| Chief Executive Officer | $264,671 | $0 | $0 | $0 | $21,531 | $0 | $23,000 | $0 | $23,892 | $0 | $333,094 | $0 | $17,500 | $0 |
| Richard D Scheinblum | ||||||||||||||
| VP Finance/CFO | $191,357 | $0 | $0 | $0 | $1,198 | $0 | $3,907 | $0 | $8,484 | $0 | $204,946 | $0 | $0 | $0 |
| Ronald Michalak MD | ||||||||||||||
| Physician | $520,325 | $0 | $0 | $0 | $450 | $0 | $5,500 | $0 | $19,239 | $0 | $545,514 | $0 | $0 | $0 |
| Terrence McNamara DO | ||||||||||||||
| Physician | $431,381 | $0 | $15,996 | $0 | $1,188 | $0 | $5,500 | $0 | $22,531 | $0 | $476,596 | $0 | $0 | $0 |
| William White MD | ||||||||||||||
| Physician | $386,622 | $0 | $15,000 | $0 | $1,980 | $0 | $1,154 | $0 | $18,049 | $0 | $422,805 | $0 | $0 | $0 |
| Robert C Knowles MD | ||||||||||||||
| Physician | $311,278 | $0 | $0 | $0 | $42,004 | $0 | $2,750 | $0 | $16,755 | $0 | $372,787 | $0 | $0 | $0 |
| Michael Lindberg MD | ||||||||||||||
| Physician | $332,294 | $0 | $0 | $0 | $1,980 | $0 | $5,500 | $0 | $17,630 | $0 | $357,404 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Lines 4a-b | 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 2018, 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, $19,551 of compensation is reported in Column B(iii), which represents the vested 2015 contribution of $17,500 and earnings of $2,051. The following individuals take part in a section 457(f) forfeitable nonqualified deferred compensation plan administered by Catholic Medical Center, their employer, which is a related organization. The amounts listed represent calendar year 2018 contributions for many years of service: Joseph Pepe: $351,362 Alexander Walker: $139,767 Robert Knowles, MD, a physician for Monadnock Community Hospital and one of the Hospital's top five highest employees, received severance compensation of $40,962 in the calendar year ending December 31, 2018; Dr. Knowles was termed effectively retired from the Hospital on September 27, 2018. |
| Part I, Line 7 | MCH compensates physicians utilizing productivity targets based on RVU (relative value units). In addition, the Compensation Committee recommends to the full board, annually, the variable pay award that may be issued to the Hospital's CEO. The payment of the award is discretionary and is subject to meeting the pre-determined goals of the Organization. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NHBFA Revenue Bonds Series 2013 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 021304598 | BondIssuerEIN |
| Bond Issued | 2013-01-01 | BondIssuedDt |
| Issue Price | $27,240,000 | IssuePriceAmt |
| Purpose | refinance existing Series 2007 and 2009 bonds | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $27,240,000 | TotalProceedsAmt |
| Refunding Escrow | $27,057,466 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $182,534 | IssuanceCostsFromProceedsAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | Yes (1) | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule K, Part III, Line 9, Part IV, line 7 and Part V: | FormAndLineReferenceDesc |
| Explanation | Although formal policies are not in place in regards to the remediation of our bond, the monitoring requirements of section 148, and procedures to ensure that violations are timely identified and corrected, Mondanock Community Hospital has compliance checks in place that substantiate these requirements. Below is a list of all compliance checks that Monadnock Community Hospital has in place to monitor the 2013 Bond Issue: 1. Covenant calculations performed monthly as part of the Financial Scorecard preparation which is reviewed by the MCH Board of Trustees; 2. Covenant calculations are performed for each quarter and reported to the bond issuer, TD Bank; 3. Covenant certificate is signed each quarter by the CFO and reported to the bond issuer, TD Bank; 4. Financial statements and statistical reports are sent to the bond issuer, TD Bank, on a quarterly basis; 5. Annual Operating and Capital budgets are reported to the bond issuer, TD Bank; 6. A No Event of Default certificate is signed by the CFO annually and reported to the bond issuer, TD Bank; 7. Annual Audited Financial statements are reported to the bond issuer, TD Bank. Each of these items that are reported to TD Bank has a specific deadline for completion as outlined in the bond documents. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Peter Cerroni | |||
| Wife of Board Member | $38,658 | Peter Cerroni serves as a trustee on the Hospital's board of directors. Peter Cerroni's spouse is also employed by Monadnock Community Hospital. She receives wages of $15,772, deferred compensation of $388 and nontaxable benefits of $22,498, for a total of $38,658 in compensation and is consistent with employee compensation for all employees at similar levels at the Hospital. | 0 |
| Michael Shea | |||
| Lessor of Rental Property | $134,289 | Michael Shea serves as the Vice Chair 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 ($107,727) as well as payments for property taxes and common area maintenance. | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part IV: | FormAndLineReferenceDesc |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $60,424 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Active Market Value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | Yes (1) | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 32b: | FormAndLineReferenceDesc |
| Explanation | The Hospital uses its third party investment broker to process gifts of publicly traded securities. Donations of such securities are sold as soon as administratively possible. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Michael Shea, who serves as the Vice Chair on the Hospital's board of directors, is the president and part owner of Belletetes, Inc., a contracting and building-supplies company. James Callahan, Esq., who serves as the Secretary on the Hospital's board of directors, is engaged by Belletetes as the company's corporate attorney. Therefore, Mr. Shea and Mr. Callahan share a business relationship. |
| Form 990, Part VI, Section A, line 6 | The sole Member of MCH shall be GraniteOne Health, a New Hampshire voluntary corporation that is exempt from taxation under section 501(c)(3) of the Internal Revenue Code. |
| Form 990, Part VI, Section A, line 7a | GraniteOne Health shall elect the elected members of MCH's Board of Trustees who are nominated as set forth in Article II of MCH's governing documents. GraniteOne Health shall also have the powers reserved to it as described in the following narrative for Form 990, Part VI, Line 7b. Vacancies on the Board of Elected Trustees occurring prior to the end of any Elected trustee's term shall be elected by GraniteOne Health from nominations by either vote of the Board at a meeting of the Board, for which notice has been given of the nomination process, or by GraniteOne Health if the vacancy is from the group of Elected Trustees nominated by GraniteOne Health. |
| Form 990, Part VI, Section A, line 7b | The following actions initiated by MCH shall require GraniteOne Health's approval: a. Adoption of the annual capital and operating budgets, provided that the expenditure of any of the cash reserves, board-designated reserves, surplus assets and other assets held by MCH on the Affiliation Date and recorded on MCH's financial statements as unrestricted assets, as well as certain parcels of real estate not required for the operation of MCH (the "Pre-Affiliation Assets") contemplated by such budgets and proposed in accordance with those powers reserved to MCH, will not be subject to the approval of GraniteOne; b. Approval of any strategic plans or material nonclinical programming and marketing plans, including material modifications thereof; c. Authorization of debt incurred, assumed, or guaranteed by the hospital in excess of Five Hundred Thousand Dollars ($500,000.00), other than as provided for in any approval annual capital or operating budget; d. Authorization of any material acquisition, disposition, formation, organization or investment by MCH of or in any other corporation, partnership, limited liability company, other entity or joint venture, other than an acquisition funded with Pre- Affiliation Assets proposed in accordance with those powers reserved to MCH will not be subject to the approval of GraniteOne; e. Authorization of the sale, disposition, mortgage, or encumbrance of any assets dedicated to the operations of MCH involving assets of Five Hundred Thousand Dollars ($500,000.00) or more, with the exception of real estate identified prior to the Affiliation; f. Authorization of MCH to enter into any merger, consolidation or joint venture; or to sell or dispose of substantially all of the assets of MCH or any of its respective subsidiaries; or to create or acquire any subsidiary organization; g. Authorization of MCH to institute any bankruptcy, insolvency or reorganization proceedings for itself or any subsidiary; h. Authorization of a capital investment by MCH or any of its subsidiaries in any individual entity or project in the form of cash or either tangible or intangible property in excess of Five Hundred Thousand Dollars ($500,000.00), except as provided in any approved annual capital or operating budget or to the extended funded by the Restricted Assets or the Pre-Affiliation Assets; i. Authorization to develop, implement or terminate clinical programs and clinical procedures by MCH or its subsidiaries; j. The amendment of the Articles of Agreement or Bylaws of MCH or its subsidiaries to the extent that it would (a) impact the Reserved Powers; or (b) reasonably be expected to have a material strategic, competitive or financial impact on the System or any of its members; and k. The MCH Board of Trustees' appointment or reappointment of the MCH CEO and the determination of the CEO's compensation. |
| Form 990, Part VI, Section B, line 11b | The Hospital's Form 990 is prepared with assistance by an independent public accounting firm. A draft of the Form 990 is initially reviewed in detail by key finance employees. Thereafter, the final draft is made available to the full board prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | On 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 15 | The 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 19 | Monadnock 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 Compensation | The 2018 compensation reported for Dr. Cooley, Dr. Kriebel, Dr. Harrington, Dr. Niemela, and Dr. Migotsky was paid by Monadnock Community Hospital for their services as physicians. No part of their compensation was remuneration for their services as an ex-officio voting members of MCH's Board of Trustees. |
| Form 990, Part XI, line 9: | Change in fair value of interest rate swap agreements -1,851,185. Change in perpetual trust 42,139. |
| Form 990, Part XI, Line 2c: Audit Review Process | The 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 9/30/18 and 9/30/19. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Alliance Ambulatory Services | |||||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 020519436 | Ambulatory Surgical Center | NH | 501(c)(3) | Line 10 | CMC Healthcare System | 0 | |
| Alliance Health Services | |||||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 611508839 | Practices | NH | 501(c)(3) | Line 10 | CMC Healthcare System | 0 | |
| Alliance Resources | |||||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 020398138 | Real Estate | NH | 501(c)(3) | Line 12b, II | CMC Healthcare System | 0 | |
| Catholic Medical Center | |||||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 020315693 | Hospital | NH | 501(c)(3) | Line 3 | GraniteOne Health | 0 | |
| CMC Healthcare System | |||||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 010568516 | Parent | NH | 501(c)(3) | Line 12b, II | 0 | N/A | |
| CMC Physician Practice Associates | |||||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 020460245 | Practices | NH | 501(c)(3) | Line 10 | CMC Healthcare System | 0 | |
| GraniteOne Health | |||||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 814663563 | Supporting Organization | NH | 501(c)(3) | Line 12a, I | 0 | N/A | |
| Huggins Hospital | |||||||||||
| 240 South Main Street | Wolfeboro | NH | 03894 | 030223332 | Hospital | NH | 501(c)(3) | Line 3 | GraniteOne Health | 0 | |
| Monadnock Health Services - INACTIVE | |||||||||||
| 452 Old Street Road | Peterborough | NH | 03458 | 020420789 | Inactive | NH | 501(c)(3) | Line 12a, I | Monadnock Community Hospital | Yes (1) | |
| St Peter's Home | |||||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 020222228 | Day Care Services | NH | 501(c)(3) | Line 10 | CMC Healthcare System | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Alliance Urgent Services | |||||||
| 100 McGregor Street | Manchester | NH | 03102 | 831238167 | Health Care Services | NH | N/A |
| Bedford Ambulatory Surgical Center LLC | |||||||
| 11 Washington Place | Bedford | NH | 03110 | 020519727 | Surgical Center | NH | N/A |
| NH Value Care ACO LLC | |||||||
| 100 McGregor Street | Manchester | NH | 03102 | 832029076 | Health Care Services | NH | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Alliance Enterprises | |||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 020386795 | Real Estate | NH | N/A | C | 0 |
| Doctors' Medical Association Inc | |||||||||
| 100 McGregor Street | Manchester | NH | 03102 | 020340690 | Medical Office Building | NH | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments