SPEARE MEMORIAL HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- SPEARE MEMORIAL HOSPITAL (EIN 02-0226774)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201941349349308379
- Schema version
- 2017v2.3
- 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 O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-14T15:34:24-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020226774 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Speare Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPEA | BusinessNameControlTxt |
| Phone | 6035361120 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 16 Hospital Road | AddressLine1Txt |
| City | Plymouth | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03264 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Michelle McEwen | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6035361120 | PhoneNum |
| Signature | 2019-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne CPA | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2019-05-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.49.157.66 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-14 | IPDt |
| IP Tm | 14:45:07 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | E86B87CE19A618452E7D988FD4F1BB89485416DA | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BFB386403C9EAE7FF660C386334FC3E1098CE7FC | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Michelle McEwen | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 16 Hospital Road | AddressLine1Txt |
| City | Plymouth | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03264 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $62,879,113 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.spearehospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1899 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | To provide inpatient, outpatient, and physician health care services | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 500 | TotalEmployeeCnt |
| Total Volunteers | 59 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $6,112 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $632,345 | PYContributionsGrantsAmt |
| CY Contributions Grants | $629,914 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $52,655,359 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $59,977,942 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,677,460 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,559,817 | CYInvestmentIncomeAmt |
| PY Other Revenue | $191,973 | PYOtherRevenueAmt |
| CY Other Revenue | $88,994 | CYOtherRevenueAmt |
| PY Total Revenue | $55,157,137 | PYTotalRevenueAmt |
| CY Total Revenue | $62,256,667 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $108,538 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $303,422 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,974,652 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,993,804 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $121,286 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,047,190 | PYOtherExpensesAmt |
| CY Other Expenses | $25,866,552 | CYOtherExpensesAmt |
| PY Total Expenses | $53,130,380 | PYTotalExpensesAmt |
| CY Total Expenses | $61,163,778 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,026,757 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,092,889 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $79,039,689 | TotalAssetsBOYAmt |
| Total Assets EOY | $72,660,085 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $36,028,588 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,558,910 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $43,011,101 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $44,101,175 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To maintain a hospital and other such institutions within the state of New Hampshire, with facilities that include medical services to provide for the diagnosis and treatment of patients that may require inpatient, outpatient, emergency care and other pursuits designed to promote the general health of the community. SMH does not discriminate relative to race, religion or national origin, ability to pay and will assure that all patients receive the same level of care through quality assessment monitoring and improvement activities. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $54,943,115 | ExpenseAmt |
| Grant | $303,422 | GrantAmt |
| Revenue | $59,977,942 | RevenueAmt |
| Desc | SMH is a 25 bed acute-care hospital that provides inpatient and outpatient services to the surrounding community. | Desc |
| Total Program Service Expenses | $54,943,115 | 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 | Yes (1) | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | 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 | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 87 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 500 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Travis Boucher | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6035361120 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 16 Hospital Road | AddressLine1Txt |
| City | Plymouth | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03264 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Patrick Miller | |||||||||
| Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Kevin Young MD | |||||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Robert Maloney | |||||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Quentin Blaine | |||||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Lisa Baker | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Julie Bernier | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Robin Fisk | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Jeannie Forrester | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Walter Johnson | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sandra Jones | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Elizabeth Kleiner | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Kenneth G Kochien | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Tom Myrick | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Nancy Puglisi | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Alison Ritz | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Margaret Turner | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Bruce Wiggett | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Michelle McEwen | |||||||||
| CEO | 40.00 | Yes (X) | Yes (X) | $295,770 | $0 | $52,414 | 1.00 | ||
| Sam Brickley II | |||||||||
| Past Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.00 | ||
| Ronda Kilanowski | |||||||||
| Past Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Thomas Lenkowski | |||||||||
| CFO | 40.00 | Yes (X) | $189,520 | $0 | $31,420 | 1.00 | |||
| Joseph Ebner MD | |||||||||
| CMO | 40.00 | $241,914 | $0 | $50,205 | Yes (X) | ||||
| Andrew Seefeld MD | |||||||||
| ER Physician | 40.00 | $465,984 | $0 | $53,065 | Yes (X) | ||||
| Joseph Casey MD | |||||||||
| General Surgeon | 40.00 | $514,765 | $0 | $71,872 | Yes (X) | ||||
| Steve Danosi MD | |||||||||
| ER Physician | 40.00 | $597,797 | $0 | $66,791 | Yes (X) | ||||
| Victor Gennaro MD | |||||||||
| Orthopedic Surgeon | 40.00 | $496,250 | $0 | $69,502 | Yes (X) | ||||
| Ernest Hanowell | |||||||||
| General Surgeon | 40.00 | $376,068 | $0 | $33,809 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,178,068 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $429,078 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 42 | 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 |
|---|---|---|---|---|---|
| Asquam Community Health | |||||
| 80 Highland Street | Laconia | NH | 03246 | Health Services | $2,330,273 |
| Plymouth Regional Rehab Services | |||||
| 790 Lake Street | Bristol | NH | 032224548 | Rehabilitation Mgmt | $828,522 |
| Medical Reimbursement Specialists | |||||
| 19 Pleasant Street Ste C | Bristol | NH | 03222 | Coding | $202,033 |
| Professional Placement Resources | |||||
| 333 1st St No Ste 200 | Jacksonville Beach | FL | 32250 | Temporary Staffing | $123,437 |
| Kleen Inc | |||||
| 1 Foundry Street | Lebanon | NH | 03766 | Laundry Services | $105,044 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $629,914 | AllOtherContributionsAmt |
| Total Contributions | $629,914 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Patient Service Revenue | 624100 | $131,484,434 | $131,484,434 | |
| Other Operating Revenue | 621400 | $2,121,719 | $1,971,548 | $150,171 |
| Provision for Bad Debts | 621410 | -$4,761,218 | -$4,761,218 | |
| Contractual/Char. Adj. | 624100 | -$68,866,993 | -$68,866,993 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $59,977,942 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $556,998 | TotalRevenueColumnAmt |
| Exclusion | $556,998 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $65,267 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $65,267 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,267 | TotalRevenueColumnAmt |
| Exclusion | $65,267 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,356,967 | SecuritiesAmt |
| Other | $248,865 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $270,202 | SecuritiesAmt |
| Other | $332,811 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,086,765 | SecuritiesAmt |
| Other | -$83,946 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,002,819 | TotalRevenueColumnAmt |
| Exclusion | $1,002,819 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $55,630 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $19,433 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,197 | TotalRevenueColumnAmt |
| Exclusion | $36,197 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Bad Debt Recovery | 900099 | $6,146 | $6,146 |
| Loss on Inv. in Subsidiaries | 900099 | -$18,616 | -$18,616 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$12,470 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,256,667 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $59,827,771 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,798,982 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299,602 | TotalAmt |
| Program Services | $299,602 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,820 | TotalAmt |
| Program Services | $3,820 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $861,243 | TotalAmt |
| Management And General | $861,243 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,406,368 | TotalAmt |
| Program Services | $25,348,348 | ProgramServicesAmt |
| Management And General | $2,001,753 | ManagementAndGeneralAmt |
| Fundraising | $56,267 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,492,426 | TotalAmt |
| Program Services | $1,396,875 | ProgramServicesAmt |
| Management And General | $92,450 | ManagementAndGeneralAmt |
| Fundraising | $3,101 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,597,055 | TotalAmt |
| Program Services | $3,309,517 | ProgramServicesAmt |
| Management And General | $280,192 | ManagementAndGeneralAmt |
| Fundraising | $7,346 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,636,712 | TotalAmt |
| Program Services | $1,474,678 | ProgramServicesAmt |
| Management And General | $158,761 | ManagementAndGeneralAmt |
| Fundraising | $3,273 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,392 | TotalAmt |
| Program Services | $166,137 | ProgramServicesAmt |
| Management And General | $17,886 | ManagementAndGeneralAmt |
| Fundraising | $369 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,846 | TotalAmt |
| Management And General | $30,846 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,763 | TotalAmt |
| Management And General | $76,763 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,359 | TotalAmt |
| Management And General | $109,359 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,605,640 | TotalAmt |
| Program Services | $5,951,682 | ProgramServicesAmt |
| Management And General | $640,747 | ManagementAndGeneralAmt |
| Fundraising | $13,211 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,876 | TotalAmt |
| Program Services | $144,949 | ProgramServicesAmt |
| Management And General | $15,605 | ManagementAndGeneralAmt |
| Fundraising | $322 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,046,298 | TotalAmt |
| Program Services | $1,843,714 | ProgramServicesAmt |
| Management And General | $198,491 | ManagementAndGeneralAmt |
| Fundraising | $4,093 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,521,781 | TotalAmt |
| Program Services | $2,272,124 | ProgramServicesAmt |
| Management And General | $244,613 | ManagementAndGeneralAmt |
| Fundraising | $5,044 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,769,527 | TotalAmt |
| Program Services | $1,594,344 | ProgramServicesAmt |
| Management And General | $171,644 | ManagementAndGeneralAmt |
| Fundraising | $3,539 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,458 | TotalAmt |
| Program Services | $76,097 | ProgramServicesAmt |
| Management And General | $8,192 | ManagementAndGeneralAmt |
| Fundraising | $169 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,360 | TotalAmt |
| Program Services | $77,810 | ProgramServicesAmt |
| Management And General | $8,377 | ManagementAndGeneralAmt |
| Fundraising | $173 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,079 | TotalAmt |
| Program Services | $333,441 | ProgramServicesAmt |
| Management And General | $35,898 | ManagementAndGeneralAmt |
| Fundraising | $740 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,843,942 | TotalAmt |
| Program Services | $2,562,392 | ProgramServicesAmt |
| Management And General | $275,862 | ManagementAndGeneralAmt |
| Fundraising | $5,688 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $603,390 | TotalAmt |
| Program Services | $543,654 | ProgramServicesAmt |
| Management And General | $58,529 | ManagementAndGeneralAmt |
| Fundraising | $1,207 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $4,949,624 | $4,459,364 | $480,358 | $9,902 |
| Medicaid Enhancement Ta | $2,367,999 | $2,133,567 | $229,696 | $4,736 |
| Miscellaneous Expenses | $816,582 | $735,989 | $78,964 | $1,629 |
| Food Costs | $238,636 | $215,011 | $23,148 | $477 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,163,778 | TotalAmt |
| Program Services | $54,943,115 | ProgramServicesAmt |
| Management And General | $6,099,377 | ManagementAndGeneralAmt |
| Fundraising | $121,286 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,734,091 | BOYAmt |
| EOY | $1,229,428 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,642,415 | BOYAmt |
| EOY | $8,533,324 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,037,105 | BOYAmt |
| EOY | $9,535,876 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $321,611 | BOYAmt |
| EOY | $342,155 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $891,649 | BOYAmt |
| EOY | $933,725 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,101,874 | BOYAmt |
| EOY | $761,343 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $53,377,900 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $33,891,165 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,400,389 | BOYAmt |
| EOY | $19,486,735 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,110,710 | BOYAmt |
| EOY | $24,364,520 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $949,145 | BOYAmt |
| EOY | $942,166 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,845,700 | BOYAmt |
| EOY | $6,525,813 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,039,689 | BOYAmt |
| EOY | $72,660,085 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,073,506 | BOYAmt |
| EOY | $6,993,154 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,093,175 | BOYAmt |
| EOY | $16,127,695 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,978 | BOYAmt |
| EOY | $43,174 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,804,929 | BOYAmt |
| EOY | $5,394,887 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,028,588 | BOYAmt |
| EOY | $28,558,910 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,315,136 | BOYAmt |
| EOY | $43,483,488 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,836 | BOYAmt |
| EOY | $20,976 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $593,129 | BOYAmt |
| EOY | $596,711 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,011,101 | BOYAmt |
| EOY | $44,101,175 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,039,689 | BOYAmt |
| EOY | $72,660,085 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,092,889 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$5,881 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $3,066 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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
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 | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $8,802 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $8,802 | 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 | The Organization pays dues to various organizations, a portion of which is attributable to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Collection Used Pub Exhibition | Yes (X) | CollectionUsedPubExhibitionInd |
| Solicited Assets Sale | 0 | SolicitedAssetsSaleInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $270,277 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $514 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $270,791 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $270,206 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $71 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $270,277 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $270,206 | BeginningYearBalanceAmt |
| End Year Balance | $270,206 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $270,207 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $16 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $17 | OtherExpendituresAmt |
| End Year Balance | $270,206 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $270,204 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $8 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5 | OtherExpendituresAmt |
| End Year Balance | $270,207 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | 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 | $855,030 | OtherCostOrOtherBasisAmt |
| Book Value | $855,030 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,546,453 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,310,646 | DepreciationAmt |
| Book Value | $14,235,807 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,710,509 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,881,566 | DepreciationAmt |
| Book Value | $3,828,943 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,265,908 | OtherCostOrOtherBasisAmt |
| Depreciation | $698,953 | DepreciationAmt |
| Book Value | $566,955 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,486,735 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from Related Party | $1,341,043 |
| Beneficial Interest in Perpetual Trusts | $325,920 |
| Investment in Subsidiaries | -$34,853 |
| Deferred System Development Costs | $4,893,703 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,525,813 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Estimated Third-Party Payor Settlements | $7,580,244 |
| Investment in Subsidiary - Boulder Point | -$2,185,357 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,394,887 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part III, Line 4: | The Hospital's artwork is intended to provide artistic pleasure and a calming appearance for patients of the Hospital to enjoy during their stay. |
| Part V, Line 4: | The intended use of the endowment fund is to provide long term operational support for the mission of the Organization. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $55,630 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $55,630 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $1,960 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $3,664 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $5,600 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $7,155 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $1,054 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $55,630 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $55,630 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $1,960 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $3,664 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $5,600 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $7,155 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,054 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $19,433 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $36,197 | 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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 225.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $2,546,109 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,546,109 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04160 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,209,093 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,635,536 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,573,557 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04210 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,755,202 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,635,536 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,119,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08370 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $945,174 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $92,035 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $853,139 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01390 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $90,426 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $90,426 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,035,600 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $92,035 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $943,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01540 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,790,802 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,727,571 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,063,231 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09910 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,304 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,304 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,304 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,304 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,973,954 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $30,846,359 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $34,930,417 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,084,058 | 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 |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 Plymouth Regional Rehabilitation Services | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Physical Therapy, Occupational Therapy & Medical Fitness | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.50000 | OrgProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Speare Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 16 Hospital Road | AddressLine1Txt |
| City | Plymouth | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03264 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.spearehospital.com | WebsiteAddressTxt |
| State License | 6283 | 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 | Speare Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 |
| 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 |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.spearehospital.com | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.pemibakercommunityhealth.org & www.midstatehealth.org | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://spearehospital.com/about-speare/community-benefits/ | StrategyWebsiteURLTxt |
| 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 | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 225.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://spearehospital.com/patients-visitors/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://spearehospital.com/patients-visitors/financial-assistance/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://spearehospital.com/patients-visitors/financial-assistance/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Speare Memorial Hospital | Part V, Section B, Line 5: Speare took into account input from persons who represent the community served by the hospital facility when conducting the 2017-2020 Community Health Needs Assessment (CHNA) of the Central New Hampshire region. For the purpose of the assessment, the geographic area of interest was 18 municipalities comprising the Central New Hampshire Public Health Region with a total resident population of 30,039, and served by the member agencies of the Central New Hampshire Health Partnership.Persons consulted who represent the community include individual community members and stakeholders. The Community Health Needs Assessment Survey yielded 409 individual responses of which 88% were residents of towns within the primary service area. Survey respondents were 74.8% female and 29.5% age 65 years or more. Key stakeholder respondents yielded:- Community member / Volunteer (13 respondents)- Business (10)- Primary Health Care (9)- Education / Youth Services (8)- Municipal / County Government (7)- Public Health (6)- Faith organization (6) - Fire / Emergency Medical Service (5)- Public Safety / Law / Justice (5)- Human Service / Social Service (5)- Mental Health / Behavioral Health (3)- Home Health Care (2)- Civic / Cultural Organization (2)- Medical Sub-Specialty (1) |
| Speare Memorial Hospital | Part V, Section B, Line 6b: Speare's CHNA was conducted in partnership with the Central New Hampshire Health Partnership. Community Health Needs Assessment Partners:- Community Action Program Belknap-Merrimack Counties - Communities for Alcohol- and Drug-free Youth (CADY) - Lakes Region Mental Health Services - Mid-State Health Center - Newfound Area Nursing Association - Pemi-Baker Community Health - Speare Memorial Hospital - Additional assistance from Whole Village Family Resource Center and Plymouth Regional Senior Center |
| Speare Memorial Hospital | Part V, Section B, Line 11: Speare is addressing the significant needs identified in the CHNA as follows:- Access to affordable health care services and insurance - Speare provides:o Subsidized Health Services o Primary Care Clinico Primary Care Grantso Prescription Assistance Programo Breast Cancer Screeningo Financial Counseling o Government-Sponsored Health Care o Medicare Costs exceeding reimbursement o Charity Care o Free & Discounted Health Care Services o School Dental Program- Working in partnership with SAU 48, Plymouth Pediatrics, Plymouth OB/GYN and the Pemi Bridge House, Speare provides free dental screenings and fluoride varnish applications; dental cleanings and sealants to school-aged children on a sliding fee scale, to "at risk" pregnant women and the homeless; restorative care for children who are in pain from decay and infection; and case management and financial assistance are available to those in need. - Access to mental health services - Speare provides:o A psychiatrist to meet with patients of Speare Primary Care as prescribed by their providers.- Access to healthy foods and opportunities for active living - Speare provides:o Community Health Education- Diabetes education and support- Nutrition education at women's health evento 5-2-1-0 Healthy NH Initiativeo Shamrock Shuffle 5k fun run/walk/strollAdditionally Speare is an active partner in the Central New Hampshire Public Health Advisory Council, Central New Hampshire Health Partnerships, Integrated Delivery Network 5, Central New Hampshire Chamber of Commerce, and the Central New Hampshire MACE/CERT. Most of these organizations work towards meeting the needs identified in the CHNA.Speare 's financial contributions to several social service agencies supports initiatives aimed at addressing those community needs that do not fall directly within the scope of Speare's mission. These needs include: alcohol and drug use prevention, treatment and recovery, domestic violence and childhood trauma, senior services including assisted living or long term care services, and access to transportation. |
| Speare Memorial Hospital | Part V, Section B, Line 16j: The application process is outlined in patient admission packets as well as monthly statements. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | An accounting system was used to calculate the amounts reported in this table. The accounting system addresses all patient segments. A cost-to-charge ratio was used. Community Relations programs and charity care given to uninsured patients were also considered in calculating amounts disclosed. |
| Part II, Community Building Activities: | Speare further promotes community health with its Community Education and Outreach programs, as well as through digital and traditional media.The backbone of Speare's Community Outreach and Education program consists of our major events: Diabetes Day, Senior Resource Fair, It's a Guy Thing men's health event, Shamrock Shuffle 5K Health Walk/Run, and Wine, Women & Wisdom women's health event. Each of these focuses on particular health issues identified by the CHNA. Programs identified by the community through ongoing engagement outside the formal assessment process include diabetes education and support, childbirth classes, car seat program, and oncology outreach and education.Additionally, Speare donates medication to community non-profit agencies.Speare uses its online and social media channels and print newsletter to connect our community with information about various health and wellness topics, specific to Speare initiatives and in general, to create discussion and information sharing. |
| Part III, Line 4: | Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable. Credit is extended without collateral.In evaluating the collectibility of accounts receivable, the Organization analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Organization analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Organization records a provision for bad debts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or on the basis of discounted rates, by State law, or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts. |
| Part III, Line 9b: | Speare Memorial Hospital has both a collections policy, and a charity care policy that describes charity eligibility and the steps to be completed before a patient's account is written off to bad debt. |
| Part VI, Line 2: | In additional to the research described in Part V - Section C, Speare has ongoing discussions with key community leaders about the identified needs, how they are being addressed and other opportunities for action. These include our legislators, municipal leaders, police and fire, local health departments, Plymouth State University, community centers and area clergy. |
| Part VI, Line 3: | Patients are educated at time of registration or through educational materials that are distributed through the hospital's website or by community outreach. Speare Memorial Hospital is a member of a state-wide community health network that provides assistance, support, and education relating to eligibility assistance. |
| Part VI, Line 4: | Speare Memorial Hospital best defines its community as those towns comprising South Eastern Grafton County based on our patient origin information and market share data published by the New Hampshire Hospital Association.Speare Memorial Hospital is located in the mountain and lakes region of New Hampshire and primarily serves constituents in Grafton County. Grafton County population size is approximately 86,000 within its 40 distinct municipalities. Its service area includes 17 towns with an approximate total population of 30,000. |
| Part VI, Line 5: | Speare further promotes community health with its Community Education and Outreach program, as well as through online and social media.The backbone of Speare's Community Outreach and Education program consisted of four major events: Senior Resource Fair, It's a Guy Thing men's health event, Shamrock Shuffle 5K Health Walk/Run, and Wine, Women & Wisdom women's health event. Each of these focused on/drilled down into specifics on particular health issues identified by the community through ongoing engagement outside the formal assessment process.Additionally, Speare used its online and social media channels to connect our community with information about various health and wellness topics, specific to Speare initiatives and in general, to create discussion and information sharing. |
| 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 (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| Communities for Drug and Alcohol Free Youth (CADY) | ||||||||
| 94 Highland Street | Plymouth | NH | 03264 | 571212859 | 501(c)(3) | $25,000 | FMV | Educate, engage and empower our schools and communities to prevent and reduce youth alcohol, tobacco, and other drug use and to promote healthy environments and promising futures. |
| Grafton County Senior Citizens Council | ||||||||
| PO Box 433 | Lebanon | NH | 03766 | 237248316 | 501(c)(3) | $10,000 | FMV | To develop, strengthen, and provide programs and services that support the health, dignity and independence of older adults and adults with disabilities living in our communities. |
| Lakes Region Mental Health Center | ||||||||
| 40 Beacon Street East | Laconia | NH | 03246 | 020272138 | 501(c)(3) | $13,967 | FMV | Lakes Region Mental Health Center is the community leader providing quality, accessible and integrated mental and physical health services, delivered with dedication and compassion. |
| Transport Central | ||||||||
| 258 Highland Avenue | Plymouth | NH | 03264 | 208463821 | 501(c)(3) | $8,175 | FMV | To initiate and provide dispatched and coordinated volunteer driver services to our residents who need transportation. |
| Foundation for Healthy Communities | ||||||||
| 125 Airport Road | Concord | NH | 03301 | 200275078 | 501(c)(3) | $194,256 | FMV | Support Medicaid Expansion |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Organization only pays grants to other Section 501(c)(3) organizations. Therefore, no additional monitoring is deemed necessary. Other assistance payments are reviewed on a periodic basis. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Michelle McEwen | ||||||||||||||
| CEO | $260,940 | $0 | $25,500 | $0 | $9,330 | $0 | $21,860 | $0 | $30,554 | $0 | $348,184 | $0 | $0 | $0 |
| Thomas Lenkowski | ||||||||||||||
| CFO | $187,680 | $0 | $0 | $0 | $1,840 | $0 | $16,324 | $0 | $15,096 | $0 | $220,940 | $0 | $0 | $0 |
| Joseph Ebner MD | ||||||||||||||
| CMO | $241,632 | $0 | $0 | $0 | $282 | $0 | $19,751 | $0 | $30,454 | $0 | $292,119 | $0 | $0 | $0 |
| Andrew Seefeld MD | ||||||||||||||
| ER Physician | $465,834 | $0 | $0 | $0 | $150 | $0 | $28,077 | $0 | $24,988 | $0 | $519,049 | $0 | $0 | $0 |
| Joseph Casey MD | ||||||||||||||
| General Surgeon | $507,430 | $0 | $0 | $0 | $7,335 | $0 | $40,103 | $0 | $31,769 | $0 | $586,637 | $0 | $0 | $0 |
| Steve Danosi MD | ||||||||||||||
| ER Physician | $592,204 | $0 | $3,900 | $0 | $1,693 | $0 | $40,950 | $0 | $25,841 | $0 | $664,588 | $0 | $0 | $0 |
| Victor Gennaro MD | ||||||||||||||
| Orthopedic Surgeon | $494,557 | $0 | $0 | $0 | $1,693 | $0 | $39,943 | $0 | $29,559 | $0 | $565,752 | $0 | $0 | $0 |
| Ernest Hanowell | ||||||||||||||
| General Surgeon | $375,812 | $0 | $0 | $0 | $256 | $0 | $30,382 | $0 | $3,427 | $0 | $409,877 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7 | FormAndLineReferenceDesc |
| Explanation | Dr. Danosi received a bonus which represented the quality performance for the results of the 2014 ED Quality dashboard period. This bonus is for collaboration and cooperation of identifying and pursuing ED goals that aligned with the organizational priorities. Compensation for the CEO is determined via a compensation committee, compensation survey or study, comparison of other organizations, Form 990 information, board approval and written employment contract. | ExplanationTxt |
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 | New Hampshire Health And Education Facilities Authority | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 020279866 | BondIssuerEIN |
| Bond Issued | 2012-12-07 | BondIssuedDt |
| Issue Price | $21,100,000 | IssuePriceAmt |
| Purpose | To pay off and provide advanced refunding for 2010 and 2004 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 |
| Retired | $4,827,541 | RetiredAmt |
| Total Proceeds | $21,100,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $209,815 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $4,566,977 | CapitalExpendituresAmt |
| Other Spent Proceeds | $16,323,208 | OtherSpentProceedsAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | Yes (1) | AdvanceRefundingInd |
| 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 |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | 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 | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | The rehabilitation department is managed by Plymouth Regional Rehabilitation Services. Dietary services are managed by Morrison Healthcare Managment Specialist Inc. The department of Wound Care and Hyperbaric is managed by Diversified Clincial Services of Jacksonville, FL. |
| Form 990, Part VI, Section A, line 6 | The Association consists of all persons who are members at the time of the adoption of the bylaws and other persons who may be elected. |
| Form 990, Part VI, Section A, line 7a | A candidate for membership may be elected by a majority vote of members present at any annual or special meeting of the Association provided that a quorum is present. Alternately, a candidate for membership may be elected by a two-thirds vote of the Board of Directors present at any regular or special meeting of the Board provided that a quorum is present. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is presented to the organization's management and board for review and acceptance at the time of filing. |
| Form 990, Part VI, Section B, line 12c | Speare Memorial Hospital has a set of procedures to follow to avoid the possibility that those in positions of authority over the Organization may receive an inappropriate benefit. Any possible conflict of interest on the part of any member of the Board, Officer or Employee of the Organization, shall be disclosed in writing to the Board and made a matter of record through an annual procedure and also when the interest involves a specific issue before the Board. |
| Form 990, Part VI, Section B, line 15a | Compensation for the CEO is determined via a compensation committee, compensation survey or study, comparison of other organizations 990 information, board approval and written employment contract. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. |
| Form 990, Part IX, line 11g | Other Fees: Program service expenses 5,951,682. Management and general expenses 640,747. Fundraising expenses 13,211. Total expenses 6,605,640. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Speare Memorial Hospital 16 Hospital Road Plymouth, NH 03264 EIN 02-0226774 Speare Memorial Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
| Form 990, Part XI, line 9: | Change in Beneficial Interest in Perpetual Trusts 3,066. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Speare Memorial At Boulder Point | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Boulder Point Drive | AddressLine1Txt |
| City | Plymouth | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03264 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263888977 | EIN |
| Primary Activities | Real Estate | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 12a, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Speare Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Speare Health Network LLC | ||||||||||||
| 16 Hospital Road | Plymouth | NH | 03264 | 043372339 | Physician/Hospital Organization | NH | Speare Memorial Hospital | C | $8 | $20,728 | 0.50000 | 0 |
| Speare Health Ventures Inc | ||||||||||||
| 19 Avery Street | Plymouth | NH | 03264 | 020366565 | Healthcare Services | NH | Speare Memorial Hospital | C | $630,191 | $1,220,725 | 1.00000 | 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 | Yes (1) | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Speare Health Venture Inc | ||
| D | $294,155 | FMV |
| Speare Memorial At Boulder Point | ||
| K | $766,358 | FMV |
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