EXETER HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- EXETER HOSPITAL INC (EIN 22-2674014)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-07
- IRS object ID
- 201712199349300706
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-07T08:24:14-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | 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 LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 650 ELM STREET SUITE 302 | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222674014 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Exeter Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EXET | BusinessNameControlTxt |
| Phone | 6035806695 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Alumni Drive | AddressLine1Txt |
| City | Exeter | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03833 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN J O'LEARY | PersonNm |
| Person Title | CFO/Treasurer | PersonTitleTxt |
| Phone | 6035806695 | PhoneNum |
| Signature | 2017-08-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Timothy R Hepburn | PreparerPersonNm |
| PTIN | P00182393 | PTIN |
| Phone | 8002447444 | PhoneNum |
| Preparation | 2017-08-01 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kevin J Callahan | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Alumni Drive | AddressLine1Txt |
| City | Exeter | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03833 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $241,677,803 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.exeterhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1907 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | The mission of Exeter Hospital is to improve the health of the community. This mission is principally accomplished without compromising Exeter Hospital's sustainability by the provision of health services and information to the community in collaboration with Exeter Health Resources' other affiliates which share this mission. Exeter Hospital works to accomplish this mission through the provision of comprehensive medical and surgical health care services including, but not limited to breast health, maternal/infant and reproductive medicine, cardiovascular, gastroenterology, sleep medicine, occupational and employee health, oncology, orthopedics and emergency care services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1589 | TotalEmployeeCnt |
| Total Volunteers | 115 | TotalVolunteersCnt |
| Total Gross UBI | $4,392 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $2,821 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $106,468 | PYContributionsGrantsAmt |
| CY Contributions Grants | $116,885 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $203,247,487 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $231,800,530 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,148,588 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,461,681 | CYInvestmentIncomeAmt |
| PY Other Revenue | $13,517 | PYOtherRevenueAmt |
| CY Other Revenue | $3,518 | CYOtherRevenueAmt |
| PY Total Revenue | $206,516,060 | PYTotalRevenueAmt |
| CY Total Revenue | $236,382,614 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $660,678 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $706,135 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $87,108,769 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $93,803,094 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $102,512,401 | PYOtherExpensesAmt |
| CY Other Expenses | $109,933,868 | CYOtherExpensesAmt |
| PY Total Expenses | $190,281,848 | PYTotalExpensesAmt |
| CY Total Expenses | $204,443,097 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $16,234,212 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $31,939,517 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $270,215,446 | TotalAssetsBOYAmt |
| Total Assets EOY | $274,105,488 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $113,101,771 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $112,078,919 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $157,113,675 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $162,026,569 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Exeter Hospital is to improve the health of the community. This mission will be principally accomplished without compromising Exeter Hospital's sustainability by the provision of health services and information to the community in collaboration with Exeter Health Resources' other affiliates which share this mission. Exeter Hospital works to accomplish this mission through the provision of comprehensive medical and surgical health care services including, but not limited to breast health, maternal/infant and reproductive medicine, cardiovascular, gastroenterology, sleep medicine, occupational and employee health, oncology, orthopedics and emergency care services. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $182,502,309 | ExpenseAmt |
| Grant | $706,135 | GrantAmt |
| Revenue | $231,838,515 | RevenueAmt |
| Desc | In Fiscal Year 2016, Exeter Hospital served the community by providing care to 5,216 acute inpatients, 158,664 outpatient visits, 30,967 emergency room visits and 651 births. In 2016, Exeter Hospital supported its mission by supporting $16,920,821 in community outreach, benefits and financial support to the community excluding $18,934,161 in uncovered Medicare expenses. Exeter Hospital supports health care access in its service area by offering a robust financial assistance program that covers the cost of up to 100% of care provided to area residents based on income and family size. In 2016, the charity care program helped people access the health care system as Exeter Hospital incurred a cost of $996,973 to provide financial assistance. In addition we provide support to vital community programs like our Healthreach Diabetes and Paramedicine programs and for providing access to contracted mental health professionals in our emergency room. We also supported access to the health system and the development of healthy life styles through our community education programs and our financial support of important healthcare related community based not for profits such as Families First and Lamprey Healthcare. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Exeter Hospital's acute care program provides acute inpatient and outpatient observation level care in our 99 staffed inpatient beds. Our inpatient services treat emergent, acute, elective surgical and palliative care patients. Approximately 73% of our admissions come from the emergency room. We offer inpatient acute services for medical and surgical diagnoses for adults as well as pediatric and obstetrical inpatient services. Exeter Hospital is fully accredited by DNV Healthcare, Inc. (an officially deemed Medicare and Medicaid Credentialing agency), earned the Magnet designation from the American Nurses Credentialing Center, which is the most prestigious distinction a healthcare organization can receive for nursing excellence and high quality patient care as well as many other service level specific national accreditations. Our practice model is guided by a series of collaborative Best Practice Committees that engage nurses and physicians in the development of the best possible evidence based care protocols. Exeter Hospital supports the safety of our patients and the efficiency of the care provided through the deployment of a 24/7 Hospitalist program that manages the majority of the medical needs of our patients during their admission. In our 10 bed ICU we also use an intensivest service to ensure that our most acute patients receive the most highly coordinated care possible, resulting in significantly lower than expected infection rates, ICU readmission rates and shorter ICU stays. For our patients at the end of their lives we ensure their safety and comfort through a physician led, highly coordinated palliative care program. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Exeter Hospital's Surgical program provides a full range of both inpatient and outpatient surgical services for patients of all ages from across our service area. Available surgical specialties include; orthopedics, general, ENT, gynecological, urological, plastics, ophthalmologic and vascular. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | The Center for Cancer Care at Exeter Hospital provides cancer patients and their families with comprehensive inpatient and outpatient services. Accredited by the American College of Surgeon's Commission on Cancer with commendation, the Center provides area residents with a leading, comprehensive approach to cancer treatment. The Center offers medical oncology, radiation oncology, surgery, clinical trials, multidisciplinary clinics and integrative oncology services. The Center is proud to have a relationship with the Massachusetts General Physician Organization for the provision of medical and radiation oncology services to patients. The medical oncology service supports a 13 chair infusion center. This unique clinical collaboration brings radiation oncologists from the world's leading academic medical center to Exeter Hospital's Center for Cancer Care. This affiliation allows Exeter Hospital's Center for Cancer Care to offer state-of-the-art radiation therapy services to patients including: Intraoperative Radiation Therapy (IORT), CT Simulation, Partial Breast Irradiation, Image Guided Radiation Therapy, Intensity Modulated Radiation Therapy and Linear Accelerator delivered treatments. The Center's affiliated surgeons work collaboratively with affiliated pathologists, the medical oncologists and with the radiation oncologists to develop the most comprehensive treatment plans for our patients.Exeter Hospital's Cardiology Department offers acute cardiac care, heart catheterization, angioplasty, angiography, implanted cardioverter defibrillators, permanent pacemaker placement and a three phase cardiac rehabilitation program. Exeter Hospital's affiliated fellowship-trained interventional cardiologists and its cardiac team have received international recognitions for their ongoing successful use of emergency angioplasty and interventional cardiology procedures. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $182,502,309 | 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 | Yes (1) | 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 | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 138 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1589 | 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 | 0 | QuidProQuoContributionsInd |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kevin J O'Leary | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6035806695 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Alumni Drive | AddressLine1Txt |
| City | Exeter | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03833 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Joseph Army | |||||||||
| Trustee (thru March 2016) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Amy Case | |||||||||
| Trustee (as of April 2016) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Susan Y Desjardins | |||||||||
| Trustee (as of April 2016) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| David Donsker MD | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Ross Gittell PhD | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Steve Hermans | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Richard Hollister MD | |||||||||
| Ex-Officio | 1.00 | 41.00 | Yes (X) | $0 | $462,270 | $28,132 | |||
| J Bonnie Newman | |||||||||
| Trustee (thru March 2016) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Katie Delahaye Paine | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Major General Joseph Simeone | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Glenn McKenzie | |||||||||
| Chairman | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| William Schleyer | |||||||||
| Vice Chairman | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Kevin J Callahan | |||||||||
| CEO/Trustee | 2.00 | 43.00 | Yes (X) | $0 | $849,778 | $191,370 | Yes (X) | ||
| Kevin J O'Leary | |||||||||
| CFO/Treasurer | 2.00 | 43.00 | $0 | $505,169 | $100,773 | Yes (X) | |||
| Constance D Sprauer | |||||||||
| Sr. VP Legal Affairs/Secretary | 2.00 | 41.00 | $0 | $358,893 | $32,735 | Yes (X) | |||
| Brian Campbell | |||||||||
| VP Ambulatory Care | 40.00 | 0.00 | $295,179 | $0 | $39,572 | Yes (X) | |||
| Donna McKinney | |||||||||
| VP Acute Care | 40.00 | 0.00 | $236,839 | $0 | $36,252 | Yes (X) | |||
| Jonathan Jackson | |||||||||
| Physicist | 40.00 | 0.00 | $231,722 | $0 | $29,654 | Yes (X) | |||
| Jane Peterson | |||||||||
| Director | 40.00 | 0.00 | $189,094 | $0 | $11,686 | Yes (X) | |||
| Deanna King | |||||||||
| Director | 40.00 | 0.00 | $174,420 | $0 | $34,522 | Yes (X) | |||
| Judith Rines | |||||||||
| Director | 40.00 | 0.00 | $173,234 | $0 | $21,331 | Yes (X) | |||
| Bonnie Thibault | |||||||||
| Director | 40.00 | 0.00 | $171,105 | $0 | $27,176 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,471,593 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,176,110 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $553,203 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 69 | 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 |
|---|---|---|---|---|---|
| Exeter Health Resources Inc | |||||
| 5 Alumni Drive | Exeter | NH | 03833 | Administrative Management Fees | $6,839,261 |
| Core Physician Services LLC | |||||
| 5 Alumni Drive | Exeter | NH | 03833 | Physician Services | $5,452,780 |
| ASHA LLC | |||||
| PO Box 945 | Traverse City | MI | 49685 | Temporary Labor | $1,455,827 |
| GE Healthcare Inc | |||||
| PO Box 96483 | Chicago | IL | 60693 | Equipment Maintenance | $1,393,019 |
| Mass General Physician Organization | |||||
| 55 Fruit Street | Boston | MA | 02114 | Physician Services | $1,111,170 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 49 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $33,050 | FundraisingAmt |
| All Other Contributions | $83,835 | AllOtherContributionsAmt |
| Total Contributions | $116,885 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Services | 621300 | $222,638,076 | $222,638,076 |
| Disproportionate Share Funding | 621300 | $6,591,563 | $6,591,563 |
| Cafeteria | 722210 | $1,428,373 | $1,428,373 |
| Other Programs | 621300 | $776,640 | $776,640 |
| Gift Shop | 453220 | $124,257 | $124,257 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $241,621 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $241,621 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $231,800,530 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,745,326 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $4,392 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,740,934 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $61,420 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $23,435 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $37,985 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,985 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,985 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,953,642 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,224,432 | SecuritiesAmt |
| Other | $12,855 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,729,210 | SecuritiesAmt |
| Other | -$12,855 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,716,355 | TotalRevenueColumnAmt |
| Exclusion | $2,716,355 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $33,050 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $34,467 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$34,467 | TotalRevenueColumnAmt |
| Exclusion | -$34,467 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $236,382,614 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $231,838,515 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $4,392 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,422,822 | 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 | $652,461 | TotalAmt |
| Program Services | $652,461 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,674 | TotalAmt |
| Program Services | $53,674 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $607,841 | TotalAmt |
| Program Services | $528,822 | ProgramServicesAmt |
| Management And General | $79,019 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,833,890 | TotalAmt |
| Program Services | $61,625,484 | ProgramServicesAmt |
| Management And General | $9,208,406 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,962,865 | TotalAmt |
| Program Services | $2,577,693 | ProgramServicesAmt |
| Management And General | $385,172 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,330,052 | TotalAmt |
| Program Services | $12,467,145 | ProgramServicesAmt |
| Management And General | $1,862,907 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,068,446 | TotalAmt |
| Program Services | $4,409,548 | ProgramServicesAmt |
| Management And General | $658,898 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,864 | TotalAmt |
| Management And General | $63,864 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,000 | TotalAmt |
| Management And General | $66,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,461,748 | TotalAmt |
| Program Services | $17,801,784 | ProgramServicesAmt |
| Management And General | $2,659,964 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,297 | TotalAmt |
| Program Services | $384,798 | ProgramServicesAmt |
| Management And General | $57,499 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $938,824 | TotalAmt |
| Program Services | $816,777 | ProgramServicesAmt |
| Management And General | $122,047 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,304 | TotalAmt |
| Program Services | $229,074 | ProgramServicesAmt |
| Management And General | $34,230 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,693,365 | TotalAmt |
| Program Services | $4,953,228 | ProgramServicesAmt |
| Management And General | $740,137 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,431 | TotalAmt |
| Program Services | $263,985 | ProgramServicesAmt |
| Management And General | $39,446 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $815,449 | TotalAmt |
| Program Services | $709,441 | ProgramServicesAmt |
| Management And General | $106,008 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,646,780 | TotalAmt |
| Program Services | $9,262,699 | ProgramServicesAmt |
| Management And General | $1,384,081 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,277,570 | TotalAmt |
| Program Services | $1,981,486 | ProgramServicesAmt |
| Management And General | $296,084 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $20,031,595 | $17,427,488 | $2,604,107 |
| Drugs | $16,061,717 | $16,061,717 | |
| Medicaid Enhancement Ta | $11,073,560 | $11,073,560 | |
| Bad Debt Expense | $8,694,985 | $8,694,985 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,099,379 | TotalAmt |
| Program Services | $10,526,460 | ProgramServicesAmt |
| Management And General | $1,572,919 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,443,097 | TotalAmt |
| Program Services | $182,502,309 | ProgramServicesAmt |
| Management And General | $21,940,788 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,319,411 | BOYAmt |
| EOY | $27,946,727 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,730,166 | BOYAmt |
| EOY | $32,067,171 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,082,125 | BOYAmt |
| EOY | $18,947,421 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,978,984 | BOYAmt |
| EOY | $3,143,804 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,928,922 | BOYAmt |
| EOY | $4,522,461 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $133,152,961 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $74,754,734 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,578,125 | BOYAmt |
| EOY | $58,398,227 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,356,623 | BOYAmt |
| EOY | $54,535,778 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,922,420 | BOYAmt |
| EOY | $68,298,364 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,318,670 | BOYAmt |
| EOY | $6,245,535 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,215,446 | BOYAmt |
| EOY | $274,105,488 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,863,291 | BOYAmt |
| EOY | $18,597,403 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,275,451 | BOYAmt |
| EOY | $56,108,478 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,963,029 | BOYAmt |
| EOY | $37,373,038 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,101,771 | BOYAmt |
| EOY | $112,078,919 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,119,819 | BOYAmt |
| EOY | $144,999,059 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,535 | BOYAmt |
| EOY | $258,189 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,769,321 | BOYAmt |
| EOY | $16,769,321 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,113,675 | BOYAmt |
| EOY | $162,026,569 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,215,446 | BOYAmt |
| EOY | $274,105,488 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $31,939,517 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,042,710 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$29,069,333 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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 | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $25,998 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $25,998 | 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 | Association Dues Allocated to Lobbying: A portion of annual membership dues paid to the American Hospital Association and the New Hampshire Hospital Association are considered lobbying expenses. For fiscal year ending September 30, 2016, the amounts deemed for lobbying were $6,307 and $19,691, respectively. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,993,856 | BeginningYearBalanceAmt |
| Contributions | $107,531 | ContributionsAmt |
| Other Expenditures | $73,877 | OtherExpendituresAmt |
| End Year Balance | $17,027,510 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $17,004,799 | BeginningYearBalanceAmt |
| Contributions | $69,258 | ContributionsAmt |
| Other Expenditures | $80,201 | OtherExpendituresAmt |
| End Year Balance | $16,993,856 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $17,006,133 | BeginningYearBalanceAmt |
| Contributions | $53,100 | ContributionsAmt |
| Other Expenditures | $54,434 | OtherExpendituresAmt |
| End Year Balance | $17,004,799 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $17,008,827 | BeginningYearBalanceAmt |
| Contributions | $41,887 | ContributionsAmt |
| Other Expenditures | $44,581 | OtherExpendituresAmt |
| End Year Balance | $17,006,133 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $17,001,122 | BeginningYearBalanceAmt |
| Contributions | $68,831 | ContributionsAmt |
| Other Expenditures | $61,126 | OtherExpendituresAmt |
| End Year Balance | $17,008,827 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.01520 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.98480 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $142,400 | OtherCostOrOtherBasisAmt |
| Book Value | $142,400 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $74,810,542 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,245,537 | DepreciationAmt |
| Book Value | $32,565,005 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $434,085 | OtherCostOrOtherBasisAmt |
| Depreciation | $189,045 | DepreciationAmt |
| Book Value | $245,040 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,510,553 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,982,436 | DepreciationAmt |
| Book Value | $23,528,117 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,255,381 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,337,716 | DepreciationAmt |
| Book Value | $1,917,665 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $58,398,227 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Limited Partnerships | $44,038,376 | F |
| Alternative Investments | $24,259,988 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $68,298,364 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Third Party Payors | $5,252,462 |
| Accrued Pension Liability | $18,701,536 |
| Swap Valuation Liability | $10,331,081 |
| Investment - Premier | $292,518 |
| Reserve for Professional Liability Claims | $2,795,441 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $37,373,038 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $236,239,989 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,042,710 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$2,268,799 | OtherRevenueAmt |
| Revenue Not Reported | -$226,089 | RevenueNotReportedAmt |
| Revenue Subtotal | $236,466,078 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$83,464 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$83,464 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $236,382,614 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $204,600,438 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $108,344 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $108,344 | ExpensesNotReportedAmt |
| Expenses Subtotal | $204,492,094 | ExpensesSubtotalAmt |
| Other Expenses Not Included | -$48,997 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | -$48,997 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $204,443,097 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The goal of the Permanent Endowment Fund is to provide a source of financial support to Exeter's patient care activities. These funds are invested in a prudent manner with regard to preserving principal while providing reasonable returns. These returns are then used for capital expenditures, other major program needs, and to generally increase the financial strength of the organization. The quasi-endowments are funds which have been donated to the organization for a purpose specified by the donor. These funds are held until used for the purpose intended by the donor. |
| Part X, Line 2: | The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code, and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the tax positions of the Hospital and has concluded that it has maintained its tax-exempt status, does not have any significant unrelated business income, and has taken no uncertain tax positions that require adjustment to the financial statements. |
| Part XI, Line 2d - Other Adjustments: | Impact of Interest Rate Swaps -2,376,330. Net Assets Released from Restricion 76,493. Net Asset Adjustment 31,038. |
| Part XI, Line 4b - Other Adjustments: | Income Included in Expenses on Audited Financial Statements -48,997. Special Event Expenses -34,467. |
| Part XII, Line 2d - Other Adjustments: | Net Assets Released from Restriction 73,877. Special Event Expenses 34,467. |
| Part XII, Line 4b - Other Adjustments: | Income Included in Expenses on Audited Financial Statements -48,997. |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)
| RegionRegionTxt | OfficesOfficesCnt | EmployeeEmployeeCnt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Region Total ExpendituresRegionTotalExpendituresAmt | Specific Services ProvidedSpecificServicesProvidedTxt |
|---|---|---|---|---|---|
| Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, | 0 | 0 | Investments in funds domiciled in the region | $24,259,988 | |
| Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso, | 0 | 0 | Grants to recipients located in region | $53,764 | Contribution of medical equipment and supplies to hospitals and clinics who serve the needy in countries outside the United States |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $24,313,752 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $24,313,752 | TotalSpentAmt |
Grants To Org Outside US GrantsToOrgOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso, | RegionTxt |
| Non Cash Assistance | $53,764 | NonCashAssistanceAmt |
| Description Of Non Cash Asst | Contribution of medical equipment and supplies to hospitals and clinics who serve the needy in countries outside the United States | DescriptionOfNonCashAsstTxt |
| Valuation Method Used | Book Value | ValuationMethodUsedDesc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 2: | All requests for grants/contributions/sponsorships over $5,000 require the approval of at least the Vice President of Strategy, Community Relations and Development to ensure that they are consistent with our mission, values and strategic plan. Each year a sub committee of Exeter Health Resources, Inc.'s (parent company) Board of Trustees is charged with overseeing our Community Benefits program and our community needs assessment and reviews a detailed report on the previous year's grants/contributions/sponsorships and approves the current year's plan for community support. That sub committee and the larger Exeter Health Resources, Inc.'s (parent company) Board of Trustees are regularly updated on our community support initiatives. The only grantee reported on Schedule F is a 501(c)(3) domestic organization located in Massachusetts that provides medical equipment and supplies to needy foreign hospitals and clinics. |
| Schedule F, Part I, Line 3: | The legal owner of Exeter Hospital, Inc.'s foreign investments is a related organization, Exeter Health Resources, Inc. Since a portion of Exeter Health Resources, Inc.'s total foreign investments are allocated to the Hospital's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, Line 3 of Exeter Hospital, Inc.'s Form 990. However, any required IRS Forms 926 and other foreign tax reporting obligations are filed by the legal owner, Exeter Health Resources, Inc.(EIN:02-0222126) |
| Schedule F, Part IV, Line 3: | Exeter Hospital, Inc. did not have an ownership interest in any foreign corporation that was greater than the 10% ownership filing threshold. Accordingly, IRS Form(s) 5471 is not required to be filed. |
| Schedule F, Part IV, Line 4: | Exeter Hospital, Inc. meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Hospital. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Kites Against Cancer | Event1Nm |
| Gross Receipts Event1 | $15,660 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $15,660 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $13,973 | OtherDirectExpensesEvent1Amt |
| Event2 | Trick Treat Trot | Event2Nm |
| Gross Receipts Event2 | $17,390 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $17,390 | CharitableContriEvent2Amt |
| Other Direct Expenses Event2 | $20,494 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $33,050 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $33,050 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $34,467 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $34,467 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$34,467 | NetIncomeSummaryAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule G, Part II, Fundraising Events | FormAndLineReferenceDesc |
| Explanation | In accordance with the IRS instructions for the reporting of income on Schedule G, event revenue deemed to be charitable contributions has been reported on line 2, thus reducing the total gross event income on line 3. This presentation gives the appearance on Schedule G of a loss from the respective events. However, when the charitable contributions are considered and added back, these two events broke even with a minimal loss of ($1,417). Up to this point, the events have been viewed primarily as community building activities. | ExplanationTxt |
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 | 320.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| 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) |
|---|---|---|
| Persons Served | 991 | PersonsServedCnt |
| Total Community Benefit Expns | $996,973 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $996,973 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5397 | PersonsServedCnt |
| Total Community Benefit Expns | $21,162,437 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,591,563 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,570,874 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07440 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6388 | PersonsServedCnt |
| Total Community Benefit Expns | $22,159,410 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,591,563 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,567,847 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07950 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16528 | PersonsServedCnt |
| Total Community Benefit Expns | $896,848 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,980 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $874,868 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 235 | PersonsServedCnt |
| Total Community Benefit Expns | $859,123 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $859,123 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2158 | PersonsServedCnt |
| Total Community Benefit Expns | $3,405,348 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $363,227 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,042,121 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01550 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 311 | PersonsServedCnt |
| Total Community Benefit Expns | $151,787 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $151,737 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $685,211 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $685,211 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 19232 | PersonsServedCnt |
| Total Community Benefit Expns | $5,998,317 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $385,257 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,613,060 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02870 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 25620 | PersonsServedCnt |
| Total Community Benefit Expns | $28,157,727 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,976,820 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,180,907 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10820 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $85,850 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $85,850 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $136,061 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $136,061 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $221,911 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $221,911 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,227,578 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $769,150 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $67,446,289 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $86,380,450 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$18,934,161 | 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 | Exeter Hospital Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 Alumni Drive | AddressLine1Txt |
| City | Exeter | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03833 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.exeterhospital.com | WebsiteAddressTxt |
| State License | 1761 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Exeter Hospital Inc | 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 |
| CHNA Conducted | 15 | 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 | See Schedule H, Part V, Section C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Schedule H, Part V, Section C | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | 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 | 320.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| 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 |
| 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 Schedule H, Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Schedule H, Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Schedule H, 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| 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 |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Exeter Hospital, Inc. | Part V, Section B, Line 5: Every three years, Exeter Hospital, in collaboration with its community partners, conducts a community needs assessment to identify, prioritize, and develop a plan to address critical health issues. The last community needs assessment was completed in FYE 2016. The purpose of the assessment was to engage community members through key leader interviews and Community Forums, and to achieve the following objectives:1) Educate and inform key leaders and Community Forum participants of the results of the FYE 2013 Community Needs Assessment and achievements to date to meet identified needs.2) Validate Priority Health Needs identified in the FYE 2013 Community Needs Assessment and further define these needs in FYE 2016 from the stakeholders' perspective.3) Identify unmet needs that have emerged since the FYE 2013 Community Needs Assessment.4) Engage key leaders and Community Forum participants in a discussion to identify solutions to address community health needs.5) Share the findings of the UNH Survey Center Household Telephone Survey.6) Where appropriate, motivate key leaders and Community Forum participants to participate in efforts to address community health needs going forward.7) Serve as a continuing foundation for the development of a Community Benefits Plan, as mandated under RSA 7:32-e.The FYE 2016 Community Needs Assessment included telephone surveys, open community forums, online surveys, key leader interviews, outreach to support agencies and the review of relevant secondary data sources. Information was solicited from a broad cross-section of the hospital's service area and included government welfare, public health, transportation, police, education and emergency preparedness officials, as well as outreach agencies that serve military & veterans, children & families, youth, elderly and the low-income. Legislators were invited to attend community forums. Providers of medical care to low-income minority population and mental health services were included. |
| Exeter Hospital, Inc. | Part V, Section B, Line 6b: Representatives from the following organizations collaborated on the hospital's community needs assessment: Exeter Area YMCA, Easter Seals NH, Lamprey Health Care, Families First Health and Support Center, Richie-McFarland Children's Center, Seacoast Mental Health Center, United Way of the Greater Seacoast as well as affiliates Core Physicians and Rockingham VNA & Hospice. |
| Exeter Hospital, Inc. | Part V, Section B, Line 11: The needs identified in the FYE 2016 Community Health Needs Assessment are:Access to care due to insurance coverage cost barriers, Substance Abuse and Addiction, Mental Health Services, Youth Suicide/Substance and Prescription drug abuse, Transportation, Affordable Housing/Homelessness and Elder Care and Support Services. The community benefit spending in FYE 2016 directly related to the FYE 2013 identified needs which were: Access to Primary Care, Health and Wellness Services, Mental health care access (behavioral health care), Nutrition, Transportation and Youth suicide/substance and prescription drug abuse.Exeter Hospital addressed these needs by promoting community health and access to primary care by providing: 1) Charity care of $ 996,973 (calculated at cost) during fiscal year 2016 which served 991 people.2) Financial assistance through its health care access program which has three components: a) The Uninsured Care Discount/Hospital Access Plus Program - Patients who are uninsured will not be charged more than amounts generally billed to patients who have insurance covering the same care. Exeter Hospital, prior to billing the patients, applies a discount towards gross charges for patients who are uninsured. This discount is not valid for patients who have health insurance coverage, including but not limited to: Medicare, Medicaid, MedPay, third party liability or any other state or federal programs. b) The Financial Assistance Program is a community-based program available to uninsured and under-insured patients who meet income and asset guidelines, and who live in our service area. To qualify, patients must first have applied for all other sources of coverage, including the Healthcare Exchange and the New Hampshire Health Protection Program. c) Exeter's Catastrophic Care Program provides financial relief for those patients who do not qualify for our Financial Assistance Program, but who are faced with a substantial debt due to a serious illness or injury. This program is calculated based on a percentage of the patient's gross income.3) Telehealth Services which provided $321,466 in telehealth monitoring services serving 10,728 persons in fiscal year 2016.4) Transportation which is an important health care support service provided by the Hospital in response to an identified community need. Each year the program enhances access for hundreds of patients who otherwise would not be able to obtain needed health care and health related support services. During fiscal year 2016 Exeter Hospital provided 293 transports at a cost of $25,323.5) Support for Youth Suicide/Substance and Prescription Drug Abuse prevention and education services by: a) The Hospital making financial contributions to the United Way of the Greater Seacoast in fiscal year 2016 of $25,000 specifically designated to support their efforts in youth substance abuse prevention and education services. b) The Hospital providing support in the amount of $30,000 to Connor's Climb Foundation which is dedicated to preventing youth suicide. All of the funds raised directly impact programs for suicide awareness, education and prevention in the New Hampshire community.6) Community Education Programs offered by the Hospital that provided community education services at an expense of $461,297 serving 5,362 in fiscal year 2016.7) Cancer Wellness and Diabetes Support Programs offered by the Hospital that provided cancer and diabetes programs at an expense of $951,443 serving 679 people in fiscal year 2016.8) Participation in research studies by the "The Center for Cancer Care" at Exeter Hospital through several national research groups sponsored by the National Cancer Institute. This enables the Center to offer clinical trials to patients undergoing treatment at the Hospital that allows patients to voluntarily take part in leading edge research that does not necessitate travel outside of the Seacoast area. During fiscal year 2016, the Hospital provided $151,737 for clinical trials and research that served 311 patients. |
| Exeter Hospital, Inc. | Part V, Section B, Line 16i: During fiscal year 2016, the 501(r) Steering Committee continued to work on and implement the operational components of 501r effective September 1, 2016. This included Board of Trustee approval on our revised policies, calculation of Amounts Generally Billed, and development of a Plain Language Summary. All of this information can be found on our website, and is advertised and paper copies are available to patients. Semi-annually, we publish an ad in the local paper which outlines our financial assistance program. Within our phone system, we have a recording which outlines the financial assistance program when patients, family members etc. are on hold during a call to Exeter Hospital. We present each patient with a copy of the Plain Language Summary at Registration. Currently we have a financial counselor located in the checkout area in our Emergency Department and an Inpatient Financial Counselor to visit inpatients who are uninsured, to inform them of our program and or if they request more information about needing assistance to pay for services. As of 9/1/2016, we updated our signage in public locations to notify patients about our Financial Assistance Program. We have also collaborated with our community partners to have this information publicly available and accessible at their locations to reach members of our community who are most likely to need financial assistance. |
| Exeter Hospital, Inc. | Part V, Section B, Line 20e: During fiscal year 2016, we notified Emergency Department patients during discharge about our financial assistance program. Upon admission, we visit all self pay and any other patient who wishes to discuss their coverage and or balances due and inform them of our program. Effective September 1, 2016, the Plain Language Summary is presented during registration of all patients. This information regarding the financial assistance program is on each patient billing statement as well as available on our website. |
| Exeter Hospital, Inc. | Part V, Section B, Line 22d: The Hospital (from 10/1/15-8/31/16) used amounts based on federal poverty guidelines and sliding scale as shown below:FAMILY DISCOUNT PERCENTAGESIZE 100% 80% 60% 40% 20% 1 23,760 23,761-33,264 33,265-38,016 38,017-42,768 42,769-47,520 2 32,040 32,041-44,856 44,857-51,264 51,265-57,672 57,673-64,0803 40,320 40,321-56,448 56,449-64,512 64,513-72,576 72,577-80,640 4 48,600 48,601-68,040 68,041-77,760 77,761-87,480 87,481-97,200 5 56,880 56,881-79,632 79,633-91,008 91,009-102,384 102,385-113,760 6 65,160 65,161-91,224 91,225- 104,257- 117,289- 104,256 117,288 130,320 7 73,460 73,461- 102,845- 117,537- 132,229- 102,844 117,536 132,228 146,9208 81,780 81,781- 114,493- 130,849- 147,205- 114,492 130,848 147,204 163,560Effective 9/1/2016 - Combined Income and Assets based on Federal Poverty Guidelines multiplied by 320% resulting in 100% Financial Assistance.Family 100%Size 1 38,0162 51,2643 64,5124 77,7605 91,0086 104,2567 117,5368 130,848From 10/1/15-8/31/16 all uninsured patients were given an automatic discount of 34% which was based on the discount given to the weighted average of the 3 largest commercial insurers. If the patient was then eligible for Financial Assistance, they were granted another (20/40/60/80 or 100%) discount on their remaining balance. As we implemented 501r, on 9/1/16 we eliminated the sliding scale and all eligible financial assistance recipients received a 100% financial assistance on their balance. Effective 9/1/2016, the uninsured discount was increased to 57%. Exeter Hospital uses the look-back method to determine the amounts generally billed (AGB) to individuals. The AGB is computed annually by dividing the sum of the amounts of all claims allowed for emergency medical care and other medically necessary care that have been allowed by Medicare fee for service and private insurers over the past 12 month period, divided by the sum of the associated gross charges for those claims. Amounts Generally Billed = 43% of gross charges. |
| Schedule H, Part V, Section B, Line 7a: | The Hospital's FYE 2016 CHNA is available at: https://www.exeterhospital.com/getmedia/26f68ce4-0cd6-447f-a137-e839dd5dcc4c/2016-Community-Health-Needs.pdf.aspxThe Hospital's FYE 2013 CHNA is available at:https://www.exeterhospital.com/getmedia/e0abde10-5387-4ce0-b081-0f23e8607a82/2013-EH-Community-Health-Needs-Assessment.pdf.aspx |
| Schedule H, Part V, Section B, Line 10a: | The Hospital's FYE 2016 Implementation Strategy is available at: https://www.exeterhospital.com/getmedia/da22bb1b-97ec-48b2-96a6-02b9f9219607/Exeter-Hospital-Community-Health-Needs-Assessment-Implementation-Plan.pdf.aspxThe Hospital's FYE 2013 Implementation Strategy is available at:https://www.exeterhospital.com/getmedia/fbd1b352-f981-4859-946e-952fbf6439e3/Commnnity-needs-implementation-planFinalBoard9-17.pdf.aspx |
| Schedule H, Part V, Section B, Line 16a-c: | The Hospital's Financial Assistance Policy is available at:https://www.exeterhospital.com/getmedia/7b5bcd2f-203c-4275-bafb-34d073d3fbc3/LD326-04-2017.pdf.aspxThe Hospital's Financial Assistance Application is available at:https://www.exeterhospital.com/getmedia/28dc235c-33bb-42a2-8d62-ed5b9cc83843/1639-Fin-Assist-App-01-11-2017.pdf.aspxThe Hospital's Plain Language Summary is available at:https://www.exeterhospital.com/getmedia/d40a2763-cc50-4143-97c6-338ae2a2af53/1641-Fin-Assist-Summary-04-2017.pdf.aspx |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 15 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Center for Orthopaedics and Movement | ||||
| 7 Alumni Drive | Exeter | NH | 03833 | Rehabilitation Services, Cardiac Rehabilitation, Massage |
| 2 - Centers for Sleep & Wound Healing | ||||
| 4 Alumni Drive | Exeter | NH | 03833 | Sleep Lab, Wound Care, Drivability |
| 3 - Epping Regional Health Center | ||||
| 212 Calef Highway | Epping | NH | 03042 | Pediatric and Adult Rehabilitation Services, Radiology, Mammmography |
| 4 - Center for Reproductive Care | ||||
| 118 Portsmouth Avenue | Stratham | NH | 03885 | Reproductive Services |
| 5 - Diagnostic Imaging & Physical Therapy | ||||
| 24 Plaistow Road | Plaistow | NH | 03865 | Physical Therapy, Radiology |
| 6 - Kingston Athleticare | ||||
| 53 Church Street | Kingston | NH | 03848 | Physical Therapy |
| 7 - Ctr for Occupational & Employee Health | ||||
| 6 Hampton Road | Exeter | NH | 03833 | Occupational Health |
| 8 - Orthopaedic & Sports Physician Therapy | ||||
| 311 Winnacunnet Road | Hampton | NH | 03842 | Physical Therapy and Athletic Performance Center |
| 9 - Rehab & Diagnostic Serv of Exeter Hosp | ||||
| 128 Route 27 | Raymond | NH | 03077 | Physical and Occupational Therapy, Radiology, Mammography |
| 10 - Rehab & Diagnostic Serv at Lamprey | ||||
| 207 South Main Street | Newmarket | NH | 03857 | Physical and Occupational Therapy, Radiology, Mammography |
| 11 - Exeter Diagnostic Serv at Hampton | ||||
| 879 Lafayette Road | Hampton | NH | 03842 | Radiology, Mammography |
| 12 - Diagnostic Imaging - Saltonstall | ||||
| 9 Buzzell Avenue | Exeter | NH | 03833 | Radiology |
| 13 - Physical Therapy at Portsmouth | ||||
| 95 Brewery Lane | Portsmouth | NH | 03801 | Physical Therapy |
| 14 - HealthReach Diabetes Nutrition & Educ | ||||
| 881 Lafayette Road | Hampton | NH | 03842 | Diabetes and Nutrition |
| 15 - Sports and Physical Therapy Practice | ||||
| 40 Industrial Drive 1 | Exeter | NH | 03833 | Athletic Performance Center |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | As of 9/1/2016, 501r was implemented and the sliding fee schedule for discounted care was eliminated. All eligible financial assistance recipients receive 100% free care. Patients who do not qualify for financial assistance and are uninsured receive a discount that is equal to AGB = 43% (amounts generally billed) using the lookback method.There are several factors regarding eligibility for Financial Assistance. The applicant must reside in our service area, a geographic location consisting of approximately 40 surrounding towns, listed on our website, Financial Assistance Policy and Plain Language Summary. The other factor is combined income and assets (as defined in our Financial Assistance Policy) are compared to the FPG. |
| Part I, Line 7: | A ratio of patient cost to charge was calculated utilizing Worksheet 2. The ratio of cost to charge was utilized in calculating line 7a total net community benefit expense for charity care. |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 8,694,985. |
| Part II, Community Building Activities: | The majority of the remaining community benefit activities reported as community building activities are cash donations to community organizations for the purpose of furthering community support and advocacy for community health improvement. |
| Part III, Line 2: | The amount reported represents total bad debt expense as reported on the audited financial statement of $8,694,985 x 37.12% (ratio of patient cost to charge) to equal $3,227,578. |
| Part III, Line 3: | The amount reported represents $2,072,064 of charges included in total bad debt expense for patient eligible for financial assistance x 37.12% (ratio of patient cost to charge) to equal $769,150. |
| Part III, Line 4: | Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history 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 of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which accounts for patients who are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.The Hospital's allowance for doubtful accounts for self-pay patients increased from 118% of self-pay accounts receivable at September 30, 2015 to 120% of self-pay accounts receivable at September 30, 2016. The Hospital's self-pay bad debt writeoffs decreased approximately $1,109,000 from $6,014,000 in FY 2015 to $4,905,000 in FY 2016. The net change in the allowance as a percentage of self-pay accounts receivable and bad debt writeoffs was a result in collection trends and a shift in payor mix resulting from the Medicaid expansion and health insurance exchange. |
| Part III, Line 8: | Medicare costs are not counted as a Community Benefit per New Hampshire or IRS guidance, therefore the cost figure of $18,934,161 is not included in the Total Unreimbursed Community Benefit Expense. The ratio of cost to charge was utilized in calculating the amount. |
| Part III, Line 9b: | If an account is sent to a collection agency and the patient applies for financial assistance within 240 days from first bill, the account will be placed on hold with the agency through the consideration process. If the patient is approved for financial assistance, the account will be retracted from the collection agency and financial assistance will be applied to the accounts. Effective 6/1/2016, Exeter Hospital will only contract with collection agencies that follow Fair Debt Collection Practices and do not engage in Extraordinary Collection Activities.The Bad Debt/Collection Policy can be located online at:https://www.exeterhospital.com/getmedia/dea9264c-9d03-4f28-803f-0bbc4b103f1b/LD327-09-2016.pdf.aspx |
| Part VI, Line 2: | Every three years, Exeter Hospital, in collaboration with its community partners, conducts a community needs assessment to identify, prioritize, and develop a plan to address critical health issues. The last community needs assessment was completed in FYE 2016. The purpose of the assessment was to engage community members through key leader interviews and Community Forums, and to achieve the following objectives:1) Educate and inform key leaders and Community Forum participants of the results of the FYE 2013 Community Needs Assessment and achievements to date to meet identified needs.2) Validate Priority Health Needs identified in the FYE 2013 Community Needs Assessment and further define these needs in FYE 2016 from the stakeholders' perspective.3) Identify unmet needs that have emerged since the FYE 2013 Community Needs Assessment.4) Engage key leaders and Community Forum participants in a discussion to identify solutions to address community health needs.5) Share the findings of the UNH Survey Center Household Telephone Survey.6) Where appropriate, motivate key leaders and Community Forum participants to participate in efforts to address community health needs going forward.7) Serve as a continuing foundation for the development of a Community Benefits Plan, as mandated under RSA 7:32-e.The FYE 2016 Community Needs Assessment included telephone surveys, open community forums, online surveys, key leader interviews, outreach to support agencies and the review of relevant secondary data sources. Information was solicited from a broad cross-section of the hospital's service area and included government welfare, public health, transportation, police, education and emergency preparedness officials, as well as outreach agencies that serve military & veterans, children & families, youth, elderly and the low-income. Legislators were invited to attend community forums. Providers of medical care to low-income minority population and mental health services were included.The report in its entirety can be accessed on the Exeter Hospital website:https://www.exeterhospital.com/getmedia/e68ce7fc-fb11-4e29-af75-7b53381d361e/EH-2016-State-File.pdf.aspx |
| Part VI, Line 3: | Exeter Hospital provides its patients with information regarding the organization's financial assistance program, and a summary of the organization's policy at the time of registration, on the back of every billing statement, and when phone contact is made when there is a balance on the account. On the Exeter Hospital website (http://www. exeterhospital.com), patients and the general public can find information on the organization's financial assistance programs; financial assistance, uninsured care discount program, catastrophic care program; and state-wide programs. As an additional measure to ensure our community members are aware of Exeter Hospital's financial assistance programs, twice a year the organization may run advertisements in community newspapers summarizing the organization's financial assistance/charity care policy. Exeter Hospital employs financial counselors specifically dedicated to assisting patients with questions regarding their eligibility for financial assistance, and assisting patients through the qualification process as applicable. All inpatient self-pay patients are provided information and counseling regarding the eligibility for financial assistance programs at the time of service. Self-pay and underinsured patients in the Emergency Department, Surgical areas and Oncology are also informed of the hospital's financial assistance programs at time of service or discharge. |
| Part VI, Line 4: | Exeter Hospital services an area that encompasses 40 communities with an estimated population of 236,113. |
| Part VI, Line 5: | Exeter Hospital addressed these needs by promoting community health and access to primary care by providing: 1) Charity care of $ 996,973 (calculated at cost) during fiscal year 2016 which served 991 people.2) Financial assistance through its health care access program which has three components: a) The Uninsured Care Discount/Hospital Access Plus Program - Patients who are uninsured will not be charged more than amounts generally billed to patients who have insurance covering the same care. Exeter Hospital, prior to billing the patients, applies a discount towards gross charges for patients who are uninsured. This discount is not valid for patients who have health insurance coverage, including but not limited to: Medicare, Medicaid, MedPay, third party liability or any other state or federal programs. b) The Financial Assistance Program is a community-based program available to uninsured and under-insured patients who meet income and asset guidelines, and who live in our service area. To qualify, patients must first have applied for all other sources of coverage, including the Healthcare Exchange and the New Hampshire Health Protection Program. c) Exeter's Catastrophic Care Program provides financial relief for those patients who do not qualify for our Financial Assistance Program, but who are faced with a substantial debt due to a serious illness or injury. This program is calculated based on a percentage of the patient's gross income.3) Telehealth Services which provided $321,466 in telehealth monitoring services serving 10,728 persons in fiscal year 2016.4) Transportation which is an important health care support service provided by the Hospital in response to an identified community need. Each year the program enhances access for hundreds of patients who otherwise would not be able to obtain needed health care and health related support services. During fiscal year 2016 Exeter Hospital provided 293 transports at a cost of $25,323.5) Support for Youth Suicide/Substance and Prescription Drug Abuse prevention and education services by: a) The Hospital making financial contributions to the United Way of the Greater Seacoast in fiscal year 2016 of $25,000 specifically designated to support their efforts in youth substance abuse prevention and education services. b) The Hospital providing support in the amount of $30,000 to Connor's Climb Foundation which is dedicated to preventing youth suicide. All of the funds raised directly impact programs for suicide awareness, education and prevention in the N.H. community.6) Community Education Programs offered by the Hospital that provided community education services at an expense of $461,297 serving 5,362 in fiscal year 2016.7) Cancer Wellness and Diabetes Support Programs offered by the Hospital that provided cancer and diabetes programs at an expense of $951,443 serving 679 people in fiscal year 2016.8) Participation in research studies by the "The Center for Cancer Care" at Exeter Hospital through several national research groups sponsored by the National Cancer Institute. This enables the Center to offer clinical trials to patients undergoing treatment at the Hospital that allows patients to voluntarily take part in leading edge research that does not necessitate travel outside of the Seacoast area. During fiscal year 2016, the Hospital provided $151,737 for clinical trials and research that served 311 patients. |
| Part VI, Line 6: | Exeter Hospital, Inc. is one of three affiliates of Exeter Health Resources, Inc. Each of the affiliated companies are committed to providing health care services that are innovative, progressive and focused on quality and the well-being of patients. The mission of Exeter Health Resources, Inc. and its affiliates is to improve the health of the community. This mission will be principally accomplished without compromising Exeter Health Resources, Inc.'s sustainability by supporting the provision of health services and information to the community by the affiliated companies of Exeter Health Resources, Inc. During fiscal year 2016, Exeter Hospital, Core Physicians and Rockingham VNA & Hospice have continued the pursuit of this mission providing $23,203,161 in charity care and other community benefit programs and services to communities in the areas served. 1) Exeter Hospital is a 100-bed community-based hospital serving New Hampshire's Seacoast Region. The Hospital's scope of care includes comprehensive medical and surgical health care services including but not limited to breast health, maternal and reproductive medicine, cardiovascular, gastroenterology, sleep medicine, occupational and employee health, oncology, orthopedics, and emergency care services. Exeter Hospital is accredited by the DNV Healthcare, Inc. and is a Magnet-recognized hospital. Magnet designation from the American Nurses Credentialing Center is the most prestigious distinction a health care organization can receive for nursing excellence and high quality patient care.2) Core Physicians is a community-based, multi-specialty group practice affiliated with Exeter Health Resources, Inc. that provides comprehensive primary, specialty and pediatric dental care throughout the greater Seacoast region. Over 160 providers in 15 locations pursue exceptional patient satisfaction through clinical competence and professional office administration.3) Rockingham Visiting Nurse Association & Hospice is a community-based home health and hospice agency providing individuals and families with the highest quality home care, hospice and community outreach programs within Rockingham County and the surrounding towns of Barrington, Dover, Durham, and Lee. Exeter Hospital works collaboratively with local non-profit agencies and organizations which strive to improve the health of the community. These relationships include:1) Lamprey Health Care: In fiscal year 2016, the Hospital continued its financial support with a community benefit grant in the amount of $381,000. Lamprey Health Care provides high quality primary medical care and health related services, with an emphasis on prevention and lifestyle management, to all individuals regardless of ability to pay. As New Hampshire's oldest community health center it provides services at three centers located in Newmarket, Raymond, and Nashua. 2) Families First Health and Support Center: In fiscal year 2016, the Hospital made financial contributions in the amount of $75,125. Families First is a community health center offering a wide variety of health services and programs including primary care, prenatal care, dental care, and mobile health care for the homeless.3) Connors Climb: In fiscal year 2016, the Hospital provided support in the amount of $30,000 to Connor's Climb. The Connor's Climb Foundation is dedicated to preventing youth suicide. The nonprofit raises funds locally to support suicide prevention and education programs in New Hampshire. All of the funds raised directly impact programs for suicide awareness, education and prevention in the N.H. Community.4) Seacoast Mental Health Center: The Hospital partners with Seacoast Mental Health Center to offer mental health services to patients and their caregivers in the Emergency Department and The Center for Cancer Care. In fiscal year 2016, Exeter helped to underwrite mental health services in the amount of $398,486 serving 778 people. 5) New Heights: In fiscal year 2016, the Hospital continued its support with contributions in the amount of $16,800. New Heights is an experiential learning organization for youth in grades 5-12 and focuses on the development and leadership of exciting, high quality summer and year-round programs designed to open young minds to new possibilities. Programs include adventure, arts & culture, STEM and team building activities. 6) United Way of Greater Seacoast: In fiscal year 2016, the Hospital made financial contributions to the United Way of the Greater Seacoast of $25,000 specifically designated to support their efforts in youth substance abuse prevention and education services. |
| 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 (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| American Cancer Society Inc | |||||||
| 250 Williams Street | Atlanta | GA | 30303 | 131788491 | 501(c)(3) | $5,000 | Making Strides 2016 Sponsor |
| Business and Industry Association of NH | |||||||
| 122 North Main Street | Concord | NH | 03301 | 020172300 | 501(c)(6) | $5,000 | Support association's mission to promote a healthy climate for job creation and a strong New Hampshire economy |
| Community Colleges of New Hampshire Foundation | |||||||
| 26 College Drive | Concord | NH | 03301 | 020516490 | 501(c)(3) | $5,000 | Contribution to Great Bay Community College's Distinguished Leaders Fund |
| Connors Climb Foundation | |||||||
| PO Box 283 | Exeter | NH | 03833 | 473553455 | 501(c)(3) | $30,000 | Grant for suicide awareness and prevention |
| Core Physicians LLC | |||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 870807914 | 501(c)(3) | $12,020 | Reimbursement of expenses incurred supporting "Patient Assistance Program RX" (Medication Bridge) |
| Dartmouth Hitchcock Clinic | |||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 222519596 | 501(c)(3) | $24,500 | Provide regional access in the greater Exeter service region to Dartmouth Hitchcock's program that provides clinical assessments for possible child victims of maltreatment |
| Exeter Junior Baseball League Inc | |||||||
| PO Box 471 | Exeter | NH | 03833 | 753241754 | 501(c)(3) | $8,000 | Sponsors the organization's primary purpose which is to develop good sportsmanship among all players for the betterment of their emotional and social well-being |
| Families First of the Greater Seacoast | |||||||
| 100 Campus Drive Suite 12 | Portsmouth | NH | 03801 | 222757341 | 501(c)(3) | $75,125 | Annual funding contribution that helps Families First continue to provide a broad range of health and family services to all regardless of ability to pay |
| Girls on the Run New Hampshire | |||||||
| 137 Water Street | Exeter | NH | 03833 | 020524090 | 501(c)(3) | $5,000 | Support organization mission to elevate and prepare girls for a lifetime of self respect and healthy living |
| Lamprey Healthcare Inc | |||||||
| 207 South Main Street | Newmarket | NH | 03857 | 237305106 | 501(c)(3) | $381,000 | Supports the provision of high quality medical care and health related services to the communities it serves regardless of the patients' ability to pay |
| New Heights Adventures for Teens | |||||||
| 100 Campus Drive Suite 23 | Portsmouth | NH | 03801 | 271918243 | 501(c)(3) | $16,800 | Supports this comprehensive out-of-school program for young people to develop the competence, character, confidence and resiliency for a healthy successful adulthood |
| Richie McFarland Children's Center | |||||||
| 11 Sandy Point Road | Stratham | NH | 03885 | 020302005 | 501(c)(3) | $10,300 | Supports providing developmental and therapy services for children with and without special needs, support and education to their families and guidance in accessing community and health resources |
| United Way of the Greater Seacoast | |||||||
| 112 Corporate Drive Unit 3 | Portsmouth | NH | 03801 | 042382233 | 501(c)(3) | $25,000 | Grant to support healthcare related programming and volunteerism |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 12 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | All requests for grants/contributions/sponsorships over $5,000 require the approval of at least the Vice President of Strategy, Community Relations and Development to ensure that they are consistent with our mission, values and strategic plan. Large grants like those given to Connors Climb, Dartmouth Hitchcock Clinic, Families First, Lamprey and United Way are also reviewed by the Chief Financial Officer and Chief Executive Officer prior to approval. Each of those requesting organizations either provides a written summary of how they have used our previous support as well as their specific plans for any new requested funding or they make a presentation in person usually to the Chief Financial Officer, the Chief Executive Officer and the Vice President of Strategy, Community Relations and Development. Each year a sub committee of Exeter Health Resources' (parent company) Board of Trustees is charged with overseeing our Community Benefits program and our community needs assessment and reviews a detailed report on the previous year's grants/ contributions/sponsorships and approves the current year's plan for community support. That sub committee and the larger Exeter Health Resources' (parent company) Board of Trustees are regularly updated on our community support initiatives. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | 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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Richard Hollister MD | ||||||||||||||
| Ex-Officio | $0 | $310,729 | $0 | $90,383 | $0 | $61,158 | $0 | $7,950 | $0 | $20,182 | $0 | $490,402 | $0 | $0 |
| Kevin J Callahan | ||||||||||||||
| CEO/Trustee | $0 | $589,297 | $0 | $210,000 | $0 | $50,481 | $0 | $167,950 | $0 | $23,420 | $0 | $1,041,148 | $0 | $0 |
| Kevin J O'Leary | ||||||||||||||
| CFO/Treasurer | $0 | $370,844 | $0 | $109,362 | $0 | $24,963 | $0 | $83,900 | $0 | $16,873 | $0 | $605,942 | $0 | $0 |
| Constance D Sprauer | ||||||||||||||
| Sr. VP Legal Affairs/Secretary | $0 | $278,729 | $0 | $68,750 | $0 | $11,414 | $0 | $15,900 | $0 | $16,835 | $0 | $391,628 | $0 | $0 |
| Brian Campbell | ||||||||||||||
| VP Ambulatory Care | $205,781 | $0 | $82,000 | $0 | $7,398 | $0 | $15,900 | $0 | $23,672 | $0 | $334,751 | $0 | $0 | $0 |
| Donna McKinney | ||||||||||||||
| VP Acute Care | $173,695 | $0 | $54,425 | $0 | $8,719 | $0 | $14,444 | $0 | $21,808 | $0 | $273,091 | $0 | $0 | $0 |
| Jonathan Jackson | ||||||||||||||
| Physicist | $230,819 | $0 | $0 | $0 | $903 | $0 | $14,125 | $0 | $15,529 | $0 | $261,376 | $0 | $0 | $0 |
| Jane Peterson | ||||||||||||||
| Director | $170,064 | $0 | $13,376 | $0 | $5,654 | $0 | $11,454 | $0 | $232 | $0 | $200,780 | $0 | $0 | $0 |
| Deanna King | ||||||||||||||
| Director | $163,456 | $0 | $8,701 | $0 | $2,263 | $0 | $10,894 | $0 | $23,628 | $0 | $208,942 | $0 | $0 | $0 |
| Judith Rines | ||||||||||||||
| Director | $150,547 | $0 | $14,643 | $0 | $8,044 | $0 | $5,289 | $0 | $16,042 | $0 | $194,565 | $0 | $0 | $0 |
| Bonnie Thibault | ||||||||||||||
| Director | $156,124 | $0 | $11,593 | $0 | $3,388 | $0 | $10,534 | $0 | $16,642 | $0 | $198,281 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Tax indemnification and gross up payments were provided to Kevin Callahan, Kevin O'Leary, Constance Sprauer, Brian Campbell and Donna McKinney (for acquisition of supplemental long term disability insurance). The benefit was treated as taxable income. |
| Part I, Line 1b | There was no existing policy concerning tax indemnification and gross up payments. However, in the instance of such action related to the acquisition of long term disability insurance described above, the tax indemnification and gross up payments were approved by the Exeter Health Resources Board of Trustees Executive Committee which is comprised of disinterested persons. |
| Part I, Line 3 | The CEO of Exeter Hospital, Inc. is compensated by a related organization, Exeter Health Resources, Inc. Exeter Health Resources, Inc. uses a compensation committee, an independent compensation consultant, a compensation survey and approval by the Board or Compensation Committee. |
| Part I, Line 4b | The organization's parent (Exeter Health Resources, Inc.) maintains a split dollar supplemental retirement plan for two executives (listed below with amounts) selected by the Exeter Health Resources Inc. Board of Trustees. The plan is closed to future participants. The Plan provides for annual payments of premiums for life insurance policies insuring the listed individuals. Those life insurance premiums are collaterally assigned to the corporation and any excess accumulated value in the policies (net of accumulated premium payments which are returned to the organization upon the executive attaining the age of 70 or at the death of the participant) is available to be paid to the participant once vested at age 62 and upon retirement from the organization. Note that the split-dollar arrangement is part of an employee benefit program and economically not a direct extension of credit. Furthermore, the reportable compensation of the respective employees includes the annual value of the life insurance provided. Life insurance premium payments during tax year: Kevin Callahan $ 329,534 Kevin O'Leary $ 137,997 Excess Accumulated Value: Kevin Callahan $2,282,718 Kevin O'Leary $ 930,279 Certain of the listed employees participate in a nonqualified deferred compensation plan as described in Internal Revenue Code Section 457 (f) sponsored by Exeter Health Resources Inc., In the calendar year ended December 31, 2015 the contribution to the plan for the non-vested benefit of Kevin Callahan was $160,000 and the contribution to the plan for the non-vested benefit of Kevin O'Leary was $68,000. The contributions are intended to provide a forfeitable supplemental retirement benefit. Participants in the 457 (f) plan do not vest until age 62 when it is payable to the participant. |
| Part I, Line 7 | The organization's parent (Exeter Health Resources, Inc.) provides an annual incentive compensation plan for executives selected by the Exeter Health Resources Board of Trustees. These executives include: Kevin Callahan, Kevin O'Leary, Constance Sprauer, Brian Campbell and Donna McKinney. The Board and / or its Executive Committee approves measurable achievement criteria for quality, patient satisfaction, process improvement, financial performance, services innovation and other compelling areas of strategic and operational interest. Additionally, the Board and /or its Executive Committee establishes minimum, targeted and maximum levels for incentive awards and approves all awards for participating executives. Jane Peterson, Deanna King, Judith Rines and Bonnie Thibeault participate in an annual incentive program which is administered by Exeter Hospital, Inc.'s Human Resources Department. The management of Exeter Hospital, Inc. approves measureable achievement criteria for Quality/Innovation, Patient Satisfaction, Process Improvement and Financial Performance on an annual basis that aligns with overall strategic interests of the company. The incentive award levels are established at minimum, target and maximum levels and those incentive awards are approved by operating management and Human Resources. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| NH Health and Education Facilities Authority | ||||||||
| A | 020279866 | NONEAVAIL | 2012-02-09 | $32,565,000 | Refinancing and refunding prior bond issuance | 0 | 0 | 0 |
| NH Health and Education Facilities Authority | ||||||||
| B | 020279866 | NONEAVAIL | 2015-03-02 | $24,020,000 | Refinancing and refunding prior bond issuance | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|
| A | $32,565,000 | $215,404 | $32,349,596 | 2012 | 0 | 0 | Yes (1) | Yes (1) |
| B | $24,020,000 | $162,154 | $23,857,846 | 2015 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd |
|---|---|---|---|---|---|---|---|---|---|
| A | Yes (1) | Yes (1) | 0 | 0 | 0 | Yes (1) | |||
| B | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Date Rebate Computation Performed | FormAndLineReferenceDesc |
| Explanation | Issuer Name: NH Health and Education Facilities Authority Date the Rebate Computation was Performed: 03/31/2017 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Exeter Health Resources, Inc., a charitable organization acting through its Board of Trustees, is the sole member of the organization. |
| Form 990, Part VI, Section A, line 7a | The Board of Trustees shall consist of a number not to exceed fifteen (15) persons. Of this number, up to thirteen (13) persons shall have been elected by the Member from among the elected members of the Board of Trustees of the Member. |
| Form 990, Part VI, Section A, line 7b | The sole member, Exeter Health Resources, Inc. has the right to approve decisions of the governing body. Additionally, the Member shall have the power to change the corporate name, merge with or acquire any corporation organized under Chapter 292 of the Revised Statutes Annotated of New Hampshire, amend the articles of agreement, dissolve the Corporation, annually appoint an independent certified public accountant to perform an audit of the accounts of the Corporation, and such other powers and rights as may be reserved to it by law or the articles of agreement. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared by an outside tax accountant with information provided by the organization. The Form 990 is reviewed by the organization's Treasurer, then presented to the Board of Trustees before it is filed with the IRS. |
| Form 990, Part VI, Section B, line 12c | The Board of Trustees has adopted a Conflict of Interest Policy that requires the disclosure of conflicts of interest either when the interest becomes a matter of possible action by the Board or during an annual disclosure process. Trustees, officers, and key employees, as well as all members of senior management, are part of the annual disclosure process, which is initiated by the issuance of a memorandum and accompanying questionnaire by the President and Chief Executive Officer (CEO). All disclosures are reviewed. Any trustee with a conflict of interest is required to abstain from voting and is not included in a quorum determination on the matter and any officer, key employee, or member of senior management with a conflict does not take part in making and is not present for any decision regarding the matter. The policy is monitored and enforced by both the President and CEO and the full Board. There are two additional conflicts of interest policies. One is applicable to all employees and contracted staff and the other is applicable to members of the Medical Staff and allied health professionals. The former policy is monitored and enforced by the Vice President of Human Resources and the Vice President of Corporate Integrity and Compliance and the latter is monitored and enforced by the President of the Medical Staff, President and CEO, General Counsel, and Compliance Officer. On an annual basis, staff within Human Resources survey all employees and contracted staff serving in a managerial role, as well as members of any committees that make recommendations or decisions regarding the purchase of goods or services by any of the corporations as a means to ensure that any conflict of interest is disclosed and appropriately managed. Employees otherwise are required to supplement or make any further written disclosure at the time a conflict arises. |
| Form 990, Part VI, Section B, line 15 | The organization's parent (Exeter Health Resources, Inc.) has a formal process for determining total compensation for the CEO and other listed officers that is intended to provide reasonable compensation for achieving the organization's mission, to recognize individual and team performance and to comply with the organization's obligations as a tax-exempt charitable organization. The Executive Committee of the Exeter Health Resources, Inc.'s Board of Trustees conducts an annual review of the compensation of the CEO, other listed officers and key employees. In doing so, the Committee retains a qualified independent compensation consultant to conduct competitive market analysis of the market ranges of base, incentive, and total cash compensation, and to provide advice concerning the reasonableness of the compensation of the CEO, other listed officers and key employees. The Committee utilizes that analysis and other appropriate information in connection with its annual review and makes recommendations to the full board of Exeter Health Resources, Inc. for adjustment of the CEO's compensation and the compensation for other listed officers. Information which the committee may consider can include but is not limited to the performance of an individual and/or that individual's contributions to a team, the performance of the organization in whole and in part, the elements of total compensation and salary history, the organization's compensation targets and comparability data, including the data prepared by the independent consultant and reviewed with the Committee. The Committee incorporates a performance appraisal process in the CEO's, other listed officers and key employees' compensation review. The CEO, other listed officers and key employees are not present when the committee discusses their respective compensation. In addition, the committee determines if the threshold requirements for incentive awards are met, consisting of the organization's performance results for quality, operating system excellence and financial performance. The results of the Committee's deliberations are presented to the Exeter Health Resources, Inc. Board and include recommendations concerning salary range adjustments and incentive awards and the basis for the Committee's decisions/recommendations. The deliberations of the Exeter Health Resources, Inc. Board are conducted in executive session with the independent members of the Board but do include the CEO only for that period of time in which the Exeter Health Resources, Inc. Board has questions concerning the performance of any listed officer or key employee other than the CEO. The Exeter Health Resources, Inc. Board reviews the CEO's performance and determines if the adjustments and awards recommended by the committee for the CEO are in the organization's best interest and for the benefit of the organization and its parent organization. For the other listed officer positions, adjustments and incentive awards are approved upon recommendation of the CEO by the Executive Committee within the Exeter Health Resources, Inc. Board approved parameters and ratified by the Exeter Health Resources, Inc. Board of Trustees. Adjustments and awards for other listed key employees are approved upon recommendation of the CEO by the Executive Committee within the Exeter Health Resources, Inc. Board approved parameters and reviewed by the Board. |
| Form 990, Part VI, Section C, line 19 | These documents are available upon request. |
| Form 990, Part VI-B, Line 16b: | Although written policies were not in place as of the end of the year covered by this tax return requiring the organization to evaluate its participation in joint venture arrangements under applicable federal law to ensure that the organization's exempt status is protected, the organization performed due diligence with respect to its joint venture arrangements to safeguard the organization's exempt status. |
| Form 990, Part IX, line 11g | Payment to Affiliate: Program service expenses 4,022,248. Management and general expenses 601,026. Fundraising expenses 0. Total expenses 4,623,274. Physician Fees: Program service expenses 6,153,884. Management and general expenses 919,546. Fundraising expenses 0. Total expenses 7,073,430. Contracted Services: Program service expenses 3,258,157. Management and general expenses 486,851. Fundraising expenses 0. Total expenses 3,745,008. Outside Fees: Program service expenses 2,470,213. Management and general expenses 369,040. Fundraising expenses 0. Total expenses 2,839,253. Contract/Temporary Labor: Program service expenses 1,717,048. Management and general expenses 256,570. Fundraising expenses 0. Total expenses 1,973,618. Consulting: Program service expenses 180,234. Management and general expenses 26,931. Fundraising expenses 0. Total expenses 207,165. |
| Form 990, Part XI, line 9: | Net Transfers to Affiliates -21,887,204. Pension Liability Adjustment -4,839,453. Impact of Interest Rate Swaps -2,376,330. Net Assets Released from Restriction 33,654. |
| Form 990, Part XII, Line 2c: | The organization is part of the consolidated operations of Exeter Health Resources, Inc. The Exeter Health Resources, Inc. Executive Committee is responsible for the oversight of the audit and the selection of an independent accountant. There has been no change in the audit process since the prior year. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| Exeter Health Resources Inc | ||||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 020222126 | Management and Supporting Organization; Holding Company | NH | 501(c)(3) | Line 11a, I | 0 | |
| Core Physicians LLC | ||||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 870807914 | Physician Practices | NH | 501(c)(3) | Line 9 | 0 | Exeter Health Resources Inc |
| Rockingham Visiting Nurse Association | ||||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 020274905 | Home Care, Hospice | NH | 501(c)(3) | Line 9 | 0 | Exeter Health Resources Inc |
| Matrix Health Inc | ||||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 020473737 | Manage Resources | NH | 501(c)(3) | Line 11b, II | 0 | Exeter Health Resources Inc |
| Exeter Med Real Inc | ||||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 020418718 | Real Estate Holding Company | NH | 501(c)(25) | 0 | Exeter Health Resources Inc | |
| Exeter Health Resources Self-Insurance Trust | ||||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 200753662 | Self Insurance Trust | NH | 501(c)(3) | Line 11a, I | 0 | Exeter Health Resources Inc |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Convergent Health Systems Inc | |||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 020469711 | Wellness Center | NH | N/A | C | 0 |
| Vx Health Services Inc | |||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 020469712 | Inactive Fitness Center | NH | N/A | C | 0 |
| Exeter Medical Services Inc | |||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 020419850 | Inactive Physician Practice | NH | N/A | C | 0 |
| Core Health Services of MA | |||||||||
| 5 Alumni Drive | Exeter | NH | 03833 | 201598042 | Inactive Physician Practice | MA | 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 | Yes (1) | 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 | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Exeter Med Real Inc | ||
| K | $1,941,711 | Cash |
| Exeter Med Real Inc | ||
| L | $429,227 | Cash |
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