VALLEY REGIONAL HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- VALLEY REGIONAL HOSPITAL INC (EIN 02-0222118)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-15
- IRS object ID
- 201732279349302973
- 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 C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-15T14:40:27-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222118 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Valley Regional Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | VALL | BusinessNameControlTxt |
| Phone | 6035427771 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 243 Elm Street | AddressLine1Txt |
| City | Claremont | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03743 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jean Shaw | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6035427771 | PhoneNum |
| Signature | 2017-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne CPA | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2017-08-15 | 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 | Peter Wright | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 243 Elm Street | AddressLine1Txt |
| City | Claremont | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $40,144,227 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.vrh.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1893 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | Critical Access Hospital | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 421 | TotalEmployeeCnt |
| Total Volunteers | 196 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $41,950 | PYContributionsGrantsAmt |
| CY Contributions Grants | $21,368 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $34,864,772 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,060,520 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,131,389 | PYInvestmentIncomeAmt |
| CY Investment Income | $520,036 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,749 | PYOtherRevenueAmt |
| CY Other Revenue | $45,483 | CYOtherRevenueAmt |
| PY Total Revenue | $39,041,860 | PYTotalRevenueAmt |
| CY Total Revenue | $36,647,407 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,597,628 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,490,056 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,693,941 | PYOtherExpensesAmt |
| CY Other Expenses | $18,961,303 | CYOtherExpensesAmt |
| PY Total Expenses | $40,291,569 | PYTotalExpensesAmt |
| CY Total Expenses | $40,451,359 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,249,709 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,803,952 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $59,416,328 | TotalAssetsBOYAmt |
| Total Assets EOY | $58,374,393 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $39,543,423 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,066,000 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,872,905 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,308,393 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Valley Regional Hospital, Inc. is to foster optimal and sustainable population health. Our vision is to provide compassionate, affordable, evidence-based, high quality care in partnership with the community. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,770,904 | ExpenseAmt |
| Revenue | $36,060,519 | RevenueAmt |
| Desc | Valley Regional Hospital is a provider of health services with facilities in the Claremont, NH area. The Hospital grants credit to patients, substantially all of whom are local residents. The Hospital also provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. The Hospital does not pursue collection of amounts determined to qualify as charity care. The Hospital maintains records to identify and monitor the level of charity care it provides. For the year ending September 30, 2016 charges forgone for services and supplies furnished under the charity care policy were approximately $1,059,000. The estimated cost of those services and supplies was approximately $723,000.In addition, the Hospital provides a number of other services to benefit certain poor and elderly patients. Medicaid and state programs do not cover the full cost of the Hospital incurred cost of providing medical care to patients. The hospital provides services to residents throughout the region. Those services include health evaluations, screenings, and flu vaccine administration at community events and in the workplace. Health education, wellness, chronic disease management, fitness, and ergonomic programs are also widely offered. For these services, and many other community services, the hospital receives little or no payment.Other community benefits can't be quantified or assigned a value. For example, the hospital provides committee and board participants and expertise to address community needs; to support community health initiatives; to advocate for and support individuals who are socially, economically and physically challenged; and to collaborate with the local public safety organizations. | Desc |
| Total Program Service Expenses | $31,770,904 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 0 | 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 | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | 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 | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 63 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 421 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jean Shaw | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6035427771 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 243 Elm Street | AddressLine1Txt |
| City | Claremont | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03743 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Peter Wright | ||||||||
| President & CEO | 38.40 | 1.60 | Yes (X) | Yes (X) | $0 | $245,693 | $20,407 | |
| Robert Porter | ||||||||
| Past Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Alison Raymond | ||||||||
| Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Lisa Richmond | ||||||||
| Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Bernard Rosen MD | ||||||||
| Past Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Jim Wimberg | ||||||||
| Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Michael O'Connell | ||||||||
| Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Michael Satzow | ||||||||
| Co-Vice Chair | 0.90 | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Robert Cricco MD | ||||||||
| Past Trustee | 39.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Michael Fuerst | ||||||||
| Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Oliver Herfort MD | ||||||||
| Trustee | 39.90 | 0.10 | Yes (X) | $259,062 | $0 | $33,631 | ||
| Sherwood Moody | ||||||||
| Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| James Borchert | ||||||||
| Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| Charlene Lovett | ||||||||
| Chair | 0.90 | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Patricia Putnam | ||||||||
| Treasurer | 0.90 | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Charles Sawyer MD | ||||||||
| Past Trustee | 39.90 | 0.10 | Yes (X) | $424,071 | $0 | $23,020 | ||
| Allan Berggren MD | ||||||||
| Secretary | 0.90 | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| John Tomlinson | ||||||||
| Co-Vice Chair | 0.90 | 0.10 | Yes (X) | Yes (X) | $36,000 | $0 | $0 | |
| Deanna Howard | ||||||||
| Past Trustee | 0.90 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| James P Wilton | ||||||||
| Trustee | 31.90 | 0.10 | Yes (X) | $285,790 | $0 | $35,405 | ||
| Jean Shaw | ||||||||
| CFO | 37.20 | 2.80 | Yes (X) | $17,398 | $92,511 | $22,481 | ||
| Jeffrey A Hanissian | ||||||||
| Physician | 36.00 | 0.00 | $335,692 | $0 | $39,460 | Yes (X) | ||
| Joel P Herrington | ||||||||
| Physician | 36.00 | 0.00 | $273,207 | $0 | $24,027 | Yes (X) | ||
| Clifford B Langweiler | ||||||||
| Physician | 36.00 | 0.00 | $370,816 | $0 | $31,344 | Yes (X) | ||
| Ivar L Frithsen | ||||||||
| Physician | 35.00 | 0.00 | $248,801 | $0 | $24,456 | Yes (X) | ||
| Robert L Bassett | ||||||||
| Physician | 32.00 | 0.00 | $519,221 | $0 | $41,649 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,770,058 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $338,204 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $295,880 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Dartmouth Hitchcock Clinic | |||||
| One Medical Center Drive | Lebanon | NH | 03756 | Medical Services | $966,363 |
| MedHost | |||||
| 2739 Momentum Place | Chicago | IL | 606895327 | IT System & Service | $574,415 |
| American Healthcare Services Association | |||||
| PO Box 945 | Traverse City | MI | 49685 | Contract Staffing | $399,943 |
| HP Cummings Construction Company | |||||
| PO Box 269 | Woodsville | NH | 03785 | Construction | $387,312 |
| D&Y | |||||
| PO Box 635715 | Cincinnati | OH | 452635715 | Contract Staffing | $366,501 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $20,815 | FundraisingAmt |
| All Other Contributions | $553 | AllOtherContributionsAmt |
| Total Contributions | $21,368 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Patient Service Revenue | 621400 | $59,071,356 | $59,071,356 | |
| Other Revenue | 900099 | $935,746 | $805,791 | $129,955 |
| Meaingful Use Revenue | 624100 | $146,758 | $146,758 | |
| Provision for Bad Debts | 621400 | -$2,760,601 | -$2,760,601 | |
| Charity/Contractual Adjustment | 621400 | -$21,332,739 | -$21,332,739 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,060,520 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $718,762 | TotalRevenueColumnAmt |
| Exclusion | $718,762 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $139,975 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $94,492 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $45,483 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,483 | TotalRevenueColumnAmt |
| Exclusion | $45,483 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,186,266 | SecuritiesAmt |
| Other | $800 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,384,719 | SecuritiesAmt |
| Other | $1,073 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$198,453 | SecuritiesAmt |
| Other | -$273 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$198,726 | TotalRevenueColumnAmt |
| Exclusion | -$198,726 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $16,536 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $20,815 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $16,536 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,647,407 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,930,565 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $695,474 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,115,940 | TotalAmt |
| Program Services | $1,100,770 | ProgramServicesAmt |
| Management And General | $15,170 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,996,165 | TotalAmt |
| Program Services | $12,694,882 | ProgramServicesAmt |
| Management And General | $3,301,283 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,994 | TotalAmt |
| Program Services | $25,253 | ProgramServicesAmt |
| Management And General | $9,741 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,211,851 | TotalAmt |
| Program Services | $2,572,122 | ProgramServicesAmt |
| Management And General | $639,729 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,131,106 | TotalAmt |
| Program Services | $910,766 | ProgramServicesAmt |
| Management And General | $220,340 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,303 | TotalAmt |
| Management And General | $74,303 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,225 | TotalAmt |
| Management And General | $70,225 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,074 | TotalAmt |
| Management And General | $202,074 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,288,523 | TotalAmt |
| Program Services | $6,145,197 | ProgramServicesAmt |
| Management And General | $1,143,326 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $334,204 | TotalAmt |
| Program Services | $269,101 | ProgramServicesAmt |
| Management And General | $65,103 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $795,017 | TotalAmt |
| Program Services | $640,147 | ProgramServicesAmt |
| Management And General | $154,870 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,927,884 | TotalAmt |
| Program Services | $1,552,332 | ProgramServicesAmt |
| Management And General | $375,552 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,880 | TotalAmt |
| Program Services | $19,229 | ProgramServicesAmt |
| Management And General | $4,651 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,054,118 | TotalAmt |
| Management And General | $1,054,118 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,999,854 | TotalAmt |
| Program Services | $1,610,282 | ProgramServicesAmt |
| Management And General | $389,572 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $373,347 | TotalAmt |
| Management And General | $373,347 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $2,549,492 | $2,052,851 | $496,641 |
| Medicaid Enhancement Ta | $1,804,265 | $1,804,265 | |
| Miscellaneous | $328,214 | $264,278 | $63,936 |
| Dues & Subscriptions | $135,903 | $109,429 | $26,474 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,451,359 | TotalAmt |
| Program Services | $31,770,904 | ProgramServicesAmt |
| Management And General | $8,680,455 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,189 | BOYAmt |
| EOY | $227,209 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,379,138 | BOYAmt |
| EOY | $7,452,354 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,633,953 | BOYAmt |
| EOY | $3,420,753 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $666,268 | BOYAmt |
| EOY | $761,863 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $470,813 | BOYAmt |
| EOY | $388,892 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $46,773,148 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,499,765 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,612,000 | BOYAmt |
| EOY | $16,273,383 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,085,835 | BOYAmt |
| EOY | $24,177,100 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,621,100 | BOYAmt |
| EOY | $3,958,967 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,738 | BOYAmt |
| EOY | $153,583 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,600,294 | BOYAmt |
| EOY | $1,560,289 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,416,328 | BOYAmt |
| EOY | $58,374,393 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,148,232 | BOYAmt |
| EOY | $4,400,549 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,404 | BOYAmt |
| EOY | $88,844 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,240,000 | BOYAmt |
| EOY | $23,685,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $172,030 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,075,787 | BOYAmt |
| EOY | $11,719,577 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,543,423 | BOYAmt |
| EOY | $40,066,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,770,901 | BOYAmt |
| EOY | $12,814,020 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,227,010 | BOYAmt |
| EOY | $1,281,512 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,874,994 | BOYAmt |
| EOY | $4,212,861 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,872,905 | BOYAmt |
| EOY | $18,308,393 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,416,328 | BOYAmt |
| EOY | $58,374,393 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,803,952 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,255,840 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$16,400 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 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 | $10,774 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,774 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Organization pays dues to local associations, a portion of which are attributable to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,948,736 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $441,723 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $945 | AdministrativeExpensesAmt |
| End Year Balance | $5,389,514 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,350,477 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$400,894 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $847 | AdministrativeExpensesAmt |
| End Year Balance | $4,948,736 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,934,551 | BeginningYearBalanceAmt |
| Contributions | $63 | ContributionsAmt |
| Investment Earnings Or Losses | $416,864 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,001 | AdministrativeExpensesAmt |
| End Year Balance | $5,350,477 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,685,173 | BeginningYearBalanceAmt |
| Contributions | $67 | ContributionsAmt |
| Investment Earnings Or Losses | $250,258 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $947 | AdministrativeExpensesAmt |
| End Year Balance | $4,934,551 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,044,562 | BeginningYearBalanceAmt |
| Contributions | $72 | ContributionsAmt |
| Investment Earnings Or Losses | $640,539 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $4,685,173 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.78170 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.21830 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $250,667 | OtherCostOrOtherBasisAmt |
| Book Value | $250,667 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,967,210 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,692,919 | DepreciationAmt |
| Book Value | $7,274,291 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $148,235 | OtherCostOrOtherBasisAmt |
| Depreciation | $127,582 | DepreciationAmt |
| Book Value | $20,653 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,261,856 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,921,122 | DepreciationAmt |
| Book Value | $8,340,734 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,145,180 | OtherCostOrOtherBasisAmt |
| Depreciation | $758,142 | DepreciationAmt |
| Book Value | $387,038 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,273,383 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Beneficial Interest in Perpetual Trusts | Desc |
| Book Value | $3,958,967 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $3,958,967 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Due To Affiliates | $101,651 |
| Estimated Third-Party Payor Settlements | $8,563,875 |
| Interest Rate Swaps | $2,342,742 |
| Reserve for Self-Funded Insurance | $711,309 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,719,577 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $38,792,250 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,255,840 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $111,028 | OtherRevenueAmt |
| Revenue Not Reported | $2,366,868 | RevenueNotReportedAmt |
| Revenue Subtotal | $36,425,382 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $202,074 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $19,951 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $222,025 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $36,647,407 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $40,356,762 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $111,028 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $111,028 | ExpensesNotReportedAmt |
| Expenses Subtotal | $40,245,734 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $202,074 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $3,551 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $205,625 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $40,451,359 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The Organization uses its endowment funds in support of health care services, purchases of equipment, health education, and indigent care. |
| Part XI, Line 2d - Other Adjustments: | Rental Expenses 94,492. Fundraising Expenses 16,536. |
| Part XI, Line 4b - Other Adjustments: | Other Nonoperating Expenses Included in Revenue 3,551. Transfer to Affiliates 16,400. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses 94,492. Fundraising Expenses 16,536. |
| Part XII, Line 4b - Other Adjustments: | Other Nonoperating Expenses Included in Revenue 3,551. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $26,230 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $11,468 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $14,762 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $3,077 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $4,275 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $85 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $7,324 | OtherDirectExpensesEvent1Amt |
| Event2 | Wine Gala | Event2Nm |
| Gross Receipts Event2 | $5,748 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $5,140 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $608 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $425 | RentFacilityCostsEvent2Amt |
| Other Direct Expenses Event2 | $183 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $5,373 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $4,207 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $1,166 | GrossRevenueOtherEventsAmt |
| Rent Fclty Costs Other Events | $600 | RentFcltyCostsOtherEventsAmt |
| Oth Direct Expnss Other Events | $567 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $37,351 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $20,815 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $16,536 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $3,077 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $5,300 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $85 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,074 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $16,536 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $0 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 275.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,467,463 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,665,064 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $802,399 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01980 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,043,612 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,342,972 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,700,640 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04200 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,511,075 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,008,036 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,503,039 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06180 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $208,227 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $208,227 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $106,865 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $106,865 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $119,527 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $119,527 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,882 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,882 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $457,501 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $457,501 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,968,576 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,008,036 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,960,540 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07310 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $65,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $65,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $104,100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $104,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,729,497 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $11,559,262 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,559,262 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | Valley Regional Hospital Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 243 Elm Street | AddressLine1Txt |
| City | Claremont | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.vrh.org | WebsiteAddressTxt |
| State License | 00007 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Valley Regional 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 14 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.vrh.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.vrh.org | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 275.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://vrh.org/patient-billing/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://vrh.org/patient-billing/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://vrh.org/patient-billing/ | 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 |
| 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 Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| 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 |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Valley Regional Hospital, Inc. | Part V, Section B, Line 5: During the period March through July, 2015, a Community Health Needs Assessment in the Valley Regional Hospital service area of New Hampshire was conducted by Valley Regional Hospital in partnership with New London Hospital, Alice Peck Day Memorial Hospital, Dartmouth-Hitchcock, and Mt. Ascutney Hospital and Health Center. Information gathering utilized in the assessment included the following: 1. Area residents survey made available through direct mail and website links 2. Physical surveys and survey collection boxes in public places throughout the region - chamber of commerce offices, physicians' offices, libraries 3. Survey of key community stakeholders who are agency, municipal, or community leaders, including: - Dr. Karen Baranowski, Executive director Connecticut Valley Homecare and Hospice - Elyse Crossman, ED Greater Claremont Chamber of Commerce - Ella Casey, ED Newport Chamber of Commerce - Dr. Middleton McGoodwin (and staff), Superintendent of Schools SAU #6 - Dr. Cindy Gallagher (and staff), Superintendent of Schools SAU #43 - Nancy Merrill, Administrator, City of Claremont - Dr. Aurora Drew, Public Health Advisory Council - Jessie Levine, Sullivan County Manager - Deborah Mozden, ED Turning Points Network - Maggie Monroe-Cassel, ED TLC - Corey Gagnon, ED Community Alliance - Dr. Richard Root, Valley Regional Healthcare - Curtis Harvie, APRN, Valley Regional Healthcare - Tracy Pike, RN, Emergency Department Manager 2. community member discussion groups convened at soup kitchens, homeless shelters, recovery communities 3. review of available population demographics and health status indicators. |
| Valley Regional Hospital, Inc. | Part V, Section B, Line 6a: Valley Regional partnered with the following other local hospitals: - New London Hospital - Alice Peck Day Memorial Hospital, - Dartmouth-Hitchcock Medical center - Mt. Ascutney Hospital and Health CenterThere is significant overlap in service area among these organizations; the CHNA identified both regional and community-specific needs. |
| Valley Regional Hospital, Inc. | Part V, Section B, Line 7d: The CHNA was widely distributed in traditional ways (hard copy mailings, website, handouts at community meetings, etc) as well as via a recorded community access cable television program. |
| Valley Regional Hospital, Inc. | Part V, Section B, Line 11: CHNA Implementation StrategyThe issues identified through the Community Health Needs Assessment far outstrip the ability of a single entity to ameliorate those issues. Valley Regional Healthcare (VRH) is an active partner in determining ways to address every one of the identified issues; we are doing so across the healthcare system, in collaboration with many other local non-profit groups.The following are the identified issues that Valley Regional Hospital can most directly affect, using its own resources:1. Alcohol and drug misuse including heroin and misuse of pain medications a. Commit personnel and other necessary resources to collaborate with other local, county and state groups that are working in prevention and treatment b. Explore ways to bring treatment opportunities (in-patient and/or out-patient) onto the VRH campus c. Provide appropriate and on-going training for staff d. Review and update policies and procedures, as needed2. Access to mental health care a. Commit personnel and other necessary resources to collaborate with other local, county and state groups that are working to increase access to mental health treatment b. In tandem with state agencies, explore ways to bring treatment opportunities (in-patient and/or out-patient) onto the VRH campus c. Provide appropriate and on-going training for staff, particularly in the Emergency Department d. Review and update policies and procedures, as needed3. Access to enough and affordable health insurance; cost of prescription drugs a. Continue to provide patient education and assistance regarding access to assistance programs b. Utilize media channels to promote those programs to the community c. Provide appropriate and on-going training for staff d. Work at the state and Federal level to advocate for those who need help4. Access to Primary Health Care a. Increase the number of primary care providers in the Valley Regional Healthcare system b. Create a media strategy to introduce PCP's to the community c. Assess accessibility in terms of hours, days of the week, same-day appointments, coordination with Urgent Care and the Emergency Department d. Create educational materials to encourage annual wellness exams for all ages5. Health care for seniors a. Continue to provide patient education and assistance regarding access to assistance programs b. Utilize media channels to promote those programs to the community c. Provide appropriate and on-going training for staff d. Work at the state and Federal level to advocate for those who need helpThe following are identified needs that the hospital can play a supportive role in the community to address:1. Lack of physical activity; need for recreational opportunities a. Continue to sponsor activities, programs and organizations that foster physical fitness, including numerous 5k races/walks, exercise classes, etc. b. Publicize the efforts that support physical activities - cross postings of Claremont Community Center programs, city and county offerings c. Promote physical activity through primary care2. Access to dental health care a. Support the efforts of the Community Dental Center through a Loaned Executive program b. Cross-promote Dental Center information c. Educate patients on Dental Center services, as appropriate3. Poor nutrition/unhealthy food a. Create an accessible community garden, in partnership with other community groups b. Provide free cooking classes to educate the community about nutrition c. Collaborate with community groups who are providing food and meals - the Claremont Soup Kitchen and Food Pantry, Meals on Wheels, summer meals program for children d. Cross-promote programs and opportunities to address healthy choices, such as Farmers' Markets4. Income, poverty and family stress a. Provide screenings in the ED, Urgent Care and primary care practices to identify domestic violence b. As one of the largest employers in the area, be an employer of choice by offering competitive wages, benefits and training c. Work with other local and state organizations, including vocational high schools, on workforce developmentPlease see the attached Strategic Implementation Plan. This plan is also posted to the Hospital's website, but was not done so as of 9/30/16. |
| Valley Regional Hospital, Inc. | Part V, Section B, Line 20e: Applications are offered to all self-pay patients along with education regarding NHHP and expanded Medicaid. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Kane Oncology Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 243 Elm Street | AddressLine1Txt |
| City | Claremont | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Oncology Center | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | It is the policy of Valley Regional Hospital to provide financial assistance to those patients who are unable to pay for all or part of the cost of their care that is not covered by other sources of funding. Valley Regional Hospital's Financial Assistance Program is a program that assists uninsured and under-insured patients who meet specific income, geographical and Valley Regional Hospital guidelines.The Hospital will cover up to 100% of the cost of care for patients depending on the patient's level of income and family size. The Hospital also is a participating provider with the NH Health Access Network. |
| Part I, Line 7: | The Organization used an overall cost to charge ratio for lines 7a and 7b. Amounts listed on lines 7e, 7f and 7i were derived from internal financial/cost accounting systems. |
| Part II, Community Building Activities: | Valley Regional Healthcare believes the skills and knowledge of its employees are the most critical assets to building a strong and healthy community. VRH employees participate on a wide variety of local boards serving or participating in health and wellness missions, including dental health, domestic violence, higher education, school boards, chambers of commerce, United Way, public transportation, elder health, and substance abuse. Employees also participate on state level boards and within elected government, working to improve policy and practice on a broad spectrum. Local businesses rely upon collaborations with VRH to provide education and expertise in community building activities such as through public and private health fairs. VRH takes advantage of public chamber activities, such as the Chili and Apple Festivals, Winter Carnivals, and Spring Home Show to provide tables of health information and free screening activities. VRH also provides financial support for non-profit organizations with complementary missions, in the form of event sponsorships. |
| Part III, Line 4: | Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts andhistorical adjustments. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable.In evaluating the collectibility of accounts receivable, the Hospital analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews dataabout these major payor sources in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a provision for bad debts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts.During 2016, the Hospital decreased its estimate from $2,950,622 to $2,430,894 in the allowance for doubtful accounts relating to self-pay patients and during 2015 the Hospital decreased its estimate from $3,041,148 to $2,950,622 in the allowance for doubtful accounts relating to self-pay patients. During 2016, self-pay write-offs increased from $3,188,142 to $3,227,833 and during 2015 self-pay write-offs decreased from $4,597,314 to $3,188,142. Such changes in write-off amounts resulted from trends experienced in the collection of amounts from self-pay patients.The Organization used a cost-to-charge ratio as its methodology for reporting bad debt expense at cost. |
| Part III, Line 8: | Medicare costs approximate Medicare revenue. The Organization does not anticipate a Medicare shortfall or that any such shortfall should be considered as community benefit. |
| Part III, Line 9b: | Patients who are known to qualify for financial assistance file a financial assistance determination application with the Hospital. If the application is approved, the patient's account shall be written off, in accordance to the level of adjustment the applicant was qualified to receive. The patient write-off guidelines are as follows:1. The determination is valid for 6 months from the date of signature for all applications except those individuals who demonstrate that they are on a fixed income (i.e. Social Security, retirment, disability), in which case approval is for 1 year from the date of signature.2. Patient qualifies according to the established Financial Assistance income guidelines3. Account notes must indicate what payor that the balance is due to (appropriate payor write-off codes to be utilized). |
| Part VI, Line 2: | The purpose of the assessment was to identify community health concerns, priorities and opportunities for community health and health care delivery systems improvement. Working with The Community Health Institute/JSI, VRH and our partner hospitals brought together key healthcare, public service and community member stakeholders to collect both qualitative and quantitative data. The CHNA provides a clear blueprint for community outreach and collaboration opportunities, and also creates a timely benchmark against which to measure progress.The purpose of the research design was as follows: 1. To clearly define the VRH service area 2. To define measurement methodologies which can identify community needs 3. To create a prioritized list of community resources 4. To develop a catalogue of available healthcare resourcesThe following health issues were identified by survey respondents: 1. Cost of prescription drugs 2. Alcohol and drug misuse 3. Access to enough, affordable health insurance 4. Heroin and misuse of pain medications 5. Access to mental health care 6. Lack of physical activity 7. Access to dental health care 8. Poor nutrition/unhealthy food 9. Income, poverty and family stress 10. Access to primary health care 11. Smoking/tobacco use 12. Mental illness 13. Cancer 14. Care for seniors |
| Part VI, Line 3: | The Community Engagement department has created and posted signage throughout the hospital and clinics, and has posted information on the hospital's website. |
| Part VI, Line 4: | Valley Regional serves a rural region which includes the 15 towns of Sullivan County and portions of eastern Vermont, with a total resident population of 43,742. Spanning 552 spare miles, it is the 2nd least populous county in NH. 10% of individuals live below the poverty line; 12.6% are under the age of 18, 7.9% over 65. |
| Part VI, Line 5: | Valley Regional Healthcare recognizes its importance to the community - economically, as one of the largest local employers, and philosophically, as a large entity entrusted with community wellness. VRH leadership instills in employees the sense of responsibility to be involved in support of the community, on behalf of the hospital.VRH employees participate and lend expertise as board members of other non-profits, including those focused on dental health, community revitalization, higher education and school boards, elder issues, public transportation, domestic violence, substance misuse and abuse, and health and wellness initiatives. Employees also participate on state and Federal boards and committees as well as Chambers of Commerce and United Way, working to improve policy and practice in healthcare delivery.Business collaborations are a priority, particularly with large employers such as Sturm Ruger, Crown Point Cabinetry, the City of Claremont, Parks and Recreation, CoWorx, and many local banks. Our common goals include health education, health screenings, worker safety and employment opportunities. |
| Part VI, Line 6: | Valley Regional Hospital is not affiliated with another healthcare system, but it collaborates voluntarily with other hospitals. Sharing resources, both material and human, participating in community groups, providing sponsorships to other non-profits whose missions are aligned, contributing to disaster and international relief efforts, partnering with the American Red Cross for blood drives - all these things represent community benefits. Additionally, we provide free physical space for groups like Alcoholics Anonymous, local non-profits, Rotary, and community groups like Healthy Vibrant Claremont. Our physicians and other providers offer free wellness programming at locations throughout the communities we serve - at senior centers, schools, recreation venues. |
| Part VI, Line 7, Reports Filed With States | NH |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Peter Wright | ||||||||||||||
| President & CEO | $0 | $245,513 | $0 | $0 | $0 | $180 | $0 | $12,420 | $0 | $7,987 | $0 | $266,100 | $0 | $0 |
| Oliver Herfort MD | ||||||||||||||
| Trustee | $244,423 | $0 | $0 | $0 | $14,639 | $0 | $5,293 | $0 | $28,338 | $0 | $292,693 | $0 | $0 | $0 |
| Charles Sawyer MD | ||||||||||||||
| Past Trustee | $424,071 | $0 | $0 | $0 | $0 | $0 | $8,605 | $0 | $14,415 | $0 | $447,091 | $0 | $0 | $0 |
| James P Wilton | ||||||||||||||
| Trustee | $264,629 | $0 | $20,000 | $0 | $1,161 | $0 | $2,271 | $0 | $33,134 | $0 | $321,195 | $0 | $0 | $0 |
| Jeffrey A Hanissian | ||||||||||||||
| Physician | $328,348 | $0 | $0 | $0 | $7,344 | $0 | $6,947 | $0 | $32,513 | $0 | $375,152 | $0 | $0 | $0 |
| Joel P Herrington | ||||||||||||||
| Physician | $260,663 | $0 | $12,279 | $0 | $265 | $0 | $0 | $0 | $24,027 | $0 | $297,234 | $0 | $0 | $0 |
| Clifford B Langweiler | ||||||||||||||
| Physician | $346,926 | $0 | $0 | $0 | $23,890 | $0 | $7,871 | $0 | $23,473 | $0 | $402,160 | $0 | $0 | $0 |
| Ivar L Frithsen | ||||||||||||||
| Physician | $203,513 | $0 | $35,000 | $0 | $10,288 | $0 | $2,465 | $0 | $21,991 | $0 | $273,257 | $0 | $0 | $0 |
| Robert L Bassett | ||||||||||||||
| Physician | $512,058 | $0 | $0 | $0 | $7,163 | $0 | $10,946 | $0 | $30,703 | $0 | $560,870 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Valley Regional Healthcare, Inc., a related organization, establishes the compensation for the Organization's CEO & CFO. Valley Regional Healthcare, Inc. uses a variety of resources to establish compensation as follows: 1. Form 990 of other organizations 2. Written employment contract 3. Compensation survey/study 4. Approval by the board/compensation committee |
| Part I, Line 7 | Individuals listed with Incentive Bonus amounts are physicians who under their employment agreements/contracts have a provision for Incentive Bonus based on their Relative Value Units (RVU) of services exceeding a target amount. |
| Form 990, Part VII, line 5: | Peter Wright, CEO is paid by Mary Hitchcock Memorial Hospital, an unrelated organization via a professional services agreement. A breakdown of Mr. Wright's 2015 compensation is as follows: Salary: $245,693 Benefits: $20,407 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | State of New Hampshire Business Finance Authority | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 521304598 | BondIssuerEIN |
| CUSIP | 64468KBJ4 | CUSIPNum |
| Bond Issued | 2008-06-02 | BondIssuedDt |
| Issue Price | $26,260,000 | IssuePriceAmt |
| Purpose | Financing for Buildings and Structures | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,575,000 | RetiredAmt |
| Total Proceeds | $26,260,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $325,806 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $25,934,194 | CapitalExpendituresAmt |
| Substantial Completion | 2010 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | Yes (1) | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Morgan Stanley & | BusinessNameLine1Txt |
| Business Name Line2 | RBS Citizens | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 20.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Date Rebate Computation Performed | FormAndLineReferenceDesc |
| Explanation | Issuer Name: State of New Hampshire Business Finance Authority Date the Rebate Computation was Performed: 06/02/2017 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | An oncology practice was re-established at the Hospital. Patients receiving treatment for cancer and other illnesses necessitating infusion therapies can now be cared for in their community. In October 2016, an oncologist will be on-site two days a week to manage cancer care, and special training has been provided to the nurses in this area. |
| Form 990, Part VI, Section A, line 6 | The sole member of the Organization is Valley Regional Healthcare, Inc. |
| Form 990, Part VI, Section A, line 7a | The Organization's directors are nominated and elected by the Organization's member at the annual meeting of the Corporation. |
| Form 990, Part VI, Section A, line 7b | The following actions and undertakings involving the business of the Organization are subject to the ratification by the member: adoption of operating budget; adoption of capital budgets; adoption of strategic plans; initiation of significant fund-raising activities; implementation of institutional affiliations, mergers, consolidations or other reorganizations; material modification of service and business offerings; material acquisitions or dispositions of assets; changes in certified public accountants, fiscal year or material accounting practices; incurrence of material indebtedness; material changes in insurance programs and arrangements; material changes in employee benefits plans; adoption of quality improvements plans; election of directors; selection of the president/CEO; amendment of the Organization's bylaws; and amendment of the articles of association. |
| Form 990, Part VI, Section B, line 11 | The Organization's CFO reviews the draft Form 990 prior to its filing. The CFO then goes over the document with the board's finance committee. |
| Form 990, Part VI, Section B, line 15 | The executive committee of the board of trustees convenes two to four times annually to review the compensation of the CEO. Regional compensation of like-sized organization is used. The amount of compensation shall be reviewed by the D-H independent compensation consultant for purposes of determining compliance with the rebuttable presumption, if necessary. The CEO compensation is tied to the strategic planning goals of the Organization. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. |
| Form 990, Part IX, line 11g | Physician Fees: Program service expenses 1,419,287. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,419,287. Purchased Services: Program service expenses 4,387,361. Management and general expenses 1,061,423. Fundraising expenses 0. Total expenses 5,448,784. Other Professional Fees: Program service expenses 338,549. Management and general expenses 81,903. Fundraising expenses 0. Total expenses 420,452. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Valley Regional Hospital, Inc. 243 Elm Street Claremont, NH 03743 EIN: 02-0222118 Valley Regional Hospital, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
| Form 990, Part XI, line 9: | Transfer to Affiliate -16,400. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Valley Regional Healthcare Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 243 Elm Street | AddressLine1Txt |
| City | Claremont | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020397338 | EIN |
| Primary Activities | Healthcare supporting organization | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 11b, II | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| George H Stowell Trust | ||||||||||
| 295 Windsor Rd | Claremont | NH | 03743 | Charitable Trust | NH | T | $49,379 | $1,860,564 | 1.00000 | 0 |
| Clarence H Martin Trust | ||||||||||
| 243 Elm St | Claremont | NH | 03743 | Charitable Trust | NH | T | $2,063,581 | 0.66670 | 0 | |
| McGuire Endowment | ||||||||||
| 243 Elm St | Claremont | NH | 03743 | Charitable Trust | NH | T | $34,822 | 1.00000 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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