LITTLETON HOSPITAL ASSOCIATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- LITTLETON HOSPITAL ASSOCIATION (EIN 02-0222152)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-05-05
- IRS object ID
- 201741259349301024
- 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 H
- Schedule I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-05T09:57:54-05:00 | 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 | 020222152 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LITT | BusinessNameControlTxt |
| Phone | 6034449000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1Txt |
| City | Littleton | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03561 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VP of Finance | PersonNm |
| Person Title | VP of Finance | PersonTitleTxt |
| Phone | 6034449000 | PhoneNum |
| Signature | 2017-05-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Barbara J McGuan CPA | PreparerPersonNm |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2017-05-01 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Regional Healthcare | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Robert F Nutter | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1Txt |
| City | Littleton | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03561 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $96,164,188 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.littletonhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1906 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | To provide health care services in Northern New Hampshire | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 577 | TotalEmployeeCnt |
| Total Volunteers | 247 | TotalVolunteersCnt |
| Total Gross UBI | $237 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$149 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $30,872 | PYContributionsGrantsAmt |
| CY Contributions Grants | $367,741 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $87,169,612 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $87,274,990 | CYProgramServiceRevenueAmt |
| PY Investment Income | $586,877 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,836 | CYInvestmentIncomeAmt |
| PY Other Revenue | $218,632 | PYOtherRevenueAmt |
| CY Other Revenue | $203,874 | CYOtherRevenueAmt |
| PY Total Revenue | $88,005,993 | PYTotalRevenueAmt |
| CY Total Revenue | $87,856,441 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $235,168 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $98,329 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $47,819,749 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,421,138 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $38,957,121 | PYOtherExpensesAmt |
| CY Other Expenses | $38,190,407 | CYOtherExpensesAmt |
| PY Total Expenses | $87,012,038 | PYTotalExpensesAmt |
| CY Total Expenses | $87,709,874 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $993,955 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $146,567 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $95,939,117 | TotalAssetsBOYAmt |
| Total Assets EOY | $98,584,999 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $49,197,745 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $49,112,149 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $46,741,372 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $49,472,850 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To provide quality, compassionate and accessible healthcare in a manner that brings value to all.To offer a full spectrum of services, including acute primary and selected secondary care; 24-hour emergency services; preventive diagnostic, theraputic, and rehabilitative services on an outpatient and inpatient basis; continuity of care from preventive programs to coordination with home health services.To provide these services without regard to race, religion, age, sex, income, creed, national origin, or disability.To maintain a sufficient number and mix of medical staff who are competent, dedicated and commmunity based, supporting them with the technologically up-to-date equipment and facility needed to provide these services competitively.To create a healthy, satisfying work environment for phsycians, nurses and other employees, with a commitment to support the continuing educational needs of its professional staff, including the physicians, nurses and allied health personnel. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $66,752,103 | ExpenseAmt |
| Grant | $98,329 | GrantAmt |
| Revenue | $87,274,990 | RevenueAmt |
| Desc | Littleton Hospital Association provides health care services on an in/outpatient basis to the general public, including charity care, community education, and various other health programs and services. | Desc |
| Total Program Service Expenses | $66,752,103 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | 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 | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 123 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 577 | 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Leslie Walker VP of Finance | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6034449000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Rd | AddressLine1Txt |
| City | Littleton | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03561 | 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Stevan Trooboff | |||||||||
| Past Chairman | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| William Bedor | |||||||||
| Chairman | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| James Hamblin | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| John Starr | |||||||||
| Vice Chair | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Dr Andrew Forrest | |||||||||
| Trustee/Physician | 40.00 | Yes (X) | $308,176 | $0 | $37,484 | ||||
| Dr John Sauter | |||||||||
| Trustee Emeritus | 40.00 | 1.00 | Yes (X) | $308,570 | $0 | $13,250 | |||
| Laurie Morgan | |||||||||
| Auxiliary Representative | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Deane Rankin | |||||||||
| Trustee/Physician | 40.00 | Yes (X) | $380,911 | $0 | $51,457 | ||||
| Roger Gingue | |||||||||
| Treasurer | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Dr Imelyn Fernandez | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Gail Tomlinson | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Kim Butler | |||||||||
| Past Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Jeff Woodward | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Erin Hennessey | |||||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Dr Dougald MacArthur | |||||||||
| Past Chief of Staff | 40.00 | Yes (X) | $706,000 | $0 | $0 | ||||
| James Nohl | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Stephen Goldberg | |||||||||
| Chief of Staff | 40.00 | Yes (X) | $316,610 | $0 | $55,049 | ||||
| Warren West | |||||||||
| Ex-Officio/ Past CEO | 40.00 | 1.00 | Yes (X) | $336,953 | $0 | $30,157 | |||
| Nick Braccino | |||||||||
| Interim President | 40.00 | 1.00 | Yes (X) | $207,397 | $0 | $40,578 | |||
| Andrew Majka | |||||||||
| CFO | 40.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Linda Gilmore | |||||||||
| CAO/CNO | 40.00 | $219,309 | $0 | $47,194 | Yes (X) | ||||
| Dr Patrick Fitzpatrick | |||||||||
| Physician | 40.00 | $721,788 | $0 | $51,143 | Yes (X) | ||||
| Dr Eric Mullins | |||||||||
| Physician | 40.00 | $693,744 | $0 | $46,159 | Yes (X) | ||||
| Dr Harlan Herr | |||||||||
| Physician | 40.00 | $575,967 | $0 | $28,456 | Yes (X) | ||||
| Dr Jeffrey Kauffman | |||||||||
| Physician | 40.00 | $466,528 | $0 | $50,000 | Yes (X) | ||||
| Dr Leon Kogan | |||||||||
| Physician | 40.00 | $496,559 | $0 | $24,464 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,738,512 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $475,391 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 68 | 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 |
|---|---|---|---|---|---|
| The Alpine Clinic PLLC | |||||
| 1095 Profile Rd | Franconia | NH | 03580 | Professional Services Agreement | $4,596,834 |
| Hutter Construction | |||||
| 810 Turnpike Road | New Ipswich | NH | 03071 | General Contractor | $645,330 |
| Balanced Healthcare Receivables LLC | |||||
| 164 Burke St | Nashua | NH | 03060 | Collection Services | $427,674 |
| Griffin York & Krause | |||||
| 121 River Front Drive | Manchester | NH | 03102 | Advertising Consultant | $341,319 |
| Rath Young & Pignatelli PC | |||||
| 1 Capital Plaza Suite 2 | Concord | NH | 03302 | Legal Services | $320,652 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $355,435 | RelatedOrganizationsAmt |
| All Other Contributions | $12,306 | AllOtherContributionsAmt |
| Noncash Contributions | $338,459 | NoncashContributionsAmt |
| Total Contributions | $367,741 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|---|
| Patient Service Revenue | 900099 | $162,442,904 | $162,442,904 | ||
| Other Revenue | 900099 | $3,128,741 | $2,434,430 | $694,311 | |
| Contract Lab | 621500 | $124,278 | $124,041 | $237 | |
| Provision for Bad Debts | 900099 | -$4,097,253 | -$4,097,253 | ||
| Contractual Allowances | 900099 | -$74,323,680 | -$74,323,680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $87,274,990 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $428,841 | TotalRevenueColumnAmt |
| Exclusion | $428,841 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $203,874 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $203,874 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $203,874 | TotalRevenueColumnAmt |
| Exclusion | $203,874 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,839,461 | SecuritiesAmt |
| Other | $49,281 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,204,347 | SecuritiesAmt |
| Other | $103,400 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$364,886 | SecuritiesAmt |
| Other | -$54,119 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$419,005 | TotalRevenueColumnAmt |
| Exclusion | -$419,005 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $87,856,441 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $86,580,442 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $237 | UnrelatedBusinessRevenueAmt |
| Exclusion | $908,021 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,329 | TotalAmt |
| Program Services | $98,329 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,353,094 | TotalAmt |
| Program Services | $1,471,507 | ProgramServicesAmt |
| Management And General | $881,587 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,132,605 | TotalAmt |
| Program Services | $33,255,380 | ProgramServicesAmt |
| Management And General | $4,877,225 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,231,413 | TotalAmt |
| Program Services | $1,082,941 | ProgramServicesAmt |
| Management And General | $148,472 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,490,504 | TotalAmt |
| Program Services | $4,775,328 | ProgramServicesAmt |
| Management And General | $715,176 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,213,522 | TotalAmt |
| Program Services | $1,903,001 | ProgramServicesAmt |
| Management And General | $310,521 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,313 | TotalAmt |
| Management And General | $287,313 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,014 | TotalAmt |
| Management And General | $135,014 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,744 | TotalAmt |
| Management And General | $97,744 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,298,587 | TotalAmt |
| Program Services | $2,743,695 | ProgramServicesAmt |
| Management And General | $2,554,892 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $434,554 | TotalAmt |
| Program Services | $29,834 | ProgramServicesAmt |
| Management And General | $404,720 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,964,325 | TotalAmt |
| Program Services | $3,027,218 | ProgramServicesAmt |
| Management And General | $937,107 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,893,819 | TotalAmt |
| Program Services | $286,393 | ProgramServicesAmt |
| Management And General | $1,607,426 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,777,016 | TotalAmt |
| Program Services | $2,321,073 | ProgramServicesAmt |
| Management And General | $1,455,943 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,435 | TotalAmt |
| Program Services | $59,532 | ProgramServicesAmt |
| Management And General | $36,903 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,893 | TotalAmt |
| Program Services | $64,893 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $894,422 | TotalAmt |
| Program Services | $894,422 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,242,668 | TotalAmt |
| Program Services | $4,400,177 | ProgramServicesAmt |
| Management And General | $842,491 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,417,174 | TotalAmt |
| Program Services | $498,582 | ProgramServicesAmt |
| Management And General | $918,592 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $9,060,391 | $9,060,391 | |
| Medicaid Enhancement Ta | $3,436,805 | $3,436,805 | |
| Miscellaneous Expenses | $1,723,472 | $779,407 | $944,065 |
| Recruiting Expenses | $365,775 | $365,775 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,709,874 | TotalAmt |
| Program Services | $66,752,103 | ProgramServicesAmt |
| Management And General | $20,957,771 | 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 | $204,935 | BOYAmt |
| EOY | $81,785 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,559,600 | BOYAmt |
| EOY | $7,871,995 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $58,784 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,931,966 | BOYAmt |
| EOY | $8,877,739 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,140,682 | BOYAmt |
| EOY | $94,403 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,624,404 | BOYAmt |
| EOY | $1,580,635 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,508,440 | BOYAmt |
| EOY | $1,612,448 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $92,648,972 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $51,117,518 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,275,394 | BOYAmt |
| EOY | $41,531,454 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,332,837 | BOYAmt |
| EOY | $35,727,434 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,963 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,896 | BOYAmt |
| EOY | $1,148,322 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,939,117 | BOYAmt |
| EOY | $98,584,999 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,131,593 | BOYAmt |
| EOY | $7,109,172 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,830 | BOYAmt |
| EOY | $580,859 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,585,000 | BOYAmt |
| EOY | $25,180,505 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,050,242 | BOYAmt |
| EOY | $3,348,960 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,752,080 | BOYAmt |
| EOY | $12,892,653 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,197,745 | BOYAmt |
| EOY | $49,112,149 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,841,613 | BOYAmt |
| EOY | $47,191,321 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,563 | BOYAmt |
| EOY | $459,376 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $720,196 | BOYAmt |
| EOY | $1,822,153 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,741,372 | BOYAmt |
| EOY | $49,472,850 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,939,117 | BOYAmt |
| EOY | $98,584,999 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $146,567 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,418,432 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,166,479 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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 | $15,177 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $15,177 | 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 | Littleton Hospital Association is a member of the NH Hospital Association and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Littleton Hospital Association and other member organizations in furtherance of their exempt purposes. Littleton Hospital Association does not directly perform any lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $886,217 | BeginningYearBalanceAmt |
| Contributions | $1,148,768 | ContributionsAmt |
| Investment Earnings Or Losses | $31,397 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $75 | OtherExpendituresAmt |
| End Year Balance | $2,066,307 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $939,547 | BeginningYearBalanceAmt |
| Contributions | $5,464 | ContributionsAmt |
| Investment Earnings Or Losses | -$57,271 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,523 | OtherExpendituresAmt |
| End Year Balance | $886,217 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $870,609 | BeginningYearBalanceAmt |
| Contributions | $5,517 | ContributionsAmt |
| Investment Earnings Or Losses | $63,496 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $75 | OtherExpendituresAmt |
| End Year Balance | $939,547 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $794,094 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $81,883 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,368 | OtherExpendituresAmt |
| End Year Balance | $870,609 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $717,945 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $77,221 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,072 | OtherExpendituresAmt |
| End Year Balance | $794,094 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.88090 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.11910 | 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 | $786,809 | OtherCostOrOtherBasisAmt |
| Book Value | $786,809 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,178,221 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,733,583 | DepreciationAmt |
| Book Value | $19,444,638 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $45,944,707 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,353,018 | DepreciationAmt |
| Book Value | $18,591,689 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,739,235 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,030,917 | DepreciationAmt |
| Book Value | $2,708,318 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $41,531,454 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Reserve for Self-Funded Health Insurance | $515,941 |
| Due to Third Party Payors | $6,958,966 |
| Deferred Compensation | $1,936,718 |
| Interest Rate Swap | $3,481,028 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,892,653 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $90,020,421 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,418,432 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $1,010,322 | OtherRevenueAmt |
| Revenue Not Reported | $2,428,754 | RevenueNotReportedAmt |
| Revenue Subtotal | $87,591,667 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $97,744 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $167,030 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $264,774 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $87,856,441 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $87,288,943 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $87,288,943 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $97,744 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $323,187 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $420,931 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $87,709,874 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d - Other Adjustments: | Unrealized Loss on Interest Rate Swap -282,584. Community Benefit Expense -156,157. Net Asset Transfers - Merger 1,449,063. |
| Part XI, Line 4b - Other Adjustments: | Foundation Subsidy 64,067. Loss on Refinancing of Debt 102,963. |
| Part XII, Line 4b - Other Adjustments: | Foundation Subsidy 64,067. Community Benefit Expense 156,157. Loss on Refinancing of Debt 102,963. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, | RegionTxt |
| Offices | 0 | OfficesCnt |
| Type Of Activities Conducted | Investments | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $9,555,535 | RegionTotalExpendituresAmt |
| 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 | $9,555,535 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $9,555,535 | TotalSpentAmt |
| Transfer To Foreign Corp | Yes (1) | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | Yes (1) | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
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 |
| Percent300 | Yes (X) | Percent300Ind |
| 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 | $3,844,568 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,441,996 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $402,572 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,731,490 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,924,444 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,807,046 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03200 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,576,058 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,366,440 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,209,618 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03660 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $485,853 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $485,853 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $97,502 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $97,502 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,664,969 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,211,646 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,453,323 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07360 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,800 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,254,124 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,211,646 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,042,478 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,830,182 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $32,578,086 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,252,096 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11690 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,561 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $47,561 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,482 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $36,482 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,600 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,600 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $87,643 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $87,643 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,016,671 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $27,656,720 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,656,720 | CostOfCareReimbursedByMedcrAmt |
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 | Littleton Regional Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1Txt |
| City | Littleton | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03561 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.littletonhealthcare.org | WebsiteAddressTxt |
| State License | 02790 | 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 | Littleton Regional Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | 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.littletonhealthcare.org | 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 | www.littletonhealthcare.org | 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.littletonhealthcare.org/pfs_assistance.php | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.littletonhospital.org/pfs_assistance.php | 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Littleton Regional Hospital | Part V, Section B, Line 5: Input from the community was solicited through a survey, which was available both electronically (through Survey Money) and via paper copy. Paper copies were distributed to various community locations. Electronic surveys were available via the Littleton and North Country Healthcare websites and through the Littleton Facebook page, plus other community partner websites. 252 surveys were completed. In addition, 49 Community leaders were also surveyed electronically. This group represented area business & economic development leaders, community board members of health & human service organizations, municipal government and human service providers. |
| Littleton Regional Hospital | Part V, Section B, Line 6a: The Hospital's CHNA was conducted along with Upper Connecticut Valley Hospital, Weeks Medical Center, and Androscoggin Valley Hospital. |
| Littleton Regional Hospital | Part V, Section B, Line 11: The Hospital is addressing the significant needs identified in its most recently conducted CHNA as follows:1. Substance Misuse, Alcohol Abuse & Mental Health Problems: 24/7 Emergency medical care available. Naloxone (Narcan) treatment for overdoses is an available option. Policy being developed for sharing Narcan kits with 3rd party friends and families. Weeks Medical Center employs several Behavorial Health Providers, including a Licensed Alcohol and Drug Counselor(LADC) through the Primary Care Offices. In addition, there are other Community based services available. Alcoholics Anonymous is given space in the hospital for regular weekly meetings. North Country Healthcare is currently in discussion with the State to determine feasibility of creating a more in-depth hospitalization/outpatient type program for the entire region and is collaborating with the NH Region 7 activities that are targeting behavorial health concerns for the entire state.2. Obesity/Overweight: North Country Healthcare member hospitals employ registered dieticians and diabetes educators who are available to provide consults through the Primary Care offices. In addition, Littleton will seek to add new fitness classes for the public. Meeting space for Weight Watchers and healthy and affordable meal choices for the public/visitors are also available.3. Smoking and Tobacco Use: Ongoing smoking cessation classes available to the public. In addition, Littleton is a smoke/tobacco free campus. Significant Needs not being addressed and why:The needs identified that Littleton is not able to address center around the County's lack of jobs. Low Income/Poverty and Unemployment/Lack of Jobs were two such items. Cost of healthy foods was also mentioned. These are not within the scope of our mission; however we will continue to work with local resources in our role as a responsible corporate citizen to improve our economy where we can. There are currently several economic development groups in the area and some new businesses are considering moving in.Other needs we are currently unable to meet revolve around lack of dental insurance, cost of prescription drugs, and access to health insurance. While Littleton cannot fix these issues, we have made a huge effort over these past 3 years to ensure as many of our patients as possible take advantage of Medicaid Expansion or the Insurance Exchanges. This has resulted in a significant drop in our uninsured population. Littleton continues to offer free care for eligible patients through our LRH Cares program. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The Hospital determines its cost of charity care based on an overall financial statement cost to charge ratio applied against gross charity care charges. |
| Part I, Line 7g: | All costs reported on Part I, Line 7g are attributable to physician practices as well as the paramedic program. |
| Part II, Community Building Activities: | Littleton Regional Healthcare is involved in many community building activities that promote the health and wellbeing of the communities it serves. We work closely with a number of local healthcare agencies including; North Country Health Consortium, North Country Home Health & Hospice, Ammonosuc Community Health Services, and Littleton Area Senior Center, to name a few, whose mission is similar to LRH. Each of these agencies addresses common concerns including access to healthcare, health improvement, and health education. LRH encourages its staff to serve oncommunity collaboration boards, and health advocacy agencies to promote the services and programs provided by LRH and surrounding agencies. We also work with local safety providers to promote safety and prevent injuries. LRH is actively involved in working with area schools to promote health and wellness among our youth. |
| 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 and historical 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 major payor source of revenue for the purpose of estimating the appropriate amounts of the allowance for doubtful accounts and the provision for bad debts. The adequacy of the allowance for doubtful accounts is regularly reviewed. For receivables associated with services provided to patients who have third-party coverage, an allowance for doubtful accounts and a provision for bad debts are established at varying levels based on the age and payor source of the receivable. For receivables associated with self-pay patients, the Hospital records a provision for bad debts in the period of service based on past experience indicating the inability or unwillingness to pay amounts for which they are financially responsible. |
| Part III, Line 8: | Any shortfall is treated as a community benefit. The Organization uses a cost to charge ratio from the Medicare cost report to determine the amount of Medicare allowable costs. |
| Part III, Line 9b: | Patients who are known to qualify for financial assistance are given a financial assistance application to fill out and return to our Financial Counselor. Upon receipt of the financial assistance application, the application is processed and the amount of financial assistance that will be granted to the patient is determined.Once the percentage of financial assistance is approved, we adjust the account balance accordingly. If a balance is left over after the financial assistance is adjusted, the patient will receive their monthly statements for the remaining balance.If the patient defaults on paying the remaining balance , their account will be sent to a third party collection agency no sooner than 120 days from date of their first statements issued. At this time we would turn the account over to the third party collection agency for further collection efforts. |
| Part VI, Line 2: | LRH takes a comprehensive approach to assess community health needs. We perform several independent data analyses based on secondary source data, augment this with local survey data and resolve any data inconsistency or discrepancies from the combined opinions formed from local experts. We rely on secondary source data amd most secondary sources use the county as the smallest unit of analysis. Since the service area comprises parts of Grafton County, we asked local residents to note if they perceived the problems, or needs, identified by secondary sources to exist in their portion of the county. |
| Part VI, Line 3: | Any applicant will receive a prompt decision on eligibility and amount of charity care offered. Notices of the Charity Care Policy are posted in the lobbies, waiting rooms and other public areas. Notices are also given to recipients who are served in their homes. |
| Part VI, Line 4: | The Hospital's defines its primary service area as Grafton County, New Hampshire. The 2012 population for Grafton County is estimated to be 90,847, and is expected to grow at a rate faster than the national rate of growth, projecting a 2017 population of 95,080. This population growth is at a faster rate than for New Hampshire as a whole.According to the population estimates utilized by Truven, provided by the Neilson Company, the 2012 median age for the County is 39.9 years, younger than the New Hampshire median age (40.4 years) but older then the national median age (36.8 years). The 2012 Median Household Income for the area is $52,729, which is lower than the New Hampshire median income of $59,470 but higher than the national median income of $49,599. Median Household Wealth and Median Home Values likewise are below State and above national values. Grafton's unemployment rate as of August 2012 was 4.4%, which is lower than the statewide rate of 5.7%, and considerably better than the national civilian unemployment rate of 8.1%.The portion of the population in the County over 65 is 15.9%, above the New Hampshire average of 13.5%. The portion of the population of women of childbearing age is 19.9%, somewhat higher than the New Hampshire average of 19.5%. In the County this population is anticipated to increase 1%, whereas for New Hampshire as a whole, the female population age 15 to 44 is anticipated to decline as a rate of just over 2%. |
| Part VI, Line 7, Reports Filed With States | NH |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Regional Healthcare Charitable Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1Txt |
| City | Littleton | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03561 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 043750643 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $64,067 | CashGrantAmt |
| Purpose Of Grant | Foregiveness of salary and benefit expense that is paid on behalf of the charitable foundation. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Organization tracks the amount of expenses paid on behalf of the Littleton Regional Hospital Charitable Foundation, a related organization, and at the end of the year will forgive the Foundation for the reimbursement of expenses related to salaries and benefits. The Organization only makes grants and other assistance payments to other 501(c)(3) organizations. Therefore, additional monitoring is not deemed necessary. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | 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 (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr Andrew Forrest | ||||||||||||||
| Trustee/Physician | $308,176 | $0 | $0 | $0 | $0 | $0 | $13,250 | $0 | $24,234 | $0 | $345,660 | $0 | $0 | $0 |
| Dr John Sauter | ||||||||||||||
| Trustee Emeritus | $262,499 | $0 | $22,889 | $0 | $23,182 | $0 | $13,250 | $0 | $0 | $0 | $321,820 | $0 | $0 | $0 |
| Dr Deane Rankin | ||||||||||||||
| Trustee/Physician | $338,898 | $0 | $0 | $0 | $42,013 | $0 | $13,250 | $0 | $38,207 | $0 | $432,368 | $0 | $0 | $0 |
| Dr Dougald MacArthur | ||||||||||||||
| Past Chief of Staff | $706,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $706,000 | $0 | $0 | $0 |
| Dr Stephen Goldberg | ||||||||||||||
| Chief of Staff | $316,610 | $0 | $0 | $0 | $0 | $0 | $13,250 | $0 | $41,799 | $0 | $371,659 | $0 | $0 | $0 |
| Warren West | ||||||||||||||
| Ex-Officio/ Past CEO | $330,902 | $0 | $0 | $0 | $6,051 | $0 | $13,250 | $0 | $16,907 | $0 | $367,110 | $0 | $0 | $0 |
| Nick Braccino | ||||||||||||||
| Interim President | $187,153 | $0 | $20,193 | $0 | $51 | $0 | $12,273 | $0 | $28,305 | $0 | $247,975 | $0 | $0 | $0 |
| Linda Gilmore | ||||||||||||||
| CAO/CNO | $199,065 | $0 | $20,193 | $0 | $51 | $0 | $11,361 | $0 | $35,833 | $0 | $266,503 | $0 | $0 | $0 |
| Dr Patrick Fitzpatrick | ||||||||||||||
| Physician | $339,226 | $0 | $345,442 | $0 | $37,120 | $0 | $13,250 | $0 | $37,893 | $0 | $772,931 | $0 | $0 | $0 |
| Dr Eric Mullins | ||||||||||||||
| Physician | $553,715 | $0 | $114,132 | $0 | $25,897 | $0 | $13,250 | $0 | $32,909 | $0 | $739,903 | $0 | $0 | $0 |
| Dr Harlan Herr | ||||||||||||||
| Physician | $493,001 | $0 | $37,222 | $0 | $45,744 | $0 | $13,250 | $0 | $15,206 | $0 | $604,423 | $0 | $0 | $0 |
| Dr Jeffrey Kauffman | ||||||||||||||
| Physician | $440,515 | $0 | $0 | $0 | $26,013 | $0 | $13,250 | $0 | $36,750 | $0 | $516,528 | $0 | $0 | $0 |
| Dr Leon Kogan | ||||||||||||||
| Physician | $451,739 | $0 | $0 | $0 | $44,820 | $0 | $13,250 | $0 | $11,214 | $0 | $521,023 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6 | Nicholas Braccino, Interim President, received a bonus based on certain goals included in his contract, one of which is related to the performance of the Organization. The Board assesses the performance of these goals and determines the bonus to be paid. |
| Part I, Line 7 | Dr. Patrick Fitzpatrick, Dr. Eric Mullins, and Dr. Harlan Herr, Highest Compensated Employees, received bonuses during the year based upon their productivity using MGMA Standards by RVU and by their specialties. Dr. John Sauter received a bonus in accordance with his employment contract. Linda Gilmore, CAO/CNO, received a bonus calculated as a percentage of her salary based on a board decision. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| New Hampshire Health and Education Facilities Authority | |||||||
| A | 020279866 | 2015-10-01 | $5,331,100 | Refunded series 2007 Bond | 0 | 0 | 0 |
| New Hampshire Health and Education Facilities Authority | |||||||
| B | 020279866 | 2015-10-01 | $20,753,200 | Refunded series 2007 Bond | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $164,355 | $5,331,100 | $41,800 | $5,289,300 | 2015 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $544,023 | $20,753,200 | $162,500 | $20,590,700 | 2015 | Yes (1) | 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 | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| (no name) | ||||||||||||
| A | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | Yes (1) | |||
| Deutsche Bank AG | ||||||||||||
| B | 0 | 0 | Yes (1) | 0 | Yes (1) | Yes (1) | 0 | 0 | Yes (1) | 20.000000000000 | 0 | 0 |
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 | Schedule K, Part III, Line 2, Lease Arrangements: | FormAndLineReferenceDesc |
| Explanation | The debt-financed property is leased to 3 physician practices which operated primarily for purposes related to the hospitals performance of its exempt purpose. Therefore, these leases are not considered to be private business use. | ExplanationTxt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | Equipment & Building Improvements | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $338,459 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | Effective July 2016, the Littleton Regional Healthcare Charitable Foundation was dissolved and all net assets were transferred to the Hospital. |
| Form 990, Part VI, Section A, line 4 | On June 30, 2015, Weeks Medical Center, Upper Connecticut Valley Hospital Association, Androscoggin Valley Hospital and Littleton Hospital Association, Inc. (collectively, the "Hospitals") entered into an Affiliation Agreement (the "Affiliation Agreement"), pursuant to which the Hospitals agreed to affiliate under a single common parent upon the closing of the agreement. The Affiliation Agreement resulted in the formation of North Country Healthcare, Inc. ("NCH"), a 501(c)(3) charitable organization. Effective April 1, 2016, the closing of the Affiliation Agreement occurred and NCH became the sole member of each of the Hospitals. In accordance with the Affiliation Agreement, each Hospital's charter and bylaws were amended to effect the establishment of NCH as the sole member and to create a shared governance structure between the Board of Directors of NCH and the Boards of each Hospital. Each Hospital continues to maintain its own Board of Directors (Corporation Board) that is distinct from the NCH Board of Directors. However, the Bylaws of NCH and each Hospital identify certain "Major matters" (divided into organizational and operational matters) that require initiation and/or authorization by a majority of the NCH Board. Members of the Hospital Boards are nominated exclusively by the Hospitals. However, the election of any such director must be approved by both the Hospital Board and the NCH Board. Some examples of other organizational "Major matters" requiring the initiation and/or approval of the NCH Board include amendments to by-laws, election of officers, dissolution of a Hospital, merger decisions and hiring/termination of Hospital Presidents. Examples of operational "Major matters" requiring the initiation and/or approval of the NCH Board include approval of annual capital and operating budgets, adoption of compensation and benefit programs, approval of information technology systems, financial systems and auditors, plus approval of any major changes to clinical services offered. The Chief Executive Officer position at each of the Hospitals has been changed to a President position. As with Board members, each Hospital President must be nominated at the Hospital level and then approved by both the Hospital Board and the NCH Board. This position reports to both the applicable Hospital Board and the Chief Executive Officer of NCH. The Chief Financial Officer of each of the Hospitals will remain an appointed position by the President, but this individual will also report to the President/Chief Financial Officer of NCH. |
| Form 990, Part VI, Section A, line 6 | Effective April 1, 2016, North Country Healthcare (NCH) became the Sole Member of Littleton Hospital Association. |
| Form 990, Part VI, Section A, line 7a | See narrative provided for Form 990, Part VI, Line 4. |
| Form 990, Part VI, Section A, line 7b | See narrative provided for Form 990, Part VI, Line 4. |
| Form 990, Part VI, Section B, line 11 | The return was reviewed by the entire Board of Directors prior to the filing. |
| Form 990, Part VI, Section B, line 12c | All Trustees, Department directors and Auxilians complete a Conflict of Interest Statement each year, and any potential conflicts are reported to the Board of Trustees and to other places as required by law. In addition, front-line employees who don't normally make decisions for the facility are expected to report forward any conflicts they may have, should they ever be in a position to influence decision making. Quality Services queries these groups on an annual basis, and tracks down people until all statements are complete. |
| Form 990, Part VI, Section B, line 15 | Key employees complete self-evaluation - HR Director prepares compensation surveys, reviews 990 of other organizations. The CFO's salary is approved by the CEO. The CEO's salary is approved by the Board. |
| Form 990, Part VI, Section C, line 19 | The hospital's governing documents and financial statements are made available upon request. The hospital's conflict of interest policy is not made available to the public. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Littleton Hospital Association 600 St. Johnsury Road Littleton, NH 03561 EIN 02-0222152 Littleton Hospital Association is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
| Form 990, Part XI, line 9: | Unrealized Loss on Interest Rate Swap -282,584. Net Asset Transfers - Merger 1,449,063. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Littleton Regional Healthcare Charitable Foundation | ||||||||||
| 600 St Johnsbury Road | Littleton | NH | 03561 | 043750643 | Charitable Foundation | NH | 501(c)(3) | Line 7 | Littleton Hospital Association | Yes (1) |
| North Country Healthcare Inc | ||||||||||
| 8 Clover Lane | Whitefield | NH | 03598 | 812225283 | Healthcare Management | NH | 501(c)(3) | Line 11a, I | 0 | |
| Androscoggin Valley Hospital | ||||||||||
| 59 Page Hill Road | Berlin | NH | 03570 | 020280367 | Critical Access Hospital | NH | 501(c)(3) | Line 3 | 0 | |
| Upper Connecticut Valley Hospital | ||||||||||
| Corliss Lane | Colebrook | NH | 03576 | 020276210 | Critical Access Hospital | NH | 501(c)(3) | Line 3 | 0 | |
| Weeks Medical Center | ||||||||||
| 173 Middle Street | Lancaster | NH | 03584 | 020222242 | Critical Access Hospital | NH | 501(c)(3) | Line 3 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Littleton Regional Hospital Charitable Foundation | ||
| B | $64,067 | FMV |
| Littleton Regional Hospital Charitable Foundation | ||
| D | $1,749,850 | FMV |
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