2017-05-15T08:21:58-05:00 2016-06-30 PRICEWATERHOUSECOOPERS LLP 101 SEAPORT BLVD BOSTON MA 02210 990 2015-07-01 264812335 Dartmouth-Hitchcock Health % DANIEL JANTZEN DART 6036505000 One Medical Center Drive Lebanon NH 03756 DANIEL JANTZEN CFO 6036505634 2017-05-11 Paul Tanis P01441612 6175305000 2015 2021-01-29 14:40:06Z JAMES WEINSTEIN DO MS One Medical Center Drive Lebanon NH 03756 33728587 false X N/A X 2009 NH To govern for an integrated health care delivery system that best serves the purposes of preventing,diagnosing treating,& curing human illness within the Northern New England Region 14 12 0 12 21987 20847 8320951 27403196 11580018 5572222 24 -1027487 -287793 -842395 19613200 31105536 454651 849186 0 0 0 0 0 0 1318135 15861216 10768787 16315867 11617973 3297333 19487563 16044581 24831076 12937190 7084846 3107391 17746230 X DARTMOUTH-HITCHCOCK HEALTH (D-HH), IS A NEW HAMPSHIRE (NH) NONPROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). D-HH WAS FORMED IN MAY 2009 WITH OPERATIONS COMMENCING ON OCTOBER 1, 2010. D-HH IS OPERATED FOR THE FOLLOWING CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES: -TO ESTABLISH, MANAGE, GOVERN, AND FUNDRAISE FOR AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT BEST SERVES THE PURPOSES OF PREVENTING, DIAGNOSING, TREATING AND CURING HUMAN ILLNESS WITHIN THE NORTHERN NEW ENGLAND REGION; -TO MANAGE A HEALTHCARE SYSTEM THAT PROVIDES HEALTH CARE SERVICES TO THE PUBLIC IN A COST-EFFECTIVE MANNER; -TO ESTABLISH AND MAINTAIN COOPERATIVE HOSPITAL AND PROVIDER RELATIONSHIPS THROUGHOUT ITS SYSTEM; -TO ACHIEVE EXCELLENCE IN CLINICAL INNOVATIONS, SERVICE, QUALITY, COST AND OUTCOMES, SUPPORTED BY A STRONG ACADEMIC PROGRAM; AND TO INTEGRATE RESEARCH, TRAINING, INFORMATION TECHNOLOGY AND ACADEMIC MEDICINE IN THE PROVIDER ORGANIZATIONS THR false false 5166923 849186 3748963 As part of its strategy to create a sustainable health system to improve the lives of the people and communities it serves for generations to come, Dartmouth-Hitchcock Health continues to work to establish and maintain cooperative hospital and provider relationships throughout the Northern New England region. In addition to continued work with the 17 members of the New England Alliance for Health, which it established as a voluntary shared services organization, D-HH has finalized affiliations with four hospitals and Visiting Nurse and Hospice of Vermont and New Hampshire. The recent affiliations with New London Hospital and Cheshire Medical Center in NH, Mt. Ascutney in VT, as well as the latest affiliation with Alice Peck Day in NH, are allowing for more coordinated care and efficiencies across systems, as well as more effective utilization of hospital beds. Benevera Health, a population health improvement company focused on care coordination and quality improvement, formed with Harvard Pilgrim, Elliot Hospital, and Frisbie Memorial Hospital, began operations on January 1, 2016 and has grown to 100,000 member lives. Improved and coordinated patient care, with early intervention when appropriate, is intended to help drive down the cost of health care, allowing Harvard Pilgrim to keep premiums lower and consistently more competitive for members. 3255228 A major D-HH initiative to create integrated relationships across New Hampshire and Vermont continues, with a goal of improving population health, offering value-based care, and embracing new payment models that move away from fee for service. The OneCare Vermont ACO with University of Vermont Medical Center includes all Vermont hospitals and hundreds of primary care physicians and specialists, two federally qualified health centers, and several rural health clinics, to coordinate the health care of approximately 42,000 of Vermonts 118,000 Medicare beneficiaries. D-HH continues to build its telemedicine program to provide care across its rural region and in particular to make specialist consultation and care available to community hospitals. Through a number of grants, including $998,356 from the US Department of Agriculture, it has purchased telemedicine equipment for more than 35 sites in Vermont and New Hampshire, including rural acute care hospitals, ambulatory care sites, rehabilitation sites and behavioral health centers. This allows caregivers at remote locations to access specialists at Dartmouth-Hitchcock and bring them "virtually" to the patient's bedside. The Connected Care Center in Lebanon is home to a 24/7 team of physicians, pharmacists and nurses supporting care in 40+ specialties. Acute care telehealth service lines, which include TeleEmergency, TelePharmacy, TeleNeurology and TeleICU, bring together pools of doctors and nurses from all over the country and the world. TeleEmergency is live at 8 hospitals, assisting local teams in direct care, transfer and transport coordination of the sickest patients. The D-H TeleICU team of intensivists is covering 46 hospitals and more than 200 active beds, across 7 states. The D-H TelePharmacy team is processing 15,000 consults and orders every month from a 7 hospital network. The TeleStroke/TeleNeurology service line has performed over 350 emergency consults since 2013. 979170 1823259 Nationally, Dartmouth-Hitchcock is a founding member, with Mayo Clinic, Intermountain Health Care, Denver Health, and The Dartmouth Institute for Health Policy and Clinical Practice, of the High Value Healthcare Collaborative (HVHC). The Collaborative currently comprises more than a dozen health systems across the country. Together, they have a patient base of more than 70 million. The goal of the Collaborative is to improve the quality of health care while lowering costs. Through data sharing and defining of best practices for 8 high-cost, high-variation conditions, the members are improving outcomes and already seeing cost savings. A $26 million grant from CMS made it possible for MHMH, a wholly-owned hospital of D-HH, to integrate first in the nation shared decision making tools into clinical care. 9401321 true true false false false false false false false false true false false true true false false true false false false false false false true false false true false true false false false false false false false false true true false false false true true true false false true 17 5 true 0 true true true BD false false false false false false false false X 14 12 true false true false false false false true true false false true true true true true true false false false NH X DANIEL JANTZEN 6036505634 ONE MEDICAL CENTER DRIVE Lebanon NH 03756 X Vincent S Conti MHA Trustee 0.5 1.5 X 0 0 0 James N Weinstein DO MS Trustee Ex-Officio/CEO 6.0 55.01 X X 0 1332138 162531 Robert A Oden Jr PhD Trustee/Vice Chair eff. 1/1/16 1.0 3.0 X X 0 0 0 Barbara J Couch MS Trustee/Board Secretary 1.0 1.5 X X 0 0 0 William J Conaty Trustee 0.5 1.5 X 0 0 0 Denis A Cortese MD Trustee 0.5 1.5 X 0 0 0 Matthew B Dunne Trustee end 12/31/15 0.5 1.5 X 0 0 0 Laura K Landy MBA Trustee 0.5 1.5 X 0 0 0 Paul P Danos PhD Trustee/BD Trsr end 12/31/15 1.0 3.0 X X 0 0 0 Steven A Paris MD Trustee/Reg Med Dir 0.5 44.01 X 0 375697 53636 Richard J Powell MD Trustee end 12/31/15 0.5 41.8 X 0 466328 117201 Anne-Lee Verville Trustee/Brd Chair eff. 1/1/16 1.0 3.0 X X 0 0 0 Troyen A Brennan MD MPH Trustee 0.5 1.5 X 0 0 0 R William Burgess Jr MBA Trustee 0.5 1.5 X 0 0 0 Duane A Compton PhD Trustee/Ex-Officio 0.5 1.81 X 0 0 0 Charles G Plimpton MBA Trustee/Bd Trsr eff. 1/1/16 1.0 3.0 X X 0 0 0 Robin Kilfeather-Mackey CPA Chief Financial Officer 6.0 55.01 X 0 550797 175125 Stephen Leblanc Exec VP Strtgy & Ntwrk Rltns 39.0 21.01 X 0 616651 179153 John Butterly MD Fmr Offr/Exec VP Med Affairs 26.0 12.0 X 0 482349 63446 Jeanine Arden Ornt Fmr General Counsel 0.0 25.0 X 0 213499 0 Carl Dematteo MD Fmr Chf Ql Compl Ofr/Physician 0.0 40.0 X 0 130501 1482 Thomas Colacchio MD Former Officer/Phys 0.0 41.0 X 0 1021525 81611 Kimberly Troland JD Fmr Intrm GC/Deputy Gen Cnsl 6.0 54.0 X 0 371724 38986 0 5561209 873171 0 true true false Raymond James Associates PO Box 23604 ST PETERSBURG FL 33742 Consulting 390282 The Trustees of Dartmouth College 37 DEWEY FIELD HANOVER NH 03755 Developmnt & Svcs 881968 OneCare VT Accountable Care Org LL 111 Colchester Avenue BURLINGTON VT 05401 ACO Activities 3433337 Avera Health 3900 West Avera Drive SIOUX FALLS SD 57108 Telehealth Svcs 686462 PriceWaterhouseCoopers LLP 101 Seaport Blvd BOSTON MA 02210 Consulting 525085 7 X 4286760 23116436 716741 27403196 MEMBER ASSESSMENTS 900004 3748963 3748963 ACO INCENTIVE INCOME 900004 1823259 1823259 5572222 0 0 0 0 0 0 1027487 -1027487 -1027487 -1027487 753169 4286760 1595564 -842395 21987 -864382 0 0 0 31105536 5572222 21987 -1891869 X 849186 849186 0 0 0 0 0 0 0 0 0 0 3221 3221 0 0 0 0 8332970 6674031 895296 763643 16017 16017 200410 200410 10995 10995 0 64663 64663 24613 24613 0 167508 167508 0 0 14872 14872 20096 20096 EVERWELL BVP EXPENSE 1325600 1325600 UBIT TAXES AND OTHER 33330 33330 GIFTS IN KIND EXPENSE 554492 554492 11617973 9401321 898517 1318135 X 117617 337212 0 0 0 0 11573754 6250687 0 0 0 0 0 0 0 0 0 0 161270 85515 90627 75755 0 217078 0 0 0 0 0 0 4262583 17950344 16044581 24831076 5202291 1671372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7734899 5413474 12937190 7084846 X 3107391 17746230 0 0 0 0 3107391 17746230 16044581 24831076 X 19487563 -4848724 X X false true X true true true X 0 0 2544108 8320951 8620543 19485602 0 0 0 0 2544108 8320951 8620543 19485602 1345247 18140355 0 42856 20847 63703 0 19549305 25288682 0.92793 0.93457 X Unusual Grants Form 990, Schedule A, Part II, Line 1 During Fiscal Year 2016, Alice Peck Day Memorial Hospital Affiliated with Dartmouth-Hitchcock Health. Dartmouth-Hitchcock Health recognized $18,782,653 in non-operating revenue on its audited financial statements as part of this transaction. As such, D-HH excluded this amount from schedule A calculations as an unusual grant for FY16. Form 990, Schedule A, Part II, Line 1 During Fiscal Year 2015, Cheshire Medical Center and Windsor Hospital Association DBA Mt. Ascutney Hospital and Health Center, Affiliated with Dartmouth-Hitchcock Health. Dartmouth-Hitchcock Health recognized $128,147,000 in non-operating revenue on its audited financial statements as part of this transaction. As such, D-HH excluded this amount from schedule A calculations as an unusual grant for FY15. Form 990, Schedule A, Part II, Line 1 During Fiscal Year 2014, the New London Hospital Association affiliated with Dartmouth-Hitchcock Health. Dartmouth-Hitchcock Health recognized $36,131,000 in non-operating revenue on its audited financial statements as part of this transaction. As such, D-HH excluded this amount from schedule A calculations as an unusual grant for FY14. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100830 48314 12126 60440 37201 63629 75755 INVESTMENT IN NNEACC 450000 INVESTMENT IN IVYMD 2510096 INVESTMENT IN ONECARE VT 25000 INVESTMENT IN EVERWELL 250000 INVESTMENT IN BENEVERA 1772006 INVESTMENT IN GREENHEALTH PROJ 150000 INVESTMENT IN IMAGINECARE 12793242 17950344 0 DUE TO AFFILIATES-DHC AND MHMH 3663124 DUE TO AFFILIATES-EVERWELL 1750350 5413474 AUDITED FINANCIAL STATEMENT FOOTNOTE REGARDING ASC 740 Schedule D, Part X, Line 2 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT INCLUDE A FOOTNOTE RELATING TO ASC 740; THERE HAVE BEEN NO CHANGES SINCE INCEPTION. Prouty Wlk/Bike 2715503 2364887 350616 112947 440 533146 CHaD Hlf Mthn 617704 593446 24258 58296 360 229 24258 14 1706722 1328427 378295 480104 1547 1189 17501 365547 5039929 4286760 753169 651347 1547 1989 17730 922951 1595564 -842395 true Grafton County Senior Citizens Council PO Box 433 Lebanon NH 03766 237248316 501(C)(3) 36295 FMV Elder Services Good Neighbor Health Clinic 70 N MAIN ST WHITE RIVER JCT VT 05001 030346949 501(C)(3) 69990 FMV PROGRAM/CLINIC SVCS Ottauquechee Health Foundation 32 PLEASANT STREET PO BOX 784 WOODSTOCK VT 05091 030197766 501(C)(3) 20000 FMV PROGRAM SUPPORT Mascoma Valley Health Initiative PO Box 2013 Canaan NH 03741 752991608 501(C)(3) 28672 FMV Hlth Adv Cnsl Sppt Listen Lebanon In Service To Each Neighbor 60 Hanover Street Lebanon NH 03766 237225952 501(C)(3) 10400 FMV Program Services Alice Peck Day Memorial Hospital 10 APD Memorial Dr Lebanon NH 03766 020222791 501(C)(3) 16000 FMV Dental Prog Svcs The Trustees of Dartmouth College 1 Rope Ferry Road Hanover NH 03755 020222111 501(c)(3) 134546 FMV Educ and Prog Sppt Fannie E Rippel Foundation 14 Maple Avenue Morristown NJ 07960 221559427 501(c)(3) 100000 FMV Prog Support Granite YMCA 117 Market Street Manchester NH 03101 020222248 501(c)(3) 7500 FMV Program Support Granite State United Way 46 South Main Street Concord NH 03301 026006033 501(c)(3) 105000 FMV Program Support City Year Inc 848 Elm Street Suite 201 Manchester NH 03101 222882549 501(c)(3) 175000 FMV Preogram Support Cheshire Medical Center 580-590 Court Street Keene NH 034315400 020354549 501(c)(3) 101463 FMV Program Support Easter Seals New Hampshire Inc 555 Auburn Street Manchester NH 03103 020272825 501(c)(3) 5625 FMV Program Support Families in Transition 122 Market Street Manchester NH 03101 020475414 501(c)(3) 5625 FMV Program Support River Valley Community College 1 College Place Claremont NH 03743 900531902 501(c)(3) 5625 FMV Program Support Upper Valley Haven 713 Hartford Avenue White River Jct VT 05001 030277908 501(c)(3) 5625 FMV Program Support 16 Procedures for monitoring the use of grant funds Form 990, Schedule I, Part I, Line 2 The organization provides grants and assistance to other organizations based on needs and relation to the mission of Dartmouth-Hitchcock Health. Funds donated are for the general purpose and/or specific purposes defined by our Community Relations team. D-HH staff monitor and sign off on any funds prior to distribution or reimbursement of expenses. true true false false false false false false false James N Weinstein DO MS Trustee Ex-Officio/CEO 0 1239023 0 0 0 93115 0 148835 0 13696 0 1494669 0 0 Robin Kilfeather-Mackey CPA Chief Financial Officer 0 513562 0 0 0 37235 0 154998 0 20127 0 725922 0 0 Stephen Leblanc Exec VP Strtgy & Ntwrk Rltns 0 480623 0 0 0 136028 0 159027 0 20126 0 795804 0 0 John Butterly MD Fmr Offr/Exec VP Med Affairs 0 433100 0 0 0 49249 0 62386 0 1060 0 545795 0 0 Jeanine Arden Ornt Fmr General Counsel 0 213499 0 0 0 0 0 0 0 0 0 213499 0 0 Carl Dematteo MD Fmr Chf Ql Compl Ofr/Physician 0 128215 0 0 0 2286 0 355 0 1127 0 131983 0 0 Thomas Colacchio MD Former Officer/Phys 0 612710 0 0 0 408815 0 64362 0 17249 0 1103136 0 0 Steven A Paris MD Trustee/Reg Med Dir 0 349732 0 0 0 25965 0 39937 0 13699 0 429333 0 0 Richard J Powell MD Trustee end 12/31/15 0 383501 0 60750 0 22077 0 99353 0 17848 0 583529 0 0 Kimberly Troland JD Fmr Intrm GC/Deputy Gen Cnsl 0 351563 0 20000 0 161 0 21239 0 17747 0 410710 0 0 Severance Payments FORM 990, SCHEDULE J, PART I LINE 4A DURING 2012, THOMAS COLACCHIO TRANSITIONED FROM AN OFFICER ROLE TO A STAFF PHYSICIAN ROLE. AS PART OF THIS TRANSITION, THOMAS COLACCHIO RECEIVED A $320,000 CHANGE OF CONTROL PAYMENT FROM DARTMOUTH-HITCHCOCK IN 2015. THE PAYMENT IS INCLUDED ON SCHEDULE J, PART II, COLUMN (B)III. Supplemental Nonqualified Retirement Information Form 990, Schedule J, Part I, Line 4b The following individuals received payments from a supplemental nonqualified retirement plan: James Weinstein $90,829 Robin Kilfeather-Mackey $16,500 Stephen Leblanc $109,692 John Butterly $41,875 Thomas Colacchio $88,815 Stephen Paris $17,319 Richard Powell $20,775 Dartmouth-Hitchcock Supplemental Retirement Plan Terms and Conditions: An eligible employee is a participant in the Dartmouth-Hitchcock Retirement Plan and/or any prior pension arrangements sponsored by Dartmouth-Hitchcock (including a qualified defined benefit plan) who would be entitled to additional contributions or benefit accruals under the terms of the Plans for the plan year, but are limited by IRC Section 401 (a)(17) and/or 415. For eligible employees, the Employer will pay the eligible employee an amount determined by the employer each year to offset the amount of the reduction in the benefit accrual or contributions as a result of limitations imposed by IRC Sections 401(a)(17) and/or 415. Note regarding compensation amounts Schedule J, part II Column B, parts I, II, and III represent actual amounts paid to employees by related entities Dartmouth-Hitchcock Clinic or Mary Hitchcock Memorial Hospital. These amounts are reported to employees on their annual W-2 forms as compensation. Columns C and D represent items earned, however, not paid directly to the employee as cash payments during the calendar year. Column C includes retirement benefits as well as any changes in pension actuarial value (if applicable) in a calendar year. Column D represents nontaxable benefits such as the cost of healthcare coverage provided by DHC or MHMH on behalf of its employees. X 7 9500 Fair Market Value X 8998 Fair Market Value X 6104 Fair Market Value X 15 162249 Fair Market Value X 69 108101 Fair Market Value X Various items for events, hear aids, & supplies 301 421789 Fair Market Value false true true Schedule M, Part I, Line 32b The organization utilizes a Joint Development Office (JDO) contract with the Trustees of Dartmouth College to assist with solicitation of donors and gifts on behalf of the entire Dartmouth-Hitchcock Health system. Contributions solicited by D-HH may be utilized by related organizations including, but not limited to, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital. Business relationships Form 990, Part VI, Section A, Line 2 Dartmouth-Hitchcock Health owns for-profit subsidiaries that provide services and support the mission of the organization. As a result, some officers of DHH may also be officers of related for-profits entities. Delegation of Committees Form 990, Part VI, Section A, Line 3 THE D-HH BOARD DELEGATES CERTAIN FINANCIAL, AUDIT AND COMPLIANCE OVERSIGHT TO THE FINANCE AND AUDIT AND COMPLIANCE COMMMITTEE OF THE JOINT BOARDS OF TRUSTEES OF MARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH-HITCHCOCK CLINIC, ACTING JOINTLY AS DARTMOUTH-HITCHCOCK ("D-H"). IN ADDITION, THE D-HH BOARD DELEGATES TO D-H, ACTING THROUGH ITS BOARDS AND APPROPRIATE COMMITTEES AND STAFF, THE OBLIGATION TO OVERSEE THE CLINICAL ACTIVITIES AND RESEARCH OF D-H AND ITS OPERATIONS IN ACCORDANCE WITH CURRENT D-H POLICIES AND PROCEDURES, INCLUDING THOSE FOR MANAGED CARE CONTRACTING, QUALITY OF CARE, AND RESEARCH PROGRAMS AND AFFILIATIONS WHICH POLICIES THE BOARD HEREBY APPROVES AND ENDORSES, PROVIDED THAT ANY SIGNIFICANT CHANGE TO SUCH POLICIES WILL BE SUBMITTED TO THE BOARD FOR APPROVAL. THE D-HH BOARD CONTINUES TO RETAIN FINAL MANAGEMENT POWERS AND DECISIONS PURSUANT TO SECTION 3.9.2 OF THE CORPORATION'S BYLAWS. Changes to Organizational Documents Form 990, Part VI, Line 4 The organization made updates to the bylaws to reflect the change of Dartmouth-Hitchcock Health from a supporting organization to a publicly supported organization. Process used by management and/or Governing Body to Review 990 Form 990, Part VI, Line 11b THE FORMS 990 AND 990-T ARE EACH REVIEWED BY EXTERNAL TAX ADVISORS, THE DIRECTOR OF CORPORATE FINANCE, VICE PRESIDENT OF CORPORATE FINANCE, AND THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURNS. ONCE THE RETURNS HAVE BEEN FULLY PREPARED A FINAL 990 AND 990-T COMPLETE ELECTRONIC VERSION IS SENT OUT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS/RESPONSES PRIOR TO OFFICIAL FILING. Conflict of Interest Policy Form 990, Part VI, Section B, Line 12C The Dartmouth-Hitchcock Health BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF-DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. THE DARTMOUTH-HITCHCOCK OFFICE OF POLICY SUPPORT, COMPLIANCE AND AUDIT SERVICES CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS, TRUSTEES, AND KEY EMPLOYEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR UNDERTAKEN Form 990, Part VI, Line 15a Although paid by a related organization, Dartmouth-Hitchcock Clinic, the Compensation for the Chief Executive Officer is evaluated by an independent third party firm for reasonableness and national data benchmarking. The Compensation Committee, along with Independent Trustees, approve the final compensation in consideration with the independent third party firm's recommendations and suggestions. This process was last undertaken in 2016. Offices & Positions for Which Process was Used & Year Undertaken Form 990, Part VI, Line 15b D-HH uses the staff of related organizations, Dartmouth-Hitchcock Clinic (DHC) and Mary Hitchcock Memorial Hospital (MHMH). Compensation for officers and key employees are evaluated by internal HR staff using national benchmarking data, along with ongoing evaluations by an independent third party firm for reasonableness, with the last formal process in 2012 (2016 for VP's and above). External benchmarking from an independent third party has been used for any Officer who was hired or received a compensation adjustment since the last formal process. Compensation rates are determined by following the guidelines of the compensation committee charter and philosophy documents and/or a formal review by compensation committee members. Avail of Gov Docs, Conflict of Interest Policy, & Financial Statements to the General Public Form 990, Part VI, Line 19 D-HH's governing documents are available through the New Hampshire Secretary of State. The audited financial statements, governing documents, and conflict of interest policy are available upon request either in electronic or hardcopy form. Average Hours Per Week Form 990 Part VII, Section A, Line 1A, Column B Dartmouth-Hitchcock Health is the sole corporate Member of Dartmouth-Hitchcock Clinic (DHC), and Mary Hitchcock Memorial Hospital (MHMH), as well as other related and supporting organizations. As part of DHC's and MHMH's affiliation agreement, the three organizations share officers. As such, the average hours per week are allocated between the organization's 990s even though compensation reported in part VII is based on the entity issuing the W-2. Other Fee For Service Expenses Form 990, Part IX, Line 11G D-HH purchases program and management staff from its supported tax-exempt entities Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital to fulfill its mission and ongoing duties. Services purchased for the Fiscal Year 2016 totaled $3,087,184. In addition, D-HH paid $5,245,786 for ACO-related, affiliation expenses, and other external consultants. Reconciliation of Net Assets Form 990, Part XI, Line 9 Net Asset Transfer $4,848,724 Delegation of Oversight Form 990, Part XII, Line 2c The D-HH Board delegates certain financial, audit and compliance oversight to the Finance and Audit Commmittee as well as the Compliance Committees of the joint boards of trustees of Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic, acting jointly as Dartmouth-Hitchcock ("D-H"). The D-HH board continues to retain final management powers and decisions pursuant to Section 3.9.2 of the Corporation's Bylaws. A-133 Audit Form 990, Part XII, Line 3a DURING FISCAL YEAR 2016, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FUNDS FROM FEDERAL AWARDS IN EXCESS OF THE $750,000 THRESHOLD SET FORTH IN THE OMB UNIFORM GUIDANCE, THEREFORE REQUIRING AN AUDIT. DUE TO THE ISSUANCE OF THE CONSOLIDATED FINANCIAL STATEMENTS, THE SINGLE AUDIT WAS PERFORMED ON THE COMBINED FINANCIAL INFORMATION OF ALL ORGANIZATIONS, INCLUDING DARTMOUTH-HITCHCOCK HEALTH. FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:8332970 Dartmouth-Hitchcock Clinic One Medical Center Drive Lebanon NH 03756 222519596 Phys Svcs NH 501(C)(3) 9 D-HH true Mary Hitchcock Memorial Hospital One Medical Center Drive Lebanon NH 03756 020222140 Hospital NH 501(C)(3) 3 D-HH true The Hitchcock Foundation One Medical Center Drive Lebanon NH 03756 020222139 HLTHCRE RSRCH NH 501(C)(3) 7 DHC true Hamden Risk Retention Group Inc 30 Main Street Suite 330 Burlington VT 05401 208530788 SELF INS. VT 501(C)(3) 11 TYPE I DHC true The New London Hospital Assoc Inc 273 County Road New London NH 03257 020222171 Hospital NH 501(c)(3) 3 D-HH true Windsor Hospital Association 289 Country Road Windsor VT 05089 030183721 Hospital VT 501(C)(3) 3 D-HH true Cheshire Medical Center 580 Court Street Keene NH 03431 020354549 Hospital NH 501(C)(3) 3 D-HH true Cheshire Health Foundation 580 Court Street Keene NH 03431 020202220 SUPPORTNG ORG NH 501(C)(3) 11 TYPE I CMC true Mt Ascutney Hosp Cmmty Hlth Found 289 Country Road Windsor VT 05089 030300481 Hospital VT 501(c)(3) 3 WHA true Historic Homes of Runnemede 289 Country road Windsor VT 05089 237396147 Healthcare VT 501(c)(3) 9 WHA true Cheshire Health Services 580 Court Street Keene NH 03431 473379283 HEALTHCARE NH 501(c)(3) 3 CMC true Alice Peck Day Memorial Hospital 10 Alice Peck Day Drive Lebanon NH 03766 020222791 Hospital NH 501(c)(3) 3 D-HH true OBNET Services LLC 1 Med Ctr Dr Lebanon NH 03756 043746287 Database Serv NH DHC 0 D-H Mster Invst Prg 1 Med Ctr Dr Lebanon NH 03756 020505863 Pooled Invest NH MHMH 0 Keene Hlth Alliance 580 Court St Keene NH 03431 300179297 Healthcare NH DHC 0 OneCare VT ACOLLC 111 COLCHESTER AVE Burlington VT 05401 455399218 Shared Saving VT DHH Related -612253 25000 false 0 true 0.50000 Pompanoosuc Investment Corporation One Medical Center Drive Lebanon NH 03756 020352330 Rl Estate Hld NH DHC C Corp true Hamden Assurance Company Limited Canons Court 22 Victoria St Hamilton BD HM EX 980121409 Liab Insur. BD DHC Foreign Corp true Hitchcock Health Connect One Medical Center Drive Lebanon NH 03756 800908979 Telehealth DE D-HH C Corp -156859 269797 1.00000 true Kearsarge Community Services 273 County Road New Lodnon NH 03257 020460136 Real Est Hldg NH NLH C Corp true New London Physician Group 273 Country Road New London NH 03257 020494420 Physician Gro NH NLH C Corp true New London Medical Center East 273 County Road New London NH 03257 020480857 Real Est Hold NH NLH C Corp true Keene Health Services 580 Court Street Keene NH 03431 020374997 Real Est Hldg NH CMC C Corp true Keene Health Realty 580 Court Street Keene NH 03431 020374998 Real Est Hldg NH CMC C Corp true Keene Health Enterprises 580 Court Street Keene NH 03431 020374999 Real Est Hldg NH CMC C Corp true Charit Remndr Unitrusts (4) One Medical Center Drive Lebanon NH 03756 Chart. Trust NH MHMH TRUST true ImagineCare One Medical Center Drive Lebanon NH 03756 813105071 Telehealth NH D-HH C Corp 0 12793242 1.00000 true false true true false false false false false false false false true false false false true true false false Mary Hitchcock Memorial Hospital Q 2624274 FMV Dartmouth-Hitchcock Clinic Q 1124689 FMV Onecare VT ACO P 3433337 FMV Everwell Inc L 1325600 FMV Cheshire Medical Center B 101463 FMV Alice Peck Day Memorial Hospital C 18782653 FMV ImagineCare Inc B 12793242 FMV