2016-05-11T08:02:33-05:00 2015-06-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2014-07-01 020354549 The Cheshire Medical Center CHES 6033545400 580-590 Court Street Keene NH 034315400 Robert Cochrane Chief Financial Officer 6033545400 2016-05-05 1 Timothy R Hepburn P00182393 8002447444 2016-05-05 2014 2016-08-17 19:52:53Z X Don Caruso 580-590 Court Street Keene NH 034315400 163839490 0 X www.cheshire-med.com X 1980 NH Community health care organization serving as a regional referral center 23 14 1123 160 154895 -89607 695254 1208416 155615611 159316387 1601362 955785 1924975 2358902 159837202 163839490 0 0 0 0 60554893 61032813 0 0 0 98088979 103365620 158643872 164398433 1193330 -558943 137587316 144627429 65004098 66131206 72583218 78496223 X The Cheshire Medical Center is a community health care organization serving as a regional referral center for Keene and the surrounding service area. It is fully committed to meeting the health care needs of these communities and providing access to quality health care services and programs. As a non-profit corporation, the Cheshire Medical Center acknowledges its commitment to provide services to the community. These services arise primarily from the four following general service categories. 1) Subsidization of government-sponsored healthcare programs - principally Medicare and Medicaid. 2) Sponsorship and/or subsidization of health-related community services and educational programs. 3) Provision of healthcare at no charge or reduced charge, according to financial need. 4) Provision of 24-hour emergency room services, without regard for ability to pay. The Cheshire Medical Center, as a matter of policy and practice has provided, and will continue to provide, a significant contributi 0 0 145411299 0 161520394 The primary purpose of the Cheshire Medical Center is to ensure access to quality health care services to all residents of the Monadnock Region. The Organization's charitable mission is enhanced through the operation of a joint operating partnership agreement with the Hitchcock Clinic. The purpose of the Joint Operating Partnership Agreement is to provide a more extensive and effective health care delivery system to the communities in the Monadnock Region by establishing joint planning and decision making processes, integrating health care services and establishing mechanisms for the reinvestment of resources to improve community health. The financial results of the joint operating partnership are reported annually on Form 1065, U.S. Partnership Return of Income. 145411299 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 177 0 1 1123 1 1 1 0 0 0 0 0 0 0 0 0 X 23 14 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 NH X Robert Cochrane CFO 6033545400 580-590 Court Street Keene NH 034315400 Ed Bergeron Jr Trustee 1.00 1.50 X 0 0 0 John Birkmeyer MD Trustee 1.00 61.50 X 0 261699 34858 Judith A Boule MD Medical Staff President 1.00 41.50 X 0 324618 276540 Wendy Fielding CPA Trustee 1.00 41.50 X 0 220559 57824 Timothy J Fisher MD Trustee 1.00 41.50 X 0 276988 74562 H Roger Hansen Trustee 1.00 2.00 X 0 0 0 Steve Horton Trustee 1.00 1.50 X 0 0 0 Nathalie Houder Trustee 1.00 1.50 X 0 0 0 Lawrence J Jaeger MD Trustee 1.00 41.50 X 0 317909 252282 Judy Kalich Trustee 1.00 1.50 X 0 0 0 Michael Kapiloff Trustee 1.00 1.50 X 0 0 0 Mary Ann Kristiansen Trustee 1.00 1.50 X 0 0 0 Geof Molina Trustee 1.00 1.50 X 0 0 0 Steven Paris MD Trustee 1.00 41.50 X 0 357571 117329 Leslie T Pitts MD Trustee 1.00 41.50 X 0 264764 209530 Kary Shumway Trustee 1.00 1.50 X 0 0 0 Katherine Snow Trustee 1.00 1.50 X 0 0 0 Sylvia McBeth Chair 2.00 1.50 X X 0 0 0 Gregg R Tewksbury CPA Vice Chair 1.00 1.50 X X 0 0 0 Robert Mucha Treasurer 1.00 1.50 X X 0 0 0 Mary Louise Caffrey Secretary 1.00 1.50 X X 0 0 0 Arthur W Nichols President 50.00 3.00 X X 572249 0 99303 Don Caruso MD CEO/CMO 11.50 41.50 X X 0 344756 254418 Robert Cochrane CFO 51.00 2.00 X 207760 0 18168 Cindi Coughlin CNO 52.00 X 196449 0 106069 Paul Pezone VP Facilities & Support Se 52.00 X 185637 0 39262 Erli Chen Physicist 50.00 X 233043 0 44230 Larry Miller Chief CRNA 50.00 X 201108 0 72699 Julie Green VP, Human Resources 50.00 X 181868 0 44843 Yvonne Goldsberry Sr. Director of Community Health 50.00 X 168691 0 33745 Letasha Heape CRNA 50.00 X 155877 0 29164 2102682 2368864 1764826 34 0 1 0 Quest Diagnostics 5763 Collection Center Drive Chicago IL 60693 Lab Diagnostic Services 616382 New England Medical Transcription Inc PO Box 430 Woolwich ME 04579 Transcription Services 563367 RF-WORKS 2172 Citygate Drive Columbus OH 43219 Wireless Network Services 484778 Cheshire Anesthesia Associates 580 Court Street Keene NH 034311718 Anesthesiology Services 455000 Allscripts LLC 24630 Network Place Chicago IL 606731246 Electronic Health Record Technology 426384 26 409829 798587 1208416 Patient Services 621300 156722340 156722340 Pharmacy and Drugs 446110 1290462 1290462 Food Services 722210 962133 962133 Miscellaneous Health Services 621300 157694 157694 Gift Shop Income 453220 103256 103256 80502 80502 159316387 409770 409770 546015 0 546015 546015 546015 Meaningful Use Income 621300 766389 766389 Childcare Center 624410 620116 465221 154895 Rebates and Discounts 621300 98569 98569 873828 873828 2358902 163839490 161520394 154895 955785 X 1424897 1162716 262181 42504221 34676766 7827455 1808691 1475892 332799 12048473 10239334 1809139 3246531 2618327 628204 217772 217772 64750 64750 25451065 23946880 1504185 295286 295286 1152151 929210 222941 374359 301921 72438 5390734 4347627 1043107 231315 186556 44759 1070933 863707 207226 9751781 7864811 1886970 484149 390466 93683 Med Supplies, Drugs, et 26475274 26475274 Bad Debt Expense 8306085 8306085 JOA Gainshare 7640000 6161660 1478340 PILOT and MET 7090020 7090020 9369946 8078761 1291185 164398433 145411299 18987134 0 25492399 16131280 13248900 16470755 2338661 2859734 2646392 3240328 204097244 125616574 67062017 78480670 20014572 21598882 394167 6784375 5451613 137587316 144627429 12675495 14668106 34853 10471 30131888 29350588 424044 217360 21737818 21884681 65004098 66131206 X 68092699 73914740 4490519 4581483 72583218 78496223 137587316 144627429 X -558943 -698531 7170479 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 21737 0 0 0 21737 0 Part II-B, Line 1: A portion of American Hospital Association and NH Hospital Association dues are available for lobbying. During 2014, the amounts available for lobbying were $6,252 and $15,485, respectively. 4487520 968233 414873 1223773 4646853 3602059 272723 929038 316300 4487520 3055274 234785 688499 376499 3602059 2634569 154965 484487 218747 3055274 2445561 168756 299947 279695 2634569 1.00000 0 0 231151 231151 92248987 48056156 44192831 111356871 77560418 33796453 260235 260235 78480670 Pooled Investments 20654035 F Funded Depreciation Account 944847 F 21598882 Pension Liability 10094198 Due to Related Party 11790483 21884681 X 161985206 -698531 303944 -394587 162379793 1459697 1459697 163839490 163319809 381073 381073 162938736 1459697 1459697 164398433 Part V, Line 4: Income from the endowments is used to support the Organization's programs. Part X, Line 2: The Medical Center and its controlled affiliates are not-for-profit corporations as described in Section 501(c)(3) of the Code, and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management has evaluated its tax positions and concluded that the Medical Center and its controlled affiliates have maintained tax-exempt status, do not have any significant unrelated business income and have taken no uncertain tax positions that require adjustment to or disclosure in the accompanying financial statements. KHS is a for-profit organization and, in accordance with federal and state laws, files a return separate from that of the Foundation. KHS files a consolidated federal income tax return and a state income tax return in New Hampshire. In 2015 and 2014, no federal income taxes were charged to operations due to KHS incurring an operating loss on a consolidated basis. With few exceptions, the Medical Center, Foundation and KHS are no longer subject to income tax examination by the U.S. federal or state tax authorities for years before 2012. Part XI, Line 2d - Other Adjustments: Revenue allocated to Cheshire Health Services 303,944. Expenses included in revenue per Audited Financial Statements Part XI, Line 4b - Other Adjustments: Expenses included in revenue per Audited Financial Statements 1,459,697. Part XII, Line 2d - Other Adjustments: Expenses allocated to Cheshire Health Services 381,073. Part XII, Line 4b - Other Adjustments: Expenses included in revenue per Audited Financial Statements 1,459,697. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Investments In Investment Entities Domiciled In Foreign Jurisdictions 3920233 0 0 0 0 0 0 3920233 0 3920233 0 0 1 1 0 0 Schedule F, Part I, line 3: The legal owner of The Cheshire Medical Center's foreign investments is a related organization, The Cheshire Health Foundation. Since a portion of the total foreign investments are allocated to the Medical Center's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, line 3 of The Cheshire Medical Center's Form 990. However, any required IRS Forms 926 and other foreign tax reporting obligations are filed by the legal owner, The Cheshire Health Foundation. Schedule F, Part IV, line 3: The Cheshire Medical Center did not have an ownership interest in any foreign corporation that is greater than the 10% filing threshold. Accordingly, IRS Form(s) 5471 is not required to be filed. Schedule F, Part IV, line 4: The Cheshire Medical Center meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Hospital. 1 1 1 X 225.000000000000 1 X 1 1 0 1 1 1473000 1473000 0.00940 20378053 7609041 12769012 0.08180 21851053 7609041 14242012 0.09120 26 16765 1483923 109293 1374630 0.00880 6 1102 350157 832 349325 0.00220 2 182 1305964 1305964 0.00840 1 43 280425 117191 163234 0.00100 6 265 251975 40472 211503 0.00140 41 18357 3672444 267788 3404656 0.02180 41 18357 25523497 7876829 17646668 0.11300 1 21240 145942 79756 66186 0.00040 3 4481 64019 48500 15519 0.00010 1 56878 56878 0.00040 2 454417 454417 0.00290 7 25721 721256 128256 593000 0.00380 1 3206149 802000 61719557 72037969 -10318412 X 1 1 1 1 Cheshire Medical Center 580 Court Street Keene NH 03431 www.cheshire-med.com 00014 X X X The Cheshire Medical Center 1 0 0 1 X X X X X X X X 13 1 0 1 1 X See Part V, Section C X 1 13 1 See Part V, Section C 0 0 1 X 225.000000000000 300.000000000000 X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X X X X X X 1 0 X X X X 1 X 0 0 The Cheshire Medical Center Part V, Section B, Line 5: Needs were prioritized based on data collected from several current assessment processes. Prioritization was completed by the Community Health Needs Assessment Leadership Team. Several hundred people participated in forums and surveys to identify community needs. The Cheshire Medical Center Part V, Section B, Line 6b: The Cheshire Medical Center collaborated with Dartmouth-Hitchcock Keene; New Hampsire Department of Health and Human Services; Greater Monadnock Public Health Network (GMPHN); The New Hampshire Hospital Association; Foundation for Healthy Communities; Antioch University New England; Monadnock United Way; New Hampshire Center for Public Policy Studies; Southwestern Regional Planning Commission; and Home Healthcare, Hospice, and Community Services. The Cheshire Medical Center Part V, Section B, Line 11: The Cheshire Medical Center has implemented strategies to address all but two of the needs identified in its most recent CHNA. Access to beahvioral health outpatient services is addressed by Community Partners Monadnock Family Services, Phoenix House, and MAPS Counseling Services. Expansion of personal and public transportation options is addressed by Community Partners Monadnock Regional Transportation Management Association, Home Healthcare Hospice and Community Services, American Red Cross, and the Southwest Regional Planning Commission. The Cheshire Medical Center Part V, Section B, Line 15e: The contact information for hospital facility staff is provided on the financial information landing page of the website (https://www.cheshire-med.com/patients_visitors/financial_assistance.html) and in the supplemental FAP Brochure, which is available at all registration stations in the hospital. Medical Center staff and administrators are currently in process of updating the FAP, application, and other related materials; contact information will be included in all financial assistance materials going forward. The Cheshire Medical Center Part V, Section B, Line 16i: The Cheshire Medical Center's Plain Language Summary was available at all registration desks and by request during the fiscal year. While it was not available on the website during the filing period, it is on the website as of the time of this filing (http://www.cheshire-med.com/images/patients_visitors/Financial_Assistance_Brochure.pdf). Additionally, the Medical Center has a committee that is working to ensure full compliance with final 501(r) regulations in advance of the deadline, which is applicable to fiscal years beginning after December 29, 2015. The Cheshire Medical Center Part V, Section B, Line 22d: The State of New Hampshire mandates a discount for all uninsured patients. This discount is equal to the average discount negotiated by the largest (by dollar) three commercial insurers. The Cheshire Medical Center has always been in full compliance with the laws of the State of New Hampshire, and a committee is in place to ensure the hospital is in full compliance with final 501(r) regulations in areas where federal regulations differ from or are more stringent than those issued by the state. Schedule H, Part V, Section B, Line 7a: The Cheshire Medical Center's 2013 CHNA is available on the Medical Center's website at: www.cheshire-med.com/images/aboutus/CHNA_2013.pdf. Schedule H, Part V, Section B, Line 10a: The Cheshire Medical Center's 2013 CHNA Implementation Strategy is available on the Medical Center's website at: www.cheshire-med.com/images/aboutus/CHNA_2013_Implementation_Plan.pdf. Schedule H, Part V, Section B, Line 16a: The Cheshire Medical Center's Financial Assistance Policy is available on the Medical Center's website at: https://www.cheshire-med.com/images/patients_visitors/ Financial_Assistance_Policy.pdf. Schedule H, Part V, Section B, Line 16b: The Cheshire Medical Center's FAP application is available on the Medical Center's website at: https://www.cheshire-med.com/images/patients_visitors/ Financial_Assistance_Application.pdf. Part V, Section B, Line 16 Financial Assistance Policy Website Availability The Cheshire Medical Center Part V, Section B, line 16a website: See Part V, Section C The Cheshire Medical Center Part V, Section B, line 16b website: See Part V, Section C 2 Cheshire Med Center Collecting Station 580-590 Court Street Keene NH 03431 Collecting Station Cheshire Health Services Inc 580-590 Court Street Keene NH 034315400 Non-Emergency Walk In Clinic Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 8,306,085. Part II, Community Building Activities: The Medical Center has been actively engaged since the spring of 2006 in Healthy Monadnock (HM) 2020: to make Keene and the surrounding region the healthiest in the nation by the year 2020. HM2020 promotes broad-based community health messaging and other environmental strategies for prevention and wellness. The "champions program" engages individuals and organizations to take steps to improve health at a personal and institutional level. The Medical Center provides staffing, office space and overall leadership for this initiative. As of June 30, 2015 there were 3,191 individual champions, 120 organizational champions, and 20 school champions. The organization is a founding member of the Council for Health Communities, which has been in existence for over 16 years and has developed a variety of prevention, transportation, referral, and health promotion programs. Part III, Line 2: At cost bad debt expense of $3,206,149 is 38.6% of the bad debt reported on The Cheshire Medical Center's Audited Financial Statements, which totals $8,306,085.The amount of bad debt expense reported on Form 990, Part IX, Line 25 is the total amount of the Medical Center's bad debt expense per the audited financial statements, $8,328,320, less $22,235, which is the amount allocated to a related entity, Cheshire Health Services, Inc. The allowance for doubtful accounts, contractual allowances in net patient service revenue, and other revenue and expenses are also accounted for in the calculations reported on this Form 990 but not reported separately in the audited financial statements. See Schedule O footnote for additional information. Part III, Line 3: Cheshire Medical Center Management estimates that approximately 25% of bad debt expense (approximately 5 times the region's poverty rate) is an appropriate estimation of patients who would have been eligible for the organization's financial assistance program but did not apply. This estimation is based on the recognition that the financial assistance program is available to residents with incomes of up to three times the federally defined poverty income levels and the assumption that patients who choose not to pay their bills are more likely to fall within the lower income levels. For 2015, the estimated amount of bad debt expense (at cost) attributable to patients who would have been eligible for financial assistance is $802,000. Part III, Line 4: Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Medical Center analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for doubtful accounts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Medical Center analyzes contractually due amounts and provides an allowance for doubtful accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which included both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center records a provision for doubtful accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.The total provision for the allowance for doubtful accounts was $1,753,292, $6,575,028 and $11,397,403 for the 2015 successor period, 2015 predecessor period, and fiscal 2014 predecessor period, respectively. The Medical Center's bad debt write-offs decreased from $11,767,403 for the fiscal 2014 predecessor period to $7,225,028 during the 2015 predecessor period and to $2,003,393 during the 2015 successor period. The decrease in the year-end allowance and bad debt write-offs was a result of collection trends and the overall reduction in self-pay accounts receivable. Part III, Line 8: This shortfall should be considered community benefit because we are the only hospital/medical center in Cheshire County, New Hampshire and we are designated by CMS as a Medicare Dependent Hospital (MDH) due to greater than 60% of our average daily census being comprised of Medicare Patients. Our presence in the community allows the residents of Cheshire County, especially the elderly population, to receive comprehensive hospital and medical services close to home. Part III, Line 9b: Systems are in place to capture financial assistance accounts prior to a bill going to the patient. FAP eligible patients are not charged more than the amount generally billed. Part VI, Line 2: In 2013, a Community Health Needs Assessment (CHNA) was completed with an implementation strategy identified for community benefit activities for the next three years. The 2013 CHNA report summarizes the work of the CHNA Leadership Team and the efforts of other local collaborative groups to assess the needs of our region. Several community partners recently completed community needs assessments, including Healthy Monadnock 2020. The results were used to strengthen and support the needs assessment process. Four community needs were prioritized above the other identified needs: -Behavioral health services: increasing the effectiveness of local services -Urgent care: timely and economical access to services instead of emergency room care -Transportation: increase access to public/private transportation particularly in rural towns -Improved coordination and communication between services: improving linkages between clinical services, faith-based organizations, and informal support networkIn addition to these priorities, the implementation strategy also provides an overview of other CMC/DHK community benefit activities that are aligned with our mission or considered necessary to support ongoing efforts from previously identified community needs. The community health needs identified in the 2013 CHNA provide the basis for the development of the Implementation Strategy. Cheshire Medical Center provides staff for the Healthy Monadnock (HM)2020 initiative and funds the community assessment process through an evaluation partnership contract with Antioch New England University. On November 10, 2011 community members attended Summit II and reviewed 31 core implementation strategies. The (HM 2020) Healthiest community Advisory Board, comprised of 30 community representatives, provides ongoing oversight of the implementation of the strategies and community planning process.The Cheshire Medical Center/Dartmouth Hitchcock Keene Community Advisory Committee reviewed and commented on the community benefit report. The 2013 CHNA, Implementation Strategy and Community Benefit reports for 2009-2015 are available to the public on the Cheshire Medical Center website: www.cheshire-med.org. Part VI, Line 3: The Cheshire Medical Center is committed to providing medically necessary care to patients regardless of their ability to pay for services. Non-emergent patients sign a financial responsibility statement upon admission to certify recognition of their responsibility for payment of their bills. However, there will be instances where the patient, due to the lack of funds or third party coverage, will not be able to meet this obligation. The Cheshire Medical Center notifies patients of their potential to obtain assistance through the registration and billing processes. Upon registration, patients without insurance are offered the opportunity to apply for financial assistance. In addition, receptionists and clinicians in all areas are educated to refer patients to the financial assistance process in the event patients express concerns with their ability to pay for services. The application information is posted on the intranet and brochures describing the program are readily available to patients. There are signs posted in Registration and throughout the facility informing patients about financial assistance. Patients are informed of the program availability on any invoices they receive and individuals who attempt to collect patient balances are also trained to refer patients to the financial assistance process. The financial assistance application process is comprehensive and evaluates a patient's eligibility for a variety of federal, state, and local government programs in addition to The Cheshire Medical Center's internally funded financial assistance program. Part VI, Line 4: The Cheshire Medical Center is the only hospital in its primary service area ("PSA"). Management defines its PSA as the City of Keene and 19 geographically proximate communities. Towns and cities included in the PSA include Alstead, Chesterfield, Fitzwilliam, Gilsum, Harrisville/Chesham, Keene, Marlborough, Marlow, Nelson/Munsonville, Richmond, Roxbury, Stoddard, Sullivan, Surry, Swanzey, Troy, Walpole, Westmoreland and Winchester, all located in Cheshire County. According to the US Census Bureau, 2014 population estimates: -Medical Center's PSA represented approximately 5.79% of New Hampshire's population. -The PSA's total population is 76,596 with 23,281 residing in Keene, the largest community in the service area. -The median age of residents in Cheshire County is 41.7 with: -14,423 or 19% less than 18 years of age -49,266 or 64% between the ages of 18-64 -12,710 or 17% over the age of 64 -Poverty rate for Cheshire County was 11.7% as compared to 8.9% for the State of New Hampshire. The median household income is $56,139 compared to the state average of $65,986.According to the US Bureau of Labor Statistics, October 2015, the State had an unemployment rate of 3.3% compared to Cheshire County's rate of 2.8%. Part VI, Line 5: The Medical Center plays an active role in promoting community health and offers educational programs including classes and workshops. Our clinical staff works closely with our community health staff to develop programs that cover emerging health concerns and are delivered at the right literacy level for our community. The programs offered a variety of chronic disease and wellness topics such as nutrition amd exercise, diabetes prevention and monitoring, high blood pressure prevention and monitoring, cultural diversity, the Health Insurance Marketplace, self-esteem and self-help, elder care services and needs, and retirement and investments. All programs are offered free of charge.In addition, the Medical Center offers several community programs including: Cheshire Smiles, a school-based dental health program for children in grades K-3, provides screening, prevention and restorative dental care for children in Cheshire County schools. The Cheshire Medical Center/Dartmouth-Hitchcock Keene also works in partnership with other community health and human service organizations to meet the dental health needs of underserved populations such as the chronically mentally ill, pregnant women who cannot afford dental care, children identified through the school based Cheshire Smiles Program, and others. The Medical Center sponsors patient visits at Dental Health Works, a public/private program serving underserved residents of Cheshire County. The Cheshire Medical Center also provides leadership and support to the Dental Public Health Task Force, a coalition of dental staff, hospital staff and concerned citizen addressing the oral health needs of adults. The Cheshire Coalition for Tobacco Free Communities addresses the use of tobacco products by people who live and work in the communities served by The Cheshire Medical Center/Dartmouth Hitchcock Keene (CMC/DHK). The Coalition is comprised of hospital staff, healthcare providers, community members and representatives of schools and colleges, law enforcement, clergy and the general public. The group meets monthly working to engage schools and the greater community with tobacco prevention initiatives which include retailer education and enforcement of tobacco laws. The Program Manager, a CMC/DHK employee, actively engages in tobacco-free activities in our local community and coordinates with state agencies and organizations.The Medication Assistance Program addresses the critical need for programs to help low income people afford medications. The Medication Assistance Program provides free or reduced cost medications for acute illnesses and improves access to medications vital to continued good health for patients who require medication on an ongoing basis and who cannot afford it. In fiscal year 2015 the program supplied 1,073 prescriptions to 252 individuals valued at $565,250. This is a significant decrease from fiscal year 2014 (2,318 prescriptions to 401 individuals valued at 1.6 million dollars) in part due to Medicaid Expansion and the Health Insurance options as a result of the Affordable Care Act.Advocates for a Healthy Youth (AFHY) is a community coalition focused on childhood obesity. Through AFHY, CMC/DHK works closely with community health providers, Keene State College, Antioch University New England, Keene Parks and Recreation Center, UNH Cooperative Extension, Keene Housing, and area schools to address the epidemic of childhood obesity. In fiscal year 2015, AFHY supported efforts in several schools, after school programs, and non-profit organizations to implement the 5-2-1-0 message via policy change and educational activities. AFHY implemented the community based Family BeFit program through collaboration with the Keene Family YMCA and Keene State College Dietetic Internship Program.CMC/DHK is a site for the New Hampshire HEAL Initiative. Through our local program, we hope that all residents can live, learn, work, play, and heal in a community where physical activity, healthy eating, and healthy living are the norm. MHEAL is focused on addressing overweight and obesity, physical inactivity, and eating choices in the Greater Monadnock Public Health Region through programs, policies, systems, and environmental changes in two key settings: worksites and foodservice venues. -Worksites: Our worksite wellness initiative is committed to helping local worksites in their efforts to provide a healthy workplace environment. MHEAL's team has worked with over 35 organizations to date to create a culture of health in the workplace by helping employers adopt and promote evidence-based worksite wellness interventions. -Foodservice venues: In partnership with Keene State College, MHEAL helps foodservice venues promote healthier food options to diners through our program called Turn a New Leaf (TANL). Foodservice venues include worksite cafeterias, restaurants, and markets. Through our efforts, 13 venues have adopted the TANL program to date, with a plan to recruit many more over the next two years.Senior Passport is a program for area residents aged 60 years and above. It encompasses low cost complete evening and weekend meals; free health education programs oriented to seniors; exercise programs; and the Cheshire Walkers Program, a walking group that takes organized nature and historic walks. Seven walks are offered each spring and fall. Walks are typically led by a community member with occasional participation by CMC/DHK staff and occur at a variety of locations throughout the region. During fiscal year 2015, 4,469 meals were provided to program members and a total of 175 seniors attended the walking program. This represents about a 20% increase in the number of meals and 15% increase in the number of participants in Cheshire Walkers from last year.Greater Monadnock Public Health Network (GMPHN) is a community health and safety collaborative which works to enhance and improve public health-related services. GMPHN is one of 13 public health networks in the state of New Hampshire. The GMPHN is housed by CMC/DHK and, in collaboration with Cheshire County, is financed with funds provided by the Centers for Disease Control and Prevention, under an agreement with the State of New Hampshire, Department of Health and Human Services, and Division of Public Health Services and a mix of state funding via the general funds. The GMPHN serves all of Cheshire County and the 10 western-most towns in Hillsborough County. The GMPHN strives to increase collaboration and planning across municipal boundaries and the health and safety sectors. Two major focuses of the work is the development of a public health advisory board and the on-going effort for public health emergency preparedness. It is made up of members of each of the coalition communities as well as representatives of regional organizations involved in providing for the public's health and safety. As of June 30, 2015 there are 41 individuals/organizations addressing development of the public health advisory council and 75 member individuals/organizations addressing emergency preparedness.Included within the GMPHN, is the Greater Monadnock Medical Reserve Corps. Developed initially to build local capacity to address public health emergency response needs, the GMMRC also supports local initiatives to address pressing public health activities. Membership included doctors, nurses, EMT/paramedics, pharmacists, veterinarians, other public health professionals, and non-medical/public health members. As of June 30, 2015 the GMMRC has a membership of over 124 individuals. Part VI, Line 6: In 2014, the Board of the Medical Center, accompanied by the Board of Dartmouth-Hitchcock, approved an affiliation agreement between the Medical Centers. This agreement is intended to improve, integrate, and streamline patient care between the Medical Centers.The affiliation, which became effective on March 2, 2015, strengthens The Cheshire Medical Center as a regional resource for southwestern New Hampshire and southeastern Vermont. The affiliation will allow more patients to receive care closer to home, will free up bed capacity for tertiary care patients at Dartmouth-Hitchcock Medical Center in Lebanon, and will allow the Cheshire Medical Center to continue its leadership role in population health and the Healthy Monadnock 2020 initiative. Cheshire Medical Center and Dartmouth-Hitchcock have worked together since 1998, by means of a Joint Operating Agreement involving Dartmouth-Hitchcock Keene, a multi-specialty group practice that comprises the majority of Cheshire Medical Center's medical staff. This new affiliation agreement is seen as a natural step that will enable both organizations to more effectively pursue a common vision of the future of health care that is based on creating a sustainable health system, focusing on population health, delivering value-based care, and embracing the opportunities provided by new payment models.In addition to The Cheshire Medical Center and the Dartmouth-Hitchcock Medical Center, the affiliated health care system includes Mary Hitchcock Memorial Hospital, Dartmouth-Hitchcock Clinic, The New London Hospital Association, Windsor Hospital Corporation, and a number of other related organizations whose primary mission is health care in the region. The Cheshire Medical Center and other members of the affiliated health care system operate jointly through interlocking directorates, strategic planning, management, and share identical missions. Part VI, Line 7, Reports Filed With States NH X 1 0 X X X X 0 1 0 0 0 0 0 1 0 John Birkmeyer MD Trustee 0 211596 0 0 0 50103 0 30458 0 4400 0 296557 0 0 Judith A Boule MD Medical Staff President 0 284901 0 0 0 39717 0 258941 0 17599 0 601158 0 0 Wendy Fielding CPA Trustee 0 220289 0 0 0 270 0 37462 0 20362 0 278383 0 0 Timothy J Fisher MD Trustee 0 276988 0 0 0 0 0 54503 0 20059 0 351550 0 0 Lawrence J Jaeger MD Trustee 0 317165 0 0 0 744 0 238600 0 13682 0 570191 0 0 Steven Paris MD Trustee 0 329589 0 0 0 27982 0 100968 0 16361 0 474900 0 0 Leslie T Pitts MD Trustee 0 264504 0 0 0 260 0 191801 0 17729 0 474294 0 0 Arthur W Nichols President 466891 0 57978 0 47380 0 77642 0 21661 0 671552 0 0 0 Don Caruso MD CEO/CMO 0 342742 0 0 0 2014 0 236579 0 17839 0 599174 0 0 Robert Cochrane CFO 207760 0 0 0 0 0 0 0 18168 0 225928 0 0 0 Cindi Coughlin CNO 163449 0 0 0 33000 0 86924 0 19145 0 302518 0 0 0 Paul Pezone VP Facilities & Support Se 144237 0 0 0 41400 0 20656 0 18606 0 224899 0 0 0 Erli Chen Physicist 188138 0 0 0 44905 0 29339 0 14891 0 277273 0 0 0 Larry Miller Chief CRNA 178618 0 0 0 22490 0 63600 0 9099 0 273807 0 0 0 Julie Green VP, Human Resources 134968 0 0 0 46900 0 25637 0 19206 0 226711 0 0 0 Yvonne Goldsberry Sr. Director of Community Health 130191 0 0 0 38500 0 18675 0 15070 0 202436 0 0 0 Letasha Heape CRNA 155877 0 0 0 0 0 6231 0 22933 0 185041 0 0 0 Part I, Line 1a The Cheshire Medical Center does not reimburse expenses for first class travel, housing allowance, health or social club dues, personal services, business use of personal residence, discretionary spending accounts, or provide tax indemnification or gross up payments. The Medical Center does reimburse Board members for companion travel to business related meetings under specific circumstances. All reimbursements are reported on a Form 1099 issued to the Board member. During the calendar year 2014, which is the basis for Form 990, Part VII and Schedule J reporting for the fiscal year ending June 30, 2015, no Board members were reimbursed under this arrangement. Part I, Line 3 The President of The Cheshire Medical Center is paid by the filing organization and methods use to determine compensation are as noted on Schedule, J, Part I, Line 3. The CEO is paid by Dartmouth-Hithcock Health, a related organization, which uses a compensation committee, an independent consultant, Form 990 of other organizatinos, written employment contract, a compensation survey or study, and approval by the Board or compensation committee to establish the CEO's compensation. Part I, Line 4b Dartmouth-Hitchcock, a related organization at the end of the filing period, paid compensation through a SERP to the following individuals listed in Part VII: Stephen A. Paris-$19,669; Judith A. Boule-$38,211. 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. Part I, Line 7 Senior Management is eligible for incentive compensation at the discretion of the Board based on, but not directly related to, overall organizational financial performance and other discretionary measures. Form 990, Part VII-A and Schedule J, Part II: The annual change in the actuarial value of the pension plan for the employees listed below has been reported as part of deferred compensation. The pension plan is held and administered by a related organization, The Cheshire Medical Center. The amounts reported for 2014 are: Arthur Nichols-$43,649 Cynthia Coughlin-$65,909 Paul Pezone-$1,101 Erli Chen-$8,595 Larry Miller-$38,424 Julienne Green-$2,806 Yvonne Goldsberry-$7,332 The present value of the accrued benefit at the beginning of the reporting period, representing accrual over multiple years of service for each participant, was: Arthur Nichols-$829,347 Cynthia Coughlin-$544,606 Paul Pezone-$32,348 Erli Chen-$120,724 Larry Miller-$982,529 Julienne Green-$79,794 Yvonne Goldsberry-$33,435 A NH Health & Education Facilities Authority 020279866 2012-11-15 29650000 Refund existing debt, acquisition of equipment 0 0 0 A 29650000 4777102 379754 554125 4777102 2013 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 A 1 0 0 0 0 0 A 1 Ed Bergeron Hired by CMC for construction services 25125 Edward Bergeron, Trustee of Cheshire Medical Center, is an officer of Bergeron Construction, which performed carpentry for the Hospital during the fiscal year. 0 Jessica Horton Child of CMC Trustee 37240 Jessica Horton, who is employed in the Radiology Department of The Cheshire Medical Center, is the child of Steve Horton, a Trustee of The Cheshire Medical Center. The 2014 W-2 compensation paid is in accordance with CMC's standard employment practices and policies. 0 Form 990, Part VI, Section A, line 4 Significant changes were made to the Articles of Agreement and Bylaws during the year. The Articles of Agreement were amended as follows: Articles III and V were amended by replacing them in their entirety with amended Articles III and V. Additionally, Articles VI and VII were added to the Articles of Agreement. Amended/added articles are as follows: ARTICLE III-PURPOSE The Corporation is established exclusively for the charitable, scientific and educational purposes set forth herein, subject to the provisions of Chapter 292 of the New Hampshire Revised Statutes Annotated, RSA 292 and the provisions of Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (the "Code"). The principal purposes for which the Corporation is established are as follows: the operation and maintenance (i) of a general hospital in Keene, New Hampshire, for the surgical and medical care of the sick and injured, and (ii) of medical centers, health care centers, laboratories, clinics, and other medical, surgical, dental, educational, civic and research facilities in Keene and in other cities and towns; the advancement of the knowledge and practice of education and research in medicine, surgery, nursing and all other subjects relating to the care, treatment and healing of humans; the furtherance of (i) the quality and accessibility of health care services, particularly in (but not limited to) the Keene, Cheshire County, Southeastern Vermont and the Greater Monadnock region (collectively referred to as the "Monadnock Region"); (ii) the efficiency of utilization of health care facilities and services,; (iii) the reasonable containment of the cost of health care to the public; and (iv) the goals, initiatives, activities and interests of the integrated health care delivery system developed and conducted by the Sole Member of the Corporation as defined in Article V of these Articles, in coordination with its affiliates including the Corporation (referred to herein as the "Dartmouth-Hitchcock System"); and the improvement of public health in cooperation with federal, state, municipal, and other health departments and offices. All activities and functions of the Corporation shall be conducted in a manner which is consistent with the requirements of Section 501(c)(3) of the Code, including for such purposes the making of distributions to organizations that qualify as exempt organizations under Section 501(c)(3) of the Code, or corresponding section of any future federal tax code, the laws of the State of New Hampshire and the By-Laws of the Corporation. ARTICLE V-MEMBERSHIP The Sole Member of the Corporation shall be Dartmouth-Hitchcock Health ("DHH"), a New Hampshire voluntary corporation. DHH as Sole Member of the Corporation shall have all reserved powers, rights and obligations as set forth in the Corporation's Bylaws. ARTICLE VI-BYLAWS The procedures and policies for the internal governance of the Corporation shall be as set forth in the By-Laws. ARTICLE VII-LIMITATION OF LIABILITY The provisions eliminating or limiting the personal liability of Trustees or officers are: Each Trustee and officer shall be indemnified by the Corporation against personal liability to the Corporation for monetary damages for breach of fiduciary duty as a Trustee or officer, or both, except with respect to: (1) Any breach of the Trustee's or officer's duty of loyalty to the Corporation or the members; (2) acts or omissions which are not in good faith or which involve intentional misconduct or a knowing violation of the law; or (3) any transaction from which the Trustee or officer derived any improper personal benefit. The following changes to the Medical Center's bylaws were made during the tax period: 1. Dartmouth-Hitchcock Health, a New Hampshire voluntary corporation, replaced The Cheshire Health Foundation, as the sole member of The Cheshire Medical Center, with rights and powers over the following actions: -approve or disapprove all material governance, programmatic and financial decisions, including the elimination or addition of any health care services or programs; - appoint 1/3 of the members of the Medical Center's Board of Trustees; -ratify the Medical Center's nomination of 2/3's of the members of the Board of Trustees; -following consultation with the Medical Center's Chairperson of the Board, to remove any Trustee if the Sole Member determines in its reasonable good faith discretion that such removal is in the best interests of the Dartmouth-Hitchcock System; -approve borrowings and material disposition of the Medical Center's assets; -approve the establishment of key strategic relationships, such as ownership or contractual participation in a network, system, affiliation, joint venture, alliance, or similar arrangement with an organization that is not part of the Dartmouth-Hitchcock System or which is not addressed in a strategic plan specific to the Corporation that has been approved by the Sole member; -approve operating and capital budgets and strategic plans; -approve policies relating to educational and research programs and affiliations; -reallocate the assets and resources of the Medical Center and the Sole Member, as appropriate, to serve the overall best interests of the Dartmouth-Hitchcock System; -appoint, evaluate, terminate, and approve the compensation of the Medical Center's President and CEO; -approve the amendments to the Medical Center's Articles of Agreement or By-Laws if such amendment would have the effect of impacting the Sole Member's reserved powers or may reasonably be expected to have a material strategic, competitive, or financial impact on the Dartmouth-Hitchcock System; -approve the dissolution or liquidation of the Medical Center. 2. The Ex Officio Trustees with voting rights were changed from the President & CEO of the Medical Center, the President of the Medical Staff, and the Chair of the Keene Health Alliance Board to the CEO of the Medical Center, the Medical Director of Dartmouth-Hitchcock Keene, the President of the Corporation's Medical Staff, and the President of the Sole Member. 3. The clause "except that certain actions of the Board shall be subject to the requirements of the Partnership Agreement between the Center and The Hitchcock Clinic, etc.," was removed from the Duties and Responsibilities of the Trustees. 4. The Duties and Responsibilities of the Trustees were updated to remove "The Board of Trustees shall have full power and authority to create, prescribe, and/or approve Bylaws, Rules and Regulations regarding the practice of medicine in the Center and to appoint, suspend or remove any practitioner from the Medical Staff in accordance with such Bylaws, Rules and Regulations." 5. Article 3.6, which delineated some Trustee responsibilities as they related the Partnership Agreement with Keene Health Alliance, was struck from the bylaws. 6. The provision regarding compensation of Board members was changed from "The Board of Trustees may approve some form of compensation for Trustees as a whole, or for Trustees holding specific offices." to "The Board of Trustees shall serve as Trustees without compensation, except that reasonable expenses may be reimbursed as approved by the Board. Trustees may also be employed by the Corporation and compensated for their services as the Board may authorize." 7. "The Chairperson and the Vice Chairperson of the Board shall each be selected from the 2/3's of the Trustees nominated by the Medical Center," was added to the bylaws. 8. The responsibilities of the Chairperson were expanded to include, "The Chairperson may execute contracts, deeds, notes, mortgages, bonds and other obligations in the name of the Corporation." 9. The article describing the position of CEO was updated to read: "The Trustees shall select, employ, and contract with a person to be the CEO of the Corporation who shall have all the authority of such a position in a business corporation and who shall be an officer of the Corporation and shall be a full voting member of the Board of Trustees, ex officio. The CEO of the Corporation shall report jointly to the Board of Trustees of the Corporation and the CEO of the Sole Member's President shall have the right to terminate the CEO, following consultation with the Corporation's Chairperson of the Board of Trustees." 10. Article 6.3, "Nomination and Evaluation Processes of the CEO" was added to the bylaws: "All candidates for the position of CEO shall be nominated by a committee of the Corporation's Board of Trustees, of which the Chairperson of the Board of Trustees shall lead and the committee shall include representatives of the Dartmouth-Hitchcock System. The nomination process shall include the ability of the Sole Member's President or designee to interview any candidate for this position. Any candidate nominated by the committee must be approved by both the Corporation's Board of Trustees and the Sole Member's President. The evaluation of the CEO shall be con Form 990, Part VI, Section A, line 6 The sole member of The Cheshire Medical Center is Dartmouth-Hitchcock Health, a New Hampshire voluntary corporation. Form 990, Part VI, Section A, line 7a The sole member has the power to appoint 1/3 of the members of The Cheshire Medical Center's Board of Trustees Form 990, Part VI, Section A, line 7b The sole member has the right to ratify The Cheshire Medical Center's nomination of 2/3 or the members of the Board of Trustees; remove Trustees after consultation with the Chaiperson of the Board; approve the dissolution or liquidation of The Cheshire Medical Center; appoint, evaluate, terminate, and approve the compensation of the President and CEO; and other governance decisions as outlined in the response to Form 990, Part VI-A, Line 4. Form 990, Part VI, Section B, line 11 A copy of the Form 990 is made available for all Board members to review prior to filing. The Board has formally delegated review of the Form 990 to the Finance and Audit Committee. Committee members receive copies of the Form 990 and it is reviewed in a meeting prior to filing. Form 990, Part VI, Section B, line 12c Officer, Board Members, and Key Employees annually disclose potential conflicts of interest and are required to recuse themselves from all Board activity related to all conflicts. Form 990, Part VI, Section B, line 15a The Cheshire Medical Center/Dartmouth Hitchcock Keene has retained Yaffe & Company, Inc. to provide consultation to the Executive Committee of the Board of Trustees regarding executive compensation, benefits, and perquisites. Yaffe & Company, Inc. is an independent consulting firm with 35 years of service and provides services to not-for-profit hospitals and health systems. Further Yaffe & Company, Inc. has been engaged directly by the Board of Trustees of The Cheshire Medical Center through its Executive Committee to only provide services to the Board. An Executive Committee d/b/a Compensation Committee Charter and Compensation Philosophy (approved by the Board) documents the compensation review process and guidelines so as to provide an orderly structure for executive total compensation decisions. Annually, a multi-tiered approach using independent comparability data is utilized to gauge appropriate comparative market levels of compensation and benefits. An annual performance evaluation is based on subjective and objective criteria which flow from the strategic plan. By way of questionnaire, Board members participate in the performance review process and a summary report is shared with the CEO. Variable pay is awarded based on achievement of specific qualitative and quantitative goals. In conjunction with the Executive Committee, challenging and measurable goals are established for the Office of the President, which provide an alignment between executive compensation and achievement of the hospital's strategic goals. Form 990, Part VI, Section C, line 19 The Organization makes governing documents, conflict of interest policy and financial statements available to members of the public upon request, through its annual report, and through state and federal filings. Form 990, Part IX, line 11g Contract Labor: Program service expenses 12,046,926. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,046,926. Physician/Medical Services: Program service expenses 5,630,576. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,630,576. Other Purchased Services: Program service expenses 2,796,092. Management and general expenses 670,854. Fundraising expenses 0. Total expenses 3,466,946. Data Processing Fees: Program service expenses 2,131,001. Management and general expenses 511,282. Fundraising expenses 0. Total expenses 2,642,283. Outside Lab Fees: Program service expenses 977,655. Management and general expenses 234,565. Fundraising expenses 0. Total expenses 1,212,220. Consulting: Program service expenses 364,630. Management and general expenses 87,484. Fundraising expenses 0. Total expenses 452,114. Form 990, Part IX, Column D: Fundraising Expenses: The Cheshire Health Foundation, a related organization, performs all fundraising activities on behalf of The Cheshire Medical Center. All fundraising expenses are reported on the Foundation's separate Form 990. Form 990, Part XI, line 9: Application of Push Down Accounting 8,991,498. Pension Liability Adjustment -1,360,710. Transfer to Affiliates -460,309. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Form 990, Part VIII-Part XI: The consolidated audited financial statements for The Cheshire Medical Center and subsidiaries report various revenue, expense, asset, and net asset amounts for the Medical Center inclusive of a related organization, Cheshire Health Services (EIN 43-3379283), which began operation on March 11, 2015. All revenue, expense, and balance sheet items related to Cheshire Health Services have been extracted from amounts reported for the Medical Center on this Form 990 and all accompanying schedules. Cheshire Health Services is a separate legal entity filing its own Form 990, and items related to it have been reported there. The Cheshire Health Foundation 580 Court Street Keene NH 03431 020202220 Management of Board designated, SPF, building, and endowment funds NH 501(c)(3) Line 11b, II The Cheshire Medical Center 1 Cheshire Health Services Inc 580 Court Street Keene NH 03431 473379283 Walk-In Medical Clinic NH 501(c)(3) Line 3 The Cheshire Medical Center 1 Dartmouth-Hitchcock Clinic One Medical Center Drive Lebanon NH 03756 222519596 Physician Services NH 501(c)(3) Line 9 Dartmouth- Hitchcock Health 0 Dartmouth-Hitchcock Health One Medical Center Drive Lebanon NH 03756 264812335 Supporting Organization NH 501(c)(3) Line 11b, II N/A 0 Dartmouth-Hitchcock Medical Center One Medical Center Drive Lebanon NH 03756 222715483 Supporting Organization NH 501(c)(3) Line 11a, I N/A 0 Everwell Inc One Medical Center Drive Lebanon NH 03756 352505275 Supporting Organization NH 501(c)(3) Line 11a, I Dartmouth- Hitchcock Health 0 Mary Hitchcock Memorial Hospital One Medical Center Drive Lebanon NH 03756 020222140 Hospital NH 501(c)(3) Line 3 Dartmouth- Hitchcock Health 0 The New London Hospital Association Inc 273 County Road New London NH 03257 020222171 Hospital NH 501(c)(3) Line 3 Dartmouth- Hitchcock Health 0 Windsor Hospital Corporation 289 County Road Windsor VT 05089 030183721 Hospital VT 501(c)(3) Line 3 Dartmouth- Hitchcock Health 0 Keene Health Alliance 580 Court Street Keene NH 03431 300179297 Healthcare NH Related -1977000 0 1 0.50000 OneCare VT ACOLIC 111 Colchester Avenue Burlington VT 05401 455399218 Shared Saving NH N/A Hitchcock Health Connect One Medical Center Drive Lebanon NH 03756 800908979 Telehealth DE N/A C 0 Keene Health Enterprises 580 Court Street Keene NH 03431 020374999 Investments/Real Estate NH Keene Health Services C 1.00000 1 Keene Health Realty 580 Court Street Keene NH 03431 020374998 Investments/Real Estate NH Keene Health Services C 37589 714879 1.00000 1 Keene Health Services 580 Court Street Keene NH 03431 020374997 Investments/Real Estate NH The Cheshire Health Foundation C 489340 201601 1.00000 1 1 0 1 1 0 0 0 0 0 1 1 1 0 1 1 0 1 1 0 The Cheshire Health Foundation K 72000 Actual Cash Value The Cheshire Health Foundation C 409829 Actual Cash Value Cheshire Health Services Inc L 297694 Actual Cash Value