THE NEW LONDON HOSPITAL ASSOCIATION INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- THE NEW LONDON HOSPITAL ASSOCIATION INC (EIN 02-0222171)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-16
- IRS object ID
- 201611379349304161
- Schema version
- 2014v6.0
- 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 G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-16T11:26:44-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | 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 | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222171 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | New London Hospital Association Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NEWL | BusinessNameControlTxt |
| Phone | 6035262911 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 County Road | AddressLine1Txt |
| City | New London | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Donald Griffin | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6035265339 | PhoneNum |
| Signature | 2016-05-13 | 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 | 2016-05-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Bruce King | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 County Road | AddressLine1Txt |
| City | New London | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $77,556,687 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.newlondonhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1918 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | NLHA is a rural community Critical Access Hospital with an extended care center. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 704 | TotalEmployeeCnt |
| Total Volunteers | 125 | TotalVolunteersCnt |
| Total Gross UBI | $152,651 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$21,191 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,804,115 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,720,947 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $41,503,638 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $59,719,738 | CYProgramServiceRevenueAmt |
| PY Investment Income | $938,070 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,677,478 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $45,245,823 | PYTotalRevenueAmt |
| CY Total Revenue | $64,118,163 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $26,212,056 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $33,325,961 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $403,956 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,471,315 | PYOtherExpensesAmt |
| CY Other Expenses | $26,745,874 | CYOtherExpensesAmt |
| PY Total Expenses | $44,683,371 | PYTotalExpensesAmt |
| CY Total Expenses | $60,071,835 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $562,452 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,046,328 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $71,158,043 | TotalAssetsBOYAmt |
| Total Assets EOY | $74,820,173 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $34,522,401 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $36,307,003 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $36,635,642 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $38,513,170 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | New London Hospital is a 25-bed rural community Critical Access Hospital with a 58-bed long term extended care center dedicated to serving the Lake Sunapee region in central New Hampshire.New London Hospital provides safe quality care for every patient, every time in partnership with patients, families and healthcare providers. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,522,219 | ExpenseAmt |
| Revenue | $47,396,702 | RevenueAmt |
| Desc | Hospital services to patients: New London Hospital Association, Inc. (NLHA) is the principal provider of primary and secondary health care for 15 towns in Sullivan and Merrimack counties in New Hampshire. The hospital provides acute and primary health care - from emergency services to family medical practice to surgical care - and essential wellness and prevention services for the 32,715 residents in its service area, a significant proportion of whom are uninsured, underinsured and/or dependent on Medicaid/Medicare benefits. This includes a large elderly population and a significant number of rural, low-income families. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,703,465 | ExpenseAmt |
| Revenue | $8,339,039 | RevenueAmt |
| Desc | Physician practices: In a recent community health needs assessment access to primary care is identified as a central community need. As a result, the hospital is committed to providing care in central locations throughout the service area, specifically in Newport and New London. NLHA employs 47 providers of which 19 are primary care including pediatrics and 28 are specialists covering general surgery, anesthesiology, orthopedics, neurology, emergency medicine, hospitalists, gynecology, and rheumatology. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,775,141 | ExpenseAmt |
| Revenue | $3,983,997 | RevenueAmt |
| Desc | Nursing Home: The Clough Center is a 58-bed extended nursing care facility located within New London Hospital. The Clough Center provides a warm and caring environment for its residents who benefit from health services personalized to meet their individual needs, including special meals, physical, occupational and speech therapy, personalized exercise sessions, and individual attention by highly skilled providers who have immediate access to the comprehensive services of a hospital and pharmacy. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $49,000,825 | 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 | Yes (1) | 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 | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 126 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 704 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Donald Griffin | PersonNm |
| Phone | 6035262911 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 County Road | AddressLine1Txt |
| City | New London | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Anne Holmes | ||||||||
| Chair | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Susan Reeves | ||||||||
| Vice Chair | 8.00 | 40.00 | Yes (X) | Yes (X) | $0 | $317,485 | $129,186 | |
| Stanley I Cundey Jr | ||||||||
| Secretary | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| David Marshall | ||||||||
| Treasurer | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Bruce P King | ||||||||
| President & CEO | 50.00 | 0.00 | Yes (X) | Yes (X) | $384 | $351,565 | $183,662 | |
| Celeste C Cook | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Karen E Ebel | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kris Eschbach DO | ||||||||
| Medical Staff President | 7.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| John C Ferries | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Peter E Hager | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Douglas W Lyon | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jane Rastallis | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Robert M Rex | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| John Kirk MD | ||||||||
| President Elect of Med. Staff | 40.00 | 0.00 | Yes (X) | $181,922 | $0 | $8,364 | ||
| John R Butterly MD | ||||||||
| Trustee | 2.00 | 40.00 | Yes (X) | $0 | $552,569 | $72,827 | ||
| Daniel Jantzen CPA | ||||||||
| Trustee | 2.00 | 50.00 | Yes (X) | $0 | $604,478 | $210,934 | ||
| Stephen J LeBlanc | ||||||||
| Trustee | 2.00 | 40.00 | Yes (X) | $0 | $602,197 | $269,589 | ||
| Carolyn Kerrigan MD | ||||||||
| Trustee | 2.00 | 40.00 | Yes (X) | $0 | $458,370 | $162,812 | ||
| Donald J Griffin | ||||||||
| Chief Financial Officer | 50.00 | 0.00 | Yes (X) | $159,373 | $0 | $7,987 | ||
| James Murphy MD | ||||||||
| Co-Chief Medical Officer | 50.00 | 0.00 | Yes (X) | $293,515 | $0 | $3,048 | ||
| Steven Powell MD MPH | ||||||||
| Co-Chief Medical Officer | 50.00 | 0.00 | Yes (X) | $485,079 | $0 | $19,721 | ||
| Sally Patton | ||||||||
| Co-Chief Nursing Officer | 50.00 | 0.00 | Yes (X) | $117,421 | $0 | $17,629 | ||
| Dave Foss | ||||||||
| Chief Information Officer | 50.00 | 0.00 | Yes (X) | $122,835 | $0 | $17,796 | ||
| Adnan S Khan MD | ||||||||
| Hospitalist | 50.00 | 0.00 | $505,067 | $0 | $2,400 | Yes (X) | ||
| Kenneth D Call MD | ||||||||
| Physician | 50.00 | 0.00 | $411,353 | $0 | $4,549 | Yes (X) | ||
| Stephen Bissah MD | ||||||||
| Hospitalist | 50.00 | 0.00 | $329,389 | $0 | $19,623 | Yes (X) | ||
| David Corbin MD | ||||||||
| Physician | 50.00 | 0.00 | $328,365 | $0 | $19,791 | Yes (X) | ||
| Donald A Eberly MD | ||||||||
| Surgeon | 50.00 | 0.00 | $292,379 | $0 | $7,216 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,227,082 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,886,664 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,157,134 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | 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 |
|---|---|---|---|---|---|
| Dartmouth Hitchcock Clinic | |||||
| One Medical Center Dr | Lebanon | NH | 03756 | Physician Staffing and Lab Services | $1,951,998 |
| AHSA LLC | |||||
| PO Box 945 | Transverse City | MI | 49685 | Staffing | $821,782 |
| New England Alliance for Health | |||||
| One Medical Center Dr | Lebanon | NH | 03756 | Management Services | $809,923 |
| Upper Valley Neurology Neurosurgery | |||||
| 106 Hanover St | Lebanon | NH | 03766 | Physician Services | $690,697 |
| NH Imaging Services | |||||
| One Pillsbury St Suite 200 | Concord | NH | 03301 | Imaging | $324,502 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $41,751 | FundraisingAmt |
| Government Grants | $189,177 | GovernmentGrantsAmt |
| All Other Contributions | $1,490,019 | AllOtherContributionsAmt |
| Noncash Contributions | $18,797 | NoncashContributionsAmt |
| Total Contributions | $1,720,947 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Revenue | 621400 | $107,786,795 | $107,786,795 | |
| Physician Services | 621110 | $2,746,967 | $2,746,967 | |
| Other Revenue | 900099 | $488,682 | $336,906 | $151,776 |
| Provision for Bad Debts | 621400 | -$1,688,547 | -$1,688,547 | |
| Contractual/Char. Adj. | 621400 | -$49,614,159 | -$49,614,159 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $59,719,738 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $444,270 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $875 | UnrelatedBusinessRevenueAmt |
| Exclusion | $443,395 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $15,622,425 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $13,389,217 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,233,208 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,233,208 | TotalRevenueColumnAmt |
| Exclusion | $2,233,208 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $49,307 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $41,751 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $49,307 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,118,163 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $59,567,962 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $152,651 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,676,603 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,432,995 | TotalAmt |
| Program Services | $786,153 | ProgramServicesAmt |
| Management And General | $646,842 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,129,137 | TotalAmt |
| Program Services | $20,924,549 | ProgramServicesAmt |
| Management And General | $4,930,452 | ManagementAndGeneralAmt |
| Fundraising | $274,136 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,100,826 | TotalAmt |
| Program Services | $3,283,994 | ProgramServicesAmt |
| Management And General | $752,136 | ManagementAndGeneralAmt |
| Fundraising | $64,696 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,663,003 | TotalAmt |
| Program Services | $1,331,754 | ProgramServicesAmt |
| Management And General | $310,774 | ManagementAndGeneralAmt |
| Fundraising | $20,475 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $503,266 | TotalAmt |
| Program Services | $403,022 | ProgramServicesAmt |
| Management And General | $100,244 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,878 | TotalAmt |
| Program Services | $153,659 | ProgramServicesAmt |
| Management And General | $38,219 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,276 | TotalAmt |
| Program Services | $126,749 | ProgramServicesAmt |
| Management And General | $31,527 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,547 | TotalAmt |
| Program Services | $57,296 | ProgramServicesAmt |
| Management And General | $14,251 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,085,951 | TotalAmt |
| Program Services | $3,272,082 | ProgramServicesAmt |
| Management And General | $813,869 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,874 | TotalAmt |
| Program Services | $97,598 | ProgramServicesAmt |
| Management And General | $94 | ManagementAndGeneralAmt |
| Fundraising | $24,182 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,144,377 | TotalAmt |
| Program Services | $1,717,245 | ProgramServicesAmt |
| Management And General | $412,048 | ManagementAndGeneralAmt |
| Fundraising | $15,084 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,076,976 | TotalAmt |
| Program Services | $862,457 | ProgramServicesAmt |
| Management And General | $214,519 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,317,633 | TotalAmt |
| Program Services | $1,055,177 | ProgramServicesAmt |
| Management And General | $258,338 | ManagementAndGeneralAmt |
| Fundraising | $4,118 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,522 | TotalAmt |
| Program Services | $47,666 | ProgramServicesAmt |
| Management And General | $10,901 | ManagementAndGeneralAmt |
| Fundraising | $955 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,636 | TotalAmt |
| Program Services | $78,188 | ProgramServicesAmt |
| Management And General | $19,138 | ManagementAndGeneralAmt |
| Fundraising | $310 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $849,031 | TotalAmt |
| Program Services | $679,915 | ProgramServicesAmt |
| Management And General | $169,116 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,072,295 | TotalAmt |
| Program Services | $3,261,146 | ProgramServicesAmt |
| Management And General | $811,149 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $763,356 | TotalAmt |
| Program Services | $611,305 | ProgramServicesAmt |
| Management And General | $152,051 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Other | $4,926,950 | $3,945,564 | $981,386 |
| Drugs and Pharmaceutica | $2,278,864 | $2,278,864 | |
| Medical Supplies | $2,085,831 | $2,085,831 | |
| Medicaid Enhancement Ta | $1,940,611 | $1,940,611 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,071,835 | TotalAmt |
| Program Services | $49,000,825 | ProgramServicesAmt |
| Management And General | $10,667,054 | ManagementAndGeneralAmt |
| Fundraising | $403,956 | 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 | $3,867,141 | BOYAmt |
| EOY | $7,224,757 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $357,302 | BOYAmt |
| EOY | $364,147 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,711 | BOYAmt |
| EOY | $37,086 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,105,551 | BOYAmt |
| EOY | $7,387,946 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $969,944 | BOYAmt |
| EOY | $1,055,863 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,302,965 | BOYAmt |
| EOY | $1,531,747 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $83,487,846 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $46,389,790 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,599,645 | BOYAmt |
| EOY | $37,098,056 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,435,104 | BOYAmt |
| EOY | $13,047,506 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,601,222 | BOYAmt |
| EOY | $2,595,189 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,871,458 | BOYAmt |
| EOY | $4,477,876 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,158,043 | BOYAmt |
| EOY | $74,820,173 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,040,568 | BOYAmt |
| EOY | $6,185,630 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,923,481 | BOYAmt |
| EOY | $17,668,091 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,982 | BOYAmt |
| EOY | $4,307 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,502,370 | BOYAmt |
| EOY | $12,448,975 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,522,401 | BOYAmt |
| EOY | $36,307,003 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,075,811 | BOYAmt |
| EOY | $33,967,261 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $318,239 | BOYAmt |
| EOY | $325,554 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,241,592 | BOYAmt |
| EOY | $4,220,355 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,635,642 | BOYAmt |
| EOY | $38,513,170 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,158,043 | BOYAmt |
| EOY | $74,820,173 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,046,328 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,926,934 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$241,866 | 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 | $9,419 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $9,419 | 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 | Per information provided by the NH Hospital Association (NHHA), the NHHA percentage of dues expended for lobbying purposed was 23.46%. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,241,594 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $178,504 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $141,831 | OtherExpendituresAmt |
| Administrative Expenses | $57,912 | AdministrativeExpensesAmt |
| End Year Balance | $4,220,355 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,052,516 | BeginningYearBalanceAmt |
| Contributions | $2,117,600 | ContributionsAmt |
| Investment Earnings Or Losses | $185,482 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $89,536 | OtherExpendituresAmt |
| Administrative Expenses | $24,468 | AdministrativeExpensesAmt |
| End Year Balance | $4,241,594 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,002,989 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $172,073 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $104,101 | OtherExpendituresAmt |
| Administrative Expenses | $18,445 | AdministrativeExpensesAmt |
| End Year Balance | $2,052,516 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,890,475 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $227,326 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $96,967 | OtherExpendituresAmt |
| Administrative Expenses | $17,845 | AdministrativeExpensesAmt |
| End Year Balance | $2,002,989 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,928,036 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $77,754 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $90,305 | OtherExpendituresAmt |
| Administrative Expenses | $25,010 | AdministrativeExpensesAmt |
| End Year Balance | $1,890,475 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,660,103 | OtherCostOrOtherBasisAmt |
| Book Value | $1,660,103 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,511,255 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,859,605 | DepreciationAmt |
| Book Value | $29,651,650 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $441,889 | OtherCostOrOtherBasisAmt |
| Depreciation | $388,970 | DepreciationAmt |
| Book Value | $52,919 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,999,483 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,277,915 | DepreciationAmt |
| Book Value | $5,721,568 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $875,116 | OtherCostOrOtherBasisAmt |
| Depreciation | $863,300 | DepreciationAmt |
| Book Value | $11,816 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $37,098,056 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from Affiliate | $637,476 |
| Other Assets | $990,658 |
| Deferred Compensation Plan Assets | $1,120,853 |
| Beneficial Interest in Perpetual Trust | $1,728,889 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,477,876 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Charitable Gift Annuities | $13,800 |
| Capital Lease Obligations | $1,008,882 |
| Other Liabilities | $20,000 |
| Interest Rate Swap | $3,530,790 |
| Estimated Third-Party Payor Settlements | $6,754,650 |
| Deferred Compensation | $1,120,853 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,448,975 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, Line 4: | FormAndLineReferenceDesc |
| Explanation | The income from the Endowment Funds is used to assist in the payment of the hospitals program-related expenses. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $52,650 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $31,155 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $21,495 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $4,928 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $15,800 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $767 | OtherDirectExpensesEvent1Amt |
| Event2 | Hospital Days | Event2Nm |
| Gross Receipts Event2 | $38,408 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $10,596 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $27,812 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $603 | NonCashPrizesEvent2Amt |
| Food And Beverage Event2 | $73 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $650 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $26,486 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $91,058 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $41,751 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $49,307 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $5,531 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $15,800 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $73 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $650 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $27,253 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $49,307 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $0 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $939,893 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $939,893 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01560 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,948,273 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,561,846 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,386,427 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02310 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,888,166 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,561,846 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,326,320 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03870 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $112,069 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $112,069 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,243 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $47,243 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,232,324 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,232,324 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07050 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,541 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,541 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,406,177 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,406,177 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07340 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,294,343 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,561,846 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,732,497 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11210 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,066 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,066 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $63,399 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63,399 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $85,465 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $85,465 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $953,582 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $22,458 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $21,287,269 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $22,405,943 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,118,674 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | New London Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 County Road | AddressLine1Txt |
| City | New London | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | New London Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 14 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.newlondonhospital.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.newlondonhospital.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 | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.newlondonshospital.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| New London Hospital Association | Part V, Section B, Line 5: The most recent Community Needs Assessment was completed in June of 2015. The New London Hospital Association, Inc. worked with several local healthcare organizations and the Community Health Institute to bring together key healthcare and public stakeholders to elicit feedback on our local healthcare needs. Input was received from persons who represent the broad interests of the community served by the healthcare facility. This group included those with special knowledge or expertise in public health, community opinion leaders (a diverse set of service providers) and healthcare consumers. |
| New London Hospital Association | Part V, Section B, Line 6a: The New London Hospital Association Inc. conducted their Community Health Needs Assessment in collaboration with Valley Regional Hospital, Alice Peck Day Memorial Hospital, Mt. Ascutney Hospital and Healthcare Center and Dartmouth- Hitchcock. |
| New London Hospital Association | Part V, Section B, Line 11: The Hospital continues to build upon previous efforts to implement a solid foundation for identifying and meeting the identified needs of our community within the scope of our resources. Strategic plans have been developed, implemented and reviewed to gauge success in these identified areas and allow refinement to ensure success. Services have been expanded to meet underserved areas and new services have been added to promote healthy life choices. Collaboration with community groups has allowed services to expand into new areas and bring forth additional resources for the community to allow better healthcare choices and remove barriers to care. |
| New London Hospital Association | Part V, Section B, Line 20e: Mailings and phone calls are used as additional follow up measures to ensure that patients are aware of the various types of discounts and financial assistance that the Organization offers. Assistance is offered to anyone in need to complete the necessary paperwork for financial assistance. |
| New London Hospital Association | Part V, Section B, Line 22d: The New London Hospital Association Inc. extends a 25% discount from gross charges to uninsured patients, which approximates the average of its three lowest negotiated commercial insurance rates. |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| New London Hospital Association Part V, Section B, line 16b website: | www.newlondonshospital.org |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Newport Health Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 John Stark Hwy | AddressLine1Txt |
| City | Newport | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03773 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Rural Health Clinic | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7g: | The Hospital is dedicated to serving and supporting the community it serves by ensuring access to programs that could not be provided with the Organization subsidizing their services. In FY 2015, the Hospital subsidized health care services to the community in the amount of $4,232,324. This included support for primary care services, community wellness programs and grants, mental health services, EMS training, community health advocacy and the medication bridge program. With a focus on wellness, primary care is of the utmost importance to our patients and their families. The Organization has locations for primary care in New London and Newport NH to expand access to the communities we serve. The Organization has developed wellness programs to offer education and provide assistance to our community members in making and sustaining healthier lifestyle choices. Costs incurred for subsidizing primary care and implementing wellness initiatives in our community amounted to over $4.2 million dollars for fiscal year 2015.The cost of prescription drugs is often beyond the means of many of the residents in our community. The Hospital supports the medication bridge program, which works with uninsured and underinsured patients to assist them in accessing prescription medication. Over 120 patients received assistance under the program, at a cost of $28,000. |
| Part II, Community Building Activities: | The Hospital participates in a wide variety of community building activities including community support and community health improvement advocacy. The Hospital supports many local service agencies through the participation of members of its management team on committees and boards. The Hospital subsidizes the cost of operations for the ABC's Childcare Center, which provides high quality childcare at afforable prices. The childcare center is open to full and part time employees of the Organization and to the community to provide a nuturing, safe and stimulating environment for the children of our community to grow and learn. |
| Part III, Line 4: | The Health System grants credit without collateral to patients. Most are local residents and are insured under third-party arrangements. Additions to the allowance for uncollectible accounts are made by means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon managements assessment of historical and expected net collections, business and economic conditions, trends in federal and state governmental healthcare coverage , and other collection indicators.The Association's allowance for doubtful accounts for self-pay accounts receivable decreased from 86% at June 30, 2014 to 74% at June 30, 2015. In addition, the Association's self-pay accounts receivable decreased from approximately $1,422,000 at June 30, 2014 to $1,015,000 at June 30, 2015. The Association has not changed its free care or uninsured discount policies during 2015. The Association does not maintain a material allowance for doubtful accounts receivable from third-party payors. The Association recognizes patient service revenue associated with services provided to patients who have third-party coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for free care, the Association recognizes revenue on the basis of its standard rates for services provided (or on the basis of discounted rates, if negotiated or provided by policy). On the basis of historical experience, a portion of the Association's uninsured patients will be unable to or unwilling to pay for the services rendered. Thus, the Association records a significant provision for bad debts related to uninsured patients in the period services are provided. The Hospital used the cost-to-charge ratio for reporting bad debt expense at cost. The estimate of bad debt attributable to charity was based upon historical experience. The Hospital provides information about financial assistance policies upon admission, prior to discharge and throughout the billing process. Although the Hospital works diligently to provide financial options to patients, a small number of patients do not provide the information necessary to complete the financial aid application.Patients who do not respond to repeated attempts for assistance may be classified as bad debt due to insufficient information on eligibility for financial assistance programs. The Hospital did not include these amounts within its community benefit reporting due to the fact that adherence with the Organization's charity care criteria could not be determined. |
| Part III, Line 9b: | Information concerning the Organization's financial assistance policy is available from a variety of sources including our website, upon admission and throughout the billing process. The Collection Coordinator is responsible for reviewing returned financial assistance applications, assisting patients with securing information necessary to complete the applications, evaluating the applications and making recommendations to the Director of Patient Business Services and/or the Chief FinancialOfficer, when applicable. The Collection Coordinator will notify patients of their eligibility and work with them to address any remaining balances. If a patient does not meet eligibilty requirements for free or discounted care, the Organization will work with the patient to create an installment plan that will allow payments of patient balances over a period of time. |
| Part VI, Line 2: | The Affordable Care Act of 2010 requires not-for-profit hospitals to conduct Community Health Needs Assessments every three years. The Organization completed its most recent Community Health Needs Assessment in June of 2015 in collaboration with Valley Regional Hospital, Alice Peck Day Memorial Hospital, Dartmouth- Hitchcock, and Mt. Ascutney Hospital and Health Center with the help of the Community Health Institute. Focus group discussions were held to elicit feedback from community members, public service officials and healthcare experts to identify community needs and prioritize the needs of our local community.The prioritization of community needs identified in the Community Needs Assessment include the following:1. Cost of prescription drugs2. Access to adequate and affordable healthcare3. Access to mental health care4. Lack of physical activity5. Alcohol and drug misuse6. Poor nutrition/unhealthy food7. Access to dental health care8. Heroin and misuse of pain medications9. Access to primary health care10. Cancer11. Mental illness12. Health care for seniors |
| Part VI, Line 3: | The Organization strives to educate patients on the availability of financial assistance in a variety of forums to widely publicize the programs and encourage patients to apply for assistance they may be eligible for. The Organization posts information in regards to financial assistance on the Hospital's website, upon admission, upon request and throughout the billing process to inform patients of assistance that may be available to them. |
| Part VI, Line 4: | The New London Hospital Association, Inc (NLHA) is the principal provider of primary and secondary healthcare for 15 towns in Sullivan and Merrimack counties of New Hampshire. The towns within our service area include: Andover, Bradford, Croydon, Danbury, Goshen, Grantham, Lempster, New London, Newbury, Newport, Springfield, Sunapee, Sutton, Washington and Wilmot. The service area has a population of 32,715, according to the United States Census Bureau, which approximates about 2.5% of NewHampshire's population. |
| Part VI, Line 5: | The New London Hospital Association Inc. is dedicated to improving the health and well-being of our community and the people we serve. The Organization provides a wide array of services ranging from health education to subsidizing health services and access to care, to community building activities which improve the quality of life for all of those within our service area.The Organization provides health education classes including safe sitter, smoking cessation, healthy lifestyle, and programs to support new parents. Additional classes include CPR, EMS and health care provider education to allow emergency medical training to residents of our community.Many services provided by the Organization are subsidized to sustain necessary services for the community. Primary care is an area that has been identified as a community need in the most recent community benefit report. The Organization not only subsidized these services but also expanded access to care by increasing hours and locations within our community. Services include expanded hours of clinics, on site treatment at community locations and outreach programs at Hospital sponsored events. The Hospital also participates in the medication bridge program which allows access to necessary prescriptions that would otherwise be cost prohibitive to our patients. Financial assistance and charity care programs strive to remove financial barriers to care and encourage patients to seek regular medical care and focus upon wellness. The Organization supports many local community organizations with programs outside the scope of services provided by the Hospital with both in-kind and monetary donations. The Hospital subsidizes the ABC's childcare program to provide a safe, nurturing atmosphere where children can grow and learn and parents can feel confident that their children are well taken care of. |
| Part VI, Line 7, Reports Filed With States | NH |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Susan Reeves | ||||||||||||||
| Vice Chair | $0 | $288,501 | $0 | $0 | $0 | $28,984 | $0 | $111,170 | $0 | $18,016 | $0 | $446,671 | $0 | $0 |
| Bruce P King | ||||||||||||||
| President & CEO | $0 | $313,800 | $0 | $0 | $384 | $37,765 | $0 | $163,148 | $0 | $20,514 | $384 | $535,227 | $0 | $0 |
| John Kirk MD | ||||||||||||||
| President Elect of Med. Staff | $173,407 | $0 | $1,025 | $0 | $7,490 | $0 | $0 | $0 | $8,364 | $0 | $190,286 | $0 | $0 | $0 |
| John R Butterly MD | ||||||||||||||
| Trustee | $0 | $498,440 | $0 | $0 | $0 | $54,129 | $0 | $72,827 | $0 | $0 | $0 | $625,396 | $0 | $0 |
| Daniel Jantzen CPA | ||||||||||||||
| Trustee | $0 | $515,042 | $0 | $0 | $0 | $89,436 | $0 | $190,359 | $0 | $20,575 | $0 | $815,412 | $0 | $0 |
| Stephen J LeBlanc | ||||||||||||||
| Trustee | $0 | $478,894 | $0 | $0 | $0 | $123,303 | $0 | $249,014 | $0 | $20,575 | $0 | $871,786 | $0 | $0 |
| Carolyn Kerrigan MD | ||||||||||||||
| Trustee | $0 | $337,624 | $0 | $83,644 | $0 | $37,102 | $0 | $141,651 | $0 | $21,161 | $0 | $621,182 | $0 | $0 |
| Donald J Griffin | ||||||||||||||
| Chief Financial Officer | $155,560 | $0 | $125 | $0 | $3,688 | $0 | $0 | $0 | $7,987 | $0 | $167,360 | $0 | $0 | $0 |
| James Murphy MD | ||||||||||||||
| Co-Chief Medical Officer | $290,618 | $0 | $125 | $0 | $2,772 | $0 | $0 | $0 | $3,048 | $0 | $296,563 | $0 | $0 | $0 |
| Steven Powell MD MPH | ||||||||||||||
| Co-Chief Medical Officer | $484,324 | $0 | $125 | $0 | $630 | $0 | $0 | $0 | $19,721 | $0 | $504,800 | $0 | $0 | $0 |
| Adnan S Khan MD | ||||||||||||||
| Hospitalist | $504,564 | $0 | $125 | $0 | $378 | $0 | $0 | $0 | $2,400 | $0 | $507,467 | $0 | $0 | $0 |
| Kenneth D Call MD | ||||||||||||||
| Physician | $409,422 | $0 | $125 | $0 | $1,806 | $0 | $0 | $0 | $4,549 | $0 | $415,902 | $0 | $0 | $0 |
| Stephen Bissah MD | ||||||||||||||
| Hospitalist | $328,844 | $0 | $125 | $0 | $420 | $0 | $0 | $0 | $19,623 | $0 | $349,012 | $0 | $0 | $0 |
| David Corbin MD | ||||||||||||||
| Physician | $327,610 | $0 | $125 | $0 | $630 | $0 | $0 | $0 | $19,791 | $0 | $348,156 | $0 | $0 | $0 |
| Donald A Eberly MD | ||||||||||||||
| Surgeon | $289,482 | $0 | $125 | $0 | $2,772 | $0 | $0 | $0 | $7,216 | $0 | $299,595 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7 | During the year the Organization provided bonus compensation based on the individuals time with the organization. Bonuses were not performance related. |
| Schedule J, Part II: | Bruce P. King, CEO is paid by Mary Hitchcock Memorial Hospital (MHMH), an affiliated organization. New London Hospital (NLHA) purchases Mr. King's services from MHMH. Compensation amounts disclosed on Form 990 & Schedule J for Mr. King represent earnings from MHMH and taxable fringe benefits directly provided to Mr. King from NLHA. Mr. King also received club dues of $650 during the year from MHMH, which was included in his compensation. John R. Butterly, MD, Stephen J. LeBlanc, MD, Daniel Jantzen, CPA, Susan Reeves, & Carolyn Kerrigan are all on the Board of Trustees for New London Hospital, but are employees of our affiliated group. Compensation for these individuals represents earnings from the affiliated group, not New London Hospital. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NH Health and Education Facilities Authority | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 020279866 | BondIssuerEIN |
| Bond Issued | 2013-10-24 | BondIssuedDt |
| Issue Price | $25,000,000 | IssuePriceAmt |
| Purpose | To refinance 2007 Bonds & finance construction of health center building | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $430,810 | RetiredAmt |
| Total Proceeds | $25,000,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $355,400 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $2,250,000 | CapitalExpendituresAmt |
| Other Spent Proceeds | $15,493,501 | OtherSpentProceedsAmt |
| Unspent | $6,901,099 | UnspentAmt |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Morgan Stanley | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 30.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | Mr. Bruce King, CEO, of New London Hospital Association (NLHA) is an employee of Mary Hitchcock Memorial Hospital (MHMH). NLHA purchases Mr. King's services from MHMH. |
| Form 990, Part VI, Section A, line 6 | The sole member of the Corporation is Dartmouth-Hitchcock Health, a New Hampshire non-profit corporation. |
| Form 990, Part VI, Section A, line 7a | The Member of the Corporation has the power to appoint 1/3 of the NLHA Board of the Trustees and must ratify the nomination of 2/3 of the members of the Board of Trustees. |
| Form 990, Part VI, Section A, line 7b | The Member has certain reserved powers which require the Organization to obtain approval of the Member. |
| Form 990, Part VI, Section B, line 11 | NLHA posted a copy of the Form 990 on its trustee intranet site and solicited trustee comments before filing the return. The Schedule B provided did not include the names of the donors. |
| Form 990, Part VI, Section B, line 12c | Each year, as part of the preparation process for the Form 990, a written conflict of interest survey is sent to each Trustee inquiring about situations that could result in conflicts of interest. |
| Form 990, Part VI, Section B, line 15 | The CEO's compensation is determined by the New London Hospital Association (NLHA) Executive Committee and Mary Hitchcock Memorial Hospital, the CEO's employer, after considering compensation for CEOs of various sized hospitals in the region. Compensation levels for all other officers and key employees are reviewed periodically by NLHA's Senior Director of Human Resources and the CEO of NLHA. These reviews include comparisons of compensation levels to independent salary survey data for comparable positions in the region. |
| Form 990, Part VI, Section C, line 19 | NLHA makes this information available to the public upon request. Additionally, Form 990 is filed with the State of New Hampshire and is available to the public through the State. NLHA also maintians public inspection copies of the Form 990 that are available upon request and its Form 990 is also available through GuideStar. NLH files a Community Benefit Report annually with the State of NH. A summary of the Community Benefit Report and summary financial information is available on NLHA's website and in annual reports to donors. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: New London Hospital 273 Country Road New London, NH 03257 EIN 02-0222171 New London Hospital 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 -220,629. Change in Beneficial Interest in Perpetual Trust -21,237. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Dartmouth Hitchcock Health | |||||||||||
| One Medical Street | Lebanon | NH | 03756 | 264812335 | Supporting Organization | NH | 501(C)(3) | Line 11b, II | N/A | 0 | |
| Dartmouth Hitchcock Clinic | |||||||||||
| One Medical Street | Lebanon | NH | 03756 | 222519596 | Physician Services | NH | 501(C)(3) | Line 9 | 0 | Dartmouth Hitchock | |
| Mary Hitchcock Memorial Hospital | |||||||||||
| One Medical Street | Lebanon | NH | 03756 | 020222140 | Hospital | NH | 501(C)(3) | Line 3 | 0 | Dartmouth Hitchock | |
| Dartmouth Hitchcock Medical Center | |||||||||||
| One Medical Street | Lebanon | NH | 03756 | 222715483 | Supporting Organization | NH | 501(C)(3) | Line 11a, I | N/A | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kearsarge Services Inc | ||||||||||||
| 273 County Road | New London | NH | 03257 | 020460136 | Real Estate | NH | New London Hospital Association | C | $45,876 | $897,797 | 1.00000 | 0 |
| New London Medical Center East | ||||||||||||
| 273 County Road | New London | NH | 03257 | 020480857 | Real Estate | NH | New London Hospital Association | C | -$6,269 | $10,750 | 1.00000 | 0 |
| New London Physician Group Inc | ||||||||||||
| 273 County Road | New London | NH | 03257 | 020494420 | Physician Practice | NH | New London Hospital Association | C | 1.00000 | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kearsarge Community Services | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $181,565 | InvolvedAmt |
| Method Of Amount Determination | Cost | MethodOfAmountDeterminationTxt |