2016-08-12T10:34:18-05:00 2015-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2014-10-01 020397338 Valley Regional Healthcare Inc VALL 6035427771 243 Elm Street Claremont NH 03743 Jean Shaw CFO 6035427771 2016-08-09 1 Barbara J McGuan CPA P00219457 2077752387 2016-08-09 2014 2016-09-27 15:27:22Z Peter Wright 243 Elm Street Claremont NH 03743 6085047 0 X www.vrh.org X 1986 NH Parent organization to Valley Regional Hospital, Inc. 19 15 123 23 0 0 336986 373102 5175957 5377107 306376 334838 -146064 -137019 5673255 5948028 0 0 0 0 3982189 4303212 0 0 0 1298838 1657934 5281027 5961146 392228 -13118 3652992 3624212 1059975 1237435 2593017 2386777 Valley Regional Healthcare, Inc. is organized to coordinate and support the activities of health care organizations, including Valley Regional Hospital, Inc. 0 0 4134226 5377107 Valley Regional Healthcare is the parent organization for Valley Regional Hospital. In this role, Valley Regional Healthcare provides integrated management and support services for the Hospital. Valley Regional Healthcare also operates Connecticut Valley Home Care, a home health care agency. 4134226 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 18 0 1 123 1 0 0 0 0 0 0 0 0 0 0 X 19 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 0 1 1 1 1 0 NH X Jean Shaw 6035427771 243 Elm Street Claremont NH 03743 Peter Wright President & CEO 1.60 38.40 X X 246174 0 22356 Robert Porter Trustee 0.10 0.90 X 0 0 0 Michael L Prozzo Jr Past Trustee 0.10 0.90 X 0 0 0 Alison Raymond Trustee 0.10 0.90 X 0 0 0 Lisa Richmond Trustee 0.10 0.90 X 0 0 0 Bernard Rosen MD Trustee 0.10 0.90 X 0 0 0 Jim Wimberg Trustee 0.10 0.90 X 0 0 0 Michael O'Connell Chair 0.10 0.90 X X 0 0 0 Michael Satzow Trustee 0.10 0.90 X 0 0 0 Robert Cricco MD Trustee 0.10 39.90 X 0 100232 1552 Michael Fuerst Trustee 0.10 0.90 X 0 0 0 Oliver Herfort MD Trustee 0.10 39.90 X 0 266010 31596 Sherwood Moody Trustee 0.10 0.90 X 0 0 0 James Borchert Trustee 0.10 0.90 X 0 0 0 Charlene Lovett Vice Chair 0.10 0.90 X X 0 0 0 Patricia Putnam Treasurer 0.10 0.90 X X 0 0 0 Allan Berggren MD Secretary 0.10 0.90 X X 0 0 0 John Tomlinson Trustee 0.10 0.90 X 0 0 0 Deanna Howard Trustee 0.10 0.90 X 0 0 0 Charles Sawyer MD Trustee 0.10 39.90 X 0 467331 21095 Allen Damren Past Trustee 0.10 0.90 X 0 0 0 Steven Monette Past VP of Finance 2.80 37.20 X 175720 0 898 Jean Shaw Interim CFO 5.00 35.00 X 0 78232 25029 Margaret Burns VP of Nursing 40.00 X 155716 0 5420 577610 911805 107946 3 0 1 1 Dartmouth Hitchcock Clinic One Medical Center Drive Lebanon NH 03756 CEO Contract Services 368088 New England Alliance for Health One Medical Center Drive Lebanon NH 03756 Professional Services 118880 2 348762 24340 373102 Patient Service Revenue 621610 3042311 3042311 Management Services 621610 2315898 2315898 Miscellaneous Revenue 900099 325354 325354 Provision for Bad Debts 621610 -107997 -107997 Contractual/Charity Adjustment 621610 -198459 -198459 5377107 246745 246745 137019 -137019 -137019 -137019 88093 0 88093 88093 88093 5948028 5377107 0 197819 X 445148 71008 374140 3030235 2516529 513706 15267 12679 2588 568617 472221 96396 243945 202590 41355 25620 25620 9450 9450 16117 16117 787938 111628 676310 88187 88187 197489 175925 21564 31554 31554 145134 140046 5088 22399 22399 37586 37586 Medical Supplies 247835 240835 7000 Miscellaneous 48625 48625 5961146 4134226 1826920 0 X 239384 105212 276122 253176 441150 443454 23564 20059 611801 345251 239686 266550 2070646 2081583 362440 454178 3652992 3624212 510203 547657 76151 109724 473621 580054 1059975 1237435 X 2559286 2353036 33731 33741 2593017 2386777 3652992 3624212 -13118 -193122 0 X 0 1 X 1 0 X X 1 Valley Regional Hospital Inc 020222118 3 1 5961146 0 1 5961146 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 304020 127789 176231 256414 216268 40146 51367 1194 50173 266550 Due from Affiliates 118598 Cash Surrender Value of Life Insurance 289183 Other Accounts Receivable 46397 454178 Due to Affiliates 515895 Reserve for Self-Funded Insurance 64159 580054 X X X X 0 0 0 0 0 0 0 0 0 Peter Wright President & CEO 245994 0 0 0 180 0 14216 0 8140 0 268530 0 0 0 Oliver Herfort MD Trustee 0 254766 0 2114 0 9130 0 5227 0 26369 0 297606 0 0 Charles Sawyer MD Trustee 0 456377 0 0 0 10954 0 8038 0 13057 0 488426 0 0 Steven Monette Past VP of Finance 175129 0 0 0 591 0 0 0 898 0 176618 0 0 0 Margaret Burns VP of Nursing 154897 0 0 0 819 0 3033 0 2387 0 161136 0 0 0 Form 990, Part VII, line 5: Peter Wright, CEO is paid by Mary Hitchcock Memorial Hospital, an unrelated organization via a professional services agreement. A breakdown of Mr. Wright's 2014 compensation is as follows: Salary: $246,174 Benefits: $22,356 Form 990, Part VI, Section A, line 6 The Corporation has an assembly of Overseers. Form 990, Part VI, Section A, line 7a The Overseers elect directors to the Board. Additionally, the CEO of Dartmouth Hitchcock Medical Center has the right to appoint one representative to the Board of Directors. Form 990, Part VI, Section A, line 7b The power to alter, amend or repeal the bylaws or to adopt new bylaws shall be vested in the Assembly of Overseers. Form 990, Part VI, Section B, line 11 The Organization's CFO reviews the draft Form 990 prior to its filing. The CFO then goes over the document with the board's finance committee. Form 990, Part VI, Section B, line 15 The executive committee of the board of trustees convenes on an annual basis to review the compensation of the CEO. The amount of compensation shall be reviewed by the D-H independent compensation consultant for purposes of determining compliance with the rebuttable presumption, if necessary. The CEO compensation is tied to the strategic planning goals of the Organization. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Purchased Services: Program service expenses 111,628. Management and general expenses 676,310. Fundraising expenses 0. Total expenses 787,938. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Valley Regional Healthcare, Inc. 243 Elm Street Claremont, NH 03743 EIN: 02-0397338 Valley Regional Healthcare, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Valley Regional Hospital Inc 243 Elm Street Claremont NH 03743 020222118 Critical Access Hospital NH 501(c)(3) 3 Valley Regional Healthcare Inc 1 George H Stowell Trust 295 Windsor Rd Claremont NH 03743 Charitable Trust NH Valley Regional Hospital Inc T 0 Clarence H Martin Trust 243 Elm St Claremont NH 03743 Charitable Trust NH Valley Regional Hospital Inc T 0 McGuire Endowment 243 Elm St Claremont NH 03743 Charitable Trust NH Valley Regional Hospital Inc T 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 Valley Regional Hospital Inc K 113518 Amounts Paid Valley Regional Hospital Inc L 2315916 Amounts Paid