LITTLETON HOSPITAL ASSOCIATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- LITTLETON HOSPITAL ASSOCIATION (EIN 02-0222152)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-05-04
- IRS object ID
- 201511249349300801
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-04T11:06:00-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222152 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Hospital Association | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LITT | BusinessNameControlTxt |
| Phone | 6034449000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1 |
| City | Littleton | City |
| State | NH | State |
| ZIP Code | 03561 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Nick Braccino | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6034449000 | PhoneNum |
| Signature | 2015-04-30 | 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 | 2015-04-30 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Regional Healthcare | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Nick Braccino | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1 |
| City | Littleton | City |
| State | NH | State |
| ZIP Code | 03561 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $89,230,369 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.littletonhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1906 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | To provide health care services in Northern New Hampshire | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 531 | TotalEmployeeCnt |
| Total Volunteers | 254 | TotalVolunteersCnt |
| Total Gross UBI | $839 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$369 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $122,101 | PYContributionsGrantsAmt |
| CY Contributions Grants | $51,695 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $80,091,833 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $84,873,335 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,383,355 | PYInvestmentIncomeAmt |
| CY Investment Income | $294,248 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $81,597,289 | PYTotalRevenueAmt |
| CY Total Revenue | $85,219,278 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $103,734 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $201,406 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $42,507,068 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $46,449,522 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $35,218,794 | PYOtherExpensesAmt |
| CY Other Expenses | $36,625,030 | CYOtherExpensesAmt |
| PY Total Expenses | $77,829,596 | PYTotalExpensesAmt |
| CY Total Expenses | $83,275,958 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,767,693 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,943,320 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $95,068,821 | TotalAssetsBOYAmt |
| Total Assets EOY | $96,738,504 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $50,423,017 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $48,296,165 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $44,645,804 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $48,442,339 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To provide quality, compassionate and accessible healthcare in a manner that brings value to all.To offer a full spectrum of services, including acute primary and selected secondary care; 24-hour emergency services; preventive diagnostic, theraputic, and rehabilitative services on an outpatient and inpatient basis; continuity of care from preventive programs to coordination with home health services.To provide these services without regard to race, religion, age, sex, income, creed, national origin, or disability.To maintain a sufficient number and mix of medical staff who are competent, dedicated and commmunity based, supporting them with the technologically up-to-date equipment and facility needed to provide these services competitively.To create a healthy, satisfying work environment for phsycians, nurses and other employees, with a commitment to support the continuing educational needs of its professional staff, including the physicians, nurses and allied health personnel. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $66,726,037 | ExpenseAmt |
| Grant | $201,406 | GrantAmt |
| Revenue | $84,873,335 | RevenueAmt |
| Desc | Littleton Hospital Association provides health care services on an in/outpatient basis to the general public, including charity care, community education, and various other health programs and services. | Desc |
| Total Program Service Expenses | $66,726,037 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 127 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 531 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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 | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Leslie Walker Controller | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6034449000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Rd | AddressLine1 |
| City | Littleton | City |
| State | NH | State |
| ZIP Code | 03561 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| William Bedor | |||||||||
| Vice-Chairman/Treasurer | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Milton Bratz | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Mell Brooks | |||||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Wayne Rioux | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John Starr | |||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Stevan Trooboff | |||||||||
| Chairman | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Deane Rankin MD | |||||||||
| Trustee/Physician | 40.00 | Yes (X) | $439,008 | $0 | $47,392 | ||||
| Roger Gingue | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| James Hamblin | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Everett Aldrich | |||||||||
| Auxiliary President | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Gary Meader | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Gail Tomlinson | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Kim Butler | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Andrew Forrest | |||||||||
| Chief of Staff | 40.00 | Yes (X) | $328,216 | $0 | $29,047 | ||||
| Jeff Woodward | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Erin Hennessey | |||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Stephen Phipps | |||||||||
| Past President, Medical Staff | 1.00 | Yes (X) | $12,000 | $0 | $0 | ||||
| George Brodeur | |||||||||
| Past Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Dr David Nelson | |||||||||
| Past Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Warren West | |||||||||
| CEO | 40.00 | 1.00 | Yes (X) | $363,240 | $0 | $25,393 | |||
| Nick Braccino | |||||||||
| CFO | 40.00 | 1.00 | Yes (X) | $211,871 | $0 | $12,144 | |||
| Linda Gilmore | |||||||||
| CAO/CNO | 40.00 | $207,794 | $0 | $43,588 | Yes (X) | ||||
| Dr Harlan Herr | |||||||||
| Physician | 40.00 | $517,488 | $0 | $12,750 | Yes (X) | ||||
| Dr Richard Caesar | |||||||||
| Physician | 40.00 | $477,888 | $0 | $42,617 | Yes (X) | ||||
| Dr Patrick Fitzpatrick | |||||||||
| Physician | 40.00 | $593,376 | $0 | $53,691 | Yes (X) | ||||
| Dr Leon Kogan | |||||||||
| Physician | 40.00 | $487,107 | $0 | $7,299 | Yes (X) | ||||
| Dr Russel Sarver | |||||||||
| Physician | 40.00 | $424,961 | $0 | $36,662 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,062,949 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $310,583 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 61 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| The Alpine Clinic PLLC | |||||
| 1095 Profile Rd | Franconia | NH | 03580 | Professional Services Agreement | $4,577,558 |
| Daniel Hebert Inc | |||||
| 12 Pleasant St | Colebrook | NH | 03576 | General Contractor | $3,772,938 |
| Quorum Health Resources Inc | |||||
| 105 Continental Place | Brentwood | TN | 37027 | Consulting Services | $420,619 |
| Griffin York & Krause | |||||
| 121 River Front Drive | Manchester | NH | 03102 | Advertising Consultant | $363,375 |
| C&A Industries | |||||
| PO Box 3037 | Omaha | NE | 68103 | Non-provider staffing | $331,847 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $39,603 | RelatedOrganizationsAmt |
| All Other Contributions | $12,092 | AllOtherContributionsAmt |
| Total Contributions | $51,695 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Service Revenue | 900099 | $141,507,288 | $141,507,288 | |
| Meaningful Use Incentive Revenues | 900099 | $740,794 | $740,794 | |
| Contract Lab | 621500 | $148,253 | $147,414 | $839 |
| Provision for Bad Debts | 900099 | -$4,642,068 | -$4,642,068 | |
| Contractual Allowances | 900099 | -$55,308,588 | -$55,308,588 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,427,656 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,427,656 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $84,873,335 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $420,309 | TotalRevenueColumnAmt |
| Exclusion | $420,309 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,885,030 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,990,259 | SecuritiesAmt |
| Other | $20,832 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$105,229 | SecuritiesAmt |
| Other | -$20,832 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$126,061 | TotalRevenueColumnAmt |
| Exclusion | -$126,061 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $85,219,278 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $84,872,496 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $839 | UnrelatedBusinessRevenueAmt |
| Exclusion | $294,248 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,406 | TotalAmt |
| Program Services | $201,406 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,719,693 | TotalAmt |
| Program Services | $855,663 | ProgramServicesAmt |
| Management And General | $864,030 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,095,554 | TotalAmt |
| Program Services | $28,897,352 | ProgramServicesAmt |
| Management And General | $4,198,202 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,053,933 | TotalAmt |
| Program Services | $918,571 | ProgramServicesAmt |
| Management And General | $135,362 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,275,938 | TotalAmt |
| Program Services | $4,560,031 | ProgramServicesAmt |
| Management And General | $715,907 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,304,404 | TotalAmt |
| Program Services | $4,542,039 | ProgramServicesAmt |
| Management And General | $762,365 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,120 | TotalAmt |
| Program Services | $3,635 | ProgramServicesAmt |
| Management And General | $139,485 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,302 | TotalAmt |
| Program Services | $91,171 | ProgramServicesAmt |
| Management And General | $81,131 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,306 | TotalAmt |
| Management And General | $119,306 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,151,800 | TotalAmt |
| Program Services | $6,503,154 | ProgramServicesAmt |
| Management And General | $1,648,646 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $708,206 | TotalAmt |
| Program Services | $24,532 | ProgramServicesAmt |
| Management And General | $683,674 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,319,296 | TotalAmt |
| Program Services | $10,726,127 | ProgramServicesAmt |
| Management And General | $593,169 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,330 | TotalAmt |
| Program Services | $6,976 | ProgramServicesAmt |
| Management And General | $360,354 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,681,006 | TotalAmt |
| Program Services | $890,283 | ProgramServicesAmt |
| Management And General | $790,723 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $342,489 | TotalAmt |
| Program Services | $265,265 | ProgramServicesAmt |
| Management And General | $77,224 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,945 | TotalAmt |
| Program Services | $33,250 | ProgramServicesAmt |
| Management And General | $68,695 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $757,784 | TotalAmt |
| Program Services | $757,784 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,195,508 | TotalAmt |
| Program Services | $5,239,280 | ProgramServicesAmt |
| Management And General | $956,228 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,013,623 | TotalAmt |
| Program Services | $115,555 | ProgramServicesAmt |
| Management And General | $898,068 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Equipment Expenses | $2,580,203 | $1,537,559 | $1,042,644 |
| Miscellaneous Expenses | $1,533,620 | $187,597 | $1,346,023 |
| Collection Agency | $1,000,284 | $119,937 | $880,347 |
| Education & Training | $437,208 | $248,870 | $188,338 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,275,958 | TotalAmt |
| Program Services | $66,726,037 | ProgramServicesAmt |
| Management And General | $16,549,921 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $327,359 | BOYAmt |
| EOY | $233,688 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,482,968 | BOYAmt |
| EOY | $8,902,413 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,619,960 | BOYAmt |
| EOY | $8,663,835 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,563,866 | BOYAmt |
| EOY | $1,703,212 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,580,589 | BOYAmt |
| EOY | $1,644,380 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,336,949 | BOYAmt |
| EOY | $1,818,371 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $87,110,443 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $43,603,771 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,267,834 | BOYAmt |
| EOY | $43,506,672 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,589,388 | BOYAmt |
| EOY | $29,886,739 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,481 | BOYAmt |
| EOY | $121,302 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,427 | BOYAmt |
| EOY | $257,892 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,068,821 | BOYAmt |
| EOY | $96,738,504 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,654,710 | BOYAmt |
| EOY | $6,171,435 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,025,458 | BOYAmt |
| EOY | $1,454,265 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,925,000 | BOYAmt |
| EOY | $27,270,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,289,282 | BOYAmt |
| EOY | $3,730,750 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,528,567 | BOYAmt |
| EOY | $9,669,715 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,423,017 | BOYAmt |
| EOY | $48,296,165 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,762,042 | BOYAmt |
| EOY | $47,488,526 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,664 | BOYAmt |
| EOY | $185,197 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $718,098 | BOYAmt |
| EOY | $768,616 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,645,804 | BOYAmt |
| EOY | $48,442,339 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,068,821 | BOYAmt |
| EOY | $96,738,504 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,943,320 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,977,764 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$124,549 | 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 | $14,954 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $14,954 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Littleton Hospital Association is a member of the NH Hospital Association and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Littleton Hospital Association and other member organizations in furtherance of their exempt purposes. Littleton Hospital Association does not directly perform any lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $870,609 | BeginningYearBalanceAmt |
| Contributions | $5,517 | ContributionsAmt |
| Investment Earnings Or Losses | $63,496 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $75 | OtherExpendituresAmt |
| End Year Balance | $939,547 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $794,094 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $81,883 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,368 | OtherExpendituresAmt |
| End Year Balance | $870,609 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $717,945 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $77,221 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,072 | OtherExpendituresAmt |
| End Year Balance | $794,094 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $767,249 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$48,189 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,115 | OtherExpendituresAmt |
| End Year Balance | $717,945 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $728,305 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $49,089 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $10,145 | OtherExpendituresAmt |
| End Year Balance | $767,249 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.81810 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.18190 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $786,809 | OtherCostOrOtherBasisAmt |
| Book Value | $786,809 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,669,584 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,547,647 | DepreciationAmt |
| Book Value | $21,121,937 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,260,501 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,302,759 | DepreciationAmt |
| Book Value | $17,957,742 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,393,549 | OtherCostOrOtherBasisAmt |
| Depreciation | $753,365 | DepreciationAmt |
| Book Value | $3,640,184 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $43,506,672 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Reserve for Self-Funded Health Insurance | $798,000 |
| Due to Third Party Payors | $4,872,336 |
| Deferred Compensation | $1,291,340 |
| Interest Rate Swap | $2,708,039 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,669,715 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $86,751,781 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,977,764 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $1,977,764 | RevenueNotReportedAmt |
| Revenue Subtotal | $84,774,017 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $119,306 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $325,955 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $445,261 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $85,219,278 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $82,955,246 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $82,955,246 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $119,306 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $201,406 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $320,712 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $83,275,958 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 4b - Other Adjustments: | Foundation Subsidy 201,406. Unrealized Loss on Interest Rate Swap 124,549. |
| Part XII, Line 4b - Other Adjustments: | Foundation Subsidy 201,406. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | Investments | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $6,743,456 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $6,743,456 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $6,743,456 | TotalSpentAmt |
| Transfer To Foreign Corp | Yes (1) | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | Yes (1) | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,251,426 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,726,411 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,525,015 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01830 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,751,803 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,051,865 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,699,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02040 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,003,229 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,778,276 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,224,953 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03870 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $319,031 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $96,471 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $222,560 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $59,606 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $59,606 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,110,408 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,570,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,539,611 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07850 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,905 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,905 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,491,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,667,268 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,824,682 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08190 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,495,179 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,445,544 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,049,635 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12060 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,398 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,398 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,651 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $34,651 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,600 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,600 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $51,649 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $51,649 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,646,443 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $20,872,991 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $20,872,991 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Regional Hospital | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1 |
| City | Littleton | City |
| State | NH | State |
| ZIP Code | 03561 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Regional Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://littletonhealthcare.org | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Littleton Regional Hospital | Part V, Section B, Line 3: The Organization deployed a Community Health Needs Assessment survey within the local population for any resident to complete. The Organization received community input from 164 area residents. The terms of gaining input stipulated each respondent would remain anonymous.The internet based survey was promoted through a paid advertisement in a local newspaper and distributed to local civic and health organizations with a request for participation. Preliminary conclusions were presented to a local group of experts, who were asked to validate prior assessments and to establish priority among various identified health and medical issues.Information analysis augmented by local opinions showed how Grafton County relates among its peers in terms of primary and chronic needs, as well as other issues of uninsured persons, low income persons and minority groups; respondents commented on if they believe certain population groups (or people with certain situations) need help to improve their condition and if so, who needs to do what.When the analysis was complete, the Organization put the information and summary conclusions before our local group of experts who were asked to agree or disagree with the summary conclusions. They were free to augment potential conclusions with additional statements of need; new needs could, and did, emerge from this exchange. Consultation with local experts occurred again via an internet based survey (explained below).With the prior steps identifying potential community needs, the local experts participated in a structured communication technique called a Delphi method, originally developed as a systematic, interactive forecasting method which relies on a panel of experts. Experts answer questionnaires in a series of rounds. The Organization contemplated and implemented one round as referenced during the above dates. After each round, the Organization provided an anonymous summary of the experts' forecasts from the previous round, as well as the reasons provided for their judgments. The process encourages experts to revise their earlier answers in light of the replies of other members of their panel. Typically, this process decreases the range of answers and moves the expert opinions toward a consensus "correct" answer. The process stops when we identify the most pressing, highest priority community needs.In the Organization's process, each local expert allocated 100 points among all identified needs, having the opportunity to introduce needs previously unidentified and to challenge conclusions developed from the data analysis. A rank order of priorities emerged, with some needs receiving virtually no support and other needs receiving identical point allocations.We dichotomized the rank order into two groups: high priority needs and low priority needs. The determination of the break point, high as opposed to low, was a qualitative interpretation by Quorum Health Resources and the Organization's executive team where a reasonable break point in rank occurred, indicated by the weight amount of points each potential need received and the number of local experts allocating any points to the need. When presented to the Organization's executive team, the dichotomized need rank order identified which needs the hospital considered high responsibility to respond vs. low responsibility to respond. The result provided a matrix of needs and guided the Organization in developing its implementation response. |
| Littleton Regional Hospital | Part V, Section B, Line 7: Alcohol Abuse, Drug Use in Youths, Mental Health and Suicide, and Smoking - LRH does not intend to develop an implementation plan for these needs for the following reasons:*Lack of expertise of competency (i.e., certain professional credential required and no such individual is in our immediate service area)*Lack of identified interventions to address need*Need is addressed by other organization or facility |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The Hospital determines its cost of charity care based on an overall financial statement cost to charge ratio applied against gross charity care charges. |
| Part I, Line 7g: | All costs reported on Part I, Line 7g are attributable to a physician practices as well as the paramedic program. |
| Part III, Line 4: | Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances that are still outstanding, after management has used reasonable collection efforts, are written off through a charge to the valuation allowance and a credit to patient accounts receivable. The valuation of charity care does not include any bad debt receivables or revenue. |
| Part III, Line 8: | Any shortfall is treated as a community benefit. The organization uses a cost to charge ratio from the Medicare cost report to determine the amount of Medicare allowable costs. |
| Part III, Line 9b: | Patients who are known to qualify for financial assistance are given a financial assistance application to fill out and return to our Financial Counselor. Upon receipt of the financial assistance application, the application is processed and the amount of financial assistance that will be granted to the patient is determined.Once the percentage of financial assistance is approved, we adjust the account balance accordingly. If a balance is left over after the financial assistance is adjusted, the patient will receive their monthly statements for the remaining balance.If the patient defaults on paying the remaining balance , their account will be sent to a third party collection agency no sooner than 120 days from date of their first statements issued. At this time we would turn the account over to the third party collection agency for further collection efforts. |
| Part VI, Line 2: | The Littleton Regional Hospital Community is defined as all people living in the communities listed in Part VI, Line 4. These communities were chosen by their geographic proximity to the Hospital and to the services and programs provided. |
| Part VI, Line 3: | Any applicant will receive a prompt decision on eligibility and amount of charity care offered. Notices of the Charity Care Policy are posted in the lobbies, waiting rooms and other public areas. Notices are also given to recipients who are served in their homes. |
| Part VI, Line 4: | The Hospital's primary service area includes Littleton, Bethlehem, Lisbon, Franconia, Sugar Hill and Carroll. The secondary service area includes Whitefield, Lancaster, Groveton, Monroe, North Woodstock, Lincoln, Woodsville and Bath (all in NH), and St. Johnsbury, Lunenberg, Lyndonville, Concord, Gilman (all in VT). The area spans across a good majority of Northern New Hampshire and the Northeast Kingdom of Vermont. |
| Part VI, Line 7, Reports Filed With States | NH |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Regional Hospital Charitable Foundation | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1 |
| City | Littleton | City |
| State | NH | State |
| ZIP Code | 03561 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 043750643 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $201,406 | CashGrantAmt |
| Purpose Of Grant | Foregiveness of salary and benefit expense that is paid on behalf of the charitable foundation. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Organization tracks the amount of expenses paid on behalf of the Littleton Regional Hospital Charitable Foundation, a related organization, and at the end of the year will forgive the Foundation for the reimbursement of expenses related to salaries and benefits. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Deane Rankin MD | ||||||||||||||
| Trustee/Physician | $394,425 | $0 | $44,174 | $0 | $409 | $0 | $12,750 | $0 | $34,642 | $0 | $486,400 | $0 | $0 | $0 |
| Dr Andrew Forrest | ||||||||||||||
| Chief of Staff | $304,880 | $0 | $3,750 | $0 | $19,586 | $0 | $12,750 | $0 | $16,297 | $0 | $357,263 | $0 | $0 | $0 |
| Warren West | ||||||||||||||
| CEO | $302,021 | $0 | $56,655 | $0 | $4,564 | $0 | $12,376 | $0 | $13,017 | $0 | $388,633 | $0 | $0 | $0 |
| Nick Braccino | ||||||||||||||
| CFO | $169,353 | $0 | $42,518 | $0 | $0 | $0 | $0 | $0 | $12,144 | $0 | $224,015 | $0 | $0 | $0 |
| Linda Gilmore | ||||||||||||||
| CAO/CNO | $188,910 | $0 | $18,884 | $0 | $0 | $0 | $10,721 | $0 | $32,867 | $0 | $251,382 | $0 | $0 | $0 |
| Dr Harlan Herr | ||||||||||||||
| Physician | $517,488 | $0 | $0 | $0 | $0 | $0 | $12,750 | $0 | $0 | $0 | $530,238 | $0 | $0 | $0 |
| Dr Richard Caesar | ||||||||||||||
| Physician | $457,888 | $0 | $20,000 | $0 | $0 | $0 | $12,750 | $0 | $29,867 | $0 | $520,505 | $0 | $0 | $0 |
| Dr Patrick Fitzpatrick | ||||||||||||||
| Physician | $376,058 | $0 | $217,318 | $0 | $0 | $0 | $12,750 | $0 | $40,941 | $0 | $647,067 | $0 | $0 | $0 |
| Dr Leon Kogan | ||||||||||||||
| Physician | $487,107 | $0 | $0 | $0 | $0 | $0 | $531 | $0 | $6,768 | $0 | $494,406 | $0 | $0 | $0 |
| Dr Russel Sarver | ||||||||||||||
| Physician | $424,961 | $0 | $0 | $0 | $0 | $0 | $2,895 | $0 | $33,767 | $0 | $461,623 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6 | Warren West, CEO, received a bonus based on certain goals included in his contract, one of which is related to the performance of the Organization. The Board assesses the performance of these goals and determines the bonus to be paid. |
| Part I, Line 7 | Deane Rankin, Trustee, and Patrick Fitzpatrick, Highest Compensated Employee, received bonuses during the year based upon their productivity using MGMA Standards by RVU and by their specialties. Dr. Andrew Forrest, Trustee, received a bonus during the year, which represented a vice chair stipend for Medical Staff Leadership. Nicholas Braccino, Officer, received a bonus during the year of which $25,000 was a sign on bonus, and the remainder was based upon 10% of his salary. Linda Gilmore, Key Employee, received a bonus during the year based upon 10% of her salary. Richard Caesar, Highest Compensated Employee, received a bonus in accordance with his employment contract. |
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 | Business Finance Authority of the State of New Hampshire | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 521304598 | BondIssuerEIN |
| CUSIP | 64468kbg0 | CUSIPNum |
| Bond Issued | 2007-11-15 | BondIssuedDt |
| Issue Price | $30,000,000 | IssuePriceAmt |
| Purpose | Refunded series 1998A and 1998B Bonds | 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 | $2,730,000 | RetiredAmt |
| Total Proceeds | $30,000,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $274,108 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $8,710,000 | CapitalExpendituresAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | Yes (1) | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | 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 | 0 | 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 | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | All persons making an annual contribution to Littleton Hospital Association or Littleton Regional Hospital Charitable Foundation, who are at least eighteen (18) years of age, or any legal adult resident of any town raising an annual appropriation to the Littleton Hospital Association shall thereupon, and without further election or action by the Association, automatically become a member of the Association. Failure to contribute to the Hospital or Foundation in the following fiscal year shall automatically terminate the membership. |
| Form 990, Part VI, Section A, line 7a | Each member of the Association shall be qualified to originate and take part in the discussion of any subject that may properly come before any meeting of the Association, to vote on such subject, and to hold any office in the Association to which he or she may be elected or appointed. |
| Form 990, Part VI, Section B, line 11 | The return was reviewed by the entire Board of Directors prior to the filing. |
| Form 990, Part VI, Section B, line 12c | All Trustees, Department directors and Auxilians complete a Conflict of Interest Statement each year, and any potential conflicts are reported to the Board of Trustees and to other places as required by law. In addition, front-line employees who don't normally make decisions for the facility are expected to report forward any conflicts they may have, should they ever be in a position to influence decision making. Quality Services queries these groups on an annual basis, and tracks down people until all statements are complete. |
| Form 990, Part VI, Section B, line 15 | Key employees complete self-evaluation - HR Director prepares compensation surveys, reviews 990 of other organizations. The CFO's salary is approved by the CEO. The CEO's salary is approved by the Board. |
| Form 990, Part VI, Section C, line 19 | The hospital's governing documents and financial statements are made available upon request. The hospital's conflict of interest policy is not made available to the public. |
| Form 990, Part XI, line 9: | Unrealized Loss on Interest Rate Swap -124,549. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Regional Hospital Charitable Foundation | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 St Johnsbury Road | AddressLine1 |
| City | Littleton | City |
| State | NH | State |
| ZIP Code | 03561 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 043750643 | EIN |
| Primary Activities | Charitable Foundation | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Littleton Hospital Association | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Littleton Regional Hospital Charitable Foundation | ||
| B | $201,406 | FMV |
| Littleton Regional Hospital Charitable Foundation | ||
| D | $257,892 | FMV |
Comments