2015-08-14T09:46:38-05:00 2014-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2013-10-01 020397338 Valley Regional Healthcare Inc VALL 6035427771 243 Elm Street Claremont NH 03743 Jean Shaw CFO 6035427771 2015-08-14 1 Joseph R Byrne CPA P01289281 2077752387 2015-08-14 2013 2016-04-25 22:37:26Z Peter Wright 243 Elm Street Claremont NH 03743 5819319 0 X www.vrh.org X 1986 NH Parent organization to Valley Regional Hospital, Inc. 23 19 114 25 0 0 336085 336986 4846394 5175957 287363 306376 -144265 -146064 5325577 5673255 0 0 0 0 4004877 3982189 0 0 0 1445680 1298838 5450557 5281027 -124980 392228 3178268 3652992 1031668 1059975 2146600 2593017 Valley Regional Healthcare, Inc. is organized to coordinate and support the activities of health care organizations, including Valley Regional Hospital, Inc. 0 0 3661027 5175957 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. 3661027 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 9 0 1 114 1 0 0 0 0 0 0 0 0 0 0 X 23 19 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 197623 0 20784 Robert Porter Trustee 0.10 0.90 X 0 0 0 Michael L Prozzo Jr 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 Carol Vivian Trustee 0.10 0.90 X 0 0 0 Jim Wimberg Trustee 0.10 0.90 X 0 0 0 Michael O'Connell Treasurer 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 280746 33725 Michael Fuerst Chair 0.10 0.90 X X 0 0 0 Oliver Herfort MD Trustee 0.10 39.90 X 0 250239 32596 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 Trustee 0.10 0.90 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 445830 18457 Allen Damren Trustee 0.10 0.90 X 0 0 0 Valerie Mahar Trustee 0.10 0.90 X 0 0 0 Steven Monette VP of Finance 2.80 37.20 X 169408 0 734 Margaret Burns VP of Nursing 40.00 0.00 X 149611 0 5256 Claire Bowen Former President & CEO 0.00 0.00 X 131448 0 8512 648090 976815 120064 4 1 1 1 Dartmouth Hitchcock Clinic One Medical Center Drive Lebanon NH 03756 CEO Contract Services 368500 Springfield Hospital PO Box 2003 Springfield VT 05156 ENT Services 127061 New England Alliance for Health One Medical Center Drive Lebanon NH 03756 Professional Services 104006 3 323478 13508 336986 Patient Service Revenue 621610 3156143 3156143 Management Services 621610 2043163 2043163 Miscellaneous Revenue 900099 204778 204778 Provision for Bad Debts 621610 -29466 -29466 Contractual/Charity Adjustment 621610 -198661 -198661 5175957 181878 181878 146064 -146064 -146064 -146064 124498 0 124498 124498 124498 5673255 5175957 0 160312 X 388549 64376 324173 2748925 2276724 472201 19385 16055 3330 604881 500977 103904 220449 182581 37868 383 383 9450 9450 17519 17519 657544 69507 588037 55061 55061 145372 124412 20960 35725 35725 130824 129308 1516 30178 30178 33853 242 33611 Medical Supplies 158094 151046 7048 Miscellaneous 24835 24835 5281027 3661027 1620000 0 84511 239384 186403 276122 334946 441150 55308 23564 561799 322113 195165 239686 1913559 2070646 408376 362440 3178268 3652992 542331 510203 72985 76151 416352 473621 1031668 1059975 X 2112505 2559286 34095 33731 2146600 2593017 3178268 3652992 392228 54189 0 X 0 1 X 1 0 X X X 0 0 0 Valley Regional Hospital Inc 020222118 3 1 1 1 5281027 1 5281027 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 304020 115613 188407 256414 205477 50937 1365 1023 342 239686 Due from Affiliates 42561 Cash Surrender Value of Life Insurance 289183 Other Accounts Receivable 30696 362440 Due to Affiliates 401409 Reserve for Self-Funded Insurance 72212 473621 X X X X 0 0 0 0 0 1 1 0 0 Peter Wright President & CEO 197492 0 0 0 131 0 8704 0 12080 0 218407 0 0 0 Robert Cricco MD Trustee 0 270844 0 0 0 9902 0 5798 0 27927 0 314471 0 0 Oliver Herfort MD Trustee 0 210808 0 4757 0 34674 0 5178 0 27418 0 282835 0 0 Charles Sawyer MD Trustee 0 435138 0 0 0 10692 0 6018 0 12439 0 464287 0 0 Steven Monette VP of Finance 168814 0 0 0 594 0 0 0 734 0 170142 0 0 0 Margaret Burns VP of Nursing 149099 0 0 0 512 0 3022 0 2234 0 154867 0 0 0 Claire Bowen Former President & CEO 131065 0 0 0 383 0 1904 0 6608 0 139960 0 0 0 Part I, Line 6 No specific goals were established by the Board for the CEO. For the CEO and Senior VPs, any increase in pay rate would be the same as an approved rate increase for all employees. Form 990, Part VII, line 5: Peter Wright, CEO is paid by Dartmouth-Hitchcock Medical Center, an unrelated organization. A breakdown of Mr. Wright's 2013 compensation is as follows: Salary: $197,623 Benefits: $20,784 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. 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 69,507. Management and general expenses 588,037. Fundraising expenses 0. Total expenses 657,544. 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 113268 Amounts Paid