2014-05-14T14:55:51-05:00 2013-06-30 020383073 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2012-07-01 020232673 THE ELLIOT HOSPITAL OF THE CITY OF MANCHESTER ELLI 6036632033 1 ELLIOT WAY MANCHESTER NH 03103 RICHARD ELWELL 6036632033 2014-05-09 1 WILLIAM G STEELE JR CPA P00233103 6036228881 2014-05-09 2012 2015-11-30 17:44:51Z DOUGLAS DEAN 1 ELLIOT WAY MANCHESTER NH 03103 388089038 0 X ELLIOT-HS.ORG X 1942 NH HOSPITAL SERVICES 22 16 3355 0 3106937 -912443 1696012 1241795 356361181 367118203 3372126 3892829 14933529 15836211 376362848 388089038 0 515623 0 0 165512221 174301641 0 0 0 207141680 212102353 372653901 386919617 3708947 1169421 354374322 364558416 280440885 257877350 73933437 106681066 ELLIOT HOSPITAL OF THE CITY OF MANCHESTER, A LEADER IN HEALTHCARE, IS DEDICATED TO PROVIDING IT'S COMMUNITY WITH EXCELLENT SERVICES OFFERED WITH DIGNITY, CARING, AND RESPECT. 0 0 302863835 515623 374229581 MEDICAL SERVICES PROVIDED TO 14,431 IN-PATIENTS AND 509,986 OUT-PATIENTS INCLUDING FREE CARE IN THE AMOUNT OF $7,023,464 (AT COST) AND CONTRIBUTIONS TO COMMUNITY PROGRAMS 620671 CONTRIBUTIONS TO MANCHESTER COMMUNITY HEALTH CENTER AND I IMAGINE 582660 COMMUNITY BENEFITS INCLUDING EDUCATIONAL PROGRAMS, HEALTH SCREENINGS, HEALTH PUBLICATIONS AND OTHER HEALTH INFORMATION SERVICES 304067166 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 0 1 251 0 1 3355 1 1 1 0 0 0 0 0 0 0 0 0 X 22 16 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X MARC CULLEROT 6036632033 1070 HOLT AVENUE UNIT 1 SUITE 2100 MANCHESTER NH 03109 DOUGLAS F DEAN 40.00 4.00 X X 1996284 0 152995 RICK PHELPS 40.00 2.00 X X 578667 0 87507 R SCOTT BACON 1.00 1.00 X X 0 0 0 JAMES C HOOD ESQ 1.00 1.00 X 0 0 0 ANN REMUS 1.00 4.00 X 0 0 0 SELMA NACCACH-HOFF 1.00 2.00 X 0 0 0 LOUISE FORSEZE 1.00 1.00 X 0 0 0 LAWRENCE M HOEPP MD 1.00 41.00 X 0 893217 20864 HOWARD BRODSKY 1.00 1.00 X 0 0 0 ROGER A SEVIGNY 1.00 1.00 X 0 0 0 DANIEL M MONFRIED 1.00 1.00 X 0 0 0 REVEREND JOHN A CERRATO JR 1.00 1.00 X 0 0 0 DIANNE M MERCIER 1.00 1.00 X 0 0 0 DAVID R A STEADMAN 1.00 1.00 X 0 0 0 ROBERT M LAVERY 1.00 41.00 X 0 586149 19812 JAMES F FITZGERALD MD 1.00 42.00 X 0 212598 22991 RICHARD L WINNEG 1.00 2.00 X 0 0 0 BARBARA A RAND 1.00 1.00 X 0 0 0 GUS EMMICK MD 1.00 42.00 X 0 285153 23587 CHARLES ROLECEK 1.00 1.00 X 0 0 0 JOHN A HESSION 1.00 1.00 X 0 0 0 JOHN F WEEKS 1.00 3.00 X 0 0 0 CHRISTOPHER S CALHOUN MD 1.00 40.00 X 0 59883 13355 RICHARD ELWELL 40.00 3.00 X 485527 0 120861 JOHN FRIBERG 40.00 0.00 X 370511 0 22948 ALEXANDER W PETRON 40.00 0.00 X 349923 0 23598 MARC G CULLEROT 40.00 0.00 X 264441 0 25459 ANITA RITENOUR MD 40.00 0.00 X 319186 0 30157 DENISE P PURINGTON 40.00 0.00 X 262941 0 23374 WILLIAM BAXTER 40.00 2.00 X 365580 0 23394 4993060 2037000 610902 114 0 1 0 JIMENEZ CONSULTING SOLUTION 10450 N 74TH ST STE 160 SCOTTSDALE AZ 85258 ICD-10 TRAINING 1113365 BIANCO ASSOCIATES 18 CENTER ST CONCORD NH 03301 REGULATORY AND LEGAL CONSULTING 829277 NH NEUROSPINE INSTITUTE 4 HAWTHORNE DR BEDFORD NH 03110 NEUROSURGERY LOCUMS COVERAGE 660000 CHAMBERLIN EDMONDS 3535 PIEDMONT ROAD SUITE 800 ATLANTA GA 30305 SELF PAY PATIENT BILLING PROVIDER 397224 AMOSKEAG ANESTHESIA PLLC 1 ELLIOT WAY MANCHESTER NH 03103 PHYSICIAN SERVICES 359976 22 1241795 1241795 PROG.SERV.REVENUE-RELATED-990 621110 367118203 367118203 367118203 1863301 -69966 1933267 2510701 0 2510701 2510701 2510701 2029528 0 2029528 2029528 2029528 MISCELLANEOUS OTHER 900099 7111378 7111378 LABORATORY SERVICES 621500 2987227 2987227 CAFETERIA REVENUE 722210 1813622 1813622 1413283 189676 1223607 13325510 388089038 374229581 3106937 9510725 X 514123 514123 1500 1500 3430989 3430989 130455553 97838244 32617309 17261727 12946295 4315432 13511189 10133392 3377797 9642183 7231637 2410546 683298 683298 198600 198600 2115236 2115236 4507171 3380378 1126793 145140 108855 36285 340676 255508 85168 9349959 7012469 2337490 23309827 23309827 15934140 11950605 3983535 5514904 4136178 1378726 PROVISION FOR BAD DEBTS 41175801 41175801 SUPPLIES 20586240 20586240 DRUGS & PHARMACEUTICUL 14999286 14999286 MEDICAID ENHANCEMENT TA 11674727 11674727 61567348 48486828 13080520 386919617 304067166 82852451 0 21588730 25662626 6095203 6188637 34960257 40411820 2143884 2405426 4336045 4028986 355273770 195363647 170552056 159910123 97644472 99938667 17053675 26012131 354374322 364558416 33887118 33268898 151706117 150115157 150000 0 94697650 74493295 280440885 257877350 X 60341629 92614711 1696379 1801521 11895429 12264834 73933437 106681066 354374322 364558416 X 1169421 895162 30683046 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 156539 156539 156539 156539 303910630 408857501 304067169 409014040 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 348114 344636 188723 156539 1038012 250000 250000 250000 250000 1000000 1500000 32124 33158 65282 13591808 474547 14066355 13860491 -268683 13591808 12771028 50000 1039463 13860491 12420985 174500 175543 12771028 14078246 -1657261 12420985 0.12810 0.87190 0 0 6681464 6681464 167964104 53724729 114239375 3997535 1825640 2171895 167325151 135942619 31382532 9305516 3870659 5434857 159910123 BOARD DESIGNATED & DONOR RESTRICTED 99938667 F 99938667 FUNDS HELD BY TRUSTEE 3415316 UNAMORTIZED BOND ISSUANCE COSTS 1953547 PENSION CASH SURRENDER VALUE 1321950 DEPOSITS 7606153 OTHER RECEIVABLES 9740211 DUE FROM AFFILIATES 1974954 26012131 PAYABLE TO THIRD PARTY PAYORS 6789469 INTEREST PAYABLE 2274308 ACCRUED PENSION & OTHER 43591648 SELF-INSURANCE RESERVES & OTHER 20207870 CURRENT PORTION OF LONG-TERM DEBT 1630000 74493295 X 388506181 895162 895162 387611019 478019 478019 388089038 363131771 0 363131771 23787846 23787846 386919617 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INCOME OF THE FUNDS HAS BEEN USED FOR OPERATING AND CAPITAL EXPENDITURES DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: PART X, INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS WAS THE FOLLOWING, "MANAGEMENT EVALUATED THE HOSPITAL'S TAX POSITIONS AND CONCLUDED THE HOSPITAL HAS MAINTAINED ITS TAX-EXEMPT STATUS, DOES NOT HAVE ANY SIGNIFICANT UNRELATED BUSINESS INCOME AND HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS." PART XI, LINE 4B - OTHER ADJUSTMENTS: EXPENSE RECLASS 478,019. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSE RECLASS 478,019. PAYMENTS TO AFFILIATES 23,309,827. 1 1 1 X 1 X 1 1 0 1 1 16667 7023464 7023464 0.01820 47742 46234454 14926517 31307937 0.08090 0 64409 53257918 14926517 38331401 0.09910 11 2153 296421 350 296071 0.00080 8 343 274488 0 274488 0.00070 7 13791002 7228701 6562301 0.01700 1 11751 11751 0.00000 7 69 620671 620671 0.00160 34 2565 14994333 7229051 7765282 0.02010 34 66974 68252251 22155568 46096683 0.11920 0 18236762 84801168 110647807 -25846639 X 1 1 1 1 THE ELLIOT HOSPITAL OF CITY OF MANCHSTR

1 ELLIOT WAY MANCHESTER NH 03103

X X X X ELLIOT HOSPITAL OF CITY OF MANCHESTER 1 1 X X X X X X X X X 12 1 1 1 X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 PART I, LINE 7: FINANCIAL ASSISTANCE AND MEANS TESTED COSTS USED RCC DERIVED FROM MEDICARE COST REPORT; OTHER BENEFITS COSTS DERIVED FROM ACTUAL COSTS AND INTERNAL COST ACCOUNTING SYSTEM. PART III, LINE 4: BAD DEBT FOOTNOTE: "NET PATIENT SERVICE REVENUES - .... THE HOSPITAL RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS, THE HOSPITAL PROVIDES A DISCOUNT APPROXIMATELY EQUAL TO THAT OF ITS LARGEST PRIVATE INSURANCE PAYORS. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED." "ACCOUNTS RECEIVABLE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS - ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY(FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: ALLOWABLE COSTS DETERMINED USING CMS METHODOLOGY UTILIZED IN COMPLETING COST REPORT; MEDICARE SHORTFALL TO BE INCLUDED IN COMMUNITY BENEFITS PART III, LINE 9B: COLLECTIONS ARE NOT PURSUED ON CHARITY CARE PATIENTS. COLLECTIONS AGENCY IS SUPPLIED INFORMATION THAT ALLOWS THEM TO IDENTIFY ONLY THOSE ACCOUNTS UPON WHICH COLLECTION EFFORTS SHOULD BE PURSUED. PART III, LINE 2 BAD DEBT EXPENSE IS DETERMINED BASED ON ANALYSIS OF HISTORICAL ACTIVITY. SELF PAY ACCOUNTS ARE GIVEN AUTOMATIC 25% DISCOUNT OFF CHARGES; SELF PAY ACCOUNTS THAT DO NOT MAKE PAYMENT ARE TRANSFERRED TO BAD DEBT. COST OF BAD DEBT IS DERIVED FROM INTERNAL COST ACCOUNTING SYSTEM. PART III, LINE 3 ORGANIZATION NOT CURRENTLY DETERMINING BAD DEBT ACCOUNTS THAT MAY HAVE BEEN CHARITABLE CARE. ELLIOT HOSPITAL OF CITY OF MANCHESTER PART V, SECTION B, LINE 3: IN CONDUCTING THE CHNA, ELLIOT WORKED WITH ANOTHER HOSPITAL, CATHOLIC MEDICAL CENTER WITH SUPPORT FROM THE MANCHESTER HEALTH DEPARTMENT. THE TWO HOSPITALS FORMED A NEEDS ASSESSMENT WORK GROUP WITH THREE REPRESENTATIVES FROM EACH HOSPITAL AND A MANCHESTER HEALTH DEPT STAFF MEMBER. A COMMUNITY BENEFIT CONSULTANT WAS CONTRACTED AS PROJECT MANAGER. A SUBCOMMITTEE OF THE WORKGROUP WAS FORMED TO GATHER AND REPORT THE SECONDARY DATA. ADDITIONALLY, ANOTHER SUBCOMMITTEE OVERSAW IDENTIFYING FOCUS GROUPS AND KEY INFORMANTS. THIS COMMITTEE ALSO DISTRIBUTED A SURVEY.DURING MARCH, APRIL AND MAY OF 2013, THE HOSPITALS ALSO CONDUCTED SEVEN FOCUS GROUPS WHICH INCLUDED CLERGY, FIRST RESPONDERS, PREGNANT WOMEN, SCHOOL NURSES, BHUTANESE REFUGEES AS WELL AS TWO SENIOR GROUPS. DUE TO CONCERNS ON THE PART OF MANY PARTICIPANTS, ANONYMITY WAS GUARANTEED AND HENCE, THEY WILL NOT BE LISTED BY NAME. A GROUP DISCUSSION WAS CONDUCTED ON MARCH 25, 2013 WITH MEMBERS OF THE MANCHESTER SUSTAINABLE ACCESS PROJECT WHICH INCLUDED THE PUBLIC HEALTH AND DEPUTY HEALTH DIRECTORS, MANCHESTER HEALTH DEPARTMENT; THE PRESIDENT, MENTAL HEALTH CENTER OF GREATER MANCHESTER; THE CHIEF MEDICAL OFFICER AND DIRECTOR, COMMUNITY HEALTH, CATHOLIC MEDICAL CENTER; VICE PRESIDENT OF PLANNING AND BUSINESS DEVELOPMENT, ELLIOT HEALTH SYSTEM AND THE MEDICAL DIRECTOR, DARTMOUTH-HITCHCOCK MANCHESTER CLINIC. (MANCHESTER SUSTAINABLE ACCESS PROJECT (MSAP) GROUP DISCUSSION ATTENDEES: JENNIFER DRISCOLL, VP, PLANNING AND BUSINESS DEVELOPMENT, ELLIOT HOSPITAL; RAEF FAHMY, DPM, CMO, CATHOLIC MEDICAL CENTER; PETER JANELLE, PRESIDENT, MENTAL HEALTH CENTER OF GREATER MANCHESTER; PAUL MERTZIC, EXECUTIVE DIRECTOR OF OPERATIONS, PPA, PC & COMMUNITY HEALTHSERVICES, CATHOLIC MEDICAL CENTER; STEVE PARIS, MD, MEDICAL DIRECTOR, DARTMOUTH HITCHCOCK MANCHESTER; TIM SOUCY, PUBLIC HEALTH DIR, MANCHESTER HEALTH DEPT; ANNA THOMAS, DEPUTY PUBLIC HEALTH DIRECTOR, MANCHESTER HEALTH DEPT. OTHER KEY INFORMANTS, TED GATSAS, MAYOR OF MANCHESTER, NH; CHRIS PAPPAS, MEMBER EXECUTIVE COUNCIL, STATE OF NH. ELLIOT HOSPITAL OF CITY OF MANCHESTER PART V, SECTION B, LINE 4: CATHOLIC MEDICAL CENTER HOSPITAL OF MANCHESTER ELLIOT HOSPITAL OF CITY OF MANCHESTER PART V, SECTION B, LINE 7: CHNA WAS COMPLETED IN JUNE FY 2013, END OF THE HOSPITALS FISCAL YEAR. THE IMPLEMENTATION STRATEGY TO ADDRESS IDENTIFIED NEEDS WAS ADOPTED IN OCTOBER 2013. ELLIOT HOSPITAL OF CITY OF MANCHESTER PART V, SECTION B, LINE 12H: DECEASED AND HOMELESS PERSONS ARE AUTOMATICALLY CONVERTED TO CHARITABLE CARE. CATASTROPHIC LIMIT CAP SET AT $50,000 FOR SELF-PAY. PART VI, LINE 3: PATIENT REGISTRATION AREAS HAVE SIGNAGE INDICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE ORGANIZATION'S CHARITY CARE POLICY. PATIENT BILLS AND STATEMENTS HAVE LANGUAGE THAT OFFERS THE OPPORTUNITY TO APPLY FOR CHARITABLE CARE. FINANCIAL ASSISTANCE OPTIONS ARE ALSO DESCRIBED ON THE ORGANIZATION'S WEB-SITE. PART VI, LINE 4: THE MANCHESTER HEALTH SERVICE AREA (HSA), A MARKET WHICH IS PRIMARILY SERVED BY CATHOLIC MEDICAL CENTER AND ELLIOT HOSPITAL IS HOME TO APPROXIMATELY 180,000 RESIDENTS AND IS COMPRISED OF THE TOWNS OF AUBURN, BEDFORD, CANDIA, DEERFIELD, GOFFSTOWN, HOOKSETT, NEW BOSTON AS WELL AS THE CITY OF MANCHESTER. THESE TOWNS ARE LOCATED IN THREE DIFFERENT COUNTIES (HILLSBOROUGH, ROCKINGHAM AND MERRIMACK) WITHIN THE STATE OF NEW HAMPSHIRE WITH 60% OF THE RESIDENTS OF THE HSA LIVING WITHIN THE CITY OF MANCHESTER. THE POPULATION OF THE MANCHESTER HSA IS CHANGING; NOT ONLY IS IT IS AGING, IT IS BECOMING INCREASINGLY MULTICULTURAL WITH RESIDENTS REFLECTING A VARIETY OF NATIONALITIES, LANGUAGES, ETHNIC TRADITIONS, RELIGIOUS BELIEFS AND IDEOLOGIES.THE CITY OF MANCHESTER IS HOME TO 60% OF THE RESIDENTS OF THE HSA AND, IN ALIGNMENT WITH THE STATE OF NEW HAMPSHIRE, THE POPULATION OF THE MANCHESTER HSA IS AGING. THE 65+ POPULATION WITHIN THE HSA IS PROJECTED TO REALIZE AN 18% GROWTH THROUGH 2018 AND MANY OTHER TOWNS WITHIN THE HSA WILL EXPERIENCE OVER 30% GROWTH IN THE 65+ AGE GROUP. THIS IS SIGNIFICANT GIVEN A 2012 REPORT FROM THE UNIVERSITY OF NEW HAMPSHIRE CARSEY INSTITUTE WHICH NOTES THAT THE AGING POPULATION WILL INCREASE THE COST OF PROVIDING STATE AND LOCAL SERVICES. IN CONTRAST TO THE GROWING 65+ POPULATION, THE PEDIATRIC POPULATION (AGES 0-17) WITHIN THE MANCHESTER HSA (EXCLUDING THE CITY OF MANCHESTER) IS PROJECTED TO REALIZE A SLIGHT DECLINE OVER THE NEXT FIVE YEARS. THE CITY OF MANCHESTER'S PEDIATRIC POPULATION IS PROJECTED TO REALIZE AN INCREASE OF ABOUT 2% IN CHILDREN AGES 0-17.ACCORDING TO THE 2010 CENSUS DATA, THE MAJORITY OF RACIAL DIVERSITY WITHIN THE MANCHESTER HSA IS WITHIN THE CITY OF MANCHESTER, AS THE CITY HAS NEARLY 84% OF THE MINORITY POPULATION IN THE MANCHESTER HSA RESIDING WITHIN ITS CITY BOUNDARIES. THE CHANGING DIVERSITY OF THE CITY OF MANCHESTER IS PARTLY THE RESULT OF THE CITY BEING A SITE FOR REFUGEE RESETTLEMENT.THE MEDIAN HOUSEHOLD INCOME FOR THE CITY OF MANCHESTER IS $53,278. THIS IS SIGNIFICANTLY LOWER THAN ALL OTHERS TOWNS WITHIN THE MANCHESTER HSA AND IS ALSO LOWER THAN THE MEDIAN HOUSEHOLD INCOME FOR THE STATE, WHICH IS $64,664.SIMILAR TO THE MEDIAN HOUSEHOLD INCOME STATISTICS, THE CITY OF MANCHESTER HAS A SIGNIFICANTLY HIGHER PERCENT OF INDIVIDUALS AND FAMILIES LIVING BELOW POVERTY, 10.2% AND 13.8%, RESPECTIVELY. THIS IS ALSO HIGH COMPARED WITH A STATE AVERAGE OF 5.2% AND 8.0%. MANCHESTER RESIDENTS LIVING BELOW THE POVERTY LEVEL IS CONCENTRATED IN THE EAST AND WESTSIDE CENTER CITY. SINCE POVERTY IS HIGHLY ASSOCIATED WITH INCREASED HEALTH RISK BEHAVIORS, LOW EDUCATIONAL ATTAINMENT, POOR HEALTH STATUS, UNEMPLOYMENT, AND A LOWER SELF-REPORTED QUALITY OF LIFE, THIS IS A SIGNIFICANT TREND. PART VI, LINE 5: EH BELIEVES STRONGLY THAT OUR INVOLVEMENT IN COMMUNITY ORGANIZATIONS SUCH AS CHILD HEALTH SERVICES, MANCHESTER MENTAL HEALTH CENTER, YMCA AND MANY MORE, IS CRITICAL TO OUR EXEMPT PURPOSE WE DEPLOY HUNDREDS OF VOLUNTEERS THROUGHOUT THE STATE TO WORK WITH NON-PROFIT ORGANIZATIONS THAT ARE DOING THEIR PART TO HELP ERADICATE ILLNESSES AND POOR HEALTH CONDITIONS OR IMPROVE THE HEALTH AND WELLNESS OF PEOPLE. MANY OF OUR LEADERS SERVE ON THE BOARDS OF THESE ORGANIZATIONS TO SHARE INSIGHT AND TO PARTICIPATE IN HELPING THEM ACHIEVE THEIR MISSION. IN ADDITION TO THE VOLUNTEER TIME AND ENERGY, EH ALSO PROVIDES HUNDREDS OF THOUSANDS OF DOLLARS IN FINANCIAL SUPPORT TO ENSURE THAT THE CRITICAL WORK OF THESE ORGANIZATIONS IS ACHIEVED AND PEOPLE ARE HELPED WITH A RANGE OF ISSUES FROM MENTAL HEALTH CARE TO OBTAINING FOOD AND SHELTER.ADDITIONALLY, GIVEN OUR HEALTH CARE SYSTEM AND HOW WIDESPREAD EH HAS BECOME IN THE COMMUNITY, WE OPEN OUR DOORS AND PROVIDE THE STAFF AND THE RESOURCES FOR LOCAL ISSUES THAT ARE UNFORESEEN BUT CREATE URGENT SITUATIONS. FOR EXAMPLE, WHEN NH RESIDENTS WERE STUCK BY POWER OUTAGES FROM AN ICE STORM LASTING DAYS, EH KEPT PATIENTS (FREE OF CHARGE) IN THE HOSPITAL UNTIL POWER IN THE HOME AS RESTORED SO THAT THEY WOULD NOT SUFFER THE HARDSHIP OF LIVING WITHOUT HEAT AND POWER. FOR DAY-TO-DAY STRUGGLES, EITHER WITH HOW TO COPE WITH THE LOSS OF A LOVED ONE OR WITH HOW TO COPE WITH CANCER, EH STAFF AND PROFESSIONALS OFFER FREE COMMUNITY SUPPORT GROUPS AND CLASSES TO REACH PEOPLE WHO ARE IN NEED OF HELP.EH PRIDES ITSELF ON THESE ACTS OF HUMANITY BECAUSE IT DOES MEET OUR PURPOSE AND MISSION AND WITHOUT QUESTION, PROMOTES THE HEALTH OF THE COMMUNITY PART VI, LINE 6: EHS IS THE UMBRELLA ORGANIZATION UNDER WHICH ELLIOT HOSPITAL (EH), ELLIOT PHYSICIAN NETWORK (EPN), ELLIOT PROFESSIONAL SERVICES (EPS), THE VISITING NURSE ASSOCIATION OF MANCHESTER AND SOUTHERN NH (VNA), AND THE MARY & JOHN ELLIOT CHARITABLE FOUNDATION OPERATE. ELLIOT HEALTH SYSTEM IS A HEALTH CARE SYSTEM THAT PROVIDES CARE TO RESIDENTS OF SOUTHERN NH SERVING A REGIONAL POPULATION OF OVER 250,000 RESIDENTS, MAKING IT ONE OF THE LARGEST PROVIDERS OF COMPREHENSIVE HEALTH CARE SERVICES IN SOUTHERN NH. EACH OF THESE ORGANIZATIONS PLAYS A CRITICAL ROLE IN THE CONTINUUM OF CARE EHS DELIVERS TO THE COMMUNITY THUS PROMOTING HEALTH. THE CORNERSTONE OF EHS IS EH, A PRIVATE, NOT FOR PROFIT HOSPITAL ESTABLISHED IN 1890, AND NOW A 296-BED ACUTE CARE FACILITY LOCATED IN MANCHESTER (NH'S LARGEST CITY) ON EHS'S MAIN CAMPUS. EH IS A PREMIER HEALTH CARE PROVIDER IN MANY DISCIPLINES, SERVING AS THE DESIGNATED TRAUMA CENTER FOR THE MANCHESTER HSA, AND DESIGNATED RECEIVING FACILITY FOR PSYCHIATRIC PATIENTS IN THE REGION. IN ADDITION EH PROVIDES MATERNITY AND PEDIATRIC SERVICES, NEWBORN INTENSIVE CARE, SURGERY, PAIN MANAGEMENT, WOUND MANAGEMENT, CARDIAC CARE, AND MUCH MORE. EHS THROUGH THE EPN AND EPS, BOTH PRIVATE, NOT FOR PROFIT PHYSICIAN GROUPS, PROVIDES PRIMARY CARE AND SPECIALTY CARE VIA OVER 211 EMPLOYED PHYSICIANS AS FAR NORTH AS HOOKSETT, EAST TO RAYMOND, SOUTH TO WINDHAM AND WEST TO NEW BOSTON. THE EPN HAS 27 PHYSICIAN PRACTICES IN THE GREATER MANCHESTER AREA. PROVIDING ACCESS TO PROVIDERS THROUGHOUT THE LOCAL COMMUNITY IS CRITICAL TO SUPPORTING THE NEED TO HELP INDIVIDUALS BECOME ACTIVE IN THEIR HEALTH CARE AND VIGILANT ABOUT THEIR YEARLY EXAMS, VACCINES, AND MEDICATIONS. EHS HAS A ROBUST ELECTRONIC MEDICAL RECORD (EMR) LINKING ALL OF THESE PROVIDERS WITH EH ALLOWING THE PROVIDER A COMPLETE UNDERSTANDING OF ANYTHING THAT MAY HAVE OCCURRED THROUGH THE EMERGENCY DEPARTMENT OR URGENT CARE THROUGHOUT THE YEAR. THE EMR IS COMPLETE WITH THE LATEST LABORATORY RESULTS, DIAGNOSTIC IMAGES, AND OTHER TEST RESULTS THAT MAY AFFECT CARE GIVEN IN THE LOCAL PROVIDER'S OFFICE.THE VNA IS ONE OF THE REGION'S OLDEST AND MOST COMPREHENSIVE NOT FOR PROFIT HOME HEALTH PROVIDERS, DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY SINCE 1897. THE VNA HAS HELPED INDIVIDUALS AND THEIR FAMILIES FACE THE CHALLENGES OF RECOVERING FROM SURGERY, PHYSICAL DISABILITIES, AND SHORT-TERM, CHRONIC, AND LIFE-LIMITING ILLNESSES. THROUGH A TRACE PROGRAM, EHS CAN ENSURE THAT OLDER ADULTS REQUIRING CARE AND WITH COMPLEX HEALTH CARE HISTORIES ARE GIVEN A CARE PLAN FROM THE HOSPITAL TO THE NURSING HOME (IF NECESSARY) AND TO THE HOME. ALL OF THIS CARE IS ALSO LINKED THROUGH THE EMR AND THROUGH OUR USE OF TELE-MEDICINE; MANY PATIENTS ARE MONITORED "VIRTUALLY" EACH DAY WHILE IN THEIR HOME. TELE-MEDICINE REQUIRES A PATIENT IN THEIR HOME TO CONNECT TO ELECTRONIC DEVICES THAT SEND INFORMATION BACK TO CARE PROVIDERS SHOWING SUCH THINGS AS BLOOD PRESSURE, PULSE, AND RESPIRATORY FUNCTION, SO THAT SHOULD INTERVENTION BE REQUIRED, A HEALTH CARE TEAM CAN BE SENT DIRECTLY TO THE PATIENT'S HOME. REPORTS FILED WITH STATES PART VI, LINE 7 NH 1 CHILD HEALTH SERVICES 1245 ELM STREET MANCHESTER NH 03101 020348711 501(C)(3) 96941 13682 FAIR MARKET VALUE TO ASSIST IN MEETING DAY-TO-DAY OPERATIONS, PROVIDE SUPPORT FOR THE ACCOUNTING AND BOOKKEEPING DEPARTMENT MANCHESTER COMMUNITY HEALTH CENTER 1415 ELM STREET MANCHESTER NH 03101 020458174 501(C)(3) 403500 TO ASSIST IN MEETING DAY-TO-DAY OPERATIONS 3 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ELLIOT HOSPITAL MAINTAINS MEMBERS ON THE BOARD OF DIRECTORS FOR CHILD HEALTH SERVICES AND MANCHESTER COMMUNITY HEALTH CENTER X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 DOUGLAS F DEAN 545926 0 217625 0 1232733 0 140856 0 12139 0 2149279 0 1003896 0 RICK PHELPS 428404 0 105001 0 45262 0 71750 0 15757 0 666174 0 0 0 LAWRENCE M HOEPP MD 0 853717 0 0 0 39500 0 7500 0 13364 0 914081 0 0 ROBERT M LAVERY 0 547139 0 0 0 39010 0 7500 0 12312 0 605961 0 0 JAMES F FITZGERALD MD 0 160528 0 35070 0 17000 0 7456 0 15535 0 235589 0 0 GUS EMMICK MD 0 163993 0 104160 0 17000 0 8030 0 15557 0 308740 0 0 RICHARD ELWELL 346099 0 91351 0 48077 0 109258 0 11603 0 606388 0 0 0 JOHN FRIBERG 300738 0 45000 0 24773 0 7500 0 15448 0 393459 0 0 0 ALEXANDER W PETRON 271964 0 46750 0 31209 0 7500 0 16098 0 373521 0 0 0 MARC G CULLEROT 212834 0 29490 0 22117 0 24919 0 540 0 289900 0 0 0 ANITA RITENOUR MD 277222 0 24964 0 17000 0 14132 0 16025 0 349343 0 0 0 DENISE P PURINGTON 200122 0 32130 0 30689 0 22344 0 1030 0 286315 0 0 0 WILLIAM BAXTER 306110 0 25470 0 34000 0 7500 0 15894 0 388974 0 0 0 PART I, LINE 4B DOUGLAS DEAN - $108,075; RICK PHELPS - $64,250; RICHARD ELWELL - $73,882; WILLIAM BAXTER - $34,640 PART I, LINE 7 THE ORGANIZATION HAS ADOPTED AN INCENTIVE PAY PROGRAM THAT PROVIDES DESIGNATED MANAGEMENT EMPLOYEES AN OPPORTUNITY TO EARN A DESIGNATED PERCENTAGE OF SALARY BASED ON THE ACHIEVEMENT BY THE ORGANIZATION OF A NUMBER OF CRITICAL SUCCESS FACTORS. THE CRITICAL SUCCESS FACTORS ARE ESTABLISHED ANNUALLY BY THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES WITH ASSISTANCE FROM AN INDEPENDENT NATIONAL COMPENSATION CONSULTING COMPANY. THE MAXIMUM POTENTIAL INCENTIVE PAYMENTS UNDER THE PLAN ARE CONSIDERED BY THE COMPENSATION CONSULTANT IN ENSURING THAT MANAGEMENT COMPENSATION IS REASONABLE. SUPPLEMENTAL INFORMATION PART III THE SALARIES OF DOUGLAS DEAN, RICK PHELPS, AND RICHARD ELWELL REPRESENT SERVICES PROVIDED TO ALL RELATED ENTITIES. SUPPLEMENTAL INFORMATION PART III PART II LINE 1 - DURING THE YEAR MR DEAN WITHDREW FUNDS FROM HIS DEFERRED COMPENSATION PLAN ($1,003,896) AS SUCH THIS AMOUNT IS REPORTED IN COLUMN B(III) AND IN PRIOR YEARS CONTRIBUTIONS TO HIS DEFERRED COMPENSATION PLAN WHICH SUPPORT THE CURRENT DISTRIBUTION WERE REPORTED IN COLUMN C. A NH HEALTH & EDUCATION FACILITIES AUTHORITY 020279866 644614GK9 2003-10-21 32245816 REFINANCE 1987, 1991, 2001 BONDS 0 0 0 B BUSINESS FINANCE AUTHORITY OF THE STATE OF NH REVENUE BONDS - 2009A 020279866 64468KBQ8 2009-12-22 130000000 FINANCE/REFINANCE COSTS OF CONSTRUCTION, REFINANCE 2008 BONDS 0 0 0 A 32245816 2810960 28988859 426666 1 1 1 1 B 127806119 11505106 6134168 30000000 1980498 78095644 1 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 0 B 0 PART V POLICY AND PROCEDURES WERE CREATED, APPROVED BY BOARD AND IMPLEMENTED IN FY 2014. JAMES C HOOD ESQ BOARD MEMBER 96749 SEVERAL ATTORNEYS AT NIXON PEABODY, LLP, HAVE BEEN CONSULTED BY ELLIOT HEALTH SYSTEM REGARDING SPECIALIZED CLAIMS AND REGULATORY LEGAL PROJECTS. JAMES HOOD IS A PARTNER AT NIXON PEABODY, LLP. 0 JOHN FRIBERG JR EMPLOYEE LONG STANDING AND ONGOING ATTORNEY-CLIENT RELATIONSHIP BETWEEN EHS AND WADLEIGH LAW FIRM. JOHN FRIBERG JR'S FATHER IS EMPLOYED BY THE WADLEIGH FIRM AND HAS WORKED ON MEDICAL MALPRACTICE CLAIMS FOR THE HOSPITAL. 0 DIANNE MERCIER BOARD MEMBER DIANNE IS PRESIDENT OF PEOPLE'S UNITED BANK, WHICH IS A DEPOSITORY FOR GRANITE SHIELD INSURANCE EXCHANGE OF WHICH EHS IS A MEMBER 0 PETER KACHAVOS MD ELLIOT BAY MEDICAL ASSOCIATES EMPLOYEE 66700 THROUGH BMA REAL ESTATE (WHICH PETER IS A MEMBER/MANAGER WITH 50% OWNERSHIP), ELLIOT RENTS 4 ELLIOT WAY, SUITE 102, 104, 106 FOR $66,700 PER YEAR 0 DR LARRY HOEPP ELLIOT GENERAL SURGERY PA EMPLOYEE 547374 WIFE OF DR HOEPP SOLD MEDICAL CONDOMINIUM TO TARRYTOWN REAL ESTATE HOLDINGS (AN ELLIOT HEALTH SYSTEM ENTITY) FOR $547,374 IN FY 2013 0 FORM 990, PART VI, SECTION A, LINE 6 ELLIOT HEALTH SYSTEM IS THE SOLE MEMBER OF THE REPORTING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A ELLIOT HEALTH SYSYTEM IS THE SOLE MEMBER OF THE REPORTING ORGANIZATION, AND HAS BOARD MEMBERS WHO ARE ALSO BOARD MEMBERS OF THE REPORTING ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED 990 IS PRESENTED TO THE BOARD PRIOR TO FILING. SPECIFIC KEY SECTIONS OF THE 990 ARE SINGLED OUT FOR ADDITIONAL DISCUSSION AND INPUT FROM BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED ANNUALLY TO SIGN A CONFLICT OF INTEREST FORM WHICH REQUIRES REPORTING ANY POTENTIAL CONFLICT OF INTEREST ARRANGEMENTS WITH THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD UTILIZES OUTSIDE COMPENSATION CONSULTANTS TO EVALUATE THE SALARIES FOR THE CEO, CFO, AND COO. THE CONSULTANTS UTILIZE THEIR INTERNAL DATA ALONG WITH NATIONAL AND LOCAL BENCHMARK DATA FROM THE INDUSTRY TO DEVELOP SALARY LEVELS. RECOMMENDATIONS OF THE CONSULTANT ARE REVIEWED BY THE COMPENSATION COMMITTEE, WHO RECOMMENDS COMPENSATION LEVELS TO THE FULL BOARD FOR APPROVAL. AN OUTSIDE CONSULTING FIRM IS ALSO USED BY THE ORGANIZATION TO REVIEW THE COMPENSATION OF THE REMAINDER OF THE VP'S. AGAIN NATIONAL AND LOCAL BENCHMARKS FOR SALARIES ARE CONSULTED TO DETERMINE SALARY LEVELS FOR THESE VP'S. FORM 990, PART VI, SECTION C, LINE 19 EACH OF THESE DOCUMENTS IS FILED WITH THE NEW HAMPSHIRE SECRETARY OF STATE AND IS AVAILABLE UPON REQUEST. ALL OTHER FUNCTIONAL EXPENSES FORM 990, PART IX, LINE 24E IMPLANTS & PROTHESIS : PROGRAM SERVICE EXPENSES 10,110,506. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,110,506. MAINTENANCE & SERVICE CONTRACTS : PROGRAM SERVICE EXPENSES 7,182,904. MANAGEMENT AND GENERAL EXPENSES 2,394,300. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,577,204. OTHER PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 5,013,925. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,013,925. UTILITIES : PROGRAM SERVICE EXPENSES 3,361,497. MANAGEMENT AND GENERAL EXPENSES 1,120,499. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,481,996. MANAGEMENT FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,160,594. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,160,594. EQUIPMENT RENTAL : PROGRAM SERVICE EXPENSES 2,909,800. MANAGEMENT AND GENERAL EXPENSES 969,933. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,879,733. PHYSICIAN FEES : PROGRAM SERVICE EXPENSES 3,745,723. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,745,723. SOFTWARE LICENSE FEES : PROGRAM SERVICE EXPENSES 3,572,883. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,572,883. CONSULTING FEES : PROGRAM SERVICE EXPENSES 2,789,945. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,789,945. MINOR EQUIPMENT PURCHASES : PROGRAM SERVICE EXPENSES 2,004,178. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,004,178. FOOD & DIETARY : PROGRAM SERVICE EXPENSES 1,865,528. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,865,528. OTHER OPERATING COSTS : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,218,156. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,218,156. LAUNDRY & LINENS : PROGRAM SERVICE EXPENSES 1,152,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,152,260. RECRUITMENT & RELOCATION FEES : PROGRAM SERVICE EXPENSES 1,079,955. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,079,955. TELEPHONE : PROGRAM SERVICE EXPENSES 720,851. MANAGEMENT AND GENERAL EXPENSES 240,283. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 961,134. MEDICAL SERVICES FEES : PROGRAM SERVICE EXPENSES 925,781. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 925,781. PURCHASED LABOR : PROGRAM SERVICE EXPENSES 833,173. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 833,173. ICD 10 PROJECT : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 733,467. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 733,467. COLLECTION FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 512,096. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 512,096. PRINTING & PUBLICATIONS : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 498,331. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 498,331. TRUST FUND FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 478,534. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 478,534. PERMITS & FEES : PROGRAM SERVICE EXPENSES 403,681. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 403,681. POSTAGE & SHIPPING : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 376,889. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 376,889. DUES & MEMBERSHIPS : PROGRAM SERVICE EXPENSES 341,318. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 341,318. BANK & CREDIT CARD FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 310,499. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 310,499. EDUCATION & TRAINING : PROGRAM SERVICE EXPENSES 200,822. MANAGEMENT AND GENERAL EXPENSES 66,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 267,761. VEHICLE EXPENSE : PROGRAM SERVICE EXPENSES 179,544. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 179,544. VALET PARKING : PROGRAM SERVICE EXPENSES 92,554. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,554. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT 30,210,142. UNREALIZED GAIN/LOSS - TEMPORARILY RESTRICTED FUNDS 105,141. UNREALIZED GAIN/LOSS - PERMANENTLY RESTRICTED FUNDS 367,763. GRANT PROCEEDS RECEIVED FOR CAPITAL PURCHASE ELLIOT HEALTH SYSTEM PROFESSIONAL & GENERAL LIABILITY INSURANCE TRUST 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 016217452 INSURANCE TRUST NH 501(C)3 LINE 11, TYPE II ELLIOT HEALTH SYSTEM 0 ELLIOT HEALTH SYSTEM 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 020509911 HOLDING COMPANY NH 501(C)3 LINE 3 0 ELLIOT PHYSICIAN NETWORK 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 020509589 PHYSICIAN SERVICES NH 501(C)3 LINE 3 ELLIOT HEALTH SYSTEM 1 ELLIOT PROFESSIONAL SERVICES 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 331003630 PHYSICIAN SERVICES NH 501(C)3 LINE 9 ELLIOT HEALTH SYSTEM 1 VNA OF MANCHESTER & SOUTHERN NH & SUBS 33 SOUTH COMMERCIAL STREET SUITE 40 MANCHESTER NH 03101 020395296 VNA HOLDING COMPANY NH 501(C)3 LINE 7 ELLIOT HOSPITAL 0 JOHN & MARY ELLIOT CHARITABLE FOUNDATION 1070 HOLT AVENUE UNIT 1 STE 2100 MANCHESTER NH 03109 020512229 FUNDRAISING NH 501(C)3 LINE 7 ELLIOT HEALTH SYSTEM 0 VNA HOME HEALTH & HOSPICE SERVICES INC 33 SOUTH COMMERCIAL STREET SUITE 40 MANCHESTER NH 03101 020222241 HOME CARE & HOSPICE SERVICES NH 501(C)3 LINE 11, TYPE II VNA OF MANCHESTER & SOUTHERN NH INC 0 VNA COMMUNITY SERVICES INC 33 SOUTH COMMERCIAL STREET SUITE 40 MANCHESTER NH 03101 020396549 NURSING SERVICES NH 501(C)3 LINE 11, TYPE II VNA OF MANCHESTER & SOUTHERN NH INC 0 VNA PERSONAL SERVICES INC 33 SOUTH COMMERCIAL STREET SUITE 40 MANCHESTER NH 03101 020395295 PRIVATE HEALTH & HOMEMAKER SERVICES NH 501(C)3 LINE 11, TYPE II VNA OF MANCHESTER & SOUTHERN NH INC 0 ELLIOT COMMON TRUST FUND LLC 1 ELLIOT WAY MANCHESTER NH 03103 203653624 INVESTMENTS NH N/A 3249060 71977206 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 ELLIOT PROFESSIONAL SERVICES P 5019419 CASH ELLIOT PHYSICIAN NETWORK P 297147 CASH ELLIOT PROFESSIONAL SERVICES Q 10490073 CASH ELLIOT PHYSICIAN NETWORK Q 14958241 CASH ELLIOT PROFESSIONAL SERVICES K 216527 CASH ELLIOT HEALTH SYSTEM 1070 HOLT AVE UNIT 1 SUITE 2100 MANCHESTER NH 03109 020509911 0 0 0 0 0 0 0 0 0 0 VNA OF MANCHESTER AND SOUTHERN NH INC & SUBSIDIARIES 33 SOUTH COMMERCIAL ST SUITE 401 MANCHESTER NH 03101 020395296 0 0 0 0 0 0 0 0 0 0 ELLIOT HOSPITAL 1 ELLIOT WAY MANCHESTER NH 03103 020232673 X 156539 0 156539 0 156539 31308 7827 148712 125231 0 ELLIOT PROFESSIONAL SERVICES 1070 HOLT AVE UNIT 1 SUITE 2100 MANCHESTER NH 03109 331003630 0 0 0 0 0 0 0 0 0 0 ELLIOT PHYSICIAN NETWORK 1070 HOLT AVE UNIT 1 SUITE 2100 MANCHESTER NH 03109 020509589 0 0 0 0 0 0 0 0 0 0 ELLIOT HEALTH SYSTEM HOLDINGS INC & SUBSIDIARIES 1070 HOLT AVE UNIT 1 SUITE 2100 MANCHESTER NH 03109 020512224 0 0 0 0 0 0 0 0 0 0 JOHN & MARY ELLIOT CHARITABLE FOUNDATION 1070 HOLT AVE UNIT 1 SUITE 2100 MANCHESTER NH 03109 020512229 0 0 0 0 0 0 0 0 0 0 ELLIOT COMMON TRUST FUND LLC 1 ELLIOT WAY MANCHESTER NH 03103 023653624 0 0 0 0 0 0 0 0 0 0 ELLIOT HEALTH SYSTEM PROFESSIONAL & GENERAL LIABILITY INSURANCE TRUST 1 ELLIOT WAY MANCHESTER NH 03101 016217452 0 0 0 0 0 0 0 0 0 0