2014-05-15T13:08:45-05:00 2013-06-30 PRICEWATERHOUSECOOPERS LLP 125 HIGH STREET BOSTON MA 02110 990 2012-07-01 020222139 The Hitchcock Foundation % JENNIFER REINING HITC 6036505000 One Medical Center Drive Suite Lebanon NH 03756 Jennifer Reining 2014-05-12 6175305000 2012 2015-11-30 17:44:51Z E Ann Gormley MD One Medical Center Drive Lebanon NH 03756 5658354 false X N/A X 1946 NH To aid & advance the study & investigation of human ailments & injuries; the causes, prevention, relief, & cure thereof, hygiene, health & public welfare, & to assist in research in the broadest sense 17 12 0 19 117558 103799 1168266 1259771 2996371 2815858 1957819 1533451 0 0 6122456 5609080 324457 559708 0 0 0 0 0 0 0 5121640 4262935 5446097 4822643 676359 786437 21638519 22768062 1164604 1269923 20473915 21498139 X THE PURPOSE OF THE HITCHCOCK FOUNDATION SHALL BE TO AID AND ADVANCE THE STUDY AND INVESTIGATION OF HUMAN AILMENTS AND INJURIES, AND THE CAUSES, PREVENTION, RELIEF, AND CURE THEREOF, AND THE STUDY AND INVESTIGATION OF PROBLEMS OF HYGIENE, HEALTH AND PUBLIC WELFARE, AND THE PROMOTION OF MEDICAL, SURGICAL AND SCIENTIFIC LEARNING, SKILL, EDUCATION AND INVESTIGATION, AND TO ENGAGE IN AND CONDUCT AND TO AID AND ASSIST IN MEDICAL, SURGICAL AND SCIENTIFIC RESEARCH IN THE BROADEST SENSE. false false 4633421 559708 2815858 The Hitchcock Foundation provides between 15 and 20 grants per year and sponsors over 400 advised funds that support clinically oriented research and education activities in furtherance of our mission. Sponsored research Funds support discrete clinical and biomedical research projects and are funded by external sources including corporations and foundations. Advised Funds are established by the Executive Director under the authority of the Board of Trustees. They are funded with contributions intended to support activities consistent with our charitable mission - particularly clinical research and education. They are not donor advised funds; rather the advisors are scientists and clinicians with expertise in the areas of research and education supported by the fund. The foundation also provides funding for research grants and fellowships; amounts awarded range from $1,000 to $125,000 and are awarded on a competitive basis. 4633421 true true false false false false false false false true true false false false true false false true false false true true false false false false false true true true false false false false false false false false false false false false false true true false false false true 107 0 true 0 true true false false false false false false false false false X 17 12 false false false false true true true true true false false true true true true true true false false false NH X JENNIFER REINING 6036531231 ONE MEDICAL CENTER DRIVE LEBANON NH 03756 X Peter Anderson MD 0.5 40.0 X X 0 254658 44412 Jocelyn Chertoff MD MS 0.5 X X 0 0 0 Peter Gardner Esq 0.3 X 0 0 0 E Ann Gormley MD 0.5 X X 0 0 0 Brian Lacy MD 0.3 40.0 X 0 442715 84276 Michele Lauria MD 0.3 40.0 X 0 374259 56250 Robert Maue PhD 0.3 X 0 0 0 Richard Powell MD 0.3 40.0 X 0 520702 92517 R Brooks Robey MD 0.3 X 0 0 0 Barry Smith MD 0.3 X 0 0 0 Edward Stansfield MA 0.5 X X 0 0 0 Michael Ward MS 0.5 40.0 X 0 182530 29397 Lawrence Dacey MD 0.3 40.0 X 0 507485 37711 Susan Pepin MD 0.3 X 0 0 0 Duane Compton PhD 0.3 X 0 0 0 James Gorham 0.3 X 0 0 0 Jeffrey Cohen MD 0.3 40.0 X 0 310460 57738 Edward Boraz PhD 0.3 X 0 0 0 Aine Donovan EdD 0.3 X 0 0 0 William Wickner MD 0.3 X 0 0 0 Jennifer Reining 40.0 X 0 94040 37447 0 2686849 439748 0 false true false Trustees of Dartmouth College 37 Dewey Field HANOVER NH 03755 Contracted Services 2569072 Mary Hitchcock Memorial Hospital One Medical Center Drive LEBANON NH 03756 Contracted Services 1204449 Dartmouth-Hitchcock Clinic One Medical Center Drive LEBANON NH 03756 Contracted Services 541129 3 1259771 1259771 SPONSORED RESEARCH, PROGRAM RESEARCH, & EDUCATION 541700 2815858 2699743 116115 2815858 364747 1443 363304 0 0 0 0 0 1217978 49274 1168704 1168704 1168704 0 0 0 0 5609080 2699743 117558 1532008 14322 14322 540351 540351 5035 5035 0 0 0 0 0 0 0 0 0 0 0 0 77845 77845 2469661 2420967 48694 69007 69007 17623 14776 2847 11492 11492 0 0 204224 204224 0 326699 322585 4114 0 0 641 641 0 TESTS & EXAMINATIONS 9733 9733 RESEARCH EXP & SUBJECT FEES 284047 284047 EDUCATIONAL MATERIAL 120219 113769 6450 LAB FEES, EQUIPMENT,& SUPLS 314991 314991 356753 308122 48631 4822643 4633421 189222 0 478589 365277 0 0 0 0 554062 620155 0 0 0 0 25132 11800 0 0 0 0 7306 6146 1801 1160 20578935 21769670 0 0 0 0 0 0 0 0 21638519 22768062 320859 238999 0 0 0 0 0 0 0 0 0 0 0 0 0 0 843745 1030924 1164604 1269923 X 7520234 11967711 10835277 7412024 2118404 2118404 20473915 21498139 21638519 22768062 786437 237787 X X false true X true true true X 8706056 2896407 798428 1168266 1259771 14828928 0 0 8706056 2896407 798428 1168266 1259771 14828928 0 14828928 507972 520396 551891 1957819 1533451 5071529 116558 116558 0 20017015 16964916 0.74082 0.84112 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6018116 463734 298716 6183134 6143370 1171 56273 182698 6018116 5256297 1041686 154613 6143370 4864103 546304 154110 5256297 6325750 -1140845 320802 4864103 0.43700 0.34260 0.22040 false false 7306 6146 1160 1160 0 AGENCY ACCOUNTS 1030924 1030924 Part V, Line 4 The Hitchcock Foundation's endowment funds include resources for the following uses: Tiffany Blake Endowment supports a research training fellowship for a young investigator at Dartmouth-Hitchcock Medical Center who is committed to clinically oriented research. Henry Heyl Endowment supports medical research grants. Helmut Schumann Lecture endowment supports an annual public lecture in "Studies in Healthful Living." Helmut Schumann Fellowship endowment supports a fellowship for a Dartmouth-Hitchcock Medical Center faculty to develop programs in primary prevention and health promotion. Residents' Revolving Loan Fund Emergency Loan Fund supports Residents and Fellows in training at Dartmouth-Hitchcock. Neurosurgical Research Fund (Barry) supports Neurosurgical Research. Harold M. Pierce Memorial Fund supports Cancer Research. Schedule D Part X, Line 2 No ASC 740 (Fin 48) footnote was included in the audited financial statements as there were no material uncertain tax positions at or since adoption. Europe (Including Iceland and Greenland) Program Services Conferences & Travel 50617 North America Program Services Conferences & Travel 7670 South America Program Services Conferences & Travel 1212 Sub-Saharan Africa Program Services Conferences & Travel 3644 Central America and the Caribbean Program Services Conferences & Travel 1756 64899 64899 Europe (Including Iceland and Greenland) Program Services 5035 Check FMV 1 1 false false false true true false true Bernice A Ray School 26 Reservoir Road Hanover NH 03755 14322 FMV Brain Conference for Staff Support 1 Medical Research Grants 20 540351 FMV Part 1 Line 2 Fellowships and large Program Project Grants are made once per year. SmalleY pilot grants are made three times per year. Amounts awarded range from $1,000 to $125,000 and are awarded on a competitive basis. All grant and fellowship-related expenses are reviewed and approved by the Foundation before paid. Requests for expenditures not in pre-approved grant budgets are rejected. false true false false false false false false false Peter Anderson MD 0 205036 0 49622 0 0 0 44412 0 0 0 299070 0 0 Brian Lacy MD 0 366521 0 57325 0 18869 0 62745 0 21531 0 526991 0 0 Michele Lauria MD 0 356768 0 11719 0 5772 0 43421 0 12829 0 430509 0 0 Richard Powell MD 0 353783 0 144900 0 22019 0 70995 0 21522 0 613219 0 0 Michael Ward MS 0 177843 0 0 0 4687 0 20568 0 8829 0 211927 0 0 Lawrence Dacey MD 0 464816 0 0 0 42669 0 24265 0 13446 0 545196 0 0 Jeffrey Cohen MD 0 248010 0 47238 0 15212 0 39500 0 18238 0 368198 0 0 Supplemental Retirement Plan Part 1, Line 4B The following individuals received amounts from the Dartmouth-Hitchcock Supplemental Retirement Plan (see below for terms). Brian Lacy $17,699 Michele Lauria $5,207 Richard Powell $21,555 Lawrence Dacey $41,895 Jeffrey Cohen $11,192 Defined Contribution Supplemental Retirement Plan Part 1, Line 4B Dartmouth-Hitchcock Supplemental Retirement Plan Terms and Conditions: An eligible employee is a participant in the Dartmouth-Hitchcock Retirement Plan and/or any prior pension arrangements sponsored by Dartmouth-Hitchcock (which consists of Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic), including a qualified defined benefit plan, who would be entitled to additional contributions or benefit accruals under the terms of the Plans for the plan year, but are limited by IRC Sections 401(a)(17) and/or IRC Section 415. For eligible employees, the Employer will pay the eligible employee an amount determined by the employer each year to offset the amount of the reduction in the benefit accrual or contribution as a result of limitations imposed by IRC Sections 401(a)(17) and/or IRC Section 415. Part VI Governance, Management and Disclosure Form 990, Section A, Line 6 The Hitchcock Foundation has the following membership: Dartmouth-Hitchcock Clinic, the sole voting member, retains limited powers in accordance with the bylaws, elects Trustees of the Board, and approves changes in bylaws. The operational management of The Hitchcock Foundation is delegated to the Board of Trustees, in accordance with the bylaws. Part VI Governance, Management and Disclosure Form 990 Section A, Line 7a & 7b Dartmouth-Hitchcock Clinic (DHC) is the sole corporate member of The Hitchcock Foundation. As such, DHC retains limited powers in accordance with the bylaws including, but not limited to, electing Trustees of the Board, and approving changes within the bylaws. Process used by management and/or Governing Body to Review 990 Form 990, Part VI, Line 11b The Form 990 is reviewed by an independent accounting firm, The Hitchcock Foundation's (THF) Executive Director. A copy of the return is emailed to the entire board prior to filing. In addition, the Treasurer of THF Board of Trustees will review prior to filing the return. Description of Process to Monitor Transactions For Conflicts of Interest Form 990, Part VI, Question 12c The Hitchcock Foundation has adopted and is included in the Dartmouth-Hitchcock Conflict of Interest Policy. The Dartmouth-Hitchcock Board of Trustees approved a policy concerning a voluntary self-disclosure of any potential conflict of interest. The Compliance and Audit Services Department conducts an annual survey and performs other procedures as considered necessary to report on compliance with the conflict of interest policy. The Compliance and Audit Services Department then reports to each board any potential conflicts for their review. Per the policy any conflicts or otherwise perceived conflicts are required to be addressed by the Board of Trustees on an ongoing basis. In the event a conflict arises, the individual may be removed in participating in any decision making regarding the identified conflict and/or its corresponding transactions. All THF board members are included in the annual conflict of interest survey. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. Whistleblower Policy Part VI, Section B, Line 13 The Organization has adopted and follows the policy of a related entity, Dartmouth-Hitchcock Clinic. Document Retention and Destruction Policy Form 990 Part VI, Section B, Line 14 The Organization has adopted and follows the policy of a related entity, Dartmouth-Hitchcock Clinic. Offices & Positions for Which Process was Used & Year Undertaken Form 990, Part VI, Question 15b The Director and staff of The Hitchcock Foundation are donated by Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital. Compensation for Officers are evaluated by an independent third party firm for reasonableness and national data benchmarking by the related organizations. The Compensation Committee along with Independent Trustees approve the final compensation in consideration with the independent third party firm's recommendations and suggestions. This process was last undertaken in 2013 for each person identified as an Officer. Part VI Governance, Management and Disclosure Form 990, Section B, Line 19 THF's governing documents are available through the New Hampshire Department of State. Certain financial information is disclosed through the Community Benefits Annual Report. The audited financial statements and the conflict of interest policy are available upon request in either electronic or hardcopy form. Compensation Form 990, Part VII, Section A, Line 1 The compensation paid by related organizations was for services provided to the related organizations and not the filing organization, with exception of the Executive Director, of which 100% of their time is spent with the Foundation. Although the individuals spent the time listed as part of their board of trustee duties, they were not compensated with respect to those hours. The time/hours reported at the related organization varies by individual and organization. Form 990, Part IX, Line 11G Other Fees for Services Other Fees for services includes reimbursement for payroll for research and education-related expenses to Dartmouth Hitchcock Clinic, Mary Hitchcock Memorial Hospital, and The Trustees of Dartmouth College in the amount of $2,283,283. The remaining $200,700 was paid to other outside entitites related to the Foundation's mission of providing research and education. Financial Statements and Reporting Part XII, Question 3a DURING FISCAL YEAR 2013, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FEDERAL FUNDING WHICH MET THE MINIMUM THRESHOLD SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. DUE TO THE NATURE OF THE CONSOLIDATED FINANCIAL STATEMENTS, THE AUDIT WAS PERFORMED ON THE FINANCIAL INFORMATION OF ALL ORGANIZATIONS, INCLUDING THE FOUNDATION. 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