2014-07-31T08:16:04-05:00 2013-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2012-10-01 020397338 Valley Regional Healthcare Inc VALL 6035427771 243 Elm Street Claremont NH 03743 Steven L Monette 6035427771 2014-07-30 1 Barbara J McGuan CPA P00219457 2077752387 2014-07-30 2012 2015-11-30 17:44:51Z Peter Wright 243 Elm Street Claremont NH 03743 5471279 0 X www.vrh.org X 1986 NH Parent organization to Valley Regional Hospital, Inc. 22 19 112 26 0 0 355257 336085 4644294 4846394 84626 287363 32886 -144265 5117063 5325577 0 0 0 0 4039395 4004877 0 0 0 1102222 1445680 5141617 5450557 -24554 -124980 3153139 3178268 1013708 1031668 2139431 2146600 Valley Regional Healthcare, Inc. is organized to coordinate and support the activities of health care organizations, including Valley Regional Hospital, Inc. 0 0 3572925 4846394 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. 3572925 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 0 0 0 1 11 0 1 112 1 0 0 0 0 0 0 0 0 0 0 X 22 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 0 1 1 1 1 0 NH X Steven Monette 6035427771 243 Elm Street Claremont NH 03743 Claire Bowen 1.60 38.40 X X 267692 0 15219 Jeffrey White 1.60 38.40 X X 0 0 0 Peter Wright 1.60 38.40 X X 0 0 0 Robert Porter 0.10 0.90 X 0 0 0 Volker Bradley MD 0.10 0.90 X 0 0 0 Albert Leahy Jr 0.10 0.90 X 0 0 0 Michael L Prozzo Jr 0.10 0.90 X 0 0 0 Alison Raymond 0.10 0.90 X 0 0 0 Lisa Richmond 0.10 0.90 X 0 0 0 Bernard Rosen MD 0.10 0.90 X 0 0 0 Carol Vivian 0.10 0.90 X 0 0 0 Jim Wimberg 0.10 0.90 X 0 0 0 Michael O'Connell 0.10 0.90 X X 0 0 0 Michael Satzow 0.10 0.90 X 0 0 0 Robert Cricco MD 0.10 39.90 X 0 280346 33455 Michael Fuerst 0.10 0.90 X X 0 0 0 Oliver Herfort MD 0.10 39.90 X 0 216148 31414 Sherwood Moody 0.10 0.90 X 0 0 0 James Borchert 0.10 0.90 X 0 0 0 Charlene Lovett 0.10 0.90 X X 0 0 0 Valerie Mahar 0.10 0.90 X 0 0 0 Patricia Putnam 0.10 0.90 X 0 0 0 Charles Sawyer MD 0.10 39.90 X 0 351677 16123 Allan Berggren MD 0.10 0.90 X X 0 0 0 Allen Damren 0.10 0.90 X 0 0 0 John Tomlinson 0.10 0.90 X 0 0 0 Deanna Howard 0.10 0.90 X 0 0 0 Steven Monette 2.80 37.20 X 165324 0 0 Margaret Burns 40.00 0.00 X 146203 0 4454 Gregg Burdett 40.00 0.00 X 138923 0 14364 718142 848171 115029 4 0 1 0 Dartmouth Hitchcock Clinic One Medical Center Drive Lebanon NH 03756 CEO Contract Services 184395 Cejka PO Box 404682 Atlanta GA 303844682 Physician Recruitment 156560 The Medicus Firm 3010 LBJ Freeway Suite 1300 Dallas TX 75234 Physician Recruitment 122393 3 324881 11204 336085 Patient Service Revenue 621610 2825740 2825740 Management Services 621610 2008920 2008920 Miscellaneous Revenue 900099 240197 240197 Provision for Bad Debts 621610 -34566 -34566 Contractual/Charity Adjustment 621610 -193897 -193897 4846394 236548 236548 1437 145702 -144265 -144265 -144265 50815 0 50815 50815 50815 5325577 4846394 0 143098 X 448235 69622 378613 2689118 2158422 530696 24276 19485 4791 615259 493838 121421 227989 182996 44993 14019 14019 14492 14492 744334 66270 678064 35822 35822 146103 136447 9656 24465 24465 131543 127064 4479 34495 34495 72331 559 71772 Medical Supplies 189741 185105 4636 Miscellaneous 38335 38335 0 5450557 3572925 1877632 0 217135 84511 37966 186403 295726 334946 6587 55308 487084 291919 226287 195165 1746286 1913559 623152 408376 3153139 3178268 579371 542331 96452 72985 337885 416352 1013708 1031668 X 2103305 2112505 36126 34095 2139431 2146600 3153139 3178268 -124980 132149 0 X 0 1 X 1 0 X X X 0 0 0 Valley Regional Hospital Inc 020222118 3 1 1 1 5450557 1 5450557 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 487084 291919 195165 195165 Due from Affiliates 83720 Cash Surrender Value of Life Insurance 289183 Other Accounts Receivable 24696 Investment in Summercrest Assisted Living, LLC 10777 408376 Due to Affiliates 329606 Reserve for Self-Funded Insurance 86746 416352 X X X X 0 0 0 0 0 1 1 0 0 Claire Bowen 258544 0 0 0 9148 0 5375 0 9844 0 282911 0 0 0 Robert Cricco MD 0 272062 0 0 0 8284 0 5549 0 27906 0 313801 0 0 Oliver Herfort MD 0 181996 0 12752 0 21400 0 4256 0 27158 0 247562 0 0 Charles Sawyer MD 0 341787 0 0 0 9890 0 5611 0 10512 0 367800 0 0 Steven Monette 165006 0 0 0 318 0 0 0 0 0 165324 0 0 0 Margaret Burns 145702 0 0 0 501 0 2954 0 1500 0 150657 0 0 0 Gregg Burdett 108448 0 0 0 30475 0 0 0 14364 0 153287 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 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. At this time, Olney & Associates CEO Survey is used to determine an appropriate rate of pay. Other determining factors include overall hospital performance and completion of individual CEO goals and objectives. 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. Other Fees Form 990, Part IX, line 11g Purchased Services: Program service expenses 66,270. Management and general expenses 678,064. Fundraising expenses 0. Total expenses 744,334. Valley Regional Hospital Inc 243 Elm Street Claremont NH 03743 020222118 Critical Access Hospital NH 501(c)(3) 3 Valley Regional Healthcare Inc 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 Valley Regional Hospital Inc K 114568 Amounts Paid