MONADNOCK COMMUNITY HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: MONADNOCK COMMUNITY HOSPITAL (EIN 02-0222157)
Tax period: 2012-10-01 to 2013-09-30
Filed: 2014-08-12
IRS object ID: 201422249349300977
Schema version: 2012v2.1
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 G
Schedule H
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-08-12T10:57:22-05:00	Timestamp
Tax Period End Date	2013-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	010494526	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BAKER NEWMAN & NOYES	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	BOX 507	AddressLine1
City	PORTLAND	City
State	ME	State
ZIP Code	04112	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	020222157	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Monadnock Community Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MONA	NameControl
Phone	6039247191	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	452 Old Street Road	AddressLine1
City	Peterborough	City
State	NH	State
ZIP Code	034581263	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Richard Scheinblum	Name
Title	VP of Finance/CFO	Title
Phone	6039247191	Phone
Date Signed	2014-08-05	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Nicholas E Porto	Name
PTIN	P01310283	PTIN
Phone	2078792100	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Cynthia K McGuire	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	452 Old Street Road	AddressLine1
City	Peterborough	City
State	NH	State
ZIP Code	034581263	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	79529693	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.monadnockhospital.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1919	YearFormation
State Legal Domicile	NH	StateLegalDomicile
Activity Or Mission Description	Critical Access Hospital serving the Monadnock Region of the State of New Hampshire.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	16	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	13	NbrIndependentVotingMembers
Total Nbr Employees	798	TotalNbrEmployees
Total Nbr Volunteers	132	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	816591	ContributionsGrantsPriorYear
Contributions Grants Current Year	1420503	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	75233641	ProgramServiceRevenuePriorYear
Program Service Revenue CY	76958001	ProgramServiceRevenueCY
Investment Income Prior Year	1384191	InvestmentIncomePriorYear
Investment Income Current Year	341552	InvestmentIncomeCurrentYear
Other Revenue Prior Year	700842	OtherRevenuePriorYear
Other Revenue Current Year	369213	OtherRevenueCurrentYear
Total Revenue Prior Year	78135265	TotalRevenuePriorYear
Total Revenue Current Year	79089269	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	39571490	SalariesEtcPriorYear
Salaries Etc Current Year	39544302	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	63069	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	434588	TotalFundrsngExpCurrentYear
Other Expense Prior Year	39666510	OtherExpensePriorYear
Other Expenses Current Year	37630255	OtherExpensesCurrentYear
Total Expenses Prior Year	79301069	TotalExpensesPriorYear
Total Expenses Current Year	77174557	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-1165804	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1914712	RevenuesLessExpensesCY
Total Assets BOY	92323694	TotalAssetsBOY
Total Assets EOY	99482264	TotalAssetsEOY
Total Liabilities BOY	45242384	TotalLiabilitiesBOY
Total Liabilities EOY	45471971	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	47081310	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	54010293	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	Monadnock Community Hospital is committed to improving the health and well-being of our community. We create exceptional experiences that engage and inspire our community to achieve the highest level of health and well-being.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	68342173	Expense
Grants	0	Grants
Revenue	77558261	Revenue
Description	The primary purpose of Monadnock Community Hospital (MCH) is to ensure access to quality health care for patients in our community, regardless of their ability to pay. Following is a summary of the services MCH provides in an effort to fulfill its mission, together with key program statistics for fiscal year 2013.Inpatient Services - Includes: intensive care unit, adult stays, pediatric stays, maternity/births, and skilled nursing. During the fiscal year, the Hospital admitted 1,351 patients and recorded 4,617 patient days. Emergency Services - MCH offers health services 24 hours per day, 7 days per week. Responsible for the immediate treatment of any medical or surgical emergency; for initiating life saving procedures in all types of emergency situations; and for providing emergency and initial evaluations and treatment for other conditions including minor illnesses and injuries, and sub acute medical problems. During the year, there were 15,472 visits to the ER. Physician Practices - Family health services, programs, and education are integral components of healthcare at MCH. Inpatient and outpatient primary care includes: medical, surgical, psychological and specialist services, provided by physicians and mid-level practitioners. These are located at the Hospital and its five satellite practices located in Antrim, Jaffrey, New Ipswich, Peterborough, and Rindge. During the year, 133,087 office visits were recorded. Surgical Services - Includes same day and short-term inpatient surgery. MCH provides surgery in the areas of orthopaedics, general surgery, OB/GYN, opthamology, urology, ENT, and podiatry. In addition, the Hospital offers some non-surgical procedures including colonoscopies, gastrocopies, and pain management injections. During the fiscal year, 2,717 procedures were performed. Radiology and Diagnostics - MCH provides advanced radiological technology and extensive imaging services including: bone density, MRI, CT, nuclear medicine, ultrasound, mammography, and other diagnostic procedures, both inpatient and outpatient. During the fiscal year, 29,889 exams were performed. Rehabilitation Services - Additionally, MCH serves the people of the Monadnock Region through its medical rehabilitation services. MCH offers rehabilitation programs for cardiac, pulmonary and diabetic rehabilitation which feature educational and exercise components. We also provide physical and occupational therapy, as well as speech rehabilitation. During the fiscal year 46,192 procedures were recorded for these services. Wellness Services - Community members wanting to improve and maintain their health have access to an award-winning, medically-based fitness facility. During the fiscal year, 88,823 member visits were recorded.Monadnock Community Hospital's Financial Grant Program provides assistance with hospital and/or physician bills for qualifying patients. In FY 2013, the Organization recorded $3,446,000 in charges foregone based on established rates. The estimated cost incurred to provide these services was $1,932,000. In addition, Monadnock Community Hospital provided other services to the community at no cost or reduced cost, such as screenings and clinics. The cost of providing these services was approximately $2,091,000 in 2013.	Description
Total Program Service Expense	68342173	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	103	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	798	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	16	NbrVotingGoverningBodyMembers
Number Independent Voting Members	13	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	1	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	NH	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Nicole Humphrey	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	6039247191	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	452 Old Street Road	AddressLine1
City	Peterborough	City
State	NH	State
ZIP Code	034581263	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
Diane Cherwin part year
Ex-Officio w/ Voting Rights	1.50	X	0	0	0
Robert J Condon Jr
Trustee	2.00	X	0	0	0
Barbara R Duckett
Trustee	2.00	X	0	0	0
Peter L Forssell MD part year
Trustee	1.00	X	0	0	0
David A Hedstrom DDS
Trustee	3.00	X	0	0	0
Gregory Kriebel MD part year
Ex-Officio w/ Voting Rights	2.00	X	214771	0	23676
Marcia Ober part year
Trustee	1.00	X	0	0	0
Amy Pfeil part year
Ex-Officio w/ Voting Rights	1.00	X	0	0	0
James D Potter MD
Ex-Officio w/ Voting Rights	4.00	X	121135	0	19296
Charles J Seigel MD part year
Ex-Officio w/ Voting Rights	1.00	X	0	0	0
Jamie Trowbridge
Trustee	1.00	X	0	0	0
Fletcher R Wilson MD
Ex-Officio w/ Voting Rights	1.00	X	0	0	0
Robert L Edwards
Chair	3.00	X	0	0	0	X
Cynthia Burgess
Immediate Past Chair	2.00	X	0	0	0	X
Carole Monroe
Vice Chair	4.00	X	0	0	0	X
Steven H Reynolds
Treasurer	2.00	X	0	0	0	X
Norman H Makechnie Esq
Secretary	1.00	X	0	0	0	X
Peter L Gosline
Chief Executive Officer	50.00	X	297159	0	79559	X
Richard Scheinblum
VP Finance/CFO	50.00		162339	0	10761	X
Terrence McNamara DO
Physician	50.00		520924	0	21324		X
Ronald Michalak MD
Physician	50.00		497804	0	28170		X
Phillip Vuocolo MD
Surgeon	50.00		468129	0	26653		X
Shawn Harrington MD
Physician	50.00		452158	0	27473		X
Jennifer Peppers MD
Surgeon	50.00		335073	0	16291		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	3069492	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	253203	TotalOtherCompensation
Number Individuals GT100 K	46	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Monadnock Region Emergency Physicians PL
380 Lafayette Road	Hampton	NH	03842	Contract Emergency Physicians	1867725
Monadnock Anesthesia Associates
C/O Surgical Suite	Peterborough	NH	03458	Contract Anesthesiologist	1143960
McKesson
PO Box 98347	Chicago	IL	60693	IS Vendor	913108
Catholic Medical Center
100 McGregor Street	Manchester	NH	03102	Contract Hospitalist	893727
Hutter Construction Corporation
PO Box 257 810 Turnpike Road	New Ipswich	NH	03071	General Contractor	876300

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	20	NumberOfContractorsGT100K
Fundraising Events	44800	FundraisingEvents
Government Grants	18070	GovernmentGrants
All Other Contributions	1357633	AllOtherContributions
Noncash Contributions	9957	NoncashContributions
Total Contributions	1420503	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Service Revenue	621400	73476212	73476212
Other Operating Revenue	621400	3481789	3481789

Field	Value	IRS element (for citing)
Total Program Service Revenue	76958001	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	481438	TotalRevenueColumn
Exclusion	$481,438	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	283311	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	396217	Securities
Other	26980	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-112906	Securities
Other	-26980	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-139886	TotalRevenueColumn
Exclusion	-$139,886	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	16465	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	44800	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	17227	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	-762	TotalRevenueColumn
Exclusion	-$762	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
Cafeteria/Vending Machine	722210	344595	344595
Employee Pharmacy Sales	446110	255665	255665
Loss on Extinguishment of Debt	525990	-230285		-$230,285

Field	Value	IRS element (for citing)
Total Other Revenue	369975	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	79089269	TotalRevenueColumn
Related Or Exempt Function Income	77558261	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$110,505	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	885254	Total
Program Services	390840	ProgramServices
Management And General	494414	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	31273962	Total
Program Services	28370221	ProgramServices
Management And General	2639721	ManagementAndGeneral
Fundraising	264020	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	481640	Total
Program Services	431923	ProgramServices
Management And General	49717	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	4786134	Total
Program Services	4189533	ProgramServices
Management And General	570277	ManagementAndGeneral
Fundraising	26324	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2117312	Total
Program Services	1887075	ProgramServices
Management And General	212069	ManagementAndGeneral
Fundraising	18168	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	154626	Total
Program Services	325	ProgramServices
Management And General	154301	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	52500	Total
Management And General	52500	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	366	Total
Fundraising	366	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	5148011	Total
Program Services	4520159	ProgramServices
Management And General	627852	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	61204	Total
Program Services	61204	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2223918	Total
Program Services	1024108	ProgramServices
Management And General	1152827	ManagementAndGeneral
Fundraising	46983	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	946124	Total
Program Services	820865	ProgramServices
Management And General	125259	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3053456	Total
Program Services	2814295	ProgramServices
Management And General	239161	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	55555	Total
Program Services	28799	ProgramServices
Management And General	25935	ManagementAndGeneral
Fundraising	821	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	38104	Total
Program Services	25369	ProgramServices
Management And General	10039	ManagementAndGeneral
Fundraising	2696	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	1210343	Total
Management And General	1210343	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4961382	Total
Program Services	4795866	ProgramServices
Management And General	165516	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	603406	Total
Program Services	467876	ProgramServices
Management And General	135530	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
Med & Pharm Supplies	7270915	7268097	2818
Provision for Bad Debts	4467531	4467531
Other Med Exp/Service C	3935458	3563022	322703	49733
NH Medicaid Enhancement	2553243	2553243

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	894113	Total
Program Services	661822	ProgramServices
Management And General	206814	ManagementAndGeneral
Fundraising	25477	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	77174557	Total
Program Services	68342173	ProgramServices
Management And General	8397796	ManagementAndGeneral
Fundraising	434588	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2208239	BOY
EOY	5064	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	11778893	BOY
EOY	17594099	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	161575	BOY
EOY	793082	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	5527100	BOY
EOY	5773955	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	196371	BOY
EOY	240184	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1286731	BOY
EOY	1242787	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	573132	BOY
EOY	867448	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	80394526	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	42318410	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	39419805	BOY
EOY	38076116	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	26642255	BOY
EOY	29923690	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	3135858	BOY
EOY	3407090	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	197606	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1393735	BOY
EOY	1361143	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	92323694	BOY
EOY	99482264	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	5921028	BOY
EOY	6773500	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	27234908	BOY
EOY	26909344	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	690631	BOY
EOY	535451	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	11395817	BOY
EOY	11253676	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	45242384	BOY
EOY	45471971	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	38489800	BOY
EOY	43706147	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1236210	BOY
EOY	2677614	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	7355300	BOY
EOY	7626532	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	47081310	BOY
EOY	54010293	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	92323694	BOY
EOY	99482264	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	1914712	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	3293756	ReconciliationUnrealizedInvest
Reconcilation Other Changes	1720515	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	1	GrantsOtherOrganizations
Grants Other Organizations	$13,643	GrantsOtherOrganizationsAmount
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	13643	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Explanation of Lobbying Activities:	Identifier
Return Reference	Part II-B, Line 1:	ReturnReference
Explanation	Monadnock Community Hospital 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 Monadnock Hospital in furtherance of its exempt purpose. Monadnock Hospital does not directly perform any lobbying activities. NHHA, Portion of dues available for lobbying: $10,300 AHA, Portion of dues available for lobbying: $3,343	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	8591510	BeginningOfYearBalance
Contributions	1127458	Contributions
Investment Earnings Or Losses	819722	InvestmentEarningsOrLosses
Other Expenditures	234544	OtherExpenditures
End Of Year Balance	10304146	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	8314205	BeginningOfYearBalance
Contributions	486841	Contributions
Investment Earnings Or Losses	948400	InvestmentEarningsOrLosses
Other Expenditures	1157936	OtherExpenditures
End Of Year Balance	8591510	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	10031251	BeginningOfYearBalance
Contributions	884501	Contributions
Investment Earnings Or Losses	93759	InvestmentEarningsOrLosses
Other Expenditures	2695306	OtherExpenditures
End Of Year Balance	8314205	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	10623404	BeginningOfYearBalance
Contributions	1266761	Contributions
Investment Earnings Or Losses	200900	InvestmentEarningsOrLosses
Other Expenditures	2059814	OtherExpenditures
End Of Year Balance	10031251	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	10282555	BeginningOfYearBalance
Contributions	1164871	Contributions
Investment Earnings Or Losses	-100136	InvestmentEarningsOrLosses
Other Expenditures	723886	OtherExpenditures
End Of Year Balance	10623404	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.25990	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.74010	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.00000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	1	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	966127	OtherCostOrOtherBasis
Book Value	966127	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	34451014	OtherCostOrOtherBasis
Depreciation	16051731	Depreciation
Book Value	18399283	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	955434	OtherCostOrOtherBasis
Depreciation	409421	Depreciation
Book Value	546013	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	43477404	OtherCostOrOtherBasis
Depreciation	25857258	Depreciation
Book Value	17620146	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	544547	OtherCostOrOtherBasis
Book Value	544547	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	38076116	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
Interest Rate Swap Agreements	$3,126,651
Estimated Third-Party Settlements	$8,127,025

Field	Value	IRS element (for citing)
Total Of Amounts	11253676	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	83668952	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	3293756	NetUnrealizedGainsInvestments
Other Revenues	1720515	OtherRevenues
Revenue Not Rptd F990	5014271	RevenueNotRptdF990
Revenue Subtotal	78654681	RevenueSubtotal
Other Revenues Not Included	434588	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	434588	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	79089269	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	76739969	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	76739969	ExpensesSubtotal
Other Expenses Not Included	434588	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	434588	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	77174557	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Description of Intended Use of Endowment Funds:	Part V, Line 4:	Temporarily restricted assets are available for health care services, including the purchase of equipment and providing health education and programs. The income and dividends on permanently restricted net assets are generally used to support health care services and for capital purchases of property and equipment.
Description of Uncertain Tax Positions Under FIN 48:	Part X, Line 2:	The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. 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 or disclosure in the accompanying financial statements. With few exceptions, the Hospital is no longer subject to tax examination by the U.S. federal or state tax authorities for years prior to 2010.
Part XI, Line 2d - Other Adjustments:		Increase in fair value of interest rate swap agreement 1,720,515.
Part XI, Line 4b - Other Adjustments:		Fundraising Expenses 434,588.
Part XII, Line 4b - Other Adjustments:		Fundraising Expenses 434,588.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	MCH Golf Classic	NameOfEvent1
Gross Receipts Event1	61265	GrossReceiptsEvent1
Charitable Contributions Event1	44800	CharitableContributionsEvent1
Gross Revenue Event1	16465	GrossRevenueEvent1
Cash Prizes Event1	640	CashPrizesEvent1
Non Cash Prizes Event1	69	NonCashPrizesEvent1
Rent Facility Costs Event1	5800	RentFacilityCostsEvent1
Food And Beverage Event1	4800	FoodAndBeverageEvent1
Other Direct Expenses Event1	5918	OtherDirectExpensesEvent1
Gross Receipts Total	61265	GrossReceiptsTotal
Charitable Contributions Total	44800	CharitableContributionsTotal
Gross Revenue Total Events	16465	GrossRevenueTotalEvents
Cash Prizes Total Events	640	CashPrizesTotalEvents
Non Cash Prizes Total Events	69	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	5800	RentFacilityCostsTotalEvents
Food And Beverage Total Events	4800	FoodAndBeverageTotalEvents
Other Direct Expenses Total Events	5918	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	17227	DirectExpenseSummaryEvents
Net Income Summary	-762	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1905244	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	1905244	NetCommunityBenefitExpense
Percent Of Total Expense	0.02620	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5856824	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5981464	DirectOffsettingRevenue
Net Community Benefit Expense	-124640	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7762068	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5981464	DirectOffsettingRevenue
Net Community Benefit Expense	1780604	NetCommunityBenefitExpense
Percent Of Total Expense	0.02620	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	740581	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	740581	NetCommunityBenefitExpense
Percent Of Total Expense	0.01020	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15960	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	15960	NetCommunityBenefitExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1653792	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	1653792	NetCommunityBenefitExpense
Percent Of Total Expense	0.02270	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	133550	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	133550	NetCommunityBenefitExpense
Percent Of Total Expense	0.00180	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2543883	TotalCommunityBenefitExpense
Net Community Benefit Expense	2543883	NetCommunityBenefitExpense
Percent Of Total Expense	0.03490	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10305951	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5981464	DirectOffsettingRevenue
Net Community Benefit Expense	4324487	NetCommunityBenefitExpense
Percent Of Total Expense	0.06110	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$2,470,191	BadDebtExpenseAmount
Amount Attributable To	232841	AmountAttributableTo
Amount Reimbursed By Medicare	20382727	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	20254947	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	127780	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Monadnock Community Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	452 Old Street Road	AddressLine1
City	Peterborough	City
State	NH	State
ZIP Code	03458	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Monadnock Community Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Insurance Status	X	InsuranceStatus
Medicaid Medicare	X	MedicaidMedicare
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Permit Lien On Residence	X	PermitLienOnResidence
Collection Activities	1	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Lien On Residence	X	LienOnResidence
Notify Upon Admission	X	NotifyUponAdmission
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Other Actions Taken	X	OtherActionsTaken
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	1	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	14	NumberOfOtherFacilities

Other Facilities OtherFacilities (14 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
Bond Wellness Center
458 Old Street Road Wellness Center	Peterborough	NH	03458	Medically-based fitness center and rehabilitation services
Monadnock Orthopaedic Associates
458 Old Street Road Wellness Center	Peterborough	NH	03458	Physician practice
Monadnock Regional Pediatrics
454 Old Street Road MAB Building	Peterborough	NH	03458	Physician practice
Jaffrey Family MedicinePT Satellite
82 Peterborough Street	Jaffrey	NH	03452	Physician practice
Monadnock Family Care
454 Old Street Road MAB Building	Peterborough	NH	03458	Physician practice
North Meadow
154 Hancock Road	Peterborough	NH	03458	Physician practice
Monadnock Internists
454 Old Street Road MAB Building	Peterborough	NH	03458	Physician practice
Peterborough Internal Medicine
454 Old Street Road MAB Building	Peterborough	NH	03458	Physician practice
Monadnock Behavioral Health
458 Old Street Road Wellness Center	Peterborough	NH	03458	Physician practice
Rindge Family Practice
145 US Route 202	Rindge	NH	03461	Physician practice
Monadnock Surgical Associates
454 Old Street Road MAB Building	Peterborough	NH	03458	Physician practice
Antrim Medical Group
12 Elm Street	Antrim	NH	03440	Physician practice
New Ipswich Family Medicine
821 Turnpike Road	New Ipswich	NH	03071	Physician practice
Neurology Center
458 Old Street Road Wellness Center	Peterborough	NH	03458	Physician practice

Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
Part I, Line 3c: N/A
Part I, Line 6a: N/A
Part I, Line 7: Charity care and means tested programs use the cost to charge ratio as their methodology. This Hospital calculates the ratio in a manner consistent with worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of cost to charges.
Part I, Line 7g: Included in the subsidized health services activities reported for FY 2013 are unreimbursed costs of $591,122 attributed to an outpatient behavioral health practice and $947,167 related to emergency and trauma services.
Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 4467531.
Part II: See previous footnotes.
Part III, Line 4: The amount reported on Part III line 2 was derived by applying the cost to charge ratio against the amount of bad debt expense reported on Form 990, Part IX, line 25, column (A) ($4,467,531). Accounts written off to bad debt include gross charges being written off less any payments received against those charges. Any cash collected on accounts previously written off is included as an offset to bad debt expense as recoveries of bad debt. The Hospital calculates the ratio in a manner consistent with worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of costs to charges. We estimated the amount of charity care in bad debt expense based on the number of applications for charity care denied due to lack of complete documentation against the average charity care write off at cost per qualified patient. We believe the amount is minimal based on our extensive efforts to educate patients and staff about our various payment plans and financial grant programs to ensure that patients who qualify for any of our programs utilize them. Depending on the specific circumstances a patient may be eligible for charity care, discounted care, payment programs, or a combination of the above. Due to these efforts, we believe that amounts written off to bad debt that could qualify as charity care is minimal.Footnote 1 to the audited financial statements of the Hospital contains the following to address bad debt: Accounts Receivable - Accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to the allowance for doubtful accounts 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 allowance for doubtful accounts and a credit to accounts receivable.
Part III, Line 8: Medicare allowable costs for the Medicare cost report are reported in accordance with CMS guidelines using the cost to charge ratio methodology.
Part III, Line 9b: As of 9/30/2011 Monadnock Community Hospital has a written credit and collection policy. Described within that policy are the collection practices and bad debt processes that are followed for patients who are known to qualify for charity care or financial assistance. The Organization maintains a Financial Assistance Program (FAP) database which is maintained by the Social Services Department of MCH. The Patient Financial Services (PFS) staff reference this database for approval status and eligibility amounts, identifying any account(s) where the discount will apply. Internal FAP insurance plans are applied to those accounts and related discount amounts are adjusted in the billing system. Remaining balances are expected to be paid in full by the patient. Payment plans may be requested by the patient and are established by the Financial Grant Coordinator based on the patient's available income and assets. Accounts are annotated to reflect payment arrangements. During bad debt processing, designated staff evaluate accounts listed as collection review for potential bad debt write off. This process includes an examination of account history for indication of FAP application.
Part V, Section B, Line 3: Monadnock Community Hospital (MCH) used a multi-phased methodology to achieve the objectives of the assessment. The methodology included the following stages: establishing a leadership team to provide project guidance and insight regarding local health resources and perspectives of community needs; strategic secondary research; four qualitative discussion groups with healthcare consumers, service providers, and other community opinion leaders; needs prioritization process. Establishing a Leadership Team - The MCH Leadership Group was established early in the project process in order to develop communication channels with, and to learn about the insights of, a diverse set of community stakeholders. In order to generate the information, MCH incorporated input from persons who represent the broad interest of the community served by the hospital facility, including those with special knowledge of our expertise in public health. Group members were selected based upon their perceived community health vision, knowledge, and power to impact the well-being of the community. The steering committee also offered critical feedback on quantitative data, refined the list of community needs, helped develop the database of available resources, and participated in quantitative and qualitative research methods to build the prioritized list of community needs identified in the report. Qualitative Discussion Groups - MCH conducted five discussion groups with individuals from a breadth of community groups regarding their perception of healthcare service gaps. The groups included in-depth discussion about topics such as community strengths, service gaps, needs prioritization, and ways that MCH may be able to help address community needs. The information gleaned was used to help triangulate statistical data and qualitative information collected through the other research modalities. The discussion groups included the following community segments: leadership group members (executives from a diverse range of organizations that have direct contact with healthcare consumers and/or provide affiliated services), healthcare consumers (consumer sectors included the homeless, people from diverse age groups and economic strata, and individuals with varying degrees of chronic illness), and community opinion leaders (healthcare consumers living in the MCH service area and also providing community services such as faith-based networking and in-school nursing).	Monadnock Community Hospital
Part V, Section B, Line 7: The Hospital will not directly address all the needs identified in the CHNA at the time of this filing. The community needs not addressed in the Hospital's implementation plan scored lower on the prioritization rationale, were determined as not being in the purview of the Hospital, and/or are better addressed by other community organizations. The needs not included in the Hospital's implementation plan include: parenting classes, lower insurance rates, and dental health services for adults and seniors.	Monadnock Community Hospital
Part V, Section B, Line 14g: The complete financial assistance policy is available upon request and in the waiting rooms. Instructions on how to find out more about financial assistance are posted on the Hospital's website, on the back of all billing invoices, and published in a brochure that is available around the Hospital and in the admissions office.Additionally, the financial assistance program is communicated to all employees during the orientation process.	Monadnock Community Hospital
Part V, Section B, Line 18e: Line E: Description from Credit and Collections Policy:The Hospital Patient Financial Services (PFS) Department shall develop and implement billing and collection procedures designed to maintain an adequate cash flow, keep accounts receivable at an acceptable level, and identify and write-off bad debts in a timely fashion. Monadnock Community Hospital contracts with an agency to process all self-pay accounts and self-pay after insurance balance statements/letters. I. Self-pay accounts and self-pay balances remaining after insurance adjudication shall be transferred to the agency on a weekly basis. The cycle for collections is three statements and/or letters and two phone call series spaced approximately thirty (30) days apart. The statements shall include:a. Previous balance (unless this is the first statement).b. Activity since last statement (except those accounts that went to a $0.00 balance).c. Current balance due.d. Telephone number(s) for inquiries concerning the statement.e. Status or reminder message where appropriate.f. Availability for the use of a credit card for payment.g. Information regarding Financial Assistance and Medication Bridge Programs.h. Return envelope.II. In the event that statements or letters are returned by the postal service as undeliverable for reasons such as "moved, left no forwarding address," "forwarding order expired," or "no such address" the agency will indicate on the daily report "mail returned." PFS staff will review system for the correct address and will make corrections within the computer system and correspondence will be re-mailed. If no correct or current information can be obtained, the specific account(s) shall be flagged for referral to an outside collection agency equipped to handle this type of situation (see bad debt processing footnote).In addition, on a weekly basis, the FAP staff run system reports to identify outpatient visits classified as self-pay. Based on the information in these reports, the guarantor of each visit is sent a financial assistance application in the mail. Determination of eligibility is contingent upon receiving a completed application and required documentation from the patient and/or guarantor.	Monadnock Community Hospital
Part V, Section B, Line 22: The State of NH does not allow healthcare providers to bill auto insurance companies directly in regards to a motor vehicle accident. The patient, when treated, has the choice to either be billed directly and they will then bill their auto insurance company or we can bill their health insurance company directly.	Monadnock Community Hospital
Part VI, Line 2: The State of NH, under RSA 7:32-f, requires every healthcare charitable trust, either alone or in conjunction with other healthcare charitable trusts in its community, to conduct a Community Health Needs Assessment to assist in determining the activities to be included in its community benefits plan. The needs assessment process includes consultation with members of the public, community organizations, service providers, and local government officials in the entity's service area to identify and prioritize the community needs that the health care entity can address directly or in collaboration with others. The Community Health Needs Assessment is updated at least every 5 years, most recently in 2012. In 2007, the Regional Community Benefits Steering Committee was formed to prepare a single Community Benefits Needs Assessment for the Monadnock Region. The work group consisted of representatives from multiple organizations, including Monadnock Community Hospital. Based on the needs assessment and community engagement process, the priority needs and health concerns of the community MCH serves include access to care - driven by financial barriers and/or availability of primary care, availability of behavioral health care, general socioeconomic issues, and transportation services. Monadnock Community Hospital used this information to help focus its community benefit efforts to meet the priority needs identified in the community benefit plan. In addition, other needs or services not specifically identified in the community needs assessment, but addressed under the Organization's community benefit plan include availability of dental or oral health care (via the Organization's Monadnock Healthy Teeth to Toes program which focuses on dental hygiene and care, nutrition, and daily physical activity for children ages kindergarten to third grade) and availability of prescription medication (via the Organization's Medication Bridge program designed to help eligible patients apply for assistance programs that provide free or discounted prescription medications).
Part VI, Line 3: MCH is committed to providing quality healthcare to anyone in need of services, regardless of ability to pay. We understand patients may not have the finances to pay for their healthcare services and medications, and do not want this to prevent anyone from receiving necessary treatment. As part of the Hospital's mission to the communities we serve, we have developed programs to help meet the needs of our patients who meet income eligibility. Through our Financial Assistance and Medication Bridge Programs, we have been providing financial assistance to those qualifying for many years. We reach out to our patients in many different ways to ensure they are aware that help is available and to guide them through the process. Brochures and signage are posted in high traffic areas and all employees of MCH are informed about the Financial Assistance Program during orientation. When a patient goes through the registration process at the Hospital the staff are trained to inform uninsured or underinsured patients about the Monadnock Community Hospital Financial Assistance and the New Hampshire Health Access programs and that there is assistance available within the Hospital to help with the application process. In addition, any time a patient calls customer service, the representative is trained to help identify and offer support to patients who may require financial assistance. Patients may qualify for free care, discounted care, payment plans or a combination of the above. Assistance is also provided in applying to federal and state programs for those who qualify.
Part VI, Line 4: The Hospital's primary service area consists of 14 towns, including Antrim, Bennington, Dublin, Francestown, Greenfield, Greenville, Hancock, Jaffrey, Mason, New Ipswich, Peterborough, Rindge, Sharon, and Temple. The Hospital serves the general population of the primary service area referenced above.
Part VI, Line 5: Monadnock Community Hospital is a critical access hospital located in the Monadnock Region of NH. Our mission is to improve the health and well-being of our community. The Hospital is served by a board of trustees consisting of local citizens active in their community and its organizations. The majority of the board is not employed by the Hospital and consists of local community and business representatives as well as medical staff. The Hospital is committed to giving back to the community to the greatest extent possible. Monadnock Community Hospital supports thousands of individuals and families with free or reduced-fee services and programs. Our Financial Assistance Program administered by the Social Services Department helps families and individuals in need with access to health care and other available community services such as catastrophic care, fuel assistance, meals on wheels, food banks, and visiting nurses. Other examples of the Hospital's effort to reach our patients beyond traditional hospital services include access to free or reduced cost medications through our Medication Bridge program; educating children on the importance of good oral hygiene, eating health, and daily physical activity through our Monadnock Healthy Teeth to Toes program; training for community agencies such as local volunteer fire and rescue personnel; prevention and wellness education including nutrition, smoking cessation and dealing with stress; providing regular community seminars regarding timely health topics; and screenings for important health issues such as breast cancer. These are just a few of the many areas where we are reaching out to others to assure they are cared for well.
Part VI, Line 6: N/A
NH	Reports Filed With States	Part VI, Line 7

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	1	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Gregory Kriebel MD part year
Ex-Officio w/ Voting Rights	211991	0	0	0	2780	0	1989	0	21687	0	238447	0	0	0
Peter L Gosline
Chief Executive Officer	263833	0	11213	0	22113	0	58560	0	20999	0	376718	0	0	0
Richard Scheinblum
VP Finance/CFO	160949	0	0	0	1390	0	1568	0	9193	0	173100	0	0	0
Terrence McNamara DO
Physician	393083	0	125463	0	2378	0	0	0	21324	0	542248	0	0	0
Ronald Michalak MD
Physician	497384	0	0	0	420	0	0	0	28170	0	525974	0	0	0
Phillip Vuocolo MD
Surgeon	446323	0	20000	0	1806	0	0	0	26653	0	494782	0	0	0
Shawn Harrington MD
Physician	380790	0	70948	0	420	0	0	0	27473	0	479631	0	0	0
Jennifer Peppers MD
Surgeon	285949	0	0	0	49124	0	0	0	16291	0	351364	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference

ExplanationExplanation

Part I, Line 4b

MCH sponsors a split-dollar life insurance employee benefit program for certain officers and key employees. Split-dollar life insurance is an arrangement in which the employee is the owner of the life insurance policy and the premiums are paid by both the employer and employee. Pursuant to MCH's split-dollar agreement, and the collateral assignment therein, the employer's share of the policy premiums paid is recovered either upon termination of the policy or at the death of the participant. Note that the split-dollar arrangement is part of an employee benefit program and economically not a direct extension of credit. Furthermore, the reportable compensation of the respective employees includes the annual value of the life insurance coverage. The present value of the policies is reported on MCH's balance sheet in Part X, Line 15 as an Other Asset. The reported present value of this asset as of 9/30/13 was $681,182. Premiums paid during the fiscal year ended 9/30/13 totaled $74,250, which included catch-up payments for the prior year. Included in Mr. Gosline's 2012 deferred compensation in Part VII and Schedule J, Part II, column (C) is $56,063, which represents the net increase as of FYE 9/30/13 in the cash surrender value (CSV) of his split-dollar life insurance policy over amounts previously reported on Form 990. Mr. Gosline was hired in 1999 and the policy was purchased in 2001. This policy is intended to provide an additional retirement benefit for Mr. Gosline's multiple years of service.

Part I, Line 7

MCH compensates physicians utilizing productivity targets based on RVU (relative value units). In addition, the Compensation Committee recommends to the full board, annually, the variable pay award that may be issued to the Hospital's CEO. The payment of the award is discretionary and is subject to meeting the pre-determined goals of the Organization.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	NHBFA Revenue Bonds Series 2013	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	021304598	IssuerEIN
Date Issued	2013-01-01	DateIssued
Issue Price	27240000	IssuePrice
Description Of Purpose	refinance existing Series 2007 and 2009 bonds	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	27240000	TotalProceeds
Refunding Escrow	27057466	RefundingEscrow
Issuance Costs From Proceeds	182534	IssuanceCostsFromProceeds
Year Of Subst Completion	2013	YearOfSubstCompletion
Current Refunding	0	CurrentRefunding
Advance Refunding	1	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00000	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00000	TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test	0	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs	0	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiled
Rebate Not Due Yet	0	RebateNotDueYet
Exception To Rebate	1	ExceptionToRebate
No Rebate Due	0	NoRebateDue
Variable Rate Issue	1	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	0	ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	Schedule K, Part III, Line 9, Part IV, line 7 and Part V:	Identifier
Return Reference	Compliance and Monitoring:	ReturnReference
Explanation	Although formal policies are not in place in regards to the remediation of our bond, the monitoring requirements of section 148, and procedures to ensure that violations are timely identified and corrected, Mondanock Community Hospital has compliance checks in place that substantiate these requirements. Below is a list of all compliance checks that Monadnock Community Hospital has in place to monitor the 2013 Bond Issue: 1. Covenant calculations performed monthly as part of the Financial Scorecard preparation which is reviewed by the MCH Board of Trustees 2. Covenant calculations are performed for each quarter and reported to the bond issuer, TD Bank 3. Covenant certificate is signed each quarter by the CFO and reported to the bond issuer, TD Bank 4. Financial statements and statistical reports are sent to the bond issuer, TD Bank, on a quarterly basis 5. Annual Operating and Capital budgets are reported to the bond issuer, TD Bank 6. A No Event of Default certificate is signed by the CFO annually and reported to the bond issuer, TD Bank 6. Annual Audited Financial statements are reported to the bond issuer, TD Bank Each of these items that are reported to TD Bank has a specific deadline for completion as outlined in the bond documents.	Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	Patti Potter	NamePerson

Field	Value	IRS element (for citing)
Relationship	Spouse to Trustee	Relationship
Amount Of Transaction	20239	AmountOfTransaction
Description Of Transaction	Mrs. Patti Potter is the spouse of Dr. James Potter, who is a trustee on MCH's Board and listed in Part VII. Mrs. Potter is compensated as an employee of MCH. The W-2 compensation paid is in accordance with MCH's standard employment practices and policies.	DescriptionOfTransaction
Sharing Of Revenues	0	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Form 990, Part VI, Section A, line 4	Monadnock Community Hospital's Board of Trustees made the following amendments to the bylaws during the fiscal year, which were formally adopted as of October 25, 2012: 1. Added a required minimum quorum of the majority of members for the Compensation, Executive, and Governance committees. 2. Made an allowance for the Executive Committee to appoint a special Compensation Committee to be responsible for the annual performance review of the Organization's President/CEO, including submitting a salary recommendation and submission of the Committee's findings in writing to the Board of Trustees. The Executive Commmittee may choose to continue performing this function itself.
Form 990, Part VI, Section B, line 11	A draft of the Form 990 is initially reviewed in detail by key finance employees. Thereafter, the final draft is presented to the full board prior to filing with the IRS. Each member of the board is provided with a draft of the Form 990 in advance of the board meeting.
Form 990, Part VI, Section B, line 12c	On an annual basis, the Organization provides all administrators/directors/managers, Board Members, and medical staff members with the conflict of interest policy. Said individuals are required to complete a new conflict of interest disclosure on an annual basis. Any conflicts of interest noted are reviewed by the Chair of the Board, in conjunction with the Corporate Compliance Officer. If the conflict of interest appears to meet the policy definitions requiring full Board review, the President of the Board takes this to the full Board meeting, and it is discussed, and appropriate action is taken (in compliance with state and federal requirements). The conflict of interest statement requires signatories to inform the Hospital of any conflict of interest that occurs at any time throughout the year. If a conflict of interest arises during the year, it is reviewed by the Compliance Officer, and if necessary, is taken to the Board President/Board. The Compliance Officer confers with legal counsel with regard to conflicts of interest, if there is any question regarding the potential conflict.
Form 990, Part VI, Section B, line 15	The Organization has a written executive compensation policy and procedure. Under this policy, the Compensation Committee, comprised of delegated representatives of the Board of Trustees, has the power and responsibility to determine the Hospital's approach to executive compensation and review the performance of the CEO. The Compensation Committee has the responsibility to set, monitor and review the base salary of the CEO. The Committee maintains minutes of sessions and final recommendations and determinations in accordance with the Board of Trustee guidelines. Annually, market data is reviewed by the Committee to determine the appropriate salary for the Hospital's CEO based upon identified standards. At the end of the time period, the Committee reviews to what extent stated goals were met and recommends an amount for the variable pay award to be approved by the full board.
Form 990, Part VI, Section C, line 19	Monadnock Community Hospital files audited financial statements annually with the New Hampshire Attorney General's Charitable Trust Unit and informs the Director of Charitable Trusts of pecuniary benefit transactions that have occurred between MCH and a board member or officer. Notices of such transactions of $5,000 or more are also published in the local newspaper in accordance with NH RSA 7:19-A, II(D). Current copies of the bylaws, conflict of interest Policy and Form 990 are on file with the Charitable Trust Unit. The Hospital also makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part VII, Section A, Column D	The 2012 compensation reported for Dr. Kriebel and Dr. Potter was paid by Monadnock Community Hospital for their services as physicians. Neither was compensated for their services as an ex-officio voting members of MCH's Board of Trustees.	Reportable Compensation for Services as Physician
Form 990, Part XI, line 9:	Change in fair value of interest rate swap agreements 1,720,515.	Changes in Net Assets or Fund Balances:
Form 990, Part XI, Line 2C	The Audit Committee oversees the audit process for Monadnock Hospital. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit for the fiscal years ended 9/30/12 and 9/30/13.	Audit Review Process
Form 990, Part I, Principal Officer:	In April of 2013, Peter Gosline, President and CEO, announced plans to retire from his position with the Hospital. In February of 2014, Cynthia McGuire was hired to become the next President and CEO of Monadnock Hospital. During the fiscal year covered by this 990 filing, Mr. Gosline was still acting President and CEO. Page 1 has been updated to reflect the new President and CEO, Ms. McGuire, however, Page 7, Part VII will still list Mr. Gosline as President and CEO.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	Monadnock Health Services - INACTIVE	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	452 Old Street Road	AddressLine1
City	Peterborough	City
State	NH	State
ZIP Code	03458	ZIPCode

Field	Value	IRS element (for citing)
EIN	020420789	EIN
Primary Activities	Inactive	PrimaryActivities
Legal Domicile State	NH	LegalDomicileState
Exempt Code Section	501(C)(3)	ExemptCodeSection
Public Charity Status	11 Type I	PublicCharityStatus
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Controlled Org	0	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg