SPEARE MEMORIAL HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SPEARE MEMORIAL HOSPITAL (EIN 02-0226774)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-02-14
IRS object ID
201310459349301016
Schema version
2011v1.2
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-02-14T09:25:58-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN020476956EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1TYLER SIMMS & STSAUVEUR CPAS PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line119 MORGAN DRIVEAddressLine1
CityLEBANONCity
StateNHState
ZIP Code03766ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN020226774EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SPEARE MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSPEANameControl
Phone6032382231Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line116 HOSPITAL ROADAddressLine1
CityPLYMOUTHCity
StateNHState
ZIP Code03264ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHELLE MCEWENName
TitlePRESIDENT/CEOTitle
Phone6035361120Phone
Date Signed2013-01-28DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameW JAY SIMMSName
PTINP00435321PTIN
Phone6036530044Phone
Date Prepared2013-01-28DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHELLE MCEWENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line116 HOSPITAL ROADAddressLine1
CityPLYMOUTHCity
StateNHState
ZIP Code03264ZIPCode
FieldValueIRS element (for citing)
Gross Receipts60262973GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteSPEAREHOSPITAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1899YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE INPATIENT, OUTPATIENT AND PHYSICIAN HEALTH CARE SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees454TotalNbrEmployees
Total Nbr Volunteers75TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year164713ContributionsGrantsPriorYear
Contributions Grants Current Year250331ContributionsGrantsCurrentYear
Program Service Revenue Prior Year50484604ProgramServiceRevenuePriorYear
Program Service Revenue CY55734614ProgramServiceRevenueCY
Investment Income Prior Year89775InvestmentIncomePriorYear
Investment Income Current Year471707InvestmentIncomeCurrentYear
Other Revenue Prior Year398985OtherRevenuePriorYear
Other Revenue Current Year311738OtherRevenueCurrentYear
Total Revenue Prior Year51138077TotalRevenuePriorYear
Total Revenue Current Year56768390TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year310000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY328000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year22016446SalariesEtcPriorYear
Salaries Etc Current Year21926043SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year120444TotalFundrsngExpCurrentYear
Other Expense Prior Year27815095OtherExpensePriorYear
Other Expenses Current Year31231672OtherExpensesCurrentYear
Total Expenses Prior Year50141541TotalExpensesPriorYear
Total Expenses Current Year53485715TotalExpensesCurrentYear
Revenues Less Expenses Prior Year996536RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3282675RevenuesLessExpensesCY
Total Assets BOY59183953TotalAssetsBOY
Total Assets EOY65430916TotalAssetsEOY
Total Liabilities BOY25075585TotalLiabilitiesBOY
Total Liabilities EOY27993419TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY34108368NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY37437497NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO MAINTAIN A HOSPITAL AND OTHER SUCH INSTITUTIONS WITHIN THE STATE OF NEW HAMPSHIRE, WITH FACILITIES THAT INCLUDE MEDICAL SERVICES TO PROVIDE FOR THE DIAGNOSIS AND TREATMENT OF PATIENTS THAT MAY REQUIRE INPATIENT, OUTPATIENT, EMERGENCY CARE AND OTHER PURSUITS DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. SMH DOES NOT DISCRIMINATE RELATIVE TO RACE, RELIGION OR NATIONAL ORIGIN, ABILITY TO PAY AND WILL ASSURE THAT ALL PATIENTS RECEIVE THE SAME LEVEL OF CARE THROUGH QUALITY ASSESSMENT MONITORING AND IMPROVEMENT ACTIVITIES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense48797157Expense
Grants328000Grants
Revenue55734614Revenue
DescriptionSMH IS A 25-BED ACUTE-CARE HOSPITAL THAT PROVIDES INPATIENT AND OUTPATIENT SERVICES TO THE SURROUNDING COMMUNITY.Description
Total Program Service Expense48797157TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109631NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees454NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1FINANCE DIRECTORBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6032382231TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1SMH 16 HOSPITAL ROADAddressLine1
CityPLYMOUTHCity
StateNHState
ZIP Code03264ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
MICHELLE MCEWEN
HOSPITAL PRESIDENT/CEO40.00XX221494044849
CLINT HUTCHINS
CHAIR1.00XX000
STANLEY LEE FREEMAN
TREASURER1.00XX000
ELDWIN WIXSON
MEMBER1.00X000
SUSAN KARKHECK
SECRETARY1.00XX000
STEVE TAKSAR
AST. TREASURER1.00XX000
QUENTIN BLAINE
MEMBER1.00X000
SAM BRICKLEY II
MEMBER1.00X000
WILLIAM LARSEN
VICE CHAIR1.00XX000
ALISON RITZ
MEMBER1.00X000
JILL DUNCAN
MEMBER1.00X000
RONALD SIBLEY
MEMBER1.00X000
LINDA CRAWFORD MD
MEMBER1.00X000
DANA MERRITHEW MD
MEMBER/PHYSICIAN40.00X203800030241
RICHARD F WERKOWSKI
CFO40.00X134320030929
MICHAEL P GIOVAN MD
PHYSICIAN40.00415561086588X
JOSEPH CASEY MD
PHYSICIAN40.00289914088231X
VICTOR GENNARO MD
PHYSICIAN40.00400839086724X
STEVE F DANOSI MD
PHYSICIAN40.00444843092266X
TIMOTHY R LYONS MD
PHYSICIAN40.00312794065008X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2423565TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation524836TotalOtherCompensation
Number Individuals GT100 K23NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events4335FundraisingEvents
Government Grants10587GovernmentGrants
All Other Contributions235409AllOtherContributions
Total Contributions250331TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE6241005491528854915288
OTHER OPERATING REVENU900099819326819326
FieldValueIRS element (for citing)
Total Program Service Revenue55734614TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column368739TotalRevenueColumn
Exclusion$368,739ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real40704Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real45036Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-4332Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-4332TotalRevenueColumn
Exclusion-$4,332ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3486681Securities
Other48306Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2958252Securities
Other473767Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities528429Securities
Other-425461Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column102968TotalRevenueColumn
Exclusion$102,968ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events37960GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events4335CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses17528FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column20432TotalRevenueColumn
Exclusion$20,432ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
PHARMACY INCOME446110163247$163,247
CAFETERIA INCOME722210132391$132,391
FieldValueIRS element (for citing)
Total Other Revenue295638TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column56768390TotalRevenueColumn
Related Or Exempt Function Income55734614RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$783,445ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total328000Total
Program Services328000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total471159Total
Management And General471159ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total15605376Total
Program Services13369627ProgramServices
Management And General2167978ManagementAndGeneral
Fundraising67771Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1266332Total
Program Services1084750ProgramServices
Management And General176083ManagementAndGeneral
Fundraising5499Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3265946Total
Program Services2763600ProgramServices
Management And General488337ManagementAndGeneral
Fundraising14009Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1317230Total
Program Services1100502ProgramServices
Management And General211150ManagementAndGeneral
Fundraising5578Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total47664Total
Management And General47664ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total57484Total
Management And General57484ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total75494Total
Management And General75494ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total95895Total
Program Services95895ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4644123Total
Program Services4589718ProgramServices
Management And General32912ManagementAndGeneral
Fundraising21493Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1296891Total
Program Services1222449ProgramServices
Management And General74442ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total86871Total
Program Services71415ProgramServices
Management And General11727ManagementAndGeneral
Fundraising3729Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total728Total
Program Services728ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total881456Total
Program Services881456ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3004309Total
Program Services3004309ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBT53427085342708
PURCHASED SERVICES521405251083081043041440
PHYSICIAN FEES & WAGES50370125037012
PROVIDER TAX STATE OF N22178232217823

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3229162Total
Program Services2578857ProgramServices
Management And General649380ManagementAndGeneral
Fundraising925Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total53485715Total
Program Services48797157ProgramServices
Management And General4568114ManagementAndGeneral
Fundraising120444Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4027602BOY
EOY7777432EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY939549BOY
EOY4454001EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2000BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7123855BOY
EOY7260625EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY2427998BOY
EOY2440850EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY777014BOY
EOY758600EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY363056BOY
EOY453318EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis44969716LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec19981250LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY25556373BOY
EOY24988466EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY12959711BOY
EOY13678453EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2826829BOY
EOY1609825EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY1032407BOY
EOY1014765EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1147559BOY
EOY994581EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY59183953BOY
EOY65430916EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2397560BOY
EOY2655504EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY16544082BOY
EOY16098028EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY920466BOY
EOY659554EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5213477BOY
EOY8580333EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25075585BOY
EOY27993419EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY33608916BOY
EOY36885858EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY233320BOY
EOY285507EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY266132BOY
EOY266132EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY34108368BOY
EOY37437497EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59183953BOY
EOY65430916EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3282675ReconcilationRevenueExpenses
Reconcilation Other Changes46454ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$11,160OtherActivitiesAmount
Total Lobbying Expenditures IIB11160TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationSPEARE MEMORIAL HOSPITAL IS A MEMBER OF THE NEW HAMPSHIRE HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS AVAILABLE FOR LOBBYING EXPENDITURES ON BEHALF OF SPEARE MEMORIAL HOSPITAL AND THE OTHER MEMBER ORGANIZATIONS IN FURTHERANCE OF THEIR EXEMPT PURPOSE. SPEARE MEMORIAL HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance271045BeginningOfYearBalance
Investment Earnings Or Losses7InvestmentEarningsOrLosses
Other Expenditures-854OtherExpenditures
End Of Year Balance270198EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance248354BeginningOfYearBalance
Contributions25000Contributions
Investment Earnings Or Losses5InvestmentEarningsOrLosses
Other Expenditures2314OtherExpenditures
End Of Year Balance271045EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance223344BeginningOfYearBalance
Contributions25000Contributions
Investment Earnings Or Losses10InvestmentEarningsOrLosses
End Of Year Balance248354EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance137808BeginningOfYearBalance
Contributions40000Contributions
Investment Earnings Or Losses45536InvestmentEarningsOrLosses
End Of Year Balance223344EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.98500PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.01500TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis564517OtherCostOrOtherBasis
Book Value564517BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27765313OtherCostOrOtherBasis
Depreciation10076101Depreciation
Book Value17689212BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis914205OtherCostOrOtherBasis
Depreciation430918Depreciation
Book Value483287BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis15343592OtherCostOrOtherBasis
Depreciation9474231Depreciation
Book Value5869361BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis382089OtherCostOrOtherBasis
Book Value382089BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24988466TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
OTHER CURRENT LIABILITIES$2,343,416
EST. THIRD-PARTY PAYER SETTLEMENTS$4,892,830
RELATED PARTY NOTE PAYABLE$335,426
INVESTMENT IN SUB-BOULDER$1,008,661
FieldValueIRS element (for citing)
Total Of Amounts8580333TotalOfAmounts
Total Revenue56768390TotalRevenue
Total Expenses53485715TotalExpenses
Excess Or Deficit For Year3282675ExcessOrDeficitForYear
Net Unrealized GL On Investments-100863NetUnrealizedGLOnInvestments
Other$147,317OtherAmount
Total Adjustments46454TotalAdjustments
Excess Or Deficit Per FS3329129ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt51068642TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-100863NetUnrealizedGainsInvestments
Other Revenues-5342708OtherRevenues
Revenue Not Rptd F990-5443571RevenueNotRptdF990
Revenue Subtotal56512213RevenueSubtotal
Investment Expenses Not Included75494InvestmentExpensesNotIncluded
Other Revenues Not Included180683OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt256177RevenueNotRptdOnFinStmt
Total Revenue Per Form99056768390TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt47739513TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal47739513ExpensesSubtotal
Investment Expenses Not Included275494InvestmentExpensesNotIncluded2
Other Expenses Not Included5670708OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt5746202ExpensesNotRptdOnFinStmt
Total Expenses Per Form99053485715TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE ENDOWMENT FUND IS USED TO SUPPORT OPERATIONS OF THE HOSPITAL.
PART XI, LINE 8 - OTHER ADJUSTMENTS:BAD DEBT EXPENSE ON MSHC RECEIVABLE 102,281. RENTAL EXPENSES 45,036. TOTAL TO SCHEDULE D, PART XI, LINE 8: 147,317.
PART XII, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT EXPENSE -5,342,708.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GRANT EXPENSE 328,000. BAD DEBT EXPENSE ON MSHC RECEIVABLE -102,281. RENTAL EXPENSES -45,036.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:GRANT EXPENSE 328,000. BAD DEBT EXPENSE 5,342,708.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event142295GrossReceiptsEvent1
Charitable Contributions Event14335CharitableContributionsEvent1
Gross Revenue Event137960GrossRevenueEvent1
Cash Prizes Event1690CashPrizesEvent1
Non Cash Prizes Event12653NonCashPrizesEvent1
Rent Facility Costs Event16336RentFacilityCostsEvent1
Other Direct Expenses Event17849OtherDirectExpensesEvent1
Gross Receipts Total42295GrossReceiptsTotal
Charitable Contributions Total4335CharitableContributionsTotal
Gross Revenue Total Events37960GrossRevenueTotalEvents
Cash Prizes Total Events690CashPrizesTotalEvents
Non Cash Prizes Total Events2653NonCashPrizesTotalEvents
Rent Facility Costs Total Events6336RentFacilityCostsTotalEvents
Other Direct Expenses Total Events7849OtherDirectExpensesTotalEvents
Direct Expense Summary Events17528DirectExpenseSummaryEvents
Net Income Summary20432NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage125.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage225.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2879301TotalCommunityBenefitExpense
Direct Offsetting Revenue1160965DirectOffsettingRevenue
Net Community Benefit Expense1718336NetCommunityBenefitExpense
Percent Of Total Expense0.03210PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense4966734TotalCommunityBenefitExpense
Direct Offsetting Revenue4599446DirectOffsettingRevenue
Net Community Benefit Expense367288NetCommunityBenefitExpense
Percent Of Total Expense0.00690PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7846035TotalCommunityBenefitExpense
Direct Offsetting Revenue5760411DirectOffsettingRevenue
Net Community Benefit Expense2085624NetCommunityBenefitExpense
Percent Of Total Expense0.03900PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense627875TotalCommunityBenefitExpense
Net Community Benefit Expense627875NetCommunityBenefitExpense
Percent Of Total Expense0.01170PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense243721TotalCommunityBenefitExpense
Net Community Benefit Expense243721NetCommunityBenefitExpense
Percent Of Total Expense0.00460PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense349860TotalCommunityBenefitExpense
Net Community Benefit Expense349860NetCommunityBenefitExpense
Percent Of Total Expense0.00650PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1221456TotalCommunityBenefitExpense
Net Community Benefit Expense1221456NetCommunityBenefitExpense
Percent Of Total Expense0.02280PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense9067491TotalCommunityBenefitExpense
Direct Offsetting Revenue5760411DirectOffsettingRevenue
Net Community Benefit Expense3307080NetCommunityBenefitExpense
Percent Of Total Expense0.06180PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,551,375BadDebtExpenseAmount
Amount Attributable To81644AmountAttributableTo
Amount Reimbursed By Medicare15102686AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare16936364CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1833678MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 PLYMOUTH REGIONAL REHABILITATION SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityPHYSICAL THERAPY, OCCUPATIONAL THERAPY & MEDICAL FITNESSDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.50000OrganizationProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SPEARE MEMORIAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line116 HOSPITAL ROADAddressLine1
CityPLYMOUTHCity
StateNHState
ZIP Code03264ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1YBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
OtherXOther
Needs Assessment Conducted11NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed1AllNeedsAddressed
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent100.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notify Upon AdmissionXNotifyUponAdmission
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART III, LINE 4: SMH HAS NO APPROPRIATE FOOTNOTE IN THE APPLICABLE AUDITED FINANCIAL STATEMENT. SMH HAS USED A RATIO OF COSTS TO CHARGES OF 48% IN DETERMINING THE COST OF BAD DEBT EXPENSE.
PART III, LINE 8: 100% OF THE SHORTFALL FROM MEDICARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE SOURCE USED TO DETERMINE THIS AMOUNT IS THE MEDICARE PAYMENTS AND EXPENSES MADE TO SPEARE MEMORIAL HOSPITAL. SERVICES THAT INCUR SUCH COSTS ARE PROVIDED BY THE HOSPITAL TO PROMOTE THE WELL-BEING OF THE COMMUNITY. THE SERVICES ARE RENDERED IN CONJUNCTION WITH THE HOSPITAL'S CHARITABLE TAX EXEMPT PURPOSE. TREATING THE SHORTFALL AS A COMMUNITY BENEFIT RELIEVES THE BURDEN ON LOCAL SOCIAL SERVICES AND GOVERNMENT SUPPORTED PROGRAMS.
PART III, LINE 9B: SPEARE MEMORIAL HOSPITAL HAS BOTH A COLLECTIONS POLICY, AND A CHARITY CARE POLICY THAT DESCRIBES CHARITY ELIGIBILITY AND THE STEPS TO BE COMPLETED BEFORE A PATIENT'S ACCOUNT IS WRITTEN OFF TO BAD DEBT.
PART V, SECTION B, LINE 1J: SPEARE MEMORIAL HOSPITAL CONDUCTED A COMMUNITY WIDE PUBLIC PRESENTATION OF THE NEEDS ASSESSMENT REPORT IN OCTOBER 2011.Y
PART VI, LINE 2: INFORMATION GATHERING THROUGH SURVEYS, FOCUS GROUPS, COMMUNITY REPRESENTATION, PUBLIC FORUMS, INPUT FROM HEALTH CARE PROVIDERS, INDUSTRY LEADERS, OUTSIDE CONSULTANTS,AND ANALYSIS OF INTERNAL DATA AND EXTERNAL DATA PROVIDED BY HOSPITAL ASSOCIATIONS, PAYERS, ETC.
PART VI, LINE 3: PATIENTS ARE EDUCATED AT TIME OF REGISTRATION OR THROUGH EDUCATIONAL MATERIALS THAT ARE DISTRIBUTED THROUGH THE HOSPITAL'S WEBSITE OR BY COMMUNITY OUTREACH. SPEARE MEMORIAL HOSPITAL IS A MEMBER OF A STATE-WID COMMUNITY HEALTH NETWORK THAT PROVIDES ASSISTANCE, SUPPORT,AND EDUCATION RELATING TO ELIGIBILITY ASSISTANCE.
PART VI, LINE 4: SPEARE MEMORIAL HOSPITAL IS LOCATED IN THE MOUNTAIN AND LAKES REGION OF NEW HAMPSHIRE AND PRIMARLY SERVES CONSTITUENTS IN GRAFTON COUNTY. GRAFTON COUNTY POPULATION SIZE IS APPROXIMATELY 86,000 WITHIN ITS 40 DISTINCT MUNICIPALITIES. ITS SERVICE AREA INCLUDES 17 TOWNS WITH AN APPROXIMATE TOTAL POPULATION OF 30,000.
PART VI, LINE 5: SPEARE MEMORIAL HOSPITAL PROVIDES PRESCRIPTION MEDICATION ASSISTANCE, PRIMARY-CARE CLINCS, MULTIPLE SUPPORT GROUPS, COMMUNITY EDUCATION PROGRAMS, SCHOOL DENTAL PROGRAM, ETC. AND HAS AFFLIATIONS AND PARTNERSHIPS WITH MANY COMMUNITY ORGANIZATIONS; AN OPEN MEDICAL STAFF AND COMMUNITY BOARD. OPERATING FUNDS ARE USED FOR ONGOING CAPITAL EXPENDITURES.
NHREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1MID-STATE HEALTH CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 BOULDER POINT DRIVE NO 1AddressLine1
CityPLYMOUTHCity
StateNHState
ZIP Code03264ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient020487172EINOfRecipient
IRC Section501 (C)(3)IRCSection
Amount Of Cash Grant328000AmountOfCashGrant
Method Of ValuationFMVMethodOfValuation
Purpose Of GrantCOMMUNITY BENEFIT GRANTPurposeOfGrant

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MICHELLE MCEWEN
22149400000181850266640266343000
DANA MERRITHEW MD
2038000000000302410234041000
RICHARD F WERKOWSKI
13432000000115740193550165249000
MICHAEL P GIOVAN MD
41556100000601400264480502149000
JOSEPH CASEY MD
28991400000617830264480378145000
VICTOR GENNARO MD
40083900000602760264480487563000
STEVE F DANOSI MD
44484300000658180264480537109000
TIMOTHY R LYONS MD
31279400000385600264480377802000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY
02027986664461TCH52004-11-0113520000CONSTRUCTION AND RENOVATION PROJECT000
NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY
02027986664461TCH52010-05-194000000CONSTRUCTION AND RENOVATION PROJECT000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
135200009781813187681320123220070011
400000058963394103720100011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
100000
000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2THE COMMUNITY RELATIONS DIRECTOR IS THE SPOUSE OF A BOARD MEMBER.
FORM 990, PART VI, SECTION A, LINE 3THE REHABILITATION DEPARTMENT IS NOW MANAGED BY ORTHOPEDIC HEALTH SERVICES. INC.
FORM 990, PART VI, SECTION A, LINE 6THE PROVISIONS OF SMH GOVERNING DOCUMENTS PROVIDES THE BOARD OF DIRECTORS IS COMPRISED OF ASSOCIATION MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7ATHE ASSOCIATION MEMBERS ELECT THE BOARD MEMBERS
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS REVIEWED BY THE HOSPITAL CFO AND THE PRESIDENT/CEO AND THE FINANCE COMMITTEE. THE TAX FORM 990 IS MADE AVAILABLE FOR REVIEW TO THE BOARD OF DIRECTORS. THE FORM 990 IS THEN SIGNED AND FILED.
FORM 990, PART VI, SECTION B, LINE 12CANNUAL COMPLIANCE FORM COMPLETED BY EACH MEMBER OF THE BOARD
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION FOR THE CEO IS DETERMINED VIA A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, COMPARISON OF OTHER ORGANIZATIONS 990 INFORMATION, BOARD APPROVAL AND WRITTEN EMPLOYMENT CONTACT.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -100,863. BAD DEBT EXPENSE ON MSHC RECEIVABLE 102,281. RENTAL EXPENSES 45,036. TOTAL TO FORM 990, PART XI, LINE 5: 46,454.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1SPEARE MEMORIAL AT BOULDER POINTBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1BOULDER POINT DRAddressLine1
CityPLYMOUTHCity
StateNHState
ZIP Code03264ZIPCode
FieldValueIRS element (for citing)
EIN263888977EIN
Primary ActivitiesREAL ESTATEPrimaryActivities
Legal Domicile StateNHLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 9PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SPEARE MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Org0ControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
SPEARE HEALTH VENTURE
16 HOSPITAL ROADPLYMOUTHNH03264020366565HEALTHCARE SERVICESNHC66812464941.00000
SPEARE HEALTH NETWORK LLC
16 HOSPITAL ROADPLYMOUTHNH03264043372339PHYSICIAN/HOSPITAL ORGANIZATIONNHC211370.50000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SPEARE MEMORIAL AT BOULDER POINT-LEASES ALL OF ITS SPACE TO SMH
J688208ACTUAL
SPEARE HEALTH VENTURE
D215673FAIR MARKET VALUE
SPEARE MEMORIAL AT BOULDER POINT
D2040520FAIR MARKET VALUE
SPEARE MEMORIAL AT BOULDER POINT
P8066ACTUAL
SPEARE MEMORIAL AT BOULDER POINT
E335426FAIR MARKET VALUE

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.