ALICE PECK DAY MEMORIAL HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: ALICE PECK DAY MEMORIAL HOSPITAL (EIN 02-0222791)
Tax period: 2011-10-01 to 2012-09-30
Filed: 2013-05-13
IRS object ID: 201311339349303561
Schema version: 2011v1.5
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 I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-13T14:12:49-05:00	Timestamp
Tax Period End Date	2012-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

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	650 Elm St Suite 302	AddressLine1
City	Manchester	City
State	NH	State
ZIP Code	03101	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	020222791	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Alice Peck Day Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% ELIZABETH LOUDERMILK	InCareOfName
Name Control	ALIC	NameControl
Phone	6034483121	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	10 ALICE PECK DAY DRIVE	AddressLine1
City	LEBANON	City
State	NH	State
ZIP Code	037662647	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	EVALIE M CROSBY	Name
Title	VP FINANCE & CFO	Title
Date Signed	2013-05-07	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	TIMOTHY R HEPBURN	Name
Phone	8002447444	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	HARRY G DORMAN III FACHE	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	10 ALICE PECK DAY DRIVE	AddressLine1
City	LEBANON	City
State	NH	State
ZIP Code	037662647	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	57641594	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.ALICEPECKDAY.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1943	YearFormation
State Legal Domicile	NH	StateLegalDomicile
Activity Or Mission Description	CRITICAL ACCESS HOSPITAL	ActivityOrMissionDescription
Nbr Voting Members Governing Body	22	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	18	NbrIndependentVotingMembers
Total Nbr Employees	516	TotalNbrEmployees
Total Nbr Volunteers	55	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	462323	ContributionsGrantsPriorYear
Contributions Grants Current Year	2648403	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	50223338	ProgramServiceRevenuePriorYear
Program Service Revenue CY	51719846	ProgramServiceRevenueCY
Investment Income Prior Year	106115	InvestmentIncomePriorYear
Investment Income Current Year	284746	InvestmentIncomeCurrentYear
Other Revenue Prior Year	40165	OtherRevenuePriorYear
Other Revenue Current Year	39312	OtherRevenueCurrentYear
Total Revenue Prior Year	50831941	TotalRevenuePriorYear
Total Revenue Current Year	54692307	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	41450	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	40000	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	28733724	SalariesEtcPriorYear
Salaries Etc Current Year	30812469	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	86744	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	256600	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	678665	TotalFundrsngExpCurrentYear
Other Expense Prior Year	20456710	OtherExpensePriorYear
Other Expenses Current Year	21328367	OtherExpensesCurrentYear
Total Expenses Prior Year	49318628	TotalExpensesPriorYear
Total Expenses Current Year	52437436	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1513313	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	2254871	RevenuesLessExpensesCY
Total Assets BOY	33647872	TotalAssetsBOY
Total Assets EOY	39832951	TotalAssetsEOY
Total Liabilities BOY	19624880	TotalLiabilitiesBOY
Total Liabilities EOY	23447694	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	14022992	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	16385257	NetAssetsOrFundBalancesEOY
Mission Description	THE MISSION OF ALICE PECK DAY MEMORIAL HOSPITAL IS TO PROVIDE PATIENT-FOCUSED HEALTHCARE SERVICES THAT ARE RESPONSIVE TO COMMUNITY NEEDS, TO PROMOTE WELLNESS, AND TO CONTINUALLY IMPROVE THE QUALITY OF HEALTHCARE SERVICES IN THE COMMUNITY.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	48446594	Expense
Grants	40000	Grants
Revenue	51628024	Revenue
Description	ALICE PECK DAY MEMORIAL HOSPITAL IS A COMMUNITY-BASED CRITICAL ACCESS HOSPITAL OPERATING IN LEBANON NH. THE HOSPITAL BEGAN AS A SMALL COTTAGE HOSPITAL IN 1932. FROM ITS HUMBLE BEGINNINGS, ALICE PECK DAY HAS CONTINUALLY DEMONSTRATED ITS COMMITMENT TO PROVIDE PATIENT-FOCUSED HEALTH CARE SERVICES WHICH IMPROVE THE QUALITY OF LIFE WITHIN ITS COMMUNITY AND PROMOTE WELLNESS FOR ALL. ALICE PECK DAY MEMORIAL HOSPITAL IS A CHARITABLE HEALTH CARE ORGANIZATION WHICH IS DEDICATED TO SERVING ITS COMMUNITY. THIS COMMITMENT INCLUDES GRANTING CREDIT TO PATIENTS, SUBSTANTIALLY ALL OF WHOM ARE LOCAL RESIDENTS. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THE ESTABLISHED RATES. COLLECTIONS ARE NOT PURSUED FOR AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY, THE ESTABLISHED COSTS OF THE SERVICES AND SUPPLIES PROVIDED AND EQUIVALENT SERVICE STATISTICS. FOR THE YEAR ENDED SEPTEMBER 30, 2012 CHARITY CARE AT A COST OF $688,102 WAS PROVIDED TO ELIGIBLE PATIENTS. ESTIMATED COSTS INCURRED IN EXCESS OF PAYMENT FOR INPATIENT AND OUTPATIENT SERVICES FOR MEDICAID PATIENTS IN THE YEAR ENDED SEPTEMBER 30, 2012 WERE $1,084,070. IN ADDITION TO THE CHARITY CARE SERVICES DESCRIBED ABOVE, THE HOSPITAL PROVIDED A NUMBER OF OTHER SERVICES FOR WHICH LITTLE OR NO PAYMENT WAS RECEIVED. SERVICES INCLUDED COMMUNITY HEALTH SERVICES, HEALTH PROFESSIONAL EDUCATION, COMMUNITY BUILDING ACTIVITIES, AND COMMUNITY BENEFIT PROGRAMS. SERVICES RANGED FROM COMMUNITY FLU CLINICS, UPPER VALLEY SMILES DENTAL PROGRAM, STUDENT AND PROFESSIONAL EDUCATION, EMERGENCY PHARMACY VOUCHERS AND MANY OTHER PROGRAMS WHICH CONTRIBUTED TO AND SUPPORTED OUR COMMUNITY. AS A LOCAL HOSPITAL, ALICE PECK DAY WORKS CLOSELY WITH COMMUNITY ORGANIZATIONS TO ADDRESS COMMUNITY NEEDS. ORGANIZATIONS THAT WERE BENEFICIARIES OF HOSPITAL STAFF TIME, MEETING SPACE, AND/OR MATERIALS INCLUDE: ALCOHOLICS ANONYMOUS, AARP, ARTHRITIS FOUNDATION, AWAKE SUPPORT GROUP, CHILDBIRTH EDUCATION AND POSTPARTUM MASSAGE, COLBY SAWYER COLLEGE, COMMUNITY HEALTH DEPARTMENT, GEISEL SCHOOL OF MEDICINE AT DARTMOUTH, GOOD NEIGHBOR HEALTH CLINIC, GRAFTON COUNTY SENIOR CENTER, GRAFTON COUNTY SENIOR CITIZEN'S COUNCIL, LEBANON AREA CHAMBER OF COMMERCE, LEBANON COLLEGE, LEBANON SCHOOL BIKE RODEO, LEBANON SCHOOL DISTRICT, NE INSTITUTE OF TECHNOLOGY, OVER-EATERS ANONYMOUS, RIVER VALLEY COMMUNITY COLLEGE, SAVVY SENIORS EXERCISE PROGRAM, UPPER VALLEY INTERFAITH PROJECT, UPPER VALLEY TURNING POINT, UPPER VALLEY SMILES DENTAL PROGRAM, VERMONT TECHNICAL COLLEGE, AND YALE UNIVERSITY. IN CERTAIN INSTANCES ASSISTANCE WAS PROVIDED TO THE COMMUNITY FOR WHICH NO VALUE CAN BE PLACED. THIS ASSISTANCE INCLUDED LEADERSHIP IN IDENTIFYING COMMUNITY NEEDS, STAFF COMMITMENT TO VOLUNTEER FOR COMMUNITY ORGANIZATIONS, ADVOCACY AND SUPPORT FOR THE SOCIALLY AND PHYSICALLY DISADVANTAGED, AND SUPPORT FOR LOCAL PUBLIC SAFETY ORGANIZATIONS. ALICE PECK DAY CONSIDERS CARING FOR OUR COMMUNITY A SPECIAL RESPONSIBILITY THAT WE ARE HONORED TO FULFILL. THROUGH ITS MANY PROGRAMS, DEDICATED STAFF AND UNWAVERING COMMITMENT TO QUALITY CARE, ALICE PECK DAY WORKS TO EXCEED THESE EXPECTATIONS AND MAKE A REAL DIFFERENCE IN OUR COMMUNITY.	Description
Total Program Service Expense	48446594	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	true	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Info In Schedule O Part V	X	InfoInScheduleOPartV
Number Forms Transmitted With1096	78	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	516	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	22	NbrVotingGoverningBodyMembers
Number Independent Voting Members	18	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	NH	StatesWhereCopyOfReturnIsFiled
Own Website	X	OwnWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ELIZABETH LOUDERMILK	NamePerson
Telephone Number	6034483121	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	10 ALICE PECK DAY DRIVE	AddressLine1
City	LEBANON	City
State	NH	State
ZIP Code	037662647	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (32 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
MICHAEL R HARRIS
CHAIR	1.0	X	X
REV DR GUY JD COLLINS
VICE CHAIR	1.0	X	X
JUDSON T PIERSON
TREASURER	2.0	X	X
KAREN G KAYEN
SECRETARY	1.0	X	X
DEBORAH A GLAZER MD
MEDICAL STAFF PRESIDENT	1.0	X		37011
MICHAEL J CRYANS
TRUSTEE	0.5	X
HARRY G DORMAN III FACHE
PRESIDENT AND CEO	45.0	X	X		323433	24433
TERRI C DUDLEY
TRUSTEE EMERITUS (NON VOTING)	1.0	X
CLAUDIA C GIBSON
AUXILIARY PRESIDENT	0.5	X
RICHARD S JENNINGS
TRUSTEE	1.0	X
BRUCE N JOHNSTONE
TRUSTEE	1.0	X
JENNIFER H JUDKINS MD
TRUSTEE	1.0	X
EDWARD T KERRIGAN
TRUSTEE	1.0	X
SARA L KOBYLENSKI
TRUSTEE	1.0	X
MIRIAM M MAGUIRE
TRUSTEE	0.5	X
SUSAN E MOONEY MD MS FACOG
VP & MEDICAL DIRECTOR	60.0	X	X	260260		32847
MICHAEL PWH PAINE FRCS
TRUSTEE	2.0	X
MARTY P CANDON
TRUSTEE	1.0	X
MARK E MELENDY
TRUSTEE	1.0	X
SHELLY L MOSES
TRUSTEE	1.0	X
CLOSEY F DICKEY
TRUSTEE EMERITUS (NON VOTING)	1.0	X
BEVERLY A RANKIN RN BSN MSA
VP PATIENT CARE & CNO	60.0	X	X	139599		20556
CURT A JACQUES II
TRUSTEE	1.0	X
BRETT C PELZTER
TRUSTEE	1.0	X
J TODD MILLER MS
COO	60.0		X	151965		25207
EVALIE M CROSBY CPA FHFMA
VP FINANCE AND CFO	50.0		X		144859	26485
BRENDA BLAIR MC SPHR
VP HUMAN RESOURCES & ORG DEV	60.0		X	113535		17423
ANDREW BEST MD
PHYSICIAN	40.0			320210		21466	X
DOUGLAS CEDENO MD
PHYSICIAN	40.0			283513		20761	X
DAVID KRONER MD
PHYSICIAN	40.0			284924		25869	X
DIANE RILEY MD
PHYSICIAN	40.0			383303		16685	X
LEONARD RUDOLF MD
PHYSICIAN	40.0			425843		4818	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2400163	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	468292	TotalReportableCompFrmRltdOrgs
Total Other Compensation	236550	TotalOtherCompensation
Number Individuals GT100 K	43	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
COMBINED SERVICES
PO BOX 1320	CONCORD	NH	03302	PLAN ADMINISTRATOR	165212
LAVALLEE BRENSINGER ARCHITECTS
155 DOW ST SUITE 400	MANCHESTER	NH	03101	ARCHITECTS	472591
UPPER VALLEY NEUROLOGY
106 HANOVER ST	LEBANON	NH	03766	PROFESSIONAL SERVICE	1936692
VALLEY REGIONAL HOSPITAL
243 ELM ST	CLAREMONT	NH	03743	LAB SERVICES	173662
COMPHEALTH MEDICAL STAFFING
PO BOX 972651	DALLAS	TX	753972651	PROFESSIONAL STAFF	331124

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	7	NumberOfContractorsGT100K
All Other Contributions	2648403	AllOtherContributions
Noncash Contributions	6643	NoncashContributions
Total Contributions	2648403	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
PATIENT SERVICE REVENUE	621400	51399105	51399105
OTHER OPERATING REVENUE	621400	228919	228919
NUTRITIONAL REVENUE	900099	91822		$91,822

Field	Value	IRS element (for citing)
Total Program Service Revenue	51719846	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	71205	TotalRevenueColumn
Exclusion	$71,205	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	52089	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	12777	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	39312	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	39312	TotalRevenueColumn
Exclusion	$39,312	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	3149551	Securities
Other	500	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	2876083	Securities
Other	60427	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	273468	Securities
Other	-59927	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	213541	TotalRevenueColumn
Exclusion	$213,541	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	54692307	TotalRevenueColumn
Related Or Exempt Function Income	51628024	RelatedOrExemptFunctionIncome
Exclusion	$415,880	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	40000	Total
Program Services	40000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	829709	Total
Program Services	77501	ProgramServices
Management And General	752208	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	24268920	Total
Program Services	23649606	ProgramServices
Management And General	367129	ManagementAndGeneral
Fundraising	252185	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	774861	Total
Program Services	721759	ProgramServices
Management And General	45199	ManagementAndGeneral
Fundraising	7903	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	3265644	Total
Program Services	3042143	ProgramServices
Management And General	190222	ManagementAndGeneral
Fundraising	33279	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1673335	Total
Program Services	1518571	ProgramServices
Management And General	138187	ManagementAndGeneral
Fundraising	16577	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	64566	Total
Program Services	11005	ProgramServices
Management And General	53561	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	56750	Total
Management And General	56750	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	256600	Total
Fundraising	256600	Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	6334001	Total
Program Services	5931894	ProgramServices
Management And General	322304	ManagementAndGeneral
Fundraising	79803	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	82652	Total
Program Services	258	ProgramServices
Management And General	82391	ManagementAndGeneral
Fundraising	3	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1143168	Total
Program Services	838338	ProgramServices
Management And General	290046	ManagementAndGeneral
Fundraising	14784	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	92906	Total
Program Services	88664	ProgramServices
Management And General	3236	ManagementAndGeneral
Fundraising	1006	Fundraising

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1143322	Total
Program Services	973158	ProgramServices
Management And General	164854	ManagementAndGeneral
Fundraising	5310	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	252270	Total
Program Services	224834	ProgramServices
Management And General	25166	ManagementAndGeneral
Fundraising	2270	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	0	Total

Interest Interest

Field	Value	IRS element (for citing)
Total	295856	Total
Program Services	249606	ProgramServices
Management And General	45015	ManagementAndGeneral
Fundraising	1235	Fundraising

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	1514389	Total
Program Services	1282033	ProgramServices
Management And General	232356	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	541743	Total
Program Services	530089	ProgramServices
Management And General	11343	ManagementAndGeneral
Fundraising	311	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
BAD DEBT EXPENSE	2439576	2439576
MEDICAID ENHANCEMENT TAX	1854160	1854160
EQUIPMENT RENTAL/MAINTENANCE	448567	437341	11162	64
MEDICAL SUPPLIES/EQUIPMENT	4463587	4456441	6841	305

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	600854	Total
Program Services	79617	ProgramServices
Management And General	514207	ManagementAndGeneral
Fundraising	7030	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	52437436	Total
Program Services	48446594	ProgramServices
Management And General	3312177	ManagementAndGeneral
Fundraising	678665	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	296478	BOY
EOY	49669	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	6445524	BOY
EOY	2737368	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	73430	BOY
EOY	1833739	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	7551295	BOY
EOY	7528117	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1220966	BOY
EOY	1238856	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	372898	BOY
EOY	387557	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	42080929	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	22981032	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	12375393	BOY
EOY	19099897	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	2827079	BOY
EOY	3395054	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	8500	BOY
EOY	8500	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	128010	BOY
EOY	122544	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	2348299	BOY
EOY	3431650	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	33647872	BOY
EOY	39832951	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	6379747	BOY
EOY	7799569	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	12144107	BOY
EOY	14807522	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	495000	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	606026	BOY
EOY	840603	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	19624880	BOY
EOY	23447694	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	13051788	BOY
EOY	15898995	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	945364	BOY
EOY	458576	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	25840	BOY
EOY	27686	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	14022992	BOY
EOY	16385257	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	33647872	BOY
EOY	39832951	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	2254871	ReconcilationRevenueExpenses
Reconcilation Other Changes	107394	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	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)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Form4720 Filed	false	Form4720Filed
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$9,337	OtherActivitiesAmount
Total Lobbying Expenditures IIB	9337	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3
Form4720 Filed4912 Tax	false	Form4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	PART II-B, LINE 1 (I), OTHER LOBBYING ACTIVITIES:	Identifier
Explanation	THE ORGANIZATION PAYS DUES TO THE NEW HAMPSHIRE HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION, A PORTION OF WHICH ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Agent Trustee Etc	true	AgentTrusteeEtc

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	25840	BeginningOfYearBalance
Investment Earnings Or Losses	1846	InvestmentEarningsOrLosses
End Of Year Balance	27686	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	28065	BeginningOfYearBalance
Investment Earnings Or Losses	-2225	InvestmentEarningsOrLosses
End Of Year Balance	25840	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	26827	BeginningOfYearBalance
Investment Earnings Or Losses	1238	InvestmentEarningsOrLosses
End Of Year Balance	28065	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	26456	BeginningOfYearBalance
Investment Earnings Or Losses	371	InvestmentEarningsOrLosses
End Of Year Balance	26827	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	927577	OtherCostOrOtherBasis
Book Value	927577	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	13168604	OtherCostOrOtherBasis
Depreciation	7655565	Depreciation
Book Value	5513039	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	250651	OtherCostOrOtherBasis
Depreciation	192510	Depreciation
Book Value	58141	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	17941661	OtherCostOrOtherBasis
Depreciation	14308951	Depreciation
Book Value	3632710	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	9792434	OtherCostOrOtherBasis
Depreciation	824004	Depreciation
Book Value	8968430	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	19099897	TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
DUE FROM AFFILIATES	3162650
OTHER ASSETS	269000

Field	Value	IRS element (for citing)
Total Book Value Other Assets	3431650	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
DEFERRED ANNUITY	$70,651
ESTIMATED 3RD PARTY SETTLEMENT	$223,122
UNREALIZED GAIN/LOSS ON INTEREST RATE SWAP	$277,830
OTHER LIABILITY	$269,000

Field	Value	IRS element (for citing)
Total Of Amounts	840603	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	SCHEDULE D,PART X, LINE 2:	Identifier
Explanation	The System consists of not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code, all of which are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the System's tax positions and concluded the System maintained its tax exempt status, does not have any significant unrelated business income, and had taken no uncertain tax positions that require adjustment to the consolidated financial statements. With few exceptions, the System is no longer subject to income tax examination by the U.S. federal or state tax authorities for years prior to 2009.	Explanation

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Mail Solicitations	X	MailSolicitations
Email Solicitations	X	EmailSolicitations
In Person Solicitations	X	InPersonSolicitations
Solicitation Of Non Govt Grants	X	SolicitationOfNonGovtGrants
Solicitation Of Govt Grants	X	SolicitationOfGovtGrants
Agreement Ref Fundraising	true	AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Field	Value	IRS element (for citing)
Name Of Individual	GRAHAM-PELTON CONSULTING INC	NameOfIndividual

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	39 BEECHWOOD RD	AddressLine1
City	SUMMIT	City
State	NJ	State
ZIP Code	07901	ZIPCode

Field	Value	IRS element (for citing)
Activity	CONSULTING	Activity
Fundraiser Control Of Funds	false	FundraiserControlOfFunds
Amount Retained By Contractor	256600	AmountRetainedByContractor

Field	Value	IRS element (for citing)
Total Retained By Contractors	256600	TotalRetainedByContractors

Form990 Schedule G Part IV Form990ScheduleGPartIV

Field	Value	IRS element (for citing)
Identifier	PART IV	Identifier
Explanation	GRAHAM-PELTON CONSULTING INC. PROVIDED CONSULTING SERVICES TO THE ENTITY FOR A CAPITAL CAMPAIGN. THEY WERE PAID FOR THESE SERVICES AS DETAILED IN LINE 2 B COLUMN V. NO FUNDS WERE IN THE CUSTODY OR CONTROL OF THE CONSULTANT.	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	275.	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	688102	TotalCommunityBenefitExpense
Net Community Benefit Expense	688102	NetCommunityBenefitExpense
Percent Of Total Expense	0.01310	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6434711	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5350641	DirectOffsettingRevenue
Net Community Benefit Expense	1084070	NetCommunityBenefitExpense
Percent Of Total Expense	0.02070	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7122813	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5350641	DirectOffsettingRevenue
Net Community Benefit Expense	1772172	NetCommunityBenefitExpense
Percent Of Total Expense	0.03380	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	163769	TotalCommunityBenefitExpense
Net Community Benefit Expense	163769	NetCommunityBenefitExpense
Percent Of Total Expense	0.00310	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	38299	TotalCommunityBenefitExpense
Net Community Benefit Expense	38299	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	9980492	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6835209	DirectOffsettingRevenue
Net Community Benefit Expense	3145283	NetCommunityBenefitExpense
Percent Of Total Expense	0.06000	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	68442	TotalCommunityBenefitExpense
Net Community Benefit Expense	68442	NetCommunityBenefitExpense
Percent Of Total Expense	0.00130	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10251002	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6835209	DirectOffsettingRevenue
Net Community Benefit Expense	3415793	NetCommunityBenefitExpense
Percent Of Total Expense	0.06510	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17373815	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12185850	DirectOffsettingRevenue
Net Community Benefit Expense	5187965	NetCommunityBenefitExpense
Percent Of Total Expense	0.09890	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	2398	TotalCommunityBuildingExpense
Net Community Building Expense	2398	NetCommunityBuildingExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	1342	TotalCommunityBuildingExpense
Net Community Building Expense	1342	NetCommunityBuildingExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	16455	TotalCommunityBuildingExpense
Net Community Building Expense	16455	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	18052	TotalCommunityBuildingExpense
Net Community Building Expense	18052	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	38247	TotalCommunityBuildingExpense
Net Community Building Expense	38247	NetCommunityBuildingExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$1,664,183	BadDebtExpenseAmount
Amount Attributable To	100000	AmountAttributableTo
Amount Reimbursed By Medicare	12924698	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	12798156	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	126542	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	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	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	ALICE PECK DAY MEMORIAL HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	10 ALICE PECK DAY DR	AddressLine1
City	LEBANON	City
State	NH	State
ZIP Code	03766	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
Other	PHYSICIAN CLINICS	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ALICE PECK DAY MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	275.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
Other Factors	X	OtherFactors
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
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	true	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Permit Lawsuit	X	PermitLawsuit
Collection Activities	true	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Lawsuit	X	Lawsuit
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	9	NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
RAM CENTER FOR COMMUNITY CARE
10 ALICE PECK DAY DR 5	LEBANON	NH	03766	PRIMARY CARE PHYSICIAN CLINIC
WOMEN'S CARE CENTER
141 MASCOMA ST	LEBANON	NH	03766	OB/GYN PHYSICIAN CLINIC
APD ORTHOPAEDIC CLINIC
10 ALICE PECK DAY DR 17-C	LEBANON	NH	03766	ORTHOPAEDIC PHYSICIAN CLINIC
GENERAL SURGERY CLINIC
10 ALICE PECK DAY DR	LEBANON	NH	03766	GENERAL SURGEON CLINIC
PAIN MANAGEMENT CLINIC
127 MASCOMA ST 3RD FLOOR	LEBANON	NH	03766	PAIN MANAGEMENT CLINIC
MIDWIFERY SERVICES
57 MECHANIC ST SUITE 2	LEBANON	NH	03766	MIDWIFERY CLINIC
APD HAND & UPPER EXTREMITY CLINIC
205 BILLINGS FARM RD UNIT 3A	WHITE RIVER JUNCTION	VT	05001	HAND & UPPER EXTREMITY ORTHOPAEDIC PHYSICIAN CLINIC
OCCUPATIONAL HEALTH SERVICES
127 MASCOMA ST	LEBANON	NH	03766	OCCUPATIONAL HEALTH PHYSICIAN CLINIC
NEUROSURGERY SERVICES AT APD (NSAPD)
106 HANOVER STREET	LEBANON	NH	03766	NEUROSURGERY PHYSICIAN CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
SCHEDULE H, PART I, LINE 3B:	FAMILY INCOME LIMIT FOR ELIGIBILITY FOR DISCOUNTED CARE RANGES FROM 200%-275% OF FPG.
SCHEDULE H, PART I, LINE 7:	THE COSTS OF CHARITY CARE AND MEANS-TESTED PROGRAMS ARE CALCULATED USING THE FACILITY-WIDE COST TO CHARGE RATIO AS CALCULATED IN WORKSHEET 2. SUBSIDIZED HEALTH SERVICES ARE CALCULATED USING THE COST TO CHARGE RATIOS PER SERVICE AREA USING A STEP-DOWN COST ALLOCATION METHODOLOGY CONSISTENT WITH MEDICARE COST REPORT METHODOLOGY. THE COST OF FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS AT COST ARE 9.89% OF TOTAL EXPENDITURES ON FORM 990, PART IX, COLUMN A, LINE 26, EXCLUDING BAD DEBT EXPENSE.
SCHEDULE H, PART I, LINE 7, COLUMN (F):	BAD DEBT EXPENSE REPORTED ON FORM 990 PART IX, LINE 25 WAS EXCLUDED FROM TOTAL EXPENSES FOR THE CALCULATION OF NET COMMUNITY BENEFIT EXPENSES AS A PERCENT OF TOTAL EXPENSE.
SCHEDULE H, PART II:	ALICE PECK DAY MEMORIAL HOSPITAL PARTICIPATES IN VARIOUS COMMUNITY BUILDING ACTIVITIES TO PROMOTE AND ADVOCATE FOR THE HEALTH NEEDS OF THE COMMUNITY. SIGNIFICANT ACTIVITIES INCLUDE PARTICIPATION IN THE UPPER VALLEY INTERFAITH PROJECT WHICH PROMOTES ADEQUATE PUBLIC TRANSPORTATION IN THE REGION, INCLUDING AVAILABILITY OF TRANSPORTATION FOR HOSPITAL AND CLINIC VISITS FOR AREA RESIDENTS. APD'S SOCIAL SERVICES DEPARTMENT WORKS WITH PATIENTS WHO SEEK ASSISTANCE WITH LIVING WILLS AND ADVANCE MEDICAL DIRECTIVES. APD PERSONNEL ARE ACTIVELY INVOLVED IN DISASTER AND EMERGENCY PREPAREDNESS PLANNING AND TRAINING ACTIVITIES. THESE ACTIVITIES ARE DESIGNED TO PROMOTE THE HEALTH AND SAFETY OF THE COMMUNITY IN THE EVENT OF WIDESPREAD OR LARGE NATURAL OR OTHER DISASTER, OR IN THE EVENT OF WIDESPREAD VIRAL OUTBREAKS, SUCH AS INFLUENZA. FINALLY, APD PERSONNEL ARE ACTIVE PARTICIPANTS IN THE NEW HAMPSHIRE HOSPITAL ASSOCIATION (NHHA). NHHA ADVOCATES FOR THE CARE AND PROTECTION OF NH HOSPITAL PATIENTS, INCLUDING MAKING QUALITY HEALTH CARE AVAILABLE, AFFORDABLE AND ACCESSIBLE TO ALL REGARDLESS OF ABILITY TO PAY.
SCHEDULE H, PART III, LINE 4:	BAD DEBT COST IS CALCULATED USING A COST TO CHARGE RATIO USING A STEP-DOWN COST ALLOCATION METHODOLOGY CONSISTENT WITH MEDICARE COST REPORTING. IN FY 12, ACCOUNTS WRITTEN OFF TO BAD DEBT INCLUDED 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. WE ESTIMATED THE AMOUNT OF CHARITY CARE IN BAD DEBT EXPENSE BASED ON THE NUMBER OF APPLICATIONS FOR CHARITY CARE. WE BELIEVE THE AMOUNT IS MINIMAL BASED ON OUR EXTENSIVE EFFORTS TO EDUCATE OUR PATIENTS AND STAFF ABOUT OUR VARIOUS PAYMENT PLANS AND CHARITY CARE 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, TIME-PAYMENT PROGRAMS OR A COMBINATION OF THE ABOVE. DUE TO THESE EFFORTS, WE FEEL THAT AMOUNTS WRITTEN OFF TO BAD DEBT THAT COULD QUALIFY AS CHARITY CARE ARE MINIMAL. FOOTNOTE 1 TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF ALICE PECK DAY HEALTH SYSTEMS, CORP. INCLUDES THE FOLLOWING TO ADDRESS BAD DEBT: ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT MANAGEMENT EXPECTS TO COLLECT ON OUTSTANDING BALANCES. MANAGEMENT PROVIDES FOR POSSIBLE UNCOLLECTIBLE AMOUNTS THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO THE VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF INDIVIDUAL ACCOUNTS AND HISTORICAL ADJUSTMENTS. ACCOUNTS DEEMED UNCOLLECTIBLE ARE WRITTEN OFF THROUGH A CHARGE AGAINST THE ESTABLISHED ALLOWANCE.
SCHEDULE H, 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.
SCHEDULE H, PART III, LINE 9B:	OUR BAD DEBTS COLLECTION POLICY APPLIES TO ALL PATIENT ACCOUNTS IN A CONSISTENT MANNER. THE POLICY SPECIFICALLY INDICATES THAT, AFTER A SECOND STATEMENT IS SENT WITH NO PAYMENT RECEIVED, A PATIENT ACCOUNTS REPRESENTATIVE WILL CONTACT THE PATIENT BY PHONE TO DETERMINE IF A FINANCIAL ASSISTANCE APPLICATION OR PAYMENT PLAN IS APPROPRIATE. THIS IS COMPLETED TO AVOID FURTHER ESCALATION OF PAST DUE ACCOUNT(S)IF THE PATIENT MAY QUALIFY FOR FULL OR PARTIAL RELIEF UNDER THE CHARITY CARE POLICY. IF THE APPLICATION IS SUCCESSFUL, THEN THE QUALIFYING BALANCE OR BALANCES ARE CLASSIFIED AS CHARITY CARE AND NO LONGER PURSUED FOR COLLECTIONS. ONCE A PATIENT BALANCE IS CLASSIFIED AS CHARITY CARE, IT IS NOT SUBJECT TO COLLECTION ACTIVITIES. ALICE PECK DAY IS COMMITTED TO HELPING OUR PATIENTS OBTAIN QUALITY HEALTHCARE, REGARDLESS OF ABILITY TO PAY. OUR FINANCIAL ASSISTANCE PROGRAMS ENCOURAGE AND ENABLE OUR PATIENTS TO MAKE HEALTHCARE DECISIONS FREE OF FINANCIAL BARRIERS. WE EDUCATE OUR PATIENTS ABOUT OUR PROGRAMS AND PROVIDE ASSISTANCE PRIOR TO THEIR RECEIVING SERVICES, AT REGISTRATION FOR SERVICES AND DURING OUR BILLING PROCESS TO ENSURE THAT ANY AND ALL PATIENTS IN NEED OF ASSISTANCE ARE PROVIDED WITH THE HELP THEY QUALIFY FOR UNDER APD PROGRAMS. BROCHURES AND SIGNS ARE PLACED IN HIGH TRAFFIC AREAS SUCH AS THE ER AND REGISTRATION. OUR STAFF IS TRAINED TO IDENTIFY PATIENTS DURING REGISTRATION, PROVIDE INFORMATION AND OFFER ASSISTANCE IN COMPLETING THE NECESSARY FORMS. DURING OUR BILLING PROCESS, CALLS ARE MADE TO PATIENTS WITH OUTSTANDING BALANCES. APD STAFF WORK WITH PATIENTS TO IDENTIFY PROBLEMS THEY ARE FACING IN DEALING WITH OUTSTANDING BALANCES. PATIENTS ARE NOTIFIED AGAIN OF THE MANY TYPES OF FINANCIAL ASSISTANCE AVAILABLE FOR WHICH THEY MAY QUALIFY. PROGRAMS ARE EXPLAINED, AND ASSISTANCE IS OFFERED, IF NEEDED, IN COMPLETING THE APPLICATIONS. DUE TO THIS MULTI-LEVEL APPROACH AND STAFF THAT IS TRAINED TO IDENTIFY CLIENTS WHO MAY NEED FINANCIAL ASSISTANCE, VERY FEW QUALIFYING PATIENTS REACH THE POINT OF BAD DEBT. OUR COLLECTION POLICIES AND PROCEDURES IN CONJUCTION WITH OUR SMALL SIZE, ALLOW OUR ORGANIZATION TO PLACE GREAT EMPHASIS ON HELPING ALL PATIENTS WHO MAY BE IN NEED TO APPLY FOR, AND OBTAIN, THE APPROPRIATE LEVEL OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART V, LINE 11:	ALICE PECK DAY MEMORIAL HOSPITAL OFFERS FINANCIAL ASSISTANCE TO PATIENTS DEMONSTRATING NEED. IN MAKING THE NEED DETERMINATION, APD PARTICIPATES WITH AND HONORS THE FOUNDING PRINCIPLES AND GUIDELINES OF THE NEW HAMPSHIRE HEALTH ACCESS NETWORK (NHHAN). ACCORDINGLY, DECISIONS REGARDING THE GRANTING OF FINANCIAL ASSISTANCE WILL BE BASED PRIMARILY ON A PATIENT AND HIS OR HER HOUSEHOLD INCOME AND ASSETS. THERE WILL BE MINIMAL CONSIDERATION OF EXPENSES EXCEPT WHEN THEY IDENTIFY AREAS FOR FURTHER INVESTIGATION OR INCOMPLETE OR INACCURATE INFORMATION. THE VALUE OF A PATIENT'S PRINCIPAL RESIDENCE IS NOT CONSIDERED IN QUALIFYING A PATIENT FOR IN-HOUSE ASSISTANCE. APD REQUIRES EXHAUSTION OF OTHER PAYMENT METHODOLOGIES, INCLUDING BUT NOT LIMITED TO: WORKER'S COMPENSATION, VETERANS BENEFITS, MEDICAID, LIABILITY (AUTO ACCIDENTS), VICTIMS OF CRIME AND COBRA. WHEN APPLICABLE, PROOF OF DETERMINATION MAY BE REQUIRED PRIOR TO CONSIDERATION FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART V, LINE 13:	PLEASE SEE PART V LINE 3 FOR A DESCRIPTION OF THE FINANCIAL ASSISTANCE PROGRAM AND THE EFFORTS MADE TO PUBLICIZE AND PROMOTE THE PROGRAM.
SCHEDULE H, PART V, LINE 19D:	THE HOSPITAL FACILITY PROVIDES UNINSURED PATIENTS WITH A 15% DISCOUNT. AT THE TIME THE DISCOUNT WAS ESTABLISHED THE DISCOUNT APPROXIMATED THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES FOR SERVICES AT THE HOSPITAL FACILTY. THE AVERAGE OF THE THREE LOWEST COMMERICAL INSURANCE RATES WAS APPROXIMATELY 87.5%, THE RATE APPLIED TO UNINSURED PATIENTS WAS LOWER THAN THAT RATE, AT 85%, REPRESENTING A 15% DISCOUNT.
SCHEDULE H, PART VI, LINE 2:	DUE TO OUR RURAL LOCATION AND SIZE, A COLLABORATIVE EFFORT BETWEEN THE UNITED WAY, DARTMOUTH HITCHCOCK MEMORIAL HOSPITAL AND ALICE PECK DAY MEMORIAL HOSPITAL CREATED THE FY 2009 COMMUNITY BENEFITS PLAN. PRIORITY NEEDS AND HEALTH CONCERNS FOR OUR COMMUNITY WERE BASED UPON INFORMATION COLLECTED FROM COMMUNITY NEEDS ASSESSMENTS AND COMMUNITY SURVEYS. IDENTIFIED NEEDS INCLUDED: AVAILABILITY OF ORAL HEALTH, AVAILABILITY OF PRIMARY CARE, PRESCRIPTION ASSISTANCE, TRANSPORTATION, AVAILABILITY OF BEHAVIORAL HEALTH AND ACCESS TO ALCOHOL/DRUG TREATMENT. ALICE PECK DAY USED ITS INFORMATION TO HELP FOCUS ITS COMMUNITY BENEFIT EFFORTS TO MEET THE PRIORITY NEEDS IDENTIFIED IN THE COMMUNITY BENEFIT PLAN. OF SPECIAL NOTE IS THE UPPER VALLEY SMILES PROGRAM THAT HAS SERVED A PRIORITY NEED FOR ORAL HEALTH WITHIN OUR LOCAL COMMUNITY. UPPER VALLEY SMILES HAS TOUCHED THE LIVES OF MANY CHILDREN IN OUR COMMUNITY AND PROVIDED MUCH NEEDED CARE FOR A VERY VULNERABLE POPULATION.
SCHEDULE H, PART VI, LINE 3:	ALICE PECK DAY BELIEVES THAT QUALITY HEALTH CARE SHOULD BE AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. OUR FINANCIAL ASSISTANCE PROGRAMS AND STAFF ARE DEDICATED TO HELPING PEOPLE OBTAIN THE CARE THEY NEED. WE REACH OUT TO OUR PATIENTS IN MANY DIFFERENT WAYS TO ENSURE THAT THEY ARE AWARE THAT HELP IS AVAILABLE AND TO HELP GUIDE THEM THROUGH THE PROCESS. BROCHURES AND SIGNAGE ARE POSTED IN HIGH TRAFFIC AREAS SUCH AS THE EMERGENCY ROOM, REGISTRATION AND THE LOBBY. REGISTRATION STAFF ARE TRAINED TO IDENTIFY PATIENTS WHO MAY BE IN NEED OF FINANCIAL ASSISTANCE. ONCE IDENTIFIED, STAFF NOTIFY THE PATIENT THAT APD HAS VARIOUS FORMS OF FINANCIAL ASSISTANCE AND EXPLAIN THAT ASSISTANCE IS AVAILABLE FOR ANYONE WHO MIGHT REQUIRE HELP OR GUIDANCE IN COMPLETING ANY NECESSARY PAPERWORK. IN ADDITION TO THE ABOVE, OUR BILLING STAFF ARE TRAINED TO HELP IDENTIFY AND OFFER ASSISTANCE TO ANY ONE WHO MIGHT REQUIRE FINANCIAL ASSISTANCE. PATIENTS WITH OUTSTANDING CLAIMS ARE CONTACTED BY OUR CREDIT COORDINATOR WHO WORKS WITH THEM TO CLEAR UP BALANCES THROUGH THE VARIETY OF PROGRAMS WE OFFER. ASSISTANCE IS ALSO PROVIDED IN APPLYING FOR FEDERAL/STATE PROGRAMS TO THOSE WHO QUALIFY. SPECIALLY TRAINED STAFF GUIDE APPLICANTS THROUGH THE PROCESS TO ENSURE FORMS ARE FILLED OUT CORRECTLY, ALL REQUIRED DOCUMENTATION IS ATTACHED AND THE APPLICANTS UNDERSTAND WHAT THEY CAN EXPECT TO HAPPEN ALONG THE WAY.
SCHEDULE H, PART VI, LINE 4:	ALICE PECK DAY MEMORIAL HOSPITAL IS PART OF THE LEBANON HEALTH CARE SERVICE AREA. THE LEBANON SERVICE AREA COMPRISES CITIES AND TOWNS IN NEW HAMPSHIRE AND VERMONT. APD'S SERVICE AREA IN NH COMPRISES 15 TOWNS IN ADDITION TO THE CITY OF LEBANON, INCLUDING CANAAN, CORNISH, CROYDON, DORCHESTER, ENFIELD, GRAFTON, GRANTHAM, HANOVER, LYME, NEWPORT, ORANGE, ORFORD, PIERMONT, PLAINFIELD AND WARREN. VERMONT TOWNS INCLUDE EAST THETFORD, FAIRLEE, HARTFORD, HARTLAND, NORTH HARTLAND, NORTH THETFORD, POST MILLS, QUECHEE, SHARON, SOUTH STRAFFORD, STRAFFORD, THETFORD, THETFORD CENTER, VERSHIRE, WEST VERSHIRE, WEST FAIRLEE, WEST HARTFORD, WHITE RIVER JUNCTION AND WOODSTOCK.
SCHEDULE H, PART VI, LINE 5:	ALICE PECK DAY ACTIVELY PROMOTES COMMUNITY-BASED LEADERSHIP DEVELOPMENT. STAFF MEMBERS PARTICIPATE IN TWO LOCAL CHAMBERS OF COMMERCE, LEADERSHIP UPPER VALLEY, FOUNDATION FOR HEALTHY COMMUNITIES, THE RURAL HEALTH COALITION AND THE ADVOCACY TASK FORCE. AS AN ACTIVE MEMBER OF THE COMMUNITY, APD WORKS TO BE PROACTIVE CONCERNING DISASTER READINESS. STAFF HAVE PARTICIPATED IN ONSITE TRAINING FOR DISASTER PREPAREDNESS AS WELL AS OFF-SITE TRAINING WITH OTHER REGIONAL HOSPITALS. COLLABORATIVE EFFORTS INCLUDE ALL HAZARD REGIONAL TRAINING, EMERGENCY RESPONSE TRAINING, AND A REGIONAL MASS CASUALTY RESPONSE PROGRAM TO HELP FACILITATE COOPERATIVE EFFORTS IF SUCH NEEDS ARISE.
SCHEDULE H, PART VI, LINE 6:	ALICE PECK DAY MEMORIAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN LEBANON NH. THE HOSPITAL IS SERVED BY A BOARD OF TRUSTEES CONSISTING OF LOCAL CITIZENS ACTIVE IN COMMUNITY ACTIVITIES AND ORGANIZATIONS. THE MAJORITY OF BOARD MEMBERS ARE NOT EMPLOYED BY THE HOSPITAL, AND INCLUDE LOCAL GOVERNMENT AND BUSINESS REPRESENTATIVES AS WELL AS PRACTICING INDEPENDENT PHYSICIANS. DESPITE ITS SMALL SIZE, APD IS COMMITTED TO GIVING BACK TO THE COMMUNITY TO THE GREATEST EXTENT POSSIBLE. DURING FY 2012, CASH DONATIONS WERE GIVEN TO ORGANIZATIONS TO HELP THOSE IN NEED. LOCAL FINANCIAL CONTRIBUTIONS HELPED SUPPORT FREE PRIMARY CARE CLINICS FOR THE UNINSURED, PROVIDED TRANSPORTATION FOR THE ELDERLY AND DISABLED TO RECEIVE MEDICAL CARE, AND PROVIDED LOCAL NON PROFIT ORGANIZATIONS WITH MEETING SPACE AND REFRESHMENTS. ALICE PECK DAY SUPPORTED COMMUNITY FLU CLINICS, PROVIDED EMERGENCY PRESCRIPTION DRUG VOUCHERS, SUBSIDIZED SENIOR EXERCISE PROGRAMS, PROVIDED SUPPLIES FOR HURRICANE IRENE RELIEF, AND WORKED TOWARD THE EXPANSION OF LOCAL PUBLIC TRANSPORTATION TO ENSURE ALL THOSE IN NEED OF MEDICAL CARE COULD RECEIVE IT. ONE OF APD'S MOST EXCITING AND CELEBRATED PROGRAMS IS THE UPPER VALLEY SMILES PROGRAM. THIS PROGRAM PROVIDES AN ORAL HEALTH SAFETY NET FOR DISADVANTAGED RESIDENTS WITHIN OUR SERVICE AREA. IN 6 DIFFERENT SCHOOLS OVER 1,300 STUDENTS RECEIVED ORAL HEALTH EDUCATION, WITH NEARLY 400 OF THOSE CHILDREN RECEIVING SCREENINGS FROM A DENTAL TEAM. ADDITIONALLY, OVER 1,600 PREVENTATIVE SEALANTS WERE GIVEN TO 260 LOW INCOME, UNINSURED CHILDREN. FOLLOW UP RESTORATIVE TREATMENT WAS GIVEN TO 91 OF THE 26O CHILDREN AND WAS PROVIDED BY LOCAL AREA DENTISTS. ALICE PECK DAY HOSTED TWO FREE ORAL HEALTH CLINICS FOR 18 HOMELESS CHILDREN WHO RECEIVED ORAL HEALTH EDUCATION, A DENTAL CLEANING AND FLUORIDE APPLICATIONS. WITH GRANT SUPPORT, APD CONTINUED ITS PILOT WOMEN, INFANTS AND CHILDREN (WIC) ORAL HEALTH INITIATIVE IN LEBANON AND ENFIELD NEW HAMPSHIRE, AND EXPANDED THIS PROGRAM TO SERVE A NEW SITE IN HARTFORD, VERMONT. UNDER THE WIC INITIATIVE, A TOTAL OF 147 LOW-INCOME CHILDREN AGED 0-10 RECEIVED ORAL HEALTH EDUCATION, A DENTAL SCREENING AND PREVENTATIVE CARE. INDIVIDUALS WERE PROVIDED WITH ASSISTANCE IN APPLYING FOR NH/VT MEDICAID TO ENSURE INCREASED ACCESS TO MEDICAL CARE FOR THIS NEEDY POPULATION. AS A RESULT, A SIGNIFICANT NUMBER OF PEOPLE WERE SUCCESSFULLY ENROLLED AND RECEIVED ONGOING CARE. TO PROMOTE HEALTH PROFESSIONAL EDUCATION, APD PROVIDED CLINICAL UNDERGRADUATE TRAINING TO COLBY-SAWYER COLLEGE, GEISEL SCHOOL OF MEDICINE AT DARTMOUTH, NEW ENGLAND INSTITUTE OF TECHNOLOGY, RIVER VALLEY COMMUNITY COLLEGE, VERMONT TECHNICAL COLLEGE, YALE UNIVERSITY, AND LEBANON COLLEGE. APD ANNUALLY SPONSORS DISTRICT-WIDE PROFESSIONAL DEVELOPMENT FOR SCHOOL NURSES IN OUR LOCAL AREA AND FOR OTHERS WITHIN OUR REGION. THESE INITIATIVES AND ONGOING EFFORTS CONTINUE TO ADDRESS SEVERAL OF THE MOST PRESSING COMMUNITY NEEDS AS IDENTIFIED IN OUR COMMUNITY NEEDS ASSESSMENT.
STATE FILING OF COMMUNITY BENEFIT REPORT	NH,	990 SCHEDULE H, PART VI

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
GOOD NEIGHBOR HEALTH CLINIC
70 N MAIN ST	WRJ	VT	05001	030346949	501(c)3	20000	OPERATIONAL SUPPORT FOR CLINIC PROVIDING FREE PRIMARY CARE SERVICES TO PATIENTS IN THE UPPER VALLEY ARE OF NH AND WHITE RIVER JUNCTION AREA IN VERMONT. PATIENTS RECEIVING FREE CARE ARE AT OR BELOW 225% OF THE FEDERAL POVERTY LEVEL.
GRAFTON COUNTY SENIOR CITIZENS COUNCIL
PO BOX 433	LEBANON	NH	03766	237248316	501(c)3	20000	Operational support for transportation services for area senior-citizens. The Council provides lift-assisted buses with priority on medical transport for hospital or clinic appointments.

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Schedule I, Part 1, Line 2	Identifier
Explanation	As part of APD's Access Improvement Plan developed in 2003, Hospital staff and Board members identified the Grafton County Senior Citizens Council and the Good Neighbor Health Clinic (which also includes the Red Logan Dental Clinic) as essential to providing access to health care in the Upper Valley NH and White River VT areas. Based on the needed services provided, the Board approved on-going monetary support for these organizations. The annual amount to be contributed by APD to these organizations is approved annually through the annual budget process. APD receives and reviews each year the organizations' published annual reports and also maintains informal contacts throughout the year to monitor the organizations' operations and services.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	true	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgs	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Base Compensation Filing OrgBaseCompensationFilingOrg	Other Compensation Filing OrgOtherCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg	Bonus Filing OrgBonusFilingOrg
HARRY G DORMAN III FACHE
278317	45116	9800	14633	347866
J TODD MILLER MS
					128608	23357	4605	20602	177172
SUSAN E MOONEY MD MS FACOG
					243490	16770	9800	23047	293107
EVALIE M CROSBY CPA FHFMA
131128	13731	5992	20493	171344
BEVERLY A RANKIN RN BSN MSA
					125975	13624		20556	160155
ANDREW BEST MD
					318824	1386	9800	11666	341676
DOUGLAS CEDENO MD
					256365	27148	9800	10961	304274
DAVID KRONER MD
					250503	21688	9800	16069	310793	12733
DIANE RILEY MD
					382505	798		16685	399988
LEONARD RUDOLF MD
					391862	981		4818	430661	33000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifier

ExplanationExplanation

FORM 990, SCHEDULE J, PART I, LINE 7:

IN FISCAL YEAR 2012, CERTAIN PROVIDERS WERE PAID THROUGH AN RVU (RELATIVE VALUE UNIT) SYSTEM, A PRODUCTIVITY MEASUREMENT SET BY MEDICARE TO ASSIGN VALUE TO SERVICES.

FORM 990, SCHEDULE J, PART II:

SALARY AND BENEFIT EXPENSE FOR THE CEO AND CFO ARE CHARGED TO APD HEALTH SYSTEMS, CORP. AND THEN ALLOCATED TO ALICE PECK DAY MEMORIAL HOSPITAL AND ALICE PECK DAY LIFECARE CENTER, INC. BASED ON THE RELATIVE SHARE OF SERVICES PERFORMED FOR THOSE ENTITIES. ON THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS THESE EXPENSES ARE INCLUDED IN SALARIES AND BENEFITS EXPENSE. ON LINE 24(E) OF FORM 990, SCHEDULE IX , THESE EXPENSES ($474,767) HAVE BEEN RECLASSIFIED FROM SALARY AND BENEFIT EXPENSE TO LINE 24(E).

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	BUSINESS FINANCE AUTHORITY OF THE STATE OF NH	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	521304598	IssuerEIN
Date Issued	2010-11-30	DateIssued
Issue Price	12282000	IssuePrice
Description Of Purpose	CURRENT REFUND EXISTING BONDS	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	false	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Amount Retired	0	AmountRetired
Amount Bond Defeased	0	AmountBondDefeased
Total Proceeds	12282000	TotalProceeds
Amount In Reserve Fund	0	AmountInReserveFund
Capitalized Interest	0	CapitalizedInterest
Refunding Escrow	12237068	RefundingEscrow
Issuance Costs From Proceeds	44932	IssuanceCostsFromProceeds
Credit Enhancement	0	CreditEnhancement
Working Capital Expenditures	0	WorkingCapitalExpenditures
Capital Expenditures	0	CapitalExpenditures
Other Spent Proceeds	0	OtherSpentProceeds
Amount Unspent	0	AmountUnspent
Year Of Subst Completion	2010	YearOfSubstCompletion
Current Refunding	true	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	true	FinalAllocationMade
Adequate Books And Recds Maintaind	true	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	false	OwningBondFinancedProperty
Any Lease Arrangements	false	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	false	MngmentCntrctBondFinancdPrprty
Any Research Agreements	false	AnyResearchAgreements
Prcntge Prvt Business Use By Others	0	PrcntgePrvtBusinessUseByOthers
Post Issuance Compliance Procdrs	true	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	false	Form8038TFiled
Variable Rate Issue	true	VariableRateIssue
Hedge Identified In Books And Recds	true	HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

Field	Value	IRS element (for citing)
Business Name Line1	TD BANKNORTH NA	BusinessNameLine1

Field	Value	IRS element (for citing)
Term Of Hedge	5.	TermOfHedge
Superintegrated Hedge	false	SuperintegratedHedge
Hedge Terminated	false	HedgeTerminated
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvested
Exception To Rebate	true	ExceptionToRebate

Field	Value	IRS element (for citing)
Fed Tax Requirements Compliance	X	FedTaxRequirementsCompliance

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (16 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
FORM 990, PART I, LINE 5 AND PART V, LINE 2A:	FOR ADMINISTRATIVE PURPOSES, ALICE PECK DAY MEMORIAL HOSPITAL ACTS AS COMMON PAYMASTER FOR BOTH ALICE PECK DAY HEALTH SYSTEMS, CORP. AND ALICE PECK DAY LIFECARE CENTER, INC.
FORM 990, PART IV, LINE 34:	ALICE PECK DAY HEALTH SYSTEMS, CORP. (02-0479095) IS THE DIRECT CONTROLLING PARENT COMPANY OF ALICE PECK DAY LIFECARE CENTER, INC. (02-0479094) AND ALICE PECK DAY MEMORIAL HOSPITAL (02-0222791). ALICE PECK DAY HEALTH SYSTEMS, CORP. IS ALSO THE DIRECT CONTROLLING PARENT COMPANY OF ALICE PECK DAY REALTY CORP. (EIN 02-0485369) AND ALICE PECK DAY HEALTH MANAGEMENT CORP. (EIN 02-0485370), BOTH ENTITIES ARE INACTIVE AND HOLD NO ASSETS.
FORM 990, PART VI, SECTION A, LINE 6:	ALICE PECK DAY HEALTH SYSTEMS, CORP., A CHARITABLE CORPORATION, ACTING BY AND THROUGH ITS BOARD OF TRUSTEES, IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A:	ALL TRUSTEES SHALL BE ELECTED BY THE BOARD OF TRUSTEES OF THE MEMBER AT THE ANNUAL MEETING OF THE MEMBER. A NOMINATION SLATE FOR THE TRUSTEES SHALL BE SUBMITTED BY THE GOVERNANCE COMMITTEE OF THE MEMBER. ANY TRUSTEE MAY BE REMOVED AT ANY TIME, WITH OR WITHOUT CAUSE, BY THE MEMBER. VACANCIES ON THE BOARD OF TRUSTEES DUE TO DEATH, RESIGNATION, OR OTHER CAUSE EXCEPT REMOVAL SHALL BE FILLED BY ELECTION BY THE REMAINING MEMBERS OF THE BOARD. VACANCIES CAUSED BY REMOVAL SHALL BE FILLED BY ELECTION BY THE MEMBER. TRUSTEES ELECTED TO FILL VACANCIES SHALL HOLD OFFICE UNTIL THE NEXT ANNUAL MEETING OF THE MEMBER, AT WHICH TIME SUCCESSORS SHALL BE ELECTED IN THE MANNER PROVIDED FOR IN THE CASE OF ORIGINAL ELECTIONS.
FORM 990, PART VI, SECTION A, LINE 7B:	THE ORGANIZATION'S ANNUAL OPERATING BUDGET AND ALL CAPITAL BUDGETS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. ANY OVERALL STRATEGIC PLAN FOR THE ORGANIZATION, INCLUDING THE DEVELOPMENT OF OFF-SITE FACILITIES OR THE ADDITION OF NEW PROGRAMS AND AFFILIATIONS WITH OTHER INSTITUTIONS, SHALL BE CONSISTENT WITH THE STRATEGIC PLAN OF THE MEMBER AS DETERMINED BY THE MEMBER. THE BORROWING OF ANY SUM IN EXCESS OF $50,000 WHICH HAS A STATED TERM OF GREATER THAN ONE YEAR OR WHICH IS SECURED BY A MORTGAGE OF ALL OR ANY PORTION OF THE ORGANIZATION'S REAL PROPERTY OR BY A SECURITY INTEREST IN THE ORGANIZATION'S ASSETS OR REVENUES SHALL BE SUBJECT TO APPROVAL BY THE MEMBER, PROVIDED, HOWEVER, THAT THE APPROVAL BY THE MEMBER SHALL NOT BE NECESSARY FOR ANY BORROWING TO PURCHASE OR LEASE EQUIPMENT OR OTHER PERSONAL PROPERTY SECURED BY A PURCHASE MONEY LIEN OR TITLE RETENTION OR SECURITY AGREEMENT EXCEPT AS INCIDENT TO THE REVIEW OF THE CAPITAL BUDGET. ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE ORGANIZATION OR THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS OR THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE CORPORATION SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. THE BOARD SHALL SELECT CERTIFIED PUBLIC ACCOUNTANTS FOR THE ORGANIZATION WHICH WILL AUDIT THE BOOKS AND RECORDS OF THE MEMBER. THE BOARD SHALL SELECT THE PRESIDENT WHO MUST BE CONFIRMED BY THE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11:	THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE FINANCE AND GOVERNANCE COMMITTEES OF THE BOARD OF TRUSTEES IN ADVANCE OF THE FILING DEADLINE TO ENABLE A DETAILED AND CONSCIENTIOUS REVIEW BY ALL MEMBERS OF BOTH COMMITTEES. THE COMPLETED FORM 990 IS ALSO DISTRIBUTED TO ALL MEMBERS OF THE FULL BOARD FOR REVIEW NO LATER THAN THE FINAL REGULARLY SCHEDULED BOARD MEETING PRIOR TO THE FILING DEADLINE. ALL QUESTIONS AND CONCERNS ARE ADDRESSED BY THE CHIEF FINANCIAL OFFICER AND INCORPORATED INTO THE FORM 990 AS DEEMED APPROPRIATE. AFTER ALL INPUT FROM THE BOARD, FINANCE, AND GOVERNANCE COMMITTEES HAS BEEN APPROPRIATELY ADDRESSED AND INCORPORATED INTO THE FINAL FORM 990, A VOTE OF ACCEPTANCE OF THE FINAL DOCUMENT IS REQUIRED. THE VOTE IS RECORDED IN THE MINUTES OF THE BOARD OF TRUSTEES PRIOR TO THE FILING OF THE FORM 990. ONCE APPROVED, SENIOR MANAGEMENT FILES THE FINAL FORM 990 WITH THE INTERNAL REVENUE SERVICE AS REQUIRED.
FORM 990, PART VI, SECTION B, LINE 12C:	ALICE PECK DAY HAS A MULTI-FACETED CONFLICT OF INTEREST POLICY. MEMBERS OF THE BOARD OF TRUSTEES COMPLETE CONFLICT OF INTEREST QUESTIONNAIRES ON AN ANNUAL BASIS AND ANY NEW MEMBERS COMPLETE THE QUESTIONNAIRE UPON JOINING THE BOARD. AS PART OF OUR ONGOING MONITORING PROCESS, OUR EXECUTIVE ASSISTANT REVIEWS ALL BOARD QUESTIONNAIRES AND DISCLOSURES TO IDENTIFY ANY POTENTIAL CONFLICTS BEFORE THEY ARISE. IN ADDITION, OUR EXECUTIVE ASSISTANT ATTENDS ALL BOARD MEETINGS TO ENSURE THAT IF ANY CONFLICTS ARISE, THEY ARE HANDLED APPROPRIATELY. IF SUCH CONFLICTS ARISE, THE ORGANIZATION COMPLIES WITH THE NEW HAMPSHIRE AND FEDERAL REQUIREMENTS FOR DISCLOSURES OF SUCH EVENTS. THE ORGANIZATION IS COMMITTED TO CONDUCTING ITS BUSINESS IN A MANNER THAT IS BOTH ETHICAL AND LEGAL. AS PART OF THIS COMMITTMENT, A STANDARD OF CONDUCT FORM IS REQUIRED OF ALL EMPLOYEES OF THE ORGANIZATION. THIS IS REVIEWED WITH ALL EMPLOYEES UPON HIRE AND ON AN ANNUAL BASIS THEREAFTER. THE STANDARD OF CONDUCT COVERS CONFLICT OF INTEREST AND OTHER VITAL MATTERS TO ENSURE ALL BUSINESS ACTIVITY IS CONDUCTED IN A MANNER THAT IS CONSISTENT WITH THE HIGHEST STANDARDS OF HONESTY, INTEGRITY AND FAIRNESS.
FORM 990, PART VI, SECTION B, LINE 15:	THE COMPENSATION COMMITTEE OF THE ALICE PECK DAY HEALTH SYSTEMS, CORP. BOARD OF TRUSTEES IS RESPONSIBLE FOR DETERMINING THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER/PRESIDENT. THE VICE PRESIDENT OF HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT PROVIDES COMPENSATION DATA OF COMPARABLE ORGANIZATIONS WITH APPROXIMATELY THE SAME SIZE STAFF AND SPENDING IN A LOCATION OF SIMILIAR SIZE. THE COMMITTEE DETERMINES THE APPROPRIATE COMPENSATION AND APPROVES AN AMOUNT THAT IS THEN COMMUNICATED TO HUMAN RESOURCES FOR ADJUSTMENT. THE CEO/PRESIDENT IS RESPONSIBLE FOR REVIEWING THE PERFORMANCE OF SENIOR MANAGEMENT STAFF. THE INFORMATION IS BROUGHT TO THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES ALONG WITH A RECOMMENDATION FOR THE SALARY OF EACH INDIVIDUAL. THE COMPENSATION IS DETERMINED THROUGH A VARIETY OF ANALYSIS OF SALARY DATA AND PERFORMANCE. INDIVIDUAL SALARY INCREASES ARE THEN BASED ON OVERALL PERFORMANCE, WITHIN BUDGETED INCREASES FOR THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES THE BASE COMPENSATION AND SALARY INCREASE AMOUNT.
FORM 990, PART VI, SECTION C, LINE 19:	THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII, SECTION A, COLUMN D:	DR. SUSAN E. MOONEY IS A PRACTICING PHYSICIAN IN ADDITION TO BEING THE CHIEF MEDICAL OFFICER AND VICE PRESIDENT. SHE WORKED AN AVERAGE OF 61 HOURS PER WEEK, OF WHICH AN AVERAGE OF 41 HOURS PER WEEK WERE SPENT ON EXECUTIVE MATTERS AND 20 IN HER ROLE AS A PHYSICIAN.
FORM 990, PART VII, SECTION A COLUMN E:	REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS: THE COMPENSATION REPORTED FOR HARRY G. DORMAN III, FACHE, AND EVALIE M. CROSBY, CPA, FHFMA, WAS PAID BY ALICE PECK DAY HEALTH SYSTEMS, CORP. FOR THEIR SERVICES AS FULL-TIME EXECUTIVES. THESE INDIVIDUALS WORKED AN AVERAGE OF 62 HOURS PER WEEK, OF WHICH MR. DORMAN SPENT AN AVERAGE OF 45 HOURS PER WEEK AND MS. CROSBY SPENT AN AVERAGE OF 50 HOURS A WEEK DEDICATED TO ALICE PECK DAY MEMORIAL HOSPITAL.
FORM 990, PART XII, LINE 2C:	OVERSIGHT OF AUDIT PROCESS: THE FINANCE COMMITTEE ACTS AS THE AUDIT COMMITTEE AND OVERSEES THE AUDIT PROCESS FOR THE ALICE PECK DAY ENTITIES. THE AUDIT PROCESS FOR THE FINANCIAL STATEMENTS DID NOT CHANGE FROM THE PRIOR YEAR. INDEPENDENT ACCOUNTANTS PERFORMED THE AUDIT FOR THE FISCAL YEARS ENDED 9/30/11 AND 9/30/12.
FORM 990, PART XI, LINE 5:	OTHER CHANGES IN NET ASSETS OR FUND BALANCE: CHANGE IN INTEREST RATE SWAPS: -61,341 CHANGE IN ANNUITY VALUATION: -15,114 UNREALIZED GAIN ON INVESTMENTS: 178,406
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:HARRY G. DORMAN III, FACHE TITLE:PRESIDENT AND CEO HOURS:17	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:SUSAN E. MOONEY, MD, MS, FACOG TITLE:VP & MEDICAL DIRECTOR HOURS:1	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:EVALIE M. CROSBY, CPA, FHFMA TITLE:VP FINANCE AND CFO HOURS:12	FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
ALICE PECK DAY HEALTH SYSTEMS CORP
10 ALICE PECK DAY DRIVE	LEBANON	NH	03766	020479095	PROMOTE HEALT	NH	501(C)3	LINE 11B,II	N/A	false
ALICE PECK DAY LIFECARE CENTER INC
10 ALICE PECK DAY DRIVE	LEBANON	NH	03766	020479094	INDEP & ASSIS	NH	501(C)3	LINE 9		false	APDHS
ALICE PECK DAY REALTY CORP
10 ALICE PECK DAY DRIVE	LEBANON	NH	03766	020485369	INACTIVE	NH	501(C)2			false	APDHS

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	ALICE PECK DAY HEALTH MANAGEMENT CORP	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	10 ALICE PECK DAY DRIVE	AddressLine1
City	LEBANON	City
State	NH	State
ZIP Code	037662647	ZIPCode

Field	Value	IRS element (for citing)
EIN	020485370	EIN
Primary Activity	INACTIVE	PrimaryActivity
Legal Domicile State	NH	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Type Of Entity	C corp.	TypeOfEntity

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