2013-08-29T11:32:31-07:00 2012-12-31 WILLIAM STEELE& ASSOCIATES 40 STARK STREET MANCHESTER NH 03101 990 2012-01-01 020222215 ST JOSEPH HOSPITAL STJO 6038823000 172 KINSLEY ST NASHUA NH 030612013 RICHARD BOEHLER 6038823000 2013-08-14 true WILLIAM G M STEELE JR CPSA ASSOCIAT 6036228881 2012 2016-02-24 21:20:13Z DAVID ROSS 172 KINSLEY ST NASHUA NH 030612013 188232641 false 0928 X stjosephospital.com X 1943 NH healthcare services to anyone needing care 14 10 1606 350 107472 669121 0 194262473 188125169 2260394 0 -26497 107472 197165491 188232641 0 0 81831327 84055965 0 0 90347984 86313425 172179311 170369390 24986180 17863251 223191366 258203971 115700175 134757618 107491191 123446353 X healthcare services to anyone needing care false false 40223633 59430497 INPATIENT MEDICAL, SURGICAL AND MENTAL HEALTH SERVICES TO ANYONE NEEDING CARE IN THE GREATER NASHUA AREA. 40223633 59430497 OUTPATIENT SERVICES INCLUDING SURGERY, RADIOLOGY, LABORATORY, REHABILITATIVE, CARDIOVASCULAR, BREAST HEALTH, ADULT DAY CARE, CARDIAC REHAB, AND MENTAL HEALTH TO ANYONE NEEDING SERVICES IN THE GREATER NASHUA AREA. 83541393 123432570 EACH YEAR ST. JOSEPH HOSPITAL PROVIDES MILLIONS OF DOLLARS WORTH OF CHARITY CARE AND COMMUNITY SERVICES REFLECTING OUR HEALING MISSION AND OUR VALUES. ST. JOSEPH HOSPITAL FOLLOWS THE METHODOLOGY RECOMMENDED BY THE CATHOLIC HEALTH ASSOCIATION FOR CALCULATING THE COST OF CHARITY CARE AND COMMUNITY BENEFITS. COMMUNITY BENEFIT REPORT FOR 2011 IS THE BASIS FOR THE EXPENSES ASSOCIATED WITH THESE ACTIVITIES. 25808346 School of nursing, LNA and other health professionals provided to the community in its mission of providing healthcare to the community in its mission of providing healthcare to the 25808346 129291634 true true false true false false false false false true true true true true true false false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false true true true true false true 0 0 true 1606 true true true false false false false false false false false false X 14 10 false false false false true true true true true false false true true true true true true true true false NH X X RICHARD PLAMONDON 6038823000 172 KINSLEY ST NASHUA NH 030612013 JIM HAMILL 40.00 X X 160553 0 889 RICHARD PLAMONDON 40.00 X 286455 0 49899 PAM DUCHENE 40.00 X 268726 0 39827 KEITH CHOINKA 40.00 X 243770 0 21040 BEVERLY ROBINSON 40.00 X 190431 0 33901 JAMES MCKENNA 40.00 X 220145 0 31201 JACQUI WOOLLEY 40.00 X 196578 0 35553 GREG ZUERCHER MD 40.00 X 325071 0 40487 MICHAEL MCGEE MD 40.00 X 270405 0 44427 ROBERT DEMERS 40.00 X 168457 0 38588 - W STEWART BLACKWOODMD 1.00 X 0 292205 27907 LINDA SHELDON 1.00 X 0 182215 26040 LOUISE TROTTIER 3.00 X X 0 0 0 SRSUZANNE FORGET 1 X X DALE GILPIN 1 X MSGRJOHN PQUINN 1 X ALLISE MDESMET 1 X LORI KLAMBERT 1 X STEVEN BEAUDETTE MD 1 X SHARON TAMPOSI 1 X CHARLES SMITH 1 X 2330591 474420 389759 10 false true false COVENANT HEALTH SYS 100 AMES POND RD TEWKSBURY MA 01876 Managment & other svcs. 3198178 MMAYO MEDICL LAB BOX9146 MINNEAPLIS MN 55480 laboratory services 1179636 COVENANT HEALTH SYSTEMS INSURANCE BOX 69 CAYMAN IS CJ DE 00000 insurance 3587871 HOSPITAL MEDICINE ASSOCIATES BOX 1953962 CINCINNATI OH 452634850 physician services 1919738 ALLIANCE HEALTHCARE SERVICES BOX 96485 CHICAGO IL 60693 Imaging services 1447527 5 Patient services 622110 182863067 School of nursing 622110 1272660 cafeteria 622110 993111 Program fees 622110 124848 Thrift/gift shop 622110 216743 2654740 2362747 188125169 housekeeping svc 721100 21045 21045 laundry svc 812300 6576 6576 answering svc 561100 79851 79851 107472 188232641 185762422 107472 2362747 0 0 0 0 0 0 0 0 1012766 447936 564830 0 0 0 0 0 67815199 50861399 16953800 0 2248929 1686697 562232 0 8139276 6104457 2034819 0 4839795 3629846 1209949 0 3112797 2334598 778199 0 200363 0 200363 0 115278 0 115278 0 0 0 0 0 0 0 3112797 2334598 778199 0 0 0 0 0 880673 660505 220168 0 4059953 3044965 1014988 0 3839408 2879531 959877 0 0 0 0 0 3184768 2388576 796192 0 20765 15574 5191 0 0 0 0 0 130966 98225 32741 0 3107347 2330510 776837 0 2719728 0 2719728 0 8850578 6637934 2212644 0 2403855 1802891 600964 0 bad debts 9630494 9630494 0 0 Medicaid tax 6058364 6058364 0 0 purchased/contract svc 6400651 4800488 1600163 0 repairs/PM contracts 5303408 3977556 1325852 0 23181232 17566490 5614742 0 170369390 129291634 41077756 0 1012221 3284367 15940927 35924945 110 16474727 13572730 2521163 2720864 1698199 1802794 4416557 6081076 169786923 109138204 62487122 60648719 50608381 49972067 28522646 48971581 18887752 11784466 20621561 23440362 223191366 258203971 16772058 18948557 142528 97239 72213230 97838826 26572359 17872996 115700175 134757618 X 106520097 122390841 606885 691267 364209 364245 107491191 123446353 223191366 258203971 17863251 -5158623 X X false true X true true true X 0 0 0 0 0 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED Pt II-B Line 1i A portion of the dues paid to the NH Hospital Association, CATHOLIC HEALTH ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. false true 971094 971094 1064132 246999 243 340280 971094 1124772 301910 284 362834 1064132 1421717 397836 142 694923 1124772 1901086 329950 15853 825172 1421717 false false 3586823 3586823 93355728 48029869 45325859 1688633 1231561 457072 69512778 59876774 9636004 1642961 1642961 60648719 48971581 F 48971581 Investment in subsidiaries 11784466 C 11784466 unamortized bond expense 1441130 other accounts receivable 1858508 due from affiliate 15981520 due from other funds 123346 Nashua Regional Cancer Center 2227653 other equity investments 558205 Surgery Center of greater Nashua 1250000 23440362 Due to third party payors 937121 Other 1095855 malpractice tail liability 1076304 environmental liability 6335106 pension liability 6714332 due to affiliate for bond redistribution 1136994 lease payable 577284 17872996 Pt XI Line 4b .... Pt IV Line 2b .. true true true X true X true true true false true true 5351 8798 14149 14149 true X true true FIRST CHOICE PHO Physician hospital organization 0.50000 0.00000 0.50000 1 1 ST JOSEPH HOSPITAL

172 KINSLEY ST NASHUA NH 030612013

X X X X ST JOSEPH HOSPITAL 1 true true 300 true 222300 true X X true true X X X X X X true X false true X false false Pt III Line 4 Adjusted based on cost to charge ratio Pt III Line 9b Every statement sent to patients indicates that financial assistance is available, phone number and email contact. All customer service personnel are attuned to asking patients if they need assistance. Pt VI Line 2 The needs assessment was conducted as a collaborative effort between St. Joseph Hospital and several other healthcare institutions, civic agencies and other non profit entities from throughout Greater Nashua. The assessment included a telephone survey of over 500 households, two focus groups of patients and key leaders representing city/town government, education, healthcare, businesses and non profit institutions. Pt VI Line 3 Signage and brochures are at every point of registration, which explain our charity care and financial assistance policies. We have dedicated financial counselors who meet in person or on the telephone assisting patients and families needing financial assistance. Information can also be found on the hospital web site, as well as in hospital community newsletters/quarterly publications. All customer service and registraton personnel are trained to ask patients and families if they need financial assistance. Pt VI Line 4 St.Joseph Hospital serves people of all ages, race,gender,religion, ethnicity regardless of their ability to pay. The hospital's primary and secondary service areas consist of 17 cities and towns referred to as the Greater Nashua Area and consist of:Amherst,Brookline,Hudson Hollis,Litchfield,Merrimack,Milford,Nashua,Wilton,Greenville, Dunstable(MA),Londonderry,Lyndeborough,Mont Vernon,Pelham,Pepperell(MA, and Windham. Pt VI Line 5 The hospital maintains an open medical staff, representing over forty different specialties and treats all patients regardless of their ability to pay. The Board of Directors is made up of community members with varied backgrounds and industries. The hospital utilizes any surplus funds to further its mission by providing free and low cost healthcare services, educational offerings, free screenings, support groups, and works collaboratively with other healthcare agencies to meet the identified healthcare needs of our community. Pt VI Line 5 St.Joseph Hospital is an affiliate of Covenant Health Systems, Tewksbury, MA. It is the responsibility of the entire staff of St.Joseph Hospital to serve and promote the health of the Greater Nashua Community. Pt III Line 4 Text of the footnote in financial statement-"The allowance for doubtful accounts is provided based on an analysis by management of the collectibility of outstanding balances. Management considers the age of the outstanding balances and past collection efforts in determing the reserve for doubtful accounts. Accounts deemed uncollectible are charged off against the established reserve". Bad debts are reported as charges. Pt V Sec B 15e Extensive efforts are made to determine eligibility for free care, before any credit reporting, liens or lawsuits are filed. Pt VI Line 7 NH false true false false false false false true false JIM HAMILL 138053 22500 889 161442 RICHARD PLAMONDON 240482 20997 24976 24453 25446 336354 PAM DUCHENE 212052 35171 21503 7350 32477 308553 KEITH CHOINKA 191788 26470 25512 7372 13668 264810 BEVERLY ROBINSON 165298 25133 7367 26534 224332 JAMES MCKENNA 188441 12272 19432 6580 24621 251346 JACQUI WOOLLEY 178537 13960 4081 1332 34221 232131 GREG ZUERCHER MD 276614 30484 17973 7350 33137 365558 MICHAEL MCGEE MD 246527 23878 7353 37074 314832 ROBERT DEMERS 138151 6401 23905 5126 33462 207045 W STEWART BLACKWOODMD 237389 25000 29816 27907 320112 LINDA SHELDON 157553 10640 14022 26040 208255 Pt I Line 1b These benefits are included in taxable income and are part of the analysis of the overall reasonableness of the executive compensation. Pt I Line 4b Supplemental employee retirement plan- Richard Plamondon $16,500 Pt I Line 7 "cash in" of earned time A NH HEALTH & EDUCATION FACILITIES AUTHORITY 020279866 644614KA6 2004-05-13 21173782 Renovations&improvements false false true B NH HEALTH & EDUCATION FACILITIES AUTHORITY 020279866 644614UG2 2007-10-30 53869522 Renovations&equipment false false true A 21173782 1507744 423476 2004 false true true true B 53680000 4911229 681812 2008 false true false true A false false false false 0.00000 0.00000 0.00000 true B false false false false 0.00000 0.00000 0.00000 true A true false false false false B true false false false false Pt VI, Line 7a St.Joseph Hospital is a subsidiary of Covenant Health Systems, and as Pt VI, Line 7b such, all decisions are subject to its review. Pt VI, Line 8a All meetings of the Board and Committees have minutes taken at Pt VI, Line 8b the time of the meeting and readily available for review. Pt VI, Line 11a 990's are reviewed by independent tax accountant, and then reviewed at the Finance Committee and Board level. Pt VI, Line 12c Each year, St.Joseph Hospital conducts a survey of Board members and key members of management to determine whether there are conflicts of interest(actual or potential). An annual report is presented to the Board. Board members and key managers have a continuing obligation to report any proposed transaction which may be perceived as a conflict of interest. Pt XII, Line 2c The Finance Committee meets with the independent auditors to review audited financial statements, and they are reviewed at Covenant Health Systems. Pt VI, Line 15 Every 2-3 years, the Compensation Committee of Covenant Health System's Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is used to develop recommendations for changes to the compensation program. Since 2003 the Committee has engaged Mercer Human Resources Consulting to conduct this analysis. Objectives of the analysis are to: assess the compositeness of the current total cash compensation levels for the senior management team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if any, are competitive and reasonable. Pt VI, Line 19 Upon request the organization will make available corporate documents and financial statements. Form 990, Part III, Line 4d SCHOOL OF NURSING, LNA AND OTHER HEALTH PROFESSIONALS PROVIDED TO THE 25808346. 0. 0. Form 990, Part IX, Line 24f PHYSICIAN FEES MEDICAL SUPPLIES FOOD SUPPLIES MISCELLANEOUS Pt VI, Line 6 Covenant Health System is the sole member of St.Joseph Hospital. Pt VI, Line 11b 990's are reviewed by an independent tax accountant and Pt VI, Line 11b then reviewed by the finance committee and Board Pt VI, Line 15a Every 2-3 years the Compensation Committee of Covenant Health System's Pt VI, Line 15a Board of Directors engages an external consultant to ptovide competitive Pt VI, Line 15a market data from various survey sources, which is used to develop Pt VI, Line 15a recommendations fo changes to the compensation program. Since 2003 Pt VI, Line 15a the Committee has engaged Mercer Resources Consulting to Pt VI, Line 15a ensure that the annual incentive opportunities, if any, are competitive and reasonable. conduct this analysis. Objectives of the analysis are to: access the competitiveness of the current compensation levelsfor the senior management team, develop market based competitive salary ranges for executive positions and Pt VI, Line 15b see 15A Pt XI,Line 5 Pension adjustment (5,721,371),loss on subsidiaries (13,466,622) donated capital 246,999, unrealized losses (1,645,621), discontinued operations (2,533,273) and fund activity at other entities for pension and and unrealized losses (498,842). SJH SURGICENTER LLC 172 KINSLEY ST NASHUA NH 030612013 204181845 OUTPATIENT SURGERY NH ST JOSEPH HOSPITAL COVENANT HEALTH SYSTEMS 420 BEDFORD ST LEXINGTON MA 024201502 222484505 HEALTHCARE MA 501(c)(3) 509(a)(2) SOUHEGAN NURSING ASSOCIATION 24 NORTH RIVER RD MILFORD NH 03055 020222795 HOME HEALTH&HOSPICE NH 501(c)(3) 509(a)(1) STJOSEPH HOSPITAL THE SURGICENTER AT STJOSEPH HOSPITAL INC 172 KINSLEY ST NASHUA NH 030612013 020222215 HEALTHCARE NH 501(c)(3) 509(a)(1) STJOSEPH HOSPITAL DH FAMILY MEDICINE OF NASHUA 172 KINSLEY ST NASHUA NH 030612013 208404257 PHYSICIAN SERVICES NH 501(c)(3) 509(a)(2) STJOSEPH HOSPITAL STJOSEPH HOSPITAL CORPORATE SERVICES 172 KINSLEY ST NASHUA NH 030612013 020405197 HOLDING COMPANY NH STJOSEPH HOSPITAL C 1.00000 FIRST CHOICE PHO 172 KINSLEY ST NASHUA NH 03060 020461536 physician hospital organization NH STJOSEPH HOSPITAL C 0.50000 false false false false false false false false false true true false false false true true true true true STJOSEPH CORPORATE SERVICES i cash STJOSEPH CORPORATE SERVICES j cash STJOSEPH CORPORATE SERVICES n cash SOUHEGAN NURSING ASSOCIATION n cash STJOSEPH CORPORATE SERVICES p cash SOUHEGAN NURSING ASSOCIATION p STJOSEPH CORPORATE SERVICES q DH FAMILY MEDICINE OF NASHUA q SOUHEGAN NURSING ASSOCIATION r SURGICENTER AT ST JOSEPH HOSPITAL r COVENANT HEALTH SYSTEMS o