2013-08-14T13:33:35-05:00 2012-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2011-10-01 020397338 Valley Regional Healthcare Inc VALL 6035427771 243 Elm Street Claremont NH 03743 Steven L Monette 6035427771 2013-08-13 1 Barbara J McGuan CPA P00219457 2077752387 2013-08-13 2011 2016-02-24 21:20:13Z Claire Bowen 243 Elm Street Claremont NH 03743 5148974 0 X www.vrh.org X 1986 NH Parent organization to Valley Regional Hospital, Inc. 21 17 97 5 0 0 402572 355257 4855393 4644294 107141 84626 70736 32886 5435842 5117063 0 0 0 0 4405200 4039395 0 0 0 954599 1102222 5359799 5141617 76043 -24554 2821141 3153139 868147 1013708 1952994 2139431 Valley Regional Healthcare, Inc. is organized to coordinate and support the activities of health care organizations, including Valley Regional Hospital, Inc. 0 0 3416485 4644294 Valley Regional Healthcare is the parent organization for Valley Regional Hospital. In this role, Valley Regional Healthcare provides integrated management and support services for the Hospital. Valley Regional Healthcare also operates Connecticut Valley Home Care, a home health care agency. 3416485 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 14 0 1 97 1 0 0 0 0 0 0 0 0 0 0 X 21 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 0 1 1 1 1 0 NH X Steven Monette 6035427771 243 Elm Street Claremont NH 03743 Volker Bradley MD 1.00 X 0 0 0 Albert Leahy Jr 1.00 X 0 0 0 Michael O'Connell 1.00 X 0 0 0 Michael L Prozzo Jr 1.00 X 0 0 0 Alison Raymond 1.00 X 0 0 0 Lisa Richmond 1.00 X 0 0 0 Bernard Rosen MD 1.00 X 0 0 0 Michael Satzow 1.00 X 0 0 0 Carol Vivian 1.00 X X 0 0 0 Jim Wimberg 1.00 X 0 0 0 Claire Bowen 40.00 X X 274279 0 14139 Robert Porter 1.00 X 0 0 0 Robert Cricco MD 1.00 X 0 282213 22394 Michael Fuerst 1.00 X X 0 0 0 Oliver Herfort MD 1.00 X 0 195328 27484 Sherwood Moody 1.00 X 0 0 0 Charlene Lovett 1.00 X 0 0 0 James Borchert 1.00 X 0 0 0 Valerie Mahar 1.00 X 0 0 0 Patricia Putnam 1.00 X 0 0 0 Charles Sawyer MD 1.00 X 0 288427 14670 Steven Monette 40.00 X 152126 0 1686 Margaret Burns 40.00 X 150169 0 6108 Gregg Burdett 40.00 X 134831 0 21797 711405 765968 108278 4 0 1 0 0 355257 355257 Patient Service Revenu 621610 2899678 2899678 Management Services 621610 1781531 1781531 Miscellaneous Revenue 900099 179500 179500 Contractual/Char. Adj. 621610 -216415 -216415 4644294 43129 43129 12933 31911 -18978 -18978 -18978 41497 0 41497 41497 41497 Other Revenue 900099 51864 51864 51864 5117063 4644294 0 117512 442231 67295 374936 2939245 2110237 829008 26718 20100 6618 405069 267420 137649 226132 146181 79951 366 366 13000 13000 15971 15971 248045 76568 171477 43077 43077 360073 339295 20778 138124 126376 11748 125278 120994 4284 42869 42869 60594 1248 59346 Provision for Bad Debts 41164 41164 Miscellaneous 13661 13661 5141617 3416485 1725132 0 50 217135 206239 37966 289128 295726 14412 6587 483696 257409 250172 226287 1459973 1756125 601167 613313 2821141 3153139 377653 579371 101833 96452 388661 337885 868147 1013708 X 1913902 2103305 39092 36126 1952994 2139431 2821141 3153139 X -24554 210991 X 0 1 1 X 0 X X X 0 0 0 Valley Regional Hospital Inc 020222118 3 1 1 1 5141617 1 5141617 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 483696 257409 226287 226287 Due from Affiliates 324130 Cash Surrender Value of Life Insurance 289183 613313 Due to Affiliates 290165 Reserve for Self-Funded Insurance 47720 337885 X X X X 0 0 0 0 0 1 1 0 0 Claire Bowen 260128 0 5000 0 9151 0 5175 0 8964 0 288418 0 0 0 Robert Cricco MD 0 273924 0 0 0 8289 0 597 0 21797 0 304607 0 0 Oliver Herfort MD 0 167298 0 3014 0 25016 0 3929 0 23555 0 222812 0 0 Charles Sawyer MD 0 281037 0 0 0 7390 0 5595 0 9075 0 303097 0 0 Steven Monette 151809 0 0 0 317 0 0 0 1686 0 153812 0 0 0 Margaret Burns 149070 0 0 0 1099 0 2922 0 3186 0 156277 0 0 0 Gregg Burdett 130796 0 0 0 4035 0 0 0 21797 0 156628 0 0 0 Part I, Line 6 No specific goals were established by the Board for the CEO. For the CEO and Senior VPs, any increase in pay rate would be the same as an approved rate increase for all employees. Form 990, Part VI, Section A, line 6 The Corporation has an assembly of Overseers. Form 990, Part VI, Section A, line 7a The Overseers elect directors to the Board. Form 990, Part VI, Section A, line 7b The power to alter, amend or repeal the bylaws or to adopt new bylaws shall be vested in the Assembly of Overseers. Form 990, Part VI, Section B, line 11 The Organization's CFO reviews the draft Form 990 prior to its filing. The CFO then goes over the document with the board's finance committee. Form 990, Part VI, Section B, line 15 The executive committee of the board of trustees convenes on an annual basis to review the compensation of the CEO. At this time, Olney & Associates CEO Survey is used to determine an appropriate rate of pay. Other determining factors include overall hospital performance and completion of individual CEO goals and objectives. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 210,991. Valley Regional Hospital Inc 243 Elm Street Claremont NH 03743 020222118 Critical Access Hospital NH 501(c)(3) 3 Valley Regional Health Care Inc 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0