MARY HITCHCOCK MEMORIAL HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: MARY HITCHCOCK MEMORIAL HOSPITAL (EIN 02-0222140)
Tax period: 2010-10-01 to 2011-09-30
Filed: 2012-08-15
IRS object ID: 201212289349301536
Schema version: 2010v3.7
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 F
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-08-15T11:44:44-05:00	Timestamp
Tax Period End Date	2011-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE SUITE 2600	AddressLine1
City	INDIANAPOLIS	City
State	IN	State
ZIP Code	46204	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	020222140	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mary Hitchcock Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MARY	NameControl
Phone	6036505000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	One Medical Center Drive	AddressLine1
City	Lebanon	City
State	NH	State
ZIP Code	03756	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Robin Kilfeather-Mackey	Name
Title	CFO	Title
Phone	6036505668	Phone
Date Signed	2012-08-02	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	3176817000	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	James Weinstein MD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	One Medical Center Drive	AddressLine1
City	Lebanon	City
State	NH	State
ZIP Code	03756	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	1008558078	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.dartmouth-hitchcock.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1889	YearFormation
State Legal Domicile	NH	StateLegalDomicile
Activity Or Mission Description	ADVANCING HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	18	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	16	NbrIndependentVotingMembers
Total Nbr Employees	5430	TotalNbrEmployees
Total Nbr Volunteers	500	TotalNbrVolunteers
Total Gross UBI	2667946	TotalGrossUBI
Contributions Grants Prior Year	10252966	ContributionsGrantsPriorYear
Contributions Grants Current Year	9876785	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	815774940	ProgramServiceRevenuePriorYear
Program Service Revenue CY	853974784	ProgramServiceRevenueCY
Investment Income Prior Year	18049083	InvestmentIncomePriorYear
Investment Income Current Year	20457772	InvestmentIncomeCurrentYear
Other Revenue Prior Year	37950598	OtherRevenuePriorYear
Other Revenue Current Year	47455058	OtherRevenueCurrentYear
Total Revenue Prior Year	882027587	TotalRevenuePriorYear
Total Revenue Current Year	931764399	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	990807	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	979917	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	534789852	SalariesEtcPriorYear
Salaries Etc Current Year	557911351	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	2343599	TotalFundrsngExpCurrentYear
Other Expense Prior Year	315249387	OtherExpensePriorYear
Other Expenses Current Year	375099356	OtherExpensesCurrentYear
Total Expenses Prior Year	851030046	TotalExpensesPriorYear
Total Expenses Current Year	933990624	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	30997541	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-2226225	RevenuesLessExpensesCY
Total Assets BOY	1129681214	TotalAssetsBOY
Total Assets EOY	1147030352	TotalAssetsEOY
Total Liabilities BOY	675063960	TotalLiabilitiesBOY
Total Liabilities EOY	718120459	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	454617254	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	428909893	NetAssetsOrFundBalancesEOY
Mission Description	ADVANCING HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	767420962	Expense
Grants	825332	Grants
Revenue	838584593	Revenue
Description	PSA #1: Hospital Operations Mary Hitchcock Memorial Hospital (the Hospital), is an acute and tertiary care teaching hospital located in Lebanon, New Hampshire. The Hospital is a not-for-profit organization, as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from Federal income taxes on related income pursuant to Section 501(a) of the Code. The Hospital provides a broad range of patient services and health related community services, consistent with its role as a community hospital, a major teaching hospital and a tertiary care referral hospital. These include a full range of services in both acute and critical medicine, surgery, psychiatry and rehabilitation for infants, children and adults. During FY 2011 the Hospital provided 121,342 acute patient days of inpatient service and had 25,062 total acute care discharges, while the Hospital's emergency room was open to the public 24 hours per day, 7 days per week and had 24,349 discharges. The Hospital operates as an integral component of the Dartmouth Hitchcock Medical Center (DHMC), a New Hampshire nonprofit corporation organized for the exploration and coordination of matters of mutual interest among its members which consist of the Hospital, Dartmouth-Hitchcock Clinic (the Clinic), Geisel School of Medicine (GSM), a component of Dartmouth College, and the Veterans Affairs Medical Center in White River Junction, Vermont. The Clinic provides the physician staff to the Hospital and the sophistication essential for the development of the Hospital as the largest and only teaching hospital in New Hampshire and the designation by the federal government as a Rural Referral Center for northern New England. The mission of the Hospital is to advance health through research, education, clinical practice and community partnerships, providing each person the best care, in the right place, at the right time, every time. Consistent with this mission and in partnership with the Clinic, the Hospital provides high quality, cost effective, comprehensive, and integrated health care to individuals, families, and the communities it serves regardless of a patient's ability to pay. The Hospital actively supports community-based health care and promotes the coordination of services among health care providers and social services organizations. The Hospital also seeks to work collaboratively with other area health care providers to improve the health status of the region. Effective with fiscal year 2000, the Hospital and the Clinic began filing an annual Community Benefit Report with the State of New Hampshire which outlines the community and charitable benefits they provide. The most recent Community Benefit Reports are available upon request or can be found on Dartmouth-Hitchcock's web site (www.dartmouth-hitchcock.org). Financial assistance, formerly called charity care, represents services provided to patients who cannot afford health care services due to inadequate financial resources which result from being uninsured or underinsured. For the year ended September 30, 2011 the Hospital provided financial assistance to 9,312 patients in the amount of $30,402,969, as measured by gross charges. The estimated cost of providing this care for the year ended September 30, 2011 was $12,666,607. The Hospital also routinely provides services to Medicaid patients at reimbursement levels that are below the cost of the care provided. The Community health activities includes the cost or value of several different types of programs including the cost of community based education, health fairs, health screenings, support groups, and programs and materials that promote wellness and prevent illness. Examples of these types of efforts include partnering with the Healthy Eating Active Living NH initiative, the Women's Health Resource Center, and smoking prevention and cessation. This category also includes financial contributions and the contribution of time and services to community programs, hospitals and agencies. The Hospital also provides a significant amount of uncompensated care to its patients reported as provision for bad debts, which is not included in the amounts reported above. During the years ended September 30, 2011, the Hospital reported a provision for bad debts of approximately $27,385,917.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	42852056	Expense
Revenue	36532317	Revenue
Description	As a component of an integrated academic medical center, the Hospital provides significant support for academic and research programs through its support of The Geisel School of Medicine at Dartmouth College. MHMH provides support for Physicians' unpaid teaching time as part of its Community Benefit Initiatives, consisting of the time physicians spend providing clinical supervision and education for residents and medical students. In addition, the Hospital provides in-kind support for research and other grants representing costs in excess of awards for numerous grant-funded health research and service initiatives awarded to the Clinic and GSM. Other community benefit initiatives include subsidizing the costs of providing medical and clinical education to professionals across New Hampshire, Vermont and beyond as well as uncompensated costs of academic and medical research activities.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	810273018	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
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	true	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	true	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	true	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	true	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	true	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	true	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	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	959	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	5430	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	true	ForeignFinancialAccount
Name Of Foreign Country	BD	NameOfForeignCountry
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	true	QuidProQuoContributions
Quid Pro Quo Disclosure	true	QuidProQuoDisclosure
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	18	NbrVotingGoverningBodyMembers
Number Independent Voting Members	16	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	true	LocalChapters
Policies Reference Chapters	false	PoliciesReferenceChapters
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	true	InvestmentInJointVenture
Written Policy Or Procedure	true	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	NH	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ROBIN KILFEATHER-MACKEY	NamePerson
Telephone Number	6036505668	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	ONE MEDICAL CENTER DRIVE	AddressLine1
City	Lebanon	City
State	NH	State
ZIP Code	03756	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (45 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
Michael J Goran MD
Trustee	1.0	X	0	0	0
Alfred L Griggs
Trustee/Chair Emeritus	1.0	X	0	0	0
Stephen P Barba
Board Secretary Trustee	2.0	X	0	0	0	X
Alan C Keiller
Trustee/Board Treasurer	2.0	X	0	0	0	X
Stephen F Christy
Trustee Ended 9/23/11	1.0	X	0	0	0
Wayne G Granquist
Trustee/Board Chair	2.0	X	0	0	0	X
Jennie L Norman
Trustee	1.0	X	0	0	0
Richard S Shreve
Trustee/President Appointee	1.0	X	0	0	0
Hugh C Smith MD
Trustee	1.0	X	0	0	0
Vincent S Conti
Trustee	1.0	X	0	0	0
Anne-Lee Verville
Trustee	1.0	X	0	0	0
Nancy Formella
Pres MHMH/Trustee Ex Officio	60.0	X	783533	0	28191	X
Thomas Colacchio MD
Trustee/Pres D-HH	1.0	X	0	735805	56310	X
Barbara Couch
Trustee	1.0	X	0	0	0
Wiley Souba MD
Tstee Ex-Off Dean DMS Eff 10/1	1.0	X	0	0	0
William J Conaty
Trustee Eff 6/1/2011	1.0	X	0	0	0
John L Harrison Jr
Tstee/Ex Off,DHMC Aux Eff 10/1	1.0	X	0	0	0
William W Helman IV
Trustee Appointee Eff 4/28/11	1.0	X	0	0	0
Robert A Oden Jr PhD
Trustee Appointee Eff 1/27/11	1.0	X	0	0	0
Carl Dematteo
Chief Quality Compliance Offcr	30.0		0	570672	26593	X
Robin Kilfeather-Mackey CPA
Chief Financial Officer	27.5		0	375702	21496	X
Peter Johnson
Chief Information Officer	30.0		0	421481	30493	X
Linda Von Reyn
Chief Nursing Officer	30.0		322292	0	29131	X
Daniel Jantzen CPA
Chief Operating Officer	30.0		528264	0	32570	X
Stephen Leblanc
Exec VP D-H Health	25.0		0	475512	28446	X
John Butterly MD
Exec VP of Med Affairs, D-HH	25.0		0	500322	62741	X
Brian Lally
Chief Advancement Officer	30.0		0	253101	47210	X
Lawrence Dacey MD
Chief Medical Officer	30.0		0	567275	34574	X
Alan Weston
Chief HR Officer (Eff 1/24/11)	30.0		0	0	0	X
Mary Oseid
V.P Ambulatory Care	20.0		0	254337	28473		X
Christine Schon
V.P Comm. Grp. Pract. Ops	20.0		0	200195	37860		X
William Mroz
V.P. Operations/Clinical Svcs	20.0		253554	0	46149		X
Sandra Dickau
V.P. Operations/Patient Care	20.0		249038	0	17769		X
Mary Kay Boudewyns
V.P. Revenue Management	20.0		205136	0	18357		X
Gail Dahlstrom
V.P. Facilities Mgmt	20.0		210377	0	16262		X
Michael Ward
V.P. Cancer Services	20.0		0	244106	28145		X
David Gladstone
Chief Clinical Phys Rad/Onc	40.0		260931	0	48441			X
Bruce King
Pres & CEO New London Hosp	40.0		294973	0	29159			X
Susan Reeves
VP/Chair Nurs Colby Saw Collg	40.0		275908	0	27548			X
Neil Castaldo
Legal Counsel	40.0		626176	0	50387			X
Mark Bellerive
Asst Chief Clin Phys Rad/Onc	40.0		241028	0	54740			X
Richard Showalter
Former Key Employee			246600	0	23840				X
John Collins
Former Key Employee			117666	376380	55295				X
Victoria George
Former Key Employee			0	163495	19140				X
Richard Davis
Former Key Employee			0	101865	3741				X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4615476	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	5240248	TotalReportableCompFrmRltdOrgs
Total Other Compensation	903061	TotalOtherCompensation
Number Individuals GT100 K	349	NumberIndividualsGT100K
Formers Listed	true	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
ACCRETIVE HEALTH
401 N MICHIGAN AVE SUITE 2700	CHICAGO	IL	60611	REVENUE MNGT SERVICE	17740601
TRUSTEES OF DARTMOUTH COLLEGE
37 DEWEY FIELD	HANOVER	NH	03755	ADMIN & DIR SUPPORT	19703242
Harvey Construction
10 Harvey Road	BEDFORD	NH	03110	Construction Svcs	6097857
Pizzagalli Construction Company
50 Joy Drive	SOUTH BURLINGTON	VT	05403	CONSTRUCTION SVCS	5454014
NEW HAMPSHIRE IMAGING SERVICES INC
ONE PILLSBURY ST SUITE 200	CONCORD	NH	60122	Imaging Services	4902277

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	182	NumberOfContractorsGT100K
Fundraising Events	3636162	FundraisingEvents
Government Grants	1459162	GovernmentGrants
All Other Contributions	4781461	AllOtherContributions
Noncash Contributions	80673	NoncashContributions
Total Contributions	9876785	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE	621110	852329035	852329035
FEE FOR SERVICE GRANTS, OTHER, RESEARCH	621110	1101573	1101573
MOBILE ECHO CARD REVENUE	621110	538079	538079
HOLTERSCAN REVENUE	621110	6097	6097

Field	Value	IRS element (for citing)
Total Program Service Revenue	853974784	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	8735804	TotalRevenueColumn
Exclusion	$8,735,804	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	912438	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	621507	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	290931	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	290931	TotalRevenueColumn
Exclusion	$290,931	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	87079087	Securities
Other	34554	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	74923268	Securities
Other	813042	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	12155819	Securities
Other	-778488	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	11721968	TotalRevenueColumn
Exclusion	$11,721,968	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	398506	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	3636162	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	435862	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	-37356	TotalRevenueColumn
Exclusion	-$37,356	ExclusionAmount

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

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA	722212	3786785	$3,786,785
PHARMACY INCOME	622110	19652733	$19,604,626	48107
MEANINGFUL USE	622110	8820337			8820337

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	14941628	TotalRevenueColumn
Related Or Exempt Function Income	12321789	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	2619839	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	47201483	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	931764399	TotalRevenueColumn
Related Or Exempt Function Income	875116910	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	2667946	UnrelatedBusinessRevenue
Exclusion	$44,102,758	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	597765	Total
Program Services	597765	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	382152	Total
Program Services	382152	ProgramServices

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	5878645	Total
Program Services	2028306	ProgramServices
Management And General	3529394	ManagementAndGeneral
Fundraising	320945	Fundraising

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	400069670	Total
Program Services	339773152	ProgramServices
Management And General	60296518	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	62379679	Total
Program Services	52978123	ProgramServices
Management And General	9401556	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	61393081	Total
Program Services	52140220	ProgramServices
Management And General	9252861	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	28190276	Total
Program Services	23941577	ProgramServices
Management And General	4248699	ManagementAndGeneral

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	1804254	Total
Management And General	1804254	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	310510	Total
Management And General	310510	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	0	Total

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	60967294	Total
Program Services	47654698	ProgramServices
Management And General	13312596	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	2072695	Total
Program Services	48338	ProgramServices
Management And General	2024357	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	124650029	Total
Program Services	119171566	ProgramServices
Management And General	5478463	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	4415279	Total
Program Services	3973751	ProgramServices
Management And General	441528	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	12276800	Total
Program Services	11033807	ProgramServices
Management And General	1242993	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	1522679	Total
Program Services	569603	ProgramServices
Management And General	953076	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	115504	Total
Program Services	6633	ProgramServices
Management And General	108871	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	14217121	Total
Program Services	12795409	ProgramServices
Management And General	1421712	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	35647345	Total
Program Services	32970920	ProgramServices
Management And General	2676425	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	8658545	Total
Program Services	7869603	ProgramServices
Management And General	788942	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAID ENHANCEMENT TAX	43490956	43490956
PROVISION FOR BAD DEBTS	27385917	27385917
EQUIPMENT RENTAL & MAINT	10135956	9122358	1013598
D-HH ASSESSMENT	3506925	3506925
DHMC ASSESSMENT	3005949	3005949

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	20915598	Total
Program Services	15825290	ProgramServices
Management And General	3067654	ManagementAndGeneral
Fundraising	2022654	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	933990624	Total
Program Services	810273018	ProgramServices
Management And General	121374007	ManagementAndGeneral
Fundraising	2343599	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	82299	BOY
EOY	357738	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	49127873	BOY
EOY	49844820	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	135997590	BOY
EOY	152519707	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	457401	BOY
EOY	354122	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	2503233	BOY
EOY	2003212	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	13257671	BOY
EOY	13445617	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	4420595	BOY
EOY	5281075	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	725762783	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	350269617	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	331068501	BOY
EOY	375493166	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	453576706	BOY
EOY	279749986	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	81461317	BOY
EOY	212463631	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	2238669	BOY
EOY	2477568	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	55489359	BOY
EOY	53039710	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	1129681214	BOY
EOY	1147030352	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	170120779	BOY
EOY	198080127	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	362562261	BOY
EOY	356318885	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	5544170	BOY
EOY	4351905	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	136836750	BOY
EOY	159369542	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	675063960	BOY
EOY	718120459	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	378725214	BOY
EOY	354333671	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	48353644	BOY
EOY	46706072	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	27538396	BOY
EOY	27870150	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	454617254	BOY
EOY	428909893	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1129681214	BOY
EOY	1147030352	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-2226225	ReconcilationRevenueExpenses
Reconcilation Other Changes	-23481136	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
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	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

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
Volunteers	false	Volunteers
Paid Staff Or Management	true	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	true	DirectContactLegislators
Direct Contact Legislators	$159,713	DirectContactLegislatorsAmount
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	159713	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	LOBBYING ACTIVITY EXPLANATION	Identifier
Return Reference	SCHEDULE C, PART II, B	ReturnReference
Explanation	MARY HITCHCOCK MEMORIAL HOSPITAL EMPLOYS TWO FULL TIME STAFF WHOSE DUTIES INCLUDE LOBBYING. TYPICAL EXPENSES ASSOCIATED WITH THE LOBBYING ACTIVITIES INCLUDE STAFF SALARY, TRAVEL, MEMBERSHIP FEES AND DUES. FOR THE FISCAL YEAR ENDED SEPTMEBER 30, 2011, MARY HITCHCOCK MEMORIAL HOSPITAL INCURRED $159,713 IN CONJUCTION WITH THIS ACTIVITY. FROM TIME TO TIME, MARY HITCHCOCK MEMORIAL HOSPITAL, THROUGH ITS EMPLOYEES AND THE USE OF CONSULTANTS, CONTACTS GOVERNMENT OFFICIALS AND LEGISLATORS. THIS CONTACT IS FOR THE PURPOSE OF PROPOSING LEGISLATION OR EXPRESSING AN OPINION ON CHANGES IN LEGISLATION THAT AFFECT THE HOSPITAL AND ITS ABILITY TO CARRY OUT ITS MISSION. TYPICAL ACTIVITIES INCLUDE EMAILING, CALLING, AND MEETING WITH GOVERNMENT OFFICIALS AND LEGISLATORS.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	54110647	BeginningOfYearBalance
Contributions	398541	Contributions
Investment Earnings Or Losses	842732	InvestmentEarningsOrLosses
Other Expenditures	1328695	OtherExpenditures
End Of Year Balance	54023225	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	49493627	BeginningOfYearBalance
Contributions	3040219	Contributions
Investment Earnings Or Losses	2769857	InvestmentEarningsOrLosses
Other Expenditures	1193056	OtherExpenditures
End Of Year Balance	54110647	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	49870808	BeginningOfYearBalance
Contributions	4146452	Contributions
Investment Earnings Or Losses	-3921625	InvestmentEarningsOrLosses
Other Expenditures	602008	OtherExpenditures
End Of Year Balance	49493627	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.31000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.52000	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.17000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	1559834	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	28328291	OtherCostOrOtherBasis
Book Value	29888125	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	364837418	OtherCostOrOtherBasis
Depreciation	200607161	Depreciation
Book Value	164230257	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4111615	OtherCostOrOtherBasis
Depreciation	3282408	Depreciation
Book Value	829207	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	326925624	OtherCostOrOtherBasis
Depreciation	146380048	Depreciation
Book Value	180545577	BookValue

Field	Value	IRS element (for citing)
Other Land Buildings		OtherLandBuildings
Total Of Book Value Land Buildings	375493166	TotalOfBookValueLandBuildings
Financial Derivatives		FinancialDerivatives
Closely Held Equity Interests		CloselyHeldEquityInterests

Other Securities OtherSecurities (3 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
FIXED INCOME, HEDGE FUNDS, &OT	101942963	F
PRIVATE EQUITIES	34565284	F
PUBLIC EQUITIES	75955384	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	212463631	TotalOfBookValueSecurities
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
THIRD PARTY SETTLEMENTS	$23,789,287
ACCRUED POST RETMNT PENS & MED	$125,082,000
INTEREST RATE SWAP	$10,498,255

Field	Value	IRS element (for citing)
Total Of Amounts	159369542	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	Intended use of Endowment Funds	Identifier
Return Reference	Schedule D Part V Line 4	ReturnReference
Explanation	The intended use of the endowment funds is to promote and advance the following mission-related programs: healthcare services, research, charity care, and health education. ASC 740 (FIN 48) Footnote Schedule D Part X No ASC 740 (FIN 48) footnote was included in the audited financial statements as there were no material uncertain tax positions at or since adoption.	Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable (13 entries)

RegionRegion	Type Of Activities ConductedTypeOfActivitiesConducted	Specific Services ProvidedSpecificServicesProvided	Total ExpendituresTotalExpenditures
Central America and the Caribbean	Program Services	INSURANCE	5826349
Central America and the Caribbean	Program Services	Educational Travel Exp	13885
East Asia and the Pacific	Program Services	Educational Travel Exp	5192
Europe (Including Iceland and Greenland)	Program Services	Insurance	244300
Europe (Including Iceland and Greenland)	Program Services	Educational Travel Exp	53120
Europe (Including Iceland and Greenland)	Program Services	Med Equip & Supplies	52570
Middle East and North Africa	Program Services	Collection Services	12825
North America	Program Services	Educational Travel Exp	58594
North America	Program Services	Med Equip and Supplies	173492
North America	Program Services	Software	15680
South America	Program Services	Educational Travel Exp	987
South Asia	Program Services	Educational Travel Exp	2067
Sub-Saharan Africa	Program Services	Educational Travel Exp	4319

Field	Value	IRS element (for citing)
Subtotal Number Of Offices	0	SubtotalNumberOfOffices
Subtotal Number Of Employees	0	SubtotalNumberOfEmployees
Total Number Of Offices	0	TotalNumberOfOffices
Total Number Of Employees	0	TotalNumberOfEmployees
Subtotal Amount Spent	6463380	SubtotalAmountSpent
Total Amount Spent	6463380	TotalAmountSpent
Transfer To Foreign Corp	true	TransferToForeignCorp
Interest In Foreign Trust	false	InterestInForeignTrust
Own Foreign Corp	true	OwnForeignCorp
Passive Foreign Invest Co	true	PassiveForeignInvestCo
Foreign Partnership	true	ForeignPartnership
Boycott Countries	false	BoycottCountries

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	Prouty Bike/Wlk	NameOfEvent1
Gross Receipts Event1	2819750	GrossReceiptsEvent1
Charitable Contributions Event1	2647440	CharitableContributionsEvent1
Gross Revenue Event1	172310	GrossRevenueEvent1
Non Cash Prizes Event1	30037	NonCashPrizesEvent1
Food And Beverage Event1	16644	FoodAndBeverageEvent1
Entertainment Event1	8000	EntertainmentEvent1
Other Direct Expenses Event1	245985	OtherDirectExpensesEvent1
Name Of Event2	Chad Hlf Mrthn	NameOfEvent2
Gross Receipts Event2	454909	GrossReceiptsEvent2
Charitable Contributions Event2	424924	CharitableContributionsEvent2
Gross Revenue Event2	29985	GrossRevenueEvent2
Non Cash Prizes Event2	5235	NonCashPrizesEvent2
Rent Facility Costs Event2	388	RentFacilityCostsEvent2
Food And Beverage Event2	528	FoodAndBeverageEvent2
Other Direct Expenses Event2	61503	OtherDirectExpensesEvent2
Total Number Of Other Events	10	TotalNumberOfOtherEvents
Gross Receipts Other Events	760009	GrossReceiptsOtherEvents
Charitable Contrib Other Events	563798	CharitableContribOtherEvents
Gross Revenue Other Events	196211	GrossRevenueOtherEvents
Cash Prizes Other Events	1950	CashPrizesOtherEvents
Non Cash Prizes Other Events	12648	NonCashPrizesOtherEvents
Rent Facility Costs Other Events	10502	RentFacilityCostsOtherEvents
Food And Beverage Other Events	2961	FoodAndBeverageOtherEvents
Entertainment Other Events	4650	EntertainmentOtherEvents
Other Direct Expenses Other Events	34831	OtherDirectExpensesOtherEvents
Gross Receipts Total	4034668	GrossReceiptsTotal
Charitable Contributions Total	3636162	CharitableContributionsTotal
Gross Revenue Total Events	398506	GrossRevenueTotalEvents
Cash Prizes Total Events	1950	CashPrizesTotalEvents
Non Cash Prizes Total Events	47920	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	10890	RentFacilityCostsTotalEvents
Food And Beverage Total Events	20133	FoodAndBeverageTotalEvents
Entertainment Total Events	12650	EntertainmentTotalEvents
Other Direct Expenses Total Events	342319	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	435862	DirectExpenseSummaryEvents
Net Income Summary	-37356	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
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	12665877	TotalCommunityBenefitExpense
Net Community Benefit Expense	12665877	NetCommunityBenefitExpense
Percent Of Total Expense	0.01400	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	133698432	TotalCommunityBenefitExpense
Direct Offsetting Revenue	81674685	DirectOffsettingRevenue
Net Community Benefit Expense	52023747	NetCommunityBenefitExpense
Percent Of Total Expense	0.05740	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	146364309	TotalCommunityBenefitExpense
Direct Offsetting Revenue	81674685	DirectOffsettingRevenue
Net Community Benefit Expense	64689624	NetCommunityBenefitExpense
Percent Of Total Expense	0.07140	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3382491	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4883	DirectOffsettingRevenue
Net Community Benefit Expense	3377608	NetCommunityBenefitExpense
Percent Of Total Expense	0.00370	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	37882527	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9613363	DirectOffsettingRevenue
Net Community Benefit Expense	28269164	NetCommunityBenefitExpense
Percent Of Total Expense	0.03120	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3415350	TotalCommunityBenefitExpense
Net Community Benefit Expense	3415350	NetCommunityBenefitExpense
Percent Of Total Expense	0.00380	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3138542	TotalCommunityBenefitExpense
Net Community Benefit Expense	3138542	NetCommunityBenefitExpense
Percent Of Total Expense	0.00350	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1065190	TotalCommunityBenefitExpense
Net Community Benefit Expense	1065190	NetCommunityBenefitExpense
Percent Of Total Expense	0.00120	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	48884100	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9618246	DirectOffsettingRevenue
Net Community Benefit Expense	39265854	NetCommunityBenefitExpense
Percent Of Total Expense	0.04330	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	195248409	TotalCommunityBenefitExpense
Direct Offsetting Revenue	91292931	DirectOffsettingRevenue
Net Community Benefit Expense	103955478	NetCommunityBenefitExpense
Percent Of Total Expense	0.11270	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	24500	TotalCommunityBuildingExpense
Net Community Building Expense	24500	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	977	TotalCommunityBuildingExpense
Net Community Building Expense	977	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	9076	TotalCommunityBuildingExpense
Net Community Building Expense	9076	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	2876	TotalCommunityBuildingExpense
Net Community Building Expense	2876	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	165634	TotalCommunityBuildingExpense
Net Community Building Expense	165634	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	69157	TotalCommunityBuildingExpense
Net Community Building Expense	69157	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	12580	TotalCommunityBuildingExpense
Net Community Building Expense	12580	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	284800	TotalCommunityBuildingExpense
Net Community Building Expense	284800	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReported
Bad Debt Expense	$10,202,188	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	238062074	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	225286179	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	12775895	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost Accounting System	X	CostAccountingSystem

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	Mary Hitchcock Memorial Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	One Medical Center Drive	AddressLine1
City	Lebanon	City
State	NH	State
ZIP Code	03756	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Childrens Hospital	X	ChildrensHospital
Teaching Hospital	X	TeachingHospital
Research Facility	X	ResearchFacility
Er24 Hours	X	Er24Hours
Other	PSYCH UNIT AND TRANSPLANT UNIT	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Mary Hitchcock Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	1	NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Norris Cotton Cancer Center	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1080 Hospital Drive	AddressLine1
City	St Johnsbury	City
State	VT	State
ZIP Code	05819	ZIPCode

Field	Value	IRS element (for citing)
Facility Type	Cancer Center	FacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part I Line 6a	Community Benefits Report	Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic (Collectively referred to as Dartmouth-Hitchcock (D-H)) share common board members and operate under an affiliation agreement. D-H performs a joint Community Needs Assessment and files a consolidated Community Benefits report. For purposes of IRS Form Schedule H, only Hospital numbers were used. All amounts relating to DHC were excluded. Part I Line 7G Subsidized health services related to physician clinics The Organization did not include any subsidized health service costs attributable to a physician clinic on Part I, line 7G. Part I Line 7f Bad Debts Bad debt expense included on Form 990 Part IX Line 25 totaling $27,385,917, was excluded from total expenses for the calculation of net Community Benefits as a percent of total expenses. This bad debt expense represents bad debts allocated to MHMH, and not those atrributed to Dartmouth-Hitchcock Clinic. Part I Line 7 Costing Methodology The costing methodology used to calculate the amounts reported was a cost-to-charge ratio derived from worksheet 2, Ratio of Patient Care Cost-to-Charges. Part III Line 3 As part of the hospital's financial assistance policy, MHMH makes information available to patients for eligibility and how to apply for free or discounted care. If the patient does not respond to the hospital's attempts to complete the financial assistance package, these patients may be written off to bad debt. MHMH currently does not have a methodology to determine how many patients who would have qualified for financial assistance if the documentation was provided. The hospital is currently reviewing this process to come up with a tracking methodology for FY12 that is in compliance with Medicare cost report regulations. Part III Line 4 Costing Methodology used on lines 2 A cost-to-charge ratio was used to determine amounts reported on Part III, Section A, line 2. Patient Financial Assistance Qualification MHMH's Policy is to exert everything in the Organization's power to obtain sufficient and adequate information to determine eligibility for financial assistance. If the required information is not obtained in order to determine eligibility for financial assistance, then the amount is recognized as bad debt. In addition, beginning in fiscal year 2011, MHMH applies a 30% discount for uninsured patients before financial assistance is applied. Bad Debt Costing Methodology The costing methodology used to calculate the amounts reported on Part 3, Line 2 is the cost-to-charge ratio as derived from Schedule H, Worksheet 2, Ratio of Patient Care Cost-To-Charges. Audited financial Statement Disclosure for Charity Care and Provision for Bad Debt: (Please note that MHMH files a combined AFS with DHC and other Subsidiaries) D-H provides care to patients who meet certain criteria under their financial assistance policies without charge or at amounts less than their established rates. Because MHMH does not anticipate collection of amounts determined to qualify as charity care, they are not reported as revenue. The Organization grants credit without collateral to patients, most of whom are local residents and are insured under third-party arrangements. Additions to the allowance for uncollectible accounts are made by means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in federal and state governmental healthcare coverage and other collection indicators. Part III Line 8 Medicare Shortfalls The costing methodology used to calculate the amounts reported as Medicare shortfalls was derived from the Internal Revenue Service's Worksheet B as provided for Part III calculations. MHMH had revenues of $6,685,930 and costs of $11,172,829 for services not included on the Medicare Cost Report (Ambulance Services, Laboratory and other fees screens, and Medicare Part C & D services) MHMH incurred a net loss of $4,486,899 on the provision of these services. Part III Line 9b Credit and Collection Policy MHMH has a Credit and Collection Policy that addresses the procedures for patients who choose not to make payment or work with MHMH to make payment arrangements for their bill. The Organization has a separate Financial Assistance Policy that addresses those patients who are unable to make payment. MHMH is a charitable health care organization who treats patients that come for medically necessary care, regardless of their financial status. MHMH offers financial assistance in the form of free or discounted care to those patients who have an inability to pay their bills. The requirements and criteria for consideration for financial assistance are outlined within the Financial Assistance policy. Guidelines for financial assistance qualification are defined as well as the levels of assistance available. Patients can qualify for 25%, 50%, 75%, or 100% reduction based on Federal Poverty Levels as well as a catastrophic guideline of 10% of 2 year's income for those that may not qualify based on assets and income, but who have a bill beyond their means to pay. The policy also addresses that payment plans are available for anyone with a self-pay balance remaining after their reduction. Part V Facility information The Hospital has a Cancer Treatment Center located in Saint Johnsbury, Vermont. This location is registered under the same license as the Organization's main Campus located in Lebanon, New Hamshire.
Needs Assessment		Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic (Collectively referred to as Dartmouth-Hitchcock (D-H)) share common board members and operate under an affiliation agreement. D-H performs a joint Community Needs Assessment and files a consolidated Community Benefits report. Description of Community Needs Assessment Dartmouth-Hitchcock participates with other health care charitable trusts and community partners in each of our service areas to complete community health needs assessments. Each of our regions (Lebanon, Concord, Manchester and Nashua) has utilized different approaches, as described below: 1. Lebanon Service Area: In 2005, the Upper Valley region defined a set of 14 specific indicator areas that had been identified in earlier community needs assessments as being key areas of need. These 14 indicator areas offer an opportunity for the region to track progress toward meeting these health needs over time. The 2008 Community Needs Assessment was organized around these needs. For each indicator area, we sought data regarding the indicator by: a. Identifying quantifiable, reliable, regularly collected population data sources, such as Youth Risk Behavior Surveys and the Behavioral Risk Factors Surveillance System. b. Hosting small focus groups of key community stakeholders with long-term knowledge and experience related to each of the key indicator areas. c. Seeking commentary on focus group data from additional key stakeholders in individual interview formats. These activities provided data and analysis needed to compile narrative reports for each key indicator area, including both quantitative population health data and local interpretation and analysis of factors impacting each area of need. In addition Dartmouth-Hitchcock and Alice Peck Day Memorial Hospital solicited input to help prioritize identified community health needs through two additional actions: a. Distributing a brief health needs priority survey to residents attending free public flu clinics in Lebanon and Canaan. b. Asking key leaders of health, human service, and government assistance organizations to complete a Survey Monkey questionnaire which asked them to prioritize the needs of i. Clients they serve ii. The community at-large iii. Barriers to health iv. The community health interventions they desired most from Dartmouth-Hitchcock and Alice Peck Day Memorial Hospital v. The community health interventions they were most likely to implement through their own organizations in the next 1-3 years. 2. Concord Service Area: In 2008, Dartmouth-Hitchcock Concord participated as a member of the Capitol Region Health Needs Assessment. Data gathering methods used in this assessment included: a. Reviewing of population health data from county, state, and hospital data sets. b. Conducting stakeholder interviews with key elected and appointed City and State officials as well as representatives from health constituency groups. c. Hosting focus groups for various constituent groups, including seniors, teens, young parents, educators, clergy, and health care/human service providers. d. Conducting community listening sessions open to the general public in six communities surrounding Concord. e. Administering a random, probabilistic telephone survey of residents in 24 communities surrounding Concord. f. Distributing a written survey to adults and teens in a variety of community locations. g. Posting an online survey using zoomerang.com to gather feedback from respondents. 3. Manchester Area: Dartmouth-Hitchcock Manchester was a collaborator in the 2006 "Community Indicators" project sponsored by Heritage United Way in partnership with Southern New Hampshire University. This project utilized several sources of gathering data regarding community needs: a. Utilizing data from the US Census, the Bureau of Labor Statistics, and research generated by public agencies, institutions, community-based organizations, and academic centers. b. Input from stakeholder groups, including donor groups, business leaders, agencies, clients, local philanthropies, advocates, researchers, and the Heritage United Way Board of Directors. c. Three Community Discussion forums where data and reports generated as part of the Community Indicators Project were presented for discussion at open forums. 4. Nashua Service Area: Dartmouth-Hitchcock Nashua participated in the development of the 2006 "Greater Nashua Measures Up" community needs assessment project. Methods for gathering information used in this assessment include: a. Collecting population health data from published sources including: i. The 2000 Census of Population and Housing ii. The Mayor's Task Force on Housing iii. Nashua Continuum of Care's point-in-time counts of the homeless iv. Southern New Hampshire Services' 2004-2007 assessment of the needs of low-income individuals v. State and local government data on education, employment, crime, and health status b. Conducting a regional, randomized household telephone survey regarding personal and community health care needs. c. Hosting focus groups of service recipients, including Hispanic-speaking and Portuguese-speaking groups and teen representatives from the Mayor's Taskforce on Youth in Nashua. d. Surveying human service agencies regarding community health needs.
Patient Education of Eligibility for Assistance		All uninsured inpatients, same day surgery, observation, and Emergency Department patients are pro-actively screened using an automated tool to identify potential qualification for other federal, state, and local programs. In addition, specific outpatient activities deemed to have a higher rate of need are screened as part of regular protocol. If a patient appears to be eligible, on-site Financial Counselors assist the patient in completing the appropriate paperwork/applications and provide instruction regarding how to complete the qualification process. In some cases a Financial Counselor will act on behalf of the patient, at their signed consent, in order to complete the application process (for example, in New Hampshire a patient must be physically present at the District Office). If a patient doesn't qualify for specific programs, they are also considered for financial assistance as part of their screening. For outpatient services that are not routinely screened, staff interacting with patients are instructed to provide either a financial assistance application or contact information for a Financial Counselor when a patient expresses their inability to make payment. Every application is screened for completed income and asset documentation. Applications are also screened to assure there are no other potential options of federal, state, or local programs. The website, patient statements, and financial brochures all include information about financial assistance and how to apply. Community Information The Organization defines it's service region as New Hampshire and eastern Vermont, with the largest presence in the Lebanon, New Hampshire region, site of Dartmouth-Hitchcock Medical Center which includes Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinics main Northern clinic. MHMH serves the general population with a wide range of services. In addition to general hospital populations, the Organization provides services to patients with highly-specialized needs that are not available elsewhere in New Hampshire. MHMH is the states only tertiary referral center, provides a comprehensive cancer center (Norris Cotton Cancer Center - NCCC), operates the only Level I Trauma Center in New Hampshire, operates the Childrens Hospital (Childrens Hospital at Dartmouth CHaD), hosts a Level III neonatal intensive care nursery and the only pediatric intensive care unit in New Hampshire, and operates the only helicopter transport service in the state. As such, the service population is both the general public seeking primary health care services as well as residents with unique and highly-specialized health care needs.
Promotion of Community Health		MHMH supports organizations and initiatives that further health by strengthening and developing key community capacities, such as improved housing, economic development initiatives, and healthcare workforce development activities as determined by the Organization's Needs Assessment. In addition, the Organization participates in or provides leadership for a wide array of health-oriented community coalitions, such as the Upper Valley Housing Coalition, the Nashua Tobacco Coalition, the DHMC Outpatient Falls Risk Reduction Task Force, the Community Oral Health Initiative, the Bridges to Prevention substance use prevention coalition, and ServiceLink. MHMH has also provided leadership to the Upper Valley Healthy Eating Active Living (UV HEAL) Partnership, an initiative to reduce the growth of childhood obesity, and has been active in similar partnerships in Nashua and Manchester. At MHMH's Lebanon campus, the Hospital extends Professional Staff Privileges to qualified and appropriate physicians who are employees of Dartmouth-Hitchcock Clinic, Mary Hitchcock Memorial Hospital, or Dartmouth College and who also hold a faculty appointment at Dartmouth College. Mary-Hitchcockss Trustees annually set strategic priorities for the institution and approve operating and capital budgets which allocate surplus funds to improvements in patient care, medical education, research, as well as maintenance of a prudent reserve. Examples of these investments include the development of Mary Hitchcockss Patient Safety Training Lab, ongoing Quality and Patient Safety initiatives; purchases of new and emerging medical technologies, awards made to support translational research, and support for undergraduate medical education at Dartmouth Medical School. Of the eighteen voting members of Dartmouth-Hitchcocks Board of Trustees, fifteen live within the geographic region we serve. Sixteen are neither contractors nor employees of MHMH.
Affiliated Health Care System		Community Benefits are provided by the Dartmouth-Hitchcock health care system, which includes Mary Hitchcock Memorial Hospital, Dartmouth-Hitchcock Clinic, and other related organizations whose primary mission is health care. Mary Hitchcock Memorial Hospital (MHMH) in Lebanon is New Hampshires largest hospital. In Fiscal Year 2011 MHMH had 396 licensed inpatient beds. The Dartmouth-Hitchcock Clinic (DHC) is a multi-specialty physician practice with a network of providers across New Hampshire and Vermont. While DHCs main offices are located in Lebanon, the Clinic also has multi-specialty practices in Manchester, Nashua, Concord and Keene. In addition, the Clinic provides primary care in rural communities in Vermont and northern New Hampshire. MHMH, DHC sites, and the Dartmouth Medical School (DMS) faculty and students make up the Dartmouth-Hitchcock (D-H) health care system. The Hospital and Clinic operate jointly through interlocking directorates, strategic planning and management. They share identical missions. The Medical School, which works closely with the Hospital and Clinic, is focused on medical education and research.
STATE FILING OF COMMUNITY BENEFIT REPORT	990 SCHEDULE H, PART VI	NH,

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (16 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
Child Health Services
1245 Elm Street	Manchester	NH	03104	020348711	501(C)(3)	17500	Program Support
Good Neighbor Health Clinic
70 No Main St	White River Jct	VT	05001	030346949	501(C)(3)	42000	Programs/Clinic Svcs
Manchester Community Health Center
145 Hollis Street	Manchester	NH	03101	020458174	501(C)(3)	35000	Program Support
The Hitchcock Foundation
1 Medical Center Drive	Lebanon	NH	03756	020222139	501(C)(3)	7000	Program Support
Cheshire Health Foundation
580 Court Street	Keene	NH	03431	020202220	501(C)(3)	17322	Program Support
Grafton Country Senior Citizens Council
P O Box 433	Lebanon	NH	03766	237248316	501(C)(3)	21000	Elder Services
Vital Communities
195 No Main St	White River Jct	VT	05001	030355283	501(c)(3)	17500	Program Support
Granite State Fit Kids
291 West Hollis St	Nashua	NH	03062	020519379	501(c)(3)	5250	Program Support
Stagecoach
7 Bayberry Way	Mont Vernon	NH	03057	030276517	501(c)(3)	24500	Program Support
Granite State United Way
46 South Main St	Concord	NH	03301	026006033	501(c)(3)	16310	Program Support
Bridges to Prevention Program
260 Highland St	Plymouth	NH	03264	201057931	501(C)(3)	7000	Program Support
Indian Stream Health Center
141 Corliss Ln	Colebrook	NH	03756	200999212	501(C)(3)	35000	Programs/Clinic Svcs
Schweitzer Program
330 Brookline Ave	Boston	MA	02215	131982786	501(C)(3)	7000	Program Support
VT Program for Quality Healthcare
132 Main Street	Montpelier	VT	05602	222982253	501(C)(3)	28000	Program Support
VNA and Hospice of VT and NH
66 Benning Street	West Lebanon	NH	03784	036006494	501(C)(3)	47600	Program Support
VT Oxford Program
33 Kilburn Street	Burlington	VT	05401	030344168	501(C)(3)	14000	Program Support

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	16	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (5 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant
Godfrey Nursing Awards	2	1400
Levine Nursing Awards	8	12687
Varnum Nursing Awards	39	28000
TDI Scholarships	20	170422
Knox Nursing Award	23	15058

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Form 990, Schedule I	Identifier
Return Reference	Description of Organization's Procedures for Monitoring the Use of Grants	ReturnReference
Explanation	For each of the awards established by Mary Hitchcock Memorial Hospital; Godfrey Nursing Awards, Levine Nursing Awards, Knox Nursing Award, Varnum Nursing Awards, there are written established guidelines and procedures. Grant award payments are processed in accordance with the specific terms of each of the grants noted above. The Dartmouth Institute Scholarships (TDI) are paid directly to the College on the behalf of the individuals receiving the award. The coordinators of the program(s) are responsible for assuring that all terms are met, including proper documentation of expenses with receipts.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	true	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	true	SeverancePayment
Supplemental Nonqual Retire Plan	true	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	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (27 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Nancy Formella
666246	0	0	0	117287	0	9188	0	19003	0	811724	0	0	0
Thomas Colacchio MD
0	676930	0	0	0	58875	0	31410	0	24900	0	792115	0	0
Carl Dematteo
0	490025	0	0	0	80647	0	8820	0	17773	0	597265	0	0
Robin Kilfeather-Mackey CPA
0	363950	0	0	0	11752	0	8820	0	12676	0	397198	0	0
Peter Johnson
0	388659	0	0	0	32822	0	8820	0	21673	0	451974	0	0
Linda Von Reyn
280852	0	0	0	41440	0	8895	0	20236	0	351423	0	0	0
Daniel Jantzen CPA
469627	0	0	0	58637	0	12250	0	20320	0	560834	0	0	0
Stephen Leblanc
0	446635	0	0	0	28877	0	8820	0	19626	0	503958	0	0
John Butterly MD
0	447775	0	7500	0	45047	0	39740	0	23001	0	563063	0	0
Brian Lally
0	251389	0	0	0	1712	0	26510	0	20700	0	300311	0	0
Lawrence Dacey MD
0	511281	0	0	0	55994	0	8820	0	25754	0	601849	0	0
David Gladstone
258794	0	0	0	2137	0	28715	0	19726	0	309372	0	0	0
Bruce King
236022	0	47500	0	11451	0	8935	0	20224	0	324132	0	0	0
Susan Reeves
247589	0	0	0	28319	0	7350	0	20198	0	303456	0	0	0
Neil Castaldo
491435	0	70000	0	64741	0	31410	0	18977	0	676563	0	0	0
Mark Bellerive
241028	0	0	0	0	0	39534	0	15206	0	295768	0	0	0
Richard Showalter
179529	0	0	0	67071	0	8763	0	15077	0	270440	0	0	0
John Collins
0	104956	0	116408	117666	155016	0	31410	0	23885	117666	431675	0	0
Victoria George
0	162992	0	0	0	503	0	19140	0	0	0	182635	0	0
Mary Oseid
0	246162	0	0	0	8175	0	8820	0	19653	0	282810	0	0
Christine Schon
0	196759	0	0	0	3436	0	22813	0	15047	0	238055	0	0
William Mroz
237719	0	0	0	15835	0	31410	0	14739	0	299703	0	0	0
Sandra Dickau
244385	0	0	0	4653	0	9167	0	8602	0	266807	0	0	0
Mary Kay Boudewyns
200420	0	0	0	4716	0	6114	0	12243	0	223493	0	0	0
Gail Dahlstrom
202200	0	0	0	8177	0	0	0	16262	0	226639	0	0	0
Michael Ward
0	231126	0	0	0	12980	0	8785	0	19360	0	272251	0	0
Richard Davis
0	97816	0	0	0	4049	0	3741	0	0	0	105606	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Supplemental Compensation Information	Schedule J, Part I - Line 1a The Organization has in place a Management Self Development Plan (MSDP) designed to promote professional and personal development. The MSDP is capped at 2% of gross pay and may be utilized for expenses such as professional dues, meetings and seminars, tuition reimbursement, and other miscellaneous items that promote professional knowledge. The monies may also be used for up to a 50% reimbursement of the cost of a fitness/wellness program designed to maintain the health of management personnel. All expenses are submitted for approval before reimbursement.
Supplemental Retirement Information	The following individuals received payments from a supplemental nonqualified retirement plan: Thomas Colacchio $58,875 Nancy Formella $112,157 Carl Dematteo $71,527 Robin Kilfeather-Mackey $7,482 Peter Johnson $32,822 Linda Von Reyn $28,137 Daniel Jantzen $58,223 Stephen Leblanc $23,676 John Butterly $40,093 Lawrence Dacey $55,580 Susan Reeves $8,247 Neil Castaldo $42,979 Mary Oseid $8,175 William Mroz $971 Sandra Dickau $3,465 Michael Ward $2,461 Richard Showalter $23,700 John Collins $26,745 Dartmouth-Hitchcock Supplemental Retirement Plan: Terms and Conditions: An eligible employee is a participant in the Dartmouth-Hitchcock Retirement Plan and/or any prior pension arrangements sponsored by Dartmouth-Hitchcock (including two qualified defined benefit plans) who would be entitled to additional contributions or benefit accruals under the terms of the Plans for the plan year, but are limited by IRC Section 401 (a)(17) and/or 415. For eligible employees, the Employer will pay the eigible employee an amount determined by the employer each year to offset the amount of the reduction in the benefit accrual or contributions as a result of limitations imposed by IRC Sections 401(a)(17) and/or 415.	Schedule J, Part I - line 4b

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
New Hampshire Health and Education Facilities Auth
020279866	644614Y07	2009-08-19	134661088	CURRENT REFUND 2008(A),(B),(C)	false	false	false
New Hampshire Health and Education Facilities Auth
020279866		2009-03-30	5935000	VARIOUS EQUIPMENT	false	false	false
New Hampshire Health and Education Facilities Auth
020279866	644614G29	2010-06-16	73647839	CONSTR. OF FACILITY AND Equip	false	false	false
New Hampshire Health and Education Facilities Auth
020279866		2011-08-31	38119624	Current Refund 2001(A)	false	false	false

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Total ProceedsTotalProceeds	Capitalized InterestCapitalizedInterest	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Amount UnspentAmountUnspent	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
134841419	0	2273111	0	132387977	0	2010	true	false	false
5935000	0	0	5935000	0	0	2009	false	false	true	true
73666926	3766049	1168560	44137605	0	24610964		false	false	false
38119624	0	97500	0	38022124	0	2011	true	false	false	false

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs

false	false	false	false	false
false	false	false	false	false

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate	Term Of HedgeTermOfHedge
(no name)
false	false	false	false	false	false	false	false
(no name)
false	false	false	false	false	false	false	false
(no name)
false	false	false	false	false	false	false	false
Morgan Stanley
false	true	true	true	false	false	false	false	29.8

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Identifier	Schedule K, Part I(f)	Identifier
Return Reference	Issue dates of Bonds on Schedule K:	ReturnReference
Explanation	Current Refund 2008(A), issued 9/4/2008, which advance refunds 1985 Current Refund 2008(B), issued 10/31/2008, which advance refunds 1993 Current Refund 2008(c), issued 12/19/2008 Current Refund 2001(A), issued 10/17/2001, which advance refunds 1994	Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable (6 entries)

Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
DANIEL JANTZEN
SPLIT DOLLAR LIFE	X	$82,043	82043	false	true	true
SUSAN REEVES
SPLIT DOLLAR LIFE	X	$108,267	108267	false	true	true
SANDRA DICKAU
SPLIT DOLLAR LIFE	X	$12,824	12824	false	true	true
BRUCE KING
SPLIT DOLLAR LIFE	X	$99,352	99352	false	true	true
MARY KING
SPLIT DOLLAR LIFE	X	$10,743	10743	false	true	true
DEBORAH JANTZEN
SPLIT DOLLAR LIFE	X	$40,893	40893	false	true	true

Field	Value	IRS element (for citing)
Total Balance Due	354122	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Hypertherm
Trustee Baraba Couch	250000	See Attached	false
Ingrid Mroz
Key Employee William Mroz	115155	SPOUSE EMPLOYED BY MHMH	false
John Collins
Former Key Employee	155869	See Attached	false

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	Schedule L Part IV	Identifier
Return Reference	Business Transactions	ReturnReference
Explanation	Name of Interested Person: Barbara Couch Relationship: Trustee Description of Transaction: Barbara Couch is a greater than 35% owner of Hypertherm, an entity that contracts with MHMH for certain medical services for its employees. John Collins provided expertise services on behalf of MHMH to Hamden Assurance Risk Retention Group, and Hamden Assurance Company Ltd; related organizations that provides liability insurance to Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital.	Explanation

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArt
Art Historical Treasures		ArtHistoricalTreasures
Art Fractional Interest		ArtFractionalInterest
Books And Publications		BooksAndPublications
Clothing And Household Goods		ClothingAndHouseholdGoods
Cars And Other Vehicles		CarsAndOtherVehicles
Boats And Planes		BoatsAndPlanes
Intellectual Property		IntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	11	NumberOfContributions
Noncash Contribs Rptd F990	40397	NoncashContribsRptdF990
Method Of Determining Revenues	Fair Market Value	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Securities Closely Held Stock		SecuritiesCloselyHeldStock
Securities Prtnrshp Trust Intrsts		SecuritiesPrtnrshpTrustIntrsts
Securities Miscellaneous		SecuritiesMiscellaneous
Qualified Contrib Hist Struct		QualifiedContribHistStruct
Qualified Contrib Other		QualifiedContribOther
Real Estate Residential		RealEstateResidential
Real Estate Commercial		RealEstateCommercial
Real Estate Other		RealEstateOther
Collectibles		Collectibles
Food Inventory		FoodInventory
Drugs And Medical Supplies		DrugsAndMedicalSupplies
Taxidermy		Taxidermy
Historical Artifacts		HistoricalArtifacts
Scientific Specimens		ScientificSpecimens
Archaeological Artifacts		ArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

Non Cash CheckboxNonCashCheckbox	DescriptionDescription	Number Of ContributionsNumberOfContributions	Noncash Contribs Rptd F990NoncashContribsRptdF990	Method Of Determining RevenuesMethodOfDeterminingRevenues
X	Travel/Fuel for Patients	1	40000	FMV
X	Misc Prgm Rltd	276	276	FMV Nt Prov by Donor

Field	Value	IRS element (for citing)
Number Of8283 Received	0	NumberOf8283Received
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	true	ReviewProcessUnusualNCGifts
Third Parties Used	true	ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

Field	Value	IRS element (for citing)
Identifier	Line 32B	Identifier
Explanation	The organization uses Dartmouth-Hitchcock Medical Center, a supporting Organization, for solicitation of contributions and annual fund activities. From time to time, the Hospital may receive non-cash contributions directly from its donors.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (27 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part V - Question 1a	Independent Contractors	Dartmouth-Hitchcock Clinic (DHC) is part of the Dartmouth-Hitchcock Health system which includes DHC, Mary Hitchcock Memorial Hospital (MHMH) and subsidiaries. MHMH received authority from the Internal Revenue Service to act as DHC's pay agent as of the beginning of fiscal year 2010. All expenses are paid directly by MHMH and reimbursed by DHC. MHMH manages all required IRS reporting in regards to 1099's for independent contractors.
Description of classes of members, persons, and the nature of their rights		Part VI, Question 6 & 7a Dartmouth-Hitchcock Health (D-HH) is the sole corporate Member of Mary Hitchcock Memorial Hospital (MHMH). D-HH has specific authority and reserved powers, including the power to confirm the election of members of the MHMH's Board of Trustees and the power to approve significant governance, financial and operational decisions of MHMH's Trustees. Part VI, Question 7b In addition to reserved powers, Dartmouth-Hitchcock Health (D-HH) shall have the authority to take actions to establish, manage, and govern the System as an integrated health care delivery system in furtherance of the mission of the Hospital and other Organizations. These powers include but are not limited to items such as the ability to approve, disapprove or modify all material governance, programmatic and financial decisions of MHMH's Board of Trustees, to appoint or remove a member of the Hospital's Board of Trustees, assess the Hospital a monetary amount for the payment of the expenses of D-HH, approve the Hospital's budget, approve the borrowings or dispositions of assets by the Hospital, approve key strategic relationships, approve the elimination or addition of any material health care service or program, and other authority to take action on behalf of the Hospital. Disregarded Entities Part VI, Question 10a & 10b MHMH is the sole corporate member of New England Alliance for Health (NEAH), a disregarded entity which coordinates and performs services for its membership consisting of community hospitals, behavioral health centers, and home healthcare agencies that come together in a shared commitment to improve the quality, efficiency, and availability of health care in New Hampshire, Vermont, and western Massachusetts. The organization does not have any local chapters, branches, or affiliates that would require written policies and procedures governing the activities. NEAH is operated as a department of MHMH and therefore does not require separate policies and procedures.
Describe the Process used by Management &/or Governing Body to Review 990	Form 990, Part VI, Question 11b	The Audit Committee of the MHMH Board of Trustees is presented with a substantially complete Form 990. THE FORMS 990 AND 990-T ARE REVIEWED BY THE DIRECTOR OF CORPORATE FINANCE, VICE PRESIDENT OF CORPORATE FINANCE AND THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURN. The Committee members are expected to review these forms before the meeting. AT THE MEETING A PRESENTATION IS MADE BY THE ORGANIZATION'S TAX ADVISOR AND THE ORGANIZATION'S FINANCE STAFF, WITH TIME ALLOTTED FOR QUESTIONS FROM THE COMMITTEE. ONCE THE RETURN HAS BEEN FULLY PREPARED A FINAL 990 AND 990-T COMPLETE ELECTRONIC VERSION IS SENT OUT TO EACH BOARD MEMBER PRIOR TO THE OFFICIAL FILING.
Description of Process to Monitor Transactions for Conflicts of Interest	Form 990, Part VI, Question 12c	The Mary Hitchcock Memorial Hospital Board of Trustees approved a policy concerning a voluntary self-disclosure of any potential conflict of interest. The Compliance and Audit Services Department conducts an annual survey and performs other procedures as considered necessary to report on compliance with the conflict of interest policy. The Compliance and Audit Services Department then reports to the board any potential conflicts for their review. Per the policy any conflicts or otherwise perceived are required to be addressed by the Board of Trustees on an ongoing basis.If a conflict arises, the individual is asked to recuse themselves from voting on any related items. The policy applies to all trustees, employees, and their immediate family members. All MHMH board members are included in the annual conflict of interest survey.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR UNDERTAKEN	Form 990, Part VI, Question 15a	Compensation for the President is evaluated by an independent third party firm for reasonableness and national data benchmarking. The Compensation Committee along with Independent Trustees approve the final compensation in consideration with the independent third party firm's recommendations and suggestions. This process is completed on an annual basis.
Offices & Positions for Which Process was Used & Year Undertaken	Form 990, Part VI, Question 15b	Compensation for the Officers and Key Employees are evaluated by an independent third party firm for reasonableness and national data benchmarking. The Compensation Committee along with Independent Trustees approve the final compensation in consideration with the independent third party firm's recommendations and suggestions. THIS PROCESS WAS LAST UNDERTAKEN IN 2011 FOR EACH PERSON IDENTIFIED AS AN OFFICER OR KEY EMPLOYEE.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public	Form 990, Part VI, Question 19	MHMH's governing documents are available through the New Hampshire Department of State. Certain financial information is disclosed through the Community Benefits Annual Report. The audited financial statements, governing documents, and conflict of interest policy are available upon request in either electronic or hardcopy form. Average Hours Per Week Part VII Section A, Line 1A, Column B As part of MHMH's and Dartmouth-Hitchcock Clinic's affiliation agreement, the two organizations share officers. As such, the average hours per week are allocated between the two organization's 990's even though compensation reported in part VII is based on the entity issuing the W-2. In addition, certain officers spend time on Dartmouth-Hitchcock Health, the sole corporate member of both MHMH and DHC.
Financial Statements and Reporting		Part XI, Question 5 Other Changes in Net Assets Include: Change in Unrealized gain/loss: ($18,009,745) Pension-related charges: ($4,807,296) Series 2001A unrealized Gain/Loss on Hedge ($664,092) Total changes in net assets: ($23,481,133) Part XII, Question 2d The organization's financial information is included in the audited financial statements of Dartmouth-Hitchcock and Subsidiaries, which consists of Dartmouth-Hitchcock Clinic and subsidiaries, as well as Mary Hitchcock Memorial Hospital. Part XII, Question 3a DURING FISCAL YEAR 2011, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FUNDS FROM FEDERAL AWARDS IN EXCESS OF THE MINIMUM THRESHHOLD SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133, THEREFORE REQUIRING AN AUDIT. DUE TO THE ISSUANCE OF THE COMBINED FINANCIAL STATEMENTS, THE SINGLE AUDIT WAS PERFORMED ON THE COMBINED FINANCIAL INFORMATION OF ALL ORGANIZATIONS.
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Nancy Formella TITLE:Pres MHMH/Trustee Ex Officio HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Thomas Colacchio, MD TITLE:Trustee/Pres D-HH HOURS:60
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Carl Dematteo TITLE:Chief Quality Compliance Offcr HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Robin Kilfeather-Mackey, CPA TITLE:Chief Financial Officer HOURS:33
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Peter Johnson TITLE:Chief Information Officer HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Linda Von Reyn TITLE:Chief Nursing Officer HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Daniel Jantzen, CPA TITLE:Chief Operating Officer HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Stephen Leblanc TITLE:Exec VP D-H Health HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:John Butterly, MD TITLE:Exec VP of Med Affairs, D-HH HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Brian Lally TITLE:Chief Advancement Officer HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Lawrence Dacey, MD TITLE:Chief Medical Officer HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Alan Weston TITLE:Chief HR Officer (Eff 1/24/11) HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Mary Oseid TITLE:V.P Ambulatory Care HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Christine Schon TITLE:V.P Comm. Grp. Pract. Ops HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:William Mroz TITLE:V.P. Operations/Clinical Svcs HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Sandra Dickau TITLE:V.P. Operations/Patient Care HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Mary Kay Boudewyns TITLE:V.P. Revenue Management HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Gail Dahlstrom TITLE:V.P. Facilities Mgmt HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Michael Ward TITLE:V.P. Cancer Services HOURS:20

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	NEW ENGLAND ALLIANCE FOR HEALTH LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	ONE MEDICAL CENTER DRIVE	AddressLine1
City	LEBANON	City
State	NH	State
ZIP Code	03756	ZIPCode

Field	Value	IRS element (for citing)
EIN	264232401	EIN
Primary Activities	HLTH IMPROVMT	PrimaryActivities
Legal Domicile State	NH	LegalDomicileState
Total Income	2263708	TotalIncome
EOY Assets	223442	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

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

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1
DARTMOUTH-HITCHCOCK CLINIC
ONE MEDICAL CENTER DRIVE	LEBANON	NH	03756	222519596	PHYSICIAN SVC	NH	501(c)(3)	9	D-HH
DARTMOUTH-HITCHCOCK MEDICAL CENTER
ONE MEDICAL CENTER DRIVE	LEBANON	NH	03756	222715483	SUPPORTNG ORG	NH	501(c)(3)	11 TYPE I	NA
DARTMOUTH - HITCHCOCK HEALTH
One Medical Center Drive	Lebanon	NH	03756	264812335	SUPPORTNG ORG	NH	501(c)(3)	7	NA
HAMDEN RISK RETENTION GROUP INC
30 MAIN STREET STE 330	BURLINGTON	VT	05401	208530788	Self Ins	VT	501(c)(3)	11 TYPE I	DHC
The Hitchcock Foundation
One Medical Center Drive	Lebanon	NH	03756	020222139	HLTHCRE RSRCH	NH	501(c)(3)	7	DHC

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
D-H Mster Invst Prg
1 Med Ctr Dr	LEBANON	NH	03756	020205863	POOLED INVEST	NH	MHMH	Excluded	28867109	425150120	false	$1,912	true	0.93413
New Eng Phmcy Col
1 Med Ctr Dr	LEBANON	NH	03756	263819035	Group Purchas	NH	NA	Related	-107046	8492	false	$0	true	0.43069
The Hitchcock Ptshp
1 Med Ctr Dr	LEBANON	NH	03756	020514823	Invst in Ptnr	NH	MHMH	Investment	19495	0	false	$0	true	0.61420
KEENE HLTH ALLIANCE
580 Court St	Keene	NH	03431	300179297	Healthcare	NH	NA	N/A	0	0		$0
Obnet Services LLC
1 Med Ctr Dr	Lebanon	NH	03756	043746287	Database Serv	NH	DHC	Related	0	0	false	$0

Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Percentage OwnershipPercentageOwnership	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	CountryAddressForeign/Country	Postal CodeAddressForeign/PostalCode	Legal Domicile Foreign CountryLegalDomicileForeignCountry	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets
D & L Parsells Charit Remndr Unitrust
One Medical Center Drive	Lebanon	NH	03756	510538760	Chart. Trust	NH	N/A	Trust	1.00000
F & E Cluthe Charitable Rmndr Unitrust
One Medical Center Drive	Lebanon	NH	03756	026103634	Chart. Trust	NH	N/A	Trust	1.00000
Hitchcock Hospital Pooled Incme Fnd LIT2
One Medical Center Drive	Lebanon	NH	03756	223035122	Chart. Trust	NH	N/A	Pooled incme fd	1.00000
Pompanoosuc Investment Corp
1 Medical Ctr Dr	Lebanon	NH	03756	020352330	Real Est Hldg	NH		C Corporation		NA
Hamden Assurance Co Ltd
				980121409	Liab. Insuance			Foreign Corp	0.25000	DHC	44 Church St	Hamilton	BD	HM 12	BD	0	0
DH Pension Grp Trst
1 Medical Ctr Dr	Lebanon	NH	03756	202588083	Pension Trust	NH		Trust	0.00000	NA						0	0

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	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	DARTMOUTH - HITCHCOCK CLINIC	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	D & E	TransactionType
Amount Involved	53041620	AmountInvolved