HITCHCOCK FOUNDATION: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- HITCHCOCK FOUNDATION (EIN 02-0222139)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-15
- IRS object ID
- 201231369349306048
- 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 D
- Schedule F
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-15T15:14:51-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | 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 | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222139 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Hitchcock Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HITC | 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 | Ethan Dmitrovsky MD | Name |
| Title | Treasurer | Title |
| Phone | 6036531231 | Phone |
| Date Signed | 2012-05-14 | 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 | E Ann Gormley 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 | 11776098 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1946 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | To aid & advance the study & investigation of human ailments & injuries; the causes, prevention, relief, & cure thereof, hygiene, health & public welfare, & to assist in research in the broadest sense | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 25 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 27 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2896407 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 798428 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5443510 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5825735 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 257401 | InvestmentIncomePriorYear |
| Investment Income Current Year | 524322 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1487 | OtherRevenuePriorYear |
| Other Revenue Current Year | 791 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8598805 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7149276 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 65101 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 357737 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8525557 | OtherExpensePriorYear |
| Other Expenses Current Year | 7324169 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8590658 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7681906 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8147 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -532630 | RevenuesLessExpensesCY |
| Total Assets BOY | 19526330 | TotalAssetsBOY |
| Total Assets EOY | 22960676 | TotalAssetsEOY |
| Total Liabilities BOY | 920299 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1349977 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18606031 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 21610699 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE PURPOSE OF THE HITCHCOCK FOUNDATION SHALL BE TO AID AND ADVANCE THE STUDY AND INVESTIGATION OF HUMAN AILMENTS AND INJURIES, AND THE CAUSES, PREVENTION, RELIEF, AND CURE THEREOF, AND THE STUDY AND INVESTIGATION OF PROBLEMS OF HYGIENE, HEALTH AND PUBLIC WELFARE, AND THE PROMOTION OF MEDICAL, SURGICAL AND SCIENTIFIC LEARNING, SKILL, EDUCATION AND INVESTIGATION, AND TO ENGAGE IN AND CONDUCT AND TO AID AND ASSIST IN MEDICAL, SURGICAL AND SCIENTIFIC RESEARCH IN THE BROADEST SENSE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 4187160 | Expense |
| Grants | 99660 | Grants |
| Revenue | 5825735 | Revenue |
| Description | Sponsored research Funds support discrete clinical and biomedical research projects and are funded by external sources including corporations and foundations. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3136395 | Expense |
| Description | Advised Funds are established by the Executive Director under the authority of the Board of Trustees. They are funded with contributions intended to support activities consistent with our charitable mission - particularly clinical research and education. They are not donor advised funds; rather the advisors are scientists and clinicians with expertise in the areas of research and education supported by the fund. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 258077 | Expense |
| Grants | 258077 | Grants |
| Description | These expenses represent funding for research grants and fellowships. Amounts awarded range from 1,000 to 125,000. All grants are awarded on a competitive basis. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 7581632 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | 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 | false | 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 | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | 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 | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 128 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 25 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | 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 |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| 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 | JENNIFER REINING | NamePerson |
| Telephone Number | 6036531231 | 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 (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Peter Anderson MD | ||||||
| Board Secretary/Phys | 0.3 | X | X | 0 | 204806 | 25381 |
| Suzanne Beyea RN PhD | ||||||
| Trustee/DHC Dir Rsch & Aging | 0.3 | X | 0 | 112125 | 32392 | |
| Jocelyn Chertoff MD MS | ||||||
| Board Chair/Phy | 0.3 | X | X | 0 | 471142 | 61916 |
| Ethan Dmitrovsky MD | ||||||
| Treasurer | 0.3 | X | X | 0 | 0 | 0 |
| Peter Gardner Esq | ||||||
| Trustee | 0.3 | X | 0 | 0 | 0 | |
| E Ann Gormley MD | ||||||
| Vice Chair/Phy | 0.3 | X | X | 0 | 451586 | 26989 |
| Penny Klotz MBA | ||||||
| Trustee | 0.3 | X | 0 | 0 | 0 | |
| Brian Lacy MD | ||||||
| Trustee/Phy | 0.3 | X | 0 | 376765 | 50298 | |
| Michele Lauria MD | ||||||
| Trustee/Phy | 0.3 | X | 0 | 292146 | 55590 | |
| Peter Martin MD | ||||||
| Trustee | 0.3 | X | 0 | 0 | 0 | |
| Robert Maue PhD | ||||||
| Trustee | 0.3 | X | 0 | 0 | 0 | |
| Richard Powell MD | ||||||
| Trustee/Phy | 0.3 | X | 0 | 426532 | 61648 | |
| Richard Reindollar MD | ||||||
| Trustee/DHC Dept Chair OBGYN | 0.3 | X | 0 | 498446 | 27063 | |
| R Brooks Robey MD | ||||||
| Trustee | 0.3 | X | 0 | 0 | 0 | |
| Roger D Sloboda PhD | ||||||
| Trustee | 0.3 | X | 0 | 0 | 0 | |
| Barry Smith MD | ||||||
| Trustee/Phy | 0.3 | X | 0 | 120000 | 0 | |
| Edward Stansfield MA | ||||||
| Trustee | 0.3 | X | 0 | 0 | 0 | |
| Linda Titus - Ernstoff PhD | ||||||
| Trustee | 0.3 | X | 0 | 0 | 0 | |
| Michael Ward MS | ||||||
| Trustee/DHC VP Operations | 0.3 | X | 0 | 244106 | 28145 | |
| John Bryant | ||||||
| Ex-Officio | 0.3 | X | 0 | 0 | 0 | |
| John Butterly MD | ||||||
| Ex-Off/PtYr End 7/1/10/ExecVP | 0.3 | X | 0 | 500322 | 62741 | |
| Diane Campbell RN | ||||||
| Ex-Officio | 0.3 | X | 0 | 0 | 0 | |
| Charles Mannix Esq | ||||||
| Ex-Officio | 0.3 | X | 0 | 0 | 0 | |
| William Rigby MD | ||||||
| Ex-Off/Partial Yr Ended10/1/10 | 0.3 | X | 0 | 0 | 0 | |
| Lawrence Dacey | ||||||
| Ex-Officio(Eff 7/1/10)/CMO | 0.3 | X | 0 | 567275 | 34574 | |
| Susan Pepin MD | ||||||
| Trustee(Eff 7/1/10)/Phy | 0.3 | X | 0 | 317234 | 33524 | |
| William Kinlaw MD | ||||||
| Ex-Officio (Eff 10/1/10) | 0.3 | X | 0 | 0 | 0 | |
| Michael Shoob | ||||||
| Executive Director | 40.0 | X | 0 | 120100 | 18620 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4702585 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 518881 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Trustees of Dartmouth College | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 37 Dewey Field | AddressLine1 |
| City | HANOVER | City |
| State | NH | State |
| ZIP Code | 03755 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Contracted Services | DescriptionOfServices |
| Compensation | 1788579 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 798428 | AllOtherContributions |
| Total Contributions | 798428 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SPONSORED RESEARCH | Description |
| Business Code | 541700 | BusinessCode |
| Total Revenue Column | 5825735 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5825735 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5825735 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 551100 | TotalRevenueColumn |
| Exclusion | $551,100 | 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 Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4600044 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4626822 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -26778 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -26778 | TotalRevenueColumn |
| Exclusion | -$26,778 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTEREST ON REVOLVING LOANS | Description |
| Business Code | 523000 | BusinessCode |
| Total Revenue Column | 791 | TotalRevenueColumn |
| Exclusion | $791 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 791 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7149276 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5825735 | RelatedOrExemptFunctionIncome |
| Exclusion | $525,113 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 357737 | Total |
| Program Services | 357737 | 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 | 0 | Total |
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 | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 56303 | Total |
| Management And General | 56303 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4791797 | Total |
| Program Services | 4765567 | ProgramServices |
| Management And General | 26230 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8679 | Total |
| Program Services | 8679 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32504 | Total |
| Program Services | 28694 | ProgramServices |
| Management And General | 3810 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4489 | Total |
| Program Services | 4489 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7200 | Total |
| Program Services | 7200 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 323247 | Total |
| Program Services | 323247 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 430915 | Total |
| Program Services | 430915 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1073 | Total |
| Management And General | 1073 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| TESTS & EXAMINATIONS | 469639 | 469639 | |
| RESEARCH EXP & SUBJECT FEES | 881850 | 881850 | |
| EDUCATIONAL MATERIAL | 162897 | 162897 | |
| LAB FEES, EQUIPMENT,& SUPLS | 101361 | 101361 | |
| MEMBERSHPS,LICENSES,& OTHER | 52215 | 39357 | 12858 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7681906 | Total |
| Program Services | 7581632 | ProgramServices |
| Management And General | 100274 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90756 | BOY |
| EOY | 87620 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77164 | BOY |
| EOY | 167389 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 399012 | BOY |
| EOY | 736318 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27066 | BOY |
| EOY | 25746 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7595 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5460 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3208 | BOY |
| EOY | 2135 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18929124 | BOY |
| EOY | 21941468 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19526330 | BOY |
| EOY | 22960676 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 329926 | BOY |
| EOY | 585308 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 590373 | BOY |
| EOY | 764669 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 920299 | BOY |
| EOY | 1349977 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2340782 | BOY |
| EOY | 6383427 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14146845 | BOY |
| EOY | 13108868 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2118404 | BOY |
| EOY | 2118404 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18606031 | BOY |
| EOY | 21610699 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19526330 | BOY |
| EOY | 22960676 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -532630 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 3537298 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 9081349 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8956116 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8706056 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2896407 | CurrentTaxYearMinus1Year |
| Current Tax Year | 798428 | CurrentTaxYear |
| Total | 30438356 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 9081349 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8956116 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8706056 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2896407 | CurrentTaxYearMinus1Year |
| Current Tax Year | 798428 | CurrentTaxYear |
| Total | 30438356 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 1337312 | AmountsSubstContributorsTotal |
| Public Support Total170 | 29101044 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 478189 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 716824 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 507972 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 520396 | CurrentTaxYearMinus1Year |
| Current Tax Year | 551891 | CurrentTaxYear |
| Total | 2775272 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 33213628 | TotalSupport |
| Gross Receipts From Admissions Etc | 11269245 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.87618 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.93507 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
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 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 | 5256297 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1041686 | InvestmentEarningsOrLosses |
| Other Expenditures | 154613 | OtherExpenditures |
| End Of Year Balance | 6143370 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4864103 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 546304 | InvestmentEarningsOrLosses |
| Other Expenditures | 154110 | OtherExpenditures |
| End Of Year Balance | 5256297 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 6325750 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -1140845 | InvestmentEarningsOrLosses |
| Other Expenditures | 320802 | OtherExpenditures |
| End Of Year Balance | 4864103 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.42000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.34000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.24000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7595 | OtherCostOrOtherBasis |
| Depreciation | 5460 | Depreciation |
| Book Value | 2135 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 2135 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | AGENCY ACCOUNTS | Description |
| Amount | $764,669 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 764669 | TotalOfAmounts |
| Total Revenue | 7149276 | TotalRevenue |
| Total Expenses | 7681906 | TotalExpenses |
| Excess Or Deficit For Year | -532630 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 3537298 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 3537298 | TotalAdjustments |
| Excess Or Deficit Per FS | 3004668 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 7423008 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 273732 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 273732 | RevenueNotRptdF990 |
| Revenue Subtotal | 7149276 | RevenueSubtotal |
| Total Revenue Per Form990 | 7149276 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7955638 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 273732 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 273732 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7681906 | ExpensesSubtotal |
| Total Expenses Per Form990 | 7681906 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part V, Line 4 | The Hitchcock Foundation's endowment funds include resources for the following uses: Tiffany Blake Endowment Supports a research training fellowship for a young investigator at Dartmouth-Hitchcock Medical Center who is committed to clinically oriented research. Henry Heyl Endowment Supports medical research grants. Helmut Schumann Lecture Endowment Supports an annual public lecture in "Studies in Healthful Living." Helmut Schumann Fellowship Endowment Supports a fellowship for a Dartmouth-Hitchcock Medical Center faculty to develop programs in primary prevention and health promotion. Residents' Revolving Loan Fund Emergency Loan Fund for Residents and Fellows in training at Dartmouth-Hitchcock Medical Center Neurosurgical Research Fund (Barry) Supports Neurosurgical Research Harold M. Pierce Memorial Fund - Cancer Research Supports Cancer Research |
| Schedule D Part X, Line 2 | 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. |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable (4 entries)
| RegionRegion | Type Of Activities ConductedTypeOfActivitiesConducted | Specific Services ProvidedSpecificServicesProvided | Total ExpendituresTotalExpenditures |
|---|---|---|---|
| Europe (Including Iceland and Greenland) | Program Services | Conferences & Travel | 7282 |
| East Asia and the Pacific | Program Services | Conferences & Travel | 2016 |
| North America | Program Services | Conferences & Travel | 4902 |
| Sub-Saharan Africa | Program Services | Conferences & Travel | 4050 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Amount Spent | 18250 | SubtotalAmountSpent |
| Total Amount Spent | 18250 | TotalAmountSpent |
| Transfer To Foreign Corp | false | TransferToForeignCorp |
| Interest In Foreign Trust | false | InterestInForeignTrust |
| Own Foreign Corp | false | OwnForeignCorp |
| Passive Foreign Invest Co | false | PassiveForeignInvestCo |
| Foreign Partnership | false | ForeignPartnership |
| Boycott Countries | false | BoycottCountries |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Medical Research Grants | TypeOfGrant |
| Number Of Recipients | 12 | NumberOfRecipients |
| Amount Of Cash Grant | 357737 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part 1 Line 2 | Identifier |
| Explanation | Fellowships and large Program Project Grants are made once per year. Smaller pilot grants are made three times per year. Amounts awarded range from $1,000 to $125,000 and are awarded on a competitive basis. All grant and fellowship-related expenses are reviewed and approved by the Foundation before paid. Requests for expenditures not in pre-approved grant budgets are rejected. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | 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 (11 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 | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Peter Anderson MD | |||||||||||||
| 0 | 194206 | 0 | 10600 | 0 | 0 | 0 | 25381 | 0 | 0 | 230187 | 0 | 0 | |
| Jocelyn Chertoff MD MS | |||||||||||||
| 0 | 423732 | 0 | 15752 | 0 | 31658 | 0 | 38515 | 0 | 0 | 533058 | 0 | 0 | 23401 |
| E Ann Gormley MD | |||||||||||||
| 0 | 342427 | 0 | 89290 | 0 | 19869 | 0 | 8820 | 0 | 0 | 478575 | 0 | 0 | 18169 |
| Brian Lacy MD | |||||||||||||
| 0 | 336053 | 0 | 21300 | 0 | 19412 | 0 | 30185 | 0 | 0 | 427063 | 0 | 0 | 20113 |
| Michele Lauria MD | |||||||||||||
| 0 | 283430 | 0 | 5186 | 0 | 3530 | 0 | 32635 | 0 | 0 | 347736 | 0 | 0 | 22955 |
| Richard Powell MD | |||||||||||||
| 0 | 331375 | 0 | 80190 | 0 | 14967 | 0 | 38270 | 0 | 0 | 488180 | 0 | 0 | 23378 |
| Richard Reindollar MD | |||||||||||||
| 0 | 460602 | 0 | 0 | 0 | 37844 | 0 | 7350 | 0 | 0 | 525509 | 0 | 0 | 19713 |
| Michael Ward MS | |||||||||||||
| 0 | 231126 | 0 | 0 | 0 | 12980 | 0 | 8785 | 0 | 0 | 272251 | 0 | 0 | 19360 |
| John Butterly MD | |||||||||||||
| 0 | 447775 | 0 | 7500 | 0 | 45047 | 0 | 39740 | 0 | 0 | 563063 | 0 | 0 | 23001 |
| Lawrence Dacey | |||||||||||||
| 0 | 511281 | 0 | 0 | 0 | 55994 | 0 | 8820 | 0 | 0 | 601849 | 0 | 0 | 25754 |
| Susan Pepin MD | |||||||||||||
| 0 | 297245 | 0 | 9218 | 0 | 10771 | 0 | 8820 | 0 | 0 | 350758 | 0 | 0 | 24704 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Defined Contribution Supplemental Retirement Plan | Part 1, Line 4B | The following individuals received amounts from the Dartmouth-Hitchcock Defined Contribution Supplemental Retirement Plan (see below for terms). Jocelyn Chertoff $30,884 E. Ann Gormley $19,455 Brian Lacy $18,544 Michele Lauria $3,260 Michael Ward $2,461 Richard Powell $14,553 Richard Reindollar $29,857 Lawrence Dacey $55,580 Susan Pepin $10,547 John Butterly $40,093 |
| Defined Contribution Supplemental Retirement Plan | Part 1, Line 4B | Dartmouth-Hitchcock Defined Contribution 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 (which consists of Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic), 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 Sections 401(a)(17) and/or IRC Section 415. For eligible employees, the Employer will pay the eligible employee an amount determined by the employer each year to offset the amount of the reduction in the benefit accrual or contribution as a result of limitations imposed by IRC Sections 401(a)(17) and/or IRC Section 415. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (21 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Part VI Governance, Management and Disclosure - Section A, Line 6: | The Hitchcock Foundation has the following membership: Dartmouth-Hitchcock Clinic. The sole voting member retains limited powers in accordance with the bylaws, elects Trustees of the Board, and approves changes in bylaws. The operational management of The Hitchcock Foundation is delegated to the Board of Trustees, in accordance with bylaws. | |
| Part VI Governance, Management and Disclosure - Section A, Line 7a & 7b: | Dartmouth-Hitchcock Clinic (DHC) is the sole corporate member of The Hitchcock Foundation. As such, DHC retains limited powers in accordance with the bylaws including, but not limited to, electing Trustees of the Board, and approving changes in bylaws. | |
| Process used by management and/or Governing Body to Review 990 | The Form 990 is reviewed by The Hitchcock Foundation's (THF) Executive Director, Dartmouth-Hitchcock Clinic's Director of Corporate Finance. A copy of the return is emailed to the entire board prior to filing. In addition, the Treasurer of THF Board of Trustees will review prior to filing the return. | Form 990, Part VI, Line 11b |
| Description of Process to Monitor Transactions For Conflicts of Interest | The Hitchcock Foundation has adopted and is included in the Dartmouth-Hitchcock Conflict of Interest Policy. The Dartmouth-Hitchcock 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 each board any potential conflicts for their review. Per the policy any conflicts or otherwise perceived conflicts are required to be addressed by the Board of Trustees on an ongoing basis. In the event a conflict arises, the individual may be removed in participating in any decision making regarding the identified conflict and/or its corresponding transactions. All THF board members are included in the annual conflict of interest survey. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. | Form 990, Part VI, Question 12c |
| Whistleblower Policy | The Organization follows the policy of a related entity, Dartmouth-Hitchcock Clinic. Document Retention and Destruction Policy Part VI, Section B, Line 14 The Organization follows the policy of a related entity, Dartmouth-Hitchcock Clinic. Offices & Positions for Which Process was Used & Year Undertaken Form 990, Part VI, Question 15b The Director and staff of The Hitchcock Foundation are donated by Dartmouth-Hitchcock Clinc and Mary Hitchcock Memorial Hospital. Compensation for Officers are evaluated by an independent third party firm for reasonableness and national data benchmarking by the related organizations. 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. | Part VI, Section B, Line 13 |
| Part VI Governance, Management and Disclosure - Section B, Line 19 | THF'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 and the conflict of interest policy are available upon request in either electronic or hardcopy form. | |
| Part VII Compensation, Section A, Line 1 | The compensation paid by related organizations was for services provided to the related organizations and not the filing organization, with exception of the Executive Director, of which 100% of their time is spent with the Foundation. Although the individuals spent the time listed as part of their board of trustee duties, they were not compensated with respect to those hours. The time/hours at the related organization varies by individual and organization, and would be the hours necessary to total to their respective full hours per week. | |
| Reconciliation of Net Assets | Increase in unrealized gain on investments $3,537,298 Financial Statements and Reporting Part XII, Question 3a DURING FISCAL YEAR 2011, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FEDERAL FUNDING WHICH MET THE MINIMUM THRESHOLD SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. DUE TO THE NATURE OF THE CONSOLIDATED FINANCIAL STATEMENTS, THE AUDIT WAS PERFORMED ON THE FINANCIAL INFORMATION OF ALL ORGANIZATIONS, INCLUDING THE FOUNDATION. | Part XI, Line 5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Peter Anderson, M.D. TITLE:Board Secretary/Phys HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Suzanne Beyea, R.N., PhD. TITLE:Trustee/DHC Dir Rsch & Aging HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Jocelyn Chertoff, M.D., M.S. TITLE:Board Chair/Phy HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:E. Ann Gormley, M.D. TITLE:Vice Chair/Phy HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Brian Lacy, M.D. TITLE:Trustee/Phy HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Michele Lauria, M.D. TITLE:Trustee/Phy HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Richard Powell, M.D. TITLE:Trustee/Phy HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Richard Reindollar, M.D. TITLE:Trustee/DHC Dept Chair OBGYN HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Barry Smith, M.D. TITLE:Trustee/Phy HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Michael Ward, M.S. TITLE:Trustee/DHC VP Operations HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:John Butterly, M.D. TITLE:Ex-Off/PtYr End 7/1/10/ExecVP HOURS:60 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Lawrence Dacey TITLE:Ex-Officio(Eff 7/1/10)/CMO HOURS:60 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Susan Pepin, M.D. TITLE:Trustee(Eff 7/1/10)/Phy HOURS:40 | FORM 990 PART VII |
Schedule R IRS990ScheduleR
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 Health | |||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 264812335 | Parent Org | NH | 501(c)(3) | 7 | NA |
| Dartmouth-Hitchcock Clinic | |||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 222519596 | Phys Svc | NH | 501(c)(3) | 9 | D-HH |
| Hamden Assurance Risk Retention Group | |||||||||
| 30 Main Street Suite 330 | Burlington | VT | 05401 | 208530788 | Slf Insurance | VT | 501(c)(3) | 11 Type 1 | DHC |
| Mary Hitchcock Memorial Hospital | |||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020222140 | Hospital | NH | 501(c)(3) | 3 | D-HH |
| Dartmouth Hitchcock Medical Ctr | |||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 222715483 | Supportng OrG | NH | 501(C)(3) | 11 Type 1 | NA |
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 |
|---|---|---|---|---|---|---|---|
| OBNet Services LLP | |||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 043746287 | Database Serv | NH | NA |
| Keene Hlth Alliance | |||||||
| 580 Crt St | Keene | NH | 03431 | 300179297 | Healthcare | NH | NA |
| New Eng Phmcy Coll | |||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 263819035 | Group Purchasing | NH | NA |
| DH Master Invst Prg | |||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 020505863 | Investments | NH | NA |
| The Hitchcock Ptshp | |||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 020514823 | Pooled Invst | NH | NA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pompanoosuc Investment Corp | |||||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020352330 | Real Est Hldg | NH | NA | C Corp | |||||
| Hamden Assurance Co LTD | |||||||||||||
| 980121409 | Liab Ins | NA | C Corp | 44 Church Street | Hamilton | HM EX | BD | BD | |||||
| 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 | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | 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 (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Mary Hitchcock Memorial Hospital | |
| O | 832493 |
| Mary Hitchcock Memorial Hospital | |
| P | 884205 |
| Dartmouth Hitchcock Clinic | |
| O | 2600710 |
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