FURP.ORG / PUBLIC DATA EXPLORER

VALLEY REGIONAL HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
VALLEY REGIONAL HOSPITAL INC (EIN 02-0222118)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-14
IRS object ID
201232279349302713
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-08-14T14:04:54-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1100AddressLine1
CityPortlandCity
StateMEState
ZIP Code041041100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN020222118EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Valley Regional Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlVALLNameControl
Phone6035427771Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1243 Elm StreetAddressLine1
CityClaremontCity
StateNHState
ZIP Code03743ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSteven L MonetteName
TitleCFOTitle
Phone6035427771Phone
Date Signed2012-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBarbara J McGuan CPAName
Phone2077752387Phone
Date Prepared2012-08-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonClaire BowenNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1243 Elm StreetAddressLine1
CityClaremontCity
StateNHState
ZIP Code03743ZIPCode
FieldValueIRS element (for citing)
Gross Receipts52551086GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.vrh.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1893YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionCritical Access HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees447TotalNbrEmployees
Total Nbr Volunteers5TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year463666ContributionsGrantsPriorYear
Contributions Grants Current Year112735ContributionsGrantsCurrentYear
Program Service Revenue Prior Year45473332ProgramServiceRevenuePriorYear
Program Service Revenue CY46099943ProgramServiceRevenueCY
Investment Income Prior Year817891InvestmentIncomePriorYear
Investment Income Current Year1364767InvestmentIncomeCurrentYear
Other Revenue Prior Year-68899OtherRevenuePriorYear
Other Revenue Current Year-59678OtherRevenueCurrentYear
Total Revenue Prior Year46685990TotalRevenuePriorYear
Total Revenue Current Year47517767TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year30291GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY3914GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year23839331SalariesEtcPriorYear
Salaries Etc Current Year24533738SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year22650910OtherExpensePriorYear
Other Expenses Current Year23295921OtherExpensesCurrentYear
Total Expenses Prior Year46520532TotalExpensesPriorYear
Total Expenses Current Year47833573TotalExpensesCurrentYear
Revenues Less Expenses Prior Year165458RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-315806RevenuesLessExpensesCY
Total Assets BOY56224360TotalAssetsBOY
Total Assets EOY58108658TotalAssetsEOY
Total Liabilities BOY35293155TotalLiabilitiesBOY
Total Liabilities EOY39097439TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY20931205NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19011219NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission of Valley Regional is to serve and respond to the ongoing healthcare needs of the residents in the greater Claremont, New Hampshire area.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense39677932Expense
Grants3914Grants
Revenue46099943Revenue
DescriptionValley Regional Hospital is a provider of health services with facilities in the Claremont, NH area. The Hospital grants credit to patients, substantially all of whom are local residents. The Hospital also provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. The Hospital does not pursue collection of amounts determined to qualify as charity care. The Hospital maintains records to identify and monitor the level of charity care it provides. For the year ending September 30, 2011 charges forgone for services and supplies furnished under the charity care policy were approximately $1,930,793. The estimated cost of those services and supplies was approximately $1,414,000.In addition, the Hospital provides a number of other services to benefit certain poor and elderly patients. Medicaid and state programs do not cover the full cost of the Hospital incurred cost of providing medical care to patients. During the year ending September 30, 2011, the Hospital incurred costs in excess of payments of approximately $5,790,000.The Hospital provides services to the community at large for which it receives little or no payment. Services include health evaluation and screening programs at community and/or work site, flu shot, and health educational and fitness programs.The Hospital also provided other community benefits on which no value could be placed, such as leadership in identifying community needs, staff commitment to volunteer community health organizations, advocacy and support for the socially and physically disadvantaged, and support for the local public safety organization.Description
Total Program Service Expense39677932TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109641NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees447NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Steven MonetteBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6035427771TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1243 Elm StreetAddressLine1
CityClaremontCity
StateNHState
ZIP Code03743ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Claire Bowen
President/Secretary40.00XX029206510030
Robert Porter
Chair1.00XX000
Volker Bradley MD
Trustee1.00X000
Albert Leahy Jr
Trustee1.00X000
Debra Livingston
Trustee1.00X000
Nancy Merrill
Past Trustee1.00X000
Michael L Prozzo Jr
Trustee1.00X000
Alison Raymond
Trustee1.00X000
Lisa Richmond
Trustee1.00X000
Bernard Rosen MD
Trustee1.00X000
Carol Vivian
Vice Chair1.00XX000
Jim Wimberg
Trustee1.00X000
Randolph Knight MD
Past Medical Staff President40.00XX241120024915
Michael O'Connell
Trustee1.00X000
Michael Satzow
Trustee1.00X000
Evelyn Schlosser
Trustee1.00X000
Robert Cricco MD
Trustee1.00X000
Allen Damren
Past Trustee1.00X000
Michael Fuerst
Trustee1.00X000
Oliver Herfort MD
Trustee1.00X000
Sherwood Moody
Trustee1.00X000
Carol Boerner MD
Medical Staff President40.00XX000
Charlene Lovett
Trustee1.00X000
Steven Monette
CFO/Treasurer40.00X0144947889
John Houde MD
Physician40.00490548024322X
Carl Tetirick
Physician40.00277056023322X
Charles Sawyer
Physician40.0028996403524X
Michael Ritondo
Physician40.00268084023075X
Douglass Weiss
Physician40.0047314602772X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2039918TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs437012TotalReportableCompFrmRltdOrgs
Total Other Compensation112849TotalOtherCompensation
Number Individuals GT100 K19NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Medical Doctor Associates
PO Box 277185AtlantaGA303847185Contract Labor525583
D&Y
PO Box 635715CincinnatiOH452635715Contract Labor389572
American Health Centers Inc
498 Essex StreetBangorME04401MRI Services377754
Dartmouth Hitchcock Clinic
One Medical Center DriveLebanonNH03756Contract Labor357231
Healthcare Management Systems
2739 Momentum PlaceChicagoIL606895327IT Systems & Services328284
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K
Fundraising Events20111FundraisingEvents
Government Grants17312GovernmentGrants
All Other Contributions75312AllOtherContributions
Total Contributions112735TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Patient Service Rev.6214006523640565236405
Other Revenue900099599636599636
Lab Outreach Revenue621400440334440334
Cafeteria Revenue900099164796$164,796
Char/Contract Adjust.621400-20341228-20341228
FieldValueIRS element (for citing)
Total Program Service Revenue46099943TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column620567TotalRevenueColumn
Exclusion$620,567ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real45865Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real105543Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-59678Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-59678TotalRevenueColumn
Exclusion-$59,678ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5648935Securities
Other11378Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4887824Securities
Other28289Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities761111Securities
Other-16911Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column744200TotalRevenueColumn
Exclusion$744,200ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events11663GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events20111CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses11663FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column47517767TotalRevenueColumn
Related Or Exempt Function Income45935147RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,469,885ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total3914Total
Program Services3914ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total266035Total
Program Services266035ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total18162175Total
Program Services16719399ProgramServices
Management And General1442776ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total146877Total
Program Services135208ProgramServices
Management And General11669ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4735368Total
Program Services4362327ProgramServices
Management And General373041ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1223283Total
Program Services1127380ProgramServices
Management And General95903ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total30253Total
Management And General30253ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total54808Total
Management And General54808ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total178770Total
Management And General178770ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6549840Total
Program Services3773557ProgramServices
Management And General2776283ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4201125Total
Program Services3978552ProgramServices
Management And General222573ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1687034Total
Program Services451760ProgramServices
Management And General1235274ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total29711Total
Program Services22385ProgramServices
Management And General7326ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1177063Total
Management And General1177063ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2379255Total
Program Services2234086ProgramServices
Management And General145169ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total314473Total
Management And General314473ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Provision for Bad Debts431362643136260
Medicaid Enhance. Tax204739420473940
Dues & Subscriptions1674498652480925
Licenses & Taxes1089161059552961
Training53941498304111

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2263Total
Management And General2263ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total47833573Total
Program Services39677932ProgramServices
Management And General8155641ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2350BOY
EOY2295EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5305310BOY
EOY9144137EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3819111BOY
EOY2828013EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY715137BOY
EOY689774EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY244562BOY
EOY211334EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis46511605LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec22134929LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY25108569BOY
EOY24376676EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY15491938BOY
EOY15515536EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY3172437BOY
EOY3095842EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY383515BOY
EOY384360EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1981431BOY
EOY1860691EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY56224360BOY
EOY58108658EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4470073BOY
EOY4454309EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY10914BOY
EOY14898EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY26260000BOY
EOY26260000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4552168BOY
EOY8368232EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY35293155BOY
EOY39097439EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY16526254BOY
EOY14714685EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY978620BOY
EOY946798EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3426331BOY
EOY3349736EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20931205BOY
EOY19011219EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY56224360BOY
EOY58108658EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-315806ReconcilationRevenueExpenses
Reconcilation Other Changes-1604180ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$11,381OtherActivitiesAmount
Total Lobbying Expenditures IIB11381TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Other Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1i:ReturnReference
ExplanationThe Organization pays dues to local associations, a portion of which are attributable to lobbying activities.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance4115180BeginningOfYearBalance
Contributions355Contributions
Investment Earnings Or Losses-58567InvestmentEarningsOrLosses
Administrative Expenses12406AdministrativeExpenses
End Of Year Balance4044562EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3968278BeginningOfYearBalance
Contributions71Contributions
Investment Earnings Or Losses157717InvestmentEarningsOrLosses
Administrative Expenses10886AdministrativeExpenses
End Of Year Balance4115180EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4259270BeginningOfYearBalance
Contributions331Contributions
Investment Earnings Or Losses-277479InvestmentEarningsOrLosses
Administrative Expenses13844AdministrativeExpenses
End Of Year Balance3968278EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.82820PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.17180TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis250667OtherCostOrOtherBasis
Book Value250667BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16399300OtherCostOrOtherBasis
Depreciation6647003Depreciation
Book Value9752297BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis148235OtherCostOrOtherBasis
Depreciation109224Depreciation
Book Value39011BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis27475880OtherCostOrOtherBasis
Depreciation14971480Depreciation
Book Value12504400BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2237523OtherCostOrOtherBasis
Depreciation407222Depreciation
Book Value1830301BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24376676TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionBeneficial Interest in Perpetual TrustDescription
Book Value3095842BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities3095842TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Due To Affiliates$324,981
Estimated Third Party Settlements$3,317,537
Interest Rate Swap$3,779,430
Reserve for Self-Funded Insurance$855,534
Deferred Compensation$90,750
FieldValueIRS element (for citing)
Total Of Amounts8368232TotalOfAmounts
Total Revenue47517767TotalRevenue
Total Expenses47833573TotalExpenses
Excess Or Deficit For Year-315806ExcessOrDeficitForYear
Net Unrealized GL On Investments-1604180NetUnrealizedGLOnInvestments
Total Adjustments-1604180TotalAdjustments
Excess Or Deficit Per FS-1919986ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt45852023TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-1604180NetUnrealizedGainsInvestments
Other Revenues117206OtherRevenues
Revenue Not Rptd F990-1486974RevenueNotRptdF990
Revenue Subtotal47338997RevenueSubtotal
Investment Expenses Not Included178770InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt178770RevenueNotRptdOnFinStmt
Total Revenue Per Form99047517767TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt47772009TotExpensesEtcAuditedFinclStmt
Other Expenses Included117206OtherExpensesIncluded
Expenses Not Rptd F990117206ExpensesNotRptdF990
Expenses Subtotal47654803ExpensesSubtotal
Investment Expenses Not Included2178770InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt178770ExpensesNotRptdOnFinStmt
Total Expenses Per Form99047833573TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:The Organization uses its endowment funds in support of health care services, purchases of equipment, health education, and indigent care.
Part XII, Line 2d - Other Adjustments:Rental Expenses 105,543. Fundraising Expenses 11,663.
Part XIII, Line 2d - Other Adjustments:Rental Expenses 105,543. Fundraising Expenses 11,663.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf TournamentNameOfEvent1
Gross Receipts Event131774GrossReceiptsEvent1
Charitable Contributions Event120111CharitableContributionsEvent1
Gross Revenue Event111663GrossRevenueEvent1
Non Cash Prizes Event13180NonCashPrizesEvent1
Rent Facility Costs Event16534RentFacilityCostsEvent1
Food And Beverage Event1133FoodAndBeverageEvent1
Other Direct Expenses Event11816OtherDirectExpensesEvent1
Gross Receipts Total31774GrossReceiptsTotal
Charitable Contributions Total20111CharitableContributionsTotal
Gross Revenue Total Events11663GrossRevenueTotalEvents
Non Cash Prizes Total Events3180NonCashPrizesTotalEvents
Rent Facility Costs Total Events6534RentFacilityCostsTotalEvents
Food And Beverage Total Events133FoodAndBeverageTotalEvents
Other Direct Expenses Total Events1816OtherDirectExpensesTotalEvents
Direct Expense Summary Events11663DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage275.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3215752TotalCommunityBenefitExpense
Direct Offsetting Revenue1403208DirectOffsettingRevenue
Net Community Benefit Expense1812544NetCommunityBenefitExpense
Percent Of Total Expense0.04160PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5230124TotalCommunityBenefitExpense
Direct Offsetting Revenue2174305DirectOffsettingRevenue
Net Community Benefit Expense3055819NetCommunityBenefitExpense
Percent Of Total Expense0.07020PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense8445876TotalCommunityBenefitExpense
Direct Offsetting Revenue3577513DirectOffsettingRevenue
Net Community Benefit Expense4868363NetCommunityBenefitExpense
Percent Of Total Expense0.11180PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense611178TotalCommunityBenefitExpense
Direct Offsetting Revenue70226DirectOffsettingRevenue
Net Community Benefit Expense540952NetCommunityBenefitExpense
Percent Of Total Expense0.01240PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense25839TotalCommunityBenefitExpense
Net Community Benefit Expense25839NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense186217TotalCommunityBenefitExpense
Direct Offsetting Revenue14315DirectOffsettingRevenue
Net Community Benefit Expense171902NetCommunityBenefitExpense
Percent Of Total Expense0.00390PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense3914TotalCommunityBenefitExpense
Net Community Benefit Expense3914NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense827148TotalCommunityBenefitExpense
Direct Offsetting Revenue84541DirectOffsettingRevenue
Net Community Benefit Expense742607NetCommunityBenefitExpense
Percent Of Total Expense0.01700PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense9273024TotalCommunityBenefitExpense
Direct Offsetting Revenue3662054DirectOffsettingRevenue
Net Community Benefit Expense5610970NetCommunityBenefitExpense
Percent Of Total Expense0.12880PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Building Expense1472TotalCommunityBuildingExpense
Net Community Building Expense1472NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Building Expense5670TotalCommunityBuildingExpense
Net Community Building Expense5670NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Total Community Building Expense6020TotalCommunityBuildingExpense
Net Community Building Expense6020NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Total Community Building Expense3664TotalCommunityBuildingExpense
Net Community Building Expense3664NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs14NumberOfActivitiesOrPrograms
Total Community Building Expense16826TotalCommunityBuildingExpense
Net Community Building Expense16826NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,610,175BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare13199257AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare13199257CostOfCareReimbursedByMedicare

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Valley Regional Hospital IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1243 Elm StreetAddressLine1
CityClaremontCity
StateNHState
ZIP Code03743ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Valley Regional Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Kane Oncology Center
243 Elm StreetClaremontNH03743Oncology Center
River Valley Associates
241 Elm StreetClaremontNH03743Counseling & Psychotherapy Services

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanation
Part I, Line 3c: It is the policy of Valley Regional Hospital to provide financial assistance to those patients who are unable to pay for all or part of the cost of their care that is not covered by other sources of funding. Valley Regional Hospital's Financial Assistance Program is a program that assists uninsured and under-insured patients who meet specific income, geographical and Valley Regional Hospital guidelines.The Hospital will cover up to 100% of the cost of care for patients depending on the patient's level of income and family size. The Hospital also is a participating provider with the NH Health Access Network.
Part I, Line 7: The Organization used an overall cost to charge ratio for lines 7a and 7b. Amounts listed on lines 7e, 7f and 7i were derived from internal financial/cost accounting systems.
Part I, L7 Col(f): Amount of bad debt expense included on Form 990, Part IX, line 25 but subtracted for purposes of calculating the percentage in column 7f: $4,313,626.
Part II: Valley Regional Healthcare believes the skills and knowledge of its employees are the most critical assets to building a strong and healthy community. VRH employees participate on a wide variety of local boards serving or participating in health and wellness missions, including dental health, domestic violence, higher education, school boards, chambers of commerce, United Way, public transportation, elder health, and substance abuse. Employees also participate on state level boards and within elected government, working to improve policy and practice on a broad spectrum. Local businesses rely upon collaborations with VRH to provide education and expertise in community building activities such as through public and private health fairs. VRH takes advantage of public chamber activities, such as the Chili and Apple Festivals, Winter Carnivals, and Spring Home Show to provide tables of health information and free screening activities.
Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable.The Organization used a cost-to-charge ratio as its methodology for reporting bad debt expense at cost.
Part III, Line 8: Medicare costs approximate Medicare revenue. The Organization does not anticipate a Medicare shortfall or that any such shortfall should be considered as community benefit.
Part III, Line 9b: Patients who are known to qualify for financial assistance file a financial assistance determination application with the Hospital. If the application is approved, the patient's account shall be written off or discounted by the approved amount for sliding fee scale. The patient write-off guidelines are as follows:1. The determination is valid for 6 months from the date of signature for all applications except those individuals who demonstrate that they are on a fixed income (i.e. Social Security, retirment, disability), in which case approval is for 1 year from the date of signature.2. Patient qualifies according to the established Financial Assistance income guidelines3. Account notes must indicate what payor that the balance is due to (appropriate payor write-off codes to be utilized).4. If the balance is other than co-insurance and/or deductible, the balance is written off to charity care.
Part VI, Line 2: In November 2011, Valley Regional Hospital (VRH) partnered with New London Hospital to collaborate on a joint community needs assessment. While each health care facility possesses community needs assessments, which are unique to their service area, it was advantageous to pool their resources due to the overlap of service territory in eastern Sullivan County. VRH worked with Crescendo Consulting Group, LLC, (CCG) to bring together key healthcare and public service stakeholders, collect quantitative and qualitative data, and reach out to the community in order to elicit feedback directly from them and their service providers. The quantitative and qualitative findings included in the assessment are based on the most currently available data from community resources, the State of New Hampshire, and other regional sources.While this document fulfills federal and state reporting requirements, more importantly, it serves as a guidepost for community outreach efforts and as a benchmark with which to compare future progress.The purpose of the research design was to:-Clearly define the community served by VRH-Define a data-based and qualitative methodology to identify needs in the community-Develop a prioritized list of community resources-Develop a list of healthcare resources in the service area In order to generate the information, CCG and VRH incorporated input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health - community opinion leaders (a diverse set of service providers), hospital service providers, and healthcare consumers. In addition, statistical data was integrated with other community data to provide a detailed profile of needs and resources. Crescendo conducted several focus groups with service providers and stakeholders, including patients from various service lines. The following ranked needs were identified following the assessment process:1. Availability of affordable healthcare, prescriptions, and related services2. Drug and alcohol abuse early detection and treatment3. Managing the expected growth in senior health services4. Wellness initiatives and the individual's ability to maintain a healthy lifestyle 5. Obesity / Nutrition / Exercise education and services6. Addictions awareness and education7. Behavioral Health early detection and intervention8. Transportation to/from healthcare service providers9. Dental health services 10. Chronic disease screenings - broad spectrum (hypertension, cancer, heart disease, stroke)11. Elder Care Services and Dementia Spectrum Issues
Part VI, Line 3: The Community Relations Department has created and posted signs in all public areas of the hospital, as well as on the hospital's website.
Part VI, Line 4: Valley Regional Healthcare serves a rural region surrounding Claremont and Newport, NH. Sullivan County has a population of over 43,000 people, living in 15 towns over 537 square miles. VRH also serves portions of eastern VT. Through the 2012 VRH needs assessment and 2009 Sullivan County Human Services Coordination Plan, the following demographics describe the area: -Much of the growth in Sullivan County is now occurring in the rural communities, not in the more urban centers, such as Newport or Claremont.-The median age in Sullivan County is nearly 44 years of age (43.7) while the state average is 40 years. -Similarly, the median annual household income in Sullivan County is about $13,000 less than the state average. In Claremont, household income is more than $21,000 (roughly 33%) below the New Hampshire median income $41,721 compared to $63,277.-One in six Sullivan County residents is over 64 years of age. In some of communities, the percentage of seniors is over 20% and expected to rise to nearly 25% over the next decade. In addition, Sullivan County has the fourth highest rate of elderly in poverty.-Heart disease, cancer, and stroke are the leading causes of death in VRH's service area. Specifically, death rates for two of these diseases are higher in the Sullivan County than for the overall State of New Hampshire.-Sullivan County has an overall higher rate of households without vehicle ownership. While this rate points to the obvious implication and dependence upon alternate means of transportation, it is also critical to note the secondary effect upon the volunteer pool to provide potential rides to health care providers within the region.
Part VI, Line 6: While VRH is committed to supporting its local community, it also recognizes the potential for far reaching impact on an international level. VRH continually partners with neighboring health care providers to extend support in national and international disaster relief efforts, be that through donations of medical supplies or skilled healthcare providers sharing their medical knowledge in foreign lands. VRH is also an active partner with the American Red Cross to insure adequate blood supplies for local and national recipients. VRH is not part of any affiliated health care system. Its collaborations are on a voluntary basis to improve the health of all New Englanders. VRH is part of the New England Alliance for Health (NEAH), a group of community hospitals, behavioral health centers, and home health agencies that came together in a shared commitment to improve the quality, efficiency, and availability of health care in New Hampshire, Vermont and western Massachusetts. And VRH is an active member of the New Hampshire Hospital Associations.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Claire Bowen
02532520275200112930213207898030209500
Randolph Knight MD
22376802670014682019720229430266035000
John Houde MD
484738050000810031540211680514870000
Carl Tetirick
2724340280001822021540211680300378000
Charles Sawyer
2770140243401051601991015330293488000
Michael Ritondo
2562730380008011019070211680291159000
Douglass Weiss
43569802475001269800027720475918000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 6ReturnReference
ExplanationPart I, Line 6: Claire Bowen (CEO) received a bonus that is derived by a number of different factors. There is a fixed dollar amount that is set as a potential bonus. The board sets objectives for the CEO to achieve with a weighted percentage on each objective that will factor into the bonus amount. These weighted amounts equal 100% of the potential bonus. For Steve Monette (CFO), 15% of his salary is eligible for a bonus. He, too, has a weighted percent on objectives to meet during the year in determining the bonus amount he will receive.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1State of New Hampshire Business Finance AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521304598IssuerEIN
CUSIP Number64468KBJ4CUSIPNumber
Date Issued2008-06-02DateIssued
Issue Price26260000IssuePrice
Description Of PurposeFinancing for Buildings and StructuresDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds26260000TotalProceeds
Issuance Costs From Proceeds325806IssuanceCostsFromProceeds
Capital Expenditures25934194CapitalExpenditures
Year Of Subst Completion2010YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding1AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged1BondCounselRoutinelyEngaged
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1Morgan Stanley &BusinessNameLine1
Business Name Line2RBS CitizensBusinessNameLine2
FieldValueIRS element (for citing)
Term Of Hedge20.000000000000TermOfHedge
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 6The sole member of the Organization is Valley Regional Healthcare, Inc.
Form 990, Part VI, Section A, line 7aThe Organization's directors are nominated and elected by the Organization's member at the annual meeting of the Corporation.
Form 990, Part VI, Section A, line 7bThe following actions and undertakings involving the business of the Organization are subject to the ratification by the member: adoption of operating budget; adoption of capital budgets; adoption of strategic plans; initiation of significant fund-raising activities; implementation of institutional affiliations, mergers, consolidations or other reorganizations; material modification of service and business offerings; material acquisitions or dispositions of assets; changes in certified public accountants, fiscal year or material accounting practices; incurrence of material indebtedness; material changes in insurance programs and arrangements; material changes in employee benefits plans; adoption of quality improvements plans; election of directors; selection of the president/CEO; amendment of the Organization's bylaws; and amendment of the articles of association.
Form 990, Part VI, Section B, line 11The Organization's CFO reviews the draft Form 990 prior to its filing. The CFO then goes over the document with the board's finance committee.
The executive committee of the board of trustees convenes on an annual basis to review the compensation of the CEO. At this time, several resources are used to determine an appropriate rate of pay. The sources of data include, but are not limited to, Olney & Associates CEO Survey, Hay Companies Executive Compensation Survey, and the New Hampshire Hospital Association compensation survey. Other determining factors include overall hospital performance and completion of individual CEO goals and objectives.Form 990, Part VI, Section B, line 15
The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request.Form 990, Part VI, Section C, line 19
Changes in Net Assets or Fund Balances:Net unrealized losses on investments: -1,604,180.Form 990, Part XI, line 5:
Oversight of AuditThe audit process has not changed from the prior year.Form 990, Part XI, Line 2c:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Valley Regional Healthcare IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1243 Elm StreetAddressLine1
CityClaremontCity
StateNHState
ZIP Code03743ZIPCode
FieldValueIRS element (for citing)
EIN020397338EIN
Primary ActivitiesHealthcare supporting organizationPrimaryActivities
Legal Domicile StateNHLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity StatusLine 11b, IIPublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg