DARTMOUTH-HITCHCOCK HEALTH: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- DARTMOUTH-HITCHCOCK HEALTH (EIN 26-4812335)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-15
- IRS object ID
- 201242289349303104
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-15T13:56:41-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 2600 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264812335 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dartmouth-Hitchcock Health | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DART | NameControl |
| Phone | 6036505000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One Medical Center Drive | AddressLine1 |
| City | Lebanon | City |
| State | NH | State |
| ZIP Code | 03756 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Robin Kilfeather-Mackey | Name |
| Title | CFO | Title |
| Phone | 6036505668 | Phone |
| Date Signed | 2012-08-13 | 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) |
|---|---|---|
| Initial Return | X | InitialReturn |
| Name Of Principal Officer Person | JAMES WEINSTEIN | 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 | 3506925 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2009 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | To establish,manage,govern,and fundraise for an integrated health care delivery system that best serves the purposes of preventing,diagnosing treating,& curing human illness within the Northern New England Region | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3506925 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 0 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3506925 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | 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 | 0 | OtherExpensePriorYear |
| Other Expenses Current Year | 3506925 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 0 | TotalExpensesPriorYear |
| Total Expenses Current Year | 3506925 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 0 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 0 | RevenuesLessExpensesCY |
| Total Assets BOY | 0 | TotalAssetsBOY |
| Total Assets EOY | 429837 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 429837 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 0 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 0 | NetAssetsOrFundBalancesEOY |
| Mission Description | Dartmouth-Hitchcock Health (D-H Health), is a New Hampshire (NH) nonprofit corporation exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (IRC). D-H Health was formed in May 2009 with operations commencing on October 1, 2010. D-H Health is operated for the following charitable, educational and scientific purposes: -to establish, manage, govern, and fundraise for an integrated healthcare delivery system that best serves the purposes of preventing, diagnosing, treating and curing human illness within the Northern New England region; to manage a healthcare system that provides health care services to the public in a cost-effective manner; -to establish and maintain cooperative hospital and provider relationships throughout its system; -to achieve excellence in clinical innovations, service, quality, cost and outcomes, supported by a strong academic program; and to integrate research, training, information technology and academic medicine in the provider | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1142969 | Expense |
| Revenue | 1995679 | Revenue |
| Description | As part of its mission to establish and maintain cooperative hospital and provider relationships throughout its systems, D-HH assisted with key elements of cooperative relationships including completion of conversion of the former Dartmouth Hitchcock Alliance into the new LLC structure for the New England Alliance for Health (NEAH), a voluntary shared services organization. New outreach specialty services were established in the D-H two-state region increasing access to needed services. Several serious provider organization requests to D-HH for relationship exploration were responded to, some resulting in continued growth of the D-H system. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 607414 | Expense |
| Revenue | 1237462 | Revenue |
| Description | Major D-HH initiative was to pursue an integrated relationship between the D-H Manchester physicians and other Southern NH non-D-H clinics and healthcare providors. Key rationale for strategy - improve the health of the population served in the region by reducing costs and improving the quality of care. Some of the key expectations - reduction of administrative costs, improved health information exchange resulting in improved clinical outcomes and the establishment of a platform to allow participation in innovative reimbursement models. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 204111 | Expense |
| Revenue | 273784 | Revenue |
| Description | Planning processes were implemented to advance Medical Homes and to lay the foundation for development of an Accountable Care Organization (ACO) model. Medical Homes and ACOs require the investment of resources to design systems to reduce costs, to improve the quality of care in a measureable way and ultimately to reflect improvement in the health of the population. To support these efforts, an intensive planning process was undertaken to achieve a transformational change in the clinical information systems for the D-H system. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 1954494 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | 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 | false | 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 | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | 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 | false | 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 | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 5 | 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 | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | 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 | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | 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 | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| 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 | ROBIN KILFEATHER-MACKEY | NamePerson |
| Telephone Number | 6036533580 | 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 (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| Stephen Barba | ||||||
| Trustee | 1.0 | X | 0 | 0 | 0 | |
| Thomas A Colacchio MD | ||||||
| Ex-Officio, D-HH President | 10.0 | X | 0 | 735805 | 56310 | X |
| Vincent S Conti | ||||||
| Trustee | 1.0 | X | 0 | 0 | 0 | |
| Nancy A Formella MSN RN | ||||||
| Ex-Officio, MHMH President | 1.0 | X | 0 | 783533 | 28191 | |
| Michael J Goran MD | ||||||
| Trustee | 1.0 | X | 0 | 0 | 0 | |
| Alfred L Griggs | ||||||
| Trustee | 1.0 | X | 0 | 0 | 0 | |
| Alan C Keiller | ||||||
| Board Treasurer | 2.0 | X | 0 | 0 | 0 | X |
| Jennie L Norman | ||||||
| Board Secretary | 2.0 | X | 0 | 0 | 0 | X |
| Anne-Lee Verville | ||||||
| Trustee | 1.0 | X | 0 | 0 | 0 | |
| Wiley Souba MD ScD | ||||||
| Ex-Officio | 1.0 | X | 0 | 0 | 0 | |
| Wayne G Granquist | ||||||
| Trustee/Board Chair | 2.0 | X | 0 | 0 | 0 | X |
| James N Weinstein DO MS | ||||||
| Ex-Officio, DHC President | 1.0 | X | 0 | 728386 | 23001 | |
| William W Helman IV | ||||||
| Trustee | 1.0 | X | 0 | 0 | 0 | |
| Sherri Oberg | ||||||
| Trustee (Ended 2/28/11) | 1.0 | X | 0 | 0 | 0 | |
| Carl Dematteo | ||||||
| Chief Qual and Compl Officer | 5.0 | 0 | 570672 | 26593 | X | |
| Robin Kilfeather-Mackey CPA | ||||||
| Chief Financial Officer | 5.0 | 0 | 375702 | 21496 | X | |
| Stephen Leblanc | ||||||
| Exec VP D-H Health | 10.0 | 0 | 475512 | 28446 | X | |
| John Butterly | ||||||
| Exec VP of Med Affairs D-HH | 10.0 | 0 | 500322 | 62741 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4169932 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 246778 | 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 | Covington Burling LLP | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Of Contractor | AddressOfContractor | |
| Description Of Services | Legal Svcs | DescriptionOfServices |
| Compensation | 405551 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEMBER ASSESSMENTS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 3506925 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3506925 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3506925 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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 |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3506925 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3506925 | RelatedOrExemptFunctionIncome |
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 | 0 | Total |
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 | 556415 | Total |
| Program Services | 519507 | ProgramServices |
| Management And General | 36908 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98000 | Total |
| Management And General | 98000 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2696463 | Total |
| Program Services | 1278940 | ProgramServices |
| Management And General | 1417523 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7500 | Total |
| Program Services | 7500 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27327 | Total |
| Program Services | 27327 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68483 | Total |
| Program Services | 68483 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25422 | Total |
| Program Services | 25422 | 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 | 0 | Total |
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 | 14872 | Total |
| Program Services | 14872 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12443 | Total |
| Program Services | 12443 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3506925 | Total |
| Program Services | 1954494 | ProgramServices |
| Management And General | 1552431 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 283439 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 161270 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 14872 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 146398 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 429837 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 429837 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 429837 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 429837 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 0 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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 | 0 | CurrentTaxYear |
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 0 | CurrentTaxYear |
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 0 | PublicSupportTotal170 |
| Total Support | 0 | TotalSupport |
| Gross Receipts From Admissions Etc | 3506925 | GrossReceiptsFromAdmissionsEtc |
| First5 Years170 | X | First5Years170 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 100830 | InvestmentCostOrOtherBasis |
| Depreciation | 8402 | Depreciation |
| Book Value | 92428 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 60440 | InvestmentCostOrOtherBasis |
| Depreciation | 6470 | Depreciation |
| Book Value | 53970 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 146398 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Total Revenue | 3506925 | TotalRevenue |
| Total Expenses | 3506925 | TotalExpenses |
| Other | $0 | OtherAmount |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 0 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 3506925 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 3506925 | RevenueSubtotal |
| Other Revenues Not Included | 0 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 3506925 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 3506925 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 3506925 | ExpensesSubtotal |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 3506925 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule D Part X Question 2 | Identifier |
| Return Reference | ASC 740 Audited Financial Statement Footnote Disclosure | ReturnReference |
| Explanation | D-H Health is a nonprofit corporation as described in Section 501(c)(3) of the IRC and is exempt from both federal and state income taxes on related income pursuant to Section 501(a) of the IRC. D-H Health applies the provisions of ASC 740-10, Accounting for Uncertainty of Income Taxes, which addresses accounting for uncertainties in income taxes recognized in an entitys financial statements and prescribes a threshold of more-likely-than-not for recognition of tax positions taken or expected to be taken in a tax return. ASC 740-10 also provides guidance on measurement, classification, interest and penalties, and disclosure of tax uncertainties. Management has evaluated ASC 740-10 and there is no impact to D-H Healths financial statements for the year ended September 30, 2011. | 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 Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Thomas A Colacchio MD | |||||||||||||
| 0 | 676930 | 0 | 0 | 0 | 58875 | 0 | 31410 | 0 | 24900 | 0 | 792115 | 0 | 0 |
| Nancy A Formella MSN RN | |||||||||||||
| 0 | 666246 | 0 | 0 | 0 | 117287 | 0 | 9188 | 0 | 19003 | 0 | 811724 | 0 | 0 |
| James N Weinstein DO MS | |||||||||||||
| 0 | 672112 | 0 | 0 | 0 | 56274 | 0 | 0 | 0 | 23001 | 0 | 751387 | 0 | 0 |
| Carl Dematteo | |||||||||||||
| 0 | 490025 | 0 | 0 | 0 | 80647 | 0 | 8820 | 0 | 17773 | 0 | 597265 | 0 | 0 |
| Robin Kilfeather-Mackey CPA | |||||||||||||
| 0 | 363950 | 0 | 0 | 0 | 11752 | 0 | 8820 | 0 | 12676 | 0 | 397198 | 0 | 0 |
| Stephen Leblanc | |||||||||||||
| 0 | 446635 | 0 | 0 | 0 | 28877 | 0 | 8820 | 0 | 19626 | 0 | 503958 | 0 | 0 |
| John Butterly | |||||||||||||
| 0 | 447775 | 0 | 7500 | 0 | 45047 | 0 | 39740 | 0 | 23001 | 0 | 563063 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Retirement Information | Identifier |
| Return Reference | Schedule J, Part III - line 4b | ReturnReference |
| Explanation | The following individuals received payments from a supplemental nonqualified retirement plan: Thomas Colacchio $58,875 Nancy Formella $112,157 James Weinstein $53,387 Carl Dematteo $71,527 Robin Kilfeather-Mackey $7,482 Stephen Leblanc $23,676 John Butterly $40,093 Dartmouth-Hitchcock Supplemental Retirement Plan Terms and Conditions: An eligible employee is a participant in the Dartmouth-Hitchcock Retirement Plan and/or any prior pension arrangements sponsored by Dartmouth-Hitchcock (including two qualified defined benefit plans) who would be entitled to additional contributions or benefit accruals under the terms of the Plans for the plan year, but are limited by IRC Section 401 (a)(17) and/or 415. For eligible employees, the Employer will pay the eigible employee an amount determined by the employer each year to offset the amount of the reduction in the benefit accrual or contributions as a result of limitations imposed by IRC Sections 401(a)(17) and/or 415. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Delegation of Committees | Part VI Section A Question 3 | During Fiscal Year 2011, the D-HH Board delegated certain financial, audit and compliance oversight to the Finance and Audit Commmittee as well as the Compliance Committees of the joint boards of trustees of Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic, acting jointly as Dartmouth-Hitchcock ("D-H"). In addition, the D-HH Board delegated to D-H, acting through its Boards and appropriate committees and staff, the obligation to oversee the clinical activities and research of D-H and its operations in accordance with current D-H policies and procedures, including those for managed care contracting, quality of care, and research programs and affiliations which policies the Board hereby approves and endorses, provided that any significant change to such policies will be submitted to the Board for approval. The D-HH board continues to retain final management powers and decisions pursuant to Section 3.9.2 of the Corporation's Bylaws. Process used by management and/or Governing Body to Review 990 Form 990, Part VI, Line 11b The Audit Committee of the D-HH Board of Trustees is presented with a substantially complete Form 990. The Committee members review these forms before the meeting. AT THE MEETING A HIGH-LEVEL PRESENTATION IS MADE BY THE ORGANIZATION'S TAX ADVISOR AND THE ORGANIZATION'S FINANCE STAFF, WITH TIME ALLOTTED FOR QUESTIONS FROM THE COMMITTEE. ONCE THE RETURN HAS BEEN FULLY PREPARED A FINAL 990 ELECTRONIC VERSION IS SENT OUT TO EACH BOARD MEMBER PRIOR TO THE OFFICIAL FILING. THE FORM 990 IS ALSO REVIEWED BY THE DIRECTOR OF CORPORATE FINANCE, VICE PRESIDENT OF CORPORATE FINANCE AND THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURN. Conflict of Interest Policy Form 990 Part VI Section B Line 12C The Dartmouth-Hitchcock Health Board of Trustees approved a policy concerning a voluntary self-disclosure of any potential conflict of interest. The Dartmouth-Hitchcock Compliance and Audit Services Department conducts an annual survey of all officers and trustees 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 Trusteees on an ongoing basis. In the event a conflict arises, the individual may be removed from participating in any decision making regarding the identified conflict and/or its corresponding transactions. 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. Delegation of Oversight Part XII Question 2c During Fiscal Year 2011, the D-HH Board delegated certain financial, audit and compliance oversight to the Finance and Audit Commmittee as well as the Compliance Committees of the joint boards of trustees of Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic, acting jointly as Dartmouth-Hitchcock ("D-H"). The D-HH board continues to retain final management powers and decisions pursuant to Section 3.9.2 of the Corporation's Bylaws. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Thomas A. Colacchio, MD TITLE:Ex-Officio, D-HH President HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Nancy A. Formella, MSN, RN TITLE:Ex-Officio, MHMH President HOURS:60 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:James N. Weinstein, DO, MS TITLE:Ex-Officio, DHC President HOURS:60 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Carl Dematteo TITLE:Chief Qual and Compl Officer HOURS:55 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Robin Kilfeather-Mackey, CPA TITLE:Chief Financial Officer HOURS:55 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Stephen Leblanc TITLE:Exec VP D-H Health HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:John Butterly TITLE:Exec VP of Med Affairs D-HH HOURS:50 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| Dartmouth-Hitchcock Clinic | |||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 222519596 | Phys Svcs | NH | 501(c)3 | 9 | D-HH |
| Mary Hitchcock Memorial Hospital | |||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020222140 | Hospital | NH | 501(c)3 | 3 | D-HH |
| 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 |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Mary Hitchcock Memorial Hospital | |
| O | 3560690 |
| Mary Hitchcock Memorial Hospital | |
| P | 4556260 |
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