2011-08-08T15:27:09-05:00 2010-09-30 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2009-10-01 020397338 Valley Regional Healthcare Inc VALL 6035427771 243 Elm Street Claremont NH 03743 Steven L Monette 6035427771 2011-08-05 1 Barbara J McGuan CPA 2077752387 2011-08-05 2009 2016-02-24 21:20:13Z Claire Bowen 243 Elm Street Claremont NH 03743 6674560 0 X www.vrh.org X 1986 NH Parent organization to Valley Regional Hospital, Inc. 21 19 121 20 0 0 705991 412185 5324014 5461483 -81306 59332 24267 43666 5972966 5976666 4394 0 4441802 4785147 0 0 1312281 1178472 5754083 5968013 218883 8653 2824268 2909491 921408 949332 1902860 1960159 Valley Regional Healthcare, Inc. is organized to coordinate and support the activities of health care organizations, including Valley Regional Hospital, Inc. 0 0 5047186 5461483 Valley Regional Healthcare is the parent organization for Valley Regional Hospital. In this role, Valley Regional Healthcare provides integrated management and support services for the Hospital. Valley Regional Healthcare also operates Connecticut Valley Home Care, a home health care agency. 5047186 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 9 0 121 1 0 0 0 0 0 0 0 0 0 21 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 0 1 1 1 1 0 NH X Steven Monette 6035427771 243 Elm Street Claremont NH 03743 Volker Bradley MD 1.00 X 0 0 0 Clay Hawkins 1.00 X 0 0 0 Ellen Joyce MD 1.00 X 0 0 0 Albert Leahy Jr 1.00 X 0 0 0 Debra Livingston 1.00 X 0 0 0 Nancy Merrill 1.00 X 0 0 0 Michael O'Connell 1.00 X 0 0 0 Michael L Prozzo Jr 1.00 X 0 0 0 Alison Raymond 1.00 X 0 0 0 Lisa Richmond 1.00 X 0 0 0 Bernard Rosen MD 1.00 X 0 0 0 Michael Satzow 1.00 X 0 0 0 Evelyn Schlosser 1.00 X 0 0 0 Carol Vivian 1.00 X X 0 0 0 Jim Wimberg 1.00 X 0 0 0 Claire Bowen 40.00 X X 293209 0 16488 David McCrillis 1.00 X 0 0 0 Robert Porter 1.00 X X 0 0 0 Randolph Knight MD 40.00 X X 0 273470 33783 Robert Cricco MD 1.00 X 0 0 0 Allen Damren 1.00 X 0 0 0 Michael Fuerst 1.00 X 0 0 0 Oliver Herfort MD 1.00 X 0 0 0 Sherwood Moody 1.00 X 0 0 0 Steven Monette 40.00 X 143108 0 889 Margaret Burns 40.00 X 160060 0 7843 Gregg Burdett 40.00 X 144137 0 19339 740514 273470 78342 4 0 1 0 0 412185 412185 Patient Service Revenu 621610 2772382 2772382 Management Services 621610 2413487 2413487 Miscellaneous Revenue 900099 140308 140308 Child Care Services 624410 135306 135306 5461483 35644 35644 17245 42302 -25057 -25057 -25057 679280 655592 23688 23688 23688 Other Revenue 900099 68723 68723 68723 5976666 5461483 0 102998 4394 4394 453694 66969 386725 3271693 3271693 47275 47275 756755 695156 61599 255730 231725 24005 9471 9471 17500 17500 14589 14589 369624 101096 268528 71050 52563 18487 228596 212970 15626 152022 140274 11748 137288 114550 22738 472 437 35 37804 37677 127 52965 52965 Miscellaneous 47235 38926 8309 Provision for Bad Debts 31481 31481 Licenses & Taxes 8375 0 8375 5968013 5047186 920827 0 50 50 336045 121984 360717 356725 19027 13074 442487 174732 264441 267755 1313290 1400767 530698 749136 2824268 2909491 510746 428143 61715 54904 348947 466285 921408 949332 X 1902860 1960159 1902860 1960159 2824268 2909491 X 0 1 1 X 0 X X X 0 0 0 Valley Regional Hospital Inc 020222118 3 1 1 1 5968012 1 5968012 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 442487 174732 267755 267755 Due from Affiliates 459953 Cash Surrender Value of Life Insurance 289183 749136 Due to Affiliates 400893 Reserve for Self-Funded Insurance 65392 466285 5976666 5968013 8653 48646 48646 57299 6053025 48646 42302 90948 5962077 14589 14589 5976666 5995726 42302 42302 5953424 14589 14589 5968013 Part XII, Line 2d - Other Adjustments: Rental Expenses: 42302. Part XIII, Line 2d - Other Adjustments: Rental Expenses: 42302. X X X X 0 0 0 0 0 1 1 0 0 Claire Bowen 244781 0 40000 0 8428 0 9286 0 7202 0 309697 0 0 0 Randolph Knight MD 0 229608 0 0 0 43862 0 8140 0 25643 0 307253 0 0 Margaret Burns 140975 0 15826 0 3259 0 5310 0 2533 0 167903 0 0 0 Gregg Burdett 129738 0 14201 0 198 0 0 0 19339 0 163476 0 0 0 Part 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 Margaret Burns, Gregg Burdett, and Steven Monette (Senior VPs), 15% of their salary is eligible for a bonus. They too have a weighted percent on objectives to meet during the year in determining the bonus amount they will receive. For fiscal year 09-10, one of the objectives for the senior management was meeting the budgeted operating return. This counted as 35% of their potential bonus amount. Form 990, Part VI, Section A, line 6 The Corporation has an assembly of Overseers. Form 990, Part VI, Section A, line 7a The Overseers elect directors to the Board. Form 990, Part VI, Section A, line 7b The power to alter, amend or repeal the bylaws or to adopt new bylaws shall be vested in the Assembly of Overseers. Form 990, Part VI, Section B, line 11 The Organization's CFO reviews the draft Form 990 prior to its filing. The CFO then goes over the document with the board's finance committee. Form 990, Part VI, Section B, line 15 The executive committee of the board of trustees convenes on an annual basis to review the compensation of the CEO. At this time, 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 C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part XI, Line 2c Oversight of Audit The audit process has not changed from the prior year. Valley Regional Hospital Inc 243 Elm Street Claremont NH 03743 020222118 Critical Access Hospital NH 501(c)(3) 3 Valley Regional Health Care Inc 0 1 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0