2011-08-12T07:39:12-05:00 2010-09-30 Berry Dunn McNeil & Parker LLC 1000 Elm Street 15th Floor Manchester NH 03101 990 2009-10-01 020222242 Weeks Medical Center WEEK 6037884911 173 Middle Street Lancaster NH 03584 Scott Howe 6037884911 2011-08-12 1 Rachel Williamson CPA 6036697337 2011-08-11 2009 2016-02-24 21:20:13Z Scott Howe 173 Middle Street Lancaster NH 03584 48555323 0 X www.weeksmedical.org X 1948 NH To provide high quality and efficient health care services 13 13 405 152 0 0 706263 602984 39322535 43805464 397372 617897 768338 0 41194508 45026345 0 0 0 0 22010510 24112576 0 0 15076 18099673 20552296 40110183 44664872 1084325 361473 37612506 40037587 13281959 15516919 24330547 24520668 Weeks Medical Center's compassionate staff is committed to providing high quality and efficient health care services to ensure the well-being of our patients, families and communities. 0 0 36734733 44423361 Health care services to individuals in the surrounding region on an Inpatient & Outpatient basis, which includes Hospital Services, Physician Office services and Home Health & Hospice services. 36734733 1 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 28 0 405 1 0 0 0 0 0 0 0 0 0 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Scott W Howe 6037884911 173 Middle Street Lancaster NH 03584 Ernest F Angelicola 1.00 X 0 0 0 David Atkinson 1.00 X X 0 0 0 Scott Burns 1.00 X X 0 0 0 George Cook 1.00 X 0 0 0 Donald Crane 1.00 X 0 0 0 Sarah Desrochers 1.00 X 0 0 0 Stanley Holz 1.00 X 0 0 0 John Howell MD 1.00 X 0 0 0 Peter Johnson 1.00 X 0 0 0 Patrick Kelly 1.00 X 0 0 0 Patsy Pilgrim 1.00 X 0 0 0 Lisa Tetreault 1.00 X 0 0 0 Mary Donovan 1.00 X 0 0 0 Rebecca More 1.00 X 0 0 0 Marie Thompson 1.00 X 0 0 0 Scott Howe 40.00 X X 213000 0 20509 Wendy Muello MD 40.00 X X 159732 0 0 Celeste Pitts 40.00 X 95245 0 6168 Attila Barabas MD 40.00 X 428001 0 26104 Paul Kamins MD 40.00 X 408654 0 31035 Mark Morgan MD 40.00 X 352308 0 29344 Walter Voigt MD 40.00 X 335110 0 28828 Maude Keeshin MD 40.00 X 316000 0 28255 2308050 0 170243 34 0 1 0 Kingdom Emergency 1315 Hospital Drive St Johnsbury VT 05819 Emergency Dept staff 1367544 1 583690 19294 602984 Net Patient Service 621400 43005149 43005149 Miscellaneous 621400 529859 529859 Cafeteria 621400 140895 140895 Pharmacy 621400 116555 116555 Lifeline 621400 6664 6664 6342 6342 43805464 504615 504615 3642260 3512512 16466 129748 -16466 113282 113282 45026345 43805464 0 617897 788923 788923 19065935 16696646 2369289 524118 449148 74970 2492988 2114021 378967 1240612 1044719 195893 388474 58742 329732 17671 17671 50000 50000 36205 36205 4179509 3972724 206785 82835 67759 15076 386781 124121 262660 351099 351099 941190 918334 22856 142716 118497 24219 46677 43887 2790 464514 464485 29 2095658 2095658 316000 275164 40836 Patient Care Supplies 4573347 4573347 Provision for Bad Debt 3036568 3036568 MET Taxes 2358318 2358318 Miscellaneous 1084734 748672 336062 44664872 36734733 7915063 15076 30 5263999 4135439 5835967 6058111 715075 698708 170534 190383 31205828 16874912 14670532 14330916 10518715 11496192 437684 3127808 37612506 40037587 4018616 4054106 458336 382876 7635000 10000000 1170007 1079937 13281959 15516919 X 22340567 22420389 1078066 1188365 911914 911914 24330547 24520668 37612506 40037587 X 0 1 1 X 0 X 0 0 0 0 0 0 0 0 1 11431 11431 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: Weeks Medical Center is a member of the New Hampshire Hospital Association and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of WMC and other member organizations in furtherance of their exempt purposes. WMC does not directly perform any lobbying activities. 1591035 118038 46310 1662763 1517579 123226 49770 1591035 0.54840 0.45160 0 0 462709 462709 11962049 5885867 6076182 17900526 10687861 7212665 880544 301184 579360 14330916 Estimated Third-party Settlements 224259 Assets Limited to Use - Contruction Fund 2762121 Deferred Financing Costs 141428 3127808 Capital Leases 275016 Interest Rate Swap 804921 1079937 45026345 44664872 361473 432227 -603579 -171352 190121 44818788 432227 432227 44386561 36205 603579 639784 45026345 44628667 0 44628667 36205 36205 44664872 Part XI, Line 8 - Other Adjustments: Loss on Early Extinguishment of Debt: -382048. Unrealized Loss on Interest Rate Swap: -221531. Part XII, Line 4b - Other Adjustments: Loss on Early Extinguishment of Debt: 382048. Unrealized Loss on Interest Rate Swap: 221531. Hospice Ball 17788 17788 6197 17788 17788 6197 6197 11591 1 1 1 X 300.000000000000 1 X 1 1 1 0 1 1 3421573 2474160 947413 0.02280 4430520 3500121 930399 0.02240 7852093 5974281 1877812 0.04520 996176 126013 870163 0.02090 510457 510457 0.01230 4385098 4068867 316231 0.00760 5891731 4194880 1696851 0.04080 13743824 10169161 3574663 0.08600 1 1807668 20248499 20048019 200480 X 1 1 Weeks Medical Center Hospital

173 Middle Street Lancaster NH 03584

X X X X Lancaster Physicians Offices

170 Middle Street Lancaster NH 03584

Physician Office for primary care Weeks Home Health

278 Main Street Lancaster NH 03584

Home Health Whitefield Physicians Offices

8 Clover Lane Whitefield NH 03598

Physician Office for primary care Groveton Physicians Offices

12 Church Street Groveton NH 03582

Physician Office for primary care Part I, Line 7: Cost to charge ratio Part I, Line 7g: Chronic Disease Management, Emergency Department, Family Planning Program, Geriatric Psychiatrist, Psychiatric Consultations, Child Psychology Program Part III, Line 4: Patient receivables are periodically evaluated for collectibility based on credit history and current financial condition. Provisions for losses on receivables are determined on the basis of loss experience, known and inherent risks, estimated value of collateral and current economic conditions. Part III, Line 8: Cost to charge ratio from the Medicare cost report was used. Part III, Line 9b: Part VI, Line 2: In the summer of 2007, the Strategic Planning Committee conducted a community needs assessment. The community needs have been identified and became part of the planning process whereby specific initiatives were defined based on priorities and institutional capacity. The initiatives have become part of the overall 2009-2013 Strategic Plan. Part VI, Line 3: The staff is trained to discuss the Hospital's charity care policy with patients, the policy is available throughout the Hospital in the brochure and it is available on the Hospital's website. Part VI, Line 4: Weeks Medical Center's general geographic catchment area consists of nine towns, which supply almost 90% of its patients. Towns include Lancaster, Groveton, Dalton, Whitefield, North Stratford, Jefferson and Stark, in New Hampshire; and Lunenburg, Guildhall and Gilman, in Vermont. Together, these towns have a population of approximately 13,000 and cover approximately 375 square miles in both Vermont and New Hampshire.With the recent merger of WMC - Home Health and Hospice with the Upper Connecticut Valley Hospital - Home Health, the service area for homecare services have expanded to include Clarkesville, Colebrook, Columbia, Errol, Pittsburg, and Stewartstown. The expanded territory includes an additional 804 square miles and 5,542 residents.Weeks Medical Center is defined by the geographic communities that surround its facilities and by the individuals and groups who benefit from the health and wellness services provided by its various health related institutions. The definition was developed by the Board of Trustees, its Committees, administrative and professional staff in the practical application of the services provided by the institutions and the identified needs of the communities served. Part VI, Line 6: WMC plays an integral role in the Emergency Preparedness plans of our community. We are the ones who staff the 911 emergency line and tone out the ambulance when needed. In addition to being available in an emergency from a clinical standpoint, we are a large part of the community wide planning team, taking the lead in the planning of training & drills and bringing the various components together, based on State-wide standards. NH X X X X 0 0 0 0 0 0 0 0 0 Scott Howe 213000 0 0 0 0 0 6390 0 14119 0 233509 0 0 0 Wendy Muello MD 159732 0 0 0 0 0 0 0 0 0 159732 0 0 0 Attila Barabas MD 428001 0 0 0 0 0 7329 0 18775 0 454105 0 0 0 Paul Kamins MD 408654 0 0 0 0 0 12260 0 18775 0 439689 0 0 0 Mark Morgan MD 352308 0 0 0 0 0 10569 0 18775 0 381652 0 0 0 Walter Voigt MD 335110 0 0 0 0 0 10053 0 18775 0 363938 0 0 0 Maude Keeshin MD 316000 0 0 0 0 0 9480 0 18775 0 344255 0 0 0 Business Finance Authority of the State of NH 2010-09-01 10000000 Refinance existing debt and finance the Hospital's contruction project 0 0 10000000 2419490 112960 7467550 2011 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 Attila Barabas MD To cover closing costs on his new house when he moved to work at WMC X 19664 19664 0 0 0 19664 Form 990, Part VI, Section B, line 11 The Finance Committe reviews the Form 990 and provides a copy to each member prior to submission. Form 990, Part VI, Section B, line 12c The organization requires the Board Members to review and sign a Conflict of Interest Policy annually. The organization also provides annual 990 questionaires with several potential conflict situations discussed and distributed to the full Board every year at the time of the audit. Responses are sent directly to the audit firm. Any conflict discovered by the CPA's would be addressed by Hospital Management. Form 990, Part VI, Section B, line 15 The CEO's compensation is determined by the Compensation Committee of the Board, a written employment contract, a state compensation survery and approval of the full Board and Compensation Committee. Other officers have their compensation determined through a state compensation survery, along with approval of the CEO. 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.