LITTLETON HOSPITAL ASSOCIATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
LITTLETON HOSPITAL ASSOCIATION (EIN 02-0222152)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-05-11
IRS object ID
201141319349301759
Schema version
2009v1.7
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

FieldValueIRS element (for citing)
Timestamp2011-05-11T11:45:48-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

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 Line11000 Elm Street 15th FloorAddressLine1
CityManchesterCity
StateNHState
ZIP Code03101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN020222152EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Littleton Regional Hospital AssociationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLITTNameControl
Phone6034449000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1
CityLittletonCity
StateNHState
ZIP Code03561ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRobert FotterName
TitleCFOTitle
Phone6034449000Phone
Date Signed2011-05-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRachel Williamson CPAName
Phone6036697337Phone
Date Prepared2011-05-06DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRobert FotterNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1
CityLittletonCity
StateNHState
ZIP Code03561ZIPCode
FieldValueIRS element (for citing)
Gross Receipts79572604GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.littletonhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionTo provide health care services in Northern New HampshireActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees510TotalNbrEmployees
Total Nbr Volunteers175TotalNbrVolunteers
Total Gross UBI39811TotalGrossUBI
Net Unrelated Business Txbl Income-75130NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year47145ContributionsGrantsPriorYear
Contributions Grants Current Year79016ContributionsGrantsCurrentYear
Program Service Revenue Prior Year103055165ProgramServiceRevenuePriorYear
Program Service Revenue CY67664227ProgramServiceRevenueCY
Investment Income Prior Year-1148041InvestmentIncomePriorYear
Investment Income Current Year892531InvestmentIncomeCurrentYear
Other Revenue Prior Year1455652OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year103409921TotalRevenuePriorYear
Total Revenue Current Year68635774TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30691549SalariesEtcPriorYear
Salaries Etc Current Year36980445SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year70756693OtherExpensePriorYear
Other Expenses Current Year29775137OtherExpensesCurrentYear
Total Expenses Prior Year101448242TotalExpensesPriorYear
Total Expenses Current Year66755582TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1961679RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1880192RevenuesLessExpensesCY
Total Assets BOY76434421TotalAssetsBOY
Total Assets EOY79806884TotalAssetsEOY
Total Liabilities BOY43258709TotalLiabilitiesBOY
Total Liabilities EOY45277178TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY33175712NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY34529706NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide quality, compassionate and accessible healthcare in a manner that brings value to all.To offer a full spectrum of services, including acute primary and selected secondary care; 24-hour emergency services; preventive diagnostic, theraputic, and rehabilitative services on an outpatient and inpatient basis; continuity of care from preventive programs to coordination with home health services.To provide these services without regard to race, religion, age, sex, income, creed, national origin, or disability.To maintain a sufficient number and mix of medical staff who are competent, dedicated and commmunity based, supporting them with the technologically up-to-date equipment and facility needed to provide these services competitively.To create a healthy, satisfying work environment for phsycians, nurses and other employees, with a commitment to support the continuing educational needs of its professional staff, including the physicians, nurses and allied health personnel.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense53829543Expense
Revenue67664227Revenue
DescriptionLittleton Regional Hospital provides health care services on an in/outpatient basis to the general public, including charity care, community education, and various other health programs and services.Description
Total Program Service Expense53829543TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
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 Organization1BsnssRltnshpWithOrganization
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
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096107NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees510NumberOfEmployees
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
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
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 Approval0DecisionsSubjectToApproval
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 Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
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 Line1Robert Fotter CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6034449000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RdAddressLine1
CityLittletonCity
StateNHState
ZIP Code03561ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
William Bedor
Treasurer1.00XX000
Milton Bratz
Trustee1.00X000
Anna Rioux
Trustee1.00X000
Mell Brooks
Secretary1.00XX000
Edward Duffy MD
Trustee/Physician40.00X252202051362
Susan Presby
Trustee1.00X000
Wayne Rioux
Trustee1.00X000
John Starr
Vice-Chairman1.00XX000
Margaret Starr
Trustee1.00X000
Stevan Trooboff
Trustee1.00X000
Charles Wolcott MD
Trustee1.00X000
Guilbert Vickery
Chairman1.00XX000
Deane Rankin MD
Trustee1.00X000
George Brodeur
Trustee1.00X9547400
Andrew Forrest
Trustee/Physician40.00X335025060752
Robert Thibault
Trustee1.00X000
Warren West
CEO40.00X276246054788
Robert Fotter
CFO40.00X182984017775
Linda Gilmore
CAO/CNO40.00X195620041175
David Lovejoy
Physician40.00437631046545X
Michael Kindred
Physician40.00380485023832X
Harlan Herr
Physician40.00345584038267X
Nicholas Marks
Physician40.00308514066140X
Lon Howard
Physician40.00296617052266X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3106382TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation452902TotalOtherCompensation
Number Individuals GT100 K41NumberIndividualsGT100K
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
Vista Staffing Solutions Inc
File 50834Los AngelesCA90074Provide Locum Tenens594784
Sheehan Phinney Bass & Green
1000 Elm Street PO Box 3701ManchesterNH03101Legal Services472728
On Assignment Inc
File 54318Los AngelesCA90074Provide Temporary Clinical Staff439404
Healthcare Provider Advocates
PO Box 2117AmherstMA01004Provide temporary staff in billing depar403860
Quorum Health Resources Inc
105 Continental PlaceBrentwoodNH37027Consulting Services384226
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K
Related Organizations69802RelatedOrganizations
All Other Contributions9214AllOtherContributions
Total Contributions79016TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Service Revenu9000996616192666161926
Miscellaneous900099589639589639
Cafeteria900099391194391194
Other Income900099191434191434
Contract Lab62150019129415148339811

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column138740TotalRevenueColumn
Related Or Exempt Function Income138740RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue67664227TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column500731TotalRevenueColumn
Exclusion$500,731ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities11328430Securities
Other200Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities10903558Securities
Other33272Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities424872Securities
Other-33072Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column391800TotalRevenueColumn
Exclusion$391,800ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column68635774TotalRevenueColumn
Related Or Exempt Function Income67624416RelatedOrExemptFunctionIncome
Unrelated Business Revenue39811UnrelatedBusinessRevenue
Exclusion$892,531ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1467930Total
Management And General1467930ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total24597725Total
Program Services21908131ProgramServices
Management And General2689594ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total903676Total
Program Services807718ProgramServices
Management And General95958ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5290796Total
Program Services4635718ProgramServices
Management And General655078ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4720318Total
Program Services4002095ProgramServices
Management And General718223ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total654428Total
Management And General654428ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total66071Total
Management And General66071ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total145918Total
Management And General145918ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total197185Total
Management And General197185ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total9122130Total
Program Services8915417ProgramServices
Management And General206713ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1629854Total
Program Services545814ProgramServices
Management And General1084040ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total108698Total
Program Services74906ProgramServices
Management And General33792ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total79819Total
Management And General79819ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total604050Total
Program Services604050ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3408555Total
Program Services3408555ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total394507Total
Management And General394507ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Contract Wages30509462474102576844
Provision for Bad Debt27654472765447
Purchased Services16797681353932325836
Equipment Rental & Main1596954885275711679
Collection Fees75214313127739016

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3518664Total
Program Services1435256ProgramServices
Management And General2083408ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total66755582Total
Program Services53829543ProgramServices
Management And General12926039ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2430BOY
EOY3000EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8414364BOY
EOY8253747EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8848542BOY
EOY9313655EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY136BOY
EOY-1884EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1153540BOY
EOY1167509EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY978237BOY
EOY1638939EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis66460034LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec25368210LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY31518684BOY
EOY41091824EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY16447085BOY
EOY17497603EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9071403BOY
EOY842491EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY76434421BOY
EOY79806884EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6620297BOY
EOY7227912EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY836940BOY
EOY779119EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY30000000BOY
EOY29725000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5801472BOY
EOY7545147EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY43258709BOY
EOY45277178EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY32394316BOY
EOY33708016EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY159220BOY
EOY168060EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY622176BOY
EOY653630EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY33175712BOY
EOY34529706EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY76434421BOY
EOY79806884EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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$11,555OtherActivitiesAmount
Total Lobbying Expenditures IIB11555TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationLittleton Regional Hospital is a member of the NH Hospital Association and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Littleton Regional Hospital and other member organizations in furtherance of their exempt purposes. Littleton Regional Hospital does not directly perform any lobbying activities.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance728305BeginningOfYearBalance
Investment Earnings Or Losses49089InvestmentEarningsOrLosses
Other Expenditures10145OtherExpenditures
End Of Year Balance767249EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance739898BeginningOfYearBalance
Contributions9683Contributions
Investment Earnings Or Losses-21200InvestmentEarningsOrLosses
Other Expenditures75OtherExpenditures
End Of Year Balance728306EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.88070PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.11930TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis786809OtherCostOrOtherBasis
Book Value786809BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis30673489OtherCostOrOtherBasis
Depreciation13054819Depreciation
Book Value17618670BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6823OtherCostOrOtherBasis
Depreciation6823Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis18691172OtherCostOrOtherBasis
Depreciation11976038Depreciation
Book Value6715134BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16301741OtherCostOrOtherBasis
Depreciation330530Depreciation
Book Value15971211BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings41091824TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Bonds7906054F
Stocks9591549F
FieldValueIRS element (for citing)
Total Of Book Value Securities17497603TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Reserve for Self-Funded Health Insurance$1,147,000
Due to Third Party Payers$2,573,832
Deferred Compensation$558,624
Interest Rate Swap$3,265,691
FieldValueIRS element (for citing)
Total Of Amounts7545147TotalOfAmounts
Total Revenue68635774TotalRevenue
Total Expenses66755582TotalExpenses
Excess Or Deficit For Year1880192ExcessOrDeficitForYear
Net Unrealized GL On Investments526590NetUnrealizedGLOnInvestments
Other-$1,052,788OtherAmount
Total Adjustments-526198TotalAdjustments
Excess Or Deficit Per FS1353994ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt67923735TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments526590NetUnrealizedGainsInvestments
Revenue Not Rptd F990526590RevenueNotRptdF990
Revenue Subtotal67397145RevenueSubtotal
Investment Expenses Not Included145918InvestmentExpensesNotIncluded
Other Revenues Not Included1092711OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1238629RevenueNotRptdOnFinStmt
Total Revenue Per Form99068635774TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt66569741TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal66569741ExpensesSubtotal
Investment Expenses Not Included2145918InvestmentExpensesNotIncluded2
Other Expenses Not Included39923OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt185841ExpensesNotRptdOnFinStmt
Total Expenses Per Form99066755582TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierExplanationExplanation
Part XI, Line 8 - Other Adjustments:Loss on Interest Rate Swap: -1052788.
Part XII, Line 4b - Other Adjustments:Foundation Subsidy: 39923. Unrealized Gain on Interest Rate Swap: 1052788.
Part XIII, Line 4b - Other Adjustments:Foundation Subsidy: 39923.

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
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1275631TotalCommunityBenefitExpense
Net Community Benefit Expense1275631NetCommunityBenefitExpense
Percent Of Total Expense0.01990PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense3981925TotalCommunityBenefitExpense
Direct Offsetting Revenue2910410DirectOffsettingRevenue
Net Community Benefit Expense1071515NetCommunityBenefitExpense
Percent Of Total Expense0.01670PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense5257556TotalCommunityBenefitExpense
Direct Offsetting Revenue2910410DirectOffsettingRevenue
Net Community Benefit Expense2347146NetCommunityBenefitExpense
Percent Of Total Expense0.03660PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense259532TotalCommunityBenefitExpense
Direct Offsetting Revenue55740DirectOffsettingRevenue
Net Community Benefit Expense203792NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense16743TotalCommunityBenefitExpense
Net Community Benefit Expense16743NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense208875TotalCommunityBenefitExpense
Net Community Benefit Expense208875NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense95217TotalCommunityBenefitExpense
Net Community Benefit Expense95217NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense580367TotalCommunityBenefitExpense
Direct Offsetting Revenue55740DirectOffsettingRevenue
Net Community Benefit Expense524627NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5837923TotalCommunityBenefitExpense
Direct Offsetting Revenue2966150DirectOffsettingRevenue
Net Community Benefit Expense2871773NetCommunityBenefitExpense
Percent Of Total Expense0.04490PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense19479TotalCommunityBuildingExpense
Net Community Building Expense19479NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense48634TotalCommunityBuildingExpense
Net Community Building Expense48634NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense8008TotalCommunityBuildingExpense
Net Community Building Expense8008NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense76121TotalCommunityBuildingExpense
Net Community Building Expense76121NetCommunityBuildingExpense
Percent Of Total Expense0.00120PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,765,447BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare18526032AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare18526032CostOfCareReimbursedByMedicare

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24HoursOtherOther
Littleton Regional Hospital
600 St Johnsbury RoadLittletonNH03561XXXX
Littleton Rehabilitative Services
551 Meadow StreetLittletonNH03561Rehabilitation Clinic
Littleton Orthopaedics
81 Bethlehem RoadLittletonNH03561Outpatient Physician Clinic
Summit Medical Group
220 Cottage StreetLittletonNH03561Outpatient Physician Clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedPart I, Line 7: The Hospital determines its cost of charity care based on an overall financial statement cost to charge ratio applied against gross charity care charges.CostingMethodUsed
Percent Of Total Expense ExplnPart I, Line 7f: The Hospital has recorded $2,765,447 of Bad Debt Expense included on Form 990, Part IX, Line 25 which has been subtracted for purposes of calculating the percentage in this column.PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: 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 valuation of charity care does not include any bad debt receivables or revenue.BadDebtFootnote
Number Of Facility Type ExplnPart V: The Hospital operates one rehabiliation center and two outpaitent physician clinics that are not required to be licensed as a health care facility under state law.NumberOfFacilityTypeExpln
Needs AssessmentPart VI, Line 2: The Littleton Regional Hospital Community is defined as all people living in the communities listed in Part XI, Line 4. These communities were chosen by their geographic proximity to the Hospital and to the services and programs provided.NeedsAssessment
Patient Education AssistancePart VI, Line 3: Any applicant will receive a prompt decision on eligibility and amount of charity care offered. Notices of the Charity Care Policy are posted in the lobbies, waiting rooms and other public areas. Notices are also given to recipients who are served in their homes.PatientEducationAssistance
Community InformationPart VI, Line 4: The Hospital's primary service area includes Littleton, Bethlehem, Lisbon, Franconia and Sugar Hill. The secondary service area includes Whitefield, Lancaster, Goveton, Monroe, North Woodstock, Lincoln, Woodsville and Bath (all in NH), and St. Johnsbury, Lunenberg, Lyndonville, Concord, Gilman (all in VT). The area spans across a good majority of Northern New Hampshire and the Northeast Kingdom of Vermont.CommunityInformation
Reports Filed With StatesNHReportsFiledWithStates

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 Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 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
Edward Duffy MD
2519260276000122500391120303564000
Andrew Forrest
294760034015062500122500485020395777000
Warren West
257146081000110000122500425380331034000
Robert Fotter
1746650512503194022570155180200759000
Linda Gilmore
1905880503200099890311860236795000
David Lovejoy
42463101000003000000465450484176000
Michael Kindred
30401306887207600025050213270404317000
Harlan Herr
3455840000000382670383851000
Nicholas Marks
30226400062500122500538900374654000
Lon Howard
2881170008500000522660348883000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Business Finance Authority of the State of New HampshireBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521304598IssuerEIN
CUSIP Number64468kbg0CUSIPNumber
Date Issued2007-11-15DateIssued
Issue Price30000000IssuePrice
Description Of PurposeRefunded series 1998A and 1998B BondsDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds30000000TotalProceeds
Amount Defeased17757778AmountDefeased
Issuance Costs From Proceeds274108IssuanceCostsFromProceeds
Capital Expenditures11968114CapitalExpenditures
Year Of Subst Completion2007YearOfSubstCompletion
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 Engaged0BondCounselRoutinelyEngaged
Post Issuance Compliance Procdrs0PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonGeorge BrodeurNamePerson
FieldValueIRS element (for citing)
RelationshipTrusteeRelationship
Amount Of Transaction95474AmountOfTransaction
Description Of TransactionGeorge Brodeur is the Clerk of the Works for Littleton Regional Hospital's building project. He became a member of the Board of Trustees in September 2010 and was paid as an independent contractor for his services.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6All persons making an annual contribution to Littleton Regional Hospital or Littleton Regional Hospital Charitable Foundation, who are at least eighteen (18) years of age, or any legal adult resident of any town raising an annual appropriation to the Littleton Regional Hospital shall thereupon, and without further election or action by the Association, automatically become a member of the Association. Failure to contribute to the Hospital or Foundation in the following fiscal year shall automatically terminate the membership.
Form 990, Part VI, Section A, line 7aEach member of the Association shall be qualified to originate and take part in the discussion of any subject that may properly come before any meeting of the Association, to vote on such subject, and to hold any office in the Association to which he or she may be elected or appointed.
Form 990, Part VI, Section B, line 11The return was reviewed by the entire Board of Directors prior to the filing.
Form 990, Part VI, Section B, line 12cAll Trustees, Department directors and Auxilians complete a Conflict of Interest Statement each year, and any potential conflicts are reported to the Board of Trustees and to other places as required by law. In addition, front-line employees who don't normally make decisions for the facility are expected to report forward any conflicts they may have, should they ever be in a position to influence decision making. Quality Services queries these groups on an annual basis, and tracks down people until all statements are complete.
Form 990, Part VI, Section B, line 15Key employees complete self-evaluation - HR Director prepares compensation surveys, reviews 990 of other organizations. The CFO's salary is approved by the CEO. The CEO's salary is approved by the Board.
Form 990, Part VI, Section C, line 19The hospital's governing documents and financial statements are made available upon request. The hospital's conflict of interest policy is not made available to the public.
Part XI, Line 2cThe organization did not change the oversight or selection process during the tax year.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Littleton Regional Hospital Charitable FoundationBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1
CityLittletonCity
StateNHState
ZIP Code03561ZIPCode
FieldValueIRS element (for citing)
EIN043750643EIN
Primary ActivitiesCharitable FoundationPrimaryActivities
Legal Domicile StateNHLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity StatusLine 7PublicCharityStatus
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs0PerformOfServicesByOtherOrgs
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

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.