LITTLETON HOSPITAL ASSOCIATION: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
LITTLETON HOSPITAL ASSOCIATION (EIN 02-0222152)
Tax period
2024-10-01 to 2025-09-30
Filed
2026-08-10
IRS object ID
202632229349301478
Schema version
2024v5.5
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)
Return2026-08-10T14:16:18-05:00ReturnTs
Tax Period End2025-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman & NoyesBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1280 Fore Street Suite 500AddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04101ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222152EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Littleton Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLITTBusinessNameControlTxt
Phone6034449000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03561ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRobert F NutterPersonNm
Person TitlePresident & CEOPersonTitleTxt
Phone6034449000PhoneNum
Signature2026-08-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonConnor SmartPreparerPersonNm
PTINP02285543PTIN
Phone2078792100PhoneNum
Preparation2026-08-07PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Littleton Regional HealthcareBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRobert F NutterPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03561ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$170,170,125GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://littletonhealthcare.org/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1906FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionTo provide health care services in Northern New Hampshire.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee717TotalEmployeeCnt
Total Volunteers69TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,429,132PYContributionsGrantsAmt
CY Contributions Grants$1,220,883CYContributionsGrantsAmt
PY Program Service Revenue$112,525,590PYProgramServiceRevenueAmt
CY Program Service Revenue$141,098,187CYProgramServiceRevenueAmt
PY Investment Income$2,604,691PYInvestmentIncomeAmt
CY Investment Income$3,466,817CYInvestmentIncomeAmt
PY Other Revenue$296,641PYOtherRevenueAmt
CY Other Revenue$188,514CYOtherRevenueAmt
PY Total Revenue$116,856,054PYTotalRevenueAmt
CY Total Revenue$145,974,401CYTotalRevenueAmt
PY Grants And Similar Paid$135,086PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$60,799,031PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$68,205,201CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$69,824,853PYOtherExpensesAmt
CY Other Expenses$75,020,736CYOtherExpensesAmt
PY Total Expenses$130,758,970PYTotalExpensesAmt
CY Total Expenses$143,225,937CYTotalExpensesAmt
PY Revenues Less Expenses-$13,902,916PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,748,464CYRevenuesLessExpensesAmt
Total Assets BOY$102,964,897TotalAssetsBOYAmt
Total Assets EOY$98,323,846TotalAssetsEOYAmt
Total Liabilities BOY$69,020,654TotalLiabilitiesBOYAmt
Total Liabilities EOY$61,550,430TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$33,944,243NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$36,773,416NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTo provide quality, compassionate, and accessible healthcare in a manner that brings value to all.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$96,981,396ExpenseAmt
Grant$0GrantAmt
Revenue$141,098,187RevenueAmt
DescLittleton Hospital Association 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. Littleton Hospital Association offers a full spectrum of services, including acute primary and selected secondary care; 24-hour emergency services; preventative diagnostic, therapeutic, and rehabilitative services on an outpatient and inpatient basis; continuity of care from preventive programs to coordination with home health services. Littleton Hospital Association provides these services without regard to race, religion, age, sex, income, creed, national origin, or disability. Littleton Hospital Association maintains a sufficient number and mix of medical staff who are competent, dedicated and community based, supporting them with the technologically up to date equipment and facility needed to provide these services competitively. Littleton Hospital Association creates a healthy, satisfying work environment for physicians, 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.Desc
Total Program Service Expenses$96,981,396TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document96IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee717EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or Procedure0WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jennifer Griffey Interim CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6034449000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03561ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Dr Eric Emig
Trustee/Med Staff Pres (start 12/24)40.00Yes (X)$818,418$0$52,373
Dr Patrick Fitzpatrick
Trustee/Physician40.00Yes (X)$525,669$0$45,185
Dr Jennifer Lucas
Trustee/Med. Staff Pres. (end 12/24)40.00Yes (X)$447,776$0$38,462
Dr Richard McKenzie
Trustee/Physician/Vice Chair40.00Yes (X)$313,459$0$26,583Yes (X)
Dr Stephen Goldberg
Trustee/Physician40.00Yes (X)$340,125$0$28,456
Audrey Goudie
Trustee1.00Yes (X)$0$0$0
Susan Ide
Trustee1.00Yes (X)$0$0$0
Richard Jesseman
Trustee1.00Yes (X)$0$0$0
Nathan Karol
Trustee (start 12/2024)1.00Yes (X)$0$0$0
Robert MacLeod
Trustee (end 12/2024)1.00Yes (X)$0$0$0
Claire Mei
Trustee/LRH Aux. Rep. (start 2/25)1.00Yes (X)$0$0$0
Laurie Morgan
Trustee/LRH Auxiliary Rep.1.00Yes (X)$0$0$0
Stephen Noyes
Trustee1.00Yes (X)$0$0$0
Charyl Reardon
Trustee1.00Yes (X)$0$0$0
Paul Smith
Trustee1.00Yes (X)$0$0$0
Jeff Woodward
Chair(end 12/24); Treas.(start 1/25)1.00Yes (X)$0$0$0Yes (X)
Ashley Garrison
V.C. (end 12/24); Chair (start 1/25)1.00Yes (X)$0$0$0Yes (X)
Fred Chisolm
Treasurer (end 12/2024)1.00Yes (X)$0$0$0Yes (X)
Thomas Tremblay
Secretary (end 12/2024)1.00Yes (X)$0$0$0Yes (X)
Robert Nutter
President & CEO40.00$900,313$0$53,143Yes (X)
Dr Edward Duffy
CMO (end 5/25)40.00$610,423$0$65,931Yes (X)
Koren Superchi
COO/CNO40.00$396,362$0$42,663Yes (X)
Chris Frauenhofer
CFO40.00$170,048$0$14,700Yes (X)
Dr Jeffrey Kauffman
Physician40.00$772,851$0$66,319Yes (X)
Dr Jean Langevin
Physician40.00$637,770$0$54,486Yes (X)
Dr Anthony Salerni
Physician40.00$697,420$0$52,607Yes (X)
Dr Jonathan Lamphier
Physician40.00$610,580$0$47,600Yes (X)
Dr Daniel Underbakke
Physician40.00$552,560$0$43,419Yes (X)
Steven Shaffer
Former CFO40.00$334,046$0$37,859Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,127,820TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$669,786TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K106IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
The Alpine Clinic PLLC
1095 Profile RoadFranconiaNH03580Orthopedic services$2,608,239
Maxim Healthcare Staffing Services Inc
7223 Lee DeForest DriveColumbiaMD21046Staffing services$1,637,757
AHSA LLC
3051 Willowood RoadEdmondOK73034Speech pathology services$1,279,761
Red River Managed Services LLC
14111 Park Meadow DriveChantillyVA20151IT services$1,085,319
Weatherby Locums Inc
PO Box 972633DallasTX75397Staffing services$697,781
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K25CntrctRcvdGreaterThan100KCnt
Fundraising$46,316FundraisingAmt
Government Grants$447,210GovernmentGrantsAmt
All Other Contributions$727,357AllOtherContributionsAmt
Noncash Contributions$11,216NoncashContributionsAmt
Total Contributions$1,220,883TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient services621110$122,888,044$122,888,044
Disproportionate share revenue621110$12,048,368$12,048,368
Pharmacies456110$4,278,856$4,278,856
Auxiliary health services621110$1,001,891$1,001,891
Cafeteria/dining services722514$881,028$881,028
FieldValueIRS element (for citing)
Total Program Service Revenue$141,098,187TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$799,742TotalRevenueColumnAmt
Exclusion$799,742ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$196,101RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$196,101RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$196,101TotalRevenueColumnAmt
Exclusion$196,101ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$26,823,709SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$24,156,634SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,667,075SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,667,075TotalRevenueColumnAmt
Exclusion$2,667,075ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$28,158FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$46,316ContriRptFundraisingEventAmt
Fundraising Direct Expenses$35,905FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$7,747TotalRevenueColumnAmt
Exclusion-$7,747ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$3,345GamingGrossIncomeAmt
Gaming Direct Expenses$3,185GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$160TotalRevenueColumnAmt
Exclusion$160ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$145,974,401TotalRevenueColumnAmt
Related Or Exempt Func Income$141,098,187RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3,655,331ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,890,090TotalAmt
Program Services$3,379,380ProgramServicesAmt
Management And General$1,510,710ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$52,186,365TotalAmt
Program Services$36,064,281ProgramServicesAmt
Management And General$16,122,084ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,084,941TotalAmt
Program Services$749,767ProgramServicesAmt
Management And General$335,174ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,439,282TotalAmt
Program Services$4,449,976ProgramServicesAmt
Management And General$1,989,306ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,604,523TotalAmt
Program Services$2,490,967ProgramServicesAmt
Management And General$1,113,556ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$408,505TotalAmt
Management And General$408,505ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$255,303TotalAmt
Management And General$255,303ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$3,658TotalAmt
Management And General$3,658ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$83,075TotalAmt
Management And General$83,075ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$25,353,170TotalAmt
Program Services$16,367,288ProgramServicesAmt
Management And General$8,985,882ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$547,392TotalAmt
Program Services$4,706ProgramServicesAmt
Management And General$542,686ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,583,912TotalAmt
Program Services$2,808,987ProgramServicesAmt
Management And General$1,774,925ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,111,642TotalAmt
Program Services$704,019ProgramServicesAmt
Management And General$3,407,623ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,701,300TotalAmt
Program Services$2,078,751ProgramServicesAmt
Management And General$1,622,549ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$492,779TotalAmt
Program Services$449,253ProgramServicesAmt
Management And General$43,526ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,823,764TotalAmt
Program Services$620,794ProgramServicesAmt
Management And General$1,202,970ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,006,762TotalAmt
Program Services$502,576ProgramServicesAmt
Management And General$504,186ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,551,886TotalAmt
Program Services$1,534,462ProgramServicesAmt
Management And General$3,017,424ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,461,344TotalAmt
Program Services$187,248ProgramServicesAmt
Management And General$2,274,096ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Provision for bad debts$10,353,162$10,353,162
Pharmaceuticals$6,237,574$5,934,061$303,513
NH Medicaid tax$4,290,914$4,290,914
Medical/lab supplies$3,154,013$3,144,813$9,200

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,600,581TotalAmt
Program Services$865,991ProgramServicesAmt
Management And General$734,590ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$143,225,937TotalAmt
Program Services$96,981,396ProgramServicesAmt
Management And General$46,244,541ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$246,342BOYAmt
EOY$165,480EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$917,107BOYAmt
EOY$1,458,107EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$16,193,141BOYAmt
EOY$17,973,650EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,301,887BOYAmt
EOY$2,533,309EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,603,224BOYAmt
EOY$1,326,285EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$117,317,731LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$86,701,268LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$32,446,297BOYAmt
EOY$30,616,463EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$34,409,829BOYAmt
EOY$28,070,887EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$4,911,382BOYAmt
EOY$4,234,625EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$3,321,154BOYAmt
EOY$3,073,341EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,614,534BOYAmt
EOY$8,871,699EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$102,964,897BOYAmt
EOY$98,323,846EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$32,192,442BOYAmt
EOY$29,613,695EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,344,725BOYAmt
EOY$17,462,830EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,083,685BOYAmt
EOY$1,529,388EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,399,802BOYAmt
EOY$12,944,517EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$69,020,654BOYAmt
EOY$61,550,430EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$29,912,854BOYAmt
EOY$32,367,408EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,031,389BOYAmt
EOY$4,406,008EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,944,243BOYAmt
EOY$36,773,416EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$102,964,897BOYAmt
EOY$98,323,846EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,748,464ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$97,503NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$178,212OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$3,658GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$3,658TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe Hospital maintains a membership with the American Hospital Association ("AHA"). A portion of the dues remitted to the AHA may be made available for the AHA to use towards lobbying expenditures on behalf of its members' programs and missions. During the period covered by this Form 990, the Hospital paid AHA total membership dues and fees of $10,162. 36%, or approximately $3,658, of the total dues paid to the AHA were used for lobbying purposes.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,075,661BeginningYearBalanceAmt
Contributions$50ContributionsAmt
Investment Earnings Or Losses$236,937InvestmentEarningsOrLossesAmt
Other Expenditures$241,913OtherExpendituresAmt
End Year Balance$2,070,735EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,624,405BeginningYearBalanceAmt
Contributions$44,966ContributionsAmt
Investment Earnings Or Losses-$119,893InvestmentEarningsOrLossesAmt
Other Expenditures$473,817OtherExpendituresAmt
End Year Balance$2,075,661EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,386,830BeginningYearBalanceAmt
Investment Earnings Or Losses$277,727InvestmentEarningsOrLossesAmt
Other Expenditures$40,152OtherExpendituresAmt
End Year Balance$2,624,405EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,757,824BeginningYearBalanceAmt
Contributions$116,439ContributionsAmt
Investment Earnings Or Losses-$487,433InvestmentEarningsOrLossesAmt
End Year Balance$2,386,830EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,432,225BeginningYearBalanceAmt
Contributions$29,896ContributionsAmt
Investment Earnings Or Losses$403,922InvestmentEarningsOrLossesAmt
Other Expenditures$108,219OtherExpendituresAmt
End Year Balance$2,757,824EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,981,468OtherCostOrOtherBasisAmt
Book Value$1,981,468BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,037,778OtherCostOrOtherBasisAmt
Depreciation$34,619,090DepreciationAmt
Book Value$15,418,688BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,553,615OtherCostOrOtherBasisAmt
Depreciation$934,245DepreciationAmt
Book Value$1,619,370BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$61,931,242OtherCostOrOtherBasisAmt
Depreciation$51,147,933DepreciationAmt
Book Value$10,783,309BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$813,628OtherCostOrOtherBasisAmt
Book Value$813,628BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,616,463TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Malpractice insurance recovery reserves$1,188,397
Employee benefit plan assets$5,409,107
Estimated third-party payor settlements$2,274,195
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,871,699TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Operating lease liabilities$2,643,763
Fair value of interest rate swap$317,045
Malpractice and professional coverage liabilities$2,574,602
Discount stock option plan$5,034,907
Deferred executive comp$374,200
Long-term credit balance adjustments$2,000,000
FieldValueIRS element (for citing)
Total Liability$12,944,517TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$135,580,144TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$97,503NetUnrealizedGainsInvstAmt
Other Revenue-$38,729OtherRevenueAmt
Revenue Not Reported-$136,232RevenueNotReportedAmt
Revenue Subtotal$135,716,376RevenueSubtotalAmt
Investment Expenses Not Incld$83,075InvestmentExpensesNotIncldAmt
Other Revenues Not Included$10,174,950OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$10,258,025RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$145,974,401TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$132,750,971TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$38,729OtherExpensesIncludedAmt
Expenses Not Reported-$38,729ExpensesNotReportedAmt
Expenses Subtotal$132,789,700ExpensesSubtotalAmt
Investment Expenses Not Incld2$83,075InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$10,353,162OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$10,436,237ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$143,225,937TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:The Hospital maintains a perpetually restricted endowment fund, intended to provide support for current and future operations of the Hospital. Specifically, the endowment funds are restricted to be used in furtherance of health care services and related activities. The endowment fund is composed of permanently restricted capital, though accumulated earnings may be expended for the provision of care services.
Part X, Line 2:The Hospital is a tax-exempt corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. Management evaluated the Hospital's tax position and concluded the Hospital has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to or disclosure in the accompanying financial statements with the exception of the ERC reserve discussed below: The Employee Retention Credit (ERC) was established by the Coronavirus Aid, Relief and Economic Security Act (CARES Act) and was intended to help organizations retain their workforce during the pandemic. ERC provides a per employee credit to eligible businesses based on a percentage of qualified wages and health insurance benefits paid to employees. ERC is a refundable tax credit claimed quarterly as either a reduction in payroll taxes or cash refunds. The One Big Beautiful Bill Act (OBBBA) enacted July 4, 2025, further changed the ERC statute of limitations, primarily by extending the Internal Revenue Service's (IRS) timeframe for audits and collections for certain quarters and retroactively disallowing specific late claims. While management believes the Hospital met the requirements of the ERC program, a reserve has been established totaling approximately $2,700,000 as of September 30, 2025 and 2024, should the IRS determine the Hospital is not eligible to receive the credits and seeks reimbursement. This reserve is included in accounts payable, accrued expenses and other current liabilities in accompanying balance sheets.
Part XI, Line 2d - Other Adjustments:Fundraising event revenue and expenses -38,729.
Part XI, Line 4b - Other Adjustments:Provision for bad debts 10,353,162. Contribution expense Change in value of interest rate swap -178,212.
Part XII, Line 2d - Other Adjustments:Fundraising event revenue and expenses -38,729.
Part XII, Line 4b - Other Adjustments:Provision for bad debts 10,353,162. Contribution expense

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCentral America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas,RegionTxt
Offices0OfficesCnt
Employee0EmployeeCnt
Type Of Activities ConductedInvestmentsTypeOfActivitiesConductedTxt
Region Total Expenditures$4,235,000RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continuation Total Office0ContinuationTotalOfficeCnt
Continuation Total Employee0ContinuationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$4,235,000SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$4,235,000TotalSpentAmt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp OwnershipYes (1)ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990, Schedule F, Part IV:FormAndLineReferenceDesc
ExplanationThe Organization holds an interest in Drake Capital Offshore Partners, L.P ("Drake"), a Cayman Island-based exempted partnership. For U.S. tax purposes, the Partnership has filed an election to be treated as a corporation. The Organization's interest in Drake is under the ownership thresholds requiring filing of the Form 5471. Accordingly, the Organization is not required to prepare or submit to the IRS a Form 5471 regarding this investment with this tax return. Additionally, the Organization did not make any transfers to Drake during the period covered by this Form 990. Accordingly, the Organization is not required to prepare or submit to the IRS any Forms 926 regarding this investment with this tax return.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Golf TournamentEvent1Nm
Gross Receipts Event1$74,474GrossReceiptsEvent1Amt
Charitable Contri Event1$46,316CharitableContriEvent1Amt
Gross Revenue Event1$28,158GrossRevenueEvent1Amt
Non Cash Prizes Event1$8,691NonCashPrizesEvent1Amt
Rent Facility Costs Event1$7,767RentFacilityCostsEvent1Amt
Food And Beverage Event1$14,033FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$5,414OtherDirectExpensesEvent1Amt
Gross Receipts Total$74,474GrossReceiptsTotalAmt
Charitable Contributions Tot$46,316CharitableContributionsTotAmt
Gross Revenue Total Events$28,158GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$8,691NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$7,767RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$14,033FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$5,414OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$35,905DirectExpenseSummaryEventsAmt
Net Income Summary-$7,747NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$600,284TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$600,284NetCommunityBenefitExpnsAmt
Total Expense0.00450TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,510,209TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$219,295DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,290,914NetCommunityBenefitExpnsAmt
Total Expense0.03230TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,110,493TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$219,295DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,891,198NetCommunityBenefitExpnsAmt
Total Expense0.03680TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$87,611TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$87,611NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$496,237TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$496,237NetCommunityBenefitExpnsAmt
Total Expense0.00370TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,707,682TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,983,720DirectOffsettingRevenueAmt
Net Community Benefit Expns$23,723,962NetCommunityBenefitExpnsAmt
Total Expense0.17850TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,975TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,975NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$42,305,505TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,983,720DirectOffsettingRevenueAmt
Net Community Benefit Expns$24,321,785NetCommunityBenefitExpnsAmt
Total Expense0.18300TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$47,415,998TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,203,015DirectOffsettingRevenueAmt
Net Community Benefit Expns$29,212,983NetCommunityBenefitExpnsAmt
Total Expense0.21980TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,420TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,420NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$75,338TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$75,338NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,193TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$43,193NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$82,148TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$82,148NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,105TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,105NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,967TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,967NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$205,171TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$205,171NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense$4,630,132BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$18,791,036ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$19,504,080CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$713,044MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Littleton Regional HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP02790ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.littletonhealthcare.orgWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Littleton Regional HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Section COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Part V, Section COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Section CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Section CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Section CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Littleton Regional HospitalPart V, Section B, Line 5: In 2022, the Northern New Hampshire Region (composed of Littleton Regional Healthcare, Ammonoosuc Community Health Services, Mid-State Health Center, and Cottage Hospital) performed a Community Health Needs Assessment to determine the health needs of the Greater Northern New Hampshire Region. Data was gathered from multiple well-respected secondary sources to build an accurate picture of the community and its health needs. Through the assessment process, a survey was issued to a select group of local experts to review the most recent prior CHNA, to provide feedback on those past assessments, and to ascertain whether the previously identified needs remained a priority. Additionally, the group of hospitals and care facilities reviewed the data gathered from the secondary sources to determine the overall significant health needs for the community.For complete details of how the NNHR CHNA gathered community input in determining the significant health needs of the region, please see the full assessment and reports, available online at:https://littletonhealthcare.org/about-lrh/
Littleton Regional HospitalPart V, Section B, Line 6a: Littleton Regional Hospital was one of multiple hospital organizations to participate in and contribute to the Northern New Hampshire Region Facilities ("NNHR, or, the "Facilities") Community Health Needs Assessment ("CHNA"). NNHR conducted this CHNA in partnership with QHR Health ("QHR") to determine the health needs of the applicable regional and local communities. NNHR and QHR also developed an accompanying implementation plan to address the health needs identified through the CHNA process. The Northern New Hampshire Region Facilities included the following hospital facilities: - Littleton Regional Healthcare, Littleton, NH ("LRH") - Cottage Hospital, Haverhill, NH ("CH") - Mid-State Health Center ("MSHC") - Ammonoosuc Community Health Services, Littleton, NH ("ACHS")
Littleton Regional HospitalPart V, Section B, Line 6b: Littleton Regional Hospital was one of multiple hospital organizations to participate in and contribute to the Northern New Hampshire Region Facilities ("NNHR, or, the "Facilities") Community Health Needs Assessment ("CHNA"). The 2022 NNHR CHNA also involved many different organizations other than hospital facilities, including the following:- QHR Health- Stratasan- Bureau of Labor Statistics- NAMI- New Hampshire Fiscal Policy Institute- CDC- Cetners for Medicare and Madicaid Services- National Cancer Institute- Vermont Department of Health- Mental Health America- Vermont Housing Finance Agency- Vermont Legislative Joint Fiscal Office
Littleton Regional HospitalPart V, Section B, Line 11: Littleton Regional Hospital ("LRH") participated in and contributed to the shared 2022 Northern New Hampshire Region Community Health Needs Assessment for its most recent CHNA. This assessment identified ten primary, significant health needs impacting the region served by the Hospital. An implantation plan framework, which organized these needs by key groups, was developed. The framework has allowed LRH to prioritize and address the identified needs as efficiently and effectively as possible.The ten identified health needs, and a summary of how those needs fit within the Hospital's overall implementation plan, are as follows: 1. Mental Health: LRH's emergency department acts as a regional intake center for all patients with emergent behavioral health needs. LRH also contracts with Dartmouth Health's Connect Care to provide telepsychiatry in its emergency department. LRH is continuously enhancing its inpatient units to better accommodate the behavioral health needs of patients whose primary diagnosis is not itself behavioral, but who are nonetheless placed on observation or admitted. LRH continues its efforts to embed behavioral health into its primary care clinic, including recruiting providers dedicated to behavioral health, and incorporates sharing mental health resources in the clinic and to the public on an ongoing basis. 2. Affordability of Healthcare Services: LRH's onsite urgent care clinic provides cost-effective, accessible care as an alternative to the emergency department, or for conditions too urgent to wait for an appointment. LRH also offers financial assistance to qualifying patients, providing over a million dollars each year in Charity Care to those unable to pay for services. LRH's established endowment funds also help support patients needing assistance in specific health areas, such as those receiving cancer treatment. 3. Access to Mental Health and Substance Use Disorder Services: The Doorway at LRH is part of a statewide initiative to address the growing need for substance use disorder ("SUD") services. This clinic serves as a regional hub for patients throughout Northern and Central New Hampshire requiring these services. LRH understands the growing need for behavioral health services and is taking this into consideration as it prepares to embark on a complete emergency department renovation. 4. Affordable Housing: LRH has joined nine other major area employers to address the lack of affordable housing in the area, which is impacting recruitment efforts for all major employers in the community. The group is actively engaged with AHEAD (Affordable Housing Education and Development) to determine the feasibility of constructing workforce housing in the near future on an identified parcel of local land. LRH keeps a running list of housing availability for new hires seeking housing in the area, and also owns a multi-unit property in Littleton which provides on-call housing and longer-term stays options for those providing care services within the community. 5. Livable Wages: LRH is the largest employer in Northern Grafton Country and Coos County, and overhauled its compensation and benefits structure in 2022 to reinforce its position as the market leader. LRH is proud to say it achieves at or above the 75th percentile for all staff wages. 6. Drug/Substance Abuse: The Doorway at LRH serves as a single point of entry for those seeking help for substance abuse. The Doorway provides resources, treatment, and other support and services to assist in long-term recovery, including peer recovery support services, coordination of placement in treatment centers, screening and evaluation, and medication assisted treatment. LRH's emergency department also helps coordinate emergent treatment for substance use disorders for The Doorway. 7. Access to Senior Services: Senior health services was ranked as one of the top health needs in the most recent CHNA, in part due to mobility and accessibility concerns. In response to this identified need, LRH maintains a Mobile Integrated Health Program, which works closely with local EMS providers throughout the region, as well as a mobile health clinic, to address healthcare access issues throughout Grafton and Coos Counties. LRH also collaborates clinically with a regional FQHC to bring specialty care closer to home for residents of Central New Hampshire through a visiting specialist program. These mobile health services help bring care to senior citizens who cannot otherwise travel to health facilities. 8. Cancer: LRH shares resources with the public on services it provides such as skin cancer screenings, breast cancer screening, colonoscopies, cervical cancer screenings, prostate screenings, among others, and how to access these services. LRH also partners with Dartmouth Health's Norris Cotton Cancer Center to staff its onsite Oncology, Hematology, and Infusion Center. Through LRH's involvement in the visiting specialist program, many of these screenings are now available in central New Hampshire office locations. 9. Obesity: LRH employs a full-time Diabetes Educator and a full-time Registered Dietitian who both accept referrals for patients requiring these services. LRH's Diabetes Educator offers a free, virtual support group once a month for patients and nonpatients to attend. LRH encourages patients to see their provider on an annual basis to monitor health conditions, like weight concerns. 10. Alzheimer's and Dementia: LRH shares resources related to Dementia and Alzheimer's and encourages routine care to address any concerns related to these conditions. LRH also employs a Neurologist, and contracts with Dartmouth Health for supplemental tele-neurology support.The complete Implementation Plan can be found within the shared 2022 CHNA, which is available online at:https://littletonhealthcare.org/about-lrh/
Schedule H, Section B, Lines 7 and 10:Littleton Regional Hospital was one of multiple hospital organizations to participate in and contribute to the Northern New Hampshire Region Facilities ("NNHR or the "Facilities") Community Health Needs Assessment (CHNA).The NNHR CHNA and its associated CHNA Implementation Strategy is available online on the Hospital's website at:https://littletonhealthcare.org/about-lrh/A direct link to the 2022 CHNA and its Implementation Strategy is available at:https://littletonhealthcare.org/wp-content/uploads/2023/01/NNHR-2022-CHNA_Littleton.pdfAs a shared, regional CHNA, the 2022 NNHR CHNA can also be found on multiple other organizations' websites, including the following:https://www.cottagehospital.org/uploads/files/NNHR%202022%20CHNA_Cottage.pdfhttps://www.midstatehealth.org/wp-content/uploads/2023/02/NNHR-2022-CHNA_Mid-State.pdfLastly, while released outside the required CHNA reporting period for this Form 990, due to timing differences between this tax return's filing and the publication of the Organization's health assessments, the 2025 Community Health Needs Assessment is also availanle online, at the following address (the 2025 CHNA will be covered in greater detail on future Form 990 tax returns to be filed by the Hospital):https://littletonhealthcare.org/wp-content/uploads/2026/04/Northern-NH-Northeast-VT-2025-CHNA-Final.pdf
Schedule H, Part V, Section B, Line 16a & 16b:Information regarding the Hospital's billing and financial assistance policies can be found online at:https://littletonhealthcare.org/patients-and-visitors/my-bill/The Hospital's Financial Assistance Policy is available on the Hospital's website at:https://littletonhealthcare.org/wp-content/uploads/2024/02/Financial-Assistance-Program-Policy-2.20.2024.pdfThe Hospital's Financial Assistance Application is available on the Hospital's website at:https://littletonhealthcare.org/wp-content/uploads/2025/02/FAP-APPLICATION.pdfThe Hospital's Financial Assistance Plain Language and Eligibility Summary is available online at:https://littletonhealthcare.org/wp-content/uploads/2025/02/FAP-PLAIN-LANGUAGE-SUMMARY-2025.pdf

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:Littleton Hospital has several hospital clinical services and hospital-owned physician practices. Per the Instructions for IRS Form 990, Schedule H, Worksheet 6, organizations may include any applicable physician practice that the Hospital subsidizes (i.e., operates at a loss) in the completion of Schedule H and its costing method calculations. Therefore, the Hospital has included the following hospital clinical services and hospital-owned physician practices that operate at a loss (i.e., are subsidized by the Hospital) and the associated costs of these practices: a. Rural Health Clinic b. LRH Franconia Ortho c. LRH Urology Associates d. LRH Littleton Orthopaedics e. LRH Lincoln Urgent Care f. LRH General Surgery g. LRH NC Otolaryngology h. LRH Neurology i. LRH Urgent Care j. LRH NC Women's Health k. LRH NC Orthopedics l. LRH NC Sleep m. LRH Gastroenterology n. NC Spine Center o. Emergency p. Alpine Plymouth q. LRH Alpine PhysiciansThe above-listed hospital clinical services and hospital-owned physician practices have a community benefit (i.e. aggregate loss or subsidy from the Hospital) of approximately $23.72 million. In addition, the community benefit does not take into account bad debts, charity care, or contractual adjustments. Thus, this community benefit of approximately $23.72 million is a conservative figure that reconciles to the community benefit information reported on IRS Form 990, Schedule H, Part I, Line 7g, Column e.Form 990, Schedule H instructions and guidance also contains a template (Worksheet 2) that may be used to determine the overall cost to charge ratio that could be applied throughout Schedule H to convert charges to cost figures. Where applicable, the Hospital has utilized Worksheet 2 for various calculations. The only areas where Worksheet 2 was not utilized for Part 1, Line 7, were the following: a. Schedule H, Worksheet 3, Unreimbursed Medicaid and Other Means Tested Government Programs (the supporting schedule for Part I, Lines 7b and 7c); and Worksheet 6, Medicaid Allowable Costs for Subsidized Health Services, as listed in line 1c above (which is part of the line 7g costs): The Hospital did not utilize the Worksheet 2 percentage when calculating the Medicaid allowable cost. Instead, the Hospital utilized the Medicaid worksheets on the filed cost report for these allowable costs. b. Schedule H, Worksheet 4, Community Health Improvement Services and Community Benefit Operations: The hospital provided the following community health improvement services.a- Seasonal Flu Vaccine Clinicb - UpToDate Wellness Clinicc - Littleton Wellness Faird - Child passenger safetye - lactation servicesf - perinatal bereavementg - CPRh - CPR AT CHURCHi - baby's morning outj - childbirth educationk - dedicated staff cost to community benefitsl - website maintenancem - NEWT fairn - NNOo - bridge project back to school drivep - nh highland games medical field coverageq - Loon mountain orientationr- center for new beginningss - Senior Center presentationsBecause Worksheet 4 was used for these services' community benefits, Worksheet 2 was not utilized. c. Schedule H, Worksheet 5, Health Professions Education: The hospital provides nursing and life support saving education to local high school students. Because Worksheet 5 was used for these services' community benefits, Worksheet 2 was not utilized. d. Schedule H, Worksheet 8, Cash and In-Kind Donations to Community Groups: The hospital donates to support various community groups. Because Worksheet 8 was used for these services' community benefits, Worksheet 2 was not utilized. e. Community Building Activities: The Hospital provides community building activities by supporting the following activities within the below-listed entities.- Economic Development:a - MWV Chamberb - Littleton Area Chamber of Commercec - Western White Mountain Chamber of Commerce- Community Support:a - 220 sharps containers from urgent care clinicsb - EMS Omnicell- Environmental Improvements:a. Bio-Chemical Waste Management
Part I, Line 7, Column (f):The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 10,353,162.
Part II, Community Building Activities:Littleton Regional Healthcare participates in several community building activities that promote the health and wellbeing of the communities it serves. For example, LRH collaborates with a number of local agencies including the North Country Health Consortium, Littleton Area Senior Center, Ammonoosuc Community Health Services, to name just a few. These agencies share common goals that address access to healthcare, health improvement, health education, and affordable healthcare services.Additionally, LRH encourages senior management and mid-level management to be actively involved in the communities served by the Hospital. For example, LRH works with area schools to address the health of our young students, and also collaborates with local safety providers to promote safety and help prevent injury. As a community asset and center, LRH hosts multiple public engagement and volunteer opportunities. The Hospital's active volunteers provide a sense of communal enterprise, advancing high-quality, compassionate service to the Hospital's visitors, patients, and other community members.The Hospital also promotes public education and personal wellness through its publications of magazines and online blogs. These resources improve the general community's and region's access to resources and overall health literacy.Through these programs and the Hospital's collaboration with these agencies, LRH continues to bolster the strength and health of its community beyond just the services offered through its care facilities.
Part III, Line 2:The Hospital utilized Worksheet 2 from the IRS Schedule H instructions/guidance to determine the ratio of patient care cost to charge (44.72% for fiscal year 2025) and multiplied this ratio by the Hospital's total bad debt expense attributable to patients eligible under the financial assistance policy of $10,353,162 to determine the Part II, Line 2 bad debt expense of $4,630,132.
Part III, Line 4:See Footnote 2 on page 10 of the attached audited financial statements.
Part III, Line 8:Form 990, Schedule H instructions and guidance contains a template (Worksheet 2) that may be used to determine the overall cost-to-charge ratio that could be applied throughout Schedule H in order to convert charges to cost figures. Where applicable, the Hospital has utilized Worksheet 2 for various calculations. The only areas where Worksheet 2 was not utilized for Part III, Line 8 was Schedule H, Worksheet B, Line 2 & 6, Medicare Allowable Costs and Payments Related to Subsidized Health Services. The Hospital utilized the Medicare cost report estimated cost and payment for these services.The Hospital believes that its hospital clinical services, hospital-owned physician practices, emergency room, and rural health center, as detailed in these Schedules supplemental narratives, should be considered a community benefit, as community members benefit by having easy access to these services, facilities, and programs which are both offered and subsidized. These facilities and programs are offered and thus subsidized through the Hospital.
Part VI, Line 2:Littleton Regional Hospital ("LRH") takes a comprehensive approach to assess community health needs. We perform several independent data analyses based on secondary source data, augment this with local survey data and resolve any data inconsistency or discrepancies from the combined opinions formed from local experts. We rely on secondary source data and most secondary sources use the county as the smallest unit of analysis. Since the service area comprises parts of Grafton County, we asked local residents to note if they perceived the problems, or needs, identified by secondary sources to exist in their portion of the county.
Part 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. The Hospital also provides its financial assistance policies, applications, descriptions of coverage, and billing and financial literacy tools online, through the Hospital's website.
Part VI, Line 4:The Hospital defines its primary service area as Grafton County. Grafton County, New Hampshire is the 5th largest county in New Hampshire, with an estimated population of 91,118, and a growth rate of 0.03%, according to the most recent United States census data. Of this population, people under five years of age make up 3.9% of the population, and people under 18 years of age make up 20.4% of the population. This contrasts with persons 65 years of age and over, who make up 21.9% of the population. All females account for 50.2% of the overall population in the County. The most recent census data found median household income to be $82,045, with per capita income through 2018-2022 of $37,847 (adjusted for inflation for 2022 dollars). The income data also found that 11% of the County's population to be considered at poverty level. Individuals with a disability account for 15.5% of the population, and people without health insurance represent 5.3% of the population.
Part VI, Line 5:Littleton Regional Hospital's ("LRH") care services and hospital facilities significantly contribute to the health of its community. The list below covers just a few ways that the Hospital engages with its community to promote its overall health and wellbeing:Education: LRH maintains an internal Department of Education, which seeks to provide evidence-based educational opportunities, through the use of simulated learning experiences, that supports clinical staff in meeting the unique needs of a rural community.The Alpine Clinic: the largest orthopaedic practice in Northern New Hampshire with offices in four convenient locations. Our highly skilled orthopaedic surgeons have been providing care to the communities it serves for more than 20 years. With more than 90 years of combined orthopaedic experience, you can be confident that our surgeons provide the best possible care.The Doorway Program: For many people, addiction is a daily reality. The Doorway is here to help - whether it helps you or a loved one - we can connect you to support, services, and care that is right for you. The Doorway at LRH is part of a statewide initiative to address the growing opioid crisis. Littleton Regional Healthcare (LRH) serves as a hub for Northern New Hampshire.Sauter Birthing Suite: Our mission is to provide a high-quality, positive birth experience not only for our mothers but also for the entire family. Our goal is to make families feel welcome while giving the very best medical care in a comfortable, home-like environment.In addition to these specific clinics, LRH provides medical and specialty care across a wide array of practice areas, including: allergy; anesthesiology; behavioral health; cardiopulmonary; cardiology; dermatology; diagnostic imaging; emergency and urgent care; plastics; gastroenterology; general surgery; gynecology/obstetrics; hospice care; infection control; intensive care; laboratory work; maternity care; neurology and neuro surgery; occupational health; oncology; ophthalmology; orthopedics; otolaryngology; pain management; pharmacy access; primary care and family medicine; pulmonology; radiology; sleep medicine; addiction and substance abuse treatment; perioperative; and urology.
Part VI, Line 6:Littleton Regional Hospital is not itself part of a formal, affiliated health care system. However, the Hospital does coordinate with many community partners and other hospital entities to collaborate on health assessments and responses, with the purpose of improving the overall wellbeing of the community which the Hospital serves. Additional details regarding these collaborative efforts can be found in the Hospital's shared Northern New Hampshire Region's 2022 Community Health Needs Assessment.
Part VI, Line 7, Reports Filed With StatesNH

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Robert Nutter
President & CEO$422,954$0$263,611$0$213,748$0$0$0$53,143$0$953,456$0$181,563$0
Dr Eric Emig
Trustee/Med Staff Pres (start 12/24)$612,160$0$203,882$0$2,376$0$0$0$52,373$0$870,791$0$0$0
Dr Jeffrey Kauffman
Physician$771,303$0$0$0$1,548$0$0$0$66,319$0$839,170$0$0$0
Dr Anthony Salerni
Physician$607,848$0$85,000$0$4,572$0$0$0$52,607$0$750,027$0$0$0
Dr Jean Langevin
Physician$613,942$0$0$0$23,828$0$0$0$54,486$0$692,256$0$0$0
Dr Edward Duffy
CMO (end 5/25)$473,016$0$96,134$0$41,273$0$22,822$0$43,109$0$676,354$0$0$0
Dr Jonathan Lamphier
Physician$556,008$0$50,000$0$4,572$0$0$0$47,600$0$658,180$0$0$0
Dr Daniel Underbakke
Physician$509,343$0$42,857$0$360$0$0$0$43,419$0$595,979$0$0$0
Dr Patrick Fitzpatrick
Trustee/Physician$504,589$0$0$0$21,080$0$0$0$45,185$0$570,854$0$0$0
Dr Jennifer Lucas
Trustee/Med. Staff Pres. (end 12/24)$423,228$0$0$0$24,548$0$0$0$38,462$0$486,238$0$0$0
Koren Superchi
COO/CNO$295,867$0$75,820$0$24,675$0$14,768$0$27,895$0$439,025$0$0$0
Steven Shaffer
Former CFO$191,784$0$42,504$0$99,758$0$13,105$0$24,754$0$371,905$0$0$0
Dr Stephen Goldberg
Trustee/Physician$304,499$0$20,000$0$15,626$0$0$0$28,456$0$368,581$0$0$0
Dr Richard McKenzie
Trustee/Physician/Vice Chair$308,887$0$0$0$4,572$0$0$0$26,583$0$340,042$0$0$0
Chris Frauenhofer
CFO$168,788$0$0$0$1,260$0$0$0$14,700$0$184,748$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Lines 4a-bSchedule J, Line 4a, Severance Payments: During calendar year 2024, Littleon Hospital Association made severance payments to one of its former officers. Steven Shaffer, who served as the Organization's Chief Financial Officer until May 2024, received severance payments of $80,000. These payments were included in Mr. Shafer's 2024 Form W-2, Box 5 wages, and the amounts are included in Mr. Shafer's total Other Compensation as reported on this 2024 Form 990, Schedule J, Page 2, Part II, Line B(iii). Schedule J, Line 4b, Supplemental Non-Qualified Retirement Plans: Littleton Hospital Association maintains a 457(f) non-qualified deferred compensation plan. During the 2024 calendar year, certain directors, trustees, officers, key employees, and/or highest compensated employees received non-taxable employer-paid contributions into the plan. For these individuals, as these deferred compensation plan contributions were not deemed taxable, the payments have been included within the amounts reported on this Form 990, Schedule J, Part II, Column C. Such deferrals were as follows: - Steven Shaffer, $13,105. - Koren Superchi, $14,768. - Edward Duffy, $22,822. Additionally, Robert Nutter, the Organization's CEO, also participated in the Plan during this fiscal year. Mr. Nutter received distributions from his 457(f) plan of $181,563 in calendar year 2024. Such distributions have been reported on this Form 990 and included within the amounts shown on Schedule J, Part II, Column B(iii), as Other Compensation. As these payments represent distributions of amounts previously reported as deferred compensation, the distributions have also been reported on this Schedule J, Part II, Column F.
Part I, Line 7From time to time the Hospital may pay bonuses, incentive compensation, performance awards, or other non-fixed payments to selected employees or officers, based upon the accomplishment of defined goals and metrics. For example, certain bonuses are based on productivity measures using Medical Group Management Association's standards by relative value units ("RVUs"), and by each applicable individual's specialties as outlined in their respective contracts. Such performance measurement tools allow the Hospital to align alternative or non-fixed compensation with patient care outcomes and overall Hospital performance. Other bonuses are paid based on and subject to achieving organizational quality and financial metrics. The goals and measurements for these latter non-fixed payments and achievement awards were developed with input from the Board Executive Committee, and were approved by the Board of Directors.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
New Hampshire Health and Education Facilities Authority
A0202798662015-10-01$5,331,100Refunded series 2007 Bond000
New Hampshire Health and Education Facilities Authority
B0202798662015-10-01$20,753,200Refunded series 2007 Bond000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$1,954,667$5,331,100$41,800$5,289,3002015Yes (1)0Yes (1)Yes (1)
B$6,807,476$20,753,200$162,500$20,590,7002015Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)000.000000.000000.0000000Yes (1)
B0Yes (1)000.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedInd
(no name)
A000Yes (1)0000Yes (1)
Deutsche Bank AG
B000Yes (1)Yes (1)Yes (1)00Yes (1)2000.00000000000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule K, Part III, Line 2, Lease arrangements:FormAndLineReferenceDesc
ExplanationThe Hospital holds lease arrangements which may result in private business use of the bond-financed property. This private business use would be due to agreements wherein the Hospital rents excess medical practice space to physician practices, including the following: Dartmouth Hitchcock's Cardiovascular Medicine satellite offices; Shippee Family Eye Care Littleton; Littleton Internal Medicine; and White Mountain Family Health. Accordingly, of the leased space offered by the Hospital, the majority is provided to other organizations directly tax exempt under Section 501(c)(3) or otherwise affiliated with charitable entities. Additionally, the private practices operate primarily for purposes related to or in direct furtherance of the Hospital's own activities and charitable purpose, including the provision of patient care and health services to the general region in which the Hospital operates. The Hospital actively monitors these lease arrangements to ensure that the tenants' activities conducted directly further the Hospital's mission to provide care to its patients. As a result, it is the Hospital's position that the presence of these practices on or near the Hospital's own campus enhances the Hospital's patients and community's access to care and health resources. Lastly, any space occupied by lease tenants working within or around the Hospital's campus constitutes only a nominal and immaterial footprint of the entire facility. Therefore, while these private practices may operate within or around bond-financed property, the Hospital does not believe that such activities would constitute an inappropriate private benefit or unauthorized use of the bond funds. The Hospital actively monitors any such entities leasing space in the bond-financed property to make sure their activities are substantially related to the Hospital's exempt purpose and would not constitute an unauthorized private benefit or unrelated business activity.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11bThe Form 990 is prepared with the assistance of an independent CPA firm, who coordinates with the Organization's finance personnel and officers to ensure the tax return is complete and accurate prior to its finalization. A complete copy of the Form 990 is circulated among the entire Board prior to the tax return's filing with the IRS.
Form 990, Part VI, Section B, line 12cThe Hospital's Board of Trustees has adopted a policy for identifying conflicts of interest, in compliance with applicable law. Through this policy, the Board commits to conduct itself at all times in an ethical manner. The Board will identify all "pecuniary benefit transactions and comply with the requirements of New Hampshire RSA 7:19-a, as it may be amended from time to time, and any successor statute. No Trustee who also is an employee of the Association may participate in Board determinations regarding his or her compensation, and no Trustee who also is a physician employed by the Association may vote with respect to the establishment of compensation and/or benefits to be paid to the Association's employed physicians generally. To monitor and enforce this policy, all Trustees and Auxilians complete a Conflict-of-Interest Statement each year, and any potential conflicts are reported to the Board of Trustees and to other authoritative bodies as required by law. In addition, 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.
Form 990, Part VI, Section B, line 15The Board of Trustees will select, oversee and annually evaluate the Hospital's President/CEO, who will be a full-time salaried employee of the Hospital. Accordingly, compensation and benefits paid to the Hospital's President and CEO is subject to the review and approval of the Board of Trustees. The Board utilizes its Executive Committee and other resources, such as surveys, market research, and data from comparable organizations, to determine a compensation and benefits package that is reasonable and appropriate for the level of services and skills provided and employed by the President and CEO. Similarly, the Hospital's HR Director prepares compensation reports and packages using similar datapoints for other key employees and officers who are not the President and CEO. The President specifically reviews and approves the compensation and benefits of the CFO. Trustees will serve solely for the purpose of furthering the Hospital's charitable purposes and without compensation, except that reasonable expenses may be reimbursed as approved by the Board. However, Trustees may be employed by the Hospital, and in turn be compensated for their non-Trustee services as the Board may authorize.
Form 990, Part VI, Section C, line 19The Hospital's governing documents and financial statements are made available upon request to the extent required by applicable law.
Form 990, Part VI, Section A, Line 16b:Littleton Hospital Association may occasionally partner or collaborate with for-profit businesses or care practices to improve the Hospital's ability to provide services and care to its patients and the broader community. For example, certain private facilities, physician practices, or dental and eye care centers may also operate on the Hospital's campus or lease real estate from the Hospital where it has excess capacity. In the nature of transparency, the Hospital has deemed such arrangements as "joint ventures, and has therefore answered "Yes" on this Form 990, Part VI, Section A, Line 16a. The Hospital does not have a separate, formal joint venture policy. However, all joint venture arrangements and similar business agreements are subject to the review, approval, and oversight of the Hospital's top management and operational officials. The Hospital also reviews all joint venture agreements or similar contracts to ensure the arrangements are in compliance with applicable law, and the Hospital reviews any joint venture or similar activities closely and regularly. Accordingly, while there is no separate joint venture policy, any business arrangements that are similar in nature to a joint venture are thoroughly monitored and regularly reviewed to ensure that such activities are compliant with requisite laws and regulations, and that any such activities also contribute meaningfully to the Hospital's ability to fulfill its charitable purpose.
Form 990, Part XI, line 9:Change in value of interest rate swap 178,212.
Form 990, Part XII, Line 2c:The audit of the Hospital's financial statements was subject to the oversight of chief management employees, the Hospital's finance committee, and the Chief Financial Officer. The Hospital's Chief Financial Officer and other applicable staff and board members met with the auditors prior to the start, during, and at the end of the audit to review results and to coordinate timely and accurate testing of the Hospital's financial statements. These same review and oversight procedures are consistent with previous years.

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