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ALICE PECK DAY MEMORIAL HOSPITAL: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
ALICE PECK DAY MEMORIAL HOSPITAL (EIN 02-0222791)
Tax period
2024-07-01 to 2025-06-30
Filed
2026-06-01
IRS object ID
202621529349301262
Schema version
2024v5.1
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)
Return2026-06-01T14:26:16+00:00ReturnTs
Tax Period End2025-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14801 Olympia Park Plaza Suite 4000AddressLine1Txt
CityLouisvilleCityNm
State AbbreviationKYStateAbbreviationCd
ZIP402412098ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222791EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Alice Peck Day Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlALICBusinessNameControlTxt
Phone6034483121PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Alice Peck Day DriveAddressLine1Txt
CityLebanonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03766ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMichael T Lynch MD MBAPersonNm
Person TitlePresident & CEOPersonTitleTxt
Signature2026-06-01SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRachel SpurlockPreparerPersonNm
PTINP00520729PTIN
Phone5023263996PhoneNum
Preparation2026-06-01PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Michael T Lynch MD MBABusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Alice Peck Day DriveAddressLine1Txt
CityLebanonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03766ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$117,293,830GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.alicepeckday.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1943FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionTo improve the health and wellbeing of our community.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee774TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$85,446TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$71,940NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,927,093PYContributionsGrantsAmt
CY Contributions Grants$1,121,807CYContributionsGrantsAmt
PY Program Service Revenue$111,212,803PYProgramServiceRevenueAmt
CY Program Service Revenue$113,682,992CYProgramServiceRevenueAmt
PY Investment Income$1,217,048PYInvestmentIncomeAmt
CY Investment Income$1,152,974CYInvestmentIncomeAmt
PY Other Revenue$759,175PYOtherRevenueAmt
CY Other Revenue$1,336,057CYOtherRevenueAmt
PY Total Revenue$119,116,119PYTotalRevenueAmt
CY Total Revenue$117,293,830CYTotalRevenueAmt
PY Grants And Similar Paid$14,870PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$23,468CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$67,178,322PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$64,731,625CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$162,124CYTotalFundraisingExpenseAmt
PY Other Expenses$37,026,437PYOtherExpensesAmt
CY Other Expenses$38,965,560CYOtherExpensesAmt
PY Total Expenses$104,219,629PYTotalExpensesAmt
CY Total Expenses$103,720,653CYTotalExpensesAmt
PY Revenues Less Expenses$14,896,490PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$13,573,177CYRevenuesLessExpensesAmt
Total Assets BOY$146,289,517TotalAssetsBOYAmt
Total Assets EOY$156,709,167TotalAssetsEOYAmt
Total Liabilities BOY$62,353,909TotalLiabilitiesBOYAmt
Total Liabilities EOY$56,806,696TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$83,935,608NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$99,902,471NetAssetsOrFundBalancesEOYAmt
MissionTo improve the health and wellbeing of our community.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$89,848,174ExpenseAmt
Grant$23,468GrantAmt
Revenue$114,921,430RevenueAmt
DescAlice Peck Day Memorial Hospital (APD) is a community-based critical access hospital operating in Lebanon, NH. It is a not-for-profit organization as described in Section 501(c)(3) of the Internal Revenue Code (Code) and is exempt from federal income taxes on related income, pursuant to Section 501(a) of the Code. APD operates as an integral component of (and is fully owned by) Dartmouth-Hitchcock Health (D-HH), a New Hampshire not-for-profit corporation organized to support medical organizations like APD. (CONTINUED ON SCHEDULE O)Desc
Total Program Service Expenses$89,848,174TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document76IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee774EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Policies Reference ChaptersfalsePoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
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 Line1Tamera K SandersBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6034483121PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Alice Peck Day DriveAddressLine1Txt
CityLebanonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03766ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Charles J Wheelan PhD MPA
Trustee / Vice Chair0.50Yes (X)Yes (X)$0$0$0
Clayton R Adams MBA
Trustee / Treasurer2.00Yes (X)Yes (X)$0$0$0
Jennifer Sage Schiffman MPH
Secretary (through 12/31/24) / Trustee0.50Yes (X)Yes (X)$0$0$0
Laura Greer MD
Trustee/Medical Staff President/ExOfficio40.00Yes (X)Yes (X)$265,183$0$22,595
Marisa D Devlin
Trustee/Chair2.00Yes (X)Yes (X)$0$0$0
Michael T Lynch MD MBA
Chief Medical Officer40.00Yes (X)Yes (X)$379,553$0$66,068
Susan Mooney MD MS FACOG
TRUSTEE/PRESIDENT/CEO APDMH38.02.0Yes (X)Yes (X)$481,955$0$20,700
Anna Adachi-Mejia PhD
Trustee0.50Yes (X)$0$0$0
Chelsea Cassady
Trustee (through 1/1/25)0.50Yes (X)$0$0$0
Christopher L Hubble MD
Trustee0.540.0Yes (X)$0$466,573$65,298
Courtney Tanner
Trustee0.540.0Yes (X)$0$170,656$14,275
Cybele M Merrick MA MS
Trustee0.50.5Yes (X)$0$0$0
David F Duncan
Trustee0.540.5Yes (X)$0$367,601$47,168
Gerard Duprat JR MD FRCP
Trustee /Secretary (as of 1/1/25)0.50Yes (X)$0$0$0
Greg W Lange MS
Trustee (through 12/31/24)0.50Yes (X)$0$0$0
Harriett Sloane Mayor AIA
Trustee0.50.5Yes (X)$0$0$0
Jenny H Barba MBA MHSA
Trustee0.50Yes (X)$0$0$0
Laura Gillespie AB MS
Trustee/ex-officio0.51.0Yes (X)$0$0$0
Michelle Perkins
Trustee (as of 1/1/25)0.50Yes (X)$0$0$0
Patrick F Jordan III MBA
Trustee (through 6/21/25)0.543.0Yes (X)$0$1,132,708$79,260
Scott W Rodi MD MPH
Trustee0.540.0Yes (X)$0$618,436$78,029
Maryann R Caron
Executive Director MSC (as of 1/1/24)40.00Yes (X)$223,037$0$16,563
Tamera K Sanders
CFO (as of 6/23/25)40.00.5Yes (X)$0$0$0
Todd Roberts
VP Finance (through 4/28/25)38.02.0Yes (X)$242,180$0$15,534
Jean Ten Haken MSN RN CENP
CNO/COO40.00.5$274,745$0$17,422Yes (X)
Paula Seaman
Chief Nursing Officer (as of 7/1/24)40.00$162,817$0$56,772Yes (X)
Annika Brown
Medical Director - Primary Care40.00$310,260$0$33,871Yes (X)
Diane Riley MD CAQSH
Ortho Surgeon Hand Specialist40.00$470,293$0$55,077Yes (X)
Ivan Tomek MD
General Orthopedic Surgeon40.00$574,139$0$58,886Yes (X)
John S Houde MD
Physician40.00$466,896$0$57,192Yes (X)
Sari Galanes
Physician40.00$324,652$0$48,520Yes (X)
Brenda L Blair
Former VP & COO0.040.0$0$362,426$61,220Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,175,710TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,118,400TotReportableCompRltdOrgAmt
Total Other Compensation$814,450TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K109IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CONIFER REVENUE CYCLE SOLUTIONS LLC
14201 Dallas PkwyDALLASTX75254Healthcare Staffing$3,732,626
AMERICAN HEALTHCARE SERVICES ASSN
PO BOX 945TRAVERSE CITYMI49685HEALTHCARE STAFFING$2,860,584
UVNN
106 HANOVER STLEBANONNH03766SERVICES$2,190,329
ENGELBERTH CONSTRUCTION
150 WATER TOWER CIRCLECOLCHESTERVT05446CONSTRUCTION CONTRACTORS$2,098,193
MARY HITCHCOCK MEMORIAL HOSPITAL
ONE MEDICAL CENTER DRLEBANONNH03756HEALTHCARE STAFFING$1,240,550
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K18CntrctRcvdGreaterThan100KCnt
Government Grants$761,866GovernmentGrantsAmt
All Other Contributions$359,941AllOtherContributionsAmt
Noncash Contributions$35,700NoncashContributionsAmt
Total Contributions$1,121,807TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Services622110$103,743,366$103,743,366
Nutritional Services722210$201,783$201,783
PHARMACY SALES446100$3,166,268$3,166,268
MEDICAID DSH PAYMENT622110$6,571,575$6,571,575

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$113,682,992TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,152,974TotalRevenueColumnAmt
Unrelated Business Revenue$85,446UnrelatedBusinessRevenueAmt
Exclusion$1,067,528ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$97,619RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$97,619RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$97,619TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Exclusion$97,619ExclusionAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MISCELLANEOUS622110$904,841$904,841
PURCHASE REBATES AND DISCOUNTS622110$333,597$333,597

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,238,438OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$117,293,830TotalRevenueColumnAmt
Related Or Exempt Func Income$114,921,430RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$85,446UnrelatedBusinessRevenueAmt
Exclusion$1,165,147ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$23,468TotalAmt
Program Services$23,468ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,966,634TotalAmt
Program Services$453,808ProgramServicesAmt
Management And General$1,510,609ManagementAndGeneralAmt
Fundraising$2,217FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$51,499,241TotalAmt
Program Services$49,211,046ProgramServicesAmt
Management And General$2,156,989ManagementAndGeneralAmt
Fundraising$131,206FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,249,209TotalAmt
Program Services$2,149,273ProgramServicesAmt
Management And General$94,206ManagementAndGeneralAmt
Fundraising$5,730FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,173,423TotalAmt
Program Services$5,899,128ProgramServicesAmt
Management And General$258,567ManagementAndGeneralAmt
Fundraising$15,728FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,843,118TotalAmt
Program Services$2,716,794ProgramServicesAmt
Management And General$119,081ManagementAndGeneralAmt
Fundraising$7,243FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,642TotalAmt
Program Services$5,642ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$11,475TotalAmt
Program Services$11,475ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,849,760TotalAmt
Program Services$2,619,899ProgramServicesAmt
Management And General$5,229,861ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$20,033TotalAmt
Program Services$20,033ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$188,666TotalAmt
Program Services$129,907ProgramServicesAmt
Management And General$58,759ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$107,032TotalAmt
Program Services$24,279ProgramServicesAmt
Management And General$82,753ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,059,119TotalAmt
Program Services$443ProgramServicesAmt
Management And General$2,058,676ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$98,857TotalAmt
Program Services$81,312ProgramServicesAmt
Management And General$17,545ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$13,987TotalAmt
Program Services$12,768ProgramServicesAmt
Management And General$1,219ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$812,663TotalAmt
Program Services$320,037ProgramServicesAmt
Management And General$492,626ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,636,117TotalAmt
Program Services$3,131,166ProgramServicesAmt
Management And General$504,951ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,131,266TotalAmt
Program Services$1,038,806ProgramServicesAmt
Management And General$92,460ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Drugs/medical supplies$15,220,157$15,220,157
Medicaid Enhancement Tax$4,368,931$4,368,931
Repairs/maintenance$2,613,621$2,227,217$386,404
ACADEMIC, TEACHING, & MISC SUPPORT$368,333$116,105$252,228

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$459,901TotalAmt
Program Services$66,480ProgramServicesAmt
Management And General$393,421ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$103,720,653TotalAmt
Program Services$89,848,174ProgramServicesAmt
Management And General$13,710,355ManagementAndGeneralAmt
Fundraising$162,124FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$47,496,758BOYAmt
EOY$10,778,906EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,658,732BOYAmt
EOY$115,551EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,307,270BOYAmt
EOY$9,723,654EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$366,466BOYAmt
EOY$3,142,542EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$481,519BOYAmt
EOY$464,247EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$520,262BOYAmt
EOY$665,281EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$80,955,301LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$47,611,887LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$27,645,947BOYAmt
EOY$33,343,414EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$23,109,959BOYAmt
EOY$68,322,194EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$5,131,433BOYAmt
EOY$5,131,433EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$25,571,171BOYAmt
EOY$25,021,945EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$146,289,517BOYAmt
EOY$156,709,167EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,349,405BOYAmt
EOY$9,353,732EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,967,110BOYAmt
EOY$22,795,076EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$29,037,394BOYAmt
EOY$24,657,888EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$62,353,909BOYAmt
EOY$56,806,696EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$81,304,753BOYAmt
EOY$92,898,407EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,630,855BOYAmt
EOY$7,004,064EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$83,935,608BOYAmt
EOY$99,902,471EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$146,289,517BOYAmt
EOY$156,709,167EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$13,573,177ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,874,827NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$481,141OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

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)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$16,377OtherActivitiesAmt
Total Lobbying Expenditures$16,377TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYFormAndLineReferenceDesc
ExplanationAlice Peck Day Memorial Hospital pays dues to various organizations related to its exempt mission. The amount reported under other activities refers to the amount of lobbying activities identified in dues payments to outside organizations.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$523,781BeginningYearBalanceAmt
Investment Earnings Or Losses$659,194InvestmentEarningsOrLossesAmt
Other Expenditures$8,573OtherExpendituresAmt
End Year Balance$1,174,402EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$114,708BeginningYearBalanceAmt
Investment Earnings Or Losses$409,073InvestmentEarningsOrLossesAmt
End Year Balance$523,781EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$110,368BeginningYearBalanceAmt
Investment Earnings Or Losses$4,340InvestmentEarningsOrLossesAmt
End Year Balance$114,708EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$133,591BeginningYearBalanceAmt
Other Expenditures$23,223OtherExpendituresAmt
End Year Balance$110,368EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$97,000BeginningYearBalanceAmt
Investment Earnings Or Losses$36,591InvestmentEarningsOrLossesAmt
End Year Balance$133,591EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.0BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.0PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.0TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,600,000OtherCostOrOtherBasisAmt
Book Value$4,600,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$35,819,673OtherCostOrOtherBasisAmt
Depreciation$15,783,734DepreciationAmt
Book Value$20,035,939BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$245,273OtherCostOrOtherBasisAmt
Depreciation$245,273DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,159,704OtherCostOrOtherBasisAmt
Depreciation$30,129,383DepreciationAmt
Book Value$8,030,321BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,130,651OtherCostOrOtherBasisAmt
Depreciation$1,453,497DepreciationAmt
Book Value$677,154BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$33,343,414TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Closely-held equity interests
Financial derivatives
INVESTMENT IN POOLED FUNDS$68,322,194F
FieldValueIRS element (for citing)
Total Book Value Securities$68,322,194TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$612,162
RIGHT OF USE ASSETS$13,176,455
BOND ISSUANCE COSTS
OTHER ASSETS
INVESTMENTS - PROGRAM RELATED$3,217,491
INVESTMENT IN AFFILIATES$8,015,837
FieldValueIRS element (for citing)
Total Book Value Other Assets$25,021,945TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Federal Income Taxes
Medical liabilities and payables$10,564,109
Due to affiliates$108,184
RIGHT OF USE LIABILITIES$13,985,595
FieldValueIRS element (for citing)
Total Liability$24,657,888TotalLiabilityAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$0RevenueSubtotalAmt
Other Revenues Not Included$0OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$0TotalRevenuePerForm990Amt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$0ExpensesSubtotalAmt
Other Expenses Not Included$0OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$0TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part V, Line 4 Intended uses of endowment fundsFormAndLineReferenceDesc
ExplanationThe Organization uses the income from its endowment funds in support of its operations.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other225FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$453,589TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$453,589NetCommunityBenefitExpnsAmt
Total Expense0.00437TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,786,478TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,940,451DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,846,027NetCommunityBenefitExpnsAmt
Total Expense0.02744TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$14,240,067TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,940,451DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,299,616NetCommunityBenefitExpnsAmt
Total Expense0.03181TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$336,533TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,817DirectOffsettingRevenueAmt
Net Community Benefit Expns$305,716NetCommunityBenefitExpnsAmt
Total Expense0.00295TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$33,939TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$33,939NetCommunityBenefitExpnsAmt
Total Expense0.00033TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$370,472TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,817DirectOffsettingRevenueAmt
Net Community Benefit Expns$339,655NetCommunityBenefitExpnsAmt
Total Expense0.00327TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$14,610,539TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,971,268DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,639,271NetCommunityBenefitExpnsAmt
Total Expense0.03509TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$36,354TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$36,354NetCommunityBenefitExpnsAmt
Total Expense0.00035TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$36,354TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$36,354NetCommunityBenefitExpnsAmt
Total Expense0.00035TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$0BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$26,056,163ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$27,613,293CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,557,130MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Alice Peck Day Memorial HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Alice Peck Day DriveAddressLine1Txt
CityLebanonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03766ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.alicepeckday.orgWebsiteAddressTxt
State License00016StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPhysician ClinicsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Alice Peck Day Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)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 Conducted25CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.alicepeckday.org/community-reportsOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt25ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.alicepeckday.org/community-reportsStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care225.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.0FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.alicepeckday.org/patients/billing-financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.alicepeckday.org/patients/billing-financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.alicepeckday.org/patients/billing-financial-assistanceFAPSummaryOnWebsiteURLTxt
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 TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
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 (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - Alice Peck Day Memorial Hospital. During the period October 2023 through December 2024, an assessment of Community Health Needs was completed by Dartmouth Hitchcock Medical Center, Alice Peck Day Memorial Hospital, and Visiting Nurse and Hospice for Vermont and New Hampshire in partnership with Mt. Ascutney Hospital and Health Center, New London Hospital, Cheshire Medical Center, and Valley Regional Hospital with technical support from the New Hampshire Community Health Institute/JSI. The aims of the assessment are to: Better understand the health-related issues and concerns impacting the well-being of area residents; Inform community health improvement plans, partnerships and initiatives; and Guide community benefit activities of Dartmouth Hitchcock Medical Center and Alice Peck Day Memorial Hospital and partner organizations. For the purpose of the assessment, the geographic area of interest was 19 municipalities of the Upper Valley region of New Hampshire and Vermont comprising the primary service area of Dartmouth Hitchcock Medical Center and Alice Peck Day Memorial Hospital. The total resident population of the primary service area is estimated to be 72,736 people. Methods employed in the assessment included: surveys of community residents made available through social media, email distribution, website links and through paper surveys and collection boxes widely distributed in multiple locations and channels across the region; a direct email survey of community leaders and service providers representing multiple community sectors; a set of eleven community discussion groups convened across the region; and assembly of available population demographics and health status indicators including drivers of health characteristics of the hospital service area communities. Community engagement and information gathering sought to focus assessment activities on vulnerable and disproportionately served populations in the region including populations that could experience limited access to health-related services or resources due to income, age, disability, or social or physical isolation. The quantitative and qualitative information gathered through the different sources and methods was then synthesized to understand different perspectives, identify common themes and inform priorities for improvement. Between February and September 2024, the Community Health Needs Assessment committee fielded two surveys; one with targeted distribution to community leaders and service providers, and one broadly disseminated to residents across the region. The survey instruments were designed to have some questions in common to facilitate comparisons and contrasts in the analysis. The community leader survey was distributed via a unique email link to 350 individuals in positions of leadership in agencies, municipalities, business, civic and volunteer organizations serving the combined service areas of the partner organizations ranging from the Greater Windsor and Claremont area, to the New London and Newport area, and to the Upper Valley communities of New Hampshire and Vermont around Lebanon and White River Junction. The survey distribution list was developed by the planning committee. With the understanding that some organizational leaders may be more familiar with some areas of the wider region than others, the survey instrument asked respondents to identify "the areas you primarily serve or are most familiar with". Nearly all community leader survey respondents indicated the ability to afford housing has gotten worse and a majority of community leader respondents also indicated that affordability of child care and health care services have gotten worse. The community resident survey was distributed electronically through email and social media communication channels, on the Dartmouth Hitchcock Medical Center and Alice Peck Day Memorial Hospital websites, promoted through posters and fliers with links and QR codes posted around the region, and by paper copies made available at a variety of distribution points throughout the region including libraries, clinics, and community meeting spaces. The survey was available in both English and Spanish language. A total of 1,739 community members completed the Community Resident Survey, representing all 19 towns of the primary hospital service area as well as a number of bordering communities. Assessments of community health needs are conducted every three years by Dartmouth Health and partner organizations. Over the course of these assessment cycles, a relatively consistent pattern has been observed with regard to the priority issues and concerns identified for health improvement by the community. Among these priorities have been: cost of health care services including health insurance and prescription drugs; access to behavioral health services including mental health care and substance use treatment; availability of health care services including primary care and medical sub-specialties; senior services and concerns of aging; availability and affordability of dental services; and affordability and availability of basic needs including housing, healthy food and child care. In consideration of this observed consistency over time, the 2025 Community Health Needs Assessment asked respondents to the Community Resident and Community Leader surveys to reflect on a set of statements describing the main priorities and themes identified in the recent past by indicating if there has been improvement or not in those areas. In general, more community residents reported needs getting worse compared to those reporting needs getting better over the last few years in each of the topic areas. A majority of survey respondents indicated that affordability of health care, child care, and housing have gotten worse. Nearly all community leader survey respondents indicated the ability to afford housing has gotten worse and a majority of community leader respondents also indicated that affordability of child care and health care services have gotten worse. Community leaders were somewhat more likely to report that the ability to get substance use treatment has improved, and also ability for older adults to age in place, while community residents were somewhat more likely to indicate that access to sub-specialty medical services has improved.
Schedule H, Part V, Section B, Line 6a Facility , 1Facility , 1 - Alice Peck Day Memorial Hospital. An assessment of Community Health Needs was completed by Dartmouth Hitchcock Medical Center, Alice Peck Day Memorial Hospital, and Dartmouth Health Home Care in partnership with Mt. Ascutney Hospital and Health Center, New London Hospital, Cheshire Medical Center, and Valley Regional Hospital.
Schedule H, Part V, Section B, Line 6b Facility , 1Facility , 1 - Alice Peck Day Memorial Hospital. Technical assistance for the Hospital's 2025 CHNA was provided by the New Hampshire Community Health Institute/JSI.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - ALICE PECK DAY MEMORIAL HOSPITAL. Alice Peck Day Memorial Hospital's (APDMH) Fiscal Year 2025 Community Health Improvement Plan (CHIP), approved by the Board of Trustees June 2025, is a three-year document that provides a detailed set of strategies for addressing our region's top health and social needs. The 2025 Community Health Needs Assessment (CHNA) addressed the following seven identified priority health needs and issues: 1. Availability of primary care and medical subspecialty services 2. Availability and affordability of dental care services for adults 3. Availability of mental health services 4. Services for older adults including opportunities for social interaction and supports for aging in place 5. Cost of health care services including medications, affordability of health insurance 6. Health and human service workforce shortages and challenges navigating the health care system 7. Social drivers of health and well-being such as affordable access to transportation, housing, healthy foods and affordable child care In alignment with the Community Health Improvement Plan (CHIP), we are addressing access to primary and specialty care through expanded community-based services and coordinated care models. In FY26, an urgent care center was established to increase access to low-cost, non-emergency care and reduce emergency and primary care utilization. We will strengthen collaboration with community nurse programs and continue Mobile Integrated Health services to expand care outside the hospital. Community screenings, health fairs, and prevention programming will support early risk identification, improve health literacy, and connect individuals to care. We are advancing value-based and collaborative care models to improve specialty access, chronic disease management, and outcomes. We are expanding oral health access through the Upper Valley Smiles school-based program and regional partnerships, including mobile Medicaid dental services. Preventive care such as fluoride varnish and silver diamine fluoride will be integrated into clinical settings. We will also expand virtual Medicaid dental intake, including MAT patients, to improve access, reduce stigma, and support recovery. These efforts improve prevention, early intervention, and affordability of dental care. To address behavioral health needs, we are expanding integrated screening and treatment for mental health and substance use in primary care, with timely referral and on-site support. Workforce behavioral health supports will continue, with evaluation of trauma-informed programs for high-risk groups. Collaboration with schools and community partners will expand to pediatric and vulnerable population access. We are also increasing access to medication-assisted treatment, naloxone distribution, and prevention programs to support early intervention and improved coordination of care. For older adults, we are strengthening coordination with community partners to support aging in place. Services include home-based primary care, emergency department follow-up, and caregiver support. Volunteer and engagement programs such as Elder Friends will reduce isolation and increase social connection. We will also support aging-focused education and collaboration to improve care models and outcomes. Every patient at APDMH is screened annually for Social Determinants of Health, including substance use (prevention, treatment, and recovery), access to dental care, and socioeconomic factors such as housing, wages, and childcare. Patients with identified needs are referred to social work services. We screen all Primary Care patients ages 0- 18 years of age for food insecurity during annual wellness visit, and all Emergency Room patients 70 years and older. For patients who screen positive for food insecurity and request support offer non-perishable food bags, APD Alice Cafe Meal Cards, Farmers Market vouchers and automated eDH (APD electronic medical record) referral to Women, Infant and Children (WIC) in certain patient populations. Review and continuously improve APD's in-patient and outpatient-Alice Cafe -menu with affordable and healthier food choices. APD will Continue to make Alice Cafe available to community residents. APDMH partners with the Hartford Community Coalition to provide a free summer lunch program for children in low-income housing in Lebanon, NH and Hartford, VT, work with LISTEN Community Services, provide Pop Up Health Clinics (Hosted by DHMC/Community Nurses) and City of Lebanon Seasonal Winter Shelter; Collaborate Upper Valley Haven and Willing Hands in close collaboration with DH system.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - Alice Peck Day Memorial Hospital. APDMH HAS A SEPARATE UNINSURED DISCOUNT POLICY THAT OUTLINES HOW THE DISCOUNT IS CALCULATED ANNUALLY AND IS APPLIED PRIOR TO BILLING ANY UNINSURED PATIENT. THIS ASSURES A PATIENT IS NOT BILLED AT AN AMOUNT GREATER THAN THE AMOUNT GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS POLICY IS REFERENCED IN THE FINANCIAL ASSISTANCE POLICY.
Schedule H, Part V, Section B, Line 16 Facility , 1Facility , 1 - ALICE PECK DAY MEMORIAL HOSPITAL. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON APDH'S WEBSITE, INCLUDING THE VERBATIM POLICY AND A SHORTER, MORE PATIENT-FRIENDLY PLAIN-LANGUAGE SUMMARY. APDMH PROVIDES THE PLAIN LANGUAGE SUMMARY BROCHURE TO ALL INPATIENTS, EMERGENCY DEPARTMENT INTAKES, UNINSURED, AND SELF-PAY INDIVIDUALS. APDMH CONTINUES TO NOTIFY PATIENTS ON THE BACK OF THE BILLING STATEMENT ABOUT FINANCIAL ASSISTANCE AVAILABLE TO THEM. ADDITIONALLY, APDMH POSTS INFORMATION ABOUT THE POLICY IN PUBLIC AREAS THROUGHOUT THE FACILITIES INCLUDING ADMISSION OFFICES, PUBLIC AREA BOARDS THROUGHOUT THE FACILITIES, THE EMERGENCY ROOMS, AND FINANCIAL ASSISTANCE POLICY BROCHURES IN PATIENT AREAS. APDMH SCREENS 100% OF UNINSURED INPATIENT AND SAME-DAY PATIENTS PRIOR TO ADMISSION. AS PART OF THIS PROCESS, APDMH CHECKS ALL STATE AND FEDERAL PROGRAMS TO SEE IF INDIVIDUALS ARE ELIGIBLE FOR ASSISTANCE. PATIENTS ARE ALSO SCREENED TO DETERMINE QUALIFICATION FOR FINANCIAL ASSISTANCE AND THE APPLICATION IS PROVIDED AND/OR COMPLETED AT THIS TIME.
FieldValueIRS element (for citing)
Facility7FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
Neurosurgery Services at APD (NSAPD)
106 Hanover StreetLebanonNH03766Neurosurgery Physician Clinic
RAM Center for Community Care
5 Alice Peck Day DriveLebanonNH03766Primary Care Physician Clinic
APD Orthopaedic Clinic
9 Alice Peck Day DriveLebanonNH03766Orthopaedic Physician Clinic
Women's Care Center
9 Alice Peck Day DriveLebanonNH03766OB/GYN Physician Clinic
General Surgery Clinic
9 Alice Peck Day DriveLebanonNH03766General Surgery Clinic
Pain Management Clinic
9 Alice Peck Day DriveLebanonNH03766Pain Management Clinic
Occupational Health Services
9 Alice Peck Day DriveLebanonNH03766Occupational Health Physician Clinic

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3c OTHER FACTORS USED IN DETERMINING ELIGIBILITY OTHER THAN FPGAPDMH USES THE FPG GUIDELINES IN DETERMINING THE INITIAL LEVEL OF FINANCIAL ASSISTANCE PROVIDED. IN ADDITION, APDMH ALLOWS FOR CATASTROPHIC ASSISTANCE CONSIDERATION BASED ON A CALCULATION OF 10% OF TWO YEARS INCOME PLUS 10% OF AMOUNT OVER SHELTERED ASSETS. IF THE PROJECTED OR CURRENT SELF-PAY BALANCE IS GREATER THAN THIS CALCULATION, THE SELF-PAY BALANCE IS REDUCED TO THE SUM OF 10% OF TWO YEARS INCOME PLUS 10% OF ASSETS. EACH HOUSEHOLD IS ALLOWED CERTAIN SHELTERED ASSETS WHICH ARE NOT USED WHEN CALCULATING HOUSEHOLD INCOME OR ASSETS SAVINGS IS SHELTERED UP TO 100% OF FPL BASED ON FAMILY SIZE, EQUITY IN PRIMARY RESIDENCE UP TO $200,000 UP TO 55 AND $250,000 FOR AGED 55 AND OLDER, AND A RETIREMENT SHELTER OF UP TO $100,000 IN RETIREMENT ASSETS AS LONG AS IT IS EMPLOYER BASED CONTRIBUTIONS IF WORKING OR IRA IF SELF-EMPLOYED. IF A PATIENT IS RETIRED, PRIOR RETIREMENT ACCOUNTS WOULD BE INCLUDED AS A SHELTERED ASSET.
Schedule H, Part I, Line 7g Subsidized Health ServicesTHERE WERE NO AMOUNTS REPORTED ON 7g
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceTHE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED WAS A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE TO COST-TO-CHARGES FOR LINES 7A AND 7B. LINES 7E, 7F, AND 7I ARE BASED ON ACTUAL COSTS.
Schedule H, Part II Community Building ActivitiesALICE PECK DAY MEMORIAL HOSPITAL ACTIVELY SUPPORTS RURAL HEALTH, ECONOMIC DEVELOPMENT, TRANSPORTATION, AND OUTDOOR RECREATION. STAFF MEMBERS PROVIDE LEADERSHIP PARTICIPATION IN THE UPPER VALLEY BUSINESS ALLIANCE, THE FOUNDATION FOR HEALTHY COMMUNITIES, THE RURAL HEALTH COALITION, THE ADVOCACY TASK FORCE, AND THE NEAH. APDMH SPONSORS ADVANCE TRANSIT, A NOT-FOR-PROFIT CHARITABLE ORGANIZATION PROVIDING FREE TRANSIT IN VERMONT AND NEW HAMPSHIRE WITH THE GOAL OF REDUCING TRAFFIC CONGESTION. APD ALSO WORKS TO BE PROACTIVE CONCERNING DISASTER READINESS. STAFF HAVE PARTICIPATED IN ONSITE TRAINING FOR DISASTER PREPAREDNESS AS WELL AS OFF-SITE TRAINING WITH OTHER REGIONAL HOSPITALS. COLLABORATIVE EFFORTS INCLUDE ALL HAZARD REGIONAL TRAINING, EMERGENCY RESPONSE TRAINING, AND A REGIONAL MASS CASUALTY RESPONSE PROGRAM TO HELP FACILITATE COOPERATIVE EFFORTS IF SUCH NEEDS ARISE.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountAS A RESULT OF ACCOUNTING GUIDANCE (STATEMENT 15 AND ASC 606), BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyBad Debt is not treated as an expense due to accounting guidance (Statement 15 and ASC 606). As a result, an amount attributable to patients eligible under the organization's financial assistance policy is unable to be reasonably estimated.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteAPDMH IS INCLUDED IN THE DARTMOUTH-HITCHCOCK HEALTH AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS. AS A RESULT OF the adoption of ASC 606, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDE AS A REDUCTION IN NET PATIENT REVENUE. THEREFORE, THERE IS NO SEPARATE FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsTHE COSTING METHODOLOGY WAS COMPLETED ACCORDING TO GUIDANCE PROVIDED BY THE INTERNAL REVENUE SERVICE.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceThe bad debts collection policy applies to all patient accounts in a consistent manner. The policy specifically indicates that, after a second statement is sent with no payment received, a patient accounts representative will contact the patient by phone to determine if a financial assistance application or payment plan is appropriate. This is completed to avoid further escalation of past due account(s) if the patient may qualify for full or partial relief under the charity care policy. If the application is successful, then the qualifying balance or balances are classified as charity care and no longer pursued for collections. Once a patient balance is classified as charity care, it is not subject to collection activities. Alice Peck Day is committed to helping our patients obtain quality healthcare, regardless of ability to pay. Our financial assistance programs encourage and enable our patients to make healthcare decisions free of financial barriers. We educate our patients about our programs and provide assistance prior to their receiving services, at registration for services, and during our billing process to ensure that any and all patients in need of assistance are provided with the help they qualify for under APDMH programs. Brochures and signs are placed in high traffic areas such as the ER and registration. Our staff is trained to identify patients during registration, provide information, and offer assistance in completing the necessary forms. During our billing process, calls are made to patients with outstanding balances. APDMH staff work with patients to identify problems they are facing in dealing with outstanding balances. Patients are notified again of the many types of financial assistance available for which they may qualify. Programs are explained and assistance is offered, if needed, in completing the applications. Due to this multi-level approach and staff that is trained to identify clients who may need financial assistance, very few qualifying patients reach the point of bad debt. Our collection policies and procedures, in conjunction with our small size, allow our organization to place great emphasis on helping all patients who may be in need to apply for, and obtain, the appropriate level of financial assistance.
Schedule H, Part V, Section B, Line 16a FAP website- Alice Peck Day Memorial Hospital: Line 16a URL: https://www.alicepeckday.org/patients/billing-financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website- Alice Peck Day Memorial Hospital: Line 16b URL: https://www.alicepeckday.org/patients/billing-financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- Alice Peck Day Memorial Hospital: Line 16c URL: https://www.alicepeckday.org/patients/billing-financial-assistance;
Schedule H, Part VI, Line 2 Needs assessmentEvery three years, APDMH conducts a Community Health Needs Assessment (CHNA). We partner with Dartmouth-Hitchcock Health member organizations and other healthcare institutions to identify top community health needs in our region. The assessment includes a community survey, discussion groups, conversations with key stakeholders, analysis of population demographics, and health status indicators. All information-collection activities and analyses sought to focus assessment activities on vulnerable and disproportionately-served populations in the region including populations that could experience limited access to healthrelated services or resources due to income, age, disability, and social or physical isolation. Enhanced efforts were made to understand the needs of these populations through targeted surveys and community conversations including facilitated surveys and discussions at community suppers, a regional free clinic, homeless programs, and other community settings serving economically-vulnerable residents. The CHNA allows APDMH to strategically allocate resources to best meet community needs and improve community health.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceAlice Peck Day believes that quality health care should be available to all, regardless of ability to pay. Our financial assistance programs and staff are dedicated to helping people obtain the care they need. We reach out to our patients in many different ways to ensure that they are aware that help is available and to help guide them through the process. Brochures and signage are posted in high traffic areas such as the emergency room, registration, and the lobby. Registration staff are trained to identify patients who may be in need of financial assistance. Once identified, staff notify the patient that APDMH has various forms of financial assistance and explain that assistance is available for anyone who might require help or guidance in completing any necessary paperwork. In addition to the above, our billing staff are trained to help identify and offer assistance to anyone who might require financial assistance. Patients with outstanding claims are contacted by our credit coordinator who works with them to clear up balances through the variety of programs we offer. Assistance is also provided in applying for federal/state programs to those who qualify. Specially trained staff guide applicants through the process to ensure forms are filled out correctly, all required documentation is attached, and the applicants understand what they can expect to happen along the way.
Schedule H, Part VI, Line 4 Community informationAlice Peck Day Memorial Hospital is part of the Lebanon Health Care service area. The Lebanon service area comprises cities and towns in New Hampshire and Vermont. APDMH's service area in NH comprises 15 towns in addition to the city of Lebanon, including Canaan, Cornish, Croydon, Dorchester, Enfield, Grafton, Grantham, Hanover, Lyme, Newport, Orange, Orford, Piermont, Plainfield, and Warren. Vermont towns include East Thetford, Fairlee, Hartford, Hartland, North Hartland, North Thetford, Norwich, Post Mills, Quechee, Sharon, South Strafford, Strafford, Thetford, Thetford Center, Vershire, West Vershire, West Fairlee, West Hartford, White River Junction and Woodstock. Demographics: Age: According to the 2020 United States Census Bureau, the population of the APDMH Service Area is 69,612. It is slightly older on average than the New Hampshire and Vermont populations. 20% of the service area is over the age of 65, compared the statewide percentages of 17.5% in New Hampshire and 18.8% in Vermont. Income and poverty: 7.3% of households in the hospital service area have incomes under the 100% poverty level. There is a significant range of median household income between communities ranging from $52,128 to $137,344. Education: A higher proportion of the hospital service area (94.7%) have earned at least a high school diploma or equivalent compared to New Hampshire (93.1%) and Vermont (92.7%) overall. Language: The percent of the hospital service area, ages 5 or higher, who report speaking English "less than very well" is 0.9%, compared with a statewide rate of 1.4% in New Hampshire and 0.8% in Vermont. Health Insurance coverage: 4.9% of the total service area population does not have health insurance. The statewide percentage for New Hampshire is 5.9% and for Vermont it is 4.0%.
Schedule H, Part VI, Line 5 Promotion of community healthAPDMH PROVIDES FINANCIAL SUPPORT, ADMINISTRATIVE COORDINATION, AND VOLUNTEER RECRUITMENT SERVICES TO THE LEBANON COMPONENT OF THE TAKE A BITE OUT OF HUNGER PROGRAM, WHICH PROVIDES FREE MEALS DURING THE SUMMER MONTHS TO CHILDREN LIVING IN SUBSIDIZED HOUSING LOCATIONS. APDMH'S COMMUNITY HEALTH DEPARTMENT'S STAFF ARE WELL KNOWN IN THE REGION FOR UPPER VALLEY SMILES, A UNIQUE SCHOOL-BASED ORAL HEALTH PROGRAM FOR LOW-INCOME ELEMENTARY SCHOOL CHILDREN ENROLLED IN TEN SCHOOLS ACROSS THE UPPER VALLEY. THE APDMH DENTAL TEAM VISITS EACH SCHOOL ANNUALLY, PROVIDING CLASSROOM ORAL HEALTH EDUCATION, DENTAL SCREENINGS, FLUORIDE VARNISH, SEALANTS, DECAY-STOPPING FLUORIDE TREATMENTS, AND INTERIM THERAPEUTIC RESTORATIONS, ALL AT NO COST TO PARENTS. THESE COMMUNITY HEALTH PROGRAMS ARE SUPPLEMENTED BY THE IN-KIND CONTRIBUTION OF MEDICAL STAFF TIME, PRIVILEGES, AND EXPERTISE, TO SUPPORT THESE STRATEGIES AND OPPORTUNITIES, WORKING TOGETHER TO IMPROVE THE LIVES OF THOSE IN THE AREA. APDMH partnered with the Carter Community Building Association (CCBA) in Lebanon, New Hampshire, and the Upper Valley Aquatic Center (UVAC) in White River Junction, Vermont, to offer this program. APDMH pays for the gym memberships and other associated costs. There is no cost to our patients. APDMH also provides financial support, administrative coordination, and volunteer recruitment services to the Lebanon component of the Take a Bite Out of Hunger program, which provides free meals during the summer months to children living in subsidized housing locations. APDMH's Community Health Department's staff are well known in the region for Upper Valley Smiles, a unique school-based oral health program for low-income elementary school children enrolled in ten schools across the Upper Valley. The APDMH dental team visits each school annually, providing classroom oral health education, dental screenings, fluoride varnish, sealants, decay-stopping fluoride treatments, and interim therapeutic restorations, all at no cost to parents. These community health programs are supplemented by the in-kind Contribution of medical staff time, privileges, and expertise, to support these strategies and opportunities, working together to improve the lives of those in the area. More than half of the APDMH Board of Trustees are independent of APD and the Dartmouth-Health system and reside within the community service area, supporting the health of the local communities. APDMH EXTENDS PROFESSIONAL STAFF PRIVILEGES TO QUALIFIED AND APPROPRIATE PHYSICIANS WHO ARE EMPLOYEES OF DARTMOUTH HITCHCOCK CLINIC, MARY HITCHCOCK MEMORIAL HOSPITAL, AND DARTMOUTH COLLEGE, WHO ALSO HOLD A FACULTY APPOINTMENT AT GEISEL SCHOOL OF MEDICINE.
Schedule H, Part VI, Line 6 Affiliated health care systemAlice Peck Day Memorial Hospital is a critical access hospital located in Lebanon, NH. APDMH IS a member of the Dartmouth-Hitchcock Health System (D-HH) WHICH INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL, DARTMOUTH-HITCHCOCK CLINIC, AND OTHER RELATED ORGANIZATIONS WHOSE PRIMARY MISSION IS HEALTH CARE. MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) IN LEBANON IS NEW HAMPSHIRE'S LARGEST HOSPITAL. IN FISCAL YEAR 2025 MHMH HAD 461 LICENSED INPATIENT BEDS. THE DARTMOUTH-HITCHCOCK CLINIC (DHC) IS A MULTI-SPECIALTY PHYSICIAN PRACTICE WITH A NETWORK OF PROVIDERS ACROSS NEW HAMPSHIRE AND VERMONT. WHILE DHC'S MAIN OFFICES ARE LOCATED IN LEBANON, THE CLINIC ALSO HAS MULTI-SPECIALTY PRACTICES IN MANCHESTER, NASHUA, CONCORD, AND KEENE, NH AREAS AS WELL AS BENNINGTON, VT. IN ADDITION, THE CLINIC PROVIDES PRIMARY CARE IN RURAL COMMUNITIES IN VERMONT AND NORTHERN NEW HAMPSHIRE. THE HOSPITAL AND CLINIC OPERATE JOINTLY THROUGH INTERLOCKING DIRECTORATES, STRATEGIC PLANNING AND MANAGEMENT AND SHARE IDENTICAL MISSIONS. THE MEDICAL SCHOOL, WHICH WORKS CLOSELY WITH THE HOSPITAL AND CLINIC, IS FOCUSED ON MEDICAL EDUCATION AND RESEARCH
Schedule H, Part VI, Line 7 State filing of community benefit reportNH

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Hartford Community Coalition
PO BOX 4343WHITE RIVER JUNCTIONVT05001824272638501C3$7,000Summer meals program
LISTEN INC
60 Hanover StreetLebanonNH03766237225952501c3$5,000COMMUNITY DINNER DONATION
NORTHERN STAGE
76 GATES STREETWHITE RIVER JUNCTIONVT05001043387268501c3$10,000SHOW SPONSORSHIP
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant fundsFormAndLineReferenceDesc
ExplanationAPD provides support for selected community organizations that address needs identified in the Community Health Needs Assessment and are part of APD's Community Health Improvement plan. The annual amount to be contributed by APD to organizations is approved annually through the annual budget process. APD receives and reviews each year the organization's published annual reports and also maintains informal contacts throughout the year to monitor the organization's operations and services.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 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
Brenda L Blair
Former VP & COO$0$319,908$0$34,510$0$8,008$0$32,970$0$28,250$0$423,646$0$0
Susan Mooney MD MS FACOG
TRUSTEE/PRESIDENT/CEO APDMH$352,674$0$102,261$0$27,020$0$20,700$0$0$0$502,655$0$0$0
Michael T Lynch MD MBA
Chief Medical Officer$309,423$0$42,000$0$28,130$0$20,700$0$45,368$0$445,621$0$0$0
Laura Greer MD
Trustee/Medical Staff President/ExOfficio$153,742$0$111,262$0$179$0$16,145$0$6,450$0$287,778$0$0$0
Patrick F Jordan III MBA
Trustee (through 6/21/25)$0$875,781$0$180,000$0$76,927$0$32,970$0$46,290$0$1,211,968$0$0
Scott W Rodi MD MPH
Trustee$0$570,921$0$0$0$47,515$0$32,970$0$45,059$0$696,465$0$0
David F Duncan
Trustee$0$327,795$0$33,460$0$6,346$0$20,700$0$26,468$0$414,769$0$0
Courtney Tanner
Trustee$0$158,161$0$0$0$12,495$0$10,415$0$3,860$0$184,931$0$0
Christopher L Hubble MD
Trustee$0$390,920$0$49,440$0$26,213$0$20,700$0$44,598$0$531,871$0$0
Todd Roberts
VP Finance (through 4/28/25)$208,902$0$25,200$0$8,078$0$14,531$0$1,003$0$257,714$0$0$0
Maryann R Caron
Executive Director MSC (as of 1/1/24)$186,135$0$22,500$0$14,402$0$13,375$0$3,188$0$239,600$0$0$0
Jean Ten Haken MSN RN CENP
CNO/COO$244,257$0$29,300$0$1,188$0$16,229$0$1,193$0$292,167$0$0$0
Paula Seaman
Chief Nursing Officer (as of 7/1/24)$162,669$0$0$0$148$0$10,754$0$46,018$0$219,589$0$0$0
Ivan Tomek MD
General Orthopedic Surgeon$538,311$0$17,500$0$18,328$0$13,800$0$45,086$0$633,025$0$0$0
John S Houde MD
Physician$465,708$0$0$0$1,188$0$20,700$0$36,492$0$524,088$0$0$0
Diane Riley MD CAQSH
Ortho Surgeon Hand Specialist$468,539$0$0$0$1,754$0$20,700$0$34,377$0$525,370$0$0$0
Sari Galanes
Physician$194,453$0$124,072$0$6,127$0$20,119$0$28,401$0$373,172$0$0$0
Annika Brown
Medical Director - Primary Care$282,844$0$24,070$0$3,346$0$18,656$0$15,215$0$344,131$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part I, Line 4b Supplemental nonqualified retirement planFormAndLineReferenceDesc
ExplanationTHE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN (WHICH ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B (III)): David Duncan $431 Patrick Jordan $73,201 Christopher Hubble $3,600 Scott Rodi $23,741 Brenda Blair $2,617ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1The NH Health and Education Facilities AuthorityBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN020279866BondIssuerEIN
CUSIP64461XMG7CUSIPNum
Bond Issued2025-05-28BondIssuedDt
Issue Price$21,631,889IssuePriceAmt
PurposeRefund the DHOG 2018C Issue Dated 8/15/2018PurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$21,631,889TotalProceedsAmt
Issuance Costs From Proceeds$154,536IssuanceCostsFromProceedsAmt
Other Spent Proceeds$21,477,353OtherSpentProceedsAmt
Substantial Completion2025SubstantialCompletionYr
Refunding Tax Exempt BondsYes (true)RefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsYes (true)AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (true)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (true)EngageBondCounselContractsInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Engage Bond Counsel ResearchfalseEngageBondCounselResearchInd
Private Bus Use By Others0.0PrivateBusUseByOthersPct
Private Bus Concerning UBI0.0PrivateBusConcerningUBIPct
Total Private Business Use0.0TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropPct
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetYes (true)RebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd
Term Of Hedge0TermOfHedgePct
Superintegrated HedgefalseSuperintegratedHedgeInd
Hedge TerminatedfalseHedgeTerminatedInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd
Term Of GIC0TermOfGICPct
Regulatory Safe Harbor StsfdfalseRegulatorySafeHarborStsfdInd
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule K, Part I BOND AThe proceeds of this bond issue benefited the following subsidiaries of Dartmouth-Hitchcock Obligated group - Dartmouth-Hitchcock Health (EIN: 26-4812335), Alice Peck Day Memorial Hospital (EIN: 02-0222791), Mary Hitchcock Memorial Hospital (EIN: 02-0222140), Cheshire Medical Center (EIN: 02-0354549), Valley Regional Hospital, Inc. (EIN: 02-0222118), and Dartmouth-Hitchcock Clinic (EIN: 22-2519596). The portion of the issue that has been loaned to each subsidiary is being reported on that subsidiary member's schedule K.
Schedule K, Part II, Line 11 BOND APart II Bond A Line 11: The Other Spent Proceeds are the refunding proceeds of the issue no longer in escrow.

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Contribution1ContributionCnt
Noncash Contributions Rpt F990$35,700NoncashContributionsRptF990Amt
Method Of Determining RevenuesMarket valueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule M, Part I Explanations of reporting method for number of contributionsFormAndLineReferenceDesc
ExplanationSecurities - Publicly traded - THE ORGANIZATION REPORTS THE NUMBER OF INDIVIDUAL ITEMS RECEIVED DURING THE FISCAL YEAR.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION (continued)Founded in 1932 and a member of the Dartmouth Health system since 2016, APD's areas of clinical excellence include surgical services, primary care, geriatric care, and emergency services. In FY2025, Alice Peck Day Memorial Hospital (APD) was recognized as an Age-Friendly Health System by an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement. Our hospital was recognized by the American Heart Association for excellence in stroke and heart disease care, and was named by U.S. News & World Report to its 2024-2025 Best Hospitals as a High Performing hospital for Hip Replacement. APD became the first critical access hospital in the U.S. to earn Level 1 Geriatric ED accreditation, and our emergency department received Press Ganey Guardians of Excellence recognition. Our nurse residency program became the first in New Hampshire to receive Practice Transition Accreditation Program national accreditation. APD is a GUIDE participant (Guiding an Improved Dementia Experience), an initiative of the Centers for Medicare and Medicaid Services. APD's mission is to improve the health and well-being of the community. Our vision is to build a healthier community, one connection at a time. Our values include kindness, community, service, and partnership. APD employed 41 providers in FY25, of which 21 were primary care, 2 pediatric, and 18 were providers in other specialties. During FY25, APD had a total of 2,443 patient discharges consisting of 7,159 patient days. We also had 14,715 emergency department visits in FY25. APD is open 24 hours a day and 7 days a week.
Form 990, Part VI, Line 1a Delegate broad authority to a committeeThe Executive Committee of the Board consists of all board officers. The committee has the power to transact all regular business of the Corporation during the period between the meetings of the Board, subject to the powers reserved to the Member and any limitations imposed by the Board.
Form 990, Part VI, Line 2 Family/business relationships amongst interested personsSUSAN MOONEY AND CLAYTON ADAMS - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholdersThe Membership of the corporation shall consist of Dartmouth-Hitchcock health (D-HH) as the sole member.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyThe Member will retain the reserved power to appoint without limitation one-third of the Trustees (which appointees, before final appointment by Member, will be discussed with the Board Chair and other Trustees selected by the Chair for their input). The D-H/D-HH CEO or designee will serve on the Board ex officio, with full voting rights, and will count toward the one-third membership appointed by Member.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersDARTMOUTH-HITCHCOCK HEALTH (D-HH) IS THE SOLE CORPORATE MEMBER OF Alice Peck Day Memorial Hospital. D-HH HAS SPECIFIC AUTHORITY AND RESERVED POWERS, INCLUDING the power to: * Initiate and/or approve or disapprove all material governance, programmatic and financial decisions of the APD board of trustees; * Appoint without limitation one-third of the APD board of trustee members; * Ratify the two-thirds membership of the APD Board of trustees members which APD board of trustees has the right to nominate; * Remove by a vote of two-thirds any APD trustee; * Approve borrowings and dispositions of material assets; * Approve any key strategic relationships between APD and other organization; * Initiate and approve all operating and capital budgets and strategic plans; * Approve all policies relating to academic and research programs and affiliations; * Allocate the non-donor restricted assets and resources of APD and D-HH as appropriate to serve the overall best interest of the D-HH System; * Except as limited by the affiliation agreements, to appoint, evaluate the performance of, and terminate the APD CEO; * Approve any proposed amendment or repeal of the Articles of Agreement or Bylaws; * Approve the dissolution or liquidation of APD, following such approval by the APD Board of Trustees.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyPrior to filing, the completed form 990 is made available to the Finance Committee on a secure website. The Chair of the Finance Committee advises the Finance Committee members to review the Form 990 for content and raise any issues with Board Leadership or Management. The Chair of the Finance Committee then advises the Chair of the Board and the full Board that Form 990 is available for their review to enable a detailed and conscientious review by the full Board. All questions and concerns are addressed by the Chief Executive Officer and are incorporated into the Form 990 as deemed appropriate. Management files the final Form 990 with the Internal Revenue Service as required after the above review is concluded.
Form 990, Part VI, Line 12c Conflict of interest policyALICE PECK DAY HOSPITAL IS A MEMBER OF THE Dartmouth Hitchcock Health (D-HH) Compliance Advisory Group which provides oversight for audit and compliance matters related to the D-HH System. D-HH COMPLIANCE AND AUDIT SERVICES REQUIRES ANNUAL DISCLOSURE OF ANY POTENTIAL CONFLICTS OF INTEREST and CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS, TRUSTEES, AND KEY EMPLOYEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION-MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialThe Human Resources Committee of the Alice Peck Day Memorial Hospital Board of Trustees is responsible for determining the compensation of the Chief Executive Officer/President. The Chief Administrative Officer or her designee provides compensation data of comparable organizations with approximately the same size staff and spending in a location of similar size. The committee determines the appropriate compensation and approves an amount that is then communicated to Human Resources for adjustment. Dartmouth-Hitchcock Health reviews the compensation of the CEO/President in addition to the process described above. A review was last completed in FY25.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesThe CEO/President is responsible for reviewing the performance of senior management staff. The information is brought to the Human Resource Committee of the Board of Trustees along with a recommendation for the salary of each individual. The compensation is determined through a variety of analysis of salary data and performance. Individual salary increases are then based on overall performance, within budgeted increases for the organization. The Human Resources committee approves the base compensation and salary increase amount. A review was last completed in FY25.
Form 990, Part VI, Line 19 Required documents available to the publicThe Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesNet Assets Transferred or Released from Restriction - -481141; Total - -481141;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Alice Peck Day Lifecare Center Inc
10 Alice Peck Day DriveLebanonNH03766020479094Independent & Assisted LivingNH501(c)(3)10APD Memorial HospitalYes (true)
Dartmouth-Hitchcock Health
One Medical Center DriveLebanonNH03756264812335Parent OrganizationNH501(c)(3)7NAfalse
Dartmouth-Hitchcock Clinic
One Medical Center DriveLebanonNH03756222519596Physician ServicesNH501(c)(3)10D-HHfalse
Mary Hitchcock Memorial Hospital
One Medical Center DriveLebanonNH03756020222140HospitalNH501(c)(3)3D-HHfalse
The New London Hospital Association Inc
273 County RoadNew LondonNH03257020222171HospitalNH501(c)(3)3D-HHfalse
Windsor Hospital Corporation
289 Country RoadWindsorVT05089030183721HospitalVT501(c)(3)3D-HHfalse
Cheshire Medical Center
580 Court StreetKeeneNH03431020354549HospitalNH501(c)(3)3D-HHfalse
VALLEY REGIONAL HEALTHCARE INC
243 ELM STREETCLAREMONTNH03743020397338SUPPORTING ORGANIZATIONNH501(c)(3)Type IID-HHfalse
Dartmouth Health Home Care Inc
88 PROSPECT STREETWHITE RIVER JUNCTIONVT05001036006494Home Health and Hospice ServicesVT501(c)(3)10D-HHfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Alice Peck Day Lifecare Center Inc
Q$2,762,824Book
Alice Peck Day Lifecare Center Inc
O$5,038,490Book
Alice Peck Day Lifecare Center Inc
R$7,922,533Book
Alice Peck Day Lifecare Center Inc
A$278,650Book
Alice Peck Day Lifecare Center Inc
D$366,925Book