THE NEW LONDON HOSPITAL ASSOCIATION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- THE NEW LONDON HOSPITAL ASSOCIATION INC (EIN 02-0222171)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-09
- IRS object ID
- 202301299349300340
- Schema version
- 2021v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-09T15:01:19+00:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9600 Brownsboro Road Suite 400 | AddressLine1Txt |
| City | Louisville | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 402413902 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222171 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The New London Hospital Association Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NEWL | BusinessNameControlTxt |
| Phone | 6035262911 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 County Road | AddressLine1Txt |
| City | New London | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lisa Cohen | PersonNm |
| Person Title | Chief Financial Officer | PersonTitleTxt |
| Signature | 2023-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Lisa | PersonFirstNm |
| Person Last | Cohen | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rachel Spurlock | PreparerPersonNm |
| PTIN | P00520729 | PTIN |
| Phone | 5023263996 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Martin Thomas Manion | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 County Road | AddressLine1Txt |
| City | New London | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $87,595,290 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.newlondonhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1918 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | To continually improve the wellbeing of individuals in our region by providing high-quality healthcare to our communities. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 591 | TotalEmployeeCnt |
| Total Volunteers | 44 | TotalVolunteersCnt |
| Total Gross UBI | $24,089 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,067,509 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,460,669 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $65,162,979 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $83,541,446 | CYProgramServiceRevenueAmt |
| PY Investment Income | $354,198 | PYInvestmentIncomeAmt |
| CY Investment Income | $101,533 | CYInvestmentIncomeAmt |
| PY Other Revenue | $551,061 | PYOtherRevenueAmt |
| CY Other Revenue | $471,582 | CYOtherRevenueAmt |
| PY Total Revenue | $67,135,747 | PYTotalRevenueAmt |
| CY Total Revenue | $87,575,230 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $40,668 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $130,795 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $38,744,758 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $47,136,597 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $214,308 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $33,188,924 | PYOtherExpensesAmt |
| CY Other Expenses | $32,033,748 | CYOtherExpensesAmt |
| PY Total Expenses | $71,974,350 | PYTotalExpensesAmt |
| CY Total Expenses | $79,301,140 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,838,603 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,274,090 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $114,149,276 | TotalAssetsBOYAmt |
| Total Assets EOY | $114,735,565 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $69,114,513 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $61,049,590 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $45,034,763 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $53,685,975 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of the New London Hospital Association is To continually improve the wellbeing of individuals in our region by providing high-quality healthcare to our communities. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $71,075,071 | ExpenseAmt |
| Grant | $130,795 | GrantAmt |
| Revenue | $86,105,115 | RevenueAmt |
| Desc | NEW LONDON HOSPITAL ASSOCIATION, INC. (NLHA) IS THE PRINCIPAL PROVIDER OF PRIMARY AND SECONDARY HEALTH CARE FOR 15 TOWNS IN SULLIVAN AND MERRIMACK COUNTIES IN NEW HAMPSHIRE. THE HOSPITAL PROVIDES ACUTE AND PRIMARY HEALTH CARE - FROM EMERGENCY SERVICES TO FAMILY MEDICAL PRACTICE TO SURGICAL CARE AND ESSENTIAL WELLNESS AND PREVENTION SERVICES FOR THE 33,000 RESIDENTS IN ITS SERVICE AREA, A SIGNIFICANT PORTION OF WHOM ARE UNINSURED, UNDER-INSURED, AND/OR DEPENDENT ON MEDICAID/MEDICARE BENEFITS. THIS INCLUDES A LARGELY ELDERLY POPULATION AND A SIGNIFICANT NUMBER OF RURAL, LOW-INCOME FAMILIES. NLHA EMPLOYED 76 PROVIDERS IN 2022, OF WHICH 21 WERE PRIMARY CARE, 3 WERE PEDIATRICS, AND 52 WERE SPECIALTY PROVIDERS COVERING GENERAL SURGERY, ANESTHESIOLOGY, CARDIOLOGY, NEUROLOGY, EMERGENCY MEDICINE, HOSPITALISTS, GYNECOLOGY, OPHTHALMOLOGY, AND RHEUMATOLOGY. DURING FY 22, NLHA HAD A TOTAL OF 1882 PATIENT DISCHARGES CONSISTING OF 6859 PATIENT DAYS AND ATTENDED TO 7860 EMERGENCY ROOM VISITS. | Desc |
| Total Program Service Expenses | $71,075,071 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 104 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 591 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lisa Cohen | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6035262911 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 county road | AddressLine1Txt |
| City | New london | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Brian Frenkiewich | |||||||||
| Trustee/Medical Staff President | 40.0 | 0 | Yes (X) | Yes (X) | $258,444 | $0 | $29,938 | ||
| DOUGLAS LYON | |||||||||
| TRUSTEE/CHAIR | 0.5 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| John Hollinger | |||||||||
| Trustee/ Vice Chair | 0.5 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KAREN EBEL | |||||||||
| TRUSTEE/SECRETARY | 0.5 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Martin T Manion | |||||||||
| Trustee/President/CEO | 0.5 | 40.0 | Yes (X) | Yes (X) | $0 | $315,116 | $18,924 | ||
| STANLEY CUNDEY | |||||||||
| TRUSTEE/Treasurer | 0.5 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CAROL MAJEWSKI RN | |||||||||
| TRUSTEE / Patient Experience Officer | 0.5 | 40.0 | Yes (X) | $0 | $179,640 | $39,681 | |||
| Craig W Beck | |||||||||
| Trustee / CGP Chief Operating Officer | 0.5 | 40.0 | Yes (X) | $0 | $294,047 | $70,543 | |||
| JAMES MURPHY MD | |||||||||
| Trustee | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Jane Rastallis | |||||||||
| Trustee | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| JEAN TEN HAKEN MSN RN CENP | |||||||||
| Trustee (As of 7/1/21) | 0.5 | 40.0 | Yes (X) | $0 | $239,976 | $23,274 | |||
| John Kirk | |||||||||
| Trustee / Physician | 20.0 | 0 | Yes (X) | $60,893 | $0 | $0 | |||
| Karen Bonewald | |||||||||
| Trustee | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| MARK PITKIN | |||||||||
| TRUSTEE | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Mary M Oseid MHCDS | |||||||||
| Trustee / SVP-Regional Strategy | 0.5 | 40.5 | Yes (X) | $0 | $348,821 | $63,103 | |||
| PATRICIA STEVERSON | |||||||||
| TRUSTEE | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Steve Allenby | |||||||||
| Trustee | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Wendy Fielding | |||||||||
| Trustee / Chief Financial Officer | 0.5 | 40.0 | Yes (X) | $0 | $324,365 | $65,195 | |||
| Karen Beinhaur | |||||||||
| Chief Nursing Officer (as of 5/28/22) | 40.0 | 0 | Yes (X) | $123,710 | $0 | $2,104 | |||
| Kirk Dufty | |||||||||
| Chief Medical Officer | 40.0 | 0.0 | Yes (X) | $0 | $306,163 | $43,326 | |||
| LISA COHEN | |||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0 | Yes (X) | $145,215 | $0 | $10,647 | |||
| Lori Underwood | |||||||||
| Chief Operating Officer | 40.0 | 0 | Yes (X) | $155,934 | $0 | $15,460 | |||
| SALLY PATTON | |||||||||
| CHIEF NURSING OFFICER (through 5/27/22) | 40.0 | 0 | Yes (X) | $154,299 | $0 | $18,894 | |||
| ANDREW TORKELSON MD | |||||||||
| Physician | 40.0 | 0 | $379,978 | $0 | $2,976 | Yes (X) | |||
| CHRISTOPHER MAZUR MD | |||||||||
| Physician | 40.0 | 0 | $328,045 | $0 | $35,111 | Yes (X) | |||
| Eileen Kirk | |||||||||
| Physician | 40.0 | 0 | $267,467 | $0 | $21,188 | Yes (X) | |||
| MICHAEL MADAN MD | |||||||||
| Physician | 40.0 | 0 | $366,734 | $0 | $11,309 | Yes (X) | |||
| STEPHEN BISSAH MD | |||||||||
| PHYSICIAN | 40.0 | 0 | $452,033 | $0 | $35,184 | Yes (X) | |||
| DAVID FOSS | |||||||||
| Former CHIEF INFORMATION OFFICER | 40.0 | 0 | $44,712 | $103,215 | $34,464 | Yes (X) | |||
| Susan A Reeves EDDRN | |||||||||
| Former TRUSTEE and Officer | 0.0 | 40.0 | $0 | $738,583 | $68,953 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,737,464 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,849,926 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $610,274 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 51 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MARY HITCHCOCK MEMORIAL HOSPITAL | |||||
| ONE MEDICAL CENTER DR | LEBANON | NH | 03756 | HEALTHCARE STAFFING | $4,459,983 |
| DARTMOUTH-HITCHCOCK CLINIC | |||||
| ONE MEDICAL CENTER DR | LEBANON | NH | 03756 | HEALTHCARE STAFFING | $1,911,421 |
| AMERICAN HEALTHCARE STAFFING ASSN INC | |||||
| PO BOX 945 | TRAVERSE CITY | MI | 49685 | HEALTHCARE STAFFING | $1,384,510 |
| H P CUMMINGS CONSTRUCTION COMPANY | |||||
| 5 High Street | Woodsville | NH | 03785 | Construction Services | $1,062,388 |
| AVANT HEALTHCARE PROFESSIONALS LLC | |||||
| 1211 State Road 436 | Casselberry | FL | 32707 | Healthcare Staffing | $621,533 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $15,950 | FundraisingAmt |
| Related Organizations | $46,021 | RelatedOrganizationsAmt |
| Government Grants | $2,513,642 | GovernmentGrantsAmt |
| All Other Contributions | $885,056 | AllOtherContributionsAmt |
| Total Contributions | $3,460,669 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient service revenue | 622110 | $79,863,394 | $79,863,394 |
| Ambulance services | 621910 | $481,664 | $481,664 |
| Other program service revenue | 622110 | $116,646 | $116,646 |
| Pharmacy Income | 446110 | $3,079,742 | $3,079,742 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $83,541,446 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111,208 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $24,089 | UnrelatedBusinessRevenueAmt |
| Exclusion | $87,119 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $37,150 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $37,150 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,150 | TotalRevenueColumnAmt |
| Exclusion | $37,150 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $9,675 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$9,675 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$9,675 | TotalRevenueColumnAmt |
| Exclusion | -$9,675 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $3,300 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $15,950 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $10,385 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,085 | TotalRevenueColumnAmt |
| Exclusion | -$7,085 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Child Care Center | 624410 | $279,924 | $279,924 | |
| Vendor Rebates | 622110 | $85,171 | $85,171 | |
| Cafeteria Income | 722212 | $76,422 | $76,422 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $441,517 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $87,575,230 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $83,626,617 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $24,089 | UnrelatedBusinessRevenueAmt |
| Exclusion | $463,855 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,048 | TotalAmt |
| Program Services | $118,048 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,747 | TotalAmt |
| Program Services | $12,747 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,226,669 | TotalAmt |
| Program Services | $116,562 | ProgramServicesAmt |
| Management And General | $1,110,107 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,632,149 | TotalAmt |
| Program Services | $35,755,267 | ProgramServicesAmt |
| Management And General | $2,726,195 | ManagementAndGeneralAmt |
| Fundraising | $150,687 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $797,702 | TotalAmt |
| Program Services | $739,789 | ProgramServicesAmt |
| Management And General | $54,882 | ManagementAndGeneralAmt |
| Fundraising | $3,031 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,476,652 | TotalAmt |
| Program Services | $4,132,826 | ProgramServicesAmt |
| Management And General | $325,830 | ManagementAndGeneralAmt |
| Fundraising | $17,996 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,003,425 | TotalAmt |
| Program Services | $1,857,976 | ProgramServicesAmt |
| Management And General | $137,836 | ManagementAndGeneralAmt |
| Fundraising | $7,613 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,372 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $195,372 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,763 | TotalAmt |
| Program Services | $59,505 | ProgramServicesAmt |
| Management And General | $3,258 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,272,424 | TotalAmt |
| Program Services | $3,754,074 | ProgramServicesAmt |
| Management And General | $500,100 | ManagementAndGeneralAmt |
| Fundraising | $18,250 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,372 | TotalAmt |
| Program Services | $50,651 | ProgramServicesAmt |
| Management And General | $36,816 | ManagementAndGeneralAmt |
| Fundraising | $1,905 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,294,889 | TotalAmt |
| Program Services | $1,097,748 | ProgramServicesAmt |
| Management And General | $191,667 | ManagementAndGeneralAmt |
| Fundraising | $5,474 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,839 | TotalAmt |
| Program Services | $477,453 | ProgramServicesAmt |
| Management And General | $18,781 | ManagementAndGeneralAmt |
| Fundraising | $8,605 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,733,658 | TotalAmt |
| Program Services | $1,687,473 | ProgramServicesAmt |
| Management And General | $45,722 | ManagementAndGeneralAmt |
| Fundraising | $463 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,827 | TotalAmt |
| Program Services | $17,822 | ProgramServicesAmt |
| Management And General | $27,005 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,072,850 | TotalAmt |
| Program Services | $1,072,850 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,829,349 | TotalAmt |
| Program Services | $4,770,554 | ProgramServicesAmt |
| Management And General | $58,511 | ManagementAndGeneralAmt |
| Fundraising | $284 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $707,247 | TotalAmt |
| Program Services | $543,672 | ProgramServicesAmt |
| Management And General | $163,575 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAID ENHANCEMENT & OTHER TAXES | $2,833,839 | $2,833,839 | |
| Medical Supplies & Pharmaceutical | $10,462,409 | $10,462,409 | |
| Academic, Dues and Other Support | $382,811 | $114,075 | $268,736 |
| Equipment Rental & Maintenance | $1,696,871 | $1,233,083 | $463,788 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,850,228 | TotalAmt |
| Program Services | $166,648 | ProgramServicesAmt |
| Management And General | $1,683,580 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,301,140 | TotalAmt |
| Program Services | $71,075,071 | ProgramServicesAmt |
| Management And General | $8,011,761 | ManagementAndGeneralAmt |
| Fundraising | $214,308 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,050,217 | BOYAmt |
| EOY | $14,694,706 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,764,216 | BOYAmt |
| EOY | $15,270,217 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,154 | BOYAmt |
| EOY | $14,154 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,633,107 | BOYAmt |
| EOY | $12,475,357 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $977,954 | BOYAmt |
| EOY | $900,745 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,110,180 | BOYAmt |
| EOY | $646,807 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $101,361,443 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $55,388,042 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,231,978 | BOYAmt |
| EOY | $45,973,401 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,557 | BOYAmt |
| EOY | $9,557 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,822,254 | BOYAmt |
| EOY | $18,421,511 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,244,000 | BOYAmt |
| EOY | $2,244,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,291,659 | BOYAmt |
| EOY | $4,085,110 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,149,276 | BOYAmt |
| EOY | $114,735,565 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,917,332 | BOYAmt |
| EOY | $8,054,602 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,935 | BOYAmt |
| EOY | $318,605 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,526 | BOYAmt |
| EOY | $55,257 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,798,720 | BOYAmt |
| EOY | $52,621,126 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,114,513 | BOYAmt |
| EOY | $61,049,590 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,557,684 | BOYAmt |
| EOY | $48,973,793 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,477,079 | BOYAmt |
| EOY | $4,712,182 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,034,763 | BOYAmt |
| EOY | $53,685,975 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,149,276 | BOYAmt |
| EOY | $114,735,565 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $8,274,090 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,718,709 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $2,095,831 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $13,506 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $13,506 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | New London Hospital Association 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,592,725 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$174,667 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $7,046 | OtherExpendituresAmt |
| End Year Balance | $2,411,012 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,598,461 | BeginningYearBalanceAmt |
| Other Expenditures | $5,736 | OtherExpendituresAmt |
| End Year Balance | $2,592,725 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,809,705 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $73,437 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $284,681 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $2,598,461 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,147,317 | BeginningYearBalanceAmt |
| Other Expenditures | $1,337,612 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $2,809,705 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,151,824 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $279,474 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $282,629 | OtherExpendituresAmt |
| Administrative Expenses | $1,352 | AdministrativeExpensesAmt |
| End Year Balance | $4,147,317 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.0 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,241,000 | OtherCostOrOtherBasisAmt |
| Book Value | $1,241,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,054,663 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,455,052 | DepreciationAmt |
| Book Value | $31,599,611 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,932,970 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,658,261 | DepreciationAmt |
| Book Value | $12,274,709 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,132,810 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,274,729 | DepreciationAmt |
| Book Value | $858,081 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $45,973,401 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Investment in Pooled Funds | Desc |
| Book Value | $18,421,511 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $18,421,511 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Right of Use Liability | $171,501 |
| Deferred Compensation | $1,602,734 |
| Due to Affilliate | $28,960,929 |
| Estimated Third-Party Payor Settlement | $21,885,962 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $52,621,126 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part V, Line 4 Intended uses of endowment funds | FormAndLineReferenceDesc |
| Explanation | The income from the endowment funds is used to assist in the payment of the hospital's program-related expenses. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Invitational | Event1Nm |
| Gross Receipts Event1 | $13,750 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $10,450 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $3,300 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $0 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $0 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $910 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $0 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $0 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $9,475 | OtherDirectExpensesEvent1Amt |
| Event2 | Hospital Days | Event2Nm |
| Gross Receipts Event2 | $5,500 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $5,500 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $0 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $0 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $0 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $0 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $0 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $0 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $0 | OtherDirectExpensesEvent2Amt |
| Gross Revenue Other Events | $0 | GrossRevenueOtherEventsAmt |
| Gross Receipts Total | $19,250 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $15,950 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $3,300 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $0 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $0 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $910 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $0 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $0 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $9,475 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $10,385 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$7,085 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 225 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $698,079 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $698,079 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0088 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,774,264 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,097,688 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $676,576 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0085 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,472,343 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,097,688 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,374,655 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0173 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $483,972 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $483,972 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0061 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $80,072 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $80,072 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,186,279 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,027,470 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $158,809 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0020 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $2,750,323 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,027,470 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $722,853 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0091 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $12,222,666 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,125,158 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,097,508 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0264 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $29,605,174 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $31,032,705 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,427,531 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | New London Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 County Road | AddressLine1Txt |
| City | New London | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.newlondonhospital.org | WebsiteAddressTxt |
| State License | 02407 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | New London Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.newlondonhospital.org/about/annual-community-reports/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.newlondonhospital.org/about/annual-community-reports/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 225.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.0 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.newlondonhospital.org/services/billing-charges/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.newlondonhospital.org/services/billing-charges/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.newlondonhospital.org/services/billing-charges/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 3E | THE 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 , 1 | Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. During the period January through June 2021, a Community Health Needs Assessment of the New London Hospital service area was completed by New London Hospital in partnership with Dartmouth-Hitchcock, Alice Peck Day Memorial Hospital, Valley Regional Healthcare, Mt. Ascutney Hospital and Health Center, Lake Sunapee Region VNA & Hospice, Visiting Nurse and Hospice for VT and NH, and the New Hampshire Community Health Institute. The purpose of the assessment was to: better understand the health-related issues and concerns impacting the well-being of area residents; inform the community health improvement plans, partnerships and initiatives; and satisfy state and federal Community Health Needs Assessment requirements for Community Benefit Reporting. For the purpose of the assessment, the geographic area of interest was 15 municipalities comprising the New London Hospital service area with a total resident population of 33,071 people. Methods employed in the assessment included surveys of community residents made available through direct mailing, distribution at COVID-19 vaccination clinics, social media, email distribution and website links through multiple channels throughout the region; a direct email survey of community leaders representing multiple community sectors; a set of ten community discussion groups convened virtually across the region; and a review of available 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 health-related services or resources due to income, age, disability, and social or physical isolation. The community health needs assessment also acknowledged the significant impact of the COVID-19 pandemic, which was an over-arching concern affecting both the community health needs assessment process and the content of community input. Enhanced efforts were made to understand the needs of these populations through targeted surveys and virtual community conversations, multiple regional free COVID vaccination clinics, homeless programs, and other community settings serving economically-vulnerable residents. Findings of this assessment have been shared with public health officials in NH and VT, as well as with the Public Health Council of the Upper Valley. Surveys were made available through primary care clinics, free care clinics, annual town meetings/elections, and numerous other community locations. Visiting nurses and others provided pre-paid mailers and surveys to homebound residents. Residents completing surveys included members of African-American, Hispanic, Native American, and Asian populations. Surveys were distributed through regional health clinics, the region's shelter for homeless populations; the region's low-income housing trust; senior centers; substance use disorder treatment programs, delivered directly to resident homes, and other locations where populations most affected by health disparities congregate. Community partners provided assistance disseminating the survey, including the Public Health Council of the Upper Valley, whose membership includes community mental health services, substance use services, mental health peer leaders, WIC providers, senior services advocates, services working with people with physical and developmental disabilities, community nursing, visiting nurses, and other core human services. In addition to assisting in survey dissemination, these providers advocated for underserved and vulnerable populations in our region as a part of the CHNA process. During this CHNA process, we made resident surveys widely available to community residents through public list serves, direct e-mail invitations to patients of our primary care clinics, survey links on town web sites and e-news, employee e-news in major employers, and through other systems that provided widespread access to our surveys. We partnered closely with organizations, such as the Good Neighbor Health Clinic and Listen Community Services, serving populations affected by poverty, lack of insurance, homelessness, behavioral health conditions, and serious and chronic illnesses in order to survey these members of populations in our community and hosted multiple discussion groups with people affected by poverty and chronic illness. More than half of respondents to the community survey indicated that they were currently experiencing increased stress or anxiety because of the COVID-19 pandemic. |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. NEW LONDON HOSPITAL ASSOCIATION CONDUCTED THEIR COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH DARTMOUTH-HITCHCOCK, VALLEY REGIONAL HEALTH CARE, ALICE PECK DAY MEMORIAL HOSPITAL, MT. ASCUTNEY HOSPITAL AND HEALTH CENTER, LAKE SUNAPEE REGION VNA & HOSPICE, VISITING NURSE AND HOSPICE FOR VT AND NH, AND THE NEW HAMPSHIRE COMMUNITY HEALTH INSTITUTE. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. IN ADDITION TO WORKING WITH THE ENTITIES LISTED ON LINE 6A, NLHA WORKED CLOSELY WITH THE MEMBER ORGANIZATIONS OF THE GREATER SULLIVAN COUNTY PUBLIC HEALTH COUNCIL FOR THE LAKE SUNAPEE REGION TO DISSEMINATE SURVEYS, SERVE AS KEY INFORMANTS, AND TO PROVIDE OVERALL REVIEW AND FEEDBACK REGARDING FINDINGS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. |
| Schedule H, Part V, Section B, Line 7 Facility , 1 | Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. THE NEEDS ASSESSMENT WAS DISTRIBUTED TO NON-PROFIT ORGANIZATIONS THROUGHOUT THE REGION INCLUDING THE GREATER SULLIVAN COUNTY PUBLIC HEALTH COUNCIL. IT IS ALSO AVAILABLE FROM THE ORGANIZATION UPON REQUEST. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. THE NEW LONDON HOSPITAL ASSOCIATION IS INCREASING BOTH COMMUNITY BENEFITS SPENDING AND PARTNERSHIPS TO ADDRESS IDENTIFIED COMMUNITY NEEDS BASED ON THE MOST RECENT CHNA. THESE ARE IN THE AREAS OF ACCESS TO AFFORDABLE HEALTH INSURANCE, HEALTH CARE SERVICES, PRESCRIPTION DRUGS, AND MENTAL HEALTH SERVICES, AVAILABILITY OF PRIMARY CARE SERVICES, INVESTMENTS IN BEHAVIORAL HEALTH AND SUBSTANCE USE NEEDS, STRENGTHENING FAMILIES AND CHILDREN, CANCER CARE AND TREATMENT, AVAILABILITY OF PRIMARY CARE AND SENIOR CITIZEN SERVICES, AND COMMUNITY PARTNER COLLABORATIONS. IN FY 2022, THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT STRATEGIES WERE CONSISTENT WITH THE INTENTIONS IDENTIFIED IN THE 2021 COMMUNITY HEALTH IMPROVEMENT PLANS. AREAS WERE ANALYZED AND THE HOSPITAL RESPONDED BY INCREASING INVESTMENTS, MAINTAINING SIMILAR LEVELS OF INVESTMENTS FOR SERVICES AND INITIATIVES, OR LIMITING INVESTMENT IN AREAS WHERE OTHER COMMUNITY ORGANIZATIONS ALREADY PROVIDE LEADERSHIP AND SERVICES TO ADDRESS THE NEED, AND/OR WHERE THE IDENTIFIED NEED IS SIGNIFICANTLY OUTSIDE THE MISSION/SERVICES/SCOPE. COLLABORATION WITH COMMUNITY GROUPS HAS ALLOWED SERVICES TO EXPAND INTO NEW AREAS AND BRING FORTH ADDITIONAL RESOURCES TO THE COMMUNITY AND REMOVE BARRIERS TO HEALTHCARE. IN ADDITION, THE ASSOCIATION'S AFFILIATION WITH DARTHMOUTH-HITHCOCK HAS ALSO PROVIDED SUPPORT FOR THE IDENTIFIED COMMUNITY BASED NEEDS. THE NEW LONDON HOSPITAL ASSOCIATION'S COMMUNITY HEALTH IMPROVEMENT PLAN IS A 3-YEAR DOCUMENT IDENTIFYING ANTICIPATED INVESTMENTS AND ACTIVITIES THAT IT WILL TAKE TO ADDRESS NEEDS IDENTIFIED IN THE MOST RECENT CENTRAL NEW HAMPSHIRE'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). WITH THE ONSET OF COVID-19 IN FEBRUARY-MARCH 2020, NLHA HAS ADDED AND PRIORITIZED COVID-19 DRIVEN COMMUNITY NEEDS TO OUR OTHER CHNA PRIORITIES. THIS HAS INCLUDED PROVIDING SIGNIFICANT FUNDING AND STAFF SUPPORT TO HELP COMMUNITY FOOD SUPPORT PROGRAMS, BEHAVIORAL HEALTH PROVIDERS, NURSING HOMES, AND OTHER COMMUNITY ORGANIZATIONS ADAPT TO AND MAINTAIN BASIC SOCIAL SERVICES SAFELY DURING THE PANDEMIC. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - New London Hospital. PATIENTS WHOSE FAMILY INCOME EXCEEDS 300% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF NLHA. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - New London Hospital. NLHA 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 , 1 | Facility , 1 - New London Hospital. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON NLHA'S WEBSITE, INCLUDING THE VERBATIM POLICY AND A SHORTER, MORE PATIENT-FRIENDLY PLAIN-LANGUAGE SUMMARY. NLHA PROVIDES THE PLAIN-LANGUAGE SUMMARY BROCHURE TO ALL INPATIENTS, EMERGENCY DEPARTMENT INTAKES, UNINSURED, AND SELF-PAY INDIVIDUALS. NLHA CONTINUES TO NOTIFY PATIENTS ON THE BACK OF THE BILLING STATEMENT ABOUT FINANCIAL ASSISTANCE AVAILABLE TO THEM. ADDITIONALLY, NLHA 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. NLHA SCREENS 100% OF UNINSURED INPATIENT AND SAME-DAY PATIENTS PRIOR TO ADMISSION. AS PART OF THIS PROCESS, NLHA 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Newport Health Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 John Stark Hwy | AddressLine1Txt |
| City | Newport | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03773 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Rural health clinic | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 3c Other factors used in determining eligibility other than FPG | NLHA USES THE FPG GUIDELINES IN DETERMINING THE INITIAL LEVEL OF FINANCIAL ASSISTANCE PROVIDED. IN ADDITION, NLHA 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 Services | Line 7g does not include any costs attributable to a physician clinic. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | The 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 7g are based on actual costs. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | AS 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 Methodology | Bad 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 footnote | NLHA 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 costs | The costing methodology was according to the Internal Revenue Service guidance. Shortfalls in Medicare were anticipated because of the organization's central role of serving the needs of the community. This shortfall is considered a community benefit expenditure. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | NEW LONDON HOSPITAL ASSOCIATION HAS A CREDIT AND COLLECTION POLICY THAT ADDRESSES THE PROCEDURES FOR PATIENTS WHO QUALIFY FOR REDUCED-COST CARE. THE POLICY PROHIBITS USING EXTRAORDINARY COLLECTION PRACTICES OR PLACING AMOUNTS WITH COLLECTION AGENCIES. IF A FINANCIAL ASSISTANCE POLICY ELIGIBLE PATIENT HAS A BALANCE FOR WHICH THEY ARE RESPONSIBLE, AFTER A FINANCIAL ASSISTANCE DISCOUNT IS APPLIED, THE STANDARD PRACTICES ARE FOLLOWED AS OUTLINED IN THE CREDIT AND COLLECTIONS POLICY. |
| Schedule H, Part V, Section B, Line 16a FAP website | - New London Hospital: Line 16a URL: https://www.newlondonhospital.org/services/billing-charges/; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - New London Hospital: Line 16b URL: https://www.newlondonhospital.org/services/billing-charges/; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - New London Hospital: Line 16c URL: https://www.newlondonhospital.org/services/billing-charges/; |
| Schedule H, Part VI, Line 2 Needs assessment | IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL USES REGULAR FEEDBACK FROM THE COMMUNITY, PROVIDED THROUGHOUT THE YEAR, TO ASSESS ITS HEALTH NEEDS. THE HEALTH STAFF PARTICIPATES IN OR LEADS MULTIPLE COMMUNITY COALITIONS AND PROJECTS COLLABORATING AND CONNECTING WITH A WIDE ARRAY OF COMMUNITY-BASED HEALTH, MUNICIPAL, SCHOOL, SERVICE ORGANIZATION, REGIONAL PLANNING AND STATE PUBLIC HEALTH STAKEHOLDERS. WE REGULARLY REVIEW EMERGING NH STATE HEALTH DATA; QUANTITATIVE AND QUALITATIVE DATA FROM LOCAL SOURCES (NEWSPAPERS, REGIONAL PLANNING OFFICES, COMMUNITY FORUMS), AND CONVERSATIONS WITH COMMUNITY PARTNERS TO IDENTIFY CONCERNS THAT ARE EMERGING, INTENSIFYING, OR ARE THE SOURCE OF LOCAL ATTENTION SINCE THE LAST CHNA WAS CONDUCTED. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | THE ORGANIZATION STRIVES TO EDUCATE PATIENTS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IN A VARIETY OF FORUMS AND ENCOURAGES PATIENTS TO APPLY FOR ASSISTANCE THEY MAY BE ELIGIBLE FOR. THE ORGANIZATION POSTS INFORMATION IN REGARDS TO FINANCIAL ASSISTANCE ON THE HOSPITAL'S WEBSITE, UPON ADMISSION, UPON REQUEST AND THROUGHOUT THE BILLING PROCESS. |
| Schedule H, Part VI, Line 4 Community information | THE NEW LONDON HOSPITAL ASSOCIATION IS THE PRINCIPAL PROVIDER OF PRIMARY AND SECONDARY HEALTHCARE FOR 15 TOWNS IN SULLIVAN AND MERRIMACK COUNTIES OF CENTRAL NEW HAMPSHIRE. THE TOWNS WITHIN THE SERVICE AREA INCLUDE: ANDOVER, BRADFORD, CROYDON, DANBURY, GOSHEN, GRANTHAM, LEMPSTER, NEW LONDON, NEWBURY, NEWPORT, SPRINGFIELD, SUNAPEE, SUTTON, WASHINGTON, AND WILMOT. THE SERVICE AREA HAS A POPULATION OF 33,071, ACCORDING TO THE UNITED STATES CENSUS BUREAU, WHICH APPROXIMATES ABOUT 24.5% OF NEW HAMPSHIRE'S POPULATION. MEDIAN HOUSEHOLD INCOME VARIES WIDELY, FROM $54,816 TO $108,571 ANNUALLY; 21.9% OF THE POPULATION IS OVER THE AGE OF 65; 8.2% OF CHILDREN LIVE IN HOUSEHOLDS WHOSE MEDIAN HOUSEHOLD INCOME IS LESS THAN 100% OF FEDERAL POVERTY LEVEL; 24.8% OF FAMILY HOUSEHOLDS WITH CHILDREN ARE HEADED BY A SINGLE PARENT; 0.2% OF THE REGION'S RESIDENTS HAVE LIMITED ENGLISH PROFICIENCY; AND 6.3% LACK HEALTH INSURANCE. THE REGION IS SERVED BY NEW LONDON HOSPITAL ASSOCIATION, GREATER SULLIVAN COUNTY PUBLIC HEALTH NETWORK AND VALLEY REGIONAL HOSPITAL. NEWPORT IS DESIGNATED AS A FEDERAL POVERTY LEVEL MEDICALLY UNDERSERVED AREA IN THE REGION. |
| Schedule H, Part VI, Line 5 Promotion of community health | THE NEW LONDON HOSPITAL ASSOCIATION PLAYS AN ACTIVE ROLE IN PROMOTING COMMUNITY HEALTH AND OFFERS EDUCATIONAL PROGRAMS INCLUDING CLASSES AND WORKSHOPS. NLHA OFFERS A VARIETY OF HEALTH PROMOTION, EDUCATION PROGRAMS, AND DIRECT SERVICES FOR THE COMMUNITY SPANNING A BROAD SPECTRUM OF HEALTH AND WELLNESS TOPICS. THE ORGANIZATION PROVIDES HEALTH EDUCATION CLASSES INCLUDING SAFE SITTER, SMOKING CESSATION, HEALTHY LIFESTYLE, AND PROGRAMS TO SUPPORT NEW PARENTS. ADDITIONAL CLASSES INCLUDE CPR, EMS, AND HEALTH CARE PROVIDER EDUCATION TO ALLOW EMERGENCY MEDICAL TRAINING TO RESIDENTS OF OUR COMMUNITY. OTHER INITIATIVES INCLUDE HOSTING OR LEADING COMMUNITY PARTNERSHIPS TO ADDRESS SUBSTANCE MISUSE AND TREATMENT AND TO IMPROVE PUBLIC HEALTH. CASH CONTRIBUTIONS, CONTRACTED SERVICES, AND IN-KIND CONTRIBUTIONS OF STAFF TIME AND EXPERTISE ARE USED TO SUPPORT THESE STRATEGIES WHICH IMPROVE THE HEALTH OF THE COMMUNITY. THE FRIENDS OF NEW LONDON HOSPITAL ART COMMITTEE, CONSISTING OF A VOLUNTEER GROUP OF LOCAL ARTISTS AND COMMUNITY MEMBERS, EXHIBITS ART WITHIN THE HOSPITAL. THIS COMMUNITY PROGRAM DRAWS FROM THE EXTENSIVE ART COMMUNITY IN THE AREA, INVITING ARTISTS TO EXHIBIT AND SELL THEIR WORK OR SUBMIT THEIR WORKS FOR PERMANENT DISPLAY. ART CAN PLAY A POWERFUL ROLE IN BRINGING COMFORT AND RELIEF TO THOSE RECEIVING TREATMENT OR CARE IN A HOSPITAL SETTING. THIS COLLABORATION ENHANCES THE ENVIRONMENT FOR THE HOSPITAL, PATIENTS, FAMILIES, GUESTS AND STAFF AND HAS PROVEN TO BE A SUCCESSFUL PARTNERSHIP. The New London Hospital Association, Inc. extends professional staff privileges to qualified physicians, advanced practice registered nurses, and physician assistants. The New London Hospital Medical Staff is an open medical staff. OF THE 18 VOTING MEMBERS OF THE NEW LONDON HOSPITAL ASSOCIATION BOARD OF TRUSTEES AT FY22 END, 10 ARE NEITHER CONTRACTORS NOR EMPLOYEES OF THE HOSPITAL OR ITS AFFILIATES. The majority of New London Hospital Association's volunteer Board of Trustees, the governing body of the organization, represent a broad range of interests which exist in the communities it serves. In particular the trustees of the New London Hospital Association are representative of the consumer interests of the various neighborhoods and localities which are serviced by the hospital. |
| Schedule H, Part VI, Line 6 Affiliated health care system | NEW LONDON HOSPITAL ASSOCIATION IS AN AFFILIATE OF DARTMOUTH-HITCHCOCK HEALTH. THIS RELATIONSHIP ALLOWS THE STREAMLINING OF PATIENT CARE BETWEEN MEMBERS OF THE TWO HEALTHCARE SYSTEM AND STRENGTHENS THE CENTER AS A REGIONAL RESOURCE FOR THE KEARSARGE/LAKE SUNAPEE REGION IN CENTRAL NEW HAMPSHIRE. THE AFFILIATION ALLOWS MORE PATIENTS TO RECEIVE CARE CLOSER TO HOME, FREES UP BED CAPACITY FOR TERTIARY CARE PATIENTS AT DARTMOUTH-HITCHCOCK MEDICAL CENTER IN LEBANON, AND ALLOWS THE NEW LONDON HOSPITAL ASSOCIATION TO CONTINUE ITS ROLE IN PROVIDING PRIMARY CARE AND SPECIALIZED CLINICAL SERVICES IN A PATIENT AND FAMILY-FRIENDLY ENVIRONMENT. IT ENABLES NLHA TO MORE EFFECTIVELY PURSUE A COMMON VISION WITH OTHER D-HH ENTITIES OF THE FUTURE OF HEALTH CARE THAT IS BASED ON CREATING A SUSTAINABLE HEALTH SYSTEM, FOCUSING ON POPULATION HEALTH, DELIVERING VALUE-BASED CARE, AND EMBRACING THE OPPORTUNITIES PROVIDED BY NEW PAYMENT MODELS. IN ADDITION TO THE NEW LONDON HOSPITAL ASSOCIATION AND DARTMOUTH-HITCHCOCK HEALTH, THE AFFILIATED HEALTH CARE SYSTEM INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL, DARTMOUTH-HITCHCOCK CLINIC, CHESHIRE MEDICAL CENTER, WINDSOR HOSPITAL CORPORATION, ALICE PECK DAY MEMORIAL HOSPITAL, VISITING NURSE ASSOCIATION AND HOSPICE OF NEW HAMPSHIRE AND VERMONT, AND A NUMBER OF OTHER RELATED ORGANIZATIONS WHOSE PRIMARY MISSION IS HEALTH CARE IN THE REGION. THE NEW LONDON HOSPITAL ASSOCIATION AND OTHER MEMBERS OF THE AFFILIATED HEALTH CARE SYSTEM OPERATE JOINTLY THROUGH INTERLOCKING DIRECTORATES, STRATEGIC PLANNING, MANAGEMENT, AND THEY SHARE IDENTICAL MISSIONS. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | NH |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Foundation for Healthy Communities | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 Airport Road | AddressLine1Txt |
| City | Concord | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 020275078 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $117,048 | CashGrantAmt |
| Valuation Method Used | Book | ValuationMethodUsedDesc |
| Purpose Of Grant | Program Support | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Assistance to families through the Mobile Farmstand Program | GrantTypeTxt |
| Recipient | 30 | RecipientCnt |
| Cash Grant | $12,747 | CashGrantAmt |
| Valuation Method Used | Book | ValuationMethodUsedDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | FormAndLineReferenceDesc |
| Explanation | Each award established by the New London Hospital Association has written guidelines and procedures. Award payments are processed in accordance with the specific terms of each award and coordinators are responsible for assuring all terms are met, including proper documentation of expenses. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Martin T Manion | ||||||||||||||
| Trustee/President/CEO | $0 | $315,016 | $0 | $100 | $0 | $0 | $0 | $17,400 | $0 | $1,524 | $0 | $334,040 | $0 | $0 |
| Brian Frenkiewich | ||||||||||||||
| Trustee/Medical Staff President | $233,572 | $0 | $20,000 | $0 | $4,872 | $0 | $0 | $0 | $29,938 | $0 | $288,382 | $0 | $0 | $0 |
| Wendy Fielding | ||||||||||||||
| Trustee / Chief Financial Officer | $0 | $286,135 | $0 | $0 | $0 | $38,230 | $0 | $22,361 | $0 | $42,834 | $0 | $389,560 | $0 | $0 |
| Mary M Oseid MHCDS | ||||||||||||||
| Trustee / SVP-Regional Strategy | $0 | $318,940 | $0 | $100 | $0 | $29,781 | $0 | $27,660 | $0 | $35,443 | $0 | $411,924 | $0 | $0 |
| CAROL MAJEWSKI RN | ||||||||||||||
| TRUSTEE / Patient Experience Officer | $0 | $178,772 | $0 | $0 | $0 | $868 | $0 | $15,482 | $0 | $24,199 | $0 | $219,321 | $0 | $0 |
| Craig W Beck | ||||||||||||||
| Trustee / CGP Chief Operating Officer | $0 | $290,544 | $0 | $100 | $0 | $3,403 | $0 | $27,660 | $0 | $42,883 | $0 | $364,590 | $0 | $0 |
| JEAN TEN HAKEN MSN RN CENP | ||||||||||||||
| Trustee (As of 7/1/21) | $0 | $227,942 | $0 | $11,260 | $0 | $774 | $0 | $4,925 | $0 | $18,349 | $0 | $263,250 | $0 | $0 |
| Susan A Reeves EDDRN | ||||||||||||||
| Former TRUSTEE and Officer | $0 | $595,393 | $0 | $60,250 | $0 | $82,940 | $0 | $27,660 | $0 | $41,293 | $0 | $807,536 | $0 | $0 |
| DAVID FOSS | ||||||||||||||
| Former CHIEF INFORMATION OFFICER | $30,314 | $102,348 | $0 | $0 | $14,398 | $867 | $0 | $6,360 | $7,093 | $21,011 | $51,805 | $130,586 | $0 | $0 |
| SALLY PATTON | ||||||||||||||
| CHIEF NURSING OFFICER (through 5/27/22) | $150,287 | $0 | $0 | $0 | $4,012 | $0 | $0 | $0 | $18,894 | $0 | $173,193 | $0 | $0 | $0 |
| LISA COHEN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $144,821 | $0 | $0 | $0 | $394 | $0 | $0 | $0 | $10,647 | $0 | $155,862 | $0 | $0 | $0 |
| Lori Underwood | ||||||||||||||
| Chief Operating Officer | $147,428 | $0 | $0 | $0 | $8,506 | $0 | $0 | $0 | $15,460 | $0 | $171,394 | $0 | $0 | $0 |
| Kirk Dufty | ||||||||||||||
| Chief Medical Officer | $0 | $285,475 | $0 | $0 | $0 | $20,688 | $0 | $27,660 | $0 | $15,666 | $0 | $349,489 | $0 | $0 |
| ANDREW TORKELSON MD | ||||||||||||||
| Physician | $374,644 | $0 | $0 | $0 | $5,334 | $0 | $0 | $0 | $2,976 | $0 | $382,954 | $0 | $0 | $0 |
| STEPHEN BISSAH MD | ||||||||||||||
| PHYSICIAN | $431,567 | $0 | $0 | $0 | $20,466 | $0 | $0 | $0 | $35,184 | $0 | $487,217 | $0 | $0 | $0 |
| CHRISTOPHER MAZUR MD | ||||||||||||||
| Physician | $325,511 | $0 | $0 | $0 | $2,534 | $0 | $0 | $0 | $35,111 | $0 | $363,156 | $0 | $0 | $0 |
| MICHAEL MADAN MD | ||||||||||||||
| Physician | $364,393 | $0 | $0 | $0 | $2,341 | $0 | $0 | $0 | $11,309 | $0 | $378,043 | $0 | $0 | $0 |
| Eileen Kirk | ||||||||||||||
| Physician | $249,434 | $0 | $7,075 | $0 | $10,958 | $0 | $0 | $0 | $21,188 | $0 | $288,655 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | The CEO IS EMPLOYED AND PAID BY A RELATED ORGANIZATION WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, FORM 990 INFORMATION FROM OTHER ORGANIZATIONS, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE CEO'S COMPENSATION. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | DARTMOUTH HITCHCOCK CLINIC (DHC) AND MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) SPONSOR A SPLIT DOLLAR LIFE PLAN FOR CERTAIN LONG-TERM EMPLOYEES. THE ORIGINAL OBJECTIVES FOR OFFERING THESE PLANS WERE TO BETTER ENABLE DHC AND MHMH TO ATTRACT AND RETAIN QUALITY EXECUTIVE PERSONNEL, IMPROVE THE PHYSICIANS' POST-RETIREMENT LIFE INSURANCE BENEFITS, AND TO REPLACE AN INCREASINGLY COSTLY RETIREE LIFE INSURANCE PROGRAM. THE PLAN WAS FROZEN IN 1998 AND THEREFORE NO FURTHER COSTS OF THE INDIVIDUAL EMPLOYEE INSURANCE PREMIUMS HAVE BEEN FUNDED BY THE ORGANIZATION. THE NUMBER OF PARTICIPANTS AND DOLLAR VALUE CONTINUES TO DWINDLE AS INDIVIDUALS RETIRE/LEAVE THE ORGANIZATION. THE FOLLOWING INDIVIDUALS HAVE A SPLIT DOLLAR LIFE PLAN ARRANGEMENT AND THE RESPECTIVE EMPLOYER PREMIUMS: ANDREW TORKELSON $88,516 MARY OSEID $42,307 |
| Schedule J, Part II Note Regarding Compensation | FORM 990, SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY NLHA AND RELATED ORGANIZATIONS. THESE AMOUNTS ARE REPORTED TO EMPLOYEES ON THEIR ANNUAL W-2 FORMS AS COMPENSATION. COLUMNS C AND D REPRESENT ITEMS EARNED, HOWEVER, NOT PAID DIRECTLY TO THE EMPLOYEE AS CASH PAYMENTS DURING THE CALENDAR YEAR. COLUMN C INCLUDES RETIREMENT BENEFITS IN A CALENDAR YEAR. COLUMN D REPRESENTS NONTAXABLE BENEFITS SUCH AS THE COST OF HEALTHCARE COVERAGE PROVIDED ON BEHALF OF ITS EMPLOYEES. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The President/CEO is paid by a related organization, therefore line 15a is marked No in accordance with instructions. HOWEVER, THE PRESIDENT/CEO'S COMPENSATION IS DETERMINED BY THE NEW LONDON HOSPITAL ASSOCIATION'S EXECUTIVE COMMITTEE AND MARY HITCHCOCK MEMORIAL HOSPITAL'S (THE EMPLOYER) EXECUTIVE BOARD AFTER CONSIDERING COMPENSATION FOR PRESIDENTS AND CEOS OF VARIOUS-SIZED HOSPITALS IN THE REGION. COMPENSATION IS REVIEWED AND DOCUMENTED ANNUALLY WITH THE LAST REVIEW COMPLETED IN FY 2022. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | The Executive Committee shall be composed from time to time of the following members of the Board of Trustees: the then current Chairman, the Chairman-elect, the President, the then current Vice Chairman, the then current Secretary, the then current Treasurer, the then current Assistant Treasurer, and the President of the Medical Staff. The Executive Committee shall possess all powers and authority of the Board of Trustees (except those powers which the Articles of Agreement, these By-Laws or applicable laws or regulations do not permit to be delegated) between meetings of the Board of Trustees when time and circumstance require those powers to be exercised. The Executive Committee shall meet at the call of its Chairman. At least annually and based on policies established by the Board of Trustees, the Executive Committee shall evaluate the performance and review the compensation of the President. Written minutes of all meetings of the Executive Committee shall be distributed to the Board of Trustees promptly following any meeting of the Executive Committee. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The organization's sole member IS DARTMOUTH-HITCHCOCK HEALTH, A NEW HAMPSHIRE NON-PROFIT CORPORATION. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | The sole member, DARTMOUTH-HITCHCOCK HEALTH, HAS THE POWER TO APPOINT 1/3 OF THE MEMBERS and to ratify the nomination of 2/3 of the members of the organization's Board of Trustees. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Notwithstanding any other provision of these By-Laws, the following actions of the Corporation require the approval of the Member: (i) material governance, programmatic and financial decisions, including the elimination or addition of major health care services or programs and the purchase or sale of real property; (ii) to appoint one-third of the members of the NLHA Board of Trustees as set forth in Section 3(a)(i) of Article III hereof; (iii) to ratify the nomination of two-thirds of the members of the Board of Trustees as set forth in Section 3(a)(ii) of Artice III hereof; (iv) to remove any NLHA trustee not acting in the best interests of the D-H System as set forth in Section 6 of Article III hereof; (v) borrowings and dispositions of the Corporation's assets; (vi) establishment of key strategic relationships, including acquiring ownership or contractual participation in a network, system, affiliation, joint venture, alliance or similar arrangement with an organization that is not part of the D-H System or which in not addressed in an NLHA strategic plan that has been approved by the Member; (vii) adoption of operating and capital budgets and strategic plans; (viii) adoption of policies relating to academic and research programs and affiliations; (ix) to reallocate the assets and resources of NLHA and the Member, as appropriate, to serve the overall best interests of the D-H System as set forth in Article II hereof; (x) to appoint, evaluate, compensate and terminate the NLHA CEO as set forth in Section 4 of Article VI hereof (xi) amendments to the Corporation's Articles of Agreement or By-Laws if such amendment would have the effect of impacting the Member's reserved powers or may reasonably be expected to have a material strategic, competitive or financial impact on the D-H System as set forth in Article XII hereof; and (xii) dissolution or liquidation of the Corporation. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FORM 990 IS REVIEWED BY EXTERNAL TAX ADVISORS, THE DIRECTOR OF FINANCIAL COMPLIANCE, AND NLHA'S CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURN. ONCE THE RETURN HAS BEEN FULLY PREPARED, A FINAL 990 IS SENT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS AND RESPONSES PRIOR TO THE OFFICIAL FILING OF OF THE FORMS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | EACH YEAR, A WRITTEN CONFLICT OF INTEREST SURVEY IS SENT TO EACH TRUSTEE AND OFFICER INQUIRING ABOUT SITUATIONS THAT COULD RESULT IN CONFLICTS OF INTEREST. THESE INDIVIDUALS ALSO HAVE A DUTY TO VOLUNTARILY DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO ASSUMING THEIR RESPONSIBILITIES OR AT THE TIME ANY POTENTIAL CONFLICT ARISES. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE ORGANIZATION REQUIRES THE INDIVIDUAL TO REMOVE THEMSELVES FROM ANY VOTING OR DECISION MAKING WITH RESPECT TO THE CONFLICT. OVERSIGHT OF THE POLICY IS THE RESPONSIBILITY OF THE AUDIT COMMITTEE. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | THE PRESIDENT OF THE MEDICAL STAFF AND ANY OTHER PAID OFFICERS' COMPENSATION LEVELS ARE REVIEWED PERIODICALLY BY NLHA'S SENIOR DIRECTOR OF HUMAN RESOURCES AND THE CEO OF NLHA. THESE REVIEWS INCLUDE COMPARISONS OF COMPENSATION LEVELS TO INDEPENDENT SALARY SURVEY DATA FOR COMPARABLE POSITIONS IN THE REGION, WITH THE LAST REVIEW CONDUCTED AND DOCUMENTED IN FY 2022. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE NEW LONDON HOSPITAL MAKES GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Net Asset Transfers - 2095831; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Dartmouth-Hitchcock Health | ||||||||||
| one medical center drive | lebanon | NH | 03756 | 264812335 | PARENT ORGANIZATION | NH | 501(c)(3) | 7 | Na | false |
| VISITING NURSE ASSOCIATION AND HOSPICE OF VERMONT AND NEW HAMPSHIRE INC | ||||||||||
| 88 Prospect Street | White River Junction | VT | 05001 | 036006494 | HOSPICE | VT | 501(c)(3) | 10 | D-HH | false |
| CHESHIRE MEDICAL CENTER | ||||||||||
| 580 COURT STREET | KEENE | NH | 03431 | 020354549 | HOSPITAL | NH | 501(c)(3) | 3 | D-HH | false |
| WINDSOR HOSPITAL CORPORATION | ||||||||||
| 289 COUNTY ROAD | WINDSOR | VT | 05089 | 030183721 | HOSPITAL | VT | 501(c)(3) | 3 | D-HH | false |
| MARY HITCHCOCK MEMORIAL HOSPITAL | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 020222140 | HOSPITAL | NH | 501(c)(3) | 3 | D-HH | false |
| DARTMOUTH-HITCHCOCK CLINIC | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 222519596 | PHYSICIAN SERVICES | NH | 501(c)(3) | 10 | D-HH | false |
| ALICE PECK DAY MEMORIAL HOSPITAL | ||||||||||
| 10 ALICE PECK DAY DRIVE | LEBANON | NH | 03766 | 020222791 | HOSPITAL | NH | 501(c)(3) | 3 | D-HH | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Woodis Merrifield Irrev Trust | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 273 County Road | AddressLine1Txt |
| City | New London | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03257 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Charitable Trust | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | Trust | EntityTypeTxt |
| Share Of Total Income | $89,730 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,547,267 | ShareOfEOYAssetsAmt |
| Ownership | 0.7 | OwnershipPct |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |