2023-11-14T15:05:23-06:00 2022-12-31 010494526 Baker Newman & Noyes 650 Elm Street Suite 302 Manchester NH 03101 990 2022-01-01 020222215 St Joseph Hospital STJO 6038823000 172 Kinsley Street Nashua NH 030612013 John Jurczyk SVP and President 6038823000 2023-11-02 1 John Jurczyk 999009999 0 Connor Smart P02285543 6036262200 2023-11-02 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z John Jurczyk 172 Kinsley Street Nashua NH 030612013 298167249 0 X stjosephhospital.com X 1943 NH Healthcare services to anyone needing care. 11 11 1842 76 44525 0 1509890 342876 244228868 249711949 30319380 4147532 -3867129 -17614 272191009 254184743 81782 71095 0 0 114894647 119218327 0 0 0 132170016 158406513 247146445 277695935 25044564 -23511192 290885778 239592401 135893355 134385392 154992423 105207009 We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities. 0 0 48252350 0 66255005 Inpatient medical, surgical and rehabilitative services to anyone needing care in the greater Nashua area. 102331515 0 179133905 Outpatient services including surgery, radiology, laboratory, rehabilitative, cardiovascular, breast health, cardiac rehab, and mental health to anyone needing services in the greater Nashua area. 66388802 71095 0 Each year St. Joseph Hospital provides millions of dollars worth of charity care and community services reflecting our healing mission and our values. St. Joseph Hospital follows the methodology recommended by the Catholic Health Assocation for calculating the cost of charity care and community benefits. 2688707 0 4323039 2688707 4323039 219661374 1 1 0 1 0 0 0 0 0 1 1 1 1 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 146 0 1 1842 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NH X X Gerard F Hadley CFO eff 82023 6038823000 172 Kinsley Street Nashua NH 030612013 Maurice Arel Director (end 6/2022) 1.00 0.00 X 0 0 0 Judith Dunbar Director (end 12/2022) 1.00 0.00 X 0 0 0 Matthew Fossum Director 1.00 0.00 X 0 0 0 Kevin Halloran Director 1.00 0.00 X 0 0 0 Sean Howell Director 1.00 0.00 X 0 0 0 Uwe Hurley Director 1.00 0.00 X 0 0 0 Donnalee Lozeau Director 1.00 0.00 X 0 0 0 Deborah Novotny Director 1.00 0.00 X 0 0 0 Joseph J Porcello Director 1.00 0.00 X 0 0 0 Louise Trottier Director (end 6/2022) 1.00 0.00 X 0 0 0 Daniel M Weeks Director 1.00 0.00 X 0 0 0 John Parolin Chair 1.00 0.00 X X 0 0 0 Ralph Jenkins Vice Chair 1.00 0.00 X X 0 0 0 Arthur Urschel Secretary 1.00 0.00 X X 0 0 0 John A Jurczyk SVP & President 38.00 2.00 X 0 489171 36742 Richard Plamondon Treasurer/VP Finance 38.00 2.00 X 0 346850 33628 Stephen Grubbs CEO, Covenant Health, Inc. 1.00 49.00 X 0 853102 37161 Deepak Vatti Medical Director 40.00 0.00 X 473470 0 33296 Alison Madden VP Medical Affairs 40.00 0.00 X 394727 0 38891 Albert Tom MD Physician 40.00 0.00 X 841078 0 38238 Prasanna Gulur MD Physician 40.00 0.00 X 567202 0 34010 Umer Syed MD Physician 40.00 0.00 X 535707 0 25141 Huei Wen Lim MD Physician 40.00 0.00 X 528256 0 12839 Yong Hwa Lee MD Physician 40.00 0.00 X 497597 0 23471 3838037 1689123 313417 196 0 1 0 Covenant Health Inc 100 Ames Pond Drive Tewksbury MA 01876 Management and shared services 27262201 Medefis Inc PO Box 5068 New York NY 10087 Locum and staffing 14382012 NES Medical Services of New England PO Box 936451 Atlanta GA 31193 Healthcare services 2610125 Narragansett Bay Anesthesia One University Ave 104 Westwood MA 02090 Anesthesia Services 2144570 InCare PLLC 50 Dolphin Road Newton MA 02459 Healthcare services 1691003 19 64990 26667 251219 342876 Patient services 622110 246446457 246446457 Tuition, education, and seminars 611600 1571116 1571116 Physician and office/admin fees 622110 892351 892351 Cafeteria 722514 661258 661258 Thrift/gift shop and boutique 459420 140767 140767 249711949 1637011 1637011 172028 233922 -61894 -61894 -61894 46091073 161165 43741717 0 2349356 161165 2510521 2510521 6622 64990 6867 -245 -245 Answering services 517000 30265 30265 Housekeeping services 812900 14260 14260 44525 254184743 249711949 44525 4085393 X 28149 28149 42946 42946 940384 835013 105371 98623065 87572261 11050804 1434435 1273705 160730 11551861 10257464 1294397 6668582 5922312 746270 15343493 15343493 231524 231524 96575 96575 63234614 41512650 21721964 517389 339659 177730 5623104 3691490 1931614 905133 594207 310926 4900499 3217110 1683389 283319 185995 97324 749046 491738 257308 2714902 2714902 5031883 5031883 5316545 3490238 1826307 Med. supplies/equipment 31283363 31283363 Medicaid tax 11046318 11046318 Provision for bad debts 8221097 8221097 Repairs and maintenance 1483053 973604 509449 1424656 935270 489386 277695935 219661374 58034561 0 5015598 1255350 22679005 1051080 30241920 34181950 2074951 2007279 4239564 4203371 999163 2030179 180966677 119248152 60157235 61718525 4742565 1603431 139396833 108973409 18260757 17850499 2200188 2579550 877999 2137778 290885778 239592401 26306961 34507467 109586394 99877925 135893355 134385392 X 152759584 102778923 2232839 2428086 154992423 105207009 290885778 239592401 X -23511192 -24076859 -2197363 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 17953 0 0 0 17953 0 Part II-B, Line 1: St. Joseph's Hospital of Nashua is a member of the New Hampshire Hospital Association (NHHA). A portion of the dues paid to this association in the year ending December 31, 2022, were available for lobbying expenditures on behalf of the Hospital and other NHHA members in furtherance of their exempt purposes. The amount reported on the Hospital's 2022 Form 990, Schedule C, Part II-B, Line 1g represents the dues paid to the NHHA that the Hospital estimates to have been available for lobbying; in 2022, the Hospital paid total dues of $92,017 to the NHHA, of which approximately 19.51% was estimated to be extended for lobbying purposes. Additionally, at this time the Hospital has received correspondence from the American Hospital Association (AHA) that indicates up to 27.29% of dues paid to the AHA in 2022 may have been available for lobbying purposes. However, the Hospital is unable to determine how much (if any) dues were actually paid to AHA during this tax year, or if such fees would have actually been extended for lobbying purposes. Accordingly, the Hospital is disclosing this information here in the supplemental statements of this 2022 Form 990, Schedule C for transparency purposes. 2232839 187395 215799 207947 2428086 2093879 263264 162095 286399 2232839 2100660 395764 41894 444439 2093879 1784834 301225 137394 122793 2100660 1415041 561381 -54863 136725 1784834 0.00000 0.36930 0.63070 0 0 3748748 3748748 112309717 68000749 44308968 1048590 1044679 3911 62763554 50202724 12560830 1096068 1096068 61718525 108973409 F 108973409 Investment in Corporate Services 15052787 C Investment in Souhegan Nursing 844977 C Investment in Nashua Regional Cancer Center 1221421 C Investment in NH Imaging 6826 C Investment in First Choice PHO 727474 C Investment in NE Life -2986 C 17850499 Due to affiliates 76931550 Medicaid settlement obligations 490000 Deferred executive compensation 558325 Third party payor settlements 6714558 Environmental liability 6190919 Capital lease obligations 5305053 Malpractice tail liability 1183570 Loss in investment 1559704 Pension obligations 935966 Security deposits 8280 99877925 X Part V, Line 4: Funds to be used to assist the needy through education and/or projects for the poor as determined and approved by the board. Part X, Line 2: St. Joseph Hospital of Nashua is a part of the Covenant Health System; Covenant Health, Inc. is the sole member of the Hospital. Covenant and its member organizations are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code, except as noted below. St. Joseph Hospital Corporate Services, Inc., a wholly-owned subsidiary of Nashua, is a for-profit organization, which is subject to federal and state income taxes. St. Joseph Hospital Corporate Services, Inc. has net operating loss (NOL) carryforwards for tax purposes. The NOLs are not anticipated to be utilized so the amounts have been fully offset with a reserve. CHIL, a wholly-owned subsidiary, is domiciled in the Cayman Islands. No income taxes are levied in the Cayman Islands and CHIL has been granted an exemption for any taxes that might be introduced. Accordingly, no provision for income taxes has been made in the accompanying financial statements. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. The System has evaluated the position taken on its filed tax returns. The System has concluded no uncertain income tax positions exist at December 31, 2022. Commit to Get Fit 71612 64990 6622 1460 1000 336 500 3571 71612 64990 6622 1460 1000 336 500 3571 6867 -245 1 1 1 X 1 X 1 1 0 1 1 5947 1427749 1427749 0.00530 16628 22207321 7872495 14334826 0.05320 22575 23635070 7872495 15762575 0.05850 1249770 1249770 0.00460 1249770 1249770 0.00460 22575 24884840 7872495 17012345 0.06310 1 8221097 0 80069572 127255450 -47185878 X 1 1 1 First Choice PHO Physician Hospital Organization 0.50000 0.00000 0.50000 1 1 St Joseph Hospital 172 Kinsley Street Nashua NH 030612013 00023 X X X St Joseph Hospital 0 0 1 X X X X X X X X X 20 1 1 1 1 X See Part V, Section C X See Part V, Section C X 1 22 1 See Part V, Section C 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 St. Joseph Hospital Part V, Section B, Line 5: St. Joseph Hospital worked with officials from the City of Nashua Division of Public Health and other members of the community, including local police and fire departments, school officials, ambulance service leaders, directors of community agencies, hospital leaders, physicians and area residents through focus groups to gather input for the community health needs assessment (CHNA).The 2020 CHNA employed numerous research methods to gather input from the community, including online surveys, in-person interviews, and data analysis. The CHNA utilized these methods separately and decisively for each of its identified community health needs.The City of Nashua Division of Public Health and Community Services (DPHCS) conducted a community-based survey in 2020 and invited Greater Nashua residents help determine what the biggest health priorities were in their communities, and to share their COVID-19 experiences. Online surveys were distributed widely throughout the Greater Nashua community via social media, community networks, and physical posted flyers. The surveys were available in both English and Spanish. Specifically designed surveys were administered to evaluate each of the community's various health needs. For example, different surveys were used to gather community-data regarding substance abuse, access to care, mental and behavioral health, chronic disease, environmental health, and child and maternal health. Community input through these surveys allowed the collaborative report to better evaluate unique health risks and concerns within various social groups and communities.The research was originally designed as a series of in-person, focus group sessions to be held across the Greater Nashua region throughout the summer of 2020. Research design began in January, 2020, but when the COVID-19 pandemic called for social distancing, research design had to be adjusted to accommodate online data collection. With the switch to an online survey based design, research questions were modified from a semi-structured interview design to a survey design. St. Joseph Hospital Part V, Section B, Line 6a: St. Joseph Hospital took part in the 2020 Greater Nashua Community Health Assessment for its most recent CHNA. This Assessment was conducted by the Nashua Department Division of Public Health and their Public Health Advisory Council partners. It is a product of the dedication and collaboration of over 33 organizations, programs, and City departments serving the GNPHR. A full list of the hospital facilities that participated in this Assessment can be found through the City of Nashua Community Health Assessment homepage at:https://nashuanh.gov/560/Community-Health-Assessment St. Joseph Hospital Part V, Section B, Line 6b: St. Joseph Hospital took part in the 2020 Greater Nashua Community Health Assessment for its most recent CHNA. This Assessment was conducted by the Nashua Department Division of Public Health and their Public Health Advisory Council partners. It is a product of the dedication and collaboration of over 33 organizations, programs, and City departments serving the GNPHR. A full list of the facilities other than hospitals that participated in this Assessment can be found through the City of Nashua Community Health Assessment homepage at:https://nashuanh.gov/560/Community-Health-Assessment St. Joseph Hospital Part V, Section B, Line 11: St. Joseph Hospital of Nashua coordinates with the City of Nashua Division of Public Health and Community Services (DPHCS), as well as other community agencies, partners, and members to create a collaborative and comprehensive Community Health Improvement Plan (CHIP). The 2022 Greater Nashua CHIP (released January 2022) is the fourth consecutive CHIP, based off the 2020 CHA. The Hospital also participated in the previous DPHCS Reports, including three completed CHAs (2011, 2014, and 2017) and three CHIPs (2012-2015, 2015-2018, and 2018-2021). The CHAs and CHIPs are published over staggered periods to ensure that the CHIPs are released in a timely manner to address identified health needs.This Community Health Improvement Plan (CHIP) is the result of a cooperative investment of partner and stakeholder time and resources during the COVID-19 pandemic when many were stretched beyond capacity. Under the strategic leadership of the City of Nashua Division of Public Health and Community Services (DPHCS) a systems approach was utilized to address emergent public health issues in collaboration with stakeholders and community members. Informed by the 2020 Community Health Assessment (CHA) and a process involving the Greater Nashua Public Health Advisory Council (PHAC) Executive Committee, the 2022 CHIP will guide our efforts to achieve a healthier Greater Nashua Public Health Region (GNPHR).The Greater Nashua PHAC Executive Committee and CHIP Planning Team chose the following health priority areas for the CHIP 2022 based on the 2020 Greater Nashua CHA: 1. Behavioral Health (Suicide, Mental Health, and Substance Use) 2. Chronic Disease (Heart Disease/ Stroke, Diabetes, and Asthma) 3. Communicable diseases 4. Maternal and Child Health 5. Public Health Emergency PreparednessBEHAVIORAL HEALTH:Behavioral health is the scientific study of the emotions, behaviors, and biology relating to a person's mental well-being, their ability to function in everyday life, and their concept of self. Behavioral health encompasses mental health, substance misuse, and suicide prevention and is a top priority in the Greater Nashua Public Health Region (GNPHR) for a variety of reasons. These reasons include our region's high prevalence of substance misuse, high rate of opioid overdose fatalities, high rate of suicide attempts and deaths by suicide, lack of access to timely treatment for those seeking behavioral health services, and limited mental health promotion and awareness. Approximately one in eight visits to emergency departments in the United States (U.S.) involves mental and substance use disorders.Collectively, the main objectives under Behavioral Health include: 1) Reduce substance use among all age groups (illicit Substances, alcohol, tobacco, marijuana 2) Increase awareness of behavioral health resources to improve or maintain mental health in all age groups 3) Improve access to substance use and mental health services through workforce developmentCHRONIC DISEASESApproximately six in ten Americans live with at least one chronic disease, such as heart disease and stroke, cancer, or diabetes. Many chronic diseases are caused by a variety of risk factors that can be reduced by making healthy lifestyle choices. Not only the leading cause of death and disability, chronic diseases are also the leading driver of health care costs in the United States (US). It is a public health priority in the Greater Nashua Public Health Region (GNPHR) to provide health promotion and education to help our community prevent chronic diseases and manage symptoms when prevention is not possible to reduce the burden of chronic disease on our society.Collectively, the main priorities under chronic disease include: 1) Increasing prevention efforts for Type II diabetes 2) Increasing control of hypertension 3) Increase identification and treatment of depression for those with chronic diseaseCOMMUNICABLE DISEASESCommunicable, or infectious diseases, are caused by microorganisms such as bacteria, viruses, parasites and fungi that can be spread, directly or indirectly, from one person to another. Transmission can occur in a variety of ways, including direct physical contact with an infectious person, consuming contaminated foods or beverages, contact with contaminated body fluids, contact with contaminated inanimate objects, or being bitten by an infected insect. In some cases, pathogens that result in infectious diseases can become airborne and spread via the air we breathe (i.e., through inhalation). Some disease agents can be transmitted from animals to humans, and some of these agents can be transmitted in more than one way.Collectively, the main priorities under communicable disease include: 1) Increase vaccination uptake for vaccine preventable diseases 2) Increase community preparedness for communicable disease outbreaks 3) Increase effectiveness of public health system in preventing and addressing communicable disease.MATERNAL AND CHILD HEALTHMaternal health is the health of a woman during her pregnancy, birth, and postpartum period, making it an important predictor of newborn health. Children's health is the physical, mental, emotional, and social well-being of children from infancy all the way through adolescence. Many factors affect maternal and child health, including race and ethnicity, age, income level, educational attainment, medical insurance coverage, access to medical care, pre-pregnancy health, and general health status. The well-being of infants, children, and mothers determines the health of our next generation and can help predict future public health challenges for families, communities, and the healthcare system.Health behaviors and health status before a woman is pregnant can be influenced by a variety of environmental and social factors, such as access to medical care and chronic stress. Some of these factors can affect and compound others, creating a rippling effect. For instance, factors ranging from age to medical insurance coverage affect a woman's general health status; a woman's health status, in turn, directly influences her risk of pregnancy complications and her child's cognitive and physical development.Main takeaways from the Maternal and Child Health CHA: - In 2018, 93.7% of NH moms reported ever breastfeeding, and 69% reported breastfeeding for more than 8 weeks. According to the CDC, only one in four infants in the U.S. are exclusively breastfed for six months. - Children in the GNPHR are at increased risk of high blood lead levels, as 17% of homes were built before 1950, and 10.8% of six year olds are living below the federal poverty level. - In 2018, 7.5% of pregnant women in NH smoked cigarettes in their last three months of pregnancy, and 5.9% used marijuana or hash during their pregnancy. - In 2018, 14.9% of women in NH received follow-up care for depression after giving birth, and 13% women were diagnosed with depression after giving birth. - Approximately 4.6% of Nashua youth (aged 6-18) are uninsured.Collectively, the main priorities under Maternal and Child Health include: 1) Improve access and availability of universal screenings 2) Support access to affordable healthcare and referrals for families 3) Support children's social & emotional development through easily accessible services & supports 4) Improve access and supports for healthy nutrition 5) Increase the capacity of all families to advocate for themselves and their childrenPUBLIC HEALTH EMERGENCY PREPAREDNESSFrom natural disasters to terrorism, all crises have the potential to negatively impact public health. The goal of Public Health Emergency Preparedness (PHEP) is to increase a community's ability to respond in an efficient manner to incidents in order to preserve health and wellbeing of the population. There are 15 functional areas that encompass PHEP as outlined in the CDC's Public Health Emergency Preparedness and Response Capabilities.Main takeaways from the PHEP CHA 2020: - Fewer than 12% of households in Nashua have a written disaster plan. - 97.8% of Nashua households have a smoke detector. - 19% of Nashua households feel well prepared to handle an emergency. - 40% of U.S. adults don't consider themselves prepared but plan to prepare for emergencies and 68% of U.S. adults have set aside some money for an emergency.Collectively, the main priorities under PHEP include: 1) Improving the regional communications structure 2) Increasing public health planning, exercising and training among various sectors 3) Strengthening the working relationship between the region (GNPHR) and the State of New HampshireThe full 2022 CHIP can be found through the following website, in either an interactive web-based format or as a readable PDF:https://nashuanh.gov/564/Community-Health-Improvement-Plan-CHIP Schedule H, Part V, Section B, Line 7: Access to the Hospital's past and present CHNA reports can be found at the following web-address:https://nashuanh.gov/560/Community-Health-AssessmentAn Interactive Dashboard and PDF-copy of the most current CHNA can be found at the following web-address:https://dashboards.mysidewalk.com/gnphr-cha Schedule H, Part V, Section B, Line 10: The Hospital collaborated with the City of Nashua Division of Public Health to develop the Greater Nashua Community Health Improvement Plan (CHIP).Both past and present copies of the Greater Nashua CHIP can be found through the City of Nashua website, at: https://nashuanh.gov/564/Community-Health-Improvement-Plan-CHIP 12 1 - Milford Urgent Care 442 Nashua Street Milford NH 03055 Urgent care, PT, OT, radiology, mammography, and physician services 2 - S Nashua Radiology & Phy Offices 172 Daniel Webster Highway Nashua NH 03060 Radiology and physician practice 3 - Nashua Pediatrics-Physician Practice 155 Kinsley Street Nashua NH 03060 Physician practice 4 - Amherst Street PT & OT 460 Amherst Street Nashua NH 03060 Physical and Occupational Therapy 5 - Family Medicine of Merrimack 4 Dobson Way Merrimack NH 03054 Physician practice 6 - Merrimack PT 382 Daniel Webster Highway Merrimack NH 03054 Physicial therapy 7 - Hudson PT OT and Radiology 208 Robinson Road Hudson NH 03051 Physical and Occupational Therapy, Radiology 8 - NE Boulevard PT & OT 75 Northeastern Boulevard Nashua NH 03060 Physical and Occupational Therapy 9 - Dartmouth Exit 8 PT & OT 2300 Southwood Drive Nashua NH 03063 Physical and Occupational Therapy 10 - Neurology - Physician Practice 171 Kinsley Street Nashua NH 03060 Physician practice 11 - OBGYN - Physician Practice Harris Pond Merrimack NH 03054 Physician practice 12 - SJ Physicians 171 Kinsley Street Nashua NH 03060 Physician practice Part I, Line 7: Costing methodology is an overall cost-to-charge ratio based on operating expenses as a percent of gross revenue applied to the related gross charges. Line 7a is based on gross charges written off as charity care times the overall cost-to-charge ratio. Line 7b is based on gross charges of patients with a primary payor of Traditional Medicaid or Medicaid Manage Care times the overall cost-to-charge ratio. Line 7e uses various methods to aggregate costs including but not limited to - actual expenditures for staff, supplies, and hospital space usage by community groups and cash donations. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 8,221,097. Part II, Community Building Activities: The Hospital maintains an open medical staff, representing over forty different specialties and treats all patients regardless of their ability to pay. The board of directors is made up of community members with varied backgrounds and industries. The Hospital utilizes any surplus funds to further its mission by providing free and low cost healthcare services, educations offerings, free screenings, support groups, and works collaboratively with other healthcare agencies to meet the identified healthcare needs of our community. St. Joseph Hospital is a member of Covenant Health Inc. of Tewksbury, MA. It is the responsibility of the entire staff of St. Joseph Hospital to serve and promote the health of the greater Nashua community.Additionally, St. Joseph Hospital strives to improve the health of its community through community-based partnerships and initiatives, some of which are detailed below: The Greater Nashua Healthy Community Collaborative:The Greater Nashua Healthy Community Collaborative is working to increase awareness and education about the importance of preventive medicine and health screenings, particularly for heart disease and peripheral vascular disease (PVD). Screening can help identify potential problems early, such as high cholesterol or high blood sugar (diabetes), so they can be treated before they become more serious and potentially lead to a heart attack, stroke or other traumatic event. The Collaborative has also helped to establish a prescription assistance program to help their clients to obtain prescription medications. Collaborative members include healthcare organizations, human service providers, and public agencies that come together on a regular basis to address needs that have been identified by the Community Health Assessment of Greater Nashua.Screenings and Planning:The Hospital frequently makes available free blood pressure screenings and free breast and cervical cancer screenings. The Hospital also provides access to advanced care plans that provide comfort and peace-of-mind for end of life care and transitions.These efforts, combined with the Hospital's general operations and commitment to high-quality care, continually and significantly build and improve the communities which the Hospital serves. Part III, Line 2: Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the system analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts, adjusted based on cost to charge ratio. The allowance for doubtful accounts is provided based on an analysis by management of the collectability of outstanding balances. Management considers the age of the outstanding balances and past collection efforts in determining the reserve for doubtful accounts. Accounts deemed uncollectible are charged off against the established reserve. Bad debts are reported as charged. Part III, Line 3: Patients deemed eligible for financial assistance follow the Hospital's financial assistance policies. Therefore, no bad debt expense related to patients eligible under the Hospital's financial assistance policy is included as a community benefit. Part III, Line 4: St. Joseph Hospital adopted the new accounting standards as issued by the FASB in May 2014, effective January 1, 2018, where the provision for bad debt is no longer presented as a separate line item and net patient service revenue is presented net of estimated implicit price concession revenue deductions. The adoption of the new standard did not have an impact on the recognition of revenues for any periods prior to adoption. The adoption of this accounting standard is detailed in the Hospital's audited financial statements, Footnote 3, Patient Service Revenues. The Hospital continues to operate under this adopted standard. Part III, Line 8: None were reported as a community benefit. Costing methodology is an overall cost-to-charge ratio based on operating expenses as a percent of gross revenue applied to the gross charges of patients with a primary payor of traditional Medicare or Medicare Advantage. Part III, Line 9b: Every statement sent to patients indicates that financial assistance is available and provides a phone number and email contact. All customer service personnel are attuned to asking patients if they need assistance.The financial assistance application is also available on-line by visiting the facility's website. Part VI, Line 2: St. Joseph Hospital worked with the City of Nashua Division of Public Health officials and other members of the community, including local police and fire departments, school officials, ambulance service leaders, directors of community agencies, hospital leaders, physicians and area residents through focus groups to gather input for the Community Health Needs Assessment (CHNA).A Community Health Assessment (CHA) is a collaborative process that identifies key health needs and issues through systematic, comprehensive data collection and analysis. CHAs provide information on a variety of health topics and help identify resources which assist with policy formulation, program implementation, and evaluation. CHAs are also a crucial component of accreditation as they help measure how well a public health system is fulfilling the assurance function, one of the three fundamental purposes of public health. The Greater Nashua CHA is part of an ongoing comprehensive community health improvement process. The purpose of the CHA is to identify vulnerable populations using comparable data within the Greater Nashua Public Health Region (GNPHR) and to subsequently identify trends in health issues, environmental health hazards, and social and economic factors that affect the different populations' health. Collected and analyzed data will be used to identify priority issues within the Greater Nashua Region, and to develop strategies for further actions; these actions are outlined in the form of a Community Health Improvement Plan (CHIP). The CHIP creates a foundation for a work plan to improve the health of the community over the course of three years' time. One of the main objectives of the most recent Community Needs Assessment's research was to determine the biggest health concerns in the community in order to determine community health priorities. The research for this report indicated that most people in the Greater Nashua Region are concerned about behavioral health (including substance use, mental health, and suicide), affordable and accessible healthcare, and outbreaks of communicable disease (40%, 30%, and 26% of respondents, respectively). In regards to upcoming concerns for the next three years, most people are concerned about behavioral health (including substance use, mental health, and suicide), affordable and accessible healthcare, and outbreaks of communicable disease (38.6%, 36.1%, and 25.4% of respondents, respectively). Part VI, Line 3: Signage and brochures are at every point of registration, which explain the free-care and financial assistance policies. There are dedicated financial counselors who meet in person or over the telephone to provide guidance and support to patients and families who require financial assistance. Information can also be found on the hospital web site, As well as in the Hospital's community newsletters/quarterly publications. All customer service and registration personnel are trained to ask patients and families if they need financial assistance.Free Care is available for patients who qualify. If a patient's or their family's income is 200% or less of the Federal Poverty Guidelines, the patient may qualify for assistance for their self-pay balance. Patients may inquire about this program before arriving for care or at the time of registration or check-in. Patients may also inquire about Free Care after receiving their billing-statements. Additionally, the Hospital makes available financial representatives to answer all billing and payment questions. Representatives are available to assist with questions regarding insurance benefits, hospital charges, payment options, and the applications for financial assistance. Part VI, Line 4: St. Joseph Hospital serves people of all ages, race, gender, religion, ethnicity regardless of their ability to pay. The Hospital's service area is all of New Hampshire.For its 2022 tax year, the Hospital continued to refer and rely on the collaborative 2020 Community Health Assessment that was prepared and informed in association with the City of Nashua. The four geographies mentioned most often throughout this report are the City of Nashua, the Greater Nashua Public Health Region, Hillsborough County, and the State of New Hampshire (NH). Throughout the State of NH, there are 13 public health regions. The Greater Nashua Region is composed of the City of Nashua and its 12 surrounding towns which include Amherst, Brookline, Hollis, Hudson, Litchfield, Lyndeborough, Mason, Merrimack, Milford, Mont Vernon, Pelham, and Wilton.As of 2019, the combined population of the Greater Nashua Region was estimated to be about 88,000 individuals. To gauge the demographics of this region, the CHA used a variety of survey and online-polling tools. The majority of survey respondents were Nashua residents (73.6%), but the remaining 26% of respondents were distributed throughout the Greater Nashua region. About 18% of respondents identify within the constructs of racial or ethnic diversity, and the remaining 82% of participants identified as white or Caucasian. 27.1% of respondents were between the ages of 50 and 59; approximately 80% of all respondents were aged 59 or younger. The majority of respondents were at least partially college-educated, with approximately 85% of respondents having completed some college, or having completed an Associate's, Bachelor's, or Graduate degree. Part VI, Line 5: The Hospital maintains an open medical staff, representing over forty different specialties and treats all patients regardless of their ability to pay. The board of directors is made up of community members with varied backgrounds and industries. The Hospital utilizes any surplus funds to further its mission by providing free and low cost healthcare services, educations offerings, free screenings, support groups, and works collaboratively with other healthcare agencies to meet the identified healthcare needs of our community. It is the responsibility of the entire staff of St. Joseph Hospital to serve and promote the health of the greater Nashua community.Additionally, St. Joseph Hospital provides a variety of programs and initiatives to improve the general wellbeing and to promote the health of its community. For example, the Hospital is proud to maintain the following community outreach programs:- Community Health Education: the Hospital regularly hosts a wide variety of seminars and workshop activities to promote wellness and healthy living. - Empty Cradle Support Group: a bereavement support-resource for families coping with the loss of a child. - The Marguerite d'Youville Fund for the Poor: a Fund to provide medicine and medical care for the poor and uninsured members of its community.- Palliative Care: a comprehensive support network for the terminally ill and community education regarding all aspects of "end of life" planning.- School of Nursing and Scholarship Fund: academic instruction in the scientific, technical, spiritual, and social aspects of nursing, with training programs in several healthcare occupations. Scholarship support is provided to students based on financial need and desire to pursue a career in healthcare. Part VI, Line 6: St. Joseph Hospital of Nashua is a member and related organization to the Covenant Health System; Covenant Health Inc. is the sole corporate member of the Hospital. Covenant Health is an innovative, Catholic regional health delivery network and a leader in values-based, not-for-profit health and elder care. Covenant consists of hospitals, skilled nursing and rehabilitation centers, assisted living residences, and community-based health and elder care organizations throughout New England. Through its partnership and membership with Covenant Health, the Hospital is able to better navigate the increasingly complex and competitive healthcare marketplace while improving its ability to offer high-quality patient service. Access to Covenant Health resources allows the Hospital to compete on cost and quality of care; to maintain financial strength while fulfilling its care-oriented missions; to enhance the skills of its staff and leadership; and to strengthen the Hospital's ability to serve its community. Through the Covenant Health System, the Hospital can access and utilize funds and resources that allow it to better serve its priority communities and their specific health care needs.Additionally, the Hospital frequently and actively collaborates with the City of Nashua Division of Public Health and Community Services as well as other similarly geographically located institutions to enhance the quality and availability of care throughout New Hampshire. Part VI, Line 7: New Hampshire 1 Roman Catholic Bishop of Manchester 153 Ash Street Manchester NH 03104 026004670 501(c)(3) 0 12000 Book Value Medical Supplies Support for the Bishop Assistance program. 1 0 d'Youville Fund for General Assistance 15 13257 Prescription Assistance Program 27 4653 25036 Costs per books. Medical and pharmaceutical supplies. Part I, Line 2: All accounting is managed through Covenant Health's Accounts Payable (St. Joseph Hospital's (SJH) parent corporation) and SJH's Finance Department. Specific procedures and management protocols have been established for tracking grant awards. St. Joseph's has a Foundation which houses a Grants Associate that is overseen by Covenant Health's Director of Grants Administration. The Director's background over the last 30 years in the nonprofit sector has focused, in part, on financial management and grants contracts, reporting, and oversight. The Grants Associate is responsible for building and maintaining the Foundations grants research, writing, and reporting program. St. Joseph's grants management systems are also monitored by St. Joseph's Executive Director of Philanthropy to ensure redundant mechanisms of oversight. St. Joseph's Finance Department monitors and maintains a list of all contracts through a contract database. The database provides designated individuals with access to the actual contract. Finance and the Foundation review all contracts to ensure that any payments or financial reporting requirements are met. All grant expenditures are assigned to specific grants and require authorization from the departmental director requesting the expense, the Grants Associate or the Director of Grants Administration, and the Executive Director of Philanthropy. Starting in 2020, the Organization created and began to maintain an Employee Emergency Assistance Program to solicit donor contributions and to provide financial assistance to employees who meet qualifications as needy or who are experiencing financial hardship. Generally, to be considered needy or experiencing financial hardship, an employee's prior year and projected current year household income must be below 200% of the federal poverty guideline and the employee must be experiencing housing instability, including imminent risk of homelessness. X X 1 1 0 0 0 0 0 0 0 1 0 Stephen Grubbs CEO, Covenant Health, Inc. 0 775120 0 50000 0 27982 0 9150 0 28011 0 890263 0 0 Albert Tom MD Physician 839368 0 0 0 1710 0 3120 0 35118 0 879316 0 0 0 Prasanna Gulur MD Physician 565738 0 0 0 1464 0 0 0 34010 0 601212 0 0 0 Umer Syed MD Physician 534901 0 0 0 806 0 4524 0 20617 0 560848 0 0 0 Huei Wen Lim MD Physician 527540 0 0 0 716 0 663 0 12176 0 541095 0 0 0 John A Jurczyk SVP & President 0 451619 0 28824 0 8728 0 9150 0 27592 0 525913 0 0 Yong Hwa Lee MD Physician 493158 0 0 0 4439 0 8957 0 14514 0 521068 0 0 0 Deepak Vatti Medical Director 452800 0 0 0 20670 0 9032 0 24264 0 506766 0 0 0 Alison Madden VP Medical Affairs 385730 0 7500 0 1497 0 6100 0 32791 0 433618 0 0 0 Richard Plamondon Treasurer/VP Finance 0 333787 0 7500 0 5563 0 8102 0 25526 0 380478 0 0 Part I, Line 1a Certain top executives of the Hospital may access a limited discretionary spending account with which to pursue and cover business-related expenditures that further that Hospital's mission and general operations. Additionally, the Hospital pays membership dues to the Country Club of Nashua on behalf of its President and other top executives. Any meals, entertainment, or other personsal expenses incurred by Hospital staff and executives through the use of the membership must be paid for by the applicable individuals; should the Hospital pay for such costs when paying for the Club's membership, the Hospital will request reimbursement from the relevant persons. The Hospital does not request reimbursement for the cost of the membership; the Club's facilities, conference rooms, and meeting spaces are used primarily for Hospital functions, meetings, and other operations, are the dues are considered to be a business expense incurred by the Hospital. Part I, Line 3 All compensation paid to the Hospital's SVP and President is established, reviewed, and approved by Covenant Health, the Hospital's sole corporate member. Covenant Health utilizes a compensation committee, independent compensation consultants, and compensation surveys and studies of similarly experienced executives employed by comparable organizations to determine a reasonable and appropriate compensation package for the Hospital's SVP and President. The compensation plan is subject to the approval of the Compensation Committee of Covenant Health's Board of Directors. Part I, Line 7 "Cash in" of earned time. Form 990, Part VI, Section A, line 6 Covenant Health, Inc. is the sole member of St. Joseph Hospital. Form 990, Part VI, Section A, line 7a As the sole member of St. Joseph Hospital, Covenant Health, Inc. retains the ability to elect and remove the Organization's board of directors with or without cause. Form 990, Part VI, Section A, line 7b As the sole corporate member of the Organization, Covenant Health, Inc. has the following powers and rights over the Organization and its subsidiaries as outlined in the Organization's bylaws: 1. To approve any change in the written statements of philosophy and mission; 2. To amend and to repeal the organizing and governing documents; 3. To elect the Board of Directors or remove them with or without cause; 4. To appoint and remove the president; 5. To approve all plans of merger, consolidation, reorganization, dissolution, or the sale, lease assignment, or transfer of substantially all of the assets, or the purchase or acquisition of an interest in any corporation, partnership, joint venture, or other entity; 6. To approve the acquisition, sale, or encumbrance of any real estate valued in excess of an amount set by the Member in writing; 7. To approve the sale, assignment, or transfer of any equity interest or membership interest in any subsidiary; 8. To approve any reclassification or other change of any capital stock or other equity security; and, 9. To approve the issuance of, or the creation of any obligation to issue, any equity security. Form 990, Part VI, Section B, line 11b The Forms 990 are prepared by an independent tax accountant, and are then reviewed by the St. Joseph Hospital Finance Committee and board of directors prior to filing. Form 990, Part VI, Section B, line 12c Each year, St. Joseph Hospital conducts a survey of the board members and key management members to determine whether there are conflicts of interest (be they actual or potential). Board members and key employees have a continuing obligation to report any proposed transactions which may be perceived as a conflict of interest. Form 990, Part VI, Section B, line 15 The compensation of officers and key employees is subject to the oversight and decisions of Covenant Health, a related entity and the sole member of the Center. Every two-to-three years the Compensation Committee of the Covenant Health board of directors engages an external consultant to provide competitive market data from various survey sources, which is used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable. Form 990, Part VI, Section C, line 19 The Hospital will make its corporate and governing documents and its financial available upon request. Form 990, Part IX, line 11g Maintenance contracts: Program service expenses 1,706,078. Management and general expenses 892,725. Fundraising expenses 0. Total expenses 2,598,803. Medical service providers: Program service expenses 30,766,317. Management and general expenses 0. Fundraising expenses 0. Total expenses 30,766,317. Contracted and purchased labor: Program service expenses 428,336. Management and general expenses 224,132. Fundraising expenses 0. Total expenses 652,468. Collections and admin support: Program service expenses 0. Management and general expenses 1,967,755. Fundraising expenses 0. Total expenses 1,967,755. Shared service fees: Program service expenses 8,611,919. Management and general expenses 18,637,352. Fundraising expenses 0. Total expenses 27,249,271. Form 990, Part XI, line 9: Transfers to affiliates -30,000. Adjustment to defined benefit pension obligation -657,462. Net periodic pension cost -1,509,901. Form 990, Part XII, Line 2c: The audit process has not changed from the previous year. SJH Surgicenter LLC 172 Kinsley Street Nashua NH 030612013 204181845 Inactive Outpatient Surgery NH St Joseph Hospital Alternative Health Services 360 Broadway Bangor ME 04402 010422885 Home health and hospice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Bangor Nursing & Rehabilitation Center 103 Texas Avenue Bangor ME 04401 010538534 Nursing home and restorative facility ME 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Waltham Inc dba Maristhill Nursing & Rehab Center 66 Newton Street Waltham MA 02453 043333609 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Worcester Inc dba St Mary Care Center 39 Queen Street Worchester MA 01610 043419625 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Community Clinical Services PO Box 7291 Lewiston ME 04243 010409788 Physician practice ME 501(c)(3) Line 10 St Mary's Health System 0 Covenant Health Foundation Inc 100 Ames Pond Drive Tewksbury MA 01876 800199674 Charitable foundation MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Covenant Health Investment Trust 420 Bedford Street Lexington MA 02420 046835128 Investment trust MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Covenant Health Inc 100 Ames Pond Drive Tewksbury MA 01876 222484505 Health care management and resource organization MA 501(c)(3) Line 10 N/A 0 Fanny Allen Corporation Inc 790 College Parkway Colchester VT 05446 222495808 Charitable foundation VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Fanny Allen Holdings Inc 790 College Parkway Colchester VT 05446 030181052 Real estate holding company VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Helping Hands of St Marguerite Inc 799 Concord Avenue Cambridge MA 02138 800199674 Private home-care health services MA 501(c)(3) Line 10 Covenant Health Inc 0 M & J Company 360 Broadway Bangor ME 04402 222480150 Lease holding company ME 501(c)(2) St Joseph Healthcare Foundation 0 Mary Immaculate Guild Inc 172 Lawrence Street Lawrence MA 01841 463073987 Supporting grants and donations MA 501(c)(3) Line 12a, I Covenant Health Inc 0 MI Adult Day Health Care Center Inc 189 Maple Street Lawrence MA 01841 042921888 Adult day care services MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Management Inc 172 Lawrence Street Lawrence MA 01841 042857794 Assisted living services MA 501(c)(3) Line 12a, I Covenant Health Inc 0 MI Nursing Restorative Center Inc 172 Lawrence Street Lawrence MA 01841 042104851 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community II Inc 189 Maple Street Lawrence MA 01841 042679954 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community III Inc 189 Maple Street Lawrence MA 01841 042186043 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community Inc 189 Maple Street Lawrence MA 01841 042647207 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Transportation Inc 189 Maple Street Lawrence MA 01841 042921889 Elderly transportation services MA 501(c)(3) Line 10 Covenant Health Inc 0 Mount St Rita Health Centre 15 Sumner Brown Road Cumberland RI 02864 050342330 Nursing home RI 501(c)(3) Line 10 Covenant Health Inc 0 Neighborhood Housing Initiative PO Box 7291 Lewiston ME 04243 010539730 Affordable housing services ME 501(c)(3) Line 10 St Mary's Health System 0 Penacook Place Inc 150 Water Street Haverhill MA 01830 237090088 Nursing home MA 501(c)(3) Line 10 Covenant Health Inc 0 Souhegan Nursing Association 24 North River Road Milford NH 03055 020222795 Home health and hospice NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 1 St Joseph Ambulatory Care Inc 360 Broadway Bangor ME 04402 222480373 Physician practice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 St Andre Health Care 407 Pool Street Biddeford ME 04005 010342399 Nursing home and restorative facility ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Healthcare Foundation 360 Broadway Bangor ME 04402 222480149 Healthcare foundation ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Hospital 360 Broadway Bangor ME 04402 010212435 Hospital and health care facility ME 501(c)(3) Line 3 St Joseph Healthcare Foundation 0 St Joseph Manor Health Care 215 Thatcher Street Brockton MA 02302 042565937 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Mary's D'Youville Pavilion PO Box 7291 Lewiston ME 04243 010211558 Nursing home and restorative facility ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Health system PO Box 7291 Lewiston ME 04243 222504349 Hospital and health care facility ME 501(c)(3) Line 12a, I Covenant Health Inc 0 St Mary's Regional Medical Center PO Box 7291 Lewiston ME 04243 010211551 Hospital and health care facility ME 501(c)(3) Line 3 St Mary's Health System 0 St Mary's Residences PO Box 7291 Lewiston ME 04243 222504356 Low income housing ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Villa Nursing Home Inc 675 St Marys Villa Road Moscow PA 18444 232057177 Nursing home and restorative facility PA 501(c)(3) Line 10 Covenant Health Inc 0 The Surgicenter at St Joseph Hospital Inc 172 Kinsley Street Nashua NH 03061 020222215 Healthcare and surgery center NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 1 Youville Hospital and Rehabilitation Center Inc 1575 Cambridge Street Cambridge MA 02138 043239563 Hospital and health care facility MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville House Inc 1573 Cambridge Street Cambridge MA 02138 043239593 Assisted living services MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville Lifecare Inc 1575 Cambridge Street Cambridge MA 02138 042103582 Hospital and health care facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Youville Place 10 Pelham Road Lexington MA 02421 043297834 Assisted living services MA 501(c)(3) Line 10 Covenant Health Inc 0 Campus Holding PO Box 7291 Lewiston ME 04240 010406049 Holding company ME N/A C 0 Covenant Health Insurance LTD PO Box 69 Grand Cayman CJ KY1-1102 043360127 Self-insurance company CJ N/A C 0 First Choice PHO 172 Kinsley Street Nashua NH 03060 020461536 Physician hospital organization NH St Joseph Hospital of Nashua C 60962 762410 0.50000 1 GNM Corporation 172 Kinsley Street Nashua NH 03060 020400550 Real estate holding company NH N/A C 0 SJ Physicians Services 172 Kinsley Street Nashua NH 03060 020522234 Physician practice NH N/A C 0 St Joseph Hospital Corporate Services 172 Kinsley Street Nashua NH 030612013 020405197 Holding company NH St Joseph Hospital of Nashua C 2068285 28686760 1.00000 1 Strauss Incorporated 360 Broadway Bangor ME 04402 010391369 Repairs and transcriptions ME N/A C 0 0 0 0 1 1 0 0 0 0 0 1 0 0 1 1 1 0 0 0 GNM Corporation D 1000 Cash St Joseph Corporate Services E 15350000 Cash SJ Physicians Services E 6274000 Cash GNM Corporation K 1191000 Cash SJ Physicians Services P 3610000 Cash