CHESHIRE MEDICAL CENTER: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- CHESHIRE MEDICAL CENTER (EIN 02-0354549)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-05-13
- IRS object ID
- 202531339349302163
- Schema version
- 2023v6.0
- 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 H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-05-13T08:10:01+00:00 | ReturnTs |
| Tax Period End | 2024-06-30 | 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 | 4801 Olympia Park Plaza Suite 4000 | AddressLine1Txt |
| City | Louisville | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 402412098 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020354549 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cheshire Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHES | BusinessNameControlTxt |
| Phone | 6033545400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580 - 590 Court Street | AddressLine1Txt |
| City | Keene | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 034315400 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Ann Marie Coppo | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2025-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Scifres | PreparerPersonNm |
| PTIN | P01316095 | PTIN |
| Phone | 5023263996 | PhoneNum |
| Preparation | 2025-05-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joseph Perras | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580 - 590 Court Street | AddressLine1Txt |
| City | Keene | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 034315400 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $307,906,797 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.cheshiremed.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | TO LEAD OUR COMMUNITY TO OPTIMAL HEALTH AND WELLNESS THROUGH OUR CLINICAL AND SERVICE EXCELLENCE, COLLABORATION, AND COMPASSION FOR EVERY PATIENT, EVERY TIME. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1249 | TotalEmployeeCnt |
| Total Volunteers | 88 | TotalVolunteersCnt |
| Total Gross UBI | $450,503 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $56,196 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,005,336 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,679,183 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $253,756,281 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $293,860,323 | CYProgramServiceRevenueAmt |
| PY Investment Income | $209,419 | PYInvestmentIncomeAmt |
| CY Investment Income | $261,859 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,613,448 | PYOtherRevenueAmt |
| CY Other Revenue | $3,105,432 | CYOtherRevenueAmt |
| PY Total Revenue | $263,584,484 | PYTotalRevenueAmt |
| CY Total Revenue | $307,906,797 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $730,772 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $369,917 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $108,807,655 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $116,771,894 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $631,758 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $178,278,747 | PYOtherExpensesAmt |
| CY Other Expenses | $195,449,175 | CYOtherExpensesAmt |
| PY Total Expenses | $287,817,174 | PYTotalExpensesAmt |
| CY Total Expenses | $312,590,986 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$24,232,690 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,684,189 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $146,820,184 | TotalAssetsBOYAmt |
| Total Assets EOY | $161,863,854 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $93,638,347 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $86,247,654 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $53,181,837 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $75,616,200 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF CHESHIRE MEDICAL CENTER IS TO LEAD OUR COMMUNITY TO OPTIMAL HEALTH AND WELLNESS THROUGH OUR CLINICAL AND SERVICE EXCELLENCE, COLLABORATION, AND COMPASSION FOR EVERY PATIENT, EVERY TIME. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $280,597,429 | ExpenseAmt |
| Grant | $369,917 | GrantAmt |
| Revenue | $294,899,012 | RevenueAmt |
| Desc | CHESHIRE MEDICAL CENTER (CHESHIRE) IS A COMMUNITY HOSPITAL LOCATED IN KEENE, NEW HAMPSHIRE. CHESHIRE IS A NOT-FOR-PROFIT ORGANIZATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS A MEMBER OF THE DARTMOUTH HEALTH SYSTEM ("DH"), A NOT-FOR-PROFIT TAX-EXEMPT CORPORATION WITH A PRINCIPAL PLACE OF BUSINESS AT ONE MEDICAL CENTER DRIVE, LEBANON, NEW HAMPSHIRE. CONSISTENT WITH THE DH VISION AND STRATEGY TO CREATE A SUSTAINABLE HEALTH SYSTEM, CHESHIRE AND DH SHARE A COMMON COMMITMENT TO IMPROVING POPULATION HEALTH, VALUE-BASED CARE, AND CREATING NEW PAYMENT MODELS FOR THE BENEFIT OF THE CITIZENS OF NEW HAMPSHIRE AND VERMONT. CHESHIRE PROVIDES A BROAD RANGE OF PATIENT SERVICES AND HEALTH-RELATED COMMUNITY SERVICES, CONSISTENT WITH ITS ROLE AS A COMMUNITY HOSPITAL. THESE INCLUDE A FULL RANGE OF SERVICES IN BOTH ACUTE AND CRITICAL MEDICINE, SURGERY, AND REHABILITATION. DURING FY24, CHESHIRE PROVIDED 253,893 PROVIDER VISITS AND HAD 3,760 HOSPITAL ADMISSIONS AND DISCHARGES. THE EMERGENCY DEPARTMENT WAS OPEN TO THE PUBLIC 24 HOURS PER DAY, 7 DAYS PER WEEK AND HAD 25,410 ER PATIENT VISITS. THERE ARE A TOTAL OF 222 PROVIDERS CONSISTING OF 136 PHYSICIANS AND 86 ASSOCIATE PROVIDERS. EACH YEAR, CHESHIRE MEDICAL CENTER FILES AN ANNUAL COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW HAMPSHIRE WHICH OUTLINES THE COMMUNITY AND CHARITABLE BENEFITS CHESHIRE PROVIDES. THE MOST RECENT COMMUNITY BENEFIT REPORTS ARE AVAILABLE UPON REQUEST OR CAN BE FOUND ON CHESHIRE'S WEBSITE (https://www.cheshiremed.org/about/community-benefits-reporting). Currently, Cheshire's Community Benefit priorities involve improving healthcare access in rural communities, behavioral health supports, substance use disorder prevention and supports, and aging population services. Some examples of community benefit programs provided by Cheshire during FY24 to address the identified community needs include the hosting of a free "Teddy Bear" clinic for pediatric patients and their caregivers, providing local schools with a "Read-A-Marathon" program offering books to over 1,000 children with social emotional health topic focus, distribution of 36 NaloxBoxes and over 2,000 Narcan overdose reversal kits distributed in public facilities across the region, and facilitating a "Healthy Aging" community education series with offerings such as chair-based yoga and silver sneakers to help aging adults with physical activity. IN TOTAL, CHESHIRE PROVIDED more than $20 MILLION IN COMMUNITY BENEFITS INCLUDING UNREIMBURSED CHARITY CARE, HEALTH SERVICES, HEALTH PROFESSION EDUCATION, SUBSIDIZED HEALTH SERVICES, AND COMMUNITY-BUILDING ACTIVITIES. THESE CONTRIBUTIONS ARE IN ADDITION TO THE OVER $38 MILLION DOLLARS IN UNREIMBURSED MEDICARE COSTS ABSORBED BY CHESHIRE. | Desc |
| Total Program Service Expenses | $280,597,429 | 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 | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | 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 | false | 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 | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 188 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1249 | 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 | false | QuidProQuoContributionsInd |
| 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 | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Ann Marie Coppo | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6033545400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580-590 COURT STREET | AddressLine1Txt |
| City | KEENE | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 034315400 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 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 |
|---|---|---|---|---|---|---|---|---|---|
| Barbara Duckett | |||||||||
| Trustee/Secretary (through 1/24) | 0.5 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Joseph L Perras MD | |||||||||
| Trustee/CEO/President ex-officio (as of 8/7/23) | 40.0 | 1.5 | Yes (X) | Yes (X) | $0 | $620,829 | $33,818 | ||
| KATHRYN F WILLBARGER | |||||||||
| COO /Trustee and Interim CEO (through 8/6/23) | 40.0 | 1.0 | Yes (X) | Yes (X) | $380,067 | $0 | $34,064 | ||
| Les Pitts MD | |||||||||
| Trustee/Ex-Officio Med. Staff Pres | 0.5 | 40.5 | Yes (X) | Yes (X) | $0 | $292,890 | $71,646 | ||
| Mark Bodin | |||||||||
| Trustee / Treasurer | 0.5 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARK GAVIN | |||||||||
| TRUSTEE / Vice Chair (through12/31/23) / Chair (as of 1/1/24) | 1.0 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SUSAN ABERT | |||||||||
| TRUSTEE / Chair (through 12/31/23) | 1.0 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ANDREW G TREMBLAY MD | |||||||||
| TRUSTEE | 1.0 | 40.0 | Yes (X) | $0 | $311,879 | $66,511 | |||
| Cherie Holmes MD | |||||||||
| Trustee | 1.0 | 40.0 | Yes (X) | $0 | $454,795 | $50,799 | |||
| Daniel Smith | |||||||||
| Trustee / Vice Chair (as of 1/20/23) | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Elizabeth Cotter | |||||||||
| Trustee/Secretary (as of 1/24) | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| Gina OBrien MD | |||||||||
| Trustee (as of 1/20/23) | 0.5 | 40.0 | Yes (X) | $0 | $410,980 | $26,368 | |||
| Maria Padin MD | |||||||||
| TRUSTEE / CGP Chief Medical Officer | 1.0 | 41.0 | Yes (X) | $0 | $560,847 | $67,853 | |||
| Michael Chelstowski | |||||||||
| Trustee | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Michael Farhm | |||||||||
| Trustee | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Michael Waters | |||||||||
| Trustee / DH Treasurer | 0.5 | 40.0 | Yes (X) | $0 | $311,063 | $24,340 | |||
| Robert Palmer | |||||||||
| Trustee (as of 1/1/24) | 0 | Yes (X) | $0 | $0 | $0 | ||||
| Stephen Leblanc | |||||||||
| Trustee | 0.5 | 42.5 | Yes (X) | $0 | $918,361 | $66,015 | |||
| Susan Howard | |||||||||
| Trustee (through 1/31/24) | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Tim Ruehr | |||||||||
| Trustee (through 12/31/23) | 0.5 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Anne Tyrol | |||||||||
| Chief Nursing Officer | 40.0 | 0 | Yes (X) | $224,304 | $0 | $41,364 | |||
| AnnMarie Coppo | |||||||||
| Interim CFO (as of 5/3/24) | 40.0 | 0.5 | Yes (X) | $133,274 | $0 | $48,751 | |||
| Daniel Gross | |||||||||
| Chief Financial Officer (through 5/2/24) | 40.0 | 1.5 | Yes (X) | $290,020 | $0 | $44,904 | |||
| ERLI CHEN | |||||||||
| PHYSICiST | 40.0 | 0 | $259,554 | $0 | $41,630 | Yes (X) | |||
| Kevin Forrest | |||||||||
| VP Facilities & Support Services | 40.0 | 0 | $170,156 | $0 | $13,855 | Yes (X) | |||
| Lisa Hanamoto | |||||||||
| RN Baylor-WN-IP/PRCD | 40.0 | 0 | $162,732 | $0 | $22,641 | Yes (X) | |||
| Matthew Borden | |||||||||
| Pharmacist | 40.0 | 0 | $179,218 | $0 | $11,940 | Yes (X) | |||
| SANDRA M PHIPPS | |||||||||
| VP PHILANTHROPY/COMM RELATIONS | 40.0 | 0.5 | $165,844 | $0 | $30,679 | Yes (X) | |||
| David Quigley | |||||||||
| Former Key / VP - Clinical Operations (through 3/7/23) | 0.0 | 40.0 | $0 | $162,207 | $6,458 | Yes (X) | |||
| DON CARUSO MD | |||||||||
| FORMER CEO/PRESIDENT | 1.0 | 41.0 | $0 | $229,871 | $19,018 | Yes (X) | |||
| JENNIFER L DINUBILA DO | |||||||||
| Former Med Staff Pres. | 0.0 | 40.0 | $0 | $395,755 | $54,444 | Yes (X) | |||
| Michael Ormont MD | |||||||||
| Former Medical Staff Pres. | 0.0 | 40.0 | $0 | $370,461 | $38,006 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,965,169 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,039,938 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $815,104 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 97 | 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 | Address Line2ContractorAddress/USAddress/AddressLine2Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| Prolucent Health inc | ||||||
| 10000 N Central Expressway | Suite 400 | Dallas | TX | 75231 | Workforce Services | $8,109,410 |
| CONIFER REVENUE CYCLE SOLUTIONS | ||||||
| PO BOX 655025 | DALLAS | TX | 752655025 | Revenue Management | $6,539,839 | |
| Walsh Brothers Incorporated | ||||||
| 210 Commerical Street | Boston | MA | 02109 | Construction Services | $5,039,383 | |
| Fastaff LLC | ||||||
| PO Box 911452 | Denver | CO | 802911452 | Workforce Services | $3,485,661 | |
| MARY HITCHCOCK MEMORIAL HOSPITAL | ||||||
| One Medical Center Dr | Lebanon | NH | 03756 | Health Services | $2,531,057 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 34 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,658,122 | RelatedOrganizationsAmt |
| Government Grants | $4,462,495 | GovernmentGrantsAmt |
| All Other Contributions | $558,566 | AllOtherContributionsAmt |
| Total Contributions | $10,679,183 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622110 | $275,434,182 | $275,434,182 | |
| PHARMACY REVENUE | 446110 | $18,408,039 | $18,040,538 | $367,501 |
| Laboratory Services | 621500 | $18,102 | $18,102 |
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 | $293,860,323 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $261,859 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $64,900 | UnrelatedBusinessRevenueAmt |
| Exclusion | $196,959 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,362 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,362 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,362 | TotalRevenueColumnAmt |
| Exclusion | $11,362 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Food Services | 722514 | $1,006,077 | $1,006,077 | |
| Childcare Revenue | 624410 | $663,701 | $663,701 | |
| Rebates and Discounts | 622110 | $501,528 | $501,528 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $922,764 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $922,764 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,094,070 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $307,906,797 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $294,899,012 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $450,503 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,878,099 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,588 | TotalAmt |
| Program Services | $198,588 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,329 | TotalAmt |
| Program Services | $171,329 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,311,917 | TotalAmt |
| Program Services | $53,789 | ProgramServicesAmt |
| Management And General | $1,240,526 | ManagementAndGeneralAmt |
| Fundraising | $17,602 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,037,011 | TotalAmt |
| Program Services | $71,909,325 | ProgramServicesAmt |
| Management And General | $6,829,595 | ManagementAndGeneralAmt |
| Fundraising | $298,091 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,522,581 | TotalAmt |
| Program Services | $5,024,545 | ProgramServicesAmt |
| Management And General | $477,207 | ManagementAndGeneralAmt |
| Fundraising | $20,829 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,384,493 | TotalAmt |
| Program Services | $24,005,097 | ProgramServicesAmt |
| Management And General | $2,279,886 | ManagementAndGeneralAmt |
| Fundraising | $99,510 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,515,892 | TotalAmt |
| Program Services | $4,108,641 | ProgramServicesAmt |
| Management And General | $390,219 | ManagementAndGeneralAmt |
| Fundraising | $17,032 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,070 | TotalAmt |
| Program Services | $149,070 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,475 | TotalAmt |
| Management And General | $11,475 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,459 | TotalAmt |
| Program Services | $49,459 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,063,906 | TotalAmt |
| Program Services | $90,736,997 | ProgramServicesAmt |
| Management And General | $2,225,440 | ManagementAndGeneralAmt |
| Fundraising | $101,469 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,614 | TotalAmt |
| Program Services | $146,614 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,421,067 | TotalAmt |
| Program Services | $1,307,572 | ProgramServicesAmt |
| Management And General | $104,580 | ManagementAndGeneralAmt |
| Fundraising | $8,915 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,089 | TotalAmt |
| Program Services | $341,153 | ProgramServicesAmt |
| Fundraising | $20,936 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,030,735 | TotalAmt |
| Program Services | $1,579,516 | ProgramServicesAmt |
| Management And General | $5,451,219 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,464 | TotalAmt |
| Program Services | $197,110 | ProgramServicesAmt |
| Management And General | $25,850 | ManagementAndGeneralAmt |
| Fundraising | $504 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,112 | TotalAmt |
| Program Services | $19,112 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,716,679 | TotalAmt |
| Program Services | $1,716,679 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,654,321 | TotalAmt |
| Program Services | $3,592,883 | ProgramServicesAmt |
| Management And General | $6,061,438 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,081,371 | TotalAmt |
| Program Services | $1,382,963 | ProgramServicesAmt |
| Management And General | $1,698,408 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $54,715,700 | $54,715,700 | |
| MEDICAID ENHANCEMENT & PILOT TAXES | $10,045,252 | $10,045,252 | |
| Shared Services - Related Party | $4,882,401 | $3,751,711 | $1,130,690 |
| EQUIPMENT RENTAL AND MAINTENANCE | $4,860,983 | $3,110,522 | $1,750,461 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,015,477 | TotalAmt |
| Program Services | $2,283,802 | ProgramServicesAmt |
| Management And General | $1,684,805 | ManagementAndGeneralAmt |
| Fundraising | $46,870 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $312,590,986 | TotalAmt |
| Program Services | $280,597,429 | ProgramServicesAmt |
| Management And General | $31,361,799 | ManagementAndGeneralAmt |
| Fundraising | $631,758 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,078,490 | BOYAmt |
| EOY | $15,605,587 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $248 | BOYAmt |
| EOY | $248 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,489,115 | BOYAmt |
| EOY | $16,513,441 | 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 |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,818,437 | BOYAmt |
| EOY | $4,904,983 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $965,562 | BOYAmt |
| EOY | $1,076,029 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $276,054,454 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $207,984,995 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,063,264 | BOYAmt |
| EOY | $68,069,459 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,779,211 | BOYAmt |
| EOY | $27,699,843 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,625,857 | BOYAmt |
| EOY | $27,994,264 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,820,184 | BOYAmt |
| EOY | $161,863,854 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,793,861 | BOYAmt |
| EOY | $17,484,959 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,453,584 | BOYAmt |
| EOY | $3,118,884 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,821,546 | BOYAmt |
| EOY | $20,886,037 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,569,356 | BOYAmt |
| EOY | $44,757,774 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,638,347 | BOYAmt |
| EOY | $86,247,654 | 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 | $34,388,347 | BOYAmt |
| EOY | $40,224,026 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,793,490 | BOYAmt |
| EOY | $35,392,174 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,181,837 | BOYAmt |
| EOY | $75,616,200 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,820,184 | BOYAmt |
| EOY | $161,863,854 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,684,189 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,921,558 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $24,196,994 | 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 | $49,459 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $49,459 | 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 | CHESHIRE MEDICAL CENTER PAYS DUES TO VARIOUS ORGANIZATIONS RELATED TO ITS EXEMPT MISSION AND A THIRD PARTY REPRESENTING THE RURAL HOSPITAL COALITION. THE AMOUNT REPORTED UNDER OTHER ACTIVITIES ON LINE 1i REFERS TO THE AMOUNT OF LOBBYING ACTIVITIES IDENTIFIED IN DUES TO OUTSIDE ORGANIZATIONS ALONG WITH THE THIRD PARTY REPRESENTATIVE. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $218,161 | OtherCostOrOtherBasisAmt |
| Book Value | $218,161 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $82,799,225 | OtherCostOrOtherBasisAmt |
| Depreciation | $60,765,754 | DepreciationAmt |
| Book Value | $22,033,471 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $37,647,700 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,451,531 | DepreciationAmt |
| Book Value | $22,196,169 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $155,389,368 | OtherCostOrOtherBasisAmt |
| Depreciation | $131,767,710 | DepreciationAmt |
| Book Value | $23,621,658 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $68,069,459 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Investment in Pooled Fund | Desc |
| Book Value | $27,699,843 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $27,699,843 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from Affiliate | $25,868,943 |
| Deferred 457(b) Plan Assets | $477,026 |
| Other Assets | $1,648,295 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $27,994,264 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| PENSION LIABILITY | |
| DUE TO RELATED PARTY | $37,970,360 |
| RESERVES FOR ESTIMATED 3RD PARTY SETTLEMENTS | $6,402,837 |
| Right of Use Lease Obligations | $384,577 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $44,757,774 | TotalLiabilityAmt |
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 | $2,397,129 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,397,129 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0077 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,710,620 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,361,457 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,349,163 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0331 | 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 | $34,107,749 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,361,457 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,746,292 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0408 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $79,269 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $79,269 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0003 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,453,779 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $251,842 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,201,937 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0166 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,871,470 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,689 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,861,781 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0060 | 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) |
|---|---|---|
| Total Community Benefit Expns | $242,460 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $192,460 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0006 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $7,646,978 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $311,531 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,335,447 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0235 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $41,754,727 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,672,988 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,081,739 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0642 | 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) |
|---|---|---|
| Total Community Benefit Expns | $849,467 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,300 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $818,167 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0026 | 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) |
|---|---|---|
| Total Community Benefit Expns | $650,638 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $650,638 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0021 | 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 | $1,500,105 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,300 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,468,805 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0047 | 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 | $97,148,014 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $135,647,146 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$38,499,132 | 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 | CHESHIRE MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580 COURT STREET | AddressLine1Txt |
| City | KEENE | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03431 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.cheshiremed.org | WebsiteAddressTxt |
| State License | 00014 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | IN-PATIENT REHAB | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHESHIRE MEDICAL CENTER | 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 | 22 | 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.cheshiremed.org/about/community-benefits-reporting | 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 | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.cheshiremed.org/about/community-benefits-reporting | 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.dartmouth-hitchcock.org/patients-visitors/financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance | 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 WHICH ARE IDENTIFIED THROUGH CHNA. |
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - CHESHIRE MEDICAL CENTER. The hospital took into account a cross-section of community members through an RDD telephone survey conducted by the UNH Survey Center that was analyzed by age, education, income, etc. The Council for a Healthier Community is a group, established in 1995, that includes community leaders representing local and county government, business, education sector, social service agencies, health care and public health organizations, faith-based groups and non-profit organizations providing childcare, mental health and substance abuse prevention. The hospital worked with the Council for a Healthier Community to determine the priorities from our community health needs assessment. Key people involved include: Tim Murphy (Southwest Regional Planning Commission); Ellen Avery (Community Volunteer Transportation Co.); Chris Coates (Greater Monadnock Public Health Advisory Council); Phil Wyzik (Monadnock Family Services); Phil Suter (Greater Keene Chamber of Commerce); NH State Senator Jay Kahn; George Tremblay (Antioch University); Liz LaRose (Monadnock United Way); and others. |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - CHESHIRE MEDICAL CENTER. THE CHESHIRE MEDICAL CENTER COLLABORATED WITH MONADNOCK COMMUNITY HOSPITAL ALLOWING US TO COMPARE COMMUNITY NEEDS AGAINST A MULTI-HOSPITAL REGION. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - CHESHIRE MEDICAL CENTER. THE CHESHIRE MEDICAL CENTER COLLABORATED WITH THE NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES; GREATER MONADNOCK PUBLIC HEALTH NETWORK; THE NEW HAMPSHIRE HOSPITAL ASSOCIATION; FOUNDATION FOR HEALTHY COMMUNITIES; ANTIOCH UNIVERSITY NEW ENGLAND; AND SOUTHWESTERN REGIONAL PLANNING COMMISSION. THESE ORGANIZATIONS HELPED TO DISSEMINATE SURVEYS, SERVE AS KEY INFORMANTS, AND TO PROVIDE OVERALL ANALYSIS, REVIEW, AND FEEDBACK. |
| Schedule H, Part V, Section B, Line 7 Facility , 1 | Facility , 1 - CHESHIRE MEDICAL CENTER. THE NEEDS ASSESSMENT WAS DISTRIBUTED TO NON-PROFIT ORGANIZATIONS THROUGHOUT THE REGION. IT IS ALSO AVAILABLE FROM THE ORGANIZATION UPON REQUEST AND IS POSTED ON THE CMC WEBSITE. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - CHESHIRE MEDICAL CENTER. THE CHESHIRE MEDICAL CENTER IS INCREASING AND SUSTAINING REGIONAL PARTNERSHIPS TO ADDRESS IDENTIFIED COMMUNITY NEEDS BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2022. THESE NEEDS ARE IN THE AREAS OF BEHAVIORAL HEALTH, SUBSTANCE AND ALCOHOL MISUSE, TOBACCO USE, OBESITY, AND EMERGENCY PREPAREDNESS. IN FY 2023, THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT STRATEGIES WERE CONSISTENT WITH THE INTENTIONS IDENTIFIED IN THE FY 2022 COMMUNITY HEALTH IMPROVEMENT PLAN. 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 HOSPITAL'S AFFILIATION WITH DARTMOUTH HEALTH HAS ALSO PROVIDED SUPPORT FOR THE IDENTIFIED COMMUNITY-BASED NEEDS. THE CHESHIRE MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY IS A 3-YEAR DOCUMENT IDENTIFYING ANTICIPATED INVESTMENTS AND ACTIVITIES THAT IT WILL TAKE TO ADDRESS NEEDS IDENTIFIED IN THE MONADNOCK REGION OF NEW HAMPSHIRE. MULTIPLE DEPARTMENTS WITHIN CHESHIRE MEDICAL CENTER ALIGN THEIR EFFORTS TO BEST MEET KNOWN COMMUNITIES NEEDS SUCH AS ACCESS TO TRANSPORTATION AND FOOD ACCESS. WE SUPPORT COMMUNITY PARTNERS SUCH AS MONADNOCK ALLIANCE FOR SUSTAINABLE TRANSPORTATION AND THE COMMUNITY VOLUNTEER TRANSPORTATION COMPANY TO SUPPORT REGIONAL ACCESS TO HEALTHCARE AND OTHER COMMUNITY SUPPORTS SUCH AS THE GROCERY STORE AND PHARMACY. CHESHIRE SUPPORTS MULTIPLE COMMUNITY WORK GROUPS THAT ARE LED BY COMMUNITY ORGANIZATIONS TO CONTINUE TO ADVANCE HEALTH OUTCOMES IN THE MONADNOCK REGION. MANY PARTNERSHIPS WERE CREATED AND DEEPENED THROUGH THE REGIONAL PANDEMIC RESPONSE THAT HAS NOW TRANSITIONED TO MEETING OTHER COMMUNITY NEEDS, SUCH AS BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER CONTINUUM OF CARE. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - Cheshire Medical Center. 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 CMC. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - Cheshire Medical Center. CMC 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 - Cheshire Medical Center. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON CMC'S WEBSITE, INCLUDING THE VERBATIM POLICY AND A SHORTER, MORE PATIENT-FRIENDLY PLAIN-LANGUAGE SUMMARY. CMC PROVIDES THE PLAIN-LANGUAGE SUMMARY BROCHURE TO ALL INPATIENTS, EMERGENCY DEPARTMENT INTAKES, UNINSURED, AND SELF-PAY INDIVIDUALS. CMC CONTINUES TO NOTIFY PATIENTS ON THE BACK OF THE BILLING STATEMENT ABOUT FINANCIAL ASSISTANCE AVAILABLE TO THEM. ADDITIONALLY, CMC 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. CMC SCREENS 100% OF UNINSURED INPATIENT AND SAME-DAY PATIENTS PRIOR TO ADMISSION. AS PART OF THIS PROCESS, CMC 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 | CHESHIRE MEDICAL CENTER COLLECTING STATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580-590 COURT STREET | AddressLine1Txt |
| City | KEENE | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03431 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | COLLECTING STATION | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7g Subsidized Health Services | The amount on line 7g, column c, 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, 7g, and 7i are based on actual costs. |
| Schedule H, Part II Community Building Activities | The Center for Population Health at Cheshire Medical Center is the state-designated coalition building entity for the Monadnock Regional Public Health Network, which brings together organizations and individuals from around the region to promote and provide for the public health in lieu of a local governmental public health department model. Cheshire Medical Center receives some grant dollars through the New Hampshire Department of Health and Human Services to provide local public health service organization and oversight. However, Cheshire is committed to the health and wellbeing of its region and commits additional community benefit support beyond what the grant is able to financially reimburse, providing additional funding for expert staff support, direct public health programming, and community organizing around public health initiatives. The Regional Public Health Network coalition, known as the Healthy Monadnock Alliance, is driven by a shared set of priority areas identified through community health needs assessment. Currently the priority areas around which coalition members unite concern improving access to healthcare, food access, active living, substance use prevention and supports for youth, emergency preparedness, and behavioral health for community members. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | AS A RESULT OF NEW 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 no longer 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 | THE CHESHIRE MEDICAL CENTER IS INCLUDED IN THE DARTMOUTH-HITCHCOCK HEALTH AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS. AS A RESULT OF ACCOUNTING CHANGES (ASC 606), BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED 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 COMPLETED ACCORDING TO GUIDANCE PROVIDED BY THE INTERNAL REVENUE SERVICE. THE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THE CHESHIRE MEDICAL CENTER IS THE ONLY HOSPITAL/MEDICAL CENTER IN CHESHIRE COUNTY, NEW HAMPSHIRE AND IS DESIGNATED BY CMS AS A MEDICARE DEPENDENT HOSPITAL (MDH) DUE TO GREATER THAN HALF OF OUR AVERAGE DAILY CENSUS BEING COMPRISED OF MEDICARE PATIENTS. OUR PRESENCE IN THE COMMUNITY ALLOWS THE RESIDENTS OF CHESHIRE COUNTY, ESPECIALLY THE ELDERLY POPULATION, TO RECEIVE COMPREHENSIVE HOSPITAL AND MEDICAL SERVICES CLOSE TO HOME. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | CHESHIRE MEDICAL CENTER 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 | - CHESHIRE MEDICAL CENTER: Line 16a URL: https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - CHESHIRE MEDICAL CENTER: Line 16b URL: https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - CHESHIRE MEDICAL CENTER: Line 16c URL: https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance; |
| Schedule H, Part VI, Line 2 Needs assessment | IN ADDITON 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 PARTICPATES 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 & VT 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 CHESHIRE MEDICAL CENTER IS COMMITTED TO PROVIDING MEDICALLY NECESSARY CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. ALL UNINSURED INPATIENTS, SAME DAY SURGERY, OBSERVATION, AND EMERGENCY DEPARTMENT PATIENTS ARE PRO-ACTIVELY SCREENED USING PAPER AND/OR AN AUTOMATED TOOL TO IDENTIFY POTENTIAL QUALIFICATION FOR OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. IN ADDITION, SPECIFIC OUTPATIENT ACTIVITIES DEEMED TO HAVE A HIGHER RATE OF NEED ARE SCREENED AS PART OF REGULAR PROTOCOL. IF A PATIENT APPEARS TO BE ELIGIBLE, ON-SITE FINANCIAL COUNSELORS ASSIST THE PATIENT IN COMPLETING THE APPROPRIATE PAPERWORK/APPLICATIONS AND PROVIDE INSTRUCTION REGARDING HOW TO COMPLETE THE QUALIFICATION PROCESS. IN SOME CASES A FINANCIAL COUNSELOR WILL ACT ON BEHALF OF THE PATIENT, AT THEIR SIGNED CONSENT, IN ORDER TO COMPLETE THE APPLICATION PROCESS (FOR EXAMPLE, IN NEW HAMPSHIRE A PATIENT MUST BE PHYSICALLY PRESENT AT THE DISTRICT OFFICE). IF A PATIENT DOESN'T QUALIFY FOR SPECIFIC PROGRAMS, THEY ARE ALSO CONSIDERED FOR FINANCIAL ASSISTANCE AS PART OF THEIR SCREENING. FOR OUTPATIENT SERVICES THAT ARE NOT ROUTINELY SCREENED, STAFF INTERACTING WITH PATIENTS ARE INSTRUCTED TO PROVIDE EITHER A FINANCIAL ASSISTANCE APPLICATION OR CONTACT INFORMATION FOR A FINANCIAL COUNSELOR WHEN A PATIENT EXPRESSES THEIR INABILITY TO MAKE PAYMENT. EVERY APPLICATION IS SCREENED FOR COMPLETED INCOME AND ASSET DOCUMENTATION. APPLICATIONS ARE ALSO SCREENED TO ASSURE THERE ARE NO OTHER POTENTIAL OPTIONS OF FEDERAL, STATE, OR LOCAL PROGRAMS. THE WEBSITE, PATIENT STATEMENTS, AND FINANCIAL BROCHURES ALL INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE AND HOW TO APPLY. |
| Schedule H, Part VI, Line 4 Community information | Geography: Cheshire Medical Center serves Cheshire County in the southwestern corner of New Hampshire. The county is comprised of 22 towns and 1 city, ranging in population from a few hundred to several thousand, and the county seat is the city of Keene where Cheshire Medical Center's main campus is located. Cheshire County is designated as a rural county with a low-density population, as more than two thirds of people (69%) reside in a rural area. General Population: The latest population estimates put a total county population of 77,703 residents. The county is an aging one, with more than 1 in 5 residents (23%) age 65 or older. There are around 14,000 children under the age of 18 residing in the county, or 18% of the overall population. Most community members identify as non-Hispanic white (93%), with English being the predominantly spoken language (95%). Socioeconomic Factors: The median household income is around $69,000 annually. Most adult residents over the age of 25 have completed high school (94%), and two thirds of residents have completed some college education (68%). 70% of households own their home. 1 in 4 residents age 16-64 are unemployed (26%). 1 out of 10 residents lives in poverty (10%), and the same proportion of residents are experiencing food insecurity (11%), with 1 in 10 children living in poverty and 15% living in single parent homes. 7% of the adult population is not covered by any type of health insurance, while only 4% of children are uninsured. Population Health Epidemiology: The average life expectancy of Cheshire County residents is 78 years, on par with the state average. 15% of the adult population report being in poor or fair health overall, experiencing on average 4 days a month of poor physical health and 5 days a month of poor mental health. 1 in 3 adults are obese (31%), and 1 in 5 residents report having little to no regular physical activity (20%). |
| Schedule H, Part VI, Line 5 Promotion of community health | CHESHIRE MEDICAL CENTER (CMC) PLAYS AN ACTIVE ROLE IN PROMOTING COMMUNITY HEALTH AND OFFERS EDUCATIONAL PROGRAMS INCLUDING CLASSES AND WORKSHOPS. CMC (IN PARTNERSHIP WITH DARTMOUTH HEALTH) OFFERS A VARIETY OF HEALTH PROMOTION, EDUCATIONAL PROGRAMS, AND DIRECT SERVICES FOR THE COMMUNITY SPANNING A BROAD SPECTRUM OF HEALTH AND WELLNESS TOPICS. OUR CLINICAL STAFF WORKS CLOSELY WITH THE STAFF OF THE CENTER FOR POPULATION HEALTH TO DEVELOP PROGRAMS THAT COVER EMERGING HEALTH CONCERNS AND ARE DELIVERED AT THE RIGHT LITERACY LEVEL FOR OUR COMMUNITY. THE PROGRAMS OFFERED INCLUDE A VARIETY OF CHRONIC DISEASE AND WELLNESS TOPICS SUCH AS: STRESS MANAGEMENT AND RESILIENCY, NUTRITION, PHYSICAL EDUCATION AND EXERCISE, HIGH BLOOD PRESSURE PREVENTION AND MONITORING, DIABETES PREVENTION AND MONITORING, ADVANCED DIRECTIVE PLANNING, MEMORY LOSS, TOBACCO CESSATION AND WRITING AS A TOOL TO MANAGE STRESS. ALL PROGRAMS ARE OFFERED FREE OF CHARGE AND OPEN TO ANYONE INTERESTED. IN ADDITION, CMC SUPPORTS SEVERAL COMMUNITY PROGRAMS INCLUDING CHESHIRE SMILES, A SCHOOL-BASED DENTAL HEALTH PROGRAM FOR CHILDREN IN GRADES K-3, WHICH PROVIDES SCREENING, PREVENTION AND RESTORATIVE DENTAL CARE FOR CHILDREN IN CHESHIRE COUNTY SCHOOLS. CHESHIRE MEDICAL CENTER ALSO WORKS IN PARTNERSHIP WITH OTHER COMMUNITY HEALTH AND HUMAN SERVICE ORGANIZATIONS TO MEET THE DENTAL HEALTH NEEDS OF UNDERSERVED POPULATIONS SUCH AS THE CHRONICALLY MENTALLY ILL, PREGNANT WOMEN WHO CANNOT AFFORD DENTAL CARE, CHILDREN IDENTIFIED THROUGH THE SCHOOL-BASED CHESHIRE SMILES PROGRAM, AND OTHERS. OTHER INITIATIVES INCLUDE HOSTING OR LEADING COMMUNITY PARTNERSHIPS TO ADDRESS SUBSTANCE MISUSE AND TREATMENT AND TO IMPROVE PUBLIC HEALTH; AND PARTICIPATION OF OUR STAFF IN OTHER PARTNERSHIPS SUCH AS THE FOUNDATION FOR HEALTHY COMMUNITIES AND THE CHESHIRE COALITION FOR TOBACCO-FREE COMMUNITIES. IN ADDITION, THE HOSPITAL OPERATES HEALTH EDUCATION AND OTHER SUPPORT SERVICES SUCH AS ADVANCE CARE PLANNING, SENIOR PASSPORT, AND VARIOUS HEALTH AND WELLNESS PROGRAMS. 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. CHESHIRE MEDICAL CENTER ALSO SUPPORTS HEALTH PROFESSIONALS' EDUCATION THROUGH TRAININGS AND CERTIFICATIONS FOR DIFFERENT MEDICAL LICENSES SUCH AS LPN, MA, RN, JUST TO NAME A FEW. WE ARE ALSO IN THE BEGINNING STAGES OF STARTING A FAMILY MEDICINE RESIDENCY PROGRAM THAT WILL WELCOME ITS FIRST CLASS OF RESIDENTS IN 2024 TO INCREASE ACCESS TO HEALTHCARE IN THE MONADNOCK REGION. WE ARE COMMITTED TO CONTINUING TO ENGAGE WITH OUR COMMUNITY AND SUPPORT ADVANCING THE HEALTH AND WELLBEING OF OUR REGION. FOR MORE STORIES INCLUDING ADDITIONAL EXAMPLES OF COMMUNITY BENEFIT ACTIVITIES PLEASE VISIT: Annual Reports to the Community | About | Cheshire Medical Center. CMC EXTENDS PROFESSIONAL STAFF PRIVILEGES TO QUALIFIED AND APPROPRIATE PHYSICIANS WHO ARE EMPLOYEES OF DARTMOUTH HITCHCOCK CLINIC, MARY HITCHCOCK MEMORIAL HOSPITAL, AND DARTMOUTH COLLEGE, WHO ALSO HOLD A FACULTY APPOINTMENT AT GEISEL SCHOOL OF MEDICINE. OF THE 18 VOTING MEMBERS OF THE CHESHIRE MEDICAL CENTER BOARD OF TRUSTEES AT THE END OF THE FISCAL YEAR, 10 ARE NEITHER CONTRACTORS NOR EMPLOYEES OF THE HOSPITAL OR ITS AFFILIATES. The majority of Cheshire Medical Center's volunteer Board of Trustees, the governing body of the organization, represents a broad range of interests which exist in the communities it serves. In particular the trustees, who are neither employees nor independent contractors (nor family members thereof) of the Cheshire Medical Center, 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 | ALIGNING OF PATIENT CARE BETWEEN THE TWO HEALTHCARE SYSTEMS AND STRENGTHENS THE CENTER AS A REGIONAL RESOURCE FOR SOUTHWESTERN NEW HAMPSHIRE AND SOUTHEASTERN VERMONT. 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 CHESHIRE MEDICAL CENTER TO CONTINUE ITS LEADERSHIP ROLE IN POPULATION HEALTH AND THE HEALTHY MONADNOCK 2020 INITIATIVE. CHESHIRE MEDICAL HAS A MULTI-SPECIALTY GROUP PRACTICE THAT COMPRISES THE MAJORITY OF CHESHIRE MEDICAL CENTER'S MEDICAL STAFF AND WITH THE AFFILIATION, IT ENABLES BOTH ORGANIZATIONS TO MORE EFFECTIVELY PURSUE A COMMON VISION 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 CHESHIRE MEDICAL CENTER AND THE DARTMOUTH-HITCHCOCK HEALTH, THE AFFILIATED HEALTH CARE SYSTEM INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL, DARTMOUTH-HITCHCOCK CLINIC, THE NEW LONDON HOSPITAL ASSOCIATION, 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 CHESHIRE MEDICAL CENTER AND OTHER MEMBERS OF THE AFFILIATED HEALTH CARE SYSTEM OPERATE JOINTLY THROUGH INTERLOCKING DIRECTORATES, STRATEGIC PLANNING, MANAGEMENT, AND 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 (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| Foundation for Healthy Communities | ||||||||
| 125 Airport Rd | Concord | NH | 03301 | 020275078 | 501(c)(3) | $188,588 | Book | Program Support |
| Dental Health Works | ||||||||
| 69V Island Street | Keene | NH | 03431 | 300275867 | 501(c)(3) | $10,000 | Book | Program Support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc |
|---|---|---|---|
| Patient and family support/assistance | 88 | $10,652 | Book |
| Nursing and healthcare scholarships | 39 | $160,677 | Book |
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 | ALL GRANTS AND ASSISTANCE ARE PAID TO 501(C)(3) ORGANIZATIONS OR GOVERNMENTAL ENTITIES. | 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 (21 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DON CARUSO MD | ||||||||||||||
| FORMER CEO/PRESIDENT | $0 | $185,732 | $0 | $0 | $0 | $44,139 | $0 | $16,578 | $0 | $2,440 | $0 | $248,889 | $0 | $0 |
| JENNIFER L DINUBILA DO | ||||||||||||||
| Former Med Staff Pres. | $0 | $370,962 | $0 | $0 | $0 | $24,793 | $0 | $24,990 | $0 | $29,454 | $0 | $450,199 | $0 | $0 |
| Michael Ormont MD | ||||||||||||||
| Former Medical Staff Pres. | $0 | $308,001 | $0 | $0 | $0 | $62,460 | $0 | $31,590 | $0 | $6,416 | $0 | $408,467 | $0 | $0 |
| Les Pitts MD | ||||||||||||||
| Trustee/Ex-Officio Med. Staff Pres | $0 | $292,116 | $0 | $0 | $0 | $774 | $0 | $28,590 | $0 | $43,056 | $0 | $364,536 | $0 | $0 |
| KATHRYN F WILLBARGER | ||||||||||||||
| COO /Trustee and Interim CEO (through 8/6/23) | $354,376 | $0 | $7,570 | $0 | $18,121 | $0 | $31,590 | $0 | $2,474 | $0 | $414,131 | $0 | $0 | $0 |
| Joseph L Perras MD | ||||||||||||||
| Trustee/CEO/President ex-officio (as of 8/7/23) | $0 | $448,299 | $0 | $128,661 | $0 | $43,869 | $0 | $29,445 | $0 | $4,373 | $0 | $654,647 | $0 | $0 |
| Cherie Holmes MD | ||||||||||||||
| Trustee | $0 | $401,569 | $0 | $11,229 | $0 | $41,997 | $0 | $31,590 | $0 | $19,209 | $0 | $505,594 | $0 | $0 |
| Stephen Leblanc | ||||||||||||||
| Trustee | $0 | $686,348 | $0 | $122,500 | $0 | $109,513 | $0 | $31,590 | $0 | $34,425 | $0 | $984,376 | $0 | $0 |
| Maria Padin MD | ||||||||||||||
| TRUSTEE / CGP Chief Medical Officer | $0 | $484,606 | $0 | $35,700 | $0 | $40,541 | $0 | $31,590 | $0 | $36,263 | $0 | $628,700 | $0 | $0 |
| ANDREW G TREMBLAY MD | ||||||||||||||
| TRUSTEE | $0 | $309,966 | $0 | $0 | $0 | $1,913 | $0 | $30,132 | $0 | $36,379 | $0 | $378,390 | $0 | $0 |
| Michael Waters | ||||||||||||||
| Trustee / DH Treasurer | $0 | $285,002 | $0 | $19,950 | $0 | $6,111 | $0 | $23,033 | $0 | $1,307 | $0 | $335,403 | $0 | $0 |
| Gina OBrien MD | ||||||||||||||
| Trustee (as of 1/20/23) | $0 | $410,314 | $0 | $0 | $0 | $666 | $0 | $19,800 | $0 | $6,568 | $0 | $437,348 | $0 | $0 |
| Daniel Gross | ||||||||||||||
| Chief Financial Officer (through 5/2/24) | $281,572 | $0 | $7,260 | $0 | $1,188 | $0 | $17,854 | $0 | $27,050 | $0 | $334,924 | $0 | $0 | $0 |
| Anne Tyrol | ||||||||||||||
| Chief Nursing Officer | $218,284 | $0 | $5,750 | $0 | $270 | $0 | $14,145 | $0 | $27,219 | $0 | $265,668 | $0 | $0 | $0 |
| AnnMarie Coppo | ||||||||||||||
| Interim CFO (as of 5/3/24) | $127,213 | $0 | $355 | $0 | $5,706 | $0 | $9,965 | $0 | $38,786 | $0 | $182,025 | $0 | $0 | $0 |
| David Quigley | ||||||||||||||
| Former Key / VP - Clinical Operations (through 3/7/23) | $0 | $81,464 | $0 | $0 | $0 | $80,743 | $0 | $5,751 | $0 | $707 | $0 | $168,665 | $0 | $0 |
| ERLI CHEN | ||||||||||||||
| PHYSICiST | $239,412 | $0 | $0 | $0 | $20,142 | $0 | $23,832 | $0 | $17,798 | $0 | $301,184 | $0 | $0 | $0 |
| SANDRA M PHIPPS | ||||||||||||||
| VP PHILANTHROPY/COMM RELATIONS | $164,870 | $0 | $0 | $0 | $974 | $0 | $12,669 | $0 | $18,010 | $0 | $196,523 | $0 | $0 | $0 |
| Kevin Forrest | ||||||||||||||
| VP Facilities & Support Services | $157,425 | $0 | $0 | $0 | $12,731 | $0 | $12,408 | $0 | $1,447 | $0 | $184,011 | $0 | $0 | $0 |
| Matthew Borden | ||||||||||||||
| Pharmacist | $174,078 | $0 | $5,000 | $0 | $140 | $0 | $11,064 | $0 | $876 | $0 | $191,158 | $0 | $0 | $0 |
| Lisa Hanamoto | ||||||||||||||
| RN Baylor-WN-IP/PRCD | $161,555 | $0 | $0 | $0 | $1,177 | $0 | $11,064 | $0 | $11,577 | $0 | $185,373 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 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 PAID BY DARTMOUTH-HITCHCOCK CLINIC, A RELATED ORGANIZATION, WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, FORM 990 OF 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) sponsors a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable DHC 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 to new participants in 1998. THE FOLLOWING INDIVIDUAL HAS A SPLIT DOLLAR LIFE PLAN ARRANGEMENT AND RESPECTIVE EMPLOYER PREMIUM: STEPHEN LEBLANC $68,044 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NH HEALTH AND ED FACILITIES AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 020279866 | BondIssuerEIN |
| CUSIP | 644614V48 | CUSIPNum |
| Bond Issued | 2012-11-15 | BondIssuedDt |
| Issue Price | $30,360,529 | IssuePriceAmt |
| Purpose | REFUND OF EXISTING DEBT; ACQUISITION | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $7,985,000 | RetiredAmt |
| Total Proceeds | $30,360,529 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $379,754 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $554,125 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $4,777,102 | CapitalExpendituresAmt |
| Other Spent Proceeds | $24,649,548 | OtherSpentProceedsAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (true) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (true) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.0001 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.0 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.0001 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | Yes (true) | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule K, Part II Bond A Line 11: | FormAndLineReferenceDesc |
| Explanation | The Other Spending Proceeds are the refunding proceeds of the issue no longer in escrow. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15a PROCESS TO ESTABLISH CEO COMPENSATION | THE CEO IS PAID BY A RELATED ORGANIZATION. EXECUTIVE COMPENSATION IS EVALUATED BY AN INDEPENDENT THIRD-PARTY FIRM FOR REASONABLENESS AND NATIONAL DATA BENCHMARKING. THE TALENT DEVELOPMENT AND COMPENSATION COMMITTEE, ALONG WITH INDEPENDENT TRUSTEES, APPROVE THE FINAL COMPENSATION IN CONSIDERATION WITH THE INDEPENDENT THIRD-PARTY FIRM'S RECOMMENDATIONS AND SUGGESTIONS. THIS PROCESS WAS CONTEMPORANEOUSLY DOCUMENTED AND LAST UNDERTAKEN IN 2024. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | As described in the organization's bylaws, the Executive Committee shall consist of the officers of the Board of Trustees of the Corporation and an additional trustee recommended by the Chairperson of the Board and approved by the Board. The Chairperson of the Board of Trustees shall be the Chairperson of the Executive Committee, which shall work at the direction of (and report to) the Board of Trustees, undertaking specific activities assigned to it by the full Board. The Executive Committee shall serve as a resource in the following areas: policy formulation, preparation of background material and analysis for Board deliberations, evaluation of the CEO's performance and recommendations on compensation, and other areas in which the Board requires the deliberation of the officers. The Executive Committee shall have the power to transact all regular business of the Corporation between meetings of the Board. The Executive Committee shall also perform functions of the "Executive Compensation Committee." |
| Form 990, Part VI, Line 6 Classes of members or stockholders | DARTMOUTH-HITCHCOCK HEALTH, A NEW HAMPSHIRE VOLUNTARY CORPORATION, IS THE SOLE CORPORATE MEMBER OF THE CHESHIRE MEDICAL CENTER. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | DARTMOUTH-HITCHCOCK HEALTH, A NEW HAMPSHIRE VOLUNTARY CORPORATION, IS THE SOLE CORPORATE MEMBER OF THE CHESHIRE MEDICAL CENTER. D-HH HAS THE POWER TO APPOINT 1/3 OF THE MEMBERS OF THE CHESHIRE MEDICAL CENTER'S BOARD OF TRUSTEES. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | THE SOLE MEMBER HAS THE RIGHT TO RATIFY THE CHESHIRE MEDICAL CENTER'S NOMINATION OF 2/3 OF THE MEMBERS OF THE BOARD OF TRUSTEES; REMOVE TRUSTEES AFTER CONSULTATION WITH THE CHAIRPERSON OF THE BOARD, APPROVE THE DISSOLUTION OR LIQUIDATION OF THE CHESHIRE MEDICAL CENTER; APPOINT, EVALUATE, TERMINATE, AND APPROVE THE COMPENSATION OF THE PRESIDENT AND CEO; AND OTHER GOVERNANCE DECISIONS. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FORM 990 IS REVIEWED BY EXTERNAL TAX ADVISORS AND THE CFO 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 THE FORMS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | CHESHIRE MEDICAL CENTER'S BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF-DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. THE DARTMOUTH-HITCHCOCK COMPLIANCE AND AUDIT SERVICES DEPARTMENT CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS AND TRUSTEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CURCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | THE EXECUTIVE COMMITTEE HAS A COMPENSATION REVIEW PROCESS TO PROVIDE AN ORDERLY STRUCTURE FOR EXECUTIVE COMPENSATION DECISIONS. ANNUALLY, THE COMMITTEE USES A MULTI-TIERED APPROACH THAT INCLUDES INDEPENDENT COMPARABILITY DATA TO GAUGE APPROPRIATE COMPARATIVE MARKET LEVELS OF COMPENSATION AND BENEFITS. AN ANNUAL PERFORMANCE EVALUATION IS BASED ON SUBJECTIVE AND OBJECTIVE CRITERIA WHICH FLOWS FROM THE ORGANIZATION'S STRATEGIC PLAN. BY WAY OF QUESTIONNAIRE, BOARD MEMBERS PARTICIPATE IN THE PERFORMANCE REVIEW PROCESS AND A SUMMARY REPORT IS SHARED WITH THE CEO. VARIABLE PAY IS AWARDED BASED ON ACHIEVEMENT OF SPECIFIC QUALITATIVE AND QUANTITATIVE GOALS. IN CONJUNCTION WITH THE EXECUTIVE COMMITTEE, CHALLENGING AND MEASURABLE GOALS ARE ESTABLISHED, WHICH PROVIDE ALIGNMENT BETWEEN EXECUTIVE COMPENSATION AND ACHIEVEMENT OF THE HOSPITAL'S STRATEGIC INITIATIVES. DURING FY24, COMPENSATION FOR THE FOLLOWING POSITIONS WERE REVIEWED: CHIEF NURSING OFFICER, CHIEF OPERATING OFFICER, AND THE CHIEF FINANCIAL OFFICER. THE PRESIDENT OF THE MEDICAL STAFF IS PAID BY A RELATED PARTY WHO CONDUCTED A SIMILAR REVIEW. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE CHESHIRE MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | Other Revenue - Total Revenue: 500000, Related or Exempt Function Revenue: 500000, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Revenue - Total Revenue: 422764, Related or Exempt Function Revenue: 422764, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part IX, Line 11g Other Fees | Contracted Healthcare Services - Total Expense: 71259536, Program Service Expense: 71259536, Management and General Expenses: , Fundraising Expenses: ; Lab and Radiology Services - Total Expense: 1883534, Program Service Expense: 1883534, Management and General Expenses: , Fundraising Expenses: ; Consulting and Other Services - Total Expense: 19920836, Program Service Expense: 17593927, Management and General Expenses: 2225440, Fundraising Expenses: 101469; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | NET ASSET TRANSFERS - 24196994; |
| Form 990, Part XII, Line 3a FINANCIAL STATEMENTS AND REPORTING | THE MEDICAL CENTER WAS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE DARTMOUTH-HITCHCOCK HEALTH SYSTEM. DURING FISCAL YEAR 2024, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FEDERAL FUNDING WHICH MET THE MINIMUM THRESHOLD SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 . DUE TO THE NATURE OF THE CONSOLIDATED FINANCIAL STATEMENTS, THE AUDIT WAS PERFORMED ON THE FINANCIAL INFORMATION OF ALL ORGANIZATIONS, INCLUDING CHESHIRE MEDICAL CENTER. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CHESHIRE HEALTH FOUNDATION | ||||||||||
| 580 COURT STREET | KEENE | NH | 03431 | 020202220 | SUPPORTING ORGANIZATION | NH | 501(c)(3) | Type I | CMC | Yes (true) |
| CHESHIRE HEALTH SERVICES | ||||||||||
| 580-590 COURT STREET | KEENE | NH | 03431 | 473379283 | HEALTHCARE | NH | 501(c)(3) | 3 | CMC | Yes (true) |
| DARTMOUTH-HITCHCOCK CLINIC | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 222519596 | PHYSICIAN SERVICES | NH | 501(c)(3) | 10 | D-HH | false |
| DARTMOUTH-HITCHCOCK HEALTH | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 264812335 | PARENT ORGANIZATION | NH | 501(c)(3) | 7 | NA | false |
| MARY HITCHCOCK MEMORIAL HOSPITAL | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 020222140 | HOSPITAL | NH | 501(c)(3) | 3 | D-HH | false |
| THE NEW LONDON HOSPITAL ASSOCIATION INC | ||||||||||
| 273 COUNTY ROAD | NEW LONDON | NH | 03257 | 020222171 | 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 |
| ALICE PECK DAY MEMORIAL HOSPITAL | ||||||||||
| 10 ALICE PECK DAY DRIVE | LEBANON | NH | 03766 | 020222791 | HOSPITAL | NH | 501(c)(3) | 3 | D-HH | false |
| VISITING NURSE ASSOCIATON 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 |
| SOUTHWESTERN VERMONT HEALTH CARE CORPORATION | ||||||||||
| 100 HOSPITAL DRIVE | BENNINGTON | VT | 05201 | 030179435 | HOSPITAL | VT | 501(c)(3) | 3 | D-HH | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEENE HEALTH ENTERPRISES | ||||||||||||
| 580 COURT STREET | KEENE | NH | 03431 | 020374999 | REAL ESTATE HOLDING | NH | CMC | C Corporation | $0 | $0 | 1 | Yes (true) |
| KEENE HEALTH REALTY | ||||||||||||
| 580 COURT STREET | KEENE | NH | 03431 | 020374998 | REAL ESTATE HOLDING | NH | CMC | C Corporation | -$27,663 | $438,520 | 1 | Yes (true) |
| KEENE HEALTH SERVICES | ||||||||||||
| 580 COURT STREET | KEENE | NH | 03431 | 020374997 | REAL ESTATE HOLDING | NH | CMC | C Corporation | $11,693 | $1,418,238 | 1 | Yes (true) |
| 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 | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | 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 | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Cheshire Health Foundation | ||
| C | $5,628,122 | Book |
| Cheshire Health Foundation | ||
| K | $72,000 | Book |
| Cheshire Health Foundation | ||
| Q | $81,896 | Book |