2025-05-09T13:19:30-05:00 2024-06-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2023-07-01 020226774 Speare Memorial Hospital SPEA 6035361120 16 Hospital Road Plymouth NH 03264 Joseph Caristi Chief Financial Officer 6035361120 2025-05-02 1 1 Melissa Magoon CPA P01712842 2077752387 2025-05-02 2023 2025-03-06 01:10:19Z Michelle McEwen 16 Hospital Road Plymouth NH 03264 83742114 0 X www.spearehospital.com X 1899 NH We are a patient and family-centered hospital committed to kindness, collaboration, safety, excellence, proficiency, and professionalism. Our mission is to work together to serve the needs of our patients and community. We envision a community who works together to achieve optimal health. 15 13 566 30 0 0 2014379 718448 75440985 77015829 1243301 2627882 64064 47968 78762729 80410127 82752 88483 0 0 40845909 43845404 0 0 125921 36258272 36228454 77186933 80162341 1575796 247786 91200273 88979170 27342761 23367205 63857512 65611965 X To maintain a hospital and other such institutions within the state of New Hampshire, with facilities that include medical services to provide for the diagnosis and treatment of patients that may require inpatient, outpatient, emergency care and other pursuits designed to promote the general health of the community. SMH does not discriminate relative to race, religion or national origin, ability to pay and will assure that all patients receive the same level of care through quality assessment monitoring and improvement activities. Speare's formal mission statement is to work together to serve the needs of our patients and community, and a vision of a community where all can achieve optimal health. 0 0 76938403 88483 77015829 Speare Memorial Hospital is a nonprofit 25-bed acute-care critical access hospital that provides inpatient and outpatient services to the residents and visitors of the surrounding Central New Hampshire communities that includes those who are uninsured, underinsured, Medicaid/Medicare dependenty, and rural, low-income families. Services include emergency medicine (24 hours/ 7-days per week), intensive care, labor and delivery, rehabilitation (physical therapy, occupational therapy, cardiac, pulmonary, medical fitness), advanced imaging (3D mammography, MRI, bone density, CT, nuclear medicine, ultrasound), infusion therapy, nutrition, and essential wellness and prevention programs. SMH owns six practices staffed with physicians and mid-level professionals providing primary care, surgery (in-office, outpatient, inpatient), obstetrics and gynecology, pediatrics, orthopedics, and ophthalmology services. In fiscal year 2023, SMH provided the following services: 12,945 emergency room visits, 2,345 surgical services, 28,615 physical and occupational therapy treatments, 144,883 laboratory tests, 27,178 radiology exams, and 3,746 oncology services. 76938403 1 1 0 1 0 0 0 1 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 99 0 1 566 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 13 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 0 NH X Joseph Caristi 6035361120 16 Hospital Road Plymouth NH 03264 Kevin Young MD Chair 1.00 1.00 X X 0 0 0 Steven Camerino Vice Chair 1.00 1.00 X X 0 0 0 Robert Maloney Treasurer 1.00 1.00 X X 0 0 0 Julie Bernier Secretary 1.00 1.00 X X 0 0 0 Lisa Baker Director/Physician 40.00 1.00 X 108924 0 31675 Dolores Hopper Director 1.00 1.00 X 0 0 0 Walter Johnson Director 1.00 1.00 X 0 0 0 Susan Scrimshaw Director 1.00 1.00 X 0 0 0 Elizabeth Kleiner Director 1.00 1.00 X 0 0 0 Patrick Miller Director 1.00 1.00 X 0 0 0 Thomas Myrick Director 1.00 1.00 X 0 0 0 Nancy Puglisi Director 1.00 1.00 X 0 0 0 Margaret Turner Director 1.00 1.00 X 0 0 0 Bruce Wiggett Director 1.00 1.00 X 0 0 0 Michelle McEwen CEO 40.00 1.00 X X 386556 0 61538 Joseph Caristi CFO 40.00 1.00 X 0 0 0 Nancy Pierce Past Interim CFO 40.00 1.00 X 124618 0 26707 Joseph Ebner MD CMO 40.00 0.00 X 332896 0 47196 Meaghan Smith CNO 40.00 0.00 X 185276 0 49066 Jonathan Beach Physician 40.00 0.00 X 375094 0 71527 Ernest Hanowell Physician 40.00 0.00 X 368043 0 33613 Paul Musco MD Physician 40.00 0.00 X 512958 0 71256 Andrew Seefeld MD Physician 40.00 0.00 X 454807 0 80084 Savan Patel Physician 40.00 0.00 X 416278 0 37750 Travis Boucher Former CFO 0.00 0.00 X 142541 0 31903 3407991 0 542315 61 1 1 0 American Healthcare Staffing Association PO Box 1928 Edmond OK 73083 Contract Labor 3887935 Huntzinger Management Group 72 Glenmura National Blvd Moosic PA 18507 IT Services 2216961 Medical Information Tech PO Box 74569 Chicago IL 60696 EHR System 1361910 Concord Orthopaedics 264 Pleasant Street Concord NH 03301 Contract Labor 1180200 Philips Healthcare 22100 Bothell Everett Highway Bothell WA 98021 Equipment Maintenance 1107674 44 64550 653898 11177 718448 Patient Service Revenue 624100 175382381 175382381 Other Operating Revenue 621400 3132634 2962984 169650 Contractual/Char. Adj. 624100 -101499186 -101499186 77015829 1526256 1526256 72506 0 72506 72506 72506 4391398 6500 3296272 0 1095126 6500 1101626 1101626 11177 64550 35715 -24538 -24538 80410127 76846179 0 2845500 X 88483 88483 1354453 140599 1213854 34837461 34378541 369558 89362 1826806 1801506 25300 3633961 3587940 46021 2192723 2088281 98548 5894 89688 85646 4042 179086 171016 8070 109794 109794 12180549 11785281 385840 9428 80372 76750 3122 500 735029 701905 30353 2771 2590573 2473830 116743 1795722 1714799 80923 72046 68799 2195 1052 325310 315735 9575 3564010 3459104 104906 1242632 1186633 55999 Medical Supplies 9079090 8669945 409145 Medicaid Enhancement Ta 3265497 3265497 Miscellaneous Expenses 640674 612276 11484 16914 Common Area Fees 278382 265837 12545 80162341 76938403 3098017 125921 X 2392 2442 15805654 8460385 11539426 9881226 5417686 7670226 1604782 1621772 997144 1026359 58660960 43348884 15551315 15312076 32954112 36541886 5000 5000 1139552 838502 6183210 7619296 91200273 88979170 9390339 7968761 10897827 10285931 7054595 5112513 27342761 23367205 X 63043293 64716982 814219 894983 63857512 65611965 91200273 88979170 X 247786 1442435 64232 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14213 14213 0 Part II-B, Line 1: The Organization pays dues to various organizations, a portion of which is attributable to lobbying activities. X 0 210160 3301 213461 272633 -62473 210160 272591 42 272633 272584 7 272591 271915 669 272584 0.00000 1.00000 0.00000 1 0 855030 855030 33557610 24621172 8936438 22587391 17568074 5019317 1660929 1159638 501291 15312076 Due from Related Party 5351988 Beneficial Interest in Perpetual Trusts 387007 Investment in Subsidiaries -34853 Deferred System Development Costs 1126835 Deferred Compensation 634958 Executive Life Insurance 153361 7619296 Estimated Third-Party Payor Settlements 6279700 Investment in Subsidiary - Boulder Point -2185356 Deferred Compensation 634958 Operating Lease Liabilities 383211 5112513 Part III, Line 4: The Hospital's artwork is intended to provide artistic pleasure and a calming appearance for patients of the Hospital to enjoy during their stay. Part V, Line 4: The intended use of the endowment fund is to provide long term operational support for the mission of the Organization. Golf Tournament 75727 64550 11177 5134 9675 8293 12613 75727 64550 11177 5134 9675 8293 12613 35715 -24538 1 1 1 X 125.000000000000 1 X 225.000000000000 1 1 0 1 1 259656 259656 0.00320 12094394 6989364 5105030 0.06370 12354050 6989364 5364686 0.06690 424978 424978 0.00530 88483 88483 0.00110 513461 513461 0.00640 12867511 6989364 5878147 0.07330 1 0 30982219 35084265 -4102046 X 1 1 1 1 Speare Memorial Hospital 16 Hospital Road Plymouth NH 03264 www.spearehospital.com 01300 X X X X Speare Memorial Hospital 0 0 1 X X X X X X X 23 1 0 1 1 X https://spearehospital.com/about-speare/community-benefit/ X www.pemibakercommunityhealth.org & www.midstatehealth.org X 1 23 1 https://spearehospital.com/about-speare/community-benefit/ 0 1 X 125.000000000000 225.000000000000 X X X X X 1 1 X X X 1 X https://spearehospital.com/patients-visitors/financial-assistance/ X https://spearehospital.com/patients-visitors/financial-assistance/ X https://spearehospital.com/patients-visitors/financial-assistance/ X X X X X X 1 X 0 X X X X 1 X 0 0 Speare Memorial Hospital Part V, Section B, Line 5: Speare Memorial Hospital conducted a Community Health Needs Assessment (CHNA) in the spring and summer of 2023, in conjunction with other community organizations that make up the Central NH Health Partnership. The geographic area of focus were 18 municipalities with a resident population of 31,356. Methods employed in the CHNA included a survey of community residents that were made available via social media, e-mail distribution, website links through multiple channels, and direct e-mail survey of key stakeholders and community leaders representing various community sectors. In addition to seeking community input, data collection and analysis was used as a secondary source of data. Most of the data used in the analysis was available from public internet sources and proprietary data. Examples of data sources utilized include: www.countyhealthrankings.org, Bureau of Labor Statistics, NH DHHS, NAMI, CDC, CMS: Mapping Medicare Disparities by Population, Center for Housing Policy and Economic Policy Institute.The CHNA survey was conducted during May and June 2023 and yielded 335 responses. The makeup of respondents is listed below (some individuals are counted in more than one sector):Community Resident: 180Healthcare Professional: 137Educator: 31Representative of Chronic Disease Group: 16Government: 14Public Health Official: 7Demographics of Survey Respondents as compared to Service Area: CNHHP Service Area Survey RespondentsAge 0-17 15.3% n/a18-44 35.1% 44.5%45-64 28.0% 36.1%65+ 21.6% 19.4%Race/Ethnicity:White 91.6% 96.4%Black 0.5% 0.3%Asian & Pacific Islander 1.4% 1.2%Other 4.1% 1.2%Hispanic 2.4% 0.9% Speare Memorial Hospital Part V, Section B, Line 6b: Speare's CHNA was conducted in partnership with the Central New Hampshire Health Partnership. Besides Speare Memorial Hospital, the Community Health Needs Assessment Partners include:- Community Action Program Belknap-Merrimack Counties- Communities for Alcohol- and Drug-free Youth (CADY)- Lakes Region Mental Health Services- Mid-State Health Center- Pemi-Baker Community Health Speare Memorial Hospital Part V, Section B, Line 11: The 2023 CHNA identified the following health priorities and goals:Access to Behavioral Health ServicesGoal: Increase community access and coordination of mental and substance abuse services across the regionManagement of Chronic DiseasesGoal: Reduce the onset of chronic diseases thrugh meaningful and impactful prevention, education and management of programsAccess to Healthcare for SeniorsGoal: Enhance access to healthcare that promotes health, independence, and quality of life of seniors Addressing the Social Determinants of HealthGoal: Improve health outcomes through thoughtful investment of time and resources to the root causes of healthSpeare is addressing these priorities as follows:- Enhancing Access to Services with financial counseling and assistance in obtaining health insurance coverage- Providing sliding scale discounted or free services- Providing services to Medicare and Medicaid patients that reimburse less than cost- Increasing behavioral health resources- Increasing primary care resources to enhance access- Implementing population health tools to assist with screening and chronic care management- Community Education on various health topics- Creating a series of videos focused on educating seniors or their caretakers on aspects of quality of life - Conducting Social Determinants of Health (SDOH) screening of patients- Utilizing a Community Health Worker to assist patients who have screened positive for SDOH- Community Health Grants program Speare Memorial Hospital Part V, Section B, Line 16j: The application process is outlined in patient admission packets as well as monthly statements. Part I, Line 7: An accounting system was used to calculate the amounts reported in this table. The accounting system addresses all patient segments. A cost-to-charge ratio was used. Community Relations programs and charity care given to uninsured patients were also considered in calculating amounts disclosed. Part II, Community Building Activities: Speare further promotes community health with its Community Education and Outreach programs, as well as through digital and traditional media. Additionally, Speare conducts a needs assessment to identify priority areas that are in need within the community. Its Community Outreach and Education programs were redirected to virtual efforts, including the Virtual Healthy Aging Series and a succession of informational/educational content on our social media channels and website. Each of these focuses on particular health issues identified by the CHNA.Programs identified by the community through ongoing engagement outside the formal assessment process include diabetes education and support, childbirth classes, car seat program, and oncology outreach and education. Additionally, Speare donates medication to community non-profit agencies. Speare uses its digital platforms (website and social media channels) and traditional marketing tools (newsletters, news articles, educational print material) to connect our community with information about various health and wellness topics, specific to Speare initiatives and in general, to create discussion and information sharing. Part III, Line 4: See Pages 8-11 of audited financial statements for footnote disclosure. Part III, Line 9b: Speare Memorial Hospital has both a collections policy, and a charity care policy that describes charity eligibility and the steps to complete before a patient's account is written off to bad debt. Part VI, Line 2: In addition to the research described in Part V - Section C, Speare has ongoing discussions with key community leaders about the identified needs, how they are being addressed and other opportunities for action. These include our legislators, municipal leaders, police and fire, local health departments, Plymouth State University, community centers and area clergy. Part VI, Line 3: Patients are educated at time of registration, through educational materials that are distributed through the hospital's website, or by community outreach. Speare Memorial Hospital is a member of a state-wide community health network that provides assistance, support, and education relating to eligibility assistance. Part VI, Line 4: Speare Memorial Hospital best defines its community as those towns comprising South Eastern Grafton County based on our patient origin information and, when available, market share data published by the New Hampshire Hospital Association.Speare Memorial Hospital is located in the mountain and lakes region of New Hampshire and primarily serves constituents in Grafton County. Grafton County population size is approximately 86,000 within its 40 distinct municipalities. Its service area includes 17 towns with an approximate total population of 30,000. Part VI, Line 5: Speare further promotes community health with its Community Education and Outreach program, as well as through educational information shared through our website and social media channels.Speare's Community Outreach and Education program was adapted to reach people virtually. The Virtual Healthy Aging Series, Childbirth Classes, Dietary and Nutrition Education each focused on/drilled down into specifics on particular health issues identified by the community through ongoing engagement outside the formal assessment process. Additionally, Speare used its digital channels to connect our community with information about various health and wellness topics, specific to Speare initiatives and in general, to create discussion and information sharing. Part VI, Line 7, Reports Filed With States NH 1 Communities for Alcohol and Drug Free Youth 94 Highland Street Plymouth NH 03264 571212859 501(c)(3) 9750 0 Program expenses for Newfound middle school Thriving in the Middle School program; speakers for annual Shout Out to Parents event; youth leadership programs; and Pemi-Baker teacher in-service programs Grafton County Senior Citizens Council PO Box 433 Lebanon NH 03766 237248316 501(c)(3) 10000 0 To provide healthcare transportation for older adults and adults with disabilities in Speare's service area Lakes Region Mental Health Center 40 Beacon Street East Laconia NH 03246 020272138 501(c)(3) 12625 0 To support mental health services in Speare's service area Responders Together NH PO Box 293 Bristol NH 03222 883161790 501(c)(3) 7875 0 Funding is for two trainings per year, through the International Critical Incident Stress Foundation group, for 25 to 35 responders to become certified peer supporters. Transport Central 258 Highland Street Plymouth NH 03264 208463821 501(c)(3) 12500 0 Provide mileage reimbursement for Transport Central volunteer drivers 5 0 Part I, Line 2: The Organization only pays grants to other Section 501(c)(3) organizations. Therefore, no additional monitoring is deemed necessary. Other assistance payments are reviewed on a periodic basis. X X X X X 0 0 0 0 0 0 0 1 0 Paul Musco MD Physician 467658 0 45300 0 0 0 37471 0 33785 0 584214 0 0 0 Andrew Seefeld MD Physician 454807 0 0 0 0 0 38170 0 41914 0 534891 0 0 0 Savan Patel Physician 416278 0 0 0 0 0 35213 0 2537 0 454028 0 0 0 Michelle McEwen CEO 353556 0 33000 0 0 0 29216 0 32322 0 448094 0 0 0 Jonathan Beach Physician 375094 0 0 0 0 0 32700 0 38827 0 446621 0 0 0 Ernest Hanowell Physician 368043 0 0 0 0 0 31417 0 2196 0 401656 0 0 0 Joseph Ebner MD CMO 309279 0 23617 0 0 0 11961 0 35235 0 380092 0 0 0 Meaghan Smith CNO 185276 0 0 0 0 0 7895 0 41171 0 234342 0 0 0 Travis Boucher Former CFO 136185 0 6356 0 0 0 10605 0 21298 0 174444 0 0 0 Nancy Pierce Past Interim CFO 124618 0 0 0 0 0 11041 0 15666 0 151325 0 0 0 Part I, Line 7 Bonuses were approved at the discretion of the Board and Management for meeting certain criteria. Compensation for the CEO is determined via a compensation committee, information, board approval and written employment contract. Physician contracts include a provision that they may earn the following bonuses: Productivity, Quality and Patient Experience. The Quality and Patient Experience bonuses are granted if particular targets are met, and the maximum bonus for each of these is $3,000. The Productivity Bonus is established to reward efficiency and access. The bonus is paid when the physician has exceeded a predetermined target which is established using market compensation and productivity data of similar type organizations. A New Hampshire Health And Education Facilities Authority 020279866 2022-05-26 11683764 To pay off and provide advanced refunding for 2012 Bond 0 0 0 A 1279359 11683764 11683764 2022 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 Form 990, Part VI, Section A, line 6 The Association consists of all persons who are members at the time of the adoption of the bylaws and other persons who may be elected. Form 990, Part VI, Section A, line 7a A candidate for membership may be elected by a majority vote of members present at any annual or special meeting of the Association provided that a quorum is present. Alternately, a candidate for membership may be elected by a two-thirds vote of the Board of Directors present at any regular or special meeting of the Board provided that a quorum is present. Form 990, Part VI, Section A, line 7b The Association members reserve the right to approve changes to the Organization's By-Laws. Form 990, Part VI, Section B, line 11b The Form 990 is provided to and reviewed with the Board of Directors, annually, prior to submitting. Form 990, Part VI, Section B, line 12c Speare Memorial Hospital has a set of procedures to follow to avoid the possibility that those in positions of authority over the Organization may receive an inappropriate benefit. Any possible conflict of interest on the part of any member of the Board, Officer or Employee of the Organization, shall be disclosed in writing to the Board and made a matter of record through an annual procedure and also when the interest involves a specific issue before the Board. Form 990, Part VI, Section B, line 15a Compensation for the CEO is determined via a compensation committee, compensation survey or study, comparison of other organizations 990 information, board approval and written employment contract. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Other Fees: Program service expenses 8,265,628. Management and general expenses 380,637. Fundraising expenses 9,428. Total expenses 8,655,693. Contract Nursing & Technicians: Program service expenses 3,519,653. Management and general expenses 5,203. Fundraising expenses 0. Total expenses 3,524,856. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Speare Memorial Hospital 16 Hospital Road Plymouth, NH 03264 EIN 02-0226774 Speare Memorial Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Change in Beneficial Interest in Perpetual Trusts 64,232. Speare Memorial At Boulder Point Boulder Point Drive Plymouth NH 03264 263888977 Real Estate NH 501(c)(3) Line 12a, I Speare Memorial Hospital 1 Speare Health Network LLC 16 Hospital Road Plymouth NH 03264 043372339 Physician/Hospital Organization NH Speare Memorial Hospital C 20728 0.50000 0 Speare Health Ventures Inc 16 Hospital Road Plymouth NH 03264 020366565 Healthcare Services NH Speare Memorial Hospital C 2405904 2373415 1.00000 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 Speare Health Ventures Inc D 353915 FMV Speare Memorial At Boulder Point K 939735 FMV Speare Memorial At Boulder Point D 7316311 FMV