2022-03-11T15:45:50-06:00 2021-06-30 010494526 Baker Newman & Noyes 650 Elm Street Suite 302 Manchester NH 03101 990 2020-07-01 020483054 Southern New Hampshire Medical Center SOUT 6035772000 8 Prospect Street PO Box 2014 Nashua NH 030612014 Thomas E Wilhelmsen Jr Interim President 6035772000 2022-02-07 1 Thomas Wilhelmsen Jr 999009999 Connor Smart P02285543 6036262200 2022-02-07 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Thomas E Wilhelmsen Jr 8 Prospect Street PO Box 2014 Nashua NH 030612014 289875408 0 X www.snhhealth.org X 1892 NH Southern New Hampshire Medical Center is dedicated to providing exceptional care that improves the health and well-being of individuals and communities we serve. 15 12 2025 107 456114 0 2029325 8982470 243976402 256455749 11437603 15700424 4964411 4245484 262407741 285384127 71121 2454 0 0 124423050 118905689 0 0 0 98362960 127701608 222857131 246609751 39550610 38774376 464724660 499808183 204427922 183654903 260296738 316153280 X Southern New Hampshire Medical Center is dedicated to providing exceptional care that improves the health and well-being of individuals and communities we serve. Southern New Hampshire Medical Center is a provider of choice, delivering convenient access to high value, quality care in an environment that embraces dignity, compassion and service to the people of our community. 0 0 202145017 2454 260025709 Provides acute healthcare services to a diverse population base including indigent within southern and central New Hampshire. Southern New Hampshire Medical Center is a nonprofit hospital, serving all who need care, regardless of ability to pay. Medical services provided included 9,365 inpatient admissions, 227,703 outpatient registrations, 32,701 emergency room visits, 4,983 surgical procedures, and 1,282 births. 5295356 0 0 Charity Care ($2,565,979) and other uncompensated care ($2,729,377) at cost. 1824444 0 0 Community health services and health professional education. 209264817 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 223 0 1 2025 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Paul Trainor 6032819290 8 Prospect Street Nashua NH 03061 Marc Sadowsky MD Trustee 8.00 3.00 X 39400 0 0 Scott A Wolf DO President/CEO & Secretary 40.00 3.00 X X 28936 0 35 Colin T McHugh Interim President (end 12/2020) 42.00 3.00 X X 131144 228114 27547 Melliyal Annamalai Trustee 2.00 3.00 X 0 0 0 Bobbie D Bagley MSMPHRNCPH Trustee 2.00 3.00 X 0 0 0 Sister Paula Marie Buley Trustee 2.00 3.00 X 0 0 0 Michael Gonzales Trustee 2.00 3.00 X 0 0 0 Colleen P Guiry MD Trustee (end 12/2020) 2.00 0.00 X 0 0 0 Mary Jordan Trustee 2.00 3.00 X 0 0 0 Joseph N Laplante Trustee 2.00 3.00 X 0 0 0 Karen Maynard MD Trustee 2.00 43.00 X 0 669666 48983 Marlene Santiago MD Trustee 2.00 3.00 X 0 0 0 John J Sullivan Trustee 2.00 3.00 X 0 0 0 Phillip Sullivan MD Trustee 2.00 2.00 X 0 0 0 Timothy C Sullivan Esq Trustee 2.00 3.00 X 0 0 0 Rachel Rowe Board Chair 2.00 3.00 X X 0 0 0 Timothy J Whitaker Board Chair (end 6/2021) 2.00 3.00 X X 0 0 0 Thomas A Pursch Board Vice Chair (end 12/2020) 2.00 3.00 X X 0 0 0 Charla B Stevens Esq Board Vice Chair 2.00 3.00 X X 0 0 0 Paul Trainor Senior VP & CFO, Treasurer 42.00 3.00 X 513456 0 51251 Joseph M Leahy MD Physician 40.00 0.00 X 475482 0 44419 Robert Dorf DO EO Pres. Foundation Medical Ptrs. 42.00 2.00 X 0 440201 44324 Andrew Watt MD Assoc. VP Med. Info./Physician 40.00 0.00 X 418126 0 40336 Dilip Yarabothu MD Physician 40.00 0.00 X 384162 0 15675 Brett Sweeney MD Physician 40.00 0.00 X 366329 0 16089 Michael S Rose Former Tres./Pres. & Sec. 0.00 0.00 X 959179 0 108033 Susan Desocio Former Pres. Fnd Medical Ptrs. 0.00 0.00 X 395394 0 8906 3711608 1337981 405598 145 1 1 1 Fulcrum Associates 5 Tech Circle Amherst NH 03031 Construction 2093830 Cerner Corporation 51 Sawyer Road Waltham MA 02453 System support 994459 Janitech Inc 60 Pine Street D Methuen MA 01844 Janitorial Services 769256 Sodexo Inc 9801 Washington Boulevard Gaithersburg MD 20878 Food services 729108 Baxter Healthcare Corp One Baxter Parkway Deerfield IL 60015 Medical Equipment 660711 15 7370838 1611632 10094 8982470 Hospital services 621110 270964264 270964264 Provision for bad debts 621110 -14508515 -14508515 256455749 13210564 13210564 3784382 0 3784382 3784382 3564972 219410 6981141 4491281 2489860 2489860 2489860 Ancillary- NE Rehab Food Services 722210 365528 365528 Ancillary- NE Rehab Environmental 811000 87226 87226 8348 4988 3360 461102 285384127 260025709 456114 15919834 X 2454 2454 778302 778302 99598667 80442533 19156134 3183361 2632291 551070 9643639 7737982 1905657 5701720 4643696 1058024 104447 104447 150000 150000 136045 136045 43634349 42827362 806987 172329 172329 402388 402388 1785090 1453845 331245 5257933 4282259 975674 13121 10686 2435 134221 109315 24906 2594862 2113354 481508 5777157 5777157 13537511 11025460 2512051 2400661 1955189 445472 Supplies 33506070 27288609 6217461 NH MET 11993183 11993183 Repairs and maintenance 2264414 1844224 420190 Food services 577468 470312 107156 3260359 2654906 605453 246609751 209264817 37344934 0 58214326 34847906 14093493 6850798 23346056 30347389 4389498 5080977 3079713 2267496 346808978 207709474 130873541 139099504 216200886 269036069 5417895 2618852 9109252 9659192 464724660 499808183 78417927 76558299 3277096 559414 86007681 79396614 36725218 27140576 204427922 183654903 X 256129172 310528837 4167566 5624443 260296738 316153280 464724660 499808183 X 38774376 37171765 -20089599 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 32928 0 0 0 32928 0 Part II-B, Line 1: Part II-B, Line 1f: Southern New Hampshire Medical Center partners with various like-minded trade associations which support public policies and initiatives that focus on improving health outcomes and the experience of health care, while also aiming to reduce the overall cost of receiving that care. To maintain these partnerships, Southern New Hampshire Medical Center is required to pay membership dues back to these various trade associations. A portion of the dues paid to these associations has been designated as available for lobbying expenditures. Any lobbying expenditures paid by the associations are incurred in order to help track and discuss legislation affecting health care policy. The specific dues paid by Southern New Hampshire Medical Center to the trade associations in this fiscal year, as well as the portion of the dues that were available for lobbying expenditures, are detailed below: New Hampshire Hospital Association - Total 2020 dues: $109,971 - Portion of dues available for lobbying: $23,853 American Hospital Association - Total 2020 dues: $35,507 - Portion of dues available for lobbying: $9,075 107270588 33620596 140891184 103449323 3821265 107270588 101098156 2351167 103449323 92152052 8946104 101098156 81781493 10370559 92152052 0.98320 0.01680 0.00000 0 0 15332049 15332049 169744121 104067086 65677035 4988894 2983950 2004944 150137218 100658438 49478780 6606696 6606696 139099504 Unearned income - MOB 81999 Insurance reserves 6266584 Accrued SERP obligations 2152253 Long-term accrued pension expense 9517341 457 (B) deferred comp plan obligations 3769042 Employer social security liabilities 3459259 Equipment capital leases 1894098 27140576 X Part V, Line 4: The intended uses of the Organization's endowment funds are to fulfill donors' intentions on the permanently restricted funds and for future plant replacement and technology investments from board designated funds. Part X, Line 2: The System, Medical Center, Surgery Center, Legacy Trust and Foundation are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code, and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the System's tax positions and concluded the System has maintained its tax-exempt status, does not have any significant unrelated business income and has taken no uncertain tax positions that require adjustment to the consolidated financial statements. 1 1 1 X 225.000000000000 0 1 1 1 0 1 1 2588357 2588357 0.01050 40876359 21929205 18947154 0.07680 43464716 21929205 21535511 0.08730 137032 137032 0.00060 913210 913210 0.00370 2960573 1431363 1529210 0.00620 41402 41402 0.00020 590710 590710 0.00240 4642927 1431363 3211564 0.01310 48107643 23360568 24747075 0.10040 220184 220184 0.00090 3312 3312 0.00000 5085 5085 0.00000 228581 228581 0.00090 1 14508515 2752785 53192696 72938917 -19746221 X 1 1 1 1 Southern New Hampshire Medical Center 8 Prospect Street PO Box 2014 Nashua NH 030612014 www.snhhealth.org 02496 X X X X Southern New Hampshire Medical Center 0 0 1 X X X X X X X X 20 1 1 1 1 X See Part V, Section C X See Part V, Section C X 1 20 1 See Part V, Section C 0 1 X 225.000000000000 X X X X X X 1 1 X X X X 1 X Please see Part V X Please see Part V X Please see Part V X X X X X X 1 X 0 X X X X X 1 X 0 1 Southern New Hampshire Medical Center Part V, Section B, Line 5: Southern New Hampshire Medical Center worked with officials from the City of Nashua Division of Public Health and other members of the community, including local police and fire departments, school officials, ambulance service leaders, directors of community agencies, hospital leaders, physicians and area residents through focus groups to gather input for the community health assessment.The 2020 CHA employed numerous research methods to gather input from the community, including online surveys, in-person interviews, and data analysis. The CHA utilized these methods separately and decisively for each of its identified community health needs.The City of Nashua Division of Public Health and Community Services (DPHCS) conducted a community-based survey in 2020 and invited Greater Nashua residents help determine what the biggest health priorities were in their communities, and to share their COVID-19 experiences. Online surveys were distributed widely throughout the Greater Nashua community via social media, community networks, and physical posted flyers. The surveys were available in both English and Spanish. Specifically designed surveys were administered to evaluate each of the community's various health needs. For example, different surveys were used to gather community-data regarding substance abuse, access to care, mental and behavioral health, chronic disease, environmental health, and child and maternal health. Community input through these surveys allowed the collaborative report to better evaluate unique health risks and concerns within various social groups and communities.The research was originally designed as a series of in-person, focus group sessions to be held across the Greater Nashua region throughout the summer of 2020. Research design began in January, 2020, but when the COVID-19 pandemic called for social distancing, research design had to be adjusted to accommodate online data collection. With the switch to an online survey based design, research questions were modified from a semi-structured interview design to a survey design. Southern New Hampshire Medical Center Part V, Section B, Line 6a: Southern New Hampshire Medical Center took part in the 2020 Greater Nashua Community Health Assessment for its most recent CHNA. This Assessment was conducted by the Nashua Department Division of Public Health and their Public Health Advisory Council partners. It is a product of the dedication and collaboration of over 33 organizations, programs, and City departments serving the GNPHR. A full list of the hospital facilities that participated in this Assessment can be found through the City of Nashua Community Health Assessment homepage at:https://nashuanh.gov/560/Community-Health-Assessment Southern New Hampshire Medical Center Part V, Section B, Line 6b: Southern New Hampshire Medical Center took part in the 2020 Greater Nashua Community Health Assessment for its most recent CHNA. This Assessment was conducted by the Nashua Department Division of Public Health and their Public Health Advisory Council partners. It is a product of the dedication and collaboration of over 33 organizations, programs, and City departments serving the GNPHR. A full list of the facilities other than hospitals that participated in this Assessment can be found through the City of Nashua Community Health Assessment homepage at:https://nashuanh.gov/560/Community-Health-Assessment Southern New Hampshire Medical Center Part V, Section B, Line 11: Southern New Hampshire Medical Center (SNHMC) participated and contributed to the Southern New Hampshire Health Implementation Strategy for its fiscal year ending in 2021. The Strategy identified a series of Priority 1 and Priority 2 health needs and programs. Identified Priority 1 health needs included: - Behavioral and mental health, substance misuse, and suicide prevention- Obesity, weight management, exercise, and nutrition- Access to care, coverage, and insuranceIdentified Priority 2 health needs included:- Healthcare for women, mothers, and babies- Environment health- Chronic disease and cancer- Communicable disease- Public health emergency preparedness- Social determinants of health- General safetyWhile each of the identified priority health needs demand their own unique approach and solutions, there are some common programs and initiatives that Southern NH Medical Center has undertaken which address the significant health needs of its community as a whole. For example, SNHMC continues to focus on training and retaining a highly skilled and professional staff of care providers across all spectrums of the health industry. SNHMC also places great value on community outreach and engagement, including collaboration with community groups and partners. Additionally, through improved information technology, patient records, patient advocacy, and health care education and literacy, SNHMC is able to provide more personalized, direct care to its community in order to address the identified health priorities. As an example, SNHMC screens all patients for food insecurity and nutrition, to ensure that patients have adequate access to healthy food sources. SNHMC offers multiple care locations and scheduling opportunities to ensure that patient needs are being met, that access to care is available and convenient, and that the health and wellness concerns of SNHMC's community are being addressed.For more information on how Southern New Hampshire Medical Center is addressing the needs identified in the CHNA, our Implementation Strategy is available on our website at: https://www.snhhealth.org/community-health. Southern New Hampshire Medical Center Part V, Section B, Line 13b: Southern New Hampshire Medical Center offers a discount equal to the average of their three largest payors plus Medicare to all self pay patients. Discounted care is provided to all uninsured and underinsured patients. Southern New Hampshire Medical Center Part V, Section B, Line 20e: See response for Part III, Section C, Line 9b above.Prior to placing accounts with collection agencies, Southern New Hampshire Medical Center pulls out patients who qualify for charity based on census tract data and does not place those accounts with an agency but rather awards charity or free care assistance for their encounter. Southern New Hampshire Medical Center Part V, Section B, Line 24: Southern New Hampshire Medical Center may charge patients who are having cosmetic or experimental, non-covered services gross charges for that encounter. Schedule H, Part V-B, Line 16a: Southern New Hampshire Medical Center's Financial Assistance Policy is available on their website at: English: https://www.snhhealth.org/SNHH/media/Documents/CharitableCare-eff-04012019-final-english-version-for-posting-update-062_1.pdfSpanish: https://www.snhhealth.org/SNHH/media/Documents/CharitableCare-eff-04012019-final-spanish-vesion-update-062020_1.pdf Schedule H, Part V-B, Line 16b: Southern New Hampshire Medical Center's FAP Application is available on their website at:English: https://www.snhhealth.org/SNHH/media/Documents/Charitable-Care-Financial-Assistance-Application-and-Cover-Letter-ENGLISH-050321.pdfSpanish: https://www.snhhealth.org/SNHH/media/Documents/Charitable-Care-Financial-Assistance-Application-and-Cover-Letter-SPANISH-050321.pdf Schedule H, Part V-B, Line 16c: Southern New Hampshire Medical Center's FAP Plain Language Summary is available on their website at:https://www.snhhealth.org/billing-and-insurance/charitable-care-policy Schedule H, Part V, Section B, Line 7: Access to Southern New Hampshire Medical Center's past CHNA reports can be found at the following web-address:https://www.snhhealth.org/community-healthAdditionally, the collaborative Greater Nashua CHA, to which Southern New Hampshire Medical Center proudly contributed, can be found at the following web-address:https://www.nashuanh.gov/560/Community-Health-Assessment Schedule H, Part V, Section B, Line 10: Southern New Hampshire Health is dedicated to meeting the health needs of the communities it serves. We take a number of steps to fulfill this mission; we work collaboratively with the city of Nashua and other social service agencies to identify the health concerns and needs in the city and the greater Nashua region. However, Southern NH Health also completes its own community health needs assessment, building on the city's vital work. We support the city's action plan and broaden our assessment to define and address the unmet health needs in all of the 32 communities we serve. More information about these efforts can be found at the following web address:https://www.snhhealth.org/community-health 10 1 - Southern NH Rehabilitation Center 17 Prospect Street Nashua NH 03060 Rehab 2 - Southern New Hampshire Rehab - Milford 10 Jones Road Milford NH 03055 Rehab 3 - Southern NH Rehabilitation Services 696 Daniel Webster Highway Merrimack NH 03054 Rehab 4 - Cardiac & Pulmonary Rehab -West Campus 29 Northwest Boulevard Nashua NH 03063 Rehab 5 - Pediatric Rehab Center 5 George Street Hudson NH 03051 Rehab 6 - Southern NH Rehabilitation Center 460 Amherst Street Nashua NH 03063 Rehab 7 - Southern New Hampshire Rehab - Hudson 300 Derry Road Hudson NH 03051 Rehab 8 - Southern New Hampshire Lab Services 112A Spit Brook Road Nashua NH 03063 Lab 9 - Southern New Hampshire Lab Services 33 Windham Road Pelham NH 03076 Lab 10 - Southern New Hampshire Lab Services 280 Main Street 1st Floor Nashua NH 03060 Lab Part I, Line 3c: Southern New Hampshire Medical Center offers a discount equal to the average of their three largest payors plus Medicare to all self pay patients. Discounted care is provided to all uninsured and underinsured patients. Part I, Line 7: The costing methodology used was the ratio of cost to charge as outlined in Worksheet 2 of the instructions. The only exception to this was for subsidized service area where the cost structure was specific to that service area. For those areas, our Cost Accounting system was used. Part II, Community Building Activities: Southern New Hampshire Medical Center is committed to improving the health and well-being of the Greater Nashua area and our community building activities help us achieve this goal. Through our involvement in the Rotary Club and Nashua Chamber of Commerce, along with other community organizations, we are able to exchange ideas with area leaders concerning health care issues and make informative decisions that best address the health needs of our community. We provide Medicare Counseling to area senior citizens giving them the guidance they need to make informed decisions about their healthcare coverage. Our support of the United Way's Day of Caring has resulted in a growing number of our employees going out into the area and helping members of the community with healthcare and other needs. We are strong in our commitment to the Greater Nashua area and plan to continue to support and grow community building activities that improve the overall health of the area. A majority of the organization's Board of Trustees is comprised of persons who reside in the Primary Service Area (PSA) who otherwise have no relationship with the organization. Many members of the organization volunteer their time to other community agencies in the PSA. Part III, Line 2: Southern New Hampshire Medical Center's Bad Debt Expense includes accounts that have been referred to a collection agency after making reasonable attempts to determine eligibility under the financial assistance policy, along with estimates of current accounts receivable based in historical experience. Part III, Line 3: A significant portion of Southern New Hampshire Medical Center's uninsured patients will be unable or unwilling to pay for the services provided. Thus, Southern New Hampshire Medical Center records a significant provision for bad debts related to uninsured patients in the period the services are provided. The FASB issued an accounting standards update that states that a health care entity that recognizes significant amounts of patient service revenue at the time services are rendered, even though it does not assess the patient's ability to pay, must present bad debts as a reduction of net patient revenue and not as a separate item in the operating expense. The ratio of cost to charge methodology was used to determine costs of these services as outlined in worksheet 2 of the instructions. Consistent with the accounting treatment mentioned above, since the system does not assess the patient's ability to pay, the cost of bad debt for those patients without any form of insurance should be classified as community benefit, consistent with charity care. Part III, Line 4: See page nine of the attached audited financial statements. Part III, Line 8: The ratio of cost to charge methodology was used to determine cost as outlined in Worksheet 2 of the instructions. There are service areas where government programs such as Medicare and Medicaid do not reimburse the organization adequate amounts to cover the costs to provide those services. Southern New Hampshire Medical Center must provide those services regardless of the financial shortfall. Part III, Line 9b: Southern New Hampshire Medical Center recognizes that not all patients who qualify for financial assistance will follow through with an application for financial assistance. Prior to placing any account with a collection agency, Southern New Hampshire Medical Center uses a financial assistance qualification service to categorize patients based primarily on income and assets estimated from census tract data. Those patients whose estimated income/assets fall within Southern New Hampshire Medical Center's financial assistance guidelines are awarded charity or free care assistance for their encounter. Part VI, Line 2: Southern New Hampshire Medical Center worked with the City of Nashua Division of Public Health officials and other members of the community, including local police and fire departments, school officials, ambulance service leaders, directors of community agencies, hospital leaders, physicians and area residents through focus groups to gather input for the Community Health Needs Assessment (CHNA).A Community Health Assessment (CHA) is a collaborative process that identifies key health needs and issues through systematic, comprehensive data collection and analysis. CHAs provide information on a variety of health topics and help identify resources which assist with policy formulation, program implementation, and evaluation. CHAs are also a crucial component of accreditation as they help measure how well a public health system is fulfilling the assurance function, one of the three fundamental purposes of public health. The Greater Nashua CHA is part of an ongoing comprehensive community health improvement process. The purpose of the CHA is to identify vulnerable populations using comparable data within the Greater Nashua Public Health Region (GNPHR) and to subsequently identify trends in health issues, environmental health hazards, and social and economic factors that affect the different populations' health. Collected and analyzed data will be used to identify priority issues within the Greater Nashua Region, and to develop strategies for further actions; these actions are outlined in the form of a Community Health Improvement Plan (CHIP). The CHIP creates a foundation for a work plan to improve the health of the community over the course of three years' time. One of the main objectives of the most recent Community Needs Assessment's research was to determine the biggest health concerns in the community in order to determine community health priorities. The research for this report indicated that most people in the Greater Nashua Region are concerned about behavioral health (including substance use, mental health, and suicide), affordable and accessible healthcare, and outbreaks of communicable disease (40%, 30%, and 26% of respondents, respectively). In regards to upcoming concerns for the next three years, most people are concerned about behavioral health (including substance use, mental health, and suicide), affordable and accessible healthcare, and outbreaks of communicable disease (38.6%, 36.1%, and 25.4% of respondents, respectively). Part VI, Line 3: Southern New Hampshire Medical Center complies with the Southern New Hampshire Health financial assistance policy. Southern NH Health is committed to providing charitable care to persons who have health care needs and are uninsured, underinsured, and ineligible for governmental programs and are otherwise unable to pay for medically necessary care based on their individual financial situations. Southern NH Health strives to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. Charitable care is not considered to be a substitute for personal responsibility and patients are expected to cooperate with Southern NH Health's policies and procedures for obtaining charitable care and to contribute to the cost of their care based on their individual ability to pay. Patients with the financial capacity to purchase health insurance shall be encouraged to do so, as a means of access to health care services, for their overall personal health and protection of their individual assets. Since July 2010, the State of New Hampshire has mandated that any uninsured patient who receives nonelective, medically necessary hospital services are billed an amount no greater than the amount generally received from patients covered by insurance. Additionally, the 2015 Federal 501(r) regulations further require that when calculating this discount, Medicare reimbursement must be included. Therefore, Southern NH Medical Center reduces the amounts owed by uninsured patients by the uninsured discount prior to the patients receiving their first statements of balances due. These discounted balances, and not gross charges, are the balances upon which financial assistance is based, granted and classified for reporting purposes. The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates insurance coverage for individuals starting on January 1, 2014. Additionally, it expands Medicaid coverage to all individuals at or below 100% of the Federal Poverty Level (FPL). The New Hampshire Legislature approved Medicaid expansion effective August 15, 2014. The Granite Advantage Health Care Program (GAHCP) extends NH Medicaid eligibility to all individuals at or below 138% of the Federal Poverty Level. The granting of charitable care shall be based on an individualized determination of financial need, and shall not take into account age, gender, race, social or immigrant status, sexual orientation or religious affiliation.At each registration point, Southern New Hampshire Medical Center has signage and brochures explaining our various forms of financial assistance, including charity care. Additionally, patient registrars offer the charity brochures to self pay patients. Patients who call regarding billing concerns are offered charity assistance. Additionally, verbiage regarding charity care is printed on each billing statement the patient receives. Also, charity care information is available on our hospital website. There is staff available on site at the hospital to assist with financial assistance, Medicaid, and Expanded Medicaid applications. We actively participate in Medicaid Exchange programs and a Prescription Assistance Program to help those with financial needs.Additional information regarding Southern New Hampshire Medical Center's financial assistance policies can be found on the Southern New Hampshire Health website, as provided on this Schedule H. Part VI, Line 4: Southern New Hampshire Medical Center serves people of all ages, race, gender, religion, ethnicity regardless of their ability to pay. Southern New Hampshire Health's service area consists of nineteen New Hampshire and four Massachusetts towns. The service area is divided into a Primary Service Area (PSA) of twelve New Hampshire towns (Amherst, Brookline, Hollis, Hudson, Litchfield, Lyndeborough, Merrimack, Milford, Mont Vernon, Nashua, Pelham, and Wilton), a Secondary Service Area (SSA) of seven New Hampshire towns (Derry, Greenville, Londonderry, New Boston, New Ipswich, Salem, and Windham) and a Massachusetts Service Area (MSA) of four neighboring Massachusetts towns (Dunstable, Pepperell, Townsend, and Tyngsboro).For its 2020 tax year, Southern New Hampshire Medical Center collaborated with the City of Nashua in developing the Greater Nashua Community Health Assessment. The four geographies mentioned most often throughout this report are the City of Nashua, the Greater Nashua Public Health Region, Hillsborough County, and the State of New Hampshire (NH). Throughout the State of NH, there are 13 public health regions. The Greater Nashua Region is composed of the City of Nashua and its 12 surrounding towns which include Amherst, Brookline, Hollis, Hudson, Litchfield, Lyndeborough, Mason, Merrimack, Milford, Mont Vernon, Pelham, and Wilton.As of 2019, the combined population of the Greater Nashua Region was estimated to be about 88,000 individuals. To gauge the demographics of this region, the CHA used a variety of survey and online-polling tools. The majority of survey respondents were Nashua residents (73.6%), but the remaining 26% of respondents were distributed throughout the Greater Nashua region. About 18% of respondents identify within the constructs of racial or ethnic diversity, and the remaining 82% of participants identified as white or Caucasian. 27.1% of respondents were between the ages of 50 and 59; approximately 80% of all respondents were aged 59 or younger. The majority of respondents were at least partially college-educated, with approximately 85% of respondents having completed some college, or having completed an Associate's, Bachelor's, or Graduate degree. Part VI, Line 5: Southern New Hampshire Medical Center provides a variety of services that promote the health of the greater Nashua community. Throughout the year we hold Community Medical Education seminars that offer area residents an opportunity to look behind the scenes of medicine and learn more about the latest medical technology, research and advances. We also perform free public health screenings, such as impact testing for sports teams at local schools, and balance and hearing screenings for the elderly. Our commitment to community health is also evident in the time our leadership spends on the boards of several local health organizations to help improve and promote health services available to area residents.Through the past fiscal year, Southern New Hampshire Medical Center has worked in collaboration with various other government agencies and care providers to address the COVID-19 Pandemic. From the outset of the Pandemic, Southern New Hampshire Health's Incident Command team quickly went to work preparing to care for COVID-19 patients. At that time, the Medical Center activated the Incident Command team whose attention quickly turned to PPE. Nation-wide shortages of surgical masks, N95 masks, gowns, face shields, and cleaning supplies dominated the headlines. Inconsistent images of protective practices at different hospitals and in different countries became another source of concern. A plan to manage PPE was devised and put into place. At the height of the pandemic, rounds were conducted multiple times a day to answer questions and provide the most up-to-date information. All essential workers coming to work at Southern New Hampshire Health rose to the challenges imposed by the Pandemic. In order to meet the potential for increasing demand, clinical areas were re-purposed and some staff were re-assigned to expand critical care capabilities. Teams also came together and collaborated in new and creative ways, such as using tablets for virtual family visits and continuous monitoring of patients. What was unexpected was the outpouring of caring and compassion from the community to our staff in the form of care packages, food, home-made masks, and notes of thanks and encouragement. All of this has been greatly appreciated by our staff and it has helped to keep them going during this uncertain time.While the COVID-19 Pandemic naturally came to the forefront of Southern New Hampshire Medical Center's community health and care programs, Southern New Hampshire Medical Center continued to engage its community and to promote the wellbeing of its fellow citizens throughout the year on a variety of levels. For example, Southern New Hampshire Medical Center continued to focus its attention on educating, maintaining, and supporting a highly educated and competent workforce. Additionally, Southern New Hampshire Medical Center continued to advocate for community safety, nutrition, and personal wellness. Part VI, Line 6: Southern New Hampshire Health System, Inc. is a not-for-profit entity organized to support Southern NH Medical Center and Foundation Medical Partners, Inc. Both Southern New Hampshire Medical Center and Foundation are not-for-profit entities, established to provide medical services to the people of the greater Nashua area.On April 30, 2018 Southern New Hampshire Health System became part of the new non-profit healthcare organization named SolutionHealth. This new non-profit healthcare entity is the combination of two New Hampshire non-profit health care organizations, Elliot Health System (EHS) and Southern New Hampshire Health System (SNHHS), combining together to protect the future sustainability of accessible, comprehensive, value-based clinical care. SolutionHealth is a regional healthcare system with a governing body with members from both EHS and SNHHS. This new organization services over 400,000 community members, is located in the two largest and most diverse cities in New Hampshire and employs over 700 physicians and advanced practice providers in New Hampshire.Additionally, Southern New Hampshire Medical Center frequently and actively collaborates with the City of Nashua Division of Public Health and Community Services as well as other similarly geographically located institutions to enhance the quality and availability of care throughout New Hampshire. Part VI, Line 7, Reports Filed With States NH X 1 1 X X X X 1 1 0 0 0 0 0 1 0 Michael S Rose Former Tres./Pres. & Sec. 422499 0 165307 0 371373 0 92263 0 15770 0 1067212 0 0 0 Karen Maynard MD Trustee 0 665557 0 1867 0 2242 0 15304 0 33679 0 718649 0 0 Paul Trainor Senior VP & CFO, Treasurer 368206 0 109561 0 35689 0 48674 0 2577 0 564707 0 0 0 Joseph M Leahy MD Physician 440302 0 33938 0 1242 0 11200 0 33219 0 519901 0 0 0 Robert Dorf DO EO Pres. Foundation Medical Ptrs. 0 381825 0 57566 0 810 0 11200 0 33124 0 484525 0 0 Andrew Watt MD Assoc. VP Med. Info./Physician 370378 0 33938 0 13810 0 11200 0 29136 0 458462 0 0 0 Susan Desocio Former Pres. Fnd Medical Ptrs. 0 0 0 0 395394 0 8906 0 0 0 404300 0 0 0 Dilip Yarabothu MD Physician 369501 0 14175 0 486 0 11200 0 4475 0 399837 0 0 0 Colin T McHugh Interim President (end 12/2020) 131144 209722 0 17719 0 673 0 0 14080 13467 145224 241581 0 0 Brett Sweeney MD Physician 330612 0 15750 0 19967 0 11200 0 4889 0 382418 0 0 0 Part I, Line 1a Southern New Hampshire Medical Center uses the facilities at the Nashua Country Club for meetings and other business related purposes. The Club does not have a corporate membership; therefore, an individual associated with Southern New Hampshire Medical Center must be a member of the Club. The membership is titled in the CEO's name and invoices are addressed to the CEO, not Southern New Hampshire Medical Center. Southern New Hampshire Medical Center pays the annual dues and all related expenses incurred by the organization. The facilities are only available to Club members. Part I, Lines 4a-b Schedule J, Part 1, Line 4a: Both Michael Rose and Susan DeSocio, who served SNHMC as its President & CEO and FMP as its President, respectively, left the organizations during the previous tax year. Both individuals began receiving severance payments from SNHMC during the 2020 calendar year. Michael Rose's severance agreement entitled him to receive bi-weekly severance payments of normal base compensation. A portion of his severance payments were made to him during the 2020 calendar year, and were included in his 2020 Form W-2 wages. Accordingly, these payments are reflected in Rose's compensation as reported on Schedule J, Part II, Column B(iii). Susan DeSocio also received bi-weekly severance payments of normal base compensation during the 2020 calendar year, and were also included in her 2020 Form W-2 wages. Accordingly, these payments are reflected in DeSocio's compensation as reported on Schedule J, Part II, Column B(iii). Both Michael Rose and Susan DeSocio are listed as "former" officers and employees on Southern New Hampshire Medical Center's Form 990, Part VII and Schedule J, in accordance with IRS Instructions. Schedule J, Part I, Line 4b: Southern New Hampshire Medical Center provides a Supplemental Executive Retirement Plan to certain executives. Funding for this plan during the year was provided as follows: Michael S. Rose - $81,063; Paul Trainor - $37,474; and Susan Desocio - $8,906. Part I, Line 7 There is an additional compensation plan available to managers, directors and senior management that is part of their annual performance plan. The plan takes into consideration quality measures, patient satisfaction, individual goals, budget adherence and overall organizational performance. The range and overall pool is reviewed and approved by the Board of Trustees. The amount designated for the CEO and CFO are considered in the compensation consultant's analysis of executive compensation reported on the 990 Part VI section B Line 15b. Unrelated Organization Compensation Marc Sadowsky, is also the Medical Director of the Medical Center's Electro Convulsive Therapy (ECT) unit. During Calendar year 2020 the Medical Center paid New England Neurological Association $12,600 for ECT and $26,800 for weekend coverage provided by Dr.Sadowsky to Southern New Hampshire Health System. A NHHEF Authority 020279866 2016-06-07 10500000 Equipment purchase 0 0 0 B NHHEF Authority 020279866 6446147E3 2016-11-01 59345000 Refunding 0 0 0 C NHHEF Authority 020279866 2019-08-30 24500000 Equipment purchase 0 0 0 A 10500000 25802 10474198 0 0 1 1 B 59345000 199985 59145015 0 1 1 1 C 24500000 37729 24462271 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 1 0 0 0 0 1 A 1 B 1 C 1 Form 990, Part VI, Section A, line 3 In June of 2020, at the end of the Organization's previous fiscal year covered by this tax filing period, Michael S. Rose, the President and CEO of the Organization, resigned from his position with the Organization. Colin McHugh, who is the VP of Value Innovation at SolutionHealth, a related tax-exempt entity, was hired to serve the Organization as an Interim President until such time as a permanent replacement for Mr. Rose could be found; McHugh began spending a portion of his working time with the Organization in October of 2019, and McHugh ended his term as the Interim President in December, 2020. While Mr. McHugh served the Organization as its Interim President, a portion of Mr. McHugh's SolutionHealth compensation was charged to Southern New Hampshire Health System as a management fee. For the calendar year ending December 31, 2020, SolutionHealth charged SNHMC a total of $145,224 ($131,144 to cover McHugh's salary and wages and $14,080 for nontaxable benefits) for his services to Southern New Hampshire Health System. The management fee was paid directly by Southern New Hampshire Medical Center back to SolutionHealth. Accordingly, McHugh's compensation, as paid by SNHMC, has been reflected on the Organization's Form 990, Part VII, and is included in Part IX, Line 5. Form 990, Part VI, Section A, line 6 Southern New Hampshire Health System, Inc., is the sole corporate member of Southern New Hampshire Medical Center (SNHMC) and the two (2) organizations have identical boards with the exception of one (1) additional member, who is a physician, serving solely on the SNHMC board. Form 990, Part VI, Section A, line 7a Southern New Hampshire Medical Center is governed by the Board of Trustees, who are elected by the Trustees of its sole member Southern New Hampshire Health System, Inc. Form 990, Part VI, Section A, line 7b The sole Member, Southern New Hampshire Health System, Inc. (SNHHS), may consider any issue that may properly come before any meeting of Southern New Hampshire Medical Center (the Medical Center). In addition to any rights and powers conferred on SNHHS by law or these bylaws, The Medical Center, and in the bylaws of SNHHS, SNHHS shall, after due consultation with the Board of Trustees of the Medical Center: (a) appoint and remove, with or without cause, the President/Chief Executive Officer of the Medical Center, subject to ratification of the Board of Trustees of the Medical Center; (b) conduct system-wide strategic planning encompassing all corporations, including the Medical Center, of which SNHHS is the sole corporate member and periodically develop, adopt, and periodically amend or revise a system-wide strategic plan that, among other things, established strategic priorities for the Medical Center; (c) conduct system-wide financial and capital planning encompassing all corporations, including the Medical Center, of which SNHHS is the sole corporate member and periodically develop, adopt, and periodically amend or revise system-wide financial plans and operating and capital improvements budget that, among other things, establish financial and budgetary priorities of the Medical Center; (d) periodically conduct by appropriate means an evaluation of the performance of each member of a board of trustees of all corporations, including the Medical Center, of which SNHHS is the sole corporate member, the results of which shall be used by the SNHHS Governance Committee to determine the Trustee's continued service on such board of trustees. The business and affairs of the Medical Center shall be managed by its board of trustees. The Medical Center's board, however, shall not, without approval of SNHHS: (a) elect or appoint the members of the Medical Center's Board of Trustees or remove such person serving from time to time in that capacity; (b) adopt or amend the Medical Center's Mission Statement; (c) adopt, amend or waive any material provision of the Medical Center's strategic plan or any annual operating or capital improvements plan or budget; (d) incur indebtedness for borrowed money or enter into any capital lease obligation, in either case, that has not been specifically set forth in a written operating budget approved previously by the Member where the amount of the obligation exceeds $1,000,000 in amount; (e) enter into, agree to enter into or otherwise approve of any transaction including an incorporation, merger, consolidation, affiliation, dissolution, liquidation or sale of substantially all of the assets of the Corporation; (f) authorize expenditures contained in a capital and operating budget, even if previously approved by the Board of Trustees of the Medical Center; (g) approve, adopt or enter into a professional or general service contract where the annual expense to the Medical Center exceeds $1,000,000 and that has not been previously approved in SNHMC's annual budget; (h) amend the Articles of Agreement or these Bylaws; (i) acquire or agree to acquire by merging, consolidating with or by purchasing substantially all of the assets of any business or corporation, partnership, joint venture, association, business organization or division thereof; and (j) elect or remove officers of the Medical Center. Form 990, Part VI, Section B, line 11b A copy of the 990 was presented to the full Board and approved by the Finance Committee of the Board of Trustees prior to submission. Form 990, Part VI, Section B, line 12c The organization requires all its personnel, including Leaders, to formally acknowledge that they have read and will abide by our Code of Conduct, which includes our conflict of interest policy. SNHHS/SNHMC monitors compliance of its conflict of interest process, which requires completion of disclosure forms by all Leaders on an annual basis or on a reappointment basis (every two years) for medical/allied staff, to ensure full compliance. Interim disclosures are also required and reviewed should a subsequent conflict arise. Any related party disclosures require review and approval by a designated committee. Compliance reports are provided to SNHHS/SNHMC's compliance committee and Board of Trustees. Form 990, Part VI, Section B, line 15 The compensation of the CEO and CFO is evaluated by an outside consultant. The compensation of the CEO is approved by the Executive Compensation Committee of the Board and the Board of Trustees. A market analysis is performed for all key employees on an annual basis. Once the CEO and CFO approve the final compensation figures for key employees, the CEO reports these figures to the chairperson and vice chairperson of the Board. Form 990, Part VI, Section C, line 19 The organization makes its 990 and 990-T available for inspection upon request. The Code of Conduct is also available on the organization's website. The Code of Conduct addresses certain corporate policies including confidentiality, conflict of interest, patient rights and other governing documents. The organization also makes all relevant documents available to the public upon request. Form 990, Part IX, line 11g Corporate allocation: Program service expenses 39,285,476. Management and general expenses 0. Fundraising expenses 0. Total expenses 39,285,476. Service contracts: Program service expenses 1,791,193. Management and general expenses 408,107. Fundraising expenses 0. Total expenses 2,199,300. Contracted medical services: Program service expenses 1,750,693. Management and general expenses 398,880. Fundraising expenses 0. Total expenses 2,149,573. Form 990, Part XI, line 9: Pension adjustment 15,823,201. Transfers to affiliates -33,062,499. Transfer to SolutionHealth, Inc. -2,850,301. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Foundation Medical Partners Inc 8 Prospect Street Nashua NH 03060 020456218 Physician Services NH 501(c)(3) Line 10 SNHHS 0 Southern New Hampshire Health System 8 Prospect Street Nashua NH 03060 020509221 Medical Services NH 501(c)(3) Line 12b, II SolutionHealth 0 SolutionHealth 360 Route 101 Unit 8 Manchester NH 03110 830741190 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Elliot Health System 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509911 Management NH 501(c)(3) Line 12b, II SolutionHealth 0 Elliot Health System Professional & General LIT 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 016217452 Insurance Trust NH 501(c)(3) Line 12a, I Elliot Hospital 0 Elliot Hospital One Elliot Way Manchester NH 03103 020232673 Medical Services NH 501(c)(3) Line 3 Elliot Health System 0 Elliot Physician Network 10 Prospect Street Manchester NH 03109 020509589 Physician Services NH 501(c)(3) Line 3 Elliot Hospital 0 Elliot Professional Services Network Inc 10 Prospect Street Manchester NH 03109 331003630 Physician Services NH 501(c)(3) Line 10 Elliot Hospital 0 Everwell Inc 1 Medical Center Drive Lebanon NH 03756 352506275 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Mary and John Elliot Charitable Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512229 Fundraising NH 501(c)(3) Line 7 Elliot Health System 0 VNA Community Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020396549 Nursing Services NH 501(c)(3) Line 7 Elliot Health System 0 VNA Home Health and Hospice Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020222241 Home Care and Hospice NH 501(c)(3) Line 10 Elliot Health System 0 VNA of Manchester & Southern NH Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395296 VNA Holding Company NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA Personal Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395295 Private Health and Homemaker Services NH 501(c)(3) Line 10 Elliot Health System 0 Legacy Trust of Southern New Hampshire Health Inc 8 Prospect Street Nashua NH 03060 844779887 Fundraising NH 501(c)(3) Line 7 SNHHS 0 The Surgery Center of Greater Nashua 10 Prospect Street Nashua NH 03060 461084049 Medical Services NH 501(c)(3) Line 3 SNHHS 0 Elliot Common Trust Fund LLC One Elliot Way Manchester NH 03103 203653624 Investments NH N/A 0 0 Elliot Health System Holdings & Subsidiaries 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512224 Management NH N/A C 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 1 1 1 1 0