2022-05-13T14:18:23-05:00 2021-06-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2020-07-01 020226774 Speare Memorial Hospital SPEA 6035361120 16 Hospital Road Plymouth NH 03264 Travis Boucher CFO 6035361120 2022-05-13 1 Travis Boucher 999009999 Joseph R Byrne P01289281 2077752387 2022-05-13 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Michelle McEwen 16 Hospital Road Plymouth NH 03264 82822034 0 X www.spearehospital.com X 1899 NH To work together to serve the needs of our patients and community, and a vision of a community where all can achieve optimal health. 17 14 535 14 0 0 5628304 7926033 59796402 67543021 1660741 2798031 51512 58329 67136959 78325414 255644 249020 0 0 36712203 37548243 0 0 99618 28970376 29450436 65938223 67247699 1198736 11077715 83889184 103298307 36373458 41526924 47515726 61771383 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 63142952 249020 67543021 SMH is a 25 bed acute-care hospital that provides inpatient and outpatient services to the surrounding community. 63142952 1 1 0 1 0 0 0 1 0 1 1 0 0 0 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 80 0 1 535 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 17 14 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 0 NH X Travis Boucher 6035361120 16 Hospital Road Plymouth NH 03264 Patrick Miller Chair 1.00 0.00 X X 0 0 0 Kevin Young MD Director 40.00 0.00 X 149172 0 13426 Margaret Turner Director 1.00 0.00 X 0 0 0 Nancy Puglisi Director 1.00 0.00 X 0 0 0 Elizabeth Kleiner Director 1.00 0.00 X 0 0 0 Ronda Kilanowki Director 1.00 0.00 X 0 0 0 Sandra Jones Director 1.00 0.00 X 0 0 0 Walter Johnson Director 1.00 1.00 X 0 0 0 Thomas Myrick Director 1.00 1.00 X 0 0 0 Steven Camerino Director 1.00 0.00 X 0 0 0 Julie Bernier Director 1.00 0.00 X 0 0 0 Quentin Blaine Secretary 1.00 0.00 X X 0 0 0 Robert Maloney Treasurer 1.00 1.00 X X 0 0 0 Bruce Wiggett Vice Chair 1.00 1.00 X X 0 0 0 Jeanie Forrester Director 1.00 0.00 X 0 0 0 Lisa Baker Director 40.00 0.00 X 113385 0 10074 Michelle McEwen CEO 40.00 1.00 X X 363481 0 58454 Travis Boucher CFO 40.00 1.00 X 191993 0 54736 Kristine Hering CNO 40.00 0.00 X 184310 0 16838 Joseph Ebner MD CMO 40.00 0.00 X 293230 0 60349 Andrew Seefeld MD Director of Emergency Medicine 40.00 0.00 X 476427 0 65312 Thomas Scott MD Emergency Medicine Physician 40.00 0.00 X 406398 0 76089 Robert Chastanet MD General Surgeon 40.00 0.00 X 378543 0 44883 Paul Musco MD Chief of Surgery 40.00 0.00 X 424657 0 67443 Steven Danosi MD Emergency Medicine Physician 40.00 0.00 X 485151 0 75271 3466747 0 542875 59 0 1 0 Asquam Community Health Collaborative 80 Highland Street Laconia NH 03246 IT Services 2279080 Weatherby Locums PO Box 972633 Dallas TX 75397 Contracted Providers 916468 Plymouth Regional Rehab Services 790 Lake St Bristol NH 03222 Rehab Management 839555 American Healthcare Staffing Association PO Box 1928 Edmond OK 73083 Contracted Clinical Staff 793121 Alliance Heathcare Services Inc PO Box 735714 Dallas TX 75373 Contracted MRI-Nuclear Medicine 588988 9 32500 7092230 801303 7926033 Patient Service Revenue 624100 149058282 149058282 Other Operating Revenue 621400 2621680 2507808 113872 Contractual/Char. Adj. 624100 -84136941 -84136941 67543021 735738 735738 57193 0 57193 57193 57193 6549891 4487598 2062293 2062293 2062293 10158 32500 9022 1136 1136 78325414 67429149 0 2970232 X 249020 249020 1509447 286057 1223390 28915497 28593637 242254 79606 1582885 1526988 55897 3837739 3621578 216161 1702675 1562933 131531 8211 52605 48288 4317 49882 45788 4094 88525 81260 7265 109017 109017 11416041 10612332 796749 6960 82858 76058 6800 2810438 2579779 228139 2520 1461927 1341944 119983 874344 802585 71759 36015 33059 2340 616 72179 66255 5924 307411 241253 66158 2686786 2590805 95981 965017 885816 79201 Medical Supplies 5242315 4812067 429703 545 Medicaid Enhancement Ta 2282514 2282514 Common Area Fees 293109 269053 24056 Dues & Subscriptions 251051 230447 19949 655 368402 303436 64461 505 67247699 63142952 4005129 99618 X 14879933 20747332 10417373 17399152 6651617 7862611 358000 346293 1201726 1234739 745826 482606 57163125 40951438 17322703 16211687 26292105 33281958 5000 5000 839208 743228 5175693 4983701 83889184 103298307 9882376 11363764 14041530 12942567 12449552 17220593 36373458 41526924 X 46886685 61098726 629041 672657 47515726 61771383 83889184 103298307 X 11077715 3134856 43086 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 11762 11762 0 Part II-B, Line 1: The Organization pays dues to various organizations, a portion of which is attributable to lobbying activities. X 0 272584 7 272591 271915 669 272584 270791 1124 271915 270277 514 270791 270206 71 270277 0.00000 1.00000 0.00000 1 0 855030 855030 32266829 21346390 10920439 22317614 18667224 3650390 1723652 937824 785828 16211687 Estimated Third-Party Payor Settlements 10201318 Investment in Subsidiary - Boulder Point -2185356 Deferred Compensation 730793 CARES Act Funding 8473838 17220593 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 42658 32500 10158 1210 2115 3520 1770 407 42658 32500 10158 1210 2115 3520 1770 407 9022 1136 1 1 1 X 125.000000000000 1 X 225.000000000000 1 1 0 1 1 436731 436731 0.00650 10435281 6504781 3930500 0.05840 10872012 6504781 4367231 0.06490 495018 495018 0.00740 61974 61974 0.00090 556992 556992 0.00830 11429004 6504781 4924223 0.07320 1 0 25377324 28737282 -3359958 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 20 1 0 1 1 X https://spearehospital.com/about-speare/community-benefit/ X www.pemibakercommunityhealth.org & www.midstatehealth.org X 1 20 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 took into account input from persons who represent the community served by the hospital facility when conducting the 2020-2023 Community Health Needs Assessment (CHNA) of the Central New Hampshire region. For the purpose of the assessment, the geographic area of interest was 17 municipalities comprising the Central New Hampshire Public Health Region with a total resident population of 30,332, and served by the member agencies of the Central New Hampshire Health Partnership. The Assessment took place during the spring and early summer of 2020, in the midst of the COVID-19 pandemic, which limited our efforts to gather qualitative information for the CHNA. Methods employed in the CHNA included: surveys of community residents made available through social media, email distribution and website links through multiple channels through the region; a direct email survey of key stakeholders and community leaders representing multiple community sectors; a set of community discussion groups and individual interviews conducted virtually. In addition, the CHNA included a review of available population demographics and health status indicators. Persons consulted who represent the community include individual community members and stakeholders. The Community Health Needs Assessment Survey yielded 505 individual responses of which 80% were residents of towns within the primary service area. Survey respondents were 84% female.Key stakeholder respondents yielded representation from the following sectors:- Community member / Volunteer (25.3%)- Public Health (17.7%)- Education / Youth Services (17.7%)- Municipal / County Government (13.9%)- Human Service / Social Service (10.1%)- Fire / Emergency Medical Service (8.9%)- Mental Health / Behavioral Health (8.9%)- Business (7.6%)- Primary Health Care (6.3%)- Faith organization (6.3%)- Hospital (5.1%)- Civic / Cultural Organization (3.8%)- Public Safety / Law / Justice (2.5%)- Home Health Care (2.5%)- Medical Sub-Specialty (2.5%)- Dental/Oral Health (2.5%) 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- Newfound Area Nursing Association- Pemi-Baker Community Health Speare Memorial Hospital Part V, Section B, Line 11: Speare is addressing the significant needs identified in the CHNA as follows:- Access to affordable health care services and insurance Speare provides:o Subsidized Health Serviceso Primary Care Clinico Prescription Assistance Programo Breast Cancer Screeningo Financial Counselingo Medicare and Medicaid Costs exceeding reimbursemento Charity Careo Free & Discounted Health Care Serviceso Community Health Grants- Speare provides grants to local non-profit health and social service agencies that provide services aligned with our CHNA. Grants have supported transportation services, "Got Lunch" programs, Substance Misuse Prevention and Recovery programs, and mental health and wellness activities for socially and economically disadvantaged NH Girls. - School Dental Programo Working in partnership with SAU 48, Lin-Wood Public Schools, Warren Village School, Ashland Elementary School, Plymouth Pediatrics, Plymouth OB/GYN, Lincoln Woodstock community child care, and Plymouth and Bristol Women, Infant and Children (WIC) programs, Speare provides: free dental screenings, silver diamine fluoride, temporary fillings and fluoride varnish applications; dental cleanings and sealants to school-aged children on a sliding fee scale; and, case management and financial assistance to those in need.- Access to mental health services - Speare provides:o A psychiatrist to meet with patients of Speare Primary Care as prescribed by their providers and a licensed clinical mental health counselor to meet with patients and families at Plymouth Pediatric & Adolescent Medicine .- Community Health Education:o Diabetes education and supporto Virtual Healthy Aging Series to educate elders and caretakersAdditionally Speare is an active partner in the Central New Hampshire Public Health Advisory Council, Central New Hampshire Health Partnerships, Community Health Services Network (IDN), Central NH Community Opioid Response Program, Plymouth Coordinating Council, Central New Hampshire Chamber of Commerce, and the Central New Hampshire MACE/CERT. These organizations work towards meeting the needs identified in the CHNA.Speare provides financial contributions to several social service agencies that supports initiatives aimed at addressing community needs that do not fall directly within the scope of its mission. These needs include: alcohol and drug use prevention, treatment and recovery, domestic violence and childhood trauma, senior services including assisted living or long term care services, and access to transportation. 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 8-9 of audited financial statements for footnote disclosure.In 2021, the Organization adopted FASB Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606), and related guidance, which supersedes accounting standards that previously existed under U.S. generally accepted accounting principles and provides a single revenue model to address revenue recognition to be applied by all companies. Under the new standard, companies recognize revenue when a customer obtains control of promised goods or services in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods and services. ASU No. 2014-09 also requires companies to disclose additional information, including the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. The Organization adopted this ASU for the year ended June 30, 2021 and elected the modified retrospective method; therefore, the consolidated financial statements and related notes have been presented accordingly.As a result of the adoption of the rules described above, the Organization is recording $0 of bad debt expense for 2020. 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 Drug and Alcohol Free Youth (CADY) 94 Highland Street Plymouth NH 03264 571212859 501(c)(3) 12000 Educate, engage and empower our schools and communities to prevent and reduce youth alcohol, tobacco, and other drug use and to promote healthy environments and promising futures. Grafton County Senior Citizens Council PO Box 433 Lebanon NH 03766 237248316 501(c)(3) 10000 To develop, strengthen, and provide programs and services that support the health, dignity and independence of older adults and adults with disabilities living in our communities. Transport Central 258 Highland Avenue Plymouth NH 03264 208463821 501(c)(3) 12500 To initiate and provide dispatched and coordinated volunteer driver services to our residents who need transportation. Foundation for Healthy Communities 125 Airport Road Concord NH 03301 200275078 501(c)(3) 168700 Support Medicaid Expansion and the Bureau on Alcohol & Drug Abuse Prevention Lakes Region Mental Health Center 40 Beacon Street East Laconia NH 03246 020272138 501(c)(3) 13824 Lakes Region Mental Health Center is the community leader providing quality, accessible and integrated mental and physical health services, delivered with dedication and compassion. 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 Steven Danosi MD Emergency Medicine Physician 481194 0 0 0 3957 0 41258 0 34013 0 560422 0 0 0 Andrew Seefeld MD Director of Emergency Medicine 476115 0 0 0 312 0 38691 0 26621 0 541739 0 0 0 Paul Musco MD Chief of Surgery 421101 0 1500 0 2056 0 34324 0 33119 0 492100 0 0 0 Thomas Scott MD Emergency Medicine Physician 405681 0 0 0 717 0 34526 0 41563 0 482487 0 0 0 Robert Chastanet MD General Surgeon 377203 0 0 0 1340 0 32785 0 12098 0 423426 0 0 0 Michelle McEwen CEO 328631 0 30382 0 4468 0 26806 0 31648 0 421935 0 0 0 Joseph Ebner MD CMO 274676 0 18053 0 501 0 23541 0 36808 0 353579 0 0 0 Travis Boucher CFO 188517 0 3339 0 137 0 16917 0 37819 0 246729 0 0 0 Kristine Hering CNO 177928 0 6052 0 330 0 15370 0 1468 0 201148 0 0 0 Kevin Young MD Director 148422 0 750 0 0 0 12760 0 666 0 162598 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 a bonus based on compensation survey or study, comparison of other organizations, Form 990 meeting certain productivity, quality and patient experience criteria. A New Hampshire Health And Education Facilities Authority 020279866 2012-12-07 21100000 To pay off and provide advanced refunding for 2010 and 2004 Bonds 0 0 0 A 8045088 21100000 209815 4566977 16323208 2015 1 1 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 1 0 0 0 1 A 0 Date Rebate Computation Performed Issuer Name: New Hampshire Health And Education Facilities Authority Date the Rebate Computation was Performed: 12/31/2021 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 8,437,336. Management and general expenses 747,424. Fundraising expenses 6,960. Total expenses 9,191,720. Contract Nursing & Technicians: Program service expenses 2,174,996. Management and general expenses 49,325. Fundraising expenses 0. Total expenses 2,224,321. 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 43,086. 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 1248386 1573209 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 324035 FMV Speare Memorial At Boulder Point K 856107 FMV