2025-06-30T11:21:55-05:00 2024-09-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2023-10-01 851443782 Concord Hospital - Laconia CONC 6032284677 250 Pleasant Street Concord NH 033017559 Scott Sloane Senior VP, CFO, & Treasurer 6032284677 2025-06-11 1 0 Connor Smart P02285543 2078792100 2025-06-11 2023 2025-03-06 01:10:19Z Robert P Steigmeyer 250 Pleasant Street Concord NH 033017559 140536605 0 X www.concordhospital.org/locations/ X 2020 NH Hospital 6 5 1087 31 217325 20575 1569605 1122743 137121396 139255990 136590 80208 1059699 27134 139887290 140486075 284 895 0 0 86250080 88020903 0 0 264161 64320142 65588781 150570506 153610579 -10683216 -13124504 60120009 55120961 24712747 32990076 35407262 22130885 CH-Laconia is a charitable organization which exists to meet the health needs of individuals within the communities it serves. 0 0 129071845 895 139065799 Various hospital services; see Schedule H.In FYE 2024, CH-L invested over $19 million in community benefit programs, services, and other expenses. The largest areas of support were charitable care services and subsidized programs and services. Our investment enhances the Hospital's ability to provide quality patient care, respond to identified community health needs and address the Hospital's charitable mission overall. 129071845 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 1087 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NH X X Scott Sloane Senior VP CFO 6032277000 250 Pleasant Street Concord NH 033017539 X Robert Steigmeyer President & CEO, Member Ex-Officio 1.00 62.00 X X 0 1585081 316861 Lucy Karl Esq Trustee 1.00 6.00 X 0 0 0 Robert Segal Trustee 1.00 7.00 X 0 0 0 Manisha Patel DDS Chair 1.00 7.00 X X 0 0 0 Charles Fanaras Vice Chair 1.00 7.00 X X 0 0 0 William Chapman Esq Secretary (end 1/2024) 1.00 6.00 X X 0 0 0 Lucy Hodder Esq Secretary 1.00 6.00 X X 0 0 0 Scott Sloane Senior VP, CFO, & Treasurer 1.00 62.00 X 0 693400 154062 Mary Bakken System Chief Operating Officer 1.00 51.00 X 0 702300 145242 Matthew Gibb MD Chief Clinical Officer 1.00 51.00 X 0 871082 126234 Kevin McCarthy Chief Administrative Officer 1.00 51.00 X 0 474591 104369 Christopher Weinmann MD Physician 50.00 0.00 X 0 570861 38601 David Croasdale MD Physician 50.00 0.00 X 0 474660 13301 Tajammul Shafique MD Physician 50.00 0.00 X 0 467612 42600 Stephen Marshall MD Physician 50.00 0.00 X 0 462339 44194 Krista Hachey MD Physician 50.00 0.00 X 0 402198 17063 0 6704124 1002527 147 0 1 0 Concord Orthopaedics PA 264 Pleasant Street Concord NH 03301 Medical services 3104762 Medefis Consolidated PO Box 5068 New York NY 10087 Healthcare solutions 2995430 Anesthesia Associates PA 1 Pillsbury Street Suite 202 Concord NH 03301 Medical services 1925000 Dew Construction Corp 277 Blair Park Road Suite 130 Williston VT 05495 Construction services 1816313 Core Medical Group PO Box 3065478 Nashville TN 37230 Staffing and recruiting 1325472 20 89379 1033364 1122743 Patient services 621400 132037161 131841411 195750 Disproportionate share funding 621400 5244103 5244103 Hospital auxiliary services 621400 1275477 1275477 Pharmacies 456110 644034 644034 Food services 722210 55215 55215 139255990 111955 111955 21575 0 21575 21575 21575 31747 -31747 -31747 -31747 24342 18783 5559 5559 140486075 139065799 217325 80208 X 895 895 73406059 61457858 11833250 114951 1142556 956568 184205 1783 8315997 6962298 1340721 12978 5156291 4316937 831307 8047 4584 4584 85086 85086 30000 30000 3275 3275 16408241 12847690 3508598 51953 19758 16806 2929 23 1720602 1463556 255065 1981 579156 492634 85855 667 5345636 4547037 792446 6153 329506 280280 48847 379 75580 64289 11204 87 5256107 3526297 1674126 55684 2368004 2014241 351037 2726 Drugs/medical supplies 15409626 13107539 2302087 Provision for bad debts 8229209 8229209 NH MET 6225000 6225000 Repairs/maintenance 2795183 1963690 825555 5938 704228 599021 104396 811 153610579 129071845 24274573 264161 8484 3450 81093 0 18209206 15555889 1386655 1479596 2261607 2316549 39605402 13316996 27337170 26288406 1983736 2345147 8827058 7106924 25000 25000 60120009 55120961 4443016 5043386 66216 69081 20203515 27877609 24712747 32990076 X 33423526 19785738 1983736 2345147 35407262 22130885 60120009 55120961 X -13124504 280177 -432050 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 27288 0 0 0 27288 0 Part II-B, Line 1: Concord Hospital - Laconia ("CH-L") was a member of the American Hospital Association & the New Hampshire Hospital Association in the fiscal year ended 9/30/2024. A portion of the dues paid to these organizations were available for lobbying expenditures on behalf of CH-L and the other member organizations in furtherance of their exempt purposes. The portion of the dues used for lobbying by the American Hospital Association and the New Hampshire Hospital Association were $10,562 and $16,726, respectively. 1983737 374685 10000 3275 2345147 2280376 300168 -50397 542966 3444 1983737 1967767 589241 -236590 35925 4117 2280376 1967767 1967767 0.00000 0.84440 0.15560 0 0 650000 650000 9882138 3069323 6812815 28298233 10247673 18050560 775031 775031 26288406 Due to affiliates 15249701 Third-party settlements and Medicare liabilities 5450904 Operating lease liabilities 7177004 27877609 X Part V, Line 4: On May 1, 2021, Concord Hospital, Inc., the sole member of Concord Hospital - Laconia, acquired certain assets of LRGHealthcare, which included the hospitals that became Concord Hospital - Laconia and Concord Hospital - Franklin, and their ambulatory sites. As part of this acquisition, Concord Hospital, Inc. also acquired LRGHealthcare's existing endowments, which were subsequently divided and allocated to the two new hospital-entities. The majority of the funds received by Concord Hospital - Laconia as part of the acquisition of LRGHealthcare are restricted for the use of providing discounted and/or free medical care. Concord Hospital - Laconia's Board also has the ability to designate and set aside unrestricted endowment funds to be used for general hospital and healthcare operations as the Board sees fit and for the furtherance of Concord Hospital - Laconia's mission. Part X, Line 2: The Hospital, CH-Laconia, CH-Franklin, CRHCDC, CRHVC, and the Trust 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. CH-ACO was organized as a single member limited liability company and has elected to be treated as a disregarded entity for federal and state income tax reporting purposes. Accordingly, all income or losses and applicable tax credits are reported on the member's income tax returns, with the exception of taxes due to the State of New Hampshire. 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 had taken no uncertain tax positions that require adjustment to or disclosure in the accompanying consolidated financial statements. GSIE, CHIG, CH-ACO, CEC and CRHSC account for income taxes in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes. FASB ASC 740 is an asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of temporary differences between the tax and financial reporting basis of certain assets and liabilities. Resulting income tax expense and the temporary differences between the tax and financial reporting basis are not material. 1 1 1 X 225.000000000000 1 X 500.000000000000 1 1 1 0 1 1 2 891 586462 586462 0.00400 18339092 10580510 7758582 0.05340 2 891 18925554 10580510 8345044 0.05740 2 670 177823 177823 0.00120 2 308 273499 133625 139874 0.00100 6 85131 22294315 11841191 10453124 0.07190 6 78480 78480 0.00050 16 86109 22824117 11974816 10849301 0.07460 18 87000 41749671 22555326 19194345 0.13200 1 2109 2109 0.00000 1 2109 2109 0.00000 1 2050930 219450 60083001 74666427 -14583426 X 1 1 1 1 Concord Hospital - Laconia 80 Highland Street Laconia NH 03246 See Part VI 04500 X X X Concord Hospital - Laconia 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X See Part V, Section C X See Part V, Section C X X 1 23 1 See Part V, Section C 0 1 X 225.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X X 1 X 0 X X X X X 1 X 0 0 Concord Hospital - Laconia Part V, Section B, Line 5: See the narrative for Schedule H, Part VI, line 2. Concord Hospital - Laconia Part V, Section B, Line 6a: The most recent CHNA was conducted with the other hospitals within the Concord Hospital System, which includes Concord Hospital, Inc., Concord Hospital - Franklin, and Concord Hospital - Laconia. Concord Hospital - Laconia Part V, Section B, Line 6b: The Hospital's most recently published CHNA was prepared by New Hampshire Community Health Institute/JSI. The Community Health Institute/JSI was founded in 1978 and the New Hampshire office is located in Bow, NH. The Community Health Institute/JSI serves clients globally as a resource that collaborates with government agencies, the private sector, and local nonprofit and civil society organizations to identify and implement solutions to public health and health care challenges. In New Hampshire, the New Hampshire Community Health Institute/JSI supports hospitals and other non-profit organizations to conduct Community Health Needs Assessments and develop Implementation Strategies to address significant health needs. Additionally, for this community health needs assessment, Concord Hospital received input from a Community Collaborative of representatives from local organizations. These local organizations include Community Action Program Belknap-Merrimack Counties, Foundation for Healthy Communities, Granite United Way - Capital Area Public Health Network, Granite VNA, HealthFirst, Lakes Region Mental Health Center, NH Department of Health and Human Services, Partnership for Public Health, and Riverbend Community Mental Health. Concord Hospital - Laconia Part V, Section B, Line 7d: The Hospital's 2023 Health Needs Assessments is on the Hospital's website at: https://www.concordhospital.org/app/files/public/10459c81-bd2d-4180-894e-9b0e476c5133/2023ConcordLakesRegionCommunityHealthNeedsAssessment.pdf The website also provides instructions on how to obtain a printed copy. Concord Hospital - Laconia Part V, Section B, Line 11: Part V, Section B, Line 11: The fiscal year beginning October 1, 2023, Form NHCT-31, Community Benefits Plan Report, can be found at the Hospital facility's website:https://www.concordhospital.org/app/files/public/da91f0bf-d61f-4163-b534-9018c7f66b45/2024CommunityBenefitsPlanReportLaconia.pdfThe 2024-2026 Concord Hospital Community Health Improvement Plan outlines how Concord Hospital is addressing the significant needs identified in its most recently conducted CHNA covered by this tax filing. The Community Health Improvement Plan is on the Hospital's website at:https://www.concordhospital.org/app/files/public/da91f0bf-d61f-4163-b534-9018c7f66b45/2024CommunityBenefitsPlanReportLaconia.pdf Concord Hospital - Laconia Part V, Section B, Line 16j: The Hospital includes information about charitable care services in many publications that go to the community. In addition, we collaborate with many community organizations that support vulnerable populations, including low-income individuals and families; our financial assistance program is well understood by those agencies who often refer people to the program. The Hospital's Financial Assistance Policy is available online in English, and is able to be translated to other languages on the Concord Hospital, Inc. and Concord Hospital - Laconia websites. Concord Hospital - Laconia Part V, Section B, Line 20e: Concord Hospital-Laconia follows Concord Hospital, Inc.'s financial, billing, and collection policies. Concord Hospital, Inc. is a charitable organization which exists to meet the health needs of individuals within the community it serves. It is the established policy of Concord Hospital, Inc. to provide services on the sole basis of the medical necessity of such services as determined by the medical staff without reference to race, color, ethnicity, national origin, sexual orientation, marital status, religion, age, gender, disability, or inability to pay for such services. As such, patients requiring urgent or emergent services shall not be denied those services based on ability to pay.Concord Hospital, Inc. has a generous financial assistance program. Individuals who cannot afford to pay for their medical care are encouraged to apply for financial assistance. Financial assistance is available to individuals who are uninsured and for those individuals who have insurance, but cannot afford their out-of-pocket costs such as co-payments, co-insurance, and deductibles.In addition to the efforts taken as indicated in Schedule H, Part V, Lines 20a through 20c, the Hospital also takes additional measures to ensure that patients eligible for financial assistance do not have anExtraordinary Collection Action (ECA) levied against them. Each month, Concord Hospital reviews accounts prelisted for bad debt for potential referral to a collection attorney. Concurrent to referring the account(s) to the collection attorney, the manager of customer service or designee will provide the financial assistance supervisor a copy of the list of individuals and accounts to be referred. The financial assistance supervisor or designee will attempt to orally notify each responsible party of the availability of financial assistance and the application process. The financial assistance supervisor or designee will record in account notes the date and outcome of the call. Concurrent to referring the account(s) to a collection attorney, the manager of customer service or designee will send a written notice to the responsible party. This notice will include the following information:- Statement that account(s) are being placed with collection attorney- Statement of the ECA(s) that may be initiated- Deadline that the ECA(s) may be initiated, which will be no sooner than 120 days passed the mailing date of the first statement or 30 days passed the mailing date of the initiation notice, whichever is later- Statement that financial assistance is available and where to find the financial assistance policy and application.The manager of customer service or designee will record in account notes the date the notice was mailed. He or she will also send a copy of the notice to be scanned to the patient's account(s).Prior to engaging in any legal or collection action, the collection attorney must receive written approval from the manager of customer service or director of patient financial services. These individuals may only authorize legal action if all of the following conditions are met:- The collection attorney has no reason to believe the responsible party is unable to pay the debt.- AND at least 120 days have passed since the mailing date of the first statement- AND at least 30 days have passed since the mailing date of the initiation notice- AND account notes indicate that the Hospital has made at least one attempt to orally notify the individual about the financial assistance policy. Schedule H, Part V, Section B, Line 16a-c: The Hospital's Financial Assistance Policy, Application, and Plain Language Summary are all available online through the following website:https://www.concordhospital.org/patients-visitors/billing-insurance-financial-assistance/Specifically, the complete Financial Assistance Policy is available at the following website:https://www.concordhospital.org/app/files/public/2d417ffa-2ff1-4b62-bc42-0e382158c9ad/Financial-Assistance-Policy.pdfThe Concord Hospital Plain Language Summary and the Financial Assistance Application are both available online within the same document on the following website:https://www.concordhospital.org/app/files/public/eab7d7b2-fdc7-471c-b1f3-dbd157ca5231/Plain%20Language%20Summary%20of%20Financial%20Assistance%20Policy.pdf Schedule H, Part V, Section B, Line 7a-10: All Charitable Achievements and Health Needs Assessment documents for the Concord Hospital System can be found on the Concord Hospital website at the following address:https://www.concordhospital.org/about-us/charitable-achievements-and-health-needs-assessment/The 2022 Concord and Lakes Region Community Health Needs Assessment, published in September 2023, is available online at:https://www.concordhospital.org/app/files/public/10459c81-bd2d-4180-894e-9b0e476c5133/2023ConcordLakesRegionCommunityHealthNeedsAssessment.pdfThe 2024-2026 Concord Hospital Community Health Improvement Plan is available online at:https://www.concordhospital.org/app/files/public/7284ad7a-196f-4379-856a-ba20ed2b2b96/2024-26CHCHIP.pdfThe Concord Hospital Form NHCT-31, Community Benefits Plan Report, for the year beginning October 1, 2023, is available online at:https://www.concordhospital.org/app/files/public/c0e3eb75-bd0e-4930-a0cc-18bd42a28eeb/2024CommunityBenefitsPlanReportConcord.pdf 19 1 - CHL Primary Care - Meredith 238 Daniel Webster Highway Meredith NH 032535803 Outpatient services 2 - CHL Internal Medicine - 724 N Main St 724N Main Street Laconia NH 032462742 Outpatient services 3 - CHL General Surgery 85 Spring Street Laconia NH 032463113 Surgical services 4 - CHL Obstetrics and Gynecology - Laconia 734N Main Street Laconia NH 032462777 Outpatient services 5 - CHL Pulmonary and Critical Care Medicine 85 Spring Street Laconia NH 032463113 Outpatient services 6 - CHL Urologic Institute - Laconia 724N Main Street Laconia NH 032462742 Urology services 7 - CHL Pediatrics - Belmont 8 Corporate Drive Belmont NH 032203103 Pediatrics 8 - CHL Primary Care - Gilford 14 Maple Street Gilford NH 032496578 Outpatient services 9 - CHL Primary Care - Belmont 8 Corporate Drive Belmont NH 032203103 Outpatient services 10 - CHL Neurology - Laconia 724N Main Street Laconia NH 032462742 Outpatient services 11 - CHL Sleep Center - Gilford 14 Maple Street 200 Gilford NH 032496580 Outpatient services 12 - CHL Wound Healing - Laconia 85 Spring Street Laconia NH 032463113 Outpatient services 13 - CHL Recovery Clinic - Gilford 14 Maple Street Gilford NH 032496580 Recovery services 14 - CHL Endocrinology - Laconia 724N Main Street Laconia NH 032462742 Outpatient services 15 - CHL Dental Center - Laconia 29 Elliot Street Laconia NH 032463235 Outpatient services 16 - CHL Podiatry - Laconia 724N Main Street Laconia NH 032462742 Outpatient services (closed) 17 - CHL OccupationalEE Health - Gilford 14 Maple Street Suite 120 Gilford NH 032496578 Outpatient services 18 - Lab at CH Primary-Meredith 238 Daniel Webster Highway Meredith NH 032535803 Outpatient laboratory services 19 - CHL Orthopedics - Laconia 80 Highland Street Laconia NH 032463246 Outpatient services Part I, Line 7: Subsidized Health Services represents those activities that assure access to medical care and support for people with special medical needs and those who may be faced with chronic health conditions. Many of these activities also ensure access to needed health services, which might otherwise not be available without subsidization. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 8,229,209. Part II, Community Building Activities: In 2023, Concord Hospital-Laconia's Community Building Activities focused on emergency preparedness. Concord Hospital-Laconia continued to support community building activities through organizational and employee involvement with Granite United Way, Lakes Region Community Services, Winnipesaukee Public Health Network and recycling/environmental service programs. Concord Hospital-Laconia works with community partners to stay abreast on the status of current health concerns. Part III, Line 2: The amount reported on Part III, Line 2 was derived by applying the cost to charge ratio against the amount of bad debt expense reported on Form 990, Part IX, Line 25, and Column (A). Accounts Receivable: The allowance for doubtful accounts is provided based on an analysis by management of the collectability of outstanding balances. Management considers the age of outstanding balances and past collection efforts in determining the allowance for doubtful accounts. Accounts are charged against the allowance for doubtful accounts when deemed uncollectible. Charity Care: The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as community benefit. The amount on Line 3 is calculated by determining the revenue for all patients that have completed an application for financial assistance and only reporting the amount for those that did not complete the financial assistance process for any number of reasons and were then transferred to bad debt. Part III, Line 3: See narrative for Part III, Line 2. Part III, Line 4: See page 12 of the attached audited financial statements. Part III, Line 8: The Medicare shortfall of $14,583,426 represents the costs of unreimbursed services. In addition, many of the subsidized health services reported on line 7g include some revenue and expenses from services to Medicare patients, Medicare allowable costs on line 6 were determined using the cost to charge ratio methodology. The Hospital has not included its Medicare shortfall as a community benefit in Part I. Part III, Line 9b: The Hospital has a Financial Assistance policy in addition to, and complementing, the bad debt collection policy. The policy describes the Hospital's program of financial assistance for medically necessaryservices to individuals and families who are uninsured, underinsured, or who experience a catastrophic healthcare event and do not quality for any other state or federal assistance programs. Patient education of eligibility for assistance is described below in the statement for Part VI, Line 3. Schedule H, Part V, Section A, Hospital Website: The Concord Hospital-Laconia website can be found online at the following address:https://www.concordhospital.org/locations/profile/concord-hospital-laconia/ Part VI, Line 2: Every three years, the Hospital conducts a comprehensive community health needs assessment, engaging numerous community organizations and health partners in the process, to identify far-reaching health needs faced by people in the communities served by the Hospital. Assessment methodologies address both quantitative and qualitative data and include stakeholder interviews, focus groups, community listening sessions, web survey, written surveys, and analysis of various data sets. Assessment results are shared with community members and serve as the basis to develop new or expanded services in response to need. In 2023, Concord Hospital conducted a system-wide health needs assessment to include Concord Hospital - Concord, Concord Hospital - Laconia and Concord Hospital - Franklin. The results and the corresponding 2024-2026 Community Health Improvement Plan have been approved by the Board and are available on the Concord Hospital website at: https://www.concordhospital.org/about-us/charitable-achievements-and-health-needs-assessment/ Part VI, Line 3: Concord Hospital - Laconia follows the financial assistance procedures and policies of its parent, Concord Hospital, Inc. (the Hospital). The Hospital provides a financial assistance packet including an explanatory program cover sheet and application to all uninsured patients. The Hospital actively meets with all hospitalized patients who are uninsured as well as any insured patient who is having difficulty paying for balances after insurance has paid. The Hospital routinely provides information and education regarding other insurance coverage options as well as direct assistance in applying for Medicaid.The Hospital also actively meets with all people who indicate that they do not have insurance or will have difficulty paying their obligations to inform and work with them to understand what local programs are available to them, including how they can benefit from the Hospital's Financial Assistance program. Part VI, Line 4: Concord Hospital-Laconia serves the region surrounding Laconia, NH. The primary area focuses on 13 towns with a population of more than 64,000. More than 75 percent of the inpatient and Emergency Department discharges from Concord Hospital-Laconia are for patients living in the seven towns that have a combined population of approximately 39,000. The remainder of patients originated from bordering towns; a small percentage were non-NH residents. Communities served include small but growing populations and include low-income, uninsured adults and children. Compared to New Hampshire overall, the service area population has proportionally more senior (about 27.2 percent over 65 compared to about 18 percent in NH overall). The service area has a similar proportion of children and youth compared to the state (17.9 percent under 18 compared to 19 percent in NH overall) ranging from about 10 percent of Sandwich residents to approximately 29 percent in Ashland. Additionally, the region overall has a higher proportion of family households with children that are headed by single parents (29.8 percent compared to 28 percent for NH) and individuals with a disability (15.8 percent compared to 12.7 percent for NH), The 2023 Concord and Lakes Region Community Health Needs Assessment also found that 7.7 percent of the population in the Lakes Region lived at or below 100% of the Poverty Level, 6.2 percent of the population is uninsured and 15.8 percent of the population enrolled in Medicaid. Medically Underserved Areas and Populations (MUA/Ps) are designated by the Health Resources and Services Administration based on an "Index of Medical Underservice." The low income population of the Franklin Service Area (rural areas of Belknap, Grafton, and Merrimack counties) was identified as a primary care MUP. Part VI, Line 5: Concord Hospital - Laconia develops programs and services to address Community health needs and invests in initiatives that align with the Hospital's charitable mission. A reasonable amount of Concord Hospital - Laconia's community benefit investment remains in the area of charitable care to ensure that those without insurance or with limited insurance have access to needed medical care. The Hospital strives to address the needs of vulnerable populations, including our low-income neighbors and other vulnerable populations.The total population of the Concord Hospital health system's primary service area in 2021 was 249,846 according to the United States Census Bureau (American Community Survey, 2021) or about 18 percent of the total population of New Hampshire. The service area population has increased by approximately 3.5 percent or about 8,400 people over the last 3 years. NH's population grew by about 2 percent over the same time frame. Compared to New Hampshire overall, the service area population has proportionally more seniors, about 20 percent are age 65+ compared to about 18 percent in NH overall. The percent of residents within the primary service area living below the federal poverty level mirrors NH's at about 7 percent of households. In the primary service area, the percent of family households with children headed by a single parent is 29.4 percent compared to NH at 28.0 percent. The population the primary service area with a disability is 14.5 percent compared to 12.7 percent in NH across all age groups, with the greatest percent disabled in the 65+ age group at 31.5 percent compared to NH overall at 29.8 percent.Additionally, several areas are characterized as "rent burdened," defined as households spending more than 30 percent of income on housing, identified as a contributor to poor health outcomes. Data from the US Census Bureau (2021 American Community Survey) for the primary service area noted 6.0 percent of the population is uninsured, 21.6 percent have Medicare coverage, and 14.5 percent of the population is enrolled in Medicaid. Medically Underserved Areas and Populations (MUA/Ps) are designated by the Health Resources and Services Administration based on an "Index of Medical Underservice." The low income population of the Franklin Service Area (rural areas of Belknap, Grafton, and Merrimack counties) was identified as a primary care MUP.These achievements are at the heart of the organization's community benefit activity. Beyond that, there is a focus on programs and services that benefit every resident and support that far reaching goal of a healthier community. Part VI, Line 6: Concord Hospital - Laconia is a part of the Concord Hospital System. Concord Hospital, Inc., (the Hospital) located in Concord, New Hampshire, is a not-for-profit acute care hospital. The Hospital provides inpatient, outpatient, emergency care and physician services for residents within its geographic region. Admitting physicians are primarily practitioners in the local area. Subsidiaries of Concord Hospital are as follows:- Capital Region Health Care Development Corporation (CRHCDC) is a not-for-profit real estate corporation that owns and operates medical office buildings and other properties.- Capital Region Health Ventures Corporation (CRHVC) is a not-for-profit corporation that engages in health care delivery partnerships and joint ventures. It operates ambulatory surgery and diagnostic facilities independently and in cooperation with other entities. - Concord Hospital ACO (CH-ACO) is a single member limited liability company that engages in providing medical services to Medicare beneficiaries as accountable care organizations. CH-ACO has a perpetual life and is subject to termination in certain events. CH-ACO had minimal activity during fiscal years 2024 and 2023.- Concord Hospital - Laconia (CH-Laconia) is a not-for-profit corporation formed to operate a licensed hospital providing inpatient, outpatient, emergency care and physician services for residents within its geographic region of Laconia, New Hampshire. The CH-Laconia facility includes 137 acute care beds and was designated a Rural Referral Center in 1986, and a Sole Community Hospital in 2009. Admitting physicians are primarily practitioners in the local area. CH-Laconia is controlled by the Hospital- Concord Hospital - Franklin (CH-Franklin) is a not-for-profit corporation formed to operate a licensed hospital providing inpatient, outpatient, emergency care and physician services for residents within its geographic region of Franklin, New Hampshire. The CH-Franklin facility was designated a Critical Access Hospital effective July 1, 2004, and includes 25 acute care beds. CH-Franklin also operates a 10 bed designated psychiatric receiving facility. Admitting physicians are primarily practitioners in the local area. CH-Franklin is controlled by the Hospital.- Granite Shield Insurance Exchange and Subsidiaries (GSIE) was formed on December 20, 2010, in the State of Vermont as an industrial insured reciprocal insurance entity and unincorporated association. GSIE commenced underwriting activities on January 1, 2011. GSIE was formed to provide healthcare professional liability, general liability and medical stop loss insurance to its subscribers through GSI Services, LLC (GSI), the attorney-in-fact. GSI was formed in the State of Vermont as a limited liability company on December 14, 2010, and acts as an agent to enable the subscribers of GSIE to exchange insurance contracts. Through December 31, 2020, GSI was equally controlled by each of the subscribers of GSIE, all of which were health systems located in the State of New Hampshire, inclusive of the Hospital. Effective January 1, 2021, the Hospital became the sole voting member of GSIE, resulting in all activity of GSIE being recorded within the accompanying consolidated financial statements. - Concord Hospital Insurance Group, LLC (CHIG) is a Vermont domiciled single parent captive entity and operates in a manner and conducts activities similar to GSIE, as described above. CHIG began operations in late 2022. GSIE entered into a loss portfolio transfer agreement with CHIG in September 2022, whereas GSIE would transfer all of its existing and future claims to CHIG, with the exception of acts prior to CRHC. This transfer was completed prior to September 30, 2023.- Concord Endoscopy Center, LLC (CEC) is a New Hampshire limited liability company that engages in providing gastrointestinal services, including the diagnosis and treatment of digestive and liver diseases. CEC has a perpetual life and is subject to termination in certain events. At September 30, 2023, CRHVC held a majority interest and control of CEC. As further discussed below, during 2024, the System acquired the remaining noncontrolling interest in CEC, increasing its ownership to 100%.- Capital Region Healthcare Services Corporation (CRHSC) is a for-profit provider of health care services, including an eye surgery center and assisted living facility. CRHSC became a subsidiary of the Hospital effective October 1, 2022.The Hospital, its subsidiaries, and the Trust are collectively referred to as "the System". Part VI, Line 7, Reports Filed With States NH 0 1 0 0 0 0 0 1 0 Robert Steigmeyer President & CEO, Member Ex-Officio 0 898727 0 434592 0 251762 0 275511 0 41350 0 1901942 0 187779 Matthew Gibb MD Chief Clinical Officer 0 659310 0 194853 0 16919 0 95586 0 30648 0 997316 0 0 Mary Bakken System Chief Operating Officer 0 518398 0 157752 0 26150 0 106744 0 38498 0 847542 0 0 Scott Sloane Senior VP, CFO, & Treasurer 0 507270 0 158321 0 27809 0 118893 0 35169 0 847462 0 0 Christopher Weinmann MD Physician 0 546526 0 18053 0 6282 0 1571 0 37030 0 609462 0 0 Kevin McCarthy Chief Administrative Officer 0 351087 0 93230 0 30274 0 74210 0 30159 0 578960 0 0 Tajammul Shafique MD Physician 0 456794 0 0 0 10818 0 597 0 42003 0 510212 0 0 Stephen Marshall MD Physician 0 454507 0 3449 0 4383 0 6643 0 37551 0 506533 0 0 David Croasdale MD Physician 0 410726 0 63623 0 311 0 0 0 13301 0 487961 0 0 Krista Hachey MD Physician 0 398152 0 0 0 4046 0 2054 0 15009 0 419261 0 0 Part I, Line 3 The compensation for the Organization's CEO was established by a related organization, Concord Hospital, Inc. That organization established the CEO's compensation by using a compensation committee, independent compensation consultant, and a compensation study. The compensation was also approved by the Hospital's compensation committee. Part I, Line 4b Robert P. Steigmeyer, President & CEO, participated in a 457(f) plan with Concord Hospital, Inc. during the fiscal year covered by this tax return. Under the terms of the plan, amounts deferred and contributed to the plan are subject to a three-year vesting period. After satisfying this vesting period, 457(f) deferred amounts are to be included in Mr. Steigmeyer's taxable W-2 wages. The calendar year ending within the Hospital's current reporting period of September 30, 2024 (tax year 2023) includes amounts previously set aside as deferred under Mr. Steigmeyer's 457(f) plan more than three years ago, and have therefore become vested. Accordingly, Mr. Steigmeyer is now recognizing in his W-2 taxable wages vested 457(f) plan deferrals. For the period covered by this tax return, included within Mr. Steigmeyer's 2023 Form W-2 taxable wages are $187,779 of vested 457(f) deferrals, which represent amounts previously reported on Schedule J, Part II, Column C, as deferred compensation for the fiscal year ending September 30, 2020. In accordance with IRS instructions, this vested and taxable amount has been included in Schedule J, Part II, Column B(iii) and Column F. Beginning with the September 30, 2015 tax year, there have been contributions to Mr. Steigmeyer's 457(f) plan. Each contribution, plus earnings, will be reported in Mr. Steigmeyer's W-2 after a three-year vesting period. For the fiscal years ended September 30, 2022, 2023, and 2024, Mr. Steigmeyer received total plan contributions (including interest and investment credits) of $221,218, $231,021, and $247,552, respectively. Due to the timing between the Hospital's fiscal year filing period and the calendar year period by which compensation and benefits information is reported on Form 990, Schedule J, the amount included in Mr. Steigmeyer's deferred compensation amounts in this Schedule J, Part II, Column C, includes the $184,993 contribution to his 457(f) plan, plus $46,088 of earnings. During the year ending September 30, 2021, the Hospital established a Supplemental Executive Retirement Plan (SERP) for the Senior Vice Presidents of Concord Hospital. Under the terms of this SERP, the Hospital credits Senior Executives' accounts at the end of each fiscal year, and the credit shall vest and become payable on the third anniversary of the date such amounts are credited to the account, provided the Senior Executives remain continuously employed through the applicable vesting date. The three-year vesting period SERP amount will be included in taxable W-2 wages upon vesting and payment. For the fiscal years ended September 30, 2022, 2023, and 2024, total contributions to the SERP, including interest and investment earnings credits, for Scott Sloane were $43,139, $48,021, and $76,659, respectively; contributions for Matthew Gibb were $53,536, $59,576, and $94,968, respectively; and contributions for Mary Bakken were $23,333, $44,441, and $72,323, respectively. Due to the timing between the Hospital's fiscal year filing period and the calendar year period by which compensation and benefits information is reported on Form 990, Schedule J, the amount included in these individuals' deferred compensation amounts on this Schedule J, Part II, Column C, including contributions to their 457(f) plans and earnings, are as follows: - Scott Sloane: contributions, $42,732; interest credit, $5,290. - Matthew Gibb: contributions, $52,703; interest credit, $6,873. - Mary Bakken: contributions, $42,668; interest credit, $1,773. As none of the SERP contributions have yet satisfied the three-year vesting conditions as of the period covered by this tax return, none of the SERP contributions have yet been included in the W-2 wages for these Senior Executives. Part I, Line 7 Incentive Pay: The primary purpose of the incentive pay is to recognize the quality of the performance of the CEO, CFO, COO, and CMO during the preceding fiscal year. The amount of the incentive pay bonus is based on performance relative to strategic goals and measurable objectives. When the executive's performance excels, the incentive pay should reflect the accomplishment and allow for the sum of base salary and incentive pay to reach as high as the 75th percentile of peer institutions. Form 990, Page 1, Box J: The full address to reach the Concord Hospital-Laconia website is as follows: https://www.concordhospital.org/locations/profile/ concord-hospital-laconia/ Form 990, Part V, Lines 1-2; and Part VII, Section B: Concord Hospital - Laconia ("CH-L") is part of the Concord Hospital Health System. All officers, employees, executives, physicians, contractors and/or other labor providers who offer services to CH-L are legally and technically employed and compensated by either Concord Hospital, Inc., the Organization's sole member. CH-L does not file its own payroll reporting forms, including Forms W-2, 1099-MISC, or 1099-NEC. However, CH-L does have dedicated employees and contractors that are paid through Concord Hospital, Inc., with Concord Hospital, Inc. acting as a common paymaster for CH-L. Therefore, and in accordance with IRS Instructions, the Organization has listed its share of the System's total employees on this Form 990, Part V, Line 2, even though such individuals' Forms W-2 were technically filed by Concord Hospital, Inc. As the common paymaster for CH-L, Concord Hospital, Inc. ensured that all required federal employment tax returns for all System employees were timely and compliantly filed, and so Part V, Line 2b has been answered "yes." This also applies to CH-L's top-five highest paid employees and top-five highest paid independent contractors; these individuals and service providers, while compensated for services performed in their capacity as Concord Hospital Health System employees rendered on behalf of and for CH-L, are technically paid by and receive payroll reporting forms from Concord Hospital, Inc. In accordance with IRS Instructions and to maintain transparency, such persons and contractors have been disclosed as CH-L's top-five highest paid employees and independent contractors, though such persons and entities are technically paid by related organizations. Form 990, Part VI, Section A, line 6 Concord Hospital, Inc. is the sole member of the Organization. Form 990, Part VI, Section A, line 7a The Organization's Board of Trustees shall consist of the members of the Executive Committee of the Organization's sole member, Concord Hospital, Inc., as well as the Chief Administrative Officer and CEO, ex officio, without vote. Form 990, Part VI, Section A, line 7b The sole Member of the Organization, Concord Hospital, Inc., may initiate and implement any proposal or take action with respect to any of the following, and if any proposal with respect to any of the following is otherwise initiated, it shall not become effective unless approved by the Member. (a) Approval of any merger, consolidation, reorganization, liquidation or dissolution of the Corporation or any subsidiary or affiliate entity; (b) Entering into any change of control transaction or sale of substantially all of the assets of the Corporation; (c) Approval of any amendment or restatement of the Articles of Agreement or the Bylaws of the Corporation; (d) Approval of the annual operating and capital budgets of the Corporation, including the consolidated or combined budgets of the Corporation that include subsidiary organizations of the Corporation; (e) Approval of long-term or material agreements of the Corporation or any subsidiary organization including, but not limited to, debt or equity financings, capitalized leases and installment contracts, that are not contemplated in an approved budget; (f) Approval of any indebtedness or increase of indebtedness for borrowed money, secured or unsecured, of the Corporation or any subsidiary or affiliate in excess of the amount approved in the annual budget; (g) Establishment of undergraduate or graduate medical education programs by the Corporation or any subsidiary or affiliate with medical schools; (h) Contracting with an unrelated third party for all or substantially all of the management of the assets or operations of the Corporation or any subsidiary or affiliate entity; (i) Approval of strategic plans of the Corporation or any subsidiary or affiliate entity; (j) Establishment of third party relationships which have significant financial or strategic implications; (k) Appointment or removal of the Chief Administrative Officer of the Corporation (the Chief Administrative Officer), as recommended by the Members President and Chief Executive Officer (the CEO); and (l) Renewal of employment, and decisions regarding compensation and other material terms of employment, of the Chief Administrative Officer, as recommended by the Members CEO. Form 990, Part VI, Section B, line 11b The 990 is reviewed in detail with the Audit Committee of the Concord Hospital, Inc.'s Board of Trustees. All board members receive a copy of the 990 to review prior to filing the report. Form 990, Part VI, Section B, line 12c Each Trustee, officer and committee member, upon entering the duties of his/her office and annually thereafter, will be advised of this policy and shall sign a statement acknowledging his/her understanding of and agreement to this policy. Annual reviews will adhere to state regulations that require public notice for any significant pecuniary transaction. Form 990, Part VI, Section B, line 15 Any determination for compensation or benefits paid to the organization's officers or key employees is performed by Concord Hospital, Inc., the sole member of the filing Organization, and its Board of Trustees and committees thereof. The evaluation of the performance of the Chief Executive Officer ("CEO") of Concord Hospital, Inc. and its subsidiaries (collectively the "Hospital") is an important responsibility of the Board of Trustees (the "Board") and is vital in ensuring that the Hospital meets its mission. The Board has delegated the responsibility of initiating the process of conducting the CEO's performance evaluation and initiating the process of setting the CEO's compensation to the Board's Compensation Committee. The Compensation Committee also is charged with the responsibility of reviewing the appropriateness of the compensation of the Hospital's Chief Operating Officer (COO), Chief Financial Officer (CFO), and Chief Medical Officer (CMO) as proposed by the CEO. The Compensation Committee shall present its report of the CEO's annual performance to the Board for its further input and consideration. The Compensation Committee shall also make its recommendation to the Board concerning the CEO's compensation. Finally, the Compensation Committee shall make its recommendation to the Board concerning the compensation of the COO, CFO, and CMO. The Board shall review the recommendations of the Compensation Committee as to the compensation of the Hospital's CEO, COO, CFO, and CMO and shall set their compensation as the Board deems appropriate. Although the Hospital continues to value the role of Capital Region Health Care Corporation ("CRHC") and the Hospital's participation in that organization, the Board acknowledges that it is not the responsibility of the Board to evaluate or set the compensation of the Chief Executive Officer of CRHC. Neither is it the role of the Board of Trustees of CRHC to evaluate, or set the compensation of, the Hospital's CEO. Accordingly, CRHC's Board of Trustees is not involved in evaluating or setting the compensation of the Hospital's CEO. The Board acknowledges that the Hospital's CEO may also serve as the Chief Executive Officer of CRHC and that the Hospital may charge CRHC for these services. The Board may consider the comments of the Board of Trustees of CRHC, as outlined herein, when deemed relevant in evaluating the performance of the Hospital's CEO. The Board directs that the Compensation Committee and the Board itself, in their respective undertakings of recommending and setting the compensation of the Hospital's CEO, COO, CFO, and CMO, avoid conflicts of interest and be guided by the "rebuttable presumption of reasonableness" regulations under the so-called "Excess Benefit Transaction" provisions of the Internal Revenue Code ("IRC"). The Board authorizes the Compensation Committee to use such financial and advisory (e.g., legal counsel, consultant) resources as it reasonably deems appropriate to fulfill its duties in evaluating the CEO's performance and in making its recommendations to the Board regarding compensation for the CEO, COO, CFO, and CMO. Form 990, Part VI, Section C, line 19 Yes, the organization makes all of this information available to the public. Audited financial statements and the most recent quarter ended financial statements are posted to the Electronic Municipal Market Access (EMMA) website. In addition to this, the Hospital sends its annual report, including a financial summary, to members of the community via the US Postal service. Governing documents and conflicts of interest filings adhere to state regulations that require public notice for any significant pecuniary transaction. Form 990, Part VII, Section A, Column E: The compensation reported for Robert P. Steigmeyer and Scott Sloane was paid by Concord Hospital, Inc. for their services as full-time executives. In total, they worked an average of 63 hours per week for all entities in the Concord Hospital health care system, of which an average of 1 hour per week was dedicated to Concord Hospital-Laconia. Concord Hospital-Laconia (CH-L) is also listing on its Form 990, Part VII, Matthew Gibb, who serves as the Organization's Chief Clinical Officer, and Mary Bakken, who serves as the Organization's System Chief Operating Officer. Matthew Gibb and Mary Bakken are both employed and compensated by Concord Hospital Inc. (CH), the sole parent of CH-L. While directly paid by CH, their services are also considered essential to the operations of CH-L. Accordingly, they have been disclosed on this Form 990 as Key Employees of CH-L. Form 990, Part IX, line 11g Administrative and maintenance: Program service expenses 5,206,251. Management and general expenses 1,197,342. Fundraising expenses 51,953. Total expenses 6,455,546. IT support services: Program service expenses 2,311,256. Management and general expenses 2,311,256. Fundraising expenses 0. Total expenses 4,622,512. Professional medical services: Program service expenses 3,755,183. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,755,183. Intercompany services: Program service expenses 1,575,000. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,575,000. Form 990, Part XI, line 9: Net transfers to affiliates -1,447,886. Net periodic benefits adjustment 1,015,836. Form 990, Part XII, Line 2c: Concord Hospital - Laconia (CH-L) is included in the Concord Hospital, Inc. and Subsidiaries Audited Consolidated Financial Statements. Concord Hospital, Inc. is the sole member of CH-L. CH-L's Board in conjunction with Concord Hospital's chief financial executives review the CH-L's financial statements monthly, and its Finance Committee receives monthly financial statements which are reviewed bi-monthly within Finance Committee meetings. Concord Hospital also has an audit committee of its Board, which reviews the annual audit process and the selection of the independent accountant for the entire Concord Hospital-System. The same independent firm of accountants performed the audit for the Concord Hospital-System's fiscal years ending 9/30/2023 and 9/30/2024. Capital Region Health Care Corporation 250 Pleasant Street Concord NH 03301 020222123 Promote comprehensive health service system NH 501(c)(3) Line 12a, I N/A 0 Capital Region Health Care Development Corporation 250 Pleasant Street Concord NH 03301 020429749 Provide medical care to community NH 501(c)(2) Concord Hospital 0 Capital Region Health Ventures Corp 250 Pleasant Street Concord NH 03301 020438264 Support Concord Hospital and other affiliates NH 501(c)(3) Line 12b, II Concord Hospital 0 Concord Hospital 250 Pleasant Street Concord NH 03301 222594672 Hospital NH 501(c)(3) Line 3 Capital Region Health Care Corporation 0 Concord Hospital - Franklin 250 Pleasant Street Concord NH 03301 851433123 Hospital NH 501(c)(3) Line 3 Concord Hospital 0 Concord Hospital Trust 250 Pleasant Street Concord NH 03301 260378710 Fundraising NH 501(c)(3) Line 12a, I Concord Hospital 0 Concord Regional Visiting Nurse Association Inc PO Box 1797 Concord NH 033021797 020222122 Home health care & hospice services NH 501(c)(3) Line 10 N/A 0 Riverbend Community Mental Health Inc 3-5 North State Street Concord NH 033022032 020264383 Multi-service team NH 501(c)(3) Line 7 N/A 0 Concord Imaging Center LLC 2 1/2 Beacon Street Concord NH 03301 020436605 Provide radiology services to community NH N/A 0 0 Capital Orthopedic Surgery Center 250 Pleasant Street Concord NH 03301 020522860 Provide medical care to community NH N/A 0 0 Concord Endoscopy Center LLC 60 Commerical Street Concord NH 03301 201184756 Provide medical care to community NH N/A 0 0 Capital Region Health Services Corporation 250 Pleasant Street Concord NH 03301 020428631 Medical services NH N/A C 0 Capital Region Primary Care Corporation 250 Pleasant Street Concord NH 03301 020495275 Inactive NH N/A C 0 Lakes Region Medical Office Building 250 Pleasant Street Concord NH 03301 020409867 Rental properties and condominiums NH N/A C 0 Hillside Medical Park Condo Association 250 Pleasant Street Concord NH 03301 863920257 Rental properties and condominiums NH N/A C 0 CH Memorial West Condominium Association 250 Pleasant Street Concord NH 03301 372006095 Rental properties and condominiums NH N/A C 0 0 0 1 0 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1