STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

COTTAGE HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
COTTAGE HOSPITAL (EIN 02-0223321)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-01-28
IRS object ID
202130289349300103
Schema version
2019v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-01-28T07:40:32-06:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010523282PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12211 Congress StreetAddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04102ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020223321EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Cottage HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOTTBusinessNameControlTxt
Phone6037479000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line190 Swiftwater RoadAddressLine1Txt
CityWoodsvilleCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03785ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAnn DuffyPersonNm
Person TitleCFOPersonTitleTxt
Phone6037479000PhoneNum
Signature2021-01-27SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJoseph R ByrnePreparerPersonNm
PTINP01289281PTIN
Phone2077752387PhoneNum
Preparation2021-01-27PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMaria R RyanPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line190 Swiftwater RoadAddressLine1Txt
CityWoodsvilleCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03785ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$37,579,047GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.cottagehospital.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1903FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionMedical care and related servicesActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee398TotalEmployeeCnt
Total Volunteers41TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$387,029PYContributionsGrantsAmt
CY Contributions Grants$1,723,633CYContributionsGrantsAmt
PY Program Service Revenue$34,218,933PYProgramServiceRevenueAmt
CY Program Service Revenue$34,202,932CYProgramServiceRevenueAmt
PY Investment Income$314,922PYInvestmentIncomeAmt
CY Investment Income$178,617CYInvestmentIncomeAmt
PY Other Revenue$47,274PYOtherRevenueAmt
CY Other Revenue$39,976CYOtherRevenueAmt
PY Total Revenue$34,968,158PYTotalRevenueAmt
CY Total Revenue$36,145,158CYTotalRevenueAmt
PY Grants And Similar Paid$6,200PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$7,472CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$20,496,200PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,907,823CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,707,187PYOtherExpensesAmt
CY Other Expenses$15,388,437CYOtherExpensesAmt
PY Total Expenses$34,209,587PYTotalExpensesAmt
CY Total Expenses$35,303,732CYTotalExpensesAmt
PY Revenues Less Expenses$758,571PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$841,426CYRevenuesLessExpensesAmt
Total Assets BOY$33,556,630TotalAssetsBOYAmt
Total Assets EOY$41,461,746TotalAssetsEOYAmt
Total Liabilities BOY$16,902,564TotalLiabilitiesBOYAmt
Total Liabilities EOY$23,742,582TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,654,066NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$17,719,164NetAssetsOrFundBalancesEOYAmt
MissionTo strengthen the health of our community by providing accessible, compassionate, quality healthcare. To be the healthcare organization of choice for our service area.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$22,533,390ExpenseAmt
Grant$7,472GrantAmt
Revenue$29,588,591RevenueAmt
DescCottage Hospital provided health care to approximately 669 inpatients and 28,973 outpatients during the fiscal year.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,971,739ExpenseAmt
Revenue$2,746,360RevenueAmt
DescThe Ray of Hope Geriatric Behavioral Health Unit provides quality care for those struggling with a behavioral health issue. This inpatient program is for geriatric patients 65 years and older with persistent or late onset behavioral health illnesses or concerns. Specialized care focuses on assessment, treatment, rehabilitation, prevention, family/community support and education surrounding behavioral health.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,095,855ExpenseAmt
Revenue$1,867,981RevenueAmt
DescThe Rowe Health Center provides internal medicine, behavioral health, general surgery, podiatry, gastroenterology and endocrinology services. We are proud to offer a team-based approach to provide all of our patients with accessible, convenient, high quality care. With extended hours and same day acute appointments available, meeting the needs of our patients is our priority.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$26,600,984TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming ActivitiesYes (1)GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document33IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee398EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
DAF Excess Business Holdings0DAFExcessBusinessHoldingsInd
Taxable Distributions0TaxableDistributionsInd
Distribution To Donor0DistributionToDonorInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ann DuffyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6037479000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line190 Swiftwater RoadAddressLine1Txt
CityWoodsvilleCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03785ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Mark Gleicher
Chairperson1.00Yes (X)Yes (X)$0$0$0
William Daley
Vice Chair1.00Yes (X)Yes (X)$0$0$0
Teresa Puffer
Secretary1.00Yes (X)Yes (X)$0$0$0
Mark Johnson
Trustee1.00Yes (X)$0$0$0
Terry Larsen MD
Medical Staff Secretary40.00Yes (X)$212,133$0$0
Kevin Lawrence
Trustee1.00Yes (X)$0$0$0
Ashley Luurtsema
Trustee1.00Yes (X)$0$0$0
Tom Page
Trustee1.00Yes (X)$0$0$0
David Robinson
Trustee1.00Yes (X)$0$0$0
William Taxter
Trustee1.00Yes (X)$0$0$0
Kathryn Walsh CRNA
Medical Staff President40.00Yes (X)$200,258$0$24,130
Tim Page
Past Trustee1.00Yes (X)$0$0$0
Amy Perry
Past Trustee1.00Yes (X)$0$0$0
Maria Ryan
CEO40.00Yes (X)Yes (X)$287,993$0$28,341
Ann Duffy
CFO40.00Yes (X)$130,807$0$14,885
Christopher Findley
Chief of ED40.00$417,848$0$28,237Yes (X)
Charles Sawyer
Physician ED40.00$391,720$0$20,970Yes (X)
Christopher Danielson
Physician RHC40.00$324,425$0$32,306Yes (X)
Domenic Martinello
Physician ED40.00$234,400$0$490Yes (X)
Marlene Sarkis
Physician RHC40.00$233,359$0$27,379Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,432,943TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$176,738TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Dartmouth Hitchcock Clinic
One Medical Center DriveLebanonNH03756Medical Services$853,121
Athena Health Inc
311 Arsenal StreetWatertownMA02472EMR Service Contract$491,954
Alliance Healthcare
PO Box 96485ChicagoIL606936485MRI & Nuclear Medicine Services$431,926
Weatherby Locums Inc
PO Box 972633DallasTX753972633Staffing Services$237,266
Siemens Medical Solutions
PO Box 120001 Dept 0733DallasTX753120733Maintenance Contract$180,550
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Government Grants$1,500,671GovernmentGrantsAmt
All Other Contributions$222,962AllOtherContributionsAmt
Noncash Contributions$12,510NoncashContributionsAmt
Total Contributions$1,723,633TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Patient Service Revenue622110$63,031,516$63,031,516
DSH Payments622110$3,689,264$3,689,264
Other Operating Revenue622110$793,354$158,112$635,242
Provision For Bad Debt622110-$1,445,873-$1,445,873
Contractual/Char. Adj.622110-$31,865,329-$31,865,329
FieldValueIRS element (for citing)
Total Program Service Revenue$34,202,932TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$180,518TotalRevenueColumnAmt
Exclusion$180,518ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$3,133RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$3,133RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,133TotalRevenueColumnAmt
Exclusion$3,133ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,406,846SecuritiesAmt
Other$20,142OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,303,692SecuritiesAmt
Other$125,197OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$103,154SecuritiesAmt
Other-$105,055OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,901TotalRevenueColumnAmt
Exclusion-$1,901ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$41,843GamingGrossIncomeAmt
Gaming Direct Expenses$5,000GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,843TotalRevenueColumnAmt
Exclusion$36,843ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,145,158TotalRevenueColumnAmt
Related Or Exempt Func Income$33,567,690RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$853,835ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$7,472TotalAmt
Program Services$7,472ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$898,546TotalAmt
Program Services$436,521ProgramServicesAmt
Management And General$462,025ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,860,242TotalAmt
Program Services$12,208,818ProgramServicesAmt
Management And General$3,651,424ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$269,432TotalAmt
Program Services$194,411ProgramServicesAmt
Management And General$75,021ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,745,803TotalAmt
Program Services$1,205,459ProgramServicesAmt
Management And General$540,344ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,133,800TotalAmt
Program Services$850,341ProgramServicesAmt
Management And General$283,459ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$106,951TotalAmt
Program Services$4,702ProgramServicesAmt
Management And General$102,249ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$193,130TotalAmt
Management And General$193,130ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$9,534TotalAmt
Management And General$9,534ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,554,503TotalAmt
Program Services$5,503,765ProgramServicesAmt
Management And General$1,050,738ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$109,993TotalAmt
Program Services$67,584ProgramServicesAmt
Management And General$42,409ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,344,224TotalAmt
Program Services$627,501ProgramServicesAmt
Management And General$716,723ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$23,975TotalAmt
Program Services$8,679ProgramServicesAmt
Management And General$15,296ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$331,000TotalAmt
Program Services$318,311ProgramServicesAmt
Management And General$12,689ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,599,899TotalAmt
Program Services$556,185ProgramServicesAmt
Management And General$1,043,714ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$299,692TotalAmt
Program Services$210,390ProgramServicesAmt
Management And General$89,302ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Supplies$2,952,246$2,783,916$168,330
Medicaid Enhancement Ta$1,338,520$1,338,520
Education and Recruitme$355,934$243,932$112,002
Miscellaneous Expenses$168,836$34,477$134,359

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$35,303,732TotalAmt
Program Services$26,600,984ProgramServicesAmt
Management And General$8,702,748ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$467,013BOYAmt
EOY$1,466,930EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,915,252BOYAmt
EOY$12,752,367EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,172BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,809,138BOYAmt
EOY$4,370,201EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$540,721BOYAmt
EOY$536,348EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$420,996BOYAmt
EOY$257,216EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$34,920,387LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$22,016,258LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,856,922BOYAmt
EOY$12,904,129EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,345,927BOYAmt
EOY$7,964,204EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$207,965BOYAmt
EOY$214,872EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$978,524BOYAmt
EOY$995,479EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$33,556,630BOYAmt
EOY$41,461,746EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,071,535BOYAmt
EOY$3,258,495EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$4,273,248EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,329,531BOYAmt
EOY$5,177,192EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,804,514BOYAmt
EOY$2,639,800EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,696,984BOYAmt
EOY$8,393,847EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,902,564BOYAmt
EOY$23,742,582EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,994,361BOYAmt
EOY$16,166,526EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,659,705BOYAmt
EOY$1,552,638EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,654,066BOYAmt
EOY$17,719,164EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,556,630BOYAmt
EOY$41,461,746EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$841,426ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$216,765NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$6,907OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$7,908OtherActivitiesAmt
Total Lobbying Expenditures$7,908TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationCottage Hospital is a member of the New Hampshire Hospital Association and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Cottage Hospital and other member organizations in furtherance of their exempt purposes. Cottage Hospital does not directly perform any lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,441,360BeginningYearBalanceAmt
Investment Earnings Or Losses-$63,571InvestmentEarningsOrLossesAmt
Other Expenditures$39,549OtherExpendituresAmt
End Year Balance$1,338,240EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,445,662BeginningYearBalanceAmt
Investment Earnings Or Losses$31,310InvestmentEarningsOrLossesAmt
Other Expenditures$35,612OtherExpendituresAmt
End Year Balance$1,441,360EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,449,641BeginningYearBalanceAmt
Investment Earnings Or Losses$34,311InvestmentEarningsOrLossesAmt
Other Expenditures$38,290OtherExpendituresAmt
End Year Balance$1,445,662EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,262,506BeginningYearBalanceAmt
Contributions$157,122ContributionsAmt
Investment Earnings Or Losses$67,594InvestmentEarningsOrLossesAmt
Other Expenditures$37,581OtherExpendituresAmt
End Year Balance$1,449,641EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,256,981BeginningYearBalanceAmt
Investment Earnings Or Losses$47,280InvestmentEarningsOrLossesAmt
Other Expenditures$41,755OtherExpendituresAmt
End Year Balance$1,262,506EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.98860PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.01140TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$531,787OtherCostOrOtherBasisAmt
Book Value$531,787BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,716,497OtherCostOrOtherBasisAmt
Depreciation$10,060,159DepreciationAmt
Book Value$8,656,338BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,247,682OtherCostOrOtherBasisAmt
Depreciation$11,404,974DepreciationAmt
Book Value$2,842,708BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,424,421OtherCostOrOtherBasisAmt
Depreciation$551,125DepreciationAmt
Book Value$873,296BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,904,129TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Deferred Compensation$977,679
Due to Third-Party Payors$3,766,368
CARES Act Funding$3,649,800
FieldValueIRS element (for citing)
Total Liability$8,393,847TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$36,364,296TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$216,765NetUnrealizedGainsInvstAmt
Other Revenue$11,907OtherRevenueAmt
Revenue Not Reported$228,672RevenueNotReportedAmt
Revenue Subtotal$36,135,624RevenueSubtotalAmt
Investment Expenses Not Incld$9,534InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$9,534RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$36,145,158TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$35,299,198TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$5,000OtherExpensesIncludedAmt
Expenses Not Reported$5,000ExpensesNotReportedAmt
Expenses Subtotal$35,294,198ExpensesSubtotalAmt
Investment Expenses Not Incld2$9,534InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$9,534ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$35,303,732TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:The intended use of the Hospital's endowment fund is to support the hospital in its efforts to provide quality healthcare to residents of the communities it serves and others who may use the hospital.
Part XI, Line 2d - Other Adjustments:Gaming Expenses 5,000. Change in Funds Held in Trust by Others 6,907.
Part XII, Line 2d - Other Adjustments:Gaming Expenses 5,000.

Schedule G IRS990ScheduleG

Gaming Information GamingInformationGrp

FieldValueIRS element (for citing)
Gross Revenue Other Gaming$41,843GrossRevenueOtherGamingAmt
Rent Fclty Costs Other Gaming$5,000RentFcltyCostsOtherGamingAmt
Volunteer Labor Other Gaming0VolunteerLaborOtherGamingInd
Gross Revenue Total Gaming$41,843GrossRevenueTotalGamingAmt
Rent Fclty Costs Total Gaming$5,000RentFcltyCostsTotalGamingAmt
Direct Expense Summary Gaming$5,000DirectExpenseSummaryGamingAmt
Net Gaming Income Summary$36,843NetGamingIncomeSummaryAmt
FieldValueIRS element (for citing)
States Where Gaming ConductedNHStatesWhereGamingConductedCd
LicensedYes (1)LicensedInd
License Suspended Etc0LicenseSuspendedEtcInd
Gaming With NonmembersYes (1)GamingWithNonmembersInd
Member Of Other Entity0MemberOfOtherEntityInd
Gaming Own Facility0.00000GamingOwnFacilityPct
Gaming Other Facility1.00000GamingOtherFacilityPct
Individual With BooksAnn Duffy CFOIndividualWithBooksNm

Persons With Books US Address PersonsWithBooksUSAddress

FieldValueIRS element (for citing)
Address Line190 Swiftwater RoadAddressLine1Txt
CityWoodsvilleCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03785ZIPCd
FieldValueIRS element (for citing)
Cntrct With3rd Prty For Game RevYes (1)CntrctWith3rdPrtyForGameRevInd
Gaming Revenue Received By Org$36,843GamingRevenueReceivedByOrgAmt
Gaming Revenue Rtn By3 Prty$5,000GamingRevenueRtnBy3PrtyAmt

Third Party Business Name ThirdPartyBusinessName

FieldValueIRS element (for citing)
Business Name Line1Manchester Poker Room & CasinoBusinessNameLine1Txt

Third Party US Address ThirdPartyUSAddress

FieldValueIRS element (for citing)
Address Line11279 S Willow StreetAddressLine1Txt
CityManchesterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03103ZIPCd
FieldValueIRS element (for citing)
Charitable Distribution Rqr0CharitableDistributionRqrInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule G, Part III, Line 15aFormAndLineReferenceDesc
ExplanationThe Organization had an agreement where Manchester Poker Room & Casino would provide Cottage Hospital a percentage of revenue from Manchester Poker Room & Casino's games of chance proceeds. Cottage Hospital never paid Manchester Poker Room & Casino directly and was not directly involved in administrating any of the games of chance. Cottage Hospital was charged $500 a day for the ten day event which was taken directly out of the proceeds earned by Manchester Poker Room & Casino which then donated the remaining $36,843 of proceeds to Cottage Hospital.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$402,499TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$284,412DirectOffsettingRevenueAmt
Net Community Benefit Expns$118,087NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$402,499TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$284,412DirectOffsettingRevenueAmt
Net Community Benefit Expns$118,087NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$184,394TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$184,394NetCommunityBenefitExpnsAmt
Total Expense0.00520TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$293,916TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$293,916NetCommunityBenefitExpnsAmt
Total Expense0.00830TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,972TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$24,972NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$503,282TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$503,282NetCommunityBenefitExpnsAmt
Total Expense0.01420TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$905,781TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$284,412DirectOffsettingRevenueAmt
Net Community Benefit Expns$621,369NetCommunityBenefitExpnsAmt
Total Expense0.01750TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$93,417TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$93,417NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,724TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,724NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$172,366TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$172,366NetCommunityBenefitExpnsAmt
Total Expense0.00490TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$282,507TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$282,507NetCommunityBenefitExpnsAmt
Total Expense0.00790TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$749,755BadDebtExpenseAmt
Reimbursed By Medicare$15,665,750ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$15,950,756CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$285,006MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Cottage HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line190 Switfwater RoadAddressLine1Txt
CityWoodsvilleCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03785ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.cottagehospital.orgWebsiteAddressTxt
State License01770StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Cottage HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.cottagehospital.orgOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLwww.cottagehospital.orgStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.cottagehospital.org/patient-info/financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.cottagehospital.org/patient-info/financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.cottagehospital.org/patient-info/financial-assistanceFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Cottage HospitalPart V, Section B, Line 5: Key leaders and focus groups within the community. For example, politicians, business health partners, staff and administration.
Cottage HospitalPart V, Section B, Line 11: The Hospital's most recent CHNA showed the following areas as the greatest need, a description of what we have done to address the need is included:- Increasing access to transportation to medical appointments and other health services - Cottage has some influence with three transportation services being available in the Area, Stagecoach, HMSC Bus, and RCT (VT) - Increasing awareness around Hospital services and programs - Cottage utilizes social media and community outreach initiatives to communicate the services that Cottage offers to the community.- Increasing access to drug and other substance abuse treatment services - Cottage providers identify patients with substance abuse issues and refer to a facility with appropriate resources.- Increasing access to counseling services for mental health for children- Increasing awareness of emergency care and trauma services. - Cottage utilizes social media and community outreach initiates to communicate the emergency and trauma care services provided.- Increasing access to dentistry services- Increasing access to counseling services for mental health for adults. Cottage offers outpatient treatment as well as short-term inpatient services for adults struggling with behavioral issues via an IP geriatric psych unit.- Enhancing drug and other substance abuse education and prevention - Cottage works with a local substance misuse prevention program referring patients as appropriate.- Improving access to financial assistance for healthcare services and prescription drugs. - Cottage provides a financial counselor and patient care counselor to assist patients with understanding financial options available to them.- Increasing access to specialty care for chronic conditions like diabetes and heart disease - Cottage provides services via a diabetic counselor, endocrinologist and offers a diabetic prevention program.- Increasing access to primary care services - Cottage offers primary care services, and will utilize community outreach efforts to assist patients in a continuum of care.- Increasing access to long-term care or dementia care for seniors - Cottage offers a short stay geriatric psych unit for patients that need short-term assistance. Those that require long-term care will be referred to an external long-term care facility.- Increasing access to care coordination or support services to help people better manage their own health via patient outreach initiatives.- Increasing access to emergency care and trauma services - Cottage utilizes social media and community outreach initiatives to educate the community on available services.
Cottage HospitalPart V, Section B, Line 13b: Catastrophic relief guidelines: the Hospital recognizes that on occasion a patient may experience a serious illness or injury. A catastrophic relief program is available to patients that may need substantial financial assistance for an extended episode of care. The policy provides relief to uninsured (or grossly uninsured)individuals whose financial responsibility to the Hospital exceeds $30,000 for any single episode of care. Patients whose family income exceeds 300% of the FPL and whose financial responsibility to the hospital exceeds $30,000 for any single episode of care may be eligible for this program on a case-by-case basis.

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:Part 1, Lines 7a-c; The Hospital uses a cost-to-charge ratio. The cost-to-charge ratio was derived from the Form 990, Schedule H, Worksheet 2, ratio of patient care cost-to-charges.Part 1, Lines 7e & f; The Hospital's costs are determined based on an evaluation of a labor plus estimated overhead absorption rate applied on an hourly basis.Part 1, Lines 7g & 7i; Represent actual costs derived from the Hospital's accounting system.
Part II, Community Building Activities:Our community building activities are determined and aligned through our Community Health Needs Assessment. This assessment is evaluated every three years. Key leaders of the community, as well as peers within different demographic segments, are interviewed by a third party. Programs typically target preventative care, areas of health not being met within our community, and education in specialty medicine available within our service market. We strategically collaborate with other organizations to build a stronger message.
Part III, Line 2:Part III, line 2-3; The Hospital uses a cost-to-charge ratio. The cost-to-charge ratio was derived from the Form 990 Schedule H worksheet 2, ratio of patient care cost-to-charges. The CCR was then applied to bad debt expense at charge value in order to arrive at the estimated expense reported.
Part III, Line 4:Patient accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectible of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payors sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payors sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with service provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary.For receivables associated with self-pay patients, including both patients without insurance and patients with deductible and nonpayment balances due for which third-party coverage exists for only part of the bill, the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.
Part III, Line 8:As Cottage Hospital operates at a loss from Medicare, the shortfall could be treated as community benefit as there are no other funds available to subsidize the loss. Medicare allowable costs have been determined using a cost-to-charge ratio determined in accordance with worksheet 2, ratio of patient care cost-to-charges, of the Form 990 Schedule H instructions.
Part III, Line 9b:If the patient has been on charity care in the past but it has now expired, the patient would have to re-apply.
Part VI, Line 2:Cottage Hospital just recently conducted its Community Health Needs Assessment (completed in December 2019). The Affordable Care Act of 2010 requires not-for-profit hospital to conduct a CHNA every three years. In addition, the state of New Hampshire requires one to be done every five years. Key healthcare and public service stakeholders representing a breadth of community perspectives participated in the research as key leaders and sources of information. The stakeholder research was supplemented by an in-depth review of demographic and epidemiological data in order to identify underlying health trends in the service area. The assessment included listing the prioritized community needs, the definition of the community served, a description of the methodology to identify needs in the community, a description of the approach used to prioritize community needs and a list of healthcare resources. The information gathered was then used as part of the Hospital's strategic planning process. The CHNA is available on the Hospital's website.
Part VI, Line 3:If at the time of registration or admission, a patient indicates that he or she has no other medical payer available, i.e., no insurance, Medicaid, or Medicare, the Hospital asks if the patient would like an application for Medicaid and/or for the Hospital's charity care program. The Hospital then documents on the patient's account whether or not the patient took either of the applications, or if the applications were turned down.If the patient is admitted and unable to respond to the question of payers available at the time of admission, case management notifies the patient financial counselor. After checking with nursing to see if the patient is alert and able to discuss the payer issue, the patient financial counselor will visit the patient's bedside.
Part VI, Line 4:The Hospital's geographic area includes its primary market: New Hampshire - Bath, Benton, Haverhill, Lisbon, Monroe, Piermont, and in Vermont - Barnet, Bradford, Corinth, Groton, Newbury, Ryegate, Wells River and Woodville. The secondary market includes, but is not limited to: in New Hampshire - Landaff, Littleton, Orford, Rumney, Warren and Wentworth and in Vermont - Fairlee, Groton, McIndoe Falls, Peacham, Thetford, and Topsham. Demographically, the hospital services the general population.
Part VI, Line 7, Reports Filed With StatesNH

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Terry Larsen MD
Medical Staff Secretary$156,610$0$0$0$55,523$0$0$0$0$0$212,133$0$0$0
Kathryn Walsh CRNA
Medical Staff President$195,758$0$3,500$0$1,000$0$5,751$0$18,379$0$224,388$0$0$0
Maria Ryan
CEO$256,461$0$31,532$0$0$0$10,067$0$18,274$0$316,334$0$0$0
Christopher Findley
Chief of ED$389,045$0$0$0$28,803$0$0$0$28,237$0$446,085$0$0$0
Charles Sawyer
Physician ED$391,720$0$0$0$0$0$11,300$0$9,670$0$412,690$0$0$0
Christopher Danielson
Physician RHC$324,425$0$0$0$0$0$7,622$0$24,684$0$356,731$0$0$0
Domenic Martinello
Physician ED$234,400$0$0$0$0$0$0$0$490$0$234,890$0$0$0
Marlene Sarkis
Physician RHC$233,359$0$0$0$0$0$0$0$27,379$0$260,738$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 7FormAndLineReferenceDesc
ExplanationMaria Ryan, CEO, received a bonus of $31,532 in 2019. The bonus is determined based on the Board of Director's review of the CEO's performance and compensation agreement. Kathryn Walsh and Ann Duffy received bonuses of $3,500 and $2,571 based on performance.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Business Finance Authority of the State of NHBusinessNameLine1Txt
FieldValueIRS element (for citing)
CUSIPNoneAvailCUSIPNum
Bond Issued2011-05-31BondIssuedDt
Issue Price$7,745,000IssuePriceAmt
PurposeRefinance Mortgage and Terminate HedgePurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$2,567,808RetiredAmt
Total Proceeds$7,745,000TotalProceedsAmt
Issuance Costs From Proceeds$156,490IssuanceCostsFromProceedsAmt
Other Spent Proceeds$7,588,510OtherSpentProceedsAmt
Substantial Completion2011SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 4In 2019, Cottage Hospital's legal counsel recommended modernizing the corporate bylaws. As a result, the corporate structure was dissolved and the Corporate Officer roles including President, Vice President and Clerk were eliminated in addition to the Corporator Membership.
Form 990, Part VI, Section B, line 11bCottage Hospital gathers the information, and our CPA firm completes the Form 990. The Form 990 is then reviewed by the CFO and Director of Finance, before it is sent to the Board of Directors for their review. Once all of this has been completed, the CFO signs the Form 990, and it is sent to the IRS.
Form 990, Part VI, Section B, line 12cThe members of the Board of Trustees are required to file an annual Conflict of Interest Statement.
Form 990, Part VI, Section B, line 15The following were used to determine compensation of the CEO: comparison data and a compensation survey. The CEO's compensation is approved by the Executive Committee and the Board of Trustees. The compensation of officers and key employees, other than the CEO, is set by management using available industry data and benchmarks. Compensation of these employees is indirectly approved when the Board approves the annual operating budget.
Form 990, Part VI, Section C, line 18The Organization makes its Form 1023 and Form 990 available upon request and through a third party website.
Form 990, Part VI, Section C, line 19By using the Annual Report and website.
Form 990, Part IX, line 11gPurchased Services: Program service expenses 3,582,455. Management and general expenses 997,913. Fundraising expenses 0. Total expenses 4,580,368. Other Professional Fees: Program service expenses 1,921,260. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,921,260. Consulting Fees: Program service expenses 50. Management and general expenses 52,825. Fundraising expenses 0. Total expenses 52,875.
Form 990, Part X, Line 10: Land, Buildings, and EquipmentSection 1.263(a)-3(n) Election: Cottage Hospital 90 Swiftwater Road Woodsville, NH 03785 EIN: 02-0223321 Cottage 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 Funds Held in Trust by Others 6,907.