2020-08-12T11:55:56-05:00 2019-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2018-10-01 020222118 Valley Regional Hospital Inc VALL 6035427771 243 Elm Street Claremont NH 03743 Jean Shaw CFO 6035427771 2020-08-07 1 Joseph R Byrne P01289281 2077752387 2020-08-07 69.49.157.66 2020-08-07 16:35:52 ED P 8B04EC08AF02322EA9ED1307B74D8AF8BDCA5114 AFAA3DB4FE1C09EACD089651B4BEF68615A227D3 2018 2020-09-23 17:36:50Z Deanna Howard 243 Elm Street Claremont NH 03743 47381298 0 X www.vrh.org X 1893 NH Critical Access Hospital 18 15 415 22 0 0 88104 195433 42459596 44046148 1282065 778613 -99502 65500 43730263 45085694 0 0 0 0 21623373 23375042 0 0 0 21518598 20829529 43141971 44204571 588292 881123 47541765 49163552 21527131 21662211 26014634 27501341 X The mission of Valley Regional Hospital, Inc. is to improve community health, patient experience, and value. Our vision is to partner with the community to optimize health by ensuring access to high value health care. 0 0 38893766 44046148 Valley Regional Hospital is a provider of health services with facilities in the Claremont, NH area. The Hospital grants credit to patients, substantially all of whom are local residents. The Hospital also provides care to patients who meet certain criteria under its Financial Assistance policy without charge or at amounts less than its established rates. The Hospital does not pursue collection of amounts determined to qualify as financially-assisted care. The Hospital maintains records to identify and monitor the level of financially-assisted care it provides. For the year ending September 30, 2019 charges forgone for services and supplies furnished under the charity care policy were approximately $925,000. The estimated cost of those services and supplies was approximately $563,000.In addition, the Hospital provides a number of other services to benefit certain poor and elderly patients. Medicaid and state programs do not cover the full cost of the Hospital incurred cost of providing medical care to patients. The hospital provides services to residents throughout the region. Those services include health evaluations, screenings, and flu vaccine administration at community events and in the workplace. Health education, wellness, chronic disease management, fitness, and ergonomic programs are also widely offered. For these services, and many other community services, the hospital receives little or no payment.Other community benefits can't be quantified or assigned a value. For example, the hospital provides committee and board participants and expertise to address community needs; to support community health initiatives; to advocate for and support individuals who are socially, economically and physically challenged; and to collaborate with the local public safety organizations. 38893766 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 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 65 0 1 415 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 0 1 1 1 1 0 NH X Jean Shaw 6035427771 243 Elm Street Claremont NH 03743 Patricia Putnam Chair 0.90 0.10 X X 0 0 0 John Tomlinson Co-Vice Chair 0.90 0.10 X X 36000 0 0 Allan Berggren MD Secretary 0.90 0.10 X X 0 0 0 James Borchert Trustee 0.90 0.10 X 0 0 0 Scott Bouranis Trustee 0.90 0.10 X 0 0 0 Cynthia L Burr Trustee 0.90 0.10 X 0 0 0 Eric Crainich Trustee 0.90 0.10 X 0 0 0 Terri Decker Trustee 0.90 0.10 X 0 0 0 Michael Fuerst Trustee 0.90 0.10 X 0 0 0 Bryan Huot Trustee 0.90 0.10 X 0 0 0 Katherine Lajoie Trustee 0.90 0.10 X 0 0 0 Steve LeBlanc Trustee 0.90 0.10 X 0 0 0 Lisa Richmond Trustee 0.90 0.10 X 0 0 0 Alex Scott Trustee 0.90 0.10 X 0 0 0 Tom Sullivan Trustee 0.90 0.10 X 0 0 0 Gailyn Thomas MD Trustee 0.90 0.10 X 0 0 0 James P Wilton DPM Trustee 39.90 0.10 X 282263 0 29951 Deanna Howard Interim CEO 38.40 1.60 X X 0 0 0 Peter Wright Past President & CEO 38.40 1.60 X X 0 213955 33221 Michael O'Connell Past Chair 0.90 0.10 X X 0 0 0 Jean Shaw CFO 37.20 2.80 X 0 155971 32225 Randolph R Knight Physician 40.00 0.00 X 402584 0 30041 Jeffrey A Hanissian Physician 36.00 0.00 X 339246 0 29655 Joel P Herrington Physician 36.00 0.00 X 304801 0 27044 Azem Dushaj Physician 40.00 0.00 X 281487 0 36942 Ivar L Frithsen Physician 35.00 0.00 X 276391 0 25524 1922772 369926 244603 22 0 1 1 Dartmouth Hitchcock Clinic One Medical Center Drive Lebanon NH 03756 Medical Services 1898219 Americanl Healthcare Services Associatio PO Box 1928 Edmondy OK 73083 Contract Staffing 1047988 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Locum Tenens Staffing 885059 Barton Associates Inc PO Box 417844 Boston MA 02241 Contract Staffing 657359 Triage LLC PO Box 3291 Omaha NE 68103 Contract Staffing 631728 18 35000 160433 195433 Patient Service Revenue 622100 74959604 74959604 Other Revenue 900099 1515025 1347072 167953 Provision for Bad Debts 622100 -3563812 -3563812 Charity/Contractual Adjustment 622100 -28864669 -28864669 44046148 762321 762321 161874 96374 65500 65500 65500 1840522 375000 2108872 90358 -268350 284642 16292 16292 45085694 43878195 0 1012066 X 348214 348214 18476253 16226068 2250185 90776 79883 10893 3166969 2784241 382728 1292830 1138045 154785 60342 60342 52355 52355 158787 158787 8660097 7876818 783279 2594 2283 311 808002 711263 96739 776876 683864 93012 2509846 2209353 300493 16281 14332 1949 281376 247688 33688 322441 322441 Medical Supplies 4579080 4030847 548233 Medicaid Enhancement Ta 2095434 2095434 Miscellaneous 393766 346620 47146 Dues & Subscriptions 112252 98813 13439 44204571 38893766 5310805 0 X 967021 437141 7842391 8778778 5807306 5195075 942276 847983 453559 329215 3949233 1101091 1705321 2848142 23921295 24242346 4271283 4143100 1631313 2341772 47541765 49163552 5051258 4993958 102706 111484 16373167 16556769 21527131 21662211 X 19894214 21452180 1595243 1652167 4525177 4396994 26014634 27501341 47541765 49163552 X 881123 733767 -128183 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10357 10357 0 Part II-B, Line 1: The Organization pays dues to local associations, a portion of which are attributable to lobbying activities. 5990786 -94455 1231 5895100 5712343 279662 1219 5990786 5389514 323912 1083 5712343 4948736 441723 945 5389514 5350477 -400894 847 4948736 0.00000 0.74590 0.25410 0 0 250667 250667 1581952 664009 917943 603838 44455 559383 1506846 386697 1120149 5930 5930 0 2848142 Beneficial Interest in Perpetual Trusts 4143100 F 4143100 Due To Affiliates 174069 Estimated Third-Party Payor Settlements 15473262 Reserve for Self-Funded Insurance 909438 16556769 Part V, Line 4: The Organization uses its endowment funds in support of health care services, purchases of equipment, health education, and indigent care. 1 1 X 1 X 1 X 275.000000000000 1 1 0 1 1 2577954 2112629 465325 0.01050 6655310 5583223 1072087 0.02430 9233264 7695852 1537412 0.03480 698079 184788 513291 0.01160 123119 123119 0.00280 5736 5736 0.00010 10003 10003 0.00020 836937 184788 652149 0.01470 10070201 7880640 2189561 0.04950 5710 5710 0.00010 11264 11264 0.00030 159 159 0.00000 5243 5243 0.00010 3385 3385 0.00010 25761 25761 0.00060 1 1858409 14014540 14014540 X 1 1 1 1 Valley Regional Hospital Inc 243 Elm Street Claremont NH 03743 www.vrh.org 00007 X X X X Valley Regional Hospital Inc 1 0 0 1 X X X X X X X X X 17 1 1 0 1 X www.vrh.org/about-vrh/public-reports X X 1 17 1 www.vrh.org/about-vrh/public-reports 0 1 X 200.000000000000 275.000000000000 X X X X 1 1 X X X 1 X http://vrh.org/patient-billing/ X http://vrh.org/patient-billing/ X http://vrh.org/patient-billing/ X X X X X 1 X 0 X 1 X 0 0 Valley Regional Hospital, Inc. Part V, Section B, Line 5: During the period January through June 2018, Valley Regional Hospital conducted a Community Health Needs Assessment of its service area, in partnership with New London Hospital, Alice Peck Day Memorial Hospital, Dartmouth-Hitchcock, and Mt. Ascutney Hospital and Health Center, Visiting Nurse and Hospice of VT & NH, and the NH Community Health Institute. Information gathering utilized in the assessment included the following: 1. Surveys of community residents made available on-line and paper surveys placed in numerous locations throughout the region; 2. Series of community discussion groups; 3. Review of results compiled from other recent assessment activities focused on specifically on behavorial health needs and gaps; 4. Review of applicable population demographics and health status indicators; 5. Direct email survey with over 100 stakeholders and community leaders representing multiple community sectors, including:- Derek Ferland, Sullivan County Manager- Nancy Merrill, Claremont City Planner- Dr. Middleton McGoodwin, Superintendent SAU #6- Elyse Crossman, ED, Claremont Chamber of Commerce- Sally Bouchard, ED, Sullivan County Oral Health Collaborative- Ted Purdy, Sullivan County Healthcare- Deborah Mozden, ED, Turning Points Network- Mark Brislin, Claremont Community Center- Mark Mills, CEO, Pathways of the River Valley- Ryan McNutt, Claremont City Manager- Charlene Lovett, Claremont City Mayor- Dr. Cindy Gallagher, Superintendent SAU #43- Ella Casey, ED, Newport Chamber of Commerce- Jim Culhane, CEO, Lake Sunapee Visiting Nurse & Hospice- Sue Ellen Griffin, CEO, West Central Behavorial Health- Maggie Monroe-Cassel, ED, TLC Family Center- PJ Lovely, Newport Recreation Department- Ashley Greenfield, Sullivan County Public Health Network Valley Regional Hospital, Inc. Part V, Section B, Line 6a: Due to significant overlap in service area, Valley Regional Hospital partnered with the following hospitals to identify both regional and community-specific needs for the community health needs assessment: - New London Hospital - Alice Peck Day Memorial Hospital, - Dartmouth-Hitchcock Medical Center, - Mt. Ascutney Hospital and Health CenterThere is significant overlap in service area among these organizations; the CHNA identified both regional and community-specific needs. Valley Regional Hospital, Inc. Part V, Section B, Line 7d: The CHNA was widely distributed in traditional ways (hard copy mailings, website, handouts at community meetings, etc) as well as via a recorded community access cable television program. Valley Regional Hospital, Inc. Part V, Section B, Line 11: CHNA Implementation StrategyThe multitude of community issues identified through the assessment process far exceed the ability of a single entity to solve the issues; however, Valley Regional is committed to being an active partner in determining ways to address all of the identified issues, in collaboration with many other local nonprofit groups and community leaders. 1. Access to mental health care: a. Commit personnel and other necessary resources in collaboration with West Central Behavioral Health, Counseling Associates and other community mental health providers to create and foster bi-directional patient care opportunities and relationships. b. Launch a tele-psych pilot program through DHMC. c. Create and utilize assessment screeners for Social Determinants of Health and Depression at routine healthcare visits. d. Develop and enhance protocols to safely care for patients awaiting behavioral health placement. e. Provide staff education for the Emergency Department and outpatient physician practices, specifically for mental health/integrated care.2. Alcohol and Drug Misuse, Treatment and Recovery: a. Commit personnel and other necessary resources in collaboration with local, county and state groups working in prevention and treatment recovery. b. Explore opportunities to incorporate treatment methods (in-patient and outpatient) within the VRH campus. c. Open and manage a needle exchange program. d. Support and encourage recovery-friendly pediatrics. e. Provide appropriate and on-going training for staff, particularly in the Emergency Department and outpatient physician practices. f. When appropriate, VRH will commit staff resources to serve on community boards that support intervention/prevention efforts.3. Access to Affordable Health Insurance and Prescriptions: a. Case Management will assist clinic and in-hospital patients with forms and identifying payment options. b. Staff will be knowledgeable to provide referral opportunities to community organizations, such as ServiceLink and DHHS. c. VRH will continue its commitment to providing services to patients with low income through its Financial Assistance Program. d. VRH's Medication Assistance Program for indigent patients will provide discounted or free medications from pharmaceutical companies. 4. Family Violence, Child Abuse, Bullying: a. Surveys will be conducted in physician practices to identify violence in patients' homes as part of routine screenings. b. Information fliers on domestic violence will be available and distributed in physician practices and bathrooms throughout the VRH campus. c. Partner with community organizations, such as Turning Points and TLC, to provide support and collaboration. d. Screen all patients in the Emergency Department and Urgent Care at point of triage, referring to BEAS, DCYF or TPN when appropriate. e. Commit VRH staff resources to the Sullivan County's Continuum of Care meetings and appropriate board appointments. 5. Access to Care for Seniors: a. Offer falls assessment screenings and fall prevention programs for in-patients and physician practices. b. Offer maintenance supervised exercise programs for graduates of cardiac/pulmonary rehab. c. Collaborate with Claremont Community Center to assist seniors with mobility challenges. d. Advocate at the local and state levels for senior needs, as communicated by patients. 6. Availability and Affordability of Dental Care: a. Continue VRH's longstanding collaboration with Sullivan County Oral Health Collaborative, which operates the community's only nonprofit dental center. b. Provide financial contribution restricted to the renovation and expansion of services at Community Dental Care of Claremont. c. Provide comprehensive oral health information packets for Emergency Department patients. d. When appropriate, VRH will commit staff resources to serve on community boards that support dental care efforts. 7. Availability of Primary Care Services: a. Increase the number of primary care providers in the Valley Regional Healthcare system. b. Create a media strategy to introduce PCP's to the community. c. Assess accessibility in terms of hours, days of the week, same-day appointments, coordination with Urgent Care and the Emergency Department. d. Create educational materials to encourage annual wellness exams for all ages.8. Social Determination of Health, including transportation and poverty: a. Offer flexible scheduling to coordinate local transportation availability. b. Create and utilize an assessment form that asks outpatients specific questions about housing, transportation, poverty, etc. c. Provide resources to patients who have limited knowledge of community resources available to them. Valley Regional Hospital, Inc. Part V, Section B, Line 20e: Applications are offered to all self-pay patients along with education regarding Granite Advantage and expanded Medicaid. 1 1 - Kane Oncology Center 243 Elm Street Claremont NH 03743 Oncology Center Part I, Line 3c: It is the policy of Valley Regional Hospital to provide financial assistance to those patients who are unable to pay for all or part of the cost of their care that is not covered by other sources of funding. Valley Regional Hospital's Financial Assistance Program is a program that assists uninsured and under-insured patients who meet specific income, geographical and Valley Regional Hospital guidelines.The Hospital will cover up to 100% of the cost of care for patients depending on the patient's level of income and family size. The Hospital also is a participating provider with the NH Health Access Network. Part I, Line 7: The Organization used an overall cost to charge ratio for lines 7a and 7b. Amounts listed on lines 7e, 7f and 7i were derived from internal financial/cost accounting systems. Part II, Community Building Activities: Valley Regional Healthcare believes the skills and knowledge of its employees are the most critical assets to building a strong and healthy community. VRH employees participate on a wide variety of local boards serving or participating in health and wellness missions, including dental health, domestic violence, higher education, school boards, chambers of commerce, United Way, public transportation, elder health, and substance abuse. Employees also participate on state level boards and within elected government, working to improve policy and practice on a broad spectrum. Local businesses rely upon collaborations with VRH to provide education and expertise in community building activities such as through public and private health fairs. VRH takes advantage of public chamber activities to provide tables of health information and free screening activities. VRH also provides financial support for non-profit organizations with complementary missions, in the form of event sponsorships. Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable.In evaluating the collectibility of accounts receivable, the Organization analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Organization 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 (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Organization records a provision for bad debts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts.During 2019, the Organization decreased its estimate from $2,765,823 to $2,583,372 in the allowance for doubtful accounts relating to self-pay patients and during 2018 the Organization increased its estimate from $2,097,771 to $2,765,823 in the allowance for doubtful accounts relating to self-pay patients. During 2019, self-pay write-offs increased from $2,720,189 to $3,168,063 and during 2018 self-pay write-offs increased from $2,606,612 to $2,720,189. Such changes in the allowance for doubtful accounts resulted from trends experienced in the collection of amounts from self-pay patients, the deterioration in the aging of self-pay receivables, and billing delays experienced during the conversion to a new electronic medical record system during 2019.The Organization used a cost-to-charge ratio as its methodology for reporting bad debt expense at cost. Part III, Line 8: Medicare costs approximate Medicare revenue. The Organization does not anticipate a Medicare shortfall or that any such shortfall should be considered as community benefit. Part III, Line 9b: Patients who are known to qualify for financial assistance file a financial assistance determination application with the Hospital. If the application is approved, the patient's account shall be written off, in accordance to the level of adjustment the applicant was qualified to receive. The patient write-off guidelines are as follows:1. The determination is valid for 6 months from the date of signature for all applications except those individuals who demonstrate that they are on a fixed income (i.e. Social Security, retirment, disability), in which case approval is for 1 year from the date of signature.2. Patient qualifies according to the established Financial Assistance income guidelines3. Account notes must indicate what payor that the balance is due to (appropriate payor write-off codes to be utilized). Part VI, Line 2: The purpose of the assessment was to identify community health concerns, priorities and opportunities for community health and health care delivery systems improvement. In collaboration with The Community Health Institute/JSI and our partner hospitals, key healthcare, public service and community member stakeholders were engaged to collect and analyze qualitative and quantitative data.The CHNA provides a clear blueprint for community outreach and collaboration opportunities, and also creates a timely benchmark against which to measure progress.The purpose of the research design was as follows: 1. To clearly define the VRH service area 2. To define measurement methodologies which can identify community needs 3. To create a prioritized list of community resources 4. To develop a catalogue of available healthcare resourcesThe following health issues were identified by survey respondents: 1. Access to Mental Health Care 2. Alcohol and Drug Misuse, Treatment and Recovery 3. Access to affordable health insurance and prescriptions. 4. Family Violence, Child Abuse and Bullying 5. Access to Care for Seniors 6. Availability and Affordability of Dental Care 7. Availability of Primary Care Services 8. Social Determinants of Health, including transportation and poverty. Part VI, Line 3: The Community Engagement department has created and posted signage throughout the hospital and clinics, and has posted information on the hospital's website. Part VI, Line 4: Valley Regional serves a rural region which includes the 15 towns of Sullivan County and portions of eastern Vermont, with a total resident population of 43,051. Spanning 552 square miles, the County is the 2nd least populated in NH. 11% of Sullivan County children live below 100% of the Federal Poverty level, while 33% of children are below 200% poverty level. Just over 6% of residents have no access to a vehicle within their home environment, and 14.4% of residents have at least one form of disability. Part VI, Line 5: Valley Regional Healthcare recognizes its importance to the community - economically, as one of the largest local employers, and philosophically, as a large entity entrusted with community wellness. VRH leadership instills in employees the sense of responsibility to be involved in support of the community, on behalf of the hospital.VRH employees participate and lend expertise as board members of other non-profits, including those focused on dental health, community revitalization, higher education and school boards, elder issues, public transportation, domestic violence, substance misuse and abuse, and health and wellness initiatives. Employees also participate on state and Federal boards and committees as well as Chambers of Commerce and United Way, working to improve policy and practice in healthcare delivery.Business collaborations are a priority, particularly with large employers such as Claremont Parks and Recreation, Whelen Engineering, River Valley Technical Center, Claremont Savings Bank, National Field Representatives, Red River and The City of Claremont. Our common goals include health education, health screenings, worker safety and employment opportunities. Part VI, Line 6: Valley Regional Hospital is not affiliated with another healthcare system, but it collaborates voluntarily with other hospitals. Sharing resources, both material and human, participating in community groups, providing sponsorships to other non-profits whose missions are aligned, contributing to disaster and international relief efforts, partnering with the American Red Cross for blood drives - all these things represent community benefits. Additionally, we provide free physical space for local non-profits, Rotary, BNI, Patient Transformation Network, and community groups like TLC Family Resource Center. Our physicians and other providers offer free wellness programming at locations throughout the communities we serve - at senior centers, schools, recreation venues. Part VI, Line 7, Reports Filed With States NH 0 0 0 0 0 0 0 1 0 James P Wilton DPM Trustee 263909 0 10000 0 8354 0 212 0 29739 0 312214 0 0 0 Peter Wright Past President & CEO 0 212469 0 250 0 1236 0 19672 0 13549 0 247176 0 0 Jean Shaw CFO 0 155556 0 0 0 415 0 129 0 32096 0 188196 0 0 Randolph R Knight Physician 360775 0 0 0 41809 0 209 0 29832 0 432625 0 0 0 Jeffrey A Hanissian Physician 330859 0 0 0 8387 0 251 0 29404 0 368901 0 0 0 Joel P Herrington Physician 289402 0 10000 0 5399 0 0 0 27044 0 331845 0 0 0 Azem Dushaj Physician 214700 0 10000 0 56787 0 87 0 36855 0 318429 0 0 0 Ivar L Frithsen Physician 227500 0 27500 0 21391 0 0 0 25524 0 301915 0 0 0 Part I, Line 3 Valley Regional Healthcare, Inc., a related organization, establishes the compensation for the Organization's CEO & CFO. Valley Regional Healthcare, Inc. uses a variety of resources to establish compensation as follows: 1. Form 990 of other organizations 2. Written employment contract 3. Compensation survey/study 4. Approval by the board/compensation committee Part I, Line 7 Individuals listed with Incentive Bonus amounts are physicians who under their employment agreements/contracts have a provision for Incentive Bonuses based on Quality, Patient Satisfaction and Relative Value Units (RVUs) of services exceeding a target amount. Form 990, Part VII, line 5: Peter Wright, CEO is paid by Mary Hitchcock Memorial Hospital, an unrelated organization via a professional services agreement. A breakdown of Mr. Wright's 2018 compensation is as follows: Salary: $213,955 Benefits: $33,221 Deanna Howard, Interim CEO, is paid by Dartmouth Hitchcock Medical Center, an unrelated organization via a professional services agreement. Ms. Howard started as Interim CEO in March 2019, and therefore has no reportable compensation presented on the 2018 Form 990. Form 990, Part VI, Section A, line 6 The sole member of the Organization is Valley Regional Healthcare, Inc. Form 990, Part VI, Section A, line 7a The Organization's directors are nominated and elected by the Organization's member at the annual meeting of the Corporation. Form 990, Part VI, Section A, line 7b The following actions and undertakings involving the business of the Organization are subject to the ratification by the member: adoption of operating budget; adoption of capital budgets; adoption of strategic plans; initiation of significant fund-raising activities; implementation of institutional affiliations, mergers, consolidations or other reorganizations; material modification of service and business offerings; material acquisitions or dispositions of assets; changes in certified public accountants, fiscal year or material accounting practices; incurrence of material indebtedness; material changes in insurance programs and arrangements; material changes in employee benefits plans; adoption of quality improvements plans; election of directors; selection of the president/CEO; amendment of the Organization's bylaws; and amendment of the articles of association. Form 990, Part VI, Section B, line 11b The Organization's CFO reviews the draft Form 990 prior to its filing. The CFO then goes over the document with the board's finance committee. Form 990, Part VI, Section B, line 15 The executive committee of the board of trustees convenes two to four times annually to review the compensation of the CEO. Regional compensation of like-sized organization is used. The amount of compensation shall be reviewed by the D-H independent compensation consultant for purposes of determining compliance with the rebuttable presumption, if necessary. The CEO compensation is tied to the strategic planning goals of the Organization. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part IX, line 11g Physician Fees: Program service expenses 2,117,812. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,117,812. Purchased Services: Program service expenses 5,483,913. Management and general expenses 745,864. Fundraising expenses 0. Total expenses 6,229,777. Other Professional Fees: Program service expenses 275,093. Management and general expenses 37,415. Fundraising expenses 0. Total expenses 312,508. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Valley Regional Hospital, Inc. 243 Elm Street Claremont, NH 03743 EIN: 02-0222118 Valley Regional Hospital, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Net Loss of Beneficial Interest In Perpetual Trust -128,183. Valley Regional Healthcare Inc 243 Elm Street Claremont NH 03743 020397338 Healthcare supporting organization NH 501(c)(3) Line 12b, II N/A 0 George H Stowell Trust 295 Windsor Rd Claremont NH 03743 Charitable Trust NH T 60915 1953587 1.00000 0 Clarence H Martin Trust 243 Elm St Claremont NH 03743 Charitable Trust NH T 2155655 0.66670 0 McGuire Endowment 243 Elm St Claremont NH 03743 Charitable Trust NH T 33858 1.00000 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0