STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

LITTLETON HOSPITAL ASSOCIATION: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
LITTLETON HOSPITAL ASSOCIATION (EIN 02-0222152)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-08-14
IRS object ID
202042279349301884
Schema version
2018v3.2
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)
Return2020-08-14T13:44:13-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

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 Line1PO Box 1100AddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP041041100ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222152EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Littleton Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLITTBusinessNameControlTxt
Phone6034449000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03561ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSteven CiampaPersonNm
Person TitleInterim CFOPersonTitleTxt
Phone6034449000PhoneNum
Signature2020-08-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBarbara J McGuan CPAPreparerPersonNm
PTINP00219457PTIN
Phone2077752387PhoneNum
Preparation2020-08-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address69.49.157.66IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-08-12IPDt
IP Tm13:58:33IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id8B04EC08AF02322EA9ED1307B74D8AF8BDCA5114AtSubmissionCreationDeviceId
At Submission Filing Device Id15D84E00388989A2FD892B611AF49EE7CA45C0C7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Littleton Regional HealthcareBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRobert F NutterPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03561ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$117,066,896GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.littletonhospital.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1906FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionTo provide health care services in Northern New HampshireActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee599TotalEmployeeCnt
Total Volunteers204TotalVolunteersCnt
Total Gross UBI$624TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$190,650PYContributionsGrantsAmt
CY Contributions Grants$144,867CYContributionsGrantsAmt
PY Program Service Revenue$90,002,857PYProgramServiceRevenueAmt
CY Program Service Revenue$95,138,108CYProgramServiceRevenueAmt
PY Investment Income$953,306PYInvestmentIncomeAmt
CY Investment Income$976,814CYInvestmentIncomeAmt
PY Other Revenue$129,802PYOtherRevenueAmt
CY Other Revenue$167,885CYOtherRevenueAmt
PY Total Revenue$91,276,615PYTotalRevenueAmt
CY Total Revenue$96,427,674CYTotalRevenueAmt
PY Grants And Similar Paid$289,692PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$279,956CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$46,613,305PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$52,914,768CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$42,185,480PYOtherExpensesAmt
CY Other Expenses$46,391,867CYOtherExpensesAmt
PY Total Expenses$89,088,477PYTotalExpensesAmt
CY Total Expenses$99,586,591CYTotalExpensesAmt
PY Revenues Less Expenses$2,188,138PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,158,917CYRevenuesLessExpensesAmt
Total Assets BOY$106,611,122TotalAssetsBOYAmt
Total Assets EOY$101,138,670TotalAssetsEOYAmt
Total Liabilities BOY$45,999,446TotalLiabilitiesBOYAmt
Total Liabilities EOY$48,768,190TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$60,611,676NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$52,370,480NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTo provide quality, compassionate and accessible healthcare in a manner that brings value to all.To offer a full spectrum of services, including acute primary and selected secondary care; 24-hour emergency services; preventive diagnostic, theraputic, and rehabilitative services on an outpatient and inpatient basis; continuity of care from preventive programs to coordination with home health services.To provide these services without regard to race, religion, age, sex, income, creed, national origin, or disability.To maintain a sufficient number and mix of medical staff who are competent, dedicated and commmunity based, supporting them with the technologically up-to-date equipment and facility needed to provide these services competitively.To create a healthy, satisfying work environment for phsycians, nurses and other employees, with a commitment to support the continuing educational needs of its professional staff, including the physicians, nurses and allied health personnel.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$84,039,016ExpenseAmt
Grant$279,956GrantAmt
Revenue$95,138,108RevenueAmt
DescLittleton Hospital Association provides health care services on an in/outpatient basis to the general public, including charity care, community education, and various other health programs and services.Desc
Total Program Service Expenses$84,039,016TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
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 ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document142IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee599EmployeeCnt
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 ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
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 Members16GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 Line1Leslie WalkerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6034449000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03561ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Roger Gingue
Chairman1.00Yes (X)Yes (X)$0$0$0
Jeff Woodward
Vice Chair1.00Yes (X)Yes (X)$0$0$0
Erin Hennessey
Treasurer1.00Yes (X)Yes (X)$0$0$0
Dr Patrick Fitzpatrick
Secretary/Chief of Staff40.00Yes (X)Yes (X)$686,408$0$34,468
Milton Bratz
Trustee1.00Yes (X)$0$0$0
Fred Chisolm
Trustee1.00Yes (X)$0$0$0
Dr Edward Duffy
Interim NCH CEO1.00Yes (X)Yes (X)$0$481,341$42,53440.00
Ashley Garrison
Trustee1.00Yes (X)$0$0$0
Dr Stephen Goldberg
Trustee/Physician40.00Yes (X)$327,347$0$34,987
Robin Hallquist
Medical Staff President1.00Yes (X)$0$0$0
Richard Jesseman
Trustee1.00Yes (X)$0$0$0
Elizabeth Kunz
Trustee1.00Yes (X)$0$0$0
Laurie Morgan
Trustee & LRH Auxiliary1.00Yes (X)$0$0$0
Dr Deane Rankin
Trustee/Physician40.00Yes (X)$342,901$0$41,182
Ed Shanshala II
Trustee1.00Yes (X)$0$0$0
Paul Smith
Trustee1.00Yes (X)$0$0$0
William Bedor
Past Chairman1.00Yes (X)Yes (X)$0$0$01.00
Ned Brewer
Past Trustee1.00Yes (X)$0$0$0
Dr John Sauter
Past Trustee Emeritus40.00Yes (X)$423,395$0$461.00
Robert Nutter
President40.00Yes (X)$423,651$0$34,383
Leslie Walker
VP of Finance40.00Yes (X)$197,597$0$35,652
Dr Eric Mullins
Physician40.00$798,358$0$34,399Yes (X)
Dr Harlan Herr
Physician40.00$637,035$0$19,328Yes (X)
Dr Jeffrey Kauffman
Physician40.00$553,732$0$35,907Yes (X)
Dr Jennifer Lucas
Physician40.00$464,467$0$29,110Yes (X)
Dr Jean Langevin
Physician40.00$470,573$0$11,587Yes (X)
Warren West
Former NCH CEO0.00$149,127$382,550$8,4040.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,474,591TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$863,891TotReportableCompRltdOrgAmt
Total Other Compensation$361,987TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K81IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
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
The Alpine Clinic PLLC
1095 Profile RdFranconiaNH03580Professional Services Agreement$1,880,343
Trumbull-Nelson Construction
PO Box 1000HanoverNH03755General Contractor$748,193
J&J Health Care Systems Inc
PO Box 406663AtlantaGA30384Supply Chain Management$673,282
Comphealth
PO Box 972651DallasTX75397Locums$629,866
Balanced Healthcare Receivable LLC
164 Burke StreetNashuaNH03060A/R Collections$626,757
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Fundraising$57,561FundraisingAmt
All Other Contributions$87,306AllOtherContributionsAmt
Total Contributions$144,867TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Service Revenue900099$181,907,940$181,907,940
Other Revenue900099$5,009,158$4,260,807$748,351
Contract Lab621500$68,599$67,975$624
Provision for Bad Debts900099-$5,343,535-$5,343,535
Contractual Allowances900099-$86,504,054-$86,504,054
FieldValueIRS element (for citing)
Total Program Service Revenue$95,138,108TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$599,297TotalRevenueColumnAmt
Exclusion$599,297ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$182,185RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$182,185RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$182,185TotalRevenueColumnAmt
Exclusion$182,185ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$20,981,199SecuritiesAmt
Other$12,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$20,572,485SecuritiesAmt
Other$43,197OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$408,714SecuritiesAmt
Other-$31,197OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$377,517TotalRevenueColumnAmt
Exclusion$377,517ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$9,240FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$57,561ContriRptFundraisingEventAmt
Fundraising Direct Expenses$23,540FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$14,300TotalRevenueColumnAmt
Exclusion-$14,300ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$96,427,674TotalRevenueColumnAmt
Related Or Exempt Func Income$94,389,133RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$624UnrelatedBusinessRevenueAmt
Exclusion$1,893,050ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$279,956TotalAmt
Program Services$279,956ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,105,893TotalAmt
Program Services$2,414,609ProgramServicesAmt
Management And General$691,284ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$40,657,721TotalAmt
Program Services$35,225,636ProgramServicesAmt
Management And General$5,432,085ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$674,697TotalAmt
Program Services$560,624ProgramServicesAmt
Management And General$114,073ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,913,730TotalAmt
Program Services$4,901,818ProgramServicesAmt
Management And General$1,011,912ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,562,727TotalAmt
Program Services$2,112,754ProgramServicesAmt
Management And General$449,973ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$381,545TotalAmt
Management And General$381,545ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$71,750TotalAmt
Management And General$71,750ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$94,736TotalAmt
Management And General$94,736ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,423,370TotalAmt
Program Services$6,663,562ProgramServicesAmt
Management And General$759,808ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$468,527TotalAmt
Program Services$308,326ProgramServicesAmt
Management And General$160,201ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,256,606TotalAmt
Program Services$3,459,243ProgramServicesAmt
Management And General$1,797,363ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,946,793TotalAmt
Program Services$1,281,137ProgramServicesAmt
Management And General$665,656ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,571,718TotalAmt
Program Services$3,008,535ProgramServicesAmt
Management And General$1,563,183ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$188,111TotalAmt
Program Services$123,791ProgramServicesAmt
Management And General$64,320ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$65,984TotalAmt
Program Services$43,422ProgramServicesAmt
Management And General$22,562ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$927,208TotalAmt
Program Services$927,208ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,559,575TotalAmt
Program Services$3,753,651ProgramServicesAmt
Management And General$805,924ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,149,968TotalAmt
Program Services$756,766ProgramServicesAmt
Management And General$393,202ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$13,285,947$13,285,947
Medicaid Enhancement Ta$3,736,209$3,736,209
Miscellaneous Expense$1,934,967$979,412$955,555
Recruiting Expense$328,853$216,410$112,443

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$99,586,591TotalAmt
Program Services$84,039,016ProgramServicesAmt
Management And General$15,547,575ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$381,331BOYAmt
EOY$134,354EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,589,585BOYAmt
EOY$1,202,745EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$20,827BOYAmt
EOY$6,244EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,123,489BOYAmt
EOY$11,060,454EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$40,824BOYAmt
EOY$29,946EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,938,794BOYAmt
EOY$2,195,332EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,166,750BOYAmt
EOY$2,287,417EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$100,930,581LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$62,879,640LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$37,741,010BOYAmt
EOY$38,050,941EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$46,009,180BOYAmt
EOY$43,719,926EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,599,332BOYAmt
EOY$2,451,311EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$106,611,122BOYAmt
EOY$101,138,670EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,862,111BOYAmt
EOY$9,200,193EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$520,715BOYAmt
EOY$608,811EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,598,088BOYAmt
EOY$22,772,521EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,042,507BOYAmt
EOY$1,774,773EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,976,025BOYAmt
EOY$14,411,892EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$45,999,446BOYAmt
EOY$48,768,190EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$58,054,504BOYAmt
EOY$49,733,881EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$558,620BOYAmt
EOY$636,381EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,998,552BOYAmt
EOY$2,000,218EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$60,611,676BOYAmt
EOY$52,370,480EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$106,611,122BOYAmt
EOY$101,138,670EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,158,917ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$59,421NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$5,141,700OtherChangesInNetAssetsAmt
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$15,707OtherActivitiesAmt
Total Lobbying Expenditures$15,707TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,365,387BeginningYearBalanceAmt
Contributions$1,539ContributionsAmt
Investment Earnings Or Losses$56,233InvestmentEarningsOrLossesAmt
Other Expenditures$48,499OtherExpendituresAmt
End Year Balance$2,374,660EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,286,360BeginningYearBalanceAmt
Contributions$3,245ContributionsAmt
Investment Earnings Or Losses$128,304InvestmentEarningsOrLossesAmt
Other Expenditures$52,522OtherExpendituresAmt
End Year Balance$2,365,387EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,068,307BeginningYearBalanceAmt
Contributions$950ContributionsAmt
Investment Earnings Or Losses$221,332InvestmentEarningsOrLossesAmt
Other Expenditures$4,229OtherExpendituresAmt
End Year Balance$2,286,360EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$886,217BeginningYearBalanceAmt
Contributions$1,150,768ContributionsAmt
Investment Earnings Or Losses$31,397InvestmentEarningsOrLossesAmt
Other Expenditures$75OtherExpendituresAmt
End Year Balance$2,068,307EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$939,547BeginningYearBalanceAmt
Contributions$5,464ContributionsAmt
Investment Earnings Or Losses-$57,271InvestmentEarningsOrLossesAmt
Other Expenditures$1,523OtherExpendituresAmt
End Year Balance$886,217EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.84230PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.15770TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$764,443OtherCostOrOtherBasisAmt
Book Value$764,443BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$42,428,399OtherCostOrOtherBasisAmt
Depreciation$25,138,197DepreciationAmt
Book Value$17,290,202BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$53,488,681OtherCostOrOtherBasisAmt
Depreciation$36,184,769DepreciationAmt
Book Value$17,303,912BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,249,058OtherCostOrOtherBasisAmt
Depreciation$1,556,674DepreciationAmt
Book Value$2,692,384BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$38,050,941TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Due to Third Party Payors$8,832,269
Deferred Compensation$3,039,019
Interest Rate Swap$2,319,861
Due to Related Party$220,743
FieldValueIRS element (for citing)
Total Liability$14,411,892TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$90,929,546TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$59,421NetUnrealizedGainsInvstAmt
Other Revenue-$788,856OtherRevenueAmt
Revenue Not Reported-$729,435RevenueNotReportedAmt
Revenue Subtotal$91,658,981RevenueSubtotalAmt
Investment Expenses Not Incld$94,736InvestmentExpensesNotIncldAmt
Other Revenues Not Included$4,673,957OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$4,768,693RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$96,427,674TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$99,170,742TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$23,540OtherExpensesIncludedAmt
Expenses Not Reported$23,540ExpensesNotReportedAmt
Expenses Subtotal$99,147,202ExpensesSubtotalAmt
Investment Expenses Not Incld2$94,736InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$344,653OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$439,389ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$99,586,591TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:All endowed funds are used based on the donors' wishes. The principal of the funds remains, and only the interest earned can be distributed.
Part XI, Line 2d - Other Adjustments:Unrealized Gain/Loss on Interest Rate Swap -812,396. Fundraising Expenses 23,540.
Part XI, Line 4b - Other Adjustments:Community Benefit Expense 344,653. Disaffiliation Expenses 4,329,304.
Part XII, Line 2d - Other Adjustments:Fundraising Expenses 23,540.
Part XII, Line 4b - Other Adjustments:Community Benefit Expense 344,653.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCentral America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas,RegionTxt
Offices0OfficesCnt
Employee0EmployeeCnt
Type Of Activities ConductedInvestmentsTypeOfActivitiesConductedTxt
Region Total Expenditures$9,964,316RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continuation Total Office0ContinuationTotalOfficeCnt
Continuation Total Employee0ContinuationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$9,964,316SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$9,964,316TotalSpentAmt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp OwnershipYes (1)ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign PartnershipYes (1)ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Dr. Moose Golf TournamentEvent1Nm
Gross Receipts Event1$66,801GrossReceiptsEvent1Amt
Charitable Contri Event1$57,561CharitableContriEvent1Amt
Gross Revenue Event1$9,240GrossRevenueEvent1Amt
Non Cash Prizes Event1$5,872NonCashPrizesEvent1Amt
Rent Facility Costs Event1$14,756RentFacilityCostsEvent1Amt
Food And Beverage Event1$1,396FoodAndBeverageEvent1Amt
Entertainment Event1$1,516EntertainmentEvent1Amt
Gross Receipts Total$66,801GrossReceiptsTotalAmt
Charitable Contributions Tot$57,561CharitableContributionsTotAmt
Gross Revenue Total Events$9,240GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$5,872NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$14,756RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$1,396FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,516EntertainmentTotalEventsAmt
Direct Expense Summary Events$23,540DirectExpenseSummaryEventsAmt
Net Income Summary-$14,300NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
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 Budget0ExpensesExceedBudgetInd
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$533,975TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$533,975NetCommunityBenefitExpnsAmt
Total Expense0.00540TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,873,567TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,946,682DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,926,885NetCommunityBenefitExpnsAmt
Total Expense0.02940TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,407,542TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,946,682DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,460,860NetCommunityBenefitExpnsAmt
Total Expense0.03480TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$263,645TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$53,575DirectOffsettingRevenueAmt
Net Community Benefit Expns$210,070NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,959TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$41,959NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,781,048TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,671,957DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,109,091NetCommunityBenefitExpnsAmt
Total Expense0.10150TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$303,981TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$303,981NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,390,633TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,725,532DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,665,101NetCommunityBenefitExpnsAmt
Total Expense0.10710TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,798,175TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$27,672,214DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,125,961NetCommunityBenefitExpnsAmt
Total Expense0.14190TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,721TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$29,721NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$62,067TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$62,067NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,708TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,708NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$95,496TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$95,496NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,629,773BadDebtExpenseAmt
Reimbursed By Medicare$28,190,710ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$28,190,710CostOfCareReimbursedByMedcrAmt

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 Line1Littleton Regional HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RoadAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03561ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.littletonhealthcare.orgWebsiteAddressTxt
State License02790StateLicenseNum
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 Line1Littleton Regional 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 Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.littletonhealthcare.org/pdf/LRH_CHNA_Implementation_a_2017.pdfOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttps://littletonhealthcare.org/pdf/LRH_CHNA_11_19.pdfStrategyWebsiteURLTxt
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
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 URLhttps:lllittletonhealthcare.org/pdf/LRH Financial Assistance Policy2018.pdfFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://littletonhealthcare.org/pdf/LRH Financial Assistance Application.pdFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://littletonhealthcare.org/pdf/LRH FinanciaI Assistanee Policy2018.pdfFAPSummaryOnWebsiteURLTxt
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 Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Littleton Regional HospitalPart V, Section B, Line 5: In 2019, the Northern New Hampshire Region (Littleton Regional Healthcare, Ammonoosuc Community Health Services and Coos County Fmaily Health Services) performed a Community Health Needs Assessment to determine the health needs of the Greater Northern New Hampshire Region. Data was gathered from multiple well-respected secondary sources to build an accurate picture of the community and its health needs. A survey of a select group of local Experts was performed to review the prior CHNA and provide feedback, and to ascertain whether the previously identified needs are still a priority. Additionally, the group review the data gathered from the secondary sources and determined the Significant Health Needs for the community.
Littleton Regional HospitalPart V, Section B, Line 6a: LRH's (the Hospital) CHNA was conducted along with Ammonoosuc Community Health Services and Coos County Family Health Services.
Littleton Regional HospitalPart V, Section B, Line 11: The Hospital is addressing the significant needs identified in its most recent CHNA as follows:- Drug/Substance Abuse: The Doorway at LRH is part of a statewide initiative to address the growing opioid crisis. Littleton Regional Healthcare serves as a HUB for Northern New Hampshire. Fire, police and first responders carry Narcan with them to administer during calls. LRH offers a women's health conference annually that attracts close to 400 women. The Conference offers education on drug and substance misuse.- Mental Health: LRH employs a part time psychiatrist and also refers to local agencies who treat mental health issues. LRH offers community education on topics related to mental health issues to raise awareness that mental health issues can happen to anyone or any family and should be treated with the same care as diabetes, cardiac issued, etc. LRH hosts two community wellness fairs that includes up to 50 agencies who come to provide information on a number of health related issues including mental health issues.- Obesity/Overweight: LRH's Registered Dietician shares health related information about healthy eating habits including healthy diets and recipes through North Country Nutrition & Wellness a Blog for visitors to the LRH website. LRH offers entry level fitness classes on campus including yoga, and Bone Builders. LRH's 43.6 acres makes walking on the campus a favorite for everyone to walk and run. This encourages staying fit and addresses the obesity/overweight community health need.- Accessibility (Transportation/Disability, Access to Care, etc.): LRH provides transportation to and from appointments and procedures at LRH through our Care-A-Van service. LRH invests more than $118,000 annually in this service to assist individuals who cannot drive or cannot afford a vehicle so that they can get to and from Littleton Regional Healthcare.- Alcohol Abuse: LRH hosts Alcohol Anonymous weekly meetings at no cost to AA. Again, the Doorway at LRH offers drug/substance abuse treatment in the region we serve.- Affordability: In 2019, LRH provided $1,085,003 in charity care for individuals who are unable to pay for healthcare services. Our patient financial services staff works with patients who do not have insurance but want to be covered to help them make a selection that works for them. We work with patients to help them pay their healthcare bills on a monthly basis, at a level that works for their financial capabilities.- Dental: LRH does not address this need directly, but we do refer patients to Ammonoosuc Community Health Services who offers high-quality, affordable dental care that is open to everyone regardless of ability to pay. They accept Medicaid and most major insurances and work with uninsured through a sliding fee scale payment option.

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:The Hospital determines its cost of charity care based on an overall financial statement cost to charge ratio applied against gross charity care charges.
Part I, Line 7g:All costs reported on Part I, Line 7g are attributable to physician practices.
Part II, Community Building Activities:Littleton Regional Healthcare is involved in several community building activities that promote the health and wellbeing of the communities it serves. We collaborate with a number of local agencies including the North Country Health Consortium, Littleton Area Senior Center, Ammonoosuc Community Health Services and others. These agencies share common goals that address access to healthcare, health improvement, health education and affordable healthcare services. LRH encourages senior management and mid-level management to be actively involved in the communities we serve. We work with area schools to address the health of our young students and we work with local safety providers to promote safety and help prevent injury.
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 Hospital analyzes past results and identifies trends for each major payor source of revenue for the purpose of estimating the appropriate amounts of the allowance for doubtful accounts and the provision for bad debts. The adequacy of the allowance for doubtful accounts is regularly reviewed. For receivables associated with services provided to patients who have third-party coverage, an allowance for doubtful accounts and a provision for bad debts are established at varying levels based on the age and payor source of the receivable. For receivables associated with self-pay patients, the Hospital records a provision for bad debts in the period of service based on past experience indicating the inability or unwillingness to pay amounts for which they are financially responsible.
Part III, Line 8:Any shortfall is treated as a community benefit. The Organization uses a cost to charge ratio from the Medicare cost report to determine the amount of Medicare allowable costs.
Part III, Line 9b:Patients who are known to qualify for financial assistance are given a financial assistance application to fill out and return to our Financial Counselor. Upon receipt of the financial assistance application, the application is processed and the amount of financial assistance that will be granted to the patient is determined.Once the percentage of financial assistance is approved, we adjust the account balance accordingly. If a balance is left over after the financial assistance is adjusted, the patient will receive their monthly statements for the remaining balance.If the patient defaults on paying the remaining balance , their account will be sent to a third party collection agency no sooner than 120 days from date of their first statements issued. At this time we would turn the account over to the third party collection agency for further collection efforts.
Part VI, Line 2:LRH takes a comprehensive approach to assess community health needs. We perform several independent data analyses based on secondary source data, augment this with local survey data and resolve any data inconsistency or discrepancies from the combined opinions formed from local experts. We rely on secondary source data amd most secondary sources use the county as the smallest unit of analysis. Since the service area comprises parts of Grafton County, we asked local residents to note if they perceived the problems, or needs, identified by secondary sources to exist in their portion of the county.
Part VI, Line 3:Any applicant will receive a prompt decision on eligibility and amount of charity care offered. Notices of the Charity Care Policy are posted in the lobbies, waiting rooms and other public areas. Notices are also given to recipients who are served in their homes.
Part VI, Line 4:The Hospital defines its primary service area as Grafton County, Grafton County, New Hampshire's estimated population is 89,947 with a growth rate of -0.04% in the past year according to the most recent United States census data. Grafton County, New Hampshire is the 5th largest county in New Hampshire.According to the United States Census, the Population estimates base July 1, 2018 is 89,786 in Grafton County, New Hampshire. Persons under 5 years of age will make up 4.1 of the population. Persons under 18 years of age will make up 16.2% of the population. Persons 65 years of age and over will make up 20.7% and all females will make up 50.6 of the overall population. Median household income (in 2018 dollars), 2014 - 2018 was $63,153. Per capita income in past 12 months {in 2018 dollars) 2014-2018 is $36,619. 9.0% of the population is considered at poverty level. Individuals with a disability, under age 65 years, percent 2014- 2018 is 9.9%. People without health insurance, under the age of 65 years is 8.4.
Part VI, Line 7, Reports Filed With StatesNH

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Foundation for Healthy CommunitiesBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1125 Airport RoadAddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03301ZIPCd
FieldValueIRS element (for citing)
Recipient EIN020275078RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$241,648CashGrantAmt
Purpose Of GrantSupport Medicaid Expansion and Drug & Alcohol Commission.PurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2FormAndLineReferenceDesc
ExplanationAmounts paid to organizations were required by the State of NH in order to support Medicaid expansion. Therefore, additional monitoring of funds was not deemed to be necessary.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
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 (13 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
Dr Patrick Fitzpatrick
Secretary/Chief of Staff$412,280$0$262,459$0$11,669$0$5,721$0$28,747$0$720,876$0$0$0
Dr Edward Duffy
Interim NCH CEO$0$382,050$0$91,000$0$8,291$0$8,228$0$34,306$0$523,875$0$0
Dr Stephen Goldberg
Trustee/Physician$238,701$0$68,055$0$20,591$0$6,740$0$28,247$0$362,334$0$0$0
Dr Deane Rankin
Trustee/Physician$342,033$0$0$0$868$0$7,876$0$33,306$0$384,083$0$0$0
Dr John Sauter
Past Trustee Emeritus$313,106$0$64,076$0$46,213$0$0$0$46$0$423,441$0$0$0
Robert Nutter
President$310,192$0$77,880$0$35,579$0$5,506$0$28,877$0$458,034$0$0$0
Leslie Walker
VP of Finance$170,620$0$17,500$0$9,477$0$5,906$0$29,746$0$233,249$0$0$0
Dr Eric Mullins
Physician$651,300$0$78,319$0$68,739$0$5,553$0$28,846$0$832,757$0$0$0
Dr Harlan Herr
Physician$490,023$0$94,792$0$52,220$0$5,571$0$13,757$0$656,363$0$0$0
Dr Jeffrey Kauffman
Physician$530,006$0$0$0$23,726$0$6,211$0$29,696$0$589,639$0$0$0
Dr Jennifer Lucas
Physician$423,753$0$20,000$0$20,714$0$6,112$0$22,998$0$493,577$0$0$0
Dr Jean Langevin
Physician$445,003$0$0$0$25,570$0$0$0$11,587$0$482,160$0$0$0
Warren West
Former NCH CEO$0$206,550$0$50,000$149,127$126,000$1,615$4,571$0$2,218$150,742$389,339$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4aWarren West, Former NCH CEO, received a severance payment in the amount of $221,053 during calendar year 2018. Littleton Hospital Association paid $95,053 of the severence and the remaining $126,000 was paid by Androscoggin Valley Hospital, Weeks Medical Center, and Upper Connecticut Valley Hospital; all related organizations.
Part I, Line 7Dr. Patrick Fitzpatrick, Chief of Staff, Dr. Stephen Goldberg, Dr. John Sauter, and Highest Compensated Employees; Dr. Harlan Herr, Dr. Eric Mullins and Dr. Jennifer Lucas all received bonuses during the year based upon their productivity using MGMA Standards by RVU and by their specialties outlined in their respective contracts. The Board approved bonuses based on performance of the organization for fiscal year 2018. The President received 15% of gross salary and the senior team received 10% of salary.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
New Hampshire Health and Education Facilities Authority
A0202798662015-10-01$5,331,100Refunded series 2007 Bond000
New Hampshire Health and Education Facilities Authority
B0202798662015-10-01$20,753,200Refunded series 2007 Bond000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$721,364$5,331,100$41,800$5,289,3002015Yes (1)0Yes (1)Yes (1)
B$2,421,645$20,753,200$162,500$20,590,7002015Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)0000Yes (1)
B0Yes (1)0000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedInd
(no name)
A00Yes (1)00000Yes (1)
Deutsche Bank AG
B00Yes (1)0Yes (1)Yes (1)00Yes (1)20.00000000000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule K, Part III, Line 2, Lease Arrangements:FormAndLineReferenceDesc
ExplanationThe debt-financed property is leased to 3 physician practices which operated primarily for purposes related to the hospitals performance of its exempt purpose. Therefore, these leases are not considered to be private business use.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 2Urgent Care services
Form 990, Part VI, Section A, line 2Roger Gingue, Board Chair and Dr. Patrick Fitzpatrick, Board Secretary and Chief of Staff, have a family relationship.
Form 990, Part VI, Section A, line 6On April 1, 2016, North Country Healthcare, Inc. (NCHI) became the sole corporate member of Littleton Hospital Association. Effective September 30, 2019, Littleton Hospital Association formally disaffiliated with NCHI and is now a stand-alone entity.
Form 990, Part VI, Section A, line 7aNorth Country Healthcare, Inc. ("NCH") has worked with members of Littleton Hospital Association ("LHA") to create a shared governance structure between the Board of Directors of NCH and the Board of Trustees at LHA. LHA continues to maintain its own Board of Directors (Corporation Board) that is distinct from the NCH Board of Directors. However, the Bylaws of NCH and LHA identify certain "Major matters" (divided into organizational and operational matters) that require initiation and/or authorization by a majority of the NCH Board. Members of the LHA Board are nominated exclusively by the LHA. However, the election of any such director must be approved by both the LHA Board and the NCH Board. Some examples of other organizational "Major matters" requiring the initiation and/or approval of the NCH Board include amendments to by-laws, election of officers, dissolution of a Hospital, merger decisions and hiring/termination of Hospital Presidents. Examples of operational "Major matters" requiring the initiation and/or approval of the NCH Board include approval of annual capital and operating budgets, adoption of compensation and benefit programs, approval of information technology systems, financial systems and auditors, plus approval of any major changes to clinical services offered.
Form 990, Part VI, Section A, line 7bThe Chief Executive Officer position at LHA has been changed to a President position. As with Board members, the Hospital President must be nominated at the Hospital level and then approved by both the Hospital Board and the NCH Board. The President of LHA reports to both the applicable Hospital Board and the Chief Executive Officer of NCH. The Chief Financial Officer position at LHA has been changed to the Vice President of Finance position. The Vice President of Finance at LHA will remain an appointed position by the President, this individual will also report to the President/Chief Financial Officer of NCH.
Form 990, Part VI, Section B, line 11bThe return was reviewed by the entire Board of Trustees prior to the filing.
Form 990, Part VI, Section B, line 12cAll Trustees, Department directors and Auxilians complete a Conflict of Interest Statement each year, and any potential conflicts are reported to the Board of Trustees and to other places as required by law. In addition, front-line employees who don't normally make decisions for the facility are expected to report forward any conflicts they may have, should they ever be in a position to influence decision making. Quality Services queries these groups on an annual basis, and tracks down people until all statements are complete.
Form 990, Part VI, Section B, line 15Key employees complete self-evaluation - HR Director prepares compensation surveys, reviews 990 of other organizations and market data. The VP of Finance salary is approved by the President. The President's salary is approved by the Board.
Form 990, Part VI, Section C, line 19The hospital's governing documents and financial statements are made available upon request. The hospital's conflict of interest policy is not made available to the public.
Form 990, Part X, Line 10: Land, Buildings, and EquipmentSection 1.263(a)-3(n) Election: Littleton Hospital Association 600 St. Johnsury Road Littleton, NH 03561 EIN 02-0222152 Littleton Hospital Association is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).
Form 990, Part XI, line 9:Unrealized Gain/Loss on Interest Rate Swap -812,396. Disaffiliation expenses -4,329,304.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
North Country Healthcare Inc
8 Clover LaneWhitefieldNH03598812225283Healthcare ManagementNH501(c)(3)Line 12a, IN/A0
Androscoggin Valley Hospital
59 Page Hill RoadBerlinNH03570020280367Critical Access HospitalNH501(c)(3)Line 3N/A0
Upper Connecticut Valley Hospital
Corliss LaneColebrookNH03576020276210Critical Access HospitalNH501(c)(3)Line 3N/A0
Weeks Medical Center
173 Middle StreetLancasterNH03584020222242Critical Access HospitalNH501(c)(3)Line 3N/A0
North Country Home Health & Hospice Agency Inc
536 Cottage StreetLittletonNH03561020300637Home Health AgencyNH501(c)(3)Line 10N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd