2020-08-14T13:44:13-05:00 2019-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2018-10-01 020222152 Littleton Hospital Association LITT 6034449000 600 St Johnsbury Road Littleton NH 03561 Steven Ciampa Interim CFO 6034449000 2020-08-12 1 Barbara J McGuan CPA P00219457 2077752387 2020-08-12 69.49.157.66 2020-08-12 13:58:33 ED P 8B04EC08AF02322EA9ED1307B74D8AF8BDCA5114 15D84E00388989A2FD892B611AF49EE7CA45C0C7 2018 2020-09-23 17:36:50Z Littleton Regional Healthcare Robert F Nutter 600 St Johnsbury Road Littleton NH 03561 117066896 0 X www.littletonhospital.org X 1906 NH To provide health care services in Northern New Hampshire 16 12 599 204 624 0 190650 144867 90002857 95138108 953306 976814 129802 167885 91276615 96427674 289692 279956 0 0 46613305 52914768 0 0 0 42185480 46391867 89088477 99586591 2188138 -3158917 106611122 101138670 45999446 48768190 60611676 52370480 X To 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. 1 0 84039016 279956 95138108 Littleton 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. 84039016 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 1 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 142 0 1 599 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Leslie Walker 6034449000 600 St Johnsbury Road Littleton NH 03561 Roger Gingue Chairman 1.00 X X 0 0 0 Jeff Woodward Vice Chair 1.00 X X 0 0 0 Erin Hennessey Treasurer 1.00 X X 0 0 0 Dr Patrick Fitzpatrick Secretary/Chief of Staff 40.00 X X 686408 0 34468 Milton Bratz Trustee 1.00 X 0 0 0 Fred Chisolm Trustee 1.00 X 0 0 0 Dr Edward Duffy Interim NCH CEO 1.00 40.00 X X 0 481341 42534 Ashley Garrison Trustee 1.00 X 0 0 0 Dr Stephen Goldberg Trustee/Physician 40.00 X 327347 0 34987 Robin Hallquist Medical Staff President 1.00 X 0 0 0 Richard Jesseman Trustee 1.00 X 0 0 0 Elizabeth Kunz Trustee 1.00 X 0 0 0 Laurie Morgan Trustee & LRH Auxiliary 1.00 X 0 0 0 Dr Deane Rankin Trustee/Physician 40.00 X 342901 0 41182 Ed Shanshala II Trustee 1.00 X 0 0 0 Paul Smith Trustee 1.00 X 0 0 0 William Bedor Past Chairman 1.00 1.00 X X 0 0 0 Ned Brewer Past Trustee 1.00 X 0 0 0 Dr John Sauter Past Trustee Emeritus 40.00 1.00 X 423395 0 46 Robert Nutter President 40.00 X 423651 0 34383 Leslie Walker VP of Finance 40.00 X 197597 0 35652 Dr Eric Mullins Physician 40.00 X 798358 0 34399 Dr Harlan Herr Physician 40.00 X 637035 0 19328 Dr Jeffrey Kauffman Physician 40.00 X 553732 0 35907 Dr Jennifer Lucas Physician 40.00 X 464467 0 29110 Dr Jean Langevin Physician 40.00 X 470573 0 11587 Warren West Former NCH CEO 0.00 0.00 X 149127 382550 8404 5474591 863891 361987 81 1 1 0 The Alpine Clinic PLLC 1095 Profile Rd Franconia NH 03580 Professional Services Agreement 1880343 Trumbull-Nelson Construction PO Box 1000 Hanover NH 03755 General Contractor 748193 J&J Health Care Systems Inc PO Box 406663 Atlanta GA 30384 Supply Chain Management 673282 Comphealth PO Box 972651 Dallas TX 75397 Locums 629866 Balanced Healthcare Receivable LLC 164 Burke Street Nashua NH 03060 A/R Collections 626757 11 57561 87306 144867 Patient Service Revenue 900099 181907940 181907940 Other Revenue 900099 5009158 4260807 748351 Contract Lab 621500 68599 67975 624 Provision for Bad Debts 900099 -5343535 -5343535 Contractual Allowances 900099 -86504054 -86504054 95138108 599297 599297 182185 0 182185 182185 182185 20981199 12000 20572485 43197 408714 -31197 377517 377517 9240 57561 23540 -14300 -14300 96427674 94389133 624 1893050 279956 279956 3105893 2414609 691284 40657721 35225636 5432085 674697 560624 114073 5913730 4901818 1011912 2562727 2112754 449973 381545 381545 71750 71750 94736 94736 7423370 6663562 759808 468527 308326 160201 5256606 3459243 1797363 1946793 1281137 665656 4571718 3008535 1563183 188111 123791 64320 65984 43422 22562 927208 927208 4559575 3753651 805924 1149968 756766 393202 Medical Supplies 13285947 13285947 Medicaid Enhancement Ta 3736209 3736209 Miscellaneous Expense 1934967 979412 955555 Recruiting Expense 328853 216410 112443 99586591 84039016 15547575 0 X 381331 134354 6589585 1202745 20827 6244 9123489 11060454 40824 29946 1938794 2195332 2166750 2287417 100930581 62879640 37741010 38050941 46009180 43719926 2599332 2451311 106611122 101138670 5862111 9200193 520715 608811 23598088 22772521 2042507 1774773 13976025 14411892 45999446 48768190 X 58054504 49733881 558620 636381 1998552 2000218 60611676 52370480 106611122 101138670 X -3158917 59421 -5141700 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15707 15707 0 Part II-B, Line 1: Littleton 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. 2365387 1539 56233 48499 2374660 2286360 3245 128304 52522 2365387 2068307 950 221332 4229 2286360 886217 1150768 31397 75 2068307 939547 5464 -57271 1523 886217 0.00000 0.84230 0.15770 0 0 764443 764443 42428399 25138197 17290202 53488681 36184769 17303912 4249058 1556674 2692384 38050941 Due to Third Party Payors 8832269 Deferred Compensation 3039019 Interest Rate Swap 2319861 Due to Related Party 220743 14411892 90929546 59421 -788856 -729435 91658981 94736 4673957 4768693 96427674 99170742 23540 23540 99147202 94736 344653 439389 99586591 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. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Investments 9964316 0 0 0 0 0 0 9964316 0 9964316 0 0 1 0 1 0 Dr. Moose Golf Tournament 66801 57561 9240 5872 14756 1396 1516 66801 57561 9240 5872 14756 1396 1516 23540 -14300 1 1 X 1 X 1 X 1 1 0 1 1 533975 533975 0.00540 13873567 10946682 2926885 0.02940 14407542 10946682 3460860 0.03480 263645 53575 210070 0.00210 41959 41959 0.00040 26781048 16671957 10109091 0.10150 303981 303981 0.00310 27390633 16725532 10665101 0.10710 41798175 27672214 14125961 0.14190 29721 29721 0.00030 62067 62067 0.00060 3708 3708 0.00000 95496 95496 0.00090 1 2629773 28190710 28190710 X 1 1 1 1 Littleton Regional Hospital 600 St Johnsbury Road Littleton NH 03561 www.littletonhealthcare.org 02790 X X X X Littleton Regional Hospital 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X http://www.littletonhealthcare.org/pdf/LRH_CHNA_Implementation_a_2017.pdf X 1 16 1 https://littletonhealthcare.org/pdf/LRH_CHNA_11_19.pdf 0 1 X 200.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 X https:lllittletonhealthcare.org/pdf/LRH Financial Assistance Policy2018.pdf X https://littletonhealthcare.org/pdf/LRH Financial Assistance Application.pd X https://littletonhealthcare.org/pdf/LRH FinanciaI Assistanee Policy2018.pdf X X X X X 1 X 0 X X 1 X 0 0 Littleton Regional Hospital Part 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 Hospital Part 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 Hospital Part 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. 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 States NH 1 Foundation for Healthy Communities 125 Airport Road Concord NH 03301 020275078 501(c)(3) 241648 Support Medicaid Expansion and Drug & Alcohol Commission. 1 0 Schedule I, Part I, Line 2 Amounts 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. X X X X 1 0 0 0 0 0 0 1 0 Dr Patrick Fitzpatrick Secretary/Chief of Staff 412280 0 262459 0 11669 0 5721 0 28747 0 720876 0 0 0 Dr Edward Duffy Interim NCH CEO 0 382050 0 91000 0 8291 0 8228 0 34306 0 523875 0 0 Dr Stephen Goldberg Trustee/Physician 238701 0 68055 0 20591 0 6740 0 28247 0 362334 0 0 0 Dr Deane Rankin Trustee/Physician 342033 0 0 0 868 0 7876 0 33306 0 384083 0 0 0 Dr John Sauter Past Trustee Emeritus 313106 0 64076 0 46213 0 0 0 46 0 423441 0 0 0 Robert Nutter President 310192 0 77880 0 35579 0 5506 0 28877 0 458034 0 0 0 Leslie Walker VP of Finance 170620 0 17500 0 9477 0 5906 0 29746 0 233249 0 0 0 Dr Eric Mullins Physician 651300 0 78319 0 68739 0 5553 0 28846 0 832757 0 0 0 Dr Harlan Herr Physician 490023 0 94792 0 52220 0 5571 0 13757 0 656363 0 0 0 Dr Jeffrey Kauffman Physician 530006 0 0 0 23726 0 6211 0 29696 0 589639 0 0 0 Dr Jennifer Lucas Physician 423753 0 20000 0 20714 0 6112 0 22998 0 493577 0 0 0 Dr Jean Langevin Physician 445003 0 0 0 25570 0 0 0 11587 0 482160 0 0 0 Warren West Former NCH CEO 0 206550 0 50000 149127 126000 1615 4571 0 2218 150742 389339 0 0 Part I, Line 4a Warren 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 7 Dr. 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. A New Hampshire Health and Education Facilities Authority 020279866 2015-10-01 5331100 Refunded series 2007 Bond 0 0 0 B New Hampshire Health and Education Facilities Authority 020279866 2015-10-01 20753200 Refunded series 2007 Bond 0 0 0 A 721364 5331100 41800 5289300 2015 1 0 1 1 B 2421645 20753200 162500 20590700 2015 1 0 1 1 A 0 1 0 0 0 0 1 B 0 1 0 0 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 1 1 Deutsche Bank AG 20.000000000000 0 0 0 0 1 A 1 B 1 Schedule K, Part III, Line 2, Lease Arrangements: The 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. Form 990, Part III, line 2 Urgent Care services Form 990, Part VI, Section A, line 2 Roger Gingue, Board Chair and Dr. Patrick Fitzpatrick, Board Secretary and Chief of Staff, have a family relationship. Form 990, Part VI, Section A, line 6 On 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 7a North 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 7b The 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 11b The return was reviewed by the entire Board of Trustees prior to the filing. Form 990, Part VI, Section B, line 12c All 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 15 Key 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 19 The 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 Equipment Section 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. North Country Healthcare Inc 8 Clover Lane Whitefield NH 03598 812225283 Healthcare Management NH 501(c)(3) Line 12a, I N/A 0 Androscoggin Valley Hospital 59 Page Hill Road Berlin NH 03570 020280367 Critical Access Hospital NH 501(c)(3) Line 3 N/A 0 Upper Connecticut Valley Hospital Corliss Lane Colebrook NH 03576 020276210 Critical Access Hospital NH 501(c)(3) Line 3 N/A 0 Weeks Medical Center 173 Middle Street Lancaster NH 03584 020222242 Critical Access Hospital NH 501(c)(3) Line 3 N/A 0 North Country Home Health & Hospice Agency Inc 536 Cottage Street Littleton NH 03561 020300637 Home Health Agency NH 501(c)(3) Line 10 N/A 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0