2020-10-29T11:51:45-05:00 2019-12-31 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2019-01-01 020222215 St Joseph Hospital STJO 6038823000 172 Kinsley Street Nashua NH 030612013 John Jurczyk SVP and President 6038823000 2020-10-12 1 Nicholas E Porto P01310283 8002447444 2020-10-12 208.105.168.164 2020-10-12 11:21:25 ED P 38659DA796957EF4727498C6F5EA77981E0D27E4 89AC92FCC1626BCC8DCEA1D9A8E0D80C82D36257 2019 2021-01-29 14:40:06Z John Jurczyk 172 Kinsley Street Nashua NH 030612013 245568881 0 X stjosephhospital.com X 1943 NH Healthcare services to anyone needing care. 11 10 1909 240 67882 0 143169 461378 203824950 230267456 7067737 11464275 -11853 10740 211024003 242203849 0 35000 0 0 96975644 112589791 0 0 0 133929521 123212497 230905165 235837288 -19881162 6366561 260709399 273734500 141102584 134907189 119606815 138827311 We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities. 0 0 37172812 35000 61095881 Inpatient medical, surgical and rehabilitative services to anyone needing care In the greater Nashua area. 78908733 165185161 Outpatient services including surgery, radiology, laboratory, rehabilitative, cardiovascular, breast health, cardiac rehab, and mental health to anyone needing services in the greater Nashua area. 51192991 Each year St. Joseph Hospital provides millions of dollars worth of charity care and community services reflecting our healing mission and our values. St. Joseph Hospital follows the methodology recommended by the Catholic Health Assocation for calculating the cost of charity care and community benefits. Community benefit report for 2017 is the basis for the expenses associated with these activities. 2073286 3986414 2073286 3986414 169347822 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 1 0 1 0 0 0 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 1 1 1 0 0 0 1 147 0 1 1909 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NH X X Richard Plamondon 6038823000 172 Kinsley Street Nashua NH 030612013 Albert Tom Physician 40.00 0.00 X 735243 0 41426 Prasanna Gulur Physician 40.00 0.00 X 680071 0 24993 Srikant Muddana Physician 40.00 0.00 X 558462 0 49024 Young Hwa Lee Physician 40.00 0.00 X 546736 0 17715 Michael Remar Physician 40.00 0.00 X 486239 0 45832 John A Jurczyk SVP & President 38.00 2.00 X X 0 428719 27563 Richard Plamondon Treasurer / VP Finance 38.00 2.00 X 0 316113 26141 Andrea Erickson VP Patient Care Services 40.00 0.00 X 228784 0 4484 Alison Madden VP Medical Affairs 40.00 0.00 X 214367 0 13978 Judith Dunbar Director 1.00 0.00 X 0 0 0 Ralph Jenkins Director 1.00 0.00 X 0 0 0 Donnalee Lozeau Director 1.00 0.00 X 0 0 0 Mary Murphy Director 1.00 0.00 X 0 0 0 Joseph J Porcello Director (beg 10/2019) 1.00 0.00 X 0 0 0 Daniel M Weeks Director (beg 10/2019) 1.00 0.00 X 0 0 0 Louise Trottier Chairman 1.00 0.00 X X 0 0 0 Maurice Arel Immediate Past Chairman 1.00 0.00 X X 0 0 0 Sr Paula Marie Buley Vice Chairman (end 5/2019) 1.00 0.00 X X 0 0 0 John Parolin Vice Chairman 40.00 0.00 X X 0 0 0 Arthur Urschel Secretary 1.00 0.00 X X 0 0 0 3449902 744832 251156 157 0 1 0 Hospital Medicine Associates LLC PO Box 634850 Cincinnati OH 452634850 Physician services 2047883 CompHealth Associates Inc PO Box 972625 Dallas TX 753972625 Physician services 1581409 The ROI Companies 1920 Greenspring Drive Suite 200 Timonium MD 21093 Third park collection 1008125 Workgroup Technology Partners PO Box 110 Westbrook ME 040980110 IT consultants 868690 Granite State Anesthesiologists 168 Kinsley Street Nashua NH 03060 Physician services 806486 47 104279 357099 8577 461378 Patient services 622110 226281042 226281042 Tuition, education, and seminars 611600 1921282 1921282 Other program fees 622110 1133349 1133349 Cafeteria 722514 786458 786458 Thrift/gift shop and boutique 453220 145325 145325 230267456 5285261 5285261 138110 210663 -72553 -72553 -72553 9314474 3129391 6069 6185083 -6069 6179014 6179014 34320 104279 18909 15411 15411 Answering services 517000 47622 47622 Housekeeping services 812900 20260 20260 67882 242203849 230267456 67882 11407133 35000 35000 461613 461613 91587717 68637094 22950623 2997774 2247448 750326 11366920 8521457 2845463 6175767 4631825 1543942 455649 341737 113912 10316 10316 131745 131745 20443508 17693888 2749620 32565 24424 8141 2862385 2146789 715596 938191 703643 234548 4738453 3553840 1184613 149400 112050 37350 199575 149681 49894 2780135 2085101 695034 27469182 27469182 7580748 5685561 1895187 4560012 3420009 1140003 Patient-billed supplies 25438796 25438796 Medicaid tax 9955213 9955213 Provision for bad debts 7645745 7645745 Repair/PM contracts 4228057 3171043 1057014 3592822 2685865 906957 235837288 169347822 66489466 0 4149016 4784987 21579534 25276093 25093256 31685821 2317762 2204278 1634307 1453670 1226523 998274 187630920 130479805 58888169 57151115 72526890 71277915 43019657 47511238 14512392 15226076 15761893 16165033 260709399 273734500 31059875 28046093 297155 45021 89008765 86976690 20736789 19839385 141102584 134907189 X 117821981 136726651 1784834 2100660 119606815 138827311 260709399 273734500 X 6366561 10784926 2069009 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 16292 0 0 0 16292 0 Part II-B, Line 1: St. Joseph's Hospital of Nashua is a member of the New Hampshire Hospital Association (NHHA). A portion of the dues paid to the association in the year ending December 31, 2019 were available for lobbying expenditures on behalf of the Hospital in furtherance of their exempt purposes. The amount reported on the Hospital's 2019 Form 990, Schedule C, Part II-B, Line 1g represents the amount of dues paid by the Hospital that were available for lobbying purposes. 1784834 301225 137394 122793 2100660 1415041 561381 -54863 136725 1784834 1113776 894143 31108 623986 1415041 1092933 445602 49 424808 1113776 1097962 317867 47 322943 1092933 0.00000 0.50500 0.49500 0 0 3783337 3783337 114145494 72921033 41224461 2284065 2198838 85227 62450471 54664172 7786299 4967553 695762 4271791 57151115 47511238 F 47511238 Investment in Corporate Services 14465904 C Investment in Souhegan Nursing 760172 C 15226076 Other accounts receivable 967309 Due from affiliates 12636909 Nashua Regional Cancer Center 1945480 Other equity investments 582176 Deposits 33159 16165033 All other liabilities 16209 Malpractice tail liability 1012787 Environmental liability 6326526 Pension obligations 1495385 Redistribution liabilities 921413 Loss in investment 1559704 Medicaid settlement obligations 5381432 Deferred executive compensation 1509919 Capital lease obligations 1616010 19839385 X Part V, Line 4: Funds to be used to assist the needy through education and/or projects for the poor as determined and approved by the board. Part X, Line 2: Covenant and its member organizations are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code, except as noted below. St. Joseph Hospital Corporate Services, Inc., a wholly-owned subsidiary of Nashua, is a for-profit organization, which is subject to federal and state income taxes. St. Joseph Hospital Corporate Services, Inc. has net operating loss (NOL) carryforwards for tax purposes. The NOLs are not anticipated to be utilized so the amounts have been fully offset with a reserve. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated the position taken on its filed tax returns. The System has concluded no uncertain income tax positions exist at December 31, 2019. Golf Tournament 138599 104279 34320 0 0 11750 7159 0 0 138599 104279 34320 11750 7159 18909 15411 1 1 1 X 1 X 1 1 0 1 1 7491 828151 828151 0.00360 12850 9648696 9648696 0.04230 20341 10476847 10476847 0.04590 1093968 1093968 0.00480 1093968 1093968 0.00480 20341 11570815 11570815 0.05070 1 7645745 67736526 107358702 -39622176 X 1 1 1 First Choice PHO Physician Hospital Organization 0.50000 0.00000 0.50000 1 1 St Joseph Hospital 172 Kinsley Street Nashua NH 030612013 00023 X X X St Joseph Hospital 0 0 1 X X X X X X X X X 17 1 1 1 1 X See Part V, Section C X See Part V, Section C X 1 17 1 See Part V, Section C 0 1 X 150.000000000000 200.000000000000 X X X X 1 1 X X X 1 X https://www.stjosephhospital.com/patients-and-visitors/financial-assist X https://www.stjosephhospital.com/patients-and-visitors/financial-assist X https://www.stjosephhospital.com/patients-and-visitors/financial-assist X X X X X X 1 X 0 X X X X 1 X 0 0 St. Joseph Hospital Part V, Section B, Line 5: St. Joseph Hospital worked with the City of Nashua Division of Public Health officials and other members of the community, including local police and fire departments, school officials, ambulance service leaders, directors of community agencies, hospital leaders, physicians and area residents through focus groups to gather input for the community health needs assessment (CHNA). St. Joseph Hospital Part V, Section B, Line 6a: Southern New Hampshire Medical Center, Dartmouth Hitchcock Clinic St. Joseph Hospital Part V, Section B, Line 6b: The CHNA was conducted in partnership with the following healthcare organizations: St. Joseph Hospital, Southern NH Medical Center, Dartmouth Hitchock Clinic, Nashua, the City of Nashua Division of Public Health & Community Services, and several other local nonprofit agencies that also took part in the development of the CHNA. The Public Health Advisory Council (PHAC) provided oversight and direction for the development of the CHNA. St. Joseph Hospital is a member of the PHAC. St. Joseph Hospital Part V, Section B, Line 11: St. Joseph Hospital's (SJH) "Community Benefits Implementation Plan" describes how SJH is addressing the needs identified in the CHNA. The implementation plan can be found on the hospital website at: https://www.stjosephhospital.com/community-health/community-benefits-report Schedule H, Part V, Section B, Line 7: Hospital facility website:https://www.stjosephhospital.com/community-health/health-communityOther website:https://www.nashuanh.gov/DocumentCenter/View/11382/2017-Community-Health-Assessment Schedule H, Part V, Section B, Line 10: The Hospital's most recent Implementation Plan is available at:https://www.stjosephhospital.com/community-health/health-community 10 1 - Milford Urgent Care 442 Nashua Street Milford NH 03055 Urgent care, PT, OT, radiology, mammography, and physician services 2 - NE Boulevard PT & OT 75 Northeastern Boulevard Nashua NH 03060 Physical and Occupational Therapy 3 - Hudson PT OT and Radiology 208 Robinson Road Hudson NH 03051 Physical and Occupational Therapy, Radiology 4 - Exit 8 PT & OT 2300 Southwood Drive Nashua NH 03063 Physical and Occupational Therapy 5 - Amherst Street PT & OT 460 Amherst Street Nashua NH 03060 Physical and Occupational Therapy 6 - Merrimack PT 382 Daniel Webster Highway Merrimack NH 03054 Physicial therapy 7 - S Nashua Radiology & Physician Offices 172 Daniel Webster Highway Nashua NH 03060 Radiology and physician practice 8 - Nashua Pediatrics - Physician Practice 155 Kinsley Street Nashua NH 03060 Physician practice 9 - OBGYN - Physician Practice Harris Pond Merrimack NH 03054 Physician practice 10 - Neurology - Physician Practice 171 Kinsley Street Nashua NH 03060 Physician practice Part I, Line 7: Costing methodology is an overall cost-to-charge ratio based on operating expenses as a percent of gross revenue applied to the related gross charges. Line 7a is based on gross charges written off as charity care times the overall cost-to-charge ratio. Line 7b is based on gross charges of patients with a primary payor of Traditional Medicaid or Medicaid Manage Care times the overall cost-to-charge ratio. Line 7e uses various methods to aggregate costs including but not limited to - actual expenditures for staff, supplies, and hospital space usage by community groups and cash donations. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 7,645,745. Part II, Community Building Activities: The Hospital maintains an open medical staff, representing over forty different specialties and treats all patients regardless of their ability to pay. The board of directors is made up of community members with varied backgrounds and industries. The Hospital utilizes any surplus funds to further its mission by providing free and low cost healthcare services, educations offerings, free screenings, support groups, and works collaboratively with other healthcare agencies to meet the identified healthcare needs of our community. St. Joseph Hospital is an affiliate of Covenant Health Inc. of Tewksbury, MA. It is the responsbility of the entire staff of St. Joseph Hospital to serve and promote the health of the greater Nashua community. Part III, Line 2: Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the system analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts, adjusted based on cost to charge ratio. The allowance for doubtful accounts is provided based on an analysis by management of the collectability of outstanding balances. Management considers the age of the outstanding balances and past collection efforts in determing the reserve for doubtful accounts. Accounts deemed uncollectible are charged off against the established reserve. Bad debts are reported as charged. Part III, Line 3: Patients deemed eligible for financial assistance follow the Hospital's financial assistance policies. Therefore, no bad debt expense related to patients eligible under the Hospital's financial assistance policy is included as a community benefit. Part III, Line 4: St. Joseph Hospital adopted the new accounting standards as issued by the FASB in May 2014, effective January 1, 2018, where the provision for bad debt is no longer presented as a separate line item and net patient service revenue is presented net of estimated implicit price concession revenue deductions. The adoption of the new standard did not have an impact on the recognition of revenues for any periods prior to adoption. The adoption of this accounting standard is detailed in the Hospital's audited financial statements, pages 15-18, Footnote 3, Patient Service Revenues. The Hospital continues to operate under this adopted standard. Part III, Line 8: None were reported as a community benefit. Costing methodology is an overall cost-to-charge ratio based on operating expenses as a percent of gross revenue applied to the gross charges of patients with a primary payor of traditional Medicare or Medicare Advantage. Part III, Line 9b: Every statement sent to patients indicates that financial assistance is available and provides a phone number and email contact. All customer service personnel are attuned to asking patients if they need assistance.The financial assistance application is also available on-line by visiting the facility's website. Part VI, Line 2: St. Joseph Hospital worked with the City of Nashua Division of Public Health officials and other members of the community, including local police and fire departments, school officials, ambulance service leaders, directors of community agencies, hospital leaders, physicians and area residents through focus groups to gather input for the community health needs assessment (CHNA). Part VI, Line 3: Signage and brochures are at every point of registration, which explain the free-care and financial assistance policies. There are dedicated financial counselors who meet in person or over the telephone to provide guidance and support to patients and families who require financial assistance. Information can also be found on the hospital web site, As well as in the Hospital's community newsletters/quarterly publications. All customer service and registration personnel are trained to ask patients and families if they need financial assistance. Part VI, Line 4: St. Joseph Hospital serves people of all ages, race, gender, religion, ethnicity regardless of their ability to pay. The Hospital's service area is all of New Hampshire. Part VI, Line 5: The Hospital maintains an open medical staff, representing over forty different specialties and treats all patients regardless of their ability to pay. The board of directors is made up of community members with varied backgrounds and industries. The Hospital utilizes any surplus funds to further its mission by providing free and low cost healthcare services, educations offerings, free screenings, support groups, and works collaboratively with other healthcare agencies to meet the identified healthcare needs of our community. St. Joseph Hospital is an affiliate of Covenant Health Inc. of Tewksbury, MA. It is the responsbility of the entire staff of St. Joseph Hospital to serve and promote the health of the greater Nashua community. Part VI, Line 7: New Hampshire Schedule H, Part VI, Section A, Line 6: St Joseph Hospital, a member of Covenant Health, is a 208-licensed bed acute facility. Our Mission is to continue the healing ministry of the Catholic Church in the spirit of St Marguerite D'Youville by providing preventive, curative, restorative, and supportive services with compassion and respect for everyone. We take seriously the "preventive" aspect of the mission statement by offering prevention and wellness programs for the community, offer health screenings and working to provide access to healthy food through the nutrition center. Health System leadership participate in various community groups to conduct health care needs assessments and to develop community interventions to improve health. 1 Southern New Hampshire Medical Center PO Box 2014 Nashua NH 030612014 020483054 501(c)(3) 25000 Prescription Assistance Marguerite's Place Inc 87 Palm Street Nashua NH 030603828 020466392 501(c)(3) 5000 Continued Support of Mother and Children in need St Joseph Community Services Inc PO Box 910 Merrimack NH 030540910 020335003 501(c)(3) 5000 Meals on Wheels Assistance 3 0 Part I, Line 2: All accounting is managed through Covenant Health's Accounts Payable (St. Joseph Hospital's (SJH) parent corporation) and SJH's Finance Department. Specific procedures and management protocols have been established for tracking grant awards. St. Joseph's has a Foundation which houses a Grants Associate that is overseen by Covenant Health's Director of Grants Administration. The Director's background over the last 30 years in the nonprofit sector has focused, in part, on financial management and grants contracts, reporting, and oversight. The Grants Associate is responsible for building and maintaining the Foundations grants research, writing, and reporting program. St. Joseph's grants management systems are also monitored by St. Joseph's Executive Director of Philanthropy to ensure redundant mechanisms of oversight. St. Joseph's Finance Department monitors and maintains a list of all contracts through a contract database. The database provides designated individuals with access to the actual contract. Finance and the Foundation review all contracts to ensure that any payments or financial reporting requirements are met. All grant expenditures are assigned to specific grants and require authorization from the departmental director requesting the expense, the Grants Associate or the Director of Grants Administration, and the Executive Director of Philanthropy. 1 0 0 0 0 0 0 0 1 0 Albert Tom Physician 733893 0 0 0 1350 0 0 0 41426 0 776669 0 0 0 Prasanna Gulur Physician 678721 0 0 0 1350 0 2735 0 22258 0 705064 0 0 0 Srikant Muddana Physician 557562 0 0 0 900 0 2750 0 46274 0 607486 0 0 0 Young Hwa Lee Physician 543322 0 0 0 3414 0 2786 0 14929 0 564451 0 0 0 Michael Remar Physician 481775 0 0 0 4464 0 2790 0 43042 0 532071 0 0 0 John A Jurczyk SVP & President 0 425625 0 0 0 3094 0 2800 0 24763 0 456282 0 0 Richard Plamondon Treasurer / VP Finance 0 312739 0 0 0 3374 0 2559 0 23582 0 342254 0 0 Andrea Erickson VP Patient Care Services 228268 0 0 0 516 0 1942 0 2542 0 233268 0 0 0 Alison Madden VP Medical Affairs 213550 0 0 0 817 0 1587 0 12391 0 228345 0 0 0 Part I, Line 3 All compensation paid to the Hospital's SVP and President is established, reviewed, and approved by Covenant Health, the Hospital's sole corporate member. Covenant Health utilizes a compensation committee, independent compensation consultants, and compensation surveys and studies of similarly experienced executives employed by comparable organizations to determine a reasonable and appropriate compensation package for the Hospital's SVP and President. The compensation plan is subject to the approval of the Compensation Committee of Covenant Health's Board of Directors. Part I, Line 7 "Cash in" of earned time. A NH Health & Education Facilities Authority 020279866 644614UG2 2007-10-30 53869522 Renovations & Equipment 0 0 1 B NH Health & Education Facilities Authority 042456011 575840QA4 2012-06-27 27000000 Renovations & Improvements 1 0 0 C NH Health & Education Facilities Authority 042456011 2014-07-17 16900000 Refunding Issue 0 0 0 D NH Health & Education Facilities Authority 042456011 2017-03-21 7960000 Renovations & Equipment 0 0 0 A 53869522 4911229 681812 2008 0 1 1 1 B 27000000 572615 21991329 0 1 0 1 C 16900000 260000 2014 0 1 1 1 D 7960000 159200 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 A 1 0 0 0 0 0 B 1 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 D 0 1 0 0 0 0 0 0 0 A 0 B 0 C 0 D 0 Schedule K, Part III, Line 9; Part IV, Line 7, & Part V: All bonds are carefully and consistently monitored for potential violations of Federal tax requirements. However, the monitoring procedures were not written as of the end of the year covered by this tax return. The Organization is considering adopting formal policies that would set forth the Organization's methodology for ensuring post-issuance compliance with IRS requirements pertaining to tax-exempt debt. Such policies would also contain specific language regarding organizational responsibility, record retention, private business use, arbitrage rebate, and remedial actions as applicable to the Organization's tax-exempt debts. Although formal policies are not in place in regards to the remediation of the Organization's bonds, the Organization does maintain compliance checks to ensure that the monitoring requirements of Section 148 are maintained, and that procedures are in place to ensure that any violations are identified and corrected in a timely manner. Form 990, Part VI, Section A, line 6 Covenant Health, Inc. is the sole member of St. Joseph Hospital. Form 990, Part VI, Section A, line 7a As the sole member of St. Joseph Hospital, Covenant Health, Inc. retains the ability to elect and remove the Organization's board of directors with or without cause. Form 990, Part VI, Section A, line 7b As the sole corporate member of the Organization, Covenant Health, Inc. has the following powers and rights over the Organization and its subsidiaries as outlined in the Organization's bylaws: 1. To approve any change in the written statements of philosophy and mission; 2. To amend and to repeal the organizing and governing documents; 3. To elect the Board of Directors or remove them with or without cause; 4. To appoint and remove the president; 5. To approve all plans of merger, consolidation, reorganization, dissolution, or the sale, lease assignment, or transfer of substantially all of the assets, or the purchase or acquisition of an interest in any corporation, partnership, joint venture, or other entity; 6. To approve the acquisition, sale, or encumberance of any real estate valued in excess of an amount set by the Member in writing; 7. To approve the sale, assignment, or transfer of any equity interest or membership interest in any subsidiary; 8. To approve any reclassification or other change of any capital stock or other equity security; and, 9. To approve the issuance of, or the creation of any obligation to issue, any equity security. Form 990, Part VI, Section B, line 11b The Forms 990 are prepared by an independent tax accountant, and are then reviewed by the St. Joseph Hospital Finance Committee and board of directors prior to filing. Form 990, Part VI, Section B, line 12c Each year, St. Joseph Hospital conducts a survey of the board members and key management members to determine whether there are conflicts of interest (be they actual or potential). Board members and key employees have a continuing obligation to report any proposed transactions which may be perceived as a conflict of interest. Form 990, Part VI, Section B, line 15 The compensation of officers and key employees is subject to the oversight and decisions of Covenant Health, a related entity and the sole member of the Center. Every two-to-three years the Compensation Committee of the Covenant Health board of drectors engages an external consultant to provide competitive market data from various survey sources, which is used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable. Form 990, Part VI, Section C, line 19 The Hospital will make its corporate and governing documents and its financial available upon request. Form 990, Part XI, line 9: Net long term pension adjustment 3,360,105. Transfers to affiliates -1,291,096. Form 990, Part XII, Line 2c: The audit process has not changed from the previous year. SJH Surgicenter LLC 172 Kinsley Street Nashua NH 030612013 204181845 Inactive Outpatient Surgery NH 0 0 St Joseph Hospital Youville Lifecare Inc 1575 Cambridge Street Cambridge MA 02138 042103582 Hospital and health care facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Manor Health Care 215 Thatcher Street Brockton MA 02302 042565937 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 St Mary's Health system PO Box 7291 Lewiston ME 04243 222504349 Hospital and health care facility ME 501(c)(3) Line 12a, I Covenant Health Inc 0 Youville Place 10 Pelham Road Lexington MA 02421 043297834 Assisted living services MA 501(c)(3) Line 10 Covenant Health Inc 0 St Mary's Villa Nursing Home Inc 675 St Marys Villa Road Moscow PA 18444 232057177 Nursing home and restorative facility PA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Waltham Inc dba Maristhill Nursing & Rehab Center 66 Newton Street Waltham MA 02453 043333609 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 CHS of Worcester Inc dba St Mary Care Center 39 Queen Street Worchester MA 01610 043419625 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Fanny Allen Holdings Inc 790 College Parkway Colchester VT 05446 030181052 Real estate holding company VT 501(c)(3) Line 12a, I Covenant Health Inc 0 St Andre Health Care 407 Pool Street Biddeford ME 04005 010342399 Nursing home and restorative facility ME 501(c)(3) Line 10 Covenant Health Inc 0 MI Nursing Restorative Center Inc 172 Lawrence Street Lawrence MA 01841 042104851 Nursing home and restorative facility MA 501(c)(3) Line 10 Covenant Health Inc 0 Helping Hands of St Marguerite Inc 799 Concord Avenue Cambridge MA 02138 800199674 Private home-care health services MA 501(c)(3) Line 10 Covenant Health Inc 0 Providentia Prima Trust 420 Bedford Street Lexington MA 02420 046835128 Investment trust MA 501(c)(3) Line 12a, I Covenant Health Inc 0 Fanny Allen Corporation Inc 790 College Parkway Colchester VT 05446 222495808 Charitable foundation VT 501(c)(3) Line 12a, I Covenant Health Inc 0 Youville House Inc 1573 Cambridge Street Cambridge MA 02138 043239593 Assisted living services MA 501(c)(3) Line 10 Youville Lifecare Inc 0 Youville Hospital and Rehabilitation Center Inc 1575 Cambridge Street Cambridge MA 02138 043239563 Hospital and health care facility MA 501(c)(3) Line 10 Youville Lifecare Inc 0 St Mary's Regional Medical Center PO Box 7291 Lewiston ME 04243 010211551 Hospital and health care facility ME 501(c)(3) Line 3 St Mary's Health System 0 Community Clinical Services PO Box 7291 Lewiston ME 04243 010409788 Physician practice ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's D'Youville Pavilion PO Box 7291 Lewiston ME 04243 010211558 Nursing home and restorative facility ME 501(c)(3) Line 10 St Mary's Health System 0 St Mary's Residences PO Box 7291 Lewiston ME 04243 222504356 Low income housing ME 501(c)(3) Line 10 St Mary's Health System 0 Neighborhood Housing Initiative PO Box 7291 Lewiston ME 04243 010539730 Affordable housing services ME 501(c)(3) Line 10 St Mary's Health System 0 Souhegan Nursing Association 24 North River Road Milford NH 03055 020222795 Home health and hospice NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 1 The Surgicenter at St Joseph Hospital Inc 172 Kinsley Street Nashua NH 03061 020222215 Healthcare and surgery center NH 501(c)(3) Line 10 St Joseph Hospital of Nashua NH Inc 1 MI Management Inc 172 Lawrence Street Lawrence MA 01841 042857794 Assisted living services MA 501(c)(3) Line 12a, I Covenant Health Inc 0 MI Adult Day Health Care Center Inc 189 Maple Street Lawrence MA 01841 042921888 Adult day care services MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community Inc 189 Maple Street Lawrence MA 01841 042647207 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community II Inc 189 Maple Street Lawrence MA 01841 042679954 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Residential Community III Inc 189 Maple Street Lawrence MA 01841 042186043 HUD low income housing MA 501(c)(3) Line 10 Covenant Health Inc 0 MI Transportation Inc 189 Maple Street Lawrence MA 01841 042921889 Elderly transportation services MA 501(c)(3) Line 10 Covenant Health Inc 0 Mary Immaculate Guild Inc 172 Lawrence Street Lawrence MA 01841 463073987 Supporting grants and donations MA 501(c)(3) Line 12a, I Covenant Health Inc 0 St Joseph Healthcare Foundation 360 Broadway Bangor ME 04402 222480149 Healthcare foundation ME 501(c)(3) Line 10 Covenant Health Inc 0 St Joseph Hospital 360 Broadway Bangor ME 04402 010212435 Hospital and health care facility ME 501(c)(3) Line 3 St Joseph Healthcare Foundation 0 M & J Company 360 Broadway Bangor ME 04402 222480150 Lease holding company ME 501(c)(2) St Joseph Healthcare Foundation 0 St Joseph Ambulatory Care Inc 360 Broadway Bangor ME 04402 222480373 Physician practice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Alternative Health Services 360 Broadway Bangor ME 04402 010422885 Home health and hospice ME 501(c)(3) Line 10 St Joseph Healthcare Foundation 0 Mount St Rita Health Centre 15 Sumner Brown Road Cumberland RI 02864 050342330 Nursing home RI 501(c)(3) Line 10 Covenant Health Inc 0 Penacook Place Inc 150 Water Street Haverhill MA 01830 237090088 Nursing home MA 501(c)(3) Line 10 Covenant Health Inc 0 Covenant Health Inc 100 Ames Pond Drive Tewksbury MA 01876 222484505 Health care management and resource organization MA 501(c)(3) Line 10 N/A 0 Covenant Health Foundation Inc 100 Ames Pond Drive Tewksbury MA 01876 800199674 Charitable foundation MA 501(c)(3) Line 12a, I Covenant Health Inc 0 St Joseph Hospital Corporate Services 172 Kinsley Street Nashua NH 030612013 020405197 Holding company NH St Joseph Hospital of Nashua C 1705465 26706904 1.00000 1 First Choice PHO 172 Kinsley Street Nashua NH 03060 020461536 Physician hospital organization NH St Joseph Hospital of Nashua C 143730 633286 0.50000 1 Covenant Health Insurance LTD PO Box 69 Grand Cayman CJ KY1-1102 043360127 Self-insurance company CJ N/A C 0 Campus Holding PO Box 7291 Lewiston ME 04240 010406049 Holding company ME N/A C 0 Strauss Incorporated 360 Broadway Bangor ME 04402 010391369 Repairs and transcriptions ME N/A C 0 GNM Corporation 172 Kinsley Street Nashua NH 03060 020400550 Real estate holding company NH N/A C 0 SJ Physicians Services 172 Kinsley Street Nashua NH 03060 020522234 Physician practice NH N/A C 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 St Joseph Corporate Services K 1000320 Cash St Joseph Corporate Services O 3685 Cash St Joseph Corporate Services P 3954200 Cash St Joseph Corporate Services R 65000 Cash Souhegan Nursing Association R 15000 Cash