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LITTLETON HOSPITAL ASSOCIATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
LITTLETON HOSPITAL ASSOCIATION (EIN 02-0222152)
Tax period
2016-10-01 to 2017-09-30
Filed
2019-01-08
IRS object ID
201930089349300883
Schema version
2016v3.0
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)
Return2019-01-08T15:18:41-06:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

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 Begin2016-10-01TaxPeriodBeginDt

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)
PersonLeslie WalkerPersonNm
Person TitleVP of FinancePersonTitleTxt
Phone6034449000PhoneNum
Signature2018-12-20SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBarbara J McGuan CPAPreparerPersonNm
PTINP00219457PTIN
Phone2077752387PhoneNum
Preparation2018-12-20PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address69.49.157.66IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-12-20IPDt
IP Tm11:09:36IPTm
IP TimezoneESIPTimezoneCd
Federal Original Submission Id0103152018123034fe01FederalOriginalSubmissionId
Federal Original Submission Id2018-05-03FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdC9B17F91A2F9740444165E3537F2E031898F407FAtSubmissionCreationDeviceId
At Submission Filing Device IdE262D3C9A45A77A46A0A2832CF74466488750570AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnYes (X)AmendedReturnInd

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$86,153,195GrossReceiptsAmt
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 Body14VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee572TotalEmployeeCnt
Total Volunteers226TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$367,741PYContributionsGrantsAmt
CY Contributions Grants$203,320CYContributionsGrantsAmt
PY Program Service Revenue$87,274,990PYProgramServiceRevenueAmt
CY Program Service Revenue$85,164,572CYProgramServiceRevenueAmt
PY Investment Income$9,836PYInvestmentIncomeAmt
CY Investment Income$428,551CYInvestmentIncomeAmt
PY Other Revenue$203,874PYOtherRevenueAmt
CY Other Revenue$177,088CYOtherRevenueAmt
PY Total Revenue$87,856,441PYTotalRevenueAmt
CY Total Revenue$85,973,531CYTotalRevenueAmt
PY Grants And Similar Paid$98,329PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$43,994CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$49,421,138PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$48,989,327CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$38,190,407PYOtherExpensesAmt
CY Other Expenses$36,106,254CYOtherExpensesAmt
PY Total Expenses$87,709,874PYTotalExpensesAmt
CY Total Expenses$85,139,575CYTotalExpensesAmt
PY Revenues Less Expenses$146,567PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$833,956CYRevenuesLessExpensesAmt
Total Assets BOY$98,584,999TotalAssetsBOYAmt
Total Assets EOY$102,102,426TotalAssetsEOYAmt
Total Liabilities BOY$49,112,149TotalLiabilitiesBOYAmt
Total Liabilities EOY$47,152,717TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$49,472,850NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$54,949,709NetAssetsOrFundBalancesEOYAmt
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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$63,466,687ExpenseAmt
Grant$43,994GrantAmt
Revenue$85,164,572RevenueAmt
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$63,466,687TotalProgramServiceExpensesAmt
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 Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln 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 Document128IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee572EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
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 Walker VP of FinanceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6034449000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 St Johnsbury RdAddressLine1Txt
CityLittletonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03561ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
William Bedor
Chairman1.001.00Yes (X)Yes (X)$0$0$0
Roger Gingue
Vice Chair1.001.00Yes (X)Yes (X)$0$0$0
Jeff Woodward
Treasurer1.00Yes (X)Yes (X)$0$0$0
Erin Hennessey
Secretary1.00Yes (X)Yes (X)$0$0$0
John Starr
Past Vice Chair1.001.00Yes (X)Yes (X)$0$0$0
Dr Andrew Forrest
Past Trustee/Physician40.00Yes (X)$0$0$0
Dr John Sauter
Trustee Emeritus40.001.00Yes (X)$396,397$0$13,250
Laurie Morgan
Auxiliary Representative1.00Yes (X)$0$0$0
Dr Deane Rankin
Trustee/Physician40.00Yes (X)$375,728$0$53,087
Dr Nicholas Marks
Trustee/Physician40.00Yes (X)$477,989$0$52,812
Elizabeth Kunz
Trustee1.00Yes (X)$0$0$0
Ed Shanshala II
Trustee1.00Yes (X)$0$0$0
Ned Brewer
Trustee1.00Yes (X)$0$0$0
Dr Imelyn Fernandez
Past Trustee1.00Yes (X)$0$0$0
Gail Tomlinson
Past Trustee1.00Yes (X)$0$0$0
James Nohl
Past Trustee1.00Yes (X)$0$0$0
Dr Patrick Fitzpatrick
Chief of Staff40.00Yes (X)$634,831$0$54,809
Dr Stephen Goldberg
Trustee/Physician40.00Yes (X)$348,387$0$60,617
Robert Nutter
President40.00Yes (X)Yes (X)$0$0$0
Nick Braccino
Past Interim President40.001.00Yes (X)$188,034$0$14,452
Andrew Majka
Past CFO40.001.00Yes (X)$256,315$0$0
Leslie Walker
VP of Finance40.00Yes (X)$109,370$0$45,503
Linda Gilmore
CAO/CNO40.00$192,774$0$48,928Yes (X)
Dr Eric Mullins
Physician40.00$786,849$0$49,708Yes (X)
Dr Harlan Herr
Physician40.00$606,671$0$30,231Yes (X)
Dr Jeffrey Kauffman
Physician40.00$574,240$0$53,803Yes (X)
Dr Leon Kogan
Physician40.00$495,650$0$15,583Yes (X)
Dr Jennifer Lucas
Physician40.00$447,430$0$42,803Yes (X)
Warren West
NCH CEO0.0040.00$399,494$0$45,221Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$6,290,159TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$580,807TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K61IndivRcvdGreaterThan100KCnt
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$2,985,530
Trumbull-Nelson Construction
PO Box 1000HanoverNH03755General Contractor$2,224,365
Envision Pharmaceutical Svc Inc
2181 E Aurora Road Suite 201TwinsburgOH44087Pharmacy Services$811,772
Comphealth
PO Box 972651DallasTX75397Locum$796,244
McKesson Technologies Inc
PO Box 98347ChicagoIL606938347IT Support$675,541
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Fundraising$57,979FundraisingAmt
All Other Contributions$145,341AllOtherContributionsAmt
Total Contributions$203,320TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Service Revenue900099$162,403,391$162,403,391
Other Revenue900099$3,722,722$3,695,051$27,671
Contract Lab621500$125,112$125,112$0
Provision for Bad Debts900099-$4,447,206-$4,447,206
Contractual Allowances900099-$76,639,447-$76,639,447
FieldValueIRS element (for citing)
Total Program Service Revenue$85,164,572TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$532,517TotalRevenueColumnAmt
Exclusion$532,517ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$199,749RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$199,749RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$199,749TotalRevenueColumnAmt
Exclusion$199,749ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$52,200SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$52,654SecuritiesAmt
Other$103,512OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$454SecuritiesAmt
Other-$103,512OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$103,966TotalRevenueColumnAmt
Exclusion-$103,966ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$837FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$57,979ContriRptFundraisingEventAmt
Fundraising Direct Expenses$23,498FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$22,661TotalRevenueColumnAmt
Exclusion-$22,661ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$85,973,531TotalRevenueColumnAmt
Related Or Exempt Func Income$85,136,901RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$633,310ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$43,994TotalAmt
Program Services$43,994ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,323,281TotalAmt
Program Services$2,467,906ProgramServicesAmt
Management And General$855,375ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$38,266,221TotalAmt
Program Services$32,548,055ProgramServicesAmt
Management And General$5,718,166ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$567,647TotalAmt
Program Services$489,756ProgramServicesAmt
Management And General$77,891ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,706,669TotalAmt
Program Services$4,012,946ProgramServicesAmt
Management And General$693,723ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,125,509TotalAmt
Program Services$1,792,369ProgramServicesAmt
Management And General$333,140ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$139,038TotalAmt
Management And General$139,038ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$89,154TotalAmt
Management And General$89,154ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$88,107TotalAmt
Management And General$88,107ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,802,770TotalAmt
Program Services$1,702,978ProgramServicesAmt
Management And General$4,099,792ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$441,300TotalAmt
Program Services$27,335ProgramServicesAmt
Management And General$413,965ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,114,387TotalAmt
Program Services$260,689ProgramServicesAmt
Management And General$853,698ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$181,567TotalAmt
Program Services$1,971ProgramServicesAmt
Management And General$179,596ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,941,678TotalAmt
Program Services$2,351,442ProgramServicesAmt
Management And General$1,590,236ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$87,867TotalAmt
Program Services$50,206ProgramServicesAmt
Management And General$37,661ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$67,443TotalAmt
Program Services$67,443ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$916,367TotalAmt
Program Services$916,367ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,848,783TotalAmt
Program Services$3,924,947ProgramServicesAmt
Management And General$923,836ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$453,958TotalAmt
Program Services$66,632ProgramServicesAmt
Management And General$387,326ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$12,223,414$12,223,414
Medicaid Enhancement Ta$3,510,562$3,510,562
Miscellaneous Expenses$1,791,166$517,843$1,273,323
Recruiting Expenses$408,693$394$408,299

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$85,139,575TotalAmt
Program Services$63,466,687ProgramServicesAmt
Management And General$21,672,888ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$81,785BOYAmt
EOY$975,078EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,871,995BOYAmt
EOY$6,342,252EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$58,784BOYAmt
EOY$39,250EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,877,739BOYAmt
EOY$8,606,746EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$94,403BOYAmt
EOY$74,231EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,580,635BOYAmt
EOY$1,821,601EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,612,448BOYAmt
EOY$1,447,215EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$93,995,591LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$55,428,034LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$41,531,454BOYAmt
EOY$38,567,557EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$35,727,434BOYAmt
EOY$42,898,947EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,148,322BOYAmt
EOY$1,329,549EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$98,584,999BOYAmt
EOY$102,102,426EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,109,172BOYAmt
EOY$6,079,767EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$580,859BOYAmt
EOY$863,987EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,180,505BOYAmt
EOY$24,395,530EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,348,960BOYAmt
EOY$2,005,714EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,892,653BOYAmt
EOY$13,807,719EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$49,112,149BOYAmt
EOY$47,152,717EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$47,191,321BOYAmt
EOY$52,340,287EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$459,376BOYAmt
EOY$614,117EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,822,153BOYAmt
EOY$1,995,305EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$49,472,850BOYAmt
EOY$54,949,709EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$98,584,999BOYAmt
EOY$102,102,426EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$833,956ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,544,037NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,098,866OtherChangesInNetAssetsAmt
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$13,220OtherActivitiesAmt
Total Lobbying Expenditures$13,220TotalLobbyingExpendituresAmt
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$2,068,307BeginningYearBalanceAmt
Contributions$950ContributionsAmt
Investment Earnings Or Losses$221,332InvestmentEarningsOrLossesAmt
Other Expenditures$4,229OtherExpendituresAmt
End Year Balance$2,286,360EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$870,609BeginningYearBalanceAmt
Contributions$5,517ContributionsAmt
Investment Earnings Or Losses$63,496InvestmentEarningsOrLossesAmt
Other Expenditures$75OtherExpendituresAmt
End Year Balance$939,547EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$794,094BeginningYearBalanceAmt
Investment Earnings Or Losses$81,883InvestmentEarningsOrLossesAmt
Other Expenditures$5,368OtherExpendituresAmt
End Year Balance$870,609EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.87270PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.12730TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$786,809OtherCostOrOtherBasisAmt
Book Value$786,809BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$42,230,466OtherCostOrOtherBasisAmt
Depreciation$23,933,550DepreciationAmt
Book Value$18,296,916BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$46,860,461OtherCostOrOtherBasisAmt
Depreciation$30,324,533DepreciationAmt
Book Value$16,535,928BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,117,855OtherCostOrOtherBasisAmt
Depreciation$1,169,951DepreciationAmt
Book Value$2,947,904BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$38,567,557TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Reserve for Self-Funded Health Insurance$395,941
Due to Third Party Payors$8,359,268
Deferred Compensation$2,626,634
Interest Rate Swap$2,382,162
Due to Related Party$43,714
FieldValueIRS element (for citing)
Total Liability$13,807,719TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$90,030,899TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$3,544,037NetUnrealizedGainsInvstAmt
Other Revenue$601,438OtherRevenueAmt
Revenue Not Reported$4,145,475RevenueNotReportedAmt
Revenue Subtotal$85,885,424RevenueSubtotalAmt
Investment Expenses Not Incld$88,107InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$88,107RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$85,973,531TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$84,554,040TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$84,554,040ExpensesSubtotalAmt
Investment Expenses Not Incld2$88,107InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$497,428OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$585,535ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$85,139,575TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 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 1,098,866. Community Benefit Expense -520,926. Fundraising Expenses 23,498.
Part XII, Line 4b - Other Adjustments:Community Benefit Expense 520,926. Fundraising Expenses -23,498.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCentral America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas,RegionTxt
Offices0OfficesCnt
Type Of Activities ConductedInvestmentsTypeOfActivitiesConductedTxt
Region Total Expenditures$10,427,265RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continutation Total Office0ContinutationTotalOfficeCnt
Continutation Total Employee0ContinutationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$10,427,265SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$10,427,265TotalSpentAmt
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$58,816GrossReceiptsEvent1Amt
Charitable Contri Event1$57,979CharitableContriEvent1Amt
Gross Revenue Event1$837GrossRevenueEvent1Amt
Non Cash Prizes Event1$100NonCashPrizesEvent1Amt
Rent Facility Costs Event1$15,990RentFacilityCostsEvent1Amt
Food And Beverage Event1$1,525FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$5,883OtherDirectExpensesEvent1Amt
Gross Receipts Total$58,816GrossReceiptsTotalAmt
Charitable Contributions Tot$57,979CharitableContributionsTotAmt
Gross Revenue Total Events$837GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$100NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$15,990RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$1,525FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$5,883OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$23,498DirectExpenseSummaryEventsAmt
Net Income Summary-$22,661NetIncomeSummaryAmt

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$3,971,357TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,441,996DirectOffsettingRevenueAmt
Net Community Benefit Expns$529,361NetCommunityBenefitExpnsAmt
Total Expense0.00620TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,482,459TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,235,496DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,246,963NetCommunityBenefitExpnsAmt
Total Expense0.02640TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,453,816TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,677,492DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,776,324NetCommunityBenefitExpnsAmt
Total Expense0.03260TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$358,356TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$358,356NetCommunityBenefitExpnsAmt
Total Expense0.00420TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$121,879TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$121,879NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,424,666TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,333,071DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,091,595NetCommunityBenefitExpnsAmt
Total Expense0.05980TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,490TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,490NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,912,391TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,333,071DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,579,320NetCommunityBenefitExpnsAmt
Total Expense0.06550TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,366,207TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,010,563DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,355,644NetCommunityBenefitExpnsAmt
Total Expense0.09810TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,691TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$26,691NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$72,106TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$72,106NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

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$102,505TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$102,505NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,105,571BadDebtExpenseAmt
Reimbursed By Medicare$25,861,535ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$25,861,535CostOfCareReimbursedByMedcrAmt

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 Fclts0CHNAConductedWithNonFcltsInd
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 URLhttp://www.littletonhealthcare.org/pdf/LRH_CHNA_Implementation_a_2017.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
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.littletonhospital.org/pdf/LRH_Financial_Assistance_Policy__2018.FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://littletonhealthcare.org/pdf/LRH_Financial_Assistance_Application.pdfFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.littletonhospital.org/pdf/LRH_Financial_Assistance_Policy2018.pdFAPSummaryOnWebsiteURLTxt
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 2016, input from the community was solicited through a survey, which was available both electronically (through Survey Money) and via paper copy. Paper copies were distributed to various community locations. Electronic surveys were available via the Littleton and North Country Healthcare websites and through the Littleton Facebook page, plus other community partner websites. 252 surveys were completed. In addition, 49 Community leaders were also surveyed electronically. This group represented area business & economic development leaders, community board members of health & human service organizations, municipal government and human service providers.
Littleton Regional HospitalPart V, Section B, Line 6a: The Hospital's CHNA was conducted along with Upper Connecticut Valley Hospital, Weeks Medical Center, and Androscoggin Valley Hospital.
Littleton Regional HospitalPart V, Section B, Line 11: The Hospital is addressing the significant needs identified in its most recently conducted CHNA as follows:1. Substance Misuse, Alcohol Abuse & Mental Health Problems: Naloxone (Narcan) treatment for overdoses is an available option. Fire, police and first responders now carry Narcan with them to administer during calls. LRH employs a full time behavior health provider. Alcohol Anonymous is given space at LRH to host their weekly meetings. LRH offers a women's health conference each year that attracts close to 400 women. The conference offers education on mental health issues and substance misuse, and alcohol abuse. 2. Obesity/Overweight: North Country Healthcare affiliated hospitals employ full time registered dieticians and diabetes educators who are available to provide consults through the primary care offices. LRH offers fitness classes for community members - we currently host Bone Builders and Yoga. We offer Weight Watchers at no cost for the space. LRH developed a Healthy Eating & Fitness Blog that community members can visit to learn about ways to eat healthy and stay active. 3. Smoking and Tobacco Use: Ongoing smoking cessation classes available to the public. In addition, Littleton is a smoke/tobacco free campus. LRH includes Weeks Medical Center who offers a smoking cessation class to participate in wellness fairs, women's health conference, and any other community events.Significant Needs not being addressed and why:The needs identified that Littleton is not able to address center around the County's lack of jobs. Low Income/Poverty and Unemployment/Lack of Jobs were two such items. Cost of healthy foods was also mentioned. These are not within the scope of our mission; however we will continue to work with local resources in our role as a responsible corporate citizen to improve our economy where we can. There are currently several economic development groups in the area and some new businesses are considering moving in.Other needs we are currently unable to meet revolve around lack of dental insurance, cost of prescription drugs, and access to health insurance. While Littleton cannot fix these issues, we have made a huge effort over these past 3 years to ensure as many of our patients as possible take advantage of Medicaid Expansion or the Insurance Exchanges. This has resulted in a significant drop in our uninsured population. Littleton continues to offer free care for eligible patients through our LRH Cares program.

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 as well as the paramedic program.
Part II, Community Building Activities:Littleton Regional Healthcare is involved in many community building activities that promote the health and wellbeing of the communities it serves. We work closely with a number of local healthcare agencies including; North Country Health Consortium, North Country Home Health & Hospice, Ammonosuc Community Health Services, and Littleton Area Senior Center, to name a few, whose mission is similar to LRH. Each of these agencies addresses common concerns including access to healthcare, health improvement, and health education. LRH encourages its staff to serve oncommunity collaboration boards, and health advocacy agencies to promote the services and programs provided by LRH and surrounding agencies. We also work with local safety providers to promote safety and prevent injuries. LRH is actively involved in working with area schools to promote health and wellness among our youth.
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's defines its primary service area as Grafton County, New Hampshire. The 2012 population for Grafton County is estimated to be 90,847, and is expected to grow at a rate faster than the national rate of growth, projecting a 2017 population of 95,080. This population growth is at a faster rate than for New Hampshire as a whole.According to the population estimates utilized by Truven, provided by the Neilson Company, the 2012 median age for the County is 39.9 years, younger than the New Hampshire median age (40.4 years) but older then the national median age (36.8 years). The 2012 Median Household Income for the area is $52,729, which is lower than the New Hampshire median income of $59,470 but higher than the national median income of $49,599. Median Household Wealth and Median Home Values likewise are below State and above national values. Grafton's unemployment rate as of August 2012 was 4.4%, which is lower than the statewide rate of 5.7%, and considerably better than the national civilian unemployment rate of 8.1%.The portion of the population in the County over 65 is 15.9%, above the New Hampshire average of 13.5%. The portion of the population of women of childbearing age is 19.9%, somewhat higher than the New Hampshire average of 19.5%. In the County this population is anticipated to increase 1%, whereas for New Hampshire as a whole, the female population age 15 to 44 is anticipated to decline as a rate of just over 2%.
Part VI, Line 7, Reports Filed With StatesNH

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 Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract ExceptionYes (1)InitialContractExceptionInd
Rebuttable Presumption ProcYes (1)RebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 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 John Sauter
Trustee Emeritus$308,512$0$81,834$0$6,051$0$13,250$0$0$0$409,647$0$0$0
Dr Deane Rankin
Trustee/Physician$369,677$0$0$0$6,051$0$13,250$0$39,837$0$428,815$0$0$0
Dr Nicholas Marks
Trustee/Physician$310,337$0$163,908$0$3,744$0$13,250$0$39,562$0$530,801$0$0$0
Dr Patrick Fitzpatrick
Chief of Staff$433,657$0$173,355$0$27,819$0$13,250$0$41,559$0$689,640$0$0$0
Dr Stephen Goldberg
Trustee/Physician$264,336$0$27,000$0$57,051$0$13,250$0$47,367$0$409,004$0$0$0
Nick Braccino
Past Interim President$182,284$0$0$0$5,750$0$9,404$0$5,048$0$202,486$0$0$0
Andrew Majka
Past CFO$231,264$0$25,000$0$51$0$0$0$0$0$256,315$0$0$0
Leslie Walker
VP of Finance$109,319$0$0$0$51$0$5,949$0$39,554$0$154,873$0$0$0
Linda Gilmore
CAO/CNO$192,723$0$0$0$51$0$10,099$0$38,829$0$241,702$0$0$0
Dr Eric Mullins
Physician$637,552$0$149,246$0$51$0$13,250$0$36,458$0$836,557$0$0$0
Dr Harlan Herr
Physician$532,730$0$73,890$0$51$0$13,250$0$16,981$0$636,902$0$0$0
Dr Jeffrey Kauffman
Physician$553,240$0$20,949$0$51$0$13,250$0$40,553$0$628,043$0$0$0
Dr Leon Kogan
Physician$475,599$0$0$0$20,051$0$13,250$0$2,333$0$511,233$0$0$0
Dr Jennifer Lucas
Physician$447,430$0$0$0$0$0$6,700$0$36,103$0$490,233$0$0$0
Warren West
NCH CEO$393,494$0$0$0$6,000$0$13,250$0$31,971$0$444,715$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7Dr. Stephen Goldberg, Dr. Nicholas Marks, Dr. Harlan Herr, Dr. Eric Mullins and Dr. Jeffrey Kauffman, Highest Compensated Employees; Dr. Patrick Fitzpatrick, Chief of Staff and Dr. John Sauter all received bonuses during the year based upon their productivity using MGMA Standards by RVU and by their specialties outlined in their respective contracts.
Part I, Line 8Andrew Majka's bonus was a sign-on bonus paid in accordance with his initial employment agreement.

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 CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$346,607$5,331,100$41,800$5,289,3002015Yes (1)0Yes (1)Yes (1)
B$1,155,628$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 (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Page 1, Box B, Amended ReturnForm 990, Part VII, as originally filed, included Russell Keene as an officer. Mr. Keene was not on the Board of Directors for Littleton Hospital Association (LHA), nor was he an employee of LHA; therefore, he has been removed from this Amended 2016 Form 990. Additionally, LHA inadvertently reported Warren West as an Officer, when in fact he is a Former Officer. His 2016 calendar year compensation was also erroneously reported as being paid by a related organization when it should have been reported as paid by LHA. Schedule R has been amended to include North Country Home Health and Hospice Agency, EIN 02-0300637, which was inadvertantly omitted from the originally filed Form 990.
Form 990, Part VI, Section A, line 6North Country Healthcare (NCH) became the Sole Member of Littleton Hospital Association.
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 Directors 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. 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 1,098,866.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationInd
North Country Healthcare Inc
8 Clover LaneWhitefieldNH03598812225283Healthcare ManagementNH501(c)(3)Line 12a, I0
Androscoggin Valley Hospital
59 Page Hill RoadBerlinNH03570020280367Critical Access HospitalNH501(c)(3)Line 30
Upper Connecticut Valley Hospital
Corliss LaneColebrookNH03576020276210Critical Access HospitalNH501(c)(3)Line 30
Weeks Medical Center
173 Middle StreetLancasterNH03584020222242Critical Access HospitalNH501(c)(3)Line 30
North Country Home Health & Hospice Agency
536 Cottage StreetLittletonNH03561020300637Home health and hospice careNH501(c)(3)Line 100
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 Org0LoansOrGuaranteesToOtherOrgInd
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 Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd