STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

EXETER HOSPITAL INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
EXETER HOSPITAL INC (EIN 22-2674014)
Tax period
2016-10-01 to 2017-09-30
Filed
2018-08-14
IRS object ID
201802269349300795
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)
Return2018-08-14T10:19:26-05:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER NEWMAN & NOYES LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1650 ELM STREET SUITE 302AddressLine1Txt
CityMANCHESTERCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03101ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN222674014EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Exeter Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEXETBusinessNameControlTxt
Phone6035806695PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15 Alumni DriveAddressLine1Txt
CityExeterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03833ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEVIN J O'LEARYPersonNm
Person TitleCFO/TreasurerPersonTitleTxt
Phone6035806695PhoneNum
Signature2018-08-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTimothy R HepburnPreparerPersonNm
PTINP00182393PTIN
Phone8002447444PhoneNum
Preparation2018-08-08PreparationDt
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKevin J CallahanPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15 Alumni DriveAddressLine1Txt
CityExeterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03833ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$271,097,838GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.exeterhospital.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1907FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionThe mission of Exeter Hospital is to improve the health of the community. This mission will be principally accomplished without compromising Exeter Hospital's own sustainability through the provision of health services and information to the community in collaboration with Exeter Health Resources' other affiliates which share this mission.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee1644TotalEmployeeCnt
Total Volunteers110TotalVolunteersCnt
Total Gross UBI$10,352TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$7,937NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$116,885PYContributionsGrantsAmt
CY Contributions Grants$199,723CYContributionsGrantsAmt
PY Program Service Revenue$231,800,530PYProgramServiceRevenueAmt
CY Program Service Revenue$241,741,049CYProgramServiceRevenueAmt
PY Investment Income$4,461,681PYInvestmentIncomeAmt
CY Investment Income$11,880,423CYInvestmentIncomeAmt
PY Other Revenue$3,518PYOtherRevenueAmt
CY Other Revenue$19,999CYOtherRevenueAmt
PY Total Revenue$236,382,614PYTotalRevenueAmt
CY Total Revenue$253,841,194CYTotalRevenueAmt
PY Grants And Similar Paid$706,135PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$933,417CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$93,803,094PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$101,882,996CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$109,933,868PYOtherExpensesAmt
CY Other Expenses$114,701,262CYOtherExpensesAmt
PY Total Expenses$204,443,097PYTotalExpensesAmt
CY Total Expenses$217,517,675CYTotalExpensesAmt
PY Revenues Less Expenses$31,939,517PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$36,323,519CYRevenuesLessExpensesAmt
Total Assets BOY$274,105,488TotalAssetsBOYAmt
Total Assets EOY$284,364,235TotalAssetsEOYAmt
Total Liabilities BOY$112,078,919TotalLiabilitiesBOYAmt
Total Liabilities EOY$100,299,810TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$162,026,569NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$184,064,425NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe mission of Exeter Hospital is to improve the health of the community. This mission will be principally accomplished without compromising Exeter Hospital's own sustainability through the provision of health services and information to the community in collaboration with Exeter Health Resources' other affiliates which share this mission. Exeter Hospital works to accomplish this mission through the provision of comprehensive medical and surgical health care services including, but not limited to breast health, maternal/infant and reproductive medicine, cardiovascular, gastroenterology, sleep medicine, occupational and employee health, oncology, orthopedics and emergency care services.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$198,018,657ExpenseAmt
Grant$933,417GrantAmt
Revenue$241,794,734RevenueAmt
DescIn Fiscal Year 2017, Exeter Hospital served the community by providing care to 5,313 acute inpatients, 166,703 outpatient visits, 29,784 emergency room visits and 631 births. In 2017, Exeter Hospital supported its mission by supporting $7,635,189 in community outreach, benefits and financial assistance to the community excluding $33,056,102 in uncovered Medicare and Medicaid expenses. Exeter Hospital supports health care access in its service area by offering a robust financial assistance program that covers the cost of up to 100% of care provided to area residents based on income and family size. In 2017, the charity care program helped people access the health system as Exeter Hospital incurred a cost of $993,124 to provide financial assistance. In addition we provide support to vital community programs like our Healthreach Diabetes and Paramedicine programs and for providing access to contracted mental health professionals in our emergency room. We also supported access to the health system and the development of healthy life styles through our community education programs and our financial support of important healthcare related community based not for profits such as Lamprey Healthcare and Families First.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescExeter Hospital's acute care program provides acute inpatient and outpatient observation level care in our 99 staffed inpatient beds. Our inpatient services treat emergent, acute, elective surgical and palliative care patients. Approximately 75% of our admissions come from the emergency room. We offer inpatient acute services for medical and surgical diagnoses for adults as well as pediatric and obstetrical inpatient services. Exeter Hospital is fully accredited by DNV Healthcare, Inc. (an officially deemed Medicare and Medicaid Credentialing agency), earned the Magnet designation from the American Nurses Credentialing Center, which is the most prestigious distinction a healthcare organization can receive for nursing excellence and high quality patient care as well as many other service level specific national accreditations. Our practice model is guided by a series of collaborative Best Practice Committees that engage nurses and physicians in the development of the best possible evidence based care protocols. Exeter Hospital supports the safety of our patients and the efficiency of the care provided through the deployment of a 24/7 Hospitalist program that manages the majority of the medical needs of our patients during their admission. In our 10 bed ICU we also use an intensivest service to ensure that our most acute patients receive the most highly coordinated care possible, resulting in significantly lower than expected infection rates, ICU readmission rates and shorter ICU stays. For our patients at the end of their lives we ensure their safety and comfort through a physician led, highly coordinated palliative care program.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
DescExeter Hospital's Surgical program provides a full range of both inpatient and outpatient surgical services for patients of all ages from across our service area. Available surgical specialties include; orthopedics, general, ENT, gynecological, urological, plastics, ophthalmologic and vascular.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
DescThe Center for Cancer Care at Exeter Hospital provides cancer patients and their families with comprehensive inpatient and outpatient services. Accredited by the American College of Surgeon's Commission on Cancer with commendation, the Center provides area residents with a leading, comprehensive approach to cancer treatment. The Center offers medical oncology, radiation oncology, surgery, clinical trials, multidisciplinary clinics and integrative oncology services. The Center is proud to have a relationship with the Massachusetts General Physician Organization for the provision of medical and radiation oncology services to patients. The medical oncology service supports a 13 chair infusion center. This unique clinical collaboration brings radiation oncologists from the world's leading academic medical center to Exeter Hospital's Center for Cancer Care. This affiliation allows Exeter Hospital's Center for Cancer Care to offer state-of-the-art radiation therapy services to patients including: Intraoperative Radiation Therapy (IORT), CT Simulation, Partial Breast Irradiation, Image Guided Radiation Therapy, Intensity Modulated Radiation Therapy and Linear Accelerator delivered treatments. The Center's affiliated surgeons work collaboratively with affiliated pathologists, the medical oncologists and with the radiation oncologists to develop the most comprehensive treatment plans for our patients.Exeter Hospital's Cardiology Department offers acute cardiac care, heart catheterization, angioplasty, angiography, implanted cardioverter defibrillators, permanent pacemaker placement and a three phase cardiac rehabilitation program. Exeter Hospital's affiliated fellowship-trained interventional cardiologists and its cardiac team have received international recognitions for their ongoing successful use of emergency angioplasty and interventional cardiology procedures.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$198,018,657TotalProgramServiceExpensesAmt
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 SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To OrgYes (1)MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document140IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1644EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
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 Members13GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
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 VentureYes (1)InvestmentInJointVentureInd
Written Policy Or Procedure0WrittenPolicyOrProcedureInd
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 Line1Kevin J O'LearyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6035806695PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15 Alumni DriveAddressLine1Txt
CityExeterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03833ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Amy Case
Trustee1.001.00Yes (X)$0$0$0
Susan Y Desjardins
Trustee1.001.00Yes (X)$0$0$0
David Donsker MD
Trustee1.001.00Yes (X)$0$0$0
Suzanne Foster
Trustee (as of April 2017)1.001.00Yes (X)$0$0$0
Ross Gittell PhD
Trustee1.001.00Yes (X)$0$0$0
Steve Hermans
Trustee1.001.00Yes (X)$0$0$0
Richard Hollister MD
Ex-Officio Member1.0041.00Yes (X)$0$467,163$28,303
Katie Delahaye Paine
Trustee1.001.00Yes (X)$0$0$0
Major General Joseph Simeone
Trustee1.001.00Yes (X)$0$0$0
Sally Ward
Trustee (as of April 2017)1.001.00Yes (X)$0$0$0
William Schleyer
Chair (as of April 2017)/Vice Chair (end Mar 2017)1.001.00Yes (X)$0$0$0Yes (X)
Glenn McKenzie
Chairman (end March 2017)1.001.00Yes (X)$0$0$0Yes (X)
Robert Schoenberger
Vice Chairman (as of APril 2017)1.001.00Yes (X)$0$0$0Yes (X)
Kevin J Callahan
CEO/Trustee2.0043.00Yes (X)$0$2,348,957$192,874Yes (X)
Kevin J O'Leary
CFO/Treasurer2.0043.00$0$514,025$93,114Yes (X)
Constance D Sprauer
Sr. VP Legal Affairs/Secretary2.0041.00$0$329,420$32,993Yes (X)
Brian Campbell
VP Ambulatory Care40.000.00$298,117$0$39,452Yes (X)
Donna McKinney
VP Acute Care40.000.00$293,791$0$37,960Yes (X)
Jonathan Jackson
Physicist40.000.00$249,335$0$30,903Yes (X)
Jane Peterson
Director40.000.00$194,433$0$12,022Yes (X)
Susan Callahan
Director40.000.00$186,538$0$19,851Yes (X)
Joan Raczy
Pharmacist40.000.00$183,977$0$35,021Yes (X)
Deanna King
Director40.000.00$182,199$0$35,359Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,588,390TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,659,565TotReportableCompRltdOrgAmt
Total Other Compensation$557,852TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K77IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
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
Exeter Health Resources Inc
5 Alumni DriveExeterNH03833Administrative Management Fees$7,043,819
Core Physician Services LLC
5 Alumni DriveExeterNH03833Physician Services$5,494,651
ASHA LLC
PO Box 945Traverse CityMI49685Temporary Labor$2,133,048
Mass General Physician Organization
PO Box 3662BostonMA022413864Physician Services$1,883,534
GE Healthcare Inc
PO Box 96483ChicagoIL60693Equipment Maintenance$1,411,137
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K54CntrctRcvdGreaterThan100KCnt
Fundraising$55,287FundraisingAmt
All Other Contributions$144,436AllOtherContributionsAmt
Noncash Contributions$9,748NoncashContributionsAmt
Total Contributions$199,723TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Services621300$232,183,240$232,183,240
Disproportionate Share Funding621300$6,461,110$6,461,110
Cafeteria722210$1,499,225$1,499,225
Other Programs621300$1,264,931$1,264,931
Gift Shop453220$121,708$121,708

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$210,835TotalRevenueColumnAmt
Related Or Exempt Func Income$210,835RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$241,741,049TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,610,851TotalRevenueColumnAmt
Unrelated Business Revenue$10,352UnrelatedBusinessRevenueAmt
Exclusion$1,600,499ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$75,671RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$21,986RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$53,685RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$53,685TotalRevenueColumnAmt
Related Or Exempt Func Income$53,685RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$27,434,291SecuritiesAmt
Other$32,603OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$17,197,322SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$10,236,969SecuritiesAmt
Other$32,603OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,269,572TotalRevenueColumnAmt
Exclusion$10,269,572ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$3,650FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$55,287ContriRptFundraisingEventAmt
Fundraising Direct Expenses$37,336FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$33,686TotalRevenueColumnAmt
Exclusion-$33,686ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$253,841,194TotalRevenueColumnAmt
Related Or Exempt Func Income$241,794,734RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$10,352UnrelatedBusinessRevenueAmt
Exclusion$11,836,385ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$876,031TotalAmt
Program Services$876,031ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$57,386TotalAmt
Program Services$57,386ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$669,320TotalAmt
Program Services$597,489ProgramServicesAmt
Management And General$71,831ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$76,723,805TotalAmt
Program Services$68,489,823ProgramServicesAmt
Management And General$8,233,982ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$3,060,707TotalAmt
Program Services$2,732,233ProgramServicesAmt
Management And General$328,474ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$15,915,262TotalAmt
Program Services$14,207,240ProgramServicesAmt
Management And General$1,708,022ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,513,902TotalAmt
Program Services$4,922,151ProgramServicesAmt
Management And General$591,751ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$140,339TotalAmt
Management And General$140,339ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$66,000TotalAmt
Management And General$66,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$22,902,996TotalAmt
Program Services$20,445,050ProgramServicesAmt
Management And General$2,457,946ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$560,682TotalAmt
Program Services$500,510ProgramServicesAmt
Management And General$60,172ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$847,613TotalAmt
Program Services$756,647ProgramServicesAmt
Management And General$90,966ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$340,634TotalAmt
Program Services$304,077ProgramServicesAmt
Management And General$36,557ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$6,077,161TotalAmt
Program Services$5,424,961ProgramServicesAmt
Management And General$652,200ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$269,542TotalAmt
Program Services$240,615ProgramServicesAmt
Management And General$28,927ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$938,331TotalAmt
Program Services$837,630ProgramServicesAmt
Management And General$100,701ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$10,942,861TotalAmt
Program Services$9,768,476ProgramServicesAmt
Management And General$1,174,385ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,135,824TotalAmt
Program Services$1,013,928ProgramServicesAmt
Management And General$121,896ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Supplies$21,459,043$19,156,063$2,302,980
Drugs$18,418,660$18,418,660
Medicaid Enhancement Ta$11,570,541$11,570,541
Bad Debt Expense$6,620,562$6,620,562

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$12,410,473TotalAmt
Program Services$11,078,584ProgramServicesAmt
Management And General$1,331,889ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$217,517,675TotalAmt
Program Services$198,018,657ProgramServicesAmt
Management And General$19,499,018ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$27,946,727BOYAmt
EOY$37,984,098EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$32,067,171BOYAmt
EOY$17,256,883EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$18,947,421BOYAmt
EOY$19,106,438EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,143,804BOYAmt
EOY$3,663,197EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,522,461BOYAmt
EOY$4,379,763EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$134,673,483LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$78,218,125LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$58,398,227BOYAmt
EOY$56,455,358EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$54,535,778BOYAmt
EOY$53,046,458EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$68,298,364BOYAmt
EOY$85,604,290EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,245,535BOYAmt
EOY$6,867,750EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$274,105,488BOYAmt
EOY$284,364,235EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$18,597,403BOYAmt
EOY$17,450,903EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$56,108,478BOYAmt
EOY$52,689,148EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$37,373,038BOYAmt
EOY$30,159,759EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$112,078,919BOYAmt
EOY$100,299,810EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$144,999,059BOYAmt
EOY$166,992,668EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$258,189BOYAmt
EOY$302,436EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,769,321BOYAmt
EOY$16,769,321EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$162,026,569BOYAmt
EOY$184,064,425EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$274,105,488BOYAmt
EOY$284,364,235EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$36,323,519ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,648,103NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$15,933,766OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
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$21,979OtherActivitiesAmt
Total Lobbying Expenditures$21,979TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationAssociation Dues Allocated to Lobbying: A portion of annual membership dues paid to the American Hospital Association and the New Hampshire Hospital Association are considered lobbying expenses. For fiscal year ending September 30, 2017, the amounts deemed for lobbying were $6,334 and $15,645, respectively.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$17,027,510BeginningYearBalanceAmt
Contributions$154,049ContributionsAmt
Other Expenditures$109,802OtherExpendituresAmt
End Year Balance$17,071,757EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,993,856BeginningYearBalanceAmt
Contributions$107,531ContributionsAmt
Other Expenditures$73,877OtherExpendituresAmt
End Year Balance$17,027,510EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$17,004,799BeginningYearBalanceAmt
Contributions$69,258ContributionsAmt
Other Expenditures$80,201OtherExpendituresAmt
End Year Balance$16,993,856EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$17,006,133BeginningYearBalanceAmt
Contributions$53,100ContributionsAmt
Other Expenditures$54,434OtherExpendituresAmt
End Year Balance$17,004,799EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$17,008,827BeginningYearBalanceAmt
Contributions$41,887ContributionsAmt
Other Expenditures$44,581OtherExpendituresAmt
End Year Balance$17,006,133EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.01770BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.98230PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$142,400OtherCostOrOtherBasisAmt
Book Value$142,400BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$75,023,983OtherCostOrOtherBasisAmt
Depreciation$46,115,144DepreciationAmt
Book Value$28,908,839BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$394,212OtherCostOrOtherBasisAmt
Depreciation$186,909DepreciationAmt
Book Value$207,303BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$54,693,412OtherCostOrOtherBasisAmt
Depreciation$30,088,428DepreciationAmt
Book Value$24,604,984BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,419,476OtherCostOrOtherBasisAmt
Depreciation$1,827,644DepreciationAmt
Book Value$2,591,832BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$56,455,358TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Limited Partnerships$61,749,985F
Alternative Investments$23,854,305F
FieldValueIRS element (for citing)
Total Book Value Securities$85,604,290TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Due to Third Party Payors$4,510,264
Accrued Pension Liability$14,575,741
Swap Valuation Liability$6,504,280
Reserve for Professional Liability Claims$4,569,474
FieldValueIRS element (for citing)
Total Liability$30,159,759TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$257,995,010TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,648,103NetUnrealizedGainsInvstAmt
Other Revenue$2,557,504OtherRevenueAmt
Revenue Not Reported$4,205,607RevenueNotReportedAmt
Revenue Subtotal$253,789,403RevenueSubtotalAmt
Other Revenues Not Included$51,791OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$51,791RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$253,841,194TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$217,575,686TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$109,802OtherExpensesIncludedAmt
Expenses Not Reported$109,802ExpensesNotReportedAmt
Expenses Subtotal$217,465,884ExpensesSubtotalAmt
Other Expenses Not Included$51,791OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$51,791ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$217,517,675TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:The goal of the Permanent Endowment Fund is to provide a source of financial support to Exeter's patient care activities. These funds are invested in a prudent manner with regard to preserving principal while providing reasonable returns. These returns are then used for capital expenditures, other major program needs, and to generally increase the financial strength of the organization. The quasi-endowments are funds which have been donated to the organization for a purpose specified by the donor. These funds are held until used for the purpose intended by the donor.
Part X, Line 2:The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code, and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the tax positions of the Hospital and has concluded that it has maintained its tax-exempt status, does not have any significant unrelated business income, and has taken no uncertain tax positions that require adjustment to the financial statements.
Part XI, Line 2d - Other Adjustments:Impact of Interest Rate Swaps 2,403,455. Net Assets Released from Restricted Gifts 154,049.
Part XI, Line 4b - Other Adjustments:Income Included in Expenses on Audited Financial Statements 51,791.
Part XII, Line 2d - Other Adjustments:Net Assets Released from Restricted Gifts 109,802.
Part XII, Line 4b - Other Adjustments:Income Included in Expenses on Audited Financial Statements 51,791.

Schedule F IRS990ScheduleF

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

Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)

RegionRegionTxtOfficesOfficesCntEmployeeEmployeeCntType Of Activities ConductedTypeOfActivitiesConductedTxtRegion Total ExpendituresRegionTotalExpendituresAmtSpecific Services ProvidedSpecificServicesProvidedTxt
Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas,00Investments in funds domiciled in the region$21,682,452
Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso,00Grants to recipients located in region$57,386Contribution of medical equipment and supplies to hospitals and clinics who serve the needy in countries outside the United States
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continutation Total Office0ContinutationTotalOfficeCnt
Continutation Total Employee0ContinutationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$21,739,838SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$21,739,838TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp

FieldValueIRS element (for citing)
RegionSub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso,RegionTxt
Cash Grant$0CashGrantAmt
Non Cash Assistance$57,386NonCashAssistanceAmt
Description Of Non Cash AsstContribution of medical equipment and supplies to hospitals and clinics who serve the needy in countries outside the United StatesDescriptionOfNonCashAsstTxt
Valuation Method UsedBook ValueValuationMethodUsedDesc
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp Ownership0ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 2:All requests for grants/contributions/sponsorships over $5,000 require the approval of at least the Vice President of Strategy, Community Relations and Development to ensure that they are consistent with our mission, values and strategic plan. Each year a subcommittee of Exeter Health Resources, Inc.'s (parent company) Board of Trustees is charged with overseeing our Community Benefits program and our community needs assessment and reviews a detailed report on the previous year's grants/contributions/sponsorships and approves the current year's plan for community support. That subcommittee and the larger Exeter Health Resources, Inc.'s (parent company) Board of Trustees are regularly updated on our community support initiatives. The only grantee reported on Schedule F is a 501(c)(3) domestic organization located in Massachusetts that provides medical equipment and supplies to needy foreign hospitals and clinics.
Schedule F, Part I, Line 3:The legal owner of Exeter Hospital, Inc.'s foreign investments is a related organization, Exeter Health Resources, Inc. Since a portion of Exeter Health Resources, Inc.'s total foreign investments are allocated to the Hospital's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, Line 3 of Exeter Hospital, Inc.'s Form 990. However, any required IRS Forms 926 and other foreign tax reporting obligations are filed by the legal owner, Exeter Health Resources, Inc.(EIN:02-0222126)
Schedule F, Part IV, Line 3:Exeter Hospital, Inc. did not have an ownership interest in any foreign corporation that was greater than the 10% ownership filing threshold. Accordingly, IRS Form(s) 5471 is not required to be filed.
Schedule F, Part IV, Line 4:Exeter Hospital, Inc. meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Hospital.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Caring HandsEvent1Nm
Gross Receipts Event1$19,900GrossReceiptsEvent1Amt
Charitable Contri Event1$16,250CharitableContriEvent1Amt
Gross Revenue Event1$3,650GrossRevenueEvent1Amt
Non Cash Prizes Event1$3,905NonCashPrizesEvent1Amt
Rent Facility Costs Event1$2,710RentFacilityCostsEvent1Amt
Food And Beverage Event1$5,277FoodAndBeverageEvent1Amt
Entertainment Event1$200EntertainmentEvent1Amt
Other Direct Expenses Event1$2,363OtherDirectExpensesEvent1Amt
Event2Kites CancerEvent2Nm
Gross Receipts Event2$26,629GrossReceiptsEvent2Amt
Charitable Contri Event2$26,629CharitableContriEvent2Amt
Other Direct Expenses Event2$14,714OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$12,408GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$12,408CharitableContriOtherEventsAmt
Oth Direct Expnss Other Events$8,167OthDirectExpnssOtherEventsAmt
Gross Receipts Total$58,937GrossReceiptsTotalAmt
Charitable Contributions Tot$55,287CharitableContributionsTotAmt
Gross Revenue Total Events$3,650GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$3,905NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$2,710RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$5,277FoodAndBeverageTotalEventsAmt
Entertainment Total Events$200EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$25,244OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$37,336DirectExpenseSummaryEventsAmt
Net Income Summary-$33,686NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule G, Part II, Fundraising EventsFormAndLineReferenceDesc
ExplanationIn accordance with the IRS instructions for the reporting of income on Schedule G, event revenue deemed to be charitable contributions has been reported on line 2, thus reducing the total gross event income on line 3. This presentation gives the appearance on Schedule G of a loss from the respective events. However, when the charitable contributions are considered and added back, these three events had a positive net revenue of $21,601.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other320.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
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)
Persons Served978PersonsServedCnt
Total Community Benefit Expns$993,124TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$993,124NetCommunityBenefitExpnsAmt
Total Expense0.00470TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served4910PersonsServedCnt
Total Community Benefit Expns$22,269,679TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,461,110DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,808,569NetCommunityBenefitExpnsAmt
Total Expense0.07500TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served5888PersonsServedCnt
Total Community Benefit Expns$23,262,803TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,461,110DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,801,693NetCommunityBenefitExpnsAmt
Total Expense0.07970TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served15286PersonsServedCnt
Total Community Benefit Expns$949,906TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$32,979DirectOffsettingRevenueAmt
Net Community Benefit Expns$916,927NetCommunityBenefitExpnsAmt
Total Expense0.00430TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served125PersonsServedCnt
Total Community Benefit Expns$848,728TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,041DirectOffsettingRevenueAmt
Net Community Benefit Expns$847,687NetCommunityBenefitExpnsAmt
Total Expense0.00400TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served1936PersonsServedCnt
Total Community Benefit Expns$3,722,561TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$402,212DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,320,349NetCommunityBenefitExpnsAmt
Total Expense0.01570TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Persons Served782PersonsServedCnt
Total Community Benefit Expns$389,206TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,766DirectOffsettingRevenueAmt
Net Community Benefit Expns$374,440NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$931,518TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$931,518NetCommunityBenefitExpnsAmt
Total Expense0.00440TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served18129PersonsServedCnt
Total Community Benefit Expns$6,841,919TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$450,998DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,390,921NetCommunityBenefitExpnsAmt
Total Expense0.03020TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served24017PersonsServedCnt
Total Community Benefit Expns$30,104,722TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,912,108DirectOffsettingRevenueAmt
Net Community Benefit Expns$23,192,614NetCommunityBenefitExpnsAmt
Total Expense0.10990TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$85,937TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$85,937NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$165,207TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$165,207NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$251,144TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$251,144NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$2,674,423BadDebtExpenseAmt
Bad Debt Expense Attributable$2,170,722BadDebtExpenseAttributableAmt
Reimbursed By Medicare$73,920,615ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$96,277,579CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$22,356,964MedicareSurplusOrShortfallAmt

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 Line1Exeter Hospital IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15 Alumni DriveAddressLine1Txt
CityExeterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03833ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.exeterhospital.comWebsiteAddressTxt
State License1761StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Exeter Hospital IncBusinessNameLine1Txt
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
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Schedule H, Part V, Section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Schedule H, Part V, Section CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care320.000000000000FPGFamilyIncmLmtFreeCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Schedule H, Part V, Section CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Schedule H, Part V, Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Section CFAPSummaryOnWebsiteURLTxt
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 TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Exeter Hospital, Inc.Part V, Section B, Line 5: Every three years, Exeter Hospital, in collaboration with its community partners, conducts a community needs assessment to identify, prioritize, and develop a plan to address critical health issues. The last community needs assessment was completed in FYE 2016. The purpose of the assessment was to engage community members through key leader interviews and Community Forums, and to achieve the following objectives:1) Educate and inform key leaders and Community Forum participants of the results of the FYE 2013 Community Needs Assessment and achievements to date to meet identified needs.2) Validate Priority Health Needs identified in the FYE 2013 Community Needs Assessment and further define these needs in FYE 2016 from the stakeholders' perspective.3) Identify unmet needs that have emerged since the FYE 2013 Community Needs Assessment.4) Engage key leaders and Community Forum participants in a discussion to identify solutions to address community health needs.5) Share the findings of the UNH Survey Center Household Telephone Survey.6) Where appropriate, motivate key leaders and Community Forum participants to participate in efforts to address community health needs going forward.7) Serve as a continuing foundation for the development of a Community Benefits Plan, as mandated under RSA 7:32-e.The FYE 2016 Community Needs Assessment included telephone surveys, open community forums, online surveys, key leader interviews, outreach to support agencies and the review of relevant secondary data sources. Information was solicited from a broad cross-section of the hospital's service area and included government welfare, public health, transportation, police, education and emergency preparedness officials, as well as outreach agencies that serve military & veterans, children & families, youth, elderly and the low-income. Legislators were invited to attend community forums. Providers of medical care to low-income minority population and mental health services were included.
Exeter Hospital, Inc.Part V, Section B, Line 6b: Representatives from the following organizations collaborated on the hospital's community needs assessment: Exeter Area YMCA, Easter Seals NH, Lamprey Health Care, Families First Health and Support Center, Richie-McFarland Children's Center, Seacoast Mental Health Center, United Way of the Greater Seacoast as well as affiliates Core Physicians and Rockingham VNA & Hospice.
Exeter Hospital, Inc.Part V, Section B, Line 11: The needs identified in the FYE 2016 Community Health Needs Assessment are:Access to care due to insurance coverage cost barriers, Substance Abuse and Addiction, Mental Health Services, Youth Suicide/Substance and Prescription drug abuse, Transportation, Affordable Housing/Homelessness and Elder Care and Support Services. The community benefit spending in FYE 2017 directly related to the FYE 2016 identified needs which were: Access to care due to insurance coverage cost barriers, Substance Abuse and Addiction, Mental Health Services, Youth Suicide/Substance and Prescription drug abuse, Transportation, Affordable Housing/Homelessness and Elder Care and Support Services. Exeter Hospital addressed these needs by promoting community health and access to primary care by providing: 1) Charity care of $993,124 (calculated at cost) during fiscal year 2017 which served 978 people.2) Financial assistance through its health care access program which has three components: a) The Uninsured Care Discount/Hospital Access Plus Program - Patients who are uninsured will not be charged more than amounts generally billed to patients who have insurance covering the same care. Exeter Hospital, prior to billing the patients, applies a discount towards gross charges for patients who are uninsured. This discount is not valid for patients who have health insurance coverage, including but not limited to: Medicare, Medicaid, MedPay, third party liability or any other state or federal programs. b) The Financial Assistance Program (FAP) is a community-based program available to uninsured and under-insured patients who meet income and asset guidelines, and who live in our service area. To qualify, patients must first have applied for all other sources of coverage, including the Healthcare Exchange and the New Hampshire Health Protection Program. c) Exeter's Catastrophic Care Program provides financial relief for those patients who do not qualify for our Financial Assistance Program, but who are faced with a substantial debt due to a serious illness or injury. This program is calculated based on a percentage of the patient's gross income.3) Telehealth Services which provided $338,009 in telehealth monitoring services serving 10,226 persons in fiscal year 2017.4) Transportation which is an important health care support service provided by the Hospital in response to an identified community need. Each year the program enhances access for hundreds of patients who otherwise would not be able to obtain needed health care and health related support services. During fiscal year 2017 Exeter Hospital provided 241 transports at a cost of $26,522.5) Support for Youth Suicide/Substance and Prescription Drug Abuse prevention and education services by: a) The Hospital making financial contributions to Haven of New Hampshire in fiscal year 2017 of $40,000 specifically designated to support their efforts in addressing public health through violence prevention and improving the well-being of children and families. b) The Hospital providing support in the amount of $17,000 to Connor's Climb Foundation which is dedicated to preventing youth suicide. All of the funds raised directly impact programs for suicide awareness, education and prevention in the New Hampshire community.6) Community Education Programs offered by the Hospital that provided community education services at an expense of $383,077 serving 2,727 persons in fiscal year 2017.7) Cancer Wellness and Diabetes Support Programs offered by the Hospital served 704 people by providing cancer and diabetes programs at an expense of $1,110,161 in fiscal year 2017.8) Participation in research studies by the "The Center for Cancer Care" at Exeter Hospital through several national research groups sponsored by the National Cancer Institute. This enables the Center to offer clinical trials to patients undergoing treatment at the Hospital that allows patients to voluntarily take part in leading edge research that does not necessitate travel outside of the Seacoast area. During fiscal year 2017, the Hospital provided $374,440 for clinical trials and research that served 782 patients.
Exeter Hospital, Inc.Part V, Section B, Line 16j: The financial assistance policy (FAP), financial assistance application and plain language summary can be found on our website, and are advertised and paper copies are available to patients. Semi-annually, we publish an ad in the local paper which outlines our financial assistance program. Within our phone system, we have a recording which outlines the financial assistance program when patients, family members etc. are on hold during a call to Exeter Hospital. We present each patient with a copy of the Plain Language Summary at Registration. Currently we have a financial counselor located in the checkout area in our Emergency Department and an Inpatient Financial Counselor to visit inpatients who are uninsured, to inform them of our program and or if they request more information about needing assistance to pay for services. Signage in public locations notifies patients about our Financial Assistance Program. We have also collaborated with our community partners to have this information publically available and accessible at their locations to reach members of our community who are most likely to need financial assistance.
Exeter Hospital, Inc.Part V, Section B, Line 20e: During fiscal year 2017, we notified Emergency Department patients during discharge about our financial assistance program. Upon admission, we visit all self pay and any other patient who wishes to discuss their coverage and or balances due and inform them of our program. The Plain Language Summary is presented during registration of all patients. This information regarding the financial assistance program is on each patient billing statement as well as available on our website.
Schedule H, Part V, Section B, Line 7a:The Hospital's FYE 2016 CHNA is available at: https://www.exeterhospital.com/getmedia/26f68ce4-0cd6-447f-a137-e839dd5dcc4c/2016-Community-Health-Needs.pdf.aspx
Schedule H, Part V, Section B, Line 10a:The Hospital's FYE 2016 Implementation Strategy is available at: https://www.exeterhospital.com/getmedia/da22bb1b-97ec-48b2-96a6-02b9f9219607/Exeter-Hospital-Community-Health-Needs-Assessment-Implementation-Plan.pdf.aspx
Schedule H, Part V, Section B, Line 16a-c:The Hospital's Financial Assistance Policy is available at:https://www.exeterhospital.com/getmedia/9b45d4eb-d6bd-4155-9712-7718a510b5f2/LD326-04-2018.pdf.aspxThe Hospital's Financial Assistance Application is available at:https://www.exeterhospital.com/getmedia/55329600-c7fd-45fd-8e56-3dc1b5abe0ea/1639-Fin-Assist-App-03-2018_4.pdf.aspxThe Hospital's Plain Language Summary is available at:https://www.exeterhospital.com/getmedia/6476920e-bac4-4370-bddc-57641c722915/1641-Fin-Assist-Summary-04-2018.pdf.aspx
FieldValueIRS element (for citing)
Facility15FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Center for Orthopaedics and Movement
7 Alumni DriveExeterNH03833Rehabilitation Services, Cardiac Rehabilitation, Massage
2 - Centers for Sleep & Wound Healing
4 Alumni DriveExeterNH03833Sleep Lab, Wound Care, Drivability
3 - Epping Regional Health Center
212 Calef HighwayEppingNH03042Pediatric and Adult Rehabilitation Services, Radiology, Mammmography
4 - Center for Reproductive Care
118 Portsmouth AvenueStrathamNH03885Reproductive Services
5 - Diagnostic Imaging & Physical Therapy
24 Plaistow RoadPlaistowNH03865Physical Therapy, Radiology
6 - Ctr for Occupational & Employee Health
6 Hampton RoadExeterNH03833Occupational Health
7 - Kingston Athleticare
53 Church StreetKingstonNH03848Physical Therapy
8 - Orthopaedic & Sports Physical Therapy
311 Winnacunnet RoadHamptonNH03842Physical Therapy and Athletic Performance Center
9 - Exeter Diagnostic Serv at Hampton
879 Lafayette RoadHamptonNH03842Radiology, Mammography
10 - Rehab & Diagnostic Serv of Exeter Hosp
128 Route 27RaymondNH03077Physical and Occupational Therapy, Radiology, Mammography
11 - Rehab & Diagnostic Serv at Lamprey
207 South Main StreetNewmarketNH03857Physical and Occupational Therapy, Radiology, Mammography
12 - Diagnostic Imaging - Saltonstall
9 Buzzell AvenueExeterNH03833Radiology
13 - Physical Therapy at Portsmouth
95 Brewery LanePortsmouthNH03801Physical Therapy
14 - HealthReach Diabetes Nutrition & Educ
881 Lafayette RoadHamptonNH03842Diabetes and Nutrition
15 - Sports and Physical Therapy Practice
40 Industrial Drive 1ExeterNH03833Athletic Performance Center

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:All eligible financial assistance recipients receive 100% free care. Patients who do not qualify for financial assistance and are uninsured receive a discount that is equal to AGB = 42% (amounts generally billed) using the lookback method.There are several factors regarding eligibility for Financial Assistance. The applicant must reside in our service area, a geographic location consisting of approximately 40 surrounding towns, listed on our website, Financial Assistance policy and Plain Language Summary. The other factor is combined income and assets (as defined in our Financial Assistance policy) are compared to the FPG.
Part I, Line 7:A ratio of patient cost to charge was calculated utilizing Worksheet 2. The ratio of cost to charge was utilized in calculating line 7a total net community benefit expense for charity care.
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 $ 6,620,562.
Part II, Community Building Activities:The majority of the remaining community benefit activities reported as community building activities are cash donations to community organizations for the purpose of furthering community support and advocacy for community health improvement.
Part III, Line 2:The amount reported represents total bad debt expense as reported on the audited financial statement of $8,000,070 x 33.43% (ratio of patient cost to charge) to equal $2,674,423. This amount does not include any estimated provisions which are in bad debt expense reported on the audited financial statements.
Part III, Line 3:The amount reported represents $6,493,336 of charges included in total bad debt write offs for patient eligible for financial assistance x 33.43% (ratio of patient cost to charge) to equal $2,170,722.
Part III, Line 4:Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital 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. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which accounts for patients who are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.The Hospital's allowance for doubtful accounts for self-pay patients decreased from 120% of self-pay accounts receivable at September 30, 2016 to 101% of self-pay accounts receivable at September 30, 2017. The Hospital's self-pay bad debt write-offs decreased approximately $1,319,000 from $4,905,000 in 2016 to $3,586,000 in 2017. The net change in the allowance as a percentage of self-pay accounts receivable and bad debt write-offs was a result of collection trends and a shift in payor mix, resulting from the Medicaid expansion and health insurance exchange.
Part III, Line 8:Medicare costs are not counted as a Community Benefit per New Hampshire or IRS guidance, therefore the cost figure of $22,356,964 is not included in the Total Unreimbursed Community Benefit Expense. The ratio of cost to charge was utilized in calculating the amount.
Part III, Line 9b:If an account is sent to a collection agency and the patient applies for financial assistance within 240 days from first bill, the account will be placed on hold with the agency through the consideration process. If the patient is approved for financial assistance, the account will be retracted from the collection agency and financial assistance will be applied to the accounts. Exeter Hospital only contracts with collection agencies that follow Fair Debt Collection Practices and do not engage in Extraordinary Collection Activities.The Bad Debt/Collection Policy can be located online at:https://www.exeterhospital.com/getmedia/dea9264c-9d03-4f28-803f-0bbc4b103f1b/LD327-09-2016.pdf.aspx
Part VI, Line 2:Every three years, Exeter Hospital, in collaboration with its community partners, conducts a community needs assessment to identify, prioritize, and develop a plan to address critical health issues. The last community needs assessment was completed in FYE 2016. The purpose of the assessment was to engage community members through key leader interviews and Community Forums, and to achieve the following objectives:1) Educate and inform key leaders and Community Forum participants of the results of the FYE 2013 Community Needs Assessment and achievements to date to meet identified needs.2) Validate Priority Health Needs identified in the FYE 2013 Community Needs Assessment and further define these needs in FYE 2016 from the stakeholders' perspective.3) Identify unmet needs that have emerged since the FYE 2013 Community Needs Assessment.4) Engage key leaders and Community Forum participants in a discussion to identify solutions to address community health needs.5) Share the findings of the UNH Survey Center Household Telephone Survey.6) Where appropriate, motivate key leaders and Community Forum participants to participate in efforts to address community health needs going forward.7) Serve as a continuing foundation for the development of a Community Benefits Plan, as mandated under RSA 7:32-e.The FYE 2016 Community Needs Assessment included telephone surveys, open community forums, online surveys, key leader interviews, outreach to support agencies and the review of relevant secondary data sources. Information was solicited from a broad cross-section of the hospital's service area and included government welfare, public health, transportation, police, education and emergency preparedness officials, as well as outreach agencies that serve military & veterans, children & families, youth, elderly and the low-income. Legislators were invited to attend community forums. Providers of medical care to low-income minority population and mental health services were included.The report in its entirety can be accessed on the Exeter Hospital website:https://www.exeterhospital.com/getmedia/ab627f1a-3ed4-4290-a7e7-a2256955e010/1-EH-2017-Community-Health-Needs-(2).pdf.aspx
Part VI, Line 3:Exeter Hospital provides its patients with information regarding the organization's financial assistance program, and a summary of the organization's policy at the time of registration, on the back of every billing statement, and when phone contact is made when there is a balance on the account. On the Exeter Hospital website (http://www. exeterhospital.com), patients and the general public can find information on the organization's financial assistance programs; financial assistance, uninsured care discount program, catastrophic care program; and state-wide programs. As an additional measure to ensure our community members are aware of Exeter Hospital's financial assistance programs, twice a year the organization may run advertisements in community newspapers summarizing the organization's financial assistance/charity care policy. Exeter Hospital employs financial counselors specifically dedicated to assisting patients with questions regarding their eligibility for financial assistance, and assisting patients through the qualification process as applicable. All inpatient self-pay patients are provided information and counseling regarding the eligibility for financial assistance programs at the time of service. Self-pay and underinsured patients in the Emergency Department, Surgical areas and Oncology are also informed of the hospital's financial assistance programs at time of service or discharge.
Part VI, Line 4:Exeter Hospital services an area that encompasses 40 communities with an estimated population of 237,228.
Part VI, Line 5:Exeter Hospital addressed these needs by promoting community health and access to primary care by providing: 1) Charity care of $ 993,124 (calculated at cost) during fiscal year 2017 which served 978 people.2) Financial assistance through its health care access program which has three components: a) The Uninsured Care Discount/Hospital Access Plus Program - Patients who are uninsured will not be charged more than amounts generally billed to patients who have insurance covering the same care. Exeter Hospital, prior to billing the patients, applies a discount towards gross charges for patients who are uninsured. This discount is not valid for patients who have health insurance coverage, including but not limited to: Medicare, Medicaid, MedPay, third party liability or any other state or federal programs. b) The Financial Assistance Program is a community-based program available to uninsured and under-insured patients who meet income and asset guidelines, and who live in our service area. To qualify, patients must first have applied for all other sources of coverage, including the Healthcare Exchange and the New Hampshire Health Protection Program.c) Exeter's Catastrophic Care Program provides financial relief for those patients who do not qualify for our Financial Assistance Program, but who are faced with a substantial debt due to a serious illness or injury. This program is calculated based on a percentage of the patient's gross income.3) Telehealth Services which provided $338,009 in telehealth monitoring services serving 10,226 persons in fiscal year 2017.4) Transportation which is an important health care support service provided by the Hospital in response to an identified community need. Each year the program enhances access for hundreds of patients who otherwise would not be able to obtain needed health care and health related support services. During fiscal year 2017 Exeter Hospital provided 241 transports at a cost of $26,522.5)Support for Youth Suicide/Substance and Prescription Drug Abuse prevention and education services by: a) The Hospital making financial contributions to Haven of New Hampshire in fiscal year 2017 of $40,000 specifically designated to support their efforts in addressing public health through violence prevention and improving the well-being of children and families. b) The Hospital providing support in the amount of $17,000 to Connor's Climb Foundation which is dedicated to preventing youth suicide. All of the funds raised directly impact programs for suicide awareness, education and prevention in the New Hampshire community.6) Community Education Programs offered by the Hospital that provided community education services at an expense of $383,077 serving 2,727 persons in fiscal year 2017.7)Cancer Wellness and Diabetes Support Programs offered by the Hospital served 704 people by providing cancer and diabetes programs at an expense of $1,110,161 in fiscal year 2017.8) Participation in research studies by the "The Center for Cancer Care" at Exeter Hospital through several national research groups sponsored by the National Cancer Institute. This enables the Center to offer clinical trials to patients undergoing treatment at the Hospital that allows patients to voluntarily take part in leading edge research that does not necessitate travel outside of the Seacoast area. During fiscal year 2017, the Hospital provided $374,440 for clinical trials and research that served 782 patients.
Part VI, Line 6:Exeter Hospital, Inc. is one of three affiliates of Exeter Health Resources, Inc. Each of the affiliated companies are committed to providing health care services that are innovative, progressive and focused on quality and the well-being of patients. The mission of Exeter Health Resources, Inc. and its affiliates is to improve the health of the community. This mission will be principally accomplished without compromising Exeter Health Resources, Inc.'s sustainability by supporting the provision of health services and information to the community by the affiliated companies of Exeter Health Resources, Inc. During fiscal year 2017, Exeter Hospital, Core Physicians and Rockingham VNA & Hospice have continued the pursuit of this mission providing $67,312,514 in charity care and other community benefit programs and services to communities in the areas served. 1) Exeter Hospital is a 100-bed community-based hospital serving New Hampshire's Seacoast Region. The Hospital's scope of care includes comprehensive medical and surgical health care services including but not limited to breast health, maternal/child and reproductive medicine, cardiovascular, gastroenterology, sleep medicine, occupational and employee health, oncology, orthopedics, and emergency care services. Exeter Hospital is accredited by the DNV Healthcare, Inc. and is a Magnet-recognized hospital. Magnet designation from the American Nurses Credentialing Center is the most prestigious distinction a health care organization can receive for nursing excellence and high quality patient care.2) Core Physicians is a community-based, multi-specialty group practice affiliated with Exeter Health Resources, Inc. that provides comprehensive primary, specialty and pediatric dental care throughout the greater Seacoast region. Over 160 providers in 15 locations pursue exceptional patient satisfaction through clinical competence and professional office administration.3) Rockingham Visiting Nurse Association & Hospice is a community-based home health and hospice agency providing individuals and families with the highest quality home care, hospice and community outreach programs within Rockingham County and the surrounding towns of Barrington, Lee, Dover and Durham. Exeter Hospital works collaboratively with local non-profit agencies and organizations which strive to improve the health of the community. These relationships include:1) Lamprey Health Care: In fiscal year 2017, the Hospital continued its financial support with a community benefit grant in the amount of $380,500. Lamprey Health Care provides high quality primary medical care and health related services, with an emphasis on prevention and lifestyle management, to all individuals regardless of ability to pay. As New Hampshire's oldest community health care center it provides services at three centers located in Newmarket, Raymond, and Nashua. 2) Families First Health and Support Center: In fiscal year 2017, the Hospital made financial contributions in the amount of $51,000. Families First is a community health center offering a wide variety of health services and programs including primary care, prenatal care, dental care, and mobile health care for the homeless.3) Seacoast Mental Health Center: The Hospital partners with Seacoast Mental Health Center to offer mental health services to patients and their caregivers in the Emergency Department and The Center for Cancer Care. In fiscal year 2017, Exeter helped to underwrite mental health services in the amount of $463,482 serving 541 people. 4) New Heights: In fiscal year 2017, the Hospital continued its support with contributions in the amount of $50,000. New Heights is an experiential learning organization for youth in grades 5-12 and focuses on the development and leadership of exciting, high quality summer and year-round programs designed to open young minds to new possibilities. Programs include adventure, arts & culture, STEM and team building activities.5) Haven of New Hampshire: The Hospital made financial contributions of $40,000 specifically designated to support their efforts in addressing public health through violence prevention and improving the well-being of children and families.6) Connors Climb: In fiscal year 2017, the Hospital provided support in the amount of $17,000 to The Connor's Climb Foundation which is dedicated to preventing youth suicide. The nonprofit raises funds locally to support suicide prevention and education programs in New Hampshire. All of the funds raised directly impact programs for suicide awareness, education and prevention in the New Hampshire Community.
Part VI, Line 7, Reports Filed With StatesNH

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (28 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescAddress Line2USAddress/AddressLine2Txt
Arts in Reach - Encouraging Growth Through the Arts
PO Box 236PortsmouthNH03802020507428501(c)(3)$17,500Support organization's mission to provide support/service to disadvantaged teen-age girls
Big Brothers Big Sisters of New Hampshire
25 Lowell StreetManchesterNH03101020348477501(c)(3)$12,500Support organization's mission to provide programs and services that promote positive change in children identified as being at risk
Carriage Barn Equestrian Center Therapeutic Riding Program Inc
PO Box 247East KingstonNH03827050526877501(c)(3)$25,000Support programs that seek to promote the health and well-being of disabled individuals of all ages
Community Colleges of New Hampshire Foundation
26 College DriveConcordNH03301020516490501(c)(3)$10,000Contribution to Great Bay Community College's Distinguished Leaders Fund
Connors Climb Foundation
PO Box 283ExeterNH03833473553455501(c)(3)$17,000Grant for suicide awareness and prevention
Cooperative Alliance for Seacoast Transportation
42 Sumner DriveDoverNH03820020362579501(c)(3)$5,000Public Transportation
Core Physicians LLC
5 Alumni DriveExeterNH03833870807914501(c)(3)$11,820Reimbursement of expenses incurred supporting "Patient Assistance Program RX" (Medication Bridge)
Exeter Junior Baseball and Softball League Inc
PO Box 471ExeterNH03833753241754501(c)(3)$7,000Sponsors the organization's primary purpose which is to develop good sportsmanship among all players for the betterment of their emotional and social well-being
Families First of the Greater Seacoast
100 Campus Drive Suite 12PortsmouthNH03801222757341501(c)(3)$52,000Annual funding contribution that helps Families First continue to provide a broad range of health and family services to all regardless of ability to pay
Gather
210 West RoadPortsmouthNH03801020226943501(c)(3)$26,000Support organization's commitment to ending local hunger through collaboration and leadership
Girls on the Run New Hampshire
137 Water StreetExeterNH03833020524090501(c)(3)$15,000Support organization mission to elevate and prepare girls for a lifetime of self respect and healthy living
Haven Violence Prevention and Support Services
20 International DrivePortsmouthNH03801020337620501(c)(3)$40,000Support organization's mission to prevent sexual assualt, domestic violence and stalking
Lamprey Healthcare Inc
207 South Main StreetNewmarketNH03857237305106501(c)(3)$390,500Supports the provision of high quality medical care and health related services to the communities it serves regardless of the patients' ability to pay
NAMI New Hampshire
85 North State StreetConcordNH03301222760743501(c)(3)$6,000Support for people affected by mental illness
New Heights Adventures for Teens
100 Campus Drive Suite 23PortsmouthNH03801271918243501(c)(3)$50,000Supports this comprehensive out-of-school program for young people to develop the competence, character, confidence and resiliency for a healthy successful adulthood
Prescott Park Arts Festival Inc
PO Box 4370PortsmouthNH03802020370018501(c)(3)$5,000Promote artistic excellence in the community
Raymond Coalition for Youth
4 Epping StreetRaymondNH03077020713987501(c)(3)$11,500Mobilize resources to promote positive youth development, family strengthening, and community building activities
Richie McFarland Children's Center
11 Sandy Point RoadStrathamNH03885020302005501(c)(3)$7,000Supports providing developmental and therapy services for children with and without special needs, support and education to their families and guidance in accessing community and health resources
Seacoast Child Advocacy Center Inc
100 Campus DrivePortsmouthNH03801020510546501(c)(3)$6,500Support to provide a safe, friendly environment for interviews and evaluation of alledged child abuse
Seacoast Eat Local Inc
2 Washington Street Suite 331DoverNH03820452547575501(c)(3)$5,080To advocate for eating locally grown food for the health of our community, environment and economy
Seacoast Family Promise
27 Hampton RoadExeterNH03833020529881501(c)(3)$8,000Empower families with children experiencing homelessness to achieve sustainable independence through community based response$2,786Book ValueVarious household appliances and furniture
Seacoast Mental Health Center Inc
1145 Sagamore AvenuePortsmouthNH03801020262862501(c)(3)$10,000Support organization's mission to provide high quality, effective accessible mental health services
Seacoast Pathways
PO Box 1528PortsmouthNH03802462658558501(c)(3)$5,000Support individuals living with the effects of mental illness
Society of St Vincent de Paul Exeter Inc
PO Box 176ExeterNH03833203945985501(c)(3)$20,000Grant for substance abuse, transportation and food delivery to homebound seniors$1,614Book ValueTray line food products
Southern District YMCA-Camp Lincoln Inc
56 Linden StreetExeterNH03833043383996501(c)(3)$12,500Community benefits grant/suicide prevention
Transportation Assistance for Seacoast Citizens
200 High StreetHamptonNH03842262869209501(c)(3)$5,000Donation to assist the provision of transportation to the seacoast community
University of New Hampshire Foundation Inc
Elliott Alumni Center 9 EdgewoodDurhamNH03824020437506501(c)(3)$7,500Support Northeast Passage's adaptive sports and recreation programsRoad
Womenade of Greater Squamscott
PO Box 653StrathamNH03885202173469501(c)(3)$6,000Grant to provide short term financial assistance to those in need/fundraiser sponsor
FieldValueIRS element (for citing)
Total501c3 Org28Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationAll requests for grants/contributions/sponsorships over $5,000 require the approval of at least the Vice President of Strategy, Community Relations and Development to ensure that they are consistent with our mission, values and strategic plan. Large grants like those given to Carriage Barn, Families First, Gather, Haven, Lamprey, New Heights and Society of St. Vincent DePaul are also reviewed by the Chief Financial Officer and Chief Executive Officer prior to approval. Each of those requesting organizations either provides a written summary of how they have used our previous support as well as their specific plans for any new requested funding or they make a presentation in person usually to the Chief Financial Officer, the Chief Executive Officer and the Vice President of Strategy, Community Relations and Development. Each year a subcommittee of Exeter Health Resources, Inc.'s (parent company) Board of Trustees is charged with overseeing our Community Benefits program and our community needs assessment and reviews a detailed report on the previous year's grants/ contributions/sponsorships and approves the current year's plan for community support. That subcommittee and the larger Exeter Health Resources' (parent company) Board of Trustees are regularly updated on our community support initiatives.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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
Richard Hollister MD
Ex-Officio Member$0$322,852$0$80,554$0$63,757$0$7,950$0$20,353$0$495,466$0$0
Kevin J Callahan
CEO/Trustee$0$609,697$0$210,000$0$1,529,260$0$167,950$0$24,924$0$2,541,831$0$1,120,000
Kevin J O'Leary
CFO/Treasurer$0$382,929$0$116,625$0$14,471$0$75,950$0$17,164$0$607,139$0$0
Constance D Sprauer
Sr. VP Legal Affairs/Secretary$0$279,818$0$42,500$0$7,102$0$15,900$0$17,093$0$362,413$0$0
Brian Campbell
VP Ambulatory Care$211,429$0$74,536$0$12,152$0$15,900$0$23,552$0$337,569$0$0$0
Donna McKinney
VP Acute Care$224,361$0$59,482$0$9,948$0$15,900$0$22,060$0$331,751$0$0$0
Jonathan Jackson
Physicist$241,205$0$7,500$0$630$0$15,192$0$15,711$0$280,238$0$0$0
Jane Peterson
Director$178,398$0$13,649$0$2,386$0$11,738$0$284$0$206,455$0$0$0
Susan Callahan
Director$148,659$0$19,488$0$18,391$0$11,271$0$8,580$0$206,389$0$0$0
Joan Raczy
Pharmacist$160,627$0$0$0$23,350$0$11,539$0$23,482$0$218,998$0$0$0
Deanna King
Director$168,499$0$11,598$0$2,102$0$11,365$0$23,994$0$217,558$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3The CEO of Exeter Hospital, Inc. is compensated by a related organization, Exeter Health Resources, Inc. Exeter Health Resources, Inc. uses a compensation committee, an independent compensation consultant, a compensation survey and approval by the Board or Compensation Committee.
Part I, Line 4bThe organization's parent (Exeter Health Resources, Inc.) maintains a split dollar supplemental retirement plan for two executives (listed below with amounts) selected by the Exeter Health Resources Inc. Board of Trustees. The plan is closed to future participants. The Plan provides for annual payments of premiums for life insurance policies insuring the listed individuals. Those life insurance premiums are collaterally assigned to the corporation and any excess accumulated value in the policies (net of accumulated premium payments which are returned to the organization upon the executive attaining the age of 70 or at the death of the participant) is available to be paid to the participant once vested at age 62 and upon retirement from the organization. Note that the split-dollar arrangement is part of an employee benefit program and economically not a direct extension of credit. Furthermore, the reportable compensation of the respective employees includes the annual value of the life insurance provided. Life insurance premium payments during tax year: Kevin Callahan $ 130,022 Kevin O'Leary $ 70,894 Excess Accumulated Value: Kevin Callahan $2,583,976 Kevin O'Leary $1,047,139 Certain of the listed employees participate in a nonqualified deferred compensation plan as described in Internal Revenue Code Section 457 (f) sponsored by Exeter Health Resources Inc., In the calendar year ended December 31, 2016 the contribution to the plan for the vested benefit of Kevin Callahan was $160,000 and the contribution to the plan for the non-vested benefit of Kevin O'Leary was $68,000. The contributions are intended to provide a forfeitable supplemental retirement benefit. Participants in the 457(f) plan do not vest until age 62 when it is payable to the participant. During the calendar year ended December 31, 2016, Kevin Callahan reached the age of 62 and received a total distribution equal to $1,487,265 from the 457(f) plan. It should be noted that this distribution includes plan contributions reported on prior years; Forms 990, Part VII, Column F and also on Schedule J, Column C as deferred compensation. Accordingly, the total amount of previously reported plan contributions, $1,120,000 is reflected on Schedule J, Part II, Column F so as to not overstate compensation in the current year that was earned over a period of many years.
Part I, Line 7The organization's parent (Exeter Health Resources, Inc.) provides an annual incentive compensation plan for executives selected by the Exeter Health Resources Board of Trustees. These executives include: Kevin Callahan, Kevin O'Leary, Constance Sprauer, Brian Campbell and Donna McKinney. The Board and / or its Executive Committee approves measurable achievement criteria for quality, patient satisfaction, process improvement, financial performance, services innovation and other compelling areas of strategic and operational interest. Additionally, the Board and /or its Executive Committee establishes minimum, targeted and maximum levels for incentive awards and approves all awards for participating executives. Jonathan Jackson, Jane Peterson, Susan Callahan, and Deanna King participate in an annual incentive program which is administered by Exeter Hospital, Inc.'s Human Resources Department. The management of Exeter Hospital, Inc. approves measureable achievement criteria for Quality/Innovation, Patient Satisfaction, Process Improvement and Financial Performance on an annual basis that aligns with overall strategic interests of the company. The incentive award levels are established at minimum, target and maximum levels and those incentive awards are approved by operating management and Human Resources.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
NH Health and Education Facilities Authority
A020279866NONEAVAIL2012-02-09$32,565,000Refinancing and refunding prior bond issuance000
NH Health and Education Facilities Authority
B020279866NONEAVAIL2015-03-02$24,020,000Refinancing and refunding prior bond issuance000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$32,565,000$215,404$32,349,596201200Yes (1)Yes (1)
B$24,020,000$162,154$23,857,846201500Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.0000000Yes (1)
B00000.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
AYes (1)Yes (1)000Yes (1)
BYes (1)Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6Exeter Health Resources, Inc., a charitable organization acting through its Board of Trustees, is the sole member of the organization.
Form 990, Part VI, Section A, line 7aThe Board of Trustees shall consist of a number not to exceed fifteen (15) persons. Of this number, up to thirteen (13) persons shall have been elected by the Member from among the elected members of the Board of Trustees of the Member.
Form 990, Part VI, Section A, line 7bThe sole member, Exeter Health Resources, Inc. has the right to approve decisions of the governing body. Additionally, the Member shall have the power to change the corporate name, merge with or acquire any corporation organized under Chapter 292 of the Revised Statutes Annotated of New Hampshire, amend the articles of agreement, dissolve the Corporation, annually appoint an independent certified public accountant to perform an audit of the accounts of the Corporation, and such other powers and rights as may be reserved to it by law or the articles of agreement.
Form 990, Part VI, Section B, line 11bThe Form 990 is prepared by an outside tax accountant with information provided by the organization. The Form 990 is reviewed by the organization's Treasurer and then presented to the Board of Trustees before it is filed with the IRS.
Form 990, Part VI, Section B, line 12cThe Board of Trustees has adopted a Conflict of Interest Policy that requires the disclosure of conflicts of interest either when the interest becomes a matter of possible action by the Board or during an annual disclosure process. Trustees, officers, and key employees, as well as all members of senior management, are part of the annual disclosure process, which is initiated by the issuance of a memorandum and accompanying questionnaire by the President and Chief Executive Officer (CEO). All disclosures are reviewed. Any trustee with a conflict of interest is required to abstain from voting and is not included in a quorum determination on the matter and any officer, key employee, or member of senior management with a conflict does not take part in making and is not present for any decision regarding the matter. The policy is monitored and enforced by both the President and CEO and the full Board. There are two additional conflicts of interest policies. One is applicable to all employees and contracted staff and the other is applicable to members of the Medical Staff and allied health professionals. The former policy is monitored and enforced by the Vice President of Human Resources and the Vice President of Corporate Integrity and Compliance and the latter is monitored and enforced by the President of the Medical Staff, President and CEO, General Counsel, and Compliance Officer. On an annual basis, staff within Human Resources survey all employees and contracted staff serving in a managerial role, as well as members of any committees that make recommendations or decisions regarding the purchase of goods or services by any of the corporations as a means to ensure that any conflict of interest is disclosed and appropriately managed. Employees otherwise are required to supplement or make any further written disclosure at the time a conflict arises.
Form 990, Part VI, Section B, line 15The organization's parent (Exeter Health Resources, Inc.) has a formal process for determining total compensation for the CEO and other listed officers that is intended to provide reasonable compensation for achieving the organization's mission, to recognize individual and team performance and to comply with the organization's obligations as a tax-exempt charitable organization. The Executive Committee of the Exeter Health Resources, Inc.'s Board of Trustees conducts an annual review of the compensation of the CEO, other listed officers and key employees. In doing so, the Committee retains a qualified independent compensation consultant to conduct competitive market analysis of the market ranges of base, incentive, and total cash compensation, and to provide advice concerning the reasonableness of the compensation of the CEO, other listed officers and key employees. The Committee utilizes that analysis and other appropriate information in connection with its annual review and makes recommendations to the full board of Exeter Health Resources, Inc. for adjustment of the CEO's compensation and the compensation for other listed officers. Information which the committee may consider can include but is not limited to the performance of an individual and/or that individual's contributions to a team, the performance of the organization in whole and in part, the elements of total compensation and salary history, the organization's compensation targets and comparability data, including the data prepared by the independent consultant and reviewed with the Committee. The Committee incorporates a performance appraisal process in the CEO's, other listed officers and key employees' compensation review. The CEO, other listed officers and key employees are not present when the committee discusses their respective compensation. In addition, the committee determines if the threshold requirements for incentive awards are met, consisting of the organization's performance results for quality, operating system excellence and financial performance. The results of the Committee's deliberations are presented to the Exeter Health Resources, Inc. Board and include recommendations concerning salary range adjustments and incentive awards and the basis for the Committee's decisions/recommendations. The deliberations of the Exeter Health Resources, Inc. Board are conducted in executive session with the independent members of the Board but do include the CEO only for that period of time in which the Exeter Health Resources, Inc. Board has questions concerning the performance of any listed officer or key employee other than the CEO. The Exeter Health Resources, Inc. Board reviews the CEO's performance and determines if the adjustments and awards recommended by the committee for the CEO are in the organization's best interest and for the benefit of the organization and its parent organization. For the other listed officer positions, adjustments and incentive awards are approved upon recommendation of the CEO by the Executive Committee within the Exeter Health Resources, Inc. Board approved parameters and ratified by the Exeter Health Resources, Inc. Board of Trustees. Adjustments and awards for other listed key employees are approved upon recommendation of the CEO by the Executive Committee within the Exeter Health Resources, Inc. Board approved parameters and reviewed by the Board.
Form 990, Part VI, Section C, line 19These documents are available upon request.
Form 990, Part VI-B, Line 16b:Although written policies were not in place as of the end of the year covered by this tax return requiring the organization to evaluate its participation in joint venture arrangements under applicable federal law to ensure that the organization's exempt status is protected, the organization performed due diligence with respect to its joint venture arrangements to safeguard the organization's exempt status.
Form 990, Part IX, line 11gPayment to Affiliate: Program service expenses 4,011,493. Management and general expenses 482,270. Fundraising expenses 0. Total expenses 4,493,763. Physician Fees: Program service expenses 7,058,882. Management and general expenses 848,633. Fundraising expenses 0. Total expenses 7,907,515. Contracted Services: Program service expenses 3,201,267. Management and general expenses 384,863. Fundraising expenses 0. Total expenses 3,586,130. Outside Fees: Program service expenses 3,027,481. Management and general expenses 363,970. Fundraising expenses 0. Total expenses 3,391,451. Contract/Temporary Labor: Program service expenses 2,479,098. Management and general expenses 298,042. Fundraising expenses 0. Total expenses 2,777,140. Consulting: Program service expenses 666,829. Management and general expenses 80,168. Fundraising expenses 0. Total expenses 746,997.
Form 990, Part XI, line 9:Net Transfers to Affiliates -23,099,770. Pension Liability Adjustment 4,718,302. Impact of Interest Rate Swaps 2,403,455. Net Assets Released from Restriction 44,247.
Form 990, Part XII, Line 2c:The organization is part of the consolidated operations of Exeter Health Resources, Inc. The Exeter Health Resources, Inc. Executive Committee is responsible for the oversight of the audit and the selection of an independent accountant. There has been no change in the audit process since the prior year.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Exeter Health Resources Inc
5 Alumni DriveExeterNH03833020222126Management and Supporting Organization; Holding CompanyNH501(c)(3)Line 12a, I0
Core Physicians LLC
5 Alumni DriveExeterNH03833870807914Physician PracticesNH501(c)(3)Line 100Exeter Health Resources Inc
Rockingham Visiting Nurse Association
5 Alumni DriveExeterNH03833020274905Home Care, HospiceNH501(c)(3)Line 100Exeter Health Resources Inc
Matrix Health Inc
5 Alumni DriveExeterNH03833020473737Manage ResourcesNH501(c)(3)Line 12b, II0Exeter Health Resources Inc
Exeter Med Real Inc
5 Alumni DriveExeterNH03833020418718Real Estate Holding CompanyNH501(c)(25)0Exeter Health Resources Inc
Exeter Health Resources Self-Insurance Trust
5 Alumni DriveExeterNH03833200753662Self Insurance TrustNH501(c)(3)Line 12a, I0Exeter Health Resources Inc

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Core Health Services of MABusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15 Alumni DriveAddressLine1Txt
CityExeterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03833ZIPCd
FieldValueIRS element (for citing)
EIN201598042EIN
Primary ActivitiesInactive Physician PracticePrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Exeter Med Real Inc
K$2,035,781Cash
Exeter Med Real Inc
L$471,649Cash