CHESHIRE MEDICAL CENTER: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: CHESHIRE MEDICAL CENTER (EIN 02-0354549)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-15
IRS object ID: 201811359349311106
Schema version: 2016v3.1
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-15T15:23:34-05:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BAKER NEWMAN & NOYES LLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	650 ELM STREET SUITE 302	AddressLine1Txt
City	MANCHESTER	CityNm
State Abbreviation	NH	StateAbbreviationCd
ZIP	03101	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	020354549	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	The Cheshire Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% KATHRYN WILLBARGER	InCareOfNm
Business Name Control	CHES	BusinessNameControlTxt
Phone	6033545400	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	580-590 Court Street	AddressLine1Txt
City	Keene	CityNm
State Abbreviation	NH	StateAbbreviationCd
ZIP	034315400	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DON CARUSO	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	6033545400	PhoneNum
Signature	2018-05-15	SignatureDt

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Timothy R Hepburn	PreparerPersonNm
PTIN	P00182393	PTIN
Phone	8002447444	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Don Caruso	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	580-590 Court Street	AddressLine1Txt
City	Keene	CityNm
State Abbreviation	NH	StateAbbreviationCd
ZIP	034315400	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$205,018,210	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.cheshire-med.com	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1980	FormationYr
Legal Domicile State	NH	LegalDomicileStateCd
Activity Or Mission	To lead Keene, NH to become the nation's healthiest community through clinical and service excellence, collaborations, and compassion for every patient, every time	ActivityOrMissionDesc
Voting Members Governing Body	18	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	1314	TotalEmployeeCnt
Total Volunteers	169	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$971,455	PYContributionsGrantsAmt
CY Contributions Grants	$1,019,827	CYContributionsGrantsAmt
PY Program Service Revenue	$162,842,712	PYProgramServiceRevenueAmt
CY Program Service Revenue	$200,628,728	CYProgramServiceRevenueAmt
PY Investment Income	$115,332	PYInvestmentIncomeAmt
CY Investment Income	$1,442,230	CYInvestmentIncomeAmt
PY Other Revenue	$1,696,200	PYOtherRevenueAmt
CY Other Revenue	$1,927,245	CYOtherRevenueAmt
PY Total Revenue	$165,625,699	PYTotalRevenueAmt
CY Total Revenue	$205,018,030	CYTotalRevenueAmt
PY Grants And Similar Paid	$219,946	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,156,399	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$75,660,041	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$121,758,429	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$94,760,044	PYOtherExpensesAmt
CY Other Expenses	$84,227,294	CYOtherExpensesAmt
PY Total Expenses	$170,640,031	PYTotalExpensesAmt
CY Total Expenses	$207,142,122	CYTotalExpensesAmt
PY Revenues Less Expenses	-$5,014,332	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$2,124,092	CYRevenuesLessExpensesAmt
Total Assets BOY	$134,879,963	TotalAssetsBOYAmt
Total Assets EOY	$126,657,747	TotalAssetsEOYAmt
Total Liabilities BOY	$74,712,747	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$63,505,786	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$60,167,216	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$63,151,961	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE CHESHIRE MEDICAL CENTER IS A COMMUNITY HOSPITAL LOCATED IN KEENE, NEW HAMPSHIRE WITH A MISSION TO LEAD OUR COMMUNITY TO BECOME THE NATIONS HEALTHIEST COMMUNITY THROUGH OUR CLINICAL AND SERVICE EXCELLENCE, COLLABORATION, AND COMPASSION FOR EVERY PATIENT, EVERY TIME.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$176,999,289	ExpenseAmt
Grant	$1,156,399	GrantAmt
Revenue	$202,554,537	RevenueAmt
Desc	The Cheshire Medical Center (CMC), is a community hospital located in Keene, New Hampshire. CMC is a not-for-profit organization, as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from Federal income taxes on related income pursuant to Section 501(a) of the Code. On March 2, 2014, CMC affiliated with Dartmouth-Hitchcock Health ("D-HH") a non-profit tax-exempt corporation with a principal place of business at One Medical Center Drive, Lebanon, New Hampshire. Consistent with the D-HH vision and strategy to create a sustainable health system, CMC and D-HH share a common commitment to improving population health, value-based care, and creating new payment models for the benefit of the citizens of New Hampshire and Vermont. CMC provides a broad range of patient services and health related community services, consistent with its role as a community hospital. These include a full range of services in both acute and critical medicine, surgery, and rehabilitation. During FY17 CMC provided 19,147 days of inpatient care and had 4,154 hospital discharges, while the emergency department was open to the public 24 hours per day, 7 days per week and had 22,964 patient visits. Each year Cheshire Medical Center files an annual Community Benefit Report with the State of New Hampshire which outlines the community and charitable benefits they provide. The most recent Community Benefit Reports are available upon request or can be found on Cheshires website (http://www.cheshire-med.com/about_us/communityben_report.html). The Community health activities include the cost or value of several different types of programs including the cost of community based education programs, involving a variety of chronic disease and wellness topics such as: stress management and resiliency, nutrition, physical education and exercise, high blood pressure prevention and monitoring, diabetes prevention and monitoring, advanced directive planning, and others. In total, CMC provided over $8 million in Community Benefits including unreimbursed charity care, health services, health profession education, subsidized health services, and community-building activities. These contributions are in addition to the over $25 million dollars in unreimbursed Medicaid and Medicare costs absorbed by CMC.	Desc
Total Program Service Expenses	$176,999,289	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	178	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1314	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	18	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NH	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	KATHRYN WILLBARGER	PersonNm
Phone	6033545454	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	580-590 COURT STREET	AddressLine1Txt
City	Keene	CityNm
State Abbreviation	NH	StateAbbreviationCd
ZIP	034315400	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Ed Bergeron Jr
Trustee end 1/1/17	1.0	0.0	Yes (X)	$0	$0	$0
John Birkmeyer MD
Trustee end 10/14/16	1.0	60.0	Yes (X)	$0	$881,467	$39,333
Judith Boule MD
Trustee end 1/1/17	1.0	40.5	Yes (X)	$0	$318,698	$285,605
H Roger Hansen
Trustee/Vice Chair	1.0	1.5	Yes (X)	$0	$0	$0	Yes (X)
Nathalie Houder
Trustee/Treasurer	1.0	0.5	Yes (X)	$0	$0	$0	Yes (X)
Michael Kapiloff
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
Geof Molina
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
Steven Paris MD
Trustee/At Large eff 1/1/17	1.0	41.01	Yes (X)	$0	$419,708	$51,805
Leslie Pitts MD
Trustee	1.0	40.0	Yes (X)	$0	$311,687	$206,097
Kary Shumway
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
Katherine Snow
Trustee/Secretary eff 1/1/17	1.0	1.0	Yes (X)	$0	$0	$0	Yes (X)
Sylvia McBeth
Trustee end 1/1/17	1.0	0.0	Yes (X)	$0	$0	$0
Gregg Tewksbury CPA
Trustee/Board Chair	2.0	0.5	Yes (X)	$0	$0	$0	Yes (X)
Mary Louise Caffrey
Trustee/Bd Scrtry end 1/1/17	1.0	0.5	Yes (X)	$0	$0	$0	Yes (X)
Don Caruso MD
Trustee/CEO	1.0	42.0	Yes (X)	$0	$481,452	$245,158	Yes (X)
Cherie Holmes MD
Trustee/Ex-Officio	1.0	40.0	Yes (X)	$0	$420,601	$124,316
Wendy Fielding
Trustee	1.0	40.0	Yes (X)	$0	$236,246	$39,755
Timothy Fisher MD
Trustee end 1/1/17	1.0	40.0	Yes (X)	$0	$355,429	$42,897
Maria Padin
Trustee eff 1/1/17	1.0	61.0	Yes (X)	$0	$409,356	$197,804
Anne Huot
Trustee eff 1/1/17	1.0	0.0	Yes (X)	$0	$0	$0
Martha Landry
Trustee eff 1/1/17	1.0	0.0	Yes (X)	$0	$0	$0
John Round
Trustee eff 1/1/17	1.0	0.0	Yes (X)	$0	$0	$0
Andrew Tremblay MD
Trustee eff 1/1/17	1.0	40.0	Yes (X)	$0	$289,219	$58,272
Jennifer DiNubila DO
Trustee eff 1/1/17	1.0	40.0	Yes (X)	$0	$354,876	$34,709
Robert Cochrane
CFO End 2/28/2017	51.0	2.0		$296,476	$0	$21,666	Yes (X)
Cindi Coughlin
CNO	40.0	0.0		$220,836	$0	$115,253	Yes (X)
Kathryn Willbarger
VP Finance eff 3/1/17	40.0	0.0		$120,771	$0	$30,759	Yes (X)
Paul Pezone
VP Facilities & Support Srvcs	40.0	0.0		$202,370	$0	$24,839		Yes (X)
Julie Green
VP Human Resources	40.0	0.0		$202,458	$0	$29,316		Yes (X)
Erli Chen
Physicist	40.0	0.0		$227,194	$0	$44,742			Yes (X)
Latasha Heape
Chief CRNA	50.0	0.0		$168,596	$0	$23,370			Yes (X)
Jose Montero
VP Pop Hlth/Sys End 11/13/16	40.0	0.0		$219,110	$0	$23,408			Yes (X)
Denis Fortier
Director of Pharmacy	40.0	0.0		$152,722	$0	$32,920			Yes (X)
Peter Malloy
CIO End 2/3/17	40.0	0.0		$151,485	$0	$17,985			Yes (X)
Arthur W Nichols
Former President	0.0	0.0		$506,030	$0	$73,485				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,468,048	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$4,478,739	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,763,494	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	45	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Fresenius Management Services
16343 Collections Center Drive	CHICAGO	IL	60693	Dialysis Service	$235,971
The MacMillin Company LLC
17 Elm Street	KEENE	NH	03431	Construction	$280,924
Experis US Inc
29973 Network Place	CHICAGO	IL	60673	Staffing Service	$209,781
Biofire Diagnostics LLC
PO Box 581463	SALT LAKE CITY	UT	84158	Diagnostic Testing	$199,205
KE Bergeron Mechanical
PO Box 48	DUBLIN	NH	03444	Construction	$180,503

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	17	CntrctRcvdGreaterThan100KCnt
Related Organizations	$338,618	RelatedOrganizationsAmt
Government Grants	$384,392	GovernmentGrantsAmt
All Other Contributions	$296,817	AllOtherContributionsAmt
Total Contributions	$1,019,827	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621300	$198,766,540	$198,766,540
PHARMACY AND DRUGS	446110	$569,535	$569,535
FOOD SERVICES	722210	$1,085,559	$1,085,559
MISCELLANEOUS HEALTH SERVICES	621300	$81,749	$81,749
GIFT SHOP INCOME	453220	$113,274	$113,274

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,071	TotalRevenueColumnAmt
Related Or Exempt Func Income	$12,071	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$200,628,728	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,100,697	TotalRevenueColumnAmt
Exclusion	$1,100,697	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Personal	$1,616	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Personal	$180	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$1,436	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,436	TotalRevenueColumnAmt
Exclusion	$1,436	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$336,533	SecuritiesAmt
Other	$5,000	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$336,533	SecuritiesAmt
Other	$5,000	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$341,533	TotalRevenueColumnAmt
Exclusion	$341,533	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEANINGFUL USE	621300	$168,350	$168,350
CHILDCARE INCOME	624410	$660,714	$660,714
REBATES AND DISCOUNTS	621300	$702,179	$702,179

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$394,566	TotalRevenueColumnAmt
Related Or Exempt Func Income	$394,566	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,925,809	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$205,018,030	TotalRevenueColumnAmt
Related Or Exempt Func Income	$202,554,537	RelatedOrExemptFuncIncomeAmt
Exclusion	$1,443,666	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$340,119	TotalAmt
Program Services	$340,119	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$816,280	TotalAmt
Program Services	$816,280	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,912,663	TotalAmt
Program Services	$1,564,558	ProgramServicesAmt
Management And General	$348,105	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$437,802	TotalAmt
Management And General	$437,802	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$86,351,819	TotalAmt
Program Services	$70,635,788	ProgramServicesAmt
Management And General	$15,716,031	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,079,523	TotalAmt
Program Services	$1,701,050	ProgramServicesAmt
Management And General	$378,473	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$27,207,708	TotalAmt
Program Services	$22,255,905	ProgramServicesAmt
Management And General	$4,951,803	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,768,914	TotalAmt
Program Services	$3,082,972	ProgramServicesAmt
Management And General	$685,942	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$103,142	TotalAmt
Program Services	$84,370	ProgramServicesAmt
Management And General	$18,772	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$69,690	TotalAmt
Program Services	$57,006	ProgramServicesAmt
Management And General	$12,684	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$17,835	TotalAmt
Program Services	$17,835	ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$45,100	TotalAmt
Program Services	$45,100	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$16,262,852	TotalAmt
Program Services	$13,303,013	ProgramServicesAmt
Management And General	$2,959,839	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$777,920	TotalAmt
Program Services	$636,339	ProgramServicesAmt
Management And General	$141,581	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,578,199	TotalAmt
Program Services	$1,290,967	ProgramServicesAmt
Management And General	$287,232	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$8,692,825	TotalAmt
Program Services	$7,110,731	ProgramServicesAmt
Management And General	$1,582,094	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$254,594	TotalAmt
Program Services	$208,258	ProgramServicesAmt
Management And General	$46,336	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$78,400	TotalAmt
Program Services	$78,400	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,019,078	TotalAmt
Program Services	$833,606	ProgramServicesAmt
Management And General	$185,472	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$10,345,816	TotalAmt
Program Services	$8,462,877	ProgramServicesAmt
Management And General	$1,882,939	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$669,779	TotalAmt
Program Services	$547,879	ProgramServicesAmt
Management And General	$121,900	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$33,039,596	$33,039,596
MET AND PILOT TAXES	$8,140,932	$8,140,932
FOOD AND CAFETERIA EXPENSES	$1,011,603	$1,011,603
CHILD CARE EXPENSES	$829,286	$678,356	$150,930

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,290,647	TotalAmt
Program Services	$1,055,749	ProgramServicesAmt
Management And General	$234,898	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$207,142,122	TotalAmt
Program Services	$176,999,289	ProgramServicesAmt
Management And General	$30,142,833	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$15,651,110	BOYAmt
EOY	$10,644,911	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$17,351,293	BOYAmt
EOY	$17,222,925	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,895,599	BOYAmt
EOY	$3,135,600	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,111,297	BOYAmt
EOY	$1,953,881	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$211,371,961	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$146,438,926	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$71,445,933	BOYAmt
EOY	$64,933,035	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$20,406,022	BOYAmt
EOY	$23,868,744	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$944,847	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$2,067,141	BOYAmt
EOY	$1,008,141	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$286,667	BOYAmt
EOY	$179,167	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,720,054	BOYAmt
EOY	$3,711,343	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$134,879,963	BOYAmt
EOY	$126,657,747	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$8,296,967	BOYAmt
EOY	$6,276,717	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$101,463	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$28,037,718	BOYAmt
EOY	$26,964,602	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$38,378,062	BOYAmt
EOY	$30,163,004	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$74,712,747	BOYAmt
EOY	$63,505,786	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$55,694,213	BOYAmt
EOY	$58,249,962	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,473,003	BOYAmt
EOY	$4,901,999	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$60,167,216	BOYAmt
EOY	$63,151,961	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$134,879,963	BOYAmt
EOY	$126,657,747	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$2,124,092	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$2,138,448	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$2,970,389	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$17,835	OtherActivitiesAmt
Total Lobbying Expenditures	$17,835	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Form 990 Schedule C, Part II B, Line 1I	FormAndLineReferenceDesc
Explanation	Cheshire Medical Center pays dues to various organizations related to its exempt mission. The amount reported under other activities on line 1I refers to the amount of lobbying activities identified in dues payments to outside organizations.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,542,620	BeginningYearBalanceAmt
Contributions	$209,216	ContributionsAmt
Investment Earnings Or Losses	$175,241	InvestmentEarningsOrLossesAmt
Other Expenditures	$66,580	OtherExpendituresAmt
End Year Balance	$4,860,497	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,646,853	BeginningYearBalanceAmt
Contributions	$264,489	ContributionsAmt
Investment Earnings Or Losses	$60,023	InvestmentEarningsOrLossesAmt
Other Expenditures	$428,745	OtherExpendituresAmt
End Year Balance	$4,542,620	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,487,520	BeginningYearBalanceAmt
Contributions	$968,233	ContributionsAmt
Investment Earnings Or Losses	$414,873	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,223,773	OtherExpendituresAmt
End Year Balance	$4,646,853	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,602,059	BeginningYearBalanceAmt
Contributions	$272,723	ContributionsAmt
Investment Earnings Or Losses	$929,038	InvestmentEarningsOrLossesAmt
Other Expenditures	$316,300	OtherExpendituresAmt
End Year Balance	$4,487,520	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,055,274	BeginningYearBalanceAmt
Contributions	$234,785	ContributionsAmt
Investment Earnings Or Losses	$688,499	InvestmentEarningsOrLossesAmt
Other Expenditures	$376,499	OtherExpendituresAmt
End Year Balance	$3,602,059	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Term Endowment Balance EOY	1.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$231,151	OtherCostOrOtherBasisAmt
Book Value	$231,151	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$90,282,038	OtherCostOrOtherBasisAmt
Depreciation	$51,036,067	DepreciationAmt
Book Value	$39,245,971	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,262,455	OtherCostOrOtherBasisAmt
Depreciation	$2,596,095	DepreciationAmt
Book Value	$666,360	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$117,593,317	OtherCostOrOtherBasisAmt
Depreciation	$92,806,765	DepreciationAmt
Book Value	$24,786,553	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,000	OtherCostOrOtherBasisAmt
Book Value	$3,000	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$64,933,035	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
PENSION LIABILITY	$14,311,503
DUE TO RELATED PARTY	$11,882,096
RESERVES FOR INSURANCE RELATED	$1,279,929
ESTIMATED THIRD PARTY SETTLEME	-$766,406
ACCRUED EARNED TIME	$3,455,882

Field	Value	IRS element (for citing)
Total Liability	$30,163,004	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Intended uses of Endowment Funds	FormAndLineReferenceDesc
Explanation	Form 990, Schedule D, Part V, Line 4 The intended use of the endowment funds is to promote and advance mission-related programs of The Cheshire Medical Center.	ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
Central America and the Caribbean	Investments	$2,586,365
North America	Investments	$1,527,162

Field	Value	IRS element (for citing)
Subtotal Spent	$4,113,527	SubtotalSpentAmt
Total Spent	$4,113,527	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (true)	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Activities per region	FormAndLineReferenceDesc
Explanation	Form 990, Schedule F, Part I, Line 3 The legal owner of The Cheshire Medical Center's foreign investments is a related organization, The Cheshire Health Foundation. Since a portion of the total foreign investments are allocated to the Medical Center's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, line 3 of The Cheshire Medical Center's Form 990. However, any required IRS Forms 926 and other foreign tax reporting obligations are filed by the legal owner, The Cheshire Health Foundation. Ownership interest in a foreign corporation Form 990, Schedule F, Part IV, Line 3 The Cheshire Medical Center did not have an ownership interest in any foreign corporation that is greater than the 10% filing threshold. Accordingly, IRS Form(s) 5471 are not required to be filed. Direct or Indirect shareholder of a PFIC or QEF during the tax year Form 990, Schedule F, Part IV, Line 4 The Cheshire Medical Center meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Medical Center.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	225.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,291,391	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$638,941	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$652,450	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,593,809	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,980,444	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,613,365	NetCommunityBenefitExpnsAmt
Total Expense	0.01740	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,885,200	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$23,619,385	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,265,815	NetCommunityBenefitExpnsAmt
Total Expense	0.02050	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,567,549	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$458,110	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,109,439	NetCommunityBenefitExpnsAmt
Total Expense	0.01020	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,422,873	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,422,873	NetCommunityBenefitExpnsAmt
Total Expense	0.00690	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,226,562	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$452,601	NetCommunityBenefitExpnsAmt
Total Expense	0.00220	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$210,220	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,233	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$203,987	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$432,610	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$432,610	NetCommunityBenefitExpnsAmt
Total Expense	0.00210	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,859,814	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$464,343	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,621,510	NetCommunityBenefitExpnsAmt
Total Expense	0.02240	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$33,745,014	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$24,083,728	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,887,325	NetCommunityBenefitExpnsAmt
Total Expense	0.04290	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	2965	PersonsServedCnt
Total Community Benefit Expns	$285,522	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$174,318	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$111,204	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	3242	PersonsServedCnt
Total Community Benefit Expns	$131,918	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$58,666	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$73,252	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$139,719	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$139,719	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	5	ActivitiesOrProgramsCnt
Persons Served	6207	PersonsServedCnt
Total Community Benefit Expns	$557,159	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$232,984	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$324,175	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,212,169	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,303,042	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$65,188,433	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$87,491,655	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$22,303,222	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Cheshire Medical Center	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	580 Court Street	AddressLine1Txt
City	Keene	CityNm
State Abbreviation	NH	StateAbbreviationCd
ZIP	03431	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.cheshire-med.com	WebsiteAddressTxt
State License	00014	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Cheshire Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Part V, Section C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	See Part V, Section C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	225.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Other Method	Yes (X)	OtherMethodInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Part V, Section C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Part V, Section C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Part V, Section C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Input from persons representing broad community interests	Form 990, Schedule H, Part V, Section B, Line 5 Needs were prioritized based on data collected from several current assessment processes. Prioritization was completed by CHNA Leadership team. Several hundred people participated in forums and surveys to identify needs.
CHNA conducted with one or more organizations	Form 990, Schedule H, Part V, Section B, Line 6A & 6B The Cheshire Medical Center collaborated with Dartmouth-Hitchcock Clinic and Mary Hitchchcock Memorial Hospital; New Hampshire Department of Health and Human Servces; Greater Monadnock Public Health Network; The New Hampshire Hospital Association; Foundation for Healthy Communities; Antioch University New England; Monadnock United Way; New Hampshire Center for Public Policy Studies; Southwestern Regional Planning Commission; and Home Healthcare, Hospice, and Community Services.
Community health needs assessment public availability	FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7a The Cheshire Medical Center's 2015 CHNA is available on the Medical Center's website at: http://www.cheshire-med.com/about_us/communityben_report.html
Community health needs implementation strategy	FORM 990, SCHEDULE H, PART V, SECTION B, LINE 10a The Cheshire Medical Center's 2015 CHNA Implementation Strategy is available on the Medical Center's website at: http://www.cheshire-med.com/about_us/communityben_report.html
Community health needs identified	FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11 The Cheshire Medical Center has implemented strategies to address all but two of the needs identified in its most recent CHNA. Access to behavioral health outpatient services is addressed by Community Partners Monadnock Family Services, Phoenix House, and MAPS Counseling Services. Expansion of personal and public transportation options is addressed by Community Partners Monadnock Regional Transportation Management Association, Home Healthcare Hospice and Community Services, and Southwest Regional Planning Commission.
Method for applying for financial assistance	Form 990, Schedule H, Part V, Section B, Line 15e The contact information for hospital facility staff available on the website (www.cheshire-med.com/patients_visitors/financial_assistance.html), in the supplemental FAP Brochure, and at all registration stations within the Medical Center.
Measures to publicize the Financial Assistance Policy	Form 990, Schedule H, Part V, Lines 16a, b, c, and i The Cheshire Medical Center's Financial Assistance Policy is available on the Medical Center's website at: http://www.cheshire-med.com/patients_visitors/financial_assistance.html The Cheshire Medical Center's FAP application is available on the Medical Center's website at: http://www.cheshire-med.com/patients_visitors/financial_assistance.html The Cheshire Medical Center's Plain Language Summary was available at all registration desks and by request and is available on the Medical Center's website at: http://www.cheshire-med.com/patients_visitors/financial_assistance.html
Maximum charges to financial assistance policy eligible individuals	Form 990, Schedule H, Part V, Section B, Line 22d The state of New Hampshire mandates a discount for all uninsured patients. This discount is equal to the average discount negotiated by the largest (by dollar) three commercial insurers. The Cheshire Medical Center has always been in full compliance with the laws of the state New Hampshire, and a committee is in place to ensure the hospital is in full compliance with final 501(r) regulations in areas where federal regulations differ from or are more stringent than those issued by the state. For fiscal year 2017, the uninsured discount rate was 45%.

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Cheshire Med Center Collecting Station
580-590 Court Street	Keene	NH	03431	Collecting Station
Cheshire Health Services Inc
580-590 Court Street	Keene	NH	03431	Non-Emergency Walk In Clinic

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Community Building Activities	Form 990, Schedule H, Part II The Medical Center has been actively engaged since the spring of 2006 in Healthy Monadnock (HM) 2020: to make Keene and the surrounding region the healthiest in the nation by the year 2020. Healthy Monadnock is a community engagement initiative designed to foster and sustain a positive culture of health through the Monadnock region. The initiative engages individuals, organizations, and partners to increase healthy eating and active living, increase income and jobs, improve mental wellbeing, increase emergency preparedness, reduce substance misuse including tobacco, increase educational attainment and increase access and quality of healthcare. The Healthy Monadnock website links the Community Health Improvement Plan, invites the public to get involved, and promotes partner strategies and successes. The Healthy Monadnock initiative supports the implementation of population level environmental strategies that promote wellness and prevent the leading causes of death in the community. The "Champions Program" engages individuals, schools, and organizations to take steps to improve health at a personal and institutional level. As of June 30, 2017 there are 3,582 individual champions, 182 organizational champions, and 25 school champions. Individuals are either improving their personal health or working in support of the Healthy Monadnock goals and strategies. Organizations and schools are working to implement evidence based environmental and policy chnages that supports the health of their employees/students. There are 10 community partners involved in forwarding 11 of the 21 HM action strategies to improve healthy eating and active living in the places where we live, learn, work, and play. Partner identification and engagement is on-going to implement the remaining action strategies to increase educational attainment, improve income and jobs, improve quality and access to health care, and improve mental wellbeing. The organization is a founding member of the Council for Health Communities which has been in existence for over 20 years and has developed a variety of prevention, transportation, referral, and health promotion programs and now serves as the Public Health Advisory Council for the Monadnock Region. The purpose of the CHC is to lead the Healthy Monadnock community driven process for providing strategic directions, setting priorities, facilitating implementation, aligning activities, and ensuring evaluation that will improve health outcomes in the Greater Monadnock region. Membership is diverse, open to representatives from all institutions and organizations. It includes unaffiliated individuals, to allow for independent voices and real grass roots engagement.
Bad Debt expense	Form 990, Schedule H, Part III, Section A, Line 2 At cost bad debt expense of $5,212,169 is 37% of the bad debt reported on The Cheshire Medical Center's Audited Financial Statements, which totals $14,125,119.
Estimated bad debt expense attributable to FAP eligible patients	Form 990, Schedule H, Part III, Section A, Line 3 Cheshire Medical Center Management estimates that approximately 25% of bad debt expense (approximately 5 times the region's poverty rate) is an appropriate estimation of patients who would have been eligible for the organization's financial assistance program but did not apply. This estimation is based on the recognition that the financial assistance program is available to residents with incomes of up to three times the federally defined poverty income levels and the assumption that patients who choose not to pay their bills are more likely to fall within the lower income levels. For 2017, the estimated amount of bad debt expense (at cost) attributable to patients who would have been eligible for financial assistance is $1,303,042.
Financial statement footnote describing bad debt expense	Form 990, Schedule H, Part III, Section A, Line 4 Footnote 1: Charity Care and Provision for Bad Debts The Health System provides care to patients who meet certain criteria under their financial assistance policies without charge or at amounts less than their established rates. Because the Health System does not anticipate collection of amounts determined to qualify as charity care, they are not reported as revenue. The Health System grants credit without collateral to patients. Most are local residents and are insured under third-party arrangements. Additions to the allowance for uncollectible accounts are made by means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon managements assessment of historical and expected net collections, business and economic conditions, trends in federal and state governmental healthcare coverage, and other collection indicators (Notes 1 and 4). Footnote 4: Accounts receivable are reduced by an allowance for estimated uncollectibles. In evaluating the collectability of accounts receivable, the Health System analyzes past collection history and identifies trends for several categories of self-pay accounts (uninsured, residual balances, precollection accounts and charity) to estimate the appropriate allowance percentages in establishing the allowance for bad debt expense. Management performs collection rate look-back analyses on a quarterly basis to evaluate the sufficiency of the allowance for estimated uncollectibles. Throughout the year, after all reasonable collection efforts have been exhausted, the difference between the standard rates and the amounts actually collected, including contractual adjustments and uninsured discounts, will be written off against the allowance for estimated uncollectibles. In addition to the review of the categories of revenue,management monitors the write offs against established allowances as of a point in time to determine the appropriateness of the underlying assumptions used in estimating the allowance for estimated uncollectibles.
Medicare shortfalls	Form 990, Schedule H, Part III, Section B, Line 8 The shortfall should be considered community benefit because The Cheshire Medical Center is the only hospital/medical center in Cheshire County, New Hampshire and is designated by CMS as a Medicare Dependent Hospital (MDH) due to greater than 60% of our average daily census being comprised of Medicare Patients. Our presence in the community allows the residents of Cheshire County, especially the elderly population, to receive comprehensive hospital and medical services close to home.
Credit and Collection Policy	Form 990, Schedule H, Part III, Section C, Line 9b Systems are in place to capture financial assistance accounts prior to a bill going to the patient. FAP eligible patients are not charged more than the amount generally billed.
Needs Assessment	Form 990, Schedule H, Part VI, Line 2 In 2016 (tax form year 2015), a Community Health Needs Assessment (CHNA) was completed with an implementation strategy identified for community benefit activities for the next three years. The Council for a Healthier Community (CHC) serves as the CHNA Leadership Team (see Attachment A: CHC Membership List). The CHC is the Public Health Advisory Council for the Greater Monadnock region. The primary purpose of the CHC is to provide a community framework that supports open communication and sets priorities for community collaboration and funding that encourages the health and wellness of the Greater Monadnock region. As such, their responsibilities include: Identifying and encouraging action planning to ensure community public health needs are met without unnecessary duplication - Supporting the needs assessments and data collection activities for the region - Advising and making recommendations, as appropriate, on funding opportunities. - Making recommendations within the Greater Monadnock region and to the state regarding priorities for service delivery based on needs assessments and data collection. The members of the CHNA Leadership Team represent the 33 towns in the Monadnock region. In addition, they represent, and are able to speak to the issues of our most vulnerable populations including the medically underserved and persons with low income. The 2016 CHNA report summarizes the work of the Council for a Healthier Community (CHC) and the collaborative efforts of other local groups to assess the needs of our region. This report is the compilation of work that occurred over the last three years, beginning in September of 2014 when the CHC reviewed the State Health Improvement Plan and identified regional assets and needs. The first Greater Monadnock Community Health Improvement Plan was finalized in September 2015, which serves as the foundation of this Community Health Needs Assessment. In addition, to ensure a comprehensive assessment and avoid duplication of efforts, the results of other community partners needs assessments were used to strengthen and support our process. The CHNA Leadership Team reviewed health and social well-being information from existing sources, recent assessments and neighboring service area CHNAs. They identified secondary data to review and then prioritized needs using a nominal group voting process. The results revealed five priority areas: - Behavioral Health: covering the full range of mental and emotional well-being; from daily stress and satisfaction to the treatment of mental illness - Substance & Alcohol Misuse: pose some of the greatest risks to individuals and community health and safety - Tobacco use: the most preventable cause of death - Obesity: increases the risk for many chronic diseases and impacts 25% of the regions adult population - Emergency Preparedness: Natural, accidental, or even intentional public health threats are all around us. The more prepared we are as a community; the more resilient we will be to recover from a disaster or emergency. Though not articulated as a stand-alone priority area, the need to address the social determinants of health is a focus in the Implementation Strategy that is embedded within each of these priority areas. We know that education, jobs, income, family stability, safety and transportation will contribute to health and wellbeing and require special attention given our rural location and socioeconomic pressures. In addition to these priorities, the implementation strategy also provides an overview of other CMC/DH community benefit activities that are aligned with our mission or considered necessary to support ongoing efforts from previously identified community needs. The community health needs identified in the 2016 CHNA provide the basis for the development of the Implementation Strategy. The 2016 CHNA, Implementation Strategy and Community Benefit report is available to the public on the Cheshire Medical Center website: www.cheshire-med.org.
Patient education of eligibility for assistance	Form 990, Schedule H, Part VI, Line 3 The Cheshire Medical Center is committed to providing medically necessary care to patients regardless of their ability to pay for services. Non-emergent patients sign a financial responsibility statement upon admission to certify recognition of their responsibility for payment of their bills. However, there will be instances where the patient, due to lack of funds or third party coverage, will not be able to meet this obligation. The Cheshire Medical Center notifies patients of their potential to obtain assistance through the registration and billing processes. Upon registration, patients without insurance are offered the opportunity to apply for financial assistance. In addition, receptionists and clinicians in all areas are educated to refer patients to the financial assistance process in the event patients express concerns with their ability to pay for services. The application information is posted on the intranet and brochures describing the program are readily available to patients. There are signs posted in Registration and throughout the facility informing patients about financial assistance. Patients are informed of the program availability on any invoices they receive and individuals who attempt to collect patient balances are also trained to refer patients to the financial assistance process. The financial assistance application process is comprehensive and evaluates a patient's eligibility for a variety of federal, state, and local government programs in addition to The Cheshire Medical Center's internally funded financial assistance program.
Community information	Form 990, Schedule H, Part VI, Line 4 The Medical Center is the only hospital in its primary service area ("PSA). Management defines its PSA as the City of Keene and 19 geographically proximate communities. Towns and cities included in the PSA include Alstead, Chesterfield, Fitzwilliam, Gilsum, Harrisville/Chesham, Keene, Marlborough, Marlow, Nelson/Munsonville, Richmond, Roxbury, Stoddard, Sullivan, Surry, Swanzey, Troy, Walpole, Westmoreland and Winchester, all located in Cheshire County. Based on US Census Bureau population estimates in July 2016: -Medical Centers PSA represented approximately 4.52% of New Hampshires population. -The PSAs total population is 59,612 with 23,406 residing in Keene, the largest community in the service area. -The median age of residents in Cheshire County is 42.0 with: -15,112 or 19.6% less than 18 years of -50,663 or 65.7% between the ages of 18-64 -11,342 or 14.7% over the age of 64 -In 2016, the poverty rate for Cheshire County was 9.9% as compared to 8.4% for the State of New Hampshire. The median household income is $57,782 compared to the state average of $66,779. According to the 2016 Bureau of Labor Statistics, the State had an unemployment rate of 2.8% compared to Cheshire Countys rate of 2.7% (not seasonally-adjusted).
Promotion of community health	Form 990, Schedule H, Part VI, Line 5 The Medical Center plays an active role in promoting community health and offers educational programs including classes and workshops. CMC/DH offers a variety of health promotion and education programs for the community spanning a broad spectrum of health and wellness topics. Our clinical staff works closely with the staff of the Center for Population Health to develop programs that cover emerging health concerns and are delivered at the right literacy level for our community. The programs offered a variety of chronic disease and wellness topics such as: stress management and resiliency, nutrition, physical education and exercise, high blood pressure prevention and monitoring, diabetes prevention and monitoring, advanced directive planning, memory loss, tobacco cessation and writing as tool to manage stress. A total of 1,008 community members participated in the 81 educational programs offered. All programs are offered free of charge. In addition, the Medical Center offers several community programs including: Cheshire Smiles, a school-based dental health program for children in grades K-3, provides screening, prevention and restorative dental care for children in Cheshire County schools. Cheshire Medical Center /Dartmouth-Hitchcock also works in partnership with other community health and human service organizations to meet the dental health needs of underserved populations such as the chronically mentally ill, pregnant women who cannot afford dental care, children identified through the school based Cheshire Smiles Program, and others. The Medical Center sponsors patient visits at Dental Health Works, a public/private program serving underserved residents of Cheshire County. The Medical Center also provides leadership and support to the Dental Public Health Task Force, a coalition of dental staff, hospital staff and concerned citizens addressing the oral health needs of adults. Cheshire Medical Center is committed to supporting healthy and resilient living for all members of the community. In addition to health information from our medical and nursing staff, our website links to reliable and up-to-date sources of health information and provides details regarding health and wellness programs offered at no charge. Cheshires community benefits report and service quality information are shared on the website for public viewing. The website incorporates "Healthwise", a searchable health information database. During Fiscal Year 2017 the website had a total of 326,908 visits and 867,616 page views for an average of 27,242 visits and 72,301 page views per month. Health + Wellness, an electronic newsletter, delivering timely medical news, useful health tips, and wellness information is distributed to an average of 1,600 patients and community members monthly. In addition to the website, Cheshires Facebook page serves as a tool to distribute health and wellness information. As of June 30, 2017, our FaceBook page has 1,948 "likes". Cheshire Medical Center has 666 followers on Twitter as of June 30,2017. The Cheshire Medical Center YouTube channel has 79 videos and an estimated 65,495 minutes watched during the 2017 fiscal year. The Cheshire Coalition for Tobacco Free Communities addresses the use of tobacco products by people who live and work in the communities served by CMC/DHK. The Coalition is comprised of hospital staff, healthcare providers, community members and representatives of schools and colleges, law enforcement, clergy and the general public. The group meets monthly working to engage schools and the greater community with tobacco prevention initiatives which include retailer education and enforcement of tobacco laws. The Program Manager, a CMC/DHK employee, actively engages in tobacco-free activities in our local community and coordinates with state agencies and organizations. Major accomplishments of the Coalition during this period were initiatives to increase access to services through "Butt Stops" staged at 13 sites around the community prior to the Great American Smoke-out and a "Bag the Butts" campaign to clean up cigarette litter at parks in the region. The "Bag the Butts" campaign complemented our efforts to assist nine communities with their implementation of tobacco free parks and recreation policies. The Medication Assistance Program provides assistance to patients needing help to secure medications because they lack insurance coverage or financial resources to pay for their medications, which now includes elderly residents with Medicare who experience a gap in their Medicare D coverage. Due to Medicaid Expansion and the Health Insurance options as a result of the Affordable Care Act the need for assistance to secure medications continues to decrease. In FY2017 the program supplied 318 prescriptions to 81 individuals valued at $368,384, compared to 1,073 prescriptions to 252 individuals in FY2016. Advocates for Healthy Youth (AFHY) is a community coalition focused on childhood obesity. Through AFHY, CMC/DH works closely with community health providers, Keene State College, Antioch University New England, Keene Family YMCA, Keene Parks and Recreation Center, UNH Cooperative Extension, Keene Housing, the Childrens Museum, and area schools to address the epidemic of childhood obesity. In FY 2017 AFHY supported efforts in several schools, after school programs, and non-profit organizations to implement environmental changes and programs that support healthy eating and physical activity. Senior Passport is a program for area residents aged 60 years and above. It encompasses low cost complete evening and weekend meals; free health education programs oriented to seniors; exercise programs; and the Cheshire Walkers Program, a walking group that takes organized nature and historic walks. Seven to ten walks are offered each spring and fall. Walks are typically led by a community member with participation by CMC/DHK staff and occur at a variety of locations throughout the region. During FY2017 5,409 meals were provided to program members and a total of 413 seniors attended the walking program. This represents about an 8% increase in the number of meals and 76% increase in the number of participants in Cheshire Walkers from last year. Greater Monadnock Public Health Network (GMPHN) is a community health and safety collaborative which works to enhance and improve public health-related services. The GMPHN is one of 13 public health networks in the state of New Hampshire. The GMPHN is housed by CMC/DHK and, in collaboration with Cheshire County, is financed with funds provided by the Centers for Disease Control and Prevention, under an agreement with the State of New Hampshire, Department of Health and Human Services, and Division of Public Health Services and a mix of state funding via the general funds. The GMPHN serves all of Cheshire County and the 10 western-most towns in Hillsborough County. The GMPHN strives to increase collaboration and planning across municipal boundaries and the health and safety sectors. There are three major focuses of the work: 1. Development of a governance structure for the public health advisory board 2. Public health emergency preparedness with all region partners including municipalities, long-term care and assisted living facilities, schools, and businesses. It is made up of members of each of the coalition communities as well as representatives of regional organizations involved in providing for the publics health and safety. 3. Through Monadnock Voices for Prevention, substance misuse prevention and development of a continuum of care to address prevention, intervention, treatment, and recovery services are provided. As of June 30, 2017 there are 51 individuals and/or organizations addressing development of the public health advisory council, 109 member individuals/organizations addressing emergency preparedness and over 1,200 individuals reached through the efforts of Monadnock Voices for Prevention. Included within the GMPHN, is the Greater Monadnock Medical Reserve Corps. Developed initially to build local capacity to address public health emergency response needs, the GMMRC also supports local initiatives to address pressing public health activities. Membership included doctors, nurses, EMT/paramedics, pharmacists, veterinarians, other public health professionals, and non-medical/public health members. As of June 30, 2017 the GMMRC has a membership of over 116 individuals.
Affiliated health care system	Form 990, Schedule H, Part VI, Line 6 In 2014, the Board of the Medical Center, accompanied by the Board of Dartmouth-Hitchcock Health, approved an affiliation agreement between the Medical Centers. This agreement improves, integrates, and streamlines patient care between the two healthcare systems. The affiliation, which became effective on March 2, 2015, strengthens The Cheshire Medical Center as a regional resource for southwestern New Hampshire and southeastern Vermont. The affiliation will allow more patients to receive care closer to home, will free up bed capacity for tertiary care patients at Dartmouth-Hitchcock Medical Center in Lebanon, and will allow the Cheshire Medical Center to continue its leadership role in population health and the Healthy Monadnock 2020 initiative. Cheshire Medical Center and Dartmouth-Hithcock have worked together since 1998, by means of a Joint Operating Agreement involving Dartmouth-Hitchcock Keene, a multi-specialty group practice that comprises the majority of Cheshire Medical Center's medical staff. This affiliation agreement was seen as a natural step that will enable both organizations to more effectively pursue a common vision of the future of health care that is based on creating a sustainable health system, focusing on population health, delivering value-based care, and embracing the opportunities provided by new payment models. In addition to The Cheshire Medical Center and the Dartmouth-Hitchcock Health, the affiliated health care system includes Mary Hitchcock Memorial Hospital, Dartmouth-Hitchcock Clinic, The New London Hospital Associaton, Windsor Hospital Corporation, Alice Peck Day Memorial Hospital,Visting Nurse Association and Hospice of New Hampshire and Vermont, and a number of other related organizations whose primary mission is health care in the region. The Cheshire Medical Center and other members of the affiliated health care system operate jointly through interlocking directorates, strategic planning, management, and share indentical missions.
State filing of community benefit report	Form 990, Schedule H, Part VI, Line 7 The Cheshire Medical Center files its Community Benefit Report with the State of New Hampshire.

Schedule I IRS990ScheduleI

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NH Health Protection Prog (DHHS)	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	129 Pleasant St	AddressLine1Txt
City	Concord	CityNm
State Abbreviation	NH	StateAbbreviationCd
ZIP	03301	ZIPCd

Field	Value	IRS element (for citing)
Cash Grant	$340,119	CashGrantAmt
Valuation Method Used	FMV	ValuationMethodUsedDesc
Non Cash Assistance	Healthcare Assist.	NonCashAssistanceDesc
Purpose Of Grant	Healthcare assist.	PurposeOfGrantTxt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc
CMC Tuition Reimbursement Program	68	$179,989	FMV
Awards and Educational Assistance	14	$24,628	FMV

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (22 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
John Birkmeyer MD
Trustee end 10/14/16	$0	$661,213	$0	$0	$0	$220,254	$0	$20,575	$0	$18,758	$0	$920,800	$0	$0
Judith Boule MD
Trustee end 1/1/17	$0	$280,153	$0	$550	$0	$37,995	$0	$266,199	$0	$19,406	$0	$604,303	$0	$0
Steven Paris MD
Trustee/At Large eff 1/1/17	$0	$391,378	$0	$0	$0	$28,330	$0	$36,365	$0	$15,440	$0	$471,513	$0	$0
Leslie Pitts MD
Trustee	$0	$302,675	$0	$250	$0	$8,762	$0	$183,859	$0	$22,238	$0	$517,784	$0	$0
Don Caruso MD
Trustee/CEO	$0	$394,902	$0	$57,630	$0	$28,920	$0	$222,758	$0	$22,400	$0	$726,610	$0	$0
Robert Cochrane
CFO End 2/28/2017	$296,476	$0	$0	$0	$0	$0	$0	$0	$21,666	$0	$318,142	$0	$0	$0
Cindi Coughlin
CNO	$220,836	$0	$0	$0	$0	$0	$95,962	$0	$19,291	$0	$336,089	$0	$0	$0
Paul Pezone
VP Facilities & Support Srvcs	$190,427	$0	$0	$0	$11,943	$0	$3,711	$0	$21,128	$0	$227,209	$0	$0	$0
Erli Chen
Physicist	$213,052	$0	$200	$0	$13,942	$0	$24,314	$0	$20,428	$0	$271,936	$0	$0	$0
Latasha Heape
Chief CRNA	$168,596	$0	$0	$0	$0	$0	$0	$0	$23,370	$0	$191,966	$0	$0	$0
Julie Green
VP Human Resources	$194,058	$0	$0	$0	$8,400	$0	$8,271	$0	$21,045	$0	$231,774	$0	$0	$0
Jose Montero
VP Pop Hlth/Sys End 11/13/16	$219,110	$0	$0	$0	$0	$0	$0	$0	$23,408	$0	$242,518	$0	$0	$0
Denis Fortier
Director of Pharmacy	$142,754	$0	$0	$0	$9,968	$0	$12,187	$0	$20,733	$0	$185,642	$0	$0	$0
Peter Malloy
CIO End 2/3/17	$151,485	$0	$0	$0	$0	$0	$0	$0	$17,985	$0	$169,470	$0	$0	$0
Cherie Holmes MD
Trustee/Ex-Officio	$0	$404,429	$0	$0	$0	$16,172	$0	$114,995	$0	$9,321	$0	$544,917	$0	$0
Wendy Fielding
Trustee	$0	$235,976	$0	$0	$0	$270	$0	$18,219	$0	$21,536	$0	$276,001	$0	$0
Timothy Fisher MD
Trustee end 1/1/17	$0	$350,007	$0	$0	$0	$5,422	$0	$20,575	$0	$22,322	$0	$398,326	$0	$0
Maria Padin
Trustee eff 1/1/17	$0	$398,748	$0	$0	$0	$10,608	$0	$177,879	$0	$19,925	$0	$607,160	$0	$0
Andrew Tremblay MD
Trustee eff 1/1/17	$0	$286,217	$0	$200	$0	$2,802	$0	$36,354	$0	$21,918	$0	$347,491	$0	$0
Jennifer DiNubila DO
Trustee eff 1/1/17	$0	$350,366	$0	$0	$0	$4,510	$0	$12,345	$0	$22,364	$0	$389,585	$0	$0
Arthur W Nichols
Former President	$0	$0	$0	$0	$506,030	$0	$60,780	$0	$12,705	$0	$579,515	$0	$0	$0
Kathryn Willbarger
VP Finance eff 3/1/17	$111,393	$0	$0	$0	$9,378	$0	$15,645	$0	$15,114	$0	$151,530	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Compensation of top employees	Form 990, Schedule J, Part I, Line 3 The CEO is paid by Dartmouth-Hitchcock Clinic, a related organization, which uses a compensation committee, an independent consultant, Form 990 of other organizations, a compensation survey or study, and approval by the Board or compensation committee to establish the CEO's compensation. Severance Payments Form 990, Schedule J, Part I line 4a DURING CALENDAR YEAR 2016, FORMER PRESIDENT ARTHUR NICHOLS RECEIVED A MULTI-YEAR SEVERANCE PACKAGE. CALENDAR YEAR 2016 INCLUDED PAYMENTS TOTALING $506,030 FROM CHESHIRE MEDICAL CENTER. THE PAYMENT REPRESENTS BASE PAY, BENEFITS, AS WELL AS A CASH PAYMENT GROSS UP FOR HEALTH, DENTAL, AND 457B CONTRIBUTIONS. THE PAYMENT IS INCLUDED ON SCHEDULE J, PART II, COLUMN (B)III. DURING CALENDAR YEAR 2016, FORMER TRUSTEE JOHN BIRKMEYER RECEIVED SEVERANCE PAYMENTS TOTALING $129,856 FROM DARTMOUTH-HITCHCOCK, A RELATED ORGANIZATION. THESE PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (B)III. SCHEDULE J, PART II, COLUMN (B)III.
Supplemental Nonqualified Retirement Plan	Form 990, Schedule J, Part I, Line 4B THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (WHICH ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B (III)): Don Caruso $26,826 Leslie Pitts $8,493 Steven Paris $19,684 Timothy Fisher $5,422 Judith Boule $36,165 Cherie Holmes $15,398 Claire Fabian $20,114 Maria Padin $10,074 John Birkmeyer $53,500 Andrew Tremblay $2,533 Jennifer DiNubila $4,330 Dartmouth-Hitchcock Supplemental Retirement Plan Terms and Conditions: An eligible employee is a participant in the Dartmouth-Hitchcock Retirement Plan and/or any prior pension arrangements sponsored by Dartmouth-Hitchcock (including a qualified defined benefit plan) who would be entitled to additional contributions or benefit accruals under the terms of the Plans for the plan year, but are limited by IRC Section 401(a)(17) and/or 415. For eligible employees, the Employer will pay the eligible employee an amount determined by the employer each year to offset the amount of the reduction in the benefit accrual or contributions as a result of limitations imposed by IRC Sections 401(a)(17) and/or 415. D-H sponsors a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable D-H to attract and retain quality executive personnel, improve the physicians' post-retirement life insurance benefits, and to replace an increasingly costly retiree life insurance program. The plan was frozen in 1998 and therefore no further costs of the individual employee insurance premiums have been funded by the organization. The number of participants and dollar value continues to dwindle as individuals retire/leave the organization.
Non-Fixed Payments	Form 990, Schedule J, Part I, Line 7 Senior Management is eligible for incentive compensation at the discretion of the Board based on, but not directly related to, overall organizational financial performance and discretionary measures.
Note Regarding Compensation	Schedule J, Part II Column B, parts I, II, and III represent actual amounts paid to employees. These amounts are reported to employees on their annual W-2 forms as compensation. Columns C and D represent items earned, however, not paid directly to the employee as cash payments during the calendar year. Column C includes retirement benefits as well as any changes in pension actuarial value (if applicable) in a calendar year. Column D represents nontaxable benefits such as the cost of healthcare coverage provided by the organization on behalf of its employees.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	NH HEALTH AND ED FACILITIES AUTHORITY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	020279866	BondIssuerEIN
CUSIP	644614V48	CUSIPNum
Bond Issued	2012-11-15	BondIssuedDt
Issue Price	$30,360,529	IssuePriceAmt
Purpose	Refund of existing debt	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$2,915,000	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$30,360,529	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$379,754	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$554,125	WorkingCapitalExpendituresAmt
Capital Expenditures	$4,777,102	CapitalExpendituresAmt
Other Spent Proceeds	$24,649,548	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Substantial Completion	2013	SubstantialCompletionYr
Current Refunding	Yes (true)	CurrentRefundingInd
Advance Refunding	false	AdvanceRefundingInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0	PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	Yes (true)	RebateNotDueYetInd
Exception To Rebate	false	ExceptionToRebateInd
No Rebate Due	false	NoRebateDueInd
Variable Rate Issue	false	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	false	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Other Spent Proceeds	FormAndLineReferenceDesc
Explanation	Form 990, Schedule K, Part II, Column A, Line 11 The other spent proceeds are the refunding proceeds of the issue that are no longer in escrow.	ExplanationTxt

Schedule L IRS990ScheduleL

Field	Value	IRS element (for citing)
Total Balance Due	$0	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Robert Therrien
Business Owner & Trustee	$165,281	Services provided by owned co	false
Ed Bergeron
Business Owner & Trustee	$238,425	Services provided by owned co	false
Ashley Copeland
Trustee H. Roger Hansen	$45,127	Family member employed by CMC	false
Elizabeth Lehr
Trustee H. Roger Hansen	$17,453	Family member employed by CMC	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Business Relationships	Form 990, Part VI, Section A, Line 2 Cheshire Medical Center is part of the Dartmouth-Hitchcock Health System, which owns for-profit subsidiaries that provide services and support the mission of the organizations. As a result, some officers of The Cheshire Medical Center may also be officers of related for-profits entities. Classes of members and the nature of their rights Form 990, Part VI, Section A, Line 6 & 7a Dartmouth-Hitchcock Health, a New Hampshire voluntary corporation, is the sole corporate member of The Cheshire Medical Center. D-HH has the power to appoint 1/3 of the members of The Cheshire Medical Center's Board of Trustees. Governance decisions reserved to or subject to approval by persons other than the governing body Form 990, Part VI, Section A, Line 7B The sole member has the right to ratify The Cheshire Medical Center's nomination of 2/3 of the members of the Board of Trustees; remove Trustees after consultation with the Chairperson of the Board; approve the dissolution or liquidation of The Cheshire Medical Center; appoint, evaluate, terminate, and approve the compensation of the President and CEO; and other governance decisions.
Process used by management and/or Governing Body to Review 990	Form 990, Part VI, Section B, Line 11b The Form 990 is reviewed by an independent accounting firm and CMC's Board of Trustees. A copy of the return is uploaded to the Board portal in advance of filing.
Conflict of Interest Policy	Form 990, Part VI, Section B, Line 12C Cheshire Medical Center's Board of Trustees approved a policy concerning a voluntary self-disclosure of any potential conflict of interest. The Dartmouth-Hitchcock Compliance and Audit Services Department conducts an annual survey of all officers and trustees and performs other procedures as considered necessary to report on compliance with the conflict of interest policy. The Department then reports to each board any potential conflicts for their review. Per the policy, any conflicts or otherwise perceived conflicts are required to be addressed by the Board of Trusteees on an ongoing basis. In the event a conflict arises, the individual may be removed from participating in any decision making regarding the identified conflict and/or its corresponding transactions. If the board or committee has reasonable cause to believe that an interested person has failed to disclose actual or possible conflicts of interest, it shall inform such person on the basis for such belief and afford him/her an opportunity to explain the alleged failure to disclose. If, after hearing the response of the interested person and making such further investigation as may be warranted in the curcumstances, the board or committee determines that such person has in fact failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR UNDERTAKEN	Form 990, Part VI, Section B, Line 15a The Cheshire Medical Center/Dartmouth-Hitchcock Keene has retained Yaffe & Company, Inc. to provide consultation to the Executive Committee of the Board of Trustees regarding executive compensation, benefits, and prerequisites. Yaffe & Company, Inc. is an independent consulting firm with 35 years of service and provides services to not-for-profit hospitals and health systems. Further, Yaffe & Company, Inc. has been engaged directly by the Board of Trustees of The Cheshire Medical Center through its Executive Committee to only provide services to the Board. An Executive Committee d/b/a Compensation Committee Charter and Compensation Philosophy (approved by the Board) documents the compensation review process and guidelines so as to provide an orderly structure for executive total compensation decisions. Annually, a multi-tiered approach using independent comparability data is utilized to gauge appropriate comparative market levels of compensation and benefits. An annual performance evaluation is based on subjective and objective criteria which flows from the strategic plan. By way of questionnaire Board members participate in the performance review process and a summary report is shared with the CEO. Variable pay is awarded based on achievement of specific qualititative and quantitative goals. In conjunction with the Executive Committee, challenging and measurable goals are established for the Office of the President, which provide alignment between executive compensation and achievement of the hospital's strategic goals.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public	Form 990, Part VI, Section C, Line 19 The Cheshire Medical Center makes governing documents, conflict of interest policy, and financial statements available to members of the public upon request, through its annual report, and through state and federal filings. Fundraising Expenses Form 990, Part IX, Column D The Cheshire Health Foundation, a related organization, performs all fundraising activities on behalf of Cheshire Medical Center. All fundraising expenses are reported on the Foundation's Form 990.
Reconciliation of Net Assets	Form 990, Part XI, Line 9 Other changes in net assets include: Pension Liability Adjustment, net Assets released for capital purchases, and net asset transfers $2,970,389
Audit Committee and Financial Statement Oversight	Form 990, Part XII, Question 2c Cheshire Medical Center delegates oversight of the audit to the Finance & Audit subcommittee. The full Board reviews and approves the Audited Financial Statements. The organization is also included in the audit and consolidated financial statements of its parent organization, Dartmouth-Hitchcock Health. Financial Statements and Reporting Form 990, Part XII, Question 3a The Medical Center was included in the consolidated audited financial statements of the Dartmouth-Hitchcock Health System. During Fiscal Year 2017, Mary Hitchcock Memorial Hospital expended federal funding which met the minimum threshold set forth in the Single Audit Act and OMB Circular A-133. Due to the nature of the consolidated financial statements, the audit was performed on the financial information of all organizations, including Cheshire Medical Center.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Cheshire Health Foundation
580 Court Street	Keene	NH	03431	020202220	Supportng Org	NH	501(c)(3)	12 TYPE I	CMC	Yes (true)
Cheshire Health Services
580-590 Court Street	Keene	NH	03431	473379283	HEALTHCARE	NH	501(C)(3)	3	CMC	Yes (true)
Dartmouth-Hitchcock Clinic
One Medical Center Drive	Lebanon	NH	03756	222519596	Phys Svcs	NH	501(c)(3)	10	D-HH	Yes (true)
Dartmouth-Hitchcock Health
One Medical Center Drive	Lebanon	NH	03756	264812335	Parent Org	NH	501(c)(3)	7	NA	false
Mary Hitchcock Memorial Hospital
One Medical Center Drive	Lebanon	NH	03756	020222140	Hospital	NH	501(c)(3)	3	D-HH	Yes (true)
The New London Hospital Association Inc
273 County Road	New London	NH	03257	020222171	Hospital	NH	501(c)(3)	3	D-HH	Yes (true)
Windsor Hospital Corporation
289 County Road	Windsor	VT	05089	030183721	Hospital	VT	501(c)(3)	3	D-HH	Yes (true)
Alice Peck Day Memorial Hospital
10 Alice Peck Day Drive	Lebanon	NH	03766	020222791	Hospital	NH	501(c)(3)	3	D-HH	Yes (true)
VNA & Hospice of VT and NH Inc
205 Billings Farm Road 5	Wilder	VT	05088	036006494	Hospice	VT	501(c)(3)	10	D-HH	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
Keene Hlth Alliance
580 Court Street	Keene	NH	03431	300179297	Healthcare	NH	NA	RELATED	-$1,888,000	$0	false	$0	Yes (true)	0.50000
One Care VT ACO LLC
111 Colchester Avenue	Burlington	VT	05401	455399218	Shared Saving	VT	NA				false	$0	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
Hitchcock Health Connect
One Medical Center Drive	Lebanon	NH	03756	800908979	Telehealth	NH	D-HH	C Corp	Yes (true)
Keene Health Enterprises
580 Court Street	Keene	NH	03431	020374999	Real Est Hldg	NH	KHS	C Corp	Yes (true)	$0	$0	1.00000
Keene Health Realty
580 Court Street	Keene	NH	03431	020374998	Real Est Hldg	NH	KHS	C Corp	Yes (true)	-$37,212	$638,620	1.00000
Keene Health Services
580 Court Street	Keene	NH	03431	020374997	Real Est Hldg	NH	CHF	C Corp	Yes (true)	-$11,120	$184,959	1.00000
ImagineCare Inc
1 Medical Ctr Dr	Lebanon	NH	03756	813105071	Software Tech	NH	D-HH	C Corp	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Mary Hitchcock Memorial Hospital
M	$29,239,512	FMV
Mary Hitchcock Memorial Hospital
P	$669,792	FMV
Dartmouth-Hitchcock Clinic
M	$12,531,219	FMV
Dartmouth-Hitchcock Clinic
P	$287,054	FMV
The Cheshire Health Foundation
C	$338,618	FMV
The Cheshire Health Foundation
k	$772,000	FMV
The Cheshire Health Foundation
p	$1,308,922	FMV
Cheshire Health Services
q	$1,899,561	FMV

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Related Party Controlling Entity Disclosure	FormAndLineReferenceDesc
Explanation	Form 990, Schedule R, Part II, Line G, and Part IV, column I The Organization has checked "yes" as a section 512(b) controlled entity. Although the filing organization does not directly control each of the organizations listed, as part of its affiliation with Dartmouth-Hitchcock Health (parent organization), all organizations related under D-HH are defined as a controlled entity within the meaning of IRC 512(b)(13).	ExplanationTxt