WINDSOR HOSPITAL CORPORATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: WINDSOR HOSPITAL CORPORATION (EIN 03-0183721)
Tax period: 2016-10-01 to 2017-09-30
Filed: 2018-06-20
IRS object ID: 201801719349300610
Schema version: 2016v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-06-20T08:15:57-05:00	ReturnTs
Tax Period End	2017-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	020476956	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Tyler Simms & St Sauveur CPAs PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	19 Morgan Drive	AddressLine1Txt
City	Lebanon	CityNm
State Abbreviation	NH	StateAbbreviationCd
ZIP	03766	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	030183721	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	windsor hospital corporation	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	WIND	BusinessNameControlTxt
Phone	8026746711	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	289 County Road	AddressLine1Txt
City	Windsor	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05089	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	David Sanville	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	8026746711	PhoneNum
Signature	2018-06-18	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	W Jay Simms	PreparerPersonNm
PTIN	P00435321	PTIN
Phone	6036530044	PhoneNum
Preparation	2018-05-03	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	216.107.201.226	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-06-18	IPDt
IP Tm	15:06:33	IPTm
IP Timezone	ED	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DA39A3EE5E6B4B0D3255BFEF95601890AFD80709	AtSubmissionCreationDeviceId
At Submission Filing Device Id	E125F4664CA59E986E126FDFBB4724C3AED932BF	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2018-06-14 16:35:46Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	MTASCUTNEY HOSPITAL & HEALTH CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	David Sanville	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	289 County Road	AddressLine1Txt
City	Windsor	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05089	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$52,886,516	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	mtascutneyhospital.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1933	FormationYr
Legal Domicile State	VT	LegalDomicileStateCd
Activity Or Mission	To improve the lives of those we serve. Our activities include providing healthcare.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	550	TotalEmployeeCnt
Total Volunteers	174	TotalVolunteersCnt
Total Gross UBI	-$3,029	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$3,029	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,048,528	PYContributionsGrantsAmt
CY Contributions Grants	$906,396	CYContributionsGrantsAmt
PY Program Service Revenue	$48,955,981	PYProgramServiceRevenueAmt
CY Program Service Revenue	$51,135,484	CYProgramServiceRevenueAmt
PY Investment Income	$1,763,248	PYInvestmentIncomeAmt
CY Investment Income	$624,393	CYInvestmentIncomeAmt
PY Other Revenue	$221,132	PYOtherRevenueAmt
CY Other Revenue	$159,577	CYOtherRevenueAmt
PY Total Revenue	$51,988,889	PYTotalRevenueAmt
CY Total Revenue	$52,825,850	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$29,253,933	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$30,149,034	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$223,218	CYTotalFundraisingExpenseAmt
PY Other Expenses	$20,352,611	PYOtherExpensesAmt
CY Other Expenses	$20,347,045	CYOtherExpensesAmt
PY Total Expenses	$49,606,544	PYTotalExpensesAmt
CY Total Expenses	$50,496,079	CYTotalExpensesAmt
PY Revenues Less Expenses	$2,382,345	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$2,329,771	CYRevenuesLessExpensesAmt
Total Assets BOY	$46,763,552	TotalAssetsBOYAmt
Total Assets EOY	$50,695,886	TotalAssetsEOYAmt
Total Liabilities BOY	$26,988,956	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$25,152,463	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$19,774,596	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$25,543,423	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Mount Ascutney Hospital and Health Center's mission is to improve the lives of those we serve.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$41,020,721	ExpenseAmt
Revenue	$51,246,093	RevenueAmt
Desc	Mt. Ascutney Hospital and Health Center (MAHHC) operates a not-for-profit critical access hospital which provides primary and secondary health care. MAHHC's primary service area includes Windsor, Claremont, Woodstock, Hartland, Springfield, and Brownsville. The hospital provides essential healthcare services including emergency department, med/surg inpatient, and ancillary diagnostic tests, imaging/radiology procedures, and wellness/prevention services. MAHHC staffs a total of 25 acute med/surg beds and 10 acute rehabilitation beds. During the year, there were 1,016 discharges, 1,507 surgeries, 58,953 lab tests, and 11,238 imaging procedures. MAHHC identified access to primary care as a central community need and is committed to providing the physician services of family practice, internal medicine and pediatrics in Windsor and Woodstock. MAHHC provides free care to patients who meet certain criteria. Foregone charges furnished under MAHHC's free care policy amounted to $733,410 in FY17.	Desc
Total Program Service Expenses	$41,020,721	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	62	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	550	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	David Sanville	PersonNm
Phone	8026746711	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	289 County Road	AddressLine1Txt
City	Windsor	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05089	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
John Gilman
Trustee	1.00	Yes (X)	$0	$0	$0
Michael Newbold
Trustee	1.00	Yes (X)	$0	$0	$0
Lynn Peterson MD
Trustee	1.00	Yes (X)	$0	$0	$0
Hon Donna Sweaney
vice-chair	1.00	Yes (X)	$0	$0	$0	Yes (X)
Steven Smith MD
Trustee	1.00	Yes (X)	$0	$177,772	$96,013		40.00
Donna VanFleet
chair	1.00	Yes (X)	$0	$0	$0	Yes (X)
maria padin md
dh Representative	1.00	Yes (X)	$0	$409,356	$197,804		40.00
William Palmer MD
Trustee	1.00	Yes (X)	$0	$191,066	$170,950		40.00
Vincent Fusca III
trustee	1.00	Yes (X)	$0	$330,998	$24,833		40.00
Deanna S Howard
DH Representative	1.00	Yes (X)	$0	$165,139	$28,397		40.00
Matthew S Houde
Dh Representative	1.00	Yes (X)	$0	$139,190	$29,402		40.00
Stephen D Surgenor MD
Dh Representative	1.00	Yes (X)	$0	$527,655	$65,123		40.00
Alan Keiller
treasurer/DH Representative	1.00	Yes (X)	$0	$0	$0	Yes (X)	40.00
John Tansey
secretary	1.00	Yes (X)	$0	$0	$0	Yes (X)
gay landstrom
interim CEO (effective through 1/17)	40.00	Yes (X)	$0	$579,445	$39,835	Yes (X)	1.00
joseph perras
president & CEO (from 1/17)	40.00	Yes (X)	$291,241	$0	$11,341	Yes (X)	1.00
Patty O'Neill
Treasurer (effective through 12/16)	1.00	Yes (X)	$0	$0	$0	Yes (X)
david sanville
cfo	32.00		$160,554	$0	$18,521	Yes (X)
mary joyce
physician	40.00		$247,222	$0	$18,521			Yes (X)
christopher connor
physician	40.00		$304,416	$0	$8,947			Yes (X)
andrew robinson
physician	40.00		$259,787	$0	$24,157			Yes (X)
dennis heibein
physician	40.00		$238,491	$0	$8,947			Yes (X)
Peter rauert
physician	40.00		$334,066	$0	$12,231			Yes (X)
kevin donovan
CEO (former CEO)	0.00		$0	$174,811	$40,569		40.00		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,835,777	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,695,432	TotReportableCompRltdOrgAmt
Total Other Compensation	$795,591	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	38	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
mary hitchcock memorial hospital
one medical drive	lebanon	NH	03756	professional and Physician Services	$2,040,902
Emergency Services of New England
po box 12	chester	VT	05143	Physician Asst for Emergency Room	$1,391,997
Dartmouth-Hitchcock Clinic
one medical drive	lebanon	NH	03756	Professional and Physician Services	$874,672
Sodexo Inc & Affiliates
po box 360170	pittsburgh	PA	15251	Mngmt & Support Staff - Envmmntl Srvs	$780,558
cerner
po box 959156	st louis	MO	63195	support for emr	$587,464

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	14	CntrctRcvdGreaterThan100KCnt
Fundraising	$7,900	FundraisingAmt
Government Grants	$598,994	GovernmentGrantsAmt
All Other Contributions	$299,502	AllOtherContributionsAmt
Noncash Contributions	$3,279	NoncashContributionsAmt
Total Contributions	$906,396	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Services	621110	$88,433,431	$88,433,431
Program & Misc Other	621110	$2,882,459	$2,882,459
DSH/VAHHS Revenue	621110	$541,427	$541,427
Provision for Doubtful Accounts	621110	-$1,725,743	-$1,725,743
Contractual Allowances	621110	-$38,996,090	-$38,996,090

Field	Value	IRS element (for citing)
Total Program Service Revenue	$51,135,484	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$192,143	TotalRevenueColumnAmt
Unrelated Business Revenue	-$3,029	UnrelatedBusinessRevenueAmt
Exclusion	$195,172	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$30,647	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$30,647	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,647	TotalRevenueColumnAmt
Exclusion	$30,647	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$479,715	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$47,465	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$479,715	SecuritiesAmt
Other	-$47,465	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$432,250	TotalRevenueColumnAmt
Exclusion	$432,250	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$31,522	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$7,900	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$13,201	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$18,321	TotalRevenueColumnAmt
Exclusion	$18,321	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	Equity in income of subsidiaries	Desc
Business	621110	BusinessCd
Total Revenue Column	$110,609	TotalRevenueColumnAmt
Related Or Exempt Func Income	$110,609	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$110,609	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$52,825,850	TotalRevenueColumnAmt
Related Or Exempt Func Income	$51,246,093	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	-$3,029	UnrelatedBusinessRevenueAmt
Exclusion	$676,390	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$532,851	TotalAmt
Program Services	$34,681	ProgramServicesAmt
Management And General	$498,170	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$23,508,248	TotalAmt
Program Services	$20,190,926	ProgramServicesAmt
Management And General	$3,180,104	ManagementAndGeneralAmt
Fundraising	$137,218	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$977,250	TotalAmt
Program Services	$828,637	ProgramServicesAmt
Management And General	$142,995	ManagementAndGeneralAmt
Fundraising	$5,618	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,501,714	TotalAmt
Program Services	$3,178,886	ProgramServicesAmt
Management And General	$314,099	ManagementAndGeneralAmt
Fundraising	$8,729	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,628,971	TotalAmt
Program Services	$1,370,453	ProgramServicesAmt
Management And General	$249,233	ManagementAndGeneralAmt
Fundraising	$9,285	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$54,237	TotalAmt
Management And General	$54,237	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$86,662	TotalAmt
Management And General	$86,662	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,971,223	TotalAmt
Program Services	$2,158,701	ProgramServicesAmt
Management And General	$1,797,473	ManagementAndGeneralAmt
Fundraising	$15,049	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$105,489	TotalAmt
Program Services	$14,803	ProgramServicesAmt
Management And General	$75,756	ManagementAndGeneralAmt
Fundraising	$14,930	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$63,943	TotalAmt
Program Services	$49,369	ProgramServicesAmt
Management And General	$13,539	ManagementAndGeneralAmt
Fundraising	$1,035	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$312,914	TotalAmt
Program Services	$183,511	ProgramServicesAmt
Management And General	$124,515	ManagementAndGeneralAmt
Fundraising	$4,888	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$728,508	TotalAmt
Program Services	$701,104	ProgramServicesAmt
Management And General	$27,404	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$67,980	TotalAmt
Program Services	$42,722	ProgramServicesAmt
Management And General	$25,152	ManagementAndGeneralAmt
Fundraising	$106	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$219,414	TotalAmt
Management And General	$219,414	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,104,831	TotalAmt
Program Services	$2,104,831	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$965,929	TotalAmt
Program Services	$530,061	ProgramServicesAmt
Management And General	$433,681	ManagementAndGeneralAmt
Fundraising	$2,187	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
purchased services	$4,738,865	$4,203,222	$535,643
Supplies	$3,286,479	$3,089,350	$185,260	$11,869
Dues/Fees/Taxes	$2,083,534	$1,787,531	$292,801	$3,202
Utilities	$651,853	$29,924	$621,929

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$905,184	TotalAmt
Program Services	$522,009	ProgramServicesAmt
Management And General	$374,073	ManagementAndGeneralAmt
Fundraising	$9,102	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$50,496,079	TotalAmt
Program Services	$41,020,721	ProgramServicesAmt
Management And General	$9,252,140	ManagementAndGeneralAmt
Fundraising	$223,218	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,472,557	BOYAmt
EOY	$6,094,896	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$171,778	BOYAmt
EOY	$172,467	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$993,244	BOYAmt
EOY	$603,278	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$5,368,536	BOYAmt
EOY	$5,888,667	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$549,408	BOYAmt
EOY	$478,194	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$325,675	BOYAmt
EOY	$581,355	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$41,974,310	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$24,839,100	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$17,732,576	BOYAmt
EOY	$17,135,210	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$13,735,024	BOYAmt
EOY	$15,281,709	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,830,928	BOYAmt
EOY	$1,856,051	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,583,826	BOYAmt
EOY	$2,604,059	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$46,763,552	BOYAmt
EOY	$50,695,886	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,180,684	BOYAmt
EOY	$4,820,536	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$278,460	BOYAmt
EOY	$753,948	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$22,529,812	BOYAmt
EOY	$19,577,979	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$26,988,956	BOYAmt
EOY	$25,152,463	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$12,429,466	BOYAmt
EOY	$18,320,180	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,495,059	BOYAmt
EOY	$1,345,233	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$5,850,071	BOYAmt
EOY	$5,878,010	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$19,774,596	BOYAmt
EOY	$25,543,423	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$46,763,552	BOYAmt
EOY	$50,695,886	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$2,329,771	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$996,397	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$2,442,659	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	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 (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	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)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$11,073	OtherActivitiesAmt
Total Lobbying Expenditures	$11,073	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	The Hospital paid $10,392 in the form of dues to the Vermont Association of Hospitals and Health Systems (VAHHS). VAHHS is a member-owned organization devoted to improving the health status of communities throughout Vermont through activities which include advocacy, policy development, education and research. The Hospital also paid $681 in the form of dues to the American Hospital Association (AHA).	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,667,571	BeginningYearBalanceAmt
Investment Earnings Or Losses	$475,456	InvestmentEarningsOrLossesAmt
Other Expenditures	$184,785	OtherExpendituresAmt
End Year Balance	$4,958,242	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,431,980	BeginningYearBalanceAmt
Investment Earnings Or Losses	$420,076	InvestmentEarningsOrLossesAmt
Other Expenditures	$184,485	OtherExpendituresAmt
End Year Balance	$4,667,571	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,759,330	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$30,485	InvestmentEarningsOrLossesAmt
Other Expenditures	$296,865	OtherExpendituresAmt
End Year Balance	$4,431,980	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,645,093	BeginningYearBalanceAmt
Investment Earnings Or Losses	$312,380	InvestmentEarningsOrLossesAmt
Other Expenditures	$198,143	OtherExpendituresAmt
End Year Balance	$4,759,330	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,536,888	BeginningYearBalanceAmt
Investment Earnings Or Losses	$298,805	InvestmentEarningsOrLossesAmt
Other Expenditures	$190,600	OtherExpendituresAmt
End Year Balance	$4,645,093	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.85080	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.14920	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$410,000	OtherCostOrOtherBasisAmt
Book Value	$410,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,584,668	OtherCostOrOtherBasisAmt
Depreciation	$8,197,775	DepreciationAmt
Book Value	$8,386,893	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,528,575	OtherCostOrOtherBasisAmt
Depreciation	$10,023,287	DepreciationAmt
Book Value	$2,505,288	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,451,067	OtherCostOrOtherBasisAmt
Depreciation	$6,618,038	DepreciationAmt
Book Value	$5,833,029	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$17,135,210	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
Rental Deposits	$5,560
Equity in Subsidiary	$2,396,799
Other Receivables	$201,700

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$2,604,059	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
dartmouth-hitchcock clinic (related) accounts payable	$543,956
Est. Settlements W/ 3rd party payors	$1,133,202
mary hitchcock memorial hospital & neah (related) accounts payable	$58,698
mary hitchcock memorial hospital (related) note payable	$10,838,163
Other Liabilities	$1,316,626
Post Retirement Benefit Obligation	$5,687,334

Field	Value	IRS element (for citing)
Total Liability	$19,577,979	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$56,191,447	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$996,397	NetUnrealizedGainsInvstAmt
Other Revenue	$2,442,661	OtherRevenueAmt
Revenue Not Reported	$3,439,058	RevenueNotReportedAmt
Revenue Subtotal	$52,752,389	RevenueSubtotalAmt
Investment Expenses Not Incld	$86,662	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	-$13,201	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$73,461	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$52,825,850	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$50,422,620	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$13,203	OtherExpensesIncludedAmt
Expenses Not Reported	$13,203	ExpensesNotReportedAmt
Expenses Subtotal	$50,409,417	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$86,662	InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt	$86,662	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$50,496,079	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Line 4:	In general, the amount of the original gift and any required accumulations by the donor are not expendable. However, the market value of the fund may fall below that amount depending on current financial conditions in the underlying investments. Under the policy of the Hospital, the endowment assets are invested moderately with the intent of providing a predictable stream of funding to the hospital. The Hospital invests in equity funds, bond funds and money market investments to achieve its long-term return objectives within limited risk constraints. Actual returns in any year may vary from budgeted amounts due to market fluctuations.
Part X, Line 2:	ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes, addresses the accounting uncertainty of income taxes recognized in an enterprise's financial statements and prescribes a threshold of "more-likely-than-not" for recognition and derecognition of tax positions taken or expected to be taken in a tax return. Subtopic 740-10 also provides guidance on measurement classification, interest and penalties and disclosure. The Organization has determined that the provisions of Subtopic 740-10 do not have a material effect on the Organization's financial statements. The Organization believes it is no longer subject to examinations for fiscal years prior to 2014.
Part XI, Line 2d - Other Adjustments:	Other components of net periodic benefit cost 141,188. Change in net assets to recognize funded status of post-retirement plans 986,472. rounding 1. transfer of net assets from dartmouth hitchcock-health 1,315,000.
Part XI, Line 4b - Other Adjustments:	Fundraising Expenses -13,201.
Part XII, Line 2d - Other Adjustments:	Rounding 2. Fundraising Expenses 13,201.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	Golf Tournament	Event1Nm
Gross Receipts Event1	$39,422	GrossReceiptsEvent1Amt
Charitable Contri Event1	$7,900	CharitableContriEvent1Amt
Gross Revenue Event1	$31,522	GrossRevenueEvent1Amt
Cash Prizes Event1	$1,262	CashPrizesEvent1Amt
Rent Facility Costs Event1	$2,560	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$7,033	FoodAndBeverageEvent1Amt
Other Direct Expenses Event1	$2,346	OtherDirectExpensesEvent1Amt
Gross Receipts Total	$39,422	GrossReceiptsTotalAmt
Charitable Contributions Tot	$7,900	CharitableContributionsTotAmt
Gross Revenue Total Events	$31,522	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$1,262	CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$2,560	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$7,033	FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events	$2,346	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$13,201	DirectExpenseSummaryEventsAmt
Net Income Summary	$18,321	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	225.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$347,526	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$347,526	NetCommunityBenefitExpnsAmt
Total Expense	0.00690	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,120,610	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,501,408	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,619,202	NetCommunityBenefitExpnsAmt
Total Expense	0.07170	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,468,136	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,501,408	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,966,728	NetCommunityBenefitExpnsAmt
Total Expense	0.07860	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$258,286	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$258,286	NetCommunityBenefitExpnsAmt
Total Expense	0.00510	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$168,726	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$168,726	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,089,517	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,844,453	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,245,064	NetCommunityBenefitExpnsAmt
Total Expense	0.12370	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,500	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,500	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,523,029	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,844,453	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,678,576	NetCommunityBenefitExpnsAmt
Total Expense	0.13220	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,991,165	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,345,861	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,645,304	NetCommunityBenefitExpnsAmt
Total Expense	0.21080	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$733,410	BadDebtExpenseAmt
Reimbursed By Medicare	$20,320,670	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$21,134,724	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$814,054	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 (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	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	Windsor Hospital Corporation	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	289 County Road	AddressLine1Txt
City	Windsor	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05089	ZIPCd

Field	Value	IRS element (for citing)
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	Distinct Part Rehab Unit	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Windsor Hospital Corporation	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	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 (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Schedule O	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	See Schedule O	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	225.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
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
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	see schedule O	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See schedule o	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE SCHEDULE O	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
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	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 (1)	NondisEmergencyCarePolicyInd
Look Back Medicare	Yes (X)	LookBackMedicareInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Windsor Hospital Corporation	Part V, Section B, Line 5: Methods employed in the assessment included a survey of area residents made available through direct mail and website links, a survey of key community stakeholders who are agency, municipal or community leaders, a series of community discussion groups convened in the Mt. Ascutney Hospital service area, and a review of available population demographics and health status indicators. At the beginning of the survey, respondents were asked to indicate the region they primarily serve or are most familiar with. A total of 33 key stakeholder respondents indicated that their responses were reflective of the Greater Windsor service area. Respondents represented the following sectors:Human service/Social Service 21%Mental /Behavioral Health 3%Home Health Care 6%Primary Health Care 12%Medical subspecialty 6%Public safety/Fire 3%Emergency Medical Services 3%Education/Youth Services 6%Municipal/County Government 6%Community Member/Volunteer 6%
Windsor Hospital Corporation	Part V, Section B, Line 6a: Other facilities were Dartmouth Hitchcock Medical Center, Alice Peck Day Memorial Hospital, New London Hospital and Valley Regional Hospital.
Windsor Hospital Corporation	Part V, Section B, Line 7d: A benefit report was prepared and made available and distributed through 5 Community Presentations, conducted by the Community Benefit Staff, as well as a thorough presentation made to the Hospital's Board of Trustees. The Mt. Ascutney Community Health Foundation and Committee, as well as the Windsor Area Community Partnership, participated in the distribution of the report. The CHNA and all information in the Needs Assessment is available for stakeholders. The CHNA is also available via paper copy for public inspection upon request at the Hospital's main information desk. It is also available prominently on the following website, http://www.mtascutneyhospital.org/sites/default/files/content/documents/MTA%202015%20CHNA%20report.pdf.
Windsor Hospital Corporation	Part V, Section B, Line 11: The hospital is addressing the significant needs identified in the most recently conducted CHNA in an implementation plan that mirrors best practices in each of the areas of need. This implementation plan was accomplished through efforts of the hospital and working in partnership with community organizations, as indicated. The outcomes of the implementation plan have been presented to the hospital Board of Trustees, community groups and posted on the hospital website. An effectiveness evaluation has also been accomplished and presented to the aforementioned groups. The accomplishments of the 2015 CHNA implementation plan during fiscal year ended Septemebr 30, 2017 are as follows: Served as Integrator for Community Infrastructure, Networking, and Partnership Windsor HSA Community Collaborative Community Health Subcommittee of Board of Trustees Blueprint for Health CHT, Interagency Care Management, Spoke/MAT Windsor Area Community Partnership PATCH Windsor Area Drug Task Force Mt. Ascutney Prevention Partnership1. Alcohol and drug misuse including heroin and use of pain medications -Completed extensive revisions to the Consumer Guide for Substance Use Treatment subsequent liberal distribution throughout the Hospital, community partners and community -Delineated and publicized a community based access to treatment services protocol -Medication Assisted Therapy, counseling, support and case management through Spoke services in pediatrics, primary care, Connecticut Valley Recovery Services, Bradford Psychiatric Associates; led quality improvement projects within each site -Partnership with Blue Cross Blue Shield and Department of Health Office of Alcohol and Drug Abuse to implement a systematic and ongoing Screening, Brief Intervention and Referral to Treatment (SBIRT) protocol for substance use within the clinics and ED -SBIRT/Motivational Interviewing for substance misuse community trainings to SASH, spoke staff, Turning Point recovery coaches, HCRS, Court Diversion, White River Family Practice, school staff -Organized and delivered provider education regarding marijuana -Participated in Gov. Summit for Substance Misuse Workforce and Workgroup -Multidisciplinary Functional Recovery Consult Team for patients with chronic pain -Interagency Care Management through CHT -A plethora of education and prevention initiatives including "Be Aware Don't Share," "Most Dangerous Leftovers," "Drug Take Back," prom and grad season education, retailer compliance recognition, work with Vermont league of cities and towns and regional planning boards regarding education on the impact of marijuana legalization -Monitored, tracked and distributed data from the Vermont Prescription Monitoring System. Distributed data to providers. Outcomes show Windsor area to be the lowest prescribers in the state. -Provider education was provided by UVM and the Vermont medical society on both opioid management and a new state regulations. New regulation protocols have been implemented. -Organized a Regional Youth Summit for Substance Misuse Services involving the court system, law enforcement, school, prevention, early intervention and treatment professionals to share knowledge of existing resources, identify gaps and barriers and propose new solutions. A new partnership was formed to work on new solutions.2. Access to mental health -Distribution brochure of Local Mental Health Counselors in the hospital and throughout the community -3 WRAP workshops delivered for skill building and self-management support for anxiety, depression and general mental health -Expansion of a HCRS embedded clinician/LADAC to four days a week in Patient Centered Medical Home supported by SBIRT grant -Hired and supported a psychiatrist within our Patient Centered Medical Home -Partnership in interagency care management with HCRS and other partners -Provided Mental Health First Aid training to hospital staff and community partners X2 -336 mental health counseling sessions were provided through the Windsor Connection Resource Center3. Access to dental care -Application of fluoride in pediatric clinics -Outreach to recruit a local dentist work with Springfield Medical Services and Deputy Commissioner Of Health -Services and Managed Care -Dental vouchers for care through Windsor Community Health Clinic -Dental clinic in the school, provided education to 252 children and their parents, provided dental screening and sealant applications to 60 children in 2017 -Community Health Team, Spoke Staff and staff of the Windsor Community Health Clinic assist patients to find dental homes, care and financing4. Access to affordable health insurance, cost of prescription drugs -Windsor Community Health Clinic assists community members with Vermont Health Connect, and Medicare and Medicaid applications -Medicare Boot Camp - March 31, 2017 and July 24, 2017 -Medication Voucher Program is offered through the Windsor Community Health Clinic5. Nutrition/access to affordable food -Membership in the Upper Valley Hunger Council -Work with the school, three local churches, recreation department, low-income housing, Windsor Connection Resource Center and Windsor Food Shelf to provide Summer Food Program, 1070 meals served -Food Drive for the Food shelf working with schools, town government and churches -Implementation of 3-4-50 reaching over 1,000 people through outreach to towns, schools, businesses, day cares and Health and Human Services agencies -Recognized at the Gold Level for 3-4-50 Worksite Wellness -Creating a family friendly version of Eat Well on $4/day-Good and Cheap Cook Book created by pediatric staff, AHEC and illustrated by local students. -Working with Vermont Housing Association, MAHHC and SASH to organize a cooking matters class for residents at Union Square Apartments -Nurse in pediatric clinic created a farmers market flyer to distribute to families -Implemented VeggieVanGo working with the Vermont Food Bank as a monthly community resource. Served 90 -130 families each month. Physicians are writing prescriptions for vegetables to families in need.6. Lack of physical activity, need for recreational opportunities and active living -Readiness Assessment for Health and Wellness Committees in Windsor, Weathersfield and Woodstock -Implementation of 3-4-50 reaching over 1,000 people through outreach to towns, schools, businesses, day cares and Health and Human Services agencies -Registered and recognized at the Gold Level for 3-4-50 Worksite Wellness activities7. Income, poverty and family stress -PATCH services at the Windsor Connection Resource Center from October 2016 through September 2017 include visits for economic services and for mental health counseling -Ten Parent-to-Parent Collaborative Problem-Solving Programs -A Family Wellness Program with wellness coaching has been embedded in the pediatric clinic based on the research effective Vermont Family-Based Approach Program after receipt of grant funding and consultation and training with Dr. Hudziak and his staff. 111 family wellness visits from Sept. 2016 through Aug. 2017 -Promise Community to promote kindergarten readiness and emotional and social competence of children and families through a five prong strategy -Provided interagency care planning, coordination and management to high risk pediatric and complex chronic care patients using a best practice model and tools8. Access to transportation -Participating in Regional Transportation Coalition -Volunteers in Action provision of rides -Use of transportation vouchers -Work with VTrans, The Current and local community partners on Rides to Wellness grant initiative -Developed and distributed 2 transportation algorithms to maximize use of existing resources 9. Access to primary health care -Achievement of NCQA re-designation as a Level III Patient Centered Medical Home -Implementation of Annual Wellness visits by the Collaborative Care Nurse -Recruitment of primary care providers10. Health care for seniors -Interagency care management in partnership with Senior Solutions -Woodstock Area Adult Day Services -Aging in Place Initiatives by VIA new group formed in Weathersfield -SASH Wellness Nurse -HASS at Olde Windsor Village11. Tobacco use/smoking -Regular cessation groups and 1:1 counseling has been provided -Prevention activities to decrease tobacco advertising and use -Implementation of 3-4-50 and non-smoking pledge cards -Community education about the impact of vaping provided -Recognized at the Gold Level for 3-4-50 Worksite Wellness
Windsor Hospital Corporation	Part V, Section B, Line 13b: patients whose family income exceeds 300% of FPL may be eligible to receive a discount based on the self-pay balance. Discounts will be granted such that the total self-pay bill does not exceed 10% of 2 years gross income, plus 10% of assets in excess of the sheltered asset calculation described earlier in the Policy. Any discounts other than those described above must be approved by the Financial Assistance Appeals Committee based on a written appeal from the patient or responsible party.
Windsor Hospital Corporation	Part V, Section B, Line 13h: MAHHC applies a discount to the FAP eligible patient's gross charges to all balances where there is no insurance, or to medically necessary services processed by insurance carriers resulting in a balance, which the patient is expected to pay.

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 7:	A cost accounting system was used to calculate the amounts reported in the table. A cost accounting system addresses all patients segments. A cost-to-charge ratio was used.
Part I, Line 7g:	Physician Clinic costs included within Subsidized Health Services are $6,245,064 of the total Community Benefit Expenses and $9,844,453 of the Direct Offsetting Revenue.
Part III, Line 2:	Bad debt expense is derived from the write off of patient accounts after they have been sent 4 statements over a course of 120 days. Also, Bad debt expense contains estimates for future write-offs based on management's judgements and financial models.
Part III, Line 4:	Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances still outstanding after management has used reasonable collection efforts are written off through a charge to the provision for doubtful accounts and a credit to accounts receivable.In evaluating the collectability of accounts receivable, the Hospital analyzes past results and identifies trends for each major payor source of revenue for the purposes of estimating the appropriate amounts of the allowance for doubtful accounts and the provision for doubtful accounts. Data in each major payor source are regularly reviewed to evaluate the adequacy of the allowance for doubtful accounts. Specifically, for receivables relating to services provided to patients having third-party coverage, an allowance for doubtful accounts and a corresponding provision for doubtful accounts are established at varying levels based on the age of the receivables and payor source. For receivables relating to self-pay patients, a provision for doubtful accounts is made in the period services are rendered based on experience indicating the inability or unwillingness of patients to pay amounts for which they are financially responsible. Actual write-offs are charged against the provision for doubtful accounts.
Part III, Line 8:	The shortfall represents the PPS reimbursement difference on the Rehab units. Since the reimbursement does not cover the costs of these units, a subsidy is created. Because the Hospital determined that these services are important to our service area, the Hospital covers the subsidy. The costing methodology used above was the cost to charge ratio.
Part III, Line 9b:	MAHHC's collection policy and charitable care policies are consistently applied to all patients. Our collection policy applies to any balance owed by the patient whether it is a balance after insurance, a balance with no insurance, or a balance after an adjustment for partial charitable care. Statements, credit reporting, collection efforts, and write-off criteria are the same for all like balances, regardless of the reason for the balance and regardless of whether it is a balance after charitable care or not. Patients who qualify for financial assistance receive the appropriate adjustment on their bill. If a balance remains after that adjustment, they are billed according to the collection policy, for the remainder.
Part VI, Line 2:	In addition to the Community Health Needs Assessment, the needs of the community are assessed through ongoing review of health indicators such as the youth risk behavior survey, BRFSS, quality indicators from both the hospital and external evaluations such as One Care Vermont and the That practice profiles. Community health needs are also assessed through patient satisfaction surveys and the patient complaint process. The hospital also has a community health team embedded in our patient centered medical home who respond to the needs of patients with complex chronic care needs.
Part VI, Line 3:	Windsor Community Health Clinic (A department within the Hospital) provides information and one-on-one assistance with any individual that is identified without insurance. This begins at the time that a patient presents for their health care appointment; the registration staff make the introduction and provide information to the patient on the services. Also, a referral from the physician/provider may direct a patient to this department. The staff of this department assist patients in applying for health insurance, whether on the commercial "exchange", or in governmental insurers. They also provide information on and the application for Financial Assistance; often time, assisting patients with completing the application. This is a dedicated staff that is on site during the normal business hours when the majority of patients would be seeking care.
Part VI, Line 4:	MAHHC's primary service area includes Windsor, Hartland, Woodstock, Springfield, Weathersfield, Brownsville, VT and Cornish, and Claremont, NH. MAHHC is the largest employer in the town of Windsor, with many of its residents having lower than average paying jobs and struggle with financial stability; including transportation difficulties.
Part VI, Line 5:	The hospital has established A Director of Community Health, a Prevention Education and Health Promotion Department and a Community Health Committee which is a subcommittee of the Board of Trustees. Our staff organize, lead and implement health promotion and prevention programs for high risk behaviors such as alcohol, tobacco and drug misuse. We promote exercise and nutrition programs in a well-established campaign working with the Vermont Department of Health in the 3-4-50 campaign. This campaign involves outreach and engagement to and with the community to decrease the three behaviors of tobacco use, lack of exercise and poor nutrition that are related to the four conditions of heart disease and stroke, diabetes, cancer and respiratory diseases that account for over 50% of the deaths in Vermont. This year our outreach impacted over 1000 people. We serve as an integrator and leader of community health by chairing and leading the following community partnerships; Windsor area community partnership, Windsor PA TCH team, blueprint for health extended team, Windsor HSA community collaborative and Windsor drug task force. Mission statements and minutes are available per request.
Part VI, Line 6:	The Hospital Community Benefit staff is an active participant in Regional Community Health committee, which is lead and organized by Dartmouth-Hitchcock. The Hospital is affiliated, formally, with Dartmouth-Hitchcock. As are other local hospitals, Alice Peck Day Memorial Hospital and New London Hospital. Valley Regional Hospital is also part of the Regional Community Health committee. The participants collaborate, compare solutions and offer support to each other as all are serving overlapping service areas.
Part VI, Line 7	There are no requirements to file a community benefits report in the state of Vermont.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	Yes (X)	CompensationSurveyInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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
Steven Smith MD
Trustee	$0	$176,998	$0	$0	$0	$774	$0	$76,703	$0	$19,310	$0	$273,785	$0	$0
maria padin md
dh Representative	$0	$398,748	$0	$0	$0	$10,608	$0	$177,879	$0	$19,925	$0	$607,160	$0	$0
William Palmer MD
Trustee	$0	$189,878	$0	$0	$0	$1,188	$0	$158,353	$0	$12,597	$0	$362,016	$0	$0
Vincent Fusca III
trustee	$0	$319,753	$0	$0	$0	$11,245	$0	$23,344	$0	$1,489	$0	$355,831	$0	$0
Deanna S Howard
DH Representative	$0	$163,908	$0	$0	$0	$1,231	$0	$23,344	$0	$5,053	$0	$193,536	$0	$0
Matthew S Houde
Dh Representative	$0	$139,190	$0	$0	$0	$0	$0	$8,890	$0	$20,512	$0	$168,592	$0	$0
Stephen D Surgenor MD
Dh Representative	$0	$455,683	$0	$47,500	$0	$24,472	$0	$42,733	$0	$22,390	$0	$592,778	$0	$0
gay landstrom
interim CEO (effective through 1/17)	$0	$544,439	$0	$0	$0	$35,006	$0	$20,575	$0	$19,260	$0	$619,280	$0	$0
joseph perras
president & CEO (from 1/17)	$291,241	$0	$0	$0	$0	$0	$0	$0	$11,341	$0	$302,582	$0	$0	$0
david sanville
cfo	$160,554	$0	$0	$0	$0	$0	$0	$0	$18,521	$0	$179,075	$0	$0	$0
mary joyce
physician	$247,222	$0	$0	$0	$0	$0	$0	$0	$18,521	$0	$265,743	$0	$0	$0
christopher connor
physician	$304,416	$0	$0	$0	$0	$0	$0	$0	$8,947	$0	$313,363	$0	$0	$0
andrew robinson
physician	$259,787	$0	$0	$0	$0	$0	$0	$0	$24,157	$0	$283,944	$0	$0	$0
dennis heibein
physician	$238,491	$0	$0	$0	$0	$0	$0	$0	$8,947	$0	$247,438	$0	$0	$0
Peter rauert
physician	$334,066	$0	$0	$0	$0	$0	$0	$0	$12,231	$0	$346,297	$0	$0	$0
kevin donovan
CEO (former CEO)	$0	$170,076	$0	$0	$0	$4,735	$0	$29,444	$0	$11,125	$0	$215,380	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3	THE former CEO and interim CEO were PAID BY MARY HITCHCOCK MEMORIAL HOSPITAL, A RELATED ORGANIZATION, WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE CEO'S COMPENSATION.
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)): MARY HITCHCOCK MEMORIAL HOSPITAL, A RELATED ORGANIZATION, PAID GAY LANDSTROM $33,499, KEVIN DONOVAN $4,712 AND VINCENT FUSCA $6,601. DARTMOUTH-HITCHCOCK CLINIC, A RELATED ORGANIZATION, PAID MARIA PADIN $10,074 AND STEPHEN D SURGENOR $24,010.
Part I, Line 7	SMITH, CONNOR AND HEIBEIN RECEIVED BONUSES. THE BONUSES WERE AWARDED EITHER DUE TO MEETING RVU GOALS OR BASED ON QUALITY AND CITIZENSHIP.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, line 2	MOUNT ASCUTNEY HOSPITAL & HEALTH CENTER IS A PART OF THE DARTMOUTH-HITCHCOCK HEALTH SYSTEM, WHICH OWNS FOR-PROFIT SUBSIDIARIES THAT PROVIDE SERVICES AND SUPPORT THE MISSION OF THE ORGANIZATION. AS A RESULT, SOME OFFICERS OF THE MAHHC ALSO MAY BE OFFICERS OF FOR-PROFIT ENTITIES WITHIN THE HEALTHCARE SYSTEM.
Form 990, Part VI, Section A, line 6	DARTMOUTH-HITCHCOCK HEALTH, A NEW HAMPSHIRE VOLUNTARY CORPORATION, IS THE SOLE CORPORATE MEMBER OF MOUNT ASCUTNEY HOSPITAL & HEALTH CENTER.
Form 990, Part VI, Section A, line 7a	DARTMOUTH-HITCHCOCK HEALTH HAS THE POWER TO APPOINT 1/3 OF THE MEMBERS OF MAHHC'S BOARD OF TRUSTEES.
Form 990, Part VI, Section A, line 7b	THE SOLE MEMBER HAS THE RIGHT TO RATIFY MOUNT ASCUTNEY HOSPITAL & HEALTH 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 MAHHC; APPOINT, EVALUATE, TERMINATE, AND APPROVE THE COMPENSATION OF THE PRESIDENT AND CEO; AND OTHER GOVERNANCE DECISIONS.
Form 990, Part VI, Section B, line 11b	board of trustees reviewed prior to filing, provided multiple days to provide feedback and/or questions and Hospital then filed after there was satisfaction.
Form 990, Part VI, Section B, line 12c	The finance and audit committee monitor and report to the Board of Directors
Form 990, Part VI, Section B, line 15	The Executive Committee of the Board meets annually to review compensation for the CEO, using independent surveys of area compensation for executives of various sized hospitals. Other officers and key employees salaries are determined, by the HR Department using comparable market data.
Form 990, Part VI, Section C, line 19	All internal policies, governing documents, and financial statements are made available upon request
Form 990, Part XI, line 9:	Change in Net Assets to recognize funded status of post retirement plans 986,472. Other components of net periodic benefit cost 141,188. Rounding -1. transfer of net assets from Dartmouth hitchcock-health 1,315,000.
Form 990, Part XII, Line 3b:	the single audit was performed on the combined financial information of dartmouth-hitchcock Health and subsidiaries including mount ascutney hospital and health center.
Schedule H, Part V, Line 7a:	http://www.mtascutneyhospital.org/sites/default/files/content/documents/ MTA%202015%20CHNA%20report.pdf
Schedule H, Part V, Line 10a:	http://www.mtascutneyhospital.org/sites/default/files/content/ documents/CHNA%20Implementation%20Plan%202015-2.pdf
schedule H, Part V, Line 16a:	http://www.mtascutneyhospital.org/sites/default/files/content/documents/ MAH%20Financial%20Assistance%20Policy_0.pdf
schedule H, Part V, Line 16b:	http://www.mtascutneyhospital.org/sites/default/files/Financial%20Assist ance%20Application%2010012016.pdf
schedule H, Part V, Line 16c:	http://www.mtascutneyhospital.org/sites/default/files/content/documents/ MAH17_FinancialAssistancePolicyBrochure_Web.pdf

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 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	Direct Controlling NADirectControllingNACd
HISTORIC HOMES OF RUNNEMEDE
289 County Road	Windsor	VT	05089	237396147	providing svcs for the aging	VT	501(c)(3)	Line 10	WINDSOR HOSPITAL CORPORATION	Yes (1)
Mount Ascutney Hospital Community Health Foundation Inc
289 County Road	Windsor	VT	05089	030300481	health education & promotion	VT	501(c)(3)	Line 3	WINDSOR HOSPITAL CORPORATION	Yes (1)
Dartmouth-Hitchcock MEDICAL CENTER
One Medical Center Drive	Lebanon	NH	03756	222715483	Supporting Org	NH	501(c)(3)	Line 12a, I		0	N/A
MARY HITCHCOCK MEMORIAL HOSPITAL
One Medical Center Drive	Lebanon	NH	03756	020222140	Hospital	NH	501(c)(3)	Line 3	Dartmouth-Hitchcock Health	0
Dartmouth-Hitchcock clinic
ONe Medical Center Drive	Lebanon	NH	03756	222519596	Phys Svcs	NH	501(c)(3)	Line 10	Dartmouth-Hitchcock Health	0
Hitchcock Foundation
One Medical Center Drive	Lebanon	NH	03756	020222139	Hlthcre Rsrch	NH	501(c)(3)	Line 7	Dartmouth-Hitchcock CLINIC	0
Hamden Risk Retention Group Inc
30 Main Street Suite 330	Burlington	VT	05401	208530788	Self Ins	VT	501(c)(3)	Line 12a, I	Dartmouth-Hitchcock Clinic	0
The New London Hospital Assoc Inc
273 County Road	New London	NH	03257	020222171	Hospital	NH	501(c)(3)	Line 3	Dartmouth-Hitchcock Health	0
Everwell Inc
One Medical Center Drive	Lebanon	NH	03756	352506275	Supporting Org	NH	501(c)(3)	Line 12a, I		0	N/A
VISITING NURSE ASSOCIATION AND HOSPICE OF VT AND NH INC
205 billings farm rd no 5	wilder	VT	05088	036006494	Hospice	VT	501(c)(3)	Line 10	dartmouth-Hitchcock health	0
CHESHIRE MEDICAL CENTER
580 COURT STREET	KEENE	NH	03431	020354549	HOSPital	NH	501(c)(3)	Line 3	dartmouth-Hitchcock health	0
ALICE PECK DAY MEMORIAL HOSPITAL
10 alice peck day dr	lebanon	NH	03766	020222791	hospital	NH	501(c)(3)	Line 3	dartmouth-Hitchcock health	0
SURGERY CENTER OF GREATER NASHUA
10 prospect st no 101	nashua	NH	03060	461084049	surgery center	NH	501(c)(3)	Line 3		0	N/A
CHESHIRE HEALTH FOUNDATION
580 COURT STREET	keene	NH	03431	020202220	supporting org	NH	501(c)(3)	Line 12a, I	cheshire medical center	0
Chesire health services
580 COURT STREET	keene	NH	03431	473379283	healthcare	NH	501(c)(3)	Line 3	cheshire medical center	0
dartmouth-hitchcock health
one Medical Center Drive	lebanon	NH	03756	264812335	parent org	NH	501(c)(3)	Line 7		0	N/A

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	Direct Controlling NADirectControllingNACd
DH MASTER INVESTMENT PARTNERSHIP
one MED CTR DR	LEBANON	NH	03756	020505863	POOLED INVESTMENT	NH	mary hitchcock memorial hospital	Excluded	$1,494,553	$14,772,295	0	-$3,029	0	0.02460
new england pharMACY COLLAB
one MED CTR DR	leBANON	NH	03756	263819035	group purchasing	NH			-$5,770		0		0	0.04740	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
imaginecare inc
one mediCAL CENTER DRIVE	leBANON	NH	03756	813105071	software technology	DE	N/A	C	0
HITCHCOCK HEALTH CONNECT INC
ONE MEDICAL CENTER DRIVE	LEBANON	NH	03756	800908979	TELEHEALTH	DE	N/A	C	0
POMPANOOSUC INVESTMENT CORPORATION
ONE MEDICAL CENTER DRIVE	LEBANON	NH	03756	020352330	real estate hldg	NH	N/A	C	0
HAMDEN ASSURANCE COMPANY LIMITED
				980121409	liability insurance		N/A	C	0	44 church st	HAMILTON	BD	hm 12	BD
KEARSARGE COMMUNITY SERVICES INC
273 COUNTY RD	NEW LONDON	NH	03257	020460136	real estate hldg	NH	N/A	C	0
NEW LONDON PHYSICIAN GROUP INC
273 COUNTY RD	NEW LONDON	NH	03257	020494420	PHYSICIAN GROUP	NH	N/A	C	0
NEW LONDON MEDICAL CENTER EAST INC
273 COUNTY RD	NEW LONDON	NH	03257	020480857	real estate hldg	NH	N/A	C	0
KEENE HEALTH SERVICES
580 COURT STREET	KEENE	NH	03431	020374997	real estate hldg	NH	N/A	C	0
KEENE HEALTH REALTY
580 COURT STREET	KEENE	NH	03431	020374998	real estate hldg	NH	N/A	C	0
KEENE HEALTH ENTERPRISES
580 COURT STREET	KEENE	NH	03431	020374999	real estate hldg	NH	N/A	C	0
88 Prospect St Condo Owners Assoc
88 prospect street	white river junction	VT	06002	020480857	real estate hldg	VT	N/A	C	0
CHARITABLE REMAINDER UNITRUSTS (10)
289 COUNTY RD	WINDSOR	VT	05089		CHARITABLE TRUST	VT	N/A	T	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (1)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Mary Hitchcock Memorial HospitalDartmouth Hitchcock Health
E	$10,838,163	Actual
Historic Homes of Runnemede
Q	$152,751	actual
Dartmouth-hitchcock health
S	$1,315,000	actual
NEW ENGLAND ALLIANCE FOR HEALTH llc (MHMH)
P	$666,821	ACTUAL
DARTMOUTH-HITCHCOCK clinic
E	$543,956	ACTUAL
DARTMOUTH-HITCHCOCK clinic
O	$3,214,612	ACTUAL
MARy Hitchcock Memorial Hospital
P	$322,991	ACTUAL