2017-05-15T08:21:58-05:00 2016-06-30 990 2015-07-01 020222139 The Hitchcock Foundation % JENNIFER REINING HITC 6036530481 One Medical Center Drive Lebanon NH 03756 JENNIFER REINING Executive Director 6036531231 2017-05-11 2015 2021-01-29 14:40:06Z E Ann Gormley MD One Medical Center Drive Lebanon NH 03756 4146422 false X N/A X 1946 NH To advance the study of human ailments & injuries; the causes, prevention, relief, & cure thereof, hygiene, health & public welfare, & to assist in research in the broadest sense 12 7 0 7 5712 -19988 1554538 1416161 1951305 2340771 861658 238472 5051 4273 4372552 3999677 586979 623152 0 0 0 0 0 0 0 3217332 3388284 3804311 4011436 568241 -11759 24465673 23508954 1536161 1180873 22929512 22328081 X THE PURPOSE OF THE HITCHCOCK FOUNDATION SHALL BE TO AID AND ADVANCE THE STUDY AND INVESTIGATION OF HUMAN AILMENTS AND INJURIES, AND THE CAUSES, PREVENTION, RELIEF, AND CURE THEREOF, AND THE STUDY AND INVESTIGATION OF PROBLEMS OF HYGIENE, HEALTH AND PUBLIC WELFARE, AND THE PROMOTION OF MEDICAL, SURGICAL AND SCIENTIFIC LEARNING, SKILL, EDUCATION AND INVESTIGATION, AND TO ENGAGE IN AND CONDUCT AND TO AID AND ASSIST IN MEDICAL, SURGICAL AND SCIENTIFIC RESEARCH IN THE BROADEST SENSE. false false 3853278 623152 2316271 The Hitchcock Foundation provides between 15 and 20 grants per year and sponsors over 400 advised funds that support clinically oriented research and education activities in furtherance of our mission. Sponsored research Funds support discrete clinical and biomedical research projects and are funded by external sources including corporations and foundations. Advised Funds are established by the Executive Director under the authority of the Board of Trustees. They are funded with contributions intended to support activities consistent with our charitable mission - particularly clinical research and education. They are not donor advised funds; rather the advisors are scientists and clinicians with expertise in the areas of research and education supported by the fund. The foundation also provides funding for research grants and fellowships; amounts awarded range from $1,000 to $125,000 and are awarded on a competitive basis. 3853278 true true false false false false false false false true true false false false true false false true false false true true false false false false false true true true false false false false false false false false false false false false false true true false false false true 56 0 0 true true false false false false false false false false false X 12 7 true false false false true true true true true false false true true true true true true false false false NH X JENNIFER REINING 6036531231 ONE MEDICAL CENTER DRIVE LEBANON NH 03756 X E Ann Gormley MD Board Chair/Physician 0.5 40.0 X X 0 498218 230719 Robert Maue PhD Trustee 0.3 0.0 X 0 0 0 Richard Powell MD Trustee/Vice Chair end 7/1/15 0.3 42.0 X X 0 466328 117201 R Brooks Robey MD Trustee 0.3 0.0 X 0 0 0 Barry Smith MD Trustee/Board Secretary 0.5 0.0 X X 0 0 0 Edward Stansfield MA Trustee/Board Treasurer 0.5 0.0 X X 0 0 0 Michael Ward MS Trustee 0.5 0.0 X 0 0 0 Duane Compton PhD Trustee Ex-Officio 0.3 2.01 X 0 0 0 Jeffrey Cohen MD Trustee Ex-Officio/Physician 0.3 41.5 X 0 402436 136011 William Wickner MD Trustee 0.3 0.0 X 0 0 0 Lawrence Dacey MD Trustee 0.3 1.0 X 0 0 188491 Michael Zegans MD Trustee 0.3 40.0 X 0 340083 76249 Michele Lauria MD Trustee/Phy End 7/1/15 0.3 0.0 X 0 217797 29752 Philip Goodney MD Trustee eff. 7/1/15 0.3 40.0 X 0 418331 63254 Jennifer Reining Executive Director 40.0 0.0 X 0 103350 17392 0 2446543 859069 0 false true false Trustees of Dartmouth College 37 Dewey Field HANOVER NH 03755 Contracted Services 2182064 Mary Hitchcock Memorial Hospital One Medical Center Drive LEBANON NH 03756 Contracted Services 722732 Dartmouth-Hitchcock Clinic One Medical Center Drive LEBANON NH 03756 Contracted Services 309742 3 434234 981927 1416161 SPONSORED RESEARCH, PROGRAM RESEARCH, & EDUCATION 541700 2340771 2316271 24500 2340771 269262 -18788 288050 0 4273 4273 0 0 0 115955 146745 -30790 -30790 -30790 0 0 0 0 3999677 2316271 5712 261533 X 81308 81308 499394 499394 42450 42450 0 0 0 0 0 0 0 25629 25629 0 0 0 0 96694 96694 2171440 2170390 1050 487 487 18215 16352 1863 3281 3241 40 0 0 65301 65301 0 344623 344047 576 0 0 454 454 0 RESEARCH EXP & SUBJECT FEES 92041 92041 EDU MATERIAL & HONORARIUMS 80277 80277 LAB FEES, EQUIPMENT, & SUPLS 354323 354323 TESTS & EXAMINATIONS 22322 22322 113197 81345 31852 4011436 3853278 158158 0 X 182337 175601 0 0 0 0 337550 488533 0 0 0 0 4000 4000 0 0 0 0 5153 4501 1105 652 23940681 22840168 0 0 0 0 0 0 0 0 24465673 23508954 379964 277504 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1156197 903369 1536161 1180873 X 14517776 14456472 6293332 5753205 2118404 2118404 22929512 22328081 24465673 23508954 -11759 -589672 X X false true X false true true X 1168266 1259771 699178 1554538 1416161 6097914 0 0 1168266 1259771 699178 1554538 1416161 6097914 1121448 4976466 1957819 1533451 293945 283716 292323 4361254 116558 29250 27325 3061 176194 0 10635362 11370229 0.46792 0.50041 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6367453 6701 -120263 286676 5967215 6658392 1303 -7186 285056 6367453 6183134 768976 293718 6658392 6018116 463734 298716 6183134 6143370 1171 56273 182698 6018116 0.43890 0.35500 0.20610 false false 5153 4501 652 652 0 AGENCY ACCOUNTS 903369 903369 Use of Endowment Funds Form 990, Schedule D, Part V, Line 4 The Hitchcock Foundation's endowment funds include resources for the following uses: -The Tiffany Blake Endowment supports a research training fellowship for a young investigator at Dartmouth-Hitchcock Medical Center, who is committed to clinically oriented research. -The Henry Heyl Endowment supports medical research grants. -The Helmut Schumann Lecture endowment supports an annual public lecture in "Studies in Healthful Living." -The Helmut Schumann Fellowship endowment supports a fellowship for a Dartmouth-Hitchcock Medical Center faculty to develop programs in primary prevention and health promotion. -The Residents' Revolving Loan Fund Emergency Loan Fund supports Residents and Fellows in training at Dartmouth-Hitchcock. -The Neurosurgical Research Fund (Barry) supports Neurosurgical Research. -The Harold M. Pierce Memorial Fund supports Cancer Research. Form 990, Schedule D, Part X, Line 2 No ASC 740 footnote was included in the audited financial statements as there were no material uncertain tax positions at or since adoption. true Europe (Including Iceland and Greenland) Program Services Conferences & Travel 612 Middle East and North Africa Program Services Conference & Travel 2135 Sub-Saharan Africa Program Services Program Support 14325 Europe (Including Iceland and Greenland) Program Services Program Support 24189 Central America and the Caribbean Program Services Conference & Travel 1189 42450 42450 Europe (Including Iceland and Greenland) Program Sppt 24189 Check FMV Sub-Saharan Africa Program Sppt 6000 Check FMV 2 true false true true true false Monitoring use of grant funds Form 990, Schedule F, Part I, Line 2 The Foundation provides unrestricted program support for certain foreign organizations. Program support to specific organizations is chosen and directed by the physicians and/or researchers working directly with the charity. true Community Gallery DBA Ava Gallery 11 Bank Street Lebanon NH 03766 237394706 501(C)(3) 14950 FMV CHAD Arts Prog Connecticut Pharmacists Foundation Inc 35 Cold Springs Road Rocky Hill CT 06067 651193552 501(C)(3) 55000 FMV Pharm Edu 2 Medical Research Grants 29 460577 FMV Patient Care Support 21 4613 FMV Tuition Scholarships 2 34204 FMV Part 1 Line 2 Fellowships and large Program Project Grants are given every two years. Small pilot grants are made twice a year. Amounts awarded range from $1,000 to $125,000 and are awarded on a competitive basis. All grant and fellowship-related expenses are reviewed and approved by the Foundation before paid. Requests for expenditures not in pre-approved grant budgets are rejected. false true false false false false false false false E Ann Gormley MD Board Chair/Physician 0 357458 0 103962 0 36798 0 214627 0 16092 0 728937 0 0 Richard Powell MD Trustee/Vice Chair end 7/1/15 0 383501 0 60750 0 22077 0 99353 0 17848 0 583529 0 0 Jeffrey Cohen MD Trustee Ex-Officio/Physician 0 382972 0 0 0 19464 0 115884 0 20127 0 538447 0 0 Lawrence Dacey MD Trustee 0 0 0 0 0 0 0 178092 0 10399 0 188491 0 0 Michael Zegans MD Trustee 0 309188 0 18821 0 12074 0 57873 0 18376 0 416332 0 0 Michele Lauria MD Trustee/Phy End 7/1/15 0 170469 0 30075 0 17253 0 23636 0 6116 0 247549 0 0 Philip Goodney MD Trustee eff. 7/1/15 0 344054 0 60556 0 13721 0 43734 0 19520 0 481585 0 0 Note regarding compensation amounts Schedule J, part II Column B, parts I, II, and III represent actual amounts paid to employees by MHMH or DHC, related entities of THF. 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 D-H on behalf of its employees. Supplemental Nonqualified Retirement Plan Form 990, Schedule J, Part I, Line 4B The following individuals received payments from a supplemental nonqualified retirement plan (see below for terms). Michele Lauria $17,018 Richard Powell $20,775 Jeffrey Cohen $15,576 Defined Contribution Supplemental Retirement Plan Form 990, Schedule J, Part 1, Line 4B 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 (which consists of Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic), 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 Sections 401(a)(17) and/or IRC Section 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 contribution as a result of limitations imposed by IRC Sections 401(a)(17) and/or IRC Section 415. Business Relationships Form 990, Part VI, Section A, Line 2 The Hitchcock Foundation is part of the Dartmouth-Hitchcock Health System, which owns for-profit subsidiaries that provide services and supports the mission of the organizations. As a result, some officers of THF may also be officers of related for-profits entities. Governance & Management Form 990, Part VI, Section A, Lines 7a & 7b Dartmouth-Hitchcock Clinic (DHC) is the sole corporate member of The Hitchcock Foundation. As such, DHC retains limited powers in accordance with the bylaws including, but not limited to, electing Trustees of the Board, and approving changes within the bylaws. Process used by management and/or Governing Body to Review 990 Form 990, Part VI, Line 11b The Form 990 is reviewed by The Hitchcock Foundation's (THF) Executive Director and Treasurer of the Board of Trustees. A copy of the return is emailed to the entire board prior to filing. Conflict of Interest Policy Form 990, Part VI, Section B, Line 12C The Hitchcock Foundation Board of Trustees approved a policy concerning a voluntary self-disclosure of any potential conflict of interest. The Dartmouth-Hitchcock, Office of Policy Support, Compliance and Audit Services 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 Compliance and Audit Services 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 CIRCUMSTANCES, 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. Whistleblower Policy Form 990, Part VI, Section B, Line 13 The Organization has adopted and follows the policy of a related entity, Dartmouth-Hitchcock Clinic. Document Retention and Destruction Policy Form 990, Part VI, Section B, Line 14 The Organization has adopted and follows the policy of a related entity, Dartmouth-Hitchcock Clinic. Offices & Positions for Which Process was Used & Year Undertaken Form 990, Part VI, Question 15b The Director and staff of The Hitchcock Foundation are donated by Dartmouth-Hitchcock Clinic (DHC) and Mary Hitchcock Memorial Hospital (MHMH). Compensation for officers and key employees are evaluated by internal DHC AND MHMH HR staff using national benchmarking data, along with ongoing evaluations by an independent third party firm for reasonableness, with the last formal process in 2012. Compensation rates are determined by following the guidelines of the compensation committee charter and philosophy documents and/or a formal review by DHC AND MHMH compensation committee members. Governing documents, COI policy, Financial Statement Availability Form 990, Part VI, Section C, Line 19 THF's governing documents are available through the New Hampshire Department of State. The audited financial statements, governing documents, and the conflict of interest policy are available upon request in either electronic or hardcopy form. Compensation Form 990, Part VII, Section A, Line 1 The compensation paid by related organizations was for services provided to the related organizations and not the filing organization, with exception of the Executive Director, of which 100% of their time is spent with the Foundation. Although the individuals spent the time listed as part of their board of trustee duties, they were not compensated with respect to those hours. The time/hours reported at the related organization varies by individual and organization. Other Fees for Services Form 990, Part IX, Line 11G Other Fees for services includes reimbursement for payroll for research and education-related expenses to Dartmouth Hitchcock Clinic, Mary Hitchcock Memorial Hospital, and The Trustees of Dartmouth College in the amount of $2,114,976. The remaining $56,464 was paid to other outside entitites related to the Foundation's mission of providing research and education. Audit Committee and Financial Statement Oversight FROM 990, PART XII, QUESTION 2C THE ORGANIZATION DOES NOT DELEGATE ANY OVERSIGHT OF THE AUDIT TO A SUBCOMMITTEE. THE FULL BOARD REVIEWS AND APPROVES ALL INFORMATION AND FINANCIAL STATEMENTS. THE ORGANIZATION IS INCLUDED IN THE AUDIT AND FINANCIAL STATEMENTS OF ITS PARENT ORGANIZATION, DARTMOUTH-HITCHCOCK CLINIC. Financial Statements and Reporting FORM 990, Part XII, Question 3a DURING FISCAL YEAR 2016, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FUNDS FROM FEDERAL AWARDS IN EXCESS OF THE $750,000 THRESHOLD SET FORTH IN THE OMB UNIFORM GUIDANCE, THEREFORE REQUIRING AN AUDIT. DUE TO THE ISSUANCE OF THE CONSOLIDATED FINANCIAL STATEMENTS, THE SINGLE AUDIT WAS PERFORMED ON THE COMBINED FINANCIAL INFORMATION OF ALL ORGANIZATIONS, INCLUDING THE HITCHCOCK FOUNDATION. FORM 990 PART IX LINE 11G DESCRIPTION:RESEARCH AND MGMT EXPENS TOTAL FEES:2171440 Dartmouth-Hitchcock Health One Medical Center Drive Lebanon NH 03756 264812335 Parent Org NH 501(c)(3) 7 NA false Dartmouth-Hitchcock Clinic One Medical Center Drive Lebanon NH 03756 222519596 Phys Svc NH 501(c)(3) 9 D-HH true Hamden Assurance Risk Retention Group 30 Main Street Suite 330 Burlington VT 05401 208530788 Slf Insurance VT 501(c)(3) 11 Type 1 DHC true Mary Hitchcock Memorial Hospital One Medical Center Drive Lebanon NH 03756 020222140 Hospital NH 501(c)(3) 3 D-HH true The New London Hospital Association Inc 273 County Rd New London NH 03257 020222171 Health Care NH 501(c)(3) 3 D-HH true Windsor Hospital Association 289 Country Road Windsor VT 05089 030183721 Hospital VT 501(C)(3) 3 D-HH true Cheshire Medical Center 580 Court Street Keene NH 03431 020354549 Hospital NH 501(C)(3) 3 D-HH true Cheshire Health Foundation 580 Court Street Keene NH 03431 020202220 SUPPORTNG ORG NH 501(C)(3) 11 TYPE I CMC true Mt Ascutney Hosp Cmmty Hlth Found 289 County Road Windsor VT 05089 030300481 Foundation VT 501(c)(3) 3 WHA true Historic Homes of Runnemede 289 County Road Windsor VT 05089 237396147 Healthcare VT 501(c)(3) 9 WHA true Alice Peck Day Memorial Hospital 10 Alice Peck Day Drive Lebanon NH 037662647 020222791 Hospital NH 501(c)(3) 3 D-HH true Cheshire Health Services 580 Court Street Keene NH 03431 473379283 HEALTHCARE NH 501(c)(3) 3 CMC true OBNet Services LLP 1 Med Ctr Dr Lebanon NH 03756 043746287 Database Serv NH NA Keene Hlth Alliance 580 Crt St Keene NH 03431 300179297 Healthcare NH NA DH Master Invst Prg 1 Med Ctr Dr Lebanon NH 03756 020505863 Investments NH MHMH Excluded 456083 22840202 false -18788 false 0.04139 One Care VT ACOLLC 111 COLCHESTER AVE Burlington VT 05401 455399218 Shared Saving VT NA Pompanoosuc Investment Corp One Medical Center Drive Lebanon NH 03756 020352330 Real Est Hldg NH DHC C Corp true Hamden Assurance Co LTD 44 Church Street Hamilton HM EX BD 980121409 Liab Ins BD DHC C Corp true Hitchcock Health Connect 1 Medical Ctr Dr Lebanon NH 03756 800908979 Telehealth DE D-HH C Corp true Kearsarge Community Services 273 County Road New London NH 03257 020460136 Real Est Hldg NH NLH C Corp true New London Physician Group Inc 273 County Road New London NH 03257 020494420 Physician Gro NH NLH C Corp true New London Medical Center East 273 County Road New London NH 03257 020480857 Real EST HLDG NH NLH C Corp true Charit Remndr Unitrusts (5) One Medical Center Drive Lebanon NH 03756 Chart. Trust NH MHMH TRUST true Keene Health Services 580 Court Street Keene NH 03431 020374997 Real Est Hldg NH CMC C Corp true Keene Health Realty 580 Court Street Keene NH 03431 020374998 Real Est Hldg NH CMC C Corp true Keene Health Enterprises 580 Court Street Keene NH 03431 020374999 Real Est Hldg NH CMC C Corp true Imaginecare One Medical Center Drive Lebanon NH 03756 Telehealth NH D-HH C Corp true false true true false false false false false false false false false false false true true false true Mary Hitchcock Memorial Hospital P 1318408 FMV Dartmouth Hitchcock Clinic P 1883440 FMV Dartmouth-Hitchcock Master Investment Program S 650000 FMV Dartmouth Hitchcock Clinic B 42731 FMV Mary Hitchcock Memorial Hospital B 99705 FMV Dartmouth Hitchcock Clinic C 130270 FMV Mary Hitchcock Memorial Hospital C 303964 FMV