DARTMOUTH-HITCHCOCK HEALTH: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- DARTMOUTH-HITCHCOCK HEALTH (EIN 26-4812335)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201741359349302004
- Schema version
- 2015v3.0
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T08:21:58-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRICEWATERHOUSECOOPERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SEAPORT BLVD | AddressLine1Txt |
| City | BOSTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02210 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264812335 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dartmouth-Hitchcock Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DANIEL JANTZEN | InCareOfNm |
| Business Name Control | DART | BusinessNameControlTxt |
| Phone | 6036505000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One Medical Center Drive | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03756 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANIEL JANTZEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6036505634 | PhoneNum |
| Signature | 2017-05-11 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Paul Tanis | PreparerPersonNm |
| PTIN | P01441612 | PTIN |
| Phone | 6175305000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES WEINSTEIN DO MS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One Medical Center Drive | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03756 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,728,587 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | To govern for an integrated health care delivery system that best serves the purposes of preventing,diagnosing treating,& curing human illness within the Northern New England Region | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $21,987 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $20,847 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,320,951 | PYContributionsGrantsAmt |
| CY Contributions Grants | $27,403,196 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,580,018 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,572,222 | CYProgramServiceRevenueAmt |
| PY Investment Income | $24 | PYInvestmentIncomeAmt |
| CY Investment Income | -$1,027,487 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$287,793 | PYOtherRevenueAmt |
| CY Other Revenue | -$842,395 | CYOtherRevenueAmt |
| PY Total Revenue | $19,613,200 | PYTotalRevenueAmt |
| CY Total Revenue | $31,105,536 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $454,651 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $849,186 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,318,135 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,861,216 | PYOtherExpensesAmt |
| CY Other Expenses | $10,768,787 | CYOtherExpensesAmt |
| PY Total Expenses | $16,315,867 | PYTotalExpensesAmt |
| CY Total Expenses | $11,617,973 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,297,333 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $19,487,563 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,044,581 | TotalAssetsBOYAmt |
| Total Assets EOY | $24,831,076 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,937,190 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,084,846 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,107,391 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,746,230 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | DARTMOUTH-HITCHCOCK HEALTH (D-HH), IS A NEW HAMPSHIRE (NH) NONPROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). D-HH WAS FORMED IN MAY 2009 WITH OPERATIONS COMMENCING ON OCTOBER 1, 2010. D-HH IS OPERATED FOR THE FOLLOWING CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES: -TO ESTABLISH, MANAGE, GOVERN, AND FUNDRAISE FOR AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT BEST SERVES THE PURPOSES OF PREVENTING, DIAGNOSING, TREATING AND CURING HUMAN ILLNESS WITHIN THE NORTHERN NEW ENGLAND REGION; -TO MANAGE A HEALTHCARE SYSTEM THAT PROVIDES HEALTH CARE SERVICES TO THE PUBLIC IN A COST-EFFECTIVE MANNER; -TO ESTABLISH AND MAINTAIN COOPERATIVE HOSPITAL AND PROVIDER RELATIONSHIPS THROUGHOUT ITS SYSTEM; -TO ACHIEVE EXCELLENCE IN CLINICAL INNOVATIONS, SERVICE, QUALITY, COST AND OUTCOMES, SUPPORTED BY A STRONG ACADEMIC PROGRAM; AND TO INTEGRATE RESEARCH, TRAINING, INFORMATION TECHNOLOGY AND ACADEMIC MEDICINE IN THE PROVIDER ORGANIZATIONS THR | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,166,923 | ExpenseAmt |
| Grant | $849,186 | GrantAmt |
| Revenue | $3,748,963 | RevenueAmt |
| Desc | As part of its strategy to create a sustainable health system to improve the lives of the people and communities it serves for generations to come, Dartmouth-Hitchcock Health continues to work to establish and maintain cooperative hospital and provider relationships throughout the Northern New England region. In addition to continued work with the 17 members of the New England Alliance for Health, which it established as a voluntary shared services organization, D-HH has finalized affiliations with four hospitals and Visiting Nurse and Hospice of Vermont and New Hampshire. The recent affiliations with New London Hospital and Cheshire Medical Center in NH, Mt. Ascutney in VT, as well as the latest affiliation with Alice Peck Day in NH, are allowing for more coordinated care and efficiencies across systems, as well as more effective utilization of hospital beds. Benevera Health, a population health improvement company focused on care coordination and quality improvement, formed with Harvard Pilgrim, Elliot Hospital, and Frisbie Memorial Hospital, began operations on January 1, 2016 and has grown to 100,000 member lives. Improved and coordinated patient care, with early intervention when appropriate, is intended to help drive down the cost of health care, allowing Harvard Pilgrim to keep premiums lower and consistently more competitive for members. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,255,228 | ExpenseAmt |
| Desc | A major D-HH initiative to create integrated relationships across New Hampshire and Vermont continues, with a goal of improving population health, offering value-based care, and embracing new payment models that move away from fee for service. The OneCare Vermont ACO with University of Vermont Medical Center includes all Vermont hospitals and hundreds of primary care physicians and specialists, two federally qualified health centers, and several rural health clinics, to coordinate the health care of approximately 42,000 of Vermonts 118,000 Medicare beneficiaries. D-HH continues to build its telemedicine program to provide care across its rural region and in particular to make specialist consultation and care available to community hospitals. Through a number of grants, including $998,356 from the US Department of Agriculture, it has purchased telemedicine equipment for more than 35 sites in Vermont and New Hampshire, including rural acute care hospitals, ambulatory care sites, rehabilitation sites and behavioral health centers. This allows caregivers at remote locations to access specialists at Dartmouth-Hitchcock and bring them "virtually" to the patient's bedside. The Connected Care Center in Lebanon is home to a 24/7 team of physicians, pharmacists and nurses supporting care in 40+ specialties. Acute care telehealth service lines, which include TeleEmergency, TelePharmacy, TeleNeurology and TeleICU, bring together pools of doctors and nurses from all over the country and the world. TeleEmergency is live at 8 hospitals, assisting local teams in direct care, transfer and transport coordination of the sickest patients. The D-H TeleICU team of intensivists is covering 46 hospitals and more than 200 active beds, across 7 states. The D-H TelePharmacy team is processing 15,000 consults and orders every month from a 7 hospital network. The TeleStroke/TeleNeurology service line has performed over 350 emergency consults since 2013. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $979,170 | ExpenseAmt |
| Revenue | $1,823,259 | RevenueAmt |
| Desc | Nationally, Dartmouth-Hitchcock is a founding member, with Mayo Clinic, Intermountain Health Care, Denver Health, and The Dartmouth Institute for Health Policy and Clinical Practice, of the High Value Healthcare Collaborative (HVHC). The Collaborative currently comprises more than a dozen health systems across the country. Together, they have a patient base of more than 70 million. The goal of the Collaborative is to improve the quality of health care while lowering costs. Through data sharing and defining of best practices for 8 high-cost, high-variation conditions, the members are improving outcomes and already seeing cost savings. A $26 million grant from CMS made it possible for MHMH, a wholly-owned hospital of D-HH, to integrate first in the nation shared decision making tools into clinical care. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $9,401,321 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (true) | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 5 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | Yes (true) | ForeignFinancialAccountInd |
| Foreign Country | BD | ForeignCountryCd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANIEL JANTZEN | PersonNm |
| Phone | 6036505634 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03756 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| Vincent S Conti MHA | ||||||||
| Trustee | 0.5 | 1.5 | Yes (X) | $0 | $0 | $0 | ||
| James N Weinstein DO MS | ||||||||
| Trustee Ex-Officio/CEO | 6.0 | 55.01 | Yes (X) | $0 | $1,332,138 | $162,531 | Yes (X) | |
| Robert A Oden Jr PhD | ||||||||
| Trustee/Vice Chair eff. 1/1/16 | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Barbara J Couch MS | ||||||||
| Trustee/Board Secretary | 1.0 | 1.5 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| William J Conaty | ||||||||
| Trustee | 0.5 | 1.5 | Yes (X) | $0 | $0 | $0 | ||
| Denis A Cortese MD | ||||||||
| Trustee | 0.5 | 1.5 | Yes (X) | $0 | $0 | $0 | ||
| Matthew B Dunne | ||||||||
| Trustee end 12/31/15 | 0.5 | 1.5 | Yes (X) | $0 | $0 | $0 | ||
| Laura K Landy MBA | ||||||||
| Trustee | 0.5 | 1.5 | Yes (X) | $0 | $0 | $0 | ||
| Paul P Danos PhD | ||||||||
| Trustee/BD Trsr end 12/31/15 | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Steven A Paris MD | ||||||||
| Trustee/Reg Med Dir | 0.5 | 44.01 | Yes (X) | $0 | $375,697 | $53,636 | ||
| Richard J Powell MD | ||||||||
| Trustee end 12/31/15 | 0.5 | 41.8 | Yes (X) | $0 | $466,328 | $117,201 | ||
| Anne-Lee Verville | ||||||||
| Trustee/Brd Chair eff. 1/1/16 | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Troyen A Brennan MD MPH | ||||||||
| Trustee | 0.5 | 1.5 | Yes (X) | $0 | $0 | $0 | ||
| R William Burgess Jr MBA | ||||||||
| Trustee | 0.5 | 1.5 | Yes (X) | $0 | $0 | $0 | ||
| Duane A Compton PhD | ||||||||
| Trustee/Ex-Officio | 0.5 | 1.81 | Yes (X) | $0 | $0 | $0 | ||
| Charles G Plimpton MBA | ||||||||
| Trustee/Bd Trsr eff. 1/1/16 | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Robin Kilfeather-Mackey CPA | ||||||||
| Chief Financial Officer | 6.0 | 55.01 | $0 | $550,797 | $175,125 | Yes (X) | ||
| Stephen Leblanc | ||||||||
| Exec VP Strtgy & Ntwrk Rltns | 39.0 | 21.01 | $0 | $616,651 | $179,153 | Yes (X) | ||
| John Butterly MD | ||||||||
| Fmr Offr/Exec VP Med Affairs | 26.0 | 12.0 | $0 | $482,349 | $63,446 | Yes (X) | ||
| Jeanine Arden Ornt | ||||||||
| Fmr General Counsel | 0.0 | 25.0 | $0 | $213,499 | $0 | Yes (X) | ||
| Carl Dematteo MD | ||||||||
| Fmr Chf Ql Compl Ofr/Physician | 0.0 | 40.0 | $0 | $130,501 | $1,482 | Yes (X) | ||
| Thomas Colacchio MD | ||||||||
| Former Officer/Phys | 0.0 | 41.0 | $0 | $1,021,525 | $81,611 | Yes (X) | ||
| Kimberly Troland JD | ||||||||
| Fmr Intrm GC/Deputy Gen Cnsl | 6.0 | 54.0 | $0 | $371,724 | $38,986 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,561,209 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $873,171 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Raymond James Associates | |||||
| PO Box 23604 | ST PETERSBURG | FL | 33742 | Consulting | $390,282 |
| The Trustees of Dartmouth College | |||||
| 37 DEWEY FIELD | HANOVER | NH | 03755 | Developmnt & Svcs | $881,968 |
| OneCare VT Accountable Care Org LL | |||||
| 111 Colchester Avenue | BURLINGTON | VT | 05401 | ACO Activities | $3,433,337 |
| Avera Health | |||||
| 3900 West Avera Drive | SIOUX FALLS | SD | 57108 | Telehealth Svcs | $686,462 |
| PriceWaterhouseCoopers LLP | |||||
| 101 Seaport Blvd | BOSTON | MA | 02210 | Consulting | $525,085 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Fundraising | $4,286,760 | FundraisingAmt |
| All Other Contributions | $23,116,436 | AllOtherContributionsAmt |
| Noncash Contributions | $716,741 | NoncashContributionsAmt |
| Total Contributions | $27,403,196 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEMBER ASSESSMENTS | 900004 | $3,748,963 | $3,748,963 |
| ACO INCENTIVE INCOME | 900004 | $1,823,259 | $1,823,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,572,222 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,027,487 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$1,027,487 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,027,487 | TotalRevenueColumnAmt |
| Exclusion | -$1,027,487 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $753,169 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $4,286,760 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $1,595,564 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$842,395 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $21,987 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$864,382 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,105,536 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,572,222 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $21,987 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$1,891,869 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $849,186 | TotalAmt |
| Program Services | $849,186 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,221 | TotalAmt |
| Management And General | $3,221 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,332,970 | TotalAmt |
| Program Services | $6,674,031 | ProgramServicesAmt |
| Management And General | $895,296 | ManagementAndGeneralAmt |
| Fundraising | $763,643 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,017 | TotalAmt |
| Program Services | $16,017 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,410 | TotalAmt |
| Program Services | $200,410 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,995 | TotalAmt |
| Program Services | $10,995 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,663 | TotalAmt |
| Program Services | $64,663 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,613 | TotalAmt |
| Program Services | $24,613 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,508 | TotalAmt |
| Program Services | $167,508 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,872 | TotalAmt |
| Program Services | $14,872 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,096 | TotalAmt |
| Program Services | $20,096 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| EVERWELL BVP EXPENSE | $1,325,600 | $1,325,600 | |
| UBIT TAXES AND OTHER | $33,330 | $33,330 | |
| GIFTS IN KIND EXPENSE | $554,492 | $554,492 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,617,973 | TotalAmt |
| Program Services | $9,401,321 | ProgramServicesAmt |
| Management And General | $898,517 | ManagementAndGeneralAmt |
| Fundraising | $1,318,135 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,617 | BOYAmt |
| EOY | $337,212 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,573,754 | BOYAmt |
| EOY | $6,250,687 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $161,270 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $85,515 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,627 | BOYAmt |
| EOY | $75,755 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $217,078 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,262,583 | BOYAmt |
| EOY | $17,950,344 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,044,581 | BOYAmt |
| EOY | $24,831,076 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,202,291 | BOYAmt |
| EOY | $1,671,372 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,734,899 | BOYAmt |
| EOY | $5,413,474 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,937,190 | BOYAmt |
| EOY | $7,084,846 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,107,391 | BOYAmt |
| EOY | $17,746,230 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,107,391 | BOYAmt |
| EOY | $17,746,230 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,044,581 | BOYAmt |
| EOY | $24,831,076 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $19,487,563 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$4,848,724 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,544,108 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,320,951 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,620,543 | CurrentTaxYearAmt |
| Total | $19,485,602 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,544,108 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,320,951 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,620,543 | CurrentTaxYearAmt |
| Total | $19,485,602 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,345,247 | SubstantialContributorsTotAmt |
| Public Support Total170 | $18,140,355 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $42,856 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,847 | CurrentTaxYearAmt |
| Total | $63,703 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $19,549,305 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $25,288,682 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.92793 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93457 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Unusual Grants | FormAndLineReferenceDesc |
| Explanation | Form 990, Schedule A, Part II, Line 1 During Fiscal Year 2016, Alice Peck Day Memorial Hospital Affiliated with Dartmouth-Hitchcock Health. Dartmouth-Hitchcock Health recognized $18,782,653 in non-operating revenue on its audited financial statements as part of this transaction. As such, D-HH excluded this amount from schedule A calculations as an unusual grant for FY16. Form 990, Schedule A, Part II, Line 1 During Fiscal Year 2015, Cheshire Medical Center and Windsor Hospital Association DBA Mt. Ascutney Hospital and Health Center, Affiliated with Dartmouth-Hitchcock Health. Dartmouth-Hitchcock Health recognized $128,147,000 in non-operating revenue on its audited financial statements as part of this transaction. As such, D-HH excluded this amount from schedule A calculations as an unusual grant for FY15. Form 990, Schedule A, Part II, Line 1 During Fiscal Year 2014, the New London Hospital Association affiliated with Dartmouth-Hitchcock Health. Dartmouth-Hitchcock Health recognized $36,131,000 in non-operating revenue on its audited financial statements as part of this transaction. As such, D-HH excluded this amount from schedule A calculations as an unusual grant for FY14. | ExplanationTxt |
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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $100,830 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,314 | DepreciationAmt |
| Book Value | $12,126 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $60,440 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,201 | DepreciationAmt |
| Book Value | $63,629 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $75,755 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INVESTMENT IN NNEACC | $450,000 |
| INVESTMENT IN IVYMD | $2,510,096 |
| INVESTMENT IN ONECARE VT | $25,000 |
| INVESTMENT IN EVERWELL | $250,000 |
| INVESTMENT IN BENEVERA | $1,772,006 |
| INVESTMENT IN GREENHEALTH PROJ | $150,000 |
| INVESTMENT IN IMAGINECARE | $12,793,242 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $17,950,344 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES-DHC AND MHMH | $3,663,124 |
| DUE TO AFFILIATES-EVERWELL | $1,750,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,413,474 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | AUDITED FINANCIAL STATEMENT FOOTNOTE REGARDING ASC 740 | FormAndLineReferenceDesc |
| Explanation | Schedule D, Part X, Line 2 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DOES NOT INCLUDE A FOOTNOTE RELATING TO ASC 740; THERE HAVE BEEN NO CHANGES SINCE INCEPTION. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Prouty Wlk/Bike | Event1Nm |
| Gross Receipts Event1 | $2,715,503 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $2,364,887 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $350,616 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $112,947 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $440 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $533,146 | OtherDirectExpensesEvent1Amt |
| Event2 | CHaD Hlf Mthn | Event2Nm |
| Gross Receipts Event2 | $617,704 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $593,446 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $24,258 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $58,296 | NonCashPrizesEvent2Amt |
| Food And Beverage Event2 | $360 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $229 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $24,258 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 14 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $1,706,722 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $1,328,427 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $378,295 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $480,104 | NonCashPrizesOtherEventsAmt |
| Rent Fclty Costs Other Events | $1,547 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $1,189 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $17,501 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $365,547 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $5,039,929 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $4,286,760 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $753,169 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $651,347 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,547 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $1,989 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $17,730 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $922,951 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $1,595,564 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$842,395 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|---|
| Grafton County Senior Citizens Council | |||||||||
| PO Box 433 | Lebanon | NH | 03766 | 237248316 | 501(C)(3) | $36,295 | FMV | Elder Services | |
| Good Neighbor Health Clinic | |||||||||
| 70 N MAIN ST | WHITE RIVER JCT | VT | 05001 | 030346949 | 501(C)(3) | $69,990 | FMV | PROGRAM/CLINIC SVCS | |
| Ottauquechee Health Foundation | |||||||||
| 32 PLEASANT STREET | WOODSTOCK | VT | 05091 | 030197766 | 501(C)(3) | $20,000 | FMV | PROGRAM SUPPORT | PO BOX 784 |
| Mascoma Valley Health Initiative | |||||||||
| PO Box 2013 | Canaan | NH | 03741 | 752991608 | 501(C)(3) | $28,672 | FMV | Hlth Adv Cnsl Sppt | |
| Listen Lebanon In Service To Each Neighbor | |||||||||
| 60 Hanover Street | Lebanon | NH | 03766 | 237225952 | 501(C)(3) | $10,400 | FMV | Program Services | |
| Alice Peck Day Memorial Hospital | |||||||||
| 10 APD Memorial Dr | Lebanon | NH | 03766 | 020222791 | 501(C)(3) | $16,000 | FMV | Dental Prog Svcs | |
| The Trustees of Dartmouth College | |||||||||
| 1 Rope Ferry Road | Hanover | NH | 03755 | 020222111 | 501(c)(3) | $134,546 | FMV | Educ and Prog Sppt | |
| Fannie E Rippel Foundation | |||||||||
| 14 Maple Avenue | Morristown | NJ | 07960 | 221559427 | 501(c)(3) | $100,000 | FMV | Prog Support | |
| Granite YMCA | |||||||||
| 117 Market Street | Manchester | NH | 03101 | 020222248 | 501(c)(3) | $7,500 | FMV | Program Support | |
| Granite State United Way | |||||||||
| 46 South Main Street | Concord | NH | 03301 | 026006033 | 501(c)(3) | $105,000 | FMV | Program Support | |
| City Year Inc | |||||||||
| 848 Elm Street | Manchester | NH | 03101 | 222882549 | 501(c)(3) | $175,000 | FMV | Preogram Support | Suite 201 |
| Cheshire Medical Center | |||||||||
| 580-590 Court Street | Keene | NH | 034315400 | 020354549 | 501(c)(3) | $101,463 | FMV | Program Support | |
| Easter Seals New Hampshire Inc | |||||||||
| 555 Auburn Street | Manchester | NH | 03103 | 020272825 | 501(c)(3) | $5,625 | FMV | Program Support | |
| Families in Transition | |||||||||
| 122 Market Street | Manchester | NH | 03101 | 020475414 | 501(c)(3) | $5,625 | FMV | Program Support | |
| River Valley Community College | |||||||||
| 1 College Place | Claremont | NH | 03743 | 900531902 | 501(c)(3) | $5,625 | FMV | Program Support | |
| Upper Valley Haven | |||||||||
| 713 Hartford Avenue | White River Jct | VT | 05001 | 030277908 | 501(c)(3) | $5,625 | FMV | Program Support | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 16 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Procedures for monitoring the use of grant funds | FormAndLineReferenceDesc |
| Explanation | Form 990, Schedule I, Part I, Line 2 The organization provides grants and assistance to other organizations based on needs and relation to the mission of Dartmouth-Hitchcock Health. Funds donated are for the general purpose and/or specific purposes defined by our Community Relations team. D-HH staff monitor and sign off on any funds prior to distribution or reimbursement of expenses. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James N Weinstein DO MS | ||||||||||||||
| Trustee Ex-Officio/CEO | $0 | $1,239,023 | $0 | $0 | $0 | $93,115 | $0 | $148,835 | $0 | $13,696 | $0 | $1,494,669 | $0 | $0 |
| Robin Kilfeather-Mackey CPA | ||||||||||||||
| Chief Financial Officer | $0 | $513,562 | $0 | $0 | $0 | $37,235 | $0 | $154,998 | $0 | $20,127 | $0 | $725,922 | $0 | $0 |
| Stephen Leblanc | ||||||||||||||
| Exec VP Strtgy & Ntwrk Rltns | $0 | $480,623 | $0 | $0 | $0 | $136,028 | $0 | $159,027 | $0 | $20,126 | $0 | $795,804 | $0 | $0 |
| John Butterly MD | ||||||||||||||
| Fmr Offr/Exec VP Med Affairs | $0 | $433,100 | $0 | $0 | $0 | $49,249 | $0 | $62,386 | $0 | $1,060 | $0 | $545,795 | $0 | $0 |
| Jeanine Arden Ornt | ||||||||||||||
| Fmr General Counsel | $0 | $213,499 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $213,499 | $0 | $0 |
| Carl Dematteo MD | ||||||||||||||
| Fmr Chf Ql Compl Ofr/Physician | $0 | $128,215 | $0 | $0 | $0 | $2,286 | $0 | $355 | $0 | $1,127 | $0 | $131,983 | $0 | $0 |
| Thomas Colacchio MD | ||||||||||||||
| Former Officer/Phys | $0 | $612,710 | $0 | $0 | $0 | $408,815 | $0 | $64,362 | $0 | $17,249 | $0 | $1,103,136 | $0 | $0 |
| Steven A Paris MD | ||||||||||||||
| Trustee/Reg Med Dir | $0 | $349,732 | $0 | $0 | $0 | $25,965 | $0 | $39,937 | $0 | $13,699 | $0 | $429,333 | $0 | $0 |
| Richard J Powell MD | ||||||||||||||
| Trustee end 12/31/15 | $0 | $383,501 | $0 | $60,750 | $0 | $22,077 | $0 | $99,353 | $0 | $17,848 | $0 | $583,529 | $0 | $0 |
| Kimberly Troland JD | ||||||||||||||
| Fmr Intrm GC/Deputy Gen Cnsl | $0 | $351,563 | $0 | $20,000 | $0 | $161 | $0 | $21,239 | $0 | $17,747 | $0 | $410,710 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Severance Payments | FORM 990, SCHEDULE J, PART I LINE 4A DURING 2012, THOMAS COLACCHIO TRANSITIONED FROM AN OFFICER ROLE TO A STAFF PHYSICIAN ROLE. AS PART OF THIS TRANSITION, THOMAS COLACCHIO RECEIVED A $320,000 CHANGE OF CONTROL PAYMENT FROM DARTMOUTH-HITCHCOCK IN 2015. THE PAYMENT IS INCLUDED ON SCHEDULE J, PART II, COLUMN (B)III. Supplemental Nonqualified Retirement Information Form 990, Schedule J, Part I, Line 4b The following individuals received payments from a supplemental nonqualified retirement plan: James Weinstein $90,829 Robin Kilfeather-Mackey $16,500 Stephen Leblanc $109,692 John Butterly $41,875 Thomas Colacchio $88,815 Stephen Paris $17,319 Richard Powell $20,775 Dartmouth-Hitchcock Supplemental Retirement Plan Terms and Conditions: An eligible employee is a participant in the Dartmouth-Hitchcock Retirement Plan and/or any prior pension arrangements sponsored by Dartmouth-Hitchcock (including a qualified defined benefit plan) who would be entitled to additional contributions or benefit accruals under the terms of the Plans for the plan year, but are limited by IRC Section 401 (a)(17) and/or 415. For eligible employees, the Employer will pay the eligible employee an amount determined by the employer each year to offset the amount of the reduction in the benefit accrual or contributions as a result of limitations imposed by IRC Sections 401(a)(17) and/or 415. |
| Note regarding compensation amounts | Schedule J, part II Column B, parts I, II, and III represent actual amounts paid to employees by related entities Dartmouth-Hitchcock Clinic or Mary Hitchcock Memorial Hospital. 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 DHC or MHMH on behalf of its employees. |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 7 | ContributionCnt |
| Noncash Contributions Rpt F990 | $9,500 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp |
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $8,998 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $6,104 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 15 | ContributionCnt |
| Noncash Contributions Rpt F990 | $162,249 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 69 | ContributionCnt |
| Noncash Contributions Rpt F990 | $108,101 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Drugs And Medical Supplies | DrugsAndMedicalSuppliesGrp | |
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | Various items for events, hear aids, & supplies | Desc |
| Contribution | 301 | ContributionCnt |
| Noncash Contributions Rpt F990 | $421,789 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | Yes (true) | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule M, Part I, Line 32b | FormAndLineReferenceDesc |
| Explanation | The organization utilizes a Joint Development Office (JDO) contract with the Trustees of Dartmouth College to assist with solicitation of donors and gifts on behalf of the entire Dartmouth-Hitchcock Health system. Contributions solicited by D-HH may be utilized by related organizations including, but not limited to, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Business relationships | Form 990, Part VI, Section A, Line 2 Dartmouth-Hitchcock Health owns for-profit subsidiaries that provide services and support the mission of the organization. As a result, some officers of DHH may also be officers of related for-profits entities. Delegation of Committees Form 990, Part VI, Section A, Line 3 THE D-HH BOARD DELEGATES CERTAIN FINANCIAL, AUDIT AND COMPLIANCE OVERSIGHT TO THE FINANCE AND AUDIT AND COMPLIANCE COMMMITTEE OF THE JOINT BOARDS OF TRUSTEES OF MARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH-HITCHCOCK CLINIC, ACTING JOINTLY AS DARTMOUTH-HITCHCOCK ("D-H"). IN ADDITION, THE D-HH BOARD DELEGATES TO D-H, ACTING THROUGH ITS BOARDS AND APPROPRIATE COMMITTEES AND STAFF, THE OBLIGATION TO OVERSEE THE CLINICAL ACTIVITIES AND RESEARCH OF D-H AND ITS OPERATIONS IN ACCORDANCE WITH CURRENT D-H POLICIES AND PROCEDURES, INCLUDING THOSE FOR MANAGED CARE CONTRACTING, QUALITY OF CARE, AND RESEARCH PROGRAMS AND AFFILIATIONS WHICH POLICIES THE BOARD HEREBY APPROVES AND ENDORSES, PROVIDED THAT ANY SIGNIFICANT CHANGE TO SUCH POLICIES WILL BE SUBMITTED TO THE BOARD FOR APPROVAL. THE D-HH BOARD CONTINUES TO RETAIN FINAL MANAGEMENT POWERS AND DECISIONS PURSUANT TO SECTION 3.9.2 OF THE CORPORATION'S BYLAWS. Changes to Organizational Documents Form 990, Part VI, Line 4 The organization made updates to the bylaws to reflect the change of Dartmouth-Hitchcock Health from a supporting organization to a publicly supported organization. Process used by management and/or Governing Body to Review 990 Form 990, Part VI, Line 11b THE FORMS 990 AND 990-T ARE EACH REVIEWED BY EXTERNAL TAX ADVISORS, THE DIRECTOR OF CORPORATE FINANCE, VICE PRESIDENT OF CORPORATE FINANCE, AND THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURNS. ONCE THE RETURNS HAVE BEEN FULLY PREPARED A FINAL 990 AND 990-T COMPLETE ELECTRONIC VERSION IS SENT OUT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS/RESPONSES PRIOR TO OFFICIAL FILING. Conflict of Interest Policy Form 990, Part VI, Section B, Line 12C The Dartmouth-Hitchcock Health 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, TRUSTEES, AND KEY EMPLOYEES 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. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR UNDERTAKEN Form 990, Part VI, Line 15a Although paid by a related organization, Dartmouth-Hitchcock Clinic, the Compensation for the Chief Executive Officer is evaluated by an independent third party firm for reasonableness and national data benchmarking. The Compensation Committee, along with Independent Trustees, approve the final compensation in consideration with the independent third party firm's recommendations and suggestions. This process was last undertaken in 2016. Offices & Positions for Which Process was Used & Year Undertaken Form 990, Part VI, Line 15b D-HH uses the staff of related organizations, Dartmouth-Hitchcock Clinic (DHC) and Mary Hitchcock Memorial Hospital (MHMH). Compensation for officers and key employees are evaluated by internal 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 (2016 for VP's and above). External benchmarking from an independent third party has been used for any Officer who was hired or received a compensation adjustment since the last formal process. Compensation rates are determined by following the guidelines of the compensation committee charter and philosophy documents and/or a formal review by compensation committee members. Avail of Gov Docs, Conflict of Interest Policy, & Financial Statements to the General Public Form 990, Part VI, Line 19 D-HH's governing documents are available through the New Hampshire Secretary of State. The audited financial statements, governing documents, and conflict of interest policy are available upon request either in electronic or hardcopy form. Average Hours Per Week Form 990 Part VII, Section A, Line 1A, Column B Dartmouth-Hitchcock Health is the sole corporate Member of Dartmouth-Hitchcock Clinic (DHC), and Mary Hitchcock Memorial Hospital (MHMH), as well as other related and supporting organizations. As part of DHC's and MHMH's affiliation agreement, the three organizations share officers. As such, the average hours per week are allocated between the organization's 990s even though compensation reported in part VII is based on the entity issuing the W-2. Other Fee For Service Expenses Form 990, Part IX, Line 11G D-HH purchases program and management staff from its supported tax-exempt entities Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital to fulfill its mission and ongoing duties. Services purchased for the Fiscal Year 2016 totaled $3,087,184. In addition, D-HH paid $5,245,786 for ACO-related, affiliation expenses, and other external consultants. Reconciliation of Net Assets Form 990, Part XI, Line 9 Net Asset Transfer $4,848,724 Delegation of Oversight Form 990, Part XII, Line 2c The D-HH Board delegates certain financial, audit and compliance oversight to the Finance and Audit Commmittee as well as the Compliance Committees of the joint boards of trustees of Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic, acting jointly as Dartmouth-Hitchcock ("D-H"). The D-HH board continues to retain final management powers and decisions pursuant to Section 3.9.2 of the Corporation's Bylaws. A-133 Audit Form 990, Part XII, Line 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 DARTMOUTH-HITCHCOCK HEALTH. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:8332970 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Dartmouth-Hitchcock Clinic | ||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 222519596 | Phys Svcs | NH | 501(C)(3) | 9 | D-HH | Yes (true) |
| Mary Hitchcock Memorial Hospital | ||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020222140 | Hospital | NH | 501(C)(3) | 3 | D-HH | Yes (true) |
| The Hitchcock Foundation | ||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020222139 | HLTHCRE RSRCH | NH | 501(C)(3) | 7 | DHC | Yes (true) |
| Hamden Risk Retention Group Inc | ||||||||||
| 30 Main Street Suite 330 | Burlington | VT | 05401 | 208530788 | SELF INS. | VT | 501(C)(3) | 11 TYPE I | DHC | Yes (true) |
| The New London Hospital Assoc Inc | ||||||||||
| 273 County Road | New London | NH | 03257 | 020222171 | Hospital | NH | 501(c)(3) | 3 | D-HH | Yes (true) |
| Windsor Hospital Association | ||||||||||
| 289 Country Road | Windsor | VT | 05089 | 030183721 | Hospital | VT | 501(C)(3) | 3 | D-HH | Yes (true) |
| Cheshire Medical Center | ||||||||||
| 580 Court Street | Keene | NH | 03431 | 020354549 | Hospital | NH | 501(C)(3) | 3 | D-HH | Yes (true) |
| Cheshire Health Foundation | ||||||||||
| 580 Court Street | Keene | NH | 03431 | 020202220 | SUPPORTNG ORG | NH | 501(C)(3) | 11 TYPE I | CMC | Yes (true) |
| Mt Ascutney Hosp Cmmty Hlth Found | ||||||||||
| 289 Country Road | Windsor | VT | 05089 | 030300481 | Hospital | VT | 501(c)(3) | 3 | WHA | Yes (true) |
| Historic Homes of Runnemede | ||||||||||
| 289 Country road | Windsor | VT | 05089 | 237396147 | Healthcare | VT | 501(c)(3) | 9 | WHA | Yes (true) |
| Cheshire Health Services | ||||||||||
| 580 Court Street | Keene | NH | 03431 | 473379283 | HEALTHCARE | NH | 501(c)(3) | 3 | CMC | Yes (true) |
| Alice Peck Day Memorial Hospital | ||||||||||
| 10 Alice Peck Day Drive | Lebanon | NH | 03766 | 020222791 | Hospital | NH | 501(c)(3) | 3 | D-HH | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | UBI Code VUBICodeVAmt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OBNET Services LLC | ||||||||||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 043746287 | Database Serv | NH | DHC | $0 | ||||||
| D-H Mster Invst Prg | ||||||||||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 020505863 | Pooled Invest | NH | MHMH | $0 | ||||||
| Keene Hlth Alliance | ||||||||||||||
| 580 Court St | Keene | NH | 03431 | 300179297 | Healthcare | NH | DHC | $0 | ||||||
| OneCare VT ACOLLC | ||||||||||||||
| 111 COLCHESTER AVE | Burlington | VT | 05401 | 455399218 | Shared Saving | VT | DHH | $0 | Related | -$612,253 | $25,000 | false | Yes (true) | 0.50000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pompanoosuc Investment Corporation | |||||||||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020352330 | Rl Estate Hld | NH | DHC | C Corp | Yes (true) | ||||||||
| Hamden Assurance Company Limited | |||||||||||||||||
| 980121409 | Liab Insur. | DHC | Foreign Corp | Yes (true) | Canons Court 22 Victoria St | Hamilton | BD | HM EX | BD | ||||||||
| Hitchcock Health Connect | |||||||||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 800908979 | Telehealth | DE | D-HH | C Corp | Yes (true) | -$156,859 | $269,797 | 1.00000 | |||||
| Kearsarge Community Services | |||||||||||||||||
| 273 County Road | New Lodnon | NH | 03257 | 020460136 | Real Est Hldg | NH | NLH | C Corp | Yes (true) | ||||||||
| New London Physician Group | |||||||||||||||||
| 273 Country Road | New London | NH | 03257 | 020494420 | Physician Gro | NH | NLH | C Corp | Yes (true) | ||||||||
| New London Medical Center East | |||||||||||||||||
| 273 County Road | New London | NH | 03257 | 020480857 | Real Est Hold | NH | NLH | C Corp | Yes (true) | ||||||||
| Keene Health Services | |||||||||||||||||
| 580 Court Street | Keene | NH | 03431 | 020374997 | Real Est Hldg | NH | CMC | C Corp | Yes (true) | ||||||||
| Keene Health Realty | |||||||||||||||||
| 580 Court Street | Keene | NH | 03431 | 020374998 | Real Est Hldg | NH | CMC | C Corp | Yes (true) | ||||||||
| Keene Health Enterprises | |||||||||||||||||
| 580 Court Street | Keene | NH | 03431 | 020374999 | Real Est Hldg | NH | CMC | C Corp | Yes (true) | ||||||||
| Charit Remndr Unitrusts (4) | |||||||||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | Chart. Trust | NH | MHMH | TRUST | Yes (true) | |||||||||
| ImagineCare | |||||||||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 813105071 | Telehealth | NH | D-HH | C Corp | Yes (true) | $0 | $12,793,242 | 1.00000 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Mary Hitchcock Memorial Hospital | ||
| Q | $2,624,274 | FMV |
| Dartmouth-Hitchcock Clinic | ||
| Q | $1,124,689 | FMV |
| Onecare VT ACO | ||
| P | $3,433,337 | FMV |
| Everwell Inc | ||
| L | $1,325,600 | FMV |
| Cheshire Medical Center | ||
| B | $101,463 | FMV |
| Alice Peck Day Memorial Hospital | ||
| C | $18,782,653 | FMV |
| ImagineCare Inc | ||
| B | $12,793,242 | FMV |