CHESHIRE MEDICAL CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CHESHIRE MEDICAL CENTER (EIN 02-0354549)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-11
- IRS object ID
- 201611329349300021
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-11T08:02:33-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010494526 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER NEWMAN & NOYES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 650 ELM STREET SUITE 302 | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020354549 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Cheshire Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHES | BusinessNameControlTxt |
| Phone | 6033545400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580-590 Court Street | AddressLine1Txt |
| City | Keene | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 034315400 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Robert Cochrane | PersonNm |
| Person Title | Chief Financial Officer | PersonTitleTxt |
| Phone | 6033545400 | PhoneNum |
| Signature | 2016-05-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Timothy R Hepburn | PreparerPersonNm |
| PTIN | P00182393 | PTIN |
| Phone | 8002447444 | PhoneNum |
| Preparation | 2016-05-05 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | Don Caruso | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580-590 Court Street | AddressLine1Txt |
| City | Keene | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 034315400 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $163,839,490 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cheshire-med.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | Community health care organization serving as a regional referral center | ActivityOrMissionDesc |
| Voting Members Governing Body | 23 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1123 | TotalEmployeeCnt |
| Total Volunteers | 160 | TotalVolunteersCnt |
| Total Gross UBI | $154,895 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$89,607 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $695,254 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,208,416 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $155,615,611 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $159,316,387 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,601,362 | PYInvestmentIncomeAmt |
| CY Investment Income | $955,785 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,924,975 | PYOtherRevenueAmt |
| CY Other Revenue | $2,358,902 | CYOtherRevenueAmt |
| PY Total Revenue | $159,837,202 | PYTotalRevenueAmt |
| CY Total Revenue | $163,839,490 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $60,554,893 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $61,032,813 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $98,088,979 | PYOtherExpensesAmt |
| CY Other Expenses | $103,365,620 | CYOtherExpensesAmt |
| PY Total Expenses | $158,643,872 | PYTotalExpensesAmt |
| CY Total Expenses | $164,398,433 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,193,330 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$558,943 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $137,587,316 | TotalAssetsBOYAmt |
| Total Assets EOY | $144,627,429 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $65,004,098 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $66,131,206 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $72,583,218 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $78,496,223 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The Cheshire Medical Center is a community health care organization serving as a regional referral center for Keene and the surrounding service area. It is fully committed to meeting the health care needs of these communities and providing access to quality health care services and programs. As a non-profit corporation, the Cheshire Medical Center acknowledges its commitment to provide services to the community. These services arise primarily from the four following general service categories. 1) Subsidization of government-sponsored healthcare programs - principally Medicare and Medicaid. 2) Sponsorship and/or subsidization of health-related community services and educational programs. 3) Provision of healthcare at no charge or reduced charge, according to financial need. 4) Provision of 24-hour emergency room services, without regard for ability to pay. The Cheshire Medical Center, as a matter of policy and practice has provided, and will continue to provide, a significant contributi | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $145,411,299 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $161,520,394 | RevenueAmt |
| Desc | The primary purpose of the Cheshire Medical Center is to ensure access to quality health care services to all residents of the Monadnock Region. The Organization's charitable mission is enhanced through the operation of a joint operating partnership agreement with the Hitchcock Clinic. The purpose of the Joint Operating Partnership Agreement is to provide a more extensive and effective health care delivery system to the communities in the Monadnock Region by establishing joint planning and decision making processes, integrating health care services and establishing mechanisms for the reinvestment of resources to improve community health. The financial results of the joint operating partnership are reported annually on Form 1065, U.S. Partnership Return of Income. | Desc |
| Total Program Service Expenses | $145,411,299 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 177 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1123 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 23 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Robert Cochrane CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6033545400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580-590 Court Street | AddressLine1Txt |
| City | Keene | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 034315400 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Ed Bergeron Jr | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| John Birkmeyer MD | |||||||||
| Trustee | 1.00 | 61.50 | Yes (X) | $0 | $261,699 | $34,858 | |||
| Judith A Boule MD | |||||||||
| Medical Staff President | 1.00 | 41.50 | Yes (X) | $0 | $324,618 | $276,540 | |||
| Wendy Fielding CPA | |||||||||
| Trustee | 1.00 | 41.50 | Yes (X) | $0 | $220,559 | $57,824 | |||
| Timothy J Fisher MD | |||||||||
| Trustee | 1.00 | 41.50 | Yes (X) | $0 | $276,988 | $74,562 | |||
| H Roger Hansen | |||||||||
| Trustee | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Steve Horton | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| Nathalie Houder | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| Lawrence J Jaeger MD | |||||||||
| Trustee | 1.00 | 41.50 | Yes (X) | $0 | $317,909 | $252,282 | |||
| Judy Kalich | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| Michael Kapiloff | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| Mary Ann Kristiansen | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| Geof Molina | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| Steven Paris MD | |||||||||
| Trustee | 1.00 | 41.50 | Yes (X) | $0 | $357,571 | $117,329 | |||
| Leslie T Pitts MD | |||||||||
| Trustee | 1.00 | 41.50 | Yes (X) | $0 | $264,764 | $209,530 | |||
| Kary Shumway | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| Katherine Snow | |||||||||
| Trustee | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| Sylvia McBeth | |||||||||
| Chair | 2.00 | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Gregg R Tewksbury CPA | |||||||||
| Vice Chair | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Robert Mucha | |||||||||
| Treasurer | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Mary Louise Caffrey | |||||||||
| Secretary | 1.00 | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Arthur W Nichols | |||||||||
| President | 50.00 | 3.00 | Yes (X) | $572,249 | $0 | $99,303 | Yes (X) | ||
| Don Caruso MD | |||||||||
| CEO/CMO | 11.50 | 41.50 | Yes (X) | $0 | $344,756 | $254,418 | Yes (X) | ||
| Robert Cochrane | |||||||||
| CFO | 51.00 | 2.00 | $207,760 | $0 | $18,168 | Yes (X) | |||
| Cindi Coughlin | |||||||||
| CNO | 52.00 | $196,449 | $0 | $106,069 | Yes (X) | ||||
| Paul Pezone | |||||||||
| VP Facilities & Support Se | 52.00 | $185,637 | $0 | $39,262 | Yes (X) | ||||
| Erli Chen | |||||||||
| Physicist | 50.00 | $233,043 | $0 | $44,230 | Yes (X) | ||||
| Larry Miller | |||||||||
| Chief CRNA | 50.00 | $201,108 | $0 | $72,699 | Yes (X) | ||||
| Julie Green | |||||||||
| VP, Human Resources | 50.00 | $181,868 | $0 | $44,843 | Yes (X) | ||||
| Yvonne Goldsberry | |||||||||
| Sr. Director of Community Health | 50.00 | $168,691 | $0 | $33,745 | Yes (X) | ||||
| Letasha Heape | |||||||||
| CRNA | 50.00 | $155,877 | $0 | $29,164 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,102,682 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,368,864 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,764,826 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 34 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Quest Diagnostics | |||||
| 5763 Collection Center Drive | Chicago | IL | 60693 | Lab Diagnostic Services | $616,382 |
| New England Medical Transcription Inc | |||||
| PO Box 430 | Woolwich | ME | 04579 | Transcription Services | $563,367 |
| RF-WORKS | |||||
| 2172 Citygate Drive | Columbus | OH | 43219 | Wireless Network Services | $484,778 |
| Cheshire Anesthesia Associates | |||||
| 580 Court Street | Keene | NH | 034311718 | Anesthesiology Services | $455,000 |
| Allscripts LLC | |||||
| 24630 Network Place | Chicago | IL | 606731246 | Electronic Health Record Technology | $426,384 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $409,829 | RelatedOrganizationsAmt |
| All Other Contributions | $798,587 | AllOtherContributionsAmt |
| Total Contributions | $1,208,416 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Services | 621300 | $156,722,340 | $156,722,340 |
| Pharmacy and Drugs | 446110 | $1,290,462 | $1,290,462 |
| Food Services | 722210 | $962,133 | $962,133 |
| Miscellaneous Health Services | 621300 | $157,694 | $157,694 |
| Gift Shop Income | 453220 | $103,256 | $103,256 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $80,502 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $80,502 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $159,316,387 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $409,770 | TotalRevenueColumnAmt |
| Exclusion | $409,770 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $546,015 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $546,015 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $546,015 | TotalRevenueColumnAmt |
| Exclusion | $546,015 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Meaningful Use Income | 621300 | $766,389 | $766,389 | |
| Childcare Center | 624410 | $620,116 | $465,221 | $154,895 |
| Rebates and Discounts | 621300 | $98,569 | $98,569 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $873,828 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $873,828 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,358,902 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163,839,490 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $161,520,394 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $154,895 | UnrelatedBusinessRevenueAmt |
| Exclusion | $955,785 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,424,897 | TotalAmt |
| Program Services | $1,162,716 | ProgramServicesAmt |
| Management And General | $262,181 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,504,221 | TotalAmt |
| Program Services | $34,676,766 | ProgramServicesAmt |
| Management And General | $7,827,455 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,808,691 | TotalAmt |
| Program Services | $1,475,892 | ProgramServicesAmt |
| Management And General | $332,799 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,048,473 | TotalAmt |
| Program Services | $10,239,334 | ProgramServicesAmt |
| Management And General | $1,809,139 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,246,531 | TotalAmt |
| Program Services | $2,618,327 | ProgramServicesAmt |
| Management And General | $628,204 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,772 | TotalAmt |
| Management And General | $217,772 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,750 | TotalAmt |
| Management And General | $64,750 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,451,065 | TotalAmt |
| Program Services | $23,946,880 | ProgramServicesAmt |
| Management And General | $1,504,185 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,286 | TotalAmt |
| Program Services | $295,286 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,152,151 | TotalAmt |
| Program Services | $929,210 | ProgramServicesAmt |
| Management And General | $222,941 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,359 | TotalAmt |
| Program Services | $301,921 | ProgramServicesAmt |
| Management And General | $72,438 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,390,734 | TotalAmt |
| Program Services | $4,347,627 | ProgramServicesAmt |
| Management And General | $1,043,107 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,315 | TotalAmt |
| Program Services | $186,556 | ProgramServicesAmt |
| Management And General | $44,759 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,070,933 | TotalAmt |
| Program Services | $863,707 | ProgramServicesAmt |
| Management And General | $207,226 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,751,781 | TotalAmt |
| Program Services | $7,864,811 | ProgramServicesAmt |
| Management And General | $1,886,970 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $484,149 | TotalAmt |
| Program Services | $390,466 | ProgramServicesAmt |
| Management And General | $93,683 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Med Supplies, Drugs, et | $26,475,274 | $26,475,274 | |
| Bad Debt Expense | $8,306,085 | $8,306,085 | |
| JOA Gainshare | $7,640,000 | $6,161,660 | $1,478,340 |
| PILOT and MET | $7,090,020 | $7,090,020 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,369,946 | TotalAmt |
| Program Services | $8,078,761 | ProgramServicesAmt |
| Management And General | $1,291,185 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,398,433 | TotalAmt |
| Program Services | $145,411,299 | ProgramServicesAmt |
| Management And General | $18,987,134 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,492,399 | BOYAmt |
| EOY | $16,131,280 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,248,900 | BOYAmt |
| EOY | $16,470,755 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,338,661 | BOYAmt |
| EOY | $2,859,734 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,646,392 | BOYAmt |
| EOY | $3,240,328 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $204,097,244 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $125,616,574 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,062,017 | BOYAmt |
| EOY | $78,480,670 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,014,572 | BOYAmt |
| EOY | $21,598,882 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $394,167 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,784,375 | BOYAmt |
| EOY | $5,451,613 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,587,316 | BOYAmt |
| EOY | $144,627,429 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,675,495 | BOYAmt |
| EOY | $14,668,106 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,853 | BOYAmt |
| EOY | $10,471 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,131,888 | BOYAmt |
| EOY | $29,350,588 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $424,044 | BOYAmt |
| EOY | $217,360 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,737,818 | BOYAmt |
| EOY | $21,884,681 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,004,098 | BOYAmt |
| EOY | $66,131,206 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,092,699 | BOYAmt |
| EOY | $73,914,740 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,490,519 | BOYAmt |
| EOY | $4,581,483 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,583,218 | BOYAmt |
| EOY | $78,496,223 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,587,316 | BOYAmt |
| EOY | $144,627,429 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$558,943 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$698,531 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $7,170,479 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $21,737 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $21,737 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | A portion of American Hospital Association and NH Hospital Association dues are available for lobbying. During 2014, the amounts available for lobbying were $6,252 and $15,485, respectively. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,487,520 | BeginningYearBalanceAmt |
| Contributions | $968,233 | ContributionsAmt |
| Investment Earnings Or Losses | $414,873 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,223,773 | OtherExpendituresAmt |
| End Year Balance | $4,646,853 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,602,059 | BeginningYearBalanceAmt |
| Contributions | $272,723 | ContributionsAmt |
| Investment Earnings Or Losses | $929,038 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $316,300 | OtherExpendituresAmt |
| End Year Balance | $4,487,520 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,055,274 | BeginningYearBalanceAmt |
| Contributions | $234,785 | ContributionsAmt |
| Investment Earnings Or Losses | $688,499 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $376,499 | OtherExpendituresAmt |
| End Year Balance | $3,602,059 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,634,569 | BeginningYearBalanceAmt |
| Contributions | $154,965 | ContributionsAmt |
| Investment Earnings Or Losses | $484,487 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $218,747 | OtherExpendituresAmt |
| End Year Balance | $3,055,274 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,445,561 | BeginningYearBalanceAmt |
| Contributions | $168,756 | ContributionsAmt |
| Investment Earnings Or Losses | $299,947 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $279,695 | OtherExpendituresAmt |
| End Year Balance | $2,634,569 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $231,151 | OtherCostOrOtherBasisAmt |
| Book Value | $231,151 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $92,248,987 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,056,156 | DepreciationAmt |
| Book Value | $44,192,831 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $111,356,871 | OtherCostOrOtherBasisAmt |
| Depreciation | $77,560,418 | DepreciationAmt |
| Book Value | $33,796,453 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $260,235 | OtherCostOrOtherBasisAmt |
| Book Value | $260,235 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $78,480,670 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Pooled Investments | $20,654,035 | F |
| Funded Depreciation Account | $944,847 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $21,598,882 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Liability | $10,094,198 |
| Due to Related Party | $11,790,483 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $21,884,681 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $161,985,206 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$698,531 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $303,944 | OtherRevenueAmt |
| Revenue Not Reported | -$394,587 | RevenueNotReportedAmt |
| Revenue Subtotal | $162,379,793 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,459,697 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,459,697 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $163,839,490 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $163,319,809 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $381,073 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $381,073 | ExpensesNotReportedAmt |
| Expenses Subtotal | $162,938,736 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,459,697 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,459,697 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $164,398,433 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Income from the endowments is used to support the Organization's programs. |
| Part X, Line 2: | The Medical Center and its controlled affiliates are not-for-profit corporations as described in Section 501(c)(3) of the Code, and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management has evaluated its tax positions and concluded that the Medical Center and its controlled affiliates have maintained tax-exempt status, do not have any significant unrelated business income and have taken no uncertain tax positions that require adjustment to or disclosure in the accompanying financial statements. KHS is a for-profit organization and, in accordance with federal and state laws, files a return separate from that of the Foundation. KHS files a consolidated federal income tax return and a state income tax return in New Hampshire. In 2015 and 2014, no federal income taxes were charged to operations due to KHS incurring an operating loss on a consolidated basis. With few exceptions, the Medical Center, Foundation and KHS are no longer subject to income tax examination by the U.S. federal or state tax authorities for years before 2012. |
| Part XI, Line 2d - Other Adjustments: | Revenue allocated to Cheshire Health Services 303,944. Expenses included in revenue per Audited Financial Statements |
| Part XI, Line 4b - Other Adjustments: | Expenses included in revenue per Audited Financial Statements 1,459,697. |
| Part XII, Line 2d - Other Adjustments: | Expenses allocated to Cheshire Health Services 381,073. |
| Part XII, Line 4b - Other Adjustments: | Expenses included in revenue per Audited Financial Statements 1,459,697. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | Investments In Investment Entities Domiciled In Foreign Jurisdictions | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $3,920,233 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $3,920,233 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $3,920,233 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | Yes (1) | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule F, Part I, line 3: | The legal owner of The Cheshire Medical Center's foreign investments is a related organization, The Cheshire Health Foundation. Since a portion of the total foreign investments are allocated to the Medical Center's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, line 3 of The Cheshire Medical Center's Form 990. However, any required IRS Forms 926 and other foreign tax reporting obligations are filed by the legal owner, The Cheshire Health Foundation. |
| Schedule F, Part IV, line 3: | The Cheshire Medical Center did not have an ownership interest in any foreign corporation that is greater than the 10% filing threshold. Accordingly, IRS Form(s) 5471 is not required to be filed. |
| Schedule F, Part IV, line 4: | The Cheshire Medical Center meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Hospital. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 225.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,473,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,473,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,378,053 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,609,041 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,769,012 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08180 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,851,053 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,609,041 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,242,012 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09120 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 26 | ActivitiesOrProgramsCnt |
| Persons Served | 16765 | PersonsServedCnt |
| Total Community Benefit Expns | $1,483,923 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $109,293 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,374,630 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00880 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 1102 | PersonsServedCnt |
| Total Community Benefit Expns | $350,157 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $832 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $349,325 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 182 | PersonsServedCnt |
| Total Community Benefit Expns | $1,305,964 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,305,964 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00840 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 43 | PersonsServedCnt |
| Total Community Benefit Expns | $280,425 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $117,191 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $163,234 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 265 | PersonsServedCnt |
| Total Community Benefit Expns | $251,975 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,472 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $211,503 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 41 | ActivitiesOrProgramsCnt |
| Persons Served | 18357 | PersonsServedCnt |
| Total Community Benefit Expns | $3,672,444 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $267,788 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,404,656 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02180 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 41 | ActivitiesOrProgramsCnt |
| Persons Served | 18357 | PersonsServedCnt |
| Total Community Benefit Expns | $25,523,497 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,876,829 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,646,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11300 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 21240 | PersonsServedCnt |
| Total Community Benefit Expns | $145,942 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $79,756 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $66,186 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 4481 | PersonsServedCnt |
| Total Community Benefit Expns | $64,019 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,519 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $56,878 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $56,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $454,417 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $454,417 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 25721 | PersonsServedCnt |
| Total Community Benefit Expns | $721,256 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $128,256 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $593,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,206,149 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $802,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $61,719,557 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $72,037,969 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$10,318,412 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cheshire Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 580 Court Street | AddressLine1Txt |
| City | Keene | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03431 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cheshire-med.com | WebsiteAddressTxt |
| State License | 00014 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Cheshire Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 225.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| The Cheshire Medical Center | Part V, Section B, Line 5: Needs were prioritized based on data collected from several current assessment processes. Prioritization was completed by the Community Health Needs Assessment Leadership Team. Several hundred people participated in forums and surveys to identify community needs. |
| The Cheshire Medical Center | Part V, Section B, Line 6b: The Cheshire Medical Center collaborated with Dartmouth-Hitchcock Keene; New Hampsire Department of Health and Human Services; Greater Monadnock Public Health Network (GMPHN); The New Hampshire Hospital Association; Foundation for Healthy Communities; Antioch University New England; Monadnock United Way; New Hampshire Center for Public Policy Studies; Southwestern Regional Planning Commission; and Home Healthcare, Hospice, and Community Services. |
| The Cheshire Medical Center | Part V, Section B, Line 11: The Cheshire Medical Center has implemented strategies to address all but two of the needs identified in its most recent CHNA. Access to beahvioral health outpatient services is addressed by Community Partners Monadnock Family Services, Phoenix House, and MAPS Counseling Services. Expansion of personal and public transportation options is addressed by Community Partners Monadnock Regional Transportation Management Association, Home Healthcare Hospice and Community Services, American Red Cross, and the Southwest Regional Planning Commission. |
| The Cheshire Medical Center | Part V, Section B, Line 15e: The contact information for hospital facility staff is provided on the financial information landing page of the website (https://www.cheshire-med.com/patients_visitors/financial_assistance.html) and in the supplemental FAP Brochure, which is available at all registration stations in the hospital. Medical Center staff and administrators are currently in process of updating the FAP, application, and other related materials; contact information will be included in all financial assistance materials going forward. |
| The Cheshire Medical Center | Part V, Section B, Line 16i: The Cheshire Medical Center's Plain Language Summary was available at all registration desks and by request during the fiscal year. While it was not available on the website during the filing period, it is on the website as of the time of this filing (http://www.cheshire-med.com/images/patients_visitors/Financial_Assistance_Brochure.pdf). Additionally, the Medical Center has a committee that is working to ensure full compliance with final 501(r) regulations in advance of the deadline, which is applicable to fiscal years beginning after December 29, 2015. |
| The Cheshire Medical Center | Part V, Section B, Line 22d: The State of New Hampshire mandates a discount for all uninsured patients. This discount is equal to the average discount negotiated by the largest (by dollar) three commercial insurers. The Cheshire Medical Center has always been in full compliance with the laws of the State of New Hampshire, and a committee is in place to ensure the hospital is in full compliance with final 501(r) regulations in areas where federal regulations differ from or are more stringent than those issued by the state. |
| Schedule H, Part V, Section B, Line 7a: | The Cheshire Medical Center's 2013 CHNA is available on the Medical Center's website at: www.cheshire-med.com/images/aboutus/CHNA_2013.pdf. |
| Schedule H, Part V, Section B, Line 10a: | The Cheshire Medical Center's 2013 CHNA Implementation Strategy is available on the Medical Center's website at: www.cheshire-med.com/images/aboutus/CHNA_2013_Implementation_Plan.pdf. |
| Schedule H, Part V, Section B, Line 16a: | The Cheshire Medical Center's Financial Assistance Policy is available on the Medical Center's website at: https://www.cheshire-med.com/images/patients_visitors/ Financial_Assistance_Policy.pdf. |
| Schedule H, Part V, Section B, Line 16b: | The Cheshire Medical Center's FAP application is available on the Medical Center's website at: https://www.cheshire-med.com/images/patients_visitors/ Financial_Assistance_Application.pdf. |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| The Cheshire Medical Center Part V, Section B, line 16a website: | See Part V, Section C |
| The Cheshire Medical Center Part V, Section B, line 16b website: | See Part V, Section C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Cheshire Med Center Collecting Station | ||||
| 580-590 Court Street | Keene | NH | 03431 | Collecting Station |
| Cheshire Health Services Inc | ||||
| 580-590 Court Street | Keene | NH | 034315400 | Non-Emergency Walk In Clinic |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 8,306,085. |
| Part II, Community Building Activities: | The Medical Center has been actively engaged since the spring of 2006 in Healthy Monadnock (HM) 2020: to make Keene and the surrounding region the healthiest in the nation by the year 2020. HM2020 promotes broad-based community health messaging and other environmental strategies for prevention and wellness. The "champions program" engages individuals and organizations to take steps to improve health at a personal and institutional level. The Medical Center provides staffing, office space and overall leadership for this initiative. As of June 30, 2015 there were 3,191 individual champions, 120 organizational champions, and 20 school champions. The organization is a founding member of the Council for Health Communities, which has been in existence for over 16 years and has developed a variety of prevention, transportation, referral, and health promotion programs. |
| Part III, Line 2: | At cost bad debt expense of $3,206,149 is 38.6% of the bad debt reported on The Cheshire Medical Center's Audited Financial Statements, which totals $8,306,085.The amount of bad debt expense reported on Form 990, Part IX, Line 25 is the total amount of the Medical Center's bad debt expense per the audited financial statements, $8,328,320, less $22,235, which is the amount allocated to a related entity, Cheshire Health Services, Inc. The allowance for doubtful accounts, contractual allowances in net patient service revenue, and other revenue and expenses are also accounted for in the calculations reported on this Form 990 but not reported separately in the audited financial statements. See Schedule O footnote for additional information. |
| Part III, Line 3: | Cheshire Medical Center Management estimates that approximately 25% of bad debt expense (approximately 5 times the region's poverty rate) is an appropriate estimation of patients who would have been eligible for the organization's financial assistance program but did not apply. This estimation is based on the recognition that the financial assistance program is available to residents with incomes of up to three times the federally defined poverty income levels and the assumption that patients who choose not to pay their bills are more likely to fall within the lower income levels. For 2015, the estimated amount of bad debt expense (at cost) attributable to patients who would have been eligible for financial assistance is $802,000. |
| Part III, Line 4: | Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Medical Center analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for doubtful accounts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Medical Center analyzes contractually due amounts and provides an allowance for doubtful accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which included both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center records a provision for doubtful accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.The total provision for the allowance for doubtful accounts was $1,753,292, $6,575,028 and $11,397,403 for the 2015 successor period, 2015 predecessor period, and fiscal 2014 predecessor period, respectively. The Medical Center's bad debt write-offs decreased from $11,767,403 for the fiscal 2014 predecessor period to $7,225,028 during the 2015 predecessor period and to $2,003,393 during the 2015 successor period. The decrease in the year-end allowance and bad debt write-offs was a result of collection trends and the overall reduction in self-pay accounts receivable. |
| Part III, Line 8: | This shortfall should be considered community benefit because we are the only hospital/medical center in Cheshire County, New Hampshire and we are designated by CMS as a Medicare Dependent Hospital (MDH) due to greater than 60% of our average daily census being comprised of Medicare Patients. Our presence in the community allows the residents of Cheshire County, especially the elderly population, to receive comprehensive hospital and medical services close to home. |
| Part III, Line 9b: | Systems are in place to capture financial assistance accounts prior to a bill going to the patient. FAP eligible patients are not charged more than the amount generally billed. |
| Part VI, Line 2: | In 2013, a Community Health Needs Assessment (CHNA) was completed with an implementation strategy identified for community benefit activities for the next three years. The 2013 CHNA report summarizes the work of the CHNA Leadership Team and the efforts of other local collaborative groups to assess the needs of our region. Several community partners recently completed community needs assessments, including Healthy Monadnock 2020. The results were used to strengthen and support the needs assessment process. Four community needs were prioritized above the other identified needs: -Behavioral health services: increasing the effectiveness of local services -Urgent care: timely and economical access to services instead of emergency room care -Transportation: increase access to public/private transportation particularly in rural towns -Improved coordination and communication between services: improving linkages between clinical services, faith-based organizations, and informal support networkIn addition to these priorities, the implementation strategy also provides an overview of other CMC/DHK community benefit activities that are aligned with our mission or considered necessary to support ongoing efforts from previously identified community needs. The community health needs identified in the 2013 CHNA provide the basis for the development of the Implementation Strategy. Cheshire Medical Center provides staff for the Healthy Monadnock (HM)2020 initiative and funds the community assessment process through an evaluation partnership contract with Antioch New England University. On November 10, 2011 community members attended Summit II and reviewed 31 core implementation strategies. The (HM 2020) Healthiest community Advisory Board, comprised of 30 community representatives, provides ongoing oversight of the implementation of the strategies and community planning process.The Cheshire Medical Center/Dartmouth Hitchcock Keene Community Advisory Committee reviewed and commented on the community benefit report. The 2013 CHNA, Implementation Strategy and Community Benefit reports for 2009-2015 are available to the public on the Cheshire Medical Center website: www.cheshire-med.org. |
| Part VI, Line 3: | The Cheshire Medical Center is committed to providing medically necessary care to patients regardless of their ability to pay for services. Non-emergent patients sign a financial responsibility statement upon admission to certify recognition of their responsibility for payment of their bills. However, there will be instances where the patient, due to the lack of funds or third party coverage, will not be able to meet this obligation. The Cheshire Medical Center notifies patients of their potential to obtain assistance through the registration and billing processes. Upon registration, patients without insurance are offered the opportunity to apply for financial assistance. In addition, receptionists and clinicians in all areas are educated to refer patients to the financial assistance process in the event patients express concerns with their ability to pay for services. The application information is posted on the intranet and brochures describing the program are readily available to patients. There are signs posted in Registration and throughout the facility informing patients about financial assistance. Patients are informed of the program availability on any invoices they receive and individuals who attempt to collect patient balances are also trained to refer patients to the financial assistance process. The financial assistance application process is comprehensive and evaluates a patient's eligibility for a variety of federal, state, and local government programs in addition to The Cheshire Medical Center's internally funded financial assistance program. |
| Part VI, Line 4: | The Cheshire Medical Center is the only hospital in its primary service area ("PSA"). Management defines its PSA as the City of Keene and 19 geographically proximate communities. Towns and cities included in the PSA include Alstead, Chesterfield, Fitzwilliam, Gilsum, Harrisville/Chesham, Keene, Marlborough, Marlow, Nelson/Munsonville, Richmond, Roxbury, Stoddard, Sullivan, Surry, Swanzey, Troy, Walpole, Westmoreland and Winchester, all located in Cheshire County. According to the US Census Bureau, 2014 population estimates: -Medical Center's PSA represented approximately 5.79% of New Hampshire's population. -The PSA's total population is 76,596 with 23,281 residing in Keene, the largest community in the service area. -The median age of residents in Cheshire County is 41.7 with: -14,423 or 19% less than 18 years of age -49,266 or 64% between the ages of 18-64 -12,710 or 17% over the age of 64 -Poverty rate for Cheshire County was 11.7% as compared to 8.9% for the State of New Hampshire. The median household income is $56,139 compared to the state average of $65,986.According to the US Bureau of Labor Statistics, October 2015, the State had an unemployment rate of 3.3% compared to Cheshire County's rate of 2.8%. |
| Part VI, Line 5: | The Medical Center plays an active role in promoting community health and offers educational programs including classes and workshops. Our clinical staff works closely with our community health staff to develop programs that cover emerging health concerns and are delivered at the right literacy level for our community. The programs offered a variety of chronic disease and wellness topics such as nutrition amd exercise, diabetes prevention and monitoring, high blood pressure prevention and monitoring, cultural diversity, the Health Insurance Marketplace, self-esteem and self-help, elder care services and needs, and retirement and investments. All programs are offered free of charge.In addition, the Medical Center offers several community programs including: Cheshire Smiles, a school-based dental health program for children in grades K-3, provides screening, prevention and restorative dental care for children in Cheshire County schools. The Cheshire Medical Center/Dartmouth-Hitchcock Keene also works in partnership with other community health and human service organizations to meet the dental health needs of underserved populations such as the chronically mentally ill, pregnant women who cannot afford dental care, children identified through the school based Cheshire Smiles Program, and others. The Medical Center sponsors patient visits at Dental Health Works, a public/private program serving underserved residents of Cheshire County. The Cheshire Medical Center also provides leadership and support to the Dental Public Health Task Force, a coalition of dental staff, hospital staff and concerned citizen addressing the oral health needs of adults. The Cheshire Coalition for Tobacco Free Communities addresses the use of tobacco products by people who live and work in the communities served by The Cheshire Medical Center/Dartmouth Hitchcock Keene (CMC/DHK). The Coalition is comprised of hospital staff, healthcare providers, community members and representatives of schools and colleges, law enforcement, clergy and the general public. The group meets monthly working to engage schools and the greater community with tobacco prevention initiatives which include retailer education and enforcement of tobacco laws. The Program Manager, a CMC/DHK employee, actively engages in tobacco-free activities in our local community and coordinates with state agencies and organizations.The Medication Assistance Program addresses the critical need for programs to help low income people afford medications. The Medication Assistance Program provides free or reduced cost medications for acute illnesses and improves access to medications vital to continued good health for patients who require medication on an ongoing basis and who cannot afford it. In fiscal year 2015 the program supplied 1,073 prescriptions to 252 individuals valued at $565,250. This is a significant decrease from fiscal year 2014 (2,318 prescriptions to 401 individuals valued at 1.6 million dollars) in part due to Medicaid Expansion and the Health Insurance options as a result of the Affordable Care Act.Advocates for a Healthy Youth (AFHY) is a community coalition focused on childhood obesity. Through AFHY, CMC/DHK works closely with community health providers, Keene State College, Antioch University New England, Keene Parks and Recreation Center, UNH Cooperative Extension, Keene Housing, and area schools to address the epidemic of childhood obesity. In fiscal year 2015, AFHY supported efforts in several schools, after school programs, and non-profit organizations to implement the 5-2-1-0 message via policy change and educational activities. AFHY implemented the community based Family BeFit program through collaboration with the Keene Family YMCA and Keene State College Dietetic Internship Program.CMC/DHK is a site for the New Hampshire HEAL Initiative. Through our local program, we hope that all residents can live, learn, work, play, and heal in a community where physical activity, healthy eating, and healthy living are the norm. MHEAL is focused on addressing overweight and obesity, physical inactivity, and eating choices in the Greater Monadnock Public Health Region through programs, policies, systems, and environmental changes in two key settings: worksites and foodservice venues. -Worksites: Our worksite wellness initiative is committed to helping local worksites in their efforts to provide a healthy workplace environment. MHEAL's team has worked with over 35 organizations to date to create a culture of health in the workplace by helping employers adopt and promote evidence-based worksite wellness interventions. -Foodservice venues: In partnership with Keene State College, MHEAL helps foodservice venues promote healthier food options to diners through our program called Turn a New Leaf (TANL). Foodservice venues include worksite cafeterias, restaurants, and markets. Through our efforts, 13 venues have adopted the TANL program to date, with a plan to recruit many more over the next two years.Senior Passport is a program for area residents aged 60 years and above. It encompasses low cost complete evening and weekend meals; free health education programs oriented to seniors; exercise programs; and the Cheshire Walkers Program, a walking group that takes organized nature and historic walks. Seven walks are offered each spring and fall. Walks are typically led by a community member with occasional participation by CMC/DHK staff and occur at a variety of locations throughout the region. During fiscal year 2015, 4,469 meals were provided to program members and a total of 175 seniors attended the walking program. This represents about a 20% increase in the number of meals and 15% increase in the number of participants in Cheshire Walkers from last year.Greater Monadnock Public Health Network (GMPHN) is a community health and safety collaborative which works to enhance and improve public health-related services. GMPHN is one of 13 public health networks in the state of New Hampshire. The GMPHN is housed by CMC/DHK and, in collaboration with Cheshire County, is financed with funds provided by the Centers for Disease Control and Prevention, under an agreement with the State of New Hampshire, Department of Health and Human Services, and Division of Public Health Services and a mix of state funding via the general funds. The GMPHN serves all of Cheshire County and the 10 western-most towns in Hillsborough County. The GMPHN strives to increase collaboration and planning across municipal boundaries and the health and safety sectors. Two major focuses of the work is the development of a public health advisory board and the on-going effort for public health emergency preparedness. It is made up of members of each of the coalition communities as well as representatives of regional organizations involved in providing for the public's health and safety. As of June 30, 2015 there are 41 individuals/organizations addressing development of the public health advisory council and 75 member individuals/organizations addressing emergency preparedness.Included within the GMPHN, is the Greater Monadnock Medical Reserve Corps. Developed initially to build local capacity to address public health emergency response needs, the GMMRC also supports local initiatives to address pressing public health activities. Membership included doctors, nurses, EMT/paramedics, pharmacists, veterinarians, other public health professionals, and non-medical/public health members. As of June 30, 2015 the GMMRC has a membership of over 124 individuals. |
| Part VI, Line 6: | In 2014, the Board of the Medical Center, accompanied by the Board of Dartmouth-Hitchcock, approved an affiliation agreement between the Medical Centers. This agreement is intended to improve, integrate, and streamline patient care between the Medical Centers.The affiliation, which became effective on March 2, 2015, strengthens The Cheshire Medical Center as a regional resource for southwestern New Hampshire and southeastern Vermont. The affiliation will allow more patients to receive care closer to home, will free up bed capacity for tertiary care patients at Dartmouth-Hitchcock Medical Center in Lebanon, and will allow the Cheshire Medical Center to continue its leadership role in population health and the Healthy Monadnock 2020 initiative. Cheshire Medical Center and Dartmouth-Hitchcock have worked together since 1998, by means of a Joint Operating Agreement involving Dartmouth-Hitchcock Keene, a multi-specialty group practice that comprises the majority of Cheshire Medical Center's medical staff. This new affiliation agreement is seen as a natural step that will enable both organizations to more effectively pursue a common vision of the future of health care that is based on creating a sustainable health system, focusing on population health, delivering value-based care, and embracing the opportunities provided by new payment models.In addition to The Cheshire Medical Center and the Dartmouth-Hitchcock Medical Center, the affiliated health care system includes Mary Hitchcock Memorial Hospital, Dartmouth-Hitchcock Clinic, The New London Hospital Association, Windsor Hospital Corporation, and a number of other related organizations whose primary mission is health care in the region. The Cheshire Medical Center and other members of the affiliated health care system operate jointly through interlocking directorates, strategic planning, management, and share identical missions. |
| Part VI, Line 7, Reports Filed With States | NH |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John Birkmeyer MD | ||||||||||||||
| Trustee | $0 | $211,596 | $0 | $0 | $0 | $50,103 | $0 | $30,458 | $0 | $4,400 | $0 | $296,557 | $0 | $0 |
| Judith A Boule MD | ||||||||||||||
| Medical Staff President | $0 | $284,901 | $0 | $0 | $0 | $39,717 | $0 | $258,941 | $0 | $17,599 | $0 | $601,158 | $0 | $0 |
| Wendy Fielding CPA | ||||||||||||||
| Trustee | $0 | $220,289 | $0 | $0 | $0 | $270 | $0 | $37,462 | $0 | $20,362 | $0 | $278,383 | $0 | $0 |
| Timothy J Fisher MD | ||||||||||||||
| Trustee | $0 | $276,988 | $0 | $0 | $0 | $0 | $0 | $54,503 | $0 | $20,059 | $0 | $351,550 | $0 | $0 |
| Lawrence J Jaeger MD | ||||||||||||||
| Trustee | $0 | $317,165 | $0 | $0 | $0 | $744 | $0 | $238,600 | $0 | $13,682 | $0 | $570,191 | $0 | $0 |
| Steven Paris MD | ||||||||||||||
| Trustee | $0 | $329,589 | $0 | $0 | $0 | $27,982 | $0 | $100,968 | $0 | $16,361 | $0 | $474,900 | $0 | $0 |
| Leslie T Pitts MD | ||||||||||||||
| Trustee | $0 | $264,504 | $0 | $0 | $0 | $260 | $0 | $191,801 | $0 | $17,729 | $0 | $474,294 | $0 | $0 |
| Arthur W Nichols | ||||||||||||||
| President | $466,891 | $0 | $57,978 | $0 | $47,380 | $0 | $77,642 | $0 | $21,661 | $0 | $671,552 | $0 | $0 | $0 |
| Don Caruso MD | ||||||||||||||
| CEO/CMO | $0 | $342,742 | $0 | $0 | $0 | $2,014 | $0 | $236,579 | $0 | $17,839 | $0 | $599,174 | $0 | $0 |
| Robert Cochrane | ||||||||||||||
| CFO | $207,760 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $18,168 | $0 | $225,928 | $0 | $0 | $0 |
| Cindi Coughlin | ||||||||||||||
| CNO | $163,449 | $0 | $0 | $0 | $33,000 | $0 | $86,924 | $0 | $19,145 | $0 | $302,518 | $0 | $0 | $0 |
| Paul Pezone | ||||||||||||||
| VP Facilities & Support Se | $144,237 | $0 | $0 | $0 | $41,400 | $0 | $20,656 | $0 | $18,606 | $0 | $224,899 | $0 | $0 | $0 |
| Erli Chen | ||||||||||||||
| Physicist | $188,138 | $0 | $0 | $0 | $44,905 | $0 | $29,339 | $0 | $14,891 | $0 | $277,273 | $0 | $0 | $0 |
| Larry Miller | ||||||||||||||
| Chief CRNA | $178,618 | $0 | $0 | $0 | $22,490 | $0 | $63,600 | $0 | $9,099 | $0 | $273,807 | $0 | $0 | $0 |
| Julie Green | ||||||||||||||
| VP, Human Resources | $134,968 | $0 | $0 | $0 | $46,900 | $0 | $25,637 | $0 | $19,206 | $0 | $226,711 | $0 | $0 | $0 |
| Yvonne Goldsberry | ||||||||||||||
| Sr. Director of Community Health | $130,191 | $0 | $0 | $0 | $38,500 | $0 | $18,675 | $0 | $15,070 | $0 | $202,436 | $0 | $0 | $0 |
| Letasha Heape | ||||||||||||||
| CRNA | $155,877 | $0 | $0 | $0 | $0 | $0 | $6,231 | $0 | $22,933 | $0 | $185,041 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | The Cheshire Medical Center does not reimburse expenses for first class travel, housing allowance, health or social club dues, personal services, business use of personal residence, discretionary spending accounts, or provide tax indemnification or gross up payments. The Medical Center does reimburse Board members for companion travel to business related meetings under specific circumstances. All reimbursements are reported on a Form 1099 issued to the Board member. During the calendar year 2014, which is the basis for Form 990, Part VII and Schedule J reporting for the fiscal year ending June 30, 2015, no Board members were reimbursed under this arrangement. |
| Part I, Line 3 | The President of The Cheshire Medical Center is paid by the filing organization and methods use to determine compensation are as noted on Schedule, J, Part I, Line 3. The CEO is paid by Dartmouth-Hithcock Health, a related organization, which uses a compensation committee, an independent consultant, Form 990 of other organizatinos, written employment contract, a compensation survey or study, and approval by the Board or compensation committee to establish the CEO's compensation. |
| Part I, Line 4b | Dartmouth-Hitchcock, a related organization at the end of the filing period, paid compensation through a SERP to the following individuals listed in Part VII: Stephen A. Paris-$19,669; Judith A. Boule-$38,211. 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. |
| Part I, Line 7 | Senior Management is eligible for incentive compensation at the discretion of the Board based on, but not directly related to, overall organizational financial performance and other discretionary measures. |
| Form 990, Part VII-A and Schedule J, Part II: | The annual change in the actuarial value of the pension plan for the employees listed below has been reported as part of deferred compensation. The pension plan is held and administered by a related organization, The Cheshire Medical Center. The amounts reported for 2014 are: Arthur Nichols-$43,649 Cynthia Coughlin-$65,909 Paul Pezone-$1,101 Erli Chen-$8,595 Larry Miller-$38,424 Julienne Green-$2,806 Yvonne Goldsberry-$7,332 The present value of the accrued benefit at the beginning of the reporting period, representing accrual over multiple years of service for each participant, was: Arthur Nichols-$829,347 Cynthia Coughlin-$544,606 Paul Pezone-$32,348 Erli Chen-$120,724 Larry Miller-$982,529 Julienne Green-$79,794 Yvonne Goldsberry-$33,435 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NH Health & Education Facilities Authority | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 020279866 | BondIssuerEIN |
| Bond Issued | 2012-11-15 | BondIssuedDt |
| Issue Price | $29,650,000 | IssuePriceAmt |
| Purpose | Refund existing debt, acquisition of equipment | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $29,650,000 | TotalProceedsAmt |
| In Reserve Fund | $4,777,102 | InReserveFundAmt |
| Issuance Costs From Proceeds | $379,754 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $554,125 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $4,777,102 | CapitalExpendituresAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | Yes (1) | Form8038TFiledInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Ed Bergeron | |||
| Hired by CMC for construction services | $25,125 | Edward Bergeron, Trustee of Cheshire Medical Center, is an officer of Bergeron Construction, which performed carpentry for the Hospital during the fiscal year. | 0 |
| Jessica Horton | |||
| Child of CMC Trustee | $37,240 | Jessica Horton, who is employed in the Radiology Department of The Cheshire Medical Center, is the child of Steve Horton, a Trustee of The Cheshire Medical Center. The 2014 W-2 compensation paid is in accordance with CMC's standard employment practices and policies. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 4 | Significant changes were made to the Articles of Agreement and Bylaws during the year. The Articles of Agreement were amended as follows: Articles III and V were amended by replacing them in their entirety with amended Articles III and V. Additionally, Articles VI and VII were added to the Articles of Agreement. Amended/added articles are as follows: ARTICLE III-PURPOSE The Corporation is established exclusively for the charitable, scientific and educational purposes set forth herein, subject to the provisions of Chapter 292 of the New Hampshire Revised Statutes Annotated, RSA 292 and the provisions of Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (the "Code"). The principal purposes for which the Corporation is established are as follows: the operation and maintenance (i) of a general hospital in Keene, New Hampshire, for the surgical and medical care of the sick and injured, and (ii) of medical centers, health care centers, laboratories, clinics, and other medical, surgical, dental, educational, civic and research facilities in Keene and in other cities and towns; the advancement of the knowledge and practice of education and research in medicine, surgery, nursing and all other subjects relating to the care, treatment and healing of humans; the furtherance of (i) the quality and accessibility of health care services, particularly in (but not limited to) the Keene, Cheshire County, Southeastern Vermont and the Greater Monadnock region (collectively referred to as the "Monadnock Region"); (ii) the efficiency of utilization of health care facilities and services,; (iii) the reasonable containment of the cost of health care to the public; and (iv) the goals, initiatives, activities and interests of the integrated health care delivery system developed and conducted by the Sole Member of the Corporation as defined in Article V of these Articles, in coordination with its affiliates including the Corporation (referred to herein as the "Dartmouth-Hitchcock System"); and the improvement of public health in cooperation with federal, state, municipal, and other health departments and offices. All activities and functions of the Corporation shall be conducted in a manner which is consistent with the requirements of Section 501(c)(3) of the Code, including for such purposes the making of distributions to organizations that qualify as exempt organizations under Section 501(c)(3) of the Code, or corresponding section of any future federal tax code, the laws of the State of New Hampshire and the By-Laws of the Corporation. ARTICLE V-MEMBERSHIP The Sole Member of the Corporation shall be Dartmouth-Hitchcock Health ("DHH"), a New Hampshire voluntary corporation. DHH as Sole Member of the Corporation shall have all reserved powers, rights and obligations as set forth in the Corporation's Bylaws. ARTICLE VI-BYLAWS The procedures and policies for the internal governance of the Corporation shall be as set forth in the By-Laws. ARTICLE VII-LIMITATION OF LIABILITY The provisions eliminating or limiting the personal liability of Trustees or officers are: Each Trustee and officer shall be indemnified by the Corporation against personal liability to the Corporation for monetary damages for breach of fiduciary duty as a Trustee or officer, or both, except with respect to: (1) Any breach of the Trustee's or officer's duty of loyalty to the Corporation or the members; (2) acts or omissions which are not in good faith or which involve intentional misconduct or a knowing violation of the law; or (3) any transaction from which the Trustee or officer derived any improper personal benefit. The following changes to the Medical Center's bylaws were made during the tax period: 1. Dartmouth-Hitchcock Health, a New Hampshire voluntary corporation, replaced The Cheshire Health Foundation, as the sole member of The Cheshire Medical Center, with rights and powers over the following actions: -approve or disapprove all material governance, programmatic and financial decisions, including the elimination or addition of any health care services or programs; - appoint 1/3 of the members of the Medical Center's Board of Trustees; -ratify the Medical Center's nomination of 2/3's of the members of the Board of Trustees; -following consultation with the Medical Center's Chairperson of the Board, to remove any Trustee if the Sole Member determines in its reasonable good faith discretion that such removal is in the best interests of the Dartmouth-Hitchcock System; -approve borrowings and material disposition of the Medical Center's assets; -approve the establishment of key strategic relationships, such as ownership or contractual participation in a network, system, affiliation, joint venture, alliance, or similar arrangement with an organization that is not part of the Dartmouth-Hitchcock System or which is not addressed in a strategic plan specific to the Corporation that has been approved by the Sole member; -approve operating and capital budgets and strategic plans; -approve policies relating to educational and research programs and affiliations; -reallocate the assets and resources of the Medical Center and the Sole Member, as appropriate, to serve the overall best interests of the Dartmouth-Hitchcock System; -appoint, evaluate, terminate, and approve the compensation of the Medical Center's President and CEO; -approve the amendments to the Medical Center's Articles of Agreement or By-Laws if such amendment would have the effect of impacting the Sole Member's reserved powers or may reasonably be expected to have a material strategic, competitive, or financial impact on the Dartmouth-Hitchcock System; -approve the dissolution or liquidation of the Medical Center. 2. The Ex Officio Trustees with voting rights were changed from the President & CEO of the Medical Center, the President of the Medical Staff, and the Chair of the Keene Health Alliance Board to the CEO of the Medical Center, the Medical Director of Dartmouth-Hitchcock Keene, the President of the Corporation's Medical Staff, and the President of the Sole Member. 3. The clause "except that certain actions of the Board shall be subject to the requirements of the Partnership Agreement between the Center and The Hitchcock Clinic, etc.," was removed from the Duties and Responsibilities of the Trustees. 4. The Duties and Responsibilities of the Trustees were updated to remove "The Board of Trustees shall have full power and authority to create, prescribe, and/or approve Bylaws, Rules and Regulations regarding the practice of medicine in the Center and to appoint, suspend or remove any practitioner from the Medical Staff in accordance with such Bylaws, Rules and Regulations." 5. Article 3.6, which delineated some Trustee responsibilities as they related the Partnership Agreement with Keene Health Alliance, was struck from the bylaws. 6. The provision regarding compensation of Board members was changed from "The Board of Trustees may approve some form of compensation for Trustees as a whole, or for Trustees holding specific offices." to "The Board of Trustees shall serve as Trustees without compensation, except that reasonable expenses may be reimbursed as approved by the Board. Trustees may also be employed by the Corporation and compensated for their services as the Board may authorize." 7. "The Chairperson and the Vice Chairperson of the Board shall each be selected from the 2/3's of the Trustees nominated by the Medical Center," was added to the bylaws. 8. The responsibilities of the Chairperson were expanded to include, "The Chairperson may execute contracts, deeds, notes, mortgages, bonds and other obligations in the name of the Corporation." 9. The article describing the position of CEO was updated to read: "The Trustees shall select, employ, and contract with a person to be the CEO of the Corporation who shall have all the authority of such a position in a business corporation and who shall be an officer of the Corporation and shall be a full voting member of the Board of Trustees, ex officio. The CEO of the Corporation shall report jointly to the Board of Trustees of the Corporation and the CEO of the Sole Member's President shall have the right to terminate the CEO, following consultation with the Corporation's Chairperson of the Board of Trustees." 10. Article 6.3, "Nomination and Evaluation Processes of the CEO" was added to the bylaws: "All candidates for the position of CEO shall be nominated by a committee of the Corporation's Board of Trustees, of which the Chairperson of the Board of Trustees shall lead and the committee shall include representatives of the Dartmouth-Hitchcock System. The nomination process shall include the ability of the Sole Member's President or designee to interview any candidate for this position. Any candidate nominated by the committee must be approved by both the Corporation's Board of Trustees and the Sole Member's President. The evaluation of the CEO shall be con |
| Form 990, Part VI, Section A, line 6 | The sole member of The Cheshire Medical Center is Dartmouth-Hitchcock Health, a New Hampshire voluntary corporation. |
| Form 990, Part VI, Section A, line 7a | The sole member has the power to appoint 1/3 of the members of The Cheshire Medical Center's Board of Trustees |
| Form 990, Part VI, Section A, line 7b | The sole member has the right to ratify The Cheshire Medical Center's nomination of 2/3 or the members of the Board of Trustees; remove Trustees after consultation with the Chaiperson of the Board; approve the dissolution or liquidation of The Cheshire Medical Center; appoint, evaluate, terminate, and approve the compensation of the President and CEO; and other governance decisions as outlined in the response to Form 990, Part VI-A, Line 4. |
| Form 990, Part VI, Section B, line 11 | A copy of the Form 990 is made available for all Board members to review prior to filing. The Board has formally delegated review of the Form 990 to the Finance and Audit Committee. Committee members receive copies of the Form 990 and it is reviewed in a meeting prior to filing. |
| Form 990, Part VI, Section B, line 12c | Officer, Board Members, and Key Employees annually disclose potential conflicts of interest and are required to recuse themselves from all Board activity related to all conflicts. |
| Form 990, Part VI, Section B, line 15a | The Cheshire Medical Center/Dartmouth Hitchcock Keene has retained Yaffe & Company, Inc. to provide consultation to the Executive Committee of the Board of Trustees regarding executive compensation, benefits, and perquisites. Yaffe & Company, Inc. is an independent consulting firm with 35 years of service and provides services to not-for-profit hospitals and health systems. Further Yaffe & Company, Inc. has been engaged directly by the Board of Trustees of The Cheshire Medical Center through its Executive Committee to only provide services to the Board. An Executive Committee d/b/a Compensation Committee Charter and Compensation Philosophy (approved by the Board) documents the compensation review process and guidelines so as to provide an orderly structure for executive total compensation decisions. Annually, a multi-tiered approach using independent comparability data is utilized to gauge appropriate comparative market levels of compensation and benefits. An annual performance evaluation is based on subjective and objective criteria which flow from the strategic plan. By way of questionnaire, Board members participate in the performance review process and a summary report is shared with the CEO. Variable pay is awarded based on achievement of specific qualitative and quantitative goals. In conjunction with the Executive Committee, challenging and measurable goals are established for the Office of the President, which provide an alignment between executive compensation and achievement of the hospital's strategic goals. |
| Form 990, Part VI, Section C, line 19 | The Organization makes governing documents, conflict of interest policy and financial statements available to members of the public upon request, through its annual report, and through state and federal filings. |
| Form 990, Part IX, line 11g | Contract Labor: Program service expenses 12,046,926. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,046,926. Physician/Medical Services: Program service expenses 5,630,576. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,630,576. Other Purchased Services: Program service expenses 2,796,092. Management and general expenses 670,854. Fundraising expenses 0. Total expenses 3,466,946. Data Processing Fees: Program service expenses 2,131,001. Management and general expenses 511,282. Fundraising expenses 0. Total expenses 2,642,283. Outside Lab Fees: Program service expenses 977,655. Management and general expenses 234,565. Fundraising expenses 0. Total expenses 1,212,220. Consulting: Program service expenses 364,630. Management and general expenses 87,484. Fundraising expenses 0. Total expenses 452,114. |
| Form 990, Part IX, Column D: | Fundraising Expenses: The Cheshire Health Foundation, a related organization, performs all fundraising activities on behalf of The Cheshire Medical Center. All fundraising expenses are reported on the Foundation's separate Form 990. |
| Form 990, Part XI, line 9: | Application of Push Down Accounting 8,991,498. Pension Liability Adjustment -1,360,710. Transfer to Affiliates -460,309. |
| Form 990, Part XII, Line 2c: | The audit process has not changed from the prior year. |
| Form 990, Part VIII-Part XI: | The consolidated audited financial statements for The Cheshire Medical Center and subsidiaries report various revenue, expense, asset, and net asset amounts for the Medical Center inclusive of a related organization, Cheshire Health Services (EIN 43-3379283), which began operation on March 11, 2015. All revenue, expense, and balance sheet items related to Cheshire Health Services have been extracted from amounts reported for the Medical Center on this Form 990 and all accompanying schedules. Cheshire Health Services is a separate legal entity filing its own Form 990, and items related to it have been reported there. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| The Cheshire Health Foundation | |||||||||||
| 580 Court Street | Keene | NH | 03431 | 020202220 | Management of Board designated, SPF, building, and endowment funds | NH | 501(c)(3) | Line 11b, II | The Cheshire Medical Center | Yes (1) | |
| Cheshire Health Services Inc | |||||||||||
| 580 Court Street | Keene | NH | 03431 | 473379283 | Walk-In Medical Clinic | NH | 501(c)(3) | Line 3 | The Cheshire Medical Center | Yes (1) | |
| Dartmouth-Hitchcock Clinic | |||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 222519596 | Physician Services | NH | 501(c)(3) | Line 9 | Dartmouth- Hitchcock Health | 0 | |
| Dartmouth-Hitchcock Health | |||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 264812335 | Supporting Organization | NH | 501(c)(3) | Line 11b, II | 0 | N/A | |
| Dartmouth-Hitchcock Medical Center | |||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 222715483 | Supporting Organization | NH | 501(c)(3) | Line 11a, I | 0 | N/A | |
| Everwell Inc | |||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 352505275 | Supporting Organization | NH | 501(c)(3) | Line 11a, I | Dartmouth- Hitchcock Health | 0 | |
| Mary Hitchcock Memorial Hospital | |||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020222140 | Hospital | NH | 501(c)(3) | Line 3 | Dartmouth- Hitchcock Health | 0 | |
| The New London Hospital Association Inc | |||||||||||
| 273 County Road | New London | NH | 03257 | 020222171 | Hospital | NH | 501(c)(3) | Line 3 | Dartmouth- Hitchcock Health | 0 | |
| Windsor Hospital Corporation | |||||||||||
| 289 County Road | Windsor | VT | 05089 | 030183721 | Hospital | VT | 501(c)(3) | Line 3 | Dartmouth- Hitchcock Health | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Keene Health Alliance | ||||||||||||
| 580 Court Street | Keene | NH | 03431 | 300179297 | Healthcare | NH | Related | -$1,977,000 | 0 | Yes (1) | 0.50000 | |
| OneCare VT ACOLIC | ||||||||||||
| 111 Colchester Avenue | Burlington | VT | 05401 | 455399218 | Shared Saving | NH | N/A | |||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | OwnershipOwnershipPct | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hitchcock Health Connect | |||||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 800908979 | Telehealth | DE | N/A | C | 0 | ||||
| Keene Health Enterprises | |||||||||||||
| 580 Court Street | Keene | NH | 03431 | 020374999 | Investments/Real Estate | NH | C | Yes (1) | Keene Health Services | 1.00000 | |||
| Keene Health Realty | |||||||||||||
| 580 Court Street | Keene | NH | 03431 | 020374998 | Investments/Real Estate | NH | C | Yes (1) | Keene Health Services | 1.00000 | $37,589 | $714,879 | |
| Keene Health Services | |||||||||||||
| 580 Court Street | Keene | NH | 03431 | 020374997 | Investments/Real Estate | NH | C | Yes (1) | The Cheshire Health Foundation | 1.00000 | $489,340 | $201,601 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| The Cheshire Health Foundation | ||
| K | $72,000 | Actual Cash Value |
| The Cheshire Health Foundation | ||
| C | $409,829 | Actual Cash Value |
| Cheshire Health Services Inc | ||
| L | $297,694 | Actual Cash Value |