MARY HITCHCOCK MEMORIAL HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: MARY HITCHCOCK MEMORIAL HOSPITAL (EIN 02-0222140)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-15
IRS object ID: 201411359349304986
Schema version: 2012v2.3
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 G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-15T12:11:07-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	125 HIGH STREET	AddressLine1
City	BOSTON	City
State	MA	State
ZIP Code	02110	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	020222140	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mary Hitchcock Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% ROBIN KILFEATHER-MACKEY	InCareOfName
Name Control	MARY	NameControl
Phone	6036505000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	One Medical Center Drive	AddressLine1
Address Line2	Suite	AddressLine2
City	Lebanon	City
State	NH	State
ZIP Code	03756	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Robin Kilfeather-Mackey	Name
Title	CFO	Title
Date Signed	2014-05-09	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	6175305000	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	James Weinstein DO MS	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	One Medical Center Drive	AddressLine1
City	Lebanon	City
State	NH	State
ZIP Code	03756	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	1419405393	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.dartmouth-hitchcock.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1889	YearFormation
State Legal Domicile	NH	StateLegalDomicile
Activity Or Mission Description	ADVANCING HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	18	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	16	NbrIndependentVotingMembers
Total Nbr Employees	5468	TotalNbrEmployees
Total Nbr Volunteers	600	TotalNbrVolunteers
Total Gross UBI	3366625	TotalGrossUBI
Net Unrelated Business Txbl Income	223929	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	6948016	ContributionsGrantsPriorYear
Contributions Grants Current Year	10592896	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	641096400	ProgramServiceRevenuePriorYear
Program Service Revenue CY	866375747	ProgramServiceRevenueCY
Investment Income Prior Year	13110550	InvestmentIncomePriorYear
Investment Income Current Year	29410853	InvestmentIncomeCurrentYear
Other Revenue Prior Year	41203940	OtherRevenuePriorYear
Other Revenue Current Year	47037304	OtherRevenueCurrentYear
Total Revenue Prior Year	702358906	TotalRevenuePriorYear
Total Revenue Current Year	953416800	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	449450	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	6002824	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	402260707	SalariesEtcPriorYear
Salaries Etc Current Year	565819711	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	1968759	TotalFundrsngExpCurrentYear
Other Expense Prior Year	276919525	OtherExpensePriorYear
Other Expenses Current Year	344911925	OtherExpensesCurrentYear
Total Expenses Prior Year	679629682	TotalExpensesPriorYear
Total Expenses Current Year	916734460	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	22729224	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	36682340	RevenuesLessExpensesCY
Total Assets BOY	1214347432	TotalAssetsBOY
Total Assets EOY	1236397775	TotalAssetsEOY
Total Liabilities BOY	753738222	TotalLiabilitiesBOY
Total Liabilities EOY	697527563	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	460609210	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	538870212	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	ADVANCING HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	762752749	Expense
Grants	512404	Grants
Revenue	898485694	Revenue
Description	Mary Hitchcock Memorial Hospital (the Hospital), is an acute and tertiary care teaching hospital located in Lebanon, New Hampshire. The Hospital is a not-for-profit organization, as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from Federal income taxes on related income pursuant to Section 501(a) of the Code. The Hospital provides a broad range of patient services and health related community services, consistent with its role as a major teaching hospital and a tertiary care referral hospital. These include a full range of services in both acute and critical medicine, surgery, psychiatry and rehabilitation for infants, children and adults. During fiscal year 2013 the Hospital provided 119,824 acute patient days of inpatient service and had 25,599 total acute care discharges, while the Hospital's emergency room was open to the public 24 hours per day, 7 days per week and had 30,409 discharges. The Hospital operates as a member of Dartmouth-Hitchcock Medical Center (DHMC), a New Hampshire nonprofit corporation organized for the exploration and coordination of matters of mutual interest among its members: the Hospital, Dartmouth-Hitchcock Clinic (the Clinic), Geisel School of Medicine (GSM), a component of Dartmouth College; and the Veterans Affairs Medical Center in White River Junction, Vermont. The Clinic provides the physician staff to the Hospital and the sophistication essential for the development of the Hospital as the largest hospital and only academic medical center in New Hampshire, and for the designation by the federal government as a Rural Referral Center for northern New England. The shared mission of the Hospital and Clinic is to "advance health through research, education, clinical practice and community partnerships, providing each person the best care, in the right place, at the right time, every time". Its strategic operating plan lays out a path to creating a "sustainable health system to improve the lives of the people and communities we serve, for generations to come." The focus of this work, across the Dartmouth-Hitchcock organization, i.e. all Hospital and Clinic sites, is in three main areas: Improving Population Health; Delivering Value Based Care; and Developing and Implementing New Payment Models. Consistent with this mission and in partnership with the Clinic, the Hospital provides high quality, cost effective, comprehensive, and integrated health care to individuals, families, and the communities it serves, regardless of a patient's ability to pay. The Hospital actively supports community-based health care and promotes the coordination of services among health care providers and social services organizations. The Hospital also seeks to work collaboratively with other area health care providers to improve the health status of the region. In 2012, Dartmouth-Hitchcock (D-H) was selected by the Centers for Medicare and Medicaid (CMS) as one of 32 organizations nationally to participate in the Pioneer Accountable Care demonstration project. At the end of one year, it was one of only 13 to meet all quality and safety metrics and show significant cost reductions, while providing coordinated, patient-centered care to the assigned Medicare population. Also in 2012, D-H joined with Fletcher Allen Health Care, Vermont's academic medical center, to form OneCare Vermont, an ACO that includes all 14 of the state's hospitals, hundreds of primary care physicians and specialists, two federally qualified health centers, and several rural health clinics, to coordinate the health care of approximately 42,000 of Vermont's 118,000 Medicare beneficiaries (40 percent of the Hospital and Clinic patients are from Vermont). During the same period, Dartmouth-Hitchcock entered into a non-ownership affiliation with Mayo Clinic as part of the Mayo Clinic Care Network. This arrangement allows D-H physicians to partner with colleagues from Mayo for second opinions and consultations, thus bringing the expertise of both organizations to individual patient care. Much of the consultation is done via telemedicine, another expanding initiative of D-H in 2012. The program is intended to strengthen our ability to serve patients in our region with the highest-quality care, close to home. It also allows the Hospital and Clinic to get care to patients in emergency situations quickly and to partner with local health organizations in the delivery of care, something that is particularly important in our rural area. The Dartmouth-Hitchcock Center for Telehealth currently offers neurological and stroke care via telemedicine, as well as dermatology services. Additional care disciplines are being brought on line as of this writing. In late 2012, Dartmouth-Hitchcock formed the Partners in Community Wellness, a group of more than 300 volunteer members from throughout New Hampshire and Vermont. With the resources of D-H, the group is engaged in education and community health initiatives. An example is the Vial of Life campaign, through which the Partners have distributed, at no charge, more than 10,000 emergency information kits to physicians, emergency responders, fire departments and public safety organizations, and businesses and individuals. This ongoing effort will next focus on getting the kits to more than 1,000 schools in the region. Nationally, Dartmouth-Hitchcock is a founding member, with Mayo Clinic, Intermountain Health Care, Denver Health, and The Dartmouth Institute for Health Policy and Clinical Practice, of the High Value Healthcare Collaborative (HVHC). The Collaborative currently comprises 19 health systems and the TRICARE system of the Department of Defense. Together, they have a patient base of more than 100 million. The goal of the Collaborative is to improve the quality of health care while lowering costs. Through data sharing and defining of best practices for 8 high-cost, high-variation conditions, the members are improving outcomes and already seeing cost savings. A $26 million grant from CMS is making it possible to integrate shared decision making - the Hospital was the first in the nation to create a Center for Shared Decision Making and integrate tools into clinical care - into the work of the Collaborative. Beyond that grant, however, the HVHC is self-funded by the member health systems. Effective with fiscal year 2000, the Hospital and the Clinic began filing an annual Community Benefit Report with the State of New Hampshire which outlines the community and charitable benefits they provide. The most recent Community Benefit Reports are available upon request or can be found on Dartmouth-Hitchcock's web site (www.dartmouth-hitchcock.org). Financial assistance, formerly called charity care, represents services provided to patients who cannot afford health care services due to inadequate financial resources which result from being uninsured or underinsured. For the year ended June 30, 2013 the Hospital provided financial assistance to patients in the amount of $31,586,929, as measured by gross charges. The estimated cost of providing this care for the year ended June 30, 2013 was $12,641,089. The Hospital also routinely provides services to Medicaid patients at reimbursement levels that are well below the cost of the care provided. The community health activities section of the report includes the cost or value of several different types of hospital-sponsored programs, such as community based education, health fairs, health screenings, support groups, and programs and materials that promote wellness and prevent illness. Examples of these types of efforts include partnering with the Healthy Eating Active Living NH initiative, the Partners in Community Wellness, ReThink Health, the Women's Health Resource Center, and smoking prevention and cessation programs. This category also includes financial contributions and the contribution of time and services to community programs, hospitals and agencies. The Hospital also provides a significant amount of uncompensated care to its patients reported as provision for bad debts, which is not included in the amounts reported above. During the year ended June 30, 2013, the Hospital reported a provision for bad debts of approximately $22,716,348.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	43564704	Expense
Grants	5490420	Grants
Revenue	8968076	Revenue
Description	As a component of an integrated academic medical center, the Hospital provides significant support for academic and research programs. Through its affiliation with The Geisel School of Medicine at Dartmouth, the Hospital provides support for physicians' unpaid teaching time, consisting of the time physicians spend providing clinical supervision and education for residents and medical students. In addition, the Hospital provides in-kind support for research and other grants awarded to the Clinic and Medical School, to offset costs in excess of grant awards. Other community benefit initiatives include subsidizing the costs of providing medical and clinical education to professionals across New Hampshire, Vermont and beyond, as well as uncompensated costs of academic and medical research activities.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	806317453	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	true	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	true	ForeignOffice
Foreign Activities	true	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	true	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	true	LoanToOfficerOrDQP
Grant To Related Person	true	GrantToRelatedPerson
Bsnss Rltnshp With Organization	true	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	true	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	1038	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	5468	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	true	ForeignFinancialAccount
Name Of Foreign Country	BD	NameOfForeignCountry
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	true	QuidProQuoContributions
Quid Pro Quo Disclosure	true	QuidProQuoDisclosure
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	18	NbrVotingGoverningBodyMembers
Number Independent Voting Members	16	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	true	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	true	InvestmentInJointVenture
Written Policy Or Procedure	true	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	NH	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ROBIN KILFEATHER-MACKEY	NamePerson
Telephone Number	6036505634	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	ONE MEDICAL CENTER DRIVE	AddressLine1
City	Lebanon	City
State	NH	State
ZIP Code	03756	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (53 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
Wayne G Granquist
Trustee/Brd Chair end 12/31/12	2.0	5.5	X	X	0	0	0
Jennie L Norman
Trustee/Board Secretary	2.0	4.0	X	X	0	0	0
Hugh C Smith MD
Trustee	1.0	2.0	X		0	0	0
Vincent S Conti
Trustee	1.0	2.0	X		0	0	0
Anne-Lee Verville
Trustee	1.0	2.0	X		0	0	0
Nancy Formella MSN RN
TTE Advisor End 12/1/2012	41.0	19.5	X	X	3209060	0	58814
Barbara Couch
Trustee	1.0	2.0	X		0	0	0
Wiley Souba MD ScD
Trustee/Ex-Officio, Dean DMS	1.0	2.5	X		0	0	0
William J Conaty
Trustee	1.0	2.0	X		0	0	0
William W Helman IV
Trustee	1.0	2.5	X		0	0	0
Robert A Oden Jr PhD
Trustee/Board Chair Eff 1/1/13	2.0	4.0	X	X	0	0	0
Ruth Williams Brinkley
Trustee End 11/2/12	1.0	2.0	X		0	0	0
James Weinstein DO MS
Trustee Ex-Officio/CEO	37.0	24.5	X	X	0	833051	59682
Alan C Keiller
Trustee/Board Treasurer	2.0	4.5	X	X	0	0	0
Michael J Goran MD
Trustee	1.0	2.0	X		0	0	0
Alfred Griggs
Trustee/Chair Emeritus	1.0	1.5	X		0	0	0
Richard S Shreve
Trustee/Ex Officio Pres Apptee	1.0	2.0	X		0	0	0
John L Harrison Jr
Trustee End 9/30/12	1.0	1.0	X		0	0	0
Denis A Cortese MD
Trustee Eff 9/1/12	1.0	2.0	X		0	0	0
Matthew B Dunne
Trustee Eff 1/1/13	1.0	2.0	X		0	0	0
Senator Judd A Gregg
Trustee Eff 1/1/13	1.0	1.0	X		0	0	0
Laura K Landy
Trustee Eff 9/1/12	1.0	2.0	X		0	0	0
Robin Kilfeather-Mackey CPA
Chief Financial Officer	37.0	24.0		X	0	451645	37043
Linda Von Reyn
Chief Nursing Officer	41.0	19.0		X	458727	0	37027
Daniel Jantzen CPA
Chief Operating Officer	41.0	20.0		X	608217	0	59542
Stephen Leblanc
ExecVP Strtgy&Ntwrk Eff 2/3/13	13.0	47.0		X	0	535986	36773
John Butterly MD
Exec VP of Med Affairs, D-HH	18.0	42.0		X	0	538707	93348
Alan Weston
Chief Human Resources Officer	41.0	19.0		X	311437	0	65426
Neil Castaldo
Sr Advisor to CEO Eff 7/1/12	41.0	19.0		X	622913	0	70272
Gregg Meyer MD
CCO/EVP Pop Hlth	41.0	19.0		X	0	531180	97818
Jeanine Arden Ornt
General Counsel	38.0	24.0		X	415319	0	72262
Vincent Fusca
Chief of Staff	41.0	19.0		X	230806	0	20753
Edward Merrens MD
CMO Eff 9/1/12	28.0	12.0		X	0	343307	65544
George Blike MD
Chf Qlty&Value Ofr Eff 7/1/12	41.0	19.0		X	0	389078	48677
Mary Oseid
V.P Ambulatory Care	28.0	12.0			0	258638	45523	X
Christine Schon
V.P Comm. Grp. Pract. Ops	28.0	12.0			0	209756	58175	X
William Mroz
V.P. Operations/Clinical Svcs	41.0	19.0			245900	0	48844	X
Gail Dahlstrom
V.P. Facilities Mgmt	41.0	19.0			225829	0	32934	X
Michael Ward
V.P. Cancer Svcs end 7/31/12	28.0	12.0			0	182530	29397	X
Tina Naimie CPA
VP Corporate Finance	28.0	13.5			213338	0	39214	X
Wendy Fielding
VP Financial Planning	28.0	12.0			213833	0	70331	X
Barbara Walters DO MBA
Med Dir/Dir Acct Care eff 11/1	28.0	12.0			0	353318	57527	X
David Gladstone MD
Chief Clinical Phys Rad/Onc	28.0	12.0			278096	0	81270		X
Bruce King
Pres & CEO New London Hosp	28.0	12.0			480870	0	59042		X
Susan Reeves
VP/Chair Nurs Colby Saw Collg	28.0	12.0			263926	0	66647		X
Kevin Donovan
CEO Mt Ascutney Hospital	28.0	12.0			255527	0	63985		X
Janet West
VP Compliance & Audit Svcs	28.0	12.0			262991	0	59687		X
Carl Dematteo MD
Former Chf Qual Compl Ofr	28.0	12.0			0	496126	7530			X
Lawrence Dacey MD
Former CMO End 6/30/12 / Phys	28.0	13.0			0	507485	37711			X
Andrew Gettinger MD
Former Chief Med Info Ofr	28.0	12.0			0	336449	39315			X
Thomas Colacchio MD
Former Officer/Phys	28.0	13.0			0	1041556	66668			X
Sandra Dickau
Former VP Ops/Ptnt Care	28.0	13.0			127765	0	0			X
Mary Kay Boudewyns
Former Key Employee	28.0	12.0			212298	0	48103			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	8636852	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	7008812	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1734884	TotalOtherCompensation
Number Individuals GT100 K	311	NumberIndividualsGT100K
Formers Listed	true	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ACCRETIVE HEALTH
401 N MICHIGAN AVE SUITE 2700	CHICAGO	IL	60611	REVENUE MNGT SERVICE	9609834
TRUSTEES OF DARTMOUTH COLLEGE
37 DEWEY FIELD	HANOVER	NH	03755	ADMIN & DIR SUPPORT	15068724
Dew Construction Corp
277 Blair Park Road Suite 130	WILLISTON	VT	05495	Construction Svcs	21042504
Suffolk Construction
99 Conifer Hill Drive	DANVERS	MA	01923	Construction Svcs	11854285
Cross Country Staffing
40 Eastern Ave	MALDEN	MA	02148	Staffing Services	8114232

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	226	NumberOfContractorsGT100K
Fundraising Events	4762860	FundraisingEvents
Government Grants	2119307	GovernmentGrants
All Other Contributions	3710729	AllOtherContributions
Noncash Contributions	74602	NoncashContributions
Total Contributions	10592896	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE	621110	860232393	860232393
RESEARCH RELATED ACTIVITIES	621110	6143354	6143354

Field	Value	IRS element (for citing)
Total Program Service Revenue	866375747	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	3229121	TotalRevenueColumn
Unrelated Business Revenue	33033	UnrelatedBusinessRevenue
Exclusion	$3,196,088	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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

Royalties Revenue RoyaltiesRevenue

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

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	1020985	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	622175	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	398810	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	398810	TotalRevenueColumn
Exclusion	$398,810	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	490453063	Securities
Other	56695	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	464289939	Securities
Other	38087	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	26163124	Securities
Other	18608	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	26181732	TotalRevenueColumn
Exclusion	$26,181,732	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	391177	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	4762860	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	1038392	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	-647215	TotalRevenueColumn
Exclusion	-$647,215	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

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

Net Income Or Loss NetIncomeOrLoss

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

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PHARMACY INCOME	621110	21279124	21228606	50518
MEANINGFUL USE	621110	8056864	8056864
NEW ENGLAND ALLIANCE FOR HEALTH	621110	2452514		2452514

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	15497207	TotalRevenueColumn
Related Or Exempt Function Income	11792553	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	830560	UnrelatedBusinessRevenue
Exclusion	$2,874,094	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	47285709	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	953416800	TotalRevenueColumn
Related Or Exempt Function Income	907453770	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	3366625	UnrelatedBusinessRevenue
Exclusion	$32,003,509	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	4852703	Total
Program Services	4852703	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	1150121	Total
Program Services	1150121	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	13964432	Total
Program Services	6546020	ProgramServices
Management And General	6716071	ManagementAndGeneral
Fundraising	702341	Fundraising

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	1769887	Total
Program Services	1769887	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	411635024	Total
Program Services	359612189	ProgramServices
Management And General	52022741	ManagementAndGeneral
Fundraising	94	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	52968971	Total
Program Services	46274701	ProgramServices
Management And General	6694258	ManagementAndGeneral
Fundraising	12	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	56502847	Total
Program Services	49361962	ProgramServices
Management And General	7140872	ManagementAndGeneral
Fundraising	13	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	28978550	Total
Program Services	25316212	ProgramServices
Management And General	3662331	ManagementAndGeneral
Fundraising	7	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	2177535	Total
Program Services	13224	ProgramServices
Management And General	2164311	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	398282	Total
Management And General	398282	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	67146	Total
Program Services	67146	ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	55856076	Total
Program Services	45165892	ProgramServices
Management And General	10690184	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	1654591	Total
Program Services	20853	ProgramServices
Management And General	1633738	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	15118669	Total
Program Services	14082932	ProgramServices
Management And General	1035714	ManagementAndGeneral
Fundraising	23	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	5371282	Total
Program Services	5371282	ProgramServices

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	13742583	Total
Program Services	11475082	ProgramServices
Management And General	2267501	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	2198185	Total
Program Services	1254696	ProgramServices
Management And General	943489	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	92534	Total
Program Services	91759	ProgramServices
Management And General	775	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	15152336	Total
Program Services	12727962	ProgramServices
Management And General	2424374	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	37802329	Total
Program Services	31749381	ProgramServices
Management And General	6052948	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	3341728	Total
Program Services	2422347	ProgramServices
Management And General	919381	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	121012752	121012752
MEDICAID ENHANCEMENT TAX	38261451	38261451
EQUIPMENT RENTAL & MAINT	10388589	8726415	1662174
ACADEMIC,GME,TEACHING & SPT	2312102	2312102

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	19963755	Total
Program Services	16678382	ProgramServices
Management And General	2019104	ManagementAndGeneral
Fundraising	1266269	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	916734460	Total
Program Services	806317453	ProgramServices
Management And General	108448248	ManagementAndGeneral
Fundraising	1968759	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	82965	BOY
EOY	465422	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	59257093	BOY
EOY	44311533	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	154672421	BOY
EOY	139143022	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	372579	BOY
EOY	416185	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	1624728	BOY
EOY	1304221	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	13456700	BOY
EOY	15029475	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	5763032	BOY
EOY	23786320	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	847679846	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	434157391	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	398310201	BOY
EOY	413522455	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	280979122	BOY
EOY	199883362	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	233104661	BOY
EOY	343778631	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	2714834	BOY
EOY	2884068	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	64009096	BOY
EOY	51873081	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	1214347432	BOY
EOY	1236397775	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	211075005	BOY
EOY	108309292	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	340309	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	356346495	BOY
EOY	350027555	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	3489268	BOY
EOY	150382530	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	182827454	BOY
EOY	88467877	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	753738222	BOY
EOY	697527563	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	381928668	BOY
EOY	464266717	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	50788670	BOY
EOY	46465618	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	27891872	BOY
EOY	28137877	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	460609210	BOY
EOY	538870212	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1214347432	BOY
EOY	1236397775	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	36682340	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	5179665	ReconciliationUnrealizedInvest
Reconcilation Other Changes	36398997	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	true	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	true	DirectContactLegislators
Direct Contact Legislators	$130,626	DirectContactLegislatorsAmount
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$63,814	OtherActivitiesAmount
Total Lobbying Expenditures IIB	194440	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	LOBBYING ACTIVITY EXPLANATION	Identifier
Return Reference	FORM 990, SCHEDULE C, PART II B, LINES 1B & 1G	ReturnReference
Explanation	MARY HITCHCOCK MEMORIAL HOSPITAL EMPLOYS TWO FULL TIME STAFF WHOSE DUTIES INCLUDE LOBBYING. TYPICAL EXPENSES ASSOCIATED WITH THE LOBBYING ACTIVITIES INCLUDE STAFF SALARY, TRAVEL, MEMBERSHIP FEES AND DUES. FROM TIME TO TIME, MARY HITCHCOCK MEMORIAL HOSPITAL, THROUGH ITS EMPLOYEES AND THE USE OF CONSULTANTS, CONTACTS GOVERNMENT OFFICIALS AND LEGISLATORS. THIS CONTACT IS FOR THE PURPOSE OF PROPOSING LEGISLATION OR EXPRESSING AN OPINION ON CHANGES IN LEGISLATION THAT AFFECT THE HOSPITAL AND ITS ABILITY TO CARRY OUT ITS MISSION. TYPICAL ACTIVITIES INCLUDE EMAILING, CALLING, AND MEETING WITH GOVERNMENT OFFICIALS AND LEGISLATORS. FOR THE FISCAL YEAR ENDED JUNE 30, 2013, MARY HITCHCOCK MEMORIAL HOSPITAL INCURRED $130,626 IN CONJUCTION WITH THESE ACTIVITIES. FORM 990 SCHEDULE C, PART II B, LINE 1I DHC pays dues to various organizations related to its exempt mission. The amount reported under other activities on line 1I refers to the amount of lobbying activities identified in dues payments to outside organizations.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	57050185	BeginningOfYearBalance
Contributions	188155	Contributions
Investment Earnings Or Losses	-357053	InvestmentEarningsOrLosses
Grants Or Scholarships	5322	GrantsOrScholarships
Other Expenditures	1940831	OtherExpenditures
End Of Year Balance	54935134	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	54023225	BeginningOfYearBalance
Contributions	30717	Contributions
Investment Earnings Or Losses	3834255	InvestmentEarningsOrLosses
Grants Or Scholarships	15000	GrantsOrScholarships
Other Expenditures	823012	OtherExpenditures
End Of Year Balance	57050185	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	54110647	BeginningOfYearBalance
Contributions	398541	Contributions
Investment Earnings Or Losses	842732	InvestmentEarningsOrLosses
Other Expenditures	1328695	OtherExpenditures
End Of Year Balance	54023225	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	49493627	BeginningOfYearBalance
Contributions	3040219	Contributions
Investment Earnings Or Losses	2769857	InvestmentEarningsOrLosses
Other Expenditures	1193056	OtherExpenditures
End Of Year Balance	54110647	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	49870808	BeginningOfYearBalance
Contributions	4146452	Contributions
Investment Earnings Or Losses	-3921625	InvestmentEarningsOrLosses
Other Expenditures	602008	OtherExpenditures
End Of Year Balance	49493627	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.30220	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.51220	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.18560	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	91148	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	38958963	OtherCostOrOtherBasis
Book Value	39050111	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	452647759	OtherCostOrOtherBasis
Depreciation	231269306	Depreciation
Book Value	221378453	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4204881	OtherCostOrOtherBasis
Depreciation	3468488	Depreciation
Book Value	736393	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	313239307	OtherCostOrOtherBasis
Depreciation	199419597	Depreciation
Book Value	113819710	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	38537788	OtherCostOrOtherBasis
Book Value	38537788	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	413522455	TotalOfBookValueLandBuildings
Financial Derivatives		FinancialDerivatives
Closely Held Equity Interests		CloselyHeldEquityInterests

Other Securities OtherSecurities (5 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
FIXED INCOME	187099845	F
PUBLIC EQUITIES	58490627	F
PRIVATE EQUITIES	24845871	F
HEDGE FUNDS	35025013	F
OTHER INVESTMENTS	38317275	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	343778631	TotalOfBookValueSecurities
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
THIRD PARTY SETTLEMENTS	$22,986,617
ACCRUED POST RETMNT PENS & MED	$56,740,980
INTEREST RATE SWAP	$8,740,280

Field	Value	IRS element (for citing)
Total Of Amounts	88467877	TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	Intended use of Endowment Funds	Identifier
Return Reference	Form 990 Schedule D Part V Line 4	ReturnReference
Explanation	The intended use of the endowment funds is to promote and advance the following mission-related programs: healthcare services, research, charity care, and health education. ASC 740 (Fin 48) Footnote Form 990 Schedule D Part X No ASC 740 (Fin 48) footnote was included in the audited financial statements as there were no material uncertain tax positions at or since adoption.	Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable (16 entries)

RegionRegion	Type Of Activities ConductedTypeOfActivitiesConducted	Specific Services ProvidedSpecificServicesProvided	Total ExpendituresTotalExpenditures	Number Of EmployeesNumberOfEmployees
Central America and the Caribbean	Program Services	Educational Travel Exp	9257
East Asia and the Pacific	Program Services	Educational Travel Exp	4179
Europe (Including Iceland and Greenland)	Program Services	Educational Travel Exp	36447
Middle East and North Africa	Program Services	Educational Travel Exp	2949
North America	Program Services	Educational Travel Exp	31858
South America	Program Services	Educational Travel Exp	2562
Sub-Saharan Africa	Program Services	Educational Travel Exp	710
North America	Program Services	Medical Labs & Suppls	1086507
Europe (Including Iceland and Greenland)	Program Services	Insurance Services	240810
Middle East and North Africa	Program Services	Collection Services	21643
North America	Program Services	Dues, Lic, & Publicatn	8477
North America	Program Services	Marketing Services	15894
North America	Program Services	IT Services & Misc	30140
Europe (Including Iceland and Greenland)	Program Services	Medical Labs & Suppls	410986
Sub-Saharan Africa	Program Services	Medical Svcs in Rwanda	77156	1
Sub-Saharan Africa	Fundraising	Fundraising Event	3032

Field	Value	IRS element (for citing)
Subtotal Number Of Employees	1	SubtotalNumberOfEmployees
Total Number Of Employees	1	TotalNumberOfEmployees
Subtotal Amount Spent	1982607	SubtotalAmountSpent
Total Amount Spent	1982607	TotalAmountSpent
Transfer To Foreign Corp	true	TransferToForeignCorp
Interest In Foreign Trust	false	InterestInForeignTrust
Own Foreign Corp	true	OwnForeignCorp
Passive Foreign Invest Co	true	PassiveForeignInvestCo
Foreign Partnership	true	ForeignPartnership
Boycott Countries	false	BoycottCountries

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	NCCC Prouty	NameOfEvent1
Gross Receipts Event1	3738170	GrossReceiptsEvent1
Charitable Contributions Event1	3622239	CharitableContributionsEvent1
Gross Revenue Event1	115931	GrossRevenueEvent1
Non Cash Prizes Event1	20225	NonCashPrizesEvent1
Rent Facility Costs Event1	11756	RentFacilityCostsEvent1
Food And Beverage Event1	17892	FoodAndBeverageEvent1
Entertainment Event1	300	EntertainmentEvent1
Other Direct Expenses Event1	620116	OtherDirectExpensesEvent1
Name Of Event2	CHAD Hero Hlf M	NameOfEvent2
Gross Receipts Event2	604947	GrossReceiptsEvent2
Charitable Contributions Event2	578989	CharitableContributionsEvent2
Gross Revenue Event2	25958	GrossRevenueEvent2
Non Cash Prizes Event2	25957	NonCashPrizesEvent2
Food And Beverage Event2	2280	FoodAndBeverageEvent2
Entertainment Event2	5109	EntertainmentEvent2
Other Direct Expenses Event2	18463	OtherDirectExpensesEvent2
Total Number Of Other Events	6	TotalNumberOfOtherEvents
Gross Receipts Other Events	810920	GrossReceiptsOtherEvents
Charitable Contrib Other Events	561632	CharitableContribOtherEvents
Gross Revenue Other Events	249288	GrossRevenueOtherEvents
Cash Prizes Other Events	2507	CashPrizesOtherEvents
Non Cash Prizes Other Events	142127	NonCashPrizesOtherEvents
Rent Facility Costs Other Events	107906	RentFacilityCostsOtherEvents
Food And Beverage Other Events	13277	FoodAndBeverageOtherEvents
Entertainment Other Events	3790	EntertainmentOtherEvents
Other Direct Expenses Other Events	46687	OtherDirectExpensesOtherEvents
Gross Receipts Total	5154037	GrossReceiptsTotal
Charitable Contributions Total	4762860	CharitableContributionsTotal
Gross Revenue Total Events	391177	GrossRevenueTotalEvents
Cash Prizes Total Events	2507	CashPrizesTotalEvents
Non Cash Prizes Total Events	188309	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	119662	RentFacilityCostsTotalEvents
Food And Beverage Total Events	33449	FoodAndBeverageTotalEvents
Entertainment Total Events	9199	EntertainmentTotalEvents
Other Direct Expenses Total Events	685266	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	1038392	DirectExpenseSummaryEvents
Net Income Summary	-647215	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	225.	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12641089	TotalCommunityBenefitExpense
Net Community Benefit Expense	12641089	NetCommunityBenefitExpense
Percent Of Total Expense	0.01380	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	137312048	TotalCommunityBenefitExpense
Direct Offsetting Revenue	42149107	DirectOffsettingRevenue
Net Community Benefit Expense	95162941	NetCommunityBenefitExpense
Percent Of Total Expense	0.10380	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	149953137	TotalCommunityBenefitExpense
Direct Offsetting Revenue	42149107	DirectOffsettingRevenue
Net Community Benefit Expense	107804030	NetCommunityBenefitExpense
Percent Of Total Expense	0.11760	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2904566	TotalCommunityBenefitExpense
Direct Offsetting Revenue	162547	DirectOffsettingRevenue
Net Community Benefit Expense	2742019	NetCommunityBenefitExpense
Percent Of Total Expense	0.00300	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	42282857	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10952291	DirectOffsettingRevenue
Net Community Benefit Expense	31330566	NetCommunityBenefitExpense
Percent Of Total Expense	0.03420	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5002964	TotalCommunityBenefitExpense
Net Community Benefit Expense	5002964	NetCommunityBenefitExpense
Percent Of Total Expense	0.00550	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4091445	TotalCommunityBenefitExpense
Net Community Benefit Expense	4091445	NetCommunityBenefitExpense
Percent Of Total Expense	0.00450	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5523616	TotalCommunityBenefitExpense
Net Community Benefit Expense	5523616	NetCommunityBenefitExpense
Percent Of Total Expense	0.00590	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	59805448	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11114838	DirectOffsettingRevenue
Net Community Benefit Expense	48690610	NetCommunityBenefitExpense
Percent Of Total Expense	0.05310	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	209758585	TotalCommunityBenefitExpense
Direct Offsetting Revenue	53263945	DirectOffsettingRevenue
Net Community Benefit Expense	156494640	NetCommunityBenefitExpense
Percent Of Total Expense	0.17070	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	27600	TotalCommunityBuildingExpense
Net Community Building Expense	27600	NetCommunityBuildingExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	323	TotalCommunityBuildingExpense
Net Community Building Expense	323	NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	385867	TotalCommunityBuildingExpense
Net Community Building Expense	385867	NetCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	88899	TotalCommunityBuildingExpense
Net Community Building Expense	88899	NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	11371	TotalCommunityBuildingExpense
Net Community Building Expense	11371	NetCommunityBuildingExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	514060	TotalCommunityBuildingExpense
Net Community Building Expense	514060	NetCommunityBuildingExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReported
Bad Debt Expense	$25,604,955	BadDebtExpenseAmount
Amount Reimbursed By Medicare	247564903	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	250254484	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2689581	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mary Hitchcock Memorial Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	One Medical Center Drive	AddressLine1
City	Lebanon	City
State	NH	State
ZIP Code	03756	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Childrens Hospital	X	ChildrensHospital
Teaching Hospital	X	TeachingHospital
Research Facility	X	ResearchFacility
Er24 Hours	X	Er24Hours
Other	Psych Unit and Transplant Unit Cancer Center	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Mary Hitchcock Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	true	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
Other Needs Addressed	X	OtherNeedsAddressed
All Needs Addressed	true	AllNeedsAddressed
Organization Incur Excise Tax	false	OrganizationIncurExciseTax
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	225.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	300.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Other Factors	X	OtherFactors
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	true	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Schedule H Part I Line 6a	Community Benefits Report	Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic (Collectively referred to as Dartmouth-Hitchcock (D-H)) share common board members and operate under an affiliation agreement. D-H performs a joint Community Health Needs Assessment (CHNA) and files a consolidated Community Benefits report. For purposes of IRS Form Schedule H, only Hospital numbers were used. All amounts relating to DHC were excluded. The New Hampshire Community Benefits Report filed for fiscal year 2013, DHC and MHMH combined, totaled $195,377,110. Form 990, Schedule H Part I Line 7G Subsidized health services related to physician clinics The Organization did not include any subsidized health service costs attributable to a physician clinic on Part I, line 7G. Form 990, Schedule H Part I Line 7f Bad Debt Expense Bad debt expense included on Form 990 Part IX Line 25 totaling $25,604,955, was excluded from total expenses for the calculation of net Community Benefits as a percent of total expenses. Form 990, Schedule H Part I Line 7 Costing Methodology The costing methodology used to calculate the amounts reported was a cost-to-charge ratio derived from worksheet 2, Ratio of Patient Care Cost-to-Charges. Form 990, Schedule H Part II Community Building Activities Community Building activities include expenses related to coalitions that address rural emergency/trauma services, prevention of pediatric obesity, prevention of substance abuse, falls reduction for older adults, public health networks, prescription drug misuse, and low-income housing. These also include cash support and/or contributed in-kind support for the development and maintenance of housing for low-income families, regional economic development, and support for regional workforce development services. Form 990, Schedule H Part III Section A Lines 2 and 3 Bad Debt Expense The amounts reported on Part III, Section A, line 2 were derived from MHMH's audited financial statements (provision for bad debt). As part of the hospital's financial assistance policy, MHMH makes information available to patients for eligibility and how to apply for free or discounted care. If the patient does not respond to the hospital's attempts to complete the financial assistance package, these patients may be written off to bad debt. MHMH currently does not have a methodology to determine how many patients who would have qualified for financial assistance if the documentation was provided. The hospital is currently reviewing this process to come up with a tracking methodology that is in compliance with Medicare cost report regulations. Form 990, Schedule H Part III Section A Line 4 Audited financial Statement Disclosure for Charity Care and Provision for Bad Debt (Please note that MHMH files a combined audited financial statement with Dartmouth-Hitchcock Clinic and other Subsidiaries). MHMH provides care to patients who meet certain criteria under their financial assistance policies without charge or at amounts less than their established rates. Because MHMH does not anticipate collection of amounts determined to qualify as charity care, they are not reported as revenue. MHMH grants credit without collateral to patients, most of whom are local residents and are insured under third-party arrangements. Additions to the allowance for uncollectible accounts are made by means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in federal and state governmental healthcare coverage and other collection indicators. Form 990, Schedule H Part III Section A Line 4 Patient Financial Assistance Qualification MHMH's Policy is to exert everything in the Organization's power to obtain sufficient and adequate information to determine eligibility for financial assistance. If the required information is not obtained in order to determine eligibility for financial assistance, then the amount is recognized as bad debt. MHMH's discount for uninsured patients is currently 40% (before financial assistance is applied). Form 990, Schedule H Part III Section B Line 8 Medicare Shortfalls The costing methodology used to calculate the amounts reported as Medicare shortfalls was derived from the Internal Revenue Service's Worksheet B as provided for Part III calculations. MHMH had revenues of $24,173,651 and costs of $29,645,748 for services not included on the Medicare Cost Report (Ambulance Services, Laboratory and other fees screens, and Medicare Part C & D services). MHMH incurred a net loss of $5,472,097 on the provision of these services. Form 990, Schedule H Part III, Line 9b Credit and Collection Policy MHMH has a Credit and Collection Policy that addresses the procedures for patients who choose not to make payment or work with MHMH to make payment arrangements for their bill. The Organization has a separate Financial Assistance Policy that addresses those patients who are unable to make payment. MHMH is a charitable health care organization who treats patients that come for medically necessary care, regardless of their financial status. MHMH offers financial assistance in the form of free or discounted care to those patients who have an inability to pay their bills. The Financial Assistance Policy outlines eligibility criteria for financial assistance; the method by which patients may apply for financial assistance; the basis for calculating amounts charged to patients eligible for financial assistance under this policy; D-H's measures to widely publicize the policy within the community served; and the limitation of charges for emergency or other medically necessary care. Patients can qualify for 25%, 50%, 75%, or 100% reduction based on Federal Poverty Levels as well as a catastrophic guideline of 10% of 2 year's income for those that may not qualify based on assets and income, but who have a bill beyond their means to pay. Form 990, Schedule H, Part V, Section B Line 1 CHNA Report Descriptions Although the final community needs health assessment did not specifically describe the hospital service area, it is described in the annual community benefits report filed with the state of NH. Form 990, Schedule H, Part V, Section B Line 3 Input From Representatives of Community Served by the Hospital Facility D-H is actively engaged in the development of an active Upper Valley Regional Public Health Advisory Council (35+ community representatives) and broader ReThink Health Initiatives (100+ community representatives). Members of these two community health advisory groups have had the opportunity to review and comment on drafts of Dartmouth-Hitchock's Community Health Improvement Plan. The plan document has also been circulated to public health officials in Vermont for their comment. In addition, Dartmouth-Hitchcock representatives serve on numerous boards, task forces, municipal health leadership and planning teams, and other community health leadership entities in order to ensure that we both participate in and better understand the needs of our community. Form 990, Schedule H, Part V, Section B Line 4 CHNA Conducted With One Or More Other Hospital Facilities During 2012, MHMH partnered with Alice Peck Day Memorial Hospital and Mount Ascutney Hospital and Health Care Form 990, Schedule H, Part V, Section B Line 5a The Community Health Needs Assessment can be found online at http://patients.dartmouth-hitchcock.org/community_health/community_benefit s_program.html. Form 990, Schedule H, Part V, Section B Line 5b & 5c The Needs Assessment was distributed to non-profit organizations throughout the region including the United Way. It is also available on the State of New Hampshire's Website and upon request. Form 990, Schedule H Part V, Section B Line 6i Based upon the most recent community benefits report, MHMH is increasing community benefits spending to address identified community needs, particularly, oral health, needs of older adults, substance misuse prevention, and obesity/nutrition/physical activity. Form 990, Schedule H Part V, Section B Line 12h D-H has a separate Uninsured Discount Policy that outlines how the discount is calculated annually and that it is applied prior to billing any uninsured patient. This assures a patient is not billed at an amount greater than the amount generally billed to patients with insurance. This is referenced as a link in the Financial Assistance Policy.
Form 990, Schedule H Part V, Section B Line 14	Financial Assistance Policy availability within the Community	MHMH financial assistance policy is posted on MHMH's website, including the verbatim policy and a shorter, more patient-friendly version. MHMH has also made additional changes internally to increase awareness of the policy, including adding information to the back of the patient's statement about financial assistance available to them, posting information about the policy in public areas throughout the facilities, and ensuring financial assistance policy brochures are available in patient areas. MHMH Screens 100% of uninsured inpatient and same-day patients prior to admission. As part of this process, MHMH checks all state and federal programs to see if individuals are eligible for assistance. Patients are also screend to determine qualification for financial assistance and the application is provided and/or completed at this time. Form 990, Schedule H Part V, Section B Line 20D Maximum charges to financial assistance policy-eligible individuals for emergency or medically-necessary care MHMH uses the average of the three highest commerical payer discounts and applies this as a discount for all uninsured patients. The discount rate is 40%. Form 990, Schedule H Part V, Section B Line 22 Gross Charges to financial assistance policy-eligible individuals Occasionally MHMH may charge an amount equal to the gross charges for any service provided to patients in the event the patient's insurance does not cover a particular service or elective procedure. In certain situations, state law may still prohibit MHMH from charging gross charges. Form 990, Schedule H Part V, Section C Facility information The Hospital has a Cancer Treatment Center located in Saint Johnsbury, Vermont. This location is registered under the same license as the Organization's main Campus located in Lebanon, New Hampshire.
Form 990, Schedule H Part VI Line 2	Needs Assessment	Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic (Collectively referred to as Dartmouth-Hitchcock (D-H)) share common board members and operate under an affiliation agreement. D-H performs a joint Community Needs Assessment and files a consolidated Community Benefits report. Dartmouth-Hitchcock participates with other health care charitable trusts and community partners in each of our service areas to complete community health needs assessments. During 2012, MHMH partnered with Alice Peck Day Memorial Hospital, Mount Ascutney Hospital and Health Care, and Granite United Way to conduct a Community Needs Assessment. The needs assessment included reviewing health data available throughout NH and VT Health Departments; BRFSS and youth Risk Behavior Surveys; focus groups with community members from lower-income neighborhoods; and electronic surveys of professional health and social service providers as well as community residents. This information was reviewed by a Steering Committee comprised of community leaders from the health care system, education, public health, and other social service organizations to develop a community needs assessment. The Steering Committee's work was reviewed at larger community gatherings in fall 2012 for further comments and feedback. In addition, MHMH reviewed related health data generated through www.CHNA.org as a comparative tool. MHMH monitors emerging health data on an ongoing basis as it is released by each state, schools, and other community entities. As part of the needs assessment, the Steering Committee reviewed: 1. Health, economic, and education data from sources including Youth Risk Behavior Surveys, the Behavioral Risk Factor Surveillance System, public health and hospital discharge data available in NH Health WRQS, census data, and reports from the New England Common Assessment Program. Additionally, it reviewed the 2011 NH State Health Profile and Upper Valley Regional Health Profile, quantitative and qualitative data from local souces (newspapers, regional planning offices, community forums) to identify concerns that emerged, intensified, or were the source of local attention since the last secondary data was collected. Emergent issues that are not well-reflected in secondary data but were reflected elsewhere include oral health needs (data from UV Smiles school-based oral health clinics), prescription drug misuse (data from the NH Governor's Commission on Alcohol and other Drug Abuse Prevention, Intervention, and Treatment), housing assessments (data from Upper Valley Lake Sunapee Regional Planning Commission), and reductions in availability of appropriate mental health services (news outlets and professional stakeholder interviews). 2. Opinion data from professional stakeholders using an online opinion poll of regional leaders in health, public health, education, municipal governments, public safety, and social service providers. 67 informed stakeholders responded to this survey. 3. Focus group data collected from 6 focus groups largely consisting of lower-income consumers of health/welfare services. 4. Opinion data from residents collected through community list-servs, individual interviews at human service organizations, and focus groups. These surveys were targeted primarily to economically stable households. 196 residents responded to surveys. Dartmouth-Hitchcock regularly monitors newly released health, economic, and education data from our service region to identify emerging regional needs and concerns, including FY 2013 Youth risk Behavior Surveys, the 2013 NH State Health Improvement Plan, NH's emerging state plans to address substance misuse, prescription drug misuse, obesity, and children's behavioral health.
Form 990, Schedule H Part VI Line 3	Patient Education of Eligibility for Assistance	All uninsured inpatients, same day surgery, observation, and Emergency Department patients are pro-actively screened using an automated tool to identify potential qualification for other federal, state, and local programs. In addition, specific outpatient activities deemed to have a higher rate of need are screened as part of regular protocol. If a patient appears to be eligible, on-site Financial Counselors assist the patient in completing the appropriate paperwork/applications and provide instruction regarding how to complete the qualification process. In some cases a Financial Counselor will act on behalf of the patient, at their signed consent, in order to complete the application process (for example, in New Hampshire a patient must be physically present at the District Office). If a patient doesn't qualify for specific programs, they are also considered for financial assistance as part of their screening. For outpatient services that are not routinely screened, staff interacting with patients are instructed to provide either a financial assistance application or contact information for a Financial Counselor when a patient expresses their inability to make payment. Every application is screened for completed income and asset documentation. Applications are also screened to assure there are no other potential options of federal, state, or local programs. The website, patient statements, and financial brochures all include information about financial assistance and how to apply. Form 990, Schedule H Part VI Line 4 Community Information The Organization defines its service region as New Hampshire and eastern Vermont, with the largest presence in the Lebanon, New Hampshire region, site of Dartmouth-Hitchcock Medical Center which includes Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinics main Northern clinic. MHMH serves the general population with a wide range of services. In addition to general hospital populations, the Organization provides services to patients with highly-specialized needs that are not available elsewhere in New Hampshire. MHMH is the states only tertiary referral center, provides the states only comprehensive cancer center (Norris Cotton Cancer Center - NCCC), operates the only Level I Trauma Center in New Hampshire, operates the only comprehensive childrens hospital and accredited pediatric trauma center in New Hampshire (Childrens Hospital at Dartmouth CHaD), hosts the only Level IV neonatal intensive care nursery and one of two pediatric intensive care units in New Hampshire, and operates the only helicopter transport service in the state. As such, the service population is both the general public seeking primary health care services as well as residents with unique and highly-specialized health care needs.
Form 990, Schedule H Part VI Line 5	Promotion of Community Health	MHMH supports organizations and initiatives that further health by strengthening and developing key community capacities to address identifed community health needs. This includes hosting or leading community partnerships to address substance misuse, reduce obestiy through community-level strategies; provide funding for children's oral health initiatives, and participation of our staff in other partnerships including the Outpatient Falls Prevention Task Force; the Transportation Management Association, and the Upper Valley Housing Authority. In addition, MHMH operates health education and support services such as a Women's Health Resource Center, the Aging Resource Center; and a Health Education Center. MHMH uses cash contributions, contracted services, and in-kind contribution of staff time and expertise, to support these strategies which improve community health. At MHMH's Lebanon, NH campus, the Hospital extends Professional Staff Privileges to qualified and appropriate physicians who are employees of Dartmouth-Hitchcock Clinic, Mary Hitchcock Memorial Hospital, and Dartmouth College, who also hold a faculty appointment at Geisel School of Medicine. Mary-Hitchcockss Trustees annually set strategic priorities for the institution and approve operating and capital budgets which allocate surplus funds to improvements in patient care, medical education, research, as well as maintenance of a prudent reserve. Examples of these investments include the development of Mary Hitchcockss Patient Safety and Training Center, ongoing Quality and Patient Safety initiatives; purchases of new and emerging medical technologies, awards made to support translational research, and support for undergraduate medical education at Geisel School of Medicine. Of the 18 voting members of Mary Hitchcock Board of Trustees, 17 are neither contractors nor employees of MHMH.
Form 990, Schedule H Part VI Line 6	Affiliated Health Care System	Community Benefits are provided by the Dartmouth-Hitchcock health care system, which includes Mary Hitchcock Memorial Hospital, Dartmouth-Hitchcock Clinic, and other related organizations whose primary mission is health care. Mary Hitchcock Memorial Hospital (MHMH) in Lebanon is New Hampshires largest hospital. In Fiscal Year 2013 MHMH had 396 licensed inpatient beds. The Dartmouth-Hitchcock Clinic (DHC) is a multi-specialty physician practice with a network of providers across New Hampshire and Vermont. While DHCs main offices are located in Lebanon, the Clinic also has multi-specialty practices in Manchester, Nashua, Concord, and Keene areas. In addition, the Clinic provides primary care in rural communities in Vermont and northern New Hampshire. MHMH, DHC sites, and the Geisel School of Medicine (formerly known as the Dartmouth Medical School) faculty and students make up the Dartmouth-Hitchcock (D-H) health care system. The Hospital and Clinic operate jointly through interlocking directorates, strategic planning and management and share identical missions. The Medical School, which works closely with the Hospital and Clinic, is focused on medical education and research.
STATE FILING OF COMMUNITY BENEFIT REPORT	990 SCHEDULE H, PART VI	NH,

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (15 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Method Of ValuationMethodOfValuation	Purpose Of GrantPurposeOfGrant
Child Health Services
1245 Elm Street	Manchester	NH	03105	020348711	501(C)(3)	41014	FMV	Program Support
Good Neighbor Health Clinic
70 No Main St	White River Jct	VT	05001	030346949	501(C)(3)	44850	FMV	Programs/Clinic Svcs
Grafton Country Senior Citizens Council
P O Box 433	Lebanon	NH	03766	237248316	501(C)(3)	24840	FMV	Elder Services
Albert Schweitzer Fellowship Inc
10 Sausville Road	Etna	NH	03750	131982786	501(C)(3)	13800	FMV	Program Services
Stagecoach
7 Bayberry Way	Mont Vernon	NH	03057	030276517	501(c)(3)	25875	FMV	Transportn Subsidy
Granite State United Way
46 South Main St	Concord	NH	03301	026006033	501(c)(3)	22080	FMV	Program Support
Indian Stream Health Center
141 Corliss Ln	Colebrook	NH	03756	200999212	501(C)(3)	34500	FMV	Programs/Clinic Svcs
David's House
461 Mount Support Rd	Lebanon	NH	03766	222593431	501(C)(3)	23115	FMV	Program Support
Lamprey Health
22 Prospect Street	Nashua	NH	03060	237305106	501(C)(3)	51257	FMV	Program Services
Mascoma Valley Health Initiative
PO Box 2013	Canaan	NH	03741	752991608	501(C)(3)	6900	FMV	Hlth Adv Cnsl Sppt S
The Trustees of Dartmouth College
1 Rope Ferry Road	Hanover	NH	03755	020222111	501(C)(3)	4340289	FMV	Educ and Prog Svcs
Alice Peck Day Memorial Hospital
10 Alice Peck Day Memorial Drive	Lebanon	NH	03766	020222791	501(C)(3)	5520	FMV	Dental Prog Svcs
Advance Transit
PO Box 1027	Wilder	VT	05088	222558708	(501)(C)(3)	66213	FMV	Transportn Subsidy
Connecticut River Transit
706 Rockingham Road	Rockingham	VT	05101	861069523	501(C)(3)	20700	FMV	Transportn Subsidy
City of Manchester NH
1 City Hall Plaza	Manchester	NH	03101			17250	FMV	Child Hlth Svcs

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	15	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (9 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant	Method Of ValuationMethodOfValuation
Patterson Awards	6	789	FMV
Levine Nursing Awards	8	4347	FMV
Varnum Nursing Awards	34	27600	FMV
The Dartmouth Institute Scholarships	45	587995	FMV
Knox Nursing Award	32	47582	FMV
Prouty Award	54	53987	FMV
E. Hintze Nursing Awards	1	2145	FMV
Daniels Nursing Award	8	3372	FMV
D-H Tuition Reimbursement Program	294	422304	FMV

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Form 990, Schedule I	Identifier
Return Reference	Description of Organization's Procedures for Monitoring the Use of Grants	ReturnReference
Explanation	Each award established by Mary Hitchcock Memorial Hospital( Levine Nursing Awards, Knox Nursing Award, Patterson, Varnum, Hintze, and Prouty) has written established guidelines and procedures. Award payments are processed in accordance with the specific terms of each of the awards noted above. The Dartmouth Institute Scholarships (TDI) are paid directly to the College on the behalf of the individuals receiving the award. The coordinators of the program(s) are responsible for assuring that all terms are met, including proper documentation of expenses with receipts.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	X	FirstClassOrCharterTravel
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	true	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	true	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (33 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Nancy Formella MSN RN
TTE Advisor End 12/1/2012	699182	0	0	0	2509878	0	39000	0	19814	0	3267874	0	0	0
Carl Dematteo MD
Former Chf Qual Compl Ofr	0	56240	0	0	0	439886	0	6733	0	797	0	503656	0	0
Robin Kilfeather-Mackey CPA
Chief Financial Officer	0	420635	0	0	0	31010	0	17000	0	20043	0	488688	0	0
Linda Von Reyn
Chief Nursing Officer	310148	0	0	0	148579	0	17000	0	20027	0	495754	0	0	0
Daniel Jantzen CPA
Chief Operating Officer	477890	0	0	0	130327	0	39500	0	20042	0	667759	0	0	0
Stephen Leblanc
ExecVP Strtgy&Ntwrk Eff 2/3/13	0	451778	0	0	0	84208	0	17000	0	19773	0	572759	0	0
John Butterly MD
Exec VP of Med Affairs, D-HH	0	491826	0	0	0	46881	0	72035	0	21313	0	632055	0	0
Lawrence Dacey MD
Former CMO End 6/30/12 / Phys	0	464816	0	0	0	42669	0	24265	0	13446	0	545196	0	0
Alan Weston
Chief Human Resources Officer	307083	0	0	0	4354	0	45316	0	20110	0	376863	0	0	0
David Gladstone MD
Chief Clinical Phys Rad/Onc	263455	0	0	0	14641	0	61245	0	20025	0	359366	0	0	0
Bruce King
Pres & CEO New London Hosp	309062	0	0	0	171808	0	39000	0	20042	0	539912	0	0	0
Susan Reeves
VP/Chair Nurs Colby Saw Collg	246598	0	0	0	17328	0	46995	0	19652	0	330573	0	0	0
Neil Castaldo
Sr Advisor to CEO Eff 7/1/12	490202	0	70000	0	62711	0	48907	0	21365	0	693185	0	0	0
Mary Oseid
V.P Ambulatory Care	0	251102	0	0	0	7536	0	34000	0	11523	0	304161	0	0
Christine Schon
V.P Comm. Grp. Pract. Ops	0	206145	0	0	0	3611	0	42749	0	15426	0	267931	0	0
William Mroz
V.P. Operations/Clinical Svcs	242039	0	0	0	3861	0	40833	0	8011	0	294744	0	0	0
Sandra Dickau
Former VP Ops/Ptnt Care	0	0	0	0	127765	0	0	0	0	0	127765	0	0	0
Gail Dahlstrom
V.P. Facilities Mgmt	219112	0	0	0	6717	0	17000	0	15934	0	258763	0	0	0
Michael Ward
V.P. Cancer Svcs end 7/31/12	0	177843	0	0	0	4687	0	20568	0	8829	0	211927	0	0
James Weinstein DO MS
Trustee Ex-Officio/CEO	0	777576	0	0	0	55475	0	38368	0	21314	0	892733	0	0
Gregg Meyer MD
CCO/EVP Pop Hlth	0	530732	0	0	0	448	0	83828	0	13990	0	628998	0	0
Andrew Gettinger MD
Former Chief Med Info Ofr	0	190974	0	0	0	145475	0	31490	0	7825	0	375764	0	0
Kevin Donovan
CEO Mt Ascutney Hospital	250012	0	0	0	5515	0	44358	0	19627	0	319512	0	0	0
Tina Naimie CPA
VP Corporate Finance	213166	0	0	0	172	0	37410	0	1804	0	252552	0	0	0
Wendy Fielding
VP Financial Planning	213563	0	0	0	270	0	50447	0	19884	0	284164	0	0	0
Barbara Walters DO MBA
Med Dir/Dir Acct Care eff 11/1	0	330728	0	0	0	22590	0	39421	0	18106	0	410845	0	0
Jeanine Arden Ornt
General Counsel	413330	0	0	0	1989	0	58995	0	13267	0	487581	0	0	0
Vincent Fusca
Chief of Staff	228833	0	0	0	1973	0	19471	0	1282	0	251559	0	0	0
Mary Kay Boudewyns
Former Key Employee	203146	0	0	0	9152	0	39000	0	9103	0	260401	0	0	0
Edward Merrens MD
CMO Eff 9/1/12	0	331888	0	0	0	11419	0	51519	0	14025	0	408851	0	0
George Blike MD
Chf Qlty&Value Ofr Eff 7/1/12	0	376104	0	0	0	12974	0	27682	0	20995	0	437755	0	0
Thomas Colacchio MD
Former Officer/Phys	0	987376	0	0	0	54180	0	46995	0	19673	0	1108224	0	0
Janet West
VP Compliance & Audit Svcs	237568	0	0	0	25423	0	44245	0	15442	0	322678	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Supplemental Compensation Information	Form 990, Schedule J, Part I - Line 1a FROM TIME TO TIME, THE ORGANIZATION PROVIDES CHARTERED TRAVEL SERVICES TO THE CEO. THE COST OF PROVIDING THE CHARTERED SERVICE HAS BEEN DEEMED A COST-EFFICIENT MANNER TO ALLOW THE OFFICER TO WORK WHILE TRAVELLING VERSUS THE TIME LOST DRIVING, ETC. ALL REQUESTS ARE APPROVED BEFORE PAYMENT TO ENSURE COMPLIANCE WITH INTERNAL POLICIES. The Organization has in place a Management Self Development Plan (MSDP) designed to promote professional and personal development. The MSDP is capped at 2% of gross pay and may be utilized for expenses such as professional dues, meetings and seminars, tuition reimbursement, and other miscellaneous items that promote professional knowledge. The monies may also be used for up to a 50% reimbursement of the cost of a fitness/wellness program designed to maintain the health of management personnel. All expenses are submitted for approval before reimbursement.
Severance Payments	The following listed individuals received Severance and/or change in control payments during calendar year 2012: During 2012 Nancy Formella received a $2,281,750 separation package which included severance pay, medical and dental benefits, life and disability benefits (including tax gross-up, and a SERP make-up benefit). The separation payment is in lieu of a multi-year contractual obligation. The payment is included on Schedule J, Line B, Part iii. During 2012, Thomas Colacchio transitioned from an officer role to a staff physician role. As part of this transition, Thomas Colacchio received a $320,000 change of control payment from Dartmouth-Hitchcock. The payment is included on Schedule J, Line B, Part i. During 2012 Carl Dematteo received a $436,667 separation payment in lieu of a multi-year contracutal obligation.The payment is included on Schedule J, Line B, Part iii. Supplemental Nonqualified Retirement Plan: SCHEDULE J, PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (WHICH ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B (III)): Nancy Formella $223,316 Carl DeMatteo $2,020 Robin Kilfeather-Mackey $13,832 Linda Von Reyn $117,277 Daniel Jantzen $98,663 Stephen LeBlanc $61,531 John Butterly $43,380 Alan Weston $3,580 David Gladstone $3,687 Bruce King $138,810 Susan Reeves $6,733 Neil Castaldo $40,949 Mary Oseid $7,536 William Mroz $2,955 James Weinstein $53,721 Andrew Gettinger $145,475 Kevin Donovan $1,561 Barbara Walters $21,402 Edward Merrens $11,149 George Blike $12,560 Thomas Colacchio $54,180 Lawrence Dacey $41,895 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. MHMH sponsors a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable MHMH to attract and retain quality executive personnel, improve the physicians' post-retirement life insurance benefits, and to replace an increasingly costly retiree life insurance program. The plan was frozen in 1998 and therefore no further costs of the individual employee insurance premiums have been funded by the organization. The number of participants and dollar value continues to dwindle as individuals retire/leave the organization.	Form 990, Schedule J, Part I line 4a

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
New Hampshire Health and Education Facilities Auth
A	020279866	644614Y07	2009-08-19	134661088	CURRENT REFUND 2008 (A), (B), (C)	false	false	false
New Hampshire Health and Education Facilities Auth
B	020279866		2009-03-30	5935000	VARIOUS EQUIPMENT	false	false	false
New Hampshire Health and Education Facilities Auth
C	020279866	644614G29	2010-06-16	73647839	CONSTR. OF FACILITY AND EQUIP.	false	false	false
New Hampshire Health and Education Facilities Auth
D	020279866		2011-08-31	38119624	CURRENT REFUND 2001 (A)	false	false	false

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceeds	Capitalized InterestCapitalizedInterest	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade
A	134841419	0	2273111	0	132387977	2010	true	false	true
B	5935000	0	0	5935000	0	2009	false	false	true
C	73666926	3766049	1168560	68732317	0	2012	false	false	true
D	38119624	0	97500	0	38022124	2011	true	false	true

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Remedial Action TakenRemedialActionTaken	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	false	false	false	false	false	false	false	true
B	false	false	false	false	false	false	false	true
C	false	false	false	false	false	false	false	true
D

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Business Name Line1NameOfGICProvider/BusinessNameLine1	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs	Term Of HedgeTermOfHedge
0
A	false	true	true	false	false	false	false	false	false	0	false	true
0
B	false	true	false	false	false	false	false	false	false	0	false	true
0
C	false	true	false	false	false	false	false	false	false	0	false	true
Morgan Stanley
D	false	true	true	false	true	true	true	false	false	0	false	true	29.8

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	true
B	true
C	true
D	true

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Additional Information Part I(F)	0	Current Refund 2008 (A), Issued 9/4/2008, Which Advance Refunds 1985 Current Refund 2008 (B), Issued 10/31/2008, Which Advance Refunds 1993 Current Refund 2008 (C), Issued 12/19/2008 Current Refund 2001(A), Issued 10/17/2001, Which Advance Refunds 1997 & 1994
Part II Line 3, Column A & C	0	Difference Between Part I Column E & Line 3 is investment earnings

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

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

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	New Hampshire Health and Education Facilities Auth	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	020279866	IssuerEIN
Date Issued	2012-11-28	DateIssued
Issue Price	116170000	IssuePrice
Description Of Purpose	CURRENT REFUND 2002	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	false	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Amount Retired	0	AmountRetired
Amount Bond Defeased	0	AmountBondDefeased
Total Proceeds	116170000	TotalProceeds
Amount In Reserve Fund	0	AmountInReserveFund
Capitalized Interest	0	CapitalizedInterest
Refunding Escrow	0	RefundingEscrow
Issuance Costs From Proceeds	520000	IssuanceCostsFromProceeds
Credit Enhancement	0	CreditEnhancement
Working Capital Expenditures	0	WorkingCapitalExpenditures
Capital Expenditures	0	CapitalExpenditures
Other Spent Proceeds	115650000	OtherSpentProceeds
Amount Unspent	0	AmountUnspent
Year Of Subst Completion	2013	YearOfSubstCompletion
Current Refunding	true	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	false	FinalAllocationMade

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00000	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00000	TotalPrivateBusinessUse

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiled
Rebate Not Due Yet	true	RebateNotDueYet
Exception To Rebate	true	ExceptionToRebate
No Rebate Due	false	NoRebateDue
Variable Rate Issue	false	VariableRateIssue
Hedge Identified In Books And Recds	false	HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Superintegrated Hedge	false	SuperintegratedHedge
Hedge Terminated	false	HedgeTerminated
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvested
Written Proc To Monitor Reqs	true	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	true	ProcToUndertkCorrectiveAction

Schedule L IRS990ScheduleL

Loan Table LoanTable (5 entries)

Relationship With OrganizationRelationshipWithOrganization	Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
DANIEL JANTZEN
Officer	SPLIT DOLLAR LIFE	X	$99,940	99940	false	true	true
SUSAN REEVES
Highly-Comp EE	SPLIT DOLLAR LIFE	X	$130,152	130152	false	true	true
BRUCE KING
Highly-Comp EE	SPLIT DOLLAR LIFE	X	$121,174	121174	false	true	true
MARY KING
Disqualified Person	SPLIT DOLLAR LIFE	X	$16,202	16202	false	true	true
DEBORAH JANTZEN
Disqualified Person	SPLIT DOLLAR LIFE	X	$48,717	48717	false	true	true

Field	Value	IRS element (for citing)
Total Balance Due	416185	TotalBalanceDue

Form990 Schedule L Part III Form990ScheduleLPartIII

Field	Value	IRS element (for citing)
Name Of Interested Person	Janet West	NameOfInterestedPerson
Relationship With Organization	Highly-Compensated EE	RelationshipWithOrganization
Amount Of Grant	23352	AmountOfGrant
Type Of Assistance	Edu.Scholarship	TypeOfAssistance
Purpose Of Assistance	Masters in Healthcare	PurposeOfAssistance

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Hypertherm
Trustee Barbara Couch	322681	See Part V	false
Nathaniel Arden-Ornt
Officer Arden Ornt	62183	Family member employed by MHMH	false
Vincent Fusca III
Officer Fusca II	74784	Family member employed by MHMH	false

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	Form 990, Schedule L Part IV	Identifier
Return Reference	Business Transactions	ReturnReference
Explanation	Name of Interested Person: Barbara Couch Relationship: Trustee Description of Transaction: Barbara Couch is a greater than 35% owner of Hypertherm, an entity that contracts with MHMH for certain medical services for its employees.	Explanation

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArt
Art Historical Treasures		ArtHistoricalTreasures
Art Fractional Interest		ArtFractionalInterest
Books And Publications		BooksAndPublications
Clothing And Household Goods		ClothingAndHouseholdGoods
Cars And Other Vehicles		CarsAndOtherVehicles
Boats And Planes		BoatsAndPlanes
Intellectual Property		IntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	12	NumberOfContributions
Noncash Contribs Rptd F990	22384	NoncashContribsRptdF990
Method Of Determining Revenues	Fair Market Value	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Securities Closely Held Stock		SecuritiesCloselyHeldStock
Securities Prtnrshp Trust Intrsts		SecuritiesPrtnrshpTrustIntrsts
Securities Miscellaneous		SecuritiesMiscellaneous
Qualified Contrib Hist Struct		QualifiedContribHistStruct
Qualified Contrib Other		QualifiedContribOther
Real Estate Residential		RealEstateResidential
Real Estate Commercial		RealEstateCommercial
Real Estate Other		RealEstateOther
Collectibles		Collectibles
Food Inventory		FoodInventory
Drugs And Medical Supplies		DrugsAndMedicalSupplies
Taxidermy		Taxidermy
Historical Artifacts		HistoricalArtifacts
Scientific Specimens		ScientificSpecimens
Archaeological Artifacts		ArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

Non Cash CheckboxNonCashCheckbox	DescriptionDescription	Number Of ContributionsNumberOfContributions	Noncash Contribs Rptd F990NoncashContribsRptdF990	Method Of Determining RevenuesMethodOfDeterminingRevenues
X	Travel and Fuel Cards for Patients	2	52000	FMV
X	Various items for events, hearing aids,& supplies	218	218	FMV

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	true	ReviewProcessUnusualNCGifts
Third Parties Used	true	ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

Field	Value	IRS element (for citing)
Identifier	Line 32B	Identifier
Explanation	The organization uses Dartmouth-Hitchcock Medical Center, a supporting Organization, for solicitation of contributions and annual fund activities. From time to time, the Hospital may receive non-cash contributions directly from its donors.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Changes to Organizational Documents Since Last 990 Filing	Form 990, Part VI Section A Line 4	Effective January 1, 2013, the Mary Hitchcock Memorial Hospital (MHMH) Board of Trustees amended and restated the MHMH Bylaws. The primary purpose of the amendments was to simplify the corporation's governance structure, which had become unwieldy. The amendments did not alter the mission of MHMH, the role of its Board of Trustees, the Trustees' oversight of the chief executive officer selection, performance and compensation, the disposition of assets upon dissolution, or any other fundamental component of the MHMH governance documents. The following is a brief statement of the significant changes to the MHMH Bylaws: 1. The number of Trustees was reduced from 28 to a range from 17 to 24. Two new categories of Trustees also were established: a physician Trustee who is a Clinical Chair or Center Director, and a physician who practices in one of the Community Group Practices. 2. The Assembly of Overseers, primarily responsible for nominating Trustees and serving in an advisory role to the Board, was eliminated. The Bylaws now provide for different nominations by category of Trustee. For example, the Board of Governors will nominate physician positions, and the MHMH Board will nominate candidates for the Public Trustee positions. Others serve ex officio. 3. The Board of Governors was reduced in size from 31 to 18 and will be chaired by the MHMH President/CEO. Three new categories of Governors were established: a provider from a Community Group Practice, a nurse, and an associate provider. The Board of Governors' role was consolidated to the following three functions: - Serve as the executive committee of the professional staff in satisfaction of Joint Commission requirements; - Provide input and make recommendations to the CEO as to management issues and matters of concern to the professional staff; and - Provide input and make recommendations to the MHMH Board of Trustees. 4. The selection process for a new President/CEO must be reviewed by the Board of Governors and include two criteria: (1) the candidate must be a licensed physician; and (2) a preference for an internal candidate. 5. The Committees of the MHMH Board were reorganized into six standing committees: Governance, Value, Finance, Compensation, Research and Education, and Audit and Compliance. 6. The following requirements have been added to the process for amending or repealing the MHMH Bylaws, which maintain the requirements of a 2/3 majority vote of all Trustees: - The proposed amendment(s) and the reason for it must be published and available to all Dartmouth-Hitchcock employees. - All Dartmouth-Hitchcock employees will be given the opportunity to provide input to the Trustees about the amendment. - All physicians credentialed at any Dartmouth-Hitchcock facility will have the opportunity to vote on an advisory recommendation regarding the amendment. - All associate providers credentialed at any Dartmouth-Hitchcock facility will have the opportunity to vote on an advisory recommendation regarding the amendment. - The Board of Trustees must request the written advice and recommendation of the Board of Governors on each proposed amendment.
Description of classes of members, persons, and the nature of their rights	Form 990, Part VI, Question 6 & 7a	Dartmouth-Hitchcock Health (D-HH) is the sole corporate Member of Mary Hitchcock Memorial Hospital (MHMH). D-HH has specific authority and reserved powers, including the power to confirm the election of members of the MHMH's Board of Trustees and the power to approve significant governance, financial and operational decisions of MHMH's Trustees. Description of classes of members, persons, and the nature of their rights Form 990, Part VI, Question 7b In addition to reserved powers, Dartmouth-Hitchcock Health (D-HH) shall have the authority to take actions to establish, manage, and govern the System as an integrated health care delivery system in furtherance of the mission of the Hospital and other Organizations. These powers include but are not limited to items such as the ability to approve, disapprove or modify all material governance, programmatic and financial decisions of MHMH's Board of Trustees, to appoint or remove a member of the Hospital's Board of Trustees, assess the Hospital a monetary amount for the payment of the expenses of D-HH, approve the Hospital's budget, approve the borrowings or dispositions of assets by the Hospital, approve key strategic relationships, approve the elimination or addition of any material health care service or program, and other authority to take action on behalf of the Hospital.
Describe the Process used by Management &/or Governing Body to Review 990	Form 990, Part VI, Question 11b	The Audit Committee of the MHMH Board of Trustees is presented with a substantially complete Form 990. THE FORMS 990 AND 990-T ARE REVIEWED BY THE DIRECTOR OF CORPORATE FINANCE, VICE PRESIDENT OF CORPORATE FINANCE, AND THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURN. The Committee members are expected to review these forms before the meeting. AT THE MEETING A PRESENTATION IS MADE BY THE VICE PRESIDENT OF CORPORATE FINANCE, WITH TIME ALLOTTED FOR QUESTIONS FROM THE COMMITTEE. ONCE THE RETURN HAS BEEN FULLY PREPARED A FINAL 990 AND 990-T COMPLETE ELECTRONIC VERSION IS SENT OUT TO EACH BOARD MEMBER PRIOR TO THE OFFICIAL FILING.
Description of Process to Monitor Transactions for Conflicts of Interest	Form 990, Part VI, Question 12c	The Mary Hitchcock Memorial Hospital Board of Trustees approved a policy concerning a voluntary self-disclosure of any potential conflict of interest. The Compliance and Audit Services Department conducts an annual survey and performs other procedures as considered necessary to report on compliance with the conflict of interest policy. The Compliance and Audit Services Department then reports to the board any potential conflicts for their review. Per the policy any conflicts or otherwise perceived are required to be addressed by the Board of Trustees on an ongoing basis. If a conflict arises, the individual is asked to recuse themselves from voting on any related items. The policy applies to all trustees, employees, and their immediate family members. All MHMH board members are included in the annual conflict of interest survey.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR UNDERTAKEN	Form 990, Part VI, Question 15a	Compensation for the President is evaluated by an independent third party firm for reasonableness and national data benchmarking. The Compensation Committee along with Independent Trustees approve the final compensation in consideration with the independent third party firm's recommendations and suggestions. This process was last undertaken in 2013.
Offices & Positions for Which Process was Used & Year Undertaken	Form 990, Part VI, Question 15b	Compensation for Officers and Key Employees are evaluated by an independent third party firm for reasonableness and national data benchmarking. The Compensation Committee along with Independent Trustees approve the final compensation in consideration with the independent third party firm's recommendations and suggestions. THIS PROCESS WAS LAST UNDERTAKEN IN 2013 FOR EACH PERSON IDENTIFIED AS AN OFFICER OR KEY EMPLOYEE.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public	Form 990, Part VI, Question 19	MHMH's governing documents are available through the New Hampshire Secretary of State. Certain financial information is disclosed through the Community Benefits Annual Report. The audited financial statements, governing documents, and conflict of interest policy are available upon request either in electronic or hardcopy form. Average Hours Per Week Form 990 Part VII Section A, Line 1A, Column B As part of MHMH's and Dartmouth-Hitchcock Clinic's affiliation agreement, the two organizations share officers. As such, the average hours per week are allocated between the two organizations' 990's even though compensation reported in part VII is based on the entity issuing the W-2. In addition, certain officers spend time on Dartmouth-Hitchcock Health, the sole corporate member of both MHMH and DHC, along with two supporting organizations Dartmouth-Hitchcock Medical Center and Hamden Risk Retention Group. Statement of Functional Expenses Form 990 Part IX Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic operate under an affiliation agreement as directed by Dartmouth-Hitchcock Health, the sole Corporate Member of both entities. Due to the integrated operating structure, related mission, and close relationship of the two tax-exempt organizations, expenses are shared between the two entities. All expenses reported within this 990 are the organization's share of expenses as designated by the affiliation agreement.
Financial Statements and Reporting	Form 990 Part XI, Question 9	Other Changes in Net Assets Include: Pension-related charges: $33,818,200 Unrealized Gain/Loss on Hedge and other $2,230,716 Other expenses/changes in net assets $350,081 Total changes in net assets: $36,398,997 Audited Financial Statements Form 990 Part XII, Question 2d The organization's financial information is included in the audited financial statements of Dartmouth-Hitchcock and Subsidiaries, which consists of Dartmouth-Hitchcock Clinic, Mary Hitchcock Memorial Hospital, and subsidiaries. A-133 Audit Form 990 Part XII, Question 3a DURING FISCAL YEAR 2013, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FUNDS FROM FEDERAL AWARDS IN EXCESS OF THE MINIMUM THRESHHOLD SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133, THEREFORE REQUIRING AN AUDIT. DUE TO THE ISSUANCE OF THE COMBINED FINANCIAL STATEMENTS, THE SINGLE AUDIT WAS PERFORMED ON THE COMBINED FINANCIAL INFORMATION OF ALL ORGANIZATIONS. Additional footnote regarding payments to former officer. Mr. Varnum, the former President of MHMH, over the course of his employment chose to defer a portion of his compensation. In calendar year 2012, Mr. Varnum withdrew approximately $1.5 million of deferred compensation.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Total IncomeTotalIncome	EOY AssetsEOYAssets	Business Name Line1DirectControllingEntityName/BusinessNameLine1
NEW ENGLAND ALLIANCE FOR HEALTH LLC
ONE MEDICAL CENTER DRIVE	LEBANON	NH	03756	264232401	HLTH IMPROVMT	NH	20971	226804	MHMH
D-H Specialty Services LLC
One Medical Center Drive	Lebanon	NH	03756	460876427	Shd Svgs Prgm	NH	0	0	MHMH

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
DARTMOUTH-HITCHCOCK CLINIC
ONE MEDICAL CENTER DRIVE	LEBANON	NH	03756	222519596	PHYSICIAN SVC	NH	501(c)(3)	9	D-HH	true
DARTMOUTH-HITCHCOCK MEDICAL CENTER
ONE MEDICAL CENTER DRIVE	LEBANON	NH	03756	222715483	SUPPORTNG ORG	NH	501(c)(3)	11 TYPE I	NA	true
DARTMOUTH - HITCHCOCK HEALTH
One Medical Center Drive	Lebanon	NH	03756	264812335	SUPPORTNG ORG	NH	501(C)(3)	11 Type II	NA	false
HAMDEN RISK RETENTION GROUP INC
30 MAIN STREET STE 330	BURLINGTON	VT	05401	208530788	Self Ins	VT	501(c)(3)	11 TYPE I	DHC	true
The Hitchcock Foundation
One Medical Center Drive	Lebanon	NH	03756	020222139	HLTHCRE RSRCH	NH	501(c)(3)	7	DHC	true

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
D-H Mster Invst Prg
1 Med Ctr Dr	LEBANON	NH	03756	020205863	POOLED INVEST	NH	MHMH	Excluded	27345924	499506630	false	$33,033	true	0.95814
The Hitchcock Ptshp
1 Med Ctr Dr	LEBANON	NH	03756	020514823	Invst in Ptnr	NH	MHMH	Investment	9747	243682	false	$0	true	0.61420
KEENE HLTH ALLIANCE
580 Court St	Keene	NH	03431	300179297	Healthcare	NH	DHC
Obnet Services LLC
1 Med Ctr Dr	Lebanon	NH	03756	043746287	Database Serv	NH	DHC
One Care VT ACOLLC
111 COLCHESTER AVE	Burlington	VT	05401	455399218	Shared Saving	VT	DHH

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Percentage OwnershipPercentageOwnership	Controlled OrgControlledOrg	EINEIN	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	CountryAddressForeign/Country	Postal CodeAddressForeign/PostalCode	Legal Domicile Foreign CountryLegalDomicileForeignCountry	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets
Charit Remndr Unitrusts (4)
One Medical Center Drive	Lebanon	NH	03756	Chart. Trust	NH	N/A	Trust	1.00000	true
Pompanoosuc Investment Corp
1 Medical Ctr Dr	Lebanon	NH	03756	Real Est Hldg	NH		C Corporation		false	020352330	NA
Hamden Assurance Co Ltd
				Liab. Insuanc			Foreign Corp	0.25800	false	980121409	DHC	44 Church St	Hamilton	BD	HM 12	BD
Hitchcock Health Connect
1 Medical Ctr Dr	Lebanon	NH	03756	Telehealth	DE		C Corp			800908979	NA						0	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	true	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	true	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	true	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	true	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
Dartmouth-Hitchcock Clinic
JKLMN	103062318	FMV
Dartmouth-Hitchcock Health
Q	2261216	FMV
Dartmouth-Hitchcock Health
P	1941996	FMV
Dartmouth-Hitchcock Medical Center
L	347380	FMV
Dartmouth-Hitchcock Medical Center
M	1538619	FMV
Hamden Risk Retention Group
O	5504744	FMV
The Hitchcock Foundation
Q	1172181	FMV
The Hitchcock Foundation
P	758628	FMV
Dartmouth-Hitchcock Master Investment Program
R	28590	FMV