DARTMOUTH-HITCHCOCK MEDICAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- DARTMOUTH-HITCHCOCK MEDICAL CENTER (EIN 22-2715483)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-15
- IRS object ID
- 201431359349304763
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-15T11:45:56-05:00 | 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 | 222715483 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dartmouth-Hitchcock Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % TINA NAIMIE | InCareOfName |
| Name Control | DART | NameControl |
| Phone | 6036531155 | 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 | 037560001 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Tina E Naimie | Name |
| Title | Treasurer | 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 | Tina Naimie | 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 | 5084343 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.dhmc.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | Provides health care admin,planning & other services to supported orgs to promote, advance & strengthen activities such as regional programs, education & research,gov't & public relations,fundraising & other svcs | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 7 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1749941 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 871037 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4671034 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3995121 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 591 | InvestmentIncomePriorYear |
| Investment Income Current Year | 400 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 150895 | OtherRevenuePriorYear |
| Other Revenue Current Year | 194228 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6572461 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5060786 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1737047 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 862979 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 3643882 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4858116 | OtherExpensePriorYear |
| Other Expenses Current Year | 4135974 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6595163 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4998953 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -22702 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 61833 | RevenuesLessExpensesCY |
| Total Assets BOY | 4534519 | TotalAssetsBOY |
| Total Assets EOY | 3951669 | TotalAssetsEOY |
| Total Liabilities BOY | 1206301 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 567508 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3328218 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3384161 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | DARTMOUTH-HITCHCOCK MEDICAL CENTER'S MISSION IS TO OFFER ADMINISTRATIVE, PLANNING, AND OTHER SERVICES DESIGNED TO PROMOTE, ADVANCE, AND STRENGTHEN THE INTERDEPENDENT AND SYNERGISTIC ACTIVITIES OF THE INDEPENDENT SUPPORTED ORGANIZATIONS IN THE AREAS OF HEALTHCARE, EDUCATION AND RESEARCH, GOVERNMENT AND PUBLIC RELATIONS, CHARITABLE FUNDRAISING AND OTHER RESOURCE DEVELOPMENT ACTIVITIES NOT INCONSISTENT WITH THE PURPOSES OF THE SUPPORTED ORGANIZATIONS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1331230 | Expense |
| Grants | 862979 | Grants |
| Revenue | 4106917 | Revenue |
| Description | Promotion of multidisciplinary and regional health care programs, education and research, government and public relations, charitable fundraising and other resource development activities. | Description |
| Total Program Service Expense | 1331230 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | 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 | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | 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 | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | 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 | 4 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | 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 | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| 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 | TINA NAIMIE | NamePerson |
| Telephone Number | 6036531155 | 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 | 037560001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | OfficerOfficer | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Peter M Fahey | ||||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |||
| Wayne G Granquist | ||||||||
| Vice Chair/Trustee | 1.5 | X | 0 | 0 | 0 | 6.0 | X | |
| Alfred L Griggs | ||||||||
| Chair/Trustee | 0.5 | X | 0 | 0 | 0 | 2.0 | X | |
| Alan C Keiller | ||||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | 6.0 | ||
| James N Weinstein DO MS | ||||||||
| Trustee Secretary/D-H CEO | 1.5 | X | 0 | 833051 | 59682 | 60.0 | X | |
| William W Wyman | ||||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |||
| William W Helman IV | ||||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | 3.0 | ||
| Wiley Souba MD ScD | ||||||||
| Ex-Officio | 0.5 | X | 0 | 828357 | 45120 | 43.0 | ||
| Marc F Levenson MD | ||||||||
| Trustee End 1/1/13 | 0.5 | X | 0 | 195931 | 0 | 40.0 | ||
| Deborah Amdur MSW | ||||||||
| Trustee Eff 1/2/13 | 0.5 | X | 0 | 0 | 0 | |||
| Carol Folt PhD | ||||||||
| Trustee | 0.5 | X | 0 | 633455 | 40945 | 40.0 | ||
| Nancy Formella MSN RN | ||||||||
| TTE Advisor End 12/1/12 | 0.5 | X | 0 | 3209060 | 58814 | 60.0 | X | |
| Tina E Naimie CPA | ||||||||
| Treasurer/VP Corp Finance D-H | 1.5 | 0 | 213338 | 39214 | 40.0 | X | ||
| Anne Page CPA | ||||||||
| Frmer Treasurer/VP Reg Finance | 0 | 240860 | 54273 | 40.0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 6154052 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 298048 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Trustees of Dartmouth College | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Rope Ferry Road | AddressLine1 |
| City | HANOVER | City |
| State | NH | State |
| ZIP Code | 03755 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Devlpmnt and Fundrsg | DescriptionOfServices |
| Compensation | 3643882 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 871037 | AllOtherContributions |
| Noncash Contributions | 23557 | NoncashContributions |
| Total Contributions | 871037 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ASSESSMENTS TO MEMBERS FOR SERVICES | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 3995121 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3995121 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3995121 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 587 | TotalRevenueColumn |
| Exclusion | $587 | 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 |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 23370 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 23557 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -187 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -187 | TotalRevenueColumn |
| Exclusion | -$187 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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 (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| REIM OF PROP TAXES BY SUPPORTED ORGS | 900099 | 111796 | 111796 | |
| INCOME FROM ANNUITIES | 900099 | 82432 | $82,432 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 194228 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5060786 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4106917 | RelatedOrExemptFunctionIncome |
| Exclusion | $82,832 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 862979 | Total |
| Program Services | 862979 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23841 | Total |
| Management And General | 23841 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 2979107 | Total |
| Fundraising | 2979107 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118293 | Total |
| Program Services | 1402 | ProgramServices |
| Fundraising | 116891 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63367 | Total |
| Fundraising | 63367 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 389982 | Total |
| Fundraising | 389982 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63494 | Total |
| Fundraising | 63494 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31041 | Total |
| Fundraising | 31041 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27755 | Total |
| Program Services | 27755 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROPERTY TAXES | Description |
| Total | 439094 | Total |
| Program Services | 439094 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4998953 | Total |
| Program Services | 1331230 | ProgramServices |
| Management And General | 23841 | ManagementAndGeneral |
| Fundraising | 3643882 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1238737 | BOY |
| EOY | 898853 | 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 | 272677 | BOY |
| EOY | 58333 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82624 | BOY |
| EOY | 81225 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3204415 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 508424 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2723746 | BOY |
| EOY | 2695991 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78859 | BOY |
| EOY | 72969 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 137876 | BOY |
| EOY | 144298 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4534519 | BOY |
| EOY | 3951669 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1120725 | BOY |
| EOY | 564370 | 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 | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 0 | BOY |
| EOY | 0 | 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 | 85576 | BOY |
| EOY | 3138 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1206301 | BOY |
| EOY | 567508 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3191977 | BOY |
| EOY | 3239863 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 136241 | BOY |
| EOY | 144298 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3328218 | BOY |
| EOY | 3384161 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4534519 | BOY |
| EOY | 3951669 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 61833 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -5890 | ReconciliationUnrealizedInvest |
| 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 | false | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (4 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | AmountAmount |
|---|---|---|---|
| MARY HITCHCOCK MEMORIAL HOSPITAL | |||
| 020222140 | 03 | true | $442,424 |
| DARTMOUTH-HITCHCOCK CLINIC | |||
| 222519596 | 0 | true | $0 |
| TRUSTEES OF DARTMOUTH COLLEGE | |||
| 020222111 | 02 | true | $420,155 |
| VETERANS AFFAIRS MEDICAL CENTER | |||
| 741612229 | 02 | true | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 4 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 862579 | SumOfAmounts |
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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2675179 | OtherCostOrOtherBasis |
| Book Value | 2675179 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 355231 | OtherCostOrOtherBasis |
| Depreciation | 334419 | Depreciation |
| Book Value | 20812 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 174005 | OtherCostOrOtherBasis |
| Depreciation | 174005 | Depreciation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 2695991 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ANNUITY LIABILITY | Description |
| Amount | $3,138 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3138 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule D, Part X, Line 2 | Identifier |
| Return Reference | Audited Financial Statement Footnote Regarding FIN48 (ASC 740) | ReturnReference |
| Explanation | The organization's audited financial statements did not include a footnote relating to FIN48 (ASC 740) since there have been no changes since inception. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (2 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 |
|---|---|---|---|---|---|---|---|---|
| Mary Hitchcock Memorial Hospital | ||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020222140 | 501(c)3 | 442424 | FMV | Gen support |
| Trustees of Dartmouth College | ||||||||
| 1 Rope Ferry Road | Hanover | NH | 03755 | 020222111 | 501(c)3 | 420155 | FMV | Gen support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule I, Part I, Question 2 | Identifier |
| Explanation | The majority of the DHMC board members are nominated by the board members of the supported organizations. All assistance represents fundraising proceeds raised on the behalf of DHMC's supported organizations and is given for general and unrestricted operating use. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James N Weinstein DO MS | ||||||||||||||
| Trustee Secretary/D-H CEO | 0 | 777576 | 0 | 0 | 0 | 55475 | 0 | 38368 | 0 | 21314 | 0 | 892733 | 0 | 0 |
| Wiley Souba MD ScD | ||||||||||||||
| Ex-Officio | 0 | 707267 | 0 | 0 | 0 | 121090 | 0 | 22500 | 0 | 22620 | 0 | 873477 | 0 | 0 |
| Marc F Levenson MD | ||||||||||||||
| Trustee End 1/1/13 | 0 | 93761 | 0 | 102170 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 195931 | 0 | 0 |
| Tina E Naimie CPA | ||||||||||||||
| Treasurer/VP Corp Finance D-H | 0 | 213166 | 0 | 0 | 0 | 172 | 0 | 37410 | 0 | 1804 | 0 | 252552 | 0 | 0 |
| Anne Page CPA | ||||||||||||||
| Frmer Treasurer/VP Reg Finance | 0 | 218623 | 0 | 0 | 0 | 22237 | 0 | 46336 | 0 | 7937 | 0 | 295133 | 0 | 0 |
| Carol Folt PhD | ||||||||||||||
| Trustee | 0 | 539641 | 0 | 0 | 0 | 93814 | 0 | 22500 | 0 | 18445 | 0 | 674400 | 0 | 0 |
| Nancy Formella MSN RN | ||||||||||||||
| TTE Advisor End 12/1/12 | 0 | 699182 | 0 | 0 | 0 | 2509878 | 0 | 39000 | 0 | 19814 | 0 | 3267874 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Severance Payments | Form 990, Schedule J, Part I line 4a | 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. Part I Line 4B The following individuals received the following amounts from the Dartmouth-Hitchcock Supplemental Retirement Plan (see below for terms): James Weinstein $53,721 Nancy Formella $223,316 |
| Terms of the Dartmouth-Hitchcock Supplemental | Retirement Plan: | An eligible employee is a participant in the Dartmouth-Hitchcock Retirement Plan and/or any prior pension arrangements sponsored by Dartmouth-Hitchcock (which consists of Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic), including a qualified defined benefit plan, who would be entitled to additional contributions or benefit accruals under the terms of the Plans for the plan year, but are limited by IRC Sections 401(a)(17) and/or IRC Section 415. For eligible employees, the Employer will pay the eligible employee an amount determined by the employer each year to offset the amount of the reduction in the benefit accrual or contribution as a result of limitations imposed by IRC Sections 401(a)(17) and/or IRC Section 415. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990 Part VI Section A Line 6 & 7a | DHMC has four Members, referred to as components: Dartmouth College/Geisel School of Medicine; Dartmouth-Hitchcock Clinic; Mary Hitchcock Memorial Hospital; and the Veterans Affairs Center. The components shall be represented, respectively, by the Dean of Geisel School of Medicine, President of the Clinic, President of the Hospital, and Director of the Veterans Affairs, all of whom shall be Ex-Officio. The College/Medical School, Clinic, and Hospital shall each be represented by two individuals (component trustees), nominated by their respective Boards of Trustees and elected by the DHMC Board. Such individuals should normally be trustees of the component boards, but is not a requirement. All members of the board, both elected and ex-officio, shall have voting rights. In addition, the DHMC board may elect as many as five Non-Component Trustees. Form 990 Part VI Section B Line 11b After preparation and review by internal tax staff and external consultants, the return is reviewed by the Treasurer. The final form 990 is shared electronically with the Trustees prior to filing, and the trustees are provided an opportunity to review, ask questions, and recommend changes before filing of the return. | |
| Form 990 Part VI Section B Line 12C | The Dartmouth-Hitchcock Medical Center Board of Trustees approved a policy concerning a voluntary self-disclosure of any potential conflict of interest. The Dartmouth-Hitchcock Compliance and Audit Services Department conducts an annual survey of all officers and trustees and performs other procedures as considered necessary to report on compliance with the Dartmouth-Hitchcock Medical Center conflict of interest policy. Per the policy, any conflicts or otherwise perceived conflicts are required to be addressed by the Board of Trusteees on an ongoing basis. In the event a conflict arises, the individual shall be removed from participating in any decision making regarding the identified conflict and/or its corresponding transactions. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. Form 990 Part VI Section B Line 15a The organization's treasurer is compensated by Mary Hitchcock Memorial Hospital (MHMH), a related and supported organization of DHMC. As part of their role at MHMH, their compensation is reviewed by external parties and MHMH's compensation committee. | |
| Form 990 Part VI Section C Line 19 | The Organization makes its audited financial statements, governing documents, and conflict of interest policy available upon request in hardcopy form. | |
| Form 990 Part VII Section A, Line 1 | The compensation paid by related organizations was for services provided to those related organizations and not the filing organization. Although the individuals worked the time listed as part of their board of trustee duties, they were not compensated with respect to those hours. The time/hours at the related organization varies by individual and organization, and would be the hours necessary to total to their respective full hours per week. | |
| Form 990 Part IX, Statement of Functional Expenses | The Organization uses the resources of a member organization, The Trustees of Dartmouth College, to provide its Fundraising and Development Function. The amounts reported as Purchased services represent reimbursement for services provided by the College to DHMC. Line 25, Fundraising Expenses The Organization uses the resources of a member organization, The Trustees of Dartmouth College, to provide its Fundraising and Development Function. The amounts reported as fundraising expenses represent costs incurred raising funds for the Organization as well as fundraising on the behalf of its supported members including Dartmouth Hitchcock Clinic, Mary Hitchcock Memorial Hospital, and the Trustees of Dartmouth College. During fiscal year 2013, the total costs paid to Dartmouth College for these services were $3,643,882. Total fundraising revenue recognized by DHMC was $871,037. All additional fundraising revenue generated by DHMC on behalf of its supported organizations was recognized directly by the Supported Organizations in the amount of $26,513,643. | Line 11G, Purchased Services |
| Statement Regarding Form 5471 Filing Requirements | The Organizations's Form 5471 filing requirements have been or will be satisfied by Dartmouth-Hitchcock Clinic, One Medical Center Drive, Lebanon, New Hampshire, 03756, EIN: 22-2519596, the majority shareholder of Hamden Insurance Company Limited. Dartmouth-Hitchcock Clinic has filed the form 5471 and the applicable schedules with the IRS Service Center, Philadelphia, PA. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Dartmouth-Hitchcock Health | |||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 264812335 | Parent Org | NH | 501(C)(3) | 11 Type II | NA | false | |
| Dartmouth-Hitchcock Clinic | |||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 222519596 | Phys Group | NH | 501(C)(3) | 9 | D-H Health | true | |
| Mary Hitchcock Memorial Hospital | |||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020222140 | Hospital | NH | 501(C)(3) | 3 | D-H Health | true | |
| Trustees of Dartmouth College | |||||||||||
| 1 Rope Ferry Road | Hanover | NH | 03755 | 020222111 | Med. School | NH | 501(C)(3) | 2 | NA | false | |
| Veterans Affairs Med & Regnl Office Cntr | |||||||||||
| 215 North Main Street | White River Junction | VT | 05001 | 741612229 | Hospital | VT | false | N/A | |||
| Hamden Risk Retention Group | |||||||||||
| 30 Main Street Suite 330 | Burlington | VT | 05401 | 208530788 | Slf Insurance | VT | 501(C)(3) | 11 Type 1 | DHC | true | |
| The Hitchcock Foundation | |||||||||||
| One Medical Center Dr | Lebanon | NH | 03756 | 020222139 | Research Aid | 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 |
|---|---|---|---|---|---|---|---|
| OBNET Services LLC | |||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 043746287 | Database Serv | NH | NA |
| Keene Hlth Alliance | |||||||
| 580 Crt St | Keene | NH | 03431 | 300179297 | Healthcare | NH | NA |
| DH Master Invst Prg | |||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 020505863 | Investments | NH | NA |
| The Hitchcock Ptshp | |||||||
| 1 Med Ctr Dr | Lebanon | NH | 03756 | 020514823 | Pooled Invst | NH | NA |
| OneCare VT ACOLLC | |||||||
| 111 COLCHESTER AVE | Burlington | VT | 05401 | 455399218 | Shared Saving | VT | NA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pompanoosuc Investment Corp | ||||||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 020352330 | Real Est Hldg | NH | NA | C Corp | false | |||||
| Hamden Assurance Co LTD | ||||||||||||||
| 980121409 | Liab Ins | NA | C Corp | false | 44 Church Street | Hamilton | HM EX | BD | BD | |||||
| Hitchcock Health Connect | ||||||||||||||
| One Medical Center Drive | Lebanon | NH | 03756 | 800908979 | Telehealth | DE | NA | C Corp | ||||||
| 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 | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | 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 | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Mary Hitchcock Memorial Hospital | ||
| M | 347380 | FMV |
| Mary Hitchcock Memorial Hospital | ||
| L | 1538619 | FMV |
| Dartmouth Hitchcock Clinic | ||
| L | 691264 | FMV |
| Dartmouth Hitchcock Clinic | ||
| M | 156069 | FMV |