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SOUTHERN NEW HAMPSHIRE MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SOUTHERN NEW HAMPSHIRE MEDICAL CENTER (EIN 02-0483054)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-05-03
IRS object ID
201301239349300205
Schema version
2011v1.2
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

FieldValueIRS element (for citing)
Timestamp2013-05-03T06:39:24-07:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WILLIAM STEELE & ASSOCIATES PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line140 STARK STREETAddressLine1
CityMANCHESTERCity
StateNHState
ZIP Code03101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN020483054EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN NEW HAMPSHIRE MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSOUTNameControl
Phone6035772000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line18 PROSPECT STREET PO BOX 2014AddressLine1
CityNASHUACity
StateNHState
ZIP Code030612014ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS E WILHELMSEN JRName
TitlePRESIDENT/ CEOTitle
Phone6035772000Phone
Date Signed2013-05-01DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1THOMAS E WILHELMSEN JRBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line18 PROSPECT STREETAddressLine1
CityNASHUACity
StateNHState
ZIP Code030612014ZIPCode
FieldValueIRS element (for citing)
Gross Receipts207159315GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteSNHMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1892YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionSOUTHERN NEW HAMPSHIRE MEDICAL CENTER IS COMMITTED TO IMPROVING, MAINTAINING, AND PRESERVING THE OVERALL HEALTH AND WELL-BEING OF INDIVIDUALS LIVING IN THE GREATER NASHUA AREA BY PROVIDING INFORMATION, EDUCATION, AND ACCESS TO EXCEPTIONAL HEALTH AND MEDICAL CARE SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1799TotalNbrEmployees
Total Nbr Volunteers339TotalNbrVolunteers
Total Gross UBI328629TotalGrossUBI
Contributions Grants Prior Year816723ContributionsGrantsPriorYear
Contributions Grants Current Year130522ContributionsGrantsCurrentYear
Program Service Revenue Prior Year200329966ProgramServiceRevenuePriorYear
Program Service Revenue CY194694882ProgramServiceRevenueCY
Investment Income Prior Year304080InvestmentIncomePriorYear
Investment Income Current Year12276873InvestmentIncomeCurrentYear
Other Revenue Prior Year58885OtherRevenuePriorYear
Other Revenue Current Year57038OtherRevenueCurrentYear
Total Revenue Prior Year201509654TotalRevenuePriorYear
Total Revenue Current Year207159315TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year104377822SalariesEtcPriorYear
Salaries Etc Current Year98610250SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year92728005OtherExpensePriorYear
Other Expenses Current Year73818198OtherExpensesCurrentYear
Total Expenses Prior Year197105827TotalExpensesPriorYear
Total Expenses Current Year172428448TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4403827RevenuesLessExpensesPriorYear
Revenues Less Expenses CY34730867RevenuesLessExpensesCY
Total Assets BOY282484638TotalAssetsBOY
Total Assets EOY313156702TotalAssetsEOY
Total Liabilities BOY145486060TotalLiabilitiesBOY
Total Liabilities EOY159975014TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY136998578NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY153181688NetAssetsOrFundBalancesEOY
Mission DescriptionSOUTHERN NEW HAMPSHIRE MEDICAL CENTER IS COMMITTED TO IMPROVING, MAINTAINING, AND PRESERVING THE OVERALL HEALTHMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense125160750Expense
Revenue194395340Revenue
DescriptionPROVIDES ACUTE HEALTHCARE SERVICES TO A DIVERSE POPULATION BASE INCLUDING INDIGENT WITHIN SOUTHERN AND CENTRAL NEW HAMPSHIRE. SEE ATTACHED 2012 ANNUAL REPORTDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense10515500Expense
DescriptionCHARITY CARE ($5,603,650) AND OTHER UNCOMPENSATED CARE ($4,911,850) AT COSTDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2343189Expense
Revenue27951Revenue
DescriptionCOMMUNITY HEALTH SERVICES AND HEALTH PROFESSIONAL EDUCATIONDescription
FieldValueIRS element (for citing)
Total Program Service Expense138019439TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096142NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1799NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL ROSENamePerson
Telephone Number6035772004TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line18 PROSPECT STREETAddressLine1
CityNASHUACity
StateNHState
ZIP Code030612014ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
PRAVEN K SUCHDEV MD
Board Chair2.00XX000
TIMOTHY C SULLIVAN
Board Vice Chair2.00XX000
THOMAS E WILHELMSEN JR
President/ CEO40.00XX6862450225372
MICHAEL S ROSE
Treasurer40.00X352152052247
J TERRANCE BUCHANNAN MD
Trustee2.00X000
ROBERT B EISENBERG TRUSTEE
Trustee2.00X000
COLLEEN P GUIRY MD
Trustee2.00X000
HOLLY J HARMON-MORSE
Trustee2.00X000
CLIFFORD R KINGHORN JR JUDGE
Trustee2.00X000
LORI A LIBERTY
Trustee2.00X000
JOHN M MERCIER
Trustee2.00X000
MARTHA E O'NEIL
Trustee2.00X000
THOMAS A PURSCH
Trustee2.00X000
JAMES K STEINER
Trustee2.00X000
TIMOTHY J WHITAKER
Trustee2X
DAVID CAWLEY
VP Administration4019664141395X
SUSAN DESOCIO
President FMP4029362645139X
RICHARD DUGUAY
VP Clinical Services4022921122587X
MERRYLL ROSENFELD
VP Human Resources4020351627925X
COLETTE TILTON
VP PT Care Services4023340217341X
STEPHANIE WOLF-ROSENBLUM
VP Med Affairs40308192640006658X
ANDREW WATT
VP Medical Info Systems4032609921959X
JOSEPH M LEAHY
D.O.4035730225981X
COLIN H O'BRIEN
M.D.4029597724952X
DANIEL WEIDNER
M.D.4029394432424X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4354498TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs64000TotalReportableCompFrmRltdOrgs
Total Other Compensation581396TotalOtherCompensation
Number Individuals GT100 K81NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SIEMENS MEDICAL SOLUTIONS
DEPT AT 40065ATLANTAGA31192SYSTEM SUPPORT2825525
QUEST DIAGNOSTICS
5763 COLLECTION CTR DRCHICAGOIL60693LAB1335031
FULCRUM ASSOCIATES
5 TECH CIRCLEAMHERSTNH03031CONSTRUCTION1088810
JIM ALLARD CONTRACTING
26 CHEROKEE AVENASHUANH03062CONSTRUCTION791303
SODEXO INC
9801 WASHINGTON BLVDGAITHERSBURGMD20878FOOD SERVICES767040
FieldValueIRS element (for citing)
Number Of Contractors GT100 K30NumberOfContractorsGT100K
All Other Contributions130522AllOtherContributions
Total Contributions130522TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenue
HOSPITAL SERVICES621110194366253
ANCILLARY SERVICES (NE REHAB FOO722210256307256307
ANCILLARY SERVICES (NE REHAB ENV8110006760567605
ANCILLARY SERVICES (ANSWERING SE90009947174717
FieldValueIRS element (for citing)
Total Program Service Revenue194694882TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column12191946TotalRevenueColumn
Exclusion$12,191,946ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other84927Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other84927Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column84927TotalRevenueColumn
Exclusion$84,927ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column57038TotalRevenueColumn
Related Or Exempt Function Income57038RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue57038TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column207159315TotalRevenueColumn
Related Or Exempt Function Income194423291RelatedOrExemptFunctionIncome
Unrelated Business Revenue328629UnrelatedBusinessRevenue
Exclusion$12,276,873ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3289707Total
Program Services0ProgramServices
Management And General3289707ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total77077154Total
Program Services61661723ProgramServices
Management And General15415431ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1226614Total
Program Services981291ProgramServices
Management And General245323ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11692809Total
Program Services9722746ProgramServices
Management And General1970063ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5323966Total
Program Services4259173ProgramServices
Management And General1064793ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total287601Total
Program Services0ProgramServices
Management And General287601ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total136125Total
Program Services0ProgramServices
Management And General136125ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1958623Total
Program Services0ProgramServices
Management And General1958623ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total773364Total
Program Services0ProgramServices
Management And General773364ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1526987Total
Program Services1221590ProgramServices
Management And General305397ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4153906Total
Program Services3323125ProgramServices
Management And General830781ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total36578Total
Program Services29262ProgramServices
Management And General7316ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total257486Total
Program Services205989ProgramServices
Management And General51497ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total4520083Total
Program Services3616066ProgramServices
Management And General904017ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11257307Total
Program Services9005846ProgramServices
Management And General2251461ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1471735Total
Program Services1177388ProgramServices
Management And General294347ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
NH MEDICAID ENHANCEMENT TAX101158571011585700
SERVICE CONTRACTS321600325728026432010
PURCHASED SERVICES535317748170945360830
SUPPLIES232366862064586825908180

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5516680Total
Program Services4663619ProgramServices
Management And General853061ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total172428448Total
Program Services138019439ProgramServices
Management And General34409009ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY51519812BOY
EOY52106037EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY17878976BOY
EOY21136572EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2801125BOY
EOY2614903EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2865323BOY
EOY2765253EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis225857693LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec111717298LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY109783380BOY
EOY114140395EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY86479257BOY
EOY106523261EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY730357BOY
EOY679454EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10426408BOY
EOY13190827EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY282484638BOY
EOY313156702EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY27817116BOY
EOY37291296EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY94560036BOY
EOY93490966EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1082219BOY
EOY750094EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY22026689BOY
EOY28442658EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY145486060BOY
EOY159975014EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY134626503BOY
EOY150775973EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY16562BOY
EOY50202EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2355513BOY
EOY2355513EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY136998578BOY
EOY153181688EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY282484638BOY
EOY313156702EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses34730867ReconcilationRevenueExpenses
Reconcilation Other Changes-18547757ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Total1700PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Pertcentage1700PublicSupportPertcentage170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$28,129GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB28129TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierExplanationExplanation
Pt II-B Line 1iNone
Pt II-B Line 1f22.96% OF DUES TO AMERICAN HOSPITAL ASSOCIATION, 23.76% OF DUES TO NEW HAMPSHIRE HOSPITAL ASSOCIATION, ALONG WITH DIRECT PAYMENTS THROUGH NEW HAMPSHIRE HOSPITAL ASSOCIATION WERE USED FOR LOBBYING ACTVITES.

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance51079549BeginningOfYearBalance
Investment Earnings Or Losses9503822InvestmentEarningsOrLosses
End Of Year Balance60583371EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance50596135BeginningOfYearBalance
Investment Earnings Or Losses483414InvestmentEarningsOrLosses
End Of Year Balance51079549EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance46166746BeginningOfYearBalance
Investment Earnings Or Losses4429389InvestmentEarningsOrLosses
End Of Year Balance50596135EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.96110BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.03890PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis8239003OtherCostOrOtherBasis
Book Value8239003BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis129532687OtherCostOrOtherBasis
Depreciation58738633Depreciation
Book Value70794054BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1916274OtherCostOrOtherBasis
Depreciation1385278Depreciation
Book Value530996BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis71786170OtherCostOrOtherBasis
Depreciation51593387Depreciation
Book Value20192783BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis14383559OtherCostOrOtherBasis
Book Value14383559BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings114140395TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
M.O.B. RECVB. L.T.5897903
INVESTMENT IN NASHUA REGIONAL CANCER CENTER2295025
INVESTMENT IN PHO72646
SECURITY / WORKING FUND DEPOSITS354269
RECRUITMENT232619
SENTRY INSURANCE / DENTAL INSURANCE966400
MALPRACTICE INSURANCE RECEIVABLE LT3186639
OTHER185326
FieldValueIRS element (for citing)
Total Book Value Other Assets13190827TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
UNEARNED INCOME - MOB$159,567
INSURANCE RESERVES$1,076,813
OTHER LIABILITIES SERP$1,631,374
ACCRUED PENSION EXPENSE-LT$20,950,493
457 (B) DEFERRED COMP PLAN$1,437,772
MALPRACTICE INSURANCE RECEIVABLE LT$3,186,639
FieldValueIRS element (for citing)
Total Of Amounts28442658TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierExplanationExplanation
Pt V Line 4Prior to 2011 certain funds were moved from operating cash to investments as Board Designated. These funds were reclassified as unrestricted investments as of 9/30/2011. Adjustments have been made to prior year balances to remain consistent with the current year.
Pt V Line 4The intended uses of the organization's endowment funds are to fulfill donor's intentions on the Permanently Restricted Funds and for future plant replacement and technology investments from Board Designated Funds.
990 Part IV Line 11FTHE SYSTEM, MEDICAL CENTER AND FOUNDATION ARE NOT-FOR -PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. MANAGEMENT EVALUATED THE SYSTEM'S TAX POSITIONS AND CONCLUDED THE SYSTEM HAS MAINTAINED ITS TAX-EXEMPT STATUS, DOES NOT HAVE ANY SIGNIFICANT UNRELATED BUSINESS INCOME AND HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage225.00000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5603650TotalCommunityBenefitExpense
Net Community Benefit Expense5603650NetCommunityBenefitExpense
Percent Of Total Expense0.03250PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense24896471TotalCommunityBenefitExpense
Direct Offsetting Revenue7527457DirectOffsettingRevenue
Net Community Benefit Expense17369014NetCommunityBenefitExpense
Percent Of Total Expense0.10070PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense30500121TotalCommunityBenefitExpense
Direct Offsetting Revenue7527457DirectOffsettingRevenue
Net Community Benefit Expense22972664NetCommunityBenefitExpense
Percent Of Total Expense0.13320PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense404852TotalCommunityBenefitExpense
Direct Offsetting Revenue27951DirectOffsettingRevenue
Net Community Benefit Expense376901NetCommunityBenefitExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1436666TotalCommunityBenefitExpense
Net Community Benefit Expense1436666NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1664462TotalCommunityBenefitExpense
Direct Offsetting Revenue1137627DirectOffsettingRevenue
Net Community Benefit Expense526835NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense33825TotalCommunityBenefitExpense
Net Community Benefit Expense33825NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense414340TotalCommunityBenefitExpense
Net Community Benefit Expense414340NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3954145TotalCommunityBenefitExpense
Direct Offsetting Revenue1165578DirectOffsettingRevenue
Net Community Benefit Expense2788567NetCommunityBenefitExpense
Percent Of Total Expense0.01620PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense34454266TotalCommunityBenefitExpense
Direct Offsetting Revenue8693035DirectOffsettingRevenue
Net Community Benefit Expense25761231NetCommunityBenefitExpense
Percent Of Total Expense0.14940PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense26964TotalCommunityBuildingExpense
Net Community Building Expense26964NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense44346TotalCommunityBuildingExpense
Net Community Building Expense44346NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense710TotalCommunityBuildingExpense
Net Community Building Expense710NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense3966TotalCommunityBuildingExpense
Net Community Building Expense3966NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense5471TotalCommunityBuildingExpense
Net Community Building Expense5471NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense81457TotalCommunityBuildingExpense
Net Community Building Expense81457NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$6,643,148BadDebtExpenseAmount
Amount Attributable To4911850AmountAttributableTo
Amount Reimbursed By Medicare41498466AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare47589604CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-6091138MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN NEW HAMPSHIRE MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line18 PROSPECT STREET PO BOX 2014AddressLine1
CityNASHUACity
StateNHState
ZIP Code030612014ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN NEW HAMPSHIRE MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedtrueAllNeedsAddressed
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent225FPGFreePercent
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasisfalseExplainsBasis
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (65 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 3cThe Medical Center offers a discount equal to the average of their three largest payors to all self pay patients.
Pt I Line 7The costing methodology used was the ratio of cost to charge as outlined in Worksheet 2 of the instructions. The only
Pt I Line 7exception to this was for subsidized service areas where the cost structure was specific to that service area. For those areas, our Cost
Pt I Line 7Accounting system was used.
Pt IISouthern New Hampshire Medical Center is committed to improving the health and well-being of the Greater Nashua area and our
Pt IIcommunity building activities help us achieve this goal. Through our involvement in the Rotary Club and Nashua Chamber of Commerce,
Pt IIalong with other community organizations, we are able to exchange ideas with areas leaders concerning health care issues and make
Pt IIinformative decisions that best address the health needs of our community. We provide Medicare Counseling to area senior citizens giving
Pt IIthem the guidance they need to make informed decisions about their healthcare coverage. Our support of the United Ways Day of Caring
Pt IIhas resulted in a growing number of our employees going out into the area and helping members of the community with healthcare and
Pt IIother needs. We are strong in our commitment to the Greater Nashua area and plan to continue to support and grow community building
Pt IIactivities that improve the overall health of the area.
Pt III Line 4On the basis of historical experience, a significant portion of the System's uninsured patients will be unable or unwilling to
Pt III Line 4pay for the services provided. Thus, the System records a significant provision for bad debts related to uninsured patients in the period the
Pt III Line 4services are provided. The FASB issued an Accounting Standards Update that states that a health care entity that recognizes significant
Pt III Line 4amounts of patient service revenue at the time services are rendered, even though it does not assess the patient's ability to pay, must
Pt III Line 4present bad debts as a reduction of net patient revenue and not as a separate item in operating expenses. The ratio of cost to charge
Pt III Line 4methodology was used to determine cost as outlined in worksheet 2 of the instructions. Consistent with the accounting treatment
Pt III Line 4mentioned above, since the System does not assess the patient's ability to pay, the costs of bad debt for those patients without any form of
Pt III Line 4insurance should be classified as community benefit.
Pt III Line 8The ratio of cost to charge methodology was used to determine cost as outlined in Worksheet 2 of the instructions. There
Pt III Line 8are service areas where government programs such as Medicare and Medicaid do not reimburse the organization adequate amounts to
Pt III Line 8cover the costs to provide those services. The hospital must provide those services regardless of the financial shortfall.
Pt III Line 9bSNHMC recognizes that not all patients who qualify for financial assistance will follow through with an application for
Pt III Line 9bfinancial assistance. Prior to placing any account with a collection agency, the Medical Center uses a financial assistance qualification
Pt III Line 9bservice to categorize patients based primarily on income and assets estimated from census tract data. Those patients whose estimated
Pt III Line 9bincome/assets fall within the Medical Centers financial assistance guidelines are awarded charity or free care assistance for their encounter.
Pt V Sec B 3The Southern New Hampshire Health System 2012 Community Health Needs Assessment and Implementation Strategy was
Pt V Sec B 3collaboration with the City of Nashua and other area health partners. The 2011 Creating a Healthier Community: City of Nashua Health
Pt V Sec B 3Assessment (the Assessment) was published by the City of Nashua Division of Public Health and Community Services on September 9,
Pt V Sec B 32011. The program coordinators of the Assessment were Ashley Conley, epidemiologist, and Debbie Daniels, medical director from the
Pt V Sec B 3Nashua Department of Public Health. The assessment results include information gathered from a door-to-door survey of 833 households in
Pt V Sec B 3Nashua conducted in October and November of 2010. In conjunction with this, in March 2011, data were gathered from two focus groups,
Pt V Sec B 3one with area key leaders, the other consisting of medical partners from the greater Nashua area.
Pt V Sec B 4The hospital's Community Health Needs Assessment was a collaboration of City of Nashua Health Department and other
Pt V Sec B 4stakeholders, including St. Joseph Hospital. The Medical Center prepared its own separate assessment, based on that information.
Pt V Sec B 10The State of New Hampshire mandates a discount for all uninsured patients. This discount is equal to the average discount
Pt V Sec B 10negotiated by the top (by volume) three commercial insurers. This discount for the uninsured is automatic and applied to all balances prior
Pt V Sec B 10to sending the first billing statement to the patient.
Pt V Sec B 17eSee response for III.C.9b above. Prior to placing accounts with collection agencies, SNHMC culls out patients who qualify
Pt V Sec B 17efor charity based on census tract data and does not place those accounts with an agency but rather, awards charity or free care assistance
Pt V Sec B 17efor their encounter.
Pt V Sec B 19dThe State of New Hampshire mandates a discount for all uninsured patients. This discount is equal to the average discount
Pt V Sec B 19dnegotiated by the top (by volume) three commercial insurers. This discount for the uninsured is automatic and applied to all balances prior
Pt V Sec B 19dto sending the first billing statement to the patient.
Pt V Sec B 21SNHMC may charge patients who are having cosmetic or experimental, non-covered services gross charges for that
Pt V Sec B 21encounter.
Pt VI Line 2The 2011 Creating a Healthier Community: City of Nashua Community Health Assessment was performed as a collaborative
Pt VI Line 2effort by the City of Nashua Public Health Department and community residents, medical providers, and key leaders.
Pt VI Line 3At each registration point, SNHMC has signage and brochures explaining our various forms of financial assistance, including
Pt VI Line 3charity care. Additionally, patient registrars offer the charity brochures to self pay patients. Patients who call regarding billing
Pt VI Line 3concerns are offered charity assistance. Additionally, verbiage regarding charity care is printed on each billing statement the patient
Pt VI Line 3receives. Also, charity care information is available on our hospital website.
Pt VI Line 4SNHHS's service area consists of nineteen New Hampshire and four Massachusetts towns. The service area is divided into a
Pt VI Line 4Primary Service Area (PSA) of twelve New Hampshire towns (Amherst, Brookline, Hollis, Hudson, Litchfield, Lyndeborough,
Pt VI Line 4Merrimack, Milford, Mont Vernon, Nashua, Pelham and Wilton), a Secondary Service Area (SSA) of seven New Hampshire towns (Derry,
Pt VI Line 4Greenville, Londonderry, New Boston, New Ipswich, Salem and Windham) and a Massachusetts Service Area (MSA) of four neighboring
Pt VI Line 4Massachusetts towns (Dunstable, Pepperell, Townsend and Tyngsboro). According to the 2009 needs assessment, the population of greater
Pt VI Line 4Nashua is aging, is growing, and is becoming more diverse.
Pt VI Line 5A majority of the organization's Board of Trustees is comprised of persons who reside in the PSA who otherwise have no
Pt VI Line 5relationship with the organization. Many members of the organization volunteer their time to other community agencies in the PSA.
Pt VI Line 6Southern NH Health System, Inc. is a not-for-profit entity organized to support Southern NH Medical Center and Foundation
Pt VI Line 6Medical Partners, inc. Both the Medical Center and Foundation are not-for-profit entities, established to provide medical services to the
Pt VI Line 6people of the greater Nashua area.
Pt VI Line 7NH

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
THOMAS E WILHELMSEN JR
4784301529275488819380231570911617
MICHAEL S ROSE
24723765000399152279229455404399
DAVID CAWLEY
15171915000299221772423671238036
SUSAN DESOCIO
23604840100174781176833371338765
RICHARD DUGUAY
165511390002470022587251798
MERRYLL ROSENFELD
158282244002083427925231441
COLETTE TILTON
165559190004884317341250743
STEPHANIE WOLF-ROSENBLUM
236956300004123666583148506400064000
ANDREW WATT
29631820000978121959348058
JOSEPH M LEAHY
319992200001731025981383283
COLIN H O'BRIEN
2727352324224952320929
DANIEL WEIDNER
2661342781032424326368
MARC DEBELL
2819201046613737306123
PETER ROW
2690651674023679309484

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 1aSouthern New Hampshire Medical Center uses the facilities at the Nashua Country Club for meetings and other business related purposes. The Club does not have corporate memberships, therefore, an individual associated with the Medical Center must be a member of the Club. The membership is titled in the CEOs name and invoices are addressed to the CEO, not SNHMC. SNHMC pays the annual dues and all related expenses incurred by the organization. The facilities are only available to Club members.
Pt I Line 4bFunding for Supplemental Employee Retirement Plan - David Cawley - $17,724.00, Susan DeSocio - $11,768.00, Michael S. Rose - $ 22,792.00, and Thomas E. Wilhelmsen - $193,802.00
Pt I Line 7There is an additional compensation plan available to managers, directors and senior management that is part of their annual performance plan. The plan takes into consideration quality measures, patient satisfaction, individual goals, budget adherence and overall organizational performance. The range and overall pool is reviewed and approved by the Board of Trustees' Executive Compensation Committee. The amounts designated for the CEO and CFO are considered in the compensation consultant's analysis of executive compensation reported on the 990 Part VI section B Line 15b.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
NHHEF AUTHORITY
020279866644614SWO2007-08-3089836797REFUNDING AND NEW CONSTRUCTIONtruefalsefalse
NHHEF AUTHORITY
0202798660000000002010-12-155500000EQUIPMENT PURCHASEfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
898367974973143894952539155834truetruetruetrue
5500000256725474328falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalse0.000000.000000.00000true
falsefalsefalsefalse0.000000.000000.00000true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
truefalsefalsefalsefalsefalse
truefalsefalsefalsefalsefalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (25 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 6Southern New Hampshire Health System, Inc., is the sole corporate member of Southern New Hampshire Medical Center
Pt VI, Line 6(SNHMC) and the two (2) organizations have identical boards with the exception of two (2) additional members serving
Pt VI, Line 6solely on the SNHMC board. These include a physician member and the current SNHMC chief of staff who is an ex-officio member.
Pt VI, Line 7aThe Medical Center is governed by the Board of Trustees, who are elected by the Trustees of it sole member Southern New Hampshire
Pt VI, Line 7aHealth System, Inc.
Pt VI, Line 11aA copy of the 990 was presented to the Full Board and approved by the Finance committee of the Board of Trustee prior to submission.
Pt VI, Line 12cThe organization requires all its personnel, including Leaders, to formally acknowledge that they have read & will abide by
Pt VI, Line 12cour Code of Conduct, which includes our conflict of interest policy. SNHHS/SNHMC monitors compliance of its conflict of
Pt VI, Line 12cinterest process, which requires completion of disclosure forms by all Leaders on an annual basis or on a reappointment
Pt VI, Line 12cbasis (every two years) for medical/allied staff, to ensure full compliance. Interim disclosures are also required and
Pt VI, Line 12creviewed should a subsequent conflict arise. Any Related Party disclosures require review and approval by a designated
Pt VI, Line 12ccommittee. An annual compliance report is provided to SNHHS/SNHMCs compliance committee and Board of Trustees.
Pt VI, Line 15The compensation of the CEO and CFO is evaluated by an outside consultant. The compensation of the CEO is approved by the Executive
Pt VI, Line 15Compensation Committee of the Board and the Board of Trustees. A market analysis is performed for all key employees
Pt VI, Line 15on an annual basis. Once the CEO and CFO approved the final compensation figures for key employees, the CEO reports
Pt VI, Line 15these figures to the chairperson and vice chairperson of the Board.
Pt VI, Line 19The organization makes its 990 and 990T available for inspection and provides an Annual Report that is available on its
Pt VI, Line 19website. The Code of Conduct is also available on the organization's website. The Code of Conduct addresses certain
Pt VI, Line 19corporate policies including confidentiality, conflicts of interest, patient rights and other governing documents. The organization also
Pt VI, Line 19makes all relevant documents available to the public upon request.
990 Part I Line 9 & 17Per FASB ASU No 2011-07, bad debt is recognized as a reduction in revenue
990 Part I Line 9 & 17and not as operating expenses in fiscal year 2012.
990 Part VII Section A Column BThe average hours per week devoted to the Foundation Medical Partners, a related organization by Key employee Stephanie
990 Part VII Section A Column BWolf- Rosenblum, VP of Medical Affairs, is 8 hours.
900 Part XI Line 5FAS157 and FAS159 Pension Adjustment - (10,553,801), Transfer to Affiliates - (12,838,344) and Pension Curtailment 4,844,388.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
FOUNDATION MEDICAL PARTNERS INC
8 PROSPECT STREETNASHUANH03060020456218PHYSICIAN SERVICESNH501(c)(3)9SNHHSfalse
SOUTHERN NEW HAMPSHIRE HEALTH SYSTEM
8 PROSPECT STREETNASHUANH03060020509221MEDICAL SERVICESNH501(c)(3)11NAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
ADVANTAGE NETWORK PHO
10 PROSPECT STREETNASHUANH03060020482950MEDICAL SERVICENHSNHMCC36831828310.50000
SOUTHERN NH HEALTH VENTURES INC
8 PROSPECT STREETNASHUANH03060020499623MEDICAL SERVICENHSNHMCC1.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
FOUNDATION MEDICAL PARTNERS INC
d600074FM Value
FOUNDATION MEDICAL PARTNERS INC
f132235Cost
FOUNDATION MEDICAL PARTNERS INC
i1609144FM Value
FOUNDATION MEDICAL PARTNERS INC
j171105FM Value
FOUNDATION MEDICAL PARTNERS INC
k2843156Cost
FOUNDATION MEDICAL PARTNERS INC
l1079222
FOUNDATION MEDICAL PARTNERS INC
n124449
FOUNDATION MEDICAL PARTNERS INC
o64349919
FOUNDATION MEDICAL PARTNERS INC
p51611516
FOUNDATION MEDICAL PARTNERS INC
q12838343