MASS GENERAL BRIGHAM INCORPORATED: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MASS GENERAL BRIGHAM INCORPORATED (EIN 02-0260334)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-10-03
- IRS object ID
- 201102769349300300
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-10-03T06:45:36-05:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER NEWMAN & NOYES | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 507 | AddressLine1 |
| City | PORTLAND | City |
| State | ME | State |
| ZIP Code | 04112 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020260334 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WENTWORTH-DOUGLASS HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WENT | NameControl |
| Phone | 6037425252 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 CENTRAL AVENUE | AddressLine1 |
| City | DOVER | City |
| State | NH | State |
| ZIP Code | 038202526 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PETER E WALCEK | Name |
| Title | CFO/VP OF FINANCE | Title |
| Phone | 6037422804 | Phone |
| Date Signed | 2011-09-27 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIMOTHY R HEPBURN | Name |
| Phone | 2078792100 | Phone |
| Date Prepared | 2011-09-26 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GREGORY J WALKER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 CENTRAL AVENUE | AddressLine1 |
| City | DOVER | City |
| State | NH | State |
| ZIP Code | 038202526 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 267963444 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WDHOSPITAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1905 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | HELP INDIVIDUALS AND THEIR FAMILIES ATTAIN THEIR HIGHEST LEVEL OF HEALTH | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1938 | TotalNbrEmployees |
| Total Nbr Volunteers | 146 | TotalNbrVolunteers |
| Total Gross UBI | 49754 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -74329 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 339037 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 457903 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 217797771 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 231897057 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1405612 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4296908 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -11189015 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3127926 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 208353405 | TotalRevenuePriorYear |
| Total Revenue Current Year | 239779794 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 255980 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 102177523 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 109299227 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 94403496 | OtherExpensePriorYear |
| Other Expenses Current Year | 99588377 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 196836999 | TotalExpensesPriorYear |
| Total Expenses Current Year | 208887604 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 11516406 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 30892190 | RevenuesLessExpensesCY |
| Total Assets BOY | 297036119 | TotalAssetsBOY |
| Total Assets EOY | 311808165 | TotalAssetsEOY |
| Total Liabilities BOY | 125866477 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 122256744 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 171169642 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 189551421 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | WENTWORTH-DOUGLASS IS THE LARGEST ACUTE CARE HOSPITAL IN THE SEACOAST REGION OF NEW HAMPSHIRE AND SOUTHERN MAINE, SPECIALIZING IN TRAUMA AND EMERGENCY SERVICES, SURGERY, CANCER CARE, BIRTHING, ORTHOPEDIC SERVICES, CARDIOVASCULAR SERVICES, SLEEP DISORDERS, REHABILITATION, PAIN MANAGEMENT, WOUND HEALING, WELLNESS AND PREVENTION PROGRAMS, PLUS EXTENSIVE DIAGNOSTIC SERVICES.A HEALTHCARE LEADER IN THE SEACOAST REGION SINCE 1906, WENTWORTH-DOUGLASS HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 181806388 | Expense |
| Revenue | 235268931 | Revenue |
| Description | WENTWORTH-DOUGLASS HOSPITAL (WDH OR THE HOSPITAL) IS AN ACUTE CARE HOSPITAL LOCATED IN DOVER, NEW HAMPSHIRE. WDH IS A NOT-FOR-PROFIT ORGANIZATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. WENTWORTH-DOUGLASS HOSPITAL IS THE LARGEST ACUTE CARE HOSPITAL IN THE SEACOAST REGION OF NEW HAMPSHIRE AND SOUTHERN MAINE, SPECIALIZING IN TRAUMA AND EMERGENCY SERVICES, SURGERY, CANCER CARE, BIRTHING, ORTHOPEDIC SERVICES, CARDIOVASCULAR SERVICES, SLEEP DISORDERS, REHABILITATION, PAIN MANAGEMENT, WOUND HEALING, WELLNESS, AND PREVENTION PROGRAMS PLUS EXTENSIVE DIAGNOSTIC SERVICES. A HEALTHCARE LEADER IN THE SEACOAST SINCE 1906, WENTWORTH-DOUGLASS HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. AT WENTWORTH-DOUGLASS HOSPITAL, WE ARE COMMITTED TO SERVING OUR COMMUNITY AND ADDRESSING THE NEEDS OF ALL OUR PATIENTS. OUR COMMUNITY BENEFITS PROGRAMS ARE AVAILABLE TO LOCAL RESIDENTS WITH INCOME AT OR BELOW 300% OF FEDERAL POVERTY LEVEL GUIDELINES, ONE OF THE MOST GENEROUS PROGRAMS IN THE STATE OF NH. WDH FILES AN ANNUAL COMMUNITY BENEFITS REPORT WITH THE STATE OF NH WHICH OUTLINES THE COMMUNITY AND CHARITABLE BENEFITS PROVIDED. NUMEROUS PROGRAMS WERE DEVELOPED TO ASSIST PEOPLE IN THE AREA WE SERVE, INCLUDING FINANCIAL AID, FAMILY RESOURCE COUNSELOR PROGRAM, MEDICATION ASSISTANCE PROGRAM, PHYSICIAN REFERRAL SERVICES, CARE-VAN TRANSPORTATION SERVICES, AND WENTWORTH-DOUGLASS COMMUNITY DENTAL CENTER. THE HOSPITAL PROVIDED $16,915,000 OF COMMUNITY ASSISTANCE PROGRAMS IN 2010 (AS MEASURED BY GROSS CHARGES) IMPACTING 23,831 PATIENTS. IN TOTAL, THE HOSPITAL AND WDPC TOGETHER PROVIDED $17,754,966 OF COMMUNITY ASSISTANCE PROGRAMS IN 2010 (AS MEASURED BY GROSS CHARGES) IMPACTING 35,635 PATIENTS.THE HOSPITAL'S CORE PROGRAMS INCLUDE OUR CANCER CENTER, EMERGENCY DEPARTMENT, AND SURGICAL SERVICES. IN ADDITION, WDH OFFERS OTHER KEY SERVICES IN THE AREAS OF WOMEN'S AND CHILDREN'S SERVICES AND CARDIOLOGY SERVICES.1. THE SEACOAST CANCER CENTER AT WENTWORTH-DOUGLASS HOSPITAL OFFERS THE MOST COMPREHENSIVE CANCER TREATMENT SERVICES COVERING THE SEACOAST REGION OF NEW HAMPSHIRE AND SOUTHERN MAINE. FOUNDED 30 YEARS AGO AS A SINGLE ROOM ADJACENT TO THE EMERGENCY DEPARTMENT, THE CANCER CENTER'S SERVICES NOW INCLUDE EXTENSIVE, STATE OF THE ART MEDICAL AND RADIATION ONCOLOGY DIAGNOSTIC SERVICES WITH MULTIPLE TREATMENT OPTIONS. IN 2008, A $9.3 MILLION EXPANSION PROJECT BROUGHT THE NOVALIS TX STEREOTACTIC RADIOSURGERY TO THE SEACOAST, SAVING PATIENTS TRAVEL TIME TO DISTANT TREATMENT CENTERS. THE NEW SERVICE GIVES HOPE TO PATIENTS WITH COMPLEX TUMORS OF THE BRAIN, LIVER AND OTHER VITAL ORGANS. WENTWORTH-DOUGLASS HOSPITAL WAS THE FIRST HOSPITAL, NATIONWIDE, TO INSTALL THE NOVALIS TX SYSTEM CREATED BY BRAINLAB AND VARIAN MEDICAL.A MULTIDISCIPLINARY CHEST CLINIC, LOCATED IN THE SEACOAST CANCER CENTER, SAW ITS FIRST PATIENTS IN OCTOBER 2008. THE MEDICAL TEAM FOCUSES ON TIMELY ACCESS TO SERVICES FOR PATIENTS WITH LUNG NODULES AND LUNG CANCER. 2. THE EMERGENCY DEPARTMENT AT WENTWORTH-DOUGLASS HOSPITAL IS THE BUSIEST IN THE SEACOAST AND FOURTH BUSIEST IN THE STATE OF NEW HAMPSHIRE. CLOSE LINKAGES TO LOCAL EMERGENCY SERVICES PERSONNEL AND FIRE & RESCUE DEPARTMENTS CONTINUE TO EXTEND THE SKILL AND CAPABILITIES OF THE DEPARTMENT. THROUGH INTERNAL AND EXTERNAL EDUCATION EFFORTS, THE EMERGENCY DEPARTMENT FOCUSED ON IMPROVING PATIENT CARE FOR SPECIFIC TYPES OF HEART ATTACK (STEMI) AND STROKE. THE DEPARTMENT'S EFFORTS IN THE FALL OF 2008, THROUGH A CLINICAL COLLABORATION WITH MASSACHUSETTS GENERAL HOSPITAL, CREATED THE STROKE INITIATIVE TO FORM A CENTER OF EXCELLENCE FOR STROKE CARE. IN OCTOBER 2009 THE AMERICAN HEART/STROKE ASSOCIATION AWARDED WDH THE BRONZE AWARD FOR ACHIEVING THEIR HIGH STANDARD, QUALITY GUIDELINES FOR SIX CONSECUTIVE MONTHS. IN JUNE 2010 THE HOSPITAL RECEIVED NOTICE OF THEIR SILVER PLUS AWARD FOR 12 CONSECUTIVE MONTHS OF ACHIEVEMENT.TO ACCOMMODATE INCREASING PATIENTS THE DEPARTMENT ALSO ADDED ADDITIONAL SPACE FOR SIX TREATMENT ROOMS AND OPENED A WALK-IN URGENT CARE CENTER IN LEE, NH TO SUPPORT THE GROWING POPULATION AREAS IN THE TOWNS SURROUNDING LEE.THE HOSPITAL'S GENEROUS CHARITY CARE PROGRAM OFFERS EMERGENCY, WALK-IN AND OTHER HOSPITAL SERVICES AT NO CHARGE FOR QUALIFYING PATIENTS AT 300% OF THE FEDERAL POVERTY LEVEL. 3. SURGICAL SERVICES AT WENTWORTH-DOUGLASS HOSPITAL INCLUDE A WIDE ARRAY OF SERVICES AND TECHNOLOGICAL ADVANCES FREQUENTLY ASSOCIATED WITH LARGER MEDICAL CENTERS. A RECENT RENOVATION TO ENLARGE OPERATING ROOMS CREATED DIGITAL ORS AND SPACE FOR NEW EQUIPMENT SUCH AS THE DAVINCI ROBOTIC SURGICAL SYSTEM. NOW IN ITS FOURTH YEAR, THE ROBOTIC PROGRAM BEGAN WITH OB/GYN SURGEONS, AND NOW INCLUDES THORACIC, GENERAL SURGERY AND UROLOGY. ANOTHER CLINICAL COLLABORATION WITH MGH AT WDH BRINGS A GYN/ONCOLOGY SURGEON TO WDH TO PERFORM "MEDICAL CENTER" SURGERY IN THE COMMUNITY SETTING, ELIMINATING THE TIME AND THE FRUSTRATION OF TRAVEL TO AND PARKING AT METROPOLITAN CITIES.A RANGE OF MINIMALLY INVASIVE PROCEDURES INCLUDING ROBOTIC SURGERY, SINGLE INCISION LAPAROSCOPIC SURGERY (SILS) USED BY GENERAL SURGEONS AND VIDEO ASSISTED THORACIC SURGERY (VATS) PROCEDURES USED BY THE THORACIC SURGEON OFFER PATIENTS THE BENEFITS OF COMPLEX SURGERY WITH LESS BLOOD LOSS, LESS INFECTION AND FASTER RECOVERY.THE JOINT REPLACEMENT PROGRAM INTRODUCED IN 2006 OFFERS A UNIQUE APPROACH TO JOINT REPLACEMENT SURGERY WITH PRE-OP GROUP EDUCATION AND POST-OP GROUP REHAB. SURGEONS, ANESTHESIOLOGISTS, NURSING, REHAB AND NUTRITION STAFF WORKED COLLABORATIVELY TO CREATE THIS NEW APPROACH TO JOINT REPLACEMENT CARE. IN 2009 THE HOSPITAL CREATED THE NORTHERN NEW ENGLAND SPINE CENTER, A PARTNERSHIP OF SPECIALISTS TO COORDINATE AND EXPEDITE THE CARE OF PATIENTS WITH NECK AND BACK PAIN. THE SPINE CENTER MEMBERS INCLUDE A SPINE SURGEON, PHYSIATRY SPECIALISTS, PAIN SPECIALISTS, WDH REHAB, BEHAVIORAL HEALTH SPECIALISTS AND A WDH SPINE COORDINATOR. THE VIRTUAL CENTER HOLDS BIMONTHLY MULTIDISCIPLINARY CONFERENCES TO COORDINATE THE CARE AND TREATMENT OF SPINE CENTER PATIENTS.OTHER SERVICES:IN ADDITION TO THE SERVICES LISTED ABOVE, WENTWORTH-DOUGLASS HOSPITAL OFFERS TRADITIONAL SERVICES WITH NON-TRADITIONAL COMPONENTS. ONE EXAMPLE IS THE BIRTH CENTER. CURRENTLY THE BIRTH CENTER IS THE FASTEST GROWING BIRTHING SERVICE IN THE SEACOAST AREA WITH NEARLY 1,000 BIRTHS PER YEAR. IN AN EFFORT TO SUPPORT A SMALL BUT GROWING AND YOUNG INDONESIAN POPULATION, THE BIRTH CENTER TRANSLATED ALL FORMS AND INFORMATION FOR NEW MOMS INTO INDONESIAN. LOCAL CHURCH GROUPS WELCOMED INDONESIAN FAMILIES INTO THEIR COMMUNITIES.CARDIOLOGY SERVICES RECENTLY REPLACED THE CATH LAB WITH NEW EQUIPMENT AND THE DEPARTMENT ADDED NON-INVASIVE CARDIOVASCULAR SERVICES AT A NEW, OFFSITE MEDICAL OFFICE BUILDING IN DOVER, EXTENDING THE OPTIONS NOW AVAILABLE FOR PATIENTS. A SECOND CARDIOVASCULAR INTERVENTIONAL LAB WILL BE OPEN LATE IN 2010 TO ACCOMMODATE GROWING PATIENT VOLUME AND URGENT CASES.ALL THE COMMUNITY ASSISTANCE (BENEFIT) SERVICES SUPPORT LOW INCOME, UNINSURED INDIVIDUALS AND FAMILIES IN THE HOSPITAL'S SERVICE AREA WITH CHARITY CARE (FINANCIAL ASSISTANCE), MEDICATION ASSISTANCE, THE WENTWORTH-DOUGLASS COMMUNITY DENTAL CENTER AND THE CARE-VAN FREE PATIENT TRANSPORT SERVICE. | Description |
| Total Program Service Expense | 181806388 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 258 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1938 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | NH | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETER E WALCEK CFOVP OF FINANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6037402804 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 CENTRAL AVENUE | AddressLine1 |
| City | DOVER | City |
| State | NH | State |
| ZIP Code | 038202526 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| THEODORE RISTAINO | |||||||
| CHAIRMAN | 5.00 | X | X | 0 | 0 | 0 | |
| NEIL GARVEY | |||||||
| VICE CHAIRMAN | 3.00 | X | X | 0 | 0 | 0 | |
| ROGER HAMEL | |||||||
| TREASURER | 3.00 | X | X | 0 | 0 | 0 | |
| WILLIAM BOC | |||||||
| SECRETARY | 3.00 | X | X | 0 | 0 | 0 | |
| CAROL BAILEY | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| GERALD DALEY EDD | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| LISA DESTEFANO | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| PETER DIRKSMEIER MD | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| DAVID FLAVIN MD | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| WILLIAM HASSETT MD | |||||||
| TRUSTEE/MED STAFF PRES | 8.00 | X | 0 | 315100 | 18030 | ||
| WES KENNEDY | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| DONNA RINALDI | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| MICHAEL STEINBERG | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| STEVEN C WEBB | |||||||
| TRUSTEE | 3.00 | X | 0 | 0 | 0 | ||
| ANN TORR | |||||||
| TRUSTEE - EMERITUS (NON-VOTING) | 2.00 | X | 0 | 0 | 0 | ||
| JOSEPH WHITE MD | |||||||
| TRUSTEE - NON-VOTING | 2.00 | X | 61000 | 0 | 0 | ||
| ROBERT DECOLFMAKER | |||||||
| TRUSTEE - EMERITUS (NON-VOTING) | 0.10 | X | 0 | 0 | 0 | ||
| LINDA HAGAN | |||||||
| TRUSTEE - NON-VOTING | 2.00 | X | 0 | 0 | 0 | ||
| GREGORY J WALKER | |||||||
| PRESIDENT/CEO | 55.00 | X | X | 605304 | 0 | 147782 | |
| PETER E WALCEK | |||||||
| CFO/VP FINANCE | 55.00 | X | 302237 | 0 | 74502 | ||
| PAUL R CASS | |||||||
| VP MEDICAL AFFAIRS/CMO | 45.00 | 290495 | 0 | 73795 | X | ||
| ELLEN L CAILLE | |||||||
| EXECUTIVE VICE PRESIDENT | 55.00 | 257999 | 0 | 72398 | X | ||
| SHEILA M WOOLLEY | |||||||
| CNO/VP PATIENT CARE | 45.00 | 244314 | 0 | 42386 | X | ||
| DANIEL N DUNN | |||||||
| COO/SR. VP OPERATIONS | 45.00 | 242460 | 0 | 32464 | X | ||
| MALCOLM D ROSENSON MD | |||||||
| CHIEF DEPT MEDICINE | 45.00 | 218464 | 0 | 25434 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2222273 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 315100 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 486791 | TotalOtherCompensation |
| Number Individuals GT100 K | 120 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SODEXHO INC & AFFILIATES | |||||
| 9801 WASHINGTONIAN BOULEVARD | GAITHERSBURG | MD | 208785355 | FOOD SERVICES/MANAGEMENT | 1539861 |
| MAYO COLLABORATIVE SERVICES INC | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 55480 | REFERENCE LAB | 1129925 |
| HEALTH PLAN PREMIUMS | |||||
| 1500 W PACK DR SUITE 330 | WESTBOROUGH | MA | 01581 | TPA FEES - HEALTH PLAN | 844404 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| 51 VALLEY STREAM PARKWAY | MALVERN | PA | 19355 | INFORMATION SERVICES | 839085 |
| KLEEN INC | |||||
| 1 FOUNDRY STREET | LEBANON | NH | 03776 | LAUNDRY/LINEN SERVICES | 660357 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 24 | NumberOfContractorsGT100K |
| Related Organizations | 354119 | RelatedOrganizations |
| All Other Contributions | 103784 | AllOtherContributions |
| Total Contributions | 457903 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE RE | 900099 | 229462892 | 229462892 | |
| CAFETERIA | 722320 | 1073341 | 1046926 | 26415 |
| CHILD CARE SERVICE | 624410 | 876148 | 876148 | |
| REBATES | 900099 | 360588 | 360588 | |
| MEDICAL & SURGICAL SUP | 900099 | 58125 | 58125 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 65963 | TotalRevenueColumn |
| Related Or Exempt Function Income | 65963 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 231897057 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1301464 | TotalRevenueColumn |
| Unrelated Business Revenue | 19739 | UnrelatedBusinessRevenue |
| Exclusion | $1,281,725 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2462439 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 433840 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2028599 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2028599 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2302562 | RelatedOrExemptFunctionIncome |
| Exclusion | -$273,963 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 30685070 | Securities |
| Other | 60184 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 27676713 | Securities |
| Other | 73097 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3008357 | Securities |
| Other | -12913 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2995444 | TotalRevenueColumn |
| Exclusion | $2,995,444 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| OTHER | 541200 | 775105 | 771505 | 3600 |
| TRANSCRIPTION | 900099 | 319218 | 319218 | |
| MANAGEMENT FEES | 900099 | 5004 | 5004 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1099327 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 239779794 | TotalRevenueColumn |
| Related Or Exempt Function Income | 235268931 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 49754 | UnrelatedBusinessRevenue |
| Exclusion | $4,003,206 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1129824 | Total |
| Management And General | 1129824 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83124077 | Total |
| Program Services | 71776525 | ProgramServices |
| Management And General | 11347552 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2964088 | Total |
| Program Services | 2687617 | ProgramServices |
| Management And General | 276471 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14481508 | Total |
| Program Services | 12285694 | ProgramServices |
| Management And General | 2195814 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7599730 | Total |
| Program Services | 6436971 | ProgramServices |
| Management And General | 1162759 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 596788 | Total |
| Management And General | 596788 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119603 | Total |
| Management And General | 119603 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32072 | Total |
| Management And General | 32072 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66416 | Total |
| Management And General | 66416 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2417284 | Total |
| Program Services | 2314812 | ProgramServices |
| Management And General | 102472 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 618202 | Total |
| Program Services | 618202 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3482322 | Total |
| Program Services | 2959974 | ProgramServices |
| Management And General | 522348 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3650471 | Total |
| Program Services | 2865620 | ProgramServices |
| Management And General | 784851 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 427335 | Total |
| Program Services | 320501 | ProgramServices |
| Management And General | 106834 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3406916 | Total |
| Program Services | 3236570 | ProgramServices |
| Management And General | 170346 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16802274 | Total |
| Program Services | 14281933 | ProgramServices |
| Management And General | 2520341 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 872075 | Total |
| Program Services | 828471 | ProgramServices |
| Management And General | 43604 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES & OTHER EXPENS | 29663058 | 25260747 | 4402311 |
| PROVISION FOR BAD DEBT | 12881022 | 12881022 | |
| PHARMACY | 8142420 | 8142420 | |
| PURCHASED SERVICES | 7758425 | 7370504 | 387921 |
| SERVICE CONTRACTS | 4946441 | 4204475 | 741966 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3705253 | Total |
| Program Services | 3334330 | ProgramServices |
| Management And General | 370923 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208887604 | Total |
| Program Services | 181806388 | ProgramServices |
| Management And General | 27081216 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36419 | BOY |
| EOY | 52444 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35663824 | BOY |
| EOY | 32204188 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27487526 | BOY |
| EOY | 27170789 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3051612 | BOY |
| EOY | 3116219 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2342187 | BOY |
| EOY | 2420487 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 276758368 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 145170838 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135591471 | BOY |
| EOY | 131587530 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61449522 | BOY |
| EOY | 81902090 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14951672 | BOY |
| EOY | 17549525 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13976602 | BOY |
| EOY | 13279816 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2485284 | BOY |
| EOY | 2525077 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 297036119 | BOY |
| EOY | 311808165 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29474358 | BOY |
| EOY | 30194996 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 193148 | BOY |
| EOY | 128258 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91929006 | BOY |
| EOY | 84841863 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4269965 | BOY |
| EOY | 7091627 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125866477 | BOY |
| EOY | 122256744 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 168102683 | BOY |
| EOY | 186712004 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1968164 | BOY |
| EOY | 1672323 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1098795 | BOY |
| EOY | 1167094 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 171169642 | BOY |
| EOY | 189551421 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 297036119 | BOY |
| EOY | 311808165 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 30892190 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -12510411 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 1 | MailingsMembers |
| Mailings Members | $11,200 | MailingsMembersAmount |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $32,072 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 43272 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | DURING 2010, WDH REPRESENTATIVES ATTENDED NEW HAMPSHIRE HOSPITAL ASSOCIATION MEETINGS AND CONTACTED STATE LEGISLATORS TO PROVIDE EDUCATIONAL INFORMATION AND WDH'S POSITION ON KEY BILLS. IN ADDITION, GREGORY WALKER, CEO, PROVIDED CORRESPONDENCE TO SENATORS REGARDING PERTINENT FEDERAL AND STATE ISSUES. NHHA, PORTION OF DUES ALLOCATED TO LOBBYING, $25,194 AHA, PORTION OF DUES ALLOCATED TO LOBBYING, $6,878 | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 89122889 | BeginningOfYearBalance |
| Contributions | 25362 | Contributions |
| Investment Earnings Or Losses | 21394694 | InvestmentEarningsOrLosses |
| Other Expenditures | -10553631 | OtherExpenditures |
| End Of Year Balance | 121096576 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 87480527 | BeginningOfYearBalance |
| Contributions | 9452164 | Contributions |
| Investment Earnings Or Losses | 9150040 | InvestmentEarningsOrLosses |
| Other Expenditures | -16959842 | OtherExpenditures |
| End Of Year Balance | 89122889 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 98989793 | BeginningOfYearBalance |
| Contributions | 17943608 | Contributions |
| Investment Earnings Or Losses | -29452874 | InvestmentEarningsOrLosses |
| End Of Year Balance | 87480527 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.92930 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00900 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.06160 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3292772 | OtherCostOrOtherBasis |
| Book Value | 3292772 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 94049595 | OtherCostOrOtherBasis |
| Depreciation | 34806591 | Depreciation |
| Book Value | 59243004 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8471566 | OtherCostOrOtherBasis |
| Depreciation | 1272431 | Depreciation |
| Book Value | 7199135 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 110874154 | OtherCostOrOtherBasis |
| Depreciation | 85947297 | Depreciation |
| Book Value | 24926857 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 60070281 | OtherCostOrOtherBasis |
| Depreciation | 23144519 | Depreciation |
| Book Value | 36925762 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 131587530 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ALTERNATIVE INVESTMENTS | Description |
| Book Value | 17549525 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 17549525 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | EST THIRD-PARTY PAYOR SETTLEMENT | Description |
| Amount | $7,091,627 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 7091627 | TotalOfAmounts |
| Total Revenue | 239779794 | TotalRevenue |
| Total Expenses | 208887604 | TotalExpenses |
| Excess Or Deficit For Year | 30892190 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 5472259 | NetUnrealizedGLOnInvestments |
| Other | -$17,982,670 | OtherAmount |
| Total Adjustments | -12510411 | TotalAdjustments |
| Excess Or Deficit Per FS | 18381779 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 227202967 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 5472259 | NetUnrealizedGainsInvestments |
| Other Revenues | -17982670 | OtherRevenues |
| Revenue Not Rptd F990 | -12510411 | RevenueNotRptdF990 |
| Revenue Subtotal | 239713378 | RevenueSubtotal |
| Investment Expenses Not Included | 66416 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 66416 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 239779794 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 208821188 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 208821188 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 66416 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 66416 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 208887604 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | TO FURTHER THE HOSPITAL'S CHARITABLE MISSION. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT -707,597. NET CHANGE IN RESTRICTED ASSETS HELD BY WDHHF 128,796. NET LOSS ON INVESTMENTS IN JOINT VENTURES & RELATED ORGANIZATIONS -17,403,869. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT -707,597. NET INCREASE IN RESTRICTED CONTRIBUTIONS HELD BY WDHHF 128,796. INVESTMENT IN JOINT VENTURES & RELATED ORGANIZATIONS -17,403,869. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11757 | PersonsServed |
| Total Community Benefit Expense | 6953658 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6953658 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03550 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8943822 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8943822 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04560 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11757 | PersonsServed |
| Total Community Benefit Expense | 15897480 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 15897480 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08110 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12074 | PersonsServed |
| Total Community Benefit Expense | 898817 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 898817 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00460 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 427335 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 427335 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 440063 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 440063 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12074 | PersonsServed |
| Total Community Benefit Expense | 1766215 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1766215 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00900 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 23831 | PersonsServed |
| Total Community Benefit Expense | 17663695 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 17663695 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $5,750,345 | BadDebtExpenseAmount |
| Amount Attributable To | 575034 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 56284764 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 96168292 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -39883528 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NONE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WENTWORTH-DOUGLASS HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 CENTRAL AVENUE | AddressLine1 |
| City | DOVER | City |
| State | NH | State |
| ZIP Code | 038202526 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WENTWORTH-DOUGLASS HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 32 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (32 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| STRAFFORD HEALTH ALLIANCE | ||||
| 200 ROUTE 108 3 | SOMERSWORTH | NH | 038781106 | PHYSICAL THERAPY CLINICS & WOMEN'S IMAGING SERVICES |
| WDH PROFESSIONAL CENTER AT DOVER | ||||
| 10 MEMBERS WAY | DOVER | NH | 03820 | DIAGNOSTIC SERVICES |
| LEE OTPTIMAGINGURGENT CARE | ||||
| 65 CALEF HIGHWAY | LEE | NH | 03861 | OCCUPATIONAL/PHYSICAL THERAPY, IMAGING & URGENT CARE |
| WDPC - HOSPITALISTS | ||||
| 789 CENTRAL AVENUE LEVEL 2 | DOVER | NH | 03820 | INPATIENT PHYSICIAN SERVICES |
| WDPC - STRAFFORD MEDICAL ASSOCIATES | ||||
| 10 MEMBERS WAY SUITE 302 | DOVER | NH | 03820 | PRIMARY CARE PRACTICE |
| WDPC - DOVER FAMILY PRACTICE | ||||
| 10 MEMBERS WAY | DOVER | NH | 03820 | PRIMARY CARE PRACTICE |
| WDPC - ENDOCRINOLOGY & DIABETES | ||||
| 19 WEBB PLACE | DOVER | NH | 03820 | SPECIALTY CARE PRACTICE |
| WDPC - ADULT & CHILDREN'S MEDICINE | ||||
| 10 MEMBERS WAY SUITE 201 | DOVER | NH | 03820 | PRIMARY CARE PRACTICE |
| WDPC - SEACOAST PULMONARY (INTENSIVISTS) | ||||
| 789 CENTRAL AVENUE LEVEL 3 | DOVER | NH | 03820 | SPECIALTY CARE PRACTICE |
| WENTWORTH HOMECARE & HOSPICE | ||||
| 113 NEW ROCHESTER ROAD | DOVER | NH | 03820 | HOSPICE AND HOME CARE SERVICES |
| LEE URGENT CARE | ||||
| 65 CALEF HIGHWAY | LEE | NH | 03861 | URGENT CARE FACILITY & DIAGNOSTIC SERVICES |
| WDPC - PRIMARY CARE OF DOVER | ||||
| 10 MEMBERS WAY SUITE 300 | DOVER | NH | 03820 | PRIMARY CARE PRACTICE |
| WDPC - DOVER INTERNAL AND GERIATRIC MEDI | ||||
| 10 MEMBERS WAY SUITE 301 | DOVER | NH | 03820 | PRIMARY CARE PRACTICE |
| WDPC - DURHAM HEALTH CENTER | ||||
| 36 MADBURY ROAD | DURHAM | NH | 03824 | PRIMARY CARE PRACTICE |
| WDPC - HILLTOP FAMILY PRACTICE | ||||
| 85 MAIN STREET | SOMERSWORTH | NH | 03878 | PRIMARY CARE PRACTICE |
| DURHAM REHAB AND SPORTS THERAPY CENTER | ||||
| 16 JENKINS COURT | DURHAM | NH | 03824 | SPECIALTY CARE PRACTICE |
| WDPC - LEE FAMILY PRACTICE | ||||
| 65 CALEF HIGHWAY SUITE 200 | LEE | NH | 03861 | PRIMARY CARE PRACTICE |
| WDPC - SOUTH BERWICK FAMILY PRACTICE | ||||
| 31 COLCORD STREET | SOUTH BERWICK | ME | 03908 | PRIMARY CARE PRACTICE |
| WDPC - BELLAMY HEALTH CENTER | ||||
| 15 OLD ROLLINSFORD ROAD | DOVER | NH | 03820 | PRIMARY CARE PRACTICE |
| WDPC - BARRINGTON HEALTH CENTER | ||||
| 2 CENTURY PINES DRIVE | BARRINGTON | NH | 03825 | PRIMARY CARE PRACTICE |
| WDPC - MARSHWOOD FAMILY CARE | ||||
| 19 LEVESQUE DRIVE SUITE 2 | ELIOT | ME | 03903 | PRIMARY CARE PRACTICE |
| WDPC - WENTWORTH COMMUNITY DENTAL CARE | ||||
| 668 CENTRAL AVENUE | DOVER | NH | 03820 | DENTAL SERVICES |
| MEDICAL ONCOLOGY | ||||
| 789 CENTRAL AVENUE | DOVER | NH | 03820 | SPECIALTY CARE PRACTICE |
| WDPC - SEACOAST ARTHRITIS & OSTEOPOROSIS | ||||
| 15 OLD ROLLINSFORD ROAD SUITE 204 | DOVER | NH | 03820 | SPECIALTY CARE PRACTICE |
| WDPC - GREAT BAY FAMILY PRACTICE | ||||
| 60 EXETER ROAD UNIT 3 | NEWMARKET | NH | 03857 | PRIMARY CARE PRACTICE |
| HEALTH PARTNERS OF NEW HAMPSHIRE INC | ||||
| 789 CENTRAL AVENUE | DOVER | NH | 038202526 | PHYSICIAN/HOSPITAL ORGANIZATION |
| WDPC - DOVER INTERNAL AND GERIATRIC MEDI | ||||
| 31 COLCORD STREET | SOUTH BERWICK | ME | 03908 | PRIMARY CARE PRACTICE |
| WDPC - SUMMIT INFECTIOUS DISEASE | ||||
| 15 OLD ROLLINSFORD ROAD | DOVER | NH | 03820 | INPATIENT SPECIALTY CARE |
| WDPC - PALLIATIVE CARE | ||||
| 789 CENTRAL AVENUE LEVEL 3 | DOVER | NH | 03820 | INPATIENT PHYSICIAN SERVICES |
| WDPC - WENTWORTH INTERNAL MEDICINE | ||||
| 10 MEMBERS WAY SUITE 303 | DOVER | NH | 03820 | PRIMARY CARE PRACTICE |
| CENTER FOR MEDICAL GENETICS | ||||
| 17 OLD ROLLINSFORD ROAD SUITE 6 | DOVER | NH | 03842 | SPECIALTY CARE PRACTICE |
| WENTWORTH-DOUGLASS HOSPITAL EARLY LEARNI | ||||
| 789 CENTRAL AVENUE | DOVER | NH | 03820 | CHILDCARE SERVICES |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: N/A | ||
| PART I, LINE 6A: N/A | ||
| PART I, LINE 7: THE HOSPITAL USES THE RATIO OF COST TO CHARGE METHODOLOGY TO CALCULATE THE COST OF THE COMMUNITY BENEFITS IT PROVIDES. THE RATIO OF COST TO CHARGE METHODOLOGY WAS USED TO REDUCE CHARITY CARE CHARGES DOWN TO COSTS AND WAS ALSO USED TO CALCULATE THE MEDICAID SHORTFALL. | ||
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 12881022. | ||
| PART II: SEE FORM 990, PART III, LINE 4A. | ||
| PART III, LINE 4: FROM FOOTNOTE 1 OF THE 2010 AUDITED CONSOLIDATED FINANCIAL STATEMENTS:"THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS PROVIDED BASED ON AN ANALYSIS BY MANAGEMENT OF THE COLLECTIBILITY OF OUTSTANDING BALANCES. MANAGEMENT CONSIDERS THE AGE OF OUTSTANDING BALANCES AND PAST COLLECTION EFFORTS IN DETERMINING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ACCOUNTS DEEMED UNCOLLECTIBLE ARE CHARGED OFF AGAINST THE ESTABLISHED ALLOWANCE." THE HOSPITAL USES THE RATIO OF COST TO CHARGE METHODOLOGY TO REDUCE BAD DEBT EXPENSES DOWN TO COST. IN 2010, IT COST THE HOSPITAL $5,750,345 TO PROVIDE CARE TO PATIENTS, FOR WHICH THE HOSPITAL RECEIVED NO PAYMENTS FOR SERVICES RENDERED. WHILE THE HOSPITAL CONSIDERS THE $5,750,345 TO BE THE COST OF CARE PROVIDED TO PATIENTS FOR SERVICES RENDERED FOR WHICH NO PAYMENT WAS RECEIVED, WE DO NOT CONSIDER THIS TO BE A COMMUNITY BENEFIT AND THEREFORE HAVE NOT REPORTED IT IN PART I, LINE 7. | ||
| PART III, LINE 8: IN 2010, THE HOSPITAL PROVIDED CARE COSTING $96M TO MEDICARE PATIENTS, FOR WHICH IT WAS REIMBURSED $56M, REPRESENTING A LOSS ON MEDICARE SERVICES OF $39M. THIS AMOUNT REPRESENTS THE AMOUNT BY WHICH THE HOSPITAL WAS UNDERPAID (RELATIVE TO COST) BY THE FEDERAL GOVERNMENT FOR CARE PROVIDED TO MEDICARE PATIENTS, WHO ARE 65 AND OLDER, REGARDLESS OF INCOME OR DISABILITY. WHILE THE HOSPITAL CONSIDERS THE $39M COST TO BE A SIGNIFICANT SHORTFALL COMPARED TO THE COST OF PROVIDING THE SERVICES RENDERED, WE DO NOT CONSIDER THIS AMOUNT TO BE A COMMUNITY BENEFIT AND THEREFORE HAVE NOT REPORTED IT IN PART I, LINE 7. | ||
| PART III, LINE 9B: HOSPITALS IN NEW HAMPSHIRE WORK HARD TO MAKE HIGH-QUALITY HEALTH CARE AVAILABLE, AFFORDABLE, AND ACCESSIBLE TO ALL, REGARDLESS OF ABILITY TO PAY. WENTWORTH-DOUGLASS HOSPITAL OFFERS MANY FINANCIAL ASSISTANCE AND REFERRAL PROGRAMS TO ENSURE THAT COST WILL NOT BE A BARRIER TO ANYONE IN OUR COMMUNITY GETTING THE HEALTH CARE SERVICES THEY NEED. IF PAYMENT OF HEALTH CARE EXPENSES CREATES A FINANCIAL HARDSHIP FOR PATIENTS, OUR STAFF PROVIDES ASSISTANCE TO COMPLETE THE FINANCIAL APPLICATION PROCESS. AS PART OF THIS FINANCIAL APPLICATION PROCESS, THE HOSPITAL WILL ASSESS PATIENTS' ELIGIBILITY FOR HEALTH INSURANCE COVERAGE THROUGH FEDERAL OR STATE PROGRAMS SUCH AS NEW HAMPSHIRE MEDICAID. IF IT IS DETERMINED THAT PATIENTS MAY BE ELIGIBLE FOR ONE OF THESE PROGRAMS, THE HOSPITAL ASSISTS PATIENTS THROUGH THE APPLICATION PROCESS. PATIENTS ARE REQUIRED TO SUPPLY THE FINANCIAL OR MEDICAL DOCUMENTATION THAT IS NECESSARY TO SECURE SUCH INSURANCE COVERAGE.THE HOSPITAL UNDERSTANDS THAT HEALTH CARE COSTS CAN COME UP UNEXPECTEDLY. WHETHER PATIENTS ARE INSURED OR UNINSURED, AND WHETHER OR NOT PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, WE UNDERSTAND THAT PATIENTS MAY HAVE DIFFICULTY PAYING HEALTHCARE COSTS IN FULL AT THE TIME OF SERVICE OR IN A LUMP SUM. OUR BILLING TEAM WORKS WITH PATIENTS TO SET UP INTEREST-FREE PAYMENT PLANS TO HELP EASE THE FINANCIAL BURDEN OF HEALTH CARE COSTS. | ||
| PART VI, LINE 2: WENTWORTH-DOUGLASS HOSPITAL'S COMMUNITY BENEFIT TASK FORCE, A COMMITTEE OF THE BOARD OF TRUSTEES THAT WAS ESTABLISHED IN 2000, CONDUCTS COMMUNITY NEEDS ASSESSMENTS EVERY 3-5 YEARS. THE MOST RECENT NEEDS ASSESSMENT, COMPLETED IN 2008, INCLUDED FIVE FOCUS GROUPS WITH KEY LEADERS FROM PROVIDERS, GOVERNMENT, HEALTHCARE, SCHOOLS AND SOCIAL SERVICE AGENCIES IN THE HOSPITAL'S PRIMARY SERVICE AREA. FOUR MAIN PROJECTS ARE CONTAINED IN THE ANNUAL COMMUNITY ASSISTANCE (BENEFIT) PLAN AS A RESULT OF THE NEEDS IDENTIFIED IN THE ORIGINAL AND SUBSEQUENT ASSESSMENTS: FINANCIAL ASSISTANCE (CHARITY CARE), MEDICATION ASSISTANCE, CARE-VAN FREE PATIENT TRANSPORT AND THE WENTWORTH-DOUGLASS COMMUNITY DENTAL CENTER WHICH PROVIDES DENTAL HEALTH SERVICES AND ACCESS TO DENTAL CARE TO NEEDY FAMILIES IN THE COMMUNITY. | ||
| PART VI, LINE 3: WDH & WDPC TAKE AN ACTIVE ROLE IN ASSISTING PATIENTS WHO MAY BE INTERESTED AND QUALIFY FOR FINANCIAL ASSISTANCE, WHETHER IT IS STATE, FEDERAL OR OUR OWN CHARITY CARE BENEFITS. OUR FAMILY RESOURCE/COMMUNITY BENEFITS DEPARTMENT HAS SEVERAL PROCESSES IN PLACE TO ENSURE PATIENTS ARE AWARE OF THE FINANCIAL ASSISTANCE AVAILABLE TO THEM.PATIENTS CAN LEARN MORE ABOUT THESE PROGRAMS BY VISITING OUR WEBSITE, READING OUR FOUNDATION NEWSLETTERS, OR CONTACTING OUR FINANCIAL ASSISTANCE OFFICE. FROM THE TIME OF REGISTRATION THROUGH OUR BILLING PROCESS, PATIENTS HAVE AVAILABLE THE OPPORTUNITY TO OBTAIN AN APPLICATION FOR FINANCIAL ASSISTANCE. ALL SELF PAY PATIENTS AT THE TIME OF REGISTRATION ARE PROVIDED WITH OUR CHARITY CARE COVER LETTER AND APPLICATION, WITH INFORMATION ABOUT THE CHARITY CARE PROGRAM AND DETAILS ON HOW TO CONTACT OUR FINANCIAL ASSISTANCE REPRESENTATIVE(S). OUR REPRESENTATIVES ALSO SEE MANY PATIENTS WHILE THEY ARE HERE FOR SERVICES. SOCIAL WORK SERVICES AND COMMUNITY BENEFITS TEAM UP TO ASSIST AND MAKE SURE OUR PATIENTS ARE RECEIVING THE OPPORTUNITIES TO GET ANY AND ALL ASSISTANCE AVAILABLE TO THEM. WE SEND FIVE BILLING STATEMENTS TO OUR PATIENTS WITH THE FINANCIAL ASSISTANCE GUIDELINES AND CONTACT INFORMATION IF PATIENTS FEEL THEY MAY MEET THESE GUIDELINES AND NEED ASSISTANCE WITH THEIR BILL(S). | ||
| PART VI, LINE 4: WENTWORTH-DOUGLASS HOSPITAL SERVES THE SEACOAST AREA OF NEW HAMPSHIRE AND SOUTHERN MAINE - STRAFFORD COUNTY, ROCKINGHAM COUNTY AND YORK COUNTY, MAINE. OUR COMMUNITY INCLUDES A SMALL BUT GROWING INDONESIAN POPULATION, WELCOMED BY LOCAL CHURCH GROUPS. THE COMMUNITY ALSO INCLUDES LOW-INCOME, UNINSURED ADULTS AND CHILDREN SUPPORTED BY THE HOSPITAL'S COMMUNITY ASSISTANCE PLAN PROGRAMS. | ||
| PART VI, LINE 6: WDH OWNS 100% OF WENTWORTH-DOUGLASS PHYSICIAN CORPORATION (WDPC), WHICH FILES ITS OWN FORM 990 (SEE SCHEDULE R FOR MORE DETAILS). WDH OVERSEES ALL OF WDPC'S PRIMARY CARE PRACTICES, SPECIALTY PRACTICES, AND ITS DENTAL CLINIC. ACCORDINGLY, ALL OF WDPC'S FACILITY LOCATIONS HAVE BEEN LISTED ON WDH'S SCHEDULE H. WDPC PROVIDED COMMUNITY BENEFITS EXCEEDING $867,000 IN 2010. THE CORPORATION SUPPORTS NUMEROUS COMMUNITY BASED PROGRAMS, INCLUDING THE COMMUNITY DENTAL CENTER AND PETE'S PLACE, WHICH IS A GRIEF SUPPORT ORGANIZATION FOR CHILDREN WHO HAVE SUFFERED THE LOSS OF A LOVED ONE OR FRIEND. THE PROGRAM ALSO PROVIDES GROUP COUNSELING AT AREA SCHOOLS FOR STUDENTS WHO HAVE LOST A CLASSMATE.THE WENTWORTH-DOUGLASS COMMUNITY DENTAL CENTER IS OPEN TO LOW-INCOME, UNINSURED ADULTS AND CHILDREN LIVING IN THE HOSPITAL'S PRIMARY SERVICE AREA (DOVER, DURHAM, MADBURY, LEE, BARRINGTON, SOMERSWORTH, ROLLINSFORD, NH AND BERWICK AND SO. BERWICK, ME) OR PATIENTS OF THE PHYSICIAN PRACTICES WHO HAVE A FAMILY INCOME AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES IN CONJUCTION WITH A DISCOUNTED FEE SCHEDULE. IN 2010, THE DENTAL CENTER PROVIDED $493,000 OF COMMUNITY-BASED CLINIC SERVICES THROUGH 4,760 VISITS.WDPC PROVIDES FINANCIAL AID INFORMATION AND RESOURCES TO ASSIST PATIENTS WITH THEIR HEALTHCARE BILLS. MEDICAL CARE IS PROVIDED AT NO CHARGE FOR ELIGIBLE PATIENTS AT 300% OF THE FEDERAL POVERTY LEVEL. IN 2010 WDPC PROVIDED $374,000 OF FINANCIAL AID (STATED AT COST).MEDICAID COSTS EXCEEDING REIMBURSEMENT TOTALED $520,639 FOR THE CORPORATION IN 2010. | ||
| PART VI, LINE 7: THE AFFILIATES OF WENTWORTH-DOUGLASS HOSPITAL INCLUDE WENTWORTH-DOUGLASS PHYSICIAN CORPORATION, WENTWORTH-DOUGLASS COMMUNITY HEALTH CORPORATION AND THE WENTWORTH-DOUGLASS HOSPITAL AND HEALTH FOUNDATION. OUR AFFILIATES SERVE TO FURTHER OUR MISSION OF HELPING OUR PATIENTS AND THEIR FAMILIES ATTAIN THEIR HIGHEST LEVEL OF HEALTH. THE WENTWORTH-DOUGLASS PHYSICIAN CORPORATION WAS FORMED IN RESPONSE TO A COMMUNITY NEEDS ASSESSMENT THAT IDENTIFIED A LACK OF PRIMARY CARE SERVICES IN THE COMMUNITY. THE FORMATION OF THE PHYSICIAN CORPORATION AND RECRUITMENT OF PRIMARY CARE PHYSICIANS CLOSED THE GAP BY IMPROVING ACCESS TO PRIMARY CARE MEDICAL SERVICES IN OUR COMMUNITY. WENTWORTH-DOUGLASS COMMUNITY HEALTH CORPORATION (THE WORKS) SERVES TO PROMOTE COMMUNITY HEALTH AND WELLNESS, WHILE REMAINING FAMILY FOCUSED. THE WORKS OFFERS SPECIALLY DESIGNED AND SUPERVISED FITNESS PROGRAMS, AIMED TO HELP MANAGE DIABETES, LOWER RISK OF HEART DISEASE, AND IMPROVE QUALITY OF LIFE. IN ADDITION, THE HOSPITAL COLLABORATES WITH THE WORKS TO OFFER GROUP EXERCISE PROGRAMS TO OUR PATIENTS, INCLUDING CANCER CENTER PATIENTS, WHO ARE PROVIDED A FREE THREE MONTH MEMBERSHIP AND INVITED TO PARTICIPATE IN A PROGRAM THAT COMBINES REHABILITATION AND GROUP EXERCISE.THE WENTWORTH-DOUGLASS HOSPITAL AND HEALTH FOUNDATION SERVES TO CULTIVATE, SECURE AND STEWARD PHILANTHROPIC GIFTS THAT WILL SUPPORT THE CAPITAL, PROGRAMMATIC AND ENDOWMENT NEEDS OF WENTWORTH-DOUGLASS HOSPITAL. | ||
| NH | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM HASSETT MD | |||||||||||||
| 0 | 153396 | 0 | 36984 | 0 | 124720 | 0 | 9600 | 0 | 8430 | 0 | 333130 | 0 | 0 |
| GREGORY J WALKER | |||||||||||||
| 406373 | 0 | 65462 | 0 | 133469 | 0 | 127804 | 0 | 19978 | 0 | 753086 | 0 | 0 | 0 |
| PETER E WALCEK | |||||||||||||
| 271159 | 0 | 21465 | 0 | 9613 | 0 | 55200 | 0 | 19302 | 0 | 376739 | 0 | 0 | 0 |
| PAUL R CASS | |||||||||||||
| 266258 | 0 | 20737 | 0 | 3500 | 0 | 54450 | 0 | 19345 | 0 | 364290 | 0 | 0 | 0 |
| ELLEN L CAILLE | |||||||||||||
| 224833 | 0 | 23146 | 0 | 10020 | 0 | 46320 | 0 | 26078 | 0 | 330397 | 0 | 0 | 0 |
| SHEILA M WOOLLEY | |||||||||||||
| 216734 | 0 | 17036 | 0 | 10544 | 0 | 33620 | 0 | 8766 | 0 | 286700 | 0 | 0 | 0 |
| DANIEL N DUNN | |||||||||||||
| 213377 | 0 | 18149 | 0 | 10934 | 0 | 14679 | 0 | 17785 | 0 | 274924 | 0 | 0 | 0 |
| MALCOLM D ROSENSON MD | |||||||||||||
| 214464 | 0 | 0 | 0 | 4000 | 0 | 8732 | 0 | 16702 | 0 | 243898 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | CERTAIN RETIREMENT AND FRINGE BENEFITS FOR GREGORY J. WALKER (PRESIDENT/CEO) HAVE BEEN GROSSED-UP UTILIZING THE APPLICABLE MARGINAL FEDERAL TAX RATE AS THE MOST EFFICIENT AND COST EFFECTIVE MEANS TO FULFILL THE TARGET BENEFIT GOAL AT RETIREMENT. |
| PART I, LINE 4B | GREGORY J. WALKER (PRESIDENT/CEO) - 2010 TOTAL CONTRIBUTIONS TO THE 457(F) PLAN = $113,104. THIS SUPPLEMENTAL RETIREMENT PLAN CONTRIBUTION IS INTENDED TO FUND BENEFITS ACCRUING AND PAYABLE AT RETIREMENT FOR MULTIPLE YEARS OF SERVICE THAT BEGAN IN CALENDAR YEAR 1997. IN 2010, THE HOSPITAL ALSO EXECUTED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WHICH PROVIDES BENEFITS TO OTHER QUALIFYING EXECUTIVES. THE CONTRIBUTIONS ARE INTENDED TO PROVIDE A FORFEITABLE SUPPLEMENTAL RETIREMENT BENEFIT AND ARE BEING PROVIDED IN CONSIDERATION FOR MANY YEARS OF SERVICE TO THE HOSPITAL. THE RESPECTIVE CONTRIBUTIONS FOR THE 2010 PLAN YEAR, FOR THOSE INDIVIDUALS IDENTIFIED IN SCHEDULE J - PART II, ARE AS FOLLOWS: PETER E. WALCEK = $40,500, PAUL R. CASS = $39,750, ELLEN L. CAILLE =$37,500 AND SHEILA M. WOOLLEY = $21,320. |
| PART I, LINE 7 | AT-RISK COMPENSATION, WHICH IS SUBJECT TO REVIEW AND PAID ANNUALLY. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NHHEFA CAPITAL ANTICIPATION NOTEWDH ISSUE SERIES 2009G | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 020279866 | IssuerEIN |
| CUSIP Number | NONEAVAIL | CUSIPNumber |
| Date Issued | 2009-04-01 | DateIssued |
| Issue Price | 30000000 | IssuePrice |
| Description Of Purpose | ASSIST IN FUNDING OF SIGNIFICANT CAPITAL PROJECTS AND REFINANCING | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 30000000 | TotalProceeds |
| Issuance Costs From Proceeds | 37500 | IssuanceCostsFromProceeds |
| Year Of Subst Completion | 2010 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 1 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| PETER DIRKSMEIER MD | |||
| EMPLOYEE OF SOSMED | 317453 | IN 2010, SOSMED PAID THE HOSPITAL $82,460 AS RENTAL FEES FOR PROFESSIONAL MEDICAL SPACE LOCATED AT THE WD PROFESSIONAL CENTER IN LEE, NH AND $40,509 FOR PRACTICE SUPPORT SERVICES. THE HOSPITAL COLLECTED ON BEHALF OF SOSME ACCOUNTS RECEIVABLES FOR A SUPPORTED PHYSICIAN IN THE AMOUNT OF $183,720. THE HOSPITAL RECEIVED, ON BEHALF OF WENTWORTH-DOUGLASS PHYSICIAN CORPORATION, $10,764 FOR THE RESPECTIVE BILLING SERVICES RENDERED. | 0 |
| WENTWORTH HOMECARE AND HOSPICE LLC | |||
| CURRENT OFFICER SERVES BOTH ORGANIZATIONS | 880050 | THE HOSPITAL HAS A 50% OWNERSHIP INTEREST IN WENTWORTH HOMECARE AND HOSPICE, LLC. THE HOSPITAL ACCOUNTS FOR ITS INVESTMENT IN JOINT VENTURES UNDER THE EQUITY METHOD. THE 2010 INCOME RECORDED FOR THE HOSPITAL SHARE OF REVENUES EQUALED $880,050 FROM WHICH IT RECEIVED A DISTRIBUTION OF $725,000. | 1 |
| GRANITE STATE INSURANCE EXCHANGE | |||
| CURRENT OFFICER SERVES BOTH ORGANIZATIONS | 350000 | IN DECEMBER OF 2010, THE HOSPITAL MADE AN INITIAL CAPITAL CONTRIBUTION TO GRANITE STATE INSURANCE EXCHANGE (GSIE) OF $100,000. A SECOND CAPITAL CONTRIBUTION OF $250,000 WAS MADE TO GSIE IN FEBRUARY OF 2011 BRINGING THE HOSPITAL'S OWNERSHIP INTEREST IN GSIE TO APPROXIMATELY 11%. NO OPERATING ACTIVITY OCCURRED IN GSIE DURING 2010. | 1 |
| STRAFFORD HEALTH ALLIANCE | |||
| CURRENT OFFICER SERVES BOTH ORGANIZATIONS | 243652 | THE HOSPITAL HAS A 50% OWNERSHIP INTEREST IN STRAFFORD HEALTH ALLIANCE (SHA). THE HOSPITAL ACCOUNTS FOR INVESTMENT IN JOINT VENTURES UNDER THE EQUITY METHOD. THE HOSPITAL MADE A CAPITAL CONTRIBUTION IN 2010 TO SHA OF $100,000. THE 2010 ALLOCATED LOSS TO THE HOSPITAL EQUALED $42,887. IN ADDITION, SHA PURCHASED VARIOUS MANAGEMENT SERVICES FROM THE HOSPITAL THAT AMOUNTED TO LESS THAN $10,000. SHA LEASED SPACE FOR THE WOMEN'S LIFE IMAGING CENTER PROGRAM AND ADMINISTRATIVE OFFICES THROUGH A RELATED ENTITY OF THE HOSPITAL. THE AMOUNT PAID IN 2010 WAS $80,157. SHA ALSO LEASED ADDITIONAL SPACE FROM A RELATED ENTITY OF THE HOSPITAL FOR A THORACIC SURGEON THAT INCLUDED OTHER OPERATING EXPENSES. THE TOTAL AMOUNT PAID DURING CALENDAR YEAR 2010 EQUALED $96,382. | 1 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE FORM 990 IS INITIALLY REVIEWED IN DETAIL BY THE FINANCE COMMITTEE AND KEY FINANCE EMPLOYEES. THEREAFTER, THE FINAL DRAFT IS PRESENTED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS. EACH MEMBER OF THE BOARD AND FINANCE COMMITTEE IS PROVIDED WITH A DRAFT OF THE FORM 990 IN ADVANCE OF EACH MEETING. | |
| A COPY OF THE HOSPITAL CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, TRUSTEES, MEDICAL STAFF OFFICERS AND COMMITTEE MEMBERS, AND THE MANAGEMENT TEAM. ALL ARE REQUIRED TO REPORT ANY CONFLICTS AND SIGN, DATE, AND RETURN THE POLICY, WHETHER OR NOT A CONFLICT EXISTS, TO CONFIRM COMPLIANCE. CONFLICTS ARE DISCLOSED IN ACCORDANCE WITH STATE OF NEW HAMPSHIRE RSA 7:19-A IN THE LOCAL NEWSPAPER AND SUBMITTED TO THE NEW HAMPSHIRE ATTORNEY GENERAL. | FORM 990, PART VI, SECTION B, LINE 12C | |
| CEO'S COMPENSATION: THE CEO'S COMPENSATION AND BENEFITS ARE REVIEWED, ADJUSTED AND VOTED ON BY THE FULL BOARD ANNUALLY. EVERY OTHER YEAR, A NATIONAL INDEPENDENT CONSULTING FIRM IS ENGAGED BY THE BOARD TO PROVIDE COMPARATIVE MARKET COMPENSATION DATA FOR EXECUTIVE AND MANAGEMENT POSITIONS AT THE HOSPITAL. THE BOARD OF TRUSTEES USES THE DATA TO COMPARE WENTWORTH-DOUGLASS' CEO COMPENSATION WITH THAT OF OTHER HOSPITAL EXECUTIVES NATIONALLY AND IN THE NORTHEAST REGION TO DETERMINE THE CEO'S ANNUAL SALARY. ON ALTERNATE YEARS, WHEN THE CONSULTING FIRM IS NOT ENGAGED, THE BOARD USES SALARY RANGES ESTABLISHED THE PRIOR YEAR AND MARKET ECONOMIC DATA TO VALIDATE THAT THE CEO'S SALARY IS COMPETITIVE AND MAKE MARKET ADJUSTMENTS. THE CEO IS EXCUSED FROM BOARD DISCUSSION AND VOTING ON ISSUES SURROUNDING CEO COMPENSATION AND BENEFITS. COMPENSATION OF KEY EMPLOYEES: THE CEO REVIEWS THE SALARIES OF KEY EMPLOYEES ANNUALLY AND DETERMINES COMPENSATION BASED ON PERFORMANCE, SALARY RANGES AND MARKET COMPETITIVE DATA. COMPENSATION DATA IS PROVIDED BY AN INDEPENDENT NATIONAL CONSULTING FIRM EVERY OTHER YEAR. THE CEO PRESENTS SALARY RANGE DATA FOR KEY EMPLOYEES TO THE BOARD ANNUALLY FOR APPROVAL. USING THE BOARD APPROVED SALARY RANGE DATA, THE CEO RECOMMENDS SALARY INCREASES FOR VICE PRESIDENTS TO THE BOARD FOR APPROVAL AND THE VICE PRESIDENTS RECOMMEND SALARY INCREASES FOR DIRECTORS AND OTHER MANAGEMENT POSITIONS TO THE CEO, FOR APPROVAL. PHYSICIAN SALARY RANGES ARE ESTABLISHED ANNUALLY USING THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) SALARY SURVEY DATA. DUE TO A POTENTIAL CONFLICT OF INTEREST, DR. WILLIAM HASSETT, PRESIDENT OF THE MEDICAL STAFF AND AN EMPLOYEE OF A RELATED ORGANIZATION (WENTWORTH-DOUGLASS PHYSICIAN CORPORATION), IS EXCLUDED FROM SALARY DISCUSSIONS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| WENTWORTH-DOUGLASS HOSPITAL FILES AUDITED FINANCIAL STATEMENTS ANNUALLY WITH THE NEW HAMPSHIRE ATTORNEY GENERAL'S CHARITABLE TRUST UNIT AND INFORMS THE DIRECTOR OF CHARITABLE TRUSTS OF PECUNIARY BENEFIT TRANSACTIONS THAT HAVE OCCURRED BETWEEN WDH AND A BOARD MEMBER OR OFFICER. NOTICES OF SUCH TRANSACTIONS OF $5,000 OR MORE ARE ALSO PUBLISHED IN THE LOCAL NEWSPAPER IN ACCORDANCE WITH NH RSA 7:19-A, II(D). CURRENT COPIES OF THE BYLAWS, CONFLICT OF INTEREST POLICY AND FORM 990 ARE ON FILE WITH THE CHARITABLE TRUST UNIT. | FORM 990, PART VI, SECTION C, LINE 19 | |
| REPORTABLE COMPENSATION FROM THE ORGANIZATION | THE 2010 COMPENSATION REPORTED FOR DR. JOSEPH WHITE WAS PAID BY WENTWORTH-DOUGLASS HOSPITAL FOR HIS SERVICES AS A MEDICAL DIRECTOR. DR. WHITE IS NOT COMPENSATED FOR HIS SERVICES AS A NON-VOTING TRUSTEE OF WDH. | FORM 990, PART VII, SECTION A, COLUMN D |
| REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS | THE 2010 COMPENSATION REPORTED FOR DR. WILLIAM HASSETT WAS PAID BY WENTWORTH-DOUGLASS PHYSICIAN CORPORATION FOR HIS SERVICES AS A FULL-TIME PHYSICIAN. DR. HASSETT IS NOT COMPENSATED FOR HIS SERVICES AS A TRUSTEE OF WDH. | FORM 990, PART VII, SECTION A, COLUMN E |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 5,472,259. CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT -707,597. NET CHANGE IN RESTRICTED ASSETS HELD BY WDHHF 128,796. NET LOSS ON INVESTMENTS IN JOINT VENTURES & RELATED ORGANIZATIONS -17,403,869. TOTAL TO FORM 990, PART XI, LINE 5: -12,510,411. | FORM 990, PART XI, LINE 5: |
| AUDIT REVIEW PROCESS | THE FINANCE COMMITTEE OVERSEES THE AUDIT PROCESS FOR WENTWORTH-DOUGLASS HOPSPITAL AND ALL RELATED ORGANIZATIONS. THE AUDIT PROCESS FOR THE FINANCIAL STATEMENTS DID NOT CHANGE FROM THE PRIOR YEAR. INDEPENDENT ACCOUNTANTS PERFORMED THE AUDIT IN BOTH 2009 AND 2010. | FORM 990, PART XI, LINE 2C |
| GOVERNING BODY AND MANAGEMENT | STEVEN C. WEBB IS A TRUSTEE OF THE HOSPITAL AND AN EXECUTIVE AT TD BANKNORTH. THE HOSPITAL MAINTAINS OPERATING AND PAYROLL ACCOUNTS WITH TD BANKNORTH. TRANSACTIONS IN 2010 WERE IN EXCESS OF $10,000. AN EXACT FIGURE CANNOT BE STATED DUE TO DAILY ACCOUNT ACTIVITY AND BALANCE CHANGES. BOTH ACCOUNTS WERE ACTIVE PRIOR TO MR. WEBB JOINING THE BOARD AND ALL TRANSACTIONS WITH TD BANKNORTH ARE AT A FAIR MARKET RATE. FOR 2010, MR. WEBB HAS BEEN CLASSIFIED AS AN INDEPENDENT BOARD MEMBER. | FORM 990, PART VI, LINE 1A AND LINE 1B |
| WDH SPONSORS A SPLIT-DOLLAR LIFE INSURANCE EMPLOYEE BENEFIT PROGRAM FOR CERTAIN OFFICERS AND KEY EMPLOYEES. SPLIT DOLLAR LIFE INSURANCE IS AN ARRANGEMENT IN WHICH THE EMPLOYEE IS THE OWNER OF THE LIFE INSURANCE POLICY AND THE PREMIUMS ARE PAID BY BOTH THE EMPLOYER AND EMPLOYEE. PURSUANT TO WDH'S SPLIT-DOLLAR AGREEMENT, AND THE COLLATERAL ASSIGNMENT THEREIN, THE EMPLOYER'S SHARE OF THE POLICY PREMIUMS PAID IS RECOVERED EITHER UPON TERMINATION OF THE POLICY OR AT THE DEATH OF THE PARTICIPANT. NOTE THAT THE SPLIT-DOLLAR ARRANGEMENT IS PART OF AN EMPLOYEE BENEFIT PROGRAM AND ECONOMICALLY NOT A DIRECT EXTENSION OF CREDIT. FURTHERMORE, THE REPORTABLE COMPENSATION OF THE RESPECTIVE EMPLOYEES INCLUDES THE ANNUAL VALUE OF THE LIFE INSURANCE. | FORM 990, PART IV, LINE 26 AND PART X, LINE 15 | |
| FUNDRAISING EXPENSES | WENTWORTH-DOUGLASS HOSPITAL AND HEALTH FOUNDATION (A RELATED ORGANIZATION) PERFORMS ALL FUNDRAISING ACTIVITIES ON BEHALF OF WENTWORTH-DOUGLASS HOSPITAL. ALL FUNDRAISING EXPENSES ARE REPORTED ON THE FOUNDATION'S SEPARATE FORM 990. | FORM 990, PART IX, COLUMN D |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| WENTWORTH-DOUGLASS PHYSICIAN CORPORATION | ||||||||||
| 789 CENTRAL AVENUE | DOVER | NH | 03820 | 020497927 | HEALTH CARE | NH | 501(C)(3) | 170(B)(1) (A)(III) | N/A | 1 |
| WENTWORTH-DOUGLASS HOSPITAL & HEALTH FOUNDATION | ||||||||||
| 789 CENTRAL AVENUE | DOVER | NH | 03820 | 510491062 | PHILANTHROPIC FUND RAISING & STEWARDSHIP | NH | 501(C)(3) | 509(A)(3) | N/A | 1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WENTWORTH-DOUGLASS COMMUNITY HEALTH CORPORATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 CENTRAL AVENUE | AddressLine1 |
| City | DOVER | City |
| State | NH | State |
| ZIP Code | 03820 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020399963 | EIN |
| Primary Activity | HEALTH FITNESS CENTER | PrimaryActivity |
| Legal Domicile State | NH | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | -76535 | ShareOfTotalIncome |
| Share Of EOY Assets | 11842875 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| WENTWORTH-DOUGLASS HOSPITAL & HEALTH FOUNDATION | ||
| C | 354119 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS HOSPITAL & HEALTH FOUNDATION | ||
| B | 68752 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS COMMUNITY HEALTH CORPORATION | ||
| A | 19739 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS COMMUNITY HEALTH CORPORATION | ||
| J | 144000 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS COMMUNITY HEALTH CORPORATION | ||
| N | 129679 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS COMMUNITY HEALTH CORPORATION | ||
| P | 83178 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS COMMUNITY HEALTH CORPORATION | ||
| Q | 482201 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS PHYSICIAN CORPORATION | ||
| P | 315586 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS PHYSICIAN CORPORATION | ||
| B | 16252278 | ACTUAL PER BOOKS |
| WENTWORTH-DOUGLASS PHYSICIAN CORPORATION | ||
| I | 2302562 | ACTUAL PER BOOKS |