FMH Wind-Down Company: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- FMH Wind-Down Company (EIN 02-0222131)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-09-21
- IRS object ID
- 201122649349300712
- Schema version
- 2009v1.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-09-21T11:27:29-07:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020222131 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRISBIE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FRIS | NameControl |
| Phone | 6033325211 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 WHITEHALL RD | AddressLine1 |
| City | ROCHESTER | City |
| State | NH | State |
| ZIP Code | 03867 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN A MARZINZIK | Name |
| Title | VP FINANCE, CFO | Title |
| Phone | 6033325211 | Phone |
| Date Signed | 2011-06-20 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN A MARZINZIK | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 WHITEHALL RD | AddressLine1 |
| City | ROCHESTER | City |
| State | NH | State |
| ZIP Code | 03867 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 146344640 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.frisbiehosiptal.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1941 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | To excel at caring for the community by providing safe, effective, equitable, timely healthcare services. We will ally ourselves with other community healcare providers to enhance our mutual ability to improve the heakth of our community and the quality of life for the people we serve. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1164 | TotalNbrEmployees |
| Total Nbr Volunteers | 82 | TotalNbrVolunteers |
| Total Gross UBI | 8400 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 133001026 | ProgramServiceRevenueCY |
| Investment Income Current Year | 910382 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 1258475 | OtherRevenueCurrentYear |
| Total Revenue Current Year | 135169883 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 61761379 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 120443 | TotalFundrsngExpCurrentYear |
| Other Expenses Current Year | 69466445 | OtherExpensesCurrentYear |
| Total Expenses Current Year | 131227824 | TotalExpensesCurrentYear |
| Revenues Less Expenses CY | 3942059 | RevenuesLessExpensesCY |
| Total Assets BOY | 130619891 | TotalAssetsBOY |
| Total Assets EOY | 130821436 | TotalAssetsEOY |
| Total Liabilities BOY | 54503679 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 52048019 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 76116212 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 78773417 | NetAssetsOrFundBalancesEOY |
| Mission Description | To excel at caring for the community by providing safe, effective, equitable, timely healthcare services. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 118996621 | Expense |
| Revenue | 133001026 | Revenue |
| Description | FRISBIE MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL THAT CONTINUOSLY EVALUATES AND ADDRESSES THE COMPREHENSIVE HEALTHCARE NEEDS OF ROCHESTER, NH AND THE SURROUNDING COMMUNITIES. IN RESPONSE TO THESE HEALTHCARE NEEDS, THE HOSPITAL COORDINATES, DEVELOPS, AND PROVIDES HIGH QUALITY, AFFORADABLE, PREVENTATIVE, EDUACTIONAL, ACUTE AND CHRONIC CARE SERVICES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3204105 | Expense |
| Description | FRISBIE MEMORIAL HOSPITAL PROVIDED INCOMPENSATED CARE FOR THOSE IN NEED. FRISBIE RANKS AMOUNG THE TOP IN NEW HAMPSHIRE FOR THE MONEY VALUE OF CHARITY CARE PROVIDED TO PATIENTS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 448715 | Expense |
| Description | FRISBIE MEMORIAL HOSPITAL PRESENTED OR SPONSORED NUMEROUS COMMUNITY PROGRAMS WHICH ASSISTED WITH THE SPECIAL NEEDS OF OUR MOST VULNERABLE AT RISK POPULATION GROUPS. THESE PROGRAMS IMPROVED EDUCATION AND HEALTH AWARENESS IN THE COMMUNITY AND PROVIDED GREATER ACCESS TO HEALTH SERVICES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 122649441 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 44 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1164 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN A MARZINZIK | NamePerson |
| Telephone Number | 6033325211 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 WHITEHALL RD | AddressLine1 |
| City | ROCHESTER | City |
| State | NH | State |
| ZIP Code | 03867 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| JOSEPH BEHRE | |||||||||
| Trustee | 2.00 | X | |||||||
| MARILYN BERRY | |||||||||
| Trustee | 2.00 | X | |||||||
| JOHN BRITTON MD | |||||||||
| Trustee | 2.00 | X | |||||||
| JANET DAVIS | |||||||||
| Trustee | 2.00 | X | |||||||
| ROBERT HARRIGAN MD | |||||||||
| Trustee | 2.00 | X | |||||||
| MARK HOURIHANE | |||||||||
| Trustee | 2.00 | X | |||||||
| DAVID KEEFE | |||||||||
| Trustee | 2.00 | X | |||||||
| DAVIDPEARSON | |||||||||
| Trustee | 2.00 | X | |||||||
| RONALD POULIN | |||||||||
| Trustee | 2.00 | X | |||||||
| GREGORY SMITH | |||||||||
| Trustee | 2.00 | X | |||||||
| ROBERT STEELE | |||||||||
| Chairman | 3.00 | X | X | ||||||
| STEVEN POGGI | |||||||||
| Vice Chairman | 3.00 | X | X | ||||||
| PETER GOWELL | |||||||||
| Treasurer | 3.00 | X | X | ||||||
| GARY USHER MD | |||||||||
| Secretary | 3.00 | X | X | ||||||
| ALVIN FELGAR | |||||||||
| President, CEO | 40.00 | X | 388806 | 0 | 107550 | ||||
| JOHN MARZINZIK | |||||||||
| VP Finance, CEO | 40.00 | X | 241950 | 0 | 51930 | ||||
| MARY FLYNN | |||||||||
| Trustee | 2.00 | X | |||||||
| KAREN DUTCHER | |||||||||
| VP Patient Care | 40 | 183886 | 49394 | X | |||||
| DEBORAH SHIPMAN | |||||||||
| VP Ancillary Services | 40 | 168776 | 17091 | X | |||||
| CAROL THEMELIS | |||||||||
| VP Human Resources | 40 | 168696 | 52090 | X | |||||
| PAULA MAHONEY | |||||||||
| VP Physician Practices | 40 | 161081 | 42890 | X | |||||
| RALPH BROADWATER | |||||||||
| MD | 40 | 477708 | 15253 | X | |||||
| DAVID SHIN | |||||||||
| MD | 40 | 404677 | 20811 | X | |||||
| MICHAEL METZGER | |||||||||
| MD | 40 | 398924 | 25899 | X | |||||
| JAY BURNS | |||||||||
| MD | 40 | 396581 | 25478 | X | |||||
| SACHIN SAKSENA | |||||||||
| MD | 40 | 358742 | 25331 | X | |||||
| SARA STACEY | |||||||||
| DO, Former Medical Director | 40 | 332287 | 24819 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3682114 | TotalReportableCompFromOrg |
| Total Other Compensation | 458536 | TotalOtherCompensation |
| Number Individuals GT100 K | 36 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CROTHALL FACILITIES MGMT | |||||
| 13028 COLLECTIONS CTR | CHICAGO | IL | 60693 | Facilities Management | 2583141 |
| SURGICAL ASSOCIATES | |||||
| 21 WHITEHALL RD | ROCHESTER | NH | 03867 | Physician Practice | 1544870 |
| NH IMAGING | |||||
| 11 PILLSBURY ST | CONCORD | NH | 03301 | MRI/PET Imaging | 944127 |
| LABCORP OF AMERICA | |||||
| PO BOX 470 | PORTSMOUTH | NH | 03802 | LAboratory Services | 739498 |
| DARTMOUTH HITCHCOCK | |||||
| ONE MEDICAL CENTER DR | LEBANON | NH | 06756 | Oncology Services | 700210 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 20 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient Service Revenue | 900099 | 105645756 | 105645756 |
| Net Medicare/Medicaid | 900099 | 27355270 | 27355270 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 133001026 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 806580 | TotalRevenueColumn |
| Exclusion | $806,580 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 11278559 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 11174757 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 103802 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 103802 | TotalRevenueColumn |
| Exclusion | $103,802 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Misc Revenue | 900099 | 688939 | $688,939 |
| Cafeteria Income | 722210 | 411040 | $411,040 |
| Gift Shop Income | 453220 | 150096 | $150,096 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8400 | TotalRevenueColumn |
| Unrelated Business Revenue | 8400 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1258475 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 135169883 | TotalRevenueColumn |
| Related Or Exempt Function Income | 133001026 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 8400 | UnrelatedBusinessRevenue |
| Exclusion | $2,160,457 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1323291 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1323291 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48500108 | Total |
| Program Services | 47336243 | ProgramServices |
| Management And General | 1087978 | ManagementAndGeneral |
| Fundraising | 75887 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 973870 | Total |
| Program Services | 938954 | ProgramServices |
| Management And General | 32639 | ManagementAndGeneral |
| Fundraising | 2277 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7744033 | Total |
| Program Services | 7542431 | ProgramServices |
| Management And General | 189460 | ManagementAndGeneral |
| Fundraising | 12142 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3220077 | Total |
| Program Services | 3123799 | ProgramServices |
| Management And General | 90586 | ManagementAndGeneral |
| Fundraising | 5692 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 198559 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 198559 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71039 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 71039 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1067782 | Total |
| Program Services | 440212 | ProgramServices |
| Management And General | 625212 | ManagementAndGeneral |
| Fundraising | 2358 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4139364 | Total |
| Program Services | 3786797 | ProgramServices |
| Management And General | 352567 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17678 | Total |
| Program Services | 9653 | ProgramServices |
| Management And General | 7170 | ManagementAndGeneral |
| Fundraising | 855 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 163231 | Total |
| Program Services | 137784 | ProgramServices |
| Management And General | 25447 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1875296 | Total |
| Program Services | 1875296 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6101046 | Total |
| Program Services | 6101046 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Purchased Services | 12070132 | 10829968 | 1222935 | 17229 |
| Repair & Maintenance | 2143229 | 1565700 | 577529 | 0 |
| Provision for Bad Debt | 13538703 | 13538703 | 0 | 0 |
| Insurance | 1859404 | 0 | 1859404 | 0 |
| Misc | 816123 | 414429 | 401694 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25404859 | Total |
| Program Services | 25008426 | ProgramServices |
| Management And General | 392430 | ManagementAndGeneral |
| Fundraising | 4003 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131227824 | Total |
| Program Services | 122649441 | ProgramServices |
| Management And General | 8457940 | ManagementAndGeneral |
| Fundraising | 120443 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8953194 | BOY |
| EOY | 10935546 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14449220 | BOY |
| EOY | 13791942 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3230000 | BOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2761431 | BOY |
| EOY | 2831016 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 709311 | BOY |
| EOY | 2852023 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 126935375 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 57910209 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71548747 | BOY |
| EOY | 69025166 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20529342 | BOY |
| EOY | 17775720 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2388777 | BOY |
| EOY | 1445435 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6049869 | BOY |
| EOY | 12164588 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130619891 | BOY |
| EOY | 130821436 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11048345 | BOY |
| EOY | 14377384 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31505000 | BOY |
| EOY | 29835000 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5546249 | BOY |
| EOY | 1654603 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6404085 | BOY |
| EOY | 6181032 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54503679 | BOY |
| EOY | 52048019 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74351583 | BOY |
| EOY | 76999024 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41937 | BOY |
| EOY | 51701 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1722692 | BOY |
| EOY | 1722692 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76116212 | BOY |
| EOY | 78773417 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130619891 | BOY |
| EOY | 130821436 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Public Support Total170 | 0 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Pertcentage170 | 0 | PublicSupportPertcentage170 |
| Public Support Total509 | 0 | PublicSupportTotal509 |
| Public Support Percentage509 | 0 | PublicSupportPercentage509 |
| Investment Income Percentage | 0 | InvestmentIncomePercentage |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $4,950 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 4950 | TotalLobbyingExpendituresIIB |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Pt II-B Line 1i | Identifier |
| Explanation | Lobbying portion of hospital association dues. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 23618029 | BeginningOfYearBalance |
| Contributions | 13042 | Contributions |
| Investment Earnings Or Losses | 2001449 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 100000 | GrantsOrScholarships |
| End Of Year Balance | 25532520 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 27248420 | BeginningOfYearBalance |
| Contributions | 24976 | Contributions |
| Investment Earnings Or Losses | 197883 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 100000 | GrantsOrScholarships |
| Other Expenditures | 3753250 | OtherExpenditures |
| End Of Year Balance | 23618029 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.93000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.07000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 181776 | OtherCostOrOtherBasis |
| Book Value | 181776 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 70782015 | OtherCostOrOtherBasis |
| Depreciation | 19126335 | Depreciation |
| Book Value | 51655680 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3146667 | OtherCostOrOtherBasis |
| Depreciation | 1315394 | Depreciation |
| Book Value | 1831273 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 37805586 | OtherCostOrOtherBasis |
| Depreciation | 27534372 | Depreciation |
| Book Value | 10271214 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15019331 | OtherCostOrOtherBasis |
| Depreciation | 9934108 | Depreciation |
| Book Value | 5085223 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 69025166 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Hedge Funds | Description |
| Book Value | 1445435 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1445435 | TotalOfBookValueSecurities |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Other Assets | 3233702 |
| Deferred Finance Costs | 622034 |
| Investment in Affiliates | 2164100 |
| Collateralization of Interest Rate Swap | 6144752 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 12164588 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Interest Rate Swap | $5,733,083 |
| Estimated Third Party Settlement | $447,949 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 6181032 | TotalOfAmounts |
| Total Revenue | 135169883 | TotalRevenue |
| Total Expenses | 131227824 | TotalExpenses |
| Excess Or Deficit For Year | 3942059 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -539871 | NetUnrealizedGLOnInvestments |
| Other | -$754,747 | OtherAmount |
| Total Adjustments | -1294618 | TotalAdjustments |
| Excess Or Deficit Per FS | 2647441 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 136163199 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 851402 | NetUnrealizedGainsInvestments |
| Other Revenues | 141914 | OtherRevenues |
| Revenue Not Rptd F990 | 993316 | RevenueNotRptdF990 |
| Revenue Subtotal | 135169883 | RevenueSubtotal |
| Total Revenue Per Form990 | 135169883 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 132729556 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 1501732 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 1501732 | ExpensesNotRptdF990 |
| Expenses Subtotal | 131227824 | ExpensesSubtotal |
| Total Expenses Per Form990 | 131227824 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt V Line 4 | To further the hospital's charitable mission |
| Pt XII Line 2d | Net assets released from restriction |
| Pt XIII Line 2d | See supporting statement See Supporting statement |
| Pt XI Line 8 | See Supporting statement |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 0.00000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3204105 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3204105 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02440 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12507850 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5391870 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7115980 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05680 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15711955 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5391870 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10320085 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08120 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 448715 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 448715 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 204000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 204000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1489571 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1025457 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 464114 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 159100 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 159100 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2301386 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1025457 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1275929 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00970 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18013341 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6417327 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11596014 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09090 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $6,769,352 | BadDebtExpenseAmount |
| Amount Attributable To | 676935 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 23178953 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 33971546 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -10792593 | MedicareSurplusOrShortfall |
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRISBIE MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 WHITEHALL RD | AddressLine1 |
| City | ROCHESTER | City |
| State | NH | State |
| ZIP Code | 03867 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | Geropsychiatric Unit | Other |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | ORGANIZATION USES 300% FPG TO DETERMINE ELIGIBILITY | IncomeBasedCriteria |
| Bad Debt Footnote | FINANCIAL STATEMENT FOOTNOTE: PATIENT ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT MANAGEMENTEXPECTS TO COLLECT FROM OUTATANDING BALANCES. | BadDebtFootnote |
| Debt Collection Policy | COLLECTION POLICY PROVIDES FOR ACCOUNTS KNOWN TO QUALIFY FOR FREE CARE TO BE REMOVED FROM TRANSFER TO AN OUTSIDE AGENCY FOR FURTHER COLLECTION ACTIVITY | DebtCollectionPolicy |
| Needs Assessment | FRISBIE MEMORIAL HOSPITAL CONDUCTS A COMMUNITY NEEDS ASSESSMENT EVERY FIVE YEARS, THE MOST RECENT COMPLETED IN 2008. FMH WORKED WITH CRESENDO CONSULTING GROUP TO BRING TOGETHER HEALTHCARE AND PUBLIC SERVICE STAKEHOLDERS, COLLECTING QUANTITATIVE AND QUALITATIVE DATA. | NeedsAssessment |
| Patient Education Assistance | FMH TAKES AN ACTIVE ROLE IN ASSISTING PATIENTS WHOM MAY QUALIFY FOR FINANCIAL ASSISTANCE UNDER FEDERAL, STATE, LOCAL GOVERNMENT UNDER THE ORGANIZATION'S OWN CHARITY CARE POLICY. | PatientEducationAssistance |
| Community Information | FMH'S PSA IS URBAN CONSISTING OF NORTHERN STAFFORD, NH AND WESTERN YORK, ME COUNTIES. POPULATION SERVED IS OVER 70,000 WITHA MEDIUM INCOME OF $47,626 AND 4.7% OF COMMUNITY RESIDENTS LIVING BELOW THE FEDERAL POVERTY GUIDELINES. | CommunityInformation |
| Reports Filed With States | NH | ReportsFiledWithStates |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AVIS GOODWIN COMM HEALTH | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 652F CENTRAL AVE | AddressLine1 |
| City | DOVER | City |
| State | NH | State |
| ZIP Code | 03820 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 020204203 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 100000 | AmountOfCashGrant |
| Purpose Of Grant | Primary Care funding | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Pt I Line 2 | Identifier |
| Explanation | Avis Goodwin submits financial statements for review to demonstrate need for outside help in meeting operating expenses. Avis Goodwin serves a high number of uninsured patients, payment for which is based on ability to pay. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|
| ALVIN FELGAR | ||||
| 338806 | 50000 | 87093 | 20457 | 496356 |
| JOHN MARZINZIK | ||||
| 211950 | 30000 | 31653 | 20277 | 293880 |
| KAREN DUTCHER | ||||
| 168386 | 15500 | 39592 | 9802 | 233280 |
| DEBORAH SHIPMAN | ||||
| 156276 | 12500 | 17091 | 185867 | |
| CAROL THEMELIS | ||||
| 156196 | 12500 | 42327 | 9763 | 220786 |
| PAULA MAHONEY | ||||
| 148581 | 12500 | 25799 | 17091 | 203971 |
| RALPH BROADWATER | ||||
| 301795 | 175913 | 5088 | 10165 | 492961 |
| DAVID SHIN | ||||
| 404077 | 600 | 20811 | 425488 | |
| MICHAEL METZGER | ||||
| 398324 | 600 | 5088 | 20811 | 424823 |
| JAY BURNS | ||||
| 221631 | 174950 | 4667 | 20811 | 422059 |
| SACHIN SAKSENA | ||||
| 358142 | 600 | 5088 | 20243 | 384073 |
| SARA STACEY | ||||
| 331687 | 600 | 4542 | 20277 | 357106 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| NHHEFA | ||||||
| 020279866 | 644614KT5 | 2005-03-04 | 10650000 | Refunding Series 2003 Bonda | false | false |
| NHHEFA | ||||||
| 020279866 | 644614QD4 | 2006-07-27 | 25000000 | Building Construction | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount DefeasedAmountDefeased | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capital ExpendituresCapitalExpenditures |
|---|---|---|---|---|---|---|---|---|
| 10650000 | 10385167 | 270950 | 2005 | true | false | true | true | |
| 25000000 | 386805 | 2008 | true | false | true | true | 24613195 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|
| false | false | false | false | true | true |
| false | false | false | false | true | true |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|
| false | false | false | false | false | false | false |
| false | false | false | false | false | false | false |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| JOHN BRITTON MD | |||
| Trustee | 1544870 | Subsidy | false |
| JOHN BRITTON MD | |||
| Trustee | -1254628 | Assignment of AR | true |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt VI-B, Line 11A | The form 990 is presented to the Board Audit Committee and key financial employees prior to filing, members are provided with a copy of the Form 990 prior to the committee meeting |
| Pt VI-B, Line 12c | In accordance with the writted conflict of interest policy the office of the Presidant annually secures a signed copy of the Trustee/Officer Conflict of interest statement and maintains on file. |
| Pt VI-B, Line 15 | Each year the executive compensation committee comprised of four members of the FMH Board reviews the hospital CEO performance and compensation. Senior manangement compensation is also reviewed by the committee, but compensation is determined by the CEO. The VP of Human Resources presents the compensation committee with comparative salary and benefit data. |
| Pt VI-C, Line 19 | The Bylaws of Frisbie Memorial Hospital, Conflict of Interest Policy, and audited financial statements are not pubically published, however these documents are available for public inspection upon request. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRISBIE FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 WHITEHALL RD | AddressLine1 |
| City | ROCHESTER | City |
| State | NH | State |
| ZIP Code | 03867 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020465942 | EIN |
| Primary Activities | Coordinate Funds raised for hospital | PrimaryActivities |
| Legal Domicile State | NH | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 11 | PublicCharityStatus |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEACOAST BUSINESS & HEALTH | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 396 HIGH ST SUITE 1 | AddressLine1 |
| City | SOMERSWORTH | City |
| State | NH | State |
| ZIP Code | 03878 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020375898 | EIN |
| Primary Activity | Outpatient Healthcare | PrimaryActivity |
| Legal Domicile State | NH | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 190394 | ShareOfTotalIncome |
| Share Of EOY Assets | 1051756 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| FRISBIE FOUNDATION | |
| j | 2370774 |
| FRISBIE FOUNDATION | |
| p | 131200 |