2024-07-18T09:56:30-05:00 2023-09-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2022-10-01 020222118 Valley Regional Hospital Inc VALL 6035427771 243 Elm Street Claremont NH 03743 Celeste Pitts Interim CFO 6035427771 2024-07-17 1 Celeste Pitts 999009999 1 Melissa Magoon CPA P01712842 2077752387 2024-07-17 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Jocelyn Caple 243 Elm Street Claremont NH 03743 65669876 0 X www.vrh.org X 1893 NH Critical Access Hospital 14 12 435 13 0 0 2693251 481992 55397090 63971940 3891469 964141 90130 13727 62071940 65431800 0 0 0 0 26352401 28728130 0 0 0 27978256 33322142 54330657 62050272 7741283 3381528 66016739 72533242 23687768 24129421 42328971 48403821 X The mission of Valley Regional Hospital, Inc. is to improve community health, patient experience, and value. Our vision is to partner with the community to optimize health by ensuring access to high value health care. 0 0 51415751 63971940 Valley Regional Hospital is a provider of health services with facilities in the Claremont, NH area. The Hospital grants credit to patients, substantially all of whom are local residents.The Hospital also provides care to patients who meet certain criteria under its Financial Assistance policy without charge or at amounts less than its established rates. The Hospital does not pursue collection of amounts determined to qualify as financially-assisted care.The Hospital maintains records to identify and monitor the level of financially-assisted care it provides. For the year ending September 30, 2023 charges forgone for services and supplies furnished under the charity care policy were approximately $511,000. The estimated cost of those services and supplies was approximately $318,000.In addition, the Hospital provides a number of other services to benefit certain poor and elderly patients. Medicaid and state programs do not cover the full cost of the Hospital incurred cost of providingmedical care to patients. The hospital provides services to residents throughout the region. Those services include health evaluations, screenings, and flu vaccine administration at community events and in the workplace. Health education, wellness, chronic disease management, fitness, and ergonomic programs are also widely offered. For these services, and many other community services, the hospital receives little or no payment.Other community benefits can't be quantified or assigned a value. For example, the hospital provides committee and board participants and expertise to address community needs; to support community health initiatives; to advocate for and support individuals who are socially, economically and physically challenged; and to collaborate with the local public safety organizations. 51415751 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 63 0 1 435 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 NH X Celeste Pitts 6035427771 243 Elm Street Claremont NH 03743 Patricia Putnam Chair 0.90 0.10 X X 0 0 0 Terri Decker Vice Chair 0.90 0.10 X X 0 0 0 Lisa Richmond Treasurer 0.90 0.10 X X 0 0 0 Bryan Huot Secretary 0.90 0.10 X X 0 0 0 James Borchert Trustee 0.90 0.10 X 0 0 0 Scott Bouranis Trustee 0.90 0.10 X 0 0 0 Eric Crainich Trustee 0.90 0.10 X 0 0 0 Michael Fuerst Trustee 0.90 0.10 X 0 0 0 Katherine Lajoie Trustee 0.90 0.10 X 0 0 0 Alex Scott Trustee 0.90 0.10 X 0 0 0 Samuel Shields Trustee 0.90 0.10 X 0 0 0 Tom Sullivan Trustee 0.90 0.10 X 0 0 0 Jocelyn Caple MD Interim President & CEO 38.40 1.60 X X 0 421499 0 Juliann Barrett DO Co-CMO 39.90 0.10 X 311703 0 7944 Gailyn Thomas MD Past Trustee 19.90 0.10 X 194633 0 0 Cynthia L Burr Past Trustee 0.90 0.10 X 0 0 0 Steve Gordon Past Interim CEO 38.40 1.60 X X 0 0 0 Jean Shaw Past CFO 37.20 2.80 X 0 178428 41390 Joshua Rudner Co-CMO 24.00 0.00 X 323752 0 18377 Thomas Marks Physician 40.00 0.00 X 613795 0 0 Charles M Sawyer Physician 24.00 0.00 X 379049 0 19685 Jeffrey A Hanissian Physician 36.00 0.00 X 370108 0 43226 Fernanda Magalhaes De Melo Manara M Physician 40.00 0.00 X 334568 0 33326 Joel P Herrington Physician 28.00 0.00 X 329260 0 32757 2856868 599927 196705 39 0 1 1 American Healthcare Services Association PO Box 670529 Dallas TX 752670529 Contracted Staffing 3436491 Dartmouth Hitchcock Clinic One Medical Center Drive Lebanon NH 037560000 Medical Services 1681020 Triage LLC PO Box 773328 Chicago IL 606773328 Contracted Staffing 747494 EM Staff 36 Coventry Road Concord NH 03301 Contracted Staffing 417342 Amnesia Anesthesia PO Box 1362 Claremont NH 03743 Medical Services 387832 11 481992 481992 Patient Service Revenue 622110 92816436 92816436 Medicaid DSH Revenue 622110 3355810 3355810 Other Revenue 622110 1131607 970226 161381 Charity/Contractual Adjustment 622110 -33331913 -33331913 63971940 1035580 1035580 36320 22593 13727 13727 13727 95606 48438 123496 91987 -27890 -43549 -71439 -71439 65431800 63810559 0 1139249 X 856409 856409 21798420 19020071 2778349 244925 216610 28315 4266419 3796083 470336 1561957 1390198 171759 343830 343830 57588 32661 24927 150061 150061 14892810 11346398 3546412 200 200 1154797 948866 205931 944730 799110 145620 2882725 1656503 1226222 11406 10591 815 91968 65704 26264 808558 678872 129686 971439 2002 969437 Medical Supplies 7608870 7552729 56141 Medicaid Enhancement Ta 2879059 2879059 Miscellaneous 400650 133292 267358 Dues & Subscriptions 123451 30393 93058 62050272 51415751 10634521 0 X 485322 208547 20288504 18357053 3758691 5648979 1013838 1168455 388122 566847 9691658 3011455 4572999 6680203 27835459 30445712 4461628 5147651 0 885003 3212176 3424792 66016739 72533242 6793531 7406673 123518 121623 16770719 16601125 23687768 24129421 X 35835853 41050735 6493118 7353086 42328971 48403821 66016739 72533242 X 3381528 2007299 686023 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 12104 12104 0 Part II-B, Line 1: The Organization pays dues to local associations, a portion of which are attributable to lobbying activities. 6314371 941032 83947 7171456 7279159 -891253 73535 6314371 6058402 1287893 67136 7279159 5895100 163302 6058402 5990786 -94455 1231 5895100 0.00000 0.75320 0.24680 0 0 250667 250667 671829 307984 363845 3116744 502936 2613808 4764448 2190984 2573464 887970 9551 878419 6680203 Beneficial Interest in Perpetual Trusts 5147651 F 5147651 Due To Affiliates 17354 Estimated Third-Party Payor Settlements 14785898 Reserve for Self-Funded Insurance 912870 Lease Liabilities 885003 16601125 Part V, Line 4: The Organization uses its endowment funds in support of health care services, purchases of equipment, health education, and indigent care. 1 1 X 1 X 1 X 275.000000000000 1 1 1 0 1 1 3197335 1341237 1856098 0.02990 9977800 6422157 3555643 0.05730 13175135 7763394 5411741 0.08720 1484 632717 632717 0.01020 37458 37458 0.00060 7257 7257 0.00010 1484 677432 677432 0.01090 1484 13852567 7763394 6089173 0.09810 3250 3250 0.00010 81 81 0.00000 326 326 0.00000 6686 6686 0.00010 27598 27598 0.00040 37941 37941 0.00060 1 0 0 28295017 28314966 -19949 X 1 1 1 1 Valley Regional Hospital Inc 243 Elm Street Claremont NH 03743 www.vrh.org 00007 X X X X Valley Regional Hospital Inc 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X https://vrh.org/public-reports/ X X 1 20 1 https://vrh.org/public-reports/ 0 1 X 200.000000000000 275.000000000000 X X X X 1 1 X X X 1 X https://vrh.org/patients-visitors/patient-billing/financial-assistance/ X https://vrh.org/patients-visitors/patient-billing/financial-assistance/ X https://vrh.org/patients-visitors/patient-billing/financial-assistance/ X X X X X 1 X 0 X 1 X 0 0 Valley Regional Hospital, Inc. Part V, Section B, Line 5: During the period February through July 2021, Valley Regional Hospital conducted a Community Health Needs Assessment of its service area, in partnership with New London Hospital, Alice Peck Day Memorial Hospital, Dartmouth-Hitchcock, Mt. Ascutney Hospital and Health Center, Visiting Nurse and Hospice of VT & NH, Lake Sunapee Region VNA & Hospice, and the NH Community Health Institute.Information gathering utilized in the assessment included the following:1. Surveys received from 569 community residents from all 15 towns, made available on-line and paper surveys placed in numerous locations throughout the region;2. Series of 10 community discussion groups;3. Summary information associated with over 2,000 primary care patient assessments, collected from 2019-2021, identifying gaps in social determinants of health, which could impact medical health outcomes. 4. Direct email survey with 207 responding stakeholders and community leaders representing multiple community sectors, including:- Derek Ferland, Sullivan County Manager- Nancy Merrill, Claremont City Planner- Elyse Crossman, ED, Claremont Chamber of Commerce- Sally Bouchard, ED, Sullivan County Oral Health Collaborative- Ted Purdy, Sullivan County Healthcare- Deborah Mozden, ED, Turning Points Network- Mark Brislin, Claremont Community Center- Mark Mills, CEO, Pathways of the River Valley- Ed Morris, Claremont City Manager- Charlene Lovett, Claremont City Mayor- Courtney Porter, Claremont School District- Brendan Minnihan, Superintendent SAU #43- Ella Casey, ED, Newport Chamber of Commerce- Jim Culhane, CEO, Lake Sunapee Visiting Nurse & Hospice- Sue Ellen Griffin, CEO, West Central Behavioral Health- Stephanie Slayton, ED, TLC Family Center- PJ Lovely, Newport Recreation Department- Taralyn Belaski, Sullivan County Public Health Network- Denise Liveston, President, Claremont Senior Center- Dale Girard, President, Golden Cross Ambulance Service Valley Regional Hospital, Inc. Part V, Section B, Line 6a: Due to significant overlap in service area, Valley Regional Hospital partnered with the following hospitals to identify both regional and community-specific needs for the community health needs assessment: - New London Hospital - Alice Peck Day Memorial Hospital, - Dartmouth-Hitchcock Medical Center, - Mt. Ascutney Hospital and Health CenterThere is significant overlap in service area among these organizations; the CHNA identified both regional and community-specific needs. Valley Regional Hospital, Inc. Part V, Section B, Line 6b: Due to significant overlap in service area, Valley Regional Hospital partnered with the following organizations to identify both regional and community-specific needs for the community health needs assessment: - Visiting Nurse and Hospice for VT and NH- Lake Sunapee VNA & Hospice- New Hampshire Community Health InstituteThere is significant overlap in service area among these organizations; the CHNA identified both regional and community-specific needs. Valley Regional Hospital, Inc. Part V, Section B, Line 7d: The CHNA was widely distributed in traditional ways (hard copy mailings, website, social media links, paper copy handouts at community meetings, etc.) as well as distributed through COVID-19 vaccination clinics and primary care practices. Valley Regional Hospital, Inc. Part V, Section B, Line 11: CHNA Implementation StrategyThe diverse community issues identified through the assessment process far exceed the ability of a single entity to solve the issues; however, Valley Regional is committed to being an active partner in determining ways to address all of the identified issues, in collaboration with many other local nonprofit groups and community leaders.1. Availability of Mental Health Services:a. VRH will seek private and public funding sources to launch a hospital-wide integrative model of mental & medical health care, within its primary care, emergency and in-patient departments.b. VRH will enhance their primary care staff with providers who specialize in the care of patients with mental health challenges.c. VRH will hire additional emergency department staff to provide mental health triage assessment, medication reconciliation, and assistance with Social Determinants of Health factors.d. VRH will utilize collaborations with local mental health programs and providers to assist with the referral process and provide on-site care when appropriate.e. Patients facing mental health challenges seen in the primary care setting will benefit from an onsite social worker and community health navigator to assist with areas of life that may be contributing to a decline in health.f. VRH staff will complete training opportunities to enhance compassionate treatment and care for patients entering VRH service areas.2. Cost of Health Care Services, Affordability of Health Insurance: a. VRH will increase its team of primary care providers to address the availability of appointments for community members. b. Patients will be made aware of new providers and health savings options in a timely manner. c. Patients will be presented with health care options, community supports and financial assistance options by the Community Health Navigator, Social Workers & Case Managers in the primary care practices, and Emergency and Med/Surg Departments.d. Indigent patients will be provided with information about VRH's Medication Assistance Program, providing discounted or free medications from pharmaceutical companies. 3. Alcohol and Drug Use Prevention, Treatment and Recovery:a. VRH will seek private and public funding sources to launch a hospital-wide integrative model of mental & medical health care, with a component addressing SUD, within its primary care, emergency and in-patient departments.b. VRH staff will complete training opportunities to enhance compassionate treatment and care for patients entering VRH service areas.c. Patients facing mental health challenges seen in the primary care setting will benefit from an onsite social worker and community health navigator to assist with factors of life that may be contributing to a decline in health.d. VRH will hire additional primary care staff, who specialize in the care of patients with SUD and mental health challenges. e. VRH will hire additional emergency department staff to provide mental health triage assessment, medication reconciliation, and assistance with Social Determinants of Health factors. f. VRH will utilize collaborations with local mental health programs and providers to assist with the referral process and provide on-site care when appropriate.4. Socio-economic conditions affecting health and well-being, such as housing affordability, access to healthy foods and affordable, dependable childcare:a. Address factors in a patient's life that could contribute to a decline in healthy living at the time of their medical appointments. b. Patients will be referred to community organizations and resources, as well as given assistance in completing necessary applications by the Community Health Navigator & Social Workers.c. Provide up-to-date information to the key patient providers of community resources.d. Provide primary care patients a resource for fruit and veggie purchases when indicating a positive food insecurity on the patient assessment form.5. Availability and Affordability of Dental Care:a. Continue VRH's longstanding collaboration with Sullivan County Oral Health Collaborative, which operates the community's only nonprofit dental center. b. Providers will have up-to-date information of local oral health services and referrals options to provide patients. c. Patients experiencing immediate dental needs will be triaged within primary care, urgent care and the emergency department, as care and complexity demands, with referrals made to local dental resources.6. Prevent Child Abuse and Neglect: a. Patients will be asked and surveyed for abuse and violence in the home as part of routine screenings. Appropriate referrals will occur to BEAS, CDYF and TPN. b. Local organizations will provide referral resources that can be accessed in private bathrooms and within patient care rooms.c. Local organizations will benefit from collaboration and partnership with VRH in their missions to support survivors of violence and neglect.d. VRH staff will participate in "trauma-informed" training opportunities across all departments providing healthcare services to patients. Valley Regional Hospital, Inc. Part V, Section B, Line 20e: Applications are offered to all self-pay patients along with education regarding Medicaid. 1 1 - Kane Oncology Center 243 Elm Street Claremont NH 03743 Oncology Center Part I, Line 3c: It is the policy of Valley Regional Hospital to provide financial assistance to those patients who are unable to pay for all or part of the cost of their care that is not covered by other sources of funding. Valley Regional Hospital's Financial Assistance Program is a program that assists uninsured and under-insured patients who meet specific income, geographical and Valley Regional Hospital guidelines.The Hospital will cover up to 100% of the cost of care for patients depending on the patient's level of income and family size. The Hospital also is a participating provider with the NH Health Access Network. Part I, Line 7: The Organization used an overall cost to charge ratio for lines 7a and 7b. Amounts listed on lines 7e, 7f and 7i were derived from internal financial/cost accounting systems. Part II, Community Building Activities: Valley Regional Healthcare believes the skills and knowledge of its employees are the most critical assets to building a strong and healthy community. VRH employees participate on a wide variety of local boards serving or participating in health and wellness missions, including dental health, domestic violence, higher education, school boards, chambers of commerce, public transportation, elder health, and substance abuse. Employees also participate on state level boards and within elected government, working to improve policy and practice on a broad spectrum.Local businesses rely upon collaborations with VRH to provide education and expertise in community building activities such as through public and private health fairs. VRH takes advantage of public chamber activities to provide tables of health information and free screening activities. VRH also provides financial support for non-profit organizations with complementary missions, in the form of event sponsorships. Part III, Line 4: Please refer to pages 9-13 and page 17 of the attached audited financial statements. Part III, Line 8: Medicare costs approximate Medicare revenue. Any shortfalls should be considered community benefits. Part III, Line 9b: Patients who are known to qualify for financial assistance file a financial assistance determination application with the Hospital. If the application is approved, the patient's account shall be written off, in accordance to the level of adjustment the applicant was qualified to receive. The patient write-off guidelines are as follows:1. The determination is valid for 6 months from the date of signature for all applications except those individuals who demonstrate that they are on a fixed income (i.e. Social Security, retirment, disability), in which case approval is for 1 year from the date of signature.2. Patient qualifies according to the established Financial Assistance income guidelines3. Account notes must indicate what payor that the balance is due to (appropriate payor write-off codes to be utilized). Part VI, Line 2: The purpose of the assessment was to identify community health concerns, priorities and opportunities for community health and health care delivery systems improvement. In collaboration with The Community Health Institute/JSI and our partner hospitals, key healthcare, public service and community member stakeholders were engaged to collect and analyze qualitative and quantitative data.The CHNA provides a clear blueprint for community outreach and collaboration opportunities, and also creates a timely benchmark against which to measure progress.The purpose of the research design was as follows:1. To clearly define the VRH service area2. To define measurement methodologies which can identify community needs3. To create a prioritized list of community resources4. To develop a catalogue of available healthcare resourcesThe following health issues were identified by survey respondents:1. Availability of Mental Health Services 2. Cost of Health Care Services, Affordability of Health Insurance 3. Alcohol and Drug Use Prevention, Treatment and Recovery:4. Socio-economic conditions affecting health and well-being, such as housing affordability, access to healthy foods and affordable, dependable childcare 5. Availability and Affordability of Dental Care 6. Prevent Child Abuse and Neglect Part VI, Line 3: The Community Engagement department has created and posted signage throughout the hospital and clinics, and has posted information on the hospital's website. Part VI, Line 4: Valley Regional serves a rural region which includes the 15 towns of Sullivan County and portions of eastern Vermont, with a total resident population of 43,104. Spanning 552 square miles, the County is the 2nd least populated in NH. 16.6% of Sullivan County children live below 100% of the Federal Poverty level, with four communities with child poverty estimates over 20%: Croydon (24%), Claremont (26%), Cornish (27%) and Langdon (42%). Just over 6% of residents have no access to a vehicle within their home environment. Community members of all ages have at least one form of disability, with 5.1% under the age of 18; 10.6% between age 18 and 64; and, 30.4% over the age of 65. Part VI, Line 5: Valley Regional Healthcare recognizes its importance to the community - economically, as one of the largest local employers, and philosophically, as a large entity entrusted with community wellness. VRH leadership instills in employees the sense of responsibility to be involved in support of the community, on behalf of the hospital.VRH employees participate and lend expertise as board members of other non-profits, including those focused on dental health, community revitalization, higher education and school boards, elder issues, public transportation, domestic violence, substance misuse and abuse, and health and wellness initiatives. Employees also participate on state and Federal boards and committees as well as Chambers of Commerce and United Way, working to improve policy and practice in healthcare delivery.Business collaborations are a priority, particularly with large employers such as Claremont Parks and Recreation, Whelen Engineering, River Valley Technical Center, Claremont Savings Bank, National Field Representatives, Sturm Ruger, Red River and The City of Claremont. Our common goals include health education, health screenings, worker safety and employment opportunities. Part VI, Line 6: Valley Regional Hospital is not affiliated with another healthcare system, but it collaborates voluntarily with other hospitals. Sharing resources, both material and human, participating in community groups, providing sponsorships to other non-profits whose missions are aligned, contributing to disaster and international relief efforts, partnering with the American Red Cross for blood drives - all these things represent community benefits. Our physicians and other providers offer free wellness programming at locations throughout the communities we serve - at senior centers, schools, recreation venues.Valley Regional Hospital has entered into a letter of intent for affiliation with Dartmouth-Hitchcock Medical Center. Part VI, Line 7, Reports Filed With States NH 0 0 0 0 0 0 0 1 0 Thomas Marks Physician 609231 0 0 0 4564 0 0 0 0 0 613795 0 0 0 Jocelyn Caple MD Interim President & CEO 0 421499 0 0 0 0 0 0 0 0 0 421499 0 0 Jeffrey A Hanissian Physician 361272 0 0 0 8836 0 5800 0 37426 0 413334 0 0 0 Charles M Sawyer Physician 368597 0 0 0 10452 0 5800 0 13885 0 398734 0 0 0 Fernanda Magalhaes De Melo Manara M Physician 269070 0 65274 0 224 0 0 0 33326 0 367894 0 0 0 Joel P Herrington Physician 313581 0 10000 0 5679 0 5800 0 26957 0 362017 0 0 0 Joshua Rudner Co-CMO 311075 0 10000 0 2677 0 5800 0 12577 0 342129 0 0 0 Juliann Barrett DO Co-CMO 284220 0 15000 0 12483 0 6843 0 1101 0 319647 0 0 0 Jean Shaw Past CFO 0 177768 0 0 0 660 0 4467 0 36923 0 219818 0 0 Gailyn Thomas MD Past Trustee 194633 0 0 0 0 0 0 0 0 0 194633 0 0 0 Part I, Line 3 Valley Regional Healthcare, Inc., a related organization, establishes the compensation for the Organization's CEO. Valley Regional Healthcare, Inc. uses a variety of resources to establish compensation as follows: 1. Written employment contract 2. Compensation survey/study 3. Approval by the board/compensation committee Part I, Line 7 Individuals listed with Incentive Bonus amounts are physicians who under their employment agreements/contracts have a provision for Incentive Bonuses based on Quality, Patient Satisfaction and Relative Value Units (RVUs) of services exceeding a target amount. Form 990, Part VII, line 5: Jocelyn F. Caple, Interim President & CEO, is paid by Mary Hitchcock Memorial Hospital, an unrelated organization via a professional services agreement. During calendar year 2022, Valley Regional Healthcare paid Mary Hitchcock Memorial Hospital $421,499 for services rendered to Valley Regional Healthcare. The actual compensation paid to Ms. Caple by Mary Hitchcock Memorial Hospital is not known to the Organization. As such, pursuant to the Form 990 instructions, the Organization is reporting the amount paid for services rendered as compensation to Ms. Caple, and is reporting this amount on Form 990, Part VII, Column E. Gailyn Thomas, Trustee, is a contracted physician paid through Mary Hitchcock Memorial Hospital, an unrelated organization, for services rendered to Valley Regional Hospital. During calendar year 2022, Valley Regional Hospital paid Mary Hitchcock Memorial Hospital $194,633 for services rendered to Valley Regional Hospital. The actual compensation paid to Dr. Thomas by Mary Hitchcock Memorial Hospital is not known to the Hospital. As such, pursuant to the Form 990 instructions, the Hospital is reporting the amount paid for services rendered as compensation to Dr. Thomas, and is reporting this amount on Form 990, Part VII, Column D. Dr. Thomas resigned from the Valley Regional Hospital Board on October 11, 2022. Form 990, Part VI, Section A, line 6 The sole member of the Organization is Valley Regional Healthcare, Inc. Form 990, Part VI, Section A, line 7a The Organization's directors are nominated and elected by the Organization's member at the annual meeting of the Corporation. Form 990, Part VI, Section A, line 7b The following actions and undertakings involving the business of the Organization are subject to the ratification by the member: adoption of operating budget; adoption of capital budgets; adoption of strategic plans; initiation of significant fund-raising activities; implementation of institutional affiliations, mergers, consolidations or other reorganizations; material modification of service and business offerings; material acquisitions or dispositions of assets; changes in certified public accountants, fiscal year or material accounting practices; incurrence of material indebtedness; material changes in insurance programs and arrangements; material changes in employee benefits plans; adoption of quality improvements plans; election of directors; selection of the president/CEO; amendment of the Organization's bylaws; and amendment of the articles of association. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the CFO and a full copy is shared and reviewed with the CEO and the Finance Committee members. The Finance Committee members are given an opportunity for comment prior to filing. The review is conducted by the CFO. Form 990, Part VI, Section B, line 12c The Risk & Compliance Office requires annual review of the conflict of interest policy. All Officers, Directors, Trustees, and Key Employees must sign an acknowledgment of the policy and disclose any interests that could give rise to conflicts. The signed forms are held in the following locations: Officers and Trustees - Executive Assistant office Directors and Key Employees - In the Elsevier Human Resources system Contracted Services - within or alongside any contract in the corresponding administration or materials area Form 990, Part VI, Section B, line 15 The executive committee of the board of trustees convenes two to four times annually to review the compensation of the CEO. Regional compensation of like-sized organizations are used. The amount of compensation shall be reviewed by the D-H independent compensation consultant for purposes of determining compliance with the rebuttable presumption, if necessary. The CEO compensation is tied to the strategic planning goals of the Organization. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part IX, line 11g Physician Fees: Program service expenses 2,893,832. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,893,832. Purchased Services: Program service expenses 8,426,075. Management and general expenses 2,834,650. Fundraising expenses 0. Total expenses 11,260,725. Other Professional Fees: Program service expenses 26,491. Management and general expenses 711,762. Fundraising expenses 0. Total expenses 738,253. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Valley Regional Hospital, Inc. 243 Elm Street Claremont, NH 03743 EIN: 02-0222118 Valley Regional Hospital, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Net Gain of Beneficial Interest In Perpetual Trust 686,023. Valley Regional Healthcare Inc 243 Elm Street Claremont NH 03743 020397338 Healthcare supporting organization NH 501(c)(3) Line 12b, II N/A 0 Charitable Remainder Trusts (3) Charitable Trust NH Valley Regional Hospital Inc 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0