2024-08-14T16:14:22-05:00 2023-09-30 010494526 BAKER NEWMAN & NOYES BOX 507 PORTLAND ME 04112 990 2022-10-01 020222157 Monadnock Community Hospital MONA 6039247191 452 Old Street Road Peterborough NH 03458 Richard D Scheinblum VP of Finance/CFO 6039247191 2024-08-12 1 0 Connor Smart P02285543 2078792100 2024-08-12 2022 2024-08-08 14:25:15Z Cynthia K McGuire 452 Old Street Road Peterborough NH 03458 114997479 0 X https://monadnockcommunityhospital.com/ X 1919 NH Critical access hospital serving the Monadnock region of the State of New Hampshire 15 14 689 84 0 0 3702928 2549679 98841588 108750614 2628032 2995931 105262 54045 105277810 114350269 52497 42599 0 0 48257221 51084911 0 0 782666 50529644 56169084 98839362 107296594 6438448 7053675 164422071 178215506 61900614 58809075 102521457 119406431 X Monadnock Community Hospital is committed to improving the health and well-being of our community. We will elevate the health of our community by providing accessible, high quality and value based care. 0 0 95188881 42599 108750614 The primary purpose of Monadnock Community Hospital (MCH) is to ensure access to quality health care for patients in our community, regardless of their ability to pay. The following is a summary of the services MCH provides in an effort to fulfill its mission, together with key program statistics for fiscal year 2023.Inpatient Services - Includes: adult stays, maternity/births, and swing bed nursing. During the fiscal year, the Hospital admitted 1,122 patients and recorded 3,712 patient days. Emergency Services - MCH offers health services 24 hours per day, 7 days per week. Responsible for the immediate treatment of any medical or surgical emergency; for initiating life saving procedures in all types of emergency situations; and for providing emergency and initial evaluations and treatment for other conditions including minor illnesses and injuries, and sub-acute medical problems. During the year, there were 13,353 visits to the ER. Physician Practices - Family health services, programs, and education are integral components of healthcare at MCH. Inpatient and outpatient primary care includes: medical, surgical, psychological and specialist services, provided by physicians and mid-level practitioners. These are located at the Hospital and its four satellite practices located in Antrim, Jaffrey, New Ipswich, and Rindge. During the year, 57,400 primary care office visits were recorded. Surgical Services - Includes same day and short-term inpatient surgery. MCH provides surgery in the areas of orthopaedics, general surgery, OB/GYN, ophthalmology, urology, ENT, and podiatry. In addition, the Hospital offers some non-surgical procedures including colonoscopies, gastroscopies, and pain management injections. During the fiscal year, 2,091 procedures were performed. Radiology and Diagnostics - MCH provides advanced radiological technology and extensive imaging services including: bone density, MRI, CT, nuclear medicine, ultrasound, mammography, and other diagnostic procedures, both inpatient and outpatient. During the fiscal year, 33,581 exams were performed. Rehabilitation Services - Additionally, MCH serves the people of the Monadnock Region through its medical rehabilitation and fitness services. MCH offers rehabilitation programs for cardiac and diabetic rehabilitation, along with pulmonary fitness, which feature educational and exercise components. We also provide physical and occupational therapy, as well as speech rehabilitation. During the fiscal year, 70,879 procedures were recorded for these services. Monadnock Community Hospital's Financial Grant Program provides assistance with hospital and/or physician bills for qualifying patients. In fiscal year 2023, the Organization recorded $517,000 in charges foregone based on established rates. The estimated cost incurred to provide these services was $266,807. In addition, Monadnock Community Hospital provided other services to the community at no cost or reduced cost, such as screenings and clinics. The cost of providing these services was approximately $3,549,000 in fiscal year 2023. 95188881 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 118 0 1 689 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X X Richard D Scheinblum 6039247191 452 Old Street Road Peterborough NH 03458 X Shawn Harrington MD Trustee/Physician 41.50 0.00 X 424370 0 33992 Cynthia McGuire Chief Executive Officer 55.00 0.60 X X 361273 0 49483 William White MD Ex-Officio (voting) (end 4/2023) 27.90 0.00 X 493846 0 27655 Alexander J Walker Esq Ex-Officio (voting) 3.00 43.20 X 0 705005 397339 Robert Boyd Trustee (end 4/2023) 3.00 0.00 X 0 0 0 Peter Cerroni DMD Trustee 3.00 0.00 X 0 0 0 Casandra Clark Trustee 3.00 0.00 X 0 0 0 Jeffrey R Crocker Esq Trustee 3.00 0.00 X 0 0 0 Carolyn Garretson Trustee 3.00 0.00 X 0 0 0 Paula Hunter Trustee 3.00 0.00 X 0 0 0 Eric Lasky MD Ex-Officio (voting) 3.00 0.00 X 0 0 0 Stephen Lehmkuhl MD Ex-Officio (end 9/2023) 3.00 0.00 X 0 0 0 Leslie Lewis Trustee 3.00 0.00 X 0 0 0 Michael Shea Trustee 3.00 0.00 X 0 0 0 Iris Waitt Trustee 3.00 0.00 X 0 0 0 James Callahan Esq Chair 3.00 0.00 X X 0 0 0 Paul Faber Vice Chair 3.00 0.00 X X 0 0 0 Thomas S Bates CPA Treasurer 3.00 0.00 X X 0 0 0 Patricia Shuster Clerk 3.00 0.00 X X 0 0 0 Richard D Scheinblum VP Finance/CFO 50.00 0.00 X 238719 0 23143 Lucas Shippee DO Physician 41.50 0.00 X 398435 0 6100 Terrence McNamara DO Physician 41.50 0.00 X 425612 0 36282 Daniel Perli MD Physician/Chief Medical Officer 50.00 0.00 X 429160 0 10769 Dmitry Tarasevich MD Physician 41.50 0.00 X 354888 0 16783 Michele Gunning MD Physician 41.50 0.00 X 299650 0 5937 Joseph Pepe MD Former Ex-Officio 0.00 0.50 X 0 733333 1338 3425953 1438338 608821 61 1 1 0 Monadnock Region Emergency Physicians PL 107 Locke Road Hampton NH 03842 Contract Emergency Physician Group 2846000 Catholic Medical Center 195 McGregor Street Manchester NH 03102 Contract Physician and Lab Services 2698684 AHSA LLC PO Box 70529 Dallas TX 75267 Contract Staffing Group 2301544 Allscripts Healthcare LLC 24630 Network Place Chicago IL 60673 IT Vendor 1557445 Monadnock Anesthesia Assoc 452 Old Street Road Peterborough NH 03458 Contract Anesthesia Group 1471992 38 X 52596 1923328 573755 20515 2549679 Net patient service revenue 621400 98551105 98551105 Disproportionate share funding 621400 5880181 5880181 Other operating revenue 621400 3790582 3790582 Cafeteria/vending machine 722514 326627 326627 Employee pharmacy sales 456110 202119 202119 108750614 2801260 2801260 148285 97906 50379 50379 50379 717226 522555 194671 194671 194671 29214 52596 26749 2465 2465 1201 0 1201 1201 114350269 108750614 0 3049976 14250 14250 28349 28349 1652481 979863 672618 40495706 36401880 3791234 302592 473031 447986 22129 2916 5831301 5207349 585075 38877 2632392 2329225 281597 21570 180786 180786 114261 114261 16055 16055 148408 148408 8380346 7784299 595260 787 133678 133678 3027311 430227 2561964 35120 1413582 1413582 2716003 2529714 186289 55583 46821 7614 1148 259069 114466 11508 133095 1132312 1132312 4417889 4086327 331562 763302 683010 80292 Med. supplies/services 22518245 21808343 485527 224375 Provision for bad debt 5533909 5533909 NH medicaid enhancement 4678470 4678470 Food/dietary supplies 379928 379928 299947 157205 120556 22186 107296594 95188881 11325047 782666 4669 1682 32786022 30354114 7243620 9105689 622147 940993 1448643 1462118 1278329 1290843 105577709 66622761 36780471 38954948 78964865 89688993 5086409 5919721 289509 206896 206896 164422071 178215506 11279309 9912425 10945 21948491 21265883 155175 145664 28517639 27474158 61900614 58809075 X 88730215 104705702 13791242 14700729 102521457 119406431 164422071 178215506 X 7053675 8693131 1138168 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 16055 0 0 0 16055 0 Part II-B, Line 1: Monadnock Community Hospital is a member of the New Hampshire Hospital Association (NHHA) and the American Hospital Association (AHA). A portion of the dues paid to these organizations was amde available for lobbying expenditures on behalf of Monadnock Hospital in furtherance of its exempt purpose. Monadnock Hospital does not directly perform any lobbying activities. A detail of dues paid to these associations by the Hospital during this tax year is as follows: - NHHA, portion of dues available for lobbying: $11,502 - AHA, portion of dues available for lobbying: $4,553 In addition, MCH hosts an annual legislative breakfast, which is a bipartisan event to which legislators, local politicians, and other public officials are invited to discuss health care issues in New Hampshire. The breakfast was held virtually this year and therefore did not incur any related expenses. 13791242 169000 1687615 947128 14700729 17052611 595517 -2789108 1067778 13791242 14658179 320443 2714995 641006 17052611 13707881 205145 1372618 627465 14658179 13417044 169256 750558 628977 13707881 0.00000 0.66790 0.33210 1 0 964622 964622 36412050 23836270 12575780 842848 841774 1074 63436267 41944717 21491550 3921922 3921922 38954948 Estimated third-party settlements 27183993 Operating lease liabilities 290165 27474158 X 117814301 8693131 1236074 9929205 107885096 148408 6316765 6465173 114350269 100929327 97906 97906 100831421 148408 6316765 6465173 107296594 Part V, Line 4: Temporarily restricted assets are available for health care services, including the purchase of equipment and providing health education and programs. The income and dividends on permanently restricted net assets are generally used to support health care services and for capital purchases of property and equipment. Part X, Line 2: The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Hospital's tax positions and concluded the Hospital has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to or disclosure in the accompanying financial statements. Part XI, Line 2d - Other Adjustments: Increase in fair value of perpetual trust interest 627,268. Increase in fair value of interest rate swap agreement 495,650. Rental property expenses 97,906. Increase in fair value of equipment due to lease-transfer 15,250. Part XI, Line 4b - Other Adjustments: Provision for bad debt, net against revenues 5,533,909. Fundraising expenses, unrelated to fundraising events 782,856. Part XII, Line 2d - Other Adjustments: Rental property expenses 97,906. Part XII, Line 4b - Other Adjustments: Provision for bad debt, net against revenues 5,533,909. Fundraising expenses, unrelated to fundraising events 782,856. MCH Golf Classic 81810 52596 29214 1080 8907 7320 5568 3874 81810 52596 29214 1080 8907 7320 5568 3874 26749 2465 1 1 1 X 275.000000000000 1 X 1 1 0 1 1 266807 266807 0.00260 13694207 11783598 1910609 0.01880 13961014 11783598 2177416 0.02140 328000 328000 0.00320 2000 2000 0.00000 2947000 2947000 0.02900 271500 271500 0.00270 3548500 3548500 0.03490 17509514 11783598 5725916 0.05630 1 2855867 39655 28399849 28625968 -226119 X 1 1 1 1 Monadnock Community Hospital 452 Old Street Road Peterborough NH 03458 02507 X X X X Monadnock Community Hospital 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X see Part V, Section C X 1 20 1 See Part V, Section C 0 1 X 275.000000000000 400.000000000000 X X X 1 1 X X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X X 1 X 0 X X X X X 1 X 0 0 Monadnock Community Hospital Part V, Section B, Line 5: Monadnock Community Hospital (MCH) used a methodology that was highly focused on identifying needs among underserved populations. The approach used was designed to elicit perspective from a broad range of community stakeholders - especially those representing higher risk groups. MCH used a multi-phased methodology to achieve the objectives of the assessment. MCH reached out to a group of individuals to participate in its Community Health Needs Assessment (CHNA) to contribute insights from patients, community service organizations, and staff. Each person provided project feedback regarding perceptions of area health needs, data evaluation, and other guidance during the CHNA process. The individuals had a breadth of community health vision, knowledge, and leadership to impact the well-being of the service area.The CHNA methodology includes a combination of quantitative and qualitative research methods designed to evaluate perspectives and opinions of area stakeholders and healthcare consumers - especially those from underserved populations. The methodology used helped prioritize the needs and establish a basis for continued community engagement - in addition to simply developing a broad, community-based list of needs. The major sections of the methodology include the following:- Strategic Secondary Research. This type of research includes a thorough analysis of previously published materials that provide insight regarding the community profile and health-related measures.- Qualitative Interviews and Discussion Groups. This form of primary research includes discussion groups and interviews with a MCH CHNA Leadership Group, other community service providers, and healthcare consumers who represent a span of healthcare consumers in the service area.- Community Survey. Crescendo conducted an online survey with more than 440 community members. Survey results and analysis can be found in this report. The survey instrument is contained in the appendices.- A Needs Prioritization Process. Following the secondary research, qualitative interviews, focus group discussions, and community survey, a list of 28 community health issues was generated. MCH CHNA Leadership Group members participated in a needs prioritization meeting where top needs were discussed, along with MCH locus of control for each item. The discussions allowed a formation of a prioritized needs analysis.To ensure broad and deep community engagement in the CHNA, MCH compiled a group of community leaders, which represented public health and diverse community interests.The qualitative primary research stage included stakeholder interviews and focus group discussions across the community. The 13 one-on-one interviews lasted approximately 30 minutes in length, although some community members chose to share a great deal of information, so some calls exceeded 30 minutes. The interviews provided the opportunity to have in-depth discussions about community, social, health, and service issues with individuals able to provide insight regarding health services and access needs. The stakeholder interview guide was designed to elicit respondents' opinions about community strengths and resources, health-related needs, the expected ongoing impact of the COVID-19 pandemic, the community-based strategies to address those needs, special insights from marginalized groups, and other topics. The two focus group discussions (FGDs) - plus two MCH CHNA Leadership Group meetings - (held via Zoom) used a moderator's guide similar to the stakeholder interview guide (see Appendix). The FGDs enabled the participants to highlight areas of consensus as to what they see as the biggest health-related needs facing the community.In total over 40 individuals provided input from the following segments:- Healthcare service consumers- General community members- MCH CHNA Leadership Group- Community service providersA community wide survey was conducted in the Monadnock service area. The survey included representation from all thirteen Monadnock service area towns, with respondents completing the survey instrument online. Monadnock Hospital facilitated survey advertising via internal and external communications lists and social media. In general, the secondary data utilizes the most current data sets available. The dramatic changes in 2020 and 2021 due to the COVID-19 pandemic may have impacted some of the traditional projection tools, source data, and data collection methods. For example, the American Community Survey (ACS) which provides detailed population and housing information revised its messaging, altered their mailout strategy, and made sampling adjustments to accommodate the National Processing Center's staffing limitations. Where relevant, the impacts or new data due to the COVID-19 pandemic are noted. In addition, in-person interviews and focus group discussions were conducted only by telephone or in a virtual setting. The decision to may have impacted some of traditional in-person dynamics. Monadnock Community Hospital Part V, Section B, Line 11: Please see attached implementation plan for how the Hospital is addressing (or any needs it is not addressing and why) the significant needs of the community in which it serves. Monadnock Community Hospital Part V, Section B, Line 16j: The complete financial assistance policy is available upon request and in the waiting rooms. Instructions on how to find out more about financial assistance are posted on the Hospital's website, on the back of all billing invoices, and published in a brochure that is available around the Hospital and in the admissions office. Monadnock Community Hospital Part V, Section B, Line 20e: The Hospital Patient Financial Services (PFS) Department shall develop and implement billing and collection procedures designed to maintain an adequate cash flow, keep accounts receivable at an acceptable level, and identify and write-off bad debts in a timely fashion. Monadnock Community Hospital contracts with an agency to process all self-pay accounts and self-pay after insurance balance statements/letters.I. Self-pay accounts and self-pay balances remaining after insurance adjudication shall be transferred to the agency on a weekly basis. The cycle for collections is three (3) statements and/or letters and two phone call series spaced approximately thirty (30) days apart. The statements shall include:a. Previous balance (unless this is the first statement).b. Activity since last statement (except those accounts that went to a $0.00 balance).c. Current balance due.d. Telephone number(s) for inquiries concerning the statement.e. Status or reminder message where appropriate.f. Availability for the use of a credit card for payment.g. Information regarding Financial Assistance and Medication Bridge Programs.h. Return envelope.II. In the event that statements or letters are returned by the postal service as undeliverable for reasons such as "moved, left no forwarding address," "forwarding order expired, or "no such address" the agency will indicate on the daily report "mail returned." PFS staff will review system for the correct address and will make corrections within the computer system and correspondence will be re-mailed. If no correct or current information can be obtained, the specific account(s) shall be flagged for referral to an outside collection agency equipped to handle this type of situation (see bad debt processing footnote).In addition, during an emergency room visit if a patient is classified as self-pay, a Financial Assistance application is either given to the patient and/or guarantor at the visit or a Financial Assistance application is put in the mail to the patient and/or guarantor. Determination of eligibility is contingent upon receiving a completed application and required documentation from the patient and/or guarantor. Schedule H, Part V, Section B, Line 7a & 10a: The Hospital's current and prior Community Health Needs Assessment and Implementation Plan can be found at the following address:https://monadnockcommunityhospital.com/about-us/community-health-needs-and-benefits/A direct link to the 2020 CHNA (for fiscal years ending in 2021-2024) is:https://monadnockhosp.wpenginepowered.com/wp-content/uploads/2022/08/2021CHNA-FINAL.pdfA direct link to the 2020 CHNA Implementation Plan (for fiscal years ending in 2021-2024) is:https://monadnockhosp.wpenginepowered.com/wp-content/uploads/2022/08/MCH-Implementation-Plan-FINAL.pdf Schedule H, Part V, Section B, Line 16b: The complete financial assistance policy is available upon request and in the waiting rooms. Instructions on how to find out more about financial assistance are posted on the Hospital's website, on the back of all billing invoices, and published in a brochure that is available around the Hospital and in the admissions office.The Hospital's Financial Assistance Policy, Plain Language Summary, Financial Assistance Application, and additional financial assistance information is available on the Hospital's website at:https://monadnockcommunityhospital.com/financial-services/financial-assistance/A direct link to the Hospital's assistance policy is:http://monadnockhosp.wpenginepowered.com/wp-content/uploads/2020/11/MCH-FAP-Policy.pdfA direct link to the Hospital's assistance application is:http://monadnockhosp.wpenginepowered.com/wp-content/uploads/2023/03/MCH-FAP-Application-FY23.pdfA direct link to the Hospital's plain language summary is:http://monadnockhosp.wpenginepowered.com/wp-content/uploads/2023/03/Financial-Assistance-Eligibility-Summary-Plain-Language-Summary-FY23.pdfA direct link to the Hospital's statement and explanation for Amounts Generally Billed ("AGB") is:https://monadnockcommunityhospital.com/wp-content/uploads/2024/03/Appendix-A-Amount-Generally-Billed.pdfA direct link to the Hospital's statement of participating providers under the financial assistance policy is:https://monadnockcommunityhospital.com/wp-content/uploads/2024/03/Appendix-C-Participating-Providers.pdfLastly, a direct link to a statement of services ineligble for charity care under the Hospital's financial assistance policy is:https://monadnockcommunityhospital.com/wp-content/uploads/2024/03/Appendix-B-Ineligible-Services.pdf 10 1 - Monadnock Orthopedic Associates 458 Old Street Road Wellness Center Peterborough NH 03458 Physician practice 2 - Monadnock Regional Pediatrics 454 Old Street Road MAB Building Peterborough NH 03458 Physician practice 3 - Monadnock Internal Medicine 454 Old Street Road MAB Building Peterborough NH 03458 Physician practice 4 - Jaffrey Family Medicine 82 Peterborough Road Jaffrey NH 03452 Physician practice 5 - Monadnock Behavioral Health 458 Old Street Road Wellness Center Peterborough NH 03458 Physician practice 6 - Antrim Rural Health Clinic 12 Elm Street Antrim NH 03440 Physician practice 7 - Monadnock Family Care 454 Old Street Road MAB Building Peterborough NH 03458 Physician practice 8 - Rindge Family Practice 145 US Route 202 Rindge NH 03461 Physician practice 9 - Monadnock Surgical Associates 454 Old Street Road MAB Building Peterborough NH 03458 Physician practice 10 - New Ipswich Family Medicine 821 Turnpike Road New Ipswich NH 03071 Physician practice Part I, Line 3c: N/A Part I, Line 6a: N/A Part I, Line 7: Charity care and means tested programs use the cost to charge ratio as their methodology. This Hospital calculates the ratio in a manner consistent with worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of cost to charges. Part I, Line 7g: Included in the subsidized health services activities reported for FY 2023 are unreimbursed costs of $256,000 attributed to an outpatient behavioral health practice and $2,497,000 related to emergency and trauma services. 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 $ 5,533,909. Part II, Community Building Activities: Monadnock Community Hospital, a not-for-profit hospital, owns a primary care network of physicians, nurse practitioners, physician assistants, psychiatrists, psychologists and social workers. This network provides a wide range of primary and behavioral health care services for individuals and families with offices in Peterborough, Rindge, Jaffrey, Antrim and New Ipswich.Each year, MCH seeks to make the Monadnock Region a healthier place to live by identifying new and changing healthcare needs, then developing a strategy to address some of the most pressing issues. In addition, no one is turned away who is in need of medical care. Our mission is to provide health care for everyone in our community, regardless of their ability to pay. Some examples of our efforts to reach beyond traditional hospital services include:- Providing services to patients unable to pay- Offering access to medication, free or at reduced cost - millions of dollars in medicine has been dispensed since the "Medication Bridge" program was started in 2002.- Helping children in Preschool access dental health care.- Provide training for community agencies, such as local volunteer fire and rescue personnel.- Offer prevention and wellness education, from smoking cessation to dealing with stress.- Screenings and clinics for important health issues such as breast cancer.- Supplying information and support regarding timely health topics.- Offer behavioral health (Substance use & mental health) trainings to the community through Be The Change- Offer space for community organization to meet, including local support groups.- The hospital has a Mobile Integrated Health department.MCH also offers a robust system of volunteer programs and services to engage its stakeholders, to bring people together in civic action, and to promote the wellbeing and success of its community. Volunteer Services responds to department requests for volunteer help and works with the requesting department to develop a written service description, if necessary. Every effort is made to fill the position(s) with qualified volunteers. Volunteers assist with all levels of the Hospital's operations, including materials management, blood drives, emergency department assistance, general support and maintenance, recycling, shuttle and transportation, and other related services. Lastly, the Hospital remains committed to improving not just the physical health but also the quality of life in its community. The Monadnock Region has a rich and vibrant history of support for the Arts. Here at Monadnock Community Hospital, we are in a unique position to help connect the world of healing and the world of art. Our intent is to host a venue for artists to exhibit in varied mediums, resulting in a visual experience which promotes the proven healing and restorative benefits of beautiful artwork. Our vision is to eventually develop a permanent art collection for the hospital which will be enjoyed for generations by patients and visitors to our campus. Our Healing Arts Committee is comprised of individuals representing a strong interest in the Healing Arts initiative and has convened to create and develop all aspects of the MCH Healing Arts Gallery as an established and vital venue going forward. The gallery holds three shows per year displaying work from all local artists. Part III, Line 2: The amount reported on Part III, Line 2 was derived by applying the cost to charge ratio against the amount of bad debt expense reported on Form 990, Part IX, Line 25, Column (A) ($5,533,909). Accounts written off to bad debt include gross charges being written off less any payments received against those charges. Any cash collected on accounts previously written off is included as an offset to bad debt expense as recoveries of bad debt. The Hospital calculates the ratio in a manner consistent with Worksheet 2, patient care charges to patient care expenses, to arrive at the ratio of costs to charges. Part III, Line 3: The estimated amount of charity care included in bad debt expense is based on the number of applications for charity care denied due to lack of complete documentation against the average charity care write off at cost per qualified patient. We believe the amount is minimal based on our extensive efforts to educate patients and staff about our various payment plans and financial assistance programs to ensure that patients who qualify for any of our programs utilize them. Depending on the specific circumstances, a patient may be eligible for charity care, discounted care, payment programs, or a combination of the above. Due to these efforts, we believe that amounts written off to bad debt that could qualify as charity care is minimal. Part III, Line 4: Please see footnote 1 on page 8 of the attached audited financial statements. Part III, Line 8: Medicare allowable costs for the Medicare cost report are reported in accordance with CMS guidelines using the cost to charge ratio methodology. Part III, Line 9b: As of September 30, 2011, Monadnock Community Hospital has a written credit and collection policy. Described within that policy are the collection practices and bad debt processes that are followed for patients who are known to qualify for charity care or financial assistance. The Organization utilizes a Financial Assistance Program (FAP) file which is maintained by the Patient Financial Assistance Program of MCH. Internal FAP insurance plans are applied to those accounts and related discount amounts are adjusted in the billing system. Remaining balances are expected to be paid in full by the patient. Payment plans may be requested by the patient and are established by the Patient Financial Services staff according to established criteria. Accounts are annotated to reflect payment arrangements. During bad debt processing, designated staff evaluate accounts listed as collection review for potential bad debt write off. This process includes an examination of account history for indication of FAP application. Part VI, Line 2: Section 9007(a) of the Affordable Care Act (March 2010) requires that all non-profit hospitals and health systems to complete a Community Health Needs Assessment every three years. The purpose of the Monadnock Community Hospital CHNA is to identify and prioritize community needs. In doing so, it will also provide a solid technical platform to analyze service area population health, finely tune outreach activities, highlight opportunities for collaboration, strengthen the existing community health activities, and meet IRS regulations. The practical purpose is this: the CHNA provides a data- and research-based foundation from which to develop and drive hospital activities that impact the most people, address the most urgent needs, and otherwise respond to the highest priority needs within the hospital's purview.The needs assessment process includes consultation with members of the public, community organizations, service providers, and local government officials in the entity's service area to identify and prioritize the community needs that the health care entity can address directly or in collaboration with others.The major strength of MCH is found in the ability of our physicians and staff to offer extensive services utilizing state-of-the-art technology, while maintaining the personalized care of a community hospital. MCH is a 25-bed Critical Access Hospital offering Medical, Surgical and Intensive Care; Obstetrics; Pediatrics; and Mental Health services. In addition, a wide variety of outpatient services are available, including Pulmonary, Cardiac and Physical Rehabilitation; 24-hour Emergency Care; a fully equipped laboratory; and an extensive Radiology department. MCH is fortunate to have strong leadership and a dedicated community that allows us to meet the ever-changing requirements of today's healthcare environment. As that environment changes, MCH is also committed to changing and providing the communities we serve with appropriate and innovative programs.The most common sources of information used to find out about healthcare providers and health monitoring were physicians/healthcare workers, medical websites, hospital websites, and friends and relatives (word of mouth). MCH also utilizes secondary data resources, such as income, education, demographics, geographic location, and employment data to evaluate and estimate its community's access to care, healthcare literacy, and general wellbeing.MCH currently addresses all, or most, of the community needs identified in the CHNA in some way. For each of the top 10 needs identified in the CHNA, MCH examined its current programs, outreach efforts and collaborations, as well as consideration for new initiatives such that each of the needs was assigned to one of the following groups:- Needs that are not part of MCH's purview (e.g., better addressed by other organizations). In this case, MCH will support and advocate for addressing the need but are not able to address the need directly.- Needs that MCH will address through collaboration with community partners.- Needs for which MCH will enhance existing programs or establish new ones. The hospital has current activities that may be able to be modified or expanded to address the community health need, or newly created activities or initiatives may be required to do so. Part VI, Line 3: MCH is committed to providing quality healthcare to anyone in need of services, regardless of ability to pay. We understand patients may not have the finances to pay for their healthcare services and medications, and do not want this to prevent anyone from receiving necessary treatment. As part of the Hospital's mission to the communities we serve, we have developed programs to help meet the needs of our patients who meet income eligibility. Through our Financial Assistance and Medication Bridge Programs, we have been providing financial assistance for many years to those who qualify. We reach out to our patients in many different ways to ensure that they are aware that help is available and to guide them through the process. Brochures and signage are posted in high traffic areas and all employees of MCH are informed about the Financial Assistance Program during orientation. When a patient goes through the registration process at the Hospital the staff are trained to inform uninsured or underinsured patients about the Monadnock Community Hospital Financial Assistance and the New Hampshire Health Access programs and that there is assistance available within the Hospital to help with the application process. In addition, any time a patient calls customer service, the representative is trained to help identify and offer support to patients who may require financial assistance. Patients may qualify for free care, discounted care, payment plans or a combination of the above. Resources are also provided in applying to federal and state programs for those who qualify. Part VI, Line 4: Monadnock Community Hospital is a 25-bed acute care facility serving a geographically distinctive market in the Greater Monadnock region of New Hampshire, whose population of 38,816 includes 13 towns in Cheshire and Hillsborough counties.The Social Vulnerability Index (SVI) helps identify areas of community health need. Developed by the Centers for Disease Control and Prevention as a metric for analyzing population data to identify vulnerable populations, the SVI's measures are housed within the domains of Socioeconomic Status, Household Composition and Disability, Minority Status and Language, Housing, and Transportation. The tool may be used to rank overall population wellbeing and mobility relative to County and State averages. It can also be used to determine the most vulnerable populations during disaster preparedness and global pandemics. The Hospital's most recent CHNA indicates the following findings from the SVI:- The Monadnock service area is defined by its high senior citizen population. Nearly 20% (19.5%) of Monadnock service area residents are age 65 and over, a somewhat higher percentage than the state (18.5%) and county (15.2%) average.- Median incomes are strong in the Monadnock service area ($75,683), and poverty rates are slightly lower (6.4%) than the Hillsborough County average (7.8%). By town, high poverty rates are noteworthy in Jaffrey (8.7%), Rindge (7.8%) Peterborough (7.5%), Greenfield (7.3%) and Antrim (7.3%). Poverty rates are low in Hancock (1.6%), Francestown (3.7%), and Sharon (3.8%).- The number of single-parent households in the Monadnock service area is high - over 30% (30.9%). Single-Parent Households may indicate a vulnerable population, which may experience a lack of childcare options and/or a single source of income - contributing factors to the cycle of poverty.- While Hillsborough County experiences great population diversity compared with the New Hampshire average, which is not reflected in the Monadnock service area. Just 4.7% of the service area population identifies as an ethnic minority, well below county (15.6%) and state (8.4%) averages.- Youth (i.e., age 17 or younger) make up nearly 20% of the Monadnock service area population (19.7%) -similar to state and county averages. Part VI, Line 5: Monadnock Community Hospital is a critical access hospital located in the Monadnock Region of NH. Our mission is to improve the health and well-being of our community. The Hospital is served by a board of trustees consisting of local citizens active in their community and its organizations. The majority of the board is not employed by the Hospital and consists of local community and business representatives as well as medical staff. Each year, MCH seeks to make the Monadnock Region a healthier place to live by identifying new and changing healthcare needs, then developing a strategy to address some of the most pressing issues. In addition, no one is turned away who is in need of medical care. Our mission is to provide health care for everyone in our community, regardless of their ability to pay. The Hospital is committed to giving back to the community to the greatest extent possible. Monadnock Community Hospital supports thousands of individuals and families with free or reduced-fee services and programs. Our Financial Assistance Program administered by the Social Services Department helps families and individuals in need with access to health care and other available community services such as catastrophic care, fuel assistance, meals on wheels, food banks, and visiting nurses. Other examples of the Hospital's effort to reach our patients beyond traditional hospital services include access to free or reduced cost medications through our Medication Bridge program; training for community agencies such as local volunteer fire and rescue personnel; offering prevention and wellness education including nutrition, smoking cessation and dealing with stress; providing regular community seminars regarding timely health topics; screenings and clinics for important health issues such as breast cancer; offer behavioral health (substance use & mental health) trainings to the community through Be The Change. These are just a few of the many areas where we are reaching out to others to assure they are cared for well. Part VI, Line 6: GraniteOne Health is a non-profit, New Hampshire-based healthcare system consisting of Catholic Medical Center (CMC) in Manchester, Huggins Hospital (HH) in Wolfeboro, and Monadnock Community Hospital (MCH) in Peterborough. GraniteOne Health draws on the resources and expertise of these strong, trusted hospitals to enhance collaboration, strengthen clinical partnerships and meet the health needs of the communities by providing greater access to high-quality care and a seamless patient experience. The organization will enable the hospitals to grow their clinical relationships, build economies of scale, and improve value to patients.Both Huggins and Monadnock have long-standing clinical relationships with CMC in specialty areas such as cardiology and vascular care. GraniteOne allows the hospitals to explore further collaborations in clinical areas as well as other services that could benefit from economies of scale, all while maintaining a seamless patient experience.GraniteOne Health offers access points throughout New Hampshire to advanced clinical services such as open heart surgery, angioplasty, minimally invasive heart valve and vascular surgery, cancer care, comprehensive weight loss management, orthopedics, innovative maternal health services and over 30 other medical and surgical subspecialties. GraniteOne Health gives patients access to high-quality, coordinated care across the continuum of health. Part VI, Line 7, Reports Filed With States NH 1 Town of Peterborough 1 Grove Street Peterborough NH 03458 Government 7500 0 For the benefit of the Peterborough Ambulance Community Volunteer Transportation Company 375 Jaffrey Road Suite 3 Peterborough NH 03458 262838428 501(c)(3) 6750 0 Support no-fee transportation to those in need in the Monadnock Region 2 0 Dr. Mark Luedke Memorial Scholarship Fund 2 16349 Dr. Herbert E. Flewelling Scholarship 3 4500 Norma A. Houghton Nursing Scholarship 1 1500 Peter L Gosline Scholarship 6 6000 Part I, Line 2: During the fiscal year ending September 30, 2023, the Hospital made contributions to a governmental entity, the Town of Peterborough, and a 501(c)(3) organization located in the Hospital's geographic region. The Hospital established the Dr. Mark Luedke Memorial Scholarship Fund in memory of the Organization's former Radiology Medical Director. The fund is to support clinical education and certification for members of MCH's Radiology Department, and is disbursed with the input of the Director of Radiology, the Chief Nursing Officer, and the VP of Human Resources. The Hospital also established the Dr. Herbert E. Flewelling Scholarship to honor the memory of Dr. Flewelling, who practiced both in Peterborough and Jaffrey. Annually two scholarships of $1,000.00 are usually awarded each year to two graduates of local area high schools. The scholarships are given to outstanding students who are furthering their education in the medical field. The actual cash award is made upon satisfactory completion of six months of education. The Hospital also established the Norma A. Houghton Nursing Scholarship to honor the memory of Norma A. Houghton, who devoted her profession to being an RN certified as a lactation consultant, and who served the birthing suite at the Hospital from 1977-2006. Annually, two scholarships of up to $1,500.00 are usually awarded each year to two graduates of local area high schools. The scholarship are given to outstanding students who are furthering their education in the nursing field. The Hospital also established the Peter L. Gosline Employee Education Scholarship Fund in 2014 to honor Peter Gosline, the president and CEO of the Hospital from 1998 to 2014. The Scholarship provides financial assistance to eligible employees pursuing higher education and skills development within health services professions. X X X 1 1 0 0 0 0 0 1 0 Alexander J Walker Esq Ex-Officio (voting) 0 627831 0 0 0 77174 0 292846 0 104493 0 1102344 0 0 Joseph Pepe MD Former Ex-Officio 0 0 0 0 0 733333 0 0 0 1338 0 734671 0 0 William White MD Ex-Officio (voting) (end 4/2023) 490036 0 0 0 3810 0 6100 0 21555 0 521501 0 0 0 Terrence McNamara DO Physician 425162 0 0 0 450 0 6100 0 30182 0 461894 0 0 0 Shawn Harrington MD Trustee/Physician 414680 0 5000 0 4690 0 6100 0 27892 0 458362 0 0 0 Daniel Perli MD Physician/Chief Medical Officer 428890 0 0 0 270 0 0 0 10769 0 439929 0 0 0 Cynthia McGuire Chief Executive Officer 338350 0 0 0 22923 0 23600 0 25883 0 410756 0 17500 0 Lucas Shippee DO Physician 397985 0 0 0 450 0 6100 0 0 0 404535 0 0 0 Dmitry Tarasevich MD Physician 354438 0 0 0 450 0 6100 0 10683 0 371671 0 0 0 Michele Gunning MD Physician 299200 0 0 0 450 0 5937 0 0 0 305587 0 0 0 Richard D Scheinblum VP Finance/CFO 238029 0 0 0 690 0 4679 0 18464 0 261862 0 0 0 Part I, Lines 4a-b Schedule J, Page 1, Line 4a, severance payments: Dr. Joseph Pepe, who previously served as an ex-officio trustee of the Hospital and was the President and CEO of Catholic Medical Center (a related organization), until his retirement in June, 2021. As part of his retirement, Dr. Pepe became entitled to severance compensation, as per his employment agreement, from Catholic Medical Center. Dr. Pepe received severance compensation of $733,333 during calendar year 2022, after his formal retirement in June, 2021. This severance was included in his 2022 Form W-2 wages, and is also included in the amount of compensation reported on this Schedule J, Part II, Column B(iii). Schedule J, Page 1, Line 4b, supplemental non-qualified retirement plans: Cynthia McGuire, President & CEO, participates in a 457(f) plan with Monadnock Community Hospital. After a three year vesting period, amounts previously contributed to her by Monadnock Community Hospital are reported as part of her W-2 wages. In calendar year 2022, a total of $17,500 was deposited into Ms. McGuire's 457(f) plan account, which is included in the amount reported on Schedule J, Part II, Column C for this current fiscal year Form 990 filing. Additionally, $19,113 of compensation is reported in Column B(iii), which represents the vested 2019 contribution of $17,500 and earnings of $1,613. The $17,500 has also been reported on this Schedule J, Part II, Column F, as compensation deferred in a previous period which became taxable during this filing period (calendar year 2022 for purposes of income and benefit reporting). Alexander Walker, Jr. takes part in a section 457(f) forfeitable nonqualified deferred compensation plan administered by Catholic Medical Center. In calendar year 2022, Mr. Walker received contributions of $280,211 from Catholic Medical Center into his 457(f) Plan. Such contributions are included in the total deferred compensation reported for Mr. Walker on this Schedule J, Part II, Column C. Part I, Line 7 MCH may from time-to-time compensate physicians utilizing quality and productivity targets based on WRVU (work relative value units). In addition, the Compensation Committee may recommend to the full board, annually, the variable pay award that may be issued to the Hospital's CEO. The payment of any such awards are discretionary and are subject to meeting the pre-determined goals of the Organization. A NHBFA Revenue Bonds Series 2013 021304598 2013-01-01 27240000 refinance existing Series 2007 and 2009 bonds 0 0 0 A 5974117 27240000 27057466 182534 2013 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 1 0 0 0 0 A 0 Schedule K, Part III, Line 9, Part IV, line 7 and Part V: Although formal policies are not in place in regards to the remediation of our bond, the monitoring requirements of section 148, and procedures to ensure that violations are timely identified and corrected Monadnock Community Hospital has compliance checks in place that substantiate these requirements. Below is a list of all compliance checks that Monadnock Community Hospital has in place to monitor the 2013 Bond Issue: 1. Covenant calculations performed monthly as part of the Financial Scorecard preparation which is reviewed by the MCH Board of Trustees. 2. Covenant calculations are performed for each quarter and reported to the bond issuer, TD Bank. 3. Covenant certificate is signed each quarter by the CFO and reported to the bond issuer, TD Bank. 4. Financial statements and statistical reports are send to the bond issuer, TD Bank, on a quarterly basis. 5. Annual Operating and Capital budgets are reported to the bond issuer, TD Bank. 6. A No Event of Default certificate is signed by the CFO annually and reported to the bond issuer, TD Bank. 7. Annual Audited Financial statements are reported to the bond issuer, TD Bank. Each of these items that are reported to TD Bank has a specific deadline for completion as outlined in the bond documents. Michael Shea Lessor of Rental Property 144149 Michael Shea served as a Trustee on the Hospital's board of directors. Mr. Shea is also the president and part owner of Belletetes, Inc. Monadnock Community Hospital leases a building in Jaffrey, NH for the Jaffrey Family Medicine Practice which is owned by Belletetes, Inc. Terms are at arms-length. The total amount reported in Column C represents rental payments ($144,149) as well as payments for property taxes and common area maintenance. 0 Form 990, Part VI, Section A, line 2 James Callahan, Esq., and Michael Shea, who each served on the Hospital's Board during this tax year, share a business relationship. Form 990, Part VI, Section A, line 6 The sole Member of MCH shall be GraniteOne Health, a New Hampshire voluntary corporation that is exempt from taxation under section 501(c)(3) of the Internal Revenue Code. Form 990, Part VI, Section A, line 7a GraniteOne Health shall elect the elected members of MCH's Board of Trustees who are nominated as set forth in Article II of MCH's governing documents. GraniteOne Health shall also have the powers reserved to it as described in the following narrative for Form 990, Part VI, Line 7b. Vacancies on the Board of Elected Trustees occurring prior to the end of any Elected trustee's term shall be elected by GraniteOne Health from nominations by either vote of the Board at a meeting of the Board, for which notice has been given of the nomination process, or by GraniteOne Health if the vacancy is from the group of Elected Trustees nominated by GraniteOne Health. Form 990, Part VI, Section A, line 7b The following actions initiated by MCH shall require GraniteOne Health's approval: a. Adoption of the annual capital and operating budgets, provided that the expenditure of any of the cash reserves, board-designated reserves, surplus assets and other assets held by MCH on the Affiliation Date and recorded on MCH's financial statements as unrestricted assets, as well as certain parcels of real estate not required for the operation of MCH (the "Pre-Affiliation Assets") contemplated by such budgets and proposed in accordance with those powers reserved to MCH, will not be subject to the approval of GraniteOne; b. Approval of any strategic plans or material nonclinical programming and marketing plans, including material modifications thereof; c. Authorization of debt incurred, assumed, or guaranteed by the hospital in excess of Five Hundred Thousand Dollars ($500,000.00), other than as provided for in any approval annual capital or operating budget; d. Authorization of any material acquisition, disposition, formation, organization or investment by MCH of or in any other corporation, partnership, limited liability company, other entity or joint venture, other than an acquisition funded with Pre- Affiliation Assets proposed in accordance with those powers reserved to MCH will not be subject to the approval of GraniteOne; e. Authorization of the sale, disposition, mortgage, or encumbrance of any assets dedicated to the operations of MCH involving assets of Five Hundred Thousand Dollars ($500,000.00) or more, with the exception of real estate identified prior to the Affiliation; f. Authorization of MCH to enter into any merger, consolidation or joint venture; or to sell or dispose of substantially all of the assets of MCH or any of its respective subsidiaries; or to create or acquire any subsidiary organization; g. Authorization of MCH to institute any bankruptcy, insolvency or reorganization proceedings for itself or any subsidiary; h. Authorization of a capital investment by MCH or any of its subsidiaries in any individual entity or project in the form of cash or either tangible or intangible property in excess of Five Hundred Thousand Dollars ($500,000.00), except as provided in any approved annual capital or operating budget or to the extended funded by the Restricted Assets or the Pre-Affiliation Assets; i. Authorization to develop, implement or terminate clinical programs and clinical procedures by MCH or its subsidiaries; j. The amendment of the Articles of Agreement or Bylaws of MCH or its subsidiaries to the extent that it would (a) impact the Reserved Powers; or (b) reasonably be expected to have a material strategic, competitive or financial impact on the System or any of its members; and k. The MCH Board of Trustees' appointment or reappointment of the MCH CEO and the determination of the CEO's compensation. Form 990, Part VI, Section B, line 11b The Hospital's Form 990 is prepared with assistance by an independent public accounting firm. A draft of the Form 990 is initially reviewed in detail by key finance employees. Thereafter, the draft is made available to the full board for review and comment prior to filing with the IRS. Form 990, Part VI, Section B, line 12c On an annual basis, the Organization provides all administrators/directors/managers, Board Members, and medical staff members with the conflict of interest policy. Said individuals are required to complete a new conflict of interest disclosure on an annual basis. Any conflicts of interest noted are reviewed by the Chair of the Board, in conjunction with the Corporate Compliance Officer. If the conflict of interest appears to meet the policy definitions requiring full Board review, the Chair of the Board takes this to the full Board meeting, and it is discussed, and appropriate action is taken (in compliance with state and federal requirements). The conflict of interest statement requires signatories to inform the Hospital of any conflict of interest that occurs at any time throughout the year. If a conflict of interest arises during the year, it is reviewed by the Compliance Officer, and if necessary, is taken to the Board Chair/Board. The Compliance Officer confers with legal counsel with regard to conflicts of interest, if there is any question regarding the potential conflict. Form 990, Part VI, Section B, line 15 The Organization has a written executive compensation policy and procedure. Under this policy, the Compensation Committee, comprised of delegated representatives of the Board of Trustees, has the power and responsibility to determine the Hospital's approach to executive compensation and review the performance of the CEO. The Compensation Committee has the responsibility to set, monitor and review the base salary of the CEO. The Committee maintains minutes of sessions and final recommendations and determinations in accordance with the Board of Trustee guidelines. Annually, market data is reviewed by the Committee to determine the appropriate salary for the Hospital's CEO based upon identified standards. At the end of the time period, the Committee reviews to what extent stated goals were met and recommends an amount for the variable pay award to be approved by the full board. Form 990, Part VI, Section C, line 19 Monadnock Community 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 MCH 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. The Hospital also makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part VII, Section A, Column D: Director Compensation The 2022 compensation reported for Dr. White, as paid by Monadnock Community Hospital, was paid in return for medical services provided by Dr. White as a physician employed by the Hospital. No part of Dr. White's compensation was remuneration in return for his services as a voting member of the Hospital's Board of Trustees. Form 990, Part VIII, Line 7: Realized Capital Gains The amount reported on lines 7c and 7d as realized gains agrees to reporting from the Hospital's custodian bank and third party investment managers. Due to the volume of investment activity, the Hospital relies on the custodian bank and third party investment managers to track the sale of investments at the individual asset level. Therefore the ability to track and report proceeds and basis of the sales is extremely difficult. Form 990, Part XI, line 9: Increase in fair value of interest rate swap agreement 495,650. Increase in fair value of perpetual trust interest 627,268. Increase in fair value of equipment due to lease-transfer 15,250. Form 990, Part XI, Line 2c: Audit Review Process The Audit Committee oversees the audit process for Monadnock Hospital. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit for the fiscal years ended 9/30/2022 and 9/30/2023. Alliance Ambulatory Services 100 McGregor Street Manchester NH 03102 020519436 Ambulatory Surgical Center NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Health Services 100 McGregor Street Manchester NH 03102 611508839 Practices NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Resources 100 McGregor Street Manchester NH 03102 020398138 Real Estate NH 501(c)(3) Line 12b, II CMC Healthcare System 0 Catholic Medical Center 100 McGregor Street Manchester NH 03102 020315693 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 CMC Healthcare System 100 McGregor Street Manchester NH 03102 010568516 Parent NH 501(c)(3) Line 12b, II N/A 0 CMC Physician Practice Associates 100 McGregor Street Manchester NH 03102 020460245 Practices NH 501(c)(3) Line 10 CMC Healthcare System 0 GraniteOne Health 100 McGregor Street Manchester NH 03102 814663563 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Huggins Hospital 240 South Main Street Wolfeboro NH 03894 030223332 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 Monadnock Health Services - INACTIVE 452 Old Street Road Peterborough NH 03458 020420789 Inactive NH 501(c)(3) Line 12a, I Monadnock Community Hospital 1 St Peter's Home 100 McGregor Street Manchester NH 03102 020222228 Day Care Services NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Urgent Services 100 McGregor Street Manchester NH 03102 831238167 Health Care Services NH N/A 0 0 Bedford Ambulatory Surgical Center LLC 11 Washington Place Bedford NH 03110 020519727 Surgical Center NH N/A 0 0 NH Value Care ACO LLC 100 McGregor Street Manchester NH 03102 832029076 Health Care Services NH N/A 0 0 Alliance Enterprises 100 McGregor Street Manchester NH 03102 020386795 Real Estate NH N/A C 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0