2024-07-01T10:22:09-05:00 2023-09-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2022-10-01 020222123 Capital Region Health Care Corporation CAPI 6032277000 250 Pleasant Street Concord NH 03301 Scott Sloane Senior VP, CFO, & Treasurer 6032277000 2024-06-20 1 Scott Sloane 999009999 0 Connor Smart P02285543 2078792100 2024-06-20 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z Robert P Steigmeyer 250 Pleasant Street Concord NH 03301 434909 0 X www.concordhospital.org X 1944 NH To provide medical care 19 17 0 20 46490 45490 0 0 434909 434909 0 0 0 0 434909 434909 0 0 0 0 0 0 0 0 0 176240 146583 176240 146583 258669 288326 2656192 2908565 785226 845853 1870966 2062712 To provide medical care 0 0 146583 0 388419 To promote a comprehensive health service system, which provides high quality, cost-effective health related services, delivered in a caring and personal manner, either directly or by arrangements with others, to meet the needs of the people of Central New Hampshire. 146583 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NH X Scott Sloane Senior VP CFO 6032277000 250 Pleasant Street Concord NH 033017539 X Robert P Steigmeyer President & CEO 1.00 62.00 X X 0 1440673 303393 Teri Brehio MD Trustee 1.00 50.00 X 0 292894 81859 Sol Asmar Trustee 1.00 6.00 X 0 0 0 Frank Boucher Trustee 1.00 0.00 X 0 0 0 James Doremus Trustee 1.00 0.00 X 0 0 0 Michelline Dufort Trustee (end 1/2023) 1.00 0.00 X 0 0 0 Philip Emma Trustee (end 1/2023) 1.00 7.00 X 0 0 0 BJ Entwisle MD Trustee 1.00 0.00 X 0 0 0 Charles Fanaras Trustee 1.00 7.00 X 0 0 0 Michael T Griffin Trustee 1.00 0.00 X 0 0 0 Lucy C Hodder Esq Trustee 1.00 1.00 X 0 0 0 Lucy Karl Trustee 1.00 6.00 X 0 0 0 David Green MD Trustee (start 1/2023) 1.00 0.00 X 0 0 0 Linda Lorden Trustee 1.00 1.00 X 0 0 0 Mary E Miller Trustee 1.00 0.00 X 0 0 0 Peter Noordsij Trustee (start 1/2023) 1.00 1.00 X 0 0 0 Manisha Patel DDS Trustee 1.00 7.00 X 0 0 0 Muriel Schadee CPA Trustee (end 1/2023) 1.00 1.00 X 0 0 0 Robert Segal Trustee 1.00 7.00 X 0 0 0 Jeffrey Towle Trustee 1.00 2.00 X 0 0 0 David Ruedig Chair 1.00 0.00 X X 0 0 0 William Chapman Esq Vice Chair & Secretary 1.00 6.00 X X 0 0 0 Scott Sloane Senior VP, CFO, & Treasurer 1.00 62.00 X 0 636917 143367 0 2370484 528619 0 0 1 0 0 Rental income 531190 434909 388419 46490 434909 434909 388419 46490 0 100198 100198 33953 33953 12432 12432 146583 146583 0 0 211775 360976 1296 1334 3039652 1066844 1985240 1972808 1000 1000 456881 572447 2656192 2908565 252078 379283 533148 466570 785226 845853 X 1870966 2062712 1870966 2062712 2656192 2908565 X 288326 -96580 X 0 0 0 X X 1 Concord Hospital Inc 222594672 3 1 0 146583 1 0 146583 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Schedule A, Part I, Line 12g, Column (v) & (vi): Health service system support to Capital Region Health Care Corporation's supported organization by means of property management services. The amount of the Organization's total expenses is an approximation of the nonmonetary support provided by Capital Region Health Care Corporation. But for the existence of Capital Regional Health Care Corporation, these functions would otherwise be carried out by the supported organization. 3039652 1066844 1972808 1972808 Due from affiliates 572447 572447 Note payable to Concord Hospital 466570 466570 0 1 0 0 0 0 0 0 0 Robert P Steigmeyer President & CEO 0 864308 0 349416 0 226949 0 261361 0 42032 0 1744066 0 174774 Scott Sloane Senior VP, CFO, & Treasurer 0 488716 0 126153 0 22048 0 107931 0 35436 0 780284 0 0 Teri Brehio MD Trustee 0 270747 0 19217 0 2930 0 46393 0 35466 0 374753 0 0 Part I, Line 3 The compensation for the Organization's CEO was established by a related organization, Concord Hospital. That organization established the CEO's compensation by using a compensation committee, independent compensation consultant, and a compensation study. The compensation was also approved by the Hospital's compensation committee. Part I, Line 4b Capital Region Health Care Corporation is a related organization to Concord Hospital. Robert P. Steigmeyer, President & CEO, participated in a 457(f) plan with Concord Hospital, Inc. during the fiscal year covered by this tax return. Under the terms of the plan, amounts deferred and contributed to the plan are subject to a three-year vesting period. After satisfying this vesting period, 457(f) deferred amounts are to be included in Mr. Steigmeyer's taxable W-2 wages. The calendar year ending within the Hospital's current reporting period of September 30, 2023 (tax year 2022) includes amounts previously set aside as deferred under Mr. Steigmeyer's 457(f) plan more than three years ago, and have therefore become vested. Accordingly, Mr. Steigmeyer is now recognizing in his W-2 taxable wages vested 457(f) plan deferrals. For the period covered by this tax return, included within Mr. Steigmeyer's 2022 Form W-2 taxable wages are $174,774 of vested 457(f) deferrals, which represent amounts previously reported on Schedule J, Part II, Column C, as deferred compensation for the fiscal year ending September 30, 2019. In accordance with IRS instructions, this vested and taxable amount has been included in Schedule J, Part II, Column B(iii) and Column F. Beginning with the September 30, 2015 tax year, there have been contributions to Mr. Steigmeyer's 457(f) plan. Each contribution, plus earnings, will be reported in Mr. Steigmeyer's W-2 after a three-year vesting period. For the fiscal years ended September 30, 2021, 2022, and 2023, Mr. Steigmeyer received total plan contributions (including interest and investment credits) of $197,425, $221,218, and $231,021, respectively. Due to the timing between the Hospital's fiscal year filing period and the calendar year period by which compensation and benefits information is reported on Form 990, Schedule J, the amount included in Mr. Steigmeyer's deferred compensation amounts in this Schedule J, Part II, Column C, includes the $177,820 contribution to his 457(f) plan, plus $43,398 of earnings. During the year ending September 30, 2021, the Hospital established a Supplemental Executive Retirement Plan (SERP) for the Senior Vice Presidents of Concord Hospital. Under the terms of this SERP, the Hospital credits Senior Executives' accounts at the end of each fiscal year, and the credit shall vest and become payable on the third anniversary of the date such amounts are credited to the account, provided the Senior Executives remain continuously employed through the applicable vesting date. The three-year vesting period SERP amount will be included in taxable W-2 wages upon vesting and payment. For the fiscal years ended September 30, 2021, 2022, and 2023, total contributions to the SERP, including interest and investment earnings credits, for Scott Sloane were $26,462, $43,139, and $48,021, respectively. Due to the timing between the Hospital's fiscal year filing period and the calendar year period by which compensation and benefits information is reported on Form 990, Schedule J, the amounts included in Mr. Sloane's deferred compensation on this Schedule J, Part II, Column C, including contributions to his 457(f) plan and earnings, are as follows: contributions, $41,088; interest credit, $2,051. As none of the SERP contributions have yet satisfied the three-year vesting conditions as of the period covered by this tax return, none of the SERP contributions have yet been included in Mr. Sloane's W-2 wages. Form 990, Part VI, Section B, line 11b All board members receive a copy of the 990 to review prior to filing the report. Form 990, Part VI, Section B, line 12c Each trustee, officer and committee member, upon entering the duties of his/her office and annually thereafter, will be advised of this policy and shall sign a statement acknowledging his/her understanding of and agreement to this policy. Annual reviews will adhere to state regulations that require public notice for any significant pecuniary transaction. Form 990, Part VI, Section B, line 15 The evaluation of the performance of the Chief Executive Officer ("CEO") of Concord Hospital and its subsidiaries (collectively the "Hospital") is an important responsibility of the Concord Hospital Board of Trustees (the "Board") and is vital in ensuring that the Hospital meets its mission. The Board has delegated the responsibility of initiating the process of conducting the CEO's performance evaluation and initiating the process of setting the CEO's compensation to the Board's Compensation Committee. The Compensation Committee also is charged with the responsibility of reviewing the appropriateness of the compensation of the Hospital's Chief Operating Officer (COO), Chief Financial Officer (CFO), and Chief Medical Officer (CMO) as proposed by the CEO. The Compensation Committee shall present its report of the CEO's annual performance to the Board for its further input and consideration. The Compensation Committee shall also make its recommendation to the Board concerning the CEO's compensation. Finally, the Compensation Committee shall make its recommendation to the Board concerning the compensation of the COO, CFO, and CMO. The Board shall review the recommendations of the Compensation Committee as to the compensation of the Hospital's CEO, COO, CFO, and CMO and shall set their compensation as the Board deems appropriate. The Board directs that the Compensation Committee and the Board itself, in their respective undertakings of recommending and setting the compensation of the Hospital's CEO, COO, CFO and CMO, avoid conflicts of interest and be guided by the "rebuttable presumption of reasonableness" regulations under the so-called "Excess Benefit Transaction" provisions of the Internal Revenue Code ("IRC"). The Board authorizes the Compensation Committee to use such financial and advisory (e.g., legal counsel, consultant) resources as it reasonably deems appropriate to fulfill its duties in evaluating the CEO's performance and in making its recommendations to the Board regarding compensation for the CEO, COO, CFO, and CMO. Form 990, Part VI, Section C, line 19 Financial statements are available upon request. Governing documents and conflicts of interest filings adhere to state regulations that require public notice for any significant pecuniary transaction. Form 990, Part VII, Section A, Column E: The compensation reported for Robert P. Steigmeyer and Scott Sloane were paid by Concord Hospital for their services as full-time executives. In total, they each worked an average of 63 hours per week for all entities in the Concord Hospital health care system, of which an average of 1 hour per week was dedicated to Capital Region Health Care Corp. Dr. Teri Brehio was paid for services performed as an employee of Concord Hospital. Form 990, Part XI, line 9: Net transfers to affiliates -96,580. Concord Hospital 250 Pleasant Street Concord NH 03301 222594672 Provide medical care NH 501(c)(3) Line 3 Capital Region Health Care Corp 1 Capital Region Health Ventures Corp 250 Pleasant Street Concord NH 03301 020438264 Provide medical care to community NH 501(c)(3) Line 12b, II Concord Hospital 0 Concord Regional Visiting Nurses Association 250 Pleasant Street Concord NH 03301 020222122 Home health care & hospice services NH 501(c)(3) Line 10 N/A 1 Capital Region Health Care Development Corp 250 Pleasant Street Concord NH 03301 020429749 Support Concord Hospital & other affiliates NH 501(c)(2) Concord Hospital 0 Concord Hospital Trust 250 Pleasant Street Concord NH 03301 260378710 Fundraising NH 501(c)(3) Line 12a, I Concord Hospital 0 Riverbend Community Mental Health Inc 3-5 North State Street Concord NH 033022032 020264383 Multi-service team NH 501(c)(3) Line 7 N/A 0 Concord Hospital - Franklin 250 Pleasant Street Concord NH 03301 851433123 Provide medical care to community NH 501(c)(3) Line 3 Concord Hospital 0 Concord Hospital - Laconia 250 Pleasant Street Concord NH 03301 851443782 Provide medical care to community NH 501(c)(3) Line 3 Concord Hospital 0 Concord Imaging Center LLC 2 1/2 Beacon Street Concord NH 03301 020436605 Provide radiology services to community NH N/A 0 0 Capital Orthopedic Surgery Center 250 Pleasant Street Concord NH 03301 020522860 Provide medical care to community NH N/A 0 0 Concord Endoscopy Center LLC 60 Commerical Street Concord NH 03301 201184756 Provide medical care to community NH N/A 0 0 OSC Condo LLC 250 Pleasant Street Concord NH 03301 872969559 Rental Property NH N/A 0 0 Capital Region Health Services Corporation 250 Pleasant Street Concord NH 03301 020428631 Medical services NH N/A C 1 Capital Region Primary Care Corporation 250 Pleasant Street Concord NH 03301 020495275 Inactive NH N/A C 0 Lakes Region Medical Office Building 250 Pleasant Street Concord NH 03301 020409867 Rental properties and condominiums NH N/A C 0 Hillside Medical Park Condo Association 250 Pleasant Street Concord NH 03301 863920257 Rental properties and condominiums NH N/A C 0 CH Memorial West Condominium Association 250 Pleasant Street Concord NH 03301 372006095 Rental properties and condominiums NH N/A C 0 0 0 0 1 1 0 0 0 0 1 0 1 1 1 1 0 1 0 0 Concord Hospital E 466570 Actual per books Concord Hospital J 15776 Actual per books Concord Hospital L 146583 Actual per books Concord Hospital Q 96580 Actual per books Schedule R, Part III: In accordance with IRS instructions, the partnerships listed in Part III are being reported due to their control relationship with Capital Region Health Ventures Corp and Venture Corp's brother/sister relationship with Capital Region Health Care Corp.