2024-05-13T11:42:25+00:00 2023-06-30 350921680 CROWE LLP 9600 Brownsboro Road Suite 400 Louisville KY 402413902 990 2022-07-01 222519596 Dartmouth-Hitchcock Clinic DART 6036531154 One Medical Center Drive Lebanon NH 03756 Wendy E Fielding CFO 2024-05-13 true Wendy Fielding 999009999 Kim Scifres P01316095 5023263996 2022 2023-04-26 12:10:37Z Joanne M Conroy MD One Medical Center Drive Lebanon NH 03756 638430473 false X www.dartmouth-hitchcock.org X 1983 NH Advancing health through research, education, clinical practice, and community partnerships; providing each person the best care in the right place, at the right time, every time. 23 17 6206 333 677921 0 39587886 41922401 431755697 461675908 -31124 -23228 140312712 134842046 611625171 638417127 3939176 3732146 0 364509067 394551019 0 165292 292073756 337564669 660521999 735847834 -48896828 -97430707 244752235 296975257 558910192 681857268 -314157957 -384882011 WE ADVANCE HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME. false false 590969489 3732146 591057715 Dartmouth-Hitchcock Clinic (DHC) is a not-for-profit organization as described in Section 501(c)(3) of the Internal Revenue Code (Code) and is exempt from federal income taxes on related income, pursuant to Section 501(a) of the Code. DHC and its subsidiaries form a multispecialty physician practice group which operates throughout New Hampshire and Vermont and provides both medical services to patients and medical education and research. Health care services provided during fiscal year 2023 resulted in 1,381,030 office visits recorded by DHC personnel, with 339,320 unique patients served. The promotion of health through the medical practice activities of DHC provides the basis for the organization's tax-exempt status. DHC operates as an integral component of (and is fully owned by) Dartmouth-Hitchcock Health (D-HH), a New Hampshire not-for-profit corporation organized to support medical organizations like DHC. DHC provides the physician and advanced practice provider staff to a related affiliate, Mary Hitchcock Memorial Hospital (MHMH, also a fully-owned member of D-HH) and the related sophistication essential for the development and operations of the Hospital as the largest and only teaching hospital in New Hampshire and the designation by the federal government as a rural referral center for northern New England. The shared mission of DHC and MHMH is to advance health through research, education, clinical practice, and community partnerships, providing each person the best care, in the right place, at the right time, every time. Consistent with this mission, and in partnership with MHMH, DHC provides high-quality, cost-effective, comprehensive, and integrated health care to individuals, families, and the communities it serves regardless of a patient's ability to pay. DHC actively supports community-based health care and promotes the coordination of services among health care providers and social services organizations within the regions it serves. DHC also seeks to work collaboratively with other area health care providers to improve the health status of residents in the region. DHC and MHMH jointly file an annual community benefits report with the State of New Hampshire which outlines the community and charitable benefits DHC and MHMH provide. The complete and updated community benefits reports are available upon request; these reports can also be found on the organization's website. The broad categories used in the community benefit report to summarize the benefits mentioned here include: "financial assistance" (formerly called "charity care"), which represents services provided to patients who cannot afford health care services due to inadequate financial resources which result from being uninsured or underinsured. For the year ended June 30, 2023, DHC provided financial assistance to 18,289 patients in the amount of $14,447,588. as measured by gross charges. The cost of providing this care for the year ended June 30, 2022, was $12,950,295. DHC also routinely provides services to Medicaid patients at reimbursement levels that are well below the cost of the care provided. The uncompensated cost of care for Medicaid patients for the year ended June 30, 2023 was $56,821,173. Community health activities include the cost or value of several different types of programs, including the cost of community-based education, health fairs, health screenings, support groups, and programs and materials that promote wellness and prevent illness. Examples of these types of efforts include Granite State Fit Kids Health Program for elementary schools, the Women's Health Resource Centers in Lebanon, NH, and Smoking Prevention and Cessation programs. This category also includes financial contributions and the contribution of time and services to community programs, hospitals, and agencies. DHC also provides a significant amount of uncompensated care to its patients that is reported as "provision for bad debts," which is not included in the amounts reported above. For the fiscal year ended June 30, 2023, DHC reported a provision for bad debts of approximately $28,572,611. 39891554 3476020 As a component of an integrated academic medical center, Dartmouth-Hitchcock Clinic (DHC) provides significant support for academic and research programs through its support of the Geisel School of Medicine at Dartmouth College (GSM). DHC provides support for physicians' unpaid teaching time as part of its community benefit initiatives, consisting of the time physicians spend providing clinical supervision and education for residents and medical students. In addition, DHC provides in-kind support for research and other grants representing costs in excess of awards for numerous grant-funded health research and service initiatives awarded to Mary Hitchcock Memorial Hospital (MHMH) and GSM. Other community benefit initiatives include subsidizing the costs of providing medical and clinical education to professionals across New Hampshire, Vermont, and beyond as well as uncompensated costs of academic and medical research activities. 630861043 true true false true false false false false true true true false true true false false true false true true true false false false false false true true true false false false true false false true false false false false false true true true true false false true 0 0 6206 true true true false false false false false false false false false true false X 23 17 false false false false true true true true true false false true true true true true true true true false NH X Wendy E Fielding 6036531154 One Medical Center Drive Lebanon NH 03756 Charles G Plimpton MBA Trustee / Treasurer 1.5 2.5 X X 0 0 0 David P Paul Trustee / Secretary 0.8 1.8 X X 0 0 0 Joanne M Conroy MD Trustee, Ex-Officio, CEO 16.2 39.9 X X 1666034 0 47441 ROBERTA L HINES MD TRUSTEE / Chair 1.5 2.0 X X 0 0 0 Aaron J Mancuso MD Trustee (through 12/31/22) / Physician 12.0 28.0 X 466892 0 64550 Carl W Dobson MD Trustee/ Medical Director 0.8 40.0 X 0 471672 58700 Celestna M Dooley-Jones PHD Trustee (as of 1/1/23) 0.8 0.8 X 0 0 0 Duane A Compton PHD Trustee / Ex-Officio 0.8 1.7 X 0 0 0 Edward H Stansfield III MA Trustee 0.8 2.3 X 0 0 0 Elof Eriksson MD PhD Trustee 0.8 0.8 X 0 0 0 Gary L Freed MD Trustee/ Physician 12.0 28.0 X 720881 0 25997 Gary V Desir Trustee (as of 1/1/23) 0.8 0.8 X 0 0 0 Geraldine Bednash PHD RN FAAN Trustee 0.8 1.3 X 0 0 0 Jarvis A Green Trustee (on leave As of 1/1/23) 0.8 0.8 X 0 0 0 Jennifer L Moyer MBA Trustee 0.8 1.3 X 0 0 0 Laura Chiang Trustee (as of 1/1/23) / Physician 12.0 28.0 X 362259 0 54582 Marc B Wolpow JDMBA Trustee (through 11/16/22) 0.8 1.3 X 0 0 0 Mark S Speers MBA Trustee (as of 1/1/23) 0.8 0.8 X 0 0 0 Mark W Begor MBA Trustee 0.8 1.3 X 0 0 0 Nancy M Dunbar MD Trustee / Physician 12.0 28.0 X 389532 0 67854 Pamela Thompson MSRNCENP Trustee 0.8 1.3 X 0 0 0 Paul A Taheri MD MBA Trustee (as of 6/24/23) 0.8 1.6 X 0 0 0 Paul P Danos PHD Trustee (through 12/31/22) 0.8 1.3 X 0 0 0 Sandra L Wong MD Trustee/SVP Svc Ln & Dept Chair 12.0 28.0 X 791139 0 38485 Sherri C Oberg Trustee 0.8 0.8 X 0 0 0 Thomas Glynn PHD Trustee 0.8 0.8 X 0 0 0 Thomas Raffio Trustee 0.8 0.8 X 0 0 0 Aimee M Claiborne Chief Human Resource Officer 12.0 28.5 X 0 518080 43314 EDWARD MERRENS Chief Clinical Officer 12.0 29.0 X 801775 0 49533 JOHN KACAVAS Chief Legal Officer (through 12/31/22) 12.0 31.0 X 0 805496 69720 Kimberly Troland JD Interim Chief Legal Officer (as of 1/1/23) 12.0 28.5 X 0 435137 46824 Matthew Haag Chief Development Officer 12.0 28.0 X 0 403945 40807 Patrick F Jordan III MBA Chief Operating Officer 12.0 31.0 X 0 829011 69885 Stephen Leblanc Chief Strategy Officer 12.0 31.0 X 782783 0 64656 Susan A Reeves EDDRN Executive VP (medical center) 12.0 28.0 X 0 717088 61682 Wendy Fielding Chief Financial Officer 12.0 28.5 X 0 407870 64547 David F Duncan System VP - Facilities Mgmt 12.0 29.0 X 0 309143 45557 Jeffrey Obrien MHA Chief Operating Officer - DHMC 12.0 28.0 X 0 387194 70301 Karen Clements RNBSNMSB Chief Nursing Officer 12.0 28.0 X 0 430010 41911 Martin Purcell MBA Chief Information Officer 12.0 28.0 X 0 547555 46242 Simon Hillier Dept Chair ANESTHESIOLOGY 12.0 28.0 X 635001 0 66182 Staci Hermann PHARMDMS CHIEF PHARMACY OFFICER 12.0 28.0 X 0 342664 32321 Daniel Stewart Physician 12.0 28.0 X 1075702 0 67685 John Nigriny Physician 40.0 0 X 1072884 0 68216 Lixia Ellis Physician 40.0 0 X 1171610 0 62345 Matthew LeBoeuf Physician 12.0 28.0 X 1013330 0 57935 Timothy Ryken Physician 12.0 28.0 X 1115672 0 61671 DANIEL P JANTZEN Chief Financial Officer - MHMH 12.0 31.0 X 0 968827 64656 GEORGE T BLIKE MD MHCDS Former/ Chief Quality & Value Officer (DHC) 10.0 11.5 X 154960 0 11234 Maria Padin MD Chief Medical Officer, CGP (DHC) 12.0 30.0 X 526550 0 65544 Peter D Solberg MD Chief Health Information Officer (DHC) 12.0 28.0 X 503674 0 73362 Richard I Rothstein MD Former Dept Chair/Srvc LN LDR - MED (DHC) 12.0 28.0 X 674829 0 66031 13925507 7573692 1769770 1890 true true false 0 27355217 14567184 41922401 NET PATIENT SERVICE REVENUE 621300 461675908 461675908 0 0 0 0 461675908 19611 1723 17888 822325 62048 7919 5427 814406 56621 871027 871027 -42839 -42839 0 -42839 -42839 CONTRACTED REVENUE 621300 120065265 119389067 676198 CAFETERIA INCOME 722514 436994 436994 OTHER REVENUE 621300 13468760 13468760 0 0 0 0 133971019 638417127 594533735 677921 1283070 3308498 3308498 359696 359696 63952 63952 5654182 2096791 3393301 164090 755101 328584 425315 1202 303241974 265126405 38115569 22140329 19262086 2878243 42633701 37091320 5542381 20125732 17509387 2616345 760535 32580 727955 317294 77144 240150 71833911 64020681 7813230 0 1163613 38217 1125396 9679690 7299759 2379931 11419476 913558 10505918 9999318 595946 9403372 1491571 865067 626504 50185 49442 743 8144588 52611 8091977 3371553 1321583 2049970 7116463 5889964 1226499 MEDICAL SUPPLIES 195854283 193964937 1889346 EQUIP REPAIR & MAINTENANCE 8113587 4729103 3384484 ACADEMIC, GME, TEACHING & SUPPORT 3666012 3156882 509130 RECRUITMENT COSTS 997698 55194 942504 3584892 2651656 933236 0 735847834 630861043 104821499 165292 154050 50805627 61758670 172807 173404 0 0 410959 298678 5616432 8550855 126324369 113206141 16421544 13118228 356287 331022 53655396 71147802 1706081 1719520 115453052 139877078 244752235 296975257 317098927 448670757 0 0 2034494 1553369 239776771 231633142 558910192 681857268 X -315748181 -386563240 1590224 1681229 -314157957 -384882011 244752235 296975257 X -97430707 168980 26537673 X false true X true true true X 8020230 24093904 74843390 39587886 41922401 188467811 501802116 472942824 545666182 570079194 594533735 2685024051 0 0 0 509822346 497036728 620509572 609667080 636456136 2873491862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2873491862 1008778 989972 909298 963456 902261 4773765 0 1008778 989972 909298 963456 902261 4773765 3882 4453 0 0 0 8335 485850 421974 338902 388346 436994 2072066 511320856 498453127 621757772 611018882 637795391 2880346028 0.9976 0.9975 0 0.0 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - OTHER INCOME, COLUMN A - 485850.0, COLUMN B - 421974.0, COLUMN C - 338902.0, COLUMN D - 388346.0, COLUMN E - 436994.0, COLUMN F - 2072066.0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 54777 54777 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LINE 1I DHC PAYS DUES TO VARIOUS ORGANIZATIONS RELATED TO ITS EXEMPT MISSION. THE AMOUNT REPORTED UNDER OTHER ACTIVITIES ON LINE 1I REFERS TO THE AMOUNT OF LOBBYING ACTIVITIES IDENTIFIED IN DUES PAYMENTS TO OUTSIDE ORGANIZATIONS. 1522069 97122 6201 1612990 1705532 -116575 66888 1522069 1360094 368174 22736 1705532 1345817 28397 14120 1360094 1340985 61035 56203 1345817 0.0 0.619 0.381 false false 2505032 7215859 9720891 72481325 69125290 3356035 27567760 27586966 -19206 16554393 16493885 60508 13118228 Investment in Pooled Funds 1630233 F INVESTMENT IN CAPTIVE 69517569 F 71147802 DHC 457(B) PLAN ASSETS 126091445 DUE FROM AFFILIATE 13785249 OTHER MISC ASSETS 384 ESTIMATED THIRD PARTY SETTLEMENT 139877078 ACCRUED POST RETIREMENT PENSION 142155314 RESERVES FOR INSURANCE RELATED LOSS 89477828 ESTIMATED THIRD PARTY SETTLEMENT 0 231633142 Schedule D, Part X, Line 2 ASC 740 (FIN 48) FOOTNOTE NO ASC 740 (FIN 48) FOOTNOTE WAS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS AS THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT OR SINCE ADOPTION. Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUND WAS ESTABLISHED TO PROVIDE RESEARCH AND CLINICAL SUPPORT FOR THE CARDIOTHORACIC SURGERY CHAIR AT DARTMOUTH-HITCHCOCK CLINIC true Central America and the Caribbean 0 0 Grant to recipients located in the region 28919 Central America and the Caribbean 0 0 Investments 69517569 South Asia 0 1 Program Services,Grant to recipients located in the region DOCTORS HELPED TO LAUNCH LIFE SAVING EMERGENCY MEDICAL EDUCATION TO BHUTAN 2187 Europe (Including Iceland and Greenland) 0 0 Fundraising,Grant to recipients located in the region 71783 North America (Canada & Mexico only) 0 0 Fundraising,Grant to recipients located in the region 22550 Sub-Saharan Africa 0 2 Fundraising,Program Services,Grant to recipients located in the region PROVIDERS WENT TO RWANDA TO HELP TRAIN AND DELIVER EMDOSCOPIC CARE ALONGSIDE RWANDAN PEERS. 22360 0 3 0 0 0 3 69665368 0 69665368 Sub-Saharan Africa Program Support 4592 Cash FMV Europe (Including Iceland and Greenland) Program Support 18172 Cash FMV Central America and the Caribbean Program Support 28919 Cash FMV North America (Canada & Mexico only) Program Support 12269 Cash FMV 4 0 true false true false true false Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds THE CLINIC PROVIDES UNRESTRICTED PROGRAM SUPPORT FOR CERTAIN FOREIGN ORGANIZATIONS. PROGRAM SUPPORT TO SPECIFIC ORGANIZATIONS IS CHOSEN AND DIRECTED BY THE PHYSICIANS AND/OR RESEARCHERS WORKING DIRECTLY WITH THE CHARITY. Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual; EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; NORTH AMERICA (CANADA & MEXICO ONLY)-Accrual; SOUTH ASIA-Accrual; SUB-SAHARAN AFRICA-Accrual Schedule F, Part II, Line 1 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual; EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; NORTH AMERICA (CANADA & MEXICO ONLY)-Accrual; SUB-SAHARAN AFRICA-Accrual true American Cancer Society 131788491 501(c)3 23200 FMV PROGRAM SUPPORT American Heart Association 135613797 501(c)3 10150 FMV PROGRAM SUPPORT Amoskeag Health 020458174 501(c)3 11600 FMV PROGRAM SUPPORT COLBY-SAWYER COLLEGE 020222120 Section 115 17689 FMV EDUCATIONAL SERVICES COMMUNITY COLLEGE SYSTEM OF N HAMPSHIRE 900531902 Section 115 5664 FMV EDUCATIONAL SERVICES Community Nurse Connection 831224873 501(c)(3) 5800 FMV CHARITABLE PROGRAM SUPPORT Families Flourish Northeast 844591232 501(c)3 7250 FMV PROGRAM SUPPORT Families in Transition 020475414 501(c)3 6525 FMV PROGRAM SUPPORT Foundation for Healthy Communities (NHHA) 020275078 501(c)3 498492 FMV PROGRAM SUPPORT Good Neighbor Health Clinic 030346949 501(c)3 23200 FMV PROGRAM SUPPORT Grafton County Senior Citizens Council 237248316 501(c)3 8410 FMV PROGRAM SUPPORT Granite United Way 026006033 501(c)3 11600 FMV PROGRAM SUPPORT HIVHCV Resource Center 223104237 501(c)3 5800 FMV PROGRAM SUPPORT Listen Community Services 237225952 501(c)3 21750 FMV PROGRAM SUPPORT Mascoma Community Healthcare 465672753 501(c)(3) 34800 FMV PROGRAM SUPPORT MEDICAL UNIVERSITY OF SOUTH CAROLINA 576000722 Section 115 54952 FMV EDUCATIONAL SERVICES Mt Ascutney Hospital and Health Center 030183721 501(c)3 11600 FMV PROGRAM SUPPORT NAVAL HEALTH RESEARCH CENTER 800520146 Federal 15888 FMV CHARITABLE RESEARCH New Hampshire Charitable Foundation 026005625 501(c)3 17400 FMV CHARITABLE PROGRAM SUPPORT New Hampshire Hunger Solutions Inc 222936618 501(c)3 13050 FMV PROGRAM SUPPORT New Hampshire Legal Assistant 020300897 501(c)3 11165 FMV CHARITABLE PROGRAM SUPPORT New Hampshire Women's Foundation 020495092 501(c)3 8700 FMV PROGRAM SUPPORT NH Healthcare Workers for Climate 872425617 501(c)(3) 5800 FMV PROGRAM SUPPORT NH Triple Play LLC 320153852 29000 FMV PROGRAM SUPPORT Public Health Council of the Upper Valley 752991608 501(c)3 21750 FMV CHARITABLE PROGRAM SUPPORT REGENTS OF THE UNIVERSITY OF CALIFORNIA 943067788 Section 115 7339 FMV EDUCATIONAL SERVICES RIVER VALLEY COMMUNITY COLLEGE 540903278 Section 115 5121 FMV EDUCATIONAL SERVICES Southeast Vermont Transit Inc 030353976 501(c)3 8700 FMV PROGRAM SUPPORT Southeastern Vermont Community Action 030216740 501(c)(3) 17400 FMV PROGRAM SUPPORT The Family Place 030305264 501(c)4 6989 FMV CHARITABLE PROGRAM SUPPORT The Hitchcock Foundation 020222139 501(c)3 220910 FMV PROGRAM SUPPORT TLC Family Resource Center 522439830 501(c)3 14790 FMV PROGRAM SUPPORT Tri-Valley Transit 030335768 501(c)3 13211 FMV PROGRAM SUPPORT TRUSTEES OF THE UNIV OF PENNSYLVANIA 231352685 Section 115 13134 FMV EDUCATIONAL SERVICES Twin Pines Housing Trust 222809527 501(c)3 15950 FMV PROGRAM SUPPORT UNIV SYSTEM OF NEW HAMPSHIRE 026000937 Section 115 31533 FMV EDUCATIONAL SERVICES UNIVERSITY OF ALABAMA AT BIRMINGHAM 636005396 Section 115 11214 FMV EDUCATIONAL SERVICES UNIVERSITY OF CALIFORNIA SAN DIEGO 956006144 Section 115 9181 FMV EDUCATIONAL SERVICES UNIVERSITY OF COLORADO 846000555 Section 115 10273 FMV EDUCATIONAL SERVICES UNIVERSITY OF MARYLAND 526002033 Section 115 40098 FMV EDUCATIONAL SERVICES UNIVERSITY OF NEBRASKA MEDICAL CTR 470491233 Section 115 5192 FMV EDUCATIONAL SERVICES UNIVERSITY OF PITTSBURGH 250965591 Section 115 18969 FMV EDUCATIONAL SERVICES UNIVERSITY OF WASHINGTON 916001537 Section 115 10384 FMV EDUCATIONAL SERVICES Upper Valley Haven 030277908 501(c)3 13050 FMV PROGRAM SUPPORT Upper Valley Lake Sunapee Regional Planning Foundation 834074101 501(c)3 11600 FMV PROGRAM SUPPORT VIRGINIA COMMONWEALTH UNIVERSITY 546001758 Section 115 10548 FMV EDUCATIONAL SERVICES Where Technologies LLC 474001501 5926 FMV PROGRAM SUPPORT White River Council on Aging 030261891 501(c)(3) 5800 FMV PROGRAM SUPPORT Willing Hands Enterprises 202204811 501(c)3 6235 FMV PROGRAM SUPPORT Women's Information Service of the Upper Valley 020346512 501(c)3 5800 FMV PROGRAM SUPPORT 47 3 Awards and Educational Assistance 28 315507 FMV Patient Assistance 1560 44189 FMV Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. EACH AWARD ESTABLISHED BY DARTMOUTH-HITCHCOCK CLINIC (DHC) HAS WRITTEN GUIDELINES AND PROCEDURES. AWARD PAYMENTS ARE PROCESSED IN ACCORDANCE WITH THE SPECIFIC TERMS OF EACH AWARD. THE DARTMOUTH INSTITUTE SCHOLARSHIPS (TDI) ARE PAID DIRECTLY TO DARTMOUTH COLLEGE ON BEHALF OF THE INDIVIDUALS RECEIVING THE AWARD. THE COORDINATORS OF THE PROGRAMS ARE RESPONSIBLE FOR ASSURING THAT ALL TERMS ARE MET, INCLUDING PROPER DOCUMENTATION OF EXPENSES WITH RECEIPTS. X true true X X X X false true false false false false false false false Joanne M Conroy MD Trustee, Ex-Officio, CEO 1473908 0 0 0 192126 0 29250 0 18191 0 1713475 0 0 0 Sandra L Wong MD Trustee/SVP Svc Ln & Dept Chair 730754 0 0 0 60385 0 23150 0 15335 0 829624 0 0 0 Carl W Dobson MD Trustee/ Medical Director 0 385157 0 65500 0 21015 0 15250 0 43450 0 530372 0 0 Gary L Freed MD Trustee/ Physician 658973 0 0 0 61908 0 23150 0 2847 0 746878 0 0 0 Aaron J Mancuso MD Trustee (through 12/31/22) / Physician 454911 0 2014 0 9967 0 22803 0 41747 0 531442 0 0 0 Nancy M Dunbar MD Trustee / Physician 358120 0 813 0 30599 0 23150 0 44704 0 457386 0 0 0 Laura Chiang Trustee (as of 1/1/23) / Physician 336431 0 1032 0 24796 0 13890 0 40692 0 416841 0 0 0 DANIEL P JANTZEN Chief Financial Officer - MHMH 0 815505 0 0 0 153322 0 29250 0 35406 0 1033483 0 0 Maria Padin MD Chief Medical Officer, CGP (DHC) 475513 0 0 0 51037 0 29250 0 36294 0 592094 0 0 0 Richard I Rothstein MD Former Dept Chair/Srvc LN LDR - MED (DHC) 623212 0 0 0 51617 0 29250 0 36781 0 740860 0 0 0 Wendy Fielding Chief Financial Officer 0 365911 0 0 0 41959 0 29250 0 35297 0 472417 0 0 Aimee M Claiborne Chief Human Resource Officer 0 486145 0 0 0 31935 0 23150 0 20164 0 561394 0 0 Patrick F Jordan III MBA Chief Operating Officer 0 777526 0 0 0 51485 0 29250 0 40635 0 898896 0 0 JOHN KACAVAS Chief Legal Officer (through 12/31/22) 0 680386 0 0 0 125110 0 29250 0 40470 0 875216 0 0 Stephen Leblanc Chief Strategy Officer 687948 0 0 0 94835 0 29250 0 35406 0 847439 0 0 0 EDWARD MERRENS Chief Clinical Officer 725384 0 0 0 76391 0 29250 0 20283 0 851308 0 0 0 Susan A Reeves EDDRN Executive VP (medical center) 0 639528 0 250 0 77310 0 29250 0 32432 0 778770 0 0 Kimberly Troland JD Interim Chief Legal Officer (as of 1/1/23) 0 385359 0 0 0 49778 0 23150 0 23674 0 481961 0 0 Matthew Haag Chief Development Officer 0 368250 0 0 0 35695 0 23150 0 17657 0 444752 0 0 GEORGE T BLIKE MD MHCDS Former/ Chief Quality & Value Officer (DHC) 154960 0 0 0 0 0 11234 0 0 0 166194 0 0 0 Peter D Solberg MD Chief Health Information Officer (DHC) 464308 0 0 0 39366 0 29250 0 44112 0 577036 0 0 0 Karen Clements RNBSNMSB Chief Nursing Officer 0 392531 0 250 0 37229 0 26136 0 15775 0 471921 0 0 Staci Hermann PHARMDMS CHIEF PHARMACY OFFICER 0 319419 0 0 0 23245 0 15006 0 17315 0 374985 0 0 Simon Hillier Dept Chair ANESTHESIOLOGY 575558 0 0 0 59443 0 29250 0 36932 0 701183 0 0 0 Jeffrey Obrien MHA Chief Operating Officer - DHMC 0 372337 0 0 0 14857 0 29250 0 41051 0 457495 0 0 Martin Purcell MBA Chief Information Officer 0 475663 0 0 0 71892 0 29250 0 16992 0 593797 0 0 David F Duncan System VP - Facilities Mgmt 0 304108 0 0 0 5035 0 18300 0 27257 0 354700 0 0 Daniel Stewart Physician 972144 0 0 0 103558 0 23150 0 44535 0 1143387 0 0 0 John Nigriny Physician 977062 0 6085 0 89737 0 23150 0 45066 0 1141100 0 0 0 Timothy Ryken Physician 921075 0 3851 0 190746 0 29250 0 32421 0 1177343 0 0 0 Matthew LeBoeuf Physician 946470 0 9598 0 57262 0 13890 0 44045 0 1071265 0 0 0 Lixia Ellis Physician 980251 0 170589 0 20770 0 18300 0 44045 0 1233955 0 0 0 Schedule J, Part I, Line 1a Discretionary spending account THE ORGANIZATION HAS IN PLACE A PLAN TO SUPPORT CONTINUING MEDICAL EDUCATION. THE PLAN PROVIDES FIXED DOLLAR LIMITS PER PROVIDER PER 2-YEAR PERIOD THAT CAN BE USED TO DEFRAY THE COSTS OF OBTAINING AND ATTENDING CONTINUING MEDICAL EDUCATION EVENTS AND RELATED TRAVEL. ADDITIONALLY, THESE MONIES CAN BE USED FOR PROFESSIONAL BOOKS, LICENSES, MEMBERSHIPS, AND RELATED EXPENSES. AMOUNTS MUST BE SUBMITTED FOR APPROVAL PRIOR TO REIMBURSEMENT. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Dartmouth Hitchcock Clinic (DHC) and Mary Hitchcock Memorial Hospital (MHMH) sponsor a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable DHC and MHMH to attract and retain quality executive personnel, improve the physicians' post-retirement life insurance benefits, and to replace an increasingly costly retiree life insurance program. The plan was frozen to new participants in 1998. The number of participants and dollar value continues to dwindle as individuals retire/leave the organization. THE FOLLOWING INDIVIDUALS HAVE A SPLIT DOLLAR LIFE PLAN ARRANGEMENT AND RESPECTIVE EMPLOYER PREMIUMS: DANIEL JANTZEN $144,065 STEPHEN LEBLANC $65,927 RICHARD ROTHSTEIN $107,477 Schedule J, Part I, Line 3 ESTABLISHING COMPENSATION CEO The process for determining compensation of the CEO is the responsibility of the Compensation Committee of Dartmouth Hitchcock Health (DHH). The compensation committee consists of the Chairperson of the Board and three or more members of the board who are elected by the board, acting upon the recommendation of the chairperson and are not employees of DHH, a related organization or a subsidiary organization of a related organization. The compensation committee determines the compensation of the CEO of DHC within ranges established by the board. Schedule J, Part II NOTE REGARDING COMPENSATION SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY DHC AND RELATED ORGANIZATIONS. THESE AMOUNTS ARE REPORTED TO EMPLOYEES ON THEIR ANNUAL W-2 FORMS AS COMPENSATION. COLUMNS C AND D REPRESENT ITEMS EARNED, HOWEVER, NOT PAID DIRECTLY TO THE EMPLOYEE AS CASH PAYMENTS DURING THE CALENDAR YEAR. COLUMN C INCLUDES RETIREMENT BENEFITS IN A CALENDAR YEAR. COLUMN D REPRESENTS NONTAXABLE BENEFITS SUCH AS THE COST OF HEALTHCARE COVERAGE PROVIDED BY D-H ON BEHALF OF ITS EMPLOYEES. Stephen Leblanc Officer Split Dollar Life X 0 65927 false true true Richard Rothstein Former Officer Split Dollar Life X 0 107477 false true true 173404 Tung Nguyen Family member of Trustee Laura Chiang 516660 Employment Compensation false Patrick J O'Brien Family member of Trustee Jeffrey O'Brien 75678 Employment compensation false James Ebert Family member of a former officer Maria Padin 62577 Employment compensation false Rachel Black Family member of former officer Maria Padin 106193 Employment Compensation false Collin Black Family member of former officer Maria Padin 53600 Employment Compensation false Chartis Entity more than 35% owned 407316 Trustee owns an entity that owns a vendor false Form 990, Part VI, Line 1a Delegate broad authority to a committee The DARTMOUTH-HITCHCOCK CLINIC (DHC) board has a Governance Committee who has the authority/responsibility of the DHC Board to ensure that DHC continues to fulfill its central mission and vision. This committee has authority to act on behalf of the full Board when the need arises. The chairs of the following committees and the CEO serve on the governance committee: Board committee, Talent Development and Compensation Committee, Research and Education Committee, Finance Committee, and Value Committee. Form 990, Part VI, Line 6 Classes of members or stockholders DARTMOUTH-HITCHCOCK HEALTH (D-HH) IS THE SOLE CORPORATE MEMBER OF DARTMOUTH-HITCHCOCK CLINIC (DHC). D- HH HAS SPECIFIC AUTHORITY AND RESERVED POWERS, INCLUDING THE POWER TO CONFIRM THE ELECTION OF MEMBERS OF DHC'S BOARD OF TRUSTEES AND THE POWER TO APPROVE SIGNIFICANT GOVERNANCE, FINANCIAL AND OPERATIONAL DECISIONS OF DHC'S TRUSTEES. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body DARTMOUTH-HITCHCOCK HEALTH (D-HH) IS THE SOLE CORPORATE MEMBER OF DARTMOUTH-HITCHCOCK CLINIC (DHC). D-HH HAS SPECIFIC AUTHORITY AND RESERVED POWERS, INCLUDING THE POWER TO CONFIRM THE ELECTION OF MEMBERS OF DHC'S BOARD OF TRUSTEES AND THE POWER TO APPROVE SIGNIFICANT GOVERNANCE, FINANCIAL AND OPERATIONAL DECISIONS OF DHC'S TRUSTEES. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders IN ADDITION TO RESERVED POWERS, DARTMOUTH-HITCHCOCK HEALTH (D-HH) SHALL HAVE THE AUTHORITY TO TAKE ACTIONS TO ESTABLISH, MANAGE, AND GOVERN THE SYSTEM AS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM IN FURTHERANCE OF DHC'S MISSION. THESE POWERS INCLUDE BUT ARE NOT LIMITED TO ITEMS SUCH AS THE ABILITY TO APPROVE, DISAPPROVE, OR MODIFY ALL MATERIAL GOVERNANCE, PROGRAMMATIC, AND FINANCIAL DECISIONS OF DHC'S BOARD OF TRUSTEES, TO APPOINT OR REMOVE A MEMBER OF DHC'S BOARD OF TRUSTEES, ASSESS DHC A MONETARY AMOUNT FOR THE PAYMENT OF THE EXPENSES OF D-HH, APPROVE DHC'S BUDGET, APPROVE THE BORROWINGS OR DISPOSITIONS OF ASSETS BY DHC, APPROVE KEY STRATEGIC RELATIONSHIPS, APPROVE THE ELIMINATION OR ADDITION OF ANY MATERIAL HEALTH CARE SERVICE OR PROGRAM, AND OTHER AUTHORITY TO TAKE ACTION ON BEHALF OF DHC. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORMS 990 AND 990-T ARE REVIEWED BY THE DIRECTOR OF FINANCIAL COMPLIANCE, VICE PRESIDENT OF CORPORATE FINANCE, AND BY EXTERNAL CONSULTANTS ALONG WITH THE CHIEF FINANCIAL OFFICER BEFORE THE FILING OF THE RETURN. ONCE THE RETURN HAS BEEN FULLY PREPARED, A FINAL 990 AND 990-T IS SENT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS AND RESPONSES PRIOR TO OFFICIAL FILING OF THE FORMS. Form 990, Part VI, Line 12c Conflict of interest policy THE DARTMOUTH-HITCHCOCK CLINIC (DHC) BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. DARTMOUTH-HITCHCOCK HEALTH'S COMPLIANCE AND AUDIT SERVICES DEPARTMENT CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS, TRUSTEES, AND KEY EMPLOYEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL INVOLVED MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION-MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE COMPENSATION FOR THE CEO IS EVALUATED BY AN INDEPENDENT THIRD PARTY FIRM FOR REASONABLENESS AND NATIONAL DATA BENCHMARKING. THE TALENT DEVELOPMENT AND COMPENSATION COMMITTEE, ALONG WITH INDEPENDENT TRUSTEES, APPROVE THE FINAL COMPENSATION IN CONSULTATION WITH THE INDEPENDENT THIRD PARTY FIRM'S RECOMMENDATIONS AND SUGGESTIONS. THIS PROCESS WAS CONTEMPORANEOUSLY DOCUMENTED AND LAST UNDERTAKEN IN 2023. Form 990, Part VI, Line 15b Process to establish compensation of other employees COMPENSATION FOR OFFICERS AND KEY EMPLOYEES ARE EVALUATED BY INTERNAL HUMAN RESOURCES STAFF USING NATIONAL BENCHMARKING DATA, ALONG WITH ONGOING EVALUATIONS BY AN INDEPENDENT THIRD PARTY FIRM FOR REASONABLENESS, WITH THE LAST FORMAL PROCESS IN 2023. THIS PROCESS WAS CONTEMPORANEOUSLY DOCUMENTED. EXTERNAL BENCHMARKING FROM AN INDEPENDENT THIRD PARTY HAS BEEN USED FOR ANY OFFICER WHO WAS HIRED OR RECEIVED A COMPENSATION ADJUSTMENT SINCE THE LAST FORMAL PROCESS. COMPENSATION RATES ARE DETERMINED BY FOLLOWING THE GUIDELINES OF THE COMPENSATION COMMITTEE CHARTER AND PHILOSOPHY DOCUMENTS AND A FORMAL REVIEW BY COMPENSATION COMMITTEE MEMBERS. THE PROCESS DESCRIBED ABOVE TO ESTABLISH COMPENSATION WAS USED FOR THE FOLLOWING POSITIONS: Chief Financial Officer, Chief Strategy Officer, Chief Clinical Officer, Chief Legal Officer, Chief Human Resources Officer, Chief Operating Officer, Chief Nursing - Executive, Chief Nursing Officer, Chief Pharmacy Officer, Chief Quality & Value Officer, Department Chair - Anesthesia, Department Chair - Pathology, and similar positions. Form 990, Part VI, Line 19 Required documents available to the public DHC'S GOVERNING DOCUMENTS ARE AVAILABLE THROUGH THE NEW HAMPSHIRE SECRETARY OF STATE. CERTAIN FINANCIAL INFORMATION IS DISCLOSED THROUGH THE COMMUNITY BENEFITS ANNUAL REPORT. THE AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST EITHER IN ELECTRONIC OR HARD COPY FORM. Form 990, Part VII, Section A, Line 1a, Column (B) AVERAGE HOURS PER WEEK AS PART OF DARTMOUTH-HITCHCOCK CLINIC'S (DHC) AND MARY HITCHCOCK MEMORIAL HOSPITAL'S (MHMH) AFFILIATION AGREEMENT, THE TWO ORGANIZATIONS SHARE OFFICERS. AS SUCH, THE AVERAGE HOURS PER WEEK ARE ALLOCATED BETWEEN THE TWO ORGANIZATIONS ON THEIR FORM 990'S EVEN THOUGH COMPENSATION REPORTED IN PART VII IS BASED ON THE ENTITY ISSUING THE W-2. IN ADDITION, CERTAIN OFFICERS SPEND TIME ON DARTMOUTH-HITCHCOCK HEALTH (D-HH), THE SOLE CORPORATE MEMBER OF BOTH MHMH AND DHC, ALONG WITH TWO SUPPORTING ORGANIZATIONS: DARTMOUTH-HITCHCOCK MEDICAL CENTER (DHMC) AND HAMDEN RISK RETENTION GROUP (HAMDEN). CERTAIN OFFICERS ALSO SPEND TIME ON RELATED ENTITIES, INCLUDING ALICE PECK DAY MEMORIAL HOSPITAL (APD), WINDSOR HOSPITAL CORPORATION (DBA MOUNT ASCUTNEY HOSPITAL AND HEALTH CENTER) (MAHHC), MOUNT ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION, HISTORIC HOMES OF RUNNEMEDE, CHESHIRE MEDICAL CENTER (CHESHIRE), CHESHIRE HEALTH FOUNDATION, CHESHIRE HEALTH SERVICES, THE NEW LONDON HOSPITAL ASSOCIATION (NLH), VISITING NURSE ASSOCIATION & HOSPICE OF VT AND NH (VNA), AND THE HITCHCOCK FOUNDATION (THF). Form 990, Part VII, Section B, Line 1 INDEPENDENT CONTRACTORS DARTMOUTH-HITCHCOCK CLINIC (DHC) IS PART OF THE DARTMOUTH-HITCHCOCK HEALTH (D-HH) SYSTEM, WHICH INCLUDES DHC, MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH), AND ITS SUBSIDIARIES. MHMH RECEIVED AUTHORITY FROM THE INTERNAL REVENUE SERVICE TO ACT AS DHC'S PAY AGENT AND IMPLEMENTED THIS PROCESS AT THE BEGINNING OF FISCAL YEAR 2010. ALL EXPENSES ARE PAID DIRECTLY BY MHMH AND REIMBURSED BY DHC. MHMH MANAGES ALL REQUIRED IRS REPORTING RELATED TO THESE DISBURSEMENTS. Form 990, Part IX, Column (A) STATEMENT OF FUNCTIONAL EXPENSES MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) AND DARTMOUTH-HITCHCOCK CLINIC (DHC) OPERATE UNDER AN AFFILIATION AGREEMENT AS DIRECTED BY DARTMOUTH-HITCHCOCK HEALTH (D-HH), THE SOLE CORPORATE MEMBER OF BOTH ENTITIES. DUE TO THE INTEGRATED OPERATING STRUCTURE, RELATED MISSION, AND CLOSE RELATIONSHIP OF DHC AND MHMH, EXPENSES ARE SHARED BETWEEN THE TWO ENTITIES. ALL EXPENSES REPORTED WITHIN THIS FORM 990 ARE DHC'S SHARE OF EXPENSES AS DESIGNATED BY THE AFFILIATION AGREEMENT. Form 990, Part XI, Line 9 Other changes in net assets or fund balances NET ASSET RELEASED FROM RESTRICTED - 26537673; RENAISSANCE PSYCHIATRY OF NEW ENGLAND ONE MEDICAL CENTER DRIVE LEBANON NH 03756 813076466 PSYCHIATRY SERVICES NH -56704 697947 Dartmouth-Hitchcock Clinic MARY HITCHCOCK MEMORIAL HOSPITAL ONE MEDICAL CENTER DRIVE LEBANON NH 03756 020222140 HOSPITAL NH 501(c)(3) 3 D-HH false HITCHCOCK FOUNDATION ONE MEDICAL CENTER DRIVE LEBANON NH 03756 020222139 HeaLTH CaRE ReSeaRCH NH 501(c)(3) 7 DHC true HAMDEN ASSURANCE RISK RETENTION GROUP INC 30 MAIN STREET STE 330 BURLINGTON VT 05401 208530788 SELF INSURANCE VT 501(c)(3) Type I DHC true DARTMOUTH-HITCHCOCK HEALTH ONE MEDICAL CENTER DRIVE LEBANON NH 03756 264812335 PARENT ORGANIZATION NH 501(c)(3) 7 NA false THE NEW LONDON HOSPITAL ASSOCIATION INC 273 COUNTY ROAD NEW LONDON NH 03257 020222171 HOSPITAL NH 501(c)(3) 3 D-HH false WINDSOR HOSPITAL CORPORATION 289 COUNTY ROAD WINDSOR VT 05089 030183721 HOSPITAL VT 501(c)(3) 3 D-HH false CHESHIRE MEDICAL CENTER 580 COURT STREET KEENE NH 03431 020354549 HOSPITAL NH 501(c)(3) 3 D-HH false ALICE PECK DAY MEMORIAL HOSPITAL 10 ALICE PECK DAY DRIVE LEBANON NH 03766 020222791 HOSPITAL NH 501(c)(3) 3 D-HH false Visiting Nurse Association AND HOSPICE OF VERMONT AND NEW HAMPSHIRE INC 88 Prospect Street White River Junction VT 05001 036006494 HOSPICE VT 501(c)(3) 10 D-HH false POMPANOOSUC INVESTMENT CORPORATION ONE MEDICAL CENTER DRIVE LEBANON NH 03756 020352330 REAL ESTATE HOLDING NH Dartmouth-Hitchcock Clinic C Corporation -127 75632 1 true HAMDEN ASSURANCE CO LTD 980121409 LIABILITY INSURANCE BD Dartmouth-Hitchcock Clinic C Corporation 0 56503948 0.702 true false true true false true false false false false true true true true true true true true true true Hitchcock Foundation O 420672 FMV HAMDEN ASSURANCE RISK RETENTION GROUP INC M 9289117 FMV Hitchcock Foundation B 220910 FMV