TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Amy Case...................................................................... Trustee	1.00 ................. 1.00	X				0	0	0
(2) Ret Maj Gen Susan Desjardins...................................................................... Trustee	1.00 ................. 1.00	X				0	0	0
(3) David Donsker MD...................................................................... Trustee	1.00 ................. 1.00	X				0	0	0
(4) Suzanne Foster...................................................................... Trustee	1.00 ................. 1.00	X				0	0	0
(5) Ross Gittell PhD...................................................................... Trustee (as of April 2019)	1.00 ................. 1.00	X				0	0	0
(6) Steve Hermans Esq...................................................................... Trustee	1.00 ................. 1.00	X				0	0	0
(7) Richard Hollister MD...................................................................... Ex-Officio Member	1.00 ................. 41.00	X				0	496,303	28,873
(8) Sally Ward...................................................................... Trustee	1.00 ................. 1.00	X				0	0	0
(9) William Schleyer...................................................................... Chair	1.00 ................. 1.00	X	X			0	0	0
(10) Ret Maj Gen Joseph Simeone...................................................................... Vice Chair (end April 2019)	1.00 ................. 1.00	X	X			0	0	0
(11) Rob Eberle...................................................................... Vice Chair (as of April 2019)	1.00 ................. 1.00	X	X			0	0	0
(12) Kevin J Callahan...................................................................... CEO/President/Trustee	2.00 ................. 43.00	X	X			0	949,721	25,957
(13) Kevin J O'Leary...................................................................... CFO/Treasurer	2.00 ................. 43.00		X			0	589,569	93,957
(14) Constance D Sprauer...................................................................... Sr. VP Legal Affairs/Secre	2.00 ................. 41.00		X			0	378,502	34,060
(15) Brian Campbell...................................................................... VP Ambulatory Care	40.00 ................. 0.00			X		329,578	0	35,574
(16) Donna McKinney...................................................................... VP Acute Care	40.00 ................. 0.00			X		310,125	0	40,785
(17) Jonathan Jackson...................................................................... Physicist	40.00 ................. 0.00				X	266,584	0	32,441

(A) Name and business address	(B) Description of services	(C) Compensation
Exeter Health Resources Inc 5 Alumni Drive Exeter,NH03833	Administrative Management Fees	10,257,564
Core Physician Services LLC 5 Alumni Drive Exeter,NH03833	Physician Services	5,724,844
Hutter Construction PO Box 257 New Ipswich,NH03071	Building Contractor	4,319,944
Mass General Physician Organization PO Box 3864 Boston,MA022413864	Physician Services	1,950,741
ASHA Inc PO Box 670529 Dallas,TX75267	Temporary Staffing	1,310,109
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 61

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Exeter Hospital Inc

Employer identification number

22-2674014

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

Exeter Hospital Inc

Employer identification number

22-2674014

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization Exeter Hospital Inc

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization Exeter Hospital Inc		Employer identification number 22-2674014

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization Exeter Hospital Inc			Employer identification number 22-2674014
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Exeter Hospital Inc

Employer identification number

22-2674014

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................
d	Other exempt purpose expenditures ........................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

26,822

Total. Add lines 1c through 1i ....................................................................................................

26,822

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	Association Dues Allocated to Lobbying: A portion of annual membership dues paid to the American Hospital Association and the New Hampshire Hospital Association are considered lobbying expenses. For fiscal year ending September 30, 2019, the amounts deemed for lobbying were $6,945 and $19,877, respectively.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Exeter Hospital Inc

Employer identification number

22-2674014

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	17,140,056	17,071,757	17,027,510	16,993,856	17,004,799
b	Contributions ...	570,439	174,933	154,049	107,531	69,258
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	390,544	106,634	109,802	73,877	80,201
f	Administrative expenses ....
g	End of year balance ......	17,319,951	17,140,056	17,071,757	17,027,510	16,993,856

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

3.180 %

Permanent endowment SchDMd Bullet

96.820 %

Temporarily restricted endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	142,400		142,400
b	Buildings ....	71,716,243	42,167,524	29,548,719
c	Leasehold improvements	407,328	229,846	177,482
d	Equipment ....	60,268,103	31,849,189	28,418,914
e	Other .....	4,830,500	1,162,551	3,667,949
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				61,955,464

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) Limited Partnerships	100,417,347	F
(B) Alternative Investments	14,677,178	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	115,094,525

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Due to Third Party Payors	5,111,975
Accrued Pension Liability	20,478,132
Swap Valuation Liability	6,519,599
Reserve for Professional Liability Claims	1,448,968
Deferred Compensation	365,600
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	33,924,274
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	291,575,748
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-9,567,864
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-2,777,436
e	Add lines 2a through 2d .....................			2e	-12,345,300
3	Subtract line 2e from line 1..................			3	303,921,048
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	303,921,048

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	252,950,425
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	672,383
e	Add lines 2a through 2d....................			2e	672,383
3	Subtract line 2e from line 1...................			3	252,278,042
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	252,278,042

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Part V, Line 4:	The goal of the Permanent Endowment Fund is to provide a source of financial support to Exeter's patient care activities. These funds are invested in a prudent manner with regard to preserving principal while providing reasonable returns. These returns are then used for capital expenditures, other major program needs, and to generally increase the financial strength of the organization. The quasi-endowments are funds which have been donated to the organization for a purpose specified by the donor. These funds are held until used for the purpose intended by the donor.
Part X, Line 2:	The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code, and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the tax positions of the Hospital and has concluded that it has maintained its tax-exempt status, does not have any significant unrelated business income, and has taken no uncertain tax positions that require adjustment to the financial statements.
Part XI, Line 2d - Other Adjustments:	Impact of Interest Rate Swaps -3,006,625. Net Assets Released from Restricted Gifts -443,194. Income Included in Expenses on Audited Financial Statements 672,383.
Part XII, Line 2d - Other Adjustments:	Income Included in Expenses on Audited Financial Statements 672,383.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
Exeter Hospital Inc

Employer identification number

22-2674014

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in region
	Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas,	0	0	Investments in funds domiciled in the region	14,677,178
















3a	Sub-total .....	0	0		14,677,178
b	Total from continuation sheets to Part I ...				0
c	Totals (add lines 3a and 3b)	0	0		14,677,178

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018

Schedule F (Form 990) 2018

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2018

Schedule F (Form 990) 2018Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation
Schedule F, Part I, Line 3:	The legal owner of Exeter Hospital, Inc.'s foreign investments is a related organization, Exeter Health Resources, Inc. Since a portion of Exeter Health Resources, Inc.'s total foreign investments are allocated to the Hospital's assets on the financial statements, those allocated investments have been disclosed on Schedule F, Part I, Line 3 of Exeter Hospital, Inc.'s Form 990. However, any required IRS Forms 926 and other foreign tax reporting obligations are filed by the legal owner, Exeter Health Resources, Inc.(EIN:02-0222126)
Schedule F, Part IV, Line 3:	Exeter Hospital, Inc. did not have an ownership interest in any foreign corporation that was greater than the 10% ownership filing threshold. Accordingly, IRS Form(s) 5471 is not required to be filed.
Schedule F, Part IV, Line 4:	Exeter Hospital, Inc. meets the exception for tax-exempt organizations with respect to filing Form 8621. Accordingly, Form 8621 is not required to be filed for the Hospital.

Schedule F (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
Exeter Hospital Inc

Employer identification number

22-2674014

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Trick or Trot (event type)	(b) Event #2 Kites (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	42,974	20,981	63,955
2	Less: Contributions . . . .	42,974	20,981	63,955
3	Gross income (line 1 minus line 2) . . . . . .

4	Cash prizes . . . . .
5	Noncash prizes . . . .	434		434
6	Rent/facility costs . . . .
7	Food and beverages . . .	830	1,480	2,310
8	Entertainment . . . .	500		500
9	Other direct expenses . . .	13,366	2,899	16,265
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			19,509
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			-19,509

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference

Explanation

Schedule G, Part II, Fundraising Events

In accordance with the IRS instructions for the reporting of income on Schedule G, event revenue deemed to be charitable contributions has been reported on line 2, thus reducing the total gross event income on line 3. This presentation gives the appearance on Schedule G of a loss from the event. However, when the charitable contributions are considered and added back, this event had a profit of $44,446.

Schedule G (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Exeter Hospital Inc

Employer identification number

22-2674014

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 32000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	824	1,024,845		1,024,845	0.430 %
b	Medicaid (from Worksheet 3, column a) . . . . .	5,193	31,113,665	5,193,628	25,920,037	10.760 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	6,017	32,138,510	5,193,628	26,944,882	11.190 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	15,904	1,094,014	19,655	1,074,359	0.450 %
f	Health professions education (from Worksheet 5) . . .	258	1,903,111		1,903,111	0.790 %
g	Subsidized health services (from Worksheet 6) . . . .	1,967	3,937,590	350,909	3,586,681	1.490 %
h	Research (from Worksheet 7) .	1,138	482,735	3,973	478,762	0.200 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .		1,301,335		1,301,335	0.540 %
j	Total. Other Benefits . .	19,267	8,718,785	374,537	8,344,248	3.470 %
k	Total. Add lines 7d and 7j .	25,284	40,857,295	5,568,165	35,289,130	14.660 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	40,516	40,516	0.020 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	182,253	182,253	0.080 %
8	Workforce development
9	Other
10	Total	222,769	222,769	0.100 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,984,632

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

2,406,232

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

88,811,169

Enter Medicare allowable costs of care relating to payments on line 5.....

110,418,062

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-21,606,893

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	Exeter Hospital Inc 5 Alumni Drive Exeter,NH03833 www.exeterhospital.com 1761	X	X	X

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Exeter Hospital Inc
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Schedule H, Part V, Section C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Schedule H, Part V, Section C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Exeter Hospital Inc
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 320.000000000000% and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

See Schedule H, Part V, Section C

The FAP application form was widely available on a website (list url):

See Schedule H, Part V, Section C

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Section C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	Exeter Hospital Inc
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Exeter Hospital Inc
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Exeter Hospital, Inc.	Part V, Section B, Line 5: Every three years, Exeter Hospital, in collaboration with its community partners, conducts a community needs assessment to identify, prioritize, and develop a plan to address critical health issues. The last community needs assessment was completed in FYE 2019. The purpose of the assessment was to engage community members through key leader interviews and Community Forums, and to achieve the following objectives:1) Educate and inform key leaders and Community Forum participants of the results of the FYE 2016 Community Needs Assessment and achievements to date to meet identified needs.2) Validate Priority Health Needs identified in the FYE 2016 Community Needs Assessment and further define these needs in FYE 2019 from the stakeholders' perspective.3) Identify unmet needs that have emerged since the FYE 2016 Community Needs Assessment.4) Engage key leaders and Community Forum participants in a discussion to identify solutions to address community health needs.5) Share the findings of the UNH Survey Center Household Telephone Survey.6) Where appropriate, motivate key leaders and Community Forum participants to participate in efforts to address community health needs going forward.7) Serve as a continuing foundation for the development of a Community Benefits Plan, as mandated under RSA 7:32-e.The FYE 2019 Community Needs Assessment included telephone surveys, open community forums, online surveys, key leader interviews, outreach to support agencies and the review of relevant secondary data sources. Information was solicited from a broad cross-section of the hospital's service area and included government welfare, public health, transportation, police, education and emergency preparedness officials, as well as outreach agencies that serve military & veterans, children & families, youth, elderly and the low-income. Legislators were invited to attend community forums. Providers of medical care to low-income minority population and mental health services were included.
Exeter Hospital, Inc.	Part V, Section B, Line 6b: Representatives from the following organizations collaborated on the hospital's community needs assessment: Exeter Area YMCA, Lamprey Health Care, Seacoast Public Health Network, Foundation for Seacoast Health, Greater Seacoast Community Health, Richie-McFarland Children's Center, Seacoast Mental Health Center, Society of St. Vincent de Paul Exeter as well as affiliates Core Physicians and Rockingham VNA & Hospice.
Exeter Hospital, Inc.	Part V, Section B, Line 11: The needs identified in the FYE 2019 Community Health Needs Assessment are:Access to care due to insurance coverage cost barriers, Substance Use Disorder, Mental Health, Elder Care and Support Services and Transportation.The community benefit spending in FYE 2019 directly related to the FYE 2016 identified needs which were: Access to care due to insurance coverage cost barriers, Substance Abuse and Addiction, Mental Health Services, Youth Suicide/Substance and Prescription drug abuse, Transportation, Affordable Housing/Homelessness and Elder Care and Support Services. Exeter Hospital addressed these needs by promoting community health and access to primary care by providing: 1) Charity care of $ 1,024,845 (calculated at cost) during fiscal year 2019 which served 824 people.2) Financial assistance through its health care access program which has three components: a) The Uninsured Care Discount/Hospital Access Plus Program - Patients who are uninsured will not be charged more than amounts generally billed to patients who have insurance covering the same care. Exeter Hospital, prior to billing the patients, applies a discount towards gross charges for patients who are uninsured. This discount is not valid for patients who have health insurance coverage, including but not limited to: Medicare, Medicaid, MedPay, third party liability or any other state or federal programs. b) The Financial Assistance Program (FAP) is a community-based program available to uninsured and under-insured patients who meet income and asset guidelines, and who live in our service area. To qualify, patients must first have applied for all other sources of coverage, including the Healthcare Exchange and the New Hampshire Health Protection Program. c) Exeter's Catastrophic Care Program provides financial relief for those patients who do not qualify for our Financial Assistance Program, but who are faced with a substantial debt due to a serious illness or injury. This program is calculated based on a percentage of the patient's gross income.3) Mental Health Care access was provided by Exeter Hospital partnering with Seacoast Mental Health to offer services to patients and their caregivers in the Emergency Department and the Center for Cancer Care. In fiscal year 2019, the hospital helped to underwrite mental healthcare services in the amount of $459,525 serving 700 people.4) Community Education Programs offered by the Hospital at an expense of $348,020 served 2,695 people in fiscal year 2019.5) Diabetes support programs run by the Hospital in fiscal year 2019 served 644 people at an expense of $1,210,466.6) Participation in research studies by the "The Center for Cancer Care" at Exeter Hospital through several national research groups sponsored by the National Cancer Institute. This enables the Center to offer clinical trials to patients undergoing treatment at the Hospital that allows patients to voluntarily take part in leading edge research that does not necessitate travel outside of the Seacoast area. During fiscal year 2019, the Hospital provided $478,762 for clinical trials and research that served 1,138 patients.7) Telehealth Services which provided $449,406 in telehealth community support serving 9,782 persons in fiscal year 2019.8) Transportation which is an important health care support service provided by the Hospital in response to an identified community need. Each year the program enhances access for hundreds of patients who otherwise would not be able to obtain needed health care and health related support services. During fiscal year 2019 Exeter Hospital provided transports at a cost of $53,802.9) Access to care related community benefit grant was provided to Lamprey Health Care by the Hospital in the amount of $285,000 in fiscal year 2019. 10) Support for Youth Suicide/Substance Misuse Prevention by: a) The Hospital making a $429,522 financial contribution through the NH Foundation for Healthy Communities to support the NH Bureau of Drug and Alcohol services for their programs to combat addiction and substance misuse disorder. b) The Hospital providing support in the amount of $37,500 to Connor's Climb Foundation which is dedicated to preventing youth suicide. All of the funds raised directly impact programs for suicide awareness, education and prevention in the New Hampshire community. c) The Hospital making financial contributions to HAVEN in fiscal year 2019 of $35,000 in alignment with its suicide prevention efforts. HAVEN is the largest violence prevention and support services agency in NH. d) In FY 2019, Exeter Hospital provided support to the Chase Home for Children in the amount of $32,000. During this time, the Chase home served 75 residential and 140 community youth and families. The home also provided another 60 diversion interventions. The Chase Home in Portsmouth is one of the oldest nonprofit entities in New Hampshire and has been committed to helping at-risk children in dire circumstances live happier and healthier lives for more than 140 years. e) Arts In Reach: In fiscal year 2019, the Hospital contributed $31,000 in financial support to Arts In Reach. Arts In Reach provides teenage girls in the Greater Seacoast of New Hampshire a platform to develop both their creative freedom and power of voice in a positive, supportive setting. f) NAMI NH: In fiscal 2019, Exeter Hospital provided support to NAMI NH in the amount of $10,000. NAMI New Hampshire is a grassroots organization working to improve the quality of life for all by providing support, education and advocacy for people affected by mental illness and suicide. Comprised of a network of affiliate chapters and support groups, staff and volunteers, NAMI NH provides information, education and support to all families and communities affected by mental illness and suicide. 11) In FY 2019, Exeter Hospital provided $46,000 to Womenade of Greater Squamscott. Womenade of Greater Squamscott is a non-profit 501(c)3, organized in 2005 to provide local residents with short-term financial assistance not readily available through other resources. Anonymous requests are received from community validators such as school nurses, guidance counselors, doctor's offices, clergy, social service organizations, hospice and more.
Exeter Hospital, Inc.	Part V, Section B, Line 16j: The financial assistance policy (FAP), financial assistance application and plain language summary can be found on our website, and are advertised and paper copies are available to patients. Semi-annually, we publish an ad in the local paper which outlines our financial assistance program. Within our phone system, we have a recording which outlines the financial assistance program when patients, family members etc. are on hold during a call to Exeter Hospital. We present each patient with a copy of the Plain Language Summary at Registration. Currently we have a financial counselor located in the checkout area in our Emergency Department and an Inpatient Financial Counselor to visit inpatients who are uninsured, to inform them of our program and or if they request more information about needing assistance to pay for services. Signage in public locations notifies patients about our Financial Assistance Program. We have also collaborated with our community partners to have this information publically available and accessible at their locations to reach members of our community who are most likely to need financial assistance.
Exeter Hospital, Inc.	Part V, Section B, Line 20e: During fiscal year 2019, we notified Emergency Department patients during discharge about our financial assistance program. Upon admission, we visit all self pay and any other patient who wishes to discuss their coverage and or balances due and inform them of our program. The Plain Language Summary is presented during registration of all patients. This information regarding the financial assistance program is on each patient billing statement as well as available on our website.
Schedule H, Part V, Section B, Line 7a:	The Hospital's FYE 2019 CHNA is available at:https://www.exeterhospital.com/getmedia/98181805-2bc3-4d5f-bf8e-41ae487abcbc/EH-CHNA-REPORT-9-26-19-FINAL_1.pdf.aspx
Schedule H, Part V, Section B, Line 10a:	The Hospital's FYE 2016 Implementation Strategy is available at:https://www.exeterhospital.com/getmedia/da22bb1b-97ec-48b2-96a6-02b9f9219607/Exeter-Hospital-Community-Health-Needs-Assessment-Implementation-Plan.pdf.aspx
Schedule H, Part V, Section B, Line 16a-c:	The Hospital's Financial Assistance Policy is available at:https://www.exeterhospital.com/getmedia/45c72995-c5f6-4021-b4c4-c6210f3e60bb/LD326.pdf.aspxThe Hospital's Financial Assistance Application is available at:https://www.exeterhospital.com/getmedia/1e5913cf-ff30-42b6-8205-e653eab3c1d1/1639-Fin-Assist-App-04-2019.pdf.aspxThe Hospital's Financial Assistance Plain Language Summary is available at:https://www.exeterhospital.com/getmedia/6bd0594e-3783-49c3-a814-577f7dbaf7c8/1641-Fin-Assist-Summary-03-2020.pdf.aspx

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?16
Name and address		Type of Facility (describe)
1	1 - Center for Orthopaedics and Movement 7 Alumni Drive Exeter,NH03833	Rehabilitation Services, Cardiac Rehabilitation, Massage
2	2 - Centers for Sleep & Wound Healing 4 Alumni Drive Exeter,NH03833	Sleep Lab, Wound Care, DriveAbility
3	3 - Epping Regional Health Center 212 Calef Highway Epping,NH03042	Pediatric and Adult Rehabilitation Services, Radiology, Mammography
4	4 - Center for Reproductive Care 118 Portsmouth Avenue Stratham,NH03885	Reproductive Services
5	5 - Diagnostic Imaging & Physical Therapy 24 Plaistow Road Plaistow,NH03865	Physical Therapy, Radiology
6	6 - Ctr for Occupational & Employee Health 6 Hampton Road Exeter,NH03833	Occupational Health
7	7 - Kingston Athleticare 53 Church Street Kingston,NH03848	Physical Therapy
8	8 - Orthopaedic & Sports Physical Therapy 311 Winnacunnet Road Hampton,NH03842	Physical Therapy and Athletic Performance Center
9	9 - Exeter Diagnostic Services at Hampton 879 Lafayette Road Hampton,NH03842	Radiology, Mammography
10	10 - Rehab & Diagnostic Serv of Exeter Hosp 128 Route 27 Raymond,NH03077	Physical and Occupational Therapy, Radiology, Mammography
11	11 - Rehab & Diagnostic Serv at Lamprey 207 South Main Street Newmarket,NH03857	Physical and Occupational Therapy, Radiology, Mammography
12	12 - Diagnostic Imaging - Saltonstall 9 Buzzell Avenue Exeter,NH03833	Radiology
13	13 - Physical Therapy at Portsmouth 95 Brewery Lane Portsmouth,NH03801	Physical Therapy
14	14 - HealthReach Diabetes Nutrition & Educ 881 Lafayette Road Hampton,NH03842	Diabetes and Nutrition
15	15 - Sports and Physical Therapy Practice 40 Industrial Drive 1 Exeter,NH03833	Athletic Performance Center
16	16 - Epping Athletic Performance Center 88 Shirking Road Epping,NH03042	Athletic Performance Center

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 3c:	All eligible financial assistance recipients receive 100% free care. Patients who do not qualify for financial assistance and are uninsured receive a discount that is equal to AGB = 42% (amounts generally billed) using the lookback method.There are several factors regarding eligibility for Financial Assistance. The applicant must reside in our service area, a geographic location consisting of approximately 40 surrounding towns, listed on our website, Financial Assistance policy and Plain Language Summary. The other factor is combined income and assets (as defined in our Financial Assistance Policy) are compared to the FPG.
Part I, Line 7:	A ratio of patient cost to charge was calculated utilizing Worksheet 2. The ratio of cost to charge was utilized in calculating line 7a total net community benefit expense for charity care.
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 $ 11,369,405.
Part II, Community Building Activities:	The majority of the remaining community benefit activities reported as community building activities are cash donations to community organizations for the purpose of furthering community support and advocacy for community health improvement.
Part III, Line 2:	The amount reported represents total bad debt write-offs net of recoveries as reported on the audited financial statements of $9,649,636 x 30.93% (ratio of patient cost to charge) to equal $ 2,984,632. This amount does not include any estimated provisions which are in bad debt expense reported on the audited financial statements.
Part III, Line 3:	The amount reported represents $7,779,605 of charges included in total bad debt write offs for patient eligible for financial assistance x 30.93% (ratio of patient cost to charge) to equal $2,406,232.
Part III, Line 4:	Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which accounts for patients who are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Hospital's allowance for doubtful accounts for self-pay patients decreased from 95% of self-pay accounts receivable at September 30, 2018 to 94% of self-pay accounts receivable at September 30, 2019. The Hospital's self-pay bad debt write-offs increased approximately $564,000 from $2,976,000 in 2018 to $3,540,000 in 2019. The net change in the allowance as a percentage of self-pay accounts receivable and bad debt write-offs was a result of collection trends and a shift in payor mix.
Part III, Line 8:	Medicare costs are not counted as a Community Benefit per New Hampshire or IRS guidance, therefore the cost figure of $21,606,893 is not included in the Total Unreimbursed Community Benefit Expense. The ratio of cost to charge was utilized in calculating the amount.
Part III, Line 9b:	If an account is sent to a collection agency and the patient applies for financial assistance within 240 days from first bill, the account will be placed on hold with the agency through the consideration process. If the patient is approved for financial assistance, the account will be retracted from the collection agency and financial assistance will be applied to the accounts. Exeter Hospital only contracts with collection agencies that follow Fair Debt Collection Practices and do not engage in Extraordinary Collection Activities.The Bad Debt/Collection Policy can be located online at:https://www.exeterhospital.com/getmedia/dea9264c-9d03-4f28-803f-0bbc4b103f1b/LD327-09-2016.pdf.aspx
Part VI, Line 2:	Every three years, Exeter Hospital, in collaboration with its community partners, conducts a community needs assessment to identify, prioritize, and develop a plan to address critical health issues. The last community needs assessment was completed in FYE 2019. The purpose of the assessment was to engage community members through key leader interviews and Community Forums, and to achieve the following objectives:1) Educate and inform key leaders and Community Forum participants of the results of the FYE 2016 Community Needs Assessment and achievements to date to meet identified needs.2) Validate Priority Health Needs identified in the FYE 2016 Community Needs Assessment and further define these needs in FYE 2019 from the stakeholders' perspective.3) Identify unmet needs that have emerged since the FYE 2016 Community Needs Assessment.4) Engage key leaders and Community Forum participants in a discussion to identify solutions to address community health needs.5) Share the findings of the UNH Survey Center Household Telephone Survey.6) Where appropriate, motivate key leaders and Community Forum participants to participate in efforts to address community health needs going forward.7) Serve as a continuing foundation for the development of a Community Benefits Plan, as mandated under RSA 7:32-e.The FYE 2019 Community Needs Assessment included telephone surveys, open community forums, online surveys, key leader interviews, outreach to support agencies and the review of relevant secondary data sources. Information was solicited from a broad cross-section of the hospital's service area and included government welfare, public health, transportation, police, education and emergency preparedness officials, as well as outreach agencies that serve military & veterans, children & families, youth, elderly and the low-income. Legislators were invited to attend community forums. Providers of medical care to low-income minority population and mental health services were included.The report in its entirety can be accessed on the Exeter Hospital website:https://www.exeterhospital.com/getmedia/98181805-2bc3-4d5f-bf8e-41ae487abcbc/EH-CHNA-REPORT-9-26-19-FINAL_1.pdf.aspx
Part VI, Line 3:	Exeter Hospital provides its patients with information regarding the organization's financial assistance program, and a summary of the organization's policy at the time of registration, on the back of every billing statement, and when phone contact is made when there is a balance on the account. On the Exeter Hospital website (http://www.exeterhospital.com), patients and the general public can find information on the organization's financial assistance programs; financial assistance, uninsured care discount program, catastrophic care program; and state-wide programs. As an additional measure to ensure our community members are aware of Exeter Hospital's financial assistance programs, twice a year the organization may run advertisements in community newspapers summarizing the organization's financial assistance/charity care policy. Exeter Hospital employs financial counselors specifically dedicated to assisting patients with questions regarding their eligibility for financial assistance, and assisting patients through the qualification process as applicable. All inpatient self-pay patients are provided information and counseling regarding the eligibility for financial assistance programs at the time of service. Self-pay and underinsured patients in the Emergency Department, Surgical areas and Oncology are also informed of the hospital's financial assistance programs at time of service or discharge.
Part VI, Line 4:	Exeter Hospital services an area that encompasses 40 communities with an estimated population of 241,926.
Part VI, Line 5:	Exeter Hospital addressed these needs by promoting community health and access to primary care by providing: 1) Charity care of $ 1,024,845 (calculated at cost) during fiscal year 2019 which served 824 people.2) Financial assistance through its health care access program which has three components: a. The Uninsured Care Discount/Hospital Access Plus Program - Patients who are uninsured will not be charged more than amounts generally billed to patients who have insurance covering the same care. Exeter Hospital, prior to billing the patients, applies a discount towards gross charges for patients who are uninsured. This discount is not valid for patients who have health insurance coverage, including but not limited to: Medicare, Medicaid, MedPay, third party liability or any other state or federal programs. b. The Financial Assistance Program (FAP) is a community-based program available to uninsured and under-insured patients who meet income and asset guidelines, and who live in our service area. To qualify, patients must first have applied for all other sources of coverage, including the Healthcare Exchange and the New Hampshire Health Protection Program. c. Exeter's Catastrophic Care Program provides financial relief for those patients who do not qualify for our Financial Assistance Program, but who are faced with a substantial debt due to a serious illness or injury. This program is calculated based on a percentage of the patient's gross income.3) Mental Health Care access was provided by Exeter Hospital partnering with Seacoast Mental Health to offer services to patients and their caregivers in the Emergency Department and the Center for Cancer Care. In fiscal year 2019, the hospital helped to underwrite mental healthcare services in the amount of $459,525 serving 700 people.4) Community Education Programs offered by the Hospital at an expense of $348,020 served 2,695 people in fiscal year 2019.5) Diabetes support programs run by the Hospital in fiscal year 2019 served 644 people at an expense of $1,210,466.6) Participation in research studies by the "The Center for Cancer Care" at Exeter Hospital through several national research groups sponsored by the National Cancer Institute. This enables the Center to offer clinical trials to patients undergoing treatment at the Hospital that allows patients to voluntarily take part in leading edge research that does not necessitate travel outside of the Seacoast area. During fiscal year 2019, the Hospital provided $478,762 for clinical trials and research that served 1,138 patients.7) Telehealth Services which provided $449,406 in telehealth community support serving 9,782 persons in fiscal year 2019.8) Transportation which is an important health care support service provided by the Hospital in response to an identified community need. Each year the program enhances access for hundreds of patients who otherwise would not be able to obtain needed health care and health related support services. During fiscal year 2019 Exeter Hospital provided transports at a cost of $53,802.9) Access to care related community benefit grant was provided to Lamprey Health Care by the Hospital in the amount of $285,000 in fiscal year 2019. 10) Support for Youth Suicide/Substance Misuse Prevention by: a. The Hospital making a $429,522 financial contribution through the NH Foundation for Healthy Communities to support the NH Bureau of Drug and Alcohol services for their programs to combat addiction and substance misuse disorder. b. The Hospital providing support in the amount of $37,500 to Connor's Climb Foundation which is dedicated to preventing youth suicide. All of the funds raised directly impact programs for suicide awareness, education and prevention in the New Hampshire community. c. The Hospital making financial contributions to HAVEN in fiscal year 2019 of $35,000 in alignment with its suicide prevention efforts. HAVEN is the largest violence prevention and support services agency in NH. d. In FY 2019, Exeter Hospital provided support to the Chase Home for Children in the amount of $32,000. During this time, the Chase home served 75 residential and 140 community youth and families. The home also provided another 60 diversion interventions. The Chase Home in Portsmouth is one of the oldest nonprofit entities in New Hampshire and has been committed to helping at-risk children in dire circumstances live happier and healthier lives for more than 140 years. e. Arts In Reach: In fiscal year 2019, the Hospital contributed $31,000 in financial support to Arts In Reach. Arts In Reach provides teenage girls in the Greater Seacoast of New Hampshire a platform to develop both their creative freedom and power of voice in a positive, supportive setting. f. NAMI NH: In fiscal year 2019, Exeter Hospital provided support to NAMI NH in the amount of $10,000. NAMI New Hampshire is a grassroots organization working to improve the quality of life for all by providing support, education and advocacy for people affected by mental illness and suicide. Comprised of a network of affiliate chapters and support groups, staff and volunteers, NAMI NH provides information, education and support to all families and communities affected by mental illness and suicide. 11) In FY 2019, Exeter Hospital provided $46,000 to Womenade of Greater Squamscott. Womenade of Greater Squamscott is a non-profit 501(c)3, organized in 2005 to provide local residents with short-term financial assistance not readily available through other resources. Anonymous requests are received from community validators such as school nurses, guidance counselors, doctor's offices, clergy, social service organizations, hospice and more.
Part VI, Line 6:	Exeter Hospital, Inc. is one of three affiliates of Exeter Health Resources, Inc. Each of the affiliated companies are committed to providing health care services that are innovative, progressive and focused on quality and the well-being of patients. The mission of Exeter Health Resources and its affiliates is to improve the health of the community. This mission will be principally accomplished without compromising Exeter Health Resources, Inc.'s sustainability by supporting the provision of health services and information to the community by the affiliated companies of Exeter Health Resources, Inc. During Fiscal Year 2019, Exeter Hospital, Core Physicians and Rockingham VNA & Hospice have continued the pursuit of this mission. During FY 2019, the affiliates provided $78,346,360 in charity care and other community benefit programs and services to communities in the areas served. 1) Exeter Hospital is a 100-bed community-based hospital serving New Hampshire's Seacoast Region. The Hospital's scope of care includes comprehensive medical and surgical health care services including, but not limited to: breast health, maternal/child and reproductive medicine, cardiovascular, gastroenterology, sleep medicine, occupational and employee health, oncology, orthopedics, and emergency care services. Exeter Hospital is accredited by the DNV Healthcare, Inc. and is a Magnet-recognized hospital. Magnet designation from the American Nurses Credentialing Center is the most prestigious distinction a health care organization can receive for nursing excellence and high quality patient care.2) Core Physicians is a community-based, multi-specialty group practice affiliated with Exeter Health Resources that provides comprehensive primary, specialty and pediatric dental care throughout the greater Seacoast region. Over 160 providers in 30 locations pursue exceptional patient satisfaction through clinical competence and professional office administration.3) Rockingham Visiting Nurse Association & Hospice is a community-based home health and hospice agency providing individuals and families with the highest quality home care, hospice and community outreach programs within Rockingham County and the surrounding towns of Barrington, Lee, Dover and Durham. Exeter Hospital works collaboratively with local non-profit agencies and organizations which strive to improve the health of the community. These relationships include:1) Seacoast Mental Health: The Hospital partners with Seacoast Mental Health to offer mental health services to patients and their caregivers in the Emergency Department and the Center for Cancer Care. In fiscal year 2019, the Hospital helped to underwrite mental healthcare services in the amount of $459,525 serving 700 people.2) The Hospital making a $429,522 financial contribution through the NH Foundation for Healthy Communities to support the NH Bureau of Drug and Alcohol services for their programs to combat addiction and substance misuse disorder.3) Lamprey Health Care: The Hospital continued its financial support by providing a community benefit grant in the amount of $285,000 in fiscal year 2019.4) HAVEN: The Hospital made financial contributions to HAVEN in fiscal year 2019 of $35,000 in alignment with its suicide prevention efforts. HAVEN is the largest violence prevention and support services agency in NH.5) Connor's Climb: In fiscal year 2019, The Hospital provided support in the amount of $37,500 to Connor's Climb Foundation which is dedicated to preventing youth suicide. All of the funds raised directly impact programs for suicide awareness, education and prevention in the New Hampshire community.6) Arts In Reach: In fiscal year 2019, the Hospital contributed $31,000 in financial support to Arts In Reach. Arts In Reach provides teenage girls in the Greater Seacoast of New Hampshire a platform to develop both their creative freedom and power of voice in a positive, supportive setting. 7) NAMI NH: In fiscal year 2019, Exeter Hospital provided support to NAMI NH in the amount of $10,000. NAMI New Hampshire is a grassroots organization working to improve the quality of life for all by providing support, education and advocacy for people affected by mental illness and suicide. Comprised of a network of affiliate chapters and support groups, staff and volunteers, NAMI NH provides information, education and support to all families and communities affected by mental illness and suicide. 8) Chase Home for Children: In fiscal year 2019, Exeter Hospital provided support to the Chase Home for Children in the amount of $32,000. During this time, the Chase home served 75 residential and 140 community youth and families. The home also provided another 60 diversion interventions. The Chase Home in Portsmouth is one of the oldest nonprofit entities in New Hampshire and has been committed to helping at-risk children in dire circumstances live happier and healthier lives for more than 140 years.9) Womenade of Greater Squamscott: In fiscal year 2019, Exeter Hospital provided $46,000 to Womenade of Greater Squamscott. Womenade of Greater Squamscott is a non-profit 501(c)3, organized in 2005 to provide local residents with short-term financial assistance not readily available through other resources. Anonymous requests are received from community validators such as school nurses, guidance counselors, doctor's offices, clergy, social service organizations, hospice and more.
Part VI, Line 7, Reports Filed With States	NH

Schedule H (Form 990) 2018

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Exeter Hospital Inc

Employer identification number
22-2674014

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) American Cancer Society Inc 250 Williams St NW 400 Atlanta,GA30303	13-1788491	501(c)(3)	5,000				Sponsorship - Making Strides Against Breast Cancer
(2) Arts in Reach - Encouraging Growth PO Box 236 Portsmouth,NH03802	02-0507428	501(c)(3)	31,000				Support for the organization's mission to provide support/service to disadvantaged teen-age girls.
(3) Austin17House PO Box 910 Raymond,NH03077	36-4864665	501(c)(3)	21,400				Suicide prevention grant
(4) Big Brothers Big Sisters of NH 4 Greenleaf Woods Drive 201 Portsmouth,NH03801	02-0348477	501(c)(3)	27,500				Grant to support organization's mission to provide programs and services that promote positive change in children identified as being at risk
(5) Chase Home for Children 698 Middle Road Portsmouth,NH03801	02-2229190	501(c)(3)	32,000				Suicide prevention grant
(6) Community Colleges of NH Foundation 26 College Drive Concord,NH03301	02-0516490	501(c)(3)	10,000				Contribution to Great Bay Community College's Distinguished Leaders Fund
(7) Connor's Climb Foundation PO Box 283 Exeter,NH03833	47-3553455	501(c)(3)	39,560				5k Sponsorship and Grant for suicide awareness and prevention
(8) Cooperative Alliance for Seacoast Transportation 42 Sumner Drive Dover,NH03820	02-0362579	501(c)(3)	5,000				Support for community transportation services
(9) Core Physicians LLC 5 Alumni Drive Exeter,NH03833	87-0807914	501(c)(3)	70,986				Support Behavioral Health program and Med bridge assistance.
(10) Cross Roads House Inc 600 Lafayette Road Portsmouth,NH03801	22-2549963	501(c)(3)	5,000				Support of organization's mission to aid individuals experiencing homelessness
(11) Dartmouth-Hitchcock Health One Medical Drive Lebanon,NH03756	26-4812335	501(c)(3)	10,000				Suicide prevention grant
(12) Exeter Junior Baseball and Softball League Inc PO Box 471 Exeter,NH03833	75-3241754	501(c)(3)	7,000				Support the organization's primary purpose which is to develop good sportsmanship among all players for the betterment of their emotional and social well-being
(13) Foundation for Health Communities Inc 125 Airport Road Concord,NH03301	02-0260158	501(c)(3)	429,522				This contribution through the NH Foundation for Healthy Communities to support the NH Bureau of Drug and Alcohol services for their programs to combat addiction and substance misuse disorder.
(14) Gather 210 West Road 3 Portsmouth,NH03801	02-0226943	501(c)(3)	21,000				Aid organization in providing food to needy through it's programs such as Pantry Market
(15) Girls on the Run New Hampshire 137 Water Street Exeter,NH03833	02-0524090	501(c)(3)	18,500				Support organization's mission to elevate and prepare girls for a lifetime of self respect and healthy living
(16) HAVEN Violence Prevention and Support Services 20 International Drive 300 Portsmouth,NH03801	02-0337620	501(c)(3)	35,000				Support organization's mission to prevent sexual assault, domestic violence and stalking
(17) The Hug Foundations of MA Inc 943 R Brockton Avenue Abington,MA02351	45-3085579	501(c)(3)		6,244	Book Value	Medical Supplies	Medical Supplies
(18) Lamprey Health Care Inc 207 South Main Street Newmarket,NH03857	23-7305106	501(c)(3)	285,000				Supports the provision of high quality medical care and health related services to the communities it serves regardless of the patients' ability to pay
(19) My Breast Cancer Support PO Box 1576 Portsmouth,NH03802	43-2072206	501(c)(3)	5,000				Sponsorship - "Celebrate Pink 5K"
(20) NAMI New Hampshire 85 North State Street Concord,NH03301	22-2760743	501(c)(3)	10,000				Support the organization's mission to improve the quality of life for all persons affected by mental illness and serious emotional issues
(21) New Hampshire Public Broadcasting 268 Mast Road Durham,NH03824	94-3443883	501(c)(3)	10,000				Suppport the organization's mission to engage minds, connect commuities & celebrate NH
(22) On Belay Inc PO Box 391 Newmarket,NH03857	26-0648162	501(c)(3)	5,000				Support the organization's mission to build community among youth who have or have had a family member with cancer using adventure based programs that encourage participants to uncover their inner resilience
(23) Prescott Park Arts Festival Inc PO Box 4370 Portsmouth,NH03802	02-0370018	501(c)(3)	5,000				Promote artistic excellence in the community
(24) Raymond Coalition for Youth 4 Epping Street Raymond,NH03077	02-0713987	501(c)(3)	7,361				Grant for Project Safeguard (substance misuse prevention conference for youth)
(25) Richie McFarland Children's Center 11 Sandy Point Road Stratham,NH03885	02-0302005	501(c)(3)	6,000				Supports providing developmental and therapy services for children with and without special needs, support and education to their families and guidance in accessing community and health resources
(26) Rockingham Nutrition & Meals 106 North Road Brentwood,NH03833	02-0342196	501(c)(3)	5,000				Benefits Meals on Wheels program
(27) Rotary Club of Exter PO Box 861 Exeter,NH03833	02-6009900	501(c)(4)	5,875				Fund 6 recovery coaches and a special event in an effort to combat substance misuse disorder
(28) The Schwartz Center for Compassionate Healthcare PO Box 417597 Boston,MA02241	04-1564655	501(c)(3)	5,000				Event sponsor to aid organization's vision that all who seek & provide healthcare experience compassion
(29) Seacoast Eat Local Inc 2 Washington Street Suite 331 Dover,NH03820	45-2547575	501(c)(3)	9,626				To advocate for eating locally grown food for the health of our community, environment and economy.
(30) Seacoast Family Promise 27 Hampton Road Exeter,NH03833	02-0529881	501(c)(3)	5,000				Empower families with children experiencing homelessness to achieve sustanable independence
(31) Seacoast Mental Health Center Inc 1145 Sagamore Avenue Portsmouth,NH03801	02-0262862	501(c)(3)	7,500				Support organization's mission to provide high quality, effective accessible mental health services
(32) Seacoast Pathways 155 Brewery Lane 102 Portsmouth,NH03803	46-2658558	501(c)(3)	5,000				Support organization's mission to support adults living with mental illness on their paths to recovery through work ordered day
(33) Society of St Vincent de Paul Exeter Inc PO Box 176 Exeter,NH03833	20-3945985	501(c)(3)	24,922				Grant for substance abuse, transportation and food delivery to homebound seniors.
(34) Strawberry Banke Museum PO Box 300 Portsmouth,NH03802	02-0260158	501(c)(3)	6,500				Support museum's mission to promote understanding of the lives of individuals and the value of community through encounters with the history and ongoing preservation of a New England Seaport Neighborhood
(35) Transportation Assistance for Seacoast Citizens 200 High Street Hampton,NH03842	26-2869209	501(c)(3)	5,000				Support of organization mission to help people maintain their health, independence and dignity by mobilizing volunteer drivers to provide rides to eligible residents of the NH seacoast communities
(36) University System of New Hampshire 5 Chenell Drive 301 Concord,NH03301	02-6000937	501(c)(3)		7,436	Book Value	Medical Supplies & Equipment	Medical Supplies & Equipment
(37) Womenade of Greater Squamscott PO Box 653 Stratham,NH03885	20-2173469	501(c)(3)	46,000				Grant to provide short term financial assistance to those in need/fund raiser sponsor.

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Part I, Line 2:

All requests for grants/contributions/sponsorships over $5,000 require the approval of at least the Vice President of Strategy, Community Relations and Advancement to ensure that they are consistent with our mission, values and strategic plan. Larger grants like those given to Arts in Reach, Chase Home, Connor's Climb, Haven, Lamprey, Foundation for Healthy Communities and Womenade are also reviewed by the Chief Financial Officer and Chief Executive Officer prior to approval. Each of those requesting organizations either provides a written summary of how they have used our previous support as well as their specific plans for any new requested funding or they make a presentation in person usually to the Chief Financial Officer, the Chief Executive Officer and the Vice President of Strategy, Community Relations and Advancement. Each year a subcommittee of Exeter Health Resources, Inc.'s (parent company) Board of Trustees is charged with overseeing our Community Benefits program and our community needs assessment and reviews a detailed report on the previous year's grants/ contributions/sponsorships and approves the current year's plan for community support. That subcommittee and the larger Exeter Health Resources, Inc.'s (parent company) Board of Trustees are regularly updated on our community support initiatives.

Schedule I (Form 990) 2018

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Exeter Hospital Inc

Employer identification number

22-2674014

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Richard Hollister MD Ex-Officio Member	(i) (ii)	0 ------------- 337,236	0 ------------- 96,399	0 ------------- 62,668	0 ------------- 8,250	0 ------------- 20,623	0 ------------- 525,176	0 ------------- 0
2Kevin J Callahan CEO/President/Trustee	(i) (ii)	0 ------------- 656,192	0 ------------- 225,000	0 ------------- 68,529	0 ------------- 8,250	0 ------------- 17,707	0 ------------- 975,678	0 ------------- 0
3Kevin J O'Leary CFO/Treasurer	(i) (ii)	0 ------------- 425,316	0 ------------- 134,502	0 ------------- 29,751	0 ------------- 76,250	0 ------------- 17,707	0 ------------- 683,526	0 ------------- 0
4Constance D Sprauer Sr. VP Legal Affairs/Secre	(i) (ii)	0 ------------- 295,816	0 ------------- 73,812	0 ------------- 8,874	0 ------------- 16,500	0 ------------- 17,560	0 ------------- 412,562	0 ------------- 0
5Brian Campbell VP Ambulatory Care	(i) (ii)	263,317 ------------- 0	56,898 ------------- 0	9,363 ------------- 0	16,500 ------------- 0	19,074 ------------- 0	365,152 ------------- 0	0 ------------- 0
6Donna McKinney VP Acute Care	(i) (ii)	249,178 ------------- 0	50,104 ------------- 0	10,843 ------------- 0	16,500 ------------- 0	24,285 ------------- 0	350,910 ------------- 0	0 ------------- 0
7Jonathan Jackson Physicist	(i) (ii)	264,723 ------------- 0	0 ------------- 0	1,861 ------------- 0	16,245 ------------- 0	16,196 ------------- 0	299,025 ------------- 0	0 ------------- 0
8Susan Callahan Director	(i) (ii)	173,535 ------------- 0	25,233 ------------- 0	10,475 ------------- 0	12,673 ------------- 0	8,891 ------------- 0	230,807 ------------- 0	0 ------------- 0
9Deanna King Director	(i) (ii)	181,712 ------------- 0	11,777 ------------- 0	3,956 ------------- 0	12,182 ------------- 0	17,052 ------------- 0	226,679 ------------- 0	0 ------------- 0
10Nolan Gagne Physicist	(i) (ii)	193,371 ------------- 0	0 ------------- 0	29 ------------- 0	11,944 ------------- 0	17,379 ------------- 0	222,723 ------------- 0	0 ------------- 0
11Jeff Meisner Director	(i) (ii)	173,538 ------------- 0	12,176 ------------- 0	7,590 ------------- 0	12,319 ------------- 0	20,978 ------------- 0	226,601 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 1a	Tax indemnification and gross up payments were provided to Brian Campbell and Donna McKinney (for acquisition of supplemental long term disability insurance). The benefit was treated as taxable income.
Part I, Line 1b	There was no existing policy concerning tax indemnification and gross up payments. However, in the instance of such action related to the acquisition of long term disability insurance described above, the tax indemnification and gross up payments were approved by the Exeter Health Resources Board of Trustees Executive Committee which is comprised of disinterested persons.
Part I, Line 3	The CEO of Exeter Hospital, Inc. is compensated by a related organization, Exeter Health Resources, Inc. Exeter Health Resources, Inc. uses a compensation committee, an independent compensation consultant, a compensation survey and approval by the Board or compensation committee.
Part I, Line 4b	The organization's parent (Exeter Health Resources, Inc.) maintains a split dollar supplemental retirement plan for two executives (listed below with amounts) selected by the Exeter Health Resources Inc. Board of Trustees. The plan is closed to future participants. The Plan provides for annual payments of premiums for life insurance policies insuring the listed individuals. Those life insurance premiums are collaterally assigned to the corporation and any excess accumulated value in the policies (net of accumulated premium payments which are returned to the organization upon the executive attaining the age of 70 or at the death of the participant) is available to be paid to the participant once vested at age 62 and upon retirement from the organization. Note that the split-dollar arrangement is part of an employee benefit program and economically not a direct extension of credit. Furthermore, the reportable compensation of the respective employees includes the annual value of the life insurance provided. Life insurance premium payments during tax year: Kevin J. Callahan $ 315,428 Kevin J. O'Leary $ 137,323 Excess Accumulated Value: Kevin J. Callahan $ 3,174,709 Kevin J. O'Leary $ 1,307,722 Certain of the listed employees participate in a nonqualified deferred compensation plan as described in Internal Revenue Code Section 457 (f) sponsored by Exeter Health Resources Inc., In the calendar year ended December 31, 2018 the contribution to the plan for the non-vested benefit of Kevin J. O'Leary was $68,000. The contribution is intended to provide a forfeitable supplemental retirement benefit. Participants in the 457 (f) plan do not vest until age 62 when it is payable to the participant.
Part I, Line 7	The organization's parent (Exeter Health Resources, Inc.) provides an annual incentive compensation plan for executives selected by the Exeter Health Resources Board of Trustees. These executives include: Kevin J. Callahan, Kevin J. O'Leary, Constance D. Sprauer, Brian Campbell and Donna McKinney. The Board and/or its Executive Committee approves measurable achievement criteria for quality, patient satisfaction, process improvement, financial performance, services innovation and other compelling areas of strategic and operational interest. Additionally, the Board and /or its Executive Committee establishes minimum, targeted and maximum levels for incentive awards and approves all awards for participating executives. Susan Callahan, Deanna King and Jeffrey Meisner participate in an annual incentive program which is administered by Exeter Hospital, Inc.'s Human Resources Department. The management of Exeter Hospital, Inc. approves measureable achievement criteria for Quality/Innovation, Patient Satisfaction, Process Improvement and Financial Performance on an annual basis that aligns with overall strategic interests of the company. The incentive award levels are established at minimum, target and maximum levels and those incentive awards are approved by operating management and Human Resources.

Schedule J (Form 990) 2018

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Exeter Hospital Inc

Employer identification number
22-2674014

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	NH Health and Education Facilities Authority	02-0279866	NONEAVAIL	02-09-2012	32,565,000	Refinancing and refunding prior bond issuance		X		X		X
B	NH Health and Education Facilities Authority	02-0279866	NONEAVAIL	03-02-2015	24,020,000	Refinancing and refunding prior bond issuance		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	32,565,000		24,020,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	215,404		162,154
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	32,349,596		23,857,846
12 Other unspent proceeds .............
13 Year of substantial completion .............	2012		2015
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......
b Exception to rebate? ........
c No rebate due? .........
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Exeter Hospital Inc

Employer identification number

22-2674014

Return Reference	Explanation
Form 990, Part VI, Section A, line 6	Exeter Health Resources, Inc., a charitable organization acting through its Board of Trustees, is the sole member of the organization.
Form 990, Part VI, Section A, line 7a	The Board of Trustees shall consist of a number not to exceed fifteen (15) persons. Of this number, up to thirteen (13) persons shall have been elected by the Member from among the elected members of the Board of Trustees of the Member.
Form 990, Part VI, Section A, line 7b	The sole member, Exeter Health Resources, Inc. has the right to approve decisions of the governing body. Additionally, the Member shall have the power to change the corporate name, merge with or acquire any corporation organized under Chapter 292 of the Revised Statutes Annotated of New Hampshire, amend the articles of agreement, dissolve the Corporation, annually appoint an independent certified public accountant to perform an audit of the accounts of the Corporation, and such other powers and rights as may be reserved to it by law or the articles of agreement.
Form 990, Part VI, Section B, line 11b	The Form 990 is prepared by an outside tax accountant with information provided by the organization. The Form 990 is reviewed by the organization's Treasurer and then presented to the Board of Trustees before it is filed with the IRS.
Form 990, Part VI, Section B, line 12c	The Board of Trustees has adopted a Conflict of Interest Policy that requires the disclosure of conflicts of interest either when the interest becomes a matter of possible action by the Board or during an annual disclosure process. Trustees, officers, and key employees, as well as all members of senior management, are part of the annual disclosure process, which is initiated by the issuance of a memorandum and accompanying questionnaire by the President and Chief Executive Officer (CEO). All disclosures are reviewed. Any trustee with a conflict of interest is required to abstain from voting and is not included in a quorum determination on the matter and any officer, key employee, or member of senior management with a conflict does not take part in making and is not present for any decision regarding the matter. The policy is monitored and enforced by both the President and CEO and the full Board. There are two additional conflicts of interest policies. One is applicable to all employees and contracted staff and the other is applicable to members of the Medical Staff and allied health professionals. The former policy is monitored and enforced by the Vice President of Human Resources and the Vice President of Corporate Integrity and Compliance and the latter is monitored and enforced by the President of the Medical Staff, President and CEO, General Counsel, and Compliance Officer. On an annual basis, staff within Human Resources survey all employees and contracted staff serving in a managerial role, as well as members of any committees that make recommendations or decisions regarding the purchase of goods or services by any of the corporations as a means to ensure that any conflict of interest is disclosed and appropriately managed. Employees otherwise are required to supplement or make any further written disclosure at the time a conflict arises.
Form 990, Part VI, Section B, line 15	The organization's parent (Exeter Health Resources, Inc.) has a formal process for determining total compensation for the CEO and other listed officers that is intended to provide reasonable compensation for achieving the organization's mission, to recognize individual and team performance and to comply with the organization's obligations as a tax-exempt charitable organization. The Executive Committee of the Exeter Health Resources, Inc.'s Board of Trustees conducts an annual review of the compensation of the CEO, other listed officers and key employees. In doing so, the Committee retains a qualified independent compensation consultant to conduct competitive market analysis of the market ranges of base, incentive, and total cash compensation, and to provide advice concerning the reasonableness of the compensation of the CEO, other listed officers and key employees. The Committee utilizes that analysis and other appropriate information in connection with its annual review and makes recommendations to the full board of Exeter Health Resources, Inc. for adjustment of the CEO's compensation and the compensation for other listed officers. Information which the committee may consider can include but is not limited to the performance of an individual and/or that individual's contributions to a team, the performance of the organization in whole and in part, the elements of total compensation and salary history, the organization's compensation targets and comparability data, including the data prepared by the independent consultant and reviewed with the Committee. The Committee incorporates a performance appraisal process in the CEO's, other listed officers and key employees' compensation review. The CEO, other listed officers and key employees are not present when the committee discusses their respective compensation. In addition, the committee determines if the threshold requirements for incentive awards are met, consisting of the organization's performance results for quality, operating system excellence and financial performance. The results of the Committee's deliberations are presented to the Exeter Health Resources, Inc. Board and include recommendations concerning salary range adjustments and incentive awards and the basis for the Committee's decisions/recommendations. The deliberations of the Exeter Health Resources, Inc. Board are conducted in executive session with the independent members of the Board but do include the CEO only for that period of time in which the Exeter Health Resources, Inc. Board has questions concerning the performance of any listed officer or key employee other than the CEO. The Exeter Health Resources, Inc. Board reviews the CEO's performance and determines if the adjustments and awards recommended by the committee for the CEO are in the organization's best interest and for the benefit of the organization and its parent organization. For the other listed officer positions, adjustments and incentive awards are approved upon recommendation of the CEO by the Executive Committee within the Exeter Health Resources, Inc. Board approved parameters and ratified by the Exeter Health Resources, Inc. Board of Trustees. Adjustments and awards for other listed key employees are approved upon recommendation of the CEO by the Executive Committee within the Exeter Health Resources, Inc. Board approved parameters and reviewed by the Board.
Form 990, Part VI, Section C, line 19	These documents are available upon request.
Form 990, Part VI-B, Line 16b:	Although written policies were not in place as of the end of the year covered by this tax return requiring the organization to evaluate its participation in joint venture arrangements under applicable federal law to ensure that the organization's exempt status is protected, the organization performed due diligence with respect to its joint venture arrangements to safeguard the organization's exempt status.
Form 990, Part VII, Section A, Line 1:	Kevin J. Callahan, Kevin J. O'Leary and Constance D. Sprauer, who serve as officers of Exeter Hospital, Inc., are compensated by a related organization, Exeter Health Resources, Inc. Their compensation is based on their roles as CEO, CFO and Sr. VP Legal Affairs, respectively, of the consolidated Exeter Health Resources, Inc. system.
Form 990, Part IX, line 11g	Payment to Affiliate: Program service expenses 6,694,970. Management and general expenses 804,882. Fundraising expenses 0. Total expenses 7,499,852. Physician Fees: Program service expenses 8,347,272. Management and general expenses 1,003,526. Fundraising expenses 0. Total expenses 9,350,798. Contracted Services: Program service expenses 3,201,298. Management and general expenses 384,866. Fundraising expenses 0. Total expenses 3,586,164. Outside Fees: Program service expenses 2,881,206. Management and general expenses 346,384. Fundraising expenses 0. Total expenses 3,227,590. Contract/Temporary Labor: Program service expenses 2,468,654. Management and general expenses 296,786. Fundraising expenses 0. Total expenses 2,765,440. Consulting: Program service expenses 554,077. Management and general expenses 66,612. Fundraising expenses 0. Total expenses 620,689.
Form 990, Part XI, line 9:	Net Transfers to Affiliates -28,675,636. Pension Liability Adjustment -15,330,745. Impact of Interest Rate Swaps -3,006,625. Net Assets Released From Restrictions Used For Capital -126,131.
Form 990, Part XII, Line 2c:	The organization is part of the consolidated operations of Exeter Health Resources, Inc. The Exeter Health Resources, Inc. Executive Committee is responsible for the oversight of the audit and the selection of an independent accountant. The audit process has not changed since the prior year.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: The mission of Exeter Hospital is to improve the health of the community. This mission will be accomplished without compromising Exeter Hospital's sustainability principally by the provision of health services and information to the community in collaboration with Exeter Health Resources' other affiliates which share this mission.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	1,727
6	Total number of volunteers (estimate if necessary) .............	6	55
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	21,906
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	17,735

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	252,181	5,510,784
9	Program service revenue (Part VIII, line 2g) .........	259,845,117	284,824,280
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	11,076,463	13,560,375
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	11,411	25,609
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	271,185,172	303,921,048
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	984,548	1,304,570
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	107,627,475	113,431,727
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	126,064,230	137,541,745
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	234,676,253	252,278,042
19	Revenue less expenses. Subtract line 18 from line 12.......	36,508,919	51,643,006
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	285,647,104	285,871,430
21	Total liabilities (Part X, line 26).............	95,620,104	100,908,425
22	Net assets or fund balances. Subtract line 21 from line 20.....	190,027,000	184,963,005

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 230,759,600 including grants of $ 1,304,570 ) (Revenue $ 284,869,398 )
	In fiscal year 2019, Exeter Hospital served the community by providing care to 5,362 acute inpatients, 187,049 outpatient visits, 27,832 emergency room visits and 548 births. In 2019, Exeter Hospital supported its mission by supporting $9,591,862 in community outreach, benefits and financial assistance to the community excluding $38,997,109 in uncovered Medicare and Medicaid expenses. Exeter Hospital supports health care access in its service area by offering a robust financial assistance program that covers the cost of 100% of care provided to area residents based on income and family size. In 2019, the charity care program helped people access the health system as Exeter Hospital incurred a cost of $1,024,845 to provide financial assistance. In addition we provide support to vital community programs like our Healthreach Diabetes and Paramedicine programs and for providing access to contracted mental health professionals in our emergency room. We also supported access to the health system and the development of healthy life styles through our community education programs and our financial support of important healthcare related community based not for profits such as Lamprey Healthcare and Families First.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	Exeter Hospital's acute care program provides acute inpatient and outpatient observation level care in our 99 staffed inpatient beds. Our inpatient services treat emergent, acute, elective surgical and palliative care patients. Approximately 74% of our admissions come from the emergency room. We offer inpatient acute services for medical and surgical diagnoses for adults as well as pediatric and obstetrical inpatient services. Exeter Hospital is fully accredited by DNV Healthcare, Inc. (an officially deemed Medicare and Medicaid Credentialing agency), earned the Magnet designation from the American Nurses Credentialing Center, which is the most prestigious distinction a healthcare organization can receive for nursing excellence and high quality patient care as well as many other service level specific national accreditations. Our practice model is guided by a series of collaborative Best Practice Committees that engage nurses and physicians in the development of the best possible evidence based care protocols. Exeter Hospital supports the safety of our patients and the efficiency of the care provided through the deployment of a 24/7 Hospitalist program that manages the majority of the medical needs of our patients during their admission. In our 10 bed ICU we also use an intensivest service to ensure that our most acute patients receive the most highly coordinated care possible, resulting in significantly lower than expected infection rates, ICU readmission rates and shorter ICU stays. For our patients at the end of their lives we ensure their safety and comfort through a physician led, highly coordinated palliative care program.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	Exeter Hospital's Surgical program provides a full range of both inpatient and outpatient surgical services for patients of all ages from across our service area. Available surgical specialties include; orthopedics, general, ENT, gynecological, urological, plastics, ophthalmologic and vascular.

	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	The Center for Cancer Care at Exeter Hospital provides cancer patients and their families with comprehensive inpatient and outpatient services. Accredited by the American College of Surgeon's Commission on Cancer with commendation, the Center provides area residents with a leading, comprehensive approach to cancer treatment. The Center offers medical oncology, radiation oncology, surgery, clinical trials, multidisciplinary clinics and integrative oncology services. The Center is proud to have a relationship with the Massachusetts General Physician Organization for the provision of medical and radiation oncology services to patients. The medical oncology service supports 13 treatment areas. This unique clinical collaboration brings radiation oncologists from the world's leading academic medical center to Exeter Hospital's Center for Cancer Care. This affiliation allows Exeter Hospital's Center for Cancer Care to offer state-of-the-art radiation therapy services to patients including: Intraoperative Radiation Therapy (IORT), CT Simulation, Partial Breast Irradiation, Image Guided Radiation Therapy, Intensity Modulated Radiation Therapy, Breath Hold Technique for Breast Cancer Treatment and Linear Accelerator delivered treatments. The Center's affiliated surgeons work collaboratively with affiliated pathologists, the medical oncologists and with the radiation oncologists to develop the most comprehensive treatment plans for our patients.Exeter Hospital's Cardiology Department offers acute cardiac care, heart catheterization, angioplasty, angiography, implanted cardioverter defibrillators, permanent pacemaker placement and a three phase cardiac rehabilitation program. Exeter Hospital's affiliated fellowship-trained interventional cardiologists and its cardiac team have received international recognitions for their ongoing successful use of emergency angioplasty and interventional cardiology procedures.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses230,759,600

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Susan Callahan........................................................................ Director	40.00 .......................0.00	X	209,243	0	21,564
(19) Deanna King........................................................................ Director	40.00 .......................0.00	X	197,445	0	29,234
(20) Nolan Gagne........................................................................ Physicist	40.00 .......................0.00	X	193,400	0	29,323
(21) Jeff Meisner........................................................................ Director	40.00 .......................0.00	X	193,304	0	33,297

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,699,679	2,414,095	405,065

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	63,955
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	5,446,829

g	Noncash contributions included in lines 1a - 1f:$ 2,164
h Total. Add lines 1a-1f.......		5,510,784

		Business Code
2a	Net Patient Services	621300	276,765,622	276,765,622
b	Disproportionate Share Funding	621300	5,193,628	5,193,628
c	Cafeteria	722210	1,593,275	1,593,275
d	Other Programs	621300	820,565	820,565
e	Gift Shop	453220	103,550	103,550
f	All other program service revenue.		347,640	347,640
g	Total. Add lines 2a–2f ....		284,824,280

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,522,525		21,906	1,500,619
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		65,570
b	Less: rental expenses		20,452
c	Rental income or (loss)		45,118
d	Net rental income or (loss)......			45,118	45,118
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	41,400	26,495,327
b	Less: cost or other basis and sales expenses	0	14,498,877
c	Gain or (loss)	41,400	11,996,450
d	Net gain or (loss).....			12,037,850			12,037,850
8a	Gross income from fundraising events (not including $ 63,955of contributions reported on line 1c). See Part IV, line 18 ....
	a		0
b	Less: direct expenses ...b		19,509
c	Net income or (loss) from fundraising events..			-19,509			-19,509
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			303,921,048	284,869,398	21,906	13,518,960

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,304,570	1,304,570
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	716,062	639,214	76,848
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	85,921,466	76,700,393	9,221,073
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,524,417	3,146,177	378,240
9	Other employee benefits .......	17,118,908	15,281,711	1,837,197
10	Payroll taxes ...........	6,150,874	5,490,764	660,110
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	60,586		60,586
c	Accounting ...........	70,000		70,000
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	27,050,533	24,147,477	2,903,056
12	Advertising and promotion ....	482,259	430,503	51,756
13	Office expenses .......	763,318	681,399	81,919
14	Information technology ......	306,740	273,821	32,919
15	Royalties ..
16	Occupancy ...........	6,310,227	5,633,015	677,212
17	Travel ............	365,394	326,180	39,214
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,491,004	1,330,990	160,014
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	11,359,995	10,140,843	1,219,152
23	Insurance ...	889,291	793,852	95,439
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Drugs	26,459,122	26,459,122
b	Supplies	23,720,842	21,175,126	2,545,716
c	Medicaid Enhancement Ta	13,723,449	13,723,449
d	Bad Debt Expense	11,369,405	11,369,405
e	All other expenses	13,119,580	11,711,589	1,407,991
25	Total functional expenses. Add lines 1 through 24e	252,278,042	230,759,600	21,518,442	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			30,078,280	1	23,331,659
2	Savings and temporary cash investments .........			12,402,350	2	12,564,951
3	Pledges and grants receivable, net ......			0	3	60,650
4	Accounts receivable, net .............			23,954,667	4	27,914,696
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			4,349,200	8	4,482,425
9	Prepaid expenses and deferred charges ......			4,286,974	9	4,456,403
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	137,364,574
b	Less: accumulated depreciation	10b	75,409,110	57,304,245	10c	61,955,464
11	Investments—publicly traded securities .			30,367,029	11	32,663,720
12	Investments—other securities. See Part IV, line 11 .....			118,964,865	12	115,094,525
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			3,939,494	15	3,346,937
16	Total assets. Add lines 1 through 15 (must equal line 34)...			285,647,104	16	285,871,430

17	Accounts payable and accrued expenses .....	20,268,597	17	20,185,484
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	50,757,211	20	46,798,667
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	24,594,296	25	33,924,274
26	Total liabilities. Add lines 17 through 25..	95,620,104	26	100,908,425

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	172,886,944	27	167,643,054
28	Temporarily restricted net assets ...........	370,735	28	550,630
29	Permanently restricted net assets	16,769,321	29	16,769,321
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	190,027,000	33	184,963,005
34	Total liabilities and net assets/fund balances ........	285,647,104	34	285,871,430

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Exeter Health Resources Inc 5 Alumni Drive Exeter,NH03833 02-0222126	Management and Supporting Organization; Holding Company	NH	501(c)(3)	Line 12a, I			No
(2)Core Physicians LLC 5 Alumni Drive Exeter,NH03833 87-0807914	Physician Practices	NH	501(c)(3)	Line 10	Exeter Health Resources Inc		No
(3)Rockingham Visiting Nurse Association 5 Alumni Drive Exeter,NH03833 02-0274905	Home Care, Hospice	NH	501(c)(3)	Line 10	Exeter Health Resources Inc		No
(4)Matrix Health Inc 5 Alumni Drive Exeter,NH03833 02-0473737	Manage Resources	NH	501(c)(3)	Line 12b, II	Exeter Health Resources Inc		No
(5)Exeter Med Real Inc 5 Alumni Drive Exeter,NH03833 02-0418718	Real Estate Holding Company	NH	501(c)(25)		Exeter Health Resources Inc		No
(6)Exeter Health Resources Self-Insurance Trust 5 Alumni Drive Exeter,NH03833 20-0753662	Self Insurance Trust	NH	501(c)(3)	Line 12a, I	Exeter Health Resources Inc		No

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Exeter Med Real Inc	K	2,038,587	Cash
(2) Exeter Med Real Inc	O	472,275	Cash

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No