TY 2019 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)
(1) Joseph Pepe MD...................................................................... President & CEO	42.20 ................. 1.20	X	X		866,957	0	420,805
(2) Alexander Walker Jr Esq...................................................................... Executive VP & COO	40.10 ................. 0.50		X		537,215	0	221,123
(3) Edward Dudley III...................................................................... Executive VP & CFO	40.20 ................. 0.70		X		508,525	0	211,634
(4) Louis I Fink MD...................................................................... Director	1.30 ................. 40.50	X			0	637,986	26,200
(5) Robert A Catania MD...................................................................... Director (end 7/2020)	1.00 ................. 40.20	X			0	585,112	43,275
(6) William Goodman...................................................................... VP, Medical Affairs/CMO	40.00 ................. 0.00		X		445,637	0	42,508
(7) Carolanne O'Sullivan...................................................................... Senior VP, Provider Network	40.00 ................. 0.00			X	317,801	0	51,228
(8) Tina-Marie Legere...................................................................... Senior VP, Operations	40.00 ................. 0.00			X	312,606	0	37,555
(9) Ivan Ip...................................................................... Chief Medical Information Officer	40.00 ................. 0.00			X	322,838	0	18,138
(10) Keith Stahl...................................................................... Associate Chief Medical Officer	40.00 ................. 0.00			X	332,619	0	7,670
(11) Merryll Rosenfeld...................................................................... VP, Human Resources	40.00 ................. 0.00			X	256,961	0	44,990
(12) Thomas Della Flora...................................................................... VP, Chief Information Officer	40.00 ................. 0.00		X		256,953	0	42,264
(13) Carolyn Claussen MD...................................................................... Director	0.70 ................. 40.30	X			0	202,302	11,205
(14) Michael Gilbert MD...................................................................... Director	40.00 ................. 0.20	X			0	0	0
(15) Susan M Kinney...................................................................... Director	0.90 ................. 0.30	X			0	0	0
(16) Derek McDonald...................................................................... Director/Bishop's Delegate	2.00 ................. 0.40	X			0	0	0
(17) Marie McKay CPA...................................................................... Director	0.70 ................. 1.00	X			0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Dartmouth Hitchcock Clinic 1 Medical Center Drive Lebanon,NH03756	Medical services	27,313,762
Harvey Construction Corp 10 Harvey Road Bedford,NH03110	Construction and renovations	5,281,526
iMethods LLC 8787 Perimeter Park Boulevard Jacksonville,FL32216	Healthcare IT solutions	2,482,213
Anesthesia Care Group PC 87 McGregor Street 1400 Manchester,NH03101	Medical services	1,628,232
Xtend Healthcare LLC 90 Volunteer Drive Suite 150 Hendersonville,TN37075	Billing and revenue management	1,103,373
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 92

- 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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

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) 2019

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

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) 2019

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) 2019

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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, 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 2019. 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 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

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

2019

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization Catholic Medical Center

Part I Contributors	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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization Catholic Medical Center		Employer identification number 02-0315693

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization Catholic Medical Center			Employer identification number 02-0315693
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) (2019)

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

2019

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

Catholic Medical Center

Employer identification number

02-0315693

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) 2019

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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|No

(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? ..........................................................

Yes

36,281

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

60,500

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

96,781

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:	Catholic Medical Center (CMC) is a member of the New Hampshire Hospital Association (NHHA) and the American Hospital Association (AHA). A portion of the dues paid to these organizations in the fiscal year ending September 30, 2020 was available for lobbying expenditures on behalf of CMC and the other member-organizations in furtherance of their exempt purposes. The portion of the dues paid that constituted lobbying was as follows: NHHA: $25,200 AHA: $11,081 Also in the 2020 fiscal year, the Hospital paid the Diocese of Manchester for lobbying services, which included providing information regarding public policy pending before the legislature. The Diocese participated in the administrative rule-making process with respect to rules concerning the certificate of needs board. They also provided general communication with elected officials. CMC paid the Diocese $60,500 for these services.

Return Reference

Explanation

Part II-B, Line 1:

Catholic Medical Center (CMC) is a member of the New Hampshire Hospital Association (NHHA) and the American Hospital Association (AHA). A portion of the dues paid to these organizations in the fiscal year ending September 30, 2020 was available for lobbying expenditures on behalf of CMC and the other member-organizations in furtherance of their exempt purposes. The portion of the dues paid that constituted lobbying was as follows: NHHA: $25,200 AHA: $11,081 Also in the 2020 fiscal year, the Hospital paid the Diocese of Manchester for lobbying services, which included providing information regarding public policy pending before the legislature. The Diocese participated in the administrative rule-making process with respect to rules concerning the certificate of needs board. They also provided general communication with elected officials. CMC paid the Diocese $60,500 for these services.

Schedule C (Form 990 or 990EZ) 2019

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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

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 FASB 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 FASB 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 FASB 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) 2019

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 ....	11,244,891	10,426,818	9,726,007	9,492,810	8,240,087
b	Contributions ...	16,173,712	1,536,316	646,924	169,811	666,127
c	Net investment earnings, gains, and losses	203,284	-63,353	430,243	112,670	783,730
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	625,929	654,890	376,356	49,284	197,134
f	Administrative expenses ....
g	End of year balance ......	26,995,958	11,244,891	10,426,818	9,726,007	9,492,810

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

34.670 %

Term endowment SchDMd Bullet

65.330 %

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)

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

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 .....	672,812		672,812
b	Buildings ....	110,400,029	50,887,018	59,513,011
c	Leasehold improvements	9,694,467	6,707,981	2,986,486
d	Equipment ....	189,706,132	145,000,929	44,705,203
e	Other .....	24,299,920	7,936,171	16,363,749
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				124,241,261

Schedule D (Form 990) 2019

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) Private investment funds	50,862,486	F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	50,862,486

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	235,068,213
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) 2019

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	424,443,924
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	5,690,993
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	261,386
e	Add lines 2a through 2d .....................			2e	5,952,379
3	Subtract line 2e from line 1..................			3	418,491,545
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	154,266
b	Other (Describe in Part XIII.) ...........	4b	40,591,872
c	Add lines 4a and 4b....................			4c	40,746,138
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	459,237,683

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	423,196,234
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	156,501
e	Add lines 2a through 2d....................			2e	156,501
3	Subtract line 2e from line 1...................			3	423,039,733
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	154,266
b	Other (Describe in Part XIII.) ............	4b	17,979,092
c	Add lines 4a and 4b.....................			4c	18,133,358
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	441,173,091

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:	Proceeds from the Organization's endowment funds are used in operations.
Part X, Line 2:	The Medical Center is a not-for-profit corporation as described in Section 501(c)(3) of the Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Medical Center's tax positions and concluded the Medical Center has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to the financial statements.
Part XI, Line 2d - Other Adjustments:	Special event expenses 77,029. Gift Shop cost of goods sold 79,472. Changes in FMV of perpetual trust 104,885.
Part XI, Line 4b - Other Adjustments:	Donations to others included in audited revenues 511,173. Provision for bad debts net against revenues 17,467,919. Pension related changes net of periodic costs 22,351,129. Change in FMV of interest rate swap agreement 261,651.
Part XII, Line 2d - Other Adjustments:	Special event expenses 77,029. Gift Shop cost of goods sold 79,472.
Part XII, Line 4b - Other Adjustments:	Provision for bad debts net against revenues 17,467,919. Donations to others included in audited revenues 511,173.

Schedule D (Form 990) 2019

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

2019

Open to Public Inspection

Name of the organization
Catholic Medical Center

Employer identification number

02-0315693

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 10 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)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	Accordant Philanthropy 195 Teal Nest Court Ponte Vedra Beach, FL32082	Fundraising research and capital campaigns		No	0	71,919	0
	Eleni Eliades 5 Masefield Drive Nashua, NH03062	Fundraising research and capital campaigns		No	0	18,200	0








Total . . . . . . . . . . . . . . . . . . . .						90,119

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) 2019

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 Gala (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	192,230	192,230
2	Less: Contributions . . . .	174,875	174,875
3	Gross income (line 1 minus line 2) . . . . . .	17,355	17,355

4	Cash prizes . . . . .	0
5	Noncash prizes . . . .	88	88
6	Rent/facility costs . . . .	13,906	13,906
7	Food and beverages . . .	43,855	43,855
8	Entertainment . . . .	11,105	11,105
9	Other direct expenses . . .	8,075	8,075
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		77,029
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		-59,674

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) 2019

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 I, Line 2b(iv)

In the tax period covered by this return, the Hospital engaged with two independent professional fundraisers to assist the Hospital in its capital campaign and fundraising efforts. Due to the nature in which contributions were raised over past year, the Hospital cannot reasonably determine an accurate allocation of the total receipts that were generated directly from the respective professional fundraisers. Accordingly, the amount of gross receipts in Part I, Line 2b(iv) for each is reported as zero. However, the Hospital generated over $15,423,000 in gross receipts from the activities that the professional fundraisers listed in Part I assisted with.

Schedule G (Form 990 or 990-EZ) 2019

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

2019

Open to Public Inspection

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

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 22500.0000000000 %

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: . . . . . . . .

Yes

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		(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) . . .	6,446,622		6,446,622	1.520 %
b	Medicaid (from Worksheet 3, column a) . . . . .	61,567,777	30,724,278	30,843,499	7.290 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	68,014,399	30,724,278	37,290,121	8.810 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,673,177	130,591	1,542,586	0.360 %
f	Health professions education (from Worksheet 5) . . .	2,430,084		2,430,084	0.570 %
g	Subsidized health services (from Worksheet 6) . . . .	16,178,558	6,438,966	9,739,592	2.300 %
h	Research (from Worksheet 7) .	32,118	3,218	28,900	0.010 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	824,053	193,295	630,758	0.150 %
j	Total. Other Benefits . .	21,137,990	6,766,070	14,371,920	3.390 %
k	Total. Add lines 7d and 7j .	89,152,389	37,490,348	51,662,041	12.200 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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	5,050	5,050	0 %
3	Community support	4,595	4,595	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	152,953	152,953	0.040 %
8	Workforce development
9	Other
10	Total	162,598	162,598	0.040 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

5,547,813

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. ......

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).....

93,682,004

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

142,992,433

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

-49,310,429

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) 2019

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	Catholic Medical Center 100 McGregor Street Manchester,NH03102 00646	X	X	X

Schedule H (Form 990) 2019

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)

	Catholic Medical Center
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..................................

Yes

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 Part V, Section C

Other website (list url): see Part V, Section C

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 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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Catholic Medical Center
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 225.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

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 Part V, Section C

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

see 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) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	Catholic Medical Center
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 (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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) 2019

Page 7

Part VFacility Information (continued)

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

	Catholic Medical Center
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) 2019

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, 20a, 20b, 20c, 20d, 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
Catholic Medical Center	Part V, Section B, Line 5: A variety of different secondary data sources were accessed. They included but were not limited to the Centers for Disease Control and Prevention (CDC), New Hampshire Department of Health and Human Services (NHDHHS), Youth Behavioral Risk Factor Surveillance Survey, City of Manchester, Census data, and local town data. Representatives from CMC, Elliot Health System (EHS) and Manchester Health Department interviewed key leaders from towns in our service area to ascertain the key health related issues that they were facing and dealing with in their local communities. The towns that were included in the interview process were Auburn, Bedford, Candia, Hooksett, Goffstown, Deerfield, and New Boston. Though the overall needs were similar the priority of them varies between the towns. Overall, the common themes were substance use, the availability of behavioral health services, transportation (especially in the elderly populations and the more rural areas of New Boston and Deerfield), self-care and management of chronic disease, and access to health care for the low income populations and communities. Communications on community needs were collected via discussions with local leaders in the health care field. These leaders consisted of individuals from: Catholic Medical Center, Dartmouth-Hitchcock Clinic, Public Health Department - City of Manchester, NH, Elliot Health System, and Community Health & Mission.
Catholic Medical Center	Part V, Section B, Line 6a: Elliot Health System in Manchester, NH.
Catholic Medical Center	Part V, Section B, Line 6b: Manchester Health Department.
Catholic Medical Center	Part V, Section B, Line 7d: The Catholic Medical Center "Healthy Living News", the Medical Center's community newsletter, provides a summary report of the community benefits that the Medical Center provides. The Healthy Living News is distributed to our primary and secondary service areas, approximately 120,000 people.
Catholic Medical Center	Part V, Section B, Line 11: Catholic Medical Center has addressed the needs identified in the June 30, 2019 CHNA through the implementation of programs and services throughout the Manchester health service area (HSA). Mental illness and violence are often intrinsically intertwined. CMC has increased services within our Behavioral Health Department and developed the Opioid Use/Misuse Resource. This is an online tool available to all CMC staff to create consistency of care in the treatment and recovery of this public health epidemic. Health Care for the Homeless (HCH) of CMC provides behavioral health services and substance abuse counseling to the homeless throughout the Manchester HSA. CMC has improved the mental health assessment tool in Primary Care, a key component in the early identification and treatment of mental illness. In collaboration with Governor Hassan's Senior Director of Substance Misuse and Behavioral Health and Boston University School of Medicine, CMC conducted the fourth annual "State-of-the Art Management of the Opiate-dependent Patient, Pain Treatment and the Heroin Epidemic". The targeted audience for this conference included prescribers, nurses, allied health professionals, pharmacists and social service agencies. The program addressed many facets of substance abuse within our community, hospitals, and practices. In addition, CMC hosted the Annual Summit on the Treatment of Opioid-Dependent Patients and Pain, added an Addiction Medicine Practice, and increased the number of providers utilizing medication assisted treatment.The Doorway of Greater Manchester: In May 2020, CMC, assumed leadership of The Doorway Program of Greater Manchester. The NH Doorway system was launched in January 2019 with funding from the State Opioid Response grant from the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA) and is designed to be an access point for those seeking services for substance use disorder (SUD). A 2018 study from SAMHSA found that 20.3 million people aged 12 or older, or 7.4% of this population had a SUD. SUD continues to be an area of concern identified in the Greater Manchester Community Health Needs Assessment. Of those with an addiction-related condition, only 11% received treatment. By operating the Doorway, CMC is committed to assisting those with SUD by connecting them with clinical treatment and wrap-around services to break the cycle of addiction. Wilson Street Integrated Health: Continuing its mission of caring for the region's most vulnerable neighbors, CMC opened Wilson Street Integrated Health (WSIH), located within the Manchester Recovery and Treatment Center (MRTC). Wilson Street Integrated Health is a service of the Health Care for the Homeless Program of Manchester, a collaboration between CMC and the City of Manchester Health Department. The new practice offers primary care, social work, counseling and medication assisted treatment to our most vulnerable patients, as well as providing our patients with easy access to our MRTC partners: Hope for New Hampshire Recovery, The Willows Substance Use Treatment Center, and the Mental Health Center of Greater Manchester's Mobile Crisis Response Team. Ambulatory care, chronic disease, including asthma and aging issues have all been addressed through various means. Catholic Medical Center's Primary Care has implemented The Patient-Centered Medical Home (PCMH) Model, a proactive approach to preventative medicine through the introduction of care coordinators to the primary care practices. All care managers work with the practices' most high risk patients (asthma, diabetes, COPD, etc) to ensure they understand their medications and follow-up care. The PCMH Model encourages patients to become involved and educated in their personal care plan. CMC offers free health screenings, chronic disease, and self-management classes to the community. These programs provide the opportunity for early detection of chronic disease; referral based follow-up care and education on adopting healthy lifestyle behaviors, communicating with the healthcare team, problem solving, and goal setting. To aid with aging issues, CMC's Parish Nurse program provides nurse consultations, education, referrals, and screenings at Parishes throughout the Greater Manchester Area.In order to address the barriers to access of health care services related to poverty (lack of insurance, cost, transportation and education on accessing care, and lack of medical home) CMC provides comprehensive care to Manchester's underserved and refugee populations. Health Care for the Homeless provides primary medicine and behavioral health care to over 1,700 homeless patients. CMC's Certified Application Counselors (CAC) provide outreach and enrollment services to the communities' uninsured. CACs provide information on a full range of qualified health plan (QHP) options and assist individuals in applying for coverage through a QHP in the ACA's Marketplace Exchange. CMC has staffed the emergency department with a community health worker to improve primary care access for the homeless population, provide education on accessing care, and transportation support. CMC provides shuttle support at no cost to patients with offsite appointments such as primary care, outpatient PT, and other services that are not available at the Hospital. CMC assists patients through the Medication Assistance program to obtain medications they would otherwise not be able to afford and has developed a prescription delivery program with Rite Aid Pharmacy to assist patients with filling their medications upon discharge.CMC's Poisson Dental Facility has expanded access to oral health services to patients of the Pregnancy Care Center and Manchester Community Health Center (MCHC). The Poisson Dental Facility provides access to exams and treatment planning for women from the Pregnancy Care Center and access to oral health care during the first post-partum year until their treatment plan has been completed. CMC's Poisson Dental facility provides oral health services to not-for-profit agencies in our community including Mental Health Center of Greater Manchester, Moore Center Services, Manchester Health Department, and Health Care for the Homeless (HCH). The majority of HCH patients often arrive with very poor oral health. In an effort to meet the growing need for oral health services, CMC's Poisson Dental expanded services to include school-based dental care for children in need attending Manchester elementary, middle, and high schools. This school-based program is made possible through collaboration with the City of Manchester Health Department and Easter Seals NH. Poisson Dental also provides onsite dentistry at Dartmouth Hitchcock Manchester by integrating these services within their pediatric practice. This allows for ease of access for the patients and direct communication amongst the providers of care.CMC's Fertility Education provides teens at local schools and parishes educational opportunities such as The Cradle Within, Ideal Dating, Sexual Risk Behavior, and Conflict Resolution. The goal is to equip adolescents with the tools to identify healthy relationships and the benefits of choosing sexual risk avoidance behaviors. The Pregnancy Care Center provides supportive prenatal care to all women, including teens, regardless of their ability to pay. Their mission is to improve pregnancy outcomes by serving those most in need and unable to access services in a traditional prenatal setting. The Pregnancy Care Center expanded services, adding Centering Group Prenatal Care; this program is a multifaceted model of group care that integrates the three major components of care: health assessment, education, and support. Visits promote greater patient engagement, personal empowerment, and community-building. Veteran's Support: In June of 2018, Easter Seals and Catholic Medical Center launched a pilot program to provide Easter Seals' Military & Veteran Services (MVS) care coordination services onsite to veterans, service members, and their immediate family members (including CMC staff members). Easter Seals MVS provides care coordination services to veterans of all eras, regardless of branch, active duty status, length of service, or discharge status. Among other things, Easter Seals MVS can help patients (and staff members who are veterans) to determine eligibility for and connect to military and civilian benefits and resources, stabilize housing, and find employment support.Breast & Cervical Cancer Screening: Regular screenings and follow-up care can help prevent or more effectively treat breast and cervical cancers. The Let No Woman Be Overlooked Breast and Cervical Cancer Program allows women throughout New Hampshire who do not have access to essential, basic, preventive care access free screenings.(Explanation is continued later in Part V, Facility Information)
Catholic Medical Center	Part V, Section B, Line 16j: Signs are posted throughout the hospital facility and physician practices that list the financial programs available and contact information for assistance.
Part V, Line 7a & 7b:	Hospital's Website URL for Community Health Needs Assessment: www.catholicmedicalcenter.org/about-cmc/in-the-community/community-health-needs-assessment The CHNA can also be found at:https://www.elliothospital.org/website/downloads/Manchester-Report-Final-compressed.pdf
Part V, Line 10a:	Hospital's Website URL for Community Health Implementation Plan:www.catholicmedicalcenter.org/about-cmc/in-the-community/community-health-implementation
Schedule H, Part V, Section B, Line 16a-16c:	The financial assistance policy, application, and plain language summary are available online: https://www.catholicmedicalcenter.org/patients-visitors/financial-assistance
Part V, Section B, Line 11 (continued):	Catholic Medical Center has a long history of providing services to the community and currently has programs in place to meet every identified need in the most recent CHNA. In addition to the programs we currently offer, we will expand many of our services in response to the needs of the community that have not been addressed.

Schedule H (Form 990) 2019

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?56
Name and address		Type of Facility (describe)
1	1 - New England Heart Institute 100 McGregor Street Manchester,NH03102	Cardiovascular Health
2	2 - Hospital Medicine 100 McGregor Street Manchester,NH03102	Hospital Medicine
3	3 - Cardiothoracic Surgical Associates 100 McGregor Street Manchester,NH03102	Cardiothoracic Surgical Associates
4	4 - Women's Wellness & Fertility Center 88 McGregor Street Suite 201 Manchester,NH03102	Women's Health
5	5 - Surgical Care Group 87 McGregor Street Suite 3100 Manchester,NH03102	Surgical Care
6	6 - Amoskeag Family Practice 1750 Elm Street Suite 201A Manchester,NH03101	Family Medicine
7	7 - Bedford Center Int Med & Pediatric 188 Route 101 Bedford,NH03110	Internal Medicine and Pediatrics
8	8 - Outpatient Rehabilitation 188 Route 101 Bedford,NH03110	Outpatient Rehabilitation
9	9 - Family Physicians of Manchester 57 Webster Street Suite 110 Manchester,NH03104	Family Medicine
10	10 - Goffstown Family Practice 17A Tatro Drive Suite 201 Goffstown,NH03045	Family Medicine
11	11 - Granite State Internal Medicine 188 Route 101 Bedford,NH03110	Internal Medicine
12	12 - Hooksett Internal Medicine 11 Kimball Drive Unit 132 Hooksett,NH03103	Internal Medicine
13	13 - Highlander Way Internal Medicine 1 Highlander Way Manchester,NH03103	Internal Medicine
14	14 - Comprehensive Rheumatology at CMC 160 South River Road Bedford,NH03110	Comprehensive Rheumatology
15	15 - Lakeview Internal Medicine 27 Londonderry Turnpike Hooksett,NH03106	Internal Medicine
16	16 - Outpatient Rehabilitation 27 Londonderry Turnpike Hooksett,NH03106	Outpatient Rehabilitation
17	17 - Queen City Medical Associates 775 South Main Street Manchester,NH03102	Skilled Practitioners
18	18 - Willowbend Family Practice 5 Washington Place Suite 1A Bedford,NH03110	Family Medicine
19	19 - Webster Street Internal Medicine 57 Webster Street Manchester,NH03104	Internal Medicine
20	20 - Urgent Care at Bedford Medical Park 5 Washington Place Suite 1B Bedford,NH03110	Urgent Care
21	21 - New England Heart Institute 59 Page Hill Road Berlin,NH03570	Heart and Vascular services
22	22 - Surgical Care Group 59 Page Hill Road Berlin,NH03570	General Surgery services
23	23 - Comprehensive Neurological Care 59 Page Hill Road Berlin,NH03570	TeleNeurology services
24	24 - New England Heart Institute 452 Old Street Road Peterborough,NH03458	Heart and Vascular services
25	25 - Surgical Care Group 452 Old Street Road Peterborough,NH03458	General Surgery services
26	26 - Surgical Care Group 452 Old Street Road Peterborough,NH03458	Vascular Surgery services
27	27 - Comprehensive Rheumatology 452 Old Street Road Peterborough,NH03458	Rheumatology services
28	28 - Hospital Medicine Services 452 Old Street Road Peterborough,NH03458	Hospitalists
29	29 - New England Heart Institute 173 Middle Street Lancaster,NH03584	Heart and Vascular services
30	30 - Surgical Care Group 173 Middle Street Lancaster,NH03584	General Surgery services
31	31 - Comprehensive Neurological Care CMC 1 Highlander Way Manchester,NH03103	Comprehensive Neurological Care
32	32 - Outpatient Rehabilitation 769 South Main Street Suite 201 Manchester,NH03102	Outpatient Rehabilitation
33	33 - New England Heart Institute 181 Corliss Lane Colebrook,NH03576	Heart and Vascular services
34	34 - Hospital Medicine services 181 Corliss Lane Colebrook,NH03576	Hospitalists
35	35 - Cholesterol Management Center 195 McGregor Street Suite 312 Manchester,NH03102	Cholesterol Management services
36	36 - Cholesterol Management 6 Tsienneto Road Derry,NH03038	Cholesterol Management services
37	37 - New England Heart Institute 6 Tsienneto Road Derry,NH03038	Heart and Vascular services
38	38 - Surgical Care Group 6 Tsienneto Road Derry,NH03038	Vascular Surgery services
39	39 - New England Heart Institute 160 South River Road Bedford,NH03110	Heart and Vascular services
40	40 - Surgical Care Group 160 South River Road Bedford,NH03110	General Surgery services
41	41 - Vein and Vascular Specialists 160 South River Road Bedford,NH03110	Vein and Vascular Specialists
42	42 - New England Heart Institute 7 Holland Way Exeter,NH03833	Heart and Vascular services
43	43 - New England Heart Institute 240 S Main Street Wolfeboro,NH03894	Heart and Vascular services
44	44 - Surgical Care Group 240 S Main Street Wolfeboro,NH03894	General Surgery services
45	45 - New England Heart Institute 369 Hounsell Avenue 5 Gilford,NH03249	Heart and Vascular services
46	46 - New England Heart Institute 401 Boulder Point Drive Suite 1 Plymouth,NH03264	Heart and Vascular services
47	47 - Cholesterol Management 166 Kinsley Street Suite 301 Nashua,NH03060	Cholesterol Management services
48	48 - New England Heart Institute-Nashua 166 Kinsley Street Suite 301 Nashua,NH03060	NEHI Nashua
49	49 - Bedford Ambulatory Surgical Center 9 Washington Place Suite 204 Bedford,NH03110	Gastroenterology services
50	50 - Surgical Care Group 160 South River Road Bedford,NH03110	General Surgery services
51	51 - New England Heart Institute 1 Parkland Drive Derry,NH03038	Heart and Vascular services
52	52 - New England Heart Institute 172 Kinsley Street Nashua,NH03060	Heart and Vascular services
53	53 - Surgical Care Group 172 Kinsley Street Nashua,NH03060	Vascular Surgery services
54	54 - New England Heart Institute 16 Hospital Road Plymouth,NH03264	Heart and Vascular services
55	55 - Surgical Care Group 16 Hospital Road Plymouth,NH03264	General Surgery services
56	56 - New England Heart Institute 31 Stiles Road Salem,NH03079	Heart and Vascular services

Schedule H (Form 990) 2019

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 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 $ 17,853,506.
Part II, Community Building Activities:	Catholic Medical Center participates in a wide range of community building activities, committees, boards, and partnerships to promote the health of the communities it serves, including City Year, Granite United Way, and New Hampshire Charities, among others. The Medical Center sponsors emergency service efforts through planning hours for emergency preparedness and bioterrorism preparedness safety management.COVID-19: During the unprecedented COVID-19 pandemic, CMC was an integral part of the community's response activities. Early on in the pandemic, CMC partnered with the City of Manchester at the City's first COVID testing center located at the NH State Armory. Shortly thereafter, CMC collaborated with the City of Manchester, NH National Guard, and other healthcare partners to stand up the Greater Manchester Alternative Care Site (GMACS), a 250-bed field hospital located at Southern New Hampshire University (SNHU). CMC's Incident Command Center held weekly calls with the City's Emergency Operations Center, ensuring constant communication and updated information sharing. Finally, CMC has provided clinical and non-clinical staff to support the State's fixed Covid Vaccine site at SNHU as well as super clinics held at the New Hampshire Motor Speedway.
Part III, Line 2:	Costing methodology ratio of cost to charge is used to arrive at cost of bad debt expense.
Part III, Line 3:	Patients deemed eligible for financial asssistance follow CMC's charity care policies. Therefore, no bad debt expense related to patients eligible under the Hospital's financial assistance policy is included as a community benefit.
Part III, Line 4:	See Footnote 2 on Page 11 of the attached audited financial statements.
Part III, Line 8:	The entire Medicare shortfall is reported in our Community Benefit Report to the State of New Hampshire. The Medicare shortfall represents costs incured by the Hospital for providing care to Medicare patients in the Hospital's service area that were not reimbursed by the federal government. The Hospital considers this amount to be a significant shortfall for providing healthcare-related services to these patients which ultimately benefits the community it serves.
Part III, Line 9b:	CMC is a charitable healthcare organization that treats patients for emergency or medically necessary care regardless of their financial status. CMC's Collections Policy and Procedures addresses the procedures for patients who choose not to make payment or work with CMC to make payment arrangements for their bill. The policy contains specific language that applies to those patients who may qualify for financial assistance. CMC will hold collection activities where the patient has submitted a completed financial assistance application. CMC makes reasonable efforts to determine whether an individual is eligible for financial assistance under our Financial Assistance Policy (FAP). In order to determine whether a patient is eligible for financial assistance, CMC provides written notice that indicates the availability of financial assistance, provides a plain-language summary of the FAP, and attempts to notify the individual orally about the FAP and how the patient may get assistance with the application process. CMC also publishes the policy on our website, at patient registration locations, and provides notice to the community.
Part VI, Line 2:	In collaboration with the city of Manchester and other health care and social service agencies, Catholic Medical Center participates in a community needs assessment as required by the New Hampshire Attorney General's Office Division of Charitable Trusts.Since hospitals are required to assess the needs of their community every three years, CMC has completed a 2019 Needs Assessment and approved by the board and made widely available to the public during the fiscal year covered by the Hospital's 2018 Form 990. The previous Needs Assessment was completed in fiscal year 2016 by CMC and the Elliot Hospital of the City of Manchester. Additional information is obtained on an ongoing basis to assist the Organization in evaluating progress towards meeting our goals and the identification of new areas of need. This information is collected through community surveys, focus groups and discussions with community leaders, program evaluations and communication with those in the community who interact with our vulnerable populations.
Part VI, Line 3:	Patients are notified of CMC's FAP via notices upon registration, discharge, postings to our website, in the hospital, and physician practices. Signage is posted throughout the Hospital and physician practices highlighting Catholic Medical Center's financial assistance. CMC also communicates the policy to the community via mailings and other postings in relevant local support organizations. CMC also contacts patients verbally to inform them of the programs available.
Part VI, Line 4:	Catholic Medical Center's primary service area consists of the following towns and cities: Allenstown, Auburn, Bedford, Goffstown, Hooksett, Manchester, and New Boston. Our secondary service area is made up of Amherst, Concord, Derry, Litchfield, Londonderry, Merrimack, Milford, Nashua, Peterborough, Raymond, Salem and Weare.
Part VI, Line 5:	Catholic Medical Center is involved in numerous community initiatives to improve the health outcomes of our community, including, but not limited to the following: DSRIP 1115 Waiver, N4H a federally funded program with the state of New Hampshire to transform care by integrating primary and behavioral health care to improve health outcomes; a collaboration with The Manchester Health Department, Easter Seals, and Catholic Medical Center to provide school-based dental care to school-aged children in need. Services are provided at all Manchester elementary and middle schools along with one of the high schools; partnership with Dartmouth Hitchcock Clinic for the integration of dental care within a pediatric clinic setting, improving oral health and overall health and a partnership with Amoskeag Health Center to provide oral health exams and hygiene and a referral to a dental home for children ages 1-5; 500 Cities initiative with CMC's Parish Nurse Program and Manchester Health Department to offer assessments and services to high risk populations located within neighborhoods; primary care, specialty care and care coordination the homeless population via the HRSA grant; Medication Assistance Program offering free or reduced cost medication through the pharmaceutical companies and other low cost resources; emergency bioterrorism preparedness safety management.
Part VI, Line 6:	Catholic Medical Center operates as part of CMC Healthcare System. Under the System, CMC offers a range of healthcare services to the community. The System includes CMC as a licensed, 330 bed full-service, acute care hospital, physician practices, general care surgical capabilities, and advanced care for cardiac needs. Catholic Medical Center offers full medical-surgical care with more than 25 subspecialties, comprehensive orthopedic care, inpatient and outpatient rehabilitation services, a 24-hour emergency department, outpatient behavioral health services, and diagnostic imaging. In addition, Catholic Medical Center has the Special Care Nursery which is a state-of-the-art neonatal facility designed to meet the distinct needs of our babies and their families. Catholic Medical Center is also home to the nationally recognized New England Heart and Vascular Institute (NEHVI), which provides a full-range of cardiac services, and is a pioneer in offering innovative surgical procedures. The Institute is also a national center for advanced clinical trials and cardiovascular rehabilitation and wellness education to help patients recover in a multi-step program of exercise, education, risk factor management, and the development of healthy lifestyles. The System also participates in two joint ventures, Bedford Ambulatory Surgical Center and Alliance Urgent Care Services, through its wholly-owned entity, Alliance Ambulatory Services, and Tuft's Health Freedom Plan (dissolved during the fiscal year) through the Granite Health Network.CMC has a deeply rooted history of providing care to those most in need through the Community Health and Mission department. CMC reaches beyond the walls of the hospital and into the community, assisting underserved individuals with health information and access to care. Community Health and Mission provides a wide variety of education, clinical services and resources for those in our primary and secondary markets. It is the home of the Pregnancy Care Center, the Poisson Dental Facility, the Health Care for the Homeless program, and the Parish Nurse program. We provide medication assistance, breast and cervical cancer screenings, and health screenings.
Part VI, Line 7, Reports Filed With States	NH

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

2019

Open to Public
Inspection

Name of the organization
Catholic Medical Center

Employer identification number
02-0315693

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) Foundation for Healthy Communities 125 Airport Road Concord,NH03301	02-0275078	501(c)(3)	361,173				NH Hospital Association, NH Medicaid Expansion, Drug and Alcohol Abuse Prevention Initiatives
(2) New Hampshire Department of Health and Human Services 129 Pleasant Street Concord,NH033013852		GOV	150,000				Funding for the Governor's Commission on Alcohol and Other Drugs
(3) Amoskeag Health (formerly Manchester Community Health Center) 145 Hollis Street Manchester,NH03101	02-0458174	501(c)(3)	31,372	1,763	Book value	Medical equipment and supplies	Funding and equipment for health care services and initiatives

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) 2019

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) Hermsdorf Scholarships - financial assistance for the training of worthy and needy students who are employees of CMC.	9	4,875
(2) Mary Sanford Scholarships - financial assistance for individuals pursuing a career in nursing.	2	2,000
(3) BSN or Higher Scholarships - financial assistance to employees who wish to improve their performance and proficiency in the nursing field.	5	4,500
(4) Caring for Co-workers program to provide general assistance to individuals in need.	29	65,789
(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:

The Hospital will only makes donations to 501(c)(3) public charities or governmental municipalities. The Hospital may award grants to individuals living in the United States if the recipient-individuals are employees of the Catholic Medical Center system, and if the recipient-individuals meet certain merit and financial-need eligibility requirements. Grants to individuals are awarded in the form of scholarships to pursue higher education and skills in the healthcare field while also working for the Hospital.

Schedule I (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

2019

Open to Public Inspection

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

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 on 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 .........

Yes

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 on 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? .............

Yes

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) 2019

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)
1Joseph Pepe MD President & CEO	(i) (ii)	816,646 ------------- 0	0 ------------- 0	50,311 ------------- 0	384,974 ------------- 0	35,831 ------------- 0	1,287,762 ------------- 0	0 ------------- 0
2Alexander Walker Jr Esq Executive VP & COO	(i) (ii)	476,101 ------------- 0	0 ------------- 0	61,114 ------------- 0	164,660 ------------- 0	56,463 ------------- 0	758,338 ------------- 0	0 ------------- 0
3Edward Dudley III Executive VP & CFO	(i) (ii)	465,356 ------------- 0	0 ------------- 0	43,169 ------------- 0	169,541 ------------- 0	42,093 ------------- 0	720,159 ------------- 0	0 ------------- 0
4Louis I Fink MD Director	(i) (ii)	0 ------------- 484,990	0 ------------- 122,996	0 ------------- 30,000	0 ------------- 23,500	0 ------------- 2,700	0 ------------- 664,186	0 ------------- 0
5Robert A Catania MD Director (end 7/2020)	(i) (ii)	0 ------------- 534,994	0 ------------- 29,998	0 ------------- 20,120	0 ------------- 20,700	0 ------------- 22,575	0 ------------- 628,387	0 ------------- 0
6William Goodman VP, Medical Affairs/CMO	(i) (ii)	435,137 ------------- 0	0 ------------- 0	10,500 ------------- 0	16,848 ------------- 0	25,660 ------------- 0	488,145 ------------- 0	0 ------------- 0
7Carolanne O'Sullivan Senior VP, Provider Network	(i) (ii)	290,628 ------------- 0	0 ------------- 0	27,173 ------------- 0	22,033 ------------- 0	29,195 ------------- 0	369,029 ------------- 0	0 ------------- 0
8Tina-Marie Legere Senior VP, Operations	(i) (ii)	293,106 ------------- 0	0 ------------- 0	19,500 ------------- 0	15,506 ------------- 0	22,049 ------------- 0	350,161 ------------- 0	0 ------------- 0
9Ivan Ip Chief Medical Information Officer	(i) (ii)	322,838 ------------- 0	0 ------------- 0	0 ------------- 0	16,800 ------------- 0	1,338 ------------- 0	340,976 ------------- 0	0 ------------- 0
10Keith Stahl Associate Chief Medical Officer	(i) (ii)	332,619 ------------- 0	0 ------------- 0	0 ------------- 0	4,970 ------------- 0	2,700 ------------- 0	340,289 ------------- 0	0 ------------- 0
11Merryll Rosenfeld VP, Human Resources	(i) (ii)	250,208 ------------- 0	0 ------------- 0	6,753 ------------- 0	16,741 ------------- 0	28,249 ------------- 0	301,951 ------------- 0	0 ------------- 0
12Thomas Della Flora VP, Chief Information Officer	(i) (ii)	250,693 ------------- 0	0 ------------- 0	6,260 ------------- 0	14,522 ------------- 0	27,742 ------------- 0	299,217 ------------- 0	0 ------------- 0
13Carolyn Claussen MD Director	(i) (ii)	0 ------------- 171,184	0 ------------- 31,118	0 ------------- 0	0 ------------- 11,194	0 ------------- 11	0 ------------- 213,507	0 ------------- 0

Schedule J (Form 990) 2019

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	Catholic Medical Center provides certain fringe benefits that have gross-up calculations to cover taxes for a select few officers and/or highly compensated employees. In no case did this amount exceed $15,000 during the year for any one individual.
Part I, Lines 4a-b	Schedule J, Page 1, Line 4a, serverance payments: In August of 2020, Tina-Marie Legere, Catholic Medical Center's Senior VP of Operations and one of the Hospital's top-five highest compensated employees, began receiving severance payments; Ms. Legere received $34,848 within the fiscal period covered by this tax return. Ms. Legere did not receive any severance compensation during the 2019 calendar year. Accordingly, none of Ms. Legere's severance is included in her reported compensation on Schedule J, Part II. All $34,848 of Ms. Legere's severance compensation will be included in her 2020 Form W-2, Box 5 wages. Should Ms. Legere be reported on the Hospital's 2020 Form 990, for the period ending September 30, 2021, Ms. Legere's 2020 calendar year severance-income will be included in her compensation as reported on the 2020 Schedule J, Part II. Schedule J, Page 1, Line 4b, supplemental non-qualified retirement plans: The following individuals take part in a section 457(f) forfeitable nonqualified deferred compensation plan. The amounts listed represent calendar year 2019 contributions for many years of service: Joseph Pepe: $361,904 Edward Dudley, III: $150,429 Alexander Walker, Jr., Esq.: $143,960
Part I, Line 7	A portion of compensation is at-risk and variable, and payment depends on the quality of job performance.

Schedule J (Form 990) 2019

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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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
Catholic Medical Center

Employer identification number
02-0315693

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	New Hampshire Health And Education Facilities Authority	02-0279866	644614x79	12-19-2012	38,249,382	See Part VI		X		X		X
B	New Hampshire Health And Education Facilities Authority	02-0279866		09-03-2015	32,720,000	See Part VI		X		X		X
C	New Hampshire Health And Education Facilities Authority	02-0279866	64461XBT1	09-21-2017	65,363,417	See Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	18,230,000		3,835,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	38,249,517		32,779,647		66,661,097
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............	34,643,460		28,696,342
7 Issuance costs from proceeds ...............	597,089		257,332		785,623
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	3,008,968		3,825,973		65,769,643
11 Other spent proceeds .............
12 Other unspent proceeds .............					105,831
13 Year of substantial completion .............	2013		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........	X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		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		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2019

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		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		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 %		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 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		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		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		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		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X	X		X
b Exception to rebate? ........	X			X		X
c No rebate due? .........	X			X		X
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			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

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		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		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		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		X

Part Ⅵ

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

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: New Hampshire Health And Education Facilities Authority Date the Rebate Computation was Performed: 06/19/2014
Schedule K, Part I, Line A(f):	Refinance of Series 2002A Bonds Refinance of Series 2002B Bank Placement Refinance of Series 2012 Capital Note Routine Capital Improvements
Schedule K, Part I, Line B(f):	Advance & Current refunding of Series 2006 Bonds, and Construction
Schedule K, Part I, Line C(f):	To finance various construction projects.

Schedule K (Form 990) 2019

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2019

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Thomas Della Flora	Family Member Compensation	29,511	The wife of Thomas Della Flora, an officer of the Hospital, received $29,511 in compensation as an employee (Registered Nurse) of the Hospital. Compensation paid to Mr. Della Flora's wife is in line with the salary structure for similarly employed persons at the Hospital and does not represent higher than market rate compensation due to her familial relationship with Mr. Della Flora.		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2019

Additional Data

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Software Version:

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		1,212	Per books
5 Clothing and household goods .......	X		3,423	Per books
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	3	10,037,409	Gift Date FMV
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...	X	14	34,204	Per books
20 Drugs and medical supplies .	X	3	3,820	Per books
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Office goods )	X	2	397	Per books
26 Other ( Electronics )	X	1	297	Per books
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2019)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2019)

Additional Data

Software ID:
Software Version:

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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

2019

Open to Public
Inspection

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

Return Reference	Explanation
Form 990, Part VI, Section A, line 6	The members of Catholic Medical Center are CMC Healthcare System and GraniteOne Health.
Form 990, Part VI, Section A, line 7a	Directors of CMC are appointed by the members.
Form 990, Part VI, Section A, line 7b	The members have reserved powers over CMC but do not approve each separate action taken by the CMC board.
Form 990, Part VI, Section B, line 11b	Form 990 is prepared by an independent tax accounting firm (Baker Newman Noyes). Upon completion, a draft of the Form 990 is sent to the Organization, where the CFO, Controller, and Director of Accounting perform a final in-house review prior to submission to the Board of Directors for final approval. Upon approval from Board, the Form 990 is filed with the Internal Revenue Service.
Form 990, Part VI, Section B, line 12c	Officers and directors are required to complete a conflict of interest questionnaire annually.
Form 990, Part VI, Section B, line 15	CMC utilizes a compensation committee of the board of directors to set compensation levels and determine bonus potential for its senior leadership team. The committee is assisted by an independent consultant who surveys like-sized and performing institutions to benchmark relevant salary scales for each position. The consultant's findings are presented to the compensation committee who considers that external data with actual performance against a list of pre-established goals per senior leaders to set prospective compensation levels and bonus values. Bonus amounts are determined by how well an executive achieves a pre-defined set of goals. These goals, in general, are tied to the achievement of a specific task or project. Some goals are attached to achieve overall financial performance and mission performance, not solely revenue generation.
Form 990, Part VI, Section C, line 19	CMC makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part XI, line 9:	Change in fair market value of perpetual trust 104,885. Change in fair market value of interest rate swap -261,651. Net assets released for operations -466,761. Pension related changes net of periodic costs -22,351,129. Net transfers to affiliates -43,158,906.
Form 990, Part XII, Line 2c:	The audit process has not changed from 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) 2019

Additional Data

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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Catholic Medical Center

Employer identification number

02-0315693

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(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)Alliance Ambulatory Services 100 McGregor Street Manchester,NH03102 02-0519436	Ambulatory Surgical Center	NH	501(c)(3)	Line 10	CMC Healthcare System		No
(2)Alliance Health Services 100 McGregor Street Manchester,NH03102 61-1508839	Practices	NH	501(c)(3)	Line 10	CMC Healthcare System		No
(3)Alliance Resources 100 McGregor Street Manchester,NH03102 02-0398138	Real Estate	NH	501(c)(3)	Line 12b, II	CMC Healthcare System		No
(4)CMC Healthcare System 100 McGregor Street Manchester,NH03102 01-0568516	Parent	NH	501(c)(3)	Line 12b, II	N/A		No
(5)CMC Physician Practice Associates 100 McGregor Street Manchester,NH03102 02-0460245	Practices	NH	501(c)(3)	Line 10	CMC Healthcare System		No
(6)GraniteOne Health 100 McGregor Street Manchester,NH03102 81-4663563	Supporting Organization	NH	501(c)(3)	Line 12a, I	N/A		No
(7)Huggins Hospital 240 South Main Street Wolfeboro,NH03894 03-0223332	Hospital	NH	501(c)(3)	Line 3	GraniteOne Health		No
(8)Monadnock Community Hospital 452 Old Street Road Peterborough,NH03458 02-0222157	Hospital	NH	501(c)(3)	Line 3	GraniteOne Health		No
(9)St Peter's Home 100 McGregor Street Manchester,NH03102 02-0222228	Day Care Services	NH	501(c)(3)	Line 10	CMC Healthcare System		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(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
(1) Bedford Ambulatory Surgical Center LLC 11 Washington Place Bedford,NH03110 02-0519727	Surgical Center	NH	N/A
(2) Alliance Urgent Care Services 100 McGregor Street Manchester,NH03102 83-1238167	Health Care Services	NH	N/A
(3) NH Value Care ACO LLC 100 McGregor Street Manchester,NH03102 83-2029076	Health Care Services	NH	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) 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) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) Alliance Enterprises 100 McGregor Street Manchester,NH03102 02-0386795	Real Estate	NH	N/A	C			Yes
(2) Doctors' Medical Association Inc 100 Mcgregor Street Manchester,NH03102 02-0340690	Medical Office Building	NH	N/A	C				No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(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

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: The heart of Catholic Medical Center is to carry out Christ's healing ministry by offering health, healing, and hope to every individual who seeks our care.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	3,368
6	Total number of volunteers (estimate if necessary) .............	6	175
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	39,272
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	33,082

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,074,621	38,230,311
9	Program service revenue (Part VIII, line 2g) .........	481,267,408	417,005,470
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,078,866	3,986,664
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	64,034	15,238
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	490,484,929	459,237,683
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	825,151	621,472
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)	220,694,101	211,070,965
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	52,527	90,119
b	Total fundraising expenses (Part IX, column (D), line 25) 583,254
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	230,643,573	229,390,535
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	452,215,352	441,173,091
19	Revenue less expenses. Subtract line 18 from line 12.......	38,269,577	18,064,592
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	437,721,429	530,592,222
21	Total liabilities (Part X, line 26).............	346,964,225	482,212,995
22	Net assets or fund balances. Subtract line 21 from line 20.....	90,757,204	48,379,227

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 371,295,387 including grants of $ 621,472 ) (Revenue $ 411,479,271 )
	Medical and surgical services provided to 11,194 inpatients and 410,000 outpatients during the year.

4b	(Code: ) (Expenses $ 5,027,955 including grants of $ 0 ) (Revenue $ 5,601,111 )
	Various other services. Please see Schedule H.Catholic Medical Center (CMC), as an agency of the Roman Catholic Church, shall provide health care in a manner consistent with the ethical and religious directives for Catholic health care services as interpreted by the Roman Catholic Bishop of Manchester. CMC shall employ the highest quality health care professionals and the most appropriate technology to deliver an array of services either directly or through strategic alliances with compatible health care providers. With dignity and compassion, CMC shall treat the body, mind, and spirit of all who seek or provide care and comfort. Additional details provided in Schedule H.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses376,323,342

(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)		(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) John J Munoz MD........................................................................ President of Medical Staff	0.80 .......................0.40	X		0	0	0
(19) Catherine Provencher........................................................................ Director	1.20 .......................0.20	X		0	0	0
(20) Timothy Riley........................................................................ Director	1.80 .......................0.40	X		0	0	0
(21) John G Cronin Esq........................................................................ Chair	2.10 .......................0.50	X	X	0	0	0
(22) Neil Levesque........................................................................ Vice Chair	1.90 .......................0.40	X	X	0	0	0
(23) Matthew Kfoury........................................................................ Secretary	2.10 .......................0.40	X	X	0	0	0
(24) Pamela Diamantis........................................................................ Treasurer	2.40 .......................0.20	X	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,158,112	1,425,400	1,178,595

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	174,875
d	Related organizations		1d	7,500
e	Government grants (contributions)		1e	18,705,743

f	All other contributions, gifts, grants, and similar amounts not included above		1f	19,342,193

g	Noncash contributions included in lines 1a - 1f:$		1g	10,080,761

h Total. Add lines 1a-1f.......		38,230,311

		Business Code
2a	Patient services	621400	393,098,481	393,098,481
b	Disproportionate Share Funding	621400	18,380,790	18,380,790
c	Miscellaneous programs	621400	1,818,367	1,818,367
d	Lab clients	621500	1,774,139	1,774,139
e	Cafeteria and dining	722210	1,462,553	1,462,553
f	All other program service revenue.		471,140	471,140
g	Total. Add lines 2a–2f .....		417,005,470

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,688,189		39,272	3,648,917
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		39,247,233	7a
b	Less: cost or other basis and sales expenses		38,948,758	7b
c	Gain or (loss)		298,475	7c
d	Net gain or (loss).........			298,475			298,475
8a	Gross income from fundraising events (not including $ 174,875of contributions reported on line 1c). See Part IV, line 18 ....
			8a	17,355
b	Less: direct expenses ...		8b	77,029
c	Net income or (loss) from fundraising events..			-59,674			-59,674
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a	154,384
b	Less: cost of goods sold ..		10b	79,472
c	Net income or (loss) from sales of inventory..			74,912	74,912
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			459,237,683	417,080,382	39,272	3,887,718

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	544,308	544,308
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	77,164	77,164
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	3,553,621	2,852,025	701,596
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........	167,892,166	134,428,781	33,069,377	394,008
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	4,722,971	3,779,968	929,869	13,134
9	Other employee benefits .......	22,020,187	17,672,713	4,347,474
10	Payroll taxes ...........	12,882,020	10,316,613	2,537,879	27,528
11	Fees for services (non-employees):
a	Management ......	514,407		514,407
b	Legal .........	428,832		428,832
c	Accounting ...........	142,650		142,650
d	Lobbying ...........	60,050		60,050
e	Professional fundraising services. See Part IV, line 17	90,119			90,119
f	Investment management fees ......	154,266		154,266
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	18,566,594	14,559,414	3,988,980	18,200
12	Advertising and promotion ....	1,253,562	983,974	269,588
13	Office expenses .......	5,937,710	4,629,154	1,268,291	40,265
14	Information technology ......	8,189,689	6,428,431	1,761,258
15	Royalties ..
16	Occupancy ...........	16,498,173	12,950,110	3,548,063
17	Travel ............	1,001,243	785,918	215,325
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	507,866	398,645	109,221
20	Interest ...........	4,030,869	3,182,304	848,565
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	15,065,079	9,775,268	5,289,811
23	Insurance ...	2,819,030	2,212,775	606,255
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	Medical supplies	91,982,212	90,637,369	1,344,843
b	NH Medicaid Tax	22,054,486	22,054,486
c	Physician fees	18,704,688	17,300,454	1,404,234
d	Provision for bad debt	17,853,506	17,853,506
e	All other expenses	3,625,623	2,899,962	725,661
25	Total functional expenses. Add lines 1 through 24e	441,173,091	376,323,342	64,266,495	583,254
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 ........			46,658,265	1	143,987,899
2	Savings and temporary cash investments .........			18,017,902	2	30,902,145
3	Pledges and grants receivable, net ......			1,651,449	3	7,028,642
4	Accounts receivable, net .............			83,681,232	4	70,177,619
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			4,600,802	8	4,836,875
9	Prepaid expenses and deferred charges ......			6,335,880	9	5,226,465
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	334,773,360
b	Less: accumulated depreciation	10b	210,532,099	118,690,076	10c	124,241,261
11	Investments—publicly traded securities .			94,420,016	11	82,207,736
12	Investments—other securities. See Part IV, line 11 .....			53,673,754	12	50,862,486
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			9,992,053	15	11,121,094
16	Total assets. Add lines 1 through 15 (must equal line 33)...			437,721,429	16	530,592,222

17	Accounts payable and accrued expenses .....	71,094,367	17	89,591,946
18	Grants payable ...		18
19	Deferred revenue .........	1,135,012	19	1,065,325
20	Tax-exempt bond liabilities .........	114,487,719	20	110,427,602
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	3,857,711	23	46,059,909
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	156,389,416	25	235,068,213
26	Total liabilities. Add lines 17 through 25..	346,964,225	26	482,212,995

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	79,512,313	27	21,383,269
28	Net assets with donor restrictions ...........	11,244,891	28	26,995,958
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	90,757,204	32	48,379,227
33	Total liabilities and net assets/fund balances ........	437,721,429	33	530,592,222