Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
Concord Hospital |
222594672 | 3 | Yes | 15,209,341 | 1,058,530 | |
| (B)
Concord Hospital - Franklin |
851433123 | 3 | No | 54,648 | 3,803 | |
| (C)
Concord Hospital - Laconia |
851443782 | 3 | No | 3,219,929 | 224,099 | |
|
Total 3
|
18,483,918 | 1,286,432 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 on 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.).. | ||||||
| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part I, Line 12g: | Concord Hospital Trust serves as the philanthropic arm of Concord Hospital. Through its philanthropic fundraising activity, donations are contributed to the Trust and then granted to Concord Hospital for the purposes of supporting Concord Hospital's charitable purposes. A portion of the expenses incurred directly by Concord Hospital, as well as some of the other Concord Hospital affiliated entities, do aid in general fundraising processes and operations, but the majority of these responsibilities falls on the Trust. But for Concord Hospital Trust's efforts, Concord Hospital and its affiliated entities would otherwise need to carry out these activities. The amount of fundraising expenses as reported on the Trust's Form 990, Part IX, Line 24, Column D approximates the amount of nonmonetary support the Trust provides to Concord Hospital and its affiliated entities. |
| Schedule A, Section B, Line 2: | See narrative for Schedule A, Part IV, Section A, Line 1. While neither Concord Hospital - Laconia nor Concord Hospital - Franklin control the Trust, both Concord Hospital - Laconia and Concord Hospital - Franklin are 100% wholly-owned subsidiaries of Concord Hospital. Concord Hospital is also the sole member of the Trust. Additionally, Concord Hospital - Laconia, Concord Hospital - Franklin, Concord Hospital, and the Trust share many common Trustees, and the same executive officers. As 100% wholly-owned subsidiaries of Concord Hospital, and as hospital organizations serving communities in New Hampshire and New England, both Concord Hospital - Franklin and Concord Hospital - Laconia contribute and promote the exempt, charitable mission of Concord Hospital. Accordingly, while neither Concord Hospital - Franklin or Concord Hospital - Laconia control the Trust, they do share a common controlling entity with the Trust, and both of the new hospitals contribute to the furtherance of the charitable purpose and mission of the Trust's controlling organization. The vast majority of the Trust's grants are paid in support of Concord Hospital Inc., the Trust's sole member, or to support individuals who are employed and/or live and work in the communities served by Concord Hospital. In furtherance and support of Concord Hospital's exempt mission, the Trust also provides grants from time to time to other organizations other than its Supported Organization, albeit to a much lesser degree and in much smaller amounts. These donations are listed in detail on each annual Form 990, Schedule I. While these funds may not be provided directly to the Supported Organization, these funds do benefit and contribute to the wellbeing of Concord Hospital's service area, and serve to advance the goals and missions of the Hospital. According to Article IV of the Trust's Articles of Agreement, the Trust may make donations in such amounts as the trustees determine is appropriate for the public welfare or for the broader community, as long as such donations are for charitable, religious, educational, scientific, civil, or other similar purposes, and as long as the Trust remains exempt under Section 501(c)(3) of the Internal Revenue Code. |
| Schedule A, Part IV, Section A, Line 1: | On October 19, 2020, the Concord Hospital Inc. (CH), the sole member of Concord Hospital Trust, entered into an asset purchase agreement with LRGHealthcare to acquire certain assets and assume certain liabilities of Lakes Region General Hospital in Laconia, New Hampshire, and Franklin Regional Hospital in Franklin, New Hampshire. The Hospital's bid was accepted and approved by the State of New Hampshire during 2021. The transaction was completed effective May 1, 2021. As a result of this acquisition, two new Hospital organizations were formed - Concord Hospital - Laconia (CH-L) and Concord Hospital - Franklin (CH-F). Both of these new Hospitals are 100% wholly-owned subsidiaries of Concord Hospital, Inc. As wholly owned-subsidiaries of CH, it is possible that a portion of the Trust's fundraising efforts may ultimately benefit or support CH-F or CH-L. As of this tax return's filing, the Trust's bylaws and governing documents have not been amended to specifically list or name CH-L or CH-F as supported organizations of the Trust. However, both CH-L and CH-F are subject to the control and review of CH, both organizations share many of the same Trustees and Officers with CH and the Trust, both serve the same charitable class and work to advance similar charitable purposes as CH, the Trust's named supported organization. As CH-F and CH-L were acquired by CH for the purpose of providing and advancing healthcare services in New England and New Hampshire, supporting these two entities, while not specifically named in the Trust's governing documents, ultimately supports CH and its overall mission. Additionally, according to Article III of the Concord Hospital Trust's Articles of Agreement, the Trust was formed for the advancement of knowledge and the practice of care, treatment, healing, education, and research for the people of Central New Hampshire, and that the Trust was to be for the benefit of Concord Hospital Inc. and its affiliated organizations. As 100% wholly-owned subsidiaries of Concord Hospital, the two new Hospitals are reasonably considered affiliated organizations of Concord Hospital, and therefore support on behalf of these institutions is in keeping with the spirit and purpose of the Trust's Articles of Agreement. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Section A, line 6 | Concord Hospital, Inc., a charitable corporation, acting through its board of trustees, is the sole Member of the Trust. |
| Form 990, Part VI, Section A, line 7a | The Board of Trustees shall be composed of not less than five, nor more than seventeen persons, excluding ex-officio Trustees, the number to be established by the Member of the Trust, Concord Hospital. |
| Form 990, Part VI, Section A, line 7b | The affairs of the Trust shall be managed by the Trustees who shall have and may exercise all the powers of the Trust except those reserved to the Member by law, the Articles of Agreement, or the Bylaws. In addition: - Any voluntary dissolution, merger, or consolidation of the Trust, or the sale or transfer of all or substantially all of the Trust's assets, or the creation or acquisition of any subsidiary or affiliate corporation shall be subject to approval by the Member. - Any amendment of the Trust's Articles of Agreement shall be subject to approval by the Member - Any changes to the Trust's not-for-profit status shall be subject to approval by the Member. |
| Form 990, Part VI, Section B, line 11b | All Board members receive a public disclosure copy of the Form 990 to review prior to filing the report. |
| Form 990, Part VI, Section B, line 12c | Each Trustee, officer and committee member, upon entering the duties of his/her office and annually thereafter, will be advised of this policy and shall sign a statement acknowledging his/her understanding of and agreement to this policy. Annual reviews will adhere to state regulations that require public notice for any significant pecuniary transaction. |
| Form 990, Part VI, Section B, line 15 | The evaluation of the performance of the Chief Executive Officer ("CEO") of Concord Hospital and its subsidiaries (collectively the "Hospital") is an important responsibility of the Concord Hospital Board of Trustees (the "Board") and is vital in ensuring that the Hospital meets its mission. The Board has delegated the responsibility of initiating the process of conducting the CEO's performance evaluation and initiating the process of setting the CEO's compensation to the Board's Compensation Committee. The Compensation Committee also is charged with the responsibility of reviewing the appropriateness of the compensation of the Hospital's Chief Operating Officer (COO), Chief Financial Officer (CFO), and Chief Medical Officer (CMO) as proposed by the CEO. The Compensation Committee shall present its report of the CEO's annual performance to the Board for its further input and consideration. The Compensation Committee shall also make its recommendation to the Board concerning the CEO's compensation. Finally, the Compensation Committee shall make its recommendation to the Board concerning the compensation of the COO, CFO, and CMO. The Board shall review the recommendations of the Compensation Committee as to the compensation of the Hospital's CEO, COO, CFO, and CMO and shall set their compensation as the Board deems appropriate. The Board directs that the Compensation Committee and the Board itself, in their respective undertakings of recommending and setting the compensation of the Hospital's CEO, COO, CFO and CMO, avoid conflicts of interest and be guided by the "rebuttable presumption of reasonableness" regulations under the so-called "Excess Benefit Transaction" provisions of the Internal Revenue Code ("IRC"). The Board authorizes the Compensation Committee to use such financial and advisory (e.g., legal counsel, consultant) resources as it reasonably deems appropriate to fulfill its duties in evaluating the CEO's performance and in making its recommendations to the Board regarding compensation for the CEO, COO, CFO, and CMO. |
| Form 990, Part VI, Section C, line 19 | Yes, the organization makes all of this information available to the public. Audited financial statements and the most recent quarter ended financial statements are posted to the Electronic Municipal Market Access (EMMA) website. In addition to this, the Hospital sends its annual report, including a financial summary, to members of the community via the US Postal service. Governing documents and conflicts of interest filings adhere to state regulations that require public notice for any significant pecuniary transaction. |
| Form 990, Part VII, Section A, Column E | The compensation reported for Robert Steigmeyer and Scott Sloane was paid by Concord Hospital for their services as full-time executives. In total, they worked an average of 63 hours per week for all entities in the Concord Hospital health care system, of which an average of 1 hour per week was dedicated to Concord Hospital Trust. Paul Racicot and Suzanne Meyer were paid by Concord Hospital for their services as full-time employees. |
| Form 990, Part XI, line 9: | Equity transfers to affiliates 4,214,182. |
| Form 990, Part XII, Line 2c: | There was no change in the process for oversight of the audit of financial statements for the fiscal year. The same independent firm of accountants performed the audit for the fiscal years ending 9/30/2022 and 9/30/2023. |
| Software ID: | |
| Software Version: |