Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
Do not enter social security numbers on this form as it may be made public.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2024
Open to Public Inspection
A For the 2024 calendar year, or tax year beginning 07-01-2024 , and ending 06-30-2025
BCheck if applicable:
CName of organization
Mary Hitchcock Memorial Hospital
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
One Medical Center Drive
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Lebanon, NH03756
D Employer identification number

02-0222140
E Telephone number

G Gross receipts $ 2,663,081,272
F Name and address of principal officer:
JOANNE M CONROY MD
One Medical Center Drive
Lebanon,NH03756
I
Tax-exempt status: (   ) (insert no.) or
J
Website:
WWW.DARTMOUTH-HITCHCOCK.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number  
K Form of organization:  
L Year of formation: 1889
M State of legal domicile: NH
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: ADVANCING HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, COMMUNITY PARTNERSHIPS; PROVIDING EACH PERSON THE BEST CARE IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.
2 Check this box
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 18
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2024 (Part V, line 2a) ...... 5 7,047
6 Total number of volunteers (estimate if necessary) ............. 6 294
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 94,651,708
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 1,201,808
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 29,766,770 60,666,288
9 Program service revenue (Part VIII, line 2g) ......... 2,178,328,478 2,554,561,938
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,693,369 2,662,506
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 52,716,608 44,222,768
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 2,263,505,225 2,662,113,500
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 9,196,931 12,361,943
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,058,310,342 1,270,958,061
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) 600,858    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,151,324,073 1,226,314,470
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,218,831,346 2,509,634,474
19 Revenue less expenses. Subtract line 18 from line 12....... 44,673,879 152,479,026
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,337,348,189 2,797,879,554
21 Total liabilities (Part X, line 26)............. 1,217,610,319 1,473,389,867
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,119,737,870 1,324,489,687
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
Signature of officer Date
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name

Firm's EIN
Firm's address



Phone no.
May the IRS discuss this return with the preparer shown above? See Instructions. ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2024)
Form 990 (2024)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: WE ADVANCE HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,997,498,000 including grants of $ 12,361,943 ) (Revenue $ 2,417,522,817 )
MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) IS AN ACUTE AND TERTIARY CARE TEACHING HOSPITAL LOCATED IN LEBANON, NEW HAMPSHIRE. MHMH PROVIDES A BROAD RANGE OF PATIENT SERVICES AND HEALTH-RELATED COMMUNITY SERVICES, CONSISTENT WITH ITS ROLE AS A MAJOR TEACHING HOSPITAL, A TERTIARY CARE REFERRAL HOSPITAL, AND AS A PROSPECTIVE PAYMENT SYSTEM HOSPITAL (AS DEFINED BY CMS). MHMH PROVIDES A FULL RANGE OF SERVICES IN BOTH ACUTE AND CRITICAL MEDICINE, SURGERY, PSYCHIATRY AND REHABILITATION FOR INFANTS, CHILDREN AND ADULTS. DURING FY 2025, MHMH PROVIDED 160,781 ACUTE PATIENT DAYS OF INPATIENT SERVICE AND HAD 30,558 TOTAL ACUTE CARE DISCHARGES, WHILE MHMH'S EMERGENCY ROOM WAS OPEN TO THE PUBLIC 24 HOURS PER DAY, 7 DAYS PER WEEK AND HAD 35,874 DISCHARGES. (Continued on Schedule O)
4b (Code:   ) (Expenses $ 127,376,231 including grants of $   ) (Revenue $ 83,769,473 )
AS A COMPONENT OF NEW HAMPSHIRE'S ONLY INTEGRATED ACADEMIC MEDICAL CENTER, MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) PROVIDES THE GEISEL SCHOOL OF MEDICINE AT DARTMOUTH (GSM) SUPPORT FOR PHYSICIANS' UNPAID TEACHING TIME AS PART OF ITS COMMUNITY BENEFIT INITIATIVES. THIS SUPPORT CONSISTS OF THE TIME PHYSICIANS SPEND PROVIDING CLINICAL SUPERVISION AND EDUCATION FOR RESIDENTS AND MEDICAL STUDENTS. IN ADDITION, THE HOSPITAL PROVIDES IN-KIND SUPPORT FOR RESEARCH AND OTHER GRANTS REPRESENTING COSTS IN EXCESS OF AWARDS FOR NUMEROUS GRANT-FUNDED HEALTH RESEARCH AND SERVICE INITIATIVES AWARDED TO DARTMOUTH-HITCHCOCK CLINIC (DHC) AND GSM. OTHER COMMUNITY BENEFIT INITIATIVES INCLUDE SUBSIDIZING THE COSTS OF PROVIDING MEDICAL AND CLINICAL EDUCATION TO PROFESSIONALS ACROSS NEW HAMPSHIRE, VERMONT AND BEYOND AS WELL AS UNCOMPENSATED COSTS OF ACADEMIC AND MEDICAL RESEARCH ACTIVITIES.
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expenses2,124,874,231
Form 990 (2024)
Form 990 (2024)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment
List of Attached Documents:
// Content
......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
List of Attached Documents:
// Content
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
List of Attached Documents:
// Content
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2024)
Form 990 (2024)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
List of Attached Documents:
// Content
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
List of Attached Documents:
// Content
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part IIClick to see attachment
List of Attached Documents:
// Content
...........
26
Yes
 
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
List of Attached Documents:
// Content
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
1,135
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2024)
Form 990 (2024)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
7,047
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
Yes
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, or any disqualified or other person engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2024)
Form 990 (2024)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
18
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
No
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filed
NH
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
Wendy E FieldingONE MEDICAL CENTER DRIVE   LEBANON,NH03756 (603) 653-5634
Form 990 (2024)
Form 990 (2024)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, box 6 of Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) David P Paul......................................................................
Trustee / Secretary/Treasurer
 0.8
.................
1.8 		X   X       0 0 0
(2) Joanne M Conroy MD......................................................................
Trustee, Ex-Officio, CEO
 37.8
.................
18.3 		X   X       0 2,473,236 52,662
(3) ROBERTA L HINES MD......................................................................
TRUSTEE / Chair
 1.5
.................
2.0 		X   X       0 0 0
(4) Celestina M Dooley-Jones PHD......................................................................
Trustee
 0.8
.................
0.8 		X           0 0 0
(5) Duane A Compton PHD......................................................................
Trustee / Ex-Officio
 0.8
.................
1.7 		X           0 0 0
(6) Emily Zeitler......................................................................
Trustee (as of 1/1/25)
 12.0
.................
28.0 		X           0 516,001 69,972
(7) Gary V Desir......................................................................
Trustee
 0.8
.................
0.8 		X           0 0 0
(8) Geraldine Bednash PHD RN FAAN......................................................................
Trustee
 0.8
.................
1.3 		X           0 0 0
(9) Jason T Garbarino DNP RN GERO-BC......................................................................
Trustee (as of 1/18/25)
 1.3
.................
0.8 		X           0 0 0
(10) Jennifer L Moyer MBA......................................................................
Trustee
 0.8
.................
1.3 		X           0 0 0
(11) Jonathan B Thyng MD......................................................................
Trustee/Medical Director
 28.0
.................
12.0 		X           0 378,761 77,043
(12) Keith Loud MD......................................................................
Trustee
 0.1
.................
40.0 		X           0 543,027 70,523
(13) Laura Chiang......................................................................
Trustee
 28.0
.................
12.0 		X           0 417,975 67,621
(14) Laurel J Richie......................................................................
Trustee (as of 1/1/25)
 1.3
.................
0.8 		X           0 0 0
(15) M Elyse Allan......................................................................
Trustee
  
.................
0 		X           0 0 0
(16) Marcus Coe MD......................................................................
Trustee
 0.1
.................
40.0 		X           0 836,390 70,093
(17) Mark S Speers MBA......................................................................
Trustee
 0.8
.................
0.8 		X           0 0 0
Form 990 (2024)
Form 990 (2024)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Nancy M Dunbar MD........................................................................
Trustee / Physician (Through 12/31/24)
 28.0
.......................12.0 		X           0 394,799 70,831
(19) Sherri C Oberg........................................................................
Trustee
 0.8
.......................0.8 		X           0 0 0
(20) Aimee M Claiborne........................................................................
Chief Human Resource Officer
 28.0
.......................12.5 		    X       670,485 0 53,691
(21) Edward J Merrens MD........................................................................
Chief Clinical Officer
 28.0
.......................13.0 		    X       0 1,051,727 49,303
(22) John Kacavas........................................................................
Chief Legal Officer
 28.0
.......................15.0 		    X       792,086 0 53,353
(23) Martin T Manion........................................................................
COO (as of 4/24/25)
 40.0
.......................0.0 		    X       497,844 0 22,728
(24) Matthew Haag........................................................................
Chief Development Officer
 28.0
.......................12.5 		    X       517,588 0 43,749
(25) Stephen LeBlanc........................................................................
Chief Strategy Officer
 28.0
.......................15.0 		    X       0 1,016,111 69,299
(26) Susan A Reeves EDD RN........................................................................
Executive VP (medical center)
 28.0
.......................12.0 		    X       216,596 0 12,996
(27) Wendy Fielding........................................................................
Chief Financial Officer
 28.0
.......................13.5 		    X       537,524 0 68,364
(28) David F Duncan........................................................................
System VP - Facilities Mgmt
 28.0
.......................13.0 		      X     367,601 0 47,168
(29) Martin Purcell MBA........................................................................
Chief Information Officer
 28.0
.......................12.0 		      X     620,026 0 70,350
(30) Patrick F Jordan III MBA........................................................................
Chief Operating Officer - DHC (through 6/21/25)
 28.0
.......................15.5 		      X     1,132,708 0 79,260
(31) Samuel Shields........................................................................
System VP - Strtgy & Rgnl Ops
 40.0
.......................1.5 		      X     399,147 0 30,060
(32) Simon C Hillier........................................................................
Dept. Chair - Anesthesiology
 28.0
.......................12.0 		      X     0 433,831 68,285
(33) Tracy Galvin........................................................................
Chief Nursing Officer
 28.0
.......................12.0 		      X     394,259 0 47,519
(34) Barbara Vance........................................................................
VP-Research Ops (through 7/13/24)
 40.0
.......................0 		        X   431,221 0 25,074
(35) Christopher L Hubble MD........................................................................
VP Patient Safety
 40.0
.......................0.5 		        X   466,573 0 65,298
(36) Daniel P Jantzen........................................................................
CFO D-HH/Former CFO MHMH
 28.0
.......................15.0 		        X   1,184,287 0 71,877
(37) Jennifer Gilkie........................................................................
System VP Comm-Marketing,
 40.0
.......................0 		        X   401,447 0 77,825
(38) Kimberly Troland JD........................................................................
DH Gnrl Cnsl &Sys Dep Gnl Cnsl
 40.0
.......................0.0 		        X   581,281 0 52,939
(39) Maria Padin MD........................................................................
Former Officer/Chief medical Officer, CGP
 28.0
.......................14.5 		          X 0 599,295 68,542
(40) Peter D Solberg MD........................................................................
Chief Health Information Officer - Former
 0.0
.......................40.0 		          X 0 588,556 77,090
(41) Staci Hermann PHARMD MS........................................................................
Former Chief Pharmacy Officer
 40.0
.......................0.0 		          X 122,608 0 10,389
1b Sub-Total..............
c Total from continuation sheets to Part VII, Section A..
d Total (add lines 1b and 1c)......... 9,333,281 9,249,709 1,643,904
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 1,496
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
PROLUCENT HEALTH INC

10000 N Central Expressway
Suite 400
Dallas,TX75231 		Healthcare Staffing 90,627,084
CONIFER REVENUE CYCLE SOLUTIONS LLC

1500 S Douglas Rd Ste 200
Anaheim,CA92806 		Revenue Management Services 50,974,112
HINCKLEY ALLEN & SNYDER LLP

650 ELM STREET
SUITE 500
MANCHESTER,NH03101 		Legal Services 14,556,311
COMPHEALTH MEDICAL STAFFING INC

PO BOX 972651
DALLAS,TX753972651 		Staffing Services 8,702,229
TRUSTEES OF DARTMOUTH COLLEGE

DARTMOUTH COLLEGE
6132 MCNUTT RM 103
Hanover,NH03755 		Staffing Services 7,682,381
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 162
Form 990 (2024)
Form 990 (2024)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 46,079,246
f All other contributions, gifts, grants, and similar amounts not included above1f 14,587,042
g Noncash contributions included in lines 1a - 1f:$ 1g 80,933
h Total. Add lines 1a-1f....... 60,666,288
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 622110 2,189,219,193 2,183,741,974 5,477,219  
b RESEARCH RELATED ACTIVITIES 622110 8,070,073 8,070,073    
c PHARMACY INCOME 446110 355,386,981 280,178,645 75,208,336  
d NEAH & PROGRAM RELATED INVESTMENTS 541900 1,885,691 1,059,351 826,340  
e
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f ..... 2,554,561,938
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ...... 3,245,510   1,340,921 1,904,589
4 Income from investment of tax-exempt bond proceeds        
5 Royalties...........        
(i) Real (ii) Personal
6a Gross rents 6a 413,249  
b Less: rental expenses 6b 384,768  
c Rental income or (loss) 6c 28,481 0
d Net rental income or (loss)....... 28,481     28,481
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7a    
b Less: cost or other basis and sales expenses 7b 443,791 139,213
c Gain or (loss) 7c -443,791 -139,213
d Net gain or (loss)......... -583,004     -583,004
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..      
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  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..        
OtherRevenueMiscAmt
Business Code
11a CAFETERIA 722514 4,153,148     4,153,148
b Other Revenue 622110 40,041,139 28,242,247 11,798,892  
c            
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... 44,194,287
12 Total revenue. See instructions..... 2,662,113,500 2,501,292,290 94,651,708 5,503,214
Form 990 (2024)
Form 990 (2024)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 11,669,873 11,669,873
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 462,612 462,612
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 229,458 229,458
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 13,987,181 4,680,180 8,706,143 600,858
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 2,895,542 685,378 2,210,164  
7 Other salaries and wages........ 993,119,017 855,223,018 137,895,999  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 68,085,231 58,553,299 9,531,932  
9 Other employee benefits ....... 129,021,909 111,028,971 17,992,938  
10 Payroll taxes ........... 63,849,181 54,910,377 8,938,804  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 4,782,864 170,202 4,612,662  
c Accounting ........... 831,451 153,019 678,432  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 201,265,116 182,775,178 18,489,938 0
12 Advertising and promotion .... 3,342,400 71,629 3,270,771  
13 Office expenses ....... 30,040,315 18,659,562 11,380,753  
14 Information technology ...... 36,772,824 3,309,554 33,463,270  
15 Royalties ..        
16 Occupancy ........... 27,272,443 2,194,772 25,077,671  
17 Travel ............ 4,646,762 3,200,009 1,446,753  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 518,200 429,802 88,398  
20 Interest ........... 22,921,308 168,666 22,752,642  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 59,733,704 20,476,538 39,257,166  
23 Insurance ... 17,683,820 14,147,056 3,536,764  
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 682,141,457 675,195,142 6,946,315  
b MEDICAID ENHANCEMENT TAX 82,358,795 82,358,795    
c EQUIPMENT RENTAL & MAINT 26,181,523 8,587,835 17,593,688  
d ACADEMIC, GME, TEACHING & EDUCATIONAL 10,277,568 8,680,435 1,597,133  
e All other expenses 15,543,920 6,852,871 8,691,049 0
25 Total functional expenses. Add lines 1 through 24e 2,509,634,474 2,124,874,231 384,159,385 600,858
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).        
Form 990 (2024)
Form 990 (2024)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments ......... 645,592 2 640,089
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 291,458,793 4 322,929,016
5 Loans and other receivables from 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 .......
223,089 5 229,855
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) ...
0 6 0
7 Notes and loans receivable, net ........... 11,744,790 7 11,911,463
8 Inventories for sale or use ............ 45,376,713 8 53,358,583
9 Prepaid expenses and deferred charges ...... 43,864,012 9 70,903,447
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,820,875,558
b Less: accumulated depreciation 10b 1,153,853,070 631,561,804 10c 667,022,488
11 Investments—publicly traded securities . 54,442,256 11 58,075,913
12 Investments—other securities. See Part IV, line 11 ..... 896,668,634 12 994,816,185
13 Investments—program-related. See Part IV, line 11 .. 12,362,908 13 13,300,455
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 348,999,598 15 604,692,060
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,337,348,189 16 2,797,879,554
Liabilities 17 Accounts payable and accrued expenses ..... 244,613,274 17 242,657,032
18 Grants payable ...   18  
19 Deferred revenue ......... 1,435,160 19 655,654
20 Tax-exempt bond liabilities ......... 25,500,000 20 321,181,994
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 .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 57,772,058 23 122,805,582
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 888,289,827 25 786,089,605
26 Total liabilities. Add lines 17 through 25.. 1,217,610,319 26 1,473,389,867
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 968,951,031 27 1,152,335,154
28 Net assets with donor restrictions ........... 150,786,839 28 172,154,533
Organizations that do not follow FASB ASC 958, check here right arrow 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 ........... 1,119,737,870 32 1,324,489,687
33 Total liabilities and net assets/fund balances ........ 2,337,348,189 33 2,797,879,554
Form 990 (2024)
Form 990 (2024)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,662,113,500
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
2,509,634,474
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
152,479,026
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,119,737,870
5
Net unrealized gains (losses) on investments ...............
5
99,398,282
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-47,125,491
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,324,489,687
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Uniform Guidance, 2 C.F.R. Part 200, Subpart F?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2024)
Form 990 (2024)
Additional Data


Software ID: 24020961
Software Version: 2024v5.1
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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
2024
Open to Public
Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(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
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2024

Schedule A (Form 990) 2024
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) right arrow (a) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (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) right arrow (a) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (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  
12
12
 
13
First 5 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
14
14
 
15
15
 
16a
33 1/3% support test—2024. 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
b
33 1/3% support test—2023. 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—2024. 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
b
10%-facts-and-circumstances test—2023. 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
18
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) 2024

Schedule A (Form 990) 2024
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) right arrow (a) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (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) right arrow (a) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (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.)..            
14
First 5 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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2024. 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
b
33 1/3 % support tests—2023. 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
20
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) 2024

Schedule A (Form 990) 2024
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
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.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on 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.
9c
 
 
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
 
 
b
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) 2024

Schedule A (Form 990) 2024
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, 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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
By reason of the relationship described in line 2 above, 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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
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.
2a
 
 
b
Did the activities described on line 2a, above 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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
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?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990) 2024

Schedule A (Form 990) 2024
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990) 2024

Schedule A (Form 990) 2024
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 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 2024 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-2024 		(iii)
Distributable
Amount for 2024
1 Distributable amount for 2024 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2024:
a From 2019.......  
b From 2020.......  
c From 2021.......  
d From 2022.......  
e From 2023.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2024 distributable amount  
i Carryover from 2019 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2024 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2024 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2024, 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 2024. 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 2025. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2020.....  
b Excess from 2021.....  
c Excess from 2022.....  
d Excess from 2023.....  
e Excess from 2024.....  
Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024
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) 2024


Additional Data


Software ID: 24020961
Software Version: 2024v5.1
Schedule B
(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

right arrow Attach to Form 990, 990-EZ, or 990-PF.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
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 ......... Right Arrow $  
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) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025) Page 2
Name of organization
Mary Hitchcock Memorial Hospital
  		Employer identification number
02-0222140
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025)
Page 3
Name of organization
Mary Hitchcock Memorial Hospital
  		Employer identification number

02-0222140
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) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025)
Page 4
Name of organization
Mary Hitchcock Memorial Hospital
  		Employer identification number

02-0222140
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (Rev. 1-2025)
Additional Data


Software ID: 24020961
Software Version: 2024v5.1
SCHEDULE C
(Form 990)

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

right arrow Complete if the organization is described below. right arrow Attach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2024
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
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................right arrow
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................right arrow
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................right arrow
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................right arrow

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........right arrow

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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.
Cat. No. 50084S
Schedule C (Form 990) 2024

Schedule C (Form 990) 2024
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 right arrowexpenses, and share of excess lobbying expenditures).
B Check right arrow
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ...................................................................................................................

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) 2021 (b) 2022 (c) 2023 (d) 2024 (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) 2024


Schedule C (Form 990) 2024
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
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
248,255
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
197,478
j
Total. Add lines 1c through 1i ....................................................................................................
445,733
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
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
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LINES IB & 1G MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) EMPLOYS THREE FULL TIME STAFF WHOSE DUTIES INCLUDE LOBBYING. TYPICAL EXPENSES ASSOCIATED WITH THE LOBBYING ACTIVITIES INCLUDE STAFF SALARY, TRAVEL, MEMBERSHIP FEES AND DUES. FROM TIME TO TIME, MARY HITCHCOCK MEMORIAL HOSPITAL, THROUGH ITS EMPLOYEES AND THE USE OF CONSULTANTS, CONTACTS GOVERNMENT OFFICIALS AND LEGISLATORS. THIS CONTACT IS FOR THE PURPOSE OF PROPOSING LEGISLATION OR EXPRESSING AN OPINION ON CHANGES IN LEGISLATION THAT AFFECT MHMH AND ITS ABILITY TO CARRY OUT ITS MISSION. THE ACTIVITIES INCLUDE SENDING LETTERS TO, CALLING, AND MEETING WITH GOVERNMENT OFFICIALS AND LEGISLATORS. FOR THE FISCAL YEAR ENDED JUNE 30, 2025, MARY HITCHCOCK MEMORIAL HOSPITAL INCURRED $248,255 IN CONJUNCTION WITH THESE ACTIVITIES. LINE 1I MHMH PAYS DUES TO VARIOUS ORGANIZATIONS RELATED TO ITS EXEMPT MISSION. THE AMOUNT REPORTED UNDER OTHER ACTIVITIES ON LINE 1I REFERS TO THE AMOUNT OF LOBBYING ACTIVITIES IDENTIFIED IN DUES PAYMENTS TO OUTSIDE ORGANIZATIONS.
Schedule C (Form 990) 2024


Additional Data


Software ID: 24020961
Software Version: 2024v5.1

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
right arrow 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.
right arrow Attach to Form 990.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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 July 25, 2006, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow  
4
Number of states where property subject to conservation easement is located right arrow  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow $  
8
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)? .............................
9
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.
1a
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.
b
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 .........................right arrow $  
(ii)
Assets included in Form 990, Part X ...............................right arrow $  
2
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:
a
Revenue included on Form 990, Part VIII, line 1 ..........................right arrow $  
b
Assets included in Form 990, Part X ...............................right arrow $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) (Rev. 1-2025)

Schedule D (Form 990) (Rev. 1-2025)
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 97,313,410 88,797,563 81,833,643 73,799,593 61,828,667
b Contributions ... 3,991,324 587,329 3,189,501 12,519,797 2,758,262
c Net investment earnings, gains, and losses 7,897,804 8,400,809 2,743,447 -4,250,857 10,467,971
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		1,563,871 472,291 -1,030,972 234,890 1,255,307
f Administrative expenses ....          
g End of year balance ...... 107,638,667 97,313,410 88,797,563 81,833,643 73,799,593
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment right arrow14.86 %
b
Permanent endowment right arrow57.91 %
c
Term endowment right arrow27.23 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   63,945,513 63,945,513
b Buildings ....   910,085,600 504,149,894 405,935,706
c Leasehold improvements   4,111,615 4,051,297 60,318
d Equipment ....   780,938,759 645,651,879 135,286,880
e Other .....   61,794,071   61,794,071
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..right arrow 667,022,488
Schedule D (Form 990) (Rev. 1-2025)

Schedule D (Form 990) (Rev. 1-2025)
Page 3
Part VII
Investments - Other 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) Closely-held equity interests		    

(B) Financial derivatives		    

(C) PRIVATE EQUITIES		 9,371 F

(D) HEDGE FUNDS		    

(E) OTHER INVESTMENTS		    

(F) INVESTMENT IN POOLED FUNDS (MIP)		 994,806,814 F
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)right arrow 994,816,185
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)right arrow  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)INVESTMENT IN CAPTIVE 36,674,399
(2)CAPITAL LEASE RECEIVABLE 34,065,690
(3)DUE FROM AFFILIATES 514,985,220
(4)UNAMORTIZED BOND ISSUANCE COSTS 53,700
(5)OTHER INVESTMENT ASSETS 6,765,627
(6)INVESTMENT IN MIP  
(7)457B PLAN ASSETS 4,670,303
(8)OTHER RECEIVABLES 7,477,121
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........right arrow 604,692,060
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  
Federal Income Taxes  
THIRD PARTY RESERVES 47,151,519
ACCRUED POST RETMNT PENS & MED 58,678,035
Payable to Dartmouth Hitchcock Health 680,260,051





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)right arrow 786,089,605
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) (Rev. 1-2025)

Schedule D (Form 990) (Rev. 1-2025)
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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ........... 2d 0
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1.................. 3 0
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b 0
c Add lines 4a and 4b.................... 4c 0
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 0
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  
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 0
e Add lines 2a through 2d.................... 2e 0
3 Subtract line 2e from line 1................... 3 0
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ........... 4b 0
c Add lines 4a and 4b..................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 0
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
Schedule D, Part V, Line 4 Intended uses of endowment funds THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROMOTE AND ADVANCE THE FOLLOWING MISSION-RELATED PROGRAMS: HEALTHCARE SERVICES, RESEARCH, CHARITY CARE, COMMUNITY OUTREACH AND ADVOCACY, EQUIPMENT PURCHASES, AND HEALTH EDUCATION.
Schedule D (Form 990) (Rev. 1-2025)


Additional Data


Software ID: 24020961
Software Version: 2024v5.1




SCHEDULE F(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right arrow Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right arrow Attach to Form 990.Right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region		 (f) Total expenditures
for and investments
in the region
Central America and the Caribbean 0 0 Investments   31,751,661
South Asia 0 2 Program Services DOCTORS HELPED TO LAUNCH LIFE-SAVING EMERGENCY MEDICAL EDUCATION TO BHUTAN. 12,062
Sub-Saharan Africa 0 2 Program Services,GRANTS TO RECIPIENTS LOCATED IN THE REGION PROVIDERS WENT TO RWANDA TO HELP TRAIN AND DELIVER ENDOSCOPIC CARE ALONGSIDE RWANDAN PEERS. 99,081
Europe (Including Iceland and Greenland) 0 0 GRANTS TO RECIPIENTS LOCATED IN THE REGION   92,991
North America (Canada & Mexico only) 0 0 GRANTS TO RECIPIENTS LOCATED IN THE REGION   45,019
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 4 32,000,814
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 4 32,000,814
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) (Rev. 1-2025)
Schedule F (Form 990) (Rev. 1-2025)
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of noncash
assistance 		(h) Description
of noncash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
Sub-Saharan Africa PROGRAM SUPPORT 91,448 CASH     FMV
Europe (Including Iceland and Greenland) PROGRAM SUPPORT 56,809 CASH     FMV
Europe (Including Iceland and Greenland) PROGRAM SUPPORT 36,182 CASH     FMV
North America (Canada & Mexico only) PROGRAM SUPPORT 13,205 CASH     FMV
North America (Canada & Mexico only) PROGRAM SUPPORT 13,350 CASH     FMV
North America (Canada & Mexico only) PROGRAM SUPPORT 18,464 CASH     FMV
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
6
3 Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) (Rev. 1-2025)
Schedule F (Form 990) (Rev. 1-2025)Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
noncash
assistance 		(g) Description
of noncash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) (Rev. 1-2025)
Schedule F (Form 990) (Rev. 1-2025)
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) (Rev. 1-2025)
Schedule F (Form 990) (Rev. 1-2025)
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds THE HOSPITAL PROVIDES UNRESTRICTED PROGRAM SUPPORT FOR CERTAIN FOREIGN ORGANIZATIONS CHOSEN AND DIRECTED BY THE PHYSICIANS AND/OR RESEARCHERS WORKING DIRECTLY WITH THE CHARITY.
Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual; EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; NORTH AMERICA (CANADA & MEXICO ONLY)-Accrual; SOUTH ASIA-Accrual; SUB-SAHARAN AFRICA-Accrual
Schedule F, Part II, Line 1 Method used to account for expenditures on org's financial statements EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; NORTH AMERICA (CANADA & MEXICO ONLY)-Accrual; SUB-SAHARAN AFRICA-Accrual
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) (Rev. 1-2025)
Additional Data


Software ID: 24020961
Software Version: 2024v5.1



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2024
Open to Public Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
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? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    12,528,401   12,528,401 0.507 %
b Medicaid (from Worksheet 3, column a) . . . . .     347,936,168 187,322,937 160,613,231 6.506 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 360,464,569 187,322,937 173,141,632 7.013 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     8,095,101 1,970,137 6,124,964 0.248 %
f Health professions education (from Worksheet 5) . . .     76,611,116 20,784,320 55,826,796 2.261 %
g Subsidized health services (from Worksheet 6) . . . .     25,758,185 15,327,503 10,430,682 0.423 %
h Research (from Worksheet 7) .     90,128,747 61,005,645 29,123,102 1.180 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,273,419   1,273,419 0.052 %
j Total. Other Benefits . . 0 0 201,866,568 99,087,605 102,778,963 4.163 %
k Total. Add lines 7d and 7j . 0 0 562,331,137 286,410,542 275,920,595 11.177 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     55,000   55,000 0.002 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 55,000 0 55,000 0.002 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
0
3
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. ......
3
0
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
407,141,862
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
458,086,595
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-50,944,733
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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) 2024
Schedule H (Form 990) 2024
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) 		Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 MARY HITCHCOCK MEMORIAL HOSPITAL
ONE MEDICAL CENTER DRIVE
LEBANON,NH03756
WWW.DARTMOUTH-HITCHCOCK.ORG
01799 		X X X X   X X   PSYCHIATRIC UNIT AND TRANSPLANT UNIT CANCER CENTER 1
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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)
1
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): 		1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 24
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 24
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.dartmouth-hitchcock.org/about/community-health
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2024
Schedule H (Form 990) 2024
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
1
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 225.0%
and FPG family income limit for eligibility for discounted care of 300.0%
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a Described the information the hospital facility may require an individual to provide as part of his or her application
b Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application
c Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process
d Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications
e Other (describe in Section C)
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.dartmouth-hitchcock.org/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE
b
https://www.dartmouth-hitchcock.org/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
Page 6
Part VFacility Information (continued)

Billing and Collections
1
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
1
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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
Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY WHICH ARE IDENTIFIED THROUGH CHNA.
Schedule H, Part V, Section B, Line 5 Facility 1, 1 Facility 1, 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) AND DARTMOUTH-HITCHCOCK CLINIC (DHC, COLLECTIVELY KNOWN AS D-H) ARE ACTIVELY ENGAGED IN THE DEVELOPMENT OF THE UPPER VALLEY REGIONAL PUBLIC HEALTH ADVISORY COUNCIL AND GREATER SULLIVAN COUNTY PUBLIC HEALTH ADVISORY COUNCIL (WITH 60+ COMMUNITY REPRESENTATIVES). MEMBERS OF THESE TWO COMMUNITY HEALTH ADVISORY GROUPS HAVE HAD THE OPPORTUNITY TO REVIEW AND COMMENT ON DRAFTS OF D-H'S COMMUNITY HEALTH IMPROVEMENT PLAN. THE PLAN DOCUMENT HAS ALSO BEEN CIRCULATED TO PUBLIC HEALTH OFFICIALS IN NEW HAMPSHIRE AND VERMONT FOR THEIR COMMENT. IN ADDITION, D-H REPRESENTATIVES SERVE ON NUMEROUS BOARDS, TASK FORCES, MUNICIPAL HEALTH LEADERSHIP AND PLANNING TEAMS, AND OTHER COMMUNITY HEALTH LEADERSHIP ENTITIES IN ORDER TO ENSURE THAT BOTH ORGANIZATIONS PARTICIPATE IN AND BETTER-UNDERSTAND THE NEEDS OF OUR COMMUNITY. MHMH CONTRACTED WITH JOHN SNOW RESEARCH AND TRAINING INSTITUTE/COMMUNITY HEALTH INSTITUTE TO PROVIDE CONSULTATION AND TECHNICAL EXPERTISE TO OUR ASSESSMENT PROCESS. JOHN SNOW RESEARCH AND TRAINING INSTITUTE IS A PUBLIC HEALTH MANAGEMENT CONSULTING AND RESEARCH ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF INDIVIDUALS AND COMMUNITIES THROUGHOUT THE WORLD. DURING THE PERIOD FEBRUARY THROUGH NOVEMBER 2024, A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY DARTMOUTH-HITCHCOCK AND ALICE PECK DAY MEMORIAL HOSPITAL, WITH SIGNIFICANT ADDITIONAL COORDINATION WITH NEW LONDON HOSPITAL, VALLEY REGIONAL HOSPITAL, AND MT. ASCUTNEY HOSPITAL AND HEALTH CENTER. THE PURPOSE OF THE ASSESSMENT WAS TO IDENTIFY COMMUNITY HEALTH CONCERNS, PRIORITIES, AND OPPORTUNITIES FOR COMMUNITY HEALTH AND HEALTH CARE DELIVERY SYSTEMS IMPROVEMENT. WHILE DARTMOUTH-HITCHCOCK MEDICAL CENTER SERVES AS A TERTIARY REFERRAL MEDICAL CENTER FOR A LARGE, MULTI-STATE AREA, THE GEOGRAPHIC AREA OF INTEREST FOR THE PURPOSES OF THIS ASSESSMENT WAS THE PRIMARY SERVICE AREA OF MARY HITCHCOCK MEMORIAL HOSPITAL, MT. ASCUTNEY HOSPITAL AND HEALTH CENTER, AND ALICE PECK DAY MEMORIAL HOSPITAL. THIS PRIMARY SERVICE AREA WAS DEFINED AS 19 MUNICIPALITIES COMPRISING THE UPPER VALLEY OF NEW HAMPSHIRE AND VERMONT WITH A TOTAL RESIDENT POPULATION OF APPROXIMATELY 70,000 PEOPLE. METHODS EMPLOYED IN THE ASSESSMENT INCLUDED A SURVEY OF AREA RESIDENTS MADE AVAILABLE THROUGH DIRECT MAIL AND WEBSITE LINKS, A SURVEY OF KEY COMMUNITY STAKEHOLDERS WHO ARE AGENCY, MUNICIPAL, OR COMMUNITY LEADERS, A SERIES OF COMMUNITY DISCUSSION GROUPS CONVENED IN THE PRIMARY SERVICE AREA, AND A REVIEW OF AVAILABLE POPULATION DEMOGRAPHICS AND HEALTH STATUS INDICATORS. IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), POPULATIONS EXPERIENCING HEALTH DISPARITIES OR VULNERABLE TO POOR HEALTH OUTCOMES ARE PRIMARILY DEFINED AS THOSE POPULATIONS FACING SIGNIFICANT INCOME CHALLENGES, WHICH IN THIS REGION ARE STRONGLY ASSOCIATED WITH NEGATIVE IMPACTS ON HEALTH. ENHANCED EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THESE POPULATIONS THROUGH TARGETED SURVEYS AND VIRTUAL COMMUNITY CONVERSATIONS, , HOMELESS PROGRAMS, AND OTHER COMMUNITY SETTINGS SERVING ECONOMICALLY-VULNERABLE RESIDENTS. FINDINGS OF THIS ASSESSMENT HAVE BEEN SHARED WITH PUBLIC HEALTH OFFICIALS IN NH AND VT, AS WELL AS WITH THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY. DURING THIS ASSESSMENT, MARY HITCHCOCK MEMORIAL HOSPITAL USED SURVEYS FROM FEBRUARY 2024 THROUGH SEPTEMBER 2024 TO GENERATE INPUT FROM 1,739 RESIDENTS. SURVEYS WERE MADE AVAILABLE THROUGH PRIMARY CARE CLINICS, FREE CARE CLINICS, ANNUAL TOWN MEETINGS/ELECTIONS, AND NUMEROUS OTHER COMMUNITY LOCATIONS. RESIDENTS COMPLETING SURVEYS INCLUDED MEMBERS OF BLACK, HISPANIC, NATIVE AMERICAN, CAUCASIAN, LATINO, AND ASIAN POPULATIONS. SURVEYS WERE DISTRIBUTED THROUGH REGIONAL HEALTH CLINICS, THE REGION'S SHELTER FOR HOMELESS POPULATIONS, THE REGION'S LOW-INCOME HOUSING TRUST, SENIOR CENTERS, SUBSTANCE USE DISORDER TREATMENT PROGRAMS, AND OTHER LOCATIONS WHERE POPULATIONS MOST AFFECTED BY HEALTH DISPARITIES CONGREGATE. MARY HITCHCOCK MEMORIAL HOSPITAL DISSEMINATED THE SURVEY TOGETHER WITH MULTIPLE COMMUNITY ORGANIZATIONS THAT SERVE LOW-INCOME, FRAIL, AND POPULATIONS WITH SPECIFIC HEALTH CONDITIONS. COMMUNITY PARTNERS PROVIDED ASSISTANCE DISSEMINATING THE SURVEY, INCLUDING THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY, WHOSE MEMBERSHIP INCLUDES COMMUNITY MENTAL HEALTH SERVICES, SUBSTANCE USE SERVICES, MENTAL HEALTH PEER LEADERS, WIC PROVIDERS, SENIOR SERVICES ADVOCATES, SERVICES WORKING WITH PEOPLE WITH PHYSICAL AND DEVELOPMENTAL DISABILITIES, COMMUNITY NURSING, VISITING NURSES, AND OTHER CORE HUMAN SERVICES. IN ADDITION TO ASSISTING IN SURVEY DISSEMINATION, THESE PROVIDERS ADVOCATED FOR UNDERSERVED AND VULNERABLE POPULATIONS IN OUR REGION AS A PART OF THE CHNA PROCESS. DURING THIS CHNA PROCESS, WE MADE RESIDENT SURVEYS WIDELY AVAILABLE TO COMMUNITY RESIDENTS THROUGH PUBLIC LIST SERVES, DIRECT E-MAIL INVITATIONS TO PATIENTS OF OUR PRIMARY CARE CLINICS, SURVEY LINKS ON TOWN WEB SITES AND E-NEWS, EMPLOYEE E-NEWS IN MAJOR EMPLOYERS, AND THROUGH OTHER SYSTEMS THAT PROVIDED WIDESPREAD ACCESS TO OUR SURVEYS. WE PARTNERED CLOSELY WITH ORGANIZATIONS SERVING POPULATIONS AFFECTED BY POVERTY, LACK OF INSURANCE, HOMELESSNESS, BEHAVIORAL HEALTH CONDITIONS, AND SERIOUS AND CHRONIC ILLNESSES IN ORDER TO SURVEY THESE MEMBERS OF POPULATIONS IN OUR COMMUNITY, AND HOSTED MULTIPLE DISCUSSION GROUPS WITH PEOPLE AFFECTED BY POVERTY AND CHRONIC ILLNESS. HOUSEHOLD MEDIAN INCOME, INSURANCE STATUS, AND OTHER INDICATORS OF POVERTY ARE SIGNIFICANT DRIVERS OF DISPARITY IN OUR REGION. THESE POPULATIONS FACE NOTABLE HEALTH CONDITIONS ASSOCIATED WITH POVERTY. DURING OUR ASSESSMENT PROCESS, MHMH MADE SPECIFIC EFFORTS TO CONTACT AND RECEIVE INPUT FROM MEMBERS OF LOWER-INCOME POPULATIONS AND PROVIDERS OF SERVICES FOR THOSE POPULATIONS, INCLUDING: *VIRTUAL DISCUSSION GROUP WITH MEMBERS OF EMPLOYEE RESOURCE GROUPS (MARCH 22, 2024) *VIRTUAL DISCUSSION GROUP WITH MEMBERS OF THE BUSINESS COMMUNITY (CHAMBER OF COMMERCE, LARGE EMPLOYERS, GROUPS WITH INTEREST IN BROADER ECONOMIC ISSUES) (MARCH 25, 2024) *VIRTUAL DISCUSSION GROUP WITH PROVIDERS OF CARE MANAGEMENT FOR BEHAVIORAL HEALTH (MARCH 27, 2024) *VIRTUAL DISCUSSION GROUP WITH LGBTQ+ POPULATIONS AND ASSOCIATED SERVICE PROFESSIONALS (APRIL 1, 2024) *IN-PERSON DISCUSSION GROUP WITH PARTICIPANTS IN SUD SERVICES AT UPPER VALLEY TURNING POINTS (MAY 8, 2024) * VIRTUAL DISCUSSION GROUP WITH VT SCHOOL NURSES (MAY 21, 2024) *IN-PERSON DISCUSSION WITH TLC FAMILY/RECOVERY RESOURCE CENTER (JUNE 3, 2024) *IN-PERSON DISCUSSION GROUP WITH YOUNG AND PARENTING YOUTH AND YOUNG ADULTS AT THE FAMILY PLACE (JUNE 18, 2024) *VIRTUAL DISCUSSION GROUP WITH CASE MANAGEMENT, SOCIAL WORKERS, AND SERVICE COORDINATORS OF THE UPPER VALLEY (JULY 9, 2024) *VIRTUAL DISCUSSION GROUP WITH MEMBERS OF THE BIPOC COMMUNITY (SEPTEMBER 9, 2024) *IN-PERSON DISCUSSION GROUP WITH CAREGIVERS AND FAMILY MEMBERS OF ADULTS WITH SPECIAL NEEDS AT VISIONS FOR CREATIVE HOUSING SOLUTIONS (NOVEMBER 20, 2024) * WORKING WITH THE GOOD NEIGHBOR HEALTH CLINIC AND SMALL COMMUNITY-BASED CLINICS TO DISSEMINATE SURVEYS TO PATIENTS WHO ARE UNINSURED AND LOW-INCOME. DISSEMINATING SURVEYS AT THE UPPER VALLEY HAVEN (SHELTER); LISTEN COMMUNITY SERVICES (BASIC NEED SUPPORT, FOOD SHELF, AND COMMUNITY DINNERS); TO PARENTS OF CHILDREN IN DARTMOUTH-HITCHCOCK AND ALICE PECK DAY'S PEDIATRICS CLINICS; VIA WOMEN, INFANTS, AND CHILDREN'S CLINICS; THROUGH GRAFTON COUNTY SENIOR CITIZENS COUNCIL (HOME-DELIVERED MEALS AND CONGREGATE MEALS); AND THROUGH OTHER COMMUNITY ORGANIZATIONS SERVING PEOPLE AFFECTED BY POVERTY AND POOR HEALTH. *WORKING WITH THE 26-MEMBER CHNA ADVISORY COUNCIL, TO INFORM DATA COLLECTION AND DISTRIBUTION STRATEGIES. ADVISORY COUNCIL MEMBER ORGANIZATIONS INCLUDED ALICE PECK DAY HOSPITAL, ,DARTMOUTH HITCHCOCK MEDICAL CENTER, THE CITY OF LEBANON, GOOD NEIGHBOR HEALTH CLINIC, GRAFTON COUNTY SENIOR CITIZENS COUNCIL, HARTFORD SCHOOL DISTRICT, HIV/HRC RESOURCE CENTER, LAKE SUNAPEE VNA, LEBANON SAU 88, LISTEN COMMUNITY SERVICES, MASCOMA HIGH SCHOOL, THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY, SPECIAL NEEDS SUPPORT CENTER, THE FAMILY PLACE, TLC RECOVERY CENTER, UPPER VALLEY HAVEN, VERMONT DEPARTMENT OF HEALTH, WAYPOINT, WEST CENTRAL BEHAVIORAL HEALTH, AND WIC.
Schedule H, Part V, Section B, Line 6a Facility 1, 1 Facility 1, 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. DURING FEBRUARY 2024 - NOVEMBER 2024, MHMH PARTNERED WITH ALICE PECK DAY MEMORIAL HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT. WE ALSO COORDINATED CHNA APPROACHES WITH NEIGHBORING HOSPITALS AND ORGANIZATIONS INCLUDING VALLEY REGIONAL HOSPITAL, NEW LONDON HOSPITAL, MOUNT ASCUTNEY HOSPITAL AND HEALTH CENTER, AND CHESHIRE MEDICAL CENTER. WE USED SIMILAR COMMUNITY HEALTH NEEDS ASSESSMENT TOOLS AND APPROACHES, ALLOWING US TO COMPARE COMMUNITY HEALTH NEEDS ACROSS A BROAD GEOGRAPHIC, MULTI-HOSPITAL REGION.
Schedule H, Part V, Section B, Line 6b Facility 1, 1 Facility 1, 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. DURING FEBRUARY 2024 - NOVEMBER 2024, IN ADDITION TO WORKING WITH DARTMOUTH-HITCHCOCK CLINIC, MHMH WORKED CLOSELY WITH THE MEMBER ORGANIZATIONS OF THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY (60+ MEMBER ORGANIZATIONS) AND GREATER SULLIVAN COUNTY PUBLIC HEALTH ADVISORY COUNCIL, AND OUR 26-MEMBER CHNA ADVISORY COMMITTEE TO DISSEMINATE SURVEYS, SERVE AS KEY INFORMANTS, AND TO PROVIDE OVERALL REVIEW AND FEEDBACK RE: FINDINGS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.
Schedule H, Part V, Section B, Line 7 Facility 1, 1 Facility 1, 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. THE CHNA WAS DISTRIBUTED TO NON-PROFIT ORGANIZATIONS THROUGHOUT THE REGION INCLUDING THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY, WHICH IS A MEMBERSHIP GROUP OF REGIONAL NON-PROFIT, MUNICIPAL, SAFETY, HUMAN SERVICE, AND PUBLIC HEALTH ORGANIZATIONS. IT IS ALSO AVAILABLE FROM THE ORGANIZATION UPON REQUEST AND IS POSTED ON THE MHMH WEB PAGE (https://www.dartmouth-hitchcock.org/about/community-health)
Schedule H, Part V, Section B, Line 11 Facility 1, 1 Facility 1, 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MHMH IS INCREASING COMMUNITY BENEFITS SPENDING TO ADDRESS IDENTIFIED COMMUNITY NEEDS BASED ON THE MOST RECENT CHNA IN AREAS OF TRAUMA AND VIOLENCE, SOCIAL DETERMINANTS OF HEALTH, IMPROVING ACCESS TO HEALTH CARE, AND NEEDS OF OLDER ADULTS, AS WELL AS MAINTAINING ONGOING INVESTMENTS IN BEHAVIORAL HEALTH AND SUBSTANCE USE NEEDS, STRENGTHENING FAMILIES AND CHILDREN, AND CANCER CARE AND TREATMENT. IN FY 2025, MARY HITCHCOCK MEMORIAL HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT STRATEGIES WERE CONSISTENT WITH THE INTENTIONS IDENTIFIED IN OUR PREVIOUS COMMUNITY HEALTH IMPROVEMENT PLANS. AREAS WERE ANALYZED AND MHMH RESPONDED BY INCREASING INVESTMENTS, MAINTAINING SIMILAR LEVELS OF INVESTMENTS FOR SERVICES AND INITIATIVES, OR LIMITING INVESTMENT IN AREAS WHERE OTHER COMMUNITY ORGANIZATIONS ALREADY PROVIDE LEADERSHIP AND SERVICES TO ADDRESS THE NEED, AND/OR WHERE THE IDENTIFIED NEED IS SIGNIFICANTLY OUTSIDE THE MISSION/SERVICES/SCOPE OF MHMH. MARY HITCHCOCK MEMORIAL HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN IS A 3-YEAR DOCUMENT IDENTIFYING ANTICIPATED INVESTMENTS AND ACTIVITIES THAT IT WILL TAKE TO ADDRESS NEEDS IDENTIFIED IN THE MOST RECENT UPPER VALLEY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA).
Schedule H, Part V, Section B, Line 13 Facility 1, 1 Facility 1, 1 - MARY HTCHCOCK MEMORIAL HOSPITAL. PATIENTS WHOSE FAMILY INCOME EXCEEDS 300% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF MHMH.
Schedule H, Part V, Section B, Line 13 Facility 1, 1 Facility 1, 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MHMH HAS A SEPARATE UNINSURED DISCOUNT POLICY THAT OUTLINES HOW THE DISCOUNT IS CALCULATED ANNUALLY AND IS APPLIED PRIOR TO BILLING ANY UNINSURED PATIENT. THIS ASSURES A PATIENT IS NOT BILLED AT AN AMOUNT GREATER THAN THE AMOUNT GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS POLICY IS REFERENCED IN THE FINANCIAL ASSISTANCE POLICY.
Schedule H, Part V, Section B, Line 16 Facility 1, 1 Facility 1, 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. THE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY CAN BE FOUND AT https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance. MHMH HAS PLAIN LANGUAGE SUMMARY BROCHURES AVAILABLE AT ALL ADMISSION SITES AS WELL AS PLAIN LANGUAGE SUMMARY POSTERS AT ALL PHYSICAL LOCATIONS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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?0
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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
Schedule H, Part V, Section A FACILITY INFORMATION THE HOSPITAL HAS A SECOND CANCER TREATMENT CENTER LOCATED IN SAINT JOHNSBURY, VERMONT. THIS LOCATION IS REGISTERED UNDER THE SAME LICENSE AS THE ORGANIZATION'S MAIN CAMPUS LOCATED IN LEBANON, NEW HAMPSHIRE.
Schedule H, Part I, Line 3c OTHER FACTORS USED IN DETERMINING ELIGIBILITY OTHER THAN FPG MHMH USES THE FEDERAL POVERTY GUIDELINES (FPG) IN DETERMINING THE INITIAL LEVEL OF FINANCIAL ASSISTANCE PROVIDED. IN ADDITION, MHMH ALLOWS FOR CATASTROPHIC ASSISTANCE CONSIDERATION BASED ON A CALCULATION OF 10% OF TWO YEARS' INCOME PLUS 10% OF AMOUNT OVER SHELTERED ASSETS. IF THE PROJECTED OR CURRENT SELF-PAY BALANCE IS GREATER THAN THIS CALCULATION, THE SELF-PAY BALANCE IS REDUCED TO THE SUM OF 10% OF TWO YEARS' INCOME PLUS 10% OF ASSETS. EACH HOUSEHOLD IS ALLOWED CERTAIN SHELTERED ASSETS WHICH ARE NOT USED WHEN CALCULATING HOUSEHOLD INCOME OR ASSETS. SAVINGS IS SHELTERED UP TO 100% OF FEDERAL POVERTY LIMITS (FPL) BASED ON FAMILY SIZE, EQUITY IN PRIMARY RESIDENCE UP TO $200,000 (UP TO AGE 55) AND $250,000 FOR PATIENTS AGED 55 AND OLDER, AND A RETIREMENT SHELTER OF UP TO $100,000 IN RETIREMENT ASSETS AS LONG AS THE FUNDS ARE EMPLOYER-BASED CONTRIBUTIONS (IF WORKING) OR IN AN IRA (IF SELF-EMPLOYED). IF A PATIENT IS RETIRED, PRIOR RETIREMENT ACCOUNTS WOULD BE INCLUDED AS A SHELTERED ASSET.
Schedule H, Part I, Line 6a COMMUNITY BENEFITS REPORT MARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH-HITCHCOCK CLINIC (COLLECTIVELY REFERRED TO AS DARTMOUTH-HITCHCOCK (D-H)) SHARE COMMON BOARD MEMBERS AND OPERATE UNDER AN AFFILIATION AGREEMENT. D-H PERFORMS A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND FILES A CONSOLIDATED COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW HAMPSHIRE. FOR PURPOSES OF IRS FORM 990, SCHEDULE H, ONLY MARY HITCHCOCK MEMORIAL HOSPITAL NUMBERS WERE USED. ALL AMOUNTS RELATING TO DHC WERE EXCLUDED. THE NEW HAMPSHIRE COMMUNITY BENEFITS REPORT FILED FOR FISCAL YEAR 2025 SHOWS THAT COMBINED, DHC AND MHMH PROVIDED BENEFIT TOTALING $339,983,750.
Schedule H, Part I, Line 7g Subsidized Health Services THE ORGANIZATION DID NOT INCLUDE ANY SUBSIDIZED HEALTH SERVICE COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC ON PART I, LINE 7G.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 40911127
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED WAS A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE TO COST-TO-CHARGES.
Schedule H, Part II Community Building Activities Community building activities include expenses related to coalitions such as ones that address regional public health networks, improvement in systems of care for substance use and mental health disorders, prevention of substance abuse, falls reduction for older adults, and prescription drug misuse. They also include investments in regional public transportation, affordable housing, and workforce training initiatives that enable unemployed and marginally employed persons to access careers in our hospital, other health care settings, and other regional employers.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount BASED ON ACCOUNTING GUIDANCE, BAD DEBT IS RECORDED AS A REDUCTION TO NET PATIENT REVENUE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology The hospital is unable to estimate accurately the amount of bad debt expense attributable to patients eligible for financial assistance. Although a portion of bad debt expense may be related to patients who would qualify for charity care, a reportable figure cannot be reasonably estimated.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote MHMH IS INCLUDED IN THE DARTMOUTH-HITCHCOCK HEALTH AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS. AS A RESULT OF ACCOUNTING CHANGES (ASC 606), BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE. THEREFORE, THERE IS NO SEPARATE FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The costing methodology used to calculate the amounts reported as Medicare shortfalls was derived from the Internal Revenue Service's Worksheet B as provided for Part III calculations. MHMH had revenues of $227,999,645 and costs of $301,645,852 for services not included on the Medicare Cost Report (Ambulance Services, Laboratory and other free screens, and Medicare Part C & D services.) MHMH incurred a net loss of $73,646,207 on the provision of these services. Because of the central role of the organization in serving the healthcare needs of its community and the demographic characteristics of the community served, it is likely that a portion of the Medicare shortfall should be considered community benefit expenditure. MHMH has not identified a specific amount of Medicare shortfall that should be reported as such.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance MHMH HAS A CREDIT AND COLLECTION POLICY THAT ADDRESSES THE PROCEDURES FOR PATIENTS WHO QUALIFY FOR REDUCED-COST CARE. THE POLICY PROHIBITS USING EXTRAORDINARY COLLECTION PRACTICES OR PLACING AMOUNTS WITH COLLECTION AGENCIES. IF A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE HAS A BALANCE FOR WHICH THEY ARE RESPONSIBLE AFTER A FINANCIAL ASSISTANCE DISCOUNT IS APPLIED, THE STANDARD PRACTICES ARE FOLLOWED AS OUTLINED IN THE D-H CREDIT AND COLLECTIONS POLICY.
Schedule H, Part V, Section B, Line 16a FAP website 1 - MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16a URL: https://www.dartmouth-hitchcock.org/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16b FAP Application website 1 - MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16b URL: https://www.dartmouth-hitchcock.org/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website 1 - MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16c URL: https://www.dartmouth-hitchcock.org/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE;
Schedule H, Part VI, Line 2 Needs assessment MARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH HITCHCOCK CLINIC (COLLECTIVELY REFERRED TO AS DARTMOUTH-HITCHCOCK (D-H)) SHARE COMMON BOARD MEMBERS AND OPERATE UNDER AN AFFILIATION AGREEMENT. D-H PERFORMS A JOINT COMMUNITY NEEDS ASSESSMENT AND FILES A CONSOLIDATED COMMUNITY BENEFITS REPORT. DARTMOUTH-HITCHCOCK PARTICIPATES WITH OTHER HEALTH CARE CHARITABLE TRUSTS AND COMMUNITY PARTNERS IN EACH OF OUR SERVICE AREAS TO COMPLETE COMMUNITY HEALTH NEEDS ASSESSMENTS. DURING FY2025, MHMH PARTNERED WITH ALICE PECK DAY MEMORIAL HOSPITAL, TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT. WE ALSO WORKED TOGETHER WITH NEIGHBORING HOSPITALS, INCLUDING MOUNT ASCUTNEY HOSPITAL AND HEALTH CENTER, VALLEY REGIONAL HOSPITAL, NEW LONDON HOSPITAL, AND VISITING NURSE & HOSPICE OF VT & NH TO USE SIMILAR COMMUNITY HEALTH NEEDS ASSESSMENTS TOOLS AND APPROACHES, TO ALLOW COMPARABILITY OF HEALTH DATA ACROSS A WIDER GEOGRAPHIC REGION. COLLECTIVELY D-H AND PARTNERED HOSPITALS HIRED COMMUNITY HEALTH INSTITUTE/JOHN SNOW RESEARCH AND TRAINING INSTITUTE, A PUBLIC HEALTH CONSULTING FIRM, TO PROVIDE TECHNICAL ASSISTANCE AND ANALYSIS RELATED TO OUR COMMUNITY HEALTH NEEDS ASSESSMENTS. THE NEEDS ASSESSMENT INCLUDED REVIEWING SELECTED SERVICE AREA DEMOGRAPHICS; PUBLIC HEALTH DATA AVAILABLE THROUGH NH AND VT HEALTH DEPARTMENTS, HOSPITAL DISCHARGE DATA, BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY AND YOUTH RISK BEHAVIOR SURVEYS; FOCUS GROUPS WITH EMPLOYERS AND WITH COMMUNITY MEMBERS RECEIVING SERVICES AT REGIONAL SAFETY NET SERVICE ORGANIZATIONS; ELECTRONIC SURVEYS OF PROFESSIONAL HEALTH AND SOCIAL SERVICE PROVIDERS; AS WELL AS PAPER AND ELECTRONIC CONVENIENCE SURVEYS OF COMMUNITY RESIDENTS. FINDINGS OF THE FY2025 COMMUNITY HEALTH NEEDS ASSESSMENT WERE REVIEWED AT 2 LARGE VIRTUAL COMMUNITY MEETINGS (80+ TOTAL STAKEHOLDERS) HOSTED IN CONCERT WITH THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY AND OTHERS FOR FURTHER COMMENTS AND FEEDBACK. THE FINDINGS WERE ALSO REVIEWED IN 16 DEPARTMENT MEETINGS WITHIN MHMH INCLUDING MORE THAN 50 STAFF. ADDITIONALLY, MHMH COMMUNITY HEALTH STAFF PARTICIPATE IN OR LEAD MULTIPLE COMMUNITY COALITIONS AND PROJECTS CONNECTING US TO A WIDE ARRAY OF COMMUNITY-BASED HEALTH, MUNICIPAL, SCHOOL, SERVICE ORGANIZATION, REGIONAL PLANNING AND STATE PUBLIC HEALTH STAKEHOLDERS. WE REGULARLY REVIEW EMERGING NH & VT STATE HEALTH DATA; QUANTITATIVE AND QUALITATIVE DATA FROM LOCAL SOURCES (NEWSPAPERS, REGIONAL PLANNING OFFICES, COMMUNITY FORUMS), AND CONVERSATIONS WITH COMMUNITY PARTNERS TO IDENTIFY CONCERNS THAT ARE EMERGING, INTENSIFYING, OR ARE THE SOURCE OF LOCAL ATTENTION SINCE THE LAST CHNA WAS CONDUCTED.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance ALL UNINSURED INPATIENTS, SAME DAY SURGERY, OBSERVATION, AND EMERGENCY DEPARTMENT PATIENTS ARE PROACTIVELY SCREENED USING PAPER AND/OR AN AUTOMATED TOOL TO IDENTIFY POTENTIAL QUALIFICATION FOR OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. IN ADDITION, SPECIFIC OUTPATIENT ACTIVITIES DEEMED TO HAVE A HIGHER RATE OF NEED ARE SCREENED AS PART OF OUR REGULAR PROTOCOL. IF A PATIENT APPEARS TO BE ELIGIBLE, ON-SITE FINANCIAL COUNSELORS ASSIST THE PATIENT IN COMPLETING THE APPROPRIATE PAPERWORK/APPLICATIONS AND PROVIDE INSTRUCTIONS REGARDING HOW TO COMPLETE THE QUALIFICATION PROCESS. IN SOME CASES, A FINANCIAL COUNSELOR WILL ACT ON BEHALF OF THE PATIENT, AT THEIR SIGNED CONSENT, IN ORDER TO COMPLETE THE APPLICATION PROCESS (FOR EXAMPLE, IN NEW HAMPSHIRE A PATIENT MUST BE PHYSICALLY PRESENT AT THE DISTRICT OFFICE). IF A PATIENT DOESN'T QUALIFY FOR SPECIFIC PROGRAMS, THEY ARE ALSO CONSIDERED FOR FINANCIAL ASSISTANCE AS PART OF THEIR SCREENING. FOR OUTPATIENT SERVICES THAT ARE NOT ROUTINELY SCREENED, STAFF INTERACTING WITH PATIENTS ARE INSTRUCTED TO PROVIDE EITHER A FINANCIAL ASSISTANCE APPLICATION OR CONTACT INFORMATION FOR A FINANCIAL COUNSELOR WHEN A PATIENT EXPRESSES THEIR INABILITY TO MAKE PAYMENT. EVERY APPLICATION IS SCREENED FOR COMPLETED INCOME AND ASSET DOCUMENTATION. APPLICATIONS ARE ALSO SCREENED TO ASSURE THERE ARE NO OTHER POTENTIAL OPTIONS OF FEDERAL, STATE, OR LOCAL PROGRAMS. THE WEBSITE, PATIENT STATEMENTS, AND FINANCIAL BROCHURES ALL INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE AND HOW TO APPLY.
Schedule H, Part VI, Line 4 Community information THE ORGANIZATION DEFINES ITS SERVICE REGION AS NEW HAMPSHIRE AND EASTERN VERMONT, WITH THE LARGEST PRESENCE IN A 19-TOWN HOSPITAL SERVICE AREA REGION ADJOINING LEBANON, NEW HAMPSHIRE, SITE OF DARTMOUTH-HITCHCOCK MEDICAL CENTER WHICH INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH-HITCHCOCK CLINIC'S MAIN NORTHERN CLINIC. THE 19-TOWN HOSPITAL SERVICE AREA REGION HAS A POPULATION OF 70,000 PEOPLE, WITH TOWNS RANGING IN POPULATION FROM 200-14,000 PEOPLE. THESE TOWNS ARE GENERALLY CONSIDERED RURAL, THOUGH THE HANOVER, LEBANON, NH AND HARTFORD, VT COMMUNITIES ARE CONSIDERED TO BE A MICROPOLITAN AREA. AMONG THE REGION'S 19 TOWNS, MEDIAN HOUSEHOLD INCOME VARIES WIDELY, FROM $50K-$120K ANNUALLY. 17.5% OF THE POPULATION IS OVER THE AGE OF 65; 11% OF CHILDREN LIVE IN HOUSEHOLDS WHOSE MEDIAN HOUSEHOLD INCOME IS LESS THAN 100% OF FEDERAL POVERTY LEVEL, 26.8% OF CHILDREN LIVE IN HOUSEHOLDS WITH INCOME LESS THAN 200% OF FEDERAL POVERTY LEVEL; 1.5% OF THE REGION'S RESIDENTS HAVE LIMITED ENGLISH PROFICIENCY; AND 7.1% LACKED HEALTH INSURANCE. 11.8% OF NH RESIDENTS AND 24.9% OF VERMONT RESIDENTS ARE MEDICAID BENEFICIARIES. THE REGION IS SERVED BY MHMH AND BY ALICE PECK DAY MEMORIAL HOSPITALS. THERE ARE NO FEDERALLY QUALIFIED HEALTH CENTERS OPERATING WITHIN THE REGION, THOUGH ONE REGIONAL COMMUNITY HEALTH CLINIC IS PURSUING THIS STATUS. THE GOOD NEIGHBOR HEALTH CLINIC, IN HARTFORD, VT, OFFERS CARE TO UNINSURED COMMUNITY MEMBERS. TWO MINOR CIVIL DIVISIONS IN OUR REGION, DORCHESTER NH AND PIERMONT NH, ARE CONSIDERED MEDICALLY UNDERSERVED AREAS. MHMH SERVES THE GENERAL POPULATION WITH A WIDE RANGE OF SERVICES. IN ADDITION TO GENERAL HOSPITAL POPULATIONS, THE ORGANIZATION PROVIDES SERVICES TO PATIENTS WITH HIGHLY-SPECIALIZED NEEDS THAT ARE NOT AVAILABLE ELSEWHERE IN NEW HAMPSHIRE. MHMH IS THE STATE'S ONLY TERTIARY REFERRAL CENTER, PROVIDES THE STATE'S ONLY COMPREHENSIVE CANCER CENTER (DARTMOUTH CANCER CENTER), OPERATES THE ONLY LEVEL I TRAUMA CENTER IN NEW HAMPSHIRE, OPERATES THE ONLY COMPREHENSIVE CHILDREN'S HOSPITAL AND ACCREDITED PEDIATRIC TRAUMA CENTER IN NEW HAMPSHIRE (CHILDREN'S HOSPITAL AT DARTMOUTH - CHAD), HOSTS THE ONLY LEVEL IV NEONATAL INTENSIVE CARE NURSERY, HAS ONE OF TWO PEDIATRIC INTENSIVE CARE UNITS IN NEW HAMPSHIRE, AND OPERATES THE ONLY HELICOPTER TRANSPORT SERVICE IN THE STATE. AS SUCH, THE SERVICE POPULATION IS BOTH THE GENERAL PUBLIC SEEKING PRIMARY HEALTH CARE SERVICES AS WELL AS RESIDENTS WITH UNIQUE AND HIGHLY-SPECIALIZED HEALTH CARE NEEDS.
Schedule H, Part VI, Line 5 Promotion of community health MHMH supports organizations and initiatives that further health by strengthening and developing key community capacities to address identified community health needs. This includes hosting or leading community partnerships to address substance misuse and treatment and to improve public health; providing funding for child and adult oral health initiatives, and participation of our staff in other partnerships including the outpatient falls prevention task force, the transportation management association, and the Upper Valley Housing Coalition. In addition, MHMH operates health education and support services such as a women's health resource center, the aging resource center, and a health education center. MHMH uses cash contributions, contracted services, and in-kind contributions of staff time and expertise to support these strategies which improve community health. At MHMH's Lebanon, NH campus, the hospital extends professional staff privileges to qualified and appropriate physicians who are employees of Dartmouth Hitchcock Clinic, Mary Hitchcock Memorial Hospital, and Dartmouth College, who also hold a faculty appointment at the Geisel School of Medicine at Dartmouth College. MHMH's trustees annually set strategic priorities for the institution and approve operating and capital budgets which support improvements, patient care, medical education, and research. Examples of these investments include the development of MHMH's patient safety and training center; ongoing quality and patient safety initiatives; purchases of new and emerging medical technologies; support for translational research, and medical education. Of the 18 voting members of the Mary Hitchcock board of trustees at the end of FY25, 12 are neither contractors nor employees of MHMH nor family members thereof and are representative of the consumer interests of the various neighborhoods and localities which are serviced by hospital.
Schedule H, Part VI, Line 6 Affiliated health care system COMMUNITY BENEFITS ARE PROVIDED BY THE DARTMOUTH HEALTH SYSTEM, WHICH INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL, DARTMOUTH-HITCHCOCK CLINIC, AND OTHER RELATED ORGANIZATIONS WHOSE PRIMARY MISSION IS HEALTHCARE. MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) IN LEBANON IS NEW HAMPSHIRE'S LARGEST HOSPITAL. IN FISCAL YEAR 2025 MHMH HAD 460 LICENSED INPATIENT BEDS . THE DARTMOUTH-HITCHCOCK CLINIC (DHC) IS A MULTI-SPECIALTY PHYSICIAN PRACTICE WITH A NETWORK OF PROVIDERS ACROSS NEW HAMPSHIRE AND VERMONT. WHILE DHC'S MAIN OFFICES ARE LOCATED IN LEBANON, THE CLINIC ALSO HAS MULTI-SPECIALTY PRACTICES IN MANCHESTER, NASHUA, CONCORD, AND KEENE, NH AREAS AS WELL AS BENNINGTON, VT. IN ADDITION, THE CLINIC PROVIDES PRIMARY CARE IN RURAL COMMUNITIES IN VERMONT AND NORTHERN NEW HAMPSHIRE. THE HOSPITAL AND CLINIC OPERATE JOINTLY THROUGH INTERLOCKING DIRECTORATES, STRATEGIC PLANNING AND MANAGEMENT AND THEY SHARE IDENTICAL MISSIONS. THE GEISEL SCHOOL OF MEDICINE AT DARTMOUTH COLLEGE, WHICH WORKS CLOSELY WITH THE HOSPITAL AND CLINIC, IS FOCUSED ON MEDICAL EDUCATION AND RESEARCH.
Schedule H, Part VI, Line 7 State filing of community benefit report NH
Schedule H (Form 990) 2024
Additional Data


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Schedule I
(Form 990)
(Rev. January 2025)
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 instructions and the latest information.
OMB No. 1545-0047
Open to Public
Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number
02-0222140
Part I
General Information on Grants and Assistance
1
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? ........................
2
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) Advance Transit
PO Box 1027
Wilder,VT05088 		22-2558708 501(c)3 113,042   FMV   CHARITABLE PROGRAM SUPPORT
(2) American Cancer Society
2 Commerce Drive Suite 110
BEDFORD,NH03110 		13-1788491 501(c)3 29,600   FMV   PROGRAM SUPPORT
(3) American Heart Association
POBox 1590
Hagerstown,MD217411590 		13-5613797 501(c)3 37,000   FMV   CHARITABLE PROGRAM SUPPORT
(4) Amoskeag Health
145 Hollis Street
MANCHESTER,NH03101 		02-0458174 501(c)3 22,200   FMV   PROGRAM SUPPORT
(5) Baby Steps Family Assistance
169 Main St
Suite 211
CLAREMONT,NH03743 		82-1200566 501(c)3 7,400   FMV   PROGRAM SUPPORT
(6) BAYLOR COLLEGE OF MEDICINE
PO BOX 301207
DALLAS,TX753031207 		74-1613878 501(c)3 15,112   FMV   CHARITABLE RESEARCH
(7) BOARD OF REGENTS OF UNIV OF NEBRASKA
UNIV OF NEBRASKA MEDICAL CENTER
985045 NEBRASKA MED CTR
OMAHA,NE681985045 		47-0049123 STATE OF NE 42,726   FMV   EDUCATIONAL SERVICES
(8) BOSTON MEDICAL CENTER
ATTN ELTA ETIENNE
660 HARRISON AVE GAMBRO 2
BOSTON,MA02118 		04-3314093 501(c)3 37,489   FMV   CHARITABLE RESEARCH
(9) BOSTON UNIVERSITY
PO BOX 28763
NEW YORK,NY100878763 		04-2103547 501(c)3 6,796   FMV   CHARITABLE RESEARCH
(10) CASE WESTERN RESERVE UNIVERSITY
NPD PATH SURVEILLANCE CTR
PO BOX 92910
CLEVELAND,OH44194 		34-1018992 STATE OF AL 33,607   FMV   EDUCATIONAL SERVICES
(11) CENTERSTONE RESEARCH INSTITUTE INC
44 VANTAGE WAY
NASHVILLE,TN372197520 		26-2505456 501(c)3 97,727   FMV   CHARITABLE RESEARCH
(12) Cheshire Medical Center
580 COURT STREET
KEENE,NH03431 		02-0354549 501(c)3 8,880   FMV   CHARITABLE PROGRAM SUPPORT
(13) CHILDREN'S HOSPITAL OF PHILADELPHIA
PO BOX 8500
PHILADELPHIA,PA191787932 		04-2774441 501(c)3 84,783   FMV   CHARITABLE RESEARCH
(14) City of Lebanon
City Hall 51 Park Street
LEBANON,NH03766 		02-6000473 Lebanon, NH 239,039   FMV   PROGRAM SUPPORT
(15) City of Nashua
FMO
70 EAST HOLLIS ST
NASHUA,NH03060 		02-6000581 Nashua, NH 12,000   FMV   PROGRAM SUPPORT
(16) Claremont Learning Partnership
169 Main Street
CLAREMONT,NH03743 		82-0901496 501(c)3 11,100   FMV   PROGRAM SUPPORT
(17) Claremont Senior Center Inc
5 ACER HEIGHTS RD
CLAREMONT,NH03743 		04-3376555 501(c)3 5,550   FMV   PROGRAM SUPPORT
(18) Claremont Soup Kitchen Inc
51 Central Street
CLAREMONT,NH03743 		02-0367045 501(c)3 7,400   FMV   PROGRAM SUPPORT
(19) COLBY-SAWYER COLLEGE
FINANCIAL SERVICES
541 MAIN STREET
NEW LONDON,NH03257 		02-0222120 STATE OF NH 56,044   FMV   EDUCATIONAL SERVICES
(20) COMMUNITY COLLEGE SYSTEM NEW HAMPSHIRE
C/O RIVER VALLEY COMM COLLEGE
ONE COLLEGE DRIVE
CLAREMONT,NH037439707 		90-0531902 STATE OF NH 51,128   FMV   EDUCATIONAL SERVICES
(21) Community Nurse Connection
PO Box 1302
LEBANON,NH03766 		83-1224873 501(c)3 18,500   FMV   CHARITABLE PROGRAM SUPPORT
(22) COOK & CADEAUX LLC
KC PARSONNET
358 MAIN STREET
NORWICH,VT05055 		74-3182360   7,684   FMV   CHARITABLE RESEARCH
(23) CREARE LLC
16 GREAT HOLLOW RD
HANOVER,NH03755 		02-0259551   7,148   FMV   CHARITABLE RESEARCH
(24) DANA-FARBER CANCER INSTITUTE INC
PO BOX 412846
BOSTON,MA022412846 		04-2263040 501(c)3 31,004   FMV   CHARITABLE PROGRAM SUPPORT
(25) Early Care and Education Association
Po Box 5428
WEST LEBANON,NH03784 		85-3076751 501(c)3 55,500   FMV   PROGRAM SUPPORT
(26) Families Flourish Northeast
235 Whitford Street
MANCHESTER,NH03104 		84-4591232 501(c)3 22,200   FMV   PROGRAM SUPPORT
(27) FAMILIES FLOURISH NORTHEAST INC
235 Whitford Street
MANCHESTER,NH03104 		84-4591233 501(c)3 18,552   FMV   PROGRAM SUPPORT
(28) FAMILY PLACE INC
319 US ROUTE 5 SOUTH
NORWICH,VT05055 		03-0305264 501(c)3 8,485   FMV   CHARITABLE EDUCATIONAL SERVICES
(29) Girls Incorporated of New Hampshire
1711 South Willow Street Unit 5
MANCHESTER,NH03103 		23-7416090 501(c)3 7,400   FMV   PROGRAM SUPPORT
(30) Good Neighbor Health Clinic
POBox 1250
WHITE RIVER JUNCTION,VT05001 		03-0346949 501(c)3 37,000   FMV   PROGRAM SUPPORT
(31) Grafton County Senior Citizens Council
10 Campbell St
LEBANON,NH03766 		23-7248316 501(c)3 17,020   FMV   PROGRAM SUPPORT
(32) GRANITE UNITED WAY
22 CONCORD STREET
MANCHESTER,NH03101 		02-6006033 501(c)3 86,044   FMV   EDUCATIONAL SERVICES
(33) Hartford Community Coalition
POBox 4343
WHITE RIVER JUNCTION,VT05001 		82-4272638 501(c)3 11,100   FMV   PROGRAM SUPPORT
(34) HEADREST INC
141 MASCOMA STREET
LEBANON,NH03766 		23-7256865 501(c)3 48,887   FMV   CHARITABLE PROGRAM SUPPORT
(35) HIVHCV Resource Center
2 Blacksmith Street
LEBANON,NH03766 		22-3104237 501(c)3 16,650   FMV   PROGRAM SUPPORT
(36) INDIANA INSTITUTE FOR MEDICAL RESEARCH
C/O IMCU-VA BRANCH
PO BOX 47769
INDIANAPOLIS,IN46247 		35-1781809 501(c)3 51,615   FMV   CHARITABLE RESEARCH
(37) JOHNS HOPKINS UNIVERSITY
3910 KESWICK ROAD N4327-B
BALTIMORE,MD21211 		52-0595110 501(c)3 357,614   FMV   EDUCATIONAL SERVICES
(38) KAISER FOUNDATION RESEARCH INSTITUTE
KAISER FOUNDATION HOSPITAL
P O BOX 748165
LOS ANGELES,CA900748165 		94-1105628 501(c)3 752,565   FMV   CHARITABLE RESEARCH
(39) LISTEN COMMUNITY SERVICES
60 HANOVER ST
LEBANON,NH03766 		23-7225952 501(c)3 92,783   FMV   CHARITABLE PROGRAM SUPPORT
(40) LITTLE RIVERS HEALTHCARE INC
4628 Main Street
POBox 8
Newbury,VT05051 		16-1678092 501(c)3 25,070   FMV   CHARITABLE PROGRAM SUPPORT
(41) MAGEE-WOMENS RESEARCH INSTITUTE AND FDN
3240 CRAFT PLACE
PITTSBURGH,PA15213 		25-1462312 501(c)3 109,759   FMV   CHARITABLE RESEARCH
(42) MAINE COUNCIL ON AGING
PO BOX 988
BRUNSWICK,ME04011 		46-1549012 501(c)3 27,308   FMV   CHARITABLE PROGRAM SUPPORT
(43) Makin' It Happen Coalition for Resilient
YOUTH INC
180 BRIDGE STREET
MANCHESTER,NH03104 		46-2768846 501(c)3 8,880   FMV   CHARITABLE PROGRAM SUPPORT
(44) Mark Stebbins Community Center
497 HOOKSEET RD
UNIT 326
MANCHESTER,NH03104 		87-4002783 501(c)3 7,400   FMV   CHARITABLE PROGRAM SUPPORT
(45) Mascoma Community Healthcare
PO Box 550
Canaan,NH03741 		46-5672753 501(c)3 18,500   FMV   CHARITABLE PROGRAM SUPPORT
(46) MASSACHUSETTS GENERAL HOSPITAL
100 CHARLES RIVER PLAZA STE 600
BOSTON,MA021142792 		04-2697983 501(c)3 60,904   FMV   CHARITABLE PROGRAM SUPPORT
(47) MAYO CLINIC ARIZONA
PO BOX 860334
MINNEAPOLIS,MN554860334 		86-0800150 501(c)3 22,992   FMV   CHARITABLE RESEARCH
(48) MEDICAL UNIVERSITY OF SOUTH CAROLINA
268 Calhoun Street
CHARLESTON,SC29407 		57-6000722 STATE OF SC 315,242   FMV   EDUCATIONAL SERVICES
(49) MEDSTAR HEALTH RESEARCH INSTITUTE
10980 GRANTCHESTER WAY
COLUMBIA,MD21044 		52-6056274 501(c)3 8,880   FMV   CHARITABLE RESEARCH
(50) MEMORIAL SLOAN-KETTERING CANCER CENTER
PO BOX 27084
NEW YORK,NY100876352 		13-1924236 501(c)3 55,916   FMV   CHARITABLE RESEARCH
(51) MOCO Arts
40 ROXBURY STREET
KEENE,NH03431 		02-0514391 501(c)3 7,400   FMV   PROGRAM SUPPORT
(52) Mt Ascutney Hospital and Health Center
289 COUNTY RD
WINDSOR,VT05089 		03-0183721 501(c)3 22,200   FMV   CHARITABLE RESEARCH
(53) MY CNA NOW LLC DBA LNA HEALTH CAREERS
22 CONCORD ST 3RD FLOOR
MANCHESTER,NH03101 		85-0569951   11,840   FMV   CHARITABLE RESEARCH
(54) NATIONWIDE CHILDREN'S HOSPITAL
LABORATORY SERVICES DEPT 781633
PO BOX 78000
DETROIT,MI482781633 		31-4379441 501(c)3 9,873   FMV   CHARITABLE RESEARCH
(55) NAVAL HEALTH RESEARCH CENTER
140 SYLVESTER ROAD
SAN DIEGO,CA92106 		80-0520146 501(c)3 189,646   FMV   CHARITABLE RESEARCH
(56) New Hampshire Hunger Solutions Inc
POBox 3477
CONCORD,NH03301 		22-2936618 501(c)3 11,100   FMV   PROGRAM SUPPORT
(57) NEW HAMPSHIRE LEGAL ASSISTANCE
117 NORTH STATE STREET
CONCORD,NH03301 		02-0300897 501(c)3 98,084   FMV   CHARITABLE PROGRAM SUPPORT
(58) NEW YORK UNIVERSITY
433 FIRST AVENUE 6TH FLOOR
New York,NY10010 		13-5562308 STATE OF AL 49,049   FMV   EDUCATIONAL SERVICES
(59) NORTH COUNTRY HEALTH CONSORTIUM INC
262 COTTAGE STREET
LITTLETON,NH03561 		02-0503184 501(c)3 144,771   FMV   CHARITABLE PROGRAM SUPPORT
(60) NORTHEASTERN VT REGIONAL HOSPITAL
PO BOX 905
ST JOHNSBURY,VT058190905 		03-6013761 501(c)3 20,419   FMV   CHARITABLE PROGRAM SUPPORT
(61) NORTHWESTERN UNIVERSITY
633 NORTH ST CLAIR STREET
CHICAGO,IL60611 		36-2167817 501(c)3 55,935   FMV   CHARITABLE EDUCATIONAL SERVICES
(62) OREGON CLINIC PC
847 NE 19TH AVENUE
PORTLAND,OR97232 		93-1127856 501(c)3 107,748   FMV   CHARITABLE RESEARCH
(63) OREGON HEALTH & SCIENCE UNIVERSITY
PO BOX 575
PORTLAND,OR97207 		93-1176109 501(c)3 192,209   FMV   CHARITABLE EDUCATIONAL SERVICES
(64) PUBLIC HEALTH COUNC OF THE UPPER VALLEY
ONE COURT STREET
LEBANON,NH03766 		75-2991608 501(c)3 46,489   FMV   CHARITABLE PROGRAM SUPPORT
(65) RECTOR & VISITORS OF UNIV OF VIRGINIA
JOHN W STEINKE
PO BOX 801355
CHARLOTTESVILLE,VA229081355 		54-6001796 STATE OF VA 30,478   FMV   EDUCATIONAL SERVICES
(66) RHODE ISLAND HOSPITAL
PO BOX 373
PROVIDENCE,RI02901 		05-0258954 501(c)3 18,410   FMV   CHARITABLE RESEARCH
(67) RIVER VALLEY COMMUNITY COLLEGE
RVCC BOOKSTORE 967
CLAREMONT,NH03743 		54-0903278 STATE OF NH 7,250   FMV   EDUCATIONAL SERVICES
(68) RUTGERS THE STATE UNIVERSITY OF NJ
33 KNIGHTSBRIDGE ROAD
PISCATAWAY,NJ08854 		22-6001086 501(c)3 18,144   FMV   EDUCATIONAL SERVICES
(69) SEVEN COUNTIES SERVICES INC
ATTN ACCTS RECEIVABLE
10401 LINN STATION RD
LOUISVILLE,KY40223 		31-0939757 501(c)3 180,462   FMV   CHARITABLE RESEARCH
(70) SINAI HOSPITAL OF BALTIMORE INC
2401 W BELVEDERE AVENUE
BALTIMORE,MD21215 		52-0486540 501(c)3 39,571   FMV   CHARITABLE RESEARCH
(71) Southeast Vermont Transit Inc
706 Rockingham Road
ROCKINGHAM,VT05101 		03-0353976 501(c)3 22,200   FMV   PROGRAM SUPPORT
(72) Southwestern Community Services
PO Box 603 / 63 Community Way
KEENE,NH03431 		02-6013808 501(c)3 7,400   FMV   CHARITABLE PROGRAM SUPPORT
(73) STANFORD UNIVERSITY
ADMINISTRATION
PO BOX 884253
LOS ANGELES,CA900884253 		94-1156365 501(c)3 50,202   FMV   CHARITABLE PROGRAM SUPPORT
(74) TAMPA VA RESEARCH & EDUCATION FOUNDATION
5620 E FOWLER AVENUE
TEMPLE TERRACE,FL33617 		59-3444354 501(c)3 8,880   FMV   CHARITABLE RESEARCH
(75) THE BRIGHAM AND WOMEN'S HOSPITAL INC
75 FRANCIS ST
BOSTON,MA02115 		04-2312909 501(c)3 56,463   FMV   CHARITABLE RESEARCH
(76) The Collaborative
91 VT ROUTE 11
S LONDONDERRY,VT05148 		03-0359264 501(c)3 8,880   FMV   EDUCATIONAL SERVICES
(77) THE FAMILY RESOURCE CENTER AT GORHAM
123 MAIN STREET STE 1
GORHAM,NH03581 		04-3383141 501(c)3 16,071   FMV   CHARITABLE PROGRAM SUPPORT
(78) THE UNIVERSITY OF TEXAS HEALTH SCIENCE
CENTER AT SAN ANTONIO
7703 FLOYD CURL DRIVE
SAN ANTONIO,TX782293900 		74-1586031 STATE OF TX 126,424   FMV   EDUCATIONAL SERVICES
(79) TLC FAMILY RESOURCE CENTER
62 PLEASANT ST
CLAREMONT,NH03743 		52-2439830 501(c)3 8,429   FMV   CHARITABLE PROGRAM SUPPORT
(80) Tri-Valley Transit
279 Creek Road
MIDDLEBURY,VT05753 		03-0335768 501(c)3 23,951   FMV   PROGRAM SUPPORT
(81) TRUSTEES COLUMBIA UNIVERSITY
710 W 168TH STREET
NEW YORK,NY10032 		13-5598093 501(c)3 14,278   FMV   CHARITABLE EDUCATIONAL SERVICES
(82) TRUSTEES OF DARTMOUTH COLLEGE
CASHIERS OFFICE / AR
6132 MCNUTT RM 103
HANOVER,NH03755 		02-0222111 501(c)3 3,335,783   FMV   CHARITABLE EDUCATIONAL SERVICES
(83) TRUSTEES OF THE UNIV OF PENNSYLVANIA
THE WHARTON SCHOOL
LOCKBOX 9726
PHILADELPHIA,PA191789726 		23-1352685 STATE OF PA 126,708   FMV   EDUCATIONAL SERVICES
(84) Twin Pines Housing Trust
226 Holiday Drive Suite 20
WHITE RIVER JUNCTION,VT05001 		22-2809527 501(c)3 29,600   FMV   PROGRAM SUPPORT
(85) UNIV OF MICHIGAN
DEPT OF PATHOLOGY BILLING
2800 PLYMOUTH ROAD
ANN ARBOR,MI48109 		38-6006309 STATE OF AL 6,660   FMV   EDUCATIONAL SERVICES
(86) UNIVERSITY OF ALABAMA AT BIRMINGHAM
GRANTS CONTRACTS ACCOUNTING
1720 2ND AVE SOUTH
BIRMINGHAM,AL352940109 		63-6005396 STATE OF AL 1,104,793   FMV   EDUCATIONAL SERVICES
(87) UNIVERSITY OF ARIZONA
SPONSORED PRJCTS CONTR SRVCS
PO BOX 41867
TUCSON,AZ85717 		74-2652689 STATE OF AL 8,880   FMV   EDUCATIONAL SERVICES
(88) UNIVERSITY OF CALIFORNIA SAN FRANCISCO
SUNDRY DEBTOR - BOX 0815
SAN FRANCISCO,CA94143 		94-6036493 STATE OF CA 10,600   FMV   EDUCATIONAL SERVICES
(89) UNIVERSITY OF COLORADO ANSCHUTZ
UNIVERSITY OF COLORADO
12801 E 17th AVE L18-10101 MAIL
AURORA,CO80045 		84-6000555 STATE OF CO 99,287   FMV   EDUCATIONAL SERVICES
(90) UNIVERSITY OF CONNECTICUT HEALTH CENTER
263 FARMINGTON AVENUE
FARMINGTON,CT06030 		52-1725543 STATE OF AL 5,886   FMV   EDUCATIONAL SERVICES
(91) UNIVERSITY OF FLORIDA
123 GRINTER HALL
GAINESVILLE,FL32611 		59-6002052 STATE OF FL 100,549   FMV   EDUCATIONAL SERVICES
(92) UNIVERSITY OF MARYLAND
PO BOX 41428
BALTIMORE,MD212036428 		52-6002033 STATE OF MD 122,452   FMV   EDUCATIONAL SERVICES
(93) UNIVERSITY OF MINNESOTA
PO BOX 1450
MINNEAPOLIS,MN554855960 		41-6007513 STATE OF AL 80,757   FMV   EDUCATIONAL SERVICES
(94) UNIVERSITY OF PITTSBURGH
PO BOX 640458
PITTSBURGH,PA152640458 		25-0965591 STATE OF PA 40,174   FMV   EDUCATIONAL SERVICES
(95) UNIVERSITY OF TEXAS SOUTHWESTERN MED CTR
5323 HARRY HINES BLVD
DALLAS,TX752359029 		75-6002868 STATE OF TX 64,068   FMV   EDUCATIONAL SERVICES
(96) UNIVERSITY OF UTAH
GRANTS CONTRACTS ACCOUNTING
201 S PRESIDENTS CIR RM 406
SALT LAKE CITY,UT841129020 		87-6000525 STATE OF UT 27,284   FMV   EDUCATIONAL SERVICES
(97) UNIVERSITY OF VERMONT
MEDICAL CENTER
PO BOX 1902
BURLINGTON,VT05402 		03-0179440 STATE OF VT 43,861   FMV   EDUCATIONAL SERVICES
(98) UNIVERSITY OF WASHINGTON
GRANT CONTRACT ACCOUNTING
12455 COLLECTIONS DRIVE
CHICAGO,IL60693 		91-6001537 STATE OF WA 58,978   FMV   EDUCATIONAL SERVICES
(99) UNIVERSITY SYSTEM OF NEW HAMPSHIRE
5 CHANELL DRIVE
CONCORD,NH03301 		02-6000937 STATE OF NH 31,531   FMV   EDUCATIONAL SERVICES
(100) Upper Valley Business Alliance
377 N MAIN ST
WEST LEBANON,NH03784 		84-3255631 501(c)6 8,140   FMV   PROGRAM SUPPORT
(101) Upper Valley Haven
713 Hartford Ave
WHITE RIVER JUNCTION,VT05001 		03-0277908 501(c)3 53,576   FMV   PROGRAM SUPPORT
(102) Upper Valley Lake Sunapee Regional Planning Foundation
10 Water Street Ste 225
LEBANON,NH037661604 		83-4074101 501(c)3 22,200   FMV   PROGRAM SUPPORT
(103) VANDERBILT UNIVERSITY MEDICAL CENTER
VUMC FINANCE DEPT 1236
DALLAS,TX753121236 		35-2528741 501(c)3 81,979   FMV   CHARITABLE EDUCATIONAL SERVICES
(104) Vermont Association for Mental Health
1 BLANCHARD CT STE 204
MONTPELIER,VT05602 		03-0226306 501(c)3 8,880   FMV   PROGRAM SUPPORT
(105) Veterans Education & Research Assn of
PO BOX 4655
WHITE RIVER JUNCTION,VT05001 		22-3091219 501(c)3 6,935   FMV   PROGRAM SUPPORT
(106) VETERANS MED RESEARCH FOUNDATION OF SD
PO BOX 515298
LOS ANGELES,CA900516598 		33-0189397 501(c)3 8,880   FMV   CHARITABLE RESEARCH
(107) VIRGINIA COMMONWEALTH UNIVERSITY
BOX 843035
RICHMOND,VA23219 		54-6001758 STATE OF VA 40,910   FMV   EDUCATIONAL SERVICES
(108) WAKE FOREST UNIVERSITY
OFFICE OF CONT MEDICAL EDUC
MEDICAL CENTER BOULEVARD
WINSTONSALEM,NC271571028 		56-0532138 501(c)3 31,069   FMV   EDUCATIONAL SERVICES
(109) WASHINGTON UNIVERSITY
7425 FORSYTH
ST LOUIS,MO63105 		43-0653611 STATE OF MO 45,234   FMV   EDUCATIONAL SERVICES
(110) WEBER STATE UNIVERSITY
3885 WEST CAMPUS DR DEPT 1101
OGDEN,UT844081101 		87-6000535 501(c)3 8,777   FMV   EDUCATIONAL SERVICES
(111) WEILL MEDICAL COLLEGE OF CORNELL
ATTN CORNELL ECHO 2001
525 EAST 68TH ST BOX 222
NEW YORK,NY10021 		13-1623978 STATE OF VA 157,058   FMV   EDUCATIONAL SERVICES
(112) WEST VIRGINIA UNIVERSITY RESEARCH CORPOR
ONE WATERFRONT PLACE
MORGANTOWN,WV265066001 		55-0665758 STATE OF WV 7,069   FMV   EDUCATIONAL SERVICES
(113) WESTAT INC
PO BOX 1004 ATTN ACCOUNTS RECEIVA
ROCKVILLE,MD20850 		84-0529566   19,569   FMV   CHARITABLE RESEARCH
(114) White River Council on Aging
262 North Main St
WHITE RIVER JUNCTION,VT05001 		03-0261891 501(c)3 7,400   FMV   PROGRAM SUPPORT
(115) Willing Hands Enterprises
198 CHURCH STREET
NORWICH,VT05055 		20-2204811 501(c)3 15,910   FMV   CHARITABLE PROGRAM SUPPORT
(116) WMU HOMER STRYKER MD SCHOOL OF MEDICINE
PO BOX 50391
KALAMAZOO,MI490050391 		45-4135256 501(c)3 53,232   FMV   EDUCATIONAL SERVICES
(117) Women's Information Service of the Upper Valley
38 Bank Street
LEBANON,NH03766 		02-0346512 501(c)3 14,800   FMV   PROGRAM SUPPORT
(118) YALE UNIVERSITY
GRANT CONTRACT FINANCIAL ADMINIST
PO BOX 1873
NEW HAVEN,CT065081873 		06-0646973 501(c)3 13,431   FMV   EDUCATIONAL SERVICES
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
113
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
5
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) Rev. 1-2025

Schedule I (Form 990) Rev. 1-2025
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) Awards and Educational Assistance 75 308,591   FMV  
(2) Patient Assistance 2562 154,021   FMV  
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds EACH AWARD ESTABLISHED BY MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) HAS WRITTEN GUIDELINES AND PROCEDURES. AWARD PAYMENTS ARE PROCESSED IN ACCORDANCE WITH THE SPECIFIC TERMS OF EACH AWARD. THE DARTMOUTH INSTITUTE SCHOLARSHIPS (TDI) ARE PAID DIRECTLY TO DARTMOUTH COLLEGE ON BEHALF OF THE INDIVIDUALS RECEIVING THE AWARDS. THE COORDINATORS OF THE PROGRAM ARE RESPONSIBLE FOR ASSURING THAT ALL TERMS ARE MET, INCLUDING PROPER DOCUMENTATION OF EXPENSES WITH RECEIPTS.
Schedule I (Form 990) Rev. 1-2025



Additional Data


Software ID: 24020961
Software Version: 2024v5.1


Schedule J
(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic Attach to Form 990.
medium right arrow graphic Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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 .....
1b
Yes
 
2
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? ....
2
Yes
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) (Rev. 1-2025)

Schedule J (Form 990) (Rev. 1-2025)
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, 1099-MISC compensation, and/or 1099-NEC (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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Joanne M Conroy MD
Trustee, Ex-Officio, CEO 		(i)

(ii)		 0
-------------
1,685,674 		0
-------------
552,000 		0
-------------
235,562 		0
-------------
32,970 		0
-------------
19,692 		0
-------------
2,525,898 		0
-------------
0
2Nancy M Dunbar MD
Trustee / Physician (Through 12/31/24) 		(i)

(ii)		 0
-------------
363,926 		0
-------------
0 		0
-------------
30,873 		0
-------------
26,070 		0
-------------
44,761 		0
-------------
465,630 		0
-------------
0
3Laura Chiang
Trustee 		(i)

(ii)		 0
-------------
392,389 		0
-------------
0 		0
-------------
25,586 		0
-------------
25,500 		0
-------------
42,121 		0
-------------
485,596 		0
-------------
0
4Marcus Coe MD
Trustee 		(i)

(ii)		 0
-------------
789,876 		0
-------------
0 		0
-------------
46,514 		0
-------------
26,070 		0
-------------
44,023 		0
-------------
906,483 		0
-------------
0
5Keith Loud MD
Trustee 		(i)

(ii)		 0
-------------
505,321 		0
-------------
0 		0
-------------
37,706 		0
-------------
32,970 		0
-------------
37,553 		0
-------------
613,550 		0
-------------
0
6Jonathan B Thyng MD
Trustee/Medical Director 		(i)

(ii)		 0
-------------
362,780 		0
-------------
0 		0
-------------
15,981 		0
-------------
32,970 		0
-------------
44,073 		0
-------------
455,804 		0
-------------
0
7Emily Zeitler
Trustee (as of 1/1/25) 		(i)

(ii)		 0
-------------
482,221 		0
-------------
0 		0
-------------
33,780 		0
-------------
26,070 		0
-------------
43,902 		0
-------------
585,973 		0
-------------
0
8Maria Padin MD
Former Officer/Chief medical Officer, CGP 		(i)

(ii)		 0
-------------
505,838 		0
-------------
62,420 		0
-------------
31,037 		0
-------------
32,970 		0
-------------
35,572 		0
-------------
667,837 		0
-------------
0
9Wendy Fielding
Chief Financial Officer 		(i)

(ii)		 434,374
-------------
0 		47,500
-------------
0 		55,650
-------------
0 		32,970
-------------
0 		35,394
-------------
0 		605,888
-------------
0 		0
-------------
0
10Aimee M Claiborne
Chief Human Resource Officer 		(i)

(ii)		 535,867
-------------
0 		110,000
-------------
0 		24,618
-------------
0 		26,070
-------------
0 		27,621
-------------
0 		724,176
-------------
0 		0
-------------
0
11John Kacavas
Chief Legal Officer 		(i)

(ii)		 752,457
-------------
0 		38,400
-------------
0 		1,229
-------------
0 		20,700
-------------
0 		32,653
-------------
0 		845,439
-------------
0 		0
-------------
0
12Stephen LeBlanc
Chief Strategy Officer 		(i)

(ii)		 0
-------------
733,963 		0
-------------
155,000 		0
-------------
127,148 		0
-------------
32,970 		0
-------------
36,329 		0
-------------
1,085,410 		0
-------------
0
13Edward J Merrens MD
Chief Clinical Officer 		(i)

(ii)		 0
-------------
796,803 		0
-------------
165,000 		0
-------------
89,924 		0
-------------
32,970 		0
-------------
16,333 		0
-------------
1,101,030 		0
-------------
0
14Susan A Reeves EDD RN
Executive VP (medical center) 		(i)

(ii)		 216,346
-------------
0 		250
-------------
0 		0
-------------
0 		12,996
-------------
0 		0
-------------
0 		229,592
-------------
0 		0
-------------
0
15Matthew Haag
Chief Development Officer 		(i)

(ii)		 394,030
-------------
0 		85,000
-------------
0 		38,558
-------------
0 		26,070
-------------
0 		17,679
-------------
0 		561,337
-------------
0 		0
-------------
0
16Martin T Manion
COO (as of 4/24/25) 		(i)

(ii)		 418,164
-------------
0 		54,648
-------------
0 		25,032
-------------
0 		20,700
-------------
0 		2,028
-------------
0 		520,572
-------------
0 		0
-------------
0
17Staci Hermann PHARMD MS
Former Chief Pharmacy Officer 		(i)

(ii)		 114,027
-------------
0 		0
-------------
0 		8,581
-------------
0 		5,984
-------------
0 		4,405
-------------
0 		132,997
-------------
0 		0
-------------
0
18Peter D Solberg MD
Chief Health Information Officer - Former 		(i)

(ii)		 0
-------------
478,082 		0
-------------
62,100 		0
-------------
48,374 		0
-------------
32,970 		0
-------------
44,120 		0
-------------
665,646 		0
-------------
0
19Simon C Hillier
Dept. Chair - Anesthesiology 		(i)

(ii)		 0
-------------
372,348 		0
-------------
0 		0
-------------
61,483 		0
-------------
32,970 		0
-------------
35,315 		0
-------------
502,116 		0
-------------
0
20Patrick F Jordan III MBA
Chief Operating Officer - DHC (through 6/21/25) 		(i)

(ii)		 875,781
-------------
0 		180,000
-------------
0 		76,927
-------------
0 		32,970
-------------
0 		46,290
-------------
0 		1,211,968
-------------
0 		0
-------------
0
21Martin Purcell MBA
Chief Information Officer 		(i)

(ii)		 508,830
-------------
0 		62,100
-------------
0 		49,096
-------------
0 		32,970
-------------
0 		37,380
-------------
0 		690,376
-------------
0 		0
-------------
0
22David F Duncan
System VP - Facilities Mgmt 		(i)

(ii)		 327,795
-------------
0 		33,460
-------------
0 		6,346
-------------
0 		20,700
-------------
0 		26,468
-------------
0 		414,769
-------------
0 		0
-------------
0
23Samuel Shields
System VP - Strtgy & Rgnl Ops 		(i)

(ii)		 347,386
-------------
0 		35,000
-------------
0 		16,761
-------------
0 		26,070
-------------
0 		3,990
-------------
0 		429,207
-------------
0 		0
-------------
0
24Tracy Galvin
Chief Nursing Officer 		(i)

(ii)		 361,375
-------------
0 		29,600
-------------
0 		3,284
-------------
0 		20,700
-------------
0 		26,819
-------------
0 		441,778
-------------
0 		0
-------------
0
25Daniel P Jantzen
CFO D-HH/Former CFO MHMH 		(i)

(ii)		 859,350
-------------
0 		180,000
-------------
0 		144,937
-------------
0 		32,970
-------------
0 		38,907
-------------
0 		1,256,164
-------------
0 		0
-------------
0
26Kimberly Troland JD
DH Gnrl Cnsl &Sys Dep Gnl Cnsl 		(i)

(ii)		 474,470
-------------
0 		35,350
-------------
0 		71,461
-------------
0 		28,272
-------------
0 		24,667
-------------
0 		634,220
-------------
0 		0
-------------
0
27Jennifer Gilkie
System VP Comm-Marketing, 		(i)

(ii)		 358,909
-------------
0 		38,000
-------------
0 		4,538
-------------
0 		32,970
-------------
0 		44,855
-------------
0 		479,272
-------------
0 		0
-------------
0
28Barbara Vance
VP-Research Ops (through 7/13/24) 		(i)

(ii)		 231,541
-------------
0 		0
-------------
0 		199,680
-------------
0 		14,228
-------------
0 		10,846
-------------
0 		456,295
-------------
0 		0
-------------
0
29Christopher L Hubble MD
VP Patient Safety 		(i)

(ii)		 390,920
-------------
0 		49,440
-------------
0 		26,213
-------------
0 		20,700
-------------
0 		44,598
-------------
0 		531,871
-------------
0 		0
-------------
0
Schedule J (Form 990) (Rev. 1-2025)

Schedule J (Form 990) (Rev. 1-2025)
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
Schedule J, Part I, Line 1a Discretionary spending account THE ORGANIZATION HAS IN PLACE A MANAGEMENT SELF DEVELOPMENT PLAN (MSDP) DESIGNED TO PROMOTE PROFESSIONAL AND PERSONAL DEVELOPMENT. THE MSDP IS CAPPED AT 2% OF GROSS PAY AND MAY BE UTILIZED FOR EXPENSES SUCH AS PROFESSIONAL DUES, MEETINGS AND SEMINARS, TUITION REIMBURSEMENT, AND OTHER MISCELLANEOUS ITEMS THAT PROMOTE PROFESSIONAL KNOWLEDGE. ALL EXPENSES ARE SUBMITTED FOR APPROVAL BEFORE REIMBURSEMENT.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees THE ORGANIZATION HAS IN PLACE A MANAGEMENT SELF DEVELOPMENT PLAN (MSDP) DESIGNED TO PROMOTE PROFESSIONAL AND PERSONAL DEVELOPMENT. THE MSDP IS CAPPED AT 2% OF GROSS PAY AND MAY BE UTILIZED FOR EXPENSES SUCH AS PROFESSIONAL DUES, MEETINGS AND SEMINARS, TUITION REIMBURSEMENT, AND OTHER MISCELLANEOUS ITEMS THAT PROMOTE PROFESSIONAL KNOWLEDGE. ALL EXPENSES ARE SUBMITTED FOR APPROVAL BEFORE REIMBURSEMENT.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE CEO IS PAID BY DARTMOUTH-HITCHCOCK CLINIC (DHC), A RELATED ORGANIZATION, WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE CEO'S COMPENSATION.
Schedule J, Part I, Line 4a Severance or change-of-control payment BARBARA VANCE WHO SERVED AS VP-RESEARCH OPERATIONS RECEIVED SEVERANCE PAYMENTS TOTALING $189,965.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Dartmouth Hitchcock Clinic (DHC) and Mary Hitchcock Memorial Hospital (MHMH) sponsor a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable DHC and MHMH to attract and retain quality executive personnel, improve the physicians' post-retirement life insurance benefits, and to replace an increasingly costly retiree life insurance program. The plan was frozen to new participants in 1998. The number of participants and dollar value continues to dwindle as individuals retire/leave the organization. THE FOLLOWING INDIVIDUALS HAVE A SPLIT DOLLAR LIFE PLAN ARRANGEMENT AND RESPECTIVE EMPLOYER PREMIUMS: DANIEL JANTZEN $152,890 STEPHEN LEBLANC $70,131 Separate from the Split Dollar Life plan, the following individuals received payments from a nonqualified retirement plan (which are reflected in schedule J, Part II, Column B (III)): Staci Hermann $4,512 Wendy Fielding $13,607 Joanne Conroy $190,800 David Duncan $431 Patrick Jordan $73,201 Edward Merrens $66,150 Stephen LeBlanc $65,562 Jonathan Thyng $4,800 Keith Loud $12,480 Laura Chiang $2,586 Marcus Coe $46,244 Aimee Claiborne $24,576 Nancy Dunbar $7,460 Maria Padin $25,884 Simon Hillier $33,600 Kimberly Troland $29,340 Matthew Haag $14,931 Emily Zeitler $10,600 Peter Solberg $24,600 Barbara Vance $1,206 Christopher Hubble $3,600 Jennifer Gilkie $1,979 Martin Manion $2,032 Martin Purcell $26,907 Samuel Shields $2,885
Schedule J, Part II NOTE REGARDING COMPENSATION FORM 990, SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY MHMH AND RELATED ORGANIZATIONS. THESE AMOUNTS ARE REPORTED TO EMPLOYEES ON THEIR ANNUAL W-2 FORMS AS COMPENSATION. COLUMNS C AND D REPRESENT ITEMS EARNED, HOWEVER, NOT PAID DIRECTLY TO THE EMPLOYEE AS CASH PAYMENTS DURING THE CALENDAR YEAR. COLUMN C INCLUDES RETIREMENT BENEFITS IN A CALENDAR YEAR. COLUMN D REPRESENTS NONTAXABLE BENEFITS SUCH AS THE COST OF HEALTHCARE COVERAGE PROVIDED BY D-H ON BEHALF OF ITS EMPLOYEES.
Schedule J (Form 990) (Rev. 1-2025)

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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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public
Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number
02-0222140
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
Yes No Yes No Yes No
A NH HEALTH AND ED FACILITIES AUTHORITY
  		02-0279866 64461XMG7 05-28-2025 321,411,451 REFUNDING AND CONSTRUCTION   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 0      
2 Amount of bonds legally defeased .............. 0      
3 Total proceeds of issue .................. 321,411,451      
4 Gross proceeds in reserve funds ............. 0      
5 Capitalized interest from proceeds ............. 0      
6 Proceeds in refunding escrows ............... 0      
7 Issuance costs from proceeds ............... 2,296,135      
8 Credit enhancement from proceeds ............. 0      
9 Working capital expenditures from proceeds ............. 0      
10 Capital expenditures from proceeds ............. 998,386      
11 Other spent proceeds ............. 114,449,656      
12 Other unspent proceeds ............. 203,667,274      
13 Year of substantial completion .............
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 2020, a current refunding issue)? ........ 		X              
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........ 		  X            
16 Has the final allocation of proceeds been made? ..........   X            
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) (Rev. 1-2025)

Schedule K (Form 990) (Rev. 1-2025)
Page 2
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            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X              
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. 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? X              
c Are there any research agreements that may result in private business use of bond-financed property? .............   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? X              
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 %      
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 %      
6 Total of lines 4 and 5 ............. 0 %      
7 Does the bond issue meet the private security or payment test? ...   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            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 %      
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X            
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              
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            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X              
b Exception to rebate? ........   X            
c No rebate due? .........   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              
Schedule K (Form 990) (Rev. 1-2025)

Schedule K (Form 990) (Rev. 1-2025)
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge ......... 0 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........   X            
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC ......... 0 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........   X            
6 Were any gross proceeds invested beyond an available temporary period?   X            
7 Has the organization established written procedures to monitor the requirements of section 148? ... 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              
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Schedule K, Part I, Column (a) Bond A THE ISSUER NAME IS NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY.
Schedule K, Part I, Column (f) Bond A Refund DHOG Series 2014B Dated 08/13/2014, DHOG Series 2016B Dated 07/01/2016, DHOG Series 2017B Dated 12/27/2017, and finance new capital projects.
Schedule K, Part II, Line 11 Bond A The Other Spent Proceeds are the refunding proceeds of the issue no longer in escrow.
Schedule K (Form 990) (Rev. 1-2025)

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Software ID: 24020961
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Schedule L
(Form 990)
(Rev. January 2025)
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.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $
 

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?
To From Yes No Yes No Yes No
(1) DANIEL JANTZEN
  		OFFICER SPLIT DOLLAR LIFE   X 0 152,890   No Yes   Yes  
(2) DEBORAH JANTZEN
  		FAMILY MEMBER SPLIT DOLLAR LIFE   X 0 76,965   No Yes   Yes  
Total ............... $ 229,855
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) (Rev. 1-2025)
Schedule L (Form 990) (Rev. 1-2025)
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?
Yes No
(1) Samuel R Shields
  		Family member of Key Employee Samuel N Shields 37,181 Employment Compensation   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) (Rev. 1-2025)


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Software ID: 24020961
Software Version: 2024v5.1




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large image 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
2024
Open to Public Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
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 ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..   1 14,580 Opinions of experts
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .   3 66,353 Market value
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 ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
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
29
1
Yes
No
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
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
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) (2024)
Schedule M (Form 990) (2024)
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, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributions THE ORGANIZATION USES DARTMOUTH-HITCHCOCK HEALTH, MHMH'S PARENT ORGANIZATION, FOR SOLICITATION OF CONTRIBUTIONS AND ANNUAL FUND ACTIVITIES.
Schedule M, Part I Explanations of reporting method for number of contributions Securities - Publicly traded - MHMH is reporting the number of contributors of stock.
Schedule M (Form 990) (2024)

Additional Data


Software ID: 24020961
Software Version: 2024v5.1
SCHEDULE O
(Form 990)
(Rev. January 2025)
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.
Attach to Form 990 or 990-EZ.
 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public
Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
Return Reference Explanation
Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION Continued from Form 990 Part III Line 4a DARTMOUTH-HITCHCOCK CLINIC (DHC) PROVIDES THE PHYSICIAN STAFF FOR THE HOSPITAL AND THE SOPHISTICATION ESSENTIAL FOR THE DEVELOPMENT OF THE HOSPITAL AS THE LARGEST ACADEMIC MEDICAL CENTER IN NEW HAMPSHIRE, ALONG WITH THE DESIGNATION BY THE FEDERAL GOVERNMENT AS A RURAL REFERRAL CENTER FOR NORTHERN NEW ENGLAND. THE SHARED MISSION OF MHMH AND DHC IS TO ADVANCE HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME. CONSISTENT WITH THIS MISSION AND IN PARTNERSHIP WITH DHC, MHMH PROVIDES HIGH-QUALITY, COST-EFFECTIVE, COMPREHENSIVE, AND INTEGRATED HEALTH CARE TO INDIVIDUALS, FAMILIES, AND THE COMMUNITIES IT SERVES, REGARDLESS OF A PATIENT'S ABILITY TO PAY. THROUGH FORMAL AFFILIATIONS AND OTHER CLINICAL COLLABORATIONS, MHMH ALSO SEEKS TO PARTNER WITH OTHER AREA HEALTH CARE PROVIDERS TO IMPROVE THE HEALTH STATUS OF THE REGION. * THE JACK BYRNE CENTER FOR PALLIATIVE & HOSPICE CARE COORDINATES MHMH'S CLINICAL, EDUCATIONAL, AND RESEARCH EFFORTS AND VISITING NURSE ALLIANCES AROUND THE REGION TO OFFER MUCH-NEEDED END-OF-LIFE CARE FOR PATIENTS IN A CLINICAL SETTING THAT MEETS THE NEEDS OF PATIENTS AND THEIR FAMILIES. * MHMH ALSO CONTINUES TO BUILD ITS TELE-MEDICINE PROGRAM TO PROVIDE CARE ACROSS ITS RURAL REGION AND IN PARTICULAR TO MAKE SPECIALIST CONSULTATION AND CARE AVAILABLE TO CRITICAL ACCESS AND COMMUNITY HOSPITALS. THIS ALLOWS CAREGIVERS AT REMOTE LOCATIONS TO ACCESS SPECIALISTS AT MHMH AND DHC AND TO BRING THEM "VIRTUALLY" TO THE PATIENT'S BEDSIDE. MHMH'S CONNECTED CARE CENTER FOR TELE-HEALTH IN LEBANON OFFERS A 24/7 TEAM OF PHYSICIANS, PHARMACISTS, AND NURSES SUPPORTING THE FOLLOWING ACUTE CARE TELE-HEALTH SERVICE LINES: TELE-EMERGENCY, TELE-PHARMACY, TELE-NEUROLOGY, TELE-ICU, TELE-PSYCHIATRY, AND TELE-NEONATOLOGY; OUTPATIENT TELE-URGENT CARE 7 DAYS/WEEK; AND OUTPATIENT VIRTUAL VISITS IN PEDIATRICS AND MORE THAN 30 SPECIALTY SERVICES TO PATIENTS IN 17 CLINICAL LOCATIONS ALONG WITH PATIENT HOMES. * Center for Advancing Rural Health Equity (CARHE): Mary Hitchcock Memorial Hospital supports the Center for Advancing Rural Health Equity, which focuses on improving access to care, health outcomes, and equity for rural and underserved populations across northern New England. Through research, community partnerships, education, and data-driven initiatives, the Center works to address disparities related to geography, socioeconomic status, and access to specialty and preventive services. This work advances MHMH's mission to improve population health while strengthening care delivery in rural communities. * Project ECHO (Extension for Community Healthcare Outcomes): In partnership with Dartmouth Hitchcock Clinic, MHMH supports Project ECHO, a nationally recognized tele-mentoring model that expands access to specialty knowledge by connecting community-based clinicians with interdisciplinary expert teams. Through regularly-scheduled virtual learning sessions, Project ECHO builds local capacity to manage complex conditions, improves quality of care in community settings, and reduces the need for patients to travel long distances for specialty services. This initiative supports MHMH's academic, educational, and community benefit mission. * DHART Ground and Air Medical Transport: MHMH supports the Dartmouth-Hitchcock Advanced Response Team (DHART), which provides critical ground and air medical transport services across New Hampshire, Vermont, and surrounding regions. DHART enables rapid access to advanced medical care for critically-ill or injured patients, particularly those in rural and remote areas. This service plays a vital role in ensuring timely, life-saving care and reinforces MHMH's role as a regional tertiary and referral center. * Community Immunization and Population Health Initiatives: Through its population health efforts, MHMH supports community-based immunization programs designed to improve access to preventive care and protect public health. These initiatives are delivered in collaboration with community partners and focus on reaching underserved and at-risk populations across the region. By promoting vaccination and disease prevention, MHMH contributes to improved community health outcomes and reduced preventable illness. MHMH PARTNERS WITH REGIONAL COLLEGES (INCLUDING COLBY-SAWYER COLLEGE) TO SUPPORT NURSING EDUCATION AND CLINICAL EXPERIENCES FOR STUDENTS AS WELL AS CONTINUING EDUCATION AND CAREER ADVANCEMENT FOR MHMH STAFF. MHMH ALSO PROVIDES TRAINING PROGRAMS FOR ENTRY INTO FRONTLINE HEALTHCARE CAREERS THROUGH THE WORKFORCE READINESS INSTITUTE, A PROGRAM OF MHMH THAT IS A LICENSED CAREER SCHOOL WITH THE STATE OF NEW HAMPSHIRE. MHMH HAS ALSO ESTABLISHED TRAINING PATHWAYS FOR CURRENT HEALTHCARE EMPLOYEES TO ADVANCE THEIR HEALTHCARE CAREERS THROUGH CONTINUED EDUCATION. MHMH OFFERS PAID INTERNSHIP PROGRAMS FOR HIGH SCHOOL AND COLLEGE STUDENTS LOOKING TO EXPLORE HEALTHCARE CAREERS. MHMH ALSO HOSTS THE PROJECT SEARCH PROGRAM FOR STUDENTS WITH INTELLECTUAL DISABILITIES, ALLOWING THESE STUDENTS TO DEVELOP TRANSFERRABLE AND MARKETABLE JOB SKILLS. MHMH AND DHC JOINTLY FILE AN ANNUAL COMMUNITY BENEFITS REPORT WITH THE STATE OF NEW HAMPSHIRE WHICH OUTLINES THE COMMUNITY AND CHARITABLE BENEFITS MHMH AND DHC PROVIDE. THE MOST RECENT COMMUNITY BENEFITS REPORT IS AVAILABLE ON REQUEST. FINANCIAL ASSISTANCE (FORMERLY CALLED "CHARITY CARE") REPRESENTS SERVICES PROVIDED TO PATIENTS WHO CANNOT AFFORD HEALTH CARE SERVICES DUE TO INADEQUATE FINANCIAL RESOURCES WHICH RESULT FROM BEING UNINSURED OR UNDERINSURED. FOR THE YEAR ENDED JUNE 30, 2025, MHMH PROVIDED FINANCIAL ASSISTANCE TO 26,191 PATIENTS IN THE AMOUNT OF $35,221,237 AS MEASURED BY GROSS CHARGES. THE COST OF PROVIDING THIS CARE FOR THE YEAR ENDED JUNE 30, 2024 WAS $28,734,667. MHMH ALSO ROUTINELY PROVIDES SERVICES TO MEDICAID PATIENTS AT REIMBURSEMENT LEVELS THAT ARE BELOW THE COST OF THE CARE PROVIDED. THE COMMUNITY HEALTH ACTIVITIES NOTED INCLUDE THE COST OR VALUE OF SEVERAL DIFFERENT TYPES OF PROGRAMS INCLUDING THE COST OF COMMUNITY-BASED EDUCATION, HEALTH FAIRS, HEALTH SCREENINGS, SUPPORT GROUPS, AND PROGRAMS AND MATERIALS THAT PROMOTE WELLNESS AND PREVENT ILLNESS. EXAMPLES OF THESE TYPES OF EFFORTS INCLUDE PARTNERING WITH THE "HEALTHY EATING ACTIVE LIVING NH" INITIATIVE, THE WOMEN'S HEALTH RESOURCE CENTER, AND SMOKING PREVENTION AND CESSATION PROGRAMS. THIS CATEGORY OF SUPPORT ALSO INCLUDES FINANCIAL CONTRIBUTIONS AND THE DONATION OF TIME AND SERVICES TO COMMUNITY PROGRAMS, HOSPITALS AND AGENCIES. MHMH ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE TO ITS PATIENTS THAT IS REPORTED AS BAD DEBT, WHICH IS NOT INCLUDED IN THE AMOUNTS REPORTED ABOVE. DURING THE YEAR ENDED JUNE 30, 2025, THE HOSPITAL REPORTED EXPENSE FOR BAD DEBT OF $40,911,127.
Form 990, Part VI, Line 15a OFFICES & POSITIONS FOR WHICH PROCESS WAS USED & YEAR UNDERTAKEN ALTHOUGH PAID BY A RELATED ORGANIZATION, DARTMOUTH-HITCHCOCK CLINIC, THE COMPENSATION FOR THE CEO IS EVALUATED BY AN INDEPENDENT THIRD PARTY FIRM FOR REASONABLENESS AND NATIONAL DATA BENCHMARKING. THE TALENT DEVELOPMENT AND COMPENSATION COMMITTEE, ALONG WITH INDEPENDENT TRUSTEES, APPROVE THE FINAL COMPENSATION IN CONSIDERATION WITH THE INDEPENDENT THIRD PARTY FIRM'S RECOMMENDATIONS AND SUGGESTIONS. THIS PROCESS WAS CONTEMPORANEOUSLY DOCUMENTED AND LAST UNDERTAKEN IN 2024.
Form 990, Part VI, Line 1a Delegate broad authority to a committee The Mary Hitchcock Memorial Hospital (MHMH) board has a Governance Committee who has the authority/responsibility of the MHMH Board to ensure that MHMH continues to fulfill its central mission and vision. This committee has authority to act on behalf of the full Board when the need arises. Members are all members of the governing board.
Form 990, Part VI, Line 6 Classes of members or stockholders DARTMOUTH-HITCHCOCK HEALTH (D-HH) IS THE SOLE CORPORATE MEMBER OF MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH).
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body D-HH HAS SPECIFIC AUTHORITY AND RESERVED POWERS, INCLUDING THE POWER TO CONFIRM THE ELECTION OF MEMBERS OF MHMH'S BOARD OF TRUSTEES AND THE POWER TO APPROVE SIGNIFICANT GOVERNANCE, FINANCIAL, AND OPERATIONAL DECISIONS OF MHMH'S TRUSTEES.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders IN ADDITION TO RESERVED POWERS, DARTMOUTH-HITCHCOCK HEALTH (D-HH) SHALL HAVE THE AUTHORITY TO TAKE ACTIONS TO ESTABLISH, MANAGE, AND GOVERN MHMH TO CREATE AND MAINTAIN AN INTEGRATED HEALTH CARE DELIVERY SYSTEM IN FURTHERANCE OF THE MISSION OF MHMH AND OTHER ORGANIZATIONS WITHIN THE SYSTEM. THESE POWERS INCLUDE BUT ARE NOT LIMITED TO ITEMS SUCH AS THE ABILITY TO APPROVE, DISAPPROVE, OR MODIFY ALL MATERIAL GOVERNANCE, PROGRAMMATIC, AND FINANCIAL DECISIONS OF MHMH'S BOARD OF TRUSTEES, TO APPOINT OR REMOVE A MEMBER OF MHMH'S BOARD OF TRUSTEES, ASSESS MHMH A MONETARY AMOUNT FOR THE PAYMENT OF THE EXPENSES OF D-HH, APPROVE MHMH'S BUDGET, APPROVE THE BORROWINGS OR DISPOSITIONS OF ASSETS BY MHMH, APPROVE KEY STRATEGIC RELATIONSHIPS, APPROVE THE ELIMINATION OR ADDITION OF ANY MATERIAL HEALTH CARE SERVICE OR PROGRAM, AND OTHER AUTHORITY TO TAKE ACTION ON BEHALF OF MHMH.
Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCIAL COMPLIANCE, THE VICE PRESIDENT OF CORPORATE FINANCE, THE CHIEF FINANCIAL OFFICER, AND EXTERNAL TAX ADVISORS BEFORE THE FILING OF THE RETURN. ONCE THE RETURN HAS BEEN FULLY PREPARED, A FINAL FORM 990 IS SENT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS AND RESPONSES PRIOR TO OFFICIAL FILING.
Form 990, Part VI, Line 12c Conflict of interest policy THE MARY HITCHCOCK MEMORIAL HOSPITAL BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF-DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. THE DARTMOUTH-HITCHCOCK HEALTH (D-HH) COMPLIANCE AND AUDIT SERVICES DEPARTMENT CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS, TRUSTEES, AND KEY EMPLOYEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION-MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
Form 990, Part VI, Line 15b Process to establish compensation of other employees COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS EVALUATED BY INTERNAL HUMAN RESOURCES STAFF USING NATIONAL BENCHMARKING DATA (ALONG WITH ONGOING EVALUATIONS AND APPROVAL BY AN INDEPENDENT THIRD-PARTY FIRM FOR REASONABLENESS). THE LAST FORMAL PROCESS WAS COMPLETED IN 2025 AND CONTEMPORANEOUSLY DOCUMENTED. EXTERNAL BENCHMARKING FROM AN INDEPENDENT THIRD PARTY HAS BEEN USED FOR ANY OFFICER WHO WAS HIRED OR RECEIVED A COMPENSATION ADJUSTMENT SINCE THE LAST FORMAL PROCESS. COMPENSATION RATES ARE DETERMINED BY FOLLOWING THE GUIDELINES OF THE COMPENSATION COMMITTEE CHARTER AND PHILOSOPHY DOCUMENTS AND A FORMAL REVIEW BY COMPENSATION COMMITTEE MEMBERS. THE PROCESS DESCRIBED ABOVE TO ESTABLISH COMPENSATION WAS USED FOR THE FOLLOWING POSITIONS: Chief Financial Officer, Chief Strategy Officer, Chief Clinical Officer, Chief Legal Officer, Chief Human Resources Officer, Chief Operating Officer, Chief Nursing - Executive, Chief Nursing Officer, Chief Pharmacy Officer, Chief Quality & Value Officer, Department Chair - Anesthesia, Department Chair - Radiology, Department Chair - Pathology and similar positions.
Form 990, Part VI, Line 19 Required documents available to the public MHMH'S GOVERNING DOCUMENTS ARE AVAILABLE THROUGH THE NEW HAMPSHIRE SECRETARY OF STATE. THE AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST EITHER IN ELECTRONIC OR HARD COPY FORM.
Form 990, Part VII, Section A, Line 1a, Column (B) AVERAGE HOURS PER WEEK AS PART OF DARTMOUTH-HITCHCOCK CLINIC AND MARY HITCHCOCK MEMORIAL HOSPITAL'S AFFILIATION AGREEMENT, THE TWO ORGANIZATIONS SHARE OFFICERS. AS SUCH, THE AVERAGE HOURS PER WEEK ARE ALLOCATED BETWEEN THE TWO ORGANIZATIONS' FORMS 990 EVEN THOUGH COMPENSATION REPORTED IN PART VII IS BASED ON THE ENTITY ISSUING THE W-2. IN ADDITION, CERTAIN OFFICERS SPEND TIME ON DARTMOUTH-HITCHCOCK HEALTH (THE SOLE CORPORATE MEMBER OF BOTH MHMH AND DHC), AND/OR DARTMOUTH-HITCHCOCK CLINIC ALONG WITH OTHER AFFILIATED ORGANIZATIONS: DARTMOUTH-HITCHCOCK MEDICAL CENTER, HAMDEN RISK RETENTION GROUP (AND RELATED ENTITIES), ALICE PECK DAY MEMORIAL HOSPITAL, WINDSOR HOSPITAL CORPORATION (DBA MT ASCUTNEY HOSPITAL AND HEALTH CENTER), MT. ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION, HISTORIC HOMES OF RUNNEMEDE, CHESHIRE MEDICAL CENTER, CHESHIRE HEALTH FOUNDATION, CHESHIRE HEALTH SERVICES, THE NEW LONDON HOSPITAL ASSOCIATION, VNA & HOSPICE OF VT AND NH, THE HITCHCOCK FOUNDATION, AND SOUTHWESTERN VERMONT HEALTH CARE CORPORATION.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances NET ASSET TRANSFER FROM AFFILIATES - 26185636; PENSION-RELATED AND OTHER CHANGES - -55618141; NET ASSET RELEASED FROM RESTRICTION - -17692986; Total - -47125491;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) (Rev. 1-2025)


Additional Data


Software ID: 24020961
Software Version: 2024v5.1
SCHEDULE R
(Form 990)
(Rev. January 2025)
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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
Open to Public Inspection
Name of the organization
Mary Hitchcock Memorial Hospital
 
Employer identification number

02-0222140
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
(1) NEW ENGLAND ALLIANCE FOR HEALTH LLC
ONE MEDICAL CENTER DRIVE
LEBANON,NH03756
26-4232401 		HEALTH IMPROVEMENT NH 138,423 1,382,379 MHMH
 
(2) D-H SPECIALTY SERVICES LLC
ONE MEDICAL CENTER DRIVE
LEBANON,NH03756
46-0876427 		SHARED SAVINGS PROGRAM NH 0 0 MHMH
 








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?
Yes No
(1)DARTMOUTH-HITCHCOCK CLINIC
ONE MEDICAL CENTER DRIVE

LEBANON,NH03756
22-2519596 		PHYSICIAN SERVICES NH 501(c)(3) 10 D-HH
 
 
No
(2)DARTMOUTH-HITCHCOCK HEALTH
ONE MEDICAL CENTER DRIVE

LEBANON,NH03756
26-4812335 		PARENT ORGANIZATION NH 501(c)(3) 7 NA
 
 
No
(3)THE NEW LONDON HOSPITAL ASSOCIATION INC
273 COUNTY ROAD

NEW LONDON,NH03257
02-0222171 		HOSPITAL NH 501(c)(3) 3 D-HH
 
 
No
(4)WINDSOR HOSPITAL CORPORATION
289 COUNTY ROAD

WINDSOR,VT05089
03-0183721 		HOSPITAL VT 501(c)(3) 3 D-HH
 
 
No
(5)CHESHIRE MEDICAL CENTER
580 COURT STREET

KEENE,NH03431
02-0354549 		HOSPITAL NH 501(c)(3) 3 D-HH
 
 
No
(6)ALICE PECK DAY MEMORIAL HOSPITAL
10 ALICE PECK DAY DRIVE

LEBANON,NH03766
02-0222791 		HOSPITAL NH 501(c)(3) 3 D-HH
 
 
No
(7)DARTMOUTH HEALTH HOME CARE INC
88 Prospect Street

White River JUNCTION,VT05001
03-6006494 		HOSPICE VT 501(c)(3) 10 D-HH
 
 
No
(8)DARTMOUTH -HITCHCOCK MEDICAL CENTER
ONE MEDICAL CENTER DRIVE

LEBANON,NH03756
22-2715483 		SUPPORTING ORGANIZATION NH 501(c)(3) Type I NA
 
 
No
(9)SOUTHWESTERN VERMONT HEALTH CARE CORPORATION
100 HOSPITAL DRIVE

BENNINGTON,VT05201
03-0179435 		HOSPITAL VT 501(c)(3) 3 D-HH
 
 
No
(10)VALLEY REGIONAL HEALTHCARE INC
243 ELM STREET

CLAREMONT,NH03743
02-0397338 		SUPPORTING ORGANIZATION NH 501(c)(3) Type II D-HH
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(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?



 		(k)
Percentage
ownership
Yes No Yes No
(1) DARTMOUTH-HITCHCOCK MASTER INVESTMENT PROGRAM OF POOLED INVESTMENT ACCOUNTS

1 MED CTR DR
LEBANON,NH03756
02-0205863 		POOLED INVESTMENTS NH MHMH
  		Excluded 60,370,160 1,047,183,489   No 1,407,160 Yes   65.633 %












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
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) BENEFICIAL INTEREST TRUSTS (2)

ONE MEDICAL CENTER DRIVE
LEBANON,NH03756
 CHARITABLE TRUST NH MHMH
  		Trust 0 0 100 %   No












Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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) (Rev. 1-2025)

Additional Data


Software ID: 24020961
Software Version: 2024v5.1