Skip to content
Nonprofiteer
← ALICE PECK DAY MEMORIAL HOSPITAL

Form 990 for tax year 2022

Filed by ALICE PECK DAY MEMORIAL HOSPITAL.

Totals

Total revenue
$105,043,692
Total expenses
$95,559,929
Contributions and grants received
$2,845,272
Grants paid
$26,883
Program service revenue
$100,955,821
Investment income
$408,974
Other revenue
$833,625
Total assets, end of year
$126,644,590
Total liabilities, end of year
$60,454,188
Net assets or fund balances, end of year
$66,190,402
Program services expenses (Part IX)
$83,848,352
Management and general expenses
$11,278,377
Fundraising expenses
$433,200
Program service expenses (Part III)
$83,848,352

Program services were 87.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $342,367

  • 1f · All other contributions, gifts and grants

    $2,502,905

  • 1g · Noncash contributions included above

    $16,083

  • 2a · Program service revenue: Patient Services

    total $98,694,305 · related or exempt $98,694,305

  • 2b · Program service revenue: Nutritional Services

    total $178,965 · related or exempt $178,965

  • 2c · Program service revenue: PHARMACY SALES

    total $2,082,551 · related or exempt $2,082,551

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $408,974 · unrelated business $11,764 · excluded $397,210

  • 6a · Gross rents

    real property $176,242

  • 6c · Rental income or loss

    real property $176,242 · personal property $0

  • 6d · Net rental income or loss

    total $176,242 · excluded $176,242

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11a · Other revenue: PURCHASE REBATES AND DISCOUNTS

    total $219,607 · related or exempt $219,607

  • 11b · Other revenue: MISCELLANEOUS

    total $437,776 · related or exempt $437,776

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $657,383

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $26,883 · program services $26,883

  • 5 · Compensation of officers, directors and key employees

    total $2,806,567 · program services $1,350,831 · management and general $1,430,315 · fundraising $25,421

  • 7 · Other salaries and wages

    total $46,689,754 · program services $44,332,636 · management and general $2,009,315 · fundraising $347,803

  • 8 · Pension plan contributions

    total $1,435,076 · program services $1,366,110 · management and general $58,790 · fundraising $10,176

  • 9 · Other employee benefits

    total $4,740,318 · program services $4,512,511 · management and general $194,193 · fundraising $33,614

  • 10 · Payroll taxes

    total $2,282,561 · program services $2,172,867 · management and general $93,508 · fundraising $16,186

  • 11b · Fees: legal

    total $9,182 · program services $9,182

  • 11c · Fees: accounting

    total $11,475 · program services $11,475

  • 11g · Fees: other

    total $6,551,827 · program services $2,609,824 · management and general $3,942,003 · fundraising $0

  • 12 · Advertising and promotion

    total $62,423 · program services $62,188 · management and general $235

  • 13 · Office expenses

    total $225,916 · program services $126,789 · management and general $99,127

  • 14 · Information technology

    total $249,822 · program services $860 · management and general $248,962

  • 16 · Occupancy

    total $2,405,272 · program services $2,282,527 · management and general $122,745

  • 17 · Travel

    total $104,941 · program services $70,878 · management and general $34,063

  • 20 · Interest

    total $805,097 · program services $344,879 · management and general $460,218

  • 22 · Depreciation, depletion and amortization

    total $3,372,417 · program services $2,805,573 · management and general $566,844

  • 23 · Insurance

    total $591,441 · program services $462,279 · management and general $129,162

  • 24a · Other expenses: Drugs/medical supplies

    total $14,636,319 · program services $14,636,319

  • 24b · Other expenses: Medicaid Enhancement Tax

    total $4,426,365 · program services $4,426,365

  • 24c · Other expenses: Repairs/maintenance

    total $2,143,207 · program services $1,770,068 · management and general $373,139

  • 24d · Other expenses: STAFF DUES, LICENSES AND EDUCATION

    total $236,558 · program services $43,187 · management and general $193,371

  • 24e · All other expenses

    total $1,746,508 · program services $424,121 · management and general $1,322,387 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $23,774,817 · end of year $34,977,939

  • 2 · Savings and temporary cash investments

    beginning of year $15,148,336 · end of year $5,772,155

  • 4 · Accounts receivable

    beginning of year $10,584,815 · end of year $10,892,710

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $10,062,109 · end of year $9,254,233

  • 8 · Inventories for sale or use

    beginning of year $483,860 · end of year $432,490

  • 9 · Prepaid expenses and deferred charges

    beginning of year $296,108 · end of year $477,128

  • 10a · Land, buildings and equipment: cost or other basis

    $69,984,441

  • 10b · Land, buildings and equipment: accumulated depreciation

    $42,260,382

  • 10c · Land, buildings and equipment, net

    beginning of year $24,757,285 · end of year $27,724,059

  • 12 · Investments: other securities

    beginning of year $14,900,028 · end of year $15,720,716

  • 13 · Investments: program-related

    beginning of year $0

  • 14 · Intangible assets

    beginning of year $5,131,433 · end of year $5,131,433

  • 15 · Other assets

    beginning of year $16,957,240 · end of year $16,261,727

  • 17 · Accounts payable and accrued expenses

    beginning of year $9,477,976 · end of year $7,463,873

  • 19 · Deferred revenue

    beginning of year $76,941

  • 20 · Tax-exempt bond liabilities

    beginning of year $23,950,003 · end of year $22,860,000

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $33,271,890 · end of year $30,130,315

  • 27 · Net assets without donor restrictions

    beginning of year $54,590,374 · end of year $63,708,222

  • 28 · Net assets with donor restrictions

    beginning of year $728,847 · end of year $2,482,180

Mission and programs · 2022

Mission

To improve the health and wellbeing of our community.

  • Alice Peck Day Memorial Hospital (APD) is a community-based critical access hospital operating in Lebanon, NH. It is a not-for-profit organization as described in Section 501(c)(3) of the Internal Revenue Code (Code) and is exempt from federal income taxes on related income, pursuant to Section 501(a) of the Code. APD operates as an integral component of (and is fully owned by) Dartmouth-Hitchcock Health (D-HH), a New Hampshire not-for-profit corporation organized to support medical organizations like APD. Founded in 1932 and a member of the Dartmouth Health system since 2016, APD's areas of clinical excellence include surgical services, primary care, geriatric care, sleep health, and emergency services.In 2023, Alice Peck Day Memorial Hospital was listed as the #3 hospital in New Hampshire by Newsweek; received top marks from Becker's Hospital Review as one of the best hospitals for nurse communication, physician communication, and staff responsiveness; and was named by U.S. News & World Report to its 2023-2024 Best Hospitals as a High Performing hospital for Hip Replacement. APD's mission is to improve the health and well-being of the community. Our vision is to build a healthier community, one connection at a time. Our values include kindness, community, service, and partnership. APD employed 41 providers in FY23, of which 19 were primary care, 3 were in pediatrics, and 19 were providers in other specialties. During FY23, APD had a total of 965 patient discharges consisting of 6,174 patient days. We also had 11,373 emergency department visits in FY23, open 24 hours a day, 7 days a week..

    Expenses $83,848,352 · Grants $26,883 · Revenue $101,613,204

As filed on the 2022 return.

Listed in Part VII

  • Charles J Wheelan PhD MPA

    Trustee / Vice Chair (as of 1/1/23)

    Total calculated
    $0
    Hours/week
    0.5

  • Clayton R Adams MBA

    Trustee / Treasurer

    Total calculated
    $0
    Hours/week
    2

  • Greg W Lange MS

    Trustee / Chair (through 12/31/22)

    Total calculated
    $0
    Hours/week
    2

  • Jennifer Sage Schiffman MPH

    Trustee / Secretary

    Total calculated
    $0
    Hours/week
    0.5

  • Laura Greer MD

    Trustee/Medical Staff President/ExOfficio (as of 1/1/23)

    Total calculated
    $234,010
    From this org
    $223,252
    From related orgs
    $0
    Other
    $10,758
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $132,362
    Bonus
    $90,890
    Other
    $0
    Deferred
    $4,541
    Nontaxable benefits
    $6,217
    Filer's total
    $234,010

  • Marisa D Devlin

    Trustee/Vice Chair (through 12/31/22)/Chair (as of 1/1/23)

    Total calculated
    $0
    Hours/week
    2

  • Susan Mooney MD Ms Facog

    TRUSTEE/PRESIDENT/CEO APDMH

    Total calculated
    $477,352
    From this org
    $431,970
    From related orgs
    $0
    Other
    $45,382
    Hours/week
    38 + 2 related

    Schedule J breakdown matched by us

    Base
    $334,143
    Bonus
    $75,101
    Other
    $22,726
    Deferred
    $6,100
    Nontaxable benefits
    $39,282
    Filer's total
    $477,352

  • Anna Adachi-Mejia PhD

    Trustee (as of 1/1/23)

    Total calculated
    $0
    Hours/week
    0.5

  • Chelsea Paige

    Trustee (as of 1/1/23)

    Total calculated
    $0
    Hours/week
    0.5

  • Cybele M Merrick MA MS

    Trustee

    Total calculated
    $0
    Hours/week
    0.5

  • David F Duncan

    Trustee

    Total calculated
    $354,700
    From this org
    $0
    From related orgs
    $309,143
    Other
    $45,557
    Hours/week
    0.5 + 40.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $304,108 related
    Bonus
    $0
    Other
    $0 + $5,035 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $27,257 related
    Filer's total
    $0 + $354,700 related

  • Ellesse-Roselee Akr

    Trustee (as of 1/1/23, resigned 3/30/23)

    Total calculated
    $0

  • George T Blike MD Mhcds

    Trustee

    Total calculated
    $166,194
    From this org
    $0
    From related orgs
    $154,960
    Other
    $11,234
    Hours/week
    0.5 + 21 related

    Schedule J breakdown matched by us

    Base
    $0 + $154,960 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $11,234 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $166,194 related

  • Gerard Duprat JR MD FRCP

    Trustee

    Total calculated
    $0
    Hours/week
    0.5

  • Jenny H Barba MBA MHSA

    Trustee

    Total calculated
    $0
    Hours/week
    0.5

  • Kyle Fisher MBA

    Trustee (through 8/31/22)

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Patrick F Jordan III MBA

    Trustee

    Total calculated
    $898,896
    From this org
    $0
    From related orgs
    $829,011
    Other
    $69,885
    Hours/week
    0.5 + 42.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $777,526 related
    Bonus
    $0
    Other
    $0 + $51,485 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $40,635 related
    Filer's total
    $0 + $898,896 related

  • Phillip Collins MD

    Ex-Officio (Through 12/31/22)/President Med Staff

    Total calculated
    $252,079
    From this org
    $212,226
    From related orgs
    $0
    Other
    $39,853
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $204,511
    Bonus
    $4,233
    Other
    $3,482
    Deferred
    $4,318
    Nontaxable benefits
    $35,535
    Filer's total
    $252,079

  • Sara L Kobylenski MSW

    Trustee

    Total calculated
    $0
    Hours/week
    0.5 + 2 related

  • Scott W Rodi MD MPH

    Trustee

    Total calculated
    $584,513
    From this org
    $0
    From related orgs
    $509,984
    Other
    $74,529
    Hours/week
    0.5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $469,447 related
    Bonus
    $0 + $300 related
    Other
    $0 + $40,237 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $45,279 related
    Filer's total
    $0 + $584,513 related

  • Sloane Mayor AIA

    Trustee

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Tina E Naimie CPA MSA MHCDS

    Trustee

    Total calculated
    $344,735
    From this org
    $0
    From related orgs
    $313,173
    Other
    $31,562
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $294,710 related
    Bonus
    $0
    Other
    $0 + $18,463 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $2,312 related
    Filer's total
    $0 + $344,735 related

  • Michael T Lynch MD MBA

    Chief Medical Officer

    Total calculated
    $370,994
    From this org
    $360,478
    From related orgs
    $0
    Other
    $10,516
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $321,695
    Bonus
    $13,153
    Other
    $25,630
    Deferred
    $6,100
    Nontaxable benefits
    $4,416
    Filer's total
    $370,994

  • Todd Roberts

    VP Finance

    Total calculated
    $232,685
    From this org
    $188,301
    From related orgs
    $0
    Other
    $44,384
    Hours/week
    38 + 2 related

    Schedule J breakdown matched by us

    Base
    $168,186
    Bonus
    $13,153
    Other
    $6,962
    Deferred
    $4,022
    Nontaxable benefits
    $40,362
    Filer's total
    $232,685

  • Dale C Vidal MD Ms

    Executive Director MSC

    Total calculated
    $577,332
    From this org
    $526,166
    From related orgs
    $0
    Other
    $51,166
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $483,735
    Bonus
    $13,153
    Other
    $29,278
    Deferred
    $6,100
    Nontaxable benefits
    $45,066
    Filer's total
    $577,332

  • Jean Ten Haken Msn RN Cenp

    CNO/COO

    Total calculated
    $270,195
    From this org
    $246,927
    From related orgs
    $0
    Other
    $23,268
    Hours/week
    40 + 0.5 related

    Schedule J breakdown matched by us

    Base
    $233,000
    Bonus
    $13,153
    Other
    $774
    Deferred
    $5,068
    Nontaxable benefits
    $18,200
    Filer's total
    $270,195

  • Brian Lombardo MD

    PHYSICIAN

    Total calculated
    $302,176
    From this org
    $261,086
    From related orgs
    $0
    Other
    $41,090
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $196,043
    Bonus
    $43,355
    Other
    $21,688
    Deferred
    $5,471
    Nontaxable benefits
    $35,619
    Filer's total
    $302,176

  • Diane Riley MD Caqsh

    Ortho Surgeon Hand Specialist

    Total calculated
    $492,707
    From this org
    $450,013
    From related orgs
    $0
    Other
    $42,694
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $439,756
    Bonus
    $9,069
    Other
    $1,188
    Deferred
    $6,100
    Nontaxable benefits
    $36,594
    Filer's total
    $492,707

  • Ivan Tomek MD

    General Orthopedic Surgeon

    Total calculated
    $620,193
    From this org
    $573,288
    From related orgs
    $0
    Other
    $46,905
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $523,336
    Bonus
    $28,678
    Other
    $21,274
    Deferred
    $6,100
    Nontaxable benefits
    $40,805
    Filer's total
    $620,193

  • John P Houde MD

    Physician

    Total calculated
    $581,233
    From this org
    $529,429
    From related orgs
    $0
    Other
    $51,804
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $517,567
    Bonus
    $10,674
    Other
    $1,188
    Deferred
    $6,100
    Nontaxable benefits
    $45,704
    Filer's total
    $581,233

  • Peter Loescher

    Physician

    Total calculated
    $315,864
    From this org
    $265,152
    From related orgs
    $0
    Other
    $50,712
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $238,378
    Bonus
    $5,500
    Other
    $21,274
    Deferred
    $5,610
    Nontaxable benefits
    $45,102
    Filer's total
    $315,864

  • Brenda L Blair

    Former VP & COO

    Total calculated
    $402,125
    From this org
    $0
    From related orgs
    $343,522
    Other
    $58,603
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $327,318 related
    Bonus
    $0
    Other
    $0 + $16,204 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $29,353 related
    Filer's total
    $0 + $402,125 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 7 Non-fixed payments
Certain Alice Peck Day Memorial Hospital employees listed on Schedule J were paid a bonus in lieu of a 2% cost of living raise for calendar 2022. Instead, management awarded a 2% bonus calculated on base pay.
Schedule J, Part II Form 990, Part VII Section A Former Officer Compensation
Brenda Blair, Mary Hitchcock Memorial Hospital's VP Total Rewards, and former APD Memorial Hospital's VP and Chief Medical Officer transitioned from APDMH to MHMH in May 2019. Because Blair was reported as an Officer on APD's 990 in fiscal year 2019, and in accordance with IRS instructions, Blair's earnings from MHMH are reported on Form 990 Part VII, and Schedule J, Part II.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
13 May 2024
IRS schema version
2022v5.0
Source object
202431349349305408

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.