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Nonprofiteer
← CHESHIRE MEDICAL CENTER

Form 990 for tax year 2022

Filed by CHESHIRE MEDICAL CENTER.

Totals

Total revenue
$263,584,484
Total expenses
$287,817,174
Contributions and grants received
$7,005,336
Grants paid
$730,772
Program service revenue
$253,756,281
Investment income
$209,419
Other revenue
$2,613,448
Total assets, end of year
$146,820,184
Total liabilities, end of year
$93,638,347
Net assets or fund balances, end of year
$53,181,837
Program services expenses (Part IX)
$259,322,489
Management and general expenses
$27,748,762
Fundraising expenses
$745,923
Program service expenses (Part III)
$259,322,489

Program services were 90.1% 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.

  • 1d · Related organizations

    $1,601,947

  • 1e · Government grants (contributions)

    $5,160,415

  • 1f · All other contributions, gifts and grants

    $242,974

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $249,873,000 · related or exempt $249,873,000

  • 2b · Program service revenue: PHARMACY REVENUE

    total $3,865,179 · related or exempt $3,768,436 · unrelated business $96,743

  • 2c · Program service revenue: Laboratory Services

    total $18,102 · related or exempt $0 · unrelated business $18,102

  • 2f · All other program service revenue

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

  • 3 · Investment income

    total $209,419 · unrelated business $26,183 · excluded $183,236

  • 6a · Gross rents

    real property $8,740

  • 6c · Rental income or loss

    real property $8,740 · personal property $0

  • 6d · Net rental income or loss

    total $8,740 · excluded $8,740

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11a · Other revenue: Rebates and Discounts

    total $729,041 · related or exempt $729,041

  • 11b · Other revenue: Food Services

    total $968,701 · excluded $968,701

  • 11c · Other revenue: Childcare Revenue

    total $640,708 · excluded $640,708

  • 11d · All other revenue

    total $266,258 · related or exempt $266,258 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $2,604,708

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $567,082 · program services $567,082

  • 2 · Grants to domestic individuals

    total $163,690 · program services $163,690

  • 5 · Compensation of officers, directors and key employees

    total $1,100,916 · program services $50,250 · management and general $1,031,975 · fundraising $18,691

  • 7 · Other salaries and wages

    total $75,488,664 · program services $68,384,330 · management and general $6,684,111 · fundraising $420,223

  • 8 · Pension plan contributions

    total $2,405,378 · program services $1,940,417 · management and general $437,458 · fundraising $27,503

  • 9 · Other employee benefits

    total $25,321,829 · program services $22,938,760 · management and general $2,242,110 · fundraising $140,959

  • 10 · Payroll taxes

    total $4,490,868 · program services $4,068,227 · management and general $397,642 · fundraising $24,999

  • 11b · Fees: legal

    total -$258,826 · management and general -$258,826

  • 11d · Fees: lobbying

    total $9,250 · program services $9,250

  • 11g · Fees: other

    total $88,730,176 · program services $86,354,158 · management and general $2,345,135 · fundraising $30,883

  • 12 · Advertising and promotion

    total $170,821 · program services $169,976 · fundraising $845

  • 13 · Office expenses

    total $1,416,302 · program services $1,097,253 · management and general $312,237 · fundraising $6,812

  • 14 · Information technology

    total $338,012 · program services $319,285 · fundraising $18,727

  • 16 · Occupancy

    total $6,696,532 · program services $1,554,197 · management and general $5,142,335

  • 17 · Travel

    total $133,953 · program services $98,614 · management and general $32,893 · fundraising $2,446

  • 20 · Interest

    total $1,031,456 · program services $1,031,456

  • 22 · Depreciation, depletion and amortization

    total $8,613,851 · program services $3,342,921 · management and general $5,270,930

  • 23 · Insurance

    total $2,430,126 · program services $2,183,757 · management and general $246,369

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $45,486,968 · program services $45,486,968

  • 24b · Other expenses: MEDICAID ENHANCEMENT & PILOT TAXES

    total $9,844,259 · program services $9,844,259

  • 24c · Other expenses: FOOD AND CAFETERIA EXPENSES

    total $1,049,214 · program services $1,049,214

  • 24d · Other expenses: EQUIPMENT RENTAL AND MAINTENANCE

    total $5,560,506 · program services $3,560,735 · management and general $1,999,771

  • 24e · All other expenses

    total $7,026,147 · program services $5,107,690 · management and general $1,864,622 · fundraising $53,835

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $20,164,964 · end of year $14,078,490

  • 2 · Savings and temporary cash investments

    beginning of year $248 · end of year $248

  • 4 · Accounts receivable

    beginning of year $18,220,184 · end of year $17,489,115

  • 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 $432,873

  • 8 · Inventories for sale or use

    beginning of year $4,019,770 · end of year $3,818,437

  • 9 · Prepaid expenses and deferred charges

    beginning of year $890,395 · end of year $965,562

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

    $267,805,168

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

    $198,741,904

  • 10c · Land, buildings and equipment, net

    beginning of year $63,066,866 · end of year $69,063,264

  • 12 · Investments: other securities

    beginning of year $28,147,145 · end of year $24,779,211

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $17,359,667 · end of year $16,625,857

  • 17 · Accounts payable and accrued expenses

    beginning of year $20,877,088 · end of year $16,793,861

  • 19 · Deferred revenue

    beginning of year $394,847 · end of year $5,453,584

  • 20 · Tax-exempt bond liabilities

    beginning of year $22,732,055 · end of year $21,821,546

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $35,880,202 · end of year $49,569,356

  • 27 · Net assets without donor restrictions

    beginning of year $53,624,430 · end of year $34,388,347

  • 28 · Net assets with donor restrictions

    beginning of year $18,793,490 · end of year $18,793,490

Mission and programs · 2022

Mission

THE MISSION OF CHESHIRE MEDICAL CENTER IS TO LEAD OUR COMMUNITY TO OPTIMAL HEALTH AND WELLNESS THROUGH OUR CLINICAL AND SERVICE EXCELLENCE, COLLABORATION, AND COMPASSION FOR EVERY PATIENT, EVERY TIME.

Activities or mission (Part I)

TO LEAD OUR COMMUNITY TO OPTIMAL HEALTH AND WELLNESS THROUGH OUR CLINICAL AND SERVICE EXCELLENCE, COLLABORATION, AND COMPASSION FOR EVERY PATIENT, EVERY TIME.

  • THE CHESHIRE MEDICAL CENTER (CMC) IS A COMMUNITY HOSPITAL LOCATED IN KEENE, NEW HAMPSHIRE. CMC IS A NOT-FOR-PROFIT ORGANIZATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS AFFILIATED WITH DARTMOUTH-HITCHCOCK HEALTH ("D-HH"), A NOT-FOR-PROFIT TAX-EXEMPT CORPORATION WITH A PRINCIPAL PLACE OF BUSINESS AT ONE MEDICAL CENTER DRIVE, LEBANON, NEW HAMPSHIRE. CONSISTENT WITH THE D-HH VISION AND STRATEGY TO CREATE A SUSTAINABLE HEALTH SYSTEM, CMC AND D-HH SHARE A COMMON COMMITMENT TO IMPROVING POPULATION HEALTH, VALUE-BASED CARE, AND CREATING NEW PAYMENT MODELS FOR THE BENEFIT OF THE CITIZENS OF NEW HAMPSHIRE AND VERMONT. CMC PROVIDES A BROAD RANGE OF PATIENT SERVICES AND HEALTH-RELATED COMMUNITY SERVICES, CONSISTENT WITH ITS ROLE AS A COMMUNITY HOSPITAL. THESE INCLUDE A FULL RANGE OF SERVICES IN BOTH ACUTE AND CRITICAL MEDICINE, SURGERY, AND REHABILITATION. DURING FY23, CMC PROVIDED 253,448 PROVIDER VISITS AND HAD 3,406 HOSPITAL ADMISSIONS AND DISCHARGES. THE EMERGENCY DEPARTMENT WAS OPEN TO THE PUBLIC 24 HOURS PER DAY, 7 DAYS PER WEEK AND HAD 24,907 ER PATIENT VISITS. THERE ARE A TOTAL OF 222 PROVIDERS CONSISTING OF 128 PHYSICIANS AND 94 ASSOCIATE PROVIDERS. EACH YEAR CHESHIRE MEDICAL CENTER FILES AN ANNUAL COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW HAMPSHIRE WHICH OUTLINES THE COMMUNITY AND CHARITABLE BENEFITS CMC PROVIDES. THE MOST RECENT COMMUNITY BENEFIT REPORTS ARE AVAILABLE UPON REQUEST OR CAN BE FOUND ON CMC'S WEBSITE (https://www.cheshiremed.org/about/reports-community). THE COMMUNITY HEALTH ACTIVITIES INCLUDE THE COST OR VALUE OF SEVERAL DIFFERENT TYPES OF PROGRAMS INCLUDING THE COST OF COMMUNITY-BASED EDUCATION PROGRAMS INVOLVING A VARIETY OF CHRONIC DISEASE AND WELLNESS TOPICS SUCH AS STRESS MANAGEMENT AND RESILIENCY, NUTRITION, PHYSICAL EDUCATION AND EXERCISE, HIGH BLOOD PRESSURE PREVENTION AND MONITORING, DIABETES PREVENTION AND MONITORING, ADVANCED DIRECTIVE PLANNING, AND OTHERS. IN TOTAL, CMC PROVIDED ALMOST $23 MILLION IN COMMUNITY BENEFITS INCLUDING UNREIMBURSED CHARITY CARE, HEALTH SERVICES, HEALTH PROFESSION EDUCATION, SUBSIDIZED HEALTH SERVICES, AND COMMUNITY-BUILDING ACTIVITIES. THESE CONTRIBUTIONS ARE IN ADDITION TO THE OVER $33.8 MILLION DOLLARS IN UNREIMBURSED MEDICARE COSTS ABSORBED BY CMC.

    Expenses $259,322,489 · Grants $730,772 · Revenue $254,636,735

As filed on the 2022 return.

Listed in Part VII

  • Barbara Duckett

    Trustee/Secretary

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Claire Fabian MD

    Trustee (10/31/22)

    Total calculated
    $399,990
    From this org
    $0
    From related orgs
    $341,761
    Other
    $58,229
    Hours/week
    0.5 + 40.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $313,325 related
    Bonus
    $0
    Other
    $0 + $28,436 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $28,979 related
    Filer's total
    $0 + $399,990 related

  • Don Caruso MD

    TRUSTEE/CEO/PRESIDENT (through 5/26/23)

    Total calculated
    $565,957
    From this org
    $0
    From related orgs
    $500,413
    Other
    $65,544
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $449,237 related
    Bonus
    $0
    Other
    $0 + $51,176 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $36,294 related
    Filer's total
    $0 + $565,957 related

  • Kathryn Willbarger

    Trustee (as of 5/27/23) / COO / Interim CEO (as of 5/27/23)

    Total calculated
    $333,061
    From this org
    $302,306
    From related orgs
    $0
    Other
    $30,755
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $301,662
    Bonus
    $0
    Other
    $644
    Deferred
    $27,227
    Nontaxable benefits
    $3,528
    Filer's total
    $333,061

  • Les Pitts MD

    Trustee/Ex-Officio (as of 11/1/22)

    Total calculated
    $365,390
    From this org
    $0
    From related orgs
    $293,543
    Other
    $71,847
    Hours/week
    0.5 + 40.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $289,706 related
    Bonus
    $0
    Other
    $0 + $3,837 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $42,597 related
    Filer's total
    $0 + $365,390 related

  • Mark Bodin

    Trustee / Treasurer (as of 1/11/23)

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Mark Gavin

    TRUSTEE / Vice Chair

    Total calculated
    $0
    Hours/week
    1 + 0.5 related

  • Robert Mitchell

    TRUSTEE / Treasurer (through 1/10/23)

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Susan Abert

    TRUSTEE / Chair

    Total calculated
    $0
    Hours/week
    1 + 0.5 related

  • Andrew Tremblay MD

    TRUSTEE

    Total calculated
    $380,234
    From this org
    $0
    From related orgs
    $313,664
    Other
    $66,570
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $309,822 related
    Bonus
    $0
    Other
    $0 + $3,842 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $37,320 related
    Filer's total
    $0 + $380,234 related

  • Cherie Holmes MD

    Trustee

    Total calculated
    $558,696
    From this org
    $0
    From related orgs
    $510,301
    Other
    $48,395
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $463,515 related
    Bonus
    $0
    Other
    $0 + $46,786 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $19,145 related
    Filer's total
    $0 + $558,696 related

  • Daniel Smith

    Trustee (as of 1/20/23)

    Total calculated
    $0
    Hours/week
    0.5

  • Elizabeth Cotter

    Trustee

    Total calculated
    $0
    Hours/week
    0.5 + 1 related

  • Gina OBrien

    Trustee (as of 1/20/23)

    Total calculated
    $244,044
    From this org
    $0
    From related orgs
    $230,282
    Other
    $13,762
    Hours/week
    0.5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $200,000 related
    Bonus
    $0 + $30,000 related
    Other
    $0 + $282 related
    Deferred
    $0 + $12,585 related
    Nontaxable benefits
    $0 + $1,177 related
    Filer's total
    $0 + $244,044 related

  • Maria Padin MD

    TRUSTEE / CGP Chief Medical Officer

    Total calculated
    $592,094
    From this org
    $0
    From related orgs
    $526,550
    Other
    $65,544
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $475,513 related
    Bonus
    $0
    Other
    $0 + $51,037 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $36,294 related
    Filer's total
    $0 + $592,094 related

  • Michael Chelstowski

    Trustee (as of 3/17/23)

    Total calculated
    $0
    Hours/week
    0.5

  • Michael Farhm

    Trustee

    Total calculated
    $0
    Hours/week
    0.5

  • Michael Kapiloff

    TRUSTEE (through 12/31/22)

    Total calculated
    $0
    Hours/week
    1

  • Michael Waters

    Trustee / DH Treasurer

    Total calculated
    $314,203
    From this org
    $0
    From related orgs
    $291,149
    Other
    $23,054
    Hours/week
    0.5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $285,002 related
    Bonus
    $0
    Other
    $0 + $6,147 related
    Deferred
    $0 + $21,698 related
    Nontaxable benefits
    $0 + $1,356 related
    Filer's total
    $0 + $314,203 related

  • Nathalie Houder

    TRUSTEE (Through 12/31/22)

    Total calculated
    $0
    Hours/week
    1 + 0.5 related

  • Stephen Leblanc

    Trustee

    Total calculated
    $847,439
    From this org
    $0
    From related orgs
    $782,783
    Other
    $64,656
    Hours/week
    0.5 + 42.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $687,948 related
    Bonus
    $0
    Other
    $0 + $94,835 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $35,406 related
    Filer's total
    $0 + $847,439 related

  • Susan Howard

    Trustee

    Total calculated
    $0
    Hours/week
    0.5

  • Tim Ruehr

    Trustee (as of 1/20/23)

    Total calculated
    $0
    Hours/week
    0.5

  • Amy Matthews

    CHIEF NURSING OFFICER (through 9/2/2022)

    Total calculated
    $290,205
    From this org
    $273,326
    From related orgs
    $0
    Other
    $16,879
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $194,850
    Bonus
    $0
    Other
    $78,476
    Deferred
    $16,032
    Nontaxable benefits
    $847
    Filer's total
    $290,205

  • Anne Tyrol

    Chief Nursing Officer (as of 10/30/22)

    Total calculated
    $204,484
    From this org
    $43,992
    From related orgs
    $147,793
    Other
    $12,699
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $33,950 + $147,643 related
    Bonus
    $10,000
    Other
    $42 + $150 related
    Deferred
    $1,815 + $3,108 related
    Nontaxable benefits
    $0 + $7,776 related
    Filer's total
    $45,807 + $158,677 related

  • Daniel Gross

    Chief Financial Officer

    Total calculated
    $318,598
    From this org
    $278,760
    From related orgs
    $0
    Other
    $39,838
    Hours/week
    40 + 1.5 related

    Schedule J breakdown matched by us

    Base
    $277,572
    Bonus
    $0
    Other
    $1,188
    Deferred
    $16,991
    Nontaxable benefits
    $22,847
    Filer's total
    $318,598

  • David Quigley

    VP - Clinical Operations at CMC

    Total calculated
    $290,815
    From this org
    $0
    From related orgs
    $265,554
    Other
    $25,261
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $251,826 related
    Bonus
    $0
    Other
    $0 + $13,728 related
    Deferred
    $0 + $24,031 related
    Nontaxable benefits
    $0 + $1,230 related
    Filer's total
    $0 + $290,815 related

  • Erli Chen

    PHYSICiST

    Total calculated
    $295,416
    From this org
    $255,996
    From related orgs
    $0
    Other
    $39,420
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $236,454
    Bonus
    $0
    Other
    $19,542
    Deferred
    $24,024
    Nontaxable benefits
    $15,396
    Filer's total
    $295,416

  • Jacquelyn Ethier

    Associate Chief Nursing Officer

    Total calculated
    $197,519
    From this org
    $189,852
    From related orgs
    $0
    Other
    $7,667
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $138,291
    Bonus
    $2,382
    Other
    $49,179
    Deferred
    $7,034
    Nontaxable benefits
    $633
    Filer's total
    $197,519

  • Kevin Forrest

    VP Facilities & Support Services

    Total calculated
    $187,027
    From this org
    $171,786
    From related orgs
    $0
    Other
    $15,241
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $159,073
    Bonus
    $0
    Other
    $12,713
    Deferred
    $13,265
    Nontaxable benefits
    $1,976
    Filer's total
    $187,027

  • Sandra Phipps

    VP PHILANTHROPY/COMM RELATIONS

    Total calculated
    $199,887
    From this org
    $167,071
    From related orgs
    $0
    Other
    $32,816
    Hours/week
    40 + 0.5 related

    Schedule J breakdown matched by us

    Base
    $166,097
    Bonus
    $0
    Other
    $974
    Deferred
    $13,329
    Nontaxable benefits
    $19,487
    Filer's total
    $199,887

  • Shawn V Lafrance

    VP Population Health

    Total calculated
    $246,043
    From this org
    $198,561
    From related orgs
    $0
    Other
    $47,482
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $193,587
    Bonus
    $0
    Other
    $4,974
    Deferred
    $17,453
    Nontaxable benefits
    $30,029
    Filer's total
    $246,043

  • Jennifer Dinubila Do

    Former

    Total calculated
    $455,072
    From this org
    $0
    From related orgs
    $395,177
    Other
    $59,895
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $364,205 related
    Bonus
    $0
    Other
    $0 + $30,972 related
    Deferred
    $0 + $23,150 related
    Nontaxable benefits
    $0 + $36,745 related
    Filer's total
    $0 + $455,072 related

  • Michael Ormont MD

    Former TRUSTEE

    Total calculated
    $443,370
    From this org
    $0
    From related orgs
    $386,300
    Other
    $57,070
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $352,339 related
    Bonus
    $0
    Other
    $0 + $33,961 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $27,820 related
    Filer's total
    $0 + $443,370 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

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
THE CEO IS PAID BY DARTMOUTH-HITCHCOCK CLINIC, A RELATED ORGANIZATION, WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, 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
Amy Matthews, who served as the chief nursing officer received severance payments totaling $77,940. Jacquelyn Ethier, who served as the associate chief nursing officer received severance totaling $49,179.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
Dartmouth Hitchcock Clinic (DHC) sponsors a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable DHC 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 FOLLOWING INDIVIDUAL HAS A SPLIT DOLLAR LIFE PLAN ARRANGEMENT AND RESPECTIVE EMPLOYER PREMIUM: STEPHEN LEBLANC $65,927

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • KEENE HEALTH ENTERPRISES

    C Corporation · REAL ESTATE HOLDING · NH · 100% owned · share of income $0 · share of assets $0 · controlled entity

    Directly controlled by CMC

  • KEENE HEALTH REALTY

    C Corporation · REAL ESTATE HOLDING · NH · 100% owned · share of income $55,933 · share of assets $460,701 · controlled entity

    Directly controlled by CMC

  • KEENE HEALTH SERVICES

    C Corporation · REAL ESTATE HOLDING · NH · 100% owned · share of income $615 · share of assets $126,970 · controlled entity

    Directly controlled by CMC

Provenance

Return type
form_990
Tax year
2022
Filed
14 May 2024
IRS schema version
2022v5.0
Source object
202401359349303775

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