Form 990 for tax year 2023
Filed by ANDROSCOGGIN VALLEY HOSPITAL INC.
Totals
- Total revenue
- $94,030,287
- Total expenses
- $90,360,730
- Contributions and grants received
- $173,677
- Grants paid
- $5,000
- Program service revenue
- $93,056,193
- Investment income
- -$843,133
- Other revenue
- $1,643,550
- Total assets, end of year
- $64,738,399
- Total liabilities, end of year
- $14,118,679
- Net assets or fund balances, end of year
- $50,619,720
- Program services expenses (Part IX)
- $72,426,718
- Management and general expenses
- $17,934,012
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $72,426,718
Program services were 80.2% 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.
-
1c · Fundraising events
$36,933
-
1e · Government grants (contributions)
$91,667
-
1f · All other contributions, gifts and grants
$45,077
-
1g · Noncash contributions included above
$16,560
-
2a · Program service revenue: NET PATIENT REVENUE
total $91,950,154 · related or exempt $91,950,154
-
2b · Program service revenue: 340(B) PHARMACY REVENUE
total $1,106,039 · related or exempt $1,106,039
-
3 · Investment income
total $28,621 · excluded $28,621
-
6a · Gross rents
real property $209,139
-
6b · Less rental expenses
real property $0
-
6c · Rental income or loss
real property $209,139
-
6d · Net rental income or loss
total $209,139 · excluded $209,139
-
7a · Gross sales of assets other than inventory
securities $848,751 · other assets $3,000
-
7b · Less cost or other basis and sales expenses
securities $0 · other assets $1,723,505
-
7c · Gain or loss
securities $848,751 · other assets -$1,720,505
-
7d · Net gain or loss
total -$871,754 · excluded -$871,754
-
8a · Fundraising events: gross income
$4,560
-
8a · Fundraising events: contributions included on line 1c
$36,933
-
8b · Fundraising events: direct expenses
$15,467
-
8c · Net income from fundraising events
total -$10,907 · excluded -$10,907
-
11a · Other revenue: CAFETERIA REVENUE
total $453,890 · excluded $453,890
-
11d · All other revenue
total $991,428 · excluded $991,428
-
11e · Other revenue, total
$1,445,318
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $5,000 · program services $5,000
-
5 · Compensation of officers, directors and key employees
total $854,640 · program services $431,239 · management and general $423,401
-
7 · Other salaries and wages
total $28,032,024 · program services $27,115,835 · management and general $916,189
-
8 · Pension plan contributions
total $752,131 · program services $740,601 · management and general $11,530
-
9 · Other employee benefits
total $6,079,627 · program services $5,690,188 · management and general $389,439
-
10 · Payroll taxes
total $1,870,349 · program services $1,841,870 · management and general $28,479
-
11b · Fees: legal
total $150,464 · management and general $150,464
-
11d · Fees: lobbying
total $14,557 · management and general $14,557
-
11f · Fees: investment management
total $33,940 · management and general $33,940
-
11g · Fees: other
total $13,248,327 · program services $12,454,306 · management and general $794,021
-
12 · Advertising and promotion
total $135,159 · program services $106,542 · management and general $28,617
-
13 · Office expenses
total $73,952 · program services $55,625 · management and general $18,327
-
14 · Information technology
total $136,610 · management and general $136,610
-
16 · Occupancy
total $695,612 · program services $683,935 · management and general $11,677
-
17 · Travel
total $402,722 · program services $383,144 · management and general $19,578
-
19 · Conferences, conventions and meetings
total $271,863 · program services $248,853 · management and general $23,010
-
20 · Interest
total $52,855 · program services $44,906 · management and general $7,949
-
22 · Depreciation, depletion and amortization
total $4,028,116 · program services $3,422,309 · management and general $605,807
-
23 · Insurance
total $1,515,860 · program services $1,515,860
-
24a · Other expenses: INTERCOMPANY ALLOCATION
total $11,267,390 · program services $704,094 · management and general $10,563,296
-
24b · Other expenses: MEDICAL SUPPLIES
total $7,431,930 · program services $7,416,645 · management and general $15,285
-
24c · Other expenses: BAD DEBT EXPENSE
total $7,124,863 · program services $7,124,863
-
24d · Other expenses: MCD TAX
total $3,428,199 · management and general $3,428,199
-
24e · All other expenses
total $2,754,540 · program services $2,440,903 · management and general $313,637
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $2,870 · end of year $2,820
-
2 · Savings and temporary cash investments
beginning of year $5,602,081 · end of year $10,878,313
-
4 · Accounts receivable
beginning of year $9,744,180 · end of year $13,071,667
-
8 · Inventories for sale or use
beginning of year $1,026,390 · end of year $1,736,783
-
9 · Prepaid expenses and deferred charges
beginning of year $846,828 · end of year $472,939
-
10a · Land, buildings and equipment: cost or other basis
$70,407,061
-
10b · Land, buildings and equipment: accumulated depreciation
$48,311,483
-
10c · Land, buildings and equipment, net
beginning of year $24,829,155 · end of year $22,095,578
-
11 · Investments: publicly traded securities
beginning of year $18,330,061 · end of year $15,991,693
-
15 · Other assets
beginning of year $16,779,202 · end of year $488,606
-
17 · Accounts payable and accrued expenses
beginning of year $8,986,192 · end of year $6,210,495
-
20 · Tax-exempt bond liabilities
beginning of year $3,322,832 · end of year $2,394,738
-
25 · Other liabilities
beginning of year $19,710,804 · end of year $5,513,446
-
27 · Net assets without donor restrictions
beginning of year $45,140,939 · end of year $50,619,720
Mission and programs · 2023
Mission
DELIVERING THE BEST HEALTHCARE EXPERIENCE FOR EVERY PATIENT, EVERY DAY.
Activities or mission (Part I)
CRITICAL ACCESS HOSPITAL
-
ANDROSCOGGIN VALLEY HOSPITAL IS A CRITICAL ACCESS HOSPITAL. THE HOSPITAL PROVIDES A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES TO MEET THE HEALTH NEEDS OF THE UPPER ANDROSCOGGIN VALLEY AND SURROUNDING COMMUNITIES. WITH A COMMITMENT TO THE HIGHEST QUALITY SURGICAL CARE - AVH IS LEADING THE WAY TO A HEALTHIER FUTURE FOR OUR HEALTH CARE COMMUNITY.
Expenses $72,426,718 · Grants $5,000 · Revenue $93,056,193
-
EDUCATIONAL PROGRAMS OFFERED BY AVH INCLUDE CHILDBIRTH CLASSES, BABYSITTING COURSE, WELLNESS FAIRS, LECTURE SERIES, CPR AND FIRST AID COURSES, NUTRITIONAL COUNSELING, AND A VARIETY OF SUPPORT GROUPS.
-
OTHER COMMUNITY BENEFITS PROVIDED BY THE HOSPITAL INCLUDE THE PROVISION OF CARE TO THE UNDERINSURED; THE PROMOTION OF GOOD HEALTH FOR CHILDREN THROUGH PARTICIPATION IN THE HEALTHY KIDS PROGRAM; AND THE SPONSORSHIP OF NUMEROUS CLINICS AND PROGRAMS SUPPORTING GOOD HEALTH IN THE COMMUNITY.
As filed on the 2023 return.
Listed in Part VII
-
David BacklerDAVID BACKLER
CHAIR
- Total calculated
- $0
- Hours/week
- 1
-
Donna GoodrichDONNA GOODRICH
CHAIR (THRU 10/23)
- Total calculated
- $0
- Hours/week
- 1 + 1.5 related
-
Martha LaflammeMARTHA LAFLAMME
VICE CHAIR
- Total calculated
- $0
- Hours/week
- 1 + 0.5 related
-
Jay PoulinJAY POULIN
SECRETARY
- Total calculated
- $0
- Hours/week
- 1 + 0.5 related
-
Javier CardenasJAVIER CARDENAS
DIRECTOR/HOSPITALIST
- Total calculated
- $505,799
- From this org
- $493,874
- From related orgs
- $0
- Other
- $11,925
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $451,779
- Bonus
- $13,125
- Other
- $28,970
- Deferred
- $0
- Nontaxable benefits
- $11,925
- Filer's total
- $505,799
-
Jessica Foster-HebertJESSICA FOSTER-HEBERT
DIRECTOR/NCHHHA DIR. CLIN
- Total calculated
- $163,902
- From this org
- $0
- From related orgs
- $155,260
- Other
- $8,642
- Hours/week
- 1 + 39 related
Schedule J breakdown matched by us
- Base
- $0 + $126,733 related
- Bonus
- $0 + $25,847 related
- Other
- $0 + $2,680 related
- Deferred
- $0 + $4,374 related
- Nontaxable benefits
- $0 + $4,268 related
- Filer's total
- $0 + $163,902 related
-
Christy LangloisCHRISTY LANGLOIS
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Susan LessardSUSAN LESSARD
DIRECTOR/APRN
- Total calculated
- $0
- Hours/week
- 30
-
Richard LunaRICHARD LUNA
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Thomas McCueTHOMAS MCCUE
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Jessie PerkinsJESSIE PERKINS
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Brianne TeaboldtBRIANNE TEABOLDT
MEDICAL STAFF PRESIDENT (THRU 12/23)
- Total calculated
- $0
- Hours/week
- 1
-
Daniel Van BurenDANIEL VAN BUREN
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Tyler WhiteTYLER WHITE
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
Thomas MeeTHOMAS MEE
SYSTEM CEO
- Total calculated
- $724,548
- From this org
- $0
- From related orgs
- $706,230
- Other
- $18,318
- Hours/week
- 1 + 45 related
Schedule J breakdown matched by us
- Base
- $0 + $559,584 related
- Bonus
- $0 + $133,893 related
- Other
- $0 + $12,753 related
- Deferred
- $0 + $6,394 related
- Nontaxable benefits
- $0 + $11,924 related
- Filer's total
- $0 + $724,548 related
-
Michael PetersonMICHAEL PETERSON
PRESIDENT
- Total calculated
- $423,678
- From this org
- $412,863
- From related orgs
- $0
- Other
- $10,815
- Hours/week
- 40 + 2 related
Schedule J breakdown matched by us
- Base
- $312,811
- Bonus
- $75,921
- Other
- $24,131
- Deferred
- $0
- Nontaxable benefits
- $10,815
- Filer's total
- $423,678
-
Matthew StreeterMATTHEW STREETER
SYSTEM CFO
- Total calculated
- $378,399
- From this org
- $0
- From related orgs
- $357,595
- Other
- $20,804
- Hours/week
- 1 + 45 related
Schedule J breakdown matched by us
- Base
- $0 + $290,340 related
- Bonus
- $0 + $66,580 related
- Other
- $0 + $675 related
- Deferred
- $0 + $8,934 related
- Nontaxable benefits
- $0 + $11,870 related
- Filer's total
- $0 + $378,399 related
-
Keith Shute MDKEITH SHUTE MD
CHIEF MEDICAL OFFICER
- Total calculated
- $578,463
- From this org
- $540,836
- From related orgs
- $0
- Other
- $37,627
- Hours/week
- 39.5 + 0.5 related
Schedule J breakdown matched by us
- Base
- $460,537
- Bonus
- $63,642
- Other
- $16,657
- Deferred
- $14,306
- Nontaxable benefits
- $23,321
- Filer's total
- $578,463
-
Brian O'HearnBRIAN O'HEARN
CNO
- Total calculated
- $240,835
- From this org
- $229,911
- From related orgs
- $0
- Other
- $10,924
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $187,858
- Bonus
- $31,779
- Other
- $10,274
- Deferred
- $0
- Nontaxable benefits
- $10,924
- Filer's total
- $240,835
-
Richard KardellRICHARD KARDELL
ENT MD
- Total calculated
- $599,919
- From this org
- $588,424
- From related orgs
- $0
- Other
- $11,495
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $446,947
- Bonus
- $89,083
- Other
- $52,394
- Deferred
- $0
- Nontaxable benefits
- $11,495
- Filer's total
- $599,919
-
Glenn HallGLENN HALL
GENERAL SURGEON
- Total calculated
- $568,536
- From this org
- $554,792
- From related orgs
- $0
- Other
- $13,744
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $496,465
- Bonus
- $32,995
- Other
- $25,332
- Deferred
- $8,828
- Nontaxable benefits
- $4,916
- Filer's total
- $568,536
-
Krzysztof PlociennikKRZYSZTOF PLOCIENNIK
MD PROVIDER
- Total calculated
- $544,087
- From this org
- $526,422
- From related orgs
- $0
- Other
- $17,665
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $461,375
- Bonus
- $13,350
- Other
- $51,697
- Deferred
- $0
- Nontaxable benefits
- $17,665
- Filer's total
- $544,087
-
Bradley MahlonBRADLEY MAHLON
ORTHOPEDIC SURGEON
- Total calculated
- $649,978
- From this org
- $637,456
- From related orgs
- $0
- Other
- $12,522
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $578,937
- Bonus
- $29,200
- Other
- $29,319
- Deferred
- $0
- Nontaxable benefits
- $12,522
- Filer's total
- $649,978
-
Stephen KraunzSTEPHEN KRAUNZ
EMERGENCY MEDICINE PRACTITIONER
- Total calculated
- $472,759
- From this org
- $469,474
- From related orgs
- $0
- Other
- $3,285
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $434,162
- Bonus
- $0
- Other
- $35,312
- Deferred
- $0
- Nontaxable benefits
- $3,285
- Filer's total
- $472,759
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
- 4b · Supplemental nonqualified retirement plan
Answered no
- 4a · Severance or change-of-control payment
- 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)
- PART I, LINE 3
- NORTH COUNTRY HEALTHCARE, A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION: - COMPENSATION COMMITTEE - FORM 990 OF OTHER ORGANIZATIONS - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
- PART I, LINE 4B
- THOMAS MEE, SYSTEM CEO, PARTICIPATED IN A 457(F) PLAN ADMINISTERED BY NORTH COUNTRY HEALTHCARE, A RELATED ORGANIZATION. THERE WERE NO CONTRIBUTIONS OR DISTRIBUTIONS IN 2023.
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
No itemized grants to organizations 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.
-
501(C)(3) · CRITICAL ACCESS HOSPITAL · NH · controlled entity
Directly controlled by NORTH COUNTRY HEALTHCARE INC
-
501(C)(3) · HEALTHCARE MANAGEMENT · NH
-
UPPER CONNECTICUT VALLEY HOSPITAL
501(C)(3) · CRITICAL ACCESS HOSPITAL · NH · controlled entity
Directly controlled by NORTH COUNTRY HEALTHCARE INC
-
NORTH COUNTRY HOME HEALTH & HOSPICE AGENCY INC
501(C)(3) · HOME HEALTH AGENCY · NH · controlled entity
Directly controlled by NORTH COUNTRY HEALTHCARE INC
-
501(C)(3) · SUPPORTING SERVICES · NH · controlled entity
Directly controlled by ANDROSCOGGIN VALLEY HOSPITAL INC
-
ANDROSCOGGIN VALLEY HOSPITAL FOUNDATION
501(C)(3) · MANAGEMENT AND FINANCIAL SUPPORT · NH · controlled entity
Directly controlled by ANDROSCOGGIN VALLEY HOSPITAL INC
-
GREAT NORTHWOODS COMMUNITY FOUNDATION
501(C)(3) · HEALTHCARE SERVICES · NH · controlled entity
Directly controlled by ANDROSCOGGIN VALLEY HOSPITAL INC
-
501(C)(3) · SUPPORTING ORGANIZATION · NH · controlled entity
Directly controlled by WEEKS MEDICAL CENTER
Provenance
- Return type
- form_990
- Tax year
- 2023
- Filed
- 15 August 2025
- IRS schema version
- 2023v6.0
- Source object
- 202532279349302913
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