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Nonprofiteer
← DARTMOUTH-HITCHCOCK CLINIC

Form 990 for tax year 2022

Filed by DARTMOUTH-HITCHCOCK CLINIC.

Totals

Total revenue
$638,417,127
Total expenses
$735,847,834
Contributions and grants received
$41,922,401
Grants paid
$3,732,146
Program service revenue
$461,675,908
Investment income
-$23,228
Other revenue
$134,842,046
Total assets, end of year
$296,975,257
Total liabilities, end of year
$681,857,268
Net assets or fund balances, end of year
-$384,882,011
Program services expenses (Part IX)
$630,861,043
Management and general expenses
$104,821,499
Fundraising expenses
$165,292
Program service expenses (Part III)
$630,861,043

Program services were 85.7% 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)

    $27,355,217

  • 1f · All other contributions, gifts and grants

    $14,567,184

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

    total $461,675,908 · related or exempt $461,675,908

  • 2f · All other program service revenue

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

  • 3 · Investment income

    total $19,611 · unrelated business $1,723 · excluded $17,888

  • 6a · Gross rents

    real property $822,325 · personal property $62,048

  • 6b · Less rental expenses

    real property $7,919 · personal property $5,427

  • 6c · Rental income or loss

    real property $814,406 · personal property $56,621

  • 6d · Net rental income or loss

    total $871,027 · excluded $871,027

  • 7a · Gross sales of assets other than inventory

    securities -$42,839

  • 7c · Gain or loss

    securities -$42,839 · other assets $0

  • 7d · Net gain or loss

    total -$42,839 · excluded -$42,839

  • 11a · Other revenue: CONTRACTED REVENUE

    total $120,065,265 · related or exempt $119,389,067 · unrelated business $676,198

  • 11b · Other revenue: CAFETERIA INCOME

    total $436,994 · excluded $436,994

  • 11c · Other revenue: OTHER REVENUE

    total $13,468,760 · related or exempt $13,468,760

  • 11d · All other revenue

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

  • 11e · Other revenue, total

    $133,971,019

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $3,308,498 · program services $3,308,498

  • 2 · Grants to domestic individuals

    total $359,696 · program services $359,696

  • 3 · Grants to foreign organizations and individuals

    total $63,952 · program services $63,952

  • 5 · Compensation of officers, directors and key employees

    total $5,654,182 · program services $2,096,791 · management and general $3,393,301 · fundraising $164,090

  • 6 · Compensation of disqualified persons

    total $755,101 · program services $328,584 · management and general $425,315 · fundraising $1,202

  • 7 · Other salaries and wages

    total $303,241,974 · program services $265,126,405 · management and general $38,115,569

  • 8 · Pension plan contributions

    total $22,140,329 · program services $19,262,086 · management and general $2,878,243

  • 9 · Other employee benefits

    total $42,633,701 · program services $37,091,320 · management and general $5,542,381

  • 10 · Payroll taxes

    total $20,125,732 · program services $17,509,387 · management and general $2,616,345

  • 11b · Fees: legal

    total $760,535 · program services $32,580 · management and general $727,955

  • 11c · Fees: accounting

    total $317,294 · program services $77,144 · management and general $240,150

  • 11g · Fees: other

    total $71,833,911 · program services $64,020,681 · management and general $7,813,230 · fundraising $0

  • 12 · Advertising and promotion

    total $1,163,613 · program services $38,217 · management and general $1,125,396

  • 13 · Office expenses

    total $9,679,690 · program services $7,299,759 · management and general $2,379,931

  • 14 · Information technology

    total $11,419,476 · program services $913,558 · management and general $10,505,918

  • 16 · Occupancy

    total $9,999,318 · program services $595,946 · management and general $9,403,372

  • 17 · Travel

    total $1,491,571 · program services $865,067 · management and general $626,504

  • 19 · Conferences, conventions and meetings

    total $50,185 · program services $49,442 · management and general $743

  • 20 · Interest

    total $8,144,588 · program services $52,611 · management and general $8,091,977

  • 22 · Depreciation, depletion and amortization

    total $3,371,553 · program services $1,321,583 · management and general $2,049,970

  • 23 · Insurance

    total $7,116,463 · program services $5,889,964 · management and general $1,226,499

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $195,854,283 · program services $193,964,937 · management and general $1,889,346

  • 24b · Other expenses: EQUIP REPAIR & MAINTENANCE

    total $8,113,587 · program services $4,729,103 · management and general $3,384,484

  • 24c · Other expenses: ACADEMIC, GME, TEACHING & SUPPORT

    total $3,666,012 · program services $3,156,882 · management and general $509,130

  • 24d · Other expenses: RECRUITMENT COSTS

    total $997,698 · program services $55,194 · management and general $942,504

  • 24e · All other expenses

    total $3,584,892 · program services $2,651,656 · management and general $933,236 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $154,050

  • 4 · Accounts receivable

    beginning of year $50,805,627 · end of year $61,758,670

  • 5 · Loans and receivables from officers and key people

    beginning of year $172,807 · end of year $173,404

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $410,959 · end of year $298,678

  • 8 · Inventories for sale or use

    beginning of year $5,616,432 · end of year $8,550,855

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

    $126,324,369

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

    $113,206,141

  • 10c · Land, buildings and equipment, net

    beginning of year $16,421,544 · end of year $13,118,228

  • 11 · Investments: publicly traded securities

    beginning of year $356,287 · end of year $331,022

  • 12 · Investments: other securities

    beginning of year $53,655,396 · end of year $71,147,802

  • 13 · Investments: program-related

    beginning of year $1,706,081 · end of year $1,719,520

  • 15 · Other assets

    beginning of year $115,453,052 · end of year $139,877,078

  • 17 · Accounts payable and accrued expenses

    beginning of year $317,098,927 · end of year $448,670,757

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $2,034,494 · end of year $1,553,369

  • 25 · Other liabilities

    beginning of year $239,776,771 · end of year $231,633,142

  • 27 · Net assets without donor restrictions

    beginning of year -$315,748,181 · end of year -$386,563,240

  • 28 · Net assets with donor restrictions

    beginning of year $1,590,224 · end of year $1,681,229

Mission and programs · 2022

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.

Activities or mission (Part I)

Advancing 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.

  • Dartmouth-Hitchcock Clinic (DHC) 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. DHC and its subsidiaries form a multispecialty physician practice group which operates throughout New Hampshire and Vermont and provides both medical services to patients and medical education and research. Health care services provided during fiscal year 2023 resulted in 1,381,030 office visits recorded by DHC personnel, with 339,320 unique patients served. The promotion of health through the medical practice activities of DHC provides the basis for the organization's tax-exempt status. DHC 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 DHC. DHC provides the physician and advanced practice provider staff to a related affiliate, Mary Hitchcock Memorial Hospital (MHMH, also a fully-owned member of D-HH) and the related sophistication essential for the development and operations of the Hospital as the largest and only teaching hospital in New Hampshire and the designation by the federal government as a rural referral center for northern New England. The shared mission of DHC and MHMH 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 MHMH, DHC 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. DHC actively supports community-based health care and promotes the coordination of services among health care providers and social services organizations within the regions it serves. DHC also seeks to work collaboratively with other area health care providers to improve the health status of residents in the region. DHC and MHMH jointly file an annual community benefits report with the State of New Hampshire which outlines the community and charitable benefits DHC and MHMH provide. The complete and updated community benefits reports are available upon request; these reports can also be found on the organization's website. The broad categories used in the community benefit report to summarize the benefits mentioned here include: "financial assistance" (formerly called "charity care"), which 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, 2023, DHC provided financial assistance to 18,289 patients in the amount of $14,447,588. as measured by gross charges. The cost of providing this care for the year ended June 30, 2022, was $12,950,295. DHC also routinely provides services to Medicaid patients at reimbursement levels that are well below the cost of the care provided. The uncompensated cost of care for Medicaid patients for the year ended June 30, 2023 was $56,821,173. Community health activities 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 Granite State Fit Kids Health Program for elementary schools, the Women's Health Resource Centers in Lebanon, NH, and Smoking Prevention and Cessation programs. This category also includes financial contributions and the contribution of time and services to community programs, hospitals, and agencies. DHC also provides a significant amount of uncompensated care to its patients that is reported as "provision for bad debts," which is not included in the amounts reported above. For the fiscal year ended June 30, 2023, DHC reported a provision for bad debts of approximately $28,572,611.

    Expenses $590,969,489 · Grants $3,732,146 · Revenue $591,057,715

  • Withheld by Nonprofiteer: this text may name a private individual.

    Expenses $39,891,554 · Revenue $3,476,020

As filed on the 2022 return. A text marked withheld matched a screen for wording that may name a private individual, such as an honorific or "in memory of". Most of what it withholds names no one; it is withheld so that what does is never shown.

Listed in Part VII

  • Charles G Plimpton MBA

    Trustee / Treasurer

    Total calculated
    $0
    Hours/week
    1.5 + 2.5 related
  • David P Paul

    Trustee / Secretary

    Total calculated
    $0
    Hours/week
    0.8 + 1.8 related
  • Joanne M Conroy MD

    Trustee, Ex-Officio, CEO

    Total calculated
    $1,713,475
    From this org
    $1,666,034
    From related orgs
    $0
    Other
    $47,441
    Hours/week
    16.2 + 39.9 related

    Schedule J breakdown matched by us

    Base
    $1,473,908
    Bonus
    $0
    Other
    $192,126
    Deferred
    $29,250
    Nontaxable benefits
    $18,191
    Filer's total
    $1,713,475
  • Roberta L Hines MD

    TRUSTEE / Chair

    Total calculated
    $0
    Hours/week
    1.5 + 2 related
  • Aaron J Mancuso MD

    Trustee (through 12/31/22) / Physician

    Total calculated
    $531,442
    From this org
    $466,892
    From related orgs
    $0
    Other
    $64,550
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $454,911
    Bonus
    $2,014
    Other
    $9,967
    Deferred
    $22,803
    Nontaxable benefits
    $41,747
    Filer's total
    $531,442
  • Carl W Dobson MD

    Trustee/ Medical Director

    Total calculated
    $530,372
    From this org
    $0
    From related orgs
    $471,672
    Other
    $58,700
    Hours/week
    0.8 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $385,157 related
    Bonus
    $0 + $65,500 related
    Other
    $0 + $21,015 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $43,450 related
    Filer's total
    $0 + $530,372 related
  • Celestna M Dooley-Jones PHD

    Trustee (as of 1/1/23)

    Total calculated
    $0
    Hours/week
    0.8 + 0.8 related
  • Duane A Compton PHD

    Trustee / Ex-Officio

    Total calculated
    $0
    Hours/week
    0.8 + 1.7 related
  • Edward H Stansfield III MA

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 2.3 related
  • Elof Eriksson MD PhD

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 0.8 related
  • Gary L Freed MD

    Trustee/ Physician

    Total calculated
    $746,878
    From this org
    $720,881
    From related orgs
    $0
    Other
    $25,997
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $658,973
    Bonus
    $0
    Other
    $61,908
    Deferred
    $23,150
    Nontaxable benefits
    $2,847
    Filer's total
    $746,878
  • Gary V Desir

    Trustee (as of 1/1/23)

    Total calculated
    $0
    Hours/week
    0.8 + 0.8 related
  • Geraldine Bednash PHD RN FAAN

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 1.3 related
  • Jarvis A Green

    Trustee (on leave As of 1/1/23)

    Total calculated
    $0
    Hours/week
    0.8 + 0.8 related
  • Jennifer L Moyer MBA

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 1.3 related
  • Laura Chiang

    Trustee (as of 1/1/23) / Physician

    Total calculated
    $416,841
    From this org
    $362,259
    From related orgs
    $0
    Other
    $54,582
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $336,431
    Bonus
    $1,032
    Other
    $24,796
    Deferred
    $13,890
    Nontaxable benefits
    $40,692
    Filer's total
    $416,841
  • Marc B Wolpow JDMBA

    Trustee (through 11/16/22)

    Total calculated
    $0
    Hours/week
    0.8 + 1.3 related
  • Mark S Speers MBA

    Trustee (as of 1/1/23)

    Total calculated
    $0
    Hours/week
    0.8 + 0.8 related
  • Mark W Begor MBA

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 1.3 related
  • Nancy M Dunbar MD

    Trustee / Physician

    Total calculated
    $457,386
    From this org
    $389,532
    From related orgs
    $0
    Other
    $67,854
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $358,120
    Bonus
    $813
    Other
    $30,599
    Deferred
    $23,150
    Nontaxable benefits
    $44,704
    Filer's total
    $457,386
  • Pamela Thompson MSRNCENP

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 1.3 related
  • Paul A Taheri MD MBA

    Trustee (as of 6/24/23)

    Total calculated
    $0
    Hours/week
    0.8 + 1.6 related
  • Paul P Danos PHD

    Trustee (through 12/31/22)

    Total calculated
    $0
    Hours/week
    0.8 + 1.3 related
  • Sandra L Wong MD

    Trustee/SVP Svc Ln & Dept Chair

    Total calculated
    $829,624
    From this org
    $791,139
    From related orgs
    $0
    Other
    $38,485
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $730,754
    Bonus
    $0
    Other
    $60,385
    Deferred
    $23,150
    Nontaxable benefits
    $15,335
    Filer's total
    $829,624
  • Sherri C Oberg

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 0.8 related
  • Thomas Glynn PHD

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 0.8 related
  • Thomas Raffio

    Trustee

    Total calculated
    $0
    Hours/week
    0.8 + 0.8 related
  • Aimee M Claiborne

    Chief Human Resource Officer

    Total calculated
    $561,394
    From this org
    $0
    From related orgs
    $518,080
    Other
    $43,314
    Hours/week
    12 + 28.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $486,145 related
    Bonus
    $0
    Other
    $0 + $31,935 related
    Deferred
    $0 + $23,150 related
    Nontaxable benefits
    $0 + $20,164 related
    Filer's total
    $0 + $561,394 related
  • Edward Merrens

    Chief Clinical Officer

    Total calculated
    $851,308
    From this org
    $801,775
    From related orgs
    $0
    Other
    $49,533
    Hours/week
    12 + 29 related

    Schedule J breakdown matched by us

    Base
    $725,384
    Bonus
    $0
    Other
    $76,391
    Deferred
    $29,250
    Nontaxable benefits
    $20,283
    Filer's total
    $851,308
  • John Kacavas

    Chief Legal Officer (through 12/31/22)

    Total calculated
    $875,216
    From this org
    $0
    From related orgs
    $805,496
    Other
    $69,720
    Hours/week
    12 + 31 related

    Schedule J breakdown matched by us

    Base
    $0 + $680,386 related
    Bonus
    $0
    Other
    $0 + $125,110 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $40,470 related
    Filer's total
    $0 + $875,216 related
  • Kimberly Troland JD

    Interim Chief Legal Officer (as of 1/1/23)

    Total calculated
    $481,961
    From this org
    $0
    From related orgs
    $435,137
    Other
    $46,824
    Hours/week
    12 + 28.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $385,359 related
    Bonus
    $0
    Other
    $0 + $49,778 related
    Deferred
    $0 + $23,150 related
    Nontaxable benefits
    $0 + $23,674 related
    Filer's total
    $0 + $481,961 related
  • Matthew Haag

    Chief Development Officer

    Total calculated
    $444,752
    From this org
    $0
    From related orgs
    $403,945
    Other
    $40,807
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $0 + $368,250 related
    Bonus
    $0
    Other
    $0 + $35,695 related
    Deferred
    $0 + $23,150 related
    Nontaxable benefits
    $0 + $17,657 related
    Filer's total
    $0 + $444,752 related
  • Patrick F Jordan III MBA

    Chief Operating Officer

    Total calculated
    $898,896
    From this org
    $0
    From related orgs
    $829,011
    Other
    $69,885
    Hours/week
    12 + 31 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
  • Stephen Leblanc

    Chief Strategy Officer

    Total calculated
    $847,439
    From this org
    $782,783
    From related orgs
    $0
    Other
    $64,656
    Hours/week
    12 + 31 related

    Schedule J breakdown matched by us

    Base
    $687,948
    Bonus
    $0
    Other
    $94,835
    Deferred
    $29,250
    Nontaxable benefits
    $35,406
    Filer's total
    $847,439
  • Susan A Reeves EDDRN

    Executive VP (medical center)

    Total calculated
    $778,770
    From this org
    $0
    From related orgs
    $717,088
    Other
    $61,682
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $0 + $639,528 related
    Bonus
    $0 + $250 related
    Other
    $0 + $77,310 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $32,432 related
    Filer's total
    $0 + $778,770 related
  • Wendy Fielding

    Chief Financial Officer

    Total calculated
    $472,417
    From this org
    $0
    From related orgs
    $407,870
    Other
    $64,547
    Hours/week
    12 + 28.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $365,911 related
    Bonus
    $0
    Other
    $0 + $41,959 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $35,297 related
    Filer's total
    $0 + $472,417 related
  • David F Duncan

    System VP - Facilities Mgmt

    Total calculated
    $354,700
    From this org
    $0
    From related orgs
    $309,143
    Other
    $45,557
    Hours/week
    12 + 29 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
  • Jeffrey Obrien MHA

    Chief Operating Officer - DHMC

    Total calculated
    $457,495
    From this org
    $0
    From related orgs
    $387,194
    Other
    $70,301
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $0 + $372,337 related
    Bonus
    $0
    Other
    $0 + $14,857 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $41,051 related
    Filer's total
    $0 + $457,495 related
  • Karen Clements RNBSNMSB

    Chief Nursing Officer

    Total calculated
    $471,921
    From this org
    $0
    From related orgs
    $430,010
    Other
    $41,911
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $0 + $392,531 related
    Bonus
    $0 + $250 related
    Other
    $0 + $37,229 related
    Deferred
    $0 + $26,136 related
    Nontaxable benefits
    $0 + $15,775 related
    Filer's total
    $0 + $471,921 related
  • Martin Purcell MBA

    Chief Information Officer

    Total calculated
    $593,797
    From this org
    $0
    From related orgs
    $547,555
    Other
    $46,242
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $0 + $475,663 related
    Bonus
    $0
    Other
    $0 + $71,892 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $16,992 related
    Filer's total
    $0 + $593,797 related
  • Simon Hillier

    Dept Chair ANESTHESIOLOGY

    Total calculated
    $701,183
    From this org
    $635,001
    From related orgs
    $0
    Other
    $66,182
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $575,558
    Bonus
    $0
    Other
    $59,443
    Deferred
    $29,250
    Nontaxable benefits
    $36,932
    Filer's total
    $701,183
  • Staci Hermann PHARMDMS

    CHIEF PHARMACY OFFICER

    Total calculated
    $374,985
    From this org
    $0
    From related orgs
    $342,664
    Other
    $32,321
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $0 + $319,419 related
    Bonus
    $0
    Other
    $0 + $23,245 related
    Deferred
    $0 + $15,006 related
    Nontaxable benefits
    $0 + $17,315 related
    Filer's total
    $0 + $374,985 related
  • Daniel Stewart

    Physician

    Total calculated
    $1,143,387
    From this org
    $1,075,702
    From related orgs
    $0
    Other
    $67,685
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $972,144
    Bonus
    $0
    Other
    $103,558
    Deferred
    $23,150
    Nontaxable benefits
    $44,535
    Filer's total
    $1,143,387
  • John Nigriny

    Physician

    Total calculated
    $1,141,100
    From this org
    $1,072,884
    From related orgs
    $0
    Other
    $68,216
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $977,062
    Bonus
    $6,085
    Other
    $89,737
    Deferred
    $23,150
    Nontaxable benefits
    $45,066
    Filer's total
    $1,141,100
  • Lixia Ellis

    Physician

    Total calculated
    $1,233,955
    From this org
    $1,171,610
    From related orgs
    $0
    Other
    $62,345
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $980,251
    Bonus
    $170,589
    Other
    $20,770
    Deferred
    $18,300
    Nontaxable benefits
    $44,045
    Filer's total
    $1,233,955
  • Matthew LeBoeuf

    Physician

    Total calculated
    $1,071,265
    From this org
    $1,013,330
    From related orgs
    $0
    Other
    $57,935
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $946,470
    Bonus
    $9,598
    Other
    $57,262
    Deferred
    $13,890
    Nontaxable benefits
    $44,045
    Filer's total
    $1,071,265
  • Timothy Ryken

    Physician

    Total calculated
    $1,177,343
    From this org
    $1,115,672
    From related orgs
    $0
    Other
    $61,671
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $921,075
    Bonus
    $3,851
    Other
    $190,746
    Deferred
    $29,250
    Nontaxable benefits
    $32,421
    Filer's total
    $1,177,343
  • Daniel P Jantzen

    Chief Financial Officer - MHMH

    Total calculated
    $1,033,483
    From this org
    $0
    From related orgs
    $968,827
    Other
    $64,656
    Hours/week
    12 + 31 related

    Schedule J breakdown matched by us

    Base
    $0 + $815,505 related
    Bonus
    $0
    Other
    $0 + $153,322 related
    Deferred
    $0 + $29,250 related
    Nontaxable benefits
    $0 + $35,406 related
    Filer's total
    $0 + $1,033,483 related
  • George T Blike MD Mhcds

    Former/ Chief Quality & Value Officer (DHC)

    Total calculated
    $166,194
    From this org
    $154,960
    From related orgs
    $0
    Other
    $11,234
    Hours/week
    10 + 11.5 related

    Schedule J breakdown matched by us

    Base
    $154,960
    Bonus
    $0
    Other
    $0
    Deferred
    $11,234
    Nontaxable benefits
    $0
    Filer's total
    $166,194
  • Maria Padin MD

    Chief Medical Officer, CGP (DHC)

    Total calculated
    $592,094
    From this org
    $526,550
    From related orgs
    $0
    Other
    $65,544
    Hours/week
    12 + 30 related

    Schedule J breakdown matched by us

    Base
    $475,513
    Bonus
    $0
    Other
    $51,037
    Deferred
    $29,250
    Nontaxable benefits
    $36,294
    Filer's total
    $592,094
  • Peter D Solberg MD

    Chief Health Information Officer (DHC)

    Total calculated
    $577,036
    From this org
    $503,674
    From related orgs
    $0
    Other
    $73,362
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $464,308
    Bonus
    $0
    Other
    $39,366
    Deferred
    $29,250
    Nontaxable benefits
    $44,112
    Filer's total
    $577,036
  • Richard I Rothstein MD

    Former Dept Chair/Srvc LN LDR - MED (DHC)

    Total calculated
    $740,860
    From this org
    $674,829
    From related orgs
    $0
    Other
    $66,031
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    $623,212
    Bonus
    $0
    Other
    $51,617
    Deferred
    $29,250
    Nontaxable benefits
    $36,781
    Filer's total
    $740,860

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

  • 1a · Discretionary spending account
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 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)

Schedule J, Part I, Line 1a Discretionary spending account
THE ORGANIZATION HAS IN PLACE A PLAN TO SUPPORT CONTINUING MEDICAL EDUCATION. THE PLAN PROVIDES FIXED DOLLAR LIMITS PER PROVIDER PER 2-YEAR PERIOD THAT CAN BE USED TO DEFRAY THE COSTS OF OBTAINING AND ATTENDING CONTINUING MEDICAL EDUCATION EVENTS AND RELATED TRAVEL. ADDITIONALLY, THESE MONIES CAN BE USED FOR PROFESSIONAL BOOKS, LICENSES, MEMBERSHIPS, AND RELATED EXPENSES. AMOUNTS MUST BE SUBMITTED FOR APPROVAL PRIOR TO REIMBURSEMENT.
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 $144,065 STEPHEN LEBLANC $65,927 RICHARD ROTHSTEIN $107,477
Schedule J, Part I, Line 3 ESTABLISHING COMPENSATION CEO
The process for determining compensation of the CEO is the responsibility of the Compensation Committee of Dartmouth Hitchcock Health (DHH). The compensation committee consists of the Chairperson of the Board and three or more members of the board who are elected by the board, acting upon the recommendation of the chairperson and are not employees of DHH, a related organization or a subsidiary organization of a related organization. The compensation committee determines the compensation of the CEO of DHC within ranges established by the board.
Schedule J, Part II NOTE REGARDING COMPENSATION
SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY DHC 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.

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

The 10 largest by cash amount. The API serves every itemized grant.

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.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • RENAISSANCE PSYCHIATRY OF NEW ENGLAND

    PSYCHIATRY SERVICES · NH · income -$56,704 · assets $697,947

    Directly controlled by Dartmouth-Hitchcock Clinic

Related corporations and trusts

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

  • POMPANOOSUC INVESTMENT CORPORATION

    C Corporation · REAL ESTATE HOLDING · NH · 100% owned · share of income -$127 · share of assets $75,632 · controlled entity

    Directly controlled by Dartmouth-Hitchcock Clinic

  • HAMDEN ASSURANCE CO LTD

    C Corporation · LIABILITY INSURANCE · BD · 70.2% owned · share of income $0 · share of assets $56,503,948 · controlled entity

    Directly controlled by Dartmouth-Hitchcock Clinic

Provenance

Return type
form_990
Tax year
2022
Filed
13 May 2024
IRS schema version
2022v5.0
Source object
202441349349304084

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

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