2024-05-13T13:06:59+00:00 2023-06-30 350921680 CROWE LLP 9600 Brownsboro Road Suite 400 Louisville KY 402413902 990 2022-07-01 020202220 Cheshire Health Foundation CHES 6033545400 580-590 Court Street Keene NH 03431 Daniel J Gross CFO 2024-05-13 true Anne Marie Coppo 999009999 Kim Scifres P01316095 5023263996 2022 2023-04-26 12:10:37Z DON CARUSO MD MPH 580-590 Court Street Keene NH 03431 1862473 false X https://www.cheshirehealthfoundation.org X 1896 NH CHESHIRE HEALTH FOUNDATION CULTIVATES AND STEWARDS CHARITABLE SUPPORT TO ADVANCE THE HEALTH AND WELLNESS MISSION OF CHESHIRE MEDICAL CENTER. 16 14 0 14 23564 1681 3682228 1678758 0 45997 64302 71415 42571 3799640 1785631 3150448 1580519 0 0 0 8732 305840 198327 3456288 1778846 343352 6785 45951204 34238471 13230411 1500262 32720793 32738209 CHESHIRE HEALTH FOUNDATION CULTIVATES AND STEWARDS CHARITABLE SUPPORT TO ADVANCE THE HEALTH AND WELLNESS MISSION OF CHESHIRE MEDICAL CENTER. THE CHESHIRE HEALTH FOUNDATION PROVIDES MANAGEMENT OF BOARD-DESIGNATED, SPECIAL-PURPOSE, BUILDING, AND ENDOWMENT FUNDS. false false 1770114 1580519 The Cheshire Health Foundation raises funds to support the health and wellness mission of Cheshire Medical Center. For Fiscal Year 2023, Medical Center senior leaders and Trustees collaborated with Foundation Trustees to determine strategic needs for the year. The purchase of a new, state-of-the-art 3D mammography machine and upgrades for the Medical Center's existing 3D mammography machine were the main funding priorities and charitable donations funded these purchases. The new 3D mammography unit and upgraded, existing 3D unit are helping Cheshire to expand mammography appointments, thus meeting growing patient care needs. The superior imaging capabilities of both units will help identify invasive cancers in their earliest stages, reduce the rate of false positives and minimize patient call-backs. With two mammography machines in use, patients and appointments will be minimally impacted when either unit has downtime for routine maintenance or repairs. Both machines are vital to Cheshire's ability to continue providing high quality care to patients that remains close to home. The Foundation also received gifts for a wide variety of specialized equipment to support inpatient and outpatient Physical Therapy, Women's Health and the Birthing Pavilion, EKG equipment, patient financial assistance, and other specific needs. Scholarship funds increased through donations to the Cindi Coughlin Professional Nursing Scholarship Fund and the Ben Tatro Memorial Healthcare Scholarship Fund. Other funds raised supported Cheshire's local Dartmouth Cancer Center through equipment and program needs and assisting patients financially who have difficulty meeting their daily living expenses. In addition, charitable support received helped Cheshire continue renovations on the West Campus building for the new Family Medicine Residency Program, and will fund support for future capital projects. Bequests received benefited future strategic capital purchases. Planned gifts over the years have created specific purpose funds and permanently restricted endowment funds that support patient care, including patient financial assistance, and nursing scholarships and professional development. 1770114 true true false false false false false false true true true false true true false false true false false false false false false true false false true false true false false false false false false false false true false false false false true false false false true 2 0 true 0 true true false false false false true true false false false false false false X 16 14 false false false false true true true true true false false true true true true true true false false false NH X Daniel J Gross 6033545400 580-590 COURT STREET KEENE NH 03431 CEIL GOFF TRUSTEE/TREASURER 0.5 0 X X 0 0 0 DON CARUSO MD TRUSTEE/CEO/PRESIDENT (through 5/26/23) 0.5 41.5 X X 0 500413 65544 JULIE TEWKSBURY TRUSTEE / Vice Chair (through 12/31/22) 0.5 0 X X 0 0 0 KATHRYN WILLBARGER Trustee / Interim CEO (as of 5/27/23) 0.5 40.5 X X 0 302306 30755 ROBERT ENGLUND MD TRUSTEE / Vice Chair (as of 1/1/23) 0.5 0 X X 0 0 0 ROBERT THERRIEN TRUSTEE/CHAIR 0.5 0 X X 0 0 0 WILLIAM CHASE MD TRUSTEE/Secretary 0.5 0 X X 0 0 0 Aalok Khole MD Trustee / Physician 0.5 40.0 X 0 256650 32117 ALAN STROSHINE TRUSTEE 0.5 0 X 0 0 0 Christopher Hamblet Trustee 0.5 0 X 0 0 0 Cindy Westover Trustee 0.5 0 X 0 0 0 Elizabeth Cotter TRUSTEE 0.5 1.0 X 0 0 0 HEATHER MINKLER TRUSTEE 0.5 0 X 0 0 0 HELENE MOGRIDGE TRUSTEE (through 12/31/22) 0.5 0 X 0 0 0 Jane Larmon Trustee (as of 1/1/23) 0.5 0 X 0 0 0 KATHERINE SNOW TRUSTEE 0.5 0 X 0 0 0 Matt Mucha Trustee (as of 1/1/23) 0.5 0 X 0 0 0 Patricia Campbell MD Trustee 0.5 0 X 0 0 0 Patti Seymour Trustee 0.5 0 X 0 0 0 Daniel Gross CFO of Cheshire Medical Center 0.5 41.0 X 0 278760 39838 SANDRA PHIPPS VP PHILANTHROPY/COMM RELATIONS 0.5 40.0 X 0 167071 32816 0 1505200 201070 0 false true false 0 99951 1578807 40683 1678758 0 0 0 0 0 64350 23564 40786 84600 42980 41620 0 41620 41620 8019 7971 48 0 -48 -48 20931 99951 25891 -4960 -4960 5911 0 0 5911 5911 1785631 0 23564 83309 1580519 1580519 31705 31705 0 0 2498 2498 1500 1500 31898 31898 69225 69225 56767 56767 Other Expenses 4734 4734 0 0 0 0 1778846 1770114 0 8732 12332030 2650487 0 2000000 0 15000 15000 0 0 0 0 0 0 41011 38277 5805909 3040432 2834703 2765477 248419 199531 20971937 22300507 0 0 0 7508104 6269192 45951204 34238471 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13230411 1500262 13230411 1500262 X 3150737 3741529 29570056 28996680 32720793 32738209 45951204 34238471 X 6785 76171 -65540 X false true X true false X X 1 THE CHESHIRE MEDICAL CENTER 020354549 3 true 1580519 0 1 1580519 0 true false false false false false false false false false false false false false false true false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25835380 10971 1320761 582035 26585077 27658744 -1666734 156630 25835380 21594703 2020506 4806606 763071 27658744 22396539 10538 111672 0 924046 0 21594703 19120418 12000 4031121 0 767000 0 22396539 0.0 0.3021 0.6979 false false 2572848 2572848 2467851 2370482 97369 765210 669950 95260 0 0 0 2765477 Investment in pooled funds 22300507 F 22300507 DUE FROM AFFILIATES 308685 GIFT ANNUITIES AND SPLIT DLP 265591 BENEFICIAL INTERESTS IN TRUSTS 5694916 6269192 DUE TO AFFILIATES 1489593 GIFT ANNUITY LIABILITY 10669 1500262 Schedule D, Part V, Line 4 Intended uses of endowment funds THE INTENDED USE OF ENDOWMENT FUNDS IS TO SUPPORT AND ADVANCE THE HEALTH AND WELLNESS MISSION-RELATED PROGRAMS OF CHESHIRE MEDICAL CENTER. GOLF TOURNAMENT 76747 55816 20931 4769 111 9509 140 TRIBUTE 44135 44135 0 455 6686 1581 2640 0 120882 99951 20931 5224 111 16195 1581 2780 25891 -4960 true CHESHIRE MEDICAL CENTER 580-590 COURT STRET KEENE NH 03431 020354549 501 (c)(3) 935679 BOOK PROGRAM SUPPORT 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. ALL GRANTS AND ASSISTANCE ARE PAID TO CONFIRMED 501(C)(3) ORGANIZATIONS, CHURCHES, OR GOVERNMENT ENTITIES. false false false false false false false false false DON CARUSO MD TRUSTEE/CEO/PRESIDENT (through 5/26/23) 0 449237 0 0 0 51176 0 29250 0 36294 0 565957 0 0 KATHRYN WILLBARGER Trustee / Interim CEO (as of 5/27/23) 0 301662 0 0 0 644 0 27227 0 3528 0 333061 0 0 Aalok Khole MD Trustee / Physician 0 236393 0 0 0 20257 0 15362 0 16755 0 288767 0 0 SANDRA PHIPPS VP PHILANTHROPY/COMM RELATIONS 0 166097 0 0 0 974 0 13329 0 19487 0 199887 0 0 Daniel Gross CFO of Cheshire Medical Center 0 277572 0 0 0 1188 0 16991 0 22847 0 318598 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The CEO IS EMPLOYED AND PAID BY A RELATED ORGANIZATION WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, FORM 990 INFORMATION FROM OTHER ORGANIZATIONS, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE CEO'S COMPENSATION. X 4 34936 Market value X Fundraising Supplies 1 5747 Market value 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Securities - Publicly traded - THE NUMBER OF ITEMS REPRESENTS THE NUMBER OF CONTRIBUTIONS. Other - Fundraising Supplies The number represents the total of all noncash fundraising contributions. Form 990, Part VI, Line 15a PROCESS FOR DETERMINING CFO COMPENSATION THE PRESIDENT, CHIEF FINANCIAL OFFICER (CFO), AND VICE PRESIDENT OF PHILANTHROPY ARE PAID BY A RELATED ORGANIZATION, THEREFORE, QUESTION 15B IS CHECKED NO. HOWEVER, THE RELATED ORGANIZATION HAS RETAINED YAFFE & COMPANY, INC. TO PROVIDE CONSULTATION TO THE EXECUTIVE COMMITTEE OF THE RELATED BOARD OF TRUSTEES REGARDING EXECUTIVE COMPENSATION, BENEFITS, AND PREREQUISITES FOR THE OFFICERS. YAFFE & COMPANY, INC. IS AN INDEPENDENT CONSULTING FIRM WITH 40 YEARS OF EXPERIENCE AND PROVIDES SERVICES TO NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS. IN ADDITION, BY WAY OF A QUESTIONNAIRE, BOARD MEMBERS PARTICIPATE IN THE PERFORMANCE REVIEW PROCESS AND PREPARE A DOCUMENTED REPORT. ANNUALLY, A MULTI-TIERED APPROACH USING INDEPENDENT COMPARABILITY DATA IS UTILIZED TO GAUGE APPROPRIATE COMPARATIVE MARKET LEVELS OF COMPENSATION AND BENEFITS WITH THE LATEST REVIEW OCCURRING IN FY 2023. Form 990, Part VI, Line 15b OTHER OFFICERS OFFICERS ARE PAID BY A RELATED ORGANIZATION, THEREFORE, QUESTION 15B IS CHECKED NO. HOWEVER, THE RELATED ORGANIZATION HAS RETAINED YAFFE & COMPANY, INC. TO PROVIDE CONSULTATION TO THE EXECUTIVE COMMITTEE OF THE RELATED BOARD OF TRUSTEES REGARDING EXECUTIVE COMPENSATION, BENEFITS, AND PREREQUISITES FOR OFFICERS. YAFFE & COMPANY, INC. IS AN INDEPENDENT CONSULTING FIRM WITH 40 YEARS OF EXPERIENCE AND PROVIDES SERVICES TO NOT-FOR-PROFIT HOSPITALS AND HEALTH SYSTEMS. IN ADDITION BY WAY OF A QUESTIONNAIRE, BOARD MEMBERS PARTICIPATE IN THE PERFORMANCE REVIEW PROCESS AND PREPARE A DOCUMENTED REPORT. ANNUALLY, A MULTI-TIERED APPROACH USING INDEPENDENT COMPARABILITY DATA IS UTILIZED TO GAUGE APPROPRIATE COMPARATIVE MARKET LEVELS OF COMPENSATION AND BENEFITS WITH THE LATEST REVIEW OCCURRING IN FY 2023. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Cheshire Health Foundation has an Executive Committee consisting of (i)the officers of the Board of Trustees of the Foundation, (ii) the immediate past Chairperson (to the extent such individual is eligible to and continues to serve as a Trustee), and (iii) an additional Trustee recommended by the Chairperson of the Board and approved by the Board. The chairperson of the Board of Trustees is the chairperson of the Executive Committee. The Executive Committee has the power, to the extent legally permissible and as authorized by the Board of Trustees by policy or otherwise, to transact all regular business of the Foundation between meetings of the Board; provided that any action to be taken by the Executive Committee shall not conflict with the express wishes of the Board, and that all matters reasonably believed by the Executive Committee to be of major significance to the Foundation shall be referred to the Board. The Executive committee does not have the power to amend the by-laws, appoint or remove trustees, approve a dissolution or merger or the sale of all of the Foundation's assets or take any action that is contrary to, or a substantial departure from, the direction of the Board, or which represents major change in the affairs, business, or policy of the Foundation. Form 990, Part VI, Line 6 Classes of members or stockholders The sole member of Cheshire Health Foundation is the Cheshire Medical Center, a New Hampshire not-for-profit corporation. The member has the exclusive power and authority to elect and remove trustees (other than the ex-officio trustees), and the member has the power to fill vacancies on the board. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE SOLE MEMBER OF THE FOUNDATION IS THE CHESHIRE MEDICAL CENTER, A NEW HAMPSHIRE NON-PROFIT CORPORATION. THE MEMBER HAS THE POWER TO APPOINT OR REMOVE EACH TRUSTEE OF THE FOUNDATION. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Notwithstanding any other provision of these Bylaws, the Sole Member shall have the right to take the following actions or have the right to approve by majority vote of the Sole Member's Board of Trustees, prior to the adoption and implementation, of all of the following acts of the Foundation: (i) any repeal, alteration or amendment of the Articles of Agreement or Bylaws of the Foundation; (ii) the election or removal of any Trustee of the Foundation; (iii) any merger with or consolidation of the Foundation with and into another entity, or the acquisition by the Foundation of substantially all of the assets of another entity or the sale or lease of substantially all of the assets of the Foundation to any person or entity; (iv) (a) any conveyance, purchase, sale or lease of, or grant of mortgages, trust deeds or creation of other liens or encumbrances on, real property assets of the Foundation, or (b) any other material conveyance of any assets or the incurring of any material indebtedness of the Foundation; (v) any creation of an affiliate or subsidiary organization, or any affiliation of the Foundation with any other entity for the purpose of the joint conduct of business or other programs, whether in the form or participation in a corporation (either through the holding of stock or membership), partnership, joint venture, co-tenancy or any other form of ownership or control; (vi) acceptance of gifts that are: (1) contingent upon actions of the Sole Member or its affiliates; (2) limited to use, by or for the benefit of, the Sole Member or its affiliates; or (3) require any payout from the Sole Member or one of its affiliates; and (vii) to approve the dissolution or liquidation of the Foundation. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 IS REVIEWED BY EXTERNAL TAX ADVISORS, AND THE CFO BEFORE THE FILING OF THE RETURN. ONCE THE RETURN HAS BEEN FULLY PREPARED, A FINAL VERSION IS SENT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS AND RESPONSES PRIOR TO THE OFFICIAL FILING OF OF THE FORMS. Form 990, Part VI, Line 12c Conflict of interest policy THE FOUNDATION'S BOARD OF TRUSTEES APPROVED A POLICY CONCERNING VOLUNTARY SELF-DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. THE DARTMOUTH-HITCHCOCK COMPLIANCE AND AUDIT SERVICES DEPARTMENT CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS AND TRUSTEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION-MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. Form 990, Part VI, Line 19 Required documents available to the public THE CHESHIRE HEALTH FOUNDATION MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER REVENUE - Total Revenue: 5911, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 5911; Form 990, Part XI, Line 9 Other changes in net assets or fund balances NET ASSET TRANSFERS BETWEEN AFFILIATES - -65540; Form 990, Part XII, Line 3a FINANCIAL STATEMENTS AND REPORTING THE FOUNDATION WAS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE DARTMOUTH-HITCHCOCK HEALTH SYSTEM. DURING FISCAL YEAR 2023, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FEDERAL FUNDING WHICH MET THE MINIMUM THRESHOLD SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. DUE TO THE NATURE OF THE CONSOLIDATED FINANCIAL STATEMENTS, THE AUDIT WAS PERFORMED ON THE FINANCIAL INFORMATION OF ALL ORGANIZATIONS, INCLUDING CHESHIRE HEALTH FOUNDATION. CHESHIRE HEALTH SERVICES 580-590 COURT STREET KEENE NH 03431 473379283 HEALTHCARE NH 501(c)(3) 3 CMC false CHESHIRE MEDICAL CENTER 580 COURT STREET KEENE NH 03431 020354549 HOSPITAL NH 501(c)(3) 3 D-HH false DARTMOUTH-HITCHCOCK HEALTH ONE MEDICAL CENTER DRIVE LEBANON NH 03756 264812335 PARENT ORGANIZATION NH 501(c)(3) 7 NA false KEENE HEALTH ENTERPRISES 580 COURT STREET KEENE NH 03431 020374999 REAL ESTATE HOLDING NH CMC C Corporation false KEENE HEALTH REALTY 580 COURT STREET KEENE NH 03431 020374998 REAL ESTATE HOLDING NH CMC C Corporation false KEENE HEALTH SERVICES 580 COURT STREET KEENE NH 03431 020374997 REAL ESTATE HOLDING NH CMC C Corporation false Fitch Charitable Trust 580-590 Court Street Keene NH 03431 Charitable Trust NH CHF Trust 1 false M Hayden Irrevocable TUW 580-590 Court Street Keene NH 03431 CHARITABLE IRREVOCABLE TRUST NH CHF Trust 1 false false true false false false false false false false false false true false true true true true true true