2024-07-30T12:11:15-05:00 2023-09-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2022-10-01 020223332 Huggins Hospital HUGG 6035697571 PO Box 912 Wolfeboro NH 03894 Joshua Upham CFO 6035697571 2024-07-29 1 1 Joseph R Byrne P01289281 2077752387 2024-07-29 2022 2024-08-08 14:25:15Z Jeremy Roberge PO Box 912 Wolfeboro NH 03894 130486469 0 X www.hugginshospital.org X 1907 NH Critical Access Hospital 15 11 635 20 0 0 2763257 2068553 88614005 99086681 5348058 3186872 113418 106797 96838738 104448903 229925 289538 0 0 51005101 52494303 0 0 239871 42407253 45364258 93642279 98148099 3196459 6300804 150852808 156750032 63796561 58769620 87056247 97980412 Huggins Hospital's mission is to empower the fulfillment of life through better health. 0 0 77293606 289538 99086681 Huggins Hospital is a non-profit Critical Access Hospital that provides medical services to the region's year-round population of 30,000 residents and approximately 120,000 seasonal residents and visitors. Our services include primary care, inpatient care, intensive care, surgery, medical imaging and diagnostics, gynecology, orthopedics, pediatrics, cardiology, infusion services, respiratory therapy, speech therapy, nutrition services, cardiac and physical rehabilitation, social services and emergency services. 77293606 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 78 0 1 635 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Joshua Upham 6035697590 PO Box 912 Wolfeboro NH 03894 Corrine Smith RN Chairman 2.00 0.00 X X 0 0 0 Michael L'Ecuyer Vice Chairman 2.00 0.00 X X 0 0 0 Howie Knight Treasurer 2.00 0.00 X X 0 0 0 Susan John Assistant Treasurer 2.00 0.00 X X 0 0 0 James Cubeddu PA-C Secretary 40.00 0.00 X X 136618 0 17755 Kathy Barnard Trustee 2.00 0.00 X 0 0 0 Christian Coulter Trustee 2.00 0.00 X 0 0 0 Michael Gallup Trustee 2.00 0.00 X 0 0 0 Les MacLeod Trustee 2.00 0.00 X 0 0 0 Diana Scott Trustee 2.00 0.00 X 0 0 0 Don Smith Trustee 2.00 0.00 X 0 0 0 Cecile Chase Trustee 2.00 0.00 X 0 0 0 Alex Walker Esq Trustee 1.00 40.00 X 0 705005 397338 Jamison Costello DO Trustee/Med. Staff President 40.00 0.00 X 216349 0 45189 Jeremy Roberge President & CEO 40.00 1.00 X X 434865 0 30011 Stephen Wainwright Past Assistant Treasurer 2.00 0.00 X X 0 0 0 David Booth Past Trustee 2.00 0.00 X 0 0 0 William Marsh MD Past Trustee 2.00 0.00 X 0 0 0 Judith Cole APRN Past Trustee 2.00 0.00 X 0 0 0 Joshua Upham CFO 40.00 1.00 X 280138 0 6144 John S Boornazian Chief Medical Officer 24.00 0.00 X 182813 0 9137 Monica O'Clair Chief Strategy Officer 40.00 0.00 X 213405 0 34714 Stacey Savage Chief Nursing Officer 40.00 0.00 X 196098 0 6848 Jeremy Paul Hogan Surgeon 40.00 0.00 X 492289 0 49609 Brent Richardson Surgeon 40.00 0.00 X 386242 0 33830 George Costello Surgeon 30.00 0.00 X 333952 0 27251 Michael Giovan Past Surgeon 30.00 0.00 X 295123 0 24280 Eric Lewis Physician 40.00 0.00 X 269004 0 37808 Joseph Pepe MD Former Trustee 0.00 0.00 X 0 733333 1338 3436896 1438338 721252 79 1 1 0 Emergency Physician Associates Inc PO BOX 634850 Cincinnati OH 45263 ER and Hospitalist Service Management 2927401 Weatherby Locums Inc PO BOX 972633 Dallas TX 75397 Locums and Outside Labor 2330694 Collaborative Anesthesia Partners PO Box 160 Plymouth NH 03264 Anesthesia Service Management 1703390 Barton Heathcare Staffing LLC PO Box 412801 Boston MA 02241 Outside Contract Labor 1264614 NCM Management Inc 6 Lily Pond Road Gilford NH 03249 Construction Management 1261216 13 23400 2045153 2068553 Patient Service Revenue 622100 196272508 196272508 Miscellaneous 622100 2489150 1143400 1345750 Contractual/Char. Adj. 622100 -99674977 -99674977 99086681 1748159 1748159 108179 2094 106085 106085 106085 27381343 75404 26018034 0 1363309 75404 1438713 1438713 18150 23400 17438 712 712 104448903 97740931 0 4639419 X 289538 289538 1810084 343653 1466431 40365619 32884333 7385318 95968 1069578 873508 193519 2551 6726502 5375122 1335786 15594 2522520 1992736 524024 5760 2048059 2048059 283801 283801 156650 156650 14489072 10894740 3489878 104454 105708 50998 54710 627715 457391 167954 2370 135941 65776 70165 2758687 1353055 1405632 44000 21195 22805 32473 15642 16831 987596 922416 65180 6347689 5928739 418950 1041423 359298 682125 Medical Supplies 10835521 10466386 369135 Medicaid Provider Tax 4114513 4114513 Miscellaneous 1355410 884567 457669 13174 98148099 77293606 20614622 239871 X 4867113 13309988 18268998 14418087 11367539 10664238 703934 769390 705098 758983 112904704 66428720 49873694 46475984 58469110 63733840 6597322 6619522 150852808 156750032 10586677 9823613 23456311 22866175 29753573 26079832 63796561 58769620 X 70737354 79819323 16318893 18161089 87056247 97980412 150852808 156750032 X 6300804 4057571 565790 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14159 14159 0 Part II-B, Line 1: Huggins Hospital is a member of the NH Hospital Association and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Huggins Hospital and other organizations in furtherance of their exempt purposes. Huggins Hospital does not directly perform any lobbying activities. 10721737 1312198 608000 11425935 13732733 -2347996 663000 10721737 11962767 2333966 564000 13732733 11594957 931810 564000 11962767 11989038 169919 564000 11594957 0.00000 0.30720 0.69280 0 0 1171195 1171195 53014361 38754724 14259637 50943481 23388807 27554674 7775667 4285189 3490478 46475984 Interest Rate Swap 522151 Finance Lease Payable 266190 Estimated Third-Party Payor Settlements 25291491 26079832 Part V, Line 4: The intended use of the endowment fund is to support health care services including indigent care, health education, as well as capital improvements and acquisitions. Golf Event 41550 23400 18150 7488 9950 41550 23400 18150 7488 9950 17438 712 1 1 1 X 125.000000000000 1 X 1 1 0 1 1 661929 419924 242005 0.00250 10957234 11727344 0 0.00000 11619163 12147268 242005 0.00250 447975 447975 0.00460 405176 405176 0.00410 17995012 13798622 4196390 0.04280 123656 123656 0.00130 18971819 13798622 5173197 0.05280 30590982 25945890 5415202 0.05530 14009 14009 0.00010 14009 14009 0.00010 20009996 19928498 81498 X 1 1 1 1 Huggins Hospital PO Box 912 Wolfeboro NH 03894 www.hugginshospital.org 120420900 X X X X Huggins Hospital 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X www.hugginshospital.org/about/community-health-needs-assessment X 1 22 1 www.hugginshospital.org/about/community-health-needs-assessment 0 1 X 125.000000000000 200.000000000000 X 1 1 X X X X 1 X www.hugginshospital.org/resources/financial-assistance-and-billing X www.hugginshospital.org/resources/financial-assistance-and-billing X www.hugginshospital.org/resources/financial-assistance-and-billing/ X X X X X 1 X 0 X X X X 1 X 0 0 Huggins Hospital Part V, Section B, Line 5: In 2022, multiple organizations, along with community members, collaborated to build a comprehensive Community Health Needs Assessment identifying and defining significant health needs, issues, and concerns of Carroll County and other communities served by Huggins Hospital. The process included in-person focus groups as well as community surveys. The process centered on gathering and analyzing data as well as receiving input from persons who represented the broad interests of the community to provide direction for creating a plan to improve the health of local communities. Many of the community's social support service organizations and other healthcare agencies participated. Along with the direct feedback from community members, these organizations provided input through a viewpoint of the clients they represent. Many of the organizations who participated in Huggins Hospital's Community Health Needs Assessment employ people with special knowledge and expertise in public health issues. Huggins Hospital Part V, Section B, Line 11: Huggins Hospital's most recent Community Health Needs Assessment and Implementation Plan was completed in 2022. The Implementation Plan includes strategies to address Access to Care, Access to Mental Health Services and Social Determinants of Health Improvement. Huggins Hospital, along with its partners in the Huggins Community Health Network - a network of healthcare and social service organizations in southern Carroll County - work together to identify the gaps and barriers that exist to improving the overall health and wellbeing of the community. The group also improves connections, navigation and referral to all resources in the community. Part I, Line 7: Financial Assistance and Means-Tested Government Programs: The amounts reported on Lines 7a & 7b were computed using a cost-to-charge ratio. Schedule H, Part I, Section 7, Row b, Column d (Direct Offsetting Revenue): DSH payment for this year was reflective of both the payment and a liability reduction associated with Years 2011 through 2017. Huggins reserved portions of DSH payments for those years as a result of the pending redistribution amongst NH hospitals. While Huggins will be paying back $7.7M for those years, the Hospital reserved $10.4M which resulted in a $2.7M increase in DSH payments for this year offsetting the community benefit for 2022. Part II, Community Building Activities: Huggins Hospital provides Community Building Activities to strengthen the community's capacity to promote the health and well-being of its residents. Community building activities include expenditures and in-kind donations for the development of programs, policies and partnerships intended to address physical and social economic determinants of health.Economic Development: Huggins Hospital is one of the New Hampshire Eastern Lakes Region's primary economic drivers as a large regional employer. The Hospital provides assurance to year-round and seasonal residents and visitors that 24/7 access to health care is available every day of the year. The economic health and quality of life hinges on the financial strength and the ability of the Hospital to provide healthcare in the region. Multiple Leadership Team members sit on local boards and assist with economic development initiatives with groups such as the Wolfeboro Chamber, the Wolfeboro Economic Development Corporation and the Eastern Lakes Region Housing Coalition. The Hospital also supports these agencies with cash and in-kind donations listed in the hospital's Community Benefits Report.Community Support: Huggins Hospital works collaboratively with local resources to build and maintain a healthy community. The Hospital maintains relationships with many organizations to promote and create better community health including Governor Wentworth Regional School District, Starting Point, Carroll County Coalition for Public Health, Central NH VNA & Hospice, Northern Human Services, local summer camps and many more. Huggins Hospital provides direct in-kind and cash donations to organizations who also strive to support a healthy community that you can find listed in the Financial Contributions section of the Community Benefits Report. As part of our community support, Huggins Hospital also provides paramedic-level services out in the community through the Paramedic Intercept Program. This program allows for a faster connection to a higher level of care that many rural areas do not have available. These quick connections to this high-level emergency care helps save lives and get people the care they need sooner. This program is counted on the Community Benefits Report under Community-Based Clinical Services.Coalition Building: Huggins Hospital staff members sit on multiple public health and regional health network groups to address healthcare concerns in multiple areas including chronic disease, substance misuse, mental health, behavioral health, elderly health, healthy childhood development and more.Community Health Improvement Advocacy: Huggins Hospital develops its Community Health Needs Assessment through comprehensive community outreach and involvement that creates a natural path to health improvement advocacy in our community. As mentioned before, employees at Huggins Hospital are involved in many community groups dedicated to the health of our community. Our employees are professionals in health care and are passionate about what they do. Not only do the employees sit on numerous health advocacy committees and boards, they also volunteer at other local healthcare organizations and support community healthcare initiatives. Emergency medical professionals at Huggins Hospital train local EMS for emergency preparedness and strive to improve the quality of emergency care. Huggins Hospital supports other local non-profits that provide needed support outside the Hospital's scope-of-care including mental health agencies and agencies for domestic violence support. The support for these initiatives is represented in multiple categories of the Community Benefits Report. Workforce Development: As a rural hospital with rural primary care locations, Huggins Hospital needs extra support in finding healthcare providers to maintain local services. Huggins Hospital uses a support system to help recruit qualified providers to the Eastern Lakes Region community in order to provide the healthcare services the community needs. Part III, Line 4: Please refer to pages 12 - 16 of the attached audited financial statements. Part III, Line 8: The Organization used a cost-to-charge ratio as its costing methodology to determine the amount of Medicare allowable costs. Part III, Line 9b: As a not-for-profit, tax-exempt, and charitable organization, Huggins Hospital serves all in medical need regardless of ability to pay. The organization is governed by a volunteer Board of Trustees committed to balancing community needs with our available resources to meet those needs. As a hospital-employed medical staff, all twelve physician practices accept patients regardless of ability to pay. Part VI, Line 2: Please see Part V, Section B. The Huggins Hospital Community Health Needs Assessment and Implementation Plan can also be found online at: https://www.hugginshospital.org/assets/pdf/CHNA_and_Implementation_Plan_2022.pdf. Part VI, Line 3: Huggins Hospital provides a notice to all patients both in the hospital and its physician practices of the financial assistance programs available to them. There is a staff of financial counselors who work with the uninsured and underinsured to assist in qualifying for Charity Care or a sliding fee schedule depending on the family income. Financial counselors also assist those uninsured in applying for and receiving assistance through the Medicaid program. Information about our financial assistance programs can be found on our website and in print or in person at all of our locations. Part VI, Line 4: Huggins Hospital is a non-profit, rural, Critical Access Hospital. Our community's year-round population is approximately 33,000 citizens which expands in the tourist season to about 120,000 residents. Huggins Hospital is the largest employer in Wolfeboro. The primary service area for Huggins Hospital includes: Alton, Brookfield, Effingham, Freedom, Ossipee, Tamworth, Tuftonboro, Wakefield and Wolfeboro. Secondary service areas include parts of Barnstead, Gilford, Moultonborough and New Durham. These towns are located in Carroll, Belknap and Strafford Counties. Part VI, Line 5: Huggins Hospital has played an important role in the Eastern Lakes Region of New Hampshire for more than 100 years, enabling unwavering support to patients and their families, community members and employees. Gifts made to the Hospital's annual giving program and special initiatives support programs that are important to the region. Part VI, Line 6: Huggins Hospital is part of GraniteOne Health, an affiliation with Catholic Medical Center and Monadnock Community Hospital. All three organizations are non-profit, charitable organizations focused on improving the health of their respective communities as well as all the communities served by all of GraniteOne Health organizations. The affiliation is collaborative, allowing the three organizations to maintain their own identities and strategies while offering support to one another to improve on community health initiatives already in place. Huggins Hospital continues to work through the process of disaffiliation with GraniteOne Health, with the hope that it will be completed in Calendar Year 2024. Part VI, Line 7, Reports Filed With States NH 1 Foundation for Healthy Communities 125 Airport Road Concord NH 03301 020275078 501(c)(3) 289538 0 To support NH Alcohol 1 0 Part I, Line 2: Amounts paid to Organizations were required by the State of NH in order to support Medicaid expansion. Therefore, additional monitoring of funds was not deemed to be necessary. X X X 1 1 0 0 0 0 0 1 0 Alex Walker Esq Trustee 0 630932 0 0 0 74073 0 383583 0 13755 0 1102343 0 0 Joseph Pepe MD Former Trustee 0 0 0 0 0 733333 0 1338 0 0 0 734671 0 0 Jeremy Paul Hogan Surgeon 466627 0 25600 0 62 0 8971 0 40638 0 541898 0 0 0 Jeremy Roberge President & CEO 372265 0 62600 0 0 0 9567 0 20444 0 464876 0 0 0 Brent Richardson Surgeon 381780 0 4400 0 62 0 4313 0 29517 0 420072 0 0 0 George Costello Surgeon 303390 0 30500 0 62 0 8986 0 18265 0 361203 0 0 0 Michael Giovan Past Surgeon 245123 0 50000 0 0 0 6346 0 17934 0 319403 0 0 0 Eric Lewis Physician 249628 0 19314 0 62 0 7066 0 30742 0 306812 0 0 0 Joshua Upham CFO 249056 0 31082 0 0 0 5982 0 162 0 286282 0 0 0 Jamison Costello DO Trustee/Med. Staff President 198162 0 18100 0 87 0 6017 0 39172 0 261538 0 0 0 Monica O'Clair Chief Strategy Officer 189405 0 24000 0 0 0 5161 0 29553 0 248119 0 0 0 Stacey Savage Chief Nursing Officer 190098 0 6000 0 0 0 5784 0 1064 0 202946 0 0 0 John S Boornazian Chief Medical Officer 131999 0 50752 0 62 0 9137 0 0 0 191950 0 0 0 James Cubeddu PA-C Secretary 122556 0 14000 0 62 0 5950 0 11805 0 154373 0 0 0 Part I, Lines 4a-b Joseph Pepe MD, Former President/CEO of CMC, received a severance payment in the amount of $733,333 during calendar year 2022. Joseph Pepe MD, Former President/CEO of CMC and Alex Walker Esq., Executive Vice President & Chief Operating Officer of CMC, participate in a supplemental non-qualified retirement plan as described in Internal Revenue Code Section 457(f). During calendar 2022 $280,646 was deferred into the plan for Mr. Walker. No amount was deferred for Mr. Pepe. Part I, Line 7 Bonuses paid to physicians/surgeons were based off of performance metrics relating to increased service access. The Bonuses for Senior Leadership are currently driven off of organizational goals as well as individual goals. Part II Joseph Pepe MD, a Former Trustee on the Huggins Hospital board, is the President/CEO of Catholic Medical Center (a related organization) and is compensated by Catholic Medical Center. Alex Walker, Esq., a Trustee on the Huggins Hospital board, is the Executive Vice President & Chief Operating Officer of Catholic Medical Center (a related organization) and is compensated by Catholic Medical Center. A New Hampshire Health & Education Facilities Authority Series 2017A 020279866 2017-06-30 14380488 Refinance of Series 2009 State of New Hampshire Bond 0 0 0 B New Hampshire Health & Education Facilities Authority Series 2017B 020279866 2017-06-30 14160667 Refinance of Series 2007 State of New Hampshire Bond 0 0 0 A 2073424 14380488 184943 14195545 2017 0 1 1 1 B 1695779 14160667 117813 14042854 2017 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 1 0 Deutsche Bank AG 35.000000000000 0 0 0 0 1 A 0 B 0 Date Rebate Computation Performed Issuer Name: New Hampshire Health & Education Facilities Authority Series 2 Date the Rebate Computation was Performed: 06/23/2023 Issuer Name: New Hampshire Health & Education Facilities Authority Series 2 Date the Rebate Computation was Performed: 06/23/2023 Form 990, Part VI, Section B, line 11b A designated officer or management official meets with the preparer to discuss a draft of the Form 990 in detail. Once any necessary revisions are made, this draft is then submitted to the Finance & Budget Committee for further review. Afterwards, a copy of the public inspection copy of Form 990 is made available to the full board for their general review and comment prior to filing the return. A designated officer then signs the return after considering board comments. Form 990, Part VI, Section B, line 12c A copy of the conflict of interest policy is given to every officer, board member, and key employee on an annual basis, along with an annual disclosure statement. Each person is asked to complete, date and sign the disclosure statement, listing any known financial interest that the individual, or a member of the individual's family, has in any business entity that transacts business with the Organization. The Chairman of the board then reviews and maintains the disclosure statements for future reference. If a conflict arises, the board member will recuse themselves from participation in the deliberations and decisions relating to that conflict. Form 990, Part VI, Section B, line 15 The Hospital relies on externally available market data to determine the appropriate salary and any incentive compensation for the President as well as other officers and key employees of the organization. Each year, the President provides the Board with a listing of the five highest paid senior staff. Base salary and incentive compensation provided to the President is determined by three members of the Executive Committee of the Board as part of an annual performance review and their recommendation is shared with the full Board for final approval. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are made available to the public upon request for inspection in the President's office. Form 990, Part IX, line 11g Physician Fees: Program service expenses 6,820,647. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,820,647. Contracted Services: Program service expenses 2,924,524. Management and general expenses 2,247,543. Fundraising expenses 1,332. Total expenses 5,173,399. Other Professional Services: Program service expenses 981,161. Management and general expenses 1,061,128. Fundraising expenses 103,122. Total expenses 2,145,411. Collection Fees: Program service expenses 40,953. Management and general expenses 44,065. Fundraising expenses 0. Total expenses 85,018. Consulting Fees: Program service expenses 127,455. Management and general expenses 137,142. Fundraising expenses 0. Total expenses 264,597. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Huggins Hospital PO Box 912 Wolfeboro, NH 03894 EIN 02-0223332 Section 1.263(a)-3(n) Election: Huggins Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Change in Value of Interest Rate Swap 585,588. Change in Beneficial interest in Perpetual Trust -19,798. Hospital and Community Aid Association Inc PO Box 1377 Wolfeboro NH 03894 026008048 Purchases equipment for the benefit of Huggins Hospital and its' patients. NH 501(c)(3) Line 12b, II 0 GraniteOne Health 100 McGregor Street Manchester NH 03102 814663563 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Alliance Ambulatory Services 100 McGregor Street Manchester NH 03102 020519436 Ambulatory Surgical Center NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Health Services 100 McGregor Street Manchester NH 03102 611508839 Practices NH 501(c)(3) Line 10 CMC Healthcare System 0 Alliance Resources Incorporated 100 McGregor Street Manchester NH 03102 020398138 Real Estate NH 501(c)(3) Line 12b, II CMC Healthcare System 0 Catholic Medical Center 100 McGregor Street Manchester NH 03102 020315693 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 CMC Healthcare System 100 McGregor Street Manchester NH 03102 010568516 Management NH 501(c)(3) Line 12b, II N/A 0 Catholic Medical Ctr Physicans Practice Assoc 100 McGregor Street Manchester NH 03102 020460245 Practices NH 501(c)(3) Line 10 CMC Healthcare System 0 Monadnock Community Hospital 452 Old Street Road Peterborough NH 03458 020222157 Hospital NH 501(c)(3) Line 3 GraniteOne Health 0 Monadnock Health Services 452 Old Street Road Peterborough NH 03102 020420789 Inactive NH 501(c)(3) Line 12a, I Monadnock Community Hospital 0 St Peters Home 100 McGregor Street Manchester NH 03102 020222228 Day Care Services NH 501(c)(3) Line 10 CMC Healthcare System 0 Bedford Ambulatory Surgical Center 11 Washington Place Bedford NH 03110 020519727 Surgical Center NH N/A 0 0 McGregor Street MOB LLC 100 McGregor Street Manchester NH 03110 134347316 Medical Office Building NH N/A 0 0 Huggins Senior Housing PO Box 912 Wolfeboro NH 03894 020490445 Elderly Housing NH Huggins Hospital C 862 678593 1.00000 1 Alliance Enterprises 100 McGregor Street Manchester NH 03102 020386795 Real Estate NH N/A C 0 Doctor's Medical Association 100 McGregor Street Manchester NH 03102 020340690 Medical Office Building NH N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0