SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
Nashua Regional Cancer Center Inc
 
Employer identification number

02-0444860
Return Reference Explanation
Form 990, Part VI, Section A, line 6 The Center's stockholders include three not-for-profit acute care hospitals: Mary Hitchcock Memorial Hospital, Southern New Hampshire Medical Center, and St. Joseph Hospital. Each stockholder made equal capital contributions to the Center and was issued 100 shares of the Center's common stock at a par value of $1 per share.
Form 990, Part VI, Section A, line 7a The Center's stockholders each have a representative on the Board of Directors.
Form 990, Part VI, Section A, line 7b The Center's Board of Directors has a representative from each of its shareholders who are each entitled to a vote. No single shareholder has a controlling vote.
Form 990, Part VI, Section B, line 11b The organization's 990 is provided to the Audit Committee and the Board President for review.
Form 990, Part VI, Section B, line 12c Members of the Governing Board and key employees are required to fill out a Declaration of Duality and Conflict of Interest statement each year. This statement is reviewed for potential conflicts of interest.
Form 990, Part VI, Section B, line 15 The members of the governing body use external human resource experts to review the compensation for the Executive Director.
Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy and financial statements are available to the public upon request.
Form 990, Part XI, line 9: Distributions to Stockholders -1,800,000.
Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Nashua Regional Cancer Center, Inc. 11 North Southwood Park Drive, Nashua, NH 03063 EIN 02-0444860 Nashua Regional Cancer Center, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).
Form 990, Schedule A, Part I, Line 3 The Organization's tax exemption is based upon the classification of a hospital or cooperative hospital service organization described in section 170(b)(1)(A)(iii). Since the Organization is not licensed by the State of New Hampshire as a hospital, Schedule H is not required.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2016


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