SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
New London Hospital Association Inc
 
Employer identification number

02-0222171
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		0 0 850,606 0 850,606 1.33 %
b Medicaid (from Worksheet 3, column a) . . . . . 0 0 6,232,927 5,277,634 955,293 1.49 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . . 0 0 0 0 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 7,083,533 5,277,634 1,805,899 2.82 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 0 0 226,857 0 226,857 0.35 %
f Health professions education (from Worksheet 5) . . . 0 0 155,953 0 155,953 0.24 %
g Subsidized health services (from Worksheet 6) . . . . 0 0 3,006,743 0 3,006,743 4.69 %
h Research (from Worksheet 7) . 0 0 0 0 0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 0 0 30,380 0 30,380 0.05 %
j Total. Other Benefits . . 0 0 3,419,933 0 3,419,933 5.34 %
k Total. Add lines 7d and 7j . 0 0 10,503,466 5,277,634 5,225,832 8.16 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing 0 0 0 0 0 0 %
2 Economic development 0 0 0 0 0 0 %
3 Community support 0 0 57,153 0 57,153 0.09 %
4 Environmental improvements 0 0 0 0 0 0 %
5 Leadership development and
training for community members		 0 0 0 0 0 0 %
6 Coalition building 0 0 0 0 0 0 %
7 Community health improvement advocacy 0 0 21,323 0 21,323 0.03 %
8 Workforce development 0 0 517 0 517 0 %
9 Other 0 0 0 0 0 0 %
10 Total 0 0 78,993 0 78,993 0.12 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,502,318
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
25,320,434
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
26,897,911
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-1,577,477
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 New London Hospital
273 County Road
New London,NH03257
www.newlondonhospital.org
02407 		        X   X      
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
New London Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.newlondonhospital.org/
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
New London Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.newlondonhospital.org/services/billing-charges/
b
https://www.newlondonhospital.org/services/billing-charges/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
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Part VFacility Information (continued)

Billing and Collections
New London Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
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Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
New London Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
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Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. During the period January through June 2018, a Community Health Needs Assessment of the New London Hospital service area was completed by New London Hospital in partnership with Dartmouth-Hitchcock, Alice Peck Day Memorial Hospital, Valley Regional Healthcare, Mt. Ascutney Hospital and Health Center, Visiting Nurse and Hospice for VT and NH, and the New Hampshire Community Health Institute. The purpose of the assessment was to identify community health concerns, priorities and opportunities for community health and health care delivery systems improvement. For the purpose of the assessment, the geographic area of interest was 15 municipalities comprising the New London Hospital service area with a total resident population of 32,912 people. Methods employed in the assessment included surveys of community residents made available on-line and paper surveys placed in numerous locations throughout the region; a direct email survey of key stakeholders and community leaders representing multiple community sectors; a set of community discussion groups; compilation of results from assessment activities focused specifically on behavioral health needs and gaps; and a review of available population demographics and health status indicators. All information collection activities and analyses sought to focus assessment activities on vulnerable and disproportionately served populations in the region including populations that could experience limited access to health-related services or resources due to income, age, disability, and social or physical isolation. The 2018 Community Health Needs Assessment Survey conducted by New London Hospital yielded 717 individual responses of which 80% were residents of towns within the primary service area or approximately 2% of the total adult population. In addition to the survey of community residents, the 2018 Community Health Needs Assessment included a similar survey sent by direct email to key stakeholders and community leaders from around the region. This activity occurred in conjunction with all the Community Health Needs Assessment partners with the survey going to 265 individuals across the greater Upper Valley region of NH and VT including the New London region. A total of 153 completed responses were received (58%), of which 35 respondents indicated serving or being most familiar with the New London region. A set of four discussion groups were convened in the spring of 2018 as part of the effort by New London Hospital to understand the health-related needs of the community and to plan programs and services that address those needs. These discussion groups reached out to organizations serving populations affected by poverty, lack of insurance, homelessness, and behavioral health issues. The purpose of the discussion groups was to get input on health issues that matter to the community and thoughts and perceptions about the health of the community. These discussion groups which were convened representing a variety of important community sectors and perspectives included New London Hospital Volunteers, Kearsarge Interfaith Leadership Council, Newport Food Pantry, and Newport parents and school personnel.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. NEW LONDON HOSPITAL ASSOCIATION CONDUCTED THEIR COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH DARTMOUTH-HITCHCOCK, VALLEY REGIONAL HEALTH CARE, ALICE PECK DAY MEMORIAL HOSPITAL, MT. ASCUTNEY HOSPITAL AND HEALTH CENTER, VISITING NURSE AND HOSPICE FOR VT AND NH, AND THE NEW HAMPSHIRE COMMUNITY HEALTH INSTITUTE.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. DURING DECEMBER 2018, IN ADDITION TO WORKING WITH THE ENTITIES LISTED ON LINE 6A, NLH WORKED CLOSELY WITH THE MEMBER ORGANIZATIONS OF THE GREATER SULLIVAN COUNTY PUBLIC HEALTH COUNCIL FOR THE LAKE SUNAPEE REGION TO DISSEMINATE SURVEYS, SERVE AS KEY INFORMANTS, AND TO PROVIDE OVERALL REVIEW AND FEEDBACK RE: FINDINGS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. THE NEEDS ASSESSMENT WAS DISTRIBUTED TO NON-PROFIT ORGANIZATIONS THROUGHOUT THE REGION INCLUDING THE GREATER SULLIVAN COUNTY PUBLIC HEALTH COUNCIL. IT IS ALSO AVAILABLE FROM THE ORGANIZATION UPON REQUEST.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. THE NEW LONDON HOSPITAL ASSOCIATION IS INCREASING BOTH COMMUNITY BENEFITS SPENDING AND PARTNERSHIPS TO ADDRESS IDENTIFIED COMMUNITY NEEDS BASED ON THE MOST RECENT CHNA. THESE ARE IN THE AREAS OF ACCESS TO AFFORDABLE HEALTH INSURANCE, HEALTH CARE SERVICES, PRESCRIPTION DRUGS, AND MENTAL HEALTH SERVICES, AVAILABILITY OF PRIMARY CARE SERVICES, INVESTMENTS IN BEHAVIORAL HEALTH AND SUBSTANCE USE NEEDS, STRENGTHENING FAMILIES AND CHILDREN, CANCER CARE AND TREATMENT, AVAILABILITY OF PRIMARY CARE AND SENIOR CITIZEN SERVICES, AND COMMUNITY PARTNER COLLABORATIONS. IN FY 2019, THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT STRATEGIES WERE CONSISTENT WITH THE INTENTIONS IDENTIFIED IN THE FY2018 COMMUNITY HEALTH IMPROVEMENT PLANS. AREAS WERE ANALYZED AND THE HOSPITAL RESPONDED BY INCREASING INVESTMENTS, MAINTAINING SIMILAR LEVELS OF INVESTMENTS FOR SERVICES AND INITIATIVES, OR LIMITING INVESTMENT IN AREAS WHERE OTHER COMMUNITY ORGANIZATIONS ALREADY PROVIDE LEADERSHIP AND SERVICES TO ADDRESS THE NEED, AND/OR WHERE THE IDENTIFIED NEED IS SIGNIFICANTLY OUTSIDE THE MISSION/SERVICES/SCOPE. COLLABORATION WITH COMMUNITY GROUPS HAS ALLOWED SERVICES TO EXPAND INTO NEW AREAS AND BRING FORTH ADDITIONAL RESOURCES TO THE COMMUNITY AND REMOVE BARRIERS TO HEALTHCARE. IN ADDITION, THE ASSOCIATION'S AFFILIATION WITH DARTHMOUTH-HITHCOCK HAS ALSO PROVIDED SUPPORT FOR THE IDENTIFIED COMMUNITY BASED NEEDS. THE NEW LONDON HOSPITAL ASSOCIATION'S COMMUNITY HEALTH IMPROVEMENT PLAN IS A 3-YEAR DOCUMENT IDENTIFYING ANTICIPATED INVESTMENTS AND ACTIVITIES THAT IT WILL TAKE TO ADDRESS NEEDS IDENTIFIED IN THE MOST RECENT CENTRAL NEW HAMPSHIRE'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA).
Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - NEW LONDON HOSPITAL ASSOCIATION. MAILINGS AND PHONE CALLS ARE USED AS ADDITIONAL FOLLOW UP MEASURES TO ENSURE THAT PATIENTS ARE AWARE OF THE VARIOUS TYPES OFF DISCOUNTS AND FINANCIAL ASSISTANCE THAT THE ORGANIZATION OFFERS. ASSISTANCE IS OFFERED TO ANYONE IN NEED TO COMPLETE THE NECESSARY PAPERWORK FOR FINANCIAL ASSISTANCE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address Type of Facility (describe)
1 Newport Health Center
11 John Stark Hwy
Newport,NH03773 		Rural health clinic
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 9 PART V, LINE 9 NEW LONDON HOSPITAL CONDUCTED A NEW CHNA WHICH WAS COMPLETED IN FY18 AND APPROVED BY THE BOARD IN JUNE OF 2018. THE COMMUNITY HEALTH IMPLEMENTATION PLAN/STRATEGY ("CHIP") WAS APPROVED BY THE BOARD ON OCTOBER 25, 2018.
Schedule H, Part V, Section B, Line 13 PART V, Line 13G IN ORDER TO RECEIVE FINANCIAL ASSISTANCE, AN INDIVIDUAL MUST BE A RESIDENT IN ONE OF 15 COMMUNITIES IN NH OR THEIR PRIMARY CARE PHYSICIAN MUST BE ON-STAFF AT NEW LONDON HOSPITAL
Schedule H, Part V, Section B, Line 16 PART V, Line 16 I THE ORGANIZATION REVIEWED THE SERVICE AREA AND DETERMINED NO TRANSLATIONS WERE NECESSARY FOR THE POPULATION SERVED.
Schedule H, Part I, Line 7g Subsidized Health Services THE NEW LONDON HOSPITAL ASSOCIATION IS DEDICATED TO SERVING AND SUPPORTING THE COMMUNITY IT SERVES BY ENSURING ACCESS TO PROGRAMS THAT COULD NOT BE PROVIDED WITHOUT THE ORGANIZATION SUBSIDIZING THEIR SERVICES. IN FY 2019, THE HOSPITAL SUBSIDIZED HEALTH CARE SERVICES TO THE COMMUNITY IN EXCESS OF $3 MILLION. THIS INCLUDED SUPPORT FOR PRIMARY CARE SERVICES, AMBULANCE, MOBILE INTEGRATED HEALTH, COMMUNITY WELLNESS PROGRAMS AND GRANTS, MENTAL HEALTH SERVICES, AND THE MEDICATION BRIDGE PROGRAM. WITH A FOCUS ON WELLNESS, PRIMARY CARE IS THE UTMOST IMPORTANCE TO OUR PATIENTS AND THEIR FAMILIES. THE HOSPITAL HAS LOCATIONS FOR PRIMARY CARE IN NEW LONDON AND NEWPORT, NEW HAMPSHIRE, TO EXPAND ACCESS TO THE COMMUNITIES WE SERVE. NEW LONDON HOSPITAL HAS AN AMBULANCE SERVICE THAT SERVED 7 OF OUR LOCAL COMMUNITIES IN FY 2019. ADVANCED LIFE SUPPORT IS PROVIDED BY PARAMEDICS IN CONJUNCTION WITH EMERGENCY SERVICES TO PROVIDE CRITICAL CARE TO THE RESIDENTS OF OUR COMMUNITIES. A MOBILE INTEGRATED HEALTH UNIT HAS BEEN INTRODUCED TO OUR COMMUNITIES TO PROVIDE CARE TO OUR PATIENTS UPON LEAVING THE HOSPITAL TO ENSURE THAT THEY CAN UNDERSTAND THE ASPECTS OF THEIR CARE PLAN AND HAVE ACCESS TO THE NECESSARY RESOURCES FOR RECOVERY. NEW LONDON HOSPITAL HAS DEVELOPED WELLNESS PROGRAMS TO OFFER EDUCATION AND PROVIDE ASSISTANCE TO OUR COMMUNITY MEMBERS IN MAKING AND SUSTAINING HEALTHIER LIFESTYLE CHOICES. THE COST OF PRESCRIPTION DRUGS IS OFTEN BEYOND THE MEANS OF MANY OF THE RESIDENTS IN OUR COMMUNITIES. THE HOSPITAL SUPPORTS THE MEDICATION BRIDGE PROGRAM, WHICH WORKS WITH UNINSURED AND UNDERINSURED PATIENTS TO ASSIST THEM IN ACCESSING PRESCRIPTION MEDICATIONS.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The amounts were derived from the organization's cost accounting systems.
Schedule H, Part II Community Building Activities THE HOSPITAL PARTICIPATES IN A WIDE VARIETY OF COMMUNITY BUILDING ACTIVITIES INCLUDING COMMUNITY SUPPORT AND COMMUNITY HEALTH IMPROVEMENT ADVOCACY. THE HOSPITAL SUPPORTS MANY LOCAL SERVICE AGENCIES THROUGH THE PARTICIPATION OF MEMBERS OF ITS MANAGEMENT TEAM ON LOCAL COMMITTEES AND BOARDS. THE HOSPITAL SUBSIDIZES THE COST OF OPERATIONS FOR THE ABC'S CHILDCARE CENTER, WHICH PROVIDES HIGH QUALITY CHILDCARE AT AFFORDABLE PRICES. THE CHILDCARE CENTER IS OPEN TO FULL AND PART-TIME EMPLOYEES OF THE ORGANIZATION AND TO THE COMMUNITY TO PROVIDE A NURTURING, SAFE AND STIMULATING ENVIRONMENT FOR THE CHILDREN OF THE COMMUNITY TO GROW AND LEARN.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology The hospital is unable to estimate accurately the amount of bad debt expense attributable to patients eligible for financial assistance. Although a portion of bad debt expense may be related to patients who would qualify for charity care, a reportable figure cannot be reasonably estimated.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote NLH IS INCLUDED IN THE DARTMOUTH-HITCHCOCK HEALTH AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS. THE AMOUNT REPORTED ON SCHEDULE H REPRESENTS NLH'S PORTION ONLY. NLH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR FINANCIAL ASSISTANCE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. BECAUSE NLH DOES NOT ANTICIPATE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. NLH GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS. MOST ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY ARRANGEMENTS. ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR BAD DEBT. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The costing methodology was according to the Internal Revenue Service guidance. Shortfalls in Medicare were anticipated because of the organization's central role of serving the needs of the community. This shortfall is considered a community benefit expenditure.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance NEW LONDON HOSPITAL ASSOCIATION HAS A CREDIT AND COLLECTION POLICY THAT ADDRESSES THE PROCEDURES FOR PATIENTS WHO QUALIFY FOR REDUCED-COST CARE. THE POLICY PROHIBITS USING EXTRAORDINARY COLLECTION PRACTICES OR PLACING AMOUNTS WITH COLLECTION AGENCIES. IF A FINANCIAL ASSISTANCE POLICY ELIGIBLE PATIENT HAS A BALANCE FOR WHICH THEY ARE RESPONSIBLE, AFTER A FINANCIAL ASSISTANCE DISCOUNT IS APPLIED, THE STANDARD PRACTICES ARE FOLLOWED AS OUTLINED IN THE CREDIT AND COLLECTIONS POLICY.
Schedule H, Part V, Section B, Line 16a FAP website - New London Hospital: Line 16a URL: https://www.newlondonhospital.org/services/billing-charges/;
Schedule H, Part V, Section B, Line 16b FAP Application website - New London Hospital: Line 16b URL: https://www.newlondonhospital.org/services/billing-charges/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - New London Hospital: Line 16c URL: https://www.newlondonhospital.org/services/billing-charges/;
Schedule H, Part VI, Line 2 Needs assessment IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL USES REGULAR FEEDBACK FROM THE COMMUNITY, PROVIDED THROUGHOUT THE YEAR, TO ASSESS ITS HEALTH NEEDS. THE HEALTH STAFF PARTICIPATES IN OR LEADS MULTIPLE COMMUNITY COALITIONS AND PROJECTS COLLABORATING AND CONNECTING WITH A WIDE ARRAY OF COMMUNITY-BASED HEALTH, MUNICIPAL, SCHOOL, SERVICE ORGANIZATION, REGIONAL PLANNING AND STATE PUBLIC HEALTH STAKEHOLDERS. WE REGULARLY REVIEW EMERGING NH STATE HEALTH DATA; QUANTITATIVE AND QUALITATIVE DATA FROM LOCAL SOURCES (NEWSPAPERS, REGIONAL PLANNING OFFICES, COMMUNITY FORUMS), AND CONVERSATIONS WITH COMMUNITY PARTNERS TO IDENTIFY CONCERNS THAT ARE EMERGING, INTENSIFYING, OR ARE THE SOURCE OF LOCAL ATTENTION SINCE THE LAST CHNA WAS CONDUCTED.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE ORGANIZATION STRIVES TO EDUCATE PATIENTS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IN A VARIETY OF FORUMS, AND ENCOURAGES PATIENTS TO APPLY FOR ASSISTANCE THEY MAY BE ELIGIBLE FOR. THE ORGANIZATION POSTS INFORMATION IN REGARDS TO FINANCIAL ASSISTANCE ON THE HOSPITAL'S WEBSITE, UPON ADMISSION, UPON REQUEST AND THROUGHOUT THE BILLING PROCESS.
Schedule H, Part VI, Line 4 Community information THE NEW LONDON HOSPITAL ASSOCIATION IS THE PRINCIPAL PROVIDER OF PRIMARY AND SECONDARY HEALTHCARE FOR 15 TOWNS IN SULLIVAN AND MERRIMACK COUNTIES OF CENTRAL NEW HAMPSHIRE. THE TOWNS WITHIN THE SERVICE AREA INCLUDE: ANDOVER, BRADFORD, CROYDON, DANBURY, GOSHEN, GRANTHAM, LEMPSTER, NEW LONDON, NEWBURY, NEWPORT, SPRINGFIELD, SUNAPEE, SUTTON, WASHINGTON, AND WILMOT. THE SERVICE AREA HAS A POPULATION OF 32,912, ACCORDING TO THE UNITED STATES CENSUS BUREAU, WHICH APPROXIMATES ABOUT 2 5% OF NEW HAMPSHIRE'S POPULATION. MEDIAN HOUSEHOLD INCOME VARIES WIDELY, FROM $51K-$95K ANNUALLY; 22.9% OF THE POPULATION IS OVER THE AGE OF 65; 5.4% OF CHILDREN LIVE IN HOUSEHOLDS WHOSE MEDIAN HOUSEHOLD INCOME IS LESS THAN 100% OF FEDERAL POVERTY LEVEL, 22.1% OF CHILDREN LIVE IN HOUSEHOLDS WITH INCOME LESS THAN 200% OF FEDERAL POVERTY LEVEL; 0.4% OF THE REGION'S RESIDENTS HAVE LIMITED ENGLISH PROFICIENCY; AND 8.1% LACKED HEALTH INSURANCE. THE REGION IS SERVED BY NEW LONDON HOSPITAL ASSOCIATION, GREATER SULLIVAN COUNTY PUBLIC HEALTH NETWORK AND VALLEY REGIONAL HOSPITAL. THERE PRESENTLY ARE NO MEDICALLY UNDERSERVED AREAS IN THE REGION.
Schedule H, Part VI, Line 5 Promotion of community health THE NEW LONDON HOSPITAL ASSOCIATION PLAYS AN ACTIVE ROLE IN PROMOTING COMMUNITY HEALTH AND OFFERS EDUCATIONAL PROGRAMS INCLUDING CLASSES AND WORKSHOPS. NLH OFFERS A VARIETY OF HEALTH PROMOTION, EDUCATION PROGRAMS, AND DIRECT SERVICES FOR THE COMMUNITY SPANNING A BROAD SPECTRUM OF HEALTH AND WELLNESS TOPICS. THE ORGANIZATION PROVIDES HEALTH EDUCATION CLASSES INCLUDING SAFE SITTER, SMOKING CESSATION, HEALTHY LIFESTYLE, AND PROGRAMS TO SUPPORT NEW PARENTS. ADDITIONAL CLASSES INCLUDE CPR, EMS, AND HEALTH CARE PROVIDER EDUCATION TO ALLOW EMERGENCY MEDICAL TRAINING TO RESIDENTS OF OUR COMMUNITY. OTHER INITIATIVES INCLUDE HOSTING OR LEADING COMMUNITY PARTNERSHIPS TO ADDRESS SUBSTANCE MISUSE AND TREATMENT AND TO IMPROVE PUBLIC HEALTH. CASH CONTRIBUTIONS, CONTRACTED SERVICES, AND IN-KIND CONTRIBUTIONS OF STAFF TIME AND EXPERTISE ARE USED TO SUPPORT THESE STRATEGIES WHICH IMPROVE THE HEALTH OF THE COMMUNITY. THE FRIENDS OF NEW LONDON HOSPITAL ART COMMITTEE, CONSISTING OF A VOLUNTEER GROUP OF LOCAL ARTISTS AND COMMUNITY MEMBERS, EXHIBITS ART WITHIN THE HOSPITAL. THIS COMMUNITY PROGRAM DRAWS FROM THE EXTENSIVE ART COMMUNITY IN THE AREA, INVITING ARTISTS TO EXHIBIT AND SELL THEIR WORK OR SUBMIT THEIR WORKS FOR PERMANENT DISPLAY. ART CAN PLAY A POWERFUL ROLE IN BRINGING COMFORT AND RELIEF TO THOSE RECEIVING TREATMENT OR CARE IN A HOSPITAL SETTING. THIS COLLABORATION ENHANCES THE ENVIRONMENT FOR THE HOSPITAL, PATIENTS, FAMILIES, GUESTS AND STAFF AND HAS PROVEN TO BE A SUCCESSFUL PARTNERSHIP. The New London Hospital Association, Inc. extends professional staff privileges to qualified physicians, advanced practice registered nurses, and physician assistants. The New London Hospital Medical Staff is an open medical staff. OF THE 18 VOTING MEMBERS OF THE NEW LONDON HOSPITAL ASSOCIATION BOARD OF TRUSTEES AT FY19 END, 9 ARE NEITHER CONTRACTORS NOR EMPLOYEES OF THE HOSPITAL OR ITS AFFILIATES. The majority of New London Hospital Association's volunteer Board of Trustees, the governing body of the organization, represent a broad range of interests which exist in the communities it serves. In particular the trustees of the New London Hospital Association are representative of the consumer interests of the various neighborhoods and localities which are serviced by the hospital.
Schedule H, Part VI, Line 6 Affiliated health care system NEW LONDON HOSPITAL ASSOCIATION IS AN AFFILIATE OF DARTMOUTH-HITCHCOCK HEALTH. THIS RELATIONSHIP ALLOWS THE STREAMLINING OF PATIENT CARE BETWEEN MEMBERS OF THE TWO HEALTHCARE SYSTEM AND STRENGTHENS THE CENTER AS A REGIONAL RESOURCE FOR THE KEARSARGE/LAKE SUNAPEE REGION IN CENTRAL NEW HAMPSHIRE. THE AFFILIATION ALLOWS MORE PATIENTS TO RECEIVE CARE CLOSER TO HOME, FREES UP BED CAPACITY FOR TERTIARY CARE PATIENTS AT DARTMOUTH-HITCHCOCK MEDICAL CENTER IN LEBANON, AND ALLOWS THE NEW LONDON HOSPITAL ASSOCIATION TO CONTINUE ITS ROLE IN PROVIDING PRIMARY CARE AND SPECIALIZED CLINICAL SERVICES IN A PATIENT AND FAMILY-FRIENDLY ENVIRONMENT. IT ENABLES NLH TO MORE EFFECTIVELY PURSUE A COMMON VISION WITH OTHER D-HH ENTITIES OF THE FUTURE OF HEALTH CARE THAT IS BASED ON CREATING A SUSTAINABLE HEALTH SYSTEM, FOCUSING ON POPULATION HEALTH, DELIVERING VALUE-BASED CARE, AND EMBRACING THE OPPORTUNITIES PROVIDED BY NEW PAYMENT MODELS. IN ADDITION TO THE NEW LONDON HOSPITAL ASSOCIATION AND DARTMOUTH-HITCHCOCK HEALTH, THE AFFILIATED HEALTH CARE SYSTEM INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL, DARTMOUTH-HITCHCOCK CLINIC, CHESHIRE MEDICAL CENTER, WINDSOR HOSPITAL CORPORATION, ALICE PECK DAY MEMORIAL HOSPITAL, VISITING NURSE ASSOCIATION AND HOSPICE OF NEW HAMPSHIRE AND VERMONT, AND A NUMBER OF OTHER RELATED ORGANIZATIONS WHOSE PRIMARY MISSION IS HEALTH CARE IN THE REGION. THE NEW LONDON HOSPITAL ASSOCIATION AND OTHER MEMBERS OF THE AFFILIATED HEALTH CARE SYSTEM OPERATE JOINTLY THROUGH INTERLOCKING DIRECTORATES, STRATEGIC PLANNING, MANAGEMENT, AND THEY SHARE IDENTICAL MISSIONS.
Schedule H, Part VI, Line 7 State filing of community benefit report NH
Schedule H (Form 990) 2018
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