Community Benefit Insight - Tax-exempt hospital

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Southern New Hampshire Medical Center

Southern Nh Medical Center

8 Prospect Street
Nashua, NH 03060

Bed count	188	Medicare provider number	300020	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 020483054

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

9.66%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 2,367,667 0.90 %
Medicaid as % of operating expenses	$ 18,811,180 7.18 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 1,226,761 0.47 %
Subsidized health services as % of operating expenses	$ 1,589,095 0.61 %
Research as % of operating expenses	$ 55,654 0.02 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 404,814 0.15 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 874,436 0.33 %
Community building* as % of operating expenses	$ 225,438 0.09 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 225,438 0.09 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 219,752 97.48 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 0 0 %
Community health improvement advocacy as % of community building expenses	$ 2,973 1.32 %
Workforce development as % of community building expenses	$ 0 0 %
Other as % of community building expenses	$ 2,713 1.20 %
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 12,063,556 4.60 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 2,103,390 17.44 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 223146631 including grants of $ 0) (Revenue $ 281135807)
Provides acute healthcare services to a diverse population base including indigent within southern and central New Hampshire. Southern New Hampshire Medical Center is a nonprofit hospital, serving all who need care, regardless of ability to pay. Medical services provided included 8,724 inpatient admissions, 230,050 outpatient registrations, 33,753 emergency room visits, 4,933 surgical procedures, and 1,195 births.

4B (Expenses $ 4382402 including grants of $ 0) (Revenue $ 0)
Charity Care ($2,320,639) and other uncompensated care ($2,061,763) at cost.

4C (Expenses $ 2777875 including grants of $ 0) (Revenue $ 0)
Community health services and health professional education.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

Southern New Hampshire Medical Center
Part V, Section B, Line 5: Southern New Hampshire Medical Center worked with officials from the City of Nashua Division of Public Health and other members of the community, including local police and fire departments, school officials, ambulance service leaders, directors of community agencies, hospital leaders, physicians and area residents through focus groups to gather input for the community health assessment.The 2020 CHA employed numerous research methods to gather input from the community, including online surveys, in-person interviews, and data analysis. The CHA utilized these methods separately and decisively for each of its identified community health needs.The City of Nashua Division of Public Health and Community Services (DPHCS) conducted a community-based survey in 2020 and invited Greater Nashua residents help determine what the biggest health priorities were in their communities, and to share their COVID-19 experiences. Online surveys were distributed widely throughout the Greater Nashua community via social media, community networks, and physical posted flyers. The surveys were available in both English and Spanish. Specifically designed surveys were administered to evaluate each of the community's various health needs. For example, different surveys were used to gather community-data regarding substance abuse, access to care, mental and behavioral health, chronic disease, environmental health, and child and maternal health. Community input through these surveys allowed the collaborative report to better evaluate unique health risks and concerns within various social groups and communities.The research was originally designed as a series of in-person, focus group sessions to be held across the Greater Nashua region throughout the summer of 2020. Research design began in January, 2020, but when the COVID-19 pandemic called for social distancing, research design had to be adjusted to accommodate online data collection. With the switch to an online survey based design, research questions were modified from a semi-structured interview design to a survey design.

Southern New Hampshire Medical Center
Part V, Section B, Line 6a: Southern New Hampshire Medical Center took part in the 2020 Greater Nashua Community Health Assessment for its most recent CHNA. This Assessment was conducted by the Nashua Department Division of Public Health and their Public Health Advisory Council partners. It is a product of the dedication and collaboration of over 33 organizations, programs, and City departments serving the GNPHR. A full list of the hospital facilities that participated in this Assessment can be found through the City of Nashua Community Health Assessment homepage at:https://nashuanh.gov/560/Community-Health-Assessment

Southern New Hampshire Medical Center
Part V, Section B, Line 6b: Southern New Hampshire Medical Center took part in the 2020 Greater Nashua Community Health Assessment for its most recent CHNA. This Assessment was conducted by the Nashua Department Division of Public Health and their Public Health Advisory Council partners. It is a product of the dedication and collaboration of over 33 organizations, programs, and City departments serving the GNPHR. A full list of the facilities other than hospitals that participated in this Assessment can be found through the City of Nashua Community Health Assessment homepage at:https://nashuanh.gov/560/Community-Health-Assessment

Southern New Hampshire Medical Center
Part V, Section B, Line 11: Southern New Hampshire Medical Center (SNHMC) participated and contributed to the Southern New Hampshire Health Implementation Strategy for its fiscal year ending in 2021; the information and conclusions from this Strategy continue to be relevant for this year's tax filing. The Strategy identified a series of Priority 1 and Priority 2 health needs and programs. Identified Priority 1 health needs included: - Behavioral and mental health, substance misuse, and suicide prevention- Obesity, weight management, exercise, and nutrition- Access to care, coverage, and insuranceIdentified Priority 2 health needs included:- Healthcare for women, mothers, and babies- Environment health- Chronic disease and cancer- Communicable disease- Public health emergency preparedness- Social determinants of health- General safetyWhile each of the identified priority health needs demand their own unique approach and solutions, there are some common programs and initiatives that Southern NH Medical Center has undertaken which address the significant health needs of its community as a whole. For example, SNHMC continues to focus on training and retaining a highly skilled and professional staff of care providers across all spectrums of the health industry. SNHMC also places great value on community outreach and engagement, including collaboration with community groups and partners. Additionally, through improved information technology, patient records, patient advocacy, and health care education and literacy, SNHMC is able to provide more personalized, direct care to its community in order to address the identified health priorities. As an example, SNHMC screens all patients for food insecurity and nutrition, to ensure that patients have adequate access to healthy food sources. SNHMC offers multiple care locations and scheduling opportunities to ensure that patient needs are being met, that access to care is available and convenient, and that the health and wellness concerns of SNHMC's community are being addressed.For more information on how Southern New Hampshire Medical Center is addressing the needs identified in the CHNA, our Implementation Strategy is available on our website at: https://www.snhhealth.org/community-health.

Southern New Hampshire Medical Center
Part V, Section B, Line 13b: Southern New Hampshire Medical Center offers a discount equal to the average of their three largest payors plus Medicare to all self pay patients. Discounted care is provided to all uninsured and underinsured patients.

Southern New Hampshire Medical Center
Part V, Section B, Line 20e: See response for Part III, Section C, Line 9b above.Prior to placing accounts with collection agencies, Southern New Hampshire Medical Center pulls out patients who qualify for charity based on census tract data and does not place those accounts with an agency but rather awards charity or free care assistance for their encounter.

Southern New Hampshire Medical Center
Part V, Section B, Line 24: Southern New Hampshire Medical Center may charge patients who are having cosmetic or experimental, non-covered services gross charges for that encounter.

Schedule H, Part V-B, Line 16a:
Southern New Hampshire Medical Center's Financial Assistance Policy is available on their website at: English: https://www.snhhealth.org/SNHH/media/Documents/CharitableCare-eff-04012019-final-english-version-for-posting-update-062_1.pdfSpanish: https://www.snhhealth.org/SNHH/media/Documents/CharitableCare-eff-04012019-final-spanish-vesion-update-062020_1.pdf

Schedule H, Part V-B, Line 16b:
Southern New Hampshire Medical Center's FAP Application is available on their website at:English: https://www.snhhealth.org/SNHH/media/Documents/Charitable-Care-Financial-Assistance-Application-and-Cover-Letter-ENGLISH-050321.pdfSpanish: https://www.snhhealth.org/SNHH/media/Documents/Charitable-Care-Financial-Assistance-Application-and-Cover-Letter-SPANISH-050321.pdf

Schedule H, Part V-B, Line 16c:
Southern New Hampshire Medical Center's FAP Plain Language Summary is available on their website at:https://www.snhhealth.org/billing-and-insurance/charitable-care-policy

Schedule H, Part V, Section B, Line 7:
Access to Southern New Hampshire Medical Center's past CHNA reports can be found at the following web-address:https://www.snhhealth.org/community-healthThe Southern New Hampshire Health System's 2021 Community Health Needs Assessment is available at the following web-address:https://www.snhhealth.org/getattachment/Community-Health/Southern-NH-Health-System-s-Community-Health-Needs-Assessment-(2021).pdf.aspx?lang=en-USAdditionally, the collaborative Greater Nashua CHA, to which Southern New Hampshire Medical Center proudly contributed, can be found at the following web-address:https://www.nashuanh.gov/560/Community-Health-Assessment

Schedule H, Part V, Section B, Line 10:
Southern New Hampshire Health is dedicated to meeting the health needs of the communities it serves. We take a number of steps to fulfill this mission; we work collaboratively with the city of Nashua and other social service agencies to identify the health concerns and needs in the city and the greater Nashua region. However, Southern NH Health also completes its own community health needs assessment, building on the city's vital work. We support the city's action plan and broaden our assessment to define and address the unmet health needs in all of the 32 communities we serve. More information about these efforts can be found at the following web address:https://www.snhhealth.org/community-health

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 3c:
Southern New Hampshire Medical Center offers a discount equal to the average of their three largest payors plus Medicare to all self-pay patients. Discounted care is provided to all uninsured and underinsured patients.

Part I, Line 7:
The costing methodology used was the ratio of cost to charge as outlined in Worksheet 2 of the instructions. The only exception to this was for subsidized service area where the cost structure was specific to that service area. For those areas, our Cost Accounting system was used.

Part II, Community Building Activities:
Southern New Hampshire Medical Center is committed to improving the health and well-being of the Greater Nashua area and our community building activities help us achieve this goal. Through our involvement in the Rotary Club and Nashua Chamber of Commerce, along with other community organizations, we are able to exchange ideas with area leaders concerning health care issues and make informative decisions that best address the health needs of our community. We provide Medicare Counseling to area senior citizens giving them the guidance they need to make informed decisions about their healthcare coverage. Our support of the United Way's Day of Caring has resulted in a growing number of our employees going out into the area and helping members of the community with healthcare and other needs. We are strong in our commitment to the Greater Nashua area and plan to continue to support and grow community building activities that improve the overall health of the area. A majority of the organization's Board of Trustees is comprised of persons who reside in the Primary Service Area (PSA) who otherwise have no relationship with the organization. Many members of the organization volunteer their time to other community agencies in the PSA.

Part III, Line 2:
Southern New Hampshire Medical Center's Bad Debt Expense includes accounts that have been referred to a collection agency after making reasonable attempts to determine eligibility under the financial assistance policy, along with estimates of current accounts receivable based in historical experience.

Part III, Line 3:
A significant portion of Southern New Hampshire Medical Center's uninsured patients will be unable or unwilling to pay for the services provided. Thus, Southern New Hampshire Medical Center records a significant provision for bad debts related to uninsured patients in the period the services are provided. The FASB issued an accounting standards update that states that a health care entity that recognizes significant amounts of patient service revenue at the time services are rendered, even though it does not assess the patient's ability to pay, must present bad debts as a reduction of net patient revenue and not as a separate item in the operating expense. The ratio of cost to charge methodology was used to determine costs of these services as outlined in worksheet 2 of the instructions. Consistent with the accounting treatment mentioned above, since the system does not assess the patient's ability to pay, the cost of bad debt for those patients without any form of insurance should be classified as community benefit, consistent with charity care.

Part III, Line 4:
See page nine of the attached audited financial statements.

Part III, Line 8:
The ratio of cost to charge methodology was used to determine cost as outlined in Worksheet 2 of the instructions. There are service areas where government programs such as Medicare and Medicaid do not reimburse the organization adequate amounts to cover the costs to provide those services. Southern New Hampshire Medical Center must provide those services regardless of the financial shortfall.

Part III, Line 9b:
Southern New Hampshire Medical Center recognizes that not all patients who qualify for financial assistance will follow through with an application for financial assistance. Prior to placing any account with a collection agency, Southern New Hampshire Medical Center uses a financial assistance qualification service to categorize patients based primarily on income and assets estimated from census tract data. Those patients whose estimated income/assets fall within Southern New Hampshire Medical Center's financial assistance guidelines are awarded charity or free care assistance for their encounter.

Part VI, Line 2:
Southern New Hampshire Medical Center worked with the City of Nashua Division of Public Health officials and other members of the community, including local police and fire departments, school officials, ambulance service leaders, directors of community agencies, hospital leaders, physicians and area residents through focus groups to gather input for the Community Health Needs Assessment (CHNA).A Community Health Assessment (CHA) is a collaborative process that identifies key health needs and issues through systematic, comprehensive data collection and analysis. CHAs provide information on a variety of health topics and help identify resources which assist with policy formulation, program implementation, and evaluation. CHAs are also a crucial component of accreditation as they help measure how well a public health system is fulfilling the assurance function, one of the three fundamental purposes of public health. The Greater Nashua CHA is part of an ongoing comprehensive community health improvement process. The purpose of the CHA is to identify vulnerable populations using comparable data within the Greater Nashua Public Health Region (GNPHR) and to subsequently identify trends in health issues, environmental health hazards, and social and economic factors that affect the different populations' health. Collected and analyzed data will be used to identify priority issues within the Greater Nashua Region, and to develop strategies for further actions; these actions are outlined in the form of a Community Health Improvement Plan (CHIP). The CHIP creates a foundation for a work plan to improve the health of the community over the course of three years' time. One of the main objectives of the most recent Community Needs Assessment's research was to determine the biggest health concerns in the community in order to determine community health priorities. The research for this report indicated that most people in the Greater Nashua Region are concerned about behavioral health (including substance use, mental health, and suicide), affordable and accessible healthcare, and outbreaks of communicable disease (40%, 30%, and 26% of respondents, respectively). In regards to upcoming concerns for the next three years, most people are concerned about behavioral health (including substance use, mental health, and suicide), affordable and accessible healthcare, and outbreaks of communicable disease (38.6%, 36.1%, and 25.4% of respondents, respectively).

Part VI, Line 7, Reports Filed With States
NH

Part VI, Line 3:
Southern New Hampshire Medical Center complies with the Southern New Hampshire Health financial assistance policy. Southern NH Health is committed to providing charitable care to persons who have health care needs and are uninsured, underinsured, and ineligible for governmental programs and are otherwise unable to pay for medically necessary care based on their individual financial situations. Southern NH Health strives to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. Charitable care is not considered to be a substitute for personal responsibility and patients are expected to cooperate with Southern NH Health's policies and procedures for obtaining charitable care and to contribute to the cost of their care based on their individual ability to pay. Patients with the financial capacity to purchase health insurance shall be encouraged to do so, as a means of access to health care services, for their overall personal health and protection of their individual assets. Since July 2010, the State of New Hampshire has mandated that any uninsured patient who receives nonelective, medically necessary hospital services are billed an amount no greater than the amount generally received from patients covered by insurance. Additionally, the 2015 Federal 501(r) regulations further require that when calculating this discount, Medicare reimbursement must be included. Therefore, Southern NH Medical Center reduces the amounts owed by uninsured patients by the uninsured discount prior to the patients receiving their first statements of balances due. These discounted balances, and not gross charges, are the balances upon which financial assistance is based, granted and classified for reporting purposes. The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates insurance coverage for individuals starting on January 1, 2014. Additionally, it expands Medicaid coverage to all individuals at or below 100% of the Federal Poverty Level (FPL). The New Hampshire Legislature approved Medicaid expansion effective August 15, 2014. The Granite Advantage Health Care Program (GAHCP) extends NH Medicaid eligibility to all individuals at or below 138% of the Federal Poverty Level. The granting of charitable care shall be based on an individualized determination of financial need, and shall not take into account age, gender, race, social or immigrant status, sexual orientation or religious affiliation.At each registration point, Southern New Hampshire Medical Center has signage and brochures explaining our various forms of financial assistance, including charity care. Additionally, patient registrars offer the charity brochures to self pay patients. Patients who call regarding billing concerns are offered charity assistance. Additionally, verbiage regarding charity care is printed on each billing statement the patient receives. Also, charity care information is available on our hospital website. There is staff available on site at the hospital to assist with financial assistance, Medicaid, and Expanded Medicaid applications. We actively participate in Medicaid Exchange programs and a Prescription Assistance Program to help those with financial needs.Additional information regarding Southern New Hampshire Medical Center's financial assistance policies can be found on the Southern New Hampshire Health website, as provided on this Schedule H.

Part VI, Line 4:
Southern New Hampshire Medical Center serves people of all ages, race, gender, religion, ethnicity regardless of their ability to pay. Southern New Hampshire Health's service area consists of nineteen New Hampshire and four Massachusetts towns. The service area is divided into a Primary Service Area (PSA) of twelve New Hampshire towns (Amherst, Brookline, Hollis, Hudson, Litchfield, Lyndeborough, Merrimack, Milford, Mont Vernon, Nashua, Pelham, and Wilton), a Secondary Service Area (SSA) of seven New Hampshire towns (Derry, Greenville, Londonderry, New Boston, New Ipswich, Salem, and Windham) and a Massachusetts Service Area (MSA) of four neighboring Massachusetts towns (Dunstable, Pepperell, Townsend, and Tyngsboro).For its 2020 tax year, Southern New Hampshire Medical Center collaborated with the City of Nashua in developing the Greater Nashua Community Health Assessment; much of the information from this report is still relevant for the 2021 tax filings. The four geographies mentioned most often throughout this report are the City of Nashua, the Greater Nashua Public Health Region, Hillsborough County, and the State of New Hampshire (NH). Throughout the State of NH, there are 13 public health regions. The Greater Nashua Region is composed of the City of Nashua and its 12 surrounding towns which include Amherst, Brookline, Hollis, Hudson, Litchfield, Lyndeborough, Mason, Merrimack, Milford, Mont Vernon, Pelham, and Wilton.As of 2019, the combined population of the Greater Nashua Region was estimated to be about 88,000 individuals. To gauge the demographics of this region, the CHA used a variety of survey and online-polling tools. The majority of survey respondents were Nashua residents (73.6%), but the remaining 26% of respondents were distributed throughout the Greater Nashua region. About 18% of respondents identify within the constructs of racial or ethnic diversity, and the remaining 82% of participants identified as white or Caucasian. 27.1% of respondents were between the ages of 50 and 59; approximately 80% of all respondents were aged 59 or younger. The majority of respondents were at least partially college-educated, with approximately 85% of respondents having completed some college, or having completed an Associate's, Bachelor's, or Graduate degree.

Part VI, Line 5:
Southern New Hampshire Medical Center provides a variety of services that promote the health of the greater Nashua community. Throughout the year we hold Community Medical Education seminars that offer area residents an opportunity to look behind the scenes of medicine and learn more about the latest medical technology, research and advances. We also perform free public health screenings, such as impact testing for sports teams at local schools, and balance and hearing screenings for the elderly. Our commitment to community health is also evident in the time our leadership spends on the boards of several local health organizations to help improve and promote health services available to area residents.Through the past fiscal year, Southern New Hampshire Medical Center has worked in collaboration with various other government agencies and care providers to address the COVID-19 Pandemic. From the outset of the Pandemic, Southern New Hampshire Health's Incident Command team quickly went to work preparing to care for COVID-19 patients. At that time, the Medical Center activated the Incident Command team whose attention quickly turned to PPE. Nation-wide shortages of surgical masks, N95 masks, gowns, face shields, and cleaning supplies dominated the headlines. Inconsistent images of protective practices at different hospitals and in different countries became another source of concern. A plan to manage PPE was devised and put into place. At the height of the pandemic, rounds were conducted multiple times a day to answer questions and provide the most up-to-date information. All essential workers coming to work at Southern New Hampshire Health rose to the challenges imposed by the Pandemic. In order to meet the potential for increasing demand, clinical areas were re-purposed and some staff were re-assigned to expand critical care capabilities. Teams also came together and collaborated in new and creative ways, such as using tablets for virtual family visits and continuous monitoring of patients. What was unexpected was the outpouring of caring and compassion from the community to our staff in the form of care packages, food, home-made masks, and notes of thanks and encouragement. All of this has been greatly appreciated by our staff and it has helped to keep them going during this uncertain time.While the COVID-19 Pandemic naturally came to the forefront of Southern New Hampshire Medical Center's community health and care programs, Southern New Hampshire Medical Center continued to engage its community and to promote the wellbeing of its fellow citizens throughout the year on a variety of levels. For example, Southern New Hampshire Medical Center continued to focus its attention on educating, maintaining, and supporting a highly educated and competent workforce. Additionally, Southern New Hampshire Medical Center continued to advocate for community safety, nutrition, and personal wellness.

Part VI, Line 6:
Southern New Hampshire Health System, Inc. is a not-for-profit entity organized to support Southern NH Medical Center and Foundation Medical Partners, Inc. Both Southern New Hampshire Medical Center and Foundation are not-for-profit entities, established to provide medical services to the people of the greater Nashua area.On April 30, 2018 Southern New Hampshire Health System became part of the new non-profit healthcare organization named SolutionHealth. This new non-profit healthcare entity is the combination of two New Hampshire non-profit health care organizations, Elliot Health System (EHS) and Southern New Hampshire Health System (SNHHS), combining together to protect the future sustainability of accessible, comprehensive, value-based clinical care. SolutionHealth is a regional healthcare system with a governing body with members from both EHS and SNHHS. This new organization services over 400,000 community members, is located in the two largest and most diverse cities in New Hampshire and employs over 700 physicians and advanced practice providers in New Hampshire.Additionally, Southern New Hampshire Medical Center frequently and actively collaborates with the City of Nashua Division of Public Health and Community Services as well as other similarly geographically located institutions to enhance the quality and availability of care throughout New Hampshire.

Operating expenses	$ 262,122,124
Total amount spent on community benefits as % of operating expenses	$ 25,329,607 9.66 %