The Hitchcock Foundation

“Form 990, Section A, Line 6 The Hitchcock Foundation has the following membership: Dartmouth-Hitchcock Clinic, the sole voting member, retains limited powers in accordance with the bylaws, elects Trustees of the Board, and approves changes in bylaws. The operational management of The Hitchcock Foundation is delegated to the Board of Trustees, in accordance with the bylaws.”

“Form 990 Section A, Line 7a & 7b Dartmouth-Hitchcock Clinic (DHC) is the sole corporate member of The Hitchcock Foundation. As such, DHC retains limited powers in accordance with the bylaws including, but not limited to, electing Trustees of the Board, and approving changes within the bylaws.”

“Form 990, Section B, Line 19 THF's governing documents are available through the New Hampshire Department of State. Certain financial information is disclosed through the Community Benefits Annual Report. The audited financial statements and the conflict of interest policy are available upon request in either electronic or hardcopy form.”

“Form 990, Part VI, Line 11b The Form 990 is reviewed by an independent accounting firm, The Hitchcock Foundation's (THF) Executive Director. A copy of the return is emailed to the entire board prior to filing. In addition, the Treasurer of THF Board of Trustees will review prior to filing the return.”

“Form 990, Part VI Section B Line 12C The Dartmouth Hitchcock Foundation Board of Trustees approved a policy concerning a voluntary self-disclosure of any potential conflict of interest. The Dartmouth-Hitchcock, Office of Policy Support, Compliance and Audit Services conducts an annual survey of all officers and trustees and performs other procedures as considered necessary to report on compliance with the conflict of interest policy. The Compliance and Audit Services Department then reports to each board any potential conflicts for their review. Per the policy, any conflicts or otherwise perceived conflicts are required to be addressed by the Board of Trusteees on an ongoing basis. In the event a conflict arises, the individual may be removed from participating in any decision making regarding the identified conflict and/or its corresponding transactions. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.”

“Part VI, Section B, Line 13 The Organization has adopted and follows the policy of a related entity, Dartmouth-Hitchcock Clinic. Document Retention and Destruction Policy Form 990 Part VI, Section B, Line 14 The Organization has adopted and follows the policy of a related entity, Dartmouth-Hitchcock Clinic. Offices & Positions for Which Process was Used & Year Undertaken Form 990, Part VI, Question 15b The Director and staff of The Hitchcock Foundation are donated by Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital. Compensation for officers and key employees are evaluated by internal HR staff using national benchmarking data, along with ongoing evaluations by an independent third party firm for reasonableness, with the last formal process in 2012. External benchmarking from an independent third party has been used for any Officer who was hired or received a compensation adjustment since the last process 2012. Compensation rates are determined by following the guidelines of the compensation committee charter and philosophy documents and/or a formal review by compensation committee members.”

“Form 990, Part VII, Section A, Line 1 The compensation paid by related organizations was for services provided to the related organizations and not the filing organization, with exception of the Executive Director, of which 100% of their time is spent with the Foundation. Although the individuals spent the time listed as part of their board of trustee duties, they were not compensated with respect to those hours. The time/hours reported at the related organization varies by individual and organization. Form 990, Part IX, Line 11G Other Fees for Services Other Fees for services includes reimbursement for payroll for research and education-related expenses to Dartmouth Hitchcock Clinic, Mary Hitchcock Memorial Hospital, and The Trustees of Dartmouth College in the amount of $1,718,896. The remaining $225,295 was paid to other outside entitites related to the Foundation's mission of providing research and education. Form 990, Part XI, Line 9 Reconciliation of Net Assets-Other Changes Net assets released from restriction: ($1,302,122 )”

“FORM 990 Part XII, Question 3a DURING FISCAL YEAR 2014, MARY HITCHCOCK MEMORIAL HOSPITAL EXPENDED FEDERAL FUNDING WHICH MET THE MINIMUM THRESHOLD SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. DUE TO THE NATURE OF THE CONSOLIDATED FINANCIAL STATEMENTS, THE AUDIT WAS PERFORMED ON THE FINANCIAL INFORMATION OF ALL ORGANIZATIONS, INCLUDING THE FOUNDATION.”