2024-08-14T16:04:52-05:00 2023-09-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2022-10-01 030179418 Gifford Medical Center Inc GIFF 8027287000 44 South Main Street Randolph VT 05060 William D King CFO 8027287000 2024-08-12 1 1 Joseph R Byrne P01289281 2077752387 2024-08-12 2022 2024-08-08 14:25:15Z Daniel A Bennett 44 South Main Street Randolph VT 05060 81621844 0 X www.giffordhealthcare.org X 1905 VT Gifford Medical Center is a non-profit acute care hospital providing healthcare on an inpatient and outpatient basis. 15 11 497 35 0 0 2679346 715513 70587246 66662659 3121015 1758405 1066295 1116401 77453902 70252978 109956 149132 0 0 38541220 42202656 0 0 6325 31514112 31429644 70165288 73781432 7288614 -3528454 102925623 102439864 29108001 31057840 73817622 71382024 X The mission of Gifford Healthcare Inc. and its subsidiaries is to enhance the health and well-being of our communities by providing excellent patient-centered care including senior living services. 0 0 58457041 149132 66662659 Gifford Medical Center Inc. ("Gifford") operates a not-for-profit, 25 bed critical access hospital whereby medical providers and nurses provide around the clock care to patients. Inpatient care services include a medical/surgical unit, a birthing center, and end of life care. Gifford also offers a range of clinical and ancillary services: diagnostic imaging, laboratory testing, anesthesiology, cardiology, chiropractic care, hospitalists, neurology, oncology, orthopedics, pathology, podiatry, sports medicine, general surgery, and urology.Gifford Medical Center's caring and knowledgeable surgery team offers general surgery services including skin lesion and cyst removal, comprehensive breast care, diagnosis and treatment of all forms of cancer, wound care, pill endoscopy, colonoscopies and appendix removal. General surgeons provide a wide range of procedures (primarily focusing on the abdominal organs as well as diseases of the skin, breast, soft tissue and hernias) in both office and operating room settings.Gifford Medical Center offers various other health care services to the central Vermont area. Other services available include radiology, laboratory, respiratory therapy, physical therapy, occupationaltherapy, speech pathology, electro cardiology, chemotherapy, emergency, skilled nursing, labor and delivery, nursery, radioisotope, and electroencephalography. 58457041 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 113 0 1 497 1 0 0 0 0 0 0 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 X William D King 8027287000 44 South Main Street Randolph VT 05060 X Daniel Bennett President & CEO 40.00 2.00 X X 366183 0 46287 Megan O'Brien Past Trustee/Med. Staff President 40.00 0.00 X 141550 0 8291 Emilija Florance Trustee/Med. Staff President 40.00 0.00 X 242031 0 26574 Victor Ribaudo Chair 1.00 2.00 X X 0 0 0 Megan Cicio Vice Chair 1.00 2.00 X X 0 0 0 Peter Reed Secretary 1.00 2.00 X X 0 0 0 Jody Davignon Treasurer 1.00 2.00 X X 0 0 0 Kristin Chandler Director/Trustee 1.00 2.00 X 0 0 0 Matthew Considine Director/Trustee 1.00 2.00 X 0 0 0 Frederick Hauser Trustee 1.00 1.00 X 0 0 0 Sarah Jackson Director/Trustee 1.00 2.00 X 0 0 0 Theron Manning Director/Trustee 1.00 2.00 X 0 0 0 Jeffrey Nelb Director/Trustee 1.00 2.00 X 0 0 0 Morgan Rilling Director/Trustee 1.00 2.00 X 0 0 0 Clay Westbrook Director/Trustee 1.00 2.00 X 0 0 0 Todd Winslow Director/Trustee 1.00 2.00 X 0 0 0 Lincoln Clark Past Director/Trustee 1.00 2.00 X 0 0 0 Jennifer Bertrand CFO 40.00 2.00 X 257122 0 13302 Dennis P Gilroy Physician 40.00 0.00 X 452299 0 46242 John A Dreslin Physician Specialty Clinic 40.00 0.00 X 437049 0 18088 Jeffrey J Bath Physician 40.00 0.00 X 435877 0 48413 Joshua T White Chief Medical Officer 40.00 0.00 X 378596 0 48569 Aleksandr Sokolovsky Surgeon 40.00 0.00 X 322656 0 9052 3033363 0 264818 47 0 1 0 FocusOne Solutions LLC PO Box 850861 Minneapolis MN 554850861 Contract Nursing 2117700 Medstream Anesthesia PLLC PO Box 63467 Charlotte NC 282633467 Contract Anesthesia 1457679 SHC Services Inc PO Box 677896 Dallas TX 752677896 Contract Nursing 1171798 Dartmouth-Hitchcock Clinic One Medical Center Drive Lebanon NH 03766 Contract Providers 944078 Berry Dunn McNeil & Parker LLC 2211 Congress Street Portland ME 04102 Audit & Tax Services 881704 14 10764 36652 668097 715513 Patient Service Revenue 622100 119001820 119001820 Management Fee 622100 11120514 11120514 Fixed Prospective Revenue 622100 3963519 3963519 Other Revenue 622100 1181609 920541 261068 Contractual Allowances/Charity Ca 622100 -68604803 -68604803 66662659 945059 945059 1128496 187998 940498 940498 940498 11957874 11109994 34534 847880 -34534 813346 813346 212243 10764 36340 175903 175903 70252978 66401591 0 3135874 X 10000 10000 139132 139132 1101340 209222 892118 32780873 27587069 5189444 4360 1027790 860707 166961 122 5333144 4353815 978717 612 1959509 1588140 371146 223 112441 41457 70984 137915 2500 135415 12986417 9428679 3557738 30541 2626 27915 959809 570999 388701 109 134861 75255 59591 15 2473503 1234884 1238338 281 58557 55778 2772 7 438402 355315 83037 50 3607034 2923424 683200 410 550490 162032 388395 63 Medical Supplies and Dr 5174919 5174919 Medicaid Provider Tax 3468784 3468784 Other Supplies 898315 16236 882035 44 Miscellaneous Expenses 397656 196068 201559 29 73781432 58457041 15318066 6325 X 518984 320252 5421852 1338252 3000 9189064 5795480 1146466 1081795 1408213 1463577 94746847 60074631 35702579 34672216 31440513 28662371 624709 3843500 17470243 25262421 102925623 102439864 8000741 8260128 15600468 14800524 5506792 7997188 29108001 31057840 X 71231683 68719821 2585939 2662203 73817622 71382024 102925623 102439864 -3528454 1092856 0 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 18595 18595 0 Part II-B, Line 1: Gifford Medical Center, Inc. Is a member of the Vermont Association of Hospitals and Health Systems and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Gifford Medical Center in furtherance of its exempt purpose. Gifford Medical Center does not directly perform any lobbying activities. Gifford Medical Center also paid a lobbying firm to advocate on their behalf. 9603493 100000 895453 968894 9630052 11519437 200000 -1634182 481762 9603493 10540908 100000 1315462 436933 11519437 10156593 100000 666849 382534 10540908 9008731 600 1485691 338429 10156593 0.82510 0.17490 0.00000 1 0 751116 751116 40472164 24136217 16335947 154659 136157 18502 47621289 32692121 14929168 5747619 3110136 2637483 34672216 Other Receivables 161409 Due From Affiliates 25101012 25262421 Deferred Annuities 565426 Deferred Compensation 3636495 Operating Lease Liabilities 2348642 Estimated Amounts Due to Third-Party Payers 1446625 7997188 Part V, Line 4: The intended uses of the Organization's endowment funds are for health care services and capital, indigent care, community outreach initiatives, nursing, buildings, maintenance, and operations. Last Mile Ride 223007 10764 212243 5000 1520 8759 874 1000 19187 223007 10764 212243 5000 1520 8759 874 1000 19187 36340 175903 1 1 1 X 1 X 1 1 1 0 0 1560524 2683 1557841 0.02110 8433961 5235830 3198131 0.04330 9994485 5238513 4755972 0.06440 591065 353077 237988 0.00320 51649 51649 0.00070 149132 149132 0.00200 791846 353077 438769 0.00590 10786331 5591590 5194741 0.07030 1 0 10376722 11934868 -1558146 X 1 1 1 1 Gifford Medical Center PO Box 2000 Randolph VT 05060 www.giffordhealthcare.org 829 X X X X Gifford Medical Center 1 0 0 1 X X X X X X X X X 20 1 0 1 1 X www.giffordhealthcare.org/about-us/community-reports X 1 20 1 www.giffordhealthcare.org/about-us/community-reports 0 1 X 200.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X www.giffordhealthcare.org/service/financial-assistance/ X www.giffordhealthcare.org/service/financial-assistance X www.giffordhealthcare.org/service/financial-assistance X X X X X X 1 X 0 X X X X 1 X 0 0 Gifford Medical Center Part V, Section B, Line 5: Gifford Medical Center partnered with the Randolph Executive Community Council (RECC), which is comprised of community partners and serves as the Community Collaborative for the Randolph service area, to identify the significant health needs of our community. A survey was conducted to assess the most prevalent health and social needs within the community Gifford serves. 530 respondents completed the survey.The hospital facility gained input from representatives of the following organizations:- Gifford Health Care- Central Vermont Council on Aging - Capstone Community Action - Clara Martin Center - Bi-State Primary Care Association - Randolph Area Community Development / SASH- Visiting Nurse & Hospice for Vermont and New Hampshire- Stagecoach Transportation Services- South Royalton Health Center - Vermont Foodbank - BAYADA Gifford Medical Center Part V, Section B, Line 11: Gifford has strategically worked to address the community's need within its role as a health care provider. Areas initially identified as health challenges include: Mental health services, substance abuse counseling, nutrition/obesity, and dental care. Mental health services: In partnership with Gifford Healthcare, we have continued to strengthen our mental health services. This has included adding a behavioral health support group that focuses on post-partum mental health. Additionally, Gifford has actively sought out counselors with a wide variety of clinical skills to add to our behavioral health team, including those with expressive arts, marriage and family counseling, and youth focused mental heath care.Substance abuse counseling: In partnership with our parent corporation, Gifford Healthcare, Inc., a Federally Qualified Health Center, Gifford's behavioral health and blueprint for health team specialists offer counseling and one-on-one patient care at all Gifford primary care locations. Our addiction medicine program offers ongoing Suboxone treatment for patients with complex needs, Suboxone provider support, education, consultation, and therapy to help patients rebuild lives affected by opioid use disorder.Obesity: Gifford's primary care team has long been a proponent of healthy lifestyle choices for good health and the prevention of disease and obesity. BMIs are determined at annual health screenings and patients are guided by providers and Gifford's registered dietitians on healthy diets and portion control. Discussions in support group settings (such as diabetes and other chronic conditions) often focus on healthy choices to reduce and prevent disease. Patients are strongly encouraged to be physically active. In 2019 Gifford began a partnership with Veggie Van Go, a program of the Vermont Foodbank. Once a month all area community members with any food insecurities are invited to Gifford to pick up healthy food items.Dental care: Gifford Healthcare's federally qualified health center designation has brought resources that help us support local dentists as they strive to better care for the underserved and uninsured. To increase awareness of dental health, we have partnered with Healthhub, a local nonprofit with a mobile dental trailer. The trailer travels to a variety of locations, including area schools and Gifford, to offer screenings, x-rays, examinations and cleanings by a dental hygienist. Gifford Medical Center Part V, Section B, Line 16j: Gifford Medical Center contacts any uninsured patients that will register with the hospital to see if they are in need of financial assistance. Schedule H, Part V, Line 18d: Currently, Gifford has an outdated credit and collections policy that makes reference to legal procedures. Gifford does not actively engage in any legal action for nonpayment. Gifford is in the process of updating this policy to more accurately reflect actual processes and practices. 6 1 - Gifford Health Center at Berlin 82 East View Lane Berlin VT 05641 Specialty Care Practice 2 - Advance Physical Therapy 108 N Main Street White River Junction VT 05001 Rehab Services 3 - Gifford Health Center at Kingwood 1422 Route 66 Randolph VT 05060 Physician Practice and Rehab Services 4 - Sharon Health Center 12 Shippee Lane Sharon VT 05065 Sports Medicine Practice 5 - Twin River Health Center 108 N Main Street White River Junction VT 05001 Physician Practice and Rehab Services 6 - Gifford Speciality Care 44 South Main Street Randolph VT 05060 Specialty Care Practice Part I, Line 7: The cost to charge ratio calculated on IRS worksheet 2 was used in the calculation of cost on IRS worksheets 1 and 6. Part III, Line 2: The Organization used the cost-to-charge ratio as its costing methodology to calculate bad debt expense at cost. Part III, Line 4: Please refer to pages 11-14 and 19-20 of the attached audited financial statements. Part III, Line 8: Serving patients with Government health benefits, such as Medicare, is a component of the community benefit standard that tax-exempt hospitals are held to. This implies that serving Medicare patients is a community benefit and that the hospital operates to promote the health of the community. Part III, Line 9b: The application for and approval of financial assistance can occur before, during or after treatment so long as the account has not been written off to bad debt prior to receipt of a completed application and the necessary documentation. Accounts sent to bad debt after required information has been received can be returned from collections for processing without penalty to the applicant. Gifford Medical Center, Inc., encourages the application process to begin as early as possible. Part VI, Line 2: Identifying and meeting the community's health care needs would not be possible without input from the public.Gifford Medical Center provides ample opportunities for the public to provide both input and actively participate in medical center activities. The community health needs assessment process, annual hospital report card meetings, patient satisfaction surveys and one-on-one comments to hospital staff and board members help direct strategic planning and operational decisions. Every three years, Gifford engages in an extensive strategic planning process that results in the identification and implementation of a list of initiatives the hospital strives to achieve over the coming three years. Success at achieving those initiatives throughout, and by the conclusion of the three-year period is extensively monitored by the hospital's leaders, including its volunteer board of trustees. Part VI, Line 3: Gifford's Financial Assistance Program is available on our website. Patients are encouraged to seek assistance and speak with one of our advocates, who will provide one-to-one financial counseling to address patient financial needs in the most appropriate manner. Additionally, information is posted throughout the facility regarding patient rights and responsibilities, which states that a patient has the right to receive medical treatment regardless of their ability to pay and financial assistance is encouraged and available. Part VI, Line 4: In addition to the clinical offices located on the organization's main campus in Randolph, Vermont, the Organization operates community health care centers located in Sharon, Berlin, and Randolph, Vermont. The Randolph/Braintree area provides the most visits and is located in Orange County, Vermont. Part VI, Line 5: Gifford Medical Center strives to improve the health of its patients by providing and assuring access to affordable and high quality health care, and by promoting the health and wellbeing of everyone in our service area.Gifford collaborates and partners with local and state agencies to provide fresh produce to our community at no charge. Gifford provides education to the community regarding healthy eating, supports initiatives that promote responsible physical activity for all ages, provides continued prevention education for smoking cessation, vaping, and other higher risk behaviors.Gifford continues to focus on reducing the use of antibiotics through its Antibiotic Stewardship Program. The goal of the program is to reduce the reliance on antibiotics to assist in preventing the creation of super bugs that are resistant to commonly used antibiotics.Surplus funds that may be generated in a given year are used to support infrastructure improvements, the purchase of new or routine replacement of equipment, investments in technology, or other resources and services that are required to meet the needs of the community we serve. Gifford's governing body is comprised of community members who reside within its service area and dedicate a portion of their time to ensuring Gifford Medical Center meets the needs of its community. Part VI, Line 6: The Gifford Health Care System includes Gifford Health Care, Inc. (GHC), Gifford Medical Center, Inc. (GMC), and Gifford Retirement Community, Inc. (GRC). GHC is a Federally Qualified Health Center (FQHC). Gifford Medical Center, Inc. Is a 25-bed Critical Access Hospital (CAH) providing general and specialty services. Gifford Retirement Community, Inc. has a 30-bed nursing home unit, adult day services and independent living facility. 1 Tri-Valley Transit Inc 297 Creek Road Middlebury VT 057531906 030335768 501(c)(3) 10000 0 Operations support 1 0 End of Life Care/Comforting Patients & Families 79 137932 1200 Fair Market Value Quilts Part I, Line 2: The Organization provides grants to patients using the results of the Last Mile Ride special fundraising event. The grants assist patients and their families with end of life care and planning. X X X X X X 0 0 0 0 0 0 0 1 0 Dennis P Gilroy Physician 452299 0 0 0 0 0 15250 0 30992 0 498541 0 0 0 Jeffrey J Bath Physician 425211 0 10000 0 666 0 15250 0 33163 0 484290 0 0 0 John A Dreslin Physician Specialty Clinic 430000 0 6000 0 1049 0 15250 0 2838 0 455137 0 0 0 Joshua T White Chief Medical Officer 362958 0 14828 0 810 0 15250 0 33319 0 427165 0 0 0 Daniel Bennett President & CEO 354783 0 0 0 11400 0 15146 0 31141 0 412470 0 0 0 Aleksandr Sokolovsky Surgeon 272292 0 49955 0 409 0 0 0 9052 0 331708 0 0 0 Jennifer Bertrand CFO 254180 0 0 0 2942 0 11844 0 1458 0 270424 0 0 0 Emilija Florance Trustee/Med. Staff President 220632 0 21200 0 199 0 11706 0 14868 0 268605 0 0 0 Part I, Line 7 Gifford maintains financial incentives for providers. Provider incentives incorporate productivity, citizenship (contribution to hospital and community activities) and retention. Gifford's productivity measures are designed to ensure that all providers achieve a standard level of productivity. A Vermont Educational and Health Buildings Financing Agency 237154467 2021-04-01 16899942 To Refinance Existing Bond 0 0 0 A 1896626 16899942 237048 16662894 2021 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: Vermont Educational and Health Buildings Financing Agency Date the Rebate Computation was Performed: 05/01/2021 Magee Office Equipment & TDS Leasing Inc Entity more than 35% owned by Todd Winslow, Director/Trustee 132047 Purchased Supplies 0 Rachel A Westbrook Family member of Clay Westbrook, Director/Trustee 112334 Employment 0 Form 990, Part V, Lines 1a & 2a: Gifford Medical Center files all W-2s & 1099s for its related organizations, Gifford Health Care, Inc. (GHC) and Gifford Retirement Community, Inc. (GRC). The amounts reported on Part V, lines 1a & 1b are the allocable amounts specific to Gifford Medical Center, Inc. The compensation, employee benefits and payroll taxes are then allocated to GHC and GRC for the amounts that represent work performed for those organizations. Therefore, the amount reported on Part IX includes only those amounts allocated to work performed directly for Gifford Medical Center. The highest paid employees are determined by the work performed for each organization. Therefore, the five highest paid employees listed on Part VII and Schedule J are those employees who work directly for Gifford Medical Center, Inc. In addition the CEO and CFO's compensation has been shown in Part IX as paid by Gifford Medical Center only, although their time spent is attributable to all three entities. Form 990, Part VI, Section B, line 11b The Form 990 is prepared by an independent accounting firm based on the audited financial statements and information provided by the accounting department of the organization. The completed Form 990 is presented and reviewed by the Finance Committee of the Board of Trustees and an electronic copy of the complete Form 990 is made available to all Board Members prior to filing. Form 990, Part VI, Section B, line 12c Gifford Medical Center, Inc. requires board members to complete an annual conflict of interest survey. Any duality of interest or possible conflict of interest on the part of any director shall be disclosed to the other board members. Any director having duality of interest or possible conflict of interest on any matter shall not vote or use his personal influence on the matter, and shall not be present for discussion of the matter. The minutes of the meeting shall reflect that a disclosure was made and that the director abstained from voting and discussion. Form 990, Part VI, Section B, line 15 Gifford Medical Center's Chief Executive Officer is evaluated annually by a board compensation committee that relies on data and input from a variety of independent sources. The compensation information is then reviewed by the Executive Committee of the Board of Trustees and resultant recommendations are presented to the Board of Trustees for final approval. To evaluate the compensation of the Organization's other officers and key employees, the compensation review is administered by human resources and the CEO. The human resources department has some internal and external sources that are utilized to compare compensation amounts. Form 990, Part VI, Section C, line 19 The Organization makes its conflict of interest policy available upon request. The financial statements are available on the Organization's website, and upon request. Form 990, Part VII, Section A Board Member Compensation: Megan O'Brien (BOD term ended 03/23/23), Emilija Florance (BOD term started 04/27/23)(Medical Staff President), and Daniel Bennett (CEO) are employees of Gifford Medical Center/Gifford Health Care as well as members of the Board of Directors. Their compensation is related to their roles as employees. No trustees receive compensation for their roles as trustees. Form 990, Part IX, line 11g Contract Labor: Program service expenses 4,651,022. Management and general expenses 374,422. Fundraising expenses 0. Total expenses 5,025,444. Other Professional Fees: Program service expenses 4,108,753. Management and general expenses 2,833,036. Fundraising expenses 0. Total expenses 6,941,789. Service Contracts: Program service expenses 668,904. Management and general expenses 350,280. Fundraising expenses 0. Total expenses 1,019,184. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Gifford Medical Center, Inc. 44 South Main Street Randolph, VT 05060 EIN 03-0179418 Gifford Medical Center, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Gifford Health Care Inc 44 South Main Street Randolph VT 05060 460938716 FQHC/Parent VT 501(c)(3) Line 10 N/A 0 Gifford Retirement Community Inc 44 South Main Street Randolph VT 05060 463593492 Skilled Nursing Facility and Retirement Community VT 501(c)(3) Line 10 Gifford Health Care Inc 0 Charitable Remainder Trusts (11) Deferred Annuity VT Gifford Medical Center Inc 1 Charitable Remainder Trusts (3) Deferred Annuity VT Gifford Retirement Community Inc 0 0 0 1 1 0 0 0 0 0 1 1 0 0 1 1 0 1 1 1