2025-08-12T06:39:13-05:00 2024-09-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2023-10-01 030177161 Carlos G Otis Health Care Center CARL 8023657920 PO Box 216 Townshend VT 053530216 Stephen A Brown CFO 8023657920 2025-08-08 1 0 Connor Smart P02285543 2078792100 2025-08-08 2023 2025-03-06 01:10:19Z Grace Cottage Hospital L Olivia Sweetnam PO Box 216 Townshend VT 053530216 38174673 0 X www.gracecottage.org X 1949 VT Provision of health care services. 12 11 270 18 0 0 1755873 1400183 32430987 36772935 -25215 -5522 0 0 34161645 38167596 0 0 0 0 21654859 24186539 0 0 390407 12961417 15872059 34616276 40058598 -454631 -1891002 19995508 24904522 5262995 8611056 14732513 16293466 X Carlos G. Otis Health Care Center (d/b/a Grace Cottage Hospital) is organized for charitable, benevolent, scientific, and educational purposes. In particular, it supports and encourages the development of comprehensive, integrated health care related services, advancing the health and well-being of the community, through all relevant means. 0 0 36447008 0 36772935 Grace Cottage Hospital is a critical access hospital offering 24-hour emergency services, inpatient acute and skilled care, 24-hour diagnostic imaging services, a full-service laboratory, a pharmacy, a variety of outpatient medical care services, including physical therapy, occupational therapy, and speech therapy, and a rural health clinic providing primary care and psychiatric services. Please refer to this Form 990, Schedule H, for additional information regarding the Hospital's patient services and community benefits. 36447008 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 19 0 1 270 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Stephen A Brown 8023653601 185 Grafton Road Townshend VT 05353 X Timothy P Shafer MD Trustee/Physician 41.00 0.00 X 244439 0 34334 Al Claussen III Trustee 1.00 0.00 X 0 0 0 Thomas Kalchthaler Trustee 1.00 1.00 X 0 0 0 Karren Meyer Trustee 1.00 0.00 X 0 0 0 Winthrop Pennock Trustee (start 11/2023) 1.00 0.00 X 0 0 0 Terry Pollio Trustee 1.00 0.00 X 0 0 0 Tracy Sloan Trustee (start 11/2023) 1.00 1.00 X 0 0 0 Rachel Stettler Trustee (end 10/2023) 1.00 1.00 X 0 0 0 Sarah Vangel Trustee 1.00 0.00 X 0 0 0 Martha Dale President 1.00 0.00 X X 0 0 0 Edward Druke Vice President 1.00 0.00 X X 0 0 0 Lucas Farrell Treasurer 1.00 0.00 X X 0 0 0 Barry Emerson Treasurer (end 11/2023) 1.00 0.00 X X 0 0 0 Sheila Scheuerman Secretary 1.00 1.00 X X 0 0 0 Douglas DiVello CEO 41.00 1.00 X 371406 0 51885 Stephen A Brown CFO 45.58 0.00 X 331467 0 36669 George Terwilliger Physician 40.00 0.00 X 281335 0 35441 Wyll Everett MD Physician 40.26 0.00 X 237776 0 46064 Philip Schafer PA-C (Physician Assistant) 40.38 0.00 X 218980 0 32936 Jeremy Morrison MD Physician 34.19 0.00 X 206927 0 45272 Marc-Olivier Ratte MD Physician 33.84 0.00 X 202179 0 21930 2094509 0 304531 46 0 1 0 Brunelle & Son Construction 416 Tucker Reed Road East Dummerston VT 05346 Construction and renovation 802107 Cerner Corporation PO Box 959156 St Louis MO 63195 Hardware and software support 433822 EM Staff PO Box 540 Exeter NH 03833 Staffing solutions 274104 Cross Country Staffing PO Box 404674 Atlanta GA 30384 Staffing solutions 263881 Virtual Radiologic Corporation 25983 Network Place Chicago IL 60673 Radiology services 187558 13 1061273 329910 9000 1400183 Patient services 621400 29740537 29740537 Pharmacies 456110 6504475 6504475 GCF administration 621400 423126 423126 Cafeteria 722514 86444 86444 Auxiliary service charges 621990 18353 18353 36772935 1555 1555 7077 -7077 -7077 -7077 38167596 36772935 0 -5522 1185855 274117 911738 17538166 15993506 1265794 278866 442450 405313 30049 7088 3710243 3292482 360774 56987 1309825 1143137 147053 19635 9832 9832 91805 91805 2933693 2905992 27701 76574 206 76368 1299444 1122419 157860 19165 981530 917608 61668 2254 303538 295322 8216 162941 142717 15046 5178 9463 9463 211553 211553 973056 973056 382292 323779 57279 1234 Medical supplies/lab 5416889 5416889 Provision for bad debt 1281645 1281645 Medicaid Tax 1054630 1054630 Equipment repairs 357019 357019 326155 326155 40058598 36447008 3221183 390407 775632 87146 31556 34329 2744968 3235353 923286 932937 270503 293243 19237358 13987305 4804138 5250053 10445425 15071461 19995508 24904522 2662529 4093606 1427357 3367450 1173109 1150000 5262995 8611056 X 11094939 10299162 3637574 5994304 14732513 16293466 19995508 24904522 X -1891002 3451955 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 3777 0 0 0 3777 0 Part II-B, Line 1: The Carlos G. Otis Health Care Center 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 associations was made available for lobbying expenditures on behalf of the Carlos G. Otis Health Care Center in furtherance of its exempt purposes. Carlos G. Otis HealthCare Center does not directly perform any lobbying activities. The dues paid by the HealthCare Center during this tax period were as follows: - AHA, portion of dues available for lobbying: $848 - VAHHS, portion of dues available for lobbying: $2,929 3960410 1088 510343 264856 4206985 3837791 43397 346864 267642 3960410 3726261 1211226 -448720 650976 3837791 3897999 -171738 3726261 3421086 476913 3897999 0.73540 0.26460 0.00000 0 1 1 30549 30549 9740738 7974697 1766041 8291749 5944507 2347242 1174322 68101 1106221 5250053 Beneficial interest in net assets of GCF 12394203 Deposits with trustee 7542 Malpractice reserve coverage and assets 1150000 Estimated third-party payor settlements receivables 1519716 15071461 Malpractice reserve obligations 1150000 1150000 X 39992265 3106314 3106314 36885951 1281645 1281645 38167596 38776953 0 38776953 1281645 1281645 40058598 Part V, Line 4: The Carlos G. Otis Health Care Center and the Grace Cottage Foundation use their endowment funds to provide a source of support and revenue to assist with the provision of health care and care services within their communities. The organizations' endowment funds are composed of the following balance types: - Funds that are composed of quasi-endowment, board designated assets, which have been set aside by the Board of Trustees but which the Board may, at its discretion, subsequently use for other purposes. Or, - Funds that are permanently restricted by the original donor, in which case the endowment's capital must be maintained but earnings on which can be used in furtherance of authorized purposes. In all instances, the endowment funds are invested in a prudent manner with regard to preserving principal while providing reasonable returns, and all endowment funds are to be used to fund capital improvements, hospital maintenance, and/or patient and care services. Part X, Line 2: OHCC and the Foundation are tax-exempt corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. In addition, the Foundation qualifies for the charitable contribution deduction under Section 170(b)(1)(a) and has been classified as an organization that is not a private foundation as defined under Section 509(a). Management evaluated the Organization's tax positions and concluded the Organization has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to or disclosure in the accompanying consolidated financial statements. Part XI, Line 2d - Other Adjustments: Change in beneficial interest in net assets of Grace Cottage Foundation 3,106,314. Part XI, Line 4b - Other Adjustments: Provision for bad debt 1,281,645. Part XII, Line 4b - Other Adjustments: Provision for bad debt 1,281,645. 1 1 1 X 250.000000000000 1 X 1 1 1 0 1 1 368611 368611 0.00950 5727863 2314113 3413750 0.08800 6096474 2314113 3782361 0.09750 374777 223138 151639 0.00390 12733 12733 0.00030 387510 223138 164372 0.00420 6483984 2537251 3946733 0.10170 1 850659 27415 13547859 13728607 -180748 X 1 1 1 1 Grace Cottage Hospital 185 Grafton Road Townshend VT 05353 www.gracecottage.org 962 X X X X Grace Cottage Hospital 1 0 0 1 X X X X X X X X X 23 1 1 1 1 X See Part V, Section C X See Part V, Section C X 1 23 1 See Part V, Section C 0 1 X 250.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 Grace Cottage Hospital Part V, Section B, Line 5: As required by Vermont statute and Treasury Regulation 501(r), Grace Cottage Hospital conducts a Community Health Needs Assessment (CHNA) every three years. Our most recent CHNA was done collaboratively in 2024 with Brattleboro Memorial Hospital (BMH) and the Brattleboro Retreat. The three hospitals set up a steering committee made up of individuals from the Vermont Department of Health, the Vermont Agency of Human Services, United Way of Windham County, Brattleboro Memorial Hospital, Grace Cottage Hospital, and the Brattleboro Retreat.The healthcare organizations focused on involving as many stakeholders and community members as possible in the data collection process, which took place from January to June 2024. Primary data was obtained through a community-wide consumer survey and several segmented community focus groups. The consumer survey was distributed via paper copy and online. The focus groups were held in person. In total, 524 consumer surveys were collected for Windham County. The following medically underserved populations were represented in the surveys: - Elderly/Senior Population - Unhoused Population - New Americans (Immigrants) - LGBTQIA+ - Racial and Ethnic Minority Populations - Low-income individualsAdditionally, the participating organizations engaged a wide range of professional stakeholders through the surveys, including health care providers, town officials, human service organizations, and other nonprofit organizations.Secondary data was collected from multiple sources including: U.S. Centers for Disease Control and Prevention, U.S. Department of Health & Human Services, U.S. Census, National Institute of Health, Feeding America, the University of Wisconsin Population Health Institute's County Health Rankings & Roadmaps, Vermont Department of Health, Vermont Department of Mental Health, Vermont Department of Labor, Vermont Department of Education, Vermont Department of Transportation, Vermont Foodbank, Vermont Town and County Data Pages, and the Windham Regional Commission. The secondary data was benchmarked against state and national trends, where possible. Grace Cottage identified the following as High-Priority Significant Health Needs in our service area: access to Primary Care, Cancer Screening and prevention, and Mental Health Treatment and support.The Grace Cottage Board of Trustees adopted the 2024 Community Health Needs Assessment on Nov. 15, 2024, and the Board approved the Implementation Plan on March 21, 2025. An updated Implementation Plan is available for public viewing at:https://gracecottage.org/about-us/our-hospital/community-health-needs-assessment/ Grace Cottage Hospital Part V, Section B, Line 6a: The 2024 (tax years 2023-2025) Community Health Needs Assessment was conducted with input and assistance from Brattleboro Memorial Hospital and The Brattleboro Retreat. Grace Cottage Hospital Part V, Section B, Line 6b: The 2024 (tax years 2023-2025) Community Health Needs Assessment was conducted with input and assistance from the United Way, the Vermont Department of Health, and the Vermont Agency of Community Services. Grace Cottage Hospital Part V, Section B, Line 11: The Hospital published its most recent CHNA in the 2023 tax year (2024 fiscal year), and subsequently and timely approved and adopted the associated CHNA Implementation Plan. While the CHNA Implementation Plan was technically published within the 2024 tax year (2025 fiscal year), it was approved and adopted within the required timeline as set forth in Section 501(r). For this reason, and because this most recent Implementation Plan was developed pursuant to the 2023 CHNA, "2023" has been reported on this Form 990, Schedule H, Part V, Section B, Line 9.While area residents indicate that dental health is a significant health need in our service area, Grace Cottage Hospital is not addressing this, as we do not provide dental services. The Level 2 & 3 Priorities identified in the 2024 CHNA - Basic Needs (housing, food access, transportation, employment, safety) and Healthy Aging (heart disease and cardiovascular) - are addressed with all patients on an on-going and personal basis. Grace Cottage Hospital Part V, Section B, Line 13b: Generally, Grace Cottage Hospital uses the Federal Poverty Guidelines to determine eligibility for financial assistance. However, applications may be reviewed on a case-by-case basis and at times financial assistance granted even if a patient is above the prescribed FPG level or qualifies only for a lesser reduction in fees if there is a prevailing circumstance that justifies additional financial support. Grace Cottage Hospital Part V, Section B, Line 20e: Grace Cottage Hospital (GCH) located in rural, mountainous Townshend, VT provides services to patients, whether a community member, second homeowner, or vacationer, through our Critical Access Hospital, Rural Health Clinic, and Outpatient Rehabilitation. Taking pride in the community we serve, we make every attempt possible to notify patients of the Reduced Fee Program and Formal Payment Plan options at GCH that will allow patients to receive care without undue hardship. The following are some of the steps currently in place, to notify patients of the available options:- All registration areas of the Critical Access Hospital, Rural Health Clinic, and Outpatient Rehabilitation Services have visible signs on display notifying patients of our Reduced Fee Program.- All registration staff upon verification of no insurance, limited insurance coverage with high patient responsibility portions, or communication from patient indicating difficulty with paying bill, will offer a Reduced Fee Application, Policy, and business card for our Resource Advocate, identifying the many services she provides to patients free of charge and her contact information. Staff will also offer to schedule an appointment for the patient with Resource Advocate for assistance in completing the Reduced Fee Application, troubleshooting issues with insurance, and/or applying for insurance coverage whether it is primary or secondary.- Patients receive at least 5 billing statements over the course of 120-day time frame (patients in a formal payment plan or who have a billing issue arise may increase the number of statements to be received or increase the number of days to complete the 5 billing statement cycle). Every statement has a message that notifies them of the Reduced Fee Program and steps to take to get started.- Once a patient balance is past due (>30 days from date of first patient billing) Patient Accounts Specialists contact patients via phone in an attempt to alert patient to past due balance, offer a formal payment plan if balance unable to be paid in full. If/when patient indicates difficulty in paying their bill, Patient Accounts Specialists will notify patient of the Reduced Fee Program and offer to mail the application and policy to them. Patient Accounts Specialists note the patient account with a briefing of the phone call. If a patient balance is aged >120 days from the date of the first billing statement and a potential to be sent to a third- party collections agency the account is reviewed, if there is a note from patient accounts indicating a Reduced Fee application and policy have been mailed to the patient within the last 45 days a hold will be placed on transferring the balance to the third-party collections agency. After 45-60 days, if no Reduced Fee application or communication from the patient is received, the balance will be transferred to the third-party collection agency at that time.- All Reduced Fee applications are processed with required documentation to determine eligibility in accordance with our Sliding Fee Scale based on Federal Poverty Guidelines. If required documents are missing, a written request is sent to the patient and application held while awaiting documents. All processed applications are filed, written notice of eligibility is mailed to the patient, eligibility is noted on patient's account and adjustments are made manually after insurance processing and prior to a billing statement being mailed to the patient, and all applications are documented on a yearly spreadsheet showing household members, date of application (eligibility begin date), expiration date, whether they are eligible, percentage they are eligible for, and comments for case by case applications that identifies parameters for this approval/denial i.e.: only one date of service. Schedule H, Part V, Section B, Line 7a, 7b and 10a: Many of the Hospital's past year CHNA and CHNA Implementation Plans may be found on the Hospital's website at:https://gracecottage.org/about-us/our-hospital/community-health-needs-assessment/The Hospital's 2024 (tax year 2023) CHNA is available at: https://gracecottage.org/wp-content/uploads/2025/07/2024-CHNA-Report-12-4-24-final.pdfAdditionally, the 2025 CHNA Implementation Plan, approved and published in conjunction with the 2024 CHNA, is available online at:https://gracecottage.org/wp-content/uploads/2025/03/2025-CHNA-Implementation-Plan-Annual-Update.pdfThe 2025 CHNA Implementation Plan was approved and adopted by the Organization within the applicable timeline as required under Section 501(r), though it was technically published during the Hospital's 2025 fiscal year (2024 tax year). The 2021 CHNA Implementation Plan and its annual updates are therefore the next most recently approved reports before the 2025 CHNA Implementation Plan. The original 2021 CHNA Implementation Plan can be found online at:https://gracecottage.org/wp-content/uploads/2022/06/2021-CHNA-Implementation-Plan-Final-11-19-21.pdfThe 2023 Annual Update to the 2021 CHNA Implementation Plan can be found online at:https://gracecottage.org/wp-content/uploads/2024/04/2023-CHNA-Implementation-Plan-Annual-Update.pdf Schedule H, Part V, Section B, Line 16a-16c: General information regarding the Hospital's billing, insurance, and finance policies are available online at:https://gracecottage.org/patients-visitors/billing-and-insurance/The Hospital's Financial Assistance Policy is available on its website at: https://gracecottage.org/wp-content/uploads/2024/07/Financial-Assistance-Policy-July-2024.pdfThe Hospital's Financial Assistance Application is available on its website at: https://gracecottage.org/wp-content/uploads/2024/08/Financial-Assistance-Application-Updated-8-16-24.pdfThe Hospital's Plain Language Summary is available on its website at:https://gracecottage.org/wp-content/uploads/2024/08/Plain-Language-Financial-Assistance-Summary-updated-8-19-24.pdf 2 1 - Messenger Valley Pharmacy 170 Grafton Road Townshend VT 05353 Pharmacy 2 - Grace Cottage Family Health 185 Grafton Road Townshend VT 05353 Rural health clinic Part I, Line 3c: N/A Part I, Line 6a: N/A Part I, Line 7: The amounts reported for Charity Care and Means-Tested Government Programs were calculated using a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. Part I, Line 7g: N/A Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 1,281,645. Part II, Community Building Activities: See previous and subsequent narrative responses. Part III, Line 2: The cost of the bad debt expense reported on line 2 was calculated by applying the ratio of patient care cost-to-charges (calculated on Worksheet 2) to the total bad debt expense. The amount of bad debt expense for accounts written off as bad debt is the account balance after all charity care discounts, contractual allowances, and insurance/patient payments have been applied. Any cash collected on accounts previously written off is included as an offset to bad debt expense. Part III, Line 3: The amount of bad debt expense (at cost) attributable to patients eligible under our charity care policy reported on line 3 was estimated based on a review of Reduced Fee/Free Care Applications. The number of approved completed applications versus the number of incomplete applications was compared, and a ratio was applied to the Charity Care balance to estimate this number. It is felt that this estimate should actually be much higher because, though we work hard to educate our patients regarding the charity care policy, including having a Resource Advocate to help patients complete them if they require assistance, many of the applications we distribute to patients are not returned. Knowing our patient population as we do, we believe it is primarily attributable to patients not wanting to share the income information. Part III, Line 4: Footnote 1 of the Organization's audited financial statements detail the Organization's significant accounting policies, including the Organization's treatment of accounts receivable and uncollectible amounts. Part III, Line 8: Medicare allowable costs reported in the Medicare Cost Report are reported in accordance with CMS Guidelines using the cost-to-charge ratio methodology.As a Critical Access Hospital (CAH), the Organization is eligible for reimbursement of up to 101% of allowable Medicare costs and services. However, the Organization is subject to a 2% Medicare Sequestration, which resulted in a Medicare Shortfall reported on its Form 990, Schedule H, Part III, Section B. Part III, Line 9b: financial assistance. If a patient is unable to pay a balance in full after reduced fees and financial assistance have been applied, the patient is required to set up an acceptable payment plan per the collections policy. Any patient making acceptable monthly payments on their balance will not be at risk for further collections actions and/or forfeiture of their reduced fee care or financial assistance. However, any balance remaining after that discount that goes unpaid as agreed upon will follow the collections actions outlined in the Hospital's collection policy. Failure to resolve the balance in full or any missed payments will result in forfeiture of reduced fees and/or financial assistance, and the patient's account will be placed with a collections agency for further action. Additionally, the patient will not be eligible for reduced fees or financial assistance until a substantial effort is put forth to rectify the outstanding balance. Part VI, Line 2: Grace Cottage Hospital is such a small hospital in a rural, relatively sparsely populated area that our community leaders, patients, and members of the public are quick to inform our administrators and our medical staff about how Grace Cottage serves the healthcare needs of the public. Grace Cottage's small size ensures that we can be responsive to community requests made via our website, our monthly e-newsletter from the CEO to 3500+ community members, e-mails to members of our staff, or informal face-to-face meetings with people in the communities we serve. Part VI, Line 3: Although we are Vermont's smallest Critical Access Hospital, Grace Cottage Hospital believes that quality health care should be available to all; and that we all have a responsibility to help others in need regardless of their ability to pay. Posters and brochures detailing the availability of help with billing, public programs, and charity care are displayed in high traffic areas throughout the Hospital, rural health clinic, and pharmacy, as well as listed on the Hospital's website. The staff reaches out to patients in a variety of ways to ensure that they are aware that help is available. During fiscal year 2024, the Hospital continued to employ a Patient Resource Advocate to help uninsured and underinsured patients locate and procure services for which they may qualify. The Patient Resource Advocate's services are free of charge for community members (those 65 and older were also encouraged to contact Senior Solutions, formerly Southeastern Vermont Council on Aging). The Hospital's Patient Resource Advocate helps many people with a wide variety of resource issues, helping to fill out necessary forms and making connections for patients with other federal, state and local resources. This employee is an expert in filling out reduced fee applications, finding sources for reduced-cost or free prescription medications, and locating other avenues of support. Part VI, Line 4: Grace Cottage Hospital plays a vital role in healthcare for this rural, mountainous community. Its federal designation as a critical access hospital recognizes its importance in providing health care to an otherwise medically underserved community. The Hospital's emergency department is especially vital to members of the community, who would otherwise have to travel many miles on winding, mountainous highways to reach emergency medical care at another hospital. Grace Cottage Hospital is located in Windham County, in southeastern Vermont. According to the 2020 U.S. Census, Windham County has an estimated total of 45,905 residents. Grace Cottage Hospital's patient base is approximately 30,000 residents, mostly from 21 surrounding towns. The median household income of Windham County, Vermont, is $68,021 (2020 U.S. Census). Income statistics for the total population served by Grace Cottage Hospital are not available because Grace Cottage only requires income information from patients requesting reduced fees or free care. Part VI, Line 5: Grace Cottage Hospital is a Critical Access Hospital located in rural, mountainous Townshend, Vermont. The Hospital is served by a Board of Trustees consisting of local citizens active in community businesses and organizations. All trustees reside or work in the Hospital's service area, and bring a wealth of community input to the Hospital's strategic planning process. The Hospital extends medical staff privileges to all qualified physicians in the community.Grace Cottage Hospital applies any surplus funds towards improving its ability to provide quality patient care and being an integral part of assuring the health and well-being of the communities we serve. For example, in view of the fact that Mental Health was identified as a High Priority Significant Need in our Community Health Needs Assessment, Grace Cottage continues to employ two full-time psychiatric nurse practitioners and a full-time licensed clinical social worker. All of these professionals are embedded in the family health practice, where they are key players in the healthcare team. Despite its small size, Grace Cottage Hospital is committed to giving back to the community to the greatest extent possible. Grace Cottage's Community Health Team has been able to provide free consultations, open to everyone in the community served by Grace Cottage. Members of the Community Health Team include a Diabetes Educator and an RN Care Coordinator. Grace Cottage Hospital is a very active partner in numerous community collaborations and programs, including (but not limited to): - West River Valley Thrives: supporting and promoting healthy lifestyle choices, with an emphasis on the prevention of alcohol, tobacco, and other drug use by young people. - Townshend Community Hope and Action: promoting a healthy, connected community through area events and education. - West River Valley Food Group/Vermont Food Bank: organizing the procurement and distribution of food to those in need. A VeggieVanGo truck hosted by Grace Cottage comes from the Vermont Food Bank to Newfane once a month for free food distribution of fresh produce and other healthy food items. No proof of eligibility is required. On average, 250 individuals take the free food home to their families. - Windham County Community Substance Use Response (CSUR) is a collaborative effort that grew out of the 2019-2022 Consortium on Substance Use (COSU), a three-year, multi-agency collaboration funded by a $1 million federal Health Resources & Services Administration (HRSA) grant and a VT Department of Health Community Action grant through the Centers for Disease Control & Prevention. These grants were awarded to COSU with Health Care & Rehabilitation Services of Southeastern Vermont, Inc. (HCRS), serving as its fiscal agent. When grant funding ended in 2022, some of the agencies chose to carry on this important work and formed a new consortium called Community Substance Use Response (CRSU); Grace Cottage is a collaborating partner with this consortium. CRSU's work focuses on collaborative prevention, harm reduction, treatment, and recovery efforts. It also aims to increase education and awareness within communities to address the devastating impacts of heroin, fentanyl and other substances on Windham County. - Accountable Communities for Health: a network of partners that support measurable improvement in meeting the needs of families and individuals in our community. Focus is on developing systems to improve community health and well-being; supporting appropriate use of resources; and improving access to community services. - Community Wellness: Current programs offered free to the community are Strong Bones exercise classes and Tai Chi strength and balance classes. In response to the last Community Health Needs Assessment, the Hospital has worked collaboratively with local schools and organizations to promote healthy, fun activities and to provide opportunities that make the most of staying as healthy as possible. Heavily promoted activities included a 5K in the spring, and a snowshoe gathering in the late winter. Grace Cottage Hospital plays a pivotal role in Emergency/Disaster Preparedness in this rural, mountainous area of Windham County, Vermont. The Hospital works collaboratively with: - the local town volunteer fire and first responder rescue departments; - the regional ambulance service, Rescue Inc.; - Windham County Regional Commission - the Local Emergency Planning Committee covering the towns that Grace Cottage serves; - the local Citizens Emergency Response Team (CERT); - Vermont Association of Hospitals and Health Systems; - Vermont Department of Health.Grace Cottage Hospital staff participate in onsite training for disaster preparedness as well as offsite training with other hospitals. Part VI, Line 6: N/A Part VI, Line 7, Reports Filed With States VT X X 0 0 0 0 0 0 0 1 0 Douglas DiVello CEO 331245 0 12614 0 27547 0 9900 0 41985 0 423291 0 0 0 Stephen A Brown CFO 286320 0 12900 0 32247 0 9900 0 26769 0 368136 0 0 0 George Terwilliger Physician 280292 0 0 0 1043 0 8602 0 26839 0 316776 0 0 0 Wyll Everett MD Physician 232047 0 4686 0 1043 0 6520 0 39544 0 283840 0 0 0 Timothy P Shafer MD Trustee/Physician 230272 0 12064 0 2103 0 7495 0 26839 0 278773 0 0 0 Jeremy Morrison MD Physician 197069 0 8815 0 1043 0 6393 0 38879 0 252199 0 0 0 Philip Schafer PA-C (Physician Assistant) 190747 0 6100 0 22133 0 6713 0 26223 0 251916 0 0 0 Marc-Olivier Ratte MD Physician 196504 0 4632 0 1043 0 5447 0 16483 0 224109 0 0 0 Part I, Line 7 Physician contracts provide the opportunity to receive additional payments for productivity above minimum thresholds. For the period reported, the physicians listed on this Form 990, Part VII, who received incentive compensation under such a contract were as follows: - Wyll Everett, $4,656. - Jeremy Morrison, $8,615. - Marc-Olivier Ratte, $4,632. - Timothy Shafer, $12,064. The CEO's contract provides an opportunity to earn annual incentive compensation of up to a maximum of 10% of annual base salary upon attainment of mutually agreed upon goals. This incentive compensation opportunity may be modified from time to time at the discretion of the Board of Trustees. For the period reported, Douglas DiVello received a payment of $12,614. Additionally, the Hospital's CFO also received bonus and incentive compensation of $12,900 during the 2023 calendar year, and as reported on this Form 990, Schedule J, Part II. $12,500 of this compensation was awarded due to the CFO taking on certain CEO responsibilities and job duties on an interim basis while the CEO was unavailable during this reporting period. In the addition to the incentive and productivity payments detailed above, certain individuals listed on Part VII also received wellness stipends and other non-fixed payments which have also been included in the total reported on this Schedule J, Part II, Column B(ii) as "bonuses." Form 990, Part VI, Section B, line 11b A draft of the Form 990 is initially reviewed in detail by Carlos G. Otis Health Care Center's key finance employees. Thereafter, the final draft is provided to the full Board for review prior to filing with the IRS. Form 990, Part VI, Section B, line 12c A copy of the conflict of interest policy is distributed annually to the Board of Trustees and each Trustee signs to confirm that they have thoroughly read, understand, and agree to comply with the conflict of interest policy. Form 990, Part VI, Section B, line 15 CEO's Compensation: The CEO's compensation and benefits are reviewed, adjusted and voted on by the full Board annually. The Board used external market compensation data to determine the CEO's initial compensation when hired and annually uses such data to compare OHCC's CEO compensation with that of other hospital executives in the Northeast region. The CEO is excused from Board discussion and voting on issues surrounding CEO compensation and benefits. Compensation of other hospital employees: The CEO reviews the salaries of employees annually and determines compensation based on performance and salary ranges, using regional salary range data for comparison. Form 990, Part VI, Section C, line 19 Upon request, Carlos G. Otis Health Care Center, Inc. makes its governing documents, conflict of interest policy, and financial statements available to the public. Form 990, Part VII, Section A: The compensation reported for Dr. Timothy Shafer was for his services as a full-time physician. He was not compensated for his services as a member of OHCC's Board of Trustees. Form 990, Part XI, line 9: Change in beneficial interest in net assets of GCF 3,106,314. Transfers from affliate 345,641. Form 990, Part XI, Line 2c: The Finance and Audit Committee oversees the audit process for the Carlos G. Otis Health Care Center, Inc. and Grace Cottage Foundation, Inc. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit for both fiscal years. Grace Cottage Foundation Inc PO Box 1 Townshend VT 05353 030343282 Solicit contributions for the funding of health care services by OHCC VT 501(c)(3) Line 12a, I Carlos G Otis Health Care Center 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1 Grace Cottage Foundation Inc C 1061273 Actual per books Grace Cottage Foundation Inc D 59465 Actual per books Grace Cottage Foundation Inc Q 423126 Actual per books Grace Cottage Foundation Inc S 345641 Actual per books Form 990, Schedule R, Part V, Transactions with Related Organizations: In addition to the transactions reported on this Form 990, Schedule R, Part V, the Grace Cottage Foundation holds certain endowment funds on behalf of the Hospital, the income of which is to assist the Hospital in its operations and charitable activities. The Foundation makes annual transfers of this income to the Hospital in accordance with the applicable endowment and spending policies and restrictions.