2025-08-14T09:18:08-05:00 2024-09-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2023-10-01 030179418 Gifford Medical Center Inc GIFF 8027287000 44 South Main Street Randolph VT 05060 Cheyenne Holland CFO 8027287000 2025-08-13 1 1 Melissa Magoon CPA P01712842 2077752387 2025-08-13 2023 2025-03-06 01:10:19Z Michael Costa 44 South Main Street Randolph VT 05060 107495685 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. 14 12 512 35 0 0 715513 657691 66662659 69822075 1758405 3897517 1116401 963891 70252978 75341174 149132 198441 0 0 42202656 44119544 0 0 0 31429644 33486088 73781432 77804073 -3528454 -2462899 102439864 101156177 31057840 35331395 71382024 65824782 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 57054762 198441 69822075 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. 57054762 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 1 103 0 1 512 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Cheyenne Holland 8027287000 44 South Main Street Randolph VT 05060 X 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 Treasurer 1.00 2.00 X X 0 0 0 Kristin Chandler Secretary 1.00 2.00 X X 0 0 0 Matthew Considine Director/Trustee 1.00 2.00 X 0 0 0 Jody Davignon 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 Jeffrey Nelb Director/Trustee 1.00 2.00 X 0 0 0 Morgan Rilling Director/Trustee 1.00 2.00 X 0 0 0 Cindy Rosalbo Director/Trustee 1.00 2.00 X 0 0 0 Clay Westbrook Director/Trustee 1.00 2.00 X 0 0 0 Theron Manning Past Director/Trustee 1.00 2.00 X 0 0 0 Todd Winslow Past Director/Trustee 1.00 2.00 X 0 0 0 Emilija Florance Trustee/Med. Staff President 40.00 0.00 X 257917 0 27817 Daniel Bennett President & CEO 40.00 2.00 X X 399393 0 50757 Jennifer Bertrand Past CFO 40.00 2.00 X 279345 0 14407 Cheyenne Holland CFO 40.00 2.00 X 158925 0 0 William King Past Inteirm CFO 40.00 2.00 X 369968 0 0 Jeffrey J Bath Physician 40.00 0.00 X 487399 0 58938 Dennis P Gilroy Physician 40.00 0.00 X 486759 0 58388 Aleksandr Sokolovsky Surgeon 40.00 0.00 X 447127 0 31875 John A Dreslin Physician Specialty Clinic 40.00 0.00 X 445060 0 19148 Bruce W Andrus Physician 40.00 0.00 X 438541 0 41239 3770434 0 302569 53 0 1 1 FocusOne Solutions LLC PO Box 850861 Minneapolis MN 554850861 Contract Nursing 2072308 Forvis Mazars PO Box 60282 Charlotte NC 28260 Coding & Billing 2009832 Medstream Anesthesia PLLC PO Box 63467 Charlotte NC 282633467 Contract Anesthesia 1250695 OBHG Vermont PC 77 Londes Hill Road Greenville SC 29607 Contract Providers 1077844 Weatherby Locums Inc PO Box 972633 Dallas TX 75397 Contract Providers 878106 8 8545 34060 615086 657691 Patient Service Revenue 621400 119597566 119597566 Management Fee 621400 10715488 10715488 Fixed Prospective Revenue 621400 3051426 3051426 Other Revenue 621400 2771036 2443177 327859 Contractual Allowances/Charity Ca 621400 -66313441 -66313441 69822075 361958 361958 1029011 203591 825420 825420 825420 35026737 435865 31583695 343348 3443042 92517 3535559 3535559 162348 8545 23877 138471 138471 75341174 69494216 0 5189267 X 10173 10173 188268 188268 1558529 886769 671760 33619147 22795160 10823987 1156184 888671 267513 5738290 3510229 2228061 2047394 1579675 467719 51267 51267 111264 111264 11872 11872 15181335 11529408 3651927 464635 358491 106144 148707 114735 33972 1766518 1520045 246473 9441 7284 2157 477834 368675 109159 4068536 3139095 929441 701071 540914 160157 Medical Supplies and Dr 5261271 5261271 Medicaid Provider Tax 3221260 3221260 Miscellaneous Expenses 1132590 846945 285645 Other Supplies 878487 287694 590793 77804073 57054762 20749311 0 X 1024 1025 1299819 1930432 5956889 10728378 1081795 1152261 1463577 1433435 95072499 63225245 34672216 31847254 29020032 21947501 3843500 2782170 25101012 29333721 102439864 101156177 8260128 13594834 14800524 13956240 7997188 7780321 31057840 35331395 X 68719821 62648627 2662203 3176155 71382024 65824782 102439864 101156177 X -2462899 -61902 -3032441 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 17074 17074 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. 9521049 100000 1671571 3523301 7769319 9660042 100000 957215 1196208 9521049 11519437 200000 -1634182 425213 9660042 10540908 100000 1315462 436933 11519437 10156593 100000 666849 382534 10540908 0.72446 0.27554 0.00000 1 0 677616 677616 40192362 25180187 15012175 156742 143846 12896 48304685 34678352 13626333 5741094 3222860 2518234 31847254 Due From Affiliates 29333721 29333721 Deferred Annuities 571698 Deferred Compensation 4340946 Operating Lease Liabilities 1734919 Estimated Amounts Due to Third-Party Payers 1132758 7780321 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 170893 8545 162348 5000 1250 5822 750 1000 10055 170893 8545 162348 5000 1250 5822 750 1000 10055 23877 138471 1 1 1 X 1 X 1 1 1 0 0 945171 945171 0.01210 10631972 4081850 6550122 0.08420 11577143 4081850 7495293 0.09630 715291 399998 315293 0.00410 84952 84952 0.00110 198441 198441 0.00260 998684 399998 598686 0.00780 12575827 4481848 8093979 0.10410 1 0 10473200 12921572 -2448372 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 23 1 0 1 1 X www.giffordhealthcare.org/about-us/community-reports X 1 24 1 www.giffordhealthcare.org/about-us/community-reports 1 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. 434 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: Please see the attached Community Health Needs Assessment and Implementation Plan. 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. 4 1 - Gifford Health Center at Berlin 82 East View Lane Berlin VT 05641 Specialty Care Practice 2 - Gifford Health Center at Kingwood 1422 Route 66 Randolph VT 05060 Physician Practice and Rehab Services 3 - Sharon Health Center 12 Shippee Lane Sharon VT 05065 Sports Medicine Practice 4 - 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 11-15 and 18-19 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. 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) 10173 0 Operations support 1 0 End of Life Care/Comforting Patients & Families 90 184243 4025 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 Jeffrey J Bath Physician 451645 0 17308 0 18446 0 16500 0 42438 0 546337 0 0 0 Dennis P Gilroy Physician 452049 0 0 0 34710 0 16500 0 41888 0 545147 0 0 0 Bruce W Andrus Physician 425609 0 10000 0 2932 0 6188 0 35051 0 479780 0 0 0 Aleksandr Sokolovsky Surgeon 397361 0 44125 0 5641 0 15940 0 15935 0 479002 0 0 0 John A Dreslin Physician Specialty Clinic 434618 0 9380 0 1062 0 16500 0 2648 0 464208 0 0 0 Daniel Bennett President & CEO 391213 0 0 0 8180 0 16500 0 34257 0 450150 0 0 0 William King Past Inteirm CFO 369968 0 0 0 0 0 0 0 0 0 369968 0 0 0 Jennifer Bertrand Past CFO 238310 0 0 0 41035 0 13223 0 1184 0 293752 0 0 0 Emilija Florance Trustee/Med. Staff President 220509 0 37200 0 208 0 12530 0 15287 0 285734 0 0 0 Cheyenne Holland CFO 158925 0 0 0 0 0 0 0 0 0 158925 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. Form 990, Part VII, Line 5: Cheyenne Holland, CFO, and William King, Past Interim CFO, are paid by Forvis Mazars, an unrelated organization, via a professional agreement. During calendar year 2023, Gifford Medical Center paid Forvis Mazars $158,925 and $369,968 for the services of Ms. Holland and Mr. King, respectively. The actual compensation paid to Ms. Holland and Mr. King is unknown to the Organization. A Vermont Educational and Health Buildings Financing Agency 237154467 2021-04-01 16899942 To Refinance Existing Bond 0 0 0 A 2756312 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, Past Director/Trustee 140190 Purchased Supplies 0 Rachel A Westbrook Family member of Clay Westbrook, Director/Trustee 124504 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: Emilija Florance (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 3,652,137. Management and general expenses 1,115,438. Fundraising expenses 0. Total expenses 4,767,575. Other Professional Fees: Program service expenses 4,729,045. Management and general expenses 2,133,238. Fundraising expenses 0. Total expenses 6,862,283. Service Contracts: Program service expenses 3,148,226. Management and general expenses 403,251. Fundraising expenses 0. Total expenses 3,551,477. 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). Form 990, Part XI, line 9: Transfers to Affiliates -3,032,441. 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 (12) 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