WINDSOR HOSPITAL CORPORATION: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- WINDSOR HOSPITAL CORPORATION (EIN 03-0183721)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-05
- IRS object ID
- 202122179349300317
- Schema version
- 2019v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-08-05T09:00:14-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9600 Brownsboro Road Suite 400 | AddressLine1Txt |
| City | Louisville | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 402411122 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030183721 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Windsor Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WIND | BusinessNameControlTxt |
| Phone | 8026746711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 County Road | AddressLine1Txt |
| City | Windsor | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David Sanville | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2021-08-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIM SCIFRES | PreparerPersonNm |
| PTIN | P01316095 | PTIN |
| Phone | 5023263996 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mt Ascutney Hospital and Health Center | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David Sanville | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 County Road | AddressLine1Txt |
| City | Windsor | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $57,486,195 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | mtascutneyhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1933 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | To improve the lives of those we serve. We provide high-quality healthcare. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 573 | TotalEmployeeCnt |
| Total Volunteers | 160 | TotalVolunteersCnt |
| Total Gross UBI | -$4,418 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$4,418 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,332,952 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,992,986 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $53,489,218 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $52,028,106 | CYProgramServiceRevenueAmt |
| PY Investment Income | $704,709 | PYInvestmentIncomeAmt |
| CY Investment Income | $564,367 | CYInvestmentIncomeAmt |
| PY Other Revenue | $168,749 | PYOtherRevenueAmt |
| CY Other Revenue | $2,893,716 | CYOtherRevenueAmt |
| PY Total Revenue | $55,695,628 | PYTotalRevenueAmt |
| CY Total Revenue | $57,479,175 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $33,429,358 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,727,511 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $129,573 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,228,616 | PYOtherExpensesAmt |
| CY Other Expenses | $21,165,587 | CYOtherExpensesAmt |
| PY Total Expenses | $54,657,974 | PYTotalExpensesAmt |
| CY Total Expenses | $55,893,098 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,037,654 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,586,077 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $56,791,953 | TotalAssetsBOYAmt |
| Total Assets EOY | $67,806,425 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,202,152 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $38,443,947 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,589,801 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $29,362,478 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Mt. Ascutney Hospital and Health Center's mission is to improve the lives of those we serve. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $45,629,936 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $54,903,454 | RevenueAmt |
| Desc | Mt. Ascutney Hospital and Health Center (MAHHC) Operates a not-for-profit critical access hospital which provides primary and secondary health care. MAHHC primary service area includes Bridgewater, Brownsville, Hartland, Reading, Weathersfield, Windsor, & Woodstock (VT) as well as Claremont, Cornish, and Plainfield (NH). The hospital provides essential health care services including emergency department/medical/surgical inpatient, and ancillary diagnostic tests, imaging/radiology procedures, and wellness/prevention services. MAHHC staffs a total of 25 acute medical/surgical beds and 10 acute rehabilitation beds. During the year, there were 1,018 discharges, 1,487 surgeries, 58,749 lab tests, and 12,026 imaging procedures. MAHHC identified access to primary care as a central community need and is committed to providing the physician services of family practice, internal medicine and pediatrics in Windsor and Woodstock. MAHHC provides free care to patients who meet certain criteria. Foregone charges furnished under MAHHC's free care policy amount to $797,296 in FY20. | Desc |
| Total Program Service Expenses | $45,629,936 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 68 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 573 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David Sanville | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8026746711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 County Road | AddressLine1Txt |
| City | Windsor | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Alan C Keiller | ||||||||
| Trustee/Chair | 1.0 | 0.1 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Donna Sweaney | ||||||||
| Trustee/Vice Chair (Through 12/2019) | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| John Tansey | ||||||||
| Trustee/Vice Chair (Eff. 2/2020) | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Joseph L Perras MD | ||||||||
| President/CEO/Ex-officio | 40.0 | 0.5 | Yes (X) | Yes (X) | $389,836 | $0 | $12,862 | |
| Pamela Brown | ||||||||
| Trustee/Secretary (Eff. 2/2020) | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Vincent Fusca III | ||||||||
| Trustee/Treasurer (Eff. 2/2020) | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Annice Mason | ||||||||
| Trustee/Physician | 1.0 | 0 | Yes (X) | $230,350 | $0 | $7,669 | ||
| Deanna Howard | ||||||||
| Trustee | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| John Gerstmayr | ||||||||
| Trustee (Eff. 2/2020) | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| John Gilman | ||||||||
| Trustee | 1.0 | 0.5 | Yes (X) | $0 | $0 | $0 | ||
| Maria Padin MD | ||||||||
| Trustee (Through 5/2020) | 1.0 | 41.0 | Yes (X) | $0 | $430,924 | $64,642 | ||
| Matthew Houde | ||||||||
| Trustee | 1.0 | 40.0 | Yes (X) | $0 | $220,260 | $49,499 | ||
| Michael Kilcullen | ||||||||
| Trustee (Eff. 2/2020) | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Patrick F Jordan III MBA | ||||||||
| Trustee | 0.5 | 56.5 | Yes (X) | $0 | $770,233 | $64,134 | ||
| Steve Crihfield | ||||||||
| Trustee | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Steven Smith MD | ||||||||
| Trustee | 1.0 | 40.0 | Yes (X) | $0 | $193,127 | $54,642 | ||
| Steven Surgenor | ||||||||
| Trustee | 1.0 | 40.0 | Yes (X) | $0 | $491,883 | $60,877 | ||
| David Sanville | ||||||||
| CFO | 36.0 | 0.5 | Yes (X) | $237,331 | $0 | $28,530 | ||
| Paul Calandrella | ||||||||
| Chief Operating Officer | 40.0 | 0 | Yes (X) | $212,874 | $0 | $33,410 | ||
| Alden Hall | ||||||||
| Physician | 40.0 | 0 | $252,489 | $0 | $11,188 | Yes (X) | ||
| Christopher Connor | ||||||||
| Ophthalmologist | 40.0 | 0 | $344,827 | $0 | $22,179 | Yes (X) | ||
| Dennis Heibein | ||||||||
| CRNA | 40.0 | 0 | $264,713 | $0 | $22,085 | Yes (X) | ||
| Mary Joyce | ||||||||
| Physician | 40.0 | 0 | $264,292 | $0 | $30,875 | Yes (X) | ||
| Peter Rauert | ||||||||
| Anesthesiologist | 40.0 | 0 | $416,179 | $0 | $31,025 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,612,891 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,106,427 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $493,617 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 46 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MARY HITCHCOCK MEMORIAL HOSPITAL | |||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | Healthcare Services | $2,524,160 |
| EMERGENCY SERVICES OF NE INC | |||||
| PO BOX 12 | Chester | VT | 05143 | Healthcare Services | $1,574,328 |
| Dartmouth-Hitchcock Clinic | |||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | Healthcare Services | $847,096 |
| CERNER CORPORATION | |||||
| PO Box 959156 | ST Louis | MO | 631959156 | Healthcare Services | $792,510 |
| AMERICAN HEALTHCARE SERVICES ASSOCIATION | |||||
| PO BOX 670529 | Dallas | TX | 752670529 | Healthcare Services | $525,728 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $20,000 | RelatedOrganizationsAmt |
| Government Grants | $782,396 | GovernmentGrantsAmt |
| All Other Contributions | $1,190,590 | AllOtherContributionsAmt |
| Total Contributions | $1,992,986 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 622110 | $45,485,289 | $45,485,289 |
| Health care Reform Payments | 622110 | $3,987,540 | $3,987,540 |
| Program and miscellaneous | 622110 | $2,555,277 | $2,555,277 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $52,028,106 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $571,387 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$4,418 | UnrelatedBusinessRevenueAmt |
| Exclusion | $575,805 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,368 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,368 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,368 | TotalRevenueColumnAmt |
| Exclusion | $18,368 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $7,020 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$7,020 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,020 | TotalRevenueColumnAmt |
| Exclusion | -$7,020 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Stimulus Payment | 622110 | $2,533,288 | $2,533,288 |
| Purchase Discounts | 622110 | $183,161 | $183,161 |
| Other Income | 622110 | $158,899 | $158,899 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,875,348 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,479,175 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,903,454 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$4,418 | UnrelatedBusinessRevenueAmt |
| Exclusion | $587,153 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,152,860 | TotalAmt |
| Program Services | $830,059 | ProgramServicesAmt |
| Management And General | $322,801 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,027,074 | TotalAmt |
| Program Services | $22,331,367 | ProgramServicesAmt |
| Management And General | $4,637,317 | ManagementAndGeneralAmt |
| Fundraising | $58,390 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $980,321 | TotalAmt |
| Program Services | $809,843 | ProgramServicesAmt |
| Management And General | $168,321 | ManagementAndGeneralAmt |
| Fundraising | $2,157 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,519,704 | TotalAmt |
| Program Services | $2,937,323 | ProgramServicesAmt |
| Management And General | $575,116 | ManagementAndGeneralAmt |
| Fundraising | $7,265 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,047,552 | TotalAmt |
| Program Services | $1,691,482 | ProgramServicesAmt |
| Management And General | $351,565 | ManagementAndGeneralAmt |
| Fundraising | $4,505 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,657,844 | TotalAmt |
| Program Services | $2,701,914 | ProgramServicesAmt |
| Management And General | $1,923,377 | ManagementAndGeneralAmt |
| Fundraising | $32,553 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,873 | TotalAmt |
| Management And General | $20,873 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,159 | TotalAmt |
| Program Services | $10,159 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,032 | TotalAmt |
| Management And General | $81,032 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,894,183 | TotalAmt |
| Program Services | $4,624,991 | ProgramServicesAmt |
| Management And General | $269,192 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,843 | TotalAmt |
| Program Services | $39,501 | ProgramServicesAmt |
| Management And General | $35,287 | ManagementAndGeneralAmt |
| Fundraising | $2,055 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,112 | TotalAmt |
| Program Services | $109,715 | ProgramServicesAmt |
| Management And General | $26,863 | ManagementAndGeneralAmt |
| Fundraising | $1,534 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,957 | TotalAmt |
| Program Services | $153,310 | ProgramServicesAmt |
| Management And General | $222,235 | ManagementAndGeneralAmt |
| Fundraising | $8,412 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,235,755 | TotalAmt |
| Program Services | $1,218,165 | ProgramServicesAmt |
| Management And General | $17,537 | ManagementAndGeneralAmt |
| Fundraising | $53 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,866 | TotalAmt |
| Program Services | $26,820 | ProgramServicesAmt |
| Management And General | $9,909 | ManagementAndGeneralAmt |
| Fundraising | $137 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,250 | TotalAmt |
| Program Services | $267,037 | ProgramServicesAmt |
| Management And General | $55,502 | ManagementAndGeneralAmt |
| Fundraising | $711 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,539,322 | TotalAmt |
| Program Services | $2,097,737 | ProgramServicesAmt |
| Management And General | $435,999 | ManagementAndGeneralAmt |
| Fundraising | $5,586 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $543,965 | TotalAmt |
| Program Services | $339,981 | ProgramServicesAmt |
| Management And General | $203,464 | ManagementAndGeneralAmt |
| Fundraising | $520 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical and other supplies | $3,676,609 | $3,484,232 | $190,408 | $1,969 |
| Dues, Fees, and Taxes | $2,164,171 | $1,814,005 | $348,204 | $1,962 |
| Miscellaneous Expenses | $382,646 | $142,295 | $238,587 | $1,764 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,893,098 | TotalAmt |
| Program Services | $45,629,936 | ProgramServicesAmt |
| Management And General | $10,133,589 | ManagementAndGeneralAmt |
| Fundraising | $129,573 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,769,055 | BOYAmt |
| EOY | $5,720,700 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,005,914 | BOYAmt |
| EOY | $12,015,078 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,066,871 | BOYAmt |
| EOY | $504,425 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,314,165 | BOYAmt |
| EOY | $5,331,022 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $386,754 | BOYAmt |
| EOY | $421,300 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,925 | BOYAmt |
| EOY | $384,861 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $45,713,501 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $28,952,147 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,116,755 | BOYAmt |
| EOY | $16,761,354 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,808,032 | BOYAmt |
| EOY | $19,050,433 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,851,391 | BOYAmt |
| EOY | $1,949,047 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,914,091 | BOYAmt |
| EOY | $5,668,205 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,791,953 | BOYAmt |
| EOY | $67,806,425 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,672,758 | BOYAmt |
| EOY | $7,246,002 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,147,853 | BOYAmt |
| EOY | $8,692,787 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $779,234 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,602,307 | BOYAmt |
| EOY | $22,505,158 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,202,152 | BOYAmt |
| EOY | $38,443,947 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,412,279 | BOYAmt |
| EOY | $21,568,085 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,177,522 | BOYAmt |
| EOY | $7,794,393 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,589,801 | BOYAmt |
| EOY | $29,362,478 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,791,953 | BOYAmt |
| EOY | $67,806,425 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,586,077 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $819,972 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $366,628 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $10,159 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,159 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | Mt. Ascutney Hospital and Health Center pays dues to various organizations related to its exempt mission. The amount reported under other activities in line 1i refers to the amount of lobbying activities identified in dues payments to these outside organizations. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,052,695 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $404,533 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $200,950 | OtherExpendituresAmt |
| End Year Balance | $5,256,278 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,060,299 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $188,211 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $195,815 | OtherExpendituresAmt |
| End Year Balance | $5,052,695 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,958,242 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $289,494 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $187,437 | OtherExpendituresAmt |
| End Year Balance | $5,060,299 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,667,571 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $475,456 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $184,785 | OtherExpendituresAmt |
| End Year Balance | $4,958,242 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,431,980 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $420,076 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $184,485 | OtherExpendituresAmt |
| End Year Balance | $4,667,571 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.8025 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.1975 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $410,000 | OtherCostOrOtherBasisAmt |
| Book Value | $410,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,618,942 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,305,671 | DepreciationAmt |
| Book Value | $8,313,271 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,047,091 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,197,665 | DepreciationAmt |
| Book Value | $3,849,426 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,637,468 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,448,811 | DepreciationAmt |
| Book Value | $4,188,657 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,761,354 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Rental Deposits | $13,278 |
| Equity in subsidiary | $2,658,768 |
| Other receivables | $431,400 |
| Right of use assets, net | $2,564,759 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,668,205 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to affiliates | |
| Est. Settlement w/3rd party payors | $1,732,815 |
| Affiliate note payable | $17,451,929 |
| Post retirement benefit obligation | $511,337 |
| Right of Use Obligations | $2,591,307 |
| Other Liabilities | $217,770 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $22,505,158 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 Intended uses of endowment funds | The intended use of the endowment funds is to promote and advance the following mission-related programs: healthcare services, charity care, community outreach and advocacy, and equipment purchases. |
| Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | The footnote to the organization's financial statements states "the organization has determined that the provisions of subtopic 740-10 do not have a material effect on the organization's financial statements. " |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 225 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $298,118 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $298,118 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0053 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,680,667 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,167,347 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,513,320 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0807 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $5,978,785 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,167,347 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,811,438 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0861 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,210,703 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,889,036 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $321,667 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0058 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $250,260 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $250,260 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0045 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,936,656 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,328,937 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,607,719 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0467 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,680 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,680 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $6,399,299 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,217,973 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,181,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0569 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $12,378,084 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,385,320 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,992,764 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1430 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $22,549,618 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $22,907,647 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$358,029 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Windsor Hospital Corporation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 County Road | AddressLine1Txt |
| City | Windsor | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.mtascutneyhospital.org | WebsiteAddressTxt |
| State License | 863 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Distinct Part Rehab Unit | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Windsor Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.mtascutneyhospital.org/about/community-health-needs | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.mtascutneyhospital.org/about/community-health-needs | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 225.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.0 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 3E | The significant health needs are a prioritized description of the significant health needs of the community and identified through the CHNA. |
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - Windsor Hospital Corporation. Methods employed in the assessment included a survey of area residents made available through the electronic mail, physical printed surveys distributed through the communities at approximately 72 sites and website links, a survey of key community stakeholders who are agency, municipal or community leaders, a series of community discussion groups convened in the Mt. Ascutney Hospital service area, and a review of available population demographics and health status indicators. At the beginning of the survey, respondents were asked to indicate the region they primarily serve or are most familiar with. A total of 137 key stakeholder respondents indicated that their responses were reflective of the greater Windsor area. Respondents represented the following sectors: - Human Service/Social Service - Mental/behavioral health - Home Health Care - Primary Health Care - Medical Subspecialty - Public Safety/Fire - Emergency Medical Services - Education/Youth Services - Municipal/County Government - Community Member/Volunteer |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - Windsor Hospital Corporation. The CHNA was conducted with other hospital facilities including Mary Hitchcock Memorial Hospital (MHMH), Alice Peck Day Memorial Hospital, New London Hospital, and Valley Regional Hospital. During January though July 2018, MAHHC completed its community health needs assessment in partnership with the aforementioned neighboring hospitals and the Visiting Nurses and Hospice of VT and NH, as well as MHMH. USING SIMILAR COMMUNITY HEALTH NEEDS ASSESSMENT TOOLS AND APPROACHES, ALLOWED US TO COMPARE COMMUNITY HEALTH NEEDS ACROSS A BROAD GEOGRAPHIC, MULTI-HOSPITAL REGION. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - Windsor Hospital Corporation. Through January to July, 2018, MAHHC worked with Mary Hitchcock Memorial Hospital and community partners (72 organizations) to disseminate surveys, serve as key informants (of which there were 137), and to provide overall review and feedback regarding findings identified in the community health needs assessment. |
| Schedule H, Part V, Section B, Line 7 Facility , 1 | Facility , 1 - Windsor Hospital Corporation. A benefit report was prepared and made available and distributed though 5 community presentations, which included 2 regional summits with over 100 participants, conducted by the community benefit staff, as well as a thorough presentation made to the hospital's board of trustees. The Mt. Ascutney Community Health Committee, as well as the Windsor area community partnership and Woodstock Health and Wellness Network, participated in the distribution of the report. The CHNA and all information in the needs assessment is available for stakeholders. The CHNA is also available, upon request, via paper copy at the hospital's main information desk. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - Windsor Hospital Corporation. The mission of Mt. Ascutney Hospital and Health Center (MAHHC) is to improve the lives of those we serve. To accomplish this, we and our community partners regularly reach out to engage in dialogue with people across our area about pressing health needs. The result of this work is a comprehensive local community health needs assessment (CHNA). This assessment is designed to identify community health concerns and priorities and opportunities to improve community health and healthcare delivery systems. The geographic area covered by the assessment includes 13 municipalities in Vermont and New Hampshire that comprise the Mt. Ascutney Hospital and Health Center service area. The CHNA leads to a local community health improvement plan (CHIP) with strategies and metrics to improve health and reduce risks leading to chronic disease not only for individuals, but for the entire community. This CHNA-CHIP process, which incorporates input from people who represent the community's broad interests, is an essential part of creating an accountable community for health. It is not only the law for tax-exempt hospitals, as part of the patient protection and affordable care act, but it is also sound medicine. The assessment process fosters engagement, and the results help us to understand the specific issues facing our communities so that we can develop effective, collective solutions. In fiscal year 2020, we implemented the following programs within our Community Health Improvement Plan designed to address the priority health needs of the Community Health Needs Assessment. COVID-19 was not anticipated in the 2018 Community Health Needs Assessment. However significant energy, expertise, and time was devoted to mount a community response to reduce the impact of the pandemic and support our community use through the pandemic. Over and above the hospital response, which included establishing a Respiratory Clinic, modifying the physical plant, allocating staffing, changing work flows and providing care to the ill through our Emergency Department, clinic and inpatient unit. Mt. Ascutney Hospital and Health Center (MAHHC) led a community response to mitigate the population health effects of COVID-19 and protect the vulnerable in our communities. This work included establishing a leadership forum and subcommittees on communication, food security, economic security and family wellness. The Communication Subcommittee worked to educate the community, share resources, promote health and reduce the risk of infection as well as decreased socialization and provide compassionate support. We created a website to both channel people's needs to resources and recruit and mobilize volunteers to meet specific needs. The Food Security Committee worked with the school and restaurants to provide meals to families, increased support for the elderly through the Meals on Wheels programs, and supported food shelves with volunteers, donations and food drives. We also linked the food shelves with Farms for milk, eggs, and cheese which were in low volume. VeggieVanGo served an average of 350 families each month which is a significant increase over the 150 families prior to COVID. We promoted gardens and worked with restaurants. Economic support included administering grants and working in partnership with local Health and Human Service agencies as well as our Community Health Team to link those in need with resources. We provided infection prevention education to families and assisted with resources to decrease anxiety and improve coping. We organized 3 prevention suicide trainings by working with HCRS. We also convened regional recreation departments and summer camps to maximize safe recreation for students during the summer. Access to mental health was our #1 community health need. During 2020 we increased our Psychiatry program to include 3 Psychiatrists providing services as part of our Patient Centered Medical Home. We continued a contractual agreement with monthly pediatric psychiatry consultation. We provided 1 Wellness Recovery Action Plan (WRAP) self-management class. Our work with the Windsor Connection Resource Center provided 288 mental health counseling sessions. We utilized Chaplaincy services to provide staff support. We designed and implemented 6 Trauma Informed Care classes of which 196 individuals participated. We worked with the Windsor High School to provide "You Matter" suicide prevention gatekeeper training. We provided a monthly support group for parents who experienced the death of a child. We worked with the Family Wellness Program to provide COVID-19 coping strategies to all families in our pediatric practice. Our Family Wellness Therapist developed a Mental Health Access Team. Access to this service has increased over 30% and the number of visits has more than doubled. Our Family Wellness Coach taped a video "For Your Health" television show helping families with cope during COVID-19. Alcohol and substance misuse was our #2 community health need. During 2020 in the area of prevention we became a recipient of a state wide Prevention Network Grant that sub-awarded $253,000 to 11 community organizations to implement prevention strategies at the local level. Sectors included restorative Justice, school district, recovery centers, law enforcement and health care. We provided funding and support for integration of collaborative problem-solving across the school district with 150 leadership and staff. CPS is a best practice approach overcoming social emotional learning challenges with children. Rebuilding these essential skills is an upstream substance misuse prevention approach. We worked with 3 towns to adopt of town health chapter templates and continue to work with 5 other towns. We co-created a health policy clearing house with the local regional planning commission. This provides best practice policy solutions to rebuilding local cultures of health and preventing substance misuse. We designated a data dashboard for the use of partner organizations and communities to access local relevant population health indicators for the purpose of health planning or grant writing. We promoted mail back envelopes for over 30 kiosks at very various community locations. We supported drug take-back efforts collecting 735 pounds of prescription medications. In the area of treatment, we led a cross sector workgroup for alcohol and substance misuse to address barriers to treatment options. This group with 25 members that met monthly developed an anti-stigma campaign. MAHHC leads a Spoke Program in 4 sites serving 197 MAT patients with counseling, care coordination, health coaching and education. MAHHC pediatric private practice serves a small population of mothers of pediatric patients with MAT, counseling and providing a therapeutic playgroup. Blueprint for Health Self-Management Programs offers Chronic Pain Self-Management Program. We worked tirelessly to prevent opioid deaths. Initiatives in this area included implementation of Rapid Access to Medication (RAM) program in the Mt. Ascutney Hospital and Health Center Emergency Department (ED) and Springfield Medical Center ED. We tracked time from ED to treatment. Outcome studies available per request. Similar to the PARRI Project, we developed teams in Windsor and Hartford of Police/EMS/Recovery coaches/mental health workers who respond after an overdose to the patient and family with support, education, resources and referral to treatment. We are collaborating with the existing program in Springfield for a county wide approach. MAHHC ED is a Narcan distribution site for the community. We have worked with the Syringe Service and Connecticut Valley Recovery Services (CVRS) to increase education and access to Narcan. We continue to work on an educational booklet that will take various formats depending on the audience. Two YouTube videos were created and released in collaboration with the Green Peak Alliance, Syringe Service Program and States Attorney on Narcan education and the Good Samaritan Law. In the area of recovery, MAHHC entered in an agreement with Springfield Turning Point Recovery Center to link patients to Recovery Coaches 7 days a week 24 hours a day. Once the patient consents, the Recovery Coach meets with the patient in the Emergency Department. They also follow the patient to provide support in the first 10 days and beyond after the Emergency Department visit. Recovery Coaches have provided real and meaningful support to our patients struggling with addiction. Out of 52 visits 23 patients continue with follow-up. Of those 18 are still in recovery. Recovery Coaches have become active members in our Alcohol and Drug Abuse Workgroup for the Community Health Improvement Plan. They have also attended community meetings, such as the PATCH meetings, bringing valuable expertise and insight in this process. (Continued on Schedule O) |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - Windsor Hospital Corporation. Patients whose family income exceeds 300% of FPL may be eligible to receive a discount based on the self-pay balance. Discounts will be granted such that the total self-pay bill does not exceed 10% of 2 years gross income, plus 10% of assets in excess of the sheltered asset calculation as described in the policy. Any discounts for patients whose family exceeds 300% of FPL must be approved by the financial assistance appeals committee based on a written appeal from the patient or responsible party. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - Windsor Hospital Corporation. MAHHC applies a discount, calculated annually, to the FAP eligible patient's gross charges and balances where there is no insurance, or to medically necessary services processed by insurance carriers resulting in a balance, which the patient is expected to pay. This assures a patient is not billed at an amount greater than generally billed to patients with insurance. This policy is reference in the Financial Assistance for Healthcare Services policy (FAP). |
| Schedule H, Part V, Section B, Line 16 Facility , 1 | Facility , 1 - Windsor Hospital Corporation. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON MAHHC'S WEBSITE, INCLUDING THE VERBATIM POLICY AND A SHORTER, MORE PATIENT-FRIENDLY PLAIN-LANGUAGE SUMMARY. MAHHC PROVIDES THE PLAIN-LANGUAGE SUMMARY BROCHURE TO ALL INPATIENTS, EMERGENCY DEPARTMENT INTAKES, UNINSURED, AND SELF-PAY INDIVIDUALS. MAHHC CONTINUES TO NOTIFY PATIENTS ON THE BACK OF THE BILLING STATEMENT ABOUT FINANCIAL ASSISTANCE AVAILABLE TO THEM. ADDITIONALLY, MAHHC POSTS INFORMATION ABOUT THE POLICY IN PUBLIC AREAS THROUGHOUT THE FACILITIES INCLUDING ADMISSION OFFICES, PUBLIC AREA BOARDS THROUGHOUT THE FACILITIES, THE EMERGENCY ROOMS, AND FINANCIAL ASSISTANCE POLICY BROCHURES IN PATIENT AREAS. MAHHC SCREENS 100% OF UNINSURED INPATIENT AND SAME-DAY PATIENTS PRIOR TO ADMISSION. AS PART OF THIS PROCESS, MAHHC CHECKS ALL STATE AND FEDERAL PROGRAMS TO SEE IF INDIVIDUALS ARE ELIGIBLE FOR ASSISTANCE. PATIENTS ARE ALSO SCREENED TO DETERMINE QUALIFICATION FOR FINANCIAL ASSISTANCE AND THE APPLICATION IS PROVIDED AND/OR COMPLETED AT THIS TIME. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (18 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part VI, Line 7 State Filing of Community Benefit Report | The state of Vermont does not administer any community benefit reporting regulations. |
| Schedule H, Part V, Section B, Line 11 Addressing needs identified in CHNA | (Continued from Schedule H, Part V, Line 11, Section C) Access to affordable health insurance and prescription medication was our #3 community health need. We continued to provide access to health insurance through the Windsor Community Health Clinic in our Patient Centered Medical Home and the Thompson Senior Center in Woodstock. We received and distributed COVID-19 relief funding from the Vermont Community Foundation to help with the needs of the community impacted by the pandemic. We partnered with area dental practices including a new partner in Claremont to provide donation based factors and assist our patients to link to Dental Homes. We have helped patients navigate and receive services to Vermont Health Connect during the emergency special enrollment and throughout the year. Strengthening families, our #4 community health need, included work in conjunction with the pediatric clinic and the community to overcome poverty and family stress by increasing skills and capacity for positive relationships in the family unit. The Family Wellness Coach saw 116 individuals in 239 sessions. The Family Wellness Therapist saw 116 individuals in 532 sessions. We implemented a DULCE (Developmental Understanding and Legal Collaboration for Everyone) program in conjunction with 2 parent-child centers. This program includes to full-time family specialists who were pared with pediatricians for the families of newborns through their 6 months of life. In this universally available program, we served 90 families across both clinics with a participation rate of 80%. Partners in this endeavor include the Vermont Department of Health, OneCare Vermont, 2 parent-child centers and Vermont Legal Aid. We developed a Community Health Improvement Plan workgroup with diverse multisector agencies in individuals to enhance social connectedness for children and families. Using a Collective Impact approach, the Strengthening Families Workgroup initiated a regional Circle of Security collaboration and a Strengthening Families Playgroup. We continue to work with the Windsor Connection Resource Center and provide leadership for the collaboration of health and human service agencies called PATCH. We worked with local citizens and a community group called Sled Dog Disco to create developmental asset activities, helping to build a flourishing community. We worked with each surrounding school to develop school supply lists and raised $6683 to purchase all needed school supplies for 455 students who qualify for free and reduced lunches. Access to primary care, our #5 community health need, continued in our 10th year as a NCQA recognized Patient Centered Medical Home demonstrating meeting all the standards. Much work has been done to recruit and retain primary care providers. Our Community Health Team continues to work with community partners to provide care coordination, education, and interventions to improve the quality of care in the continuum of care for very high risk chronic care patients to preventative care. MAHHC continues to provide leadership to the multisector network of Health and Human Services in this care coordination effort. We provided self-management care workshops through the Blueprint for Health in an effort to prevent disease, reduce complications and improve the quality of life for those with chronic conditions. In 2020 we provided workshops on diabetes self-management, diabetes prevention, chronic pain, and Wellness Recovery and Action Planning (WRAP) for mental health. In Senior health, our #6 community health need, we developed a Community Health Implementation Plan Workgroup. This workgroup with multisector representation brought together all area aging in place groups. We developed a quick guide refrigerator magnet with phone numbers for local health related resource agencies. We provided startup funding through a grant for a community nurse position with Reading-West Windsor Aging in Place. We brought together on a monthly basis Aging in Place groups to share best practices and collaborate to support Elders in the community. We provided support to Scotland House, an area adult day and wellness program, through leadership and guidance to their Board of Directors. We worked with Support and Services at Home (SASH) and Housing and Support Services (HASS) to provide care in Windsor Village and the community for approximately 100 high risk elders. This work includes staffing, care coordination and program development. Affordable housing is our #7 community health need. We convened a multisector workgroup, Community Health Mentation Plan Affordable Housing, to address the lack of affordable homes in our communities. We interviewed public and private housing providers and municipal leaders. We conducted a Community Readiness Assessment to reach the goal of creating additional rentals within existing homes. We mapped the assets of the MAHHC service area for housing. We launched a landlord interview together to build up the network of unknown people who are successfully meeting the economic and social needs by renting to others at affordable rates. Dental care is the #8 community health need, which our Community Health Team and Windsor Community Health Clinic linked patients and need with dental homes. We come through generous grants and donations, provided $20,058 in dental vouchers to eligible patients for dental care. Prior to COVID-19, we also worked with Flossbar to make cleanings and screenings available to the community. We provided space and outreach to and for patients to meet their dental needs. Food security was identified as a priority within our Community Health Implementation Plan. Prior to COVID-19, our Volunteers in Action Program hosted 59 community meals. Throughout the year Meals on Wheels were provided through Volunteers in Action working with Senior Solutions. We organized and worked with the Vermont Food Bank on the VeggieVanGo monthly program which distributes free produce serving 150 families prior to COVID-19 and 350 families post COVID-19. We worked with the schools to provide volunteers to distribute food to families' post COVID-19 and through the summer. We worked with area food shelves, local citizens and restaurants to fundraiser and distribute food to families an elderly who were food insecure. We developed a Food Security Multisector Workgroup. This workgroup worked to increase access to nursing food for people in the community. RiseVT operates through our staff working in conjunction with OneCare Vermont. RiseVT distributed Amplify Grants to build capacity and access to healthy foods including healthy snacks and drinks, gardening projects and support of the food shelves. RiseVT encouraged physical activity through mindfulness and yoga classes at Headstart preschool, providing equipment for aerobics, bingo bowling, organizing a 5K race in conjunction with the Windsor Recreation Department and Windsor Food Shelf, organized an at home Olympics contest during COVID-19, distributed free bike helmets for pediatric patients and provided play equipment to support gross motor skill development at a local childcare center. RiseVT also started the Windsor Walks Program. Walking loops were identified with skills and marketing to promote increased exercise. Smoking/tobacco use/vaping, working in conjunction with the Vermont Department of Health, we launched a Monthly Vaping Digest to keep school, community and health care partners aware of the number of cases of vaping associated lung disease. This digest also expanded to include additional prevention resources. We created and marketed a visual, locked display case of older and newer styles of vaping devices to educate school personnel and parents. We created a handout with the signs of nicotine withdrawal and how to access cessation services. We worked with a Hartland Elementary health teacher to design a smoking/vaping research and reporting activity for middle school students. We designed and ordered stickers, pens, hand sanitizers and cell phone wallets designed to build awareness of vaping quit resources. We worked with school wellness committees to provide prevention information and education. We worked with Tobacco Cessation Coaches to provide one-on-one cessation and cessation classes. We presented at the town Select Board Meeting leading to an adoption of a smoke/vape-free town oriented parks and land policy that went into effect September 1, 2020. We worked with Two Rivers Ottauquechee Regional Health Commission to develop an online search triple health policy clearing house including many policies centering on smoke/vape free environments. (Continued below) |
| Schedule H, Part V, Section B, Line 11 Addressing needs identified in CHNA (Continued) | (Continued from above) Transportation is a barrier to accessing healthcare. Our Volunteers in Action program continues to lead the Rides to Wellness Program utilizing volunteers to provide rides to medical appointments. Other transportation services included shopping trips and non-medical appointments. The service had to be discontinued with the advent of COVID-19. However, we provided 534 rides, driving 4930 miles. Through generous donations we are also able to provide gas cards to those in need. |
| Schedule H, Part I, Line 7g Subsidized Health Services | The organization did not include any subsidized health service costs attributable to a physician clinic on part I, line 7G. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | A cost accounting system which addresses all patients' segments was used to calculate the amounts reported in the table. A cost-to-charge ratio is used in calculating Medicare allowable cost of care. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | AS A RESULT OF NEW ACCOUNTING GUIDANCE (STATEMENT 15 AND ASC 606), EFFECTIVE FY20 BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | Bad Debt is no longer treated as an expense effective FY20 as a result of new accounting guidance (Statement 15 and ASC 606). As a result, an amount attributable to patients eligible under the organization's financial assistance policy is unable to be reasonably estimated. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | AS A RESULT OF ACCOUNTING CHANGES (ASC 606), BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDE AS A REDUCTION IN NET PATIENT REVENUE. THEREFORE, THERE IS NO SEPARATE FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | The shortfall represents the PPS reimbursement difference of the rehab units. Since the reimbursement does not cover the costs of these units, a subsidy is created. Because the hospital determined that these services are important to the service area, the hospital covers the subsidy. The costing methodology used in the calculation was the cost to charge ratio. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | MAHHC's collection policy and charitable care policies are consistently applied to all patients. Our collection policy applies to any balance owed by the patient whether it is a balance after insurance, a balance with no insurance, or a balance after an adjustment for partial charitable care. Statements and write-off criteria are the same for all like balances, regardless of the reason for the balance and regardless of whether it is a balance after charitable care or not. Patients for financial assistance receive the appropriate adjustment on their bill. If a balance remains after that adjustment, they are billed according to the collection policy for it. |
| Schedule H, Part V, Section B, Line 16a FAP website | - Windsor Hospital Corporation: Line 16a URL: https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - Windsor Hospital Corporation: Line 16b URL: https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - Windsor Hospital Corporation: Line 16c URL: https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance; |
| Schedule H, Part VI, Line 2 Needs assessment | During the period January through July 2018, a Community Health Needs Assessment was completed by Mt. Ascutney Hospital and Health Center in partnership with Dartmouth-Hitchcock, Alice Peck Day Memorial Hospital, Valley Regional Health Care, New London Hospital, Visiting Nurse and Hospice of Vermont and New Hampshire, and the John Snow Institute. The purpose of the assessment was to identify community health needs, priorities and opportunities for community health and health care delivery system improvement. For the purpose of the assessment the geographic area for Mt. Ascutney Hospital and Health Center was 13 municipalities in Vermont and New Hampshire with a total resident population of 44,035 people. Methods employed in the assessment included surveys of community residents made available online and on paper placed in numerous locations throughout the region. We did a direct email survey of key stakeholders and community leaders representing multiple community sectors. We organized and delivered a set of community discussion groups. We compiled the results from the assessment activities and focused specifically on behavioral health needs and gaps and a review of population demographics and health status indicators. All information from the collective activities were analyzed to produce the assessment which lead us in focusing our work to serve vulnerable and disproportionally served populations in the region including populations that experience limited healthcare to health related services or resources due to income, age, disability and social or physical isolation. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | PATIENTS who are identified as without insurance at registration or referred to by a physician/provider are provided with information as to available local, state and Federal services by dedicated staff. Patients are also assisted in applying for health insurance, whether on the commercial exchange or with governmental insurers. Information and the application for financial assistance is provided, along with assistance in completing the application if needed. The applications are reviewed to assure that all required information is provided. THE WEBSITE, PATIENT STATEMENTS, AND FINANCIAL BROCHURES ALL INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE AND HOW TO APPLY. |
| Schedule H, Part VI, Line 4 Community information | MAHHC's primary service area includes Bridgewater, Brownsville, Hartland, Reading, Weathersfield, Windsor, and Woodstock (VT) as well as Claremont, Cornish, and Plainfield (NH). MAHHC is the largest employer in the Town of Windsor, with many of its residents having lower than average paying jobs and who struggle with financial stability, which includes transportation difficulties. |
| Schedule H, Part VI, Line 5 Promotion of community health | The hospital supports a Director of Community Health, the Mt. Ascutney Prevention Program (MAPP) and a Community Health Committee which is a subcommittee of the Board of Trustees. Our staff continue to organize, lead and implement population health programs, health promotion and prevention programs that address high risk behavior such as alcohol, tobacco and drug misuse. We promote exercise and nutrition programs. We organized and implemented the Community Health Implementation Plan. We serve as an integrator and leader of community health by chairing and leading the following community collaborations; the Windsor HSA Community Collaborative, the Windsor PATCH Team, the Blueprint for Health care coordination team, the 6 multisector work groups resulting from the Community Health Needs Assessment. |
| Schedule H, Part VI, Line 6 Affiliated health care system | The Hospital's Director of Community Health an active participant in the regional Community Health Committee which is lead and organized by Dartmouth-Hitchcock. The hospital is affiliated, formally, with Dartmouth-Hitchcock as are the other local hospitals, Alice Peck Day Memorial Hospital, New London Hospital, and Valley Regional Hospital. These hospital representatives collaborate and compare solutions and offer support to each other in our community health programs. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joseph L Perras MD | ||||||||||||||
| President/CEO/Ex-officio | $374,894 | $0 | $0 | $0 | $14,942 | $0 | $11,200 | $0 | $1,662 | $0 | $402,698 | $0 | $0 | $0 |
| Patrick F Jordan III MBA | ||||||||||||||
| Trustee | $0 | $654,825 | $0 | $80,400 | $0 | $35,008 | $0 | $21,355 | $0 | $42,779 | $0 | $834,367 | $0 | $0 |
| Maria Padin MD | ||||||||||||||
| Trustee (Through 5/2020) | $0 | $394,016 | $0 | $0 | $0 | $36,908 | $0 | $26,955 | $0 | $37,687 | $0 | $495,566 | $0 | $0 |
| Annice Mason | ||||||||||||||
| Trustee/Physician | $230,151 | $0 | $0 | $0 | $199 | $0 | $6,683 | $0 | $986 | $0 | $238,019 | $0 | $0 | $0 |
| Matthew Houde | ||||||||||||||
| Trustee | $0 | $219,719 | $0 | $0 | $0 | $541 | $0 | $16,367 | $0 | $33,132 | $0 | $269,759 | $0 | $0 |
| Steven Smith MD | ||||||||||||||
| Trustee | $0 | $183,620 | $0 | $0 | $0 | $9,507 | $0 | $18,018 | $0 | $36,624 | $0 | $247,769 | $0 | $0 |
| Steven Surgenor | ||||||||||||||
| Trustee | $0 | $467,086 | $0 | $0 | $0 | $24,797 | $0 | $26,955 | $0 | $33,922 | $0 | $552,760 | $0 | $0 |
| David Sanville | ||||||||||||||
| CFO | $208,133 | $0 | $0 | $0 | $29,198 | $0 | $9,478 | $0 | $19,052 | $0 | $265,861 | $0 | $0 | $0 |
| Paul Calandrella | ||||||||||||||
| Chief Operating Officer | $211,921 | $0 | $0 | $0 | $953 | $0 | $8,477 | $0 | $24,933 | $0 | $246,284 | $0 | $0 | $0 |
| Peter Rauert | ||||||||||||||
| Anesthesiologist | $415,226 | $0 | $0 | $0 | $953 | $0 | $11,200 | $0 | $19,825 | $0 | $447,204 | $0 | $0 | $0 |
| Christopher Connor | ||||||||||||||
| Ophthalmologist | $325,000 | $0 | $18,304 | $0 | $1,523 | $0 | $11,200 | $0 | $10,979 | $0 | $367,006 | $0 | $0 | $0 |
| Dennis Heibein | ||||||||||||||
| CRNA | $261,956 | $0 | $0 | $0 | $2,757 | $0 | $10,478 | $0 | $11,607 | $0 | $286,798 | $0 | $0 | $0 |
| Mary Joyce | ||||||||||||||
| Physician | $262,824 | $0 | $0 | $0 | $1,468 | $0 | $10,513 | $0 | $20,362 | $0 | $295,167 | $0 | $0 | $0 |
| Alden Hall | ||||||||||||||
| Physician | $251,987 | $0 | $0 | $0 | $502 | $0 | $10,079 | $0 | $1,109 | $0 | $263,677 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part II NOTE REGARDING COMPENSATION | FORM 990, SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY MAHHC AND RELATED ORGANIZATIONS. THESE AMOUNTS ARE REPORTED TO EMPLOYEES ON THEIR ANNUAL W-2 FORMS AS COMPENSATION. COLUMNS C AND D REPRESENT ITEMS EARNED, HOWEVER, NOT PAID DIRECTLY TO THE EMPLOYEE AS CASH PAYMENTS DURING THE CALENDAR YEAR. COLUMN C INCLUDES RETIREMENT BENEFITS IN A CALENDAR YEAR. COLUMN D REPRESENTS NONTAXABLE BENEFITS SUCH AS THE COST OF HEALTHCARE COVERAGE PROVIDED BY MAHHC ON BEHALF OF ITS EMPLOYEES. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | THE CEO'S COMPENSATION AMOUNT IS DETERMINED BY A RELATED ORGANIZATION, WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE MAHHC BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE CEO'S COMPENSATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | An Executive Committee, consisting of the Chair, Vice-Chair, Secretary and Treasurer, Immediate Past Chair, and such other trustees elected by the board as may be necessary to make a committee of not less than five members. This committee shall, in the interim between meetings of the board, exercise all of the power of the body, but in accordance with the general power of the hospital and direction of the board. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Dartmouth-Hitchcock Health (D-HH), a New Hampshire voluntary corporation, is the sole corporate member of Mt. Ascutney Hospital and Health Center. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Dartmouth-Hitchcock Health (D-HH), a New Hampshire voluntary corporation, is the sole corporate member of Mt. Ascutney Hospital and Health Center. D-HH has the power to appoint 1/3 of the members of the Mt. Ascutney Hospital and Health Center board of trustees. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The sole member has the right to ratify Mt. Ascutney Hospital and Health Center's nomination of 2/3 of the members of the board of trustees; remove trustees after consultation with the chairperson of the board; approve the dissolution or liquidation of Mt. Ascutney Hospital and Health Center; appoint, evaluate, terminate, and approve the compensation of the president and ceo; and other governance decisions. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The Form 990 is reviewed by external tax advisors and the chief financial officer before the filing of the return. In addition, once the return has been fully prepared, a final 990 is sent to each board member and time is allocated for comments and responses prior to the official filing of the forms. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Mt. Ascutney Hospital and Health Center's BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF-DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. The Compliance and audit services department of an affiliate, Dartmouth-Hitchcock, 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 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 OF 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 CURCUMSTANCES, 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. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The compensation committee of Mt. Ascutney Hospital and Health Center's board meets annually to review and approve compensation for the president/CEO,, which is recommended by the compensation committee of a related organization. The compensation is determined using an outside consultant and comparability survey and/or study including contemporaneous substantiation. This process was last undertaken in FY20. The compensation committee consists of the executive committee and a D-HH representative. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS EVALUATED BY INTERNAL HUMAN RESOURCES STAFF USING NATIONAL BENCHMARKING DATA (ALONG WITH ONGOING EVALUATIONS BY AN INDEPENDENT THIRD-PARTY FIRM FOR REASONABLENESS). THE LAST FORMAL PROCESS WAS COMPLETED IN 2020. EXTERNAL BENCHMARKING FROM AN INDEPENDENT THIRD PARTY HAS BEEN USED FOR ANY OFFICER WHO WAS HIRED OR RECEIVED A COMPENSATION ADJUSTMENT SINCE THE LAST FORMAL PROCESS. COMPENSATION RATES ARE DETERMINED BY FOLLOWING THE GUIDELINES OF THE COMPENSATION COMMITTEE CHARTER AND PHILOSOPHY DOCUMENTS AND A FORMAL REVIEW BY COMPENSATION COMMITTEE MEMBERS. Included in this process is the CFO and the chief operating officer. |
| Form 990, Part VI, Line 19 Required documents available to the public | Mt. Ascutney Hospital and Health Center makes governing documents, conflict of interest policy, and financial statements available to members of the public upon request. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Change in net assets to recognize funded status of post-retirement plans - 4279620; Amount of fund asset transfers - 73170; Gain on pension plan termination - -4081777; Equity in subsidiary income - 95615; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HISTORIC HOMES OF RUNNEMEDE INC | ||||||||||
| 40 MAXWELL PERKINS LANE | WINDSOR | VT | 05089 | 237396147 | ASSISTED LIVING FACILITY | VT | 501(c)(3) | 10 | WINDSOR HOSPITAL CORPORATION | Yes (true) |
| MOUNT ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION | ||||||||||
| 289 COUNTY ROAD | WNDSOR | VT | 05089 | 030300481 | INACTIVE | VT | 501(c)(3) | 3 | WINDSOR HOSPITAL CORPORATION | Yes (true) |
| DARTMOUTH-HITCHCOCK HEALTH | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 264812335 | PARENT ORG | NH | 501(c)(3) | 7 | NOT APPLICABLE | false |
| MARY HITCHCOCK MEMORIAL HOSPITAL | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 020222140 | HOSPITAL | NH | 501(c)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| DARTMOUTH-HITCHCOCK CLINIC | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 222519596 | PHYSICIAN SERVICES | NH | 501(c)(3) | 10 | DARTMOUTH-HITCHCOCK HEALTH | false |
| THE NEW LONDON HOSPITAL ASSOCIATION INC | ||||||||||
| 273 COUNTY ROAD | NEW LONDON | NH | 03257 | 020222171 | HOSPITAL | NH | 501(c)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| CHESHIRE MEDICAL CENTER | ||||||||||
| 580 COURT STREET | KEENE | NH | 03431 | 020354549 | HOSPITAL | NH | 501(c)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| ALICE PECK DAY MEMORIAL HOSPITAL | ||||||||||
| 10 ALICE PECK DAY DRIVE | LEBANON | NH | 03766 | 020222791 | HOSPITAL | NH | 501(c)(3) | 3 | DARTMOUTH-HITCHCOCK HEALTH | false |
| VISITING NURSE AND HOSPICE FOR VERMONT AND NEW HAMPSHIRE | ||||||||||
| 88 Prospect Street | White River Juction | VT | 05001 | 036006494 | HOSPICE | VT | 501(c)(3) | 10 | DARTMOUTH-HITCHCOCK HEALTH | false |
| DARTMOUTH -HITCHCOCK MEDICAL CENTER | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 222715483 | SUPPORTING ORG. | NH | 501(c)(3) | Type I | NOT APPLICABLE | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mount Ascutney Professional Center Owners Assoc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 County Road | AddressLine1Txt |
| City | Windsor | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05089 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030320283 | EIN |
| Primary Activities | Real Estate Management | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Windsor Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C Corporation | EntityTypeTxt |
| Share Of Total Income | $10,785 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $13,218 | ShareOfEOYAssetsAmt |
| Ownership | 1 | OwnershipPct |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Historic Homes of Runnemede Inc | ||
| Q | $172,380 | FMV |
| Mount Ascutney Professional Owners Assoc | ||
| K | $103,018 | FMV |