SPRINGFIELD HOSPITAL INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- SPRINGFIELD HOSPITAL INC (EIN 03-0179437)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-16
- IRS object ID
- 202132289349302868
- Schema version
- 2019v5.2
- 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 G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-08-16T13:07:54-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | 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 | 030179437 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPRI | BusinessNameControlTxt |
| Phone | 8028852151 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kayda Wescott | PersonNm |
| Person Title | Interim CFO | PersonTitleTxt |
| Phone | 8028852151 | PhoneNum |
| Signature | 2021-08-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2021-08-16 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Robert Adcock | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,705,943 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.springfieldhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1914 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | 25-Bed Critical Access Hospital | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 540 | TotalEmployeeCnt |
| Total Volunteers | 23 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $243,556 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,265,313 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $49,631,544 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $40,414,089 | CYProgramServiceRevenueAmt |
| PY Investment Income | $316,363 | PYInvestmentIncomeAmt |
| CY Investment Income | $13,996 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,724 | PYOtherRevenueAmt |
| CY Other Revenue | $5,042 | CYOtherRevenueAmt |
| PY Total Revenue | $50,195,187 | PYTotalRevenueAmt |
| CY Total Revenue | $47,698,440 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,030,293 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,429,574 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $26,212,787 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,615,272 | PYOtherExpensesAmt |
| CY Other Expenses | $26,141,038 | CYOtherExpensesAmt |
| PY Total Expenses | $64,075,139 | PYTotalExpensesAmt |
| CY Total Expenses | $52,357,825 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$13,879,952 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,659,385 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,192,779 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,092,094 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,240,995 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,577,074 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$7,048,216 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$12,484,980 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, and employees want to work. Our plan is to accomplish this by:1. Empowering our caregivers with education, technology, and opportunities for personal and professional development;2. Creating an environment which builds collaborative relationships among clinicians, staff, and patients;3. Providing our communities with the educational resources and support to make informed decisions emphasizing prevention and wellness; and4. Offering safe, personalized, high quality care. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $42,401,018 | ExpenseAmt |
| Grant | $4,000 | GrantAmt |
| Revenue | $40,414,089 | RevenueAmt |
| Desc | Springfield Hospital (SH) is a 25-bed critical access hospital located in Springfield, VT. SH also operates The Windham Center, a 10-bed comprehensive inpatient mental health program in Bellows Falls, VT; off-site physical therapy services, five hospital-owned specialty clinics (ENT, general surgery, orthopaedics, gynecology and urology, and an adult day care center in Springfield, VT. Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, and employees want to work. Our plan is to accomplish this by:- Empowering our caregivers with education, technology, and opportunities for personal and professional development;- Creating an environment, which builds collaborative relationships among clinicians, staff, and patients;- Providing our communities with the educational resources and support to make informed decisions emphasizing prevention and wellness; and,- Offering safe, personalized, high-quality care.SH provides health services to residents throughout its catchment area. Many of the services benefit the elderly, the poor, the indigent, the underinsured and the uninsured. SH receives minimal reimbursement from these programs, with 40% of Springfield Hospital net revenue coming from Medicare and Medicaid funding.Springfield Hospital has a charity care policy under which patients who meet certain criteria will receive care without charge, or at amounts less than established rates. Patients qualify for 100% charity care at up to 200% of the federal poverty guideline (FPG) and 50% assistance up to 300% of the FPG. The Hospital does not bill patients nor pursue collection of amounts determined to qualify as charity care. For FY20, charges foregone for charity care, based on established rates, amounted to $889K.Springfield Hospital operates a number of specialty practices to provide needed specialty care to health center patients. These clinics include Connecticut Valley ENT, Surgical Associates, Connecticut Valley Orthopaedics, Springfield Gynecology and Springfield Urology. In addition, SH provides an outpatient clinic serving patients needing treatment and minimizing their need to travel great distances for medical oncology or infusion services. Cardiology services are also offered on-site 6 days each month at the specialty clinic. Charitable support, in the form of gas cards and/or medication cards, is provided to patients who do not have needed funds. This charitable support program is available through donations and grant funding. Other community benefit programs include the following:Job Training and Shadowing Programs: These programs, in cooperation with Vocational Rehab and training programs through the State of Vermont, provide opportunities to gain on-the-job experience in the healthcare field. We also work with area high school students to provide opportunities for career education and summer employment. Healthcare Scholarships: Springfield Hospital raises funds that are then donated to individuals to further their educational pursuits in healthcare careers. In FY 2020, we donated four scholarships of $1,000 each.BeSeatSmart Program: This program helps residents comply with Vermont's child passenger restraint law, while ensuring the safety of our smallest patients. During FY 2020, 13 child safety seats were provided to families in need, and a total of 20 child safety seats were installed and/or inspected by the Child Passenger Safety Technician, on site at Springfield Hospital. The safety seat checks are offered as a free community service. We estimate the value of this program to be $1,000 based on staff time to educate parents on the proper use and installation of the child safety seats and administrative assistant costs.Employee Donations For Community Causes: Throughout the year, the Hospital encourages employees to participate in and donate to fundraising events in support of various associations that address community needs, for example Hearts of Hope and the Santa Claus Club. In addition, Springfield Hospital partners with the Vermont Food Bank in offering Veggie VanGo that provides free fresh fruits and vegetables to families in need on a monthly basis. The Springfield Hospital Veggie VanGo site serves approximately 300-400 families each month.EMS Preceptor Programs: Through Springfield Hospital's Emergency Department, area EMS continue their education by participating in a preceptor program, allowing personnel to observe patient care.Hospital Based Support Groups: Springfield Hospital routinely provides education and support groups on a variety of topics such as Alzheimers' Caregivers. Group meetings meet monthly and are free to participants, educational in nature, and offer an opportunity for group discussion. During FY 2020, these groups were suspended for public safety precautions related to COVID-19.Meeting Rooms: Free meeting room space is offered to community groups when space is available. Groups that offer information on health or wellness are given a priority; such as Alcoholics Anonymous, Vermont Department of Health, the community health team and the community collaborative. During FY 2020, these groups were suspended for public safety precautions related to COVID-19.Training Site Partnerships: Springfield Hospital is a training site for Vermont Technical College for their Licensed Practical Nurses and several other schools for their Registered Nurses. Generally, the following participating schools have students doing practicums: University of New Hampshire, University of Vermont, Norwich University, University of Massachusetts, Smith College, Antioch New England Graduate School, River Valley College, VTC, St Joseph's College of Maine, Castleton State College. The program utilization generally requires an estimated 1,500 to 1,700 hours for clinical work, although we had lower activity in 2020 due to COVID-19.Community Education: Springfield Hospital promotes health education programs, open to the public, which include American Heart Association CPR and First Aid classes. The Hospital also collaborates with the Springfield Medical Care Systems' community health team in offering community health and wellness education programs throughout the year emphasizing preventive programming around diet, exercise and nutrition.Springfield Community: Springfield Hospital encourages employees to become an active volunteer to help improve the communities we call home. Employees donate their time in a variety of areas ranging from serving as Board Members for local groups, participation in fundraising activities, including the Springfield Hospital Annual Golf Tournament and Apple Blossom Cotillion fundraising events. Volunteer Service: Volunteer Services provide a variety of services to patients and visitors. The donation of time and fundraising activities support programs that include Clerical Services, Activities Assistant at Adult Day Services, Materials Management Support, Inpatient Discharge Phone Calling Support and Special Services in the Emergency Department. Volunteer numbers and time were drastically reduced I 2020 due to COVID-19. In 2020, prior to early March, Springfield Hospital had 28 volunteers. These individuals volunteered approximately 650 hours.The Windham Center: The Windham Center is a 10-bed inpatient mental health unit that provides mental health services to residents of Windham and Windsor counties and other communities. Programs provide treatment for men and women who are 18 years of age and older. Multidisciplinary teams include psychiatrists, social workers, clinicians, drug and alcohol counselors, and nurses. The Windham Center serves the general population and financial assistance is available, based on need. The Windham Center had 190 admissions in 2020, and incurred $29K in charity care expense and $487K in non-reimbursed Medicaid and Medicare costs for the same time period.Adult Day Care Service: Springfield Hospital operates an adult day care service, located in Springfield, VT. A cost-effective choice to long term nursing home health care, the Springfield Area Adult Day Service assists families with seniors or disabled adults, over the age of 18, who face the challenge of losing their independence. The structured program offers a safe and protective environment where nutritious meals, social activities, health care services, nursing oversight, and coordination of needed social and support services are provided. Transportation is available through an arrangement with the local bus service, Marble Valley Regional Transit. | Desc |
| Total Program Service Expenses | $42,401,018 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 95 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 540 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | 0 | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VT | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kayda Wescott | PersonNm |
| Phone | 8028857646 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Jim Rumrill | |||||||||
| Chairperson | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Heather Presch | |||||||||
| Vice Chairperson | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Richard Dexter III | |||||||||
| Treasurer | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| David Sandelman | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Gabriel St Pierre | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Lynn Raymond-Empey | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Robert Cantu MD | |||||||||
| Director/Orthopaedic Surgeon | 40.00 | 0.00 | Yes (X) | $556,530 | $0 | $9,007 | |||
| Eliot Hall MD | |||||||||
| Director | 1.00 | 40.00 | Yes (X) | $0 | $290,562 | $15,467 | |||
| Stephen Lyon | |||||||||
| Past Secretary | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Gerald Drabyn MD | |||||||||
| Past Director | 1.00 | 40.00 | Yes (X) | $0 | $182,023 | $14,736 | |||
| Jim Remy | |||||||||
| Past Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael Halstead | |||||||||
| Interim CEO/President | 40.00 | 0.00 | Yes (X) | $254,275 | $113,862 | $0 | |||
| Allan Scroggins | |||||||||
| Interim CFO | 20.00 | 20.00 | Yes (X) | $67,478 | $28,919 | $0 | |||
| Cecil Beehler MD | |||||||||
| Past Chief Medical Officer | 1.00 | 40.00 | Yes (X) | $0 | $378,327 | $9,094 | |||
| David Muller MD | |||||||||
| Orthopaedic Surgeon | 40.00 | 0.00 | $607,253 | $0 | $18,031 | Yes (X) | |||
| Khalid Husain MD | |||||||||
| General Surgeon | 40.00 | 0.00 | $468,495 | $0 | $15,965 | Yes (X) | |||
| Xiangtian Hu MD | |||||||||
| Anesthesiologist | 40.00 | 0.00 | $384,153 | $0 | $6,369 | Yes (X) | |||
| Vitaliano Sicilia MD | |||||||||
| Hospitalist Physician | 40.00 | 0.00 | $302,384 | $0 | $1,061 | Yes (X) | |||
| John Ciocchi MD | |||||||||
| General Surgeon | 40.00 | 0.00 | $330,381 | $0 | $5,960 | Yes (X) | |||
| Wayne Scholz | |||||||||
| Former Interim CFO | 0.00 | 0.00 | $72,611 | $41,023 | $0 | Yes (X) | |||
| Thomas Marshall | |||||||||
| Former Interim CFO | 0.00 | 0.00 | $86,818 | $37,208 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,130,378 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,071,924 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $95,690 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Bluewater Emergency Partners | |||||
| 14 Maine Street Box 44 | Brunswick | ME | 04011 | Physicians | $1,689,775 |
| Clinical Colleagues Inc | |||||
| PO Box 824246 | Philadelphia | PA | 191824246 | Physicians | $1,022,007 |
| Weatherby Locums Inc | |||||
| PO Box 972633 | Dallas | TX | 753972633 | Physicians | $958,168 |
| Quorum Health Resources LLC | |||||
| 1573 Mallory Lane Suite 200 | Brentwood | TN | 37027 | Consulting Services | $845,536 |
| Soliant Health | |||||
| PO Box 934411 | Atlanta | GA | 311934411 | Staffing Services | $548,371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $8,200 | FundraisingAmt |
| Government Grants | $7,123,347 | GovernmentGrantsAmt |
| All Other Contributions | $133,766 | AllOtherContributionsAmt |
| Total Contributions | $7,265,313 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Patient Service Revenue | 622110 | $93,130,531 | $93,130,531 | |
| Miscellaneous Revenue | 622110 | $6,086,768 | $5,988,164 | $98,604 |
| Adult Daycare Revenue | 624120 | $617,877 | $617,877 | |
| Provision for Bad Debts | 622110 | -$4,117,891 | -$4,117,891 | |
| Contractual Allowances | 622110 | -$55,303,196 | -$55,303,196 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $40,414,089 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,996 | TotalRevenueColumnAmt |
| Exclusion | $13,996 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $12,545 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $8,200 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,503 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,042 | TotalRevenueColumnAmt |
| Exclusion | $5,042 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,698,440 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $40,315,485 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $117,642 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $887,289 | TotalAmt |
| Program Services | $565,536 | ProgramServicesAmt |
| Management And General | $321,753 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,198,178 | TotalAmt |
| Program Services | $16,457,140 | ProgramServicesAmt |
| Management And General | $2,741,038 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $458,368 | TotalAmt |
| Program Services | $393,724 | ProgramServicesAmt |
| Management And General | $64,644 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,215,627 | TotalAmt |
| Program Services | $3,630,488 | ProgramServicesAmt |
| Management And General | $585,139 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,453,325 | TotalAmt |
| Program Services | $1,251,671 | ProgramServicesAmt |
| Management And General | $201,654 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,600 | TotalAmt |
| Management And General | $96,600 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,439 | TotalAmt |
| Management And General | $126,439 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,136 | TotalAmt |
| Management And General | $37,136 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,523,851 | TotalAmt |
| Program Services | $8,825,583 | ProgramServicesAmt |
| Management And General | $1,698,268 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,138 | TotalAmt |
| Program Services | $361 | ProgramServicesAmt |
| Management And General | $66,777 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,179 | TotalAmt |
| Program Services | $95,556 | ProgramServicesAmt |
| Management And General | $102,623 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,449,373 | TotalAmt |
| Program Services | $588,396 | ProgramServicesAmt |
| Management And General | $860,977 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,702 | TotalAmt |
| Program Services | $35,432 | ProgramServicesAmt |
| Management And General | $3,270 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $438,178 | TotalAmt |
| Program Services | $29,393 | ProgramServicesAmt |
| Management And General | $408,785 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,595,703 | TotalAmt |
| Program Services | $1,429,331 | ProgramServicesAmt |
| Management And General | $166,372 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $741,889 | TotalAmt |
| Program Services | $663,455 | ProgramServicesAmt |
| Management And General | $78,434 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $4,326,993 | $4,092,650 | $234,343 |
| Healthcare Provider Tax | $3,508,015 | $3,508,015 | |
| Miscellaneous Expenses | $2,137,871 | $830,287 | $1,307,584 |
| Reorganization Expenses | $854,971 | $854,971 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,357,825 | TotalAmt |
| Program Services | $42,401,018 | ProgramServicesAmt |
| Management And General | $9,956,807 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,203,692 | BOYAmt |
| EOY | $6,299,641 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $356,526 | BOYAmt |
| EOY | $359,297 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $620,514 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,438,526 | BOYAmt |
| EOY | $8,826,704 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,250 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $247,471 | BOYAmt |
| EOY | $230,072 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $937,715 | BOYAmt |
| EOY | $801,235 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $41,268,045 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,313,414 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,951,599 | BOYAmt |
| EOY | $10,954,631 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,192,779 | BOYAmt |
| EOY | $28,092,094 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,481,283 | BOYAmt |
| EOY | $9,580,646 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $269,284 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $994,393 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,759,712 | BOYAmt |
| EOY | $29,732,751 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,240,995 | BOYAmt |
| EOY | $40,577,074 | 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 | -$7,931,988 | BOYAmt |
| EOY | -$13,427,178 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $883,772 | BOYAmt |
| EOY | $942,198 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$7,048,216 | BOYAmt |
| EOY | -$12,484,980 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,192,779 | BOYAmt |
| EOY | $28,092,094 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,659,385 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$777,379 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | 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 | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $6,298 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,298 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Organization paid dues to Vermont Association of Hospitals and Health Systems of which a percentage of the dues were used for lobbying. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $87,157 | OtherCostOrOtherBasisAmt |
| Book Value | $87,157 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,291,064 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,018,610 | DepreciationAmt |
| Book Value | $6,272,454 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $948,319 | OtherCostOrOtherBasisAmt |
| Depreciation | $598,951 | DepreciationAmt |
| Book Value | $349,368 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,264,532 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,156,019 | DepreciationAmt |
| Book Value | $3,108,513 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,676,973 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,539,834 | DepreciationAmt |
| Book Value | $1,137,139 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,954,631 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Other Current Liabilities | $3,776,810 |
| Pension Liability | $5,163,028 |
| Liabilities Subject to Compromise | $19,002,998 |
| Estimated Third-Party Payor Settlements | $1,732,938 |
| Due to Related Party | $56,977 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $29,732,751 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $46,928,564 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $7,503 | OtherRevenueAmt |
| Revenue Not Reported | $7,503 | RevenueNotReportedAmt |
| Revenue Subtotal | $46,921,061 | RevenueSubtotalAmt |
| Other Revenues Not Included | $777,379 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $777,379 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $47,698,440 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $52,365,328 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $7,503 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $7,503 | ExpensesNotReportedAmt |
| Expenses Subtotal | $52,357,825 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $52,357,825 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d - Other Adjustments: | Fundraising Expenses 7,503. |
| Part XI, Line 4b - Other Adjustments: | Change in Net Assets to Recognize Funded Status of Pension Plan 757,412. Transfer to Affilate 19,967. |
| Part XII, Line 2d - Other Adjustments: | Fundraising Expenses 7,503. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $20,745 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $8,200 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $12,545 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $2,000 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $4,175 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $511 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $817 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $20,745 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $8,200 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $12,545 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $2,000 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $4,175 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $511 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $817 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $7,503 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $5,042 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $418,710 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $418,710 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00800 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,455,603 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,999,837 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,455,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08510 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,874,313 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,999,837 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,874,476 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09310 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,874,313 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,999,837 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,874,476 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09310 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,877,124 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $17,117,732 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,398,690 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$280,958 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | Springfield Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.springfieldmed.org | WebsiteAddressTxt |
| State License | 902 | 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 | Inpatient Psychiatric Unit | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Page 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Page 8 | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Page 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Page 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Page 8 | 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 |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Springfield Hospital, Inc. | Part V, Section B, Line 5: A steering committee was formed to conduct this assessment, review the data ad recommend priorities and strategies to Springfield Hospital's Board of Directors. Members included: Anna Smith, Chief of Marketing and Development, Springfield Medical Care Systems (SMCS); Laura Jensen, MPH, Program Coordinator, Lifestyle Medicine Department, SMCS; Becky Thomas, MA, MCHES, Vermont Department of Health; Steve Geller, Executive Director, Southeastern Vermont Community Action; Susan White, Health Professionals Resource Coordinator, Southern VT AHEC; Lynn Raymond-Empey, Executive Director, Valley Health Connections; Christian Craig, Executive Director, Edgar May Health & Recreation Center; Laura Schairbaum, MA, Director, Greater Falls Connections; Sue Graff, MS, Field Services Director, VT Agency of Human Services; Mark Boutwell, Director of Social Services, Senior Solutions; Sandra Knowlton Soho, MS, ACO Clinical Consultant, OneCare VT; Trisha Paradis, Executive Director, Neighborhood Connections; Cecil Beehler, MD, Chief Medical Officer, SMCS; Thomas Dougherty, MPH, Director Community Health Team; George Karabakakis, PhD, Chief Executive Officer, Healthcare & Rehabilitation Services; Stephanie Mahoney, President, Chester/Andover Family Center Board of Directors; Adam Ameele, PsyD, Director of Behavioral Health, SMCS. |
| Springfield Hospital, Inc. | Part V, Section B, Line 6b: Springfield Medical Care Systems, Inc. |
| Springfield Hospital, Inc. | Part V, Section B, Line 11: The process included focus groups in Springfield, Bellows Falls, Chester, Ludlow, Londonderry, VT and Charlestown, NH. A community survey was distributed and promoted through newspaper, email and social media. 551 surveys were received, 34 people participated in focus group discussions, and 43 key stakeholders provided information on patient care needs, barriers to access, and the impact of social determinants of health on health outcomes. A medical staff survey was also conducted. In person community stakeholder interviews and a review of population demographics and health status indicators were conducted. Secondary data from Community Commons and Robert Wood Johnson County Health Rankings are reported at the county level. Secondary data also includes a variety of state and national resources, including Vermont's Behavioral Risk Factor Surveillance System, the Vermont Blueprint Community Profiles, and national sources such as the National Institute of Mental Health and the Centers for Disease Control and Prevention (CDC) among others. Priority needs identified include 1) dental care/oral health; 2) Substance Use Disorder; 3) Mental Health; and, 4) Affordable Health Care. An implementation plan for each of these categories is included, along with an impact statement for our 2019 CHNA implementation strategy and progress report. Note For Public Input Info - Monthly Board meetings are open to the public for comments and questions.Please see attached Implementation Strategy and status updates through April 2021.The Hospital's CHNA & Implementation Plan can also be accessed via the Hospital's website - www.springfieldhospital.org/community-health-needs-assessment/ |
| Springfield Hospital, Inc. | Part V, Section B, Line 20e: A patient financial counselor meets with patient prior to discharge if medical condition allows. |
| Part V, line 7a, Hospital facility's CHNA website: | www.springfieldmed.org/community-needs-assessment-2/ |
| Part V, line 10a, Hospital facility's Implementation Strategy website: | www.springfieldmed.org/wp-content/uploads/2020/02/SPR-2019-CHNA-SH-Implementation.pdf |
| Part V, line 16a, FAP website: | www.springfieldhospital.org/wp-content/uploads/2021/04/FAPolicy4-7-21.pdf |
| Part V, line 16b, FAP Application website: | www.springfieldhospital.org/wp-content/uploads/2021/04/SMCS-SH-CombinedFAP-App2021v3final.pdf |
| Part V, line 16c, FAP Plain Language Summary website: | www.springfieldhospital.org/financial-assistance-from-springfield-hospital/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - The Windham Center | ||||
| 1 Hospital Court 12 | Bellows Falls | VT | 05101 | Inpatient Psych Unit |
| 2 - Connecticut Valley Orthopaedics and Spor | ||||
| 29 Ridgewood Rd | Springfield | VT | 05156 | Specialty Practice |
| 3 - Surgical Associates | ||||
| 29 Ridgewood Rd | Springfield | VT | 05156 | Specialty Practice |
| 4 - Springfield Hospital Rehabilitation Serv | ||||
| 100 River Street | Springfield | VT | 05156 | Physical Therapy |
| 5 - Springfield Area Adult Day Services | ||||
| 266 River Street | Springfield | VT | 05156 | Adult Day Services |
| 6 - Connecticut Valley ENT | ||||
| 29 Ridgewood Rd | Springfield | VT | 05156 | Specialty Practice |
| 7 - Mountain View Physical Therapy | ||||
| 8 Main St | Ludlow | VT | 05149 | Physical Therapy |
| 8 - Springfield Urology | ||||
| 25 Ridgewood Rd | Springfield | VT | 05156 | Specialty Practice |
| 9 - Springfield Gynecology | ||||
| 25 Ridgewood Rd | Springfield | VT | 05156 | Specialty Practice |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7g: | Amount represents funding required by Springfield Medical Care Syetems in order to operate, conduct, and provide various medical services to the community served. |
| Part III, Line 2: | The Organization used the cost to charge ratio calculated on Worksheet 2 multiplied by bad debt expense per the Organization's audited financial statements. |
| Part III, Line 4: | Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. In evaluating the collectibility of accounts receivable, the Hospital analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a provision for bad debts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts. |
| Part III, Line 8: | Worksheet A from the Form 990 Instructions was used to determine the amount reported on Line 6. |
| Part III, Line 9b: | Financial assistance is written off from charges before any collection efforts are made. |
| Part VI, Line 2: | Our planning process is participative and incorporates ongoing public input regarding community health care, hospital services, and new opportunities. Conducted on an annual basis, planning includes information from various sources as outlined below: - Public Input is invited at any time through our website, e-mail, or regular mail. - Monthly Board of Directors' meetings are open to the public.1) A community needs assessment tool is available on our website's home page, www.springfieldmed.org, that provides ongoing opportunity for community feedback. 2) A Community Relations Line offers an invitation to provide feedback directly to the Quality & Systems Improvement Department via phone or email. This contact information can be found on the home page of our website, www.springfieldmed.org, by calling 802-885-7299, or by e-mailing communityrelations@springfieldmed.org. - Ongoing information is received throughout the year to help us with our quality improvement initiatives. Our patient satisfaction survey process is conducted in cooperation with N.R.C. Picker, and monitors quality and services on a monthly basis.- Outreach activity for planning and partnering with local boards, community services, and membership organizations is ongoing. This includes partnering with Vermont's Blueprint For Health, the VT Chronic Care Collaborative, the Edgar May Health & Recreation Center, emergency planning, career/education, and youth and elderly services agencies, to name a few, and provides ongoing community input. - A Community Health Team is fully operational, meeting monthly to collaborate and partner with area agencies to remove barriers and improve access and quality of care. The team now exceeds 100 participants. New members are welcomed at each meeting as word of the team spreads throughout the community. The quarterly Community Collaborative Group is an extension of this group and all members of the Community Health Team are invited to participate as often as they wish. - Our Board of Directors and Corporators provide ongoing participation through local representation. As a small community hospital, representatives interact regularly with community members and are available to answer questions or receive feedback. - Our volunteer network creates ongoing opportunities for patient interaction and community outreach activities. - Public meetings and events are held as needed throughout the year allowing our community to be directly involved in our work, and public comment and suggestions are invited. |
| Part VI, Line 3: | Enrollment counselors are available at physician practice offices, at Valley Health Connections on River Street in Springfield, VT, and at Springfield Hospital to meet privately to consult with patients about their eligibility for a variety of public programs and/or financial assistance. Information is provided through certified navigators and enrollment counselors, distributed to the community via our Community Health Team and area social service agencies, and is included in every welcome packet to new patients. It is also available via our website. |
| Part VI, Line 4: | The Organization is a non-profit corporation directed by a dedicated Board of Directors comprised of patients and community members. The service area includes towns located in the Vermont counties of Windsor, Windham and Bennington; and New Hampshire counties of Sullivan (two towns) and Cheshire (one town). Springfield Medical Care Systems, the parent corporation, provides and coordinates care from nine health center locations in the towns of Springfield, Ludlow, Chester, Londonderry and Rockingham, VT, and Charlestown NH. Springfield Hospital is located in Springfield, VT. The service area is rural, primarily white, and has an older, lower income population. The community includes uninsured and Medicaid patients which represents 25% of the patient population. In NH, MUPs include Alstead, Acworth, Charlestown, Langdon and Walpole. In VT, MUPs include Rockingham, Athens, Grafton and Westminster in Windham County and Ludlow, Plymouth, Weston, and Reading in Windsor County. In addition to Springfield Hospital other area hospitals serving a portion of the service area include Brattleboro Memorial Hospital, Rutland Regional Medical Center, Mt. Ascutney Hospital, and Grace Cottage Hospital in Vermont and Valley Regional Hospital, Cheshire Medical Center, and Dartmouth-Hitchcock Medical Center in New Hampshire. Springfield Medical Care Systems maintains collaborative working relationships with each of these institutions.Median Population by Age (2010 Census source: USA.com)Windsor County: 45.8 Windham County: 44.9Vermont: 41.5 US: 37.2Cheshire County: 40.7 Sullivan County: 43.9 NH: 41.1 Median Household IncomeWindsor County: $50,893 Windham County: $46,714Vermont: $51,841US: $51,914Cheshire County: $48,030Sullivan County: $50,689NH: $63,277Population in PovertyWindsor County: 9.73%Windham County: 11.13%Vermont: 11.12%US: 13.82%Cheshire County: 11.8%Sullivan County: 10.04%NH: 8.29% |
| Part VI, Line 5: | The health of our area communities and access to quality health care is served through the community health center network of the organization's parent corporation, Springfield Medical Care Systems, which is the primary source of preventive and coordinated care in our service area. The organization is directed by a Board of Directors comprised of community members and patients. Free health screenings, education programs and support groups are offered throughout the year. Financial assistance is communicated broadly across the service area, available to all who qualify based on a sliding fee scale, and includes dental, vision and pharmacy assistance. |
| Part VI, Line 6: | Springfield Hospital is a subsidiary of Springfield Medical Care Systems (SMCS). SMCS is comprised of a network of primary care offices (federally-qualified health centers) that provide ongoing care and outreach to our local communities, employing a medical home model of care, and focusing on prevention and efficient care management in cooperation with the Chronic Care Collaborative and the Vermont Blueprint for Health. Need for specialty services is referred by SMCS' health center medical staff to Springfield Hospital and its outpatient specialty clinicians, other area hospitals, or to designated tertiary care facilities for the appropriate level of care as needed. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Robert Cantu MD | ||||||||||||||
| Director/Orthopaedic Surgeon | $555,404 | $0 | $1,000 | $0 | $126 | $0 | $7,525 | $0 | $1,482 | $0 | $565,537 | $0 | $0 | $0 |
| Eliot Hall MD | ||||||||||||||
| Director | $0 | $290,562 | $0 | $0 | $0 | $0 | $0 | $762 | $0 | $14,705 | $0 | $306,029 | $0 | $0 |
| Gerald Drabyn MD | ||||||||||||||
| Past Director | $0 | $182,023 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,736 | $0 | $196,759 | $0 | $0 |
| Michael Halstead | ||||||||||||||
| Interim CEO/President | $254,275 | $113,862 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $254,275 | $113,862 | $0 | $0 |
| Cecil Beehler MD | ||||||||||||||
| Past Chief Medical Officer | $0 | $378,327 | $0 | $0 | $0 | $0 | $0 | $4,274 | $0 | $4,820 | $0 | $387,421 | $0 | $0 |
| David Muller MD | ||||||||||||||
| Orthopaedic Surgeon | $539,753 | $0 | $67,500 | $0 | $0 | $0 | $5,049 | $0 | $12,982 | $0 | $625,284 | $0 | $0 | $0 |
| Khalid Husain MD | ||||||||||||||
| General Surgeon | $432,495 | $0 | $0 | $0 | $36,000 | $0 | $4,910 | $0 | $11,055 | $0 | $484,460 | $0 | $0 | $0 |
| Xiangtian Hu MD | ||||||||||||||
| Anesthesiologist | $384,153 | $0 | $0 | $0 | $0 | $0 | $2,886 | $0 | $3,483 | $0 | $390,522 | $0 | $0 | $0 |
| Vitaliano Sicilia MD | ||||||||||||||
| Hospitalist Physician | $292,420 | $0 | $9,930 | $0 | $34 | $0 | $0 | $0 | $1,061 | $0 | $303,445 | $0 | $0 | $0 |
| John Ciocchi MD | ||||||||||||||
| General Surgeon | $330,381 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,960 | $0 | $336,341 | $0 | $0 | $0 |
| Wayne Scholz | ||||||||||||||
| Former Interim CFO | $72,611 | $41,023 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $72,611 | $41,023 | $0 | $0 |
| Thomas Marshall | ||||||||||||||
| Former Interim CFO | $86,818 | $37,208 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $86,818 | $37,208 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7 | Robert Cantu and David Muller received bonus compensation in 2019 for their productivity. Vitaliano Sicilia's bonus is contingent in part on the following metrics: - Core Measures - Patient Experience - Meaningful Use - Completion of Medical Records |
| Form 990, Part VII, line 5: | Michael Halstead, Interim CEO, was compensated by a third party, Quorum Health Resources for services rendered to both Springfield Hospital, Inc. and Springfield Medical Care Systems, Inc., a related organization. Quorum Health Resources received the following amounts from the filing Organization and its related organization respectively for services rendered: Springfield Hospital, Inc.: $254,275 Springfield Medical Care Systems, Inc.: $113,862 Allan Scroggins, Interim CFO, was compensated by a third party, Quorum Health Resources for services rendered to both Springfield Hospital, Inc. and Springfield Medical Care Systems, Inc., a related organization. Quorum Health Resources received the following amounts from the filing Organization and its related organization respectively for services rendered: Springfield Hospital, Inc.: $67,478 Springfield Medical Care Systems, Inc.: $28,919 Wayne Scholz, Former Interim CFO, was compensated by a third party, Quorum Health Resources for services rendered to both Springfield Hospital, Inc. and Springfield Medical Care Systems, Inc., a related organization. Quorum Health Resources received the following amounts from the filing Organization and its related organization respectively for services rendered: Springfield Hospital, Inc.: $72,611 Springfield Medical Care Systems, Inc.: $41,023 Thomas Marshall, Former Interim CFO, was compensated by a third party, Quorum Health Resources for services rendered to both Springfield Hospital, Inc. and Springfield Medical Care Systems, Inc., a related organization. Quorum Health Resources received the following amounts from the filing Organization and its related organization respectively for services rendered: Springfield Hospital, Inc.: $86,818 Springfield Medical Care Systems, Inc.: $37,208 Neither Springfield Hospital, Inc. nor Springfield Medical Care Systems, Inc. are aware of the amounts of compensation paid to the individuals noted above by Quorum Health Resources. The amounts shown are the amounts paid to the unrelated third party for services rendered. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 4 | Springfield Hospital, Inc. made the following changes to its bylaws during the tax year: 1. Eliminated all references to Springfield Medical Care Systems, Inc., who is no longer the parent of Springfield Hospital as of December 2020. 2. Combined Class A and Class B members into a single class of members. 3. Composition of the the Board changed from 9-17 board members to 10-14 board members. 4. Removed the residence requirement from the qualifications of the Board members. 5. Added "There should be efforts to include individuals on the Board of Directors with the following expertise: accounting, human resources, quality/performance improvement, medical, and legal." to the Board member qualifications. |
| Form 990, Part VI, Section A, line 6 | The Organization has a single class of members. |
| Form 990, Part VI, Section A, line 7a | The responsibilities of the Members are limited to election of Members and election of the Board of Directors of the Hospital. |
| Form 990, Part VI, Section A, line 7b | The Bylaws may be amended at an annual, regular or special meeting of the Members by a two-thirds vote of the Members. |
| Form 990, Part VI, Section B, line 11b | Form 990 is reviewed by the Organization's Chief Financial Officer upon completion. |
| Form 990, Part VI, Section B, line 12c | Conflicts of interest are reviewed by the Corporate Compliance Officer and Chief Executive Officer on an annual basis. Members must recuse themselves from voting on issues where a conflict is actual or implied. |
| Form 990, Part VI, Section B, line 15 | For FY20, the Hospital's CEO was compensated by a third party, Quorum Health Resources for services rendered to Springfield Hospital, Inc. The Hospital is not aware of the amount of compensation paid to the CEO by Quorum Health Resources. The amounts shown on Part VII & Schedule J are the amounts paid to the unrelated third party for services rendered. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. |
| Form 990, Part IX, line 11g | Purchased Services: Program service expenses 8,825,583. Management and general expenses 1,698,268. Fundraising expenses 0. Total expenses 10,523,851. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Springfield Hospital, Inc. PO Box 2003 Springfield, VT 05156 EIN: 03-0179437 Springfield Hospital, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
| Form 990, Part XI, line 9: | Change in Net Assets to Recognize Funded Status of Pension Plan -757,412. Transfer to Affiliate -19,967. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Medical Care Systems Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030284813 | EIN |
| Primary Activities | Primary medical care, support and enabling | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 3 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |