2020-08-13T16:26:48-05:00 2019-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-10-01 030179418 GIFFORD MEDICAL CENTER INC % WAYNE D BENNETT GIFF 8027287000 44 SOUTH MAIN STREET RANDOLPH VT 05060 DANIEL A BENNETT CEO 2020-07-15 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920202265000011 2020-08-13 P 74C51B083D6172D3D43AC87F1A33B4712A418457 EADA8263F67F30EEC173F90D1C5FD4FB3EC213FF 2018 2020-11-06 18:47:13Z DANIEL A BENNETT 44 SOUTH MAIN STREET RANDOLPH VT 05060 58230951 false X WWW.GIFFORDMED.ORG X 1905 VT GIFFORD MEDICAL CENTER IS A NON-PROFIT ACUTE CARE HOSPITAL PROVIDING HEALTHCARE ON AN INPATIENT AND OUTPATIENT BASIS. 15 13 735 80 60589 -32505 574672 312380 52205859 53700435 2269857 3158064 484995 506709 55535383 57677588 80226 70393 0 0 31501880 30481966 0 0 87076 23791018 22509322 55373124 53061681 162259 4615907 94970572 94756847 34829494 34949078 60141078 59807769 X AS A COMMUNITY HOSPITAL, GIFFORD MEDICAL CENTER'S MISSION IS TO IMPROVE AND MANAGE THE HEALTH OF THE PEOPLE WE SERVE BY PROVIDING AND ASSURING ACCESS TO AFFORDABLE, HIGH-QUALITY HEALTH CARE, AND BY PROMOTING THE HEALTH AND WELL-BEING OF EVERYONE IN OUR SERVICE AREA. false false 10168755 5963036 25 BED CRITICAL ACCESS HOSPITAL, HOSPITALISTS AND SKILLED NURSES PROVIDE 24 HOUR CARE TO HOSPITALIZED PATIENTS. CARE IS PROVIDED IN THREE NEIGHBORING UNITS: HOWELL PAVILION (A MEDICAL/SURGICAL UNIT), A TRANSITIONAL CARE UNIT (FOR PATIENTS NEEDING REHABILITATION OR SOMETIMES TRANSITIONING TO A NURSING HOME), AND OUR BIRTHING CENTER(WITH CERTIFIED MIDWIVES FOR LOW INTERVENTION BIRTHS, AND THE 24/7 BACK-UP SUPPORT OF FOUR OB/GYN PHYSICIANS). END-OF-LIFE CARE IS PROVIDED IN A SPECIAL GARDEN ROOM SUITE DESIGNED TO SUPPORT PATIENTS (AND THEIR FAMILIES) IN ADVANCED ILLNESS OR AT THE END OF LIFE. SERVICES FOR THESE PATIENTS ARE SUPPORTED BY THE HOSPITAL'S ANNUAL LAST MILE RIDE. 7626103 4214151 GIFFORD MEDICAL CENTER OFFERS A RANGE OF CLINICAL SERVICES AT ITS MAIN CAMPUS AND OUTLYING CLINICS. SPECIALTY SERVICES INCLUDE: ANESTHESIOLOGY, CARDIOLOGY, CHIROPRACTIC CARE, HOSPITALIST, NEUROLOGY, ONCOLOGY, ORTHOPEDICS, PATHOLOGY, PODIATRY, SPORTS MEDICINE, RADIOLOGY, REHABILITATIVE SERVICES, GENERAL SURGERY AND UROLOGY. 5273327 7442004 GIFFORD MEDICAL CENTER'S CARING AND KNOWLEDGEABLE SURGERY TEAM OFFERS GENERAL SURGERY SERVICES INCLUDING SKIN LESION AND CYST REMOVAL, COMPREHENSIVE BREAST CARE, DIAGNOSIS AND TREATMENT OF ALL FORMS OF CANCER, WOUND CARE, PILL ENDOSCOPY, COLONOSCOPIES AND APPENDIX REMOVAL. GENERAL SURGEONS PROVIDE A WIDE RANGE OF PROCEDURES (PRIMARILY FOCUSING ON THE ABDOMINAL ORGANS AS WELL AS DISEASES OF THE SKIN, BREAST, SOFT TISSUE AND HERNIAS) IN BOTH OFFICE AND OPERATING ROOM SETTINGS. 26988884 70393 36081244 50057069 true true false true false false false false false true true false false true true false false true false false false false false false true false true true false true true true false false false false false false false false false true false false false false false true false false false true X 124 2 true 735 true true true false false false false false false false false false false false X 15 13 false false false false true true false true true false false true true true true true true true false false X WAYNE D BENNETT 8027282276 P O BOX 2000 RANDOLPH VT 05060 X MATT CONSIDINE CHAIR 1.0 2.0 X X 0 0 0 LINCOLN CLARK VICE CHAIR 1.0 2.0 X X 0 0 0 BARBARA ROCHAT SECRETARY 1.0 2.0 X X 0 0 0 JODY DAVIGNON TREASURER 1.0 2.0 X X 0 0 0 CAROL BUSHEY TRUSTEE 1.0 2.0 X 0 0 0 SHELIA JACOBS TRUSTEE 1.0 2.0 X 0 0 0 PETER REED TRUSTEE 1.0 2.0 X 0 0 0 SUE SHERMAN TRUSTEE ENDING 12/2018 1.0 2.0 X 0 0 0 CLAY WESTBROOK TRUSTEE 1.0 2.0 X 0 0 0 BRADFORD ATWOOD TRUSTEE 1.0 1.0 X 0 0 0 JOAN GOLDSTEIN TRUSTEE ENDING 12/2018 1.0 2.0 X 0 0 0 BEN JICKLING TRUSTEE 1.0 2.0 X 0 0 0 THERON MANNING TRUSTEE 1.0 2.0 X 0 0 0 JOSEPH PELLETIER TRUSTEE/MED STAFF PRESIDENT 40.0 0.0 X 202029 0 21312 TODD WINSLOW TRUSTEE 1.0 1.0 X 0 0 0 PETER NOWLAN TRUSTEE 1.0 2.0 X 0 0 0 DANIEL BENNETT CEO 40.0 2.0 X X 270773 0 18382 JEFFREY HEBERT CFO 40.0 2.0 X 191986 0 10608 RICHARD GRAHAM UROLOGIST 40.0 0.0 X 450729 0 27710 JEFFREY BATH RADIOLOGIST 40.0 0.0 X 435106 0 18470 ALAN ERIKSEN RADIOLOGIST 40.0 0.0 X 418728 0 14933 DEREK CHASE ORTHOPEDIST 40.0 0.0 X 400395 0 7697 CHRISTOPHER ROHAN ANESTHESIOLOGIST 40.0 0.0 X 348147 0 14247 2717893 0 133359 63 false true false FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET SUITE 420 OMAHA NE 68154 CONTRACTED LABOR 711111 WEATHERBY LOCUMS INC 5003 SOUTH MIAMI BLVD SUITE 400 DURHAM NC 27703 CONTRACTED LABOR 707711 DARTMOUTH-HITCHCOCK CLINIC ONE MEDICAL CENTER DRIVE LEBANON NH 03756 CONTRACTED LABOR 484622 ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO IL 60693 MRI SERVICES 440757 UNIVERSITY OF VERMONT - TSP PO BOX 1389 WILLISTON VT 05495 EQUIPMENT REPAIR 286207 12 82763 229617 312380 NET PATIENT SERVICE REVENUE 624100 50470709 50470709 ACO PROGRAM REVENUE 624100 1943080 1943080 DAYCARE REVENUE 812900 346454 285865 60589 CAFETERIA REVENUE 722210 296837 296837 PHARMACY REVENUE 446110 97182 97182 546173 546173 53700435 920418 920418 0 0 515395 50888 464507 0 464507 464507 2484328 227311 327370 146623 2156958 80688 2237646 2237646 70684 82763 28482 42202 42202 0 0 0 0 0 0 0 57677588 53639846 60589 3664773 X 0 70393 70393 0 0 715090 111671 603419 0 23257304 22306809 902651 47844 1064181 1023296 38689 2196 3867711 3632870 227073 7768 1577680 1477813 96712 3155 0 0 78998 78998 0 0 169630 169630 6086691 5701404 373114 12173 27770 26012 1702 56 1026470 959691 64669 2110 0 0 793073 742872 48615 1586 333488 312378 20443 667 0 138794 130008 8508 278 974655 912960 59746 1949 0 2799624 2622408 171617 5599 166481 155943 10205 333 MEDICAL SUPPLIES & DRUGS 4127529 4127529 PROVIDER TAXES 2813815 2813815 LICENSES, DUES, SUBSCRIPTIONS 399316 374039 24478 799 BAD DEBT 2361692 2361692 211296 193466 17267 563 53061681 50057069 2917536 87076 200308 199681 1811149 3727428 258029 131096 6142802 7915918 0 0 0 0 0 0 1333379 1258986 1456996 1315908 85603497 50083349 37146674 35520148 37893897 35125467 0 0 0 0 5788 5788 8721550 9556427 94970572 94756847 13665068 12497318 0 0 472457 399038 18445735 17755001 0 0 0 0 400490 321867 0 0 1845744 3975854 34829494 34949078 X 57963059 57749480 594529 474799 1583490 1583490 60141078 59807769 94970572 94756847 X 4615907 -1516184 -3433032 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 13716 13716 false SCHEDULE C, PART II-B, LINE 1I OTHER LOBBYING ACTIVITIES: GIFFORD MEDICAL CENTER, INC. IS A MEMBER OF THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS AVAILABLE FOR LOBBYING EXPENDITURES ON BEHALF OF GIFFORD MEDICAL CENTER IN FURTHERANCE OF ITS EXEMPT PURPOSE. GIFFORD MEDICAL CENTER DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. 9128944 339195 9468139 8357491 771453 9128944 8082089 275402 8357491 7276399 805690 8082089 6292507 462077 521815 7276399 0.77510 0.16720 0.05770 true false 790516 790516 38191169 19283869 18907300 154659 106760 47899 40938795 28082817 12855978 5528358 2609903 2918455 35520148 OTHER RECEIVABLES 32251 DUE FROM AFFILIATES 9524176 9556427 0 EST AMT DUE TO THIRD PARTY 1047437 INTEREST RATE SWAP AGREEMENT 2928417 3975854 52053575 -1516184 -3946923 -5463107 57516682 160906 160906 57677588 50459361 28482 28482 50430879 169630 2461172 2630802 53061681 SCHEDULE D, PART V USE OF ENDOWMENT FUNDS: THE TEMPORARILY RESTRICTED ENDOWMENT NET ASSETS ARE USED FOR HEALTH CARE SERVICES AND CAPITAL. THE PERMANENTLY RESTRICTED ENDOWMENT NET ASSETS ARE USED FOR INDIGENT CARE, COMMUNITY OUTREACH INITIATIVES, NURSING, BUILDINGS, MAINTENANCE AND OPERATIONS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $(1,482,182) CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT (2,361,692) BAD DEBT EXPENSE ( 169,630) INVESTMENT MANAGEMENT FEES ( 99,480) EXPENSES INCLUDED IN REVENUE 166,061 NET ASSETS RELEASED FROM RESTRICTION ------------ $(3,946,923) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $( 28,482) FUNDRAISING EVENT EXPENSES 189,388 TEMPORARY RESTRICTED CONTRIBUTIONS ---------- $ 160,906 SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 28,482 FUNDRAISING EVENT EXPENSES SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 99,480 EXPENSES INCLUDED IN REVENUE 2,361,692 BAD DEBT EXPENSE ------------ $ 2,461,172 LAST MILE RIDE 153447 82763 70684 5000 94 3345 1588 18455 0 153447 82763 70684 5000 94 3345 1588 18455 28482 42202 true true X true X 225. true X true true false false 201913 201913 0.00400 11016320 6900737 4115583 0.08120 11218233 6900737 4317496 0.08520 456050 267694 188356 0.00370 4738 4400 338 0.00000 461192 253491 207701 0.00410 921980 525585 396395 0.00780 12140213 7426322 4713891 0.09300 127074 28837 98237 0.00220 127074 28837 98237 0.00220 true 2361692 240893 17896994 17717294 179700 X true true 1 1 GIFFORD MEDICAL CENTER PO BOX 2000 RANDOLPH VT 05060 WWW.GIFFORDHEALTHCARE.ORG 829 X X X X GIFFORD MEDICAL CENTER 1 false false true X X X X X X X X X 17 true false false true X SEE PART V, SECTION C X true 17 true SEE PART V, SECTION C false true X 225. 300. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE 2015 SURVEY FORM WAS REVIEWED AND MINOR REVISIONS WERE MADE FOR 2017-2018. TO REACH A BROADER DEMOGRAPHIC SAMPLE, THE SURVEY WAS ADMINISTERED ONLINE THROUGH SURVEY MONKEY AND A LINK WAS DISTRIBUTED VIA EMAIL AND FACEBOOK TO REACH STAFF AND COMMUNITY MEMBERS. THE SURVEY WAS ALSO SHARED ON FRONT PORCH FORUM, A SOCIAL NETWORKING SITE DESIGNED TO CONNECT PEOPLE WITH OTHERS IN THEIR NEIGHBORHOODS. MEMBERS OF THE RANDOLPH EXECUTIVE COMMUNITY COUNCIL WERE PROVIDED WITH PAPER COPIES TO DISTRIBUTE TO CLIENTS EITHER DIRECTLY OR BY PLACING THEM IN AGENCY WAITING ROOMS. COMMUNITY HEALTH TEAM (BLUEPRINT) PARTNER AGENCIES WERE ALSO ASKED TO DISTRIBUTE PRINTED COPIES, AND PRINTED COPIES WERE PUT IN ALL OF GIFFORD PRIMARY CARE CLINICS. SCHEDULE H, PART V, SECTION B, LINES 7A & 10A CHNA & IMPLEMENTATION STRATEGY WEBSITE: HTTPS://GIFFORDHEALTHCARE.ORG/ABOUT-US/COMMUNITY-REPORTS/ SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: GIFFORD'S MISSION IS TO PROVIDE ACCESSIBLE, QUALITY LOCAL HEALTH CARE TO EVERY PERSON WHO WALKS THROUGH OUR DOORS. IN 2018, AS PART OF THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT, WE PERFORMED A COMMUNITY HEALTHCARE NEEDS ASSESSMENT IN PART THROUGH SURVEYING COMMUNITY MEMBERS IN MULTIPLE AREA TOWNS. GIFFORD HAS STRATEGICALLY WORKED TO ADDRESS THE COMMUNITY'S NEED WITHIN ITS ROLE AS A HEALTH CARE PROVIDER. AREAS INITIALLY IDENTIFIED AS HEALTH PROBLEMS INCLUDE: PREVENTATIVE HEALTH CARE, SUBSTANCE ABUSE COUNSELING, NUTRITION/OBESITY, AND DENTAL CARE. THIS UPDATE OUTLINES AREAS OF ONGOING FOCUS IN 2018: PREVENTATIVE HEALTHCARE/ACCESS TO HEALTHCARE: TO FACILITATE AN INCREASED FOCUS ON PREVENTATIVE HEALTH CARE AND IMPROVE ACCESS TO CARE, GIFFORD HAS IMPLEMENTED A NEW PRIMARY CARE TEAM MODEL THAT PAIRS A PHYSICIAN WITH NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS WHO ARE SPECIALLY TRAINED TO HELP PATIENTS WITH PREVENTATIVE AND PRIMARY CARE. SUBSTANCE ABUSE COUNSELING: AS A FEDERALLY QUALIFIED HEALTH CENTER GIFFORD'S BEHAVIORAL HEALTH AND BLUEPRINT FOR HEALTH TEAM SPECIALISTS OFFER COUNSELING AND ONE-ON-ONE PATIENT CARE AT ALL GIFFORD PRIMARY CARE LOCATIONS. A NEWLY-CREATED ADDICTION MEDICINE PROGRAM, FULLY STAFFED WITH A BOARD CERTIFIED PSYCHIATRIST CERTIFIED IN ADDICTION MEDICINE, AND A LICENSED ALCOHOL AND DRUG COUNSELOR, OFFERS ONGOING SUBOXONE TREATMENT FOR PATIENTS WITH COMPLEX NEEDS, SUBOXONE PROVIDER SUPPORT, EDUCATION, CONSULTATION, AND THERAPY TO HELP PATIENTS REBUILD LIVES DAMAGED BY OPIOID USE DISORDER. OBESITY: GIFFORD'S PRIMARY CARE TEAM HAS LONG BEEN A PROPONENT OF HEALTHY LIFESTYLE CHOICES FOR GOOD HEALTH AND THE PREVENTION OF DISEASE AND OBESITY. BMIS ARE DETERMINED AT ANNUAL HEALTH SCREENINGS AND PATIENTS ARE GUIDED BY PROVIDERS AND GIFFORD'S REGISTERED DIETITIANS ON HEALTHY DIETS AND PORTION CONTROL. DISCUSSIONS IN SUPPORT GROUP SETTINGS (SUCH AS DIABETES AND OTHER CHRONIC CONDITIONS) OFTEN FOCUS ON HEALTHY CHOICES TO REDUCE AND PREVENT DISEASE. PATIENTS ARE STRONGLY ENCOURAGED TO BE PHYSICALLY ACTIVE. IN 2019 GIFFORD WILL BEGIN A PARTNERSHIP WITH VEGGIE VAN GO, A PROGRAM OF THE VERMONT FOODBANK. ONCE A MONTH ALL AREA COMMUNITY MEMBERS WITH ANY FOOD INSECURITIES WILL BE INVITED TO GIFFORD TO PICK UP VEGETABLES AS NO COST. DENTAL CARE: GIFFORD'S FEDERALLY QUALIFIED HEALTH CENTER DESIGNATION HAS BROUGHT RESOURCES THAT HELP US SUPPORT LOCAL DENTISTS AS THEY STRIVE TO BETTER CARE FOR THE UNDERSERVED AND UNINSURED. TO INCREASE AWARENESS OF DENTAL HEALTH, WE HAVE PARTNERED WITH HEALTHHUB, A LOCAL NONPROFIT WITH A MOBILE DENTAL TRAILER. THE TRAILER TRAVELS TO A VARIETY OF LOCATIONS, INCLUDING AREA SCHOOLS AND GIFFORD, TO OFFER SCREENINGS, X-RAYS, EXAMINATIONS AND CLEANINGS BY A DENTAL HYGIENIST. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C FAP, FAP APPLICATION, AND PLS WEBSITE: HTTPS://GIFFORDHEALTHCARE.ORG/SERVICE/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, LINE 16J MEASURES TO PUBLICIZE THE POLICY: GIFFORD MEDICAL CENTER CONTACTS ANY UNINSURED PATIENTS THAT WILL REGISTER WITH THE HOSPITAL TO SEE IF THEY ARE IN NEED OF FINANCIAL ASSISTANCE. 5 GIFFORD HEALTH CARE AT BERLIN 82 EAST VIEW LANE BERLIN VT 05641 RURAL HEALTH CENTER ADVANCE PHYSICAL THERAPY 331 OLCOTT DRIVE WHITE RIVER JUNCTION VT 05001 RURAL HEALTH CENTER KINGWOOD HEALTH CENTER 1422 ROUTE 66 RANDOLPH VT 05060 RURAL HEALTH CENTER SHARON HEALTH CENTER 12 SHIPPEE LANE SHARON VT 05065 RURAL HEALTH CENTER TWIN RIVER HEALTH CENTER 108 N MAIN STREET WHITE RIVER JUNCTION VT 05001 RURAL HEALTH CENTER SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE OF $2,361,692. SCHEDULE H, PART I, LINE 7G SUBSIDIZED SERVICES: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHS) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. GIFFORD MEDICAL CENTER CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1 AND 6. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: INCLUDED IN PART II AS COMMUNITY BUILDING ACTIVITIES ARE LOCAL HIGH SCHOOL LECTURES, JOB SHADOWING, AND AFTER SCHOOL PROGRAMS. THESE ACTIVITIES PROVIDE OPPORTUNITIES TO ADDRESS THE ROOT CAUSE OF HEALTH PROBLEMS, INCLUDING POVERTY, HOMELESS, AND UNEMPLOYMENT. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE ORGANIZATION CALCULATED BAD DEBT USING THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBLE OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAY SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: THE APPLICATION FOR AND APPROVAL OF FINANCIAL ASSISTANCE CAN OCCUR BEFORE, DURING OR AFTER TREATMENT SO LONG AS THE ACCOUNT HAS NOT BEEN WRITTEN OFF TO BAD DEBT PRIOR TO RECEIPT OF A COMPLETED APPLICATION AND THE NECESSARY DOCUMENTATION. ACCOUNTS SENT TO BAD DEBT AFTER REQUIRED INFORMATION HAS BEEN RECEIVED CAN BE RETURNED FROM COLLECTIONS FOR PROCESSING WITHOUT PENALTY TO THE APPLICANT. GIFFORD MEDICAL CENTER, INC., ENCOURAGES THE APPLICATION PROCESS TO BEGIN AS EARLY AS POSSIBLE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: IDENTIFYING AND MEETING THE COMMUNITY'S HEALTH CARE NEEDS WOULD NOT BE POSSIBLE WITHOUT INPUT FROM THE PUBLIC. GIFFORD MEDICAL CENTER PROVIDES AMPLE OPPORTUNITIES FOR THE PUBLIC TO PROVIDE BOTH INPUT AND ACTIVELY PARTICIPATE IN MEDICAL CENTER ACTIVITIES. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, ANNUAL HOSPITAL REPORT CARD MEETINGS, PATIENT SATISFACTION SURVEYS AND ONE-ON-ONE COMMENTS TO HOSPITAL STAFF AND BOARD MEMBERS HELP DIRECT STRATEGIC PLANNING AND OPERATIONAL DECISIONS. EVERY THREE YEARS, GIFFORD ENGAGES IN AN EXTENSIVE STRATEGIC PLANNING PROCESS THAT RESULTS IN THE IDENTIFICATION AND IMPLEMENTATION OF A LIST OF INITIATIVES THE HOSPITAL STRIVES TO ACHIEVE OVER THE COMING THREE YEARS. SUCCESS AT ACHIEVING THOSE INITIATIVES THROUGHOUT, AND BY THE CONCLUSION OF THE THREE-YEAR PERIOD IS EXTENSIVELY MONITORED BY THE HOSPITAL'S LEADERS, INCLUDING ITS VOLUNTEER BOARD OF TRUSTEES. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PATIENTS ARE ADVISED OF COMMUNITY OUTREACH AND ARE ENCOURAGED TO SET UP AN APPOINTMENT TO MEET WITH THE APPROPRIATE GIFFORD MEDICAL CENTER PERSONNEL. THE PATIENTS ARE ALSO DIRECTED TO GMC'S WEBSITE FOR AN EXPLANATION OF THE FREE CARE POLICY PROCESS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: IN ADDITION TO THE CLINICAL OFFICES LOCATED ON THE ORGANIZATION'S MAIN CAMPUS IN RANDOLPH, VERMONT, THE ORGANIZATION OPERATES COMMUNITY HEALTH CARE CENTERS LOCATED IN SHARON, BERLIN, RANDOLPH, AND WHITE RIVER JUNCTION, VERMONT. THE RANDOLPH/BRAINTREE AREA PROVIDES THE MOST VISITS AND IS LOCATED IN ORANGE COUNTY, VERMONT. ORANGE COUNTY DEMOGRAPHICS SHOW APPROXIMATELY 21.2% OVER THE AGE OF 65 AND 18.3% UNDER 18 YEARS. OVER 96.8% ARE WHITE, WITH 49.9% FEMALE. THE AVERAGE HOUSEHOLD INCOME IS $60,159 WITH THE POVERTY LEVEL AT 10.2%, COMPARED TO THE STATE'S 11.0%. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: AS A COMMUNITY HOSPITAL, GIFFORD MEDICAL CENTER'S MISSION TO IMPROVE THE HEALTH OF THE PEOPLE BY PROVIDING AND ASSURING ACCESS TO AFFORDABLE AND HIGH QUALITY HEALTH CARE, AND BY PROMOTING THE HEALTH AND WELLBEING OF EVERYONE IN OUR SERVICE AREA. WE OFFER DIAGNOSTIC TECHNOLOGIES THAT INCLUDE A 64-SLICE CT SCANNER, A MOBILE MRI UNIT, A FILMLESS RADIOLOGY SYSTEM, 3D MAMMOGRAPHY AND STEREOTACTIC BREAST BIOPSIES. OUR 25-BED CRITICAL ACCESS HOSPITAL HAS A BIRTHING CENTER THAT IS RECOGNIZED AROUND THE STATE. WE HAVE A 24-HOUR EMERGENCY DEPARTMENT, A CHILDCARE CENTER AND SO MUCH MORE. THE FOLLOWING ARE THE ACTIVITIES FOR 2019: FROM NEW COLLABORATIONS WITH PARTNERS LIKE VEGGIEVANGO AND THE VERMONT FOOD BANK TO THE RE-INVIGORATION OF THE STAFF WELLNESS COMMITTEE, 2019 SAW GIFFORD CONTINUE AND GROW OUR LONGTIME COMMITMENT TO COMMUNITY HEALTH OUTREACH ON AND OFF CAMPUS. THROUGHOUT THE YEAR, WE WORKED TO ADDRESS FOOD INSECURITY BY PROVIDING ACCESS TO FRESH PRODUCE AND EDUCATING ABOUT HEALTHY EATING CHOICES, SUPPORTED INITIATIVES THAT PROMOTE (SAFE) PHYSICAL ACTIVITY FOR ALL AGES, AND CONTINUED PREVENTION EDUCATION AROUND VAPING AND OTHER RISKY BEHAVIORS THROUGH RISE VT. THE GIFFORD TEAM KICKED OFF THE GIVING SEASON WITH A FOOD DRIVE TO BENEFIT THE BETHEL FOOD SHELF, DELIVERING A VAN FULL OF GOODS ON #GIVINGTUESDAY, DEC. 3. ALSO IN DECEMBER, GIFFORD PROVIDERS AND STAFF SERVED 130 OF OUR NEIGHBORS DURING A FREE, CHEF-PREPARED COMMUNITY DINNER AT THE MEDICAL CENTER, AND HOSTED ADDITIONAL DINNERS IN CHELSEA AND ROYALTON. GIFFORD'S USE OF ANTIBIOTICS WERE REDUCED BY HALF FROM THE PREVIOUS YEAR DUE TO ENACTING AN ANTIBIOTIC STEWARDSHIP PROGRAM. THE REDUCTION OF ANTIBIOTICS IS TO HELP PREVENT THE CREATION OF SUPER BUGS THAT ARE RESISTANT TO COMMONLY USED ANTIBIOTICS. IN MAY 2019, PEDIATRIC AND ADOLESCENT MEDICINE AT GIFFORD WAS AMONG FOUR PRACTICES IN THE STATE RECOGNIZED BY THE VERMONT DEPARTMENT OF HEALTH FOR ACHIEVING HIGH IMMUNIZATION RATES FOR BOTH CHILDREN AND TEENS IN 2018. STATE PUBLIC HEALTH NURSE JAN EBERLY PRESENTED THE GIFFORD TEAM WITH A CERTIFICATE FOR THEIR ACHIEVEMENT ON MAY 1, DURING NATIONAL INFANT IMMUNIZATION WEEK, MARKING THE THIRD YEAR IN A ROW GIFFORD HAS BEEN RECOGNIZED. FOR A PRACTICE TO RECEIVE RECOGNITION FROM VDH, AT LEAST 90 PERCENT OF ITS CHILD PATIENTS MUST BE UP TO DATE WITH IMMUNIZATIONS FOR 11 VACCINE-PREVENTABLE DISEASES, INCLUDING MEASLES, MUMPS AND WHOOPING COUGH. AT LEAST 80 PERCENT OF TEEN PATIENTS MUST BE VACCINATED TO PREVENT MENINGITIS AND CANCERS CAUSED BY HUMAN PAPILLOMAVIRUS (HPV). SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE GIFFORD HEALTH CARE SYSTEM INCLUDES GIFFORD HEALTH CARE, INC. (GHC), GIFFORD MEDICAL CENTER, INC. (GMC), AND GIFFORD RETIREMENT COMMUNITY, INC. (GRC). GHC IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). GIFFORD MEDICAL CENTER, INC. IS A 25-BED CRITICAL ACCESS HOSPITAL (CAH) PROVIDING GENERAL AND SPECIALTY SERVICES. GIFFORD RETIREMENT COMMUNITY, INC. HAS A 30-BED NURSING HOME UNIT, ADULT DAY SERVICES AND INDEPENDENT LIVING FACILITY. true PATIENT GRANTS 62 70393 SCHEDULE I, PART I, LINE 2 MONITORING GRANT FUNDS: THE ORGANIZATION PROVIDES GRANTS TO PATIENTS USING THE RESULTS OF THE LAST MILE RIDE SPECIAL FUNDRAISING EVENT. THE GRANTS ASSIST PATIENTS AND THEIR FAMILIES WITH END OF LIFE CARE AND PLANNING. MULTIPLE COMMITTEES REVIEW GRANT REQUESTS AND THE BOARD REVIEWS DISTRIBUTIONS. X X X X X X false false false false false false false true false JOSEPH PELLETIER TRUSTEE/MED STAFF PRESIDENT 180548 0 21481 0 0 0 10574 0 10738 0 223341 0 0 0 DANIEL BENNETT CEO 252273 0 0 0 18500 0 13750 0 4632 0 289155 0 0 0 JEFFREY HEBERT CFO 184884 0 0 0 7102 0 9587 0 1021 0 202594 0 0 0 RICHARD GRAHAM UROLOGIST 407229 0 25000 0 18500 0 13750 0 13960 0 478439 0 0 0 JEFFREY BATH RADIOLOGIST 376644 0 45000 0 13462 0 13750 0 4720 0 453576 0 0 0 ALAN ERIKSEN RADIOLOGIST 366279 0 52449 0 0 0 11000 0 3933 0 433661 0 0 0 DEREK CHASE ORTHOPEDIST 397282 0 3113 0 0 0 4615 0 3082 0 408092 0 0 0 CHRISTOPHER ROHAN ANESTHESIOLOGIST 324978 0 10861 0 12308 0 7577 0 6670 0 362394 0 0 0 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: GIFFORD MAINTAINS FINANCIAL INCENTIVES FOR PROVIDERS. PROVIDER INCENTIVES INCORPORATE PRODUCTIVITY, CITIZENSHIP (CONTRIBUTION TO HOSPITAL AND COMMUNITY ACTIVITIES) AND RETENTION. GIFFORD'S PRODUCTIVITY MEASURES ARE DESIGNED TO ENSURE THAT ALL PROVIDERS ACHIEVE A STANDARD LEVEL OF PRODUCTIVITY. GIFFORD ALSO HAS AN EMPLOYEE REFERRAL PROGRAM. THE EMPLOYEE RECEIVES COMPENSATION FOR THE SUCCESSFUL HIRE OF A QUALIFIED CANDIDATE. A VERMONT EDUCATION AND HEALTH BUILDING FINANCING AG 237154467 2014-12-17 20840000 TO FINANCE GIFFORD'S CAPITAL PROJE false false false A 0 0 20840000 0 0 18654218 185782 0 0 2000000 0 0 2014 true false true true A false false false false 0 false false false true A false false true false true false 0 false 0 false false A true MAGEE OFFICE SUPPLIES SEE PART V 128041 PURCHASED SUPPLIES false SCHEDULE L, PART IV, LINE 1, COLUMN B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: TODD WINSLOW, A DIRECTOR, IS 50% OWNER OF MAGEE OFFICE SUPPLIES. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICE ACCOMPLISHMENTS: GIFFORD MEDICAL CENTER OFFERS VARIOUS OTHER HEALTH CARE SERVICES TO THE CENTRAL VERMONT AREA. OTHER SERVICES AVAILABLE INCLUDE ANESTHESIOLOGY, RADIOLOGY, LABORATORY, RESPIRATORY THERAPY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH PATHOLOGY, ELECTROCARDIOLOGY, CHEMOTHERAPY, EMERGENCY, SKILLED NURSING, LABOR AND DELIVERY, NURSERY, RADIOISOTOPE, AND ELECTROENCEPHALOGRAPHY. FORM 990, PART V, LINE 2A W-2'S FILED: GIFFORD MEDICAL CENTER ALSO FILES W-2'S FOR ITS RELATED ORGANIZATIONS, GIFFORD HEALTH CARE, INC. (GHC) AND GIFFORD RETIREMENT COMMUNITY, INC. (GRC). THE TOTAL NUMBER OF W-2'S FILED INCLUDES THESE W-2'S. THE COMPENSATION, EMPLOYEE BENEFITS AND PAYROLL TAXES ARE THEN ALLOCATED TO GHC AND GRC FOR THE AMOUNTS THAT REPRESENT WORK PERFORMED FOR THOSE ORGANIZATIONS. THEREFORE, THE AMOUNT REPORTED ON PART IX INCLUDES ONLY THOSE AMOUNTS ALLOCATED TO WORK PERFORMED DIRECTLY FOR GIFFORD MEDICAL CENTER. THE HIGHEST PAID EMPLOYEES ARE DETERMINED BY THE WORK PERFORMED FOR EACH ORGANIZATION. THEREFORE, THE FIVE HIGHEST PAID EMPLOYEES LISTED ON PART VII AND SCHEDULE J ARE THOSE EMPLOYEES WHO WORK DIRECTLY FOR GIFFORD MEDICAL CENTER, INC. IN ADDITION, DANIEL BENNETT SERVED AS CEO AND JEFFREY HEBERT SERVED AS CFO OVER GIFFORD MEDICAL CENTER, GIFFORD HEALTH CARE, AND GIFFORD RETIREMENT COMMUNITY. THEIR COMPENSATION HAS BEEN SHOWN IN PART VIII AS PAID BY GIFFORD MEDICAL CENTER ONLY, ALTHOUGH THEIR TIME SPENT IS ATTRIBUTABLE TO ALL THREE ENTITIES. FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B ORGANIZATION'S MEMBERS: THE MEMBERSHIP OF THE ORGANIZATION CONSISTS OF THOSE PERSONS SERVING AS CORPORATORS. TO BE ELIGIBLE TO SERVE AS A CORPORATOR, AN INDIVIDUAL MUST SUPPORT THE MISSION AND PURPOSES OF THE ORGANIZATION. CORPORATORS ARE NOMINATED BY THE NOMINATING COMMITTEE AND ELECTED BY MAJORITY VOTE OF THE CORPORATORS PRESENT AT THE ANNUAL MEETING OF THE CORPORATORS, AND SERVE A TERM OF THREE YEARS. THE CORPORATORS SHALL ELECT A MINORITY OF THE TRUSTEES OF THE ORGANIZATION, WHO MANAGE AND CONDUCT THE AFFAIRS OF THE ORGANIZATION. THE CORPORATORS MAKE NO OTHER GOVERNANCE DECISIONS FOR THE ORGANIZATION, NOR ARE THE DECISION OF THE BOARD OF TRUSTEES SUBJECT TO APPROVAL BY THE CORPORATIONS. ADDITIONALLY, THE BOARD OF DIRECTORS OF GIFFORD HEALTH CARE, INC. (GHC), APPOINTS A MAJORITY OF THE DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FIRST REVIEWS THE FORM 990. THEN THE FULL BOARD OF TRUSTEES REVIEWS THE PUBLIC DISCLOSURE COPY OF THE FORM 990 AT ONE OF THE BOARD MEETINGS PRIOR TO FILING. THE PUBLIC DISCLOSURE COPY DOES NOT LIST THE NAMES OR ADDRESSES OF THE DONORS TO RESPECT THE CONFIDENTIALITY OF THE DONORS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: GIFFORD MEDICAL CENTER, INC. REQUIRES BOARD MEMBERS TO COMPLETE A YEARLY CONFLICT OF INTEREST SURVEY. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR SHALL BE DISCLOSED TO THE OTHER BOARD MEMBERS. ANY TRUSTEE HAVING DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS PERSONAL INFLUENCE ON THE MATTER, AND SHALL NOT BE PRESENT FOR DISCUSSION OF THE MATTER. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE AND THAT THE DIRECTOR ABSTAINED FROM VOTING AND DISCUSSION. FORM 990, PART VI, SECTION B, LINE 15A CEO COMPENSATION REVIEW: GIFFORD MEDICAL CENTER USES A BOARD COMPENSATION COMMITTEE WITH INPUT AND DATA FROM A VARIETY OF INDEPENDENT SOURCES. THE EVALUATION AND RECOMMENDATION IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 15B OTHER OFFICER & KEY EMPLOYEE COMPENSATION REVIEW: TO EVALUATE THE COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES, THE COMPENSATION REVIEW IS ADMINISTERED BY HUMAN RESOURCES AND THE CEO. THE HUMAN RESOURCES DEPARTMENT HAS SOME INTERNAL AND EXTERNAL SOURCES THAT ARE UTILIZED TO COMPARE COMPENSATION AMOUNTS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE, ANOTHER'S WEBSITE AND UPON REQUEST. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: JOSEPH PELLETIER (MEDICAL STAFF PRESIDENT) AND DANIEL BENNETT (CEO) ARE EMPLOYEES OF GIFFORD MEDICAL CENTER/GIFFORD HEALTH CARE AS WELL AS MEMBERS OF THE BOARD OF DIRECTORS. THEIR COMPENSATION IS RELATED TO THEIR ROLES AS EMPLOYEES. NO TRUSTEES RECEIVE COMPENSATION FOR THEIR ROLES AS TRUSTEES. FORM 990, PART VI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: $(1,482,182) CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT (1,950,850) TRANSFERS TO AFFILIATES ------------ $(3,433,032) FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:3090980 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:1043132 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN TOTAL FEES:944900 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:834015 FORM 990 PART IX LINE 11G DESCRIPTION:FREIGHT TOTAL FEES:86094 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:66995 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER CONTRACTED SERVICES TOTAL FEES:20575 GIFFORD HEALTH CARE INC 44 SOUTH MAIN STREET RANDOLPH VT 05060 460938716 FQHC/PARENT VT 501(C)(3) 10 NA false GIFFORD RETIREMENT COMMUNITY INC 44 SOUTH MAIN STREET RANDOLPH VT 05060 463593492 RETIREMENT VT 501(C)(3) 10 GHC false false false false true false false false false false true true false false true false false true true true