NORTH COUNTRY HOSPITAL & HEALTH CENTER,INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: NORTH COUNTRY HOSPITAL & HEALTH CENTER,INC (EIN 03-0185556)
Tax period: 2018-10-01 to 2019-09-30
Filed: 2020-08-17
IRS object ID: 202032309349302163
Schema version: 2018v3.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-08-17T10:27:35-05:00	ReturnTs
Tax Period End	2019-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1Txt
City	SPRINGFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	658062523	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	030185556	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NORTH COUNTRY HOSPITAL & HEALTH CENTER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% TRACEY PAUL	InCareOfNm
Business Name Control	NORT	BusinessNameControlTxt
Phone	8023347331	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	189 PROUTY DR	AddressLine1Txt
City	NEWPORT	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05855	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TRACEY PAUL	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	8023347331	PhoneNum
Signature	2020-06-16	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Brian D Todd	PreparerPersonNm
PTIN	P00422601	PTIN
Phone	4178658701	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.126.162	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	43032920202305000002	FederalOriginalSubmissionId
Federal Original Submission Id	2020-08-17	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	74C51B083D6172D3D43AC87F1A33B4712A418457	AtSubmissionCreationDeviceId
At Submission Filing Device Id	EADA8263F67F30EEC173F90D1C5FD4FB3EC213FF	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-11-06 18:47:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	D BRIAN NALL	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	189 PROUTY DR	AddressLine1Txt
City	NEWPORT	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05855	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$108,387,726	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.NCHSI.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1919	FormationYr
Legal Domicile State	VT	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE HEALTH CARE SERVICES TO THE RESIDENTS OF ORLEANS AND ESSEX COUNTIES, ENSURING THAT HEALTH CARE IS AVAILABLE TO ALL PEOPLE.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	658	TotalEmployeeCnt
Total Volunteers	40	TotalVolunteersCnt
Total Gross UBI	$17,803	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$14,159	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$181,559	PYContributionsGrantsAmt
CY Contributions Grants	$331,527	CYContributionsGrantsAmt
PY Program Service Revenue	$84,634,595	PYProgramServiceRevenueAmt
CY Program Service Revenue	$91,057,538	CYProgramServiceRevenueAmt
PY Investment Income	$2,019,176	PYInvestmentIncomeAmt
CY Investment Income	$1,262,303	CYInvestmentIncomeAmt
PY Other Revenue	$11,439	PYOtherRevenueAmt
CY Other Revenue	-$16,066	CYOtherRevenueAmt
PY Total Revenue	$86,846,769	PYTotalRevenueAmt
CY Total Revenue	$92,635,302	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$50,815,978	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$51,925,393	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$36,012,174	PYOtherExpensesAmt
CY Other Expenses	$37,872,762	CYOtherExpensesAmt
PY Total Expenses	$86,828,152	PYTotalExpensesAmt
CY Total Expenses	$89,798,155	CYTotalExpensesAmt
PY Revenues Less Expenses	$18,617	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$2,837,147	CYRevenuesLessExpensesAmt
Total Assets BOY	$86,415,286	TotalAssetsBOYAmt
Total Assets EOY	$86,819,379	TotalAssetsEOYAmt
Total Liabilities BOY	$32,562,799	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$30,993,344	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$53,852,487	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$55,826,035	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	QUALITY PATIENT CARE IS OUR GREATEST COMMITMENT, EMPLOYEES ARE OUR GREATEST ASSET, EXCELLENT PATIENT EXPERIENCE IS OUR GREATEST ACCOMPLISHMENT, AND THE HEALTH OF OUR COMMUNITY IS OUR GREATEST RESPONSIBILITY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$44,400,993	ExpenseAmt
Revenue	$64,653,721	RevenueAmt
Desc	THE HOSPITAL OFFERS OUTPATIENT SERVICES INCLUDING EMERGENCY ROOM, LAB WORK, DIAGNOSTIC IMAGING (X-RAY, CT SCAN, MRI, MAMMOGRAMS, NUCLEAR IMAGING ULTRASOUND), OUTPATIENT SURGERIES, PULMONARY, CARDIAC CARE AND THERAPY SERVICES (PHYSICAL, SPEECH AND REHABILITATIVE).	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$9,837,811	ExpenseAmt
Revenue	$14,325,155	RevenueAmt
Desc	INPATIENT HOSPITAL CARE WAS PROVIDED AT A CRITICAL ACCESS HOSPITAL TOTALING 6,287 PATIENT DAYS FOR THE YEAR. THE HOSPITAL'S INPATIENT CARE SERVICES INCLUDE A 24 HOUR EMERGENCY DEPARTMENT, MEDICAL AND SURGICAL SERVICES, INTENSIVE CARE UNITS, BIRTHING CENTER, CLINICAL LABORATORY, MRI AND ULTRASOUND, NEUROLOGY, ORTHOPEDICS, PHARMACY, REHABILITATION SERVICES, OCCUPATIONAL AND PHYSICAL THERAPY AMONG OTHERS. THE HOSPITAL ALSO PROVIDED COMMUNITY GRANTS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$21,620,161	ExpenseAmt
Revenue	$12,078,662	RevenueAmt
Desc	THE HOSPITAL'S PHYSICIAN PRACTICE CLINICS PROVIDE INTERNAL MEDICINE RADIOLOGY PROGRAM, PSYCHIATRIC, OB/GYN, NEUROLOGY, ORTHOPEDICS, OCCUPATIONAL HEALTH, PULMONARY-SLEEP, AND SURGICAL SERVICES.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$75,858,965	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	74	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	658	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
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	TRACEY PAUL	PersonNm
Phone	8023347331	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	189 PROUTY DRIVE	AddressLine1Txt
City	NEWPORT	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05855	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DWIGHT NALL
CEO BEG 10/2018	40.0	2.0	Yes (X)	Yes (X)	$68,987	$0	$3,127
THOMAS FRANK
TRUSTEE/COO/INTERIM CEO	40.0	2.0	Yes (X)		$311,668	$0	$16,698
FRANK KNOLL
CHAIR	10.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
THOMAS MILNAMOW
VICE CHAIR - BOARD	5.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
HEIDI BROWN
VICE CHAIR FINANCE	5.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
MELISSA PETTERSSON
SECRETARY/CLERK	5.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
UMAIR MALIK MD
MEDICAL STAFF PRESIDENT	40.0	2.0	Yes (X)	Yes (X)	$293,721	$0	$38,238
CHARLES LAGOY MD
MEDICAL STAFF VP	40.0	2.0	Yes (X)	Yes (X)	$283,182	$0	$38,320
CHRISTOPHER RICKMAN MD
TRUSTEE	40.0	2.0	Yes (X)		$329,697	$0	$40,718
GARY GILLESPIE
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
BOB WILSON
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
JANET OSBORNE
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
JIM BIERNAT
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
STEVE WRIGHT
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
TERRIE MCQUILLEN
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
ANDRE BISSONNETTE
CHIEF FINANCIAL OFFICER	40.0	2.0		Yes (X)	$219,076	$0	$43,566
AVRIL COCHRAN
VP PATIENT CARE SERVICES	40.0	2.0			$178,258	$0	$27,564	Yes (X)
STEPHANE MULLIGAN MD
PHYSICIAN	40.0	0.0			$609,556	$0	$35,359		Yes (X)
LARRY SISSON MD
PHYSICIAN	40.0	0.0			$564,289	$0	$24,187		Yes (X)
PETER STUART MD
PHYSICIAN	40.0	0.0			$526,156	$0	$23,085		Yes (X)
GREG WALKER MD
PHYSICIAN	40.0	0.0			$523,965	$0	$57,638		Yes (X)
VERONIKA JEDLOVSZKY MD
PHYSICIAN	40.0	0.0			$432,847	$0	$51,399		Yes (X)
CLAUDIO FORT
FORMER CEO	0.0	0.0			$102,923	$0	$20,084			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,444,325	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$419,983	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	78	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
NORTH COUNTRY RADIOLOGY PC
189 PROUTY DRIVE	NEWPORT	VT	05855	PHYSICIAN	$1,077,957
BKD LLP
910 E ST LOUIS STREET	SPRINGFIELD	MO	65806	AUDIT/TAX/COST REPOR	$376,776
CLAUDE PAUL CONSTRUCTION
635 SHATTUCK HILL ROAD	NEWPORT	VT	05855	CONSTRUCTION	$262,972
GOLDFISH LOCUM TENENS
6865 WINDCREST DRIVE SUITE 300	PLANO	TX	75024	LOCUM STAFF	$225,386
COMPHEALTH
PO BOX 972651	DALLAS	TX	75397	LOCUM STAFF	$183,864

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	6	CntrctRcvdGreaterThan100KCnt
Government Grants	$101,787	GovernmentGrantsAmt
All Other Contributions	$229,740	AllOtherContributionsAmt
Total Contributions	$331,527	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE	624100	$77,659,719	$77,659,719
FIXED PROSPECTIVE REVENUE	624100	$6,049,992	$6,049,992
340B PHARMACY	624100	$4,673,248	$4,673,248
OTHER PATIENT SERVICE REVENUE	722514	$2,389,359	$2,389,359
CAFETERIA	446110	$285,220	$285,220

Field	Value	IRS element (for citing)
Total Program Service Revenue	$91,057,538	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,011,502	TotalRevenueColumnAmt
Exclusion	$1,011,502	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$15,957,199	SecuritiesAmt
Other	$46,026	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$15,688,967	SecuritiesAmt
Other	$63,457	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$268,232	SecuritiesAmt
Other	-$17,431	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$250,801	TotalRevenueColumnAmt
Exclusion	$250,801	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
LOSS ON INVEST IN EQUITY INVESTEE	812900	-$33,869	-$33,869
ADMIN SERVICES	561000	$11,975		$11,975
HOUSEKEEPING	900099	$5,828		$5,828

Field	Value	IRS element (for citing)
Other Revenue Total	-$16,066	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$92,635,302	TotalRevenueColumnAmt
Related Or Exempt Func Income	$91,057,538	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$17,803	UnrelatedBusinessRevenueAmt
Exclusion	$1,228,434	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,820,676	TotalAmt
Program Services	$1,558,064	ProgramServicesAmt
Management And General	$262,612	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$123,007	TotalAmt
Management And General	$123,007	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$38,652,799	TotalAmt
Program Services	$28,910,768	ProgramServicesAmt
Management And General	$9,742,031	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,581,649	TotalAmt
Program Services	$1,392,203	ProgramServicesAmt
Management And General	$189,446	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$7,076,560	TotalAmt
Program Services	$6,217,300	ProgramServicesAmt
Management And General	$859,260	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,670,702	TotalAmt
Program Services	$2,341,578	ProgramServicesAmt
Management And General	$329,124	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$97,010	TotalAmt
Management And General	$97,010	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$63,105	TotalAmt
Management And General	$63,105	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$92,493	TotalAmt
Management And General	$92,493	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$358,459	TotalAmt
Management And General	$358,459	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$8,742,020	TotalAmt
Program Services	$8,670,259	ProgramServicesAmt
Management And General	$71,761	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$248,833	TotalAmt
Management And General	$248,833	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,107,261	TotalAmt
Program Services	$1,960,245	ProgramServicesAmt
Management And General	$147,016	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$50,424	TotalAmt
Program Services	$50,424	ProgramServicesAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,477,153	TotalAmt
Program Services	$1,415,297	ProgramServicesAmt
Management And General	$61,856	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$147,796	TotalAmt
Program Services	$143,574	ProgramServicesAmt
Management And General	$4,222	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$227,176	TotalAmt
Program Services	$227,176	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$667,291	TotalAmt
Program Services	$595,456	ProgramServicesAmt
Management And General	$71,835	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,113,752	TotalAmt
Program Services	$3,670,901	ProgramServicesAmt
Management And General	$442,851	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$734,099	TotalAmt
Management And General	$734,099	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$5,696,003	$5,696,003
PROVIDER TAX	$4,555,652	$4,555,652
REPAIRS & MAINTENANCE	$4,274,376	$4,234,206	$40,170
BAD DEBT	$3,422,797	$3,422,797

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$797,062	TotalAmt
Program Services	$797,062	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$89,798,155	TotalAmt
Program Services	$75,858,965	ProgramServicesAmt
Management And General	$13,939,190	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$498,403	BOYAmt
EOY	$205,116	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,476,694	BOYAmt
EOY	$4,559,804	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$31,142	BOYAmt
EOY	$24,875	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$8,588,342	BOYAmt
EOY	$7,428,223	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,628,596	BOYAmt
EOY	$2,519,168	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$887,834	BOYAmt
EOY	$758,426	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$80,072,775	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$57,792,051	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$23,403,358	BOYAmt
EOY	$22,280,724	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$43,306,575	BOYAmt
EOY	$44,471,720	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$262,532	BOYAmt
EOY	$618,663	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$950,085	BOYAmt
EOY	$763,172	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,381,725	BOYAmt
EOY	$3,189,488	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$86,415,286	BOYAmt
EOY	$86,819,379	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$11,310,983	BOYAmt
EOY	$11,079,637	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$17,027,790	BOYAmt
EOY	$16,221,604	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$1,673,839	BOYAmt
EOY	$729,913	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,550,187	BOYAmt
EOY	$2,962,190	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$32,562,799	BOYAmt
EOY	$30,993,344	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$49,444,068	BOYAmt
EOY	$51,553,180	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,613,560	BOYAmt
EOY	$3,477,996	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$794,859	BOYAmt
EOY	$794,859	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$53,852,487	BOYAmt
EOY	$55,826,035	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$86,415,286	BOYAmt
EOY	$86,819,379	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$2,837,147	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$252,692	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$1,116,291	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

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)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$13,869	OtherActivitiesAmt
Total Lobbying Expenditures	$13,869	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1(I)	FormAndLineReferenceDesc
Explanation	OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE VERMONT HOSPITAL ASSOCIATION, WHICH HAS REPORTED THAT APPROXIMATELY 11.63% OF DUES SUPPORT LOBBYING EFFORTS. IN ADDITION, THE ORGANIZATION PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION, WHICH HAS REPORTED THAT APPROXIMATELY 21.78% OF DUES SUPPORT LOBBYING EFFORTS.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,458,184	BeginningYearBalanceAmt
Investment Earnings Or Losses	$51,349	InvestmentEarningsOrLossesAmt
End Year Balance	$3,509,533	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,247,829	BeginningYearBalanceAmt
Investment Earnings Or Losses	$210,355	InvestmentEarningsOrLossesAmt
End Year Balance	$3,458,184	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,855,688	BeginningYearBalanceAmt
Investment Earnings Or Losses	$392,141	InvestmentEarningsOrLossesAmt
End Year Balance	$3,247,829	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,647,384	BeginningYearBalanceAmt
Investment Earnings Or Losses	$208,304	InvestmentEarningsOrLossesAmt
End Year Balance	$2,855,688	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,745,606	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$98,222	InvestmentEarningsOrLossesAmt
End Year Balance	$2,647,384	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.22980	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.77020	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$405,921	OtherCostOrOtherBasisAmt
Book Value	$405,921	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$19,765,302	OtherCostOrOtherBasisAmt
Depreciation	$14,338,176	DepreciationAmt
Book Value	$5,427,126	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$24,874,457	OtherCostOrOtherBasisAmt
Depreciation	$18,044,467	DepreciationAmt
Book Value	$6,829,990	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$32,701,953	OtherCostOrOtherBasisAmt
Depreciation	$23,722,700	DepreciationAmt
Book Value	$8,979,253	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,325,142	OtherCostOrOtherBasisAmt
Depreciation	$1,686,708	DepreciationAmt
Book Value	$638,434	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$22,280,724	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
EST AMTS DUE TO 3RD PARTY PAYER	$1,399,537
INTEREST RATE SWAP	$1,562,653

Field	Value	IRS element (for citing)
Total Liability	$2,962,190	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$88,382,740	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$232,156	NetUnrealizedGainsInvstAmt
Other Revenue	-$3,661,947	OtherRevenueAmt
Revenue Not Reported	-$3,894,103	RevenueNotReportedAmt
Revenue Subtotal	$92,276,843	RevenueSubtotalAmt
Investment Expenses Not Incld	$358,459	InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt	$358,459	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$92,635,302	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$85,997,749	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$85,997,749	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$358,459	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$3,441,947	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$3,800,406	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$89,798,155	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	ENDOWMENT FUNDS: NORTH COUNTRY HEALTH SYSTEMS (NCHS), A RELATED ORGANIZATION, HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND OTHER ITEMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT. UNDER NCHS'S POLICIES, THE PRIMARY INVESTMENT GOAL IS GROWTH IN THE ENDOWMENT ACCOUNTS. NCHS EXPECTS ITS ENDOWMENT FUNDS TO PROVIDE AN AVERAGE RATE OF RETURN THAT EXCEEDS BENCH MARK RETURNS INDICATED FOR VARIOUS ASSET CLASSES.
SCHEDULE D, PART X, LINE 2	UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2D	AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $(3,422,797) BAD DEBT EXPENSE (220,000) NET ASSETS RELEASED FROM RESTRICTION (19,150) OTHER EXPENSES INCLUDED IN REVENUE ----------- $(3,661,947)
SCHEDULE D, PART XII, LINE 4B	AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 3,422,797 BAD DEBT EXPENSE 19,150 OTHER EXPENSES INCLUDED IN REVENUE ----------- $ 3,441,947

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	300.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	false	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	false	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$741,126	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$741,126	NetCommunityBenefitExpnsAmt
Total Expense	0.00860	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,194,678	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,729,155	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,465,523	NetCommunityBenefitExpnsAmt
Total Expense	0.19060	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,935,804	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,729,155	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,206,649	NetCommunityBenefitExpnsAmt
Total Expense	0.19920	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,056	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$14,056	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$85,973	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$85,973	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$51,196	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,780	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$44,416	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$66,217	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$66,217	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$217,442	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,780	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$210,662	NetCommunityBenefitExpnsAmt
Total Expense	0.00250	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,153,246	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,735,935	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,417,311	NetCommunityBenefitExpnsAmt
Total Expense	0.20170	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$3,422,797	BadDebtExpenseAmt
Bad Debt Expense Attributable	$554,910	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$24,800,355	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$25,047,745	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$247,390	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NORTH COUNTRY HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	189 PROUTY DRIVE	AddressLine1Txt
City	NEWPORT	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05855	ZIPCd

Field	Value	IRS element (for citing)
Website Address	NCHSI.ORG	WebsiteAddressTxt
State License	832	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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	NORTH COUNTRY HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	18	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	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
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	COMMUNITY INPUT: IN KEEPING WITH THE GUIDELINES FOR A COMPREHENSIVE CHNA, A NUMBER OF KEY COMMUNITY STAKEHOLDERS WHO REPRESENT THE BROAD INTEREST OF THE NEWPORT HOSPITAL SERVICE AREA, INCLUDING LEADERS AND REPRESENTATIVES OF ORGANIZATIONS THAT SERVE VARIOUS SEGMENTS OF THE POPULATION IN THE NCH SERVICE AREA WERE INVITED TO PARTICIPATE ON THE CHNA ADVISORY TEAM. WITH THE NCH CORE TEAM AS A SUBGROUP OF THE CHNA ADVISORY TEAM, THE ADVISORY TEAM WAS LEAD AND DISCUSSION WAS FACILITATED BY J. RIFFON.
SCHEDULE H, PART V, SECTION B, LINE 7A & 10	WEBSITE URL FOR CHNA REPORT/IMPLEMENTATION STRATEGY: HTTPS://WWW.NORTHCOUNTRYHOSPITAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
SCHEDULE H, PART V, SECTION B, LINE 11	ADDRESSING IDENTIFIED NEEDS: AFTER REVIEW OF THE COMBINATION OF DATA AND THE RESULTS OF THE COMMUNITY SURVEY AND FOCUS GROUP PROCESSES, THE ADVISORY TEAM PRIORITIZED THE FOLLOWING AS KEY HEALTH CONCERNS RECOMMENDED FOR DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR THE 2018 NCH COMMUNITY HEALTH NEEDS ASSESSMENT: - SUPPORTING SUBSTANCE FREE LIFE STYLE AND MENTAL WELLNESS - SUPPORTING OLDER VERMONTERS AGING IN PLACE - SUPPORTING TOBACCO FREE LIFE STYLES - SUPPORTING HEALTHY EATING AND PHYSICAL ACTIVITY - SUPPORTING ACCESS TO MEDICAL AND ORAL HEALTH RESOURCES ADDITIONALLY, THE ADVISORY TEAM ACKNOWLEDGES THERE ARE RELATED KEY CONCERNS WHICH WERE IDENTIFIED THROUGH THE ASSESSMENT PROCESS THAT IMPACT THE HEALTH OF THE NCH SERVICE AREA BUT WHICH NCH'S IMPLEMENTATION STRATEGY DOES NOT INTEND TO DIRECTLY ADDRESS WITH SPECIFIC MEASURES OR ACTIVITIES TO ASSESS PROGRESS. THESE RELATED KEY CONCERNS INCLUDE: - HIGHER RATES OF UNEMPLOYMENT AND POVERTY - LOWER RATE OF HIGH SCHOOL EDUCATION AMONG ADULTS - TRANSPORTATION CHALLENGES - REDUCED ACCESS TO POST HIGH SCHOOL EDUCATION FOR SOME COMMUNITY MEMBERS DUE TO FINANCIAL BARRIERS HOWEVER, NCH'S IMPLEMENTATION STRATEGY CONTAINS A RECOMMENDATION TO ADDRESS THE RELATED HEALTH CONCERNS LISTED ABOVE BY A COMMITMENT TO ASSESS THE NEED AND COMMUNITY CAPACITY TO IMPLEMENT THE BRIDGES OUT OF POVERTY INITIATIVE IN THE NCH SERVICE AREA. THIS IS A NATIONALLY RECOGNIZED COMMUNITY SUPPORT PROGRAM WHICH HELPS A COMMUNITY MOVE INDEPENDENTLY FROM POVERTY TO SELF-SUFFICIENCY.
SCHEDULE H, PART V, SECTION B, LINE 16A	WEBSITE URL FOR FAP: HTTPS://WWW.NORTHCOUNTRYHOSPITAL.ORG/FINANCIAL-SERVICES/
SCHEDULE H, PART V, SECTION B, LINE 16B	WEBSITE URL FOR FAP APPLICATION: https://www.northcountryhospital.org/financial-services/
SCHEDULE H, PART V, SECTION B, LINE 16C	WEBSITE URL FOR PLAIN LANGUAGE FAP SUMMARY: HTTPS://WWW.NORTHCOUNTRYHOSPITAL.ORG/FINANCIAL-SERVICES/
SCHEDULE H, PART V, SECTION B, LINE 20E	EFFORTS INITIATED BY THE HOSPITAL: EVERY PATIENT THAT IS FLAGGED FOR COLLECTION IS INVITED TO A FINANCIAL AID APPOINTMENT.

Field	Value	IRS element (for citing)
Facility	7	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
NORTH COUNTRY PRIMARY CARE BARTON
488 ELM ST	BARTON	VT	05822	FAMILY MED, NEWBORN CARE, PEDIATRICS, GERIATRICS, ETC
NORTH COUNTRY PRIMARY CARE NEWPORT
186 MEDICAL VILLAGE DRIVE	NEWPORT	VT	05855	FAMILY CARE, NEWBORN CARE, PEDIATRICS, GERIATRICS, ETC.
NORTH COUNTRY HOSPITAL OBGYN SERVICES
81 MEDICAL VILLAGE DRIVE SUITE 2	NEWPORT	VT	05855	OB/GYN SERVICES
NORTH COUNTRY SURGICAL ASSOCIATES
41 MEDICAL VILLAGE DR	NEWPORT	VT	05855	SURGERY
NORTH COUNTRY ORTHOPEDICS
81 MEDICAL VILLAGE DR SUITE 1	NEWPORT	VT	05855	ORTHOPEDICS
NORTH COUNTRY NEUROLOGY SERVICES
MEDICAL ARTS BLDG 2ND FLOOR 189 P	NEWPORT	VT	05855	NEUROLOGY
NORTH COUNTRY PEDIATRICS
121 MEDICAL VILLAGE DR	NEWPORT	VT	05855	NEWBORN CARE, PEDIATRICS

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 OT $3,422,797.
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 WORKSHEETS 1, 3, AND 6.
SCHEDULE H, PART I, LINE 7G	SUBSIDIZED SERVICES: AMOUNTS USED IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G PRIMARILY CAME FROM COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHCS). NORTH COUNTRY HOSPITAL PROVIDES PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITIES AT THE CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. NORTH COUNTRY HOSPITAL CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES: OUR ORGANIZATION'S COMMUNITY-BUILDING ACTIVITIES INCLUDE ACTIVE PARTICIPATION BY HOSPITAL STAFF ON A NUMBER OF ECONOMIC-BUILDING COLLABORATIONS SUCH AS THE LOCAL ROTARY AND CHAMBER OF COMMERCE AS WELL AS ON LOCAL PARTNERSHIPS SUCH AS THOSE THAT FOCUS ON PREVENTION AND REDUCTION OF DOMESTIC VIOLENCE, PREVENTION/REDUCTION OF ALCOHOL, DRUGS AND TOBACCO, PROMOTION OF PHYSICAL ACTIVITY AND HEALTHY LIFESTYLE CHOICES. THE HOSPITAL ALSO PROVIDES MEETING SPACE AT NO CHARGE FOR NUMEROUS AGENCIES AND GROUPS THAT TARGET VARIOUS ASPECTS OF COMMUNITY HEALTH SUCH AS ALCOHOLICS ANONYMOUS, EARLY CHILDHOOD DEVELOPMENT, GRIEVING SUPPORT GROUPS, DRIVING SAFETY COURSES, YOUTH BEHAVIOR SUPPORT TEAMS AND YOUTH COURT DIVERSION TEAMS.
SCHEDULE H, PART III, SECTION A, LINE 2	BAD DEBT EXPENSE: BAD DEBT EXPENSE REPORTED ON LINE 2 IS THE AMOUNT PER THE AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION A, LINE 3	BAD DEBT EXPENSE ATTRIBUTABLE TO FINANCIAL ASSISTANCE: THE ORGANIZATION HAS ESTIMATED THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 BY UTILIZING DATA FROM THE U.S. CENSUS BUREAU. THE ORGANIZATION ESTIMATED THE PERCENTAGE BY OBTAINING THE PERCENT OF THE POPULATION IN ITS SERVICE AREA FALLING BELOW THE FEDERAL POVERTY GUIDELINES.
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, THAT NOTE CAN BE FOUND ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION B, LINE 8	COMMUNITY BENEFIT: THE COMMUNITY IS BETTER SERVED WITH PROVIDERS AVAILABLE IN THE ORGANIZATION'S REMOTE REGION. THE ENTIRETY OF ANY SHORTFALL REPORTED SHOULD BE TREATED AS COMMUNITY BENEFIT. THE ORGANIZATION ACCEPTS ALL MEDICARE PATIENTS KNOWING THAT THERE WILL LIKELY BE SHORTFALLS. ADDITIONALLY, TREATING MEDICARE PATIENTS IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION POLICY: WHEN IDENTIFIED AS A POSSIBLE WRITE OFF TO MEDICARE BAD DEBT, AN ACCOUNT MUST MEET MEDICARE'S CRITERIA FOR REPORTING ON THE COST REPORT. AN ACCOUNT FOR A MEDICARE PATIENT MUST UNDERGO HOSPITAL COLLECTION EFFORTS FOR AT LEAST 120 DAYS FROM THE INITIAL DATE OF BILLING TO THE PATIENT BEFORE BEING CONSIDERED FOR WRITE-OFF TO A THIRD PARTY AGENCY. THESE MEDICARE ACCOUNTS WILL BE CLOSED AND RETURNED BY THE AGENCIES AFTER 120 DAYS FROM PLACEMENT IF COLLECTION EFFORTS FAIL AND THEY ARE DEEMED UNCOLLECTIBLE. IF A MEDICARE PATIENT IS DECEASED AND NO ESTATE CAN BE IDENTIFIED, IT WILL BE DEEMED UNCOLLECTIBLE AND MAY BE DIRECTLY CONSIDERED FOR WRITE-OFF RATHER THAN TURNED OVER TO A THIRD PARTY AGENCY. IF A MEDICARE PATIENT FILES FOR BANKRUPTCY, THE ACCOUNTS WILL BE DEEMED UNCOLLECTIBLE AND WILL BE DIRECTLY CONSIDERED FOR WRITE-OFF. IF A MEDICARE PATIENT QUALIFIES FOR FREE CARE UNDER THE HOSPITAL'S GUIDELINES, THE ACCOUNT(S) WILL BE DEEMED UNCOLLECTIBLE AND WILL BE WRITTEN OFF TO THE APPROPRIATE PAT CODE(S). WHEN A MEDICARE ACCOUNT IS DEEMED UNCOLLECTIBLE, THE DEDUCTIBLE AND/OR COINSURANCE AMOUNTS WILL BE WRITTEN OFF USING THE APPROPRIATE PAT CODE(S). NON COVERED AMOUNTS DO NOT QUALIFY FOR MEDICARE BAD DEBT. ALL SUPPORTING DOCUMENTATION REGARDING DEDUCTIBLE AND COINSURANCE AMOUNTS WILL BE COLLECTED AND FILED FOR COST REPORTING PURPOSES. THE HOSPITAL ALSO COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT TO COMPLY WITH IRS 501(R) REQUIREMENTS.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: THE HOSPITAL ACTIVELY PARTICIPATES IN A NUMBER OF COMMUNITY PARTNERSHIPS THAT FOCUS ON VARIOUS ASPECTS OF LOCAL HEALTH NEEDS - INCLUDING, FOR EXAMPLE, HEALTH DISPARITIES, ALCOHOL, DRUG AND TOBACCO PREVENTION, PROMOTING HEALTHY EATING AND PHYSICAL ACTIVITY. THE VT DEPARTMENT OF HEALTH REMAINS AN EXCELLENT AND VERY THOROUGH DATA SOURCE, WITH DATA AVAILABLE STATEWIDE, BY COUNTY AND BY SCHOOL SUPERVISORY DISTRICTS. DATA IS AVAILABLE ACROSS THE LIFESPAN AND INCLUDES, FOR EXAMPLE TOPICS SUCH AS COMMUNICABLE DISEASE, CHRONIC DISEASE, OCCUPATIONAL HEALTH DATA, RISK FACTORS SUCH AS ALCOHOL, DRUG AND TOBACCO USE, OBESITY, LIFESTYLE CHOICES. DATA REGARDING SOCIOECONOMIC STATUS AND EDUCATION LEVEL IS ALSO READILY AVAILABLE, AGAIN FOR THE STATE AS WELL AS BY COUNTY AND SCHOOL DISTRICT. ALL DATA IS EASILY ACCESSIBLE ONLINE AT WWW.HEALTHVERMONT.GOV AND AT HUMANSERVICES.VERMONT.GOV. THE HOSPITAL ALSO COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT TO COMPLY WITH NEW IRS 501(R) REQUIREMENTS.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FOR BALANCES OVER $500.00 A HELP IS AVAILABLE LETTER IS MAILED WITH THE INITIAL BILL, REGARDLESS OF WHETHER THE BALANCE IS SELF-PAY, PRIMARY OR AFTER INSURANCE. IN ADDITION, OUR COLLECTION LETTERS ALL REFER TO OUR FREE CARE PROGRAM ASKING THE PATIENT TO CALL TO DISCUSS THIS AND OTHER OPTIONS. WHEN FREE CARE IS DISCUSSED WITH THE PATIENT, IT IS EXPLAINED THAT THEY ARE REQUIRED TO APPLY FOR OTHER ASSISTANCE AND WE OFFER OUR HELP IN THE APPLICATION PROCESS. FOR SELF-PAY PATIENTS THAT ARE IP, ONE OF THE FINANCIAL COUNSELORS ATTEMPTS TO DISCUSS MEDICAID AS WELL AS FREE CARE.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: WE SERVE TWO OF THE MOST ECONOMICALLY CHALLENGED COUNTIES IN VERMONT. WITH A TOTAL OF APPROXIMATELY 30,000 RESIDENTS IN OUR SERVICE AREA, OUR POPULATION, AS COMPARED TO VT AND THE US, HAS A SIGNIFICANTLY HIGHER PERCENTAGE OF PERSONS LIVING UNDER THE FEDERAL POVERTY LEVEL AND A VERY HIGH RATE OF ADULTS AGE 25+ WITHOUT A HIGH SCHOOL EDUCATION, WHILE THE MEDIAN HOUSEHOLD INCOME IS SIGNIFICANTLY LOWER, AGAIN AS COMPARED TO VT AND THE US. OUR REGION CONSISTENTLY HAS ONE OF THE HIGHEST RATES OF UNEMPLOYMENT IN THE STATE. THIS PRIMARILY WHITE POPULATION IS FOUND IN VERY SMALL COMMUNITIES SCATTERED OVER A RURAL, MOUNTAINOUS, AND LAKE-DOTTED AREA, MAKING TRAVELING AND NETWORKING A CHALLENGE, PARTICULARLY IN THE HARSH WINTER MONTHS.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: IN ADDITION TO THE COMMUNITY BUILDING ACTIVITIES LISTED ON PART II, OTHER COMMUNITY BENEFITS INCLUDE ACTIVITIES SUCH AS PROVIDING SKILLED NURSING SERVICES WHILE ACUTELY ILL PATIENTS ARE TRANSFERRED BY AMBULANCE TO A TERTIARY CARE CENTER, PROVIDING SUPPORT AND SUPERVISION IN THE EDUCATION OF STUDENT NURSES AND MEDICAL STUDENTS, DONATING SUPPLIES AND EQUIPMENT TO OTHER NON-PROFIT ORGANIZATIONS FOR THEIR CONTINUED USE, ACTIVE PARTICIPATION ON THE BOARDS OF SEVERAL HEALTH RELATED AGENCIES SUCH AS THE VISITING NURSE ASSOCIATION, THE DOMESTIC VIOLENCE TASK FORCE, AND THE AREA AGENCY ON AGING. THE ORGANIZATION ALSO IMPLEMENTS A HELP LINE FOR THE HOMEBOUND OR FRAIL INDIVIDUALS WHO LIVE ALONE. A NUMBER OF LOCAL RESIDENTS RECEIVE THIS SERVICE AT NO COST TO THEM.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM ROLES: NORTH COUNTRY HEALTH SYSTEMS, INC. AND ITS SUBSIDIARIES COLLECTIVELY DO BUSINESS AS NORTH COUNTRY HEALTH SYSTEM (NCHS). NORTH COUNTRY HEALTH SYSTEMS, INC. (HEALTH SYSTEM) IS THE PARENT HOLDING COMPANY FOR ITS WHOLLY OWNED SUBSIDIARIES, WHICH INCLUDE NORTH COUNTRY HOSPITAL AND HEALTH CENTER, INC. (HOSPITAL) AND NORTH COUNTRY HEALTH SERVICES, INC., D/B/A DERBY GREEN (DERBY GREEN). NORTH COUNTRY HOSPITAL AND HEALTH CENTER, INC. OPERATES A 25-BED ACUTE ARE HOSPITAL FACILITY IN NEWPORT, VERMONT. THE HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN NEWPORT, VERMONT, AND THE SURROUNDING AREA. THE HOSPITAL ALSO OPERATES A NUMBER OF PHYSICIAN CLINICS IN THE SAME GEOGRAPHIC AREA. DERBY GREEN OPERATES A 23-BED NURSING HOME LOCATED IN DERBY, VERMONT.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	Yes (true)	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	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
ANDRE BISSONNETTE
CHIEF FINANCIAL OFFICER	$183,797	$0	$30,529	$0	$4,750	$0	$14,387	$0	$29,179	$0	$262,642	$0	$0	$0
THOMAS FRANK
TRUSTEE/COO/INTERIM CEO	$244,168	$0	$51,000	$0	$16,500	$0	$14,549	$0	$2,149	$0	$328,366	$0	$0	$0
AVRIL COCHRAN
VP PATIENT CARE SERVICES	$155,815	$0	$22,443	$0	$0	$0	$6,490	$0	$21,074	$0	$205,822	$0	$0	$0
UMAIR MALIK MD
MEDICAL STAFF PRESIDENT	$276,039	$0	$3,584	$0	$14,098	$0	$8,829	$0	$29,409	$0	$331,959	$0	$0	$0
CHARLES LAGOY MD
MEDICAL STAFF VP	$255,303	$0	$12,559	$0	$15,320	$0	$8,944	$0	$29,376	$0	$321,502	$0	$0	$0
CHRISTOPHER RICKMAN MD
TRUSTEE	$290,197	$0	$12,500	$0	$27,000	$0	$19,166	$0	$21,552	$0	$370,415	$0	$0	$0
STEPHANE MULLIGAN MD
PHYSICIAN	$573,565	$0	$25,000	$0	$10,991	$0	$3,909	$0	$31,450	$0	$644,915	$0	$0	$0
LARRY SISSON MD
PHYSICIAN	$494,361	$0	$38,466	$0	$31,462	$0	$20,625	$0	$3,562	$0	$588,476	$0	$0	$0
PETER STUART MD
PHYSICIAN	$344,046	$0	$148,881	$0	$33,229	$0	$19,250	$0	$3,835	$0	$549,241	$0	$0	$0
GREG WALKER MD
PHYSICIAN	$425,092	$0	$67,929	$0	$30,944	$0	$20,625	$0	$37,013	$0	$581,603	$0	$0	$0
VERONIKA JEDLOVSZKY MD
PHYSICIAN	$359,510	$0	$64,150	$0	$9,187	$0	$19,247	$0	$32,152	$0	$484,246	$0	$0	$0
CLAUDIO FORT
FORMER CEO	$89,916		$0		$13,007		$6,315		$13,769		$123,007		$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A	HEALTH CLUB BENEFITS: ALL EMPLOYEES OF THE ORGANIZATION RECEIVE THE BENEFIT OF A LOCAL HEALTH CLUB'S MEMBERSHIP.
SCHEDULE J, PART I, LINE 5A	COMPENSATION CONTINGENT ON THE REVENUES OF THE ORGANIZATION: PHYSICIANS EARN COMPENSATION BASED UPON THEIR PRODUCTIVITY AGAINST ESTABLISHED TARGETS. INCREASED PRODUCTIVITY IS DIRECTLY RELATED TO INCREASED REVENUES FOR THE ORGANIZATION. VP/DIRECTOR INCENTIVES ARE ALSO BASED ON REVENUES AND PERFORMANCE.
SCHEDULE J, PART I, LINE 7	NON FIXED PAYMENTS: THE SENIOR TEAM AND CERTAIN DOCTORS ARE GIVEN BONUSES BASED ON SPECIFIC PROGRAM PERFORMANCE.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
VERMONT EDUCATIONAL AND HLTH BLDGS FINANCING AGNCY
A	030292808	924166AR2	2007-06-01	$23,795,000	REFUND 04 BONDS, CAP IMPROV	false	false	false
VERMONT EDUCATIONAL AND HLTH BLDGS FINANCING AGNCY
B	237154467		2016-06-01	$18,743,131	BOND REFUNDING- NORTH COUNTRY HOSP	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$0	$0	$24,215,685	$0	$0	$16,900,515	$171,170	$9,000	$0	$7,135,000	$0	$0	2010	Yes (true)	false	Yes (true)	Yes (true)
B	$0	$0	$18,743,131	$0	$0	$0	$222,402	$0	$0	$0	$0	$0		Yes (true)	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	0	false	false	false	Yes (true)
B	false	false	false	0	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
0
A	false	false	false	Yes (true)	Yes (true)	false	false	0	false	false
PEOPLES
B	Yes (true)				Yes (true)	Yes (true)	false	0	false	false	false	false

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	false
B	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE K, PART IV, LINE 2C	FormAndLineReferenceDesc
Explanation	A REBATE CALCULATION IS BEING PERFORMED FOR THE BONDS AS OF 6/1/12. NO REBATE IS EXPECTED.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 1	ORGANIZATION'S MISSION: OUR MISSION: OUR MISSION IS TO PROVIDE EXCEPTIONAL CARE THAT MAKES A DIFFERENCE IN THE LIVES OF OUR PATIENTS AND COMMUNITY. VISION: WE WILL BE REGARDED AS AN EXCEPTIONAL COMMUNITY RESOURCE THAT HAS SIGNIFICANTLY IMPROVED THE HEALTH OF THE COMMUNITY. OUR VALUES: - QUALITY PATIENT CARE IS OUR GREATEST COMMITMENT - EMPLOYEES ARE OUR GREATEST ASSETS - EXCELLENT PATIENT EXPERIENCE IS OUR GREATEST ACCOMPLISHMENT - THE HEALTH OF THE COMMUNITY IS OUR GREATEST RESPONSIBILITY
FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B	MEMBERS/STOCKHOLDERS/OTHER PERSONS: THE SOLE MEMBER OF THE HOSPITAL SHALL BE NORTH COUNTRY HEALTH SYSTEMS, INC., A VERMONT NOT-FOR-PROFIT CORPORATION, ACTING THROUGH ITS BOARD OF TRUSTEES AND HEREINAFTER REFERRED TO AS THE MEMBER WHEN ACTING IN ITS CAPACITY AS SUCH. THE MEMBER SHALL HAVE THE EXCLUSIVE RIGHT TO ENJOY AND EXERCISE ALL RIGHTS AND POWERS CONFERRED ON MEMBERS OF NON-PROFIT CORPORATIONS UNDER THE LAWS OF THE STATE OF VERMONT, SUBJECT TO THE TERMS AND CONDITIONS OF THE AFFILIATION. THE MEMBER SHALL HAVE SUCH OTHER POWERS AS ARE SPECIFIED IN THE ARTICLES OF ASSOCIATION AND IN THESE BYLAWS, INCLUDING, WITHOUT THE POWER TO ELECT AND REMOVE TRUSTEES AND TO AMEND AND RESTATE THE ARTICLES OF ASSOCIATION. TWELVE OF THE TRUSTEES SHALL BE ELECTED BY THE MEMBER. THE AUTHORITY OF THE BOARD OF TRUSTEES TO EXERCISE THE FOLLOWING POWERS IS CONDITIONED ON THE PRIOR APPROVAL OF THE MEMBER: (1) THE ADOPTION OF ANNUAL OPERATING BUDGETS; (2) THE ADOPTION OF CAPITAL BUDGETS; (3) ANY VOLUNTARY DISSOLUTION, MERGER, OR CONSOLIDATION OF THE HOSPITAL OR THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE HOSPITAL'S ASSETS, OR THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE CORPORATION OF THE HOSPITAL; (4) ANY AGREEMENT OR TRANSACTION, EITHER OF WHICH IS OF A MATERIAL NATURE, WITH ANOTHER CORPORATION CONTROLLED DIRECTLY BY OR AFFILIATED WITH THE MEMBER; AND (5) THE BORROWING OF ANY SUM IN EXCESS OF $100,000 WHICH HAS A STATED TERM GREATER THAN ONE YEAR OR WHICH IS SECURED BY A MORTGAGE OF ALL OR ANY PORTION OF THE HOSPITAL'S REAL PROPERTY OR BY A SECURITY INTEREST IN THE HOSPITAL'S ASSETS OR REVENUES, BUT NOT INCLUDING ANY BORROWING OF LESS THAN $ 100,000 TO PURCHASE OR LEASE EQUIPMENT OR OTHER PERSONAL PROPERTY THAT IS SECURED SOLELY BY A PURCHASE MONEY TITLE RETENTION OR OTHER FORM OF SECURITY INSTRUMENT OR AGREEMENT IN THE EQUIPMENT OR PERSONAL PROPERTY BEING ACQUIRED.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS: 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 FORM 990 IS REVIEWED BY THE ORGANIZATION'S MANAGEMENT AND FINANCE TEAM IN DETAIL. AFTER IT HAS BEEN REVIEWED, IT IS THEN PROVIDED TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 12C	MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD, COMMITTEE, OR OTHER INDIVIDUALS WHO, ON BEHALF OF THE CORPORATION, ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. IN THE EVENT THAT A TRUSTEE, OFFICER, COMMITTEE MEMBER OR MEMBER OF THE CORPORATION'S LEADERSHIP GROUP BECOMES CONCERNED THAT ANOTHER INTERESTED PERSON HAS AN UNDISCLOSED FINANCIAL INTEREST OR IS EXERTING INAPPROPRIATE INFLUENCE RELATED TO A FINANCIAL INTEREST, THIS CONCERN SHOULD BE RAISED WITH THE CHAIR OF THE APPROPRIATE BOARD OR COMMITTEE OR, IF INVOLVING THE LEADERSHIP GROUP, AN APPROPRIATE CORPORATE OFFICER. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD OR COMMITTEE MEMBERS. IT SHALL BE THE RESPONSIBILITY OF THE CHAIR OF THE BOARD OR COMMITTEE TO INSTRUCT AN INTERESTED PERSON ON THE RESTRICTIONS ON HIS OR HER PARTICIPATION PURSUANT TO THIS POLICY IN ANY FURTHER CONSIDERATION OF THE SUBJECT MATTER OF THE CONFLICT OF INTEREST AND TO ENFORCE THESE RESTRICTIONS. AWARENESS/COMPLIANCE WITH POLICY EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. EACH INTERESTED PERSON SHALL DISCLOSE ON AN ANNUAL SURVEY FORM POTENTIAL CONFLICTS OF INTEREST AND FINANCIAL INTERESTS RELEVANT TO THIS POLICY. EACH INTERESTED PERSON SHALL ALSO PROVIDE ON AN ANNUAL SURVEY FORM A LIST OF IMMEDIATE FAMILY MEMBERS, INCLUDING SPOUSE, CHILDREN, GRANDCHILDREN, PARENTS, SIBLINGS AND ANY OTHER PERSON WHO LIVES IN HIS/HER HOUSEHOLD, IN ORDER THAT THE CORPORATION MAY HAVE A RECORD OF ALL INDIVIDUALS WHO MAY BE CONSIDERED DISQUALIFIED PERSONS UNDER INTERNAL REVENUE SERVICE REGULATIONS FOR THE PURPOSE OF ENSURING COMPLIANCE WITH TAX EXEMPT STATUS REQUIREMENTS FOR CHARITABLE ORGANIZATIONS. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT INVOLVES THE CONFLICT OF INTEREST. THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, INCLUDING A CONSIDERATION OF INDEPENDENT COMPARABILITY DATA, VALUATIONS OR APPRAISALS, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE (OR QUORUM) OF ALL OF THE DISINTERESTED TRUSTEES OR COMMITTEE MEMBERS (REGARDLESS OF THE NUMBER PRESENT AT A MEETING): (I) WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT, (II) WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION, AND (III) WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATIONS.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	COMPENSATION REVIEW: THE BOARD ANNUALLY REVIEWS THE CEO AND SENIOR TEAM SALARIES USING COMPARABILITY DATA. THE REVIEW PROCESS IS DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE VIEWED BY THE PUBLIC UPON AN APPOINTMENT WITH THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER OR ASSISTANT.
FORM 990, PART VII, SECTION A	BOARD OF DIRECTORS: NORTH COUNTRY HOSPITAL AND HEALTH CENTER, NORTH COUNTRY HEALTH SERVICES, AND NORTH COUNTRY HEALTH SYSTEMS SHARE A BOARD OF DIRECTORS. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. DWIGHT NALL, CEO, AND ANDRE BISSONNETTE, CHIEF FINANCIAL OFFICER, EACH WORK APPROXIMATELY 40 HOURS PER WEEK BETWEEN NORTH COUNTRY HOSPITAL AND HEALTH CENTER, NORTH COUNTRY HEALTH SERVICES, AND NORTH COUNTRY HEALTH SYSTEMS. THEY ARE COMPENSATED FOR THEIR DUTIES IN THAT CAPACITY. CHRISTOPHER RICKMAN, CHARLES LAGOY, THOMAS FRANK AND UMAIR MALIK ARE COMPENSATED AS EMPLOYEES OF NORTH COUNTRY HOSPITAL. THEY DO NOT RECEIVE ANY COMPENSATION FOR THEIR DUTIES AS BOARD OF DIRECTORS MEMBERS.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS: $ 929,378 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 186,913 CHANGE IN INTEREST IN NET ASSETS OF NCHS ---------- $1,116,291

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
NORTH COUNTRY HEALTH SYSTEMS
189 PROUTY DRIVE	NEWPORT	VT	05829	222566964	PARENT/FUNDRS	VT	501(C)(3)	12B II	NA	false
NORTH COUNTRY HLTH SRVCS DBA DERBY GREEN
2853 US-5	DERBY	VT	05829	222570334	SKILLED NURSG	VT	501(C)(3)	10	NCHS	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	NORTHEAST KINGDOM HLTHCARE COL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	55 SHERMAN DRIVE	AddressLine1Txt
City	ST JOHNSBURY	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05819	ZIPCd

Field	Value	IRS element (for citing)
EIN	452787538	EIN
Primary Activities	SLEEP LAB SVC	PrimaryActivitiesTxt
Legal Domicile State	VT	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	RELATED	PredominantIncomeTypeTxt
Share Of Total Income	$10,310	ShareOfTotalIncomeAmt
Share Of EOY Assets	$663,893	ShareOfEOYAssetsAmt
Disproportionate Allocations	false	DisproportionateAllocationsInd
UBI Code V	$0	UBICodeVAmt
General Or Managing Partner	Yes (true)	GeneralOrManagingPartnerInd
Ownership	0.60000	OwnershipPct

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd