2019-08-15T13:21:21-05:00 2018-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2017-10-01 030179437 Springfield Hospital Inc SPRI 8028857344 PO Box 2003 Springfield VT 05156 Thomas Marshall Interim CFO 8028857344 2019-08-15 1 Barbara J McGuan CPA P00219457 2077752387 2019-08-15 69.49.157.66 2019-08-15 10:21:53 ED P E7B858A5D43A1C12EA56452E98FB06825C34A804 32BC52385E097AD1B92E63E6016D3C1011811B46 2017 2019-02-21 02:37:17Z Michael Halstead PO Box 2003 Springfield VT 05156 60957807 0 X www.springfieldhospital.org X 1914 VT 25-Bed Critical Access Hospital 12 9 511 48 0 0 334441 538872 53571895 54506580 1272278 1194356 -3039 -407 55175575 56239401 610390 1697253 0 0 30681954 33384845 0 0 0 26857540 28456425 58149884 63538523 -2974309 -7299122 40943110 35760253 24964045 26308599 15979065 9451654 X Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, and employees want to work. Our plan is to accomplish this by:1. Empowering our caregivers with education, technology, and opportunities for personal and professional development;2. Creating an environment which builds collaborative relationships among clinicians, staff, and patients;3. Providing our communities with the educational resources and support to make informed decisions emphasizing prevention and wellness; and4. Offering safe, personalized, high quality care. 0 0 48108759 1697253 54506580 Springfield Hospital (SH) is a 25-bed critical access hospital located in Springfield, VT. SH is a subsidiary of Springfield Medical Care Systems, a nine-site federally qualified health center network. SH also operates The Windham Center, a comprehensive inpatient mental health program in Bellows Falls, VT; off-site physical therapy services, three hospital-owned specialty clinics (ENT, general surgery, and orthopedics), and an adult day care center in Springfield, VT.Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, and employees want to work. Our plan is to accomplish this by:o Empowering our caregivers with education, technology, and opportunities for personal and professional development;o Creating an environment, which builds collaborative relationships among clinicians, staff, and patients;o Providing our communities with the educational resources and support to make informed decisions emphasizing prevention and wellness; and,o Offering safe, personalized, high-quality care.SH provides health services to residents throughout its catchment area. Many of the services benefit the elderly, the poor, the indigent, the underinsured and the uninsured. SH receives minimal reimbursement from these programs, with 55% of Springfield Hospital net revenue coming from Medicare and Medicaid funding.Springfield Hospital has a charity care policy under which patients who meet certain criteria will receive care without charge, or at amounts less than established rates. Patients qualify for 100% charity care at up to 200% of the federal poverty guideline (FPG) and 50% assistance up to 300% of the FPG. The Hospital does not bill patients nor pursue collection of amounts determined to qualify as charity care. For FY18, charges foregone for charity care, based on established rates, amounted to $1,879K.Springfield Hospital operates a number of specialty practices to provide needed specialty care to health center patients. These clinics include Connecticut Valley ENT, Surgical Associates, and Connecticut Valley Orthopaedics. In addition, SH provides an outpatient clinic serving patients needing treatment and minimizing their need to travel great distances for medical oncology or infusion services. Cardiology services are also offered onsite 6 days each month at the specialty clinic. Charitable support, in the form of gas cards and/or medication cards, is provided to patients who do not have needed funds. This charitable support program is through donations and grant funding. Other community benefit programs include the following:Job Training and Shadowing Programs: These programs, in cooperation with Vocational Rehab and training programs through the State of Vermont, provide opportunities to gain on-the-job experience in the healthcare field. We also work with area high school students to provide opportunities for career education and summer employment. Healthcare Scholarships: Springfield Hospital raises funds that are then donated to individuals to further their educational pursuits in healthcare careers. In FY 2018, we donated four scholarships of $1,000 each, and also provide $3,200 annually to AHEC for the MedQuest and Advanced MedQuest programs during the school year. BeSeatSmart Program: This program helps residents comply with Vermont's child passenger restraint law, while ensuring the safety of our smallest patients. During FY 2018, 32 child safety seats were provided to families in need, and 76 child safety seats were inspected by the Child Passenger Safety Technician, on site at Springfield Hospital. The safety seat checks are offered as a free community service. We estimate the value of this program to be $1200 based on staff time to educate parents on the proper use and installation of the child safety seats and administrative assistant costs.Childbirth Education & Lactation Support: The Childbirth Center of Springfield Hospital offers all expectant mothers an opportunity to take a Childbirth Education Class. These free classes are designed to prepare women and their partners for the labor and birth process. Certified Lactation Consultants provide lactation consulting services. Employee Donations For Community Causes: Throughout the year, the Hospital encourages employees to participate in and donate to fundraising events in support of various associations that address community needs, like Relay for Life, Race for the Cure, Hearts of Hope, food and clothing drives for The Family Center, and the Santa Claus Club. In addition, Springfield Hospital partners with the Vermont Food Bank in offering Veggie VanGo; and provides free fresh fruits and vegetables to families in need on a monthly basis. The Springfield Hospital Veggie VanGo site serves approximately 200 families each month.EMS Preceptor Programs: Through Springfield Hospital's Emergency Department, area EMS continue their education by participating in a preceptor program, allowing personnel to observe patient care. In FY 2018, approximately 800 hours of clinical hours were utilized by District 11 EMS personnel. Hospital Based Support Groups: Springfield Hospital provides education and support groups on a variety of topics such as Alzheimers' Caregivers and Breast Cancer. Group meetings meet monthly and are free to participants, educational in nature, and offer an opportunity for group discussion. The Childbirth Center at Springfield Hospital also launched a Baby and Me Playgroup open to infants 3 months and younger along with their caregiver to connect new families and enhance education and socialization opportunities.Meeting Rooms: Free meeting room space is offered to community groups when space is available. Groups that offer information on health or wellness are given a priority; such as Alcoholics Anonymous, Vermont Department of Health, the community health team and the community collaborative. Training Site Partnerships: Springfield Hospital is a training site for Vermont Technical College for their Licensed Practical Nurses. The following schools also have students doing practicums: University of New Hampshire, University of Vermont, Norwich University, University of Massachusetts, Smith College, Antioch New England Graduate School, River Valley College, VTC, St Joseph's College of Maine, Castleton State College. The program utilization is estimated to exceed 1,700 hours for clinical work. Community Education: Springfield Hospital coordinates health promotion programs, open to the public, which includes American Heart Association CPR and First Aid classes. The Hospital also collaborates with the SMCS community health team in offering community health and wellness education programs throughout the year emphasizing preventive programming around diet, exercise and nutrition.Springfield Community: Springfield Hospital encourages employees to become an active volunteer to help improve the communities we call home. Employees donate their time in a variety of areas ranging from serving as Board Members for local groups. Employees also participate in fundraisers such as The Relay for Life, Susan G. Komen Race For the Cure, Annual Rotary Sale, and organize the Springfield Hospital Annual Golf Tournament and Apple Blossom Cotillion fundraising events. Volunteer Service: Volunteer Services provide a variety of services to patients and visitors. The donation of time and fundraising activities support programs that include Clerical Services, Activities Assistant at Adult Day Services, Materials Management Support, Inpatient Discharge Phone Calling Support and Special Services in the Emergency Department. In 2018, Springfield Hospital had 59 volunteers. These individuals volunteered approximately 5,488 hours.The Windham Center - The Windham Center is a 10-bed inpatient mental health unit that provides mental health services to residents of Windham and Windsor counties and other communities. Programs provide treatment for men and women who are 18 years of age and older. Multidisciplinary teams include psychiatrists, social workers, clinicians, drug and alcohol counselors, and nurses. The Windham Center serves the general population and financial assistance is available, based on need. The Windham Center had 349 admissions in 2018, and incurred $65K in charity care expense and $403K in non-reimbursed Medicaid and Medicare costs for the same time period. 48108759 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 74 0 1 511 1 0 0 0 0 0 0 0 0 0 0 X 12 9 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 VT X Thomas Marshall 8028857344 PO Box 2003 Springfield VT 05156 Angela Page Past Director 1.00 X 0 0 0 David Sandelman Director 1.00 X 0 0 0 Gabriel St Pierre Director 1.00 X 0 0 0 Gerald Drabyn MD Director 1.00 40.00 X 0 192113 24563 Jim Rumrill Vice Chairperson 2.00 1.00 X X 0 0 0 Nathan Cobb Treasurer 2.00 2.00 X X 0 0 0 Richard Marasa MD Past Director 40.00 X 643744 106875 0 Sarah Vail Chairperson 1.00 2.00 X X 0 0 0 Timothy Ford CEO/President 30.00 10.00 X X 0 350572 17901 Robert Beaudry Director 1.00 X 0 0 0 Stephen Lyon Secretary 2.00 1.00 X X 0 0 0 Karen Murray Director 1.00 X 0 0 0 Jim Remy Director 1.00 X 0 0 0 Richard Summermatter MD Director 1.00 40.00 X 0 252305 12230 Cecil Beehler MD Chief Medical Officer 1.00 40.00 X 0 360574 14842 Scott Whittemore CFO 30.00 10.00 X 0 226419 9193 Craig Hofsess MD Anesthesiologist 40.00 X 358047 0 28085 David Muller MD Orthopaedic Surgeon 40.00 X 600042 0 19994 Robert Cantu MD Orthopaedic Surgeon 40.00 X 354440 0 22348 Khalid Husain MD General Surgeon 40.00 X 362727 0 40376 Xiangtian Hu MD Anesthesiologist 40.00 X 410839 0 11854 2729839 1488858 201386 30 0 1 0 Emergency Services of New England PO Box 12 Chester VT 05143 Physician Services 4169287 Comprehensive Benefits Administrators PO Box 2365 South Burlington VT 054072365 Benefit Management 847740 Richard Marasa MD PC 1 Walnut Hill Court Springfield VT 05156 Physician Services 643744 University of VT Med CTR Inc PO Box 1902 Burlington VT 054021902 Lab Services 405660 Mayo Collaborative Services PO Box 9146 Minneapolis MN 554809146 Lab Services 265179 23 7200 49167 482505 538872 Patient Service Revenue 622110 121252778 121252778 Miscellaneous Revenue 622110 8535871 8385958 149913 Adult Daycare Revenue 624120 1348329 1348329 Provision for Bad Debts 622110 -5028274 -5028274 Contractual Allowances 622110 -71602124 -71602124 54506580 286691 286691 5607311 4699646 907665 907665 907665 18353 7200 18760 -407 -407 56239401 54356667 0 1343862 X 1697253 1697253 643744 643744 24804186 18292392 6511794 501028 367700 133328 5718044 4196418 1521626 1717843 1260708 457135 51341 51341 72517 72517 57603 57603 11467274 9025269 2442005 148857 3621 145236 376771 130191 246580 1336021 432203 903818 67423 38607 28816 605258 605258 1581699 1570298 11401 642143 523037 119106 Medical Supplies 4738985 4585446 153539 Healthcare Provider Tax 3240700 3240700 Other Expenses 2141858 1132177 1009681 Repairs & Maintenance 777181 657736 119445 1150794 311259 839535 63538523 48108759 15429764 0 X 179225 145429 574375 65497 10387319 8617249 40750 60250 277296 272042 694572 610549 39531520 27138563 13248273 12392957 14196845 12525280 1344455 1071000 40943110 35760253 10346613 12191716 11221381 11211816 3396051 2905067 24964045 26308599 X 15182288 8552715 303286 405448 493491 493491 15979065 9451654 40943110 35760253 X -7299122 -118100 889811 X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 1928 1928 0 Part II-B, Line 1: The Organization paid dues to organizations of which a percentage of the dues were used for lobbying. The Organization paid dues to the VAHHS and American Hospital Association. 87157 87157 14217938 7218113 6999825 948319 555843 392476 22076042 17955364 4120678 2202064 1409243 792821 12392957 Other Current Liabilities 644890 Pension Liability 2260177 2905067 55332619 -118100 908571 790471 54542148 1697253 1697253 56239401 61860030 18760 18760 61841270 1697253 1697253 63538523 Part XI, Line 2d - Other Adjustments: Fundraising Expenses 18,760. Change in Net Assets to Recognize Funded Status of Pension Plan 889,811. Part XI, Line 4b - Other Adjustments: Transfer to Affiliate 1,697,253. Part XII, Line 2d - Other Adjustments: Fundraising Expenses 18,760. Part XII, Line 4b - Other Adjustments: Transfer to Affiliate 1,697,253. Golf Tournament 25553 7200 18353 2000 6020 4139 6601 25553 7200 18353 2000 6020 4139 6601 18760 -407 1 1 X 1 X 1 X 1 1 0 0 776563 776563 0.01220 14065235 9310537 4754698 0.07480 14841798 9310537 5531261 0.08700 1697253 -757405 2454658 0.03860 1697253 -757405 2454658 0.03860 16539051 8553132 7985919 0.12560 1 2008318 17553237 18633577 -1080340 X 1 1 1 1 Springfield Hospital PO Box 2003 Springfield VT 05156 www.springfieldmed.org 854 X X X X Inpatient Psychiatric Unit Springfield Hospital Inc 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X www.springfieldhospital.org X 1 15 1 www.springfieldhospital.org 1 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X www.springfieldhospital.org X www.springfieldhospital.org X www.springfieldhospital.org X X X X X 1 X 0 X 1 X 0 0 Springfield Hospital, Inc. Part V, Section B, Line 5: A steering committee was formed to conduct this assessment, review the data, and recommend priorities and strategis to Springfield Hospital's Board of Directors. Members Include:- Cecil Beehler, II, MD, Chief Medical Officer, Springfield Medical Care Systems- Tom Dougherty, MPH, Executive Director, Neighborhood Connections- Steve Geller, Executive Director, Southeaster Vermont Community Action- Trevor Hanbridge, Blueprint Project Manager, SMCS Community Health Team- Emily Mastaler, Chief Operations Officer, Health Care & Rehabilitation Services- Lynn Raymond-Empey, Executive Director, Valley Health Connections- Carol Stamatakis, Executive Director, Senior Solutions & Anila Hood, Nutrition/Wellness Director, Senior Solutions- Becky Thomas, District Director, Vermont Department of Health- Susan White, Education Resource Coordinator, Southern VT Area Health Education Center- Anna Smith, Chief, Marketing and Community Relations, Springfield Hospital In-person or Telephone InterviewsOutreach by phone or personal interview to community leaders and stakeholders targeted the following:- The SMCS Community Health Team (a nearly 200 member community health team that meets monthly);- Medical Providers;- Community leaders;- General public;- Area businesses;- Community Health Officers;- Police, Fire and EMT;- Schools;- Town officials;- Home Health/VNA;- Health Care and Rehabilitation Services of Vermont (Community Mental Health);- Southeastern Vermont Community Action.Community-wide surveySurveys were conducted targeting the medical staff, employees and community residents (via Survey Monkey). Distribution of the community survey included employees, Community Health Team partner agencies (asking them to distribute to their email and/or contact lists), medical offices, and the public at large. The survey was available online and by paper copy. The survey was made available at the Hospital, Valley Health Connections, all primary and specialty care offices, adn the local Vermont Department of Health District Office. The community survey was also widely advertised in the local newspapers throughout the region and on the website. A total of 758 responses were received to the community survey. Springfield Hospital, Inc. Part V, Section B, Line 6b: Springfield Medical Care Systems, Inc. Springfield Hospital, Inc. Part V, Section B, Line 11: The Hospital is addressing the significant needs identified in its most recently conducted CHNA as follows:Improve the Health and Wellbeing of those Living with Substance Abuse and Mental Health Issues1. Develop educational outreach efforts regarding smoking, drinking, substance abuse, STDs, and violence. 2. Continue offering tobacco treatment or intervention programs, and market them to physician offices and the public. 3. Encourage participation in the Wellness, Recovery, Action Program (WRAP) throughout the SMCS system. 4. Engage community partners, through our Community Health Team monthly meetings, to more clearly define mental health needs and develop strategies. 5. Continue to improve local access, and integration of education and outpatient counseling, at primary care offices. 6. Continue to collaborate with Health Care and Rehabilitation Services (HCRS) to provide emergency care to people in crisis. 7. Partner with local Prevention Coalitions and community partners to develop strategies for prevention and intervention. 8. Expand access to Suboxone Therapy (MAT). 9. Continue to access to Group Therapy and Individual Therapy. 10. Utilize psychiatric services at The Windham Center, as appropriate, for inpatient care. 11. Monitor grant opportunities to expand access to mental health services. 12. Integrate mental health services into local school settings.13. Support the local ACEs efforts for awareness and prevention of Adverse Childhood Experiences. 14. Support VT Department of Health efforts for safe storage and disposal of unused or expired medications. 15. Expedite treatment for pregnant women and new mothers battling addiction. 16. Encourage health care access for low-income populations through continued use of financial assistance programs. Improve Outreach and Education Targeting Obesity among Children and Adults 1. Re-examine the program design and utilization for the RX for Exercise Program, in partnership with the Edgar May Health & Recreation Center. 2. Explore possible program development around lifestyle medicine. 3. Continue quality improvement work to identify patients with obesity and co-morbid conditions of diabetes and heart disease and offer treatment options. 4. Continue FQHC standard protocol to monitor BMI and intervene for elevated BMI in all patients. 5. Continue Healthier Living Workshops, Nutrition Counseling, and Community Education including cooking classes. 6. Develop a community education campaign to raise awareness for available resources. Continue to Improve Access to Oral Health Care for Children and Adults1. Explore feasibility of making dental services available at other geographic locations. 2. Enhance access to low-income populations through continued use of financial assistance programs. 3. Monitor special funding opportunities, including grant funding, to expand dental services in the area. 4. Redistribute the resource "Guide to Fluoride Levels in Public Water Systems" to all medical providers and post to web for public access. (Know Your Fluoride Level- share list of towns)5. Expand the dental hygienist activities in area school systems and explore the offering sealant program in schools.6. Recruit additional dentist and hygienists. 7. Support the Dental Therapy Program within the SMCS system.For more information, please see the Hospital's most recently completed Community Health Needs Assessment and Implementation Strategy attached to this return. Springfield Hospital, Inc. Part V, Section B, Line 20e: A patient financial counselor meets with patient prior to discharge if medical condition allows. 7 1 - The Windham Center 1 Hospital Court 12 Bellows Falls VT 05101 Inpatient Psych Unit 2 - Connecticut Valley Orthopaedics and Spor 29 Ridgewood Rd Springfield VT 05156 Specialty Practice 3 - Surgical Associates 29 Ridgewood Rd Springfield VT 05156 Specialty Practice 4 - Springfield Hospital Rehabilitation Serv 100 River Street Springfield VT 05156 Physical Therapy 5 - Springfield Area Adult Day Services 266 River Street Springfield VT 05156 Adult Day Services 6 - Connecticut Valley ENT 29 Ridgewood Rd Springfield VT 05156 Specialty Practice 7 - Mountain View Physical Therapy 8 Main St Ludlow VT 05149 Physical Therapy Part I, Line 7g: Amount represents funding required by Springfield Medical Care Syetems in order to operate, conduct, and provide various medical services to the community served. Part III, Line 2: The Organization used the cost to charge ratio calculated on Worksheet 2 multiplied by bad debt expense per the Organization's audited financial statements. Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. In evaluating the collectibility of accounts receivable, the Hospital analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a provision for bad debts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts. Part III, Line 8: Worksheet A from the Form 990 Instructions was used to determine the amount reported on Line 6. Part III, Line 9b: Financial assistance is written off from charges before any collection efforts are made. Part VI, Line 2: Our planning process is participative and incorporates ongoing public input regarding community health care, hospital services, and new opportunities. Conducted on an annual basis, planning includes information from various sources as outlined below: - Public Input is invited at any time through our website, e-mail, or regular mail. - Quarterly Board of Directors' meetings are open to the public.1) A community needs assessment tool is available on our website's home page, www.springfieldmed.org, that provides ongoing opportunity for community feedback. 2) A Community Relations Line offers an invitation to provide feedback directly to the Quality & Systems Improvement Department via phone or email. This contact information can be found on the home page of our website, www.springfieldmed.org, by calling 802-885-7299, or by e-mailing communityrelations@springfieldmed.org. - Ongoing information is received throughout the year to help us with our quality improvement initiatives. Our patient satisfaction survey process is conducted in cooperation with N.R.C. Picker, and monitors quality and services on a monthly basis.- Community participation and presentations are made on a regular basis to local public service and public gatherings. Outreach activity for planning and partnering with local boards, community services, and membership organizations is ongoing. This includes partnering with Vermont's Blueprint For Health, the VT Chronic Care Collaborative, the Edgar May Health & Recreation Center, emergency planning, career/education, and youth and elderly services agencies, to name a few, and provides ongoing community input. - A Community Health Team is now fully operational, meeting monthly to collaborate and partner with area agencies to remove barriers and improve access and quality of care. The team now exceeds 100 participants. New members are welcomed at each meeting as word of the team spreads throughout the community. The quarterly Community Collaborative Group is an extension of this group and all members of the Community Health Team are invited to participate as often as they wish. - Our Board of Directors and Corporators provide ongoing participation through local representation. As a small community hospital, representatives interact regularly with community members and are available to answer questions or receive feedback. - Our volunteer network, whose annual participation of over 12,000 volunteer hours, creates ongoing opportunities for patient interaction and community outreach activities. - Public meetings and events are held throughout the year allowing our community to be directly involved in our work, and public comment and suggestions are invited. Part VI, Line 3: Enrollment counselors are available at physician practice offices, at Valley Health Connections on River Street in Springfield, VT, and at Springfield Hospital to meet privately to consult with patients about their eligibility for a variety of public programs and/or financial assistance. Information is provided through certified navigators and enrollment counselors, distributed to the community via our Community Health Team and area social service agencies, and is included in every welcome packet to new patients. It is also available via our website. Part VI, Line 4: The Organization is a non-profit corporation directed by a dedicated Board of Directors comprised of patients and community members. The service area includes towns located in the Vermont counties of Windsor, Windham and Bennington; and New Hampshire counties of Sullivan (two towns) and Cheshire (one town). Springfield Medical Care Systems, the parent corporation, provides and coordinates care from nine health center locations in the towns of Springfield, Ludlow, Chester, Londonderry and Rockingham, VT, and Charlestown NH. Springfield Hospital is located in Springfield, VT. The service area is rural, primarily white, and has an older, lower income population. The community includes uninsured and Medicaid patients which represents 25% of the patient population. In NH, MUPs include Alstead, Acworth, Charlestown, Langdon and Walpole. In VT, MUPs include Rockingham, Athens, Grafton and Westminster in Windham County and Ludlow, Plymouth, Weston, and Reading in Windsor County. In addition to Springfield Hospital other area hospitals serving a portion of the service area include Brattleboro Memorial Hospital, Rutland Regional Medical Center and Grace Cottage Hospital in Vermont and Valley Regional Hospital, Cheshire Medical Center, and Dartmouth-Hitchcock Medical Center in New Hampshire. Springfield Medical Care Systems maintains collaborative working relationships with each of these institutions.Median Population by Age (2010 Census source: USA.com)Windsor County: 45.8 Windham County: 44.9Vermont: 41.5 US: 37.2Cheshire County: 40.7 Sullivan County: 43.9 NH: 41.1 Median Household IncomeWindsor County: $50,893 Windham County: $46,714 Vermont: $51,841US: $51,914Cheshire County: $48,030Sullivan County: $50,689NH: $63,277Population in PovertyWindsor County: 9.73%Windham County: 11.13%Vermont: 11.12%US: 13.82%Cheshire County: 11.8%Sullivan County: 10.04%NH: 8.29% Part VI, Line 5: The health of our area communities and access to quality health care is served through the community health center network of the organization's parent corporation, Springfield Medical Care Systems, which is the primary source of preventive and coordinated care in our service area. The organization is directed by a Board of Directors comprised of community members and patients. Free health screenings, education programs and support groups are offered throughout the year. Financial assistance is communicated broadly across the service area, available to all who qualify based on a sliding fee scale, and includes dental, vision and pharmacy assistance. Part VI, Line 6: Springfield Hospital is a subsidiary of Springfield Medical Care Systems (SMCS). SMCS is comprised of a network of primary care offices (federally-qualified health centers) that provide ongoing care and outreach to our local communities, employing a medical home model of care, and focusing on prevention and efficient care management in cooperation with the Chronic Care Collaborative and the Vermont Blueprint for Health. Need for specialty services is referred by SMCS' health center medical staff to Springfield Hospital and its outpatient specialty clinicians, other area hospitals, or to designated tertiary care facilities for the appropriate level of care as needed. 1 Springfield Medical Care Systems Inc PO Box 2003 Springfield VT 05156 030284813 501(c)(3) 1697253 The Organization received a contribution to be used for the benefit of Springfield Medical Care System, a related organization. The Organization transferred this money to Springfield Medical Care System to be used for its intended purpose. 1 Part I, Line 2: All assistance provided by the Organization during the year was to Springfield Medical Care System, a related organization, which has the same bookkeeper as the Organization and, therefore, no monitoring is deemed necessary. 0 0 0 0 0 0 0 1 1 0 Gerald Drabyn MD Director 0 192113 0 0 0 0 0 0 0 24563 0 216676 0 0 Richard Marasa MD Past Director 643744 106875 0 0 0 0 0 0 0 0 643744 106875 0 0 Timothy Ford CEO/President 0 350572 0 0 0 0 0 3583 0 14318 0 368473 0 0 Richard Summermatter MD Director 0 252305 0 0 0 0 0 5124 0 7106 0 264535 0 0 Cecil Beehler MD Chief Medical Officer 0 360574 0 0 0 0 0 5545 0 9297 0 375416 0 0 Scott Whittemore CFO 0 224809 0 0 0 1610 0 4489 0 4704 0 235612 0 0 Craig Hofsess MD Anesthesiologist 358047 0 0 0 0 0 5274 0 22811 0 386132 0 0 0 David Muller MD Orthopaedic Surgeon 535042 0 65000 0 0 0 5459 0 14535 0 620036 0 0 0 Robert Cantu MD Orthopaedic Surgeon 344440 0 10000 0 0 0 3405 0 18943 0 376788 0 0 0 Khalid Husain MD General Surgeon 362727 0 0 0 0 0 5603 0 34773 0 403103 0 0 0 Xiangtian Hu MD Anesthesiologist 410839 0 0 0 0 0 5585 0 6269 0 422693 0 0 0 Part I, Line 3 Springfield Medical Care Systems, Inc., a related organization, establishes the compensation for the Organization's CEO. Springfield Medical Care Systems, Inc. uses a variety of resources to establish compensation as follows: 1. Compensation committee 2. Independent compensation consultant 3. Written employment contract 4. Compensation survey/study 5. Approval by the board/compensation committee Part I, Line 7 David Muller received bonus compensation of $65,000 in 2017 for his productivity. Part I, Line 8 Robert Cantu received a $10,000 sign on bonus. Gerald Drabyn MD Board Member Personal Loan X 88500 60250 0 0 1 60250 Form 990, Part III, Line 4a, Program Service Accomplishments: Adult Day Care Service - Springfield Hospital operates an adult day care service, located in Springfield, VT. A cost-effective choice to long term nursing home health care, the Springfield Area Adult Day Service assists families with seniors or disabled adults, over the age of 18, who face the challenge of losing their independence. The structured program offers a safe and protective environment where nutritious meals, social activities, health care services, nursing oversight, and coordination of needed social and support services are provided. Transportation is available through an arrangement with the local bus service, The Current, at a FY 2018 cost of approximately $20,000. Annually, approximately 91 participants and see total participant visits of 8,308 annually throughout the region are served by the Springfield Area Adult Day Service. Form 990, Part VI, Section A, line 6 The Organization has corporators. Form 990, Part VI, Section A, line 7a The Organization has corporators who elect board members. Form 990, Part VI, Section A, line 7b The corporators approve the selection of the Organization's auditors and approve by-law changes. Form 990, Part VI, Section B, line 11b Form 990 is reviewed by the Organization's Chief Financial Officer and Director of Finance upon completion. Form 990, Part VI, Section B, line 12c Conflicts of interest are reviewed by the Corporate Compliance Officer and Chief Executive Officer on an annual basis. Members must recuse themselves from voting on issues where a conflict is actual or implied. Form 990, Part VI, Section B, line 15a The parent organization has a compensation committee which uses an independent compensation consultant who performs a market analysis on similar health care providers with similar revenue in order to establish the base salary of the CEO. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part IX, line 11g Collection Services: Program service expenses 0. Management and general expenses 85,151. Fundraising expenses 0. Total expenses 85,151. Purchased Services: Program service expenses 2,528,591. Management and general expenses 583,124. Fundraising expenses 0. Total expenses 3,111,715. Contracted Services: Program service expenses 5,161,076. Management and general expenses 712,021. Fundraising expenses 0. Total expenses 5,873,097. Locum Expense: Program service expenses 1,335,602. Management and general expenses 985,704. Fundraising expenses 0. Total expenses 2,321,306. Consulting Services: Program service expenses 0. Management and general expenses 76,005. Fundraising expenses 0. Total expenses 76,005. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Springfield Hospital, Inc. PO Box 2003 Springfield, VT 05156 EIN: 03-0179437 Springfield Hospital, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Change in Net Assets to Recognize Funded Status of Pension Plan 889,811. Springfield Medical Care Systems Inc PO Box 2003 Springfield VT 05156 030284813 Primary medical care, support and enabling VT 501(c)(3) Line 3 N/A 0 0 1 0 0 0 0 0 0 1 1 0 0 1 0 1 0 0 1 0