2018-07-31T10:04:51-05:00 2017-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2016-10-01 030183483 RUTLAND HOSPITAL INC % JUDI K FOX RUTL 8027757111 160 ALLEN STREET RUTLAND VT 05701 JUDI K FOX CFO 8027757111 2018-05-30 true Brian D Todd P00422601 4178658701 2016 2022-09-23 18:48:47Z RUTLAND REGIONAL MEDICAL CENTER CLAUDIO D FORT 160 ALLEN STREET RUTLAND VT 05701 265897178 false X WWW.RRMC.ORG X 1892 VT TO PROVIDE COMPREHENSIVE INPATIENT AND OUTPATIENT MEDICAL SERVICES AND TO IMPROVE HEALTH OF THE RESIDENTS OF RUTLAND AND SURROUNDING COUNTIES. SEE SCHEDULE O ADD'L INFORMATION. 18 13 1900 345 2228674 -65992 2385744 4023170 256648259 257500461 3262431 3189523 5581 84510 262302015 264797664 961077 672031 0 0 144142230 150187163 0 0 182081 102531129 106135857 247634436 256995051 14667579 7802613 260183979 274435855 102051409 83784181 158132570 190651674 X TO IMPROVE THE HLTH OF THE RUTLAND REGION AND SURROUNDING COMMUNITIES BY PROVIDING APPROPRIATE, SUPERIOR, INTEGRATED, PREVENTATIVE, DIAGNOSTIC AND THERAPEUTIC HEALTH SERVICES IN A CARING ENVIRONMENT THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY & RELATIONSHIPS. false false 111391263 139747635 ANCILLARY CARE. ANCILLARY CARE SERVICES INCLUDE OPERATING ROOM, EMERGENCY ROOM, PHYSICAL REHABILITATION, ANESTHESIOLOGY, ONCOLOGY, PULMONARY, RESPIRATORY, PHYSICAL THERAPY, CARDIAC CATH, ENDOSCOPY, AMBULATORY, DELIVERY, RADIATION, PSYCHIATRIC COUNSELING, OCCUPATIONAL THERAPY, RECOVERY, HIV CLINIC, AND SPEECH THERAPY. SEE SCHEDULE O FOR MORE INFORMATION. 41505907 52071879 INPATIENT CARE. INPATIENT CARE SERVICES INCLUDE MEDICAL AND SURGICAL, INTENSIVE CARE, HOSPITALISTS, PSYCHIATRIC, OBSTETRICS AND GYNECOLOGY, NURSERY, AND NURSING. SEE SCHEDULE O FOR MORE INFORMATION. 25589453 32103644 DIAGNOSTIC SERVICES. DIAGNOSTIC SERVICES INCLUDE LABORATORY, RADIOLOGY, ELECTROENCEPHALOGRAPHY, AND CT SCANNING. SEE SCHEDULE O FOR MORE INFORMATION. 26914339 672031 33577303 205400962 true true false true false false false false false true true false false false true false true true false false false false false false true false true true true false true true false false false false false false false false false true false false false false false true false false false true 193 0 true 1900 true true true false false false false true true false false false false X 18 13 false false false false true true true true true false false true true true true true true true false false X JUDI K FOX 8027757111 160 ALLEN STREET RUTLAND VT 05701 X MICHAEL J KENOSH MD DIRECTOR 40.0 1.0 X 553713 0 71981 JOSEPH KRAUS SECRETARY 1.0 1.0 X X 0 0 0 DENISE CLARK DIRECTOR 1.0 1.0 X 0 0 0 MIKE SOLIMANO VICE CHAIR 1.0 1.0 X X 0 0 0 TODD GREGORY MD DIRECTOR 40.0 1.0 X 363000 0 48491 PAUL GALLO DIRECTOR 1.0 1.0 X 0 0 0 JOHN CASELLA CHAIR 1.0 1.0 X X 0 0 0 JESSICA ANDERSON DIRECTOR ENDING 4/2017 1.0 1.0 X 0 0 0 MICHELE NELSON DIRECTOR BEGINNING 4/2017 1.0 1.0 X 0 0 0 MEGAN SMITH DIRECTOR ENDING 4/2017 1.0 1.0 X 0 0 0 MARK FOLEY JR DIRECTOR BEGINNING 4/2017 1.0 1.0 X 0 0 0 MICHAEL DICK DMD DIRECTOR 1.0 1.0 X 0 0 0 CORT JONES DIRECTOR 1.0 1.0 X 0 0 0 TJ SABOTKA DIRECTOR 1.0 1.0 X 0 0 0 LARRY JENSEN DIRECTOR 1.0 1.0 X 0 0 0 STEPHEN LEFFLER MD DIRECTOR 1.0 1.0 X 0 0 0 JOHN R BUTTERLY MD DIRECTOR 1.0 1.0 X 0 0 0 STANLEY M SHAPIRO MD DIRECTOR 40.0 1.0 X 528591 0 50039 ERIC MARSH MD DIRECTOR 40.0 1.0 X 954844 0 48402 RON J CIOFFI DIRECTOR 1.0 1.0 X 0 0 0 THOMAS W HUEBNER PRESIDENT / CEO 40.0 1.0 X 555839 0 77239 JUDI K FOX CFO 40.0 1.0 X 204672 0 49132 MELBOURNE D BOYTON MD ORTHOPEDIC SRGN/CHIEF MED OFFR 40.0 0.0 X 1064035 0 72038 SCOTT J GRAHAM MD CHIEF MEDICAL INFO OFFICER 40.0 0.0 X 335010 0 48467 PHILIP R LAPP MEDICAL DIRECTOR 40.0 0.0 X 291174 0 53679 BARBARA M ROBINSON VP CLINICAL SERVICES 40.0 0.0 X 276092 0 39202 CAROL M EGAN VP CHIEF NURSING OFFICER 40.0 0.0 X 218631 0 46024 MARY T NEMETH VP CORPORATE SUPPORT SERVICES 40.0 0.0 X 215995 0 34201 JOHN WALLACE GEN COUNSEL COMPLIANCE OFFICER 40.0 0.0 X 201539 0 40570 BRIAN KERNS VP HUMAN RESOURCES 40.0 0.0 X 196055 0 57729 JEFFREY MCKEE VP COMMUNITY & BEH HEALTH SVCS 40.0 0.0 X 184508 0 9408 WILLIAM A LIGHTHART MD ORTHOPAEDICS 40.0 0.0 X 926985 0 48433 MICHAEL ROBERTELLO MD CARDIOLOGY 40.0 0.0 X 733886 0 68177 MATTHEW ZMURKO MD ORTHOPAEDICS 40.0 0.0 X 510639 0 65726 ANN STIEN MD ORTHOPAEDICS 40.0 0.0 X 506152 0 59349 DALE JANIK MD GASTRONENTEROLOGY 40.0 0.0 X 502841 0 62092 EDWARD T OGORZALEK FORMER CFO 0.0 0.0 X 294421 0 68508 DARREN CHILDS FORMER VP QUALITY IMPROVEMENT 0.0 0.0 X 158997 0 34197 9777619 0 1153084 150 true true false CERNER CORP CORP ST LOUIS MO 631959156 PROFESSIONAL SERVICE 4716021 SHERIDAN HEALTHCARE OF VERMONT PO BOX 452197 SUNRISE FL 333232197 ANESTHESIOLOGISTS 1829539 UNIVERSITY OF VT MED CTR PO BOX 1902 BURLINGTON VT 05402 LAB SERVICES 1036846 RANSTAD NORTH AMERICA 13792 COLLECTIONS CENTER DRIVE CHICAGO 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12801745 9391468 3410277 2566448 2566448 MEDICAL SUPPLIES & DRUGS 29007280 29007280 MEDICAID TAX ASSESSMENT 14644716 14644716 BAD DEBTS 7056413 7056413 LICENSES, DUES, SUBSCRIPTIONS 1193739 584637 609102 460966 126226 334740 256995051 205400962 51412008 182081 X 5412 5075 14381749 10360498 165061 105295 24064311 27274766 0 0 0 0 2577374 2710306 1442117 1735125 3148062 3357235 251070186 169932960 81726125 81137226 120103600 134856071 0 0 0 0 0 0 12570168 12894258 260183979 274435855 31559422 30593852 0 0 0 0 31350000 31196435 0 0 0 0 8791244 6862654 0 0 30350743 15131240 102051409 83784181 X 153266261 185674131 4187667 4298901 678642 678642 158132570 190651674 260183979 274435855 X 7802613 10771700 13944791 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X X false true true false false false false true 80755 false true 25496 106251 false SCHEDULE C, PART II-B, LINE 1 LOBBYING EXPENSES: THE ORGANIZATION PAID LOBBYING FEES OF $75,925 TO A PROFESSIONAL GOVERNMENT AFFAIRS AND COMMUNICATION STRATEGIES COMPANY. THE ORGANIZATION'S CEO, THOMAS HUEBNER, SPENDS TIME EACH YEAR WORKING DIRECTLY WITH STATE LEGISLATORS TO IMPROVE SERVICES FOR THE RUTLAND REGION. APPROXIMATELY .0094%, OR $4,830, OF HIS SALARY IS ALLOCATED TO THIS ACTIVITY. ALSO, DUES ARE PAID TO THE HOSPITAL ASSOCIATION AND THE VERMONT HOSPITAL ASSOCIATION. A PORTION OF DUES IS ATTRIBUTABLE TO LOBBYING: $ 18,185 VHA 7,311 AHA -------- $ 25,496 7634079 74330 7019302 689107 7285252 348827 7634079 7589626 21075 325449 7285252 7458038 376664 245076 7589626 7419888 303224 265074 7458038 0.70560 0.29440 false false 645676 645676 42271274 25875001 16396273 61706962 29815415 31891547 139441938 112131397 27310541 7004336 2111147 4893189 81137226 0 ACCRUED PENSION 7244302 EST AMTS DUE TO THIRD PARTY 7886938 15131240 282519995 10771700 7572559 18344259 264175736 48720 573208 621928 264797664 250112125 222207 222207 249889918 48720 7056413 7105133 256995051 SCHEDULE D, PART V, LINE 1E, COLUMN A OTHER EXPENDITURES FOR FACILITIES AND PROGRAMS: THE AMOUNT LISTED AS OTHER EXPENDITURES WAS A RECLASSIFICATION OF FUNDS RATHER THAN AN EXPENDITURE. THE AMOUNT IS COMPRISED OF THE FOLLOWING: $ 6,898,042 UNRESTRICTED CHANGES IN ENDOWMENT NET ASSETS 121,260 TEMPORARILY RESTRICTED CHANGES IN ENDOWMENT NET ASSETS ----------- $ 7,019,302 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUND PURPOSE: RRMC'S ENDOWMENTS CONSIST OF VARIOUS INDIVIDUAL DONOR-RESTRICTED AND BOARD DESIGNATED FUNDS WHICH WERE ESTABLISHED FOR GENERAL OPERATIONAL AND CERTAIN DEPARTMENTAL PURPOSES. AS REQUIRED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA (GAAP), NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. RRMC'S GOVERNING BODY HAS INTERPRETED THE STATE OF VERMONT PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT (SPMIFA), ADOPTED IN MAY OF 2009, AS REQUIRING PRESERVATION OF THE FAIR VALUE OF THE ORIGINAL GIFT AS OF THE GIFT DATE OF THE DONOR-RESTRICTED ENDOWMENT FUNDS ABSENT EXPLICIT DONOR STIPULATIONS TO THE CONTRARY. AS A RESULT OF THIS INTERPRETATION, RRMC CLASSIFIES AS PERMANENTLY RESTRICTED NET ASSETS (A) THE ORIGINAL VALUE OF GIFTS DONATED TO THE PERMANENT ENDOWMENT, (B) THE ORIGINAL VALUE OF SUBSEQUENT GIFTS TO THE PERMANENT ENDOWMENT AND (C) ACCUMULATIONS TO THE PERMANENT ENDOWMENT MADE IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE ACCUMULATION IS ADDED TO THE FUND. THE REMAINING PORTION OF DONOR-RESTRICTED ENDOWMENT FUNDS IS CLASSIFIED AS TEMPORARILY RESTRICTED NET ASSETS UNTIL THOSE AMOUNTS ARE APPROPRIATED FOR EXPENDITURE BY RRMC IN A MANNER CONSISTENT WITH THE STANDARD OF PRUDENCE PRESCRIBED BY SPMIFA. IN ACCORDANCE WITH SPMIFA, RRMC CONSIDERS THE FOLLOWING FACTORS IN MAKING A DETERMINATION TO APPROPRIATE OR ACCUMULATE DONOR-RESTRICTED ENDOWMENT FUNDS: 1. DURATION AND PRESERVATION OF THE FUND 2. PURPOSES OF RRMC AND THE FUND 3. GENERAL ECONOMIC CONDITIONS 4. POSSIBLE EFFECT OF INFLATION AND DEFLATION 5. EXPECTED TOTAL RETURN FROM INVESTMENT INCOME AND APPRECIATION OR DEPRECIATION OF INVESTMENTS 6. OTHER RESOURCES OF RRMC 7. INVESTMENT POLICIES OF RRMC 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: $ 12,090,471 NET LOSS FROM DEF BEN PLAN & POSTRETIREMENT BEN COST 1,854,320 LOSS ON INTEREST RATE SWAP AGREEMENT 684,181 NET ASSETS RELEASED FROM RESTRICTIONS ( 7,056,413) PROVISION FOR UNCOLLECTIBLE ACCOUNTS ------------ $ 7,572,559 SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12 BUT NOT ON LINE 1: $ 550,084 TEMPORARILY RESTRICTED CONTRIBUTIONS 245,331 TEMPORARILY RESTRICTED INVESTMENT RETURN ( 68,761) SPECIAL EVENTS EXPENSE ( 153,446) RENTAL EXPENSES ------------ $ 573,208 SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 153,446 RENTAL EXPENSES 68,761 SPECIAL EVENTS EXPENSE ----------- $ 222,207 SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 7,056,413 PROVISION FOR UNCOLLECTIBLE ACCOUNTS GOLF TOURN 40218 18118 22100 248 5005 15013 15168 GREEN MT GALA 122256 107651 14605 17371 10403 1 19452 9162 10290 825 4728 181926 134931 46995 248 5005 33209 30299 68761 -21766 true true X true X 300. true X 500. true true true false true true 3155478 3155478 0.01260 63433635 37777933 25655702 0.10260 66589113 37777933 28811180 0.11520 8 25896 2465526 1864622 600904 0.00240 1048515 1048515 0.00420 65949803 45249383 20700420 0.08280 634632 634632 0.00250 8 25896 70098476 47114005 22984471 0.09190 8 25896 136687589 84891938 51795651 0.20710 1 200 185509 185509 0.00070 1 300 51215 51215 0.00020 1 71464 71464 0.00030 1 3491 3491 4 500 311679 311679 0.00120 false 7056413 938503 72059092 94342412 -22283320 X true true 1 1 RUTLAND HOSPITAL 160 ALLEN STREET RUTLAND VT 05701 WWW.RRMC.ORG 884 X X X MED DEV RURAL COMMUNITY HOSPITAL RUTLAND HOSPITAL 1 false false true X X X X X X X X 15 true false false true X SEE PART V SECTION C X SEE PART V SECTION C X X true 15 true SEE PART V SECTION C false true X 300. 500. X X X X true true X X X X true X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: RUTLAND REGIONAL MEDICAL CENTER CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY WE SERVE THROUGH INTERACTIONS WITH THE STATE OF VERMONT HEALTH DEPARTMENT AND THE DEPARTMENT OF VERMONT HEALTH ACCESS, THE PUBLIC, OTHER COMMUNITY ORGANIZATIONS, FEEDBACK FROM MEDICAL PROVIDERS AND PATIENTS, ALONG WITH NOTING TRENDS IN UTILIZATION OF SERVICES AND PRESENTATION OF ILLNESS, INJURY AND DISEASE. ONE INPUT TO THIS ONGOING REVIEW IS THE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IS CONDUCTED EVERY THREE (3) YEARS. TO IDENTIFY AND PRIORITIZE THE HEALTH NEEDS OF THE HOSPITAL SERVICE AREAS CONSTITUENTS. THE PROCESS TAKES INTO CONSIDERATION AVAILABLE DATA REPORTS ON HEALTH INDICATORS AND RECOMMENDED HEALTH OUTCOME METRICS, AND COMBINES THIS INFORMATION WITH INPUT FROM COMMUNITY MEMBERS AND LEADERS. WE TAKE INTO CONSIDERATION THE INFLUENCE OF ENVIRONMENT, ACCESS TO HEALTHCARE, HEALTHY LIFESTYLE CHOICES, AND SOCIOECONOMIC FACTORS AND THE EFFECT THEY HAVE INDIVIDUALLY AND COLLECTIVELY ON HEALTH STATUS OF A COMMUNITY. TO ACHIEVE THIS, WE HAVE USED A SIX-STEP APPROACH TO CONDUCTING THIS AND OTHER NEEDS ASSESSMENTS, INCLUDING: 1. DEFINING THE COMMUNITY WE SERVE (OUR HOSPITAL SERVICE AREA); 2. CONDUCTING SECONDARY RESEARCH TO COLLECT DATA FROM OTHER SOURCES TO ANALYZE EXISTING DATA THAT RELATES TO THE HEALTH STATUS OF THE POPULATION; 3. CONDUCTING SURVEYS OF COMMUNITY MEMBERS AS CONSUMERS OF HEALTH SERVICES; 4. SOLICITING INPUT FROM COMMUNITY LEADERS; 5. REVIEW THE INFORMATION COLLECTED TO IDENTIFY THE NEEDS OF OUR COMMUNITY; 6. PRIORITIZE AND REPORT THE IDENTIFIED NEEDS AND RECOMMENDATIONS. TO OVERSEE THE WORK PERFORMED, WE COLLABORATE WITH COMMUNITY LEADERS WITH SPECIAL KNOWLEDGE OR EXPERTISE OF PUBLIC HEALTH, COMMUNITY HEALTH AND SOCIAL SERVICES, AND TARGET POPULATIONS, TO SERVE AS AN ADVISORY COMMITTEE THROUGHOUT THE PROCESS OF COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS GROUP OF INDIVIDUALS BROUGHT DIVERSITY OF PERSPECTIVE TO THE PROCESS: - VERMONT DEPARTMENT OF HEALTH - RUTLAND MENTAL HEALTH SERVICES, INC. - VISITING NURSE ASSOCIATION AND HOSPICE OF THE SOUTHWEST REGION. - RUTLAND HOUSING AUTHORITY - COMMUNITY MEMBER, BOARD MEMBER OF COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, COMMISSIONER RUTLAND CITY POLICE - RUTLAND BLUEPRINT MANAGER, RUTLAND REGIONAL MEDICAL CENTER - PSYCHIATRIC SERVICES AND WEST RIDGE TREATMENT CENTER, RUTLAND REGIONAL MEDICAL CENTER - DIVISION OF ALCOHOL AND DRUG ABUSE PROGRAMS, VERMONT DEPARTMENT OF HEALTH - RUTLAND REGIONAL PLANNING COMMISSION - UNITED WAY OF RUTLAND COUNTY THE ADVISORY COMMITTEE MET MONTHLY BEGINNING IN MAY OF 2014 TO MONITOR THE PROGRESS OF THE WORK, PROVIDE INPUT AND SUPPORT, AND TO PROVIDE ASSISTANCE WHEN NECESSARY. IN ADDITION TO THE ADVISORY COMMITTEE IS AN OVERSIGHT COMMITTEE, MADE UP OF A DIVERSE COMBINATION OF COMMUNITY PARTNERS, THE BOWSE COMMUNITY HEALTH IMPROVEMENT COMMITTEE. THE BOWSE COMMUNITY HEALTH IMPROVEMENT COMMITTEE IS CHARGED WITH GENERAL OVERSIGHT OF RUTLAND REGIONAL MEDICAL CENTERS COMMUNITY SERVICE, OR BENEFITS PROVIDED TO THE COMMUNITY ABOVE AND BEYOND THEIR PRIMARY ROLE AS A PROVIDER OF HOSPITAL-BASED MEDICAL SERVICES. AS SUCH, THIS GROUP PROVIDED VALUABLE FEEDBACK THROUGHOUT THE PROCESS AS STAKEHOLDERS IN THE HEALTH AND PROMOTION OF HEALTH ACROSS OUR COMMUNITY. SCHEDULE H, PART V, SECTION B, LINE 7A CHNA AVAILABILITY: THE MOST RECENTLY CONDUCTED CHNA REPORT CAN BE FOUND AT THE FOLLOWING URL: HTTP://WWW.RRMC.ORG/APP/FILES/PUBLIC/1615/COMMUNITY-HEALTH-NEEDS-ASSESSMEN T-2015-2017.PDF SCHEDULE H, PART V, SECTION B, LINE 7B CHNA OTHER WEBSITE: http://gmcboard.vermont.gov/hospital-budget/health-needs SCHEDULE H, PART V, SECTION B, LINE 7D CHNA AVAILABILITY TO PUBLIC: THE COMMUNITY BENEFITS COORDINATOR DEVELOPED AND FOLLOWED A COMMUNICATION PLAN UTILIZING ELECTRONIC COMMUNICATION, CONFERENCE CALLS, NEWSPAPER ARTICLES AND PRESENTATIONS THROUGHOUT THE COMMUNITY TO DISSEMINATE THE COMMUNITY HEALTH NEEDS ASSESSMENT, SPECIFICALLY, MORE THAT 20 PRESENTATIONS WERE HOSTED BY AREA AGENCIES AND COALITION, WITHIN THE HOSPITAL ORGANIZATION, FOR THE REGIONAL VT DEPT OF HEALTH AND IN PUBLIC MEETINGS FOR THE ROTARY AND UNITED WAY MEMBERSHIP. SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY: THE IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL: http://www.rrmc.org/app/files/public/1682/Implementation-Strategy-2015-201 7-.pdf SCHEDULE H, PART V, SECTION B, LINE 11 IMPLEMENTATION STRATEGY: THE CHNA PROCESS HAS PROVEN A VALUABLE TOOL BOTH TO IDENTIFY AREAS WHERE ATTENTION SHOULD BE FOCUSED TO ADDRESS CERTAIN NEEDS AND CONCERNS, AND TO KEEP THE DIALOG GOING BETWEEN ORGANIZATIONS AND COMMUNITY MEMBERS TO SHARE INFORMATION, INSIGHTS, AND PLANS FOR THE FUTURE, AND TO HELP IDENTIFY OPPORTUNITIES FOR COLLABORATION TO ADDRESS IDENTIFIED NEEDS. THIS ROUND OF THE CHNA INVOLVED DISCUSSION OF THE MANY PROJECTS AND PROGRAMS THAT ARE WORKING TO ADDRESS NEEDS ACROSS OUR COMMUNITY THAT HAVE BEEN IDENTIFIED THROUGH EARLIER ASSESSMENTS, WHILE DRAWING OUR ATTENTION TO SOME CHANGES IN THE NEEDS OF OUR COMMUNITY. THESE CHANGES ARE DUE IN PART TO THE CHANGING CULTURE OF HEALTH AND HEALTH CARE. IN SOME WAYS, WE BEGAN TO THINK BIGGER, AND IN OTHERS WE FOUND OURSELVES MORE FOCUSED ON SPECIFIC ISSUES WITHIN A CATEGORY OF INTEREST. FOR EXAMPLE, WE CONTINUE TO SEE THE RELATIONSHIP OF HEALTH NEEDS, SERVICES, AND CULTURE IN RUTLAND COUNTY AS DEPICTED HERE, BUT WE ARE SEEING MORE INTEREST AND EMPHASIS ON STRENGTHENING THE FOUNDATION THROUGH CULTURE CHANGE. COMMUNITY HEALTH IMPROVEMENT IS A BROAD TERM THAT ENCOMPASSES MANY ASPECTS AND ELEMENTS, FROM THE INDIVIDUAL TO THE HEALTH SYSTEM AS A WHOLE. CONSIDERING THIS AND TRYING TO TARGET KEY ISSUES THAT WILL HAVE A SIGNIFICANT IMPACT ON OUR COMMUNITY, THESE ARE THE PRIORITY AREAS WE HAVE IDENTIFIED: I. CLINICAL CARE: KEY ISSUES TO ADDRESS: - MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR ADULTS AND YOUTH - RECRUITMENT AND RETENTION OF PRIMARY CARE PROVIDERS, BOTH MEDICAL AND DENTAL IMPORTANCE: - TO CONTINUE TO ADDRESS THE DRUG PROBLEM IN OUR COMMUNITY, THROUGH TREATMENT, AFTERCARE AND PREVENTION. - TO CONTINUE TO IMPROVE ACCESS TO CARE FOR ALL COMMUNITY MEMBERS. II. HEALTHY BEHAVIORS: KEY ISSUES TO ADDRESS: - LIFE SKILLS FOR YOUTH - PHYSICAL ACTIVITY FOR AND BY ADULTS AND YOUTH IMPORTANCE: - TO IMPROVE AND PROMOTE HEALTHY CHOICES AND ACTIVITIES TO SUPPORT A HEALTHY COMMUNITY IN WHICH TO LIVE AND RAISE A FAMILY. III. SOCIAL AND ECONOMIC DETERMINANTS KEY ISSUES TO ADDRESS: - RECRUITMENT AND RETENTION OF BUSINESSES AND PEOPLE TO THE AREA - SOCIETAL CULTURE BUILDING - EDUCATIONAL ATTAINMENT IMPORTANCE: - TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY, MAKING IT AN ATTRACTIVE PLACE TO LIVE AND WORK. IV. PHYSICAL ENVIRONMENT: KEY ISSUES TO ADDRESS: -HOUSING -TRANSPORTATION, VEHICULAR IMPORTANCE: -TO IMPROVE INFRASTRUCTURE TO SUPPORT A HEALTHY COMMUNITY WITH ACCESS TO WORK, RECREATIONAL OPPORTUNITIES, AND SERVICES. AS THE PRIORITY AREAS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT OVERLAP, THERE ARE SHARED PURPOSES OF MANY OF THE INITIATIVES OUTLINED HERE. WE NEED THE STRENGTH OF THE TRIAD. THE HOSPITALS ACTIVITIES, POLICY CHANGE, AND COMMUNITY COMMITMENT TO REALIZE CHANGE IN THE HEALTH STATUS OF OUR COMMUNITY AND ITS MEMBERS. RUTLAND REGIONAL MEDICAL CENTER (RRMC) LEADS AND PARTNERS IN MANY COLLABORATIVE INITIATIVES TO ADDRESS ISSUES OF ACCESS TO AND UTILIZATION OF HEALTH CARE SERVICES, AND TO IMPROVE AND PROMOTE HEALTHY CHOICES AND BEHAVIORS; WE SUPPORT RELY ON COMMUNITY ORGANIZATIONS THAT WORK TO INFLUENCE SOCIAL, PHYSICAL AND ECONOMIC FACTORS THAT ARE BEYOND THE SCOPE OF A HEALTHCARE ORGANIZATIONS CONTROL OR EXPERTISE. IN OUR RURAL COMMUNITY, COLLABORATION AND COORDINATION ARE BOTH NECESSARY AND BENEFICIAL TO AFFECTING CHANGE. THIS IMPLEMENTATION STRATEGY HIGHLIGHTS THE ACTIONS RRMC WILL EMPLOY THAT ARE NEW OR SIGNIFICANT IMPROVEMENTS BUILDING UPON EXISTING EFFORTS TO ADDRESS THE PRIORITIZED HEALTH NEEDS. COMMUNITY HEALTH PRIORITIES: A. MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR ADULTS AND YOUTH ANTICIPATED IMPACT: - REDUCE BARRIERS TO CARE - IDENTIFY ISSUES EARLY TO REDUCE SUBSTANCE ABUSE - IMPROVE RECOVERY SUCCESS - REDUCE INAPPROPRIATE UTILIZATION OF SERVICES GOALS: 1. INCREASE NUMBER OF PEOPLE RECEIVING TREATMENT; 2. REDUCE WAITLIST OCCUPANCY; 3. REDUCE HIGH SCHOOL SENIOR BINGE DRINKING AND MISUSE OF PRESCRIPTION DRUGS ACTIVITIES: 1. OPERATIONALIZE AND INTEGRATE SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIRT) MODEL IN THE EMERGENCY DEPARTMENT AT RRMC LEAD ORGANIZATION/PARTNER(S): - RRMC, STATE OF VERMONT PERFORMANCE MEASURES: - NUMBER OF AREAS SBIRT EMPLOYED AT RRMC; NUMBER OF SCREENS COMPLETED 2. MEDICATION ASSISTED TREATMENT EXPANSION AT WEST RIDGE RECOVERY CENTER, THE OPIATE TREATMENT HUB OWNED AND OPERATED BY RRMC LEAD ORGANIZATION/PARTNER(S): - RRMC, STATE OF VERMONT PERFORMANCE MEASURES: - NUMBER OF PATIENTS SERVED; AVERAGE WAITLIST OCCUPANCY; WAIT TIME FOR APPOINTMENT 3. EXPANSION OF OPIATE TREATMENT SPOKES, BY PROVIDING SUPPORT TO EMBED NURSING AND CLINICAL ADDICTIONS/BEHAVIORAL HEALTH COUNSELORS IN PRACTICES PRESCRIBING BUPRENORPHINE LEAD ORGANIZATION/PARTNER(S): - RRMC, SPOKE PRACTICES PERFORMANCE MEASURES: - NUMBER OF SPOKE SITES; NUMBER OF FTES; NUMBER OF PATIENTS SERVED 4. SUPPORT THE EXPANSION OF COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION (CHCRR), OUR FEDERALLY QUALIFIED HEALTH CENTERS, TO ADDITIONAL PRIMARY CARE LOCATIONS, AND THROUGH EXPLORATION OF MODELS OF SERVICE DELIVERY (TRANSITIONS OF CARE, CASE MANAGEMENT, CARE COORDINATION). LEAD ORGANIZATION/PARTNER(S): - RRMC, CHCRR PERFORMANCE MEASURES: - NUMBER OF PRIMARY CARE SITES 5. IMPLEMENTATION AND PROMOTION OF A TOBACCO FREE SUPPORT GROUP, TO BRIDGE THE GAP BETWEEN CESSATION AND SUSTAINABILITY, IN COLLABORATION WITH OUR COMMUNITY PARTNERS. LEAD ORGANIZATION/PARTNER(S): - RRMC, EVERGREEN SUBSTANCE ABUSE SERVICES, TURNING POINT CENTER OF RUTLAND, AND RUTLAND AREA PREVENTION COALITION PERFORMANCE MEASURES: - NUMBER OF SITES; NUMBER OF GROUPS OFFERED; NUMBER OF ATTENDEES 6. TOBACCO CESSATION PROGRAMMING THROUGH COMMUNITY-BASED WORKSHOPS WILL CONTINUE TO BE STRENGTHENED AND EXPANDED, WITH EXPLORATION OF APPROACHES FOR SPECIFIC POPULATIONS (COLLEGE STUDENTS, PREGNANT WOMEN). LEAD ORGANIZATION/PARTNER(S): - RRMC PERFORMANCE MEASURES: - NUMBER OF SITES; NUMBER OF WORKSHOPS; NUMBER OF ATTENDEES 7. CONTINUE OUR RECRUITMENT AND RETENTION EFFORTS, PARTICULARLY FOR MEDICAL PROVIDERS, AND PSYCHIATRIC PROVIDERS FOR ADULTS AND CHILDREN. LEAD ORGANIZATION/PARTNER(S): - RRMC, CHCRR, RUTLAND MENTAL HEALTH SERVICES (RMHS) PERFORMANCE MEASURES: - NUMBER RECRUITED; NUMBER OF FTES PRIMARY CARE B. PROMOTE A HEALTHY CULTURE BY POSITIVELY INFLUENCING HEALTHY BEHAVIORS, SOCIAL AND ECONOMIC DETERMINANTS, AND PHYSICAL ENVIRONMENT ANTICIPATED IMPACT: - IMPROVE AND PROMOTE HEALTHY CHOICES AND ACTIVITIES - IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY - IMPROVE INFRASTRUCTURE TO SUPPORT A HEALTHY COMMUNITY WITH ACCESS TO WORK, RECREATIONAL OPPORTUNITIES AND SERVICES - INCREASE SKILLS, FOR PERSON AND FAMILY GOALS: 1. INCREASE NUMBER OF PEOPLE EATING RECOMMENDED FRUITS AND VEGETABLES; 2. INCREASE PERCENT OF RUTLAND RESIDENTS THAT ARE PHYSICALLY ACTIVE; 3. REDUCE RUTLAND COUNTY RESIDENTS REPORTING POOR MENTAL HEALTH DAYS; 4. IMPROVE EDUCATIONAL ATTAINMENT; 5. REDUCE PERCENT OF RUTLAND COUNTY RESIDENTS USING TOBACCO; 6. INCREASE RATE OF EXCLUSIVE BREASTFEEDING. ACTIVITIES: 1. RRMC TO GRANT FUNDS TO COMMUNITY-BASED PROJECTS THAT AIM TO IMPROVE THE HEALTH STATUS OF RESIDENTS IN THE RUTLAND REGION THROUGH THE BOWSE HEALTH TRUST. LEAD ORGANIZATION/PARTNER(S): - RRMC PERFORMANCE MEASURES: - NUMBER PROGRAMS FUNDED; AMOUNT OF FUNDING AWARDED 2. EXPLORE AND IMPLEMENT HEALTH AND WELLNESS SERVICES AND/OR FACILITIES TO RESPOND TO COMMUNITY HEALTH AND WELLNESS NEEDS, IN COLLABORATION WITH COMMUNITY PARTNERS. LEAD ORGANIZATION/PARTNER(S): - RRMC PERFORMANCE MEASURES: - NUMBER RECRUITED; NUMBER OF PROGRAMS OFFERED 3. SUPPORT AND PROMOTE TOBACCO FREE PUBLIC PLACES, HOUSING, ETC. THROUGH POLICIES, ORDINANCES AND CULTURE CHANGE. LEAD ORGANIZATION/PARTNER(S): - RRMC PERFORMANCE MEASURES: - NUMBER OF NEW SITES 4. OPERATIONALIZE AND IMPLEMENT THE CENTERING PREGNANCY MODEL FOR PREGNANT WOMEN, TO IMPROVE OUTCOMES BY ENGAGING PATIENTS AND PROMOTING HEALTHY CHOICES, SUCH AS BREASTFEEDING. LEAD ORGANIZATION/PARTNER(S): - RRMC PERFORMANCE MEASURES: - NUMBER OF PARTICIPANTS; PERCENT OF PARTICIPANTS MAKING ONE HEALTH PROMOTION CHANGE; PERCENT OF BREASTFEEDING AT DISCHARGE RUTLAND REGIONAL MEDICAL CENTER IS THE LEAD HEALTH ORGANIZATION FOR OUR REGION, PROVIDING MANY SERVICES AND PROGRAMS TO RESPOND TO THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS. IN SOME SITUATIONS, HOWEVER, DUE TO CAPACITY LIMITATIONS, OR SIMPLY THE NATURE OF THE WORK, RRMC IS NOT THE NATURAL OR LOGICAL RESOURCE OR LEADER. THE PRIORITIZED NEEDS IDENTIFIED IN OUR CHNA RELATED TO SOCIAL AND ECONOMIC DETERMINANTS AND PHYSICAL ENVIRONMENT, FALL INTO THIS CATEGORY. THERE ARE MANY NEW AND EMERGING PROJECTS AND ACTIVITIES BEING LED BY OTHER COMMUNITY PARTNERS THAT WILL HAVE AN IMPACT ON THE HEALTH STATUS OF OUR COMMUNITY; THEREFORE, WE PROVIDE SOME SPECIFIC EXAMPLES HERE OF INITIATIVES BEING LED BY OTHERS: I. ACCESS TO AND UTILIZATION OF CARE: - SUBSTANCE ABUSE AND ELDERLY IS A LOCAL PROJECT ENHANCEMENT OF THE REGIONAL ACTIVITIES OF THE STATEWIDE ELDERCARE PROGRAM. SCHEDULE H, PART V, SECTION B, LINE 16A FINANCIAL ASSISTANCE POLICY AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: http://www.rrmc.org/app/files/public/1430/FAP-Policy_2017.pdf SCHEDULE H, PART V, SECTION B, LINE 16B FINANCIAL ASSISTANCE POLICY APPLICATION FORM AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY APPLICATION FORM IS AVAILABLE AT THE FOLLOWING URL: http://www.rrmc.org/app/files/public/533/pdf-forms-FreeCareForm.pdf SCHEDULE H, PART V, SECTION B, LINE 16C FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY AVAILABILITY: THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: http://www.rrmc.org/app/files/public/1345/FAP-Summary.pdf SCHEDULE H, PART V, SECTION B, LINE 16I LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER THE IRC SECTION 501(R). HOWEVER, THE ORGANIZATION HAS A CONTRACT WITH A TRANSLATIONS SERVICE PROVIDER. 13 RUTLAND HEART CENTER 12 COMMONS STREET RUTLAND VT 05701 PATIENT CLINIC RUTLAND REG DIABETES & ENDOCRINOLOGY CTR 8 ALBERT CREE DRIVE RUTLAND VT 05701 PATIENT CLINIC RUTLAND REGIONAL GENERAL SURGERY 6 COMMONS STREET RUTLAND VT 05701 PATIENT CLINIC RUTLAND REGIONAL WOMEN'S HEALTH 147 ALLEN STREET RUTLAND VT 05701 PATIENT CLINIC RUTLAND REGIONAL DIGESTIVE SERVICES 1 ALBERT CREE DRIVE RUTLAND VT 05701 PATIENT CLINIC RUTLAND ENT 69 ALLEN ST SUITE 1 RUTLAND VT 05701 PATIENT CLINIC RUTLAND BEHAVIORAL HEALTH CLINIC 1 COMMONS STREET RUTLAND VT 05701 PATIENT CLINIC VERMONT ORTHOPAEDIC CLINIC 3 ALBERT CREE DRIVE RUTLAND VT 05701 PATIENT CLINIC DORSET ENT 51A TENNIS WAY EAST DORSET VT 05253 PATIENT CLINIC KILLINGTON MEDICAL CLINIC 3902 KILLINGTON ROAD KILLINGTON VT 05751 PATIENT CLINIC WESTRIDGE TREATMENT CENTER 1 SCALE AVE BLDG 10 RUTLAND VT 05701 PATIENT CLINIC MARBLE VALLEY UROLOGY 145 ALLEN ST RUTLAND VT 05701 PATIENT CLINIC MARBLE VALLEY EYE CARE 1 ALBERT CREE DRIVE RUTLAND VT 05701 PATIENT CLINIC SCHEDULE H, PART I, LINE 3B ELIGIBILITY FOR DISCOUNTED CARE: THE ORGANIZATION WILL PROVIDE DISCOUNTED CARE TO LOW INCOME INDIVIDUALS WHOSE FAMILY INCOME FALLS BETWEEN 301% AND 500% OF THE FEDERAL POVERTY GUIDELINES USING A GRADUATED RANGE OF DEDUCTIBLES FROM $250 AT THE LOWEST LEVEL TO $3,000 AT THE HIGHEST LEVEL. SCHEDULE H, PART I, LINE 3C OTHER FACTORS USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: THE ORGANIZATION USES ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS AND UNDERINSURANCE STATUS IN ADDITION TO FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSES: THE PERCENT OF TOTAL EXPENSES ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) LESS BAD DEBT EXPENSE OF $7,056,413. 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 AND 3. SCHEDULE H, PART I, LINE 7G SUBSIDIZED SERVICES: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH PHYSICIAN CLINICS IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM THESE CLINICS OF $4,441,089. THE ORGANIZATION PROVIDES SPECIALTY CARE SERVICES TO THE SURROUNDING COMMUNITIES AT THE CLINICS. THESE SERVICES ARE PROVIDED IN AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. THE ORGANIZATION 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: RUTLAND REGIONAL MEDICAL CENTER IS THE ONLY MAJOR MEDICAL CENTER IN CENTRAL VERMONT, AND IS ONE OF THE LARGEST EMPLOYERS IN THE REGION. AS SUCH, WE ARE RELIED UPON BY THE COMMUNITIES WE SERVE TO PROVIDE HEALTH RESOURCES AND LEADERSHIP. WE RECOGNIZE THAT THERE IS MORE TO HEALTH THAN ILLNESS AND DISEASE, SOCIAL DETERMINANTS SUCH AS LOW INCOME LEVELS, AND AN AGING POPULATION, ALONG WITH A SAFE ENVIRONMENT AND A WELL-ROUNDED CULTURE CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR POPULATION. THEREFORE, OUR LEADERSHIP AND COMMITMENT TO OUR COMMUNITY THROUGH A VARIETY OF INITIATIVES AND SUPPORTS BEYOND PROVIDING ESSENTIAL HOSPITAL-BASED CARE, ENCOMPASSING SOCIAL, PERSONAL, COMMUNITY AND HEALTH-RELATED ISSUES IMPACTING THE CITIZENS OF THE RUTLAND REGIONAL. MANY STAFF AND LEADERS ARE INVOLVED IN LOCAL, REGIONAL AND STATEWIDE COALITIONS, COLLABORATIVES AND COMMITTEES OF OTHER ORGANIZATIONS, WHERE WE LEARN ABOUT TRENDS AND ISSUES OF INTEREST OF CONCERN TO BRING BACK TO OUR HOSPITAL AND REVIEW IN THE CONTEXT OF OUR COMMUNITY AND OUR HEALTH SYSTEM; THESE INCLUDE THE RUTLAND FREE CLINIC, RUTLAND REGIONAL CHAMBER OF COMMERCE, TO NAME A FEW. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT AT THE REGIONAL, STATE AND NATIONAL LEVEL ALSO IMPACTS OUR COMMUNITY. IN ADDITION TO THESE EFFORTS, OUR COMMUNITY BUILDING ACTIVITIES IN THE PAST YEAR INCLUDED EFFORTS TO SUPPORT VIBRANCY IN THE COMMUNITY THROUGH THE ARTS, A VARIETY OF EVENTS AND ACTIVITIES BY SCHOOLS TO PROMOTE STRONG EDUCATION AND POSITIVE DECISION-MAKING, MENTORING YOUNG CHILDREN THROUGH READING TO BUILD SELF-CONFIDENCE AND ESTEEM IN ADDITION TO CORE ACADEMIC ACHIEVEMENT, ALONG WITH WORKFORCE DEVELOPMENT, ESPECIALLY AS RELATED TO THE HEALTH CARE. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE AMOUNT OF BAD DEBT LISTED ON LINE 2 AGREES TO BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. USING AN AVERAGE OF DATA FROM 2012-2016, APPROXIMATELY 13.3 PERCENT OF RUTLAND COUNTY WAS CONSIDERED TO LIVE IN POVERTY. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, RRMC ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, RRMC ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). 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), RRMC RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. FOR THOSE WHO DO NOT QUALIFY FOR CHARITY CARE THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE ORGANIZATION USES INFORMATION FROM THE MEDICARE COST REPORT TO COMPUTE THE MEDICARE ALLOWABLE COSTS OF CARE ON LINE 6. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: HOSPITAL CARE WILL NOT BE DENIED TO ANY PERSON SOLELY ON THE BASIS OF THEIR ABILITY TO PAY. HOWEVER, ANY INDIGENT PATIENTS WILL BE REFERRED FOR FINANCIAL ASSISTANCE. RRMC DOES NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE MAKING REASONABLE COLLECTION EFFORTS TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THAT HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ACCOUNTS ARE CONSIDERED BAD DEBT, AND ARE TRANSFERRED TO AN OUTSIDE AGENCY FOR COLLECTION, WHEN GUARANTOR HAS BEEN OFFERED (AND HAS DENIED OR FAILS TO RETURN APPLICATION FOR) ASSISTANCE UNDER THE RRMC FINANCIAL ASSISTANCE POLICY. THE PAYMENT PLAN POLICY REQUIRES PAYMENTS OF A MINIMUM OF $25.00 PER MONTH, AND THAT ALL BALANCES BE PAID WITHIN 10 MONTHS. THE FREE CARE POLICY SPECIFICALLY STATES THAT ALL UNINSURED AND UNDERINSURED PATIENTS BE GIVEN INFORMATION ON THE FREE CARE PROGRAM, AND THAT STAFF PERFORM DUE DILIGENCE TO GIVE THEM INFORMATION AND HAVE THE APPLICATION RETURNED, AND THAT THE HOSPITAL SEND 3 STATEMENTS AND A FINAL NOTICE BEFORE SENDING AN ACCOUNT TO BAD DEBT. IT ALSO STATES THAT RRMC WILL REFRAIN FORM EXTRAORDINARY COLLECTION ACTIONS TO OBTAIN PAYMENT FOR A DEBT. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: RUTLAND REGIONAL MEDICAL CENTER CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY WE SERVE THROUGH INTERACTIONS WITH THE STATE OF VERMONT HEALTH DEPARTMENT AND THE DEPARTMENT OF VERMONT HEALTH ACCESS, THE PUBIC, OTHER COMMUNITY ORGANIZATIONS, FEEDBACK FROM MEDICAL PROVIDERS AND PATIENTS, ALONG WITH NOTING TRENDS IN UTILIZATION OF SERVICES AND PRESENTATION OF ILLNESS, INJURY AND DISEASE. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: RRMC HAS "DO YOU NEED HELP WITH YOUR MEDICAL BILLS?" SIGNAGE POSTED AT EVERY ACCESS POINT THROUGHOUT THE HOSPITAL AND ITS OFF-SITE CLINICS (RUTLAND GENERAL SURGERY, WOMEN'S HEALTH ETC.) THE SIGNAGE PROVIDES CONTACT INFORMATION FOR THE PATIENTS TO CALL THE FINANCIAL COUNSELORS FOR HELP AS NEEDED. REGISTRATION OFFERS FINANCIAL ASSISTANCE PROGRAM APPLICATIONS TO ALL MEDICARE INSURED PATIENTS WITH NO OTHER INSURANCE, ALL SELF-PAY PATIENTS, AND ANY OTHER PERSON REQUESTING THE INFORMATION OR ANYONE WHO SPEAKS TO BEING IN FINANCIAL NEED. ALL SELF-PAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR WHILE THEY ARE AN IN-PATIENT AND THEY WILL ASSIST THEM IN APPLYING FOR OUR FINANCIAL ASSISTANCE, AS WELL AS, APPLYING FOR STATE AND FEDERAL PROGRAMS. ALL STATEMENTS HAVE THE RRMC WEBSITE ADDRESS TO VIEW OUR FINANCIAL ASSISTANCE PROGRAM AND THE BILLING AND COLLECTIONS POLICY AND PROCEDURE. THE WEBSITE ALSO HAS CONTACT PHONE NUMBERS FOR THE PATIENT TO CALL WITH QUESTIONS OR CONCERNS ABOUT THEIR BILL. THE RRMC WEB SITE NOT ONLY DESCRIBES THE FINANCIAL ASSISTANCE PROGRAM BUT, ALSO SHOWS THE INCOME GUIDELINES (BASED ON THE FEDERAL POVERTY) FOR FINANCIAL ASSISTANCE, AN ON-LINE APPLICATION, AS WELL AS, INFORMATION ON MEDICAID PROGRAMS AVAILABLE WITH SHORT DESCRIPTIONS. LASTLY, ALL PATIENTS WHO ARE SENT A STATEMENT SHOWING THEIR OF POCKET EXPENSES ARE CALLED TO DEVELOP A PAYMENT PLAN. AT THIS TIME FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED AND MAILED AS REQUESTED. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: A. GEOGRAPHIC DESCRIPTION: RUTLAND COUNTY, COMPOSED OF 933 SQUARE MILES, IS LOCATED IN CENTRAL VERMONT. THE POPULATION MOSTLY RESIDES IN THE 27 SMALL TOWNS AND OUTLYING RURAL AREAS. RUTLAND CITY IS THE LARGEST POPULATION CENTER (ESTIMATED AT 16,495 IN 2010). RUTLAND REGIONAL MEDICAL CENTER (RRMC) IS DEPENDED UPON BY MORE THAN 60,000 RESIDENTS OF THE HOSPITAL SERVICE AREA (HSA), WHICH INCLUDES RUTLAND COUNTY AND SOME PORTIONS OF SOUTHERN AND NORTH CENTRAL VERMONT AND EVEN WASHINGTON COUNTY, NEW YORK. B. TARGET POPULATIONS THE POPULATION OF RUTLAND COUNTY CONTINUES TO BE OLDER. THE MEDIAN AGE FOR MALES AND FEMALES IN RUTLAND COUNTY IS HIGHER THAN THE STATE. RUTLAND COUNTY'S MEDIAN AGE WAS 45.5 YEARS OLD, COMPARED TO VERMONT'S AVERAGE AGE OF 43.1. ADDITIONALLY, THE SENIOR POPULATION CONTINUES TO GROW - 25.3% OF RUTLAND COUNTY RESIDENTS ARE 60 YEARS AND OLDER, SLIGHTLY MORE THAN THE STATEWIDE AVERAGE (22.7%); RUTLAND COUNTY'S POPULATION ALSO OVER 65 YEARS OR OLDER IS ALSO HIGHER (20.9%) COMPARED TO THE STATE (18.1%). RUTLAND COUNTY MEDIAN HOUSEHOLD INCOME ($49,372) CONTINUES TO LAG BEHIND THE STATE ($56,990) THE NATIONAL AVERAGE OF MEDIAN INCOMES IS $59,039. FROM 2011 TO 2015, THE PROPORTION OF ALL INDIVIDUALS IN RUTLAND COUNTY LIVING BELOW POVERTY IS 12.5%, CONTINUING TO BE ABOVE STATE AVERAGE OF 11.9% IN 2016. WHILE RUTLAND COUNTY HAS A COMPARABLE PERCENTAGE OF HIGH SCHOOL GRADUATES (OR EQUIVALENCE) AT 88%, COMPARED TO THE STATE AT 88%, WE LAG BEHIND IN HIGHER EDUCATION (SOME COLLEGE WITH NO DEGREE, ASSOCIATE'S, AND BACHELOR'S) AT 63.% COMPARED TO THE STATE AT 67%. SPECIFIC TARGET POPULATIONS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDE: I. SENIOR POPULATIONS II. INDIVIDUALS LIVING IN POVERTY III. ADULTS AND YOUTH WITH SUBSTANCE ABUSE ISSUES IV. YOUTH AND ADULTS WHO ARE OVERWEIGHT OR OBESE SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: RUTLAND REGIONAL MEDICAL CENTER (RRMC) ENGAGES IN A NUMBER OF COMMUNITY SUPPORTIVE ACTIVITIES IN ORDER TO PROMOTE THE HEALTH OF THE COMMUNITY THE ORGANIZATION SERVES. RUTLAND COUNTY CONTINUES TO NEED PRIMARY CARE PROVIDERS AND HAS SHORTAGES OR IS AT RISK FOR SHORTAGES IN MANY SPECIALTY SERVICES. RRMC ACTIVELY RECRUITS BOTH PRIMARY CARE AND SPECIALTY PRACTICE PROVIDERS FOR THE REGION. IN FY17, ELEVEN PROVIDERS WERE RECRUITED TO THE REGION, INCLUDING PSYCHIATRY, GENERAL SURGERY, HOSPITAL MEDICINE, ENT, ORTHOPEDIC, EYE CARE AND EMERGENCY MEDICINE. RRMC ALSO SUPPORTS A HOSPITALIST PROGRAM WHERE HOSPITAL PHYSICIANS PROVIDE CARE FOR PRIMARY CARE PROVIDER'S PATIENTS THAT ARE ADMITTED TO THE HOSPITAL. THIS ALLOWS THE PRIMARY CARE PROVIDER TO PROVIDE MORE HOURS OF OFFICE CARE WHILE THEIR HOSPITALIZED PATIENTS HAVE 24 HOUR ACCESS TO A DOCTOR. THIS SYSTEM PROVIDES EFFICIENCIES TO THE HEALTH CARE SYSTEM IN RUTLAND COUNTY. RUTLAND COUNTY'S MEDICAID POPULATION CONTINUES TO INCREASE. THIS PUTS FINANCIAL STRAIN ON THE HEALTH SYSTEM IN OUR REGION, AS THE CARE PROVIDED FOR THIS GROWING POPULATION IS NOT REIMBURSED FOR THE FULL COST OF CARE. LEADERS AT RRMC ADVOCATE AT THE STATE AND LOCAL LEVEL TO MAINTAIN THE MEDICAID REIMBURSEMENT RATES FOR BOTH IN-PATIENT AND OUT-PATIENT CARE IN ORDER TO MAINTAIN ACCESS FOR MEDICAID PATIENTS. RRMC ALSO PROVIDES SUPPORT FOR FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) IN THE REGION BY HAVING A LEADER REPRESENTATIVE ON THE BOARD OF THE ORGANIZATION. THE FQHCS ARE REIMBURSED AT A HIGHER LEVEL FOR CARING FOR MEDICAID PATIENTS. RRMC LEADERS AND STAFF ALSO PARTICIPATE AS BOARD AND COMMITTEE MEMBERS IN SUPPORT OF OTHER NON-PROFIT ORGANIZATIONS, SUCH AS UNITED WAY OF RUTLAND COUNTY, VISITING NURSE ASSOCIATION AND HOSPICE OF THE SOUTHWEST REGION, RUTLAND COUNTY NUTRITION COALITION, RUTLAND'S PROJECT VISION, PLUS MANY OTHERS. RRMC PARTNERS WITH UNITED WAY OF RUTLAND COUNTY TO OFFER AND PROVIDE A LEADERSHIP AND BOARD TRAINING PROGRAM EACH YEAR, GRADUATING ON AVERAGE TWELVE COMMUNITY MEMBERS READY TO SERVE AS ACTIVE CONTRIBUTORS TO NON-PROFIT ORGANIZATIONS THROUGHOUT OUR REGION. RUTLAND COUNTY IS ECONOMICALLY CHALLENGED AND RRMC SUPPORTS WORK TO HELP THOSE IN POVERTY AS WELL AS TO BRING NEW BUSINESSES TO THE AREA. RRMC PARTICIPATES IN BRIDGES OUT OF POVERTY, A PROGRAM WHICH AIMS TO KEEP THE WORKING POOR EMPLOYED. THIS PROGRAM NOT ONLY BENEFITS THOSE LIVING IN POVERTY IN RUTLAND COUNTY, BUT RRMC'S OWN WORKFORCE. IN CONJUNCTION WITH FOR-PROFIT, NON-PROFIT AND GOVERNMENT AGENCIES, THE BRIDGES OUT OF POVERTY COUNCIL DELIVERS THE WORKING BRIDGES TRAINING TO HR PROFESSIONALS AND LINE MANAGERS ON THE WORKPLACE IMPLICATIONS OF ECONOMIC DIVERSITY; IMPLEMENTED AN EMERGENCY LOAN AND SAVINGS PROGRAM FOR EMPLOYEES; HOUSED WORKSITE RESOURCE COORDINATORS IN COMPANIES TO HELP EMPLOYEES FIND HELP WITH HOUSING, CHILDCARE, TRANSPORTATION, ECONOMIC ASSISTANCE AND OTHER RESOURCES WITHOUT HAVING TO LEAVE WORK; AND BEGAN DISCUSSION OF HOW TO ENCOURAGE THE EMPLOYEES TO USE HEALTH AND WELLNESS STRATEGIES. TRAUMA SUPPORT - ESTABLISHED IN 1993, THE TRAUMA SUPPORT PROGRAM AT RRMC WAS THE FIRST OF ITS KIND IN VERMONT. IT WAS DEVELOPED TO MEET THE IMMEDIATE AND LONG-TERM NEEDS OF FAMILIES IMPACTED BY SUDDEN DEATH OR TRAUMATIC INJURY OR ILLNESS. RRMC STAFF, ON THEIR OWN TIME, AND OTHER COMMUNITY VOLUNTEERS TAKE TURNS BEING ON CALL 24 HOURS A DAY, 7 DAYS A WEEK TO PERSONALLY PROVIDE SUPPORT AND ASSISTANCE TO FAMILIES IMPACTED BY TRAUMA OR DEATH IN MANY WAYS, E.G., BY BEING A LIAISON WITH MEDICAL PERSONNEL TO GET INFORMATION OR OFFERING CONTINUED SUPPORT VIA PHONE AND CORRESPONDENCE. BONE MARROW PROGRAM - THE MARROW DONOR PROGRAM AT RRMC WAS ESTABLISHED IN 1998. SINCE THEN, WE HAVE SUCCESSFULLY ADDED OVER 7,500 POTENTIAL DONORS TO THE NATIONAL REGISTER. BRIDGES & BEYOND THIS PROGRAM IS RUN OUT OF THE SOCIAL WORK DEPARTMENT AND WORKS WITH PATIENTS AND FAMILIES TO ARRANGE TRANSPORTATION, GENERAL ASSISTANCE (SUCH AS MEAL PREPARATION), OR COMPANIONSHIP FOR THOSE DISABLED AND FRAIL PATIENTS RETURNING HOME FROM A HOSPITAL STAY. DIABETES EDUCATION AND SELF-MANAGEMENT THIS PROGRAM IS OPERATED FROM THE DIABETES CENTER AND IS RECOGNIZED AND CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION. THROUGH THIS WORK, PEOPLE WITH DIABETES LEARN HEALTH AND LIFESTYLE SKILLS TO HELP THEM MANAGE THEIR DISEASE SYMPTOMS. OTHER BENEFITS INCLUDE PATIENT AND FAMILY SUPPORT GROUPS, AND GLUCOSE METER AND INSULIN INSTRUCTION. ADVANCE DIRECTIVES PROGRAM BEGINNING IN 2013, A NEW PROGRAM WAS DESIGNED AND IMPLEMENTED THROUGH THE COMMUNITY HEALTH IMPROVEMENT OFFICE, WHERE TRAINED VOLUNTEERS FROM THE COMMUNITY PROVIDE SUPPORT TO COMMUNITY MEMBERS TO COMPLETE ADVANCE DIRECTIVE FORMS ON A BY-APPOINTMENT BASIS. COMMUNITY RESOURCE GUIDE - BEGINNING IN 2012, THE COMMUNITY HEALTH IMPROVEMENT STAFF COLLECTED AND VERIFIED INFORMATION FROM ACROSS THE REGION FOR INCLUSION IN A RESOURCE GUIDE FOR USE BY HEALTH CARE PROVIDERS AND SOCIAL AND HUMAN SERVICES PERSONNEL TO HELP THEM READILY IDENTIFY POTENTIAL RESOURCES FOR THEIR CLIENTS. THIS GUIDE WAS DEVELOPED IN RESPONSE TO AN IDENTIFIED NEED FOR INFORMATION, AND IS UPDATED AND DISTRIBUTED ANNUALLY TO PROVIDER AND SOCIAL AND HUMAN SERVICES OFFICES ACROSS THE REGION, PHYSICALLY AND ELECTRONICALLY FOR EASE OF USE. COMMUNITY HEALTH TEAM - THE COMMUNITY HEALTH TEAM PROVIDES PATIENT CARE COORDINATION, CASE MANAGEMENT AND PANEL MANAGEMENT FOR NCQA-ACCREDITED PATIENT CENTERED MEDICAL HOME PRACTICES IN OUR REGION. THERE ARE 9 PRACTICES ACCOUNTING FOR 28,000 PATIENTS IN THE RUTLAND REGION. THE COMMUNITY HEALTH TEAM ALSO PROVIDES SELF-MANAGEMENT PROGRAMMING TO THE COMMUNITY AT LARGE, INCLUDING: TOBACCO CESSATION, HEALTHIER LIVING WORKSHOPS, DIABETES PREVENTION PROGRAM, WELLNESS RECOVERY ACTION PLANNING, IN-HOME ASTHMA INTERVENTION PROGRAM, HEALTHY NUTRITION WORKSHOPS, AND SUPPORTS THE DIABETES PHYSICAL ACTIVITY PROGRAM. WORKING WITH THE STATE OF VERMONT AND OTHER PARTNERS IN OUR REGION, WE SUPPORT AND PROMOTE QUALITY IMPROVEMENT COLLABORATIVES FOCUSED ON LEARNING, ENHANCING SERVICES, AND BRIDGING SERVICE GAPS. OTHER INFORMATION: RRMC HAS 18 BOARD MEMBERS WHO REPRESENT THE RESIDENTS OF RUTLAND COUNTY IN THEIR SERVICE; 5 OF THESE ARE PHYSICIANS, 3 REPRESENT HEALTH CARE PARTNERS, AND 10 ARE RUTLAND COUNTY RESIDENTS WHO REPRESENT A VARIETY OF BUSINESS SECTORS. ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST DISCLOSURE PROCESS WHICH IS NECESSARY TO COMPLY WITH FEDERAL AND STATE LAWS, INCLUDING THE FEDERAL ANTI-KICKBACK STATUTE AND THE TAX CODE. RRMC HAS PREDOMINANTLY AN OPEN MEDICAL STAFF. THE ONLY EXCEPTIONS ARE THE FOLLOWING SPECIALTIES FOR WHICH THERE ARE EITHER BOARD-APPROVED EXCLUSIVE CONTRACTS OR HOSPITAL-EMPLOYED PHYSICIANS ONLY: ANESTHESIA, EMERGENCY MEDICINE, CRITICAL CARE, MEDICAL ONCOLOGY, RADIATION ONCOLOGY, ORTHOPEDICS, AND RADIOLOGY. ALL NEW APPLICANTS UNDERGO AN EXTENSIVE REVIEW PROCESS, INCLUDING PRIMARY SOURCE VERIFICATION OF THEIR EDUCATION, TRAINING, BOARD CERTIFICATION, MALPRACTICE HISTORY, AND PREVIOUS HOSPITAL AFFILIATIONS. WHEN DEEMED COMPLETE, THEIR APPLICATION IS REVIEWED BY THE CREDENTIALS COMMITTEE, WHICH IS MADE UP OF PHYSICIANS AND AT LEAST ONE BOARD MEMBER. THE CREDENTIAL COMMITTEE MAKES A RECOMMENDATION TO THE EXECUTIVE COMMITTEE, WHICH INCLUDES THE CHAIRMAN OF THE BOARD. THE MEDICAL EXECUTIVE COMMITTEE MAKES THE FINAL RECOMMENDATION TO THE FULL BOARD, WHICH HAS THE ULTIMATE AUTHORITY TO GRANT MEDICAL STAFF PRIVILEGES. ALL MEDICAL STAFF APPOINTMENTS ARE FOR A TWO YEAR PERIOD. ALL MEDICAL STAFF IS SUBJECT TO ONGOING PEER REVIEW OF THEIR CLINICAL WORK. EVERY TWO YEARS, EVERY MEMBER OF THE MEDICAL STAFF MUST UNDERGO A REAPPOINTMENT PROCESS WHICH IS DESIGNED TO REVIEW THEIR CLINICAL AND PROFESSIONAL ACTIVITY AND BEHAVIOR. THOSE REAPPOINTMENTS GO THROUGH THE SAME SEQUENCE AS THE NEW APPLICANTS. RRMC'S CREDENTIALING PROCESS HAS BEEN SURVEYED BY BOTH THE JOINT COMMISSION AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND FOUND TO BE IN FULL COMPLIANCE WITH THEIR STANDARDS (TJC) AND THEIR CONDITIONS OF PARTICIPATION (CMS). AS A RURAL COMMUNITY HEALTH SYSTEM, RRMC PROVIDES A BROAD ARRAY OF SERVICES. THE FOLEY CANCER AT RRMC PROVIDES TREATMENT TECHNOLOGIES THAT INCLUDE HIGH TECH DIAGNOSTIC IMAGING, MEDICAL ONCOLOGY WITH TRADITIONAL IV THERAPIES (SUCH AS CHEMOTHERAPY), AND RADIATION ONCOLOGY FEATURING A STATE-OF-THE-ART LINEAR ACCELERATOR. SUPPORTIVE CARE PROGRAMS INCLUDE PALLIATIVE CARE, PAIN MANAGEMENT, ACUPUNCTURE AND A WOMEN'S BREAST CARE PROGRAM, AND A VARIETY OF SUPPORT GROUPS FOR PATIENTS, FAMILY AND/OR CAREGIVERS. THE HOSPITAL PROVIDES 24-HOUR EMERGENCY CRISIS CARE, AS WELL AS PSYCHIATRIC INTENSIVE CARE, MEDICAL DETOXIFICATION AND DUAL DIAGNOSIS AND TREATMENT OF SIMULTANEOUS SUBSTANCE ABUSE AND BEHAVIORAL HEALTH DISORDERS. THE 24-HOUR EMERGENCY DEPARTMENT PROVIDES CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE FAST TRACK TREATMENT AREA ALLEVIATES WAIT TIMES FOR PATIENTS WITH LESS ACUTE ILLNESSES OR INJURIES SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: RRMC INCLUDES A VAST ARRAY OF SERVICES OFFERED IN THE HOSPITAL SETTING AND IN A VARIETY OF CLINICS: CENTER FOR SLEEP DISORDERS, COMMUNITY HEALTH TEAM, COMPREHENSIVE CARE & INFECTIOUS DISEASES CLINIC, ENT & AUDIOLOGY, FOLEY CANCER CENTER, KILLINGTON MEDICAL CLINIC, LABORATORY SERVICES AT SEVERAL LOCATIONS, MARBLE VALLEY EYE CARE, MARBLE VALLEY UROLOGY, PHYSICAL MEDICINE & REHABILITATION, RUTLAND DIABETES & ENDOCRINOLOGY CENTER, RUTLAND DIGESTIVE SERVICES, RUTLAND GENERAL SURGERY AND THE WOUND, OSTOMY & CONTINENCE CLINIC, RUTLAND HEALTH FOUNDATION, RUTLAND HEART CENTER, RUTLAND KIDNEY CENTER, RUTLAND PULMONARY CENTER, RUTLAND REGIONAL BEHAVIORAL HEALTH, RUTLAND REGIONAL NEUROLOGY CENTER, RUTLAND WOMENS HEALTHCARE, VERMONT ORTHOPEDIC CLINIC, AND WEST RIDGE ADDICTION RECOVERY. RRMC IS PART OF RUTLAND REGIONAL HEALTH SERVICES, INC. THIS PARENT ORGANIZATION IS A TAX-EXEMPT ENTITY AND INCLUDES, IN ADDITION TO RRMC AND IT SPECIALTY CLINICS, VERMONT SPORTS MEDICINE CENTER, THE GABLES AT EAST MOUNTAIN AND THE MEADOWS AT EAST MOUNTAIN. VERMONT SPORT MEDICINE CLINIC PROVIDES PHYSICAL THERAPY AND OTHER SERVICES TO PATIENTS RECOVERING FROM ILLNESS, INJURY OR SURGERY. THE GABLES AT EAST MOUNTAIN PROVIDES SENIOR ADULTS ACCOMMODATIONS AND AMENITIES TO MAKE RETIREMENT RELAXING AND ENJOYABLE, AND THE MEADOWS AT EAST MOUNTAIN PROVIDE ASSISTED LIVING WITH AROUND-THE-CLOCK SERVICES TO SUPPORT RESIDENTS IN LIVING AN ACTIVE AND HEALTHY LIFESTYLE. SUPPORT RESIDENTS IN LIVING AN ACTIVE AND HEALTHY LIFESTYLE. true RUTLAND DISMAS HOUSE 103 PARK AVENUE RUTLAND VT 05701 030369442 501(C)(3) 5150 COMMUNITY HEALTH IMPROVEMENT VERMONT FARMERS FOOD CENTER 22 ROBERTS AVENUE RUTLAND VT 05701 455293058 501(C)(3) 13862 COMMUNITY HEALTH IMPROVEMENT VERMONT ADAPTIVE SKI & SPORTS PO BOX 139 KILLINGTON VT 05701 742472938 501(C)(3) 13750 COMMUNITY HEALTH IMPROVEMENT RUTLAND AREA FARM FOOD PO BOX 561 POULTNEY VT 05741 208283600 501(C)(3) 35276 COMMUNITY HEALTH IMPROVEMENT BROC COMMUNITY ACTION SW VT 60 CENTER STREET RUTLAND VT 05701 030216505 501(C)(3) 42391 COMMUNITY HEALTH IMPROVEMENT COME ALIVE OUTSIDE INC PO BOX 267 RUTLAND VT 05701 472357025 501(C)(3) 46000 COMMUNITY HEALTH IMPROVEMENT WONDERFEET PO BOX 6243 RUTLAND VT 05701 454692194 501(C)(3) 42787 COMMUNITY HEALTH IMPROVEMENT CITY OF RUTLAND PO BOX 969 RUTLAND VT 05701 036000658 GOVT 62442 COMMUNITY HEALTH IMPROVEMENT RUTLAND REGION EDUCATION CORPORATION PO BOX 6015 RUTLAND VT 05701 030353236 501(C)(3) 50613 COMMUNITY HEALTH IMPROVEMENT RUTLAND WEST NEIGHBORHOOD 110 MARBLE STREET RUTLAND VT 05701 030301526 501(C)(3) 9000 COMMUNITY HEALTH IMPROVEMENT COMMUNITY HEALTH CENTERS OF RUTLAND REG 375 ROUTE 30 NORTH BOMOSEEN VT 05701 221179701 501(C)(3) 226510 COMMUNITY HEALTH IMPROVEMENT RUTLAND REGION CHAMBER OF COMMERCE 50 MERCHANTS ROW RUTLAND VT 05701 030111510 501(C)(3) 10000 COMMUNITY HEALTH IMPROVEMENT RUTLAND REGION PLANNING COMMISSION PO BOX 965 RUTLAND VT 05701 030220669 501(C)(3) 25000 COMMUNITY HEALTH IMPROVEMENT PARAMOUNT CENTER INC 30 CENTER STREET RUTLAND VT 05701 222528303 501(C)(3) 25000 COMMUNITY HEALTH IMPROVEMENT COALITION TO PROTECT AMERICAS HEALTH PO BOX 30211 BETHESDA MD 208240211 522253225 501(C)(3) 20000 COMMUNITY HEALTH IMPROVEMENT PARTS FOR PAWS LTD 723 CARMEL PLACE RUTLAND VT 05701 814280912 501(C)(3) 14500 COMMUNITY HEALTH IMPROVEMENT RUTLAND FREE CLINIC DBA PARK STREET HEAL 145 STATE ST RUTLAND VT 05701 830427544 501(C)(3) 10000 COMMUNITY HEALTH IMPROVEMENT 17 SCHEDULE I, PART I, LINE 2 GRANTS MONITORING: RRHS AWARDED A FIVE-YEAR COMMUNITY BENEFIT GRANT TO COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. (CHCRR) IN THE AMOUNT OF $4,600,000 THAT WAS FUNDED BY RRMC AND WAS EFFECTIVE MAY 1, 2008. THE ORIGINAL TERM OF THE AGREEMENT ENDED ON APRIL 30, 2013, AND ORIGINAL AMOUNTS GRANTED HAD BEEN EXPENDED BY RRMC BY THAT TIME. IN 2011, THE AGREEMENT WAS AMENDED TO INCLUDE AN ADDITIONAL SUBSIDY FROM RRMC TO CHCRR FOR UP TO $600,000 PER YEAR, THROUGH JUNE 30, 2016, TO DEFRAY THE COST OF UNCOMPENSATED CARE TO SUPPORT THE RUTLAND CLINIC FOR PRIMARY CARE SERVICE. THIS AGREEMENT WAS NOT EXTENDED BEYOND JUNE 30, 2016. EFFECTIVE DECEMBER 1, 2013, RRHS ENTERED INTO AN AGREEMENT TO PROVIDE CHCRR A COMMUNITY BENEFIT GRANT OVER A PERIOD OF FIFTY-EIGHT MONTHS FROM DECEMBER 1, 2013, TO SEPTEMBER 30, 2018. THESE PAYMENTS ARE BEING MADE MONTHLY AND RANGE FROM $17,358 TO $19,537, FOR A TOTAL GRANT OF $1,066,810. RRHS CONTINUALLY WORKS WITH CHCRR TO ENSURE THE ORGANIZATION IS USING FUNDS APPROPRIATELY AND FURTHERING THE CHCRR EXEMPT PURPOSE. THE OTHER GRANTS LISTED ON SCHEDULE I, PART II, WERE PROVIDED BY THE JAMES T BOWSE HEALTH TRUST, A DEPARTMENT OF RUTLAND REGIONAL MEDICAL CENTER. THE BOWSE TRUST ONLY CONSIDERS GRANT PROPOSALS THROUGH ITS FORMAL GRANT PROPOSAL PROCESS, WHICH REQUIRES THAT THE REQUESTING ORGANIZATION MEET CERTAIN CRITERIA AND SUBMIT A PLANNING GRANT/LETTER OF INTENT, FULL PROPOSAL, AND PLANNING GRANT BUDGET FORM DESCRIBING HOW THE GRANT WILL BE USED. SCHEDULE I, PART II, COLUMN H PURPOSE OF GRANT OR ASSISTANCE: ASSISTANCE FOR RUTLAND DISMAS HOUSE, VERMONT FARMERS FOOD CENTER, VERMONT ADAPTIVE SKI & SPORTS, RUTLAND AREA FARM FOOD, BROC COMMUNITY ACTION SW VT, COME ALIVE OUTSIDE, INC., WONDERFEET, CITY OF RUTLAND, RUTLAND REGION EDUCATION CORPORATION, AND RUTLAND WEST NEIGHBORHOOD WAS PROVIDED BY THE JAMES T BOWSE HEALTH TRUST, A DEPARTMENT OF RUTLAND REGIONAL MEDICAL CENTER. SEE SCHEDULE H, PART VI, LINE 6 FOR MORE INFORMATION REGARDING PROGRAMS FUNDED BY THE JAMES T BOWSE HEALTH TRUST. X X X false false false true false false false false false MICHAEL J KENOSH MD DIRECTOR 451811 0 99565 0 2337 0 40525 0 31456 0 625694 0 0 0 TODD GREGORY MD DIRECTOR 358086 0 4192 0 722 0 17225 0 31266 0 411491 0 0 0 STANLEY M SHAPIRO MD DIRECTOR 304115 0 216246 0 8230 0 22525 0 27514 0 578630 0 0 0 ERIC MARSH MD DIRECTOR 579551 0 374153 0 1140 0 17225 0 31177 0 1003246 0 0 0 THOMAS W HUEBNER PRESIDENT / CEO 545704 0 0 0 10135 0 45825 0 31414 0 633078 0 0 0 JUDI K FOX CFO 203763 0 0 0 909 0 18104 0 31028 0 253804 0 0 0 WILLIAM A LIGHTHART MD ORTHOPAEDICS 605276 0 320569 0 1140 0 17225 0 31208 0 975418 0 0 0 MICHAEL ROBERTELLO MD CARDIOLOGY 436966 0 293122 0 3798 0 40525 0 27652 0 802063 0 0 0 MATTHEW ZMURKO MD ORTHOPAEDICS 370268 0 139784 0 587 0 35225 0 30501 0 576365 0 0 0 ANN STIEN MD ORTHOPAEDICS 244920 0 260200 0 1032 0 40525 0 18824 0 565501 0 0 0 DALE JANIK MD GASTRONENTEROLOGY 401006 0 97759 0 4076 0 35225 0 26867 0 564933 0 0 0 MELBOURNE D BOYTON MD ORTHOPEDIC SRGN/CHIEF MED OFFR 660801 0 399121 0 4113 0 40525 0 31513 0 1136073 0 0 0 SCOTT J GRAHAM MD CHIEF MEDICAL INFO OFFICER 329295 0 5103 0 612 0 17225 0 31242 0 383477 0 0 0 PHILIP R LAPP MEDICAL DIRECTOR 253254 0 35298 0 2622 0 22525 0 31154 0 344853 0 0 0 BARBARA M ROBINSON VP CLINICAL SERVICES 272137 0 0 0 3955 0 27825 0 11377 0 315294 0 0 0 CAROL M EGAN VP CHIEF NURSING OFFICER 215598 0 0 0 3033 0 23459 0 22565 0 264655 0 0 0 MARY T NEMETH VP CORPORATE SUPPORT SERVICES 213049 0 0 0 2946 0 22916 0 11285 0 250196 0 0 0 JOHN WALLACE GEN COUNSEL COMPLIANCE OFFICER 199442 0 0 0 2097 0 9478 0 31092 0 242109 0 0 0 BRIAN KERNS VP HUMAN RESOURCES 195776 0 0 0 279 0 27268 0 30461 0 253784 0 0 0 JEFFREY MCKEE VP COMMUNITY & BEH HEALTH SVCS 183790 0 0 0 718 0 8281 0 1127 0 193916 0 0 0 DARREN CHILDS FORMER VP QUALITY IMPROVEMENT 158349 0 0 0 648 0 13905 0 20292 0 193194 0 0 0 EDWARD T OGORZALEK FORMER CFO 250192 0 0 0 44229 0 45683 0 22825 0 362929 0 38426 0 SCHEDULE J, PART I, LINE 5A COMPENSATION CONTINGENT ON THE REVENUES OF THE ORGANIZATION: PHYSICIANS EARN COMPENSATION BASED UPON THEIR PRODUCTIVITY AGAINST ESTABLISH TARGETS. INCREASED PRODUCTIVITY IS DIRECTLY RELATED TO INCREASED REVENUES FOR THE ORGANIZATION. SCHEDULE J, PART II, COLUMN F COMPENSATION REPORTED ON PRIOR FROM 990: COMPENSATION IS REPORTED ON THE FROM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR SUBJECT TO SUBSTANTIAL RISK OF FOREITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. A VT EDUCATIONAL & HLTH BUILDING FINANCE AGENCY 237154467 2017-09-03 31350000 PARTIAL REFUND 9/10 SERIES BONDS false false false A 0 0 31350000 0 0 31157038 192962 0 0 0 0 0 2013 true false true true A false false true true false 0 false false false true A false false true false true true DEUTSCHE BANK TD B 10. false true false 0 false true A true SCHEDULE K, PART IV, LINE 7 REQUIREMENTS OF SECTION 148: THE TAX-EXEMPT BONDS DO NOT HAVE ANY OUTSTANDING PROCEEDS AND THEREFORE ARE NOT SUBJECT TO THE ARBITRAGE REQUIREMENTS OF SECTION 148. FOLEY SERVICES FOLEY DISTRIBUTING M FOLEY JR - SEE PART V 292608 SUPPLIES & JANITORIAL PRODUCTS false SCHEDULE L, PART IV, COLUMN B BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: MARK FOLEY, JR, CURRENT BOARD MEMBER, OWNS FOLEY SERVICES, INC WHILE HIS FATHER OWNS FOLEY DISTRIBUTING. THESE COMPANIES SUPPLIED PAPER AND JANITORIAL PRODUCTS TO THE ORGANIZATION FOR $292,608 IN FISCAL YEAR 2017. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION AND MOST SIGNIFICANT ACTIVITIES: MISSION: TO IMPROVE THE HEALTH OF THE RUTLAND REGIONAL AND SURROUNDING COMMUNITIES BY PROVIDING APPROPRIATE, SUPERIOR, INTEGRATED, PREVENTATIVE, DIAGNOSTIC AND THERAPEUTIC HEALTH SERVICES IN A CARING ENVIRONMENT THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY AND RELATIONSHIPS. VISION: TO BE THE BEST COMMUNITY HEALTHCARE SYSTEM IN NEW ENGLAND. GOALS: *QUALITY: WE WILL PROVIDE SUPERIOR HEALTH SERVICES WHICH MEET OUR CUSTOMER NEEDS THROUGH: GOOD CLINICAL OUTCOMES, UP-TO-DATE TECHNOLOGY, EFFECTIVE PROCESSES, COMPETENT AND CARING STAFF AND WELL MAINTAINED FACILITIES. *GROWTH: WE WILL DEVELOP NEW SERVICES AND EXPAND EXISTING SERVICES TO MEET CUSTOMER NEEDS RESULTING IN INCREASED MARKET SHARE AND EXPANSION INTO NEW MARKETS. *INFORMATION EXCELLENCE: WE WILL PROVIDE SUPERIOR, COORDINATED INFORMATION RESOURCES, PROCESSES, AND SYSTEMS THAT MEET CUSTOMER NEEDS FOR EFFECTIVE INFORMATION GATHERING, RECORDING, ACCESS, ANALYSIS, AND DISSEMINATION ACROSS THE HEALTHCARE CONTINUUM. *FINANCIAL STRENGTH: WE WILL ACHIEVE FINANCIAL STRENGTH AND STABILITY BY OPTIMIZING REIMBURSEMENT AND IMPROVING OUR COSTS STRUCTURE TO PRODUCE SUFFICIENT MARGINS, AND INCREASING PHILANTHROPIC GIVING. *EMPLOYMENT ENGAGEMENT: WE WILL CREATE AN ENVIRONMENT WHERE EMPLOYEE ENGAGEMENT FLOURISHES AND WE COMMIT OUR HEARTS AND MINDS TO MEETING AND EXCEEDING THE NEEDS OF OUR CUSTOMERS AND EACH OTHER. EXCEEDING THE NEEDS OF OUR CUSTOMERS AND EACH OTHER. FORM 990, PART I, LINE 6 TOTAL NUMBER OF VOLUNTEERS: THE TOTAL NUMBER OF VOLUNTEERS INCLUDING NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND OTHER INDIVIDUALS WHO VOLUNTEER TIME TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. FORM 990, PART III, LINES 4A-D EXEMPT PURPOSE ACHIEVEMENTS: RUTLAND REGIONAL MEDICAL CENTER FY 2017 COMMUNITY BENEFITS REPORT: RUTLAND REGIONAL MEDICAL CENTER IS COMMITTED OT PROVIDING SUPERIOR, INTEGRATED, DIAGNOSTIC, THERAPEUTIC AND PREVENTATIVE HEALTH SERVICES AND TO PROMOTING OVERALL COMMUNITY HEALTH AND WELL-BEING. COMMUNITY BENEFITS ARE THE ACTIVITIES AND SERVICES RUTLAND REGIONAL ENGAGES IN AND SUPPORTS THAT GO BEYOND THE ROUTINE PATIENT CARE SERVICES. DOCUMENTING THESE EFFORTS IS A PART OF WHAT DIFFERENTIATES TAX-EXEMPT FROM TAXABLE HEALTH CARE ORGANIZATIONS. FREE AND DISCOUNTED CARE RUTLAND REGIONAL PROVIDES LOW- AND NO-COST CARE FOR ELIGIBLE RESIDENTS OF OUR AREA THROUGH A FINANCIAL ASSISTANCE PROGRAM. THE FREE CARE PROVISION FOR 2017 TOTALED $5,753,971. RRMC IS ADDRESSING THE KEY ISSUES THAT HAVE THE MOST SIGNIFICANT IMPACT ON THE COMMUNITY HEALTH AND WELL-BEING, WHICH INCLUDE THE FOLLOWING: *CLINICAL CARE -CONTINUING TO ADDRESS THE DRUG PROBLEM IN THE COMMUNITY THROUGH MENTAL HEALTH AND SUBSTANCE ABUSE AND SERVICES FOR ADULTS AND YOUTH, INCLUDING TREATMENT, AFTERCARE AND PREVENTION -CONTINUING TO IMPROVE ACCESS TO CARE FOR ALL COMMUNITY MEMBERS BY CONTINUING FOCUSED PROVIDER RECRUITMENT, AND RETENTION, ACTIVITIES *HEALTHY BEHAVIORS -IMPROVING AND PROMOTING HEALTHY CHOICES AND ACTIVITIES TO SUPPORT A HEALTHY COMMUNITY IN WHICH TO LIVE AND RAISE A FAMILY, BY SUPPORTING AND PROMOTING LIFE SKILLS DEVELOPMENT FOR AND BY YOUTH, AND PHYSICAL ACTIVITY AND HEALTH EATING BY ADULTS AND YOUTH *SOCIAL & ECONOMIC DETERMINANTS -IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY, MAKING IT AN ATTRACTIVE PLACE TO LIVE AND WORK *PHYSICAL ENVIRONMENT -IMPROVING INFRASTRUCTURE TO SUPPORT A HEALTHY COMMUNITY WITH ACCESS TO WORK, RECREATIONAL OPPORTUNITIES AND SERVICES FOR MORE DETAILS ON THESE ACTIVITIES AND THE WORK PERFORMED BY RUTLAND REGIONAL WITH COMMUNITY PARTNERS, PLEASE REVIEW THE PROGRESS REPORT ON HTTP://WWW.RRMC.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. IN ADDITION TO THESE ACTIVITIES, RUTLAND REGIONAL IS NOW REQUIRED BY FEDERAL REGULATIONS TO CONDUCT A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS. THE RUTLAND COUNTY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE WORKED HARD TO BE INCLUSIVE, BOTH IN THE INFORMATION COLLECTED AND REVIEWED, AND BY BROADLY REQUESTING INPUT FROM AROUND OUR COMMUNITIES. FROM START TO FINISH, THE ASSESSMENT TAKES ABOUT ONE YEAR TO COMPLETE, AND INCLUDES COMPILATION OF CONSUMER SURVEYS AND THROUGH FOCUS GROUP MEETINGS. ALL OF THE INFORMATION GATHERED IS REVIEWED, AND PRIORITIZED BY A BROAD, COMMUNITY-BASED COMMITTEE. A FINAL REPORT HAS NOW BEEN PUBLISHED WITH THE FINDINGS. THIS REPORT IS MADE PUBLICALLY AVAILABLE ON WWW.RRMC.ORG. THE PURPOSE OF THE ASSESSMENT IS TO: -DESCRIBE THE HEALTH STATUS OF THE COMMUNITY -IDENTIFY THE COMMUNITY'S HEALTH NEEDS -COMPARE THE NEEDS TO THOSE IDENTIFIED PREVIOUSLY CONDUCTING ASSESSMENTS PERIODICALLY FOR MORE THAN 15 YEARS, WE HAVE SEEN SOME HEALTH INDICATORS IMPROVE AND OTHERS DECLINE. BY MONITORING THESE CHANGES, THE COMMITTEE IS ABLE TO IDENTIFY WHERE ADDITIONAL RESOURCES ARE NEEDED. ORGANIZATION, INCLUDING RUTLAND REGIONAL, USES THIS IMPORTANT INFORMATION TO GUIDE THEIR PLANNING. FOR RUTLAND REGIONAL SPECIFICALLY, IT HELPS WITH THE DEVELOPMENT OF NEW HOSPITAL SERVICES AND COMMUNITY PROGRAMS. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: THE REVENUES AND EXPENSES REPORTED ON PART III, LINE 4D, REPRESENT THOSE AMOUNTS THAT ATTRIBUTABLE TO OTHER PROGRAM SERVICES CONDUCTED BY THE ORGANIZATION. THESE OTHER SERVICES PRIMARILY REPRESENT OTHER SUPPORT SERVICES THAT ARE PROVIDED TO HOSPITAL PATIENTS OR THAT ARE CONDUCTED TO SUPPORT THE OVERALL FUNCTION OF THE HOSPITAL, SUCH AS CENTRAL SUPPLY AND PHARMACY SERVICES. OTHER SERVICES ALSO INCLUDE BENEFIT TO THE COMMUNITY THROUGH THE PAYMENT OF GRANTS TO OTHER COMMUNITY ORGANIZATIONS. SEE SCHEDULE I FOR DETAIL REGARDING THESE GRANT PAYMENTS. FORM 990, PART VI, LINES 6, 7A, & 7B MEMBERS OR STOCKHOLDERS: PER ARTICLE II, SECTION 1, OF THE ORGANIZATION'S BYLAWS, RUTLAND REGIONAL HEALTH SERVICES IS THE SOLE MEMBER OF RUTLAND REGIONAL MEDICAL CENTER. ARTICLE III, SECTIONS 1 AND 2, OR THE BYLAWS STATE THAT THE BOARD SHALL CONSIST OF EIGHTEEN DIRECTORS. OF THESE DIRECTORS, FOURTEEN ARE CHOSEN OR APPROVED BY THE ORGANIZATION'S SOLE MEMBERS. ARTICLE VIII, SECTION 5, OF THE BYLAWS DISCUSS POWERS RESERVED TO THE MEMBER, RUTLAND REGIONAL HEALTH SERVICES, INC., AND STATE THAT THE CORPORATION SHALL SUBMIT TO THE BOARD OF DIRECTORS OF THE MEMBER FOR ITS PRIOR APPROVAL THAT FOLLOWING: A) THE APPOINTMENT OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, B) ALL OPERATING AND CAPITAL BUDGETS FOR THE CORPORATION, C) STRATEGIC PLANS FOR THE CORPORATION, D) CAPITAL EXPENDITURES OF $100,000 OR MORE WHICH ARE UNBUDGETED, E) PURCHASE AND SALE OF ALL SIGNIFICANT ASSETS, AND F) THE BYLAWS AND ANY AMENDMENTS THERETO. 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. A DRAFT COPY IS THEN REVIEWED BY TOP MANAGEMENT. ONCE A FINAL DRAFT IS COMPLETE, IT IS MAILED TO EACH MEMBER OF THE EXECUTIVE FINANCE COMMITTEE. THE COMMITTEE WILL MEET AND DISCUSS THE RETURN WITH A TAX ADVISOR. AFTER APPROVAL, A FINAL 990 DRAFT WILL BE PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: ANNUALLY, ALL ORGANIZATION LEADERS REVIEW THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY TO ENSURE ALL CONFLICTS ARE MADE KNOWN. SEE THE POLICY BELOW. POLICY *DUTY TO DISCLOSE 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 DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, OR OTHER INDIVIDUALS WHO, ON BEHALF OF THE CORPORATION, ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. *DUTY TO VOICE CONCERN IN THE EVENT THAT AN INTERESTED PERSON BECOMES CONCERNED THAT ANOTHER INTERESTED PERSON WHO IS A BOARD MEMBER, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS 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 A MEMBER OF LEADERSHIP COUNCIL, A DIRECTOR OR MANAGER OR OTHER INTERESTED PERSON, AN APPROPRIATE CORPORATE OFFICER. *DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS 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. HOWEVER, IN NO EVENT SHALL AN INTERESTED PERSON PARTICIPATE IN THE DELIBERATION AND/OR DETERMINATION OF COMPENSATION THAT HE/SHE WILL RECEIVE FROM THE CORPORATION FOR EMPLOYMENT, PROFESSIONAL CONTRACT OR OTHERWISE. *DEFINITIONS -INTERESTED PERSON - FOR THE PURPOSES OF THIS POLICY, AN INTERESTED PERSON IS ANY BOARD MEMBER, PRINCIPAL OFFICER, MEMBER OF THE LEADERSHIP COUNCIL, DIRECTOR, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. IF AN INDIVIDUAL IS AN INTERESTED PERSON WITH RESPECT TO ANY ENTITY IN THE RRMC/RRHS HEALTH CARE SYSTEM, HE OR SHE IS AN INTERESTED PERSON WITH RESPECT TO ALL ENTITIES IN THE HEALTH CARE SYSTEM. *PROCEDURES -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 RESULTS IN THE CONFLICT OF INTEREST. .THE CHAIRPERSON 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 .IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. -ANNUAL STATEMENTS .AWARENESS/COMPLIANCE WITH POLICY - EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THIS 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 BE ENGAGED PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. .CONFLICT OF INTEREST SURVEY - EACH INTERESTED PERSON SHALL DISCLOSE ON AN ANNUAL SURVEY FORM POTENTIAL CONFLICTS OF INTEREST AND FINANCIAL INTERESTS RELEVANT TO THIS POLICY. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW POLICY: THE FOLLOWING POLICY APPLIES TO THE OFFICERS AND KEY EMPLOYEES OF RUTLAND REGIONAL MEDICAL CENTER (RRMC): -IT IS THE POLICY OF RRMC TO OFFER MARKET-COMPETITIVE PAY SO TO ATTRACT AND RETAIN THE BEST TALENT FROM OUR LABOR MARKET. -DESIGNATION OF RRMC' KEY EMPLOYEES IS MADE BY THE HUMAN RESOURCE DEPARTMENT USING IRS GUIDELINES. -THE RRHS KEY EMPLOYEE LABOR MARKET IS TYPICALLY ALL HOSPITALS NATIONALLY WITH SIMILAR REVENUES AS RRMC. -KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE HUMAN RESOURCES DEPARTMENT USING THREE SOURCES OF INDEPENDENT COMPETITIVE MARKET DATA. -JOBS HELD BY KEY EMPLOYEES ARE MATCHED WITH SIMILAR JOBS IN MARKET DATA WITH AN INDICATION OF JOB MATCH STRENGTH (WEAK, MODERATE OR STRONG). -THE MARKET REVIEW PRODUCES A REPORT OF KEY EMPLOYEE CURRENT BASE PAY VS. MARKET TOTAL CASH COMPENSATION AND ANY RECOMMENDED PAY ACTIONS. -GENERALLY SPEAKING, KEY EMPLOYEE BASE PAY VARIANCES OF -5% VS. MARKET TOTAL CASH COMPENSATION ARE CONSIDERED TO BE NON-COMPETITIVE PROMPTING A RECOMMENDED BASE PAY INCREASE TO BE CONSIDERED. -THE RESULTS OF THE REVIEW AND RECOMMENDED PAY ACTIONS ARE REVIEWED AND APPROVED BY THE CEO. INFORMATION IS MADE AVAILABLE TO EXECUTIVE FINANCE UPON REQUEST. -THE CEO PAY IS REVIEWED AND APPROVED BY THE CHAIR AND CO-CHAIR OF THE BOARD OF DIRECTORS. THIS REVIEW IS DOCUMENTED IN THE EXECUTIVE SESSION BOARD MINUTES. -THE MOST RECENT COMPENSATION REVIEW OCCURRED DURING DECEMBER OF 2017. -THE KEY EMPLOYEES REVIEW WAS CONDUCTED IN DECEMBER OF 2017 COVERING NON-PHYSICIAN EMPLOYEE EARNING AT LEAST $175,000. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE ANNUALLY IN THE ANNUAL REPORT, AND ARE ALSO AVAILABLE UPON WRITTEN REQUEST. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. ALL REQUESTS MUST BE FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT), AND REQUESTED DOCUMENTS WILL BE MAILED. FORM 990, PART VII, COLUMN D BOARD MEMBERS RECEIVING COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. THE FOLLOWING BOARD MEMBERS RECEIVED COMPENSATION FROM RUTLAND REGIONAL MEDICAL CENTER FOR SERVICES PROVIDED AS PHYSICIANS: - MICHAEL KENOSH, MD - TODD GREGORY, MD - STANLEY SHAPIRO, MD - ERIC MARSH, MD FORM 990, PART X, LINE 20B TAX-EXEMPT BOND LIABILITIES: THE ORGANIZATION'S TOTAL TAX-EXEMPT BOND LIABILITIES ON THE BALANCE SHEET IS COMPRISED OF THE FOLLOWING: $ 31,350,000 BOND LIABILITIES ( 153,565) UNAMORTIZED BOND ISSURANCE COSTS ------------- $ 31,196,435 FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 12,090,471 LOSS FROM DEF BEN PLAN & POSTRETIREMENT BEN COSTS 1,854,320 LOSS ON INTEREST RATE SWAP AGREEMENT ------------- $ 13,944,791 RUTLAND REGIONAL HEALTH SERVICES INC 160 ALLEN STREET RUTLAND VT 05701 222534389 HOLDING CO VT 501(C)(3) 12B II NA false THE MEADOWS AT EAST MOUNTAIN 157 HERITAGE HILL PLACE RUTLAND VT 05701 030330343 ELDER CARE VT RRHS THE GABLES AT EAST MOUNTAIN ONE GABLES PLACE RUTLAND VT 05701 030358050 ELDER CARE VT RRHS VERMONT SPORTS MEDICINE CENTER 160 ALLEN ST RUTLAND VT 05701 061231501 PHYSICAL THERAPY VT RRHS false false true false false false false false false false true false true true true true true false false