SPRINGFIELD MEDICAL CARE SYSTEMS INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SPRINGFIELD MEDICAL CARE SYSTEMS INC (EIN 03-0284813)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-15
- IRS object ID
- 201822279349302652
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-15T14:00:45-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030284813 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Medical Care Systems Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPRI | BusinessNameControlTxt |
| Phone | 8028852151 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Scott Whittemore | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8028852151 | PhoneNum |
| Signature | 2018-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Barbara J McGuan CPA | PreparerPersonNm |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2018-08-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Timothy Ford | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,940,795 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.springfieldmed.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | Federally Qualified Health Care network providing medical, behavioral health, dental & pharmacy services | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 365 | TotalEmployeeCnt |
| Total Volunteers | 22 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,915,581 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,310,020 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,842,797 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $22,366,439 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | -$227,762 | CYInvestmentIncomeAmt |
| PY Other Revenue | $77,336 | PYOtherRevenueAmt |
| CY Other Revenue | $84,336 | CYOtherRevenueAmt |
| PY Total Revenue | $25,835,714 | PYTotalRevenueAmt |
| CY Total Revenue | $27,533,033 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,996,548 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,452,106 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $116,227 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,595,119 | PYOtherExpensesAmt |
| CY Other Expenses | $8,645,653 | CYOtherExpensesAmt |
| PY Total Expenses | $24,591,667 | PYTotalExpensesAmt |
| CY Total Expenses | $28,097,759 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,244,047 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$564,726 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,562,541 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,174,525 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,550,729 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,727,439 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,011,812 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,447,086 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, (Continued on Schedule O) and employees want to work. Our plan is to accomplish this by: - Empowering our caregivers with education, technology, and opportunities for personal and professional development;- Creating an environment, which builds collaborative relationships among clinicians, staff, and patients;- Providing our communities with the educational resources and support to make informed decisions emphasizing prevention and wellness; and,- Offering safe, personalized, high-quality care. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $23,156,714 | ExpenseAmt |
| Revenue | $22,366,439 | RevenueAmt |
| Desc | Springfield Medical Care Systems (SMCS) operates a nine-site, federally-qualified health center network. These offices provide access for primary and preventive health care to the general population, and make financial assistance and charity care available to all based on a sliding fee scale. Services include primary and preventive health care for people of all ages, pediatrics, health screenings, behavioral health programs, dental care, vision care, and access to discounted pharmaceuticals. SMCS operates Ludlow Dental Center in Ludlow, VT, and Chester Family Dental in Chester, VT. Through its integrated care model, SMCS also offers diagnostic lab, radiology, and a full array of acute hospital and specialty services to its patients through Springfield Hospital, a subsidiary, and other referral sources and partnership arrangements.Primary Care Services - Our primary care network provides ongoing care and outreach to our service area, utilizing a medical home model of care and focusing on prevention and efficient care management. We work closely with the Quality Improvement Collaborative and the Vermont Blueprint for Health to develop and implement strategies for improving overall population health outcomes. Primary care offices, specialty clinics, the local hospital, and appropriate referral sources, for specialists and tertiary care when needed, are utilized to provide the best possible outcomes. Our goal is to deliver the highest quality care, i.e. appropriate care provided in the appropriate setting, with the end result being improved health outcomes, high patient satisfaction, and improved cost efficiency. A Community Health Team holds monthly public meetings to collaborate and partner with area agencies to remove barriers and improve access to care. The team now exceeds more than 45 organizations and communicates regularly with 185 individual participants -- and the numbers continue to grow. New members are welcomed at each meeting as word of the team spreads throughout the community. The Team serves as a central community contact point (similar to a hub and spoke model) to facilitate communications, networking and collaboration among all area services.Through the employment of primary care physicians and allied health professionals in Charlestown, NH; Ludlow, VT; Bellows Falls, VT; Chester, VT; Londonderry, VT; and Springfield, VT, SMCS provides access to high quality medical care with emphasis on prevention and wellness in these communities. Due to the tenuous economics of rural primary care practices, this physician availability would not exist without SMCS support. The Ludlow area has been designated by the State of Vermont as a Health Professional Shortage Area. The state and federal governments have designated the Bellows Falls, VT and Charlestown, NH areas as serving a medically-underserved population. These health centers serve an inordinately high Medicare and Medicaid caseload. During FY 2017, SMCS served a total of 35,159 patients and provided 119,535 visits. Included in this total is primary care, which served 25,574 patients and provided 85,759 visits.Behavioral HealthSMCS has a comprehensive outpatient Mental Health/ Substance abuse program and provides outpatient behavioral health counseling and collaborates with The Windham Center -- the inpatient psychiatric unit operated by its subsidiary, Springfield Hospital. With early adoption of Healthy People 2010 and NCQI Medical Home guidelines, SMCS aggressively integrated behavioral health counseling with primary care medical care by virtue of the on-site stationing of behavioral health at its primary care (FQHC) sites. SMCS practitioners coordinate care with Springfield Hospital inpatient services and, to an even greater extent, work with Springfield Hospital emergency department to assist in managing patients that present with mental health related diagnosis. During the fiscal year, SMCS served 2,424 mental health patients and provided 18,850 visits.Dental Care - SMCS' Ludlow and Chester offices serve a growing need for dental services throughout the SMCS primary care service area. Patients from all offices can be referred to the Dental Centers for care, and a financial assistance program is available for those needing assistance, based on a sliding fee scale. The two locations served 2,957 patients in FY 2017 and provided 6,692 visits. Vision - SMCS offers vision services through Lane Eye Associates in Springfield, VT and offers comprehensive eye care services including ophthalmology and optometry. In 2017, Lane served 3,173 patients and provided 5,331 visits.Plastic, Cosmetic & Reconstructive Surgery - Skin Cancer ClinicSMCS offers plastic, reconstructive and cosmetic surgery services, including skin cancer screening, through the office of Gerald A. Drabyn, MD. In the 2017 fiscal year, which ended September 30, 2017, Dr. Drabyn saw patients at Chester and Londonderry health center locations and provided care to 418 patients with 1,321 visits.Pharmacy Program - SMCS operates a 340B pharmacy charity program that helps expand access to affordable medications. Eligible patients can obtain their prescriptions at little to no cost. This program operates in partnership with five local pharmacies in Vermont: Bellows Falls, Springfield, and Ludlow, ands well as two pharmacies in Claremont, NH. Financial assistance for this program totaled $33K.Charity Care Policy - SMCS 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 50% charity care at up to 200% of the federal poverty guideline. SMCS does not bill patients nor pursue collection of amounts determined to qualify as charity care. In the fiscal year, which ended on September 30, 2017, charges foregone for charity care, based on established rates, amounted to $179K.Springfield UrologyThrough a contract with Dartmouth-Hitchcock Medical Center, SMCS offers urology services at Springfield Urology, 29 Ridgewood Road, Springfield, VT. This service offers patients a local option for needed care and patients from all offices can be referred to this location. In 2017, this office provided 1,582 patient visits. Eligibility Assistance and Enrollment Counseling ServicesThrough a partnership arrangement with Valley Health Connections (a designated 501(c)3 non-profit organization), SMCS patients can receive certified Navigator counseling to help remove barriers and facilitate access to health care for uninsured and under-insured people. VHC reports many people need guidance to navigate enrollment processes and programs are often difficult to afford for many Vermonters. This service includes enrollment assistance for preventive health care, health education and screenings, referrals to providers for ongoing health care through a medical home, and assistance with enrollment in State and local programs that pay for health care and other public programs. Similar enrollment and navigation services are also provided for New Hampshire residents who need assistance with New Hampshire programs. During the year, Valley Health Connections provided assistance to 1,826 patients.Child Day Care Services - SMCS operates two child day care services, with sites located in Springfield and Bellows Falls, VT. The Bellows Falls program serves children ages six weeks to six years and the Springfield program serves children six weeks to five years. Access to safe and educational day care is a vital component to a healthy community. SMCS provides this service to the general population, and financial assistance is available to those in need based on a sliding fee scale. During fiscal year 2017, SMCS provided care to 25 children in Bellows Falls and 34 children in Springfield at a subsidy of $49K.Subsidiary - SMCS is the parent corporation of Springfield Hospital. Springfield Hospital is a 25-bed critical access hospital located in Springfield, VT. Springfield Hospital also operates The Windham Center, a comprehensive inpatient psychiatric care hospital in Bellows Falls, VT; off-site physical therapy services, three hospital-owned specialty clinics: ENT, surgery, orthopaedics, and an adult day care center in Springfield, VT. | Desc |
| Total Program Service Expenses | $23,156,714 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 55 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 365 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VT | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Scott Whittemore | PersonNm |
| Phone | 8028852151 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Albert St Pierre | ||||||||
| Past Chairperson | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Bob Flint | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Carole Lechthaler | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| George Lamb | ||||||||
| Chairperson/Past Vice Chairperson | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.00 | |
| Jim Rumrill | ||||||||
| Vice Chairperson/ Past Director | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 2.00 | |
| Kevin Anderson | ||||||||
| Past Director | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | ||
| Lori Muse | ||||||||
| Past Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Nathan Cobb | ||||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | 2.00 | ||
| Paul Kendall | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Richard Dexter III | ||||||||
| Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Sarah Vail | ||||||||
| Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.00 | |
| Stephen Geller | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Stephen Lyon | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | 2.00 | ||
| Willie Pelton | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Cecil Beehler MD | ||||||||
| Chief Medical Officer | 40.00 | Yes (X) | $330,834 | $0 | $16,130 | |||
| Scott Whittemore | ||||||||
| CFO | 10.00 | Yes (X) | $213,505 | $0 | $9,472 | 30.00 | ||
| Timothy Ford | ||||||||
| CEO/President | 10.00 | Yes (X) | $281,466 | $0 | $18,717 | 30.00 | ||
| Barbara Dalton MD | ||||||||
| Family Medicine MD | 40.00 | $260,572 | $0 | $27,568 | Yes (X) | |||
| Eliot Hall | ||||||||
| Physician | 40.00 | $259,899 | $0 | $25,518 | Yes (X) | |||
| Michael Ritondo | ||||||||
| OB/GYN | 40.00 | $371,634 | $0 | $16,178 | Yes (X) | |||
| Richard Summermatter | ||||||||
| OB/GYN | 40.00 | $259,493 | $0 | $12,499 | Yes (X) | |||
| Theodore Miller | ||||||||
| Psychiatrist | 36.00 | $261,944 | $0 | $23,338 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,239,347 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $149,420 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Dartmouth Hitchcock | |||||
| 1 Medical Center Drive | Lebanon | NH | 03756 | Physician Services | $374,345 |
| Emergency Services of NE | |||||
| PO Box 12 | Chester | VT | 05143 | Physician Services | $208,920 |
| Simon Solano | |||||
| 192 No Runway Rd | Perkinsville | VT | 05151 | Physician Services | $177,166 |
| Michaud's Cleaning Service LLC | |||||
| 70 Windy Acres | Charlestown | NH | 03603 | Cleaning Services | $170,516 |
| Barton Associates | |||||
| PO Box 417844 | Boston | MA | 022417844 | Physician Services | $156,014 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $610,390 | RelatedOrganizationsAmt |
| Government Grants | $3,966,753 | GovernmentGrantsAmt |
| All Other Contributions | $732,877 | AllOtherContributionsAmt |
| Noncash Contributions | $48,000 | NoncashContributionsAmt |
| Total Contributions | $5,310,020 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 621110 | $26,246,202 | $26,246,202 |
| 340B Pharmacy Revenue & Other | 621110 | $4,283,682 | $4,283,682 |
| Miscellaneous Revenue | 624410 | $698,865 | $698,865 |
| Provision for Bad Debts | 621110 | -$884,907 | -$884,907 |
| Contractual Allowances | 621110 | -$7,977,403 | -$7,977,403 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $22,366,439 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $84,336 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $84,336 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $84,336 | TotalRevenueColumnAmt |
| Exclusion | $84,336 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $180,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $407,762 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$227,762 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$227,762 | TotalRevenueColumnAmt |
| Exclusion | -$227,762 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,533,033 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22,366,439 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$143,426 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $870,124 | TotalAmt |
| Management And General | $870,124 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,968,246 | TotalAmt |
| Program Services | $14,029,822 | ProgramServicesAmt |
| Management And General | $1,888,325 | ManagementAndGeneralAmt |
| Fundraising | $50,099 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,672 | TotalAmt |
| Program Services | $144,274 | ProgramServicesAmt |
| Management And General | $54,065 | ManagementAndGeneralAmt |
| Fundraising | $1,333 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,307,161 | TotalAmt |
| Program Services | $909,864 | ProgramServicesAmt |
| Management And General | $388,889 | ManagementAndGeneralAmt |
| Fundraising | $8,408 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,106,903 | TotalAmt |
| Program Services | $752,234 | ProgramServicesAmt |
| Management And General | $347,718 | ManagementAndGeneralAmt |
| Fundraising | $6,951 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,805 | TotalAmt |
| Management And General | $91,805 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,500 | TotalAmt |
| Management And General | $43,500 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,440,692 | TotalAmt |
| Program Services | $3,038,779 | ProgramServicesAmt |
| Management And General | $393,833 | ManagementAndGeneralAmt |
| Fundraising | $8,080 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,318 | TotalAmt |
| Management And General | $95,318 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $556,316 | TotalAmt |
| Program Services | $482,961 | ProgramServicesAmt |
| Management And General | $50,553 | ManagementAndGeneralAmt |
| Fundraising | $22,802 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $873,875 | TotalAmt |
| Program Services | $865,741 | ProgramServicesAmt |
| Management And General | $8,134 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,587 | TotalAmt |
| Program Services | $12,727 | ProgramServicesAmt |
| Management And General | $42,400 | ManagementAndGeneralAmt |
| Fundraising | $3,460 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,448 | TotalAmt |
| Program Services | $172,448 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $830,607 | TotalAmt |
| Program Services | $802,752 | ProgramServicesAmt |
| Management And General | $27,855 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,831 | TotalAmt |
| Program Services | $109,791 | ProgramServicesAmt |
| Management And General | $38,040 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $1,184,091 | $1,062,916 | $121,175 | |
| Other Expenses | $284,664 | $214,700 | $59,810 | $10,154 |
| Outside Training | $213,673 | $94,545 | $116,334 | $2,794 |
| Minor Equipment | $197,052 | $91,796 | $105,256 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $455,194 | TotalAmt |
| Program Services | $371,364 | ProgramServicesAmt |
| Management And General | $81,684 | ManagementAndGeneralAmt |
| Fundraising | $2,146 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,097,759 | TotalAmt |
| Program Services | $23,156,714 | ProgramServicesAmt |
| Management And General | $4,824,818 | ManagementAndGeneralAmt |
| Fundraising | $116,227 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $396,309 | BOYAmt |
| EOY | $416,395 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,119,885 | BOYAmt |
| EOY | $1,325,576 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,875,079 | BOYAmt |
| EOY | $1,711,283 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $234,369 | BOYAmt |
| EOY | $314,588 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,966,718 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,276,044 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,440,018 | BOYAmt |
| EOY | $12,690,674 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,723 | BOYAmt |
| EOY | $124,535 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,375,158 | BOYAmt |
| EOY | $1,591,474 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,562,541 | BOYAmt |
| EOY | $18,174,525 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,180,757 | BOYAmt |
| EOY | $4,717,693 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,453,084 | BOYAmt |
| EOY | $1,499,637 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,677,245 | BOYAmt |
| EOY | $3,996,013 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,239,643 | BOYAmt |
| EOY | $1,514,096 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,550,729 | BOYAmt |
| EOY | $11,727,439 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,011,812 | BOYAmt |
| EOY | $6,447,086 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,011,812 | BOYAmt |
| EOY | $6,447,086 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,562,541 | BOYAmt |
| EOY | $18,174,525 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$564,726 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | The Organization's tax exemption is based upon the classification of a hospital or cooperative hospital service organization described in section 170(b)(1)(A)(iii). Since the organization is not licensed by the State of Vermont as a hospital, Schedule H is not required. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,077 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,077 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Organization paid dues to organizations of which a percentage of the dues were used for lobbying. The Organization paid dues to the National Rural Health Association and the Bi-State Primary Care Association. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $96,301 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $155,159 | OtherCostOrOtherBasisAmt |
| Book Value | $251,460 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,968,930 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,846,633 | DepreciationAmt |
| Book Value | $5,122,297 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,688,327 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,610,641 | DepreciationAmt |
| Book Value | $5,077,686 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,527,533 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,808,278 | DepreciationAmt |
| Book Value | $1,719,255 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $530,468 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,492 | DepreciationAmt |
| Book Value | $519,976 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,690,674 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Estimated Third Party Payor Settlements | $470,054 |
| Due from Other Parties | $649,498 |
| Cash Surrender Value of Life Insurance | $153,069 |
| Deferred Compensation | $318,853 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,591,474 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Related Parties | $288,694 |
| Deposits in Transit | -$7,290 |
| Other | $668 |
| Remediation Liability | $800,231 |
| Deferred Compensation | $318,853 |
| Participant Distribution | $112,940 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,514,096 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $27,533,033 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $27,533,033 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $27,533,033 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $28,097,759 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $28,097,759 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $28,097,759 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cecil Beehler MD | ||||||||||||||
| Chief Medical Officer | $330,834 | $0 | $0 | $0 | $0 | $0 | $4,957 | $0 | $11,173 | $0 | $346,964 | $0 | $0 | $0 |
| Scott Whittemore | ||||||||||||||
| CFO | $212,008 | $0 | $0 | $0 | $1,497 | $0 | $4,096 | $0 | $5,376 | $0 | $222,977 | $0 | $0 | $0 |
| Timothy Ford | ||||||||||||||
| CEO/President | $281,466 | $0 | $0 | $0 | $0 | $0 | $3,572 | $0 | $15,145 | $0 | $300,183 | $0 | $0 | $0 |
| Barbara Dalton MD | ||||||||||||||
| Family Medicine MD | $260,572 | $0 | $0 | $0 | $0 | $0 | $4,261 | $0 | $23,307 | $0 | $288,140 | $0 | $0 | $0 |
| Eliot Hall | ||||||||||||||
| Physician | $259,899 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $25,518 | $0 | $285,417 | $0 | $0 | $0 |
| Michael Ritondo | ||||||||||||||
| OB/GYN | $371,634 | $0 | $0 | $0 | $0 | $0 | $5,023 | $0 | $11,155 | $0 | $387,812 | $0 | $0 | $0 |
| Richard Summermatter | ||||||||||||||
| OB/GYN | $259,493 | $0 | $0 | $0 | $0 | $0 | $5,010 | $0 | $7,489 | $0 | $271,992 | $0 | $0 | $0 |
| Theodore Miller | ||||||||||||||
| Psychiatrist | $261,944 | $0 | $0 | $0 | $0 | $0 | $5,087 | $0 | $18,251 | $0 | $285,282 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $48,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | Form 990 is reviewed by the organization's Chief Financial Officer upon completion. |
| Form 990, Part VI, Section B, line 12c | Conflicts of interest are reviewed by the Corporate Compliance Officer and Chief Executive Officer on an annual basis. Members must recuse themselves from voting on issues where a conflict is actual or implied. |
| Form 990, Part VI, Section B, line 15a | The 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 upon request. |
| Form 990, Part IX, line 11g | Purchased Services: Program service expenses 1,006,470. Management and general expenses 62,201. Fundraising expenses 150. Total expenses 1,068,821. Locum Expense: Program service expenses 1,611,522. Management and general expenses 8,707. Fundraising expenses 0. Total expenses 1,620,229. Consulting Services: Program service expenses 0. Management and general expenses 18,095. Fundraising expenses 0. Total expenses 18,095. Contracted Services: Program service expenses 420,787. Management and general expenses 304,830. Fundraising expenses 7,930. Total expenses 733,547. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Springfield Medical Care Systems, Inc. PO Box 2003 Springfield, VT 05156 EIN: 03-0284813 Springfield Medical Care Systems, Inc. is electing to capitalize and repair maintenance costs under Regulation Section 1.263(a)-3(n). |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Hospital Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2003 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05156 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030179437 | EIN |
| Primary Activities | Hospital inpatient and outpatient care | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Medical Care Systems Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (9 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Springfield Hospital Inc | ||
| A | $72,336 | FMV |
| Springfield Hospital Inc | ||
| C | $610,390 | FMV |
| Springfield Hospital Inc | ||
| E | $217,436 | FMV |
| Springfield Hospital Inc | ||
| J | $39,726 | FMV |
| Springfield Hospital Inc | ||
| L | $188,400 | FMV |
| Springfield Hospital Inc | ||
| O | $117,885 | FMV |
| Springfield Hospital Inc | ||
| P | $7,960 | FMV |
| Springfield Hospital Inc | ||
| Q | $50,032 | FMV |
| Springfield Hospital Inc | ||
| S | $290,000 | FMV |