NORTH COUNTRY HOSPITAL & HEALTH CENTER,INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: NORTH COUNTRY HOSPITAL & HEALTH CENTER,INC (EIN 03-0185556)
Tax period: 2015-10-01 to 2016-09-30
Filed: 2017-08-11
IRS object ID: 201702239349300625
Schema version: 2015v3.0
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 H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-08-11T09:42:23-05:00	ReturnTs
Tax Period End	2016-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

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

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	030185556	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ANDRE BISSONNETTE	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2017-04-21	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

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

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	CLAUDIO FORT	PrincipalOfficerNm

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$96,430,161	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.NCHSI.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1919	FormationYr
Legal Domicile State	VT	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE HEALTH CARE SERVICES TO THE RESIDENTS OF ORLEANS AND ESSEX COUNTIES, ENSURING THAT HEALTH CARE IS AVAILABLE TO ALL PEOPLE.	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	642	TotalEmployeeCnt
Total Volunteers	45	TotalVolunteersCnt
Total Gross UBI	$6,365	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$4,472	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$348,973	PYContributionsGrantsAmt
CY Contributions Grants	$229,580	CYContributionsGrantsAmt
PY Program Service Revenue	$83,154,416	PYProgramServiceRevenueAmt
CY Program Service Revenue	$86,508,153	CYProgramServiceRevenueAmt
PY Investment Income	$1,070,990	PYInvestmentIncomeAmt
CY Investment Income	$1,419,330	CYInvestmentIncomeAmt
PY Other Revenue	$78,694	PYOtherRevenueAmt
CY Other Revenue	-$418,828	CYOtherRevenueAmt
PY Total Revenue	$84,653,073	PYTotalRevenueAmt
CY Total Revenue	$87,738,235	CYTotalRevenueAmt
PY Grants And Similar Paid	$212,800	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$50,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$45,154,554	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$48,155,914	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$35,825,906	PYOtherExpensesAmt
CY Other Expenses	$38,713,747	CYOtherExpensesAmt
PY Total Expenses	$81,193,260	PYTotalExpensesAmt
CY Total Expenses	$86,919,661	CYTotalExpensesAmt
PY Revenues Less Expenses	$3,459,813	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$818,574	CYRevenuesLessExpensesAmt
Total Assets BOY	$81,720,283	TotalAssetsBOYAmt
Total Assets EOY	$79,972,240	TotalAssetsEOYAmt
Total Liabilities BOY	$35,494,030	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$31,606,705	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$46,226,253	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$48,365,535	NetAssetsOrFundBalancesEOYAmt
Mission	QUALITY PATIENT CARE IS OUR GREATEST COMMITMENT, EMPLOYEES ARE OUR GREATEST ASSET, EXCELLENT PATIENT EXPERIENCE IS OUR GREATEST ACCOMPLISHMENT, AND THE HEALTH OF OUR COMMUNITY IS OUR GREATEST RESPONSIBILITY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$44,357,565	ExpenseAmt
Revenue	$60,852,983	RevenueAmt
Desc	THE HOSPITAL OFFERS OUTPATIENT SERVICES INCLUDING EMERGENCY ROOM, LAB WORK, DIAGNOSTIC IMAGING (X-RAY, CT SCAN, MRI, MAMMOGRAMS, NUCLEAR IMAGING ULTRASOUND), OUTPATIENT SURGERIES, ONCOLOGY TREATMENTS, PULMONARY, CARDIAC CARE AND THERAPY SERVICES (PHYSICAL, SPEECH AND REHABILITATIVE) TOTALING 67,973 REGISTRATIONS FOR THE YEAR.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$9,605,411	ExpenseAmt
Grant	$50,000	GrantAmt
Revenue	$13,202,991	RevenueAmt
Desc	INPATIENT HOSPITAL CARE WAS PROVIDED AT A CRITICAL ACCESS HOSPITAL TOTALING 5,883 PATIENT DAYS FOR THE YEAR. THE HOSPITAL'S INPATIENT CARE SERVICES INCLUDE A 24 HOUR EMERGENCY DEPARTMENT, MEDICAL AND SURGICAL SERVICES, INTENSIVE CARE UNITS, BIRTHING CENTER, CLINICAL LABORATORY, MRI AND ULTRASOUND, NEUROLOGY, ORTHOPEDICS, PHARMACY, REHABILITATION SERVICES, OCCUPATIONAL AND PHYSICAL THERAPY AMONG OTHERS. THE HOSPITAL ALSO PROVIDED COMMUNITY GRANTS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$21,134,339	ExpenseAmt
Revenue	$12,452,179	RevenueAmt
Desc	THE HOSPITAL'S PHYSICIAN PRACTICE CLINICS PROVIDE INTERNAL MEDICINE RADIOLOGY PROGRAM, PSYCHIATRIC, OB/GYN, NEUROLOGY, ORTHOPEDICS, OCCUPATIONAL HEALTH, PULMONARY-SLEEP, SURGICAL SERVICES AND HEMATOLOGY/ONCOLOGY PRACTICES. THE PHYSICIAN PRACTICE CLINICS OF THE HOSPITAL SERVICED 97,590 PATIENTS VISITS FOR THE YEAR.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$75,097,315	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	78	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	642	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	ANDRE BISSONNETTE	PersonNm
Phone	8023347331	PhoneNum

US Address USAddress

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

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

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
CLAUDIO FORT
CEO	40.0	2.0	Yes (X)	Yes (X)	$369,848	$0	$48,092
KATHRYN AUSTIN
CHAIR	10.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
ALAN WING
VICE CHAIR - BOARD	5.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
GARY GILLESPIE
VICE CHAIR FINANCE	5.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
MELISSA PETTERSSON
SECRETARY/CLERK	5.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
RICHARD BARAW
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
MARK BEAMS
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
VERONIKA JEDLOVSZKY MD
MED STAFF PRESIDENT	40.0	2.0	Yes (X)	Yes (X)	$468,325	$0	$52,975
FRANK KNOLL
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
THOMAS MILNAMOW
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
CHRISTOPHER RICKMAN MD
TRUSTEE/PHYSICIAN	40.0	2.0	Yes (X)		$342,567	$0	$41,264
LARRY SISSON MD
MEDICAL STAFF VP BEG 10/2015	40.0	2.0	Yes (X)	Yes (X)	$542,515	$0	$44,159
BILL STENGER
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
BOB WILSON
TRUSTEE	5.0	2.0	Yes (X)		$0	$0	$0
ANDRE BISSONNETTE
CHIEF FINANCIAL OFFICER	40.0	2.0		Yes (X)	$209,638	$0	$40,550
THOMAS FRANK
CHIEF OPERATING OFFICER	40.0	2.0			$255,147	$0	$9,932	Yes (X)
SG NEALE MD
PHYSICIAN	40.0	0.0			$657,467	$0	$46,393		Yes (X)
GREG WALKER MD
PHYSICIAN	40.0	0.0			$539,991	$0	$54,270		Yes (X)
PETER STUART MD
PHYSICIAN	40.0	0.0			$534,792	$0	$22,953		Yes (X)
GENE WU MD
PHYSICIAN	40.0	0.0			$449,565	$0	$40,474		Yes (X)
MARK MEREDITH MD
PHYSICIAN	40.0	0.0			$428,572	$0	$35,539		Yes (X)
RACHEL DISANTO MD
TRUSTEE/MD STAFF PRES END 9/15	0.0	0.0			$240,833	$0	$41,169			Yes (X)
BRENDA NEFF
FORMER VP OF PATIENT CARE	0.0	0.0			$153,789	$0	$29,589			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,193,049	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$507,359	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	64	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
NORTH COUNTRY RADIOLOGY
PC	NEWPORT	VT	05855	PHYSICIAN	$947,330
MORRISON MANAGEMENT
SPECIALISTS	ATLANTA	GA	30368	CAFE MGMT	$596,800
UVM MEDICAL CENTER
INC	BURLINGTON	VT	05402	MEDICAL	$513,017
CLAUDE PAUL
CONSTRUCTION	DERBY	VT	05829	CONSTRUCTION	$210,267
SYMPHONIC HEALTHCARE
SOLUTIONS	CHARLOTTE	VT	05445	CONSULTANT	$168,273

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	6	CntrctRcvdGreaterThan100KCnt
Government Grants	$202,488	GovernmentGrantsAmt
All Other Contributions	$27,092	AllOtherContributionsAmt
Total Contributions	$229,580	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE	624100	$78,538,688	$78,538,688
EHR REVENUE	624100	$233,750	$233,750
OTHER PATIENT SERVICE REVENUE	624100	$3,587,602	$3,587,602
CAFETERIA	722514	$285,370	$285,370
340B PHARMACY	446110	$3,862,743	$3,862,743

Field	Value	IRS element (for citing)
Total Program Service Revenue	$86,508,153	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$644,108	TotalRevenueColumnAmt
Exclusion	$644,108	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$9,391,553	SecuritiesAmt
Other	$75,595	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$8,674,781	SecuritiesAmt
Other	$17,145	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$716,772	SecuritiesAmt
Other	$58,450	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$775,222	TotalRevenueColumnAmt
Exclusion	$775,222	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
GAIN ON INVEST IN EQUITY INVESTEE	812900	$145,695	$145,695
ADMIN SERVICES	561000	$3,280		$3,280
HOUSEKEEPING	900099	$3,085		$3,085

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$570,888	TotalRevenueColumnAmt
Exclusion	-$570,888	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	-$418,828	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$87,738,235	TotalRevenueColumnAmt
Related Or Exempt Func Income	$86,508,153	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$6,365	UnrelatedBusinessRevenueAmt
Exclusion	$994,137	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$50,000	TotalAmt
Program Services	$50,000	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

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

Foreign Grants ForeignGrantsGrp

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

Benefits To Members BenefitsToMembersGrp

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,425,012	TotalAmt
Program Services	$1,491,805	ProgramServicesAmt
Management And General	$933,207	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$465,380	TotalAmt
Program Services	$324,379	ProgramServicesAmt
Management And General	$141,001	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$34,992,755	TotalAmt
Program Services	$30,952,223	ProgramServicesAmt
Management And General	$4,040,532	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,472,948	TotalAmt
Program Services	$1,308,321	ProgramServicesAmt
Management And General	$164,627	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,431,303	TotalAmt
Program Services	$5,667,050	ProgramServicesAmt
Management And General	$764,253	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,368,516	TotalAmt
Program Services	$2,069,600	ProgramServicesAmt
Management And General	$298,916	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$694,711	TotalAmt
Management And General	$694,711	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$112,427	TotalAmt
Management And General	$112,427	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$216,111	TotalAmt
Management And General	$216,111	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$254,916	TotalAmt
Management And General	$254,916	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$8,232,948	TotalAmt
Program Services	$7,341,584	ProgramServicesAmt
Management And General	$891,364	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$360,380	TotalAmt
Program Services	$33,702	ProgramServicesAmt
Management And General	$326,678	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,305,842	TotalAmt
Program Services	$1,783,893	ProgramServicesAmt
Management And General	$521,949	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$40,523	TotalAmt
Program Services	$24,673	ProgramServicesAmt
Management And General	$15,850	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,179,686	TotalAmt
Program Services	$1,030,901	ProgramServicesAmt
Management And General	$148,785	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$221,849	TotalAmt
Program Services	$168,666	ProgramServicesAmt
Management And General	$53,183	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$327,717	TotalAmt
Program Services	$286,531	ProgramServicesAmt
Management And General	$41,186	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$627,935	TotalAmt
Program Services	$74,541	ProgramServicesAmt
Management And General	$553,394	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$5,000,187	TotalAmt
Program Services	$4,494,095	ProgramServicesAmt
Management And General	$506,092	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$618,991	TotalAmt
Program Services	$435,240	ProgramServicesAmt
Management And General	$183,751	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$8,163,434	$8,163,434
PROVIDER TAX	$4,464,892	$4,464,892
BAD DEBT	$2,804,196	$2,804,196
REPAIRS & MAINTENANCE	$2,710,544	$1,952,180	$758,364

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$376,458	TotalAmt
Program Services	$175,409	ProgramServicesAmt
Management And General	$201,049	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$86,919,661	TotalAmt
Program Services	$75,097,315	ProgramServicesAmt
Management And General	$11,822,346	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

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

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$8,712,080	BOYAmt
EOY	$4,298,001	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$28,567	BOYAmt
EOY	$11,155	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$8,266,834	BOYAmt
EOY	$7,992,724	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,368,139	BOYAmt
EOY	$2,530,946	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,180,891	BOYAmt
EOY	$1,194,451	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$73,927,209	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$47,111,821	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$28,038,118	BOYAmt
EOY	$26,815,388	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$29,223,916	BOYAmt
EOY	$32,844,585	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$173,495	BOYAmt
EOY	$199,190	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$834,184	BOYAmt
EOY	$912,376	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$368,000	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,526,059	BOYAmt
EOY	$3,173,424	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$81,720,283	BOYAmt
EOY	$79,972,240	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,092,567	BOYAmt
EOY	$8,680,688	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$17,034	BOYAmt
EOY	$17,234	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$19,695,000	BOYAmt
EOY	$18,559,818	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$1,682,117	BOYAmt
EOY	$1,382,017	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,007,312	BOYAmt
EOY	$2,966,948	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$35,494,030	BOYAmt
EOY	$31,606,705	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$42,744,685	BOYAmt
EOY	$44,597,471	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,686,859	BOYAmt
EOY	$2,973,355	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$794,709	BOYAmt
EOY	$794,709	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$46,226,253	BOYAmt
EOY	$48,365,535	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$81,720,283	BOYAmt
EOY	$79,972,240	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$818,574	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,574,151	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$253,443	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$15,754	OtherActivitiesAmt
Total Lobbying Expenditures	$15,754	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1(I)	FormAndLineReferenceDesc
Explanation	OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE VERMONT HOSPITAL ASSOCIATION, WHICH HAS REPORTED THAT APPROXIMATELY 12.18% OF DUES SUPPORT LOBBYING EFFORTS. IN ADDITION, THE ORGANIZATION PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION, WHICH HAS REPORTED THAT APPROXIMATELY 22.12% OF DUES SUPPORT LOBBYING EFFORTS.	ExplanationTxt

Schedule D IRS990ScheduleD

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

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,835,712	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$84,286	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$5,820	GrantsOrScholarshipsAmt
End Year Balance	$2,745,606	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,731,541	BeginningYearBalanceAmt
Investment Earnings Or Losses	$104,171	InvestmentEarningsOrLossesAmt
End Year Balance	$2,835,712	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,652,555	BeginningYearBalanceAmt
Investment Earnings Or Losses	$78,986	InvestmentEarningsOrLossesAmt
End Year Balance	$2,731,541	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.27830	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.72170	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

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

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$19,609,012	OtherCostOrOtherBasisAmt
Depreciation	$12,535,410	DepreciationAmt
Book Value	$7,073,602	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$22,950,241	OtherCostOrOtherBasisAmt
Depreciation	$14,266,319	DepreciationAmt
Book Value	$8,683,922	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$28,005,843	OtherCostOrOtherBasisAmt
Depreciation	$19,161,520	DepreciationAmt
Book Value	$8,844,323	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,956,192	OtherCostOrOtherBasisAmt
Depreciation	$1,148,572	DepreciationAmt
Book Value	$1,807,620	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$26,815,388	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
EST AMTS DUE TO 3RD PARTY PAYER	$487,116
INTEREST RATE SWAP	$2,479,832

Field	Value	IRS element (for citing)
Total Liability	$2,966,948	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$84,516,504	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$112,619	NetUnrealizedGainsInvstAmt
Other Revenue	-$3,109,112	OtherRevenueAmt
Revenue Not Reported	-$3,221,731	RevenueNotReportedAmt
Revenue Subtotal	$87,738,235	RevenueSubtotalAmt
Total Revenue Per Form990	$87,738,235	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$83,810,549	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$83,810,549	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$254,916	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$2,854,196	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$3,109,112	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$86,919,661	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	ENDOWMENT FUNDS: NORTH COUNTRY HEALTH SYSTEMS (NCHS), A RELATED ORGANIZATION, HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND OTHER ITEMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT. UNDER NCHS'S POLICIES, THE PRIMARY INVESTMENT GOAL IS GROWTH IN THE ENDOWMENT ACCOUNTS. NCHS EXPECTS ITS ENDOWMENT FUNDS TO PROVIDE AN AVERAGE RATE OF RETURN THAT EXCEEDS BENCH MARK RETURNS INDICATED FOR VARIOUS ASSET CLASSES.
SCHEDULE D, PART X, LINE 2	UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2D	AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ (2,804,196) BAD DEBT EXPENSE (254,916) INVESTMENT MANAGEMENT FEES (50,000) CONTRIBUTIONS PAID ------------- $ (3,109,112)
SCHEDULE D, PART XII, LINE 4B	AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 2,804,196 BAD DEBT EXPENSE 50,000 CONTRIBUTIONS PAID ------------ $ 2,854,196

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$552,451	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$552,451	NetCommunityBenefitExpnsAmt
Total Expense	0.00660	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,521,964	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,056,529	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,465,435	NetCommunityBenefitExpnsAmt
Total Expense	0.16010	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,074,415	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,056,529	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,017,886	NetCommunityBenefitExpnsAmt
Total Expense	0.16670	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$45,938	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,606	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$42,332	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$152,988	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$152,988	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,737,568	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,075,886	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,661,682	NetCommunityBenefitExpnsAmt
Total Expense	0.06730	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$40,256	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$40,256	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,976,750	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,079,492	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,897,258	NetCommunityBenefitExpnsAmt
Total Expense	0.07010	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$46,051,165	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$26,136,021	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,915,144	NetCommunityBenefitExpnsAmt
Total Expense	0.23680	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,363	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,363	NetCommunityBenefitExpnsAmt

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,647	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,647	NetCommunityBenefitExpnsAmt

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,501	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,501	NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,527	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,527	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,038	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$24,038	NetCommunityBenefitExpnsAmt

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$2,804,196	BadDebtExpenseAmt
Bad Debt Expense Attributable	$372,958	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$28,294,037	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$30,128,804	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,834,767	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Website Address	NCHSI.ORG	WebsiteAddressTxt
State License	832	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Average Negotiated Rates	Yes (X)	AverageNegotiatedRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	COMMUNITY INPUT: IN KEEPING WITH THE GUIDELINES FOR A COMPREHENSIVE CHNA, A NUMBER OF KEY COMMUNITY STAKEHOLDERS WHO REPRESENT THE BROAD INTEREST OF THE NEWPORT HOSPITAL SERVICE AREA, INCLUDING LEADERS AND REPRESENTATIVES OF ORGANIZATIONS THAT SERVE VARIOUS SEGMENTS OF THE POPULATION IN THE NCH SERVICE AREA WERE INVITED TO PARTICIPATE ON THE CHNA ADVISORY TEAM. WITH THE NCH CORE TEAM AS A SUBGROUP OF THE CHNA ADVISORY TEAM, THE ADVISORY TEAM WAS LEAD AND DISCUSSION WAS FACILITATED BY J. RIFFON.
SCHEDULE H, PART V, SECTION B, LINE 7A & 10	WEBSITE URL FOR CHNA REPORT: HTTPS://WWW.NORTHCOUNTRYHOSPITAL.ORG/COMMUNITY-NEEDS-ASSESSMENT/
SCHEDULE H, PART V, SECTION B, LINE 11	ADDRESSING IDENTIFIED NEEDS: AFTER REVIEW OF THE COMBINATION OF DATA AND THE RESULTS OF THE COMMUNITY SURVEY AND FOCUS GROUP PROCESSES, THE ADVISORY TEAM PRIORITIZED THE FOLLOWING AS KEY HEALTH CONCERNS RECOMMENDED FOR DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR THE 2015 NCH COMMUNITY HEALTH NEEDS ASSESSMENT: - TOBACCO USE: ADDICTION TREATMENT AND PREVENTION - ALCOHOL, STREET DRUGS AND PRESCRIPTION ABUSE: ADDICTION TREATMENT AND PREVENTION - OVERWEIGHT /OBESITY: ENCOURAGE PHYSICAL ACTIVITY AND HEALTHY EATING - ACCESS TO MEDICAL CARE WHEN NEEDED - ACCESS TO DENTAL CARE AND ORAL HEALTH SERVICES WHEN NEEDED - ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE CARE WHEN NEEDED ADDITIONALLY, THE ADVISORY TEAM ACKNOWLEDGES THERE ARE RELATED KEY CONCERNS WHICH WERE IDENTIFIED THROUGH THE ASSESSMENT PROCESS THAT IMPACT THE HEALTH OF THE NCH SERVICE AREA BUT WHICH NCH'S IMPLEMENTATION STRATEGY DOES NOT INTEND TO DIRECTLY ADDRESS WITH SPECIFIC MEASURES OR ACTIVITIES TO ASSESS PROGRESS. THESE RELATED KEY CONCERNS INCLUDE: - HIGHER RATES OF UNEMPLOYMENT, POVERTY, LACK OF HIGH SCHOOL EDUCATION - TRANSPORTATION CHALLENGES - INCREASED ELDERLY POPULATION - CHILD ABUSE OR NEGLECT - VIOLENCE IN THE HOME - RAPE AND/OR SEXUAL ASSAULT HOWEVER, NCH'S IMPLEMENTATION STRATEGY CONTAINS A RECOMMENDATION TO ADDRESS THE RELATED HEALTH CONCERNS LISTED ABOVE BY A COMMITMENT TO ASSESS THE NEED AND COMMUNITY CAPACITY TO IMPLEMENT THE BRIDGES OUT OF POVERTY INITIATIVE IN THE NCH SERVICE AREA. THIS IS A NATIONALLY RECOGNIZED COMMUNITY SUPPORT PROGRAM WHICH HELPS A COMMUNITY MOVE INDEPENDENTLY FROM POVERTY TO SELF-SUFFICIENCY.
SCHEDULE H, PART V, SECTION B, LINE 16A	WEBSITE URL FOR FAP: https://www.northcountryhospital.org/financial-services/
SCHEDULE H, PART V, SECTION B, LINE 16B	WEBSITE URL FOR FAP APPLICATION: https://www.northcountryhospital.org/financial-services/
SCHEDULE H, PART V, SECTION B, LINE 16C	WEBSITE URL FOR PLAIN LANGUAGE FAP SUMMARY: https://www.northcountryhospital.org/financial-services/

Field	Value	IRS element (for citing)
Facility	7	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

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

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN F	PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE OF $2,804,196.
SCHEDULE H, PART I, LINE 7	COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3, AND 6.
SCHEDULE H, PART I, LINE 7G	SUBSIDIZED SERVICES: AMOUNTS USED IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G PRIMARILY CAME FROM COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHC). NORTH COUNTRY HOSPITAL PROVIDES PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITIES AT THE CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. NORTH COUNTRY HOSPITAL CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. THE NET AMOUNT OF SUBSIDIZED SERVICES ATTRIBUTABLE TO RHC'S IS $5,661,682.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES: OUR ORGANIZATION'S COMMUNITY-BUILDING ACTIVITIES INCLUDE ACTIVE PARTICIPATION BY HOSPITAL STAFF ON A NUMBER OF ECONOMIC-BUILDING COLLABORATIONS SUCH AS THE LOCAL ROTARY AND CHAMBER OF COMMERCE AS WELL AS ON LOCAL PARTNERSHIPS SUCH AS THOSE THAT FOCUS ON PREVENTION AND REDUCTION OF DOMESTIC VIOLENCE, PREVENTION/REDUCTION OF ALCOHOL, DRUGS AND TOBACCO, PROMOTION OF PHYSICAL ACTIVITY AND HEALTHY LIFESTYLE CHOICES. THE HOSPITAL ALSO PROVIDES MEETING SPACE AT NO CHARGE FOR NUMEROUS AGENCIES AND GROUPS THAT TARGET VARIOUS ASPECTS OF COMMUNITY HEALTH SUCH AS ALCOHOLICS ANONYMOUS, EARLY CHILDHOOD DEVELOPMENT, GRIEVING SUPPORT GROUPS, DRIVING SAFETY COURSES, YOUTH BEHAVIOR SUPPORT TEAMS AND YOUTH COURT DIVERSION TEAMS.
SCHEDULE H, PART III, SECTION A, LINE 2	BAD DEBT EXPENSE: BAD DEBT EXPENSE REPORTED ON LINE 2 IS THE AMOUNT PER THE AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION A, LINE 3	BAD DEBT EXPENSE ATTRIBUTABLE TO FINANCIAL ASSISTANCE: THE ORGANIZATION HAS ESTIMATED THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 BY UTILIZING DATA FROM THE U.S. CENSUS BUREAU. THE ORGANIZATION ESTIMATED THE PERCENTAGE BY OBTAINING THE PERCENT OF THE POPULATION IN ITS SERVICE AREA FALLING BELOW THE FEDERAL POVERTY GUIDELINES.
SCHEDULE H, PART III, SECTION A, LINE 4	BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.
SCHEDULE H, PART III, SECTION B, LINES 5-7	MEDICARE CALCULATION: THE AMOUNTS SHOWN ON LINES 5, 6, AND 7 DO NOT INCLUDE THE MEDICARE REVENUES AND COSTS ASSOCIATED WITH THE RURAL HEALTH CLINICS. THESE MEDICARE REVENUES AND COSTS COMPRISE A PORTION OF THE TOTAL SUBSIDIES INCLUDED IN SUBSIDIZED SERVICES ON PART I, LINE 7G. AS THESE FIGURES DO NOT INCLUDE CERTAIN MEDICARE PROGRAM REVENUES AND COSTS, IT THUS CANNOT REFLECT ALL OF THE ORGANIZATION'S REVENUES AND COSTS ASSOCIATED WITH ITS PARTICIPATION IN MEDICARE PROGRAMS.
SCHEDULE H, PART III, SECTION B, LINE 8	COMMUNITY BENEFIT: THE COMMUNITY IS BETTER SERVED WITH PROVIDERS AVAILABLE IN THE ORGANIZATION'S REMOTE REGION. THE ENTIRETY OF ANY SHORTFALL REPORTED SHOULD BE TREATED AS COMMUNITY BENEFIT. THE ORGANIZATION ACCEPTS ALL MEDICARE PATIENTS KNOWING THAT THERE WILL LIKELY BE SHORTFALLS. ADDITIONALLY, TREATING MEDICARE PATIENTS IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION POLICY: WHEN IDENTIFIED AS A POSSIBLE WRITE OFF TO MEDICARE BAD DEBT, AN ACCOUNT MUST MEET MEDICARE'S CRITERIA FOR REPORTING ON THE COST REPORT. AN ACCOUNT FOR A MEDICARE PATIENT MUST UNDERGO HOSPITAL COLLECTION EFFORTS FOR AT LEAST 120 DAYS FROM THE INITIAL DATE OF BILLING TO THE PATIENT BEFORE BEING CONSIDERED FOR WRITE-OFF TO A THIRD PARTY AGENCY. THESE MEDICARE ACCOUNTS WILL BE CLOSED AND RETURNED BY THE AGENCIES AFTER 120 DAYS FROM PLACEMENT IF COLLECTION EFFORTS FAIL AND THEY ARE DEEMED UNCOLLECTIBLE. IF A MEDICARE PATIENT IS DECEASED AND NO ESTATE CAN BE IDENTIFIED, IT WILL BE DEEMED UNCOLLECTIBLE AND MAY BE DIRECTLY CONSIDERED FOR WRITE-OFF RATHER THAN TURNED OVER TO A THIRD PARTY AGENCY. IF A MEDICARE PATIENT FILES FOR BANKRUPTCY, THE ACCOUNTS WILL BE DEEMED UNCOLLECTIBLE AND WILL BE DIRECTLY CONSIDERED FOR WRITE-OFF. IF A MEDICARE PATIENT QUALIFIES FOR FREE CARE UNDER THE HOSPITAL'S GUIDELINES, THE ACCOUNT(S) WILL BE DEEMED UNCOLLECTIBLE AND WILL BE WRITTEN OFF TO THE APPROPRIATE PAT CODE(S). WHEN A MEDICARE ACCOUNT IS DEEMED UNCOLLECTIBLE, THE DEDUCTIBLE AND/OR COINSURANCE AMOUNTS WILL BE WRITTEN OFF USING THE APPROPRIATE PAT CODE(S). NON COVERED AMOUNTS DO NOT QUALIFY FOR MEDICARE BAD DEBT. ALL SUPPORTING DOCUMENTATION REGARDING DEDUCTIBLE AND COINSURANCE AMOUNTS WILL BE COLLECTED AND FILES FOR COST REPORTING PURPOSES.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: THE HOSPITAL ACTIVELY PARTICIPATES IN A NUMBER OF COMMUNITY PARTNERSHIPS THAT FOCUS ON VARIOUS ASPECTS OF LOCAL HEALTH NEEDS - INCLUDING, FOR EXAMPLE, HEALTH DISPARITIES, ALCOHOL, DRUG AND TOBACCO PREVENTION, PROMOTING HEALTHY EATING AND PHYSICAL ACTIVITY. THE VT DEPARTMENT OF HEALTH REMAINS AN EXCELLENT AND VERY THOROUGH DATA SOURCE, WITH DATA AVAILABLE STATEWIDE, BY COUNTY AND BY SCHOOL SUPERVISORY DISTRICTS. DATA IS AVAILABLE ACROSS THE LIFESPAN AND INCLUDES, FOR EXAMPLE TOPICS SUCH AS COMMUNICABLE DISEASE, CHRONIC DISEASE, OCCUPATIONAL HEALTH DATA, RISK FACTORS SUCH AS ALCOHOL, DRUG AND TOBACCO USE, OBESITY, LIFESTYLE CHOICES. DATA REGARDING SOCIOECONOMIC STATUS AND EDUCATION LEVEL IS ALSO READILY AVAILABLE, AGAIN FOR THE STATE AS WELL AS BY COUNTY AND SCHOOL DISTRICT. ALL DATA IS EASILY ACCESSIBLE ONLINE AT WWW.HEALTHVERMONT.GOV AND AT HUMANSERVICES.VERMONT.GOV. THE HOSPITAL ALSO COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT TO COMPLY WITH NEW IRS 501(R) REQUIREMENTS.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FOR BALANCES OVER $500.00 A HELP IS AVAILABLE LETTER IS MAILED WITH THE INITIAL BILL, REGARDLESS OF WHETHER THE BALANCE IS SELF-PAY, PRIMARY OR AFTER INSURANCE. IN ADDITION, OUR COLLECTION LETTERS ALL REFER TO OUR FREE CARE PROGRAM ASKING THE PATIENT TO CALL TO DISCUSS THIS AND OTHER OPTIONS. WHEN FREE CARE IS DISCUSSED WITH THE PATIENT, IT IS EXPLAINED THAT THEY ARE REQUIRED TO APPLY FOR OTHER ASSISTANCE AND WE OFFER OUR HELP IN THE APPLICATION PROCESS. FOR SELF-PAY PATIENTS THAT ARE IP, ONE OF THE FINANCIAL COUNSELORS ATTEMPTS TO DISCUSS MEDICAID AS WELL AS FREE CARE.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: WE SERVE TWO OF THE MOST ECONOMICALLY CHALLENGED COUNTIES IN VERMONT. WITH A TOTAL OF APPROXIMATELY 30,000 RESIDENTS IN OUR SERVICE AREA, OUR POPULATION, AS COMPARED TO VT AND THE US, HAS A SIGNIFICANTLY HIGHER PERCENTAGE OF PERSONS LIVING UNDER THE FEDERAL POVERTY LEVEL AND A VERY HIGH RATE OF ADULTS AGE 25+ WITHOUT A HIGH SCHOOL EDUCATION, WHILE THE MEDIAN HOUSEHOLD INCOME IS SIGNIFICANTLY LOWER, AGAIN AS COMPARED TO VT AND THE US. OUR REGION CONSISTENTLY HAS ONE OF THE HIGHEST RATES OF UNEMPLOYMENT IN THE STATE. THIS PRIMARILY WHITE POPULATION IS FOUND IN VERY SMALL COMMUNITIES SCATTERED OVER A RURAL, MOUNTAINOUS, AND LAKE-DOTTED AREA, MAKING TRAVELING AND NETWORKING A CHALLENGE, PARTICULARLY IN THE HARSH WINTER MONTHS.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: IN ADDITION TO THE COMMUNITY BUILDING ACTIVITIES LISTED ON PART II, OTHER COMMUNITY BENEFITS INCLUDE ACTIVITIES SUCH AS PROVIDING SKILLED NURSING SERVICES WHILE ACUTELY ILL PATIENTS ARE TRANSFERRED BY AMBULANCE TO A TERTIARY CARE CENTER, PROVIDING SUPPORT AND SUPERVISION IN THE EDUCATION OF STUDENT NURSES AND MEDICAL STUDENTS, DONATING SUPPLIES AND EQUIPMENT TO OTHER NON-PROFIT ORGANIZATIONS FOR THEIR CONTINUED USE, ACTIVE PARTICIPATION ON THE BOARDS OF SEVERAL HEALTH RELATED AGENCIES SUCH AS THE VISITING NURSE ASSOCIATION, THE DOMESTIC VIOLENCE TASK FORCE, AND THE AREA AGENCY ON AGING. THE ORGANIZATION ALSO IMPLEMENTS A HELP LINE FOR THE HOMEBOUND OR FRAIL INDIVIDUALS WHO LIVE ALONE. A NUMBER OF LOCAL RESIDENTS RECEIVE THIS SERVICE AT NO COST TO THEM.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM ROLES: NORTH COUNTRY HEALTH SYSTEMS, INC. AND ITS SUBSIDIARIES COLLECTIVELY DO BUSINESS AS NORTH COUNTRY HEALTH SYSTEM (NCHS). NORTH COUNTRY HEALTH SYSTEMS, INC. (HEALTH SYSTEM) IS THE PARENT HOLDING COMPANY FOR ITS WHOLLY OWNED SUBSIDIARIES, WHICH INCLUDE NORTH COUNTRY HOSPITAL AND HEALTH CENTER, INC. (HOSPITAL) AND NORTH COUNTRY HEALTH SERVICES, INC., D/B/A DERBY GREEN (DERBY GREEN). NORTH COUNTRY HOSPITAL AND HEALTH CENTER, INC. OPERATES A 25-BED ACUTE CARE HOSPITAL FACILITY IN NEWPORT, VERMONT. THE HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN NEWPORT, VERMONT, AND THE SURROUNDING AREA. THE HOSPITAL ALSO OPERATES A NUMBER OF PHYSICIAN CLINICS IN THE SAME GEOGRAPHIC AREA. DERBY GREEN OPERATES A 23-BED NURSING HOME LOCATED IN DERBY, VERMONT.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NORTHERN COUNTIES HEALTH CARE INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	165 SHERMAN DRIVE	AddressLine1Txt
City	ST JOHNSBURY	CityNm
State Abbreviation	VT	StateAbbreviationCd
ZIP	05819	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	510199559	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$50,000	CashGrantAmt
Purpose Of Grant	SUPPORT	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	PROCEDURES FOR MONITORING FUNDS: NORTH COUNTRY HOSPITAL & HEALTH CENTER AWARDED THIS GRANT FOR THE PURPOSES OF CONSTRUCTING A DENTAL CLINIC IN ORLEANS IN ORDER TO EXPAND DENTAL CARE IN THE REGION. NORTH COUNTRY HOSPITAL & HEALTH CENTER WILL WORK CLOSELY WITH THE GRANTEE TO MONITOR PROGRESS ON THE PROJECT AND ENSURE FUNDS ARE SPENT IN ACCORDANCE WITH THE MEMORANDUM OF UNDERSTANDING EXECUTED BY BOTH OF THE ORGANIZATIONS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	Yes (true)	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDRE BISSONNETTE
CHIEF FINANCIAL OFFICER	$175,466	$0	$32,111	$0	$2,061	$0	$9,098	$0	$31,452	$0	$250,188	$0	$0	$0
CLAUDIO FORT
CEO	$296,336	$0	$73,512	$0	$0	$0	$15,446	$0	$32,646	$0	$417,940	$0	$0	$0
THOMAS FRANK
CHIEF OPERATING OFFICER	$216,100	$0	$37,665	$0	$1,382	$0	$7,957	$0	$1,975	$0	$265,079	$0	$0	$0
VERONIKA JEDLOVSZKY MD
MED STAFF PRESIDENT	$448,158	$0	$18,878	$0	$1,289	$0	$19,226	$0	$33,749	$0	$521,300	$0	$0	$0
CHRISTOPHER RICKMAN MD
TRUSTEE/PHYSICIAN	$312,303	$0	$21,560	$0	$8,704	$0	$17,515	$0	$23,749	$0	$383,831	$0	$0	$0
LARRY SISSON MD
MEDICAL STAFF VP BEG 10/2015	$516,554	$0	$0	$0	$25,961	$0	$19,793	$0	$24,366	$0	$586,674	$0	$0	$0
SG NEALE MD
PHYSICIAN	$606,364	$0	$27,750	$0	$23,353	$0	$10,310	$0	$36,083	$0	$703,860	$0	$0	$0
GREG WALKER MD
PHYSICIAN	$516,369	$0	$15,960	$0	$7,662	$0	$18,550	$0	$35,720	$0	$594,261	$0	$0	$0
PETER STUART MD
PHYSICIAN	$502,337	$0	$0	$0	$32,455	$0	$18,214	$0	$4,739	$0	$557,745	$0	$0	$0
GENE WU MD
PHYSICIAN	$406,149	$0	$15,494	$0	$27,922	$0	$14,474	$0	$26,000	$0	$490,039	$0	$0	$0
MARK MEREDITH MD
PHYSICIAN	$414,384	$0	$0	$0	$14,188	$0	$11,925	$0	$23,614	$0	$464,111	$0	$0	$0
RACHEL DISANTO MD
TRUSTEE/MD STAFF PRES END 9/15	$240,833	$0	$0	$0	$0	$0	$8,921	$0	$32,248	$0	$282,002	$0	$0	$0
BRENDA NEFF
FORMER VP OF PATIENT CARE	$153,789	$0	$0	$0	$0	$0	$1,510	$0	$28,079	$0	$183,378	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

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

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

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

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	false
B	false

Supplemental Information Detail SupplementalInformationDetail

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 1	ORGANIZATIONS MISSION: OUR MISSION: OUR MISSION IS TO PROVIDE EXCEPTIONAL CARE THAT MAKES A DIFFERENCE IN THE LIVES OF OUR PATIENTS AND COMMUNITY. VISION: WE WILL BE REGARDED AS AN EXCEPTIONAL COMMUNITY RESOURCE THAT HAS SIGNIFICANTLY IMPROVED THE HEALTH OF THE COMMUNITY. OUR VALUES: - QUALITY PATIENT CARE IS OUR GREATEST COMMITMENT - EMPLOYEES ARE OUR GREATEST ASSETS - EXCELLENT PATIENT EXPERIENCE IS OUR GREATEST ACCOMPLISHMENT - THE HEALTH OF THE COMMUNITY IS OUR GREATEST RESPONSIBILITY
FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B	MEMBERS/STOCKHOLDERS/OTHER PERSONS: THE SOLE MEMBER OF THE HOSPITAL SHALL BE NORTH COUNTRY HEALTH SYSTEMS, INC., A VERMONT NOT-FOR-PROFIT CORPORATION, ACTING THROUGH ITS BOARD OF TRUSTEES AND HEREINAFTER REFERRED TO AS THE "MEMBER" WHEN ACTING IN ITS CAPACITY AS SUCH. THE MEMBER SHALL HAVE THE EXCLUSIVE RIGHT TO ENJOY AND EXERCISE ALL RIGHTS AND POWERS CONFERRED ON MEMBERS OF NON-PROFIT CORPORATIONS UNDER THE LAWS OF THE STATE OF VERMONT, SUBJECT TO THE TERMS AND CONDITIONS OF THE AFFILIATION. THE MEMBER SHALL HAVE SUCH OTHER POWERS AS ARE SPECIFIED IN THE ARTICLES OF ASSOCIATION AND IN THESE BYLAWS, INCLUDING, WITHOUT THE POWER TO ELECT AND REMOVE TRUSTEES AND TO AMEND AND RESTATE THE ARTICLES OF ASSOCIATION. TWELVE OF THE TRUSTEES SHALL BE ELECTED BY THE MEMBER. THE AUTHORITY OF THE BOARD OF TRUSTEES TO EXERCISE THE FOLLOWING POWERS IS CONDITIONED ON THE PRIOR APPROVAL OF THE MEMBER: (1) THE ADOPTION OF ANNUAL OPERATING BUDGETS; (2) THE ADOPTION OF CAPITAL BUDGETS; (3) ANY VOLUNTARY DISSOLUTION, MERGER, OR CONSOLIDATION OF THE HOSPITAL OR THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE HOSPITAL'S ASSETS, OR THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE CORPORATION OF THE HOSPITAL; (4) ANY AGREEMENT OR TRANSACTION, EITHER OF WHICH IS OF A MATERIAL NATURE, WITH ANOTHER CORPORATION CONTROLLED DIRECTLY BY OR AFFILIATED WITH THE MEMBER; AND (5) THE BORROWING OF ANY SUM IN EXCESS OF $100,000 WHICH HAS A STATED TERM GREATER THAN ONE YEAR OR WHICH IS SECURED BY A MORTGAGE OF ALL OR ANY PORTION OF THE HOSPITAL'S REAL PROPERTY OR BY A SECURITY INTEREST IN THE HOSPITAL'S ASSETS OR REVENUES, BUT NOT INCLUDING ANY BORROWING OF LESS THAN $ 100,000 TO PURCHASE OR LEASE EQUIPMENT OR OTHER PERSONAL PROPERTY THAT IS SECURED SOLELY BY A PURCHASE MONEY TITLE RETENTION OR OTHER FORM OF SECURITY INSTRUMENT OR AGREEMENT IN THE EQUIPMENT OR PERSONAL PROPERTY BEING ACQUIRED.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S MANAGEMENT AND FINANCE TEAM IN DETAIL. AFTER IT HAS BEEN REVIEWED, IT IS THEN PROVIDED TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 12C	MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD, COMMITTEE, OR OTHER INDIVIDUALS WHO, ON BEHALF OF THE CORPORATION, ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. IN THE EVENT THAT A TRUSTEE, OFFICER, COMMITTEE MEMBER OR MEMBER OF THE CORPORATION'S LEADERSHIP GROUP BECOMES CONCERNED THAT ANOTHER INTERESTED PERSON HAS AN UNDISCLOSED FINANCIAL INTEREST OR IS EXERTING INAPPROPRIATE INFLUENCE RELATED TO A FINANCIAL INTEREST, THIS CONCERN SHOULD BE RAISED WITH THE CHAIR OF THE APPROPRIATE BOARD OR COMMITTEE OR, IF INVOLVING THE LEADERSHIP GROUP, AN APPROPRIATE CORPORATE OFFICER. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD OR COMMITTEE MEMBERS. IT SHALL BE THE RESPONSIBILITY OF THE CHAIR OF THE BOARD OR COMMITTEE TO INSTRUCT AN INTERESTED PERSON ON THE RESTRICTIONS ON HIS OR HER PARTICIPATION PURSUANT TO THIS POLICY IN ANY FURTHER CONSIDERATION OF THE SUBJECT MATTER OF THE CONFLICT OF INTEREST AND TO ENFORCE THESE RESTRICTIONS. AWARENESS/COMPLIANCE WITH POLICY EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. EACH INTERESTED PERSON SHALL DISCLOSE ON AN ANNUAL SURVEY FORM POTENTIAL CONFLICTS OF INTEREST AND FINANCIAL INTERESTS RELEVANT TO THIS POLICY. EACH INTERESTED PERSON SHALL ALSO PROVIDE ON AN ANNUAL SURVEY FORM A LIST OF IMMEDIATE FAMILY MEMBERS, INCLUDING SPOUSE, CHILDREN, GRANDCHILDREN, PARENTS, SIBLINGS AND ANY OTHER PERSON WHO LIVES IN HIS/HER HOUSEHOLD, IN ORDER THAT THE CORPORATION MAY HAVE A RECORD OF ALL INDIVIDUALS WHO MAY BE CONSIDERED DISQUALIFIED PERSONS UNDER INTERNAL REVENUE SERVICE REGULATIONS FOR THE PURPOSE OF ENSURING COMPLIANCE WITH TAX EXEMPT STATUS REQUIREMENTS FOR CHARITABLE ORGANIZATIONS. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT INVOLVES THE CONFLICT OF INTEREST. THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, INCLUDING A CONSIDERATION OF INDEPENDENT COMPARABILITY DATA, VALUATIONS OR APPRAISALS, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE (OR QUORUM) OF ALL OF THE DISINTERESTED TRUSTEES OR COMMITTEE MEMBERS (REGARDLESS OF THE NUMBER PRESENT AT A MEETING): (I) WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT, (II) WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION, AND (III) WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATIONS.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	COMPENSATION REVIEW: THE BOARD ANNUALLY REVIEWS THE CEO AND SENIOR TEAM SALARIES USING COMPARABILITY DATA. THE REVIEW PROCESS IS DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE VIEWED BY THE PUBLIC UPON AN APPOINTMENT WITH THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER OR ASSISTANT.
FORM 990, PART VII, SECTION A	BOARD OF DIRECTORS: NORTH COUNTRY HOSPITAL AND HEALTH CENTER, NORTH COUNTRY HEALTH SERVICES, AND NORTH COUNTRY HEALTH SYSTEMS SHARE A BOARD OF DIRECTORS. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. CLAUDIO FORT, CEO, AND ANDRE BISSONNETTE, CHIEF FINANCIAL OFFICER, EACH WORK APPROXIMATELY 40 HOURS PER WEEK BETWEEN NORTH COUNTRY HOSPITAL AND HEALTH CENTER, NORTH COUNTRY HEALTH SERVICES, AND NORTH COUNTRY HEALTH SYSTEMS. THEY ARE COMPENSATED FOR THEIR DUTIES IN THAT CAPACITY. CHRISTOPHER RICKMAN, VERONIKA JEDLOVSZKY, AND LARRY SISSON ARE COMPENSATED AS EMPLOYEES OF NORTH COUNTRY HOSPITAL. THEY DO NOT RECEIVE ANY COMPENSATION FOR THEIR DUTIES AS BOARD OF DIRECTORS MEMBERS.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS: $(331,635) CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 78,192 CHANGE IN INTEREST IN NET ASSETS OF NCHS ---------- $(253,443)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
NORTH COUNTRY HEALTH SYSTEMS INC
189 PROUTY DRIVE	NEWPORT	VT	05855	222566964	PARENT/FUNDRS	VT	501(C)(3)	11B II	NA	false
NORTH COUNTRY HLTH SRVCS DBA DERBY GREEN
2853 US-5	DERBY	VT	05829	222570334	SKILLED NURSG	VT	501(C)(3)	9	NCHS	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

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

US Address USAddress

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

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

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Predominant Income Type	RELATED	PredominantIncomeTypeTxt
Share Of Total Income	$138,815	ShareOfTotalIncomeAmt
Share Of EOY Assets	$268,087	ShareOfEOYAssetsAmt
Disproportionate Allocations	false	DisproportionateAllocationsInd
UBI Code V	$0	UBICodeVAmt
General Or Managing Partner	Yes (true)	GeneralOrManagingPartnerInd
Ownership	0.60000	OwnershipPct

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