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        <PersonNm>RON J CIOFFI</PersonNm>
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        <PersonNm>ROSHAN SIVA MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
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        <PersonNm>STANLEY SHARPIRO MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHEN LEFFLER MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
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        <PersonNm>TJ SABOTKA</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
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        <PersonNm>TODD GREGORY MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
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        <PersonNm>THOMAS HUEBNER</PersonNm>
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        <PersonNm>EDWARD T OGORZALEK</PersonNm>
        <TitleTxt>CFO &amp; VP FISCAL SERVICES</TitleTxt>
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        <PersonNm>BAXTER C HOLLAND</PersonNm>
        <TitleTxt>VP PROFESSIONAL SUPPORT SVCS</TitleTxt>
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        <PersonNm>BARBARA M ROBINSON</PersonNm>
        <TitleTxt>VP CLINICAL SERVICES</TitleTxt>
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        <PersonNm>CAROL M EGAN</PersonNm>
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        <PersonNm>ALLISON W WOLLEN</PersonNm>
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        <PersonNm>MARY T NEMETH</PersonNm>
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        <PersonNm>JOHN S KIJEWSKI</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JI CHEN</PersonNm>
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        <PersonNm>MELBOURNE D BOYNTON MD</PersonNm>
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        <PersonNm>WILLIAM A LIGHTHART MD</PersonNm>
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        <PersonNm>ERIC MARSH MD</PersonNm>
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        <PersonNm>MICHAEL ROBERTELLO MD</PersonNm>
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        <PersonNm>MATTHEW ZMURKO MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DARREN CHILDS</PersonNm>
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      <ContractorCompensationGrp>
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          <PersonNm>SHERIDAN HEALTHCARE OF VERMONT</PersonNm>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>UNIVERSITY OF VT MED CTR</PersonNm>
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      <ContractorCompensationGrp>
        <ContractorName>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>ADVANTAGE RN LLC</PersonNm>
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      <ProgramServiceRevenueGrp>
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      <ProgramServiceRevenueGrp>
        <Desc>OTHER REVENUES</Desc>
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        <ManagementAndGeneralAmt>376570</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>106931</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>646977</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>96018</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31717</ManagementAndGeneralAmt>
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      <PymtTravelEntrtnmntPubOfclGrp>
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      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>571541</ProgramServicesAmt>
        <ManagementAndGeneralAmt>573591</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1315293</ProgramServicesAmt>
        <ManagementAndGeneralAmt>494671</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>8729749</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>2681643</ManagementAndGeneralAmt>
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        <TotalAmt>24378176</TotalAmt>
        <ProgramServicesAmt>24378176</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>12808872</ProgramServicesAmt>
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        <Desc>BAD DEBTS</Desc>
        <TotalAmt>4791443</TotalAmt>
        <ProgramServicesAmt>4791443</ProgramServicesAmt>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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          <ZIPCode>RESTRICTED</ZIPCode>
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      <TotalDirectLobbyingGrp />
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      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE C, PART II-B, LINE 1G AND 1I</FormAndLineReferenceDesc>
        <ExplanationTxt>LOBBYING EXPENSES: THE ORGANIZATION PAID LOBBYING FEES OF $76,497 TO A PROFESSIONAL GOVERNMENT AFFAIRS AND COMMUNICATION STRATEGIES COMPANY. THE ORGANIZATION'S CEO, THOMAS HUEBNER, SPENDS TIME EACH YEAR WORKING DIRECTLY WITH STATE LEGISLATORS TO IMPROVE SERVICES FOR THE RUTLAND REGION. APPROXIMATELY .0125%, OR $5,707, OF HIS SALARY IS ALLOCATED TO THIS ACTIVITY. ALSO, DUES ARE PAID TO THE HOSPITAL ASSOCIATION AND THE VERMONT HOSPITAL ASSOCIATION. A PORTION OF DUES IS ATTRIBUTABLE TO LOBBYING: $ 7,537 AHA 17,190 VHA -------- $ 24,727</ExplanationTxt>
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        <FormAndLineReferenceDesc>SCHEDULE D, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>ENDOWMENT FUND PURPOSE: RRMC'S ENDOWMENTS CONSIST OF VARIOUS INDIVIDUAL DONOR-RESTRICTED AND BOARD DESIGNATED FUNDS WHICH WERE ESTABLISHED FOR GENERAL OPERATIONAL AND CERTAIN DEPARTMENTAL PURPOSES. AS REQUIRED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA (GAAP), NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. RRMC'S GOVERNING BODY HAS INTERPRETED THE STATE OF VERMONT PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT (SPMIFA), ADOPTED IN MAY OF 2009, AS REQUIRING PRESERVATION OF THE FAIR VALUE OF THE ORIGINAL GIFT AS OF THE GIFT DATE OF THE DONOR-RESTRICTED ENDOWMENT FUNDS ABSENT EXPLICIT DONOR STIPULATIONS TO THE CONTRARY. AS A RESULT OF THIS INTERPRETATION, RRMC CLASSIFIES AS PERMANENTLY RESTRICTED NET ASSETS (A) THE ORIGINAL VALUE OF GIFTS DONATED TO THE PERMANENT ENDOWMENT, (B) THE ORIGINAL VALUE OF SUBSEQUENT GIFTS TO THE PERMANENT ENDOWMENT AND (C) ACCUMULATIONS TO THE PERMANENT ENDOWMENT MADE IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE ACCUMULATION IS ADDED TO THE FUND. THE REMAINING PORTION OF DONOR-RESTRICTED ENDOWMENT FUNDS IS CLASSIFIED AS TEMPORARILY RESTRICTED NET ASSETS UNTIL THOSE AMOUNTS ARE APPROPRIATED FOR EXPENDITURE BY RRMC IN A MANNER CONSISTENT WITH THE STANDARD OF PRUDENCE PRESCRIBED BY SPMIFA. IN ACCORDANCE WITH SPMIFA, RRMC CONSIDERS THE FOLLOWING FACTORS IN MAKING A DETERMINATION TO APPROPRIATE OR ACCUMULATE DONOR-RESTRICTED ENDOWMENT FUNDS: 1. DURATION AND PRESERVATION OF THE FUND 2. PURPOSES OF RRMC AND THE FUND 3. GENERAL ECONOMIC CONDITIONS 4. POSSIBLE EFFECT OF INFLATION AND DEFLATION 5. EXPECTED TOTAL RETURN FROM INVESTMENT INCOME AND APPRECIATION OR DEPRECIATION OF INVESTMENTS 6. OTHER RESOURCES OF RRMC 7. INVESTMENT POLICIES OF RRMC</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART X, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $(10,536,065) NET LOSS FROM DEF BEN PLAN &amp; POSTRETIREMENT BEN COSTS ( 4,791,443) PROVISION FOR UNCOLLECTIBLE ACCOUNTS 6,430,843 CHANGE IN FV OF INVESTMENTS ACCT FOR UNDER FASB 825 997,562 RHF REVENUE 641,747 NET ASSETS RELEASED FROM RESTRICTION ( 419,043) INVESTMENT EXPENSES ( 218,958) LOSS ON INTEREST RATE SWAP AGREEMENT ------------- $( 7,895,357)</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XI, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $( 395,992) RENTAL EXPENSES 287,805 TEMPORARILY RESTRICTED CONTRIBUTIONS 103,111 TEMPORARILY RESTRICTED INVESTMENT INCOME ------------- $( 5,076)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XII, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 1,210,413 RHF EXPENSES 395,992 RENTAL EXPENSES ------------ $ 1,606,405</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XII, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 4,791,443 PROVISION FOR UNCOLLECTIBLE ACCOUNTS</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
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        <TotalCommunityBenefitExpnsAmt>17275500</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>14044416</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>3231084</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01480</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <CashAndInKindContributionsGrp>
        <ActivitiesOrProgramsCnt>7</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>24457</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>2071508</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>2071508</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00940</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <ActivitiesOrProgramsCnt>24</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>41592</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>21599820</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>14048206</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>7551614</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03450</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <ActivitiesOrProgramsCnt>24</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>41592</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>80975616</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>52871276</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>28104340</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.12820</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <EconomicDevelopmentGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <TotalCommunityBenefitExpnsAmt>11811</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>11811</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </EconomicDevelopmentGrp>
      <CommunitySupportGrp>
        <ActivitiesOrProgramsCnt>2</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>32000</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>90061</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>90061</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00040</TotalExpensePct>
      </CommunitySupportGrp>
      <CoalitionBuildingGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>300</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>65996</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>65996</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00030</TotalExpensePct>
      </CoalitionBuildingGrp>
      <HealthImprovementAdvocacyGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>100</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>5096</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>250</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4846</NetCommunityBenefitExpnsAmt>
      </HealthImprovementAdvocacyGrp>
      <WorkforceDevelopmentGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <TotalCommunityBenefitExpnsAmt>175919</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>175919</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00080</TotalExpensePct>
      </WorkforceDevelopmentGrp>
      <TotalCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>6</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>32400</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>348883</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>250</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>348633</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00160</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>false</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>4791443</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>622888</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>57181671</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>78555627</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-21373956</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <OtherInd>X</OtherInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1>RUTLAND HOSPITAL</BusinessNameLine1>
        </BusinessName>
        <USAddress>
          <AddressLine1>160 ALLEN STREET</AddressLine1>
          <City>RUTLAND</City>
          <State>VT</State>
          <ZIPCode>05701</ZIPCode>
        </USAddress>
        <WebsiteAddressTxt>WWW.RRMC.ORG</WebsiteAddressTxt>
        <StateLicenseNum>836</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>MED DEV RURAL COMMUNITY HOSPITAL</OtherDesc>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1>RUTLAND HOSPITAL</BusinessNameLine1>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <CHNAConductedYr>12</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>WWW.RRMC.ORG</OwnWebsiteURLTxt>
        <RptAvailableUponRequestInd>X</RptAvailableUponRequestInd>
        <RptAvailableThruOtherMethodInd>X</RptAvailableThruOtherMethodInd>
        <AdoptImplementationStrategyInd>X</AdoptImplementationStrategyInd>
        <ExecImplementationStrategyInd>X</ExecImplementationStrategyInd>
        <DevelopCommunityWidePlanInd>X</DevelopCommunityWidePlanInd>
        <ExecCommunityWidePlanInd>X</ExecCommunityWidePlanInd>
        <AdoptBudgetInd>X</AdoptBudgetInd>
        <PrioritizeHealthNeedsInd>X</PrioritizeHealthNeedsInd>
        <PrioritizeServicesInd>X</PrioritizeServicesInd>
        <AllNeedsAddressedInd>false</AllNeedsAddressedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGUsedDeterEligFreeCareInd>true</FPGUsedDeterEligFreeCareInd>
        <FPGFamilyIncmLmtFreeCarePct>300.</FPGFamilyIncmLmtFreeCarePct>
        <FPGUsedDetermEligDscntCareInd>true</FPGUsedDetermEligDscntCareInd>
        <FPGFamilyIncmLmtDscntCarePct>500.</FPGFamilyIncmLmtDscntCarePct>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <IncomeLevelInd>X</IncomeLevelInd>
        <AssetLevelInd>X</AssetLevelInd>
        <MedicalIndigencyInd>X</MedicalIndigencyInd>
        <InsuranceStatusInd>X</InsuranceStatusInd>
        <MedicaidMedicareInd>X</MedicaidMedicareInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <PostedOnWebsiteInd>X</PostedOnWebsiteInd>
        <AttachedToInvoiceInd>X</AttachedToInvoiceInd>
        <PostedInEmergencyRoomInd>X</PostedInEmergencyRoomInd>
        <PostedInAdmissionOfficeInd>X</PostedInAdmissionOfficeInd>
        <ProvidedOnAdmissionInd>X</ProvidedOnAdmissionInd>
        <AvailableOnRequestInd>X</AvailableOnRequestInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <FAPNotifiedBeforeDischargeInd>X</FAPNotifiedBeforeDischargeInd>
        <FAPNotifiedAllPatientsInd>X</FAPNotifiedAllPatientsInd>
        <DocumentedEligDeterminationInd>X</DocumentedEligDeterminationInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <OtherMethodUsedInd>X</OtherMethodUsedInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY INPUT: TO OVERSEE THE WORK PERFORMED, WE INVITED COMMUNITY LEADERS WITH SPECIAL KNOWLEDGE OR EXPERTISE OF PUBLIC HEALTH TO SERVE AS AN ADVISORY COMMITTEE THROUGHOUT THE PROCESS OF COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS GROUP OF INDIVIDUALS BROUGHT DIVERSITY OF PERSPECTIVE TO THE PROCESS: -JAN HANSEN, RUTLAND AREA VISITING NURSE ASSOCIATION AND HOSPICE, INC. -JOANNE CALVI, VERMONT DEPARTMENT OF HEALTH -KEVIN LOSO, RUTLAND HOUSING AUTHORITY -LARRY JENSEN, COMMUNITY MEMBER, BOARD MEMBER OF COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, COMMISSIONER RUTLAND CITY POLICE -SARAH NARKEWICZ, RUTLAND BLUEPRINT MANAGER, RUTLAND REGIONAL MEDICAL CENTER -SARAH ROY, DIVISION OF ALCOHOL &amp; DRUG ABUSE PROGRAMS, VERMONT DEPARTMENT OF HEALTH -SUSAN SCHREIBMAN, RUTLAND PLANNING COMMISSION -TRACI MOORE, UNITED WAY OF RUTLAND COUNTY THE ADVISORY COMMITTEE MET MONTHLY BEGINNING IN MAY OF 2011 TO MONITOR THE PROGRESS OF THE WORK, PROVIDE INPUT AND SUPPORT, AND TO PROVIDE ASSISTANCE WHEN NECESSARY. IN ADDITION TO THE ADVISORY COMMITTEE IS AN OVERSIGHT COMMITTEE, MADE UP OF THE FOLLOWING COMMUNITY PARTNERS: -THOMAS W. HUEBNER, RUTLAND REGIONAL MEDICAL CENTER -EDWARD OGORZALEK, RUTLAND REGIONAL MEDICAL CENTER -CLAUDE LAPERLE, COMMUNITY MEMBER -LYLE JEPSON, STAFFORD TECHNICAL CENTER -JO ANN RILEY, CASTLETON COMMUNITY SENIORS -CAPRICE HOVER, RUTLAND COUNTY PARENT CHILD CENTER -VICTOR PISANELLI, JR., MD, RUTLAND REGIONAL GENERAL SURGERY -JEFF MCKEE, RUTLAND REGIONAL MEDICAL CENTER -LARRY JENSEN, COMMUNITY MEMBER AND MEMBER, BOARD OF DIRECTORS OF COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION -JAN HANSEN, RUTLAND AREA VISITING NURSE ASSOCIATION &amp; HOSPICE, INC. -KEVIN LOSO, RUTLAND HOUSING AUTHORITY -SARAH ROY, DIVISION OF ALCOHOL &amp; DRUG ABUSE PROGRAMS, VERMONT DEPARTMENT OF HEALTH -TRACI MOORE, UNITED WAY OF RUTLAND COUNTY -JOE LAROSA, COMMUNITY MEMBER -JOANNE CALVI, VERMONT DEPARTMENT OF HEALTH -PAULA BAKER, RUTLAND FREE LIBRARY -ROGER BAKER, MD, RETIRED, COMMUNITY MEMBER -SHERIFF STEPHEN BENARD -KATHY FELDER, RN, NP, MID-VERMONT UROLOGY -MELANIE GAIOTTI, DEPARTMENT OF LIQUOR CONTROL -SANDY COHEN, COMMUNITY MEMBER -ANN WARRELL, VERMONT COUNTRY STORE -BARBARA HANSON, SOUTHWESTERN VERMONT COUNCIL ON AGING -DEB HALL, RUTLAND COUNTY HOUSING COALITION -BILL LUCCI, STAFFORD TECHNICAL CENTER -DOUG NORFORD, RUTLAND MENTAL HEALTH SERVICES -GRANT WHITMER, COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION -BRIAN NOLAN, COMMUNITY MEMBER -MARTHA COULTER, COMMUNITY MEMBER -JULIE TETA, COMMUNITY MEMBER -ARDY WOLYNEC, RUTLAND AREA VISITING NURSE ASSOCIATION &amp; HOSPICE, INC. THIS GROUP IS CHARGED WITH GENERAL OVERSIGHT OF RUTLAND REGIONAL MEDICAL CENTER'S COMMUNITY SERVICE, OR BENEFITS PROVIDED TO THE COMMUNITY ABOVE AND BEYOND THEIR PRIMARY ROLE AS A PROVIDER OF HOSPITAL-BASED MEDICAL SERVICES. AS SUCH, THIS GROUP PROVIDED VALUABLE FEEDBACK THROUGHOUT THE PROCESS AS STAKEHOLDERS IN THE HEALTH AND PROMOTION OF HEALTH ACROSS OUR COMMUNITY. FIVE FOCUS GROUP SESSIONS WERE HELD IN FEBRUARY 2012, WITH INVITATIONS GOING OUT TO MORE THAN 175 COMMUNITY LEADERS. INVITATION LETTERS INCLUDED FIVE QUESTIONS TO DRAFT RESPONSES TO IN PREPARATION FOR THE MEETING, ALONG WITH A SURVEY REQUESTING FEEDBACK CONCERNING BARRIERS TO ACCESSING HEALTH SERVICES, BARRIERS TO HEALTH ACROSS THE COMMUNITY, AND "RISKY BEHAVIORS". ADDITIONALLY, THREE SURVEYS WERE CONDUCTED AS A PART OF THIS HEALTH NEEDS ASSESSMENT. THE FIRST WAS A PHONE SURVEY OF DENTAL OFFICES. WE ALSO SURVEYED RANDOM COMMUNITY MEMBERS AND EMERGENCY DEPARTMENT CONSUMERS TO IDENTIFY ISSUES CONCERNING ACCESS TO CARE, GENERAL HEALTH CARE, AND EMERGENCY CARE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>CHNA AVAILABILITY TO PUBLIC: THE COMMUNITY BENEFITS COORDINATOR DEVELOPED AND FOLLOWED A COMMUNICATION PLAN UTILIZING ELECTRONIC COMMUNICATION, CONFERENCE CALLS, NEWSPAPER ARTICLES AND PRESENTATIONS THROUGHOUT THE COMMUNITY TO DISSEMINATE THE COMMUNITY HEALTH NEEDS ASSESSMENT. SPECIFICALLY, MORE THAN 20 PRESENTATIONS WERE HOSTED BY AREA AGENCIES AND COALITIONS, WITHIN THE HOSPITAL ORGANIZATION, FOR THE REGIONAL VERMONT DEPARTMENT OF HEALTH, AND IN PUBLIC MEETINGS FOR THE ROTARY AND UNITED WAY MEMBERSHIP.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>IMPLEMENTATION STRATEGY: IN RESPONSE TO THE RESULTS OF RUTLAND REGIONAL MEDICAL CENTER'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL: http://www.rrmc.org/about/bowse-trust/community-health-assessment-update/ OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING PRIORITIES TO 2012-2015: -REDUCE SUBSTANCE ABUSE, USING TOBACCO AND ALCOHOL -IMPROVE ACCESS TO AND AVAILABILITY OF HEALTHCARE - MEDICAL, DENTAL, MENTAL HEALTH AND SUBSTANCE ABUSE -IMPROVE CHRONIC HEALTHCARE DELIVERY AND SUPPORTS -PROMOTE A CULTURE TO EMBRACE EXERCISE &amp; HEALTH EATING THIS ASSESSMENT ALSO HELPED TO CLEARLY IDENTIFY PRIORITY POPULATIONS THAT RUTLAND REGIONAL AND OTHER ORGANIZATIONS NEED TO BE AWARE OF: -SENIORS IN 2010, SENIORS REPRESENT 16.6% OF OUR POPULATION, AND THIS FIGURE CONTINUES TO GROW -INDIVIDUALS LIVING IN POVERTY 13.9% OF THE POPULATION OF RUTLAND COUNTY WAS LIVING IN POVERTY IN 2009 -ADULTS AND YOUTH WITH SUBSTANCE ABUSE ISSUES INCLUDING ILLICIT DRUG USE, ALCOHOL USE AND OTHERS, ESPECIALLY FOR THOSE AGES 18-25; RUTLAND COUNTY HAS A HIGHER NUMBER OF CURRENT SMOKERS THAN THE OVERALL STATE RATE -YOUTH AND ADULTS WHO ARE OVERWEIGHT OR OBESE; 38.7% OF ADULTS AND 14% OF HIGH SCHOOL STUDENTS REPORT BEING OVERWEIGHT; 24% OF ADULTS AND 11% OF HIGH SCHOOL STUDENTS REPORT BEING OBESE -YOUTH WITH LOW RATES OF HEALTHY EATING AND EXERCISE; 14% OF YOUTH REPORT EATING THE RECOMMENDED SERVING OF VEGETABLES DAILY; 30% OF YOUTH PARTICIPATE IN 60 MINUTES OF PHYSICAL ACTIVITY DAILY THROUGHOUT 2013, RUTLAND REGIONAL MEDICAL CENTER WORKED WITH NUMEROUS COMMUNITY PARTNERS TO SHARE INFORMATION ABOUT INITIATIVES AND ALIGN THEM WITH THE PRIORITIZED NEEDS. THE RESULT WAS THE DEVELOPMENT OF AN IMPLEMENTATION STRATEGY, SPECIFIC TO RUTLAND REGIONAL EFFORTS TO ADDRESS THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, WHILE RECOGNIZING THE ACTIVITIES OF MANY OTHER ORGANIZATIONS. AS THE PRIORITY AREAS OF THE NEEDS ASSESSMENT OVERLAP, WE NEED THE STRENGTH OF THE TRIAD - THE HOSPITAL'S ACTIVITIES, POLICY CHANGE, AND COMMUNITY COMMITMENT, TO REALIZE CHANGE IN THE HEALTH STATUS OF OUR COMMUNITY AND ITS MEMBERS. THE IMPLEMENTATION STRATEGY HIGHLIGHTS THE ACTIONS RUTLAND REGIONAL WILL EMPLOY THAT ARE NEW OR ARE SIGNIFICANT IMPROVEMENTS, BUILDING UPON EXISTING EFFORTS TO ADDRESS THE PRIORITIZED HEALTH NEEDS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>ADDRESSING IDENTIFIED NEEDS: RUTLAND REGIONAL MEDICAL CENTER IS THE LEAD HEALTH ORGANIZATION FOR OUR REGION, PROVIDING MANY SERVICES AND PROGRAMS TO RESPOND TO THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS. IN SOME SITUATIONS, HOWEVER, DUE TO CAPACITY LIMITATIONS, OR SIMPLY THE NATURE OF THE WORK, RRMC IS NOT THE NATURAL OR LOGICAL RESOURCE OR LEADER. THE PRIORITIZED NEED TO PROMOTE A CULTURE TO EMBRACE EXERCISE AND HEALTHY EATING IS NOT ONE WHERE RRMC IS BEST SUITED TO DEVELOP OR PERFORM THE WORK, BUT WE DO SUPPORT ORGANIZATIONS, EVENTS AND OTHER ACTIVITIES PROMOTING HEALTHY LIFESTYLES AND CHOICES AS OUTLINED BELOW. -THE COMMUNITY HEALTH TEAM IS SUPPORTING THE IMPLEMENTATION OF THE CASTLETON STATE COLLEGE ADULTS PHYSICAL ACTIVITY PROGRAM AND WALKRUTLAND. -PROVIDE FINANCIAL, MARKETING AND OTHER SUPPORT FOR VARIOUS COMMUNITY PARTNER ORGANIZATIONS DEVELOPING AND EXPANDING NUTRITION AND/OR PHYSICAL ACTIVITY INITIATIVES. IN GENERAL, THIS PRIORITY AREA IS ONE WHERE THE NEEDS ARE GREATER THAN THE CAPACITY ACROSS THE REGION FOR EDUCATION AND SUPPORTS FOR NUTRITION AND EXERCISE. TWO SPECIFIC AREAS OF NEED WERE IDENTIFIED THROUGH THE PROCESS OF CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOPING THIS IMPLEMENTATION STRATEGY THAT ARE NOT BEING ADDRESSED WITHIN OUR COMMUNITY AT THIS TIME DUE TO LACK OF RESOURCES AND CAPACITY. THEY ARE: -TO INCREASE RESIDENTIAL RECOVERY SERVICES FOR INDIVIDUALS WITH SUBSTANCE ABUSE. THERE IS A TARGET POPULATION IN NEED OF SUCH SUPPORT, AND THE SERVICE WOULD BE CREATED AND PROVIDED BY THE DESIGNATED MENTAL HEALTH AGENCY IN OUR REGION, RUTLAND MENTAL HEALTH SERVICES, AS THE PRIMARY PROVIDER OF SERVICES FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICE AND SUPPORTS. -COMMUNITY MEMBERS HAVE IDENTIFIED THE NEED FOR MORE, OR BETTER COORDINATED TRANSPORTATION SERVICES FOR INDIVIDUALS TO AVAIL THEMSELVES OF CARE AND TREATMENT FOR ANY PURPOSE - MEDICAL, DENTAL, MENTAL HEALTH AND SUBSTANCE ABUSE. SOME SERVICES, INCLUDING RRMC'S BRIDGES AND BEYOND PROGRAM DO PROVIDE TRANSPORTATION TO INDIVIDUALS, BUT A MORE COMPREHENSIVE APPROACH IS DESIRED AND WOULD BE LED BY TRANSPORTATION AND SOCIAL SERVICES LEADERS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 20D</FormAndLineReferenceDesc>
        <ExplanationTxt>MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE HOSPITAL FACILITY USED THE AVERAGE RATE OF ALL INSURANCE RATES TO DETERMINE THE MAXIMUM AMOUNTS TO BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>11</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>RUTLAND HEART CENTER</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>12 COMMONS STREET</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>RUTLAND REG DIABETES &amp; ENDOCRINOLOGY CTR</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>8 ALBERT CREE DRIVE</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>RUTLAND REGIONAL GENERAL SURGERY</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>6 COMMONS STREET</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>RUTLAND REGIONAL WOMEN'S HEALTH</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>147 ALLEN STREET</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>RUTLAND REGIONAL DIGESTIVE SERVICES</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>254 STRATTON ROAD</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>RUTLAND ENT</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>69 ALLEN ST SUITE 1</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>RUTLAND BEHAVIORAL HEALTH CLINIC</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>1 COMMONS STREET</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>VERMONT ORTHOPAEDIC CLINIC</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>3 ALBERT CREE DRIVE</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>DORSET ENT</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>51A TENNIS WAY</AddressLine1>
            <City>EAST DORSET</City>
            <State>VT</State>
            <ZIPCode>05253</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>KILLINGTON MEDICAL CLINIC</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>3902 KILLINGTON ROAD</AddressLine1>
            <City>KILLINGTON</City>
            <State>VT</State>
            <ZIPCode>05751</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WESTRIDGE TREATMENT CENTER</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>1 SCALE AVE BLDG 10</AddressLine1>
            <City>RUTLAND</City>
            <State>VT</State>
            <ZIPCode>05701</ZIPCode>
          </USAddress>
          <FacilityTxt>PATIENT CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 3B</FormAndLineReferenceDesc>
        <ExplanationTxt>ELIGIBILITY FOR DISCOUNTED CARE: THE ORGANIZATION WILL PROVIDE DISCOUNTED CARE TO LOW INCOME INDIVIDUALS WHOSE FAMILY INCOME FALLS BETWEEN 201% AND 500% OF THE FEDERAL POVERTY GUIDELINES USING A GRADUATED RANGE OF DEDUCTIBLES FROM $250 AT THE LOWEST LEVEL TO $3,000 AT THE HIGHEST LEVEL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7, COLUMN F</FormAndLineReferenceDesc>
        <ExplanationTxt>PERCENT OF TOTAL EXPENSES: THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) LESS BAD DEBT EXPENSE OF $4,791,443.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY BUILDING ACTIVITIES: RUTLAND REGIONAL MEDICAL CENTER IS THE ONLY MAJOR MEDICAL CENTER IN CENTRAL VERMONT, AND IS ONE OF THE LARGEST EMPLOYERS IN THE REGION. AS SUCH, WE ARE RELIED UPON BY THE COMMUNITIES WE SERVE TO PROVIDE HEALTH RESOURCES AND LEADERSHIP. WE RECOGNIZE THAT THERE IS MORE TO HEALTH THAN ILLNESS AND DISEASE, SOCIAL DETERMINANTS SUCH AS LOW INCOME LEVELS, AND AN AGING POPULATION, ALONG WITH A SAFE ENVIRONMENT AND A WELL-ROUNDED CULTURE CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR POPULATION. THEREFORE, OUR LEADERSHIP AND COMMITMENT TO OUR COMMUNITY THROUGH A VARIETY OF INITIATIVES AND SUPPORTS BEYOND PROVIDING ESSENTIAL HOSPITAL-BASED CARE, ENCOMPASSING SOCIAL, PERSONAL, COMMUNITY AND HEALTH-RELATED ISSUES IMPACTING THE CITIZENS OF THE RUTLAND REGION. MANY STAFF AND LEADERS ARE INVOLVED IN LOCAL, REGIONAL AND STATEWIDE COALITIONS, COLLABORATIVES AND COMMITTEES OF OTHER ORGANIZATIONS, WHERE WE LEARN ABOUT TRENDS AND ISSUES OF INTEREST OR CONCERN TO BRING BACK TO OUR HOSPITAL AND REVIEW IN THE CONTEXT OF OUR COMMUNITY AND OUR HEALTH SYSTEM; THESE INCLUDE THE RUTLAND FREE CLINIC, RUTLAND AREA PHYSICAL ACTIVITY COALITION, UNITED WAY OF RUTLAND COUNTY, RUTLAND REGION CHAMBER OF COMMERCE, TO NAME A FEW. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT AT THE REGIONAL, STATE AND NATIONAL LEVEL ALSO IMPACTS OUR COMMUNITY. IN ADDITION TO THESE EFFORTS, OUR COMMUNITY BUILDING ACTIVITIES IN THE PAST YEAR INCLUDED EFFORTS TO SUPPORT VIBRANCY IN THE COMMUNITY THROUGH THE ARTS, A VARIETY OF EVENTS AND ACTIVITIES BY SCHOOLS TO PROMOTE STRONG EDUCATION AND POSITIVE DECISION-MAKING, MENTORING YOUNG CHILDREN THROUGH READING TO BUILD SELF-CONFIDENCE AND ESTEEM IN ADDITION TO CORE ACADEMIC ACHIEVEMENT, ALONG WITH WORKFORCE DEVELOPMENT, ESPECIALLY AS RELATED TO THE HEALTH CARE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE: THE AMOUNT OF BAD DEBT LISTED ON LINE 2 AGREES TO BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. USING AN AVERAGE OF DATA FROM 2009-2013, APPROXIMATELY 13.0 PERCENT OF RUTLAND COUNTY WAS CONSIDERED TO LIVE IN POVERTY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, SECTION A, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>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: RRMC REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. RRMC PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, RRMC BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, SECTION B, LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE ORGANIZATION USES INFORMATION FROM THE MEDICARE COST REPORT TO COMPUTE THE MEDICARE ALLOWABLE COSTS OF CARE ON LINE 6.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, SECTION C, LINE 9B</FormAndLineReferenceDesc>
        <ExplanationTxt>COLLECTION POLICY: HOSPITAL CARE WILL NOT BE DENIED TO ANY PERSON SOLELY ON THE BASIS OF THEIR ABILITY TO PAY. HOWEVER, ANY INDIGENT PATIENTS WILL BE REFERRED FOR FINANCIAL ASSISTANCE. RRMC DOES NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE MAKING REASONABLE COLLECTION EFFORTS TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THAT HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ACCOUNTS ARE CONSIDERED BAD DEBT, AND ARE TRANSFERRED TO AN OUTSIDE AGENCY FOR COLLECTION, WHEN GUARANTOR HAS BEEN OFFERED (AND HAS DENIED OR FAILS TO RETURN APPLICATION FOR) ASSISTANCE UNDER THE RRMC FINANCIAL ASSISTANCE POLICY. THE PAYMENT PLAN POLICY REQUIRES PAYMENTS OF A MINIMUM OF $25.00 PER MONTH, AND THAT ALL BALANCES BE PAID WITHIN 10 MONTHS. THE FREE CARE POLICY SPECIFICALLY STATES THAT ALL UNINSURED AND UNDERINSURED PATIENTS BE GIVEN INFORMATION ON THE FREE CARE PROGRAM, AND THAT STAFF PERFORM DUE DILIGENCE TO GIVE THEM INFORMATION AND HAVE THE APPLICATION RETURNED, AND THAT THE HOSPITAL SEND 3 STATEMENTS AND A FINAL NOTICE BEFORE SENDING AN ACCOUNT TO BAD DEBT. IT ALSO STATES THAT RRMC WILL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS TO OBTAIN PAYMENT FOR A DEBT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>NEEDS ASSESSMENT: RUTLAND REGIONAL MEDICAL CENTER CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY WE SERVE THROUGH INTERACTIONS WITH THE STATE OF VERMONT HEALTH DEPARTMENT AND THE DEPARTMENT OF VERMONT HEALTH ACCESS, THE PUBLIC, OTHER COMMUNITY ORGANIZATIONS, FEEDBACK FROM MEDICAL PROVIDERS AND PATIENTS, ALONG WITH NOTING TRENDS IN UTILIZATION OF SERVICES AND PRESENTATION OF ILLNESS, INJURY AND DISEASE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>RRMC HAS "DO YOU NEED HELP WITH YOUR MEDICAL BILLS?" SIGNAGE POSTED AT EVERY ACCESS POINT THROUGHOUT THE HOSPITAL AND ITS OFF-SITE CLINICS (RUTLAND GENERAL SURGERY, WOMEN'S HEALTH ETC.) THE SIGNAGE PROVIDES CONTACT INFORMATION FOR THE PATIENTS TO CALL THE FINANCIAL COUNSELORS FOR HELP AS NEEDED. REGISTRATION OFFERS FINANCIAL ASSISTANCE PROGRAM APPLICATIONS TO ALL MEDICARE INSURED PATIENTS WITH NO OTHER INSURANCE, ALL SELF-PAY PATIENTS, AND ANY OTHER PERSON REQUESTING THE INFORMATION OR ANYONE WHO SPEAKS TO BEING IN FINANCIAL NEED. ALL SELF-PAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR WHILE THEY ARE AN IN-PATIENT AND THEY WILL ASSIST THEM IN APPLYING FOR OUR FINANCIAL ASSISTANCE, AS WELL AS, APPLYING FOR STATE AND FEDERAL PROGRAMS. ALL STATEMENTS HAVE THE RRMC WEBSITE ADDRESS TO VIEW OUR FINANCIAL ASSISTANCE PROGRAM AND THE BILLING AND COLLECTIONS POLICY AND PROCEDURE. THE WEBSITE ALSO HAS CONTACT PHONE NUMBERS FOR THE PATIENT TO CALL WITH QUESTIONS OR CONCERNS ABOUT THEIR BILL. THE RRMC WEB SITE NOT ONLY DESCRIBES THE FINANCIAL ASSISTANCE PROGRAM BUT, ALSO SHOWS THE INCOME GUIDELINES (BASED ON THE FEDERAL POVERTY) FOR FINANCIAL ASSISTANCE, AN ON-LINE APPLICATION, AS WELL AS, INFORMATION ON MEDICAID PROGRAMS AVAILABLE WITH SHORT DESCRIPTIONS. LASTLY, ALL PATIENTS WHO ARE SENT A STATEMENT SHOWING THEIR OUT OF POCKET EXPENSES ARE CALLED TO DEVELOP A PAYMENT PLAN. AT THIS TIME FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED AND MAILED AS REQUESTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY INFORMATION: A. GEOGRAPHIC DESCRIPTION RUTLAND COUNTY, COMPOSED OF 933 SQUARE MILES, IS LOCATED IN CENTRAL VERMONT. THE POPULATION MOSTLY RESIDES IN THE 27 SMALL TOWNS AND OUTLYING RURAL AREAS. RUTLAND CITY IS THE LARGEST POPULATION CENTER (ESTIMATED AT 16,495 IN 2010). RUTLAND REGIONAL MEDICAL CENTER IS DEPENDED UPON BY MORE THAN 60,000 RESIDENTS OF THE HOSPITAL SERVICE AREA (HSA), WHICH INCLUDES RUTLAND COUNTY AND SOME PORTIONS OF SOUTHERN AND NORTH CENTRAL VERMONT AND EVEN WASHINGTON COUNTY, NEW YORK. B. TARGET POPULATIONS RUTLAND COUNTY POPULATION HAS DECREASED SINCE 2000. IN 2010, AN ESTIMATED 61,642 PEOPLE LIVED IN RUTLAND COUNTY, A DECLINE OF 3.4% SINCE 2000. RUTLAND COUNTY RESIDENTS ARE OLDER, LIVING WITH LOWER INCOME, AND ACHIEVE LOWER EDUCATION LEVELS THAN THE AVERAGE VERMONTER, INCREASING THEIR VULNERABILITY. SPECIFICALLY, COMPARED TO VERMONT IN 2010, RUTLAND COUNTY RESIDENTS WERE OLDER, WITH A LOWER PROPORTION OF YOUTH LESS THAN 19 YEARS OF AGE (22% VERSUS 24% FOR VT); A LOWER PROPORTION OF YOUNG ADULTS AGES 20-44 YEARS (28% VERSUS 30%); A HIGHER PROPORTION OF OLDER ADULTS AGES 45-65 (32% VERSUS 30%); AND A HIGHER PROPORTION OF ELDERLY ADULTS 65 YEARS AND OLDER (16% VERSUS 14%). FROM 1999 TO 2009, THE PROPORTION OF ALL INDIVIDUALS IN RUTLAND COUNTY LIVING BELOW POVERTY INCREASED FROM 10.9% TO 13.6%. SPECIFIC TARGET POPULATIONS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDE: I. SENIOR POPULATIONS - IN 2000, 14.9% OF THE POPULATION IN RUTLAND COUNTY WAS AGE 65 OR OLDER. THIS POPULATION HAS GROWN TO 16.6% IN 2010 AND IS ANTICIPATED TO CONTINUE EXPANDING; THE PROJECTION IS THAT IN 2017 OUR SENIOR POPULATION COULD REACH 21.1%. II. INDIVIDUALS LIVING IN POVERTY - FROM 1999 TO 2009, THE PROPORTION OF INDIVIDUALS IN RUTLAND COUNTY LIVING BELOW THE POVERTY LEVEL INCREASED FROM 10.9% TO 13.6%. III. ADULTS AND YOUTH WITH SUBSTANCE ABUSE ISSUES - VERMONT RANKS IN THE TOP TEN OF STATES FOR SEVERAL MEASURE OF SUBSTANCE ABUSE, INCLUDING ILLICIT DRUG USE, ALCOHOL USE AND OTHERS, ESPECIALLY FOR THOSE AGES 18-25. RUTLAND COUNTY HAS A HIGHER NUMBER OF CURRENT SMOKERS THAN THE OVERALL STATE RATE, AND THE NUMBER OF EVERY DAY SMOKERS IS ON THE RISE. IV. YOUTH AND ADULTS WHO ARE OVERWEIGHT OR OBESE - 38.7% OF ADULTS REPORT BEING OVERWEIGHT AND 24% REPORT BEING OBESE IN RUTLAND COUNTY. V. YOUTH REPORT LOW RATES OF HEALTHY EATING AND EXERCISE (32% EAT 2 OR MORE SERVINGS OF FRUIT PER DAY; 14% EAT 3 OR MORE SERVINGS OF VEGETABLES PER DAY; 24% PARTICIPATE IN 60 MINUTES OF PHYSICAL ACTIVITY DAILY)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>PROMOTION OF COMMUNITY HEALTH: RUTLAND REGIONAL MEDICAL CENTER (RRMC) ENGAGES IN A NUMBER OF COMMUNITY SUPPORTIVE ACTIVITIES IN ORDER TO PROMOTE THE HEALTH OF THE COMMUNITY THE ORGANIZATION SERVES. RUTLAND COUNTY HAS A CONTINUED NEED FOR PRIMARY CARE PROVIDERS AND HAS SHORTAGES OR IS AT RISK FOR SHORTAGES IN MANY SPECIALTY SERVICES. RRMC ACTIVELY RECRUITS BOTH PRIMARY CARE AND SPECIALTY PRACTICE PROVIDERS FOR THE REGION. IN FY14, 14 PROVIDERS WERE RECRUITED TO THE REGION, INCLUDING PEDIATRICS, ENT, GASTROENTEROLOGY, PRIMARY CARE, PSYCHIATRIC, EMERGENCY AND CARDIOLOGY. THREE OF THESE PROVIDERS WERE RECRUITED FOR SERVICE OUTSIDE OF RRMC AND ITS SPECIALTY CLINICS. RRMC SUPPORTS A HOSPITALIST PROGRAM WHERE HOSPITAL PHYSICIANS PROVIDE CARE FOR PRIMARY CARE PROVIDER'S PATIENTS THAT ARE ADMITTED TO THE HOSPITAL. THIS ALLOWS THE PRIMARY CARE PROVIDER TO PROVIDE MORE HOURS OF OFFICE CARE WHILE THEIR HOSPITALIZED PATIENTS HAVE 24 HOURS ACCESS TO A DOCTOR DURING THE HOSPITALIZATION. THIS SYSTEM PROVIDES EFFICIENCIES TO THE HEALTH CARE SYSTEM IN RUTLAND COUNTY. RUTLAND COUNTY'S MEDICAID POPULATION CONTINUES TO INCREASE. THIS PUTS A FINANCIAL STRAIN ON THE HEALTH SYSTEM IN OUR REGION, AS THE CARE PROVIDED TO THIS GROWING POPULATION IS NOT REIMBURSED FOR THE FULL COST OF CARE. LEADERS AT RRMC ADVOCATE AT THE STATE AND LOCAL LEVEL TO MAINTAIN THE MEDICAID REIMBURSEMENT RATES FOR BOTH IN-PATIENT AND OUT-PATIENT CARE IN ORDER TO MAINTAIN ACCESS FOR MEDICAID PATIENTS. RRMC ALSO PROVIDES SUPPORT FOR THE FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) IN THE REGION, BY HAVING A LEADER REPRESENTATIVE ON THE BOARD OF THE ORGANIZATION. THE FQHCS ARE REIMBURSED AT A HIGHER LEVEL FOR CARING FOR MEDICAID PATIENTS AND PROVIDES INCREASED ACCESS FOR THESE PATIENTS. RRMC LEADERS AND STAFF ALSO PARTICIPATE AS BOARD AND COMMITTEE MEMBERS IN SUPPORT OF OTHER NON-PROFIT ORGANIZATIONS, SUCH AS THE UNITED WAY OF RUTLAND COUNTY, RUTLAND AREA VISITING NURSE ASSOCIATION AND HOSPICE, RUTLAND AREA PHYSICAL ACTIVITY COALITION, RUTLAND AREA PREVENTION COALITION, RUTLAND COUNTY NUTRITION COALITION, RUTLAND POLICE COMMISSION, THE MEDICAL RESERVE CORPS, AND MANY OTHERS. RRMC PARTNERS WITH THE UNITED WAY OF RUTLAND COUNTY TO OFFER AND PROVIDE A LEADERSHIP AND BOARD TRAINING PROGRAM. EACH YEAR, WE GRADUATE ROUGHLY 12 NEW COMMUNITY MEMBERS READY TO SERVE AS ACTIVE CONTRIBUTORS TO NON-PROFIT ORGANIZATIONS THROUGH OUR REGION. RUTLAND COUNTY IS ECONOMICALLY CHALLENGED AND RRMC SUPPORTS WORK TO HELP THOSE IN POVERTY AS WELL AS TO BRING NEW BUSINESSES INTO THE AREA. RRMC PARTICIPANTS IN BRIDGES OUT OF POVERTY, A PROGRAM WHICH AIMS TO KEEP THE WORKING POOR EMPLOYED. THIS PROGRAM NOT ONLY BENEFITS THOSE LIVING IN POVERTY IN RUTLAND COUNTY, BUT RRMC'S OWN WORKFORCE. IN CONJUNCTION WITH FOR-PROFIT, NON-PROFIT AND GOVERNMENT AGENCIES, THE BRIDGES OUT OF POVERTY COUNCIL DELIVERS THE WORKING BRIDGES TRAINING TO HR PROFESSIONALS AND LINE MANAGERS ON THE WORKPLACE IMPLICATIONS OF ECONOMIC DIVERSITY; IMPLEMENTED AN EMERGENCY LOAN AND SAVINGS PROGRAM FOR EMPLOYEES; HOUSED WORKSITE RESOURCE COORDINATORS IN COMPANIES TO HELP EMPLOYEES FIND HELP WITH HOUSING, CHILDCARE, TRANSPORTATION, ECONOMIC ASSISTANCE AND OTHER RESOURCES WITHOUT HAVING TO LEAVE WORK; AND BEGAN DISCUSSION OF HOW TO ENCOURAGE THE EMPLOYEES TO USE HEALTH AND WELLNESS STRATEGIES. TRAUMA SUPPORT - ESTABLISHED IN 1993, THE TRAUMA SUPPORT PROGRAM AT RRMC WAS THE FIRST OF ITS KIND IN VERMONT. IT WAS DEVELOPED TO MEET THE IMMEDIATE AND LONG-TERM NEEDS OF FAMILIES IMPACTED BY SUDDEN DEATH OR TRAUMATIC INJURY OR ILLNESS. RRMC STAFF, ON THEIR OWN TIME, AND OTHER COMMUNITY VOLUNTEERS TAKE TURNS BEING ON CALL 24 HOURS A DAY, 7 DAYS A WEEK. VOLUNTEERS PERSONALLY PROVIDE SUPPORT AND ASSISTANCE TO FAMILIES IMPACTED BY TRAUMA R DEATH IN MANY WAYS, I.E., BY BEING A LIAISON WITH MEDICAL PERSONNEL TO GET INFORMATION OR OFFERING CONTINUED SUPPORT VIA PHONE AND CORRESPONDENCE. BONE MARROW PROGRAM - THE MARROW DONOR PROGRAM AT RRMC WAS ESTABLISHED IN 1998. SINCE THEN, WE HAVE SUCCESSFULLY ADDED OVER 3,000 POTENTIAL DONORS TO THE NATIONAL REGISTRY, HELPING TO GIVE HOPE TO THE MORE THAN 6,000 PEOPLE SEARCHING EVERY DAY FOR AN UNRELATED MATCH TO SAVE THEIR LIVES. RRMC IS CURRENTLY THE ONLY HOSPITAL IN NEW ENGLAND WITH THIS TYPE OF PROGRAM. RRMC DOES NOT HOLD PATIENT-FOCUSED DRIVES; INSTEAD, ALL DRIVES ARE DESIGNED TO RAISE GENERAL AWARENESS OF THE NEED AND TO REGISTER AS MANY POTENTIAL DONORS AS POSSIBLE, SO THAT NOW OR IN THE FUTURE A MATCH MAY BE MADE. BRIDGES &amp; BEYOND - THIS PROGRAM IS RUN OUT OF THE SOCIAL WORK DEPARTMENT AND WORKS WITH PATIENTS AND FAMILIES TO ARRANGE TRANSPORTATION, GENERAL ASSISTANCE (SUCH AS MEAL PREPARATION), OR COMPANIONSHIP TO THOSE DISABLED AND FRAIL PATIENTS RETURNING HOME FROM A HOSPITAL STAY. DIABETES EDUCATION AND SELF-MANAGEMENT - THIS PROGRAM IS OPERATED FROM THE DIABETES CENTER AND IS RECOGNIZED AND CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION. THROUGH THIS WORK, PEOPLE WITH DIABETES LEARN HEALTH AND LIFESTYLE SKILLS TO HELP THEM MANAGE THEIR DISEASE SYMPTOMS. OTHER BENEFITS INCLUDE PATIENT AND FAMILY SUPPORT GROUPS, AND GLUCOSE METER AND INSULIN PUMP INSTRUCTION. ADVANCE DIRECTIVES PROGRAM - IN 2013, A NEW PROGRAM WAS DESIGNED AND IMPLEMENTED THROUGH THE COMMUNITY HEALTH IMPROVEMENT OFFICE, WHERE TRAINED VOLUNTEERS PROVIDE SUPPORT TO COMMUNITY MEMBERS TO COMPLETE ADVANCE DIRECTIVES FORMS ON A BY- APPOINTMENT BASIS. COMMUNITY RESOURCE GUIDE - IN 2012, THE COMMUNITY HEALTH IMPROVEMENT STAFF COLLECTED AND VERIFIED INFORMATION FROM ACROSS THE REGION FOR INCLUSION IN A RESOURCE GUIDE FOR USE BY HEALTH CARE PROVIDERS AND SOCIAL AND HUMAN SERVICES PERSONNEL TO HELP THEM READILY IDENTIFY POTENTIAL RESOURCES FOR THEIR CLIENTS. THIS GUIDE WAS DEVELOPED IN RESPONSE TO AN IDENTIFIED NEED FOR INFORMATION, AND UPDATED AND DISTRIBUTED TO PROVIDER AND SOCIAL AND HUMAN SERVICES OFFICES ACROSS THE REGION, PHYSICALLY AND ELECTRONICALLY FOR EASE OF USE. OTHER INFORMATION: RRMC HAS 17 BOARD MEMBERS WHO REPRESENT THE RESIDENTS OF RUTLAND COUNTY IN THEIR SERVICE; 6 OF THESE ARE PHYSICIANS, 2 REPRESENT HEALTH CARE PARTNERS, AND 9 ARE RUTLAND COUNTY RESIDENTS WHO REPRESENT A VARIETY OF BUSINESS SECTORS. ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST DISCLOSURE PROCESS WHICH IS NECESSARY TO COMPLY WITH FEDERAL AND STATE LAWS, INCLUDING THE FEDERAL ANTI-KICKBACK STATUTE AND THE TAX CODE. RRMC HAS PREDOMINANTLY AN OPEN MEDICAL STAFF. THE ONLY EXCEPTIONS ARE THE FOLLOWING SPECIALTIES FOR WHICH THERE ARE EITHER BOARD-APPROVED EXCLUSIVE CONTRACTS OR HOSPITAL-EMPLOYED PHYSICIANS ONLY: ANESTHESIA, EMERGENCY MEDICINE, CRITICAL CARE, MEDICAL ONCOLOGY, RADIATION ONCOLOGY, ORTHOPEDICS, AND RADIOLOGY. ALL NEW APPLICANTS UNDERGO AN EXTENSIVE REVIEW PROCESS, INCLUDING PRIMARY SOURCE VERIFICATION OF THEIR EDUCATION, TRAINING, BOARD CERTIFICATION, MALPRACTICE HISTORY, AND PREVIOUS HOSPITAL AFFILIATIONS. WHEN DEEMED COMPLETE, THEIR APPLICATION IS REVIEWED BY THE CREDENTIALS COMMITTEE, WHICH IS MADE UP OF PHYSICIANS AND AT LEAST ONE BOARD MEMBER. THE CREDENTIAL COMMITTEE MAKES A RECOMMENDATION TO THE MEDICAL EXECUTIVE COMMITTEE, WHICH INCLUDES THE CHAIRMAN OF THE BOARD. THE MEDICAL EXECUTIVE COMMITTEE MAKES A FINAL RECOMMENDATION TO THE FULL BOARD, WHICH HAS THE ULTIMATE AUTHORITY TO GRANT MEDICAL STAFF PRIVILEGES. ALL MEDICAL STAFF APPOINTMENTS ARE FOR A TWO YEAR PERIOD. ALL MEDICAL STAFF IS SUBJECT TO ONGOING PEER REVIEW OF THEIR CLINICAL WORK. EVERY TWO YEARS, EVERY MEMBER OF THE MEDICAL STAFF MUST UNDERGO A REAPPOINTMENT PROCESS WHICH IS DESIGNED TO REVIEW THEIR CLINICAL AND PROFESSIONAL ACTIVITY AND BEHAVIOR. THOSE REAPPOINTMENTS GO THROUGH THE SAME SEQUENCE AS THE NEW APPLICANTS. RRMC'S CREDENTIALING PROCESS HAS BEEN SURVEYED BY BOTH THE JOINT COMMISSION AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND FOUND TO BE IN FULL COMPLIANCE WITH THEIR STANDARDS (TJC) AND THEIR CONDITIONS OF PARTICIPATION (CMS). AS A RURAL COMMUNITY HEALTH SYSTEM, RRMC PROVIDES A BROAD ARRAY OF SERVICES. THE FOLEY CANCER CENTER AT RRMC PROVIDES TREATMENT TECHNOLOGIES THAT INCLUDE HIGH TECH DIAGNOSTIC IMAGING, MEDICAL ONCOLOGY WITH TRADITIONAL IV THERAPIES (SUCH AS CHEMOTHERAPY), AND RADIATION ONCOLOGY FEATURING A STATE-OF-THE-ART LINEAR ACCELERATOR. SUPPORTIVE CARE PROGRAMS INCLUDE PALLIATIVE CARE, PAIN MANAGEMENT, ACUPUNCTURE AND A WOMEN'S BREAST CARE PROGRAM, AND A VARIETY OF SUPPORT GROUPS. THE HOSPITAL PROVIDES 24-HOUR EMERGENCY CRISIS CARE, AS WELL AS PSYCHIATRIC INTENSIVE CARE, GERIATRIC PSYCHIATRIC PROGRAMS, MEDICAL DETOXIFICATION AND DUAL DIAGNOSIS AND TREATMENT OF SIMULTANEOUS SUBSTANCE ABUSE AND BEHAVIORAL HEALTH DISORDERS. THE 24-HOUR EMERGENCY DEPARTMENT PROVIDES CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE FAST TRACK PROGRAM IS DESIGNED TO PROCESS URGENT CARE IN A TIMELY MANNER. RRMC PROVIDES CARE FOR BOTH MEDICARE AND MEDICAID PATIENTS; THESE POPULATIONS MAKE UP 55.5% OF THE PAYER MIX FOR RRMC. BY WORKING COLLABORATIVELY WITH THE LOCAL FEDERALLY QUALIF</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>AFFILIATED HEALTH CARE SYSTEM: RUTLAND REGIONAL MEDICAL CENTER (RRMC) IS PART OF A HEALTH CARE SYSTEM WHICH INCLUDES THE FOLLOWING ADDITIONAL TAX-EXEMPT ORGANIZATIONS: RUTLAND REGIONAL HEALTH SERVICES, INC. (RRHS), VERMONT ORTHOPAEDIC CLINIC, INC. (VOC), AND RUTLAND HEALTH FOUNDATION (RHF). RRHS IS A HOLDING COMPANY ORGANIZED TO SUPPORT, PROMOTE, ADVANCE AND STRENGTHEN THE HEALTH OF PERSONS WITHIN ITS DESIGNATED SERVICE AREA. VOC OFFERS COMPREHENSIVE, HIGH QUALITY TREATMENT METHODOLOGIES FOR ORTHOPAEDIC-RELATED INJURIES. RHF PARTNERS WITH PATIENTS, PHYSICIANS, EMPLOYEES, COMMUNITY LEADERS, AND PHILANTHROPISTS TO RAISE MONEY TO HELP MEET HEALTHCARE NEEDS OF THE COMMUNITY. RRHS IS THE SOLE MEMBER OF RRMC AND VOC, AND IS THE CONTROLLING MEMBER OF RHF. THE SYSTEM PRIMARILY EARNS REVENUES BY PROVIDING HOSPITAL INPATIENT, HOSPITAL OUTPATIENT, HOSPITAL EMERGENCY CARE, AND PHYSICIAN SERVICES TO RESIDENTS IN THE RUTLAND, VERMONT, AREA. THE JAMES T BOWSE HEALTH TRUST IS A DEPARTMENT OF RUTLAND REGIONAL HEALTH SERVICES AND PROVIDES GRANT FUNDING AIMED AT IMPROVING THE HEALTH STATUS OF THE RUTLAND REGION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="IRS990ScheduleI">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>LOTHROP ELEMENTARY SCHOOL</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>3447 ROUTE 7</AddressLine1>
          <City>PITTSFORD</City>
          <State>VT</State>
          <ZIPCode>05763</ZIPCode>
        </USAddress>
        <RecipientEIN>036000625</RecipientEIN>
        <IRCSectionDesc>PITTSFORD, VT</IRCSectionDesc>
        <CashGrantAmt>8200</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>RUTLAND SOUTH SUPERVISORY UNION</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>64 GRANGE HALL ROAD</AddressLine1>
          <City>N CLARENDON</City>
          <State>VT</State>
          <ZIPCode>05759</ZIPCode>
        </USAddress>
        <RecipientEIN>030253069</RecipientEIN>
        <IRCSectionDesc>WALLINGFORD DIS</IRCSectionDesc>
        <CashGrantAmt>22600</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
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          <BusinessNameLine1>GIRL SCOUTS OF THE GREEN MOUNTAIN</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>PO BOX 10832</AddressLine1>
          <City>BEDFORD</City>
          <State>NH</State>
          <ZIPCode>03110</ZIPCode>
        </USAddress>
        <RecipientEIN>020243160</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10579</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>VERMONT ADULT LEARNING</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>60 S MAIN STREET</AddressLine1>
          <City>WATERBURY</City>
          <State>VT</State>
          <ZIPCode>05676</ZIPCode>
        </USAddress>
        <RecipientEIN>030276755</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>26708</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>RUTLAND AREA VISITING NURSES</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>7 ALBERT CREE DRIVE</AddressLine1>
          <City>RUTLAND</City>
          <State>VT</State>
          <ZIPCode>05701</ZIPCode>
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        <RecipientEIN>030185024</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>6584</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>PREVENT CHILD ABUSE</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>PO BOX 829</AddressLine1>
          <City>MONTPELIER</City>
          <State>VT</State>
          <ZIPCode>05601</ZIPCode>
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        <RecipientEIN>030267183</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>29000</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>FOXCRAFT FARM HARVEST</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>898 DELORM ROAD</AddressLine1>
          <City>LEICESTER</City>
          <State>VT</State>
          <ZIPCode>05733</ZIPCode>
        </USAddress>
        <RecipientEIN>030364354</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>35000</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>RUTLAND DISMAS HOUSE</BusinessNameLine1>
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        <USAddress>
          <AddressLine1>103 PARK AVENEUE</AddressLine1>
          <City>RUTLAND</City>
          <State>VT</State>
          <ZIPCode>05701</ZIPCode>
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        <RecipientEIN>030369442</RecipientEIN>
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        <CashGrantAmt>22175</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
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      <RecipientTable>
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          <City>RUTLAND</City>
          <State>VT</State>
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        <RecipientEIN>030210725</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>38565</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1>COMMUNITY HEALTH CENTERS OF RUTLAND REG</BusinessNameLine1>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1>375 ROUTE 30</AddressLine1>
          <City>NORTH BOMOSEEN</City>
          <State>VT</State>
          <ZIPCode>05732</ZIPCode>
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        <RecipientEIN>221179701</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>1773580</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY HEALTH IMPROVEMENT</PurposeOfGrantTxt>
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      <Total501c3OrgCnt>10</Total501c3OrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PART I, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>GRANTS MONITORING: RUTLAND REGIONAL HEALTH SERVICES (RRHS), THROUGH RUTLAND REGIONAL MEDICAL CENTER(RRMC), AWARDED A FIVE-YEAR COMMUNITY BENEFIT GRANT TO COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. (CHCRR) IN THE AMOUNT OF $4,600,000 THAT IS FUNDED BY RRMC AND WAS EFFECTIVE MAY 1, 2008. FOR THE YEARS ENDED SEPTEMBER 30, 2014 AND 2013, RESPECTIVELY, $1,773,580 AND $833,333 WAS EXPENDED FOR THE GRANT AWARD FROM RRMC AND IS INCLUDED IN RUTLAND REGIONAL MEDICAL CENTER'S GENERAL OPERATING EXPENSES. RRHS CONTINUALLY WORKS WITH CHCRR TO ENSURE THE ORGANIZATION IS USING FUNDS APPROPRIATELY AND FURTHERING THE CHCRR EXEMPT PURPOSE. THE OTHER GRANTS LISTED ON SCHEDULE I, PART II, WERE PROVIDED BY THE JAMES T BOWSE HEALTH TRUST, A DEPARTMENT OF RUTLAND REGIONAL MEDICAL CENTER. THE BOWSE TRUST ONLY CONSIDERS GRANT PROPOSALS THROUGH ITS FORMAL GRANT PROPOSAL PROCESS, WHICH REQUIRES THAT THE REQUESTING ORGANIZATION MEET CERTAIN CRITERIA AND SUBMIT A PLANNING GRANT/LETTER OF INTENT, FULL PROPOSAL, AND PLANNING GRANT BUDGET FORM DESCRIBING HOW THE GRANT WILL BE USED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PART II, COLUMN H</FormAndLineReferenceDesc>
        <ExplanationTxt>PURPOSE OF GRANT OR ASSISTANCE: ASSISTANCE FOR LOTHROP ELEMENTARY SCHOOL, RUTLAND SOUTH SUPERVISORY UNION, GIRL SCOUTS OF THE GREEN MOUNTAIN, VERMONT ADULT LEARNING, RUTLAND AREA VISITING NURSES, PREVENT CHILD ABUSE, FOXCRAFT FARM HARVEST, RUTLAND DISMAS HOUSE, AND RUTLAND MENTAL HEALTH WAS PROVIDED BY THE JAMES T BOWSE HEALTH TRUST, A DEPARTMENT OF RUTLAND REGIONAL MEDICAL CENTER. SEE SCHEDULE H, PART VI, LINE 6 FOR MORE INFORMATION REGARDING PROGRAMS FUNDED BY THE JAMES T BOWSE HEALTH TRUST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>26138</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>17954</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>383466</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BARBARA M ROBINSON</PersonNm>
        <TitleTxt>VP CLINICAL SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>225880</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>6357</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>19301</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16461</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>267999</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CAROL M EGAN</PersonNm>
        <TitleTxt>VP CHIEF NURSING OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>204798</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2905</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>17517</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>17398</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>242618</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALLISON W WOLLEN</PersonNm>
        <TitleTxt>VP HUMAN RESOURCES</TitleTxt>
        <BaseCompensationFilingOrgAmt>199352</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>286</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8863</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24040</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>232541</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARY T NEMETH</PersonNm>
        <TitleTxt>VP CORPORATE SUPPORT SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>194107</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>4764</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>20738</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9556</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>229165</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOHN S KIJEWSKI</PersonNm>
        <TitleTxt>VP CIO ENDING 10/13</TitleTxt>
        <BaseCompensationFilingOrgAmt>71442</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>110472</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7852</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8006</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>197772</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JI CHEN</PersonNm>
        <TitleTxt>DIRECTOR OF PHARMARY</TitleTxt>
        <BaseCompensationFilingOrgAmt>174348</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>143</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7444</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3015</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>184950</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DARREN CHILDS</PersonNm>
        <TitleTxt>FORMER VP QUALITY IMPROVEMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>156360</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>193</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13406</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23804</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>193763</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>SEVERANCE PAYMENTS: JOHN KIJEWSKI, VICE PRESIDENT - CIO ENDING 10/2013, RECEIVED A SEVERANCE PAYMENT OF $110,320 FROM THE ORGANIZATION DURING THE YEAR. THIS AMOUNT IS INCLUDED IN OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B(III).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 5A</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>VT EDUCATIONAL &amp; HLTH BUILDING FINANCE AGENCY</BusinessNameLine1>
        </IssuerName>
        <BondIssuerEIN>237154467</BondIssuerEIN>
        <BondIssuedDt>2013-09-03</BondIssuedDt>
        <IssuePriceAmt>31350000</IssuePriceAmt>
        <PurposeDesc>PARTIAL REFUND 09/10 SERIES BONDS</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>31350000</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>31157038</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>192962</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>0</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2013</SubstantialCompletionYr>
        <CurrentRefundingInd>true</CurrentRefundingInd>
        <AdvanceRefundingInd>false</AdvanceRefundingInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>true</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>true</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1>DEUTSCHE BANKTDBANK</BusinessNameLine1>
        </HedgeProviderName>
        <TermOfHedgePct>10.</TermOfHedgePct>
        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>true</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1>0</BusinessNameLine1>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K, PART IV, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>REQUIREMENTS OF SECTION 148: THE TAX-EXEMPT BONDS DO NOT HAVE ANY OUTSTANDING PROCEEDS AND THEREFORE ARE NOT SUBJECT TO THE ARBITRAGE REQUIREMENTS OF SECTION 148.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>FOLEY DISTRIBUTING FOLEY SERVICES</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>M FOLEY - SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>273028</TransactionAmt>
        <TransactionDesc>PAPER AND JANITORIAL SUPPLIES</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>BLUE CROSS BLUE SHIELD</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>T HUEBNER - SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>16764137</TransactionAmt>
        <TransactionDesc>INSURANCE PREMIUMS</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>RUTLAND RADIOLOGY INC</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>R SIVA - SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>455056</TransactionAmt>
        <TransactionDesc>PURCHASED SERVICES</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE L, PART IV, COLUMN B</FormAndLineReferenceDesc>
        <ExplanationTxt>BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: MARK K FOLEY, BOARD MEMBER, OWNS FOLEY DISTRIBUTING AND FOLEY SERVICES, INC. THESE COMPANIES SUPPLIED PAPER AND JANITORIAL PRODUCTS TO THE ORGANIZATION FOR $273,028 IN FISCAL YEAR 2014. THOMAS W HUEBNER, RRMC PRESIDENT &amp; CEO, IS ON THE BOARD OF BLUE CROSS BLUE SHIELD OF VERMONT. IN FISCAL YEAR 2014, THE ORGANIZATION PAID BCBS $16,764,137 IN HEALTH INSURANCE PREMIUMS. DR. RASHAN SIVA, RRMC BOARD MEMBER, IS THE SECRETARY OF RUTLAND RADIOLOGY, INC. IN FISCAL YEAR 2014, THE ORGANIZATION PAID RUTLAND RADIOLOGY, INC. $455,056 FOR RADIOLOGY SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION'S MISSION AND MOST SIGNIFICANT ACTIVITIES: MISSION: TO IMPROVE THE HEALTH OF THE RUTLAND REGION AND SURROUNDING COMMUNITIES BY PROVIDING APPROPRIATE, SUPERIOR, INTEGRATED, PREVENTATIVE, DIAGNOSTIC AND THERAPEUTIC HEALTH SERVICES IN A CARING ENVIRONMENT THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY AND RELATIONSHIPS. VISION: TO BE THE BEST COMMUNITY HEALTHCARE SYSTEM IN NEW ENGLAND. GOALS: *QUALITY: WE WILL PROVIDE SUPERIOR HEALTH SERVICES WHICH MEET OUR CUSTOMER NEEDS THROUGH: GOOD CLINICAL OUTCOMES, UP-TO-DATE TECHNOLOGY, EFFECTIVE PROCESSES, COMPETENT AND CARING STAFF AND WELL MAINTAINED FACILITIES. *GROWTH: WE WILL DEVELOP NEW SERVICES AND EXPAND EXISTING SERVICES TO MEET CUSTOMER NEEDS RESULTING IN INCREASED MARKET SHARE AND EXPANSION INTO NEW MARKETS. *INFORMATION EXCELLENCE: WE WILL PROVIDE SUPERIOR, COORDINATED INFORMATION RESOURCES, PROCESSES, AND SYSTEMS THAT MEET CUSTOMER NEEDS FOR EFFECTIVE INFORMATION GATHERING, RECORDING, ACCESS, ANALYSIS, AND DISSEMINATION ACROSS THE HEALTHCARE CONTINUUM. *FINANCIAL STRENGTH: WE WILL ACHIEVE FINANCIAL STRENGTH AND STABILITY BY OPTIMIZING REIMBURSEMENT AND IMPROVING OUR COST STRUCTURE TO PRODUCE SUFFICIENT MARGINS, AND INCREASING PHILANTHROPIC GIVING. *EMPLOYEE ENGAGEMENT: WE WILL CREATE AN ENVIRONMENT WHERE EMPLOYEE ENGAGEMENT FLOURISHES AND WE COMMIT OUR HEARTS AND MINDS TO MEETING AND EXCEEDING THE NEEDS OF OUR CUSTOMERS AND EACH OTHER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>TOTAL NUMBER OF VOLUNTEERS: THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND OTHER INDIVIDUALS WHO VOLUNTEER TIME TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAM SERVICE CHANGES: ON 9/24/2014, RUTLAND HEALTH FOUNDATION WAS DISSOLVED AND ALL REMAINING ASSETS WERE TRANSFERRED TO ITS MEMBERS, RAVNAH AND RUTLAND REGIONAL HEALTH SYSTEM. THE ASSETS DISTRIBUTED TO RRHS WERE THEN TRANSFERRED TO RUTLAND REGIONAL MEDICAL CENTER. RUTLAND HEALTH FOUNDATION IS NO LONGER A SEPARATE ENTITY, BUT A DEPARTMENT OF RRMC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINES 4A-D</FormAndLineReferenceDesc>
        <ExplanationTxt>EXEMPT PURPOSE ACHIEVEMENTS: RUTLAND REGIONAL MEDICAL CENTER FY 2014 COMMUNITY BENEFITS REPORT: RUTLAND REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDING SUPERIOR, INTEGRATED, DIAGNOSTIC, THERAPEUTIC AND PREVENTATIVE HEALTH SERVICES AND TO PROMOTING OVERALL COMMUNITY HEALTH AND WELL-BEING. COMMUNITY BENEFITS ARE THE ACTIVITIES AND SERVICES RUTLAND REGIONAL ENGAGES IN AND SUPPORTS THAT GO BEYOND THE ROUTINE PATIENT CARE SERVICES. DOCUMENTING THESE EFFORTS IS A PART OF WHAT DIFFERENTIATES TAX-EXEMPT FROM TAXABLE HEALTH CARE ORGANIZATIONS. PROGRAMMING THAT COUNTS: COMMUNITY HEALTH IMPROVEMENT INITIATIVES SCREENING SERVICES AND EDUCATIONAL PROGRAMMING ARE IMPORTANT ELEMENTS TO PROMOTING THE HEALTH OF OUR COMMUNITY. THE ASSOCIATED EXPENSES FOR 2014 EXCEEDED $1,558,739. RRMC OFFERS HEALTH LIVING WORKSHOPS, TOBACCO CESSATION PROGRAMING, CONSUMER HEALTH LIBRARY SUPPORT, BREAST CARE EDUCATION OUTREACH, AND OVER 25 SUPPORT GROUPS FOR INDIVIDUALS AND FAMILIES. HEALTH PROFESSION EDUCATION &amp; TRAINING FOR NON-EMPLOYEES AND WORKFORCE DEVELOPMENT COLLABORATING WITH EDUCATIONAL PROGRAMS, RRMC SUPPORTS A VARIETY OF TRAINING PROGRAMS FOR INDIVIDUALS INTERESTED IN MEDICAL-RELATED FIELDS. DURING 2014, RRMC'S INVESTMENT IN THESE AREAS TOTALED APPROXIMATELY $117,257. FREE AND DISCOUNTED CARE RUTLAND REGIONAL PROVIDES LOW- AND NO-COST CARE FOR ELIGIBLE RESIDENTS OF OUR AREA THROUGH A FINANCIAL ASSISTANCE PROGRAM. THE FREE CARE PROVISION FOR 2014 TOTALED $5,681,211. IN ADDITION TO THESE ACTIVITIES, RUTLAND REGIONAL IS NOW REQUIRED BY FEDERAL REGULATIONS TO CONDUCT A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS. THE RUTLAND COUNTY HEALTH NEEDS ASSESSMENT 2014 STEERING COMMITTEE HAS WORKED HARD TO BE INCLUSIVE, BOTH IN THE INFORMATION COLLECTED AND REVIEWED, AND BY BROADLY REQUESTING INPUT FROM AROUND OUR COMMUNITIES. FROM START TO FINISH, THE ASSESSMENT TAKES ABOUT ONE YEAR TO COMPLETE, AND INCLUDES COMPILATION OF SECONDARY DATA FROM OTHER SOURCES, COLLECTING INDIVIDUAL INPUT THROUGH CONSUMER SURVEYS AND THROUGH FOCUS GROUP MEETINGS. ALL OF THE INFORMATION GATHERED IS REVIEWED, AND PRIORITIZED BY A BROAD, COMMUNITY-BASED COMMITTEE. A FINAL REPORT HAS NOW BEEN PUBLISHED WITH THE FINDINGS. THIS REPORT IS MADE PUBLICALLY AVAILABLE ON WWW.RRMC.ORG. THE PURPOSE OF THE ASSESSMENT IS TO: -DESCRIBE THE HEALTH STATUS OF THE COMMUNITY -IDENTIFY THE COMMUNITY'S HEALTH NEEDS -COMPARE THE NEEDS TO THOSE IDENTIFIED PREVIOUSLY CONDUCTING ASSESSMENTS PERIODICALLY FOR MORE THAN 15 YEARS, WE HAVE SEEN SOME HEALTH INDICATORS IMPROVE AND OTHERS DECLINE. BY MONITORING THESE CHANGES, THE COMMITTEE IS ABLE TO IDENTIFY WHERE ADDITIONAL RESOURCES ARE NEEDED. ORGANIZATIONS, INCLUDING RUTLAND REGIONAL, USE THIS IMPORTANT INFORMATION TO GUIDE THEIR PLANNING. FOR RUTLAND REGIONAL SPECIFICALLY, IT HELPS WITH THE DEVELOPMENT OF NEW HOSPITAL SERVICES AND COMMUNITY PROGRAMS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER PROGRAM SERVICES: THE REVENUES AND EXPENSES REPORTED ON PART III, LINE 4D, REPRESENT THOSE AMOUNTS THAT ATTRIBUTABLE TO OTHER PROGRAM SERVICES CONDUCTED BY THE ORGANIZATION. THESE OTHER SERVICES PRIMARILY REPRESENT OTHER SUPPORT SERVICES THAT ARE PROVIDED TO HOSPITAL PATIENTS OR THAT ARE CONDUCTED TO SUPPORT THE OVERALL FUNCTION OF THE HOSPITAL, SUCH AS CENTRAL SUPPLY AND PHARMACY SERVICES. OTHER SERVICES ALSO INCLUDE BENEFIT TO THE COMMUNITY THROUGH THE PAYMENT OF GRANTS TO OTHER COMMUNITY ORGANIZATIONS. SEE SCHEDULE I FOR DETAIL REGARDING THESE GRANT PAYMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINES 6, 7A, &amp; 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OR STOCKHOLDERS: PER ARTICLE II, SECTION 1, OF THE ORGANIZATION'S BYLAWS, RUTLAND REGIONAL HEALTH SERVICES IS THE SOLE MEMBER OF RUTLAND REGIONAL MEDICAL CENTER. ARTICLE III, SECTIONS 1 AND 2, OF THE BYLAWS STATE THAT THE BOARD SHALL CONSIST OF EIGHTEEN DIRECTORS. OF THESE DIRECTORS, FOURTEEN ARE CHOSEN OR APPROVED BY THE ORGANIZATION'S SOLE MEMBER. ARTICLE VIII, SECTION 5, OF THE BYLAWS DISCUSS POWERS RESERVED TO THE MEMBER, RUTLAND REGIONAL HEALTH SERVICES, INC., AND STATE THAT THE CORPORATION SHALL SUBMIT TO THE BOARD OF DIRECTORS OF THE MEMBER FOR ITS PRIOR APPROVAL THE FOLLOWING: A) THE APPOINTMENT OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, B) ALL OPERATING AND CAPITAL BUDGETS FOR THE CORPORATION, C) STRATEGIC PLANS FOR THE CORPORATION, D) CAPITAL EXPENDITURES OF $100,000 OR MORE WHICH ARE UNBUDGETED, E) PURCHASE AND SALE OF ALL SIGNIFICANT ASSETS, AND F) THE BYLAWS AND ANY AMENDMENTS THERETO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT COPY IS THEN REVIEWED BY TOP MANAGEMENT. ONCE A FINAL DRAFT IS COMPLETE, IT IS MAILED TO EACH MEMBER OF THE EXECUTIVE FINANCE COMMITTEE. THE COMMITTEE WILL MEET AND DISCUSS THE RETURN WITH A TAX ADVISOR. AFTER APPROVAL, A FINAL 990 DRAFT WILL BE PROVIDED TO ALL BOARD MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTERST POLICY: ANNUALLY, ALL ORGANIZATION LEADERS REVIEW THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY TO ENSURE ALL CONFLICTS ARE MADE KNOWN. SEE THE POLICY BELOW. POLICY *DUTY TO DISCLOSE IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, OR OTHER INDIVIDUALS WHO, ON BEHALF OF THE CORPORATION, ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. *DUTY TO VOICE CONCERN IN THE EVENT THAT AN INTERESTED PERSON BECOMES CONCERNED THAT ANOTHER INTERESTED PERSON WHO IS A BOARD MEMBER, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS HAS AN UNDISCLOSED FINANCIAL INTEREST OR IS EXERTING INAPPROPRIATE INFLUENCE RELATED TO A FINANCIAL INTEREST, THIS CONCERN SHOULD BE RAISED WITH THE CHAIR OF THE APPROPRIATE BOARD OR COMMITTEE OR, IF INVOLVING A MEMBER OF LEADERSHIP COUNCIL, A DIRECTOR OR MANAGER OR OTHER INTERESTED PERSON, AN APPROPRIATE CORPORATE OFFICER. *DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD OR COMMITTEE MEMBERS. HOWEVER, IN NO EVENT SHALL AN INTERESTED PERSON PARTICIPATE IN THE DELIBERATION AND/OR DETERMINATION OF COMPENSATION THAT HE/SHE WILL RECEIVE FROM THE CORPORATION FOR EMPLOYMENT, PROFESSIONAL CONTRACT OR OTHERWISE. *DEFINITIONS -INTERESTED PERSON - FOR THE PURPOSES OF THIS POLICY, AN INTERESTED PERSON IS ANY BOARD MEMBER, PRINCIPAL OFFICER, MEMBER OF THE LEADERSHIP COUNCIL, DIRECTOR, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. IF AN INDIVIDUAL IS AN INTERESTED PERSON WITH RESPECT TO ANY ENTITY IN THE RRMC/RRHS HEALTH CARE SYSTEM, HE OR SHE IS AN INTERESTED PERSON WITH RESPECT TO ALL ENTITIES IN THE HEALTH CARE SYSTEM. *PROCEDURES -PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST .AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. .THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. .AFTER EXERCISING DUE DILIGENCE, INCLUDING A CONSIDERATION OF INDEPENDENT COMPARABILITY DATA, VALUATIONS OR APPRAISALS, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. .IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. -ANNUAL STATEMENTS .AWARENESS/COMPLIANCE WITH POLICY - EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THIS CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY; HAS AGREED TO COMPLY WITH THE POLICY; AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST BE ENGAGED PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. .CONFLICT OF INTEREST SURVEY - EACH INTERESTED PERSON SHALL DISCLOSE ON AN ANNUAL SURVEY FORM POTENTIAL CONFLICTS OF INTEREST AND FINANCIAL INTERESTS RELEVANT TO THIS POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINES 15A &amp; 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION REVIEW POLICY: THE FOLLOWING POLICY APPLIES TO THE ENTIRE RUTLAND REGIONAL HEALTH SERVICES (RRHS) SYSTEM, AND THE POLICY COVERS OFFICER &amp; KEY EMPLOYEE COMPENSATION: *IT IS THE POLICY OF RRHS TO OFFER MARKET-COMPETITIVE PAY SO TO ATTRACT AND RETAIN THE BEST TALENT FROM OUR LABOR MARKET. *DESIGNATION OF RRHS' KEY EMPLOYEES IS MADE BY THE COMPLIANCE DEPARTMENT. *THE RRHS KEY EMPLOYEE LABOR MARKET IS TYPICALLY ALL HOSPITALS NATIONALLY WITH SIMILAR REVENUES AS RRHS. *KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY EACH FALL USING THREE SOURCES OF INDEPENDENT COMPETITIVE MARKET DATA. *JOBS HELD BY KEY EMPLOYEES ARE MATCHED WITH SIMILAR JOBS IN MARKET DATA WITH AN INDICATION OF JOB MATCH STRENGTH (WEAK, MODERATE OR STRONG). *THE MARKET REVIEW PRODUCES A REPORT OF KEY EMPLOYEE CURRENT BASE PAY AND TOTAL CASH COMPENSATION VS. MARKET BASE PAY AND TOTAL CASH COMPENSATION WITH ANY RECOMMENDED PAY ACTIONS. *GENERALLY SPEAKING, KEY EMPLOYEE BASE PAY VARIANCES OF -5% VS. MARKET TOTAL CASH COMPENSATION ARE CONSIDERED TO BE NON-COMPETITIVE PROMPTING A RECOMMENDED BASE PAY INCREASE TO BE CONSIDERED. *THE RESULTS OF THE REVIEW AND RECOMMENDED PAY ACTIONS ARE REVIEWED AND APPROVED BY THE CEO. INFORMATION IS MADE AVAILABLE TO SYSTEM FINANCE UPON REQUEST. *THE CEO PAY IS REVIEWED AND APPROVED BY THE CHAIR AND CO-CHAIR OF THE BOARD OF DIRECTORS. THIS REVIEW IS DOCUMENTED IN THE EXECUTIVE SESSION BOARD MINUTES. THE MOST RECENT COMPENSATION REVIEW OCCURRED DURING DECEMBER OF 2014. *THE KEY EMPLOYEES REVIEW WAS CONDUCTED IN DECEMBER OF 2014 COVERING NON-PHYSICIAN EMPLOYEE EARNING AT LEAST $150,000. THIS WAS DONE INTERNALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENT DISCLOSURE: CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE ANNUALLY IN THE ANNUAL REPORT, AND ARE ALSO AVAILABLE UPON WRITTEN REQUEST. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. ALL REQUESTS MUST BE FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT), AND REQUESTED DOCUMENTS WILL BE MAILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, COLUMN D</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS RECEIVING COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. THE FOLLOWING BOARD MEMBERS RECEIVED COMPENSATION FROM RUTLAND REGIONAL MEDICAL CENTER FOR SERVICES PROVIDED AS PHYSICIANS: - MATTHEW A CONWAY, MD - DANIEL M FOLEY, MD - TODD GREGORY, MD - STANLEY SHARPIRO, MD</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER CHANGES IN NET ASSETS: $(10,536,065) NET LOSS FROM DEF BEN PLAN AND POSTRETIREMENT BEN COSTS 6,430,843 CHANGE IN FV OF INVESTMENTS FOR UNDER FASB 825 1,688,620 TRANSFER FROM RHF ( 218,958) LOSS ON INTEREST RATE SWAP AGREEMENT -------------- $( 2,635,560) TOTAL OTHER CHANGE IN NET ASSETS</ExplanationTxt>
      </SupplementalInformationDetail>
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          <AddressLine1>160 ALLEN STREET</AddressLine1>
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          <AddressLine1>5 ALBERT CREE DR</AddressLine1>
          <City>RUTLAND</City>
          <State>VT</State>
          <ZIPCode>05701</ZIPCode>
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      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>true</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
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      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
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</Return>