SPRINGFIELD HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- SPRINGFIELD HOSPITAL INC (EIN 03-0179437)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-13
- IRS object ID
- 201532259349302423
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-13T13:14:23-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030179437 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPRI | BusinessNameControlTxt |
| Phone | 8028857629 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 Ridgewood Road | AddressLine1 |
| City | Springfield | City |
| State | VT | State |
| ZIP Code | 05156 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Andrew J Majka | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8028857629 | PhoneNum |
| Signature | 2015-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne CPA | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2015-08-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Timothy Ford | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 Ridgewood Road | AddressLine1 |
| City | Springfield | City |
| State | VT | State |
| ZIP Code | 05156 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $56,624,124 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.springfieldhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1914 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | 25-Bed Critical Access Hospital | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 500 | TotalEmployeeCnt |
| Total Volunteers | 44 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $375,471 | PYContributionsGrantsAmt |
| CY Contributions Grants | $192,161 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $49,785,775 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $51,270,161 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,033,569 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,058,756 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$5,502 | PYOtherRevenueAmt |
| CY Other Revenue | -$3,971 | CYOtherRevenueAmt |
| PY Total Revenue | $51,189,313 | PYTotalRevenueAmt |
| CY Total Revenue | $52,517,107 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $26,632 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,903,902 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $27,189,496 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,794,769 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,393,825 | PYOtherExpensesAmt |
| CY Other Expenses | $26,379,437 | CYOtherExpensesAmt |
| PY Total Expenses | $51,609,953 | PYTotalExpensesAmt |
| CY Total Expenses | $59,078,108 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$420,640 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$6,561,001 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $45,124,709 | TotalAssetsBOYAmt |
| Total Assets EOY | $40,324,114 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,401,048 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,601,713 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,723,661 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,722,401 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, and employees want to work. We will accomplish this by:1. Empowering our caregivers with education, technology, and opportunities for personal and professional development;2. Creating an environment which builds collaborative relationships among clinicians, staff, and patients;3. Providing our communities with the educational resources and support to make informed decisions and apply preventive care; and4. Offering safe, personalized, high quality care. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $46,040,011 | ExpenseAmt |
| Grant | $3,903,902 | GrantAmt |
| Revenue | $51,270,161 | RevenueAmt |
| Desc | Springfield Hospital (SH) is a 25-bed critical access hospital located in Springfield, VT. SH is a subsidiary of Springfield Medical Care Systems, a seven-site federally qualified health center network. SH also operates The Windham Center, a comprehensive inpatient mental health program in Bellows Falls, VT; off-site physical therapy services, three hospital-owned specialty clinics (ENT, general surgery, and orthopaedics), and an adult day care center in Springfield, VT.SH provides health services to residents throughout its catchment area. Many of the services benefit the elderly, the poor, the indigent, the underinsured, and the uninsured. SH receives minimal reimbursement from these programs, with 66% of Springfield Hospital revenue coming from Medicare and Medicaid funding.Springfield Hospital has a charity care policy under which patients who meet certain criteria will receive care without charge, or at amounts less than established rates. Patients qualify for 100% charity care at up to 200% of the federal poverty guideline (FPG) and 50% assistance up to 300% of the FPG. The Hospital does not bill patients nor pursue collection of amounts determined to qualify as charity care. For FY14, charges foregone for charity care, based on established rates, amounted to $2,961,891.Springfield Hospital also operates a number of specialty practices to provide needed specialty care, to health center patients. These clinics include Connecticut Valley ENT, Surgical Associates, and Connecticut Valley Orthopaedics. In addition, SH provides an outpatient oncology clinic serving patients needing treatment and minimizing their need to travel great distances for medical oncology. Charitable support in the form of gas cards and/or medication cards are provided to patients who do not have needed funds. This program is sponsored through donations and grant funding.Other community benefit programs include the following:Job Training and Shadowing Programs: These programs, in cooperation with Vocational Rehab and training programs through the State of Vermont, provide opportunities to gain on-the-job experience in the healthcare field. We also work with area high school students to provide opportunities for career education and summer employment. Healthcare Scholarships: Springfield Hospital raises funds that are then donated to individuals to further their educational pursuits in healthcare careers. In FY 2014, we donated four scholarships of $1,000 each, and also provide $3,200 annually to AHEC for the MedQuest and Advanced MedQuest programs during the school year.Low Cost Infant Car Seat Program: This program helps residents comply with Vermont's child passenger restraint law, while ensuring the safety of our smallest patients. Approximately 16 infant restraints were provided during FY 2014. We estimate the value of this program to be $900 based on staff time to educate parents on the proper use and installation of the infant car seat and administrative assistant costs.Childbirth Education & Support Groups: The Childbirth Center of Springfield Hospital offers all expectant mothers an opportunity to take a Childbirth Education Class. These free classes are designed to prepare women and their partners for the labor and birth process. Licensed Lactation Consultants provide lactation consulting services.Employee Donations For Community Causes: Throughout the year, the Hospital encourages employees to participate in and donate to fund-raising events in support of various associations that address community needs, like Relay for Life, Race for the Cure, Hearts of Hope, food and clothing drives for The Family Center, and the Santa Claus Club. EMS Preceptor Programs: Through Springfield Hospital's Emergency Department, area EMS continue their education by participating in a preceptor program, allowing personnel to observe patient care. In FY 2014, approximately 800 hours of clinical hours were utilized by District 11 EMS personnel. Hospital Based Support Groups: Springfield Hospital provides education and support groups on a variety of topics such as, diabetes education, Alzheimer's, breast cancer, and pulmonary rehabilitation. Group meetings average 8-10 participants and meet monthly for 1-2 hours in duration. These groups are free to participants, educational in nature, offer an opportunity for group discussion, and often include a guest speaker.Meeting Rooms: Free meeting room space is offered to community groups as available. Groups that offer information on health or wellness are given a priority; such as Alcoholics Anonymous, Vermont Department of Health. Training Site Partnerships: Springfield Hospital is a training site for Vermont Technical College for their Licensed Practical Nurses. The following schools also have students doing practicums: University of New Hampshire, University of Vermont, University of Massachusetts, Smith College, Antioch New England Graduate School, River Valley College, VTC, St Joseph's College of Maine, Castleton State College. The program utilization is estimated to exceed 1,700 hours for clinical work. Community Education: Springfield Hospital coordinates health promotion programs, open to the public, for AARP Safe Driver Program and American Heart Association CPR and First Aid classes. Springfield Community: Springfield Hospital encourages employees to become an active volunteer to help improve the communities we call home. Employees donate their time in a variety of areas ranging from serving as Board Members for local groups supporting physical activity, The Family Center, Council on Aging, and Springfield on the Move. Employees also help organize and participate in fundraisers such as The Relay for Life, Susan G. Komen Race For the Cure and the annual Apple Blossom Cotillion. Volunteer Service: Volunteer Services provide a variety of services to patients and visitors. The donation of time and fund-raising activities support programs that include Patient Escort Service, Clerical Services, Activities Support at Adult Day Services, Materials Management Support, and Special Services in the Emergency Department. In 2014, Springfield Hospital had 44 volunteers. These individuals volunteered a total of 5,532 hours.The Windham Center: The Windham Center is a 10-bed inpatient mental health unit that provides mental health services to residents of Windham and Windsor counties and other communities. Programs provide treatment for men and women who are 18 years of age and older. Multidisciplinary teams include psychiatrists, social workers, clinicians, drug and alcohol counselors, and nurses. Vermont Life Expectancy reports a suicide rate per thousand per 100,000 population of 15.08% for Windham County, VT, and 13.83% for Windsor County, VT, compared to 12.61 for the United States overall. The Windham Center serves the general population and financial assistance is available, based on need. The Windham Center served 381 patients in 2014, and incurred $146k in charity care expense and $345k in non-reimbursed Medicaid and Medicare costs for the same period.Adult Day Care Service: Springfield Hospital operates adult day care service, located in Springfield, VT. A cost-effective choice in long term health care, Adult Day Service assists families with senior or disabled adults, over the age of 18, who face the challenge of losing their independence. The structured program offers a safe and protective environment where nutritious meals, social activities, health care services, nursing oversight, and coordination of needed social and support services are provided. Transportation is available through an arrangement with the local bus service, The Current, at a FY 2014 cost of approximately $32,000. During FY 2014, a total of 110 patients from throughout the region were served by the Adult Day Service. | Desc |
| Total Program Service Expenses | $46,040,011 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 106 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 500 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VT | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Andrew Majka | PersonNm |
| Phone | 8028857629 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 Ridgewood Road | AddressLine1 |
| City | Springfield | City |
| State | VT | State |
| ZIP Code | 05156 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Kevin Anderson | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Kathy Benson | |||||||||
| Treasurer | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Bob Flint | |||||||||
| Past Director | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| Don Hinckley | |||||||||
| Past Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Albert St Pierre | |||||||||
| Vice Chairperson | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | 1.00 | ||
| Crystal Stokarski | |||||||||
| Past Chairperson | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | 1.00 | ||
| Sarah Vail | |||||||||
| Secretary | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | 2.00 | ||
| Lori Muse | |||||||||
| Chairperson | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | 2.00 | ||
| Katrina Harris DO | |||||||||
| Director & Hospitalist Physician | 20.00 | Yes (X) | $156,137 | $0 | $16,105 | ||||
| David Sandelman | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Pete Peck | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| George Lamb | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| Richard Marasa MD | |||||||||
| Director | 40.00 | Yes (X) | $471,646 | $0 | $0 | ||||
| Jim Rumrill | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Timothy Ford | |||||||||
| CEO/President | 30.00 | Yes (X) | $0 | $32,309 | $0 | Yes (X) | 10.00 | ||
| Andrew Majka | |||||||||
| CFO | 30.00 | $0 | $248,577 | $3,481 | Yes (X) | 10.00 | |||
| Sarah Kemble | |||||||||
| Chief Medical Officer | 0.00 | $0 | $171,681 | $36,768 | Yes (X) | 40.00 | |||
| David Muller MD | |||||||||
| Orthopaedic Surgeon | 40.00 | $445,176 | $0 | $41,778 | Yes (X) | ||||
| Sara Schaefer MD | |||||||||
| Anesthesiologist | 40.00 | $236,387 | $0 | $38,755 | Yes (X) | ||||
| Anthony Fazzone MD | |||||||||
| Anesthesiologist | 40.00 | $246,894 | $0 | $10,350 | Yes (X) | ||||
| John Ciocchi MD | |||||||||
| General Surgeon | 40.00 | $258,665 | $0 | $33,817 | Yes (X) | ||||
| Kevin Berman MD | |||||||||
| General Surgeon | 40.00 | $324,189 | $0 | $39,475 | Yes (X) | ||||
| Glenn Cordner | |||||||||
| Former CEO/President | 0.00 | $0 | $141,811 | $30,458 | 0.00 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,139,094 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $594,378 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $250,987 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 26 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Emergency Services of New England | |||||
| PO Box 12 | Chester | VT | 05143 | Physician Services | $2,878,889 |
| Comprehensive Benefits Administrators | |||||
| PO Box 2365 | South Burlington | VT | 05407 | Benefit Management | $502,772 |
| Richard Marasa MD PC | |||||
| 1 Walnut Hill Court | Springfield | VT | 05156 | Physician Services | $471,646 |
| University of Vermont Med Ctr Inc | |||||
| PO Box 1902 | Burlington | VT | 05402 | Lab Services | $440,366 |
| Weatherby Locums Inc | |||||
| PO Box 972633 | Dallas | TX | 753972633 | Staffing Services | $428,503 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 24 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $13,800 | FundraisingAmt |
| All Other Contributions | $178,361 | AllOtherContributionsAmt |
| Total Contributions | $192,161 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Patient Service Revenue | 622110 | $105,304,477 | $105,304,477 | |
| Adult Daycare Revenue | 624120 | $1,523,297 | $1,523,297 | |
| Miscellaneous Revenue | 622110 | $275,091 | $125,499 | $149,592 |
| Provision for Bad Debts | 622110 | -$4,057,008 | -$4,057,008 | |
| Contractual Allowances | 622110 | -$51,775,696 | -$51,775,696 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $51,270,161 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $242,626 | TotalRevenueColumnAmt |
| Exclusion | $242,626 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,898,791 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,082,661 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $816,130 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $816,130 | TotalRevenueColumnAmt |
| Exclusion | $816,130 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $20,385 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $13,800 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $24,356 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,971 | TotalRevenueColumnAmt |
| Exclusion | -$3,971 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,517,107 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $51,120,569 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,204,377 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,903,902 | TotalAmt |
| Program Services | $3,903,902 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $643,888 | TotalAmt |
| Program Services | $643,888 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,761,047 | TotalAmt |
| Program Services | $16,734,692 | ProgramServicesAmt |
| Management And General | $6,026,355 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,575 | TotalAmt |
| Program Services | $231,941 | ProgramServicesAmt |
| Management And General | $82,634 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,451,809 | TotalAmt |
| Program Services | $2,548,473 | ProgramServicesAmt |
| Management And General | $903,336 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,623,450 | TotalAmt |
| Program Services | $1,200,270 | ProgramServicesAmt |
| Management And General | $423,180 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,591 | TotalAmt |
| Management And General | $330,591 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,967 | TotalAmt |
| Management And General | $83,967 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,038 | TotalAmt |
| Management And General | $52,038 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,296,859 | TotalAmt |
| Program Services | $7,659,773 | ProgramServicesAmt |
| Management And General | $1,637,086 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,461 | TotalAmt |
| Management And General | $89,461 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $440,915 | TotalAmt |
| Program Services | $175,838 | ProgramServicesAmt |
| Management And General | $265,077 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,601,529 | TotalAmt |
| Program Services | $534,390 | ProgramServicesAmt |
| Management And General | $1,067,139 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,410 | TotalAmt |
| Program Services | $9,728 | ProgramServicesAmt |
| Management And General | $34,682 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $319,192 | TotalAmt |
| Management And General | $319,192 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,200,335 | TotalAmt |
| Program Services | $2,161,663 | ProgramServicesAmt |
| Management And General | $38,672 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $572,254 | TotalAmt |
| Program Services | $557,558 | ProgramServicesAmt |
| Management And General | $14,696 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $5,480,644 | $5,289,822 | $190,822 |
| Healthcare Provider Tax | $2,960,223 | $2,960,223 | |
| Other Expenses | $879,928 | $348,975 | $530,953 |
| Repairs & Maintenance | $762,520 | $664,224 | $98,296 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,264,571 | TotalAmt |
| Program Services | $414,651 | ProgramServicesAmt |
| Management And General | $849,920 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,078,108 | TotalAmt |
| Program Services | $46,040,011 | ProgramServicesAmt |
| Management And General | $13,038,097 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,117 | BOYAmt |
| EOY | $244,645 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,628,455 | BOYAmt |
| EOY | $507,857 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,889,207 | BOYAmt |
| EOY | $9,875,972 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $398,638 | BOYAmt |
| EOY | $389,599 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $643,103 | BOYAmt |
| EOY | $651,100 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,803,497 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $25,256,290 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,256,109 | BOYAmt |
| EOY | $14,547,207 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,991,856 | BOYAmt |
| EOY | $13,835,526 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,002 | BOYAmt |
| EOY | $71,102 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,239,222 | BOYAmt |
| EOY | $201,106 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,124,709 | BOYAmt |
| EOY | $40,324,114 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,731,434 | BOYAmt |
| EOY | $8,240,372 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,920,000 | BOYAmt |
| EOY | $6,665,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,673,957 | BOYAmt |
| EOY | $4,904,525 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,075,657 | BOYAmt |
| EOY | $2,791,816 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,401,048 | BOYAmt |
| EOY | $22,601,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,037,738 | BOYAmt |
| EOY | $17,016,131 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $192,432 | BOYAmt |
| EOY | $212,779 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $493,491 | BOYAmt |
| EOY | $493,491 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,723,661 | BOYAmt |
| EOY | $17,722,401 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,124,709 | BOYAmt |
| EOY | $40,324,114 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$6,561,001 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $351,796 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $207,945 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,152,978 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $122,894 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $259,120 | OtherExpendituresAmt |
| Administrative Expenses | $3,834 | AdministrativeExpensesAmt |
| End Year Balance | $1,012,918 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,034,312 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $121,514 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $2,849 | AdministrativeExpensesAmt |
| End Year Balance | $1,152,978 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $891,334 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $150,499 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,504 | OtherExpendituresAmt |
| Administrative Expenses | $2,017 | AdministrativeExpensesAmt |
| End Year Balance | $1,034,312 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $907,834 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $7,469 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $21,131 | OtherExpendituresAmt |
| Administrative Expenses | $2,838 | AdministrativeExpensesAmt |
| End Year Balance | $891,334 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $861,686 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $70,988 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $22,196 | OtherExpendituresAmt |
| Administrative Expenses | $2,644 | AdministrativeExpensesAmt |
| End Year Balance | $907,834 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $87,157 | OtherCostOrOtherBasisAmt |
| Book Value | $87,157 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,882,196 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,089,212 | DepreciationAmt |
| Book Value | $6,792,984 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $966,627 | OtherCostOrOtherBasisAmt |
| Depreciation | $455,065 | DepreciationAmt |
| Book Value | $511,562 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,659,234 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,362,036 | DepreciationAmt |
| Book Value | $5,297,198 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,208,283 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,349,977 | DepreciationAmt |
| Book Value | $1,858,306 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,547,207 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Related Parties | $126,792 |
| Other Current Liabilities | $434,601 |
| Pension Liability | $2,230,423 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,791,816 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $49,197,302 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $351,796 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $232,301 | OtherRevenueAmt |
| Revenue Not Reported | $584,097 | RevenueNotReportedAmt |
| Revenue Subtotal | $48,613,205 | RevenueSubtotalAmt |
| Other Revenues Not Included | $3,903,902 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $3,903,902 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $52,517,107 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $55,198,562 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $24,356 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $24,356 | ExpensesNotReportedAmt |
| Expenses Subtotal | $55,174,206 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,903,902 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,903,902 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $59,078,108 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The funds are used to fund capital and used as loan collateral. |
| Part XI, Line 2d - Other Adjustments: | Fundraising Expenses 24,356. Change in net assets to recognize funded status of pension plan 207,945. |
| Part XI, Line 4b - Other Adjustments: | Transfer to Affiliate 3,903,902. |
| Part XII, Line 2d - Other Adjustments: | Fundraising Expenses 24,356. |
| Part XII, Line 4b - Other Adjustments: | Transfer to Affiliate 3,903,902. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Golf Tournament | NameOfEvent1Amt |
| Gross Receipts Event1 | $34,185 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $13,800 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $20,385 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $2,000 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $7,888 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $5,424 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $9,044 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $34,185 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $13,800 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $20,385 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $2,000 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $7,888 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $5,424 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $9,044 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $24,356 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$3,971 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,469,304 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,469,304 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02490 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,276,701 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,518,594 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,758,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08050 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,746,005 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,518,594 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,227,411 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10540 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,746,005 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,518,594 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,227,411 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10540 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,012,558 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $19,935,877 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,622,697 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $313,180 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Hospital | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 Ridgewood Road | AddressLine1 |
| City | Springfield | City |
| State | VT | State |
| ZIP Code | 05156 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Inpatient Psychiatric Unit | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.springfieldhospital.org | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Springfield Hospital, Inc. | Part V, Section B, Line 3: A steering committee was formed to conduct this assessment, review the data, and recommend priorities and implementation strategis to SMCS Board of Directors. Members Include:- Steve Geller, Executive Director, Southeastern Vermont Community Action- Sarah Kemble, MD, MPH, Medical Director, Springfield Medical Care Systems- Wilda Pelton, Executive Director, Valley Health Connections- Lynn Raymond-Empey, Executive Director, Vermont Coalition of Clinics for the Uninsured- Becky Thomas, MPH, Director, Vermont Department of Health- Joyce Lemire, Executive Director, Senior Solutions- Anna Smith, Director, Marketing and Community Relations, Springfield HospitalGroup Discussions and in-person or telephone interviews provided input from the following sources:- The SMCS Community Health Team (a 100+ member community health team that meets monthly);- Medical Providers;- Community Advisory Committee;- General Public;- Area Businesses; - Community Health Officers; - Police, Fire and EMT;- Schools; - Town Officials;- Home Health/VNA;- Health Care and Rehabilitation Services of Vermont (Community Mental Health);- Council on Aging; and,- Southeastern Vermont Community ActionA community-wide survey (via Survey Monkey) was distributed throughout the community. The distribution included Board Members, all Springfield Medical Care Systems medical staff, SMCS employees, and Community Health Team members, asking them to help distribute to their email and/or contact lists. The survey was also advertised on the hospital webiste and in the local newspapers. The survey was available to be completed online or via paper copy, and was made available to Hospital, Valley Health Connections, all primary and specialty care offices, and Springfield Area Adult Day Service. A total of 440 responses were received. |
| Springfield Hospital, Inc. | Part V, Section B, Line 18e: A patient financial counselor meets with patient prior to discharge if medical condition allows. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| The Windham Center | ||||
| 1 Hospital Court 12 | Bellows Falls | VT | 05101 | Inpatient Psych Unit |
| Connecticut Valley Orthopaedics and Spor | ||||
| 29 Ridgewood Rd | Springfield | VT | 05156 | Specialty Practice |
| Surgical Associates | ||||
| 29 Ridgewood Rd | Springfield | VT | 05156 | Specialty Practice |
| Springfield Hospital Rehabilitation Serv | ||||
| 100 River Street | Springfield | VT | 05156 | Physical Therapy |
| Springfield Area Adult Day Services | ||||
| 266 River Street | Springfield | VT | 05156 | Adult Day Services |
| Connecticut Valley ENT | ||||
| 29 Ridgewood Rd | Springfield | VT | 05156 | Specialty Practice |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part III, Line 4: | Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. In evaluating the collectibility of accounts receivable, the Hospital analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a provision for bad debts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts.Used the cost to charge ratio calculated times the bad debt expense. |
| Part III, Line 8: | Worksheet A from the Form 990 Instructions was used to determine the amount reported on Line 6. |
| Part III, Line 9b: | Financial assistance is written off from charges before any collection efforts are made. |
| Part VI, Line 2: | Our planning process is participative and incorporates ongoing public input regarding community health care, hospital services, and new opportunities. Conducted on an annual basis, planning includes information from various sources as outlined below: - Public Input is invited at any time through our website, e-mail, or regular mail. 1) A community needs assessment tool is available on our website's home page, www.springfieldmed.org, that provides ongoing opportunity for community feedback. 2) A Community Relations Line offers an invitation to provide feedback directly to the Quality & Systems Improvement Department via phone or email. This contact information can be found on the home page of our website, www.springfieldmed.org, by calling 802-885-7299, or by e-mailing communityrelations@springfieldmed.org.3) A Community Advisory Committee was formed as a result of our public meetings. This group meets on an ongoing basis for open dialog regarding needs assessment and to receive ongoing feedback regarding services. Suggestions or information may be sent to Anna Smith, Marketing & Community Relations, Springfield Medical Care Systems, 25 Ridgewood Road, Springfield, VT 05156, or e-mail annasmith@springfieldmed.org. - Ongoing information is received throughout the year to help us with our quality improvement initiatives. Our patient satisfaction survey process is conducted in cooperation with N.R.C. Picker, and monitors quality and services on a monthly basis.- Community participation and presentations are made on a regular basis to local public service and public gatherings. Outreach activity for planning and partnering with local boards, community services, and membership organizations is ongoing. This includes partnering with Vermont's Blueprint For Health, the VT Chronic Care Collaborative, the Edgar May Health & Recreation Center, emergency planning, career/education, and youth and elderly services agencies, to name a few, and provides ongoing community input. - A Community Health Team is now fully operational, meeting monthly to collaborate and partner with area agencies to remove barriers and improve access and quality of care. The team now exceeds 100 participants. New members are welcomed at each meeting as word of the team spreads throughout the community. The quarterly Community Advisory Group is an extension of this group and all members of the Community Health Team are invited to participate as often as they wish. - Our Board of Directors and Corporators provide ongoing participation through local representation. As a small community hospital, representatives interact regularly with community members and are available to answer questions or receive feedback. - Our volunteer network, whose annual participation of over 12,000 volunteer hours, creates ongoing opportunities for patient interaction and community outreach activities. - Public meetings and events are held throughout the year allowing our community to be directly involved in our work, and public comment and suggestions are invited. |
| Part VI, Line 3: | Enrollment counselors are available at physician practice offices, at Valley Health Connections on River Street in Springfield, VT, and at Springfield Hospital to meet privately to consult with patients about their eligibility for a variety of public programs and/or financial assistance. Information is provided through certified navigators and enrollment counselors, distributed to the community via our Community Health Team and area social service agencies, and is included in every welcome packet to new patients. It is also available via our website. |
| Part VI, Line 4: | The Organization is a non-profit corporation directed by a dedicated Board of Directors comprised of patients and community members. The service area includes 14 towns located in the Vermont counties of Windsor (eight towns) and Windham (three towns) and New Hampshire counties of Sullivan (two towns) and Cheshire (one town). Springfield Medical Care Systems, the parent corporation, provides and coordinates care from seven health center locations in the towns of Springfield, Ludlow, Chester, and Rockingham, VT, and Charlestown NH. Springfield Hospital is located in Springfield, VT. The service area is rural, primarily white, and has an older, lower income population. The community includes uninsured and Medicaid patients which represents 25% of the patient population. In NH, MUPs include Alstead, Acworth, Charlestown, Langdon and Walpole. In VT, MUPs include Rockingham, Athens, Grafton and Westminster in Windham County and Ludlow, Plymouth, Weston, and Reading in Windsor County. In addition to Springfield Hospital other area hospitals serving a portion of the service area include Brattleboro Memorial Hospital and Grace Cottage Hospital in Vermont and Valley Regional Hospital, Cheshire Medical Center, and Dartmouth-Hitchcock Medical Center in New Hampshire. Springfield Medical Care Systems maintains collaborative working relationships with each of these institutions.Median Population by Age (2010 Census source: USA.com)Windsor County: 45.8 Windham County: 44.9Vermont: 41.5 US: 37.2Cheshire County: 40.7 Sullivan County: 43.9 NH: 41.1 Median Household IncomeWindsor County: $50,893 Windham County: $46,714 Vermont: $51,841US: $51,914Cheshire County: $48,030Sullivan County: $50,689NH: $63,277Population in PovertyWindsor County: 9.73%Windham County: 11.13%Vermont: 11.12%US: 13.82%Cheshire County: 11.8%Sullivan County: 10.04%NH: 8.29% |
| Part VI, Line 5: | The health of our area communities and access to quality health care is served through the community health center network of the organization's parent corporation, Springfield Medical Care Systems, which is the primary source of preventive and coordinated care in our service area. The organization is directed by a Board of Directors comprised of community members and patients. Free health screenings, education programs and support groups are offered throughout the year. Financial assistance is communicated broadly across the service area, available to all who qualify based on a sliding fee scale, and includes dental and reduced pharmacy assistance. |
| Part VI, Line 6: | Springfield Hospital is a subsidiary of Springfield Medical Care Systems (SMCS). SMCS is comprised of a network of primary care offices (federally-qualified health centers) that provide ongoing care and outreach to our local communities, employing a medical home model of care, and focusing on prevention and efficient care management in cooperation with the Chronic Care Collaborative and the Vermont Blueprint for Health. Need for specialty services is referred by SMCS' health center medical staff to Springfield Hospital and its outpatient specialty clinicians, or to designated tertiary care facilities for the appropriate level of care as needed. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Medical Care Systems Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 Ridgewood Rd | AddressLine1 |
| City | Springfield | City |
| State | VT | State |
| ZIP Code | 05156 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 030284813 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $3,903,902 | CashGrantAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Purpose Of Grant | The Organization received a contribution to be used for the benefit of Springfield Medical Care System, a related organization. The Organization transferred this money to Springfield Medical Care System to be used for its intended purpose. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | All assistance provided by the Organization during the year was to Springfield Medical Care System, a related organization, which has the same bookkeeper as the Organization and, therefore, no monitoring is deemed necessary. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Katrina Harris DO | ||||||||||||||
| Director & Hospitalist Physician | $156,137 | $0 | $0 | $0 | $0 | $0 | $2,436 | $0 | $13,669 | $0 | $172,242 | $0 | $0 | $0 |
| Richard Marasa MD | ||||||||||||||
| Director | $471,646 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $471,646 | $0 | $0 | $0 |
| Andrew Majka | ||||||||||||||
| CFO | $0 | $238,950 | $0 | $0 | $0 | $9,627 | $0 | $3,481 | $0 | $0 | $0 | $252,058 | $0 | $0 |
| Sarah Kemble | ||||||||||||||
| Chief Medical Officer | $0 | $171,681 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $36,768 | $0 | $208,449 | $0 | $0 |
| David Muller MD | ||||||||||||||
| Orthopaedic Surgeon | $445,176 | $0 | $0 | $0 | $0 | $0 | $7,077 | $0 | $34,701 | $0 | $486,954 | $0 | $0 | $0 |
| Sara Schaefer MD | ||||||||||||||
| Anesthesiologist | $236,387 | $0 | $0 | $0 | $0 | $0 | $4,217 | $0 | $34,538 | $0 | $275,142 | $0 | $0 | $0 |
| Anthony Fazzone MD | ||||||||||||||
| Anesthesiologist | $246,894 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,350 | $0 | $257,244 | $0 | $0 | $0 |
| John Ciocchi MD | ||||||||||||||
| General Surgeon | $258,665 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $33,817 | $0 | $292,482 | $0 | $0 | $0 |
| Kevin Berman MD | ||||||||||||||
| General Surgeon | $324,189 | $0 | $0 | $0 | $0 | $0 | $5,858 | $0 | $33,617 | $0 | $363,664 | $0 | $0 | $0 |
| Glenn Cordner | ||||||||||||||
| Former CEO/President | $0 | $121,157 | $0 | $19,500 | $0 | $1,154 | $0 | $2,765 | $0 | $27,693 | $0 | $172,269 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Springfield Medical Care Systems, Inc., a related organization, establishes the compensation for the Organization's CEO. Springfield Medical Care Systems, Inc. uses a variety of resources to establish compensation as follows: 1. Compensation committee 2. Independent compensation consultant 3. Written employment contract 4. Compensation survey/study 5. Approval by the board/compensation committee | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Crystal Stokarski, Past Chairperson, and Bob Flint, Past Director, are both members of the governing body of the River Valley Technical Center located in Springfield, VT. |
| Form 990, Part VI, Section A, line 6 | The Organization has corporators. |
| Form 990, Part VI, Section A, line 7a | The Organization has corporators who elect board members. |
| Form 990, Part VI, Section A, line 7b | The corporators approve the selection of the Organization's auditors and approve by-law changes. |
| Form 990, Part VI, Section B, line 11 | Form 990 is reviewed by the Organization's Director of Finance and Chief Financial Officer upon completion. |
| Form 990, Part VI, Section B, line 12c | All officers, directors, trustees, and key employees must completed a conflict of interest statement annually. In addition, they must recuse themselves from voting on issues where a conflict is actual or implied. |
| Form 990, Part VI, Section B, line 15 | The parent organization has a compensation committee which uses an independent compensation consultant who performs a market analysis on similar health care providers with similar revenue in order to establish the base salary of the CEO and CFO. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. |
| Form 990, Part IX, line 11g | Collection Services: Program service expenses 0. Management and general expenses 94,377. Fundraising expenses 0. Total expenses 94,377. Purchased Services: Program service expenses 2,347,338. Management and general expenses 510,987. Fundraising expenses 0. Total expenses 2,858,325. Contracted Services: Program service expenses 4,011,476. Management and general expenses 580,999. Fundraising expenses 0. Total expenses 4,592,475. Locum Expense: Program service expenses 1,300,959. Management and general expenses 329,069. Fundraising expenses 0. Total expenses 1,630,028. Consulting Services: Program service expenses 0. Management and general expenses 121,654. Fundraising expenses 0. Total expenses 121,654. |
| Form 990, Part XI, line 9: | Change in net assets to recognize funded status of pension plan 207,945. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Springfield Medical Care Systems Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 Ridgewood Road PO Box 2003 | AddressLine1 |
| City | Springfield | City |
| State | VT | State |
| ZIP Code | 05156 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030284813 | EIN |
| Primary Activities | Primary medical care, support and enabling | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 3 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |