WINDSOR HOSPITAL CORPORATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- WINDSOR HOSPITAL CORPORATION (EIN 03-0183721)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-06-01
- IRS object ID
- 201541529349300349
- 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 C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-06-01T14:18:20-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 020476956 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TYLER SIMMS & ST SAUVEUR CPA PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19 MORGAN DRIVE | AddressLine1 |
| City | LEBANON | City |
| State | NH | State |
| ZIP Code | 03766 | 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 | 030183721 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINDSOR HOSPITAL CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WIND | BusinessNameControlTxt |
| Phone | 8026746711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 COUNTY ROAD | AddressLine1 |
| City | WINDSOR | City |
| State | VT | State |
| ZIP Code | 05089 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN DONOVAN | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8026746711 | PhoneNum |
| Signature | 2015-05-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | W JAY SIMMS | PreparerPersonNm |
| PTIN | P00435321 | PTIN |
| Phone | 6036530044 | PhoneNum |
| Preparation | 2015-05-22 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MTASCUTNEY HOSP & HEALTH CTR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN DONOVAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 COUNTY ROAD | AddressLine1 |
| City | WINDSOR | City |
| State | VT | State |
| ZIP Code | 05089 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $52,574,828 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | MTASCUTNEYHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1933 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE LIVES OF THOSE WE SERVE. OUR ACTIVITIES INCLUDE PROVIDING HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 579 | TotalEmployeeCnt |
| Total Volunteers | 187 | TotalVolunteersCnt |
| Total Gross UBI | $93,794 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $3,381 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $995,526 | PYContributionsGrantsAmt |
| CY Contributions Grants | $843,257 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $47,969,559 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $47,889,922 | CYProgramServiceRevenueAmt |
| PY Investment Income | $656,866 | PYInvestmentIncomeAmt |
| CY Investment Income | $474,482 | CYInvestmentIncomeAmt |
| PY Other Revenue | $24,214 | PYOtherRevenueAmt |
| CY Other Revenue | $175,682 | CYOtherRevenueAmt |
| PY Total Revenue | $49,646,165 | PYTotalRevenueAmt |
| CY Total Revenue | $49,383,343 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,907,533 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,621,744 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $291,141 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,754,508 | PYOtherExpensesAmt |
| CY Other Expenses | $20,562,857 | CYOtherExpensesAmt |
| PY Total Expenses | $48,662,041 | PYTotalExpensesAmt |
| CY Total Expenses | $49,184,601 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $984,124 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $198,742 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $42,487,151 | TotalAssetsBOYAmt |
| Total Assets EOY | $39,743,107 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $26,022,626 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,412,407 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,464,525 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,330,700 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MOUNT ASCUTNEY HOSPITAL AND HEALTH CENTER'S MISSION IS TO IMPROVE THE LIVES OF THOSE WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $39,912,236 | ExpenseAmt |
| Revenue | $47,889,922 | RevenueAmt |
| Desc | MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (MAHHC) OPERATES A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL WHICH PROVIDES PRIMARY AND SECONDARY HEALTH CARE. MAHHC'S PRIMARY SERVICE AREA INCLUDES WINDSOR, CLAREMONT, WOODSTOCK, HARTLAND, SPRINGFIELD, AND BROWNSVILLE. THE HOSPITAL PROVIDES ESSENTIAL HEALTHCARE SERVICES INCLUDING EMERGENCY DEPARTMENT, MED/SURG INPATIENT, MED/SURG OUTPATIENT, AND ANCILLARY DIAGNOSTIC TESTS, IMAGING/RADIOLOGY PROCEDURES, AND WELLNESS/PREVENTION SERVICES. MAHHC STAFFS A TOTAL OF 25 ACUTE MED/SURG BEDS AND 10 ACUTE REHABILITATION BEDS. DURING THE YEAR, THERE WERE 916 INPATIENT DISCHARGES, 1,743 OUTPATIENT SURGERIES, 76,014 OUTPATIENT LAB TESTS, AND 12,163 OUTPATIENT IMAGINING PROCEDURES. MAHHC IDENTIFIED ACCESS TO PRIMARY CARE AS A CENTRAL COMMUNITY NEED AND IS COMMITTED TO PROVIDING THE PHYSICIAN SERVICES OF FAMILY PRACTICE, INTERNAL MEDICINE AND PEDIATRICS IN WINDSOR AND WOODSTOCK. MAHHC PROVIDES FREE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA. FOREGONE CHARGES FURNISHED UNDER MAHHC'S FREE CARE POLICY AMOUNTED TO $1,280,926. | Desc |
| Total Program Service Expenses | $39,912,236 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 83 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 579 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID SANVILLE | PersonNm |
| Phone | 8026746711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 COUNTY ROAD | AddressLine1 |
| City | WINDSOR | City |
| State | VT | State |
| ZIP Code | 05089 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| NANCY LOUX | |||||||||
| PAST-PRESIDENT | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SHELLEY SEWARD | |||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| HAROLD PYKE | |||||||||
| SECRETARY | 1.00 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LARRY FRAZER | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL NEWBOLD | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| LYNN PETERSON MD | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| HON DONNA SWEANEY | |||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| STEVEN SMITH MD | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $11,800 | $157,382 | $61,091 | |||
| DONNA VANFLEET | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARY JOYCE MD | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $172,663 | $0 | $50,104 | ||||
| MARY BELL | |||||||||
| TRUSTEE (RESIGNED 6/2014) | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| VINCENT FUSCA III | |||||||||
| DH REPRESENTATIVE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PATTY O'NEILL | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| DEANNA S HOWARD | |||||||||
| DH REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MATTHEW S HOUDE | |||||||||
| DH REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEPHEN D SURGENOR MD | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ALAN KEILLER | |||||||||
| DH REPRESENTATIVE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID JONES | |||||||||
| TRUSTEE (RESIGNED 6/2014) | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| CATHERINE SCHNEIDER | |||||||||
| CMO | 40.00 | Yes (X) | $256,268 | $0 | $41,209 | ||||
| PAUL CALANDRELLA | |||||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $135,700 | $0 | $36,071 | ||||
| PAUL BUFF | |||||||||
| TRUSTEES (RESIGNED 12/2013) | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| KEVIN DONOVAN | |||||||||
| OFFICER/CEO | 40.00 | 1.00 | Yes (X) | $6,700 | $264,979 | $61,993 | |||
| DAVID SANVILLE | |||||||||
| OFFICER/CFO | 32.00 | 0.50 | Yes (X) | $195,461 | $0 | $0 | |||
| JILL LORD | |||||||||
| CNO | 40.00 | 0.50 | $155,554 | $0 | $12,853 | Yes (X) | |||
| CHRISTOPHER CONNOR MD | |||||||||
| OPTHALMOLOGIST | 40.00 | $348,555 | $0 | $47,268 | Yes (X) | ||||
| ANDREW ROBINSON MD | |||||||||
| GASTROENTEROLOGIST | 40.00 | $266,079 | $0 | $67,726 | Yes (X) | ||||
| HEIDI CRUZ MD | |||||||||
| PHYSIATRIST | 40.00 | $215,314 | $0 | $53,379 | Yes (X) | ||||
| GERALD DRABRYN MD | |||||||||
| PLASTIC SURGEON | 40.00 | $272,572 | $0 | $36,028 | Yes (X) | ||||
| JEFFREY KING MD | |||||||||
| PODIATRIST | 40.00 | $208,524 | $0 | $37,050 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,245,190 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $422,361 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $504,772 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 29 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DARTMOUTH HITCHCOCK | |||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | PROFESSIONAL AND PHYSICIAN SERVICES | $3,029,234 |
| EMERGENCY SERVICES OF NEW ENGLAND | |||||
| PO BOX 12 | CHESTER | VT | 05143 | PHYSICIAN ASST FOR EMERGENCY ROOM | $1,284,816 |
| SODEXO INC & AFFILIATES | |||||
| PO BOX 360170 | PITTSBURGH | PA | 152516170 | MNGMT & SUPPORT STAFF - ENVMMNTL SRVS | $1,012,625 |
| WEATHERBY LOCUMS | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | PHYSICIAN COVERAGE FOR HOSPITALS | $384,142 |
| SOUTHWIND | |||||
| PO BOX 79461 | BALTIMORE | MD | 212790461 | CONSULTANT FOR OPERATNG ROOM PERFORMANCE | $242,520 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $651,633 | GovernmentGrantsAmt |
| All Other Contributions | $191,624 | AllOtherContributionsAmt |
| Noncash Contributions | $48,171 | NoncashContributionsAmt |
| Total Contributions | $843,257 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 621110 | $80,390,153 | $80,390,153 |
| PROGRAM & MISC OTHER | 621110 | $2,100,574 | $2,100,574 |
| DSH/VAHHA REVENUE | 621110 | $533,586 | $533,586 |
| PROVISION FOR DOUBTFUL ACCOUNTS | 621110 | -$770,773 | -$770,773 |
| CONTRACTUAL ALLOWANCES | 621110 | -$34,363,618 | -$34,363,618 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $47,889,922 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $169,230 | TotalRevenueColumnAmt |
| Exclusion | $169,230 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $47,712 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $47,712 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,712 | TotalRevenueColumnAmt |
| Exclusion | $47,712 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,478,546 | SecuritiesAmt |
| Other | $2,323 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,175,617 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $302,929 | SecuritiesAmt |
| Other | $2,323 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $305,252 | TotalRevenueColumnAmt |
| Exclusion | $305,252 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $50,044 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $15,868 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,176 | TotalRevenueColumnAmt |
| Exclusion | $34,176 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BRIDGING THE GAP - CHILDCARE | Desc |
| Business | 624410 | BusinessCd |
| Total Revenue Column | $93,794 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $93,794 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $93,794 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,383,343 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,889,922 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $93,794 | UnrelatedBusinessRevenueAmt |
| Exclusion | $556,370 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,199,194 | TotalAmt |
| Program Services | $234,567 | ProgramServicesAmt |
| Management And General | $964,627 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,435,370 | TotalAmt |
| Program Services | $19,043,743 | ProgramServicesAmt |
| Management And General | $2,236,300 | ManagementAndGeneralAmt |
| Fundraising | $155,327 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,935 | TotalAmt |
| Program Services | $140,475 | ProgramServicesAmt |
| Management And General | $23,322 | ManagementAndGeneralAmt |
| Fundraising | $1,138 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,248,414 | TotalAmt |
| Program Services | $3,616,673 | ProgramServicesAmt |
| Management And General | $602,491 | ManagementAndGeneralAmt |
| Fundraising | $29,250 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,573,831 | TotalAmt |
| Program Services | $1,340,431 | ProgramServicesAmt |
| Management And General | $222,540 | ManagementAndGeneralAmt |
| Fundraising | $10,860 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,498 | TotalAmt |
| Management And General | $93,498 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,542 | TotalAmt |
| Program Services | $10,500 | ProgramServicesAmt |
| Management And General | $80,145 | ManagementAndGeneralAmt |
| Fundraising | $897 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,569 | TotalAmt |
| Program Services | $49,033 | ProgramServicesAmt |
| Management And General | $55,284 | ManagementAndGeneralAmt |
| Fundraising | $1,252 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $784,908 | TotalAmt |
| Program Services | $113,127 | ProgramServicesAmt |
| Management And General | $666,618 | ManagementAndGeneralAmt |
| Fundraising | $5,163 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,010 | TotalAmt |
| Program Services | $473,606 | ProgramServicesAmt |
| Management And General | $27,404 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,153 | TotalAmt |
| Program Services | $63,073 | ProgramServicesAmt |
| Management And General | $24,855 | ManagementAndGeneralAmt |
| Fundraising | $225 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,632 | TotalAmt |
| Program Services | $504,632 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,501,984 | TotalAmt |
| Program Services | $2,501,984 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $672,054 | TotalAmt |
| Program Services | $448,917 | ProgramServicesAmt |
| Management And General | $221,208 | ManagementAndGeneralAmt |
| Fundraising | $1,929 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACTED LABOR | $4,448,745 | $3,607,629 | $803,206 | $37,910 |
| SUPPLIES | $3,432,342 | $3,290,147 | $131,886 | $10,309 |
| PROFESSIONAL/CONSULTING | $3,316,196 | $1,977,137 | $1,304,811 | $34,248 |
| DUES/FEES/TAXES | $2,117,589 | $1,851,270 | $265,415 | $904 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,904,635 | TotalAmt |
| Program Services | $645,292 | ProgramServicesAmt |
| Management And General | $1,257,614 | ManagementAndGeneralAmt |
| Fundraising | $1,729 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,184,601 | TotalAmt |
| Program Services | $39,912,236 | ProgramServicesAmt |
| Management And General | $8,981,224 | ManagementAndGeneralAmt |
| Fundraising | $291,141 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,616,084 | BOYAmt |
| EOY | $2,641,381 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,776,146 | BOYAmt |
| EOY | $170,685 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $429,120 | BOYAmt |
| EOY | $614,124 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,181,442 | BOYAmt |
| EOY | $6,972,186 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,045 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $511,134 | BOYAmt |
| EOY | $541,316 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,564 | BOYAmt |
| EOY | $127,828 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,456,799 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,907,687 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,201,916 | BOYAmt |
| EOY | $11,549,112 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,088,456 | BOYAmt |
| EOY | $12,862,626 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,952,321 | BOYAmt |
| EOY | $2,035,677 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,512,923 | BOYAmt |
| EOY | $2,228,172 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,487,151 | BOYAmt |
| EOY | $39,743,107 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,820,843 | BOYAmt |
| EOY | $4,419,248 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,514,646 | BOYAmt |
| EOY | $8,047,149 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,764,463 | BOYAmt |
| EOY | $1,417,893 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,922,674 | BOYAmt |
| EOY | $9,528,117 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,022,626 | BOYAmt |
| EOY | $23,412,407 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,098,630 | BOYAmt |
| EOY | $9,213,629 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $509,713 | BOYAmt |
| EOY | $1,196,080 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,856,182 | BOYAmt |
| EOY | $5,920,991 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,464,525 | BOYAmt |
| EOY | $16,330,700 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,487,151 | BOYAmt |
| EOY | $39,743,107 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $198,742 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $334,810 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$667,377 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,358 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,358 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAID $9,109 IN THE FORM OF DUES TO THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (VAHHS). VAHHS IS A MEMBER-OWNED ORGANIZATION DEVOTED TO IMPROVING THE HEALTH STATUS OF COMMUNITIES THROUGHOUT VERMONT THROUGH ACTIVITIES WHICH INCLUDE ADVOCACY, POLICY DEVELOPMENT, EDUCATION AND RESEARCH. THE HOSPITAL ALSO PAID $2,250 IN THE FORM OF DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA). | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,856,182 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $64,809 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $5,920,991 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,880,406 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $79,267 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $5,959,673 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,705,958 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $174,448 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $5,880,406 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,787,015 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$81,057 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $5,705,958 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,710,296 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $76,719 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $5,787,015 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.88640 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.11360 | TermEndowmentBalanceEOYPct |
| 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 | $75,418 | OtherCostOrOtherBasisAmt |
| Book Value | $75,418 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,329,034 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,247,769 | DepreciationAmt |
| Book Value | $4,081,265 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,941,185 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,289,069 | DepreciationAmt |
| Book Value | $3,652,116 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,111,162 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,370,849 | DepreciationAmt |
| Book Value | $3,740,313 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,549,112 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CHARITABLE REMAINDER TRUST | $333,082 | F |
| BENEFICIAL INTEREST IN PERPETUAL TRUST | $1,702,595 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,035,677 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEFERRED FINANCING COST, NET | $44,266 |
| RENTAL DEPOSITS | $5,560 |
| EQUITY IN SUBSIDIARY | $2,109,873 |
| OTHER RECEIVABLES | $68,473 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,228,172 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER CURRENT LIABILITIES | $1,045,118 |
| EST. SETTLEMENTS W/ 3RD PARTY PAYORS | $3,012,116 |
| POST RETIREMENT BENEFIT OBLIGATION | $5,106,059 |
| INTEREST RATE SWAP | $364,824 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,528,117 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $48,725,147 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $334,810 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$968,890 | OtherRevenueAmt |
| Revenue Not Reported | -$634,080 | RevenueNotReportedAmt |
| Revenue Subtotal | $49,359,227 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $24,116 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $24,116 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $49,383,343 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $49,176,353 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $15,868 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $15,868 | ExpensesNotReportedAmt |
| Expenses Subtotal | $49,160,485 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $24,116 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $24,116 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $49,184,601 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | IN GENERAL, THE AMOUNT OF THE ORIGINAL GIFT AND ANY REQUIRED ACCUMULATIONS BY THE DONOR ARE NOT EXPENDABLE. HOWEVER, THE MARKET VALUE OF THE FUND MAY FALL BELOW THAT AMOUNT DEPENDING ON CURRENT FINANCIAL CONDITIONS IN THE UNDERLYING INVESTMENTS. UNDER THE POLICY OF THE HOSPITAL, THE ENDOWMENT ASSETS ARE INVESTED MODERATELY WITH THE INTENT OF PROVIDING A PREDICTABLE STREAM OF FUNDING TO THE HOSPITAL. THE HOSPITAL INVESTS IN EQUITY FUNDS, BOND FUNDS AND MONEY MARKET INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN LIMITED RISK CONSTRAINTS. ACTUAL RETURNS IN ANY YEAR MAY VARY FROM BUDGETED AMOUNTS DUE TO MARKET FLUCTUATIONS. |
| SCHEDULE D, PART XI, LINE 2D | UNREALIZED GAIN ON INTEREST RATE SWAP $309,733 EQUITY IN SUBSIDIARIES $172,304 CHANGE IN FUNDED STATUS OF PENSION PLAN $-1.550,151 CHARITABLE REMAINDER TRUST $18,547 BENEFICIAL INTEREST PERPETUAL TRUST $64,809 FUNDRAISING EXPENSE $15,868 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1Amt |
| Gross Receipts Event1 | $50,044 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $50,044 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $756 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $5,200 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $8,054 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $0 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,858 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $50,044 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $50,044 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $756 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $5,200 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $8,054 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,858 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $15,868 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $34,176 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| 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 | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $695,837 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $695,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01410 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,462,099 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,597,131 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $864,968 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01760 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,157,936 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,597,131 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,560,805 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03170 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $348,179 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $348,179 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00710 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $55,104 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $55,104 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,106,713 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,993,173 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,113,540 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10400 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,337 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,337 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,517,333 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,993,173 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,524,160 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11230 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,675,269 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,590,304 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,084,965 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14400 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,280,926 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $17,867,049 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $18,707,043 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$839,994 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (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 | WINDSOR HOSPITAL CORPORATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 289 COUNTY ROAD | AddressLine1 |
| City | WINDSOR | City |
| State | VT | State |
| ZIP Code | 05089 | 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 | DISTINCT PART REHAB UNIT | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINDSOR HOSPITAL CORPORATION | 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 |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MTASCUTNEYHOSPITAL.ORG | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| 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 |
| 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 |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WINDSOR HOSPITAL CORPORATION | PART V, SECTION B, LINE 3: DATA THAT INFORMED THIS NEEDS ASSESSMENT REPORT WAS COLLECTED THROUGH A NUMBER OF DATA-GATHERING ACTIVITIES - SECONDARY DATA GATHERING HEALTH, ECONOMIC, AND EDUCATION DATA FROM SOURCES INCLUDING YOUTH RISK BEHAVIOR SURVEY, THE BEHAVIORAL RISK FACTOR SUIRVEILLANCE SYSTEM, OTHER PUBLIC HEALTH AND HOSPITAL DISCHARGE DATA, CENSUS DATA, AND NECAP DATA. IN SOME CASES, ISSUES WERE HIGHLIGHTED THAT HAVE RECEIVED LOCAL ATTENTION OR WHICH HAVE EMERGED OR INTENSIFIED SINCE THE LAST SECONDARY DATA SURVEYS WERE CONDUCTED (EXAMPLED INCLUDE ORAL HEALTH, PRESCRIPTION DRUG MISUSE, HOUSING ASSESSMENTS, REDUCTIONS IN AVAILABILITY OF APPROPRIATE MENTAL HEALTH SERVICES, ETC.). PERCEPTIONS OF INFORMED REGIONAL STAKEHOLDER'S ON THE NATURE AND CAUSES OF POTENTIAL COMMUNITY NEEDS WERE GATHERED THROUGH A COMMUNITY STAKEHOLDER'S SURVEY. OPINION DATA FROM INFORMED REGIONAL STAKEHOLDERS USING AN ONLINE OPINION POLL OF REGIONAL LEADERS IN HEALTH, PUBLIC HEALTH, EDUCATION, MUNICIPAL GOVERNMENTS, PUBLIC SAFETY, AND SOCIAL SERVICE PROVIDERS. OPINION DATA FROM RESIDENTS COLLECTED THROUGH COMMUNITY LISTS, INDIVIDUAL INTERVIEWS AT HUMAN SERVICE ORGANIZATIONS AND FOCUS GROUPS. |
| WINDSOR HOSPITAL CORPORATION | PART V, SECTION B, LINE 4: OTHER FACILITIES WERE DARTMOUTH HITCHCOCK MEDICAL CENTER AND ALICE PECK DAY HOSPITAL |
| WINDSOR HOSPITAL CORPORATION | PART V, SECTION B, LINE 5D: A BENEFIT REPORT WAS PREPARED AND MADE AVAILABLE AND DISTRIBUTED THROUGH THE MT. ASCUTNEY COMMUNITY HEALTH FOUNDATION AND THE WINDSOR AREA COMMUNITY PARTNERSHIP. THE CHNA AND ALL INFORMATION GENERATED IN THE NEEDS ASSESSMENT PROCESS WILL BE AVAILABLE FOR STAKEHOLDERS PARTICIPATING IN THE PROCESS AND WILL ALSO BE AVAILABLE VIA A PAPER COPY OF THE CHNA REPORT AVAILABLE FOR PUBLIC INSPECTON UPON REQUEST.PART V, SECTION B, LINE 5B:IMPLEMENTATION PLAN IS AVAILABLE AT THE WEBSITE: HTTP://WWW.MTASCUTNEYHOSPITAL.ORG/COMMUNITY-SERVICES/COMMUNITY-RESOURCES/ COMMUNITY-HEALTH-NEEDS |
| WINDSOR HOSPITAL CORPORATION | PART V, SECTION B, LINE 10: THE WINDSOR COMMUNITY HEALTH CLINIC AT MT. ASCUTNEY HOSPITAL WAS ESTABLISHED TO SERVE MEMBERS OF OUR COMMUNITY WHO ARE NOT COVERED BY MEDICAID, VHAP, AND PRIVATE INSURANCE, AND WHO DO NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HEALTHCARE SERVICES. THE CLINIC OFFERS FREE CLINIC APPOINTMENTS TO MEMBERS WHO HAVE NO INSURANCE, OR ARE UNDER-INSURED AND MEET CERTAIN INCOME REQUIREMENTS. |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | PART I, LINE 7. A COST ACCOUNTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. A COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENTS SEGMENTS. A COST-TO-CHARGE RATIO WAS USED. |
| PART I, LINE 7G: | PART I, LINE 7G. PHYSICIAN CLINIC COSTS INCLUDED WITHIN SUBSIDIZED HEALTH SERVICES ARE $5,113,539 OF THE TOTAL COMMUNITY BENEFIT EXPENSES AND $8,993,173 OF THE DIRECT OFFSETTING REVENUE. |
| PART I, LN 7 COL(F): | PART III, LINE 4. MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF INDIVIDUAL ACCOUNTS AND HISTORICAL ADJUSTMENTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. THE COSTING METHODOLOGY USED ABOVE WAS THE COST TO CHARGE RATIO. |
| PART III, LINE 8: | PART III, LINE 8. THE SHORTFALL REPRESENTS THE PPS REIMBURSEMENT DIFFERENCE ON THE REHAB UNITS. SINCE THE REIMBURSEMENT DOES NOT COVER THE COSTS OF THESE UNITS, A SUBSIDY IS CREATED. BECAUSE THE HOSPITAL DETERMINED THAT THESE SERVICES ARE IMPORTANT TO OUR SERVICE AREA, THE HOSPITAL COVERS THE SUBSIDY, |
| PART III, LINE 9B: | PART III, LINE 9B. MAHHC'S COLLECTION POLICY AND CHARITABLE CARE POLICIES ARE CONSISTENTLY APPLIED TO ALL PATIENTS. OUR COLLECTION POLICY APPLIES TO ANY BALANCE OWED BY THE PATIENT WHETHER IT IS A BALANCE AFTER INSURANCE, A BALANCE WITH NO INSURANCE, OR A BALANCE AFTER AN ADJUSTMENT FOR PARTIAL CHARITABLE CARE. STATEMENTS, CREDIT REPORTING, COLLECTION EFFORTS, AND WRITE-OFF CRITERIA ARE THE SAME FOR ALL LIKE BALANCES, REGARDLESS OF THE REASON FOR THE BALANCE AND REGARDLESS OF WHETHER IT IS A BALANCE AFTER CHARITABLE CARE OR NOT. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE RECEIVE THE APPROPRIATE ADJUSTMENT ON THEIR BILL. IF A BALANCE REMAINS AFTER THAT ADJUSTMENT, THEY ARE BILLED ACCORDING TO THE COLLECTION POLICY, FOR THE REMAINDER. |
| PART VI, LINE 4: | MAHHC'S PRIMARY SERVICE AREA INCLUDES WINDSOR, CLAREMONT, WOODSTOCK, HARTLAND, SPRINGFIELD, AND BROWNSVILLE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN SMITH MD | ||||||||||||||
| TRUSTEE | $0 | $157,382 | $9,400 | $0 | $2,400 | $0 | $0 | $0 | $0 | $61,091 | $11,800 | $218,473 | $0 | $0 |
| MARY JOYCE MD | ||||||||||||||
| TRUSTEE | $159,744 | $0 | $8,900 | $0 | $4,019 | $0 | $5,344 | $0 | $44,760 | $0 | $222,767 | $0 | $0 | $0 |
| CATHERINE SCHNEIDER | ||||||||||||||
| CMO | $255,716 | $0 | $0 | $0 | $552 | $0 | $7,750 | $0 | $33,459 | $0 | $297,477 | $0 | $0 | $0 |
| PAUL CALANDRELLA | ||||||||||||||
| CHIEF OPERATING OFFICER | $135,259 | $0 | $0 | $0 | $441 | $0 | $2,101 | $0 | $33,970 | $0 | $171,771 | $0 | $0 | $0 |
| KEVIN DONOVAN | ||||||||||||||
| OFFICER/CEO | $6,700 | $263,575 | $0 | $0 | $0 | $1,404 | $0 | $35,093 | $0 | $26,900 | $6,700 | $326,972 | $0 | $0 |
| JILL LORD | ||||||||||||||
| CNO | $154,176 | $0 | $0 | $0 | $1,378 | $0 | $4,520 | $0 | $8,333 | $0 | $168,407 | $0 | $0 | $0 |
| CHRISTOPHER CONNOR MD | ||||||||||||||
| OPTHALMOLOGIST | $347,523 | $0 | $0 | $0 | $1,032 | $0 | $10,312 | $0 | $36,956 | $0 | $395,823 | $0 | $0 | $0 |
| ANDREW ROBINSON MD | ||||||||||||||
| GASTROENTEROLOGIST | $197,425 | $0 | $68,654 | $0 | $0 | $0 | $5,437 | $0 | $62,289 | $0 | $333,805 | $0 | $0 | $0 |
| HEIDI CRUZ MD | ||||||||||||||
| PHYSIATRIST | $215,074 | $0 | $0 | $0 | $240 | $0 | $6,600 | $0 | $46,779 | $0 | $268,693 | $0 | $0 | $0 |
| GERALD DRABRYN MD | ||||||||||||||
| PLASTIC SURGEON | $269,993 | $0 | $0 | $0 | $2,579 | $0 | $0 | $0 | $36,028 | $0 | $308,600 | $0 | $0 | $0 |
| JEFFREY KING MD | ||||||||||||||
| PODIATRIST | $187,838 | $0 | $14,030 | $0 | $6,656 | $0 | $4,251 | $0 | $32,799 | $0 | $245,574 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 | STEVEN SMITH, MD AND MARY JOYCE, MD RECEIVED BONUSES WHICH WERE BASED UPON RELATIVE VALUE UNITS (RVU'S). ANDREW ROBINSON, MD RECEIVED A BONUS WHICH WAS BASED UPON RELATIVE VALUE UNITS (RVU'S) AND LONGEVITY. |
| PART III | STEVEN SMITH, MD, TRUSTEE, WAS PAID $218,473 IN COMPENSATION AND BENEFITS BY DARTMOUTH-HITCHCOCK MEDICAL CENTER, A RELATED ORGANIZATION, FOR HIS SERVICES AS PHYSICIAN. THE ORGANIZATION REIMBURSED DARTMOUTH-HITCHCOCK FOR THE COST OF HIS SERVICES. KEVIN DONOVAN, CEO, WAS PAID $326,972 IN COMPENSATION AND BENEFITS BY DARTMOUTH-HITCHCOCK MEDICAL CENTER, A RELATED ORGANIZATION, FOR SERVICES AS CEO. THE ORGANIZATION REIMBURSED DARTMOUTH-HITCHCOCK FOR THE COST OF HIS SERVICES. GIFFORD MEDICAL CENTER, AN UNRELATED ORGANIZATION, WAS PAID $195,461 FOR DAVID SANVILLE'S SERVICES AS CFO. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERMONT EDUCATIONAL AND HEALTH BUILDINGS FINANCING AGENCY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 237154467 | BondIssuerEIN |
| Bond Issued | 2010-02-02 | BondIssuedDt |
| Issue Price | $9,244,000 | IssuePriceAmt |
| Purpose | REFINANCING OF 2004 AND 2005 BONDS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,196,851 | RetiredAmt |
| Total Proceeds | $9,244,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $128,133 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $9,115,867 | CapitalExpendituresAmt |
| Substantial Completion | 2010 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TD BANK NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 18.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $47,811 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | EFFECTIVE JULY 1, 2014, MT. ASCUTNEY HOSPITAL AND HEALTH CENTER AND DARTMOUTH-HITCHCOCK HEALTH ENTERED INTO AN OFFICIAL AFFILIATION BETWEEN THE TWO ORGANIZATIONS THAT PROMOTES THE SHARING OF RESOURCES THAT WILL ALLOW FOR A MORE SUSTAINABLE AND ACCESSIBLE HEALTH SYSTEM IN THE UPPER VALLEY. MT. ASCUTNEY WILL RETAIN ITS STATUS AS AN INDEPENDENT NOT-FOR-PROFIT COMMUNITY HOSPITAL AND WILL ALSO MAINTAIN A LOCAL BOARD OF TRUSTEES RESPONSIBLE FOR OVERSIGHT. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE OF THE BOARD. THE BOARD RECEIEVES A COPY OF THE FINAL VERSION AND IT IS DISCUSSED AT THE BOARD MEETING |
| FORM 990, PART VI, SECTION B, LINE 12C | THE FINANCE AND AUDIT COMMITTEE MONITOR AND REPORT TO THE BOARD OF DIRECTORS |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE BOARD MEETS ANNUALLY TO REVIEW COMPENSATION FOR THE CEO, USING INDEPENDENT SURVEYS OF AREA COMPENSATION FOR EXECUTIVES OF VARIOUS SIZED HOSPITALS. OTHER OFFICERS AND KEY EMPLOYEES SALARIES ARE DETERMINED, BY THE HR DEPARTMENT USING COMPARABLE MARKET DATA. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL INTERNAL POLICIES, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST |
| FORM 990, PART XI, LINE 9: | OTHER ADJUSTMENTS -667,377. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HISTORIC HOMES OF RUNNEMEDE | ||||||||||
| 40 MAXWELL PERKINS LANE | WINDSOR | VT | 05089 | 237396147 | PROVIDING SERVICES FOR THE AGING | VT | 501(C)(3) | LINE 9 | WINDSOR HOSPITAL CORPORATION | Yes (1) |
| MOUNT ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION INC | ||||||||||
| 289 COUNTY ROAD | WINDSOR | VT | 05089 | 030300481 | TO PROVIDE HEALTHCARE SERVICES TO THE WINDSOR, VERMONT COMMUNITY | VT | 501(C)(3) | LINE 3 | WINDSOR HOSPITAL CORPORATION | Yes (1) |
| DARTMOUTH-HITCHCOCK MEDICAL CENTER | ||||||||||
| ONE MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 264812335 | ESTABLISHING INTEGRATED HEALTH CARE DELIVERY SYSTEM WITHIN NORTHERN NE | NH | 501(C)(3) | 11 TYPE II | 0 | |
| MOUNT ASCUTNEY PROFESSIONAL CENTER OWNERS ASSOCIATION | ||||||||||
| 289 COUNTY ROAD | WINDSOR | VT | 05089 | 030320283 | OWNERS ASSOCIATION FOR 13 CONDOMINIUM UNITS | VT | 501(C)(3) | LINE 3 | WINDSOR HOSPITAL CORPORATION | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MT ASCUTNEY PROFESSIONAL CENTER OWNERS ASSOCIATION | ||
| R | $72,000 | ACTUAL |
| DARTMOUTH-HITCHCOCK MEDICAL CENTER | ||
| O | $105,092 | ACTUAL |
| DARTMOUTH-HITCHCOCK MEDICAL CENTER | ||
| Q | $407,019 | ACTUAL |