2014-08-06T11:19:09-05:00 2013-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2012-10-01 030183483 RUTLAND HOSPITAL INC % EDWARD T OGORZALEK RUTL 8027757111 160 ALLEN STREET Suite RUTLAND VT 05701 EDWATD T OGORZALEK 8027757111 2014-07-08 true Brian D Todd 4178658701 2012 2015-11-30 17:44:51Z RUTLAND REGIONAL MEDICAL CENTER THOMAS W HUEBNER 160 ALLEN STREET RUTLAND VT 05701 259003283 false X WWW.RRMC.ORG X 1892 VT TO PROVIDE COMPREHENSIVE INPATIENT AND OUTPATIENT MEDICAL SERVICES AND TO IMPROVE HEALTH OF THE RESIDENTS OF RUTLAND AND SURROUNDING COMMUNITIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 18 13 1758 335 2501851 577268 1273885 7018338 203313950 225155715 3757814 2093825 -295204 -311442 208050445 233956436 1473293 992258 0 0 113044636 117876452 0 0 0 90464149 99888667 204982078 218757377 3068367 15199059 209893240 223940436 127456515 104597896 82436725 119342540 X TO IMPROVE THE HLTH OF THE RUTLAND REGION AND SURROUNDING COMMUNITIES BY PROVIDING APPROPRIATE, SUPERIOR, INTEGRATED, PREVENTATIVE, DIAGNOSTIC & THERAPEUTIC HEALTH SERVICES IN A CARING ENVIRONMENT THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY & RELATIONSHIPS. true false 88705761 113441944 ANCILLARY CARE. ANCILLARY CARE SERVICES INCLUDE OPERATING ROOM, EMERGENCY ROOM, PHYSICAL REHABILITATION, ANESTHESIOLOGY, ONCOLOGY, PULMONARY, RESPIRATORY, PHYSICAL THERAPY, CARDIAC CATH, ENDOSCOPY, AMBULATORY, DELIVERY, RADIATION, PSYCHIATRIC COUNSELING, OCCUPATIONAL THERAPY, RECOVERY, HIV CLINIC, AND SPEECH THERAPY. SEE SCHEDULE O FOR MORE INFORMATION. 36962908 47270258 INPATIENT CARE. INPATIENT CARE SERVICES INCLUDE MEDICAL AND SURGICAL, INTENSIVE CARE, HOSPITALISTS, PSYCHIATRIC, OBSTETRICS AND GYNECOLOGY, NURSERY, AND NURSING. SEE SCHEDULE O FOR MORE INFORMATION. 22856618 29230335 DIAGNOSTIC SERVICES. DIAGNOSTIC SERVICES INCLUDE LABORATORY, RADIOLOGY, ELECTROENCEPHALOGRAPHY, AND CT SCANNING. SEE SCHEDULE O FOR MORE INFORMATION. 25578574 32711327 174103861 true true false true false false false false false true true false false true true false true true false false false false false false false false true true true false true true false false false false false false false false false true false false false false true true false false false true 194 0 true 1758 true true true false false false false false false false false false X 18 13 false false false false true true true true true false false true true true true true true true false false X EDWARD T OGORZALEK 8027757111 160 ALLEN STREET RUTLAND VT 05701 X BILL BANNERMAN 1.0 2.0 X 0 0 J CHRISTIAN HIGGINS MD 1.0 1.0 X 484283 0 33351 JESSICA L ANDERSON 1.0 1.0 X X 0 0 JOAN F GAMBLE 1.0 1.0 X X 0 0 JON S READNOUR ESQ 1.0 1.0 X 0 0 MARK K FOLEY 1.0 1.0 X 0 0 MATTHEW A CONWAY MD 1.0 1.0 X 327011 0 33264 RONALD J CIOFFI 1.0 2.0 X 0 0 CLAUDE LAPERLE 1.0 1.0 X 0 0 DANIEL M FOLEY MD 1.0 1.0 X 341807 0 27940 JOHN R BUTTERLY MD 1.0 1.0 X 0 0 MICHAEL DICK MD 1.0 1.0 X X 0 0 STEPHEN LEFFLER MD 1.0 1.0 X 0 0 CORT JONES 1.0 2.0 X 0 0 TJ SABOTKA 1.0 1.0 X 0 0 MICHAEL MCCORMACK 1.0 1.0 X 0 0 TODD GREGORY MD 1.0 1.0 X 292774 0 33114 DAVID WOLK 1.0 1.0 X 0 0 LARRY JENSEN 1.0 1.0 X 0 0 MARK STICKNEY MD 1.0 1.0 X 0 0 JOHN CASELLA 1.0 1.0 X 0 0 THOMAS W HUEBNER 40.0 2.0 X 447488 0 43512 EDWARD T OGORZALEK 40.0 2.0 X 253168 0 43079 MARY T NEMETH 40.0 X 194655 0 27362 BAXTER HOLLAND MD 40.0 X 331570 0 38684 BARBARA ROBINSON 40.0 X 211297 0 30623 JI CHEN 40.0 X 170918 0 7956 JOHN KIJEWSKI 40.0 X 195115 0 26070 ALLISON WOLLEN 40.0 X 233994 0 18850 CAROL EGAN 40.0 X 185070 0 28502 DARREN CHILDS 40.0 X 160928 0 30892 MELBOURNE BOYTON MD 40.0 X 884413 0 37930 MICHAEL KENOSH MD 40.0 X 493822 0 33517 WILLIAM LIGHTHART MD 40.0 X 767382 0 32319 ERIC MARSH MD 40.0 X 696081 0 33907 MICHAEL ROBERTELLO MD 40.0 X 572240 0 33491 KATHLEEN LETENDRE X 174269 0 22836 7418285 0 617199 121 true true false SHERIDAN HEALTHCARE OF VERMONT ANESTHETISTS 1565897 CERNER CORP PROFESSIONAL 3474684 FLETCHER ALLEN HEALTHCARE LAB & DIALYSIS SERV 1216108 KLEEN LAUNDRY DRY CLEANING LAUNDRY SERVICES 540853 GE HEALTHCARE CONTRACT SERVICES 858583 46 22831 5803743 1191764 7018338 NET PATIENT SERVICE REVENUE 900099 217488168 217434968 53200 LABORATORY AND SCREENING SERV 621500 2399273 2399273 CAFETERIA 722514 934033 934033 ENTEROSTOMAL NURSING SERVICES 623000 49378 49378 OTHER REVENUES 900099 4284863 4284863 225155715 695437 695437 0 0 78629 390071 -311442 0 -311442 -311442 25564973 490191 23992440 664336 1572533 -174145 1398388 1398388 0 0 0 0 233956436 222653864 2501851 1782383 992258 992258 0 0 0 4253277 2769984 1483293 197105 197105 87770045 74352241 13417804 7301704 5401297 1900407 12231829 9100902 3130927 6122492 4507361 1615131 0 364315 364315 227956 227956 115179 115179 0 382057 382057 20494872 14572282 5922590 593444 95331 498113 5064235 3382701 1681534 4128519 87259 4041260 0 5052216 3889771 1162445 0 0 1052369 600673 451696 2169172 1596938 572234 0 12262717 9027776 3234941 3201006 3201006 MEDICAL SUPPLIES & DRUGS 24913801 24913801 MEDICAID TAX ASSESSMENT 11331274 11331274 BAD DEBTS 6872448 6872448 LICENSES, DUES, SUBSCRIPTIONS 1318706 366170 952536 344381 243394 100987 218757377 174103861 44653516 0 4075 21320 10622417 6270719 226961 265948 22402032 25339943 0 0 0 0 2532829 2754432 1234153 1270064 2618171 2871074 190890046 119329391 71965162 71560655 89940764 99010637 0 0 0 0 0 0 8346676 14575644 209893240 223940436 28296490 29294545 0 0 0 0 45103004 31350000 0 0 0 0 2567473 14872126 0 0 51489548 29081225 127456515 104597896 X 75394367 114501873 6363716 4162025 678642 678642 82436725 119342540 209893240 223940436 X 15199059 3175311 771792 17759653 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X X false true true false false false false true 80377 false true 34802 115179 false LOBBYING EXPENSES SCHEDULE C, PART II-B, LINE 1G AND 1I THE ORGANIZATION PAID LOBBYING FEES OF $80,377 TO A PROFESSIONAL GOVERNMENT AFFAIRS AND COMMUNICATION STRATEGIES COMPANY. THE ORGANIZATION'S CEO, THOMAS HUEBNER, SPENDS TIME EACH YEAR WORKING DIRECTLY WITH STATE LEGISLATORS TO IMPROVE SERVICES FOR THE RUTLAND REGION. APPROXIMATELY .0095%, OR $4,251, OF HIS SALARY IS ALLOCATED TO THIS ACTIVITY. ALSO, DUES ARE PAID TO THE HOSPITAL ASSOCIATION AND THE VERMONT HOSPITAL ASSOCIATION. A PORTION OF DUES IS ATTRIBUTABLE TO LOBBYING: $ 7,492 AHA 27,310 VHA -------- $ 34,802 7419888 303224 265074 7458038 6260684 1265080 105876 7419888 11229688 253308 5222312 6260684 10241135 988553 11229688 10799491 -558356 10241135 0.89420 0.10580 false false 224094 224094 37634484 19478631 18155853 37380813 16709926 20670887 110671564 81791562 28880002 4979091 1349272 3629819 71560655 DUE FROM AFFILIATES 6457352 OTHER RECEIVABLES 6729785 INTEREST RECEIVABLE 17540 INSURANCE RECEIVABLE 1370967 14575644 0 ACCRUED PENSION 22108093 EST AMTS DUE TO THIRD PARTY 6712293 ADVANCES FROM THIRD PTY PYRS 260839 29081225 248026966 3175311 10505148 13680459 234346507 -390071 -390071 233956436 211892943 390071 390071 211502872 382057 6872448 7254505 218757377 ENDOWMENT FUND PURPOSE SCHEDULE D, PART V, LINE 4 RRMC'S ENDOWMENTS CONSIST OF VARIOUS INDIVIDUAL DONOR-RESTRICTED AND BOARD DESIGNATED FUNDS WHICH WERE ESTABLISHED FOR GENERAL OPERATIONAL AND CERTAIN DEPARTMENTAL PURPOSES. AS REQUIRED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA (GAAP), NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. RRMC'S GOVERNING BODY HAS INTERPRETED THE STATE OF VERMONT PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT (SPMIFA), ADOPTED IN MAY OF 2009, AS REQUIRING PRESERVATION OF THE FAIR VALUE OF THE ORIGINAL GIFT AS OF THE GIFT DATE OF THE DONOR-RESTRICTED ENDOWMENT FUNDS ABSENT EXPLICIT DONOR STIPULATIONS TO THE CONTRARY. AS A RESULT OF THIS INTERPRETATION, RRMC CLASSIFIES AS PERMANENTLY RESTRICTED NET ASSETS (A) THE ORIGINAL VALUE OF GIFTS DONATED TO THE PERMANENT ENDOWMENT, (B) THE ORIGINAL VALUE OF SUBSEQUENT GIFTS TO THE PERMANENT ENDOWMENT AND (C) ACCUMULATIONS TO THE PERMANENT ENDOWMENT MADE IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE ACCUMULATION IS ADDED TO THE FUND. THE REMAINING PORTION OF DONOR-RESTRICTED ENDOWMENT FUNDS IS CLASSIFIED AS TEMPORARILY RESTRICTED NET ASSETS UNTIL THOSE AMOUNTS ARE APPROPRIATED FOR EXPENDITURE BY RRMC IN A MANNER CONSISTENT WITH THE STANDARD OF PRUDENCE PRESCRIBED BY SPMIFA. IN ACCORDANCE WITH SPMIFA, RRMC CONSIDERS THE FOLLOWING FACTORS IN MAKING A DETERMINATION TO APPROPRIATE OR ACCUMULATE DONOR-RESTRICTED ENDOWMENT FUNDS: 1. DURATION AND PRESERVATION OF THE FUND 2. PURPOSES OF RRMC AND THE FUND 3. GENERAL ECONOMIC CONDITIONS 4. POSSIBLE EFFECT OF INFLATION AND DEFLATION 5. EXPECTED TOTAL RETURN FROM INVESTMENT INCOME AND APPRECIATION OR DEPRECIATION OF INVESTMENTS 6. OTHER RESOURCES OF RRMC 7. INVESTMENT POLICIES OF RRMC UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 SCHEDULE D, PART XI, LINE 2D $ 10,400,277 NET GAIN FROM DEF BEN PLAN & POSTRETIREMENT BEN COSTS ( 6,872,448) PROVISION FOR UNCOLLECTIBLE ACCOUNTS 5,519,351 CHANGE IN FV OF INVESTMENTS ACCT FOR UNDER FASB 825 1,900,460 GAIN ON INTEREST RATE SWAP AGREEMENT ( 382,057) INVESTMENT EXPENSES ( 60,435) TRANSFER TO AFFILIATES ------------- $ 10,505,148 AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 SCHEDULE D, PART XI, LINE 4B $( 390,071) RENTAL EXPENSES AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25 SCHEDULE D, PART XII, LINE 2D $ 390,071 RENTAL EXPENSES AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1 SCHEDULE D, PART XII, LINE 4B $ 6,872,448 PROVISION FOR UNCOLLECTIBLE ACCOUNTS true true X true X 300. true X 500. true true true false true true 3727005 3727005 0.01760 47601105 30675389 16925716 0.07990 4443562 4578990 -135428 55771672 35254379 20517293 0.09750 2298083 4410 2293673 0.01080 113590 113590 0.00050 16132719 12301307 3831412 0.01810 1057072 1057072 0.00500 19601464 12305717 7295747 0.03440 75373136 47560096 27813040 0.13190 1294 1294 13508 13508 0.00010 54867 54867 0.00030 8632 8632 141009 141009 0.00070 219310 219310 0.00110 false 6872448 893418 59850848 78598659 -18747811 X true true 1 1 RUTLAND HOSPITAL

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PATIENT CLINIC RUTLAND REG DIABETES & ENDOCRINOLOGY CTR

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PATIENT CLINIC RUTLAND REGIONAL GENERAL SURGERY

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PATIENT CLINIC RUTLAND REGIONAL WOMEN'S HEALTH

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PATIENT CLINIC VERMONT ORTHOPAEDIC CLINIC

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PATIENT CLINIC DORSET ENT

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PATIENT CLINIC KILLINGTON MEDICAL CLINIC

3902 KILLINGTON ROAD KILLINGTON VT 05751

PATIENT CLINIC ELIGIBILITY FOR DISCOUNTED CARE SCHEDULE H, PART I, LINE 3B THE ORGANIZATION WILL PROVIDE DISCOUNTED CARE TO LOW INCOME INDIVIDUALS WHOSE FAMILY INCOME FALLS BETWEEN 201% AND 500% OF THE FEDERAL POVERTY GUIDELINES USING A GRADUATED RANGE OF DEDUCTIBLES FROM $250 AT THE LOWEST LEVEL TO $3,000 AT THE HIGHEST LEVEL. PERCENT OF TOTAL EXPENSES SCHEDULE H, PART I, LINE 7, COLUMN F THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) LESS BAD DEBT EXPENSE OF $6,872,448. COSTING METHODOLOGY SCHEDULE H, PART I, LINE 7 THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COMMUNITY BUILDING ACTIVITIES PART II RUTLAND REGIONAL MEDICAL CENTER IS THE ONLY MAJOR MEDICAL CENTER IN CENTRAL VERMONT, AND IS ONE OF THE LARGEST EMPLOYERS IN THE REGION. AS SUCH, WE ARE RELIED UPON BY THE COMMUNITIES WE SERVE TO PROVIDE HEALTH RESOURCES AND LEADERSHIP. WE RECOGNIZE THAT THERE IS MORE TO HEALTH THAN ILLNESS AND DISEASE, SOCIAL DETERMINANTS SUCH AS LOW INCOME LEVELS, AND AN AGING POPULATION, ALONG WITH A SAFE ENVIRONMENT AND A WELL-ROUNDED CULTURE CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR POPULATION. THEREFORE, OUR LEADERSHIP AND COMMITMENT TO OUR COMMUNITY THROUGH A VARIETY OF INITIATIVES AND SUPPORTS BEYOND PROVIDING ESSENTIAL HOSPITAL-BASED CARE, ENCOMPASSING SOCIAL, PERSONAL, COMMUNITY AND HEALTH-RELATED ISSUES IMPACTING THE CITIZENS OF THE RUTLAND REGION. MANY STAFF AND LEADERS ARE INVOLVED IN LOCAL, REGIONAL AND STATEWIDE COALITIONS, COLLABORATIVES AND COMMITTEES OF OTHER ORGANIZATIONS, WHERE WE LEARN ABOUT TRENDS AND ISSUES OF INTEREST OR CONCERN TO BRING BACK TO OUR HOSPITAL AND REVIEW IN THE CONTEXT OF OUR COMMUNITY AND OUR HEALTH SYSTEM; THESE INCLUDE THE RUTLAND FREE CLINIC, RUTLAND AREA PHYSICAL ACTIVITY COALITION, UNITED WAY OF RUTLAND COUNTY, RUTLAND REGION CHAMBER OF COMMERCE, TO NAME A FEW. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT AT THE REGIONAL, STATE AND NATIONAL LEVEL ALSO IMPACTS OUR COMMUNITY. IN ADDITION TO THESE EFFORTS, OUR COMMUNITY BUILDING ACTIVITIES IN THE PAST YEAR INCLUDED EFFORTS TO SUPPORT VIBRANCY IN THE COMMUNITY THROUGH THE ARTS, A VARIETY OF EVENTS AND ACTIVITIES BY SCHOOLS TO PROMOTE STRONG EDUCATION AND POSITIVE DECISION-MAKING, MENTORING YOUNG CHILDREN THROUGH READING TO BUILD SELF-CONFIDENCE AND ESTEEM IN ADDITION TO CORE ACADEMIC ACHIEVEMENT, ALONG WITH WORKFORCE DEVELOPMENT, ESPECIALLY AS RELATED TO THE HEALTH CARE. BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A, LINE 4 THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: RRMC REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. RRMC PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, RRMC BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE AMOUNT OF BAD DEBT LISTED ON LINE 2 AGREES TO BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. USING AN AVERAGE OF DATA FROM 2008-2012, APPROXIMATELY 13.0 PERCENT OF RUTLAND COUNTY WAS CONSIDERED TO LIVE IN POVERTY. COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B, LINE 8 SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE ORGANIZATION USES INFORMATION FROM THE MEDICARE COST REPORT TO COMPUTE THE MEDICARE ALLOWABLE COSTS OF CARE ON LINE 6. COLLECTION POLICY SCHEDULE H, PART III, SECTION C, LINE 9B THE PAYMENT PLAN POLICY REQUIRES PAYMENTS OF A MINIMUM OF $25.00 PER MONTH, AND THAT ALL BALANCES BE PAID WITHIN 10 MONTHS. THE FREE CARE POLICY SPECIFICALLY STATES THAT ALL UNINSURED AND UNDERINSURED PATIENTS BE GIVEN INFORMATION ON THE FREE CARE PROGRAM, AND THAT STAFF PERFORM DUE DILIGENCE TO GIVE THEM INFORMATION AND HAVE THE APPLICATION RETURNED, AND THAT THE HOSPITAL SEND 3 STATEMENTS AND A FINAL NOTICE BEFORE SENDING AN ACCOUNT TO BAD DEBT. IT ALSO STATES THAT RRMC WILL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS TO OBTAIN PAYMENT FOR A DEBT. COMMUNITY INPUT SCHEDULE H, PART V, SECTION B, LINE 3 TO OVERSEE THE WORK PERFORMED, WE INVITED COMMUNITY LEADERS WITH SPECIAL KNOWLEDGE OR EXPERTISE OF PUBLIC HEALTH TO SERVE AS AN ADVISORY COMMITTEE THROUGHOUT THE PROCESS OF COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS GROUP OF INDIVIDUALS BROUGHT DIVERSITY OF PERSPECTIVE TO THE PROCESS: -JAN HANSEN, RUTLAND AREA VISITING NURSE ASSOCIATION AND HOSPICE, INC. -JOANNE CALVI, VERMONT DEPARTMENT OF HEALTH -KEVIN LOSO, RUTLAND HOUSING AUTHORITY -LARRY JENSEN, COMMUNITY MEMBER, BOARD MEMBER OF COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, COMMISSIONER RUTLAND CITY POLICE -SARAH NARKEWICZ, RUTLAND BLUEPRINT MANAGER, RUTLAND REGIONAL MEDICAL CENTER -SARAH ROY, DIVISION OF ALCOHOL & DRUG ABUSE PROGRAMS, VERMONT DEPARTMENT OF HEALTH -SUSAN SCHREIBMAN, RUTLAND PLANNING COMMISSION -TRACI MOORE, UNITED WAY OF RUTLAND COUNTY THE ADVISORY COMMITTEE MET MONTHLY BEGINNING IN MAY OF 2011 TO MONITOR THE PROGRESS OF THE WORK, PROVIDE INPUT AND SUPPORT, AND TO PROVIDE ASSISTANCE WHEN NECESSARY. IN ADDITION TO THE ADVISORY COMMITTEE IS AN OVERSIGHT COMMITTEE, MADE UP OF THE FOLLOWING COMMUNITY PARTNERS: -THOMAS W. HUEBNER, RUTLAND REGIONAL MEDICAL CENTER -EDWARD OGORZALEK, RUTLAND REGIONAL MEDICAL CENTER -CLAUDE LAPERLE, COMMUNITY MEMBER -LYLE JEPSON, STAFFORD TECHNICAL CENTER -JO ANN RILEY, CASTLETON COMMUNITY SENIORS -CAPRICE HOVER, RUTLAND COUNTY PARENT CHILD CENTER -VICTOR PISANELLI, JR., MD, RUTLAND REGIONAL GENERAL SURGERY -JEFF MCKEE, RUTLAND REGIONAL MEDICAL CENTER -LARRY JENSEN, COMMUNITY MEMBER AND MEMBER, BOARD OF DIRECTORS OF COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION -JAN HANSEN, RUTLAND AREA VISITING NURSE ASSOCIATION & HOSPICE, INC. -KEVIN LOSO, RUTLAND HOUSING AUTHORITY -SARAH ROY, DIVISION OF ALCOHOL & DRUG ABUSE PROGRAMS, VERMONT DEPARTMENT OF HEALTH -TRACI MOORE, UNITED WAY OF RUTLAND COUNTY -JOE LAROSA, COMMUNITY MEMBER -JOANNE CALVI, VERMONT DEPARTMENT OF HEALTH -PAULA BAKER, RUTLAND FREE LIBRARY -ROGER BAKER, MD, RETIRED, COMMUNITY MEMBER -SHERIFF STEPHEN BENARD -KATHY FELDER, RN, NP, MID-VERMONT UROLOGY -MELANIE GAIOTTI, DEPARTMENT OF LIQUOR CONTROL -SANDY COHEN, COMMUNITY MEMBER -ANN WARRELL, VERMONT COUNTRY STORE -BARBARA HANSON, SOUTHWESTERN VERMONT COUNCIL ON AGING -DEB HALL, RUTLAND COUNTY HOUSING COALITION -BILL LUCCI, STAFFORD TECHNICAL CENTER -DOUG NORFORD, RUTLAND MENTAL HEALTH SERVICES -GRANT WHITMER, COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION -BRIAN NOLAN, COMMUNITY MEMBER -MARTHA COULTER, COMMUNITY MEMBER -JULIE TETA, COMMUNITY MEMBER -ARDY WOLYNEC, RUTLAND AREA VISITING NURSE ASSOCIATION & HOSPICE, INC. THIS GROUP IS CHARGED WITH GENERAL OVERSIGHT OF RUTLAND REGIONAL MEDICAL CENTER'S COMMUNITY SERVICE, OR BENEFITS PROVIDED TO THE COMMUNITY ABOVE AND BEYOND THEIR PRIMARY ROLE AS A PROVIDER OF HOSPITAL-BASED MEDICAL SERVICES. AS SUCH, THIS GROUP PROVIDED VALUABLE FEEDBACK THROUGHOUT THE PROCESS AS STAKEHOLDERS IN THE HEALTH AND PROMOTION OF HEALTH ACROSS OUR COMMUNITY. FIVE FOCUS GROUP SESSIONS WERE HELD IN FEBRUARY 2012, WITH INVITATIONS GOING OUT TO MORE THAN 175 COMMUNITY LEADERS. INVITATION LETTERS INCLUDED FIVE QUESTIONS TO DRAFT RESPONSES TO IN PREPARATION FOR THE MEETING, ALONG WITH A SURVEY REQUESTING FEEDBACK CONCERNING BARRIERS TO ACCESSING HEALTH SERVICES, BARRIERS TO HEALTH ACROSS THE COMMUNITY, AND "RISKY BEHAVIORS". ADDITIONALLY, THREE SURVEYS WERE CONDUCTED AS A PART OF THIS HEALTH NEEDS ASSESSMENT. THE FIRST WAS A PHONE SURVEY OF DENTAL OFFICES. WE ALSO SURVEYED RANDOM COMMUNITY MEMBERS AND EMERGENCY DEPARTMENT CONSUMERS TO IDENTIFY ISSUES CONCERNING ACCESS TO CARE, GENERAL HEALTH CARE, AND EMERGENCY CARE. CHNA AVAILABILITY TO PUBLIC SCHEDULE H, PART V, SECTION B, LINE 5 THE COMMUNITY BENEFITS COORDINATOR DEVELOPED AND FOLLOWED A COMMUNICATION PLAN UTILIZING ELECTRONIC COMMUNICATION, CONFERENCE CALLS, NEWSPAPER ARTICLES AND PRESENTATIONS THROUGHOUT THE COMMUNITY TO DISSEMINATE THE COMMUNITY HEALTH NEEDS ASSESSMENT. SPECIFICALLY, MORE THAN 20 PRESENTATIONS WERE HOSTED BY AREA AGENCIES AND COALITIONS, WITHIN THE HOSPITAL ORGANIZATION, FOR THE REGIONAL VERMONT DEPARTMENT OF HEALTH, AND IN PUBLIC MEETINGS FOR THE ROTARY AND UNITED WAY MEMBERSHIP. IMPLEMENTATION STRATEGY SCHEDULE H, PART V, SECTION B, LINE 6 IN RESPONSE TO THE RESULTS OF RUTLAND REGIONAL MEDICAL CENTER'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL: http://www.rrmc.org/about/bowse-trust/community-health-assessment-update/ ADDRESSING IDENTIFIED NEEDS SCHEDULE H, PART V, SECTION B, LINE 7 RUTLAND REGIONAL MEDICAL CENTER IS THE LEAD HEALTH ORGANIZATION FOR OUR REGION, PROVIDING MANY SERVICES AND PROGRAMS TO RESPOND TO THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS. IN SOME SITUATIONS, HOWEVER, DUE TO CAPACITY LIMITATIONS, OR SIMPLY THE NATURE OF THE WORK, RRMC IS NOT THE NATURAL OR LOGICAL RESOURCE OR LEADER. THE PRIORITIZED NEED TO PROMOTE A CULTURE TO EMBRACE EXERCISE AND HEALTHY EATING IS NOT ONE WHERE RRMC IS BEST SUITED TO DEVELOP OR PERFORM THE WORK, BUT WE DO SUPPORT ORGANIZATIONS, EVENTS AND OTHER ACTIVITIES PROMOTING HEALTHY LIFESTYLES AND CHOICES AS OUTLINED BELOW. -THE COMMUNITY HEALTH TEAM IS SUPPORTING THE IMPLEMENTATION OF THE CASTLETON STATE COLLEGE ADULTS PHYSICAL ACTIVITY PROGRAM AND WALKRUTLAND. -PROVIDE FINANCIAL, MARKETING AND OTHER SUPPORT FOR VARIOUS COMMUNITY PARTNER ORGANIZATIONS DEVELOPING AND EXPANDING NUTRITION AND/OR PHYSICAL ACTIVITY INITIATIVES. IN GENERAL, THIS PRIORITY AREA IS ONE WHERE THE NEEDS ARE GREATER THAN THE CAPACITY ACROSS THE REGION FOR EDUCATION AND SUPPORTS FOR NUTRITION AND EXERCISE. TWO SPECIFIC AREAS OF NEED WERE IDENTIFIED THROUGH THE PROCESS OF CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOPING THIS IMPLEMENTATION STRATEGY THAT ARE NOT BEING ADDRESSED WITHIN OUR COMMUNITY AT THIS TIME DUE TO LACK OF RESOURCES AND CAPACITY. THEY ARE: -TO INCREASE RESIDENTIAL RECOVERY SERVICES FOR INDIVIDUALS WITH SUBSTANCE ABUSE. THERE IS A TARGET POPULATION IN NEED OF SUCH SUPPORT, AND THE SERVICE WOULD BE CREATED AND PROVIDED BY THE DESIGNATED MENTAL HEALTH AGENCY IN OUR REGION, RUTLAND MENTAL HEALTH SERVICES, AS THE PRIMARY PROVIDER OF SERVICES FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICE AND SUPPORTS. -COMMUNITY MEMBERS HAVE IDENTIFIED THE NEED FOR MORE, OR BETTER COORDINATED TRANSPORTATION SERVICES FOR INDIVIDUALS TO AVAIL THEMSELVES OF CARE AND TREATMENT FOR ANY PURPOSE - MEDICAL, DENTAL, MENTAL HEALTH AND SUBSTANCE ABUSE. SOME SERVICES, INCLUDING RRMC'S BRIDGES AND BEYOND PROGRAM DO PROVIDE TRANSPORTATION TO INDIVIDUALS, BUT A MORE COMPREHENSIVE APPROACH IS DESIRED AND WOULD BE LED BY TRANSPORTATION AND SOCIAL SERVICES LEADERS. MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS SCHEDULE H, PART V, SECTION B, LINE 20D THE HOSPITAL FACILITY USED THE AVERAGE RATE OF ALL INSURANCE RATES TO DETERMINE THE MAXIMUM AMOUNTS TO BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS. NEEDS ASSESSMENT RUTLAND REGIONAL MEDICAL CENTER CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY WE SERVE THROUGH INTERACTIONS WITH THE STATE OF VERMONT HEALTH DEPARTMENT AND THE DEPARTMENT OF VERMONT HEALTH ACCESS, THE PUBLIC, OTHER COMMUNITY ORGANIZATIONS, FEEDBACK FROM MEDICAL PROVIDERS AND PATIENTS, ALONG WITH NOTING TRENDS IN UTILIZATION OF SERVICES AND PRESENTATION OF ILLNESS, INJURY AND DISEASE. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE RRMC HAS "DO YOU NEED HELP WITH YOUR MEDICAL BILLS?" SIGNAGE POSTED AT EVERY ACCESS POINT THROUGHOUT THE HOSPITAL AND ITS OFF-SITE CLINICS (RUTLAND GENERAL SURGERY, WOMEN'S HEALTH ETC.) THE SIGNAGE PROVIDES CONTACT INFORMATION FOR THE PATIENTS TO CALL THE FINANCIAL COUNSELORS FOR HELP AS NEEDED. REGISTRATION OFFERS FINANCIAL ASSISTANCE PROGRAM APPLICATIONS TO ALL MEDICARE INSURED PATIENTS WITH NO OTHER INSURANCE, ALL SELF-PAY PATIENTS, AND ANY OTHER PERSON REQUESTING THE INFORMATION OR ANYONE WHO SPEAKS TO BEING IN FINANCIAL NEED. ALL SELF-PAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR WHILE THEY ARE AN IN-PATIENT AND THEY WILL ASSIST THEM IN APPLYING FOR OUR FINANCIAL ASSISTANCE, AS WELL AS, APPLYING FOR STATE AND FEDERAL PROGRAMS. ALL STATEMENTS HAVE THE RRMC WEBSITE ADDRESS TO VIEW OUR FINANCIAL ASSISTANCE PROGRAM AND THE BILLING AND COLLECTIONS POLICY AND PROCEDURE. THE WEBSITE ALSO HAS CONTACT PHONE NUMBERS FOR THE PATIENT TO CALL WITH QUESTIONS OR CONCERNS ABOUT THEIR BILL. THE RRMC WEB SITE NOT ONLY DESCRIBES THE FINANCIAL ASSISTANCE PROGRAM BUT, ALSO SHOWS THE INCOME GUIDELINES (BASED ON THE FEDERAL POVERTY) FOR FINANCIAL ASSISTANCE, AN ON-LINE APPLICATION, AS WELL AS, INFORMATION ON MEDICAID PROGRAMS AVAILABLE WITH SHORT DESCRIPTIONS. LASTLY, ALL PATIENTS WHO ARE SENT A STATEMENT SHOWING THEIR OUT OF POCKET EXPENSES ARE CALLED TO DEVELOP A PAYMENT PLAN. AT THIS TIME FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED AND MAILED AS REQUESTED. COMMUNITY INFORMATION A. GEOGRAPHIC DESCRIPTION RUTLAND COUNTY, COMPOSED OF 933 SQUARE MILES, IS LOCATED IN CENTRAL VERMONT. THE POPULATION MOSTLY RESIDES IN THE 27 SMALL TOWNS AND OUTLYING RURAL AREAS. RUTLAND CITY IS THE LARGEST POPULATION CENTER (ESTIMATED AT 16,495 IN 2010). RUTLAND REGIONAL MEDICAL CENTER IS DEPENDED UPON BY MORE THAN 60,000 RESIDENTS OF THE HOSPITAL SERVICE AREA (HSA), WHICH INCLUDES RUTLAND COUNTY AND SOME PORTIONS OF SOUTHERN AND NORTH CENTRAL VERMONT AND EVEN WASHINGTON COUNTY, NEW YORK. B. TARGET POPULATIONS RUTLAND COUNTY POPULATION HAS DECREASED SINCE 2000. IN 2010, AN ESTIMATED 61,642 PEOPLE LIVED IN RUTLAND COUNTY, A DECLINE OF 3.4% SINCE 2000. RUTLAND COUNTY RESIDENTS ARE OLDER, LIVING WITH LOWER INCOME, AND ACHIEVE LOWER EDUCATION LEVELS THAN THE AVERAGE VERMONTER, INCREASING THEIR VULNERABILITY. SPECIFICALLY, COMPARED TO VERMONT IN 2010, RUTLAND COUNTY RESIDENTS WERE OLDER, WITH A LOWER PROPORTION OF YOUTH LESS THAN 19 YEARS OF AGE (22% VERSUS 24% FOR VT); A LOWER PROPORTION OF YOUNG ADULTS AGES 20-44 YEARS (28% VERSUS 30%); A HIGHER PROPORTION OF OLDER ADULTS AGES 45-65 (32% VERSUS 30%); AND A HIGHER PROPORTION OF ELDERLY ADULTS 65 YEARS AND OLDER (16% VERSUS 14%). FROM 1999 TO 2009, THE PROPORTION OF ALL INDIVIDUALS IN RUTLAND COUNTY LIVING BELOW POVERTY INCREASED FROM 10.9% TO 13.6%. SPECIFIC TARGET POPULATIONS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDE: I. SENIOR POPULATIONS - IN 2000, 14.9% OF THE POPULATION IN RUTLAND COUNTY WAS AGE 65 OR OLDER. THIS POPULATION HAS GROWN TO 16.6% IN 2010 AND IS ANTICIPATED TO CONTINUE EXPANDING; THE PROJECTION IS THAT IN 2017 OUR SENIOR POPULATION COULD REACH 21.1%. II. INDIVIDUALS LIVING IN POVERTY - FROM 1999 TO 2009, THE PROPORTION OF INDIVIDUALS IN RUTLAND COUNTY LIVING BELOW THE POVERTY LEVEL INCREASED FROM 10.9% TO 13.6%. III. ADULTS AND YOUTH WITH SUBSTANCE ABUSE ISSUES - VERMONT RANKS IN THE TOP TEN OF STATES FOR SEVERAL MEASURE OF SUBSTANCE ABUSE, INCLUDING ILLICIT DRUG USE, ALCOHOL USE AND OTHERS, ESPECIALLY FOR THOSE AGES 18-25. RUTLAND COUNTY HAS A HIGHER NUMBER OF CURRENT SMOKERS THAN THE OVERALL STATE RATE, AND THE NUMBER OF EVERY DAY SMOKERS IS ON THE RISE. IV. YOUTH AND ADULTS WHO ARE OVERWEIGHT OR OBESE - 38.7% OF ADULTS REPORT BEING OVERWEIGHT AND 24% REPORT BEING OBESE IN RUTLAND COUNTY. V. YOUTH REPORT LOW RATES OF HEALTHY EATING AND EXERCISE (32% EAT 2 OR MORE SERVINGS OF FRUIT PER DAY; 14% EAT 3 OR MORE SERVINGS OF VEGETABLES PER DAY; 24% PARTICIPATE IN 60 MINUTES OF PHYSICAL ACTIVITY DAILY) PROMOTION OF COMMUNITY HEALTH RUTLAND REGIONAL MEDICAL CENTER (RRMC) ENGAGES IN A NUMBER OF COMMUNITY SUPPORTIVE ACTIVITIES IN ORDER TO PROMOTE THE HEALTH OF THE COMMUNITY THE ORGANIZATION SERVES. RUTLAND COUNTY HAS A CONTINUED NEED FOR PRIMARY CARE PROVIDERS AND HAS SHORTAGES OR IS AT RISK FOR SHORTAGES IN MANY SPECIALTY SERVICES. RRMC ACTIVELY RECRUITS BOTH PRIMARY CARE AND SPECIALTY PRACTICE PROVIDERS FOR THE REGION. IN FY13, 14 PROVIDERS WERE RECRUITED TO THE REGION, INCLUDING PEDIATRICS, ENT, GASTROENTEROLOGY, PRIMARY CARE, PSYCHIATRIC, EMERGENCY AND CARDIOLOGY. THREE OF THESE PROVIDERS WERE RECRUITED FOR SERVICE OUTSIDE OF RRMC AND ITS SPECIALTY CLINICS. RRMC SUPPORTS A HOSPITALIST PROGRAM WHERE HOSPITAL PHYSICIANS PROVIDE CARE FOR PRIMARY CARE PROVIDER'S PATIENTS THAT ARE ADMITTED TO THE HOSPITAL. THIS ALLOWS THE PRIMARY CARE PROVIDER TO PROVIDE MORE HOURS OF OFFICE CARE WHILE THEIR HOSPITALIZED PATIENTS HAVE 24 HOURS ACCESS TO A DOCTOR DURING THE HOSPITALIZATION. THIS SYSTEM PROVIDES EFFICIENCIES TO THE HEALTH CARE SYSTEM IN RUTLAND COUNTY. RUTLAND COUNTY'S MEDICAID POPULATION CONTINUES TO INCREASE. THIS PUTS A FINANCIAL STRAIN ON THE HEALTH SYSTEM IN OUR REGION, AS THE CARE PROVIDED TO THIS GROWING POPULATION IS NOT REIMBURSED FOR THE FULL COST OF CARE. LEADERS AT RRMC ADVOCATE AT THE STATE AND LOCAL LEVEL TO MAINTAIN THE MEDICAID REIMBURSEMENT RATES FOR BOTH IN-PATIENT AND OUT-PATIENT CARE IN ORDER TO MAINTAIN ACCESS FOR MEDICAID PATIENTS. RRMC ALSO PROVIDES SUPPORT FOR THE FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) IN THE REGION, BY HAVING A LEADER REPRESENTATIVE ON THE BOARD OF THE ORGANIZATION. THE FQHCS ARE REIMBURSED AT A HIGHER LEVEL FOR CARING FOR MEDICAID PATIENTS AND PROVIDES INCREASED ACCESS FOR THESE PATIENTS. RRMC LEADERS AND STAFF ALSO PARTICIPATE AS BOARD AND COMMITTEE MEMBERS IN SUPPORT OF OTHER NON-PROFIT ORGANIZATIONS, SUCH AS THE UNITED WAY OF RUTLAND COUNTY, RUTLAND AREA VISITING NURSE ASSOCIATION AND HOSPICE, RUTLAND AREA PHYSICAL ACTIVITY COALITION, RUTLAND AREA PREVENTION COALITION, RUTLAND COUNTY NUTRITION COALITION, RUTLAND POLICE COMMISSION, THE MEDICAL RESERVE CORPS, AND MANY OTHERS. RRMC PARTNERS WITH THE UNITED WAY OF RUTLAND COUNTY TO OFFER AND PROVIDE A LEADERSHIP AND BOARD TRAINING PROGRAM. EACH YEAR, WE GRADUATE ROUGHLY 12 NEW COMMUNITY MEMBERS READY TO SERVE AS ACTIVE CONTRIBUTORS TO NON-PROFIT ORGANIZATIONS THROUGH OUR REGION. RUTLAND COUNTY IS ECONOMICALLY CHALLENGED AND RRMC SUPPORTS WORK TO HELP THOSE IN POVERTY AS WELL AS TO BRING NEW BUSINESSES INTO THE AREA. RRMC PARTICIPANTS IN BRIDGES OUT OF POVERTY, A PROGRAM WHICH AIMS TO KEEP THE WORKING POOR EMPLOYED. THIS PROGRAM NOT ONLY BENEFITS THOSE LIVING IN POVERTY IN RUTLAND COUNTY, BUT RRMC'S OWN WORKFORCE. IN CONJUNCTION WITH FOR-PROFIT, NON-PROFIT AND GOVERNMENT AGENCIES, THE BRIDGES OUT OF POVERTY COUNCIL DELIVERS THE WORKING BRIDGES TRAINING TO HR PROFESSIONALS AND LINE MANAGERS ON THE WORKPLACE IMPLICATIONS OF ECONOMIC DIVERSITY; IMPLEMENTED AN EMERGENCY LOAN AND SAVINGS PROGRAM FOR EMPLOYEES; HOUSED WORKSITE RESOURCE COORDINATORS IN COMPANIES TO HELP EMPLOYEES FIND HELP WITH HOUSING, CHILDCARE, TRANSPORTATION, ECONOMIC ASSISTANCE AND OTHER RESOURCES WITHOUT HAVING TO LEAVE WORK; AND BEGAN DISCUSSION OF HOW TO ENCOURAGE THE EMPLOYEES TO USE HEALTH AND WELLNESS STRATEGIES. TRAUMA SUPPORT - ESTABLISHED IN 1993, THE TRAUMA SUPPORT PROGRAM AT RRMC WAS THE FIRST OF ITS KIND IN VERMONT. IT WAS DEVELOPED TO MEET THE IMMEDIATE AND LONG-TERM NEEDS OF FAMILIES IMPACTED BY SUDDEN DEATH OR TRAUMATIC INJURY OR ILLNESS. RRMC STAFF, ON THEIR OWN TIME, AND OTHER COMMUNITY VOLUNTEERS TAKE TURNS BEING ON CALL 24 HOURS A DAY, 7 DAYS A WEEK. VOLUNTEERS PERSONALLY PROVIDE SUPPORT AND ASSISTANCE TO FAMILIES IMPACTED BY TRAUMA R DEATH IN MANY WAYS, I.E., BY BEING A LIAISON WITH MEDICAL PERSONNEL TO GET INFORMATION OR OFFERING CONTINUED SUPPORT VIA PHONE AND CORRESPONDENCE. BONE MARROW PROGRAM - THE MARROW DONOR PROGRAM AT RRMC WAS ESTABLISHED IN 1998. SINCE THEN, WE HAVE SUCCESSFULLY ADDED OVER 3,000 POTENTIAL DONORS TO THE NATIONAL REGISTRY, HELPING TO GIVE HOPE TO THE MORE THAN 6,000 PEOPLE SEARCHING EVERY DAY FOR AN UNRELATED MATCH TO SAVE THEIR LIVES. RRMC IS CURRENTLY THE ONLY HOSPITAL IN NEW ENGLAND WITH THIS TYPE OF PROGRAM. RRMC DOES NOT HOLD PATIENT-FOCUSED DRIVES; INSTEAD, ALL DRIVES ARE DESIGNED TO RAISE GENERAL AWARENESS OF THE NEED AND TO REGISTER AS MANY POTENTIAL DONORS AS POSSIBLE, SO THAT NOW OR IN THE FUTURE A MATCH MAY BE MADE. BRIDGES & BEYOND - THIS PROGRAM IS RUN OUT OF THE SOCIAL WORK DEPARTMENT AND WORKS WITH PATIENTS AND FAMILIES TO ARRANGE TRANSPORTATION, GENERAL ASSISTANCE (SUCH AS MEAL PREPARATION), OR COMPANIONSHIP TO THOSE DISABLED AND FRAIL PATIENTS RETURNING HOME FROM A HOSPITAL STAY. DIABETES EDUCATION AND SELF-MANAGEMENT - THIS PROGRAM IS OPERATED FROM THE DIABETES CENTER AND IS RECOGNIZED AND CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION. THROUGH THIS WORK, PEOPLE WITH DIABETES LEARN HEALTH AND LIFESTYLE SKILLS TO HELP THEM MANAGE THEIR DISEASE SYMPTOMS. OTHER BENEFITS INCLUDE PATIENT AND FAMILY SUPPORT GROUPS, AND GLUCOSE METER AND INSULIN PUMP INSTRUCTION. ADVANCE DIRECTIVES PROGRAM - IN 2013, A NEW PROGRAM WAS DESIGNED AND IMPLEMENTED THROUGH THE COMMUNITY HEALTH IMPROVEMENT OFFICE, WHERE TRAINED VOLUNTEERS PROVIDE SUPPORT TO COMMUNITY MEMBERS TO COMPLETE ADVANCE DIRECTIVES FORMS ON A BY- APPOINTMENT BASIS. COMMUNITY RESOURCE GUIDE - IN 2012, THE COMMUNITY HEALTH IMPROVEMENT STAFF COLLECTED AND VERIFIED INFORMATION FROM ACROSS THE REGION FOR INCLUSION IN A RESOURCE GUIDE FOR USE BY HEALTH CARE PROVIDERS AND SOCIAL AND HUMAN SERVICES PERSONNEL TO HELP THEM READILY IDENTIFY POTENTIAL RESOURCES FOR THEIR CLIENTS. THIS GUIDE WAS DEVELOPED IN RESPONSE TO AN IDENTIFIED NEED FOR INFORMATION, AND UPDATED AND DISTRIBUTED TO PROVIDER AND SOCIAL AND HUMAN SERVICES OFFICES ACROSS THE REGION, PHYSICALLY AND ELECTRONICALLY FOR EASE OF USE. OTHER INFORMATION: RRMC HAS 17 BOARD MEMBERS WHO REPRESENT THE RESIDENTS OF RUTLAND COUNTY IN THEIR SERVICE; 6 OF THESE ARE PHYSICIANS, 2 REPRESENT HEALTH CARE PARTNERS, AND 9 ARE RUTLAND COUNTY RESIDENTS WHO REPRESENT A VARIETY OF BUSINESS SECTORS. ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST DISCLOSURE PROCESS WHICH IS NECESSARY TO COMPLY WITH FEDERAL AND STATE LAWS, INCLUDING THE FEDERAL ANTI-KICKBACK STATUTE AND THE TAX CODE. RRMC HAS PREDOMINANTLY AN OPEN MEDICAL STAFF. THE ONLY EXCEPTIONS ARE THE FOLLOWING SPECIALTIES FOR WHICH THERE ARE EITHER BOARD-APPROVED EXCLUSIVE CONTRACTS OR HOSPITAL-EMPLOYED PHYSICIANS ONLY: ANESTHESIA, EMERGENCY MEDICINE, CRITICAL CARE, MEDICAL ONCOLOGY, RADIATION ONCOLOGY, ORTHOPEDICS, AND RADIOLOGY. ALL NEW APPLICANTS UNDERGO AN EXTENSIVE REVIEW PROCESS, INCLUDING PRIMARY SOURCE VERIFICATION OF THEIR EDUCATION, TRAINING, BOARD CERTIFICATION, MALPRACTICE HISTORY, AND PREVIOUS HOSPITAL AFFILIATIONS. WHEN DEEMED COMPLETE, THEIR APPLICATION IS REVIEWED BY THE CREDENTIALS COMMITTEE, WHICH IS MADE UP OF PHYSICIANS AND AT LEAST ONE BOARD MEMBER. THE CREDENTIAL COMMITTEE MAKES A RECOMMENDATION TO THE MEDICAL EXECUTIVE COMMITTEE, WHICH INCLUDES THE CHAIRMAN OF THE BOARD. THE MEDICAL EXECUTIVE COMMITTEE MAKES A FINAL RECOMMENDATION TO THE FULL BOARD, WHICH HAS THE ULTIMATE AUTHORITY TO GRANT MEDICAL STAFF PRIVILEGES. ALL MEDICAL STAFF APPOINTMENTS ARE FOR A TWO YEAR PERIOD. ALL MEDICAL STAFF IS SUBJECT TO ONGOING PEER REVIEW OF THEIR CLINICAL WORK. EVERY TWO YEARS, EVERY MEMBER OF THE MEDICAL STAFF MUST UNDERGO A REAPPOINTMENT PROCESS WHICH IS DESIGNED TO REVIEW THEIR CLINICAL AND PROFESSIONAL ACTIVITY AND BEHAVIOR. THOSE REAPPOINTMENTS GO THROUGH THE SAME SEQUENCE AS THE NEW APPLICANTS. RRMC'S CREDENTIALING PROCESS HAS BEEN SURVEYED BY BOTH THE JOINT COMMISSION AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND FOUND TO BE IN FULL COMPLIANCE WITH THEIR STANDARDS (TJC) AND THEIR CONDITIONS OF PARTICIPATION (CMS). AS A RURAL COMMUNITY HEALTH SYSTEM, RRMC PROVIDES A BROAD ARRAY OF SERVICES. THE FOLEY CANCER CENTER AT RRMC PROVIDES TREATMENT TECHNOLOGIES THAT INCLUDE HIGH TECH DIAGNOSTIC IMAGING, MEDICAL ONCOLOGY WITH TRADITIONAL IV THERAPIES (SUCH AS CHEMOTHERAPY), AND RADIATION ONCOLOGY FEATURING A STATE-OF-THE-ART LINEAR ACCELERATOR. SUPPORTIVE CARE PROGRAMS INCLUDE PALLIATIVE CARE, PAIN MANAGEMENT, ACUPUNCTURE AND A WOMEN'S BREAST CARE PROGRAM, AND A VARIETY OF SUPPORT GROUPS. THE HOSPITAL PROVIDES 24-HOUR EMERGENCY CRISIS CARE, AS WELL AS PSYCHIATRIC INTENSIVE CARE, GERIATRIC PSYCHIATRIC PROGRAMS, MEDICAL DETOXIFICATION AND DUAL DIAGNOSIS AND TREATMENT OF SIMULTANEOUS SUBSTANCE ABUSE AND BEHAVIORAL HEALTH DISORDERS. THE 24-HOUR EMERGENCY DEPARTMENT PROVIDES CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE FAST TRACK PROGRAM IS DESIGNED TO PROCESS URGENT CARE IN A TIMELY MANNER. RRMC PROVIDES CARE FOR BOTH MEDICARE AND MEDICAID PATIENTS; THESE POPULATIONS MAKE UP 55.5% OF THE PAYER MIX FOR RRMC. BY WORKING COLLABORATIVELY WITH THE LOCAL FEDERALLY QUALIFIED HEALTH CLINICS, COMMUNITY H AFFILIATED HEALTH CARE SYSTEM RUTLAND REGIONAL MEDICAL CENTER (RRMC) IS PART OF A HEALTH CARE SYSTEM WHICH INCLUDES THE FOLLOWING ADDITIONAL TAX-EXEMPT ORGANIZATIONS: RUTLAND REGIONAL HEALTH SERVICES, INC. (RRHS), VERMONT ORTHOPAEDIC CLINIC, INC. (VOC), AND RUTLAND HEALTH FOUNDATION (RHF). RRHS IS A HOLDING COMPANY ORGANIZED TO SUPPORT, PROMOTE, ADVANCE AND STRENGTHEN THE HEALTH OF PERSONS WITHIN ITS DESIGNATED SERVICE AREA. VOC OFFERS COMPREHENSIVE, HIGH QUALITY TREATMENT METHODOLOGIES FOR ORTHOPAEDIC-RELATED INJURIES. RHF PARTNERS WITH PATIENTS, PHYSICIANS, EMPLOYEES, COMMUNITY LEADERS, AND PHILANTHROPISTS TO RAISE MONEY TO HELP MEET HEALTHCARE NEEDS OF THE COMMUNITY. RRHS IS THE SOLE MEMBER OF RRMC AND VOC, AND IS THE CONTROLLING MEMBER OF RHF. THE SYSTEM PRIMARILY EARNS REVENUES BY PROVIDING HOSPITAL INPATIENT, HOSPITAL OUTPATIENT, HOSPITAL EMERGENCY CARE, AND PHYSICIAN SERVICES TO RESIDENTS IN THE RUTLAND, VERMONT, AREA. THE JAMES T BOWSE HEALTH TRUST IS A DEPARTMENT OF RUTLAND REGIONAL HEALTH SERVICES AND PROVIDES GRANT FUNDING AIMED AT IMPROVING THE HEALTH STATUS OF THE RUTLAND REGION. true COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION 375 ROUTE 30 NORTH BOMOSEEN VT 05732 221179701 501(C)(3) 833333 COMMUNITY HLTH IMPROVE RUTLAND COMMUNITY PROGRAMS 78 S MAIN PO BOX 222 RUTLAND VT 05702 030307812 501(C)(3) 13500 COMMUNITY HLTH IMPROVE LOTHROP ELEMENTARY SCHOOL 3447 ROUTE 7 PITTSFORD VT 05763 036000625 PITTSFORD, VT 17450 COMMUNITY HLTH IMPROVE RUTLAND AREA FARM FOOD LINK PO BOX 561 POULTNEY VT 05741 208283600 501(C)(3) 12955 COMMUNITY HLTH IMPROVE RUTLAND SOUTH SUPERVISORY UNION 64 GRANGE HALL ROAD N CLARENDON VT 05759 030253069 WALLINGFORD DIS 41378 COMMUNITY HLTH IMPROVE RUTLAND AREA VISITING NURSES 7 ALBERT CREE DRIVE RUTLAND VT 05701 030185024 501(C)(3) 10611 COMMUNITY HLTH IMPROVE VERMONT ADULT LEARNING 60 S MAIN STREET WATERBURY VT 05676 030276755 501(C)(3) 30782 COMMUNITY HLTH IMPROVE PREVENT CHILD ABUSE VERMONT PO BOX 829 MONTPELIER VT 05601 030267183 501(C)(3) 24000 COMMUNITY HLTH IMPROVE 8 GRANT MONITORING SCHEDULE I, PART I, LINE 2 RUTLAND REGIONAL HEALTH SERVICES (RRHS), THROUGH RUTLAND REGIONAL MEDICAL CENTER (RRMC), AWARDED A FIVE-YEAR COMMUNITY BENEFIT GRANT TO COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. (CHCRR) IN THE AMOUNT OF $4,600,000 THAT IS FUNDED BY RRMC AND WAS EFFECTIVE MAY 1, 2008. FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, RESPECTIVELY, $833,333 AND $1,367,417 WAS EXPENDED FOR THE GRANT AWARD FROM RRMC AND IS INCLUDED IN RUTLAND REGIONAL MEDICAL CENTER'S GENERAL OPERATING EXPENSES. RRHS CONTINUALLY WORKS WITH CHCRR TO ENSURE THE ORGANIZATION IS USING FUNDS APPROPRIATELY AND FURTHERING THE CHCRR EXEMPT PURPOSE. THE OTHER GRANTS LISTED ON SCHEDULE I, PART II, WERE PROVIDED BY THE JAMES T BOWSE HEALTH TRUST, A DEPARTMENT OF RUTLAND REGIONAL MEDICAL CENTER. THE BOWSE TRUST ONLY CONSIDERS GRANT PROPOSALS THROUGH ITS FORMAL GRANT PROPOSAL PROCESS, WHICH REQUIRES THAT THE REQUESTING ORGANIZATION MEET CERTAIN CRITERIA AND SUBMIT A PLANNING GRANT/LETTER OF INTENT, FULL PROPOSAL, AND PLANNING GRANT BUDGET FORM DESCRIBING HOW THE GRANT WILL BE USED. PURPOSE OF GRANT OR ASSISTANCE SCHEDULE I, PART II, COLUMN H ASSISTANCE FOR RUTLAND COMMUNITY PROGRAMS, LOTHROP ELEMENTARY SCHOOL, RUTLAND AREA FARM FOOD LINK, RUTLAND SOUTH SUPERVISORY UNION, RUTLAND AREA VISITING NURSES, VERMONT ADULT LEARNING, AND PREVENT CHILD ABUSE VERMONT WAS PROVIDED BY THE JAMES T BOWSE HEALTH TRUST, A DEPARTMENT OF RUTLAND REGIONAL MEDICAL CENTER. SEE SCHEDULE H, PART VI, LINE 6 FOR MORE INFORMATION REGARDING PROGRAMS FUNDED BY THE JAMES T BOWSE HEALTH TRUST. X X X true false false true false false false false false J CHRISTIAN HIGGINS MD 345628 0 133025 0 5630 0 15625 0 17726 0 517634 0 0 0 MATTHEW A CONWAY MD 289750 0 31585 0 5676 0 15614 0 17650 0 360275 0 0 0 DANIEL M FOLEY MD 288926 0 49200 0 3681 0 20582 0 7358 0 369747 0 0 0 THOMAS W HUEBNER 424268 0 0 0 23220 0 25625 0 17887 0 491000 0 0 0 EDWARD T OGORZALEK 229483 0 0 0 23685 0 25435 0 17644 0 296247 0 0 0 MARY T NEMETH 184731 0 0 0 9924 0 20194 0 7168 0 222017 0 0 0 BAXTER HOLLAND MD 323501 0 0 0 8069 0 25547 0 13137 0 370254 0 0 0 BARBARA ROBINSON 205974 0 0 0 5323 0 17646 0 12977 0 241920 0 0 0 KATHLEEN LETENDRE 105635 0 0 0 68634 0 6644 0 16192 0 197105 0 0 0 JI CHEN 170780 0 0 0 138 0 7150 0 806 0 178874 0 0 0 MELBOURNE BOYTON MD 658979 0 201870 0 23564 0 20635 0 17295 0 922343 0 0 0 MICHAEL KENOSH MD 397021 0 74035 0 22766 0 15625 0 17892 0 527339 0 0 0 WILLIAM LIGHTHART MD 587203 0 172607 0 7572 0 15625 0 16694 0 799701 0 0 0 ERIC MARSH MD 528225 0 162045 0 5811 0 15625 0 18282 0 729988 0 0 0 MICHAEL ROBERTELLO MD 411019 0 154737 0 6484 0 15625 0 17866 0 605731 0 0 0 TODD GREGORY MD 287410 0 0 0 5364 0 15478 0 17636 0 325888 0 0 0 JOHN KIJEWSKI 189887 0 0 0 5228 0 8506 0 17564 0 221185 0 0 0 ALLISON WOLLEN 182034 0 25000 0 26960 0 1288 0 17562 0 252844 0 0 0 CAROL EGAN 178828 0 0 0 6242 0 15653 0 12849 0 213572 0 0 0 DARREN CHILDS 155633 0 0 0 5295 0 13611 0 17281 0 191820 0 0 0 SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4A KATHLEEN LETENDRE, FORMER VICE PRESIDENT OF PLANNING & ORG EXCELLENCE, RECEIVED A SEVERANCE PAYMENT OF $68,634 FROM THE ORGANIZATION DURING THE YEAR. THIS AMOUNT IS INCLUDED IN OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B(III). COMPENSATION CONTINGENT ON THE REVENUES OF THE ORGANIZATION SCHEDULE J, PART I, LINE 5A PHYSICIANS EARN COMPENSATION BASED UPON THEIR PRODUCTIVITY AGAINST ESTABLISHED TARGETS. INCREASED PRODUCTIVITY IS DIRECTLY RELATED TO INCREASED REVENUES FOR THE ORGANIZATION. A VT EDUCATIONAL & HLTH BUILDINGS FINANCE AGENCY 237154467 2013-09-03 31350000 REFUND 2009/2010 BONDS false false false A 0 0 31350000 0 0 31157039 192961 0 0 0 0 0 2013 true false true true A false false true true false 0 false false false true A false true false false true true DEUTSCHE BANKTDBANK 10. false false false 0 false false A true REQUIREMENTS OF SECTION 148 SCHEDULE K, PART IV, LINE 7 THE TAX-EXEMPT BONDS DO NOT HAVE ANY OUTSTANDING PROCEEDS AND THEREFORE ARE NOT SUBJECT TO THE ARBITRAGE REQUIREMENTS OF SECTION 148. FOLEY DISTRIBUTING FOLEY SERVICES M FOLEY - SEE PART V 279168 PAPER & JANITORIAL SUPPLIES false CENTRAL VERMONT PUBLIC SERVICE J GAMBLE - SEE PART V 1542808 ELECTRICITY false BLUE CROSS BLUE SHIELD OF VERMONT T HUEBNER - SEE PART V 13858863 INSURANCE PREMIUMS false BUSINESS TRANSACTION INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV, COLUMN B MARK K FOLEY, BOARD MEMBER, OWNS FOLEY DISTRIBUTING AND FOLEY SERVICES, INC. THESE COMPANIES SUPPLIED PAPER AND JANITORIAL PRODUCTS TO THE ORGANIZATION FOR $279,168 IN FISCAL YEAR 2013. JOAN F GAMBLE, BOARD MEMBER, IS AN OFFICER AT CENTRAL VERMONT PUBLIC SERVICES (CVPS). IN FISCAL YEAR 2013, THE ORGANIZATION PAID CVPS $1,542,808 FOR ELECTRICITY. THOMAS W HUEBNER, RRMC PRESIDENT & CEO, IS ON THE BOARD OF BLUE CROSS BLUE SHIELD OF VERMONT. IN FISCAL YEAR 2013, THE ORGANIZATION PAID BCBS $13,858,863 IN HEALTH INSURANCE PREMIUMS. ORGANIZATION'S MISSION AND MOST SIGNIFICANT ACTIVITIES FORM 990, PART I, LINE 1 MISSION: TO IMPROVE THE HEALTH OF THE RUTLAND REGION AND SURROUNDING COMMUNITIES BY PROVIDING APPROPRIATE, SUPERIOR, INTEGRATED, PREVENTATIVE, DIAGNOSTIC AND THERAPEUTIC HEALTH SERVICES IN A CARING ENVIRONMENT THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY AND RELATIONSHIPS. VISION: TO BE THE BEST COMMUNITY HEALTHCARE SYSTEM IN NEW ENGLAND. GOALS: *QUALITY: WE WILL PROVIDE SUPERIOR HEALTH SERVICES WHICH MEET OUR CUSTOMER NEEDS THROUGH: GOOD CLINICAL OUTCOMES, UP-TO-DATE TECHNOLOGY, EFFECTIVE PROCESSES, COMPETENT AND CARING STAFF AND WELL MAINTAINED FACILITIES. *GROWTH: WE WILL DEVELOP NEW SERVICES AND EXPAND EXISTING SERVICES TO MEET CUSTOMER NEEDS RESULTING IN INCREASED MARKET SHARE AND EXPANSION INTO NEW MARKETS. *INFORMATION EXCELLENCE: WE WILL PROVIDE SUPERIOR, COORDINATED INFORMATION RESOURCES, PROCESSES, AND SYSTEMS THAT MEET CUSTOMER NEEDS FOR EFFECTIVE INFORMATION GATHERING, RECORDING, ACCESS, ANALYSIS, AND DISSEMINATION ACROSS THE HEALTHCARE CONTINUUM. *FINANCIAL STRENGTH: WE WILL ACHIEVE FINANCIAL STRENGTH AND STABILITY BY OPTIMIZING REIMBURSEMENT AND IMPROVING OUR COST STRUCTURE TO PRODUCE SUFFICIENT MARGINS, AND INCREASING PHILANTHROPIC GIVING. *EMPLOYEE ENGAGEMENT: WE WILL CREATE AN ENVIRONMENT WHERE EMPLOYEE ENGAGEMENT FLOURISHES AND WE COMMIT OUR HEARTS AND MINDS TO MEETING AND EXCEEDING THE NEEDS OF OUR CUSTOMERS AND EACH OTHER. TOTAL NUMBER OF VOLUNTEERS FORM 990, PART I, LINE 6 THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND OTHER INDIVIDUALS WHO VOLUNTEER TIME TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. PROGRAM SERVICE CHANGES FORM 990, PART III, LINE 2 VERMONT ORTHOPAEDIC CENTER MERGED WITH RUTLAND REGIONAL MEDICAL CENTER ON 10/1/2012. IT IS NO LONGER A SEPARATE ENTITY, BUT A DEPARTMENT IN RRMC. EFFECTIVE 10/1/2013, KILLINGTON MEDICAL CLINIC MERGED WITH RUTLAND REGIONAL MEDICAL CENTER AS WELL, AND IS ALSO NOW A DEPARTMENT OF RRMC. EXEMPT PURPOSE ACHIEVEMENTS FORM 990, PART III, LINES 4A-D RUTLAND REGIONAL MEDICAL CENTER FY 2013 COMMUNITY BENEFITS REPORT: RUTLAND REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDING SUPERIOR, INTEGRATED, DIAGNOSTIC, THERAPEUTIC AND PREVENTATIVE HEALTH SERVICES AND TO PROMOTING OVERALL COMMUNITY HEALTH AND WELL-BEING. COMMUNITY BENEFITS ARE THE ACTIVITIES AND SERVICES RUTLAND REGIONAL ENGAGES IN AND SUPPORTS THAT GO BEYOND THE ROUTINE PATIENT CARE SERVICES. DOCUMENTING THESE EFFORTS IS A PART OF WHAT DIFFERENTIATES TAX-EXEMPT FROM TAXABLE HEALTH CARE ORGANIZATIONS. PROGRAMMING THAT COUNTS: COMMUNITY HEALTH IMPROVEMENT INITIATIVES SCREENING SERVICES AND EDUCATIONAL PROGRAMMING ARE IMPORTANT ELEMENTS TO PROMOTING THE HEALTH OF OUR COMMUNITY. THE ASSOCIATED EXPENSES FOR 2013 EXCEEDED $1,815,240. RRMC OFFERS HEALTH LIVING WORKSHOPS, TOBACCO CESSATION PROGRAMING, CONSUMER HEALTH LIBRARY SUPPORT, BREAST CARE EDUCATION OUTREACH, AND OVER 25 SUPPORT GROUPS FOR INDIVIDUALS AND FAMILIES. HEALTH PROFESSION EDUCATION & TRAINING FOR NON-EMPLOYEES AND WORKFORCE DEVELOPMENT COLLABORATING WITH EDUCATIONAL PROGRAMS, RRMC SUPPORTS A VARIETY OF TRAINING PROGRAMS FOR INDIVIDUALS INTERESTED IN MEDICAL-RELATED FIELDS. DURING 2013, RRMC'S INVESTMENT IN THESE AREAS TOTALED APPROXIMATELY $115,925. FREE AND DISCOUNTED CARE RUTLAND REGIONAL PROVIDES LOW- AND NO-COST CARE FOR ELIGIBLE RESIDENTS OF OUR AREA THROUGH A FINANCIAL ASSISTANCE PROGRAM. THE FREE CARE PROVISION FOR 2013 TOTALED $7,390,442. IN ADDITION TO THESE ACTIVITIES, RUTLAND REGIONAL IS NOW REQUIRED BY FEDERAL REGULATIONS TO CONDUCT A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS. THE RUTLAND COUNTY HEALTH NEEDS ASSESSMENT 2013 STEERING COMMITTEE HAS WORKED HARD TO BE INCLUSIVE, BOTH IN THE INFORMATION COLLECTED AND REVIEWED, AND BY BROADLY REQUESTING INPUT FROM AROUND OUR COMMUNITIES. FROM START TO FINISH, THE ASSESSMENT TAKES ABOUT ONE YEAR TO COMPLETE, AND INCLUDES COMPILATION OF SECONDARY DATA FROM OTHER SOURCES, COLLECTING INDIVIDUAL INPUT THROUGH CONSUMER SURVEYS AND THROUGH FOCUS GROUP MEETINGS. ALL OF THE INFORMATION GATHERED IS REVIEWED, AND PRIORITIZED BY A BROAD, COMMUNITY-BASED COMMITTEE. A FINAL REPORT HAS NOW BEEN PUBLISHED WITH THE FINDINGS. THIS REPORT IS MADE PUBLICALLY AVAILABLE ON WWW.RRMC.ORG. THE PURPOSE OF THE ASSESSMENT IS TO: -DESCRIBE THE HEALTH STATUS OF THE COMMUNITY -IDENTIFY THE COMMUNITY'S HEALTH NEEDS -COMPARE THE NEEDS TO THOSE IDENTIFIED PREVIOUSLY CONDUCTING ASSESSMENTS PERIODICALLY FOR MORE THAN 15 YEARS, WE HAVE SEEN SOME HEALTH INDICATORS IMPROVE AND OTHERS DECLINE. BY MONITORING THESE CHANGES, THE COMMITTEE IS ABLE TO IDENTIFY WHERE ADDITIONAL RESOURCES ARE NEEDED. ORGANIZATIONS, INCLUDING RUTLAND REGIONAL, USE THIS IMPORTANT INFORMATION TO GUIDE THEIR PLANNING. FOR RUTLAND REGIONAL SPECIFICALLY, IT HELPS WITH THE DEVELOPMENT OF NEW HOSPITAL SERVICES AND COMMUNITY PROGRAMS. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D THE REVENUES AND EXPENSES REPORTED ON PART III, LINE 4D, REPRESENT THOSE AMOUNTS THAT ATTRIBUTABLE TO OTHER PROGRAM SERVICES CONDUCTED BY THE ORGANIZATION. THESE OTHER SERVICES PRIMARILY REPRESENT OTHER SUPPORT SERVICES THAT ARE PROVIDED TO HOSPITAL PATIENTS OR THAT ARE CONDUCTED TO SUPPORT THE OVERALL FUNCTION OF THE HOSPITAL, SUCH AS CENTRAL SUPPLY AND PHARMACY SERVICES. OTHER SERVICES ALSO INCLUDE BENEFIT TO THE COMMUNITY THROUGH THE PAYMENT OF GRANTS TO OTHER COMMUNITY ORGANIZATIONS. SEE SCHEDULE I FOR DETAIL REGARDING THESE GRANT PAYMENTS. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINES 6, 7A, & 7B PER ARTICLE II, SECTION 1, OF THE ORGANIZATION'S BYLAWS, RUTLAND REGIONAL HEALTH SERVICES IS THE SOLE MEMBER OF RUTLAND REGIONAL MEDICAL CENTER. ARTICLE III, SECTIONS 1 AND 2, OF THE BYLAWS STATE THAT THE BOARD SHALL CONSIST OF EIGHTEEN DIRECTORS. OF THESE DIRECTORS, FOURTEEN ARE CHOSEN OR APPROVED BY THE ORGANIZATION'S SOLE MEMBER. ARTICLE VIII, SECTION 5, OF THE BYLAWS DISCUSS POWERS RESERVED TO THE MEMBER, RUTLAND REGIONAL HEALTH SERVICES, INC., AND STATE THAT THE CORPORATION SHALL SUBMIT TO THE BOARD OF DIRECTORS OF THE MEMBER FOR ITS PRIOR APPROVAL THE FOLLOWING: A) THE APPOINTMENT OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, B) ALL OPERATING AND CAPITAL BUDGETS FOR THE CORPORATION, C) STRATEGIC PLANS FOR THE CORPORATION, D) CAPITAL EXPENDITURES OF $100,000 OR MORE WHICH ARE UNBUDGETED, E) PURCHASE AND SALE OF ALL SIGNIFICANT ASSETS, AND F) THE BYLAWS AND ANY AMENDMENTS THERETO. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT COPY IS THEN REVIEWED BY TOP MANAGEMENT. ONCE A FINAL DRAFT IS COMPLETE, IT IS MAILED TO EACH MEMBER OF THE SYSTEM FINANCE COMMITTEE. THE COMMITTEE WILL MEET AND DISCUSS THE RETURN WITH A TAX ADVISOR PRIOR TO PRESENTING THE FINAL DRAFT TO THE FULL BOARD OF DIRECTORS. ALL BOARD MEMBERS ARE ALSO PROVIDED A COPY OF THE FINAL DRAFT. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL ORGANIZATION LEADERS REVIEW THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY TO ENSURE ALL CONFLICTS ARE MADE KNOWN. SEE THE POLICY BELOW. POLICY *DUTY TO DISCLOSE IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, OR OTHER INDIVIDUALS WHO, ON BEHALF OF THE CORPORATION, ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. *DUTY TO VOICE CONCERN IN THE EVENT THAT AN INTERESTED PERSON BECOMES CONCERNED THAT ANOTHER INTERESTED PERSON WHO IS A BOARD MEMBER, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS HAS AN UNDISCLOSED FINANCIAL INTEREST OR IS EXERTING INAPPROPRIATE INFLUENCE RELATED TO A FINANCIAL INTEREST, THIS CONCERN SHOULD BE RAISED WITH THE CHAIR OF THE APPROPRIATE BOARD OR COMMITTEE OR, IF INVOLVING A MEMBER OF LEADERSHIP COUNCIL, A DIRECTOR OR MANAGER OR OTHER INTERESTED PERSON, AN APPROPRIATE CORPORATE OFFICER. *DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD OR COMMITTEE MEMBERS. HOWEVER, IN NO EVENT SHALL AN INTERESTED PERSON PARTICIPATE IN THE DELIBERATION AND/OR DETERMINATION OF COMPENSATION THAT HE/SHE WILL RECEIVE FROM THE CORPORATION FOR EMPLOYMENT, PROFESSIONAL CONTRACT OR OTHERWISE. *DEFINITIONS -INTERESTED PERSON - FOR THE PURPOSES OF THIS POLICY, AN INTERESTED PERSON IS ANY BOARD MEMBER, PRINCIPAL OFFICER, MEMBER OF THE LEADERSHIP COUNCIL, DIRECTOR, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. IF AN INDIVIDUAL IS AN INTERESTED PERSON WITH RESPECT TO ANY ENTITY IN THE RRMC/RRHS HEALTH CARE SYSTEM, HE OR SHE IS AN INTERESTED PERSON WITH RESPECT TO ALL ENTITIES IN THE HEALTH CARE SYSTEM. *PROCEDURES -PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST .AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. .THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. .AFTER EXERCISING DUE DILIGENCE, INCLUDING A CONSIDERATION OF INDEPENDENT COMPARABILITY DATA, VALUATIONS OR APPRAISALS, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. .IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. -ANNUAL STATEMENTS .AWARENESS/COMPLIANCE WITH POLICY - EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THIS CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY; HAS AGREED TO COMPLY WITH THE POLICY; AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST BE ENGAGED PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. .CONFLICT OF INTEREST SURVEY - EACH INTERESTED PERSON SHALL DISCLOSE ON AN ANNUAL SURVEY FORM POTENTIAL CONFLICTS OF INTEREST AND FINANCIAL INTERESTS RELEVANT TO THIS POLICY. COMPENSATION REVIEW POLICY FORM 990, PART VI, SECTION B, LINES 15A & 15B THE FOLLOWING POLICY APPLIES TO THE ENTIRE RUTLAND REGIONAL HEALTH SERVICES (RRHS) SYSTEM, AND THE POLICY COVERS OFFICER & KEY EMPLOYEE COMPENSATION: *IT IS THE POLICY OF RRHS TO OFFER MARKET-COMPETITIVE PAY SO TO ATTRACT AND RETAIN THE BEST TALENT FROM OUR LABOR MARKET. *DESIGNATION OF RRHS' KEY EMPLOYEES IS MADE BY THE COMPLIANCE DEPARTMENT. *THE RRHS KEY EMPLOYEE LABOR MARKET IS TYPICALLY ALL HOSPITALS NATIONALLY WITH SIMILAR REVENUES AS RRHS. *KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY EACH FALL USING THREE SOURCES OF INDEPENDENT COMPETITIVE MARKET DATA. *JOBS HELD BY KEY EMPLOYEES ARE MATCHED WITH SIMILAR JOBS IN MARKET DATA WITH AN INDICATION OF JOB MATCH STRENGTH (WEAK, MODERATE OR STRONG). *THE MARKET REVIEW PRODUCES A REPORT OF KEY EMPLOYEE CURRENT BASE PAY AND TOTAL CASH COMPENSATION VS. MARKET BASE PAY AND TOTAL CASH COMPENSATION WITH ANY RECOMMENDED PAY ACTIONS. *GENERALLY SPEAKING, KEY EMPLOYEE BASE PAY VARIANCES OF -5% VS. MARKET TOTAL CASH COMPENSATION ARE CONSIDERED TO BE NON-COMPETITIVE PROMPTING A RECOMMENDED BASE PAY INCREASE TO BE CONSIDERED. *THE RESULTS OF THE REVIEW AND RECOMMENDED PAY ACTIONS ARE REVIEWED AND APPROVED BY THE CEO. INFORMATION IS MADE AVAILABLE TO SYSTEM FINANCE UPON REQUEST. *THE CEO PAY IS REVIEWED AND APPROVED BY THE CHAIR AND CO-CHAIR OF THE BOARD OF DIRECTORS. THIS REVIEW IS DOCUMENTED IN THE EXECUTIVE SESSION BOARD MINUTES. THE MOST RECENT COMPENSATION REVIEW OCCURRED DURING DECEMBER OF 2013. *THE KEY EMPLOYEES REVIEW WAS CONDUCTED IN DECEMBER OF 2013 COVERING NON-PHYSICIAN EMPLOYEE EARNING AT LEAST $150,000. THIS WAS DONE INTERNALLY. DOCUMENT DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE ANNUALLY IN THE ANNUAL REPORT, AND ARE ALSO AVAILABLE UPON WRITTEN REQUEST. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. ALL REQUESTS MUST BE FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT), AND REQUESTED DOCUMENTS WILL BE MAILED. BOARD MEMBERS RECEIVING COMPENSATION FORM 990, PART VII, COLUMN D NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. THE FOLLOWING BOARD MEMBERS RECEIVED COMPENSATION FROM RUTLAND REGIONAL MEDICAL CENTER FOR SERVICES PROVIDED AS PHYSICIANS: - J CHRISTIAN HIGGINS, MD - MATTHEW A CONWAY, MD - DANIEL M FOLEY, MD - TODD GREGORY, MD OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 $ 10,400,277 NET GAIN FROM DEF BEN PLAN AND POSTRETIREMENT BEN COSTS 5,519,351 CHANGE IN FV OF INVESTMENTS FOR UNDER FASB 825 1,900,460 GAIN ON INTEREST RATE SWAP AGREEMENT ( 60,435) TRANSFER TO AFFILIATES -------------- $ 17,759,653 TOTAL OTHER CHANGE IN NET ASSETS KILLINGTON MEDICAL CLINIC LLC 3902 KILLINGTON ROAD KILLINGTON VT 05751 461076985 MED CLINIC VT 0 0 RRMC RUTLAND REGIONAL HEALTH SERVICES 160 ALLEN STREET RUTLAND VT 05701 222534389 HOLDING CO VT 501(C)(3) 11B II NA false RUTLAND HEALTH FOUNDATION 160 ALLEN STREET RUTLAND VT 05701 030349681 FUNDRAISING VT 501(C)(3) 7 RRHS false VERMONT ORTHOPAEDIC CLINIC 160 ALLEN STREET RUTLAND VT 05701 208089565 ORTHO SVC VT 501(C)(3) 9 RRHS false THE MEADOWS AT EAST MOUNTAIN 157 HERITAGE HILL PLACE RUTLAND VT 05701 030330343 ELDER CARE VT RRHS THE GABLES AT EAST MOUNTAIN LLC ONE GABLES PLACE RUTLAND VT 05701 030358050 ELDER CARE VT RRHS VERMONT SPORTS MEDICINE CENTER 5 ALBERT CREE DR RUTLAND VT 05701 061231501 PHYSICAL THER VT RRHS false false true true false false false false false false true false true true true true true true false