STRATEGY STUDIO / PUBLIC DATA EXPLORER

WINDSOR HOSPITAL CORPORATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
WINDSOR HOSPITAL CORPORATION (EIN 03-0183721)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-14
IRS object ID
201422269349300942
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-14T09:12:13-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN010523282EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1100AddressLine1
CityPortlandCity
StateMEState
ZIP Code041041100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN030183721EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Windsor Hospital CorporationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWINDNameControl
Phone8026746711Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1289 County RoadAddressLine1
CityWindsorCity
StateVTState
ZIP Code05089ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDavid C SanvilleName
TitleCFOTitle
Phone8026746711Phone
Date Signed2014-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBarbara J McGuan CPAName
PTINP00219457PTIN
Phone2077752387Phone
Date Prepared2014-08-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Mt Ascutney Hospital & Health CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonKevin DonovanNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1289 County RoadAddressLine1
CityWindsorCity
StateVTState
ZIP Code05089ZIPCode
FieldValueIRS element (for citing)
Gross Receipts54717456GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.mtascutneyhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1933YearFormation
State Legal DomicileVTStateLegalDomicile
Activity Or Mission DescriptionTo improve the lives of those we serve. Our activities include providing healthcare.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees588TotalNbrEmployees
Total Nbr Volunteers67TotalNbrVolunteers
Total Gross UBI92804TotalGrossUBI
Net Unrelated Business Txbl Income47357NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1045106ContributionsGrantsPriorYear
Contributions Grants Current Year995526ContributionsGrantsCurrentYear
Program Service Revenue Prior Year42721756ProgramServiceRevenuePriorYear
Program Service Revenue CY47969559ProgramServiceRevenueCY
Investment Income Prior Year517785InvestmentIncomePriorYear
Investment Income Current Year656866InvestmentIncomeCurrentYear
Other Revenue Prior Year112344OtherRevenuePriorYear
Other Revenue Current Year24214OtherRevenueCurrentYear
Total Revenue Prior Year44396991TotalRevenuePriorYear
Total Revenue Current Year49646165TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29167348SalariesEtcPriorYear
Salaries Etc Current Year28907533SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year220754TotalFundrsngExpCurrentYear
Other Expense Prior Year18701283OtherExpensePriorYear
Other Expenses Current Year19754508OtherExpensesCurrentYear
Total Expenses Prior Year47868631TotalExpensesPriorYear
Total Expenses Current Year48662041TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3471640RevenuesLessExpensesPriorYear
Revenues Less Expenses CY984124RevenuesLessExpensesCY
Total Assets BOY39840458TotalAssetsBOY
Total Assets EOY42487151TotalAssetsEOY
Total Liabilities BOY28978605TotalLiabilitiesBOY
Total Liabilities EOY26022626TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10861853NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY16464525NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMount Ascutney Hospital and Health Center's mission is to improve the lives of those we serve.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
Expense34762874Expense
Revenue47876755Revenue
DescriptionMt. 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, 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. MAHHC also had 25 extended care beds until it ceased operations of its nursing home on August 30, 2013. During the year there were 995 inpatient discharges, 1,540 outpatient surgeries, 84,411 outpatient lab tests, and 11,682 outpatient imaging 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. During the year there were 33,694 primary care patient visits. MAHHC's service area includes a significant proportion of residents who are uninsured, underinsured, or dependant on Medicare/Medicaid benefits. MAHHC provides free care to patients who meet certain criteria. Foregone charges furnished under MAHHC's free care policy amounted to $794,724.Description
Total Program Service Expense34762874TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109667NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees588NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1David SanvilleBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8026747240TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1289 County RoadAddressLine1
CityWindsorCity
StateVTState
ZIP Code05089ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedHighest Compensated EmployeeHighestCompensatedEmployee
Shelley Seward
President/Past Vice President1.00XX000
Nancy Loux
Trustee/Past President1.00XX0001.00
Harold Pyke
Secretary1.00XX0000.50
Susan Plausteiner
Treasurer1.00XX000
Paul Buff
Trustee1.00X000
Beach Conger MD
Past Trustee1.00X97970024471
Larry Frazer
Trustee1.00X000
Michael Newbold
Trustee1.00X0000.50
Jane Osgood
Past Trustee1.00X000
Lynn Peterson MD
Trustee1.00X000
Alan Cummings
Past Trustee1.00X000
Nancy Formella
Past Trustee1.00X000
Hon Donna Sweaney
Vice President1.00XX000
Steven Smith MD
Trustee1.00X1687820610910.50
Donna VanFleet
Trustee1.00X000
Mary Joyce MD
Trustee1.00X173569021346
Mary Bell
Trustee1.00X000
Vincent Fusca III
Trustee1.00X0001.00
Rev David Jones
Trustee1.00X0000.50
Kevin Donovan
CEO40.00X2621270639851.00
Jill Lord
CNO40.00X15420807190.50
Catherine Schneider MD
CMO40.00X224149016565
David Sanville
CFO40.00X97883000.50
Paul Calandrella
COO40.00X10437100
Christopher Connor MD
Opthalmologist40.00346834017551X
Peter Rauert MD
Anestesiologist40.00240313026155X
Andrew Robinson MD
Gastroenterologist40.0023306100X
Perry Nelson MD
Hospitalist40.0022207600X
Heidi Cruz MD
Physiatrist40.00214606029308X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2539949TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation261191TotalOtherCompensation
Number Individuals GT100 K36NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Dartmouth-Hitchcock
One Medical Center DriveLebanonNH03756Professional and Physician Services1411203
Emergency Services of New England
PO Box 12ChesterVT05143Physician Asst. for Emergency Room1187805
Sodexo Inc & Affiliates
PO Box 360170PittsburghPA152516170Mngmt & Support Staff - Envrnmntl Srvcs449149
Huntzinger Management Group
670 North River Street Suite 401PlainsPA18705Consultant srvcs for new EMR system342135
Weatherby Locums Inc
PO Box 972633DallasTX753972633Physician Coverage for Hospital306487
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Fundraising Events28042FundraisingEvents
Government Grants474054GovernmentGrants
All Other Contributions493430AllOtherContributions
Noncash Contributions12548NoncashContributions
Total Contributions995526TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Services9000997530910475309104
Program & Misc Other9000993302259320945592804
DHS/VAHHA Revenue900099207671207671
Provision for Doubtful Accounts900099-3175557-3175557
Contractual and Charity Allowance900099-27673918-27673918
FieldValueIRS element (for citing)
Total Program Service Revenue47969559TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column281008TotalRevenueColumn
Exclusion$281,008ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real67435Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real49930Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real17505Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column17505TotalRevenueColumn
Exclusion$17,505ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5368412Securities
Other8019Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4980092Securities
Other20481Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities388320Securities
Other-12462Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column375858TotalRevenueColumn
Exclusion$375,858ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events27497GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events28042CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses20788FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column6709TotalRevenueColumn
Exclusion$6,709ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column49646165TotalRevenueColumn
Related Or Exempt Function Income47876755RelatedOrExemptFunctionIncome
Unrelated Business Revenue92804UnrelatedBusinessRevenue
Exclusion$681,080ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1471235Total
Program Services547228ProgramServices
Management And General924007ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total21586459Total
Program Services19102554ProgramServices
Management And General2348813ManagementAndGeneral
Fundraising135092Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total234073Total
Program Services208402ProgramServices
Management And General24145ManagementAndGeneral
Fundraising1526Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4013475Total
Program Services3561522ProgramServices
Management And General438166ManagementAndGeneral
Fundraising13787Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1602291Total
Program Services1383165ProgramServices
Management And General209487ManagementAndGeneral
Fundraising9639Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total71971Total
Management And General71971ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total38073Total
Management And General38073ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3277927Total
Program Services1668319ProgramServices
Management And General1589627ManagementAndGeneral
Fundraising19981Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total50548Total
Program Services5723ProgramServices
Management And General42093ManagementAndGeneral
Fundraising2732Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total89613Total
Program Services53638ProgramServices
Management And General35237ManagementAndGeneral
Fundraising738Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total844893Total
Program Services117067ProgramServices
Management And General720826ManagementAndGeneral
Fundraising7000Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1254310Total
Program Services495488ProgramServices
Management And General758822ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total64665Total
Program Services44616ProgramServices
Management And General19789ManagementAndGeneral
Fundraising260Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total538743Total
Management And General538743ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2626771Total
Management And General2626771ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total630247Total
Program Services355459ProgramServices
Management And General273553ManagementAndGeneral
Fundraising1235Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Contracted Wages43319963746034585962
Medical Supplies27673782756909104618
Dues/Fees/Taxes18676611918501675567244
Miscellaneous Expenses65696441443022072721807

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total642748Total
Program Services110470ProgramServices
Management And General525573ManagementAndGeneral
Fundraising6705Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total48662041Total
Program Services34762874ProgramServices
Management And General13678413ManagementAndGeneral
Fundraising220754Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2013099BOY
EOY1616084EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2299215BOY
EOY2776146EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY542045BOY
EOY429120EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4943761BOY
EOY7181442EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY20653BOY
EOY5045EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY537845BOY
EOY511134EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY147056BOY
EOY212564EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis33867307LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21665391LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14318455BOY
EOY12201916EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY11218112BOY
EOY11088456EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1873054BOY
EOY1952321EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1927163BOY
EOY4512923EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY39840458BOY
EOY42487151EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6011590BOY
EOY4820843EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY8731471BOY
EOY8514646EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1743586BOY
EOY2764463EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY12491958BOY
EOY9922674EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY28978605BOY
EOY26022626EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4628155BOY
EOY10098630EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY441032BOY
EOY509713EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5792666BOY
EOY5856182EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10861853BOY
EOY16464525EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39840458BOY
EOY42487151EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses984124ReconcilationRevenueExpenses
Reconciliation Unrealized Invest213273ReconciliationUnrealizedInvest
Reconcilation Other Changes4405275ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$16,127OtherActivitiesAmount
Total Lobbying Expenditures IIB16127TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationThe Hospital paid $13,891 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 $2,236 in the form of dues to the American Hospital Association (AHA).Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance5880406BeginningOfYearBalance
Investment Earnings Or Losses79267InvestmentEarningsOrLosses
End Of Year Balance5959673EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance5705958BeginningOfYearBalance
Investment Earnings Or Losses174448InvestmentEarningsOrLosses
End Of Year Balance5880406EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5787015BeginningOfYearBalance
Investment Earnings Or Losses-81057InvestmentEarningsOrLosses
End Of Year Balance5705958EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5710296BeginningOfYearBalance
Investment Earnings Or Losses76719InvestmentEarningsOrLosses
End Of Year Balance5787015EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5634030BeginningOfYearBalance
Investment Earnings Or Losses76266InvestmentEarningsOrLosses
End Of Year Balance5710296EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.98260PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.01740TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis75418OtherCostOrOtherBasis
Book Value75418BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12329034OtherCostOrOtherBasis
Depreciation7850366Depreciation
Book Value4478668BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis12722291OtherCostOrOtherBasis
Depreciation8905391Depreciation
Book Value3816900BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8740564OtherCostOrOtherBasis
Depreciation4909634Depreciation
Book Value3830930BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings12201916TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
Deposits5560
Other Assets131155
Deferred Financing Costs, net62556
Equity in Subsidiary1874998
Other Receivables85847
Medicare and Meaningful Use Receivable2352807
FieldValueIRS element (for citing)
Total Book Value Other Assets4512923TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Other Liabilities$1,076,357
Post-Retirement Benefit Obligation$3,828,918
Interest Rate Swap$550,258
Estimated Settlements with Third-Party Payors$4,467,141
FieldValueIRS element (for citing)
Total Of Amounts9922674TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt51782100TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments213273NetUnrealizedGainsInvestments
Other Revenues4475993OtherRevenues
Revenue Not Rptd F9904689266RevenueNotRptdF990
Revenue Subtotal47092834RevenueSubtotal
Investment Expenses Not Included38073InvestmentExpensesNotIncluded
Other Revenues Not Included2515258OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2553331RevenueNotRptdOnFinStmt
Total Revenue Per Form99049646165TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt46179428TotExpensesEtcAuditedFinclStmt
Other Expenses Included70718OtherExpensesIncluded
Expenses Not Rptd F99070718ExpensesNotRptdF990
Expenses Subtotal46108710ExpensesSubtotal
Investment Expenses Not Included238073InvestmentExpensesNotIncluded2
Other Expenses Not Included2515258OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt2553331ExpensesNotRptdOnFinStmt
Total Expenses Per Form99048662041TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds: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.
Part XI, Line 2d - Other Adjustments:Unrealized Gain on Interest Rate Swap 239,289. Equity in Income of Subsidiaries 178,347. Change in Funded Status of Pension Plan 3,908,372. Unrealized Appreciaton in Charitable Remainder Trust 15,752. Unrealized Appreciation in Beneficial Interest in Perpetual Trusts 63,515. Fundraising Expense 20,788. Rental Expenses 49,930.
Part XI, Line 4b - Other Adjustments:Expenses from Discontinued Operations 2,515,258.
Part XII, Line 2d - Other Adjustments:Fundraising Expense 20,788. Rental Expenses 49,930.
Part XII, Line 4b - Other Adjustments:Expenses from Discontinued Operations 2,515,258.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event12013 MAH Golf ClassicNameOfEvent1
Gross Receipts Event155539GrossReceiptsEvent1
Charitable Contributions Event128042CharitableContributionsEvent1
Gross Revenue Event127497GrossRevenueEvent1
Non Cash Prizes Event1756NonCashPrizesEvent1
Rent Facility Costs Event16416RentFacilityCostsEvent1
Food And Beverage Event17093FoodAndBeverageEvent1
Other Direct Expenses Event16523OtherDirectExpensesEvent1
Gross Receipts Total55539GrossReceiptsTotal
Charitable Contributions Total28042CharitableContributionsTotal
Gross Revenue Total Events27497GrossRevenueTotalEvents
Non Cash Prizes Total Events756NonCashPrizesTotalEvents
Rent Facility Costs Total Events6416RentFacilityCostsTotalEvents
Food And Beverage Total Events7093FoodAndBeverageTotalEvents
Other Direct Expenses Total Events6523OtherDirectExpensesTotalEvents
Direct Expense Summary Events20788DirectExpenseSummaryEvents
Net Income Summary6709NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense818566TotalCommunityBenefitExpense
Net Community Benefit Expense818566NetCommunityBenefitExpense
Percent Of Total Expense0.01680PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense6680675TotalCommunityBenefitExpense
Direct Offsetting Revenue3561612DirectOffsettingRevenue
Net Community Benefit Expense3119063NetCommunityBenefitExpense
Percent Of Total Expense0.06410PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7499241TotalCommunityBenefitExpense
Direct Offsetting Revenue3561612DirectOffsettingRevenue
Net Community Benefit Expense3937629NetCommunityBenefitExpense
Percent Of Total Expense0.08090PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense274420TotalCommunityBenefitExpense
Net Community Benefit Expense274420NetCommunityBenefitExpense
Percent Of Total Expense0.00560PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense59206TotalCommunityBenefitExpense
Net Community Benefit Expense59206NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense9432248TotalCommunityBenefitExpense
Direct Offsetting Revenue5903874DirectOffsettingRevenue
Net Community Benefit Expense3528374NetCommunityBenefitExpense
Percent Of Total Expense0.07250PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense8000TotalCommunityBenefitExpense
Net Community Benefit Expense8000NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense9773874TotalCommunityBenefitExpense
Direct Offsetting Revenue5903874DirectOffsettingRevenue
Net Community Benefit Expense3870000NetCommunityBenefitExpense
Percent Of Total Expense0.07950PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17273115TotalCommunityBenefitExpense
Direct Offsetting Revenue9465486DirectOffsettingRevenue
Net Community Benefit Expense7807629NetCommunityBenefitExpense
Percent Of Total Expense0.16040PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,842,786BadDebtExpenseAmount
Amount Reimbursed By Medicare17660130AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare17822162CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-162032MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Windsor Hospital CorporationBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1289 County RoadAddressLine1
CityWindsorCity
StateVTState
ZIP Code05089ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
OtherSkilled nursing facilityOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Windsor Hospital CorporationBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities1OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed1AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifier
Part I, Line 7: A cost accounting system was used to calculate the amounts reported in the table. The cost accounting system addresses all patient segments. A cost-to-charge ratio was used.
Part I, Line 7g: Physician Clinic costs included within Subsidized Health Services are $4,293,056 of the total Community Benefit Expenses and $2,972,398 of the Direct Offsetting Revenue.
Part III, Line 4: Management provides for probable uncollectible amounts through a charge to operations and a credit to a 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: The shortfall represents the PPS reimbursement difference on the Rehab and SNF 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: 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 V, Section B, Line 3: Data that informed this needs assessment report was collected through a number of data-gathering activites:- Secondary data gathering: Health, economic, and education data from sources including Youth Risk Behavior Survey, the Behavioral Risk Factor Surveillance 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 (examples include oral health, prescription drug misuse, housing assessments, reductions in availability of appropriate mental health services, etc.).- First informed stakeholders' forum: Perceptions of informed regional stakeholders on the nature and causes of potential community needs were gathered through a community forum.- Stakeholders' 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; 67 informed stakeholders responded to this survey.- Focus group discussions: Focus group data collected from 6 focus groups largely consisting of lower-income consumers of health/welfare services. - Residents' survey: Opinion data from residents collected through community listservs, individual interviews at human service organizations, and focus groups. These surveys targeted both economically stable and lower-income households; 196 residents responded to surveys.- Second informed stakeholders' forum: Perceptions of informed regional stakeholders on the results of Items 1 to 5 above were gathered through a second community forum.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 5c: A benefit report was prepared and made available and distributed through the Mt. Ascutney Community 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 electronically and printed summaries will be make public.Windsor Hospital Corporation
Part VI, Line 3: The Hospital posts its charity care policy on its website.
Part VI, Line 4: MAHHC's primary service area includes Windsor, Claremont, Woodstock, Hartland, Springfield, and Brownsville.
Part VI, Line 5: 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.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Steven Smith MD
Trustee1573820900002400000610910229873000
Mary Joyce MD
Trustee1715520100001017066310147150194915000
Kevin Donovan
CEO250012000121150443580196270326112000
Jill Lord
CNO15302800011800007190154927000
Catherine Schneider MD
CMO22383300031609023075420240714000
Christopher Connor MD
Opthalmologist3458020001032010000075510364385000
Peter Rauert MD
Anestesiologist239761000552057140204410266468000
Andrew Robinson MD
Gastroenterologist1930610400000000000233061000
Perry Nelson MD
Hospitalist22183600024000000222076000
Heidi Cruz MD
Physiatrist214366000240087660205420243914000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 7Steven Smith, MD received a bonus which was based upon being a preceptor. Mary Joyce, MD and Richard White, MD received bonuses which were based upon Relative Value Units (RVU's). Andrew Robinson, MD received a bonus which was based upon longevity.
Part IIISteven Smith MD, Trustee, was paid $218,473 in compensation and benefits by Dartmouth Hitchcock Medical Center, an unrelated organization, for his services as physician. The Organization reimburses Dartmouth Hitchcock for the cost of his services. He was not compensated for his duty as trustee. Kevin Donovan, CEO, was paid $319,512 in compensation and benefits by Dartmouth Hitchcock Medical Center, an unrelated organization, for his services as CEO. The Organization reimburses Dartmouth Hitchcock for the cost of his services. David Sanville, CFO, was paid $97,883 in compensation by Gifford Medical Center, an unrelated organization, for his services as CFO. This compensation includes Base Compensation, Employer Paid Deferred Compensation, Employer Paid Nontaxable Benefits and Payroll Taxes. The Organization reimburses Gifford Medical Center for the cost of his services.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Vermont Educational and Health Buildings Financing AgencyBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN237154467IssuerEIN
Date Issued2010-02-05DateIssued
Issue Price9244000IssuePrice
Description Of PurposeRefinancing of 2004 and 2005 BondsDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired729354AmountRetired
Total Proceeds9244000TotalProceeds
Issuance Costs From Proceeds128133IssuanceCostsFromProceeds
Capital Expenditures9115867CapitalExpenditures
Year Of Subst Completion2010YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet1RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1TD Bank NABusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge18.000000000000TermOfHedge
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action0ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Changes in Program ServicesForm 990, Part III, line 3Mt. Ascutney Hospital and Health Center (MAHHC) ceased operations of its nursing home facility on August 30, 2013.
Form 990, Part VI, Section B, line 11The Form 990 is reviewed and approved by the Finance Committee of the Board. The Board receives a copy of the final version and it is discussed at the Board meeting.
Form 990, Part VI, Section B, line 12cThe Finance and Audit Committees monitor and report to the Board of Directors.
Form 990, Part VI, Section B, line 15The 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 19All internal policies, governing documents, and financial statements are made available upon request
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 9:Unrealized Gain on Interest Rate Swap 239,289. Equity in Income of Subsidiaries 178,347. Change in Funded Status of Pension Plan 3,908,372. Unrealized Appreciation in Charitable Remainder Trust 15,752. Unrealized Appreciation in Beneficial Interest in Perpetual Trusts 63,515.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Historic Homes of Runnemede
40 Maxwell Perkins LaneWindsorVT050891206237396147Providing Services for the AgingVT501(c)(3)Line 9Windsor Hospital Corporation1
Mount Ascutney Hospital Community Health Foundation Inc
289 County RoadWindsorVT05089030300481To provide healthcare services to the Windsor, Vermont communityVT501(c)(3)Line 3Windsor Hospital Corporation1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg