2012-08-14T16:25:06-05:00 2011-09-30 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2010-10-01 030219309 Fletcher Allen Health Care Inc FLET 8028475959 111 COLCHESTER AVENUE BURLINGTON VT 05401 ROGER DESHAIES 2012-08-14 true PRICEWATERHOUSECOOPERS LLP 6175305000 2010 2016-02-24 21:20:13Z Dr JOHN BRUMSTED 111 COLCHESTER AVENUE BURLINGTON VT 05401 1020385332 false X WWW.FLETCHERALLEN.ORG X 1968 VT To improve the health of the people in the community we serve by integrating patient care, education, and research in a caring environment. 18 15 7313 800 6813835 -606428 2405435 5440698 884774454 885142635 21483821 12647774 734525 299277 909398235 903530384 697171 693371 0 0 529311302 542397400 0 0 1363960 331060388 319909322 861068861 863000093 48329374 40530291 969633570 1010076116 591040326 585995130 378593244 424080986 X SEE SCHEDULE O false false 198970516 189268 241643939 INPATIENT SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O. 303630466 336830 368750422 OUTPATIENT SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O. 226228748 167273 274748274 PROFESSIONAL SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O. 728829730 true true false true false false false false true true false false false true true false true false false true false false false true false true true true true true true false false false false false false false false true true false false false false true true true true false false true 579 0 true 7313 true true true true BD false false false true true false false false false X 18 15 true false false false false false false true true false false true true true true true true true true true true X ROGER DESHAIES 8028475959 111 COLCHESTER AVENUE BURLINGTON VT 05401 X DR MELINDA ESTES 50.0 X X 1787329 0 45570 DR JOHN BRUMSTED 50.0 X X 749031 0 52223 MARC MONHEIMER 2.0 X X 0 0 0 DR RUTH UPHOLD 2.0 X 0 0 0 ROGER STONE 2.0 X X 0 0 0 DR JAN CARNEY 2.0 X X 0 0 0 SARAH CARPENTER 2.0 X 0 0 0 DR PAUL DANIELSON 2.0 X 0 0 0 ELIZABETH DAVIS 2.0 X 0 0 0 A DONALD GILBERT 2.0 X 0 0 0 RITA MARKLEY 2.0 X 0 0 0 STEPHEN MARSH 2.0 X 0 0 0 DR PHILIP MEAD 2.0 X 0 0 0 DR FREDERICK C MORIN III 2.0 X 0 0 0 JOHN NEUHAUSER PHD 2.0 X 0 0 0 JOHN POWELL 2.0 X 0 0 0 PATRICIA PRELOCK 2.0 X 0 0 0 GEOFFREY SHIELDS 2.0 X 0 0 0 RUSSELL TRACY 2.0 X 0 0 0 GRETCHEN MORSE 2.0 X 0 0 0 TIMOTHY DAVIS 2.0 X 0 0 0 ROGER DESHAIES 50.0 X 766885 0 44197 DR PAUL TAHERI 50.0 X 743531 0 43170 SANDRA FELIS RN 50.0 X 617077 0 33589 DR KRISTEN DESTIGTER 50.0 X 635609 0 40426 DR BELA RATKOVITS 50.0 X 585161 0 39433 DR GRANT LINNELL 50.0 X 583299 0 40108 SPENCER KNAPP 50.0 X 668226 0 11237 DR HEATHER BURBANK 50.0 X 609531 0 28400 7745679 0 378353 426 false true false PIZZAGALLI CONSTRUCTION CO INC 193 TILLEY DRIVE SOUTH BURLINGTON VT 05403 CONSTRUCT OVERSIGHT 5923331 CSC CONSULTING INC SIX COLISEUM DR 2815 COLISEUM CTR CHARLOTTE NC 28217 IT CONSULTING 2907485 MEDIQUE USA 5900 AVENUE ANDOVER VILLE MONT-ROYAL QUEBEC CA H4T 1H5 LAUNDRY SERVICE 2214266 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 55480 LABORATORY 2206453 BEACON PARTNERS INC 97 LIBBEY PARKWAY SUITE 130 WEYMOUTH MA 02189 EMR CONSULTING 1436367 106 337082 530285 4573331 8378 5440698 PATIENT SERVICES 900099 854272846 848831936 5440910 PATIENT SERVICES - PHARMACY 446110 14586249 13213324 1372925 PREMIUM REVENUE 900099 4338040 4338040 CAFETERIA 722210 4754153 4754153 MEANINGFUL USE PRGRM 900099 1674273 1674273 5517074 5517074 885142635 9796711 9796711 0 0 697124 370500 326624 326624 326624 115667000 3603756 112524576 3895117 3142424 -291361 2851063 2851063 37408 337082 64755 -27347 -27347 0 0 0 903530384 878328800 6813835 12947051 590996 590996 102375 102375 0 0 4905224 4905224 446484 446484 423627508 373914145 49065159 648204 30167528 27640605 2496494 30429 55361451 46975506 8241859 144086 27889205 25190452 2668337 30416 0 1419620 1419620 655839 3543 652296 0 0 0 28100222 19781398 8101489 217335 1361158 1361158 134334531 131902936 2359963 71632 11237403 5391286 5846117 0 19465900 18292318 1120837 52745 2560779 1289422 1271357 0 3609279 2729466 879813 20232844 10563568 9638927 30349 0 45499826 23823638 21607976 68212 15190858 13955700 1221110 14048 CONTRACT MAINTENANCE 10045158 7936068 2099820 9270 ACADEMIC SUPPORT 9349990 4909055 4440935 LEASED EQUIPMENT 4569208 4270060 298553 595 NON-CONTRACT MAINTENANCE 2210957 1579295 629586 2076 PARKING 1507076 1305079 200031 1966 8558674 4875177 3640900 42597 863000093 728829730 132806403 1363960 -450893 3058397 70760404 94941347 1130861 1161622 102718868 114042371 7580114 7528440 16882505 17844832 41728777 37524481 771910320 358143701 430817506 413766619 257396126 276203777 30414393 33434488 10654909 10569742 969633570 1010076116 106796309 111446759 8329651 7690821 408185204 400431001 1454485 429140 66274677 65997409 591040326 585995130 X 338704939 382464230 14937698 16625791 24950607 24990965 378593244 424080986 969633570 1010076116 X 40530291 4957451 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 44684 false true 95849 140533 false LOBBYING ACTIVITY SCHEDULE C, PART II-B FLETCHER ALLEN REGULARLY MONITORS THE WORK OF THE VERMONT STATE LEGISLATURE TO IDENTIFY ISSUES THAT DIRECTLY AFFECT THE ORGANIZATION AND PERIODICALLY WORKS DIRECTLY WITH STATE LEGISLATORS TO ADVOCATE ON PARTICULAR ISSUES. STAFF EXPENDITURES ASSOCIATED WITH THESE ACTIVITIES ARE REPORTED TO THE STATE THREE TIMES A YEAR AS REQUIRED BY VERMONT LOBBYIST DISCLOSURE LAWS. STAFF ALSO WORK DIRECTLY WITH OUR CONGRESSIONAL DELEGATION (TWO SENATORS AND ONE REPRESENTATIVE) ON SPECIFIC PIECES OF LEGISLATION THAT IMPACT THE ORGANIZATION. THESE EXPENSES ARE REPORTED ON LINE G. THE ORGANIZATION ALSO BELONGS TO MEMBER ORGANIZATIONS (INCLUDING THE AMERICAN HOSPITAL ASSOCIATION, THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES, NATIONAL ASSOCIATION OF CHILDREN'S HOPSITALS, AND THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS) THAT IN TURN HAVE LOBBYING EXPENSES. THE PORTION OF DUES ASSOCIATED WITH THOSE ACTIVITIES IS REPORTED ON LINE I. 24040705 117726 903730 0 332465 0 24729696 22798137 81914 1255349 0 94695 0 24040705 22578923 142738 805381 4784 724121 0 22798137 0.00000 0.65000 0.35000 false false 8015949 8015949 488676800 177322619 311354181 37895235 26510976 11384259 221068983 146191939 74877044 16253353 8118167 8135186 413766619 0 ESTIMATED 3RD PARTY SETTLEMENT 17282420 SWAP LIABILITY 13075462 DUE TO VMCIC 649959 PENSION OBLIGATION 31614836 ASSET RETIREMENT OBLIGATION 1055248 LT FICA TAX PAYABLE 2319484 65997409 ENDOWMENT FUNDS SCHEDULE D, PART V, QUESTION 4 The funds, and all net earnings in addition thereto, are held to benefit charity, education, research and children's programs. Schedule D, Part X, FIN 48 FOR TAX YEARS BEGINNING AFTER DECEMBER 15, 2008, NONPUBLIC COMPANIES ADOPTED GUIDANCE UNDER ASC 740, INCOME TAXES, THAT PRESCRIBE A MODEL FOR THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX BENEFITS. THIS GUIDANCE DID NOT HAVE AN IMPACT ON FLETCHER ALLEN HEALTH CARE AND ITS SUBSIDIARIES. Central America and the Caribbean 0 0 Program Services SELF-INSURANCE 9431879 Central America and the Caribbean 0 0 Investments 22651491 0 0 0 0 32083370 32083370 true false true false false false BIG CHNG RND-UP 204436 204436 21204 GOLF TOURNAMENT 106532 74584 31948 2700 15680 7261 3235 2 63522 58062 5460 480 14195 374490 337082 37408 2700 15680 7741 38634 64755 -27347 SCHEDULE G, PART II, LINE 9 THE NET INCOME AMOUNT FROM FUNDRAISING EVENTS IS NET OF CHARITABLE CONTRIBUTIONS. true true X true X true X true true true false true true 7112223 7112223 0.00820 35634 180275737 100185171 80090567 0.09280 1122 2133723 1351068 782655 0.00090 36756 189521683 101536239 87985445 0.10190 2654014 2654014 0.00310 65864430 8611994 57252436 0.06630 20068481 14123222 5945259 0.00690 596020 394726 201294 0.00020 1069376 1069376 0.00120 90252321 23129942 67122379 0.07770 36756 279774004 124666181 155107824 0.17960 true 8710688 395879 199210017 213509006 -14298989 X true true 1 1 FLETCHER ALLEN HEALTH CARE INC

111 COLCHESTER AVE BURLINGTON VT 05401

X X X X X X FLETCHER ALLEN HEALTH CARE INC 1 6 CHITTENDEN COUNTY DIALYSIS CENTER

35 JOY DRIVE SOUTH BURLINGTON VT 05403

DIALYSIS RUTLAND DIALYSIS

160 ALLEN STREET RUTLAND VT 05701

DIALYSIS BERLIN DIALYSIS

130 FISHER ROAD BERLIN VT 05602

DIALYSIS UROLOGY - ST ALBANS DIALYSIS - STE 7&8

6 CREST ROAD ST ALBANS VT 05478

MEDICAL OFFICE MCHV DIALYSIS CENTER

111 COLCHESTER AVE BROWN 2 BURLINGTON VT 05401

DIALYSIS NORTH COUNTRY DIALYSIS

189 PROUTY DR NEWPORT VT 05855

DIALYSIS SCHEDULE H, PART I, LINE 7G: FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2011 FLETCHER ALLEN HEALTH CARE INCLUDED PHYSICIAN CLINIC EXPENSES IN SUBSIDIZED HEALTH SERVICES. FLETCHER ALLEN HEALTH CARE PHYSICIANS INCURRED $1,976,132 OF COSTS ASSOCIATED WITH PROVIDING PSYCHIATRY SERVICES. SCHEDULE H, PART I, LINE 7, COLUMN (F): THE PROVISION FOR BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSE OF CALCULATING THE AMOUNT REPORTED ON LINE 7(F) IS $0. ALL BAD DEBT IS SHOWN AS A DEDUCTION FROM PATIENT REVENUE. SCHEDULE H, PART I, LINE 7: FLETCHER ALLEN UTILIZED THE ALLIANCE FOR DECISION SUPPORT COST ACCOUNTING SYSTEM TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE ON LINE 7. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS, INCLUDING, BUT NOT LIMITED TO, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED AND SELF PAY. THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS ALSO UTILIZED FOR SOME OF THE FIGURES REPORTED IN THE TABLE ON LINE 7. APPROXIMATELY $48M OF OUR MEDICAID EXPENSE IS FLETCHER ALLEN HEALTH CARE'S ANNUAL MEDICAID PROVIDER TAX, ASSESSED ON VERMONT ACUTE CARE HOSPITALS BY THE STATE OF VERMONT. THE TAX ASSESSMENT IS CALCULATED AS 5.5% OF A HOSPITAL'S BASE YEAR NET PATIENT CARE REVENUE. SCHEDULE H, PART II: COMMUNITY BUILDING ACTIVITES: THE $372 REPORTED IN PART II OF SCHEDULE H REFLECTS 15 HOURS OF STAFF TIME SPENT ON COMMUNITY-BASED COALITIONS, ADVISORY GROUPS AND COMMITTEES. SCHEDULE H, PART III, LINE 4: FLETCHER ALLEN DETERMINED THE AMOUNT REPORTED IN PART III, LINE 2 BY UTILIZING WORKSHEET A AND MULTIPLYING THE TOTAL BAD DEBT WRITE-OFFS ATTRIBUTABLE TO PATIENT ACCOUNTS BY THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE NETTED AGAINST THE TOTAL GROSS CHARGES WHEN DETERMINING BAD DEBT EXPENSE. THE $395,879 REFLECTS THE ADJUSTED BAD DEBT EXPENSE FOR ALL PATIENTS WHO SUBMITTED AN INITIAL APPLICATION, HOWEVER, UPON FOLLOW-UP DID NOT RESPOND TO REQUESTS FOR ADDITIONAL INFORMATION OR SUPPORTING DOCUMENTATION. FAHC HAS A DATABASE WHICH TRACKS ALL APPLICATIONS AND THEIR STATUS; A QUERY EXTRACTED ALL INCOMPLETE/NON RESPONSIVE ARCHIVED APPLICATIONS PROVIDING A LIST OF PATIENTS & DEPENDENTS. SUBSEQUENTLY, A QUERY OF ASSOCIATED PATIENT SERVICES FROM 10/1/10 - 9/30/11 FOR "SELF PAY" AND COLLECTION ACCOUNTS WAS EXTRACTED FROM THE BILLING SYSTEM. THE COLLECTION DOLLARS WERE THEN ADJUSTED BY THE COST TO CHARGE RATIO. FLETCHER ALLEN HEALTH CARE'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. RECEIVABLES ARE REPORTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE PROVISION FOR BAD DEBTS IS REPORTED AS A DEDUCTION FROM GROSS REVENUE. THIS EXPENSE IS DETERMINED AS A PERCENTAGE OF GROSS PATIENT SERVICE REVENUE BASED ON ACTUAL WRITE-OFF HISTORY, REVIEWED ON A QUARTERLY BASIS AND ADJUSTED ON A SEMI-ANNUAL BASIS. SCHEDULE H, PART III, LINE 8: THE AMOUNT REPORTED IN PART III, LINE 6, MEDICARE ALLOWABLE COSTS OF CARE, IS DERIVED FROM FLETCHER ALLEN HEALTH CARE'S FYE 9/30/11 MEDICARE COST REPORT, WORKSHEET D-1, COMPUTATION OF INPATIENT OPERATING COSTS; WORKSHEET E PART B, CALCULATION OF OUTPATIENT SETTLEMENT; AND WORKSHEET I-4, COMPUTATION OF AVERAGE COST PER TREATMENT FOR OUTPATIENT RENAL DIALYSIS. WHILE FLETCHER ALLEN HAS HISTORICALLY FOLLOWED THE CATHOLIC HOSPITAL ASSOCIATION'S GUIDANCE AND NOT CONSIDERED ANY MEDICARE SHORTFALL (REPORTED IN PART III, LINE 7) AS A COMMUNITY BENEFIT, IT IS LIKELY THAT SOME PORTION OF MEDICARE PATIENTS WOULD HAVE QUALIFIED FOR CHARITY CARE UNDER OUR POLICIES IN THE ABSENCE OF MEDICARE COVERAGE, SUCH THAT SHORTFALLS ASSOCIATED WITH THOSE PATIENTS WOULD OTHERWISE HAVE BEEN INCLUDED IN OUR COMMUNITY BENEFITS. SCHEDULE H, PART III, LINE 9B: PURSUANT TO THE SELF-PAY COLLECTION PROCESS POLICY: SHOULD A PATIENT EXPRESS FINANCIAL HARDSHIP AND/OR IF THE PATIENT'S ACCOUNT BALANCE WOULD LIKELY QUALIFY FOR CATASTROPHIC ASSISTANCE, THE CUSTOMER SERVICE ACCOUNT RESOLUTION REPRESENTATIVE WILL PROVIDE PATIENTS WITH INFORMATION REGARDING THE FAHC PATIENT ASSISTANCE PROGRAM. PATIENTS EXPRESSING INTEREST IN THE PROGRAM WILL BE DIRECTED TO THE FAHC WEBSITE FOR A DOWNLOADABLE APPLICATION OR AN APPLICATION WILL BE SENT VIA THE US MAIL. IN ADDITION, HIGH DOLLAR ACCOUNTS ARE MONITORED WEEKLY AND SCREENED FOR POSSIBLE PATIENT ASSISTANCE. WHEN DIRECT CONTACT VIA THE PHONE CANNOT BE ESTABLISHED, THOSE ACCOUNTS WHERE BALANCES ARE HIGH, HAVE INTERMITTENT PAYMENT OR EMPLOYMENT HISTORY ARE FLAGGED AS POTENTIAL CATASTROPHIC QUALIFIERS. THESE PATIENTS WILL BE SENT AN APPLICATION VIA CERTIFIED MAIL, INVITING THEM TO APPLY FOR ASSISTANCE. SCHEDULE H, PART V: IN ADDITION TO THE FACILITIES OPERATED BY FLETCHER ALLEN HEALTH CARE (FAHC) LISTED IN SECTION A AND SECTION C, FAHC OPERATES 28 ADDITIONAL CLINIC SITES AROUND ITS SERVICE AREA. EACH OF THESE SITES IS COVERED UNDER THE FAHC HOSPITAL LICENSES. ALL LISTED OR NON-LISTED FACILITIES OPERATED BY FAHC OR ITS SUBSIDIARIES FOLLOW ALL OF THE SAME POLICIES AND PROCEDURES AS THE FAHC HOSPITAL. SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENT: FLETCHER ALLEN HAS A LONG HISTORY OF CONDUCTING NEEDS ASSESSMENTS TO GAUGE THE HEALTH CARE AND RELATED NEEDS OF THE COMMUNITIES, INCLUDING THE CREATION OF A CHARTERED COMMUNITY BENEFIT COMMITTEE IN OCTOBER, 2011 HALF OF WHOM ARE COMMUNITY MEMBERS. (THE COMMITTEE IS THE SUCCESSOR TO THE SEVERAL YEARS' OLD COMMUNITY BENEFIT ADVISORY GROUP COMPRISED EXCLUSIVELY OF FLETCHER ALLEN STAFF) THE COMMITTEE INCLUDES SIX MEMBERS FROM ACROSS THE ORGANIZATION, SIX MEMBERS FROM THE COMMUNITY-BASED VERMONT HEALTH FOUNDATION, AND IS CHAIRED BY FLETCHER ALLEN'S CHIEF MEDICAL OFFICERS. FLETCHER ALLEN IS IN MIDST OF A COMMUNITY HEALTH NEEDS ASSESSMENT. IT COMPLETED INFORMATION GATHERING (EMPIRICAL DATA AUGMENTED BY KEY LEADER INTERVIEWS, FOCUS GROUPS AND AN ELECTRONIC/PAPER-BASED SURVEY) IN APRIL, 2012. THE COMMITTEE WILL REVIEW THE SURVEY RESULTS AND OTHER RELEVANT INFORMATION IN EARLY SUMMER AND WILL USE THIS PLUS INFORMATION FROM OUR CLINICIANS AND PLANNERS TO PLAN FOR DETERMINING WHICH COMMUNITY-BASED EFFORTS TO SUPPORT IN THE NEXT FISCAL YEAR. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FLETCHER ALLEN UTILIZES A VARIETY OF METHODS TO INFORM, EDUCATE AND ASSIST PATIENTS IN IDENTIFYING PAYMENT SOURCES, INCLUDING STATE / FEDERAL PROGRAMS AS WELL AS OUR PATIENT ASSISTANCE PROGRAM. EDUCATE & INFORM: -THE FAHC PATIENT ASSISTANCE (CHARITY) PROGRAM IS REFERENCED ON THE FAHC PUBLIC WEBSITE, ALONG WITH GUIDELINES, CRITERIA, FREQUENTLY ASKED QUESTIONS AND A DOWNLOADABLE APPLICATION. ALL PATIENTS ARE INVITED TO APPLY. PATIENTS WHO WOULD NOT NORMALLY QUALIFY MAY BE CONSIDERED DUE TO SPECIAL CIRCUMSTANCES. -OUR PATIENT ASSISTANCE PROGRAM IS REFERENCED ON ALL OF OUR FAHC PATIENT STATEMENTS, ALONG WITH TELEPHONE NUMBERS FOR ASSISTANCE IN THE APPLICATION PROCESS. -PAMPHLETS REGARDING OUR HEALTH ASSISTANCE PROGRAMS ARE AVAILABLE IN THE PUBLIC WAITING ROOMS AND REGISTRATION OFFICE WITH FOLLOW-UP DIRECTIONS TO OUR COMMUNITY OUTREACH CASE MANAGERS AND COORDINATORS. -VERBAL COMMUNICATION REGARDING THE PROGRAMS IS PROVIDED TO PATIENTS DURING THE PRE-REGISTRATION PROCESS IF UNINSURED OR IF INSURED PATIENTS EXPRESS HARDSHIP, AT THE POINT OF ARRIVAL AND AT THE POINT OF DISCHARGE IN THE EMERGENCY DEPARTMENT. APPLICATIONS FOR BOTH MEDICAID AND CHARITY ARE AVAILABLE TO EACH REGISTRAR AND ARE ROUTINELY PROVIDED TO PATIENTS DURING THE INTERVIEW AND/OR PATIENTS ARE DIRECTED TO OUR PATIENT FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES FOR APPLICATION ASSISTANCE. -WITHIN THE PHYSICIAN CLINICS, APPLICATIONS ARE AVAILABLE FOR PATIENTS AND FOLLOW-UP REFERRALS ARE PROVIDED DIRECTLY TO THE CUSTOMER SERVICE DEPARTMENT. -PATIENT CALLS TO THE CUSTOMER SERVICE CENTER REGARDING BILLS, PAYMENTS, BUDGET PLANS, ETC. WILL INCLUDE EDUCATION AND, WHEN NECESSARY, COUNSELING FOR PATIENTS REGARDING BOTH THE STATE AND FEDERAL OPTIONS AS WELL AS THE FAHC CHARITY PROGRAM. APPLICATIONS FOR ASSISTANCE WITH ALL PROGRAMS ARE MAILED TO PATIENTS UPON REQUEST. APPLICATION ASSISTANCE: -ALL INPATIENTS AND OUTPATIENT PROCEDURES ARE FINANCIALLY SCREENED TO IDENTIFY THE UNDERINSURED OR UNINSURED PATIENT POPULATION. PRIOR TO SERVICE, CONCURRENT WITH SERVICE AND POST SERVICE, OUR PATIENT FINANCIAL COUNSELORS WILL CALL AND/OR MEET WITH PATIENTS AND FAMILIES TO EDUCATE THEM ON THE AVAILABLE PROGRAMS AND WHERE APPLICABLE, ASSIST IN THE APPLICATION PROCESS. THIS INCLUDES THE STATE AND FEDERAL AID APPLICATIONS AND THE FAHC CHARITY APPLICATION PROCESS. -OUR COUNSELORS WILL ADDITIONALLY MEET WITH PATIENTS AT THE BEDSIDE TO HELP COMPLETE THE APPLICATIONS, PROVIDE DETAILS ON SUPPORTING DOCUMENTATION NEEDS & FACILITATE AND EXPEDITE THE REVIEW PROCESS UNTIL A NOTICE OF DECISION HAS BEEN RECEIVED. -OUR COMMUNITY HEALTH IMPROVEMENT OFFICE PROVIDES EDUCATION AND APPLICATION ASSISTANCE FOR A VARIETY OF PROGRAMS, INCLUDING THE STATE AND FEDERAL MEDICAID APPLICATION PROCESS, THE PATIENT ASSISTANCE PROGRAM APPLICATION (CHARITY) AS WELL AS ASSIST WITH FINANCIAL ASSISTANCE TO PHARMACEUTICAL COMPANIES. PROCESSES HAVE BEEN ESTABLISHED TO REFER URGENT CARE AND EMERGENCY DEPARTMENT PATIENTS TO THE PROGRAM, WHERE CASE MANAGERS ASSIST IN BOTH THE APPLICATION PROCESS AND COMMUNITY RESOURCE NEEDS IDENTIFICATION. AS A SAFETY NET, THE CASE MANAGERS WILL ALSO RECEIVE REPORTS FOR THE UNINSURED EMERGENCY PATIENTS WHO HAVE FREQUENTED THE EMERGENCY DEPARTMENT MORE THAN 1 TIME PER MONTH. THE MANAGERS WILL THEN REACH OUT TO THE PATIENTS, SEEKING TO ASSIST PATIENTS IN IDENTIFYING FINANCIAL SPONSORSHIP. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION: FLETCHER ALLEN HEALTH CARE IS BOTH A COMMUNITY HOSPITAL AND, IN PARTNERSHIP WITH THE UNIVERSITY OF VERMONT, THE STATE'S ACADEMIC MEDICAL CENTER. IN ITS COMMUNITY HOSPITAL ROLE, FLETCHER ALLEN SERVES APPROXIMATELY 150,000 RESIDENTS IN CHITTENDEN AND GRAND ISLE COUNTIES AND PROVIDES PRIMARY CARE SERVICES AT TWELVE VERMONT SITES. THE ORGANIZATION ALSO OFFERS FREE TO THE COMMUNITY A WIDE RANGE OF HEALTH, PREVENTION AND WELLNESS PROGRAMS, ALL OF WHICH HELP TO LIMIT THE NEED FOR MORE EXPENSIVE ACUTE CARE. AS A REGIONAL REFERRAL CENTER, FLETCHER ALLEN PROVIDES ADVANCED-LEVEL CARE TO A POPULATION OF ONE MILLION PEOPLE THROUGHOUT VERMONT AND NORTHERN NEW YORK. THE MEDICAL CENTER EXTENDS BEYOND ITS FOUR MAIN CAMPUSES IN THE BURLINGTON AREA TO INCLUDE MORE THAN 30 PATIENT CARE SITES AND 100 OUTREACH CLINICS, PROGRAMS AND SERVICES THROUGHOUT THE REGION. SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: FLETCHER ALLEN IS GOVERNED BY A BOARD OF COMMUNITY VOLUNTEERS FROM OUR SERVICE AREA, INCLUDING OUR PRIMARY, SECONDARY AND TERTIARY REFERRAL REGION. THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT AND NOT DIRECTLY AFFILIATED WITH THE ORGANIZATION. FLETCHER ALLEN'S MEDICAL STAFF IS AN "OPEN STAFF" MODEL WITH MEMBERSHIP GOVERNED BY THE MEDICAL STAFF'S BY-LAWS, AND INCLUDES APPROXIMATELY 550 EMPLOYED PHYSICIANS AND 220 COMMUNITY-BASED PHYSICIANS. AS A NON-PROFIT, ANY SURPLUS FUNDS GENERATED BY FLETCHER ALLEN ARE RE-INVESTED IN OUR ORGANIZATION TO SUPPORT OUR MISSION. PLEASE SEE SCHEDULE O FOR A MORE DETAILED DESCRIPTION OF FLETCHER ALLEN'S ROLE IN OUR REGIONAL HEALTH CARE SYSTEM AND OUR COMMUNITY BENEFIT ACTIVITIES. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: COLLABORATIVE EFFORTS - FLETCHER ALLEN REGULARLY PARTNERS WITH OTHER ORGANIZATIONS AND PROVIDERS TO HELP MEET THE NEEDS OF OUR COMMUNITY. THIS INCLUDES WORKING WITH OTHER ORGANIZED SYSTEMS OF CARE (LIKE HOME HEALTH AGENCIES, OTHER VERMONT HOSPITALS, AND PHYSICIAN PRACTICES), AS WELL AS COMMUNITY-BASED ORGANIZATIONS WHOSE MISSIONS ARE SIMILAR TO OURS. FOR EXAMPLE, FLETCHER ALLEN COLLABORATES WITH COMMUNITY PARTNERS TO REGULARLY ASSESS COMMUNITY AND HEALTH CARE NEEDS, WHICH HELPS GUIDE OUR ORGANIZATION'S PRIORITIES. PLEASE READ FORM 990 PART III NARRATIVE IN SCHEDULE O FOR ADDITIONAL INFORMATION ON FLETCHER ALLEN HEALTH CARE'S INTERACTIONS IN AND WITH ITS COMMUNITY. true Champlain Initiative CO United Way of Chit 412 Farrell St S Burlington VT 05403 030217229 501(C)(3) 40000 COMMUNITY HLTH IMPRO Community Health Center of Burlington 617 Riverside Ave Burlington VT 05401 237182584 115 167996 COMMUNITY HLTH IMPRO Burlington School District's Dental Health 150 Colchester Ave Burlington VT 05401 036000410 501(C)(3) 15000 COMMUNITY HLTH IMPRO Diabetes Exercise Program - Burlington YMCA 266 College Street Burlington VT 05401 030185810 501(C)(3) 6000 COMMUNITY HLTH IMPRO United Way of Chittenden County 412 Farrell St Suite 200 S Burlington VT 05403 030217229 501(C)(3) 30000 COMMUNITY HLTH IMPRO Vermont Health Foundation 199 Main Street Suite 150 Burlington VT 05401 030289111 501(C)(3) 23900 COMMUNITY HLTH IMPRO Vermont Ethics Network 65 Main Street Room 25 Montpelier VT 056202951 030336174 501(c)(3) 6600 COMMUNITY HLTH IMPROV Downtown Street Outreach - HowardCenter Inc 300 Flynn Avenue Burlington VT 05401 030179433 501(c)(3) 35000 COMMUNITY HLTH IMPRO Northeastern Vermont Area Health Education Center 347 Emerson Falls Rd St Johnsbury VT 05819 043366707 501(c)(3) 65000 community hlth impro Champlain Valley Area Health Education Ctr 92 Fairfield St St Albans VT 05478 030357255 501(c)(3) 65000 community hlth impro Southern Vermont Area Health Education Ctr 365 Summer Street Springfield VT 05156 030360193 501(c)(3) 65000 community hlth impro University of Vermont College of Medicine 1 South Prospect St Burlington VT 05401 030179440 501(c)(3) 65000 community hlth impro AMERICAN HEART ASSOCIATION 434 HURRICANE LANE WILLISTON VT 05495 135613797 501(C)(3) 15000 GO RED EVENT AMERICAN RED CROSS 29 MANSFIELD AVENUE BURLINGTON VT 05401 530196605 501(C)(3) 47864 DISASTER RELIEF United Way of Chittenden County 412 FARRELL ST BURLINGTON VT 05403 030217229 501(C)(3) 89298 DISASTER RELIEF 14 0 Nursing Scholarships 23 79750 Allied Health Scholarships 5 18125 ENDOWMENT SCHOLARSHIPS 6 4500 SCHOLARSHIP MONITORING SCHEDULE I, PART I, QUESTION 2 THE ORGANIZATION BELIEVES STRICT APPLICATION AND APPROVAL CRITERIA FOR SCHOLARSHIP RECIPIENTS HELPS MAINTAIN THE INTEGRITY OF EACH RESPECTIVE AWARD. NURSING SCHOLARSHIPS: NURSING SCHOOL ASSISTANCE IS AWARDED TO APPLICANTS IN ORDER FOR THEM TO OBTAIN A DEGREE IN NURSING. FOR THE APPLICANT TO QUALIFY FOR THE SCHOLARSHIP, HE/SHE MUST AGREE THAT THEY WILL USE IT TO HELP FURTHER FLETCHER ALLEN HEALTH CARE'S CHARITABLE STATUS. THIS IS DONE BY HAVING THE APPLICANT COMMIT TO TWO YEARS OF SERVICE AT THE ORGANIZATION AFTER SUCCESSFUL COMPLETION OF THE DEGREE PROGRAM. IN ADDITION, A WRITTEN PROPOSAL STATING HOW ATTAINMENT OF THE DEGREE WILL BENEFIT NURSING AT THE ORGANIZATION IS REQUIRED. ALLIED HEALTH SCHOLARSHIPS: ALLIED HEALTH SCHOLARSHIPS ARE AWARDED TO SUPPORT THE CAREER DEVELOPMENT OF FLETCHER ALLEN HEALTH CARE (FAHC) EMPLOYEES IN POSITION CATEGORIES WHERE CURRENT AND PROJECTED SHORTAGES EXIST. FOR THE APPLICANT TO QUALIFY FOR THE SCHOLARSHIP, HE OR SHE MUST BE AN EMPLOYEE OF FAHC FOR ONE YEAR OR MORE, COMPLETE AN APPLICATION AND WRITTEN ESSAY, HAVE A HISTORY OF SOLID JOB PERFORMANCE, BE ACCEPTED INTO AN APPROVED ACADEMIC PROGRAM, AND PROVIDE TWO LETTERS OF RECOMMENDATION. ONCE THE SCHOLARSHIP IS AWARDED, RECIPIENTS MUST SIGN AN AGREEMENT TO WORK FOR FAHC FOR A MINIMUM OF THREE YEARS UPON GRADUATION, TAKE A MINIMUM OF SIX CREDIT HOURS EACH SEMESTER, MAINTAIN HIGH GRADES, AND WORK A MINIMUM OF 20 HOURS PER WEEK. SCHOLARSHIPS FROM THE NURSING EDUCATION ENDOWMENT FUND AND THE MARY FLETCHER HOSPITAL SCHOOL OF NURSING ALUMNI FUND: ASSISTANCE FROM THE NURSING EDUCATION ENDOWMENT FUND IS AWARDED TO ELIGIBLE APPLICANTS GOING INTO THE NURSING FIELD. APPLICANTS MUST BE EMPLOYED AT LEAST TWO YEARS AT FAHC, WORK AT LEAST 40 HOURS PER PAY PERIOD, ENROLLED IN A NURSING CERTIFICATE, DEGREE OR DOCTORATE PROGRAM, AND CURRENT EMPLOYEES IN GOOD STANDING WITH NO CURRENT DISCIPLINARY ACTION ON THEIR FILE. DECISION TO APPROVE FUNDING IS BASED ON THE APPLICANT'S COMPLETED APPLICATION FORM, TWO LETTERS OF RECOMMENDATION, AND COMMITMENT TO TWO YEARS OF SERVICE AT FAHC AFTER SUCCESSFUL COMPLETION OF THE DEGREE. ASSISTANCE FROM THE MARY FLETCHER HOSPITAL SCHOOL OF NURSING ALUMNI FUND IS ALSO AWARDED TO ELIGIBLE APPLICANTS GOING INTO THE NURSING FIELD. APPLICANTS MUST BE ENROLLED IN EITHER A FORMAL OR CONTINUING EDUCATION PROGRAM RELATED TO SOME ASPECT OF HEALTH CARE (FOR EXAMPLE, HOLISTIC NURSING, CHILD-BIRTH EDUCATION, CHEMICAL DEPENDENCY, NURSE PRACTITIONER). IN ADDITION, APPLICANTS MUST MEET THE FOLLOWING REQUIREMENTS: BE EMPLOYED BY FLETCHER ALLEN HEALTH CARE FOR AT LEAST ONE YEAR, AND PROVIDE A COMPLETED APPLICATION FORM, RESUME, WRITTEN ESSAY AND TWO LETTERS OF RECOMMENDATION. X false true X X X X false false false false false false false true false DR MELINDA ESTES 839291 0 738220 0 209818 0 22050 0 23520 0 1832899 0 0 0 ROGER DESHAIES 436568 0 257786 0 72531 0 22050 0 22147 0 811082 0 0 0 DR PAUL TAHERI 370163 0 301748 0 71620 0 17150 0 26020 0 786701 0 0 0 SANDRA FELIS RN 339932 0 219220 0 57925 0 22050 0 11539 0 650666 0 0 0 DR JOHN BRUMSTED 415144 0 270083 0 63804 0 28653 0 23570 0 801254 0 0 0 DR KRISTEN DESTIGTER 514283 0 0 0 121326 0 17150 0 23276 0 676035 0 0 0 DR BELA RATKOVITS 501937 0 0 0 83224 0 26808 0 12625 0 624594 0 0 0 DR GRANT LINNELL 525174 0 0 0 58125 0 17150 0 22958 0 623407 0 0 0 SPENCER KNAPP 348358 0 241248 0 78620 0 5967 0 5270 0 679463 0 0 0 DR HEATHER BURBANK 526773 0 0 0 82758 0 17150 0 11250 0 637931 0 0 0 PERSONAL SERVICE COMPENSATION SCHEDULE J, PART I, QUESTIONS 1A, 1B & 2 THE FOLLOWING INDIVIDUALS RECEIVED COMPENSATION OF $1,400 TO COVER TAX PREPARATION AND FINANCIAL ADVISORY SERVICES: DR. MELINDA ESTES ROGER DESHAIES DR. PAUL TAHERI SANDRA FELIS, R.N. DR. JOHN BRUMSTED SPENCER KNAPP WHILE THERE IS NO ORGANIZATION-WIDE WRITTEN POLICY REGARDING PAYMENT OF THE EXPENSE DESCRIBED ABOVE, THE AMOUNT IS INCLUDED IN THE RESPECTIVE INDIVIDUAL'S EMPLOYMENT CONTRACT WHICH IS DETERMINED THROUGH ANNUAL REVIEW (AS DISCUSSED IN SCHEDULE O). PERSONAL SERVICE COMPENSATION IS A FLAT AMOUNT INCLUDED IN THE INDIVIDUAL'S RESPECTIVE W-2 AS TAXABLE INCOME. NO REIMBURSEMENT IS MADE UNDER AN ACCOUNTABLE PLAN; THEREFORE, SUBSTANTIATION OF EXPENSE IS UNNECESSARY. NON-FIXED PAYMENTS SCHEDULE J, PART I, QUESTION 7 FLETCHER ALLEN PAID A LUMP-SUM INCENTIVE AWARD TO UPPER MANAGEMENT (DIRECTORS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL SHORT-TERM INCENTIVE (STI) PLAN AS THE PLAN'S ORGANIZATIONAL PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL QUALITY, OPERATIONAL AND HUMAN RESOURCES RELATED METRICS. IN CALENDAR YEAR 2010, THE MONTHS OF JANUARY THROUGH SEPTEMBER FALL IN OUR FISCAL YEAR 2010, WHILE THE MONTHS OF OCTOBER THROUGH DECEMBER FALL IN OUR FISCAL YEAR 2011. IN FISCAL YEAR 2010, THE TWO FINANCIAL MEASURES FOR ORGANIZATIONAL PERFORMANCE WERE OPERATING MARGIN AND GROWTH FROM COORDINATED HEALTH SYSTEMS. EACH WAS WEIGHTED AT 20%. IN FISCAL YEAR 2011, THE TWO FINANCIAL MEASURES FOR ORGANIZATIONAL PERFORMANCE WERE OPERATING MARGIN AND COST PER ADJUSTED DISCHARGE. EACH WAS WEIGHTED AT 20%. FLETCHER ALLEN PAID A LUMP-SUM INCENTIVE AWARD TO SENIOR EXECUTIVES UNDER A LONG-TERM INCENTIVE (LTI) PLAN DURING CALENDAR YEAR 2010. THE LTI PLAN COVERED FISCAL YEARS 2008 TO 2010; ITS INTENT WAS TO FURTHER THE CHARITABLE MISSION OF FLETCHER ALLEN HEALTH CARE BY FOCUSING KEY EXECUTIVES ON MULTI-YEAR GOALS CONSIDERED CRITICAL TO FLETCHER ALLEN'S SUCCESS. ADDITIONALLY, THE PLAN WAS STRUCTURED TO HELP FLETCHER ALLEN HEALTH CARE RETAIN THESE KEY EXECUTIVES OVER THE LONG TERM BY PROVIDING MEANINGFUL INCENTIVES AND REWARDS FOR SUSTAINED SUCCESS OVER THE THREE YEAR PERIOD. SENIOR EXECUTIVES ELIGIBLE FOR THIS PLAN WERE NOMINATED BY THE PRESIDENT & CHIEF EXECUTIVE OFFICER (CEO) AND APPROVED BY THE COMPENSATION COMMITTEE OF FLETCHER ALLEN HEALTH CARE'S BOARD OF TRUSTEES. THE TEN MEASURES FOCUSED ON ACHIEVEMENTS AROUND FINANCE, ELECTRONIC HEALTH RECORD IMPLEMENTATION, AND QUALITY METRICS. VEHBFA SERIES 2008A & 2004B 237154467 924166CJ8 2008-05-21 215386067 REFUND BONDS ISSUED 04/15/2004 false false false VEHBFA SERIES 2007A 237154467 924166AQ4 2007-01-25 56375337 CONSTRUCT HEALTH CARE FACILITIES false false false VEHBFA SERIES 2004A 237154467 9241606Q2 2004-04-15 49543132 REFUND BONDS ISSUED 1993 false false false 8019772 215386067 15345234 1708089 198332744 2005 true false true true 158312 56375337 3091705 895983 52387649 2005 true true 12112781 49543132 4895142 451483 44196507 2005 true false true true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false true true CITIBANK 23.2 false false false false false false false false false false false false false false false SEE SCHEDULE O FOR SUPPLEMENTAL INFORMATION VERMONT GAS SYSTEMS SEE PART V 1967389 NATURAL GAS false DR HAROLD MORRIS III SPOUSE OF CEO ESTES 33145 WAGES false R ALLEN MEAD SON OF TRUSTEE MEAD 177779 WAGES false Maria McClellan SEE PART V 163013 WAGES false Maurine R Gilbert Daughter of TTEE Gilbert 72547 WAGES false VMC INDEMNITY COMPANY LTD SEE PART V 9431879 INSURANCE PREMIUMS false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV (1) RELATIONSHIP: DONALD GILBERT, TRUSTEE, IS THE PRESIDENT AND CEO OF VERMONT GAS SYSTEMS, WHICH IS THE ORGANIZATION'S NATURAL GAS PROVIDER. (4) RELATIONSHIP: MARIA MCCLELLAN IS THE SISTER-IN-LAW OF JOHN BRUMSTED, INTERIM PRESIDENT/CEO (6) RELATIONSHIP: ROGER DESHAIES, DR. MELINDA ESTES, SANDRA FELIS, R.N., DR. PAUL TAHERI, AND DR. JOHN BRUMSTED SERVE AS DIRECTORS OF VMC INDEMNITY COMPANY, FLETCHER ALLEN HEALTH CARE'S CAPTIVE INSURANCE COMPANY. NUMBER OF VOLUNTEERS FORM 990, PART I, QUESTION 6 THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF TRUSTEES. IN ADDITION, VOLUNTEERS WORK IN OVER 50 DEPARTMENTS TO SUPPORT THE WORK OF EMPLOYEES TO MEET PATIENT NEEDS AND ENHANCE THE PATIENT EXPERIENCE AT FLETCHER ALLEN. Community Benefit Report Form 990, PART III FLETCHER ALLEN HEALTH CARE IS BOTH A COMMUNITY HOSPITAL AND, IN PARTNERSHIP WITH THE UNIVERSITY OF VERMONT, THE STATE'S ACADEMIC MEDICAL CENTER. IT IS OUR MISSION TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE BY INTEGRATING PATIENT CARE, EDUCATION AND RESEARCH IN A CARING ENVIRONMENT. IN ITS COMMUNITY HOSPITAL ROLE, FLETCHER ALLEN SERVES APPROXIMATELY 150,000 RESIDENTS IN CHITTENDEN AND GRAND ISLE COUNTIES AND PROVIDES PRIMARY CARE SERVICES AT TEN VERMONT SITES. THE ORGANIZATION ALSO OFFERS FREE TO THE COMMUNITY A WIDE RANGE OF HEALTH, PREVENTION AND WELLNESS PROGRAMS, ALL OF WHICH HELP TO LIMIT THE NEED FOR MORE EXPENSIVE ACUTE CARE. THROUGH A VITAL PARTNERSHIP, FLETCHER ALLEN HEALTH CARE, THE UNIVERSITY OF VERMONT COLLEGE OF MEDICINE AND THE UNIVERSITY OF VERMONT COLLEGE OF NURSING AND HEALTH SCIENCES FORM VERMONT'S ACADEMIC MEDICAL CENTER - ONE OF ONLY APPROXIMATELY 130 SUCH CENTERS IN THE COUNTRY. TOGETHER, THESE INSTITUTIONS ARE COMMITTED TO HELPING IMPROVE OUR REGION'S QUALITY OF LIFE WITH INNOVATIONS IN MEDICINE AND HEALTH CARE THAT ARISE FROM NEW KNOWLEDGE AND DISCOVERY. THROUGH ITS ALLIANCE WITH THE UNIVERSITY OF VERMONT, FLETCHER ALLEN IS ABLE TO PROVIDE THE BEST PATIENT CARE POSSIBLE BY BRINGING MEDICAL EDUCATION AND RESEARCH TO THE BEDSIDE, THE DOCTOR'S OFFICE AND INTO THE COMMUNITY. AS A REGIONAL REFERRAL CENTER, FLETCHER ALLEN PROVIDES ADVANCED-LEVEL CARE TO A POPULATION OF ONE MILLION PEOPLE THROUGHOUT VERMONT AND NORTHERN NEW YORK. THE MEDICAL CENTER EXTENDS BEYOND ITS FOUR MAIN CAMPUSES IN THE BURLINGTON AREA TO INCLUDE MORE THAN 30 PATIENT CARE SITES AND 100 OUTREACH CLINICS, PROGRAMS AND SERVICES THROUGHOUT THE REGION. EACH OF THESE RESPONSIBILITIES IS EQUALLY IMPORTANT IN FULFILLING FLETCHER ALLEN'S MISSION. 1. PATIENT CARE - SERVING A POPULATION OF ONE MILLION THROUGHOUT VERMONT AND NORTHERN NEW YORK, FLETCHER ALLEN PROVIDES A FULL RANGE OF SERVICES COVERING EVERY MAJOR AREA OF MEDICINE. THE MEDICAL CENTER AVERAGES MORE THAN A MILLION PATIENT VISITS EACH YEAR, INCLUDING INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT AND PHYSICIAN OFFICE VISITS. FLETCHER ALLEN IS AT THE LEADING EDGE OF HEALTH CARE INNOVATIONS, INCLUDING HAVING IMPLEMENTED A SYSTEM-WIDE ELECTRONIC HEALTH RECORD THAT SUPPORTS IMPROVED HEALTH CARE FOR OUR COMMUNITIES AND SERVING AS ONE OF THE FIRST TWO PILOT SITES FOR THE VERMONT BLUEPRINT FOR HEALTH, A STATEWIDE PUBLIC/PRIVATE PARTNERSHIP FOCUSED ON ENSURING THAT ALL VERMONTERS HAVE ACCESS TO PRIMARY CARE SERVICES USING THE "PATIENT-CENTERED MEDICAL HOME" CARE DELIVERY MODEL. IN LINE WITH THE BLUEPRINT, FLETCHER ALLEN HAS BEEN IMPLEMENTING COMMUNITY HEALTH TEAMS FOR ALL OF OUR PRIMARY CARE PRACTICES, SEVEN OF WHICH HAVE BEEN RECOGNIZED BY THE NATIONAL COMMITTEE ON QUALITY ASSURANCE AS PATIENT-CENTERED MEDICAL HOMES. 2. EDUCATION - AS AN ACADEMIC MEDICAL CENTER, WE HAVE THE SPECIAL RESPONSIBILITY OF EDUCATING THE NEXT GENERATION OF DOCTORS, NURSES AND ALLIED HEALTH PROFESSIONALS. THE VAST MAJORITY OF FLETCHER ALLEN DOCTORS NOT ONLY TAKE CARE OF PATIENTS, THEY ALSO TEACH MEDICAL STUDENTS THROUGH THEIR POSITIONS AS MEMBERS OF THE UNIVERSITY OF VERMONT COLLEGE OF MEDICINE FACULTY. A NUMBER OF FLETCHER ALLEN NURSES AND ALLIED HEALTH PROFESSIONALS ALSO TEACH AT THE UNIVERSITY OF VERMONT COLLEGE OF NURSING AND HEALTH SCIENCES. FLETCHER ALLEN HEALTH CARE SERVES AS THE CLINICAL TRAINING SITE FOR THE APPROXIMATELY 450 MEDICAL STUDENTS AND 1,000 NURSING AND ALLIED HEALTH STUDENTS WHO ATTEND THE UNIVERSITY OF VERMONT. ADDITIONALLY, FLETCHER ALLEN IS THE TRAINING SITE FOR APPROXIMATELY 280 RESIDENTS - PHYSICIANS WHO HAVE GRADUATED FROM MEDICAL SCHOOL AND ARE COMPLETING THE ADDITIONAL CLINICAL TRAINING REQUIRED FOR THEIR AREA OF CARE. PATIENTS BENEFIT FROM HAVING RESIDENTS, MEDICAL STUDENTS AND NURSING AND ALLIED HEALTH STUDENTS AS PART OF THEIR CARE TEAM. IN 2011, FLETCHER ALLEN AND THE UNIVERSITY OF VERMONT COMPLETED THE DEVELOPMENT OF A SIMULATION CENTER THAT INCLUDES 9,000 SQUARE FEET OF TEACHING SPACE WITH FULLY-FUNCTIONING HOSPITAL ROOMS AND HIGH-TECH MANNEQUINS THAT SIMULATE ALL KINDS OF DISEASES AND INJURIES. THE SIMULATION CENTER ALSO HAS HANDS-ON LABS FOR SKILL-BUILDING AS WELL AS A VIRTUAL REALITY TRAINER THAT IMPROVES ON OLD TEACHING METHODS. IN ADDITION TO BEING USED TO TRAIN FUTURE DOCTORS AND NURSES, THE NEW FACILITY IS OPEN TO ALL VERMONT MEDICAL PROFESSIONALS, INCLUDING EMERGENCY MEDICAL TECHNICIANS AND VERMONT NATIONAL GUARD MEDICS. 3. RESEARCH - A CORE MISSION OF THE ACADEMIC MEDICAL CENTER IS TO ADVANCE MEDICAL KNOWLEDGE THROUGH RESEARCH, SO IN ADDITION TO TEACHING AND TRAINING, MANY OF OUR PHYSICIANS, NURSES AND OTHER PROVIDERS ENGAGE IN BIOMEDICAL RESEARCH, SEEKING NEW CURES AND MORE EFFECTIVE TREATMENTS. THERE ARE OVER 1,000 ACTIVE CLINICAL TRIALS AT THE UNIVERSITY OF VERMONT AND FLETCHER ALLEN. CLINICAL TRIALS ARE RESEARCH STUDIES CONDUCTED USING VOLUNTEERS. EACH STUDY ANSWERS SCIENTIFIC QUESTIONS AND TRIES TO FIND BETTER WAYS TO PREVENT, SCREEN FOR, DIAGNOSE, OR TREAT A DISEASE. THIS ACTIVE RESEARCH PROGRAM HAS A DIRECT BENEFIT TO PATIENTS AT FLETCHER ALLEN, WHO HAVE ACCESS TO THE LATEST TREATMENTS AND TECHNOLOGY AND WHO ARE CARED FOR BY SOME OF THE LEADING EXPERTS IN THEIR FIELD. THE ACADEMIC MEDICAL CENTER IS ALSO ACTIVELY ENGAGED IN POPULATION-BASED HEALTH RESEARCH, INCLUDING EVALUATING VERMONT BLUEPRINT FOR HEALTH PILOT PROJECTS INVOLVING THE DEVELOPMENT AND IMPACT OF PATIENT-CENTERED MEDICAL HOMES WITHIN THE STATE. 4. COMMUNITY BENEFIT - IN ADDITION TO DELIVERING HEALTH CARE, EDUCATING HEALTH CARE PROFESSIONALS, AND RESEARCHING NEW KNOWLEDGE, FLETCHER ALLEN ALSO LIVES ITS MISSION - TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES - BY REACHING OUT TO HELP PEOPLE TAKE CARE OF THEIR HEALTH. THESE EFFORTS INCLUDE, BUT ARE NOT LIMITED TO: COMMUNITY WELLNESS AND EDUCATION - FLETCHER ALLEN OFFERS NUMEROUS FREE HEALTH EDUCATION CLASSES, IN WHICH HEALTH PROFESSIONALS PROVIDE INFORMATION ON A VARIETY OF TOPICS. MANY OTHER HEALTH AND WELLNESS PROGRAMS OFFERED THROUGHOUT THE YEAR SERVE AS A VALUABLE RESOURCE TO OUR COMMUNITY, RANGING FROM CHILD PASSENGER CAR SEAT SAFETY CHECKS TO FREE BLOOD PRESSURE SCREENINGS, TOBACCO CESSATION CLASSES, AND WORKSHOPS FOR SENIORS. FRYMOYER COMMUNITY HEALTH RESOURCE CENTER - PATIENTS, FAMILIES AND THE PUBLIC ARE MORE INTERESTED THAN EVER IN GAINING ACCESS TO THE LATEST HEALTH INFORMATION AVAILABLE. THE FRYMOYER COMMUNITY HEALTH RESOURCE CENTER AT FLETCHER ALLEN OFFERS THE COMMUNITY EASY, FREE, GUIDED ACCESS TO THE BEST INFORMATION ABOUT HEALTH AND MEDICINE. COLLABORATIVE EFFORTS - FLETCHER ALLEN REGULARLY PARTNERS WITH OTHER ORGANIZATIONS AND PROVIDERS TO HELP MEET THE NEEDS OF OUR COMMUNITY. THIS INCLUDES WORKING WITH OTHER ORGANIZED SYSTEMS OF CARE (LIKE HOME HEALTH AGENCIES, OTHER VERMONT HOSPITALS, AND PHYSICIAN PRACTICES), AS WELL AS COMMUNITY-BASED ORGANIZATIONS WHOSE MISSIONS ARE SIMILAR TO OURS. FOR EXAMPLE, FLETCHER ALLEN COLLABORATES WITH COMMUNITY PARTNERS TO REGULARLY ASSESS COMMUNITY AND HEALTH CARE NEEDS, WHICH HELPS GUIDE OUR ORGANIZATION'S PRIORITIES. Our community benefits fall into four general categories: *DIRECT FINANCIAL ASSISTANCE TO PATIENTS. THIS REPRESENTS FREE CARE GIVEN TO PATIENTS WHO QUALIFY UNDER FLETCHER ALLEN'S "PATIENT ASSISTANCE PROGRAM" POLICY. THAT POLICY OFFERS FREE CARE TO PATIENTS UNDER 200% OF THE FEDERAL POVERTY LEVEL (FPL), WITH PATIENTS BETWEEN 200% AND 400% FPL PAYING A SLIDING-SCALE DEDUCTIBLE ONLY. FOR FY 2011, WE CALCULATED THIS AMOUNT AT APPROXIMATELY $7.1 MILLION IN ACTUAL COSTS (NOT CHARGES)(SEE SCHEDULE H, LINE 7A, COLUMN E). *SUBSIDIZED PROGRAMS. THESE INCLUDE RESEARCH ACTIVITIES AND EDUCATION AND TRAINING PROGRAMS FOR HEALTH PROFESSIONALS THAT ARE NOT FULLY REIMBURSED THROUGH OTHER MEANS, AS WELL AS SUBSIDIES TO SUPPORT HEALTH SERVICES THAT BENEFIT OUR COMMUNITY, INCLUDING THE UNINSURED AND LOW-INCOME INDIVIDUALS. THOSE SERVICES INCLUDE MENTAL HEALTH SERVICES, EMERGENCY SERVICES AND CRITICAL CARE TRANSPORTATION SERVICES. FOR FY 2011, WE CALCULATED THESE SUBSIDIES AS TOTALING $6 MILLION IN COMMUNITY BENEFIT (SEE SCHEDULE H, LINE 7G, COLUMN E). *COMMUNITY PROGRAMS AND DIRECT GRANTS. THESE INCLUDED, FOR EXAMPLE, COMMUNITY HEALTH SERVICES (HEALTH EDUCATION CLASSES, SUPPORT GROUPS, SCREENING SERVICES, FREE CLINICS, ETC.), FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS (CASH DONATIONS, GRANTS, IN-KIND SUPPORT SUCH AS MEETING ROOMS, PARKING VOUCHERS, ETC.), COMMUNITY-BUILDING AND LEADERSHIP ACTIVITIES (INCLUDING ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT, ECONOMIC DEVELOPMENT, AND ENVIRONMENTAL IMPROVEMENTS), AND COMMUNITY BENEFIT OPERATIONS (INCLUDING COSTS ASSOCIATED WITH OUR OFFICE OF COMMUNITY HEALTH IMPROVEMENT, COMMUNITY NEEDS ASSESSMENTS, ETC.). FOR FY 2011, WE CALCULATED THE VALUE OF THESE COMMUNITY PROGRAMS AND GRANTS AS $3.7 MILLION (SEE SCHEDULE H, LINE 7E AND 7I, COLUMN E). *MEDICAID AND OTHER PUBLIC PROGRAM UNDERPAYMENTS. THESE INCLUDE UNDERPAYMENTS FROM VERMONT'S MEDICAID PROGRAM AS WELL AS SEVERAL SMALLER PUBLIC PROGRAMS (FOR EXAMPLE, LADIES FIRST). THESE DO NOT INCLUDE ANY UNDERPAYMENTS BY MEDICARE. FOR FY 2011, WE CALCULATED THIS AMOUNT AS $80.1 MILLION (SEE SCHEDULE H, LINE 7B, COLUMN E). OUR TOTAL COMMUNITY BENEFIT SPENDING IN FY 2011 WAS $155.1 MILLION. THIS REPRESENTS APPROXIMATELY 17.96% OF FLETCHER ALLEN'S TOTAL PROGRAM SERVICE EXPENSE IN FY 2011 (SEE SCHEDULE H, LINE 7k, COLUMN F). ORGANIZATION'S MISSION FORM 990, PART III, QUESTION 1 ACADEMIC MEDICAL CENTER AND COMMUNITY HOSPITAL. MISSION: TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE BY INTEGRATING PATIENT CARE, EDUCATION, AND RESEARCH IN A CARING ENVIRONMENT. VISION: FLETCHER ALLEN HEALTH CARE IS COMMITTED TO BEING A NATIONAL MODEL FOR THE DELIVERY OF HIGH-QUALITY ACADEMIC HEALTH CARE FOR A RURAL REGION. STATEMENT OF VALUES: *WE RESPECT THE DIGNITY OF ALL INDIVIDUALS AND ARE RESPONSIVE TO THEIR PHYSICAL, EMOTIONAL, SPIRITUAL AND SOCIAL NEEDS AND CULTURAL DIVERSITY. *WE ARE JUST AND PRUDENT STEWARDS OF LIMITED NATURAL AND FINANCIAL RESOURCES. *WE FOSTER A CLIMATE WHICH ENCOURAGES BOTH THOSE RECEIVING AND PROVIDING CARE TO MAKE RESPONSIBLE CHOICES. *WE STRIVE FOR EXCELLENCE IN QUALITY AND CARE AND SEEK TO CONTINUOUSLY LEARN AND IMPROVE. *WE ACKNOWLEDGE A PARTNERSHIP WITH THE COMMUNITY TO ENSURE THE BEST POSSIBLE CARE AT THE RIGHT TIME, IN THE RIGHT PLACE, AND BY THE RIGHT PROVIDER. *WE ARE CARING AND COMPASSIONATE TO EACH OTHER AND TO THOSE WE SERVE. *WE COMMUNICATE OPENLY AND HONESTLY WITH THE COMMUNITY WE SERVE. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, QUESTION 4A-4D FLETCHER ALLEN HEALTH CARE (FLETCHER ALLEN) IS A TERTIARY CARE TEACHING HOSPITAL THAT, IN AFFILIATION WITH THE UNIVERSITY OF VERMONT, SERVES AS VERMONT'S ACADEMIC MEDICAL CENTER. AS ARTICULATED IN OUR MISSION STATEMENT, OUR FOCUS IS ON IMPROVING THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE BY INTEGRATING PATIENT CARE, EDUCATION, AND RESEARCH IN A CARING ENVIRONMENT. THESE EFFORTS ARE RECOGNIZED IN OUR 501(C)(3) STATUS AS A CHARITABLE AND EDUCATIONAL ORGANIZATION. AS A CHARITABLE ORGANIZATION, THE PROMOTION OF HEALTH THROUGH OUR ACADEMIC MISSION - HEALTH CARE DELIVERY, RESEARCH AND EDUCATION - IS OUR PRIMARY WORK. IN ADDITION TO THE COMMUNITY BENEFITS WE PROVIDE, FLETCHER ALLEN OFFERS THE BROAD RANGE AND SCOPE OF SERVICES NECESSARY TO ACHIEVE THAT GOAL. THIS INCLUDES A FULL-TIME EMERGENCY DEPARTMENT THAT IS CERTIFIED AS A LEVEL 1 TRAUMA CENTER BY THE AMERICAN COLLEGE OF SURGEONS, AS WELL AS NON-EMERGENCY SERVICES, ALL OF WHICH ARE AVAILABLE TO ALL PATIENTS REGARDLESS OF INSURANCE STATUS OR ABILITY TO PAY; AN OPEN MEDICAL STAFF THAT INCLUDES APPROXIMATELY 500 PHYSICIANS EMPLOYED BY FLETCHER ALLEN'S FACULTY PRACTICE, AS WELL AS ABOUT 250 COMMUNITY PHYSICIANS; AND AN INDEPENDENT BOARD OF TRUSTEES THAT REPRESENT OUR COMMUNITY AS A WHOLE. IN TERMS OF PROGRAM SERVICES, FLETCHER ALLEN'S THREE LARGEST PROGRAMS (BY EXPENSES AND REVENUES) ARE OUR ACTUAL HEALTH CARE DELIVERY SERVICES, AS FOLLOWS: INPATIENT CARE: SERVICES PROVIDED TO THOSE PATIENTS WHO REQUIRE ACUTE-CARE SERVICES IN A HOSPITAL SETTING. THESE SERVICES INCLUDE, FOR EXAMPLE, OUR LABOR AND DELIVERY UNIT, NURSING UNITS FOR GENERAL MEDICAL AND SURGICAL ISSUES, AND OUR INTENSIVE CARE UNITS (INCLUDING A PEDIATRIC ICU, A NEONATAL ICU, A SURGICAL ICU AND A MEDICAL ICU). OUTPATIENT CARE: SERVICES PROVIDED TO THOSE PATIENTS WHO REQUIRE CARE, ON A WALK-IN BASIS, EITHER IN THE HOSPITAL OR IN ONE OF OUR MANY CLINIC SETTINGS. THESE INCLUDE ROUTINE PHYSICIAN VISITS, LABORATORY TESTS, CLINIC VISITS, EMERGENCY ROOM VISITS, AND MEDICAL EQUIPMENT AND SUPPLIES. PROFESSIONAL SERVICES: SERVICES DELIVERED BY MEMBERS OF THE UVM MEDICAL GROUP, OUR EMPLOYED GROUP OF PHYSICIANS. IN ADDITION TO THESE ACCOMPLISHMENTS, PROGRAM SERVICE REVENUES ARE EARNED FROM AND PROGRAM SERVICE EXPENSES ARE SPENT ON VARIOUS OTHER IMPORTANT ACTIVITIES RELATED TO THE ORGANIZATION'S TAX EXEMPT PURPOSE. COMPENSATION FROM RELATED ORGANIZATIONS - BUSINESS RELATIONSHIPS FORM 990, PART VI, QUESTION 2 DR. MELINDA ESTES, CEO AND PRESIDENT OF FLETCHER ALLEN HEALTH CARE(FAHC) UNTIL 8/2011, ALSO SERVED AS THE CHAIR OF THE BOARD OF DIRECTORS OF VERMONT MANAGED CARE INDEMNITY COMPANY (VMCIC), FAHC'S CAPTIVE INSURANCE COMPANY DOMICILED IN BERMUDA , AND PRESIDENT OF FLETCHER ALLEN HEALTH VENTURES (FAHV). DR. JOHN BRUMSTED, INTERIM CEO AND PRESIDENT OF FLETCHER ALLEN HEALTH CARE(FAHC) AS OF 8/2011, SERVES AS THE CHAIR OF THE BOARD OF DIRECTORS OF VERMONT MANAGED CARE INDEMNITY COMPANY (VMCIC), FAHC'S CAPTIVE INSURANCE COMPANY DOMICILED IN BERMUDA , AND PRESIDENT OF FLETCHER ALLEN HEALTH VENTURES (FAHV). ROGER DESHAIES, CFO AND TREASURER OF FAHC, ALSO SERVES AS THE TREASURER OF VMCIC AND THE TREASURER AND SECRETARY OF FAHV. DR. PAUL TAHERI, PRESIDENT AND CEO OF THE UVM MEDICAL GROUP, ALSO SERVES AS THE VICE PRESIDENT FOR FAHV AND AS DIRECTOR OF VMCIC. SANDRA FELIS, SR. VP OF PATIENT CARE SERVICES/CHIEF NURSING OFFICER, ALSO SERVES AS THE VP OF VMCIC. DR. FREDERICK C. MORIN III, TRUSTEE OF FAHC, IS THE DEAN OF THE COLLEGE OF MEDICINE AT THE UNIVERSITY OF VERMONT (UVM). RUSSEL TRACY, TRUSTEE OF FAHC, AND DR. JAN CARNEY, VICE CHAIR OF FAHC, ARE EMPLOYEES AT UVM. FORM 990 REVIEW FORM 990, PART VI, QUESTION 11B FLETCHER ALLEN HEALTH CARE'S (FAHC) FORM 990 IS PREPARED BY A PAID PREPARER AND REVIEWED BY FAHC'S INTERNAL MANAGEMENT. FOLLOWING THAT REVIEW, FAHC'S INTERNAL MANAGEMENT PRESENTS THE FORM 990 TO THE AUDIT COMMITTEE FOR REVIEW AND COMMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO THE FORM BEING FILED WITH THE IRS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, QUESTION 12 THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. IN ACCORDANCE WITH THE POLICY, TRUSTEES, OFFICERS, KEY EMPLOYEES AND PHYSICIANS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE AND CERTIFICATION UPON HIRING, AT LEAST ANNUALLY, PRIOR TO PARTICIPATING IN ANY DECISION THAT MAY BE AFFECTED BY A PERSONAL INTEREST, AND WHENEVER A POTENTIALLY CONFLICTING INTEREST FIRST ARISES. CONFLICT OF INTEREST DISCLOSURES AND CERTIFICATIONS MAY BE MADE ONLINE OR IN WRITING AND ARE REGULARLY REVIEWED BY THE GENERAL COUNSEL. THE CONFLICT OF INTEREST POLICY IS ENFORCED BY THE OFFICE OF GENERAL COUNSEL AND OVERSEEN BY A FIVE-PERSON CONFLICT OF INTEREST COMMITTEE. THE GENERAL COUNSEL REPORTS AT LEAST QUARTERLY ON CONFLICT OF INTEREST ISSUES TO THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. CONFLICTS OF INTEREST ARE MANAGED IN ACCORDANCE WITH THE POLICY, WHICH PROVIDES FOR A VARIETY OF REMEDIES TO ADDRESS CONFLICTS OF INTEREST. IN ADDITION, "DISQUALIFIED PERSONS," CONSISTING OF TRUSTEES, OFFICERS AND KEY EMPLOYEES ARE SUBJECT TO SPECIAL PROCEDURES TO COMPLY WITH THE INTERMEDIATE SANCTION RULES, AS OUTLINED IN THE CONFLICT OF INTEREST POLICY. COMPENSATION DETERMINATION POLICY FORM 990, PART VI, LINE 15A & 15B *FLETCHER ALLEN'S COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES HIRES AN EXTERNAL INDEPENDENT CONSULTING FIRM, TOWERS WATSON, TO ASSIST THE COMMITTEE IN ESTABLISHING THE TOTAL COMPENSATION FOR THE CEO, OFFICERS AND SENIOR MEMBERS OF THE LEADERSHIP TEAM. *THE COMPENSATION COMMITTEE, ALONG WITH THE AID OF TOWERS WATSON, HAS ESTABLISHED A COMPENSATION PHILOSOPHY FOR THE ORGANIZATION WHICH DEFINES A PEER GROUP OF ORGANIZATIONS ACROSS THE COUNTRY AND INCLUDES ORGANIZATIONS OF SIMILAR SIZE, SCOPE, AND MANAGEMENT CHALLENGE; IT HAS ALSO ESTABLISHED THE COMPETITIVE LEVEL AT WHICH THE COMMITTEE WANTS TO COMPENSATE FLETCHER ALLEN EXECUTIVES COMPARED TO THE PEER GROUP ORGANIZATIONS. *THE TOTAL COMPENSATION PLAN FOR THE EXECUTIVE STAFF INCLUDES APPROPRIATE SALARY RANGES FOR BASE SALARY ADMINISTRATION, ANNUAL AND LONG-TERM, PERFORMANCE-BASED INCENTIVE PROGRAMS AND EXECUTIVE LEVEL BENEFITS. *THE CEO'S TOTAL COMPENSATION IS REVIEWED ANNUALLY, IN CONJUNCTION WITH THE ANNUAL PERFORMANCE EVALUATION, BY THE COMPENSATION COMMITTEE WITH FINAL APPROVAL MADE BY THE BOARD OF TRUSTEES. TOTAL COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS ESTABLISHED BY THE CEO, WITHIN THE PLANS APPROVED BY THE COMMITTEE, AND REVIEWED BY THE COMPENSATION COMMITTEE ANNUALLY. *THE COMMITTEE DETERMINES PERFORMANCE INDICATORS FOR THE INCENTIVE PLANS EACH YEAR. IN ADDITION, THE COMMITTEE REVIEWS THE TOTAL COMPENSATION PLAN PERIODICALLY AND MAKES ANY RECOMMENDATIONS FOR CHANGE AS NEEDED. ALL DECISIONS OF THE COMMITTEE ARE DOCUMENTED IN MINUTES APPROVED BY THE MEMBERS OF THE COMMITTEE. *TOWERS WATSON BENCHMARKS AND ANALYZES THE TOTAL COMPENSATION FOR THESE EMPLOYEES USING PROPRIETARY HEALTH CARE EXECUTIVE COMPENSATION SURVEYS AND OTHER COMPARATIVE MARKET PAY DATA TO ENSURE THAT THIS COMPENSATION IS COMPETITIVE, EQUITABLE AND MEETS ALL REASONABLENESS STANDARDS. *TOWERS WATSON CONDUCTS REASONABLENESS TESTING TO ENSURE THAT THE COMPENSATION PAID TO THESE EMPLOYEES IS CONSISTENT WITH BOARD POLICIES AND IRS REGULATIONS. DOCUMENT DISCLOSURE FORM 990, PART VI, QUESTION 19 GOVERNANCE DOCUMENTS CONSIST OF THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS. THE ARTICLES OF INCORPORATION ARE FILED WITH THE VERMONT SECRETARY OF STATE AND PUBLICLY AVAILABLE THROUGH THAT OFFICE. THE BYLAWS ARE NOT PUBLICLY POSTED, BUT WOULD BE FURNISHED TO ANY MEMBER OF THE PUBLIC WHO REQUESTED ONE. THE CONFLICT OF INTEREST POLICY IS NOT PUBLICLY POSTED, BUT WOULD BE FURNISHED TO ANY MEMBER OF THE PUBLIC WHO REQUESTED ONE. FINANCIAL STATEMENTS ARE FILED MONTHLY WITH THE STATE OF VERMONT'S DEPARTMENT OF BANKING, SECURITIES, INSURANCE, AND HEALTH CARE ADMINISTRATION (BISHCA) AND CAN BE ACCESSED BY THE PUBLIC THROUGH THAT AGENCY. PRESS RELEASES ON QUARTERLY AND YEAR END RESULTS ARE SENT TO LOCAL NEWS MEDIA AND ARE POSTED ON THE WEB SITE ALONG WITH TWO HIGH-LEVEL TABLES SHOWING QUARTERLY AND YEAR-TO-DATE RESULTS. THE ANNUAL EXTERNAL AUDIT REPORT IS ALSO POSTED ON THE WEB SITE AND ATTACHED TO CURRENT YEAR'S FORM 990. ADOPTION OF NEW ACCOUNTING GUIDANCE FOR BAD DEBT EXPENSE FORM 990, PART IX IN JULY 2011, THE FINANCIAL ACCOUNTING STANDARDS BOARD ISSUED ACCOUNTING STANDARDS UPDATE 2011-7 (ASU 2011-7), HEALTH CARE ENTITIES: PRESENTATION AND DISCLOSURE OF NET REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. UNDER THE NEW GUIDANCE, BAD DEBTS RELATING TO PATIENT SERVICE REVENUE WILL BE SEPARATELY DISCLOSED IN THE STATEMENT OF OPERATIONS AND REPORTED AS A COMPONENT OF NET PATIENT SERVICE REVENUE. BAD DEBTS ASSOCIATED WITH ACTIVITIES OTHER THAN PATIENT SERVICE REVENUE WILL CONTINUE TO BE REPORTED AS AN OPERATING EXPENSE. FOR FAHC ASU 2011-7 WOULD BE EFFECTIVE FOR FISCAL YEARS BEGINNING AFTER DECEMBER 15, 2011, BUT EARLY ADOPTION IS PERMITTED. FAHC ELECTED TO EARLY ADOPT ASU 2011-7 FOR 2011 AND CHANGED ITS REPORTING OF THE PROVISION FOR BAD DEBTS. RECONCILIATION OF NET ASSETS FORM 990, PART XI TRANSFER FROM RELATED ORGANIZATIONS 10,000,000 NET UNREALIZED LOSS (769,000) PENSION ADJUSTMENT (2,844,000) NET ASSETS RELEASED FROM RESTRICTIONS (1,351,000) CHANGE IN BENEFICIAL INTEREST (77,000) ROUNDING (1,549) ------------ TOTAL OTHER CHANGES IN NET ASSETS 4,957,451 SCHEDULE K, PART I, LINES A AND B THE VEHBFA SERIES 2007A BOND WAS ISSUED TO REIMBURSE FLETCHER ALLEN HEALTH CARE'S CONSTRUCTION COSTS INCURRED FOR THE AMBULATORY CARE CENTER WITHIN 18 MONTHS OF THE DATE OF ISSUE. THE VEHBFA SERIES 2008A BOND REISSUED THE VEHBFA SERIES 2004B BOND. SCHEDULE K, PART III, LINES 4-6 THE PRIVATE BUSINESS USE PERCENTAGE FOR FLETCHER ALLEN HEALTH CARE (FAHC) HAS BEEN PRESENTED AT 0%. THE TAX CERTIFICATE AND AGREEMENT FILED WITH FORMS 8038 FOR THE ISSUANCES LISTED IN COLUMNS A AND B INDICATES THAT AN EQUITY CONTRIBUTION WILL BE MADE AS A PORTION OF THE FUNDING FOR THE PROJECT. THE LANGUAGE DICTATES THAT THE EQUITY CONTRIBUTION WILL BE APPLIED TO PRIVATE USE PORTION OF THE PROJECT. THE FAHC EQUITY CONTRIBUTION REPRESENTS APPROXIMATELY 33% OF THE TOTAL CONSTRUCTION COST. THE ACTUAL PRIVATE USE PORTION OF THE PROJECT IS APPROXIMATELY 1% WHICH DOES NOT EXCEED THE EQUITY IN THE PROJECT RESULTING IN THE REPORTED PERCENTAGE OF 0%. FLETCHER ALLEN SKILLED NURSING 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 HOLDING CO VT 891000 4713000 NA FLETCHER ALLEN COORDINATED TRANSPORT 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 AMBULANCE SVC VT 1365000 1200000 NA FLETCHER ALLEN EXECUTIVE SERVICES 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 CONSULTING VT 296000 100000 NA UNIV OF VT MEDICAL GROUP FKA FAPC 111 COLCHESTER AVENUE BURLINGTON VT 05401 030225105 PHYSICIAN SVC VT 501(c)(3) 11A I FAHC true FLETCHER ALLEN MEDICAL GROUP 183 PARK STREET MALONE NY 12953 203905216 PHYSICIAN SVC NY 501(c)(3) 3 FAHC true FLETCHER ALLEN HEALTH CARE FOUNDATION 111 COLCHESTER AVENUE BURLINGTON VT 05401 263159849 FUNDRAISING VT 501(c)(3) 11A I FAHC true FLETCHER ALLEN HEALTH CARE AUXILIARY 111 COLCHESTER AVENUE BURLINGTON VT 05401 208022004 SERVICE VT 501(c)(3) 11D III-O NA false FLETCHER ALLEN HEALTH VENTURES 111 COLCHESTER AVENUE BURLINGTON VT 05401 043380045 HOLDING COMPA VT NA C CORP 84798960 18498928 1.00000 VMC INDEMNITY COMPANY LTD PO BOX HM 3103 25 CHURCH STREET HAMILTON, HM FX FR CAPTIVE INSUR BD NA C CORP 11632161 48174386 1.00000 VERMONT MANAGED CARE 111 COLCHESTER AVENUE BURLINGTON VT 05401 030333056 MANAGED CARE VT FAHV C CORP 0 0 0.00000 CHARITABLE REMAINDER TRUST (1) SUPPORT VT NA PERPETUAL TRUST (7) SUPPORT VT NA PERPETUAL TRUST (1) SUPPORT CT NA PERPETUAL TRUST (1) SUPPORT NY NA false false true false false false false false true false true true true false true true true true FLETCHER ALLEN MEDICAL GROUP K 100000 COST FLETCHER ALLEN MEDICAL GROUP O 156620 COST VMC INDEMNITY COMPANY K 53000 COST VMC INDEMNITY COMPANY Q 9431879 FMV VERMONT MANAGED CARE K 326256 COST VERMONT MANAGED CARE L 213204 COST VERMONT MANAGED CARE P 3864825 COST VERMONT MANAGED CARE Q 567778 COST VERMONT MANAGED CARE R 5520448 COST UNIVERSITY OF VERMONT MEDICAL GROUP O 106539886 FMV SCHEDULE R, PART V FLETCHER ALLEN HEALTH CARE LEASES AND SHARES FACILITIES, EQUIPMENT, AND OTHER ASSETS WITH ITS RELATED ORGANIZATIONS. THE VALUE OF THESE TRANSACTIONS IS INDETERMINABLE.