NORTHWESTERN MEDICAL CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWESTERN MEDICAL CENTER INC (EIN 03-0266986)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-13
- IRS object ID
- 201232269349301783
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-13T13:44:51-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Elm Street 15th Floor | AddressLine1 |
| City | Manchester | City |
| State | NH | State |
| ZIP Code | 03101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030266986 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwestern Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 8025245911 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 Fairfield St | AddressLine1 |
| City | St Albans | City |
| State | VT | State |
| ZIP Code | 05478 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Ted Sirotta | Name |
| Title | CFO | Title |
| Phone | 8025245911 | Phone |
| Date Signed | 2012-08-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Rachel Williamson CPA | Name |
| Phone | 6036697337 | Phone |
| Date Prepared | 2012-08-06 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Ted Sirotta | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 Fairfield St | AddressLine1 |
| City | St Albans | City |
| State | VT | State |
| ZIP Code | 05478 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 90261323 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.northwesternmedicalcenter.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1977 | YearFormation |
| State Legal Domicile | VT | StateLegalDomicile |
| Activity Or Mission Description | Northwestern Medical Center's mission is to provide exceptional healthcare for our community. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 645 | TotalNbrEmployees |
| Total Nbr Volunteers | 110 | TotalNbrVolunteers |
| Total Gross UBI | 2229471 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -48015 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 249111 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 536175 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 76581990 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 78541161 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1654835 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1699251 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 356763 | OtherRevenuePriorYear |
| Other Revenue Current Year | 323363 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 78842699 | TotalRevenuePriorYear |
| Total Revenue Current Year | 81099950 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 35478977 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 37434844 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 35401037 | OtherExpensePriorYear |
| Other Expenses Current Year | 35115470 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 70880014 | TotalExpensesPriorYear |
| Total Expenses Current Year | 72550314 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7962685 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8549636 | RevenuesLessExpensesCY |
| Total Assets BOY | 83114924 | TotalAssetsBOY |
| Total Assets EOY | 89040961 | TotalAssetsEOY |
| Total Liabilities BOY | 24709903 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 24615163 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 58405021 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 64425798 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Northwestern Medical Center's mission is to provide exceptional healthcare for our community. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 57570452 | Expense |
| Revenue | 76622153 | Revenue |
| Description | Providing inpatient and outpatient services to the general public in a full-service 70-bed hospital. The Hospital publishes an annual report. Please refer to the annual report for additional explanation of the Hospital's programs and achievements. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Charity Care - The Hospital provides care to patients who meet certain criteria under its charity care policy. Because the Hospital does not pursue collection or amounts determined to qualify as charity care they are not reported in revenue. The Hospital maintains records to identify and monitor the level of charity care it provides. The records include the amount of charges foregone for services and supplies furnished under its charity care policy, the estimated cost of those services and supplies and equivalent service statistics. The following information measures the level of charity care provided during the year ended September 30, 2011.See continuation on Schedule O. Estimated costs and expenses incurred to provide charity care: $702,985.Number of charity care patients served: 504The Hospital provides health care services to residents of St. Albans, Vermont, and the surrounding area, without regard to the individual's ability to pay for their services. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 57570452 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 88 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 645 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 1 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ted Sirotta CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8025241042 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 Fairfield Street | AddressLine1 |
| City | St Albans | City |
| State | VT | State |
| ZIP Code | 05478 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Judy Ashley-McLaughlin | ||||||||
| President | 5.00 | X | X | 0 | 0 | 0 | ||
| Peter Rath | ||||||||
| Vice President | 5.00 | X | X | 0 | 0 | 0 | ||
| Kevin Manahan | ||||||||
| Treasurer | 5.00 | X | X | 0 | 0 | 0 | ||
| Michelle Lawrence | ||||||||
| Assistant Treasurer | 5.00 | X | X | 0 | 0 | 0 | ||
| Paul Clark | ||||||||
| Secretary | 5.00 | X | X | 0 | 0 | 0 | ||
| John Edwards | ||||||||
| Member | 3.00 | X | 0 | 0 | 0 | |||
| John Hango | ||||||||
| Member | 3.00 | X | 0 | 0 | 0 | |||
| Paula Kane | ||||||||
| Member | 3.00 | X | 0 | 0 | 0 | |||
| Frank Zsoldos | ||||||||
| Member | 3.00 | X | 0 | 0 | 0 | |||
| Lowrey Sullivan | ||||||||
| Member | 3.00 | X | 0 | 0 | 0 | |||
| Patrick Talcott | ||||||||
| Member | 3.00 | X | 0 | 0 | 0 | |||
| William O'Connor | ||||||||
| Member | 3.00 | X | 0 | 0 | 0 | |||
| John Casavant | ||||||||
| Past Member | 3.00 | X | 0 | 0 | 0 | |||
| Jill Berry Bowen | ||||||||
| CEO | 40.00 | X | 281627 | 0 | 0 | |||
| Ted Sirotta | ||||||||
| CFO | 40.00 | X | 184880 | 0 | 0 | |||
| Michael Barnum | ||||||||
| Physician | 40.00 | 697184 | 0 | 24179 | X | |||
| Jeremy Hatch | ||||||||
| Physician | 40.00 | 408793 | 0 | 23537 | X | |||
| Peter Burke | ||||||||
| Physician | 40.00 | 360219 | 0 | 29079 | X | |||
| Thomas Suppan | ||||||||
| Physician | 40.00 | 321652 | 0 | 19448 | X | |||
| Sherry Cipriano | ||||||||
| Physician | 40.00 | 283861 | 0 | 7882 | X | |||
| Peter Hofstetter | ||||||||
| CEO (Oct '08 - May '09) | 40.00 | 0 | 0 | 0 | X | |||
| Wesley Oswald | ||||||||
| Interim CEO | 40.00 | 0 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2538216 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 104125 | TotalOtherCompensation |
| Number Individuals GT100 K | 30 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Fletcher Allen Health Care | |||||
| PO Box 1902 | Burlington | VT | 05402 | Lab & Stress Test Services | 1067640 |
| Quorum Health Resources | |||||
| 105 Continental Place | Brentwood | TN | 37027 | Mgmt/Consulting (incl. Officers' comp.) | 1047211 |
| Brandthropology | |||||
| 266 Pine Street Suite 5 | Burlington | VT | 05401 | Community Communications | 869432 |
| Barton Associates | |||||
| 10 Dearborn Road | Peabody | MA | 01960 | Locum Physician Service | 494800 |
| Locumtenenscom | |||||
| PO Box 405547 | Atlanta | GA | 30384 | Locum Physician Service | 432929 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 62 | NumberOfContractorsGT100K |
| All Other Contributions | 536175 | AllOtherContributions |
| Noncash Contributions | 10960 | NoncashContributions |
| Total Contributions | 536175 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Net Patient Service Re | 900099 | 77585222 | 75581959 | 2003263 |
| Other Operating Revenu | 900099 | 538953 | 312745 | 226208 |
| Cafeteria | 900099 | 416986 | 416986 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 78541161 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 986727 | TotalRevenueColumn |
| Exclusion | $986,727 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 311620 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1157 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 310463 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 310463 | TotalRevenueColumn |
| Related Or Exempt Function Income | 310463 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 9872740 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 9160216 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 712524 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 712524 | TotalRevenueColumn |
| Exclusion | $712,524 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 12900 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 0 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12900 | TotalRevenueColumn |
| Exclusion | $12,900 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 81099950 | TotalRevenueColumn |
| Related Or Exempt Function Income | 76622153 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2229471 | UnrelatedBusinessRevenue |
| Exclusion | $1,712,151 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 466507 | Total |
| Management And General | 466507 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29835802 | Total |
| Program Services | 23979705 | ProgramServices |
| Management And General | 5856097 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1050866 | Total |
| Program Services | 898911 | ProgramServices |
| Management And General | 151955 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4063506 | Total |
| Program Services | 3475923 | ProgramServices |
| Management And General | 587583 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2018163 | Total |
| Program Services | 1726337 | ProgramServices |
| Management And General | 291826 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 592580 | Total |
| Management And General | 592580 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124178 | Total |
| Management And General | 124178 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105233 | Total |
| Management And General | 105233 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100171 | Total |
| Program Services | 100171 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7185680 | Total |
| Program Services | 5646574 | ProgramServices |
| Management And General | 1539106 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 542902 | Total |
| Management And General | 542902 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 306633 | Total |
| Program Services | 173246 | ProgramServices |
| Management And General | 133387 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 656171 | Total |
| Program Services | 458910 | ProgramServices |
| Management And General | 197261 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249696 | Total |
| Program Services | 150390 | ProgramServices |
| Management And General | 99306 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 629458 | Total |
| Program Services | 538438 | ProgramServices |
| Management And General | 91020 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3353160 | Total |
| Program Services | 2868293 | ProgramServices |
| Management And General | 484867 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 898852 | Total |
| Program Services | 138882 | ProgramServices |
| Management And General | 759970 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Supplies | 8927421 | 8637278 | 290143 |
| Healthcare improvement | 3964661 | 3964661 | |
| NOH | 2407842 | 2407842 | |
| Maintenance Contracts | 1490676 | 626735 | 863941 |
| Utilities | 832065 | 709991 | 122074 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2748091 | Total |
| Program Services | 1068165 | ProgramServices |
| Management And General | 1679926 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72550314 | Total |
| Program Services | 57570452 | ProgramServices |
| Management And General | 14979862 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2986 | BOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14728324 | BOY |
| EOY | 20164203 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6128498 | BOY |
| EOY | 7398595 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42203 | BOY |
| EOY | 40461 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1553943 | BOY |
| EOY | 1654532 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1474462 | BOY |
| EOY | 1440174 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 65476930 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 35875421 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30266573 | BOY |
| EOY | 29601509 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28807860 | BOY |
| EOY | 28635623 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110075 | BOY |
| EOY | 105864 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83114924 | BOY |
| EOY | 89040961 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7603453 | BOY |
| EOY | 7318985 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13200000 | BOY |
| EOY | 12960390 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3906450 | BOY |
| EOY | 4335788 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24709903 | BOY |
| EOY | 24615163 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56837480 | BOY |
| EOY | 62639492 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 719941 | BOY |
| EOY | 901676 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 847600 | BOY |
| EOY | 884630 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58405021 | BOY |
| EOY | 64425798 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83114924 | BOY |
| EOY | 89040961 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8549636 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2528859 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $20,143 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 20143 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Other Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1i: | ReturnReference |
| Explanation | Northwestern Medical Center is a member of the Vermont Association of Hospitals and Health Systems and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Northwestern Medical Center and other member organizations in furtherance of their exempt purposes. Northwestern Medical Center does not directly perform any lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 847600 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 37030 | InvestmentEarningsOrLosses |
| End Of Year Balance | 884630 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 806185 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 41415 | InvestmentEarningsOrLosses |
| End Of Year Balance | 847600 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 913985 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -107800 | InvestmentEarningsOrLosses |
| End Of Year Balance | 806185 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1020531 | OtherCostOrOtherBasis |
| Book Value | 1020531 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 36655983 | OtherCostOrOtherBasis |
| Depreciation | 17714153 | Depreciation |
| Book Value | 18941830 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25510274 | OtherCostOrOtherBasis |
| Depreciation | 16928383 | Depreciation |
| Book Value | 8581891 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2290142 | OtherCostOrOtherBasis |
| Depreciation | 1232885 | Depreciation |
| Book Value | 1057257 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 29601509 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Estimated Third Party Settlement | $2,627,000 |
| Interest Rate Swaps | $1,708,788 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4335788 | TotalOfAmounts |
| Total Revenue | 81099950 | TotalRevenue |
| Total Expenses | 72550314 | TotalExpenses |
| Excess Or Deficit For Year | 8549636 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -2265331 | NetUnrealizedGLOnInvestments |
| Other | -$263,528 | OtherAmount |
| Total Adjustments | -2528859 | TotalAdjustments |
| Excess Or Deficit Per FS | 6020777 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 78470920 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -2265331 | NetUnrealizedGainsInvestments |
| Other Revenues | 37131 | OtherRevenues |
| Revenue Not Rptd F990 | -2228200 | RevenueNotRptdF990 |
| Revenue Subtotal | 80699120 | RevenueSubtotal |
| Investment Expenses Not Included | 100171 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 300659 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 400830 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 81099950 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 72450143 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 72450143 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 100171 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 100171 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 72550314 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | The organization intends to use the endowment funds in the manner prescribed by the donors. |
| Part XI, Line 8 - Other Adjustments: | Unrealized Loss on Interest Rate Swaps -300,659. Increase in Perpetual Trusts 37,131. | |
| Part XII, Line 2d - Other Adjustments: | Increase in Perpetual Trusts 37,131. | |
| Part XII, Line 4b - Other Adjustments: | Unrealized Loss on Interest Rate Swaps 300,659. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 702985 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 702985 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00970 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18316969 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13816521 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4500448 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06200 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19019954 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13816521 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5203433 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07170 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3527403 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1274067 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2253336 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03110 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 55283 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 55283 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3582686 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1274067 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2308619 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03190 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22602640 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15090588 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7512052 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10360 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,221,640 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 18758559 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 16856962 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1901597 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwestern Medical Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 Fairfield Street | AddressLine1 |
| City | St Albans | City |
| State | VT | State |
| ZIP Code | 05478 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Not required | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Northwestern Walk-in Clinic | ||||
| 927 Ethan Allen Hwy Ste 2 | Georgia | VT | 05468 | Diagnostic Imaging, Physical Therapy & Urgent Care |
| Branon's Pools & Spa | ||||
| 248 North Main Street | St Albans | VT | 05478 | Physical Therapy |
| Physical Therapy Services | ||||
| 44 Center Street | Enosburg | VT | 05450 | Physical Therapy |
| Northwestern Georgia Health Center | ||||
| 4178 Highbridge Road | Georgia | VT | 05486 | Primary Care |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation |
|---|
| Part I, Line 7g: Subsidized health services includes the Medicare shortfall from physician practices that are not included in the Hospital's cost reporting reflected on Part III, Line 7. |
| 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 patient accounts receivable. |
| Part III, Line 8: The cost was determined using the cost to charge ratio. |
| Part III, Line 9b: During the collection process, financial assistance, a payment plan or a discount may be offered to the patient, if appropriate, and in accordance with established hospital policy. |
| The Medicare surplus of $1,901,597, reported on line 7 of Part III, does not represent all Medicare services provided by the Hospital, as required by IRS instructions. When taking all Medicare services into account, the Hospital has a Medicare shortfall in the amount of $1,638,813, as calculated using an internal costing methodology. |
| Part VI, Line 2: The Hospital currently participates in 2 community needs assessment initiatives. The Hospital partners with another local non-profit organization to complete a formal community needs assessment focused on health, education, and income. This assessment takes place approximately every three years. The Hospital also completes an informal community needs assessment with each renewal of its strategic plan that focuses on community needs related to specific healthcare providers and services. The Hospital will complete a formal community needs assessment in alignment with the Federal mandate by September 30, 2012. |
| Part VI, Line 3: The Hospital uses a variety of methods of communication to inform and educate patients about the eligibility requirements for financial assistance and charity care. For example, information related to financial assistance and charity care is available on the Hospital's website, included on the back of patient statements, posted on signs at registration areas, and patients may speak on the phone with a collection specialist. |
| Part VI, Line 4: The Hospital serves the greater Franklin and Grand Isle counties in northwestern Vermont. The service area consists of approximately 54,000 people and the area is primarily rural and agricultural in nature with some light industry. |
| Part VI, Line 6: The Hospital maintains an open medical staff and a community based Board of Directors. The Hospital's Board of Directors is elected by the Hospital's Board of Incorporators, which consists of approximately 150 local residents. The Hospital created and funds a program known as The Center for Health and Wellness, which is committed to a collaborative approach to community health improvement. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| Champlain Drug & Alcohol Services | |||||||
| 20 Ampersand Drive | Plattsburgh | NY | 12901 | 141638308 | 501(c)(3) | 12000 | Support programs complimentary to the Hospital's exempt purpose. |
| Franklin Grande Isle United Way | |||||||
| 40 Lower Newton Street | St Albans | VT | 05478 | 030273929 | 501(c)(3) | 27000 | Support programs complimentary to the Hospital's exempt purpose. |
| American Heart Association | |||||||
| Two Wall Street | Manchester | NH | 03101 | 135613797 | 501(c)(3) | 10000 | Support programs complimentary to the Hospital's exempt purpose. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 24 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jill Berry Bowen | |||||||||||||
| 281627 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 281627 | 0 | 0 | 0 |
| Ted Sirotta | |||||||||||||
| 184880 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 184880 | 0 | 0 | 0 |
| Michael Barnum | |||||||||||||
| 697184 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 16829 | 0 | 721363 | 0 | 0 | 0 |
| Jeremy Hatch | |||||||||||||
| 408793 | 0 | 0 | 0 | 0 | 0 | 12250 | 0 | 11287 | 0 | 432330 | 0 | 0 | 0 |
| Peter Burke | |||||||||||||
| 359959 | 0 | 0 | 0 | 260 | 0 | 12250 | 0 | 16829 | 0 | 389298 | 0 | 0 | 0 |
| Thomas Suppan | |||||||||||||
| 321652 | 0 | 0 | 0 | 0 | 0 | 12250 | 0 | 7198 | 0 | 341100 | 0 | 0 | 0 |
| Sherry Cipriano | |||||||||||||
| 283471 | 0 | 0 | 0 | 390 | 0 | 7350 | 0 | 532 | 0 | 291743 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 1a | Northwestern Medical Center provides fitness club membership automatically for all employees. The employees are required to sign in at the fitness club and those records are provided regularly to the Hospital to determine the amount of payment due to the fitness club. | |
| Part III | Jill Berry Bowen, CEO, was compensated through a contract with Quorum Health Resources. Her total compensation for the period ended December 31, 2010 was $281,627, which includes moving and housing allowances applicable to her first year of employment with the Hospital. Ted Sirotta, CFO, was compensated through a contract with Quorum Health Resources. His total compensation for the period ended December 31, 2010 was $184,880. | Supplemental Information |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Vermont Educational & Health Building Financing Agency | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 227154467 | IssuerEIN |
| Date Issued | 2010-09-01 | DateIssued |
| Issue Price | 13200000 | IssuePrice |
| Description Of Purpose | Refund 2005A Bond and new capital projects | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 495476 | AmountRetired |
| Total Proceeds | 13200000 | TotalProceeds |
| Refunding Escrow | 10795501 | RefundingEscrow |
| Issuance Costs From Proceeds | 110300 | IssuanceCostsFromProceeds |
| Capital Expenditures | 2294199 | CapitalExpenditures |
| Year Of Subst Completion | 2012 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| John Casavant | |||
| Board Member | 884544 | John Casavant is employed by an insurance company which the hospital purchases insurance products at market rates. | 0 |
| Jane Catton | |||
| Chief Quality Officer | 129114 | Northwestern Medical Center leases space in the doctors' office buildings owned by Jane Catton. The lease has a one-year term, has provisions for early termination without cause and is made a market rate. | 0 |
| Jane Catton | |||
| Chief Quality Officer | 266766 | Northwestern Medical Center purchases doctors' office staff support from a company owned by Jane Catton. The support agreement has a one-year term, has a provision for early termination without cause and is made at market rate. | 0 |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 8 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 10960 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 3 | The CEO and CFO are employees of Quorum Health Resources. | |
| Form 990, Part VI, Section A, line 6 | The organization has a maximum of 150 members, elected at the annual meeting from a slate of candidates nominated by the Nominating Committee. Other candidates for membership may be nominated from the floor at the annual meeting. Any person whose term as a Corporation Director has expired shall automatically become a member if that person consents to become a member. | |
| Form 990, Part VI, Section A, line 7a | The membership elects a presiding membership officer, an alternate presiding membership officer and a membership secretary. Said officers are designated as Chair, Vice Chair and Recording Secretary of the membership. | |
| Form 990, Part VI, Section B, line 11 | The CFO reviews the 990 and compares it to the audited financial statements. In addition, a copy of the 990 is provided to all members of the Hospital's Board of Directors before it is filed. | |
| Regular monitoring occurs at a minimum annually when each individual must complete the annual disclosure form. | Form 990, Part VI, Section B, line 12c | |
| The CEO and CFO are not employees of Northwestern Medical Center. They are employees of Quorum Health Resources and their respective contracts, including compensation, are approved by the Board of Directors on an annual basis. | Form 990, Part VI, Section B, line 15 | |
| Northwestern Medical Center does not formally make its governing documents and conflict of interest policy available to the public. Financial information is available to the public through the annual tax return filing, annual Medicare and Medicaid cost report filing, and financial data published by the Vermont Department of Banking, Insurance, Securities, and Health Care Administration and available on the Hospital's website, as well as summarized financial information and statistics published in the Hospital's annual report distributed to local communities and published on the Hospital's website. | Form 990, Part VI, Section C, line 19 | |
| Changes in Net Assets or Fund Balances: | Net unrealized losses on investments: -2,265,331. Unrealized Loss on Interest Rate Swaps -300,659. Increase in Perpetual Trusts 37,131. Total to Form 990, Part XI, Line 5: -2,528,859. | Form 990, Part XI, line 5: |
| No change was made in the way the independent auditor was selected or in the oversight of the audit. | Form 990, Page 11, Part XI, Line 2c |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwest Occupational Health LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 Fairfield street | AddressLine1 |
| City | St Albans | City |
| State | VT | State |
| ZIP Code | 05478 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030360669 | EIN |
| Primary Activities | Medical rehabilitative and urgent care services | PrimaryActivities |
| Legal Domicile State | VT | LegalDomicileState |
| Total Income | 0 | TotalIncome |
| EOY Assets | 1421846 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwestern Medical Center | BusinessNameLine1 |