2011-08-11T08:42:02-05:00 2010-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2009-10-01 030183483 RUTLAND HOSPITAL INC DBA RUTLAND REGIONAL MEDICAL CENTER RUTL 8027757111 160 ALLEN STREET RUTLAND VT 05701 EDWARD OGORZALEK 2011-06-06 true Brian D Todd 4178658701 2009 2016-02-24 21:20:13Z RUTLAND REGIONAL MEDICAL CENTER THOMAS W HUEBNER 160 ALLEN STREET RUTLAND VT 05701 189511139 false X WWW.RRMC.ORG X 1892 VT TO PROVIDE SUPERIOR DIAGNOSTIC, THERAPEUTIC AND PREVENTATIVE HEALTH SERVICES IN A CARING ENVIRONMENT TO THOSE IN THE RUTLAND REGION AND SURROUNDING COMMUNITIES THROUGH THE STRENGTH OF OUR PEOPLE & TECH. 18 13 1565 396 2284651 471882 605252 1629587 172524451 180149233 -630909 -161211 -185966 -926472 172312828 180691137 1400000 1289733 0 0 92649450 100515144 0 0 0 75331914 75655361 169381364 177460238 2931464 3230899 166287139 186761925 80201251 96660982 86085888 90100943 TO PROVIDE COMPREHENSIVE INPATIENT AND OUTPATIENT MEDICAL SERVICES AND TO IMPROVE HEALTH OF THE RESIDENTS OF RUTLAND AND SURROUNDING COMMUNITIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. true false 61008609 76180258 ANCILLARY CARE. ANCILLARY CARE SERVICES INCLUDE OPERATING ROOM, EMERGENCY ROOM, PHYSICAL REHABILITATION, ANESTHESIOLOGY, ONCOLOGY, PULMONARY, RESPIRATORY, PHYSICAL THERAPY, CARDIAC CATH, ENDOSCOPY, AMBULATORY, DELIVERY, RADIATION, PSYCHIATRIC COUNSELING, OCCUPATIONAL THERAPY, RECOVERY, HIV CLINIC, AND SPEECH THERAPY. SEE SCHEDULE O FOR MORE INFORMATION. 37272984 46542047 INPATIENT CARE. INPATIENT CARE SERVICES INCLUDE MEDICAL AND SURGICAL, INTENSIVE CARE, HOSPITALISTS, REHABILITATION, PSYCHIATRIC, OBSTETRICS AND GYNECOLOGY, NURSERY, AND NURSING. SEE SCHEDULE O FOR MORE INFORMATION. 23274382 29062266 DIAGNOSTIC SERVICES. DIAGNOSTIC SERVICES INCLUDE LABORATORY, RADIOLOGY, ELECTROENCEPHALOGRAPHY, AND CT SCANNING. SEE SCHEDULE O FOR MORE INFORMATION. 20886055 1289733 26080011 142442030 true true false true false false false false true true true true false false false false false false false false true true false true true false true false false false false false false false true false false false false false true false false false true 176 0 true 1565 true true true false false false false false false false false 18 13 false false true false true true true true true false false true true true true true true true false false X EDWARD OGORZALEK 8027757111 160 ALLEN STREET RUTLAND VT 05701 BILL BANNERMAN 1.0 X 0 0 0 GORDON H CHADER 1.0 X 0 0 0 J CHRISTIAN HIGGINS MD 1.0 X 5000 0 0 JESSICA L ANDERSON 1.0 X X 0 0 0 JOAN F GAMBLE 1.0 X X 0 0 0 JOHN C COLLINS 1.0 X 0 0 0 JOHN R BRUMSTEAD MD 1.0 X X 0 0 0 JON S READNOUR ESQ 1.0 X X 0 0 0 JOSEPH GIANCOLA 1.0 X 442 0 0 KIRK DUFTY MD 1.0 X 252692 0 26738 MARK K FOLEY 1.0 X 0 0 0 MARY E MORAN 1.0 X 0 0 0 MATTHEW A CONWAY MD 1.0 X 150 0 9000 MICHAEL MCCORMACK 1.0 X 0 0 0 RICHARD D LOVETT MD 1.0 X 7500 0 0 RON J CIOFFI 1.0 X 0 0 0 VICTORIA P YOUNG 1.0 X X 0 0 0 CLAUDE LAPERLE 1.0 X 0 0 0 DANIEL M FOLEY MD 1.0 X 16576 0 0 JOHN R BUTTERLY MD 1.0 X 0 0 0 MARTHA COULTER 1.0 X 0 0 0 THOMAS W HUEBNER 40.0 X 406355 0 48083 EDWARD T OGORZALEK 40.0 X 228503 0 47681 MARY T NEMETH 40.0 X 177668 0 29094 BAXTER HOLLAND 40.0 X 309741 0 46055 DORCAS WARD 40.0 X 169862 0 34592 BARBARA ROBINSON 40.0 X 169824 0 31509 MARY KOHANSKI 40.0 X 160641 0 22509 RONALD FUSCHILLO 40.0 X 217752 0 31883 HARVEY REICH 40.0 X 373743 0 45582 MICHAEL KENOSH 40.0 X 493848 0 38414 ROBERT GIERING 40.0 X 482083 0 38953 KENNETH MAR 40.0 X 277274 0 38561 MARIE PAVINI 40.0 X 282144 0 27212 4031798 0 515866 72 false true false SHERIDAN HEALTHCARE OF VERMONT ANESTHETISTS 1934890 CHG MEDICAL STAFFING DBA COMPHEALTH TEMPORARY STAFFING 790686 CERNER CORP PROFESSIONAL 722968 GE MEDICAL SYSTEMS SERVICE CONTRACTS 652959 MEDQUIST TRANSCRIPTIONS LTD TRANSCRIPTION 542176 33 1180676 190138 258773 1629587 NET PATIENT SERVICE REVENUE 900099 176341975 176341975 CAFETERIA 722210 927397 927397 ENTEROSTOMAL NURSING SERVICES 623000 74229 74229 OCCUPATIONAL HEALTH SERVICES 621400 95997 95997 LABORATORY DIAGNOSTIC AND SCREENING SERV 621500 2114425 2114425 595210 595210 180149233 271179 271179 4156 4156 0 87245 279072 -191827 -191827 -191827 8002133 102251 8490191 50739 -488058 51512 -436546 -436546 0 0 0 LOSS ON EXTINGUISHMENT OF DEBT -734645 -734645 -734645 180691137 177864582 2284651 -1087683 1289733 1289733 0 0 0 2449850 1719228 730622 0 74906796 63903354 11003442 5258668 3826296 1432372 12850215 9329489 3520726 5049615 3666112 1383503 0 481208 88904 392304 154209 154209 76487 76487 0 394393 394393 12425659 8420231 4005428 919493 313525 605968 11994112 10842060 1152052 2501984 139126 2362858 0 3277760 2297750 980010 1136880 412664 724216 0 345837 271166 74671 1398965 1015809 383156 0 7790514 5656809 2133705 1864882 1864882 DUES & SUBSCRIPTIONS 945749 201250 744499 RECRUITING & RETENTION 113174 86376 26798 MEDICAL SUPPLIES & DRUGS 14963109 14963109 MEDICAID TAX ASSESSMENT 7416007 7416007 BAD DEBT 6492646 6492646 962293 90386 871907 177460238 142442030 35018208 0 2855 3355 18840203 14102169 546012 21457146 21484303 1257259 1334965 2486686 2000321 157829504 95992374 50746196 61837130 65183266 78532635 6313528 6921035 166287139 186761925 23598489 25688842 27045000 27856439 3818915 8165968 25738847 34949733 80201251 96660982 X 82851156 81384035 2587251 8038266 647481 678642 86085888 90100943 166287139 186761925 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false false false false true 78721 false true 40846 119567 LOBBYING EXPENSES SCHEDULE C, PART II-B, LINE 1G AND 1I THE ORGANIZATION PAID LOBBYING FEES OF $76,487 TO A PROFESSIONAL GOVERNMENT AFFAIRS AND COMMUNICATION STRATEGIES COMPANY. THE ORGANIZATION'S CEO, THOMAS HUEBNER, SPENDS TIME EACH YEAR WORKING DIRECTLY WITH STATE LEGISLATORS TO IMPROVE SERVICES FOR THE RUTLAND REGION. APPROXIMATELY $2,234 OF HIS SALARY IS ALLOCATED TO THIS ACTIVITY. ALSO, DUES ARE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE VERMONT HOSPITAL ASSOCIATION. A PORTION OF DUES IS ATTRIBUTABLE TO LOBBYING: $ 6,926 AHA $ 33,920 VHA ------ $119,405 10241135 988553 11229688 10799491 -558357 10241134 0.78910 0.21090 false false 24161 24161 37004417 16582091 20422326 24361431 11061908 13299523 86661275 67322421 19338854 9778220 1025954 8752266 61837130 0 EST DUE TO THIRD PARTY PAYER 2914651 ACCRUED PENSION 32035082 34949733 180691137 177460238 3230899 338409 4955746 -4509999 784156 4015055 176156892 338409 -4904392 -4565983 180722875 -31738 -31738 180691137 177344917 279072 279072 177065845 394393 394393 177460238 FIN 48 DISCLOSURE SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. OTHER CHANGES IN NET ASSETS SCHEDULE D, PART XI, LINE 8 $(8,209,638) NET LOSS FROM DEF BEN PEN PLAN AND POSTRETRMT BEN COSTS (1,227,223) TRANSFER TO AFFILIATES 6,783,329 CHANGE IN FV OF INVESTMENTS ACCT FOR UNDER FASB 825 (1,856,467) LOSS ON INTEREST RATE SWAP AGREEMENT ----------- (4,509,999) RECONCILIATION OF REVENUE - OTHER RECONCILING ITEMS SCHEDULE D, PART XII, LINE 2D $(8,209,638) NET LOSS FROM DEF BEN PEN PLAN AND POSTRETRMT BEN COSTS (1,227,223) TRANSFER TO AFFILIATES 6,783,329 CHANGE IN FV OF INVESTMENTS ACCT FOR UNDER FASB 825 (1,856,467) LOSS ON INTEREST RATE SWAP AGREEMENT ( 394,393) INVESTMENT FEES RECLASSED ----------- (4,904,392) SCHEDULE D, PART XII, LINE 4B CONTRIBUTIONS OF $ 247,334 WERE INCLUDED AS A PRIOR PERIOD ADJUSTMENT ON THE AUDIT REPORT; HOWEVER, WERE INCLUDED IN CURRENT YEAR REVENUES ON THE TAX RETURN. EXPENSES OF ($279,072) ALLOCABLE TO RENTAL INCOME INCLUDED WITH EXPENSES ON THE AUDIT REPORT WERE RECLASSED TO BE PROPERLY INCLUDED WITH REVENUE ON THE TAX RETURN. NET CHANGE = ($31,738). RECONCILIATION OF EXPENSE - OTHER RECONCILING ITEMS SCHEDULE D, PART XIII, LINE 2D $ 279,072 EXPENSES ALLOCABLE TO RENTAL INCOME INCLUDED WITH EXPENSES ON THE AUDIT REPORT WERE RECLASSED TO BE PROPERLY INCLUDED WITH REVENUE ON THE TAX RETURN. SCHEDULE D, PART XIII, LINE 4B $( 394,393) INVESTMENT FEES INCLUDED WITH REVENUE ON THE AUDIT REPORT THAT WERE RECLASSED TO BE PROPERLY INCLUDED WITH EXPENSES ON THE TAX RETURN. ENDOWMENT FUND PURPOSE SCHEDULE D, PART V, LINE 4 ENDOWMENTS CONSIST OF VARIOUS INDIVIDUAL DONOR-RESTRICTED AND BOARD DESIGNATED FUNDS WHICH WERE ESTABLISHED FOR GENERAL OPERATIONAL AND CERTAIN DEPARTMENTAL PURPOSES. AS REQUIRED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA (GAAP), NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. true true X true X true X false true false true true 2248181 2248181 0.01310 31752830 25976657 5776173 0.03380 2097242 2312718 -215476 0.00130 36098253 28289375 7808878 0.04560 716224 8590 707634 0.00410 207528 207528 0.00120 16528338 10090624 6437715 0.03770 1364581 1364581 0.00800 18816671 10099214 8717458 0.05100 54914924 38388589 16526336 0.09660 788 788 10505 10505 0.00010 87528 87528 0.00050 8975 8975 0.00010 224596 224596 0.00130 332392 332392 0.00200 false 3361892 389979 57725165 65666783 -7941618 X true true RUTLAND HOSPITAL

160 ALLEN STREET RUTLAND VT 05701

X X X MED DEV RURAL COMM HOSP RUTLAND REG DIABETES & ENDOCRINOLOGY CTR

8 ALBERT CREE DRIVE RUTLAND VT 05701

X PATIENT CLINIC RUTLAND REGIONAL GENERAL SURGERY

241 STRATTON ROAD RUTLAND VT 05701

X PATIENT CLINIC RUTLAND REGIONAL WOMEN'S HEALTH

174 ALLEN STREET RUTLAND VT 05701

X PATIENT CLINIC RUTLAND REGIONAL DIGESTIVE SERVICES

254 STRATTON ROAD RUTLAND VT 05701

X PATIENT CLINIC THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) LESS BAD DEBT EXPENSE OF $6,492,646. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: RRMC REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. RRMC PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, RRMC BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE ORGANIZATION CALCULATED BAD DEBT AT COST BY MULTIPLYING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS BY THE RATIO OF PATIENT CARE COST TO CHARGES USED FOR SCHEDULE H, PART I CALCULATIONS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. USING DATA FROM 2009, APPROXIMATELY 11.6 PERCENT OF RUTLAND COUNTY WAS CONSIDERED TO LIVE IN POVERTY. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE PAYMENT PLAN POLICY REQUIRES PAYMENTS OF A MINIMUM OF $25.00 PER MONTH, AND THAT ALL BALANCES BE PAID WITHIN 10 MONTHS. THE FREE CARE POLICY SPECIFICALLY STATES THAT ALL UNINSURED AND UNDERINSURED PATIENTS BE GIVEN INFORMATION ON THE FREE CARE PROGRAM, AND THAT STAFF PERFORM DUE DILIGENCE TO GIVE THEM INFORMATION AND HAVE THE APPLICATION RETURNED, AND THAT THE HOSPITAL SEND 3 STATEMENTS AND A FINAL NOTICE BEFORE SENDING AN ACCOUNT TO BAD DEBT. IT ALSO STATES THAT RRMC WILL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS TO OBTAIN PAYMENT FOR A DEBT. THE FAMILY INCOME LIMIT FOR ELIGIBILITY FOR DISCOUNTED CARE IS UP TO 275%. RUTLAND REGIONAL MEDICAL CENTER WILL PAY FOR UP TO 25%. IN APRIL 2009, THE RUTLAND COUNTY HEALTH ASSESSMENT WAS COMPLETED. RUTLAND REGIONAL MEDICAL CENTER AND THE BOWSE HEALTH TRUST CONVENED THE ASSESSMENT TEAM THAT GUIDED THE HEALTH ASSESSMENT. THE ASSESSMENT TEAM REPRESENTED THE FOLLOWING ORGANIZATIONS: RUTLAND REGIONAL MEDICAL CENTER (RRMC), JAMES T. BOWSE COMMUNITY HEALTH TRUST, RUTLAND COUNTY UNITED WAY, VERMONT DEPARTMENT OF HEALTH, RUTLAND AREA VISITING NURSES ASSOCIATION AND HOSPICE (RAVNAH), COMMUNITY HEALTH CLINICS OF THE RUTLAND REGION (CHCRR). [THE NEXT ASSESSMENT WILL BE CONDUCTED BETWEEN MAY 2011 AND APRIL 2012.] THE HEALTH ASSESSMENT WAS CONDUCTED IN FIVE (5) PHASES: PHASE 1: ANALYSIS OF VERMONT AND RUTLAND COUNTY DATA PHASE 2: SURVEY OF RUTLAND COUNTY RESIDENTS PHASE 3: COMMUNITY LEADER FOCUS GROUPS PHASE 4: PRIORITIZING MEETING WITH COMMUNITY LEADERS PHASE 5: DEVELOPMENT OF THE EXECUTIVE SUMMARY / FINAL REPORT DATA ANALYSIS OVER 36 SOURCES OF EXISTING DATA WERE ANALYZED IN ORDER TO IDENTIFY AREAS FOR FURTHER STUDY. THE DATA DESCRIBES RUTLAND COUNTY AS A POPULATION THAT IS OLDER, LESS EDUCATED AND LOWER INCOME THAN VERMONTERS AS A WHOLE. THERE ARE AN INCREASING NUMBER OF VULNERABLE AND DISABLED RESIDENTS IN RUTLAND COUNTY. MANY BARRIERS CHALLENGE THEIR ACCESS TO HEALTH AND HUMAN SERVICES, MOST NOTABLY, INADEQUATE ACCESS TO PRIMARY MEDICAL AND DENTAL CARE DUE TO A LACK OF HEALTH AND DENTAL INSURANCE AND A SHORTAGE OF PROVIDERS. THE LIFESTYLES OF SOME RUTLAND COUNTY RESIDENTS INCREASE THEIR RISKS FOR CHRONIC DISEASE. RISK FACTORS FOR HEART DISEASE AND STROKE INCLUDE TOBACCO USE, OBESITY, HIGH BLOOD PRESSURE, DIABETES, INACTIVITY, POOR DIET, EXCESSIVE ALCOHOL USE AND HIGH CHOLESTEROL. THE RATES FOR EACH OF THESE RISK FACTORS IN RUTLAND COUNTY ARE HIGHER THAN THE STATE AVERAGE. SURVEY OF RUTLAND COUNTY RESIDENTS A SURVEY TO IDENTIFY BARRIERS TO ACCESSING TRADITIONAL HEALTH SERVICES WAS ANSWERED BY 501 RUTLAND COUNTY RESIDENTS. THE RESULTS SHOWED THAT YOUNG ADULTS AND THOSE WITHOUT A HIGH SCHOOL DIPLOMA ARE LEAST LIKELY TO BE ABLE TO ACCESS THE HEALTH CARE THEY NEED. INABILITY TO PAY FOR SERVICES IS THE GREATEST BARRIER. THE SERVICES THAT ARE LEAST LIKELY TO BE ACCESSED WHEN NEEDED ARE MENTAL HEALTH AND ALCOHOL OR DRUG ABUSE COUNSELING. COMMUNITY LEADER FOCUS GROUPS THE ASSESSMENT TEAM INVITED EIGHTY COMMUNITY LEADERS TO PARTICIPATE IN LOCAL FOCUS GROUPS. IN TOTAL, FORTY-SIX (46) COMMUNITY LEADERS PARTICIPATED IN FIVE (5) HEALTH ASSESSMENT FOCUS GROUPS. ONE COMMUNITY LEADER GROUP WAS HELD IN CASTLETON, ONE WAS CONVENED IN BRANDON, AND THREE (3) GROUPS WERE CONDUCTED IN RUTLAND. THE LEADERS IDENTIFIED THE STRENGTHS AND CHALLENGES IN RUTLAND COUNTY'S HEALTH AND HUMAN SERVICES SYSTEM. LACK OF HEALTH AND DENTAL INSURANCE AND TRANSPORTATION WERE IDENTIFIED AS THE LEADING BARRIERS TO CARE. RUTLAND COUNTY IS RECOGNIZED AS HAVING MANY RESOURCES TO ASSIST PEOPLE IN PREVENTION AND TREATMENT OF HEALTH PROBLEMS, BUT THESE PROGRAMS AND SERVICES ARE UNDERUTILIZED OR UNKNOWN. NAVIGATING THE ARRAY OF SERVICES AND UNDERSTANDING ELIGIBILITY TO RECEIVE THESE SERVICES IS CONFUSING AND COMPLICATED. COMMUNITY LEADERS NOTED THAT THE CULTURE IN RUTLAND COUNTY IS NOT CONDUCIVE TO PREVENTION. MANY SUGGESTIONS ABOUT HOW RUTLAND COUNTY RESIDENTS CAN IMPROVE THEIR HEALTH STATUS ARE NOTED IN THE ASSESSMENT REPORT. PRIORITIZING MEETING FINDINGS WERE SYNTHESIZED FROM THE DATA ANALYSIS, THE CONSUMER SURVEY AND FOCUS GROUPS. THESE FINDINGS WERE PRESENTED AT A COMMUNITY MEETING WHERE ATTENDEES PARTICIPATED IN A GROUP PROCESS TO PRIORITIZE THE COMMUNITY'S HEALTH NEEDS. DURING A PRIORITIZING MEETING HELD ON APRIL 30, 2009, TWENTY MEMBERS OF COMMUNITY ORGANIZATIONS SELECTED HIS OR HER TOP THREE (3) ACTIONS TO IMPROVE RUTLAND COUNTY'S HEALTH STATUS IN THE NEXT 5 YEARS. A TOTAL OF 60 ACTIONS FOR A HEALTHIER RUTLAND COUNTY WERE PRESENTED AND ARE LISTED IN THE FULL REPORT. THE TOP ACTIONS SELECTED ARE NOTED BELOW: 2009 - 2014 OBJECTIVES AND ACTIONS 1. INCREASE PREVENTION EFFORTS THAT LEAD TO A HEALTHY LIFESTYLE OBJECTIVES DECREASE % OF ADULT AND YOUTH TOBACCO USE INCREASE % OF ADULT AND YOUTH PHYSICAL ACTIVITY INCREASED % OF ADULT AND YOUTH HEALTHY DIET DECREASE % OF ADULT AND YOUTH BMI OVER 30 ACTIONS: SUPPORT PROGRAMS THAT CREATE CULTURE AND BEHAVIOR CHANGE: PROVIDE AFFORDABLE HEALTHY FOOD AT WORK, SCHOOL AND COMMUNITY EXPAND USE OF CURRENT EXERCISE PROGRAMS INCREASE WORKSITE EXERCISE PROGRAMS PHYSICIANS WILL ADDRESS BMI WITH PATIENTS AND REFER TO COMMUNITY RESOURCES EXPAND AND SUPPORT PROGRAMS THE PREVENT TEEN AGE PREGNANCY SUPPORT AND EXPAND TOBACCO PREVENTION PROGRAMS 2. IMPROVE ACCESS TO HEALTH AND HUMAN SERVICES OBJECTIVES INCREASE % ADULT COVERED BY HEALTH INSURANCE INCREASE % OF ADULTS UP-TO-DATE ON AGE APPROPRIATE SCREENINGS INCREASE % OF ADULTS AND YOUTH UP-TO-DATE ON IMMUNIZATIONS DECREASE AMBULATORY CARE SENSITIVE HOSPITALIZATIONS INCREASE % OF ADULTS AND CHILDREN RECEIVING DENTAL CARE INCREASE USE OF CURRENT RESOURCES ACTIONS: CREATE COMMUNITY CARE TEAMS FOR CHRONIC HEALTH CONDITIONS EXPAND DENTAL PROGRAMS FOR THE UNINSURED AND MEDICAID POPULATIONS INCREASE THE USE OF ELECTRONIC MEDICAL RECORDS OPEN CHCRR CLINIC IN RUTLAND CITY CREATE EMERGENCY ROOM NAVIGATORS DEVELOP A RUTLAND COUNTY RESOURCE GUIDE EXPAND HEALTH INSURANCE ENROLLMENT ASSISTANCE 3. REDUCE SUBSTANCE ABUSE OBJECTIVES DECREASE THE USE OF ILLEGAL SUBSTANCES DECREASE % OF ADULT AND YOUTH WHO BINGE DRINK DECREASE % OF ADULTS WHO ARE DEPRESSED ACTIONS: CHANGE THE CULTURE OF LEGAL AND ILLEGAL DRUG USE CHANGE THE CULTURE OF ALCOHOL USE FOR ADULTS AND YOUTH INCREASE THE USE OF ELECTRONIC MEDICAL RECORDS CASE MANAGEMENT FOR HIGH-RISK POPULATIONS 4. EXPAND COMMUNITY BASED ELDER CARE OBJECTIVES INCREASE COMMUNITY BASED SERVICES FOR ELDERS, TO MAXIMIZE THE PERCENT OF ELDERS WHO LIVE AT HOME: ACTIONS: CASE MANAGEMENT FOR AT RISK ELDERS EXPAND ATTENDANT SERVICES EXPAND MEALS ON WHEELS SPECIAL NOTE: IT SHOULD BE NOTED THAT THESE ISSUES CANNOT BE SOLVED BY THE LIMITED RESOURCES WITHIN RUTLAND COUNTY. TRUE IMPACT CAN ONLY HAPPEN WITH SYSTEM CHANGES THAT INCLUDE CHANGES TO THE REIMBURSEMENT SYSTEM. HEALTH ASSESSMENT REPORT A COPY OF THE FINAL REPORT IS AVAILABLE ON THE RRMC WEB SITE (WWW.RRMC.ORG). HARD COPIES ARE AVAILABLE IN THE RRMC HEALTH SCIENCES LIBRARY AND THE RUTLAND FREE LIBRARY. RRMC HAS SIGNS UP THROUGHOUT THE HOSPITAL AND OFF SITE CLINICAL AREAS (RUTLAND GENERAL SURGERY, WOMEN'S HEALTH ETC.) WHERE PATIENTS/FAMILIES MIGHT BE WHICH LISTS WHO TO CALL IF HELP IS NEEDED PAYING MEDICAL BILLS. IN REGISTRATION ALL PATIENTS ARE OFFERED A PACKET WITH INFORMATION ABOUT THE FREE CARE PROGRAM. ALL SELF-PAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR WHILE THEY ARE ON AN IN-PATIENT UNIT. FINANCIAL COUNSELORS ASSIST PATIENTS IN APPLYING FOR STATE AND FEDERAL PROGRAMS. ALL BILLS INCLUDE INFORMATION ABOUT WHO TO CONTACT IF A PATIENT HAS QUESTIONS OR CONCERNS ABOUT A BILL. THE RRMC WEB SITE HAS A PAGE THAT DESCRIBES THE FINANCIAL ASSISTANCE PROGRAM WHICH GIVES AN OUTLINE OF THE FREE CARE PROGRAM, THE INCOME GUIDELINES BASED ON FEDERAL POVERTY, AN ON-LINE APPLICATION, AS WELL AS INFORMATION ON ALL OF THE MEDICAID PROGRAMS AVAILABLE AND A SMALL DESCRIPTION OF EACH. VERMONT IS THE SECOND LARGEST STATE IN NEW ENGLAND AT 9,614 SQUARE MILES, BUT IS THE EIGHTH SMALLEST STATE IN THE NATION. VERMONT IS CONSIDERED THE MOST RURAL OF THE UNITED STATES BECAUSE A LARGE PERCENTAGE OF ITS RESIDENTS LIVE IN COMMUNITIES OF LESS THAN 2,500. VERMONT IS MADE UP OF 14 COUNTIES WITH THE POPULATION OF THE STATE ESTIMATED TO BE 623,908 ON JULY 1, 2006. WHILE RACIAL AND ETHNIC MINORITIES ARE ONLY 3.6% OF THE VERMONT POPULATION, THESE POPULATIONS ARE GROWING AT A MUCH FASTER RATE THAN THE NON-HISPANIC WHITE POPULATION. (2006 US CENSUS BUREAU). RUTLAND COUNTY, COMPOSED OF 933 SQUARE MILES, IS LOCATED IN CENTRAL VERMONT. THE POPULATION MOSTLY RESIDES IN THE 27 SMALL TOWNS AND OUTLYING RURAL AREAS. RUTLAND CITY IS THE LARGEST POPULATION CENTER (ESTIMATED AT 17,080 IN 2004). ALMOST 80% OF THE COUNTY'S POPULATION IS OVER THE AGE OF 18, WITH A RACIAL COMPOSITION OF 98% CAUCASIAN, AND LESS THAN 2% FROM OTHER RACES. THE MEDIAN HOUSEHOLD INCOME IN 2004 WAS $39,607, WITH APPROXIMATELY 10% OF INDIVIDUALS LIVING BELOW THE FEDERAL POVERTY LEVEL. RRMC IS A COMPREHENSIVE MEDICAL/SURGICAL HOSPITAL WITH 188 BEDS AND OVER 1,280 EMPLOYEES. WE ARE DEPENDED UPON BY MORE THAN 70,000 RESIDENTS OF THE HOSPITAL SERVICE AREA (HSA), WHICH INCLUDES RUTLAND COUNTY, SOME PORTIONS OF SOUTHERN AND NORTH CENTRAL VERMONT AND EVEN WASHINGTON COUNTY, NEW YORK. RRMC IS LOCATED APPROXIMATELY FORTY MILES FROM THE NEAREST HOSPITAL OR HEALTH SYSTEM OF ANY SIZE AND NEARLY SEVENTY MILES FROM THE ONLY MEDICAL CENTER PROVIDING MORE LICENSED BEDS TO THE CITIZENS OF VERMONT. RUTLAND COUNTY MAKES UP ABOUT 10% OF VERMONT'S POPULATION. THERE ARE A NUMBER OF DEMOGRAPHIC STATISTICS THAT PUT RUTLAND COUNTY AT RISK AS COMPARED TO THE AVERAGE VERMONTER. THE POPULATION GREW SLOWLY, BY 2% FROM 1990 TO 2000. THE MEDIAN AGE IN 2000 WAS 39.23 MAKING RUTLAND COUNTY ONE OF THE OLDEST COUNTIES IN NEW ENGLAND. RUTLAND COUNTY HAS A POPULATION THAT IS LESS EDUCATED THAN THE VERMONT RATES. THE HIGH SCHOOL DROP OUT RATE IS HIGHER AND THE COLLEGE GRADUATE RATE IS LOWER. POVERTY RATES IN RUTLAND COUNTY ARE HIGHER THAN THE STATE RATE AND MEDIAN HOUSEHOLD INCOMES ARE $4,000 LESS THAN THE STATE AVERAGE AND $5,000 LESS THAN THE NATIONAL AVERAGE. THE PERCENT OF ADULTS IN RUTLAND COUNTY WHO DO NOT HAVE HEALTH INSURANCE IS HIGHER THAN THE VERMONT'S RATE. RUTLAND REGIONAL MEDICAL CENTER ENGAGES IN A NUMBER OF COMMUNITY SUPPORTIVE ACTIVITIES IN ORDER TO INCREASE ACCESS AND AFFORDABILITY OF HEALTH AND HUMAN SERVICES. RUTLAND COUNTY HAS A SEVERE NEED FOR PRIMARY CARE PHYSICIANS AND HAS SHORTAGES OR IS AT RISK FOR SHORTAGES IN MANY SPECIALTY SERVICES. RUTLAND REGIONAL MEDICAL CENTER ACTIVELY RECRUITS BOTH PRIMARY CARE AND SPECIALTY PRACTICE PHYSICIANS FOR RUTLAND COUNTY. ALL THE POSITIONS IDENTIFIED FOR RECRUITMENT WERE IDENTIFIED THROUGH THE MD MANPOWER PLAN AS A COMMUNITY NEED. IN FY2010, 12 PHYSICIANS WERE RECRUITED TO THE REGION, INCLUDING 2 FAMILY PRACTICE DOCTORS, 2 PSYCHIATRISTS, 1 GASTROENTEROLOGOSIT, 2 PATHOLOGISTS, AND 4 HOSPITALISTS. RRMC SUPPORTS A HOSPITALIST PROGRAM WHERE HOSPITAL PHYSICIANS PROVIDE CARE FOR PRIMARY CARE PROVIDER'S PATIENTS THAT ARE ADMITTED TO THE HOSPITAL. THIS ALLOWS THE PRIMARY CARE PROVIDER TO PROVIDE MORE HOURS OF OFFICE CARE WHILE THEIR HOSPITALIZED PATIENTS HAVE 24 HOUR ACCESS TO A DOCTOR DURING THE HOSPITALIZATION. THIS SYSTEM PROVIDES EFFICIENCIES TO THE HEALTH CARE SYSTEM IN RUTLAND COUNTY. RUTLAND COUNTY'S MEDICAID POPULATION CONTINUES TO INCREASE. IN 1994, 10% OF RRMC PATIENTS WHERE COVERED BY MEDICAID. NOW 15 YEARS LATER, 14% OF RRMC'S PATIENTS ARE COVERED BY MEDICAID. THIS PUTS A FINANCIAL STRAIN ON RRMC'S BUDGET AS THE CARE PROVIDED TO THIS GROWING POPULATION IS NOT REIMBURSED FOR THE FULL COST OF CARE. LEADERS AT RRMC ADVOCATE AT THE STATE AND LOCAL LEVEL TO MAINTAIN THE MEDICAID REIMBURSEMENT RATES FOR BOTH IN-PATIENT AND OUT-PATIENT CARE IN ORDER TO MAINTAIN ACCESS FOR MEDICAID PATIENTS. LEADERS AT RRMC ALSO PROVIDE SUPPORT FOR THE FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN RUTLAND COUNTY BY BEING A BOARD MEMBER. THE FQHC GETS REIMBURSED AT A HIGHER LEVEL FOR CARING FOR MEDICAID PATIENTS AND PROVIDES INCREASED ACCESS FOR THESE PATIENTS. RRMC LEADERS AND STAFF ALSO PARTICIPATE AS BOARD MEMBERS IN THE SUPPORT OF OTHER NON-PROFIT ORGANIZATIONS, SUCH AS RUTLAND COUNTY UNITED WAY, RUTLAND AREA VISITING NURSES ASSOCIATION AND HOSPICE, RUTLAND AREA PHYSICAL ACTIVITY COALITION, RUTLAND POLICE COMMISSION, AND THE RUTLAND ECONOMIC DEVELOPMENT CORPORATION. RUTLAND COUNTY IS ECONOMICALLY CHALLENGED AND RRMC SUPPORTS WORK TO HELP THOSE IN POVERTY AS WELL AS TO BRING NEW BUSINESSES INTO THE AREA. RRMC PARTICIPATES IN A PROGRAM CALLED BRIDGES OUT OF POVERTY WHICH IS A PROGRAM WHICH AIMS TO KEEP THE WORKING POOR EMPLOYED. THIS PROGRAM NOT ONLY BENEFITS THOSE IN LIVING POVERTY IN RUTLAND COUNTY, BUT RRMC'S OWN WORKFORCE. IN CONJUNCTION WITH FOR-PROFIT, NONPROFIT AND GOVERNMENT AGENCIES, THE BRIDGES OUT OF POVERTY COUNCIL DELIVERS THE WORKING BRIDGES TRAINING TO HR PROFESSIONALS AND LINE MANAGERS ON THE WORKPLACE IMPLICATIONS OF ECONOMIC DIVERSITY; IMPLEMENTED AN EMERGENCY LOAN AND SAVINGS PROGRAM FOR EMPLOYEES; HOUSED WORKSITE RESOURCE COORDINATORS IN COMPANIES TO HELP EMPLOYEES FIND HELP WITH HOUSING, CHILD CARE, TRANSPORTATION, ECONOMIC ASSISTANCE AND OTHER RESOURCES WITHOUT HAVING TO LEAVE WORK; AND BEGAN DISCUSSIONS OF HOW TO ENCOURAGE THE EMPLOYEES TO USE HEALTH AND WELLNESS STRATEGIES. TRAUMA SUPPORT - ESTABLISHED IN 1993, THE TRAUMA SUPPORT PROGRAM AT RRMC WAS, AND STILL IS, THE FIRST OF ITS KIND IN VERMONT. IT WAS DEVELOPED TO MEET THE IMMEDIATE AND LONG-TERM NEEDS OF FAMILIES IMPACTED BY SUDDEN DEATH OR TRAUMATIC INJURY OR ILLNESS. RRMC STAFF (ON THEIR OWN TIME) AND OTHER COMMUNITY VOLUNTEERS TAKE TURNS BEING ON-CALL 24 HOURS A DAY, SEVEN DAYS A WEEK. VOLUNTEERS PERSONALLY PROVIDE SUPPORT AND ASSISTANCE TO FAMILIES IMPACTED BY A TRAUMA OR DEATH IN MANY WAYS, I.E., BY BEING A LIAISON WITH MEDICAL PERSONNEL TO GET INFORMATION OR OFFERING CONTINUED SUPPORT VIA PHONE AND CORRESPONDENCE. BONE MARROW PROGRAM - THE MARROW DONOR PROGRAM AT RRMC WAS ESTABLISHED IN 1998. SINCE THEN, WE HAVE SUCCESSFULLY ADDED OVER 3,000 POTENTIAL DONORS TO THE NATIONAL REGISTRY, HELPING TO GIVE HOPE TO THE MORE THAN 6,000 PEOPLE SEARCHING EVERY DAY FOR AN UNRELATED MATCH TO SAVE THEIR LIVES. RRMC IS CURRENTLY THE ONLY HOSPITAL IN NEW ENGLAND WITH THIS TYPE OF PROGRAM. RRMC DOES NOT HOLD PATIENT-FOCUSED DRIVES; INSTEAD ALL DRIVES ARE DESIGNED TO RAISE GENERAL AWARENESS OF THE NEED AND TO REGISTER AS MANY POTENTIAL DONORS AS POSSIBLE, SO THAT NOW OR IN THE FUTURE A MATCH MAY BE MADE. IN FY2010, RRMC SUPPORTED THE PROGRAM WITH 452 HOURS OF STAFF TIME AND SUCCESSFULLY REGISTERED 146 POTENTIAL DONORS. RRMC HAS 18 BOARD MEMBERS WHO REPRESENT THE RESIDENTS OF RUTLAND COUNTY IN THEIR SERVICE; 5 OF THESE ARE PHYSICIANS, 2 REPRESENT HEALTH CARE PARTNERS, AND 12 ARE RUTLAND COUNTY RESIDENTS WHO REPRESENT A VARIETY OF BUSINESS SECTORS. ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST DISCLOSURE PROCESS WHICH IS NECESSARY TO COMPLY WITH FEDERAL AND STATE LAWS INCLUDING THE FEDERAL ANTI KICKBACK STATUTE AND THE TAX CODE. RRMC HAS PREDOMINANTLY AN OPEN MEDICAL STAFF. THE ONLY EXCEPTIONS ARE THE FOLLOWING SPECIALTIES FOR WHICH THERE ARE EITHER BOARD-APPROVED EXCLUSIVE CONTRACTS OR HOSPITAL-EMPLOYED PHYSICIANS ONLY: ANESTHESIA, EMERGENCY MEDICINE, CRITICAL CARE, MEDICAL ONCOLOGY, RADIATION ONCOLOGY, ORTHOPEDICS, AND RADIOLOGY. ALL NEW APPLICANTS UNDERGO AN EXTENSIVE REVIEW PROCESS INCLUDING PRIMARY SOURCE VERIFICATION OF THEIR EDUCATION, TRAINING, BOARD CERTIFICATION, MALPRACTICE HISTORY, AND PREVIOUS HOSPITAL AFFILIATIONS. WHEN DEEMED COMPLETE, THEIR APPLICATION IS REVIEWED BY THE CREDENTIALS COMMITTEE WHICH IS MADE UP OF PHYSICIANS AND AT LEAST ONE BOARD MEMBER. THE CREDENTIALS COMMITTEE MAKES A RECOMMENDATION TO THE MEDICAL EXECUTIVE COMMITTEE WHICH INCLUDES THE CHAIRMAN OF THE BOARD. THE MEDICAL EXECUTIVE COMMITTEE MAKES A FINAL RECOMMENDATION TO THE FULL BOARD, WHICH HAS THE ULTIMATE AUTHORITY TO GRANT MEDICAL STAFF PRIVILEGES. ALL MEDICAL STAFF APPOINTMENTS ARE FOR A TWO YEAR PERIOD. ALL MEMBERS OF THE MEDICAL STAFF ARE SUBJECT TO ONGOING PEER REVIEW OF THEIR CLINICAL WORK. EVERY TWO YEARS, EVERY MEMBER OF THE MEDICAL STAFF MUST UNDERGO A REAPPOINTMENT PROCESS WHICH IS DESIGNED TO REVIEW THEIR CLINICAL AND PROFESSIONAL ACTIVITY AND BEHAVIOR. THOSE REAPPOINTMENTS GO THROUGH THE SAME SEQUENCE OF COMMITTEES AND BOARD AS NEW APPLICANTS." RRMC'S CREDENTIALING PROCESS HAS BEEN SURVEYED BY BOTH THE JOINT COMMISSION AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND FOUND TO BE IN FULL COMPLIANCE WITH THEIR STANDARDS (TJC) AND THEIR CONDITIONS OF PARTICIPATION (CMS)." AS A RURAL COMMUNITY HEALTH SYSTEM, RRMC PROVIDES A BROAD ARRAY OF SPECIALIZED HEALTH SERVICES. THE FOLEY CANCER CENTER AT RRMC PROVIDES TREATMENT TECHNOLOGIES THAT INCLUDE HIGH TECH DIAGNOSTIC IMAGING, MEDICAL ONCOLOGY WITH TRADITIONAL IV THERAPIES (SUCH AS CHEMOTHERAPY), AND RADIATION ONCOLOGY FEATURING A STATE-OF-THE-ART LINEAR ACCELERATOR. SUPPORTIVE PROGRAMS INCLUDE PALLIATIVE CARE, PAIN MANAGEMENT, ACUPUNCTURE AND A WOMEN'S' BREAST CARE PROGRAM. THE HOSPITAL PROVIDES 24-HOUR EMERGENCY CRISIS CARE, AS WELL AS PSYCHIATRIC INTENSIVE CARE, GERIATRIC PSYCHIATRIC PROGRAMS, MEDICAL DETOXIFICATION AND DUAL DIAGNOSIS AND TREATMENT OF SIMULTANEOUS SUBSTANCE ABUSE AND BEHAVIORAL HEALTH DISORDERS. THE 24 HOUR EMERGENCY DEPARTMENT PROVIDES CARE REGARDLESS A PATIENT'S ABILITY TO PAY. THE FAST TRACK PROGRAM IS DESIGNED TO PROCESS URGENT CARE IN A TIMELY MANNER. RRMC PROVIDES CARE FOR BOTH MEDICARE AND MEDICAID PATIENTS, THESE 2 POPULATIONS MAKE UP 61 % OF THE PAYER MIX FOR RRMC. BY WORKING COLLABORATIVELY WITH THE LOCAL FEDERALLY QUALIFIED HEALTH CLINICS, COMMUNITY HEALTH CLINICS OF THE RUTLAND REGION'S PRIMARY CARE CAPACITY IS INCREASED IN THE SERVICE AREA. THE RRMC VOLUNTEER PROGRAM IS PROVIDED BY 379 VOLUNTEERS WHO DONATED 52,201 HOURS OF SERVICE. THESE VOLUNTEERS ASSIST WITH THE NON-CLINICAL NEEDS IN THE HOSPITAL. SINCE 1896 RUTLAND REGIONAL MEDICAL CENTER HAS PROVIDED HEALTH CARE TO ALL WHO SEEK ITS SERVICES, REGARDLESS OF THEIR FINANCIAL SITUATION. OVER THE YEARS, RUTLAND REGIONAL MEDICAL CENTER HAS BECOME AN IMPORTANT CENTER FOR PROMOTING HEALTH AND WELLNESS FOR THE FULL COMMUNITY-ACTIVITIES THAT SHOULD HELP CURB LONGER-TERM HEALTH CARE COSTS. WHILE A MAJORITY OF HOSPITAL COSTS ARE RECOVERED BY USERS OF THE SERVICES, PATIENT CHARGES AND THIRD PARTY INSURANCE, THE RUTLAND HEALTH FOUNDATION ACTIVELY SEEKS ADDITIONAL CHARITABLE RESOURCES TO MEET NEEDS NOT COVERED BY THESE PAYMENTS. HOWEVER, AS INSURANCE AND OTHER REIMBURSEMENTS CONTINUE TO DECREASE, RUTLAND REGIONAL MEDICAL CENTER HAS LESS MONEY FOR CAPITAL EXPENDITURES DIRECTED TOWARD NEW AND REPLACEMENT EQUIPMENT-EQUIPMENT THAT IS INTEGRAL TO KEEPING THE HOSPITAL TECHNOLOGICALLY ADVANCED. THE RUTLAND HEALTH FOUNDATION ALSO FUNDRAISES TO SUPPORT PROGRAMS THAT DIRECTLY ASSIST THE NEEDIEST OF PATIENTS, NAMELY BRIDGES & BEYOND (RUN OUT OF THE SOCIAL WORK DEPARTMENT TO PROVIDE TRANSPORTATION, GENERAL ASSISTANCE, SUCH AS MEAL PREPARATION, AND COMPANIONSHIP TO THOSE DISABLED AND FRAIL PATIENTS RETURNING HOME FROM A HOSPITAL STAY); DIABETES EDUCATION AND SELF-MANAGEMENT PROGRAMS (RECOGNIZED AND CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION, TEACH PEOPLE WITH DIABETES THE LIFESTYLE AND HEALTH SKILLS THEY NEED TO TAKE CONTROL OF THEIR DISEASE SYMPTOMS. PATIENTS ALSO BENEFIT FROM AVAILABLE PATIENT AND FAMILY SUPPORT GROUPS, AND GLUCOSE METER AND INSULIN PUMP INSTRUCTION.); RUTLAND AREA VISITING NURSE ASSOCIATION & HOSPICE (PROVIDING IN-HOME CARE TO SUPPORT PATIENTS, WITH A SPECIALTY PROGRAM FOR HIGH-NEEDS CHILDREN REQUIRING HIGH-TECH PEDIATRIC CARE); AND, KIDS ON THE MOVE (A MULTI-FACETED PEDIATRIC REHABILITATIVE PROGRAM SERVING CHILDREN WITH SPEECH, PHYSICAL AND OCCUPATIONAL THERAPY NEEDS AT HOME, AT SCHOOL AND AT THE CLINIC). THE JAMES T BOWSE HEALTH TRUST IS AN AFFILIATE OF RUTLAND REGIONAL HEALTH SERVICES AND PROVIDES GRANT FUNDING AIMED AT IMPROVING THE HEALTH STATUS OF THE RUTLAND REGION. HERE IS A DESCRIPTION OF THE PROGRAMS THAT ARE CURRENTLY FUNDED: WALK RUTLAND WALK RUTLAND, WHICH IS HOSTED BY RUTLAND AREA PHYSICAL ACTIVITY COALITION (RAPAC), IS RECEIVING $42,000 OVER THREE YEARS TO EXPAND ITS WALKING PROGRAM THROUGHOUT RUTLAND COUNTY. THE FUNDS SUPPORT A COORDINATOR WHO ORGANIZES GROUP WALKS, COMMUNITY WALKING CHALLENGES, AND ADVOCATES FOR ACCESSIBLE WALKING SITES. A WEB-BASED PROGRAM HAS BEEN ADDED TO SUPPORT PARTICIPANTS. PARTNERS IN THIS PROGRAM INCLUDE WORKSITES, RUTLAND REGIONAL MEDICAL CENTER, RETIRED SENIOR VOLUNTEER PROGRAM'S BONE BUILDERS, VERMONT ADAPTIVE SKI AND SPORTS, THE RUTLAND REGIONAL FIELD HOUSE, RUTLAND RECREATION DEPARTMENT AND RUTLAND HIGH SCHOOL. SEEDS TO SUPPER SEEDS TO SUPPER, WHICH IS PROVIDED BY MOUNT HOLLY ELEMENTARY SCHOOL, IS RECEIVING $41,000 OVER 3 YEARS TO IMPLEMENT A CURRICULUM FOCUSED ON HEALTHY EATING AND GARDENING FOR THE STUDENTS IN KINDERGARTEN TO SIXTH GRADE. THE PARTNERS IN THIS PROJECT INCLUDE THE MOUNT HOLLY GARDENING CLUB, THE COOKING FOR LIFE PROGRAM, VERMONT CAMPAIGN TO END CHILDHOOD HUNGER, AND THE MASTER GARDENER PROGRAM. THE FIRST YEAR SURVEYS SHOW THAT FRUIT AND VEGETABLE CONSUMPTION HAS INCREASED FROM 2.4 TO 2.7 SERVINGS PER DAY. EARLY INTERVENTION PROGRAM THE EARLY INTERVENTION PROGRAM, WHICH IS HOSTED BY RUTLAND AREA PREVENTION (RAP) COALITION, IS RECEIVING $75,000 OVER 3 YEARS TO IMPLEMENT THE SECOND STEP CURRICULUM TO PRE-SCHOOL CHILDREN IN VARIOUS SETTING THROUGHOUT RUTLAND COUNTY. SECOND STEP IS A RESEARCH BASED PREVENTION PROGRAM FOR PRESCHOOLERS AND THEIR PARENTS. THE PROGRAM TEACHES PRO-SOCIAL BEHAVIORS, POSITIVE COMMUNICATION SKILLS, AND BEHAVIOR MANAGEMENT. THE GOAL OF THE PROGRAM IS TO REDUCE IMPULSIVE, AGGRESSIVE AND RISKY BEHAVIORS IN THE TARGET POPULATION. THE RUTLAND HEALTH FOUNDATION PROVIDES GRANT WRITING SUPPORT AND SECURED $176,752 IN GRANT FUNDS THAT SUPPORT A WIDE RANGE OF COMMUNITY HEALTH AND QUALITY SERVICE INITIATIVES. true COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION 375 ROUTE 30 NORTH BOMOSEEN VT 05732 221179701 501(C)(3) 1254166 COMMUNITY HLTH IMPROVE RUTLAND COMMUNITY PROGRAMS 78 S MAIN PO BOX 222 RUTLAND VT 05702 030307812 501(C)(3) 18957 COMMUNITY HLTH IMPROVE MOUNT HOLLY SCHOOL 150 SCHOOL STREET MOUNT HOLLY VT 05702 036000588 501(C)(3) 9610 COMMUNITY HLTH IMPROVE 3 0 GRANT MONITORING SCHEDULE I, PART I, LINE 2 RUTLAND REGIONAL HEALTH SERVICES (RRHS), THROUGH RUTLAND REGIONAL MEDICAL CENTER (RRMC), AWARDED A FIVE-YEAR COMMUNITY BENEFIT GRANT TO COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. (CHCRR) IN THE AMOUNT OF $4,600,000 THAT IS FUNDED BY RRMC AND WAS EFFECTIVE MAY 1, 2008. FOR THE YEARS ENDED SEPTEMBER 30, 2010 AND 2009, RESPECTIVELY, $1,254,166 AND $1,400,000 WAS EXPENDED FOR THE GRANT AWARD FROM RRMC AND IS INCLUDED IN RUTLAND REGIONAL MEDICAL CENTER'S GENERAL OPERATING EXPENSES. RRHS CONTINUALLY WORKS WITH CHCRR TO ENSURE THE ORGANIZATION IS USING FUNDS APPROPRIATELY AND FURTHERING THE CHCRR EXEMPT PURPOSE. X X X false false false true false false false false false THOMAS W HUEBNER 389855 0 0 16500 23275 24808 454438 0 EDWARD T OGORZALEK 212003 0 0 16500 27187 20494 276184 0 KIRK DUFTY MD 236192 0 0 16500 18375 8363 279430 0 MARY T NEMETH 177668 0 0 0 20783 8311 206762 0 BAXTER HOLLAND 309741 0 0 0 23275 22780 355796 0 DORCAS WARD 154057 0 0 15805 19806 14786 204454 0 BARBARA ROBINSON 169824 0 0 0 16485 15024 201333 0 MARY KOHANSKI 158554 0 2087 0 3125 19384 183150 0 RONALD FUSCHILLO 212952 0 4800 0 3095 28788 249635 0 HARVEY REICH 334190 0 23053 16500 23275 22307 419325 0 MICHAEL KENOSH 379712 0 97636 16500 18375 20039 532262 0 ROBERT GIERING 351817 0 130266 0 18375 20578 521036 0 KENNETH MAR 198781 0 78493 0 23275 15286 315835 0 MARIE PAVINI 255561 0 10083 16500 18375 8837 309356 0 COMPENSATION CONTINGENT ON THE REVENUES OF THE ORGANIZATION SCHEDULE J, PART I, LINE 5A PHYSICIANS EARN COMPENSATION BASED UPON THEIR PRODUCTIVITY AGAINST ESTABLISHED TARGETS. INCREASED PRODUCTIVITY IS DIRECTLY RELATED TO INCREASED REVENUES FOR THE ORGANIZATION. VT EDUCATIONAL & HEALTH BUILDINGS FINANCING AGENCY 237154467 2009-11-18 28330000 REFUND '01 AND '03 SERIES BONDS false false 28330000 0 24722648 0 198225 0 3409127 2010 true false true true false false true false true 0.00000 0.00000 0.00000 true false true true DEUTSCHE BANKTDBANK 10. false JOSEPH GIANCOLA J GIANCOLA - SEE SCH O 129623 RENTAL OF REAL PROPERTY false FOLEY DISRIBUTING FOLEY SERVICES M FOLEY - SEE SCH O 204733 PAPER & JANITORIAL SUPPLIES false CENTRAL VERMONT PUBLIC SERVICE J GAMBLE - SEE SCH O 1089000 ELECTRICITY false BLUE CROSS BLUE SHIELD OF VERMONT J COLLINS & T HUEBNER 1000153 INSURANCE PREMIUMS false TOTAL NUMBER OF VOLUNTEERS FORM 990, PART I, LINE 6 THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND OTHER INDIVDUALS WHO VOLUTEER TIME TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 MISSION: TO PROVIDE SUPERIOR, INTEGRATED, DIAGNOSTIC, THERAPEUTIC AND PREVENTATIVE HEALTH SERVICES IN A CARING ENVIRONMENT TO THOSE IN THE RUTLAND REGION AND SURROUNDING COMMUNITIES THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY AND RELATIONSHIPS. VISION: TO BE THE BEST COMMUNITY HOSPITAL AND HEALTH SYSTEM IN NEW ENGLAND. GOALS: *QUALITY: WE WILL PROVIDE SUPERIOR HEALTH SERVICES WHICH MEET OUR CUSTOMER NEEDS THROUGH: GOOD CLINICAL OUTCOMES, UP-TO-DATE TECHNOLOGY, EFFECTIVE PROCESSES, COMPETENT AND CARING STAFF AND WELL MAINTAINED FACILITIES. *GROWTH: WE WILL DEVELOP NEW SERVICES AND EXPAND EXISTING SERVICES TO MEET CUSTOMER NEEDS RESULTING IN INCREASED MARKET SHARE AND EXPANSION INTO NEW MARKETS. *INFORMATION EXCELLENCE: WE WILL PROVIDE SUPERIOR, COORDINATED INFORMATION RESOURCES, PROCESSES, AND SYSTEMS THAT MEET CUSTOMER NEEDS FOR EFFECTIVE INFORMATION GATHERING, RECORDING, ACCESS, ANALYSIS, AND DISSEMINATION ACROSS THE HEALTHCARE CONTINUUM. *FINANCIAL STRENGTH: WE WILL ACHIEVE FINANCIAL STRENGTH AND STABILITY BY OPTIMIZING REIMBURSEMENT AND IMPROVING OUR COST STRUCTURE TO PRODUCE SUFFICIENT MARGINS, AND INCREASING PHILANTHROPIC GIVING. *EMPLOYEE ENGAGEMENT: WE WILL CREATE AN ENVIRONMENT WHERE EMPLOYEE ENGAGEMENT FLOURISHES AND WE COMMIT OUR HEARTS AND MINDS TO MEETING AND EXCEEDING THE NEEDS OF OUR CUSTOMERS AND EACH OTHER. SIGNIFICANT PROGRAM SERVICES FORM 990, PART III, LINE 3 RRMC ADDED THE WOMEN HEALTH SERVICES CLINIC AS OF JANUARY 1, 2010. WOMEN'S HEALTH SERVICES IS A FOUR PHYSICIANS PRACTICE THAT OFFERS COMPREHENSIVE OBSTETRICAL AND GYNECOLOGICAL SERVICES TO BOTH INPATIENT AND OUTPATIENTS. THE ORGANIZATION ALSO ADDED DIGESTIVE SERVICES, WHICH IS A TWO PHYSICIANS PRACTICE THAT WILL TREAT A BROAD SPECTRUM OF DIGESTIVE DISEASES. EXEMPT PURPOSE ACHIEVEMENTS FORM 990, PART III, LINES 4A-C RUTLAND REGIONAL MEDICAL CENTER FY 2010 COMMUNITY BENEFITS REPORT: RUTLAND REGIONAL HEALTH SERVICES (RRHS) IS A COLLABORATIVE SYSTEM OF HEALTH CARE PROVIDERS OFFERING INPATIENT AND OUTPATIENT ACUTE CARE, REHABILITATION, EDUCATION, PRIMARY CARE, GRANT FUNDING AND ASSISTED LIVING HOUSING. RUTLAND REGIONAL MEDICAL CENTER (RRMC) IS A LICENSED RURAL HOSPITAL SERVING PEOPLE IN RUTLAND COUNTY AND BEYOND. IN FY 2010, RRMC SERVED 154,918 THROUGH OUTPATIENT ENCOUNTERS, 32,308 THROUGH INPATIENT DAYS AND PERFORMED 4,936 SURGICAL PROCEDURES. THE COMMITMENT OF RUTLAND REGIONAL MEDICAL CENTER TO PROVIDE SUPERIOR, INTEGRATED, DIAGNOSTIC, THERAPEUTIC, AND PREVENTATIVE HEALTH SERVICES GOES FAR BEYOND WHAT HAPPENS WITHIN THE WALLS OF THE HOSPITAL FACILITY. THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY AND RELATIONSHIPS, RUTLAND REGIONAL PROMOTES THE HEALTH OF THE COMMUNITY WE SERVE THROUGH A VARIETY OF HEALTH IMPROVEMENT INITIATIVES, CONTRIBUTIONS AND PARTNERSHIPS THROUGHOUT THE REGION. OUR EFFORTS ARE PRIORITIZED IN ACCORDANCE WITH THE RUTLAND COUNTY COMMUNITY HEALTH ASSESSMENT CONDUCTED IN 2009, WHICH IDENTIFIED THE NEEDS TO: INCREASE ACCESS TO AND AFFORDABILITY OF HEALTH AND HUMAN SERVICES; INCREASE PREVENTION EFFORTS FOR ALL; AND REDUCE SUBSTANCE ABUSE. EXAMPLES OF ACTIVITIES TO ADVANCE OUR COMMUNITY COMMITMENT INCLUDE: CHARITY CARE - RUTLAND REGIONAL PROVIDES LOW AND NO-COST CARE FOR ELIGIBLE RESIDENTS OF OUR AREA THROUGH A FINANCIAL ASSISTANCE PROGRAM. THE FREE CARE PROVISION FOR 2010 TOTALED $4,341,795. IN ADDITION, RUTLAND REGIONAL PROVIDES $30,000 IN FREE AND REDUCED COST LABORATORY AND IMAGING SERVICES TO PATIENTS OF THE RUTLAND FREE CLINIC. COALITIONS AND PARTNERSHIPS - THROUGH COLLABORATION WITH REGIONAL ORGANIZATIONS, RUTLAND REGIONAL SUPPORTS THE HEALTH AND WELL-BEING OF OUR COMMUNITY. A SUCCESSFUL COLLABORATION IN 2010 OCCURRED BETWEEN THE RUTLAND REGIONAL BREAST CARE PROGRAM, THE RUTLAND FREE CLINIC AND LADIES FIRST, WHO CAME TOGETHER TO STREAMLINE THE PROCESS OF PROVIDING BREAST HEALTH EDUCATION TO UNINSURED AND UNDERINSURED WOMEN AND FACILITATE SCREENINGS, CONSULTS AND MAMMOGRAMS. DONATIONS AND SPONSORSHIPS - A VARIETY OF ORGANIZATIONS SERVE THE NEEDS OF OUR COMMUNITY, CARING FOR AND PROMOTING HEALTH AND HEALTHY LIFESTYLES ACROSS THE REGION, WHICH RUTLAND REGIONAL SUPPORTS THROUGH DONATIONS, SPONSORSHIPS AND EMPLOYEE PARTICIPATION TOTALING OVER $1,254,166, ON A CONSOLIDATED BASIS. HIGHLIGHTS OF THESE ACCOMPLISHMENTS INCLUDE OUR FOCUS ON LOCAL NEEDS THROUGH THE ADOPT- A-FAMILY PROGRAM AND PARTICIPATION IN THE PACK THE PARAMOUNT FOOD DRIVE. PROFESSIONAL EDUCATION AND TRAINING - RUTLAND REGIONAL COLLABORATES WITH AN ARRAY OF EDUCATIONAL PROGRAMS TO PLAN, ORIENT AND SUPERVISE STUDENTS INTERESTED IN AND PURSUING CAREERS IN MEDICAL FIELDS, INCLUDING: HIGH SCHOOL STUDENTS IN PROGRAMS LIKE MEDQUEST, VOLUNTEERING, AND YES PLAN; PRECEPTING AND EVALUATING MEDICAL STUDENTS; PROVIDING NURSING STUDENT CLINICAL EXPERIENCES; AND PROVIDING CONTINUING MEDICAL EDUCATION (CME) PROGRAMMING OPEN TO STAFF OUTSIDE THE HOSPITAL. WORKFORCE DEVELOPMENT - RUTLAND REGIONAL WORKS COLLABORATIVELY TO MAINTAIN A DIVERSE PROFESSIONAL HEALTHCARE WORKFORCE TO ADDRESS THE MEDICAL AND HEALTH NEEDS OF OUR COMMUNITY, RECRUITING PHYSICIANS, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, SOCIAL WORKERS, NURSE ANESTHETISTS AND OTHERS THROUGHOUT THE YEAR. IN FY10, THIS INVESTMENT TOTALED OVER $280,000. HEALTHWISE - RUTLAND REGIONAL HAS RUN A PROGRAM ON PEG TV PROMOTING HEALTH AND HEALTHY LIVING THROUGH DISCUSSION OF HEALTH RELATED TOPICS OF INTEREST TO COMMUNITY MEMBERS OR GROUPS. COMMUNITY HEALTH IMPROVEMENT INITIATIVES - PROVIDING FREE SERVICES AND EDUCATIONAL PROGRAMMING IS A KEY ELEMENT OF SUPPORTING THE HEALTH OF OUR COMMUNITY. HEALTHY LIVING WORKSHOPS ASSIST INDIVIDUALS WITH CHRONIC ILLNESS LEARN WAYS TO IMPROVE THEIR SELF MANAGEMENT SKILLS AND FEEL MORE IN CONTROL OF THEIR HEALTH. COMMIT TO QUIT IS A FREE PROGRAM TO HELP SUPPORT CESSATION OF TOBACCO USE. SAFE SITTER BABYSITTING COURSES ARE OFFERED FOR 11- TO 13-YEAR OLDS INTERESTED IN BEGINNING BABYSITTING. OVER 25 SUPPORT GROUPS ARE AVAILABLE FOR INDIVIDUALS AND FAMILIES TO SHARE STORIES AND EXPERIENCES WITH OTHERS AND PROMOTE HEALING AND RECOVERY FROM CANCER, ALCOHOLISM, BEREAVEMENT, AND OTHER CONCERNS. IN SUMMARY, RUTLAND REGIONAL INVESTED $2,807,161 IN COMMUNITY BENEFITS AND PROVIDED $4,341,795 IN CHARITY CARE. IN ADDITION, RUTLAND REGIONAL EXPERIENCES SUBSTANTIAL SHORTFALLS IN UNREIMBURSED/UNCOMPENSATED MEDICAID CARE FOR EMERGENCY AND OTHER SERVICES EACH YEAR. LOOKING FORWARD TO FY11, RUTLAND REGIONAL WILL BE WORKING WITH AREA PRIMARY CARE PROVIDERS TO IMPLEMENT THE BLUEPRINT MEDICAL HOME MODEL OF SERVICE DELIVERY AND CONDUCTING A NEW COMMUNITY HEALTH NEEDS ASSESSMENT IN OUR EFFORTS TO CONTINUE POSITIVELY IMPACTING OUR COMMUNITY AND ITS MEMBERS. CHANGE IN ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 THE FOLLOWING SIGNIFICANT CHANGES TO THE ORGANIZATION'S BYLAWS HAVE NOT BEEN REPORTED ON ANY PRIOR FORM 990S: ARTICLE III, SECTION 1 - THE BOARD OF DIRECTORS SHALL CONSIST OF EIGHTEEN MEMBERS. ARTICLE III, SECTOIN 2(D) - THE CHAIR OF THE JAMES T. BOWSE HEALTH TRUST COMMITTEE SHALL BE DESIGNATED A MEMBER OF THE BOARD OF DIRECTORS DURING HIS/HER TERM AS A CHAIR OF THE COMMITTEE. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINES 6, 7A, & 7B PER ARTICLE II, SECTION 1, OF THE ORGANIZATION'S BYLAWS, RUTLAND REGIONAL HEALTH SERVICES IS THE SOLE MEMBER OF RUTLAND REGIONAL MEDICAL CENTER. ARTICLE III, SECTIONS 1 AND 2, OF THE BYLAWS STATE THAT THE BOARD SHALL CONSIST OF EIGHTEEN DIRECTORS. OF THESE DIRECTORS, FOURTEEN ARE CHOSEN OR APPROVED BY THE ORGANIZATION'S SOLE MEMBER. ARTICLE VIII, SECTION 5, OF THE BYLAWS DISCUSS POWERS RESERVED TO THE MEMBER, RUTLAND REGIONAL HEALTH SERVICES, INC., AND STATE THAT THE CORPORATION SHALL SUBMIT TO THE BOARD OF DIRECTORS OF THE MEMBER FOR ITS PRIOR APPROVAL THE FOLLOWING: A) THE APPOINTMENT OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, B) ALL OPERATING AND CAPITAL BUDGETS FOR THE CORPORATION, C) STRATEGIC PLANS FOR THE CORPORATION, D) CAPITAL EXPENDITURES OF $100,000 OR MORE WHICH ARE UNBUDGETED, E) PURCHASE AND SALE OF ALL SIGNIFICANT ASSETS, AND F) THE BYLAWS AND ANY AMENDMENTS THERETO. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT COPY IS THEN REVIEWED BY TOP MANAGEMENT. ONCE A FINAL DRAFT IS COMPLETE, IT IS MAILED TO EACH MEMBER OF THE SYSTEM FINANCE COMMITTEE. THE COMMITTEE WILL MEET AND DISCUSS THE RETURN WITH A TAX ADVISOR PRIOR TO PRESENTING THE FINAL DRAFT TO THE FULL BOARD OF DIRECTORS. ALL BOARD MEMBERS ARE ALSO PROVIDED A COPY OF THE FINAL DRAFT. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL ORGANIZATION LEADERS REVIEW THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY TO ENSURE ALL CONFLICTS ARE MADE KNOWN. SEE THE POLICY BELOW. POLICY *DUTY TO DISCLOSE IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THEOPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, OR OTHER INDIVIDUALS WHO, ON BEHALF OF THE CORPORATION, ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. *DUTY TO VOICE CONCERN IN THE EVENT THAT AN INTERESTED PERSON BECOMES CONCERNED THAT ANOTHER INTERESTED PERSON WHO IS A BOARD MEMBER, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS HAS AN UNDISCLOSED FINANCIAL INTEREST OR IS EXERTING INAPPROPRIATE INFLUENCE RELATED TO A FINANCIAL INTEREST, THIS CONCERN SHOULD BE RAISED WITH THE CHAIR OF THE APPROPRIATE BOARD OR COMMITTEE OR, IF INVOLVING A MEMBER OF LEADERSHIP COUNCIL, A DIRECTOR OR MANAGER OR OTHER INTERESTED PERSON, AN APPROPRIATE CORPORATE OFFICER. *DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD OR COMMITTEE MEMBERS. HOWEVER, IN NO EVENT SHALL AN INTERESTED PERSON PARTICIPATE IN THE DELIBERATION AND/OR DETERMINATION OF COMPENSATION THAT HE/SHE WILL RECEIVE FROM THE CORPORATION FOR EMPLOYMENT, PROFESSIONAL CONTRACT OR OTHERWISE. *DEFINITIONS -INTERESTED PERSON - FOR THE PURPOSES OF THIS POLICY, AN INTERESTED PERSON IS ANY BOARD MEMBER, PRINCIPAL OFFICER, MEMBER OF THE LEADERSHIP COUNCIL, DIRECTOR, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. IF AN INDIVIDUAL IS AN INTERESTED PERSON WITH RESPECT TO ANY ENTITY IN THE RRMC/RRHS HEALTH CARE SYSTEM, HE OR SHE IS AN INTERESTED PERSON WITH RESPECT TO ALL ENTITIES IN THE HEALTH CARE SYSTEM. *PROCEDURES -PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST .AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. .THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. .AFTER EXERCISING DUE DILIGENCE, INCLUDING A CONSIDERATION OF INDEPENDENT COMPARABILITY DATA, VALUATIONS OR APPRAISALS, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. .IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. -ANNUAL STATEMENTS .AWARENESS/COMPLIANCE WITH POLICY - EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THIS CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY; HAS AGREED TO COMPLY WITH THE POLICY; AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST BE ENGAGED PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. .CONFLICT OF INTEREST SURVEY - EACH INTERESTED PERSON SHALL DISCLOSE ON AN ANNUAL SURVEY FORM POTENTIAL CONFLICTS OF INTEREST AND FINANCIAL INTERESTS RELEVANT TO THIS POLICY. COMPENSATION REVIEW POLICY FORM 990, PART VI, SECTION B, LINE 15 THE FOLLOWING POLICY APPLIES TO THE ENTIRE RUTLAND REGIONAL HEALTH SERVICES (RRHS) SYSTEM, AND THE POLICY COVERS OFFICER & KEY EMPLOYEE COMPENSATION: *IT IS THE POLICY OF RRHS TO OFFER MARKET-COMPETITIVE PAY SO TO ATTRACT AND RETAIN THE BEST TALENT FROM OUR LABOR MARKET. *DESIGNATION OF RRHS' KEY EMPLOYEES IS MADE BY THE COMPLIANCE DEPARTMENT. *THE RRHS KEY EMPLOYEE LABOR MARKET IS TYPICALLY ALL HOSPITALS NATIONALLY WITH SIMILAR REVENUES AS RRHS. *KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY EACH FALL USING THREE SOURCES OF INDEPENDENT COMPETITIVE MARKET DATA. *JOBS HELD BY KEY EMPLOYEES ARE MATCHED WITH SIMILAR JOBS IN MARKET DATA WITH AN INDICATION OF JOB MATCH STRENGTH (WEAK, MODERATE OR STRONG). *THE MARKET REVIEW PRODUCES A REPORT OF KEY EMPLOYEE CURRENT BASE PAY AND TOTAL CASH COMPENSATION VS. MARKET BASE PAY AND TOTAL CASH COMPENSATION WITH ANY RECOMMENDED PAY ACTIONS. *GENERALLY SPEAKING, KEY EMPLOYEE BASE PAY VARIANCES OF -5% VS. MARKET TOTAL CASH COMPENSATION ARE CONSIDERED TO BE NON-COMPETITIVE PROMPTING A RECOMMENDED BASE PAY INCREASE TO BE CONSIDERED. *THE RESULTS OF THE REVIEW AND RECOMMENDED PAY ACTIONS ARE REVIEWED AND APPROVED BY THE CEO. INFORMATION IS MADE AVAILABLE TO SYSTEM FINANCE. *THE CEO PAY IS REVIEWED AND APPROVED BY THE CHAIR AND CO-CHAIR OF THE BOARD OF DIRECTORS. THIS REVIEW IS DOCUMENTED IN THE EXECUTIVE SESSION BOARD MINUTES. THE MOST RECENT COMPENSATION REVIEW OCCURRED DURING FALL 2010. *THE KEY EMPLOYEES REVIEW WAS CONDUCTED LAST FALL 2010 COVERING NON-PHYSICIAN EMPLOYEE EARNING AT LEAST $150,000. THIS WAS DONE INTERNALLY. DOCUMENT DISCLOSURE FORM 990, PART VI, LINE 19 CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE ANNUALLY IN THE ANNUAL REPORT, AND ARE ALSO AVAILABLE UPON WRITTEN REQUEST. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. ALL REQUESTS MUST BE FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT), AND REQUESTED DOCUMENTS WILL BE MAILED. BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV JOSEPH GIANCOLA, BOARD MEMBER, IS THE OWNER OF A BUILDING WHICH WAS RENTED TO THE ORGANIZATION FOR $129,623 IN FY 2010. MARK K. FOLEY, BOARD MEMBER, OWNS FOLEY DISTRIBUTING AND FOLEY SERVICES, INC. THESE COMPANIES SUPPLIED PAPER AND JANITORIAL PRODUCTS TO THE ORGANIZATION. JOAN F. GAMBLE, BOARD MEMBER, IS AN OFFICER AT CENTRAL VERMONT PUBLIC SERVICES (CVPS). IN FY 2010, THE ORGANIZATION PAID CVPS $1,089,000 FOR ELECTRICITY. JOHN C. COLLINS, BOARD MEMBER, IS ON THE BOARD OF BLUE CROSS BLUE SHIELD OF VERMONT (BCBS) AND THOMAS W HUEBNER, RRMC PRESIDENT & CEO, IS ON THE BOARD OF BLUE CROSS BLUE SHIELD OF VERMONT. IN FY10, THE ORGANIZAITON PAID BCBS $1,000,153 IN HEALTH INSURANCE PREMIUMS. 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