2023-08-14T09:32:04-05:00 2022-09-30 920460586 PWC US TAX LLP 101 SEAPORT BLVD BOSTON MA 02210 990 2021-10-01 030181058 PORTER HOSPITAL INC PORT 8023884701 115 PORTER DRIVE MIDDLEBURY VT 05753 SCOTT COMEAU CFO 8023884752 2023-08-14 1 SCOTT COMEAU 999009999 PAUL J TANIS P01441612 6175305000 0 AAL1 IAL1 2021 2023-04-26 12:10:37Z TOM THOMPSON 115 PORTER DRIVE MIDDLEBURY VT 05753 112024240 0 X WWW.PORTERMEDICAL.ORG X 1941 VT OPERATION OF A CRITICAL ACCESS HOSPITAL, IN LINE WITH OUR MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY, ONE PERSON AT A TIME. 17 13 680 40 0 0 2157545 4426280 96925189 100695971 607439 927280 18284 949809 99708457 106999340 0 54369 0 0 56506626 65429255 0 0 77904 35101395 36573454 91608021 102057078 8100436 4942262 83460872 76238721 28415891 22549146 55044981 53689575 X OPERATION OF A CRITICAL ACCESS HOSPITAL, IN LINE WITH OUR MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY, ONE PERSON AT A TIME. 0 0 84465867 54369 101424664 PORTER HOSPITAL, INC. ("PORTER") OPERATES A NOT-FOR PROFIT CRITICAL ACCESS HOSPITAL WITH PATIENT CARE SERVICES INCLUDING EMERGENCY ROOM, MATERNITY AND MEDICAL/SURGICAL INPATIENT AND OUTPATIENT CARE, AND ANCILLARY SERVICES INCLUDING REHABILITATION, LABORATORY TESTING, AND DIAGNOSTIC IMAGING SERVICES. AS A CRITICAL ACCESS HOSPITAL, PORTER STAFFS A TOTAL OF 25 BEDS. OF THE 25 BEDS, SIX BEDS ARE LOCATED IN THE MATERNITY UNIT, AND THE REMAINING BEDS ARE LOCATED ON THE MEDICAL/SURGICAL UNIT. PORTER RECORDED APPROXIMATELY 6,064 INPATIENT DAYS DURING THE YEAR. EMERGENCY ROOM VISITS TOTALED 12,841 FOR THE YEAR. SURGERIES FOR THE YEAR TOTALED 4,821. SUPPORT SERVICES FOR BOTH INPATIENTS AND OUTPATIENTS INCLUDE BUT ARE NOT LIMITED TO LABORATORY, DIAGNOSTIC IMAGING SERVICES, CARDIAC SERVICES, AND REHABILITATION FACILITIES. IMAGING INCLUDES RADIOLOGY, NUCLEAR MEDICINE, MRI, ULTRASOUND, AND CT SCAN. PORTER PROVIDES FREE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA. PORTER PROVIDES A NUMBER OF COMMUNITY HEALTH OUTREACH PROGRAMS TO THE GENERAL PUBLIC FOR FREE. THE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO DIABETES EDUCATION, BREAST CANCER SCREENING, PRENATAL CLASSES, BREASTFEEDING CLASSES, AND CPR COURSES. PORTER PROVIDES CLINICAL OFFICE SPACE TO THE OPEN DOOR CLINIC, WHICH PROVIDES ACCESS TO FREE QUALITY HEALTHCARE SERVICES TO THOSE WHO ARE UNINSURED OR UNDERINSURED UNTIL A PERMANENT HEALTH CARE PROVIDER CAN BE ESTABLISHED. FINALLY, PORTER HAS PARTNERED WITH LOCAL CAREER CENTERS, AS WELL AS COLLEGES TO PROVIDED CLINICAL EXPOSURE TO THEIR STUDENTS WITH GOALS OF DEVELOPING FUTURE HEALTHCARE WORKERS FOR THE COMMUNITY. 84465867 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 81 0 1 680 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X SCOTT COMEAU CFO 8023884752 115 PORTER DRIVE MIDDLEBURY VT 05753 DR LINN LARSON DIRECTOR 1.00 2.00 X 8255 0 0 DR ELYA VASILOU DIRECTOR 1.00 44.00 X 0 440002 49887 DR ANDREW MAHONEY DIRECTOR 1.00 44.00 X 0 324592 59247 DR KRISTOFER ANDERSON DIRECTOR 1.00 44.00 X 0 346235 32054 DR AMY GREGORY DIRECTOR (PART YR) 1.00 2.00 X 0 0 0 MAUREEN MCLAUGHIN TREASURER (PART YR) 1.00 2.00 X X 0 0 0 HELENA VAN VOORST DIRECTOR 1.00 2.00 X 0 0 0 DEBRA STENNER DIRECTOR 1.00 2.00 X 0 0 0 SARAH RAY DIRECTOR 1.00 2.00 X 0 0 0 CHERYL MULLINS DIRECTOR 1.00 2.00 X 0 0 0 NICHOLAS LOVEJOY DIRECTOR / SECRETARY 1.00 2.00 X X 0 0 0 ANNE COLLINS DIRECTOR 1.00 2.00 X 0 0 0 JUDSON BARTLETT VICE CHAIR 1.00 2.00 X X 0 0 0 GRETCHEN AYER DIRECTOR 1.00 2.00 X 0 0 0 MATTHEW CURRAN TREASURER 1.00 2.00 X X 0 0 0 LINDA SCHIFFER CHAIR 1.00 2.00 X X 0 0 0 SIVAN COTEL DIRECTOR / CHAIR (PT YR) 1.00 4.00 X X 0 0 0 AMEY RYAN DIRECTOR 1.00 2.00 X 0 0 0 RICHARD FOOTE DIRECTOR 1.00 2.00 X 0 0 0 TOM THOMPSON PRESIDENT & COO 10.00 40.00 X 0 483330 48416 SCOTT COMEAU CFO 25.00 25.00 X 0 126103 20030 MICHAEL LEYDEN AVP OPERATIONS 30.00 10.00 X 0 176912 30760 LINDA HAVEY AVP OPERATIONS 30.00 10.00 X 0 185973 7499 AMY BISHOP CRNA 40.00 0.00 X 274171 0 43425 WILLIAM HARRINGTON CRNA 40.00 0.00 X 299211 0 11005 ERIC BERG CRNA 40.00 0.00 X 308623 0 14143 DAVID J MYERS CRNA 40.00 0.00 X 190640 0 34977 RENEE MOSIER PHARMACY DIR 40.00 0.00 X 180187 0 32922 JUDY PEEK-LEE FMR INTERIM CFO 0.00 50.00 X 0 138158 2426 1261087 2221305 386791 37 1 1 1 CROSS COUNTRY STAFFING INC PO BOX 404678 ATLANTA GA 303844768 TRAVELING NURSING SERVICES 7443090 MEDICAL SOLUTIONS PO BOX 850737 MINNEAPOLIS MN 554850737 TRAVELING NURSING SERVICES 1996938 ALLIANCE HEALTHCARE SERVICES INC PO BOX 735714 DALLAS TX 753735714 RADIOLOGY SERVICES 1197110 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 554809146 LABORATORY SERVICES 643303 MIDDLEBURY REGIONAL EMS INC PO BOX 8648 ESSEX JUNCTION VT 05452 AMBULANCE / TRANSPORT SERVICES 349373 41 83202 3518623 824455 4426280 PATIENT SERVICE REVENUE 900099 77563891 77563891 FIXED PROSPECTIVE PAYMENTS 900099 20810103 20810103 PATIENT SERVICES - PHARMACY 446110 1510708 1510708 DSH REVENUE 900099 811269 811269 100695971 476934 476934 11659 0 11659 11659 11659 5475246 5009634 15266 465612 -15266 450346 450346 OTHER MISC REVENUE 900099 728693 728693 CAFETERIA 900099 209457 209457 938150 106999340 101424664 0 1148396 X 54369 54369 6974 6974 55200097 49172196 6027901 2174686 1898837 275849 5266957 4366321 900636 2780541 2383217 397324 83978 83978 60524 60524 9011 9011 15120 15120 11537277 5899577 5561554 76146 125722 75285 50437 10811411 10254988 556423 1520195 24603 1495592 1867989 726389 1141600 81318 66728 14590 201211 193369 7842 271600 226134 45466 2929571 2437403 490410 1758 319356 238457 80899 MEDICARE PROVIDER TAX 5587514 5587514 LEASED EQUIPMENT 473322 388134 85188 BOOKS, DUES & SUBSCRIPT 203556 37175 166381 FREIGHT 127991 123836 4155 346788 311335 35453 102057078 84465867 17513307 77904 79971 19595 30901493 7666579 14155944 17034121 2167561 2435609 481697 1362795 60077676 46163640 15562683 13914036 11826884 27790928 4993379 4793323 3291260 1221735 83460872 76238721 8482999 10139416 3447 9530945 8965927 10401947 3440356 28415891 22549146 X 49584235 47932940 5460746 5756635 55044981 53689575 83460872 76238721 X 4942262 -6173632 -124036 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9011 9011 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS, A PORTION OF WHICH IS ATTRIBUTABLE TO LOBBYING EXPENSES. 5111060 215550 415605 4911005 3965823 1546430 401193 5111060 3834593 518448 387218 3965823 3801633 416015 383055 3834593 3685569 508630 392566 3801633 0.00000 1.00000 0.00000 1 0 28987420 19921447 9065973 28557131 24640060 3917071 2533125 1602133 930992 13914036 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 4793323 F 4793323 ESTIMATED THIRD PARTY SETTLEMENTS 740297 LIABILITY FOR PENSION BENEFITS 1446309 RT OF USE OPERATING LEASE OBLIGATION 1239864 CONTRACT LIABILITIES 13886 3440356 X PART V, LINE 4: INCOME FROM ENDOWMENTS HELD AND ADMINISTERED BY MIDDLEBURY COLLEGE SUPPORTS THE ORGANIZATION'S MISSION BY PROVIDING FUNDS FOR CHARITY CARE AND ADDITIONALLY OFFSETS A PORTION OF THE ORGANIZATION'S OPERATING EXPENSES. PART X, LINE 2: PORTER HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVM HEALTH NETWORK"). PAGE 18 OF THE CONSOLIDATED FINANCIAL STATEMENTS CONTAINS A FOOTNOTE INDICATING THAT NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED. 1 1 X 1 X 1 X 360.000000000000 1 1 1 0 0 762022 762022 0.00750 12714349 2913948 9800401 0.09600 13476371 2913948 10562423 0.10350 855049 677862 177187 0.00170 77205 77205 0.00080 6815697 5028139 1787558 0.01750 54369 54369 0.00050 7802320 5706001 2096319 0.02050 21278691 8619949 12658742 0.12400 1 2912612 27949 16141839 21033121 -4891282 X 1 1 1 1 PORTER HOSPITAL INC 115 PORTER DRIVE MIDDLEBURY VT 05753 WWW.PORTERMEDICAL.ORG 899 X X X X PORTER HOSPITAL INC 1 0 0 1 X X X X X X X X X X 20 1 0 1 1 X SEE PART V, SECTION C X 1 21 1 SEE PART V, SECTION C 0 1 X 200.000000000000 360.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 PORTER HOSPITAL, INC. PART V, SECTION B, LINE 3J: THE CHNA CONDUCTED IN FY 2021 / TY 2020 CONTAINS INFORMATION AND ANALYSIS THAT EXTENDS BEYOND THE SUBJECTS DESCRIBED IN PART V, LINE 3, INCLUDING BUT NOT LIMITED TO: SECONDARY DATA SOURCES, MORTALITY STATISTICS, KEY HEALTH AND WELLBEING INDICATORS AND THEIR SOURCES, AND A DISCUSSION OF THE IMPACT OF COVID-19 ON THE COMMUNITY. PORTER HOSPITAL, INC. PART V, SECTION B, LINE 5: THE CHNA DATA COLLECTION PROCESS CONSISTED OF A CHNA SURVEY COMPLETED BY 761 RESPONDENTS, FIVE SEPARATE FOCUS GROUP SESSIONS IN WHICH 14 PERSONS PARTICIPATED, AND STAKEHOLDER INTERVIEWS WITH 33 REPRESENTATIVES FROM 23 COMMUNITY ORGANIZATIONS. THE SURVEYS WERE CONDUCTED IN FEBRUARY AND MARCH 2021 AND WERE PRIMARILY COLLECTED ONLINE. THE SURVEY WAS MADE AVAILABLE IN ENGLISH AND IN SPANISH. THE SURVEYS WERE PUBLICIZED THROUGH ELECTRONIC MAILING LISTS, ONLINE COMMUNITY MESSAGE BOARDS, SOCIAL MEDIA, AND THE PORTER HOSPITAL WEBSITE. HOWEVER, PAPER SURVEYS WERE MADE AVAILABLE BY REQUEST AND DISTRIBUTED LOCALLY AT OPEN DOOR CLINIC AND MIDDLEBURY LAUNDROMAT. PAPER SURVEYS WERE ALSO OFFERED TO INDIVIDUALS WHO RECEIVED HOME-BOUND COVID-19 VACCINATIONS.FOCUS GROUPS WERE HELD IN MAY 2021. PARTICIPANTS WERE RECRUITED VIA FLYERS SENT TO COMMUNITY PARTNERS, THROUGH COMMUNITY MEMBERS IDENTIFIED BY COMMUNITY PARTNERS, AND VIA ONLINE MESSAGE BOARDS. FOCUS GROUP DISCUSSIONS WERE GUIDED BY AN IN-DEPTH QUESTIONNAIRE, A COPY OF WHICH IS INCLUDED AS AN APPENDIX TO THE CHNA. CROSS-SECTOR STAKEHOLDERS WERE INTERVIEWED AT EXISTING MEETINGS SUCH AS THAT OF THE COMMUNITY HEALTH ACTION TEAM, BUILDING BRIGHT FUTURES GROUP, SUBSTANCE USE TREATMENT AND RECOVERY COMMITTEE, OR WERE CONDUCTED SEPARATELY TO INTERESTED INDIVIDUALS. STAKEHOLDER ORGANIZATIONS REPRESENTED MANY ASPECTS OF THE COMMUNITY AND INCLUDED: PARENT CHILD CENTER, BUILDING BRIGHT FUTURES, UNITED WAY OF ADDISON COUNTY, MARY HOGAN, MARY JOHNSON, ADDISON COUNTY SCHOOL DISTRICTS, END OF LIFE SERVICES, ADDISON COUNTY HOME HEALTH AND HOSPICE, COUNSELING SERVICES OF ADDISON COUNTY, FIELD SERVICES, PRIVATE PT PRACTICE, MOUNTAIN HEALTH CENTER, GIVING FRIDGE, TURNING POINT CENTER, DEPARTMENT FOR CHILDREN AND FAMILIES, VERMONT DEPARTMENT OF HEALTH, RESIDENCE AT OTTER CREEK, SAVIDA, BRISTOL FAMILY CENTER, PREGNANCY RESOURCE CENTER, NORTHERN LIGHTS AT CCV, AND MOUNT ABRAHAM UNIFIED SCHOOL DISTRICT. PORTER HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE TY 2020/FY 2021 CHNA WAS CONDUCTED WITH THE ASSISTANCE OF COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY OF ADDISON COUNTY, THE DEPARTMENT OF HEALTH, MIDDLEBURY COLLEGE, BLUEPRINT FOR HEALTH, AND ADDISON COUNTY HOME HEALTH AND HOSPICE, ALL OF WHICH CONTRIBUTED MEMBERS TO THE CHNA STEERING COMMITTEE. ADDITIONALLY, MIDDLEBURY COLLEGE STUDENTS SERVED IMPORTANT ROLES IN THE AREAS OF DATA COLLECTION AND ANALYSIS. FINALLY, THE LOCAL ORGANIZATIONS LISTED IN THE PREVIOUS DISCLOSURE CONTRIBUTED TO THE STAKEHOLDER MEETINGS. PORTER HOSPITAL, INC. PART V, SECTION B, LINE 11: PARTICIPANTS IN THE CHNA DATA COLLECTION PROCESSES DESCRIBED ABOVE IDENTIFIED CONCERNS AROUND THE FOLLOWING AREAS: SUBSTANCE ABUSE, INCLUDING CONCERNS ABOUT STIGMA SURROUNDING TREATMENT, AS WELL AS THE AVAILABILITY AND AFFORDABILITY OF TREATMENT;HEALTHY EATING, PRIMARILY CONCERNED AROUND AFFORDABILITY OF HEALTHY FOODS;MENTAL HEALTH, INCLUDING CONCERNS ABOUT AFFORDABILITY AND A NEED FOR MORE RESOURCES SUCH AS MENTAL HEALTH CLINICIANS;HEALTH CARE, INCLUDING CONCERNS ABOUT AFFORDABILITY, THE NEED FOR MORE PRIMARY CARE PROVIDERS, AND WELLNESS CENTERED CARE, AS WELL AS BARRIERS SUCH AS TRANSPORTATION AND LACK OF HEALTH INSURANCEENVIRONMENTAL ISSUES SUCH AS CLIMATE CHANGE AND STREET SAFETY; ANDHOUSING, INCLUDING LACK OF AFFORDABLE UNITS, SPACE TO RENT, SOBER HOUSING, AND HOUSING FOR ELDERS.A COMMUNITY MEETING WAS HELD TO PRESENT THE INFORMATION FROM THE CHNA SURVEY, FOCUS GROUPS, AND STAKEHOLDER MEETINGS WHERE 32 COMMUNITY LEADERS WERE PRESENT. ONCE THE INFORMATION WAS PRESENTED, LEADERS BROKE OUT INTO GROUPS TO IDENTIFY THE TOP THREE PRIORITIES TO BE ADDRESSED IN THE IMPLEMENTATION STRATEGY. THE TOP THREE PRIORITIES SELECTED WERE ACCESS TO MENTAL HEALTH SERVICES (72%), ACCESS TO HEALTHCARE SERVICES (60%), AND HOUSING (44%). THE IMPLEMENTATION STRATEGY CONTAINS THE FOLLOWING OBJECTIVES WITH RESPECT TO THESE PRIORITIES AND CONTAINS METRICS AND BENCHMARKS TO ESTABLISH PROGRESS.ACCESS TO MENTAL HEALTH SERVICES:- ADVANCE MENTAL WELLNESS THROUGH EQUITABLE ACCESS TO A TIMELY, RESPONSIVE, AND INTEGRATED SYSTEM;- STRONG CROSS-ORGANIZATION COMMITMENT AND ENGAGEMENT TO INCREASE ACCESS TO MENTAL HEALTH CARE; AND- CULTIVATE RESILIENT COMMUNITIES TO SUPPORT MENTAL AND SOCIAL WELLBEING.ACCESS TO HEALTHCARE SERVICES:- ENHANCE USE OF TECHNOLOGY AND ELECTRONIC HEALTH RECORD SYSTEMS TO IMPROVE ACCESS, EFFECTIVENESS, OUTREACH, AND OVERALL QUALITY OF CARE;- EXPAND WORKFORCE RECRUITMENT AND RETENTION EFFORTS TO INCREASE CAPACITY; - REIMAGINE HEALTH CARE TO INCREASE ACCESS TO SERVICES; AND- IMPROVE EQUITY IN THE HEALTH CARE SYSTEM BY DEVELOPING A COLLECTIVE APPROACH AND COORDINATED IMPACT WITHIN THE COMMUNITY.HOUSING:- STRONG CROSS-ORGANIZATIONAL COMMITMENT AND ENGAGEMENT TO EXPAND OPPORTUNITIES FOR AFFORDABLE AND QUALITY HOUSING IN ADDISON COUNTY;- REDUCE DISPLACEMENT AND HOMELESSNESS IN ADDISION COUNTY; AND- PROMOTE A SAFE ENVIRONMENT FOR YOUTH, FAMILIES, AND OLDER VERMONTERS IN THE HOME SETTING.GIVEN THE NUMBER OF INDIVIDUALS AND ORGANIZATIONS INCLUDED IN THE CHNA PROCESS AND THE VAST ARRAY OF VIEWPOINTS REPRESENTED, THE ORGANIZATION WAS UNABLE TO ADDRESS ALL OF THE NEEDS IDENTIFIED THROUGHOUT THE CHNA PROCESS. THE GROUP THEREFORE FOCUSED IMPLEMENTATION EFFORTS ON THE TOP THREE NEEDS AS DETERMINED BY CONSENSUS AT THE COMMUNITY MEETING DESCRIBED ABOVE. PORTER HOSPITAL, INC. PART V, SECTION B, LINE 13H: PATIENTS WHOSE FAMILY INCOME IS ABOVE 360% OF THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE TO RECEIVE ASSISTANCE ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES AT THE DISCRETION OF PORTER HOSPITAL. PORTER HOSPITAL, INC. PART V, SECTION B, LINE 15E: ELIGIBILITY VERIFICATION MAY INCLUDE WRITTEN DOCUMENTATION FROM THE OPEN DOOR CLINIC (A LOCAL, FREE HEALTH CLINIC FOR UNINSURED AND UNDER-INSURED ADULTS IN ADDISON COUNTY, VERMONT) OF FINANCIAL INFORMATION IN LIEU OF INCOME VERIFICATION. WHILE THE FINANCIAL ASSISTANCE POLICY DOES NOT PROVIDE A LIST OF "EXTERNAL" CONTACT INFORMATION FOR ORGANIZATIONS AGENCIES WHO MAY ASSIST PATIENTS IN THE APPLICATION PROCESS, APPLICATION COMPLETION AID IS WELL PUBLISHED WITH MULTIPLE INTERNAL, ORGANIZATIONAL AND PROVIDED BY STAFF MEMBERS AVAILABLE TO ASSIST OUR PATIENTS. IT IS ALSO IMPORTANT TO NOTE, WHENEVER POSSIBLE, PATIENTS ARE REVIEWED IN ADVANCE OF SERVICE FOR POTENTIAL HARDSHIP; THE UNINSURED AND UNDERINSURED PATIENTS WHO ARE IDENTIFIED ARE ACTIVELY COUNSELED WITH HELP FOR GOVERNMENT AND EXCHANGE PROGRAMS AS WELL AS ASSISTANCE UNDER THE FINANCIAL ASSISTANCE PROGRAM. PORTER HOSPITAL, INC. PART V, SECTION B, LINE 16J: PORTER HOSPITAL MAKES ADDITIONAL EFFORTS TO ENGAGE PATIENTS IN FINANCIAL COUNSELING AND DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE AS FOLLOWS: - SIGNAGE HAS BEEN POSTED IN ALL WAITING AREAS OF THE ORGANIZATION REGARDING FINANCIAL ASSISTANCE BEING OFFERED. - NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE HAS BEEN ADDED TO THE PATIENT PORTAL ALONG WITH A PHONE NUMBER FOR ASSISTANCE ALONG WITH OUR WEBSITE ADDRESS FOR APPLICATION. - OUTPATIENT PREREGISTRATION CALLS NOTIFY PATIENTS OF AVAILABILITY OF FINANCIAL ASSISTANCE. - REGISTRATION AREAS NOTIFY PATIENTS OF AVAILABILITY OF FINANCIAL ASSISTANCE AS WELL AS HAVING APPLICATIONS READILY AVAILABLE. - EVERY STATEMENT HAS THE NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE ALONG WITH A PHONE NUMBER TO CALL FOR ASSISTANCE AND A WEBSITE TO VISIT FOR AN APPLICATION. - THE UVMHN CUSTOMER SERVICE DEPARTMENT MAKES A REASONABLE EFFORT TO CALL PATIENTS FOR COLLECTIONS OF SELF-PAY BALANCES AND NOTIFICATION OF FINANCIAL ASSISTANCE. PORTER HOSPITAL, INC. PART V, SECTION B, LINE 20E: (ALSO APPLICABLE TO LINE 20A) PORTER HOSPITAL DOES NOT TAKE ANY EXTRAORDINARY COLLECTION ACTIONS. PART V, SECTION B, LINES 7A, 10A, AND 16A-16C: HOSPITAL FACILITY'S WEBSITE CHNA AND IMPLEMENTATION STRATEGY:WWW.PORTERMEDICAL.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/FINANCIAL ASSISTANCE POLICY, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY: WWW.PORTERMEDICAL.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/ 10 1 - UVMHN-PMC ORTHOPEDICS 2436 EXCHANGE STREET MIDDLEBURY VT 05753 PHYSICIAN CLINIC 2 - UVMHN-PMC PRIMARY CARE-MIDDLEBURY 82 CATAMOUNT PARK MIDDLEBURY VT 05753 FAMILY PHYSICIAN CLINIC 3 - UVMHN-PMC PRIMARY CARE-VERGENNES 10 NORTH STREET VERGENNES VT 05491 FAMILY PHYSICIAN CLINIC 4 - UVMHN-PMC PEDIATRIC PRIMARY CARE 1330 EXCHANGE STREET 201 MIDDLEBURY VT 05753 PHYSICIAN CLINIC 5 - UVMHN-PMC PRIMARY CARE-BRANDON 61 COURT DRIVE BRANDON VT 05733 FAMILY PHYSICIAN CLINIC 6 - UVMHN-PMC EAR NOSE & THROAT 1330 EXCHANGE STREET 202 MIDDLEBURY VT 05753 PHYSICIAN CLINIC 7 - UVMHN-PMC PRIMARY CARE-BRISTOL 61 PINE STREET BRISTOL VT 05443 PHYSICIAN CLINIC 8 - UVMHN-PMC CARDIOLOGY 115 PORTER DRIVE MIDDLEBURY VT 05753 PHYSICIAN CLINIC 9 - UVMHN-PMC PODIATRY 76 COURT STREET MIDDLEBURY VT 05753 PHYSICIAN CLINIC 10 - UVMHN-PMC WOMEN'S HEALTH 116 PORTER DRIVE MIDDLEBURY VT 05753 PHYSICIAN CLINIC PART I, LINE 3C: ALL UNINSURED PATIENTS AND PATIENTS HAVING A BALANCE AFTER INSURANCE ARE ELIGIBLE TO SUBMIT A FINANCIAL ASSISTANCE APPLICATION. IN ADDITION TO THE INCOME TEST BASED ON FEDERAL POVERTY GUIDELINES DESCRIBED IN SCHEDULE H, PART I, ELIGIBILITY IS PREDICATED UPON AN ASSET LEVEL WITHIN THE LIMITATIONS SET FORTH BY THE CMS MEDICARE LOW INCOME BENEFICIARY LIMITS. ADDITIONALLY, CATASTROPHIC FINANCIAL ASSISTANCE IS AVAILABLE TO THE MEDICALLY INDIGENT. FINALLY, PATIENTS WHOSE FAMILY INCOME IS ABOVE 360% OF THE FEDERAL POVERTY GUIDELINES, OR WHO OTHERWISE DO NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE TESTS DESCRIBED ABOVE, WERE ELIGIBLE TO RECEIVE ASSISTANCE ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES AT THE THE DISCRETION OF PORTER HOSPITAL. PART I, LINE 7: THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR THE PURPOSES OF CALCULATING AMOUNTS ON LINES 7A AND 7B. AN ACTUAL COSTING METHOD WAS USED TO CALCULATE AMOUNTS ON LINES 7E, 7F, 7G AND 7I. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES PROVIDED DESPITE A LOSS TO THE ORGANIZATION INCLUDED SERVICES PROVIDED TO PUBLIC AGENCIES AS WELL AS DEPARTMENTS MEETING NEEDS THAT ARE NOT OTHERWISE AVAILABLE IN THE COMMUNITY SUCH AS DELIVERY, NEWBORN AND POSTPARTUM SERVICES, AND SERVICES RELATED TO MENTAL HEALTH. DUE TO A CHANGE IN THE ORGANIZATION'S MEDICAL RECORDS AND BILLING SYSTEM, EXPENSE DATA FOR THESE SERVICES IS ONLY AVAILABLE FOR THE PERIOD FROM 11/6/2021 THROUGH 9/30/2022. THESE AMOUNTS ARE REPORTED ON SCH H, PART I, LINE 7G. ACTUAL EXPENSES FOR THE ENTIRE YEAR (10/1/2021-9/30/2022) CANNOT BE ACCURATELY ASCERTAINED, BUT THEY ARE MOST LIKELY HIGHER THAN THOSE REPORTED. PART I, LN 7 COL(F): THE PROVISION FOR BAD DEBT SUBTRACTED FOR PURPOSES OF OF CALCULATING THE AMOUNT REPORTED ON LINE 7(F) IS $0. BAD DEBT IS DEDUCTED FROM PATIENT SERVICE REVENUE REPORTED ON FORM 990, PART VIII. PART III, LINE 2: THE ORGANIZATION USED THE COST-TO-CHARGE RATIO AS ITS COSTING METHODOLOGY TO CALCULATE BAD DEBT EXPENSE AT COST. PART III, LINE 3: DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE NETTED AGAINST THE TOTAL GROSS CHARGES WHEN DETERMINING BAD DEBT EXPENSE. THE $27,949 REFLECTS THE ADJUSTED BAD DEBT EXPENSE FOR ALL PATIENTS WHO SUBMITTED AN INITIAL APPLICATION, BUT UPON FOLLOW-UP, DID NOT RESPOND TO REQUESTS FOR ADDITIONAL INFORMATION OR SUPPORTING DOCUMENTATION. PORTER HOSPITAL HAS A DATABASE WHICH TRACKS ALL APPLICATIONS AND THEIR STATUS; A QUERY EXTRACTED ALL INCOMPLETE/NON RESPONSIVE ARCHIVED APPLICATIONS PROVIDING A LIST OF PATIENTS & DEPENDENTS. SUBSEQUENTLY, A QUERY OF ASSOCIATED PATIENT SERVICES FROM 10/1/21-9/30/22 FOR "SELF-PAY AND COLLECTION ACCOUNTS WAS EXTRACTED FROM THE BILLING SYSTEM. PART III, LINE 4: THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED ON PAGE 27 IN FOOTNOTE 5 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE AMOUNT REPORTED IN PART III, LINE 6, MEDICARE ALLOWABLE COSTS OF CARE, IS DERIVED FROM PORTER HOSPITAL'S FYE 9/30/22 MEDICARE COST REPORT, WORKSHEETS E-1 THROUGH E-3. WHILE PORTER HOSPITAL HAS FOLLOWED THE CATHOLIC HOSPITAL ASSOCIATION'S GUIDANCE AND HAS NOT CONSIDERED ANY MEDICARE SHORTFALL (REPORTED IN PART III, LINE 7) AS A COMMUNITY BENEFIT, IT IS LIKELY THAT SOME PORTION OF MEDICARE PATIENTS WOULD HAVE QUALIFIED FOR CHARITY CARE UNDER OUR POLICIES IN THE ABSENCE OF MEDICARE COVERAGE, SUCH THAT SHORTFALLS ASSOCIATED WITH THOSE PATIENTS WOULD OTHERWISE HAVE BEEN INCLUDED IN OUR COMMUNITY BENEFITS. PART III, LINE 9B: THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY PROVIDES THAT PATIENTS INDICATING AN INABILITY TO MEET THEIR FINANCIAL OBLIGATIONS ARE TO BE REFERRED TO THE PATIENT FINANCIAL ADVOCATE. THE POLICY PROVIDES FURTHER THAT PATIENTS WHO APPLY UNDER THE FINANCIAL ASSISTANCE POLICY ARE NOT CHARGED MORE THAN AMOUNTS GENERALLY BILLED AND QUALIFY FOR A SLIDING SCALE DISCOUNT. THE BILLING AND COLLECTIONS PROCESS IS EXTENDED FOR UP TO THE LATTER OF 240 DAYS OR SIX WEEKS AFTER A PATIENT HAS REQUESTED A FINANCIAL ASSISTANCE APPLICATION FOR PATIENTS REQUESTING A FINANCIAL ASSISTANCE APPLICATION. ONCE A PATIENT IS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL PAYMENTS MADE IN EXCESS OF THE FAP-ELIGIBLE AMOUNT ARE FUNDED AND THE FAP-ELIGIBLE AMOUNT IS NOT PURSUED. PART VI, LINE 2: PORTER HOSPITAL PARTNERS WITH A NUMBER OF COMMUNITY HEALTH RESOURCE GROUPS INCLUDING MY HEALTHY VERMONT, THE VERMONT PUBLIC HEALTH INSTITUTE, AND THE VERMONT DEPARTMENT OF HEALTH DISTRICT OFFICES TO ADDRESS THE NEEDS OF ADDISON COUNTY, VERMONT AND SURROUNDING AREAS. RECENT COLLABORATIONS HAVE INCLUDED A FOOD BAGS PROJECT PILOTED AT PORTER WOMEN'S HEALTH, AND ADMINISTRATION OF VERMONT COMMUNITY HEALTH PARTNERSHIP GRANTS. ADDITIONALLY, PORTER HOSPITAL OFFERS FREE TO THE COMMUNITY A WIDE RANGE OF HEALTH, PREVENTION AND WELLNESS PROGRAMS DESIGNED TO ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY AND LIMIT THE NEED FOR MORE EXPENSIVE ACUTE CARE. CURRENT PROGRAMS ARE LISTED AT THE PORTER WEBSITE AT WWW.PORTERMEDICAL.ORG/CATEGORY/CLASSES-EVENTS. FINALLY, PORTER HOSPITAL HAS A COMMUNITY DEVELOPMENT COUNCIL THAT CONSISTS OF COMMUNITY MEMBERS AND PORTER STAFF WORKING TOGETHER TO DRIVE COMMUNITY ENGAGEMENT AND CREATE OPPORTUNITIES TO SUPPORT PORTER AND EXPAND PATIENT ACCESS. PART VI, LINE 3: PORTER HOSPITAL ("PORTER") UTILIZES A VARIETY OF METHODS TO INFORM, EDUCATE, AND ASSIST PAYMENTS IN IDENTIFYING PAYMENT SOURCES, INCLUDING STATE / FEDERAL PROGRAMS AND ITS FINANCIAL ASSISTANCE POLICY. PORTER WIDELY PUBLICIZES ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE, WHICH INCLUDES THE POLICY, THE APPLICATION, AND PLAIN LANGUAGE SUMMARY IN BOTH ENGLISH AND SPANISH. PAPER COPIES ARE AVAILABLE WITHOUT CHARGE AT LOCATIONS THROUGHOUT THE HOSPITAL INCLUDING BUT NOT LIMITED TO REGISTRATIONS DESKS IN THE ER AS WELL AS OFFSITE LOCATIONS. INDIVIDUALS ARE NOTIFIED ABOUT THE FAP WITH BILLING NOTICES AND OTHER BROCHURES PLACED THROUGHOUT PORTER FACILITIES.PORTER MAINTAINS ITS OWN HEALTH ASSISTANCE PROGRAM TO HELP ELIGIBLE LOW AND MIDDLE INCOME FAMILIES OBTAIN PRESCRIPTION MEDICATIONS, EYEGLASSES, AND MEDICAL EQUIPMENT AT NO COST. THE HEALTH ASSISTANCE PROGRAM ALSO PROVIDES ASSISTANCE WITH ENROLLMENT IN STATE AND FEDERAL PROGRAMS, INCLUDING OBTAINING INSURANCE THROUGH THE VERMONT HEALTH CONNECT EXCHANGE, AND PROVIDES ADVOCACY AND SUPPORT WITH OBTAINING OTHER HEALTH CARE RELATED RESOURCES.ADDITIONALLY, PORTER'S OFFICE OF PATIENT AND FAMILY ADVOCACY IS AVAILABLE TO HELP WITH CONCERNS ABOUT DELIVERY OF CARE, INCLUDING BUT NOT LIMITED TO COSTS. PART VI, LINE 4: ADDISON COUNTY IS LOCATED IN THE LOWER CHAMPLAIN VALLEY OF VERMONT WITH LAKE CHAMPLAIN AND THE ADIRONDACKS TO THE WEST AND THE GREEN MOUNTAINS TO THE EAST. THE UNIQUE LANDSCAPE OF ADDISON COUNTY, THE FARMLANDS OF THE CHAMPLAIN VALLEY, AND THE PREDOMINATELY WOODED SETTINGS NEAR THE GREEN MOUNTAINS PROMOTE A BLEND OF LIGHT INDUSTRY AND FARMING. THE MAJOR EMPLOYERS IN THE COUNTY INCLUDE MIDDLEBURY COLLEGE, PORTER MEDICAL CENTER (AND ITS AFFILIATES INCLUDING PORTER HOSPITAL), AND COLLINS AEROSPACE.PORTER HOSPITAL SERVES 36,777 RESIDENTS LOCATED IN ADDISON COUNTY, VERMONT, WHICH COMPRISES APPROXIMATELY 6% OF THE STATE'S TOTAL POPULATION. AS OF 2019, A VAST MAJORITY (94.5%) OF ADDISON COUNTY RESIDENTS WERE WHITE, NON-HISPANIC. HISPANIC OR LATINO RESIDENTS ARE ADDISON COUNTY'S MORE PREVALENT MINORITY POPULATION AT 2.3%. THE US CENSUS BUREAU ESTIMATES THAT 4.7% OF ADDISON COUNTY RESIDENTS UNDER THE AGE OF 65 WERE UNINSURED IN 2019. 93.5% OF THE POPULATION HAS A HIGH SCHOOL DIPLOMA OR HIGHER, 39.6% OF THE POPULATION HAS A BACHELOR'S DEGREE OR HIGHER, AND 7.9% OF THE POPULATION IS UNDER THE FEDERAL POVERTY LEVEL. THE MEDIAN HOUSEHOLD INCOME AS OF 2019 WAS $68,825. PART VI, LINE 5: IN ADDITION TO THE COLLABORATIONS AND PARTNERSHIPS DESCRIBED PREVIOUSLY:PORTER HOSPITAL ("PORTER") PROVIDES RENT-FREE CLINIC SPACE AND VOUCHERS FOR NO-COST ANCILLARY SERVICES TO THE LOCAL OPEN DOOR CLINIC IN ITS ROLE AS A CATALYST IN THE DELIVERY OF HEALTH CARE SERVICES TO ITS ENTIRE COMMUNITY. PORTER OFFERS FREE AND LOW COST COMMUNITY EDUCATION PROGRAMS ON HEALTH CARE TOPICS INCLUDING MEMORY LOSS, DEMENTIA, BREAST CANCER SCREENING, BASIC DIABETES, CPR, SMOKING CESSATION, NUTRITION, PHYSICAL FITNESS, PARENTING, PRENATAL EXERCISE AND BREASTFEEDING. A MAJORITY OF THE GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN ITS SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF PORTER NOR FAMILY MEMBERS THEREOF. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE INVESTED IN TECHNOLOGY, FACILITIES AND PROGRAMS. PART VI, LINE 6: ON APRIL 1, 2017, THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVMHN") BECAME THE SOLE MEMBER OF PORTER MEDICAL CENTER, INC., THE PARENT ORGANIZATION FOR BOTH PORTER HOSPITAL AND HELEN PORTER NURSING HOME, INC. WITH SIX HOSPITALS ACROSS VERMONT AND NORTHERN NEW YORK, AS WELL AS A MEDICAL GROUP, AND AFFILIATED CLINICS, NURSING HOMES, AND NON-HOSPITAL FACILITIES, UVMHN COMPRISES AN INTEGRATED SYSTEM OF CARE SERVING ITS COMMUNITIES. UVMHN CARRIES OUT CENTRALIZED ACTIVITIES FOR THE BENEFIT OF PATIENTS OF ALL PARTNER ORGANIZATIONS, INCLUDING IMPROVING ACCESS TO LOCAL CARE, COST SAVINGS THROUGH GREATER JOINT PURCHASING POWER, ENHANCING INFORMATION TECHNOLOGY, INCREASING ACADEMIC OPPORTUNITIES FOR PHYSICIANS, ENGAGING IN REGIONAL STRATEGIC PLANNING, AND PARTICIPATING IN JOINT QUALITY AND CLINICAL INITIATIVES, AND COLLABORATIVE EFFORTS. PORTER HOSPITAL REGULARLY PARTNERS WITH OTHER ORGANIZATIONS AND PROVIDERS TO HELP MEET THE NEEDS OF ITS COMMUNITY. THIS INCLUDES WORKING WITH OTHER ORGANIZED SYSTEMS OF CARE (LIKE HOME HEALTH AGENCIES AND PHYSICIAN PRACTICES), AS WELL AS COMMUNITY-BASED ORGANIZATIONS WHOSE MISSIONS ARE SIMILAR. FOR EXAMPLE, PORTER HOSPITAL COLLABORATES WITH COMMUNITY PARTNERS TO REGULARLY ASSESS COMMUNITY AND HEALTH CARE NEEDS, WHICH HELPS GUIDE THE ORGANIZATION'S PRIORITIES. PART VI, LINE 7, REPORTS FILED WITH STATES VT 1 HUDSON HEADWATERS HEALTH NETWORK 9 CAREY ROAD QUEENSBURY NY 12804 141628237 501(C)(3) 14700 0 COMMUNITY HEALTH IMPROVEMENT 1 PART I, LINE 2: IN FY 2021-2022, THE ORGANIZATION RELIED ON THE UVM HEALTH NETWORK AND ITS AFFILIATED ORGANIZATIONS FOR SELECTION AND MONITORING OF THE GRANT TO HUDSON HEADWATERS HEALTH NETWORK DESCRIBED IN SCH I, PART II. THE REMAINING GRANTS IN SMALLER AMOUNTS WERE MADE FOR COMMUNITY BENEFIT AS SELECTED BY THE ORGANIZATION'S COMMUNITY BENEFIT STAFF. THE ORGANIZATION HAS MORE RECENTLY IMPLEMENTED SOFTWARE FOR THE PURPOSES OF MONITORING GRANTS AND THE USE OF GRANT FUNDS. X 0 0 0 1 0 0 0 0 0 1 0 TOM THOMPSON PRESIDENT & COO 0 332859 0 89906 0 60565 0 48069 0 347 0 531746 0 0 DR ELYA VASILOU DIRECTOR 0 405722 0 0 0 34280 0 17400 0 32487 0 489889 0 0 DR ANDREW MAHONEY DIRECTOR 0 311059 0 0 0 13533 0 26100 0 33147 0 383839 0 0 DR KRISTOFER ANDERSON DIRECTOR 0 345075 0 0 0 1160 0 17400 0 14654 0 378289 0 0 ERIC BERG CRNA 303599 0 0 0 5024 0 12075 0 2068 0 322766 0 0 0 AMY BISHOP CRNA 269330 0 0 0 4841 0 8530 0 34895 0 317596 0 0 0 WILLIAM HARRINGTON CRNA 279330 0 15000 0 4881 0 9022 0 1983 0 310216 0 0 0 DAVID J MYERS CRNA 186120 0 0 0 4520 0 5661 0 29316 0 225617 0 0 0 RENEE MOSIER PHARMACY DIR 179953 0 0 0 234 0 7053 0 25869 0 213109 0 0 0 MICHAEL LEYDEN AVP OPERATIONS 0 160471 0 13780 0 2661 0 5477 0 25283 0 207672 0 0 LINDA HAVEY AVP OPERATIONS 0 171850 0 13780 0 343 0 5500 0 1999 0 193472 0 0 JUDY PEEK-LEE FMR INTERIM CFO 0 80365 0 56507 0 1286 0 0 0 2426 0 140584 0 0 PART I, LINE 1A PRESIDENT AND COO TOM THOMPSON RECEIVED COMPENSATION OF $1,400 TO COVER TAX PREPARATION AND FINANCIAL ADVISORY SERVICES. PART I, LINE 1B WHILE THERE IS NO ORGANIZATION-WIDE WRITTEN POLICY REGARDING SUCH PAYMENTS, THE AMOUNT IS PROVIDED BY CONTRACT, WHICH IS SUBJECT TO ANNUAL REVIEW. PERSONAL SERVICE COMPENSATION IS INCLUDED IN FORM W-2 AS TAXABLE INCOME. NO REIMBURSEMENT IS MADE UNDER AN ACCOUNTABLE PLAN AND THE COMPENSATION IS OFFERED ON A TAXABLE BASIS. THEREFORE, SUBSTANTIATION OF EXPENSE IS NOT REQUIRED. PART I, LINE 3 PORTER HOSPITAL CENTER RELIED ON THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVM HEALTH NETWORK"), PARENT OF PORTER HOSPITAL'S PARENT ORGANIZATION, PORTER MEDICAL CENTER, TO ESTABLISH SENIOR EXECUTIVE COMPENSATION. UVM HEALTH NETWORK UTILIZED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B PORTER MEDICAL CENTER, PARENT ORGANIZATION OF PORTER HOSPITAL, MAINTAINS A SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) UNDER CONTRACTUAL ARRANGEMENT WITH PRESIDENT AND COO TOM THOMPSON. PURSUANT TO THE TERMS OF THE SRP, PORTER MEDICAL CENTER MAKES ANNUAL CREDITS EQUAL TO 8.68% OF BASE SALARY. AMOUNTS DEFERRED DURING CALENDAR YEAR 2021 ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. AMOUNTS DEFERRED REMAIN SUBJECT TO FORFEITURE IF CERTAIN CONDITIONS ARE NOT MET. PART I, LINE 7 PORTER HOSPITAL PAID AWARDS TO CERTAIN MEMBERS OF UPPER MANAGEMENT (OFFICERS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL VARIABLE PAY PLAN AS THE PLAN'S PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL, POPULATION HEALTH & QUALITY, AND OPERATIONAL RELATED METRICS. ADDITIONALLY, CERTAIN EMPLOYEEES OF THE ORGANIZATION WERE ELIGIBLE TO RECEIVE DISCRETIONARY BONUSES FOR TAKING ON EXTRA RESPONSIBILITIES. FORM 990, PART VII, SECTION A, LINE 5 JUDY PEEK-LEE RECEIVED OR ACCRUED COMPENSATION FROM KORN FERRY, AN UNRELATED MANAGEMENT CONSULTING FIRM, FOR SERVICES RENDERED TO THE ORGANIZATION AS INTERIM CFO OF PORTER MEDICAL CENTER, PRIOR TO HER EMPLOYMENT WITH THE UNIVERSITY OF VERMONT MEDICAL CENTER, INC., A RELATED ORGANIZATION. THE TOTAL AMOUNT CHARGED TO PORTER MEDICAL CENTER FOR SUCH SERVICES DURING CY 2021 WAS $132,298. THIS AMOUNT IS NOT INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN FORM 990, PART VII, SECTION A OR SCHEDULE J, PART II, AS THOSE AMOUNTS REPRESENT COMPENSATION PAID BY THE UNIVERSITY OF VERMONT MEDICAL CENTER FOR HER SERVICES AS AN EMPLOYEE. A VERMONT EDUCATIONAL HEALTH BUILDINGS AND FINANCING AGENCY 237154467 NONEAVAIL 2015-08-06 12650000 REFUND 2006 SERIES A BONDS 0 0 0 A 3684186 12650000 138787 12511213 2015 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 A 0 SCHEDULE K, PART I, COL (C) CUSIP # BECAUSE THE BONDS ARE HELD BY A PRIVATE FINANCIAL INSTITUTION AND WERE NEVER OFFERED TO THE PUBLIC, A CUSIP NUMBER WAS NOT ASSIGNED. FORM 990, PART VI, SECTION A, LINE 2 THE GOVERNING BODY FOR PORTER HOSPITAL, INC. IS IDENTICAL TO THAT OF HELEN PORTER NURSING HOME, INC. AS WELL AS THEIR PARENT ORGANIZATION, PORTER MEDICAL CENTER. TOM THOMPSON, MICHAEL LEYDEN, LINDA HAVEY, AND SCOTT COMEAU HAD AN EMPLOYMENT RELATIONSHIP WITH PORTER MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 6 PORTER MEDICAL CENTER, INC. IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BODY OF PORTER HOSPITAL, INC. IS IDENTICAL TO THAT OF ITS PARENT ORGANIZATION, PORTER MEDICAL CENTER, INC. THE UNIVERSITY OF VERMONT HEALTH NETWORK, AS SOLE MEMBER OF PORTER MEDICAL CENTER, INC., HAS POWERS TO ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B UVM HEALTH NETWORK HAS THE POWER TO APPROVE SIGNIFICANT CORPORATE ACTIONS, INCLUDING ANNUAL OPERATING AND CAPITAL BUDGETS, STRATEGIC PLANS, THE APPOINTMENT OF THE CEO, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AND AMENDMENTS TO THE ORGANIZATION'S BYLAWS AND ARTICLES OF ORGANIZATION. UVM HEALTH NETWORK IS A VERMONT NON-PROFIT CORPORATION WHICH HAS BEEN RECOGNIZED BY THE IRS AS A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 FOR PORTER HOSPITAL, INC. IS PREPARED BY UVM MEDICAL CENTER STAFF AND REVIEWED BY PRICEWATERHOUSECOOPERS (PWC). FOLLOWING OR CONCURRENT WITH PWC'S REVIEW, A DRAFT RETURN IS PRESENTED TO THE UVM HEALTH NETWORK AUDIT COMMITTEE AND MANAGEMENT FOR REVIEW AND COMMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL QUESTIONNAIRES AND CERTIFICATIONS REQUIRED OF ALL TRUSTEES, OFFICERS, AND OTHER INDIVIDUALS IN A POSITION TO EXERCISE INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION, THROUGH ONGOING DUTIES TO DISCLOSE TRANSACTIONS IN WHICH SUCH PERSONS HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST, AND THROUGH ONGOING MONITORING EFFORTS BY THE ORGANIZATION'S CFO AND CONTROLLER. WHEN A POTENTIAL CONFLICT IS DISCLOSED OR OTHERWISE IDENTIFIED, THE BOARD OR AFFECTED BOARD COMMITTEE IS CHARGED WITH DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS, WITH THE INTERESTED PERSON BEING DISQUALIFIED FROM VOTING, PARTICIPATION, AND ATTENDANCE. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST DOES IN FACT EXIST, THEN SUCH PERSON IS RESTRICTED FROM PARTICIPATION IN ALL DELIBERATIONS PERTAINING TO THE PROPOSED TRANSACTION OR ARRANGEMENT AT ISSUE. THE REMAINING BOARD OR COMMITTEE MEMBERS MAY, AT THEIR DISCRETION, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. THE MINUTES OF THE BOARD OR AFFECTED COMMITTEE SHALL CONTAIN THE NAME OF THE INTERESTED PERSON, THE NATURE OF THE INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT WAS PRESENT, AND THE DECISION AS TO WHETHER A CONFLICT EXISTED. VIOLATIONS OF THE CONFLICT OF INTEREST POLICY ARE SUBJECT TO DISCIPLINARY AND CORRECTIVE ACTION INCLUDING BUT NOT LIMITED TO TERMINATION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DELEGATES THE SETTING OF EXECUTIVE COMPENSATION TO THE UVM HEALTH NETWORK COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE, UNDER PRINCIPLES DESCRIBED IN ITS CHARTER. THE UVM HEALTH NETWORK HAS ADOPTED A COMPENSATION PHILOSOPHY WHICH PROVIDES A FRAMEWORK FOR SETTING COMPENSATION FOR THE EXECUTIVES OF UVM HEALTH NETWORK AND ITS AFFILIATED MEMBER ORGANIZATIONS. THE PARAMETERS OF THIS PHILOSOPHY INCLUDE UTILIZING APPROPRIATE NATIONAL AND REGIONAL PEER GROUPS. SALARIES ARE TARGETED AT THE 50TH PERCENTILE OF THE NATIONAL PEER GROUP, WITH PERFORMANCE BASED VARIABLE PAY OPPORTUNITIES TO ACHIEVE UP TO THE 65TH PERCENTILE, DEPENDING ON ORGANIZATION AND INDIVIDUAL RESULTS. COMPENSATION LEVELS ARE APPROVED BY THE NETWORK COMPENSATION COMMITTEE FOR THE UVM HEALTH NETWORK/DIRECT REPORTS AND THE AFFILIATED ORGANIZATIONS' CEOS. CALCULATIONS ARE PERFORMED USING THE SAME PHILOSOPHY FOR THE THIRD TIER OF LEADERSHIP, WITH THE EXCEPTION THAT THE LOCAL BOARDS APPROVE COMPENSATION FOR ALL NON-CEO POSITIONS. ALL ACTIONS TAKEN REGARDING EXECUTIVE COMPENSATION ARE CONTEMPORANEOUSLY DOCUMENTED BY THE APPROPRIATE ORGANIZATION. THIS REVIEW IS PERFORMED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G NET ALLOCATION FOR HN SHARED SERVICES: PROGRAM SERVICE EXPENSES 3,366,033. MANAGEMENT AND GENERAL EXPENSES 4,519,372. FUNDRAISING EXPENSES 76,146. TOTAL EXPENSES 7,961,551. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 410,139. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 410,139. GROUNDSKEEPING: PROGRAM SERVICE EXPENSES 58,090. MANAGEMENT AND GENERAL EXPENSES 131,127. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,217. CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,275. MANAGEMENT AND GENERAL EXPENSES 136,280. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137,555. FREIGHT: PROGRAM SERVICE EXPENSES 72,236. MANAGEMENT AND GENERAL EXPENSES 1,608. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,844. ACO PARTICIPATION FEES: PROGRAM SERVICE EXPENSES 54,583. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,583. HAZARDOUS WASTE DISPOSAL SERVICES: PROGRAM SERVICE EXPENSES 36,707. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,707. INTERPRETER SERVICES: PROGRAM SERVICE EXPENSES 15,388. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,388. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,295,265. MANAGEMENT AND GENERAL EXPENSES 363,028. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,658,293. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS -299,929. OTHER COMPONENTS OF CURRENT PERIOD PENSION EXPENSE 209,722. PENSION PLAN ADJUSTMENT 166,882. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS -200,055. ROUNDING VARIANCE -656. 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