2023-08-14T16:08:01-05:00 2022-09-30 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2021-10-01 141364513 ELIZABETHTOWN COMMUNITY HOSPITAL ELIZ 5188736377 75 PARK STREET PO BOX 277 ELIZABETHTOWN NY 12932 ROBERT ORTMYER PRESIDENT 5188733002 2023-08-10 1 ROBERT ORTMYER 999009999 THOMAS J GIUFRE P00841958 3154463600 2023-08-10 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ROBERT ORTMYER 75 PARK STREET PO BOX 277 ELIZABETHTOWN NY 12932 56333805 0 X ECH.ORG X 1926 NY MISSION: TO PROMOTE WELLNESS IN THE COMMUNITIES WE SERVE BY PROVIDING QUALITY HEALTHCARE WITH SKILL, COMPASSION AND DIGNITY. 12 12 392 0 -232646 0 3123307 1669589 45465960 49522137 192441 -22029 5886761 4747273 54668469 55916970 0 0 0 0 24676319 33281482 0 0 0 26016125 19657430 50692444 52938912 3976025 2978058 83172080 77492427 35545645 29352074 47626435 48140353 X THE MISSION OF ECH IS TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITY AND TO PROVIDE QUALITY HEALTHCARE WITH SKILL, COMPASSION AND DIGNITY. IN CREATING OUR COMMUNITY BENEFITS PLAN WE KEEP THIS MISSION IN MIND, CONTINUALLY LOOKING FOR WAYS TO MEET COMMUNITY HEALTH NEEDS AND TO BE A GOOD NEIGHBOR. ECH IS DRIVEN BY PEOPLE WHO LIVE IN THE SERVICE AREA AND WHO WANT TO SEE THEIR FRIENDS AND NEIGHBORS GET THE CARE AND SERVICES THEY NEED. 0 0 9987211 9675381 INPATIENT ACUTE UNIT AND SUBACUTE REHABILITATIVE (SWING BED) INPATIENT PROGRAM:A 25-BED NURSING UNIT PROVIDING ACUTE AND SUB ACUTE (SWING BED)CARE. THE SMALLER ATMOSPHERE CREATES A CLOSER BOND BETWEEN THE PATIENT AND PROFESSIONALS ENCOURAGING OPTIMAL HEALING AND COMPASSIONATE CARE. THE SUB-ACUTE PROGRAM IS VITAL TO AREA RESIDENTS BECAUSE FOLLOWING A HIP-REPLACEMENT, KNEE-SURGERY OR CARDIAC OPERATION, RECUPERATION AND THERAPY CAN BE DONE AT ELIZABETHTOWN COMMUNITY HOSPITAL, SAVING THE FAMILY THE TIME AND EXPENSE OF TRAVEL. THE PROGRAM PROVIDES ONE-ON-ONE THERAPEUTIC CARE. 13702976 10704876 CLINIC SERVICES:ECH OPERATES THE ELIZABETHTOWN COMMUNITY HEALTH CENTER, WESTPORT HEALTH CENTER LOCATED IN WESTPORT,NY, THE HIGH PEAKS HEALTH CENTER LOCATED IN WILMINGTON, NY, THE SMITH HOUSE HEALTH CENTER LOCATED IN WILLSBORO, NY, THE AU SABLE FORKS HEALTH CENTER, LOCATED IN AU SABLE FORKS, NY, AND CROWN POINT HEALTH CENTER, LOCATED IN CROWN POINT, NY. ECH OPERATES AN OUTPATIENT CHEMOTHERAPY PROGRAM, WHICH INCLUDES UPDATED INFUSION EQUIPMENT MAKING IT POSSIBLE TO PROVIDE SAFE AND EFFICIENT METHODS FOR CHEMOTHERAPY AND BLOOD-RELATED INFUSIONS. IN ADDITION, THE NEW SPECIALIZED VENTILATING HOOD ENABLES THE PREPARATION OF CHEMOTHERAPY SOLUTIONS ON-SITE. THIS IS A GREAT CONVENIENCE FOR CANCER PATIENTS, SAVING THEM THE 90-MINUTE ROUND-TRIP DRIVE TO THE CLOSEST CHEMOTHERAPY FACILITY. 17794025 14519694 EMERGENCY ROOM SERVICES:ECH'S PRIOR YEARS EXPANSION OF THE EMERGENCY ROOM ADDED NEW STATE OF THE ART TRAUMA ROOMS, A TELEMENTRY SYSTEM FOR PATENT MONITORING, A REGISTRATION AREA DESIGNED FOR PATIENT PRIVACY AND CONFIDENTIALITY AND NEW WAITING AREAS FOR FAMILIES AND THEIR LOVED ONES.THE HOSPITAL OPERATES AN ALL-DIGITAL RADIOLOGY DEPARTMENT, ALLOWING TECHNOLOGISTS TO OBTAIN PATIENT IMAGES ANYWHERE IN THE HOSPITAL. IN THE EVENT OF A SIGNIFICANT EMERGENCY WITH MULTIPLE TRAUMAS, THE UNIT CAN BE USED ANYWHERE IN THE BUILDING. WHEN THE HOSPITAL IS FACED WITH AN UNUSUAL SURGE IN EMERGENCY ROOM TRAUMA CASES, HOSPITAL PROCEDURES ENABLE STAFF TO TRIAGE IN NONTRADITIONAL AREAS OF THE HOSPITAL. 1163981 19566030 1163981 19566030 42648193 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 1 392 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X SCOTT COMEAU CFO 5188733136 75 PARK STREET PO BOX 277 ELIZABETHTOWN NY 12932 MEGAN MURPHY BOARD MEMBER 0.80 X 0 0 0 MARTIN NEPHEW BOARD TREASURER 0.80 X X 0 0 0 SUSAN ALLOTT RN CHAIR 0.80 X X 0 0 0 GAYLE ALEXANDER BOARD MEMBER 0.80 X 0 0 0 STEVE CACCHIO TREASURER 0.80 X X 0 0 0 MARGARET EMERY-GINN BOARD MEMBER 0.80 X 0 0 0 ROLAND J ALLEN BOARD MEMBER 0.80 X 0 0 0 DAVID SHELMIDINE VICE CHAIR 0.80 X X 0 0 0 EVAN GEORGE SECRETARY 0.80 X X 0 0 0 ROBERT ORTMYER PRESIDENT 40.00 X X 177898 0 4901 JOSEPH BOGARDUS PHD BOARD MEMBER 0.80 X 0 0 0 TERRI MORSE BOARD MEMBER 0.80 X 0 0 0 ALAN JONES BOARD MEMBER 0.80 X 0 0 0 ALAN CHARDAVOYNE CFO 40.00 X 279244 0 11108 MATTHEW NOLAN COO 40.00 X 245072 0 9723 JOHN REMILLARD PRESIDENT 40.00 X 429795 0 1889 JULIE TROMBLEE CNO 40.00 X 221359 0 10092 ROB DEMURO MD PHYSICIAN 40.00 X 394773 0 42125 LAURA MULVEY PHISICIAN 40.00 X 325535 0 22491 MARY HALLORAN PHYSICIAN 40.00 X 329457 0 43666 DAVID MARKOWITZ ER PHYSICIAN 40.00 X 330713 0 14714 JAMES RICE ER PHYSICIAN 40.00 X 330713 0 30875 DAVID CLAUSS FORMER MEDICAL DIRECTOR 40.00 X 0 171206 22968 3064559 171206 214552 43 1 1 0 0 562698 1106891 1669589 CRITICAL ACCESS HOSPITAL 900099 49522137 49522137 49522137 21232 21232 158413 366184 -207771 -207771 -232646 24875 43261 -43261 -43261 -43261 18590 7390 11200 11200 340B REVENUE 900099 2462190 2462190 MEANINGFUL USE INCOME 900099 950346 950346 1531308 1531308 4943844 55916970 54465981 -232646 14046 1391081 1391081 26079716 23113745 2965971 1085327 840235 245092 2946435 2744444 201991 1778923 1268030 510893 226104 226104 84489 84489 78877 78877 5174755 4998718 176037 6132 6132 1161263 380428 780835 253727 182119 71608 394460 157770 236690 3693421 3508750 184671 270709 270709 CONTRACTED, LINEN & PUR 5370801 2567720 2803081 BAD DEBT EXPENSE 2116860 2116860 OTHER EXPENSES 602338 287821 314517 PROVIDER TAX 145633 145633 77861 65211 12650 52938912 42648193 10290719 0 15409526 5452384 18072661 20820018 51750 1750 4333641 9754409 758014 850159 1140616 1092615 58906586 25266677 36261461 33639909 4629254 3965295 2515157 1915888 83172080 77492427 4478187 5303829 66864 47421 3865000 0 10184287 13240005 16951307 10760819 35545645 29352074 X 46396235 47108782 1230200 1031571 47626435 48140353 83172080 77492427 X 2978058 -2464140 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1230200 600318 -145736 653211 1031571 1658795 3105896 115670 3650161 1230200 1644993 8433494 49870 8469562 1658795 1631608 864223 35904 886742 1644993 798658 3288805 41288 2497143 1631608 0.33333 0.66667 0 0 1251625 1251625 40911024 13726747 27184277 13615292 10512124 3103168 3128645 1027806 2100839 33639909 MUTUAL FUNDS 3965295 F 3965295 DUE TO AFFILIATES 122312 THIRD PARTY PAYOR SETTLEMENTS 7619830 CONTRACT LIABILITY 1312529 OPERATING LEASE LIABILITY 1706148 10760819 X PART V, LINE 4: CERTAIN BOARD-DESIGNATED FUNDS HAVE BEEN ESTABLISHED TO MEET SPECIFIC CURRENT AND FUTURE NEEDS OF THE HOSPITAL OR TO ADEQUATELY DISCHARGE FUTURE LIABILITES. THESE FUNDS INCLUDE THE PLANT AND CAPITAL IMPROVEMENT FUNDS, WHICH ARE DESIGNATED FOR SPECIFIC PROJECTS SUCH AS THE SURGICAL CENTER CONSTRUCTION, AND DESIGNATED FUNDS FOR BOTH SELF-INSURANCE AND FOR CVPH'S VARIOUS EMPLOYEE BENEFIT PLANS. TEMPORARILY RESTRICTED NET ASSETS ARE INTENDED FOR THE PURCHASE OF PROPERTY AND EQUIPMENT. PERMANENTLY RESTRICTED NET ASSETS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES, INCLUDING MEDICAL SERVICES PROVIDED TO CHILDREN, AND PROVIDING FOR CHARITY CARE. PART X, LINE 2: ENTITIES WITHIN UVM HEALTH NETWORK, WITH THE EXCEPTION OF ENTITIES SPECIFICALLY NAMED BELOW, ARE INCORPORATED AND RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). ACCORDINGLY, THE IRS HAS DETERMINED THAT THESE ORGANIZATIONS ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. HEALTH NETWORK VENTURES HOLDING, LLC, UNIVERSITY OF VERMONT HEALTH NETWORK SPECIALTY CARE TRANSPORT, LLC, UNIVERSITY OF VERMONT MEDICAL CENTER SKILLED NURSING, LLC, UNIVERSITY OF VERMONT MEDICAL CENTER EXECUTIVE SERVICES, LLC, VALCOUR IMAGING, INC., AND PORTER REAL ESTATE HOLDINGS, LLC, ARE SINGLE-MEMBER LIMITED LIABILITY CORPORATIONS. AS SUCH, FOR TAX PURPOSES, THESE ORGANIZATIONS ARE TREATED AS DIVISIONS OF THEIR SOLE MEMBER. EARNINGS AND LOSSES ARE PASSED THROUGH TO THE OWNERS, WHICH ARE TAX-EXEMPT, AND ARE TREATED IN THE SAME MANNER FOR TAX PURPOSES. NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR THESE ORGANIZATIONS. UVM HEALTH NETWORK HEALTH VENTURES, INC., MEDICAL EDUCATION CENTER CONDOMINIUM ASSOCIATION, INC., MEDIQUEST CORP., EMERGENCY MEDICAL TRANSPORT OF CVPH, INC., AND CHAMPLAIN VALLEY HEALTH NETWORK, INC. ARE TAXABLE CORPORATIONS FOR WHICH THE PROVISION FOR INCOME TAXES IS IMMATERIAL TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. GOLF 18590 18590 1000 1032 3490 1868 18590 18590 1000 1032 3490 1868 7390 11200 1 1 1 X 1 X 1 1 1 0 1 1 301002 301002 0.00590 9173005 2811277 6361728 0.12520 167136 167136 0.00330 9641143 2811277 6829866 0.13440 77048 77048 0.00150 45583018 37904446 7678572 0.15110 27328 27328 0.00050 45687394 37904446 7782948 0.15310 55328537 40715723 14612814 0.28750 1 2116860 133866 18031351 17906111 125240 X 1 1 1 1 ELIZABETHTOWN COMMUNITY HOSPITAL 75 PARK STREET PO BOX 277 ELIZABETHTOWN NY 12932 X X X 25 BEDS (ACUTE & SWING), 6 HEALTHCENTERS, CT, LAB, PHARM. PT. AMB SURG. ELIZABETHTOWN COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X 22 1 1 1 1 X HTTPS://WWW.ECH.ORG/DATA/FILES/COMMUNITY%20SERVICE%20PLAN%20WITH%20COLLABOR X WWW.CO.ESSEX.NY.US., HTTPS://AHIHEALTH.ORG/ARHN X X 1 22 1 HTTPS://WWW.ECH.ORG/DATA/FILES/COMMUNITY%20SERVICE%20PLAN%20WITH%20COLLABOR 0 1 X 200.000000000000 350.000000000000 X 1 1 X X X X 1 X HTTPS://WWW.ECH.ORG/DATA/FILES/ECH%20FINANCIAL%20ASSISTANCE%20SUMMARY%20202 X HTTPS://WWW.ECH.ORG/DATA/FILES/2020%20FAP%20APPLICATION%20ECH.PDF X HTTPS://WWW.ECH.ORG/DATA/FILES/2020%20FAP%20APPLICATION%20ECH.PDF X X X X 1 0 X X X 1 X 0 1 ELIZABETHTOWN COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: EXECUTIVES FROM THE FOLLOWING INSTITUTIONS: ADIRONDACK HEALTH, ADIRONDACK MEDICAL CENTER, ADIRONDACK RURAL HEALTH NETWORK AND ESSEX COUNTY PUBLIC HEALTH. ELIZABETHTOWN COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: COUNTY HEALTH DEPARTMENT ELIZABETHTOWN COMMUNITY HOSPITAL PART V, SECTION B, LINE 7D: ESSEX COUNTY PUBLIC HEALTH ELIZABETHTOWN COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY:COMMUNITY SERVED - ELIZABETHTOWN COMMUNITY HOSPITAL'S PRIMARY SERVICE AREA IS COMPOSED OF TWENTY-TWO ZIP CODES IN NORTHEASTERN ESSEX COUNTY. THE HOSPITAL IS LOCATED 45-60 MINUTES AWAY FROM ANY OTHER HOSPITAL, THROUGH A MOUNTAINOUS REGION AND MOSTLY ALONG A SERIES OF SECONDARY ROADS. THE REGION BOASTS A ROBUST SEASONAL POPULATION, SWELLING SIGNIFICANTLY THROUGHOUT THE SUMMER AND WINTER MONTHS, DUE TO THE CONSIDERABLE NUMBER OF SECOND HOMEOWNERS IN THE REGION, ALONG WITH INCREASED TOURISM.DEMOGRAPHICS OF ESSEX COUNTY: - 37,281 RESIDENTS- 23.5% ARE 65 YEARS OF AGE OR OLDER- 93.0% OF THE POPULATION IS WHITE, 3.1% IS HISPANIC, AND 3.2% IS BLACK/AFRICAN AMERICAN- 94.4% ADULTS HAVE HEALTH INSURANCESIGNIFICANT HEALTH NEEDS IDENTIFIED IN 2022 CHNA:- CHRONIC DISEASE- OBESITY- ACCESS TO HEALTHY FOOD- ACCESS TO CARE- SUBSTANCE ABUSE- BEHAVIORAL HEALTHNEEDS SELECTED FOR 2022 IMPLEMENTATION STRATEGY:- PREVENT CHRONIC DISEASE- PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE ABUSE DISORDERS- PROMOTE HEALTHY WOMEN, INFANTS AND CHILDRENNEEDS NOT SELECTED:- PROMOTE A HEALTHY AND SAFE ENVIRONMENT- PREVENT COMMUNICABLE DISEASE RATIONALE: - WHILE NOT SELECTED FOR THE COMMUNITY SERVICE PLAN, THE TWO INTERVENTIONS ARE INCORPORATED INTO THE SELECTED PRIORITIESHIGHLIGHTS FROM 2022 IMPLEMENTATION STRATEGY:- PREVENT CHRONIC DISEASE - IN 2019 INPATIENT AND OUTPATIENT P.T. FACILITIES OPENED TO STAFF AT ECH AND TICONDEROGA CAMPUS, THESE WERE TEMPORARILY PAUSED IN 2020 DUE TO COVID-19 - FOOD PANTRY IN CPHC OPENED IN 10/2019 AND FOOD PANTRY IN APHC OPENED IN 11/2019. JOINED THE REGIONAL FOOD BANK IN 9/2020 - EVENTS HELD IN 2022 - HEART HEALTH - WOMEN'S HEALTH - HUNTER'S SCREENING - MENTAL HEALTH AWARENESS - BLOOD DRIVES - DIABETES AWARENESS - STROKE READINESS - TELEHEALTH INCREASE - OUTPATIENT VISITS FOR PRIMARY CARE ADDED IN 2020. - CHRONIC DISEASE WELLNESS COACH - CERTIFIED AND TO BEGIN DIABETES PREVENTION PROGRAM- PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDER - SBIRT IMPLEMENTED IN BOTH HOSPITAL CAMPUSES AND ALL 6 PRIMARY CARE SITES - CREATION OF MEDICAL VILLAGE IN PRIMARY CARE. (ADDITION OF PRIMARY CARE 2021) - NARCAN KITS IN BOTH ED'S - 2 PROVIDERS TRAINED IN MAT AND ABLE TO PRESCRIBE - OPIOID STEWARDSHIP CREATED. PROVIDERS WILL BE MONITORED FOR PRESCRIBING PATTERNS.- PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN - TRANSITIONING FROM PEDIATRIC TO ADULT CARE PROCESS AND PROCEDURE INITIATIVE (PARTNERSHIP WITH AREA SCHOOLS) WAS PAUSED IN 2020 DUE TO COVID-19.ESTIMATED COMPLETION DATE FOR NEXT CHNA AND IMPLEMENTATION STRATEGY: - CHNA: DECEMBER 2024 - IMPLEMENTATION STRATEGY: JANUARY 2025METHODS PLANNED FOR QUALITATIVE RESEARCH FOR NEXT CHNA: - TO BE DONE AS JOINT DOCUMENT WITH ESSEX COUNTY PUBLIC HEALTH DEPARTMENT BASED ON RESULTS OF COMMUNITY STAKEHOLDER SURVEYMETHODS PLANNED FOR QUANTITATIVE RESEARCH FOR NEXT CHNA: - ADIRONDACK RURAL HEATH NETWORK (AHRN) TO ASSIST WITH DATA COLLECTION AND INTERPRETATION AS WELL AS COMMUNITY STAKEHOLDER SURVEY ELIZABETHTOWN COMMUNITY HOSPITAL PART V, SECTION B, LINE 13B: TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE FROM ELIZABETHTOWN COMMUNITY HOSPITAL, YOUR INCOME SHOULD BE AT OR BELOW THE YEARLY GUIDELINES BELOW. IF YOUR INCOME EXCEEDS THE GUIDELINES (350%) BUT YOU HAVE EXTENUATING CIRCUMSTANCES, AN APPLICATION MAY BE CONSIDERED WHEN SUBMITTED WITH A LETTER EXPLAINING YOUR EXTENUATING CIRCUMSTANCES. ELIZABETHTOWN COMMUNITY HOSPITAL PART V, SECTION B, LINE 24: THE ORGANIZATION USES A GLOBAL FEE SCHEDULE. IF THE PATIENT APPLIED AND WAS DEEMED ELIGIBLE, THE APPROPRIATE DISCOUNTS WERE GRANTED. 7 1 - ELIZABETHTOWN COMMUNITY HEALTH CENTER 66 PARK STREET ELIZABETHTOWN NY 12932 PRIMARY CARE HEALTH CENTER 2 - HIGH PEAKS HEALTH CENTER 18 COMMUNITY CIRCLE WILMINGTON NY 12997 PRIMARY CARE HEALTH CENTER 3 - SMITH HOUSE HEALTH CENTER 39 FARRELL ROAD WILLSBORO NY 12996 PRIMARY CARE HEALTH CENTER 4 - WESTPORT HEALTH CENTER 6097 NYS ROUTE 9N WESTPORT NY 12993 PRIMARY CARE HEALTH CENTER 5 - AU SABLE FORKS HEALTH CENTER 15 PLEASANT STREET AU SABLE FORKS NY 12912 PRIMARY CARE HEALTH CENTER 6 - CROWN POINT HEALTH CENTER 2679 MAIN STREET CROWN POINT NY 12928 PRIMARY CARE HEALTH CENTER 7 - ECH TICONDEROGA OUTPATIENT CAMPUS 101 ADIRONDACK DRIVE SUITE 1 TICONDEROGA NY 12883 MEDICAL FACILITY OP CAMPUS PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,116,860. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL STAFF PARTICIPATES IN MANY LOCAL EVENTS THAT PROVIDE COMMUNITY MEMBERS THE OPPORTUNITY TO LEARN ABOUT THE HOSPITAL AND ABOUT IMPORTANT HEALTH SCREENINGS. IN ADDITION, THE HOSPITAL HOSTS EVENTS AND OFFERS TRAINING AND SUPPORT SERVICES TO OTHER HEALTH-ORIENTED ORGANIZATIONS. ECH PARTICIPATES IN THE FOLLOWING:(1)PROVIDES ADVANCED LIFE SUPPORT TRAINING FOR REGIONAL EMERGENCY MEDICAL TECHNICIANS. (2)PROVIDES MEDICAL DIRECTORSHIP TO SEVERAL LOCAL EMS AGENCIES, PROVIDES MONTHLY COURSES AND EDUCATION FOR CME CREDITS. (3)PROVIDES MEDICAL DIRECTORSHIP TO ST. JOSEPH'S ADDICTION TREATMENT & RECOVERY CENTER (4)OFFERS FREE DIABETES HEALTH SCREENINGS AT COMMUNITY HEALTH EVENTS. (5)LENDS SPACE TO THE NORTH COUNTRY REGIONAL BLOOD DONOR CENTER FOR BLOOD DRIVES. (6)MEETING SPACE IS DONATED ON A MONTHLY BASIS TO EMS SQUADS. TECHNOLOGICAL CAPABILITIES ALLOW FOR DISTANCE TRAINING / EDUCATION. (7)WORKS WITH THE CANCER SCREENING PROGRAM TO PROVIDE INFORMATION ABOUT MAMMOGRAMS AND BONE DENSITY SCREENING AT THE ANNUAL BREAST CANCER AWARENESS EVENT. (8)HOSTS THE ESSEX COUNTY DIABETES SUPPORT GROUP MEETINGS IN THE HOSPITAL BOARDROOM. (9)EMPLOYEES FROM THROUGHOUT THE HOSPITAL USE HOSPITAL PAID TIME TO LEND THEIR EXPERTISE AND INCREASE THEIR INTERESTS IN SUCH AREAS AS THE ESSEX CO. HEALTHY LIVING PARTNERSHIP, BEHAVIOR HEALTH SERVICES NORTH, RETIRED SENIOR VOLUNTEER PROGRAM, TASK FORCE AGAINST DOMESTIC VIOLENCE, KIWANIS AND NORTH COUNTRY LIFE FLIGHT. (10)ECH'S CLINICAL STAFF COMPLETES ADDITIONAL TRAINING EACH YEAR (ACLS, PALS, BLS, VARIOUS RN / NURSING TRAINING PROGRAMS, CHEMOTHERAPY EDUCATION, PHYSICIAN EDUCATION, INFECTION CONTROL TRAINING, RADIOLOGY DEPARTMENT CONTINUING EDUCATION, LAB STAFF EDUCATION, ETC.) (11) MEETING SPACE FOR AA AND NA. (12) EACH YEAR, THE HOSPITAL ALSO HOSTS EVENTS THAT OFFER FREE HEALTH SCREENINGS TO LOCAL RESIDENTS. THE COMMUNITY HEALTH SCREENINGS ARE COORDINATED BY PUBLIC RELATIONS STAFF BUT ARE DEPENDENT UPON CLINICAL STAFF TO PERFORM EXAMS AND INTERPRET THE RESULTS. EACH EVENT IS STAFFED BY 5-8 CLINICAL STAFF MEMBERS FOR APPROXIMATELY 3-4 HOURS PER EVENT. (1)HUNTERS' HEALTH SCREENING (SEPTEMBER) IS A FREE, ANNUAL EVENT SPONSORED BY THE HOSPITAL. PARTICIPANTS RECEIVE A BASIC PHYSICAL / HEALTH SCREENING (EKG, BLOOD WORK, BLOOD PRESSURE, LAB TESTING, PHYSICIAN REVIEW AND REPORTING) AT NO COST. EVENT IS ARRANGED, COORDINATED AND PROMOTED BY ECH PUBLIC RELATIONS STAFF. IN 2022, THERE WERE 24 PARTICIPANTS AS THE EVENT REQUIRED APPOINTMENTS. (2)IN OCTOBER THE HOSPITAL HOSTS AN EVENT CO-SPONSORED BY THE CANCER SERVICES SCREENING PROGRAM OF ESSEX AND FRANKLIN COUNTIES. WOMEN WHO QUALIFIED (UN- OR UNDER-INSURED) WERE ABLE TO RECEIVE A CLINICAL BREAST EXAM AND MAMMOGRAM AT NO COST TO THEM, THROUGH THE CANCER SERVICES SCREENING PROGRAM OF ESSEX AND FRANKLIN COUNTIES. IN 2022, 10 FREE MAMMOGRAMS WERE COMPLETED DUE TO REQUIRED APPOINTMENTS. PART III, LINE 4: THE BAD DEBT INCLUDED ON LINE 2 IS DETERMINED AT COST. FINANCIAL STATEMENT FOOTNOTE FOR BAD DEBT EXPENSE:PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS AND FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL ALSO ANALYZES AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED ON PAST EXPERIENCE, INCLUDING CONSIDERATION OF CURRENT BUSINESS AND ECONOMIC CONDITIONS. WHEN THE HOSPITAL ESTABLISHES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THE HOSPITAL TAKES INTO CONSIDERATION THE FACT THAT MANY SELF-PAY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 26.0% AND 25.6% OF THE RELATED PATIENT ACCOUNTS RECEIVABLE, NET OF CONTRACTUAL ALLOWANCES AT SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY. PART III, LINE 8: USED MEDICARE ONLY TOTAL CHARGES FROM REVENUE REPORT FOR 2021 AND APPLIED THE RATIO OF COST TO CHARGES FROM THE 2020 COST REPORT DATA. PART III, LINE 9B: THE ELIZABETHTOWN COMMUNITY HOSPITAL'S HELPING HANDS PROGRAM OFFERS FREE OR REDUCED CARE TO OUR PATIENTS WHO ARE UNINSURED OR UNDERINSURED AND MEET THE INCOME ELIGIBILITY CRITERIA SET BY THE FOLLOWING GUIDELINES. THE FREE OR REDUCED CARE APPLIES ONLY TO THE SERVICES PROVIDED BY THE ELIZABETHTOWN COMMUNITY HOSPITAL, WESTPORT HEALTH CENTER, ELIZABETHTOWN COMMUNITY HEALTH CENTER, HIGH PEAKS HEALTH CENTER, AU SABLE FORKS HEALTH CENTER, SMITH HOUSE HEALTH CENTER, AND CROWN POINT HEALTH CENTER.AS AN ACCOMMODATION TO PATIENTS AND FAMILIES, COLLECTION ACTIVITY WAS SUSPENDED IN MARCH 2020 IN RECOGNITION OF THE FINANCIAL CHALLENGES ASSOCIATED WITH THE COVID-19 PANDEMIC. COLLECTION ACTIVITIES RESUMED IN JULY 2020. PART VI, LINE 2: A NUMBER OF COMMUNITY PARTNERS ARE INVOLVED IN ASSESSING COMMUNITY HEALTH NEEDS WITHIN THE HOSPITAL'S SERVICE AREA. MEETINGS CONTINUED VIRTUALLY EACH QUARTER IN 2021-2022.IN ADDITION TO ITS ESTABLISHED RELATIONSHIPS WITH OTHER HOSPITALS, COMMUNITY ORGANIZATIONS AND HEALTHCARE-BASED ORGANIZATIONS (EMS, PUBLIC HEALTH, MENTAL HEALTH, ETC.), ELIZABETHTOWN COMMUNITY HOSPITAL HAS PARTNERED WITH TWO REGIONAL GROUPS TO ASSESS THE REGION'S COMMUNITY HEALTH NEEDS - THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS COMMITTEE, AND THE ADIRONDACK RURAL HEALTH NETWORK.MOBILIZING FOR ACTION THROUGH PLANNING & PARTNERSHIP (MAPP): AGENCY REPRESENTATIVES FROM CLINTON, ESSEX, AND FRANKLIN COUNTIES MEET TO APPLY COMMUNITY BASED APPROACHES TO LOCAL HEALTH ISSUES. THE MAPP GROUP HAS WORKED TO CULL INFORMATION THROUGH ASSESSMENTS OF THE LOCAL PUBLIC HEALTH SYSTEMS, A CDC LOCAL PUBLIC HEALTH INDICATOR SURVEY, A QUALITY OF LIFE SURVEY OF SENIORS AND PARENTS WITH CHILDREN, AND FOCUS GROUPS. THE MAPP GROUP SHARES UPDATED INFORMATION ON A CONTINUAL BASIS TO REASSESS PRIORITIES AND GAUGE PROGRAM SUCCESS.ADIRONDACK RURAL HEALTH NETWORK (ARHN): THE ADIRONDACK RURAL HEALTH NETWORK IS A PARTNERSHIP OF PUBLIC, PRIVATE AND NON-PROFIT ORGANIZATIONS IN UPSTATE NEW YORK. ARHN MEMBERS COLLABORATE TO DEVELOP STRATEGIES ALONG WITH IMPLEMENTING, MONITORING AND EVALUATING VARIOUS INITIATIVES. THIS GROUP CONTINUES TO MEET ON A (ROUGHLY) QUARTERLY BASIS IN ORDER TO SHARE INFORMATION, STATISTICS, SUCCESSES, CHALLENGES AND OUTCOMES. ELIZABETHTOWN COMMUNITY HOSPITAL (ECH): IN ADDITION TO PARTNERSHIPS WITH THE ARHN AND THE MAPP PROCESSES, ECH INDEPENDENTLY SEEKS THE VIEWS OF COMMUNITY MEMBERS TO GAIN THEIR THOUGHTS REGARDING HEALTH CARE IN THEIR COMMUNITY AND GAIN FEEDBACK REGARDING ECH SERVICES. THROUGHOUT 2021-2022 MANY DIFFERENT METHODS WERE USED TO COMMUNICATE WITH AREA RESIDENTS. EACH YEAR THE HOSPITAL ADMINISTRATOR ATTENDS TOWN BOARD MEETINGS THROUGHOUT ESSEX COUNTY IN AN EFFORT TO UPDATE TOWN LEADERS AND COMMUNITY MEMBERS ABOUT THE HOSPITAL, ITS PLANS FOR THE FUTURE; AND TO ADDRESS ANY QUESTIONS. ANNUALLY, THE ADMINISTRATOR MEETS WITH EMS AND FIRE DEPARTMENTS WITHIN THE HOSPITAL SERVICE AREA TO ENCOURAGE OPEN COMMUNICATION AND FOSTER A GOOD WORKING RELATIONSHIP. THE ECH BOARD OF DIRECTORS IS COMPOSED OF 14 REPRESENTATIVES OF EITHER A SPECIFIC COMMUNITY AND/OR ORGANIZATION, INCLUDING THE ESSEX COUNTY OFFICE FOR THE AGING, TOWN OF ELIZABETHTOWN SUPERVISORS OFFICE, AND ESSEX COUNTY MENTAL HEALTH. A PLANNING COMMITTEE, COMPRISED OF BOARD MEMBERS, IDENTIFIES GAPS IN SERVICE AND DEVELOPS GOALS TO FILL THESE NEEDS. PATIENT SATISFACTION SURVEYS ARE CONDUCTED FOR EACH DEPARTMENT ON A CONTINUAL BASIS. PART VI, LINE 4: ELIZABETHTOWN COMMUNITY HOSPITAL'S PRIMARY SERVICE AREA HAS REMAINED UNCHANGED FOR 2022 PLANNING PURPOSES. IT IS COMPOSED OF TWENTY-TWO ZIP CODES IN NORTHEASTERN ESSEX COUNTY. THE HOSPITAL IS LOCATED 45-60 MINUTES AWAY FROM ANY OTHER HOSPITAL; THROUGH A MOUNTAINOUS REGION AND MOSTLY ALONG A SERIES OF SECONDARY ROADS.BASED ON U.S. CENSUS FOR 2020, 37,281 PEOPLE LIVE WITHIN ESSEX COUNTY OF WHICH 51.8% ARE MALE AND 48.2% ARE FEMALE. PEOPLE OVER THE AGE OF 65 CONSTITUTE 23.5% OF THE POPULATION AND INDIVIDUALS UNDER THE AGE OF 25 MAKE UP 22.9% OF THE POPULATION.ETHNICALLY, 93.0% OF THE POPULATION IS WHITE, NON-HISPANIC. PART VI, LINE 5: THE HOSPITAL STAFF PARTICIPATES IN MANY LOCAL EVENTS THAT PROVIDE COMMUNITY MEMBERS THE OPPORTUNITY TO LEARN ABOUT THE HOSPITAL AND ABOUT IMPORTANT HEALTH SCREENINGS. IN ADDITION, THE HOSPITAL HOSTS EVENTS AND OFFERS TRAINING AND SUPPORT SERVICES TO OTHER HEALTH-ORIENTED ORGANIZATIONS. ECH PARTICIPATES IN THE FOLLOWING:(1)PROVIDES ADVANCED LIFE SUPPORT TRAINING FOR REGIONAL EMERGENCY MEDICAL TECHNICIANS. (2)PROVIDES MEDICAL DIRECTORSHIP TO SEVERAL LOCAL EMS AGENCIES, PROVIDES MONTHLY COURSES AND EDUCATION FOR CME CREDITS. (3)PROVIDES MEDICAL DIRECTORSHIP TO ST. JOSEPH'S ADDICTION TREATMENT & RECOVERY CENTER (4)OFFERS FREE DIABETES HEALTH SCREENINGS AT COMMUNITY HEALTH EVENTS. (5)LENDS SPACE TO THE NORTH COUNTRY REGIONAL BLOOD DONOR CENTER FOR BLOOD DRIVES. (6)MEETING SPACE IS DONATED ON A MONTHLY BASIS TO EMS SQUADS. TECHNOLOGICAL CAPABILITIES ALLOW FOR DISTANCE TRAINING / EDUCATION. (7)WORKS WITH THE CANCER SCREENING PROGRAM TO PROVIDE INFORMATION ABOUT MAMMOGRAMS AND BONE DENSITY SCREENING AT THE ANNUAL BREAST CANCER AWARENESS EVENT. (8)HOSTS THE ESSEX COUNTY DIABETES SUPPORT GROUP MEETINGS IN THE HOSPITAL BOARDROOM. (9)EMPLOYEES FROM THROUGHOUT THE HOSPITAL USE HOSPITAL PAID TIME TO LEND THEIR EXPERTISE AND INCREASE THEIR INTERESTS IN SUCH AREAS AS THE ESSEX CO. HEALTHY LIVING PARTNERSHIP, BEHAVIOR HEALTH SERVICES NORTH, RETIRED SENIOR VOLUNTEER PROGRAM, TASK FORCE AGAINST DOMESTIC VIOLENCE, KIWANIS AND NORTH COUNTRY LIFE FLIGHT. (10)ECH'S CLINICAL STAFF COMPLETES ADDITIONAL TRAINING EACH YEAR (ACLS, PALS, BLS, VARIOUS RN / NURSING TRAINING PROGRAMS, CHEMOTHERAPY EDUCATION, PHYSICIAN EDUCATION, INFECTION CONTROL TRAINING, RADIOLOGY DEPARTMENT CONTINUING EDUCATION, LAB STAFF EDUCATION, ETC.) (11) MEETING SPACE FOR AA AND NA. (12)THE COMMUNITY HEALTH FAIR HELD ALLOWED FOR COMMUNITY MEMBERS TO LEARN ABOUT AVAILABLE RESOURCES PERTAINING TO HEALTH AND WELLNESS. ELIZABETHTOWN COMMUNITY HOSPITAL WAS ABLE TO EDUCATE 120 PARTICIPANTS ABOUT THE SERVICES OFFERED AT THE HOSPITAL AND SIX PRIMARY CARE SITES. THE 2022 COMMUNITY HEALTH FAIR WAS CO-SPONSORED BY ADIRONDACK HEALTH INSTITUTE, FIDELIS, AND THE HOSPITAL'S AUXILIARY. CLINICAL STAFF WAS ON SITE CONDUCTING BLOOD PRESSURE SCREENS, ISS TEAM MEMBERS WERE AVAILABLE FOR PEOPLE WANTING TO ENROLL IN THE PATIENT PORTAL. HEALTHY REFRESHMENTS WERE PROVIDED AND NUTRITION EDUCATION WAS AVAILABLE WITH A DIABETIC EDUCATOR. EACH YEAR, THE HOSPITAL ALSO HOSTS EVENTS THAT OFFER FREE HEALTH SCREENINGS TO LOCAL RESIDENTS. THE COMMUNITY HEALTH SCREENINGS ARE COORDINATED BY PUBLIC RELATIONS STAFF BUT ARE DEPENDENT UPON CLINICAL STAFF TO PERFORM EXAMS AND INTERPRET THE RESULTS. EACH EVENT IS STAFFED BY 5-8 CLINICAL STAFF MEMBERS FOR APPROXIMATELY 3-4 HOURS PER EVENT. (1)HUNTERS' HEALTH SCREENING (SEPTEMBER) IS A FREE, ANNUAL EVENT SPONSORED BY THE HOSPITAL. PARTICIPANTS RECEIVE A BASIC PHYSICAL / HEALTH SCREENING (EKG, BLOOD WORK, BLOOD PRESSURE, LAB TESTING, PHYSICIAN REVIEW AND REPORTING) AT NO COST. EVENT IS ARRANGED, COORDINATED AND PROMOTED BY ECH PUBLIC RELATIONS STAFF. IN 2022, THERE WERE 24 PARTICIPANTS. (2)IN OCTOBER THE HOSPITAL HOSTS AN EVENT CO-SPONSORED BY THE CANCER SERVICES SCREENING PROGRAM OF ESSEX AND FRANKLIN COUNTIES AND THE HOSPITAL'S AUXILIARY. THE EVENING FEATURES A SPEAKER, ALONG WITH THE OPPORTUNITY TO TAKE PART IN A FREE HEALTH SCREENING. WOMEN WHO QUALIFIED (UN- OR UNDER-INSURED) WERE ABLE TO RECEIVE A CLINICAL BREAST EXAM AND MAMMOGRAM AT NO COST TO THEM, THROUGH THE CANCER SERVICES SCREENING PROGRAM OF ESSEX AND FRANKLIN COUNTIES. IN 2022 THERE WERE 10 PARTICIPANTS. PART VI, LINE 6: THE UNIVERSITY OF VERMONT HEALTH NETWORK, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE HOSPITAL, ELIZABETHTOWN COMMUNITY HOSPITAL, LOCATED IN ELIZABETHTOWN, NEW YORK. ADDITIONAL AFFILIATES INCLUDE CHAMPLAIN VALLEY PHYSICIANS HOSPITAL, ALICE HYDE MEDICAL CENTER, CENTRAL VERMONT MEDICAL CENTER, PORTER MEDICAL CENTER AND HOME HEALTH AND HOSPICE. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X X 0 1 0 0 0 0 0 1 0 ROB DEMURO MD PHYSICIAN 382771 0 12002 0 0 0 17400 0 24725 0 436898 0 0 0 JOHN REMILLARD PRESIDENT 328367 0 36302 0 65126 0 0 0 1889 0 431684 0 0 0 MARY HALLORAN PHYSICIAN 329457 0 0 0 0 0 17400 0 26266 0 373123 0 0 0 JAMES RICE ER PHYSICIAN 330713 0 0 0 0 0 6183 0 24692 0 361588 0 0 0 LAURA MULVEY PHISICIAN 324641 0 894 0 0 0 0 0 22491 0 348026 0 0 0 DAVID MARKOWITZ ER PHYSICIAN 330713 0 0 0 0 0 6492 0 8222 0 345427 0 0 0 ALAN CHARDAVOYNE CFO 247558 0 31686 0 0 0 6932 0 4176 0 290352 0 0 0 MATTHEW NOLAN COO 208874 0 36198 0 0 0 6935 0 2788 0 254795 0 0 0 JULIE TROMBLEE CNO 193854 0 27505 0 0 0 5580 0 4512 0 231451 0 0 0 DAVID CLAUSS FORMER MEDICAL DIRECTOR 0 171206 0 0 0 0 0 11548 0 11420 0 194174 0 0 ROBERT ORTMYER PRESIDENT 137898 0 40000 0 0 0 0 0 4901 0 182799 0 0 0 PART I, LINE 3 IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN PART I, ELIZABETHTOWN COMMUNITY HOSPITAL RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THAT GUIDANCE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B JOHN REMILLARD RECEIVED A DISTRIBUTION OF $65,126. PART I, LINE 7 ELIZABETHTOWN COMMUNITY HOSPITAL PAID AWARDS TO CERTAIN MEMBERS OF UPPER MANAGEMENT (DIRECTORS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL VARIABLE PAY PLAN AS THE PLAN'S PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL, POPULATION HEALTH & QUALITY, AND OPERATIONAL RELATED METRICS. FORM 990, PART VI, SECTION A, LINE 6 THE UNIVERSITY OF VERMONT HEALTH NETWORK (UVHN) IS THE SOLE MEMBER OF ELIZABETHTOWN COMMUNITY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A UVMHN, INC., AS ELIZABETHTOWN COMMUNITY HOSPITAL'S SOLE MEMBER HAS RESERVE POWERS THAT ALLOW THE UNIVERSITY OF VERMONT HEALTH NETWORK AND UVMHN, INC, TO REFUSE THE ACCEPTANCE OF NEW BOARD MEMBERS APPOINTED BY THE ELIZABETHTOWN COMMUNITY HOSPITAL'S BOARD OF DIRECTORS IF UVMHN, INC., DOES NOT AGREE WITH THE CHOICE OF APPOINTMENTS. THE PROCESS OF APPOINTING MEMBERS TO THE GOVERNING BODY IS A COLLABORATION OF THE ELIZABETHTOWN COMMUNITY HOSPITAL BOARD OF DIRECTORS AND UVMHN, INC., AS A RESULT. FORM 990, PART VI, SECTION A, LINE 7B THE UNIVERSITY OF VERMONT HEALTH NETWORK THROUGH UVMHN, INC., HAS CERTAIN RESERVE POWERS THAT REQUIRE UVMHN, INC., TO APPROVE CERTAIN DECISIONS MADE BY THE ELIZABETHTOWN COMMUNITY HOSPITAL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND ALL MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICTING INTERESTS OR STATE "NONE" ON THE ANNUAL CONFLICT OF INTEREST FORM. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNING BOARD IS PROVIDED AN INDEPENDENT REPORT OF COMPATIBLE HOSPITALS SALARY FOR THE CEO. THE GOVERNING BOARD ALSO REVIEWS VARIOUS PERFORMANCE MEASURES AND OTHER INFORMATION AND ARRIVES AT A SALARY AND BENEFIT PACKAGE FOR THE CEO. THE DIRECTOR OF HUMAN RESOURCES OBTAINS SALARY INFORMATION FROM AN INDEPENDENT SOURCE FOR LOCAL COMPATIBLE HOSPITALS FOR EACH HIGHER LEVEL POSITION AT THE HOSPITAL. THE INDEPENDENT INFORMATION CONTAINS SALARY LEVELS FOR EACH POSITION AT THE 25TH, 50TH AND 75TH PERCENTILE. THE CEO THEN CONSIDERS THIS INFORMATION AND THE PERFORMANCE FOR EACH OF THESE EMPLOYEES AND ARRIVES AT THE APPROPRIATE SALARY LEVEL. THE APPROACH AND METHODOLOGY IS ALSO PRESENTED TO THE GOVERNING BOARD. IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN SCHEDULE J, PART I, ELIZABETHTOWN COMMUNITY HOSPITAL RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THAT GUIDANCE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 46,505. CHANGE IN INTEREST IN INVESTMENT POOL -2,312,015. RELEASE OF ASSETS FROM RESTRICTION -198,630. FORM 990, PART XII, LINE 2C THE FINANCE COMMITTEE (BOARD OF DIRECTORS) ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, AND SELECTION OF AN INDEPENDENT ACCOUNTANT. 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