2023-08-28T11:56:16-05:00 2022-09-30 366055558 GRANT THORNTON LLP 75 STATE ST 13TH FLOOR BOSTON MA 02109 990 2021-10-01 030179435 SOUTHWESTERN VERMONT HEALTH CARE CORPORATION SOUT 8024426361 100 HOSPITAL DRIVE BENNINGTON VT 05201 JAMES ROY INTERIM CFO 8024426361 2023-08-28 1 JAMES ROY XXX-XX-XXXX ERIN COUTURE P01390592 6177237900 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z THOMAS DEE 100 HOSPITAL DRIVE BENNINGTON VT 05201 16936960 0 X WWW.SVHEALTHCARE.ORG X 1912 VT SEE SCHEDULE O 20 18 22 18 0 0 0 0 3551911 3457503 10629685 4140269 112330 92451 14293926 7690223 0 0 0 0 340002 363371 0 0 0 2993296 3201987 3333298 3565358 10960628 4124865 84156797 69594455 6315278 4425567 77841519 65168888 X TO CARE FOR AND COMFORT OUR PATIENTS, RESIDENTS, AND THEIR LOVED ONES AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE. (SEE SCHEDULE O FOR ADDITIONAL INFORMATION).THE PURPOSE OF THE ORGANIZATION IS ALSO TO PROMOTE AND SUPPORT THE DEVELOPMENT AND MAINTENANCE OF A HIGHLY EFFICIENT, PATIENT-FOCUSED, INTEGRATED HEALTHCARE DELIVERY SYSTEM. 0 0 3131923 3457503 SOUTHWESTERN VERMONT HEALTH CARE CORPORATION MANAGES AND MAINTAINS MEDICAL OFFICE BUILDINGS IN BENNINGTON, MANCHESTER, WILMINGTON, POWNAL AND WEST DOVER IN VERMONT AS WELL AS HOOSICK FALLS, NEW YORK AND WILLIAMSTOWN, MASSACHUSETTS. 3131923 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1 0 1 22 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 20 18 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 1 0 X STEPHEN MAJETICH 8024475011 100 HOSPITAL DRIVE BENNINGTON VT 05201 THOMAS A DEE TRUSTEE / CEO SVMC 1.00 44.00 X X 0 625561 323586 MICHAEL E BRADY TRUSTEE / DENTIST 1.00 39.00 X 0 176942 130 LARA SHORE-SHEPPARD SECRETARY 1.00 2.00 X X 0 0 0 KATHLEEN FISHER CHAIR 1.00 3.00 X X 0 0 0 STEPHEN KELLY VICE CHAIR 1.00 3.00 X X 0 0 0 CONNIE JASTREMSKI TRUSTEE 1.00 2.00 X X 0 0 0 ANGIE MARANO TRUSTEE (AS OF 10/2021) 1.00 2.00 X 0 0 0 BRIAN G O'GRADY TRUSTEE 1.00 2.00 X 0 0 0 CAROL CONROY TRUSTEE 1.00 2.00 X 0 0 0 CHRISTINE MILES TRUSTEE 1.00 2.00 X 0 0 0 DIMITRI GARDER TRUSTEE 1.00 2.00 X 0 0 0 KRISTYN HARRINGTON TRUSTEE 1.00 2.00 X 0 0 0 RICHARD ADER TRUSTEE 1.00 3.00 X 0 0 0 ROBERT VAN DEGNA TRUSTEE 1.00 3.00 X 0 0 0 SCOTT ROGGE TRUSTEE 1.00 2.00 X 0 0 0 STANLEY STROUP TRUSTEE 1.00 2.00 X 0 0 0 SUE MAGUIRE TRUSTEE (THRU 6/2022) 1.00 2.00 X 0 0 0 TOMMY HARMON JR TRUSTEE 1.00 3.00 X 0 0 0 WAYNE GRANQUIST TRUSTEE 1.00 2.00 X 0 0 0 MATTHEW VERNON TRUSTEE (AS OF 6/2022) 1.00 2.00 X 0 0 0 BRIAN BAREFOOT TRUSTEE 1.00 2.00 X 0 0 0 MARIE GEORGE TRUSTEE (THRU 6/2022) 1.00 2.00 X 0 0 0 STEPHEN D MAJETICH CFO 1.00 46.00 X 0 529250 78824 MARK EPLER PHYSICAL THERAPIST 40.00 0.00 X 105954 0 28786 105954 1331753 431326 1 0 1 0 0 PROPERTY MANAGEMENT 531310 2028833 2028833 LLC REVENUE 900099 1428670 1428670 3457503 919384 919384 92451 0 92451 92451 92451 12467622 9224430 22307 3243192 -22307 3220885 3220885 7690223 3457503 0 4232720 299359 299359 2631 2631 45875 45875 15506 15506 93356 93356 5489 5489 173716 173716 312533 312533 14966 12721 2245 640125 544106 96019 381238 324052 57186 36163 30739 5424 LLC EXPENDITURES 1477850 1477850 SVC CONT, EQP RPR, DUES 63279 63279 SUPPLIES 3272 3272 3565358 3131923 433435 0 722046 86612 91356 53160 0 0 0 0 0 0 0 0 0 0 0 0 9647 14554 15150885 11322336 4091116 3828549 79773939 61210930 13018 558634 -4806440 4262115 3842016 84156797 69594455 391345 221551 0 0 4836 0 1251410 1188286 4667687 3015730 6315278 4425567 X 77841519 65168888 0 0 77841519 65168888 84156797 69594455 X 4124865 -16821986 564 23926 X 0 1 X 1 0 X 765568 765568 12403048 10186335 2216713 68249 40881 27368 1282331 791082 491249 631689 304038 327651 3828549 DEFERRED COMPENSATION PLAN ASSETS 1661843 DUE FROM AFFILIATES 1168690 FINANCE LEASE ASSETS 950000 OTHER ASSETS 58533 OTHER RECEIVABLES 2950 3842016 DEFERRED COMPENSATION 1653791 DUE TO AFFILIATES 938920 OTHER LIABILITIES 407386 SELF INSURANCE COSTS 15633 3015730 X -9281553 -16821986 23926 -16798060 7516507 173716 173716 7690223 3391642 0 3391642 173716 173716 3565358 PART X, LINE 2: UNCERTAIN TAX POSITIONS: SVHC, SVMC, MAHC, SVHCA, THE FOUNDATION, SVHCNY, TWIN RIVERS, NBM, AND CNR HAVE BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. THE CORPORATION IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE CODE. EACH ORGANIZATION HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS; AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. SVHCE ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH INCOME TAX ACCOUNTING GUIDANCE. THE CORPORATION FOLLOWS GUIDANCE THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING ISSUES RELATING TO FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT. THIS GUIDANCE PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN ONLY BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THE POSITION IS "MORE-LIKELY-THAN-NOT" TO BE SUSTAINED IF THE POSITION WERE TO BE CHALLENGED BY A TAXING AUTHORITY. THE ASSESSMENT OF THE TAX POSITION IS BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION, WITHOUT REGARD TO THE LIKELIHOOD THAT THE TAX POSITION MAY BE CHALLENGED. THE CORPORATION HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS AT SEPTEMBER 30, 2022 AND 2021. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET PERIODIC BENEFIT INCOME 4,159. DEFINED BENEFIT PENSION COST 19,767. 0 1 0 0 0 0 0 0 0 THOMAS A DEE TRUSTEE / CEO SVMC 0 467779 0 105000 0 52782 0 295579 0 28007 0 949147 0 0 STEPHEN D MAJETICH CFO 0 370482 0 75600 0 83168 0 50817 0 28007 0 608074 0 0 MICHAEL E BRADY TRUSTEE / DENTIST 0 175003 0 1000 0 939 0 0 0 130 0 177072 0 0 SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT OFFICIAL COMPENSATION DETERMINATION: SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: CERTAIN INDIVIDUALS LISTED SCHEDULE J, PART II PARTICIPATED IN A NON-QUALIFIED DEFERRED COMPENSATION ARRANGEMENT. UNDER THE TERMS OF THE PLAN THE INDIVIDUAL WILL BECOME VESTED IN THE PLAN IF THEY REMAIN EMPLOYED THROUGH A TARGETED DATE PURSUANT TO THE PLAN. NO AMOUNTS VESTED IN CALENDAR YEAR 2021 AND AMOUNTS CREDITED UNDER THE PLAN ARE LISTED BELOW AND INCLUDED IN SCHEDULE J, PART II, COLUMN (C). $ 287,579 THOMAS DEE $ 45,000 STEPHEN MAJETICH GENERAL EXPLANATION: THE FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, IS FILED UNDER VERMONT FLOODING FEMA-3595-EM WHICH POSTPONES THE TIME TO FILE RETURNS, PAY TAXES AND PERFORM OTHER TIME-SENSITIVE ACTS TO NOVEMBER 15, 2023. FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: PROVIDING HEALTH CARE ON BOTH AN INPATIENT AND OUTPATIENT BASIS WITH FACILITIES IN AND AROUND THE BENNINGTON, VT AREA AS WELL AS NEIGHBORING NY AND MA. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS: CERTAIN LISTED OFFICERS AND BOARD MEMBERS ALSO SERVE AS OFFICERS AND BOARD MEMBERS OF SOUTHWESTERN VERMONT HEALTHCARE ENTERPRISES, A RELATED TAXABLE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: 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. THE DRAFT 990 IS THEN REVIEWED BY MANAGEMENT AND ACCOUNTING. AFTER ALL SUGGESTED CHANGES FROM MANAGEMENT ARE MADE, THE UPDATED DRAFT FORM 990 IS THEN PRESENTED TO THE FINANCE COMMITTEE. AFTER ANY FINAL CHANGES ARE MADE, THE FORM 990 IS PRESENTED TO THE FULL BOARD OF DIRECTORS BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: TRUSTEES, SENIOR OFFICERS, AND SENIOR MEDICAL STAFF MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST AND POTENTIAL CONFLICTS OF INTEREST TO THE CORPORATE COMPLIANCE OFFICER ANNUALLY. IF THE CORPORATE COMPLIANCE DETERMINES THAT A POTENTIAL CONFLICT OF INTEREST EXISTS, THE MATTER IS REFERRED TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW AND MAY BE REFERRED TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW: THE ORGANIZATION'S CEO POSITION IS PAID BY SOUTHWESTERN VERMONT MEDICAL CENTER (SVMC). THE PROCESS SVMC USES TO DETERMINE CEO COMPENSATION IS AS FOLLOWS: THE BOARD ENGAGES AN OUTSIDE CONSULTING FIRM TO REVIEW COMPARABLE CEO SALARY DATA AND USES NATIONAL PROFESSIONAL ORGANIZATION SURVEY DATA IN THE DETERMINATION OF THE CEO'S SALARY AND BENEFITS. IN ADDITION, THE BOARD ENGAGES AN OUTSIDE CONSULTING FIRM AND ALSO USESNATIONAL PROFESSIONAL ORGANIZATION SURVEY DATA TO REVIEW THE WAGE DATA OF OTHER OFFICERS AND KEY EMPLOYEES. PROCESS BEGINS WITH A REQUEST TO SVMC'S COMPENSATION CONSULTANT ASTRON SOLUTIONS TO PERFORM A MARKET ANALYSIS OF THE CEO POSITION. THIS REPORT IS USED AS THE BASIS FOR STRUCTURING COMPENSATION FOR THE CEO DURING THE NEXT CONTRACT PERIOD. USING THE RESULTS OF THE MARKET ANALYSIS WITH INPUT FROM OUR CEO, THE COMPENSATION OFFER FOR THE NEXT CONTRACT PERIOD IS DEVELOPED AND INCORPORATED INTO THE CONTRACT. THE COMPENSATION IS THEN DISCUSSED BY THEGOVERNANCE COMMITTEE OF THE BOARD WITH ASTRON SOLUTIONS IN ATTENDANCE.ASTRON SOLUTIONS WILL PROVIDE A WRITTEN LETTER CONFIRMING THEIR AGREEMENT. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: BOARD MEMBER COMPENSATION: NO TRUSTEE RECEIVES COMPENSATION FOR THEIR SERVICES AS A TRUSTEE OF THE BOARD. MICHAEL BRADY, DDS, RECEIVES COMPENSATION FOR DENTAL SERVICES PROVIDED. THOMAS DEE IS COMPENSATED AS THE CEO OF THE SOUTHWESTERN VERMONT HEALTHCARE SYSTEM. FORM 990, PART XI, LINE 9: NET PERIODIC BENEFIT INCOME 4,159. DEFINED BENEFIT PENSION COST 19,767. SVHC-NY LLC 100 HOSPITAL DR BENNINGTON VT 05201 810770434 HEALTHCARE VT 1428670 1102694 SVHC SOUTHWESTERN VT HEALTH CARE AUXILIARY (THRU 522) 100 HOSPITAL DRIVE BENNINGTON VT 05201 222563243 SUPPORT SVHC VT 501(C)(3) LINE 10 SVHC 1 SOUTHWESTERN VERMONT MEDICAL CENTER 100 HOSPITAL DRIVE BENNINGTON VT 05201 222563241 HOSPITAL VT 501(C)(3) LINE 3 SVHC 1 MOUNT ANTHONY HOUSING CORPORATION 100 HOSPITAL DRIVE BENNINGTON VT 05201 030279740 NURSING HOMES VT 501(C)(3) LINE 10 SVHC 1 SOUTHWESTERN VT HEALTH CARE FOUNDATION 100 HOSPITAL DRIVE BENNINGTON VT 05201 453362785 FUNDRAISING VT 501(C)(3) LINE 12A, I SVHC 1 TWIN RIVERS MEDICAL PC 2 SUNRISE DRIVE HOOSICK FALLS NY 12090 473028931 HEALTH CARE NY 501(C)(3) LINE 10 SVMC 1 NORTHERN BERKSHIRE MEDICAL PC 375 MAIN STREET WILLIAMSTOWN MA 01267 814023607 HEALTH CARE MA 501(C)(3) LINE 10 SVMC 1 HOOSICK FALLS HEALTH CENTER INC 21 DANFORTH STREET HOOSICK FALLS NY 12090 141370000 NURSING HOME NY 501(C)(3) LINE 3 SVHC 1 HOOSICK FALLS HEALTH CENTER FOUNDATION 21 DANFORTH STREET HOOSICK FALLS NY 12090 223186959 FUNDRAISING NY 501(C)(3) LINE 7 HFHC 1 SVHC REALTY INC 100 HOSPITAL DRIVE BENNINGTON VT 05201 861399877 REAL ESTATE MANAGEMENT VT 501(C)(3) LINE 12A, I SVHC 1 SOUTHWESTERN VT HEALTH CARE ENTERPRISES 100 HOSPITAL DRIVE BENNINGTON VT 05201 030314501 HEALTHCARE VT SVHC C 588000 1.00000 1 1 0 0 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 0 SOUTHWESTERN VT HEALTH CARE AUXILIARY D 70863 FMV SVHC REALTY E 204136 FMV SOUTHWESTERN VERMONT MEDICAL CENTER D 712289 FMV SOUTHWESTERN VERMONT MEDICAL CENTER A 2028832 FMV