2023-11-15T09:09:36-06:00 2022-09-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2021-10-01 030179437 Springfield Hospital Inc SPRI 8028852151 PO Box 2003 Springfield VT 05156 Kayda Wescott CFO 8028852151 2023-11-14 1 Kayda Wescott 999009999 Barbara J McGuan CPA P00219457 2077752387 2023-11-14 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Robert Adcock PO Box 2003 Springfield VT 05156 61439147 0 X www.springfieldhospital.org X 1914 VT 25-Bed Critical Access Hospital 9 8 504 15 0 0 2898023 6477349 51925961 54917401 10104 21918 5387 8825 54839475 61425493 0 0 0 0 25366751 22901657 0 0 0 27934002 35161056 53300753 58062713 1538722 3362780 28932259 30767524 23278286 20074244 5653973 10693280 X Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, and employees want to work. Our plan is to accomplish this by:1. Empowering our caregivers with education, technology, and opportunities for personal and professional development;2. Creating an environment which builds collaborative relationships among clinicians, staff, and patients;3. Providing our communities with the educational resources and support to make informed decisions emphasizing prevention and wellness; and4. Offering safe, personalized, high-quality care. 0 0 48190329 54917401 Springfield Hospital (SH) is a 25-bed critical access hospital located in Springfield, VT. SH also operates The Windham Center, a comprehensive inpatient mental health program in Bellows Falls, VT; off-site physical therapy services, seven hospital-owned specialty clinics (ENT, general surgery, pain, podiatry, orthopedics, gynecology and urology), and an adult day care center in Springfield, VT. Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, and employees want to work.Our plan is to accomplish this by:- Empowering our caregivers with education, technology, and opportunities for personal and professional development;- Creating an environment, which builds collaborative relationships among clinicians, staff, and patients;- Providing our communities with the educational resources and support to make informed decisions emphasizing prevention and wellness; and,- Offering safe, personalized, high-quality care. SH provides health services to residents throughout its catchment area. Many of the services benefit the elderly, the poor, the indigent, the underinsured and the uninsured. SH receives minimal reimbursement from these programs, with 41% of Springfield Hospital net revenue coming from Medicare and Medicaid funding. Springfield Hospital has a charity care policy under which patients who meet certain criteria will receive care without charge, or at amounts less than established rates. Patients qualify for 100% charity care at up to 200% of the federal poverty guideline (FPG) and 50% assistance up to 300% of the FPG. The Hospital does not bill patients nor pursue collection of amounts determined to qualify as charity care. For FY22, charges foregone for charity care, based on established rates, amounted to $867K.Springfield Hospital operates a number of specialty practices to provide needed specialty care to health center patients. These clinics include Connecticut Valley ENT, Surgical Associates, Connecticut Valley Orthopaedics, Springfield Gynecology, Springfield Pain Clinic, Springfield Podiatry, and Springfield Urology. In addition, SH provides an outpatient clinic serving patients needing treatment and minimizing their need to travel great distances for medical oncology or infusion services. Cardiology services were also offered on-site 6 days each month at the specialty clinic. Charitable support, in the form of gas cards and/or medication cards, is provided to patients who do not have needed funds. This charitable support program is available through donations and grant funding. 48190329 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 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 0 0 0 0 1 58 0 1 504 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 9 8 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 VT X Kayda Wescott 8028857646 PO Box 2003 Springfield VT 05156 Jim Rumrill Chairperson 2.00 X X 0 0 0 Lynn Raymond-Empey Vice Chairperson 2.00 X X 0 0 0 Richard Dexter III Treasurer 2.00 X X 0 0 0 John Bond Secretary 2.00 X X 0 0 0 Doug Nilson MD Director 1.00 X 0 0 0 Eliot Hall MD Director 1.00 X 0 0 0 Gabriel St Pierre Director 1.00 X 0 0 0 Howard Schapiro MD Director 1.00 X 0 0 0 Stephen Leblanc Director 1.00 X 0 0 0 David Sandelman Past Director 1.00 X 0 0 0 Heather Presch Past Director 1.00 X 0 0 0 Robert Adcock CEO/President 40.00 X 244034 0 5797 Kayda Wescott CFO 40.00 X 167681 0 34768 Lyndsy McIntyre COO/CNO/ VP of Patient Care 40.00 X 180837 0 36183 David Muller MD Orthopedic Surgeon 40.00 X 672860 0 31048 Robert Cantu MD Orthopedic Surgeon 40.00 X 559437 0 10931 John Ciocchi MD General Surgeon 40.00 X 344487 0 25745 Adam Pruett Medical Director 40.00 X 319879 0 37390 Christopher Ryder MD Otolaryngologist 40.00 X 227305 0 29081 Michael Halstead Former Interim CEO/President 0.00 X 142280 0 0 2858800 0 210943 17 1 1 1 Bluewater Emergency Partners 14 Maine Street Box 44 Brunswick ME 04011 Physicians 3516439 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Physicians 1063687 Clinical Colleagues Inc PO Box 824246 Philadelphia PA 191824246 Physicians 949427 Quorum Health Resources LLC 1573 Mallory Lane Suite 200 Brentwood TN 37027 Consulting Services 415438 Staffing First PO Box 467 Des Moines IA 50302 Nursing Services 394670 23 16500 6325325 135524 6477349 Patient Service Revenue 621110 113412718 113412718 Miscellaneous Revenue 621110 3754005 3659274 94731 MSSA Revenue 621110 1026065 1026065 Adult Daycare Revenue 621110 684394 684394 Contractual Allowances 621110 -63959781 -63959781 54917401 21918 21918 18659 16500 13184 5475 5475 3820 470 3350 3350 61425493 54822670 0 125474 X 811578 811578 17477948 14155516 3322432 403316 313469 89847 2741335 2190297 551038 1467480 1140569 326911 271508 271508 139075 139075 19656800 18185009 1471791 81499 3223 78276 357623 198188 159435 2353774 1609489 744285 59158 55185 3973 156536 156536 1368712 969906 398806 685669 682367 3302 Medical Supplies 3998854 3824549 174305 Healthcare Provider Tax 3363263 3363263 Miscellaneous Expenses 2668585 1499299 1169286 58062713 48190329 9872384 0 X 6059485 10932980 8005 8008 679743 10234438 8788816 258355 197626 756374 513193 42264141 33203217 9959647 9060924 976212 1265977 28932259 30767524 6949889 8913025 2353104 76171 5691654 5324133 2738925 2140212 5544714 3620703 23278286 20074244 X 4665803 9830746 988170 862534 5653973 10693280 28932259 30767524 X 3362780 1676527 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6782 6782 0 Part II-B, Line 1: The Organization paid dues to Vermont Association of Hospitals and Health Systems of which a percentage of the dues were used for lobbying. 87157 87157 14922183 8800906 6121277 948319 630450 317869 24222255 22107743 2114512 2084227 1664118 420109 9060924 Other Current Liabilities 1641858 Pension Liability 1978845 3620703 63115674 1690181 1690181 61425493 0 61425493 58076367 13654 13654 58062713 0 58062713 Part XI, Line 2d - Other Adjustments: Fundraising and Gaming Expenses 13,654. Change in net assets to recognize funded status of pension plan 1,676,527. Part XII, Line 2d - Other Adjustments: Fundraising and Gaming Expenses 13,654. Golf Tournament 35159 16500 18659 2000 6495 3721 968 35159 16500 18659 2000 6495 3721 968 13184 5475 1 1 X 1 X 1 X 1 1 0 0 378553 378553 0.00650 13027042 9470679 3556363 0.06130 13405595 9470679 3934916 0.06780 13405595 9470679 3934916 0.06780 1 0 17755910 18019997 -264087 X 1 1 1 1 Springfield Hospital PO Box 2003 Springfield VT 05156 www.springfieldhospital.org 952 X X X X Inpatient Psychiatric Unit Springfield Hospital Inc 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X See Part V, Page 8 X 1 21 1 See Part V, Page 8 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X 1 X 0 X 1 X 0 0 Springfield Hospital, Inc. Part V, Section B, Line 5: A steering committee was formed to conduct this assessment, review the data and recommend priorities and strategies to Springfield Hospital's Board of Directors. Assessment activities were guided by a planning committee of the Springfield Area Community Collaborative with multiple organizations and partners involved in methods design, data collection and community engagement, as well as review of the findings. Members included: Anna Smith, VP Marketing & Development, Springfield Hospital; Allison Hopkins, Southern Windsor County Planning Commission; Astrid Bradish-Hoyt, Turning Point Recovery Center; Beth Brothers, Springfield School District; Carolyn Sweet, Southeastern Vermont Community Action (SEVCA); Christian Craig, Edgar May Recreation Center; Christopher Pont, Vermont Department of Health; Joshua Dufresne, CEO, North Star Health; Kate Lamphere, Health Care and Rehabilitation Services (HCRS); Katrina Taylor, DO, Medical Director, North Star Health; Kelsea Burch, Southeastern Vermont Community Action (SEVCA); Laura Schairbaum, Greater Falls Connections; Lee Trapeni, Springfield Supportive Housing; Lynn Raymond-Empey, Valley Health Connections; Mark Boutwell, Senior Solutions; Sue Graff, Vermont Agency for Human Services; Susan White, Southern Vermont Area Health Education Center(AHEC); Tom Dougherty, MPH, North Star Health; Trish Paradis, Springfield Family Center; Jonathan Stewart, NH Community Health Institute/JSI. The process included - 1) a combination of market surveys to community residents made available on-line through email distribution, social media and website links, as well as paper copies and collection boxes placed in numerous public locations around the region;2) a direct email survey of community leaders representing multiple community sectors;3) a set of five community discussion groups convened across the region; and,4) review of available population demographics and health status indicators including social determinants of health characteristics. Note for Public Input Information: Monthly Board meetings are also open to the public for comments and questions. Springfield Hospital, Inc. Part V, Section B, Line 6b: Springfield Medical Care Systems, Inc., dba North Star Health Springfield Hospital, Inc. Part V, Section B, Line 11: Priority needs identified are summarized on page 2 of our Community Health Needs Assessment document which is available online at https://springfieldhospital.org/community-health-needs-assessments/ or by request to the Marketing Department at Springfield Hospital 802-885-7621. In summary, priority needs include:- Cost of health care services, affordability of health insurance- Availability of primary care and specialty medical services- Availability of mental health services- Socio-economic conditions affecting health and well-being such as lack of safe and affordable housing, access to healthy foods, and affordable dependable child care.- Alcohol and drug use prevention, treatment and recovery- Affordability and availability of dental care services- Health care workforce shortageA series of Implementation Strategy documents and Progress Reports are available at https://springfieldhospital.org/community-health-needs-assessments/. These documents outline how the hospital facility is addressing the significant needs identified through the CHNA process. Springfield Hospital, Inc. Part V, Section B, Line 20e: A patient financial counselor meets with patient prior to discharge if medical condition allows. Part V, line 7a, Hospital facility's CHNA website: https://springfieldhospital.org/community-health-needs-assessments/ Part V, line 10a, Hospital facility's Implementation Strategy website: https://springfieldhospital.org/community-health-needs-assessments/ Part V, line 16a, FAP website: https://springfieldhospital.org/financial-assistance/ Part V, line 16b, FAP Application website: https://springfieldhospital.org/financial-assistance/ Part V, line 16c, FAP Plain Language Summary website: https://springfieldhospital.org/financial-assistance/ 11 1 - The Windham Center 1 Hospital Court 12 Bellows Falls VT 05101 Inpatient Psych Unit 2 - Connecticut Valley Orthopaedics and Spor 29 Ridgewood Rd Springfield VT 05156 Specialty Practice 3 - Surgical Associates 29 Ridgewood Rd Springfield VT 05156 Specialty Practice 4 - Springfield Hospital Rehabilitation Serv 100 River Street Springfield VT 05156 Physical Therapy 5 - Springfield Area Adult Day Services 266 River Street Springfield VT 05156 Adult Day Services 6 - Connecticut Valley ENT 29 Ridgewood Rd Springfield VT 05156 Specialty Practice 7 - Mountain View Physical Therapy 8 Main St Ludlow VT 05149 Physical Therapy 8 - Springfield Urology 25 Ridgewood Rd Springfield VT 05156 Specialty Practice 9 - Springfield Gynecology 25 Ridgewood Rd Springfield VT 05156 Specialty Practice 10 - Springfield Pain Clinic 25 Ridgewood Rd Springfield VT 05156 Specialty Practice 11 - Springfield Podiatry 29 Ridgewood Road Springfield VT 05156 Specialty Practice Part III, Line 2: The Organization used the cost to charge ratio calculated on Worksheet 2 multiplied by bad debt expense per the Organization's audited financial statements. Part III, Line 4: See page 8 of the attached financial statements. Part III, Line 8: Worksheet A from the Form 990 Instructions was used to determine the amount reported on Line 6. Part III, Line 9b: Financial assistance is written off from charges before any collection efforts are made. Part VI, Line 2: In addition to the research used during the CHNA process, the hospital gathers information from its Board of Directors who are local community representatives. In addition, it works in collaboration with the Vermont Hospital Association, the State of Vermont, and OneCareVT to monitor quantifiable data that provides insights into population health status and community needs for services. We also participate in the Community Collaborative which is comprised of a number of community agencies that serve a broad array of public needs. Monthly meetings include discussion of needs, possible solutions, and workgroups are developed to address issues as needed. Part VI, Line 3: Information is provided to patients at all points of entry, posted to our website, and promoted on social media, and in print advertising. Referrals for confidential consultations are offered at reception areas, through the billing offices, and via brochures and website. Part VI, Line 4: Springfield Hospital serves the southern portions of Windsor County, VT and Sullivan County, NH, and the northern portions of Windham County, VT and Cheshire County NH. The total population of the combined service area is 62,807 residents according to the US Census Bureau (2020). Compared to Vermont or New Hampshire overall, the service area population has proportionally more senior residents. About 23% are 65+ compared to about 18% in NH and 19% in VT. A substantial range is observed for this statisti within the region with the lowest proportion of senior residents in the towns of Baltimore (15%), Langdon (16%), and Cavendish (17%). In comparison, seniors are 30% or more of the resident population in five service area towns including Chester (30%), Weston (30%), Mount Holly (30%) Grafton (33%), and Landgrove (55%). The region overall has median household income ($46,391 in Springfield) is lower than the statewide median for both Vermont and NH. The percent of people living below the federal poverty level also varies across the region from about 3% in Winhall, to 20% in Baltimore, Springfield, and Athens. Part VI, Line 5: Springfield Hospital works collaboratively with the local FQHC community health center network to provide care to all, with financial assistance offered to those in need based on a sliding fee scale. We collaborate in community population health initiatives and also coordinate care working closely with our local designated mental health agency, the local recovery center, Senior Solutions, and other local health and wellness organizations. We participate in the Community Collaborative which meets monthly to address community health initiatives. We sponsor the local Fastest Kid in Town race annually, to encourage children to exercise. We help promote health education programs organized by the FQHC network and other area agencies. We also work collaboratively with Southern Vermont Area Health Education Center and we offer scholarships to facilitate educational opportunities in the health care field. X X X 0 0 0 0 0 0 0 1 0 David Muller MD Orthopedic Surgeon 558161 0 112554 0 2145 0 0 0 31048 0 703908 0 0 0 Robert Cantu MD Orthopedic Surgeon 558418 0 0 0 1019 0 0 0 10931 0 570368 0 0 0 John Ciocchi MD General Surgeon 341479 0 0 0 3008 0 0 0 25745 0 370232 0 0 0 Adam Pruett Medical Director 319652 0 0 0 227 0 0 0 37390 0 357269 0 0 0 Christopher Ryder MD Otolaryngologist 223854 0 0 0 3451 0 0 0 29081 0 256386 0 0 0 Robert Adcock CEO/President 233895 0 0 0 10139 0 0 0 5797 0 249831 0 0 0 Lyndsy McIntyre COO/CNO/ VP of Patient Care 180837 0 0 0 0 0 0 0 36183 0 217020 0 0 0 Kayda Wescott CFO 166897 0 0 0 784 0 0 0 34768 0 202449 0 0 0 Michael Halstead Former Interim CEO/President 142280 0 0 0 0 0 0 0 0 0 142280 0 0 0 Part I, Line 7 David Muller received bonus compensation in 2021 for his productivity. Form 990, Part VII, line 5: Doug Nilson, Director / ED Provider, was compensated by a third party, Bluewater Emergency Partners for services rendered to Springfield Hospital, Inc. Bluewater Emergency Partners received $3,516,439 from the filing Organization. A breakdown of compensation between Dr. Nilson and other providers is not available to filing Organization. Michael Halstead, Former Interim CEO/President, was compensated by a third party, Quorum Health Resources, for services rendered to Springfield Hospital, Inc. Quorum Health Resources received $142,280 from the filing Organization for services rendered. Form 990, Part III, Line 4a Other community benefit programs include the following: Job Training and Shadowing Programs: These programs, in cooperation with Vocational Rehab and training programs through the State of Vermont, provide opportunities to gain on-the-job experience in the healthcare field. We also work with area high school students to provide opportunities for career education and summer employment. Traditionally, these programs have been offered, however they were on hold for 2021 and 2022 due to COVID-19. Healthcare Scholarships: Springfield Hospital raises funds that are then donated to individuals to further their educational pursuits in healthcare careers. In FY 2022, we donated four scholarships of $4,000 in healthcare scholarships. BeSeatSmart Program: This program helps residents comply with Vermont's child passenger restraint law, while ensuring the safety of young children in our community. During FY 2022, 15 child safety seats were provided to families in need, and a total of 20 child safety seats were installed and/or inspected by the Child Passenger Safety Technician, on site at Springfield Hospital. The safety seat checks are offered as a free community service. We estimate the value of this program to be $1,000 based on staff time to educate parents on the proper use and installation of the child safety seats and administrative assistant costs. Employee Donations for Community Causes: Throughout the year, the Hospital encourages employees to participate in and donate to fundraising events in support of various associations that address community needs, for example Hearts of Hope and the Santa Claus Club. In addition, Springfield Hospital partners with the Vermont Food Bank in offering Veggie VanGo that provides free fresh fruits and vegetables to families in need on a monthly basis. The Springfield Hospital Veggie VanGo site serves approximately 500-600 families each month. EMS Preceptor Programs: Through Springfield Hospital's Emergency Department, area EMS received education by participating in a preceptor program, allowing personnel to participate in supervised patient care. Hospital Based Support Groups: Springfield Hospital routinely provides education and support groups on a variety of topics such as Alzheimers' Caregivers. Group meetings meet monthly and are free to participants, educational in nature, and offer an opportunity for group discussion. During FY 2021 and 2022, these groups were suspended for public safety precautions related to COVID-19. Meeting Rooms: Free meeting room space is offered to community groups when space is available. Groups that offer information on health or wellness are given a priority; such as Alcoholics Anonymous, Vermont Department of Health, the community health team and the community collaborative. During FY 2021 and 2022, these groups were suspended and did not meet in person for public safety precautions related to COVID-19. Training Site Partnerships: Springfield Hospital is a training site for Vermont Technical College for their Licensed Practical Nurses and several other schools for their Registered Nurses. Over the years, participating schools that had students doing practicums included: University of New Hampshire, University of Vermont, Norwich University, University of Massachusetts, Smith College, Antioch New England Graduate School, River Valley College, VTC, St Joseph's College of Maine, Castleton State College. The program utilization generally requires an estimated 200 hours for LPN and 400 hours for RN. There was very low participation in 2022 due to COVID-19 with only River Valley College and VTC participating. Community Education: Springfield Hospital promotes health education programs, open to the public, which include American Heart Association CPR and First Aid classes. The Hospital also collaborates with the North Star Health's community health team in offering community health and wellness education programs throughout the year emphasizing preventive health education programming around diet, exercise and nutrition. Springfield Community: Springfield Hospital encourages employees to become an active volunteer to help improve the communities we call home. Employees donate their time in a variety of areas ranging from serving as Board Members for local groups, participation in fundraising activities, including the Springfield Hospital Annual Golf Tournament and Apple Blossom Cotillion fundraising (unfortunately cancelled in 2022 due to COVID-19) events. Volunteer Service: Volunteer Services provide a variety of services to patients and visitors. The donation of time and fundraising activities support programs that include Clerical Services, Activities Assistant at Adult Day Services, Materials Management Support, Inpatient Discharge Phone Calling Support and Special Services in the Emergency Department. Volunteer numbers and time were drastically reduced in 2022 due to COVID-19. In fiscal year 2022, Springfield Hospital had 5 volunteers and volunteered approximately 435 hours. The Windham Center: The Windham Center is a 10-bed inpatient mental health unit that provides mental health services to residents of Windham and Windsor counties and other communities. Programs provide treatment for men and women who are 18 years of age and older. Multidisciplinary teams include psychiatrists, social workers, clinicians, drug and alcohol counselors, and nurses. The Windham Center serves the general population and financial assistance is available, based on need. The Windham Center had 307 admissions in 2022. Adult Day Care Service: Springfield Hospital operates an adult day care service, located in Springfield, VT. A cost-effective choice to long term nursing home health care, the Springfield Area Adult Day Service assists families with seniors or disabled adults, over the age of 18, who face the challenge of losing their independence. The structured program offers a safe and protective environment where nutritious meals, social activities, health care services, nursing oversight, and coordination of needed social and support services are provided. Transportation is available through an arrangement with the local bus service. Because of the COVID-19 pandemic and the mandated closure of all adult day services for 15 months, Adult Day Services has had approximately 50% fewer admissions. In FY2022, Adult Day had 3,148 patient days of care. Form 990, Part VI, Section A, line 4 During the fiscal year, the bylaws were amended to reduce the minimum number of Members from 51 to 25. Form 990, Part VI, Section A, line 6 The Organization has a single class of members. Form 990, Part VI, Section A, line 7a The responsibilities of the Members are limited to election of Members and election of the Board of Directors of the Hospital. Form 990, Part VI, Section A, line 7b The Bylaws may be amended at an annual, regular or special meeting of the Members by a two-thirds vote of the Members. Form 990, Part VI, Section B, line 11b Form 990 is reviewed by the Organization's Chief Financial Officer upon completion. Form 990, Part VI, Section B, line 12c Conflicts of interest are reviewed by the Corporate Compliance Officer and Chief Executive Officer on an annual basis. Members must recuse themselves from voting on issues where a conflict is actual or implied. Form 990, Part VI, Section B, line 15a CEO salary is determined by guidance from QHR. The board approved the final contract after negotiations. A written employment contract was part of the process. 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 Purchased Services: Program service expenses 14,985,034. Management and general expenses 1,471,791. Fundraising expenses 0. Total expenses 16,456,825. Physician Fees: Program service expenses 3,199,975. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,199,975. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Springfield Hospital, Inc. PO Box 2003 Springfield, VT 05156 EIN: 03-0179437 Springfield Hospital, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Change in net assets to recognize funded status of pension plan 1,676,527.