2021-08-09T10:10:29-05:00 2020-09-30 010523282 Berry Dunn McNeil & Parker LLC PO BOX 1100 Portland ME 041041100 990 2019-10-01 030266986 Northwestern Medical Center NORT 8025245911 133 Fairfield St St Albans VT 05478 Stephanie Breault CFO 8025245911 2021-08-05 1 Joseph R Byrne P01289281 2077752387 2021-08-05 2019 2022-09-23 18:48:47Z Dr Dean French 133 Fairfield St St Albans VT 05478 131551633 0 X www.northwesternmedicalcenter.org X 1977 VT Northwestern Medical Center's mission is to provide exceptional healthcare for our community. 11 10 1035 82 0 0 3523138 17679125 108019417 99602397 4254607 -243244 425346 409430 116222508 117447708 93214 91344 0 0 70554585 69331212 0 0 0 49166936 50189877 119814735 119612433 -3592227 -2164725 170440256 187646355 51526246 71123482 118914010 116522873 X Northwestern Medical Center's mission is to provide exceptional healthcare for our community. 0 1 77667472 91344 99998223 Providing inpatient and outpatient services to the general public in a full-service 70-bed hospital. The Hospital publishes an annual report. Please refer to the annual report for additional explanation of the Hospital's programs and achievements. Charity Care - The Hospital provides care to patients who meet certain criteria under its charity care policy. Because the Hospital does not pursue collection or amounts determined to qualify as charity care they are not reported in revenue. The Hospital maintains records to identify and monitor the level of charity care it provides. The records include the amount of charges foregone for services and supplies furnished under its charity care policy, the estimated cost of those services and supplies and equivalent service statistics. The following information measures the level of charity care provided during the year ended September 30, 2020.See continuation on Schedule O. Estimated costs and expenses incurred to provide charity care: $702,205Number of charity care patients served: 1,357The Hospital provides health care services to residents of St. Albans, Vermont, and the surrounding area, without regard to the individual's ability to pay for their services. 77667472 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 1 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 139 0 1 1035 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VT X Stephanie Breault CPA 8025245911 133 Fairfield Street St Albans VT 05478 Janet McCarthy President 5.00 0.00 X X 0 0 0 Jake Holzscheiter Vice President 5.00 0.00 X X 0 0 0 Leon Berthiaume Treasurer / Past President 5.00 0.00 X X 0 0 0 John Casavant Secretary 5.00 0.00 X X 0 0 0 Dawn Bugbee Member / Interim CAO 40.00 0.00 X X 0 0 0 Nick Hadden Member 5.00 0.00 X 0 0 0 Corey Parent Member 5.00 0.00 X 0 0 0 Karyn Rocheleau Member 5.00 0.00 X 0 0 0 Marietta Scholten MD Member 5.00 0.00 X 0 0 0 Lawrence Sullivan MD Member / OBGYN Physician 40.00 0.00 X 681733 0 32005 Barb Toof Member 5.00 0.00 X 0 0 0 Lorne Babb MD Past Member 5.00 0.00 X 0 0 0 Kevin Manahan Past Member 5.00 0.00 X 0 0 0 Katie Montagne MD Past Member 5.00 0.00 X 0 0 0 William O'Connor Jr Past Member 5.00 0.00 X 0 0 0 Jerry Barbini Interim CEO 40.00 0.00 X 0 0 0 Jill Berry Bowen Past CEO 40.00 0.00 X 446709 0 3573 Robyn Alvis COO Northwestern Medical Group 40.00 0.00 X 98647 0 4652 Michael Barnum MD Orthopedic Surgeon 40.00 0.00 X 1002139 0 32005 Leonard Tremblay MD OBGYN Physician 40.00 0.00 X 491664 0 25919 Gregory Brophey MD Ophthalmologist 40.00 0.00 X 636858 0 25476 Robert Beattie MD Orthopedic Surgeon 40.00 0.00 X 714238 0 30122 John P Minadeo Physician 40.00 0.00 X 473297 0 32005 Chris Hickey Former CFO 0.00 X 116671 0 9508 4661956 0 195265 101 1 1 0 University of Vermont Medical Center PO Box 1902 Burlington VT 05402 Various Medical Services 2248052 Quorum Healthcare Services 105 Continental Place Brentwood TN 37027 Management Services 1500206 Clinical Colleagues 1121 N Bethlehem Pike Suite 60-234 Spring House PA 19477 Anesthesia Services 1403170 A Cooper Mechanical Inc 171 Leroy Road Williston VT 05495 Construction Services 1076329 Shiftwise PO Box 70870 St Paul MN 55170 Traveler Staffing 987633 27 15609681 2069444 17679125 Patient Service Revenue 622100 213506804 213506804 Other Operating Revenue 622100 1727658 1727658 Cafeteria 622100 591936 591936 Provision for Bad Debts 622100 -8153915 -8153915 Contractual Allowances/Char. Adj. 622100 -108070086 -108070086 99602397 1309525 1309525 442831 47005 395826 395826 395826 12472469 22500 14047738 0 -1575269 22500 -1552769 -1552769 22786 9182 13604 13604 117447708 99406287 0 362296 X 91344 91344 1267319 798818 468501 54090186 34093017 19997169 2186741 1378350 808391 8251576 5201145 3050431 3535390 2228432 1306958 1390802 876652 514150 100534 63369 37165 103531 65258 38273 11065 11065 115120 115120 18163228 11448672 6714556 202321 127527 74794 634652 400035 234617 1878621 1184135 694486 238855 150555 88300 764150 481644 282506 5808281 3660960 2147321 1163595 733439 430156 Supplies 10969144 6914087 4055057 Provider Tax 6361131 6361131 Miscellaneous 1803558 1105535 698023 Dues & Subscriptions 481289 303367 177922 119612433 77667472 41944961 0 X 2059093 20004567 9787680 14689810 269470 179155 10203751 9908593 1814949 1930152 8145853 11298026 140247861 68688940 68886164 71558921 60566482 46816710 4611871 6576163 4094943 4684258 170440256 187646355 13572694 17883311 31243368 29729663 26478 1656484 6683706 21854024 51526246 71123482 X 114259357 112887254 4654653 3635619 118914010 116522873 170440256 187646355 X -2164725 919242 -1145654 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 5420 0 1 11065 16485 0 Part II-B, Line 1: Northwestern Medical Center engages in minimal formal lobbying. NMC's CEO and VP of Community Relations are registered as lobbyists with the Vermont Secretary of State's office for discussions with legislators and other elected officials regarding action on specific legislation and action which impacts the health of the community and the sustainability of the Organization. Northwestern Medical Center is a member of the Vermont Association of Hospitals and Health Systems and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Northwestern Medical Center and other member organizations in furtherance of their exempt purposes. 1145463 -2525 1142938 1144129 1334 1145463 1118351 25778 1144129 1054571 63780 1118351 1071601 -17030 1054571 0.00000 1.00000 0.00000 1 0 1020530 1020530 83731081 33356946 50374135 44195420 33005173 11190247 11300830 2326821 8974009 71558921 Estimated Third-Party Settlements 6145746 Deferred Compensation 3724033 Interest Rate Swaps 2455542 HHS Stimulus Deferred Revenue 3653507 Third Party Accelerated Payments 5875196 21854024 117115358 919242 9182 928424 116186934 115120 1145654 1260774 117447708 119506495 9182 9182 119497313 115120 115120 119612433 Part V, Line 4: The Organization intends to use the endowment funds in the manner prescribed by the donors. Part XI, Line 2d - Other Adjustments: Special Event Expenses 9,182. Part XI, Line 4b - Other Adjustments: Unrealized Loss on Interest Rate Swaps 1,143,129. Depreciation in Beneficial Interest in Perpetual Trusts 2,525. Part XII, Line 2d - Other Adjustments: Special Event Expenses 9,182. Schedule D, Part V, Line 3a(i) The Organization has Beneficial Interest in Trusts which are not held at nor in the possession of the Organization. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Investments 6576163 0 0 0 0 0 0 6576163 0 6576163 0 0 1 0 0 0 Part III Accounting Method: Community Partners Golf Classic 8740 8740 Martin Wennar Scholarship Dinner 8373 8373 6000 1 5673 5673 3182 22786 22786 9182 9182 13604 1 1 1 X 400.000000000000 1 X 1 1 1 0 0 724626 724626 0.00610 28737163 18058763 10678400 0.08930 29461789 18058763 11403026 0.09540 3478630 2975268 503362 0.00420 91344 91344 0.00080 3569974 2975268 594706 0.00500 33031763 21034031 11997732 0.10040 1 4483893 22841854 38929460 -16087606 X 1 1 1 1 Northwestern Medical Center 133 Fairfield Street St Albans VT 05478 www.northwesternmedicalcenter.org 898 X X X Northwestern Medical Center 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X www.northwesternmedicalcenter.org X X 1 18 1 www.northwesternmedicalcenter.org 0 1 X 400.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X www.northwesternmedicalcenter.org X www.northwesternmedicalcenter.org X www.northwesternmedicalcenter.org X X X X 1 X 0 X X X X 1 X 0 0 Northwestern Medical Center Part V, Section B, Line 5: As part of our 2018/19 (FY'19) Community Health Needs Assessment, NMC gathered input in a variety of ways including interviews with physicians, providers, and community partners; perspectives from staff and volunteers; discussions with the Incorporators from throughout our service area; patient satisfaction insights; and utilization trend analysis. Significant input, perspective, and prioritization were received through a local group of experts who were asked to validate the direction and findings of the assessment and to establish priority among various identified issues. The composition of this group of community members aligns with the Federal regulations for involvement of community leaders with specified skills or representing specified constituencies and allows for them to use their connections to their neighbors and clientele and insights there in to assist in refining and prioritizing the community health needs. Northwestern Medical Center Part V, Section B, Line 7d: In addition to making the Community Health Needs Assessment widely available via the hospital website and in response to requests, Northwestern Medical Center provided overviews of the Community Health Needs Assessment to members of the community through presentations at groups such as the NMC Incorporators (150 local members who elect the hospital Board); the Boards of Directors of Northwestern Medical Center, Franklin County Home Health Agency; Northwestern Counseling & Support Services, NOTCH (Northern Tier Centers for Health Federally Qualified Health Centers); and the St. Albans Rotary comprised of business and civic leaders from across the region; and via Health Beat, NMC's public access television show. The priorities of the Community Health Needs Assessment are frequently referenced in other hospital documents, plans, publications, and presentations as we work to integrate these findings into our efforts to care for our community. Northwestern Medical Center Part V, Section B, Line 11: NMC is addressing the significant needs identified in its most recently conducted CHNA through a variety of initiatives including: the RiseVT community campaign to embrace healthy lifestyles; the modernization of the NMC Emergency Department; the expansion of access to and integration of addiction services; continuation and strengthening of partnerships for local mental health care and advocacy for proper inpatient mental health care infrastructure at the state level; continued emphasis on tobacco prevention and cessation with expansion to address vaping; support of community-based efforts related to suicide (including the Afterglow Awareness & Fundraising event for Northwestern Counseling & Support Services); support of community-based efforts related to sexual and domestic abuse (including the Laurie's House and Voices Against Violence); support of community-based efforts related to food insecurity (including Healthy Roots, Northwest Family Foods, and Martha's Kitchen); and other strategies aligning with awareness, education, resource allocation, and collaboration. All of the top priorities identified are being addressed in some fashion by the hospital.NMC's most recent CHNA also addressed additional items that impact the community but were not ranked as top priorities, including: Prevention & Wellness Education, Access and Affordability of Care, Cancer, Physical Activity, Dental Care, Alcohol Use, Chronic Pain Management, ACES (Adverse Childhood Experiences) & Trauma, Diabetes, Housing, Transportation, Heart Disease, Parent Education/Support, Accidents, Stroke, Health Equity, Women's Health, Alzheimer's, and Kidney Disease. The prevention messaging of NMC's RiseVT community campaign to embrace healthy lifestyles extends to many of these. Many of these are also addressed through NMC's Primary Care, Pediatrics, and other medical specialty practices. NMC's support of the United Way of Northwest Vermont and other important community partners also helps address these important but not top priority items. NMC's actions in these areas are tracked through normal operations rather than through the CHNA action plan which is focused on the top priorities. The hospital does not intend to develop a CHNA implementation plan for these lower ranked needs for the following reasons: 1. Actions required are beyond the mission of NMC;2. NMC can be more effective applying its resources to higher priority needs;3. The Hospital does not possess the expertise necessary for substantive positive improvement;4. Actions contemplated for implementation fall more appropriately to the responsibility of others;5. Other than providing encouragement, implementation efforts for some needs require appropriate actions by individuals modifying their personal habits rather than a response by an organization or the Hospital; and6. The best use of NMC resources is to focus on resolving or improving higher priority needs rather than attempting to respond to everything with small, perhaps ineffective, efforts. 8 1 - Northwestern Medical Center Pediatrics 11 Crest Road St Albans VT 05478 Pediatrics 2 - Northwestern Walk-in Clinic 927 Ethan Allen Hwy Ste 2 Georgia VT 05468 Diagnostic Imaging, Physical Therapy & Urgent Care 3 - Northwestern Georgia Health Center 4178 Highbridge Road Georgia VT 05486 Primary Care 4 - Northwestern Comprehensive Pain 17-19 Catherine Street St Albans VT 05478 Pain Care 5 - Northwestern Ophthalmology 53 Fairfax Road St Albans VT 05478 Ophthalmology 6 - Physical Therapy Services 44 Center Street Enosburg VT 05450 Physical Therapy 7 - Branon's Pools & Spa 248 North Main Street St Albans VT 05478 Physical Therapy 8 - Northwestern Medical Center Pediatrics 12 First Street Swanton VT 05488 Pediatrics Part I, Line 3c: Determining eligibility for free care and/or discounted care is not solely determined by Federal Poverty Guidelines (FPG). Other considerations, such as net worth, other financial obligations, and outstanding medical bills are reviewed in addition to income. Part I, Line 7g: Subsidized health services includes the Medicare shortfall from physician practices that are not included in the Hospital's cost reporting reflected on Part III, Line 7. Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable.In evaluating the collectability of accounts receivable, the Hospital analyzes past results and identifies trends for each major payor source of revenue for the purpose of estimating the appropriate amounts of the allowance for doubtful accounts and the provision for bad debts. Data in each major payor source are regularly reviewed to evaluate the adequacy of the allowance for doubtful accounts. For receivables relating to services provided to patients having third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a corresponding provision for bad debts at varying levels based on the age of the receivables and the payor source. For receivables relating to self-pay patients (which includes both patients without insurance and patients with deductibles, and copayment balances due for which third-party coverage exists for part of the bills), the Hospital records a provision for bad debts in the period of service based on past experience which indicates patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts. Part III, Line 8: The cost was determined using the cost to charge ratio.The Medicare shortfall of $16,087,606 reported on line 7 of Part III, does not represent all Medicare services provided by the Hospital, as required by IRS instructions. When taking all Medicare services into account, the Hospital calculated a different Medicare shortfall using an internal costing methodology. Part III, Line 9b: During the collection process, financial assistance, a payment plan or a discount may be offered to the patient, if appropriate, and in accordance with established hospital policy. Part VI, Line 2: In alignment with the Federal mandate, Northwestern Medical Center conducted a comprehensive Community Health Needs Assessment in 2019. This document was formally approved by the Hospital's Board of Directors at their May 1, 2019 meeting, placing it in the Hospital's 2019 Fiscal Year. This document replaces the previous Community Health Needs Assessment which was approved in the Hospital's 2016 Fiscal Year.Seven top priorities were identified: Mental Health; Substance Abuse; Obesity; Suicide; Domestic/Sexual Assault; Food Insecurities; and Smoking & Vaping - and action plans have been created to help address each of these priorities. The current (and previous) assessment is available free of charge on the Hospital website and the Hospital's Community Relations Office is available to provide free printed copies as requested. Part VI, Line 3: The Hospital uses a variety of methods of communication to inform and educate patients about its financial assistance program. For example, information related to financial assistance and charity care is available on the Hospital's website and patient portal, included on the back of patient statements, posted on signs at registration areas, and patients may speak on the phone with a collection specialist. The Hospital's financial assistance program is also widely publicized within the community, including published information regularly placed in the local newspaper and information brochures displayed at local United Way and Department of Health offices. Part VI, Line 4: The Hospital serves the greater Franklin and Grand Isle counties in northwestern Vermont. The service area consists of approximately 56,000 people and the area is primarily rural and agricultural in nature with some light industry. Part VI, Line 5: The Hospital maintains an open medical staff and a community based Board of Directors. The Hospital's Board of Directors is elected by the Hospital's Board of Incorporators, which consists of approximately 150 local residents. The Hospital created and funds a program known as The Center for Health and Wellness, which is committed to a collaborative approach to community health improvement. 1 Howard Center Inc 208 Flynn Avenue Suite 3J Burlington VT 05401 030179433 501(c)(3) 12500 Support programs complimentary to the Hospital's exempt purpose. Martha's Kitchen Inc 86 N Main Street St Albans VT 05478 030290790 501(c)(3) 5000 Support programs complimentary to the Hospital's exempt purpose. Northwest Regional Planning Commission 75 Fairfield Street St Albans VT 05478 030223756 Governmental 60000 Support programs complimentary to the Hospital's exempt purpose. 3 0 Part I, Line 2: All assistance is given to either 501(c)(3) public charities or governmental units and their affiliates. Therefore, additional monitoring is not deemed necessary. 1 X X X 0 0 0 0 0 0 0 1 0 Lawrence Sullivan MD Member / OBGYN Physician 620659 0 60724 0 350 0 5600 0 26405 0 713738 0 0 0 Jill Berry Bowen Past CEO 415891 0 15100 0 15718 0 3573 0 0 0 450282 0 0 0 Michael Barnum MD Orthopedic Surgeon 906189 0 30000 0 65950 0 5600 0 26405 0 1034144 0 0 0 Leonard Tremblay MD OBGYN Physician 347501 0 94963 0 49200 0 5600 0 20319 0 517583 0 0 0 Gregory Brophey MD Ophthalmologist 539597 0 96811 0 450 0 5600 0 19876 0 662334 0 0 0 Robert Beattie MD Orthopedic Surgeon 690638 0 23500 0 100 0 4167 0 25955 0 744360 0 0 0 John P Minadeo Physician 427234 0 15294 0 30769 0 5600 0 26405 0 505302 0 0 0 Chris Hickey Former CFO 113390 0 3281 0 0 0 2363 0 7145 0 126179 0 0 0 Part I, Line 7 Compensation plans for Jill Berry Bowen, Past CEO, & Chris Hickey, Former CFO, may include, among other things, elements that required meeting or exceeding financial performance measures, including profitability. Michael Barnum, Robert Beattie, Gregory Brophey, John P. Minadeo, and Leonard Tremblay, Highest Compensated Employees, and Lawrence Sullivan, Board Member, received bonuses from an incentive compensation plan. A Vermont Educational & Health Building Financing Agency 237154467 NoneAvail 2016-06-01 35000000 Refund 2012A Bond and New Capital Projects 0 0 0 A 5084561 35000000 235906 17429519 17334575 2017 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 1 1 People's United Bank 12.000000000000 1 0 0 0 1 A 1 Form 990, Part III, line 3 During the fiscal year, the Hospital closed Northwestern Hope & Recovery, one of its physician practices. The patients were transferred to another community provider. Form 990, Part V, Line 13a VT Form 990, Part VI, Section A, line 3 The Organization's CEO, Jill Berry Bowen, was an employee of Quorum Health Resources until May 2020, an unrelated management company. Jerry Barbini, also an employee of Quorum Health Resources, served as Interim CEO for the remainder of the fiscal year. Please refer to Form 990, Part VII for compensation paid by Quorum Health Resources. Form 990, Part VI, Section A, line 6 The organization has a maximum of 150 members, elected at the annual meeting from a slate of candidates nominated by the Nominating Committee. Other candidates for membership may be nominated from the floor at the annual meeting. Any person whose term as a Corporation Director has expired shall automatically become a member if that person consents to become a member. Form 990, Part VI, Section A, line 7a The membership elects a presiding membership officer, an alternate presiding membership officer and a membership secretary. Said officers are designated as Chair, Vice Chair and Recording Secretary of the membership. Form 990, Part VI, Section B, line 11b The entire Form 990 is provided to the full Board of Directors for review. The Board has the opportunity to ask questions and the Board votes on giving Administration approval to file the return in advance. Form 990, Part VI, Section B, line 12c Each Board Member and each member of the management team completes an annual statement attesting that they have received a copy of the policy and that they have read and understand it and will comply with it. Each person also completes a conflict of interest survey to identify potential conflicts and relevant financial interests. Each person also provides a listing of immediate family members, including spouse, children, grandchildren, parents, siblings, and any other person(s) living in their household. All disclosures are reviewed; determination of conflicts for Board Members are voted on by the remaining Board Members and determination of conflicts by the management staff is voted on by the senior leadership team. Those with conflicts are not allowed to participate in discussion and/or votes related to the conflict. A full copy of the policy can be provided upon request. Form 990, Part VI, Section B, line 15 The CEO is not an employee of Northwestern Medical Center. He/She is an employee of Quorum Health Resources and the respective contracts, including compensation, are approved by the Board of Directors on an annual basis. Form 990, Part VI, Section C, line 19 Northwestern Medical Center does not formally make its governing documents and conflict of interest policy available to the public. Financial information is available to the public through the annual tax return filing, annual Medicare and Medicaid cost report filing, and financial data published by the Green Mountain Care Board and available on the Hospital's website, as well as summarized financial information and statistics published in the Hospital's annual report distributed to local communities and published on the Hospital's website. Form 990, Part IX, line 11g Other Professional Fees: Program service expenses 9,158,142. Management and general expenses 5,371,178. Fundraising expenses 0. Total expenses 14,529,320. Maintenance Contracts: Program service expenses 2,290,530. Management and general expenses 1,343,378. Fundraising expenses 0. Total expenses 3,633,908. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Northwestern Medical Center 133 Fairfield St. St. Albans, VT 05478 EIN: 03-0266986 Northwestern Medical Center is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Unrealized Loss on Interest Rate Swaps -1,143,129. Depreciation in Beneficial Interest in Perpetual Trusts -2,525. Northwestern Occupational Health LLC 133 Fairfield Street St Albans VT 05478 030360669 Medical rehabilitative and urgent care services VT 0 2063558 Northwestern Medical Center Northwestern Medical Center Auxiliary Inc 133 Fairfield St St Albans VT 05478 030278425 Promotion and Support of Northwestern Medical Center VT 501(c)(3) Line 12a, I Northwestern Medical Center 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0