2021-08-13T12:15:47-05:00 2020-09-30 010523282 Berry Dunn McNeil & Parker LLC PO BOX 1100 Portland ME 041041100 990 2019-10-01 460938716 Gifford Health Care Inc GIFF 8027287000 44 South Main Street Randolph VT 05060 Jennifer Bertrand CFO 8027287000 2021-08-12 1 Joseph R Byrne P01289281 2077752387 2021-08-12 2019 2022-09-23 18:48:47Z Daniel A Bennett 44 South Main Street Randolph VT 05060 14050020 0 X www.giffordhealthcare.org X 2012 VT Gifford Health Care is a non-profit CHC providing primary care services on an outpatient basis. 15 14 126 15 0 0 2148427 3293577 12321665 10753945 2648 2498 0 0 14472740 14050020 0 0 0 0 11117490 11435299 0 0 17618 4107965 3661801 15225455 15097100 -752715 -1047080 2024583 1251525 5468768 4695240 -3444185 -3443715 X The mission of Gifford Health Care, Inc. and its subsidiaries is to enhance the health and well-being of our communities by providing excellent patient-centered care including senior living services. 1 0 12381751 10753945 GHC is a CHC deemed federally qualified health center offering primary care, pediatrics, psychiatric, substance use, OB/GNY and midwifery services in convenient locations throughout central VT and the upper valley. Family-friendly primary care practices are all patient-centered medical homes and uniquely dedicated to providing high-quality, accessible care. Services include prevention and wellness such as annual well-child visits and sports physicals, childhood immunizations, acute care, family education on healthy behaviors, substance abuse and child development, medication management, psychiatric care, management of chronic conditions, eye and hearing screenings, timely care for acute illness and helping patients find dental care. 12381751 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 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 0 1 1 1 0 0 1 14 0 1 126 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Jennifer Bertrand 8027287000 44 South Main Street Randolph VT 05060 Matt Considine Chair 1.00 2.00 X X 0 0 0 Lincoln Clark Vice Chair 1.00 2.00 X X 0 0 0 Barbara Rochat Secretary 1.00 2.00 X X 0 0 0 Jody Davignon Treasurer 1.00 2.00 X X 0 0 0 Bradford Atwood Director/Trustee 1.00 2.00 X 0 0 0 Carol Bushey Director/Trustee 1.00 2.00 X 0 0 0 Fredrick Hauser Director/Trustee 1.00 2.00 X 0 0 0 Sheila Jacobs Director/Trustee 1.00 2.00 X 0 0 0 Ben Jickling Director/Trustee 1.00 2.00 X 0 0 0 Theron Manning Director/Trustee 1.00 2.00 X 0 0 0 Peter Reed Director/Trustee 1.00 2.00 X 0 0 0 Victor Ribaudo Director/Trustee 1.00 2.00 X 0 0 0 Clay Westbrook Director/Trustee 1.00 2.00 X 0 0 0 Peter Nowlan Director/Trustee 1.00 2.00 X 0 0 0 Todd Winslow Director/Trustee 1.00 2.00 X 0 0 0 Daniel Bennett President & CEO 1.00 41.00 X 0 278559 46934 Jeff Hebert Past CFO 1.00 41.00 X 0 219769 9515 Wayne D Bennett Interim CFO 1.00 41.00 X 0 30129 2477 0 528457 58926 0 0 1 0 0 2599500 694077 3293577 Patient Service Revenue 624100 13572761 13572761 Pharmacy Revenue 446110 1744590 1744590 Other Revenue 900099 292718 292718 Provision for Bad Debts 624100 -348542 -348542 Contractual Allowances/Charity Ca 624100 -4507582 -4507582 10753945 2498 2498 14050020 10753945 0 2498 X 9280906 8282108 987596 11202 319572 296994 22192 386 1253082 1164553 87017 1512 581739 540640 40397 702 6454 6454 12408 12408 1563564 964125 597552 1887 15397 15378 19 89834 56653 33073 108 819046 264420 553637 989 2336 2214 119 3 166 154 12 51656 48007 3587 62 125831 56452 69227 152 Medical Supplies and Dr 481760 481760 Miscellaneous Expenses 298163 121476 176327 360 Other Supplies 138789 55590 83031 168 Licenses, Taxes and Due 56397 46605 9724 68 15097100 12381751 2697731 17618 X 810 3278 77900 156621 1390791 662196 35606 50487 174195 85318 507294 213669 345281 293625 2024583 1251525 1017598 1050862 4451170 3644378 5468768 4695240 X -3469235 -3469236 25050 25521 -3444185 -3443715 2024583 1251525 X -1047080 1047550 X 0 1 X 1 1 1 X 1258783 1775401 1846954 2148427 4341127 11370692 10538714 10314029 11409090 12321665 10753945 55337443 11797497 12089430 13256044 14470092 15095072 66708135 0 0 0 66708135 2730 909 847 2648 2498 9632 2730 909 847 2648 2498 9632 11800227 12090339 13256891 14472740 15097570 66717767 0.99990 0.99980 0.00010 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1858 1858 0 Part II-B, Line 1: Gifford Medical Center, Inc., a related organization, is a member of the Vermont Association of Hospitals and Health Systems, the Bi-State Primary Care Association, and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Gifford Medical Center and the other member organizations in furtherance of their exempt purposes. Gifford Medical Center does not directly perform any lobbying activities. A portion of these dues have been allocated to related organizations Gifford Retirement Community, Inc. and Gifford Health Care, Inc. 348384 145134 203250 158910 68535 90375 293625 Due to Affiliate 3287785 Estimated Amounts Due to Third-Party Payors 64238 Accelerated Payments 292355 3644378 1 0 0 0 0 0 0 0 0 Daniel Bennett President & CEO 0 276131 0 0 0 2428 0 14000 0 32934 0 325493 0 0 Jeff Hebert Past CFO 0 190300 0 0 0 29469 0 9515 0 0 0 229284 0 0 Part I, Line 3 Gifford Medical Center's Chief Executive Officer is evaluated annually by a board compensation committee that relies on data and input from a variety of independent sources. The compensation information is then reviewed by the Executive Committee of the Board of Trustees and resultant recommendations are presented to the Board of Trustees for final approval. Part I, Line 4a During the year, Jeff Hebert, Past Chief Financial Officer, received a severance payment in the amount of $29,267. Mr. Hebert is compensated by Gifford Medical Center, Inc., a related organization. Form 990, Part III, line 2 During the COVID-19 pandemic, Gifford Health Care established a COVID-19 testing site to ensure the community we serve had adequate access to this much needed resource. Form 990, Part V, Lines 1a & 2a: Gifford Medical Center, a related organization of Gifford Health Care, files all W-2s and 1099s for the Organization. Salaries, pension, payroll taxes, and employee benefits of those individuals are then allocated for the amounts that represent work performed for Gifford Health Care. In addition, the CEO and CFO of Gifford Medical Center, Gifford Health Care, and Gifford Retirement Community compensation has been shown in Part VII as paid by Gifford Medical Center only, although their time spent is attributable to all three entities. Form 990, Part VI, Section B, line 11b 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 completed Form 990 is presented and reviewed by the Finance Committee of the Board of Trustees and an electronic copy of the complete Form 990 is made available to all Board Members prior to filing. Form 990, Part VI, Section B, line 12c Gifford Health Care, Inc. requires board members to complete an annual conflict of interest survey. Any duality of interest or possible conflict of interest on the part of any director shall be disclosed to the other board members. Any director having duality of interest or possible conflict of interest on any matter shall not vote or use his personal influence on the matter, and shall not be present for discussion of the matter. The minutes of the meeting shall reflect that a disclosure was made and that the director abstained from voting and discussion. Form 990, Part VI, Section B, line 15 The Organization's CEO & other officers are compensated by Gifford Medical Center, a related organization. Compensation for the Chief Executive Officer is evaluated annually by a board compensation committee that relies on data and input from a variety of independent sources. The compensation information is then reviewed by the Executive Committee of the Board of Trustees and resultant recommendations are presented to the Board of Trustees for final approval. To evaluate the compensation of the Organization's other officers and key employees, the compensation review is administered by human resources and the CEO. The human resources department has some internal and external sources that are utilized to compare compensation amounts. Form 990, Part VI, Section C, line 19 The Organization makes its conflict of interest policy available upon request. The financial statements are available on the Organization's website, and upon request. Form 990, Part IX, line 11g Professional Fees: Program service expenses 964,125. Management and general expenses 597,552. Fundraising expenses 1,887. Total expenses 1,563,564. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Gifford Health Care, Inc. 44 South Main Street Randolph, VT 05060 EIN 46-0938716 Gifford Health Care, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Transfer from Affiliate 1,047,550. Gifford Medical Center Inc 44 South Main Street Randolph VT 05060 030179418 Critical Access Hospital VT 501(c)(3) Line 3 Gifford Health Care Inc 1 Gifford Retirement Community Inc 44 South Main Street Randolph VT 05060 463593492 Skilled Nursing Facility & Retirement Community VT 501(c)(3) Line 10 Gifford Health Care Inc 1 0 0 1 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 Gifford Medical Center Inc S 1047550 FMV