2021-08-16T16:30:43-05:00 2020-09-30 010523282 Berry Dunn McNeil & Parker LLC PO BOX 1100 Portland ME 041041100 990 2019-10-01 030306549 Helen Porter Nursing Home Inc HELE 8023884701 115 Porter Drive Middlebury VT 05753 Scott Comeau CFO 8023884701 2021-08-16 1 Joseph R Byrne P01289281 2077752387 2021-08-16 2019 2022-09-23 18:48:47Z Helen Porter Rehabilitation & Nursing Tom Thompson 115 Porter Drive Middlebury VT 05753 10951769 0 X www.portermedical.org X 1986 VT Operation of 98 bed skilled nursing home 17 15 195 20 0 0 695606 707185 9879567 10240786 -6050 3305 0 0 10569123 10951276 0 0 0 0 8872595 8286880 0 0 0 3453979 3409486 12326574 11696366 -1757451 -745090 5046688 4088031 6330094 6090588 -1283406 -2002557 The mission of Helen Porter Rehabilitation and Nursing is to improve the health of our community, one person at a time. 0 0 10486007 10240786 Operated long-term community oriented 98 bed skilled nursing home. The nursing home provided services to patients that totaled 29,455 resident days during the year ended 9/30/2020. 10486007 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 1 195 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 VT X Scott Comeau 8023884752 115 Porter Drive Middlebury VT 05753 Sivan Cotel Chair 1.00 2.00 X X 0 0 0 Maureen McLaughlin Treasurer 1.00 2.00 X X 0 0 0 Linn Larson MD Secretary 1.00 2.00 X X 0 5907 0 Alix O'Meara Director 1.00 2.00 X 0 0 0 Amey Ryan Director 1.00 2.00 X 0 0 0 Amy Gregory Director 1.00 2.00 X 0 0 0 Anne Collins Director 1.00 2.00 X 0 0 0 Cheryl Mullins Director 1.00 2.00 X 0 0 0 Debra Stenner Director 1.00 2.00 X 0 0 0 Judson Bartlett Director 1.00 2.00 X 0 0 0 Kim Downs-Burns Director 1.00 2.00 X 0 0 0 Kristofer Anderson MD Director 1.00 41.00 X 0 346497 29891 Lewis Holmes MD Director 1.00 41.00 X 0 199089 13273 Linda Schiffer Director 1.00 2.00 X 0 0 0 Matthew Curran Director 1.00 2.00 X 0 0 0 Nicholas Lovejoy Director 1.00 2.00 X 0 0 0 Richard Foote Director 1.00 2.00 X 0 0 0 Stephen Koller MD Past Director 1.00 2.00 X 0 25000 0 Fred Kniffin MD CEO 1.00 41.00 X 0 390695 22598 Jennifer Bertrand CFO 1.00 41.00 X 0 241835 7290 Seleem Choudhury Past President/COO 1.00 41.00 X 0 185132 13701 Mary Jane Nottonson Nursing Home Administrator 40.00 0.00 X 165454 0 37482 165454 1394155 124235 1 0 1 0 Porter Medical Center Inc 115 Porter Drive Middlebury VT 05753 Management Services 705851 Porter Hospital 115 Porter Drive Middlebury VT 05753 Lab/Pharmacy/Radiology/Mgt. Svcs. 104723 2 673998 33187 707185 Patient Revenue 623000 11133357 11133357 Other Revenue 623000 9482 3971 5511 Provision for Bad Debts 623000 -82160 -82160 Contractual Allowances 623000 -819893 -819893 10240786 3798 3798 493 -493 -493 -493 10951276 10235275 0 8816 6134273 5805083 329190 227237 214289 12948 1468482 1384809 83673 456888 430855 26033 619408 161056 458352 26504 26504 39815 39815 531358 496712 34646 13448 3441 10007 90533 76494 14039 6163 6163 404918 328878 76040 7702 6823 879 4605 2182 2423 73297 60222 13075 266571 245698 20873 20418 20418 Medical Supplies 740050 731445 8605 Medicaid Provider Tax 482114 482114 Miscellaneous Expense 71349 26362 44987 Dues & Subscriptions 11233 2963 8270 11696366 10486007 1210359 0 X 22458 17710 1263136 1048437 1565299 997654 16483 16483 26223 7217 7655888 5672212 2132272 1983676 20817 16854 5046688 4088031 1267719 1455009 2601831 2470778 23435 36459 741973 741973 1695136 1386369 6330094 6090588 X -1946530 -2695275 663124 692718 -1283406 -2002557 5046688 4088031 X -745090 25939 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3869 3869 0 Part II-B, Line 1: The Organization pays dues to various associations, a portion of which is attributable to lobbying expenses. 0 1 X 5945348 4451351 1493997 1446455 1044059 402396 264085 176802 87283 1983676 Due to Affiliates 606913 Liability for Pension Benefits 779456 1386369 Part IV, Line 2b: The Organization holds funds belonging to residents for their personal use. The funds are made available to the residents as requested or needed. 0 0 0 0 0 0 0 1 0 Kristofer Anderson MD Director 0 334848 0 7065 0 4584 0 16304 0 13587 0 376388 0 0 Lewis Holmes MD Director 0 179158 0 14943 0 4988 0 10711 0 2562 0 212362 0 0 Fred Kniffin MD CEO 0 315365 0 22002 0 53328 0 10096 0 12502 0 413293 0 0 Jennifer Bertrand CFO 0 211016 0 26736 0 4083 0 7249 0 41 0 249125 0 0 Seleem Choudhury Past President/COO 0 154946 0 15686 0 14500 0 0 0 13701 0 198833 0 0 Mary Jane Nottonson Nursing Home Administrator 145269 0 19695 0 490 0 5254 0 32228 0 202936 0 0 0 Part I, Line 3 Porter Medical Center (PMC), a related organization, establishes the compensation for the Organization's CEO. Porter Medical Center uses a variety of resources to establish compensation as follows: 1. Independent compensation consultant 2. Written employment contract 3. Approval by the PMC Board Part I, Line 7 A lump sum incentive award has been issued to members of senior leadership and the President of Porter Medical Center, Porter Hospital, and Helen Porter Nursing Home through its annual variable pay plan, as the organization performance measures were met. Threshold measures were reviewed by the Executive Committee of the Board of Directors. These measures included, financial, population health/quality, and operational related metrics. A Vermont Educational and Health Buildings Financing Agency 237154467 2015-08-01 3100000 Refunding 2000 Series A Bonds 0 0 0 A 629222 3100000 34525 3065475 2015 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 A 0 Form 990, Part VI, Section A, line 6 As of April 1, 2017, the University of Vermont Health Network became the sole member of Porter Medical Center. Form 990, Part VI, Section A, line 7a The University of Vermont Health Network, as Porter Medical Center's sole member, has reserve powers that allow the University of Vermont Health Network to refuse the acceptance of new board members appointed by the Porter Medical Center Board of Directors if The University of Vermont Health Network does not agree with the choice of appointments. As a result, the process of appointing members to the governing body is a collaboration of the Porter Medical Center Board of Directors and the University of Vermont Health Network. Form 990, Part VI, Section A, line 7b The University of Vermont Health Network has certain reserve powers that require it to approve certain decisions made by the Porter Medical Center Board of Directors. Form 990, Part VI, Section B, line 11b Form 990 is reviewed by management and the Finance committee before filing. The Form 990 is also made available electronically to the Board of Directors before filing. Form 990, Part VI, Section B, line 12c The Organization's CFO and Controller are responsible for regularly and consistently monitoring and enforcing compliance with the conflict of interest policy. When bids are solicited to include the business of a Board member, those bids are reviewed by the Board of Directors to assure adherence to the Organization's lowest bid policy. When an issue comes up to a vote and it is connected, in any way, to the business of a Board member, the member must recuse him/herself from the vote. Form 990, Part VI, Section B, line 15a The Organization's executive committee reviews comparative data prepared by a consultant prior to referral of compensation to the board of directors. The board of directors review the findings of the consultant and vote to approve the salary of the CEO. 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 X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Helen Porter Nursing Home, Inc. 115 Porter Drive Middlebury, VT 05753 EIN 03-0306549 Helen Porter Nursing Home, 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 79,702. Other Component of Pension Expense -53,763. Form 990, Schedule A, Part I, Line 3: Reason for Public Charity Status: The Organization's exemption is based upon being classified as a hospital or cooperative hospital service organization described in 170(b)(1)(A)(iii). Since the Organization is not licensed in the state of Vermont as a hospital, but rather as a skilled nursing facility, Schedule H is not required. Porter Hospital Inc 37 Porter Drive Middlebury VT 05753 030181058 Critical Access Hospital VT 501(c)(3) Line 3 Porter Medical Center Inc 0 Porter Medical Center Inc 37 Porter Drive Middlebury VT 05753 030310862 Holding Company for Subsidiaries VT 501(c)(3) Line 12b, II N/A 0 Auxiliary of Porter Medical Center 37 Porter Drive Middlebury VT 05753 237363227 Supporting Organization VT 501(c)(3) Line 12b, II Porter Medical Center Inc 0 Univ of Vermont Health Network Inc 111 Colchester Ave Burlington VT 05401 452880726 Parent Organization VT 501(c)(3) Line 12a, I N/A 0 UVM Health Network Medical Group Inc 111 Colchester Ave Burlington VT 05401 030225105 Physician Services VT 501(c)(3) Line 12a, I UVMHN 0 UVM Medical Group-New York PLLC 183 Park Street Malone NY 12953 203905216 Physician Services NY 501(c)(3) Line 3 UVMHNMG 0 The University of Vermont Med Ctr Fdn Inc 111 Colchester Ave Burlington VT 05401 263159849 Fundraising VT 501(c)(3) Line 12a, I UVMMC 0 The University of Vermont Medical Center 111 Colchester Ave Burlington VT 05401 030219309 Hospital VT 501(c)(3) Line 3 UVMHN 0 Central Vermont Medical Center 130 Fisher Road Berlin VT 05602 222547186 Hospital VT 501(c)(3) Line 3 UVMHN 0 Community Providers Inc 75 Beekman Street Plattsburgh NY 12901 222544844 Health Service Coordinator NY 501(c)(3) Line 12a, I UVMHN 0 Champlain Valley Physicians Hospital 75 Beekman Street Plattsburgh NY 12901 141338471 Hospital NY 501(c)(3) Line 3 UVMHN 0 Elizabethtown Community Hospital 75 Park Street Elizabethtown NY 12932 141364513 Hospital NY 501(c)(3) Line 3 UVMHN 0 Emergency Medical Transport of CVPH Inc 75 Beekman Street Plattsburgh NY 12901 061718419 Ambulance Service NY 501(c)(3) Line 12b, II CPI 0 CVPH Medical Center Foundation 75 Beekman Street Plattsburgh NY 12901 141727048 Health Service Support NY 501(c)(3) Line 12b, II CVPH 0 University Health Center 111 Colchester Ave Burlington VT 05401 030229931 Hospital VT 501(c)(3) Line 12c, III-FI UVMHNMG 0 University Medical Education Associates 89 Beaumont Avenue Burlington VT 05401 237107832 Educational VT 501(c)(3) Line 10 UVMHNMG 0 Alice Hyde Medical Center 133 Park Street Malone NY 12953 150346515 Hospital NY 501(c)(3) Line 3 UVMHN 0 UVM Medical Center Auxiliary Inc 111 Colchester Ave Burlington VT 05401 208022004 Service VT 501(c)(3) Line 12c, III-FI N/A 0 UVMHN Home Healthcare & Hospice 1110 Prim Road Colchester VT 05446 030179603 Home Healthcare VT 501(c)(3) Line 3 UVMHN 0 Lake Champlain Physicians Services PC 75 Beekman Street Plattsburgh NY 12901 273785445 Physician Services NY 501(c)(3) Line 12a, I CVPH 0 VMC Indemnity Company Inc 95 St Paul St Burlington VT 05401 831102018 Insurance VT 501(c)(3) Line 12a, I UVMHN 0 Onecare Vermont ACO LLC 111 Colcester Ave Burlington VT 05401 455399218 Accountable Care VT N/A Related 0 0 Adirondack ACO LLC 75 Beekman Street Plattsburgh NY 12901 462840926 Accountable Care NY N/A N/A 0 0 UVMHN Health Ventures Inc 111 Colchester Ave Burlington VT 05401 043380045 Holding Company VT UVMHN C 0 VMC Indemnity Company LTD PO Box HM 3103 25 Church Street Hamilton HM FX BD Captive Insurance BD UVMMC C 0 UVMHN Credentialing & Enrollment 111 Colchester Ave Burlington VT 05401 030333056 Admin Services VT UVMHN Ventures C 0 Charitable Remainder Trust (5) Support VT UVMMCCVMC T 0 Perpetual Trust (4) Support VT UVMMC T 0 Charitable Irrevocable Trust (7) Support VT UVMMCCVMC T 0 Champlain Valley Health Network 75 Beekman Street Plattsburgh NY 12901 161586102 Admin Service NY CPI C 0 Mediquest Inc PO Box 1656 Plattsburgh NY 12901 141663061 Med Office Lease NY CPI C 0 Yankee Medical Inc 276 North Avenue Burlington VT 05401 030225363 Home Medical Equipment VT UVMHN Ventures C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1