2021-08-13T12:40:39-05:00 2020-09-30 010523282 Berry Dunn McNeil & Parker LLC PO BOX 1100 Portland ME 041041100 990 2019-10-01 222564588 Southern Vermont Health Service Corp SOUT 8022570341 17 Belmont Street Brattleboro VT 05301 Andre Bissonette CFO 8022570341 2021-08-11 1 Joseph R Byrne P01289281 2077752387 2021-08-11 2019 2022-09-23 18:48:47Z Steven Gordon 17 Belmont Street Brattleboro VT 05301 15522690 0 X N/A X 1983 VT To provide health management services 11 7 7 11 0 0 291516 231193 1315212 1647325 2186258 1534538 -1813 5587 3791173 3418643 68088 7043527 0 0 920815 1181753 0 0 175700 1179487 860149 2168390 9085429 1622783 -5666786 23537632 17947815 649224 660641 22888408 17287174 X The Corporation is organized for charitable, benevolent, scientific and educational purposes, in particular to support and encourage the development of comprehensive, integrated health care related services for the advancement of the health and well-being of the community, through providing financial, management and other assistance to its affiliates and other organizations and through all other relevant means. 0 0 7789620 7043527 1647325 The Organization's purpose is to assist in developing comprehensive, integrated healthcare-related services by providing financial and management assistance to its affiliates. 7789620 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 6 0 1 7 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Andre Bissonette 8022570341 17 Belmont Avenue Brattleboro VT 05301 Stephen Phillips Board Chair 1.00 4.00 X X 0 0 0 William Daley Board Vice Chair 1.00 1.00 X X 0 0 0 Michael Mandracchia Board Secretary 1.00 1.00 X X 0 0 0 Patty O'Donnell Board Member 1.00 1.00 X 0 0 0 Rhonda Calhoun Board Member 1.00 1.00 X 0 0 0 George Idelkope MD Board Member 1.00 1.00 X 0 44706 0 Donna McElligott Board Member 1.00 1.00 X 0 0 0 Elizabeth McLarney MD Board Member 1.00 40.00 X 0 727954 63665 John VP Meyer Board Member 1.00 1.00 X 0 0 0 Tony Blofsam MD Board Member 1.00 40.00 X 0 227332 37139 Sarah Swank Board member 1.00 1.00 X 0 0 0 Steven Gordon President & CEO 2.00 40.00 X 346451 0 59272 Andre Bissonette CFO 2.00 40.00 X 0 0 0 John Marzinzik Past Interim CFO 2.00 40.00 X 242529 0 0 Kathleen McGraw Chief Medical Officer 1.00 40.00 X 0 349171 45675 Jodi Stack VP Patient Care Services 1.00 40.00 X 0 190218 20925 Michael Rogers VP Financial Planning & Treasurer 2.00 40.00 X 202980 0 40727 791960 1539381 267403 3 0 1 1 Helms & Company Inc One Pillsbury Street Suite 200 Concord NH 033013570 Consulting 242529 1 231193 1973 231193 Management Fees 900099 1319999 1319999 Other Operating Income 900099 327326 327326 1647325 267691 267691 13370731 12103884 1266847 1266847 1266847 5750 163 5587 5587 3418643 1647325 0 1540125 7043527 7043527 648252 648252 358356 99908 185554 72894 123964 54507 69457 51181 5398 41845 3938 270 270 15950 15950 66650 66650 100153 225 94090 5838 33045 32925 120 243335 234635 8700 1064 670 394 340385 340385 6622 6622 Other Miscellaneous 41300 21558 6482 13260 Supplies 8318 1920 5839 559 Minor Equipment & Instr 2517 2517 Dues & Subscriptions 540 540 9085429 7789620 1120109 175700 X 1142665 1258016 5502049 366753 20547 4787 0 13356 730 752 5655584 3760139 2191319 1895445 13688305 13342773 992017 1065933 23537632 17947815 221542 226238 427682 434403 649224 660641 X 21600024 15854300 1288384 1432874 22888408 17287174 23537632 17947815 X -5666786 51237 14315 X 0 1 X 1 0 X 346509 739788 237651 291516 231193 1846657 346509 739788 237651 291516 231193 1846657 659823 1186834 222058 314767 316209 351593 267691 1472318 5587 5587 3324562 8315534 0.35700 0.35230 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 38600 38600 5591286 3760139 1831147 25698 25698 1895445 Cash Surrender Value of Life Insurance 525841 Deferred Compensation 434403 Due from Affiliates 105689 1065933 Deferred Compensation 434403 434403 -3628232 51237 15315 66552 -3694784 66650 7046777 7113427 3418643 1973002 0 1973002 66650 7045777 7112427 9085429 Part XI, Line 2d - Other Adjustments: Gain on NPV Adjustment of Insurance Policy 15,315. Part XI, Line 4b - Other Adjustments: Transfers to Affiliate 7,043,527. Provision for Uncollectible Pledges and Change in Discounted Present Value 1,000. Uncollectible Pledge Expense 2,250. Part XII, Line 4b - Other Adjustments: Transfers to Affiliate 7,043,527. Uncollectible Pledge Expense 2,250. 1 Brattleboro Memorial Hospital 17 Belmont Avenue Brattleboro VT 05301 030107300 501(c)(3) 7043527 Capital Acquisitions 1 0 Part I, Line 2: Grantee is subsidiary of Organization; therefore additional monitoring is not deemed necessary. X X X X X 0 0 0 0 0 1 1 0 0 Elizabeth McLarney MD Board Member 0 561493 0 164949 0 1512 0 33700 0 29965 0 791619 0 0 Tony Blofsam MD Board Member 0 224268 0 1000 0 2064 0 12188 0 24951 0 264471 0 0 Steven Gordon President & CEO 328200 0 16667 0 1584 0 31367 0 27905 0 405723 0 0 0 John Marzinzik Past Interim CFO 242529 0 0 0 0 0 0 0 0 0 242529 0 0 0 Kathleen McGraw Chief Medical Officer 0 314051 0 15000 0 20120 0 14700 0 30975 0 394846 0 0 Jodi Stack VP Patient Care Services 0 174858 0 15000 0 360 0 10095 0 10830 0 211143 0 0 Michael Rogers VP Financial Planning & Treasurer 200916 0 0 0 2064 0 15006 0 25721 0 243707 0 0 0 Part I, Line 6 Senior Leadership bonuses are partially based on financial operating results. Form 990, Part VII, Line 5: Southern Vermont Health Services paid Helms & Company, an unrelated third party, for services provided to both Southern Vermont Health Services and Brattleboro Memorial Hospital, a related party, by John Marzinzik, Past Interim CFO. Southern Vermont Health Services paid $242,529 for these services. Form 990, Part VI, Section A, line 6 The membership of the corporation shall consist of not more than one hundred and twenty-five (125) members. Form 990, Part VI, Section A, line 7a The Board of Directors shall consist of eleven (11) persons who are members, Honorary members or Emeritus members of the Corporation, plus the President ex officio but without power to vote. At least one member of the Board shall be a physician. The incorporator(s) shall divide the inital Directors into three groups. The number of Directors whose terms are expiring at each Annual Meeting shall be elected by the member of the Corporation at each Annual Meeting, following nomination by the Executive Committee. Directors shall hold office for three (3) years and until their successors have been elected and qualified or until their death or resignation. Directors may serve for a maximum of three (3) consecutive three-year terms. Form 990, Part VI, Section B, line 11b The role of SVHSC's Finance and Audit Committee has expanded to include review of the 990. The Finance and Audit Committee engages the auditors and receives the audit and a complete copy of the form 990, including all schedules. The Finance and Audit Committee will report to the Board that the 990 review has occurred. The Board accepts The Finance and Audit Committee reports and the 990. All members of the Board will have access to the 990 prior to filing. Form 990, Part VI, Section B, line 12c Each December, Board members are required to complete a Conflict of Interest Statement. Beginning FY 2010, these statements will be reviewed by outside counsel and reported back to the Board of Directors along with recommendations for action. Form 990, Part VI, Section B, line 15 The Executive Compensation Committee (ECC) of the Board of Directors (BOD) engages an outside compensation consultant to review executive compensation policies, procedures and conduct an independent regional and national market survey for senior leadership positions. The ECC sets the CEO's compensation and reviews the CEO's recommendations for other senior leadership compensation. The actions of the ECC are reviewed and approved by the BOD. Form 990, Part VI, Section C, line 19 Financial statements are published on our website. Our governing documents and conflict of interest policies are not made available to the public. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Southern Vermont Health Services Corporation 17 Belmont Avenue Brattleboro, VT 05301 EIN 22-2564588 Southern Vermont Health Services Corporation is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Gain on NPV Adjustment of Insurance Policy 15,315. Provision for Uncollectible Pledges and Change in Discounted Present Value -1,000. Brattleboro Memorial Hospital 17 Belmont Avenue Brattleboro VT 05301 030107300 Non-profit hospital VT 501(c)(3) Line 3 Southern Vermont Health Services Corp 1 0 1 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 Brattleboro Memorial Hospital B 7043527 Cash Brattleboro Memorial Hospital E 1004882 Cash Brattleboro Memorial Hospital L 1319999 Cash Brattleboro Memorial Hospital K 80499 Cash