2020-08-14T11:43:08-05:00 2019-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2018-10-01 222564588 Southern Vermont Health Service Corp SOUT 8022570341 17 Belmont Street Brattleboro VT 05301 Michael Rogers VP Fin. Planning & Treasurer 8022570341 2020-08-14 1 Joseph R Byrne P01289281 2077752387 2020-08-14 69.49.157.66 2020-08-14 11:04:06 ED P 8B04EC08AF02322EA9ED1307B74D8AF8BDCA5114 4E4854D6E8F439AFFC6B342DA192CB10EF694E45 2018 2020-09-23 17:36:50Z Steven Gordon 17 Belmont Street Brattleboro VT 05301 9408875 0 X N/A X 1983 VT To provide health management services 9 6 7 108 0 0 237651 291516 1435391 1315212 1056658 2186258 -5766 -1813 2723934 3791173 224127 68088 0 0 976431 920815 0 0 205779 785848 1179487 1986406 2168390 737528 1622783 23552688 23537632 692383 649224 22860305 22888408 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 732173 68088 1315212 The Organization's purpose is to assist in developing comprehensive, integrated healthcare-related services by providing financial and management assistance to its affiliates. 732173 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 12 0 1 7 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Michael Rogers 8022570341 17 Belmont Avenue Brattleboro VT 05301 Stephen Phillips Board Chair 1.00 1.00 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 George Idelkope MD Board Member 1.00 1.00 X 0 59724 0 Donna McElligott Board Member 1.00 1.00 X 0 0 0 Rhonda Calhoun Board Member 1.00 1.00 X 0 0 0 John VP Meyer Board Member 1.00 1.00 X 0 0 0 Elizabeth McLarney MD Board Member 1.00 40.00 X 0 839901 61665 Peter Carvell Past Board Member 1.00 1.00 X 0 0 0 Steven Gordon President & CEO 2.00 40.00 X 346756 0 57730 Michael Rogers VP Financial Planning & Treasurer 2.00 40.00 X 214078 0 42060 John Marzinzik Interim CFO 2.00 40.00 X 0 0 0 Kathleen McGraw Chief Medical Officer 1.00 40.00 X 0 315264 44214 Jodi Stack VP Patient Care Services 1.00 40.00 X 0 155907 18815 Mary Urquhart Former VP Patient Care Services 0.00 0.00 X 146371 0 8367 707205 1370796 232851 3 1 1 0 GPI Construction Inc 436 Canal Street Suite 101 Brattleboro VT 05301 General Contractor 185660 1 23600 267916 2383 291516 Management Fees 900099 1023000 1023000 Other Operating Income 900099 292212 292212 1315212 351593 351593 7436821 5602156 1834665 1834665 1834665 13733 23600 15546 -1813 -1813 3791173 1315212 0 2184445 X 68088 68088 660624 660624 160407 160407 59471 50946 8525 40313 36875 3438 10590 10590 19700 19700 81150 81150 367544 3775 358531 5238 60425 59127 1298 243230 234830 8400 2159 867 1292 339331 339331 7485 7485 Other Miscellaneous 32967 17367 207 15393 Supplies 13819 1920 10948 951 Dues & Subscriptions 597 597 Minor Equipment & Instr 490 250 240 2168390 732173 1230438 205779 X 1553608 1142665 965984 5502049 11896 20547 702 730 5611076 3419757 2480749 2191319 17716754 13688305 822995 992017 23552688 23537632 268643 221542 423740 427682 692383 649224 X 21602041 21600024 979222 1009342 279042 279042 22860305 22888408 23552688 23537632 X 1622783 -1599550 4870 X 0 1 X 1 0 X 639461 346509 739788 237651 291516 2254925 639461 346509 739788 237651 291516 2254925 926941 1327984 310026 222058 314767 316209 351593 1514653 3769578 8666255 0.35230 0.45110 X 0.89600 0.10400 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 38600 38600 5572476 3419757 2152719 2191319 Deferred Compensation 427682 427682 2047255 -1599550 4870 -1594680 3641935 81150 68088 149238 3791173 2019152 0 2019152 81150 68088 149238 2168390 Part XI, Line 2d - Other Adjustments: Gain on NPV Adjustment of Insurance Policy 14,870. Provision for Uncollectible Pledges and Change in Discounted Present Value -10,000. Part XI, Line 4b - Other Adjustments: Transfers to Affiliate 68,088. Part XII, Line 4b - Other Adjustments: Transfers to Affiliate 68,088. Brattlewood 14933 14160 773 3585 7297 Touch a Truck 22400 9440 12960 1536 3128 37333 23600 13733 5121 10425 15546 -1813 1 Brattleboro Memorial Hospital 17 Belmont Avenue Brattleboro VT 05301 030107300 501(c)(3) 68088 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 1 0 0 0 0 1 1 0 0 Elizabeth McLarney MD Board Member 0 617035 0 221594 0 1272 0 32925 0 28740 0 901566 0 0 Steven Gordon President & CEO 328505 0 16667 0 1584 0 31092 0 26638 0 404486 0 0 0 Michael Rogers VP Financial Planning & Treasurer 199978 0 0 0 14100 0 15882 0 26178 0 256138 0 0 0 Kathleen McGraw Chief Medical Officer 0 296206 0 0 0 19058 0 14425 0 29789 0 359478 0 0 Jodi Stack VP Patient Care Services 0 155571 0 0 0 336 0 8291 0 10524 0 174722 0 0 Mary Urquhart Former VP Patient Care Services 20690 0 0 0 125681 0 2647 0 5720 0 154738 0 0 0 Part I, Line 4a Mary Urquhart, Former VP Patient Care Services, received $94,557 in severance. Part I, Line 6 Senior Leadership bonuses are partially based on financial operating results. 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 IX, line 11g Contract Services & Consultants: Program service expenses 0. Management and general expenses 358,531. Fundraising expenses 4,989. Total expenses 363,520. Service Contracts: Program service expenses 3,775. Management and general expenses 0. Fundraising expenses 249. Total expenses 4,024. 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 14,870. Provision for Uncollectible Pledges and Change in Discounted Present Value -10,000. 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 68088 Cash Brattleboro Memorial Hospital E 940923 Cash Brattleboro Memorial Hospital L 1023000 Cash Brattleboro Memorial Hospital K 243013 Cash