2019-08-15T08:34:55-05:00 2018-09-30 PricewaterhouseCoopers LLP 101 SEAPORT BLVD SUITE 500 BOSTON MA 02210 990 2017-10-01 222547186 CENTRAL VERMONT MEDICAL CENTER INC % STEPHEN KENNEY CFO CENT 8023714100 130 FISHER ROAD BERLIN VT 05602 STEPHEN KENNEY CFO 8023744443 2019-08-14 true PAUL TANIS 08142019 P01441612 6175305000 167.68.125.77 04363820192275000013 2019-08-15 P 5477481CA79227C5174834DE40144B170BD12694 1563161100844465C8187993E1FFC143BF1C91FB 2017 2019-02-21 02:37:17Z Ms Anna T Noonan 130 Fisher Road Berlin VT 05602 224914802 false X WWW.CVMC.ORG X 1963 VT WE WORK COLLABORATIVELY TO MEET THE NEEDS AND IMPROVE THE HEALTH AND IMPROVE THE HEALTH OF THE RESIDENTS OF CENTRAL VERMONT. 17 12 2043 173 0 157477 714818 648136 202889273 210796054 1273328 11617315 223710 308676 205101129 223370181 636491 559268 0 0 139595585 138210840 0 0 17642 65207132 80491266 205439208 219261374 -338079 4108807 180162668 172815634 89939402 80766274 90223266 92049360 X SEE SCHEDULE O false false 143930544 559268 158427700 HOSPITAL SERVICES: INPATIENT, OUTPATIENT, AND 24/7 EMERGENCY DEPARTMENT SERVICES: CVMC HAS 122 LICENSED BEDS TO PROVIDE FOR A FULL SPECTRUM OF INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. 18,748 INPATIENT DAYS, MORE THAN 245,000 OUTPATIENT PROCEDURES, AND 24,753 EMERGENCY ROOM VISITS WERE RECORDED DURING FISCAL YEAR 2018. OUTPATIENT ANCILLARY SERVICE UNITS MAKE UP THE MAJORITY OF SERVICE VOLUME, INCLUDING 40,014 RADIOLOGY PROCEDURES, 470,924 LAB TESTS, 15,686 CARDIOLOGY TESTS, AND 142,273 UNITS OF PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. EMERGENCY DEPARTMENT: THE ER IS OPEN 24 HOURS A DAY 365 DAYS A YEAR. THE NUMBER OF PATIENTS SEEN IN THE ER IN FISCAL YEAR 18 WAS 24,753. THE CANCER TREATMENT CENTER PROVIDED 5,056 ONCOLOGY AND RADIATION TREATMENTS. THE HOSPITAL ALSO HAS BEEN ACTIVE IN ITS OUTREACH TO CENTRAL VERMONT'S UNINSURED AND UNDER INSURED RESIDENTS. 46334921 37099565 MEDICAL GROUP PRACTICES: AT THE END OF THE FISCAL YEAR WE HAD 25 PRIMARY CARE, INFIRMARY, AND SPECIALTY PRACTICES. THIS INCLUDED 7 PRIMARY AND FAMILY CARE CLINICS, 1 PEDIATRIC CLINICS, AS WELL AS SPECIALTY CLINICS FOR UROLOGY, PODIATRY, RHEUMATOLOGY, ENDOCRINOLOGY, ORTHOPAEDICS, PSYCHOLOGY, AND OBSTETRICS/ GYNECOLOGY. THERE WERE A TOTAL OF 226,624 PRACTICE VISITS DURING FISCAL YEAR 2018. 17069933 15268791 Woodridge Rehab & Nursing is a Medicare-certified 153-bed Skilled Nursing Facility located on the campus of Central Vermont Medical Center. Approximately two-thirds of the facilities beds are dedicated to long term care, including palliative care/end of life care and the other one-third provide short term rehabilitation therapy and post-acute care for a great variety of medical care categories, including pain management and wound care. The facility provides "person-centered", round the clock nursing care and social services support complementing daily, robust activities programs, fine dining and has a full compliment of support services including housekeeping/laundry, maintenance and transportation. Many other amenities are available to facility residents. 207335398 true true false true false false false false false true true true false false true true false true false false false false false false false false true true true false true false false false false false true false false false false false false false true true true false false true 90 0 true 2043 true true true false false false false true true false false false false X 17 12 true false false false true true true true true false false false true true true false false true true false VT X STEPHEN KENNEY CFO 8023714443 130 FISHER RD Berlin VT 05602 X CHRISTOPHER BARBIERI TRUSTEE, Until 3/12/18 1.0 0.0 X 0 0 0 JOHN BRUMSTED MD TRUSTEE 6.0 44.0 X 0 1813087 213890 JEREMIAH ECKHAUS MD TRUSTEE, PRES-ELECT MED STAFF 50.0 0.0 X 236058 0 40884 MICHAEL DELLIPRISCOLI TRUSTEE, IMMEDIATE PAST CHAIR 1.0 2.0 X 0 0 0 MARK DEPMAN MD TRUSTEE, REGNAL PHYS LEADER 44.0 6.0 X 367662 0 40506 SARAH FIELD TRUSTEE 1.0 0.0 X 0 0 0 THOMAS GOLONKA TRUSTEE, CHAIR-ELECT 1.0 2.0 X 0 0 0 JOYCE JUDY TRUSTEE 1.0 0.0 X 0 0 0 MARY MOULTON TRUSTEE 1.0 0.0 X 0 0 0 MARTA MURPHY MARBLE TRUSTEE, CHAIR 1.0 2.0 X 0 0 0 ANNA T NOONAN TRUSTEE, PRESIDENT/COO 35.0 15.0 X X 282587 191724 73067 CATHY PALMER MD TRUSTEE 3.0 42.0 X 30000 228946 40644 TONI KAEDING TRUSTEE, AS OF 04/2018 1.0 0.0 X 0 0 0 SANDY ROUSSE TRUSTEE 1.0 0.0 X 0 0 0 CONNIE COLMAN TRUSTEE, AS OF 04/2018 1.0 0.0 X 0 0 0 PAULETTE THABAULT TRUSTEE 1.0 0.0 X 0 0 0 MARILYN WHITE TRUSTEE 1.0 0.0 X 0 0 0 CORY RICHARDSON TRUSTEE, AS OF 04/2018 1.0 0.0 X 0 0 0 CHEYENNE HOLLAND TREASURER, CFO, UNTIL 07/2018 50.0 0.0 X 268444 0 63717 TODD KEATING INTERIM TREASURER,CFO 7/2018 10.0 40.0 X 0 925390 28597 PHILIP BROWN DO CHIEF MEDICAL OFF,UNTIL 3/2018 50.0 0.0 X 315055 0 34532 RICHARD MORLEY VP SUPPORT SRVCS, UNITL 2/2018 50.0 0.0 X 242817 0 22767 MATTHEW CHOATE CHIEF NURSING OFFICER 50.0 0.0 X 173181 0 30047 ROBERT PATTERSON VP OF HR & CLINICAL OPERATIONS 50.0 0.0 X 224286 0 40879 DAVID TURNER VP PHYSICIAN SERVICES 50.0 0.0 X 188770 0 13427 JUDITH TARR TARTAGLIA TRUSTEE, PRES/CEO UNTIL 3/2017 45.0 5.0 X 367062 0 14701 CHRISTIAN BEAN MD PHYSICIAN 50.0 0.0 X 578075 0 63332 JOHN BRAUN MD PHYSICIAN 50.0 0.0 X 506542 0 23812 CHRISTOPHER MERIAM MD PHYSICIAN 50.0 0.0 X 586215 0 67459 SARA GRAVES MD PHYSICIAN 50.0 0.0 X 481168 0 47529 NANCY LOTHIAN CHIEF OPERATING OFFICER 0.0 0.0 X 310007 0 30757 5157929 3159147 890547 181 true true false E F WALL ASSOCIATES INC 131 SOUTH MAIN ST PO BOX 259 BARRE VT 05641 CONSTRUCTION CNTRCTR 640260 MARCAM ASSOCIATES LLC PO BOX 60 ROCHESTER NH 03866 AR BILLING/COLLECT 698223 KLEEN LD DBA KLEEN LAUNDRY 1 FOUNDRY STREET LEBANON NH 03766 LAUNDRY SERVICES 481525 VISTA STAFFING SOLUTIONS INC 275 EAST 200 SOUTH SALT LAKE CITY UT 84111 PHYSICIAN STAFFING 477976 MEDICAL SOLUTIONS 1010 NORTH 102ND STREET OMAHA NE 68114 NURSE STAFFING 554995 21 30948 422006 195182 648136 NET PATIENT SERVICE REVENUE 900099 168947777 168947777 REV FROM MANAGED CARE AND CAPITATED 900099 31293809 31293809 340B CONTRACT PHARMACY REVENUE 900099 6416021 6416021 CONTRACT SERVICE REVENUE 900099 1245303 1245303 CAFETERIA REVENUE 900099 1063460 1063460 1829684 1829684 210796054 10198561 10198561 0 0 434543 125867 308676 0 308676 308676 1418754 -1418754 1418754 1418754 0 0 0 0 0 0 0 0 0 0 223370181 210796054 11925991 559268 559268 0 0 0 2482600 658603 1823997 260209 260209 107794452 103493966 4286375 14111 5936329 5593443 342128 758 14578531 13736469 840203 1859 7158719 6745228 412577 914 0 146154 146154 70152 70152 0 0 196448 5560 190888 12356032 10998969 1357063 793423 135878 657545 30041803 29793454 248349 2858431 2402142 456289 0 5592942 5467187 125755 126288 96888 29400 0 503724 484482 19242 490157 490157 0 9984496 9984496 660454 469555 190899 BAD DEBT EXPENSE 4232051 4232051 STATE TAX ASSESMENT 11510964 11510964 DUES & FEES 622419 304063 318356 SUNDRY EXPENSE 114197 70239 43958 191131 102336 88795 219261374 207335398 11908334 17642 0 0 25366122 8891033 0 0 25238575 20572298 0 0 0 0 1852885 3376944 4172245 4199147 1834543 1433975 175070341 106487678 71396584 68582663 47606209 0 0 62488384 0 0 0 0 2695505 3271190 180162668 172815634 37941501 42049256 0 0 0 0 682081 0 0 0 0 0 18899157 16308604 0 0 32416663 22408414 89939402 80766274 X 80671395 82560540 6290378 6215144 3261493 3273676 90223266 92049360 180162668 172815634 X 4108807 -8741939 6459226 X X false true X true true true X false false false false false false false false true 27210 27210 false LOBBYING ACTIVITY SCHEDULE C, PART II-B, LINE 1I CENTRAL VERMONT MEDICAL CENTER IS A MEMBER OF, AND PAYS DUES TO, THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SERVICE PROVIDERS AS WELL AS THE AMERICAN HOSPITAL ASSOCIATION, AND THE VERMONT HEALTH CARE ASSOCIATION. A PORTION OF THE DUES IS USED FOR LOBBYING PURPOSES. 7997540 193692 8191232 7988798 358742 350000 7997540 7726226 306265 43693 7988798 8130234 -366990 37018 7726226 7489540 676127 35433 8130234 0.38000 0.62000 true true true 5510000 5510000 55954845 33842014 22112831 31135417 14781143 16354274 75547496 54065566 21481930 6922583 3798955 3123628 68582663 NETWORK INVESTMENT POOL 62488384 F 62488384 0 ACCRUED PENSION LIABILITY 19662083 OTHER LIABILITIES 2746331 22408414 X ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 CVMC HAS ENDOWMENT INVESTMENTS AND SPENDING POLICIES THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING FOR CAPITAL AND OPERATIONAL PROGRAMS PERTAINING TO THE DELIVERY OF HOSPITAL AND SKILLED NURSING CARE SERVICES AS WELL AS INTERNAL MEDICINE, FAMILY AND SPECIALTY PHYSICIAN SERVICES IN ORDER TO MEET THE HEALTH CARE NEEDS OF THE CENTRAL VERMONT COMMUNITY. ASC 740 DISCLOSURE SCHEDULE D, PART X, LINE 2, FIN 48 (ASC 740) CENTRAL VERMONT MEDICAL CENTER, INC. IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVM HEALTH NETWORK"). THE FOOTNOTE STATES: UVM HEALTH NETWORK ACCOUNTS FOR RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) 740 INCOME TAXES, WHICH ADDRESSES HOW TO ACCOUNT FOR AND REPORT THE EFFECTS OF TAXES BASED ON INCOME. NO PROVISION FOR UNCERTAIN TAX POSITIONS IS RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. true true true X true X true true true false true true 2412830 2412830 0.01120 49130722 24752125 24378597 0.11340 51543552 24752125 26791427 0.12460 63911 63911 0.00030 388199 388199 0.00180 49688042 44197607 5490435 0.02550 558918 558918 0.00260 50699070 44197607 6501463 0.03020 102242622 68949732 33292890 0.15480 true 4232051 84641 50559218 97607836 -47048618 X true true 1 1 CENTRAL VERMONT MEDICAL CENTER 130 FISHER ROAD BERLIN VT 05602 WWW.CVMC.ORG 470001 X X X CENTRAL VERMONT MEDICAL CENTER 1 false false true X X X X X X X X X 15 true false false true X HTTP://WWW.CVMC.ORG/ABOUT-CVMC/COMMUNITY X HTTP://WWW.GMCBOARD.VERMONT.GOV X true 15 true SEE SECTION C false true X 200. 400. X X X X X true true X X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X X true X false X X X X true X false false PART V, LINE 5 CVMC INVITED A WIDE VARIETY OF PUBLIC HEALTH PROFESSIONALS, COMMUNITY LEADERS, HUMAN SERVICE PROVIDERS, AND CVMC STAFF MEMBERS TO SERVE AS A STEERING COMMITTEE THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. MEETINGS WERE HELD THROUGHOUT 2016 FOR THE COMMITTEE MEMBERS TO DELIBERATE OVER ALL COMMUNITY HEALTH CONCERNS AND REVIEW PERTINENT DATA AND INFORMATION. INPUT WAS PROVIDED BY: A. WASHINGTON COUNTY MENTAL HEALTH SERVICES B. CENTRAL VERMONT HOME HEALTH & HOSPICE C. PEOPLES HEALTH AND WELLNESS CLINIC D. U32 HIGH SCHOOL E. CENTRAL VERMONT COUNCIL ON AGING F. GREEN MOUNTAIN UNITED WAY G. VERMONT DEPARTMENT OF HEALTH H. CENTRAL VERMONT MEDICAL CENTER - LEADERSHIP, MEDICAL STAFF & COMMUNITY HEALTH TEAM I. FAMILY CENTER OF WASHINGTON COUNTY J. CENTRAL VERMONT NEW DIRECTIONS COALITION K. CENTRAL VERMONT REGIONAL PLANNING COMMISSION CENTER PART V, LINE 10A COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY WEBSITE: https://gmcboard.vermont.gov/sites/gmcb/files/files/hospital-budget/2016%2 0CVMC%20CHNA.pdf PART V, LINE 11 AT CENTRAL VERMONT MEDICAL CENTER (CVMC), WE COLLABORATE WITH OTHER NON-PROFITS, BUSINESSES, COMMUNITY LEADERS, AND GOVERNMENTAL AGENCIES TO PROVIDE A VARIETY OF PROGRAMS AND EDUCATIONAL OFFERINGS INTENDED TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. DRUG ABUSE CVMC CONTINUES TO WORK WITH COMMUNITY PARTNERS INCLUDING THE VERMONT DEPARTMENT OF HEALTH ALCOHOL AND DRUG ABUSE PROGRAM, WASHINGTON COUNTY MENTAL HEALTH SERVICES, CENTRAL VERMONT SUBSTANCE ABUSE SERVICES, TREATMENT ASSOCIATES AND CENTRAL VERMONT ADDICTION MEDICINE TO INCREASE ACCESS TO CARE AND SUPPORT TRANSITIONS OF CARE AS INDIVIDUALS MOVE THROUGH THE TREATMENT CYCLE. IT IS IMPORTANT THAT COMMUNITY MEMBERS HAVE KNOWLEDGE OF THE RESOURCES THAT ARE CURRENTLY AVAILABLE TO THEM. CVMC SPONSORS THE WASHINGTON COUNTY SUBSTANCE ABUSE REGIONAL PARTNERSHIP (WCSARP), WHICH MEETS MONTHLY TO COORDINATE SERVICES, SOLVE ACCESS AND CARE MANAGEMENT PROBLEMS, AND ERASE BOUNDARIES OF CARE. THE GROUP INCLUDES, AMONG OTHERS, THE AGENCY FOR HUMAN SERVICES BARRE HSA, VERMONT DEPARTMENT OF HEALTH, LOCAL HUB-AND-SPOKE PARTNERS, THE DESIGNATED AGENCIES FOR MENTAL HEALTH AND SUBSTANCE ABUSE (WASHINGTON COUNTY MENTAL HEALTH SERVICES, CENTRAL VERMONT SUBSTANCE ABUSE SERVICES), PREVENTION PARTNERS, THE TURNING POINT RECOVERY CENTER, THE YOUTH SERVICES BUREAU, RESIDENTIAL CARE PROVIDERS, AND LOCAL LAW ENFORCEMENT. THREE IMPORTANT PROGRAMS EMERGED OUT OF GAPS IDENTIFIED BY WCSARP: CVMC'S EMERGENCY DEPARTMENT INITIATED AN ALCOHOL WITHDRAWAL PROTOCOL IN COLLABORATION WITH WASHINGTON COUNTY MENTAL HEALTH SERVICES AND THE TURNING POINT RECOVERY CENTER TO PROVIDE 24/7 COMMUNITY-LOCATED SUPERVISED MEDICALLY ASSISTED WITHDRAWAL (MAW); . THE EMERGENCY DEPARTMENT HAS ALSO INITIATED THE STATE'S FIRST RAPID ACCESS TO MEDICATION ASSISTED TREATMENT (RAM) TO PROVIDE IMMEDIATE 24/7 INDUCTION WITH BUPRENORPHINE LINKED TO RAPID HUB-AND-SPOKE ACCESS; . THE TURNING POINT CENTER IS CURRENTLY MANAGING A VERMONT OPIOID STATE RESPONSE PROJECT TO BRING PEER RECOVERY SUPPORTS INTO THE EMERGENCY DEPARTMENT AND HOSPITAL INPATIENT UNITS TO ASSURE STABLE TRANSITIONS TO THE COMMUNITY. MENTAL HEALTH CVMC, IN PARTNERSHIP WITH WASHINGTON COUNTY MENTAL HEALTH SERVICES, HAS CREATED A MODEL OF EMBEDDING BEHAVIORAL HEALTH PRACTITIONERS WITHIN CVMC PRIMARY CARE PRACTICES. IN ADDITION, WE ARE PILOTING AN INTEGRATED HEALTH HOME THAT PROMOTES A MODEL OF HEALTH CARE THAT INTEGRATES THE SOCIAL DETERMINANTS OF HEALTH WITH SPECIALIZED TREATMENT FOR INDIVIDUALS WITH COMPLEX PHYSICAL HEALTH, MENTAL HEALTH, DEVELOPMENTAL AND SUBSTANCE ABUSE CHALLENGES. CVMC IN COLLABORATION WITH THE FAMILY CENTER OF WASHINGTON COUNTY AND WASHINGTON COUNTY MENTAL HEALTH SERVICES INITIATED THE ADVERSE CHILDHOOD EXPERIENCES (ACES) PROJECT. THE GOAL USE OF FAMILY SUPPORT SPECIALISTS EMBEDDED IN CVMC'S PEDIATRIC PRACTICE, TARGETING AGE GROUPS 0-36 MONTHS TO PROMOTE CHILD AND FAMILY PROTECTIVE FACTORS, PREVENT AND MITIGATE TOXIC STRESS, AND PROMOTE HEALTHY CHILD DEVELOPMENT FOR A PERIOD OF ONE YEAR. TOBACCO USE CVMC OFFERS A TOBACCO CESSATION PROGRAM ON AND OFF SITE THROUGHOUT THE YEAR. CURRENTLY, WE ARE ABLE TO ASSIST PARTICIPANTS WITH SUPPORT AND FREE NICOTINE REPLACEMENT THERAPY SUCH AS GUM, PATCHES AND LOZENGES. IN ADDITION, SBIRT CLINICIANS, ALSO TRAINED AS TOBACCO TREATMENT SPECIALISTS, PROVIDE INDIVIDUAL TOBACCO CESSATION COUNSELING TO PROMOTE SUCCESSFUL QUITTING. THROUGH THE CVMC SELF-MANAGEMENT PROGRAM, WE CONTINUE TO ATTEND LOCAL EMPLOYERS' WELLNESS FAIRS, INCLUDING: STATE EMPLOYEE WELLNESS, WASHINGTON COUNTY MENTAL HEALTH SERVICES AND COMMUNITY BASED OUTREACH (BARRE HERITAGE FESTIVAL, MONTPELIER ALIVE). OUR OUTREACH WORK SERVES AS A TOOL FOR EDUCATING AND NETWORKING WITH COMMUNITY MEMBERS. WE ARE CONTINUING TO WORK WITH OUR LOCAL PARTNERS, CONNECT WITH LOCAL COLLABORATIVES AND WORKGROUPS TO EXPAND OUR REACH AND SERVICE TO DIFFERENT POPULATIONS. HEALTHY DIETS CVMC RECOGNIZES THE IMPORTANCE OF INSPIRING HEALTHY LIFESTYLE CHANGES AND PROVIDING RESOURCES TO THE COMMUNITY TO ASSIST PEOPLE TRYING TO STAY HEALTHY THROUGH COMMUNITY HEALTH FAIRS. HEALTH FAIRS ARE A WAY TO MAKE IMPORTANT SCREENINGS (BLOOD PRESSURE CHECKS, BODY COMPOSITION) ASSESSABLE TO THE GENERAL POPULATION FOR LITTLE OR NO COST. CVMC CHOSE THREE UNIQUE POPULATIONS TO PROMOTE HEALTH (MONTPELIER, NORTHFIELD, AND BARRE) AND BY TAILORING CONTENT FOR EACH ONE LED TO HIGH VOLUME COMMUNITY PARTICIPATION RATES STAFFED BY REGISTERED DIETITIANS, NURSES, AND CERTIFIED HEALTH WELLNESS COACHES. CONSISTENTLY PROVIDED WAS PROACTIVE INFORMATION SUCH AS NUTRITIONAL DISPLAYS, RECIPES, SMOOTHIE BIKE, HEALTHY LIVING WORKSHOPS, WORKSITE WELLNESS IDEA, AND WALKING EXERCISE PROGRAMS. BEING PRESENT AND OFFERING ENGAGING ACTIVITIES PROVIDED THE COMMUNITY THE VENUE TO ASK HEALTH-RELATED QUESTIONS, IDEAS FOR NEEDED RESOURCES, AND MAKE CONNECTIONS FOR MEMBERS THAT MAY NOT ASK OTHERWISE. YOUTH PARTICIPATION IN PHYSICAL ACTIVITIES CVMC'S POPULATION HEALTH MANAGEMENT GOALS REVOLVE AROUND THE IDENTIFICATION OF RISK FACTORS THAT, IF ADDRESSED EARLY, CAN REDUCE THE PREVALENCE OF CHRONIC MEDICAL CONDITIONS LATER IN LIFE. PANEL MANAGEMENT EFFORTS CONTINUE WITHIN OUR CVMC PEDIATRIC PRIMARY CARE PRACTICE TO IDENTIFY CHILDREN THAT ARE OVERDUE FOR WELL-CHILD VISITS AND PROVIDE OUTREACH TO ENCOURAGE THEM TO ATTEND. BODY MASS INDEX IS CALCULATED AT EACH WELL-CHILD VISIT AND EDUCATION IS PROVIDED AROUND THE IMPORTANCE OF PHYSICAL ACTIVITY FOR OUR PEDIATRIC PATIENTS. IN ADDITION, THE CVMC SCHOOL-BASED HEALTH PROGRAM, AN EXTENSION OF OUR PEDIATRIC PRIMARY CARE PRACTICE AND OPERATES TWO DAYS EACH WEEK AT THE BARRE CITY ELEMENTARY AND MIDDLE SCHOOL, OFFERS THE BENEFIT OF BEING EMBEDDED IN THE SCHOOL SETTING. THIS PROVIDES GREATER OPPORTUNITIES FOR OUR PEDIATRIC CLINICIANS TO DISCUSS AND PROMOTE THE IMPORTANCE OF PHYSICAL ACTIVITY AND HOW IT IMPACTS OVERALL HEALTH AND WELL-BEING WITH OUR PEDIATRIC PATIENTS. NEEDS NOT BEING ADDRESSED OUR COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED ADDITIONAL DETERMINANTS OF HEALTH THAT FALL OUTSIDE THE REALM OF OUR CAPABILITIES AT CVMC. A PROMINENT NEED THAT WE ARE NOT DIRECTLY ADDRESSING IS ORAL HEALTH. SEVERAL OF OUR PHYSICIANS HAVE UNDERGONE FLUORIDE TREATMENT TRAINING, AND ARE ABLE TO PROVIDE THIS SERVICE FOR CHILDREN UP TO FOUR YEARS OF AGE WHO DO NOT HAVE ACCESS TO DENTAL CARE. HOWEVER, ONE OUT OF FOUR ADULTS IN WASHINGTON COUNTY HAS NOT VISITED A DENTIST IN THE LAST YEAR. AS A MEDICAL HOSPITAL, WE DO NOT HAVE THE FACILITIES OR EXPERTISE TO ADDRESS THIS NEED DIRECTLY. WITH THIS SAID, IT IS IMPORTANT THAT WE RECOGNIZE ALL FACTORS THAT MAY BE AFFECTING THE OVERALL HEALTH OF PATIENTS WALKING THROUGH OUR DOORS AT CVMC. WE INTEND TO CONTINUE COLLABORATION WITH COMMUNITY FACILITIES SUCH AS THE HEALTH CENTER IN PLAINFIELD AND THE PEOPLE'S HEALTH AND WELLNESS CENTER IN BARRE THAT OFFER DENTAL CARE. OTHER AREAS WERE IDENTIFIED WHICH WE HAVE CHOSEN TO ACKNOWLEDGE, BUT NOT ADDRESS DIRECTLY AS PART OF OUR STRATEGIC PLAN. SOME OF THOSE NEEDS WERE: - INCREASE AVAILABLE HOUSING FOR THOSE IN NEED - DECREASE TEENAGE PREGNANCIES - DECREASE UNPLANNED PREGNANCIES - EXPAND SERVICES TARGETING THE ELDERLY IN OUR COMMUNITY - INCREASE THE NUMBER OF WALKING PATHS AND/OR BIKE LANES IN OUR COMMUNITY - INCREASE AVAILABILITY TO MENTAL HEALTH SERVICES MENTAL HEALTH HAS BEEN IDENTIFIED AS THE COSTLIEST MEDICAL CONDITION IN THE COUNTRY AND AN AREA THAT SUFFERS FROM INADEQUATE CAPACITY. - CVMC IS WORKING ALONGSIDE WASHINGTON COUNTY MEDICAL HEALTH SERVICES TO INTEGRATE MENTAL HEALTH PRACTITIONERS INTO EVERY PRIMARY CARE PRACTICE - FAMILY PSYCHIATRY ADOPTED A FORMAL STANDARDIZED DEPRESSION SCREENING FOR PATIENTS AGED 12 AND OLDER - CVMC, IN COLLABORATION WITH WASHINGTON COUNTY MENTAL HEALTH SERVICES, IS OFFERING ADDITIONAL PRE-NATAL AND POSTPARTUM SUPPORT FOR WOMEN WITH A HISTORY OF, OR AT RISK FOR DEPRESSION. PART V, LINE 16A & 16B https://www.cvmc.org/sites/default/files/documents/CVMC-Financial-Assistan ce-Policy.pdf HTTPS://WWW.CVMC.ORG/SITES/DEFAULT/FILES/DOCUMENTS/FINANCIAL-ASSISTANCE-AP PLICATION-JANUARY-2018.PDF PART V, LINE 16C - FAP PLAIN LANGUAGE SUMMARY HTTPS://WWW.CVMC.ORG/SITES/DEFAULT/FILES/DOCUMENTS/FINANCIAL-ASSISTANCE-PO LICY-V2016.PDF PART V, LINE 16J IN ADDITION TO HAVING THE APPLICATION FOR FINANCIAL ASSISTANCE AS WELL AS THE SLIDING SCALE GRID OF HOW FINANCIAL ASSISTANCE IS AWARDED CVMC HAS COMPREHENSIVE INFORMATION ON THE WEBSITE ABOUT THE POLICY, MATERIALS REQUIRED TO APPLY AND CONTACT INFORMATION FOR THE FINANCIAL COUNSELORS SO THAT INTERESTED INDIVIDUALS CAN APPLY. ADDITIONALLY, THERE IS REFERENCE MADE TO THE POLICY ON PATIENT'S BILLS AS WELL AS APPLICATIONS AND INFORMATION AVAILABLE IN REGISTRATION AREAS IN THE HOSPITAL AND CLINIC LOCATIONS. CVMC ALSO EMPLOYS A TEAM OF FINANCIAL COUNSELORS THAT WORK WITH PATIENTS THROUGHOUT THEIR VISIT TO ENSURE THAT WE COMMUNICATE WITH AS MANY ELIGIBLE INDIVIDUALS AS POSSIBLE. THESE FINANCIAL COUNSELORS ALSO WORK WITH PATIENTS TO EXPLORE THE OTHER OPPORTUNITIES AVAILABLE TO INDIVIDUALS IN NEED THROUGHOUT THE STATE OF VERMONT. PART V, LINE 18F CVMC DID NOT INITIATE ANY OF THE ACTIONS DESCRIBED IN SCHEDULE H, PART V, SECTION B, LINE 18. HOWEVER, IF THE HOSPITAL HAD UNDERTAKEN ANY OF THE LISTED ACTIONS, IT WOULD HAVE FIRST NOTIFIED PATIENTS OF ITS FINANCIAL ASSISTANCE POLICY ON ADMISSION, PRIOR TO DISCHARGE, AND IN COMMUNICATIONS WITH THE PATIENTS REGARDING THEIR BILLS. ADDITIONALLY, CVMC WOULD HAVE DOCUMENTED ITS DETERMINATION OF WHETHER PATIENTS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY. 1 CVMC - WOODRIDGE NURSING HOME 142 Woodridge Drive BERLIN VT 05602 SKILLED NURSING FACILITY SCHEDULE H, PART VI, LINE 1 THE ORGANIZATION'S REQUIRED SCHEDULE H SPECIFIC LINE ITEM DESCRIPTIONS ARE AS FOLLOWS: PART I, LINES 3A-C: PATIENT ELIGIBILITY: ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED FOR THOSE INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE, BASED UPON A DETERMINATION OF FINANCIAL NEED IN ACCORDANCE WITH THIS POLICY. THE GRANTING OF CHARITY SHALL BE BASED ON AN INDIVIDUALIZED DETERMINATION OF FINANCIAL NEED, AND SHALL NOT TAKE INTO ACCOUNT AGE, GENDER, RACE, SOCIAL OR IMMIGRANT STATUS, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, OR RELIGIOUS AFFILIATION. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON BOTH AN INCOME TEST AND A REVIEW OF LIQUID ASSETS. -INCOME TEST: THIS PROGRAM IS LIMITED TO PATIENTS WITH DEMONSTRATED FINANCIAL NEED EITHER DUE TO LIMITED INCOME OR IF THEIR MEDICAL BILLS ARE AN EXCESSIVE PORTION OF THEIR INCOME. THE MOST RECENTLY PUBLISHED FEDERAL PROVIDER GUIDELINES WILL BE USED AS THE PRIMARY DETERMINANT. PATIENTS WHOSE HOUSEHOLD INCOME IS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL GUIDELINES (FPLG), AS ADJUSTED FOR HOUSEHOLD SIZE, MAY PASS THE INCOME TEST AND ARE CONSIDERED FOR CHARITY CARE ASSISTANCE. -NON-CUSTODIAL PARENTS MAY HAVE THEIR INCOME ADJUSTED FOR CHILD SUPPORT WHEN SUPPORTING DOCUMENTATION OF PAYMENT IS PROVIDED. -PATIENTS MAY HAVE THEIR INCOME ADJUSTED FOR ALIMONY WHEN SUPPORTING DOCUMENTATION OF PAYMENT IS PROVIDED. -DEPENDENTS MAY BE INCLUDED WITHIN THE HOUSEHOLD WHEN MORE THAN 50% OF THE SUPPORT IS PROVIDED BY THE GUARANTOR. TO QUALIFY FOR THIS HOUSEHOLD EXTENSION, THE DEPENDENT MUST BE LISTED AS A DEPENDENT ON THE FEDERAL INCOME TAX RETURN. EXCLUSIONS: -PRIMARY RESIDENCE, ASSETS HELD IN A TAX DEFERRED COMPARABLE RETIREMENT SAVINGS ACCOUNT AND COLLEGE SAVINGS ACCOUNTS HELD BY THE PATIENT FOR THE PATIENT ARE EXCLUDED FROM THE ASSETS REVIEW. -ACCOUNTS ALREADY REFERRED TO A COLLECTION AGENCY GREATER THAN 120 DAYS FROM PLACEMENT TO AGENCY, UNLESS REFERRED IN ERROR; -SERVICES REIMBURSED DIRECTLY TO THE PATIENT(S) BY AN INSURANCE CARRIER OR ALREADY COVERED BY ANOTHER THIRD PARTY. RESIDENCY CRITERIA: PATIENTS MUST RESIDE WITHIN THE CENTRAL VERMONT MEDICAL CENTER SERVICE AREA, UNLESS MEDICAL SERVICES WERE URGENT OR EMERGENT IN NATURE. SCHEDULED SERVICES FOR PATIENTS RESIDING OUTSIDE OF THE CVMC SERVICE AREA ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE FOR RESIDENTS OUTSIDE OF THE CVMC SERVICE AREA WILL BE GRANTED ONLY IN UNIQUE CIRCUMSTANCES AND WITH APPROPRIATE APPROVAL. INTERNATIONAL PATIENTS WHO ARE NOT LEGAL, PERMANENT RESIDENTS DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. THESE PATIENTS SHOULD BE COVERED BY TRAVELER COVERAGE. VERMONT RESIDENTS AND COLLEGE STUDENTS WHO RESIDE IN VERMONT PART-TIME MUST LIVE IN OUR SERVICE AREA GREATER THAN 6 MONTHS PER ANNUM TO MEET THE RESIDENCY REQUIREMENT. PROOF OF RESIDENCY MAY BE ESTABLISHED BY ONE OF IS REQUIRED BY ONE OF THE FOLLOWING: -VERMONT SERVICE AREA DRIVERS LICENSE, TAX BILL WITH VERMONT SERVICE AREA ADDRESS, LEASE FOR VERMONT SERVICE AREA PROPERTY OR A VERMONT SERVICE AREA UTILITY BILL; -POTENTIAL EXCEPTIONS MAY BE CONSIDERED ON AN INDIVIDUAL CASE-BY-CASE. PUBLIC HEALTH CARE PROGRAM/HEALTHCARE EXCHANGE CRITERION: PATIENTS APPLYING FOR CENTRAL VERMONT MEDICAL CENTER FINANCIAL ASSISTANCE ARE REVIEWED FOR THEIR POTENTIAL ELIGIBILITY FOR STATE OR FEDERAL HEALTHCARE PROGRAM BENEFITS AND/OR BENEFITS OFFERED THROUGH THE VERMONT HEALTHCARE EXCHANGE PROGRAMS. ANY PATIENT IDENTIFIED WITH POTENTIAL TO BE GRANTED SUCH ASSISTANCE WILL BE INSTRUCTED TO APPLY. FOR THOSE PATIENTS IDENTIFIED AS CANDIDATES FOR ELIGIBILITY FOR THE VERMONT HEALTHCARE EXCHANGE PROGRAM; APPLICATION FOR AND COMPLIANCE WITH THOSE PROGRAM GUIDELINES IS A PRE-REQUISITE FOR CENTRAL VERMONT MEDICAL CENTER PATIENT FINANCIAL ASSISTANCE. DETERMINATION OF FINANCIAL NEED: FINANCIAL NEED WILL BE DETERMINED IN ACCORDANCE WITH PROCEDURES THAT INVOLVE AN INDIVIDUAL ASSESSMENT OF FINANCIAL NEED WHICH WILL INCLUDE THE FOLLOWING: NOTE, IN THE CASE OF PRESUMPTIVE CHARITY, THE APPLICATION PROCESS MAY BE EXCLUDED. -INCLUDE AN APPLICATION PROCESS, IN WHICH THE PATIENT OR THE PATIENTS GUARANTOR ARE REQUIRED TO COOPERATE AND SUPPLY PERSONAL, FINANCIAL AND OTHER INFORMATION AND DOCUMENTATION RELEVANT TO MAKING A DETERMINATION OF FINANCIAL NEED; -INCLUDE THE USE OF EXTERNAL PUBLICLY-AVAILABLE DATA SOURCES THAT PROVIDE INFORMATION ON A PATIENTS OR A PATIENTS GUARANTORS ABILITY TO PAY. CENTRAL VERMONT MEDICAL CENTER RESERVES THE RIGHT TO OBTAIN A CREDIT REPORT, WHEN APPROVAL FROM THE PATIENT IS GRANTED, BEFORE FINANCIAL ASSISTANCE IS AUTHORIZED. -INCLUDE REASONABLE EFFORTS BY CENTRAL VERMONT MEDICAL CENTER TO EXPLORE APPROPRIATE ALTERNATIVE SOURCES OF PAYMENT AND COVERAGE FROM PUBLIC AND PRIVATE PAYMENT PROGRAMS, AND TO ASSIST PATIENTS TO APPLY FOR SUCH PROGRAMS; -TAKE INTO ACCOUNT THE PATIENTS AVAILABLE ASSETS, AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT; AND -INCLUDE A REVIEW OF THE PATIENTS CENTRAL VERMONT MEDICAL CENTER OUTSTANDING ACCOUNTS RECEIVABLE FOR PRIOR SERVICES RENDERED AND THE PATIENTS PAYMENT HISTORY. IT IS PREFERRED BUT NOT REQUIRED THAT A REQUEST FOR FINANCIAL ASSISTANCE AND A DETERMINATION OF FINANCIAL NEED OCCUR PRIOR TO RENDERING OF SERVICES. A PATIENT MUST HAVE A CURRENT PATIENT BALANCE THAT IS DUE TO CENTRAL VERMONT MEDICAL CENTER, AN EXPECTATION THAT AN ACCOUNT CURRENTLY PENDING INSURANCE WILL LEAVE A BALANCE THAT IS DUE TO CENTRAL VERMONT MEDICAL CENTER, OR A FUTURE SCHEDULED SERVICE AT CENTRAL VERMONT MEDICAL CENTER THAT IS EXPECTED TO LEAVE A PATIENT BALANCE. HOWEVER, THE DETERMINATION MAY BE DONE AT ANY POINT IN THE BILLING CYCLE. THE NEED FOR CHARITY ASSISTANCE SHALL BE RE-EVALUATED AT EACH SUBSEQUENT TIME OF SERVICE IF THE LAST FINANCIAL EVALUATION WAS COMPLETED MORE THAN SIX MONTHS PRIOR, OR AT ANY TIME ADDITIONAL INFORMATION RELEVANT TO THE ELIGIBILITY OF THE PATIENT FOR CHARITY BECOMES KNOWN. RE-EVALUATION OF PATIENTS WHOSE AGE EXCEEDS 65 AND WHOSE INCOME IS FIXED BELOW 400% FPLG SHALL OCCUR ANNUALLY. NOTE: IT IS PERMISSIBLE FOR PATIENTS TO SUBMIT NEW SUPPORTING FINANCIAL DOCUMENTATION PROVIDED THE APPLICATION ON FILE IS LESS THAN ONE YEAR OLD. CENTRAL VERMONT MEDICAL CENTERS VALUE OF HUMAN DIGNITY AND STEWARDSHIP SHALL BE REFLECTED IN THE APPLICATION PROCESS, FINANCIAL NEED DETERMINATION AND GRANTING OF FINANCIAL ASSISTANCE. REQUESTS FOR CHARITY SHALL BE PROCESSED PROMPTLY AND CVMC SHALL NOTIFY THE PATIENT/APPLICANT OF DECISION IN WRITING WITHIN 30 DAYS OF RECEIPT OF A COMPLETED APPLICATION. PART I, LINE 7G FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 CENTRAL VERMONT MEDICAL CENTER INCLUDED PHYSICIAN CLINIC EXPENSES IN SUBSIDIZED HEALTH SERVICES. CENTRAL VERMONT MEDICAL CENTER PHYSICIANS INCURRED $49,688,042 OF COSTS ASSOCIATED WITH PROVIDING OUTPATIENT CLINIC SERVICES. NEARLY ALL OF THE EXPENSES INCLUDED AS SUBSIDIZED HEALTH SERVICES ARE ATTRIBUTABLE TO PHYSICIAN CLINICS. AS A RESULT OF THE UNIQUE GEOGRAPHY AND POPULATION DENSITY OF THE COMMUNITY THAT CVMC SERVES, WE CONSIDER ALL OF THE PRIMARY AND SPECIALTY OUTPATIENT CARE PROVIDED BY OUR EMPLOYED GROUP OF PHYSICIANS TO BE SUBSIDIZED. IT HAS BEEN APPARENT OVER THE LAST 16 YEARS THAT THERE ARE NO NEW, UNAFFILIATED PROVIDERS COMING INTO THE CVMC SERVICE AREA AND STARTING PRACTICES. ADDITIONALLY THE MAJORITY OF THE INDEPENDENT PRACTICES THAT WERE ESTABLISHED IN THE CVMC SERVICE AREA HAVE JOINED CVMC DUE TO MANY REASONS INCLUDING ECONOMIC VIABILITY AND SUCCESSION PLANNING. AS A RESULT OF THIS SHIFT, WHICH IS COMMON NOT ONLY IN THE NORTHEAST BUT ACROSS THE UNITED STATES, CVMC'S EMPLOYED PHYSICIANS MAKE UP THE MAJORITY AND IN SOME CASES THE ENTIRETY OF THE OUTPATIENT CARE SERVICES IN OUR COMMUNITY. WERE CVMC TO CEASE THE PROVISION OF THESE SERVICES, THERE IS NO WAY THAT THE COMMUNITY AS IT EXISTS TODAY WOULD HAVE THE CAPACITY TO ABSORB THE PATIENTS AND PROVIDE THE NECESSARY CARE. GIVEN THE HISTORIC LACK OF PROVIDERS ESTABLISHING NEW PRACTICES IN THE AREA, THE PATIENTS CURRENTLY SERVED BY THESE SUBSIDIZED HEALTH SERVICES WOULD END UP RECEIVING CARE FROM THE FEDERALLY QUALIFIED HEALTH CENTER WITHIN OUR SERVICE AREA, THE CVMC EMERGENCY DEPARTMENT, OR RECEIVING CARE FROM PROVIDERS OF NEIGHBORING HOSPITALS AND HEALTH SERVICE AREAS. PART I, LINE 7, COLUMN F: THE PROVISION FOR BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSE OF CALCULATING THE AMOUNT REPORTED ON LINE 7(F) IS $4,232,051. PART I, LINE 7: CVMC FOLLOWS THE IRS GUIDELINE FOR THE COMPLETION OF SCHEDULE H, PART I, LINES 7A-K, COLUMNS A-F. CVMC'S COST-TO-CHARGE RATIO IS USED FOR EACH OF THESE CALCULATIONS. PART III, LINE 2: BAD DEBT EXPENSE WAS CALCULATED BY TAKING THE CHARGES THAT WERE WRITTEN OFF TO ALLOWANCE TO BAD DEBT RESERVE AND REDUCING BY ANY RECOVERIES. THE BAD DEBT RESERVE IS BASED ON AN EVALUATION OF THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. CVMC ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR CATEGORIES OF REVENUE TO ESTIMATE THE APPROPRIATE BAD DEBT RESERVE. MANAGEMENT REGULARLY REVIEWS ACCOUNTS RECEIVABLE DATA AND THE BAD DEBT RESERVE FOR REASONABLENESS. PART III, LINE 3: THE AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE WAS CALCULATED USING A PERCENTAGE OF COLLECTION CASES WHEREBY THE COLLECTION AGENCY HAS, UPON FURTHER COLLECTION ACTIVITY BEEN INFORMED THAT THE PATIENT REQUESTED FINANCIAL ASSISTANCE WITH HIS/HER BILL. THIS PERCENTAGE IS APPROXIMATELY 2% OF ALL COLLECTION CALL ACTIVITY. THIS PERCENTAGE WAS CALCULATED FROM THE NUMBER OF CALLS WITH A REQUEST FOR FINANCIAL ASSISTANCE LISTED ON THE COLLECTION AGENCY'S LOG AS A PERCENTAGE OF THE TOTAL NUMBER OF CALLS THE COLLECTION AGENCY MADE. PART III, LINE 4: PLEASE REFERENCE FOOTNOTE NUMBER 19 ON PAGE 46-47 IN THE FISCAL YEAR 2018 AUDITED CONSOLIDATED FINANCIAL STATEMENTS. PART III, LINE 8: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS SUCH AS MEDICARE IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD TO WHICH TAX-EXEMPT HOSPITALS ARE HELD. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. CVMC DETERMINES THE ALLOWABLE MEDICARE COSTS BY USING A COST TO CHARGE RATIO CALCULATION. PART III, LINE 9B: PAYMENT FOR SERVICES PROVIDED BY CENTRAL VERMONT MEDICAL CENTER IS DUE IN FULL AT THE TIME OF SERVICE. THE ORGANIZATION MAY DEFER PAYMENT TO SUBMIT CLAIMS TO INSURERS, AND WILL WORK WITH THEM TO FACILITATE TIMELY PROCESSING. THE ORGANIZATION WILL SUBMIT CLAIMS TO INSURERS AND FACILITATE TIMELY PAYMENT FOR ITS SERVICES WHEREVER POSSIBLE. PAYMENT PENALTIES ASSESSED BY THE PATIENTS INSURER APPLIED AS THEIR OBLIGATION TO THE HOSPITAL, PRACTICES OR NURSING HOME IS THE GUARANTORS RESPONSIBILITY. THE GUARANTOR IS RESPONSIBLE FOR COMPLYING WITH ALL PRE-AUTHORIZATION, PRE-CERTIFICATION, PHYSICIAN REFERRAL, AND OTHER POLICY REQUIREMENTS. THE PATIENTS INSURANCE POLICY IS AN AGREEMENT BETWEEN THE PATIENT/GUARANTOR AND THE INSURANCE CARRIER; IT IS NOT AN AGREEMENT BETWEEN THE ORGANIZATION AND THE INSURANCE CARRIER. CVMC (MARCAM) BILLING STAFF WILL ADHERE TO ALL LOCAL, STATE AND FEDERAL COLLECTION LAWS AND REGULATIONS REGARDING CREDIT AND COLLECTIONS. THE FAIR DEBT COLLECTION PRACTICES ACT AND THE 501R REGULATIONS ARE THE CURRENT STANDARD. THE ORGANIZATION UTILIZES A GUARANTOR BILLING SYSTEM. ADULT PATIENTS WILL BE RESPONSIBLE FOR THEMSELVES, AS WELL AS THEIR MINOR CHILDREN. TO COMPLY WITH HIPAA PRIVACY STANDARDS, MARRIED COUPLES WILL MAINTAIN SEPARATE GUARANTOR STATUS. STATEMENTS WILL BE SENT AFTER INSURANCES HAVE ACTED ON THE CLAIMS, OR IF THERE IS NO RESPONSE FROM THE INSURANCE COMPANY AFTER A REASONABLE TIME. IF THERE IS NO INSURANCE, STATEMENTS ARE SENT AS SOON AS THE CHARGES HAVE BEEN ENTERED AND THE ACCOUNT HAS BEEN FINALIZED. EACH GUARANTOR WILL BE SENT AN ITEMIZED FIRST STATEMENT AND A COMBINED STATEMENT GOING FORWARD UNLESS WE RECEIVE RETURNED MAIL WITH NO FORWARDING ADDRESS. WE WILL ALSO ATTEMPT TO CONTACT THE GUARANTOR BY TELEPHONE IF THE BILL IS NOT PAID WITHIN 30 DAYS OF THE FIRST STATEMENT MAILING. ALL STATEMENTS INDICATE THAT FINANCIAL ASSISTANCE IS AVAILABLE, AND THE PHONE NUMBER TO CONTACT A FINANCIAL COUNSELOR IS INCLUDED. AFTER 120 DAYS FROM THE DATE OF THE FIRST STATEMENT BILLING THE ACCOUNT WILL COME UP FOR REVIEW FOR PLACEMENT WITH OUR COLLECTION AGENCY. IF THE PATIENT DOES NOT PAY THE ACCOUNT IN FULL, SET UP A MONTHLY PAYMENT PLAN, OR APPLY FOR FINANCIAL AID OR OTHER STATE PROGRAM, THE BALANCE MAY THEN BE SENT TO OUR COLLECTION AGENCY OR ATTORNEY. WE MAY FILE A PROPERTY LIEN AGAINST ATTACHABLE ASSETS IN ORDER TO SECURE OUR INTEREST. GUARANTORS WHO ARE IDENTIFIED BY THE ORGANIZATION AS POTENTIALLY ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM WILL BE ENCOURAGED TO APPLY. GUARANTORS MAY ALSO INITIATE AND REQUEST CONSIDERATION FOR THE FINANCIAL AID PROGRAM BY REQUESTING AN APPLICATION FROM THE ORGANIZATION. THE PROGRAM IS ADMINISTERED BY THE PATIENT FINANCIAL SERVICES DEPARTMENT IN ACCORD WITH THE ORGANIZATIONS FINANCIAL AID POLICY (A-119). PROCEDURE 1. GUARANTORS SHALL BE BILLED FOR BALANCES WHICH ARE DETERMINED TO BE THEIR RESPONSIBILITY. THIS DETERMINATION WILL BE MADE ACCORDING TO THE FOLLOWING STANDARDS: A. THERE WAS NO INSURANCE COVERAGE FOR SERVICES RENDERED. B. INSURANCE WAS BILLED AND THE ENTIRE BALANCE WAS NOT SATISFIED BY THE INSURER BECAUSE THE PATIENT HAD OUT-OF-POCKET EXPENSES (CO-PAYMENT, CO-INSURANCE, DEDUCTIBLE, AND COST-SHARE) TO BE SATISFIED IN ACCORDANCE WITH THEIR INSURANCE POLICY PROVISIONS. C. INSURANCE WAS BILLED AND THE ENTIRE BALANCE WAS NOT SATISFIED BY THE INSURER BECAUSE THE PATIENT DID NOT COMPLY WITH THE INSURANCE POLICY REQUIREMENTS. D. INSURANCE WAS BILLED AND THE ENTIRE BALANCE WAS NOT SATISFIED BY THE INSURER BECAUSE THE SERVICES PROVIDED WERE NOT COVERED UNDER THE PATIENTS POLICY. E. INSURANCE WAS BILLED, BUT THE INSURANCE CARRIER DOES NOT RESPOND IN A TIMELY MANNER. F. THE GUARANTOR REFUSES TO ACCEPT A REASONABLE SETTLEMENT OFFER WHICH INCLUDES PAYMENT FOR OUR SERVICES (EX: THIRD PARTY LIABILITY CLAIMS). ONCE THE SELF-PAY BALANCE HAS BEEN DETERMINED, MONTHLY STATEMENTS WILL BE GENERATED TO INFORM THE GUARANTOR OF THEIR OBLIGATIONS TO THE ORGANIZATION AND TO REQUEST PAYMENT. 2. UNLESS STATEMENTS ARE RETURNED DUE TO AN INCORRECT ADDRESS, A MINIMUM OF FOUR STATEMENTS WILL BE SENT TO THE GUARANTOR FOR EACH ACCOUNT BEFORE THE ACCOUNT IS ELIGIBLE FOR BAD DEBT WRITE-OFF AND ASSIGNED TO A THIRD PARTY COLLECTION VENDOR. ACCOUNTS IN EXCESS OF $500 WITH INCORRECT ADDRESSES WILL BE RESEARCHED TO OBTAIN A CORRECT ADDRESS, AND ATTEMPTS WILL BE MADE TO CONTACT THE GUARANTOR BY TELEPHONE PRIOR TO REFERRING THEM TO COLLECTIONS. BILLING OF DECEASED PATIENTS WILL CONTINUE AS WITH OTHER PATIENTS UNLESS IT IS ESTABLISHED THAT THE PATIENT LEFT NO ESTATE OR THAT AVAILABLE ESTATE FUNDS HAVE BEEN EXHAUSTED. 3. GUARANTORS WHO WISH TO ESTABLISH A MONTHLY PAYMENT ARRANGEMENT MUST CONTACT THE ORGANIZATION TO REQUEST ONE. BOTH THE ORGANIZATION AND THE GUARANTOR MUST AGREE ON THE TERMS OF PAYMENT. FAILURE TO ABIDE BY THE TERMS OF PAYMENT WILL RESULT IN REFERRAL TO A THIRD PARTY COLLECTION VENDOR. (SEE ATTACHMENT I: PAYMENT ARRANGEMENT PROCESSES AND PROCEDURES) 4. THIRD PARTY LIABILITY AND LITIGATION ACCOUNTS ARE TO BE CONSIDERED AS THE GUARANTORS RESPONSIBILITY. GUARANTORS WILL BE BILLED AND THE ACCOUNTS MOVED TO BAD DEBT IF NO WRITTEN GUARANTEE IS RECEIVED FROM THE GUARANTOR OR THIRD PARTY, NO ARRANGEMENTS ARE MADE, NO LETTER OF PROTECTION IS RECEIVED FROM THE GUARANTORS ATTORNEY, OR PAYMENT IN FULL IS NOT RECEIVED. THE ORGANIZATION RESERVES ITS RIGHT AND RESPONSIBILITY TO REPORT THIRD PARTY LIABILITY TO PRIMARY MEDICAL INSURANCE CARRIERS. THE ORGANIZATION MAY UTILIZE ITS COLLECTION ATTORNEY TO SECURE ITS INTERESTS IN ANY SETTLEMENT. THE ORGANIZATION SHALL FILE LIENS AS ALLOWED BY LAW. 5. ACCOUNTS WILL BE REFERRED TO BAD DEBT IF THE GUARANTOR IS UNCOOPERATIVE, THE ORGANIZATIONS INTERESTS ARE UNSECURED AND IN DANGER OF BEING LOST, ACCEPTABLE ARRANGEMENTS HAVE NOT BEEN MADE, ARRANGEMENTS ARE IN DEFAULT, OR IF THE DEBTOR CANNOT BE REACHED BY MAIL OR TELEPHONE. THE CATEGORIES OF WRITE OFF ARE AS FOLLOWS: A. MEDICARE BAD DEBT B. NON-MEDICARE BAD DEBT C. UNCOLLECTIBLE BANKRUPT, DECEASED WITH NO ESTATE, NOT BILLABLE. 6. SETTLEMENT ON OBLIGATIONS WILL BE CONSIDERED ON AN INDIVIDUAL BASIS. THE GUARANTORS CIRCUMSTANCES, THE ORGANIZATIONS DEBT, THE LIKELINESS OF RECEIVING PAYMENT IN FULL AND OTHER CONCERNS WILL BE CONSIDERED. THE FINANCIAL COUNSELING TEAM LEAD IS RESPONSIBLE FOR NEGOTIATING AND APPROVING ALL OFFERS UP TO $5,000 IN LOSS. THE DIRECTOR OF PATIENT ACCESS WILL NEGOTIATE AND APPROVE ALL OFFERS UP TO $10,000 IN LOSS. THE CHIEF FINANCIAL OFFICER WILL APPROVE ALL LOSSES IN EXCESS OF $10,000. CVMC WILL OFFER A 30% PROMPT PAY DISCOUNT FOR CHARGES FOR WHICH NO INSURANCE COVERAGE IS AVAILABLE AND A 10% DISCOUNT FOR PATIENT BALANCES AFTER INSURANCE PAYMENTS AND ADJUSTMENTS. PROMPT PAYMENT MEANS PAYMENT OF THE AGREED-UPON AMOUNT WITHIN 10 WORKING DAYS FROM THE TIME WE OFFER A DISCOUNT TO THE GUARANTOR. 7. RESPONSIBILITY FOR DETERMINING THE GUARANTOR FOR AN ACCOUNT WILL BE BASED ON THE GUARANTOR ASSIGNMENT POLICY. THE ORGANIZATIONS POSITION ON DIVORCE DECREES IS THAT THE GUARANTOR IS THE PERSON WHO RECEIVED THE SERVICE OR THE PARENT WHO BRINGS THE CHILD IN FOR SERVICES AND SIGNS THE CONSENT (NOT THE SUBSCRIBER OF INSURANCE). THE ORGANIZATION CANNOT ENFORCE DIVORCE DECREES SINCE THEY ARE AN AGREEMENT BETWEEN THE DIVORCING PARTIES AND THE COURT SYSTEM. 8. PAYMENT FOR COSMETIC SERVICES OR SERVICES WHICH ARE NOT MEDICALLY NECESSARY IS DUE ON OR BEFORE THE DAY SERVICES ARE PROVIDED. EXCEPTIONS MUST BE APPROVED BY THE DIRECTOR OF ACCESS OR ADMINISTRATION. 9. ALL COLLECTION ACTIVITY PRIOR TO REFERRAL TO AN OUTSIDE COLLECTION AGENCY OR ATTORNEY WILL BE DOCUMENTED IN THE ACCOUNT NOTES. NEEDS ASSESSMENT PART VI, LINE 2 THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED USING BOTH QUALITATIVE AND QUANTITATIVE RESEARCH TECHNIQUES. INITIALLY, MEMBERS OF THE CVMC STEERING COMMITTEE GAVE VERBAL REPORTS ON THE ISSUES THEY BELIEVED TO BE THE MOST PRESSING IN THEIR ORGANIZATIONS OR IN THE GENERAL CENTRAL VERMONT COMMUNITY. FROM THERE, THE STEERING COMMITTEE REVIEWED THE RECOMMENDED LIST OF HEALTH AND SOCIOECONOMIC INDICATORS PROVIDED BY THE VERMONT DEPARTMENT OF HEALTH, AND GATHERED DATA PERTAINING TO POPULATION DEMOGRAPHICS, ACCESS TO HEALTH SERVICES, MATERNAL AND CHILD HEALTH, HEALTH STATUS AND PREVENTION, AND SOCIAL ENVIRONMENTAL MEASURES TO EVALUATE THESE CONCERNS. THIS SECONDARY RESEARCH COUPLED WITH THE STEERING COMMITTEE'S CONCERNS ALLOWED SIGNIFICANT CONCLUSIONS TO BE DRAWN AND CVMC'S PRIORITY HEALTH NEEDS TO BE SELECTED. IN ADDITION TO THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT, CVMC REGULARY MONITORS THE HEALTH NEEDS OF THE CENTRAL VERMONT COMMUNITY, THROUGHT THE COMMUNITY ALLIANCE FOR HEALTH EXCELLENCE COMMITTE (CAHE) WICH MEETS MONTHLY AND BRINGS LEADERS AND COMMUNITY PROVIDERS OF 17 DIFFERENT HEALTH CARE ORGANIZATIONS TOGETHER TO DIALOGUE AND MAKE DECIDIONS AT THE COMMUNITY LEVEL TO IMPROVE THE HEALTH CARE AND EXPERIENCE OF CARE FOR THOSE IN OUR COMMUNITY. CURRENT CAHE PROJECTS INCLUDE CARE NAVIGATION, CHRONIC HEART FAILURE, HOSPICE AND PALLIATIVE CARE AND ACES PILOT PROJECT. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT THE FOLLOWING WEB ADDRESS: HTTP://WWW.CVMC.ORG/SITE/DEFAULT/FILES/DOCUMENTS/COMMUNITY-HEALTH-NEEDS-AS SESSMENT-2016.PDF PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 CVMC'S FINANCIAL ASSISTANCE SUMMARIES ARE POSTED IN ALL PATIENT ADMISSION PACKETS AND ON THE CVMC WEBSITE. CVMC ALSO PROVIDES CONSPICUOUS DISPLAYS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE FACILITY. ALL PATIENT INVOICES LIST THE PHONE NUMBER FOR CONTACTING CVMC PATIENT FINANCIAL SERVICES FOR FINANCIAL ASSISTANCE IF PATIENTS ARE UNABLE TO PAY THEIR BILL. PATIENT FINANCIAL SERVICES HAS APPLICATIONS FOR ALL STATE FINANCIAL AID PROGRAMS ON FILE AND EMPLOYS THREE FINANCIAL COUNSELORS WHO WILL SIT DOWN WITH PATIENTS TO HELP THEM DETERMINE WHICH PROGRAMS THEY QUALIFY FOR, AS WELL AS HELP THEM FILL OUT THESE FORMS. PATIENT FINANCIAL SERVICES PROACTIVELY SCREENS PATIENT BILLING INFORMATION TO IDENTIFY INDIVIDUALS WHO MAY BE ELIGIBLE FOR STATE OR CVMC ASSISTANCE, AND WILL EITHER VISIT THAT PATIENT IN THE HOSPITAL, CALL THEM AT HOME, OR MAIL THEM THE INFORMATION. COMMUNITY INFORMATION PART VI, LINE 4 CENTRAL VERMONT MEDICAL CENTER IS THE ONLY HOSPITAL LOCATED IN OUR IMMEDIATE SERVICE AREA OF WASHINGTON COUNTY AND PARTS OF ORANGE COUNTY. THIS SERVICE AREA CONSISTS OF 23 TOWNS WITH A TOTAL POPULATION OF APPROXIMATELY 63,730. INCLUDED IN THIS SERVICE AREA IS THE FEDERALLY DESIGNATED ORWELL TOWN MEDICALLY UNDERSERVED AREA. VITAL STATISTICS: 96% WHITE 24% UNDER THE AGE OF 18 56% AGED 18 TO 64 20% OVER THE AGE OF 65 MEDIAN HOUSEHOLD INCOME OF $60,602 9.4% LIVE BELOW THE POVERTY LEVEL 3.5% NON ENGLISH SPEAKING HOUSEHOLDS ACCESS TO HEALTHCARE: 2.4% UNINSURED 17.9% MEDICAID (OR OTHER STATE PROGRAMS) RECIPIENTS 28.6% MEDICARE 51.1% PRIVATE INSURANCE PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 CENTRAL VERMONT MEDICAL CENTER IS THE ONLY HOSPITAL AND EMERGENCY CARE FACILITY LOCATED IN OUR IMMEDIATE SERVICE AREA. ALL OF ITS SERVICES, INCLUDING EMERGENCY CARE, ARE PROVIDED TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. CENTRAL VERMONT MEDICAL CENTER (CVMC) IS THE ADMINISTRATIVE ENTITY FOR THE VERMONT BLUEPRINT FOR HEALTH, PATIENT CENTERED MEDICAL HOMES FOR THE BARRE HEALTH SERVICE AREA (HSA). THE GOAL OF THE VERMONT BLUEPRINT FOR HEALTH, PASSED BY THE VERMONT LEGISLATURE IN 2010, IS TO SUPPORT VERMONT'S EFFORTS TO DEVELOP A COMPREHENSIVE, PROACTIVE SYSTEM OF CARE THAT IMPROVES THE QUALITY OF LIFE FOR PEOPLE WITH, OR AT RISK FOR CHRONIC CONDITIONS. IN A PATIENT CENTERED MEDICAL HOME, PATIENTS HAVE ACCESS TO A COMMUNITY HEALTH TEAM, WHICH CONSISTS OF A NURSE, OR DIETITIAN OR CLINICAL SOCIAL WORKER OR WELLNESS COACH. THIS TEAM WORKS WITH THE PATIENT TO HELP SET REALISTIC GOALS AND TIMELINES AND PROVIDES ONE-ON-ONE SUPPORT. THEY ALSO WORK WITH A BROAD BASE OF COMMUNITY SERVICES TO PROVIDE EACH PATIENT WITH INDIVIDUAL SUPPORT AND CARE. AT THE END OF 2018, OVER 50 PRIMARY CARE PROVIDERS WERE ALL PART OF A RECOGNIZED NATIONAL COMMITTEE FOR QUALITY ASSURANCE, PATIENT CENTERED MEDICAL HOME IN THE BARRE HSA CARING FOR OVER 30,000 PATIENTS. THERE ARE 17 COMMUNITY HEALTH TEAM STAFF MEMBERS IN THE CVMC PRACTICES. CVMC IS PROUD TO BE A PARTICIPANT IN THE VERMONT BLUEPRINT FOR HEALTH. IN ADDITION TO FINANCIAL ASSISTANCE AND SLIDING SCALE DISCOUNTS (SEE SCHEDULE H, PART I, LINES 3A & B), CVMC OFFERS NO INTEREST MONTHLY PAYMENT PLANS FOR PATIENTS WHO CANNOT PAY THEIR OUTSTANDING BALANCE IN FULL BUT ARE ABLE TO PAY OVER TIME. CVMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. CVMC APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, SUCH AS NEW TECHNOLOGIES (MRI), FACILITIES AND SERVICES. THE MAJORITY OF THE CVMC'S GOVERNING BODY (BOARD OF TRUSTEES) IS COMPRISED OF INDIVIDUALS WHO RESIDE IN CVMC'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES, FAMILY MEMBERS, NOR CONTRACTORS OF THE ORGANIZATION. CVMC ACTIVELY PARTNERS WITH MANY COMMUNITY ORGANIZATIONS, SUCH AS WASHINGTON COUNTY MENTAL HEALTH SERVICES, THE PEOPLE'S HEALTH AND WELLNESS CLINIC, CENTRAL VERMONT HOME HEALTH & HOSPICE, AND GREEN MOUNTAIN UNITED WAY, TO IMPROVE THE HEALTH AND WELLBEING OF OUR COMMUNITY. ONE EXAMPLE IS OUR FREE WOMEN'S HEALTH CLINICS WITH FINANCIAL SUPPORT FROM THE SUSAN G. KOMEN FOR THE CURE THAT CVMC SPONSORS ALONG WITH THE PEOPLE'S HEALTH AND WELLNESS CLINIC. CVMC APPLIES SURPLUS FUNDS TO REVITALIZE FACILITIES, PURCHASE EQUIPMENT, AND TO ENHANCE PROGRAMS TO BETTER SERVE OUR PATIENTS. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 AS OF OCTOBER 1, 2011, CENTRAL VERMONT MEDICAL CENTER, INC. (CVMC) AND THE UNIVERSITY OF VERMONT MEDICAL CENTER BECAME MEMBERS OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, AN INTEGRATED SYSTEM OF CARE SERVING THE COMMUNITIES OF VERMONT AND NORTHERN NEW YORK. THE UNIVERSITY OF VERMONT HEALTH NETWORK IS CARRYING OUT CENTRALIZED ACTIVITIES FOR THE BENEFIT OF PATIENTS OF PARTNER ORGANIZATIONS, INCLUDING IMPROVING ACCESS TO LOCAL CARE, COST SAVINGS THROUGH GREATER JOINT PURCHASING POWER, ENHANCING INFORMATION TECHNOLOGY, INCREASING ACADEMIC OPPORTUNITIES FOR PHYSICIANS, ENGAGING IN REGIONAL STRATEGIC PLANNING, AND PARTICIPATING IN JOINT QUALITY AND CLINICAL INITIATIVES. SINCE THE HEALTH NETWORK'S INCEPTION, CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER, ELIZABETH COMMUNITY HOSPITAL, ALICE HYDE MEDICAL CENTER, AND PORTER MEDICAL CENTER HAVE ALSO JOINED. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 VT true PEOPLES HEALTH AND WELLNESS CENTER 553 North Main St Suite 5 Barre VT 05641 030343290 501(c)(3) 21000 HEALTH CARE FOR THE UNINSURED AREA HLTH EDU CNTRS PRM UNIV VT COL OF MED UHC CMP Arnld 51 SPrpct Brlngtn VT 05401 030179440 501(c)(3) 26780 EDU LOAN RPMT TO HLTHCR PRFSNLS Washington County Mental Health Services Inc PO Box 647 Montpelier VT 056010647 030215872 501(c)(3) 500000 Support mission for mental health and substance abuse treatment services. 3 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 CENTRAL VERMONT MEDICAL CENTER OCCASIONALLY GRANTS FUNDS TO ORGANIZATIONS THAT SUPPORT CVMC'S EXEMPT PURPOSE OF SERVING THE HEALTHCARE NEEDS OF CENTRAL VERMONT RESIDENTS. GRANT FUNDS ARE APPROVED AND OVERSEEN BY THE BOARD. X X false true false false false false false false false JOHN BRUMSTED MD TRUSTEE 0 1023959 0 613889 0 175239 0 186643 0 27247 0 2026977 0 0 JEREMIAH ECKHAUS MD TRUSTEE, PRES-ELECT MED STAFF 201840 33925 293 13376 0 27508 0 276942 0 0 0 MARK DEPMAN MD TRUSTEE, REGNAL PHYS LEADER 323662 0 16213 0 27787 0 18000 0 22506 0 408168 0 0 0 ANNA T NOONAN TRUSTEE, PRESIDENT/COO 144211 164576 135376 0 3000 27148 17654 20314 14187 20912 314428 232950 0 0 CATHY PALMER MD TRUSTEE 30000 221238 0 0 7708 0 16320 0 24324 30000 269590 0 0 JUDITH TARR TARTAGLIA TRUSTEE, PRES/CEO UNTIL 3/2017 293819 0 34696 0 38547 0 6601 0 8100 0 381763 0 0 0 CHEYENNE HOLLAND TREASURER, CFO, UNTIL 07/2018 261693 0 0 0 6751 0 33900 0 29817 0 332161 0 0 0 NANCY LOTHIAN CHIEF OPERATING OFFICER 246521 0 29550 0 33936 0 18000 0 12757 0 340764 0 0 0 PHILIP BROWN DO CHIEF MEDICAL OFF,UNTIL 3/2018 315055 0 0 0 0 0 4498 0 30034 0 349587 0 0 0 RICHARD MORLEY VP SUPPORT SRVCS, UNITL 2/2018 204306 0 300 0 38211 0 0 0 22767 0 265584 0 0 0 MATTHEW CHOATE CHIEF NURSING OFFICER 170790 0 0 0 2391 0 10502 0 19545 0 203228 0 0 0 CHRISTIAN BEAN MD PHYSICIAN 440469 0 86198 0 51408 0 34761 0 28571 0 641407 0 0 0 JOHN BRAUN MD PHYSICIAN 460166 0 46065 0 311 0 19810 0 4002 0 530354 0 0 0 CHRISTOPHER MERIAM MD PHYSICIAN 443812 0 81134 0 61269 0 38785 0 28674 0 653674 0 0 0 SARA GRAVES MD PHYSICIAN 395483 0 37385 0 48300 0 18623 0 28906 0 528697 0 0 0 ROBERT PATTERSON VP OF HR & CLINICAL OPERATIONS 196548 0 19253 0 8485 0 14108 0 26771 0 265165 0 0 0 DAVID TURNER VP PHYSICIAN SERVICES 171066 0 16472 0 1232 0 10790 0 2637 0 202197 0 0 0 TODD KEATING INTERIM TREASURER,CFO 7/2018 0 568728 0 270066 0 86596 0 23430 0 5167 0 953987 0 0 SCHEDULE J, PART I, LINE 3 IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN PART I, CVMC RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THE GUIDANCE: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE EXECUTIVE BENEFITS SCHEDULE J, PART I, LINE 4B CERTAIN LISTED INDIVIDUALS PARTICIPATED IN THE UVM MEDICAL CENTER EXECUTIVE BENEFIT PLAN UNDER WHICH PARTICIPANTS ARE CREDITED A BENEFIT ALLOWANCE EQUAL TO A SPECIFIED PERCENTAGE OF BASE PAY. UNDER THE PLAN, PARTICIPANTS MAY ELECT TO HAVE THE AMOUNT OF THE BENEFIT ALLOWANCE DEFERRED TO A CAPITAL ACCUMULATION ACCOUNT SUBJECT TO SECTION 457(F). NO AMOUNTS WERE DEFERRED TO OR PAID FROM A CAPITAL ACCUMULATION ACCOUNT IN CALENDAR 2017. DURING CALENDAR YEAR 2015, THE UNIVERSITY OF VERMONT MEDICAL CENTER, INC. ENTERED INTO A SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) WITH PRESIDENT BRUMSTED. UNDER THE TERMS OF THE SRP, UVM MEDICAL CENTER MAKES ANNUAL CREDITS EQUAL TO 15% OF THE PRESIDENT'S BASE SALARY FOR EACH YEAR THROUGH THE PLAN YEAR ENDING SEPTEMBER 30, 2019. THE AMOUNT DEFERRED FOR CY17 IS REPORTED ON SCHEDULE J, PART II, COLUMN C. AMOUNTS DEFERRED REMAIN SUBJECT TO FORFEITURE IF CERTAIN CONDITIONS ARE NOT MET. SUBSTANTIAL DONOR SUBSTANTIAL CONTRIBUTOR 797108 SERVICES false DESCRIPTION OF THE ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 CENTRAL VERMONT MEDICAL CENTER TRUSTEES AND ITS STAFF ARE COMMITTED TO PROVIDING EXCELLENT CARE TO CENTRAL VERMONTERS. TO STAY ABREAST OF BEST PRACTICES, CVMC COLLABORATES WITH MANY HEALTHCARE ENTITIES TO ENSURE THIS COMMITMENT. PARTICIPATING IN THE JOINT COMMISSION ACCREDITATIONS PROCESS IS ONE MEASURE OF HOW CVMC CONTINUOUSLY STRIVES TO IMPROVE THE SAFETY AND QUALITY OF CARE PROVIDED TO ITS PATIENTS. THE HOSPITAL AND THE PHYSICIAN PRACTICE GROUPS (CVMGP, CENTRAL VERMONT MEDICAL GROUP PRACTICES) WERE ACCREDITED IN JANUARY 2016 FOR A THREE YEAR PERIOD. JOINT COMMISSION ACCREDITATION IS THE EQUIVALENT OF THE GOOD HOUSEKEEPING "SEAL OF APPROVAL" FOR MEDICAL CENTERS. THE JOINT COMMISSION EVALUATES THE QUALITY AND SAFETY OF CARE PROVIDED BY HEALTH CARE ORGANIZATIONS. TO EARN AND MAINTAIN ACCREDITATION, ORGANIZATIONS MUST HAVE AN EXTENSIVE ON-SITE REVIEW BY A TEAM OF JOINT COMMISSION HEALTH CARE PROFESSIONALS AT LEAST ONCE EVERY THREE YEARS. THE PURPOSE OF THE REVIEW IS TO EVALUATE THE ORGANIZATION'S PERFORMANCE IN AREAS THAT AFFECT PATIENT CARE. ACCREDITATION IS AWARDED BASED ON HOW WELL THE ORGANIZATION MEETS THE JOINT COMMISSION STANDARDS. CVMC PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. ALL OF CVMC'S SERVICES, INCLUDING EMERGENCY CARE, ARE PROVIDED TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. FORM 990, PART VI, LINE 2 THERE IS A BUSINESS RELATIONSHIP BETWEEN DR. JOHN BRUMSTED AN OFFICER OF THE UNIVERSTIY OF VERMONT MEDICAL CENTER (UVMMC), DR. CATHY PALMER AN EMPLOYEE OF UVMMC AND TODD KEATING, INTERIM TREASURER, CFO OF CENTRAL VERMONT MEDICAL CENTER INC. (CVMC). DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS Form 990, Part VI, Line 6 THE UNIVERSITY OF VERMONT HEALTH NETWORK IS THE SOLE MEMBER AND PARENT CORPORATION OF CENTRAL VERMONT MEDICAL CENTER, INC. (CVMC). THE UNIVERSITY OF VERMONT HEALTH NETWORK IS A VERMONT NON-PROFIT CORPORATION WHICH HAS BEEN RECOGNIZED BY THE IRS AS A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. ELECTION OF GOVERNING BODY & GOVERNANCE DECISIONS FORM 990, PART VI, LINE 7A & 7B THE UNIVERSITY OF VERMONT HEALTH NETWORK HOLDS THE POWER TO ELECT CVMC'S BOARD OF TRUSTEES AND TO APPROVE SIGNIFICANT CORPORATE ACTIONS, INCLUDING ANNUAL OPERATING AND CAPITAL BUDGETS, STRATEGIC PLANS, THE APPOINTMENT OF THE CEO, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AND AMENDMENTS TO CVMC'S BYLAWS AND ARTICLES OF ORGANIZATION. DESCRIPTION OF PROCESS USED BY MGMNT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY THE ACCOUNTING MANAGER AND REVIEWED IN DETAIL BY CVMC'S OUTSIDE TAX ADVISORS BEFORE BEING REVIEWED BY THE OFFICERS OF THE CORPORATION AND BY THE OTHER MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE ACCOUNTING MANAGER PROVIDES REGULATORY UPDATES REGARDING THE FORM 990 TO THE FINANCE COMMITTEE AND MAKES AVAILABLE TO THE FINANCE COMMITTEE THE FORM 990 ALONG WITH HIGHLIGHTS OF ALL SIGNIFICANT PARTS OF THE FORM 990. THE BOARD OF TRUSTEES IS ALSO PROVIDED VIA EMAIL A COPY OF THE "AS FILED" FORM 990 BEFORE IT IS FILED WITH THE IRS, WITH A STATEMENT NOTATING THAT SCHEDULE B IS NOT FOR PUBLIC VIEWING. THE FORM 990 IS ALSO AVAILABLE IN HARD COPY FOR THOSE THAT DO NOT HAVE ACCESS TO EMAIL. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C THE COMPLIANCE OFFICER FOR CVMC MAINTAINS THE CONFLICT OF INTEREST STATEMENTS AND REGULARLY MONITORS THEM AS WELL AS ANY OTHER ACTIVITIES THAT MAY CONSTITUTE A CONFLICT OF INTEREST. THE ORGANIZATION'S PRACTICE IS TO SEND OUT ANNUAL DISCLOSURE QUESTIONNAIRES TO BOARD OF TRUSTEE MEMBERS, SENIOR OFFICERS, AND DIRECTORS OF THE ORGANIZATION OR OTHER INDIVIDUALS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION WHO HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST, AS DEFINED BELOW, AS AN "INTERESTED PERSON." THIS DEFINITION SHALL ALSO INCLUDE MEMBERS OF THE ORGANIZATION'S LEADERSHIP GROUP, MEDICAL DIRECTORS AND ANY EMPLOYEES INVOLVED WITH RECOMMENDING OR PURCHASING PRODUCTS/SERVICES. THE RESPONSES ARE TAKEN TO THE GOVERNANCE AND HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. THE GOVERNANCE AND HUMAN RESOURCES COMMITTEE SHALL MAINTAIN A LIST OF INDIVIDUALS WHO MAY BE CONSIDERED DISQUALIFIED PERSONS UNDER IRS REGULATIONS. THE GOVERNANCE AND HUMAN RESOURCES COMMITTEE SHALL REPORT THE RESULTS OF ITS REVIEW ANNUALLY TO THE BOARD OF TRUSTEES. IF THERE IS ANY POSSIBILITY OF FINANCIAL GAIN BY A TRUSTEE AND OR EMPLOYEE FROM ANY DECISION THAT IS TO BE DELIBERATED ON, THEN THAT TRUSTEE/EMPLOYEE MAY MAKE A PRESENTATION, BUT IS THEN REMOVED FROM THOSE DISCUSSIONS TO ENSURE THAT THE TRUSTEE/EMPLOYEE WILL NOT TAKE PART IN ANY DELIBERATIONS THAT HE OR SHE MIGHT PERSONALLY GAIN FROM. THE TRUSTEE/EMPLOYEE OPERATING UNDER A CONFLICT IS PROHIBITED FROM VOTING ON ANY MATTER TO WHICH THE CONFLICT RELATES. WHISTLEBLOWER & DOCUMENT RETENTION - DESTRUCTION POLICIES FORM 990, PART VI, LINES 13 & 14 CVMC HAS BOTH A WHISTLEBLOWER AND A DOCUMENT RETENTION - DESTRUCTION POLICY. THESE POLICIES ARE EFFECTIVE WITHOUT FORMAL BOARD APPROVAL. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINES 15A & 15B THE PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION'S PRESIDENT/COO AND CFO INCLUDES A REVIEW AND APPROVAL BY THE BOARD OF TRUSTEES. AN INDEPENDENT COMPENSATION STUDY IS ALSO PERIODICALLY PERFORMED. THE MOST RECENT STUDY WAS PERFORMED IN 2017. THIS STUDY INCLUDED COMPENSATION DATA FOR CHIEF EXECUTIVE OFFICERS AND VICE PRESIDENTS. INDEPENDENT RESEARCH IS COMPLEMENTED BY A MARKET STUDY ANALYSIS PERFORMED BY THE HUMAN RESOURCES DEPARTMENT AND REVIEWED BY THE BOARD OF TRUSTEES. MARKET STUDY DATA COMES FROM, BUT IS NOT LIMITED TO, HFMA, VAHHS, NEAH, AHA, INDUSTRY SPECIFIC COMPENSATION SURVEYS AND OTHER HEALTHCARE SOURCES. THE COMPENSATION OF OTHER KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED THROUGH MARKET STUDY ANALYSIS PERFORMED BY THE HUMAN RESOURCES DEPARTMENT AND REVIEWED BY THE BOARD OF TRUSTEES IF NECESSARY. IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN SCHEDULE J, PART I, CVMC RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THE GUIDANCE: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE ORGANIZATION MAKES AVAILABLE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS OF THE ORGANIZATION FOR FY2018 CAN ALSO BE FOUND ON THE WEBSITE. WWW.CVMC.ORG FORM 990, PART VII THREE PHYSICIANS SERVING AS BOARD MEMBERS, DR. PALMER, DR. DEPMAN AND DR. ECKHAUS, RECEIVE COMPENSATION FROM THE ORGANIZATION FOR THEIR SERVICES AS PHYSICIANS. THIS COMPENSATION IS NOT RELATED TO THEIR PARTICIPATION AS MEMBERS OF THE BOARD OF TRUSTEES. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: CHANGE IN MINIMUM PENSION LIABILITY $7,018,473 FUNDS RELEASED FROM TEMP RESTRICTED ASSETS (571,429) CHANGE IN PERPETUAL TRUST 12,182 -------------------------------------- TOTAL: $6,459,226 CIRCULAR A-133 AUDIT FORM 990, PART XII, LINE 3B: DURING FY18, CVMC DID NOT REACH THE LEVEL REQUIRED TO WARRANT AN AUDIT UNDER OMB CIRCULAR A-133. HOWEVER, BECAUSE OF CVMC'S AFFILIATION WITH THE UNIVERSITY OF VERMONT MEDICAL CENTER, CVMC WAS INCLUDED IN THE A-133 THAT WAS PERFORMED FOR THE UNIVERSITY OF VERMONT MEDICAL CENTER. UNIVERSITY OF VERMONT MEDICAL CENTERINC 111 COLCHESTER AVE BURLINGTON VT 05401 030219309 HOSPITAL VT 501(c)(3) 3 UVMHN true UNIV OF VERMONT HEALTH NETWORK INC 111 COLCHESTER AVE BURLINGTON VT 05401 452880726 HOLDING CO VT 501(C)(3) 12A-I NA false UNIV OF VERMONT MEDICAL GROUP - NEW YORK 183 PARK STREET MALONE NY 12953 203905216 PHYS SVCS NY 501(C)(3) 3 UVMMG true UNIVERSITY OF VERMONT MEDICAL GROUP 111 COLCHESTER AVE BURLINGTON VT 05401 030225105 PHYS SVCS VT 501(C)(3) 12A-I UVMHN true UNIV OF VERMONT MEDICAL CTR FDN INC 111 COLCHESTER AVE BURLINGTON VT 05401 263159849 FUNDRAISING VT 501(C)(3) 12A-I UVMMC true CENTRAL VERMONT HOSPITAL AUXILIARY 130 FISHER RD BERLIN VT 05602 030264240 SERVICE VT 501(C)(3) 12D-III-O NA false COMMUNITY PROVIDERS INC 75 BEEKMAN ST PLATTSBURGH NY 12901 222544844 HLTH SVC COOR NY 501(C)(3) 12A-I UVMHN true CHAMPLAIN VALLEY PHYSICIANS HOSPITAL 75 BEEKMAN STREET PLATTSBURGH NY 12901 141338471 HOSPITAL NY 501(C)(3) 3 CPI true ELIZABETHTOWN COMMUNITY HOSPITAL 75 PARK STREET ELIZABETHTOWN NY 12932 141364513 HOSPITAL NY 501(C)(3) 3 CPI true EMERGENCY MEDICAL TRANSPORT OF CVPH INC 75 BEEKMAN ST PLATTSBURGH NY 12901 061718419 AMBULANCE SVC NY 501(C)(3) 12B-II CPI true CVPH MEDICAL CENTER FOUNDATION 75 BEEKMAN ST PLATTSBURGH NY 12901 141727048 HLTH SVC SUPP NY 501(c)(3) 12B-II CVPH true UNIVERSITY MEDICAL EDUCATION ASSOCIATES 89 BEAUMONT AVE BURLINGTON VT 05405 237107832 EDUCATIONAL VT 501(C)(3) 11 UVMMG true UNIVERSITY HEALTH CENTER 111 CoOLCHESTER AVE BURLINGTON VT 05401 030229931 HOSPITAL VT 501(C)(3) 12C-III-FI UVMMG true ALICE HYDE MEDICAL CENTER 133 PARK STREET MALONE NY 12953 150346515 HOSPITAL NY 501(C)(3) 3 CPI true PORTER MEDICAL CENTER INC 115 PORTER DRIVE MIDDLEBURY VT 05753 030310862 SUPPTG ORG VT 501(C)(3) 12-BII UVMHN true HELEN PORTER NURSING HOME 37 PORTER DRIVE MIDDLEBURY VT 05753 030306549 NURSING HOME VT 501(C)(3) 3 PMC true AUXILIARY OF PORTER MEDICAL CENTER 37 PORTER DRIVE MIDDLEBURY VT 05753 237363227 SUPPORTG ORG VT 501(C)(3) 12-B,II PMC true PORTER HOSPITAL INC 37 PORTER DRIVE MIDDLEBURY VT 05753 030181058 HOSPITAL VT 501(C)(3) 3 PMC true ONECARE VERMONT ACCOUNTABLE CA 111 COLCHESTER AVENUE BURLINGTON VT 05401 455399218 ACCOUNTABLE C VT NA ADIRONDACKS ACO LLC 75 BEEKMAN STREET PLATTSBURGH NY 12901 462840926 ACCOUNTABLE C NY NA OBNET SERVICES LLC ONE MEDICAL CENTER DR LEBANON NH 03756 043746287 HEALTH RESEAR NH NA CHARITABLE IRREVOCABLE TRUST (7) SUPPORT VT UVMMCCVMC TRUST UNIV OF VT MED CTR HEALTH VENT INC 111 COLCHESTER AVE BURLINGTON VT 05401 043380045 HOLDING COMPA VT UVMMC C CORP VMC INDEMNITY COMPANY LTD PO BOX HM 3103 25 CHURCH ST HM F HAMILTON BD HM FX FR 999999999 CAPTIVE INSUR BD UVMMC C CORP VERMONT MANAGED CARE 111 COLCHESTER AVE BURLINGTON VT 05401 030333056 ADMIN SERVICE VT UVMMCHV C CORP CHARITABLE REMAINDER TRUST (5) SUPPORT VT UVMMCCVMC TRUST PERPETUAL TRUST (4) SUPPORT VT UVMMC TRUST CHAMPLAIN VALLEY HEALTH NETWORK 75 BEEKMAN STREET PLATTSBURGH NY 12901 161586102 ADMIN SERVICE NY NA C CORP MEDQUEST INC PO BOX 1656 PLATTSBURGH NY 12901 141663061 MED OFFICE LE NY NA C CORP false false true false false false false false true true true false true false true true true false true UNIVERSITY OF VERMONT MEDICAL CENTER IJMOQ 7500000 FMV PERPETUAL TRUSTS S 148657 FMV Schedule R, Part IV, Line 1 University of Vermont Medical Center, Inc. (UVM Medical Center) has a beneficial interest in four of these trusts. CVMC has a beneficial interest in three of these trusts. Schedule R, Part V, Transaction K UVM Medical Center leases and shares facilities, equipment, and other assets with CVMC. The value of these transactions is indeterminable.