2019-08-13T08:48:00-05:00 2018-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2017-10-01 030306549 Helen Porter Nursing Home Inc HELE 8023884701 115 Porter Drive Middlebury VT 05753 Jennifer Bertrand CFO 8023884701 2019-08-12 1 Barbara J McGuan CPA P00219457 2077752387 2019-08-12 69.49.157.66 2019-08-12 16:19:45 ED P E7B858A5D43A1C12EA56452E98FB06825C34A804 2822CCB165EE8EB222BC1A8C889357795F91400A 2017 2019-02-21 02:37:17Z Helen Porter Rehabilitation & Nursing Seleem Choudhury 115 Porter Drive Middlebury VT 05753 10166071 0 X www.portermedical.org X 1986 VT Operation of 98 bed skilled nursing home 16 13 203 35 0 0 6921 463960 9862116 9698273 433 -68464 0 0 9869470 10093769 0 0 0 0 8362796 7971592 0 0 0 3919923 3700778 12282719 11672370 -2413249 -1578601 2931569 3944285 6660339 6602648 -3728770 -2658363 X The mission of Helen Porter Rehabilitation and Nursing is to improve the health of our community, one patient at a time. 0 1 9072771 9698273 Operated long-term community oriented 98 bed skilled nursing home. The nursing home provided services to patients that totaled 31,530 resident days during the year ended 9/30/2018. 9072771 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 1 0 0 0 0 1 0 0 0 1 22 0 1 203 1 0 0 0 0 0 0 0 0 0 0 X 16 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 VT X Jennifer Bertrand 8023888878 115 Porter Drive Middlebury VT 05753 Kristofer Anderson MD Director 1.00 41.00 X 0 374707 21607 Judson Bartlett Director 1.00 2.00 X 0 0 0 John Brumsted MD CEO UVM Health Network 2.00 48.00 X 0 1813087 213890 Anne Collins Director 1.00 2.00 X 0 0 0 Sivan Cotel Vice-Chair 1.00 2.00 X X 0 0 0 Matthew Curran Director 1.00 2.00 X 0 0 0 Kim Downs-Burns Director 1.00 2.00 X 0 0 0 Richard Foote Director 1.00 2.00 X 0 0 0 Lewis Holmes MD Director 1.00 41.00 X 0 165274 4942 Stephen Koller MD Director 1.00 2.00 X 0 0 0 Linn Larson MD Interim Secretary 1.00 2.00 X X 0 0 0 Maureen McLaughlin Chairperson 1.00 4.00 X X 0 0 0 Cheryl Mullins Director 1.00 2.00 X 0 0 0 Linda Schiffer Director 1.00 2.00 X 0 0 0 Steve Terry Director 1.00 2.00 X 0 0 0 Bill Townsend Interim Treasurer 1.00 2.00 X X 0 0 0 Peter DeGraff Past Director 1.00 2.00 X 0 0 0 James Keyes Past Treasurer 1.00 2.00 X X 0 0 0 Kate McIntosh Past Director 1.00 2.00 X 0 0 0 Fred Kniffin MD CEO 1.00 41.00 X 0 401718 32114 Jennifer Bertrand CFO 1.00 41.00 X 0 211584 6308 Bruce Bodemer Nursing Home Administrator 40.00 0.00 X 106220 0 2605 Arlene Mathewson Unit RN 40.00 0.00 X 109386 0 29651 Michelle Wright Director of Nursing 40.00 0.00 X 105368 0 4212 James Daily Former President/CEO 0.00 X 0 374371 0 Lynn Boggs Former President/CEO 0.00 X 0 104763 0 320974 3445504 315329 3 1 1 0 Porter Medical Center Inc 115 Porter Drive Middlebury VT 05753 Management Services 846910 Porter Hospital 115 Porter Drive Middlebury VT 05753 Lab/Pharmacy/Radiology/Mgt. Svcs. 109581 2 463960 50419 463960 Patient Revenue 623000 12032870 12032870 Other Revenue 623000 5174 2232 2942 Provision for Bad Debts 623000 -46991 -46991 Contractual Allowances 623000 -2292780 -2292780 9698273 3838 3838 72302 -72302 -72302 -72302 10093769 9695331 0 -65522 6394211 5375953 1018258 252548 212331 40217 868235 729971 138264 456598 383886 72712 677311 677311 26375 26375 40344 40344 217362 217362 22405 22405 13306 13306 100650 100650 3971 3971 1044 1044 81025 81025 212209 212209 84786 84786 Medical Supplies 1641870 1641870 Medicaid Provider Tax 516551 516551 Miscellaneous Expense 45612 45612 Dues & Subscriptions 15957 15957 11672370 9072771 2599599 0 X 46784 157608 382667 573817 1157613 1078026 13536 17654 15798 13153 7280590 5198468 1218546 2082122 96625 21905 2931569 3944285 1263457 1608342 2853081 2729207 29946 23527 8095 2800 741973 741973 1763787 1496799 6660339 6602648 X -3766108 -2798735 37338 140372 -3728770 -2658363 2931569 3944285 X -1578601 2649008 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 2022 2022 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 4787930 4219667 568263 1172869 811575 361294 1319791 167226 1152565 2082122 Due to Affiliates 760219 Liability for Pension Benefits 611580 Estimated Third-Party Settlements 125000 1496799 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. 1 1 0 0 0 0 0 1 0 Kristofer Anderson MD Director 0 342789 0 31577 0 341 0 13500 0 8107 0 396314 0 0 John Brumsted MD CEO UVM Health Network 0 1023959 0 613889 0 175239 0 186643 0 27247 0 2026977 0 0 Lewis Holmes MD Director 0 160994 0 3732 0 548 0 4942 0 0 0 170216 0 0 Fred Kniffin MD CEO 0 365057 0 0 0 36661 0 13500 0 18614 0 433832 0 0 Jennifer Bertrand CFO 0 190273 0 20000 0 1311 0 6308 0 0 0 217892 0 0 James Daily Former President/CEO 0 0 0 0 0 374371 0 0 0 0 0 374371 0 374371 Lynn Boggs Former President/CEO 0 0 0 0 0 104763 0 0 0 0 0 104763 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, Lines 4a-b Lynn Boggs, former CEO, received $104,763 for severance compensation. James Daily, former President/CEO, received a payout of $374,371 from his 457(f) deferred compensation plan. Part I, Line 7 Kristofer Anderson, M.D. and Lewis Holmes, M.D. received bonuses which were based on their productivity and quality. Bruce Bodemer and Michelle Wright received bonuses for taking on additional administrative responsibilities. A Vermont Educational and Health Buildings Financing Agency 237154467 2015-08-01 3100000 Refunding 2000 Series A Bonds 0 0 0 A 370793 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 X 1 50419 FMV 0 0 0 Form 990, Part III, line 3 In September of 2018, the nursing home completed a renovation of its Post Acute Unit. To accommodate the renovation, several programatic changes occurred as a result: The total licensed bed count reduced from 105 beds to 98 beds, specifically the Memory Care Unit was reduced by 18 beds, the Post Acute Unit was increased by 7 beds, and the Long Term Care Unit was increased by 4 beds; a new rehab gym was created within the new Post Acute wing, which created specialized treatment areas; and two of the existing End of Life rooms were relocated and replaced by two new End of Life Suites with separate accommodations for families of the resident. 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 199,008. Equity Transfer from Affiliate 2,450,000. 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 Univ of Vermont Medical Group 111 Colchester Ave Burlington VT 05401 030225105 Physician Services VT 501(c)(3) Line 12a, I UVM HLTH Net 0 Univ of Vermont Med Group-New York 183 Park Street Malone NY 12953 203905216 Physician Services NY 501(c)(3) Line 3 UVMMG 0 Univ of Vermont Med CTR FDN Inc 111 Colchester Ave Burlington VT 05401 263159849 Fundraising VT 501(c)(3) Line 12a, I UVMMC 0 Univ of Vermont Medical Center 111 Colchester Ave Burlington VT 05401 030219309 Hospital VT 501(c)(3) Line 3 UVM HLTH Net 0 Central Vermont Medical Center 130 Fisher Road Berlin VT 05602 222547186 Hospital VT 501(c)(3) Line 3 UVM HLTH Net 0 Community Providers Inc 75 Beekman Street Plattsburgh NY 12901 222544844 Health Service Coordinator NY 501(c)(3) Line 12a, I UVM HLTH Net 0 Champlain Valley Phys Hospital 75 Beekman Street Plattsburgh NY 12901 141338471 Health Service Support NY 501(c)(3) Line 3 CPI 0 Elizabethtown Community Hospital 75 Park Street Elizabethtown NY 12932 141364513 Hospital NY 501(c)(3) Line 3 CPI 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 UVMMG 0 University Medical Education Associates 89 Beaumont Avenue Burlington VT 05401 237107832 Educational VT 501(c)(3) Line 10 UVMMG 0 Alice Hyde Medical Center 133 Park Street Malone NY 12953 150346515 Hospital NY 501(c)(3) Line 3 CPI 0 University of Vermont Med CTR Aux Inc 111 Colchester Ave Burlington VT 05401 208022004 Service VT 501(c)(3) Line 12c, III-FI N/A 0 University of Vermont Health Network - Home Health and Hospice 1110 Prim Road Colchester VT 05446 030179603 Health Service Support VT 501(c)(3) Line 3 UVM HLTH Net 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 Obnet Services LLC 1 Med Ctr Dr Lebanon NH 03766 043746287 Health Research NH UVMMC Related 0 0 UVMMC Health Ventures Inc 111 Colchester Ave Burlington VT 05401 043380045 Holding Company VT UVMMC C 0 VMC Indemnity Company LTD PO Box HM 3103 25 Church Street Hamilton HM FX BD Captive Insurance BD UVMMC C 0 Vermont Managed Care Inc 111 Colchester Ave Burlington VT 05401 030333056 Admin Services VT UVM HLTH VENT C 0 Charitable Remainder Trust (5) Support VT UVMMCCVMC T 0 Prepetural Trust (4) Support VT UVMMC T 0 Charitable Irrevocable Trust (7) Support VT CVMCUVMMC 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1