2018-08-13T09:11:57-05:00 2017-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2016-10-01 030179418 GIFFORD MEDICAL CENTER INC % JEFFREY HEBERT GIFF 8027284441 44 SOUTH MAIN STREET RANDOLPH VT 05060 DANIEL A BENNETT CEO 2018-01-03 true Brian D Todd P00422601 4178658701 2016 2022-09-23 18:48:47Z DANIEL A BENNETT 44 SOUTH MAIN STREET RANDOLPH VT 05060 62826208 false X WWW.GIFFORDMED.ORG X 1905 VT GIFFORD MEDICAL CENTER IS A NON-PROFIT ACUTE CARE HOSPITAL PROVIDING HEALTHCARE ON AN INPATIENT AND OUTPATIENT BASIS. 20 18 750 150 46638 -31690 1593845 626629 60024319 58621384 2500330 1007312 402123 406761 64520617 60662086 45913 57821 0 0 33104280 31636359 3855 0 105292 23942280 25155604 57096328 56849784 7424289 3812302 90124325 97671733 32078150 35824144 58046175 61847589 X AS A COMMUNITY HOSPITAL, GIFFORD MEDICAL CENTER'S MISSION IS TO IMPROVE AND MANAGE THE HEALTH OF THE PEOPLE WE SERVE BY PROVIDING AND ASSURING ACCESS TO AFFORDABLE, HIGH-QUALITY HEALTH CARE, AND BY PROMOTING THE HEALTH AND WELL-BEING OF EVERYONE IN OUR SERVICE AREA. false false 9592701 6414910 25 BED CRITICAL ACCESS HOSPITAL, HOSPITALISTS AND SKILLED NURSES PROVIDE 24 HOUR CARE TO HOSPITALIZED PATIENTS. CARE IS PROVIDED IN THREE NEIGHBORING UNITS: HOWELL PAVILION (A MEDICAL/SURGICAL UNIT), A TRANSITIONAL CARE UNIT (FOR PATIENTS NEEDING REHABILITATION OR SOMETIMES TRANSITIONING TO A NURSING HOME), AND OUR BIRTHING CENTER (WITH CERTIFIED MIDWIVES FOR LOW INTERVENTION BIRTHS, AND THE 24/7 BACK-UP SUPPORT OF FOUR OB/GYN PHYSICIANS). END-OF-LIFE CARE IS PROVIDED IN A SPECIAL GARDEN ROOM SUITE DESIGNED TO SUPPORT PATIENTS (AND THEIR FAMILIES) IN ADVANCED ILLNESS OR AT THE END OF LIFE. SERVICES FOR THESE PATIENTS ARE SUPPORTED BY THE HOSPITAL'S ANNUAL LAST MILE RIDE. 8951218 4166352 GIFFORD MEDICAL CENTER OFFERS A RANGE OF CLINICAL SERVICES AT ITS MAIN CAMPUS AND OUTLYING CLINICS. SPECIALTY SERVICES INCLUDE: ANESTHESIOLOGY, CARDIOLOGY, CHIROPRACTIC CARE, HOSPITALIST, NEUROLOGY, ONCOLOGY, ORTHOPEDICS, PATHOLOGY, PODIATRY, SPORTS MEDICINE, RADIOLOGY, REHABILITATIVE SERVICES, GENERAL SURGERY AND UROLOGY. 5566044 10449540 GIFFORD MEDICAL CENTER'S CARING AND KNOWLEDGEABLE SURGERY TEAM OFFERS GENERAL SURGERY SERVICES INCLUDING SKIN LESION AND CYST REMOVAL, COMPREHENSIVE BREAST CARE, DIAGNOSIS AND TREATMENT OF ALL FORMS OF CANCER, WOUND CARE, PILL ENDOSCOPY, COLONOSCOPIES AND APPENDIX REMOVAL. GENERAL SURGEONS PROVIDE A WIDE RANGE OF PROCEDURES (PRIMARILY FOCUSING ON THE ABDOMINAL ORGANS AS WELL AS DISEASES OF THE SKIN, BREAST, SOFT TISSUE AND HERNIAS) IN BOTH OFFICE AND OPERATING ROOM SETTINGS. 29163325 57821 37590582 53273288 true true false true false false false false false true true false false true true false false true false false false false false false true false true true true true true true false false false false false false false false false true false false false false false true false false false true X 155 2 true 750 true true true false false false false false false false false false X 20 18 false false true false true true false true true false false false true true true true true true false false X JEFFREY HEBERT 8027282356 P O BOX 2000 RANDOLPH VT 05060 X BERTON WHITAKER INTERIM CEO END 10/16 40.0 0.0 X X 160000 0 0 MATT CONSIDINE CHAIR BEG 04/17 1.0 0.0 X X 0 0 0 LINCOLN CLARK VICE CHAIR BEG 04/17 1.0 2.0 X X 0 0 0 BARBARA ROCHAT SECRETARY 1.0 2.0 X X 0 0 0 JODY DAVIGNON TREASURER BEG 04/17 1.0 0.0 X X 0 0 0 AUGUST MEYER CHAIR END 12/16/DIRECTOR 1.0 2.0 X X 0 0 0 PETER NOWLAN CHAIR END 04/17/DIRECTOR 1.0 2.0 X X 0 0 0 BOB WRIGHT DIRECTOR 2.0 1.0 X 0 0 0 TODD WINSLOW DIRECTOR 2.0 1.0 X 0 0 0 SUE SYTSMA DIRECTOR 2.0 1.0 X 0 0 0 CLAY WESTBROOK DIRECTOR 2.0 1.0 X 0 0 0 SUE SHERMAN DIRECTOR 2.0 1.0 X 0 0 0 CAROL BUSHEY DIRECTOR 2.0 1.0 X 0 0 0 SHEILA JACOBS DIRECTOR 2.0 1.0 X 0 0 0 PETER REED DIRECTOR 2.0 2.0 X 0 0 0 JOSEPH PELLETIER DIRECTOR/MED STAFF PRESIDENT 40.0 1.0 X 199026 0 37880 DANIEL BENNETT CEO 40.0 2.0 X X 89453 0 6801 PAUL KENDALL DIRECTOR END 03/17 1.0 2.0 X 0 0 0 BRADFORD ATWOOD DIRECTOR BEG 05/17 1.0 2.0 X 0 0 0 JOAN GOLDSTEIN DIRECTOR BEG 05/17 1.0 2.0 X 0 0 0 BEN JICKLING DIRECTOR BEG 05/17 1.0 2.0 X 0 0 0 THERON MANNING DIRECTOR BEG 05/17 1.0 2.0 X 0 0 0 JEFFREY HEBERT CFO 40.0 0.0 X 182404 0 9799 STEPHANIE LANDVATER ORTHOPEDIC SURGEON 40.0 0.0 X 592721 0 49516 KENYATTA NORMAN ORTHOPEDIC SURGEON 40.0 0.0 X 457719 0 37808 RICHARD GRAHAM UROLOGIST 40.0 0.0 X 448637 0 50765 ALAN ERICKSEN RADIOLOGIST 40.0 0.0 X 387976 0 25703 JEFFREY BATH RADIOLOGIST 40.0 0.0 X 384218 0 45717 JOSEPH WOODIN PRESIDENT & CEO END 4/16 0.0 0.0 X 260404 0 18418 3162558 0 282407 61 true true false NEAGLEY CHASE CONSTRUCTION COMPAN 66 BOWDOIN STREET SOUTH BURLINGTON VT 05407 BUILDING CONTRACTOR 9224627 WEATHERBY LOCUMS P O BOX 972633 DALLAS TX 753972633 CONTRACTED SERVICES 1054505 ALLIANCE HEALTHCARE SERVICES P O BOX 96485 CHICAGO IL 606936485 MRI SERVICES 483763 NEW ENGLAND AIR SYSTEMS P O BOX 525 WILLISTON VT 05495 CONTRACTED SERVICE 470833 H P CUMMINGS CONSTRUCTION INC 5 HIGH STREET WOODSVILLE NH 03785 BUILDING CONTRACTOR 450627 20 79572 19894 527163 626629 NET PATIENT SERVICE REVENUE 624100 57211522 57211522 PHARMACY REVENUE 446110 675888 675888 DAYCARE REVENUE 812900 327190 280552 46638 CAFETERIA REVENUE 722514 302298 302298 OTHER REVENUE 624100 104486 104486 58621384 786650 786650 0 0 468684 68258 400426 0 400426 400426 2075156 218835 1884856 188473 190300 30362 220662 220662 28870 79572 22535 6335 6335 0 0 0 0 0 0 0 60662086 58574746 46638 1414073 X 7385 7385 50436 50436 0 0 685363 118453 566910 278822 278822 24317496 23422803 836713 57980 1022080 977374 42284 2422 3914447 3677980 227367 9100 1418151 1323276 91613 3262 0 272456 272456 78752 78752 0 0 162672 162672 5983369 5583081 386526 13762 26122 24375 1687 60 1497091 1395428 98168 3495 0 0 714186 666407 46136 1643 226571 211414 14636 521 0 164962 153926 10657 379 794321 741181 51313 1827 0 3333791 3110760 215363 7668 419844 391756 27122 966 MEDICAL SUPPLIES & DRUGS 4510285 4510285 PROVIDER TAXES 3164988 3164988 BAD DEBT 2904150 2904150 LICENSES, DUES, SUBSCRIPTIONS 355792 331990 22984 818 546252 505840 39023 1389 56849784 53273288 3471204 105292 64633 69368 4927902 3362779 603856 388725 7990129 8499336 0 0 0 0 0 0 1294649 1368956 1197555 1395466 83243574 43914362 40630138 39329212 28824402 36167471 0 0 0 0 9198 5788 4581863 7084632 90124325 97671733 6937892 13134664 0 0 502983 491741 19743007 19108013 0 0 0 0 383511 372691 0 0 4510757 2717035 32078150 35824144 X 55677340 59732292 1119972 705719 1248863 1409578 58046175 61847589 90124325 97671733 X 3812302 2172389 -2183277 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11554 11554 false SCHEDULE C, PART II-B, LINE 1I OTHER LOBBYING ACTIVITIES: GIFFORD MEDICAL CENTER, INC. IS A MEMBER OF THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS, THE BI-STATE PRIMARY CARE ASSOCIATION, AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS AVAILABLE FOR LOBBYING EXPENDITURES ON BEHALF OF GIFFORD MEDICAL CENTER AND THE OTHER MEMBER ORGANIZATIONS IN FURTHERANCE OF THEIR EXEMPT PURPOSES. GIFFORD MEDICAL CENTER DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. A PORTION OF THESE DUES HAVE BEEN ALLOCATED TO RELATED ORGANIZATIONS GIFFORD RETIREMENT COMMUNITY, INC. AND GIFFORD HEALTH CARE, INC. THESE ALLOCATED AMOUNTS ARE SHOWN ON THEIR RESPECTIVE SCHEDULE C. 8082089 275402 8357491 7276399 805690 8082089 6292507 462077 521815 7276399 5709055 583452 6292507 4319608 1173313 216134 5709055 0.79150 0.16870 0.03980 true false 0 790516 790516 38464185 17020279 21443906 281167 219147 62020 38230248 24429611 13800637 5477458 2245325 3232133 39329212 OTHER RECEIVABLES 100578 DUE FROM AFFILIATES 6412116 EST AMT DUE FROM THIRD PARTY 500000 BENEFICIAL INT IN TRUST 71938 7084632 0 EST AMT DUE TO THIRD PARTY 319554 INTEREST RATE SWAP AGREEMENT 2508065 2717035 60722440 2172389 -1797908 374481 60347959 314127 314127 60662086 53557888 22535 22535 53535353 162672 3151759 3314431 56849784 SCHEDULE D, PART V USE OF ENDOWMENT FUNDS: THE TEMPORARILY RESTRICTED ENDOWMENT NET ASSETS ARE USED FOR HEALTH CARE SERVICES AND CAPITAL. THE PERMANENTLY RESTRICTED ENDOWMENT NET ASSETS ARE USED FOR INDIGENT CARE, COMMUNITY OUTREACH INITIATIVES, NURSING, BUILDINGS, MAINTENANCE AND OPERATIONS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 1,370,906 CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT (2,904,150) BAD DEBT EXPENSE ( 162,672) INVESTMENT MANAGEMENT FEES ( 247,609) EXPENSES INCLUDED IN REVENUE 145,617 NET ASSETS RELEASED FROM RESTRICTION ------------ $(1,797,908) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $( 22,535) FUNDRAISING EVENT EXPENSES 175,947 TEMPORARILY RESTRICTED CONTRIBUTIONS 160,715 PERMANENTLY RESTRICTED CONTRIBUTIONS ---------- $ 314,127 SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 22,535 FUNDRAISING EVENT EXPENSES SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 2,904,150 BAD DEBT EXPENSE 247,609 EXPENSES INCLUDED IN REVENUE ----------- $ 3,151,759 LAST MILE RIDE 108442 79572 28870 2874 19661 0 108442 79572 28870 2874 19661 22535 6335 true true X true X 225. true X true true false false 193192 193192 0.00360 11241718 9017754 2223964 0.04130 11434910 9017754 2417156 0.04490 885261 513778 371483 0.00690 74245 9157 65088 0.00120 4900267 4430696 469571 0.00870 7385 7385 0.00010 5867158 4953631 913527 0.01690 17302068 13971385 3330683 0.06180 138626 51053 87573 0.00160 138626 51053 87573 0.00160 true 2904150 296342 18472814 18621026 -148212 X true true 1 1 GIFFORD MEDICAL CENTER INC P O BOX 2000 RANDOLPH VT 05060 WWW.GIFFORDHEALTHCARE.ORG 829 X X X X GIFFORD MEDICAL CENTER INC 1 false false true X X X X X X X X X 14 true false false true X SEE PART V, SECTION C X true 14 true SEE PART V, SECTION C false true X 225. 300. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE 2015 SURVEY FORM WAS REVIEWED AND MINOR REVISIONS WERE MADE FOR 2017-2018. TO REACH A BROADER DEMOGRAPHIC SAMPLE, THE SURVEY WAS ADMINISTERED ONLINE THROUGH SURVEY MONKEY AND A LINK WAS DISTRIBUTED VIA EMAIL AND FACEBOOK TO REACH STAFF AND COMMUNITY MEMBERS. THE SURVEY WAS ALSO SHARED ON FRONT PORCH FORUM, A SOCIAL NETWORKING SITE DESIGNED TO CONNECT PEOPLE WITH OTHERS IN THEIR NEIGHBORHOODS. MEMBERS OF THE RANDOLPH EXECUTIVE COMMUNITY COUNCIL WERE PROVIDED WITH PAPER COPIES TO DISTRIBUTE TO CLIENTS EITHER DIRECTLY OR BY PLACING THEM IN AGENCY WAITING ROOMS. COMMUNITY HEALTH TEAM (BLUEPRINT) PARTNER AGENCIES WERE ALSO ASKED TO DISTRIBUTE PRINTED COPIES, AND PRINTED COPIES WERE PUT IN ALL OF GIFFORD PRIMARY CARE CLINICS. SCHEDULE H, PART V, SECTION B, LINE 7A CHNA WEBSITE: https://giffordhealthcare.org/ABOUT-US/COMMUNITY-REPORTS/ SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: GIFFORD'S MISSION IS TO PROVIDE ACCESSIBLE, QUALITY LOCAL HEALTH CARE TO EVERY PERSON WHO WALKS THROUGH OUR DOORS. IN 2015, AS PART OF THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT, WE PERFORMED A COMMUNITY HEALTHCARE NEEDS ASSESSMENT IN PART THROUGH SURVEYING COMMUNITY MEMBERS IN MULTIPLE AREA TOWNS. IN 2016, THIS ASSESSMENT WAS REVIEWED AND MODIFIED AS REQUIRED BY THE FEDERAL MANDATE. GIFFORD HAS STRATEGICALLY WORKED TO ADDRESS THE COMMUNITY'S NEED WITHIN ITS ROLE AS A HEALTH CARE PROVIDER. AREAS INITIALLY IDENTIFIED AS HEALTH PROBLEMS INCLUDE: PREVENTATIVE HEALTH /ACCESS TO HEALTH CARE, SUBSTANCE ABUSE COUNSELING, OBESITY, AND DENTAL CARE. THIS UPDATE OUTLINES AREAS OF ONGOING FOCUS IN 2016: PREVENTATIVE HEALTHCARE/ACCESS TO HEALTHCARE: TO FACILITATE AN INCREASED FOCUS ON PREVENTATIVE HEALTH CARE AND IMPROVE ACCESS TO CARE, GIFFORD HAS IMPLEMENTED A NEW PRIMARY CARE TEAM MODEL THAT PAIRS A PHYSICIAN WITH NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS WHO ARE SPECIALLY TRAINED TO HELP PATIENTS WITH PREVENTATIVE AND PRIMARY CARE. SUBSTANCE ABUSE COUNSELING: AS A FEDERALLY QUALIFIED HEALTH CENTER GIFFORD'S BEHAVIORAL HEALTH AND BLUEPRINT FOR HEALTH TEAM SPECIALISTS OFFER COUNSELING AND ONE-ON-ONE PATIENT CARE AT ALL GIFFORD PRIMARY CARE LOCATIONS. A NEWLY-CREATED ADDICTION MEDICINE PROGRAM, FULLY STAFFED WITH A BOARD-CERTIFIED PSYCHIATRIST CERTIFIED IN ADDICTION MEDICINE, AND A LICENSED ALCOHOL AND DRUG COUNSELOR, OFFERS ONGOING SUBOXONE TREATMENT FOR PATIENTS WITH COMPLEX NEEDS, SUBOXONE PROVIDER SUPPORT, EDUCATION, CONSULTATION, AND THERAPY TO HELP PATIENTS REBUILD LIVES DAMAGED BY OPIOID USE DISORDER. OBESITY: GIFFORD'S PRIMARY CARE TEAM HAS LONG BEEN A PROPONENT OF HEALTHY LIFESTYLE CHOICES FOR GOOD HEALTH AND THE PREVENTION OF DISEASE AND OBESITY. BMIS ARE DETERMINED AT ANNUAL HEALTH SCREENINGS AND PATIENTS ARE GUIDED BY PROVIDERS AND GIFFORD'S REGISTERED DIETITIANS ON HEALTHY DIETS AND PORTION CONTROL. DISCUSSIONS IN SUPPORT GROUP SETTINGS (SUCH AS DIABETES AND OTHER CHRONIC CONDITIONS) OFTEN FOCUS ON HEALTHY CHOICES TO REDUCE AND PREVENT DISEASE. PATIENTS ARE STRONGLY ENCOURAGED TO BE PHYSICALLY ACTIVE. DENTAL CARE: GIFFORD'S FEDERALLY QUALIFIED HEALTH CENTER DESIGNATION HAS BROUGHT RESOURCES THAT HELP US SUPPORT LOCAL DENTISTS AS THEY STRIVE TO BETTER CARE FOR THE UNDERSERVED AND UNINSURED. TO INCREASE AWARENESS OF DENTAL HEALTH, WE HAVE OFFERED FREE MEDICAL AND DENTAL HEALTH SCREENINGS AND DISTRIBUTED INFORMATION ABOUT COMMUNITY RESOURCES THAT CAN HELP WITH ACCESS TO DENTAL CARE. GIFFORD IS NOW PARTNERING WITH TWO DENTISTS TO PROVIDE NEEDED DENTAL CARE. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C FAP, FAP APPLICATION, AND PLS WEBSITE: HTTPS://GIFFORDHEALTHCARE.ORG/SERVICE/AFFORDABLE-CARE-PROGRAM/ SCHEDULE H, PART V, LINE 16I MEASURES TO PUBLICIZE THE POLICY: GIFFORD MEDICAL CENTER CONTACTS ANY UNINSURED PATIENTS THAT WILL REGISTER WITH THE HOSPITAL TO SEE IF THEY ARE IN NEED OF FINANCIAL ASSISTANCE. 7 GIFFORD HEALTH CARE AT BERLIN 82 EAST VIEW LANE BERLIN VT 05641 RURAL HEALTH CENTER ADVANCE PHYSICAL THERAPY 331 OLCOTT DRIVE WHITE RIVER JUNCTION VT 05001 RURAL HEALTH CENTER BETHEL HEALTH CENTER 1823 ROUTE 107 BETHEL VT 05032 RURAL HEALTH CENTER KINGWOOD HEALTH CENTER 1422 ROUTE 66 RANDOLPH VT 05060 RURAL HEALTH CENTER SHARON HEALTH CENTER 12 SHIPPEE LANE SHARON VT 05065 RURAL HEALTH CENTER TWIN RIVER HEALTH CENTER 108 N MAIN STREET WHITE RIVER JUNCTION VT 05001 RURAL HEALTH CENTER PROJECT INDEPENDENCE 81 N MAIN STREET SUITE 1 BARRE VT 05641 RURAL HEALTH CENTER SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE OF $2,904,150. SCHEDULE H, PART I, LINE 7G SUBSIDIZED SERVICES: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHS) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM RHCS OF $337,757. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. GIFFORD MEDICAL CENTER CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1 AND 6. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: INCLUDED IN PART II AS COMMUNITY BUILDING ACTIVITIES ARE LOCAL HIGH SCHOOL LECTURES, JOB SHADOWING, AND AFTER SCHOOL PROGRAMS. THESE ACTIVITIES PROVIDE OPPORTUNITIES TO ADDRESS THE ROOT CAUSE OF HEALTH PROBLEMS, INCLUDING POVERTY, HOMELESS, AND UNEMPLOYMENT. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE ORGANIZATION CALCULATED BAD DEBT USING THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAY SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: THE APPLICATION FOR AND APPROVAL OF FINANCIAL ASSISTANCE CAN OCCUR BEFORE, DURING OR AFTER TREATMENT SO LONG AS THE ACCOUNT HAS NOT BEEN WRITTEN OFF TO BAD DEBT PRIOR TO RECEIPT OF A COMPLETED APPLICATION AND THE NECESSARY DOCUMENTATION. ACCOUNTS SENT TO BAD DEBT AFTER REQUIRED INFORMATION HAS BEEN RECEIVED CAN BE RETURNED FROM COLLECTIONS FOR PROCESSING WITHOUT PENALTY TO THE APPLICANT. GIFFORD MEDICAL CENTER, INC., ENCOURAGES THE APPLICATION PROCESS TO BEGIN AS EARLY AS POSSIBLE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: IDENTIFYING AND MEETING THE COMMUNITY'S HEALTH CARE NEEDS WOULD NOT BE POSSIBLE WITHOUT INPUT FROM THE PUBLIC. GIFFORD MEDICAL CENTER PROVIDES AMPLE OPPORTUNITIES FOR THE PUBLIC TO PROVIDE BOTH INPUT AND ACTIVELY PARTICIPATE IN MEDICAL CENTER ACTIVITIES. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, ANNUAL HOSPITAL REPORT CARD MEETINGS, PATIENT SATISFACTION SURVEYS AND ONE-ON-ONE COMMENTS TO HOSPITAL STAFF AND BOARD MEMBERS HELP DIRECT STRATEGIC PLANNING AND OPERATIONAL DECISIONS. EVERY THREE YEARS, GIFFORD ENGAGES IN AN EXTENSIVE STRATEGIC PLANNING PROCESS THAT RESULTS IN THE IDENTIFICATION AND IMPLEMENTATION OF A LIST OF INITIATIVES THE HOSPITAL STRIVES TO ACHIEVE OVER THE COMING THREE YEARS. SUCCESS AT ACHIEVING THOSE INITIATIVES THROUGHOUT, AND BY THE CONCLUSION OF THE THREE-YEAR PERIOD IS EXTENSIVELY MONITORED BY THE HOSPITAL'S LEADERS, INCLUDING ITS VOLUNTEER BOARD OF TRUSTEES. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PATIENTS ARE ADVISED OF COMMUNITY OUTREACH AND ARE ENCOURAGED TO SET UP AN APPOINTMENT TO MEET WITH THE APPROPRIATE GIFFORD MEDICAL CENTER PERSONNEL. THE PATIENTS ARE ALSO DIRECTED TO GMC'S WEBSITE FOR AN EXPLANATION OF THE FREE CARE POLICY PROCESS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: IN ADDITION TO THE CLINICAL OFFICES LOCATED ON THE ORGANIZATION'S MAIN CAMPUS IN RANDOLPH, VERMONT, THE ORGANIZATION OPERATES COMMUNITY HEALTH CARE CENTERS LOCATED IN SHARON, BERLIN, BETHEL, RANDOLPH, AND WHITE RIVER JUNCTION, VERMONT. THE RANDOLPH/BAINTREE AREA PROVIDES THE MOST VISITS AND IS LOCATED IN ORANGE COUNTY, VERMONT. ORANGE COUNTY DEMOGRAPHICS SHOW APPROXIMATELY 20.2% OVER THE AGE OF 65 AND 18.7% UNDER 18 YEARS. OVER 96% ARE WHITE, WITH 49.8% FEMALE. THE AVERAGE HOUSEHOLD INCOME IS $54,263 WITH THE POVERTY LEVEL AT 10.6%, COMPARED TO THE STATE'S 12.7%. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: AS A COMMUNITY HOSPITAL, GIFFORD MEDICAL CENTER'S MISSION TO IMPROVE THE HEALTH OF THE PEOPLE BY PROVIDING AND ASSURING ACCESS TO AFFORDABLE AND HIGH QUALITY HEALTH CARE, AND BY PROMOTING THE HEALTH AND WELLBEING OF EVERYONE IN OUR SERVICE AREA. WE OFFER DIAGNOSTIC TECHNOLOGIES THAT INCLUDE A 64- SLICE CT SCANNER, A MOBILE MRI UNIT, A FILMLESS RADIOLOGY SYSTEM, 3D MAMMOGRAPHY AND STEREOTACTIC BREAST BIOPSIES. OUR 25-BED CRITICAL ACCESS HOSPITAL HAS A BIRTHING CENTER THAT IS RECOGNIZED AROUND THE STATE. WE HAVE A 24-HOUR EMERGENCY DEPARTMENT, A CHILDCARE CENTER, AN ADULT DAY PROGRAM AND SO MUCH MORE. THE FOLLOWING ARE THE ACTIVITIES FOR 2017: - UPPER VALLEY NEUROLOGY AND NEUROSURGERY SPECIALISTS IN LEBANON, NH OPENED AN OFFICE IN THE KINGWOOD HEALTH CENTER OFFERING PATIENTS CONSULTATION VISITS AND SURGICAL TREATMENTS LOCALLY AT GIFFORD MEDICAL CENTER - GIFFORD HEALTH CARE AT BERLIN IS NOW OFFERING SERVICES IN TWO FACILITIES. THE CURRENT SPACE WAS RENOVATED TO INCLUDE ENHANCED LAB, X-RAY AND DIAGNOSTIC TECHNOLOGY SERVICES AND A FULLY EQUIPPED SPACE FOR PHYSICAL THERAPY SERVICES. - THE VISION FOR THE FUTURE CAMPAIGN, THE LARGEST CAPITAL CAMPAIGN IN GIFFORD'S 113 YEAR HISTORY CLOSED IN JULY AFTER RAISING NEARLY $4.6 MILLION. - THE BIRTHING CENTER OPENED ON JUNE 23RD AND SOON AFTER WELCOMED THREE NEW BABIES AND THEIR FAMILIES INTO A BEAUTIFUL NEW REMODELED SPACE AT THE HOSPITAL. NEW FEATURES INCLUDE A LARGE TUB ROOM WITH SPA-LIKE COMFORTS FOR THOSE CHOOSING HYDROTHERAPY OR WATER BIRTHS, A FULLY-EQUIPPED MODERN NURSERY FOR INFANTS NEEDING EXTRA CARE. - IN AUGUST, DAN BENNETT WAS NAMED PRESIDENT AND CEO WITH A STARTING DATE OF OCTOBER 3RD. - THE LAST MILE RIDE RAISED MORE THAN $102,000 FOR END OF LIFE CARE AND INCREASED PARTICIPATION BY 20%. - THE GIFFORD MEDICAL CENTER AUXILIARY WAS HONORED BY THE ASSOCIATION FOR FUNDRAISING PROFESSIONALS WITH THE NORTHERN NEW ENGLAND CHAPTER'S 2016 OUTSTANDING VOLUNTEER FUNDRAISER. - GIFFORD PERFORMED BETTER THAN 85% OF SIMILAR FACILITIES NATIONWIDE IN A 2015 SURVEY ON INFANT FEEDING PRACTICES IN MATERNITY CARE SETTINGS. GIFFORD SCORED 92 OF 100 POINTS ON MATERNITY PRACTICES IN THE INFANT NUTRITION AND CARE SURVEY. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE GIFFORD HEALTH CARE SYSTEM INCLUDES GIFFORD HEALTH CARE, INC. (GHC), GIFFORD MEDICAL CENTER, INC. (GMC), AND GIFFORD RETIREMENT COMMUNITY, INC. (GRC). GHC IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). GIFFORD MEDICAL CENTER, INC. IS A 25-BED CRITICAL ACCESS HOSPITAL (CAH) PROVIDING GENERAL AND SPECIALTY SERVICES. GIFFORD RETIREMENT COMMUNITY, INC. HAS A 30-BED NURSING HOME UNIT. true STAGECOACH TRANSPORTATION SERVICES INC DEPOT SQUARE PO BOX 356 RANDOLPH VT 05060 030276517 501(C)(3) 7385 COMMUNITY BENEFIT 1 PATIENT GRANTS 67 50436 SCHEDULE I, PART I, LINE 2 MONITORING GRANT FUNDS: THE ORGANIZATION PROVIDES GRANTS TO PATIENTS USING THE RESULTS OF THE LAST MILE RIDE SPECIAL FUNDRAISING EVENT. THE GRANTS ASSIST PATIENTS AND THEIR FAMILIES WITH END OF LIFE CARE AND PLANNING. MULTIPLE COMMITTEES REVIEW GRANT REQUESTS AND THE BOARD REVIEWS DISTRIBUTIONS. THE ORGANIZATION GRANTED FUNDS TO STAGECOACH TRANSPORTATION SERVICES TO SUPPORT THEIR OPERATIONS. GMC'S PATIENTS USE THE TRANSPORTATION SERVICES PROVIDED BY STAGECOACH SO GMC HAS A CLOSE RELATIONSHIP AND CAN MONITOR THE USE OF FUNDS BY OBSERVING SERVICES OFFERED IN THE COMMUNITY. X X X X X X false false false false false false false true false BERTON WHITAKER INTERIM CEO END 10/16 160000 0 0 0 0 0 0 0 0 0 160000 0 0 0 JEFFREY HEBERT CFO 175302 0 0 0 7102 0 9109 0 690 0 192203 0 0 0 JOSEPH PELLETIER DIRECTOR/MED STAFF PRESIDENT 160301 0 38725 0 0 0 10404 0 27476 0 236906 0 0 0 JOSEPH WOODIN PRESIDENT & CEO END 4/16 157274 0 40000 0 63130 0 11430 0 6988 0 278822 0 0 0 STEPHANIE LANDVATER ORTHOPEDIC SURGEON 536191 0 38530 0 18000 0 13250 0 36266 0 642237 0 0 0 KENYATTA NORMAN ORTHOPEDIC SURGEON 436735 0 20984 0 0 0 13250 0 24558 0 495527 0 0 0 RICHARD GRAHAM UROLOGIST 405637 0 25000 0 18000 0 13250 0 37515 0 499402 0 0 0 ALAN ERICKSEN RADIOLOGIST 362976 0 25000 0 0 0 9615 0 16088 0 413679 0 0 0 JEFFREY BATH RADIOLOGIST 341218 0 25000 0 18000 0 13250 0 32467 0 429935 0 0 0 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: GIFFORD MAINTAINS FINANCIAL INCENTIVES FOR PROVIDERS. PROVIDER INCENTIVES INCORPORATE PRODUCTIVITY, CITIZENSHIP (CONTRIBUTION TO HOSPITAL AND COMMUNITY ACTIVITIES) AND RETENTION. GIFFORD'S PRODUCTIVITY MEASURES ARE DESIGNED TO ENSURE THAT ALL PROVIDERS ACHIEVE A STANDARD LEVEL OF PRODUCTIVITY. GIFFORD ALSO HAS AN EMPLOYEE REFERRAL PROGRAM. THE EMPLOYEE RECEIVES COMPENSATION FOR THE SUCCESSFUL HIRE OF A QUALIFIED CANDIDATE. A VERMONT EDUCATION & HEALTH BUILDING FINANCING AG 237154467 2014-12-17 20840000 TO FINANCE GIFFORD'S CAPITAL PROJE false false false A 0 0 20840000 0 0 18654218 185782 0 0 2000000 0 0 2014 true false true true A false false false false 0 false false false true A false false true false true false 0 false 0 false false A true MAGEE OFFICE SUPPLIES SEE PART V 168757 PURCHASED SUPPLIES false SCHEDULE L, PART IV, LINE 1, COLUMN B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: TODD WINSLOW, A DIRECTOR, IS 50% OWNER OF MAGEE OFFICE SUPPLIES. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICE ACCOMPLISHMENTS: GIFFORD MEDICAL CENTER OFFERS VARIOUS OTHER HEALTH CARE SERVICES TO THE CENTRAL VERMONT AREA. OTHER SERVICES AVAILABLE INCLUDE ANESTHESIOLOGY, RADIOLOGY, LABORATORY, RESPIRATORY THERAPY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH PATHOLOGY, ELECTROCARDIOLOGY, CHEMOTHERAPY, EMERGENCY, SKILLED NURSING, LABOR AND DELIVERY, NURSERY, RADIOISOTOPE, AND ELECTROENCEPHALOGRAPHY. FORM 990, PART V, LINE 2A W-2'S FILED: GIFFORD MEDICAL CENTER ALSO FILES W-2'S FOR ITS RELATED ORGANIZATIONS, GIFFORD HEALTH CARE, INC. (GHC) AND GIFFORD RETIREMENT COMMUNITY, INC. (GRC). THE TOTAL NUMBER OF W-2'S FILED INCLUDES THESE W-2'S. THE COMPENSATION, EMPLOYEE BENEFITS AND PAYROLL TAXES AMOUNTS ARE THEN ALLOCATED TO GHC AND GRC FOR THE AMOUNTS THAT REPRESENT WORK PERFORMED FOR THOSE ORGANIZATIONS. THEREFORE, THE AMOUNT REPORTED ON PART IX INCLUDES ONLY THOSE AMOUNTS ALLOCATED TO WORK PERFORMED DIRECTLY FOR GIFFORD MEDICAL CENTER. THE HIGHEST PAID EMPLOYEES ARE DETERMINED BY THE WORK PERFORMED FOR EACH ORGANIZATION. THEREFORE, THE FIVE HIGHEST PAID EMPLOYEES LISTED ON PART VII AND SCHEDULE J ARE THOSE EMPLOYEES WHO WORK DIRECTLY FOR GIFFORD MEDICAL CENTER, INC. IN ADDITION, BERTON WHITAKER AND DANIEL BENNETT SERVED AS CEO AND JEFFREY HERBERT SERVED AS CFO OVER GIFFORD MEDICAL CENTER, GIFFORD HEALTH CARE, AND GIFFORD RETIREMENT COMMUNITY. THEIR COMPENSATION HAS BEEN SHOWN IN PART VIII AS PAID BY GIFFORD MEDICAL CENTER ONLY, ALTHOUGH THEIR TIME SPENT IS ATTRIBUTABLE TO ALL THREE ENTITIES. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES IN GOVERNING DOCUMENTS: DURING FISCAL YEAR 2017, GMC AMENDED ITS BYLAWS TO INCLUDE THE FOLLOWING SIGNIFICANT CHANGES: -MEMBERS 3.1 GMC SHALL HAVE NO MEMBERS - BOARD OF TRUSTEES 4.3 COMPOSITION THE BOARD OF GMC SHALL BE COMPOSED OF ELECTED AND EX OFFICIO TRUSTEES. (A) ELECTED TRUSTEES: THE ELECTED MEMBERS OF THE GHC BOARD OF DIRECTORS SHALL BE MEMBERS OF THE GIFFORD MEDICAL CENTER BOARD OF TRUSTEES WITH THE POWER TO VOTE. UP TO FIVE (5) ADDITIONAL TRUSTEES MAY BE ELECTED. (B) USER TRUSTEES: AT LEAST 51% OF THE TRUSTEES SHALL BE INDIVIDUALS WHO ARE ACTIVE USERS OF GMC OR GHC'S SERVICES AND WHO, AS A GROUP, REPRESENT THE INDIVIDUALS BEING SERVED IN TERMS OF DEMOGRAPHIC FACTORS, SUCH AS RACE, ETHNICITY, AND SEX. THESE TRUSTEES SHALL USE GHC AS THEIR PRINCIPAL SOURCE OF PRIMARY MEDICAL CARE SERVICES AND SHALL HAVE USED GMC'S OR GHC'S SERVICE AREA. A LEGAL GUARDIAN OF A USER WHO IS A DEPENDENT CHILD OR ADULT, OR A LEGAL SPONSOR OF A USER WHO IS AN IMMIGRANT, MAY BE CONSIDERED A USER FOR BOARD COMPOSITION PURPOSES. (C) NON-USER TRUSTEES: TRUSTEES WHO ARE NOT DESCRIBED IN SUBSECTION (B) (I.E., ARE NOT ACTIVE USERS OF GMC'S OR GHC'S SERVICES) SHALL BE REPRESENTATIVE OF THE COMMUNITY SERVED BY GMC AND GHC AND SHALL BE SELECTED FOR THEIR EXPERTISE IN COMMUNITY AFFAIRS, LOCAL GOVERNMENT, FINANCE AND BANKING, LEGAL AFFAIRS, TRADE UNIONS, OTHER COMMERCIAL AND INDUSTRIAL CONCERNS, OR SOCIAL SERVICE AGENCIES WITHIN THE SERVICE COMMUNITY. THE TRUSTEES DESCRIBED IN THIS SUBSECTION MUST LIVE OR WORK IN GMC'S SERVICE AREA. NO MORE THAN FIFTY PERCENT (50%) OF THE NON-USER TRUSTEES DESCRIBED IN THIS SUBSECTION MAY BE INDIVIDUALS WHO DERIVE MORE THAN TEN PERCENT (10%) OF THEIR ANNUAL INCOME FROM THE HEALTH CARE INDUSTRY. (D) PERSONS PROHIBITED FROM SERVING AS TRUSTEES EXCEPT AS PROVIDED IN SUBSECTION (E) (EX OFFICIO TRUSTEES), NO EMPLOYEE OF GMC OR GHC MAY SERVE AS A TRUSTEE. (E) EX OFFICIO TRUSTEE THE FOLLOWING TWO (2) INDIVIDUALS SHALL SERVE AS TRUSTEES EX OFFICIO WITH THE POWER TO VOTE: I. THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION II. THE PRESIDENT OF THE MEDICAL STAFF FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B ORGANIZATION'S MEMBERS: THE MEMBERSHIP OF THE ORGANIZATION CONSISTS OF THOSE PERSONS SERVING AS CORPORATORS. TO BE ELIGIBLE TO SERVE AS A CORPORATOR, AN INDIVIDUAL MUST SUPPORT THE MISSION AND PURPOSES OF THE ORGANIZATION. CORPORATORS ARE NOMINATED BY THE NOMINATING COMMITTEE AND ELECTED BY MAJORITY VOTE OF THE CORPORATORS PRESENT AT THE ANNUAL MEETING OF THE CORPORATORS, AND SERVE A TERM OF THREE YEARS. THE CORPORATORS SHALL ELECT A MINORITY OF THE TRUSTEES OF THE ORGANIZATION, WHO MANAGE AND CONDUCT THE AFFAIRS OF THE ORGANIZATION. THE CORPORATORS MAKE NO OTHER GOVERNANCE DECISIONS FOR THE ORGANIZATION, NOR ARE THE DECISION OF THE BOARD OF TRUSTEES SUBJECT TO APPROVAL BY THE CORPORATORS. ADDITIONALLY, THE BOARD OF DIRECTORS OF GIFFORD HEALTH CARE, INC. (GHC), APPOINTS A MAJORITY OF THE DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FIRST REVIEWS THE FORM 990. THEN THE FULL BOARD OF TRUSTEES REVIEWS THE PUBLIC DISCLOSURE COPY OF THE FORM 990 AT ONE OF THE BOARD MEETINGS PRIOR TO FILING. THE PUBLIC DISCLOSURE COPY DOES NOT LIST THE NAMES OR ADDRESSES OF THE DONORS TO RESPECT THE CONFIDENTIALITY OF THE DONORS. FORM 990, PART VI, SECTION B, 12C CONFLICT OF INTEREST POLICY: GIFFORD MEDICAL CENTER, INC. REQUIRES BOARD MEMBERS TO COMPLETE A YEARLY CONFLICT OF INTEREST SURVEY. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR SHALL BE DISCLOSED TO THE OTHER BOARD MEMBERS. ANY TRUSTEE HAVING DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS PERSONAL INFLUENCE ON THE MATTER, AND SHALL NOT BE PRESENT FOR DISCUSSION OF THE MATTER. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE AND THAT THE DIRECTOR ABSTAINED FROM VOTING AND DISCUSSION. FORM 990, PART VI, SECTION B, LINE 15A CEO COMPENSATION REVIEW: GIFFORD MEDICAL CENTER USES A BOARD COMPENSATION COMMITTEE WITH INPUT AND DATA FROM A VARIETY OF INDEPENDENT SOURCES. THE EVALUATION AND RECOMMENDATION IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 15B OTHER OFFICER & KEY EMPLOYEE COMPENSATION REVIEW: TO EVALUATE THE COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES, THE COMPENSATION REVIEW IS ADMINISTERED BY HUMAN RESOURCES AND THE CEO. THE HUMAN RESOURCES DEPARTMENT HAS SOME INTERNAL AND EXTERNAL SOURCES THAT ARE UTILIZED TO COMPARE COMPENSATION AMOUNTS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE, ANOTHER'S WEBSITE AND UPON REQUEST. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: JOSEPH PELLETIER (MEDICAL STAFF PRESIDENT), BERTON WHITAKER (INTERIM CEO) AND DANIEL BENNETT (CEO) ARE EMPLOYEES OF GIFFORD MEDICAL CENTER/GIFFORD HEALTH CARE AS WELL AS MEMBERS OF THE BOARD OF DIRECTORS. THEIR COMPENSATION IS RELATED TO THEIR ROLES AS EMPLOYEES. NO TRUSTEES RECEIVE COMPENSATION FOR THEIR ROLES AS TRUSTEES. FORM 990, PART VI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: $ 1,370,906 CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT (3,554,183) TRANSFERS TO AFFILIATES ------------ $(2,183,277) FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:2541974 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN TOTAL FEES:1403559 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:1007651 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:839528 FORM 990 PART IX LINE 11G DESCRIPTION:FREIGHT TOTAL FEES:103876 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:67424 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER CONTRACTED SERVICES TOTAL FEES:19357 GIFFORD HEALTH CARE INC 44 SOUTH MAIN STREET RANDOLPH VT 05060 460938716 FQHC/PARENT VT 501(C)(3) 10 NA false GIFFORD RETIREMENT COMMUNITY INC 44 SOUTH MAIN STREET RANDOLPH VT 05060 463593492 RETIREMENT VT 501(C)(3) 10 GHC false false false false true false false false false false true false false false true false false true true true