2017-08-15T10:18:55-04:00 2016-09-30 PricewaterhouseCoopers LLP 101 SEAPORT BOULEVARD BOSTON MA 02210 990 2015-10-01 222547186 CENTRAL VERMONT MEDICAL CENTER INC % CHEYENNE HOLLAND CFO CENT 8023714100 130 FISHER ROAD BERLIN VT 05602 CHEYENNE HOLLAND CFO 8023714100 2017-08-14 true PAUL TANIS P01441612 6175305000 2015 2021-01-29 14:40:06Z Ms Nancy Lothian 130 Fisher Road Berlin VT 05602 201591119 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. 16 11 1927 152 0 0 1095416 1449336 180996141 198325656 407448 1278579 333602 252959 182832607 201306530 30000 184700 0 0 115346402 132031942 0 0 181961 60926432 65277173 176302834 197493815 6529773 3812715 152894915 166943607 75047253 92154641 77847662 74788966 X SEE SCHEDULE O false false 126971344 184700 146426214 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. 18,844 INPATIENT DAYS, MORE THAN 239,000 OUTPATIENT PROCEDURES, AND 25,244 EMERGENCY ROOM VISITS WERE RECORDED DURING FISCAL YEAR 2016. OUTPATIENT ANCILLARY SERVICE UNITS MAKE UP THE MAJORITY OF SERVICE VOLUME, INCLUDING 36,079 RADIOLOGY PROCEDURES, 485,318 LAB TESTS, 16,612 CARDIOLOGY TESTS, AND 137,093 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 16 WAS 25,244. THE CANCER TREATMENT CENTER PROVIDED 4,236 ONCOLOGY AND RADIATION TREATMENTS. THE HOSPITAL ALSO HAS BEEN ACTIVE IN ITS OUTREACH TO CENTRAL VERMONT'S UNINSURED AND UNDER INSURED RESIDENTS. 41206527 0 38152436 MEDICAL GROUP PRACTICES: AT THE END OF THE FISCAL YEAR WE HAD 26 PRIMARY CARE, INFIRMARY, AND SPECIALTY PRACTICES. THIS INCLUDED 7 PRIMARY AND FAMILY CARE CLINICS, 2 PEDIATRIC CLINICS, AS WELL AS SPECIALTY CLINICS FOR UROLOGY, PODIATRY, RHEUMATOLOGY, ENDOCRINOLOGY, ORTHOPAEDICS, PSYCHOLOGY, AND OBSTETRICS/ GYNECOLOGY. THERE WERE A TOTAL OF 216,786 PRACTICE VISITS DURING FISCAL YEAR 2016. 16626938 0 13747006 WOODRIDGE SKILLED NURSING FACILITY: CVMC ALSO OPERATES A 153 LICENSED BED SKILLED NURSING FACILITY. THE FACILITY CONCENTRATES ITS SERVICES TO PALLIATIVE CARE, REHABILITATION, PAIN MANAGEMENT, AND ADVANCED WOUND CARE. 42,962 PATIENT DAYS WERE RECORDED IN FISCAL YEAR 2016. 184804809 true true false true false false false false false true true false false false true true false true false false false false false false true false true true true false true true false false false false false false false false true false true false false false false true true true false false true 102 0 true 1927 true false false false false false true true false false false false X 16 11 true false false false true true true true true false false false true true true false false true true false VT X CHEYENNE HOLLAND CFO 8023714443 130 FISHER RD Berlin VT 05602 X Mark Crane MD Trustee, until 9/22/16 3.0 0.0 X 62600 0 0 Sandy Rousse Trustee, as of 12/9/15 1.0 0.0 X 0 0 0 Thomas Robbins Trustee, Until 5/1/16 1.0 2.0 X 0 0 0 Marta Marble Trustee, Chair-Elect 1.0 2.0 X 0 0 0 Robin Nicholson Trustee, until 12/9/15 1.0 2.0 X 0 0 0 Judith Tarr Tartaglia Trustee, President/CEO 45.0 5.0 X X 475900 0 27485 Mark Depman MD Trustee, Medical Director EMS 50.0 0.0 X 385566 0 20692 Michael Dellipriscoli TRUSTEE, Chair 1.0 2.0 X 0 0 0 Laura Plude TRUSTEE 1.0 0.0 X 0 0 0 Carol Welch TRUSTEE, until 12/9/15 1.0 0.0 X 0 0 0 Greg Voorheis Trustee, Immediate Past Chair 1.0 2.0 X 0 0 0 Steven Shea Trustee 1.0 0.0 X 0 0 0 Christopher Barbieri Trustee 1.0 0.0 X 0 0 0 Heidi Pelletier Trustee, until 12/9/15 1.0 0.0 X 0 0 0 Marilyn White Trustee, as of 12/9/15 1.0 0.0 X 0 0 0 John Brumsted MD Trustee 6.0 44.0 X 0 1976486 209789 Joyce Judy Trustee 1.0 0.0 X 0 0 0 Sarah Field Trustee 1.0 0.0 X 0 0 0 Cathy Palmer MD Trustee,PRES CVMC MED STAFF 3.0 42.0 X 15000 236026 42497 Thomas Golonka Trustee 1.0 0.0 X 0 0 0 JEREMIAH ECKHAUS MD SEE SCHEDULE O 50.0 0.0 X 198224 0 38936 Nancy Lothian Chief Operating Officer 50.0 0.0 X 342526 0 17545 Cheyenne Holland TREASURER, CFO/VP FISCAL SRVS 50.0 0.0 X 284736 0 43861 Katherine Borne SECRETARY, EXECUTIVE ASSISTANT 50.0 0.0 X 83130 0 20018 Philip Brown DO VP Medical Affairs 50.0 0.0 X 354010 0 28012 Richard Morley VP Support Services 50.0 0.0 X 239562 0 26033 Karin Morrow Chief Nursing Officer 50.0 0.0 X 194887 0 8270 David Turner VP Physician Services 50.0 0.0 X 196515 0 12987 Daniel Wilson MD Medical Director Psych 50.0 0.0 X 318920 0 31885 Mahlon Bradley MD Physician 50.0 0.0 X 508952 0 45970 Jared Blum MD Physician 50.0 0.0 X 330817 0 44123 John Braun MD PHYSICIAN 50.0 0.0 X 492087 0 15700 Javad Mashkuri MD Physician 50.0 0.0 X 324086 0 42531 4807518 2212512 676334 156 false true false E F WALL ASSOCIATES INC 131 SOUTH MAIN ST PO BOX 259 BARRE VT 05641 CONSTRUCTION SERVICE 2318033 WEATHERBY LOCUMS 5352 NORTHWEST 21ST TERR FORT LAUDERDALE FL 33309 PHYSICIAN STAFFING 470875 CONNOR CONTRACTING INC 1100 US ROUTE 2 BERLIN VT 05602 CONSTRUCTION SERVICE 582200 BENOIT ELECTRIC 254 INDUSTRIAL LN BARRE VT 05641 ELECTRICAL SERVICES 458071 J CRONAN SECURITY INVESTIGATIONS 332 W LAKESHORE DRIVE COLCHESTER VT 05446 SECURITY SERVICES 443430 31 21547 623772 804017 192856 1449336 NET PATIENT SERVICE REVENUE 900099 187055033 187055033 REV FROM MANAGED CARE AND CAPITATED 900099 2101045 2101045 340B CONTRACT PHARMACY REVENUE 900099 4832409 4832409 MEANINGFUL USE 900099 614500 614500 CAFETERIA REVENUE 900099 1100862 1100862 2621807 2621807 198325656 1278579 1278579 0 0 527195 272138 255057 0 255057 255057 0 10353 21547 12451 -2098 -2098 0 0 0 201306530 198325656 1531538 184700 184700 0 0 0 2876213 635185 2241028 35141 35141 102071105 98177352 3749054 144699 6649907 6261311 379430 9166 13808968 12987374 802582 19012 6590608 6205477 376047 9084 546421 546421 163352 163352 5000 5000 0 0 105660 10955 94705 9694652 7666860 2027792 1090544 143513 947031 26558945 26272428 286517 2289283 2194036 95247 0 6113648 5989076 124572 107581 67377 40204 0 596860 549336 47524 752889 752889 0 9715867 9715867 775306 625768 149538 BAD DEBT EXPENSE 5191108 5191108 STATE NURSING BED TAX ASMNT 754688 754688 DUES & FEES 567404 266284 301120 SUNDRY EXPENSE 93734 68371 25363 154231 49713 104518 197493815 184804809 12507045 181961 0 0 20494662 18338172 0 0 17370365 22586553 0 0 0 0 1219958 1184660 3323890 4065469 1569997 1476111 168562435 93938760 68114385 74623675 39270169 42768290 0 0 0 0 0 0 1531489 1900677 152894915 166943607 22536484 29733965 0 0 0 0 10112510 1662941 0 0 0 0 9094138 16437800 0 0 33304121 44319935 75047253 92154641 X 69448151 65547044 5073037 5805106 3326474 3436816 77847662 74788966 152894915 166943607 X 3812715 3320182 -10191593 X 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 25147 25147 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, THE VERMONT HEALTH CARE ASSOCIATION, AND THE MEDICAL GROUP MANAGEMENT ASSOCIATION. A PORTION OF THE DUES IS USED FOR LOBBYING PURPOSES. 7726226 306265 43693 7988798 8130234 -366990 37018 7726226 7489540 676127 35433 8130234 7318467 810401 639328 7489540 7346576 437354 465463 7318467 0.43000 0.57000 false false 5510000 5510000 55630764 30156916 25473848 26824948 11972213 14852735 71660926 48504416 23156510 8935797 3305215 5630582 74623675 0 ACCRUED PENSION LIABILITY 42903233 OTHER LIABILITIES 1416702 44319935 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. GOLF TOURNAMENT 31900 21547 10353 200 8582 2252 1417 0 31900 21547 10353 200 8582 2252 1417 12451 -2098 true true X true X true X true true true false true true 1120415 1120415 0.00580 47151074 31244082 15906992 0.08270 48271489 31244082 17027407 0.08850 66851 66851 0.00030 361397 361397 0.00190 44489083 34744432 9744651 0.05070 45000 45000 0.00020 44962331 34744432 10217899 0.05310 93233820 65988514 27245306 0.14160 true 5191108 103822 66571000 83536420 -16965420 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 X true X SEE SECTION C X SEE SECTION C 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 PART V, LINE 10A COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.CVMC.ORG/SITES/DEFAULT/FILES/DOCUMENTS/COMMUNITY-NEEDS-ASSESSM ENT-2016.PDF PART V, LINE 11 The following implementation plan outlines the logistics and remedies concerning the priority areas agreed upon by the CVMC Steering Committee. At Central Vermont Medical Center, 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. Our affiliation, beginning in 2011 with the University of Vermont Medical Center, Champlain Valley Physicians Hospital Medical Center, Elizabethtown Community Hospital, and Alice Hyde Medical Center, under the University of Vermont Health Network, has increased our reach and capabilities as the primary medical center in central Vermont. This connection with the University of Vermont Health Network has been a significant step in promoting regional strategic planning, improving access to local care, enhancing information technology, and encouraging joint quality and clinical initiatives. Together, our organizations have worked to align with the state and federal health care reform agendas that promote enhanced integration and build upon our existing clinical partnerships. A number of CVMC staff members serve on boards of other mission-related community organizations and planning groups such as the Vermont Blueprint for Health, Central Vermont Health Care Coalition, Central Vermont Substance Abuse Services, Green Mountain United Way, Peoples Health & Wellness Clinic, Vermont Dietetic Association, Vermont Ethics Network, Vermont Medical Society Board, and many more. This implementation plan points to and acknowledges the valuable work of many efforts already underway throughout the county to address community health. Our Community Health Team has discussed regional strategies that are working, gaps that remain, and opportunities for improvement. Based on these recommendations, we have developed the following measures to address those areas for improvement that require more attention and collaboration. Drug Abuse Why address it? By addressing barriers to treatment and collaborating with community partners, CVMC will potentially decrease the prevalence of drug abuse, thus decreasing the number of safety and health concerns associated with it. CVMC is working with community partners including the Vermont Department of Health Alcohol and Drug Abuse Program, Washington County Mental Health Services, Central Vermont Substance Abuse Services 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. Current initiatives * Continue expanding Screening Brief Intervention and Referral to Treatment (SBIRT) model into seven medical homes throughout the CVMC Medical Group Practices. Increase communication and integrated care at each medical home with four masters level behavioral health counselors, offering onsite counseling services with documentation in their medical record. * Continue Screening Brief Intervention and Referral to Treatment (SBIRT) model in our Womens Health Clinic at CVMC. Increase communication and integrated care with immediate access to a licensed behavioral health counselor for interventions. * Continue Screening Brief Intervention and Referral to Treatment (SBIRT) model in our Emergency Department at CVMC. Two masters level behavioral health clinicians offer immediate interventions for patients scoring positive for drug use behaviors with an option to engage in free brief treatment. * Continue expanding Screening Brief Intervention and Referral to Treatment (SBIRT) model to our inpatient units at CVMC. One masters level behavioral health counselor could offer immediate interventions for patients scoring positive for drug use behaviors with an option to engage in free brief treatment. The Central Vermont Community Response Team (CVCRT) continues to meet monthly to provide wraparound services for pregnant and parenting women. This team is represented by 16 community agencies in Washington County and provides case management, advocacy and assistance to women in overcoming barriers to health and wellbeing. Clinical oversight of clinical interventions, ongoing training and support to medical staff, quality improvement and data management. Development of clinical intervention tools for medical providers to use during brief interventions and give to patients as resources. * Continue to coordinate efforts with Central Vermont Addiction Medicine (CVAM): The staff of the Central Vermont Medication Assisted Treatment (MAT) Team has been working with the staff at CVAM to ensure that there is no wait list for individuals who are seeking MAT. Currently, most new patients are seen and inducted on buprenorphine or methadone in less than 48 hours. * Continue work with the Central Vermont Opiate Addiction Steering Committee, which is working with the United Way to develop a comprehensive online resource for individuals and families struggling with addiction. This will also serve as a tool for educating community members, and will contain information about prevention efforts around central Vermont. Advance action Expand facilitation and leadership of the Washington County Substance Abuse Regional Partnership Committee to identify barriers to treatment and gaps in services. This multidisciplinary team, consisting of physicians, drug treatment facilities leadership, drug counselors, ADAP representatives, and our community mental health agency, meets monthly at CVMC to strengthen Washington Countys response to our current drug epidemic. * Continue development of parenting groups in conjunction with Treatment Associates and Central Vermont Addiction Medicine. * Expand supports for patients under the age of 18 that may be in need of medication-assisted treatment. * Engage practitioners: By increasing the MAT Team support, we are hopeful that we can encourage more practitioners to provide MAT to their patients. * Ongoing education: By continuing with the Office Based Opioid Treatment (OBOT) Learning Collaborative in conjunction with Dartmouth Hitchcock Medical Center, we can continue to educate providers on new forms of treatment, which will help improve access to care. One example of this is the use of Vivitrol, an injectable medication that blocks the opioid receptors for an individual for 30 days. Patients receiving this type of treatment can be supported by the MAT Team. * Through promotion on hospital bulletins and media centers, ensure that the public is aware of organizations such as Central Vermont Substance Abuse Services, and online resources being created by groups such as the Central Vermont Opioid Addiction Steering Committee and Washington County Regional Substance Abuse Partnership. * Continue development of a local safe harbor bridge program that offers 24/7 referral, screening, and assessment services for individuals needing medically assisted withdrawal and/or substance abuse treatment. * Continue development and support of Project Safe Catch, which is a drug amnesty program that offers addicts immediate access to substance abuse treatment in lieu of an arrest or penalty. Mental Health Why address it? As mentioned earlier in this report, according to a recent study conducted by the National Institute of Mental Health, almost half of all Americans have experienced a mental disorder at some point in their lives and almost 30% suffer from one in any given year. These problems typically take a toll on overall health. For example, patients diagnosed with a serious mental disorder die 25 years earlier than the general population. Care costs for mental health conditions are significant. The United States spent an estimated $201 billion on mental health disorders like anxiety and depression in 2013, according to an analysis published in The Journal Health Affairs, making it the costliest medical condition in the country.* Current Initiatives * Family Psychiatry, a CVMC Medical Group practice, adopted formal standardized depression screening for patients 12 and older. CVMC, in partnership with Washington County Mental Health Services, is working to integrate behavioral health practitioners into every primary care practice. * CVMC has piloted standardized trauma screening in collaboration with Washington County Mental Health into one of its primary care practices, identifying patients with a history of trauma and connecting them with services. * CVMC is partnering with Washington County Mental Health Services to pilot 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 Washington County Mental Health Services, has developed a Doula Project to support every prenatal patient seen through Central Vermont Womens Health. Research shows that doula labor support decreases the risk for postpartum depression. * CVMC, in collaboration with Washington County Mental Health Services, is offering additional prenatal and postpartum support for women with a history of depression or are at risk of postpartum depression. Those services include: case management collaboration with other community agencies prenatal yoga childbirth education referral to other Washington County Mental Health Services Programs and counseling additional postpartum support up to one year postpartum *Source: http://www.huffingtonpost.com/entry/highest-health-costs-mental_us_574302b 8e4b045cc9a716371 Advance Action CVMC Pediatric practices are planning to pilot trauma screening in collaboration with Washington County Mental Health Services and the Washington County Family Center Tobacco Use Why address it? Tobacco use is the leading cause of preventable death, but hundreds of Vermonters still die each year from tobacco-related diseases. Countless other lives, including those of friends and families of smokers, are touched by the negative effects of tobacco use in our state. Smoking leads to or complicates asthma, heart disease, cancer, lung diseases, stroke, low birth weight in babies, and infant mortality. The most recent prevalence of adult smoking in Vermont was 18% in 2014. This is the same as the national prevalence and equates to about 81,000 adult smokers in Vermont. In the last 25 years, there has been a gradual decline in smoking from a high of 24% in 1996. Current Initiatives * Continue to coordinate efforts with large and small local businesses. The BlueCross BlueShield of Vermont wellness coordinator has been working with the CVMC Tobacco Cessation program for several years now and offers a cessation class twice a year. Currently, we are able to assist participants with support and free nicotine replacement therapy such as gum, patches and lozenges. * Continue to attend local employers wellness fairs, including: The National Life Group, Washington County Mental Health Services and Norwich University. This also serves as a tool for educating community members. Advance action * Continue to add Freshstart (tobacco cessation) leaders in order to increase cessation services to Washington County residents including outlying areas. * Continuing education via webinar invitations through the Vermont Department of Health. * Through promotion on CVMC/Medical Group Practices bulletins and CVMCs web site, ensure that the general public is aware of 802Quits.org, an in-person, phone line and online support for tobacco cessation services. Healthy Diets Why address it? Obesity is one of the most serious health threats facing our nation. According to the U.S. Centers for Disease Control and Prevention, more than two-thirds of American adults and one-third of American youth are now obese or overweight. Obesity-related conditions make up several of the leading causes of death in the U.S. High rates of obesity are largely responsible for the United States declining health outcomes and rapidly rising healthcare costs. Lack of availability and affordability of healthy food contributes to the obesity epidemic. *Source: http://publichealthlawcenter.org/topics/healthy-eating Current Initiatives * Continue Fitness4Wellness pilot, CVMC Rehab and Community Health Team collaboration project. Ten- week wellness program for patients to improve their physical abilities through physical therapy as well as build new, healthier behaviors such as healthy eating through health coaching. * Continue Winning Strategies for Weight Loss, free weekly one-hour classes, targeting people with a BMI > 30. Providing education on healthy eating, a variety of nutrition topics, activity and making better lifestyle choices. Weekly action planning is also incorporated. * Continue YMCA Diabetes Prevention Program, a year-long program, hourly for 25 sessions. Targeted for people with pre-diabetes and/or a BMI > 25. Overall goal is to prevent developing diabetes with a population that is at high risk for this chronic disease. Focus is on modest weight loss of 7% body weight, and increasing weekly activity to 150 minutes. Statistics show a 58% reduction in developing diabetes if overall goals met. * Continue Healthy Eating/Healthy Living for Kids, shared medical visits with a nurse practitioner and CVMCs registered dietitian for children and their families who would benefit from better food choices and fitness practices. * Health Care Share: In partnership with Vermont Youth Conservation Corps, CVMC provides funding for the delivery of freshly harvested, organic vegetables to 150 families in need for 12 weeks. An educational binder with information on the nutritional value and preparation of the vegetables is distributed on the initial delivery in early July. In 2015, CVMC partnered with the Vermont Food Bank and the Hunger Mountain Coop to bring produce and dry food staples to CVMC for monthly food shelfs between January and June 2016. Free cooking classes were also held in CVMCs kitchen (Learning Kitchen) in collaboration with the University of Vermont Extension Program and the Vermont Food Bank. Advance Action Implement a standardized food security tool within primary care to identify additional families that may benefit from the Health Care Share program Youth Participation in Physical Activities Why address it? Nationwide, there has been an increase in overweight and obesity rates among adolescents over the last 30 years. In Vermont, approximately 13% of high school students are obese. According to the most recent Vermont Youth Risk Behavior Survey, high school students reporting 60 minutes of physical activity on all of the past seven days were less likely to be obese compared to the Vermont average. Participation in regular physical activity among the youth population results in many positive health and well-being outcomes, not only during childhood and adolescence, but also into adulthood. CVMCs 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. Continue current initiatives * Continue offering Healthy Eating/Healthy Living for Kids. This program includes six 90-minute sessions and is offered several times per year to pre-teens and their parents. The focus is to provide basic education on healthy lifestyle changes in both eating habits and activity. Action planning is incorporated to help with setting realistic goals. Each session includes private one-on-one time with a nurse practitioner and a dietitian. The sessions are held at the CVMC Pediatrics practices. * Continue our panel management efforts within our CVMC Pediatric Primary Care practices 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. The CVMC School-Based Health Center is an extension of our pediatric primary care practices and operates two days each week at the Barre City Elementary and Middle School. One benefit of being embedded in the school setting is that it provides more 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. The annual CVMC Fun Run and Walk offers our communitys youth population an opportunity to participate in a five-mile race around Berlin Pond, the proceeds of which go to the Health Care Share program. Advance Action * Work with our two Pediatrics practices to further incorporate patient self-management goals and quality measures pertaining to increased physical activity for our pediatric patient population. * Increase our involvement in the creation and promotion of new community 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 Peoples 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 MENTAL HEALTH HAS BEEN IDENTIFIED AS THE COSTLIEST MEDICAL CONDITION IN THE COUNTRY. MENTAL HEALTH HAS ALSO BEEN IDENTIFIED AS AN AREA THAT SUFFERS FROM INADEQUATE CAPACITY. CURRENT INITIATIVES UNDERTAKEN TO ASSIST IN SERVING THIS IMPORTANT NEED ARE: o CVMC IS WORKING ALONGSIDE WASHINGTON COUNTY MENTAL HEALTH SERVICES TO INTEGRATE MENTAL HEALTH PRACTITIONERS INTO EVERY PRIMARY CARE PRACTICE o FAMILY PSYCHIATRY ADOPTED A FORMAL STANDIZED DEPRESSION SCREENING FOR PATIENTS AGED 12 AND OLDER o CVMC, IN COLLABORATION WITH WASHINGTON COUNTY MENTAL HEALTH SERVICES, IS OFFERING ADDITIONAL PRE-NATAL & POSTPARTUM SUPPORT FOR WOMEN WITH A HISTORY OF, OR AT A RISK FOR DEPRESSION. A NEW 25-BED INTENSIVE-CARE PSYCHIATRIC HOSPITAL WAS CONSTRUCTED ADJACENT TO CVMC IN BERLIN. THIS $28.5 MILLION FACILITY IS PART OF A STATEWIDE NETWORK OF MENTAL HEALTH FACILITIES WHICH REPLACE THE VERMONT STATE HOSPITAL IN WATERBURY AND OPENED TO PATIENTS IN 2014. MENTAL HEALTH HAS BEEN ACKNOWLEDGED AS A PRESSING ISSUE STATEWIDE. OUR COMMUNITY HOPES THIS NEW FACILITY WILL CONTINUE TO ALLEVIATE SOME OF THE CURRENT DEMAND FOR INPATIENT CARE FOR SEVERE MENTAL HEALTH NEED. AS EXPECTED, 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 WILL BE 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 PLAINFIELD HEALTH CENTER THAT OFFER DENTAL CARE. OTHER AREAS DEEMED OUTSIDE OUR SCOPE OR ABILITY TO INFLUENCE INCLUDE: AFFORDABLE HOUSING, TEEN PREGNANCIES, UNPLANNED PREGNANCIES, SERVICES FOR THE ELDERY, AND WALKING ON PATHS/BIKE LANES. PART V, LINE 16B - FAP APPLICATION WEBSITE HTTPS://WWW.CVMC.ORG/SITES/DEFAULT/FILES/DOCUMENTS/FINANCIAL-ASSISTANCE-AP PLICATION-V2016.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 16I 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 18E 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. PART V, LINE 22D The average generally billed (AGB) to patients is calculated using the Look-Back method; actual claims paid to the organization by Medicare only or claims paid to the organization by Medicare together with all private health insurer, including any associated portions of these claims paid or owed by beneficiaries. Central Vermont Medical Center uses the combined Medicare and private health insurer look-back method calculation. This forms the minimum grant percentage awarded to patients who qualify for assistance. Calculation: Allowed claims/gross charges for prior fiscal year The amount generally billed for the previous fiscal year shall be applied to the 351 400% FPLG level. Additional discounts shall apply to each FPLG category up to a maximum assistance grant of 100% for <200% FPLG. FPLG <= 200% 201%-250% 251%-300% 301%-350% 351%-400% Grant 100% 85% 75% 65% Maximum AGB The patient grant is applied against all current balances (i.e. hospital and medical group) and extends for a coverage window of 6 months, 12 months for aged >65 years on a fixed income. When the grant period has closed, patients will be required to re-apply for financial assistance and based upon their financial status, may have their grant category adjusted. 27 CVMC - WOODRIDGE NURSING HOME 130 FISHER ROAD BERLIN VT 05602 SKILLED NURSING FACILITY CVMC WOMEN'S HEALTH 130 FISHER ROAD SUITE 1-4 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC PEDIATRICS PRIMARY CARE - BERLIN 246 GRANGER ROAD SUITE 1 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC FAMILY MEDICINE - WATERBURY 130 SOUTH MAIN STREET WATERBURY VT 05676 MEDICAL GROUP PRACTICE CVMC ADULT PRIMARY CARE - BERLIN 130 FISHER ROAD MOB-B SUITE 3 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC INTEGRATIVE FAM MED - MONTPELIER 156 MAIN STREET MONTPELIER VT 05602 MEDICAL GROUP PRACTICE CVMC FAMILY MEDICINE - BERLIN 246 GRANGER RD SUITE 2 BERLIN VT 05641 MEDICAL GROUP PRACTICE CVMC ADULT PRIMARY CARE - BARRE 225 SOUTH MAIN STREET BARRE VT 05641 MEDICAL GROUP PRACTICE CVMC CARDIOLOGY 130 FISHER ROAD SUITE 1-2 BERLIN VT 05602 MEDICAL GROUP PRACTICE GREEN MOUNTAIN FAMILY PRACTICE 87 PAINE MOUNTAIN DRIVE NORTHFIELD VT 05663 MEDICAL GROUP PRACTICE CVMC PEDIATRICS PRIMARY CARE - BARRE 225 SOUTH MAIN STREET BARRE VT 05641 MEDICAL GROUP PRACTICE CVMC FAMILY PSYCHIATRY 82 EAST VIEW LANE SUITE 3 BERLIN VT 05641 MEDICAL GROUP PRACTICE CVMC FAMILY MEDICINE - MAD RIVER 859 OLD COUNTY ROAD WAITSFIELD VT 05673 MEDICAL GROUP PRACTICE CVMC UROLOGY 130 FISHER RD MOB-C SUITE 1 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC NEUROLOGY 130 FISHER ROADM MOB-A SUITE 1 BERLIN VT 05602 MEDICAL GROUP PRACTICE NORWICH UNIVERSITY HEALTH SERVICES 63 CRESCENT AVENUE NORTHFIELD VT 05663 MEDICAL INFIRMARY CVMC ORTHOPEDICS & SPINE MEDICINE 1311 BARRE MONTPELIER RD SUITE 400 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC ORTHOPEDICS & SPORTS MEDICINE 1311 BARRE MONTPELIER RD SUITE 400 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC RHEUMATOLOGY 130 FISHER ROAD MOB-B SUITE 2-3 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC EXPRESS CARE - BERLIN 1311 BARRE MONTPELIER ROAD SUITE 2 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC ORTHOPEDICS & PODIATRY 1311 BARRE MONTPELIER RD SUITE 400 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC ENDOCRINOLOGY 130 FISHER ROAD MOB-C SUITE 1 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC WOUND CARE CENTER 1311 BARRE MONTPELIER ROAD SUITE 2 BERLIN VT 05602 MEDICAL GROUP PRACTICE GRANITE CITY PRIMARY CARE 14 NORTH MAIN STREET SUITE 4002 BARRE VT 05641 MEDICAL GROUP PRACTICE CVMC EXPRESS CARE - WATERBURY 76 MCNEIL RD SUITE 1 WATERBURY CTR VT 05677 MEDICAL GROUP PRACTICE CVMC ORTHOPEDICS & SPINE MEDICINE 76 MCNEIL ROAD SUITE 2 WATERBURY CTR VT 05677 MEDICAL GROUP PRACTICE CVMC OCCUPATIONAL MEDICINE 244 GRANGER ROAD BERLIN VT 05602 MEDICAL GROUP PRACTICE 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, 2016 CENTRAL VERMONT MEDICAL CENTER INCLUDED PHYSICIAN CLINIC EXPENSES IN SUBSIDIZED HEALTH SERVICES. CENTRAL VERMONT MEDICAL CENTER PHYSICIANS INCURRED $44,489,083 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 15 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 $5,191,108. 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 18 ON PAGE 41-42 IN THE FISCAL YEAR 2016 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 66,280. INCLUDED IN THIS SERVICE AREA IS THE FEDERALLY DESIGNATED ORWELL TOWN MEDICALLY UNDERSERVED AREA. VITAL STATISTICS: 96% WHITE 68% RURAL 19% UNDER THE AGE OF 20 63% AGED 18 TO 64 18% OVER THE AGE OF 65 MEDIAN HOUSEHOLD INCOME OF $55,176 11% LIVE BELOW THE POVERTY LEVEL 5.4% NON ENGLISH SPEAKING HOUSEHOLDS ACCESS TO HEALTHCARE: 2% UNINSURED 20% MEDICAID (OR OTHER STATE PROGRAMS) RECIPIENTS 42.3% MEDICARE 35.7% PRIVATE INSURANCE CHRONIC HEALTH CONDITIONS (ADULTS AGED 20+): 15% OBESITY RATE 6.9% LIVING WITH DIABETES 8% SMOKING RATE 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 VERMONT BLUEPRINT FOR HEALTH MULTI-PAYER PRIMARY CARE PRACTICES (PATIENT CENTERED MEDICAL HOME) FOR THE BARRE HEALTH SERVICES 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 RECEIVE CARE FROM A COMMUNITY HEALTH TEAM, WHICH CONSISTS OF NURSES, REGISTERED DIETICIANS, CERTIFIED DIABETES EDUCATORS, SOCIAL WORKERS AND A WELLNESS COACH. THIS TEAM WORKS WITH THE PATIENT TO HELP SET REALISTIC OUTCOMES, 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. THERE ARE 50 PRIMARY CARE PROVIDERS WHO ARE PARTICIPATING IN THE PCMH IN THE BARRE HSA CARING FOR OVER 55,000 PATIENTS. THERE ARE 15 COMMUNITY HEALTH TEAM MEMBERS IN THE CVMC PRACTICES. CVMC IS PROUD TO BE A PARTICIPANT IN THE VERMONT BLUEPRINT FOR HEALTH WITH THE PCMH. 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 (A NEW THERAPEUTIC POOL AND WELLNESS FACILITY FOR AQUATIC AND OTHER REHAB THERAPY SERVICES). THE MAJORITY OF THE CVMC'S GOVERNING BODY (BOARD OF TRUSTEES) IS COMPRISED OF PERSONS 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 AND 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 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, AND ALICE HYDE 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) 20000 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) 25000 EDU LOAN RPMT TO HLTHCR PRFSNLS Green Mountain Transit 15 INDUSTRIAL PARKWAY BURLINGTON VT 05401 030231413 GOVERNMENT 126000 TRANSPORATION 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 X X false true false false false false false false false Philip Brown DO VP Medical Affairs 306023 0 43489 0 4498 0 0 0 28012 0 382022 0 0 0 Nancy Lothian Chief Operating Officer 294067 0 29040 0 19419 0 0 0 17545 0 360071 0 0 0 Cheyenne Holland TREASURER, CFO/VP FISCAL SRVS 241152 0 24223 0 19361 0 15724 0 28137 0 328597 0 0 0 Richard Morley VP Support Services 198583 0 37391 0 3588 0 0 0 26033 0 265595 0 0 0 Judith Tarr Tartaglia Trustee, President/CEO 395455 0 54447 0 25998 0 0 0 27485 0 503385 0 0 0 Daniel Wilson MD Medical Director Psych 302691 0 13133 0 3096 0 0 0 31885 0 350805 0 0 0 Mark Depman MD Trustee, Medical Director EMS 333868 0 31520 0 20178 0 0 0 20692 0 406258 0 0 0 Mahlon Bradley MD Physician 461634 0 44397 0 2921 0 15900 0 30070 0 554922 0 0 0 Jared Blum MD Physician 297030 0 24653 0 9134 0 15900 0 28223 0 374940 0 0 0 John Braun MD PHYSICIAN 472133 0 19954 0 0 0 12622 0 3078 0 507787 0 0 0 John Brumsted MD Trustee 0 979064 0 492000 0 505422 0 180678 0 29111 0 2186275 0 254950 Javad Mashkuri MD Physician 283382 0 22704 0 18000 0 15900 0 26631 0 366617 0 0 0 Cathy Palmer MD Trustee,PRES CVMC MED STAFF 15000 215029 0 0 0 20997 0 16485 0 26012 15000 278523 0 0 Karin Morrow Chief Nursing Officer 178860 0 16027 0 0 0 0 0 8270 0 203157 0 0 0 David Turner VP Physician Services 167026 0 28991 0 498 0 10646 0 2341 0 209502 0 0 0 JEREMIAH ECKHAUS MD SEE SCHEDULE O 189156 0 8798 0 270 0 11374 0 27562 0 237160 0 0 0 SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) SCHEDULE J, PART I, LINE 4B DURING CALENDAR YEAR 2012, UNIVERSITY OF VERMONT MEDICAL CENTER, INC. ("UVM MEDICAL CENTER") ENTERED INTO A SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) WITH PRESIDENT BRUMSTED. UNDER THE SRP, UVM MEDICAL CENTER MAKES ANNUAL CREDITS EQUAL TO 10% OF THE PRESIDENTS BASE SALARY FOR EACH YEAR THROUGH THE PLAN YEAR ENDING SEPTEMBER 30, 2015. IN CALENDAR YEAR 2015, ALL AMOUNTS WERE PAID OUT THAT HAD BEEN CREDITED TO PRESIDENT BRUMSTED'S ACCOUNT. TOTAL AMOUNT OF PAYOUT WAS $341,852, WHICH INCLUDED $254,950 REPORTED AS DEFERRED IN COLUMN C OF PRIOR YEAR 990 RETURNS. DURING CALENDAR YEAR 2015, THE UNIVERSITY OF VERMONT MEDICAL CENTER, INC. ENTERED INTO A REVISED SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) WITH PRESIDENT BRUMSTED. UNDER THE TERMS OF THE NEW 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 CY15 IS REPORTED ON SCHEDULE J, PART II, COLUMN C. AMOUNTS DEFERRED REMAIN SUBJECT TO FORFEITURE IF CERTAIN CONDITIONS ARE NOT MET. The CEO of CVMC participates in a split dollar life insurance arrangement. The value of the premium is included in her taxable compensation in Schedule J, Part II, column (B)(iii). A VT Educational & Health Bldgs Finance Authority 237154467 000000000 2009-05-13 21023997 SEE SCH K, PART VI false false true A 19365897 0 21028838 0 0 0 144996 0 0 8000000 12879001 0 2009 true false true true A false true true true false 0 false false false true A false false false true false false 0 false 0 false true A true SCHEDULE K, PART I, LINE A, COLUMN F DESCRIPTION OF PURPOSE THE VEHBFA 2009 SERIES A&B BOND ISSUANCE WAS ISSUED ON 5/13/2009 TO SATISFY (REFINANCE) 2005 DEBT WITH VEHBFA. THE 2005 DEBT FINANCED THE CONSTRUCTION AND EQUIPMENT OF A RENOVATION AND MODERNIZATION PROJECT. $12,879,001 OF THE VEHBFA 2009 SERIES A&B BOND ISSUANCE WAS USED TO REFUND THE 2005 DEBT. THE REFUND OCCURRED ON MAY 31, 2009. THE REMAINDER WAS USED TO CONSTRUCT AND EQUIP A CANCER TREATMENT CENTER. SCHEDULE K, PART IV, COLUMN A, LINE 2C REBATE COMPUTATION DATE A REBATE COMPUTATION WAS PERFORMED IN AUGUST, 2014. SCHEDULE K, PART II, LINE B, COLUMN A TOTAL PROCEEDS OF ISSUE INCLUDE $4,841 OF INTEREST INCOME. Matt Tarr See Schedule L, Part V 35141 Wages & Benefits false SUBSTANTIAL DONOR SUBSTANTIAL CONTRIBUTOR 582200 SERVICES false SCHEDULE L, PART IV, COLUMN B RELATIONSHIP BETWEEN PARTIES: MATT TARR IS AN EMPLOYEE OF CVMC AND IS THE SON OF JUDITH TARR TARTAGLIA, AN OFFICER OF THE ORGANIZATION. X 1 192856 NET PROCEEDS false false false SCHEDULE M, PART I, COLUMN (B) THE AMOUNTS LISTED IN COLUMN (B) REPRESENT TOTAL NUMBER OF CONRIBUTIONS RECEIVED, NOT INDIVIDUAL ITEMS. 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) AND DR. CATHY PALMER AN EMPLOYEE OF UVMMC. 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 THE EXCEPTION OF SCHEDULE B. 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 CEO, CFO, AND COO 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 2016. 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. 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. WITHIN THE ANNUAL PUBLICATION OF THE ORGANIZATION'S ANNUAL REPORT THERE ARE HIGHLIGHTS OF THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ANNUAL REPORT IS ALSO AVAILABLE IN A PDF FORMAT ON THE ORGANIZATION'S WEBSITE. COMPENSATION OF TRUSTEES FORM 990, PART VII Two physicians serving as Board members, Dr. Palmer, and Dr. Crane, 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. AS OF 9/22/16, JEREMIAH ECKHAUS, MD BECAME THE PRESIDENT ELECT OF THE CVMC MED STAFF. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: CHANGE IN MINIMUM PENSION LIABILITY ($10,762,260) FUNDS RELEASED FROM THE CVMC ENDOWMENT ($359,643) GIFTS AND INVESTMENT INCOME $1,306,170 LOSS ON EXTINGUISHMENT OF DEBT ($375,860) -------------- TOTAL: ($10,191,593) CIRCULAR A-133 AUDIT FORM 990, PART XII, LINE 3B: DURING FY16, 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. 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(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.