2017-08-11T14:46:39-05:00 2016-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2015-10-01 030179418 GIFFORD MEDICAL CENTER INC % JEFFREY HEBERT GIFF 8027284441 44 SOUTH MAIN STREET RANDOLPH VT 05060 JEFFREY HEBERT CFO 2017-04-21 true Brian D Todd P00422601 4178658701 2015 2021-01-29 14:40:06Z DANIEL BENNETT 44 SOUTH MAIN STREET RANDOLPH VT 05060 66893150 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. 17 15 733 158 98407 -42412 1217919 1593845 58313083 60024319 3289370 2500330 69316 402123 62889688 64520617 39546 45913 0 0 32528140 33104280 13384 3855 122398 23623324 23942280 56204394 57096328 6685294 7424289 87269891 90124325 34620960 32078150 52648931 58046175 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. true false 9629364 6568432 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 NEDING 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 THREE 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. 8985430 4266062 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. 5587317 10699620 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. 29274788 45913 38490205 53476899 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 true false false false false true false false false true X 152 2 true 733 true true true false false false false true true false false false false X 17 15 false false false 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 AUGUST MEYER CHAIR 1.0 2.0 X X 0 0 0 PETER NOWLAN VICE CHAIR 1.0 2.0 X X 0 0 0 BARBARA ROCHAT SECRETARY 1.0 2.0 X X 0 0 0 MATT CONSIDINE TREASURER 1.0 2.0 X X 0 0 0 CAROL BUSHEY DIRECTOR 1.0 2.0 X 0 0 0 LINCOLN CLARK DIRECTOR 1.0 2.0 X 0 0 0 SHEILA JACOBS DIRECTOR 1.0 2.0 X 0 0 0 PAUL KENDALL DIRECTOR 1.0 2.0 X 0 0 0 PETER REED DIRECTOR BEGINNING 1/16 1.0 2.0 X 0 0 0 JODY RICHARDS DIRECTOR 1.0 2.0 X 0 0 0 SUE SHERMAN DIRECTOR 1.0 2.0 X 0 0 0 SUE SYTSMA DIRECTOR 1.0 2.0 X 0 0 0 CLAY WESTBROOK DIRECTOR BEGINNING 1/16 1.0 2.0 X 0 0 0 TODD WINSLOW DIRECTOR 1.0 2.0 X 0 0 0 BOB WRIGHT DIRECTOR 1.0 2.0 X 0 0 0 ELLAMARIE RUSSO-DEMARA DO DIRECTOR/MED STAFF PRESIDENT 32.0 0.0 X 106509 0 38917 JOSEPH WOODIN PRESIDENT & CEO ENDING 4/16 40.0 2.0 X X 439446 0 31128 BERTON WHITAKER INTERIM PRES & CEO 5/16-9/16 40.0 2.0 X X 0 0 0 LINDA MORSE DIRECTOR ENDING 2/16 1.0 1.0 X 0 0 0 JEFFREY HEBERT CFO 40.0 2.0 X 160584 0 10359 STEPHANIE LANDVATER ORTHOPEDIC SURGEON 40.0 0.0 X 573532 0 47444 NORMAN KENYATTA ORTHOPEDIC SURGEON 40.0 0.0 X 445454 0 33488 RICHARD GRAHAM UROLOGIST 40.0 0.0 X 423867 0 47358 JEFFREY BATH RADIOLOGIST 40.0 0.0 X 302849 0 18649 DENNIS HENZIG ANESTHESIOLOGIST 40.0 0.0 X 298814 0 37162 2751055 0 264505 49 false true false H P CUMMINGS CONSTRUCTION CO WOODSVILLE VT 03785 BUILDING CONTRACTOR 5798846 AMERICAN HEALTH CENTER PORTSMOUTH NH 03801 MRI SERVICES 493361 MORRISSWITZER ENVIRONMENTS WILLISTON VT 05495 CONTRACTED SERVICES 315945 RED RIVER COMPUTER CO INC PHILADELPHIA PA 19195 CONTRACTED SERVICES 200508 UNIVERSITY OF VERMONT BURLINGTON VT 05401 CONTRACTED SERVICES 196086 13 85119 33966 1474760 236386 1593845 NET PATIENT SERVICE REVENUE 624100 57780545 57780545 PHARMACY REVENUE 446110 694440 694440 DAYCARE REVENUE 812900 359358 260951 98407 CAFETERIA REVENUE 722514 311596 311596 OTHER REVENUE 624100 878380 878380 60024319 710311 710311 0 0 470261 64396 405865 0 405865 405865 4059062 5415 2267632 6826 1791430 -1411 1790019 1790019 20037 85119 28679 -8642 -8642 9900 5000 4900 4900 0 0 64520617 59925912 98407 2902453 8268 8268 37645 37645 0 0 786943 145426 641517 0 25019424 23673441 1278390 67593 988009 933625 51714 2670 4832435 4516238 303266 12931 1477469 1367309 106273 3887 0 72015 72015 75003 75003 0 3855 3855 3109 3109 5317137 4924261 382734 10142 89002 82366 6402 234 1522426 1406404 111929 4093 0 0 541082 500739 38920 1423 250144 231493 17993 658 0 173581 160638 12486 457 740572 685355 53269 1948 0 3523338 3260640 253430 9268 427811 395914 30772 1125 MEDICAL SUPPLIES & DRUGS 4583247 4583247 BAD DEBT 2992658 2992658 PROVIDER TAXES 2873372 2873372 LICENSES, DUES, SUBSCRIPTIONS 366175 338873 26339 963 391608 358987 31470 1151 57096328 53476899 3497031 122398 948946 64633 6536928 4927902 456707 603856 8815226 7990129 0 0 0 0 0 0 1219324 1294649 1108268 1197555 81500794 40870656 38870999 40630138 26997816 28824402 0 0 0 0 12928 9198 2302749 4581863 87269891 90124325 8912642 6937892 0 0 581629 502983 20351843 19743007 0 0 0 0 410969 383511 0 0 4363877 4510757 34620960 32078150 X 50689909 55677340 830482 1119972 1128540 1248863 52648931 58046175 87269891 90124325 X 7424289 -12809 -2014236 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 12879 12879 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. 7276399 805690 8082089 6292507 462077 521815 7276399 5709055 583452 6292507 4319608 1173313 216134 5709055 3753013 2379 564216 4319608 0.80270 0.15450 0.04280 true false 170000 790516 960516 37813518 15759468 22054050 281167 205995 75172 37207952 23032843 14175109 5407641 2042350 3365291 40630138 OTHER RECEIVABLES 140241 BOND ISSUANCE COSTS 137125 DUE FROM AFFILIATES 4108718 INSURANCE VALUATION 75456 BENEFICIAL INT IN MENIG TRUST 120323 4581863 0 EST AMT DUE TO THIRD PARTY 631786 INTEREST RATE SWAP AGREEMENT 3878971 4510757 59255934 -12809 35100 -3824431 -3802140 63058074 1462543 1462543 64520617 53883239 35100 33679 68779 53814460 3109 3278759 3281868 57096328 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: $( 697,465) CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT (2,992,658) BAD DEBT EXPENSE ( 3,109) INVESTMENT MANAGEMENT FEES ( 286,101) EXPENSES INCLUDED IN REVENUE 154,902 NET ASSETS RELEASED FROM RESTRICTION ------------ $(3,824,431) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ ( 33,679) FUNDRAISING EVENT/GAMING EXPENSES 1,375,899 TEMPORARILY RESTRICTED CONTRIBUTIONS 120,323 PERMANENTLY RESTRICTED CONTRIBUTIONS ---------- $1,462,543 SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 33,679 FUNDRAISING EVENT/GAMING EXPENSES SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $2,992,658 BAD DEBT EXPENSE 286,101 EXPENSES INCLUDED IN REVENUE ---------- $3,278,759 LAST MILE RIDE 105156 85119 20037 2794 1840 24045 0 105156 85119 20037 2794 1840 24045 28679 -8642 true true X true X 225. true X true true false false 206785 206785 0.00380 11025782 9221055 1804727 0.03340 11232567 9221055 2011512 0.03720 1588217 1104193 484024 0.00890 77304 9601 67703 0.00130 4694043 4299328 394715 0.00730 8268 8268 0.00020 6367832 5413122 954710 0.01770 17600399 14634177 2966222 0.05490 154992 50861 104131 0.00190 154992 50861 104131 0.00190 true 2992658 293280 18449173 18540414 -91241 X true true 1 1 GIFFORD MEDICAL CENTER INC PO BOX 2000 RANDOLPH VT 05060 WWW.GIFFORDMED.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 false true false true X 225. 300. 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 true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: COMMUNITY HEALTHCARE NEEDS ASSESSMENT SURVEYS WERE COMPLETED IN MANY AREA TOWNS IN 2012. THESE ASSESSMENTS WERE STILL DEEMED APPROPRIATE FOR THE 2015 CHNA. 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: Giffords 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 communitys 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 (seven mid-level providers joined our staff in 2016). Substance abuse counseling: As a Federally Qualified Health Center Giffords 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,, and consultation; and therapy to help patients rebuild lives damaged by opioid use disorder. Obesity: Giffords 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 Giffords 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. In 2016 Gifford took the childhood obesity epidemic discussion outside of the doctors office by giving local elementary and high schools grants to support increased healthy exercise initiatives and the purchase of physical education equipment; we also supported the farm-to-school food program to encourage healthy food habits. Dental care: Giffords Federally Qualified Health Center designation has brought resources that help us support local dentists as they strive to better care for the under- 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. At a free Medical and Dental Health Access Day offered in 2015 those without ongoing primary care were connected with Gifford providers to ensure that dental care would continue to be part of ongoing preventive health efforts. 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 $2,992,658. SCHEDULE H, PART I, LINE 7G SUBSIDIZED SERVICES: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHC) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM RHCS OF $205,791. 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 WORKSHEETS 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 CAUSES OF HEALTH PROBLEMS, INCLUDING POVERTY, HOMELESSNESS, 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 PAYER 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 18.4% OVER THE AGE OF 65 AND 19.2% UNDER 18 YEARS. OVER 96% ARE WHITE, WITH 50.3% FEMALE. THE AVERAGE HOUSEHOLD INCOME IS $53,869 WITH THE POVERTY LEVEL AT 9.8%, COMPARED TO THE STATE'S 13.5%. 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 WE BY PROVIDING AND ASSURING ACCESS TO AFFORDABLE AND HIGH QUALITY HEALTH CARE, AND BY PROMOTING THE HEALTH AND WELL-BEING 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. WE'RE EXTREMELY PROUD OF THOSE ADDITIONS, OUR PROGRESSIVE CAN-DO ATTITUDE, AND OUR FINANCIAL STABILITY. THE FOLLOWING ARE THE ACTIVITIES FOR 2016: - 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 INCEASED 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 TRANSPORATION SERVICES INC DEPOT SQUARE PO BOX 356 RANDOLPH VT 05060 030276517 501 (C) (3) 8268 COMMUNITY BENEFIT 1 PATIENT GRANTS 38 37645 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 false false JOSEPH WOODIN PRESIDENT & CEO ENDING 4/16 415137 0 0 0 24309 0 13250 0 17878 0 470574 0 0 0 JEFFREY HEBERT CFO 154749 0 0 0 5835 0 8050 0 2309 0 170943 0 0 0 STEPHANIE LANDVATER ORTHOPEDIC SURGEON 555532 0 0 0 18000 0 13250 0 34194 0 620976 0 0 0 NORMAN KENYATTA ORTHOPEDIC SURGEON 427454 0 0 0 18000 0 9423 0 24065 0 478942 0 0 0 RICHARD GRAHAM UROLOGIST 405867 0 0 0 18000 0 13250 0 34108 0 471225 0 0 0 JEFFREY BATH RADIOLOGIST 284849 0 0 0 18000 0 0 0 18649 0 321498 0 0 0 DENNIS HENZIG ANESTHESIOLOGIST 282256 0 0 0 16558 0 13250 0 23912 0 335976 0 0 0 A VERMONT EDUCATION & HEALTH BUILDING FINANCING AG 237154467 2014-12-17 20840000 TO FINANCE GIFFORD'S CAPITAL PORJE 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 0 MAGEE OFFICE SUPPLIES SEE PART V 146325 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. X 5 71846 FAIR MARKET VALUE X 1 170000 APPRAISED VALUE false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS REPORTED IN COLUMN B ON LINES 9 AND 15 IS THE NUMBER OF INDIVIDUAL CONTRIBUTORS. FORM 990, PART III, LINE 2 NEW PROGRAM SERVICES: GIFFORD MEDICAL CENTER IS CONTRACTING WITH UPPER VALLEY NEUROLOGY AND NEUROSUGERY TO BRING NEUROSURGICAL SERVICES TO THE AREA. 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, JOSEPH WOODIN AND JEFF HEBERT SERVED AS CEO AND CFO, RESPECTIVELY, OVER GIFFORD MEDICAL CENTER, GIFFORD HEALTH CARE, AND GIFFORD RETIREMENT COMMUNITY. THEIR COMPENSATION HAS BEEN SHOWN IN PART VII AS PAID BY GIFFORD MEDICAL CENTER ONLY, ALTHOUGH THEIR TIME SPENT IS ATTRIBUTABLE TO ALL THREE ENTITIES. 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 DECISIONS 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: ELLAMARIE RUSSO-DEMARA, DO, (MEDICAL STAFF PRESIDENT) AND JOSEPH WOODIN (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: $( 697,465) CHANGE IN FV OF INTEREST RATE SWAP AGREEMENT (1,316,771) TRANSFERS TO AFFILIATES ------------ $(2,014,236) GIFFORD HEALTH CARE INC 44 SOUTH MAIN STREET RANDOLPH VT 05060 460938716 FQHC/PARENT VT 501(C)(3) 9 NA false GIFFORD RETIREMENT COMMUNITY INC 44 SOUTH MAIN STREET RANDOLPH VT 05060 463593492 RETIREMENT VT 501(C)(3) 9 GHC false false false false true false false false false false true false false false true false false true true false