2016-08-15T07:57:00-05:00 2015-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2014-10-01 030284813 Springfield Medical Care Systems Inc SPRI 8028852151 25 Ridgewood Road Springfield VT 05156 Scott Whittemore CFO 8028852151 2016-08-12 1 Barbara J McGuan CPA P00219457 2077752387 2016-08-12 2014 2016-09-27 15:27:22Z Timothy Ford 25 Ridgewood Road Springfield VT 05156 21859341 0 X www.springfieldmed.org X 1982 VT Federally Qualified Health Care network providing medical, behavioral health, dental & pharmacy services 11 11 281 13 0 0 5730765 2958358 17001447 18816647 335703 0 86435 84336 23154350 21859341 0 0 0 0 14405321 15185388 0 0 101858 6172312 6502678 20577633 21688066 2576717 171275 14513894 14840548 8917404 9072783 5596490 5767765 X Our mission is to excel at providing personalized, quality care; where people come first. Our vision is to be the provider of choice by creating a professional environment where patients want to receive care, clinicians want to practice medicine, (Continued on Schedule O) and employees want to work. Our plan is to accomplish this by: - Empowering our caregivers with education, technology, and opportunities for personal and professional development;- Creating an environment, which builds collaborative relationships among clinicians, staff, and patients;- Providing our communities with the educational resources and support to make informed decisions emphasizing prevention and wellness; and,- Offering safe, personalized, high-quality care. 0 0 18248856 18816647 Primary Care Services - Springfield Medical Care Systems (SMCS) operates a seven-site, federally-qualified health center network. These offices provide access for primary and preventive health care to the general population, and make financial assistance and charity care available to all based on a sliding fee scale. Services include primary and preventive health care for people of all ages, pediatrics, health screenings, behavioral health programs, dental care, and access to discounted pharmaceuticals. SMCS operates The Ludlow Dental Center in Ludlow, VT. Through its integrated care model, SMCS also offers diagnostic lab, radiology, and a full array of acute hospital and specialty services to its patients through Springfield Hospital, a subsidiary, and other referral sources and partnership arrangements.Our primary care network provides ongoing care and outreach to our service area, utilizing a medical home model of care and focusing on prevention and efficient care management. We work closely with the Quality Improvement Collaborative and the Vermont Blueprint for Health to develop and implement strategies for improving overall population health outcomes. Primary care offices, specialty clinics, the local hospital, and appropriate referral sources, for specialists and tertiary care when needed, are carefully utilized to provide the best possible outcomes. Our goal is to deliver the highest quality care, i.e. appropriate care provided in the appropriate setting, with the end result being improved health outcomes, high patient satisfaction, and improved cost efficiency. A Community Health Team is fully operational, and holds monthly public meetings to collaborate and partner with area agencies to remove barriers and improve access to care. The team now exceeds more than 45 organizations and communicates regularly with 185 individual participants -- and the numbers continue to grow. New members are welcomed at each meeting as word of the team spreads throughout the community. The Team serves as a central community contact point (similar to a hub and spoke model) to facilitate communications, networking and collaboration among all area services.Through the employment of primary care physicians and allied health professionals in Charlestown, NH; Ludlow, VT; Bellows Falls, VT; Chester, VT; and Springfield, VT, SMCS provides access to high quality medical care with emphasis on prevention and wellness in these communities. Due to the tenuous economics of rural primary care practices, this physician availability would not exist without SMCS support. The Ludlow area has been designated by the State of Vermont as a Health Professional Shortage Area. The state and federal governments have designated the Bellows Falls, VT and Charlestown, NH areas as serving a medically-underserved population. These health centers serve an inordinately high Medicare and Medicaid caseload. During FY 2015, SMCS served 24,834 patients and provided 99,969 visits. Behavioral Health - SMCS has a comprehensive outpatient Mental Health/ Substance abuse program and provides outpatient behavioral health counseling and collaborates with The Windham Center -- the inpatient psychiatric unit operated by its subsidiary, Springfield Hospital. With early adoption of Healthy People 2010 and NCQI Medical Home guidelines, SMCS has aggressively integrated behavioral health counseling with primary care medical care by virtue of the on-site stationing of behavioral health at its primary care (FQHC) sites. SMCS practitioners coordinate care with Springfield Hospital inpatient services and, to an even greater extent, work with Springfield Hospital emergency department to assist in managing patients that present with mental health related diagnosis. During the fiscal year, SMCS served 2,206 mental health patients and provided 13,962 visits; and served 228 substance abuse patients and provided 4,498 clinic visits.Dental Care - SMCS' Ludlow Dental Center office serves a growing need for dental services throughout the SMCS primary care service area. Patients from all offices can be referred to the Dental Center for care, and a financial assistance program is available for those needing assistance, based on a sliding fee scale. The Center served 1,634 patients in FY 2015 as well as provided 3,443 visits. Pharmacy Program - SMCS operates a 340B pharmacy charity program that helps expand access to affordable medications. Eligible patients can obtain their prescriptions at little to no cost. This program operates in partnership with six local pharmacies in Vermont: Bellows Falls, Springfield, and Ludlow, as well as one pharmacy in Claremont, NH. Financial assistance for this program totaled $49K.Charity Care Policy - SMCS has a charity care policy under which patients who meet certain criteria will receive care without charge, or at amounts less than established rates. Patients qualify for 50% charity care at up to 200% of the federal poverty guideline. SMCS does not bill patients nor pursue collection of amounts determined to qualify as charity care. In the fiscal year, which ended on September 30, 2015, charges foregone for charity care, based on established rates, amounted to $305K.Springfield Urology - Through a contract with Dartmouth-Hitchcock Medical Center, SMCS began offering urology services at Springfield Urology, 29 Ridgewood Road, Springfield, VT in May, 2014. This service offers patients a local option for needed care and patients from all offices can be referred to this location. In 2015, this office provided 1,562 patient visits. Eligibility Assistance and Enrollment Counseling Services - Through a partnership arrangement with Valley Health Connections (a designated 501(c)(3) non-profit organization), SMCS patients can receive certified Navigator counseling to help remove barriers and facilitate access to health care for uninsured and under-insured people. VHC reports many people need guidance to navigate enrollment processes and programs are often difficult to afford for many Vermonters. This service includes enrollment assistance for preventive health care, health education and screenings, referrals to providers for ongoing health care through a medical home, and assistance with enrollment in State and local programs that pay for health care and other public programs. Similar enrollment and navigation services are also provided for New Hampshire residents who need assistance with New Hampshire programs. During the year, Valley Health Connections provided assistance to 1,940 patients.Child Day Care Services - SMCS operates two child day care services, located in Springfield and Bellows Falls, VT. The Bellows Falls program serves children ages six weeks to six years and the Springfield program serves children six weeks to five years. Access to safe and educational day care is a vital component to a healthy community. SMCS provides this service to the general population, and financial assistance is available to those in need based on a sliding fee scale. During fiscal year 2015, SMCS provided care to 26 children in Bellows Falls and 32 children in Springfield at a subsidy of $31K.Subsidiary - SMCS is the parent corporation of Springfield Hospital. Springfield Hospital is a 25-bed critical access hospital located in Springfield, VT. Springfield Hospital also operates The Windham Center, a comprehensive inpatient psychiatric care hospital in Bellows Falls, VT; off-site physical therapy services, three hospital-owned specialty clinics: ENT, surgery, orthopaedics, and an adult day care center in Springfield, VT. 18248856 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 48 0 1 281 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 VT X Scott Whittemore 8028852151 25 Ridgewood Road Springfield VT 05156 Steve Birge Past Director 1.00 0.00 X 0 0 0 Stephen Geller Director 1.00 0.00 X 0 0 0 George Lamb Director 1.00 2.00 X 0 0 0 Lori Muse Chairperson 2.00 1.00 X X 0 0 0 George S Norfleet III Director/Past Treasurer 1.00 0.00 X X 0 0 0 Willie Pelton Director 1.00 0.00 X 0 0 0 Albert St Pierre Vice Chairperson 2.00 2.00 X X 0 0 0 Crystal Stokarski Director/Past Chairperson 1.00 0.00 X X 0 0 0 Sarah Vail Secretary 2.00 2.00 X X 0 0 0 Bob Flint Director 1.00 0.00 X 0 0 0 Kathy Benson Treasurer 2.00 1.00 X X 0 0 0 Kevin Anderson Director 1.00 1.00 X 0 0 0 Cecil Beehler MD Chief Medical Officer 40.00 0.00 X 286489 0 22202 Timothy Ford CEO/President 10.00 30.00 X 233721 0 50555 Andrew Majka CFO 10.00 30.00 X 228496 0 1854 Daniel Caloras MD Family Practice Physician 40.00 0.00 X 229811 0 32597 Gary Clay MD Family Practice Physician 40.00 0.00 X 228410 0 24833 Richard Summermatter OB/GYN 40.00 0.00 X 254156 0 26760 Michael Ritondo OB/GYN 40.00 0.00 X 365033 0 27566 Theodore Miller Psychiatrist 36.00 0.00 X 235761 0 29128 2061877 0 215495 37 0 1 0 Michaud's Cleaning Service LLC 70 Windy Acres Charlestown NH 03603 Cleaning Services 220321 Dartmouth Hitchcock 1 Medical Center Drive Lebanon NH 03756 Physician Services 209692 Valley Health Connections 268 River St Springfield VT 05156 Outreach & Enrollment Services 189565 Green Mtn Comm Med & Soc Svs PO Box 207 Londonderry NH 05148 Physician Services 125174 4 956215 1338163 663980 2958358 Patient Service Revenue 621110 21014930 21014930 Physician Billing & Other 621110 4173646 4173646 Miscellaneous Revenue 624410 481611 481611 Provision for Bad Debts 621110 -674888 -674888 Contractual Allowances 621110 -6178652 -6178652 18816647 84336 0 84336 84336 84336 21859341 18816647 0 84336 823317 823317 11781669 10883112 856809 41748 158190 138750 18247 1193 1569803 1220679 338625 10499 852409 642842 204038 5529 17611 17611 42850 42850 2064390 1822005 235076 7309 55203 235 54968 444418 393283 29522 21613 809429 806462 2967 52125 4859 44293 2973 168849 168849 764756 737418 27338 84527 65531 18996 Medical Supplies 997010 886176 110834 Other Expenses 236225 106108 127981 2136 Outside Training 236136 72462 163604 70 Taxes & Licenses 152340 116093 36247 376809 183992 184029 8788 21688066 18248856 3337352 101858 X 485683 619967 674734 1368491 1525890 1399821 224993 248397 14704861 4436139 10561323 10268722 11354 -25715 1029917 960865 14513894 14840548 3454104 3026533 630726 1380503 3996654 3763516 835920 902231 8917404 9072783 X 5596490 5767765 5596490 5767765 14513894 14840548 171275 0 X 0 1 X 1 1 1 X Schedule A, Part I, Line 3 The Organization's tax exemption is based upon the classification of a hospital or cooperative hospital service organization described in section 170(b)(1)(A)(iii). Since the organization is not licensed by the State of Vermont as a hospital, Schedule H is not required. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4386 4386 0 Part II-B, Line 1: The Organization paid dues to organizations of which a percentage of the dues were used for lobbying. The Organization paid dues to the National Rural Health Association and the Bi-State Primary Care Association. 96301 40000 136301 5185593 1923963 3261630 6701684 1119853 5581831 2544573 1379205 1165368 136710 13118 123592 10268722 Due from Related Parties 145790 Estimated Third Party Payor Settlements 248846 Due from Other Parties 379618 Cash Surrender Value of Life Insurance 153069 Deferred Compensation 33542 960865 Due to Related Parties 59124 Deposits in Transit 6864 Other 270 Remediation Liability 802431 Deferred Compensation 33542 902231 21859341 0 21859341 0 21859341 21688066 0 21688066 0 21688066 X X X X X 0 0 0 0 0 0 0 0 1 0 Cecil Beehler MD Chief Medical Officer 286489 0 0 0 0 0 4407 0 17795 0 308691 0 0 0 Timothy Ford CEO/President 233721 0 0 0 0 0 19531 0 31024 0 284276 0 0 0 Andrew Majka CFO 221189 0 0 0 7307 0 1854 0 0 0 230350 0 0 0 Daniel Caloras MD Family Practice Physician 229811 0 0 0 0 0 0 0 32597 0 262408 0 0 0 Gary Clay MD Family Practice Physician 228410 0 0 0 0 0 4267 0 20566 0 253243 0 0 0 Richard Summermatter OB/GYN 254156 0 0 0 0 0 5001 0 21759 0 280916 0 0 0 Michael Ritondo OB/GYN 355033 0 10000 0 0 0 3046 0 24520 0 392599 0 0 0 Theodore Miller Psychiatrist 235761 0 0 0 0 0 4869 0 24259 0 264889 0 0 0 Part I, Line 8 Michael Ritondo, a highest compensated employee, received a bonus during the calendar year 2014 as a sign on bonus for joining the Organization. Form 990, Part VI, Section B, line 11 Form 990 is reviewed by the organization's Chief Financial Officer upon completion. Form 990, Part VI, Section B, line 12c Conflicts of interest are reviewed by the Corporate Compliance Officer, Accounting Department and Chief Financial Officer on an annual basis. Members must recuse themselves from voting on issues where a conflict is actual or implied. Form 990, Part VI, Section B, line 15a The Organization has a compensation committee which uses an independent compensation consultant who performs a market analysis on similar health care providers with similar revenue in order to establish the base salary of the CEO. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available upon request. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Springfield Medical Care Systems, Inc. 25 Ridgewood Road Springfield, VT 05156 EIN: 03-0284813 Springfield Medical Care Systems, Inc. is electing to capitalize and repair maintenance costs under Regulation Section 1.263(a)-3(n). Springfield Hospital Inc 25 Ridgewood Road Springfield VT 05156 030179437 Hospital inpatient and outpatient care VT 501(c)(3) Line 3 Springfield Medical Care Systems Inc 1 1 0 1 1 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 Springfield Hospital Inc A 72336 FMV Springfield Hospital Inc C 956216 FMV Springfield Hospital Inc L 188400 FMV Springfield Hospital Inc O 223600 FMV Springfield Hospital Inc P 96980 FMV Springfield Hospital Inc S 151606 FMV