COPLEY HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- COPLEY HOSPITAL INC (EIN 03-0179423)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-02-13
- IRS object ID
- 201500449349302060
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-02-13T13:16:52-06:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030179423 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Copley Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COPL | BusinessNameControlTxt |
| Phone | 8028884231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 528 Washington Highway | AddressLine1 |
| City | Morrisville | City |
| State | VT | State |
| ZIP Code | 05661 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Melvyn Patashnick | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8028884231 | PhoneNum |
| Signature | 2015-02-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Barbara J McGuan CPA | PreparerPersonNm |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2015-02-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Melvyn Patashnick | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 528 Washington Highway | AddressLine1 |
| City | Morrisville | City |
| State | VT | State |
| ZIP Code | 05661 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $62,031,149 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.copleyvt.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1934 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | Critical Access Hospital | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 499 | TotalEmployeeCnt |
| Total Volunteers | 124 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $988,405 | PYContributionsGrantsAmt |
| CY Contributions Grants | $146,785 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $55,316,779 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $61,795,135 | CYProgramServiceRevenueAmt |
| PY Investment Income | $62,580 | PYInvestmentIncomeAmt |
| CY Investment Income | -$18,110 | CYInvestmentIncomeAmt |
| PY Other Revenue | $29,082 | PYOtherRevenueAmt |
| CY Other Revenue | $31,669 | CYOtherRevenueAmt |
| PY Total Revenue | $56,396,846 | PYTotalRevenueAmt |
| CY Total Revenue | $61,955,479 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $57,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,268,921 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $32,068,806 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,249,608 | PYOtherExpensesAmt |
| CY Other Expenses | $25,445,746 | CYOtherExpensesAmt |
| PY Total Expenses | $53,576,029 | PYTotalExpensesAmt |
| CY Total Expenses | $57,514,552 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,820,817 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,440,927 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,042,628 | TotalAssetsBOYAmt |
| Total Assets EOY | $47,027,067 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,394,630 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,672,839 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $28,647,998 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,354,228 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To oversee and coordinate the provision of services, to provide leadership in implementing the vision promoting wellness and to assure clear access to services regardless of ability to pay. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $52,641,751 | ExpenseAmt |
| Revenue | $61,795,135 | RevenueAmt |
| Desc | Copley Hospital provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age or ability to pay. Although reimbursement is critical to the hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. Further, our mission is to serve the community with respect to providing healthcare services and healthcare education in keeping with the hospital's commitment to serve all members of its community. The Hospital offers free care and or subsidized care, care provided to persons covered by governmental programs at below cost, and health activities and programs to support the community and are considered where the need and/or individual's inability to pay coexists. These activities include a variety of services in the form of seminars, workshops, clinics, and screenings at minimal or no charge. | Desc |
| Total Program Service Expenses | $52,641,751 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 108 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 499 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kevin Dorain | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8028884231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 528 Washington Highway | AddressLine1 |
| City | Morrisville | City |
| State | VT | State |
| ZIP Code | 05661 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Michael Alexander | ||||||||
| Past Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Elizabeth Rouse | ||||||||
| Past Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Patrick Keith | ||||||||
| Past Trustee/Med. Staff. Pres. | 1.80 | 0.20 | Yes (X) | $3,150 | $0 | $0 | ||
| Willa Farrell | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Walter Frame | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Sharon Green | ||||||||
| Secretary | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Elaine Nichols | ||||||||
| Vice Chair | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Nancy Putnam | ||||||||
| Chair | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Richard Westman | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| John Steel | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Dana Wildes | ||||||||
| Treasurer | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| David Yacovone | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Henry Binder MD | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Jan Roy | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Joseph Subasic MD | ||||||||
| Trustee/Med. Staff Pres. | 41.80 | 0.20 | Yes (X) | $210,914 | $0 | $33,036 | ||
| David Silverman | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Jamey Ventura | ||||||||
| Trustee | 1.80 | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| Melvyn Patashnick | ||||||||
| President and CEO | 38.00 | 2.00 | Yes (X) | $284,559 | $0 | $34,840 | Yes (X) | |
| Rassoul Rangaviz | ||||||||
| CFO | 38.00 | 2.00 | $181,287 | $0 | $8,113 | Yes (X) | ||
| Bryan Huber MD | ||||||||
| Physician | 40.00 | 0.00 | $608,745 | $0 | $48,045 | Yes (X) | ||
| Brian Aros MD | ||||||||
| Physician | 40.00 | 0.00 | $556,088 | $0 | $36,577 | Yes (X) | ||
| Saul Trevino MD | ||||||||
| Physician | 32.00 | 0.00 | $378,439 | $0 | $24,465 | Yes (X) | ||
| Mirjam McCormack MD | ||||||||
| Physician | 40.00 | 0.00 | $373,168 | $0 | $37,240 | Yes (X) | ||
| Christopher Rohan MD | ||||||||
| Physician | 40.00 | 0.00 | $353,020 | $0 | $31,561 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,949,370 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $253,877 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 39 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HP Cummings Construction Co | |||||
| PO Box 269 | Woodsville | NH | 037850269 | General Contractor | $1,159,611 |
| Advantage RN LLC | |||||
| 4184 Reliable Parkway | Chicago | IL | 606860041 | Nursing Services | $506,016 |
| VIS Construction Consultants | |||||
| 595 Dorset Street 5 | South Burlington | VT | 05403 | Consulting Services | $477,253 |
| Apogee Medical Management | |||||
| 2525 E Camelback Road | Phoenix | AZ | 85016 | Hospitalist Services | $471,946 |
| Fletcher Allen Health Care | |||||
| PO Box 1902 | Burlington | VT | 054021902 | Medical Services | $441,193 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $146,785 | RelatedOrganizationsAmt |
| Noncash Contributions | $11,000 | NoncashContributionsAmt |
| Total Contributions | $146,785 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Gross Patient Revenue | 621400 | $102,790,023 | $102,790,023 | |
| Miscellaneous Revenue | 621400 | $1,533,637 | $1,533,637 | |
| Cafeteria Revenue | 900099 | $313,830 | $313,830 | |
| Provision for Bad Debt | 621400 | -$2,320,138 | -$2,320,138 | |
| Contractual/Char. Adj. | 621400 | -$40,522,217 | -$40,522,217 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $61,795,135 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,160 | TotalRevenueColumnAmt |
| Exclusion | $56,160 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $31,669 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $31,669 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,669 | TotalRevenueColumnAmt |
| Exclusion | $31,669 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,400 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $75,670 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$74,270 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$74,270 | TotalRevenueColumnAmt |
| Exclusion | -$74,270 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,955,479 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $59,947,668 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,861,026 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $755,899 | TotalAmt |
| Program Services | $243,950 | ProgramServicesAmt |
| Management And General | $511,949 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,119,676 | TotalAmt |
| Program Services | $23,458,067 | ProgramServicesAmt |
| Management And General | $1,661,609 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $611,380 | TotalAmt |
| Program Services | $576,012 | ProgramServicesAmt |
| Management And General | $35,368 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,901,832 | TotalAmt |
| Program Services | $3,601,678 | ProgramServicesAmt |
| Management And General | $300,154 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,680,019 | TotalAmt |
| Program Services | $1,541,466 | ProgramServicesAmt |
| Management And General | $138,553 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,567 | TotalAmt |
| Management And General | $73,567 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,785 | TotalAmt |
| Management And General | $47,785 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,661 | TotalAmt |
| Management And General | $43,661 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,164,341 | TotalAmt |
| Program Services | $6,474,896 | ProgramServicesAmt |
| Management And General | $689,445 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,703 | TotalAmt |
| Program Services | $125 | ProgramServicesAmt |
| Management And General | $159,578 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,234,935 | TotalAmt |
| Program Services | $1,032,480 | ProgramServicesAmt |
| Management And General | $202,455 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,863,887 | TotalAmt |
| Program Services | $1,490,200 | ProgramServicesAmt |
| Management And General | $373,687 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,600 | TotalAmt |
| Program Services | $31,828 | ProgramServicesAmt |
| Management And General | $9,772 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,863 | TotalAmt |
| Program Services | $44,863 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,412,729 | TotalAmt |
| Program Services | $2,028,265 | ProgramServicesAmt |
| Management And General | $384,464 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $592,425 | TotalAmt |
| Program Services | $538,198 | ProgramServicesAmt |
| Management And General | $54,227 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $8,121,114 | $8,082,079 | $39,035 |
| Service Provider Tax | $3,211,851 | $3,211,851 | |
| Education | $219,351 | $212,247 | $7,104 |
| Dues & Subscriptions | $213,934 | $73,546 | $140,388 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,514,552 | TotalAmt |
| Program Services | $52,641,751 | ProgramServicesAmt |
| Management And General | $4,872,801 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,475 | BOYAmt |
| EOY | $2,533 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,224,298 | BOYAmt |
| EOY | $14,764,040 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,363,081 | BOYAmt |
| EOY | $4,124,083 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,622,936 | BOYAmt |
| EOY | $2,837,588 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,195,433 | BOYAmt |
| EOY | $1,447,552 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,403,992 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,469,117 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,211,136 | BOYAmt |
| EOY | $15,934,875 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,184,342 | BOYAmt |
| EOY | $6,449,645 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,238,927 | BOYAmt |
| EOY | $1,466,751 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,042,628 | BOYAmt |
| EOY | $47,027,067 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,984,875 | BOYAmt |
| EOY | $4,623,923 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,995,720 | BOYAmt |
| EOY | $2,709,698 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,414,035 | BOYAmt |
| EOY | $4,339,218 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,394,630 | BOYAmt |
| EOY | $11,672,839 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,463,656 | BOYAmt |
| EOY | $28,904,583 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,304 | BOYAmt |
| EOY | $2,376,690 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,995,038 | BOYAmt |
| EOY | $4,072,955 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,647,998 | BOYAmt |
| EOY | $35,354,228 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,042,628 | BOYAmt |
| EOY | $47,027,067 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,440,927 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,265,303 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $32,090 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,571 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $43,661 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Organization pays dues to various organizations, a portion (11,571) of which is attributable to lobbying expenses. The Hospital also engaged a law firm for 32,090 for lobbying services. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $588,384 | OtherCostOrOtherBasisAmt |
| Book Value | $588,384 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,663,180 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,156,664 | DepreciationAmt |
| Book Value | $8,506,516 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $626,880 | OtherCostOrOtherBasisAmt |
| Depreciation | $45,437 | DepreciationAmt |
| Book Value | $581,443 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,892,106 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,866,611 | DepreciationAmt |
| Book Value | $5,025,495 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,633,442 | OtherCostOrOtherBasisAmt |
| Depreciation | $400,405 | DepreciationAmt |
| Book Value | $1,233,037 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,934,875 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Beneficial Interest in Net Assets of Copley Health Systems, Inc. | Desc |
| Book Value | $6,449,645 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $6,449,645 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Deferred Compensation | $1,439,218 |
| Estimated Third Party Payor Settlements | $2,900,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,339,218 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $64,220,782 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $2,265,303 | OtherRevenueAmt |
| Revenue Not Reported | $2,265,303 | RevenueNotReportedAmt |
| Revenue Subtotal | $61,955,479 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $61,955,479 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $57,514,552 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $57,514,552 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $57,514,552 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part XI, Line 2d - Other Adjustments: | FormAndLineReferenceDesc |
| Explanation | Change in Beneficial Interest in Net Assets of Copley Health Systems, Inc. 2,265,303. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $608,614 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $608,614 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,908,569 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,126,572 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,781,997 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10050 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,517,183 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,126,572 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,390,611 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11110 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $165,665 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $53,932 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $111,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $165,665 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $53,932 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $111,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,682,848 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,180,504 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,502,344 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11300 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,180,022 | BadDebtExpenseAmt |
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Copley Hospital Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 528 Washington Highway | AddressLine1 |
| City | Morrisville | City |
| State | VT | State |
| ZIP Code | 05661 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Copley Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.copleyvt.org/NeedsAssessment | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 250.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Copley Hospital, Inc. | Part V, Section B, Line 3: In March 2011, Copley Hospital engaged Toby Knox and Associates, LLC (TKA) to conduct a formal Community Healthcare Needs Assessment. The assessment process invited feedback from community stakeholders as well as reviewing relevant data and publications published by government and non-profit agencies from within the Copley community and statewide. A survey tool designed to ascertain the most pressing health and wellness needs in the Copley community was distributed by mail and email to 153 individual stakeholders representing the broad interests of the community served by Copley Hospital, including:School NursesStaff or local non-profit organizationsVermont Health Department staffAuxiliary BoardCopley Foundation CommitteeCopley Health System TrusteesTown Health OfficersCopley Medical StaffA second survey was administered at the 2011 town meetings in the towns of Morristown, Cambridge, Hyde Park, Wolcott, Waterville and Stowe. In September 2011, Copley created a multidisciplinary advisory committee, called the Community Assessment Steering Committee (CASC), consisting of the hospital's community health team, community leaders and members of the Extended Community Health Team of the Copley Service Area Blueprint for Health Program. This team includes representatives from:Lamoille Home Health & HospiceBlueprint Community Health Team LeaderBlueprint Program Area FacilitatorBehavioral Health & Wellness (CHSLV)Copley Hospital Patient & Family Services, Wellness Center and VP of Community RelationsVermont Department of Health, including Field Services Director, Public Health Specialist, and Substance Abuse Prevention ConsultantLamoille Family CenterLamoille Community Food ShareThe Manor (Long Term Care)Lamoille Regional Chamber of CommerceDepartment of Vermont Health AccessCentral Vermont Council on AgingNorthern Counties Health CareBlue Cross Blue Shield of VTLamoille County Mental HealthIn February 2012, an updated survey tool was created based on the CASC's recommendations. It was distributed by mail and email and also administered in person to clients of:Hardwick Food ShareJohnson Food ShareLamoille Community Food ShareCentral Vermont Community Action Council Central Vermont Adult Basic EducationHardwick Area Health CenterMorrisville Family HealthcareStowe Family PracticeLeadership LamoilleCopley Hospital staff conducted a secondary data review in Spring 2012 based on benchmarking guidelines suggested by the Vermont Department of Health and CASC. Data sources reviewed included:Center for Rural Studies, UVMVermont Department of Labor Economic Demographic Profile 2011U.S Bureau of Labor StatisticsU.S Census Bureau 2000 and 2010American Community Survey 2005-2009Vermont Department of Health: Health and Healthcare Trends in Vermont 2010Vermont Department of Health: Physician Survey 2010Vermont Department of Health: Behavioral Risk Factor Surveillance System (BRFSS) 2010VPQHC: Vermont Health Care Quality Report 2010Vermont Office of Health Access: Study of the Uninsured and Underinsured 2011AHEC: The Primary Care Workforce 2011 SnapshotVermont Department of Health: 2009 Dentist Survey Statistical ReportCenters for Disease Control and Prevention, Nat'l Center for Health StatisticsKaiser Family Foundation: www.statehealthfacts.org 2010 dataVermont Agency of Human Services Department of Disabilities, Aging & Independence: State of Vermont 2006-2014 Shaping the Future of Long Term Care and Independent LivingVermont Housing Finance AgencyVoices for Vermont Kids, 2007-2009Copley Hospital Quality Reports2011 Hospital Report Card, www.copleyvt.org2012 County Health Ranking from the University of Wisconsin Population Health InstituteNational Center for Health Statistics, Centers for Disease Control: Vital Statistics Reporting System, Community Health Status Report 20092012 County Health Rankings, Dartmouth Atlas of HealthVermont AHEC Search Handbook 2012Vermont Department of Health, Health Status of Vermonters, Appendix, 2008EPA Air Quality DatabaseVermont Department of Health, Health Disparities/Health Status Report 2008 |
| Copley Hospital, Inc. | Part V, Section B, Line 5d: Copley Hospital's Community Healthcare Needs Assessment was shared with the Blueprint for Health Extended Community Health Team which consists of healthcare providers and representatives from social service agencies throughout the Hospital's service area. |
| Copley Hospital, Inc. | Part V, Section B, Line 7: The Hospital adopted an implementation strategy to address the top three needs of the community, as recommended by the CASC. Other needs are being addressed by the hospital without being specifically addressed in the implementation strategy. The Hospital is not treating Obesity and Nutrition as a separate priority as obesity is included in our Blueprint integrated health system goal of "improving residents' self management of chronic conditions." Our Healthier Living Workshops and the Workforce Wellness Program currently underway all address obesity. Copley Hospital does provide a health recipe in each edition of the Copley Courier, the Hospital's newsletter distributed through community newspapers (circulation = 30,000 three times a year). In addition, healthy living tips are shared quarterly with the HOPE Health Newsletter, distributed to Copley's 475 employees, and 400 friends of Copley; it is also available in the hospital's common areas. In addition, a Copley Hospital employee serves on the Lamoille Prevention Committee and promoted substance abuse prevention education campaigns and unused prescription pill drop-off events in our community, and Copley Hospital has advocated to town officials for the adoption of a Town Wellness Plan crafted by the Fit and Healthy Council. The Town Wellness Plan encourages community development and zoning policies that encourage pedestrian and bicycling infrastructure, mixed-use development that provides opportunities for people to be physically active as part of their daily routine, and access to safe, well-maintained parks and recreation facilities. Mental Health and Substance Abuse are being addressed separately, because of the work being done in the community by Lamoille County Mental Health (the Vermont Department of Mental Health Designated Agency), CHSLV's Behavioral Health and Wellness and independent practitioners and Copley Hospital. Work is being done to improve access to behavioral health resources for all residents. Copley Hospital is contributing to this by having our Diabetes Educator and Registered Dietitian screen all Wellness Center referrals for depression and refer to a behavioral health professional as needed. We also have a program in place in our Emergency Department to refer patients without a primary care physician to a Care Coordinator for assistance in securing a primary care physician. Our Emergency Department works closely with Lamoille County Mental Health emergency response staff. Copley Hospital is also instrumental in assisting the state of Vermont's new Psychiatric Care Hospital. The Psychiatric Care Hospital opened in 2014, with Copley Hospital providing pharmacy services. |
| Copley Hospital, Inc. | Part V, Section B, Line 20d: Financial assistance applications must be completed to determine eligibility for assistance and therefore applicability of the limitation on charges under 501(r)(5). If not eligible, discount is granted for prompt payment similar to the average negotiated commercial discount rate for prompt payment of a clean claim. |
| Copley Hospital, Inc. | Part V, Section B, Line 22: If patients do not pay promptly, then the discount on gross charges is waived, as it would be under contractual arrangements with commercial insurers if they did not pay promptly. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| Copley Hospital Inc | ||||
| 88 High Street | Hardwick | VT | 05843 | Outpatient Rehab Services |
| Stoweflake Resort | ||||
| 1746 Mountain Road | Stowe | VT | 05672 | Outpatient Rehab Services |
| Mansfield Orthopaedics | ||||
| 555 Washington Highway | Morrisville | VT | 05661 | Outpatient Orthopaedic, Rehab and Radiology Services |
| Mansfield Orthopaedics | ||||
| 6 North Main Street | Waterbury | VT | 05676 | Outpatient Orthopaedic, Radiology Services |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | A cost accounting system was used to calculate the amounts reported in the table. The cost accounting system addresses all patient segments. A cost-to-charge ratio was used. The ratio was derived from Worksheet 2. |
| Part III, Line 4: | Patient accounts receivable are reduced by an allowance for doubtful accounts. In evaluating collectibility of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provisions for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. There were no significant changes to the allowance for doubtful accounts from 2013 to 2014.The Organization utilized a cost to charge ratio as the costing methodology used to determine the amount of bad debt expense at cost. |
| Part III, Line 9b: | Financial Assistance is available to guarantors who meet the eligibility requirements. Income level, household size, residency status, etc, determine eligibility. Federal Poverty Level guidelines are utilized to determine the amount of assistance a household may be eligible for. For the patient's convenience, all statements have an abbreviated version of the Financial Assistance Application on the back. Copley personnel also help patients review and apply for appropriate state-sponsored programs. |
| Part VI, Line 2: | Copley Hospital is part of an Extended Community Health Team in our community. Together we are working to address community healthcare needs. Reaching out to the community to achieve meaningful public participation is integral to Copley's mission and to inform the Extended Community Health Team. Copley completed a Community Healthcare Needs Assessment in 2012.For our assessments, Copley gathers and analyzes information about the greater Lamoille Valley community and its healthcare needs through various means including: analyzing and responding to health trends in our patients, through aggregate data from our Quality and Wellness initiatives and the Copley Service Area Blueprint for Health Program. We also review relevant data published by the Vermont Department of Health, Green Mountain Care Board, Vermont Department of Health's Blueprint for Health Program, and Federal Centers for Disease Control. Our community based advisory committee informs a Board of Trustee-approved implementation plan. The Hospital reports out on the implementation plan to the Extended Community Health Team and Board of Trustees annually. The Hospital is governed by a volunteer board of trustees made up of local citizens representing a cross section of the community served. We maintain involvement in a number of community groups within our service area. Copley continues to work collaboratively with other organizations to identify and address community health needs. Our collaborations include but are not limited to the Extended Community Health Team of the Copley Area Blueprint for Health Initiative (primary care practices) Lamoille Home Health and Hospice, The Manor (long term residential care), Lamoille County Mental Health, CHSLV Behavioral Health & Wellness, Lamoille Prevention Campaign (substance abuse), the Morrisville district office of the Vermont Department of Health, United Way, and Leadership Lamoille through the Chamber of Commerce. |
| Part VI, Line 3: | Information about Copley's Charitable Care policy, which includes helping patients apply for assistance under federal, state or local government programs, is posted by each registration desk (Main Lobby and Emergency Department). It is also available, along with the application form, online on the Hospital's website in addition to the "Hospital Report Card" website of the Green Mountain Care Board. Details are also included in the Patient Guide for inpatients, families and visitors.Copley's Charitable Care program is also promoted in our philanthropy efforts as many donors give to the program. All care providers may refer patients to the Hospital's Patient Financial Services counselors or to Patient and Family Services to connect them to assistance. |
| Part VI, Line 4: | Copley Health Systems (CHS) is an essential health care resource in the rural greater Lamoille County area of Vermont. Our services include a 25-bed Critical Access community hospital, low-income elderly housing and an independent living facility. Copley Hospital's services include 24 hour/7 days a week emergency services, women's and children's services, general surgery, primary care including laboratory services and diagnostic imaging; and an excellent orthopaedic service given our proximity to major ski areas. Our patients are largely the elderly and low-income families in a rural area. Nearly a third are below 200% of poverty level. We serve all patients, regardless of ability to pay. Chronic health conditions impact many adults in our area. We are working to increase access to healthcare and work with members of our community to improve their self management of chronic conditions such as diabetes, high blood pressure, high cholesterol, asthma and obesity. We are also helping people quit tobacco. Copley provides services for residents whose next nearest hospital may be an hour away in good weather. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joseph Subasic MD | ||||||||||||||
| Trustee/Med. Staff Pres. | $190,067 | $0 | $0 | $0 | $20,847 | $0 | $8,483 | $0 | $24,553 | $0 | $243,950 | $0 | $0 | $0 |
| Melvyn Patashnick | ||||||||||||||
| President and CEO | $246,852 | $0 | $0 | $0 | $37,707 | $0 | $10,200 | $0 | $24,640 | $0 | $319,399 | $0 | $0 | $0 |
| Rassoul Rangaviz | ||||||||||||||
| CFO | $173,902 | $0 | $0 | $0 | $7,385 | $0 | $6,968 | $0 | $1,145 | $0 | $189,400 | $0 | $0 | $0 |
| Bryan Huber MD | ||||||||||||||
| Physician | $522,450 | $0 | $68,000 | $0 | $18,295 | $0 | $10,200 | $0 | $37,845 | $0 | $656,790 | $0 | $0 | $0 |
| Brian Aros MD | ||||||||||||||
| Physician | $499,828 | $0 | $0 | $0 | $56,260 | $0 | $3,299 | $0 | $33,278 | $0 | $592,665 | $0 | $0 | $0 |
| Saul Trevino MD | ||||||||||||||
| Physician | $373,495 | $0 | $0 | $0 | $4,944 | $0 | $0 | $0 | $24,465 | $0 | $402,904 | $0 | $0 | $0 |
| Mirjam McCormack MD | ||||||||||||||
| Physician | $251,670 | $0 | $0 | $0 | $121,498 | $0 | $10,200 | $0 | $27,040 | $0 | $410,408 | $0 | $0 | $0 |
| Christopher Rohan MD | ||||||||||||||
| Physician | $335,005 | $0 | $0 | $0 | $18,015 | $0 | $0 | $0 | $31,561 | $0 | $384,581 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 5 | FormAndLineReferenceDesc |
| Explanation | Bryan Huber, a highest compensated employee, received a bonus of $68,000. A portion of the bonus ($50,000) was based upon the gross revenue he produced individually for the Hospital. The bonus is triggered when the individual produces a certain level of revenue. The bonus is 20% of the excess revenue produced over that level. There is a cap on the amount of bonus the indivdual can receive. The other portion of the bonus ($18,000) was for his assistance in recruiting another surgeon. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Copley Hospital, Inc. is a member organization whose sole corporate member is Copley Health Systems, Inc. Copley Health Systems, Inc. and the Hospital share the same board of trustees. |
| Form 990, Part VI, Section A, line 7a | Copley Hospital, Inc. shares the same board as Copley Health Systems, Inc. Each year, the members of Copley Health Systems, Inc. will hold an annual meeting. The purposes of the annual meeting shall include the election of members to the Corporation, the election of Trustees to the Corporation's Board of Trustees, the election of the community member at large of the governance and bylaws committee, and the transaction of such other business as may properly come before the membership. The Board shall consist of up to twenty-one elected members, the Chief Executive Officer of the Corporation and the President of the Medical Staff of Copley Hospital, Inc., all as voting members. All Trustees must be members of the Corporation. |
| Form 990, Part VI, Section B, line 11 | The finance committee reviews the Form 990 prior to submission. A complete copy of the form is made available to all members of the governing body through the finance office. |
| Form 990, Part VI, Section B, line 12c | The Governance Committee reviews the statements and surveys completed by interested persons and maintains a list of individuals who may be considered disqualified persons under IRS regulations. The Governance Committee reports the results of its reviews annually to the Board. The internal Compliance Committee of the Corporation reviews any potential conflict of interest which involves an interested person who is not a trustee or officer of the Corporation. The internal Compliance Committee reports the results of its reviews annually to the Board. |
| Form 990, Part VI, Section B, line 15 | The CEO's pay is determined through the use of an outside compensation firm. Senior leadership and other highly compensated individuals have their pay ranges determined through market data from Astron Solutions. The compensation for the CEO is approved by the Board. |
| Form 990, Part VI, Section C, line 19 | The governing documents are made available upon request. The conflict of interest policy and Matrix are available upon request. The financial statements are summarized in an annual report that is available to the public. The Hospital also submits both their budget and actual financial information to the State of Vermont's Green Mountain Care Board. |
| Form 990, Part IX, line 11g | Other Fees: Program service expenses 1,893,536. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,893,536. Contract Labor: Program service expenses 1,835,060. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,835,060. Purchased Services: Program service expenses 2,746,300. Management and general expenses 689,445. Fundraising expenses 0. Total expenses 3,435,745. |
| Form 990, Part XI, line 9: | Change in Beneficial Interest in Net Assets of Copley Health Systems, Inc. 2,265,303. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Lamoille Area Housing Corporation Copley Terrace Project | |||||||||||
| 528 Washington Highway | Morrisville | VT | 05661 | 030270255 | Subsidized Elderly Housing | VT | 501(c)(3) | Line 9 | Copley Health Systems Inc | 0 | |
| Copley Health Systems Inc | |||||||||||
| 528 Washington Highway | Morrisville | VT | 05661 | 030301457 | Support of Copley Hospital | VT | 501(c)(3) | Line 11b, II | 0 | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Health Center Building Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 528 Washington Highway | AddressLine1 |
| City | Morrisville | City |
| State | VT | State |
| ZIP Code | 05661 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030220357 | EIN |
| Primary Activities | Office Building Rental | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Copley Health Systems Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Health Center Building | ||
| K | $160,586 | FMV |
| Copley Health Systems Inc | ||
| C | $146,785 | FMV |
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