CARLOS G OTIS HEALTH CARE CENTER INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- CARLOS G OTIS HEALTH CARE CENTER INC (EIN 03-0177161)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-14
- IRS object ID
- 201512269349301851
- 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 L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-14T09:59:47-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010494526 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER NEWMAN & NOYES | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 507 | AddressLine1 |
| City | PORTLAND | City |
| State | ME | State |
| ZIP Code | 04112 | 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 | 030177161 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carlos G Otis Health Care Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARL | BusinessNameControlTxt |
| Phone | 8023657920 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 216 | AddressLine1 |
| City | Townshend | City |
| State | VT | State |
| ZIP Code | 053530216 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Stephen A Brown | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8023657920 | PhoneNum |
| Signature | 2015-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Nicholas E Porto | PreparerPersonNm |
| PTIN | P01310283 | PTIN |
| Phone | 2078792100 | PhoneNum |
| Preparation | 2015-08-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Grace Cottage Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Stephan Morse | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 216 | AddressLine1 |
| City | Townshend | City |
| State | VT | State |
| ZIP Code | 053530216 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,774,081 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.gracecottage.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1949 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | Provision of health care services | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 208 | TotalEmployeeCnt |
| Total Volunteers | 103 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $684,536 | PYContributionsGrantsAmt |
| CY Contributions Grants | $381,563 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,366,174 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,392,276 | CYProgramServiceRevenueAmt |
| PY Investment Income | $198 | PYInvestmentIncomeAmt |
| CY Investment Income | $242 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $21,050,908 | PYTotalRevenueAmt |
| CY Total Revenue | $20,774,081 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $12,674,441 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,261,442 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $156,978 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,850,682 | PYOtherExpensesAmt |
| CY Other Expenses | $9,449,330 | CYOtherExpensesAmt |
| PY Total Expenses | $21,525,123 | PYTotalExpensesAmt |
| CY Total Expenses | $21,710,772 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$474,215 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$936,691 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,546,744 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,414,650 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,787,260 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,706,173 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,759,484 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,708,477 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The Otis Health Care Center promotes excellence in healthcare and well being, putting people first. It aims to be the standard for patient care. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $19,748,571 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $20,392,276 | RevenueAmt |
| Desc | Grace Cottage Hospital is a critical access hospital offering 24-hour emergency services, inpatient acute and skilled care, 24-hour diagnostic imaging services, a full-service laboratory, a pharmacy, a variety of outpatient medical care services, including physical therapy, occupational therapy, and speech therapy, and a rural health clinic providing primary care and psychiatric services. | Desc |
| Total Program Service Expenses | $19,748,571 | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 208 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | Yes (1) | 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 | Stephen A Brown | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8023653601 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 185 Grafton Road | AddressLine1 |
| City | Townshend | City |
| State | VT | State |
| ZIP Code | 05353 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Edward Elliott MD | ||||||||
| Trustee (end 11/2013) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Barry Emerson | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Stanley Holt | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John Nopper | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Timothy P Shafer MD | ||||||||
| Trustee/Family Physician | 50.00 | Yes (X) | $262,175 | $0 | $28,952 | |||
| Allan Shirks | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Roger Allbee | ||||||||
| Trustee/CEO (eff. 4/2014) | 30.00 | Yes (X) | $0 | $0 | $0 | 1.00 | Yes (X) | |
| Deborah Boyle | ||||||||
| Pres. (end 11/2013)/VP (eff. 11/2013) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Stephan Morse | ||||||||
| VP (end 11/2013)/Pres. (eff. 11/2013) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Kevin Meyer | ||||||||
| Treasurer | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| J Walter Corcoran | ||||||||
| Secretary | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | Yes (X) | |
| Margaret S Cleary FACHE | ||||||||
| Interim CEO (end 1/2014) | 20.80 | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| Stephen A Brown | ||||||||
| CFO | 47.10 | $186,453 | $0 | $27,028 | Yes (X) | |||
| Maurice Geurts MD | ||||||||
| Family Physician | 50.00 | $302,387 | $0 | $28,952 | Yes (X) | |||
| Moss J Linder MD | ||||||||
| Family Physician | 44.00 | $230,294 | $0 | $25,921 | Yes (X) | |||
| Ewa Arnold MD | ||||||||
| Family Physician | 50.00 | $164,318 | $0 | $21,738 | Yes (X) | |||
| Robert Backus MD | ||||||||
| Family Physician | 41.00 | $141,602 | $0 | $21,014 | Yes (X) | |||
| Richard Meyer MD | ||||||||
| CMO/Emergency Physician | 42.00 | $138,203 | $0 | $24,522 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,425,432 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $178,127 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Cerner Corporation | |||||
| PO Box 412702 | Kansas City | MO | 64141 | IT Support | $816,443 |
| Helms and Company | |||||
| One Pillsbury Street Suite 200 | Concord | NH | 033013570 | Consulting/Management | $204,657 |
| Brattleboro Retreat | |||||
| PO Box 803 | Brattleboro | VT | 05302 | Contracted Psychiatrist | $176,455 |
| Baker Newman Noyes | |||||
| PO Box 507 | Portland | ME | 041120507 | Accounting | $110,551 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $236,675 | RelatedOrganizationsAmt |
| Government Grants | $142,781 | GovernmentGrantsAmt |
| All Other Contributions | $2,107 | AllOtherContributionsAmt |
| Noncash Contributions | $2,107 | NoncashContributionsAmt |
| Total Contributions | $381,563 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 621400 | $16,143,075 | $16,143,075 |
| Pharmacy Revenue | 446110 | $3,876,706 | $3,876,706 |
| GCF Administration/Other | 621400 | $169,486 | $169,486 |
| Miscellaneous Revenue | 621400 | $128,581 | $128,581 |
| Meaningful Use Revenue | 621990 | $74,428 | $74,428 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,392,276 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $242 | TotalRevenueColumnAmt |
| Exclusion | $242 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,774,081 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,392,276 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $242 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,511 | TotalAmt |
| Program Services | $303,695 | ProgramServicesAmt |
| Management And General | $272,816 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,262,840 | TotalAmt |
| Program Services | $8,491,364 | ProgramServicesAmt |
| Management And General | $663,842 | ManagementAndGeneralAmt |
| Fundraising | $107,634 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,788 | TotalAmt |
| Program Services | $152,316 | ProgramServicesAmt |
| Management And General | $11,504 | ManagementAndGeneralAmt |
| Fundraising | $1,968 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,600,424 | TotalAmt |
| Program Services | $1,451,376 | ProgramServicesAmt |
| Management And General | $130,939 | ManagementAndGeneralAmt |
| Fundraising | $18,109 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $655,879 | TotalAmt |
| Program Services | $587,677 | ProgramServicesAmt |
| Management And General | $60,985 | ManagementAndGeneralAmt |
| Fundraising | $7,217 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,264 | TotalAmt |
| Management And General | $65,264 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,042 | TotalAmt |
| Management And General | $21,042 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,385 | TotalAmt |
| Management And General | $79,385 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $698,067 | TotalAmt |
| Program Services | $688,622 | ProgramServicesAmt |
| Management And General | $9,445 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,030 | TotalAmt |
| Program Services | $9,612 | ProgramServicesAmt |
| Management And General | $164,655 | ManagementAndGeneralAmt |
| Fundraising | $763 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $589,155 | TotalAmt |
| Program Services | $416,333 | ProgramServicesAmt |
| Management And General | $158,501 | ManagementAndGeneralAmt |
| Fundraising | $14,321 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $656,829 | TotalAmt |
| Program Services | $588,730 | ProgramServicesAmt |
| Management And General | $65,524 | ManagementAndGeneralAmt |
| Fundraising | $2,575 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,791 | TotalAmt |
| Program Services | $266,381 | ProgramServicesAmt |
| Management And General | $7,410 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,375 | TotalAmt |
| Program Services | $115,582 | ProgramServicesAmt |
| Management And General | $20,744 | ManagementAndGeneralAmt |
| Fundraising | $4,049 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,590 | TotalAmt |
| Program Services | $13,590 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,199 | TotalAmt |
| Program Services | $29,494 | ProgramServicesAmt |
| Management And General | $32,705 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,429,173 | TotalAmt |
| Program Services | $1,425,152 | ProgramServicesAmt |
| Management And General | $4,021 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,775 | TotalAmt |
| Program Services | $205,992 | ProgramServicesAmt |
| Management And General | $36,441 | ManagementAndGeneralAmt |
| Fundraising | $342 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Medical supplies & lab | $3,428,129 | $3,428,129 |
| Provision for bad debts | $677,685 | $677,685 |
| Medicaid tax | $623,191 | $623,191 |
| Equipment repair expens | $273,650 | $273,650 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,710,772 | TotalAmt |
| Program Services | $19,748,571 | ProgramServicesAmt |
| Management And General | $1,805,223 | ManagementAndGeneralAmt |
| Fundraising | $156,978 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,224 | BOYAmt |
| EOY | $33,632 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,679 | BOYAmt |
| EOY | $35,506 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,135,385 | BOYAmt |
| EOY | $2,382,678 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,009,449 | BOYAmt |
| EOY | $1,267,839 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,585 | BOYAmt |
| EOY | $215,049 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,535,042 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,654,230 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,132,193 | BOYAmt |
| EOY | $3,880,812 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,185 | BOYAmt |
| EOY | $32,165 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,845,044 | BOYAmt |
| EOY | $6,566,969 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,546,744 | BOYAmt |
| EOY | $14,414,650 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,667,812 | BOYAmt |
| EOY | $1,490,659 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,310,000 | BOYAmt |
| EOY | $1,190,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,674,399 | BOYAmt |
| EOY | $1,088,969 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,049 | BOYAmt |
| EOY | $936,545 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,787,260 | BOYAmt |
| EOY | $4,706,173 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,117,438 | BOYAmt |
| EOY | $6,634,557 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,364 | BOYAmt |
| EOY | $505,555 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,415,682 | BOYAmt |
| EOY | $2,568,365 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,759,484 | BOYAmt |
| EOY | $9,708,477 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,546,744 | BOYAmt |
| EOY | $14,414,650 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$936,691 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $885,684 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $3,435 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $3,435 | 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 | Carlos G. Otis Health Care Center is a member of the Vermont Association of Hospitals and Health Systems and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Carlos G. Otis Health Care Center in furtherance of its exempt purpose. Carlos G. Otis Health Care Center does not directly perform any lobbying activities. AHA, portion of dues available for lobbying: $526 VAHHS, portion of dues available for lobbying: $2,909 | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,642,046 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $451,855 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $19,982 | OtherExpendituresAmt |
| End Year Balance | $3,073,919 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,608,707 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $48,373 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $15,034 | OtherExpendituresAmt |
| End Year Balance | $2,642,046 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,636,804 | BeginningYearBalanceAmt |
| Contributions | $1,267 | ContributionsAmt |
| Investment Earnings Or Losses | $99,915 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $129,279 | OtherExpendituresAmt |
| End Year Balance | $2,608,707 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,443,026 | BeginningYearBalanceAmt |
| Contributions | $186,971 | ContributionsAmt |
| Investment Earnings Or Losses | $25,839 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $19,032 | OtherExpendituresAmt |
| End Year Balance | $2,636,804 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,298,260 | BeginningYearBalanceAmt |
| Contributions | $104,897 | ContributionsAmt |
| Investment Earnings Or Losses | $39,869 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,443,026 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.15270 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.83550 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.01180 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,549 | OtherCostOrOtherBasisAmt |
| Book Value | $30,549 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,361,991 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,437,315 | DepreciationAmt |
| Book Value | $1,924,676 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,044,310 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,165,763 | DepreciationAmt |
| Book Value | $1,878,547 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $98,192 | OtherCostOrOtherBasisAmt |
| Depreciation | $51,152 | DepreciationAmt |
| Book Value | $47,040 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,880,812 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Beneficial interest in net assets of GCF | $6,410,308 |
| Deposits with Trustee | $57,097 |
| Meaningful use receivable | $74,428 |
| Other Receivables | $25,136 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,566,969 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Estimated Third Party Payor Settlements | Desc |
| Amt | $936,545 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $936,545 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,659,765 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $885,684 | OtherRevenueAmt |
| Revenue Not Reported | $885,684 | RevenueNotReportedAmt |
| Revenue Subtotal | $20,774,081 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $20,774,081 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,710,772 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $21,710,772 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $21,710,772 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | OHCC uses its endowment funds to assist in the provision of health care. |
| Part X, Line 2: | OHCC and the Foundation are tax-exempt corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. In addition, the Foundation qualifies for the charitable contribution deduction under Section 170(b)(1)(a) and had been classified as an organization that is not a private foundation under Section 509(a)(2). Management evaluated the Organization's tax positions and concluded the Organization has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertain tax positions that require adjustment to or disclosure in the accompanying consolidated financial statements. With few exceptions, the Organization is no longer subject to income tax examination by the U.S. federal or state tax authorities for years before 2011. |
| Part XI, Line 2d - Other Adjustments: | Increase in Beneficial Interest in Net Assets of GCF 885,684. |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| 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 | $249,253 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $249,253 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,289,927 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,336,935 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,952,992 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09290 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,539,180 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,336,935 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,202,245 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10480 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $57,059 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,134 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $46,925 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $57,645 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $57,645 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $114,704 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,134 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $104,570 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,653,884 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,347,069 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,306,815 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10970 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $505,747 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $246,339 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,659,654 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,235,238 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $424,416 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | 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 | Grace Cottage Hospital | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 185 Grafton Road | AddressLine1 |
| City | Townshend | City |
| State | VT | State |
| ZIP Code | 05353 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.gracecottage.org | WebsiteAddressTxt |
| State License | 814 | StateLicenseNum |
| 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 | Grace Cottage Hospital | 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 | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Section C | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Section C | OtherWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| 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 |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | 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 |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| 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 (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Grace Cottage Hospital | Part V, Section B, Line 3: As required by Vermont statute, Grace Cottage Hospital conducts a Community Health Needs Assessment (CNHA) every three years. Our most recent CHNA was done collaboratively in 2012 with Brattleboro Memorial Hospital (BMH) and the Brattleboro Retreat. These three healthcare organizations focused on involving as many stakeholders and community members as possible in the data collection. The three hospitals set up a steering committee made up of individuals from the State of Vermont Department of Health, Brattleboro Memorial Hospital, Grace Cottage Hospital, The Brattleboro Retreat, United Way of Windham County, Agency of Human Services, Visiting Nurse Association & Hospice of VT & NH, Valley Cares, West River Valley Assisted Living, and Senior Solutions. Additionally, the participating organizations engaged a wide range of stakeholders through the surveys and focus groups, including health care providers, human service organizations, youth development organizations, schools and other nonprofit organizations. An updated Community Health Needs Assessment will be completed in 2015.Grace Cottage Hospital continues to collaborate with BMH and the Brattleboro Retreat to improve community awareness of existing health and wellness programs and services to Windham County residents, which was one of the needs identified in the Community Health Needs Assessment. The three organizations publish a comprehensive Health and Wellness Calendar, distributed county-wide, twice annually, which includes listings of all health and wellness events and classes that are available for the public. In addition, the Wellness in Windham website (www.wellnessinwindham.org) is maintained by the three organizations with updated, current information on classes, programs, and services. Grace Cottage Hospital has been addressing two additional needs identified in the assessment:-Diabetes awareness, management and education. Through the Vermont Blueprint for Health initiative, Grace Cottage's Community Health Team, made up of skilled health professionals, works with diabetes patients, one-on-one, to help with disease management. -Transportation needs for the rural area in which we serve. During FY14, Grace Cottage Hospital was an active participant in the Brattleboro Business Transportation Roundtable group, working with United Way of Windham County, Windham Regional Commission, Connecticut River Transit, Go Vermont and Vital Communities to identify transportation issues in the West River Valley and in Brattleboro, and to work towards finding solutions to these issues. |
| Grace Cottage Hospital | Part V, Section B, Line 4: The 2012 Community Health Needs Assessment was conducted with Brattleboro Memorial Hospital and The Brattleboro Retreat. |
| Grace Cottage Hospital | Part V, Section B, Line 7: The community hospitals participating in the 2012 CHNA, Grace Cottage Hospital and Brattleboro Memorial Hospital, are not addressing Hepatitis C and Lyme Disease at this time as other priority health care conditions have been selected to focus on. The needs identified in the CHNA finalized at the end of fiscal year 2012 have been discussed in fiscal year 2014 as part of the Hospital's ongoing strategic planning process. |
| Grace Cottage Hospital | Part V, Section B, Line 19d: The Hospital charged standard facility rates as billed to all patient and insurers. Patients were eligible to apply for financial assistance based on policy. |
| Grace Cottage Hospital | Part V, Section B, Line 20d: The Hospital charged standard facility rates as billed to all patient and insurers. Patients were eligible to apply for financial assistance based on policy. |
| Grace Cottage Hospital | Part V, Section B, Line 22: As stated on line 20d, all charges billed were at standard facility rates. |
| Schedule H, Part V, Section B, Line 5a: | The Hospital's 2012 CHNA is available on its website at: http://gracecottage.org/about-grace-cottage/community-health-needs-assessments/ |
| Schedule H, Part V, Section B, Line 5b: | The Hospital's 2012 CHNA is available on the following websites: http://www.bmhvt.org/about/community-health-needs-assessmenthttp://www.brattlebororetreat.org/about/community-health-needs-assessment |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| Messenger Valley Pharmacy | ||||
| 170 Grafton Road | Townshend | VT | 05353 | Pharmacy |
| Grace Cottage Family Health | ||||
| 185 Grafton Road | Townshend | VT | 05353 | Rural health clinic |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | N/A |
| Part I, Line 6a: | N/A |
| Part I, Line 7: | The amounts reported for Charity Care and Means-Tested Government Programs were calculated using a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. |
| Part I, Line 7g: | N/A |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 677,685. |
| Part II, Community Building Activities: | See previous footnotes. |
| Part III, Line 2: | The cost of the bad debt expense reported on line 2 was calculated by applying the ratio of patient care cost-to-charges (calculated on Worksheet 2) to the total bad debt expense. The amount of bad debt expense for accounts written off as bad debt is the account balance after all charity care discounts, contractual allowances, and insurance/patient payments have been applied. Any cash collected on accounts previously written off is included as an offset to bad debt expense. |
| Part III, Line 3: | The amount of bad debt expense (at cost) attributable to patients eligible under our charity care policy reported on line 3 was estimated based on a review of Reduced Fee/Free Care Applications. The number of approved completed applications versus the number of incomplete applications was compared and a ratio applied to the Charity Care balance to estimate this number. It is felt that this estimate should actually be much higher because, though we work hard to educate our patients regarding the charity care policy, including having a Resource Advocate to help patients complete them if they require assistance, many of the applications we distribute to patients are not returned. Knowing our patient population as we do, we believe it is primarily attributable to patients not wanting to share the income information. |
| Part III, Line 4: | Please see responses above for information regarding costing methodology. See Page 8 of the attached audited financial statements for the footnote that addresses bad debt. |
| Part III, Line 8: | Medicare allowable costs reported in the Medicare Cost Report are reported in accordance with CMS Guidelines using the cost-to-charge ratio methodology. |
| Part III, Line 9b: | N/A |
| Part VI, Line 2: | Grace Cottage Hospital is such a small hospital in a rural, relatively sparsely populated area that our community leaders, patients, and members of the public are quick to inform our administrators and our medical staff about how Grace Cottage serves the healthcare needs of the public. Grace Cottage's small size ensures that we can be responsive to community requests made via our website, e-mails to members of our staff, or informal face-to-face meetings with people in the communities we serve. |
| Part VI, Line 3: | Although we are Vermont's smallest Critical Access Hospital, Grace Cottage Hospital believes that quality health care should be available to all; and that we all have a responsibility to help others in need regardless of their ability to pay. Posters and brochures detailing the availability of help with billing, public programs, and charity care are displayed in high traffic areas throughout the Hospital, rural health clinic and pharmacy, as well as listed on the Hospital's website. The staff reaches out to patients in a variety of ways to ensure that they are aware that help is available. During FY14, the Hospital employed a Resource Advocate to help uninsured and underinsured patients locate and procure services for which they may qualify. The Resource Advocate's services were free of charge for community members between the ages of 18-64 years (those 65 and older were encouraged to contact Senior Solutions, formerly Southeastern Vermont Council on Aging). The Hospital's Resource Advocate helped many people with a wide variety of resource issues, helping to fill out necessary forms and making connections for patients with other federal, state and local resources. This employee was an expert in filling out reduced fee applications, finding sources for reduced-cost or free prescription medications, and locating other avenues of support. |
| Part VI, Line 4: | Grace Cottage Hospital plays a vital role in healthcare for this rural, mountainous community. Its federal designation as a critical access hospital recognizes its importance in providing health care to an otherwise medically underserved community. The Hospital's emergency department is especially vital to members of the community, who would otherwise have to travel many miles on winding, mountainous highways to reach emergency medical care at another hospital. Grace Cottage Hospital is located in Windham County, in southeastern Vermont. According to the U.S. Census Bureau, Windham County has an estimated total of 43,714 residents. Grace Cottage Hospital's patient base is approximately 26,000 residents, mostly from 21 surrounding towns. The median household income of Windham County, Vermont, is $50,234 (U.S. Census Bureau "Quick Facts," updated 2013). Income statistics for the total population served by Grace Cottage Hospital are not available because Grace Cottage only requires income information from patients requesting reduced fees or free care. |
| Part VI, Line 5: | Grace Cottage Hospital is a Critical Access Hospital located in rural, mountainous Townshend, Vermont. The Hospital is served by a board of trustees consisting of local citizens active in community businesses and organizations. Only two of the ten trustees, the CEO and a physician, are hospital employees. All trustees reside in the Hospital's service area and bring a wealth of community input to the Hospital's strategic planning process. The Hospital extends medical staff privileges to all qualified physicians in the community.Grace Cottage Hospital applies any surplus funds towards improving its ability to provide quality patient care and being an integral part of assuring the health and well-being of the communities we serve. Despite its small size, Grace Cottage Hospital is committed to giving back to the community to the greatest extent possible. Area non-profit organizations providing health-related and emergency preparedness-related services to the community are provided with meeting and training space at the Hospital. In response to the last Community Health Needs Assessment, the Hospital has worked collaboratively with local schools and organizations to promote healthy, fun activities and provides opportunities that make the most of staying as healthy as possible. Community Wellness: In 2014, there were a total of 3,263 wellness visits. Wellness activities included: dance meditation, strong bones exercise classes, meditation circle, weight control programs, and yoga. Tobacco cessation classes at Grace Cottage Hospital were held under the auspices of Vermont's Blueprint for Health program.For the third consecutive year, Grace Cottage Hospital employees collaborated with Brattleboro Memorial Hospital and The Brattleboro Retreat to organize and implement a Community Health Festival. Over 50 area non-profit organizations and more than 500 members of the community attended the Health Festival on September 20, 2014. In addition, Brattleboro Memorial Hospital, The Brattleboro Retreat, and Grace Cottage Hospital collaborate on a Wellness in Windham website and Health Education calendar. Grace Cottage employees also assisted in coordinating a community blood drive in Newfane, Vermont, in conjunction with the American Red Cross.Grace Cottage Hospital plays a pivotal role in Emergency/Disaster Preparedness in this rural, mountainous area of Windham County, Vermont. The Hospital works collaboratively with:- the local town volunteer fire and first responder rescue departments; - the regional ambulance service, Rescue Inc.;- Windham County Regional Commission the Local Emergency Planning Committee covering the towns that Grace Cottage serves;- the local Citizens Emergency Response Team (CERT); - the local Radio Amateur Civil Emergency Service (RACES) West River Radio Club meets and stores equipment at Grace Cottage Hospital; - Vermont Association of Hospitals and Health Systems; - Vermont Department of Health. Grace Cottage Hospital houses the local non-profit transport ambulance service, Rescue Inc., free of charge, on the Hospital grounds, providing an ambulance garage and two rooms for use by rescue personnel. Rescue Inc. is based in Brattleboro, VT, 18 miles away; the branch that is located at Grace Cottage 24 hours a day, 365 days a year, is known as Rescue Inc. Division Two. Grace Cottage Hospital staff participate in onsite training for disaster preparedness as well as offsite training with other hospitals. |
| Part VI, Line 6: | N/A |
| Part VI, Line 7, Reports Filed With States | VT |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Timothy P Shafer MD | ||||||||||||||
| Trustee/Family Physician | $206,661 | $0 | $52,296 | $0 | $3,218 | $0 | $7,650 | $0 | $21,302 | $0 | $291,127 | $0 | $0 | $0 |
| Stephen A Brown | ||||||||||||||
| CFO | $169,264 | $0 | $0 | $0 | $17,189 | $0 | $5,726 | $0 | $21,302 | $0 | $213,481 | $0 | $0 | $0 |
| Maurice Geurts MD | ||||||||||||||
| Family Physician | $247,302 | $0 | $52,627 | $0 | $2,458 | $0 | $7,650 | $0 | $21,302 | $0 | $331,339 | $0 | $0 | $0 |
| Moss J Linder MD | ||||||||||||||
| Family Physician | $194,289 | $0 | $33,242 | $0 | $2,763 | $0 | $4,619 | $0 | $21,302 | $0 | $256,215 | $0 | $0 | $0 |
| Ewa Arnold MD | ||||||||||||||
| Family Physician | $127,385 | $0 | $34,775 | $0 | $2,158 | $0 | $2,119 | $0 | $19,619 | $0 | $186,056 | $0 | $0 | $0 |
| Robert Backus MD | ||||||||||||||
| Family Physician | $132,387 | $0 | $4,269 | $0 | $4,946 | $0 | $4,335 | $0 | $16,679 | $0 | $162,616 | $0 | $0 | $0 |
| Richard Meyer MD | ||||||||||||||
| CMO/Emergency Physician | $135,620 | $0 | $425 | $0 | $2,158 | $0 | $3,605 | $0 | $20,917 | $0 | $162,725 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7 | FormAndLineReferenceDesc |
| Explanation | Physician contracts provide the opportunity to receive additional payments for productivity above minimum thresholds. For the period reported, five physicians listed in Part VII were under such a contract: Dr. Maurice Geurts, Dr. Moss Linder, Dr. Ewa Arnold, Dr. Timothy Shafer, and Dr. Robert Backus, who received incentive compensation payments of $52,627, $33,242, $34,775, $52,296, and $4,269, respectively. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Helms & Company Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Interim CEO and Principal | RelationshipDescriptionTxt |
| Transaction | $204,657 | TransactionAmt |
| Transaction | Margaret S. Cleary, FACHE, who served as an interim-CEO of the Hospital until January, 2014, is a principal of Helms & Company, Inc. who were paid for management and consulting services rendered to the Organization. Helms and Company was paid $39,664 related to interim-CEO contracted services and $204,657 in total. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | The Organization paid Helms & Company, Inc., a healthcare consulting and management company, for interim CEO Margaret S. Cleary, FACHE, who served the Hospital from October 2013 until January 2014. Total fiscal year 2014 amount paid to Helms & Company, Inc. for providing CEO services was $30,664. |
| Form 990, Part VI, Section B, line 11 | A draft of the Form 990 is initially reviewed in detail by Carlos G. Otis Health Care Center's key finance employees. Thereafter, the final draft is provided to the full Board for review prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | A copy of the conflict of interest policy is distributed annually to the Board of Trustees and each trustee signs to confirm that they have thoroughly read, understand, and agree to comply with the conflict of interest policy. |
| Form 990, Part VI, Section B, line 15 | CEO's Compensation: The CEO's compensation and benefits are reviewed, adjusted and voted on by the full board annually. The Board used external market compensation data to determine the CEO's initial compensation when hired and annually uses such data to compare OHCC's CEO compensation with that of other hospital executives in the Northeast region. The CEO is excused from Board discussion and voting on issues surrounding CEO compensation and benefits. Compensation of other hospital employees: The CEO reviews the salaries of employees annually and determines compensation based on performance and salary ranges, using regional salary range data for comparison. |
| Form 990, Part VI, Section C, line 19 | Upon request, Carlos G. Otis Health Care Center, Inc. makes its governing documents, conflict of interest policy, and financial statements available to the public. |
| Form 990, Part VII, Section A: | OHCC had two interim CEOs during the year. Margaret S. Cleary, FACHE, was interim CEO from October, 2013 to January, 2014. Roger N. Allbee was then hired on a contracted basis at the end of December, 2013. In April 2014, Mr. Allbee became the permanent CEO and a full-time employee and officer of OHCC. Ms. Cleary was a contracted employee of Helms & Company, an unrelated management services company during the calendar year 2013. See Schedule O, Part VI, Line 3 for more information. Because IRS instructions require that compensation and benefit information be reported on Form 990, Part VII on a calendar year basis, no compensation and benefits are reported on this Form 990 for either CEO. The Organization's 2014 Form 990 will reflect Mr. Allbee's compensation information for calendar year ending 2014 which includes his time as an independent contractor and then a hired employee. Accordingly, Mr. Allbee has not been listed as an independent board member on this Form 990 for fiscal year ended September 30, 2014. The compensation reported for Dr. Timothy Shafer was for his services as a full-time physician. He was not compensated for his services as members of OHCC's Board of Trustees. |
| Form 990, Part XI, line 9: | Increase in Beneficial Interest in Net Assets of GCF 885,684. |
| Form 990, Part XI, Line 2c: | The Finance and Audit Committee oversees the audit process for the Carlos G. Otis Health Care Center, Inc. and Grace Cottage Foundation, Inc. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit for both fiscal years. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Grace Cottage Foundation Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1 | AddressLine1 |
| City | Townshend | City |
| State | VT | State |
| ZIP Code | 05353 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030343282 | EIN |
| Primary Activities | Solicit contributions for the funding of health care services by OHCC | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 11a, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carlos G Otis Health Care Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | 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 |
|---|---|---|
| Grace Cottage Foundation Inc | ||
| Q | $169,486 | Actual per books |
| Grace Cottage Foundation Inc | ||
| C | $236,675 | Actual per books |