2015-08-14T09:10:14-05:00 2014-09-30 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2013-10-01 222547186 CENTRAL VERMONT MEDICAL CENTER INC % JASON IRWIN CONTROLLER CENT 8023714100 130 FISHER ROAD Suite BERLIN VT 05602 CHEYENNE HOLLAND CFO 8023714100 2015-08-11 true PRICEWATERHOUSECOOPERS LLP P00641463 8023714100 2013 2016-04-25 22:37:26Z Ms Judith Tarr Tartaglia 130 Fisher Road Berlin VT 05602 174077481 false X WWW.CVMC.ORG X 1963 VT WE WORK COLLABORATIVELY TO MEET THE NEEDS AND IMPROVE THE HEALTH AND IMPROVE THE HEALTH OF THE RESIDENTS OF CENTRAL VERMONT. 19 14 1739 178 0 674022 2590011 157838011 169558614 1215786 1202128 2508555 337039 162236374 173687792 64500 35040 0 0 102707632 107800901 0 0 15067 57299212 57225316 160071344 165061257 2165030 8626535 148101144 155735636 65624375 68317717 82476769 87417919 X SEE SCHEDULE O false false 108444379 35040 127056460 HOSPITAL SERVICES: INPATIENT, OUTPATIENT, AND 24/7 EMERGENCY DEPARTMENT SERVICES: CVMC HAS 122 LICENSED BEDS TO PROVIDE FOR A FULL SPECTRUM OF INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. 17,278 INPATIENT DAYS, MORE THAN 380,000 OUTPATIENT PROCEEDURES, AND 26,119 EMERGENCY ROOM VISITS WERE RECORDED DURING FISCAL YEAR 2014. OUTPATIENT ANCILLARY SERVICE UNITS TOTALED OVER 613,500 INCLUDING 24,873 RADIOLOGY PROCEDURES, 411,357 LAB TESTS, 10,154 CARDIOLOGY TESTS, AND 116,067 UNITS OF PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. EMERGENCY DEPARTMENT: THE ER IS OPEN 24 HOURS A DAY 365 DAYS A YEAR. THE NUMBER OF PATIENTS SEEN IN THE ER IN FISCAL YEAR 14 WAS 26,119. THE CANCER TREATMENT CENTER PROVIDED 4,857 ONCOLOGY AND RADIATION TREATMENTS. THE HOSPITAL ALSO HAS BEEN ACTIVE IN ITS OUTREACH TO CENTRAL VERMONT'S UNINSURED AND UNDER INSURED RESIDENTS. 30962768 27211153 MEDICAL GROUP PRACTICES: AT THE END OF THE FISCAL YEAR WE HAD 21 PRIMARY CARE, INFIRMARY, AND SPECIALTY PRACTICES. THIS INCLUDED 7 PRIMARY AND FAMILY CARE CLINICS, 2 PEDIATRIC CLINICS, AS WELL AS SPECIALTY CLINICS FOR UROLOGY, PODIATRY, RHEUMATOLOGY, ENDOCRINOLOGY, ORTHOPAEDICS, PSYCHOLOGY, AND OBSTETRICS/ GYNECOLOGY. THERE WERE A TOTAL OF 178,961 PRACTICE VISITS DURING FISCAL YEAR 2014. 15690777 15291001 WOODRIDGE SKILLED NURSING FACILITY: CVMC ALSO OPERATES A 153 LICENSED BED SKILLED NURSING FACILITY. THE FACILITY CONCENTRATES ITS SERVICES TO PALLIATIVE CARE, REHABILITATION, PAIN MANAGEMENT, AND ADVANCED WOUND CARE. 47,065 PATIENT DAYS WERE RECORDED IN FISCAL YEAR 2014. 155097924 true true false true false false false false false true true false false false true true false true false false false false false false true false true true true false true true false false false false false false false false true false true false false false false true true true false false true 94 0 true 1739 true false false false false false true true false false false false X 19 14 false false false false true true true true true false false true true true true false false true true false VT X JASON IRWIN CONTROLLER 8023714225 130 FISHER RD Berlin VT 05602 X Mark Crane Trustee, Pres CVMC Med Staff 1.0 X 68600 Stephen Martin Trustee 1.0 X Thomas Robbins Trustee, Immediate Past Chair 1.0 2.0 X Marta Marble Trustee 1.0 2.0 X Robin Nicholson Trustee 1.0 2.0 X Judith Tarr Tartaglia Trustee, President/CEO 48.0 2.0 X X 409694 0 25024 Mark Depman MD Trustee, Medical Director EMS 50.0 X 336347 0 24361 Michael Dellipriscoli TRUSTEE, Chair Elect 1.0 2.0 X Laura Plude TRUSTEE 1.0 X Carol Welch TRUSTEE 1.0 X Greg Voorheis Trustee, Chair 1.0 2.0 X Steven Shea Trustee 1.0 X Christopher Barbieri Trustee as of 12/2013 1.0 X Heidi Pelletier Trustee 1.0 X Joseph Pekala MD Trustee & Pres. CVMC Med Staff 1.0 2.0 X 30000 John Brumsted MD Trustee as of 12/2013 1.0 49.0 X 1732782 135311 Joyce Judy Trustee as of 12/2013 1.0 X Dennis Minoli Trustee 1.0 X Donald Carpenter Trustee 1.0 X Edward Friihauf Trustee until 12/12/2013 1.0 X Judy Peterson Trustee until 12/12/2013 1.0 X Nancy Lothian Chief Operating Officer 50.0 X 256850 0 14146 Cheyenne Holland TREASURER, CFO/VP FISCAL SRVS 50.0 X 225532 0 24605 Katherine Borne SECRETARY, EXECUTIVE ASSISTANT 50.0 X 71639 0 17642 Philip Brown DO VP Medical Affairs 50.0 X 316523 0 24616 Richard Morley VP Support Services 50.0 X 196404 0 21892 Alison White CNO & VP NURSING AND QUALITY 50.0 X 176621 0 1411 Jeremiah Eckhaus MD Physician 50.0 X 234849 0 25286 MICHELLE HEEZEN VP PHYS. SVCS UNTIL 5/31/13 50.0 X 141395 11724 Gregory Macdonald MD Physician 50.0 X 300287 0 15762 Mark Heitzman MD Physician 50.0 X 317026 0 22045 Peter Thomashow MD Physician 50.0 X 324464 0 31920 John Braun MD PHYSICIAN 50.0 X 459769 0 19995 Matthew Greenberg MD Physician 50.0 X 302119 0 24390 4099519 1801382 440130 126 false true false E F WALL ASSOCIATES INC 131 SOUTH MAIN ST PO BOX 259 BARRE VT 05641 CONSTRUCTION CNTRCTR 756259 KLEEN INC 1 FOUNDRY STREET LEBANON NH 03766 LINEN SERVICE 403829 BLUE RIDGE CONSTRUCTION LLC PO BOX 88 EAST MONTPELIER VT 05651 PLOWING/LANDSCAPING 414865 CAPITAL EARTHMOVING INC 131 SOUTH MAIN WALL ST BARRE VT 05641 PHYSICIAN STAFFING 595555 KPMG LLP SUITE 2700 INDEPENDENT DR JACKSONVILLE FL 322019944 CONSULTING SERVICES 384968 23 10285 253419 2326307 109698 2590011 NET PATIENT SERVICE REVENUE 900099 159103060 159103060 REV FROM MANAGED CARE AND CAPITATED 900099 1707553 1707553 340B CONTRACT PHARMACY REVENUE 900099 4454558 4454558 MEANINGFUL USE 900099 1687832 1687832 CAFETERIA REVENUE 900099 870354 870354 1735257 1735257 169558614 1202128 1202128 0 0 610590 271271 339319 0 339319 339319 109698 109698 0 6440 10285 8720 -2280 -2280 0 0 0 173687792 169558614 1539167 35040 35040 0 0 0 4110686 2196697 1913989 56725 56725 78914718 75428625 3474480 11613 4980448 4656734 323018 696 14240560 13314968 923602 1990 5497764 5140427 356569 768 451049 451049 158396 158396 86198 86198 0 0 166072 15434 150638 8344045 7712766 631279 690355 110777 579578 19795149 19577038 218111 1788891 1712241 76650 0 6033695 5913411 120284 102879 82982 19897 0 451738 403811 47927 1176404 1176404 0 9380706 9380706 953098 953098 BAD DEBT EXPENSE 6081997 6081997 STATE NURSING BED TAX ASMNT 752688 752688 DUES & FEES 596973 279676 317297 MISCELLANEOUS EXPENSE 214983 115679 99304 165061257 155097924 9948266 15067 0 0 10876858 20677367 81500 10000 15704785 15913054 0 0 0 0 1326873 1486230 2620173 2849600 2305964 1793921 154273243 84202469 70356815 70070774 43416145 41396088 0 0 0 0 0 0 1412031 1538602 148101144 155735636 21479143 23693942 0 0 0 0 20194049 18809305 0 0 0 0 0 0 0 0 23951183 25814470 65624375 68317717 X 72703960 77640363 6671503 6676250 3101306 3101306 82476769 87417919 148101144 155735636 X 8626535 1343024 -5028409 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 23116 23116 false LOBBYING ACTIVITY SCHEDULE C, PART II-B, LINE 1I CENTRAL VERMONT MEDICAL CENTER IS A MEMBER OF, AND PAYS DUES TO, THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SERVICE PROVIDERS AS WELL AS THE AMERICAN HOSPITAL ASSOCIATION, THE VERMONT HEALTH CARE ASSOCIATION, AND THE MEDICAL GROUP MANAGEMENT ASSOCIATION. A PORTION OF THE DUES IS USED FOR LOBBYING PURPOSES. 7489540 676127 35433 8130234 7318467 810401 639328 7489540 7346576 437354 465463 7318467 8037955 0 38427 0 729806 0 7346576 7194461 456000 518837 0 131343 0 8037955 0.38150 0.61850 false false 5510000 5510000 54153786 27430836 26722950 20820478 11618222 9202256 67618469 42296510 25321959 6170510 2856901 3313609 70070774 0 ACCRUED PENSION LIABILITY 24819602 OTHER LIABILITIES 994868 25814470 X ENDOWMENT FUNDS SCHUEDULE D, PART V, LINE 4 CVMC HAS ENDOWMENT INVESTMENTS AND SPENDING POLICIES THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING FOR CAPITAL AND OPERATIONAL PROGRAMS PERTAINING TO THE DELIVERY OF HOSPITAL AND SKILLED NURSING CARE SERVICES AS WELL AS INTERNAL MEDICINE, FAMILY AND SPECIALTY PHYSICIAN SERVICES IN ORDER TO MEET THE HEALTH CARE NEEDS OF THE CENTRAL VERMONT COMMUNITY. ASC 740 DISCLOSURE SCHEDULE D, PART X, LINE 2 FLETCHER ALLEN PARTNERS (FAP), NOW KNOWN AS THE UNIVERSITY OF VERMONT HEALTH NETWORK, ACCOUNTS FOR RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC 740. NO PROVISION FOR UNCERTAIN TAX POSITIONS IS RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. CENTRAL VERMONT MEDICAL CENTER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF FAP. 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MEETINGS WERE HELD THROUGHOUT 2012 FOR THE COMMITTEE MEMBERS TO DELIBERATE OVER ALL COMMUNITY HEALTH CONCERNS AND REVIEW PERTINENT DATA AND INFORMATION. INPUT WAS PROVIDED BY: A. WASHINGTON COUNTY MENTAL HEALTH B. CENTRAL VERMONT HOME HEALTH & HOSPICE C. PEOPLES HEALTH AND WELLNESS D. U32 HIGH SCHOOL E. CENTRAL VERMONT COUNCIL ON AGING F. GREEN MOUNTAIN UNITED WAY G. VERMONT DEPARTMENT OF HEALTH H. CENTRAL VERMONT MEDICAL CENTER PART V, LINE 6I AT CENTRAL VERMONT MEDICAL CENTER, WE COLLABORATE WITH OTHER NON-PROFITS, BUSINESSES, COMMUNITY LEADERS, AND GOVERNMENTAL AGENCIES TO PROVIDE A VARIETY OF PROGRAMS AND EDUCATIONAL OFFERINGS INTENDED TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. OUR AFFILIATION BEGINNING IN 2011 WITH THE UNIVERSITY OF VERMONT MEDICAL CENTER (FORMERLY FLETCHER ALLEN HEALTH CARE), CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER, AND ELIZABETHTOWN COMMUNITY HOSPITAL UNDER THE UNIVERSITY OF VERMONT HEALTH NETWORK (FORMERLY FLETCHER ALLEN PARTNERS) HAS INCREASED OUR REACH AND CAPABILITIES AS THE PRIMARY MEDICAL CENTER IN CENTRAL VERMONT. THIS CONNECTION WITH THE UNIVERSITY OF VERMONT MEDICAL CENTER HAS BEEN A SIGNIFICANT STEP IN PROMOTING REGIONAL STRATEGIC PLANNING, IMPROVING ACCESS TO LOCAL CARE, ENHANCING INFORMATION TECHNOLOGY, AND ENCOURAGING JOINT QUALITY AND CLINICAL INITIATIVES. TOGETHER OUR ORGANIZATIONS HAVE WORKED TO ALIGN WITH THE STATE AND FEDERAL HEALTH CARE REFORM AGENDAS THAT PROMOTE ENHANCED INTEGRATION AND BUILD UPON OUR EXISTING CLINICAL PARTNERSHIPS. A NUMBER OF CVMC STAFF MEMBERS SERVE ON BOARDS OF OTHER MISSION RELATED COMMUNITY ORGANIZATIONS AND PLANNING GROUPS SUCH AS THE VERMONT BLUEPRINT FOR HEALTH, CENTRAL VERMONT HEALTH CARE COALITION, CENTRAL VERMONT SUBSTANCE ABUSE SERVICES, GREEN MOUNTAIN UNITED WAY, PEOPLE'S HEALTH & WELLNESS CLINIC, VERMONT DIETETIC ASSOCIATION, VERMONT ETHICS NETWORK, VERMONT MEDICAL SOCIETY BOARD, AND MANY MORE. THIS COMMUNITY INVOLVMENT HELPS TO SUPPORT THE VALUABLE WORK BEING DONE BY CVMC THROUGHOUT THE COUNTY TO ADDRESS COMMUNITY HEALTH. OUR STEERING COMMITTEE DISCUSSED REGIONAL STRATEGIES THAT ARE WORKING, GAPS THAT REMAIN, AND OPPORTUNITIES FOR IMPROVEMENT. FROM THIS POINT, WE HAVE DEVELOPED THE FOLLOWING MEASURES TO ADDRESS THOSE AREAS FOR IMPROVEMENT THAT REQUIRE MORE ATTENTION AND COLLABORATION: - PROMOTE HEALTHY LIFESTYLES - INCREASE IMMUNIZATION RATES - IMPROVE PRENATAL AND MATERNAL HEALTH - IMPROVE ACCESS TO TRANSPORTATION - FIGHT THE EPIDEMIC OF YOUTH OBESITY PART V, LINE 7 MENTAL HEALTH IS AN ISSUE THAT WAS IDENTIFIED IN THIS ASSESSMENT AS AN AREA OF NEED BUT WAS NOT PRIORITIZED OR INCLUDED IN OUR IMPLEMENTATION PLAN. WHEN WASHINGTON COUNTY YOUTH WERE SURVEYED THROUGH THE 2011 YOUTH RISK BEHAVIOR SURVEY, 23% OF STUDENTS REPORTED THAT THEY FELT SAD OR HOPELESS ALMOST EVERY DAY FOR TWO WEEKS OR MORE IN THE PAST 12 MONTHS. EVEN MORE TROUBLING IS THE STATISTIC THAT 11% OF WASHINGTON COUNTY STUDENTS REPORTED HAVING MADE A SUICIDE PLAN IN THE PAST 12 MONTHS. WITH THIS EVIDENCE AND MORE, WE RECOGNIZED COMMUNITY MENTAL HEALTH AS AN AREA WHERE IMPROVEMENT IS CERTAINLY NECESSARY BUT AS AN AREA MORE SUITED FOR COLLABORATIVE COMMUNITY AND STATE EFFORTS, WHERE CVMC DOES NOT INTEND TO IMPLEMENT INDEPENDENT IMMEDIATE ACTION. CURRENT AVAILABLE SOURCES OF CARE ARE WASHINGTON COUNTY MENTAL HEALTH SERVICE, CVMC FAMILY PSYCHIATRY ASSOCIATES, CVMC'S INPATIENT PSYCHIATRY DEPARTMENT, AND THE HEALTH CENTER IN PLAINFIELD. A SIGNIFICANT REASON WHY IMPLEMENTATION STEPS FOR MENTAL HEALTH ARE NOT INCLUDED IN THIS REPORT IS THAT A NEW 25-BED INTENSIVE-CARE PSYCHIATRIC HOSPITAL WAS CONSTRUCTED ADJACENT TO CVMC IN BERLIN. THIS $28.5 MILLION FACILITY IS PART OF A STATEWIDE NETWORK OF MENTAL HEALTH FACILITIES WHICH REPLACE THE VERMONT STATE HOSPITAL IN WATERBURY AND OPENED TO PATIENTS IN 2014. MENTAL HEALTH HAS BEEN ACKNOWLEDGED AS A PRESSING ISSUE STATEWIDE. OUR COMMUNITY HOPES THIS NEW FACILITY WILL CONTINUE TO ALLEVIATE SOME OF THE CURRENT DEMAND FOR INPATIENT CARE FOR SEVERE MENTAL HEALTH NEED. AS EXPECTED, OUR COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED ADDITIONAL DETERMINANTS OF HEALTH THAT FALL OUTSIDE THE REALM OF OUR CAPABILITIES AT CVMC. A PROMINENT NEED THAT WE ARE NOT DIRECTLY ADDRESSING IS ORAL HEALTH. SEVERAL OF OUR PHYSICIANS HAVE UNDERGONE FLUORIDE TREATMENT TRAINING, AND WILL BE ABLE TO PROVIDE THIS SERVICE FOR CHILDREN UP TO FOUR YEARS OF AGE WHO DO NOT HAVE ACCESS TO DENTAL CARE. HOWEVER, ONE OUT OF FOUR ADULTS IN WASHINGTON COUNTY HAS NOT VISITED A DENTIST IN THE LAST YEAR. AS A MEDICAL HOSPITAL, WE DO NOT HAVE THE FACILITIES OR EXPERTISE TO ADDRESS THIS NEED DIRECTLY. WITH THIS SAID, IT IS IMPORTANT THAT WE RECOGNIZE ALL FACTORS THAT MAY BE AFFECTING THE OVERALL HEALTH OF PATIENTS WALKING THROUGH OUR DOORS AT CVMC. WE INTEND TO CONTINUE COLLABORATION WITH COMMUNITY FACILITIES SUCH AS PLAINFIELD HEALTH CENTER THAT OFFER DENTAL CARE. PART V, LINE 14G IN ADDITION TO HAVING THE APPLICATION FOR FINANCIAL ASSISTANCE AS WELL AS THE SLIDING SCALE GRID OF HOW FINANCIAL ASSISTANCE IS AWARDED CVMC HAS COMPREHENSIVE INFORMATION ON THE WEBSITE ABOUT THE POLICY, MATERIALS REQUIRED TO APPLY AND CONTACT INFORMATION FOR THE FINANCIAL COUNSELORS SO THAT INTERESTED INDIVIDUALS CAN APPLY. ADDITIONALLY, THERE IS REFERENCE MADE TO THE POLICY ON PATIENT'S BILLS AS WELL AS APPLICATIONS AND INFORMATION AVAILABLE IN REGISTRATION AREAS IN THE HOSPITAL AND CLINIC LOCATIONS. CVMC ALSO EMPLOYS A TEAM OF FINANCIAL COUNSELORS THAT WORK WITH PATIENTS THROUGHOUT THEIR VISIT TO ENSURE THAT WE COMMUNICATE WITH AS MANY ELIGIBLE INDIVIDUALS AS POSSIBLE. THESE FINANCIAL COUNSELORS ALSO WORK WITH PATIENTS TO EXPLORE THE OTHER OPPORTUNITIES AVAILABLE TO INDIVIDUALS IN NEED THROUGHOUT THE STATE OF VERMONT. PART V, LINE 18E CVMC DID NOT INITIATE ANY OF THE ACTIONS DESCRIBED IN SCHEDULE H, PART V, SECTION B, LINE 17. HOWEVER, IF THE HOSPITAL HAD UNDERTAKEN ANY OF THE LISTED ACTIONS, IT WOULD HAVE FIRST NOTIFIED PATIENTS OF ITS FINANCIAL ASSISTANCE POLICY ON ADMISSION, PRIOR TO DISCHARGE, AND IN COMMUNICATIONS WITH THE PATIENTS REGARDING THEIR BILLS. ADDITIONALLY, CVMC WOULD HAVE DOCUMENTED ITS DETERMINATION OF WHETHER PATIENTS WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY. PART V, LINE 20D CVMC USES 75% OF GROSS CHARGES AS A BASIS FOR BILLING ELIGIBLE INDIVIDUALS. 22 CVMC - WOODRIDGE NURSING HOME 130 FISHER ROAD BERLIN VT 05602 SKILLED NURSING FACILITY CVMC WOMEN'S HEALTH 130 FISHER ROAD SUITE 1-4 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC PEDIATRICS PRIMARY CARE - BERLIN 246 GRANGER ROAD SUITE 1 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC FAMILY MEDICINE - WATERBURY 130 SOUTH MAIN STREET WATERBURY VT 05676 MEDICAL GROUP PRACTICE CVMC ADULT PRIMARY CARE - BERLIN 195 HOSPITAL LOOP SUITE 3 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC INTEGRATIVE FAM MED - MONTPELIER 156 MAIN STREET MONTPELIER VT 05602 MEDICAL GROUP PRACTICE CVMC FAMILY MEDICINE - BERLIN 82 EAST VIEW LANE SUITE 3 BARRE VT 05641 MEDICAL GROUP PRACTICE CVMC ADULT PRIMARY CARE - BARRE 225 SOUTH MAIN STREET BARRE VT 05641 MEDICAL GROUP PRACTICE CVMC CARDIOLOGY 130 FISHER ROAD SUITE 2-1 BERLIN VT 05602 MEDICAL GROUP PRACTICE GREEN MOUNTAIN FAMILY PRACTICE 63 CRESCENT AVENUE NORTHFIELD VT 05663 MEDICAL GROUP PRACTICE CVMC PEDIATRICS PRIMARY CARE - BARRE 225 SOUTH MAIN STREET BARRE VT 05641 MEDICAL GROUP PRACTICE CVMC FAMILY PSYCHIATRY 77 VINE STREET BARRE VT 05641 MEDICAL GROUP PRACTICE CVMC FAMILY MEDICINE - MAD RIVER 859 OLD COUNTY ROAD WAITSFIELD VT 05673 MEDICAL GROUP PRACTICE CVMC UROLOGY 286 HOSPITAL LOOP SUITE 1 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC NEUROLOGY 130 FISHER ROAD BERLIN VT 05602 MEDICAL GROUP PRACTICE NORWICH INFIRMARY 63 CRESCENT AVENUE NORTHFIELD VT 05663 MEDICAL INFIRMARY CVMC ORTHOPEDICS & SPINE MEDICINE 244 GRANGER ROAD BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC ORTHOPEDICS & SPORTS MEDICINE 130 FISHER ROAD MOB-B SUITE 2-3 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC RHEUMATOLOGY 130 FISHER ROAD BLD B SUITE 2-3 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC EXPRESS CARE 1311 BARRE MONTPELIER ROAD SUITE 2 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC ORTHOPAEDICS - PODIATRY 130 FISHER ROAD MOB B SUITE 4 BERLIN VT 05602 MEDICAL GROUP PRACTICE CVMC ENDOCRINOLOGY 130 FISHER ROAD MOB-C SUITE 1 BERLIN VT 05602 MEDICAL GROUP PRACTICE REQUIRED DESCRIPTIONS SCHEDULE H, PART VI, LINE 1 THE ORGANIZATION'S REQUIRED SCHEDULE H SPECIFIC LINE ITEM DESCRIPTIONS ARE AS FOLLOWS: PART I, LINES 3A-C: CVMC HAS A SLIDING SCALE BASED ON INCOME AND ASSETS FOR DETERMINING FREE CARE AS WELL AS DISCOUNTED CARE. FOR INDIVIDUALS WITH INCOME UP TO 200% OF THE FEDERAL POVERTY LEVEL (FPL), FREE CARE IS PROVIDED. FOR INDIVIDUALS WITH INCOME UP FROM 201% TO 250% OF THE FPL, AN 85% DISCOUNT IS GIVEN, FOR INDIVIDUALS WITH INCOME FROM 251% TO 300% OF THE FPL, A DISCOUNT OF 75% IS GIVEN, FOR INDIVIDUALS WITH INCOME FROM 301% TO 350% OF THE FPL A 65% DISCOUNT IS GIVEN, AND FOR INDIVIDUALS WITH INCOME FROM 351% TO 400% OF THE FPL A 55% DISCOUNT IS GIVEN. ASSETS INCLUDING CASH, SAVINGS, CHECKING ACCOUNTS, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, TERM CERTIFICATES, STOCKS, BONDS, MUTUAL FUNDS, OTHER LIQUID ASSETS, SECONDARY HOMES, AND RENTAL PROPERTIES MAY ALSO BE CONSIDERED IN THE FINANCIAL CALCULATION FOR INDIVIDUALS REQUESTING ASSISTANCE. PART I, LINE 7G: FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2014 CENTRAL VERMONT MEDICAL CENTER INCLUDED PHYSICIAN CLINIC EXPENSES IN SUBSIDIZED HEALTH SERVICES. CENTRAL VERMONT MEDICAL CENTER PHYSICIANS INCURRED $30,962,768 OF COSTS ASSOCIATED WITH PROVIDING OUTPATIENT CLINIC SERVICES. NEARLY ALL OF THE EXPENSES INCLUDED AS SUBSIDIZED HEALTH SERVICES ARE ATTRIBUTABLE TO PHYSICIAN CLINICS. AS A RESULT OF THE UNIQUE GEOGRAPHY AND POPULATION DENSITY OF THE COMMUNITY THAT CVMC SERVES, WE CONSIDER ALL OF THE PRIMARY AND SPECIALTY OUTPATIENT CARE PROVIDED BY OUR EMPLOYED GROUP OF PHYSICIANS TO BE SUBSIDIZED. IT HAS BEEN APPARENT OVER THE LAST 10-15 YEARS THAT THERE ARE NOT NEW, UNAFFILIATED PROVIDERS COMING INTO THE CVMC SERVICE AREA AND STARTING PRACTICES. ADDITIONALLY THE MAJORITY OF THE INDEPENDENT PRACTICES THAT WERE ESTABLISHED IN THE CVMC SERVICE AREA HAVE JOINED CVMC DUE TO MANY REASONS INCLUDING ECONOMIC VIABILITY AND SUCCESSION PLANNING. AS A RESULT OF THIS SHIFT, WHICH IS COMMON NOT ONLY IN THE NORTHEAST BUT ACROSS THE UNITED STATES, CVMC'S EMPLOYED PHYSICIANS MAKE UP THE MAJORITY AND IN SOME CASES THE ENTIRETY OF THE OUTPATIENT CARE SERVICES IN OUR COMMUNITY. WERE CVMC TO CEASE THE PROVISION OF THESE SERVICES, THERE IS NO WAY THAT THE COMMUNITY AS IT EXISTS TODAY WOULD HAVE THE CAPACITY TO ABSORB THE PATIENTS AND PROVIDE THE NECESSARY CARE. GIVEN THE HISTORIC LACK OF PROVIDERS ESTABLISHING NEW PRACTICES IN THE AREA, THE PATIENTS CURRENTLY SERVED BY THESE SUBSIDIZED HEALTH SERVICES WOULD END UP RECEIVING CARE FROM THE FEDERALLY QUALIFIED HEALTH CENTER WITHIN OUR SERVICE AREA, THE CVMC EMERGENCY DEPARTMENT, OR RECEIVING CARE FROM PROVIDERS OF NEIGHBORING HOSPITALS AND HEALTH SERVICE AREAS. PART I, LINE 7, COLUMN F: THE PROVISION FOR BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSE OF CALCULATING THE AMOUNT REPORTED ON LINE 7(F) IS $6,081,997. PART I, LINE 7: CVMC FOLLOWS THE IRS GUIDELINE FOR THE COMPLETION OF SCHEDULE H, PART I, LINES 7A-K, COLUMNS A-F. PART III, LINE 2 LINE 2 - BAD DEBT EXPENSE WAS CALCULATED BY TAKING THE CHARGES THAT WERE WRITTEN OFF TO ALLOWANCE TO BAD DEBT RESERVE AND REDUCING BY ANY RECOVERIES. PART III, LINE 3 LINE 3 - THE AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE WAS CALCULATED USING A PERCENTAGE OF COLLECTION CASES WHEREBY THE COLLECTION AGENCY HAS, UPON FURTHER COLLECTION ACTIVITY BEEN INFORMED THAT THE PATIENT REQUESTED FINANCIAL ASSISTANCE WITH HIS/HER BILL. THIS PERCENTAGE IS APPROXIMATELY 2% OF ALL COLLECTION CALL ACTIVITY. THIS PERCENTAGE WAS CALCULATED FROM THE NUMBER OF CALLS WITH A REQUEST FOR FINANCIAL ASSISTANCE LISTED ON THE COLLECTION AGENCY'S LOG AS A PERCENTAGE OF THE TOTAL NUMBER OF CALLS THE COLLECTION AGENCY MADE. PART III, LINE 4: PLEASE REFERENCE FOOTNOTE NUMBER 16 ON PAGES 39-40 IN THE FISCAL YEAR 2014 AUDITED CONSOLIDATED FINANCIAL STATEMENTS. PART III, LINE 8: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS SUCH AS MEDICARE IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD TO WHICH TAX-EXEMPT HOSPITALS ARE HELD. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. CVMC DETERMINES THE ALLOWABLE MEDICARE COSTS BY USING A COST TO CHARGE RATIO CALCULATION. PART III, LINE 9B: CVMC'S CREDIT AND COLLECTION POLICY FOR FINANCIAL ASSISTANCE STATES THAT CVMC WILL NOTIFY PATIENTS OF THE ASSISTANCE PROGRAM PRIOR TO SENDING ACCOUNTS TO COLLECTIONS. CVMC'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FREE CARE OR FINANCIAL ASSISTANCE. CVMC IS DILIGENT IN IDENTIFYING WHO QUALIFIES FOR FREE CARE AND/OR FINANCIAL ASSISTANCE. CVMC WILL NOT PURSUE COLLECTION FOR FREE CARE PATIENTS. ALSO, CVMC'S COLLECTION PRACTICES FOR FINANCIAL AID CASES INCLUDE MONITORING AND FOLLOWING UP TO ENSURE THAT THE PLAN IS CURRENT AND MATCHES THE PATIENT'S ECONOMIC NEEDS. NEEDS ASSESSMENT PART VI, LINE 2 THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED USING BOTH QUALITATIVE AND QUANTITATIVE RESEARCH TECHNIQUES. INITIALLY, MEMBERS OF THE CVMC STEERING COMMITTEE GAVE VERBAL REPORTS ON THE ISSUES THEY BELIEVED TO BE THE MOST PRESSING IN THEIR ORGANIZATIONS OR IN THE GENERAL CENTRAL VERMONT COMMUNITY. FROM THERE, THE STEERING COMMITTEE REVIEWED THE RECOMMENDED LIST OF HEALTH AND SOCIOECONOMIC INDICATORS PROVIDED BY THE VERMONT DEPARTMENT OF HEALTH, AND GATHERED DATA PERTAINING TO POPULATION DEMOGRAPHICS, ACCESS TO HEALTH SERVICES, MATERNAL AND CHILD HEALTH, HEALTH STATUS AND PREVENTION, AND SOCIAL ENVIRONMENTAL MEASURES TO EVALUATE THESE CONCERNS. THIS SECONDARY RESEARCH COUPLED WITH THE STEERING COMMITTEE'S CONCERNS ALLOWED SIGNIFICANT CONCLUSIONS TO BE DRAWN AND CVMC'S PRIORITY HEALTH NEEDS TO BE SELECTED. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT THE FOLLOWING WEB ADDRESS: http://www.cvmc.org/documents/community-health-needs-assessment-2013 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 CVMC'S FINANCIAL ASSISTANCE POLICIES ARE POSTED IN ALL PATIENT ADMISSION PACKETS AND ON THE CVMC WEBSITE. ALL PATIENT INVOICES LIST THE PHONE NUMBER FOR CONTACTING CVMC PATIENT FINANCIAL SERVICES FOR FINANCIAL ASSISTANCE IF PATIENTS ARE UNABLE TO PAY THEIR BILL. PATIENT FINANCIAL SERVICES HAS APPLICATIONS FOR ALL STATE FINANCIAL AID PROGRAMS ON FILE AND EMPLOYS THREE FINANCIAL COUNSELORS WHO WILL SIT DOWN WITH PATIENTS TO HELP THEM DETERMINE WHICH PROGRAMS THEY QUALIFY FOR, AS WELL AS HELP THEM FILL OUT THESE FORMS. PATIENT FINANCIAL SERVICES PROACTIVELY SCREENS PATIENT BILLING INFORMATION TO IDENTIFY INDIVIDUALS WHO MAY BE ELIGIBLE FOR STATE OR CVMC ASSISTANCE, AND WILL EITHER VISIT THAT PATIENT IN THE HOSPITAL, CALL THEM AT HOME, OR MAIL THEM THE INFORMATION. COMMUNITY INFORMATION PART VI, LINE 4 CENTRAL VERMONT MEDICAL CENTER IS THE ONLY HOSPITAL LOCATED IN OUR IMMEDIATE SERVICE AREA OF WASHINGTON COUNTY AND PARTS OF ORANGE COUNTY. THIS SERVICE AREA CONSISTS OF 23 TOWNS WITH A TOTAL POPULATION OF APPROXIMATELY 64,239. INCLUDED IN THIS SERVICE AREA IS THE FEDERALLY DESIGNATED ORWELL TOWN MEDICALLY UNDERSERVED AREA. VITAL STATISTICS: 97.1% WHITE 68% RURAL 20% UNDER THE AGE OF 20 66% AGED 18 TO 64 14% OVER THE AGE OF 65 MEDIAN HOUSEHOLD INCOME OF $52,832 9.7% LIVE BELOW THE POVERTY LEVEL 6.1% NON ENGLISH SPEAKING HOUSEHOLDS ACCESS TO HEALTHCARE: 9.1% UNINSURED 16.1% MEDICAID (OR OTHER STATE PROGRAMS) RECIPIENTS 62.6% PRIVATE INSURANCE CHRONIC HEALTH CONDITIONS (ADULTS AGED 20+): 20% OBESITY RATE 6.9% LIVING WITH DIABETES 21% SMOKING RATE PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 CENTRAL VERMONT MEDICAL CENTER IS THE ONLY HOSPITAL AND EMERGENCY CARE FACILITY LOCATED IN OUR IMMEDIATE SERVICE AREA. ALL OF ITS SERVICES, INCLUDING EMERGENCY CARE, ARE PROVIDED TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. CENTRAL VERMONT MEDICAL CENTER (CVMC) IS THE ADMINISTRATIVE ENTITY FOR VERMONT BLUEPRINT FOR HEALTH MULTI-PAYER PRIMARY CARE PRACTICES (PATIENT CENTERED MEDICAL HOME) FOR THE BARRE HEALTH SERVICES AREA (HSA). THE GOAL OF THE VERMONT BLUEPRINT FOR HEALTH, PASSED BY THE VERMONT LEGISLATURE IN 2010, IS TO SUPPORT VERMONT'S EFFORTS TO DEVELOP A COMPREHENSIVE, PROACTIVE SYSTEM OF CARE THAT IMPROVES THE QUALITY OF LIFE FOR PEOPLE WITH, OR AT RISK FOR CHRONIC CONDITIONS. IN A PATIENT CENTERED MEDICAL HOME, PATIENTS RECEIVE CARE FROM A COMMUNITY HEALTH TEAM, WHICH CONSISTS OF A NURSE (CERTIFIED IN DIABETES EDUCATION), A DIETITIAN, A MEDICAL SOCIAL WORKER AND A HEALTH EDUCATOR. THIS TEAM WORKS WITH THE PATIENT TO HELP SET REALISTIC OUTCOMES, GOALS AND TIMELINES AND PROVIDES ONE-ON-ONE SUPPORT. THEY ALSO WORK WITH A BROAD BASE OF COMMUNITY SERVICES TO PROVIDE EACH PATIENT WITH INDIVIDUAL SUPPORT AND CARE. AT THE END OF 2012, THERE WERE 50 PRIMARY CARE PROVIDERS WHO ARE PARTICIPATING IN THE PCMH IN THE BARRE HSA CARING FOR OVER 60,000 PATIENTS. THERE ARE 9 COMMUNITY HEALTH TEAM MEMBERS IN THE CVMC PRACTICES. CVMC IS PROUD TO BE A PARTICIPANT IN THE VERMONT BLUEPRINT FOR HEALTH WITH THE PCMH. IN ADDITION TO FINANCIAL ASSISTANCE AND SLIDING SCALE DISCOUNTS (SEE SCHEDULE H, PART I, LINES 3A & B), CVMC OFFERS NO INTEREST MONTHLY PAYMENT PLANS FOR PATIENTS WHO CANNOT PAY THEIR OUTSTANDING BALANCE IN FULL BUT ARE ABLE TO PAY OVER TIME. CVMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. CVMC APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, SUCH AS NEW TECHNOLOGIES (MRI), FACILITIES AND SERVICES (A NEW THERAPEUTIC POOL AND WELLNESS FACILITY FOR AQUATIC AND OTHER REHAB THERAPY SERVICES). THE MAJORITY OF THE CVMC'S GOVERNING BODY (BOARD OF TRUSTEES) IS COMPRISED OF PERSONS WHO RESIDE IN CVMC'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES, FAMILY MEMBERS, NOR CONTRACTORS OF THE ORGANIZATION. CVMC ACTIVELY PARTNERS WITH MANY COMMUNITY ORGANIZATIONS, SUCH AS WASHINGTON COUNTY MENTAL HEALTH SERVICES, THE PEOPLE'S HEALTH AND WELLNESS CLINIC, CENTRAL VERMONT HOME HEALTH AND HOSPICE, AND GREEN MOUNTAIN UNITED WAY, TO IMPROVE THE HEALTH AND WELLBEING OF OUR COMMUNITY. ONE EXAMPLE IS OUR FREE WOMEN'S HEALTH CLINICS WITH FINANCIAL SUPPORT FROM THE SUSAN G. KOMEN FOR THE CURE THAT CVMC SPONSORS ALONG WITH THE PEOPLE'S HEALTH AND WELLNESS CLINIC. CVMC APPLIES SURPLUS FUNDS TO REVITALIZE FACILITIES, PURCHASE EQUIPMENT, AND TO ENHANCE PROGRAMS TO BETTER SERVE PATIENTS. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 AS OF OCTOBER 1, 2011, CENTRAL VERMONT MEDICAL CENTER, INC. (CVMC) AND THE UNIVERSITY OF VERMONT MEDICAL CENTER (FORMERLY FLETCHER ALLEN HEALTH CARE, INC.) BECAME MEMBERS OF THE UNIVERSITY OF VERMONT HEALTH NETWORK (FORMERLY FLETCHER ALLEN PARTNERS, INC.), AN INTEGRATED SYSTEM OF CARE SERVING THE COMMUNITIES OF VERMONT AND NORTHERN NEW YORK. THE UNIVERSITY OF VERMONT HEALTH NETWORK IS CARRYING OUT CENTRALIZED ACTIVITIES FOR THE BENEFIT OF PATIENTS OF PARTNER ORGANIZATIONS, INCLUDING IMPROVING ACCESS TO LOCAL CARE, COST SAVINGS THROUGH GREATER JOINT PURCHASING POWER, ENHANCING INFORMATION TECHNOLOGY, INCREASING ACADEMIC OPPORTUNITIES FOR PHYSICIANS, ENGAGING IN REGIONAL STRATEGIC PLANNING, AND PARTICIPATING IN JOINT QUALITY AND CLINICAL INITIATIVES. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 VT true PEOPLES HEALTH AND WELLNESS CENTER 553 North Main St Suite 5 Barre VT 05641 030343290 501(c)(3) 10040 HEALTH CARE FOR THE UNINSURED AREA HLTH EDU CNTRS PRM UNIV VT COL OF MED UHC CMP Arnld 51 SPrpct Brlngtn VT 05401 030179440 501(c)(3) 25000 EDU LOAN RPMT TO HLTHCR PRFSLS 2 Description of Organization's Procedures for Monitoring the Use of Grants Schedule I, Part I, Line 2 CENTRAL VERMONT MEDICAL CENTER OCCASIONALLY GRANTS FUNDS TO ORGANIZATIONS THAT SUPPORT CVMC'S EXEMPT PURPOSE OF SERVING THE HEALTHCARE NEEDS OF CENTRAL VERMONT RESIDENTS. GRANT FUNDS ARE APPROVED AND OVERSEEN BY THE BOARD. X X X X false true false false false false false false false Philip Brown DO VP Medical Affairs 306535 0 9988 0 0 24616 0 341139 0 0 0 Nancy Lothian Chief Operating Officer 223584 0 15893 17373 0 0 14146 0 270996 0 0 0 Cheyenne Holland TREASURER, CFO/VP FISCAL SRVS 200055 0 16946 8531 12159 0 24605 0 262296 0 0 0 Richard Morley VP Support Services 191040 0 2027 3337 0 0 21892 0 218296 0 0 0 Alison White CNO & VP NURSING AND QUALITY 160389 0 15859 373 7119 0 1411 0 185151 0 0 0 Judith Tarr Tartaglia Trustee, President/CEO 315338 0 71704 22652 0 0 25024 0 434718 0 0 0 Gregory Macdonald MD Physician 288399 0 10548 1340 0 0 15762 0 316049 0 0 0 Mark Depman MD Trustee, Medical Director EMS 290887 0 27541 17919 0 0 24361 0 360708 0 0 0 Mark Heitzman MD Physician 308676 0 6293 2057 0 0 22045 0 339071 0 0 0 Peter Thomashow MD Physician 319699 0 4765 0 0 31920 0 356384 0 0 0 John Braun MD PHYSICIAN 459619 0 150 4338 0 19995 0 484102 0 0 0 John Brumsted MD Trustee as of 12/2013 790219 815101 127462 109050 26261 1868093 0 0 Matthew Greenberg MD Physician 282435 0 19684 17113 0 24390 0 343622 0 0 0 Jeremiah Eckhaus MD Physician 210767 0 23902 180 13586 0 25286 0 273721 0 0 0 MICHELLE HEEZEN VP PHYS. SVCS UNTIL 5/31/13 77509 63886 4003 7721 153119 SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) SCHEDULE J, PART I, LINE 4B DURING CALENDAR YEAR 2012, UNIVERSITY OF VERMONT MEDICAL CENTER, INC. (UVM MEDICAL CENTER) ENTERED INTO A SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) WITH ITS PRESIDENT, DR. BRUMSTED. UNDER THE SRP, UVM MEDICAL CENTER MAKES ANNUAL DEFERRALS EQUAL TO 10% OF THE PRESIDENT'S BASE SALARY FOR EACH YEAR THROUGH THE PLAN YEAR ENDING SEPTEMBER 30, 2015. THIS AMOUNT IS INCLUDED IN SCHEDULE J, PART II, COLUMN C. AMOUNTS DEFERRED ARE SUBJECT TO FORFEITURE IF CERTAIN CONDITIONS ARE NOT MET. An officer participates in a split dollar life insurance arrangement. The value of the premium is included in her taxable compensation in Schedule J, Part II, column (B)(iii). A VT Educational & Health Bldgs Finance Authority 237154467 2009-05-13 21023997 SEE SCH K, PART VI false false true A 10417058 0 21028838 0 0 0 144996 0 0 8000000 12879001 0 2009 true false true true A false true true true false 0 false false false true A false false false true false false 0 false 0 false true A true SCHEDULE K, PART I, LINE A, COLUMN F DESCRIPTION OF PURPOSE THE VEHBFA 2009 SERIES A&B BOND ISSUANCE WAS ISSUED ON 5/13/2009 TO SATISFY (REFINANCE) 2005 DEBT WITH VEHBFA. THE 2005 DEBT FINANCED THE CONSTRUCTION AND EQUIPMENT OF A RENOVATION AND MODERNIZATION PROJECT. $12,879,001 OF THE VEHBFA 2009 SERIES A&B BOND ISSUANCE WAS USED TO REFUND THE 2005 DEBT. THE REFUND OCCURRED ON MAY 31, 2009. THE REMAINDER WAS USED TO CONSTRUCT AND EQUIP A CANCER TREATMENT CENTER. SCHEDULE K, PART IV, COLUMN A, LINE 2C REBATE COMPUTATION DATE A REBATE COMPUTATION WAS PERFORMED IN AUGUST, 2014. Matt Tarr See Schedule L, Part V 36694 Wages & Benefits false Donna Domingue See Schedule L, Part V 6718 Wages & Benefits false Donna Leighty See Schedule L, Part V 13313 Wages & Benefits false SCHEDULE L, PART IV, COLUMN B RELATIONSHIP BETWEEN PARTIES: MATT TARR IS AN EMPLOYEE OF CVMC AND IS THE SON OF JUDITH TARR TARTAGLIA, AN OFFICER OF THE ORGANIZATION. DONNA DOMINGUE IS A FORMER EMPLOYEE OF CVMC AND IS THE MOTHER OF MICHELLE HEEZEN, A FORMER KEY EMPLOYEE OF THE ORGANIZATION. MS. HEEZEN'S EMPLOYMENT WAS TERMINATED 05/31/2013, AND MS. DOMINGUE'S EMPLOYMENT WAS TERMINATED ON 11/02/2013. DONNA LEIGHTY IS AN EMPLOYEE OF CVMC AND IS THE SISTER-IN-LAW OF ALISON WHITE, A FORMER KEY EMPLOYEE OF THE ORGANIZATION. MS. WHITE'S EMPLOYMENT WAS TERMINATED 11/04/2013. X 1 109698 Net proceeds 0 false false false SCHEDULE M, PART I, COLUMN (B) THE AMOUNTS LISTED IN COLUMN (B) REPRESENT TOTAL NUMBER OF CONTRIBUTIONS RECEIVED, NOT INDIVIDUAL ITEMS. DESCRIPTION OF THE ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 CENTRAL VERMONT MEDICAL CENTER TRUSTEES AND ITS STAFF ARE COMMITTED TO PROVIDING EXCELLENT CARE TO CENTRAL VERMONTERS. TO STAY ABREAST OF BEST PRACTICES, CVMC COLLABORATES WITH MANY HEALTHCARE ENTITIES TO ENSURE THIS COMMITMENT. PARTICIPATING IN THE JOINT COMMISSION ACCREDITATIONS PROCESS IS ONE MEASURE OF HOW CVMC CONTINUOUSLY STRIVES TO IMPROVE THE SAFETY AND QUALITY OF CARE PROVIDED TO ITS PATIENTS. THE HOSPITAL AND THE PHYSICIAN PRACTICE GROUPS (CVMGP, CENTRAL VERMONT MEDICAL GROUP PRACTICES) WERE ACCREDITED IN JANUARY 2013 FOR A THREE YEAR PERIOD. JOINT COMMISSION ACCREDITATION IS THE EQUIVALENT OF THE GOOD HOUSEKEEPING "SEAL OF APPROVAL" FOR MEDICAL CENTERS. THE JOINT COMMISSION EVALUATES THE QUALITY AND SAFETY OF CARE PROVIDED BY HEALTH CARE ORGANIZATIONS. TO EARN AND MAINTAIN ACCREDITATION, ORGANIZATIONS MUST HAVE AN EXTENSIVE ON-SITE REVIEW BY A TEAM OF JOINT COMMISSION HEALTH CARE PROFESSIONALS AT LEAST ONCE EVERY THREE YEARS. THE PURPOSE OF THE REVIEW IS TO EVALUATE THE ORGANIZATION'S PERFORMANCE IN AREAS THAT AFFECT PATIENT CARE. ACCREDITATION IS AWARDED BASED ON HOW WELL THE ORGANIZATION MEETS THE JOINT COMMISSION STANDARDS. CVMC PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. ALL OF CVMC'S SERVICES, INCLUDING EMERGENCY CARE, ARE PROVIDED TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS Form 990, Part VI, Line 6 THE UNIVERSITY OF VERMONT HEALTH NETWORK (FORMERLY FLETCHER ALLEN PARTNERS, INC.) IS THE SOLE MEMBER AND PARENT CORPORATION OF CENTRAL VERMONT MEDICAL CENTER, INC. (CVMC). THE UNIVERSITY OF VERMONT HEALTH NETWORK IS A VERMONT NON-PROFIT CORPORATION WHICH HAS BEEN RECOGNIZED BY THE IRS AS A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. ELECTION OF GOVERNING BODY & GOVERNANCE DECISIONS Form 990, Part VI, Line 7a & 7b THE UNIVERSITY OF VERMONT HEALTH NETWORK (FORMERLY FLETCHER ALLEN PARTNERS, INC.) HOLDS THE POWER TO ELECT CVMC'S BOARD OF TRUSTEES AND TO APPROVE SIGNIFICANT CORPORATE ACTIONS, INCLUDING ANNUAL OPERATING AND CAPITAL BUDGETS, STRATEGIC PLANS, THE APPOINTMENT OF THE CEO, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AND AMENDMENTS TO CVMC'S BYLAWS AND ARTICLES OF ORGANIZATION. DESCRIPTION OF PROCESS USED BY MGMNT &/OR GOVERNING BODY TO REVIEW 990 Form 990, Part VI, Line 11b THE FORM 990 IS PREPARED BY THE CONTROLLER AND REVIEWED IN DETAIL BY CVMC'S OUTSIDE TAX ADVISORS BEFORE BEING REVIEWED BY THE OFFICERS OF THE CORPORATION AND BY THE OTHER MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE CONTROLLER PROVIDES REGULATORY UPDATES REGARDING THE FORM 990 TO THE FINANCE COMMITTEE AND MAKES AVAILABLE TO THE FINANCE COMMITTEE THE FORM 990 ALONG WITH HIGHLIGHTS OF ALL SIGNIFICANT PARTS OF THE FORM 990. THE BOARD OF TRUSTEES IS ALSO PROVIDED VIA EMAIL A COPY OF THE "AS FILED" FORM 990 BEFORE IT IS FILED WITH THE IRS. THE FORM 990 IS ALSO AVAILABLE IN HARD COPY FOR THOSE THAT DO NOT HAVE ACCESS TO EMAIL. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C THE COMPLIANCE OFFICER FOR CVMC MAINTAINS THE CONFLICT OF INTEREST STATEMENTS AND REGULARLY MONITORS THEM AS WELL AS ANY OTHER ACTIVITIES THAT MAY CONSTITUTE A CONFLICT OF INTEREST. THE ORGANIZATION'S PRACTICE IS TO SEND OUT ANNUAL DISCLOSURE QUESTIONNAIRES TO BOARD OF TRUSTEE MEMBERS, SENIOR OFFICERS, AND DIRECTORS OF THE ORGANIZATION OR OTHER INDIVIDUALS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION WHO HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST, AS DEFINED BELOW, AS AN "INTERESTED PERSON." THIS DEFINITION SHALL ALSO INCLUDE MEMBERS OF THE ORGANIZATION'S LEADERSHIP GROUP, MEDICAL DIRECTORS AND ANY EMPLOYEES INVOLVED WITH RECOMMENDING OR PURCHASING PRODUCTS/SERVICES. THE RESPONSES ARE TAKEN TO THE GOVERNANCE AND HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. THE GOVERNANCE AND HUMAN RESOURCES COMMITTEE SHALL MAINTAIN A LIST OF INDIVIDUALS WHO MAY BE CONSIDERED DISQUALIFIED PERSONS UNDER IRS REGULATIONS. THE GOVERNANCE AND HUMAN RESOURCES COMMITTEE SHALL REPORT THE RESULTS OF ITS REVIEW ANNUALLY TO THE BOARD OF TRUSTEES. IF THERE IS ANY POSSIBILITY OF FINANCIAL GAIN BY A TRUSTEE AND OR EMPLOYEE FROM ANY DECISION THAT IS TO BE DELIBERATED ON, THEN THAT TRUSTEE/EMPLOYEE MAY MAKE A PRESENTATION, BUT IS THEN REMOVED FROM THOSE DISCUSSIONS TO ENSURE THAT THE TRUSTEE/EMPLOYEE WILL NOT TAKE PART IN ANY DELIBERATIONS THAT HE OR SHE MIGHT PERSONALLY GAIN FROM. THE TRUSTEE/EMPLOYEE OPERATING UNDER A CONFLICT IS PROHIBITED FROM VOTING ON ANY MATTER TO WHICH THE CONFLICT RELATES. WHISTLEBLOWER & DOCUMENT RETENTION - DESTRUCTION POLICIES FORM 990, PART VI, LINES 13 & 14 CVMC HAS BOTH A WHISTLEBLOWER AND A DOCUMENT RETENTION - DESTRUCTION POLICY. THESE POLICIES ARE EFFECTIVE WITHOUT FORMAL BOARD APPROVAL. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINES 15A & 15B THE PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION'S CEO, CFO, AND COO INCLUDES A REVIEW AND APPROVAL BY THE BOARD OF TRUSTEES. AN INDEPENDENT COMPENSATION STUDY IS ALSO PERIODICALLY PERFORMED. THE MOST RECENT STUDY WAS PERFORMED IN 2013. THIS STUDY INCLUDED COMPENSATION DATA FOR CHIEF EXECUTIVE OFFICERS AND VICE PRESIDENTS. INDEPENDENT RESEARCH IS COMPLEMENTED BY A MARKET STUDY ANALYSIS PERFORMED BY THE HUMAN RESOURCES DEPARTMENT AND REVIEWED BY THE BOARD OF TRUSTEES. MARKET STUDY DATA COMES FROM, BUT IS NOT LIMITED TO, HFMA, VAHHS, NEAH, AHA, INDUSTRY SPECIFIC COMPENSATION SURVEYS AND OTHER HEALTHCARE SOURCES. THE COMPENSATION OF OTHER KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED THROUGH MARKET STUDY ANALYSIS PERFORMED BY THE HUMAN RESOURCES DEPARTMENT AND REVIEWED BY THE BOARD OF TRUSTEES IF NECESSARY. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE ORGANIZATION MAKES AVAILABLE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC UPON REQUEST. WITHIN THE ANNUAL PUBLICATION OF THE ORGANIZATION'S ANNUAL REPORT THERE ARE HIGHLIGHTS OF THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ANNUAL REPORT IS ALSO AVAILABLE IN A PDF FORMAT ON THE ORGANIZATION'S WEBSITE. CIRCULAR A-133 AUDIT FORM 990, PART XII, LINE 3B DURING FY14 CVMC DID NOT REACH THE LEVEL REQUIRED TO WARRANT AN AUDIT UNDER OMB CIRCULAR A-133. HOWEVER, BECAUSE OF CVMC'S AFFILIATION WITH THE UNIVERSITY OF VERMONT MEDICAL CENTER (FORMERLY FLETCHER ALLEN HEALTH CARE) CVMC WAS INCLUDED IN THE A-133 THAT WAS PERFORMED FOR THE UNIVERSITY OF VERMONT MEDICAL CENTER. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: CHANGE IN MINIMUM PENSION LIABILITY ($5,678,409) FUNDS RELEASED FROM THE CVMC ENDOWMENT $650,000 TOTAL ($5,028,409) University of Vermont Medical CenterInc 111 Colchester Ave Burlington VT 05401 030219309 Hospital VT 501(c)(3) 3 UVMHN true Univ of Vermont Health Network Inc 111 Colchester Ave Burlington VT 05401 452880726 Holding Co VT 501(c)(3) 11a NA false Univ of Vermont Medical Group - New York 183 Park Street Malone NY 12953 203905216 PHYS SVCS NY 501(c)(3) 3 UVMMG true University of Vermont Medical Group 111 Colchester Ave Burlington VT 05401 030225105 PHYS SVCS VT 501(c)(3) 11a UVMMC true Univ of Vermont Medical Ctr Fdn inc 111 Colchester Ave Burlington VT 05401 263159849 Fundraising VT 501(c)(3) 11a UVMMC true Central Vermont Hospital Auxiliary 130 Fisher Rd Berlin VT 05602 030264240 Service VT 501(c)(3) 11d NA false Community Providers Inc 75 Beekman St Plattsburgh NY 12901 222544844 Hlth Svc Coor NY 501(c)(3) 11a UVMHN true Champlain Valley Physicians Hospital Med 75 Beekman St Plattsburgh NY 12901 141338471 Health Svc Su NY 501(c)(3) 3 CPI true Elizabethtown Community Hospital 75 Park Street Elizabethtown NY 12932 141364513 Hospital NY 501(c)(3) 3 CPI true Emergency Medical Transport of CVPH Inc 75 Beekman St Plattsburgh NY 12901 061718419 Ambulance Svc NY 501(c)(3) 11b CPI true CVPH Medical Center Foundation 75 Beekman St Plattsburgh NY 12901 141727048 Health Svc Su NY 501(c)(3) 3 CPI true University Medical Education Association 89 Beaumont Ave Burlington VT 05405 237107832 Educational VT 501(c)(3) 9 UVMMG true University Health Center 111 Colchester Ave Burlington VT 05401 030229931 Hospital VT 501(c)(3) 11c UVMMG true ONECARE VERMONT ACCOUNTABLE CA 455399218 ACCOUNTABLE CARE VT NA N/A ADIRONDACKS ACO LLC 462840926 ACCOUNTABLE CARE NY NA N/A OBNET SERVICES LLC 043746287 HEALTH RESEARCH NH NA N/A Charitable Irrevocable Trust (7) 130 Fisher Rd Berlin VT 05602 Support VT UVMMCCVMC Trust true UNIV OF VT MED CTR HEALTH VENT INC 111 Colchester Ave Burlington VT 05401 043380045 Holding Compa VT NA C Corp true VMC Indemnity Company LTD PO BOX HM 3103 25 Church St HM F Hamilton BD HM FX FR 999999999 Captive Insur BD NA C Corp true Vermont Managed Care 111 Colchester Ave Burlington VT 05401 030333056 Managed Care VT NA C Corp true Charitable Remainder Trust (3) 111 Colchester Ave Burlington VT 05401 Support VT UVMMCCVMC Trust true Perpetual Trust (4) 111 Colchester Ave Burlington VT 05401 Support VT NA Trust true CHAMPLAIN VALLEY HEALTH NETWORK 75 BEEKMAN STREET PLATTSBURGH NY 12901 161586102 ADMIN SERVICE NY NA C CORP true MEDQUEST INC PO BOX 1656 PLATTSBURGH NY 12901 141663061 MED. 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