2015-06-01T14:18:20-05:00 2014-09-30 020476956 TYLER SIMMS & ST SAUVEUR CPA PC 19 MORGAN DRIVE LEBANON NH 03766 990 2013-10-01 030183721 WINDSOR HOSPITAL CORPORATION WIND 8026746711 289 COUNTY ROAD WINDSOR VT 05089 KEVIN DONOVAN CEO 8026746711 2015-05-22 1 W JAY SIMMS P00435321 6036530044 2015-05-22 2013 2016-02-25 16:41:14Z MTASCUTNEY HOSP & HEALTH CTR KEVIN DONOVAN 289 COUNTY ROAD WINDSOR VT 05089 52574828 0 X MTASCUTNEYHOSPITAL.ORG X 1933 VT TO IMPROVE THE LIVES OF THOSE WE SERVE. OUR ACTIVITIES INCLUDE PROVIDING HEALTHCARE. 16 14 579 187 93794 3381 995526 843257 47969559 47889922 656866 474482 24214 175682 49646165 49383343 0 0 0 0 28907533 28621744 0 0 291141 19754508 20562857 48662041 49184601 984124 198742 42487151 39743107 26022626 23412407 16464525 16330700 X MOUNT ASCUTNEY HOSPITAL AND HEALTH CENTER'S MISSION IS TO IMPROVE THE LIVES OF THOSE WE SERVE. 0 0 39912236 47889922 MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (MAHHC) OPERATES A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL WHICH PROVIDES PRIMARY AND SECONDARY HEALTH CARE. MAHHC'S PRIMARY SERVICE AREA INCLUDES WINDSOR, CLAREMONT, WOODSTOCK, HARTLAND, SPRINGFIELD, AND BROWNSVILLE. THE HOSPITAL PROVIDES ESSENTIAL HEALTHCARE SERVICES INCLUDING EMERGENCY DEPARTMENT, MED/SURG INPATIENT, MED/SURG OUTPATIENT, AND ANCILLARY DIAGNOSTIC TESTS, IMAGING/RADIOLOGY PROCEDURES, AND WELLNESS/PREVENTION SERVICES. MAHHC STAFFS A TOTAL OF 25 ACUTE MED/SURG BEDS AND 10 ACUTE REHABILITATION BEDS. DURING THE YEAR, THERE WERE 916 INPATIENT DISCHARGES, 1,743 OUTPATIENT SURGERIES, 76,014 OUTPATIENT LAB TESTS, AND 12,163 OUTPATIENT IMAGINING PROCEDURES. MAHHC IDENTIFIED ACCESS TO PRIMARY CARE AS A CENTRAL COMMUNITY NEED AND IS COMMITTED TO PROVIDING THE PHYSICIAN SERVICES OF FAMILY PRACTICE, INTERNAL MEDICINE AND PEDIATRICS IN WINDSOR AND WOODSTOCK. MAHHC PROVIDES FREE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA. FOREGONE CHARGES FURNISHED UNDER MAHHC'S FREE CARE POLICY AMOUNTED TO $1,280,926. 39912236 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 83 0 1 579 1 1 1 0 0 0 0 0 0 0 X 16 14 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DAVID SANVILLE 8026746711 289 COUNTY ROAD WINDSOR VT 05089 NANCY LOUX PAST-PRESIDENT 1.00 1.00 X X 0 0 0 SHELLEY SEWARD PRESIDENT 1.00 X X 0 0 0 HAROLD PYKE SECRETARY 1.00 0.50 X X 0 0 0 LARRY FRAZER TRUSTEE 1.00 X 0 0 0 MICHAEL NEWBOLD TRUSTEE 1.00 0.50 X 0 0 0 LYNN PETERSON MD TRUSTEE 1.00 X 0 0 0 HON DONNA SWEANEY VICE PRESIDENT 1.00 X X 0 0 0 STEVEN SMITH MD TRUSTEE 1.00 0.50 X 11800 157382 61091 DONNA VANFLEET TRUSTEE 1.00 X 0 0 0 MARY JOYCE MD TRUSTEE 1.00 X 172663 0 50104 MARY BELL TRUSTEE (RESIGNED 6/2014) 1.00 X 0 0 0 VINCENT FUSCA III DH REPRESENTATIVE 1.00 1.00 X 0 0 0 PATTY O'NEILL TREASURER 1.00 X X 0 0 0 DEANNA S HOWARD DH REPRESENTATIVE 1.00 X 0 0 0 MATTHEW S HOUDE DH REPRESENTATIVE 1.00 X 0 0 0 STEPHEN D SURGENOR MD TRUSTEE 1.00 X 0 0 0 ALAN KEILLER DH REPRESENTATIVE 1.00 X 0 0 0 DAVID JONES TRUSTEE (RESIGNED 6/2014) 1.00 0.50 X 0 0 0 CATHERINE SCHNEIDER CMO 40.00 X 256268 0 41209 PAUL CALANDRELLA CHIEF OPERATING OFFICER 40.00 X 135700 0 36071 PAUL BUFF TRUSTEES (RESIGNED 12/2013) 1.00 X 0 0 0 KEVIN DONOVAN OFFICER/CEO 40.00 1.00 X 6700 264979 61993 DAVID SANVILLE OFFICER/CFO 32.00 0.50 X 195461 0 0 JILL LORD CNO 40.00 0.50 X 155554 0 12853 CHRISTOPHER CONNOR MD OPTHALMOLOGIST 40.00 X 348555 0 47268 ANDREW ROBINSON MD GASTROENTEROLOGIST 40.00 X 266079 0 67726 HEIDI CRUZ MD PHYSIATRIST 40.00 X 215314 0 53379 GERALD DRABRYN MD PLASTIC SURGEON 40.00 X 272572 0 36028 JEFFREY KING MD PODIATRIST 40.00 X 208524 0 37050 2245190 422361 504772 29 0 1 1 DARTMOUTH HITCHCOCK ONE MEDICAL CENTER DRIVE LEBANON NH 03756 PROFESSIONAL AND PHYSICIAN SERVICES 3029234 EMERGENCY SERVICES OF NEW ENGLAND PO BOX 12 CHESTER VT 05143 PHYSICIAN ASST FOR EMERGENCY ROOM 1284816 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 MNGMT & SUPPORT STAFF - ENVMMNTL SRVS 1012625 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 753972633 PHYSICIAN COVERAGE FOR HOSPITALS 384142 SOUTHWIND PO BOX 79461 BALTIMORE MD 212790461 CONSULTANT FOR OPERATNG ROOM PERFORMANCE 242520 11 651633 191624 48171 843257 PATIENT SERVICES 621110 80390153 80390153 PROGRAM & MISC OTHER 621110 2100574 2100574 DSH/VAHHA REVENUE 621110 533586 533586 PROVISION FOR DOUBTFUL ACCOUNTS 621110 -770773 -770773 CONTRACTUAL ALLOWANCES 621110 -34363618 -34363618 47889922 169230 169230 47712 0 47712 47712 47712 3478546 2323 3175617 0 302929 2323 305252 305252 50044 15868 34176 34176 BRIDGING THE GAP - CHILDCARE 624410 93794 93794 93794 49383343 47889922 93794 556370 1199194 234567 964627 21435370 19043743 2236300 155327 164935 140475 23322 1138 4248414 3616673 602491 29250 1573831 1340431 222540 10860 93498 93498 91542 10500 80145 897 105569 49033 55284 1252 784908 113127 666618 5163 501010 473606 27404 88153 63073 24855 225 504632 504632 2501984 2501984 672054 448917 221208 1929 CONTRACTED LABOR 4448745 3607629 803206 37910 SUPPLIES 3432342 3290147 131886 10309 PROFESSIONAL/CONSULTING 3316196 1977137 1304811 34248 DUES/FEES/TAXES 2117589 1851270 265415 904 1904635 645292 1257614 1729 49184601 39912236 8981224 291141 1616084 2641381 2776146 170685 429120 614124 7181442 6972186 5045 0 511134 541316 212564 127828 35456799 23907687 12201916 11549112 11088456 12862626 1952321 2035677 4512923 2228172 42487151 39743107 4820843 4419248 8514646 8047149 2764463 1417893 9922674 9528117 26022626 23412407 X 10098630 9213629 509713 1196080 5856182 5920991 16464525 16330700 42487151 39743107 X 198742 334810 -667377 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 11358 11358 0 PART II-B, LINE 1: THE HOSPITAL PAID $9,109 IN THE FORM OF DUES TO THE VERMONT ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (VAHHS). VAHHS IS A MEMBER-OWNED ORGANIZATION DEVOTED TO IMPROVING THE HEALTH STATUS OF COMMUNITIES THROUGHOUT VERMONT THROUGH ACTIVITIES WHICH INCLUDE ADVOCACY, POLICY DEVELOPMENT, EDUCATION AND RESEARCH. THE HOSPITAL ALSO PAID $2,250 IN THE FORM OF DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA). 5856182 64809 5920991 5880406 79267 5959673 5705958 174448 5880406 5787015 -81057 5705958 5710296 76719 5787015 0.88640 0.11360 0 0 75418 75418 12329034 8247769 4081265 13941185 10289069 3652116 9111162 5370849 3740313 11549112 CHARITABLE REMAINDER TRUST 333082 F BENEFICIAL INTEREST IN PERPETUAL TRUST 1702595 F 2035677 DEFERRED FINANCING COST, NET 44266 RENTAL DEPOSITS 5560 EQUITY IN SUBSIDIARY 2109873 OTHER RECEIVABLES 68473 2228172 OTHER CURRENT LIABILITIES 1045118 EST. SETTLEMENTS W/ 3RD PARTY PAYORS 3012116 POST RETIREMENT BENEFIT OBLIGATION 5106059 INTEREST RATE SWAP 364824 9528117 48725147 334810 -968890 -634080 49359227 24116 24116 49383343 49176353 15868 15868 49160485 24116 24116 49184601 PART V, LINE 4: IN GENERAL, THE AMOUNT OF THE ORIGINAL GIFT AND ANY REQUIRED ACCUMULATIONS BY THE DONOR ARE NOT EXPENDABLE. HOWEVER, THE MARKET VALUE OF THE FUND MAY FALL BELOW THAT AMOUNT DEPENDING ON CURRENT FINANCIAL CONDITIONS IN THE UNDERLYING INVESTMENTS. UNDER THE POLICY OF THE HOSPITAL, THE ENDOWMENT ASSETS ARE INVESTED MODERATELY WITH THE INTENT OF PROVIDING A PREDICTABLE STREAM OF FUNDING TO THE HOSPITAL. THE HOSPITAL INVESTS IN EQUITY FUNDS, BOND FUNDS AND MONEY MARKET INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN LIMITED RISK CONSTRAINTS. ACTUAL RETURNS IN ANY YEAR MAY VARY FROM BUDGETED AMOUNTS DUE TO MARKET FLUCTUATIONS. SCHEDULE D, PART XI, LINE 2D UNREALIZED GAIN ON INTEREST RATE SWAP $309,733 EQUITY IN SUBSIDIARIES $172,304 CHANGE IN FUNDED STATUS OF PENSION PLAN $-1.550,151 CHARITABLE REMAINDER TRUST $18,547 BENEFICIAL INTEREST PERPETUAL TRUST $64,809 FUNDRAISING EXPENSE $15,868 GOLF TOURNAMENT 50044 50044 756 5200 8054 0 1858 50044 50044 756 5200 8054 1858 15868 34176 1 1 1 X 1 X 1 1 1 0 1 1 695837 695837 0.01410 7462099 6597131 864968 0.01760 8157936 6597131 1560805 0.03170 348179 348179 0.00710 55104 55104 0.00110 14106713 8993173 5113540 0.10400 7337 7337 0.00010 14517333 8993173 5524160 0.11230 22675269 15590304 7084965 0.14400 1 1280926 17867049 18707043 -839994 X 1 1 1 1 WINDSOR HOSPITAL CORPORATION 289 COUNTY ROAD WINDSOR VT 05089 X X X X DISTINCT PART REHAB UNIT WINDSOR HOSPITAL CORPORATION 1 1 X X X X X X X 13 1 1 1 X WWW.MTASCUTNEYHOSPITAL.ORG X X X X X X X X X X 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X 1 1 X X 1 0 X X 1 X 0 0 WINDSOR HOSPITAL CORPORATION PART V, SECTION B, LINE 3: DATA THAT INFORMED THIS NEEDS ASSESSMENT REPORT WAS COLLECTED THROUGH A NUMBER OF DATA-GATHERING ACTIVITIES - SECONDARY DATA GATHERING HEALTH, ECONOMIC, AND EDUCATION DATA FROM SOURCES INCLUDING YOUTH RISK BEHAVIOR SURVEY, THE BEHAVIORAL RISK FACTOR SUIRVEILLANCE SYSTEM, OTHER PUBLIC HEALTH AND HOSPITAL DISCHARGE DATA, CENSUS DATA, AND NECAP DATA. IN SOME CASES, ISSUES WERE HIGHLIGHTED THAT HAVE RECEIVED LOCAL ATTENTION OR WHICH HAVE EMERGED OR INTENSIFIED SINCE THE LAST SECONDARY DATA SURVEYS WERE CONDUCTED (EXAMPLED INCLUDE ORAL HEALTH, PRESCRIPTION DRUG MISUSE, HOUSING ASSESSMENTS, REDUCTIONS IN AVAILABILITY OF APPROPRIATE MENTAL HEALTH SERVICES, ETC.). PERCEPTIONS OF INFORMED REGIONAL STAKEHOLDER'S ON THE NATURE AND CAUSES OF POTENTIAL COMMUNITY NEEDS WERE GATHERED THROUGH A COMMUNITY STAKEHOLDER'S SURVEY. OPINION DATA FROM INFORMED REGIONAL STAKEHOLDERS USING AN ONLINE OPINION POLL OF REGIONAL LEADERS IN HEALTH, PUBLIC HEALTH, EDUCATION, MUNICIPAL GOVERNMENTS, PUBLIC SAFETY, AND SOCIAL SERVICE PROVIDERS. OPINION DATA FROM RESIDENTS COLLECTED THROUGH COMMUNITY LISTS, INDIVIDUAL INTERVIEWS AT HUMAN SERVICE ORGANIZATIONS AND FOCUS GROUPS. WINDSOR HOSPITAL CORPORATION PART V, SECTION B, LINE 4: OTHER FACILITIES WERE DARTMOUTH HITCHCOCK MEDICAL CENTER AND ALICE PECK DAY HOSPITAL WINDSOR HOSPITAL CORPORATION PART V, SECTION B, LINE 5D: A BENEFIT REPORT WAS PREPARED AND MADE AVAILABLE AND DISTRIBUTED THROUGH THE MT. ASCUTNEY COMMUNITY HEALTH FOUNDATION AND THE WINDSOR AREA COMMUNITY PARTNERSHIP. THE CHNA AND ALL INFORMATION GENERATED IN THE NEEDS ASSESSMENT PROCESS WILL BE AVAILABLE FOR STAKEHOLDERS PARTICIPATING IN THE PROCESS AND WILL ALSO BE AVAILABLE VIA A PAPER COPY OF THE CHNA REPORT AVAILABLE FOR PUBLIC INSPECTON UPON REQUEST.PART V, SECTION B, LINE 5B:IMPLEMENTATION PLAN IS AVAILABLE AT THE WEBSITE: HTTP://WWW.MTASCUTNEYHOSPITAL.ORG/COMMUNITY-SERVICES/COMMUNITY-RESOURCES/ COMMUNITY-HEALTH-NEEDS WINDSOR HOSPITAL CORPORATION PART V, SECTION B, LINE 10: THE WINDSOR COMMUNITY HEALTH CLINIC AT MT. ASCUTNEY HOSPITAL WAS ESTABLISHED TO SERVE MEMBERS OF OUR COMMUNITY WHO ARE NOT COVERED BY MEDICAID, VHAP, AND PRIVATE INSURANCE, AND WHO DO NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HEALTHCARE SERVICES. THE CLINIC OFFERS FREE CLINIC APPOINTMENTS TO MEMBERS WHO HAVE NO INSURANCE, OR ARE UNDER-INSURED AND MEET CERTAIN INCOME REQUIREMENTS. PART I, LINE 7: PART I, LINE 7. A COST ACCOUNTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. A COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENTS SEGMENTS. A COST-TO-CHARGE RATIO WAS USED. PART I, LINE 7G: PART I, LINE 7G. PHYSICIAN CLINIC COSTS INCLUDED WITHIN SUBSIDIZED HEALTH SERVICES ARE $5,113,539 OF THE TOTAL COMMUNITY BENEFIT EXPENSES AND $8,993,173 OF THE DIRECT OFFSETTING REVENUE. PART I, LN 7 COL(F): PART III, LINE 4. MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF INDIVIDUAL ACCOUNTS AND HISTORICAL ADJUSTMENTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. THE COSTING METHODOLOGY USED ABOVE WAS THE COST TO CHARGE RATIO. PART III, LINE 8: PART III, LINE 8. THE SHORTFALL REPRESENTS THE PPS REIMBURSEMENT DIFFERENCE ON THE REHAB UNITS. SINCE THE REIMBURSEMENT DOES NOT COVER THE COSTS OF THESE UNITS, A SUBSIDY IS CREATED. BECAUSE THE HOSPITAL DETERMINED THAT THESE SERVICES ARE IMPORTANT TO OUR SERVICE AREA, THE HOSPITAL COVERS THE SUBSIDY, PART III, LINE 9B: PART III, LINE 9B. MAHHC'S COLLECTION POLICY AND CHARITABLE CARE POLICIES ARE CONSISTENTLY APPLIED TO ALL PATIENTS. OUR COLLECTION POLICY APPLIES TO ANY BALANCE OWED BY THE PATIENT WHETHER IT IS A BALANCE AFTER INSURANCE, A BALANCE WITH NO INSURANCE, OR A BALANCE AFTER AN ADJUSTMENT FOR PARTIAL CHARITABLE CARE. STATEMENTS, CREDIT REPORTING, COLLECTION EFFORTS, AND WRITE-OFF CRITERIA ARE THE SAME FOR ALL LIKE BALANCES, REGARDLESS OF THE REASON FOR THE BALANCE AND REGARDLESS OF WHETHER IT IS A BALANCE AFTER CHARITABLE CARE OR NOT. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE RECEIVE THE APPROPRIATE ADJUSTMENT ON THEIR BILL. IF A BALANCE REMAINS AFTER THAT ADJUSTMENT, THEY ARE BILLED ACCORDING TO THE COLLECTION POLICY, FOR THE REMAINDER. PART VI, LINE 4: MAHHC'S PRIMARY SERVICE AREA INCLUDES WINDSOR, CLAREMONT, WOODSTOCK, HARTLAND, SPRINGFIELD, AND BROWNSVILLE 1 X X X X 0 0 0 0 0 0 0 1 0 STEVEN SMITH MD TRUSTEE 0 157382 9400 0 2400 0 0 0 0 61091 11800 218473 0 0 MARY JOYCE MD TRUSTEE 159744 0 8900 0 4019 0 5344 0 44760 0 222767 0 0 0 CATHERINE SCHNEIDER CMO 255716 0 0 0 552 0 7750 0 33459 0 297477 0 0 0 PAUL CALANDRELLA CHIEF OPERATING OFFICER 135259 0 0 0 441 0 2101 0 33970 0 171771 0 0 0 KEVIN DONOVAN OFFICER/CEO 6700 263575 0 0 0 1404 0 35093 0 26900 6700 326972 0 0 JILL LORD CNO 154176 0 0 0 1378 0 4520 0 8333 0 168407 0 0 0 CHRISTOPHER CONNOR MD OPTHALMOLOGIST 347523 0 0 0 1032 0 10312 0 36956 0 395823 0 0 0 ANDREW ROBINSON MD GASTROENTEROLOGIST 197425 0 68654 0 0 0 5437 0 62289 0 333805 0 0 0 HEIDI CRUZ MD PHYSIATRIST 215074 0 0 0 240 0 6600 0 46779 0 268693 0 0 0 GERALD DRABRYN MD PLASTIC SURGEON 269993 0 0 0 2579 0 0 0 36028 0 308600 0 0 0 JEFFREY KING MD PODIATRIST 187838 0 14030 0 6656 0 4251 0 32799 0 245574 0 0 0 PART I, LINE 7 STEVEN SMITH, MD AND MARY JOYCE, MD RECEIVED BONUSES WHICH WERE BASED UPON RELATIVE VALUE UNITS (RVU'S). ANDREW ROBINSON, MD RECEIVED A BONUS WHICH WAS BASED UPON RELATIVE VALUE UNITS (RVU'S) AND LONGEVITY. PART III STEVEN SMITH, MD, TRUSTEE, WAS PAID $218,473 IN COMPENSATION AND BENEFITS BY DARTMOUTH-HITCHCOCK MEDICAL CENTER, A RELATED ORGANIZATION, FOR HIS SERVICES AS PHYSICIAN. THE ORGANIZATION REIMBURSED DARTMOUTH-HITCHCOCK FOR THE COST OF HIS SERVICES. KEVIN DONOVAN, CEO, WAS PAID $326,972 IN COMPENSATION AND BENEFITS BY DARTMOUTH-HITCHCOCK MEDICAL CENTER, A RELATED ORGANIZATION, FOR SERVICES AS CEO. THE ORGANIZATION REIMBURSED DARTMOUTH-HITCHCOCK FOR THE COST OF HIS SERVICES. GIFFORD MEDICAL CENTER, AN UNRELATED ORGANIZATION, WAS PAID $195,461 FOR DAVID SANVILLE'S SERVICES AS CFO. A VERMONT EDUCATIONAL AND HEALTH BUILDINGS FINANCING AGENCY 237154467 2010-02-02 9244000 REFINANCING OF 2004 AND 2005 BONDS 0 0 0 A 1196851 9244000 128133 9115867 2010 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 TD BANK NA 18.000000000000 0 0 0 0 0 X 3 47811 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE JULY 1, 2014, MT. ASCUTNEY HOSPITAL AND HEALTH CENTER AND DARTMOUTH-HITCHCOCK HEALTH ENTERED INTO AN OFFICIAL AFFILIATION BETWEEN THE TWO ORGANIZATIONS THAT PROMOTES THE SHARING OF RESOURCES THAT WILL ALLOW FOR A MORE SUSTAINABLE AND ACCESSIBLE HEALTH SYSTEM IN THE UPPER VALLEY. MT. ASCUTNEY WILL RETAIN ITS STATUS AS AN INDEPENDENT NOT-FOR-PROFIT COMMUNITY HOSPITAL AND WILL ALSO MAINTAIN A LOCAL BOARD OF TRUSTEES RESPONSIBLE FOR OVERSIGHT. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE OF THE BOARD. THE BOARD RECEIEVES A COPY OF THE FINAL VERSION AND IT IS DISCUSSED AT THE BOARD MEETING FORM 990, PART VI, SECTION B, LINE 12C THE FINANCE AND AUDIT COMMITTEE MONITOR AND REPORT TO THE BOARD OF DIRECTORS FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD MEETS ANNUALLY TO REVIEW COMPENSATION FOR THE CEO, USING INDEPENDENT SURVEYS OF AREA COMPENSATION FOR EXECUTIVES OF VARIOUS SIZED HOSPITALS. OTHER OFFICERS AND KEY EMPLOYEES SALARIES ARE DETERMINED, BY THE HR DEPARTMENT USING COMPARABLE MARKET DATA. FORM 990, PART VI, SECTION C, LINE 19 ALL INTERNAL POLICIES, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST FORM 990, PART XI, LINE 9: OTHER ADJUSTMENTS -667,377. HISTORIC HOMES OF RUNNEMEDE 40 MAXWELL PERKINS LANE WINDSOR VT 05089 237396147 PROVIDING SERVICES FOR THE AGING VT 501(C)(3) LINE 9 WINDSOR HOSPITAL CORPORATION 1 MOUNT ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION INC 289 COUNTY ROAD WINDSOR VT 05089 030300481 TO PROVIDE HEALTHCARE SERVICES TO THE WINDSOR, VERMONT COMMUNITY VT 501(C)(3) LINE 3 WINDSOR HOSPITAL CORPORATION 1 DARTMOUTH-HITCHCOCK MEDICAL CENTER ONE MEDICAL CENTER DRIVE LEBANON NH 03756 264812335 ESTABLISHING INTEGRATED HEALTH CARE DELIVERY SYSTEM WITHIN NORTHERN NE NH 501(C)(3) 11 TYPE II 0 MOUNT ASCUTNEY PROFESSIONAL CENTER OWNERS ASSOCIATION 289 COUNTY ROAD WINDSOR VT 05089 030320283 OWNERS ASSOCIATION FOR 13 CONDOMINIUM UNITS VT 501(C)(3) LINE 3 WINDSOR HOSPITAL CORPORATION 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 MT ASCUTNEY PROFESSIONAL CENTER OWNERS ASSOCIATION R 72000 ACTUAL DARTMOUTH-HITCHCOCK MEDICAL CENTER O 105092 ACTUAL DARTMOUTH-HITCHCOCK MEDICAL CENTER Q 407019 ACTUAL