2013-08-08T09:59:59-05:00 2012-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2011-10-01 030183483 RUTLAND HOSPITAL INC % EDWARD T OGORZALEK RUTL 8027757111 160 ALLEN STREET RUTLAND VT 05701 EDWARD T OGORZALEK 2013-08-01 true Brian D Todd 4178658701 2011 2016-02-24 21:20:13Z RUTLAND REGIONAL MEDICAL CENTER THOMAS W HUEBNER 160 ALLEN STREET RUTLAND VT 05701 241042372 false X WWW.RRMC.ORG X 1892 VT TO PROVIDE COMPREHENSIVE INPATIENT AND OUTPATIENT MEDICAL SERVICES AND TO IMPROVE HEALTH OF THE RESIDENTS OF RUTLAND AND SURROUNDING COMMUNITIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 17 11 1753 332 2799862 665185 965059 1273885 187680774 203313950 799791 3757814 6549 -295204 189452173 208050445 1265028 1473293 0 0 107256177 113044636 0 0 0 85725318 90464149 194246523 204982078 -4794350 3068367 197570340 209893240 113728582 127456515 83841758 82436725 X TO IMPROVE THE HLTH OF THE RUTLAND REGION AND SURROUNDING COMMUNITIES BY PROVIDING APPROPRIATE, SUPERIOR, INTEGRATED, PREVENTATIVE, DIAGNOSTIC & THERAPEUTIC HEALTH SERVICES IN A CARING ENVIRONMENT THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY & RELATIONSHIPS. false false 75325358 92902121 ANCILLARY CARE. ANCILLARY CARE SERVICES INCLUDE OPERATING ROOM, EMERGENCY ROOM, PHYSICAL REHABILITATION, ANESTHESIOLOGY, ONCOLOGY, PULMONARY, RESPIRATORY, PHYSICAL THERAPY, CARDIAC CATH, ENDOSCOPY, AMBULATORY, DELIVERY, RADIATION, PSYCHIATRIC COUNSELING, OCCUPATIONAL THERAPY, RECOVERY, HIV CLINIC, AND SPEECH THERAPY. SEE SCHEDULE O FOR MORE INFORMATION. 40067550 49417096 INPATIENT CARE. INPATIENT CARE SERVICES INCLUDE MEDICAL AND SURGICAL, INTENSIVE CARE, HOSPITALISTS, REHABILITATION, PSYCHIATRIC, OBSTETRICS AND GYNECOLOGY, NURSERY, AND NURSING. SEE SCHEDULE O FOR MORE INFORMATION. 23617039 29127947 DIAGNOSTIC SERVICES. DIAGNOSTIC SERVICES INCLUDE LABORATORY, RADIOLOGY, ELECTROENCEPHALOGRAPHY, AND CT SCANNING. SEE SCHEDULE O FOR MORE INFORMATION. 23567561 1473293 29066924 162577508 true true false true false false false false false true true false false false true false true true false false false false false false false false true true true false true true false false false false false false false false false true false false false false true true false false false false true 190 0 true 1753 true true true false false false false false false false false false X 17 11 false false false false true true true true true false false true true true true true true true false false X EDWARD T OGORZALEK 8027757111 160 ALLEN STREET RUTLAND VT 05701 X BILL BANNERMAN 1.0 X 0 0 0 GORDON H CHADER 1.0 X 0 0 0 J CHRISTIAN HIGGINS MD 1.0 X 149721 177888 15993 JESSICA L ANDERSON 1.0 X X 0 0 0 JOAN F GAMBLE 1.0 X X 0 0 0 JON S READNOUR ESQ 1.0 X X 0 0 0 KIRK DUFTY MD 1.0 X 265357 0 26151 MARK K FOLEY 1.0 X 0 0 0 MATTHEW A CONWAY MD 1.0 X 258052 0 38430 RONALD J CIOFFI 1.0 X 0 0 0 CLAUDE LAPERLE 1.0 X 0 0 0 DANIEL M FOLEY MD 1.0 X 324789 0 31081 JOHN R BUTTERLY MD 1.0 X 0 0 0 MICHAEL DICK MD 1.0 X 0 0 0 STEPHEN LEFFLER MD 1.0 X 0 0 0 CORT JONES 1.0 X 0 0 0 TJ SABOTKA 1.0 X 0 0 0 MICHAEL MCCORMACK 1.0 X 0 0 0 TODD GREGORY MD 1.0 X 240285 0 38408 THOMAS W HUEBNER 40.0 X 443856 0 43567 EDWARD T OGORZALEK 40.0 X 248049 0 48224 MARY T NEMETH 40.0 X 188060 0 29669 BAXTER HOLLAND 40.0 X 324242 0 37954 DORCAS WARD 40.0 X 187015 0 36306 BARBARA ROBINSON 40.0 X 212116 0 35055 CHRISTOPHER LAFAVE 40.0 X 164141 0 27107 DARREN CHILDS 40.0 X 154927 0 32236 KATHLEEN LETENDRE 40.0 X 152051 0 31737 JI CHEN 40.0 X 168632 0 11272 JOHN KIJEWSKI 40.0 X 192340 0 23060 HARVEY REICH 40.0 X 389186 0 43483 MICHAEL KENOSH 40.0 X 474133 0 38655 ROBERT GIERING 40.0 X 397536 0 37577 EITAN SOBEL 40.0 X 339609 0 35312 JOSEPH WILLIAMS 40.0 X 344507 0 31507 MARY KOHANSKI X 190922 11541 5809526 177888 704325 78 true true false SHERIDAN HEALTHCARE OF VERMONT ANESTHETISTS 1966406 CERNER CORP PROFESSIONAL 2477661 MMODAL SERVICES LTD TRANSCRIPTION 643297 KLEEN LAUNDRY DRY CLEANING LAUNDRY SERVICES 577547 GE HEALTHCARE CONTRACT SERVICES 512587 46 269455 366714 637716 1273885 NET PATIENT SERVICE REVENUE 900099 197365508 197312308 53200 LABORATORY AND SCREENING SERV 621500 2685213 2685213 CAFETERIA 722210 918504 918504 ENTEROSTOMAL NURSING SERVICES 623000 61449 61449 OTHER REVENUES 900099 2283276 2283276 203313950 2060470 2060470 0 0 89565 384769 -295204 -295204 -295204 34265865 38637 32578327 28831 1687538 9806 1697344 1697344 0 0 0 0 208050445 200514088 2799862 3462610 1473293 1473293 0 0 0 4179883 2779270 1400613 202463 202463 84846231 71461561 13384670 6393905 4701263 1692642 11706672 8591127 3115545 5715482 4181810 1533672 0 489138 489138 153574 153574 110167 110167 0 311076 311076 14094979 9723476 4371503 754222 274446 479776 5098320 4061694 1036626 4410349 93642 4316707 0 4748360 3503981 1244379 1142040 644567 497473 0 408343 362798 45545 2238131 1637559 600572 0 11901478 8707879 3193599 2700140 2700140 MEDICAL SUPPLIES & DRUGS 21802575 21802575 MEDICAID TAX ASSESSMENT 10732335 10732335 BAD DEBTS 7581672 7581672 LICENSES, DUES, SUBSCRIPTIONS 1519547 197570 1321977 267703 64990 202713 204982078 162577508 42404570 0 3575 4075 10509296 10622417 433193 226961 25472660 22402032 0 0 0 0 2298513 2532829 1333570 1234153 3846394 2618171 178948193 106983031 77317073 71965162 69834842 89940764 0 0 0 0 0 0 6521224 8346676 197570340 209893240 26182460 28296490 0 0 0 0 46218246 45103004 0 0 0 0 3314203 2567473 0 0 38013673 51489548 113728582 127456515 X 77862660 75394367 5300456 6363716 678642 678642 83841758 82436725 197570340 209893240 X 3068367 -4473400 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X X false true true false false false false true 98081 false true 34368 132449 false LOBBYING EXPENSES SCHEDULE C, PART II-B, LINE 1G AND 1I THE ORGANIZATION PAID LOBBYING FEES OF $75,799 TO A PROFESSIONAL GOVERNMENT AFFAIRS AND COMMUNICATION STRATEGIES COMPANY. THE ORGANIZATION'S CEO, THOMAS HUEBNER, SPENDS TIME EACH YEAR WORKING DIRECTLY WITH STATE LEGISLATORS TO IMPROVE SERVICES FOR THE RUTLAND REGION. APPROXIMATELY 5.02%, OR $22,282, OF HIS SALARY IS ALLOCATED TO THIS ACTIVITY. ALSO, DUES ARE PAID TO THE HOSPITAL ASSOCIATION AND THE VERMONT HOSPITAL ASSOCIATION. A PORTION OF DUES IS ATTRIBUTABLE TO LOBBYING: $ 7,535 AHA 26,833 VHA ---------- $ 34,368 6260684 1265080 105876 7419888 11229688 253308 5222312 6260684 10241135 988553 11229688 10799491 -558357 10241134 0.84010 0.15990 false false 224094 224094 38117984 18556903 19561081 32241261 14417059 17824202 104364711 72775130 31589581 4000143 1233939 2766204 71965162 0 ACCRUED PENSION 44354090 EST AMTS DUE TO THIRD PARTY 6697993 ADVANCES FROM THIRD PTY PYRS 437465 51489548 208050445 204982078 3068367 479289 -4952689 -4473400 -1405033 196069066 479289 -12845437 -12366148 208435214 -384769 -384769 208050445 197474099 384769 384769 197089330 311076 7581672 7892748 204982078 ENDOWMENT FUND PURPOSE SCHEDULE D, PART V, LINE 4 RRMC'S ENDOWMENTS CONSIST OF VARIOUS INDIVIDUAL DONOR-RESTRICTED AND BOARD DESIGNATED FUNDS WHICH WERE ESTABLISHED FOR GENERAL OPERATIONAL AND CERTAIN DEPARTMENTAL PURPOSES. AS REQUIRED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA (GAAP), NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. RRMC'S GOVERNING BODY HAS INTERPRETED THE STATE OF VERMONT PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT (SPMIFA), ADOPTED IN MAY OF 2009, AS REQUIRING PRESERVATION OF THE FAIR VALUE OF THE ORIGINAL GIFT AS OF THE GIFT DATE OF THE DONOR-RESTRICTED ENDOWMENT FUNDS ABSENT EXPLICIT DONOR STIPULATIONS TO THE CONTRARY. AS A RESULT OF THIS INTERPRETATION, RRMC CLASSIFIES AS PERMANENTLY RESTRICTED NET ASSETS (A) THE ORIGINAL VALUE OF GIFTS DONATED TO THE PERMANENT ENDOWMENT, (B) THE ORIGINAL VALUE OF SUBSEQUENT GIFTS TO THE PERMANENT ENDOWMENT AND (C) ACCUMULATIONS TO THE PERMANENT ENDOWMENT MADE IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE ACCUMULATION IS ADDED TO THE FUND. THE REMAINING PORTION OF DONOR-RESTRICTED ENDOWMENT FUNDS IS CLASSIFIED AS TEMPORARILY RESTRICTED NET ASSETS UNTIL THOSE AMOUNTS ARE APPROPRIATED FOR EXPENDITURE BY RRMC IN A MANNER CONSISTENT WITH THE STANDARD OF PRUDENCE PRESCRIBED BY SPMIFA. IN ACCORDANCE WITH SPMIFA, RRMC CONSIDERS THE FOLLOWING FACTORS IN MAKING A DETERMINATION TO APPROPRIATE OR ACCUMULATE DONOR-RESTRICTED ENDOWMENT FUNDS: 1. DURATION AND PRESERVATION OF THE FUND 2. PURPOSES OF RRMC AND THE FUND 3. GENERAL ECONOMIC CONDITIONS 4. POSSIBLE EFFECT OF INFLATION AND DEFLATION 5. EXPECTED TOTAL RETURN FROM INVESTMENT INCOME AND APPRECIATION OR DEPRECIATION OF INVESTMENTS 6. OTHER RESOURCES OF RRMC 7. INVESTMENT POLICIES OF RRMC UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. OTHER CHANGES IN NET ASSETS SCHEDULE D, PART XI, LINE 8 $(11,784,886) NET LOSS FROM DEF BEN PEN PLAN AND POSTRETRMT BEN COSTS ( 1,604,997) TRANSFER TO AFFILIATES 9,217,462 CHANGE IN FV OF INVESTMENTS ACCT FOR UNDER FASB 825 ( 780,268) LOSS ON INTEREST RATE SWAP AGREEMENT ------------- $( 4,952,689) OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 SCHEDULE D, PART XII, LINE 2D $(11,784,886) NET LOSS FROM DEF BEN PEN PLAN AND POSTRETRMT BEN COSTS ( 1,604,997) TRANSFER TO AFFILIATES 9,217,462 CHANGE IN FV OF INVESTMENTS ACCT FOR UNDER FASB 825 ( 780,268) LOSS ON INTEREST RATE SWAP AGREEMENT ( 7,581,672) PROVISION FOR UNCOLLECTIBLE ACCOUNTS ( 311,076) INVESTMENT EXPENSES ------------- $(12,845,437) OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 SCHEDULE D, PART XII, LINE 4B $( 384,769) RENTAL EXPENSES OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25 SCHEDULE D, PART XIII, LINE 2D $ 384,769 RENTAL EXPENSES OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1 SCHEDULE D, PART XIII, LINE 4B $ 7,581,672 PROVISION FOR UNCOLLECTIBLE ACCOUNTS true true X true X true X 500. true true true false true true 2773933 2773933 0.01410 39833657 25776968 14056689 0.07120 2876647 3489828 -613181 0.00310 45484237 29266796 16217441 0.08220 1417175 5760 1411415 0.00720 223682 0 223682 0.00110 12047546 9107644 2939902 0.01490 1298114 1298114 0.00660 14986517 9113404 5873113 0.02980 60470754 38380200 22090554 0.11200 2672 2672 0.00000 27094 27094 0.00010 81410 81410 0.00040 14396 14396 0.00010 141319 141319 0.00070 266891 266891 0.00130 false 7581672 940127 56445187 73850880 -17405693 X true true 1 1 RUTLAND HOSPITAL

160 ALLEN STREET RUTLAND VT 05701

X X X MED DEV RURAL COMM HOSP RUTLAND HOSPITAL 1 true true 200. true 500. true X X X X true true X X X X X true false X X true X false false 5 RUTLAND HEART CENTER

12 COMMONS STREET RUTLAND VT 05701

PATIENT CLINIC RUTLAND REG DIABETES & ENDOCRINOLOGY CTR

8 ALBERT CREE DRIVE RUTLAND VT 05701

PATIENT CLINIC RUTLAND REGIONAL GENERAL SURGERY

241 STRATTON ROAD RUTLAND VT 05701

PATIENT CLINIC RUTLAND REGIONAL WOMEN'S HEALTH

147 ALLEN STREET RUTLAND VT 05701

PATIENT CLINIC RUTLAND REGIONAL DIGESTIVE SERVICES

254 STRATTON ROAD RUTLAND VT 05701

PATIENT CLINIC ELIGIBILITY FOR DISCOUNTED CARE SCHEDULE H, PART I, LINE 3B THE ORGANIZATION WILL PROVIDE DISCOUNTED CARE TO LOW INCOME INDIVIDUALS WHOSE FAMILY INCOME FALLS BETWEEN 201% AND 500% OF THE FEDERAL POVERTY GUIDELINES USING A GRADUATED RANGE OF DEDUCTIBLES FROM $250 AT THE LOWEST LEVEL TO $3,000 AT THE HIGHEST LEVEL. PERCENT OF TOTAL EXPENSES SCHEDULE H, PART I, LINE 7, COLUMN F THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) LESS BAD DEBT EXPENSE OF $7,581,672. THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 AND 3. BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: RRMC REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. RRMC PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, RRMC BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE AMOUNT OF BAD DEBT LISTED ON LINE 2 AGREES TO BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. USING AN AVERAGE OF DATA FROM 2007-2011, APPROXIMATELY 12.4 PERCENT OF RUTLAND COUNTY WAS CONSIDERED TO LIVE IN POVERTY. COMMUNITY BENEFITS SCHEDULE H, PART III, LINE 8 SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. MEDICARE COSTING METHODOLOGY SCHEDULE H, PART III, LINE 8 THE ORGANIZATION USES INFORMATION FROM THE MEDICARE COST REPORT TO COMPUTE THE MEDICARE ALLOWABLE COSTS OF CARE ON LINE 6. PROVISIONS OF DEBT COLLECTION POLICY SCHEDULE H, PART III, LINE 9B THE PAYMENT PLAN POLICY REQUIRES PAYMENTS OF A MINIMUM OF $25.00 PER MONTH, AND THAT ALL BALANCES BE PAID WITHIN 10 MONTHS. THE FREE CARE POLICY SPECIFICALLY STATES THAT ALL UNINSURED AND UNDERINSURED PATIENTS BE GIVEN INFORMATION ON THE FREE CARE PROGRAM, AND THAT STAFF PERFORM DUE DILIGENCE TO GIVE THEM INFORMATION AND HAVE THE APPLICATION RETURNED, AND THAT THE HOSPITAL SEND 3 STATEMENTS AND A FINAL NOTICE BEFORE SENDING AN ACCOUNT TO BAD DEBT. IT ALSO STATES THAT RRMC WILL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS TO OBTAIN PAYMENT FOR A DEBT. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 IN APRIL 2009, THE RUTLAND COUNTY HEALTH ASSESSMENT WAS COMPLETED. RUTLAND REGIONAL MEDICAL CENTER AND THE BOWSE HEALTH TRUST CONVENED THE ASSESSMENT TEAM THAT GUIDED THE HEALTH ASSESSMENT. THE ASSESSMENT TEAM REPRESENTED THE FOLLOWING ORGANIZATIONS: RUTLAND REGIONAL MEDICAL CENTER (RRMC), JAMES T. BOWSE COMMUNITY HEALTH TRUST, RUTLAND COUNTY UNITED WAY, VERMONT DEPARTMENT OF HEALTH, RUTLAND AREA VISITING NURSES ASSOCIATION AND HOSPICE (RAVNAH), COMMUNITY HEALTH CLINICS OF THE RUTLAND REGION (CHCRR). [THE NEXT ASSESSMENT WILL BE COMPLETED BEFORE SEPTEMBER 2013.] THE HEALTH ASSESSMENT WAS CONDUCTED IN FIVE (5) PHASES: PHASE 1: ANALYSIS OF VERMONT AND RUTLAND COUNTY DATA PHASE 2: SURVEY OF RUTLAND COUNTY RESIDENTS PHASE 3: COMMUNITY LEADER FOCUS GROUPS PHASE 4: PRIORITIZING MEETING WITH COMMUNITY LEADERS PHASE 5: DEVELOPMENT OF THE EXECUTIVE SUMMARY / FINAL REPORT DATA ANALYSIS OVER 36 SOURCES OF EXISTING DATA WERE ANALYZED IN ORDER TO IDENTIFY AREAS FOR FURTHER STUDY. THE DATA DESCRIBES RUTLAND COUNTY AS A POPULATION THAT IS OLDER, LESS EDUCATED AND LOWER INCOME THAN VERMONTERS AS A WHOLE. THERE ARE AN INCREASING NUMBER OF VULNERABLE AND DISABLED RESIDENTS IN RUTLAND COUNTY. MANY BARRIERS CHALLENGE THEIR ACCESS TO HEALTH AND HUMAN SERVICES, MOST NOTABLY, INADEQUATE ACCESS TO PRIMARY MEDICAL AND DENTAL CARE DUE TO A LACK OF HEALTH AND DENTAL INSURANCE AND A SHORTAGE OF PROVIDERS. THE LIFESTYLES OF SOME RUTLAND COUNTY RESIDENTS INCREASE THEIR RISKS FOR CHRONIC DISEASE. RISK FACTORS FOR HEART DISEASE AND STROKE INCLUDE TOBACCO USE, OBESITY, HIGH BLOOD PRESSURE, DIABETES, INACTIVITY, POOR DIET, EXCESSIVE ALCOHOL USE AND HIGH CHOLESTEROL. THE RATES FOR EACH OF THESE RISK FACTORS IN RUTLAND COUNTY ARE HIGHER THAN THE STATE AVERAGE. SURVEY OF RUTLAND COUNTY RESIDENTS A SURVEY TO IDENTIFY BARRIERS TO ACCESSING TRADITIONAL HEALTH SERVICES WAS ANSWERED BY 501 RUTLAND COUNTY RESIDENTS. THE RESULTS SHOWED THAT YOUNG ADULTS AND THOSE WITHOUT A HIGH SCHOOL DIPLOMA ARE LEAST LIKELY TO BE ABLE TO ACCESS THE HEALTH CARE THEY NEED. INABILITY TO PAY FOR SERVICES IS THE GREATEST BARRIER. THE SERVICES THAT ARE LEAST LIKELY TO BE ACCESSED WHEN NEEDED ARE MENTAL HEALTH AND ALCOHOL OR DRUG ABUSE COUNSELING. COMMUNITY LEADER FOCUS GROUPS THE ASSESSMENT TEAM INVITED EIGHTY COMMUNITY LEADERS TO PARTICIPATE IN LOCAL FOCUS GROUPS. IN TOTAL, FORTY-SIX (46) COMMUNITY LEADERS PARTICIPATED IN FIVE (5) HEALTH ASSESSMENT FOCUS GROUPS. ONE COMMUNITY LEADER GROUP WAS HELD IN CASTLETON, ONE WAS CONVENED IN BRANDON, AND THREE (3) GROUPS WERE CONDUCTED IN RUTLAND. THE LEADERS IDENTIFIED THE STRENGTHS AND CHALLENGES IN RUTLAND COUNTY'S HEALTH AND HUMAN SERVICES SYSTEM. LACK OF HEALTH AND DENTAL INSURANCE AND TRANSPORTATION WERE IDENTIFIED AS THE LEADING BARRIERS TO CARE. RUTLAND COUNTY IS RECOGNIZED AS HAVING MANY RESOURCES TO ASSIST PEOPLE IN PREVENTION AND TREATMENT OF HEALTH PROBLEMS, BUT THESE PROGRAMS AND SERVICES ARE UNDERUTILIZED OR UNKNOWN. NAVIGATING THE ARRAY OF SERVICES AND UNDERSTANDING ELIGIBILITY TO RECEIVE THESE SERVICES IS CONFUSING AND COMPLICATED. COMMUNITY LEADERS NOTED THAT THE CULTURE IN RUTLAND COUNTY IS NOT CONDUCIVE TO PREVENTION. MANY SUGGESTIONS ABOUT HOW RUTLAND COUNTY RESIDENTS CAN IMPROVE THEIR HEALTH STATUS ARE NOTED IN THE ASSESSMENT REPORT. PRIORITIZING MEETING FINDINGS WERE SYNTHESIZED FROM THE DATA ANALYSIS, THE CONSUMER SURVEY AND FOCUS GROUPS. THESE FINDINGS WERE PRESENTED AT A COMMUNITY MEETING WHERE ATTENDEES PARTICIPATED IN A GROUP PROCESS TO PRIORITIZE THE COMMUNITY'S HEALTH NEEDS. DURING A PRIORITIZING MEETING HELD ON APRIL 30, 2009, TWENTY MEMBERS OF COMMUNITY ORGANIZATIONS SELECTED HIS OR HER TOP THREE (3) ACTIONS TO IMPROVE RUTLAND COUNTY'S HEALTH STATUS IN THE NEXT 5 YEARS. A TOTAL OF 60 ACTIONS FOR A HEALTHIER RUTLAND COUNTY WERE PRESENTED AND ARE LISTED IN THE FULL REPORT. THE TOP ACTIONS SELECTED ARE NOTED BELOW: 2009 - 2013 OBJECTIVES AND ACTIONS 1. INCREASE PREVENTION EFFORTS THAT LEAD TO A HEALTHY LIFESTYLE OBJECTIVES DECREASE % OF ADULT AND YOUTH TOBACCO USE INCREASE % OF ADULT AND YOUTH PHYSICAL ACTIVITY INCREASED % OF ADULT AND YOUTH HEALTHY DIET DECREASE % OF ADULT AND YOUTH BMI OVER 30 ACTIONS: SUPPORT PROGRAMS THAT CREATE CULTURE AND BEHAVIOR CHANGE PROVIDE AFFORDABLE HEALTHY FOOD AT WORK, SCHOOL AND COMMUNITY EXPAND USE OF CURRENT EXERCISE PROGRAMS INCREASE WORKSITE EXERCISE PROGRAMS PHYSICIANS WILL ADDRESS BMI WITH PATIENTS AND REFER TO COMMUNITY RESOURCES EXPAND AND SUPPORT PROGRAMS THE PREVENT TEEN AGE PREGNANCY SUPPORT AND EXPAND TOBACCO PREVENTION PROGRAMS 2. IMPROVE ACCESS TO HEALTH AND HUMAN SERVICES OBJECTIVES INCREASE % ADULT COVERED BY HEALTH INSURANCE INCREASE % OF ADULTS UP-TO-DATE ON AGE APPROPRIATE SCREENINGS INCREASE % OF ADULTS AND YOUTH UP-TO-DATE ON IMMUNIZATIONS DECREASE AMBULATORY CARE SENSITIVE HOSPITALIZATIONS INCREASE % OF ADULTS AND CHILDREN RECEIVING DENTAL CARE INCREASE USE OF CURRENT RESOURCES ACTIONS: CREATE COMMUNITY CARE TEAMS FOR CHRONIC HEALTH CONDITIONS EXPAND DENTAL PROGRAMS FOR THE UNINSURED AND MEDICAID POPULATIONS INCREASE THE USE OF ELECTRONIC MEDICAL RECORDS OPEN CHCRR CLINIC IN RUTLAND CITY CREATE EMERGENCY ROOM NAVIGATORS DEVELOP A RUTLAND COUNTY RESOURCE GUIDE EXPAND HEALTH INSURANCE ENROLLMENT ASSISTANCE 3. REDUCE SUBSTANCE ABUSE OBJECTIVES DECREASE THE USE OF ILLEGAL SUBSTANCES DECREASE % OF ADULT AND YOUTH WHO BINGE DRINK DECREASE % OF ADULTS WHO ARE DEPRESSED ACTIONS: CHANGE THE CULTURE OF LEGAL AND ILLEGAL DRUG USE CHANGE THE CULTURE OF ALCOHOL USE FOR ADULTS AND YOUTH INCREASE THE USE OF ELECTRONIC MEDICAL RECORDS CASE MANAGEMENT FOR HIGH-RISK POPULATIONS 4. EXPAND COMMUNITY BASED ELDER CARE OBJECTIVES INCREASE COMMUNITY BASED SERVICES FOR ELDERS, TO MAXIMIZE THE PERCENT OF ELDERS WHO LIVE AT HOME ACTIONS: CASE MANAGEMENT FOR AT RISK ELDERS EXPAND ATTENDANT SERVICES EXPAND MEALS ON WHEELS SPECIAL NOTE: IT SHOULD BE NOTED THAT THESE ISSUES CANNOT BE SOLVED BY THE LIMITED RESOURCES WITHIN RUTLAND COUNTY. TRUE IMPACT CAN ONLY HAPPEN WITH SYSTEM CHANGES THAT INCLUDE CHANGES TO THE REIMBURSEMENT SYSTEM. HEALTH ASSESSMENT REPORT A COPY OF THE FINAL REPORT IS AVAILABLE ON THE RRMC WEB SITE (WWW.RRMC.ORG). HARD COPIES ARE AVAILABLE IN THE RRMC HEALTH SCIENCES LIBRARY AND THE RUTLAND FREE LIBRARY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 RRMC HAS "DO YOU NEED HELP WITH YOUR MEDICAL BILLS?" SIGNAGE POSTED AT EVERY ACCESS POINT THROUGHOUT THE HOSPITAL AND ITS OFF-SITE CLINICS (RUTLAND GENERAL SURGERY, WOMEN'S HEALTH ETC.) THE SIGNAGE PROVIDES CONTACT INFORMATION FOR THE PATIENTS TO CALL THE FINANCIAL COUNSELORS FOR HELP AS NEEDED. REGISTRATION OFFERS FINANCIAL ASSISTANCE PROGRAM APPLICATIONS TO ALL MEDICARE INSURED PATIENTS WITH NO OTHER INSURANCE, ALL SELF-PAY PATIENTS, AND ANY OTHER PERSON REQUESTING THE INFORMATION OR ANYONE WHO SPEAKS TO BEING IN FINANCIAL NEED. ALL SELF-PAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR WHILE THEY ARE AN IN-PATIENT AND THEY WILL ASSIST THEM IN APPLYING FOR OUR FINANCIAL ASSISTANCE, AS WELL AS, APPLYING FOR STATE AND FEDERAL PROGRAMS. ALL STATEMENTS HAVE THE RRMC WEBSITE ADDRESS TO VIEW OUR FINANCIAL ASSISTANCE PROGRAM AND THE BILLING AND COLLECTIONS POLICY AND PROCEDURE. THE WEBSITE ALSO HAS CONTACT PHONE NUMBERS FOR THE PATIENT TO CALL WITH QUESTIONS OR CONCERNS ABOUT THEIR BILL. THE RRMC WEB SITE NOT ONLY DESCRIBES THE FINANCIAL ASSISTANCE PROGRAM BUT, ALSO SHOWS THE INCOME GUIDELINES (BASED ON THE FEDERAL POVERTY) FOR FINANCIAL ASSISTANCE, AN ON-LINE APPLICATION, AS WELL AS, INFORMATION ON MEDICAID PROGRAMS AVAILABLE WITH SHORT DESCRIPTIONS. LASTLY, ALL PATIENTS WHO ARE SENT A STATEMENT SHOWING THEIR OUT OF POCKET EXPENSES ARE CALLED TO DEVELOP A PAYMENT PLAN. AT THIS TIME FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED AND MAILED AS REQUESTED. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 RUTLAND COUNTY, COMPOSED OF 933 SQUARE MILES, IS LOCATED IN CENTRAL VERMONT. THE POPULATION MOSTLY RESIDES IN THE 27 SMALL TOWNS AND OUTLYING RURAL AREAS. IN 2010, AN ESTIMATED 61,642 PEOPLE LIVED IN RUTLAND COUNTY, ABOUT 9.8% OF THE STATES TOTAL POPULATION. (US CENSUS BUREAU, PROFILE OF GENERAL POPULATION, 2010). RUTLAND COUNTYS POPULATION WAS EXPECTED TO GROW AT 2% TO THE YEAR 2016 BUT HAS INSTEAD DECLINED FROM 2000 TO 2010. THE POPULATION FELL FROM 63,743 TO 61,642, A RATE OF -3.4%. (US CENSUS BUREAU, PROFILE OF GENERAL POPULATION, 2005 AND 2010) RRMC IS A COMPREHENSIVE MEDICAL/SURGICAL HOSPITAL LICENSED FOR 188 BEDS, SEEING ROUGHLY 34,126 EMERGENCY ROOM VISITS AND 7,022 INPATIENT ADMISSIONS IN FISCAL YEAR 2012. WE HAVE OVER 1,600 EMPLOYEES AND ARE DEPENDED UPON BY MORE THAN 70,000 RESIDENTS OF THE HOSPITAL SERVICE AREA (HSA), WHICH INCLUDES RUTLAND COUNTY, SOME PORTIONS OF SOUTHERN AND NORTH CENTRAL VERMONT AND EVEN WASHINGTON COUNTY, NEW YORK. RRMC IS LOCATED APPROXIMATELY FORTY MILES FROM THE NEAREST HOSPITAL OR HEALTH SYSTEM OF ANY SIZE AND NEARLY SEVENTY MILES FROM THE ONLY MEDICAL CENTER PROVIDING MORE LICENSED BEDS TO THE CITIZENS OF VERMONT. THERE ARE A NUMBER OF DEMOGRAPHIC STATISTICS THAT PUT RUTLAND COUNTY AT RISK AS COMPARED TO THE AVERAGE VERMONTER. THE MEDIAN AGE IN 2010 WAS 44.3, WHICH INCREASED FROM 39.23 YEARS IN 2000, AND REMAINS ONE OF THE HIGHEST IN NEW ENGLAND. (US CENSUS BUREAU, PROFILE OF GENERAL POPULATION, 2010) VERMONT IS PROJECTED TO HAVE 24.4% OF THE POPULATION AGE 65 YEARS AND OLDER IN 2030, MAKING IT THE 8TH RANKED STATE IN THE NATION. (US CENSUS BUREAU, POPULATION PROJECTIONS, 2030) RUTLAND COUNTY HAS A POPULATION THAT IS LESS EDUCATED THAN THE VERMONT RATES, AS DEPICTED BY THE LOWER COLLEGE GRADUATE RATE. POVERTY RATES IN RUTLAND COUNTY ARE HIGHER THAN THE STATE RATE (13.6% V. 11.5%) AND MEDIAN HOUSEHOLD INCOMES ARE LESS THAN THE STATE AVERAGE AND THE NATIONAL AVERAGE. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 RUTLAND REGIONAL MEDICAL CENTER ENGAGES IN A NUMBER OF COMMUNITY SUPPORTIVE ACTIVITIES IN ORDER TO INCREASE ACCESS AND AFFORDABILITY OF HEALTH AND HUMAN SERVICES. RUTLAND COUNTY HAS A SEVERE NEED FOR PRIMARY CARE PHYSICIANS AND HAS SHORTAGES OR IS AT RISK FOR SHORTAGES IN MANY SPECIALTY SERVICES. RUTLAND REGIONAL MEDICAL CENTER ACTIVELY RECRUITS BOTH PRIMARY CARE AND SPECIALTY PRACTICE PHYSICIANS FOR RUTLAND COUNTY. THE MD MANPOWER PLAN CONTINUES TO IDENTIFY MEDICAL PROVIDERS, ESPECIALLY PRIMARY CARE PHYSICIANS AS A COMMUNITY NEED. IN FISCAL YEAR 2012, 16 PROVIDERS WERE RECRUITED TO THE REGION, INCLUDING 1 FAMILY PRACTICE DOCTOR, 2 PSYCHIATRISTS, 1 PEDIATRICIAN, 1 GASTROENTEROLOGIST, 1 OB/GYN, 1 EMERGENCY PHYSICIAN, 1 SLEEP DISORDER PHYSICIAN, 1 ANESTHESIOLOGIST, 1 INFECTIOUS DISEASE PHYSICIAN, 1 GENERAL SURGEON, 2 HOSPITALISTS, 2 PHYSICIANS ASSISTANTS AND 1 DENTIST. SIX OF THESE PROVIDERS WERE RECRUITED FOR SERVICE OUTSIDE OF RRMC. RRMC SUPPORTS A HOSPITALIST PROGRAM WHERE HOSPITAL PHYSICIANS PROVIDE CARE FOR PRIMARY CARE PROVIDER'S PATIENTS THAT ARE ADMITTED TO THE HOSPITAL. THIS ALLOWS THE PRIMARY CARE PROVIDER TO PROVIDE MORE HOURS OF OFFICE CARE WHILE THEIR HOSPITALIZED PATIENTS HAVE 24 HOUR ACCESS TO A DOCTOR DURING THE HOSPITALIZATION. THIS SYSTEM PROVIDES EFFICIENCIES TO THE HEALTH CARE SYSTEM IN RUTLAND COUNTY. RUTLAND COUNTY'S MEDICAID POPULATION CONTINUES TO INCREASE. THIS PUTS A FINANCIAL STRAIN ON RRMC'S BUDGET AS THE CARE PROVIDED TO THIS GROWING POPULATION IS NOT REIMBURSED FOR THE FULL COST OF CARE. LEADERS AT RRMC ADVOCATE AT THE STATE AND LOCAL LEVEL TO MAINTAIN THE MEDICAID REIMBURSEMENT RATES FOR BOTH IN-PATIENT AND OUT-PATIENT CARE IN ORDER TO MAINTAIN ACCESS FOR MEDICAID PATIENTS. LEADERS AT RRMC ALSO PROVIDE SUPPORT FOR THE FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN RUTLAND COUNTY BY BEING A BOARD MEMBER. THE FQHC GETS REIMBURSED AT A HIGHER LEVEL FOR CARING FOR MEDICAID PATIENTS AND PROVIDES INCREASED ACCESS FOR THESE PATIENTS. RRMC LEADERS AND STAFF ALSO PARTICIPATE AS BOARD MEMBERS IN THE SUPPORT OF OTHER NON-PROFIT ORGANIZATIONS, SUCH AS RUTLAND COUNTY UNITED WAY, RUTLAND AREA VISITING NURSES ASSOCIATION AND HOSPICE, RUTLAND AREA PHYSICAL ACTIVITY COALITION, RUTLAND POLICE COMMISSION, AND THE RUTLAND ECONOMIC DEVELOPMENT CORPORATION. RRMC PARTNERS WITH THE UNITED WAY OF RUTLAND COUNTY TO OFFER AND RUN A LEADERSHIP AND BOARD TRAINING PROGRAM. EACH YEAR WE GRADUATE ROUGHLY 12 NEW COMMUNITY MEMBERS READY TO SERVE AS ACTIVE CONTRIBUTORS TO NON-PROFIT ORGANIZATION BOARDS THROUGHOUT OUR REGION. RUTLAND COUNTY IS ECONOMICALLY CHALLENGED AND RRMC SUPPORTS WORK TO HELP THOSE IN POVERTY AS WELL AS TO BRING NEW BUSINESSES INTO THE AREA. RRMC PARTICIPATES IN A PROGRAM CALLED BRIDGES OUT OF POVERTY WHICH IS A PROGRAM WHICH AIMS TO KEEP THE WORKING POOR EMPLOYED. THIS PROGRAM NOT ONLY BENEFITS THOSE IN LIVING POVERTY IN RUTLAND COUNTY, BUT RRMC'S OWN WORKFORCE. IN CONJUNCTION WITH FOR-PROFIT, NONPROFIT AND GOVERNMENT AGENCIES, THE BRIDGES OUT OF POVERTY COUNCIL DELIVERS THE WORKING BRIDGES TRAINING TO HR PROFESSIONALS AND LINE MANAGERS ON THE WORKPLACE IMPLICATIONS OF ECONOMIC DIVERSITY; IMPLEMENTED AN EMERGENCY LOAN AND SAVINGS PROGRAM FOR EMPLOYEES; HOUSED WORKSITE RESOURCE COORDINATORS IN COMPANIES TO HELP EMPLOYEES FIND HELP WITH HOUSING, CHILD CARE, TRANSPORTATION, ECONOMIC ASSISTANCE AND OTHER RESOURCES WITHOUT HAVING TO LEAVE WORK; AND BEGAN DISCUSSIONS OF HOW TO ENCOURAGE THE EMPLOYEES TO USE HEALTH AND WELLNESS STRATEGIES. TRAUMA SUPPORT - ESTABLISHED IN 1993, THE TRAUMA SUPPORT PROGRAM AT RRMC WAS, AND STILL IS, THE FIRST OF ITS KIND IN VERMONT. IT WAS DEVELOPED TO MEET THE IMMEDIATE AND LONG-TERM NEEDS OF FAMILIES IMPACTED BY SUDDEN DEATH OR TRAUMATIC INJURY OR ILLNESS. RRMC STAFF (ON THEIR OWN TIME) AND OTHER COMMUNITY VOLUNTEERS TAKE TURNS BEING ON-CALL 24 HOURS A DAY, SEVEN DAYS A WEEK. VOLUNTEERS PERSONALLY PROVIDE SUPPORT AND ASSISTANCE TO FAMILIES IMPACTED BY A TRAUMA OR DEATH IN MANY WAYS, I.E., BY BEING A LIAISON WITH MEDICAL PERSONNEL TO GET INFORMATION OR OFFERING CONTINUED SUPPORT VIA PHONE AND CORRESPONDENCE. BONE MARROW PROGRAM - THE MARROW DONOR PROGRAM AT RRMC WAS ESTABLISHED IN 1998. SINCE THEN, WE HAVE SUCCESSFULLY ADDED OVER 3,000 POTENTIAL DONORS TO THE NATIONAL REGISTRY, HELPING TO GIVE HOPE TO THE MORE THAN 6,000 PEOPLE SEARCHING EVERY DAY FOR AN UNRELATED MATCH TO SAVE THEIR LIVES. RRMC IS CURRENTLY THE ONLY HOSPITAL IN NEW ENGLAND WITH THIS TYPE OF PROGRAM. RRMC DOES NOT HOLD PATIENT-FOCUSED DRIVES; INSTEAD ALL DRIVES ARE DESIGNED TO RAISE GENERAL AWARENESS OF THE NEED AND TO REGISTER AS MANY POTENTIAL DONORS AS POSSIBLE, SO THAT NOW OR IN THE FUTURE A MATCH MAY BE MADE. OTHER INFORMATION: RRMC HAS 17 BOARD MEMBERS WHO REPRESENT THE RESIDENTS OF RUTLAND COUNTY IN THEIR SERVICE; 6 OF THESE ARE PHYSICIANS, 2 REPRESENT HEALTH CARE PARTNERS, AND 9 ARE RUTLAND COUNTY RESIDENTS WHO REPRESENT A VARIETY OF BUSINESS SECTORS. ALL BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST DISCLOSURE PROCESS WHICH IS NECESSARY TO COMPLY WITH FEDERAL AND STATE LAWS INCLUDING THE FEDERAL ANTI-KICKBACK STATUTE AND THE TAX CODE. RRMC HAS PREDOMINANTLY AN OPEN MEDICAL STAFF. THE ONLY EXCEPTIONS ARE THE FOLLOWING SPECIALTIES FOR WHICH THERE ARE EITHER BOARD-APPROVED EXCLUSIVE CONTRACTS OR HOSPITAL-EMPLOYED PHYSICIANS ONLY: ANESTHESIA, EMERGENCY MEDICINE, CRITICAL CARE, MEDICAL ONCOLOGY, RADIATION ONCOLOGY, ORTHOPEDICS, AND RADIOLOGY. ALL NEW APPLICANTS UNDERGO AN EXTENSIVE REVIEW PROCESS INCLUDING PRIMARY SOURCE VERIFICATION OF THEIR EDUCATION, TRAINING, BOARD CERTIFICATION, MALPRACTICE HISTORY, AND PREVIOUS HOSPITAL AFFILIATIONS. WHEN DEEMED COMPLETE, THEIR APPLICATION IS REVIEWED BY THE CREDENTIALS COMMITTEE WHICH IS MADE UP OF PHYSICIANS AND AT LEAST ONE BOARD MEMBER. THE CREDENTIALS COMMITTEE MAKES A RECOMMENDATION TO THE MEDICAL EXECUTIVE COMMITTEE WHICH INCLUDES THE CHAIRMAN OF THE BOARD. THE MEDICAL EXECUTIVE COMMITTEE MAKES A FINAL RECOMMENDATION TO THE FULL BOARD, WHICH HAS THE ULTIMATE AUTHORITY TO GRANT MEDICAL STAFF PRIVILEGES. ALL MEDICAL STAFF APPOINTMENTS ARE FOR A TWO YEAR PERIOD. ALL MEMBERS OF THE MEDICAL STAFF ARE SUBJECT TO ONGOING PEER REVIEW OF THEIR CLINICAL WORK. EVERY TWO YEARS, EVERY MEMBER OF THE MEDICAL STAFF MUST UNDERGO A REAPPOINTMENT PROCESS WHICH IS DESIGNED TO REVIEW THEIR CLINICAL AND PROFESSIONAL ACTIVITY AND BEHAVIOR. THOSE REAPPOINTMENTS GO THROUGH THE SAME SEQUENCE OF COMMITTEES AND BOARD AS NEW APPLICANTS." RRMC'S CREDENTIALING PROCESS HAS BEEN SURVEYED BY BOTH THE JOINT COMMISSION AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND FOUND TO BE IN FULL COMPLIANCE WITH THEIR STANDARDS (TJC) AND THEIR CONDITIONS OF PARTICIPATION (CMS)." AS A RURAL COMMUNITY HEALTH SYSTEM, RRMC PROVIDES A BROAD ARRAY OF SPECIALIZED HEALTH SERVICES. THE FOLEY CANCER CENTER AT RRMC PROVIDES TREATMENT TECHNOLOGIES THAT INCLUDE HIGH TECH DIAGNOSTIC IMAGING, MEDICAL ONCOLOGY WITH TRADITIONAL IV THERAPIES (SUCH AS CHEMOTHERAPY), AND RADIATION ONCOLOGY FEATURING A STATE-OF-THE-ART LINEAR ACCELERATOR. SUPPORTIVE PROGRAMS INCLUDE PALLIATIVE CARE, PAIN MANAGEMENT, ACUPUNCTURE AND A WOMEN'S' BREAST CARE PROGRAM. THE HOSPITAL PROVIDES 24-HOUR EMERGENCY CRISIS CARE, AS WELL AS PSYCHIATRIC INTENSIVE CARE, GERIATRIC PSYCHIATRIC PROGRAMS, MEDICAL DETOXIFICATION AND DUAL DIAGNOSIS AND TREATMENT OF SIMULTANEOUS SUBSTANCE ABUSE AND BEHAVIORAL HEALTH DISORDERS. THE 24 HOUR EMERGENCY DEPARTMENT PROVIDES CARE REGARDLESS A PATIENT'S ABILITY TO PAY. THE FAST TRACK PROGRAM IS DESIGNED TO PROCESS URGENT CARE IN A TIMELY MANNER. RRMC PROVIDES CARE FOR BOTH MEDICARE AND MEDICAID PATIENTS, THESE 2 POPULATIONS MAKE UP 61 % OF THE PAYER MIX FOR RRMC. BY WORKING COLLABORATIVELY WITH THE LOCAL FEDERALLY QUALIFIED HEALTH CLINICS, COMMUNITY HEALTH CLINICS OF THE RUTLAND REGION'S PRIMARY CARE CAPACITY IS INCREASED IN THE SERVICE AREA. THE RRMC VOLUNTEER PROGRAM IS PROVIDED BY OVER 325 VOLUNTEERS WHO DONATED OVER 52,000 HOURS OF SERVICE. THESE VOLUNTEERS ASSIST WITH THE NON-CLINICAL NEEDS IN THE HOSPITAL. SINCE 1896 RUTLAND REGIONAL MEDICAL CENTER HAS PROVIDED HEALTH CARE TO ALL WHO SEEK ITS SERVICES, REGARDLESS OF THEIR FINANCIAL SITUATION. OVER THE YEARS, RUTLAND REGIONAL MEDICAL CENTER HAS BECOME AN IMPORTANT CENTER FOR PROMOTING HEALTH AND WELLNESS FOR THE FULL COMMUNITY-ACTIVITIES THAT SHOULD HELP CURB LONGER-TERM HEALTH CARE COSTS. WHILE A MAJORITY OF HOSPITAL COSTS ARE RECOVERED BY USERS OF THE SERVICES, PATIENT CHARGES AND THIRD PARTY INSURANCE, THE RUTLAND HEALTH FOUNDATION ACTIVELY SEEKS ADDITIONAL CHARITABLE RESOURCES TO MEET NEEDS NOT COVERED BY THESE PAYMENTS. HOWEVER, AS INSURANCE AND OTHER REIMBURSEMENTS CONTINUE TO DECREASE, RUTLAND REGIONAL MEDICAL CENTER HAS LESS MONEY FOR CAPITAL EXPENDITURES DIRECTED TOWARD NEW AND REPLACEMENT EQUIPMENT-EQUIPMENT THAT IS INTEGRAL TO KEEPING THE HOSPITAL TECHNOLOGICALLY ADVANCED. THE RUTLAND HEALTH FOUNDATION ALSO FUNDRAISES TO SUPPORT PROGRAMS THAT DIRECTLY ASSIST THE NEED AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6 RUTLAND REGIONAL MEDICAL CENTER (RRMC) IS PART OF A HEALTH CARE SYSTEM WHICH INCLUDES THE FOLLOWING ADDITIONAL TAX-EXEMPT ORGANIZATIONS: RUTLAND REGIONAL HEALTH SERVICES, INC. (RRHS), VERMONT ORTHOPAEDIC CLINIC, INC. (VOC), AND RUTLAND HEALTH FOUNDATION (RHF). RRHS IS A HOLDING COMPANY ORGANIZED TO SUPPORT, PROMOTE, ADVANCE AND STRENGTHEN THE HEALTH OF PERSONS WITHIN ITS DESIGNATED SERVICE AREA. VOC OFFERS COMPREHENSIVE, HIGH QUALITY TREATMENT METHODOLOGIES FOR ORTHOPAEDIC-RELATED INJURIES. RHF PARTNERS WITH PATIENTS, PHYSICIANS, EMPLOYEES, COMMUNITY LEADERS, AND PHILANTHROPISTS TO RAISE MONEY TO HELP MEET HEALTHCARE NEEDS OF THE COMMUNITY. RRHS IS THE SOLE MEMBER OF RRMC AND VOC, AND IS THE CONTROLLING MEMBER OF RHF. THE SYSTEM PRIMARILY EARNS REVENUES BY PROVIDING HOSPITAL INPATIENT, HOSPITAL OUTPATIENT, HOSPITAL EMERGENCY CARE, AND PHYSICIAN SERVICES TO RESIDENTS IN THE RUTLAND, VERMONT, AREA. THE JAMES T BOWSE HEALTH TRUST IS A DEPARTMENT OF RUTLAND REGIONAL HEALTH SERVICES AND PROVIDES GRANT FUNDING AIMED AT IMPROVING THE HEALTH STATUS OF THE RUTLAND REGION. HERE IS A DESCRIPTION OF THE PROGRAMS THAT ARE CURRENTLY FUNDED: NUTRITION AXIS THE AXIS (ACCESS X INFORMATION = SOLUTIONS) PROGRAM TARGETS BOTH EMPLOYEE POPULATIONS AND RESIDENTS WHO RECEIVE NUTRITIONAL SUPPORTS FROM NON-PROFIT ORGANIZATIONS. THE GOAL IS TO REDUCE OBESITY AND CREATE HEALTHIER LIFESTYLES BY INCREASING THE USE OF LOCAL FRESH FRUITS AND VEGETABLES THROUGH EXPANSION OF THE COMMUNITY SUPPORTED AGRICULTURE PROGRAM AND EDUCATION (COOKING DEMONSTRATION, TASTE TESTING, ETC). FUNDING WAS AWARDED TOTALING $54,865 OVER THREE YEARS. SAY IT STRAIGHT RAP COALITION IS PROVIDING THIS EVIDENCE-BASED PROGRAM FOR YOUTH AND YOUNG ADULTS FOR PREVENTION OF RISKY BEHAVIORS, INCLUDING ALCOHOL/TOBACCO/OTHER DRUG ABUSE, PRECOCIOUS SEXUAL BEHAVIOR, TEEN PREGNANCY, AND BEHAVIOR LEADING TO HIV/AIDS. THE PROGRAM IS RECEIVING $46,000 OVER THREE YEARS. ITS A GIRL THING THE GIRLS SCOUTS OF THE GREEN AND WHITE MOUNTAINS COMBINED SUCCESSFUL CURRICULUM WITH EXISTING PROGRAM STRUCTURE TO ENGAGE GIRLS IN HEALTHY LIVING EXPERIENCES DAY CAMP, AFTER SCHOOL AND OUT-OF-SCHOOL PROGRAMS, COMPLEMENTED BY EXPERTS ON NUTRITION AND SUBSTANCE PREVENTION. THE PROGRAM WILL RECEIVE 425,970 OVER THREE YEARS. GET RID OF WASTE (GROW) LOTHROP ELEMENTARY SCHOOL WAS AWARDED $39,000 OVER THREE YEARS TO IMPLEMENT THIS PROJECT WITH THE GOAL OF INCREASING STUDENT WILLINGNESS TO TRY NEW FOODS AND CHOOSE HEALTHIER OPTIONS. WITH PROJECT PARTNERS, THEY WILL INTEGRATE GARDENING, COOKING, NUTRITION LESSONS, COMPOSTING AND PHYSICAL ACTIVITY INTO THE SCHOOL CURRICULUM. RSSU TRANSITIONS RUTLAND SOUTH SUPERVISORY UNION WILL USE $109,478 IN FUNDING OVER THREE YEARS TO FOCUS ON JUNIORS AND SENIORS IN HIGH SCHOOL THAT ARE NOT RECEIVING THE RESOURCES AND SUPPORT THEY NEED TO SUCCESSFULLY TRANSITION INTO THE WORKFORCE OR POST-SECONDARY EDUCATION. THEY ANTICIPATE SERVING 25 YOUTH WITH ACADEMIC AND BEHAVIORAL SUPPORT, INCLUDING PERSONAL TRANSITION PLANNING TO INCREASE THE PERCENTAGE WHO GRADUATE ON TIME AND TRANSITION INTO THE WORKFORCE OR HIGHER EDUCATION. THREE STEPS FORWARD THE RUTLAND REGION WORKFORCE INVESTMENT BOARD WAS AWARDED A $10,000 PLANNING GRANT TO FURTHER DEFINE THE ELEMENTS OF A PROGRAM TO ASSIST YOUNG WOMEN WHO HAVE DROPPED OUT OF SCHOOL OR WHO ARE AT RISK FOR DROPPING OUT, TO ACHIEVE THEIR PERSONAL AND PROFESSIONAL SUCCESS. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 THE STATE OF VERMONT DOES NOT REQUIRE FILING OF A COMMUNITY BENEFIT REPORT. THE COMMUNITY BENEFIT REPORT IS INCLUDED IN RRMC ANNUAL REPORT, WHICH IS MADE AVAILABLE TO THE PUBLIC AT WWW.RRMC.ORG. true COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION 375 ROUTE 30 NORTH BOMOSEEN VT 05732 221179701 501(C)(3) 1367417 COMMUNITY HLTH IMPROVE RUTLAND COMMUNITY PROGRAMS 78 S MAIN PO BOX 222 RUTLAND VT 05702 030307812 501(C)(3) 15500 COMMUNITY HLTH IMPROVE LOTHROP ELEMENTARY SCHOOL 3447 ROUTE 7 PITTSFORD VT 05763 036000625 PITTSFORD, VT 6000 COMMUNITY HLTH IMPROVE RUTLAND AREA FARM FOOD LINK PO BOX 561 POULTNEY VT 05741 208283600 501(C)(3) 19830 COMMUNITY HLTH IMPROVE RUTLAND SOUTH SUPERVISORY UNION 64 GRANGE HALL ROAD N CLARENDON VT 05759 030253069 WALLINGFORD DIS 41000 COMMUNITY HLTH IMPROVE RUTLAND REGIONAL WORKFORCE INVESTMENT BOARD PO BOX 6015 RUTLAND VT 05702 030276755 501(C)(3) 10000 COMMUNITY HLTH IMPROVE GIRL SCOUTS OF THE GREEN AND WHITE MOUNTAINS PO BOX 10832 BEDFORD NH 03110 020243160 501(C)(3) 6761 COMMUNITY HLTH IMPROVE 7 0 GRANT MONITORING SCHEDULE I, PART I, LINE 2 RUTLAND REGIONAL HEALTH SERVICES (RRHS), THROUGH RUTLAND REGIONAL MEDICAL CENTER (RRMC), AWARDED A FIVE-YEAR COMMUNITY BENEFIT GRANT TO COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. (CHCRR) IN THE AMOUNT OF $4,600,000 THAT IS FUNDED BY RRMC AND WAS EFFECTIVE MAY 1, 2008. FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND 2011, RESPECTIVELY, $1,367,417 AND $1,200,250 WAS EXPENDED FOR THE GRANT AWARD FROM RRMC AND IS INCLUDED IN RUTLAND REGIONAL MEDICAL CENTER'S GENERAL OPERATING EXPENSES. RRHS CONTINUALLY WORKS WITH CHCRR TO ENSURE THE ORGANIZATION IS USING FUNDS APPROPRIATELY AND FURTHERING THE CHCRR EXEMPT PURPOSE. THE OTHER GRANTS LISTED ON SCHEDULE I, PART II, WERE PROVIDED BY THE JAMES T BOWSE HEALTH TRUST, A DEPARTMENT OF RUTLAND REGIONAL MEDICAL CENTER. THE BOWSE TRUST ONLY CONSIDERS GRANT PROPOSALS THROUGH ITS FORMAL GRANT PROPOSAL PROCESS, WHICH REQUIRES THAT THE REQUESTING ORGANIZATION MEET CERTAIN CRITERIA AND SUBMIT A PLANNING GRANT/LETTER OF INTENT, FULL PROPOSAL, AND PLANNING GRANT BUDGET FORM DESCRIBING HOW THE GRANT WILL BE USED. PURPOSE OF GRANT OR ASSISTANCE SCHEDULE I, PART II, COLUMN H ASSISTANCE FOR RUTLAND COMMUNITY PROGRAMS, LOTHROP ELEMENTARY SCHOOL, RUTLAND AREA FARM FOOD LINK, RUTLAND SOUTH SUPERVISORY UNION, RUTLAND REGIONAL WORKFORCE INVESTMENT BOARD, AND GIRL SCOUTS OF THE GREEN AND WHITE MOUNTAIN WAS PROVIDED BY THE JAMES T BOWSE HEALTH TRUST, A DEPARTMENT OF RUTLAND REGIONAL MEDICAL CENTER. SEE SCHEDULE H, PART VI, LINE 6 FOR MORE INFORMATION REGARDING PROGRAMS FUNDED BY THE JAMES T BOWSE HEALTH TRUST. X X X true false false true false false false false false J CHRISTIAN HIGGINS MD 93438 155154 56138 22464 145 270 1137 0 14856 0 165714 177888 0 0 KIRK DUFTY MD 248171 0 0 0 17186 0 17763 0 8388 0 291508 0 0 0 MATTHEW A CONWAY MD 254689 0 355 0 3008 0 17763 0 20667 0 296482 0 0 0 DANIEL M FOLEY MD 269886 0 36553 0 18350 0 22663 0 8418 0 355870 0 0 0 THOMAS W HUEBNER 420986 0 0 0 22870 0 22663 0 20904 0 487423 0 0 0 EDWARD T OGORZALEK 229986 0 0 0 18063 0 27563 0 20661 0 296273 0 0 0 MARY T NEMETH 187331 0 0 0 729 0 21419 0 8250 0 217729 0 0 0 BAXTER HOLLAND 320081 0 0 0 4161 0 22663 0 15291 0 362196 0 0 0 DORCAS WARD 167435 0 0 0 19580 0 21328 0 14978 0 223321 0 0 0 BARBARA ROBINSON 209438 0 0 0 2678 0 19925 0 15130 0 247171 0 0 0 CHRISTOPHER LAFAVE 163826 0 0 0 315 0 6787 0 20320 0 191248 0 0 0 DARREN CHILDS 154488 0 0 0 439 0 11939 0 20297 0 187163 0 0 0 KATHLEEN LETENDRE 151373 0 0 0 678 0 11459 0 20278 0 183788 0 0 0 JI CHEN 168417 0 0 0 215 0 8869 0 2403 0 179904 0 0 0 HARVEY REICH 367348 0 0 0 21838 0 22663 0 20820 0 432669 0 0 0 MICHAEL KENOSH 400259 0 56714 0 17160 0 17763 0 20892 0 512788 0 0 0 ROBERT GIERING 356950 0 39404 0 1182 0 17763 0 19814 0 435113 0 0 0 EITAN SOBEL 339168 0 0 0 441 0 14700 0 20612 0 374921 0 0 0 JOSEPH WILLIAMS 344146 0 0 0 361 0 10702 0 20805 0 376014 0 0 0 TODD GREGORY MD 240082 0 0 0 203 0 17763 0 20645 0 278693 0 0 0 JOHN KIJEWSKI 191555 0 0 0 785 0 3459 0 19601 0 215400 0 0 0 MARY KOHANSKI 73442 0 117480 6809 4732 202463 0 SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4A MARY KOHANSKI, FORMER VICE PRESIDENT OF HUMAN RESOURCES, RECEIVED A SEVERANCE PAYMENT OF $116,816 FROM THE ORGANIZATION DURING THE YEAR. THIS AMOUNT IS INCLUDED IN OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B(III). COMPENSATION CONTINGENT ON THE REVENUES OF THE ORGANIZATION SCHEDULE J, PART I, LINE 5A PHYSICIANS EARN COMPENSATION BASED UPON THEIR PRODUCTIVITY AGAINST ESTABLISHED TARGETS. INCREASED PRODUCTIVITY IS DIRECTLY RELATED TO INCREASED REVENUES FOR THE ORGANIZATION. VT EDUCATIONAL & HLTH BUILDINGS FINANCE AGENCY 237154467 2009-11-18 28330000 REFUND '01 AND '03 SERIES BOND false false false VT EDUCATIONAL & HLTH BUILDINGS FINANCE AGENCY 237154467 2010-12-10 19100000 FUNDING OF VARIOUS CAPITAL PROJECT false false false 0 0 28330000 0 0 24722648 198225 0 0 3409127 0 0 2010 true false true true 0 0 19100000 0 0 8173534 136033 0 0 10790433 0 0 true false false true false false true true false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false true true DEUTSCHE BANKTDBANK 10. false false false 0 false true false true true DEUTSCHE BANKTDBANK 10. false false false 0 false true X FOLEY DISTRIBUTING FOLEY SERVICES M FOLEY - SEE PART V 287328 PAPER & JANITORIAL SUPPLIES false CENTRAL VERMONT PUBLIC SERVICE J GAMBLE - SEE PART V 1511848 ELECTRICITY false BLUE CROSS BLUE SHIELD OF VERMONT T HUEBNER - SEE PART V 12951181 INSURANCE PREMIUMS false BUSINESS TRANSACTION INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV, COLUMN B MARK K FOLEY, BOARD MEMBER, OWNS FOLEY DISTRIBUTING AND FOLEY SERVICES, INC. THESE COMPANIES SUPPLIED PAPER AND JANITORIAL PRODUCTS TO THE ORGANIZATION FOR $287,328 IN FISCAL YEAR 2012. JOAN F GAMBLE, BOARD MEMBER, IS AN OFFICER AT CENTRAL VERMONT PUBLIC SERVICES (CVPS). IN FISCAL YEAR 2012, THE ORGANIZATION PAID CVPS $1,511,848 FOR ELECTRICITY. THOMAS W HUEBNER, RRMC PRESIDENT & CEO, IS ON THE BOARD OF BLUE CROSS BLUE SHIELD OF VERMONT. IN FISCAL YEAR 2012, THE ORGANIZATION PAID BCBS $12,951,181 IN HEALTH INSURANCE PREMIUMS. ORGANIZATION'S MISSION AND MOST SIGNIFICANT ACTIVITIES FORM 990, PART I, LINE 1 MISSION: TO IMPROVE THE HEALTH OF THE RUTLAND REGION AND SURROUNDING COMMUNITIES BY PROVIDING APPROPRIATE, SUPERIOR, INTEGRATED, PREVENTATIVE, DIAGNOSTIC AND THERAPEUTIC HEALTH SERVICES IN A CARING ENVIRONMENT THROUGH THE STRENGTH OF OUR PEOPLE, TECHNOLOGY AND RELATIONSHIPS. VISION: TO BE THE BEST COMMUNITY HEALTHCARE SYSTEM IN NEW ENGLAND. GOALS: *QUALITY: WE WILL PROVIDE SUPERIOR HEALTH SERVICES WHICH MEET OUR CUSTOMER NEEDS THROUGH: GOOD CLINICAL OUTCOMES, UP-TO-DATE TECHNOLOGY, EFFECTIVE PROCESSES, COMPETENT AND CARING STAFF AND WELL MAINTAINED FACILITIES. *GROWTH: WE WILL DEVELOP NEW SERVICES AND EXPAND EXISTING SERVICES TO MEET CUSTOMER NEEDS RESULTING IN INCREASED MARKET SHARE AND EXPANSION INTO NEW MARKETS. *INFORMATION EXCELLENCE: WE WILL PROVIDE SUPERIOR, COORDINATED INFORMATION RESOURCES, PROCESSES, AND SYSTEMS THAT MEET CUSTOMER NEEDS FOR EFFECTIVE INFORMATION GATHERING, RECORDING, ACCESS, ANALYSIS, AND DISSEMINATION ACROSS THE HEALTHCARE CONTINUUM. *FINANCIAL STRENGTH: WE WILL ACHIEVE FINANCIAL STRENGTH AND STABILITY BY OPTIMIZING REIMBURSEMENT AND IMPROVING OUR COST STRUCTURE TO PRODUCE SUFFICIENT MARGINS, AND INCREASING PHILANTHROPIC GIVING. *EMPLOYEE ENGAGEMENT: WE WILL CREATE AN ENVIRONMENT WHERE EMPLOYEE ENGAGEMENT FLOURISHES AND WE COMMIT OUR HEARTS AND MINDS TO MEETING AND EXCEEDING THE NEEDS OF OUR CUSTOMERS AND EACH OTHER. TOTAL NUMBER OF VOLUNTEERS FORM 990, PART I, LINE 6 THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND OTHER INDIVIDUALS WHO VOLUNTEER TIME TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. EXEMPT PURPOSE ACHIEVEMENTS FORM 990, PART III, LINES 4A-D RUTLAND REGIONAL MEDICAL CENTER FY 2012 COMMUNITY BENEFITS REPORT: RUTLAND REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDING SUPERIOR, INTEGRATED, DIAGNOSTIC, THERAPEUTIC AND PREVENTATIVE HEALTH SERVICES AND TO PROMOTING OVERALL COMMUNITY HEALTH AND WELL-BEING. COMMUNITY BENEFITS ARE THE ACTIVITIES AND SERVICES RUTLAND REGIONAL ENGAGES IN AND SUPPORTS THAT GO BEYOND THE ROUTINE PATIENT CARE SERVICES. DOCUMENTING THESE EFFORTS IS A PART OF WHAT DIFFERENTIATES TAX-EXEMPT FROM TAXABLE HEALTH CARE ORGANIZATIONS. PROGRAMMING THAT COUNTS: COMMUNITY HEALTH IMPROVEMENT INITIATIVES SCREENING SERVICES AND EDUCATIONAL PROGRAMMING ARE IMPORTANT ELEMENTS TO PROMOTING THE HEALTH OF OUR COMMUNITY. THE ASSOCIATED EXPENSES FOR 2012 EXCEEDED $1,115,000. RRMC OFFERS HEALTH LIVING WORKSHOPS, TOBACCO CESSATION PROGRAMING, CONSUMER HEALTH LIBRARY SUPPORT, BREAST CARE EDUCATION OUTREACH, AND OVER 25 SUPPORT GROUPS FOR INDIVIDUALS AND FAMILIES. HEALTH PROFESSION EDUCATION & TRAINING FOR NON-EMPLOYEES AND WORKFORCE DEVELOPMENT COLLABORATING WITH EDUCATIONAL PROGRAMS, RRMC SUPPORTS A VARIETY OF TRAINING PROGRAMS FOR INDIVIDUALS INTERESTED IN MEDICAL-RELATED FIELDS. DURING 2012, RRMC'S INVESTMENT IN THESE AREAS TOTALED APPROXIMATELY $200,000. FREE AND DISCOUNTED CARE RUTLAND REGIONAL PROVIDES LOW- AND NO-COST CARE FOR ELIGIBLE RESIDENTS OF OUR AREA THROUGH A FINANCIAL ASSISTANCE PROGRAM. THE FREE CARE PROVISION FOR 2012 TOTALED $6,034,859 AND SERVED 2,950 PATIENTS. IN ADDITION, RUTLAND REGIONAL PROVIDED $34,869 IN FREE AND REDUCED COST LABORATORY AND IMAGING SERVICES TO THE PATIENTS OF THE RUTLAND FREE CLINIC. IN ADDITION TO THESE ACTIVITIES, RUTLAND REGIONAL IS NOW REQUIRED BY FEDERAL REGULATIONS TO CONDUCT A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS. THE RUTLAND COUNTY HEALTH NEEDS ASSESSMENT 2012 STEERING COMMITTEE HAS WORKED HARD TO BE INCLUSIVE, BOTH IN THE INFORMATION COLLECTED AND REVIEWED, AND BY BROADLY REQUESTING INPUT FROM AROUND OUR COMMUNITIES. FROM START TO FINISH, THE ASSESSMENT TAKES ABOUT ONE YEAR TO COMPLETE, AND INCLUDES COMPILATION OF SECONDARY DATA FROM OTHER SOURCES, COLLECTING INDIVIDUAL INPUT THROUGH CONSUMER SURVEYS AND THROUGH FOCUS GROUP MEETINGS. ALL OF THE INFORMATION GATHERED IS REVIEWED, AND PRIORITIZED BY A BROAD, COMMUNITY-BASED COMMITTEE. A FINAL REPORT HAS NOW BEEN PUBLISHED WITH THE FINDINGS. THIS REPORT IS MADE PUBLICALLY AVAILABLE ON WWW.RRMC.ORG. THE PURPOSE OF THE ASSESSMENT IS TO: -DESCRIBE THE HEALTH STATUS OF THE COMMUNITY -IDENTIFY THE COMMUNITY'S HEALTH NEEDS -COMPARE THE NEEDS TO THOSE IDENTIFIED PREVIOUSLY CONDUCTING ASSESSMENTS PERIODICALLY FOR MORE THAN 15 YEARS, WE HAVE SEEN SOME HEALTH INDICATORS IMPROVE AND OTHERS DECLINE. BY MONITORING THESE CHANGES, THE COMMITTEE IS ABLE TO IDENTIFY WHERE ADDITIONAL RESOURCES ARE NEEDED. ORGANIZATIONS, INCLUDING RUTLAND REGIONAL, USE THIS IMPORTANT INFORMATION TO GUIDE THEIR PLANNING. FOR RUTLAND REGIONAL SPECIFICALLY, IT HELPS WITH THE DEVELOPMENT OF NEW HOSPITAL SERVICES AND COMMUNITY PROGRAMS. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D THE REVENUES AND EXPENSES REPORTED ON PART III, LINE 4D, REPRESENT THOSE AMOUNTS THAT ATTRIBUTABLE TO OTHER PROGRAM SERVICES CONDUCTED BY THE ORGANIZATION. THESE OTHER SERVICES PRIMARILY REPRESENT OTHER SUPPORT SERVICES THAT ARE PROVIDED TO HOSPITAL PATIENTS OR THAT ARE CONDUCTED TO SUPPORT THE OVERALL FUNCTION OF THE HOSPITAL, SUCH AS CENTRAL SUPPLY AND PHARMACY SERVICES. OTHER SERVICES ALSO INCLUDE BENEFIT TO THE COMMUNITY THROUGH THE PAYMENT OF GRANTS TO OTHER COMMUNITY ORGANIZATIONS. SEE SCHEDULE I FOR DETAIL REGARDING THESE GRANT PAYMENTS. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINES 6, 7A, & 7B PER ARTICLE II, SECTION 1, OF THE ORGANIZATION'S BYLAWS, RUTLAND REGIONAL HEALTH SERVICES IS THE SOLE MEMBER OF RUTLAND REGIONAL MEDICAL CENTER. ARTICLE III, SECTIONS 1 AND 2, OF THE BYLAWS STATE THAT THE BOARD SHALL CONSIST OF EIGHTEEN DIRECTORS. OF THESE DIRECTORS, FOURTEEN ARE CHOSEN OR APPROVED BY THE ORGANIZATION'S SOLE MEMBER. ARTICLE VIII, SECTION 5, OF THE BYLAWS DISCUSS POWERS RESERVED TO THE MEMBER, RUTLAND REGIONAL HEALTH SERVICES, INC., AND STATE THAT THE CORPORATION SHALL SUBMIT TO THE BOARD OF DIRECTORS OF THE MEMBER FOR ITS PRIOR APPROVAL THE FOLLOWING: A) THE APPOINTMENT OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, B) ALL OPERATING AND CAPITAL BUDGETS FOR THE CORPORATION, C) STRATEGIC PLANS FOR THE CORPORATION, D) CAPITAL EXPENDITURES OF $100,000 OR MORE WHICH ARE UNBUDGETED, E) PURCHASE AND SALE OF ALL SIGNIFICANT ASSETS, AND F) THE BYLAWS AND ANY AMENDMENTS THERETO. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT COPY IS THEN REVIEWED BY TOP MANAGEMENT. ONCE A FINAL DRAFT IS COMPLETE, IT IS MAILED TO EACH MEMBER OF THE SYSTEM FINANCE COMMITTEE. THE COMMITTEE WILL MEET AND DISCUSS THE RETURN WITH A TAX ADVISOR PRIOR TO PRESENTING THE FINAL DRAFT TO THE FULL BOARD OF DIRECTORS. ALL BOARD MEMBERS ARE ALSO PROVIDED A COPY OF THE FINAL DRAFT. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL ORGANIZATION LEADERS REVIEW THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY TO ENSURE ALL CONFLICTS ARE MADE KNOWN. SEE THE POLICY BELOW. POLICY *DUTY TO DISCLOSE IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, OR OTHER INDIVIDUALS WHO, ON BEHALF OF THE CORPORATION, ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. *DUTY TO VOICE CONCERN IN THE EVENT THAT AN INTERESTED PERSON BECOMES CONCERNED THAT ANOTHER INTERESTED PERSON WHO IS A BOARD MEMBER, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS HAS AN UNDISCLOSED FINANCIAL INTEREST OR IS EXERTING INAPPROPRIATE INFLUENCE RELATED TO A FINANCIAL INTEREST, THIS CONCERN SHOULD BE RAISED WITH THE CHAIR OF THE APPROPRIATE BOARD OR COMMITTEE OR, IF INVOLVING A MEMBER OF LEADERSHIP COUNCIL, A DIRECTOR OR MANAGER OR OTHER INTERESTED PERSON, AN APPROPRIATE CORPORATE OFFICER. *DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD OR COMMITTEE MEMBERS. HOWEVER, IN NO EVENT SHALL AN INTERESTED PERSON PARTICIPATE IN THE DELIBERATION AND/OR DETERMINATION OF COMPENSATION THAT HE/SHE WILL RECEIVE FROM THE CORPORATION FOR EMPLOYMENT, PROFESSIONAL CONTRACT OR OTHERWISE. *DEFINITIONS -INTERESTED PERSON - FOR THE PURPOSES OF THIS POLICY, AN INTERESTED PERSON IS ANY BOARD MEMBER, PRINCIPAL OFFICER, MEMBER OF THE LEADERSHIP COUNCIL, DIRECTOR, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. IF AN INDIVIDUAL IS AN INTERESTED PERSON WITH RESPECT TO ANY ENTITY IN THE RRMC/RRHS HEALTH CARE SYSTEM, HE OR SHE IS AN INTERESTED PERSON WITH RESPECT TO ALL ENTITIES IN THE HEALTH CARE SYSTEM. *PROCEDURES -PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST .AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. .THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. .AFTER EXERCISING DUE DILIGENCE, INCLUDING A CONSIDERATION OF INDEPENDENT COMPARABILITY DATA, VALUATIONS OR APPRAISALS, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. .IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. -ANNUAL STATEMENTS .AWARENESS/COMPLIANCE WITH POLICY - EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THIS CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY; HAS AGREED TO COMPLY WITH THE POLICY; AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST BE ENGAGED PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. .CONFLICT OF INTEREST SURVEY - EACH INTERESTED PERSON SHALL DISCLOSE ON AN ANNUAL SURVEY FORM POTENTIAL CONFLICTS OF INTEREST AND FINANCIAL INTERESTS RELEVANT TO THIS POLICY. COMPENSATION REVIEW POLICY FORM 990, PART VI, SECTION B, LINES 15A & 15B THE FOLLOWING POLICY APPLIES TO THE ENTIRE RUTLAND REGIONAL HEALTH SERVICES (RRHS) SYSTEM, AND THE POLICY COVERS OFFICER & KEY EMPLOYEE COMPENSATION: *IT IS THE POLICY OF RRHS TO OFFER MARKET-COMPETITIVE PAY SO TO ATTRACT AND RETAIN THE BEST TALENT FROM OUR LABOR MARKET. *DESIGNATION OF RRHS' KEY EMPLOYEES IS MADE BY THE COMPLIANCE DEPARTMENT. *THE RRHS KEY EMPLOYEE LABOR MARKET IS TYPICALLY ALL HOSPITALS NATIONALLY WITH SIMILAR REVENUES AS RRHS. *KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY EACH FALL USING THREE SOURCES OF INDEPENDENT COMPETITIVE MARKET DATA. *JOBS HELD BY KEY EMPLOYEES ARE MATCHED WITH SIMILAR JOBS IN MARKET DATA WITH AN INDICATION OF JOB MATCH STRENGTH (WEAK, MODERATE OR STRONG). *THE MARKET REVIEW PRODUCES A REPORT OF KEY EMPLOYEE CURRENT BASE PAY AND TOTAL CASH COMPENSATION VS. MARKET BASE PAY AND TOTAL CASH COMPENSATION WITH ANY RECOMMENDED PAY ACTIONS. *GENERALLY SPEAKING, KEY EMPLOYEE BASE PAY VARIANCES OF -5% VS. MARKET TOTAL CASH COMPENSATION ARE CONSIDERED TO BE NON-COMPETITIVE PROMPTING A RECOMMENDED BASE PAY INCREASE TO BE CONSIDERED. *THE RESULTS OF THE REVIEW AND RECOMMENDED PAY ACTIONS ARE REVIEWED AND APPROVED BY THE CEO. INFORMATION IS MADE AVAILABLE TO SYSTEM FINANCE UPON REQUEST. *THE CEO PAY IS REVIEWED AND APPROVED BY THE CHAIR AND CO-CHAIR OF THE BOARD OF DIRECTORS. THIS REVIEW IS DOCUMENTED IN THE EXECUTIVE SESSION BOARD MINUTES. THE MOST RECENT COMPENSATION REVIEW OCCURRED DURING FALL 2011. *THE KEY EMPLOYEES REVIEW WAS CONDUCTED IN FALL 2011 COVERING NON-PHYSICIAN EMPLOYEE EARNING AT LEAST $150,000. THIS WAS DONE INTERNALLY. DOCUMENT DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE ANNUALLY IN THE ANNUAL REPORT, AND ARE ALSO AVAILABLE UPON WRITTEN REQUEST. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. ALL REQUESTS MUST BE FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT), AND REQUESTED DOCUMENTS WILL BE MAILED. RELATED HOURS FORM 990, PART VII, COLUMN B THE BOARD OF DIRECTORS FOR RUTLAND REGIONAL MEDICAL CENTER, RUTLAND REGIONAL HEALTH SERVICES, AND VERMONT ORTHOPAEDIC CLINIC ARE SHARED. IN ADDITION, THE FOLLOWING BOARD MEMBERS ALSO SERVE ON THE BOARD OF RUTLAND HEALTH FOUNDATION: BILL BANNERMAN RONALD J CIOFFI CORT JONES DANIEL M FOLEY, MD THOMAS W HUEBNER, CEO & PRESIDENT, AND EDWARD T OGORZALEK, CFO & VP FISCAL SERVICES, ARE COMPENSATED BY RUTLAND REGIONAL MEDICAL CENTER. THEY ACT AS OFFICERS FOR RUTLAND REGIONAL MEDICAL CENTER, RUTLAND HEALTH FOUNDATION, RUTLAND HEALTH SERVICES, AND VERMONT ORTHOPAEDIC CLINIC, WHERE THEY BOTH WORK APPROXIMATELY 40 HOURS PER WEEK. IN ADDITION, THOMAS W HUEBNER SERVES ON THE BOARD OF RUTLAND HEALTH FOUNDATION. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 $(11,784,886) NET LOSS FROM DEF BEN PEN PLAN AND POSTRETRMT BEN COSTS ( 1,604,997) TRANSFER TO AFFILIATES 9,217,462 CHANGE IN FV OF INVESTMENTS ACCT FOR UNDER FASB 825 ( 780,268) LOSS ON INTEREST RATE SWAP AGREEMENT 479,289 NET UNREALIZED GAINS ON INVESTMENTS ------------- $( 4,473,400) KILLINGTON MEDICAL CLINIC LLC 3902 KILLINGTON ROAD KILLINGTON VT 05751 461076985 MED CLINIC VT 0 0 RRMC RUTLAND REGIONAL HEALTH SERVICES 160 ALLEN STREET RUTLAND VT 05701 222534389 HOLDING CO VT 501(C)(3) 11A I NA false RUTLAND HEALTH FOUNDATION 160 ALLEN STREET RUTLAND VT 05701 030349681 FUNDRAISING VT 501(C)(3) 7 RRHS false VERMONT ORTHOPAEDIC CLINIC 160 ALLEN STREET RUTLAND VT 05701 208089565 ORTHO SVC VT 501(C)(3) 9 RRHS false THE MEADOWS AT EAST MOUNTAIN 157 HERITAGE HILL PLACE RUTLAND VT 05701 030330343 ELDER CARE VT RRHS THE GABLES AT EAST MOUNTAIN LLC ONE GABLES PLACE RUTLAND VT 05701 030358050 ELDER CARE VT RRHS VERMONT SPORTS MEDICINE CENTER 5 ALBERT CREE DR RUTLAND VT 05701 061231501 PHYSICAL THER VT RRHS false false true true false false false false false true false true true true true true true false