SOUTHWESTERN VERMONT HEALTH CARE CORPORATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SOUTHWESTERN VERMONT HEALTH CARE CORPORATION (EIN 03-0179435)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-05
IRS object ID
201342179349300324
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-05T10:00:07-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN030179435EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHWESTERN VERMONT HEALTH CARE CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% STEPHEN MAJETICHInCareOfName
Name ControlSOUTNameControl
Phone8024426361Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 HOSPITAL DRIVEAddressLine1
CityBENNINGTONCity
StateVTState
ZIP Code05201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWAYNE KACHMARName
TitleBOARD CHAIRTitle
Date Signed2013-05-04DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS DEENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 HOSPITAL DRIVEAddressLine1
CityBENNINGTONCity
StateVTState
ZIP Code05201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts25808339GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SVHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1912YearFormation
State Legal DomicileVTStateLegalDomicile
Activity Or Mission DescriptionPROVIDING HEALTH CARE ON BOTH AN INPATIENT AND OUTPATIENT BASIS WITH FACILITIES IN AND AROUND THE BENNINGTON, VT AREA.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees21TotalNbrEmployees
Total Nbr Volunteers21TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1662395ContributionsGrantsPriorYear
Contributions Grants Current Year2804628ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2339294ProgramServiceRevenuePriorYear
Program Service Revenue CY2637165ProgramServiceRevenueCY
Investment Income Prior Year2509975InvestmentIncomePriorYear
Investment Income Current Year1424024InvestmentIncomeCurrentYear
Other Revenue Prior Year-46890OtherRevenuePriorYear
Other Revenue Current Year-83620OtherRevenueCurrentYear
Total Revenue Prior Year6464774TotalRevenuePriorYear
Total Revenue Current Year6782197TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year316361GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY526962GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1597206SalariesEtcPriorYear
Salaries Etc Current Year1183492SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year550475TotalFundrsngExpCurrentYear
Other Expense Prior Year2667413OtherExpensePriorYear
Other Expenses Current Year2361439OtherExpensesCurrentYear
Total Expenses Prior Year4580980TotalExpensesPriorYear
Total Expenses Current Year4071893TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1883794RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2710304RevenuesLessExpensesCY
Total Assets BOY60804234TotalAssetsBOY
Total Assets EOY71482150TotalAssetsEOY
Total Liabilities BOY10917651TotalLiabilitiesBOY
Total Liabilities EOY8401406TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY49886583NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY63080744NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO CARE FOR AND COMFORT OUR PATIENTS, RESIDENTS, AND THEIR LOVED ONES AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1688224Expense
Grants236996Grants
Revenue1395120Revenue
DescriptionSOUTHWESTERN VERMONT HEALTH CARE CORPORATION SUPPORTS SOUTHWESTERN VERMONT MEDICAL CENTER AND OTHER RELATED PARTIES THROUGH FUNDRAISING, DEVELOPMENT AND GRANT ADMINISTRATION. SEE SCHEDULE O FOR ADDITIONAL DETAILS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1345232Expense
Revenue1242045Revenue
DescriptionSOUTHWESTERN VERMONT HEALTH CARE CORPORATION MANAGES AND MAINTAINS MEDICAL OFFICE BUILDINGS IN BENNINGTON, MANCHESTER, WILMINGTON AND WEST DOVER.Description
FieldValueIRS element (for citing)
Total Program Service Expense3033456TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109654NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees21NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSTEPHEN MAJETICHNamePerson
Telephone Number8024475002TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 HOSPITAL DRIVEAddressLine1
CityBENNINGTONCity
StateVTState
ZIP Code05201ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormer
DONALD ALBANO
TRUSTEE1.0X000
MICHAEL E BRADY DDS
CHAIR1.0X000X
SEAN L CASEY
SECRETARY1.0X000X
LODIE COLVIN
TRUSTEE1.0X000
TOMMY A HARMON JR
TRUSTEE, ENDING 9/121.0X000
TIMOTHY T HOLBROOK
TRUSTEE1.0X000
WAYNE M KACHMAR
VICE CHAIR1.0X000X
HOWARD MCNALLY
TRUSTEE, ENDING 1/121.0X000
WILLIAM TOCK MD
PRES MED STAFF, ENDING 3/121.0X024720957907
ERIC SEYFERTH MD
TRUSTEE1.0X0495650
THOMAS DEE
CEO40.0X046938337955X
MARK WALLACE
TRUSTEE1.0X000
CLAIRE MURRAY RN
TRUSTEE1.0X000
KEVIN DAILEY
TRUSTEE1.0X000
MARNY KRAUSE
TRUSTEE1.0X000
DAVID MEISELMAN ESQ
TRUSTEE1.0X000
PHILIP MARTINEZ
TRUSTEE1.0X000
MAE D'AGOSTINO
TRUSTEE, BEGINNING 9/121.0X000
WILLIAM SARCHINO DPM
PRES MED STAFF, BEGINNING 3/121.0X000
STEPHEN D MAJETICH
CFO40.0028742727273X
MARK DONAVAN MD
CMO40.0028955111826X
HARVEY YORKE
FORMER CEO015998783650X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1503122TotalReportableCompFrmRltdOrgs
Total Other Compensation218611TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonH SAUSVILLE CONSTRUCTION INCNamePerson
FieldValueIRS element (for citing)
Address Of ContractorAddressOfContractor
Description Of ServicesCONTRACTORDescriptionOfServices
Compensation114048Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Fundraising Events123357FundraisingEvents
Related Organizations28016RelatedOrganizations
Government Grants299073GovernmentGrants
All Other Contributions2354182AllOtherContributions
Noncash Contributions135061NoncashContributions
Total Contributions2804628TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PROPERTY MANAGEMENT53131025326952532695
OTHER REVENUE900099104470104470
FieldValueIRS element (for citing)
Total Program Service Revenue2637165TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1286314TotalRevenueColumn
Exclusion$1,286,314ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities19025628Securities
Other142Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities18887657Securities
Other403Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities137971Securities
Other-261Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column137710TotalRevenueColumn
Exclusion$137,710ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events47887GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events123357CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses132347FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-84460TotalRevenueColumn
Exclusion-$84,460ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming6575GrossIncomeGaming
Gaming Direct Expenses5735GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column840TotalRevenueColumn
Exclusion$840ExclusionAmount

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6782197TotalRevenueColumn
Related Or Exempt Function Income2637165RelatedOrExemptFunctionIncome
Exclusion$1,340,404ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total508508Total
Program Services508508ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total18454Total
Program Services18454ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total958151Total
Program Services524979ProgramServices
Management And General72622ManagementAndGeneral
Fundraising360550Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total34424Total
Program Services18861ProgramServices
Management And General2609ManagementAndGeneral
Fundraising12954Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total111620Total
Program Services61158ProgramServices
Management And General8460ManagementAndGeneral
Fundraising42002Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total79297Total
Program Services43448ProgramServices
Management And General6010ManagementAndGeneral
Fundraising29839Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total44920Total
Management And General44920ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total598Total
Management And General598ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total184821Total
Management And General184821ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total241135Total
Program Services173015ProgramServices
Management And General37503ManagementAndGeneral
Fundraising30617Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total2054Total
Fundraising2054Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total67064Total
Program Services16503ProgramServices
Management And General31071ManagementAndGeneral
Fundraising19490Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total796Total
Fundraising796Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1106458Total
Program Services1098551ProgramServices
Management And General7907ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total23620Total
Program Services21662ProgramServices
Fundraising1958Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6647Total
Program Services6542ProgramServices
Fundraising105Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total605688Total
Program Services475012ProgramServices
Management And General82337ManagementAndGeneral
Fundraising48339Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total44103Total
Program Services36094ProgramServices
Management And General8009ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES & DRUGS3011930119
LICENSES, DUES, SUBSCRIPTIONS25985502841764
MISCELLANEOUS EXPENSE8188117

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4071893Total
Program Services3033456ProgramServices
Management And General487962ManagementAndGeneral
Fundraising550475Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY43691BOY
EOY6910EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3124356BOY
EOY1160869EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY127144BOY
EOY77642EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY147252BOY
EOY148852EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis15927246LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8666215LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7060608BOY
EOY7261031EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY46859491BOY
EOY59539094EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY12983BOY
EOY13018EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3428709BOY
EOY3274734EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY60804234BOY
EOY71482150EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3407841BOY
EOY1378799EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY37244BOY
EOY58056EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7472566BOY
EOY6964551EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10917651BOY
EOY8401406EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY38627862BOY
EOY50374244EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2210951BOY
EOY2333095EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY9047770BOY
EOY10373405EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY49886583BOY
EOY63080744EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY60804234BOY
EOY71482150EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2710304ReconcilationRevenueExpenses
Reconcilation Other Changes10483857ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance10969363BeginningOfYearBalance
Contributions2232045Contributions
Investment Earnings Or Losses146528InvestmentEarningsOrLosses
Other Expenditures790712OtherExpenditures
Administrative Expenses18109AdministrativeExpenses
End Of Year Balance12539115EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance10633746BeginningOfYearBalance
Contributions1123257Contributions
Investment Earnings Or Losses-140292InvestmentEarningsOrLosses
Other Expenditures647348OtherExpenditures
End Of Year Balance10969363EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance10383529BeginningOfYearBalance
Contributions934099Contributions
Investment Earnings Or Losses108601InvestmentEarningsOrLosses
Other Expenditures792483OtherExpenditures
End Of Year Balance10633746EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance11140199BeginningOfYearBalance
Contributions371726Contributions
Investment Earnings Or Losses-229971InvestmentEarningsOrLosses
Other Expenditures898425OtherExpenditures
End Of Year Balance10383529EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.82730PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.17270TermEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis987742OtherCostOrOtherBasis
Book Value987742BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13439106OtherCostOrOtherBasis
Depreciation7885881Depreciation
Book Value5553225BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis39915OtherCostOrOtherBasis
Depreciation36298Depreciation
Book Value3617BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis998331OtherCostOrOtherBasis
Depreciation697886Depreciation
Book Value300445BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis462152OtherCostOrOtherBasis
Depreciation46150Depreciation
Book Value416002BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7261031TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$6,449,496
ACCRUED PENSION LIABILITIES$349,593
ESTIMATED SELF INSURANCE COSTS$69,126
OTHER LIABILITIES$96,336
FieldValueIRS element (for citing)
Total Of Amounts6964551TotalOfAmounts
Total Revenue6782197TotalRevenue
Total Expenses4071893TotalExpenses
Excess Or Deficit For Year2710304ExcessOrDeficitForYear
Net Unrealized GL On Investments5420160NetUnrealizedGLOnInvestments
Other$5,063,697OtherAmount
Total Adjustments10483857TotalAdjustments
Excess Or Deficit Per FS13194161ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt17242424TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments5420160NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities23109DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants-41609RecoveriesOfPriorYearGrants
Other Revenues4920485OtherRevenues
Revenue Not Rptd F99010322145RevenueNotRptdF990
Revenue Subtotal6920279RevenueSubtotal
Other Revenues Not Included-138082OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-138082RevenueNotRptdOnFinStmt
Total Revenue Per Form9906782197TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt4048263TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities23109DonatedServicesUseOfFacilities
Other Expenses Included138082OtherExpensesIncluded
Expenses Not Rptd F990161191ExpensesNotRptdF990
Expenses Subtotal3887072ExpensesSubtotal
Investment Expenses Not Included2184821InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt184821ExpensesNotRptdOnFinStmt
Total Expenses Per Form9904071893TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ENDOWMENT FUNDSSCHEDULE D, PART V, LINE 4THE CORPORATION'S ENDOWMENT CONSISTS OF VARIOUS INDIVIDUAL DONOR RESTRICTED FUNDS WHICH WERE ESTABLISHED TO FUND FUTURE STRATEGIC CAPITAL INVESTMENTS, AS WELL AS GENERAL OPERATIONAL AND CERTAIN DEPARTMENTAL PURPOSES.
UNCERTAIN TAX POSITIONSSCHEDULE D, PART X, LINE 2MANAGEMENT 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 RECONCILING CHANGE IN NET ASSETSSCHEDULE D, PART XI, LINE 8$ 4,986,074 NET TRANSFER FROM AFFILIATES ( 24,512) DEFINED BENEFIT PENSION COSTS 143,744 CHANGE IN BENEFICIAL INTEREST IN TRUST ( 41,609) RECOVERY OF PRIOR YEAR PLEDGES -------------- $ 5,063,697 NET ADJUSTMENT
OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12SCHEDULE D, PART XII, LINE 2D$ 4,986,074 NET TRANSFER FROM AFFILIATES ( 24,512) DEFINED BENEFIT PENSION COSTS 143,744 CHANGE IN BENEFICIAL INTEREST IN TRUST ( 184,821) INVESTMENT MANAGEMENT FEES -------------- $ 4,920,485 NET ADJUSTMENT
OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1SCHEDULE D, PART XII, LINE 4B$( 132,347) FUNDRAISING EXPENSES ( 5,735) GAMING EXPENSES -------------- $( 138,082) NET ADJUSTMENT
OTHER EXPENSES INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25SCHEDULE D, PART XIII, LINE 2D$ 132,347 FUNDRAISING EXPENSES 5,735 GAMING EXPENSES -------------- $ 138,082 NET ADJUSTMENT

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1HARVEST BALLNameOfEvent1
Gross Receipts Event183239GrossReceiptsEvent1
Charitable Contributions Event160232CharitableContributionsEvent1
Gross Revenue Event123007GrossRevenueEvent1
Rent Facility Costs Event116118RentFacilityCostsEvent1
Food And Beverage Event117422FoodAndBeverageEvent1
Entertainment Event111000EntertainmentEvent1
Other Direct Expenses Event117413OtherDirectExpensesEvent1
Name Of Event2GOLF EVENTNameOfEvent2
Gross Receipts Event256375GrossReceiptsEvent2
Charitable Contributions Event244475CharitableContributionsEvent2
Gross Revenue Event211900GrossRevenueEvent2
Non Cash Prizes Event24650NonCashPrizesEvent2
Rent Facility Costs Event213025RentFacilityCostsEvent2
Food And Beverage Event29188FoodAndBeverageEvent2
Other Direct Expenses Event28089OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events31630GrossReceiptsOtherEvents
Charitable Contrib Other Events18650CharitableContribOtherEvents
Gross Revenue Other Events12980GrossRevenueOtherEvents
Rent Facility Costs Other Events312RentFacilityCostsOtherEvents
Food And Beverage Other Events16664FoodAndBeverageOtherEvents
Entertainment Other Events3000EntertainmentOtherEvents
Other Direct Expenses Other Events15466OtherDirectExpensesOtherEvents
Gross Receipts Total171244GrossReceiptsTotal
Charitable Contributions Total123357CharitableContributionsTotal
Gross Revenue Total Events47887GrossRevenueTotalEvents
Non Cash Prizes Total Events4650NonCashPrizesTotalEvents
Rent Facility Costs Total Events29455RentFacilityCostsTotalEvents
Food And Beverage Total Events43274FoodAndBeverageTotalEvents
Entertainment Total Events14000EntertainmentTotalEvents
Other Direct Expenses Total Events40968OtherDirectExpensesTotalEvents
Direct Expense Summary Events132347DirectExpenseSummaryEvents
Net Income Summary-84460NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
SOUTHWESTERN VERMONT MEDICAL CENTER
100 HOSPITAL DRIVEBENNINGTONVT05201222563241501(C)(3)161936SUPPORT
GREATER BENNINGTON INTERFAITH COMM SRVC
107 ADAMS STREETBENNINGTONVT05201030369844501(C)(3)35000SUPPORT & FLOOD RELIEF
BROC - COMMUNITY ACTION IN SW VERMONT
33 ORCHARD RDBENNINGTONVT05201030216505501(C)(3)8148FLOOD RELIEFATTN NANY MOYE
INTERFAITH COUNCIL OF THE NORTHSHIRE
PO BOX 2544MANCHESTER CTRVT05255030259208501(C)(3)7500FLOOD RELIEF
SERVERMONT VT AGENCY OF HUMAN SERVICES
208 HURRICANE LN SUITE 200WILLISTONVT05495036000264VT HUMAN SRVCS6000VISTA PROGRAM
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
ONCOLOGY PATIENT RESOURCE FUND3317740
SVHC PATIENT RESOURCE FUND4408
SVHC PATIENT RESOURCE FUND10200BOOKGAS CARDS
VNA PATIENT RESOURCE FUND3106

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierMONITORING USE OF GRANT FUNDSIdentifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationSOUTHWESTERN VERMONT HEALTH CARE CORPORATION (SVHC) IS THE PARENT ORGANIZATION OF SOUTHWESTERN VERMONT MEDICAL CENTER, AND IS ABLE TO MONITOR USE OF GRANT FUNDS. SVHC SELECTS ALL OTHER ORGANIZATIONS TO WHICH IT PROVIDES SUPPORT BASED ON THEIR CHARITABLE PURPOSE AND THEIR TRACK RECORD FOR PROVIDING THOSE SERVICES. SVHC TRUSTS AND EXPECTS THE ORGANIZATIONS TO WHICH IT LENDS SUPPORT WILL CONTINUE TO PROVIDE THE SAME SERVICES WITH THE SUPPORT PROVIDED BY SVHC. SEE SCHEDULE O, PROGRAM SERVICE ACCOMPLISHMENTS, FOR ADDITIONAL DETAILS ON ASSISTANCE TO INDIVIDUALS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
WILLIAM TOCK MD
023050500016704029196028711030511600
THOMAS DEE
040024605000001913706496031459050733800
STEPHEN D MAJETICH
028691400051300027273031470000
MARK DONAVAN MD
0269607000199440374011452030137700
HARVEY YORKE
0000015998708365000024363700

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
TOP MANAGEMENT OFFICIAL COMPENSATION DETERMINATIONSCHEDULE J, PART I, LINE 3SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
SEVERANCE OR CHANGE OF CONTROL PAYMENTSCHEDULE J, PART I, LINE 4AHARVEY YORKE RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $148,162 FROM SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION.
BONUS DETERMINATIONSCHEDULE J, PART II, COLUMN B(II)ALL COMPENSATION IS PAID BY SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANZIATION. THE AMOUNT OF INCENTIVE COMPENSATION IS CALCULATED IN ACCORDANCE WITH THE FORMAL INCENTIVE COMPENSATION PROGRAM THAT WAS DEVELOPED BY SVHC'S HUMAN RESOURCE DEPARTMENT IN CONJUNCTION WITH OUR COMPENSATION CONSULTANT MIKE MACIEKOWICH OF ASTRON SOLUTIONS. THE ESSENCE OF THE PROGRAM IS TO REWARD OUR CEO FOR ACHIEVING POSITIVE RESULTS ON BOTH ORGANIZATIONAL AND INDIVIDUAL GOALS. GOALS ARE ESTABLISHED BY THE GOVERNANCE COMMITTEE PRIOR TO THE BEGINNING OF THE FISCAL YEAR. TYPICALLY THERE WILL BE FIVE TO SIX ORGANIZATIONAL GOALS AND EIGHT TO TEN INDIVIDUAL GOALS. SUCCESSFUL ACHIEVEMENT OF THESE GOALS RESULTS IN ADDITIONAL COMPENSATION FOR THE CEO; HOWEVER, NO PAYOUT IS MADE UNLESS SVHC'S FINANCIAL GOAL IS ACHIEVED.

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9901000NoncashContribsRptdF990
Method Of Determining RevenuesDONOR VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F9904661NoncashContribsRptdF990
Method Of Determining RevenuesDONOR VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions10NumberOfContributions
Noncash Contribs Rptd F99099885NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable (3 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XCRAFTED ITEMS32694DONOR VALUE
XAUCTION ITEMS4418872FMV
XMISCELLANEOUS247949FMV
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedtrueThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NUMBER OF CONTRIBUTIONSSCHEDULE M, PART I, COLUMN BTHE NUMBER OF CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF CONTRIBUTORS.
SALES OF NONCASH CONTRIBUTIONSSCHEDULE M, PART I, LINE 32BTHE ORGANIZATION SELLS CONTRIBUTIONS OF SECURITIES THROUGH ITS INVESTMENT BROKER.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1THE PURPOSE OF THE ORGANIZATION IS ALSO TO PROMOTE AND SUPPORT THE DEVELOPMENT AND MAINTENANCE OF A HIGHLY EFFICIENT, PATIENT-FOCUSED, INTEGRATED HEALTHCARE DELIVERY SYSTEM.
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART VI, SECTION A, LINE 4AT SVHC, STAFF WORKING DIRECTLY WITH PATIENTS IDENTIFY A PATIENT'S NEED AND FILL OUT A RESTRICTED GIFT CHECK REQUEST FORM TO PAY FOR SOMETHING THAT THE STAFF MEMBER BELIEVES THE PATIENT IS UNABLE TO PAY FOR HIMSELF. NEED IS DETERMINED BY THE STAFF MEMBER'S CONVERSATIONS WITH THE PATIENT AS WELL AS OBSERVATION AND KNOWLEDGE OF THE PATIENT'S LIVING CONDITIONS AND SITUATION. THE CHECK REQUEST IS APPROVED AND SIGNED BY THE STAFF MEMBER'S SUPERVISOR AND SENT TO THE VP OF DEVELOPMENT FOR HER APPROVAL AND PROCESSING FOR PAYMENT. IN THE CANCER CENTER, STAFF MEMBERS ARE ENCOURAGED TO REPORT ANY PATIENT NEED THEY IDENTIFY TO THE CANCER CENTER DIRECTOR, NURSE MANAGER, PHYSICIAN, OR SOCIAL SERVICES. IF THE PATIENT'S NEED IS FOR AN "EMOTIONAL BOOST", SUCH AS A MASSAGE OR OTHER SUCH SERVICE, THE PATIENT IS ELIGIBLE BY VIRTUE OF HIS/HER CANCER DIAGNOSIS. IF THE PATIENT'S NEED IS FOR FINANCIAL ASSISTANCE WITH RENT, UTILITIES, PRESCRIPTIONS, ETC., HE/SHE IS REFERRED TO SOCIAL SERVICES. SOCIAL SERVICES DETERMINES FINANCIAL NEED BY TALKING WITH THE PATIENT TO FIND OUT THEIR CURRENT SITUATION. SOCIAL SERVICES LOOKS FOR OTHER FINANCIAL RESOURCES IN THE COMMUNITY WITH WHICH TO HELP THE PATIENT AND CONSIDERS THE HEALTH SYSTEM'S PATIENT RESOURCE FUNDS. ASSISTANCE IS GENERALLY CONSIDERED TO BE A ONE-TIME, EMERGENCY STOP-GAP AID, AND NOT SOMETHING THAT WILL BE ONGOING. ONCE NEED HAS BEEN DETERMINED, THE NURSE MANAGER, THE CHIEF RADIATION THERAPIST OR SOCIAL SERVICES COMPLETES THE RESTRICTED GIFT CHECK REQUEST FORM AND OBTAINS APPROVAL FROM THE DIRECTOR OF THE CANCER CENTER. THE CHECK REQUEST FORM IS THEN SENT TO THE VP OF DEVELOPMENT FOR HER APPROVAL AND PROCESSING FOR PAYMENT. THE SVMC PATIENT RESOURCE FUND IS MAINLY USED BY SOCIAL SERVICES TO HELP NON-CANCER PATIENTS WITH THE SAME SORTS OF NEEDS THAT THE OTHER TWO FUNDS ARE USED FOR. CHECK REQUESTS TO ACCESS THIS FUND WOULD BE FILLED OUT BY A SOCIAL SERVICES STAFF MEMBER, APPROVED BY THE HEAD OF SOCIAL SERVICES AND SENT TO THE VP OF DEVELOPMENT FOR HER APPROVAL AND PROCESSING FOR PAYMENT.
FORM 990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11BTHE 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. THE DRAFT 990 IS THEN REVIEWED BY MANAGEMENT AND ACCOUNTING. AFTER ALL SUGGESTED CHANGES FROM MANAGEMENT ARE MADE, THE UPDATED DRAFT FORM 990 IS THEN PRESENTED TO THE FINANCE COMMITTEE. AFTER ANY FINAL CHANGES ARE MADE, THE FORM 990 IS PRESENTED TO THE FULL BOARD OF DIRECTORS BEFORE FILING WITH THE IRS.
MONITORING COMPLIANCE WITH CONFLICT ON INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12COFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE INTERESTS WHICH COULD RESULT IN CONFLICTS. THE COMPLIANCE OFFICER MAINTAINS RECORDS ON THE COMPLETION OF THE CONFLICT OF INTEREST FORMS, ANY POTENTIAL CONFLICTS ARE DISCUSSED AT THE AUDIT AND COMPLIANCE MEETING AND THEN RECOMMENDATIONS ARE BROUGHT BEFORE THE FULL BOARD FOR A VOTE. IN THE CASE OF A POTENTIAL CONFLICT OF INTEREST, THE BOARD MEMBER ABSTAINS FROM ALL DISCUSSION AND CONSIDERATION OF THE ITEM THAT PRESENTS THE POTENTIAL CONFLICT.
COMPENSATION REVIEWFORM 990, PART VI, SECTION B, LINES 15A & 15BALL COMPENSATION IS PAID BY SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION. THE BOARD ENGAGES AN OUTSIDE CONSULTING FIRM TO REVIEW COMPARABLE CEO SALARY DATA AND USES NATIONAL PROFESSIONAL ORGANIZATION SURVEY DATA IN THE DETERMINATION OF THE CEO'S SALARY AND BENEFITS. IN ADDITION, THE BOARD ENGAGES AN OUTSIDE CONSULTING FIRM AND ALSO USES NATIONAL PROFESSIONAL ORGANIZATION SURVEY DATA TO REVIEW THE WAGE DATA OF OTHER OFFICERS AND KEY EMPLOYEES. PROCESS BEGINS WITH A REQUEST TO OUR COMPENSATION CONSULTANT MIKE MACIEKOWICH OF ASTRON SOLUTIONS TO PERFORM A MARKET ANALYSIS OF THE CEO POSITION. THIS REPORT IS USED AS THE BASES FOR STRUCTURING COMPENSATION FOR THE CEO DURING THE NEXT CONTRACT PERIOD. USING THE RESULTS OF THE MARKET ANALYSIS WITH INPUT FROM OUR CEO, THE COMPENSATION OFFER FOR THE NEXT CONTRACT PERIOD IS DEVELOPED AND INCORPORATED INTO THE CONTRACT. THE COMPENSATION IS THEN DISCUSSED BY THE GOVERNANCE COMMITTEE OF THE BOARD WITH MIKE MACIEKOWICH IN ATTENDANCE OR ON THE PHONE. IF MIKE MACIEKOWICH IS IN AGREEMENT HE WILL PROVIDE A WRITTEN LETTER CONFIRMING HIS AGREEMENT.
DOCUMENT DISCLOSUREFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
BOARD MEMBER COMPENSATIONFORM 990, PART VII, SECTION AERIC SEYFERTH, MD IS AN EMPLOYED PHYSICIAN OF SOUTHWESTERN VERMONT MEDICAL CENTER ("SVMC"), A RELATED ORGANIZATION. WILLIAM TOCK, MD IS ALSO AN EMPLOYED PHYSICIAN OF SVMC, AS WELL AS THE PRESIDENT OF THE MEDICAL STAFF. WILLIAM SARCHINO, MD, REPLACED WILLIAM TOCK AS PRESIDENT OF THE MEDICAL STAFF IN MARCH OF 2012 AND RECEIVED COMPENSATION DURING THE FISCAL YEAR, BUT WAS NOT COMPENSATED DURING THE CALENDAR YEAR. NO TRUSTEE RECEIVES COMPENSATION FOR THEIR SERVICES AS A TRUSTEE OF THE BOARD.
HOURS WORKED FOR RELATED ORGANIZATIONSFORM 990, PART VII, SECTION A, COLUMN BALL TRUSTEES SERVED AN AVERAGE OF 1 HOUR PER WEEK ON THE BOARD OF SOUTHWESTERN VERMONT MEDICAL CENTER ("SVMC") AND MT. ANTHONY HOUSING CORPORATION ("MAHC"), BOTH RELATED ORGANIZATIONS. OFFICER THOMAS DEE SERVED ON THE BOARD OF SOUTHWESTERN VERMONT HEALTH CARE AUXILIARY ("SVHCA"), A RELATED ORGANIZATION, FOR AN AVERAGE OF .20 HOURS PER WEEK. OFFICERS THOMAS DEE, MARK DONOVAN, AND STEPHEN D MAJETICH WORKED AN AVERAGE OF 40 HOURS PER WEEK BETWEEN SVHC, SVMC, AND MAHC AS CHIEF EXECUTIVE OFFICER, CHIEF MEDICAL OFFICER, AND CHIEF FINANCIAL OFFICER, RESPECTIVELY.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5$ 4,986,074 NET TRANSFER FROM AFFILIATES ( 24,512) DEFINED BENEFIT PENSION COSTS 143,744 CHANGE IN BENEFICIAL INTEREST IN TRUST ( 41,609) RECOVERY OF PRIOR YEAR PLEDGES 5,420,160 NET UNREALIZED GAIN ON INVESTMENTS -------------- $ 10,483,857 NET ADJUSTMENT

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
SOUTHWEST VERMONT HEALTH CARE AUXILIARY
100 HOSPITAL DRIVEBENNINGTONVT05201222563243SUPPORT SVHCVT501(C)(3)9SVHCtrue
SOUTHWESTERN VERMONT MEDICAL CENTER
100 HOSPITAL DRIVEBENNINGTONVT05201222563241HOSPITALVT501(C)(3)3SVHCtrue
MOUNT ANTHONY HOUSING CORPORATION
100 HOSPITAL DRIVEBENNINGTONVT05201030279740NURSING HOMESVT501(C)(3)9SVHCtrue
SOUTHWESTERN VT HEALTH CARE FOUNDATION
100 HOSPITAL DRIVEBENNINGTONVT05201453362785FUNDRAISINGVT501(C)(3)11 A ISVHCtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SOUTHWESTERN VT HEALTH CARE ENTERPRISESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 HOSPITAL DRIVEAddressLine1
CityBENNINGTONCity
StateVTState
ZIP Code05201ZIPCode
FieldValueIRS element (for citing)
EIN030314501EIN
Primary ActivityHEALTHCAREPrimaryActivity
Legal Domicile StateVTLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SVHCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
Share Of Total Income2010ShareOfTotalIncome
Share Of EOY Assets8496ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SOUTHWESTERN VERMONT MEDICAL CENTER
A/I1327135FMV
SOUTHWESTERN VERMONT MEDICAL CENTER
B161936FMV
SOUTHWESTERN VERMONT HEALTH CARE ENTERPRISES
D62613FMV
SOUTHWESTERN VERMONT MEDICAL CENTER
E5007583FMV
SOUTHWESTERN VERMONT HEALTH CARE AUXILIARY
E274822FMV
MOUNT ANTHONY HOUSING CORPORATION
E1167091FMV
SOUTHWESTERN VERMONT MEDICAL CENTER
K851401FMV
MOUNT ANTHONY HOUSING CORPORATION
K90870FMV
SOUTHWESTERN VERMONT MEDICAL CENTER
O939864FMV
SOUTHWESTERN VERMONT MEDICAL CENTER
Q1219346FMV
MOUNT ANTHONY HOUSING CORPORATION
Q150857FMV
SOUTHWESTERN VERMONT MEDICAL CENTER
R4986074FMV

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