2012-08-06T10:15:54-05:00 2011-09-30 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2010-10-01 030306549 Helen Porter Nursing Home Inc HELE 8023884701 37 Porter Drive Middlebury VT 05753 Marilyn Olejnik 8023884701 2012-07-31 1 Barbara J McGuan CPA 2077752387 2012-07-31 2010 2016-02-24 21:20:13Z Helen Porter Healthcare & Rehab Cent James Daily 37 Porter Drive Middlebury VT 05753 9209305 0 X www.portermedical.org X 1986 VT Operation of 105 bed skilled nursing home 11 9 252 44 0 0 1084 5494 8923429 9202031 5314 1780 0 0 8929827 9209305 0 0 0 0 6688047 6859278 0 0 0 2531624 2438211 9219671 9297489 -289844 -88184 3307625 3361920 6616562 5867459 -3308937 -2505539 X The mission of Helen Porter Healthcare and Rehabilitation Center is to provide health care and related services to the people of our region. The Organization will:1. Provide a broad spectrum of services including long-term, short-term rehabilitation, respite, hospice and dementia care;2. Ensure the delivery of high quality and compassionate care to all residents in a financially responsible manner that allows individuals to achieve their greatest level of independence and dignity;3. Serve as a leader and catalyst in helping to determine and to provide for the health needs of the community, while striving to remain a financially viable organization. 0 0 7518553 9202031 Operated long-term community oriented 105 bed skilled nursing home. The nursing home provided services to patients that totaled 34,429 resident days during the year ended 9/30/2011. 7518553 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 16 0 1 252 1 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 0 X Marilyn Olejnik 8023884701 37 Porter Drive Middlebury VT 05753 James L Daily 40.00 X X 0 357592 40330 Betsy Gossens 1.00 X X 0 0 0 Nicholas Clifford 1.00 X 0 0 0 Betsy Gleason 1.00 X 0 0 0 Linda Harmon 1.00 X X 0 0 0 Elizabeth Markowski 1.00 X 0 0 0 Joe Sutton 1.00 X 0 0 0 Judy Watts 1.00 X X 0 0 0 Ann Hanson 1.00 X 0 0 0 Lynn Coale 1.00 X 0 0 0 Diana Barnard MD 1.00 X 0 141443 4411 Marilyn Olejnik 40.00 X 0 137593 12423 Neil Gruber 40.00 X 140433 0 10267 Duncan Brines 0.00 X 0 114483 17472 140433 751111 84903 1 1 1 0 0 5494 5494 Patient Revenue 623000 9116967 9116967 Lifeline Revenue 623000 43650 43650 Other Revenue 623000 23259 23259 Cafeteria Revenue 623000 9167 9167 Speech Therapy 623000 8988 8988 9202031 1780 1780 9209305 9202031 0 1780 150700 150700 5138461 4881576 256885 188440 181254 7186 990490 918437 72053 391187 361744 29443 69336 69336 2804 2804 22622 22622 135960 135960 15935 15935 1192559 1170663 21896 74535 74535 4562 4562 64819 64819 307630 307630 96945 96945 Medicare Provider Tax 430436 430436 Dues & Subscriptions 8086 8086 Miscellaneous Expense 7103 7103 Bad Debt Expense 4879 4879 9297489 7518553 1778936 0 1500 1500 505026 404115 984103 1309874 24831 26707 26723 24479 5215836 3742459 1582608 1473377 48805 0 132841 119893 1188 1975 3307625 3361920 713475 811163 3800000 3690000 16257 12364 1590590 741973 496240 611959 6616562 5867459 X -3357742 -2540649 48805 35110 -3308937 -2505539 3307625 3361920 X -88184 891582 X X 0 1 1 X 0 X 0 0 0 0 0 0 0 0 1 735 735 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: The Organization pays dues to various associations, a portion of which is attributable to lobbying expenses. 4315211 3221893 1093318 723018 407770 315248 177607 112796 64811 1473377 Due to Affiliates 117028 Liability for Pension Benefits 494931 611959 9209305 9297489 -88184 891582 891582 803398 9160599 -10274 -10274 9170873 38432 38432 9209305 9259057 0 9259057 38432 38432 9297489 Part XI, Line 8 - Other Adjustments: Change in Net Assets to Recognize Funded Status of Pension Plan -67,270. Change in Interest in Net Assets of Porter Medical Center, Inc. 56,996. Equity Transfer from Affiliate 901,856. Part XII, Line 2d - Other Adjustments: Change in Net Assets to Recognize Funded Status of Pension Plan -67,270. Change in Interest in Net Assets of Porter Medical Center, Inc. 56,996. Part XII, Line 4b - Other Adjustments: Lifeline Expenses 38,432. Part XIII, Line 4b - Other Adjustments: Lifeline Expenses 38,432. X X X X 0 1 0 0 0 0 0 0 0 James L Daily 0 320651 0 0 0 36941 0 12250 0 28080 0 397922 0 0 Marilyn Olejnik 0 131062 0 0 0 6531 0 4096 0 8327 0 150016 0 0 Neil Gruber 135019 0 0 0 5414 0 7567 0 2700 0 150700 0 0 0 Duncan Brines 0 112347 0 0 0 2136 0 8169 0 9303 0 131955 0 0 Part I, Line 4b James Daily, President & CEO, participates in a 457(f) plan, but did not receive any funds from the plan for FY 9/30/11. Form 990, Part VI, Section A, line 6 Porter Medical Center, Inc. is the parent holding company and sole corporate member of the Organization. Form 990, Part VI, Section A, line 7a Porter Medical Center, Inc., the parent holding company and sole corporate member of the Organization, has the right to appoint directors of the Organization. Form 990, Part VI, Section A, line 7b Porter Medical Center, Inc., the parent holding company and sole corporate member of the Organization, has the right to approve major expenditures, and approve long-term borrowings. Form 990, Part VI, Section B, line 11 Form 990 is reviewed by management and the finance committee before filing. Form 990, Part VI, Section B, line 12c The Organization's CFO is responsible for regularly and consistently monitoring and enforcing compliance with the conflict of interest policy. When bids are solicited to include the business of a Board member, those bids are reviewed by the Board of Directors to assure adherence to the Hospital's lowest bid policy. When an issue comes up to a vote and it is connected, in any way, to the business of a Board member, the member must recuse him/herself from the vote. Form 990, Part VI, Section B, line 15a The Organization's executive committee reviews comparative data prepared by a consultant prior to referral of compensation to the board of directors. The board of directors review the findings of the consultant and vote to approve the salary of the CEO. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Contact Addresses for Officers, Directors, Etc Form 990, Part VII Duncan Brines - P.O. Box 1144, Waitsfield, VT 05673. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Change in Net Assets to Recognize Funded Status of Pension Plan -67,270. Change in Interest in Net Assets of Porter Medical Center, Inc. 56,996. Equity Transfer from Affiliate 901,856. Total to Form 990, Part XI, Line 5: 891,582. Oversight of Audit Form 990, Part XI, Line 2c: The audit process has not changed from the prior year. Reason for Public Charity Status Form 990, Schedule A, Part I, Line 3: The Organization's exemption is based upon being classified as a hospital or cooperative hospital service organization described in 170(b)(1)(A)(iii). Since the Organization is not licensed in the state of Vermont as a hospital, but rather as a long term care facility, Schedule H is not required. Porter Real Estate Holdings LLC 37 Porter Drive Middlebury VT 05753 261585746 Real Estate Holdings VT 0 0 Porter Medical Center Inc Porter Hospital Inc 37 Porter Drive Middlebury VT 05753 030181058 Critical Access Hospital VT 501(c)(3) Line 3 Porter Medical Center Inc 0 Porter Medical Center Inc 37 Porter Drive Middlebury VT 05753 030310862 Holding Company for Subsidiaries VT 501(c)(3) Line 11b, II N/A 0 Porter Management Services Inc 37 Porter Drive Middlebury VT 05753 030308242 Management Services VT 501(c)(3) Line 11b, II Porter Medical Center Inc 0 Auxiliary of Porter Medical Center 37 Porter Drive Middlebury VT 05753 237363227 Supporting Organization VT 501(c)(3) Line 11b, II Porter Medical Center Inc 0 0 0 0 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0