2012-08-08T13:23:05-05:00 2011-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2010-10-01 030179435 SOUTHWESTERN VERMONT HEALTH CARE CORPORATION SOUT 8024426361 100 HOSPITAL DRIVE BENNINGTON VT 05201 MICHAEL BRADY 2012-07-12 true Brian D Todd 4178658701 2010 2016-02-24 21:20:13Z THOMAS DEE 100 HOSPITAL DRIVE BENNINGTON VT 05201 71930857 false X WWW.SVHEALTHCARE.ORG X 1912 VT PROVIDING HEALTH CARE ON BOTH AN INPATIENT AND OUTPATIENT BASIS WITH FACILITIES IN AND AROUND THE BENNINGTON, VT AREA. 15 11 23 20 0 0 1436425 1662395 2373005 2339294 519241 2509975 88369 -46890 4417040 6464774 413434 316361 0 0 1220832 1597206 0 0 751674 2711891 2667413 4346157 4580980 70883 1883794 46362135 60804234 10866203 10917651 35495932 49886583 X TO 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. false false 2057361 316361 1250840 SOUTHWESTERN 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. 1324794 1088454 SOUTHWESTERN VERMONT HEALTH CARE CORPORATION MANAGES AND MAINTAINS MEDICAL OFFICE BUILDINGS IN BENNINGTON, MANCHESTER, WILMINGTON AND WEST DOVER. 3382155 true true false false false false false false true true false false true true false false true false false false false false false true false false true true true false false false false false false false false true false false false false true true true false false true 35 0 true 23 true false false false false false true true false false false false X 15 11 false false false false false false false true true false false true true true true true true false false false X MELANIE SMITH 8024475002 100 HOSPITAL DRIVE BENNINGTON VT 05201 X MICHAEL E BRADY DDS 1.0 X X 0 0 0 WAYNE M KACHMAR 1.0 X X 0 0 0 LILA CESTONE 1.0 X X 0 0 0 DONALD ALBANO 1.0 X 0 0 0 SEAN L CASEY 1.0 X X 0 0 0 TOMMY A HARMON JR 1.0 X 0 0 0 TIMOTHY T HOLBROOK 1.0 X 0 0 0 HOWARD MCNALLY 1.0 X 0 0 0 RICHARD PEMBROKE 1.0 X 0 0 0 WILLIAM TOCK MD 1.0 X 0 235281 35496 ERIC SEYFERTH MD 1.0 X 0 34066 0 THOMAS DEE 1.0 X X 0 465971 3428 MARK WALLACE 1.0 X 0 0 0 CLAIRE MURRAY 1.0 X 0 0 0 KEVIN DAILEY 1.0 X 0 0 0 MARNY KRAUSE 1.0 X 0 52971 13445 FRANK SKALA 40.0 X 0 0 0 STEPHEN D MAJETICH 40.0 X 0 12000 0 MARK DONAVAN 40.0 X 0 128894 4471 RICHARD LAUVE 40.0 X 0 0 0 HARVEY YORKE X 0 366567 64656 MARK NOVOTNY MD X 0 377597 48771 0 1673347 170267 0 true true false 0 118451 27555 303345 1213044 94315 1662395 PROPERTY MANAGEMENT 531310 2329685 2329685 OTHER REVENUE 900099 9609 9609 2339294 969389 969389 0 0 66895539 65348635 6318 1546904 -6318 1540586 1540586 64240 118451 111130 -46890 -46890 0 0 0 6464774 2339294 2463085 296339 296339 20022 20022 0 0 0 0 917703 512470 72644 332589 36469 21102 2755 12612 573722 331981 43336 198405 69312 40108 5235 23969 0 25900 25900 16391 16391 0 0 146628 146628 300442 162974 60750 76718 1848 1848 354572 324171 13255 17146 0 0 1139421 1121324 14194 3903 18384 16529 1855 0 4324 4254 70 0 0 595598 475648 39463 80487 29810 24997 4813 LICENSES, DUES & SUBSCRIPTIONS 2496 150 274 2072 MEDICAL SUPPLIES & DRUGS 30086 30086 MISCELLANEOUS 1513 1513 4580980 3382155 447151 751674 48767 43691 6877567 3124356 179573 127144 144625 147252 15299304 8238696 7430133 7060608 27831915 46859491 12983 12983 3836572 3428709 46362135 60804234 2749885 3407841 26097 37244 8090221 7472566 10866203 10917651 X 24569022 38627862 2025693 2210951 8901217 9047770 35495932 49886583 46362135 60804234 X 1883794 12506857 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10633746 1123257 -140292 647348 10969363 10383529 934099 108601 792483 10633746 11140199 371726 -229971 898425 10383529 1.00000 false false 986647 986647 9439785 5244831 4194954 3789828 2295660 1494168 977757 664946 312811 105287 33259 72028 7060608 DEFERRED COMP PLAN ASSETS 1416232 DUE FROM AFFILIATE 62613 OTHER ASSETS 106714 BENEFICIAL INTEREST IN TRUST 1843150 3428709 0 DUE TO AFFILIATES 6935194 ACCRUED PENSION LIABILITIES 363342 ESTIMATED SELF INSURANCE COSTS 69465 OTHER LIABILITIES 104565 7472566 6464774 4580980 1883794 -907407 13414264 12506857 14390651 18850180 -907407 25177 13267636 12385406 6464774 6464774 4459529 25177 25177 4434352 146628 146628 4580980 ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 THE CORPORATION'S ENDOWMENT CONSISTS OF VARIOUS INDIVIDUAL DONORRESTRICTED FUNDS WHICH WERE ESTABLISHED TO FUND FUTURE STRATEGIC CAPITAL INVESTMENTS, AS WELL AS GENERAL OPERATIONAL AND CERTAIN DEPARTMENTAL PURPOSES. 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 RECONCILING CHANGE IN NET ASSETS SCHEDULE D, PART XI, LINE 8 TRANSFER FROM AFFILIATE $ 13,575,837 DEFINED BENEFIT PENSION COSTS ( 20,017) CHANGE IN BENEFICIAL INTEREST IN TRUST (141,556) -------------- TOTAL $ 13,414,264 OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 SCHEDULE D, PART XII, LINE 2D TRANSFER FROM AFFILIATE $ 13,575,837 DEFINED BENEFIT PENSION COSTS ( 20,017) INVESTMENT FEES (146,628) CHANGE IN BENEFICIAL INTEREST IN TRUST (141,556) --------------- TOTAL $ 13,267,636 GOLF TOURNAMENT 57550 37965 19585 16785 8547 6785 HARVEST BALL 89556 60911 28645 13240 9758 5000 20463 1 35585 19575 16010 625 10487 2830 16610 182691 118451 64240 30650 28792 7830 43858 111130 -46890 true SOUTHWESTERN VERMONT MEDICAL CENTER 100 HOSPITAL DRIVE BENNINGTON VT 05201 222563241 501(C)(3) 240116 SUPPORT MOUNT ANTHONY HOUSING CORPORATION 100 HOSPITAL DRIVE BENNINGTON VT 05201 030279740 501(C)(3) 5950 SUPPORT MANCHESTER RESCUE SQUAD INC PO BOX 26 MANCHESTER CENTER VT 05255 036011503 501(C)(3) 50273 FMV RESPONSE VEHICLE SUPPORT 3 ONCOLOGY PATIENT RESOURCE FUND 24 13153 SVMC PATIENT RESOURCE FUND 8 1669 VNA PATIENT RESOURCE FUND 39 965 DVHC PATIENT RESOURCE FUND 1 22 SVRCC FUND 7 4213 MONITORING USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 SOUTHWESTERN VERMONT HEALTH CARE CORPORATION (SVHC) IS THE PARENT ORGANIZATION OF SOUTHWESTERN VERMONT MEDICAL CENTER, AND IS ABLE TO MONITOR USE OF GRANT FUNDS. SEE SCHEDULE O, PROGRAM SERVICE ACCOMPLISHMENTS, FOR ADDITIONAL DETAILS ON ASSISTANCE TO INDIVIDUALS. true false false false false false false false false WILLIAM TOCK MD 0 213076 0 0 0 22205 0 7719 0 27777 0 270777 0 0 HARVEY YORKE 0 0 0 0 0 366567 0 64656 0 0 0 431223 0 0 MARK NOVOTNY MD 0 103053 0 0 0 274544 0 40829 0 7942 0 426368 0 0 THOMAS DEE 0 365835 0 0 0 100136 0 0 0 3428 0 469399 0 0 TOP MANAGEMENT OFFICIAL COMPENSATION DETERMINATION SCHEDULE J, PART I, LINE 3 SOUTHWESTERN 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 PAYMENT SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION: -HARVEY YORKE $ 342,909 -MARK NOVOTNY 268,390 X 1 3600 FMV X 90 FMV X 27192 FMV X 8 48269 FMV X MISCELLANEOUS 50 11838 FMV X CONSUMABLES 19 3326 FMV 0 false true true NUMBER OF CONTRIBUTIONS SCHEDULE M, PART I, COLUMN B THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF CONTRIBUTORS. SALES OF NONCASH CONTRIBUTIONS SCHEDULE M, PART I, LINE 32B THE ORGANIZATION SELLS CONTRIBUTIONS OF SECURITIES THROUGH ITS INVESTMENT BROKER. ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 THE 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 ACCOMPLISHMENTS FORM 990, PART VI, SECTION A, LINE 4 AT 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 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. 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. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, 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 AFTER WHICH RECOMMENDATIONS ARE BROUGHT BEFORE AND VOTED UPON BY THE FULL BOARD OF TRUSTEES. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINES 15A & 15B THE ORGANIZATION'S CEO POSITION IS PAID BY SOUTHWESTERN VERMONT MEDICAL CENTER (SVMC). THE PROCESS SVMC USES TO DETERMINE CEO COMPENSATION IS AS FOLLOWS: 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. DOCUMENT DISCLOSURE 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. COMPENSATION OF CORPORATE OFFICERS FORM 990, PART VII, SECTION A SOUTHWESTERN VERMONT MEDICAL CENTER, A RELATED ORGANIZATION, CONTRACTED WITH MANAGEMENT COMPANIES FOR THE SERVICES OF INTERIM CFO, FRANK SCALA. BOARD MEMBER COMPENSATION FORM 990, PART VII, SECTION A MARNY KRAUSE WAS EMPLOYED BY SOUTHWESTERN VERMONT MEDICAL CENTER (SVMC), A RELATED ORGANIZATION, AS THE VICE PRESIDENT OF DEVELOPMENT UNTIL JULY 2010. NO COMPENSATION WAS PROVIDED FOR HER SERVICES PROVIDED AS A TRUSTEE. WILLIAM TOCK IS AN EMPLOYED PHYSICIAN OF SVMC, AS WELL AS THE PRESIDENT OF SVMC'S MEDICAL STAFF. NO COMPENSATION WAS PROVIDED FOR HIS SERVICES PROVIDED AS A TRUSTEE. ERIC SEYFERTH IS CONTRACTED THROUGH SVMC AS AN EKG-READING PHYSICIAN. NO COMPENSATION WAS PROVIDED FOR HIS SERVICES PROVIDED AS A TRUSTEE. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 TRANSFER FROM AFFILIATE $ 13,575,837 UNREALIZED LOSS ON INVESTMENTS (907,407) DEFINED BENEFIT PENSION COSTS ( 20,017) CHANGE IN BENEFICIAL INTEREST IN TRUST (141,556) --------------- TOTAL $ 12,506,857 SOUTHWEST VERMONT HEALTH CARE AUXILIARY 100 HOSPITAL DRIVE BENNINGTON VT 05201 222563243 SUPPORT SVHC VT 501(C)(3) 9 NA SOUTHWESTERN VERMONT MEDICAL CENTER 100 HOSPITAL DRIVE BENNINGTON VT 05201 222563241 HOSPITAL VT 501(C)(3) 3 NA MOUNT ANTHONY HOUSING CORPORATION 100 HOSPITAL DRIVE BENNINGTON VT 05201 030279740 NURSING HOMES VT 501(C)(3) 9 NA SOUTHWESTERN VT HEALTH CARE ENTERPRISES 100 HOSPITAL DRIVE BENNINGTON VT 05201 030314501 HEALTHCARE VT NA C CORP 447962 10621 1.00000 true true true true true false false false true false true true true true true false true true SOUTHWESTERN VERMONT MEDICAL CENTER A 1245822 SOUTHWESTERN VERMONT HEALTH CARE ENTERPRISES A 75504 SOUTHWESTERN VERMONT MEDICAL CENTER B 240116 SOUTHWESTERN VERMONT HEALTH CARE ENTERPRISES D 62613 SOUTHWESTERN VERMONT MEDICAL CENTER E 5675652 SOUTHWESTERN VERMONT HEALTH CARE AUXILIARY E 235939 MOUNT ANTHONY HOUSING CORPORATION E 1023603 SOUTHWESTERN VERMONT MEDICAL CENTER K 582861 SOUTHWESTERN VERMONT MEDICAL CENTER O 1375720 SOUTHWESTERN VERMONT MEDICAL CENTER Q 117473 SOUTHWESTERN VERMONT HEALTH CARE AUXILIARY R 250000 SOUTHWESTERN VERMONT MEDICAL CENTER R 13575837